Will Negligence become the new standard of care?


This chart illustrates the comparison of the cost of care for similar clients who have high support care needs of 24 hours/day.  By continuing to be misled by many who claim that they can better serve these residents in the community and at a lower cost, they have no data to support that claim.  The reason is because it is impossible.

To move these clients (who do not want to be moved anyhow) to a different environment assuming that thier care cost would go down is a form of abuse and neglect.  Is this a choice which you would choose for your loved one?  I would hope not.  It’s certainly not a choice that I will choose.

What is happening though is that we are not given the choice – this “choice” is being made for us and our loved ones by those who do not have a clue about how demanding it is to care for some of these residents.  They base their information on caring for those with much lower support care needs.

When taking a look at the chart below, you can see the average support care needs which each agency reports.  Why are the advocates who care for residents with much lower support care needs able to manipulate our legislators and citizens into believing that they also know what is best for and how best to care for our residents with the higher support care needs?  This is ludicrous.



It is time that the advocates who say they are advocating for those with developmental and intellectual disabilities not only listen to people who care for those with high support needs but also re-read the US DD Act and the 1999 US Supreme Court Decision of Olmstead to understand that by continuing on the path of advocacy which they are on does not only cause more crisis and loss of services, it does not uphold the decision of Olmstead or the US DD Act.

It’s time that the family members, community members and caregivers of those with the highest support needs are allowed to be included in Stakeholder discussions and decisions.  What happened to “nothing about us without us” – does it not apply to these folks?


2011 cost of care charts  Please read this report for data, citations and more information

Stop The Harm – Look at the accurate data

Stop the Harm

Support A Continuum of Care

Family Homes – Respite – Crisis Care – Fircrest – Rainier –

– Supported Living –

Lakeland Village – Intensive Tenant Support – Medicaid Personal Care –

– Family Support – Home Ownership –

It is time to stop and think about what has previously been believed.  Many hear that people with intellectual disabilities with the highest support needs can be served in the “community” at a lesser cost than they are cared for in the Intermediate Care Facility or People with Intellectual disabilities (ICF/ID) and that by closing and consolidating the ICFs/ID there will be a windfall of savings which can then be used for more services.

This is a totally false assumption that is not  based accurate data.  The chart that I have attached is based on reported data from various sources which all point to the issue that the higher the support needs of a person, the higher their cost of care.

The  data taken from the Division of Developmental Disabilities, the Department of Social and Health Services, Internal Revenue Services, Certified Cost Reports submitted by individual agencies reporting the support needs index (average hour per resident day), the Support Intensity Scale Assessment, the CARE assessment all agree with the fact that a person with higher support needs has a higher cost and for those particular residents their cost of care is actually more  cost effective in the ICF/ID than in another environment.

What is particularly troubling is the continued inaccurate reports that are used to support false claims.  One of the major reports which came out last year was “Assessment Findings for Persons with Developmental Disabilities Served in Residential Habilitation Centers and Community Settings.” http://www.dshs.wa.gov/pdf/ms/rda/research/5/36.pdf.

The author, Barbara Lucenko,  states the residents in the  “RHC and community residential” have  the same support needs.  This was written in the “Key Points” of this report yet that conclusion was not supported by the data in the actual report. The actual report had three categories of residents:  Residential Habilitation Centers (RHC), Community Residential and Other Community.  There were significant support needs differences reported between RHC and community residential yet Ms. Lucenko chose to combine those two categories in her summary

“Support needs are higher in most general life tasks, such as daily and community living activities, for DDD clients served in RHCs and community residential settings than for those supported in other community-based settings.”

This statement is inaccurate and misleading to readers of the report.  One can also see from this data collected by the agencies themselves, the support needs of the ICF/ID resident and the residents in community settings are very different.  I have attempted to contact the author of this report several times to question this inaccuracy, she has never responded.

Cost of care as reported by each agency and DSHS payments to each agency based upon support needs of residents

Cost of Care by Reported Support Needs of Residents


Yes, in answer to those who accuse me of many horrible things  – I am biased – biased towards safe, quatlity and cost effective care for our citizens with Intellectual Disabilties.  What I find funny in an ironic way is that some of these people accuse me of the exact opposite of what I am doing.  I often wonder where they are getting their information or where they learned their math and logic because they just don’t make sense.

I do not think that people or systems are prepared to care for people with the highest support needs.

I feel like a broken record in trying to communicate and break down walls of those who have been led down the wrong path by brainwashing.  If people would stop, listen and think, I believe that we could come up with a system that really does support a continuum of care – a system which best serves each individual with their assessed support needs in a safe, quality and cost effective manner.  I’m afraid to say though that until the propaganda is questioned enough and people begin to hear other opinions and issues, it may be long haul for us.

I only hope that no more innocent people will lose their lives while we are trying to figure it out.

Cost of Care by Support Needs, nursing and some medical care included

DD EMIS Data for Home and Community Based Service Waivers




Apples to Apples

I’ve finally gathered enough information to get a close Apples to Apples Cost comparison of RHC to Supported Living.  Even with this comparison the Supporting Living Cost of care is under reported.    On this chart it is clear the scales of economy are in affect.  Compare the cost at Rainier with 372 residents to the cost of care at Fircrest with 198 Residents.

Apples to Apples