A cost-benefit analysis of community and institutional placements for persons with mental retardation in Oklahoma.

Spreat et al. (2005) compared two places where adults with intellectual disability live in Oklahoma. One group lived in large state institutions. The other group lived in small homes in regular neighborhoods.

The team tracked how much each setting cost and how well people joined community life. They also counted job-training slots in each place.

Community homes cost less money and let people shop, eat out, and use parks more often. That part looked good.

But the same homes offered fewer paid work programs than the big centers. So savings and freedom came with a trade-off.

Irvin et al. (1998) studied the same Oklahoma move earlier. They saw adults gain daily-living skills after leaving nursing homes, while those who stayed got worse. Scott’s later numbers add the price tag to that success story.

Young (2006) followed Australian adults for years. Community houses beat cluster centers on choice and skills, backing Scott’s integration win.

Friedman (2019) throws in a warning. If provider-run group homes copy institutional rules, quality may not rise even when costs fall. The three studies together say: community saves money and boosts freedom, but only when homes are truly small and person-centered.

When you write a treatment plan, push for dispersed community homes, not campus-style clusters. Ask who controls the front door, the menu, and the daily schedule. If the answer is the individual, you keep Scott’s cost benefit and dodge Carli’s quality trap. Pair the placement with a separate vocational referral so the work gap shrinks. Your advocacy can turn Oklahoma’s dollar savings into real life gains.