Can You See the Light? Health & Human Services Report from Dr. Jeffrey Reynolds

Head shot of Dr. Jeffrey Reynolds, CEO, Family and Children's Association, 2023

Family & Children’s Association CEO Dr. Jeffrey Reynolds says hope floats, but the Health and Human Services sector is in crisis. Please help him fix it.

We ran into Jeff Reynolds, CEO of one of Long Island’s major Health and Human Service Agencies, the Family and Children’s Association, last winter. It was good to see him looking very healthy after his fairly public cancer experience. I’d wanted to catch up with him for a while, look him in the eye and see how he was doing. Also, it had been about five years since we last spoke at length about his field and I was wondering what he thought now. I was glad to see he’s doing well and finding ways to use his personal experience to help others. Gratefully, he agreed to meet up soon and talk shop.

Challenges Remain

When we sat down a few weeks later, the first thing we noted is that the biggest, most systemic challenges we talked about five years ago are still there:

Long Island remains trapped between a myth that poverty doesn’t happen here, and a shortfall of government services due to the fact that the National Index on Poverty uses the same numbers to calculate cost of living for West Virginia that it does for Long Island. We still collectively pay much more in taxes out than we ever get back in services.

Private donations continue to leapfrog the Island to fund NYC and national organizations, even though it’s the much more local groups who know their communities personally and remain critical to adequately addressing local challenges. Furthermore, public and private funders alike still don’t seem to understand that, while organizations should be well-vetted, not for profit administrative, marketing and development costs in and of themselves are not misuse of funds but essential to healthy functioning. 

When we sat down a few weeks later, the first thing we noted is that the biggest, most systemic challenges we talked about five years ago are still there:

Long Island remains trapped between a myth that poverty doesn’t happen here, and a shortfall of government services due to the fact that the National Index on Poverty uses the same numbers to calculate cost of living for West Virginia that it does for Long Island. We still collectively pay much more in taxes out than we ever get back in services.

Private donations continue to leapfrog the Island to fund NYC and national organizations, even though it’s the much more local groups who know their communities personally and remain critical to adequately addressing local challenges. Furthermore, public and private funders alike still don’t seem to understand that, while organizations should be well-vetted, not for profit administrative, marketing and development costs in and of themselves are not misuse of funds but essential to healthy functioning. 

Then Came COVID

Since then, we’ve experienced COVID and bail reform. While the latter has changed the mental health to criminal justice pipeline somewhat and seeks to help undo gross injustices, it hasn’t really improved our mental healthcare system nor added the supports families with loved ones in crisis desperately need.

And now…now we’re ALL collectively traumatized with many folks suffering far more than others. The one-step forward, two-steps back dance we’ve done to get this far has been frustrating at best.

Jeff references a Brené Brown podcast featuring Dr. Amy Cuddy talking about what they called, “Pandemic Flux”:

“The pandemic flux metaphor was like we were all caged in and then released, but each time we tried to exit it was like the back of our shirts kept getting caught on the barbed wire fence as we climbed.” For a long time, “It was almost like we were being held captive in the perimeter.”

“Now,” Jeff reflects, “the problem isn’t so much COVID any more but residual effects. Plus, we are in weird economic times.”

It’s a mess.

A Cry for Help

COVID fully disrupted peoples’ social networks and support systems. They continue to experience incredible stress and anxiety. It’s a perfect storm.

Jeff says he worries about kids’ mental health, especially. Still, you can tell the baseline concern for everyone has grown significantly; that the rapid yet measured tone is that of a man who’s been in crisis mode for years. He’s a skilled leader who knows how to run marathons, but this has been going on for way too long now.

His urgent advocacy is starting to remind me of Gandalf in Tolkien’s Lord of the Rings. Even more, Jeff inspires visions of a military commander on the front lines pleading for support for his soldiers.

He wants to help kids and their families. First though, he needs to be properly equipped to care for his employees. He was concerned about them five years ago. Now, although he remains cool and focused, I suspect he’d like to scream.

