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EXECUTIVE SUMMARY
LOCAL VISION
Travis County will be a community where people with mental retardation
and other developmental disabilities and their families have a comprehensive
and flexible array of choices that support their ability to live
and participate in the community with all rights and opportunities
afforded to all people (Community Action Network [CAN] Vision).
The Community Action Network's Vision for persons with Mental Retardation/
Developmental Disabilities (MR/DD) outlines the future direction for
our community's service delivery system and focuses on the individual
and their family in regards to choosing services and supports that
are right for them. The vision allows them to participate more inclusively,
independently, and become self-reliant in community activities.
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PURPOSE OF ASSESSMENT
The purpose of this assessment is to report on the status of persons
with MR/DD in Travis County. The findings and recommendations of the
assessment will be used for future planning, policy recommendations,
issue solutions, resource allocations, and education.
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WHAT IS MENTAL RETARDATION/
DEVELOPMENTAL DISABILITIES?
In Texas, mental retardation (MR) is legally defined as a condition
that appears before age 18 in which intelligence is significantly below
average, and personal care and social behaviors do not meet what is
expected for the person's age and culture. It occurs during the developmental
phase of life and is classified as one of the many developmental disabilities.
Developmental disabilities are severe, chronic disabilities - mental
and/or physical, occurring before the age of 22. Examples include:
 mental
retardation
|
cerebral
palsy |
| deafness |
blindness |
| various
birth defects |
autism |
| epilepsy |
mental
illness |
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WHAT CAUSES MR/DD?
There are several hundred causes related to MR/DD. Most causes are
categorized under: genetic conditions, substance abuse, sexually transmitted
diseases, birth conditions, early childhood diseases, trauma, environmental,
and conditions often associated with poverty.
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HOW MANY PEOPLE ARE IMPACTED
WITH MR/DD (DEMOGRAPHICS)?
There are an estimated 22,094 persons in Travis County with mental
retardation. Estimates of other developmental disorders in Travis County
are as follows:
- 1,625 to 3,249 persons with Autism Spectrum Disorder
- 3,532 to 13,000 persons with Cerebral Palsy
- 14,621 adults with Epilepsy
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WHAT ARE SOME OF THE IMPACTS
OF MR/DD? (KEY FINDINGS)
- Mental Retardation/Developmental Disabilities can affect persons
of any age, race, religion, culture, or income. Various impacts of
MR/DD and key findings are as follows:
- People with mental retardation and developmental disabilities
who live in Austin tend to receive less benefit from the changes
in the prosperity of the region.
- Transportation reliability, dependability, affordability, and
inconvenience of long waits were the most mentioned problems from
persons with disabilities in the Travis County area.
- Last year (2000), the state Home Community-Based Services (HCS)
waiting list had grown to over 15,000, a 22 percent increase over
1999.
- Currently it is projected that in the Travis County area there
are approximately 1,000 people with MR/DD waiting for services.
- Long waiting lists result in under reporting (some people unwilling
to sign-up for services); duplication of waiting lists (some people
are on multiple lists); stress on families; and utilization of more
costly services.
- In the 1996-1997 school year, Texas ranked last in the nation
with only 1.5 percent of all children with disabilities included
in regular classrooms.
- Unemployment rates for persons with severe disabilities approach
90 percent.
- In 1995, Texas ranked 45th in the nation in the provision of integrated
employment by state MR/DD agencies with only 7.3 percent of their
clients receiving supported employment services.
- By the year 2008, the projected employment in the area of residential
care, for the state of Texas, is expected to increase by 35 percent.
- Currently MR/DD professional staffs are underpaid: Nursing Aides
are paid $7.50 an hour and Personal/Home Care Aides are paid between
$6.18 and $6.60 an hour.
- The average monthly SSI benefit covered only 83 percent of the
average cost of a one-bedroom apartment in Austin.
- In a 1997 report, 90 percent of people with disabilities were
found to have experienced some form of sexual assault.
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WHAT DOES THE MR/DD SERVICE
SYSTEM LOOK LIKE?
There is an array of services and supports used to assist people and
their families with mental retardation and developmental disabilities
in Travis County. These services, specialized and designed to assist
people with developmental disabilities, are offered through public
and private providers and include segregated and integrated opportunities.
