Meanwhile, some employees of La Frontera's
Presently, there 313 employees working in La Frontera's
That's about 22 percent -- or 87 people -- fewer than the staffing level when the firm took over as a provider.
Since April, eight people have been fired for performance reasons, and those were "mostly in
The recent reductions follow an earlier wave of layoffs, firings and resignations that happened in the first few months of 2014.
"We were hoping to increase productivity (of employees) and do some other expense reductions to be able to break even," he said.
But that didn't cut expenses enough, Ranieri said. Because personnel makes up more than 70 percent of the group's costs, that was a key area to cut, he said.
"The options were either to do layoffs or cut everybody's pay," he said. "We're basically trying to stabilize the organization financially."
In reducing personnel, Ranieri said administrators "tried to reduce staff for folks who weren't actually seeing clients."
"When we did do reductions on the clinical side, it would be with staff whose service delivery wasn't particularly high," he said.
Ranieri said most clinical employees must spend between 100 and 125 hours of time with clients each month.
"The minimum we require is 100," Silcox said. "The goal is really to get to 125."
Hours spent with clients is the basis for the agency billing for its services.
Employees in two specific programs that are more time-intensive to carry out than others don't have the same benchmarks, Silcox said.
Therapists who formerly worked for
Ranieri said some of the staffing reductions resulted from changes to the standards for what's billable to
"Consequently, we're not providing as much service," he said.
Several staff members have quit La Frontera because of displeasure -- for several reasons -- over work conditions, some
As employees resign, are laid off or are fired from La Frontera, their caseloads have been redistributed to remaining employees, said some La Frontera staff. And that has increased their stress level.
Clinical staff at La Frontera said they're squeezed between conflicting pressures. On one hand, they're mandated to meet hours-of-service benchmarks with clients. But paperwork requirements -- and the time it takes to fill those out -- also have increased.
"We cannot keep up with the numbers if they keep inundating us with paperwork," said one
Ranieri said key reasons La Frontera is now a state provider are because "a lot of billings weren't done properly and documentations weren't done properly." But it's part of the job of La Frontera employees to keep on top of that paperwork, he said.
"I've been in this business 38 years, and that's the piece that has changed the most," he said. "The documentation has gotten so much more cumbersome. But we don't make those rules."
An investigation into the remaining behavioral health providers is ongoing.
Meanwhile, some employees said there's a disconnect in
"It's really us against them:
There's only been one administrator from
Another La Frontera staff member in
"The turnaround on clinical staff does affect the clients," said the employee, whose identity also is being withheld.
Employees said their workplace problems are compounded by a series of changing records-keeping systems at La Frontera over the past year.
In the first few days of La Frontera's operations a year ago, many employees didn't have computers because the previous organizations had taken them when they vacated their offices, making way for the new provider.
Employees of the former Southwest Counseling Center, who transferred to La Frontera's payroll after the state suspended
Employees said the chaos with the record keeping, along with turnover in staff, contributed to incomplete client files, as well as adding to the difficulty of their jobs.
Ranieri acknowledged there have been several changes in the record-keeping systems. And that has led to extra work for employees, particularly because the newest software is still being implemented. But he said once that process finishes, record-keeping will be much smoother.
"I'm a clinician and psychologist by training, and if the medical records aren't working smoothly, it's a nightmare," he said. "But the bottom line is, it's not like we're doing something evil to them. That's how you run a business nowadays; that's part of the job."
Problems caused by the medical records, however, are "not the reason people get let go," Ranieri said. Rather, he contended, that's because of shortcomings in job performance.
"Some of that's true, but people exaggerate it to fit their story," he said of the impact of the record-keeping changes.
"The system was underfunded," he said.
But Frietze said he didn't want to cut staff levels at
"We had lost money but we looked for ways to close that gap, through grants and other sources," he said. "We just weren't ready to close the doors and get rid of people and services because those were essential services."
Ranieri said La Frontera's goal was to reach financial stability by
"But the work load demands in terms of the service delivery -- that's not going to change, and for some people that's an issue," he said.
With the expansion of eligibility for
"I think it's happening, but it's happening slowly," he said the ramp up in demand.
Still, the Affordable Care Act also opened the door for traditional primary medical care providers to enter the arena of mental health care, which could dampen any new demand for La Frontera's services.
(c)2014 the Las Cruces Sun-News (Las Cruces, N.M.)
Visit the Las Cruces Sun-News (Las Cruces, N.M.) at www.lcsun-news.com
Distributed by MCT Information Services