Cost Effectiveness of the Medical Fragile Developmentally Disabled in Various Care Modalities

Introduction: Agnews Developmental Center, CA which held approximately 1,000 developmentally disabled consumes is in the final stages of closure and are being relocated to a variety of care facilities. A unique modality of care has been to accept 4 to 5 consumers to community homes with a non-profit organization owning the home (SB 962). If a problem arises with the providers, the consumers remain. In addition, after the home's mortgage is retired, costs associated with care are substantially decreased.

Methods: This study measures the cost effectiveness of SB 962 homes compared to care modalities serving comparable consumers (Congregate Living Health facilities, ICF/DD-CNs, SRH, SNF, and the same consumers prior to their relocation). The effectiveness metric is Special Incidence Reports (SIRs) since SIR information is required by Regulation for all models of care. Residential Support and Home Costs are assessed with the SB 962 homes valued as an asset rather than an ongoing stream of expenses. External costs were calculated by a comparison of housing values, crime, and emergency services for neighborhoods with SB 962 homes compared to those without.

Results: An SB 962 home is substantially more cost effective than comparable models of care. SB 962 homes did not lower surrounding home values, and crime and emergency services did not increase.

Conclusion: The placing of medically fragile developmentally disabled consumers into homes owned by a non-profit separate from the care providers results in a substantial cost savings over the life of the facility compared to similar modalities of care.