IL Blog: The Cost of Institution versus Community

Dennis Borel

August 28, 2014

Opponents of State Supported Living Center (SSLC) closure sometimes claim that money is the only reason legislators are talking about this issue. Money is an important consideration, although not in the way you might think! Let's consider who stands to gain from savings brought about by SSLC closures.


State of Texas Sunset Advisory Commission Seal

Even many legislators were startled at the Sunset Advisory Commission Staff Report that stated

“The State pays about $9,395 more a month to serve a client in a State Supported Living Center (SSLC) than to serve a client with similar needs in an HCS (Home and Community-based Services) group home…”

$9,395 a month is $113,000 more per year per person. That's a lot of public money.

Why so much more expensive? Sunset cites high maintenance costs of the aging facilities and the compliance costs of a federal lawsuit settlement on pervasive abuse, neglect, and exploitation of residents. Those factors are not changing but the State does control a major component of the high costs: the size of the SSLC network. The resident population has declined 74% in the last 40 years, yet the number of institutions has only decreased from 15 to 13. Expenses do continually rise and with far fewer people choosing the institutions, the average cost has nowhere to go but through the roof. The clear path to cost control is, as the Sunset report recommends, to rightsize the network to the dwindling demand.

Meanwhile, the Medicaid community waivers called HCS and CLASS (Community Living Assistance and Support Services), which are available only to individuals who qualify for an SSLC, serve around 28,000 Texans. Plus, over four times as many people are on the HCS and CLASS waiting lists, some for over 13 years. Texas can close surplus SSLCs, still provide institutional care for those who want it and shift savings to more cost-effective community care- if we have the leadership to do it.


About Dennis

As CTD's Executive Directed since 2000, Dennis is frequently called upon for research, policy analysis, and recommendations to the Texas Legislature and state agencies on issues surrounding disabilities. Read his full bio.

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