Milwaukee area is getting new behavioral health facilities, but who is going to staff them?


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Representatives from the health sectors, government and nonprofit organizations gathered in late summer to celebrate the progress of the construction of a new emergency mental health center under construction at the north side of Milwaukee. The emergency center -…


Representatives health care, government and nonprofit sectors came together in late summer to celebrate the construction progress of a new mental health emergency center being built on the north side of Milwaukee.

The emergency center – a partnership between Milwaukee County and the region’s four largest health systems backed by public and private dollars – was widely celebrated at the beam signing ceremony. Throughout the program, speakers hailed the new facility as the most important thing the region has done in mental health in decades, a significant investment in dismantling racial inequalities in health care and an intervention needed in the broader police reform effort.

The 12,000-square-foot facility, slated to open next year, will welcome people experiencing psychological crisis and help them make the transition to long-term care. The emergency center is one of two new facilities in the county designed to serve people in crisis, along with Granite Hills Hospital, a 120-bed facility in West Allis that will provide behavioral health services to inpatients during its opening later this fall.

After decades of calls for reform in the way mental health care is delivered in Milwaukee County, many of the new buildings are signs of progress. But long-standing staffing issues – exacerbated by the COVID-19 pandemic – have created an uphill battle for those running the new facilities, which will have hundreds of positions to fill when they open in the coming months.

Some of the new positions will be filled by current employees of the County Behavioral Health Division Hospital Campus at the Milwaukee Regional Medical Center in Wauwatosa, who will eventually outsource all of its emergency services to the new facility. emergency under construction at the intersection of North 13th and Cherry Streets in Milwaukee and its inpatient services at West Allis Private Hospital.

However, even if all current BHD employees were transferred, this would not be enough to fully staff the new facilities. The HDB has 197 full-time employees who currently work in inpatient services. When open and fully operational, the new facilities will together have around 320 employees, including 250 in the hospital and 70 in the emergency center.

Granite Hills, owned by Pennsylvania-based Universal Health Services, has actively recruited staff and organized town halls in BHD in recent months.

Granite Hills General Manager Jennifer Bergersen assumed the role this summer after 22 years with the county HDO, most recently as COO under Administrator Mike Lappen. The two organizations have taken a collaborative approach to staff transition, Lappen said.

“We recognize that for both of us to be successful we need to have some sort of coordination around the staff, so this has been a very thoughtful process,” he said, noting that Bergersen has already hired a handful of executives. and BHD staff.

Once Granite Hills steps up its inpatient services, BHD will phase out until it is able to close its oversized and aging campus. Granite Hills plans to open to 10 to 12 patients this fall and expand from there.

The first group of Granite Hills employees will likely come from outside the BHD, Lappen said, noting that the hospital does not have “the staff available” at the moment.

The Mental Health Emergency Center is also planning to hire staff currently working in the BHD Psychiatric Crisis Services facility.

“We hope to attract as many of them as possible,” said Pete Carlson, vice president and chief executive officer of Aurora Behavioral Health Services.

As director of operations for the new center, Milwaukee and Downers Grove, Illinois-based attorney Aurora Health is responsible for hiring new employees, but he will be able to rely on the HR departments of his staff. partner health systems – Froedtert Health, Ascension Wisconsin and Children’s Wisconsin – to fill vacancies, Carlson said.

“We hope the workers are there. … Either way, we have supplier shortages pretty much all the time, so frankly that’s nothing new, ”Carlson said. “… We’re going to take advantage of every pipeline, every opportunity we have to fill positions.” … It’s a bit of a roll of the dice, though, because there are others looking for the same people.

BHD has felt these pressures on the workforce for some time. Her current goal is to keep her hospital and PSC employees until they can be transferred elsewhere.

When BHD announced plans to outsource behavioral health services to inpatients, the department began offering retention bonuses of 20-30% of an employee’s salary to hotline staff who remained during this transition.

Behavioral inpatient health facilities particularly struggle to find skilled workers. Nurses are scarce in the health care industry, and that pool is shrinking even further for nurses who have a deep understanding of mental illness and are ready to care for patients in psychiatric crisis.

“They are really specialized people. I don’t think most people understand that running a high acuity psychiatric unit requires very specialized knowledge and skills, ”said Lappen.

“It can be an art form,” he added. “How you approach people, how you talk to them, form a treatment alliance and trust people – these soft skills are really hard to teach. We can teach people how to do these things, but some people are good and some are not.

BHD executives expected them to face a challenge retaining employees amid the impending hospital shutdown, but couldn’t expect it to be made worse by a pandemic global, which has caused worker burnout and increased demand for mental health services.

Despite aggressive recruiting efforts – including enrollment bonuses of $ 7,500 for full-time RNs and emergency department clinicians and referral bonuses of $ 1,000 – Lappen believes that BHD has failed. not hired a permanent hospital employee for three months. He left the hospital to rely on traveling and temporary nurses.

Earlier this month, BHD increased the hourly wages of its hospital staff from $ 5 to $ 10, depending on the shift. It also offers a “critical fill bonus” of $ 250 per eight-hour shift for employees who come to work outside of their assigned hours.

“We believe that instead of paying temp workers and travelers, we prefer to reward people who have stayed with us and who are aligned with their mission and want to be here until the end,” Lappen said.

Lappen noted that a hospital the eventual size of Granite Hills will benefit from economies of scale that BHD no longer has. By early October, BHD had 26 adults and five children hospitalized on its sprawling campus, which was built in the late 1970s with a capacity of 1,300 patients. In recent years, the department has reoriented its strategy towards providing more upstream services in outpatient clinics, community facilities and through mobile crisis response teams, rather than in inpatient facilities. .

“One of the great things about Granite Hills is that they’re going to run a 120 bed hospital, so your fixed costs, like pharmacy and food and all those things that are spread over the larger census, you can do. work, “he said. “This is the biggest difference between us and Granite Hills. We have always been essentially a basic facility. “

Another key difference is the difference in the reimbursement structures between the two establishments. BHD operates as a critical access hospital for underinsured or uninsured patients, while Granite Hills will accept a mix of payers that includes those with private insurance.

Once operational and fully staffed, Granite Hills executives envision it becoming a training ground for future mental health professionals. Bergersen said she plans to partner with higher education institutions in the region to provide residences and internships for students.

“We want to have contracts with various schools in the area so that we can have students from all walks of life and clinical disciplines in our institution so that we can help develop the future mental health experts that we desperately need to do this. valuable work, ”she said.

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