March 13, 2009


County moves to fill psychiatrist position

Part-time doctor would offset growing caseload in county Mental Health Department

Staff Reporter

The Cortland County Legislature plans to vote on hiring a part-time adult psychiatrist at its March 26 meeting.
The position is in this year’s budget to help offset the workload of county psychiatrist Dr. Jason Stepkovitch.
The 17-hour-a-week position is budgeted at approximately $58,000 since County Administrator Scott Schrader expected the position to be filled by a recent graduate midyear.
The psychiatrist could begin July 1 and his annual salary would be $99,000, which would have to be budgeted for in full in 2010.
Schrader would not identify the psychiatrist who is being considered but said he has his medical degree and is currently becoming certified in psychiatry. Schrader said Stepkovitch found the psychiatrist in his search to help fill the part-time position that is available.
The position is greatly needed, said county Mental Health Director of Administrative Services Mike Kilmer.
“We can fill Jason’s schedule two times over. The need is there,” Kilmer said at Wednesday’s Health Committee meeting.
Stepkovitch gave a presentation to the county in November on the need in the county for a child psychiatrist but said the likelihood of Cortland finding one was slim since there is a shortage in the field nationally. Schrader budgeted for the part-time psychiatrist for 2009 saying at the time a child psychiatrist would be ideal but was unlikely.
Since Stepkovitch was hired in 2008 he has managed an average of 400 to 500 patients a year, about two-thirds of whom are under the age of 18, said Kilmer. This figure includes repeat patients. Stepkovitch averages about 150 to 200 visits a month from individuals needing counseling.
Kilmer said the additional part-time psychiatrist will improve the overall quality of care the county can offer.
“Dr. Stepkovitch is not only acting as the only doctor but also the clinical director. So by putting another doctor into the mix it would take some of the pressure off Dr. Stepkovitch so he can work on educating our staff and bolstering the quality of care we give to residents as well as still enhancing the availability and resources of a psychiatrist,” Kilmer said.
Kilmer said the county may not be able to afford a child psychiatrist even on a part-time basis since they can charge more than $200 an hour.
“Supply and demand dictates that they can demand what they want,” Kilmer said. He said Cortland would have a hard time competing with New York City and upstate cities like Rochester and Syracuse, to attract a psychiatrist at that rate.
To help the county meet the needs of its patients under the age of 18, the county is trying to draft a contract with a board-certified child psychiatrist who could provide services weekly.
The psychiatrist would hold weekly hour-long appointments with Stepkovitch and the other psychiatrist, Kilmer said. The doctor would provide his expertise to help the county doctors manage difficult child cases. Once the doctor and county reach an agreement the Legislature would vote on the contract. Kilmer said the doctor would likely be paid the standard rate for child psychiatrist, $200 an hour. Kilmer would not identify the candidate.
Stepkovitch was hired in 2008 at an annual salary of $205,000, with an annual 3 percent cost of living adjustment for subsequent years.


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