State Run Disability Services Cost Three Times Private Firms
Tuesday, April 23, 2013
Rhode Island Community Living and Supports (RICLAS) system have come under close scrutiny by a number of groups and individuals.
The Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH) supports two programs, the state-run RICLAS system, which serves 211 individuals, and the privately-based community operated system, which services approximately 3500 individuals.
Reports show for Fiscal Year 2011, RICLAs spent $153,250 per person, while privately operated programs spent $55,143 per individual.
GET THE LATEST BREAKING NEWS HERE -- SIGN UP FOR GOLOCAL FREE DAILY EBLASTIn state payroll information compiled by the Rhode Island Center for Freedom and Prosperity, investigative reporter Suzanne Bates found that in 2011, there were 228 community living aides (CLAs) listed on the state’s payroll, with 14 earning more than $100,000, including their overtime pay -- and all but one of those worked for RICLAS. The total amount the state paid in overtime and other salary premiums to CLAs was almost $5.3 million.
Concerned Citizen Speaks Out
The information on RICLAS and privately-operated community based program spending was detailed in correspondence from House Fiscal Advisory Staff and the Office of Health and Human Services to Deputy House Majority Leader Arthur Corvese.
The letters were provided to GoLocalProv from an individual who oversees a relative with development disabilities in privately-operated community based care, who had contacted Representative Corvese requesting information on developmental disability program spending.
"I'm concerned about the unnatural inequities in funding [between RICLAs and privately-operated community based care]," the individual, who requested anonymity, told GoLocalProv. "I care for my [family member] who receives self-directed support, so I'm responsible for payroll and scheduling with the state allotment, which is why I started looking into this. I thought everyone was funded the same way -- and I see that they're most definitely not."
Reasons for High Costs of Care Detailed in Letters
In the letter provided to Representative Corvese by House Fiscal Advisory Staff Principal Budge Analyst Linda Haley, she states that "by comparison, the annual per person cost in the privately-operated community based system is lower; however, there are circumstances specific to the state-run system that impacts the cost."
Implementation Director for Policy and Programs in the Office of Health and Human Services Michael Cronan noted, "Three major components of the overall cost of [RICLAS] are the Special Care Facilities, the age of the population, and RICLAS' function as the residential safety net for the developmental disabilities system," which are outlined further in his letter to Representative Corvese.
RICLAs were cited in the recent Medicaid Waste and Fraud Report for being an area of watch, noting at the end that the state could "realize cost savings by moving group home residents who require extra staffing needs into a common facility."
Deborah Varga, spokesperson with BHDDH, said in response, "We already have three special-care facilities. We would never "move group home residents to a common facility" - that would be an institution - and we would never move back to those dark days. Our vision is to provide the least restrictive and most integrated care possible."
Varga noted that the department had been "addressing funding and consolidation issues for some time," which was outlined in the House Fiscal letter.
"Over time, the state has transferred more of its caseload to the privately operated system. The current caseload is 34.9 percent, or 113 fewer, than the 324 individuals who were part of the state system in 2002," Healey wrote to Corvese. "The department has also downsized the number of facilities in the state run system by closing 12 in the last several years to reach the ...current count of 31."
Overtime and Contracts Outlined in Bates Article
Investigative reporter Suzanne Bates, who recently looked into overtime pay for RICLAS and other state employees, published an article last week in The Ocean State Current examining the situation.
In her article, Bates writes that RICLAS' administrator Charles Williams said the reason the overtime figure is so high "is partially because the department has been understaffed."
Bates continues, "[Williams] said the state is working to reduce the amount of overtime pay by hiring more CLAs and by adding seasonal employees. The state’s budget for RICLAS allows for 294 CLAs, and it currently has 272 on staff."
According to Bates, there were no CLA positions listed on the state’s job boards, but BHDDH has held job fairs recently to recruit CLAs, with most of the jobs were for “seasonal” employees. However, the state is limited as to the number of seasonal employees it can hire and how long they can remain on staff under an agreement with the American Federation of State and County Employees Local 1293, the union that represents the state’s CLAs.
Bates further details the Department's interaction with labor to meet staffing needs, quoting BHDDH Director Craig Stenning as saying his department is “more aggressively negotiating” with unions to increase the number of seasonal employees.
Funding Concerns Persist
The individual overseeing care for [the] family member with development disabilities wanted to address the perceived discrepancies in the two care models.
"A consumer choosing RICLAS is not limited by a "resource allocation" because they are supported by state employees, who are paid via a collective bargain agreement which sets their wage rate," the individual told GoLocalProv.
"Whereas as a consumer choosing a private provider like Trudeau or Fogarty is limited by the funding resource allocation allowed them and the wage rates set are under "project sustainability." The consumer has to plan what supports their money will get them, within the limits of the resource allocation. A RICLAS consumer has no funding resource limit with regard to staff because of the collective bargaining agreement and mandatory minimum staffing."
"This is more than just a spending problem too, this is creating a legal inequity in the system. Access to resources by privates versus the only public developmental disability agency are not the same,' claimed the individual. "All providers intake emergency placements, so that excuse is not just a RICLAS issue."
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