IL-ADD Releases Cost Analysis

The Illinois League of Advocates for the Developmentally Disabled (IL-ADD) has challenged the myth that all persons with intellectual and developmental disabilities (I/DD) can be served for less cost in smaller, unlicensed settings.

On October 13, they released a summary and  detailed cost analysis that considered the actual cost of care for an individual in a state Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) as compared to what that same individual would cost in a smaller setting. The analysis considered three care scenarios for BRB in a Home and Community-Based Services waiver setting (called "CILAs" in Illlinois).

BRB is a current resident of a state-operated ICFs/IID. BRB is 41 years old, 6' tall, 190 lbs, and healthy. He has a pervasive developmental disorder with borderline intellectual functioning. He is being treated for obsessive/compulsive behaviors which presently involve consuming huge amounts of fluid; interruptions of is O/C behaviors can bring violent responses. He also has a history of life-threatening PICA, however this has been completely extinguished in his present state-operated ICF/IID setting. He is prone to unpredictable explosive physical aggression toward peers, staff and property. He has been expelled from community-based programs.

While very challenging, BRB is not the most challenging among his peers at his ICF/IID; he cannot be dismissed as a uniquely expensive case. For example, he does not present severe medical conditions, seizure activities, sexual aggression, fire-starting, or (at this time) PICA.

Cost Comparison Findings (Summary)

Some closure advocates claim that people can be served in the community for "on average $55,000" per year. In fact, BRB's care would cost:


VOR Advocacy Manual and Tookit for State Coordinators, Members and Choice Advocates

March 2013 (revised)

First prepared in 2005, our Toolkit has been refined and updated to further assist VOR advocates achieving our shared mission on behalf of people with I/DD by maximizing and harnessing our collective skills and strengths at the state and federal levels.

Even the most seasoned advocates will find something of value within the pages of the toolkit, and every member is invited to share the Toolkit with your members. Using this resource to reach deep into your own memberships to identify leaders and maximize participation is perhaps the greatest potential impact this toolkit can have.

Click here for the VOR Advocacy Manual and Toolkit!



Scrutiny of community mental health centers is scant in fraud-prone states: federal report

Scrutiny of mental health centers is scant in fraud-prone states: report
Modern Healthcare
January 15, 2013

Despite years of warnings, the private contractors that monitor for problems in Medicare community mental health centers still aren't actively looking for problems in some the states most prone to fraud for those services, such as Louisiana and Texas, a new review of 2010 data by the U.S. Department of Health and Human Services’ Office of Inspector General shows.

And when government officials did gather enough evidence to kick a community mental health center out of Medicare, it took an average of 42 weeks to be removed from the list of approved providers. Nine agencies in Florida received payments totaling $2.5 million between when their exclusions were approved and when their bills ceased to be paid, the report says.

HHS auditors have said previously that community health centers may be particularly vulnerable to fraud, even though government contractors tasked to look for problems in the most fraud-prone areas report scant investigative activity in the area.


Safe at home: Feds, states take steps to prevent home-care crime

Safe at home: Feds, states take steps to prevent home-care crime
By Joe Carlson
Modern Health Care Magazine * January 12, 2013

As healthcare companies look toward aggressive growth in the most intimate of settings—patients' own homes—more Americans are asking how much they really know about the new home-care aide who walks through the front door.
They soon might learn more about these providers. Nationwide, many people who deliver home care will fall under a new program in the Patient Protection and Affordable Care Act that will pay for background checks for any nurse, therapist or aide who comes into contact with a long-term-care patient.

CMS officials say the program is voluntary for now, but that it might be prudent for state leaders to plan for a congressional mandate in the near future. The CMS recently made such background checks mandatory for hospice workers and is considering doing so for other providers.


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 e-mail address is being protected from spambots. You need JavaScript enabled to view it .


Oklahoma ICFs/MR: Vision for the Future

of the Northern Oklahoma Resource Center of Enid and the Southern Oklahoma Resource Center
A Safety Net for Oklahoma’s Most Vulnerable

January 2012

By the Southern Oklahoma Resource Center Parent Guardian Association
and the Oklahoma Public Employees Association


The Northern Oklahoma Resource Center of Enid (NORCE) and the Southern Oklahoma Resource Center of Pauls Valley (SORC) have been home to thousands of Oklahoma’s citizens challenged with disabilities since early in the last century. Both facilities are intermediate care facilities for persons with mental retardation (ICFMR) and receive funding from the federal government through the Medicaid program. Currently, the match rate is 64 percent federal and 36 percent state funding.

NORCE was established in 1909 and SORC was converted to an institution for the disabled in 1953. The combined total population of the facilities grew over the years to a total of 2,300 residents, with schools and farming operations. Since the 1960’s, the facilities have downsized  onsiderably, as some clients moved into community settings. The 245 residents who currently call NORCE and SORC home are challenged with severe physical and mental disabilities.

NORCE and SORC serve as a public safety net for the developmentally disabled service delivery system. In addition, the facilities are a critical part of the full continuum of care in developmental disabilities, from individuals in facilities requiring around the clock medical attention to those in community settings that need minimal in-home support.

The following PGA/OPEA Vision for the Future of NORCE and SORC does consider the concerns and recommendations of the parents and guardians first and foremost. The employees of both facilities emphasized above all else that they support the parents and guardians in their choices for their loved ones and are gravely concerned with transitioning vulnerable clients from their lifetime homes.

Read Detailed Proposal

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