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Dispatches from a Life-Long Government Employee and Conservative
One of the common themes on the right is that the government cannot do anything right, that government programs are wasteful and that they always provide poor services. There are many examples to point at, such as the VA, Public Schools, and the like. The general attitude is that government workers are lazy, have poor attitudes, and are generally no good.
I would like offer a counter to the conservative write off of all government workers and programs. This is not to say there are not many things that need to be trimmed. It is to say that blanket statements might not be accurate. Let me start with what my organization does.
I work for the government, in a taxed-based organization. I have been there my whole career of a quarter century. Six weeks out of college, I was working as a House Parent, helping men with significant developmental disabilities (mental retardation for the non-politically correct). That was my start. Now, I am the CEO.
Our Agency is one of 26 in the State of Georgia that provides safety net coverage for individuals with Behavioral Health challenges and Developmental Disabilities. We have a broad spectrum of services, ranging from outpatient therapy and psychiatric services, to 24 acute inpatient beds for mental health crisis and detox from substances. We have case managers who serve clients in the community, a supportive living program to help individuals live in the community, group homes, residential treatment programs, and we are the contractor for mental health services in the Cobb Adult Detention Center. That is “jail”, and by the way, we serve 600 people a month there, with our staff of 8, including an MD and Advanced Practice Nurse (APRN). That makes the Cobb Adult Detention Center the largest mental health facility in Cobb County, just like the jail in your community.
We are supported through State Funding, Medicaid, and a touch of Medicare. The population we serve, only around 15 percent of our population have Medicaid, 5 percent Medicare, and the remaining 80 percent are uninsured. Less than 1% have some other insurance. Of course, they cannot pay out of pocket, so the state lets us treat them on a sliding fee scale, that goes all the way up to 100 percent.
Despite what most people think about government salaries, we are underfunded. We do not have access to the State of Georgia’s pension program (and even if we did, 30 years for 30 percent of your top two years of salary is nothing to write home about; Georgia started reducing its pension plans in 1982). There is a national nursing shortage, and I cannot hire any nurses at the rates I can afford to pay, much less attract the top talent. $9/hour is not a lot of money to pay for a Client Support Worker to help care for someone with a developmental disability who cannot attend to their own Adult Daily Living Skills (this means they need help wiping their bottoms). I have seen my staff go years without COLA raises, while teachers, who work nine months of the year and get raises because they are more visible and popular.
Now, most of the staff who do work for me are dedicated, caring people, who have a mission in their hearts, God bless them. They are dedicated to making the lives of the least of the least, as good as they can be. This is hard work, and it can easily burn anyone out. If you stop caring it is time to go, but caring can be hard work some days.
So, when I see attacks on all government workers, I admit, I take it personally. These are attacks on the hard-working employees, some of whom make less than the people working at McDonalds, some of whom get hit by clients, some of whom go out into bug infested homes, or under bridges to serve our clients. These are attacks on the very people whom I am charged to serve. Our clients who nobody wants to help. Or clients who nobody wants living next to them. Without the meager laws on the books against bias, my residential clients would have no place to live.
I have seen a pastor for a church stand up and rail against land we bought from a previous mental health hospital to serve teenagers with drugs problems. I have seen our organization sued, because the city condemned that same land to block our use of it and the banks now wanted their money back. I have seen city inspectors have to be reminded that state and federal law allowed us to ignore zoning and place our clients into housing so they can live in the community. I have seen people in recovery, unable to rent an apartment because of a decade-old felony. I have heard otherwise compassionate people condemn the mentally ill, as lesser people. It is not unusual for me to hear fellow conservatives treat addiction as nothing more than an issue of willpower, or a failing of moral character.
Why do I mention all that? What my government agency does, the private sector has no will to provide. There is no money to be made on treating chronic conditions of individuals with no money, much less providing things like case management and supportive employment and supportive housing. Further, there is not enough private money applied to these areas. Mental illness and, to an even greater degree, substance addiction are still seen as moral failings (see above). Our culture in no way is ready to support the people we serve. With the utter destruction of the family, there is no one to support them. And this is not just single mom’s, but intact families who can no longer manger their loved one, who have been burned too often, or make it the problem of the State. our culture shuns these modern-day untouchables. They have no voice, no lobby, no money. They are the least of the least.
There are some things the government must do. Even if charity could, in theory, meet this need, the sad fact is that it shows no interest and likely wouldn’t until after several of our clients are in the morgue. Today, people are fine to donate for kids with cancer, but adult men who cannot control their drinking? Forget it. Remember, the pastor of a church did not want a treatment facility near their place of worship. If government organizations like mine do not exist, America will treat an increasing number in the justice system, which is an expensive way to treat them, money wise. It is even more expensive in the damage done to their lives.
