By Dave Ranney
KHI News Service

TOPEKA — The Kansas Department for Aging and Disability Services has suspended voluntary admissions to Osawatomie State Hospital, one of the state’s two inpatient facilities for people with serious mental illnesses.

The decision, according to a memo sent to the state’s 26 community mental health centers late Tuesday afternoon, was driven by “ongoing and critical census challenges” at the state hospital. The memo also outlined procedures for handling patients who are involuntary admitted.
In recent months, the 206-bed hospital has admitted record and near-record numbers of patients, causing dozens of patients to be triple-bunked in rooms meant for two.

Last month, federal health officials announced that surveyors sent to the hospital in October had found that its services were “not … sufficient to meet the needs of its patients.”

KDADS officials were warned that if the hospital’s deficiencies were not corrected, it would not be paid for Medicare services provided to patients admitted after Dec. 8.

KDADS filed a correction plan with the Centers for Medicare and Medicaid Services regional office in Kansas City in mid-November. Neither the survey nor the correction plan have been released to the public.

Federal surveyors returned to the hospital Monday.

“They are re-surveying the problem spots and determining (whether) we’ve addressed them and that situation has been rectified,” KDADS spokesperson Angela de Rocha said Wednesday.

De Rocha said the surveyors were aware of the department’s decision to suspend voluntary admissions.

The decision, she said, is allowed by state statute.

It’s not yet known how many would-be patients will be denied admission.

“It shouldn’t be a significant number,” de Rocha said. “It’s not going to have a significant impact on our census challenges, but at this point every little bit helps.”

According to the memo, would-be patients will be denied admission “if their sole diagnosis is anti-social personality syndrome, substance use disorder, or an organic mental disorder such as trauma or dementia.”

Community mental health centers will not be allowed to send patients to the hospital until an on-duty physician has reviewed their records and agreed to admit them.

The new policy will be in effect for as long as the hospital’s census exceeds 185 patients.

Typically, patients who are involuntarily admitted to the hospital have been involved in altercations with police and have been deemed a danger to themselves or others.

Kyle Kessler, executive director at the Association of Community Mental Health Centers (CMHCs) of Kansas, called the change in policy “a real concern,” adding that neither he nor his members were consulted about its potential impact on patients or the centers.

“This is a decision that the state made and that we didn’t have any input into,” Kessler said. “But the CMHCs will continue to do everything they can to treat people in their home communities.”

Between 2007 and 2012, state-funded support for a grant program that the centers use to offset the costs of treating the uninsured has dropped from $31 million a year to $10.9 million. Lawmakers last year agreed to set aside an additional $5 million for the program.

The state’s mental health advocates have long argued that community-based services for the mentally ill are significantly underfunded. And the decision to suspend voluntary admissions at Osawatomie, they say, will only make a bad situation worse.

“This just underlines the crisis that we have in mental health care in the state of Kansas,” said Rick Cagan, executive director of the National Alliance on Mental Illness-Kansas. “There are solutions out there that have been talked about for years, but for whatever reason we, as a state, keep putting off the decision for making the appropriate investment in our mental health system. And then we keep closing our options for people who’ve gotten to a point where they really need inpatient treatment.”

Expecting the community mental health centers to take on volunteer-admission patients who, prior to Tuesday, would have been admitted to the hospital is unrealistic, Cagan said.

“Do we think community mental health centers ought to be doing a better job? Yes, we do,” Cagan said. “Do we think they have the resources they need to provide more robust services? No, we don’t.”

Keith Tully, chair of the board of directors of the Elizabeth Layton Center for mental health services in Paola, agreed.

“If the hospital isn’t going to admit people who need to be there and who’ve agreed to go there, then it’s going to put more pressure on us, more pressure on law enforcement, and more stress on families that are having to cope with someone who, say, has depression or is suicidal,” Tully said. “We’re in a crisis situation, and now what we hear is how the Legislature is going to have to cut spending. What’s happening, I think, is irresponsible.”
Greg Hennen is executive director at the Four County Mental Health Center in Independence. He said the directive will leave the centers in southeast Kansas with few good options after several hospitals in the region have closed their inpatient mental health units.

He said the closure of inpatient psychiatric treatment centers in Bartlesville, Okla., and, in recent years, in Pittsburg and Coffeyville have left community mental health centers with no place to send patients who need more intensive care.

“We’ve lost 47 private beds over the last five or six years,” Hennen said.

Hennen said when his center could refer patients to area hospitals, Osawatomie was a “last resort.” But with those inpatient beds no longer available, he said, the state hospital had become “our only resource.”

Asked about the impact of the state directive, he said: “It’s going to be chaos for a while.”

Commenting on the requirement that community mental health centers get prior approval from state psychiatrists before referring “involuntary patients,” Hennen said: “The jails will start to get full.”

