The Puerto Rico Federation of Long-Term Care Institutions (FICPRO) is calling for a comprehensive review of government reimbursement rates for services to people with intellectual disabilities, saying funding must be measured against the actual cost of continuous, quality care. Figures presented at an October 7 public hearing before the House of Representatives Health Committee showed large differences in monthly payments per participant: the Department of Health pays an average of $6,413, the Department of the Family pays between $1,900 and $2,350, and the Administration of Mental Health and Addiction Services (ASSMCA) pays about $900.
FICPRO President Jonathan Morales Adorno said the gaps warrant a detailed look at what each agency’s rate covers and whether it is enough to sustain care. The federation acknowledged that agencies may serve different populations and cover different services, and said the review should identify those differences rather than assume all rates cover identical services.
FICPRO asked lawmakers to determine the actual cost of 24-hour care, identify the services in each rate, quantify differences in population needs and calculate institutions’ costs of meeting government regulations. It listed ongoing costs including payroll, food, medication, electricity, water, nursing, health professionals, maintenance and hygiene supplies. The federation warned that payments below actual expenses could threaten providers’ financial stability and the quality and continuity of services.
It has sought a rate review for years, according to Morales Adorno, and wants providers to take part directly in the legislative review. FICPRO said it is willing to give lawmakers operational and financial information.