Two employees of Larned State Hospital made rare public comments Monday about difficult working conditions at the mental health facility.
Kyle Nuckolls and Lynette Lewis described for a legislative committee the toll that mandatory overtime and limited time between shifts is taking on workers at the short-staffed facility and their families.
“I’ve never seen it this bad,” said Lewis, a pharmacy technician who has worked at Larned for 18 years.
Nuckolls and Lewis, both stewards for the Kansas Organization of State Employees labor union, addressed the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight at the Capitol.
They stressed they were speaking as individuals and not representatives of the Kansas Department for Aging and Disability Services or other state agencies.
They described co-workers vomiting into trash bins while distributing medication because they couldn’t get sick leave, day care centers unwilling or unable to provide enough hours of care to cover single-parent employees for the amount of time they needed to be at work and workers filling in on units where they don’t feel safe.
Nuckolls said he’d lost count of the number of times he’d fallen asleep at the wheel on the drive home after pulling a long shift, and co-workers had told him they too had concerns about making it home safely because they were so exhausted.
That exhaustion, he said, inevitably affects patient care at Larned, which is one of two state hospitals for Kansans with severe or persistent mental illness. The other is in Osawatomie, which lost its Medicare certification in December because of staffing and safety concerns.
“I know personally when I’m on my fourth or fifth 12-hour shift in a row, I’m going to make mistakes,” said Nuckolls, a mental health technician who lives about 20 miles from Larned in Burdett.
Working to improve morale
KDADS Interim Secretary Tim Keck, who sat in the front row during the committee hearing, said staffing concerns at Larned are valid. He’s been working to improve employee morale since he took over in December.
“It comes down to the respect they’re being shown, and it comes down to how they’re being treated,” he said. “We’re trying to change that.”
Keck said he had visited the facility in central Kansas six times. Direct care staffing vacancies, though still too high, dropped slightly in recent months, Keck said. He described new Interim Superintendent Chris Mattingly as a hospital turnaround specialist who would lead a culture change within management.
Lewis said Mattingly had said the right things and created a better work atmosphere in his first few days, but she remained wary about whether he would be able to “walk the walk.”
Nuckolls said one of Mattingly’s top priorities should be to establish better communication between workers and management. He said front-line employees are kept in the dark on major changes, citing the recent move of some inmates with mental health issues out of the hospital and into a correctional facility.
Keck said that move is one of the ways KDADS is addressing the hospital staffing shortage.
Rebecca Proctor, executive director of the union, said she appreciates the attention to staffing issues at Larned. However, she said, moving people among facilities amounts to a “shell game.”
“We don’t believe these inmate shifts are the proper solution for either the inmates or the employees involved,” she said. “While there may be some reduced pressure on staffing out at Larned State Hospital, you’re just shifting that pressure elsewhere. There’s going to be increased pressure on the folks at our correctional facilities.”
Proctor said legislators should fund pay increases and mandate regular Larned staffing updates from KDADS.
Waiver integration timing
Rep. Dan Hawkins, co-chairman of the oversight committee, said he and Sen. Laura Kelly, the committee’s top Democrat, recently traveled to Larned to see the facility and talk with employees.
Hawkins said the problems there had been building for a long time, but Mattingly seemed like the right person to lead the turnaround and he hoped employees would rally around him.
“You can’t turn a ship overnight,” Hawkins said.
The committee also heard Monday from several advocacy groups concerned about a backlog of Medicaid applications that, while declining, still numbers in the thousands.
Sean Gatewood, a former Democratic legislator who leads a coalition of groups called the KanCare Advocates Network, said the state should not move forward with a plan to consolidate Medicaid waivers for Kansans with various disabilities while the backlog and issues at the state hospitals are unresolved.
“There’s just a complete laundry list of problems,” Gatewood said. “Our position is the state needs to tend to those first.”
Legislators concerned about a lack of details on the waiver integration plan thought administration officials would delay it one year to Jan. 1, 2018.
But recent statements by Keck and Mike Randol of the Kansas Department of Health and Environment suggest they’re still planning for a Jan. 1, 2017, rollout.
Randol said Monday that his agency needs to continue preparing to hit that 2017 date because there’s been no official agreement that the administration will postpone it.
“As of now, I do not know of a final decision,” Randol said.
Hawkins, a Republican from Wichita who chairs the House Health and Human Services Committee, said legislators will continue to monitor the waiver decision.
“We are still working on waiver integration,” Hawkins said. “That’s not left our sight as a House committee.”
Andy Marso is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach him on Twitter @andymarso