St. Maarten Mental Health Foundation closing ward if government continues to deny work permits


~ Finding qualified staff a major challenge ~

PHILIPSBURG--If government continues to deny employment permit requests for qualified Mental Health Foundation (MHF) staff, the foundation will be forced to close its Admissions Ward.

While this would be a last resort, MHF Director Eileen Healy said she would not continue to admit patients with mental disorders without the necessary qualified staffers on board.

Healy made the comments during a meeting of the Central Committee of Parliament on Friday. "Work permits are being turned down as we speak. We are seriously looking at closing down Admissions soon if we don't get permits, because I won't take in more patients if we don't have qualified staff," she said.

Healy's comments sparked a strong reaction from Democratic Party (DP) Member of Parliament (MP) Leroy de Weever, who said he didn't understand where her comments "on non-cooperation" stemmed from, given that the foundation had received what he said had been a substantial increase in its subsidy from government over the years.

De Weever also questioned whose authority it was to determine whether MHF should be closed.
However, Healy pointed out that while government had been cooperating and an increase in subsidy had been budgeted for the foundation, this never had been received in January as prescribed and in fact had been given as late as August on one occasion.

Healy said obtaining qualified staff was a "major challenge and hurdle" for the foundation. This, she said, is complicated when government denies the employment permit requests for the persons from abroad.

She told MPs the foundation had gone through the required process of advertising for qualified staffers at the Labour Department and in the newspapers for several weeks and when this had not yielded any success, the foundation had submitted a request for a non- national with the necessary qualifications to work in its operations.

She told this newspaper last night that four permit requests had been submitted, two of which had been approved, one denied and one pending. The permit denied was a first-time request for a Social Psychiatric Nurse and the one that is pending is for a Registered Nurse, both of whom are for the Admissions Ward. MHF has a total of 40 workers.

In addition, while the Labour Department is supposed to give an answer on a permit request within six weeks, Healy said it took three months and longer. "And in the meantime, we have to run a facility," she said.

She stressed that the current complement of staffers in the Admissions Ward could not provide the 24-hour service that was required, without the workers for whom permits had been requested. She said too that while the foundation had at its disposal the services of part-time nurses who had full-time jobs elsewhere, these nurses often were not familiar with patients with mental disorders, which could create a dangerous situation.

The foundation had requested exemptions from Justice Minister Roland Duncan and Labour and Health Minister Cornelius de Weever. "We understand that Minster de Weever is trying to do something about it, but our staff gets desperate. ... It is not an easy situation for us now," Healy said, noting that she wanted to take only good news to Parliament, but she had challenges and wanted to speak honestly about them.

In response to Healy's comments De Weever said: "... You hinted that you are thinking of closing. How can a single person like yourself make that decision arbitrarily? And I'd like to know the structure of your foundation. Who represents the foundation? What are the authorities of the board versus the Director? Is the board or the supervisory board ultimately responsible? Is the director's power mandated or delegated? And what authorities are mandated and delegated to the director?"

Healy said her concerns were shared by the board, whose President Felix Holiday had wanted to be present at Friday's meeting, but couldn't attend. She said the executing of policies was approved by the board and delegated to the director. For serious measures, she said, the board meets, the director advises and decisions are made.
She said they didn't want to close down the facility, but if their Registered Nurse couldn't handle a 24-hour schedule without a qualified assistant, they wouldn't have a choice. "Right now we are working with on-call nurses, which is not healthy for ... our patients," Healy said.

"All civil servants don't understand the impact on all organisations. If we now have to go and dispute something that has been turned down, it takes away from the time we have to implement quality care. We want to be busy now to set up an education plan, but instead I have to go and run behind the Labour Office. If government gives a permit to start a facility ... and now tells me that I don't have a work permit [for my staff], it takes away from the work that I want to do for patients."

She said too that government's subsidy did not cover the foundation's entire operations. "Officially the subsidy should be way lower if the tariffs were higher." She said the problem of uninsured patients also was hampering the foundation.

She said while communication with Health and Labour Minister Cornelius de Weever had been "wonderful," MHF "doesn't know where the recent problems are coming from."

MHF Registered Nurse (RN) Elena Reyes, one of the persons who accompanied Healy to the meeting, suggested that government invest more in local education programmes to produce more Licensed Practical Nurses (LPNs) and RNs. "Most people have to pay out of their own pockets and we know how the economy is – not very easy." She said there had been some internships at MHF recently and she was hoping to encourage these interns to work for MHF.

Based on a suggestion from De Weever, a tour of the MHF facility will be arranged.

Healy attended the meeting with MHF Psychiatrist Dr. Sachin Gandotra, Administrator Lila Jones and Executive Secretary Micaela Warner.

In addition to De Weever, present at the meeting were President of Parliament Gracita Arrindell; MPs Jules James, Dr. Ruth Douglass, Johan "Janchi" Leonard and Silvia Olivacce-Meyers of United People's (UP) party; George Pantophlet and Dr. Lloyd Richardson of the National Alliance (NA); and independent MP Frans Richardson. Several of the MPs present also made remarks during the meeting.