Topeka — The state's three large hospitals for the developmentally disabled are institutional "dinosaurs" that should be closed, advocates for the disabled told lawmakers Monday.
Catherine Johnson, with Disability Rights Center of Kansas, said the hospitals were an inefficient use of taxpayer dollars and often failed to meet the needs of those living there.
"Thankfully, they are becoming the dinosaurs of developmental disability services," she said.
Johnson told the Legislative Budget Committee that lawmakers should follow the lead of several other states and set a date for closing large public and private hospitals for the developmentally disabled. In Kansas, those facilities include Kansas Neurological Institute in Topeka, Parsons State Hospital and the privately owned New Horizons in Pittsburg.
She said people being cared for in those hospitals would be better served in their homes or community-based settings and have the services brought to them.
The committee took no action, though the issue has long been under study by state officials.
"We are trying to get as many people into the communities receiving services as possible," said Sen. Dwayne Umbarger, R-Thayer, the committee's chairman. "We want to do what is right for them and right for the taxpayers."
Kyle Kessler, a spokesman for the Kansas Department of Social and Rehabilitation Services, said the hospitals still served a need.
"We are obviously strong believers in home and community-based services, but we also believe that some people feel more comfortable in more institutionalized settings," Kessler said.
The number of people in large institutions has dropped dramatically during the past several years, while the number of people receiving services in communities has increased.
In 1990, approximately 2,000 people were served in institutions and fewer than 4,000 in community settings. By 2005, approximately 500 people were served in institutions while more than 9,000 were served in communities, according to the Kansas Legislative Research Department.
At KNI, 98 percent of the residents are categorized in the severe to profound range of mental retardation, while at Parsons, about half the residents are considered in that category. The two facilities together cost about $47.4 million annually to operate.
Johnson said it had been shown that in previous hospital closings, people with severe disabilities could get the services they need in the community.
The state closed Norton State Hospital in 1988, Topeka State Hospital in 1997 and Winfield State Hospital in 1998.
Comments
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classclown (Class Clown) says…
How many of these people will end up on the streets?
dthroat (anonymous) says…
cc - a LOT of them because this will be just like when they closed the mental hospitals. The funding will "disappear" and not be transferred to the agencies that will have to take care of these people.
Why is it people can not understand that some people just are better off in an "institution" that left to their own. And we wonder why previous articles document how many homeless and prisoners are mentally ill. This should just make for a new category of inmates.
tanzer (anonymous) says…
everyone should visit each of the institutions mentioned... some are better than others... and some of the residents prefer to live there while others need to live there.
dthroat (anonymous) says…
sybil - I agree with you and that is absolutly the right thing for some people who can cope. A disability or metal illness does not automatically make you less deserving, but there has to be some place for those who cannot cope. When you close ALL the hospitals you take away an option that SOME people really need. Those are the people who wind up on the street or in jail with no one to take care of them or help them take care of themselves. I didn't mean to come across like I was saying we should just throw them all into one category and house them out of sight.
Agnostick (anonymous) says…
This is just... crazy...
Agnostick
agnostick@excite.com
crazyks (anonymous) says…
I work with developmentally disabled adults, and these hospitals are NEEDED for a lot of consumers. They do not adapt well in community settings; they need the structure of an institutional setting in order to function to the best of their ability. They sometimes need a place where they can be separated from other consumers if necessary, for their safety as well as the safety of others. In a community setting, this option isn't usually available.
Some are too violent to be able to live in a community setting. What is the state planning to do with them? While each person may have the right to be treated with dignity and respect, so do all the others in those community settings. I have seen far too many instances where forcing a violent person into a community setting only makes them more violent, and that subjects the other residents to fear and pain, and possible physical harm. The other residents don't deserve that, either.
State hospitals are well-staffed, 24/7. Each residence there usually has its own nursing staff, its own doctor available, its own housecleaning and cooking staff, etc. In smaller, community based settings, this is not the case. There are fewer staff that have to deal with more people than they should. If one or more of them is violent, or prone to violence, this creates a situation that isn't safe for anyone.
