Monday, August 3, 2009

"We cannot, in good conscience, cut our way out of this state budget deficit"

In My View: Government's role as protector of disabled at issue
Every year, I tell myself, "It can't get worse." Well, I've clearly been proven wrong by this year's budget, and politics. We are in the throes of a massive dismantling of Illinois' human services system - some might say "right-sizing government," while others refer to the current budget as doomsday.

From my perspective, it is clearly the latter - draconian cuts threatening the very existence of many services and organizations.

Folks have heard warnings about service cuts and/or agency closures but seem to react based on whose ox is being gored. Most react when directly affected and the service they need no longer is available. I'm focused on community-based organizations serving people with disabilities, arguably some our most vulnerable citizens, but the budget impacts all social service agencies.

What do we know about the not-for-profit sector?

*Most are 501(c)(3) charitable corporations. They do, however, need to make money - it simply means that their profits support their mission versus paying dividends or profit to owners/stockholders. Without a margin, there is no mission!

*501(c)(3)s must comply with the majority of legal requirements to which other for-profit corporations are held.

Insurance, wage and hour, human resources, federal, state and local statutes all apply to the not-for-profit sector. These organizations often significantly affect local economies because of the jobs and money brought in.

*When 501(c)(3)s go to the bank or bond their building projects, the financial community assumes the state is good for their debt - it has historically funded them at consistent levels. Future dollars may be more difficult to secure due to the state's demonstrated lack of commitment to community-based agencies (doing the state's work).

*Community agencies often pay 20 percent to 30 percent less than market wages and benefits. An interesting paradox is that employees in community agencies must possess special skills to serve people with disabilities. These agencies, with which the state contracts, already were a bargain before the current budget crisis reduced their funding.

*If a bookstore, restaurant, gas station or construction company was informed it was going to lose 10 percent to 20 percent of its business starting July 1, how many would survive? It isn't surprising then, that many human service agencies are laying off staff, decreasing services and contemplating their very survival. An odd set of circumstances, given the various stimulus packages aimed on job retention/growth.

*Most affected agencies are safety net providers - ensuring that people without options always can count on service being available. Choice is severely limited. There is only one mental health center in Springfield. There are a very limited number of providers serving people with disabilities in any given community. Under current circumstances, some agencies won't survive and the remainder will serve far fewer people.

*Mental health is health care - mental health centers are required to have licensed psychiatrists, nurses, medications, and carry liability insurance. Why then, has the community mental health system been cut disproportionately to other healthcare providers? With access to mental health services and medications in question, the inevitable result will be greater use of hospital emergency rooms, inpatient care, police involvement, incarceration - all more costly than the currently under-funded system. And did I mention patient pain and suffering?

*Illinois ranks in the lower quartile in funding services for mental health and developmental disabilities. On some indices, we are 49th. Deinstitutionalization was a policy that moved people with disabilities into community-based systems - the same community systems that are now being decimated through budget cuts.

There have been previous budget impasses and extended sessions. This is much different.

The amount of funding cut from community agencies is significantly greater than in past years.

The worldwide recession has hit government at all levels and deficits are very real. Concurrent high unemployment and an economic downturn makes raising taxes an unpopular approach to budget resolution. Citizen expectations of government far exceed the government's ability to fund the expected level and mix of services.

We cannot, in good conscience, cut our way out of this state budget deficit. While there always are examples of waste in government, much has been eliminated and what's left, if addressed, will not come close to balancing the budget.

Yes, we all need to share the burden in dealing with the budget crisis. A fair, equitable and proportional approach always is superior to across-the-board cuts. Ultimately, we need to decide, as a society, what government's role should be in protecting and providing for people with disabilities.

Brian A. Allen, MPA, LCSW, is vice president for health-care partnerships at the Hope Institute for Children and Families.

No comments:

Post a Comment