Missouri hospitals are facing staff shortages in mental health facilities

Hospitals across Missouri are facing a “crisis” in caring for patients in acute care settings who cannot find long-term care through the mental health department due to the agency’s chronic staffing shortage, according to hospital officials.

Patti Morrow, vice president of behavioral health services at Mercy Health, testified during a legislative hearing on Wednesday that “the problem is pervasive and systemic” with residents struggling with waiting lists for services.

“We are seeing a growing crisis of young people and vulnerable adults who are really being left on the doorstep of our hospitals without the necessary resources…,” Moreau said. “We are not doing a good job by the citizens of our country in terms of meeting their needs.”

Morrow said between 12 and 20 individuals are housed in Mercy Hospital settings each day pending placement within either the Department of Social Services or the Department of Mental Health. Morrow said one patient is spending 290 days in Mercy’s care, with a 10-bed unit closed in order to allocate resources to him.

“We are really approaching two birthdays and he will be in our facility,” Morrow said, adding later: “At the end of the day there is not much light at the end of the tunnel, we expect he will be with us for much longer.”

So far, Morrow said, Mercy Health has received $21,000 for his care. Overall, the system estimates that its care has cost more than $1 million when assessing lost revenue, such as no contact with the ten families.

Mercy Health wasn’t alone at Wednesday’s hearing, as representatives from SSM Health, BJC HealthCare and the Research Center for Psychiatry shared similar experiences of housing patients with long-term intellectual and developmental disabilities.

Justin Alverman, a former lawmaker and advocacy director for SSM Health, said patients’ mental health often declines because they live in a hospital for several months in a row. In all eight SSM hospitals, 25 patients are awaiting placement who have been held for more than 1,800 days in total. Last year alone, 106 adults waited for placement for a total of 7,242 days.

There simply isn’t enough workforce, Alverman said.

Dirk Deaton, R-Noel and chair of the House Subcommittee on Appropriations — Health, Mental Health and Social Services, said the delay in placements is extending to hospitals, which in these cases are not the right place for long-term care.

“I wonder, 150 years from now, what people will think about us with this kind of problem,” Deaton said, adding later, “We can and should do better.”

Over the past year, the Department of Mental Health She continued to wrestle with severe vacancies among employeesThis has resulted in reduced access to care across state-run mental health facilities As the wings close Because there is not enough staff for the family available to staff.

There are currently 210 individuals waiting in prison for admission to the Mental Health Department’s psychiatric hospital. An additional 266 people have not met with a forensic examiner to determine if they are eligible to appear in court, and it is estimated that about 50% of these individuals will be found ineligible for trial and referred to the DMH, Valerie Hone, the department’s director, told lawmakers Wednesday.

Within the department’s developmental disabilities department, Hoon said 652 people are currently on an open referral list for placement with a residential provider.

A chart shared with lawmakers shows that the number is expected to rise to more than 1,400 individuals in fiscal year 2023. There are 20 people currently hospitalized due to no residential provider, with the average hospital stay while waiting for a provider at 116 days . Currently, 127 people have been waiting for a housing provider for over a year.

“The challenge we actually face is getting people into workplaces,” Hon said.

Across the Departments of Behavioral Health and Developmental Disabilities in the Department of Mental Health, there are 1,743 full-time positions vacant. While there has been an improvement in turnover, such as for supportive care assistants, vacancy rates for clinical staff range from 26% to 50%.

“It’s very difficult once we get someone to recover if we don’t have that aspect of treatment,” Hon said.

Contracted personnel are currently used to maintain operations, with 213 being used in rehabilitation centers and psychiatric hospitals. Most of those are at Fulton State Hospital, Hon said.

Hoon said the goal is to move away from contract employees, who are paid more than their in-state counterparts.

The rates for certified nursing assistants paid to the hiring company were $78 per hour for certified nursing assistants and $195 per hour for registered behavioral health nurses. That’s compared to non-contracted support care employees who start at $15.31 an hour, Hon said.

“It’s costing us four times as much as the contract people, and if we pay more, we may not need the contracted people,” said Rep. Peter Meredith, D-St. Louis.

In order to deal with the staff shortage, Missouri entered into an emergency no-bid contract with a Texas-based construction company called SLSCO last year.

The Independent previously reported the contract It was characterized by lack of attendance and high costs.

Debra Walker, a spokeswoman for the department, said the Department of Mental Health (DMH) continues to pay temporary employees through the contract.

In fiscal years 2022 and 2023, more than $73 million was paid to SLSCO, according to the Government Accountability Portal.

In the competitive job market, the department has struggled to remain competitive, Despite the salary increases that lawmakers approved earlier this yearHun said. Increasing salaries for regular employees and those who take the night shift are strategies Hoon said could help address the problem.

We will not be asking for extra beds next year. “I’m not going to make them work,” Hon said, adding later, “There is no history in a job market like this.”

Missouri Independent It is part of the States Newsroom, a network of news outlets supported by grants and a coalition of donors as a 501c(3) public charity. The Missouri Independent maintains editorial independence.

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