His urgent advocacy is starting to remind me of Gandalf in Tolkien’s Lord of the Rings. Even more, Jeff inspires visions of a military commander on the front lines pleading for support for his soldiers.

Rising Needs, Increasing Shortfalls

Jeff goes on to explain how, while the image of the overworked, underpaid Human Services Professional has long been accepted as truth, the funding crisis has deepened considerably since we last spoke.

“Our contracts don’t change year over year. There is no cost-of-living adjustment. Last year, the State offered a 5.4% increase. This was the first increase in 10 years. They expected applause, but the truth is costs have risen over 9%. Health insurance costs are through the roof. We’ve seen a 22% increase. I don’t even want to think about my employees’ gas bills…”

You’ve heard about staffing shortages, right? Well, what’s happening in the private sector is nothing compared to what’s going on in Human Services.

“We have 20 open positions,” says Jeff, reflecting on how much of his day is now spent on job-seeking websites trying to land employees, “It’s not so bad as when we had 30 vacancies, but it’s still really tough.”

“My events person just left.” He sighs. “I couldn’t blame them. They got a job that pays $20K more.”

A Sector in Deepening Crisis

While people don’t choose this line of work for the paycheck, this is definitely about money. It’s about more than money, too. It’s about an industry of helpers actively experiencing their own mental health crisis.

Jeff is earnest, “It’s not just a staffing crisis. It’s an epidemic of massive burnout, sector wide. Keeping on often just doesn’t make sense.”

“79% of the folks here are female. 65% are people of color,” he says, “These people are all dealing with their own families and myriad issues. They’re too often sandwiched between children and parents. They’re exhausted.”

It’s hard to ask people to stay. “Everybody’s challenged, and these are the some of the most-pressed folks in our society right now. I can’t beg them to keep doing this, though sometimes I do.”

In order to address pressing societal challenges that affect us all, we need qualified people to do these jobs. These highly educated professionals, who spend their days walking with the most challenged among us, need to be paid sufficiently in order to survive.

Funding Matters

Jeff is deeply thankful that there have been a number of significant allocations of government funding lately. He is thrilled at Governor Hochul’s announcement of $1B to support desperately needed mental health services. There are other initiatives at the County level, too, which have been well-publicized and that he has also lauded.

Still, while big photo-op checks are nice, the vast majority of funding has yet to be delivered and Jeff has no idea when it’s coming. He hopes these entities understand: He really needs the cash flow now. At the very least, he’d like to be able to plan.

He also really wants people (and the State) to finally understand what esteemed foundation head Dr. Marian Conway explained to us at passionate length some time ago: That the austere, ascetic way many expect nonprofits to be run is wrong.

It’s been wrong for a long time.

Now, it’s devastating.

In order to address pressing societal challenges that affect us all, we need qualified people to do these jobs. These highly educated professionals, who spend their days walking with the most challenged among us, need to be paid sufficiently in order to survive.

The raw truth is that it makes more financial sense for social workers to leave their vocations and curse their educations, because Amazon pays that much more to box packages. For so many of these guys, social work is a huge calling. Many are filling that need with very low paying, and frankly much less effective freelance tele-work to provide mental health services on the side.

“That’s not where we desperately need these people.”

I ask if it’s difficult to advocate for this situation while trying to hire. “It doesn’t help when folks hear that nonprofit funding is uncertain, but the truth is that private enterprise isn’t certain either,” says Jeff, “They’re just less transparent about it.”

Regardless, he’s not going to stop talking about these problems. Not until they’re solved.

As social workers and other Health and Human Services Professionals are being paid less and less to do their work, mental health needs are skyrocketing.

Increasing Risk Factors

As social workers and other Health and Human Services Professionals are being paid less and less to do their work, mental health needs are skyrocketing. While some progress had been made, opioid deaths surged during the pandemic to rates that have become a new normal. The scourge of Fentanyl lacing has made issues of regular old Heroin look easy.

Meanwhile, policy changes that were initially made to boost business during lock-down are creating their own hangovers. Wine and beer are now allowed in movie theaters.

