Tuesday, June 30, 2009

Future of Kansas Neurological Institute uncertain

From The Topeka Capital-Journal. In the picture, Kansas Neurological Institute client Allen Jaimez helps client trainer Samantha Schappilly fill bags with sand for a balloon order. Jaimez pushes the button to make the machine pour the sand into the bag.

Home for more than 150 people with exceptional disabilities is a sprawling campus unlike any other in Topeka.

A team of 500 medical, occupational and direct-care staff members at Kansas Neurological Institute meet around-the-clock needs of an adult residential population with the following profile: 88 percent have profound intellectual disabilities, two-thirds are unable to walk, 82 percent can’t speak, two-thirds have a history of seizures and more than 90 percent have lived there at least a decade.

Still, more than 130 residents hold part-time jobs. They live with a measure of independence in two dozen group homes that have little in common with the warehousing model common decades ago.

“Our mission is to provide a meaningful life for everyone who lives here,” said Barney Hubert, superintendent at KNI. “It would have a significantly detrimental effect on peoples’ lives to close the campus.”

With state government tax revenue falling off a cliff and a majority of Kansas legislators opposed to tax increases sufficient to recharge the treasury, budget cutting has sliced hundreds of millions of dollars in expenditures in the past year.

It isn’t enough.

A special state commission formed in January by then-Gov. Kathleen Sebelius is exploring potential closure, consolidation or relocation of at least six state facilities to save money.

Targets include KNI and another state residential facility for disabled adults, Parsons State Hospital in southeast Kansas. Parsons serves approximately 200 people with developmental disabilities and employs 500 people. The state spends about $150,000 annually on each resident. At the same time, both facilities inject more than $25 million into the economy of Topeka and Parsons.

“If you have to look at what the future holds, the future includes closing one of these institutions,” said commission chairwoman Rochelle Chronister, a former state legislator and secretary of the Kansas Department of Social and Rehabilitation Services.

The 11-member commission also is weighing the future of Rainbow Mental Health Facility in Kansas City, Kan., Kansas School for the Deaf in Olathe, Kansas School for the Blind in Kansas City, Kan., and Beloit Juvenile Correctional Facility in Beloit.

The panel’s report — due Dec. 1 — will be controversial.

Sen. Jay Emler, R-Lindsborg, and chairman of the Senate Ways and Means Committee and member of the state facilities commission, said reform was a financial imperative.

“We’re in a world of hurt on the budget,” he said. “We need to make provision for change.”

Blowback has been intense from every constituency on the radar screen of the Facilities Closure and Realignment Commission.

Law enforcement officers in Johnson and Wyandotte counties have been fervent supporters of the 50-bed, short-term treatment facility for people suffering acute mental health episodes.

Prairie Village Police Chief Wes Jordan, president of the Johnson County Police Chiefs and Sheriffs Association, said lack of access to Rainbow could force agencies to treat the mentally ill more as criminals than as people in need of treatment. Osawatomie State Hospital is a two-hour round trip for an officer, while Rainbow is no more than a 30-minute drive.

During the past decade, hospitals in the Kansas City metropolitan area closed 700 inpatient psychiatric beds.

“If you ultimately decide this facility should close, I do not believe an open door will be in close reach,” Jordan said. “I am concerned that law enforcement will be forced to turn to the criminal justice system instead of the mental health system.”

He said officers were recently dispatched to a Prairie Village park on a report of an auto burglary in progress. Police found an adult male rummaging through cars. The man’s explanation: He was looking for cannibals.

“Although we could have certainly charged this person with a crime, it was obvious he was in need of mental health treatment,” Jordan said. “We do not need to put mentally ill people in jail. To me, it’s almost morally wrong.”

Advocates for the state’s schools for the blind and deaf have been equally resolute in advocating for those facilities.

Kevin Enyart, a 1985 graduate of the School for the Deaf, worked as a mail carrier for more than 15 years.

“I’m so thankful my parents decided to send me to school here,” he said. “If I’d stayed in the public school I might have dropped out and not gone to college.”

Mikel McCary, who graduated from the School for the Blind in 1995, said living in a dormitory with other blind students at the school provided academic, mobility and life skills that allow him to live and work in the mainstream.

“The staff members were like parents to me. The students who were there at the time I was were more along the lines of siblings rather than classmates. We fought, laughed and learned together as a family might do,” McCary said.

Less controversial, perhaps, will be a final decision about the juvenile facility in Beloit. The state’s Juvenile Justice Authority holds 350 teenagers in three correctional facilities. About 220 are in Topeka and more than 100 in Larned, with a couple dozen in Beloit.

The state closed a juvenile facility in Atchison in December and is expected to save about $2 million annually. Shutting down the Beloit operation and shifting those juveniles to Topeka could reduce state expenditures by $4 million a year.

“When you’ve got a $4 million budget and 20 kids, essentially, you’re spending $200,000 on each kid in the program. That’s expensive,” said Russ Jennings, JJA superintendent.

Anyone who thinks this commission’s report will do nothing more than collect dust on a Statehouse shelf, may want to reconsider their conclusion.

Rep. Bob Bethell, R-Alden, and chairman of the House Aging and Long-Term Care Committee, said the emotional weight of the commission’s task was overwhelming. He said a balance must be struck between the necessity of serving the needs of Kansans and respecting the budget challenges of state government. However, the state’s financial crisis makes reform of these state facilities unavoidable.

“I do not believe the status quo is appropriate,” Bethell said.