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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
I’ve never really developed this attitude. Partly, because while I’ve met a few stinkers employed in that sphere, I’ve met far more who are dedicated, caring, and just trying to do a good job. Even the public schoolteachers I know are typically work-a-holics. It seems to me that, so often, it’s not the people who are bad, but the incentives that are perverse. For that reason, I try to focus my beefs on the perverse incentives, rather than the people.
Maybe a person of outstanding character and fortitude would heroically resist any perverse incentive set. But if we think, “If I were them, I wouldn’t be seduced by those perverse incentives – I would be the hero!” I think a lot of the time, we’re fooling ourselves.
We (especially me) need to be reminded more often that virtually every topic we debate and analyze has a human face. Thank you for this candid, deeply moving post.
We are in a weird limbo. For most employees, we pay directly, but are forced by statute to use State Health Benefits. We also do agency staffing. So we are a State created organization, but not a State organization like Public Health. Frankly, that hurts, and Public Health employees have access to GA Pension (1% per year). We don’t even have that.
Thank you.
Good stuff Bryan. A lot to think about.
I hope @bryangstephens that you submit this essay to the major newspapers in Georgia.
Well said, all of it.
Thank you for being there for the people who are invisible to others.
There are not enough new doctors or nurses being trained. Further, we don’t pay for the expertise of the GP. What people need is an agent to help them to specialists. However, since that is not a “service” it is hard to get paid for in Fee for Service, and in Managed Populations, you are trying to save money.
This is part of why I think it has to be taxdollars. It is something that needs to be done, but no one really wants to do it.
Mental Illness frightens people, especially those that go to day programs. I am glad they were able to come observe. Do you have any Peer-Staff in your program?
Late to the party, Bryan, but – from the bottom of my heart – Thank you and your staff! (From one who requires assistance with certain ‘elemental’ personal tasks daily.)
So true. As CEO, I work to weed those people out. Praise God that I do not have many “Classified Staff” (something not being State employees helped, though the whole state has moved that way) and I am in an “At Will” state. The DOL still has lots of land mines, but people can be removed if needed.
Been there. When you are a Community Mental Health Case Manager, you do whatever it takes.
Thank you for sharing. Our enemy wears no uniform, shoes no mercy, and seeks out the innocent. It takes all of us to fight together, as best as we can. I have seen too many stories like yours in my two decades.
My father was local (municipal) government employee. Both of my brothers have been employees of local, county, and/or state governments. One currently works for the City of Houston, the other for a division of the State of Illinois. I have sometimes heard from them about their coworkers, but it has not sounded any worse than what I have encountered in the private sector.
My one foray into government was when I was employed by a larger consulting firm. We had a team of ten on a project to help a quasi-governmental federal corporation to upgrade and secure their IT systems. As the process and governance guy, I worked with their process modelers. What I found was in a team of five, the boss was alright, but had been moved in from elsewhere and didn’t understand the potential of his department and tools. He was not a process modeler himself. There were two modelers who were satisfied with what they were doing and didn’t think anything needed to change. The fourth guy was great. He was intelligent, understood the potential, was a strategic thinker. The fifth person, I was told, “Oh, don’t bother talking with her.”
(Cont.)
It should not, and I am guilty as anyone. I have said some rather unkind things about the people @jamesofengland says he as worked with, I need to apologize for and take back.
I have not heard one, so I guess I need to listen to one.
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.
They are expensive in the medical system too. I’ve banged my head against many a mad bugger’s wall to get them sober. When it works it’s a thing of beauty for the patient and their loved ones. When it doesn’t they get time consuming and expensive …..somewhere.
(Cont. from 44.)
I was waiting for a meeting with one of the modelers when I got to talking to a lady whose cube was outside the meeting room. It quickly became apparent that she was the one I wasn’t supposed to bother with. She was intelligent and insightful, identifying several of the issues that I had already identified. I asked, “Why did your boss say I shouldn’t bother interviewing you?”
“Oh, I’m retiring in a couple of days.”
It seems to me she was exactly the one to bother with, since she had nothing to hold onto or protect and had a lot of corporate memory that was walking out the door.
The general problem I found was that the modelers were only tolerated because they were mandated by the government. They were not considered helpful. Their models were not understood and were not used as a basis for action. The two who were satisfied with that had the attitude of, “This is what the regs say to do, and so this is what I do.” The other two were trying to find ways to be useful.
The most problematic people seemed to be managerial and executive types. The politics seemed much thicker than in any commercial corporation I had ever seen.
