Speaking out for People with
 Intellectual and Developmental Disabilities

Toolkit for Families

 

Quality of Care: Abuse and Neglect in Community Settings

 

VOR's "Widespread Abuse, Neglect and Death in Small Settings Serving People with Intellectual Disabilities" document provides a bibliography of investigative media series, state audits and peer-reviewed research in more than half the states that detail systemic concerns with regard to quality of care in community-based settings for persons with developmental disabilities. Tragedies range from physical, emotional, and financial abuse, neglect and even death. Many of these outcomes are associated with a zest to move to a "community for all" vision people with developmental disabilities without adequately considering the ramifications of separating vulnerable people from specialized care and then doing away with a critical safety net (a/k/a deinstitutionalization). The lessons learned from more than 25 states should cause policymakers and lawmakers to take pause and recognize that a range of needs requires a range of service options.

Cost: Facility-based care is cost effective

 
A 2003 peer-reviewed study of existing cost comparison literature on found that community settings for persons with developmental disabilities are not always less expensive than facilities, as some advocates claim. (Walsh, et al., "Cost Comparisons of Community and Institutional Residential Settings: Historical Review of Selected Research, Mental Retardation, Volume 41, Number 2: 103-122, April 2003; See Summary). A 2009 update by lead researcher, Kevin Walsh, confirmed that the 2003 conclusions remain valid in 2009 and beyond.

Olmstead v. L.C.

The Supreme Court Supports Residential Choice!

The Supreme Court, in its landmark Olmstead v. L.C. ruling, recognized the need for a range of services which respond to the varied and unique needs of the entire disability community: “We emphasize that nothing in the ADA or its implementing regulations condones termination of institutional settings for persons unable to handle or benefit from community settings...Nor is there any federal requirement that community-based treatment be imposed on patients who do not desire it.”  119 S. Ct. 2176, 2187 (1999).

 

Cost Comparison Study

A 2003 peer-reviewed study of existing cost comparison literature and related 2009 Update found that community settings for persons with developmental disabilities are not always less expensive than facilities, as some advocates claim. (Walsh, et al., "Cost Comparisons of Community and Institutional Residential Settings: Historical Review of Selected Research, Mental Retardation, Volume 41, Number 2: 103-122, April 2003; See Summary and 2009 Update). Cost savings at the macro level are relatively minor when institutional settings are closed, and if there are any at all, they are likely due to staffing costs when comparing state and private caregivers. For a single copy of the original cost study, or to purchase a quantity of original reprints, contact Tamie Hopp at 877-399-4VOR; or This email address is being protected from spambots. You need JavaScript enabled to view it..