More than Essential: Reimbursement Rates and the True Value of Human Services

The following is the opening letter from our latest research report, More than Essential: Reimbursement Rates and the True Value of Human Services. Visit our website to access the full report, and the one page infographic summary.

Dear Reader,

The last year has brought me an entirely new understanding of the word “essential”. It is now inextricably linked to thousands of health and human service workers, and the partners in our coalition who have kept our communities afloat since the onset of COVID-19. Human services build the bridge that promotes trust in our health systems, access to basic resources, and pathways to positive health outcomes. While the human service workforce has been deemed “essential,” the state continues to underpay and undervalue these services. Reimbursement rates are one area in which this chronic underfunding is most apparent.

The following report is an analysis of human service reimbursement rates over the past two decades. It uses the Consumer Price Index (CPI), to perform a cross-sector comparison of how rates have kept up with cost-of-living increases. Though this measure is helpful to understand the gaps in state funding, it says nothing about the true value of these essential services, the economic contributions of the sector’s workers, and the impact they have on the lives that are sustained. Keeping up with the cost of living should be the absolute lowest bar we aim to reach — and yet we fail to reach it in nearly every area of human service provision.

Illinois Partners draws three broad conclusions for legislators and key administrators to consider in their policy-making:

1) Clarity: Many human service fields lack an established rate setting methodology, leaving rates to be determined arbitrarily. A clearly defined method of setting rates would improve funding models by allowing for systematic increases based on market costs and other relevant economic indicators.

2) Transparency: We found several instances of publicly available rate reimbursement data not aligning with rates in contracts of providers. FOIA requests were submitted to identify the true reimbursement rates for some services. This process undermines faith in the system and is neither effective or efficient. Transparency is vital to building trust.

3) Equity: COVID-19 has further revealed systemic inequities and prompted unequal health and economic outcomes — this reality is especially true for frontline essential workers. With the majority of social workers and direct support professionals being women and people of color, we face an ever-expanding gender and racial wealth gap in our state — and for our sector — that must be acknowledged and rectified. Similarly, we cannot successfully address disproportionate health outcomes without acknowledging the root causes that lead to them — vast under-investment in our Black, Brown, and immigrant communities. We must have clear and consistent metrics to define what equitable distribution of state resources looks like and measurements in place to gauge progress.

This report is intended to be a catalyst for action. We present it to you with gratitude to our coalition partners who shared their time and expertise to verify its accuracy and with appreciation for everyone who joins us in our mission. Together we will achieve a human services sector that is strong, equitable, and sufficiently funded so that all Illinoisans are able to thrive.

In Solidarity,

Lauren Wright

Executive Director of Illinois Partners for Human Service

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