All developmentally disabled people are not capable of living in a community. Some will never be capable of taking care of themselves. And a group home isn't the level of independence that a lot of people believe it is. How would you like to have to share your home with eight or more other adults, especially if one or more of them is prone to violence?
moderationman (anonymous) says…
And yet still, many if not most will end up homeless. This is not a solution, but a red herring for a reduction in spending so that taxes will not have to be raised to fund schools.
cowboy (anonymous) says…
I heard an argument similar to this regarding foster care versus orphanges. Better to be in an orphanage than shuttled thru 10 to 20 foster care homes. These folks were dealt a bad hand but getting shuttled around your whole life has to do more damage than an average institution.
tanzer (anonymous) says…
thanks crazyks for pointing that stuff out. also - one of the hospitals mentioned in the article happens to take residents out into the community on a regular basis with staff support. so they are not all locked up away forever from the community. and moderation man does have a point. . many families do not have the skill/ability to take these folks back into their homes and so they end up in other institutional settings..foster homes bouncing from placement to placement..prisons..on the streets..and some do end up in over crowded group homes.. then there are those that end up in group facilities that are fantastic - but this is a highly underserved population. not enough people are trained to work with the developmentally disabled.
crazyks (anonymous) says…
And that's exactly what happens to these people if they're moved to a group home and things don't work out. They get shipped to another group home. And if that one doesn't work out, they get shipped to yet another one.
Whatever happened to the era when families kept their loved ones at home, and took care of them? Don't families care enough anymore to do this?
And if they think their loved one is too much of a problem to handle at home, then what makes them think the outcome for them is going to be any better in a group home?
I've noticed a disturbing trend with people in group homes. The grand majority of the families of these folks don't live anywhere near the group home where they place their loved one. They aren't close enough to visit them, and many of the families don't even bother to come get them and take them home for visits. Few families even call to talk to the person.
This creates a bad situation for everyone. No one likes to think that their family doesn't care about them, or doesn't want to be around them or spend time with them, especially someone who is developmentally disabled.
And these folks know what is going on. They talk about their families all the time, and wonder why they don't visit them, don't want them anymore. It's worse yet if the consumer has lived at home until adulthood and is then suddenly moved into a group home.
If you're going to do this to your children, at least do it while they're young enough to adapt more easily.
ForThePeople (anonymous) says…
Awesome comments crazyks...my sentiments precisely!
Pywacket (anonymous) says…
Cowboy== comparing "regular" children with regular needs to profoundly mentally handicapped adults who may be violent is a useless exercise. There is much to be discussed regarding what to do with children who (for whatever reason) are not with their birth parents. Let's save that for another day. Today the topic is mental institutions.
I am inclined to listen to crazyks's voice of experience here. We have a shoestring relative who thrives in a group home. We would be very apprehensive and concerned for his wellbeing if they moved someone in there who was violent, prone to delusional thinking, hallucinatory, etc. The rights of any individual need to be curtailed if they are overshadowing the rights of someone else.
No, they shouldn't be "warehoused," as was done in the bad old days. Why does everything have to be perceived as a choice between two extremes? There are points along a continuum. A happy medium can be found between the cruel institutions of the past and just turning violent or terrified or demented people loose and hoping they enjoy their new-found "rights."
Some people will always need control and supervision--for the safety of themselves and others. Some are incapable of even performing their own toileting functions. Would you like a 250-lb aggressive uncle with the mentality of a 6-month-old and the strength of an ironworker dropped off on your doorstep so he could enjoy his "freedom" from the institution where he has been cared for by professionals all his life?
Even those who are marginally self-sufficient as far as hygiene, self feeding, etc., may soon become homeless and vulnerable to the vagaries of weather and the whims of other (possibly paranoid, addicted, drunk, etc.) homeless people who have no qualms about harming them for their disability money--or just because they think they are "possessed."
Group homes are wonderful for some. They are not a blanket solution for every individual who cannot maintain his own home, job, personal relationships, etc. Some people need more.
Keep the institutions for those who need them--but don't ever let them become like the bedlams of the past. Those running them should be ever watchful and willing to incorporate new procedures and policies whenever they are shown to be effective and to exert a positive affect on the patients.
jonas (anonymous) says…
"Posted by sybil (anonymous) on September 12, 2006 at 7:04 a.m. (Suggest removal)
People have a right to live a life of dignity and not be warehoused and forgotton. there is no quality of life within istitutionl setting and the people are drugged in those places."
