Multiple forces have been converging in Kansas (and nationally) to increase the costs of traditional community services that support a variety of populations–all of whom need help to live independently.
These forces include:
- Exponentially growing waiting lists for services for children, adults, and seniors with a range of increasingly challenging care needs;
- Escalating cost for the direct support workforce (DSP), driven by unprecedented competition from better paying industries, historically low unemployment rates, and rising costs for insurance.
- Declining and increasingly complicated public funding for services that is transitioning rapidly from state/federal control to for-profit managed care strategies; and finally
- Public policy (which is fueled by consumer preference) swiftly moving away from “facility-based” approaches (assisted living, group homes, clinics) to highly decentralized, home-based, and inclusive community services that ebb and flow unpredictably and that fuel higher staff ratios, housing, and transportation costs.
In general, there have been three response trends to face these forces: (1) Agencies have merged or been acquired to become more cos- efficient and capable of dealing with complexity, (2) Agencies have moved from being nonprofit to for-profit (especially in non-urban areas where labor and housing costs are lower); and (3) Agencies that remain independent and local, increasingly rely on fundraising. To some degree, these efforts have been effective, but imbalances in any of these responses can disconnect what once was a charitable and local mission from the unique needs of a local community.