Liquor stores are allowed to open on Christmas. Take-out cocktails, and alcohol delivery are still a thing. We’ve only just begun our local experiment with legal cannabis.

“The reality is that alcohol still kills more people than opioids,” says Jeff. “These policies aren’t helping.”

While “responsible gaming programs” such as those run by Jakes 58, and Sands offer something, Jeff emphasizes that the gaming industry has dire responsibility here. So does New York State.

And Now Maybe a Casino?

Then there’s the gambling. Sports betting, cell phone gambling, a possible new casino…

There is now a $6.5B gambling industry in New York,” says Jeff, “and yet there has been no expansion of problem gambling services. None at all.”

When it comes to casinos, such as the one proposed for the Nassau Hub, there are even more challenges.

In addition to feeding gambling and addiction issues, such sites attract human traffickers and their victims, and are often associated with family violence.

While “responsible gaming programs” such as those run by Jakes 58, and Sands offer something, Jeff emphasizes that the gaming industry has dire responsibility here. So does New York State.

As NYS Comptroller Tom DiNapoli pointed out, the State is allowing gambling in an attempt to raise money. If it really wants to serve the people this way, it had best consider the whole picture and invest in the health and well-being of those driving these revenue streams.

Jeff notes that NYS has Employee Assistance Programs, which are designed to assist Executive Branch employees in dealing with a broad range of mental, physical and interpersonal issues. Perhaps this model could somehow be applied to the gaming industry…

I note PSAs and hotlines I’d noticed in other states. Jeff agrees those are important, but emphasizes that what’s required runs deeper; that any place hosting gambling should make sure staff is well trained to pick up on signs of addiction and abuse.

Even more fundamentally, these employees should have access to counseling and support services themselves BEFORE they’re in a position to refer someone else. Not only is this good for their health and welfare, it helps develop good relationships with local human service providers.

This way, gaming employees can connect those who need help with people and organizations they actually know rather than just suggesting that someone struggling make a cold call.

A Bright Spot: THRIVE Centers

I congratulate Jeff on one thing he asked for when we last sat down that has come to fruition: a recovery center on Long Island that supports people after rehab to help reduce the rate of relapse.

As we have this conversation, we are sitting in one of three Thrive Recovery Centers that now exist on Long Island. THRIVE’s mission is to help individuals and families find, maintain, and strengthen their recovery through peer-based support, navigation assistance and referral services. They provide interactive educational programs that promote wellness, economic prosperity and civic engagement and maintain a safe, welcoming haven for substance-free recreational and social activities. There’s also now an “Aspire Academy: Recovery High School Program” specifically designed for students in recovery.

Jeff thanks me. While you can tell he takes great pride in the Thrive centers, he emphasizes that Long Island really needs 10 of them.

Which Brings to Mind One More Deepening Crisis: Housing

On a broader level, recovery centers can only do so much. Like so many other Long Islanders, the biggest challenge for folks in recovery, even after they’ve managed to find an employer or three who will take a chance on them, is finding a place to live.

“There are 10 units of transitional housing in Oakdale,” he says, “Where do they go next? What’s possibly affordable? Do we export them to other states? How does that work? It’s certainly not ideal…”

While recovery centers are invaluable, on a broader level they can only do so much. Like so many other Long Islanders, the biggest challenge for folks in recovery, even after they’ve managed to find an employer or three who will take a chance on them, is finding a place to live.

The Brightest Spot: Cross-Organization Collaboration

One major positive he’s witnessed is that local health and human service organizations are working together better than they ever have. Jeff is excited about the collaboration he is seeing.

As one example, about a year and a half ago, an RFP came down for Federal dollars. He smiles, “Instead of competing, a number of us got together as a group, discussed what we were seeing in the field, and our individual strengths. We came up with a strategy to each propose different projects. I think it was really effective.”

These guys have their work cut out for them, and they can use all the support from us that they can get.

In all of the darkness, though, this is a very bright light.

One major positive he’s witnessed is that local health and human service organizations are working together better than they ever have. Jeff is excited about the collaboration he is seeing…In all of the darkness…this is a very bright light.