Does a life sitting on the curb or the bench down on Mass st., covered with a blanket and getting laughed at by frat boys convey a life of quality and quiet dignity?
"Being born with a disability does no make a person less then."
Maybe not less, but it does make them different, which means that, though many of their needs, such as love, shelter, acceptance, are undoubtedly the same, there are may be others such as medication, controls, monitoring, assistance etc. that are not standard for people not born disabled or flat out psychotic.
Who are we to say that families who have a member who is disabled are morally required to care for the disabled person. It would be nice, to be sure, but that's a lot of responsibility, time, commitment, pressure and frustration for anyone to handle, and there will be people who are simply not up to the challenge. I think, for a certain segment of the disabled population, a state-sponsored (preferably highly transparent, well-monitored, well-regulated) institution is the only option, and closing them down would be fallacious and disasterous. Should the existing institutions be reformed, or perhaps more selective in the people they admit? Yes, probably so. But to say that they are not working so get rid of them is to not provide a workable, thoughtful solution, and so will just cause more problems than are already there.
Confrontation (anonymous) says…
If you've ever walked down Kansas Avenue in Topeka, then you know the problem with letting some of these people back into the community. Scary!
mommaeffortx2 (anonymous) says…
some how this just did not make sence to me.
mommaeffortx2 (anonymous) says…
and I can't spell either.
Confrontation (anonymous) says…
I'm not making a reference to the homeless mental health patients in Topeka. There are a few high rise apartments near 10th & Kansas Ave., where these people live.
DaleRogers (anonymous) says…
Sybil - some posters have made very good points here today on this subject. Do you just disagree to disagree?
ForThePeople (anonymous) says…
Actually sybil....there are many folks in those institutions that are duel diagnosis...which complicates the situation even further!
jonas (anonymous) says…
Sybil: Then there needs to be a specific plan in place, fully detailed, saying just where and when and how the people kept in their facilities are going to be transfered to another properly controlled environment. Do you know if such a plan exists, or is being formulated?
Thank you, though, for pointing out that it is the dvlpmtly disabled being the primary focus, but that does make for a somewhat hazy definition.
as_I_live_and_breathe (anonymous) says…
Posted by jonas (anonymous) on September 12, 2006 at 9:53 a.m. (Suggest removal)
"Who are we to say that families who have a member who is disabled are morally required to care for the disabled person"
???? What a disturbing sentiment. Of course families have a moral obligation to care for family members....
the idea that we don't is one of the biggest problems in our society. I can't even imagine dumping a family member like that and YES I have first hand experience so don't start that "if you have to do it .... crap.
Families take care of thier own. Yeah it's fabulous to have organizations and even institutions to help but to imply that families should just turn their backs and abdicate the responisbilty because of a birth defect or injury is absolutly horrifing.
jonas (anonymous) says…
I_Live_and_breathe: You can find it disturbing if you wish to, but the idea of family imperitive is just a particular construct of our society, not a moral truth as you seem to imply. Family can be broadened to community, and has on occasion throughout human civilization. I would think, though, that the point is to find the disabled folks the place where they could recieve the best care. That may or may not be within the family's resources to provide. To say that someone HAS to or SHOULD take care of their dependent persons seems markedly unfair, especially in a situation like this where, in contrast to a situation like pregnancy there is no percieved choice being made, just (to speak) the bad luck of the draw.
As for the rest, the fact that you've been in that situation only means that you have the experience to speak from what you were able and willing to do, not what would be able and willing to do.
jonas (anonymous) says…
that should be "not what 'someone else' would be able and willing to do."
Pywacket (anonymous) says…
That's very righteous, asIliveandbreathe... Not all situations are the same. Not all families have the resources to deal with profound disabilities. Your cavalier comment,
"Yeah it's fabulous to have organizations and even institutions to help but to imply that families should just turn their backs and abdicate the responisbilty because of a birth defect or injury is absolutly horrifing"
shows that you have not a clue as to how devastating home care might be for families whose meager resources are already stretched to the breaking point. NOBODY here implied that families should "turn their backs" on the person. And you obviously have no idea what is entailed with caring for someone who cannot care for him- or herself.
I personally removed a younger (over 18) family member from a wretched home situation where she was spiraling into becoming a shut-in. I housed and supported her, and mentored & encouraged her until she could get on her feet, get some college under her belt, and learn to live on her own--and we're talking about a young person with above-average mental capabilities and no developmental disabilities--just a profound situation she needed "rescued" from before she became totally buggy.
