Direct care providers who help people with disabilities with life skills typically take home little in pay, but that’s not stopping some agencies from charging big bucks for their services.

Even as workers in community-based settings make just $10 to $15 per hour, some New York nonprofits are billing the state as much as $67 per hour for the work. Meanwhile, agencies that provide similar services for the elderly in New York are billing Medicare significantly less, typically around $21 per hour.

The billing trend is reaping millions for agencies and those who run them and may be one reason why Medicaid spending in the state on people with developmental disabilities has increased dramatically over the last three years.

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At one agency which billed almost $30,000 each for hundreds of children it serves, the executive director earns $400,000 annually and there was a $2.6 million surplus last year. Nonetheless, officials there argue that they are offering the state a good deal because such services are cheaper than full-time care in a group home, reports The New York Times. To read more click here.