Better is cheaper?

A provincial government-commissioned review suggests Community Living British Columbia might not save money when it begins closing group homes. This past September, the authority launched a six-month project to give developmentally disabled individuals living in those homes the option of moving into what are described as "person-centred and cost-effective" dwellings. And, as part of that process, some group homes could be closed - with the financial savings being tracked by the authority's quality service branch.

But a literature and initial program review, conducted by the University of British Columbia, notes a 1998 comparison between supported living and traditional residential services in Oregon found there was "no statistically significant difference in public support costs between supported living services and group home services." Although a 2000 study in Australia showed "per consumer staff support hours and annual (non-capital) costs on accommodation support services were far greater for group home residents than for semi-independent settings."

In an email, Community Living British Columbia communications director Sally Greenwood wrote the authority wasn't worried about that conflicting evidence. The reason: "the primary objective of the (residential options project) is to enhance quality of life for people with developmental disabilities - to provide choices and options and ensure each individual is in the best suited residential option available. If cost efficiencies are an outcome of this project, then cost savings will be allocated to assist those currently waiting for supports."

For his part, the review's principal investigator - University of British Columbia associate social work professor Tim Stainton - acknowledged existing academic literature doesn't give a definitive answer as to whether group homes are more costly than other residential options.

But, he added, "If you look at B.C.'s own figures, it's pretty clear that family care model homes and independent living homes do tend to cost less than group homes. Again, you can't be universal. But, I think, for B.C.'s own figures that would be born out. Although, at the end of the day, I'm more interested in quality outcomes."

8 Comments

Greenwood's claim that the primary objective of the review is "to provide choices and options and ensure each individual is in the best suited residential option available" is flatly contradicted by CLBC's own internal memo. That memo, cited above, shows CLBC trying to talk vulnerable adults into leaving their homes and putting as many people as possible into potentially risky and unsuitable ad hoc care to save money, pure and simple.

CLBC's Vice President very clearly tied the success of the review to closing group homes and demonstrating savings and she's the one calling the shots on the ground. An earlier leaked document noted CLBC's plans to close up to 100 group homes (with over 3,000 people on waitlists!). The internal memo also prohibits any group home placement (even if space is available!) unless there is no other choice. Most would find that a bizarre way to promote choice and placement in "the most suitable residential option available."

But then we're used to the bizarre. The Minister ordered CLBC to spend almost $2 million on a review that presumes the biggest challenge in community living today is people being held in group homes against their will (only 50 of the first 1,400 individuals have agreed to try something different, and who knows how many of those were informed consent).

This review, CLBC's Service Plan and key performance targets, indeed the entire restructuring model, all rest on assumptions that group homes are costlier and offer less benefits than other options. The answer seemed so simple--close the group homes and you'll save enough to cover the waitlists. Except their own research found no such evidence anywhere in the world. It seems Stainton and fellow architects were so certain of their innovative new CLBC model that they never bothered to do the research that was supposed to justify it until it was all already in place. Stainton now claims these alternative models are cheaper in BC. Why didn't he cite that evidence in his study, then? And if it were true only in BC, might that not set off alarm bells given the reduced oversight and standards that CLBC allows for these alternatives?

Common sense suggests focussing on the desperate plight of 3,000 plus adults and many thousands more children on endless waitlists. Find out how many are waiting to move into group homes because that's the most suitable option for them before counting on closing them all down. Build real safeguards and oversight around these alternative models so more people would consider them (although that would raise costs and defeat the whole point, huh?). Then perhaps try a little honesty as an "innovative" new approach to managing community living.

In an email, Community Living British Columbia communications director Sally Greenwood wrote the authority wasn't worried about that conflicting evidence. The reason: "the primary objective of the (residential options project) is to enhance quality of life for people with developmental disabilities - to provide choices and options and ensure each individual is in the best suited residential option available. If cost efficiencies are an outcome of this project, then cost savings will be allocated to assist those currently waiting for supports."

CLBC is underfunded by million$ and that is the raison d'être of the residential options project - Free up some loot to provide services to the thousands of folks who are currently being denied supports.

CLBC's Sally Greenwood is spinning...

As usual: Dawn Steele states it better than me.

Bizarre is nothng new at MCFD but it has become even more so.

Note that close to a year has passed since the hand-picked (by the Prem) DM emailed her new Headquarters-Provincial Office/Regional Offices Structure to all MCFD employees across the ministry and significant hiring or moving of staff to fill jobs opened by the new structure occurred.

Despite this, a new and very different structure was recently dropped on the team.....out of the blue and without consultation or warning.

Underlying this mess is another mess and it is called "NO Planning".

It is far beyond time that this DM was sent packing and a replacement hired who has direct Leadership and Management experience and who knows what he or she is doing.

These Socred/Liberals just don't give up, do they?

Twenty years ago they went on the de-institutionalisation of homes for the mentally handicapped and, of courses, it was all about offering something better.

But the better wasn't for the little people who got no say. Instead it was better for budgets because small family run operations could be pressured into accepting far less.

Today many of those former patients are free of institutions, that is if you don't call living on the street, eating at soup kitchens and other ad hoc facilities institutions.

They may have changed their name from Socred to Liberal but the magic of smoke and mirrors certainly isn't a lost art on this crowd.

"It is far beyond time that this DM was sent packing" writes no-to-apartheid and it sounds rational enough except we are being 'governed' by a group of corporate thugs.

i think the consequences of the bungled job by DM and his group of bcliberal bedmates at clbc are likely to be more bizarre than even dawn steele can imagine.

if you think we have troubles now, i believe that post DM's demise gordo's solution will be to simply contract the mess out to sodexho or accenture.

oh for the 'good old days'.

Don, that threat has been dangled in front of agencies that don't comply since Day One, when the BC Liberals began this process six years ago. It's what has kept the agencies quiet and compliant in the face of changes that many privately consider appalling.

The message is clearer than ever today: agencies that balk at implementing CLBC policies they see as detrimental to their clients will simply have their contracts pulled and CLBC will find someone else to do it. The new agency contracts spell that out very clearly.

New large for-profit agencies that are prepared to warehouse people for the lowest possible cost and at the lowest possible standards are the default that everyone's afraid of. The only question is whether it's a real threat, or just a ploy to get existing agencies to keep agreeing to lower their own standards of care? It's been remarkably effective at accomplishing the latter.

to quote bob above:" As usual: Dawn Steele states it better than me" and i am grateful for it.

THis posting may be late, but let's be honest and practical. Group Homes are not normal. Six, seven, eight or more adults living together is very abnormal. People should have the right to choose where and with whom they want to live. Would any of us choose to live with a group of adults? Why is it acceptable to congregate persons with develpmental disabilites. Closing down institutions was only the first step. The journey will not be complete until persons with disabilities are accorded the same respect and rights we all take for granted.

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