Alva Review-Courier -

OSAWATOMIE, Kan. (AP) — Kansas officials are struggling with how to improve care for some of the state's most desperately mentally ill residents in a state hospital that has suffered from years of neglect and staffing shortages.

In April, lawmakers toured the campus of the Osawatomie State Hospital, which lost its federal Medicare certification more than a year ago after a patient allegedly raped a staff member in late 2015. Federal inspectors noted the hospital's outdated facilities and said they found gaps in safety that they said put patients and staff at risk, The Kansas City Star reported (http://bit.ly/2qKcSeY ).

"I think getting decertified sort of opened our eyes wide to where we are," said Tim Keck, secretary of the Kansas Aging and Disability Services.

Osawatomie was founded more than 150 years ago about 50 miles southwest of Kansas City. It serves the eastern half of the state and can house 206 patients, although the number of patients has been capped at 146 since June 2015 because of short staffing. The agency plans to add back12 more patient beds in July.

The loss of federal certification cost the state $1 million a month in federal aid. The state's other psychiatric hospital in Larned retained its certification but also struggles with low staffing.

In May, federal inspectors conducted a preliminary review in Osawatomie after the state spent $2.9 million upgrading its acute care unit. Keck and other state officials are optimistic that 60-bed unit will regain certification and the state will recapture a part of the monthly federal payments.

Even if that happens, state officials have to decide the best way to use a campus where the most recent buildings were built in the 1960s.

Gov. Sam Brownback wants the state to partner with a private company to build a new hospital and allow the company to operate it, which he believes would save money and improve treatments. Keck said the age of the campus is part of the problem because the buildings are "cramped and outdated and just not very therapeutic for a patient with mental health issues."

Some lawmakers and mental health advocates are concerned allowing a private company to run the hospital would reduce state oversight of care at Osawatomie.

"You've got to get that profit somewhere, and it's going to have to impact patient care," said Rocky Nichols, executive director of the Disability Rights Center of Kansas. "That's a serious concern of ours."

Keck said the state can build a new facility or spend an estimated $5 million remodeling buildings that house patients to get an additional five years of use. The third option is to "keep doing what we've been doing for a long time and led us to where we are now. And I'm not a fan of that," he said.

Some of the buildings have been empty since 1990s. But they haven't been razed because that would be too costly and restoring them would cost even more.

Sen. Carolyn McGinn, a Sedgwick Republican who chairs the Senate budget committee, wants a study on the cost of tearing down the unused buildings and the cost of building a new 100-bed unit at Osawatomie. She worries privatization will reduce lawmakers' ability to intervene if problems are reported at the facility.

Nichols said state lawmakers should invest the money to fix it without a private partner.

"You've broken the state hospital," Nichols said. "You need to fix it. But you can't fix it with duct tape and bubble gum. You can't fix it by bringing in a for-profit company and have them take their cut.

"The state of Kansas can issue bonds. They can get a much better bond rate than a private company could. . So if your argument is we can build new, OK, build new. That argument lends itself to the state of Kansas building it."

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Information from: The Kansas City Star, http://www.kcstar.com