Other service agencies are larger and more comprehensive in approach,
and/or target people with specific disabilities such as autism, mental
illness, cerebral palsy, and/or the priority population as defined
through Texas Department Mental Health Mental Retardation (TDMHMR).
Overall, service providers seek to address the individual requests
of people with MR/DD. However, services and supports in the community
do not have the funding or capacity to meet local needs. Providers
focus on specific needs such as:
| employment |
daily
activities |
| specialized
support and assistance |
family
support and respite |
| early
childhood intervention |
|
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WHAT QUALITY OF LIFE CHALLENGES ARE EXPERIENCED
BY PEOPLE WITH MR/DD (GAPS IN SERVICE)?
Inclusion becomes all the more challenging when people with disabilities
have difficulty meeting living expenses with little to spend on personal
interests and recreation. People in Travis County who have mental retardation
and other developmental disabilities face many daily living challenges,
including:
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WHAT ARE SOME OF THE BEST PRACTICES IN
THE MR/DD FIELD?
A best practice can be defined as: programs, services or processes
that research or expert opinion has shown to be effective. Over the
years, there have been many best practice approaches to managing the
needs of people with developmental and other disabilities. Philosophical
shifts in service model designs, or paradigms, over the last two centuries
have been extensive. Some of the best practices in the field are:
Person-Centered
Planning (PCP)
|
Family-Centered
Planning (FCP) |
| Supported
Employment |
Supported
Home Living |
| Transition
Services |
Respite |
| Self
Determination |
Medicaid
Waiver Services |
| Meaningful
Day Activities |
Permanency
Planning |
| Assistive
Technology |
Family
Support Services |
| Applied
Behavioral Services |
Enhanced
Health Care Services |
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WHAT IS BEING SPENT IN TRAVIS COUNTY ON MR/DD
SERVICES AND SUPPORTS?
In assessing the needs of persons with developmental disabilities,
it is important to weigh the human as well as the financial costs.
Supports and services are necessary and need to be tailored to assist
people with MR/DD at home, work, school, and play. Children and adults
who have developmental disabilities may require services that are individually
planned and coordinated over an extended period of time - sometimes
even a lifetime.
- Over $13.5 million a year is being spent by CAN Partners, federal,
state, and local agencies.
- The average annual cost per person of Medicaid funded Home and
Community-Based Services (HCS) in Travis County is $47,291 and the
average annual institutional (e.g., State Schools) cost per person
is $60,053.
- Waiting lists of over 1,000 people exist in the Travis County
area and continue to increase. Over $47 million would be needed to
serve everyone on the waiting lists.
- Non-inclusive Medicaid costs for comprehensive outpatient rehabilitation
services average $4,000-$4,200 per client, per year
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RECOMMENDATIONS
- Decrease the number of people
on MR/DD waiting lists in the Travis County area.
- Increase employment and
volunteer options for persons with MR/DD.
- Increase opportunities
for persons with MR/DD to participate in inclusive social, recreational,
and meaningful activities within their communities.
- Increase resources and
response time for persons with MR/DD who are in crisis.
- Increase supports and
resources available for people with MR/DD and for their families,
especially in the areas of respite options, affordable and accessible
care, and specialized assistance.
- Improve consistency, availability,
and quality of data within the community.
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CONCLUSIONS
On an individual and community level, we can achieve the vision set
forth for persons with mental retardation/developmental disabilities
by supporting the recommendations outlined in this assessment. Specifically,
resources are needed to increase services and supports in order to decrease
the long waiting lists currently in place. Local businesses and community
organizations can enter into relationships with persons with mental retardation/developmental
disabilities and utilize an often-untapped resource. A commitment to
participate and encourage persons with mental retardation/developmental
disabilities to be a part of social, recreational, volunteer opportunities,
and employment activities will greatly improve the well being of this
population and the community as a whole, and in the process reduce the
stigma. Lastly, when the community recognizes the need for respite options,
improved transportation, affordable and accessible care and housing,
and the life long need of specialized assistance, Travis County will
be closer to achieving its vision for people with mental retardation
and other developmental disabilities.
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