Just like you, I read, listen and watch the news and hear the horrible statistic that someone every day in Maine is lost to a drug overdose. For every one person we lose to an overdose, we have at least four other people grieving this loss. This is truly a crisis that affects us as a community, and it is a complex problem that will take all of us working together to make a difference.
As a state, I see us moving forward with many wonderful initiatives, such as the work of the Health Leadership Board, the Bangor Area Recovery Network, the newly formed legislative opioid task force and small communities coming together to talk about what we are going to do with this public health crisis. I hear physicians coming forward to talk about the overprescribing of opioids and moving forward with new programs to work with chronic pain. I hear about state and federal grants to support medication-assisted recovery in physicians’ offices for the uninsured. All of these and many more are moving Maine forward in maintaining healthy communities and reducing drug overdoses.
But I hear little about the problem of recruiting and retaining a professional workforce, a problem I dealt with as an executive director of a substance use disorder and mental health treatment center. Even if our prayers were all answered today and we could open all the programs needed to support prevention, treatment and recovery, we do not have the workforce to fill the jobs. We have a behavioral health workforce problem that, if unaddressed, will leave us without the ability to offer the treatment necessary to start our community on a path to recovery. These jobs often are stressful and require a professional skill set to work with individuals who have complex problems that include substance use disorder, mental health, trauma and physical health issues.
The largest difficulty in recruitment and retention of this workforce is that agencies cannot compensate our direct care workers enough to stay in this field. Providers have the same economic pressures as other businesses, such as increasing expenses in worker’s compensation, health insurance and other administrative expenses necessary to operate a quality program. When agencies are not allowed to operate in a free market because they are subject to state imposed price control, they are unable to retain a quality staff.
We need to recognize that these direct care workers are educated and highly skilled. People working in behavioral health are entrusted with the lives of our families and friends who we love dearly. They deserve to be compensated at a level that recognizes them as professionals. They deserve to earn a living wage that gives them the ability to have a decent quality of life.
Lawmakers are considering a bill, LD 1517, that would assist Maine in improving the quality of behavioral health services. One part of this bill addresses how we set rates, and it would allow agencies for the first time in many years the ability to get reimbursed at a fair and equitable rate. We cannot continue to have agencies serve people at today’s cost with 10-year-old reimbursement rates.
The hardest part of my job was to do exit interviews on promising staff members who could no longer stay with the agency because of financial reasons. In order for agencies to remain open under this current system of fixed rates, they had little to no choice but to reduce hours, deny raises, eliminate cost of living increases and pass the increased health insurance cost onto the employee. During a crisis, when lives are being lost and we need to increase access care, we cannot expect agencies to operate quality programs with old rates that do not meet today’s financial standards.
Maine has a real opportunity to make a difference in the lives of our families by ensuring quality, affordable prevention, treatment and recovery centers — but we need to keep them open for business. To do this will be impossible without developing a workforce that is professional, passionate, dedicated and pays a fair wage.
Patricia Kimball served for 15 years as the executive director of Wellspring, a substance use disorder and mental health treatment center located in Bangor, before retiring last September.