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Mental health commissioner: staffing shortage ‘critical’

By MARY SELL, Alabama Daily News

Alabama’s mental health hospitals’ staffing shortage has reached crisis level, a panel of state lawmakers were told on Thursday.

“We’re in a crisis in our facilities right now,” Alabama Department of Mental Health Commissioner Kim Boswell told members of the Legislature’s General Fund budget committees during an informal hearing. The meeting was part of a series on how state agencies are dealing with inflation and a labor shortage and prepping for a possible recession.

“To maintain patient safety as well as staff safety, we are engaging a rapid response staffing company that will provide staffing for us for 26 weeks,” Boswell said. “It’s pretty pricey, but at this point we don’t have an alternative to that. Our situation has gotten so critical.”

Boswell said the department has shifted some administrative staff, including from her central office, to work at hospitals in Tuscaloosa recently.

Boswell said the department has to address its retention issue.

“Part of what’s happened … is as we’ve made people work more overtime, then fewer and fewer people want to stay with us because they don’t want to work all the overtime,” Boswell said. “We’ll be working with (the State Personnel Department) to figure out what we need to do to increase salaries.” 

Last month, in an effort to retain long-serving state workers, the State Personnel Board added four steps of 2.5% to state employees’ pay structure.  According to Personnel, the state’s employee turnover rate exceeds 17% and its workforce has declined by more than 1,500 employees in the last two years.

Boswell also updated lawmakers on the creation of six mental health crisis centers around the state. The Montgomery center has had “major challenges” with its building,” Boswell said.

“They’ve had a lot of supply chain issues,” she said. “They got very creative and found some modular buildings that they opened up in a temporary location.” 

Lawmakers started funding the centers last year to create space where people can be stabilized and possibly referred for outpatient treatment. The goal is to reduce the need for civil commitments and the need for inpatient care. When all six centers open, they’ll offer a combined 173 beds for short-term observations of those in crises.

For patients who have been civilly committed and need longer-term care, Boswell said there are 364 beds at Bryce Hospital and Mary Starke Harper Center in Tuscaloosa. A third hospital, Taylor Hardin Secure Medical Facility for the criminally committed, is not included in that number. There are also about 215 beds at residential facilities around the state.

Asked by Sen. Greg Albritton, R-Range, if the state has enough short- and long-term beds for those with mental health issues, Boswell said there are waiting lists at both Bryce and Taylor Hardin and the residential facilities around the state.

“Our crisis residential units are full,” Boswell said. “And so, I would say no.” 

She also said the department projects needing four or five more acute care crisis centers.

“Keep us informed,” Albritton said. “We need to have a goal, I think, of where we need to be headed toward.” 

Lawmakers also heard from Alabama Chief Justice Tom Parker, head of the Unified Judicial System. Parker and some lawmakers have been at odds recently about how to handle a shortage of circuit and district judges in some areas of the state.

Parker has advocated for more funding to fill the seats promptly. Several state lawmakers, including Albritton, the Senate General Fund budget committee leader, favor a system of moving seats from underutilized areas, including Jefferson County. Last month, one judgeship was moved to Madison County.

On Thursday, Parker said his office for two years has suggested legislation to allow retired judges to come back temporarily for one-quarter their pay, while maintaining their retirement income. 

“This is something that’s being used in seven other states with (American Rescue Act Plan funds), Parker told lawmakers.

“This is a way to provide a bridge until the Legislature thinks that they have the money to offer us the funding for all of those permanent judgeship needs that we have right now,” Parker said.

Lawmakers didn’t respond to the suggestion during the meeting, but Albritton later said he appreciated Parker’s input.

“I’ll take it under advisement,” he said.

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