Health Care

Senators seek $30.2 million to increase pay for mental health workers

Claire Ayer
Sen. Claire Ayer, D-Addison. Photo by Erin Mansfield/VTDigger

The Senate Health and Welfare Committee passed a mental health bill on Friday that would increase funding to workers at designated mental health agencies by $30.2 million in the next fiscal year.

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.”

Ann Cummings
Sen. Ann Cummings, D-Washington, is chair of the Senate Education Committee. File photo by Amy Ash Nixon/VTDigger

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.”

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Erin Mansfield

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  • What’s a few more dollars when you’re already about $17MM in the hole and facing reductions in federal appropriations?

  • Dave Bellini

    This group of underpaid workers are in effect 2nd class state employees. Most of their money comes via the state while performing a state function. They should be state employees. It’s anathema The “designated agencies” were created to privatize a government function and pay poverty wages. Notice that some of the D.A. CEO’s seem to do extraordinarily well when compared to their state counterparts however.
    End this white collar sweatshop and pay these essential workers, many with advanced degrees, a comparable wage. Workers at these “agencies” should keep quitting and getting better jobs as fast as possible. Government only responds to a crisis. You must “create the crisis” for them.

  • Lauren Norford


  • andrew nemethy

    Long overdue. Having covered as a reporter for Digger the shutdown of the state hospital and subsequent reinvention of the mental health system in the legislature, the state took important steps to improve and diversify care options. The system is still strapped for beds to accommodate those in crisis, of course – to save money the Shumlin Administration lowballed estimates of beds needed and lawmakers fought for a higher number (which is still not enough). But the always underlying issue has been the appalling pay for very difficult work. Talk to any mental health worker as I did – nurses, aides, etc – and you’ll hear stories of physical injuries and violence they encounter in their work, and how it’s a really tough job. And yet people have a passion for it. Making $15 an hour is a step in the right direction.

  • Rick Cowan

    And the folks at the Brattleboro Retreat deserve to make alot more, too. According to that publicly-funded hospital’s 2014 IRS 990 form, their prior CEO, Dr Simpson, made $507,000 per year. The current CEO certainly earns a similar amount. Sadly, our tax dollars provide fat paychecks for the CEO’s while the folks on the front line make comparatively little. If Senators Ashe, Cummings and Ayers are serious about providing adequate compensation for mental health workers without deepening our deficit, they will include a provision in their bill to restrain CEO pay.


    • Ritva Burton

      Pay and benefits for upper management and CEOs should be looked at carefully in all the designated agencies around the State. Remember the fiasco with one of the agencies’ CEO retiring with over 1/2 million $$dollar retirement package! Some of that money should have gone to pay the direct service staff.

  • Steve Baker

    I think it’s just the opposite, all of this big government nonsense is leading to more mental health problems

  • Dave Bellini

    White collar sweatshops. If the legislature really gave a dman they would end the failed “designated agency” experiment. The reason they were created was to contract out state employee work, pay workers less money and underfund it. The legislature is two faced. Return the work to state government. As state employees they will earn more. Is that too honest an assessment? Too logical? Be honest legislators, this experiment is a loser. Stop pretending.

    • EthanRogati

      You’re arguing that more government is a solution? Returning the control to the state, making designated agencies into state agencies or dissolving them and having to build facilities to replace them somehow saves money? The amount that taxes would have to go up to cover what you’re proposing is astronomical.

      Which agency did you work for or receive services from that you have a beef with? That’s how it comes across to me, frankly.

  • John Freitag

    While most people in our State can not afford new taxes and fee, clearly there needs to be adjustment with how money is prioritized within what we have.
    This is the challenge that we now face and it means that some within our current state and educational structures who are receiving excessive salary and benefits compared to others, may need to give up something to provide greater equity and better meet our overall needs. This will be particularly difficult for the NEA, one of the State’s strongest unions, who has in recent years demonstrated an inability to see beyond the short term narrow financial interests of their members and to balance that with what is needed for the greater good.

  • We should applaud the Senate Health and Welfare Committee for drawing attention to mental health. The workforce issue cannot be overlooked. Money is only a part of it. An entire health system redesign is what is required. Mental health care is delivered in all settings – primary care, private non-profit clinics, independent group and solo practices, wherever there’s a prescribing provider whether well-trained in mental health assessment and treatment or not, etc… Therefore, we really need to redesign the healthcare workforce and system to offer better quality at a lower cost.

  • Nachman Avruch

    What is a disproportionate share payment? What hospitals get it and what do they use it for? Will they lose this funding if its redirected to increasing the wage floor for mental health workers? What effect will that have on health care in Vermont? Important questions not answered by this article.