Pay to Stay

posted in: addiction, recovery | 0

 

The reality of running any addiction recovery program is that there are costs involved. Titus 2, because of the small size and the commitment of its volunteers, has minimized the cost of operating a residential program. However, there is only so much one can get donated. Rent, utilities, vehicle maintenance and operation costs, etc. are not easily obtained by donation. So, there has to be income. Every rehabilitation program either solicits donations, sells goods, or charges a fee for the program. Secular for-profit enterprises simply charge what is needed to cover their costs or what the market will bear (or what insurance will reimburse.) But for charitable, faith-based non-profit organizations, there is usually a combination of fund development activities….yard sales, thrift stores, fundraising campaigns, pledge drives, mail solicitations, and program fees for participation.

In the past some faith-based non-profits generally accepted all-comers who met acceptance criteria, regardless of ability to pay. That is not always the best approach. When a modest fee is involved, the determination and commitment of some will be tested. If they are willing and able to pay for services, they may be more likely to remain engaged in the process and be accountable for doing their part. However, there will be those who have absolutely no ability to pay, whose lives and relationships are such that there simply is no blood in the turnip, who have no personal or family resources to pay even the most modest program fee. Are they to be denied services in our community? We would hope not.

Titus 2 has six beds. The average monthly operating expense for the residential program, if all beds are full, is about $3500. So, each bed’s contribution to the expense load is about $550-600. That is how we developed our fee schedule. At Titus 2 the program fee is $500 per month for 5 months, no matter how long it takes someone to complete the basic program. It generally takes 5-8 months for someone to complete all of the work. If the fee is paid up front, a 20% discount is offered and the applicant pays $2000 total. After the basic program is completed, if the individual is employed and wishes to remain in transitional living at Titus 2, she pays $50 per week to help with the housing costs if she has her own transportation at that point. If she does not yet have personal transportation, the transitional living fee is $75 per week to help offset the cost of transporting her to and from work and other continuing appointments like probation, medical or mental health, and required church and recovery meeting activities.

We try to maintain a balance of fee-paid and charitable, no-fee paid beds. Generally, we try to maintain at least 1/3 of beds as fee-paid. Sometimes it is more, but the burden for fundraising becomes burdensome if it is less. Since we are an all-volunteer operated program, fundraising activities take time away from direct services to students, so we try to keep costs well in hand and limit the need for fundraising activities.

It seems to be the case that all previously no-fee programs in Bay County are now fee-paid, using a fee structure similar to that of Titus 2 and a local men’s program, Right Way. Fee-paid services had not been a part of the philosophy of the largest community charitable faith-based men’s and women’s residential program. Now it is. One thing that might be helpful for the community to know is how are indigent prospective addiction recovery clients being treated in access to care? What is the ratio of fee-paid to non-fee-paid beds? In addition to the percentages of the paid versus non-paid beds, what is the degree of bed utilization for a public charity that is asks for donor dollars from the community and requires client payment? Are beds going unfilled because of inability of indigent persons to pay and inability of the non-profit agency to find “sponsors” for individuals needing services?

As federal and state dollars are funneled into the community for various opioid crisis initiatives, there appear to be corresponding adjustments that are being required by groups that do not receive government funds. Such faith-based programs must be creative to maintain viability financially in competition with the better funded government supported programs, even though the outcomes of such government funded secular programs do not appear to be significantly better than charitable faith-based non-profits’ outcomes.

Furthermore, the high number of people needing services creates an environment in which programs are competing for those individuals they believe will benefit most from their program and demonstrate a higher success rate. The program that historically took all-comers now appears to take far fewer applicants and has instituted a requirement for financial contribution. It used to be that its participants worked in its enterprises and administrative offices to “pay” their way. The community needs to be mindful that there are many who will have no means of paying to stay in a residential program and for whom the likelihood of success may be limited. What are we going to do with such individuals? Leave them on the street with a much higher risk of death due to the increasing danger of adulterated, high potency street drugs? It could just be the result.

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