Still, overall, the government workers I was working with were no worse than the commercial versions, and some were outstanding.
A model of public money/private services can work, but when people throw around terms like “All Taxation is Theft”, they are not usually interested in public money going to private players.
Arguing that a particular job or program shouldn’t exist is not the same as arguing that the people working in those positions are jerks, fools, or idiots. Whatever one’s hopes for proper government, we must operate within the circumstances we’re given.
There aren’t many true anarchists claiming to be on the Right. The vast majority of conservatives want limited government, not an absence of government. If we need to defend against a semblance of heartless anarchy, that is only in response to the Left’s slanders of us.
But we should be reluctant to include the national government, at least, among our charitable efforts. Unless one believes that basic human nature has changed over the centuries and that one’s ancestors were all callous jerks who ignored the sick, the hungry, the homeless, and such, then one must acknowledge that centuries of precedent prove that people can care for the needy without the nanny state.
Some of our local charitable organizations have over the years constructed boards of directors who see their role as fundraisers primarily. It is a very successful operation model. They have created a web of organizational ties between the organizations themselves and then between the press and the business community and wealthy retired community. In addition, our CEOs of our local charities sit on other boards, raising their stature and exposure in the region generally. So, for example, you would have a seat on the local hospital board. It won’t be as easy to ignore your facility if you are sitting in their room and if they are sitting with you. And you might run into people who are very experienced in fund raising.
I know time is a problem for an organization CEO, but it will get better when you get help.
Now, as for where you are, Bryan, there’s no real money in it. So, anyone who follows that path has no other reason than dedication. If they find they are no longer on a crusade, they can get more money elsewhere. That is how most government jobs used to be. Teaching used to be that way. You had to be dedicated, because the salary was a pittance and fringe benefits nil, other than what the community might do for you. Then Big Education developed. I doubt there are any one-room schoolhouses left that are active anymore.
The military is still that way. The pay is very low for what they do and risk. Has there ever been a unionized army?
The “Get a government job” jobs that don’t serve anyone tend to be in state capitals and Washington, D.C.
The easy one first: We see drug use in over 50% of the people we treat. However, treatment for addictions is more like 10% of the total. While I don’t disagree on the effects of the nanny state, I do not think there is a great reserve of love for the clients we serve. Addiction is not seen as a thing to be treated, but a character flaw, and people often just want to lock up “Crazy people”. If a Church does not want us to treat teens with SA issues, and provide other services on land where the was a hospital, there is little hope for me that money would flow in.
And God help my clients if disability was wiped out.
Thanks for the supportive comments and well wishes. They mean a lot.
We are working on the Foundation side. I have had a lot to do since I took over.
Things will get better once you get some money coming in.
The need to raise money never ends, but you have a lot of company among the CEOs of the other local charities, and it helps to have people to laugh with.
I guess my perception of government workers doesn’t fit the norm you suggest. Although I didn’t work with many federal workers, I worked with lots of people at the municipal level and enjoyed it tremendously.
There are certainly many people who need special help and I’m grateful for organizations like yours that step in. Regarding addictions, though, I must admit I have mixed feelings, regarding the ability of people to overcome them or succumb to them.
Thank you for your commitment to this field and to your workers. They’re lucky to have you!
Agreed.
Even true anarchists should be able to understand, though, that, as you say, “Arguing that a particular job or program [in anarchists’ case, every government job or program] shouldn’t exist is not the same as arguing that the people working in those positions are jerks, fools, or idiots.”
Agreed.
I think there’s an extent to which the abundance and technological power of our prosperity has altered expectations of what counts as “not doing enough”, though. Especially considering how much – but also how little, in another sense – modern lifesaving measures can accomplish.
This post is an excellent illustration of why it’s important to have humility: humility about our knowledge and understanding of other people’s circumstances. In other words, never compare your inside with somebody else’s outside.* Before being enlightened by Mr. Stephens’s post, I might have expressed some pretty stupid opinions about what goes on in his world and in the lives of his clients.
Before making broad pronouncements about the uselessness of a government program or agency, it’s best to learn something about it. If it is truly useless then have at it. But first, get smart about it. In short, if you don’t know anything about a subject then it’s best to shut-the-heck-up.** Thanks for keeping us fact-based instead of gut-driven. The latter is what the lefties do, right?
*I stole this from Hugh McLeod’s How To Be Creative.
**Loosely translated from Wittgenstein’s Tractatus: “Wovon man nicht sprechen kann, darüber muss man schweigen.”
@bryangstephens, You should start with this one from last October. It is very moving.