By Mike Sherry
KHI News Service
KANSAS CITY, Mo. — Representatives from a broad spectrum of agencies and organizations, including hospitals and courts, are crystallizing plans they hope will help solve a health problem in Kansas City, Mo.
The issue is that people who are high, drunk or in psychiatric crisis clog emergency rooms and tie up first-responders although their needs are more suited to mental health intervention, according to organizers.
And now, two work groups tackling the problem have tentatively set July 10 as the day for a local summit of perhaps as many as 80 participants to devise a test for a new approach. Planners hope to use about $3.5 million in state funds for a pilot project that, they said, is included in a fiscal 2015 budget pending before Missouri Gov. Jay Nixon.
The hope is that the pilot project will lead to a permanent facility staffed by personnel who can address mental health crises and then connect patients with community-based services. One aim is a site that will assist police officers and ambulance personnel, much like the reconstituted Rainbow Mental Health Facility in Kansas City, Kan.
A potential joint effort by the work groups coalesced earlier this year.
Emerging ideas
According to participants in the ongoing discussions, several thoughts are emerging about a crisis stabilization center in Kansas City and for related services that also would help the target population:
● The facility should include staff members who can handle minor injuries and treat patients with dangerously high blood-alcohol content levels.
● The facility should have a short-term unit for people who need to sober up.
● Long-term housing is a critical part of the mix.
● More police forces in the region should have some officers specially trained to handle mental health crises.
● Hospitals across the region should try to track people who show up often in emergency rooms – the so-called “frequent fliers.”
As for the center itself, Kansas City Municipal Judge Joseph Locascio said the key is providing emergency personnel a central point where they can take people who appear to be suffering from a mental illness or substance abuse issue. Then, he said, mental health professionals can determine the next step.
“You don’t ask the police to make these decisions on the street,” he said.
Locascio, who presides over Kansas City Municipal Court and its specialty docket for substance abusers, heads up an ad hoc committee focused on addressing the need on the Missouri side of the metropolitan area.
Michael Dunaway is leading a bistate work group focused largely on the emergency room issue. He is senior vice president of the Kansas City Metropolitan Healthcare Council, which includes about 45 hospitals throughout the region.
“We are fully prepared to roll up our sleeves to help make this a collaborative initiative,” he said.
It remains to be seen where a permanent facility might be located and who would cover operation costs.
Dunaway said financial contributions from the various organizations interested in the services likely would cover the cost of running the facility. He expressed confidence that the groups would find a better way to serve this population.
“We will come up with a solution for this,” he said.
Dunaway and others also expressed an interest in seeing how things take shape at the Rainbow facility, which reopened April 7 through a partnership between area mental health centers and a substance-abuse assistance organization.
Looking to Rainbow
State officials closed all but six of Rainbow’s beds in 2011 after federal surveyors cited the hospital for being understaffed and the state fire marshal found safety violations.
The revamped facility reopened in April with three units, each with a 10-person capacity: a sobering unit for stays of up to six hours, a crisis-observation unit for stays up to 23 hours, and a crisis-stabilization unit for stays of up to 10 days. The center is designed so patients can move among the units as needed.
Figures provided by the facility show that in its first month of operation it logged about 100 patient visits, including 13 people treated in the crisis-stabilization unit.
Approximately 60 percent of the patients arrived via law enforcement personnel. Officials said other patient sources include friends, family and referrals from other agencies.
The big difference between the old Rainbow and the new Rainbow, staffers said, is that the facility reopened as an outpatient center where patients can choose whether to stay.
Staff said some former patients now have sought treatment on their own and that they behave better because it’s not something that is being forced on them.
“This is a different option for those individuals that just don’t fit in the state hospital equation,” said Executive Director Sharon Sawyer.
She said patient counts are increasing by the week as the word gets out that the facility is available. The gradual increase is good, Sawyer said, because it allows them to work out the kinks as they go along.
Her advice to the advocates on the Missouri side – if and when they open a facility – was to expect the unexpected.
“You think you can anticipate everything,” Sawyer said. “But you just can’t.”