Dave Ranney is a reporter for Heartland Health Monitor, a news collaboration focusing on health issues and their impact in Missouri and Kansas.

Hutch Post

TURON-  Authorities are investigating an accident involving a school bus on Wednesday in Reno County.

The Reno County Sheriffs department reported a Fairfield USD 310 school bus was hit by a dune buggy driven by James Knoll, 27,  Turon, just before 4 p.m., at the intersection of 2nd and Duncan.

There were 19 people on the bus at the time of the accident including 17 students.

Parents were able to pick their children up from the scene and take them home. No injuries were reported.

 

MIKE STOBBE, AP Medical Writer

NEW YORK (AP) — Health officials are telling doctors that the flu vaccine may not be very effective this winter.

As flu season begins to ramp up, officials say the vaccine does not protect well against the dominant strain seen most commonly so far this year.

That strain tends to cause more death and illness, especially in the elderly. CDC officials say the vaccine should still provide some protection, but it won’t be as good as if the vaccine strain was a match.

Flu vaccine effectiveness tends to vary from year to year. Last winter, flu vaccine was about 60 percent effective overall, which experts consider good.

The Centers for Disease Control and Prevention issued an advisory to doctors about the situation on Wednesday.

TOPEKA – Kansas Attorney General Derek Schmidt announced in a media release that he has joined with Texas and 15 other states in a legal challenge to President Barack Obama’s unilateral decision to stop enforcing parts of federal immigration law.

The Texas-led lawsuit, filed in federal district court in Brownsville, Texas, seeks a declaration that the president lacked constitutional authority to abandon enforcement of various provisions of federal immigration law. The suit asks the federal court to find instead that the president was obligated to follow the U.S. Constitution’s requirement that he “take care that the laws be faithfully executed” as Congress wrote them.

“Until recently, the president repeatedly made clear that there is a lawful way to fix the nation’s broken immigration system and an unlawful way,” Schmidt said. “Until he reversed course last month, the president correctly insisted that he lacked authority under the Constitution to essentially suspend the law or rewrite it to suit his preferences.”

The president’s announcement of “executive action” in November directs federal authorities to change how they enforce federal immigration law, abandoning various statutory requirements entirely. The states’ lawsuit asks the federal court to order the federal agencies to disregard the president’s ‘executive action’ and instead to follow the requirements set forth in the statutes.

“Congress has a constitutional and a moral obligation to fix our country’s broken immigration system,” Schmidt said. “There are many important interests involved in this complex debate, including many in Kansas. The diverse interests of our state in immigration reform are best served when Kansas voices in Congress are part of the solution, and the country is best served when the president and federal agencies follow the law and the Constitution. Frustration arising from political gridlock is not an excuse for a president to bypass Congress, ignoring the law and the Constitution.”

In addition to Texas and Kansas, the states filing suit today are: Alabama, Georgia, Idaho, Indiana, Louisiana, Montana, Nebraska, South Carolina, South Dakota, Utah, West Virginia and Wisconsin. Governors Phil Bryant of Mississippi, Paul R. LePage of Maine, Patrick L. McCrory of North Carolina, and C.L. “Butch” Otter of Idaho also joined as plaintiffs in the case.

The cost of the litigation will be borne by Texas.

MARCIA DUNN, Associated Press

CAPE CANAVERAL, Fla. (AP) — NASA’s new Orion spacecraft will have to wait another day to fly.

Wind gusts and a sticky rocket valve forced the Cape Canaveral launch team to call off Thursday’s attempt to send Orion into orbit on its first-ever test flight.

NASA promised to try again Friday.

Orion is how NASA hopes to one day send astronauts to Mars. This inaugural flight, while just 4½ hours, will send the unmanned capsule 3,600 miles into space.

A boat in the flight path delayed Thursday morning’s first countdown. High winds twice halted the launch with less than four minutes remaining. Then a valve in the unmanned Delta IV (four) rocket malfunctioned at the three-minute mark. Launch controllers scrambled to check all of these so-called “fill and drain” valves in the three first-stage booster engines. But time ran out.

ERICA WERNER, Associated Press

WASHINGTON (AP) — House Republicans are prepared to pass a bill declaring President Barack Obama’s executive actions on immigration “null and void.”

But even supporters acknowledge that the bill by Rep. Ted Yoho of Florida is mostly meant to send a message. It stands little chance in the Democratic-controlled Senate and would face certain veto by Obama.

Instead, its passage Thursday would set the stage for the real showdown over legislation to keep the government running past Dec. 11, when a current funding measure expires. Conservatives are demanding language in the spending bill to strip money to pay for Obama’s move to defer deportations and grant work permits to more than 4 million immigrants here illegally.

House GOP leaders fear such language would court a government shutdown.