Fee Phobia Roots in GCM- Former Salaried Positions

Charging a reasonable fee for human services is wrenching for many people in the helping profession. Geriatric care manager are typical examples. They often under value the expertise and commitment they bring to their profession. GCM’s have years of training in their field, just like lawyers and physicians, but since this is a social service they feel many times that their high level of skill is not as “ billable” as physicians and attorneys. In fact they have an ethical dilemma about billing.  Private geriatric care managers set their hourly fee too low and often non-profit agency geriatric care managers are alarmed at the hourly fee established by the non- profit sponsoring agency.

There are multiple roots to this “fee phobia”. One origin can grow from previous salaried non-profit and government positions. Case managers have been paid a salary and are unaware of the many costs associated with running a business –for profit or non-profit.  The charge for hourly geriatric care management looks large but that hourly fee salary includes all the costs of doing business.

When non profits want to add geriatric care managers they must heavily screen applicants who have other non-profit backgrounds looking at for their willingness to bill, understanding of billing and deeply rooted values that allow them to bill clients for their very valuable services. They also should be understood the actual overhead built into to a billing rate.