The Social Accountability of Not-For-Profits

The Social Accountability of Not-For-Profits

One of the wonderful things about being engaged with not-for-profit community organizations and providers is sharing in a sense of mission that is meant to make lives better, particularly for those who have scant resources of their own and high levels of need.

This feeling is shared by those who work for not-for-profits, as well as those who are donors to their causes and those who volunteer to help out.

It’s important to consider that studies have repeatedly shown that the not-for-profit sector is where innovation in care first occurs, and that nonprofits are also the providers that deliver the best and highest quality care.

Those of us who are involved with mission-driven entities recognize that these organizations exist to provide a public benefit. So many not-for-profits have grassroots origins, created to address some need in the community. Nonprofits have obligations not to some vague group of stockholders, but to the people they serve, and to those who finance their work.

A significant part of what not-for-profit entities do is related to having a social accountability agenda. Community benefit activities include various initiatives for which the organization receives no reimbursement, and “charity care” to provide many persons with low incomes, who have neither private insurance nor access to government entitlements, with care for which they cannot pay.

Of course, we are all aware of the impact of governmental cutbacks, particularly in Medicaid, in recent years, which continue in the current state fiscal year with significant changes in financing that were developed by Governor Cuomo’s Medicaid Redesign Team earlier this year and adopted by the state Legislature.

This has made private donations even more important, for they are one of the sources of funds that enable not-for-profits to engage in community benefit work.

VillageCare – an organization that has served the Village and other downtown and West Side communities, as well as other boroughs, since the mid-1970s with a wide range of services for older adults and for persons living with HIV/AIDS – provided more than $6.2 million in community benefit during 2010 for which we were not reimbursed.

These offerings by VillageCare sometimes involve significant funds, while others reflect the spending of relatively small amounts of money. This can include support for residents of certain communities, as well as underwriting certain care and services that are not covered by governmental funding, which is the single greatest source of revenue for VillageCare programs.

For example, VillageCare is a source of reliable information and help for persons living with HIV/AIDS, older adults and others. This includes providing information on community and government programs and helping individuals navigate the process of accessing entitlements and other services.

In 2010, we directed these activities specifically toward the Manhattan community in and around Greenwich Village, where we helped seniors, and the Red Hook community in Brooklyn, where an underserved population at-risk of HIV infection – predominantly poor, single black women – was provided with assistance. Other community benefit activities during the year included a twice-monthly Alzheimer’s Support Group for family and friends of nursing home residents and for the community at large, and providing social and therapeutic recreation activities at our two AIDS day treatment program – HIV services that are no longer eligible for Medicaid reimbursement.

Our largest single outlay in community benefit came in what’s called a “Medicaid shortfall.” This shortfall comes about because Medicaid does not always adequately cover the costs associated with providing long-term care, particularly in skilled nursing facilities, which included Village Nursing Home last year. Nearly $5 million went to cover this shortfall. VillageCare and other providers are left to fill the gap between the expenses associated with quality care and what government pays.

In direct charity care, VillageCare’s Certified Home Health Agency sets aside funding to provide care for those who are uninsured, which totaled almost $838,000 in 2010, and Rivington House added another $163,000 in uncompensated care to provide services to individuals regardless of their ability to pay.

Those are just some of the larger cost items that are part of VillageCare’s social accountability activities. Virtually every AIDS and senior program we operate contributes to the community benefit effort. In 2010, there were a variety additional initiatives, including:
• An MSM (Men having Sex with Men) support group operated by our Case Management program.
• Rent subsidies were provided for residents of VillageCare at 46 & Ten who were in the state’s Enriched Housing program.
• A peer internship program in our AIDS day treatment program trains HIV-positive individuals to work as outreach workers to encourage unserved individuals to get program services and treatment.
• The VillageCare Health Center uses a sliding scale based on federal poverty guidelines to make its services more accessible to the uninsured.

These undertakings are part of VillageCare’s mission to promote healing, better health and well-being to the fullest extent possible.

If you would like to learn more about our social accountability activities, please go to our website at www.villagecare.org and click on the link to Supporting Our Community 2010.