Such intervention impacts everyone in the household--spouse, other children or teens--etc. I can't fathom what it would take to "take on" someone with severe mental retardation, who could not cope with his or her own feeding, hygiene, sexual urges, hostile impulses, etc.
For a family attempting to "take care of their own," as you flippantly suggest, would (and does---read the statistics) it very often results in the primary caregiver ( good ol' MOM, I suppose) having to lose needed income, having to compromise the attention other children and her spouse need (if she is fortunate enough to be in a long-term stable relationship), and pretty much devote her life and all resources to the disabled person.
Very often, when families are pressured by guilt mongers like you, the families try this scenario and fall apart. They slide into poverty and dysfunctionality. Also--very often (this is a dirty little statistic that is out there, but you'd probably like to ignore)--the disabled person often ends up abused and/or neglected.
There are very few people who can cope with the incessant needs of the profoundly disabled AT HOME--without suffering catastrophic losses of life quality for everyone else in the home.
Far better, in certain cases, to place the individual in professional care, and schedule family visits and outings (if feasible) in whatever increments of time are available.
How dare you pass judgment on folks who (most often) are heartbroken to have to place a child or sibling in an institutional setting but who MUST do it before their own life and those of their other children become total train wrecks?!
sweetiepie (anonymous) says…
What is interesting about these institutions is that the people in them live in group homes (within the institutions) that are almost exactly like the group homes where developmentally disabled persons live in the community (and I've seen both).
Many of the people at KNI have lived there since they were very small children; it's the only home they have ever known. I'm not sure why getting them out of the only (group) home they've ever known into a group home 5 blocks away is somehow an improvement.
Parsons treats a bunch of people with dual diagnoses: mentally ill and developmentally disabled. They frequently don't do well in community settings.
And finally: these institutions do all they can to get their residents into community group homes--some people don't want to go and some people go and come back.
crazyks (anonymous) says…
I'd like to inform you all that Parsons State Hospital DOES have residences on their grounds. The only difference in the group homes there is the level of functioning of the residents, and the number of staff available and the training that is provided for staff there, as opposed to a regular group home.
A regular group home is not the place for someone who is frequently violent. This places the other residents, many who are very mild mannered and compliant, in danger. Someone who becomes violent for no apparent reason and continues to escalate until the police have to be called to intervene is not good for residents in regular group homes. A regular group home is more like a home setting, where common areas are shared, though each has their own room. Some have roommates, some do not. It's more like an old-fashioned boarding house.
Someone who is violent (and I know; the place I work for has tried this) being moved in makes the other residents fearful, they will hide in their rooms, refuse to come out to eat, refuse to get on the van with the others. Is this the kind of thing that we should subject all developmentally disabled adults to, just because someone thinks it's a nifty idea to close hospitals?
Residents with similar disabilities who are housed together do much better and are better cared for than if you try to mix them up. Higher functioning people should be in a residence together. Highly physically disabled people should be in a residence together. And violent people should be in a residence together, where there's more staff and better training to deal with it.
As for your pronouncement, Sybil, that people in these institutions are drugged all the time, this simply is NOT true. State law prohibits that kind of thing anymore. All consumers are given the least amount of medication that they need in order to live as normal and productive a life as possible. This is the trend all across the board. No medication is given unless it's considered absolutely necessary, and by a panel of professionals, not just one person. No one is drugged into submission anymore. You're living in the past.
Shouldn't we be more concerned about what is best for the consumers, and not what we think is best for the state and taxpayers? Money shouldn't even be an issue here. It takes whatever it takes to care for people properly. To do otherwise is scandalous.
Pywacket (anonymous) says…
Well said, (not so)crazyks!
as_I_live_and_breathe (anonymous) says…
Well, I suppose, since abortion is legal and acceptable, if you find yourself in the position of having to care for someone that is too much trouble, the mom should be able to kill it. Unless the disability comes after the parents are dead, then we could have a lottery and let the winner do the honors.
jhawk4evr (anonymous) says…
I think readers should take crazyks's remarks somewhat with a grain of salt. Some of the statements sounding so lofty are indeed incorrect.
