Why does L’Arche NC rely on donations to sustain each home?
People are often surprised to learn that Medicaid and Core Member fees do not cover the true cost of operating a L’Arche home. While these funds pay for a portion of the care we provide, it falls well short of what it actually costs to create a home where people with and without intellectual and developmental disabilities share life together.
Below are some of the questions we hear most often.
At L’Arche, we believe people deserve more than supervision. They deserve community.
Our home is staffed every day from 8:00 a.m. until 9:30 p.m., with assistants sharing meals, supporting daily routines, participating in community activities, building friendships, and helping make a house a home environment we all want and deserve to have. Overnight, live-in assistants remain on-site and on-call for emergencies.
Many nearby residential homes owned and operated by other organizations provide much less daytime support. For these other homes, staff are generally not present from 9:00 a.m. to 3:00 p.m., leaving adults with intellectual and developmental disabilities to navigate transportation, employment, community activities, and other parts of daily life independently or with significant help from family members. One parent whose adult child lives in a home operated by another organization shared, “They just sit at home watching TV all because they don’t have staff to help them get out in the community.”
L’Arche intentionally chooses a different model. We invest in relationships, shared life, and consistent presence because belonging isn’t created by simply providing a place to live. It is built through everyday moments of friendship, encouragement, and community. While this model is more expensive to operate, we believe it reflects the kind of life every person deserves. We hope L’Arche serves as an example of what is possible when communities invest not only in meeting basic needs, but in creating places where people are truly known, valued, and able to flourish.
Yes, but it doesn’t pay the full cost of providing a quality standard of care we believe to be dignifying.
For a fully occupied L’Arche home (four Core Members), North Carolina Medicaid provides approximately $25,000 per month toward care. However, the monthly cost of staffing one L’Arche home is approximately $33,000, leaving a funding gap of over $8,000 every month (almost $100,000 annually) before considering the many other operating costs of the home.
There are several reasons:
The state of North Carolina significantly underfunds IDD residential care. North Carolina ranks among the bottom ten states in the nation for funding residential care for people with intellectual and developmental disabilities. For comparison, another L’Arche community in a neighboring state receives approximately $412 per person, per day, while L’Arche North Carolina receives about $215 for providing comparable care. Over an average of 351 days of in-home support each year, that amounts to a Medicaid funding difference of approximately $69,147 per person annually. In North Carolina, we must fundraise that difference to provide the same level of care.
We do not receive care funding every day of the year for each Core Member. Medicaid only reimburses us for days a resident is physically present. If a Core Member is on vacation, hospitalized, or temporarily away, the home continues operating, but funding stops for those days. As noted above, we average a Core Member is present in the home 351 days of the year.
The cost of staffing doesn’t decrease when a room is empty. Staffing costs remain essentially the same regardless of whether the home has three or four Core Members. The assistants, Residential Care Manager, nurse, and clinical supports required to safely operate the home are needed at full capacity. When a room is vacant, it is often intentional as we take the time to find the right person for the household. Rather than filling the next available bed, we carefully consider compatibility and community dynamics so that the home remains a place of stability, mutual relationships, and belonging. This has been one of the natural challenges of establishing a new community, and we expect it to become less common as our homes mature and relationships become more established.
At L’Arche, we believe people deserve more than supervision. They deserve community.
Our home is staffed every day from 8:00 a.m. until 9:30 p.m., with assistants sharing meals, supporting daily routines, participating in community activities, building friendships, and helping make a house a home environment we all want and deserve to have. Overnight, live-in assistants remain on-site and on-call for emergencies.
Many nearby residential homes owned and operated by other organizations provide much less daytime support. For these other homes, staff are generally not present from 9:00 a.m. to 3:00 p.m., leaving adults with intellectual and developmental disabilities to navigate transportation, employment, community activities, and other parts of daily life independently or with significant help from family members. One parent whose adult child lives in a home operated by another organization shared, “They just sit at home watching TV all because they don’t have staff to help them get out in the community.”
L’Arche intentionally chooses a different model. We invest in relationships, shared life, and consistent presence because belonging isn’t created by simply providing a place to live. It is built through everyday moments of friendship, encouragement, and community. While this model is more expensive to operate, we believe it reflects the kind of life every person deserves. We hope L’Arche serves as an example of what is possible when communities invest not only in meeting basic needs, but in creating places where people are truly known, valued, and able to flourish.
- Relationship-centered staffing that extends beyond minimum requirements
- Competitive wages that help us recruit and retain qualified, compassionate assistants
- Residential leadership, nursing, and clinical support
- Training and staff development
- The ongoing costs of operating and maintaining a safe, welcoming home, including property taxes, property and professional liability insurance, health insurance for employees, commercial auto insurance for L’Arche vehicles, home maintenance, repairs, accessibility improvements, technology, and other essential operating expenses.
Without philanthropy, these essential parts of the L’Arche model would not be possible.
No.
Even when room and board payments are combined with Medicaid funding, they do not cover the full cost of operating a L’Arche home. Last fiscal year, philanthropy covered approximately 60% of total operating expenses, making donations essential to sustaining our community. We are grateful to have earned revenue through Medicaid and Core Member fees, giving L’Arche a more diversified funding model than many nonprofits. Even so, these revenue sources are not sufficient to support the relationship-centered community that defines L’Arche.
Friendship is at the heart of L’Arche, but friendship alone cannot meet all of the lifelong needs of adults with intellectual and developmental disabilities.
Our volunteers, neighbors, students, churches, and friends enrich our community in countless ways. They share meals, celebrate birthdays, participate in activities, and build genuine relationships. But many of our Core Members also need consistent support with medication administration, personal care, healthcare coordination, transportation, employment, and other activities of daily living. Those responsibilities require trained Direct Support Professionals working alongside a Residential Care Manager, nurse, and clinical professionals.
This model creates something that is sustainable for the long term. Rather than depending on aging parents to coordinate appointments, manage medications, provide transportation, or fill gaps in care, families know their loved one has a stable community that can support them throughout adulthood. Our hope is that Core Members can age in place, surrounded by people who know and love them, while parents and family members have the freedom to enjoy retirement, travel, and simply be family.
At L’Arche, we don’t choose between professional support and friendship. We believe people deserve both. Our Direct Support Professionals provide skilled, relationship-centered care that ensures each person’s health, safety, and daily needs are met, while volunteers, students, neighbors, and other friends help create the rich community of belonging that makes L’Arche feel like home.
Every person longs for more than safety. We long to be welcomed, to be needed, and to know that our lives matter to others.
Your generosity makes that possible. It sustains a community where people share everyday life, carry one another through challenges, celebrate each other’s joys, and discover that belonging is something we create together.
