We often hear varying opinions about what the cost of care for people with intellectual disabilities really is. This should not be so difficult to figure out given that there are resources upon resources to use. For some reason though, several of the resources which could give us the best information are not used. This makes no sense to me unless the goal is to keep the public and legislators confused and to keep pretending that there is no real way to make a comparison of cost for community and institutional care.
In the most recent airing of “Last of the Institutions” by investigative reporter Susannah Frame of King 5 News, she did refer to the cost of care for one young man with high support needs. He lives in a home supported by Alpha Supported Living. Ms. Frame also interviewed Scott Livengood, CEO of Alpha Supported Living and referenced the “average” cost of care for those in dispersed community housing. This young man’s daily care cost is $370.00 – far higher than the “average” cost reported to legislators and the public.
Using this “average” cost is a tactic that is used to hide the truth of the issue. Those in DDA and the agencies know full well what the cost of care of each individual in a community setting is. Each agency has negotiated with DDA the exact number of hours and supports that each of their clients will need. It is no mystery. Pretending that those with high support needs can be cared for at the “average” cost is nothing but a lie.
For instance, a couple of years ago I was given the daily rates for the cost of care of the 30 residents with the highest support needs and cost. The daily range was $497 to $969 with an average direct care cost of $598. If there was an “average” to use for the cost of care for residents in the shared community if they were to move to dispersed housing, this would be the average to use. See this link for the chart with the costs and the support needs assessments of these clients. Highest 30 Residential Clients by Cost and acuity
I spoke with Russ Walker, Executive Producer for King 5 Investigators. I brought up the issue of the dispersed community costs not including medical, dental, nursing care, prescription medications, and food – just to highlight a few cost centers. Mr. Walker assured me that the costs did include these and they knew since Mr. Livengood had showed them the accounting for Alpha Supported Living. It’s interesting to note that the Certified Cost Report for Alpha Supported Living does not include these costs. Certified Cost Report for Alpha Supported Living 2014
When looking at the actual data, the calculations and cost accounts are very different than what is provided to our legislators and public. When I have presented these differences to some legislators, Disability Rights Washington, the Developmental Disabilities Council and The Arc Chapters – the common response is refusal to communicate. They have not been able to prove me wrong even when given the opportunity to do so. I believe this means they are not able to prove me wrong.
Take a look for yourself and decide – what costs are missing from the community support side of the equation? Do the costs add up as equal in your judgement and calculations? Click the link for a table of the daily cost per resident.
I am using Alpha Supported Living as the example since this is the agency that Susannah Frame used in her investigation. Alpha Supported Living is one of the better agencies yet the reimbursement from the state barely covers the cost. Alpha has major fundraising campaigns to raise money to provide quality services to their residents.