The closure in recent years of several mental health facilities has left Kansas with just two in-patient facilities for patients with severe mental illness. Now, one of those facilities, Osawatomie State Hospital, is in danger of losing its ability to claim Medicare reimbursements if it doesn’t address deficiencies by Dec. 5.

Chief among those deficiencies apparently is a chronic problem with overcrowding at Osawatomie, which also can contribute to treatment and personnel problems at the hospital. The facility is licensed to serve 206 patients, but when surveyors from the Kansas Department of Health and Environment visited the hospital on Oct. 20, it had 250 patients. In many instances that meant three patients were living in rooms designed for two people. By Oct. 29, the hospital’s census was down to 235 patients.

Representatives of the Kansas Department for Aging and Disability Services say they have put together a plan for corrective action and are confident the hospital won’t lose its Medicare certification. The primary plan for reducing the census at Osawatomie is to look for ways to move patients into psychiatric beds in community hospitals or transition them to services provided by the state’s 26 licensed community mental health centers like Bert Nash Mental Health Center in Lawrence.

This strategy raises a number of questions. How many “community” hospitals in Kansas have psychiatric units. Lawrence Memorial Hospital closed its unit a number of years ago, in part, because of the difficulty of keeping enough psychiatrists to staff the unit. It seems that any hospital smaller than LMH would have similar issues.

Transitioning people with mental illness into out-patient community services has been a goal for many years, but it isn’t always practical. Most of the people at Osawatomie are there because they have been declared dangerous to themselves or others. The services offered by a community mental health center may not be enough for them.

In addition, state funding for those community centers has been slashed in recent years. Many are struggling to maintain services for their current clients without taking on the additional burden of people with serious mental illness because state hospitals are overcrowded.

Even if Osawatomie is able to meet the Dec. 5 deadline and retain its Medicare funding, it probably won’t be long before the facility is once again over its licensed capacity. KDADS officials say other states are dealing with similar problems, but that doesn’t mean the situation in Kansas is OK. Providing appropriate care for people with mental illness is a matter of public safety as well as individual quality of life. Kansas needs to find a long-range solution to what obviously is a chronic problem.