Medication is NOT "given" by a "panel of professionals" (at least none with a formal pharmaceutical background). In fact, in instances, medications are given by staff unlicensed to give meds (even though staff licensed to dispense meds are available).
It is the ward/unit physician's decision (sometimes ill-advised by non-physicians who are cottage staff, but cow-towed to anyway) as to what will be prescribed.
Additionally, there are times when a perhaps "unpleasant" resident has had to go to the medical unit of PSH&TC and after medical recovery, administrative staff from that cottage have persuaded the physician to NOT release the resident back to his/her cottage, even though the doctor and the medical unit have no further medical involvement as initially presented.
To me, that may be a form of denial of active treatment which was considered neglect at some institutions that were forced to close.
It should be recognized that any sort of placement, be it: institution, group home or own family, has the pitfall of potential abuse/neglect unless and until there is a monitoring system that can virtually guarantee the safety and well-being of those less fortunate and who are not able to live at home. (And such an entity must have authority to inspect the premises during reasonable hours without advance notice.)
But if you read the SRS Mission Statement (available at your local SRS office) it reads: "To protect children (but good luck about those two little girls in the Wichita area) and promote adult self-sufficiency."
I've always wondered why the State doesn't also note that it's avowed Mission is also to protect those adults (in institutions) it serves. Maybe it's just an oversight. Maybe not.
But I am glad that crazyks is so pleased with PSH&TC's performance, especially since the former superintendent from there is now the Sec'y of SRS. So, now, all of SRS can be guided by someone with the administrative experience that crazyks finds acceptable (but, I wonder, why has the current superintendent of PSH&TC placed so many people on "investigative leave" since assuming the mantle of superintendency? And, perhaps oddly, many of those people, who were employed during much of the former superintendent's tenure, were not under such scrutiny while the previous superintendent was there. HMMM. Is somebody seeing things a little differently?)
crazyks (anonymous) says…
At the agency I work for, a panel of people discuss what medications are necessary for each resident. This panel consists of the person's doctor, their psychiatrist, the nurse, case manager, director of housing, director of the facility, house manager, and any and all employees who have contact with the person.
The doctor and the psychiatrist have the final say about what will and will not be prescribed, and they do not "cow tow" to other staff.
No one at this agency is medicated into submission. If it's not done that way everywhere, then it should be.
Medications are only prescribed by the person's own doctor or psychiatrist. Non-medical staff do administer meds. Perhaps I wasn't clear about that.
Kansas law allows non-medical staff to administer medication to residents, if they have been trained by a licensed nurse or doctor. This does not include prescribing medications. It only entails handing the person the pills and giving them water. All people who administer medication must record it every time, on the MAR.
We are trained to recognize the meds by sight, and to know the reason each one was prescribed, and the possible side effects of each med. We also have to do this for PRN and OTC meds. Staff that has not been trained to give meds are not allowed to do so.
Every group home across Kansas does not have enough nurses and doctors to go everywhere and administer meds.
The group homes at this agency are subject to inspections at any time, any day of the week, without notice. We have had many, many such inspections while I've worked there.
jhawk4evr (anonymous) says…
"Kansas law allows non-medical staff to administer medication to residents, if they have been trained by a licensed nurse or doctor."
----------------------------------------
Would anyone who can, please cite the actual "Kansas law" that authorizes "non-medical staff" to perform such a function. I am unaware of it.
And if such a law is available, then those paying for training as CNAs and CMAs, are they wasting their time and money to be "licensed" to do something the State law already allows them to do?
And if some health-care facility requires such training and background and licensing in order to be hired or retained, what are they basing their expectation on?
Also, why is it a job requirement in at least one of the two remaining State institutions that non-professional medical staff who handle and dispense medications HAVE to maintain their State-issued license (by obtaining the required number of CEUs and paying the set fee) the same as RNs and LPNs?
Is that different in proprietary group homes such as where crazyks may work?
crazyks (anonymous) says…
"May" work? oooh...
The law you're looking for is Kansas Statute 65-1124.
Any non-medical staff can administer meds, as long as they have received a set number of hours of training by a licensed nurse. This training program has to be approved by the state. With this training we have to do coursework and score a certain percentage on a written test.
jhawk4evr (anonymous) says…
Thank you for providing the governing statute you were relying on to support your contention.
