Last year, serious problems within Rutland Mental Health brought the nonprofit close to losing its state accreditation. Corrective measures taken by the agency have restored the state’s confidence, but one of the biggest problems for the local nonprofit remains.
Rutland Mental Health is one of 11 designated agencies the state contracts with to provide community-based counseling services, substance abuse treatment, and a variety of programs for the developmentally disabled. In Rutland County, about 3,000 adults and children receive services.
But last summer, the Rutland nonprofit came close to losing its state accreditation and more than $20 million in funding. Complaints of long wait times for mental health services, communication breakdowns, high staff turnover, and a toxic work environment boiled over. Former CEO Dan Quinn resigned and several top executives retired or left the area.
Corrective measures taken by Rutland Mental Health under its current CEO Dick Courcelle have restored the state’s confidence. But Courcelle admits there's still a big problem: a lack of funding to pay staff fairly.
He says the agency is rebuilding its top management team and has worked closely with Vermont's Department of Mental Health and the Department of Disabilities, Aging and Independent Living.
Those efforts, say Courcelle, have helped Rutland Mental Health improve communication and outcomes and forge stronger ties with the state.
He says staff are working to improve governance and foster a culture where employees feel appreciated and heard.
But Courcelle says everything is more difficult when you’re grappling with a staff turnover rate higher than 27 percent.
“When you’re paying someone $11.65 an hour and they’re working with a very challenging individual, you only want to do that work for so long,” admits Courcelle.
Sitting in his Rutland office, Courcelle explains that state-funded Medicaid pays for most of their services, yet reimbursement rates have not kept up with rising costs. “The entire designated agency system in the state of Vermont [is] in peril with respect to its employee turnover rate, because we’re not able to keep employees due to funding and pay," he says.
Courcelle concedes that social work is not known to be a lucrative career, but he says too many of his employees work a second or third job just to make ends meet. And he says Rutland Mental Health constantly loses staff to other state agencies where pay rates are significantly higher.
"Yet we are doing the business of the state of Vermont," says Courcelle. "And if we didn’t do this work, then who would?”
Nick Emlen is mental health services director for Vermont Care Partners, a group that advocates for the designated agencies.
“I’ve been in this job for 15 years," he says. "I pride myself in not indulging in hyperbole. But I was at a monthly meeting of program directors in Waterbury and they were basically saying, ‘We are scared.' And hearing that, I’m scared."
What's scaring people, Emlen says, “is the number of staff vacancies. Because their staff is leaving, because of low salaries.”
Wilda White, executive director of Vermont Psychiatric Survivors, an advocacy group based in Rutland, says if you peel away that low wage you’ll find something more sinister: “Beneath that low wage is another structural problem, a rampant, unchecked, un-talked-about discrimination against people with mental health challenges and those who are employed to help us.”
That discrimination, she continues, means those who suffer from mental illness have little political power to boost funding levels.
“Part of what we have been trying to do with our dialog with the agencies is ask, 'What can we do differently?'" says Frank Reed, commissioner of Vermont’s Department of Mental Health. "How can we work with the designated agency system to provide the highest priority services, and do it in the most cost-effective way and preserve what’s critical? And then, the things that are less critical, to maybe not do as much of."
The hard part is deciding what’s less critical.