Back from Hiatus

Had to take a hiatus  – but we are now back!

Take a look at this new community – this is one innovative residential option that looks very appealing –

http://www.vinecommunities.com/

I’m looking forward to learning more about this community which is right in my backyard!

Fact or Fiction?

Personally, I do not favor one type of environment over another as long as the person has choice and they and their families understand the issues and the person is safe.  It is for this reason that I fight so hard to help others to understand the real issues and research the data for facts – not fiction or magical thinking  – so people can be aware.

One issue that is extremely disturbing is the groundless “fact” that people believe to be true – that living in the community costs less.   When looking at the whole picture, living in dispersed housing for those with higher support needs costs much, much more than living in a supportive community such as a Residential Habilitation Center (RHC)  or Intermediate Care Facility/Intellectual Disabilities (ICF/ID)

Today I am posting Pie Charts of Costs which were taken from Certified Copies of Cost Reports that various types of agencies submitted to our state (Washington).  We hear that the services in the “Community ICF/IDs” are just the same as those in the RHCs but by looking at these simple graphs one can clearly see this is not the case.

Please take a look – more data will be forthcoming regarding costs, services and cost-shifting.

RHC Cost Breakdown

 

The RHC offers a comprehensive Package to those with high support needs who choose this supportive community setting.

 

Community ICF ID cost Breakdown

 

We are told the “Community” ICF/ID offers the very same services as the RHC – the cost data does not support that statement.

 

Group Home Costs Breakdown

 

Group Homes offer fewer services and are generally for those with less high support needs.

 

Supported Living Cost Breakdown

 

Supported Living Homes offer even fewer services and supports.  

 

 

Scattered, dispersed housing = Community?

A letter from the National Council on Disability (NCD) was published urging the US Housing and Urban Development (HUD) to swiftly comply with the US Supreme Court Decision of Olmstead.  This is great – except the interpretation of Olmstead is incorrect and the NCD assumes that independent choice is the apparent optimal  goal for people with intellectual disabilities (ID).

I cannot disagree more with the Federally funded National Council on Disability, which states they represent and advocate for our loved ones. My response letter is available  here.  (May 21 letter to HUD)  Community is not a place but relationships.  NCD does not consider relationships and what those relationships mean to many in supportive communities.

We need to define choice and what that means to various people.  Those with severe intellectual disabilities with or without co-occurring psychiatric disorders are by the very definition of their condition, not able to make informed choices.  If independent choice is the apparent goal, would an independent choice of someone with severe ID and psychiatric disorder by wise and safe?  I would tend to think not.

When thinking about choice and housing it is critical to understand what type of choice is desirable – independent or supported.  One should not presume that independent choice is always the most desirable outcome.  “A well-supported choice leading to selection of a wise alternative may be preferable to a more independent but ill-informed choice that results in problems.” (R.J. Stancliffe, 2011)

With this distinction about the definition of choice and what may be safe for each individual, we then can examine Olmstead and the arguments of many regarding community housing for those with ID.

The other very concerning issue other than that of “choice” is what about the caregiver.  Does the NCD not understand that many of these people who they so want to make independent choices often need 24 hour live in and AWAKE care?  If all these people choose to have their own house, who will be there to care for them?  Does the NCD not realize that we are already in a crisis trying to find qualified caregivers for those who may live in supported communities or group homes – how will we be able to safely staff isolated and dispersed homes?

Scattered and dispersed housing does not a community make!