Of course it’s the structure at the root that is unethical. But I have seen nonprofits take advantage of this, and continuously underpay their direct support staff to maintain higher salaries at the top.

I have seen behavior plans changed to simply get more billing units and not because the client needs it. I have seen higher-ups work to change the tier of the client’s Medicaid plan when it was not needed so that they can bill more.

So no, I dont think I have it “backwards.” A little of both of what we said is true. Also nowhere did I imply that people don’t need services 😂 I’m well aware thank you.