Kansas Experiences Sharp Decline in Psych Services for Children
By Bryan Thompson, Kansas Public Radio
SALINA, Ks. – The Kansas Department of Social and Rehabilitation Services, or SRS, has been cutting budgets and closing offices throughout the state this summer. And as Bryan Thompson reports, some cost-cutting moves by the agency are having a big effect on children with severe-mental health problems, and the people who take care of them.
Kansas has 18 privately-run Psychiatric Residential Treatment Facilities, or PRTFs, that treat children with severe mental health problems. The PRTFs are, essentially, inpatient psychiatric hospitals that incorporate intensive therapy into a more home-like setting. One such facility is operated by Lakemary Center, in Paola. It serves the most difficult population of all children with severe psychiatric problems who also are afflicted with developmental disabilities.
Thirteen-year-old Lauren McReynolds is one of those children. She suffers from a rare and severe form of epilepsy. Lauren has multiple seizures every day, and her brain is gradually deteriorating. Her mother, Jenny Weaver, says Lauren functions at the level of a four-year-old, and is aggressive and impulsive - often presenting a danger to herself and those around her.
"It is very difficult," Weaver says. "It just takes a lot of people. She just needs one-on-one attention, and I can't give her that.
Lauren has been at Lakemary since last fall. Weaver comes to pick her up to go shopping, or to church, or for an overnight stay at home as often as possible, but the family can't handle her for long periods of time.
"When she decides to run away or she decides to throw my four year old across the room because she wanted something, then we know it's time for her to come back to Lakemary, where it's structured, she has the staff, and they're able to deal with her behaviors and have the care that she needs," Weaver says.
Lauren's treatment at Lakemary Center is paid for by SRS through the Medicaid program, but her placement there must be reviewed every 60 days -- and Weaver is terrified that budget cuts at SRS will mean her daughter will eventually be denied services.
Lakemary president and CEO Bill Craig understands that fear. He says community mental health centers, which refer patients like Lauren to Lakemary and other treatment centers, have in the past few months drastically reduced the number of children being screened for treatment.
"The number of screens they're doing the last few months is half what it used to be. And of those screens, they're excluding three times as many as they used to from access to service," Craig says. "So something has changed dramatically. Those kids haven't magically gone away. They're out there in those communities and those families are suffering."
Craig and other providers say community mental health centers have been told that they must either cut their own operations, or reduce the number of kids they refer to the expensive PRTFs, Psychiatric Residential Treatment Facilities. SRS officials deny this, but Craig says the agency has expressed concerns that PRTFs are being over-utilized.
"If those isolated areas of overuse were occurring, then in those areas they need to improve their community based programming," Craig says. "But the solution that was taken to that possible problem was a meat ax rather than a scalpel."
And Craig says families are suffering as a result.
"The kids in this kind of crisis destroy families, destroy marriages, destroy the ability of normal individuals to cope," says Craig. "One of the spouses has to quit their job, maybe both of them have to go to lower paying jobs so they can structure their schedules to provide the kind of intensive, around the clock care for these kids."
The situation has drawn the attention of State Senator Dick Kelsey, of Goddard. He's alarmed that kids are being denied services they desperately need.
"I started stressing the issues in March. We had meetings with them right in the Capitol," Kelsey says. "And [they said], Oh we're not making policy changes, it's just a fluke.' Well that's when it was down by 20 percent. Now it's down by 55 percent or 60 percent. The potential for these kids to harm themselves is just too great to be playing around with it."
Kelsey met recently with the governor and with top officials of SRS to express his concerns. He says he was as sured that policy changes at SRS have been made to ensure that severely-troubled kids are getting the intensive therapy they need.
A legislative budget committee has been assigned to conduct a hearing on this issue, and Kelsey will be looking for evidence that assessments and referrals to PRTFs have returned to more normal levels.
"If I have been told something today that doesn't turn out to be true, than a month from now it's going to be pretty ugly in that hearing," Kelsey says. "Because obviously, I'm not going to take that lying down."
In the meantime, Senator Kelsey is asking Lakemary and other facilities to keep him posted on their referrals, admissions, and cases they feel are not being handled correctly.
For more on changes underway at SRS, including links to more reports by Bryan Thompson, go to www.kpr.ku.edu and click on the link marked "Health Series."