<figure>
 <img src="https://media.eaglewebservices.com/public/2021/6/1623419696853.png" alt="Carlos Moreno / KCUR 89.3" />
 <figcaption>Carlos Moreno / KCUR 89.3</figcaption>
 </figure>By CELIA LLOPIS-JEPSEN <a href="https://www.kcur.org/news/2021-06-10/kansas-now-has-the-beds-need-for-most-kids-awaiting-psychiatric-care-but-not-the-workers">Kansas News Service</a>Psychiatric facilities across Kansas added enough beds last year to 
potentially dramatically cut the number of children waiting for 
intensive mental health care.But about 100 of those spots remain empty — in large part because organizations can’t find workers.In
 recent years, children have had to wait months for openings in 
specialized facilities that offer long-term psychiatric care. In 
mid-2018, the average wait neared 200 days.The waits fell in 2019 and 2020. As of last month, the average wait stood at 44 days.Yet 146 remain in line for their turn, even though 104 beds are open.Despite significant efforts to expand capacity, the residential care centers have hit fresh roadblocks.They’re
 struggling to compete in the current labor market. They need to fill 
shifts around the clock for physically and emotionally taxing work that 
sometimes pays less than $15 an hour.<figure>
 <img src="https://media.eaglewebservices.com/public/2021/6/1623419775096.png" alt="" />
 <figcaption></figcaption>
 </figure>And hiking wages is no simple task.Take KidsTLC in Olathe. 
It’s searching for the money to make that happen, while also nudging the
 state of Kansas to help it explore other incentives. Those could range 
from college tuition waivers and signing bonuses to subsidies for health
 insurance or child care.KidsTLC bought land in March 2020 to add another 50 beds for children.The
 expansion included specialized units for children with the most severe 
traumas and disorders, who often face the longest waits for placement — 
such as a program for victims of sex abuse who lash out sexually.That
 work finished in December, nearly doubling KidsTLC’s residential 
capacity. It hoped to fill the spots in two or three months, but 45 of 
the new beds remain empty.“We had space, we were licensed, and 
were feeling just exceptional about that and being able to make a 
significant dent in that waitlist,” CEO Erin Dugan said. “And then it 
became really hard to hire staff.”<h2>Longer-term care</h2>Nonprofit
 facilities offer more than 400 beds for long-term psychiatric care of 
youths across Kansas. Many of those slots were added within the past 
year and a half as the administration of Gov. Laura Kelly worked to 
license more beds and reduce wait times.“So we are proud of the 
improvement,” said Andrew Brown, the state’s commissioner of behavioral 
health services, “but ideally we would like to get to the point where 
people didn’t have to wait even a month, right? We’d like to get to the 
point where the average time is about a week or less.”Psychiatric
 residential treatment facilities are for children and youths whose 
conditions don’t improve through other care. They may struggle with 
severe depression, for example, or attachment disorders resulting from 
childhood abuse.Those services are different from acute mental 
health care. Children at risk of harming themselves, for example, can 
get immediate short-term care. But when they walk out of the hospital, 
the residential program that some may need for weeks or months of 
follow-up treatment takes longer to get into.KidsTLC wants to 
fill its empty beds, but won’t until it has the personnel to do so 
safely. It has almost 300 workers but wants about 425.<figure>
 <img src="https://media.eaglewebservices.com/public/2021/6/1623419807409.png" alt="" />
 <figcaption></figcaption>
 </figure>The agency hasn’t struggled to recruit and retain therapists and 
other salaried specialists. Hourly staff trained to work on site 24-7 
are a different matter. Dugan hopes more applicants — who must be at 
least 21 years old — will materialize as the pandemic winds down.She isn’t counting on it.Her organization offers $14-an-hour starting pay. It was working toward $15 before the pandemic hit, and is now considering $16.“These
 folks need to be paid more, so that it is a living wage and they can 
take care of their families and do the job they love and make an impact 
in the community,” she said. “The Amazons of the world, the FedEx, the 
places where 21-year-olds go to work — they’re paying $18, $19, $20.”Hiking pay will require significant fundraising by KidsTLC, which gets paid by Medicaid for its patients.Medicaid
 rates are widely considered low compared to private health insurance. 
KidsTLC expects Medicaid would likely eventually increase its payments 
in recognition of the higher hourly pay, but it says adjustments like 
that take six months to a year to kick in and won’t help retroactively.“We
 are this month sitting down to say, how do we find this large infusion 
of dollars, to at least get our minimum wage to 15 or 16?” Dugan said. 
“How does KidsTLC find a couple million dollars? It’s not sitting 
around. We don’t have a couple millions of dollars sitting around.”She said the state is also encouraging her to put together cost estimates for her other ideas, such as child care subsidies.<h2>Aetna paperwork delays</h2>Meanwhile, the state has called on one of its Medicaid contractors to reduce wait times for kids.The
 Kansas Medicaid system — also known as KanCare — is privatized. Anyone 
on Medicaid falls under one of three private companies that run the 
program: Aetna Better Health of Kansas, Sunflower or UnitedHealthcare.Those
 companies review and approve applications for residential treatment. 
But after the state began tracking wait times by company in 2019, it 
revealed that children with Aetna waited significantly longer than those
 with Sunflower or UnitedHealthcare. The company appeared to have 
problems promptly gathering paperwork such as parental releases to get 
children in line for care.“We hope that we will see improvements,” Brown said.In a statement to the Kansas News Service, Aetna said it took swift action after the state pointed out the problem.“We
 immediately took steps to review our process, identify causes for 
delays, and implement the changes necessary to minimize interruptions in
 care for our members,” the statement says. “As a result of our internal
 review we have modified our processes to eliminate avoidable delays.”Editor’s note: This story was reported in memory of KCUR reporter <a href="https://www.kcur.org/news/2021-04-25/kcur-reporter-and-beloved-colleague-aviva-okeson-haberman" target="_blank">Aviva Okeson-Haberman</a>, a dedicated journalist who began the research for it and submitted the open records requests shortly before her death.Celia
 Llopis-Jepsen reports on consumer health for the Kansas News Service. 
You can follow her on Twitter @celia_LJ or email her at celia@kcur.org.

Kan. has beds for most kids awaiting psychiatric care, not the workers