Another Story From The NY Times

The NY Times has printed another story on supports and services provided to people with developmental disabilities. The most recent story is interesting to me for a couple of reasons. First, I think it is trying to get at and identify what the systemic issues may be relative to poor performance by providers and the state's response to those issues. It seems to me that one of the problems is that the reporters either don't understand how the quality assurance and survey system does work within the Office for People With Developmental Disabilities or the people providing them with information don't know how it works and therefore are providing them with not so good information. Frankly it could be either one of these situations or a combination. It sounds like the non profit agency they are reporting on in this article had serious problems that needed to be dealt with differently but it's hard to say why things went the way they are reported to have gone. From previous discussions we also know that inferences are the wrong way to draw conclusions. The second reason the story is interesting is that there is at least some recognition in this article that the vast majority of non profits provide good services. The article has the following comment in it: "To be sure, many of the non profit organizations in New York provide exemplary care, using the state's generous reimbursement rates to devise and operate excellent programs."

Between this article and the last, there has been push back to the Times on its reporting by a number of people and entities, including comments on this blog. A group of provider organizations did send correspondence to the Times questioning the paper's method of drawing conclusions about an entire field. It wasn't the best response because it didn't get at the heart of the poor reporting issues, but at least it was something. Here is that correspondence:

The recent New York Times article, “Aiding Disabled, Nonprofits Rake
in State Money,” is misleading and unfair to the vast majority of
non-profit service providers who work to ensure that they offer
quality supports, services and programs for people with developmental
disabilities.

While the article focuses on one agency, the headline and the story by
reporter Russ Buettner use the terms nonprofits and nonprofit
providers when referring to alleged abuses of the system by a very
few, thus leaving the impression that this is a widespread problem.
The nonprofit provider agencies we represent have adopted a code of
ethics and practices to ensure that funds are used to provide the best
possible supports for people with disabilities and their families.  We
have worked in collaboration with government agencies and provide
annual fiscal reports of our operations to the appropriate State
agencies. There are also annual program surveys to ensure that we meet
all regulations and guidelines as required by local, state and federal
agencies.  We strongly reject any accusation that providers are simply
interested in “lining their pockets” by billing as much as possible.
As a group, our organizations place staff as our most valued resource,
with more than 75 percent of our operating budgets devoted to the
salaries and benefits of the thousands of people who work daily to
provide opportunities for people with disabilities to have full and
active lives in their communities. Community habilitation is an
example of a program currently in place that allows people to live
with support in the community or to remain in their family’s home for
as long as possible at a fraction of the cost of alternatives.
The vast majority of provider agencies do not maintain large surpluses
or pay excessive salaries to their executives. If a provider is able
to generate a surplus in one program, it is typically used to offset
losses incurred by the many underfunded programs our agencies provide.
The salaries of the executives are readily available to the government
agencies, and agencies are required to follow IRS guidelines (Internal
revenue Code 53.4958). Most agencies also adhere to the guidelines put
forward by the Commission on Quality Care’s “Report on Executive
Compensation”. Additionally, we are working with OPWDD to establish
executive compensation guidelines.   These steps are a result of our
organizations’ strong and involved Boards of Directors who ensure the
fiscal integrity of the agencies in order to provide the highest
quality programs and supports possible.

If the practices of one or even a few organizations appear
inappropriate, then the facts should be investigated.  We like other
New Yorkers, support immediate corrective actions when agencies are
found to be abusing the system.  OPWDD contracts with over 600
provider agencies. The vast majority of them operate in a highly
ethical manner. They daily help to support over 100,000 New Yorkers
with developmental disabilities.  OPWDD receives extensive detailed
cost reports itemizing both income and expenses every year from the
providers.  If they have any information that indicates that providers
have unethical billing practices they should investigate immediately
and not wait for the New York Times to call. However, a headline
condemning a community of providers based on the experience of one
provider is irresponsible at best.  There needs to be a balance in
reporting so that the readers are not left to believe all providers
operate in a questionable manor.

For decades, our organizations have provided needed services.  We have
worked with OPWDD and other agencies to ensure we provide quality
programs for people with disabilities. We are committed to this
process and will continue to support the providers and the State’s
efforts to improve the system.

Alliance of Long Island Agencies
       Seth Stein, Esq., Executive Director

Cerebral Palsy Associations of New York State
       Susan Constantino, President & CEO

Interagency Council of Developmental Disabilities Agencies, Inc.
       Peter Pierri , Executive Director

New York Association of Emerging & Multicultural Providers, Inc
Yvette Watts, Executive Director

NYSARC, Inc.
       Marc Brandt, Executive Director


Perhaps the Governor's office and the Office for People With Developmental Disabilities are also learning a hard lesson about being a part of condemning the non profit sector, even if by silence and acceptance of what I and others perceive as broad brush attacks. It should also be noted that the state's generous reimbursement rates have received substantial reductions over the past 12 months.

But back to the article at hand. There are numerous cases that I'm familiar with where the Office for People With Developmental Disabilities made sure that serious corrective action was taken by non profit boards when systems failed. There are numerous cases where non profits themselves have taken actions when systems or people have failed. There are executives and managers who have been terminated and removed from their positions. There is tremendous oversight and regulation that people are responding to everyday. There are fiscal and program audits by the Office for People With Developmental Disabilities. There are corporate compliance programs and training of staff and Board members - and, the Office for People with Developmental Disabilities has all of this information. So what is the problem?

Clearly the system is too big and here's the biggest nut to crack - you probably can't be an overseer, licenser and a provider at the same time. That's the big one and that's what probably needs to be talked about. More to come........