Mass shootings raise concerns about Kansas mental health system
A photo from the original blog post leading to the viral 'I Am Adam Lanza's Mother,' a mom's perspective on the mental illness conversation in America. by KHI News Service
Like many Kansans, Rick Cagan spent much of last weekend reading and listening to news reports about the gunman who killed 20 children and six adults at an elementary school in Newtown, Conn.
Cagan had a professional reason for learning what he could about the tragedy. He runs the National Alliance on Mental Illness-Kansas Chapter office in Topeka.
“It’s devastating,” he said. “It’s heartbreaking.”
According to initial news reports, the gunman, 20-year-old Adam Lanza, may have suffered from a personality disorder or had been diagnosed with Asperger’s, a form of autism. However, there is no indication that he had the kind of severe mental illness suffered by others responsible for mass shootings.
Jared Loughner, the man convicted of shooting former Arizona Congresswoman Gabrielle Giffords and killing six others, for instance, suffered from schizophrenia, a mental illness that causes disordered thinking and delusions.
And James Holmes, the man accused of shooting 12 people to death and wounding 58 others last summer at a movie theater in a Denver sought mental health treatment before the attack, according to multiple news reports.
Mass shootings nearly always rekindle debates about gun control and the adequacy of the nation’s mental health system. Commenting on the later, Cagan said many Kansans with mental illness are not getting the early treatment they need to avoid crises.
“More than 60 percent of the adults who have a serious mental illness are untreated,” he said, noting that in Kansas half the admissions to the state hospitals for the mentally ill involve people who’ve had no previous contact with their community’s mental health center.
In Kansas, state-hospital admissions are reserved for adults who are seriously mentally ill and have been deemed a danger to themselves or others.
“NAMI is always reluctant to jump in with some sort of comment when these kinds of incidents occur because there’s so much that we don’t know,” Cagan said, referring to the shootings. “But, still, blaming the individual only goes so far. At some point, we have to look at the overall well-being of our mental health system.”
Budget cuts in the mental health system
Kansas’ system, he said, hasn’t fared well in recent years.
“I don’t like saying this,” Cagan said, “but we’re just lucky this didn’t happen in Kansas.”
Kansas birth rate hits record low
New data in the state's 2011 Vital Statistics report shows a decline in the Kansas birth rate to the lowest level since the record keeping began in 1912. The abortion rate also fell to a record low. by KHI News Service
The annual report of births, deaths and other vital statistics by the state health department is now available. The new data shows a decline in the Kansas birth rate to the lowest level since the record keeping began in 1912.
The abortion rate also continued to decline and reached the lowest level since 1971, which is when abortion reporting began.
The birth rate in 2011, according to the report, was 13.8 live births per 1,000 population.
There were 39,628 live births recorded, about 2 percent fewer than reported for 2010. The rate was slightly lower than the previous low of 13.9 births per 1,000 population in 1973.
Births to young mothers, those under age 20, were down 8.6 percent.
Among the other report findings:
• Cancer again topped heart disease as the leading cause of death.
• Injuries from accidents and pneumonia/influenza each rose one level in the ranking of top 10 causes of death, coming in at fourth and eighth respectively.
• There were 247 infant deaths in 2011, a decrease of 2.4 percent from the 253 deaths in 2010. Pregnancy associated maternal deaths increased to 24 in 2011 from 19 in 2010.
• The number of reported abortions fell from 8,373 in 2010 to 7,885 in 2011. The ratio was 99.6 abortions per 1,000 live births.
→ More Kansas vital stats from 2011 in the full report, available on khi.org.
Health officials urge Kansans to get flu shots soon
Nine-year-old Abigail Wimbley being vaccinated by nurse Rebecca Goodloe at the Franklin County Health Department. Abigail's 13-year-old brother J'IL (left) was vaccinated, too. by KHI News Service
State health officials this week warned that flu season is upon us and encouraged Kansans to get vaccinated, if not for their own benefit, then for the sake of their family and community.
“By getting your flu vaccine before you see or hear about the first case of flu in your community, you give yourself and your family the best opportunity to stay flu-free throughout the season,” said Ryan Burns, immunizations director at the Kansas Department of Health and Environment.
“Although influenza can occur at any time, October is often thought of as the start of flu season, so acting now is a great way to get that protection,” he said. It takes about two weeks for the body to develop resistance to the flu virus after a vaccination.
