(Sean Whaley/Nevada News Bureau) – Staffing cuts, furloughs and a mandated eight-hour work schedule all contributed to a state employee protest outside a Las Vegas mental health facility on Saturday, a state official said.
Harold Cook, administrator of the Nevada Division of Mental Health and Developmental Services, said in an interview Monday he appreciates the concerns of employees who work at the agency’s psychiatric hospital facilities. But suggestions that patient or employee safety have been jeopardized because of staffing reductions and furloughs are not borne out by the evidence, he said.
The protest was organized by the American Federation of State, County and Municipal Employees union Local 4041 and drew more than 100 demonstrators and was directed at staffing issues at facilities where mentally ill adults receive treatment. There are 234 beds in three buildings, including 190 beds at the new Rawson-Neal Psychiatric Hospital at Jones and Oakey boulevards.
“We’ve been working on a reduced staffing level for nine months at least, and I can say at this point I’ve seen no effect on the number or types of incidents regarding injuries to staff or patients,” Cook said.
Dennis Mallory, chief of staff for the union, disagreed with Cook, saying today he believes incidents of patient-on-patient and patient-on-staff violence have increased since staffing levels were reduced last year and that staffing levels are a factor in the incidents.
“We understand the funding shortfall, that we won’t see any pay increases, no step increases, no longevity pay,” he said. “But at what point do we accept a compromise in pubic safety and security.”
The hospital employees believe Health and Human Services Department Director Mike Willden should seek an exemption from the mandatory one-day-a-month furlough for the hospital staff, which would be a first step to dealing with the problem, Mallory said.
Cook said an exemption from the furloughs is not an option the agency is willing to pursue because it would result in cuts to client services. The savings from furloughs are built into the budget and if there are exemptions, the money must be made up elsewhere, he said.
Cook said the hospital, which cares for mentally ill adults who have been found to be a danger to themselves or others, lost 81 in-patient positions due to required spending reductions. Those positions included nurses, administrators and housekeeping employees. The mandatory furloughs have had the effect of reducing staffing by another 4.6 percent.
The 2009 Legislature approved 10 certified nursing assistant contract positions to assist in covering the furlough absences reducing the total eliminated positions to 71 in the current budget.
The staffing ratio now is 2.1 full-time-equivalent positions per bed compared to 2.4 prior to the changes, Cook said. The staffing ratio is still higher than many private facilities, he said.
“We’re not operating this facility at any staffing level considered to be unsafe,” Cook said. “But the nature of this business is there is always risk.”
Mallory said the CNAs are not trained to deal with mentally ill patients. The money for the positions should be freed up to hire trained staff, he said.
“I’d rather have one psychiatric nurse than three CNAs,” Mallory said.
Cook said the reduced staffing has also necessitated a decision to require all employees to work eight-hour shifts. Up to now, some employees have worked 10- or 12-hour shifts instead but there aren’t enough positions to allow for flexible working schedules at this time.
“At this point we’re all kind of stuck with a situation that is to nobody’s liking and we’re trying to maintain the operation as effectively as possible,” Cook said. “That means not cutting client services and maintaining the health and safety of our patients and employees.”
Mallory said the employees would like to be part of the decision-making process. More than 100 have signed a grievance regarding the staffing levels, a demonstration of the depth of the concerns, he said.