There are many dogs that come into rescues with other medical needs beside spay/neutering. In the two years that I worked with Eskie rescue they had two stray Eskies that came in pregnant, and two other strays that had heartworms and required three months of treatment. In addition some dogs are so nervous and scared that they need to be retrained (or just trained) so that they can fit into a household again. My area coordinator had a trainer and a vet who worked for reduced rates for her and made themselves available to her whenever needed. And, as stated above some dogs that are rescued never find a forever home and spend their lives in foster care. Plus, many of the people who pick up their new dogs don't come with things like leashes or crates for transport, so the rescue may end up providing these for the safety of the dog. But these are things that most people don't see or think of. She didn't keep a running tab of three weeks at two sessions a week at a personal trainer for this dog, or one two trips to the vet for that dog. She just asked for a flat fee of $250.00 per adoption (that was almost three years ago, it has probably gone up since then). I think that $300.00 or $350.00 for a new family member is a fair price to pay.