Long Island drug treatment facilities facing staff shortages

Drug treatment facilities on Long Island are facing staff shortages that have been compounded by the coronavirus pandemic and an increased demand for more mental health services, New York State public health officials and addiction experts in Nassau and Suffolk counties said.

Treatment centers faced a chronic shortage of social workers, substance-abuse counselors, nurses and other staffers long before COVID-19 hit in 2020, officials said. But the virus caused the problem to intensify, as staffers started leaving in even greater numbers at the same time substance abuse and mental health problems started surging across Long Island, experts said.

Officials and addiction experts said there are many reasons behind the exodus: low wages, high caseload numbers, better job opportunities and burnout that was aggravated by COVID-19.

“A lot of folks are tired,” said John Venza, vice president of residential services at Outreach New York, which operates treatment facilities across Long Island, Queens and Brooklyn. “They work in a life-and-death business, and there hasn’t been a break in years. Drug counselors are heroes. They showed up for work when everybody else stayed at home.”

State and Nassau and Suffolk officials said they are working with treatment providers to address the shortage of social workers, counselors, nurses and others.

“The workforce challenges,” said Dr. Chinazo Cunningham, the commissioner of the New York Office of Addiction Services and Supports (OASAS), “come up in every single meeting we have with providers.”

If the staffing shortage continues, the region will continue to see a rise in fatal overdoses, said Steve Chassman, executive director of the Long Island Council on Alcoholism and Drug Dependence (LICADD), a Westbury-based nonprofit that provides treatment and support to people struggling from substance abuse.

“The chasm could become a canyon, and who falls through those gaps in services and disparities? Our neighbors on Long Island, our fellow New Yorkers who are in more need of spiritual, psychological, and social help right now than maybe ever before,” Chassman said.

Treatment struggles during height of the pandemic

Fatal overdoses spiked dramatically as a result of the pandemic. More than 100,000 Americans died of drug overdoses during the first year of the pandemic, the first time that overdose deaths toppled 100,000 during a 12-month period, according to the U.S. Centers for Disease Control and Prevention. 

Overdose deaths jumped 34% in Nassau and 12% in Suffolk in 2020, statistics show. Megan Dwyer, director of the LICADD Employee Assistance Program that works with unions, school districts, hospitals and municipalities to connect their employees with mental health services, said requests for help nearly tripled during the early years of the pandemic.

Treatment providers are struggling to keep up with the demand. A November 2021 study by the Rockefeller Institute of Government — a think tank that conducts research and analysis of problems facing New York State and the nation — said 44% of the counseling staff at treatment centers turns over every one to three years. “We are continuously filling positions,” Venza said, “and that isn’t different from any other agency.”

New York State had roughly 42 drug treatment workers per 1,000 people, the study said, far below what the 100:1,000 ratio the authors described as ideal. “The greatest need is for front-line workers: substance-abuse counselors, peer-support specialists, nurses and nurse assistants,” the study said. 

Local drug facilities feel the pinch

The Family & Children’s Association, a Garden City-based organization with 340 employees that provides treatment and recovery support, is struggling to fill 25 positions, said CEO and president Jeffrey Reynolds. Some former staffers, he said, were lured away by telehealth firms that provide better pay and allow them to work at home. Others simply dropped out.

“It’s getting nearly impossible to find folks,” Reynolds said. “It is demanding, hard work with meager pay, and I’m losing people — licensed social workers — who have decided to find something less stressful …"

The Seafield Center, which historically has roughly 350 employees, now has about 300, said Mark Epley, the CEO of the Westhampton Beach-based organization. 

“My goal, if somebody calls and needs help, is to get them into treatment within 24 hours,” Epley said. “Because of the staffing shortage, I’m not able to do that.”

The Rockefeller Institute study found that 93% of treatment center staffers in the state said they entered the field to help others. Many of them are in recovery themselves or have loved ones who struggled with addiction.

“It is definitely a calling,” Seafield staffer Justine Briscoe said. “There is no monetary value watching somebody come through these doors and really put in the work on themselves and begin the healing process.”

Fifty-one percent of staffers with master’s degrees and 88% with bachelor’s degrees at treatment centers in New York earn $50,000 or less a year, the Rockefeller Institute report said.

Many treatment center staffers also have tens of thousands of dollars — or more — in student loan debt, an unavoidable expense in a field where a master’s degree is required for advancement. LICADD’s Dwyer says she may wind up paying hundreds of dollars to the government every month for the rest of her life because she chose to pursue advanced degrees. “Why are we not valuing mental health as we value business professionals?” she asked. 

Cari Besserman, director of Suffolk Mental Hygiene Services, said there were mass retirements from the field in the first few months of the pandemic because many workers did not want to get sick or infect their families. Those who hung on, she said, had to deal with burgeoning caseloads and frantic clients while addressing their own child care needs, financial problems, anxiety, loss and grief. 

“Our staff has been telling me, ‘It feels like my clients are drowning, and they are taking me down with them,’ ” Reynolds said. 

Counselors and other staff members who worked with clients who died during the pandemic — from COVID-19, opioid overdoses or other causes — were hit especially hard, said Anthony Rizzuto, Seafield’s director of provider relations. 

“I’ve got to deal with the grief of losing one of my own patients,” Rizzuto said. “Then I got to deal with the family members, who sometimes will see me as the best thing on this Earth, and on the other end of that will see me as the blame. Then I have to deal with the feelings of the rest of the group members who established a relationship with that person.”

How providers are trying to lure new staffers

Treatment centers are providing bonuses and pay increases when they can to attract new workers, administrators said. LICADD Human Resources director Dhamary Davidson-Smith said staff members are placing a greater emphasis on work-life balance, such as working from home when possible, greater scheduling flexibility and summer hours. 

“We are looking at things that won’t break the budget, but will satisfy our staff,” Davidson-Smith said. 

Suffolk’s Besserman and Barry Wilansky, Nassau's director of substance abuse policy, said the counties are working with treatment providers to address the staffing issue. 

“It’s a complex issue,” Wilansky said. “We need to pay people a living wage, but where do we get the money? Multiple aspects of the system need to be reviewed, and reimbursing people is one of the issues.”

Gov. Kathy Hochul’s 2023 budget, Cunningham said, includes a 5.4% cost-of-living increase for drug treatment staff and other health care workers. An additional $2 billion has been budgeted for bonuses of up to $3,000 for full-time employees who remain in their positions for a year and prorated bonuses for those working fewer hours. The budget also includes up to $4 million for scholarships and fellowships for staffers pursuing advanced degrees and certification. 

Additional relief could come from money opioid manufacturers and distributors — including well-known companies such as Johnson & Johnson, Walmart, CVS and Rite-Aid — agreed to pay after settling a sweeping lawsuit filed by Nassau, Suffolk and the state. New York has collected more than $1.5 billion from those companies, Attorney General Letitia James announced on June 16. An advisory board will determine how that money — mandated by state law to be spent on drug prevention, treatment and recovery — will be used, Cunningham said. 

Chassman said cynics might accuse social workers, nurses and other drug treatment staffers of whining since they chose to enter a profession that traditionally has provided low compensation. 

“But it doesn’t mean we chose to live on the poverty line, or below it,” he said. “We chose to dedicate our professional life in service to others. I’m not saying we are better or worse, but that is a very unique individual, and in some ways our hearts are bigger than our heads.”