First, state officials offered $7,000 signing bonuses for nurses willing to work in Colorado’s two state mental hospitals.
No one seemed to care. It wasn’t much of a bonus, at least in terms of the competition across the state, which is facing a shortage of an estimated 10,000 nurses.
Then the Colorado Department of Human Services bumped its signing bonuses to $14,000, on top of 5% raises this year and temporary 8% raises for next year for nurses at the mental hospitals in Pueblo and at Fort Logan in Denver. Now, the state is making some progress on the severe staffing shortage that has plagued the hospitals since the coronavirus pandemic hit Colorado and huge numbers of nurses quit their jobs.
A recent “hiring blitz” will bring the total number of nurses hired to work at the hospitals to about 20 since mid-March, when the $14,000 bonuses went into effect. That’s five times as many as were hired in all of 2022 — which was only four nurses.
Still, it’s not nearly enough when the hospitals need to hire 263 nurses to fully function. The Colorado Mental Health Hospital campuses in Pueblo and Fort Logan, which treat people in the criminal justice system and people who have been civilly committed, eliminated a combined 100 beds during the early days of the pandemic and have not been able to open them since.
All of those beds were for forensic patients, meaning there are 100 more people with mental illness waiting in jail instead. They are people who need mental health evaluation and treatment before their criminal cases can proceed.
“This is a real tragedy,” said Leora Joseph, director of the state Office of Civil and Forensic Mental Health. “The whole justice system comes to a screeching halt until these people are able to participate in their case.
The whole justice system comes to a screeching halt until these people are able to participate in their case.
— Leora Joseph, director of the state Office of Civil and Forensic Mental Health
“What it means when we close hospital beds is that there are people who need treatment and can’t be admitted to the hospital.”
Colorado, meanwhile, is paying about $12 million each year in fines because of the backlog of people whose trials are delayed due to the forensic bed shortage. The waitlist for forensic beds now has about 460 people who need treatment to restore mental competency.
The fines, which go into a designated fund intended to solve the backlog, are part of a federal consent decree that came after multiple rounds of lawsuits against the state, including from the Disability Law Colorado, which first sued over the issue more than a decade ago. Colorado was required under the terms of the 2012 lawsuit to provide a mental health evaluation or treatment within 28 days of arrest, a timeline the state has long struggled to meet.
The larger of the two state mental hospitals, in Pueblo, had 516 beds in 2021. Now, it has enough staff to operate just 422 of those beds.
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Fort Logan, which is in southwest Denver, is licensed for 138 beds, yet has only 106 in use.
The staffing crisis is mainly due to the shortage of nurses, though the hospitals also are struggling to hire nutrition and custodial workers, Joseph said.
Nationwide, nurses have left the profession since the pandemic or have been lured to contract jobs that pay more for fewer hours. Contract nurses can travel, working in various cities, and if they want, take summers off to spend with their children.
“Obviously, we can’t run a hospital without nurses,” Joseph said. “This is a problem that is occurring across the country right now. We are not alone in this.”
The state mental hospitals will hire nurses who are not trained in psychiatric nursing and will give them the training, she said.
Historically, the state has paid nurses less than private hospital systems in Colorado, but recent salary increases have been more competitive. Now, nurses can make more than $85,000 per year, or $103,000 for a lead nurse, according to the Colorado Department of Human Services.
The hiring bonuses are expected to continue through the end of 2023, the department said.
Fully staffed, the Pueblo hospital would have 639 nurses and Fort Logan would have 78. As of now, 40% of those jobs are unfilled.
“That is an enormous vacancy rate,” Joseph said.
Nurses left the profession in droves because of the pandemic. For months after Covid hit, they were required to wear not just masks but goggles and other protective gear.
Joseph said she previously assumed that the hospitals were struggling to hire staff because the job is so demanding. Patients have such severe mental illness that nurses must check on them every 15 minutes.
“These are very sick patients,” she said. “I thought that one of the reasons we were having such a hard time is that these jobs are very hard. But it’s the patients people are motivated by — their ability to watch people get better.”