Officials recommend that everyone 6 months and older get a flu shot annually. Some children age 6 months to 8 years may need two shots this year.
Flu shots are widely available at local health departments and many doctors' offices and pharmacies. This map identifies vaccine availability by area.
Every year, 5 percent to 20 percent of the population gets the flu, more than 200,000 people are hospitalized for flu complications and about 36,000 people die from flu. Some people — including infants, children, elders and people with certain health conditions — are at high risk for serious flu complications.
Governor’s claim of waiting list progress challenged
Federal officials have not responded to Gov. Sam Brownback’s assertions that his administration is in full compliance with the Americans with Disabilities Act.
But advocates for the physically disabled say the governor’s recent open letter to federal officials asserting his administration is doing enough to help people with physical disabilities live in community settings should not go unchallenged.
“The state’s own numbers don’t support the governor’s position,” said Shannon Jones, executive director of the Statewide Independent Living Council of Kansas. “If you go back three years and look, there were 7,200 (physically disabled) people receiving services. Today there are 6,100. That’s not an increase, it’s a decrease.”
Jones’ group has been at the forefront of the state’s ADA-compliance issue, encouraging hundreds of disabled people to file complaints with federal authorities over a prolonged waiting list for services that has been growing since at least 2008.
An investigation
Officials at the U.S. Department of Health and Human Services responded to the complaints in 2009 by opening an investigation.
Then last month, Leon Rodriquez, director of the HHS Office of Civil Rights, announced that efforts to get the Brownback administration to reduce the waiting list for home- and community-based services had stalled and that the case had been turned over to the U.S. Department of Justice.
The decision increased the likelihood the state would be sued in federal court, similar to actions that the Justice Department has taken in other states with growing frequency under the administration of President Barack Obama.
Brownback responded to Rodriguez with a public letter expressing disappointment with the agency’s decision.
Underlying the dispute is a 1999 decision in a U.S. Supreme Court case, Olmstead v. L.C., which found that states have an obligation to ensure that Medicaid-funded services for people with physical and mental disabilities are provided in the most integrated settings appropriate to their needs.
Subsequent rulings involving other states have found that stalled or slow-moving waiting lists constitute violations of the ADA, which became national law in 1990 in large part thanks to then-U.S. Sen. Bob Dole of Kansas, who was left disabled for life by serious wounds suffered in World War II.
Assigning blame
In his letter to Rodriguez, Brownback, a Republican, argued that his administration had inherited the waiting list from former Gov. Kathleen Sebelius, who in December 2008 “implemented a freeze on new beneficiaries” and in March 2009 amended the policy to allow one person to begin receiving in-home services for every two who exited the program.
Sebelius, a Democrat, left Kansas to become HHS secretary in April 2009.
Brownback noted that in May 2009, HHS informed Sebelius’ successor, then-Gov. Mark Parkinson, also a Democrat, that the agency had started investigating the waiting list complaints.
“Effectively, Secretary Sebelius decided upon joining the Obama Administration that Governor Sebelius and her policies were in violation of federal law,” Brownback wrote.
→ Continue reading this story, and download Brownback's letter, at khi.org.
Kansas health centers awarded $21.7 million to expand services
In Pittsburg, the community health center so desperately needed more space that last year staff converted closets and a bathroom into offices.
But next year the number of patients the center sees is expected to grow 24 percent, said Krista Postai, chief executive of the Community Health Center of Southeast Kansas.
"And I have no place to put them," she said. "This building is totally and completely at capacity."
That should soon change.
By December 2014, using a $4.7 million federal grant, the center will nearly triple its space from 15,000 to 40,000 square feet.
The grant was announced today by the U.S. Department of Health and Human Services. It is part of more than $21.6 million awarded to five Kansas community health centers.
About 40,000 new patients will gain access to care thanks to the construction and renovation projects funded by the grants, according to HHS.
The funding stems from the Affordable Care Act, which authorized $9.5 billion to expand health services over five years and $1.5 billion for construction and renovation at community health centers.
“For many Americans, community health centers are the major source of care that ranges from prevention to treatment of chronic diseases," HHS Secretary Kathleen Sebelius said in a prepared statement. "This investment will expand our ability to provide high-quality care to millions of people while supporting good paying jobs in communities across the country.”
The grant amounts for the other Kansas health centers were:
■ $2.7 million for the Salina Family Healthcare Center in Salina.
■ $4.6 million for Hunter Health Clinic in Wichita.
