Why is it needed?

The DCP model, and the DPI’s work are needed for many reasons, including:

  • Poor care and high costs. For most adults with physical disabilities, care from various specialists is pieced together in multiple hospital systems.  As a result, the ER serves as the sole source of care for a range of predictable and avoidable medical complications. Preventable conditions (UTIs, skin breakdown, respiratory infections) have historically accounted for more than 50% of hospitalizations for many adults with severe disabilities.  The classic example of this is the matter of skin flap surgeries, which cost in excess of $50,000 in monetary terms, to say nothing of the human costs of months of dramatically limited mobility, and difficult, time-consuming, and life-altering therapy, which can include having to lie face down for weeks at a time.
  • Lack of disability-competent providers and organizations.   While the field of geriatrics has been a specialty for 30+ years, there has historically been no medical field dedicated to the health and care of persons with disabilities. Persons with disabilities require a system that blends and coordinates medical services and social supports on a dependable, sustainable, ongoing basis.  Clinicians who have the knowledge, comfort level, accessible facilities, and sufficient time to devote to caring for individuals with disabilities are essential, although woefully few in number.
  • Lack of ntegrated financing creates barriers in the delivery of appropriate care, at the appropriate (and needed) time and place.  This is a result of disjointed regulatory systems that result in avoidable costs and ineffective care, with multiple silos of care creating huge gaps. Many individuals need three or more forms of insurance to access needed care and supports. Moreover, historically risk-adjustment systems have been inadequate: they are generally based on a larger, geriatric population, under-representing the unique needs of persons with disabilities. Few individuals and organizations are prepared to maneuver through the complexities and barriers created by the systems that finance and regulate needed care.