Sponsored Residential Services: A Family-Friendly Alternative to Group Home Placement
One of the most difficult times a parent of a special needs child experiences is when their child becomes a young adult and needs transition services. It’s a time of extreme anxiety as they see their child age out of the comfort and security of the school system—and into the new world of adult services. One of the toughest decisions a parent can make is to place their child in a facility outside of the home.
Virginia’s Medicaid Intellectual Disability Waiver provides two forms of residential placement options. These options include group home placement and sponsored residential services. We will explore each of these options and discuss their benefits and limitations. Group homes have been the primary form of community-based residential services. However, sponsored residential services are rapidly becoming an alternative for families who wish to keep their loved ones at home.
When people think of outside residential placements, they usually think of a group home setting. A group home is a residence that serves individuals with intellectual disabilities and is staffed 24 hours a day. These homes are licensed and regulated by the state. Providers are reimbursed through Medicaid funding. Group homes are the primary form of outside residential placement in VA. Staff are usually trained to give medication, CPR, First Aid, and behavioral management. Group home staff provides all of the direct care services and provide all transportation to appointments and community outings. Group homes play a vital role in providing services to individuals in the community who might otherwise be placed in a state institution or more confined facility. Group homes are even more important now that Virginia is moving to downsize institutions and implement more community- based housing options.
However, there are some limitations to group home placements. Any time you live in close quarters with others, there is an increase in the chances of illness. Staffing may also impact the level of community integration. If there are not enough staff on duty, opportunities for community outings will be limited. The group home setting also provides limited one on one attention due to the needs of the other residents. Group homes also tend to have a high turnover rate. This could negatively impact the overall quality and consistency of care. As with just about any service, there are some good group homes and some group homes that do the bare minimum to keep their license. I encourage families to tour as many homes as possible, research, and ask questions before making any final decision on a placement.
Group home placements are not inexpensive but they do cost less than state institutions. Based on current reimbursement rates in Virginia, the average group home placement costs the state around $90,000 a year. This figure is what Medicaid reimburses the provider for staffing the home. This does not account for room and board which can range from $500-$700 per month.
Sponsored Residential Services
Sponsored residential services are an interesting alternative to the group home setting. Sponsored residential services are often compared to adult foster care in that it provides an opportunity for an individual to live with a private family or single caregiver instead of a home with other residents. Caregivers are hired and trained through agencies that are licensed by the state. These caregivers or “sponsors” provide all of the direct care just as the staff in the group home. Sponsors also have the flexibility of providing more one-on-one attention and more opportunities for community integration.
Another unique aspect of sponsored residential services is that parents and family members can also be certified to be sponsors and get paid for caring for their disabled family member. Some are opposed to family members getting paid to be caregivers but I think it’s a great idea. The program was originally established for rural areas of Virginia where there were limited service providers. It was actually less expensive to train family members and caregivers than to put people in facilities. In addition, the money that the family makes balances out because many parents of special needs children (or adults) have a difficult time maintaining a regular job due to the constant doctor appointments, therapy sessions, and meetings centered around services. Family members would have a better knowledge of the individual’s needs than staff in a group home. This option would also be most appropriate for individuals with specialized medical needs that can be best managed by a family member.
The average cost of sponsored residential is around $50,000 per year. Room and board costs are usually cheaper than that of a group home. Another advantage of sponsored residential services is that the income the caregiver makes is TAX-FREE. Caregivers do not have to file taxes for any income earned for providing these services.
I work with several clients and families that use this service and they have nothing but positive feedback. Clients reported that they have more freedom than they did in the group home setting. One family told me that this program has allowed their family to have the ability to go on vacations and enjoy life just like any other family. Families also point out that this program allows their loved one to receive care from people who have a personal connection with them as opposed to someone they don’t know. There is also a high turnover rate in group homes and they could have different care staff each day. High staff turnover diminishes the overall quality of care.
The sponsored residential program does have its limitations. Sponsor homes face the same regulations as group homes. They have to be approved by the fire marshal and the state licensure department. Personal homes may not be approved if they are not up to code.
The sponsor has to be able to complete documentation as if they were staff in a group home. A case manager with the sponsoring agency can assist with this documentation. This can be a difficult transition for families not use to documenting everything they do throughout the course of a day.
The sponsored residential program is not appropriate for everyone. Some family members start the program but later realize it was just too much work. Keep in mind this is a 24-hour-a-day job. Some situations call for a more structured environment due to certain behavioral and medical needs.
Group homes and sponsored residential services provide a vital service for people with intellectual and developmental disabilities. These services allow people with special needs to enjoy the same freedom to live in a normal neighborhood and community just like the rest of society. Unfortunately, institutions are the only option in some situations. However, more people are enjoying life in the community because of these community-based programs.
If you had a loved one with special needs which option would you choose?
© 2013 Martin D Gardner