|AFSME Local 602 - MSU Moorhead|
St. Peter security counselors Eric Ridout, Katie Trimbo and Mike Landkamer all have been attacked this year.
Broken bones. Concussions. Bites. Burns from boiling liquids.
These are the injuries security counselors at St. Peter Regional Treatment Center risk every shift. They know these are the hazards of their job, the hazards of dealing with mentally ill patients – people who would be in prison if they weren’t here.
But last year, there were four times as many attacks against staff as there were four years earlier. That’s not an accident, according to leaders of Local 404, which represents staff at St. Peter. Instead, they say, it’s a consequence of DHS policies that have backfired – for workers and for taxpayers.
Now the Department of Human Services is trying to change how it treats mentally ill patients in the rest of the state. St. Peter workers fear the problems they’re facing could replicate themselves elsewhere – putting other patients, workers and communities at risk.
Security counselors are the front line at St. Peter, where nearly all patients have criminal backgrounds. “You would recognize their stories from newspaper headlines somewhere along the line,” says chief steward John Collins.
Security counselors, Collins says, have two roles. They’re security guards. They’re also teachers, counselors and therapists. They spend more time working with patients than any other staff.
But as DHS reorganized operations at St. Peter over the past several years, the concerns that security counselors raised often got overruled by staff with PhDs and other initials after their names.
Now, there are fewer front-line workers, but more webs of management with less accountability. Overtime costs have soared. Injuries and workers’ compensation claims have soared. The extra costs have wiped out the savings the reorganization was supposed to deliver.
In one change, DHS decided to house all patients with a similar diagnosis together. In this “silo” approach, for example, all the patients with anti-social histories are in the same two units. “In a highly concentrated area, it doesn’t take much for them to feed off each other,” Collins says.
Other changes in policy make it more difficult for security counselors to isolate violent patients and keep them isolated long enough to be evaluated, Collins says.
Each unit, which typically holds 20-24 patients, now has four security counselors each shift. That used to be the minimum staffing, Collins says. Now it’s the maximum. There used to be as many as four “building extras” on each shift; those back-up security counselors no longer exist.
In 2008, DHS laid off 56 security counselors. Now, when someone quits, the position usually stays vacant. DHS is managing staffing shortages almost exclusively by assigning overtime, Local 404 leaders say. That affects taxpayers and security counselors. Last year, St. Peter paid nearly 32,500 hours of overtime. The extra overtime pay cost taxpayers more than $1 million.
Some of the overtime is voluntary, but much of it is mandatory, Collins says. Security counselors may not find out until the end of one 8-hour shift that they have to stay for a second shift. The extra pay definitely helps with family budgets, Collins says, but the extra hours on short notice can wreak havoc on family life.
Assaults, injuries soar
One of the biggest impacts of the changes, however, is the increase in assaults. Security counselors carry no weapons. When confronting a violent patient, they have only themselves, their training – and a radio to call for back-up.
There were 143 assaults on staff in 2009, up from only 35 four years earlier. Security counselors were hospitalized 117 times in 2009. They lost 1,300 days of work.
Injuries harm counselors physically and financially. Though workers’ compensation covers normal wages, security counselors lose shift differential and overtime pay while they recuperate. Some injuries result in permanent disabilities. That affects not only their health, but can force them into a different job. That can reduce their income now and in retirement. “It has a profound effect,” Collins says.
DHS also changed its management structure to match St. Peter’s more specialized silos of treatment. That makes it a nightmare to navigate and address system-wide problems, Local 404 leaders say.
When one worker asked how to bring concerns up the chain of command, DHS responded with a 15-page spreadsheet.
“On each unit, we had a clear boss,” Collins says. “That was the unit director. Now, you’re not going to find one desk where you can say, ‘The buck stops here’.”
Almost every unit now has two managers where there used to be one, he says. In one case, DHS hired five people to handle the duties that one unit director handled before he retired.
In addition, Collins says, while staffing of security counselors is stretched thin, DHS hasn’t been shy about trying to entice licensed medical staff to stay. Enticements include offering them five-figure retention bonuses.
Katie Trimbo was out of work for four months after a receiving a broken wrist and tendon damage breaking up a fight among patients.
“It’s really demoralizing,” he says.
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