It is absolutely necessary that we provide funding to support our direct care providers in the community settings. We have been in a crisis situation and it is only getting worse. It is time to step up and provide the support that we all say is needed but do not provide the funding to back the words up.
Please read the position paper Underfunding of Community Residential Services by the Community Residential Services Association. While I do not have all the cost reports of the community service providers nor the cost reports of the state funded services to compare the cost of care, I do know that the cost of direct care for those with high support needs is about equal across the board.
It is the costs of all the other services that add up and can make one type of residential setting appear more costly than another. It also depends on what is included in the cost reports. I believe there is cost shifting and capital costs which may not be reflected but, again, I do not know for sure since the data is extremely difficult to sift through. It is something to take into consideration.
Regardless of the cost issue there are other major concerns that need to be factored in. Personal Choice of residential setting, access to quality health care, continued learning opportunities, employment and meaningful life activities all need to be included in the big equation.
There is not one type of residential setting that guarantees that all these aspects of life will be met or even considered but I do believe that living close to family, friends and natural supports does increase the chance that the person will have a meaningful life that is fully integrated into community.