The Rest of The Story - NY Times Reporting

The New York Times has published another story in a series it is doing on supports and services to people with developmental disabilities in New York State. The series is trying to get at the expenditures of federal and state Medicaid dollars for these supports and services and is also exposing abuse and neglect in this system of support. Those who know me understand that I have a great deal of respect for the first amendment and specifically for the important role that journalists and journalism play in the pursuit of truth and action against injustice. I also respect the 'Gray Lady' as one of the oldest and most respected newspapers and news sources in the world. Great reporters have uncovered and reported on so many important stories over the years. I also hate to hear critics of the media going on and on about the media's hidden agenda and unbalanced reporting. Having said all of this, I really am disappointed in the Times' reporting on the issue mentioned above. The issues of fiscal waste and abuse of any group of people are critically important and deserve the best reporting and editorial review.

Again, I've worked for many years in this field and admit my biases. I've seen the good and the bad in terms of fiscal policy, government oversight, and yes, abuse and neglect. The gist of the latest story is that non-profit agencies supporting people with developmental disabilities are receiving much more money then they need in a particular program, that they are rolling in money and that executive directors and administrators of these agencies are making hundreds of thousands of dollars off of the system while paying the people who do the actual hands on work poverty wages. Sounds awful and also feeds on the environment of corrupt CEO's, bankers and Wall St. fat cats that is sweeping the country. And the problem is, there is some truth to what's being said in the article. But that's it - some truth, because there is always an outlier or two who can make a great headline. 

We've heard about 'the ladder of inference' before and this article is a great example of some truths being the basis for creating beliefs and then people thinking about acting on those beliefs. Two agencies are discussed in the article and the situations in both are abhorrent as presented. What the article does however is to then move to statements about large numbers of agencies, large numbers of non-profits doing the same thing with absolutely no factual basis presented. In one case, an executive director is reported as making a $400,000 annual salary while paying direct support professionals somewhere between $9-15 per hour, generating a surplus, etc. Then there's a quote by the current Commissioner of the state agency responsible for funding and overseeing these programs where she references these non-profits 'lining their pockets'. So we get to the some truth aspect.

It's easy to get tax data and confirm the salary of this one executive director. Based on the article, reported size of the agency, etc. it seems excessive and wrong. By the way, there are other executive directors who make large six figure salaries. They should be judged on specific criteria such as budget size, geographical location, years of service, expertise and various financial ratios. There is plenty of data to help get that info and come to some legitimate conclusions and the Times should be able to be a leader in that discussion.

There's more to the rest of the story that good investigative reporting would uncover. New York State has methods for determining fees and reimbursement rates. Providers have pointed out for years the problems with these methods including reimbursement levels for direct support employees. New York State also has systems in place to review, audit and act on and punish providers who are out of line both fiscally and relative to the treatment or mistreatment of individuals. This system obviously has flaws and government should be held accountable. Here's more - while some programs run surpluses, others run defecits. Non-profits have no choice but to use surplus revenues to operate deficit programs or to end them. More rest of the story - some people operate programs better then others, some grow for the sake of growth while others grow to provide choice to families and the people they support. More rest of the story - there is data that indicates how feverishly many executive managers have advocated for increasing wages for direct support staff over many years.

The other agency referenced in the article supposedly was making money hand over fist that caused sleepless nights for the former Board President. The rest of the story - again a little research shows that the agency was decertified and basically put out of business earlier this year due to, in part, the executive director stealing a couple of hundred thousand dollars. The Board President should have had sleepless nights relative to the seeming lack of oversight by the Board of Directors. Poor financial reporting was clearly identified it seems. Again, one example of what seems to have been a poorly operated organization. This does not represent an entire field or the hundreds of well informed and dedicated volunteers who serve on non-profit Boards. It's shameful to make that leap.

The latest article ends with a reference to how the Commissioner is moving from a fee for service method of funding to a managed care model. Interesting that the reporters in this series haven't identified the potential problems with this model. A little research shows lots of administrative support and overhead abuse potential in this model.

So here's what the Times' series has pointed out - Institutional care is bad, smaller community support is bad, non-profits are bad, government is bad, too much money is spent/spend less, abuse is rampant, etc, etc., etc. Big on problem identification but very weak on alternatives or solutions.

What is the lesson from all of this? There are bad apples. There are also good ones. Throw out the bad and nurture the good. Oh and let the NY Post do the sensational reporting.