Report 2009-608 Recommendations and Responses in 2013-041

Report 2009-608: High Risk Update—State Overtime Costs: A Variety of Factors Resulted in Significant Overtime Costs at the Departments of Mental Health and Developmental Services

Department Number of Years Reported As Not Fully Implemented Total Recommendations to Department Not Implemented After One Year Not Implemented as of 2012-041 Response Not Implemented as of Most Recent Response
Department of State Hospitals 4 6 1 1 1

Recommendation To: State Hospitals, Department of

To ensure that all overtime hours worked are necessary, and to protect the health and safety of its employees and patients, Mental Health should implement the Legislative Analyst's suggestion of hiring an independent consultant to evaluate the current staffing model for Mental Health's hospitals. The staffing levels at Mental Health should then be adjusted, depending on the outcome of the consultant's evaluation.

Response

As noted in last year's annual follow-up response to this recommendation, the Department of State Hospitals believes it has the in-house expertise to identify the classifications that use the highest amounts of overtime, identify the key drivers of overtime use and propose solutions to reduce the amount of overtime used DSH staff. The DSH has identified the key classifications that incur the highest overtime usage, psychiatric technicians, registered nurses and hospital police officers. The DSH has tasked in internal unit to identify look at the staffing model and relief factors to determine if those reflect our true operating need and look at other potential drivers of overtime. After the staffing models have been refined and drivers identified, DSH will implement administrative remedies and propose other solutions to address high overtime usage.

As a complementary step, the Department is undertaking and IT project, ASSIST (Automated Staff Scheduling and Information Support Tool), that is expected to help the department reduce its overtime usage. Specifically, ASSIST will do the following:

- Provide an automated scheduling tool to deal with the complexities of appropriately staffing 24/7 mental health hospitals;

- Reduce the need for level-of-care staff in the scheduling function;

- Provide data to enable root cause analysis of staffing issues such as excessive use of overtime;

- Optimize staff scheduling to reduce overtime usage;

- Enable the department to schedule lower cost staff where clinically appropriate to meet treatment needs.

The ASSIST tool will be deployed in the fourth quarter of 2014.

  • California State Auditor's Assessment of Status: Not Fully Implemented
  • Completion Date: July 2017
  • Response Date: November 2013

Current Status of Recommendations

All Recommendations in 2013-041