Oregon State Hospital on hiring spree with $10 million appropriation
It will take months to recruit more staff to relieve staff stress and improve treatment.
Oregon State Hospital in Salem (Amanda Loman/Salem Reporter)
The embattled Oregon State Hospital plans to hire more nurses to relieve overworked staff and improve care with another $10 million appropriation by the legislature.
The money will allow the establishment to convert 134 temporary nursing positions into permanent jobs and create 94 other positions. Fifty-seven of them will be additional caregivers, according to hospital superintendent Dolly Matteucci.
“It gives us the opportunity to increase the number of people who provide direct care and service to our patients,” which she says would strengthen “the heartbeat of this service.”
She is also happy to add these 134 nurses.
“It’s extremely important to us because in the normal healthcare market there is competition,” Matteucci told the Capital Chronicle. “Having a permanent position to offer versus a limited term is very helpful.”
But the money — and the go-ahead for new hires — hasn’t been what hospital officials say they need. Last November, the Oregon Health Authority, which oversees Salem Hospital and its smaller facility in Junction City, asked the Legislature for $33 million for nearly 500 new positions.
The hospital currently employs 2,240 people.
The November request stemmed from the recommendations of a study group made up of Matteucci, union members and executives.
The hospital “has been challenged over the years to provide adequate staffing to achieve a high level of quality care while ensuring patient and staff safety,” the agency said in its budget request. “This instability negatively affects the consistency of service delivery, the cohesion between care providers and the sense of responsibility towards the team and the hospital as a whole.”
During the February legislative session, Matteucci made a reduced pitch for money. This time, she suggested an allocation of $20 million – about the same amount the Legislature set aside last June for the hospital.
But lawmakers decided against allocating the full $20 million to an institution that had been plagued with problems for decades.
State Rep. Rob Nosse, chairman of the House Behavioral Health Committee, said the hospital needs to prove it can bring in the people it needs before the Legislature gives it more money. .
“They need to be able to hire those positions,” Noose said of the 94 new positions, “and make them stay.”
Matteucci said the hospital is recruiting and has strengthened its hiring strategies. In the meantime, it has filled staffing gaps in a variety of ways.
Staff are asked to work overtime, sometimes imposing overtime. He also hired professionals from placement agencies. There are currently over 100 contract employees working at the hospital and all of them receive higher salaries than the staff.
“OSH had to come up with rate increases because they couldn’t get anyone from regular contractors, due to labor shortages and the fact that nurses could make a lot more money from other agencies,” said Aria Seligmann, a spokeswoman for the hospital.
Five endowment contracts, totaling nearly $80 million, end on September 30.
The agency has also received help from members of the National Guard, some of whom have little or no mental health training. Thirty members of the Guard are still on duty at the hospital, most working directly with patients along with the staff mental health technicians. They will leave at the end of the month.
“The loss of National Guard members means the hospital is becoming more reliant on voluntary and mandatory overtime,” Seligmann said.
Decades of problems
The public hospital has had problems for years.
Failing to fulfill his obligation to admit patients in a timely manner, he faced numerous lawsuits from lawyers and patients, and was repeatedly tried for contempt of court.
He faced media investigations, such as October’s from the Salem Reporter which revealed that during the pandemic, administrators were moving some of the least stable patients to units ill-equipped to handle them. This report, and others, found high levels of violence among patients and against staff and low retention rates among employees.
“People go there, find out it’s a tough place to work, and they leave,” Noose said.
Two decades ago, the watchdog group, now known as Disability Rights Oregon, sued the hospital over its failure to admit “help and support” patients who had been court-ordered to be treated at the state hospital so that they can be tried. The US Ninth Circuit Court of Appeals ordered the hospital to admit them within seven days. The hospital also faced contempt charges in city courts for failing to admit aid and support patients as ordered. Administrators argued in these cases that the hospital was understaffed to comply.
In June 2019, as patients receiving aid and assistance were held in jail waiting for a hospital to open, the Ninth Circuit ordered the hospital to come into compliance. He did – for a while. But the pandemic hit, the state got a reprieve, and admissions slowed.
In a separate case in November 2021, the hospital faced a court order to admit patients found guilty except of insanity within seven days following a lawsuit brought by two men who had been in jail for months. .
The two sides reached a truce in December, with the hospital, Disability Rights Oregon and public defenders, with the Metropolitan Public Defender Services agreeing to a court-appointed expert to investigate the hospital’s capacity issues and offer solutions. solutions so that patients are not stuck in jail. when they need treatment.
“Prisons are designed to punish and confine,” Emily Cooper, legal director of Disability Rights Oregon told the Capital Chronicle. “Their job is not to heal or create a therapeutic environment. So if you have a serious and persistent mental illness and are exhibiting self-destructive or disturbing behavior, sometimes a prison’s only option is to put you in solitary confinement or strip and put yourself in a gown. of suicide. It can be very dehumanizing, very isolating, and together it just exacerbates your mental health.
Last year, 11 mental patients jailed in Oregon who were awaiting trial committed suicide, Cooper said. None had been found unfit to stand trial, but Cooper suspects that’s only because they hadn’t yet had a hearing or seen a lawyer where it would have been obvious.
“Based on the severity of mental illness we saw in the records of the 11 deceased, it is likely that they would have been deemed unable to help,” Cooper said.
Patients stuck in hospital
The problem of admissions to public hospitals persists.
At the end of February, 91 assisted patients were waiting for a bed. The average wait time was 24 days, with the longest wait extending to 46 days. Six other people found guilty, except for insanity, had waited an average of 17 days for a bed, with the longest wait being 33 days.
Seligmann blamed the delays on a pause in admissions in the first week of January due to Covid, saying it led to “longer wait times”.
Last year, the hospital saw a dramatic increase in orders for help and assistance, from an average of 55 per month in 2020 to 72 in 2021, Matteucci testified to lawmakers in February. In a weak month, 58 people in prison were sent to hospital for treatment; which rose to 100 the highest month.
The hospital also has a discharge problem.
As of mid-February, about 230 patients at the hospital were ready for transfer, mostly to a lower level of care, according to data she presented. Patients find themselves stuck in the state hospital because Oregon lacks behavioral health facilities in the community. Lawmakers recently allocated an additional $100 million for residential behavioral health facilities, which could help address the hospital discharge problem.
Matteucci said she was encouraged by this $100 allowance.
“I see progress being made on the continuum, and it’s wonderful and it gives me hope,” Matteucci said.
But the public – and patients – won’t see any improvement in community treatment for months, if not years. Counties have to ask for the money, buildings have to be built and people have to be hired. This has proven difficult during the pandemic.
Matteucci estimates that it will take 14 months for the hospital to hire these 94 people. She said they won’t necessarily create more openings for patients. All of its 683 beds — including two new 24-bed units in Junction City — are full.
But more staff will help the hospital provide better care, she said.
This sentiment was shared by union leaders.
“These investments in state hospital staffing will go a long way to stabilizing the workforce so that we can provide the best treatment and the best environment possible,” said David Lynch, president of the American Federation. of state, county, and municipal employees Local 3925. “While there is still a long way to go based on the Staffing Solutions Report, we know that adequate and stable staffing is essential to sustaining clients we serve and ensure that all programs and opportunities are available.”
Matteucci expressed hope that the hospital is now on the right track.
Cooper agreed, pointing out that his group’s representatives often meet with hospital officials.
“I sincerely believe that better days are ahead,” Cooper said. “We are not in court at the moment. We don’t plead. We are really focused on solutions. And that in itself is promising.
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