In thinking about work...

I've been thinking a lot about what's been bothering me about my job these days. It's strange that I am since I've been on vacation since June 10th. I've only been going into the office off and on for a half day here or there yet when I have to go in I start feeling this incredible stress even before I get there. I was thinking about what that was and why that was happening since I have always loved my job.

It occurrs to me that my job has changed in a way that I couldn't quite put my finger on before. The agency I work for is still the same small not for profit with the big heart it has always been. I've always truly loved that at the heart of the agency's mission statement is simply that we will do whatever we can to help people. But last year, we were contracted by a larger company to coordinate services under a new funding stream provided by the state of Wisconsin. The idea behind it was to eliminated long waiting lists of disabled people who were in need of services. In retrospect, it has, in a way, done what it has promised but the longer I work with it I realize that we on the front lines are being taught how to deny needed services. Just not in so many words...

Let me explain...

Recently, a mother of a young disabled woman signed up for our assistance. She wanted three things. One, a day service program for her daughter - someplace she felt comfortable leaving her daughter for the day and a place that would stimulate and challenge her daughter. Two, she needed transportation to get her daughter there 5 days per week. Three, she wanted to have her daughter take part in an evening program at the local Y two times per month which would be a respite service giving her a couple of Friday evenings away to take a break. The first two services we were able to provide after jumping through many beauracratic hoops and arguing with the administration. The last request has become tricky. Legally, we cannot limit respite services here. We have been told, however, that we should offer some other respite service (like a stay in a residential facility) which we know she will not want. This gives us the ability to say that we offered some respite, albeit not the requested respite service, and then we can legally deny payment of that service. And, since we did offer it, the mother has no recourse to appeal this decision.

Personally, I find this sickening. Effectively, what the state has done has turned services for the disabled into a large managed care conglomerate and we all know how wonderful those can be. And this is the crux of my problem...I don't feel like I'm helping anyone anymore these days. At least not at this job.

So after 15 years doing this job with this agency, I'm left with the question of where to go from here. I don't feel prepared to walk away and I don't feel motivated to stay. I have to go into the office for a half day tomorrow and I'm already feeling the stress.