Medicaid versus state funding of community residences: impact on daily life of people with mental retardation.

The unintended effects on quality of life that flow from decisions regarding funding sources used to support community-based residential programs were documented. Results show that community residence program structures play an important role in determining quality of life after deinstitutionalization. Clients living under program structures flowing from the Medicaid ICF/MR funding source were less active and involved in life than were clients living in programs funded by non-Medicaid state sources. We hypothesized that the reason for this differential outcome was the result of Medicaid funding regulations and their interpretation, which create an institutional-like set of program structures leading to restrictive care patterns.

The impact of deinstitutionalization on activities and skills of severely/profoundly mentally retarded multiply-handicapped adults.

This study evaluated the change in activity patterns and skills of severely/profoundly mentally retarded, multiply-handicapped residents as they moved from large total care institutions to community living. Twenty-seven individuals were evaluated just before leaving the institution, 3 months post-exit, and 9 months post-exit. In comparison to a nondisabled reference group, residents were less active, mobile, social, and independent both in the institution and community. Residents did show, however, significant changes toward the nondisabled pattern of daily living after moving to the community. Clients improved in 4 of 16 skill areas within 3 months after entering the community: expressive communication, eating, serving meals and washing dishes, and meal preparation.