Kansas health care system faces ongoing mental health bed shortages, waiver waitlists

TOPEKA — Over six hours Friday, lawmakers discussed ways to improve the KanCare system. Many of the issues sounded familiar, with residents across the state repeating concerns about disability waivers, long waitlists to receive care and workforce shortages. 

During the hearing, Kansans asked members of the Robert G. Bethell Joint Committee on Home and Community Based Services and KanCare Oversight for system reform. 

Kansans have raised the alarm about the Intellectual and Developmental Disabilities waiver program multiple times. They include parents Richard and Anna Elskamp, who have given testimony to the committee in the past few months on behalf of their 22-year-old daughter, Sheridan.

Sheridan is mentally 6 years old and has sensory issues, a history of seizures, behavioral issues, and communication delays, according to the Elskamps. They work full time, and payment for her day care is very expensive. Sheridan was placed on the Intellectual and Developmental Disabilities waiver program waitlist in 2013 and is still waiting for help. 

As of Jan. 13, 4,813 Kansans were on the waiting list for the program, marking a 19.2% increase from the previous two years, according to the Kansas Council on Developmental Disabilities. The organization said wait times were about a decade. 

The Elskamps urged the Legislature to use the state’s surplus to fund the program. 

“Do it now with the huge amount of dollars available, and make it a required part of all future spending as it should be,” their testimony read. “No one should have to wait years for the benefits they rightfully deserve.” 

Nursing homes also need more staff, said Rachel Monger, CEO of LeadingAge Kansas, in testimony to the committee. According to the organization’s data, 47 long-term care facilities have closed or reduced services in the state, with dementia care units at high risk of shutting down.  

With the aging workforce shrinking by more than 10% and labor costs increasing, Monger said providers in the organization haven’t been able to keep up with demand. She said it would become an even greater challenge in upcoming years. LeadingAge estimates that the population of people aged 65 or older will increase by 208,000 in the next 10 years. 

“The vast majority of these senior Kansans will need long-term care services and supports,” Monger said. “At a time when our state needs to be growing long term care options and investing in a senior care workforce, we are instead contracting in every direction.”

The Kansas Health Care Association and the Kansas Center for Assisted Living, the largest nursing home trade association in Kansas, said there has been a loss of more than 1,000 nursing home beds since the start of 2020, with 19 nursing homes shut down. CEO Linda MowBray asked the state to patch up gaps in Medicaid coverage and fully fund nursing homes. 

While the state still has significant shortages of mental health care workers, Kansas Department of Aging and Disability Services Secretary Laura Howard gave updates about governmental solutions to the gaps. 

One of the issues with mental health shortages is that a lack of space in psychiatric facilities has forced community hospitals and jails to provide housing and care for mentally unstable patients without reimbursement. People deemed a danger to themselves or others are processed by a district attorney’s office and sent to the county jail until a hospital bed is ready. Some inmates wait for months to be admitted to state psychiatric facilities. 

To open up more space, legislative leaders partnered with Gov. Laura Kelly to endorse the allocation of $15 million for planning a 50-bed minimum psychiatric hospital, likely to be located in Sedgwick County, with room for expansion. 

Lawmakers have also floated the idea of a $5 million fund for a two-year pilot program that would reimburse hospitals and jails that have been housing patients waiting to transfer to state hospitals.

Rep. Brenda Landwehr, R- Wichita, said the focus should be on creating more mental health beds. 

“That expansion beyond 50 beds has just got to be a huge, huge piece that’s laid out in there,” Landwehr said. “I’m not even sure if a hundred is enough. Can we staff that? Not right now, but that’s where we have to be.”