Published in Politics
That is one thing interesting about the national discussion of ‘Health Care’….almost all of it focuses on funding, and almost none of it is concerned with how to reduce the supply constraints.
There are a lot of “sexier” nurse jobs than working in behavioral health as well.
There is much to mull over here, so I can’t respond with much yet, other than to say well done!
Thanks. My hope it is will help people understand my passion on the subject.
I believe the blame for much of the sad mess Bryan describes falls to the Church. (I’m talking the worldwide Body here – not any particular denomination.) I fear that we Believers have for too long focused on things like church growth and worship style, allowing the “least of these” to fall through the cracks.
And note: I consider myself among the guilty.
I certainly can’t imagine Joel Osteen wanting a treatment or rehab facility adjoining his church.
http://babylonbee.com/news/joel-osteens-bible-makes-daring-escape-abusive-owner/
Thanks for a great post. I am on the board of a very similar organization on the eastern shore of Maryland (“flyover east”) which has experienced all of the indignities you speak of and more. The latest: we almost lost the lease for temporary space for our day program because the hospital accounts receivable staff several doors down complained. Fortunately, a basket of goodies and an accepted invitation to visit and observe calmed their fears and we can stay.
It’s a never ending battle. Thank you to you and your staff for serving the needs of this vulnerable population.
The Bee is OP.
The Bee on Osteen also has a running file at Snopes, which ought to say something about how close to the mark they’ve been with him.
Really excellent piece, Bryan. I know people who do very similar work, and it’s simultaneously brutal and essential. You folks deserve more credit.
On point? Optimally proctological? Organized patiently?
Just for my own clarity, are you and your employees employed paid by the state, or is it a matter of the company being primarily funded with government dollars and, as such, subject to state rules? Or is it something else?
My only government work was some community college teaching. Adjunct work. Four classes altogether. McLennan Community College in Waco.
I think the CC system does do some good work (and I usually think it does more good work than the big state schools and the Ivy Leagues). It covers some needs that private work tends not to cover thoroughly enough.
That’s about all I can contribute. Thanks for the post, Bryan, and for your better contribution.
I guess it could be the others, but if that’s the case then Joel Osteen’s proctologist needs a wetsuit.
Generalizations can sometimes be unhelpful. During the sequestration a few years ago Rob Long wrote a post with a title something like “How’s Your Sequestration Going?” I commented to the effect that the DoD workers in our town (including Mr. K.) were required to take several unpaid furlough days. The response from the Ricochetti was “stop griping” (I wasn’t) and “you’re not getting any sympathy from me” (I wasn’t asking for it). A member commenting who worked for the EPA was basically told if she had any dignity she should look for another job.
The funny thing is, government workers are probably the experts on what the stereotypical government worker is because they’ve all encountered him/her.
Excellent and eye opening post.
Thanks, Bryan, for this beautiful and heartfelt post.
From the standpoint of a person with a family member who suffers from very serious mental illness, I can attest to the excellent work done by organizations such as the one that you head.
Over the course of a quarter-of-a-century of dealing with my family member’s illness, and trying to keep him as well as he can be, our county community services center and its staff have been far-and-away the most, and sometimes the only, truly helpful and understanding, organization that we’ve dealt with.
Hospitals failed him. Doctors failed him. Counselors failed him. Social workers failed him. The police, although never failing him, and always acting with great humanity, are not where you want this sort of thing to go, although eventually that’s how it did, and perhaps that’s OK.*
But over the years, the community center’s door was always open to him, and also to his family (a difficult balancing act these days). They worked with us to keep him on his meds. They went out of their way to stay in touch with him when that became very difficult to do. They bent the rules so that when he moved slightly out of the county, somehow, someone forgot to note that in his chart, so that they could continue to see him. And when he had a severe schizophrenic break, they intervened with the police to get him into a hospital for acute care, when it looked as if we otherwise would not be able to. Even they, however, were not able to get him where he needed to be for the long term. That took the criminal justice system (thanks, federal government for setting things up this way and making it virtually impossible, in the normal course of things, for family members to have any input in these matters).
In the hell that can be the life of family members of the seriously mentally ill, the center and its staff were a beacon of hope and sanity for all of us.
I cannot speak highly enough of them, and the sort of work your organizations do. Thank you.
*Eventually, and after a long history of petty criminality, recidivism, and much cycling of his illness, my relative did end up in jail on some rather serious charges, and he is currently in supervised housing.
I just want to add my admiration for the work that you do, Bryan.
I work as a government defense contractor, so I’m really from a different world than yours. And yet, I’m surrounded by government employees and servicemen, whom I respect, and who aren’t to blame for government’s unsavory reputation.
What does draw a conservative’s ire, really, is when government tries to control areas of life, out of sheer desire for power and control. So, when they mess it up or prove themselves incompetent, it’s more schadenfreude than anything else. We want them to screw it up because they shouldn’t have been doing it anyway.
