JEFFERSON CITY, Missouri - A controversial idea could put a huge dent in Missouri’s budget deficit.
Supporters say the state’s institutions for the developmentally disabled are costing too much taxpayer money and that cheaper options are available in the community that provide similar care.
However, defenders of the state-run habilitation centers argue closing them would be devastating to hundreds of disabled residents.
Lawmaker’s proposal: closing institutions
The debate about the future of Missouri’s state-run institutions has gathered steam as lawmakers wrestle with a massive budget shortfall.
Sen. Scott Rupp, R-Wentzville, is proposing legislation that calls for the complete shutdown of the state’s six habilitation centers in the next five years. The bill would require the Department of Mental Health to develop a transition plan for the state’s 644 residents into the “most appropriate setting” in the community.
“The populations inside institutions are dwindling and within 10 years, they are going to be closed because no new residents are being admitted,” Rupp said. “We’re trying to plan for that day and have a transition put in place for those families so they have a say in their future.”
Because of the habilitation centers’ fixed costs for utilities, maintenance and employee wages, Rupp says the average cost of daily care will continue to climb as the population declines.
The lawmaker notes that a dozen other states have already eliminated their institutions in favor of community-based care.
How much could taxpayers save?
A Sunshine Records Request to the Department of Mental Health revealed the average cost of care for residents in an institution is $501 per day. The average cost in community care facilities is $308.
Taking those averages and multiplying the savings by 644 residents would result in an annual cost savings of $45 million in state and federal funds.
However, the average cost of community-based care could be higher if institutional residents—typically those with the most severe developmental disabilities—all transition into a community-based setting. That is why Rupp conservatively estimates savings to be $16 million on the low end.
Bob Bax, a spokesman for the Department of Mental Health, said the cost savings to the state are about $75 per day (estimated $17.6 million per year). The rest of the savings would be federal funds.
There are other potential cost savings from employee salaries and facility upgrades.
For instance, a recent audit by the Missouri State Auditor found that over the past three years, the Department of Mental Health had paid about $47.8 million in overtime wages. One institution employee made $98,874 in overtime compared to the $45,030 of his or her base salary.
“Employees working excessive amounts of overtime could compromise the health and safety of both clients and themselves by increasing the risk of medical errors, accidents, injuries and poor performance,” the audit said.
NBC Action News also reviewed the money spent on capital improvement projects since fiscal year 2006. Taxpayers have funded $20.1 million worth of maintenance and upgrade projects.
There is also $21.3 million planned for a construction project of the Bellefontaine Habilitation Center near St. Louis ($9 million of which was transferred from the Missouri Housing Development Commission).
Rupp’s bill has a provision to cease any building or renovation projects to state-owned centers by the end of August.
Thousands of others wait for services
Meanwhile approximately 5,000 individuals with less severe developmental disabilities are on a waiting list for services in the community.
In January, advocates for the developmentally disabled held a rally in Jefferson City. The Arc of Missouri stacked shoes inside the capitol rotunda to provide a visual of the waiting list.
A St. Joseph mother told NBC Action News about her son’s experience on the waiting list. He was living in his own apartment and qualified for five hours of care from a personal assistant in the evening.
Sonja Canchola said her son, Nicholas, has an IQ of 60 and made some poor choices, getting into trouble with the law. He ended up being admitted to the Marshall Habilitation Center, where Canchola said his progress has gone “downhill.” He is currently awaiting placement in some other type of community setting.
“I know in all my heart that if I would’ve had some help, we wouldn’t have been in that situation,” said Canchola. “Closing the institutions is one of the smartest things that anyone has ever thought of.”
Rupp believes cost savings from his bill could be used to tackle the waiting list.
Governor Jay Nixon launched his Partnership for Hope initiative to cut down on the state’s waiting list this year. However, Nixon told NBC Action News he will not support closing the habilitation centers.
“Unfortunately, there are folks who are so disabled, have so many challenges, that keeping them inside a habilitation center is the only way,”