Susannah Frame is doing a great disservice to our community. Her total lack of appreciation for the diversity of our population of citizens with intellectual and developmental disabilities is more than problematic. Without an understanding of this diversity one cannot even begin to understand the complexities involved in the care of our community members. Below are some bullet points that need clarification from Ms. Frame:
- mentioned several times about biases in the “scientific studies” but fails to mention what those biases are.
- refers to cost of care being less expensive in a community setting – but she has not explained what “cost of care” is or how it is measured.
- has not shown any indication that the cost of care is higher for those with higher support needs.
- refers to the families who have had their loved ones in the RHCs for 20-30 years and are afraid – unaware that there are many young people who live in these therapeutic communities and many more who were denied this care.
- has not offered any solutions or real alternatives or how those alternatives could be achieved.
- seems unaware of the crisis in our community care system with so little oversight that many fear for their health, safety and lives in these community settings.
- has not addressed the issue of access to care in the community such as medical care and transportation.
- has not spoken with any of the agency service providers in the community about their inability to staff and appropriately care for an influx of people with very high support needs.
- has not addressed what a person’s community is and personal choice in making that decision.
If one is going to talk about de-institutionalization without addressing safe and appropriate supports in the community, this type of advocacy endorses neglect and risk for our most vulnerable citizens. The environment that is the Least Restrictive for that Person is the environment which allows that person to interact with and be part of the community to their fullest potential. As stated in the 1999 US Supreme Court Decision of Olmstead, for some that may be the institution.
The issues above need to be addressed and discussed in any conversation dealing with care of our loved ones. The answer is not arguing “institution vs community” – the answer is to look at the diversity of the population and understand their needed supports and then how to fund and maintain those supports.
“Facts are stubborn things; and whatever may be our wishes, our inclinations, or the dictates of our passions, they cannot alter the state of facts and evidence.” John Adams
Cost of Care
Yes, it is absolutely correct that DSHS costs for care in the RHC is greater than DSHS costs for care in a community setting. Looking only through the eyes of DSHS it would make sense to close the RHCs to save DSHS funds – but looking at the big picture of how things work that is exactly the opposite of what one should do if cost was a factor. .
Cost of care is one issue discussed – but not what “cost of care” means for each setting nor the support needs of the residents in each setting. The graph below is a good example of missing costs – but necessary costs for care. Looking at the cost breakdowns for areas of care, it is clear the RHC provides a much more comprehensive package of care than the community settings. The greatest cost of care in community settings is the personal care cost and for people with higher support needs, that personal care cost is extremely high as evidenced by the data from DDA.
All of these are included in the RHC Cost
Where are they in Community costs?
Developmental Disabilities Administration. (2012). Cost of Community Clients with High Support Needs.
(2011). RHC Cost Details and Federal Reimbursement – CMS.
Community Cost of Care Reports, Public Disclosure Information Revealed. (n.d.). Retrieved from http://www.becausewecare1.com:https://becausewecare1.com/community-cost-of-care-reports-public-disclosure-information-revealed/
Clintsman, D. L. (2011). Assistant Director, Department of Social and Health Services. 30 Community DDD Residents – highest costing to DDD.
Atkinson, M. (2011). DSHS: Developmental Disabilities Services Overview. Office of Program Research and Senate Committee Services, Joint Legislative Task Force. Retrieved fromhttp://www.leg.wa.gov/JointCommittees/DDSSTF/Documents/Oct2011/DevDisabOverview.pdf
Barbara A. Lucenko, P. a. (2011). Assessment Findings for Persons with Developmental Disabilities Served in Residential Habilitation Centers and Community Settings. Department of Social and Health Services. Retrieved fromhttp://www.dshs.wa.gov/pdf/ms/rda/research/5/36.pd
Support Intensity Scale. (n.d.). Retrieved from American Association on Intellectual and Developmental Disabilities:http://www.siswebsite.org/cs/SISOnline
Division of Developmental Disabilities: Intake and Determination of Developmental Disabilities. (n.d.). Retrieved from Washington State Legislature: http://apps.leg.wa.gov/WAC/default.aspx?cite=388-823&full=true
(Data taken from Certified Residential Program Costs of Care Reports for 2010. The agencies from which data was retrieved:
Aacres WA, LLC – Tacoma Aacres WA, LLC Abbott House – Alpha Supported Living – Ambitions of Washington – Region 4 Ambitions of Washington – Region 5- The Arc of King County – The Arc of Spokane – Bethesda Lutheran Communities Camelot – Centerpoint Services – Community Alternatives for People with Autism – Community Homes – Community Integrated Services – Community Living – Bellevue – Community Living – Kent/Auburn – Community Living – Kent Intensive Community Living – Sunnyside – Community Living – Yakima – Destiny House – Educational Programs in Home Living – Friends of Families – Friendship House – Group Action for Peninsula People – Harbor Alternative Living Assoc. – Inglewood Residential Services – Integrated Living Services – Kitsap Residences – Kitsap Tenant Support Services – Life Skills Center – Maksu, Inc – Premier Care Services – Provail – Puget Sound Regional Services – ResCare – Shamrock Living Services – Shared Journeys – SL Start – Grandview – SL Start – Seattle – SL Start – Spokane – Stand Together Total Living Concepts (2010)