Missouri hospitals are facing a “crisis” caring for acutely ill patients who cannot find long-term care through the Department of Mental Health due to chronic worker shortages at agencies.
“The problem is pervasive and systemic,” said Patti Morrow, vice president of behavioral health services at Mercy Health, during a legislative hearing on Wednesday as residents struggle on waiting lists for services. I testified.
“We are witnessing a growing crisis of vulnerable youth and adults being left on the doorstep of hospitals without the resources they need…” said Moreau. “We are not doing well by the citizens of our state when it comes to meeting their needs.”
Between 12 and 20 people are admitted to Mercy Hospital settings each day, awaiting placement in either the Department of Social Services or the Department of Mental Health, Morrow said. One patient has now been in Mercy’s care for 290 days, and his 10-bed unit has been closed to free up resources for him, Morrow said.
“Two Christmases with him at our facility are really close,” Morrow said, later adding: with us for a much longer period of time. “
To date, Mercy Health has been paid $21,000 for his treatment, Morrow said. They estimate that his treatment cost him over $1 million.
Mercy Health was not the only one at Wednesday’s hearing, but representatives from SSM Health, BJC HealthCare, and the Research Psychiatric Center shared similar experiences with long-term care for patients with intellectual and developmental disabilities. did.
Former MP and SSM Health advocate Justin Alferman says patients’ mental health often declines as they spend months in the hospital. In his eight hospitals at SSM, 25 patients are awaiting placement, and in total he has been on the wait list for over 1,800 days. Last year alone, 106 adults waited for placement for a total of 7,242 days.
“Simply put, we don’t have enough workers,” says Alferman.
Dirk Deaton of R-Noel, chairman of the House Appropriations Subcommittee, said the placement delays have extended to hospitals, which in these cases are not good places for long-term care.
“What will people think of us with these kinds of problems 150 years from now?” Deaton said, adding, “We can and should do better.”
Last year, the Department of Mental Health Continuing to deal with rapid staff vacanciesaccess to care is declining across state-run mental health facilities wings are closed Because there are not enough employees to place the available beds.
There are currently 210 people awaiting admission to the Department of Mental Health’s psychiatric hospital in prison. In addition, he said 266 had met with forensic examiners to determine their incapacity to stand trial, and approximately 50% of these individuals were determined incompetent and referred to the DMH. It is estimated that , told lawmakers on Wednesday.
Within the department’s developmental disabilities division, 652 people are currently on the public referral list for placement with housing providers.
A chart shared with lawmakers shows that could increase to more than 1,400 in fiscal 2023. Twenty people are currently hospitalized due to a lack of housing providers. Provider he 116 days. Now 127 people have been waiting for a housing provider for more than a year.
“Our challenge is actually placing individuals,” says Huhn.
Across the Department of Mental Health’s Behavioral Health and Developmental Disabilities Division, 1,743 full-time positions are vacant. Although turnover rates are improving, like support care assistants, vacancy rates for clinical staff range from 26% to 50%.
“Without the therapeutic aspect, it’s very difficult to accept someone and restore their capacity,” says Huhn.
Contract staff are currently used to maintain operations, with 213 in rehabilitation centers and psychiatric hospitals. Most of them are at Fulton State Hospital, Hoon said.
Huhn said the goal is to move away from contract workers, who are paid more than state workers.
The rates for certified nursing assistants paid to staffing agencies were $78 per hour for certified nursing assistants and $195 per hour for behavioral health registered nurses. This compares to non-contracted support his care staff, which starts at $15.31 an hour, Huhn said.
“It costs four times as much for the contractor. If you pay more, you may not need the contractor,” said Rep. Peter Merides (D-St. Louis.
To address the labor shortage, Missouri last year signed a no-bid emergency contract with a Texas-based construction company called SLSCO.
The Independent previously reported a deal characterized by no-shows and high costs.
DMH continues to pay temporary staff through contracts, said Debra Walker, a DMH spokeswoman.
In fiscal 2022 and 2023, SLSCO was paid more than $73 million, according to the state accountability portal.
In a highly competitive labor market, the sector has struggled to remain competitive. Lawmakers approved earlier this year despite the pay hike, Hung said. Huhn said a strategy that could help solve the problem could be to raise wages for permanent employees and night shift workers.
“I’m not going to ask for an extra bed next year. I won’t be staffing them,” Hung said, later adding, “There is no history in the labor market like this.”
