BARRE — A growing mental health crisis in Vermont — and finding ways to fund increased demand for services — were the subject of a visit by senior legislative leaders at Washington County Mental Services Friday.
Legislators are touring the state to talk to mental health care workers to gauge the size of the problem and come up with solutions to fix it. Legislators were in Middlebury and Bennington on Tuesday and will be in St. Albans and the Upper Valley next week.
Poor pay for mental health care workers has created a critical shortage of staff and services in the field. It has led to higher costs because the burden has fallen on law enforcement and hospitals to cope with caseloads and the need to send patients to out-of-state facilities. It has also created a disproportionate burden on schools to provide costly services for children with trauma or developmental disabilities that add to the education budget and rising property taxes.
Mental health care professionals and legislators agreed that care in community settings was the most effective and cheapest treatment. There is concern that a proposed $4.3 million cut by Gov. Phil Scott in funding for mental health care services would reverse policies to de-institutionalize treatment, leading to higher costs and poorer outcomes for patients.
On Friday, Senate Pro Tem Tim Ashe and Sens. Ann Cummings and Anthony Pollina were greeted by Mary Moulton, CEO of WCMHS. The agency has an annual budget of $53 million and 850 full- and part-time employees. The statewide budget is about $400 million annually.
WCMHS celebrated its 50th anniversary last year, and in March, became the first designated agency in the state to be named a Center of Excellence by Vermont Care Partners, a trade association of nonprofit community-care agencies dealing with mental health conditions, substance abuse disorders and developmental disabilities.
Moulton praised Ashe for his work to increase the minimum wage for mental health care workers to $14 in 2014. It has helped to recruit and train workers, particularly interns. Previously, they would finish the internships and then seek better paying jobs in hospitals or working for the state, attendees heard.
Ashe acknowledged the need for the increase in pay followed growing concern about a significant increase in caseloads, which had been eclipsed by the opiate crisis in Vermont.
“Substance abuse and opiate addiction is a much more broadly understood area of our lives, but rebuilding the mental health system was top of the list for so many of our colleagues,” Ashe said. “We put a primary emphasis, two years ago, in getting every single mental health, substance abuse worker in the state to a minimum starting pay of $14, and I hope it has really helped.”
Ashe noted many of the “frontline” efforts of workers in the field have been under-appreciated.
“We’re trying to make it a real legitimate goal for career, professional development,” Ashe said. He added that the Legislature had set aside $5 million to fund an in-depth review of mental health services in the state and greater collaboration between partner agencies. “I’d like to cue you up by asking you now to offer some insights about what we can do in Montpelier to help with recruitment, retention and professional development.”
“For me, it’s all about the money,” said Susan Loynd, director of human resources at WCMHS. She urged an increase in hourly pay to $15 to help attract and keep staff, and funding for professional development.
Margaret Joyal, WCMH’s outpatient director, agreed, saying it was difficult to fill positions because of “lack of parity” in pay compared with other health agencies that offered higher pay.
It was a theme others echoed, saying it was difficult to recruit college students because of the low wages and the high cost of living.
Sen. Pollina said he and his colleagues have the difficult task of reversing proposed cuts in the state budget, acknowledging the importance of community services versus institutionalized care in emergency rooms, and in hospital psychiatric care units where the annual cost of care can range between $600,000 to $1 million per patient.
Ashe said hospital leaders also recognized their facilities were not the best places to place people with mental health issues, which put added stresses on nursing staff. However, hospitals still receive yearly budget increases that are disproportionately higher than for nonprofit mental health agencies like WCMHS, he said.
The meeting closed with remarks by Mark Tucker, superintendent of the Washington Northeast Supervisory Union, who noted that a significant increase in the placement of children suffering from trauma by the Department for Children and Families in the Cabot area had caused a spike in the local school budget of 65 percent to nearly $950,000 a year for special education costs over two years.
“In other words, these cost increases can be directly associated with the cost of treating trauma in school,” he said in a report to senators. Tucker added that the disruption had a negative effect on student academic outcomes and caused stress for teachers and difficulty retaining staff.
Those costs also led to school budget deficits and added to the overall state education budget and increased property taxes, he added.