State officials say conditions for staff and patients at Kansas’ two state-run psychiatric hospitals are improving but still need work.
Representatives from the Kansas Department for Aging and Disability Services, Osawatomie State Hospital, Larned State Hospital and the Kansas Organization of State Employees spoke Monday and Tuesday to a legislative committee overseeing the hospitals.
Using that testimony, the committee made six recommendations for the Legislature to consider during the 2017 session, including requirements for private contractors bidding to operate Osawatomie State Hospital and support for programs addressing staff shortages at both hospitals for Kansans with severe mental health issues.
Federal officials cut Medicare payments to Osawatomie State Hospital in December 2015 because of safety concerns. Tim Keck, interim KDADS secretary, said the department is trying to fix the problems at Osawatomie State Hospital and be proactive when issues come up at Larned State Hospital.
The strategy includes contracting with the consultant working on Osawatomie State Hospital recertification to look for problems at Larned State Hospital and come up with ways to solve them, he said.
Both hospitals still have staffing issues, though they have become less severe, Keck said. The vacancy rate for mental health technicians at Larned State Hospital has fallen from about 40 percent a year ago to about 25 percent now, he said.
Overall, about 36 percent of positions at Larned State Hospital and 29 percent of positions at Osawatomie State Hospital were vacant as of Dec. 7. Keck said he expects staffing numbers to continue to improve, but he noted that Larned State Hospital has particular challenges.
“The hospital has gotten a reputation as a hard place to work because of the mandated overtime,” he said. “I think it’s going to take time for people to believe the improvements we’re making are here to stay.”
Overtime hours and costs also have trended down, though they spiked in July and August, which Keck attributed to staff taking vacations.
Dwain Shaw, who leads a unit at Osawatomie State Hospital, said his unit increased its staffing from about five employees to at least nine technicians and nurses each shift. Now, the unit has one nurse for every 15 patients and one technician for every seven patients, and sometimes more if residents have serious medical or mental health needs, he said.
“We don’t run below baseline (staffing) anymore,” he said.
Forced overtime is down, though it still exists on the unit, Shaw said.
Two representatives of the Kansas Organization of State Employees shared concerns about working conditions at Larned State Hospital.
Kyle Nuckolls is a union steward for KOSE and mental health technician at Larned State Hospital. He praised Keck’s efforts “to find common ground” and Larned State Hospital Superintendent Bill Rein’s work at the hospital. But he said front-line supervisors at Larned State Hospital often focused more on punishing mistakes than helping employees learn and promotions are based on a “game of favorites.”
“This creates and continues a culture of fear and isolation,” he said.
Rebecca Proctor, executive director of KOSE, said some supervisors at Larned State Hospital have refused to allow employees to schedule time off and threatened to punish them if they call in sick three times in 90 days.
“If you create a system where people can’t use their vacation time and the only way you can get off is to call in, and then punish people for calling in, that is not an employee-friendly environment,” she said. “We do think Secretary Keck is on the right road, but we’re early on that road and there are things that need to be fixed.”
Keck and Rein said they hadn’t heard before that workplace bullying was widespread but told legislators they would investigate.
“I think it would be fair to put our antennas up,” Keck said.
The legislative committee unanimously recommended KDADS investigate claims of workplace bullying and develop polices to address it.
It also recommended that the state:
- Consider adding 20 psychiatric beds, perhaps at a private facility through a contract, at an estimated cost of $8 million.
- Continue to support programs to address workforce shortages at both state hospitals.
- Create formal relationships between the state hospitals and the University of Kansas School of Medicine.
- Fully fund crisis centers in Kansas City, Wichita and Topeka.
- Require that contractors bidding to run Osawatomie State Hospital consult with the state’s mental health centers.