Governor Laura Kelly announced today that the Kansas Department for Aging and Disability Services (KDADS) is prepared to lift the 6-½-year moratorium on voluntary admission at Osawatomie State Hospital (OSH), one of the state-run inpatient facilities for adults with serious and persistent mental illness, on January 3, 2022.
“After nearly seven years, lifting the moratorium on voluntary admissions at Osawatomie State Hospital will ensure Kansans receive the mental health treatment they need,” said Governor Laura Kelly. “Since day one, my administration has prioritized policies that provide Kansans with the mental health resources and support they deserve. I’m confident this plan will continue our efforts and provide a more comprehensive and inclusive continuum of care for everyone.”
The moratorium, in place since June 2015, was imposed by KDADS officials partly in response to insufficient space at the hospital to safely treat both involuntary and voluntary admissions.
The KDADS plan has two primary goals:
- Ensure high quality, therapeutic spaces to provide treatment.
- Use existing resources and facilities effectively to meet therapeutic needs while incorporating community-based services and private facilities to allow individuals to receive services closer to their home and community.
To increase community-based capacity for inpatient treatment, KDADS worked with the Kansas Department of Health and Environment (KDHE) to implement a new provider classification. State Institutional Alternative (SIA) is a new Kansas provider type for Medicaid and KDADS-funded programs that allows private psychiatric and community hospitals to accept patients with mental illness who have been screened and approved for admission to state psychiatric hospitals. SIA hospitals admit patients voluntarily entering acute care and those court ordered for involuntary admission and provide regional hospital alternatives to Larned State Hospital (LSH) and OSH.
Hospitals in the state can enroll to become an SIA through a process with KDADS’s contract partner HealthSource Integrated Solutions. There are currently eight approved SIA hospitals with nine locations in the state. They have collectively served 122 adults and 291 youth since September of this year.
“The partnership with HealthSource and the hospitals that have enrolled as SIAs has expanded the range of services for adults in mental health crisis,” KDADS Deputy Secretary of Hospital and Facilities Scott Brunner said. “Community hospitals that treat these patients are compensated for the higher level of care needed to act in place of the state hospitals at Larned and Osawatomie and this payment stream for Medicaid eligible patients and those without health insurance reduces the barriers to access for adults with acute mental illness close to their home or community.”
The SIA project not only replaced diversion beds that supplemented OSH capacity to meet immediate needs, but also brought additional hospitals with the same focus on in-patient stays for acute patients, initiating treatment and smoothly transitioning patients into community-based treatment. Five of the eight SIAs serve only the adult population.
To address bed capacity at OSH, KDADS was provided FY 2021 budget funds to renovate space in existing buildings on campus. The first of those projects, reopening the B2 unit, will be completed in January 2022, and will provide flexible space to move patients to make room for updating treatment units. In January, renovations will begin in the Biddle Building at OSH. Biddle renovations will add certified beds and allow conversion of many double occupancy rooms in the Adair Acute Care unit to single occupancy. With completed renovations, the total certified bed count will increase from 60 to 72, an increase from the 52 certified beds currently available with space limitations and ongoing COVID-19 restrictions. This, combined with the improved therapeutic environment, will allow for daily capacity of 85-90 percent with an increased number of single patient rooms.
This alignment of certified beds improves patient and staff safety and treatment options. At the end of the plan, OSH will have a total of 72 certified beds and 110 licensed beds. This capacity on the OSH campus compliments efforts to expand the options for acute inpatient mental health care in community hospitals.
When the moratorium is lifted, OSH will admit voluntary and involuntary patients in the order of their completed screens until the census reaches 85 percent of maximum capacity. When the census is over 85 percent of capacity, OSH will prioritize admissions to only those committed on an involuntary basis.
At the beginning of January, Adair will have a maximum capacity of 52 patients (to include three social detox beds) and OSH will have a maximum capacity of 110 patients. Staffing challenges and COVID-19 restrictions have limited the use of the full licensed capacity.
Lifting the moratorium does not eliminate the need to use a waiting list when necessary to ensure overcrowding does not occur. The demand for beds will at times still require prioritized placement at AAC and OSH for involuntary patients. As the state’s capacity increases, voluntary patients can be admitted, as bed space allows, to SIA hospitals and OSH for the most acute level of mental health treatment.
“With the additional capacity from SIA hospital partners, the continued expansion of community-based crisis stabilization centers, active management of the census using all beds available at OSH and adding additional space at OSH in 2022, we are confident lifting the moratorium will be successful as a critical component of improving the safety net for adults in mental health crisis in Kansas,” KDADS Secretary Laura Howard said.