VALUE OF CLOSING IDAHO STATE SCHOOL AND HOSPITAL

The Value of Closing Idaho State School and Hospital



The Value of Closing Idaho State School and Hospital

Introduction

Community providers in the State of Idaho are ready, willing and able to serve the neediest and most vulnerable of those individuals currently institutionalized at the Idaho State School and Hospital.

More than 3.6 million non-institutionalized Americans are diagnosed with either mental retardation or some form of developmental disability. Most of these people (90%) live in community settings and there is no measurable difference between the demographics of those living in institutions and those living in the community. The high number of non-institutionalized people with developmental disabilities highlights the need to develop a service delivery system independent of public institutions.

Trends in De-institutionalization and Institution Closure

Since the mid-1970s, there has been a national trend toward de-institutionalization. Eight state institutions specifically utilized for housing persons diagnosed with ID/DD closed between 1960 and 1976; an additional 174 state institutions or special units of 16 or more persons with these disabilities closed between 1960 and 2004.

State Trends

Between 1977 and 1996, all states reduced the number of people living in public institutions. Since 1996, the District of Columbia, Alaska, Hawaii, Maine, New Hampshire, New Mexico, Rhode Island, Vermont, and West Virginia have closed all of their public institutions. Thirty-eight additional states have closed at least one institution.

Current Issues and Costs

The national average cost of institutional care is more than six times the average cost of community-based care. Idaho varies from the national norm in that community based services for the most intense individuals is approximately 62% of the cost of institutional care for these individuals. The community based current cost of supporting an average individual with developmental disabilities is approximately 28% of the cost of institutional care. At the most intense end of the service continuum, the cost of supporting an individual at the Idaho State School and Hospital averages $800.00 per day (per data from the Idaho State School and Hospital), while the cost for the same intensive care in the community would be $496.00 per day (based on current and/or proposed reimbursement rates for community providers). Services for people with less intense support needs would cost the state even less when compared with the daily institutional rate.

How Can All People Be Supported in the Community?

There is also the often an argument that there are people at Idaho State School and Hospital that cannot be served in the community because of their significant needs. This simply is an unfounded and baseless argument and not true. (See Addendum 1) The State of Idaho can utilize a number of strategies and proposals to facilitate the elimination of state reliance on the Idaho State School and Hospital. These far less expensive strategies include:

Using existing private and state partnerships within community resource networks and community crisis/emergency response systems to address the reasons for initial institutionalization;

Developing long-term care structures for people with disabilities based on current community residential provider practices that are consumer-driven ...