Speaking out for People with
 Intellectual and Developmental Disabilities

Toolkit for Legislators


Only Providing Community-Based Care May Not Save States Money

 
A 1993 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). A 2009 update by lead researcher, Kevin Walsh, confirmed that the 2003 conclusions remain valid in 2009 and beyond.

Olmstead Does Not Support Deinstitutionalization

 

State officials and legislators often hear that Olmstead requires community placements. Such interpretation is not accurate. 

In actuality, the Supreme Court, in its landmark Olmstead v. L.C. ruling, embraced the need for a range of services to 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..

Legislator Toolkit

This site aims to provide State and Federal Legislators, Officials and their staff with the information needed to make informed law and policy decisions on behalf of citizens with mental retardation and developomental disabilities. Resources which relating to lack of quality in some community settings, information about community versus facility costs, Olmstead and more are available through links within this summary, as well as in the articles to follow.
 
Given the diversity of persons within the developmental disability community, VOR strongly supports community expansion AND strongly objects to deinstitutionalization. We do not believe expanding desperately needed quality community options must or should come at the expense of individuals whose profound cognitive disabilities, medical needs, and behavioral challenges are best served in facility based settings (a/kl/a Intermediate Care Facilities for Persons with Mental Retardation; ICFs/MR; "institutions").
 
As the resources here will illustrate, often State's close facilities serving people with profound developmental disabilities believing money will be saved and care will be improved. As the resources here will show, rarely is money saved - the individuals leaving facilities have expensive needs no matter where they reside. If not adequately funded, community placements often fail, with tragic results.
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