Paragraphs (h) and (i) are particularly interesting. The staff who does in-servicing where you work might want to review them.
Specifically, your position about the "...received a set number of hours of training by a licensed nurse..." actually reads:
"(i)..., by an unlicensed person who has been certified (operative word, and generally means either a stand-alone document attesting to or insertion in an employee's service record showing/indicating such attainment, and then kept current) as having satisfactorily completed a training program in medication administration (emphasis mine) approved by the secretary of health and environment and has completed the program (emphasis mine) on continuing education adopted by the secretary, or by an unlicensed person while engaged in and as a part of such training program (emphasis mine) in medication administration;... ."
And I believe paragraph (h) is not a substitute for paragraph (i) to the extent that it "implies" a circumvention to paragraph (i)- otherwise paragraph (i) would not have been written using the descriptive term "medication" several places.
jhawk4evr (anonymous) says…
I'm glad I was led to the correct statute (KSA 65-1124, Kansas Nurse Practice Act,[Acts which are not prohibited]) governing dispensing of medications by "certified" persons.
Shows how the State, but not the private sector, can grant exceptions to such requirements when it allows uncertified (as described by their own hand) staff to perform such duties.
I haven't figured out how the State can bypass that regulation, but it has (and may still), and as long as the higher echelon authorities in the governing and/or regulating of licenses/certifications don't mind (as far as I know, LPNs and RNs haven't complained to their supervisors about such exceptions), so why should we, John Q. Public, worry about such a minor discrepancy?
We still continue to trust that the State, knowing of such exemptions, still has the safety and welfare of the institutionalized person uppermost and therefore wouldn't allow a practice that has fairly stringent guidelines to be willy-nilly jeopardized. Right?
jhawk4evr (anonymous) says…
I'm glad I was led to the correct statute (KSA 65-1124, Kansas Nurse Practice Act,[Acts which are not prohibited]) governing dispensing of medications by "certified" persons.
Shows how the State, but not the private sector, can grant exceptions to such requirements when it allows uncertified (as described by their own hand) staff to perform such duties.
I haven't figured out how the State can bypass that regulation, but it has (and may still), and as long as the higher echelon authorities in the governing and/or regulating of licenses/certifications don't mind (as far as I know, LPNs and RNs haven't complained to their supervisors about such exceptions), so why should we, John Q. Public, worry about such a minor discrepancy?
We still continue to trust that the State, knowing of such exemptions, still has the safety and welfare of the institutionalized person uppermost and therefore wouldn't allow a practice that has fairly stringent guidelines to be willy-nilly jeopardized. Right?
crazyks (anonymous) says…
I didn't say I necessarily agreed with the statute. In fact, in my work, I would much rather NOT have the responsibility of administering meds. But this is not always pratical, especially in smaller agencies, where funds are limited and not every group home can afford to have its own nurse on staff. Perhaps this is why the state decided to do this.
This is allowed in many group homes, and also nursing homes. Rest assured that if a medication error occurs, the non-medical staff person is immediately not allowed to give meds. They cannot give med again until the training is done again, and the person is re-certified in medication delegation.
All tests and any training-related paperwork and MARS are saved by the agency, and inspected by the state on a regular basis. When an error occurs, it goes against the license of whatever nurse provided the training for that particular person. If enough errors are made, even if by multiple people, the nurse runs the risk of losing her license. We are required to notify the nurse, in writing, as quickly as possible, of any medication errors.
We all receive continuing education and training in medication administration. We are required to have so many in-service hours per year on this alone.
We are allowed to give medications only, and this includes pills, suppositories, eye drops, ear drops...it does NOT include injections or anything like that. Only the nurse is allowed to do those things.
jhawk4evr (anonymous) says…
"This is allowed in many group homes, and also nursing homes."
---------------------------------
Is what you are saying is that only "authorization" by someone at the care-facility and NOT "certification" as required by the Kansas Nurse Practice Act by a State entity is all that is needed to administer medications in a private or State-sanctioned facility?
Then I stand corrected in that the State alone allows those at institutions who are non-certified to pass meds.
Makes one wonder why the time and effort are spent to write statutes and regulations if they are not meant to mean anything, and all they do is hold the bearer of such a "certification" hostage to the tune of up to several hundreds of dollars in terms of time and travel and fees by having to renew their certifications every so often thru CEUs and license fees.
