You may not realize this, but most of the money that spurwink|ri spends is in fact state and Medicaid reimbursement for the services we deliver. We do have some other sources such as special education or insurance reimbursements but even those dollars often originated as Medicaid. The problem with this is that the payment system is “broken”.
There are five major problems that all nonprofit agencies are experiencing, not just agencies who serve persons with developmental disabilities:
- Government reimbursement does not pay for the full costs.
- Governments change the terms of contracts mid-stream.
- Government pays late.
- Overly complex contracting processes.
- Overly complex reporting requirements.
The Urban Institute, a nonprofit, nonpartisan policy research and educational organization, provides the documentation of the problems listed above in a new in-depth study entitled Human Service Nonprofits and Government Collaboration: Findings from the 2010 National Survey of Nonprofit Government Contracting and Grants. A separate organization, the National Council of Nonprofits, released its own report to provide additional context to the Urban Institute’s findings. That report is entitled Costs, Complexification and Crisis: Governments Human Services Contracting “System” Hurts Everyone.
It is my hope that we can bring theses issues to the forefront with our newly elected state officials and that the rate reform initiative at the Dept. of Behavioral Healthcare, Development Disabilities and Hospitals (BHDDH) results in a system of smooth and fair contracting practices.