KANSAS CITY, Mo. — Kansas City, Mo., would be home to a regional facility aimed largely at diverting substance abusers from jail and hospital emergency rooms under a plan that has garnered support from law enforcement officials, political leaders and health care providers.
The vision actually represents dual efforts that began independently, but which might coalesce as a collaboration between area hospitals and a coalition formed by Joseph Locascio, the presiding judge of Kansas City Municipal Court. He also oversees the city’s specialty court aimed at substance abusers.
The main goal, according to participants, is to treat underlying problems of mental illness and substance abuse instead of having individuals cycle through the criminal justice system or show up repeatedly in the ER because they are drunk, high on drugs or perhaps have quit taking their mental health medication.
Planners said the aim is also to give law enforcement personnel an option other than arresting the individuals or taking them to the hospital. Officials said the facility would give officers a safe and secure location where they could drop off people and get quickly back out on the street.
“We don’t have a front door to go to,” Sgt. Sean Hess of the Kansas City, Mo., Police Department said at a Friday meeting of Locascio’s coalition. “We go everywhere. We are fragmented.”
Similar to KCK effort
Supporters generally refer to the facility they envision as a crisis stabilization center, much like the new program that mental health officials in Johnson and Wyandotte counties have established in the Rainbow Mental Health Facility near the University of Kansas Medical Center.
The Rainbow facility, scheduled to open April 1, has room to serve nearly two dozen clients at any given time, ranging from stays of a few hours to as long as about a week and a half.
Kansas City Councilman Scott Wagner said planners on the Missouri side have talked about a 60-person facility that could serve Platte, Clay, Jackson and parts of Cass counties.
Wagner said he would hope to have a building open by early or late next year, depending upon whether organizers can find a building to remodel or they pursue new construction.
Officials are hoping to get about $3.5 million in seed money through a state appropriation now working its way through the Missouri General Assembly. The possibility of winning that funding has expedited planning for the facility, Wagner said.
Wagner said officials with the Missouri Department of Mental Health have expressed an interest in using a crisis center in Kansas City as a pilot for potential replication in other parts of the state. A department spokeswoman referred questions about the center to budget writers in the General Assembly.
Locascio’s group is talking about holding a summit in May to discuss their plan with a broader group of local organizations.
Among the limited number of participants at the table so far, Wagner said, “Everyone is saying the same thing, which is, ‘Yes this is a need. Yes, we need to do this.’ The questions really boil down to where, and who is going to be responsible and how much is it going to cost.”
Emergency responders
Fire Department representatives are also part of the coalition since substance abusers sometimes require ambulance transport. According to a report from the municipal court, more than a third of the top ambulance users during a recent reporting period had outstanding warrants, many of which were for drug or alcohol offenses.
The other group studying this issue is the Kansas City Metropolitan Healthcare Council, a combined regional office of the hospital associations in Missouri and Kansas. The council includes about 45 hospitals, said Senior Vice President Michael Dunaway.
Locascio said he began thinking about the possibility of having a crisis stabilization center in the city last summer when he heard a local presentation by Leon Evans, the chief executive officer of The Center for Health Care Services, a comprehensive treatment program in San Antonio, Texas. One of its facilities is a substance abuse treatment program it calls The Restoration Center.
The judge and some members of his group are scheduled to tour the center next week.
Locascio said he was acutely aware of the fragmentation and lack of communication in the current system from his role at the court. His sense was that all the actors in the system, including the municipal court, sometimes worked at cross purposes.
For instance, he said, what if he puts someone in jail for a week, and, during that week, the person was supposed to see a psychiatrist at Truman Medical Centers about starting on medication?
“I’m getting in the way of the resolution of the problem that may have caused the problem to begin with,” Locascio said.
Hospital perspective
For hospitals, Dunaway said, the issues comes down to finding a better way to treat a population in a less expensive environment than the emergency room and to free up ER space for more appropriate cases.
The interest, he said, is coming from hospitals that serve urban populations on both sides of the state line in Kansas City, though he declined to name any specific institutions. The discussions are just now starting, he said.
“We are just kicking the tires to try to understand the scope of the problem,” he said.
Tom Cranshaw, who recently retired as chief executive officer of Tri-County Mental Health Services, which serves the Northland, said he expected representatives of both groups to meet later this week. He said he has connections in both camps, so he is trying to bring both sides together.
Both groups, he said, had been looking at models that seem to be working in other communities. “I hope Kansas City can learn from the experience of others,” he said.
Push back?
At the Friday meeting of the judge’s group, some participants said the idea for a separate crisis stabilization center might meet resistance from other providers.
The sense was that other agencies might look upon the crisis center as a competitor for funding.
Some attendees also said that the community already has a number of community-based services available to treat the population they are talking about, but that limited funding is keeping the system from opening all its doors.
“Would we really have the same kind of problem if all the doors were open?” said Sharon Freese, associate administrator of Truman Medical Center Behavioral Health.
For instance, Myrna Trickey, chief executive officer of the Heartland Center for Behavioral Change, at 1730 Prospect Ave., said she has capacity for 16 detoxification beds. But, she said, she only has enough funding to fill nine of the beds.
People might still fall through the cracks, even with a crisis stabilization center, if some of the other community-based services have insufficient funding, she said.
“I think the problem is huge,” Trickey said, “and you are not going to be able to address the totality of the problem. There’s got to be sort of, what is the first priority, and perhaps next year, what is the second priority?”
