Driving In Reverse

If you have been paying attention at all to the discussions in our state about the funding of services for individuals with one or more developmental disabilities, you have probably heard this refrain: the rates paid to providers of services are simply not keeping up with the cost of doing business.

This isn’t a bunch of greedy providers trying to pocket more money, this is a very dangerous trend which is putting our entire system’s ability to protect some of our most vulnerable citizens in danger.

Check out the graph below, which compares rates paid to providers with the Consumer Price Index in Denver, Boulder, and Greeley from FY 1997-98 through 2011-12. I think you will notice a disturbing trend. (You can click on the graph to get a bigger view).

This graphic is based on a memorandum from staff members of Colorado’s Joint Budget Committee (JBC), to the JBC, dated January 24, 2012.

Those aren’t just lines and numbers. That growing separation between what providers are getting paid and what it actually costs to do business shown above is not a secret and has very real consequences for individuals receiving support services in our state.

Let me give you an example from here at Imagine! of how this disparity is impacting our ability to provide opportunities for the people we serve to engage fully in their communities. Boulder and Broomfield counties are enjoying a much lower unemployment rate than most areas of the state and country. What does that mean to us when we are paid 70 cents on the dollar for services rendered? It means we will have a heck of a time recruiting the talent we need to get the job done. It means we will continue to see service ratios drop, similar to growing classroom sizes in education, and a return to more congregate settings. Add to the fact that the system of payments does not incentivize the use of natural supports and personal job placements. The result is a return to what we escaped from 30 years ago. We appear to be driving in reverse.

I believe this represents a move away from a person-centered and personalized approach to services that foster lives of fulfillment. But this isn’t just about philosophies about inclusion and the meaning of being a community member. The fact is there aren’t many more places that providers can cut when it comes to providing services. The low hanging fruit has been picked, as it were. We are on the brink of a situation where the health and safety of the people we serve will be put at great risk, as fewer and fewer providers are able to stay in business while receiving only about 70 cents for every dollar’s worth of service delivered.

The disparity between what it costs to provide services and the rates providers are paid cannot continue to widen.  I encourage decision-makers to look closely at what has transpired over the last decade and begin restoration and investment in what can be a very bright future for all people concerned.

Then again, what do I know?