Report Highlights Impact Of Budget Delays On Nonprofits Who Contract With States

A recently released report by the National Council of Nonprofits draws attention to the precarious budget situations faced by nonprofits that contract with government to provide services.  The study highlights five main challenges faced by nonprofits, including budget delays, overly complex contracting and reporting requirements, the full cost of services not being paid for, and reporting procedures and contracts being changed by government half-way through completion.  Forty-five percent of nonprofits whose government contracts were changed mid-stream reported laying off employees, which is 14% higher than nonprofits whose contracts were not changed mid-stream.  In California, where nonprofits were paid with I.O.U.'s by the state in 2009, a state law prevents nonprofits from being eligible for a late payment penalty if the delayed payment is due to the Budget Act not being enacted.  A New York City survey found that 66% of nonprofits had been forced to take out a line of credit due to late payments from government agencies.  The authors reference a GAO report which found wildly different reimbursement rates for the same federal program, depending on the state.  A nonprofit delivering the services in Wisconsin could be reimbursed up to 14% in overhead costs, in Louisiana, the nonprofit would received no more than 9.4%, and in Maryland, the nonprofit would receive zero reimbursement for overhead costs because the state keeps it.  The authors conclude: "The consequences of neglecting this broken contracting system are staggering in scope, undermining the reliability of a "system" that is supposed to deliver vital human services."  For more information, visit:

National Council of Nonprofits

All 50 States Accept Additional Federal Medicaid Money But Most Still Make Cuts

Health and Human Services Secretary Kathleen Sebelius reported in September that all 50 states have requested and accepted additional federal funding for Medicaid that extends the FMAP increase until June 30, 2011.  (Governors were required to officially request the funding from the federal government and some suggested this requirement was implemented to address elected officials who publicly criticized the assistance while also accepting it.)  The Kaiser Family Foundation's Annual Medicaid Budget Survey found that even with the increased federal funding, 48 states implemented at least one new policy to control cost in fiscal year 2010.  In addition, 20 states implemented benefit restrictions for fiscal year 2010, the largest number since the surveys began in 2001.  However, under the American Recovery and Reinvestment Act, states were not allowed to restrict Medicaid eligibility standards beyond what they already had in place in July 2008 and 41 states have plans to or have already expanded or simplified eligibility processes.  Eighteen states reported implementing utilization controls and other reductions on long-term care services in FY 2010 to contain costs.  In a separate report, the Foundation found that 23 states experienced double-digit growth in enrollment in their Medicaid programs between December 2008 and December 2009. For more information, visit:

Commonwealth Fund
Kaiser Family Foundation 50 State Medicaid Budget Survey for FY 2010 and 2011
Kaiser Family Foundation Medicaid Enrollment December 2009 Snapshot

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Massachusetts Elected Officials Shadow Direct Care Workers

A state senator and representative in Massachusetts recently spent the day with direct care workers to gain a "hands-on" understanding of the importance of their work.  The "Come Care With Me Days" was sponsored by the Paraprofessional Health Institute and was designed to enlighten the public and elected officials on the work of the estimated 60,000 direct care workers in Massachusetts.  Elected officials in Iowa and Pennsylvania have also participated in this initiative, designed to call attention to the need for increased training and compensation and a lack of health care benefits for direct care workers.  For more information, visit:

Paraprofessional Health Institute

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Property Taxes Popular In Michigan To Support Seniors

A recent article in the Detroit Free Press focused on the popularity of millage (property) taxes to support senior services at the county level.  A think tank reviewed 623 ballot proposals in Michigan on a range of issues and found that voters passed every single ballot initiative for senior citizens.  Sixty-three of Michigan's 83 counties have a millage, but for counties without a millage, senior centers and programs supporting seniors rely on state and federal money and unpredictable funding from the general fund of local governments.  In contrast, in Rochester, Rochester Hills, and Oakland Township, voters approved a millage in 1982 to fund senior programs. This tax funds the Older Person's Commission and the Older Person's Center, a 90,000 square foot center with lap and therapeutic pools, fountains, and recreational activities.  The authors explain that a homeowner with a house valued at $200,000 would pay about $25 a year for this tax.  In recent August election primaries, 45 millages for senior citizens were renewed and even increased. For more information, visit:

Detroit Free Press

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