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Lawrence behavioral health providers say some TRC patients wait in ‘bottleneck’ for longer-term treatment

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Patients who need more help than what the Douglas County Treatment and Recovery Center can provide are often stuck waiting for longer-term care that isn’t available in town, according to local behavioral health administrators.

Overall, things are going well just short of six months since the TRC first opened its doors in April, its directors told the Douglas County Commission during a work session Wednesday.

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Providers say the systems now in place are working the way they’re supposed to, for the most part, and the vast majority of the 780 patients the TRC has treated so far have been discharged into the community, as opposed to another hospital.

But for patients who need more intensive treatment, the wait to secure a bed in an out-of-town hospital can often take two weeks.

“There are no inpatient beds in Douglas County. And it has been a real challenge to go and we have a patient who needs an inpatient bed to get them to that bed within that 72 hour timeframe that we have to stabilize somebody,” said Dr. Cord Huston, medical director for the TRC. “This is going to continue to be an issue until we find a way to go and get that managed.”

The TRC is only supposed to serve patients for up to 72 hours, but sometimes it has to make exceptions. Patients are stuck waiting either at the TRC or at the emergency room, he said.

“The TRC isn’t really designed to treat that patient but we take that on because of our compassion and our relationship with the patient, right?” Commission Chair Patrick Kelly asked, and the people at the table confirmed.

“The reality is, folks don’t want to take our patients, and we are managing a level of acuity at our crisis center that the hospitals don’t want to manage. We had someone waiting for a state hospital bed for over two weeks,” said Stephen O’Neill, chief operations officer at Bert Nash Community Mental Health Center. “It’s not a regulatory issue. It is an issue where these hospitals, they don’t have an agreement that says they can’t turn people away. So they do.”

Bri Harmon-Moore, director of the TRC, told commissioners that patients with a high level of acuity will often get denied.

Also, “We will often get denials for medical things, so if people have comorbidities with medical conditions — even kind of minimal ones, so maybe hard-to-control diabetes, or something like that — they will decline them for admission for that,” Harmon-Moore said.

Commissioner Karen Willey asked how many people are currently in that “bottleneck.” Harmon-Moore said the clients change every day, so it’s hard to say specifically.

“We at the TRC are always at least involved with one or two a day that we’re trying to find something for, either within our own facility or at LMH,” Harmon-Moore said. “So I’m sure the need is pretty great — if we’re touching one or two of those patients, that LMH is probably touching several more.”

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Commissioner Shannon Reid asked about the TRC’s readmission rates, which range from 23% within 30 days to 27% within 90 days, and how those rates compare to similar centers’. But the TRC directors said they’re happy to see those patients come back.

“Hospitals have this readmission rate, and they get penalized if the patient comes back,” Huston said. “Our facility — we are the crisis plan for the patient. We want them to come back if they’re having trouble because if they come back early, we can keep somebody from having to go into needing inpatient care.”

He said the TRC is actively treating patients, and sometimes people need a momentary intervention or medication even if they’ve connected with outpatient resources.

“I forecast that our rates will go up for admission, then we’re gonna start seeing that they’re gonna start coming down because people are going to be healthier in the community long term,” Huston said.

See the full presentation in the agenda item at this link.

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Mackenzie Clark (she/her), reporter/founder of The Lawrence Times, can be reached at mclark (at) lawrencekstimes (dot) com. Read more of her work for the Times here. Check out her staff bio here.

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