Analysis of Costs of Services/Supports for People with Developmental Disabilities for Nebraska, South Dakota, and Wyoming, USA.

A database was assembled from data collected on all people served by the Developmental Disabilities divisions of Nebraska, South Dakota, and Wyoming, including state institutions and state-funded programs (n=5,928). Information included provider expenditures associated with each individual, allocations made by individual reimbursement rates, services/supports received, funding sources, and individual characteristics as measured by the Inventory for Client and Agency Planning. Results from the analysis found institutions had the highest costs. Although Home and Community-Based Service recipients experienced lower levels of independence than people funded with state money, their costs were higher. South Dakota's people had the highest independence scores. This was attributed to their relatively high utilization of supervised apartments and supported living. Wyoming's costs and rates were higher than those for the other two states, presumably a result of the "Weston v. Wyoming" lawsuit. Supported employment was less expensive than community facility-based daytime programs but this finding was not consistently found in all states. South Dakota, which had a relatively higher utilization of supported employment, also had significantly higher supported employment costs. Evidence substantiated a diseconomy of scale function, as costs increased steadily with agency size. (Contains 23 references.) (CR)