Kalamazoo Psychiatric Hospital

Todd Tennis, MAGE's lobbyist from Capitol Services shared this article with MAGE.   This article shows that we have been diligently working with our lobbyists and our legislators on solutions for KPH and other mental health institutions.   The excessive overtime mandating continues to be an ongoing issue.

Kalamazoo Psychiatric Hospital a 'powder keg' with volatile patients and overworked staff, nurses' rep says.

KALAMAZOO, MI - Too few staff working too much mandatory overtime, mentally ill patients who are among the state's most troubled, and the cloud of an ongoing criminal investigation have combined to create a difficult environment at Kalamazoo Psychiatric Hospital for patients and employees alike, says John DeTizio, the labor relations director of the Michigan Association of Governmental Employees.

"It is a powder keg," John DeTizio,  said of KPH.  State officials say, however, that they are working to resolve issues at the hospital and that employees know when they hire on that they can expect a challenging patient population and long hours.

"These are tough jobs, and I give a lot of credit to our employees," said Jennifer Smith, public information officer for the Michigan Department of Community Health.

KPH has been under scrutiny over the past several months.   Two high-ranking nurses were fired earlier this year, and the director and a doctor resigned following the death of a patient. Then, the hospital's chief of clinical affairs resigned following a complaint by the acting hospital director that a treatment plan he devised violated a patient's rights.

Now, investigations are underway to consider allegations of patient abuse, including a criminal complaint that involves 16 employees. The state and the Kalamazoo Department of Public Safety are investigating.

So far this year, police have been called to KPH an average of more than five times a week.

From Jan. 1 through Nov. 10, KDPS officers were called to the hospital 231 times on a total of 188 incidents, according to Chief Jeff Hadley.   Those include 171 assault and battery complaints, 17 complaints of criminal sexual conduct and other issues that include harassment, escapes and trouble with subjects.

"We are there quite a bit," Hadley said of the regional psychiatric hospital on Oakland Drive. "My sense is you are dealing with a population that has been diagnosed with significant mental health challenges, in an enclosed environment, under constant supervision, among other folks with similar mental health challenges."

Smith agreed that the KPH population can be challenging, and that there have been "issues" at the hospital of late. "We are working diligently to make sure patients and staff are safe," and that the hospital is "a good environment," she said.
Smith said 28 employees at KPH have been suspended, with pay, since the investigation into patient abuse allegations began in October. Meanwhile, the patient census remains unchanged at 138.

In recent weeks it has not been unusual for a registered nurse manager to be required to work mandatory overtime shifts as often as three times a week, DeTizio said, and there is no limit to the number of times that can occur in a pay period.

Attempts to reach the union representative for the residential care aides were unsuccessful, but they appear to be in the same situation. The rules for mandatory overtime show there are no limitations as to how many days in a row "mandation" can occur for resident care aides or nurses who are union members. Registered nurse managers may only be "mandatoried" for two consecutive days, though the number of times that happens in a pay period is unlimited, DeTizio said.

Staff at all levels are forbidden from working more than 16 hours in a day.   The KPH workers who DeTizio represents do not have a contract, but work under the Civil Service Rules and Regulations, he said.   It is becoming increasingly difficult to hire and retain new staff, according to DeTizio.  If a nurse graduates with a nursing degree he or she can "either go work with sick people in a regular hospital, or go to a mental hospital and work with people who are not only physically ill but also are mentally ill, including criminal offenders judged not guilty by reason of insanity, or incompetent to stand trial," he said.

"Historically at KPH ... we've had a drastic problem with recruitment and retention of RN supervisors, due in part to reduction of benefits of all state employees," he said, citing cuts in medical insurance, retirement and pay.

Starting pay ranges from $23 to $34 per hour for nurses, managers and directors, according to the Civil Service compensation manual -- lower than the starting wage at nearby Bronson Methodist Hospital, where there is no mandatory overtime policy, a spokesperson there said.

The state's Smith said, however, that overall pay at KPH has increased in recent years and benefits remain competitive with the private sector.

As for staffing levels, Smith said the 2014 budget called for 508.3 full-time employees and that KPH currently has 508 filled positions -- a number that she said includes 11 direct care staff hired this month.  That's not enough, DeTizio maintains, given the environment at the hospital.  "These are extremely dangerous patients, who are constantly acting out, and can hurt other patients or employees," the representative for nurse managers said. "Many (new hires) are leaving after orientation, and one of the main reasons is staffing so short that they are being mandated (made to work overtime) incessantly."

He said he has complained of a worsening work climate at KPH for years, and has recently met with local legislators. In late October, state Rep. Sean McCann, D-Kalamazoo, requested legislative hearings to look into the situation at the hospital. State Rep. Matt Lori, chairman of the House subcommittee on the Department of Community Health, said that it would be premature to hold hearings while the investigations of KPH are pending.  DeTizio, meanwhile, said poor conditions for KPH employees continue.

"I have been representing these guys for 30 years," he said. "The last two years it has been worse."

This article is written by:  Rosemary Parker, a reporter for the Kalamazoo Gazette. Reach her at rparker3@mlive.com.