I have previously discussed personal finance for individual BCBAs. Today, I’m discussing financial management for organizations. Many programs often emphasize in their value statements that they do not focus on money or profit. Instead, they focus on providing the highest quality care possible. When there is a conflict between providing high quality care and costs, the highest quality care should always win. This is a marked contrast from other organizations that serve individuals with disabilities who focus on achieving the largest profits possible. We all know organizations like this are out there, but of course none of them advertise their profit maximization philosophy. If they did, it would almost certainly reduce profits; since parents, schools, staff, and other stakeholders would likely rebel.
There are no organizations that have unlimited financial resources; organizations that never have to make choices about spending do not exist. No matter how big the organization, no matter how much private equity they have, no matter how big their endowment, they must decide how much money to spend on each priority and what they will not spend money on. There are always more possibilities than available resources. These choices show up in things like staff salaries, the quality of the health insurance plan, the type, location, and quality of office space, resources spent on program materials, and so on.
Organizations can say that quality always comes first. They may even believe it and live this value on a day-to-day in their decisions–as they should. But when financial difficulties arise, cuts have to be made. If you are in financial trouble and don’t make changes, eventually the organization will not exist. But cuts often have a major negative impact on quality. I’ve seen this several times over the years, and imagine in this time of COVID-19, many organizations are experiencing this phenomenon.
What’s the lesson? Putting the highest quality care at the top of the list of your organizations priorities is exactly the right approach. Everyone who cares about the lives of individuals with disabilities should seek to work for an organization where this is a deeply held value. But everyone should also realize that money is an absolutely necessary condition of high-quality care. If you can’t afford to pay staff a competitive salary or purchase appropriate program materials, quality is sure to go out the window quickly.
The choice should always be to focus on high quality, not profit. Then realize that if you want to maintain high quality now as well as in the future, you better make absolutely sure you have the financial resources to live that value. High quality programs do not exist without financial resources.