National Guard members file out of a training at Oregon State Hospital on Thursday, Sept. 23, 2021. (Amanda Loman/Salem Reporter)

Leaders at Oregon State Hospital want to add hundreds of new employees to address long-standing safety concerns, but the hospital is struggling to fill vacancies it has now.

Pat Allen, director of the Oregon Health Authority, submitted a plan to the Oregon Legislature Nov. 1 to spend $33 million through 2023 to hire an additional 359 nurses, mental health specialists, security and other workers for the hospital’s campuses in Salem and Junction City.

The plan includes adding 283 nurses and mental health specialists to the roughly 1,000 currently working at the hospital.

To move forward, Oregon legislators and Gov. Kate Brown would need to approve the funding during the 2022 legislative session. The legislature earlier this year set aside $20 million to address staffing shortages at the hospital.

Patient advocates and employee unions said the expansion is badly needed to address persistent problems, including employee burnout.

"While some of these proposals exceed the 20 million set aside to address staffing we are hopeful that a robust and comprehensive package will be adopted by the legislature in the short session. We will continue to meet with legislative leadership to advocate for additional positions and increased workplace initiatives to recruit enough staff to meet safe and adequate levels," said Dan Torres, political coordinator for Oregon AFSCME, in an email. The union represents state hospital nurses.

A Salem Reporter investigation in October found the hospital is experiencing more violence between patients and more staff quitting following pandemic shifts in patient care that spread some of the hospital’s least stable patients among workers not trained to care for them.

The hospital has persistently struggled to find a way to care for hundreds of Oregonians with severe mental illnesses, particularly in recent years as the share increased of those admitted for treatment because they’re facing criminal charges.

“It’s certainly a step in the right direction,” said KC Lewis, managing attorney for the mental health rights project at Disability Rights Oregon. The organization monitors patient care in the state hospital.

“It is being acknowledged that there is a staffing problem at the state hospital and it’s being acknowledged that there is a morale problem at the state hospital,” Lewis said of the plan.

But even if hospital leaders receive the money they’re seeking from legislators during the 2022 session, it’s unclear whether they’ll be able to fill the new jobs.

The plan calls for 209 workers to be hired starting next March and another 105 in October. The remainder, about 45 workers, would be added in the spring of 2023.

So far in 2021, the hospital has had more licensed nurses resign or retire than it’s been able to hire, Superintendent Dolly Matteucci told legislators during a Nov. 17 meeting of the House Interim Committee on Behavioral Health.

She presented data showing the hospital has lost a net 17 registered nurses and licensed practical nurses so far in 2021, despite a hiring push.

At the Salem campus, 12% of all jobs were vacant, including one in four licensed practical nurse jobs, and one in five psychiatric care providers.

“We have a variety of efforts underway to stabilize our staffing while ongoing recruitment continues. And we're really focusing on appreciating staff, addressing morale, recognizing and mitigating the impact of the last 20 months,” Matteucci told legislators.

Currently, Oregon State Hospital has 17 temporary and 79 agency employees caring for patients in jobs the hospital has been unable to fill with permanent workers, hospital spokesperson Aria Seligmann said. Contracts for that temporary and expensive help were slated to expire soon, but Seligmann said the hospital intends to extend them through April.

For hospital employees, the plan is welcome news, said Jade McCredy, state worker coordinator for Oregon AFSCME, the union representing state hospital nurses. The staffing proposal came after months of meetings between hospital leaders and union members.

“It could have quite an impact on our members and overall safety in the hospital,” McCredy said.

But McCredy said the union is concerned the hospital will struggle to fill those new so many current employees that new hires will be only backfill vacancies and not expand staffing.

“That does not take away from the fact that they have to focus on both recruitment and retention,” she said. “It’s going to be a challenge to hire these positions.”

The staffing plan calls for other changes intended to make hospital jobs more attractive during a nationwide shortage in health care providers, particularly behavioral and mental health workers.

That includes moving hospital nurses to a 36-hour work schedule, where nurses are scheduled for three 12-hour shifts in one week. McCredy said most of their members currently work four 10-hour shifts in a week.

That change would allow the state hospital to be “comparable and competitive in hiring with other hospitals,” where a 36-hour week is standard, the plan said.

Lewis, the Disability Rights Oregon attorney, said the organization will continue to push for treating more patients in their home communities. He said unless Oregon is able to find a way to help people facing criminal charges get treatment where they live, the hospital will continue to see more patients than it can safely treat.

“The state hospital is a limited resource and there’s no end in sight in terms of the growth of the population,” he said. “Eventually you’re going to hit the limit again unless you do something about people coming in the front door.”

Contact reporter Rachel Alexander: [email protected] or 503-575-1241.

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