People with mental disabilities and mental health diagnoses who are unable to live at home have essentially two options… live in a psychiatric facility… or live in a community setting. As WFPL’s Stephanie Sanders reports, both options have effects on the health of the patient and Kentucky’s bank account.Screams of delight pierce the calm, afternoon air at Seneca Park, where about a dozen adults who’ve been diagnosed with some degree of mental retardation… or mental health problems… or both… are playing with brightly colored parachutes. It’s part of a day program through a Louisville organization called Dreams With Wings.Dreams With Wings is a community living provider – meaning they place adults with developmental problems into houses or apartments in the community, along with others like themselves, and an appropriate amount of staff to support their daily living routines. The program includes residential services as well as the day program, and takes pride in placing people few believed could live on their own… like Mary…"I just get excited because I know I can live on my own again, if I really try. I know I can do it."Jennifer Frommeyer runs Dreams With Wings and has watched people blossom in their new independence, taking responsibility and even jobs after transitioning into community living. In a state-run mental hospital, patients may undergo therapy to practice daily tasks such as laundry or cooking meals. Frommeyer says in their residential program, participants actually fold their own t-shirts and make their own sandwiches, and that helps them to develop as a person.The challenge for Frommeyer and others who run these community living providers is that each client is different, with unique levels of independence and medical needs. Frommeyer says sometimes it takes a lot of work to balance the needs of the patient with the right level of staffing in each home. For example, a paraplegic needs more staff care than a person who can sustain a job and household chores.Joyce Wilson runs the Dreams With Wings day program – and has experience working in a state hospital – she thinks moving a person from a mental facility, which could house hundreds of patients, into a group home has benefits."With the right supports, every individual can be out in the community, and should be out in the community.""I’m not going to disagree with that, but today, that doesn’t exist."That’s Missy McKiernan. She works at the Hazelwood Center in Louisville, which is an Intermediate Care Facility for the Mentally Retarded – and is run by the state. Her job is to place Hazelwood clients into community living programs."The level of medical care that some of our individuals need, they don’t meet. They don’t’ have 24-hour nursing care. If you have someone who has seizures that can be life-threatening, you have to have trained medical staff there to make sure that person is safe, or they could die."McKiernan says the utopian goal would be for all residents of these state-run facilities to live in group homes, but that is several years from reality. In Kentucky, about 25-hundred people are waiting for state funding for community living placement.It actually helps the state’s budget to move those who can be moved into community living programs. The state-run facilities cost about 800-dollars a day per patient, while it costs only about 168-dollars a day in the smaller group homes.The federal government is working to move more people from hospitals to group homes. A program called Money Follows the Person wants to help Kentucky – and other states – start moving people into these community settings. Kentucky was awarded a 50-million dollar grant in May 2007 to get started, but a year later that money has yet to be tapped, because state officials continue to slog through federal red tape.Meanwhile, thousands of Kentuckians with disabilities wait for a chance at community living… a chance to live their own lifestyle, instead of practicing that lifestyle in a mental facility.Listen to this story