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Fewer workers caring for more patients at state hospitals

By Dave Ranney | February 21, 2012

Osawatomie State Hospital.

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State hospitals for the mentally ill and the developmentally disabled have not replaced many employees who’ve quit or accepted Gov. Sam Brownback’s invitation to take early retirement.

At the same time, the number of patients at the hospitals has remained flat or increased.

That means fewer workers caring for more patients.

The governor’s budget proposal for the coming fiscal year would allow for 2,298 full-time positions at the five state hospitals, or 311 fewer slots than there were in fiscal 2011 and about 100 fewer than the current fiscal year.

Democratic members of the House Appropriations Committee said this week that the reduced hospital workforce was causing problems.

“At Osawatomie State Hospital we have 55 fewer FTE’s (full-time equivalent employees) than we had in the fiscal 2011 budget and we’re running over (patient) capacity,” said Rep. Bill Feuerborn of Garnett, the committee’s ranking Democrat.

Feuerborn said 13 employees at Osawatomie took the administration’s offer of early retirement. Only three of those positions were refilled. The additional vacancies occurred from people quitting or otherwise leaving the hospital’s roster.

Feuerborn’s district includes Osawatomie State Hospital, the largest of the state’s three hospitals for the mentally ill.

The committee, dominated by Republicans, debated four of the five state hospitals’ budgets on Monday, approving all four in line with the governor’s spending recommendations.

“I’m hearing from several employees who are concerned about safety issues and mandatory overtime,” Feuerborn said. “They work eight hours and then they’re told they mandatorily have to work another eight hours. But they’re not paid overtime. They’re given comp time that they have to be given permission to use.”

Feuerborn told KHI News Service he thought the arrangement might be a violation of labor laws.

“These are people who are working under a lot of stress,” he said.

Officials at the Kansas Department of Social and Rehabilitation Services said it was legal to require employees to work double shifts.

Feuerborn also said the other state hospitals were not replacing employees who had been fired or quit.

“We have 58 fewer employees at Parsons State Hospital than we did two years ago,” Feuerborn said.

The hospitals are under the broad supervision of SRS, but the individual hospital superintendents manage each somewhat differently.

Parsons State Hospital, for example, has reported that its overtime costs increased 139 percent in the current fiscal year, which began July 1, 2011.

Budget documents provided to legislators also showed Kansas Neurological Institute in Topeka losing 16 full-time positions in the proposed budget for fiscal 2013.<a name="continued"></a>

KNI and Parsons State Hospital care for people with severe developmental disabilities.

Addressing concerns

“Across the board, about a hundred positions at the state hospitals have been lost” in the past year, said Rep. Jerry Henry, a Cummings Democrat.

Henry, echoing concerns he said he heard from hospital workers, said the facilities were “OK when nobody’s sick or on vacation, or there’s a holiday. But when somebody is sick or on vacation or there’s a holiday, we’re in trouble.”

Rep. David Crum, an Augusta Republican who chairs the Appropriations Subcommittee on Social Services, told fellow committee members that SRS has been addressing the hospital employees’ concerns raised by the Democrats.

So far, he said, the agency had not requested additional funding for KNI, Parsons, Osawatomie or Rainbow Mental Health Facility in Kansas City.

The department has asked for an additional $2.4 million — all from the State General Fund — for an expansion of the Sexual Predator Treatment Program at Larned State Hospital.

The Appropriations Committee has not yet discussed the proposed budget for the Larned hospital.

Crum also said he expected SRS to monitor conditions at the hospitals and report back to the committee later in the legislative session before final budgets are approved.

According to SRS reports, Osawatomie State Hospital last year exceeded its 176-bed capacity one out of every three days; the 91-bed psychiatric unit at Larned State Hospital topped capacity nearly one of every two days.

The populations at KNI and Parsons State Hospital have remained steady.

Crum said his subcommittee had postponed a decision on whether Rainbow Mental Health Facility should be reopened with a 50- or 36-bed capacity.

“I think it would be beneficial for us to take a tour of the facility,” he said.

In March 2011, Rainbow reduced its 50-bed capacity to 36 beds after federal inspectors said the facility was understaffed.

SRS temporarily closed the hospital in November to address safety concerns raised during a State Fire Marshal's Office inspection.

Rainbow patients were moved to a 30-bed unit at Osawatomie State Hospital that previously was unused because there wasn't funding to staff it.

SRS plans to reopen Rainbow this summer. Until then, the hospital continues to operate a six- to eight-bed crisis stabilization unit.

After the hearing, Rep. Marc Rhoades, a Newton Republican and chair of the Appropriations Committee, told KHI News Service that he would be interested in exploring the possibility of using part-time workers to reduce the hospitals’ overtime costs.

“It seems there ought to be an opportunity there for people who are trained for this kind of work but who don’t want to work full-time,” Rhoades said. “It would almost be like a temp-agency thing for people who are already trained and live around the hospitals.”

The fiscal 2013 budgets endorsed Monday included:

• Rainbow Mental Health Facility — $8.3 million, a $131,000 reduction from current-year spending;

• Osawatomie State Hospital — $29.2 million, a $291,000 reduction from current-year spending;

• KNI — $28.6 million, an $802,500 reduction from current-year spending;

• Parsons State Hospital — $25.2 million, a $580,300 reduction from current-year spending.

The proposed budget for Larned State Hospital calls for spending $61.3 million, an increase of $2.1 million.

The Senate Ways and Means Committee is expected to begin its review of the state hospital budgets on Feb. 29.

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