When Bob Copple stopped to consider if health care in Riley County was at a crossroads, the only answer he could think of was yes.

“Quite honestly, we’ve been going through intersections for the last bunch of years,” said Copple, CEO at Ascension Via Christi Hospital. “And that’s all I see ahead is a bunch of intersections and crossroads.”

Copple, along with Chris Stipe, CEO of Manhattan Surgical Hospital; Tracy O’Rourke, senior vice president and chief administrative officer at Stormont Vail Health; Bruce Johnson, crisis stabilization officer at Pawnee Mental Health Services; Josh Gering, assistant director at Riley County Emergency Services; and Dr. Debra Doubek, president of the Riley County Medical Society, participated in a panel Thursday night hosted by the Flint Hills Wellness Coalition. The panel was asked the central question, “Is health care at a crossroads in Riley County?”

Copple pointed to a lack of specialist medical professionals in the community, rather than primary care physicians, as a challenge for the county.

“The very generic thing we think about is ‘Do we have enough nurses?’ and that’s definitely a big issue,” Copple said. “But it is just as vitally important that we have a respiratory therapist on that shift, and that we have lab techs, and that we have folks in imaging who can do ultrasound versus vascular ultrasounds.”

With upcoming specialist staff retirements, he said Riley County’s healthcare community will have to work hard to find replacements. However, he said the community has had relative success with primary care provider recruitment.

Doubek, representing area doctors, said Manhattan has seen seven new primary care physicians in the past two years, with two more on the way in the coming months. However, she said the area will be hurting for specialty care, especially in neurology and psychiatry.

As far as mental health, Johnson said growing awareness of the seriousness of mental care is good, but mental health facilities like Pawnee run into physical capacity issues and provider recruitment issues, which in turn limits their ability to provide services.

“The fact that I’m even able to be here today means that the community has changed over the past 10 or 20 years in recognizing that mental health is an important aspect of overall well-being,” Johnson said. “In 2013, mental health care or services surpassed heart conditions as the No. 1 most costly specific disorder. We also know now that one in four people at some point in their lives will experience serious mental illness.”

Gering said that first responders are uniquely positioned to feel, observe and respond to health trends in the community, and one troubling trend he said EMS has seen is a roughly 30% jump in the amount of calls for behavioral or mental health emergencies since 2017.

“These are callers whose only acute threat to their wellness is their own mental status,” Gering said. “That’s a shocking number for us. Unfortunately, that’s not something that paramedics are historically well prepared to be responsive to.”

However, the department has put all of its line officers through a mental health first aid certificate program, and officials hope to partner with the Riley County Police Department Crisis Intervention Team and the Riley County Crisis Intervention Task Force to put all of its staff through intensive crisis intervention training. That will help EMS personnel better respond to calls on the scene and avoid exacerbating mental health issues.

“Unfortunately, there have been times when as an industry, we labeled these people as ‘frequent fliers,’ and quite literally, they were just pawned off on someone else — in the truck and to the hospital,” Gering said. “At Riley County EMS, we’re not satisfied with missing that piece of the puzzle, and we’re working diligently to learn and grow and be part of the solution to that trend.”

Johnson said it’s a question of being smarter with using the little money they can get, as funding will always be an issue. By responding to and treating mental health emergencies at the scene or locally at places like Pawnee, he said every dollar spent on crisis stabilization efforts ultimately saves $2 in other community costs, like law enforcement, jail, ambulance and emergency room expenses.

O’Rourke said both capacity and space are issues for area health organizations, but clinics like Cotton O’Neil are trying to understand what the community needs through analyses in order to bring in specialists accordingly. The healthcare community needs to target community health more holistically as well, she said.

“Health is actually only about 20% in healthcare services you receive,” O’Rourke said. “Another 20% is your genetics, but the other 60% is determined by social factors — where you live, your ZIP code, the things you have access to in terms of healthy foods, healthy habits, safe housing. Those aspects are what you think about to shift community health and what we can be doing collectively takes partnership to address those needs first.”

Several of the panel members said healthcare legislation at the state level will be critical.

“Our Kansas legislators need to pass Medicaid expansion. Our three legislators, Tom Hawk, Sydney Carlin and Tom Phillips, get it,” Doubek said. “Full disclosure, I’m married to Tom Philips, but they get it. They voted for expansion. What we need to do is get out to the other areas of the state and help their districts vote in senators and state legislators because our legislators get it.

“From January 2014 to this week, the federal dollars that could have been given to Kansas are $3.3 million,” Doubek continued. “Those have gone to other states for their underserved and low-income people.”

In a presentation before the panel, Riley County Health Department director Jennifer Green said that in Riley County, the percentage of the population under 65 that doesn’t have health insurance sits at 9%, compared to 6% nationwide. In Kansas, that same rate is 10%. The target is to eventually end up with a 0% uninsured rate.

“We’re getting better, but we’re not there yet,” Green said.

Copple said Kansas’ comparatively higher uninsured rate is probably because the state legislature has not passed Medicaid expansion, and that it will take both legislative and advocacy work to improve those numbers.

On the provider’s end, burnout is a pressing issue for workers, especially when they have to work extensive shifts and days. The panel said their organizations have taken steps to reduce burnout, including streamlining tedious administrative tasks and limiting the amount of service provided. Copple said by limiting the number of days some specialists are on call, those specialists are better rested and tend to stick around the community, and although it might mean a small inconvenience for some patients in the community, it means the area keeps the specialists and their service.

As far as the community’s role in improving healthcare, the panel said citizens should give their healthcare providers feedback, especially when things go right. In an industry so focused on responding to when things go wrong, thank-you’s and appreciation go a long way, they said.

The panel said it’s important to recognize the work area healthcare professionals have put in. With a focus on preventative care and improving the general state of healthcare access, Riley County should expect healthcare outcomes to improve in the next couple of years, and that’s something the community should take pride in, the panel said.

“The fact that we’ve had such success on recruiting primary care, that will lead to other things,” Copple said. “It’s just a matter of getting people into the doctor now.”

City reporter for the Manhattan Mercury