March 5, 2015

Are Group Homes Becoming Community- Based Institutions?


In many states there has been a push to down- size or eliminate institutions for the mentality ill and training centers for the developmentally disabled. The changes have come due to the desire to put more emphasis on community-based services and to encourage a more inclusive approach to treatment. Decades ago it was normal to just institutionalize those with disabilities with little to no effort to maintain them in the community.
This has changed dramatically in recent years. Group homes and other community-based residential options are now beginning to become the new trend for the special needs community. These changes have been influenced by both legislation and legal action.

Benefits of a Group Home Placement
Group homes provide residents with an opportunity to live in regular communities and become integrated into society. They provide support 24 hours a day without the confines of a state institution. Group homes provide a better staff to resident ratio which should ultimately lead to a higher quality of care.
Group homes also provide more opportunities to go out into the community and become productive members of society. Residents enjoy opportunities to work and participate in a variety of activities that they would not be less likely to do in an institutional setting.

Concerns with Group Home Placement
The shift to community-based services has resulted in a surge of new group homes. This surge has lead to some service providers that are inexperienced and simply in it for the money. Each resident can provide close to $100,000 of income on an annual basis. In addition, residents also pay rent and board from their SSI benefits.
The growing “business” of group homes has the potential produce homes that fail to provide adequate support. One of the biggest problems with group homes is lack of adequate staffing. When group homes try to cut corners, staffing is usually one of the first cost cutting measures. Limited staff reduces the opportunities to participate in community activities. It also diminishes to overall quality of care.

My concern is that all of these new group homes will become “mini” institutions with inadequate regulation.  Many state licensure agencies are already understaffed. More group homes will produce an even larger pool of providers that need to be regulated by state agencies. After receiving their initial license, they are often not visited again until another one to three years depending on the type of license. There is simply no way that a few state employees can effectively regulate hundreds of private providers. And sadly, there often has to be a complaint or incident in order to expose a bad provider. 


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