The nonprofit network that delivers most state social services says the coronavirus pushed longstanding staffing woes into a crisis that is shrinking access for the disabled, abused children and others in need.
And leaders of the CT Community Nonprofit Alliance and the legislature’s budget-writing panel say their ability to fully assess the crisis is being hindered by prolonged delays in getting state funding to community-based caregivers.
To avoid closing behavioral health and substance abuse treatment programs, Perception Programs Inc. of Windham has begun scheduling appointments as much as six weeks out — for services that, until recently, could be obtained on a walk-in basis or with one week’s notice, said Perception CEO Kristie Scott.
The nonprofit, which serves 3,000 to 4,000 patients annually, offered tele-health, remote working arrangements and hazardous duty pay to protect and retain staff during the worst of the pandemic.
Like many nonprofits, Perception has raised standard pay for most caregivers, who were earning about $13.25 per hour, to $15. And as often as possible, Scott added, “I buy doughnuts.”
With 94 full-time positions in her budget, Scott is trying to run her agency with 20% of jobs vacant.
Bloomfield-based Community Solutions, which provides counseling and job placement services for inmates and foster children, has 40 of its 250 full-time posts vacant, said CEO Fernando Muniz.
While Muniz also offered hazardous duty pay last year and used state aid to boost standard compensation, it’s hard to retain staff when the jobs they find for clients pays more than Community Solutions does.
Salaried administrators have been filling vacant staff shifts on nights and weekends for weeks now — but that can’t continue indefinitely, Muniz said.
“The way we’ve been keeping it together,” he added, “is really at a breaking point.”
The state has long had a dysfunctional relationship with the hundreds of community-based nonprofits that deliver the bulk of social services.
Connecticut spends more than $1.4 billion annually to hire these agencies, an expenditure that roughly mirrors its payments to the nursing home industry, which also is facing financial and staffing crises.
But while caregivers for the elderly quickly grab politicians’ attention, nonprofit leaders say, those who serve patients with mental illness or substance abuse issues, prison inmates or the developmentally disabled don’t get a similar focus.
And Gian-Carl Casa, president of the CT Community Nonprofit Alliance, says stories like Scott’s and Muniz’s aren’t unique.
“It’s very widespread,” he said. “People are finding they can be paid more elsewhere, and they are going.”
The problem is that while Connecticut long has relied on the private nonprofit sector to keep down the cost of social services, that reliance is expected to increase dramatically over the next three to five years.
Following a directive from the General Assembly, Gov. Ned Lamont hired the Boston Consulting Group in September 2020 to craft a plan to take advantage of projected surge in state employee retirements in 2022 and 2023.
The firm issued a report in March estimating that state government, over several years, could reduce annual operating costs by as much as $900 million through various efficiency initiatives.
One key component of that savings involves continuing to reduce the number of state-employed social workers and shifting their clients onto the private sector.
But state spending on nonprofits already matches the annual budgets of the departments of Correction, Motor Vehicles and Transportation combined — and the industry has complained for decades of underfunding.
Over the past two decades, state spending on nonprofits grew only about 10%, well below inflation.
And last year Casa’s group projected it would take an extra $461 million annually to close the gap.
The Appropriations Committee responded last spring with a five-year plan to eliminate most of the differential.
That proposal was watered down, though, in final negotiations between legislative leaders and Lamont.
The final product in the two-year state budget enacted last spring included an extra $83.2 million for the industry this fiscal year and $145 million beyond last year’s levels by July 2022.
But while nonprofit leaders praised state officials for the investment, they also noted those dollars came with several strings attached.
A portion of the extra assistance — $30 million in each year — came not from the state’s coffers but from federal coronavirus relief grants that expire in 2024.
Take that away, and the state’s investment is down to $53 million in the first year of the new budget and $115 million extra in the second.
Further complicating matters, roughly three-quarters of all new funding was earmarked only for nonprofits that serve the developmentally disabled. And most of that money must be used to enhance workers’ wages and benefits, rather than to expand programs, pay down debt or to make equipment purchases or building renovations.
Sen. Cathy Osten, D-Sprague, who spearheaded the push to expand funding for nonprofits, said she knew the state couldn’t correct decades of underfunding in one biennial budget.
But Osten also said legislators are unable to fully assess how much the industry needs, because the Lamont administration has been slow getting all of the additional dollars to nonprofits.
“Until the contracts are out, I can’t even make an evaluation,” Osten said.
The fiscal year, which began July 1, is now more than halfway through its fifth month, but Casa said many providers still don’t know exactly their specific share of the extra dollars.
The state’s largest healthcare workers union, SEIU 1199 New England, threatened to strike against several nonprofit agencies that serve the developmentally disabled this fall and ultimately hit the picket lines in mid-October against one: Sunrise Northeast.
That work stoppage still has not been resolved, and Sunrise as well as other nonprofit agencies that narrowly avoided strikes also complained that they lacked sufficient information about their specific state funding.
Part of that problem stems from poor communication between the Executive and Legislative branches. Some nonprofit leaders have said the various state agencies that hire them still are awaiting precise guidelines on how those funds are to be used.
Administration officials have been saying they are working to resolve the problem as quickly as possible.
Office of Policy and Management Secretary Melissa McCaw, Lamont’s budget director, said Thursday that OPM has been analyzing proposed contracts for nonprofits that work with nine different state agencies.
“Those agencies are now in the process of negotiating and amending thousands of private provider contracts as required by the legislation to ensure increases support employee wages,” McCaw said.