ANNAPOLIS – Community mental health organizations already face a serious staffing shortage and looming state budget cuts could make the situation even more dire, advocates told lawmakers Wednesday.
“There’s a serious shortage in mental health overall,” said Herb Cromwell, executive director of Community Behavioral Health Association of Maryland.
But because the public mental health system is at the low end of the totem pole, “that shortage is particularly acute,” he said after a meeting of the Joint Committee on Access to Mental Health Services.
Some agencies in the state have gone several years without a child psychiatrist or have stopped taking psychiatric referrals for weeks, Cromwell told the committee. One organization lost five employees in the last year to state agencies.
Now, with a budget shortfall of up to $1.5 billion looming, those organizations soon may have even less funds to hire and retain quality employees, he and others said.
Community-based agencies also have to compete with state agencies, which pay employees significantly higher wages — between 11 and 18 percent more when hired and 8 to 15 percent more after three years, said Graham Atkinson, technical consultant for the state’s Community Services Reimbursement Rate Commission.
Many community organizations pay less than the state’s living wage, which will require state contractors pay employees $11.30 per hour in urban areas after Oct. 1. The community organizations will not be affected by that law.
“We pay rehabilitation assistants $9.75 per hour and rehabilitation counselors $11 per hour,” said Lori Doyle, chief of operations for Baltimore County-based Mosaic Community Services.
She said dozens of employees in the last year either left Mosaic in less than three months or did not show up for their first day of work, often because of the low salary.
And a law passed this year requires that employees at youth group homes complete a state-licensed training program.
Jim McComb, executive director of the Maryland Association of Resources for Families and Youth, applauded that move but also said Maryland should raise both standards and pay for group homes.
It is wrong to “say you have to be certified, then say we can’t pay you any more,” McComb said.
But advocates fear that help, at least from the state budget, is not on the way.
The General Assembly in 2006 mandated that the state increase fees paid to community service providers each year to cover a cost-of-living increase. Most providers use those funds to target the staffing shortage, Cromwell said.
But the law said that cost-of-living adjustment, which is set by Atkinson’s commission, “was subject to the limitations of the state budget.” Community-based mental health providers received the full 4 percent recommended for fiscal 2007, but in fiscal 2008 that adjustment was cut to 2 percent, almost half what the rate commission advocated.
Now, with the state striving to close its budget deficit, next year’s adjustment is in danger of being eliminated.
“We’ll always be vulnerable” as long as the cost-of-living adjustment is not required, Cromwell said.
Sen. Delores Kelley, D-Baltimore County, co-chair of the joint committee, has said the recommended adjustment should be mandatory, a position she reiterated Wednesday.
“Our workforce needs are so massive,” Kelley said.
But mental health advocates, while appreciative of that support, fear the cost-of-living increase might be only the first of many cutbacks.
“We’re the first in line when cuts come,” said Mosaic’s Doyle. “And when the state’s doing well, we’re always last in line.”