The way that Human Services are funded is broken.
“The state determines how much it is willing to pay for a certain service, and waits for a provider to match that cost. Many contracts have not had an open and competitive bidding process for years, if not decades. The providers are forced to bid on fixed contract amounts with no price flexibility, causing a race to the bottom in order to win the bids. There is no transparency, and contracts are frequently awarded to providers willing to do the work, even at a loss. This is 10% of the state’s operating budget, and it must be more transparent. The state needs to know if it is paying too much or too little.” www.strengthenhumanservices.org
I have worked in Human Services for over 20 years. I have been at one agency for 16 years. I am in charge of 13 homes for adults with developmental disabilities. Some of those homes have not had an increase in funding since 1987. These houses have been level funded despite the fact that rents, salaries, food, gas have increased. When I started at one house we had a nurse, physical therapist, speech and language pathologist, psychologist, and a social worker. Over the years each was cut. The party line was that the clients could access those services in the community and that it was more restrictive for them to get them at home, but in fact the services were cut because we couldn’t continue to afford them.
There is a new campaign called The Campaign to Strengthen Human Services that aims to fix the way Human Service programs are funded. The Campaign launched a web site today www.strengthenhumanservices.org. The Campaign wants the legislature to pass Senate Bill 65.
“Senate 65 seeks to establish a fair system to ensure that Massachusetts human service providers receive adequate rates from the Commonwealth for the cost of delivering services to a million residents in need of care because of mental health issues, developmental disabilities and threats against their personal safety.”
Representative Tom Stanley wrote a letter to the Speaker of the House supporting Senate Bill 65. He is looking for other State Representatives to sign the letter.
” Dear Mr. Speaker:
We are writing in support of S. 65, An Act Relative to Rates for Human and Social Service Programs.
We have become increasingly concerned about the stability of the health and human services system and feel that the benefits-both tangible and intangible-that these services bring to the Commonwealth are at risk. In its report, Reforming the Commonwealth’s $2 Billion Purchase of Human Services: Meeting the Promise for Clients and Taxpayers, the Massachusetts Taxpayers Foundation noted that the flaws in the state’s human services contracting system “were sapping the performance of the system even when budgets were growing. But budget reductions are exacerbating the problems clients already face in negotiating an increasingly dysfunctional system for providing services.” We believe S. 65 will address this mounting concern and ensure that individuals across the state are able to continue to receive quality services in their communities.
Under the current human services purchasing system, there are no safeguards to ensure rate adequacy, no appeal rights against unfair prices and no ways to prevent unfunded mandates. As a result, human and social services contracts have not kept pace with more than 15 years of inflation. Across the entire spectrum of social and human services, growing financial instability is threatening the quality of care in community-based programs. Financial instability has resulted in deferred maintenance, delayed implementation of innovative care, and workforce recruitment and retention problems. These workforce challenges are compounded by the existing shortages of direct care professionals. Reform of the system is essential to the development of a more consumer-centered system of care with a higher quality of community care.
S. 65 requires the Division of Health Care Finance and Policy (DHCFP) to treat human and social service providers like other health care providers that have class rates set by DHCFP. It sets a standard of rate adequacy and confers on social service providers the same appeal rights as are accorded to other providers whose rates are set by DHCFP. It also adjusts multi-year contracts for annual inflation, and provides a right to obtain a contract amendment if the procuring government agency adds additional units of service or new program requirements to a contract. The fair and adequate pricing mechanism for human and social services providers contained in this bill will permit the development of a more consumer-centered system of care with more stable providers and a higher quality of community care.
We respectfully request your support of S. 65 and urge you to consider action on the bill before the end of the legislative session.
Thank you for your consideration.
Please talk with your representative and ask him or her to sign the letter.