Heavy users cost the community millions


WICHITA, Kan. (KSNW) – Many leaders in the Wichita community talk about the desire to help people in crisis, but say there is also a real cost in dollars and cents to how our system operates today. Taxpayer money ends up paying for the services of many people stuck in the cycle.

The state of Wichita spent several years finding out what it cost. They looked at expenses for Ascension Via Christi St Joseph, Sedgwick County COMCARE, and the Substance Abuse Center of Kansas (SACK).

Researchers focused on heavy users – people with mental illness or substance use disorders who regularly go through the emergency department, emergency departments, drug rehab and sobering up.

Often, they are uninsured or underinsured and end up on the streets without fully managing their illness. Then he starts the cycle again.

“They are complex individuals. These are people who have decades of trauma, ”said Joan Tammany, Executive Director of COMCARE.

“They rotate and go through all the different levels of care in our community and in our state and never get exactly the right level of care that they need because it no longer exists,” said Robyn Chadwick, Ascension Via Christi St Joseph president.

With a growing behavioral health crisis, in 2015, the Kansas Health Foundation awarded a grant to Ascension Via Christi to study these heavy users. The aim was to find the gaps in the services and how much they are costing the community.

Public policy and management staff at Wichita State University conducted the research. The researchers analyzed data from 2015 to 2018, studying 519 cases of heavy users of Ascension Via Christi St Joseph, COMCARE and SACK.

“We see them in hospitals. We see them in mental health centers. We see them receiving substance use disorder treatment services, ”said Dulcinea Rakestraw, research evaluation manager at the WSU Public Policy and Management Center.

The first result was that 25% of people were heavy users from more than one organization, which meant that they would not only use the emergency department, but possibly COMCARE and SACK as well.

“There is a high crossbreeding of these individuals,” Rakestraw said.

The next conclusion was the cost.

“When people access crisis services, it comes at a very high cost,” said Rakestraw.

Between the three organizations, users received nearly $ 56 million in care over the four years. Of that, $ 17 million went through taxpayer-funded services like Medicaid and Medicare, other grants and donations from the public.

In 2018, the median cost was over $ 72,000 for each patient in the hospital, $ 20,000 for COMCARE and $ 1,000 for SACK.

“What he clearly told us and showed us is that there are huge gaps in care,” Chadwick said.

The study found that once a heavy user was released from care, they would not follow up for continuing care.

“They feel good, they are coming out of the hospital, they don’t want to see a mental health professional the same day or the next day,” Tammany said.

The study also found that wait times to transfer patients to long-term facilities were too long.

“We’re lucky if we can get them to keep that thought long enough to get them transported from here to a facility,” Chadwick said.

She said some wait times lasted two months.

Since the study’s publication in 2019, it has sparked more collaboration. As a result, the three organizations developed a common crisis plan to get more effective help from heavy users.

He also kicked off the Coalition for Addiction and Mental Health.

“If we could have services in place that take care of people and meet the needs they have, it will save money on state taxes, and it will save money for our hospital system, which in turn, will free up space for others who need emergency services, ”Chadwick said.

The coalition is continuing its work and considering several initiatives such as finding a centralized space for the meeting of services, finding a space for an expansion of COMCARE and piloting new programs, such as a system that shares patient information between organizations.

This article is a collaborative effort involving two members of the Wichita Journalism Collaborative, KSN-TV and The Journal, a print and digital magazine published by the Kansas Leadership Center. To report on this story, Journal contributor Mark Wiebe and KSN reporter Hunter Funk traveled to San Antonio to learn about the mental health system there. The Wichita Journalism Collaborative funded the trip with a grant from the New York-based Solutions Journalism Network. The Wichita Journalism Collaborative, an alliance of seven media organizations and three community groups, formed to support and improve the quality of local journalism. In addition to KSN, media partners include The Active Age, The Community Voice, The Journal (Kansas Leadership Center), KMUW, The Sunflower and The Wichita Eagle. Community partners committed to participating in the initiative include AB&C Bilingual Resources, the Elliott School of Communication at Wichita State University, and the Wichita Public Library.

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