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Larned State Hospital suffers staffing shortages, but labor and management disagree about why

— On the Friday before Christmas, officials at the state's psychiatric hospital in Larned reported they were short 20 mental health technicians and six registered nurses to fill their 3 p.m. to 11 p.m. shift.

Earlier in the month, on Sunday, Dec. 17, officials reported needing 43 mental health technicians to fill that same evening shift.

Robert Choromanski, executive director of the Kansas Organization of State Employees, the union that represents state hospital workers, said in a recent interview that staffing shortages are chronic at Larned State Hospital, and he laid the blame directly at the feet of Gov. Sam Brownback's administration, and in particular, Tim Keck, Secretary of the Kansas Department for Aging and Disability Services.

"The staffing shortages at LSH (are) because of the poor management skills displayed by KDADS Secretary Tim Keck. There is very little morale left at LSH," Choromanski said recently in an email to news outlets.

Keck declined to respond to that charge. But in a phone interview, he did confirm that there are serious staff shortages at the hospital, and that they are raising concerns at the Centers for Medicare and Medicaid Services, the same federal agency that in 2015, decertified Osawatomie State, cutting off its qualifications for receiving Medicare reimbursements.

But Keck said staff shortages are only part of the problem, and one of the larger issues has been the staff itself.

"It’s a big institution there, we’ve got a lot of people working there, and a very high percentage of employees are hard-working, dedicated that are committed to our patients and to their job, a very high percentage, probably 90 to 95 percent," he said. "But it’s like any big institution. We have a number of employees who don’t want to do what they need to do. We’re changing the culture there, I promise you that."

Keck said one issue that routinely comes up at Larned is employees calling in on payday, saying they are unavailable for work that weekend.

"We’ve heard anecdotally that people are going to a concert or a rodeo," he said. "For example, on the weekend before Christmas, which was a payday, we had, I think, about 50 people call in that weekend. So that hurts the staffing, of course. This is nothing new to Mr. Choromanski. It’s stuff he and I have talked about, and so far, I haven’t seen any solutions from him."

Larned State Hospital is a 525-bed facility located about 130 miles west of Wichita in Pawnee County. The city of Larned itself has a population of only about 3,900 people, and so the hospital is one of the largest institutions in the town.

There is also a mental health correctional facility in Larned, administered by the Kansas Department of Corrections, which houses the most severely and persistently mentally ill adult male inmates within the state prison system.

The hospital is perhaps best known for housing the state's sexual predator treatment program, where 218 beds are reserved for people who have served their sentences for violent sex crimes, but are committed to the hospital by a court for further treatment because they're still considered to be a danger to society.

Another seven "reintegration" beds in that program are actually located at Osawatomie State Hospital and are designed for people who have been treated and are ready to transition back into their communities.

Another 220 beds are reserved for what is called the "State Security Program," which treats people with mental illness who've been committed there by a court due to other kinds of criminal behavior.

The other 90 beds are reserved for the Psychiatric Services Program. Of those, 30 are designated for a crisis stabilization unit, and 60 are for patients needing long-term residential care.

Keck said his agency has made significant gains in reducing chronic staff shortages at Larned during his two years in office. According to agency figures, the number of vacant positions has been reduced from 110 in early 2016 to just 43 now.

Most of those are mental health developmental disability technicians, or MHDDT's, and registered nurses, the two biggest employee groups at the hospital.

Choromanski argues that the staffing shortages are due mainly to the relatively low wages the state pays.

"It is always a budgetary issue, because if they had paid enough people a living wage for all of those mental health and developmental disability technicians and registered nurses, and yes, I know Larned is out in western Kansas. But if they paid people enough money, people would come and do the work," he said in a phone interview. "But because the private sector pays better money, it makes no sense for them to work for the state."

Keck, however, disputed that, arguing that a bigger problem is recruiting people to work in the remote western Kansas town.

"It’s not the community’s fault. It’s the circumstances that I think you’re aware that people are moving from rural communities to the more urban communities in Kansas," Keck said. "Over time, that adds up."

Keck added that the state may need to consider relocating part of the hospital to a larger market with a more plentiful workforce.

"We’ve contemplated moving Larned State Hospital to another part of the state. It might be time to start talking about doing that," he said.

Angela De Rocha, spokeswoman for the department, said the only plan that has been discussed would involve moving the state security program, and she said those discussions were still in the preliminary stage.

Meanwhile, Choromanski said he believes the staff shortages at Larned State Hospital reflect what has happened to the entire state workforce during the Brownback administration which, according to his spokeswoman Rachel Whitten, has been cut in size by about 13.5 percent during his time in office.

He said many other agencies are suffering staff shortages now, ranging from social workers in the Department for Children and Families and prison guards in the Department of Corrections to highway maintenance workers in the Department of Transportation.

"All we can do is, we try to lobby the Legislature, to keep the pressure on the Legislature to provide the funding to ensure that critical, core state services are well-funded," he said."

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