About a dozen state disability case managers spent their lunch break outside a Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH) brick office building in Cranston — not to eat, but to protest what they say is a lack of action on staffing shortages and dragging their feet on pay negotiations.
The case managers, organized under SEIU Local 580, have been working without a contract since July 2024. They have asked for a higher pay grade in line with what similar workers make at the Rhode Island Department of Children, Youth, and Families (DCYF).
But Matthew Gunnip, a DCYF case manager and president of SEIU Local 580, told Rhode Island Current that BHDDH managers rejected the proposal without offering an alternative.
“Good faith bargaining is coming with a counterproposal,” he said, standing in the grass as temperatures reached the mid-80s. “That’s not leadership.”
Gunnip acknowledged the state’s tight budget but said that lawmakers have given BHDDH more than enough funding to bump pay for the 16 budgeted “conflict-free” case managers. Conflict-free case managers are tasked with helping clients be more involved and independent in the community.
BHDDH has a budget of roughly $219 million for fiscal year 2026.
“Like other health care and human services employers, BHDDH is navigating a challenging labor market,” BHDDH spokesperson Randal Edgar said in an email. “The department wishes to address concerns raised by employees and is scheduled to meet with the union on July 8.”
One of the top concerns for case managers is pay. A job posting from nine months ago lists the salary range between $61,460 and $71,507 per year.
“That may sound like a lot, but living on that is challenging,” case manager Alex Blue said. “We have to have cars that work, insurance is expensive, living is extremely expensive, and food is getting more expensive.”
Rep. David Morales, a Providence Democrat, joined the unionized case managers for the lunchtime 45-minute press conference arranged by SEIU Local 580. Rhode Island was one of three news outlets that attended.
“Our frontline caseworkers are being burnt out,” he said. “Having to continuously take on higher case loads and work environments that are just plain stressful.”
Erica MacDougall, who started work as a case manager for the state last August, knows those stresses all too well.
“I’ve lost weight, and I’ve lost hair,” she told reporters.
MacDougall said she’s had to juggle 45 clients, some of whom are unhoused. Clients include a man with continued to stay at home for five days with the body of his dead father, and someone who was so severely malnourished that they weighed 69 pounds. She said case managers are effectively doing two jobs: acting as frontline social workers while also drafting individualized plans for each client, which had been a separate role.
“It’s now a brand-new, unmanageable responsibility,” MacDougall said. “This task is intently time-consuming and complex, with many steps and constant changes, as many clients are new to BHDDH.”
Crafting a plan, she said, requires multiple meetings with clients. That’s on top of the monthly check-ins that case managers are required to conduct, which involve driving across the state to connect with clients in person. Some, MacDougall said, require weekly or daily check-ins.
“It’s constantly putting out fires,” MacDougall told reporters.
Because of the high-stress workload, MacDougall said she’s seen five case managers leave the job. But Edgar said he believed there are now three open positions, which he said were in the process of being filled.
As of Tuesday, the state’s job portal lists three open positions at BHDDH: a clinical psychologist, a janitor, and a certified occupational therapy assistant.
This story was originally published by the Rhode Island Current.