Community placements Do Not save large amounts of money when fairly compared with institutional placements! That is the result of a recent study commissioned by The Voice of the Retarded. Why?

Most of the former data of the eight nationally recognized studies were flawed because those reports never compared “like“ data. They always compared apples with oranges.

Diagnosis: Persons with more skills and abilities are generally placed in community settings before persons with more complex needs. The stark differences in the populations were not recognized.

Individuals in institutions tend to be older and have more severe disabilities i.e. more challenging behaviors

Persons with similar levels of dependence have different daily expenses related to their level of mental retardation.

Average functioning levels have declined in institutions as more community placements have occurred.

Community costs are many times shifted to federal sources

Staffing requirements are many times less in community placements

As the community population ages and more complex needs are required, so-called less costs are hard to sustain

Labor costs vary widely especially within the private vs. not-for-profit vs. public spectrum.

Some of the studies excluded those not likely to succeed in the community and even based findings on projections rather than actual figures!

Conclusion = While many argue that institutions cost more than community settings, others have experienced minimal differences. Staffing, revenue streams, diagnosis, certification requirements, unionization, employee benefits and other variables dictate costs. In addition, reports of 20 years ago occurred before the HCBS waiver became fully operational.

Now that time has elapsed, we see some of the flaws of community placements. Monitoring is more difficult because of the dispersed locations. There is a lack of regulation and licensure and certification standards. Low provider rates encourage minimal quality staff and training. .There is a higher rate of verbal abuse and crime. So, it is now more than choice and community involvement. It is also health and safety! The question was “which costs more?” Now the question is," What are the needs of the person?”

This detailed study exposes the myth. Idealogues should disappear. Appropriate placement should be the driving force.