Nearly 70 percent of more than 600 Kansans with serious mental illness living in specialized nursing homes prefer to be discharged and integrated into community programs with residential and service supports, authors of a new report said Monday.

That revelation was highlighted in the Disability Rights Center of Kansas' survey of nearly half of Kansans living in the state's for-profit nursing facilities focusing in residential care of people with persistent mental health challenges. The Disability Rights Center's report, shared with members of the administration of Gov. Laura Kelly, derided a system in Kansas that did little to promote transition of the nursing facility clients to community mental health providers.

While 69 percent of residents of the mental health nursing facilities expressed interest in moving to a less-restrictive environment in a community, the report said, only 9 percent of those individuals had a discharge plan. The report said 113 of 280 people interviewed had lived in one of the nursing homes for at least six years.

Rocky Nichols, executive director of the Topeka nonprofit Disability Rights Center, said the state was discriminating against the mentally ill by maintaining a system of "de facto warehouses" in violation of state and federal law. This category of nursing facility catering to the mentally disabled runs afoul of the Americans with Disabilities Act and Kansas anti-discrimination laws because people unnecessarily remain in these institutions with little prospect of leaving, he said.

He said state funding of the nursing homes increased 47 percent since 2007, while aid to state mental hospitals went up 35 percent during that time. Appropriations to the community mental health system fell 16 percent in that period while serving 30,000 more Kansans. The network of 26 community mental health centers received a $5 million increase in state aid in the upcoming fiscal year, but that left appropriations $6 million below the 2007 benchmark.

Financial, legal and health challenges are well-known to state government officials who struggle to break free of the status quo and by nursing facility operators with no incentive to transition people into community settings, Nichols said.

"We used the term 'open secret.' There hasn't been the will, political or otherwise, to change it," he said. "People are stuck there. They want out. It is something that needs to change."

Laura Howard, secretary of the Kansas Department for Aging and Disability Services, agreed with the Disability Rights Center's view that the state ought to have done more in the past to create opportunity for mentally ill residents of nursing facilities to move on.

"This isn't a new issue," said Howard, who was hired in January by the governor. "This topic is already on our work agenda."

She applauded the Disability Rights Center's interest in invigorating debate, but she took exception to language in the report comparing the state's approach to warehousing. KDADS is expected to apply by January for new federal funding to provide mental health treatment for people 21 to 64 years of age who live in psychiatric nursing facilities, Howard said.

Cindy Luxem, executive director of the Kansas Health Care Association, which includes the 10 nursing homes for the mentally ill, said the state's network of community safety-net providers didn't have the capacity to handle massive influx of people exiting nursing homes.

"These 650 individuals with severe and persistent mental illness, if they didn't have an opportunity to be part of a Nursing Facility for Mental Health, I'd be hard-pressed to think we could find services for them across the state," Luxem said.

She said four of the 10 nursing facilities were in state receivership because of financial difficulties, but argued their plight shouldn't be justification to shut them all down. Facilities in receivership are Providence Living Center in Topeka, Franklin Healthcare in Peabody, Eskridge Care and Rehabilitation Center and Edwardsville Care and Rehabilitation Center.

Nichols said the Disability Rights Center wasn't advocating closure of each long-term nursing facility for the mentally ill, but welcomed a reduction in the number and a fundamental change in their mission to focus on rehabilitation services. Individuals leaving these nursing facilities, unique to Kansas, should enroll in Medicaid so the $20 million spent annually by Kansas on nursing facilities for the mentally ill could be used to draw down $30 million in new federal aid, he said.

The state also should fund a contingent of client advocates independent of the nursing facilities and community programs to work on discharge planning and integration, he said.