The State Worker

Why can’t California end forced overtime at state hospitals?

This week’s State Worker column looks at how departments have employees work extra hours, including mandatory overtime, to staff 24/7 health facilities instead of hiring more employees. We asked a Department of State Hospitals spokesman a few questions about how his department uses mandatory overtime to maintain its operations. (A new Little Hoover Commission report criticizes the policy.)

Here’s the Q&A with Ralph Montaño of State Hospitals. His responses were emailed.

Does DSH need to cut down on mandatory overtime?

The Department of State Hospitals must ensure that it provides adequate staffing to meet patient care needs on a 24 hour, 7 day a week basis. There are many factors that contribute to DSH’s use of mandatory overtime including staffing ratios, fluctuations in patient acuity, staff illness and injuries, and vacancies. DSH has been reviewing its use of mandatory overtime in its hospitals to determine options for reducing it. Additionally, the department is currently conducting a staffing study to evaluate staffing levels in its hospitals.

The Little Hoover Commission says that the state has lapsed into using mandatory overtime as a “staffing tool” and needs to rethink how it schedules employees. Does DSH agree?

The Department’s use of mandated overtime is necessary and we do our best to limit its use. DSH is responsible for providing around-the-clock care to patients with severe mental illness. At times, a patient may need additional staff supervision (one-on-one) to prevent him from harming himself or others.

Does mandatory overtime create a danger for employees and patients?

At times, increased staffing is necessary to improve safety on a unit when a patient’s acuity increases and they become a danger to themselves or others. The department balances this need with the need to have staff work mandatory overtime.

A psych tech I interviewed said that her employer sometimes breaks her union contract by assigning too much OT within a given time. When challenged, management has replied, “Just grieve it,” and insisted staff work anyway, this employee said. Is that a practice in the department at large?


Why doesn’t DSH hire more staff and cut down on the overtime?

As mentioned previously, there are multiple factors that contribute to DSH’s use of overtime. The department must evaluate all of those factors to determine the best option for reducing overtime. While hiring more staff may sound like a simple solution, the geographic location of some of our hospitals, such as DSH-Atascadero and DSH-Coalinga, makes it difficult to recruit and retain staff. Additionally, many treatment and nursing staffing positions are in short supply within the state, which may make it difficult to fill additional positions. Therefore, it is important that the department look at all options for reducing overtime.

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