After biding her time with a glaring vacancy, Mental Health and Community Services Director Lynda Battaglia broached the topic during Tuesday’s Human Services meeting.
“So this is one that I've talked about for well over a year now, and it's finally time to bring this one forward. This is a creation of a full-time, Genesee County psychiatrist position for the Department of Mental Health. There's no doubt that this is a bigger ask, considering the salary. But it's a specialized service. And it's definitely something that's needed within the department,” Battaglia said to the group of committee members. “Right now, our wait time for somebody to get in with a psychiatrist is about six weeks. And that's when we have all of our providers. I'd like to create this position so that it benefits the community, and it benefits the clients that need to get access to provider treatments. I have to think about stability within the department as well as future planning and longevity for psychiatry.”
She requested an amendment to the 2022 management salary schedule to create one full-time staff psychiatrist (Community Mental Health) position at a base salary range of $292,500 to $331,500. That would mean an estimated salary of between $73,125 and $82,872 for the remainder of the year’s last quarter, at a fee of $150 to $170 per hour.
Fringe benefits would add up to about $21,000 more, for a quarter total of up to $103,814, according to the resolution. Battaglia doesn’t expect these costs to impact the existing 2022 budget, considering the unstaffed positions within the Mental Health Department.
There are four clinical positions and three in the finance area that have been vacant, she said. It may not be an easy job to recruit a psychiatrist to a rural area, but it would certainly add some consistency to the department, she said.
“For the last three years, we've worked with an agency to provide us with services. And that has been helpful, it has definitely been a Band-Aid and has helped fill the gap. However, in the three years, I've had my third psychiatrist. And you think about a person that comes through mental health for services, you're taking a risk every time you have a doctor that's providing the telehealth services. And if it doesn't work out, then I'm bringing in a new psychiatrist. And if that one doesn't work out, I'm bringing in another one,” she said.
“And the agency that I've gone through has been absolutely tremendous," she added. "They’re very accommodating, with excellent communication. The doctor has to be the right fit. And so to have one client have to work with three different doctors over the course of their treatment, it's very challenging, and it's frustrating the clients.”
An upside is that the position could generate revenue and potentially become self-sustaining and not cost the county additional money, she said. It could also reduce the wait time from six to three weeks, which still isn’t ideal, but “if we can cut it in half,” that’s an improvement.
Battaglia proposed creating the position as a hybrid, including in-person visits and telehealth appointments, as an incentive for the right person. She doesn’t want to offer 100 percent telehealth and feels that a hybrid model offers two options to deliver the service. That might better accommodate an applicant, and “we have clients and community members that like to do either way,” she said.
“I think for 2023, it would definitely save the county some money,” she said. “I feel like it’s a win-win all the way around.”
County Manager Matt Landers reiterated how Battaglia has been talking about this need “for quite some time.” Simply put, it sounds like a breakeven proposition, he said.
“Instead of contracting out, you're paying a county employee, and there’s potential for generating additional revenue — more billable hours — which would generate more revenue. Now we're not doing this to make money. And at the same time, if this ended up being a subsidized effort, but ended up providing better service to the community, again, it will be something that the manager's office would support,” he said. “Even going down this route and approving this, that's step one, and it's really going to be a challenge to find a qualified doctor willing to come to us, you know, rural counties have this difficulty. So, in general, I support the effort going forward, because it's not going to be budgetarily … negative to our county budget. And it's got the full support of mental health, but I think we can provide better service.”
Battaglia also requested a budget amendment to hire a full-time mental health financial program specialist position, which would cost $19,553.50 for the remainder of this year. There are funds available in the 2022 budget to cover this expense due to unstaffed positions within the department. This position for a full year will cost $78,214, according to the resolution.
The committee approved the requests, which will continue on the process for committee approval until they finally reach the Legislature for final adoption.
Photo: Lynda Battaglia, Director of Mental Health and Community Services. Photo from the county website.
