A look at who makes the most money in state government shows the impact of Hawaii’s failure to serve the mentally ill.
Eight of the state’s top 11 employees fall within the State Department of Health’s mental health programs — a result of Hawaii’s time under court oversight for lack of mental health services.
These 11 positions (two people are tied for 10th highest paid) come from a list of 14,027 state employee names, titles, and salaries obtained by Civil Beat using the state open records law. Civil Beat requested the data in early May, a week after it launched, as part of its effort to make state spending transparent.
The data, which is a public record, was provided as a PDF by the Hawaii Department of Human Resources. It was organized by department, not by name or salary. Civil Beat analyzed the data to determine the highest- and lowest-paid positions. The list includes all departments except the Hawaii Department of Education, the University of Hawaii, Hawaii Health Systems Corp., the judiciary, and the Legislature. The law prohibits the release of the specific salary for some positions, mostly those in unions. In those cases, by law, salary ranges must be made public. Civil Beat has requested salary information from the other agencies.
All the salaries provided to Civil Beat are pre-furlough. To provide precise figures for the highest paid employees, Civil Beat adjusted downward their salaries by 9.23 percent, or 24 days, to reflect the temporary pay cut Gov. Linda Lingle imposed on state employees as a cost-saving measure for the fiscal year ending June 30, 2011.
The salaries provide a view not only into the most lucrative professions in the state, but also insight into how the state has been affected by court orders related to its mental health system.
The Health Department cites the Felix Consent Decree as one reason it has so many of the top people. The 12-year federal consent decree stemmed from a 1993 lawsuit claiming that the state wasn’t adequately serving mentally and emotionally disabled young people. In 2005, the year it expired, the state was investigated for possible violations of the Civil Rights of Institutionalized Persons Act (CRIPA). That year a federal magistrate had said that the health department had failed to address unhealthy conditions that led to the suicides of 16 mentally ill people.
“Even though we are out of the lawsuit, for these folks, it hasn’t left them,” said Dr. Chiyome Fukino, director of the Hawaii State Department of Health. “We worked very hard to get out of the Department of Justice oversight. We have a much better system now, but we continually try to improve the services and make sure that we’re sustainable by staying within the budget.”
Many of the top paid experts in the health department oversee whole medical divisions as medical “chiefs” and come with specific specialties in mental health, which means that attracting the right person is competitive, said Fukino. The department bases its salaries on three main factors: the particular skills needed, the requirements of the job and the general market rates in the community.
“I couldn’t say it’s a reasonable comparison to look at what our chiefs are doing and our function and say, ‘Well they should just go back into the civil service system,'” she said. “Why would you come? You’d get all bust up by the press and the public. So we were just very fortunate to attract some high quality people who were willing to come for the challenge.”
The court is no longer overseeing the health department, but the leadership is taking steps to ensure that no further investigations need ever be done. They’re also working to transition the cost of the services from federal support provided after court oversight to the private sector. The court oversight created a system in which those with significant needs were covered entirely by the state. Now, the Department of Health is working to transition health care costs to the patients’ private health care plans, so the burden is no longer solely on the state.
“In recent months we are reconnecting the head to the body. People who had health coverage are being returned to their health plans,” Fukino said. “Given the very severe economic time the state finds itself in, if an individual has health plan, they should rely on that rather than state-sponsored services.”
In Fukino’s view, these top-paid staff members are essential for setting the state up for this financial transition in a way that ensures the state does not have to return to court oversight.
“These people who are working with me now, and I would work tooth and nail for them because they are helping produce a system that makes sense,” Fukino said. “So, if people want to pick on them, that’s one thing. But the state will be paying through the nose for being under court oversight.”
