Nonprofit Providers Say there are No More Cuts to be Made

April 5, 2015 - by Dirk Perrefort - Connecticut Post - Decades of underfunding. Cuts at every level. Uncompetitive salaries. The state's response? Do more with less.

Private providers of mental health care in the region were flabbergasted in recent weeks when state officials said nonprofit providers need to become "more efficient" amid proposed budget cuts.

They say the recent comments by Connecticut's budget chief, Ben Barnes, belie the facts -- that they've already cut most of their operations as far as they can due to years of underfunding. Even some state health care officials agree that private providers can provide the same, if not better, services for less than half the cost of state agencies.

"Don't they see that we've been working hard to find efficiencies for decades?" said Barbara DiMauro, president and CEO of Bridges, a community mental health organization in Milford. "They should really be examining the cost-effectiveness we've been building into the private sector system. I don't see them working nearly as hard on the state level to find efficiencies."

Testimony submitted last month to the Legislature's Appropriations Committee by the state Department of Developmental Services notes that while state-run residential facilities can cost upwards of $300,000 annually for each patient, private providers are offering the same services for about $131,000 a year.

Officials with the Office of Policy and Management, which Barnes oversees, dispute those comparisons.

While much of the roughly $25 million in proposed cuts to grants for nonprofit providers will impact outpatient services, industry officials say the cost of residential programs -- where the majority of the state's money is spent -- shows the stark differences in the cost for similar services provided by both the public and private systems in Connecticut.

"Private providers have a history of providing services to individuals with the same high level of need as many of those individuals who receive services in the public sector and often at less cost," said Joan Barnish, communications director for DDS.

Salary differential

Barnish noted that the state incurs some additional expenses, including administrative and quality-management protocols as well as higher staffing costs.

"The state has to be cognizant of the contractual agreements in place for many of the state employees," she said. The department's testimony noted that while the average salary for agency staff members on the front lines of behavioral health care amounts to $24 an hour, the same professionals in the private sector earn about $14.

"Our inability to pay competitive salaries has been an ongoing problem for some time," DiMauro said. "The retaining of good professional staff has become more and more of a challenge."

Recently, she said, a key employee submitted his resignation, not because he was unhappy with his work, but because he had become a father for the first time and was offered a job with the state where he could increase his annual salary by $10,000.

A report completed by the Legislature's Program Review Committee completed in January 2012 found that while DDS receives half of all funding in the state for 24-hour residential care, the department handles about 25 percent of the clients. That same report found that while it costs about $900 a day to treat each of the more than 300 patients who still live at the Southbury Training School -- a state-run residential facility -- those same services are being offered by private providers for about $400 a day.

Despite the fact that the committee removed certain costs to ensure an "apples to apples" comparison in the report, Gian-Carl Casa, a spokesman for OPM, said it's far from a direct comparison because state agencies have "entire facilities" to support.

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