Human Service Workers, Fee-for-Service Clinicians Testify on New Earned Sick Time Regulations

Joint Executive Board member Ademola Odubiyi testifies on the challenges faced by relief workers in the human service sector.

Joint Executive Board member Ademola Odubiyi testifies on the challenges faced by relief workers in the human service sector.

WORCESTER, MA – Among the strongest Central Massachusetts voices weighing in on Attorney General Maura Healy’s new Earned Sick Time regulations were representatives of SEIU Local 509. Human service worker Ademola Odubiyi and Field Services Director Jon Grossman participated in the June 5 public hearing on behalf of thousands of mental health and disability service workers — sharing real-life situations where workers could be significantly impacted by the new law’s implementation.

Read full testimony from Odubiyi and Grossman below.  If you or a colleague have an earned sick time story to share, be sure to contact Chris Condon, Legislative & Political Director, to ensure your voice is heard.


Testimony of Ademola Odubiyi – Executive Board Member, SEIU 509

My name is Ademola Odubiyi. I am a member and officer of SEIU Local 509 and I work in the human service field. I have worked for many years with the developmentally disabled in residential programs. Our pay is low and therefore I — like many others — have to work more than one job. One of my jobs is as a relief staff.

Relief — or per diem — workers work on an as-needed basis. We don’t have guaranteed hours, we work when the employer needs us to fill in “holes” in their schedule.

Many human service agencies use relief staff. They use us to fill in when regular full or part-time staff are out. Sometimes regular staff call out at the last minute, for example because they are sick. But more frequently, relief staff fill in for planned absences.   We fill in shifts where employees are on vacation or medical leave. We fill in shifts where employees have quit and have not yet been replaced. Some employers never fill certain shifts with regular staff and instead routinely rely on relief staff.

Most of the relief shifts I work are shifts I sign up for in advance. And then, if I get sick on the day of the shift, I have to either work while I’m sick — and put clients and other staff at risk — or stay home without pay.

I count on my income as relief to help pay my bills. I anticipate working, on average, a certain amount of hours each week. This is true for most relief workers I have met. For us, working relief is sometimes a primary job. We need earned sick leave just like everybody else.

Thank you.


Testimony of Jon Grossman – Private Sector Field Services Director, SEIU 509

My name is Jon Grossman and I work for SEIU 509. Our union represents many workers in the human services field. We are strong supporters of the Earned Sick Time law. Today I want to speak about its relevance to a particular group of our members and a growing number of Massachusetts employees: Fee-for-Service Clinicians.

Many clinicians that provide behavioral health services, such as counseling, are now paid on a “fee-for-service” basis. This means they are not paid for each hour that they work. Instead, they are paid for each billable unit of service that they provide. The agency they work for bills Medicaid or other insurers and pays the clinician a portion of what they receive.

For example, a Licensed Independent Clinical Social Worker, who provides outpatient therapy services, may be paid at a fee-for-service rate of, for example, $36/billable hour. For each hour (or it may be 50 minutes) they spend in a face-to-face therapy session with a client, they are paid $36. This time is billable and so they are paid. If they have to spend additional time doing documentation, making phone calls to client’s family members, contacting other care givers, travelling to see the client, or other tasks that typically are not billable, they are not paid anything additional for that time. If a client is scheduled but doesn’t show up for the appointment, they are not paid at all, despite having to be present in their office for the entire time.

The concept is: when you bill, you get paid; when you don’t bill, you don’t get paid — regardless of how much work you do.  In fact, most of the time clinicians spend in their day-to-day work is not considered billable time. It is a form of what used to be called “piece work.”

Our union represents several hundred clinicians who are paid this way and it is a very common method of compensation in Massachusetts human services today. Typically, these clinicians do not receive any paid leave time. The Employer argues that their rate of pay is higher than the rate clinicians get who provide the same services on a salaried basis. And that this compensates them for not having benefits and for time they have to work that is not billable.

This is debatable. There are increasing amounts of non-billable work requirements, such as ever increasing demands for documentation. Many people with behavioral health problems don’t reliably come to counselling sessions and no-shows are common. A clinician working full time hours can rarely count on billing over 23 hours a week, and many can only bill that many by working over 40 hours.

But even accepting that the higher rate makes up for the unbillable time worked and for doing without paid leave time, five paid sick days represents only a small fraction of this difference.   There is a significant amount of non-billable time that clinicians have to work. And salaried employees in these agencies typically enjoy the benefits that everyone should have: vacation time, personal time, bereavement leave, etc. in addition to paid sick days (typically more than 5).  Five paid sick days are a very small fraction of the difference in the compensation package between salaried staff and fee-for-service staff. So there is no case to be made that the pay rate these employees receive compensates them for the lack of earned sick leave.

Meanwhile, like everyone else without paid sick time, every time they get sick, these clinicians have to choose between working while sick, and losing a day’s pay. No one should have to be in this position. Thank you.


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