■ $4.5 million for Konza Prairie Community Health Center in Junction City.
■ $5 million for PrairieStar Health Center in Hutchinson.
The grant funds were disbursed directly to the health centers, which are private, nonprofit organizations.
Southeast Kansas
In Pittsburg, the new construction is set to begin in July and finish by December 2014, Postai said.
The center will then be able to expand most existing services as well as add optometry, physical therapy and speech therapy services. An estimated 8,200 additional patients will be able to access the center.
Plans are to add 42 positions at an average salary of $45,700 as a result of the expansion, center officials said.
The waiting room has been at capacity for years with more demand on it after one of the area's biggest employers was shuttered at the end of 2008. The wheel maker Superior closed as the auto industry crashed and the number of people near Pittsburg without insurance shot up from 12 percent in 2009 to nearly 18 percent in 2010.
"From the time we open, it is wall-to-wall people. We need space," Postai said. "You can only be open so many hours and you can only schedule so creatively. And our efficiency has been impacted by our lack of space."
Civil rights enforcers meet with governor on waiting list issue
Four civil rights enforcers from the U.S. Department of Health and Human Services met privately today with Gov. Sam Brownback and top Kansas welfare officials to discuss the state's long waiting list for services to the disabled.
Federal officials for several months have been reviewing complaints filed against the state by disabled persons and their advocates and now seem poised to take some sort of legal action, if Kansas doesn't move to remedy the problem.
Federal courts have found states in violation of the Americans with Disabilities Act for not providing adequate services to the disabled and federal officials have warned for months that they would act if the state didn't move to shorten the lists.
In Georgia, the state has had to spend close to $100 million over the past three years on additional services for the disabled as the result of a settlement with the federal government.
“Kansas had better be paying attention,” said Deirdre O’Brien, an advocate of the developmentally disabled in Georgia. “Let me tell you, the Department of Justice isn’t fooling around on this. They’re pretty serious.”
Leader of the federal visitors was Leon Rodriguez, national director of the HHS Office for Civil Rights in Washington, D.C. He was joined by Frank Campbell, the agency's regional director for civil rights. Also in the group were Mary Giliberti, a ranking HHS civil rights analyst and Robinsue Frohboese, a top civil rights litigator for HHS.
Neither Kansas nor federal officials would comment on the record about the details of the meetings.
But Brownback administration sources said the federal officials made clear they were prepared to take action unless movement is seen in the waiting lists.
Kansas officials to sit down with feds over waiting list concerns
Advocates for disabled say feds poised to act on alleged Kansas Olmstead violations.
Advocates for the disabled say they believe the federal government is close to taking action against the state of Kansas for violating the Americans with Disabilities Act.
Federal officials for months have been reviewing complaints filed by disabled Kansans and they are scheduled to meet later this week in Kansas City with state officials to discuss the issue and their findings, a step that often precedes federal action.
The disabled consider the ADA a civil rights landmark and a major highlight of the legislative legacy of former U.S. Sen. Bob Dole, a celebrated Kansas Republican who himself was disabled by grave wounds suffered as an infantryman in World War II.
For years, Kansas had the reputation of being a leader among states in providing services to the disabled, and sometimes was cited in court cases elsewhere in the country as an example of how things should be done.
But since the late 1990s, Kansas has had a growing waiting list for services. And many believe that has put the state at odds with the federal law at a time when the U.S. Justice Department has stepped up its enforcement of the disabilities act.
Since President Obama took office, the U.S. Department of Justice has joined or filed more than 25 lawsuits alleging discrimination against the disabled in 17 states.
In Georgia, the state has had to spend close to $100 million over the past three years on additional services for the disabled as the result of a settlement with the federal government.
“Kansas had better be paying attention,” said Deirdre O’Brien, an advocate of the developmentally disabled in Georgia. “Let me tell you, the Department of Justice isn’t fooling around on this. They’re pretty serious.”
Might Kansas be next?
Turning point
Seven months ago, U.S. District Attorney Barry Grissom said the U.S. Department of Health and Human Services was weeks away from citing Kansas for not doing enough to help disabled people live in community settings rather than in institutions.
The state, he said, either would have to expand its network of home- and community-based services or face the likelihood of his office filing a lawsuit in federal court.
“This is a big deal guys,” Grissom said, addressing a July 21, 2011, meeting of the Topeka Human Relations Commission. “It’s a really big deal.”
→ Continue reading at khi.org/ada.
