Ensure Strong Community-Based Human Services System Through State Rate Setting and Adequate Public and Commercial Insurance

Community-based social and health services are critical to a responsive system. Community-based non-profit organizations are small and mid-sized businesses that extend the work of government and enhance those services with private resources. Organizations that are based in local communities respond nimbly to changing needs and coordinate most effectively with families, schools, government, and other providers. To fulfill their missions, private agencies rely on a combination of private philanthropy, government contracts, and insurance reimbursement. Community services must be high quality, comprehensive, and accessible to ensure that children and families receive services in the least restrictive setting and closest to home.

After years of neglect, current contract rates and insurance payments for community services are well below actual costs of program operation which risks the viability and quality of programs. The current workforce crisis makes targeted state investment and immediate action critical. State rate-setting methodologies are law elsewhere and a rate-setting process must be passed this year in Rhode Island, with interim investments while the process is developed and implemented. Equally, the state needs to address insurance reimbursement rates for both its Medicaid and commercial insurers to achieve parity and consistency in addressing health and behavioral health needs. Flat rates and underfunding by both the state and insurers have brought the sector to the brink. It is time to act!