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August 8, 2016 / 2016 Women to Watch Honorees

Women to Watch: Debra Taylor's balanced approach to wellness takes center stage at Sweetser

PHOTo / Tim Greenway Debra D. Taylor, president and CEO of Sweetser, oversees a behavioral health organization with 700 employees and 75 sites statewide. She is pictured at the Ricker Farm, which is part of an experimental learning program offered by the Sweetser School in Saco.
PHOTo / Tim Greenway Deb Taylor, president and CEO of Sweetser, center, talks with Allison Martin, director of patient accounts at Sweetser, left, and Ginny Gentile, VP of finance at Sweetser, in their Saco office.
PHOTo / Tim Greenway Debra D. Taylor, president and CEO of Sweetser, and Julia Birtolo, a special education teacher and farm manager at the Sweetser School, talk about the program while petting Zoe in the school’s stables.

Debra D. Taylor says behavioral health has come a long way — and has a long way to go. As president and CEO of Sweetser, a nonprofit that deals with critical behavioral health issues, she recognizes that the issues are now part of a broader health care discussion. But behavioral health belongs in the same discussion as other health issues, she says.

“As I reflect on the work our organization does, a lot of people, especially here in Maine, think of the behavioral health system as fragmented. For the people who need the services, often times, that is the case. As providers, it's our responsibility to work collaboratively to erase that as the experience,” says Taylor, who joins three other 2016 Mainebiz Women to Watch.

Sweetser was founded in 1828 by Cornelius Sweetser and for years ran orphanages. Today, it deals with some of the critical behavioral health issues that have reached a crisis point in the past year, ranging from the opioid crisis to suicide prevention. Sweetser has 700 employees in 75 sites around the state and is based in Saco.

Taylor, a Sanford native who was educated in Maine universities, joined Sweetser 16 years ago and worked her way up from director of patient accounts to controller and vice president of finance, overseeing a $55 million budget. In October 2014, she was named president and CEO, stepping in after the retirement of Carl Pendleton, who had been at the organization 36 years, including 23 as president and CEO.

She had not considered the CEO path — in part because when she got started health care organizations were often run by health care professionals, not people with MBAs in finance. But that changed, as health insurance, Medicaid and other systems demanded more accountability.

“When I started here, it was unthinkable that anyone from a finance background would end up in the CEO seat,” she says. “And that was always the furthest thing from my mind. Health care has evolved, even here in behavioral health. It has become a lot more important, to boards in particular, to feel a level of confidence about the leadership and that the leadership recognizes that and has talent in that realm.”

Still, prior to Pendleton's retirement, she didn't necessarily envision herself as a CEO. “I thought I could contribute as a member of the executive team and that was something I ultimately aspired to,” she says. “I didn't necessarily feel it would be in the CEO role.”

Plus, her hands were full outside of work.

“My kids were getting older, but were not quite out of high school. I didn't want to change things for them. And then I had the unfortunate experience of having a mom with Alzheimer's. I was her main caregiver,” she says. “When you hear Alzheimer's, you're preparing for a long road. Her trajectory ended up being short. Carl announced his retirement, she passed away about six weeks later… People came to me and said, 'Would you consider being a candidate for that role?'”

When she sat down with her husband and two kids to ask them how they felt about her applying for the leadership position, their unanimous response was, “Why wouldn't you?”

Now her son is at Maine Maritime Academy and her daughter is at Colby College.

She has thrown herself into the role of president and CEO.

In the nomination form Sweetser submitted to Mainebiz, one of her direct reports stated: “She amazes me with what she accomplishes in the same 24 hours I have.”

'You don't need to be a forceful leader'

Taylor's path to becoming a CEO had a number of female mentors. (See the sidebar, “In her own words.”)

Kathy Applin was Taylor's first boss in the health care industry. Applin, who led the Visiting Nurse Service, understood the financial side of the business and took a methodical approach.

“She was one of my original influences … She had a way of calmly looking at what's in front of you,” Taylor recalls. “The strategic view of the world, so you can see the big picture. She helped me see that quiet, unassuming leadership works. You don't necessarily have to be forceful. You don't have to have an enormous presence to make an impact.”

As a manager, she has a calm demeanor and an ability to diffuse stress. Comments from her reports cite her “way of turning anxiety around,” look at things in a “methodical way” and with a “professional [approach], never political or petty.” “Deb doesn't micromanage,” another employee says. “She allows people to do their best work while supporting them.”

Having a committed team allows Taylor to focus on the issues outside the office.

“I'm not your traditional finance person. My strengths are less on the technical end of the finance and more on the managerial end,” she says. “Here it's been a nice balance. There are people on the technical end and I'm more looking at the big picture.”

“When I started here 16 years ago, behavioral health, which used to known as mental health, was an underling in the health care world,” she says. “There was not that full recognition that mental health was part of total health. There's been as everybody knows, this recognition on a national level over the past five to 10 years, transition to understanding that you cannot be well unless you're well physically and mentally. That has led to incredible transformation for us in this sector of health care. We were off to the side, we were not central to the conversation. Now we're central to that recognition of total wellness.”

There are still challenges catching up, though.

“We lag the rest of health care in a lot of ways. Funding is a huge part of that. We come last to the party on a lot of things,” she says. “We are still in that realm of fee-for-service care.”

While other health care is part of a bundled payment approach, behavioral health issues still get paid on an a la carte basis.

Finding qualified workers

Hiring is also an issue that Taylor deals with on a daily basis.

“We have a huge number of people who are committed to providing service to the population we serve,” she says of her 700 employees. But when she looks at the job markets, she sees a thin labor pool. “There are fewer of them around than we would like. That's true in nearly every industry right now. We're always looking for talented staff,” including independently licensed service providers.

Its entry level youth-and-family counselors provide guidance for troubled youth. Many of the certified counselors do not have advanced degrees or even college degrees and consequently receive modest pay.

“We have a shortage, especially in the summer. They can go and wait tables and make double what we pay,” Taylor says. “And the work doesn't get more challenging than what they do here.”

That's a major issue for a nonprofit with a budget of $55 million that serves some 21,000 to 22,000 people a year statewide.

Sweetser works with physician practices, pediatric clinics and other institutions, but also offers community-based care in schools. It offers training in areas like child- and mental-health first aid, as well as an array of courses and certification.

Much of its revenue comes from the fees paid for services. It also raises money through three signature events: an auction, a golf tournament and a bicycling event.

Like the other 7,000 nonprofits in Maine, Sweetser seeks grants from foundations and other institutions.

“I think we've done a good job of engaging people. I think our mission, our vision, is something that people can see and especially people who have been touched by the mental health services environment. That's something that resonates with people,” she says. “We are also very lucky in that we have an endowment,” which is between $25 to $30 million.

Sweetser also receives state funding through Medicaid and Maine Care. Some grant funding comes through the state as well.

“We are more challenged when the state is more challenged,” she says.

Sweetser recently received a state contract for recovery-based “peer training.” In the training, peers with “lived experience” work with Sweetser clients in mentoring roles, something like Alcoholics Anonymous. The peers self-identify as having an issue or problem and consider themselves in recovery.

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