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State reviews psychiatric residential treatment capacity for youth; McKinsey study recommends mix of bed and community investments
Summary
KDADS presented a McKinsey study and options to ease a growing wait list for psychiatric residential treatment facilities for youth, including supplemental per‑diem increases for specialty beds, more staffed beds, and investment in outpatient and aftercare services.
Drew Adkins, KDADS commissioner for behavioral health, briefed the committee on shortages of psychiatric residential treatment facility (PRTF) capacity for youth and a consulting study that identifies options to address the gap.
Adkins said Kansas had 450 licensed PRTF beds but 123 of those were not staffed, leaving a census of about 301 and a wait list of roughly 72 children as of June 20, 2025 — including 33 in foster care. KDADS presented findings from a McKinsey & Company analysis commissioned under a 2023 proviso that examined options to expand capacity and reduce readmissions.
Options reviewed included:
- Add specialized capacity: expand staffed beds or convert non‑staffed beds to specialties that can serve dual-diagnosis or justice-involved youth; supplement per-diem rates for specialized care (study suggested 50–75% per-diem increases for specialty PRTFs in some scenarios).
- Build non-specialized capacity: increase staffed beds for youth without specialized needs to relieve pressure on the system.
- Strengthen the care continuum: expand aftercare and outpatient services, including PRTF discharge planning and supports to reduce readmissions and boost step-down care.
Adkins said an estimated up-front investment of $12–18 million and annual incremental Medicaid costs of $11–17 million were possible examples depending on the option selected; McKinsey estimated cost avoidance from reduced emergency use and failed placements could partially offset investments.
Adkins told the committee KDADS is also piloting PRTF aftercare models and workforce grants funded in recent years have yielded job and staffing improvements in some facilities. He said regulatory changes would likely be necessary to create specialized PRTF units and that any rate changes or program options would require a Medicaid state plan amendment and LCC review under HB 2240.
Ending: KDADS asked the committee to consider the report’s options, including targeted rate increases, regulatory adjustments for secure or specialty PRTF units and investments in outpatient/aftercare supports; officials said they will return with cost and implementation details for the committee’s review.
