Vermont officials are sinking $5 million into new efforts to find and retain workers to help address the state's mental health crisis and opioid addiction epidemic.
The initiative, included in the state's fiscal 2019 budget, is just getting started: Human Services Secretary Al Gobeille met Wednesday with higher education administrators to begin talking about ideas to boost the mental health and substance use disorder workforce.
The budget legislation outlines some potential solutions including new scholarships, stronger loan-repayment programs and "strategic bonuses" for "professionals in Vermont's existing workforce."
But it will take time, as the program's funding is spread over four fiscal years. That's a nod toward the complexity of the problem, said Sen. Jane Kitchel, D-Caledonia, and Senate Appropriations Committee chair.
"This was a way of securing the funding but recognizing the need for a lot of work, a lot of analysis," Kitchel said.
Widespread workforce shortages have been a common theme in Vermont. Gov. Phil Scott made the state's shrinking workforce an issue in his 2016 campaign, though he recently touted an upswing in the number of workers.
The shortage seems particularly acute in the health care field, where hospital administrators commonly complain of their inability to find adequate numbers of nurses, doctors and other staff.
In June, the Green Mountain Care Board convened a panel discussion of health care workforce issues. Shawn Tester, chief executive officer of St. Johnsbury-based Northern Counties Health Care, summed up the mood among those participating.
"I know that health care reform and payment reform is on top of most health care administrators' minds," Tester told the care board. "But it's not the thing that keeps me awake at night. The thing that keeps me awake at night is trying to figure out where our future workforce is coming from."
Those workforce issues come at a time when there are intensifying demands on Vermont's health care system. That's partly due to the state's aging population, but it's also due to increasing number of mental health patients and a concentrated effort to treat opioid addiction.
On both of those fronts, the need seems clear all over Vermont.
The Brattleboro Retreat, which provides both mental health and addiction treatment, lists 46 available nursing positions and 29 mental health worker positions on its website. That's despite the fact that the Retreat is offering registered nurses up to $2,000 in relocation assistance and a $5,000 hiring bonus.
In the Northeast Kingdom, Tester told the care board, there's a "huge need" for mental health professionals. And Gobeille said he's heard about shortages of licensed drug and alcohol counselors and child psychiatrists statewide.
So when Vermont landed a $28 million one-time settlement from the tobacco industry earlier this year, Kitchel saw an opportunity to try and address those issues.
The fiscal year 2019 budget statute pulls $5 million from that tobacco settlement "to make strategic investments in order to expand the supply of high-quality substance use disorder treatment and mental health professionals available to Vermont residents in need of their services."
The legislation parcels out $1.5 million to the Agency of Human Services in fiscal 2019 and in each of the following two fiscal years. Another $500,000 is available in fiscal 2022 "to ensure successful and sustainable implementation" of new workforce programs.
"I viewed the one-time money as a real opportunity to create some funds that we could set aside to address issues that have been identified as a real need," Kitchel said. "If we did not appropriate the money and put a fence around it, it would be gone."
The Legislature didn't simply hand the money to Gobeille's agency. Rather, a work group that includes the agency, the University of Vermont, the Vermont State Colleges System, the Area Health Education Centers program, consumers and primary care doctors is supposed to evaluate proposals that are "most likely to build capacity in a cost-effective and sustainable manner."
Gobeille then must take those ideas back to lawmakers for approval. None of this fiscal year's money can be spent until the agency presents its 2019 budget-adjustment request.
"We have to have a plan together by the budget adjustment (period) that begins in December," Gobeille said. "So we're on a fairly short time horizon."
There's a heavy emphasis on the potential for colleges to help solve the problem. In addition to scholarships, the legislation mentions possible hiring bonuses or loan-repayment programs for faculty and staff "at institutions of higher education in Vermont to teach prospective substance use disorder treatment and mental health professionals."
Kitchel said she's heard that attracting nursing faculty to Vermont has been particularly difficult. "You can't have more students than you have faculty capacity," she said.
Wendy Koenig, University of Vermont's director of federal and state relations, said the school "has a great deal of faculty expertise across a range of areas that could be brought to bear on this challenge."
"We look forward to participating in the work group to define the specific ways we'll be able to best contribute," Koenig said.
The Vermont State Colleges System and the governor's office sponsored a "substance use disorder workforce summit" last year, Chancellor Jeb Spaulding said. He also listed a variety of health care programs already provided by state colleges that send "hundreds of graduates to this workforce annually."
Spaulding said the state's new investment could support more health care-related initiatives via scholarships, loan forgiveness and "operational support" for colleges and universities.
"It is important to recognize both the high cost of education in Vermont and the low wages in these fields that might both be barriers to growing this workforce," he said.
Peter Albert, senior vice president of government relations at the Retreat, said salaries and benefits "play a part" in the current workforce shortage. But he also said work environment and morale are issues that must be considered.
Plus, Albert said the demands on the workforce are changing as technology becomes more sophisticated and more care is provided outside the hospital setting.
The state's $5 million investment "is a really smart idea, and getting more people at the table to talk about it makes sense," Albert said.
Mike Faher reports on health care and Vermont Yankee for VTDigger. Email: email@example.com. Follow Mike on Twitter @MikeFaher.