Costs And Outcomes Of Community Services For People With Intellectual Disabilities [Paperback]

Roger J. Stancliffe (Editor), K. Charlie, Ph.D. Lakin (Editor)

Book Description

Publication Date: October 2004 | ISBN-10: 1557667187 | ISBN-13: 978-1557667182 | Edition: 1

With many state agencies under budgetary pressure, solid information on costs and outcomes of services for people with disabilities has never been more important. For the first time, that hard-to-find information is collected in a single volume for policy makers, advocates, providers, and researchers. Blending original research with policy analysis, critical reviews of existing knowledge, and examples of cutting-edge programs and policies, this book shows what works and helps readers make sound decisions about how to allocate resources. Topics discussed include differences in outcomes and costs among various community service models, costs of family care, criteria used to allocate funds for community services, budgeting and funding, public policy considerations, costs and outcomes of consumer-directed services, staffing, and recommendations for future policy and practice. The highly respected international contributors to this volume represent a wide range of fields, including disability services, research, evaluation, policy analysis, and administration. Readers will be better prepared to meet federal mandates for individualized services and improve the quality of life for people with intellectual and developmental disabilities.

Product Details

• Paperback: 346 pages
• Publisher: Paul H Brookes Pub Co; 1 edition (October 2004)
• Language: English
• ISBN-10: 1557667187
• ISBN-13: 978-1557667182
• Product Dimensions: 8.9 x 6 x 0.8 inches
• Shipping Weight: 1.1 pounds (View shipping rates and policies)
• Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
• Amazon Best Sellers Rank: #1,142,687 in Books (See Top 100 in Books)

Customer Reviews

Most Helpful Customer Reviews

5.0 out of 5 stars Self-determination in Service Delivery, January 27, 2011

By 

William Cooke (New York, NY) - See all my reviews
(REAL NAME)   

Amazon Verified Purchase

This review is from: Costs And Outcomes Of Community Services For People With Intellectual Disabilities (Paperback)

Honestly, I used to think that the government had everything figured out. After all, we have a president, he has cabinet secretaries overseeing massive bureaucracies; there's Congress and the Supreme Court. The states have governors, legislatures, and lower courts. In all this are administrations, agencies, authorities, bureaus, centers, all providing organization and operational function to the laws, regulations and codes, all enacted to ensure our life, liberty and ability to pursue happiness. ...Ok, naïve. What I am learning is that none of this has been figured out; republican democracy is "figure it out as you go and the strongest argument (or loudest voice) prevails".

When I was a child, I remember watching news reports about the appalling conditions of the state institution at Willowbrook. NYS began to pay attention to those with intellectual and developmental disabilities (ID/DD), their families, and advocates because not doing so would result in a costly legal battle, a public relations nightmare, and lost votes. Frankly, though, no one knew what to do with the tens of thousands of individuals throughout NYS who had some form of ID/DD. Institutions were not only hellholes, but bottomless money pits. In a climate of fear and ignorance, the concept of deinstitutionalizing the ID/DD population and integrating them into communities gradually took hold amidst a climate of fear and ignorance - I know, because in the early 1990s, I was one of the fearful and ignorant who opposed group homes being forced into communities where they were not wanted.

I relate this as a backdrop to "Costs and Outcomes" because this book is about the struggle to bring order from chaos in the world of community services for those with ID/DD. The process of deinstitutionalization and community services came about largely because of two reasons: 1) institutionalization was costly; 2) community services are therapeutic. Today we are moving from community services to a more individualized approach for many of the same reasons.

"Costs and Outcomes" incorporates original research with policy analysis, gives critical reviews of existing knowledge, and provides examples of progressive initiatives and strategies that illustrate how individualized supports and services are evolving in states and in systems around the world. As state agencies continue to function in a miasmic fiscal climate, forces are at work to ensure that there are more people with developmental disabilities being served... by fewer supports and services and by smaller staff earning less compensation. We must not "do more, with less" but "do more, better". As such, "Costs and Outcomes" is a timely book to read.

"Costs and Outcomes" examines various systems and public financing mechanisms, comparing and contrasting structured with individualized supports and services. When the public's money is being spent, who is served? How are needs identified? How are `needs' and `wants' differentiated? Who provides the supports and services? How is everyone given equal access (are they)? What are the policy implications? What are the operational issues? Can those who receive support count on it continuing when the economy tightens? How is accountability ensured? Are we doing the best we can do, or can we do better?

These questions occasionally establish a false dichotomy between the disabled and the taxpayer. After all, the disabled and their families are taxpayers, too. "Entitlements" are "rights" afforded in the American social contract. "Costs and Outcomes" presents the idea of self-determination in all areas of service delivery and offers evidence that an individuals' increased control over her own life (self-directed support) matters, that quality of life improves when she has control over the supports and services she receives, and that in such instances the public cost will actually not increase. As an equal citizen, an individual's self-determination can (and should) go hand-in-hand with maximizing cost efficiencies of public funds.

Individualized supports and services are all about the inherent dignity of, and respect due, the individual with developmental disabilities. When the loudest voice screams, "Contain costs!" a cost-efficient desired outcome can be the stronger argument. "Costs and Outcomes" is an important resource tool to understand the effort, the battles, and the progress that so many are making towards realizing self-directed support as a desired outcome.