NYT on the Cost of In-Home Services for People with Developmental Disabilities

Today's Times has an article on the costs New York pays the nonprofit providers of home-based services for people with developmental disabilities.  Basically, going by the figures given in the article, the state pays the provider an hourly rate for those services.  The rate is set regionally but is generally about $40 per hour.  The provider then pays a worker a substantially lower hourly rate (about $10-15 per hour).  It's not hard to see the incentive structure this system sets up, and the article describes a provider with 257 clients where the executive director makes $400,000 per year, which obviously seems like a large figure even in New York City.  Based on this article, the payment structure and billing process for home-based services in New York seems ripe for reform.  But it's important not to lose sight of the fact that, even with what is described in the article, home-based services are still cheaper than services provided in a group home -- and New York's group homes, as the Times has done a great job of showing, have their own problems in terms of cost and conditions.