As the spouse of someone who is "held hostage" to having to maintain a State license I certainly object to such a practice continuing that allows others who do the same or similar work to not be subject to such employment "costs" though the same rules affecting them are in effect.
BTW, in those whom you indicated formed a medication discussion "panel" I noticed there was no RPh. I'm curious as to that as that is the ONE person especially trained in drug-interactions and drug contra-indications. Probably just an oversight on the facility's part and probably has never been an issue anyway because a drug Hx for each resident is probably maintained and monitored as part of the continuum of care.
I would even bet that at your facility that charting is done according to standard principles of POMR and all documentation is SOAPed so as to ensure the highest level of care and treatment.
crazyks (anonymous) says…
Are you deliberately being obtuse, or what?
We are certified by the agency, by the nurse at the agency, who is certified and licensed by the STATE and as such allowed to train non-medical staff to administer medications. The nurse certifies to the state that we have had the required training, in a program approved by the STATE.
Again: licensed nurses in Kansas are allowed by the STATE to train non-medical staff to administer medications, in a training program approved by the STATE.
You read the statute. What part of it don't you understand?
jhawk4evr (anonymous) says…
"Non-medical staff do administer meds. Perhaps I wasn't clear about that." (earlier entry)
"We are certified (emphasis mine)..." (Latest entry)
Amazing what the inclusion of just a single word that had been missing thru-out can do.
So now the original comment can read as "Non-medical certified staff do administer meds."
That's in conformity with what the Nurse Practice Act reads.
Still, the State has non-certified staff who give meds.
Does that make sense to anyone? It doesn't to me. It makes me wonder who fills out a MARS if there's a med error.
jhawk4evr (anonymous) says…
In the number of posts I've made here, I've made several remarks alleging what I consider to be a possible abuse/neglect/statutory violation, and yet, even literally in direct communication with someone who is quite "into" being in the helping profession field, that person has not, and even no other readers, expressed any anger that I would make such an outlandish comment or wonderment that my allegation may have merit.
I realize that non-mandated staff may feel uncomfortable hearing or reading about possible allegations in any care-facility setting, but it would seem that they would, even just in passing, might say to a supervisor, who may be a mandated Reporter, (as certain degreed persons are) that there's been someone on the LJW "comment page" posting remarks they might be interested in reading.
I've thought about calling the Kansas Abuse/Neglect Hotline myself, but I'm a little reluctant to call the 1-800-922-5330 number because that now goes to the "Kansas Protection Report Center."
Does that call go to India like when calling the SRS Help Desk used to or maybe still does?
It used to be one could call the SRS Central Office Abuse/Neglect Hotline number or the AG's Office Abuse/Neglect Hotline number about possible abuse/neglect. But is it no more?
So I wonder what this "KPRC" is.
Maybe it's like the Child Support Enforcement Payment Center thing-a-ma-jig, a private entity which contracts with SRS CSE to handle support payments. Or could it be some convict taking and copying SSN's, address, medical info, etc. as was in the paper recently under some reprised DOC training program?
Who knows? Who cares? Is anybody even interested?
Apparently, even persons referenced in this LJW article are too busy with their own endeavors to see what others may have to say, even if such info could align itself with their express purpose/advocacy of getting residents out of institutions and into the community.
jhawk4evr (anonymous) says…
Marion:
Is that "Family Preservation" you mentioned above that DCCCA organization that is somehow connected with "The Farm" folks?
If so, I know another family which shares similar feelings.
Please let me know.
jhawk4evr (anonymous) says…
Just curious. Has anyone done the math here (using the State's own figures)?
"By 2005, approximately 500 people were served in institutions... . The two facilities together cost about $47.4 million annually to operate."
The taxpayer is providing services to the residents at a cost of about $47,400,000 divided by 500 so that comes to approximately $95,000 per year per resident (isn't tbat figure awfully close to a superintendent's annual salary? So maybe the 500 figure should be 502, or would it be 498?).
And I have reliably heard of an instance where that $95,000 cost allowed some residents to have a frozen (staff wouldn't even thaw it out first, much less heat it)pop-tart for a breakfast offering (ah, the joys of home-style meals).
I should think that if someone's bringing in $95,000 they should at least be able to have a breakfast at a MacDonalds.