The Vendor's Song (Rising costs, fixed rates)

I just received a copy of a letter concerning yet another unfunded State mandate service providers to the clients of this system are faced with. The figuratively millions of people who read this site regularly know that I think higher rates aren't the solution to the problems of the system. Ron Cohen, Executive Director of United Cerebral Palsy of Los Angeles, Ventura and Santa Barbara Counties just reminded me why I may want to qualify that position.

There is, after all, a funding crisis for the agencies that serve people with developmental disabilities. Reimbursement rates are fixed and things keep happening at the policy-making level (worker's compensation costs, new administrative duties, new labor laws) that raise costs without improving outcomes. The strategy of incremental funding cuts alongside incremental increases in cost is approaching its natural conclusion. As Ron points out, at his agency, 1400 people losing homes and services is not far-off. Statewide, I'd be suprised if there weren't tens of thousands of people with disabilities so threatened. Ron's just a little more honest (and normally a lot funnier) than many of his peers.

Nothing will change my conviction that the pincipal problems needing reform in this aren't rates. Nonetheless, not reforming this system while allowing the funding to ebb is causing an unnecessary crisis for service providers and, consequently for clients. The need for reform is present and acute.