It costs $388 a day to care for each disabled adult client at South Dakota's only state-owned adjustment training center, the Redfield Development Center.

It costs just $114 a day at the private, nonprofit Black Hills Workshop in Rapid City.

In fact, all 19 private ATCs in South Dakota cost less than public institutions, Black Hills Workshop vice president Brad Saathoff says. That's part of the argument for increasing state aid to private ATCs. If they close and clients are forced into public institutions, costs will go up.

Still, private training centers in South Dakota rely on the state for about 80 percent of their funding.

The state spends more than $90 million a year on the private facilities, but slightly more than 60 percent of that comes from federal Medicaid.

Tom Scheinost, executive director of the South Dakota Association of Community Based Services, argues that increases in state funding for the centers over the past 11 years have averaged just 1.83 percent.

And because 80 percent of a typical training center budget goes for wages and salaries, the centers are losing good employees.

But Saathoff also adds that costs also are rising for employee health insurance, utilities and fuel. The Black Hills Workshop and other large ATCs operate fleets of vehicles.

To catch up and attract and keep workers, ATC advocates propose a $19.2 million increase in state funding spread over three years. That would break down to $11.7 million of federal funds and $7.5 million more in state funds.

An increase in state funding triggers increases in federal matching funds.

Those increases include 3 percent annual increases for inflation. After three years, the ATCs would revert to regular inflation increases.

Alternately, Scheinost hopes the state will at least provide enough extra money to give the lowest-paid workers bigger raises than the 2.5 percent increase Gov. Mike Rounds has proposed.

ATCs also get money from other sources, including payments from clients themselves or their families, private donations and proceeds from training center businesses where clients work.

Most ATC clients have been disabled since birth, and health insurance doesn't cover long-term care.

Many ATC clients do, however, qualify for food stamps and for Supplemental Security Income from Social Security.

Contact Bill Harlan at 394-8424 or bill.harlan@rapidcityjournal.com