LARNED — As it sits on a 78-acre campus three miles west of Larned in Pawnee County, the Larned State Hospital is a complex place.
Just finding their way to the Auditorium, on the west side of the Administration building in the center of the complex, was a problem for several out-of-county leaders making their first trip to LSH on Monday.
Finding out what LSH is, and what it does, was a focus of Monday’s leadership conference hosted by the Pawnee County Commissioners in one of the more historic buildings on campus, noted Commissioner Bob Rein.
“What we’d like to achieve today is get a better understanding of what Larned State Hospital does and what Larned Correctional Mental Health Facility does,” Rein said, as more than 50 leaders from several counties gathered for a luncheon program presented by LSH and LCMHF administrations; officials from their Topeka oversight agency, the Kansas Department of Aging and Disability Services; and staff from Kansas Gov. Laura Kelly’s Office. “It is evident that some people do not have a good grip on what Larned State Hospital is, what it does and why it’s important. Not only as a regional employer, but as a pillar of the mental health system in the state. When Larned State Hospital isn’t healthy, it creates a lot of strain on organizations and people in many counties in Kansas.”
LSH Superintendent Lesia Dipman presented a brief overview of the history and composition of the complex, which today includes the Psychiatric Services Program (PSP) for voluntary, on-hold (from law enforcement) and civilly-committed patients; the State Security Program that performs forensic evaluations and admits court-ordered patients; and the Sexual Predator Treatment Program (SPTP), which is charged with maintaining a secure environment for those civilly committed as sexually violent predators in treatment.
Additionally, LCMHF Warden Tim Easley presented an overview of the facility whose focus has evolved over the past decade to provide community transition for minimum- and medium-custody inmates as the smallest of seven facilities in the Kansas Department of Corrections.
KDADS Deputy Secretary Scott Brunner and Ryan Wright from the Governor’s Office also highlighted measures being taken to enhance working conditions (salaries) for front-line staff, identify and mitigate security issues, and investigate programs and services that can reduce pressures on law enforcement offices within the system.
Highlights within each administrator’s presentation included issues exacerbated by the pandemic, including staffing shortages, waiting lists for treatment and patient bed space.
Dipman noted that the pandemic had influenced PSP procedures since May 2020, when a managed moratorium notification was issued. While working to keep the hospital open to admissions, COVID-positive cases required separate isolation units and staffing levels required 1-on-1 or 2-on-1 supervision. With a budgeted bed space availability of 90 patients, that number was reduced to 72, initiating a waiting list. In December 2021, critical staffing levels resulted in admission restrictions to 62. Admission protocols were adjusted to admit new patients equal to the number of discharges. The waiting list operates on a first-in, first-out basis, with 12 patients on the list per month.
Recently, however, the admission number was adjusted back to 74, as positive case levels have declined, Dipman noted.
Brunner said that the recent per-hour wage increases for both Mental Health Developmental Disability technicians and nursing staff is hoped to increase recruitment. KDADS is currently evaluating security needs, with not only the addition of cameras and fencing, but also updating “badge-in” identification readers and restricting access to lower security areas. Contract services for front-line positions have partly “filled the gaps,” but are an “expensive proposition,” he noted.
From the Governor’s office, Deputy Chief of Staff Ryan Wright noted that issues facing security and those affected by the pandemic will not be fixed overnight.
“There were problems before COVID, obviously, staffing has always been an ongoing issue,” Wright said. “But COVID just amplified all of those issues. We knew we weren’t going to get out of this mess overnight, so one of the first things we did is invest in our people, increase salaries so we can attract employees to the facility.
“Because of the staff shortages here, there have been enormous pressures placed on the system throughout every level of the facility,” Wright explained. “We are actually in the process of doing a comprehensive review in the HR space to see how we can get additional resources into the space. The staff that are here are dedicated, hard-working and have been doing this for an extended period of time throughout the pandemic, with a population that is often in crisis. In addition to that, we are also taking a comprehensive review of the security of the facility.
“We are planning to add more cameras, but there is more to that. There is a team that is now out doing that review. It’s not just cameras and fencing, but as in the SPTP, emergency call buttons, how we keep people safe when they are on the floor.
“We are waiting on those findings to come back,” Wright said.
Wright also said that the office is looking at tying the pay scales of the state hospitals and LCMHF together “so that there is not poaching of staff back and forth between the facilities.”
While legislators have been mostly receptive to Gov. Kelly’s list of budget enhancements, “a few key items” will be moved to the end of the legislative session in an omnibus bill, he said.
Other items discussed during the question-and-answer session at the end of forum included Alternative Treatment Centers (ATCs) such as Cottonwood Springs in Olathe and Prairie View in Newton.
Mobile Crisis Units, such as in the Wichita area, are also designed to provide 24-hour call access to a master’s level therapist and a case manager for emergency assessment, for individuals in crisis that are unable to physically come to the local community crisis center.