Yvonne Abraham

Nonprofit's nightmare

Email|Print|Single Page| Text size + By Yvonne Abraham
June 1, 2008

HOPEDALE - Think you're having trouble keeping up with the high price of food and gasoline?

Try managing it on the same money you were making 16 years ago.

That's what they're doing at Crossroads Clubhouse, which gives mentally ill men and women counseling, jobs, meals, and a place to go every weekday so that they don't spend their time cooped up at home or take up costly beds in state hospitals.

The center, in a stately old house in the Blackstone Valley, is one of hundreds of nonprofits that have contracts with the state to care for vulnerable people the state can't handle on its own.

On a recent sunny day, dozens of clients, or "members," were chatting under trees, chopping vegetables for lunch, volunteering in the office, and learning data entry.

The point of the place is not just to treat the symptoms of mental illness, but to help people live full lives in spite of them.

"I come here every day to be challenged," said Paula Fisher, a soft-spoken 53-year-old with depression and borderline personality disorder and one of the members who helps run Crossroads. "This program has meant the world to me."

With the money the state gives it every year, Crossroads transports its charges, trains them, and helps them find jobs. It also provides healthy meals, maintains the building, and pays counselors and other staff members.

But the way the state funds Crossroads, and hundreds of other similar contractors all over Massachusetts, is a disaster.

Under the current system - which is no system at all - funding stays at whatever it was when a provider first signed its contract with the state. A 2005 contract pays more than one signed in 1995, even if they're for exactly the same services. Individual providers can beg for increases from the state, but that's a crapshoot. Nobody regularly reviews all of the contracts to bring them within spitting distance of inflation.

So Crossroads is running on virtually the same annual budget it had in 1992, when it first signed its state contract. Its annual budget works out to about $37 per client per day.

A state hospital bed costs $560 per patient per day.

Sixteen years ago, 11 Crossroads staff members served 30 members a day. Now it can afford only a staff of eight, but serves twice as many people. Most employees still make less than $30,000 a year, so turnover is high. The program's transportation costs have grown by a third in that time.

Utility bills have more than doubled. Every year, more of the center's programs get cut.

That terrifies Fisher, who credits Crossroads with keeping her stable for 11 years.

"If this program goes away, what am I going to do?" she said. "Where am I going to go every day?"

A bill on Beacon Hill would require the state to set uniform rates for all of its contractors, based on what it really costs to do the job, and to review those rates every couple of years. Everybody agrees with the intent of the bill, but bigs on both sides of the State House are worried that, even though it wouldn't kick in for a couple of years, the measure would cost too much.

That's a reasonable concern.

But those same bigs are also high on $1 billion life sciences legislation that includes tax breaks and research grants that Governor Deval Patrick says will bring 250,000 jobs to the state over 10 years.

Well, there are 185,000 human service employees in this state right now, says a study by the Executive Office of Health and Human Services.

And they're paid so little for the vital work they do that the field is hemorrhaging workers.

By any rational measure, they are just as valuable - and at a fraction of the cost.

Yvonne Abraham is a Globe columnist. She can be reached at

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