A $162,221 starting salary might sound attractive to most people, but it’s not enough to get new psychiatrists to join the county Mental Health Department.
The department currently has four psychiatrists on staff but has been unable to fill a fifth position since May 2006 despite continuous recruitment efforts, county Mental Health Director Dale Angstadt said Wednesday.
“Our salary scale for psychiatrists has fallen behind that of hospitals in the area and the general cost of living,” Angstadt said in a report to the county Personnel Committee.
There’s a general shortage of psychiatrists nationally, and local hospitals start new staff psychiatrists at as much as $185,000, Angstadt said.
Committee members agreed something has to be done to raise salaries, and done quickly, since one of the four staff doctors is retiring in June and the county will need to also recruit for his position.
“My fear is we’ve got a department running short-staffed and it’s going to get shorter,” said Personnel Committee Chairman Willard Peck, R-Northumberland.
Angstadt said other issues in trying to recruit include a vacation package that doesn’t grant two weeks until after a full year on the job, and a per-hour reimbursement to private psychiatrists willing to work under contract of only $104 — again, less than hospitals will pay.
County Personnel Technician Jack Kalinkewicz told the committee the Board of Supervisors has the ability to hire doctors at a figure above base salary. However, the top pay for a psychiatrist under the county compensation plan is just $199,356, Kalinkewicz said.
Even at the current levels, the psychiatrists are the highest-paid county employees, out-earning the county administrator and all other department heads.
Psychiatrists are medical doctors specializing in the treatment of mental illness and, unlike psychologists, have the ability to prescribe medications for mental illness. Angstadt said new medical school graduates in psychiatry may have $400,000 to $500,000 in student debt, making a higher salary offer from a hospital attractive.
The Mental Health Department is based in Saratoga Springs at a building rented from Saratoga Hospital and provides help to about 1,000 outpatients at any given time, including those on Medicaid and Medicare government insurance programs, and those without any medical insurance.
Angstadt said the work can be more demanding than that in a private hospital, given the clients. “We see people who are seriously and persistently mentally ill,” he said.
Counties are required by the state to provide mental health services, though some counties choose to contract with private hospitals rather than run their own departments. Schenectady County, for instance, contracts with Ellis Hospital and Warren County contracts with Glens Falls Hospital.
A large portion of the cost of psychiatrists’ salary is reimbursed by Medicaid or the state, though Angstadt said the formula is complex.
In addition to treating the poor and uninsured, Angstadt said the work done by the county psychiatrists includes mental health evaluations of individuals on behalf of the county infirmary, the Department of Social Services, the probation department and the county jail. They also do all court-ordered competency evaluations.
The new position created in 2006, and which the county has been unable to fill, included spending half-time doing evaluations and patient treatment at the county jail in Milton. Angstadt said the four staff doctors are covering the job, adding to their workload and stress.
“I think the entire salary scale needs to be addressed,” Angstadt said.
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