BURLINGTON – Howard Center, the agency serving people with mental health diagnoses and developmental disabilities in Chittenden County, will cease to offer representative payee services as of July 1, leaving clients in a financial pinch.
A representative payee is a person or organization that receives payments from the Social Security Administration, such as Supplemental Security Income, on behalf of a beneficiary who may have a disability that prevents them from managing their own finances. By its own count, Howard Center plays this role for nearly 400 clients, free of charge, and has done so “for a very long time.”
In February, Howard Center sent a letter to these clients, informing them that they would need to find a new representative payee or else begin to pay $48 per month to another SSAapproved nonprofit which would enroll them automatically in its own representative payee program at Howard Center’s instruction.
Howard Center called BalancedCare’s price a “discounted rate,” relative to the maximum fee ($52) allowed by the SSA. The agency plans to cover the cost for the first three months following the transfer, which will give clients a chance “to review and reset their budgets to accommodate this additional expense,” according to Cathie Buscaglia, Howard Center’s Director of Innovation & Special Projects.
In Vermont, individual SSI beneficiaries receive monthly payments ranging from $72 to $1,378. “The Social Security Administration did give recipients an increase this year. And none of us like to spend our increases on new fees, but at least there is that,” Buscaglia said. “Howard Center recognizes that it’s a significant change for people to receive a service at no cost and then have a cost tied to it.”
Howard Center’s letter contained a reference to a “shift toward conflict-free case management,” an idea promoted by the Centers for Medicare & Medicaid Services.
But Buscaglia characterized conflict-free case management as a broader “philosophy” that Howard Center had begun to embrace, irrespective of any approaching regulations.
Buscaglia described how the issue of financial control can become a “distraction” in the relationship between a client and a case manager, “who’s supposed to be helping a person on their path to whatever their goals are.”
“Sometimes, people want access to their money for different things, and they see their case manager as an obstacle to them getting their money,” she explained. “It can create conflict,” she observed.
Buscaglia also brought up the lack of reimbursement for the service from the state, as well as the labor shortage at Howard Center. “It takes significant time for case managers to do this rep payee service in addition to all of the other things they’re doing for a person,” she said.
Disability Rights Vermont Executive Director Lindsey Owen lamented Howard Center’s plan.
“It seems like this decision to stop the representative payee service is missing the mark and not resolving any conflict of interest,” she said. “Eliminating a service doesn’t necessarily eliminate any of the conflict of doing both case management and direct services. It’s just taking away one of the direct services.”
“Not having a rep payee, or having to pay for it, is a really difficult position to put someone in who has very, very limited means,” she added.
According to Vermont Care Partners, the umbrella organization representing Vermont’s community mental health centers, two others already don’t offer representative payee services and more agencies within its network could soon join Howard Center in dropping the service. VCP Mental Health Services Director Dillon Burns Burns cited “ethical concerns around being in that role” but also stressed a lack of resources.