Last week’s testimony to a commission that could recommend closure of one or more state hospitals provided a capsule view of the dilemmas Kansas faces in helping care for people with developmental disabilities.

The two facilities being reviewed — Kansas Neurological Institute in Topeka and the Parsons State Hospital and Training Center — currently provide residential care for 358 Kansas residents. However, that care is expensive, and state officials want to know whether that money is well spent.

The Facilities Closure and Realignment Commission appointed by Gov. Kathleen Sebelius is trying to answer that question and make a recommendation to Gov. Mark Parkinson by Dec. 1 about keeping or closing the two hospitals. The testimony commission members heard last week illustrates why it isn’t an easy decision.

Many advocates contend that people with disabilities should be moved out of institutions and cared for in community programs that allow them to experience life more fully. However, other advocates, as well as the families of many current hospital residents, praise the respectful and caring treatment residents receive and worry about their ability to even survive without the support the hospitals provide.

Money, of course, is part of the equation. The state spends $40 million to care for 358 in state hospitals while about 1,000 Kansans are on a waiting list to receive in-home services. If there was a guarantee that closing the hospitals would funnel an additional $40 million into individual and community services for people with disabilities, the idea probably would garner broader support.

The reality, however, is that there is no such guarantee even though community programs already are seriously stretched. Even if current state legislators made such a commitment, there is no reason a future Legislature couldn’t divert that money to other purposes.

It’s a tough call. State hospitals in Kansas have worked hard to establish strong, nurturing programs for people with developmental disabilities. It would be tragic for the state to close those hospitals without being able to ensure that the residents could receive the same or better services through community-based programs.

The reduction in state hospital capacity for people with mental illness provides a cautionary example. Although community programs have done their best to meet the needs of people who would previously have been placed in residential programs, law enforcement officials across the state report a disturbing increase of people who are incarcerated primarily because of their inability to manage their mental illness. That situation not only is a disservice to the individuals involved but potentially costs the state more than it costs to provide residential treatment.

Closing a state hospital may save the state money, but it doesn’t eliminate the need. Before taking such action, the state needs to make sure community programs have the funding and personnel they need to provide a better quality of life to the new clients they will be asked to serve.