But that shouldn’t spill over into disrespect for the people who are just trying to help their fellow citizens.
A wonderful post, Bryan. What you and your colleagues do is profoundly admirable.
You are right. The private sector provides superior services, products and, in general people work smarter, not because they are better or more hard working, but because there are mechanism for feedback, accountability, an information system in prices and profits that provide real time information on everything that matters. The government in contrast, especially the Federal government has no information system, no mechanism for self correction, and no prices providing real time information. So some government workers simply work harder, longer hours with less to show because we can’t measure output nor often even know what it is. We can’t fire people so we move dead weight out of the way, with important matters especially crises managed by a small hand full of people who work almost around the clock. There is no way to fix this at the Federal level. Some programs can be moved to state or better yet local government without federal money or control where they are closer to the people they are suppose to help. Some public goods can be redesigned as private goods by creating property rights. Others are necessary and we have to find ways to recruit with integrity, and fire with greater ease. A lot of Federal programs should just be eliminated or periodically cut back to break up the cliques, force better definition of purpose and allocation of human resources. It requires constant attention and decisiveness by each new Administration.
Let me push back here. I think it would be hard to find someone suggesting that these sort of services should be provided by the for-profit private sector. However, even though your organization gets all of its funding from government sources doesn’t mean you aren’t/couldn’t be consider a private organization.
The danger of government run services (as opposed to government funded services) is the one size fits all and sclerotic approach to service that government ultimately must subsume too.
Ideally, public services should be delivered by “the little platoons” in between families and the state.
Good luck on your endeavors and I think you could do great deal of good making the case to your local authorities that the services you provide save the public money by preventing people from being housed in jails and prisons.
I doubt that. But it’s impossible to measure under current circumstances because the nanny state depresses charitable efforts merely by its existence. If people commonly believe that the state addresses these concerns, then there is less incentive for them to donate and get involved.
Also note that modern government’s effects on family structure and family values has undermined the strongest protections of retarded and addicted people. Just within my own extended family, I can cite more than a few cases in which such needful persons are attended without government care. Where families are intact and neighborly bonds remain strong, the mentally challenged are provided for.
What percentage of your clients would you estimate are addictions?
Very eloquent, Bryan.
Thank you so much for sharing your perspective. Very eye-opening!
Maybe we can boil it down to a formula: When what the government intends to accomplish is specific and limited (defeat Nazi Germany; build the interstate highway system; send a man to the moon) it can often do useful things. When what the government wants to do is general and open-ended (provide universal health care; oversee the economy; make us happy) it will almost always open up a greedy revenue-devouring maw – forever. It sounds like what you’re doing is quite specific and needed.
@bryangstephens thank you for sharing with us at Ricochet your personal experience and profession. The work you do is unappreciated, yet glows with the blessings from heaven above. May God bless you and your co workers. When conservatives argue that we are not anarchists…we believe in government and an orderly society, just not a bloated bureaucratic tyranny…that we believe in a safety net for the least fortunate amongst us–well, your clients are exactly those of whom I am thinking. You have no voice in the power structure of government, thus you can’t even get the proper compensation for your hard working associates. You need a loud voice at the State Capitol.
I have rarely found in my rather new association with government employees, the frustrating, uncaring, lackadaisical person. Before I retired, I always had an assistant of some sort take care of my licensing and taxing and regulation issues with our various governments. After I retired I had to do these things myself. Honestly, I have been pleasantly surprised. Sure one occasionally stumbles into the rude idiot that couldn’t care less, but for the most part I have my questions answered and am able to solve my problems without sitting on hold for hours at a time.
There is a simple and sad equation to why the most vulnerable people are ignored. They don’t vote, they don’t hand out campaign contributions and not their families who support them are too disorganized to lobby for government assistance. Meanwhile, unions and crony corporations can get pork.
The incentives are all for corrupt congress critters to build bridges to nowhere rather than hire more nurses. The left thinks that more government will make us more compassionate but that dynamic is not going away.
The people who genuinely cannot provide for themselves are also the least likely to get politicians elected.
I see some here have responded that there are private solutions–charitable ones. I agree. Although I might stop short of calling them complete solutions. Yours is an area where we need government assistance. This is why we also need to stop throwing money away on those who can and should be providing for themselves. In my town there are a number of private organizations that work with the same struggling souls as yourself. They are often religious groups…City Union Mission, KC Rescue Mission, Salvation Army plus a number of organizations aimed specifically at Vets, whom I am sure make up a solid percentage of your community. These groups are always headliners on my end of year donation list. I hope I can continue to contribute.
On a less depressing note, what do you think of the opportunity podcast? I admire the show because it addresses the problems of treating the people who are at the bottom of our society.