TESTIMONY OF JENNIFER HONIG

STAFF ATTORNEY, MENTAL HEALTH LEGAL ADVISORS COMMITTEE

SUBMITTED TO THE JOINT COMMITTEE ON COMMERCE & LABOR

APRIL 4, 2001

I am Jennifer Honig, Staff Attorney at Mental Health Legal Advisors Committee (MHLAC) and Co-Chair of the Coalition for the Legal Rights of People with Disabilities (CLRD). MHLAC, a state agency within the Supreme Judicial Court, is charged with advocating for individuals with mental illness in Massachusetts. CLRD is a broad coalition of disability advocates, individuals with disabilities, family members, agencies, and other organizations working to promote inclusion, independence, and opportunity for individuals with disabilities throughout the Commonwealth.

On behalf of both these organizations, I urge your support for the Human Service Workers Living Wage Bill, S. 118/ H. 2469. This legislation would guarantee all employees of agencies that deliver social services or child care under contract with the Commonwealth a wage of no less than $12.89 an hour without health care and $11.89 with health insurance. Salaries would be recalculated annually to maintain wages at no less than 135% of the federal poverty line for a family of four.

Since 1990, human services workers have not received cost of living increases to match inflation. Between 1990 and 1996, workers in private agencies funded by the state went without a pay raise. As a result, the real value of many salaries has decreased by 20 percent. The vacancy rate statewide is 30% and, in many agencies, the turnover rate is 60% per year.

As part of MHLAC's mandate, we respond regularly to concerns regarding the quality of care provided to our clients. Over the past decade, MHLAC has observed and documented a relationship between inadequate wages for mental health workers and compromised quality of care. We have noted a number of reasons for this correlation.

First, low wages for community mental health workers produce a general decline in the experience level of staff which, in turn, creates the potential for poor care. Vendors have difficulty attracting highly qualified individuals. And, as employees gain experience and educational qualifications, they often leave their jobs for higher paying positions elsewhere. Such staff turnover, and the consequential loss of continuity of care, is damaging to the therapeutic relationship. Given that people with mental illness may have particular difficulty forming relationships, relationships with caregivers are often of central importance to their lives. The loss of such caregivers is likely stressful and may be traumatic.

Second, low wages may contribute to unnecessary hospital admissions for people with psychiatric problems. We have seen that psychiatric hospitalizations often result when staff are unable to address psychiatric crises in the community. This result is more likely to occur when staff are unfamiliar with an individual's behavior and the forms of assistance which may be helpful to the individual. When staff are unable to respond effectively, individuals often decompensate -- resulting in hospital level care.

Third, low wages for community mental health workers may result in higher numbers of incidents among residents of community-based settings. Again, when staff do not know residents well, they may be unprepared to anticipate and respond to crises. And, in fact, in the Commonwealth, there has been an increase over time in the number of critical incidents reported regarding Medicaid recipients. While we do not have the data detailing the range of causes that may have led to this increase, we strongly suspect that low skilled and underpaid workers contribute to the increase in such incidents.

Fourth, low wages may contribute to the problem of the extensive wait list for residential services for people with mental illness. Vendors who cannot fill vacancies or find highly trained staff are unlikely to want to take more institutionalized and needy individuals, such as those currently stuck in institutional settings. Additionally, low paid workers may lack the skills to train residents currently in their programs to move on and live more independently. To the extent that staff cannot help people move through the system, the wait list backlog is perpetuated.

Fifth, the persistent payment of low wages devalues community-based living in the eyes of providers and consumers alike. Through low salaries, we send a message to providers that we don't value their work. We also send a message to consumers that we don't care about their self-respect or empowerment, that we are content to have a stream of strangers intrude upon their privacy, and that we aren't committed to their full integration into society.

For these reasons, MHLAC and CLRD strongly urge you to support the modest increase in wages for human services workers provided by this bill.

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