Pilot Program Helps Disabled Kansans Leave State Hospital
Roy Alcorn shot pool with friends last week as sunlight streamed through the open door of a small building at Equi-Venture Farms.
A month earlier, Alcorn was living at Osawatomie State Hospital 24 hours a day, seven days a week.
Alcorn’s new arrangement is part of a pilot program spearheaded by Ben Swinnen, executive director of Topeka-based Equi-Venture, and Tim Keck, head of the Kansas Department for Aging and Disability Services.
The program is targeted at an underserved population: Kansans with intellectual and developmental disabilities who also have severe and persistent mental illnesses. It is one of several initiatives Keck has launched to reintegrate some Osawatomie State Hospital residents into their communities.
The idea was to do a comprehensive review of patients with intellectual and developmental disabilities at Osawatomie State Hospital and determine if their mental illness was controlled enough that they could be discharged to organizations that could provide home and community-based services to support their disabilities.
“It’s a lot of work for a lot of people,” Swinnen says. “But at the end of the day if we can move someone out of a state institution, I think it’s worth it.”
Osawatomie State Hospital, one of two state-run facilities for Kansans with mental illness, has had limited capacity for more than a year amid renovations and a loss of federal funding.
Spaces at Osawatomie State Hospital are in demand, but discharging Kansans with disabilities is complicated by a gap in community-based psychiatric care for them.
Still, by working with Keck and the three insurance companies that administer Kansas Medicaid, or KanCare, Osawatomie State Hospital staff helped identify seven patients who might be ready for discharge with the right supports.
Swinnen says KDADS deemed one patient not eligible and an evaluation is pending for another, but the other five have been discharged. Two are receiving day support services at Equi-Venture in west Topeka and the other three found providers through Community Developmental Disability Organizations in other parts of the state.
“It was a happy ending,” Swinnen says. “I credit Secretary Keck for that. He was open to exploring what can be done to increase the returns to home and community-based services.”
Alcorn is one of the two Osawatomie patients who now receive services at Equi-Venture, which also served him before his stint in the hospital.
Alcorn was being treated for mental illness at Valeo Behavioral Health Care when he stepped out of a moving Valeo vehicle into traffic.
That incident — endangering himself and others — landed him at Osawatomie, where he stayed for nine months.
Swinnen says that once Equi-Venture and KDADS started looking into discharging Alcorn, the hospital staff “did a wonderful job” preparing Alcorn for it, in part by implementing Equi-Venture’s focus on positive reinforcement, rather than restrictions, to modify his behavior.
Swinnen also praises the KanCare companies. He says another challenge of getting people discharged from the state facilities is that they lose their Medicaid coverage for home and community-based services when they’re admitted.
Equi-Venture and KDADS were able to work with the three companies — Amerigroup, UnitedHealthcare and Sunflower State Health Plan — to get coverage restored for the five being discharged from Osawatomie so their support services would be reimbursed immediately, he says.
For Alcorn, getting out of Osawatomie meant getting day services at Equi-Venture plus a shared living arrangement with one other person with a developmental disability and a host, Donald “Mitch” Mitchell, who supports the two of them.
Mitchell also accompanies them to Equi-Venture during the day.
As he watches Alcorn shoot pool there, Mitchell says the move out of Osawatomie was a difficult transition for Alcorn, in part because he didn’t know how to react to the personal attention he was getting from his roommates.
“That’s what he told me: ‘I’m not used to this,’” Mitchell says.
But now, Alcorn says he likes living with Mitchell and being out of the hospital.
“(I) like to go to the movies,” Alcorn says. “Go for a Coke.”
The other former Osawatomie patient now receiving day services at Equi-Venture was on so many medications when she was discharged that she was nearly catatonic, staff member Sarah Feldhausen says.
Feldhausen and the rest of the staff helped wean her off some of the medications and found that she loves hip-hop music.
“We just had a dance party with her,” Feldhausen says.
That client is scheduled to move to shared living in Newton, where Equi-Venture has another office. She will also meet with her local Community Developmental Disability Organization to discuss other provider options in that area.
Meanwhile, Swinnen says he’s receiving inquiries about helping patients move out of the state’s other mental health facility in Larned, as well as the Parsons State Hospital and Training Center, which is one of two state-run residential campuses for Kansans with intellectual and developmental disabilities.
“I can’t guarantee the outcome in the long-term,” Swinnen says.
“But it’s worth a try,” Feldhausen says, and Swinnen agreed.
Andy Marso is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach him on Twitter @andymarso