Clarification on some of the information that Susannah Frame has reported in her “investigation” is needed. My goal with providing clarification and resources is to encourage a discussion based on facts.
The nature of an intellectual disability means people have cognitive impairments which may mean that other people will need to help them to make decisions, or make decision on their behalf. Their quality of life will depend on the availability of skilled supports. Some people will need more than others and this is why we need to have a full continuum of care to manage the wide variety of needs of this heterogeneous population. Personally, it does not matter to me what community a person chooses but it does matter that the person is given the truth about the options and that they have a choice.
Again, the story is not “community vs institution” but how do we best serve our most vulnerable people. Continuing the either/or argument only hurts everyone. Let’s look at the facts – not just wishful thinking – and work together to improve the quality of life for people all across the board.
- Susanna Frame stated ” In all, 16 states have closed all of their large facilities for the developmentally disabled, including Oregon, Hawaii, Alaska, New Mexico and Oklahoma. These states are serving this entire population in community settings” http://www.king5.com/story/news/local/investigations/2015/11/03/washington-state-developmentally-disabled-residential-habilitation-center/75065984/
- In actuality, they may have closed their “state operated” intermediate care facilities (ICF) but there are private ICFs in almost every state and if the state does not have a private ICF to use for a resident, the state will send that resident to another state for that care.
- Reviewing the reports to the Centers for Medicaid and Medicare – form 64 (CMS -64 – the statement of expenditures for which states are entitled to Federal Reimbursement) there are only 2 states which did not receive reimbursement for ICF costs. (Oregon and Vermont did not have any costs, Arizona is excluded due to their non-reporting on this CMS report)
- If what Susannah Frames states is correct, why are these states receiving Federal funds for something they have closed? That needs to be investigated.
The chart below has data retrieved from the CMS 64 Quarterly report for 2012. As one can see, Washington is not “decades” behind when the data and resources are revealed.
“CMS – 64 Quarterly Expense Report.” 2012. <https://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidBudgetExpendSystem/CMS-64-Quarterly-Expense-Report.html>.
“Community Living and Participation: Embracing the Complexity.” Intellectual and Developmental Disabilities 51.5 (2013): 423-427.
Larson, S.A., Hallas-Muchow, L., Aiken, F., Hewitt, A., Pettingell, S., Anderson, L.L., Moseley, C., Sowers. M., Fay, M.L., Smith, D., & Kardell, Y. In-Home and Residential Long-Term Supports and Services for Persons with Intellectual or Developmental Disabilities: Status and trends through 2012. Minneapolis: Univer: University of Minnesota, Research and Training Center on Community Living. Institute on Community Integration, 2014.
United States Census Bureau – Population Estimates – National Totals 2014. 2014. <https://www.census.gov/popest/data/national/totals/2014/index.html>.