Department of Behavioral Health and Developmental Services Commissioner Alison Land asked for about $216 million in American Recovery Plan Act (ARPA) funds in a presentation to legislators. Her number-one ask was $75 million to increase salaries to retain and attract staff to Virginia’s troubled mental health facilities.
A week ago, Land closed admissions at five of the state’s eight mental health facilities. On Thursday, she told the Joint Subcommittee to Study Mental Health Services in the 21st Century those closures were necessary to help reduce the number of patients at dangerously understaffed facilities.
“I did need to have to take the action of closing five of our adult and geriatric facilities to admissions temporarily because of the unsafe staffing levels and the amount of serious injuries and incidents that were occurring in our facilities,” Land said. “We’ve had 80 serious injuries now since July first, and an additional 17 on Monday and Tuesday of this week.”
Land said the injuries were due to patient-on-patient and patient-on-staff assaults. “These are serious injuries and incidents with lacerations. We’ve had orbital fractures, assaults with lots of hematomas and abrasions and broken bones,” she said.
Legislators asked Land if she sought legal counsel or other authorization for the admissions closures.
“This was not an approved decision. I did not have approval from [Health and Human Resources], or the Governor, or our legal. This was a decision that had to be made because of the safety issues in our hospital. We cannot operate like that,” Land said.
Land said the problem began before the pandemic. She’s warned legislators multiple times that the facilities are understaffed, which she said Thursday was due to non-competitive wages and dangerous environments leading to low staffing levels. That led to mandatory overtime for remaining workers, leading more to leave the system. That led to Land’s ask for $75 million to bring critical direct-care salaries to the 75th percentile.
“Nobody in this environment is going to take $11 an hour, which is where we start off our DSAs, and come into a facility where they’re going to be mandated double shifts,” Land said. “But you’re not going to come in and do that when you can go and work at the Wawa or in some other industry that’s less risk to you. You’re not going to be assaulted. I mean, I guess anybody could be assaulted at any time, but it’s not a daily thing. And you’re not face-to-face with high-risk patients in a pandemic.”
Land also requested funds for other areas, including safety infrastructure, contract staffing, community capacity, and technology. But many of Land’s asks are only short-term solutions. Long-term, she says the agency needs a bigger budget to pay for the increased salaries, and she’s hoping that if legislators give the department ARPA funds, legislators will also be prepared to fund the new salaries in the annual budget.
Land has begun using the department’s $25 million emergency fund to pay bonuses to employees to slow staffing losses.
“The emergency is now, and so we are going to spend that,” she said.
She’s also not waiting until the facilities are fully staffed to reopen admissions.
“I’m not talking about, again, that we have to be perfect in our staffing for us to reopen, but it’s got to get safer,” Land said.
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