Demand for Professional Wages and Benefits for Wraparound Services Workers

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    PA Senate & House of Representatives
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    Citizens of the Commonwealth of Pennsylvania
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Senators and Representatives of the Commonwealth of Pennsylvania:

Wraparound Services (also referred to as Behavioral Health Rehabilitation Services or BHRS) in the Commonwealth of Pennsylvania could not treat its workers worse. Workers in wraparound service today are forced to labor under the following near slave-like conditions: seven (7) day/ 70+ hour work weeks under horrid conditions (see below), no health care benefits, no retirement benefits, and no vacation benefits for the most minimal pay. These workers are expected to be available all day, every day to meet the needs of their clients, the children and families of the Commonwealth of Pennsylvania and consequently have almost no time to spend with their own families. Furthermore, as demonstrated below, these workers are not compensated for fully half the time they spend on the job.

Wraparound Services workers are a fundamental part of children's psychological services in the Commonwealth of Pennsylvania. These workers work with children from all types of families but especially common are families from disadvantaged backgrounds. Often these workers work in dangerous environments where OSHA has no jurisdiction. It is not unusual for a worker to go into a home to treat a child and be exposed to serious health hazards varying from human feces containing unknown contagions smeared on walls to urine/cockroaches/rats/filth on the floors and furniture to the more mundane yet highly dangerous second hand smoke and be doing this in an environment where everything from familial violence to alcohol abuse to illicit drug abuse and sales to prostitution takes place. There are three types of wraparound services workers who work with children under these conditions:

1) The Behavior Specialist Consultant, hereafter referred to as BSC is responsible for leading the treatment team, writing treatment and behavior plans, observing the child's behavior across various settings, leading Inter-Team Meetings (ITMs), supervising the work of the TSSs working under him, and working with all other agencies that may be involved (e.g., Juvenile Justice System, Public Schools, etc). This is a Masters and/or Doctoral level position.

2) The Mobile Therapist, hereafter referred to as MT is responsible for providing psychotherapy to the child and sometimes his family in the families home. This is a Masters and/or Doctoral level position.

a) Most companies lump these two job descriptions into one, that is BSC/MT. In these cases, these Masters or Doctoral level workers fulfill both jobs.

3) The Therapeutic Support Staff, hereafter referred to as TSS is responsible for providing behavioral interventions to the child across multiple settings (home, school, community) as directed by the BSC. This is a Bachelors level position.

The Commonwealth of Pennsylvania has determined what work a Wraparound Services worker may be paid for and calls this work "billable". On average, a BSC/MT working full-time bills 35 hours per week and is paid ONLY for those 35 billable hours. In reality, this BSC/MT actually works 70+ hours per week when non-compensable time, hereafter referred to as NC is figured in. Travel time, not including first and last trip of the day, to and from clients homes is never compensated for in any position (i.e., BSC, MT, and TSS) and often exceeds more than 3+ hours per day or 20+ hours per week in the case of full-time BSC/MTs. BSCs are frequently required to work above and beyond the number of allowed billable hours on BSC cases each and every week (i.e., on average 7+ hrs/wk). In a peculiar quirk, BSCs may bill for time spent preparing materials, engaging in phone consultations, and writing progress notes, but MTs may not (i.e., 10+ hrs/wk). All told, the number of non-billable hours worked per week usually equals or exceeds the number of billable hours worked per week; the workers are not compensated for these non-billable hours worked.

One argument offered is that the BSC/MTs are paid well, because on average these individuals earn $20.00 per billable hour. However this is grossly inflated claim since BSC/MTs are compensated for half the time (or less) they actually spend working. When NC hours along with the costs of private health insurance, professional malpractice insurance, and miscellaneous materials (cell phones, pagers, office supplies, reference materials, etc) necessary to work are factored in the equation these Masters and Doctoral level workers make roughly $8.00/hour before taxes, a salary usually associated with unskilled labor. TSS workers earn a average salary of $11.00 per billable hour; when NC time is factored into the equation, this equates to approximately $6.00/hour, which is also the approximate average salary for fast food restaurant workers.

Therefore, we the people of the Commonwealth of Pennsylvania, gathered together with one voice, demand that the Commonwealth of Pennsylvania overhaul Wraparound Services. We demand that the Senate and House of Representatives of the Commonwealth of Pennsylvania hold open hearings on this matter. At a minimum, we also demand that the Commonwealth of Pennsylvania change those hours deemed "billable" to encompass ALL hours worked AND publish minimum suggested professional working wages, conditions, and health care benefits for its Wraparound Services workers.