Psych Center staff cuts still a problem
Psych Center staff cuts still a problem Gov's budget moves Mental Health Services in right direction, but...

No relief for psych centers
But while the budget calls for an overall net staff increase of 320 at the Office of Mental Health, staffing for inpatients would drop by 383 - a threat to both safety and quality care.

"It defies logic that the same number of patients will be maintained in our psychiatric centers, but will be cared for by fewer staff," PEF representatives told state lawmakers at a January budget hearing.

"The governor's call for a temporary moratorium on psychiatric-center bed reductions is long overdue," the union told lawmakers. "And this moratorium should continue until only those patients appropriate for release are discharged into our communities and every discharged patient receives comprehensive treatment."
But PEF members at the state psycyhiatric centers already are struggling to care for patients who increasingly tend to be younger, more violent and substance abusers.

For the first two quarters of FY 1999, the injury rate for OMH employees was 27 per 100 employees, nearly twice the 15 per 100 employees in 1997-98, and about triple the 7.6 assaults per 100 staff in 1996-97.

Shared staff still out in cold
The budget also fails to restore the 149 staff positions shared with counties that were cut last year.
These employees provide a wide array of services in county clinics, emergency psychiatric services, day-treatment programs, case management and residential settings.

Although the governor would hike funding for local case management and assisted community treatment services, it would not make up for the loss of the shared staff, according to Christina Brady, a shared staffer and PEF's OMH labor-management chair.
The proposed switch to regional appointing authorities is another threat to PEF members in this budget.
Facility directors have that authority now and are more likely to avoid disrupting long-term staff-patient relationships in order to satisfy a bureaucratic demand for personnel changes.

Besides, the state already has authority to move employees across layoff units to where they are needed and to avoid layoffs. This law protects employees' seniority and gives them some choice in job assignments.

"The governor's proposal to create regional appointing authorities in OMH is simply a way to get around these employee protections," said PEF Director of Civil Service Enforcement Tom Cetrino. "It would allow OMH to hold over employees' heads the power to reassign them hundreds of miles from their homes without regard to their seniority."

Cetrino urged lawmakers to reject the proposal.

Poor staffing, lack of oversight hurts mentally retarded clients

By SHERRY HALBROOK
At first glance, the governor's proposed budget for the state Office of Mental Retardation and Developmental Disabilities (OMRDD) gives a pretty encouraging impression - a net gain of 446 staff in contrast to large staff cuts in most previous years.

The budget also shows: continued funding for state-operated NYS CARES beds, the transition of contractual information-services jobs to state operations, more service-coordination jobs for family care, more staff for intensive treatment units (ITUs), and expanded specialized-care capacity for clients with the worst behavior problems.
"It's definitely moving in the right direction," said Greg Case, PEF labor-management chair at OMRDD. "But there's still too little support for state professional staff - clinicians who provide treatment and supervisors to oversee programs and ensure quality services."

Will staff follow clients?
The budget calls for shifting hundreds of staff from institutional to community services and moving 250 clients out of state developmental centers to community settings.
But PEF is concerned, Case said, that not enough state professional staff will follow clients into community-based care.

And it appears the expanded staffing within the institutions for intensive treatment refers mostly to more direct-care staff, rather than professional staff.
That's serious, he said, because these clients have severe behavioral problems, are difficult to control and often have multiple disabilities.
In fact, OMRDD regulations require "qualified mental retardation professionals" to oversee intensive treatment at all levels.

Case said the union is asking for a detailed explanation of how professional services will be provided to these clients.
While the needs of the people served by OMRDD have increased in recent years, professional staff to provide those services have been drastically cut. Staff who remain are overloaded and, inevitably, both clients and staff suffer.

One psychologist described "a slow but steady deterioration in the behaviors of some individuals, perhaps many individuals, primarily because we no longer have the staff required for successful behavioral programming."
Escalation of minor behavior problems is common, Case said, because the few remaining staff are focusing on more critical problems, such as assaults, sexually inappropriate behavior, destruction of property and clients who wander or run off.

Staff injuries are up. The injury rate for OMRDD employees in 1997-98 was 19 injuries per 100 employees - more than twice the national average injury rate and 21 percent greater than the injury rate for employees working in the state's prisons.

Untimely inspections
Inadequate state staffing also means too little state oversight for privately operated programs.

State Mental Hygiene Law requires the state to inspect community-based programs twice each year, except for certain outstanding programs that must be inspected annually. But this standard is not being met. In fact, an OMRDD survey manual refers to a three-year cycle for the reviews. It's hardly surprising then that the state Commission on Quality of Care for the Mentally Disabled has reported widespread neglect of develop-mentally disabled residents and misuse of public funds at a number of programs operated by "not-for-profit" corporations. This problem is magnified by the rapid expansion of private community-based services under the NYS CARES program.

Last year, PEF recommended OMRDD add 33 staff to ride herd on these programs. OMRDD did get approval to add 29 people to audit programs, and has asked the Division of Budget for permission to add six more to do fiscal audits.

Case said PEF recommends OMRDD hire 33 more staff this year for quality assurance to try to keep up with the expansion of community services.
The NYS CARES expansion is supposed to include state-operated services too, but it's very slow.
The 1999-00 budget included $10 million for new state-operated residences to house up to 100 clients.

But state residences (staffed by 24 employees) for just 12 of these clients are expected to open in the next fiscal year, while privately operated residences will open for nearly 1,000 clients.

Ironically, state-operated homes offer comprehensive, high-quality services with stability and consistency while the fragmented private operations have chronic problems recruiting and retaining skilled staff.

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