9/13/07 - County continues search for psychiatrist

Legislature will consider second contract with employment agency to fill job temporarily

(As published by Cortland Standard, Corey Preston reporting)

Still lacking a full-time psychiatrist at its Department of Mental Health, Cortland County is now considering settling for a temporary doctor to fill a glaring need.

The Legislature’s Health Committee voted Wednesday to support a second contract with an employment agency, this time to provide a temporary psychiatrist for the department’s clinic on Grant Street.

The contract would pay the doctor provided by Georgia-based employment agency LocumTenens.com a daily rate of between $125 and $200, depending on the doctor’s experience and specialties.

The contract also requires the county to pay a fee of $50 for every calendar day that the doctor is employed by the county.

Should the temporary psychiatrist eventually be offered a full-time position, which the committee was hopeful would happen, the county would owe LocumTenens $28,000 for recruiting the candidate.

That aspect of the agreement is unchanged from the original agreement with LocumTenens, which was for the provision of a nontemporary, full-time candidate.

That first agreement with LocumTenens yielded just one candidate, said Mike Kilmer, director of administrative services for the department.

“It was an individual who couldn’t see children, and he needed a visa waiver — he just wasn’t a fit,” Kilmer said.

Kilmer told the committee that the need for a psychiatrist is growing increasingly dire with the Oct. 1 resignation of Dr. Susan Watrous, who had delayed resigning from the county’s Horizon House day treatment facility in order to assist the department.

Watrous has been working one-day a week for the department, serving as the doctor signing off on treatment plans developed by the department’s clinicians.

She also serves as the physician collaborator for the department’s psychiatric nurse practitioner, allowing the nurse practitioner to see patients.

Kilmer said he was considering applying for a waiver from the state Office of Mental Health that would allow patients’ primary care physicians, untrained in psychiatry, to sign off on treatment plans.

“I can’t even say how thankful we are to all the physicians that have stepped up, even though they might be uncomfortable, to help people get their medications,” Kilmer said.

Primary care physicians have been asked by the department to write prescriptions for psychiatric medications in the absence of a staff psychiatrist.