By Travis Perry │ Kansas Watchdog
OSAWATOMIE — Kansas could save more than $3 million by restructuring staff and eliminating middle management at Osawatomie State Hospital, but there’s no telling how far the state will go to realize those savings.
Late last month, a report from The Buckley Group, a Colorado firm specializing in critiquing public and private psychiatric facilities, outlined a litany of issues plaguing the eastern Kansas mental health institution. Over the course of five pages, the consultants make one thing clear: OSH is suffering from an identity crisis.
According to the report, OSH is trying to be both an acute psychiatric hospital and a residential care facility, two distinctly different functions which require vastly different staffing. While it is intended to operate as the former, it has ended up doing more of the latter than it should.
Kansas Department for Aging and Disability Services secretary Shawn Sullivan told the Kansas Health Institute that OSH suffers from an excess of middle management, a point clearly detailed in the report.
One example is the number of social workers and activity therapists on staff. OSH can accommodate as many as 190 patients at any given time, and the current ratio of social workers to patients is 1:14, while consultants suggested the state could bump that figure as high as 1:30 (with the director of social services also managing a caseload). With regard to activity therapists, OSH currently manages a 1:9 ratio, but outside critiques say that could go as high as 1:30.
According to the report, a contributing factor to OSH continuing to operate as a quasi-residential facility lies in surrounding community mental health centers. OSH staffers say these mental health centers “are sometimes reluctant or unwilling to accept the discharge from OSH because they believe the patient needs continued inpatient care and/or sufficient resources are not available to permit a safe and successful transition to the outpatient setting.”
Simply put, OSH has become a bit of a catch-all for mental health issues. To turn things around, the Buckley report says, the state will have to find a way to improve community mental health centers.
While the savings are there, the state may not jump on them anytime soon. Sullivan told KHI a proposed overhaul of the Osawatomie facility will be accomplished not through layoffs, but through better-managing staff time and decreasing meetings to increase patient interaction. Combined with a new focus on the support structure surrounding OSH, Sullivan hopes to address the problems.
“We have a lot of gaps in the system,” Sullivan told KHI. “We need to do a much better job filling in those gaps because in a lot of places around the state, those services aren’t there. And because they’re not there, the hospital has become a safety net. It has a lot lower level of acuity than it should.”
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