The following are the 10 highest paid positions in state government. Civil Beat attempted to interview each of the 10, to provide better understanding of their jobs and their unique qualifications. In cases where no detail is provided, it means the person declined to be interviewed:
Dr. Malcolm Stanton Michels, Child and Adolescent Mental Health Division Medical Director Administrator, Department of Health, $254,610
Dr. William P. Sheehan, Psychiatry Chief of the Adult Mental Health Division, Department of Health, $243,870
Kenneth S. Fink, Med Quest Division Administrator, Department of Human Services, $235,000
As the Med Quest division administrator, Fink oversees a $1.4-billion budget that provides health insurance to more than 250,000 state residents, affecting nearly 1 in 5 people who live in Hawaii. The federally-matched program draws in about $800 million in federal dollars. The 41-year old brings previous experience as a chief medical officer at the Centers for Medicare and Medicaid Services and as the director of the Evidence-based Practice Centers Program at the Agency for Healthcare and Research and Quality, both in Maryland. He said his background helps bring the state $3- or $4-million to pay for emergency services, more than covering his salary. He has two masters degrees and a medical degree. Of his work, Fink said: “I really enjoy being able to try and use the best available evidence and apply it to provide high-quality and high-efficiency health care.”
Martin S. Hirsch, Child and Adolescent Mental Health Division Medical Director, Department of Health, $217,613
Rupert Rudolf Goetz, Director of the state’s Mental Health Transformation (MHT) project and deputy medical director of the Adult Mental Health Division, $207,936
As an adult psychiatrist with background in community and child psychiatry, Goetz splits his duties between two government jobs. For four years, he’s been the director of the state’s mental health transformation project. His work is a response to the President’s New Freedom Commission on Mental Health, a federally-funded effort to boost the state’s mental health services to national standards and integrate mental health into the physical health program. This grant from the U.S. Substance Abuse and Mental Health Services Administration funds half of Goetz’s salary. The other half of Goetz’s salary comes from his other state position.
Mike McCartney, President and CEO of the Hawaii Tourism Authority (HTA), $205,008
McCartney, 50, says his job is about “integrating aloha and hospitality.” Not to mention steering the Hawaii Tourism Authority (HTA), a state agency set up in 1998 to help feed the $10.7-billion tourism industry. Backed by 34.2 percent of collections from the transient accommodations tax, a 9.25-percent fee levied on all hotel guests, the tourism authority markets Hawaii as a visitor destination and oversees the Hawaii Convention Center. McCartney’s previous positions include acting as the executive director for the Hawaii State Teachers Association, the director of the Hawaii State Department of Human Resources, the CEO of PBS Hawaii, and the chairman of the Democratic Party of Hawaii. He went to high school at Castle High School and holds a bachelors from Pacific University and a graduate degree in conflict resolution, peacekeeping and mediation from the University of Hawaii. McCartney’s salary does not include health or retirement benefits. Asked what he would want people to know about his job, he said: “I love Hawaii, I love our people, and if we work together we’ll make it through this economic downturn.”
Mark A. Fridovich, Hawaii State Hospital, Administrator, Department of Health, $195,912
Daniel Lieberman, Hawaii Family Guidance Center Psychiatric Specialist, Department of Health, $195,464
Major General Robert G.F. Lee, Adjunct General, Department of Defense, $172,568
Lee operates in several capacities as the governor’s direct representative for public safety. Lee directs the State Civil Defense, whose mission is “to assist authorities in providing for the safety, welfare, and defense of the people of Hawaii.” He also supports the Office of Veteran Services and acts as the Homeland Security Advisor to the Governor. He oversees 2,500 Air National Guard, 3,000 Army National Guard, 60 state civil defense staff, and about 20 in the office of veteran services. These men and women provide disaster preparation and relief and also deploy to Indonesia and the Philippines to decrease terrorism and improve peaceful diplomacy. In addition, his department includes the Youth Challenge Academy, an educational program for kids who are struggling in school. Lee’s state-funded salary includes a housing allowance, and has stayed at the 2007 level due to budget cuts. His salary was also subject to this year’s 9.23-percent furloughs. About his job, Lee said: “Every day we don’t get attacked and every month we don’t get a natural disaster, that allows us to get stronger.”
Rodger Clark Kollmorgen, Community Mental Health Centers Psychiatric Specialist, Department of Health, $171,817
Barry J. Worchel, Community Mental Health Centers Medical Director, Department of Health, $171,817