The cost of added staff brought an end to many treatment programs in our area. In the same area today, there are only four inpatient treatment programs, including Larned State Hospital. Those that remain have drastically reduced their level of service or have received State funding. In the beginning, Family Recovery Center regularly sent 50 to 75 applicants away annually because they were not able to pay for treatment. ADAS agreed to partially fund Family Recovery Center, primarily because of the outpatient day treatment program, which could also provide a component of up to 10 days of intermediate treatment.
Intermediate treatment is nonmedical residential care.
The advantage of such an outpatient day schedule is that when managed care emptied our beds, we were prepared with an alternate program. Like most inpatient units, our inpatient admissions have gone down drastically since the advent of managed care. Inpatient treatment dropped from 813 to 333 days during the same period in which the number of outpatient day sessions provided climbed from 749 to 1,623. Figure 1 shows the evolving pattern in utilization of outpatient, inpatient, and intermediate care days between 1987 and 1993, with ADAS support beginning in 1988. Our experience has shown that, when correctly referred, patients who complete outpatient day treatment have about the same level of recovery as inpatient treatment patients, but there are definitely times when treatment in a residential program is important.