Alabama’s mental health hospitals are short on nurses, other patient care staff

Alabama has a shortage of nurses and other employees to take care of patients in its mental hospitals, a problem that is part of an overall challenge state agencies face with a shrinking workforce.

Alabama Department of Mental Health Commissioner Kimberly Boswell said inflation has forced some employees to work second and third jobs and has made it harder to recruit and retain employees who are often asked to work overtime.

“We’re in a crisis at our facilities right now,” Boswell told lawmakers at a hearing in Montgomery. “I spent a significant amount of my time last week talking to staff in Tuscaloosa and talking to the nurses. And we are at a crisis point.”

ADMH operates three state hospitals in Tuscaloosa — Bryce Hospital, Harper Geriatric Psychiatry Center, and Taylor Hardin Secure Medical Facility.

The most urgent needs are for nurses and mental health care technicians, the employees who provide direct care for patients.

Other state agencies are also having trouble hiring and keeping employees.

In June, the State Personnel Board amended the state pay plan to add four steps to the top of the pay scale for most jobs.

Each step equates to a 2.5 percent raise. The amendment makes employees who had reached the top of their pay range eligible for an additional 10 percent in pay over two years.

Boswell talked about the ADMH staffing crisis at an informal hearing of the Legislature’s budget committees last week. Lawmakers are asking agencies for updates on how inflation and a possible recession are affecting their funding and operations.

Boswell said ADMH is hiring a rapid response staffing company to help bring in employees in over the next 26 weeks.

“Our situation has gotten so critical we’ve pulled administrative staff to work shifts,” Boswell said. “We’ve pulled clinical staff to work shifts. Some of my folks from the central office worked the Fourth of July weekend.”

Boswell said some employees are leaving because of the demands resulting from the staffing shortage.

“Part of what’s happened over time 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.

Boswell said ADMH will work with the State Personnel Department on ways to increase pay and recruit and retain staff. The commissioner said the four new pay steps approved by the Personnel Board will help. She said ADMH is considering a bonus program for direct care staff, increasing pay for entry-level jobs, and hiring part-time staff.

“What people are really looking for is flexibility,” Boswell said. “We have traditionally not hired part-time people at our facilities because it is challenging to do that. But we at this point are considering looking at part-time employees as well as multiple flexible schedules so we can attract the folks that are looking for that flexibility.”

State Personnel Director Jackie Graham said many agencies are facing challenges hiring and keeping employees, part of a trend affecting public and private employers nationwide. The decision to increase the pay scale at the top end came in response to that.

“We had noticed we had multiple requests from various agencies to increase the salary range for a multitude of problems,” Graham said. “It could be recruitment. It could be retention. Just hard to fill positions, very difficult to recruit in certain areas. So rather than take the piecemeal approach we decided to look at the pay plan as a whole.”

State employees who are eligible for the four new steps at the top of the pay scale can get up to two steps a year, or 5 percent. It is optional for state agencies to offer the new top-end raises.

About 7,500 employees out of a state work force of about 28,000 have reached the top end of their pay range. The state workforce has declined by more than 1,500 over the last two years.

The State Personnel Department has entered a contract with LinkedIn to advertise job postings. Graham said that has increased the number of applications the state receives by about 500 a week so far.

Graham said the Personnel Department is working with agencies to identify high-demand jobs to post on LinkedIn. Examples are revenue examiner, accountant, epidemiologist, environmental scientist, and state medical examiner.

“Hopefully, we can target people who have specific backgrounds for our hard-to-fill or hard-to-recruit jobs,” Graham said.

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