The committee passed the bill by a 5-0 vote, with one of the votes coming from Sen. Ann Cummings, D-Washington, the chair of the powerful Senate Finance Committee. Senate President Pro Tempore Tim Ashe, D/P-Chittenden, is also supporting it.
“This is a huge issue, and it needs a lot of light on it, and if it takes a (multi-million-dollar) appropriation to get somebody to say ‘Whoa,’ then that’s what we’re going to do,” said Sen. Claire Ayer, the chair of Senate Health and Welfare.
Ayer said she is looking at transferring money called disproportionate share hospital payments, known as DSH, that Medicaid gives to hospitals to take care of uninsured patients. About half of the funding comes from the federal government.
Medicaid has given the hospitals $37.4 million per year in payments for the past several years. Gov. Phil Scott’s budget called for reducing DSH payments by 10 percent. Ayer said she has other funding sources in mind and would do work over the weekend to finalize them.
The bill, which does not have a number on it yet, is headed to the Senate Appropriations Committee. Because the bill has an appropriation, the crossover deadline to vote it out of the Senate is March 24 — one week later than policy bills have to be voted out.
The spending items in the bill would require the Agency of Human Services, which funds designated mental health agencies and specialized services agencies, to increase pay for direct care workers to a minimum of $15 an hour — which would mean a raise for about 2,400 workers.
The bill would also require the agency to increase salaries for higher-level staff, such as case managers, to at least 85 percent of what state workers and school workers make in comparable positions for comparable lengths of employment.
Julie Tessler, the executive director of Vermont Care Partners, which represents the designated mental health agencies, said the agencies have received cost of living increases of 1 percent per year for the past decade.
The low pay makes it difficult for the agencies to retain workers; the turnover rate has been around 27 percent per year.
Tessler said the Vermont Care Partners estimated a few years ago that it needed $43 million to pay four different types of workers as much as the state pays similar workers. But she said $30.2 million “would go a long way.”
To fund the increased pay, the bill asks for $30.2 million in Medicaid money—$14 million in state money and $16.2 million in federal money—to be transferred to the Department of Mental Health. The bill would then appropriate another $240,000 to expand staff on a peer-run mental health phone line.
“We have a mental health system that’s imploding,” Cummings said. “We have chronically underfunded it, and we are reaping the havoc of not having enough staff to do the job, and we need to deal with it. We have some of our most vulnerable citizens just being warehoused in hospital emergency rooms waiting for a treatment space.”
Cummings said she is willing to seek new revenue if the Senate can’t find savings in another area of the budget, but she has not decided what she would tax. “There isn’t anything obvious at this point,” she said.
“Some of that money can probably be found in the system in savings, and then we’ll have to decide where to go from there, and those kinds of corrections will have to be made in” the Senate Appropriations Committee, Cummings said.
Ashe, the Senate president, said Thursday that workers for construction projects and road projects funded through state money are guaranteed competitive wages for their work, and “there’s no conscientious reason that justifies” why mental health workers aren’t.
“The idea that people who work with mentally ill people can be paid as low as $12 an hour for work that if they were working in state government, or for a hospital or for a doctors office would be making nearly double that—that’s why I do support increasing the wage,” he said.
Other parts of the bill, which do not have appropriations, call for the Agency of Human Services to come up with a plan for how to improve situations in the mental health system by Sept. 1. Another provision forms a taskforce to study workforce and training issues in the mental health field.
Ashe said the studies will help the Legislature understand how best to improve the system.
“These are supposed to be action plans,” Ashe said. “Figure it out. Give us the plan. Give us the language. And get it done.”