As we gathered to celebrate Independence Day 2016, I spent spending some time thinking about the price of independence for people with disabilities. It can be really hard to put a quantifiable number on how much people with disabilities who live independently in the community save society, because you often time find yourself trying to show they are not taking advantage of services and assistance that they may not need, and almost certainly don’t want. However, after a lot of thought, I have decided, rather than determining a cost of independence, I should spend a little time contemplating about the cost of dependence.
The price of “dependence” can be easy to measure. To start with the cost of being dependent on Nursing Home care in the state of North Dakota is very expensive. North Dakota Nursing Homes cost, on average, over $100,000 per year for every person who lives in them. During the past five years, the cost for nursing home care has increased at more than 8% per year. The cost is also very high if you are living in a group home or some other type of institutional setting.
If you are a person with a disability who is unemployed, the cost of dependence can be measured in the cost of economic support programs, SSI or SSDI, SNAP benefits, housing assistance, and perhaps most importantly, the fact that you are not contributing to the tax rolls through employment based taxes.
The noneconomic costs of being “dependent” can also be very high. There is a direct correlation between how expensive a service is and how little control you have over your life. This cost can be measured in lack of self-determination, lack of hope, and overall feeling that your opinions and values are inconsequential to the system in which you live. For this very reason people who are dependent are often more likely to become depressed and have shorter lives than people who live independently.
The cost for dependency is extraordinary high.
The cost for independence is a lot less. Home and Community based services can both save the state money and help people remain independent. According to a study done by the College of Nursing and Health Innovation, Arizona State University, services provided in the home saved on average $1,591.61 per month over the same services provided in a nursing home setting.
Every time a person with a disability becomes gainfully employed; they begin the process of leaving a life of poverty behind. This means more reliance on money they earn and less reliance on assistance. They also become taxpayers, adding money to the public rolls rather than taking money from it.
The ultimate way living independently saves money is when people never become dependent in the first place. Studies have shown that when students with disabilities leave school properly prepared, they are less likely to ever end up in a nursing home or to become chronically unemployed. They are given a real chance of leaving a life of poverty and economic assistance behind.
Now I always make it a point to be very clear that I do think that many people, at some point in their lives may need to move into some sort of a nursing facility or perhaps take advantage of economic assistance programs. Those systems are set up for good reason and are extraordinarily important to the continuum of care in North Dakota.
However, those programs and services should always be programs of last resort, and no person should ever be forced to take advantage of them if better alternatives exist.
At Independence, Inc. we do not work for free, and every day I work very hard to ensure we are good stewards of the dollars entrusted to us to spend. I am proud to say our staff have continually helped more and more people achieve their independent living goals, and in doing so; we have significantly reduced the cost of dependence.
