Carlene Casciano-McCann

Carlene Casciano-McCann, Executive Director of St. Mary’s Home for Children

NORTH PROVIDENCE — Carlene Casciano-McCann has seen firsthand the impacts of the pandemic on Rhode Islanders as executive director of St. Mary’s Home for Children, a nonprofit based in North Providence offering comprehensive treatment for youth traumatized by abuse or experiencing the challenges of psychiatric disorders.

Human services organizations such as St. Mary’s Home have been hard-hit by a severe nationwide workforce crisis, which has forced the local nonprofit to limit certain critical services.

“We reached a crisis point five or six months ago,” said Casciano-McCann. Staffing levels had been “holding steady” until around the spring of this year when she saw higher levels of staff turnover and struggled to hire new team members.

“I think people are exhausted,” she said. “A lot of folks are stressed and burned out from serving people through the pandemic and putting their own health at risk by being present.”

As a result, she said the residential services branch of St. Mary’s has a 30 percent vacancy rate. For the first time in the nonprofit’s 144-year history, she said they’re also experiencing vacancies in outpatient services.

Lacking the necessary staff, St. Mary’s has been forced to limit the capacity of many of its programs.

“The workforce crisis has had a huge impact on the people we serve,” Casciano-McCann said. “To properly serve the youth in residential care, we have to be staffed a certain way. If we can’t provide safe care, we have to limit our capacity.”

Residential admissions in certain residential programs were capped. For a time, she said St. Mary’s had to stop accepting students into its day school.

Though these problems are not unique to St. Mary’s Home, or even to the human services industry, Casciano-McCann worries about the number of Rhode Islanders who might be struggling to access care.

“A lot of people are not getting their needs met because they can’t get in to see anyone,” she said. St. Mary’s has 62 children in out-of-state placements because of workforce shortages in R.I. Forty-two of them are females.

The lack of available services coincides with an increased need for them.

“We’ve seen an increase in anxiety and depression in teens that has been compounded by the pandemic. The isolation people have felt over this time. The fear of what can happen during the pandemic … that lack of connection really impacts people’s well-being,” Casciano-McCann said.

St. Mary’s Home was one of 70 local health and human service organizations to sign a call to action urging state leaders to release American Rescue Plan Act funds to:

• Specifically increase wages across the community-based health and human service system;

• Provide appropriate funding to cover additional costs associated with operating during the pandemic;

• And initiate a robust workforce development strategy.

Casciano-McCann said St. Mary’s has also been working with the Rhode Island Coalition for Children and Families to advocate for workforce stabilization initiatives.

“What we’re really in need of is multi-year funding to attract and maintain a high-quality workforce,” she said. “Right now, people are leaving this industry to work for a retailer who is paying as much or more than folks in our industry.”

Our staff is doing meaningful, difficult work to advocate for traumatized youth,” she continued. “I’m advocating for increases in rates so we can pay our staff better rates.”

Three of St. Mary’s contracts were granted back in 2016, but the rates haven’t changed since then.

Funding set aside for programs under the Rhode Island Department of Children, Youth and Families is helpful, she said, but multi-year funding for non-DCYF programs is needed. Put simply, Casciano-McCann saidm there should be equity in pay between staff in DCYF-funded programs and other community-based programs.

“Adding additional staff is a wonderful start, but we’re going to take a financial hit because we can’t have our other staff members receive inequitable pay,” she said.

Her employees and others in the industry deserve a raise, she said. Many have worked through the pandemic, “constantly pivoting” through distance learning, quarantines and new stresses.

“All of this on top of the stress that our staff, therapists and teachers are already feeling. They’re working with a highly stressed population, and there’s a level of vicarious trauma. They bear witness to the horrific things our youth have been through, and are helping people heal from awful experiences,” she said.

It makes sense that they’re feeling burned-out, she said. It’s hard to find time for self-care when you’re working overtime.

Casciano-McCann said it’s incumbent on elected leaders to understand the impact of the crisis on local families being served by organizations such as St. Mary’s.

“We’re not only advocating for ourselves. We want a high-quality workforce to provide best practices and more access to care. We want to make sure people are having their needs met,” she said.

Denying access to early interventions could result in “another unfortunate opportunity to climb the ladder to more intensive services.”

“Early intervention can mitigate that and lessen the trauma to the child. Every time a child is removed from their home it is hugely traumatizing, even if their family is not functioning in a healthy way,” she said.

Casciano-McCann said she’s feeling cautiously optimistic that things will change for the better. The state’s health and human services agencies have become something of a united front. The HHS coalition has “really upped its advocacy.”

“It’s nice to see our agencies working together and stop this sort of silo-ed way of thinking,” she said. “Everyone is so committed to children, youth and families.”

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