Staff shortages in Missouri mental health facilities limit patient access to care • Missouri Independent


A staffing crisis at state-run mental health facilities has reduced access to care for patients, with a few months waiting for services, state officials told the Commission on Thursday. Mental Health.

Within the Behavioral Health Division of the Ministry of Mental Health, approximately 35% of RN positions are vacant, 57% of Licensed Practical Nurses are vacant, 32% of entry-level psychiatric technology positions are vacant, and 28 % of entry level safety assistance positions. are also vacant.

The department has slowed admissions to its adult mental hospitals, and 41 beds have been taken offline in facilities “due to our inability to staff these facilities safely,” said Nora Bock, division director of the department. behavioral health of the department.

Asked by Commissioner Lynne Unnerstall about how patients are cared for without the necessary staff, Bock said: “in many ways they are not”.

Staff shortages mean less available capacity and fewer patients served, Bock said.

Public institutions for adults can serve people who have been incarcerated by the courts, and without sufficient capacity, some must instead remain in prisons, “and it is a question of whether they are receiving an appropriate type of service”, he said. said Bock. .

“Within our facilities as well, if you just try to do it day to day, there is less treatment because people are just trying to cover the minimums and make sure people are getting their meds and getting food. “said Bock. “So this is a negative consequence in all respects, and it is a reality that occurs in our hospital settings as well as in our community settings. “

Ministry officials said the commission’s low salaries were a contributing factor to the staff shortage. The department already has spent hundreds of thousands of dollars with temp agencies to try to fill the shortages.

“We have become dependent on high cost agency recruiting contracts to meet the needs,” Bock said. “We are a little worried as these contracts may become less available in the near future. “

“In our facilities as well, if you are just trying to cope with day to day, less treatment takes place because people are just trying to cover the minimum and make sure people are getting their meds and getting food.

– Nora Bock, director of the behavioral health division of the department

Last year, facilities run by the department have also seen COVID cases increase, forcing staff to stay home and self-quarantine. But unions representing facility workers said at the time that enforcement policies were patchy and because of staff shortages, they were required to work after testing positive for the virus if they did not show evidence. symptoms.

As of Monday, there were 2,281 cases among department staff, including 24 active, and 528 cases among residents and patients, including one active. A total of six staff members and 13 patients died from the virus, according to the figures of the department.

The department worked with Learfield Communications, a marketing consultant from Plano, Texas, which has an office in Jefferson City, on a social media campaign to recruit workers. The company was paid over $ 405,000 by the Department of Mental Health for advertising services in fiscal year 2022, according to the Missouri Accountability Portal.

While the ads have generated strong engagement on social media, at a recent career fair only five candidates came forward, Sara Murphy, the department’s director of human resources, told the committee.

Potential candidates for the job have expressed disappointment with the rate of pay offered by the department, Murphy said.

“It doesn’t make the gap we need,” Murphy said.

Jessica Bax, director of DMH’s developmental disorders division, told Thursday’s meeting that October marked the first month in “a very long time” that more new employees have started than those leaving.

According to a slide shared at the meeting, 35 direct support professionals started in October, compared to 32 whose jobs ended. In both August and September, the number of employees terminated was higher than the number of new employees.

“Hopefully this is the start of some big changes, but I think we all know it’s probably not the truth,” Bax said. “In addition, there is now a vaccine warrant coming out. “

Thusday, President Joe Biden’s administration announced new federal rules for vaccinations, including one that will require healthcare workers whose facilities participate in Medicare and Medicaid health insurance programs to be vaccinated against COVID-19 by January 4. out of the industry.

While a waiting list has shrunk from previous highs, there are currently 465 people waiting for residential services, Bax said. More than half waited between three months and over a year for services.

“Having slots available and funded does not equate to access to care,” Bax said.

Angeline Stanislaus, the department’s chief medical director, also said on Thursday that a case of Legionnaires’ disease was confirmed at a Farmington facility on Wednesday afternoon.

Debra Walker, a spokesperson for the department, confirmed after Thursday’s committee meeting that the Southeast Missouri Mental Health Center was informed on Wednesday that Legionnaire’s disease was found in a patient who had been transported to the hospital.

The patient remains in the hospital, and Department of Health and Elderly Services staff are at the Southeast Missouri Mental Health Center “performing extensive water testing. ‘establishment,’ Walker said.

Inhaling water droplets containing Legionella bacteria can cause Legionnaires’ disease, a severe form of pneumonia. Usually people do not pass the disease on to each other, according to the Centers for Disease Control and Prevention.


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