Study Finds Private Care Is Less Expensive
by Christine Stuart | Sep 27, 2011 5:28pm
(3) Comments | Commenting has expired
Posted to: Health Care, Housing, Nonprofits, State Capitol
A Program Review and Investigations Committee report found it costs less to care for an individual with developmental disabilities in the community than it does at the Southbury Training School, but the state said it has no plans to immediately close the facility, which hasn’t accepted any new admissions in more than 20 years.
Hugh Dwyer, whose brother has lived at the facility for 38 years, urged the Program Review and Investigations Committee Tuesday not to close Southbury Training School, a place his brother calls home.
After sitting through a more than an hour of testimony about how great the privately run residential facilities are in Connecticut, Dwyer said he has to believe there are “horror stories” going on somewhere in the state.
Dwyer’s sister Martha, who also testified, said her brother’s roommate for 20 years was one of the ones who decided to leave Southbury for a private residential facility. “Twenty seven days later he was dead,“ Dwyer said.
She said it was an accident, but the poorly trained staff person turned his back for a few seconds and that was long enough for him to reach into the fridge, grab a hot dog, choke on it, and die.
“Some people are so severely disabled they need the benefits of a place like Southbury,” Dwyer said.
According to a draft report by the Program Review and Investigations staff it costs an average of $321,983 to care for an individual at Southbury Training School, whereas the average cost per individual with the same level of need in a private facility is about $168,786. The study took a look at all private and public care for more than 15,000 individuals with disabilities receiving care in the state. The department is also facing more stringent requirements from the Centers for Medicare and Medicaid Services agency which is emphasizing that only systems that offer consumer choice will be reimbursed.
Department of Developmental Services Commissioner Terrence Macy said currently the department is operating under a legacy system, which is an “unsustainable paradigm.” He said the department needs to embrace a new paradigm, which includes supporting clients and families in their home and in the community.
“The private sector is a less expensive option,” Macy said. The study confirmed that not only residential care, but day care and other public offerings are more expensive than private care.
Macy said he doesn’t believe the federal government would rush to penalize the state for slowly transitioning to private care.
But he said he was cognizant private providers have been asked to do more with less over the past few years.
He said he wants the transition at Southbury to occur in a thoughtful way and he wants families to be able to have a choice to stay or leave.
Beginning Nov. 1, the 425 Southbury residents will be evaluated to see if they can live successfully in the community. The information will be given to the residents and their guardians so they can make an educated decision about whether they should leave. The evaluations are largely a result of the class action lawsuit over the state’s failure to adequately evaluation residents for community placement.
David Kassel, spokesman for the Southbury Training School Home and School Association said he hasn’t finished reading the Program Review and Investigations draft report on the cost comparison between public and private care, but he believes there’s other places to find savings in the Southbury budget.
He said he doesn’t believe the report takes into consideration the cost of the infrastructure that would need to be built in order to support the 425 residents in the community. He disagreed the private sector currently has the capacity to support the additional residents.
Jamie Lazaroff, a self-advocate coordinator and ARC board member, said he understands the hesitation of parents and guardians at Southbury.
“If I was there for 40 years and felt secure for so long, I may not realize what options there are,” Lazaroff said. “They need to have an open mind.”
Lazaroff said making a connection with staff is important, but he said he’s been through several staff and some you like and some you don’t.
“You find the good ones overtime,” he said.
Thomas Fanning, president and CEO of Ability Beyond Disability, said the argument over whether institutional versus community care is polarizing because all it does is take resources and energy away from the people who need services.
“All we’ve done is take millions away from those with disabilities,” Fanning told the committee. “More studies just delay the decision.”
He said it’s time to stop talking about this and do something about it.
Stephen Becker, president and CEO of HARC, said there seems to be overall agreement that the private sector can handle the clients currently being served by the public sector for less money. He said he agrees with the recommendations made in the study.
“Acknowledging the dual system is a costly one, (as this report’s analysis finds as well) the department has been implementing a policy of not accepting new admissions to any of its homes or facilities as a way to gradually reduce public residential services,” the report’s narrative says. “In fact, as a result of the retirement incentive program the state offered in 2009 and the number of DDS employees who retired, the state was able to convert 17 DDS-supported homes to private providers.”
Lawmakers didn’t make any decisions at the meeting Tuesday, but Macy made it clear his department is headed toward getting out of delivering direct services to individuals and handing over more of that responsibility to private providers.
The next phase of the study will explore factors that influence cost of client care and explore whether there are reasons for client well-being to maintain some public capacity. The study is expected to be done before the end of 2011.
Tags: developmental disabilities, Southbury Training, Terrence Macy, Program Review and Investigations
(3) Comments
posted by: Mansfield1 | September 28, 2011 10:52am
As a parent of an adult with a serious developmental disability (Down’s) I support the effort to move to community settings. But I disagree witht he commissioner that we should “be handing over the responsibility to private providers” without including parents in the overall process. It would be far too easy to make the handoff to the privates and cut the parent or guardian out of the process. We also need to remember that there’s money to be made in government contracts. The disastrous for profit health care system in America should give everybody pause. Health insurers cream off one dollar of every three they receive in “adminstration.” My guess is a significant amount of that is profit and payouts to top executives.
Life for the disabled is difficult. Don’t make it harder by selling them to investors who have no interest in a) providing decent services to the disabled and b) intend to rake off lots in profit while paying the employees who actually take of people like my son Wal-Mart wages. The quality of care will be terrible.
posted by: sonofduffydyer | September 28, 2011 1:18pm
Another indisputable report that shows both from a quality and cost perspective, the GOVERNMENT is ridiculously expensive in comparison to private, non-governmental employers. SO WHAT! This is the 3rd or 4th study published in the last few years that reaches this conclusion but the GOVERNMENT continues to do essentially ignore the findings and the taxpayers are continually forced to cough up more and more to pay for GOVERNMENT employees to do what can be done better and less expensive by private employers. It is particularly amusing how the current administration trots out someone to acknowledge these facts, somehow comment something to the effect of ‘wouldn’t it be great to privatize this’, THEN NEVER ACT ON IT. Since the Gov just gave the state employees a guarantee of no layoffs for several years to come, this report will all be for nothing. The Gov had the opportunity to begin to set things right and he wimped out. He continues to put his special interest (read: Feeding the GOVERNMENT UNIONS) first and the interest of the tax payers, if you will, the ‘employers of the state employees’, last! Why bother spending tax payer dollars on these studies Gov?
posted by: GoatBoyPHD | September 28, 2011 2:54pm
What does fact-based hiring have to do with government goods and services?
We taxpayers exist to support SEBAC and public sector political appointees. They exist to incarcerate and institutionalize as many of us as possible and to protest any changes that would affect employment under the guise of lower quality services and increased public safety risks.
Did SEBAC ever mention that government service would improve under the new contract? Not really. Some mutterings about saving the state frem deep cuts in social services was a near as I could make out as SEBACs renewed commtiment to go with the ‘business as usual’ model.
Has Malloy outsourced DOIT yet? That was Rowland’s solution to one of the least effective state IT departments in the nation. Scuttled by state workers of course.
http://tinyurl.com/3xrm5jj