The Different Direct Care Service Options for Individuals with Severe Disabilities

There are millions of individuals in the United States that require special needs due to a disability. With such a wide array of special needs, the assistance each person requires varies based on their particular disability. Furthermore, there are certain people with special needs that have severe disabilities. These individuals require the most care and support. In this article, we’ll explain what direct care services mean and the different options for individuals with severe disabilities.
What Are Direct Care Services?
Direct care services are essential services provided for someone who has intellectual or developmental disabilities (IDD). This includes individuals with special needs or those who are severely disabled. Direct care services involve a health professional—like a direct support professional (DSP), caregiver, nurse, health aide, social worker, speech therapist, physical therapist, or occupational therapist—providing care for the individual who needs it.
Direct care services depend on the individual’s needs but can include things like:

• Providing therapy or nursing services
• Administering medications
• Running errands
• Scheduling appointments
• Helping with activities of daily living (ADL)—like toileting, dressing, eating, keeping good hygiene, moving around, and more
• Providing respite for family members
• Housekeeping
• Maintaining medical records
• Monitoring patient activity and behavior
• Developing a behavioral management plan
• These services encompass many different jobs, so which type of professional is performing them differs depending on the service being provided. Now that we’ve explained what direct care services are, let’s look at the different options that are available for individuals with severe disabilities.

The Direct Care Service Options for Individuals with Severe Disabilities
Depending on an individual’s disabilities, the direct care services they receive may be easier at specific locations. However, each option comes with its own pros and cons, including cost. Here are the main direct care service options for those with severe disabilities:

• In-Home Care Services - In-home care services allow individuals with severe disabilities to receive the care they need directly in their homes. This can help make things easier on the family because it requires no transportation and takes place in the comfort of their own living space. It also helps the direct care professional provide services because the individual is more calm and relaxed at home. It’s also easier for family and friends to visit.
  

• What Do In-Home Care Services Cost? - The cost of these services depends on several factors, including the state you live in and the hours of service required each week. Generally, in-home service is one of the most expensive options and can cost thousands of dollars a year. Each year, it’s estimated that U.S. families spend around $36 billion on in-home direct care services, which could end up costing an average family tens of thousands of dollars.
  
  
  
• State Hospitals - Another option for direct care services comes in the form of state hospitals. This choice requires families to receive care at a specific hospital from professionals that are assigned to their case. At state hospitals, there is not much personal choice, but patients still receive the care they need.
  
• What Do State Hospital Services Cost? - State hospitals are generally an option used by low-income families who get their health insurance through Medicaid/CHIP. Each state varies in its access to services and the costs associated with them. However, families that receive healthcare through Medicaid/CHIP generally pay less than families with only private insurance.
  
  
  
• Group Homes and Residential Services - Group homes and residential services are other options for direct care services. These options both can offer a highly structured environment for patients. In some cases, individuals live in a residence or home with trained staff that care for them. In others, they live with family members or in shared living residences and receive care there. Care services for these options are generally intermittent and not a permanent solution.
  
• What Do Group Home and Residential Services Cost? - Since group homes and residential services provide specialized care and housing—often with food and utilities factored in—for an individual, they can be quite expensive. Depending on where you live and the services available, group home facilities can cost anywhere between $60,000-$120,000 a year. 
  

• Day-Training and Habilitation - Another option for direct care services is day-training and habilitation. This option involves trained staff—like a DSP—helping disabled individuals to develop and maintain life skills, learn to do things independently, and more. These programs involve individuals getting dropped off and picked up each day. They also tend to have low staff-to-member ratios so each patient gets the highest quality of care.
  

• What Do Day-Training and Habilitation Care Services Cost? - The cost for day-training and habilitation care services also differs depending on where you live and the programs available. On average, 5 days of care per week can cost anywhere between $10,000-$30,000 a year.
  

One example of a day-training/habilitation option is The New Transitions Center, which is a community-based organization focused on enhancing the lives of young adults with special needs and the loved ones who support them in the Roanoke, Texas area. The Center supports young adults with varying degrees of intellectual, developmental, and physical disabilities, including those who may need assistance with ambulation and personal hygiene. 

We operate on a private pay, nonprofit model that allows us to support low staff-to-member ratios and guarantee the highest quality of daily care. We rely on generous donations to subsidize the significant overhead to ensure this level of care. Consider supporting our critical work by making a donation or exploring our member options today!