I cannot tell you over the course of a 40+ year career in human services how often I have met with elected officials stating “You are doing God’s work.” This is typically a precursor to a conversation about limited funding. It always comes down to priorities that do not meet human needs.
Twenty years ago Gov. Donald Carcieri took office promoting what he referred to as “the big audit” which systematically stripped away human services resources. One result was eliminating planning and policy positions in state government which is one reason external consultants flourish in Rhode Island.
Another was the weakening of the non-profit human services sector whereby funding salaries and infrastructure was cut and/or frozen, making the operation of these organizations challenging at best. This is when we began to hear that we needed to think in terms of “less being more” and the importance of being efficient. Managed Care took root, particularly as a means of shifting government responsibilities to private companies paying very close attention to their bottom line.