Starting salary of up to $465,000 for new deputy health secretary

Amount far exceeds other state agency administrators’ pay rate, raising eyebrows

Maryland is hiring a new deputy health secretary for an annual salary that could reach nearly $465,000 — more than three times the last deputy’s salary and far exceeding all other state agency administrators’ pay.

The deputy runs the Behavioral Health

Administration, which controls a fraction of the Health Department’s $14 billion budget though it has oversight of psychiatric and addiction facilities and programs that have become more critical with the opioid crisis.

The salary offered for the job is raising eyebrows.

“I do think it’s a fairly high salary for a state employee,” said Del. Maggie McIntosh, a Baltimore Democrat who chairs the House Appropriations Committee. “I’ve asked staff to inquire at the agency and have them justify it, which I hope they will do.”

The vacancy in the position, now running six months, is eliciting concern among other lawmakers, including Del. Erek Barron, a Prince George’s County Democrat who has criticized the department’s handling of court-ordered psychiatric evaluations and hospital placements for criminal defendants.

“It’s curious,” he said. “I’m not sure what to make of it. It is a difficult position. … To go vacant for any length of time is a real hit for what we’re trying to do at the state level.”

Health department officials say they

now want a psychiatrist atop the agency, a departure in Maryland and nationally for a position usually held by managers and not medical doctors.

Health Secretary Robert Neall said a psychiatrist would keep a closer watch on taxpayer-funded mental health and addiction programs as demand for such services increases.

Neall said the new deputy also will face an internal department issue “that needed fixing,” specifically integrating the management of programs in mental health and addiction, which are now understood to be related.

“I wanted an experienced clinician to oversee operations of mental health institutions and to lead certification and accreditation and regulation of all community behavioral health programs run by our partners,” he said. “They need to be properly overseen.”

Neall said he expects to hire a deputy by the end of November

national shortage of psychiatrists is driving up salaries, he said.

A 2017 National Council for Behavioral Health report found the nation, where one in five people has some kind of mental health condition, will be short thousands of doctors in coming years.

The state Department of Legislative Services has reported that the Health Department also has been boosting psychiatrist pay, particularly at rural state-run hospitals, beyond $200,000, to keep doctors on the job.

Still, the next closest salary to the one a prospective deputy could earn —$432,900 to $464,576 per a recent employment ad — was for Dr. Min Yu, a psychiatrist at the state-run Eastern Shore Hospital Center in Cambridge, whose salary is $310,000.

The top eight of 10 earners in the health department in 2018 were psychiatric hospital doctors, according to a state salary database compiled by The Baltimore Sun.

A salary of nearly $465,000 would put the deputy in league with some top doctors at the University of Maryland and the affiliated medical center, which Neall called the competition.

But there is no requirement that the deputy be a doctor. There are few psychiatrists running such programs elsewhere, as the position is viewed as more for an administrator, according to Chuck Ingoglia, president and CEO of the National Council for Behavioral Health

“There is nothing magical or necessary in having a physician in this role,” he said. “You need a person who has vision and a commitment to the issue and the industry.”

Neall contends a doctor will help an agency which has faced legal challenges.

Leadership of the agency, including the last deputy in charge, Barbara Bazron, was held in contempt in 2017 by a Baltimore Circuit Court judge for defying court orders to provide an adequate number of beds in psychiatric hospitals for mentally ill criminal defendants. The delays led the Maryland General Assembly to pass a law requiring the hospitals to admit inmates within 10 business days after a court order.

Bazron left in April for a similar job in Washington, D.C. She held a doctorate in philosophy and worked as a family therapist and earned $154,000 last year, according to The Sun’s salary database.

Former Acting Health Secretary Dennis Schrader, also held in contempt, later became the department’s chief operating officer after Democrats in Annapolis refused to confirm him to the top job. His annual salary last year was $174,000, according to the salary database.

Neall’s salary was $178,000 in 2018. Advocates say they just want an effective leader.

Ellen Weber, a former University of Maryland Carey School of Law professor who now runs the Legal Action Center in Washington, has been working to improve mental health services provided by the state’s Medicaid program for low-income residents.

The behavioral health office doesn’t administer Medicaid but works closely with the program to ensure beneficiaries get treatment.

The lack of leadership, she said, “affects the work being done.”

“There is nothing magical or necessary in having a physician in this role.”