A few weeks ago we met with the Governor’s Office about the mental health workforce crisis in New York. We highlighted the need for identifying a part of the $200 million coming to OMH (through FMAP and Federal Block Grant) to be dedicated specifically to workforce. While we know this is one-time money, we took the opportunity to provide a series of recommendations of how this one-time money could be utilized to help provide support to retain and recruit a quality workforce.
In addition, we were asked to survey our members about what they currently utilize to retain their workforce. That information is enclosed as well.
We can create the greatest system in the world but if we can’t even pay prevailing wages then there is no way anything can get done to help our loved ones.
Thank you for taking the time to meet with us recently regarding issues of workforce recruitment and retention.
As you know, the mental health not for profit sector has a crisis in terms of retaining a quality workforce. This is true across the entire human service sector. Regarding mental health specifically, until 2021-22, the annual COLA for the workforce has been withstood for a dozen years resulting in over $300 million lost to the mental health workforce. This has had severe implications for a workforce that is already underpaid and to agencies that are facing upwards of thirty-five percent turnover.
While the not for profit sector has shown incredible nimbleness in providing services to those that are hardest to serve, the diminishing of the workforce has consequences for services for individuals and their loved ones.
The pandemic has also created substantially new demands and needs for mental health services at the clinic and school levels. One of our members reports a waiting list of over one thousand children and adults in their Article 31 clinics. At the same time, several regions have reported that private and county operated clinics are no longer accepting names for a waiting list thereby masking the demand and need.
Turnover rates have grown over the past months despite an adoption of tele-mental health services and as schools open in the fall, we predict a substantial demand for services and treatment.
The FMAP money and the funding from the Federal block grant will provide the NYS Office of Mental Health (NYSOMH) with an estimated $190 million dollars in additional fund. While we understand this money is time limited, the workforce crisis dictates that a percentage of the funding will be well placed for workforce needs.
Per your request, we surveyed our members statewide to find out what innovative practices they are utilizing to keep quality staff in place.
Staff Bonus Payments
Not surprisingly, the number one answer they came up with is one-time bonus pay for staff. Agencies used all kinds of criteria but the common thread was around the assurance that bonuses were provided if an agency has a funding surplus for the year. Bonus pay has been tailored in different ways throughout the MHAs. Some provide across the board bonuses, other provide performance based bonuses and several provide bonuses based on longevity.
Agencies offer a wide variably of health plans but for some individuals who do not need the agencies’ health insurance or are on Medicaid, they will get a one-time stipend.
Most members offer dental, vision and some also offer life insurance.
Hazard Pay, Matching 403B’s, Loan Forgiveness and Tuition Reimbursement
This year several MHA’s provided hazard pay which was based on receiving PPP funding. Many provide matches to 403 B’s. A few MHA’s offer tuition reimbursement and loan forgiveness.
Several affiliate leaders provide bonuses to their staff that recommend someone for employment to the agency. If the individual is hired and stays with the agency for a minimum of several months than the employee that recommended them will receive a one-time bonus.
Pay for Trainings and Professional Licenses
Several agencies will pay for staff to attend training programs that will help benefit the agency as well as pay for professional licenses for staff as well as peer and family certifications. We are able to offer our members no cost Mental Health First Aid Train the Trainer Models through a Legislative grant.
Non Fiscal Incentives:
There has been a notable movement to self-care in recent years as some affiliates offer gym memberships and links with local wellness centers for yoga and tai-chi.
In order to keep quality staff, several members utilize flex hours.
Our members are very enthusiastic about hiring from within and like to do so when possible. Many of our organizations are largely peer run and find that they hire many peers who start off in their programs. One director described it as a ‘pipeline’ from clients to staff to supervisors.
The caveat is that many of our agencies are small and even setting up a career ladder is difficult given capacity issues.
Links to Educational Opportunities
Agencies have created links with local Community Colleges to incentivize the continuing of educational opportunities
This year’s funding provides OMH with an opportunity to utilize the priority area around workforce:
Among our recommendations:
1) Create a bonus structure where staff receives annual bonuses for the duration of the FMAP/Block grant money based on the discretion of leadership.
2) Create a workforce relief fund where providers facing financial hardship are able to receive one time funding to support funding for their workforce.
3) Signing bonuses for the workforce. In order to recruit quality staff, agencies should be provided with discretionary dollars to provide bonuses for joining an agency.
4) Professionalism of the direct care staff. Create a DSP certification for direct care staff in OMH as is currently done in OPWDD recognizing the importance of creating a career incentive for staff.
5) Review creation of a Tier Structure that will link not for profits to the State’s pension system. As we push the idea of creating careers in our sector, what is more powerful than having access to the State’s pension system?
We look forward to a follow up discussion about these ideas.
Board Chair, MHANYS