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IX. PRELIMINARY PLANNING AND RECOMMENDATIONS
Travis County citizens with mental retardation and other developmental disabilities
have life-long conditions that often require consistent support by other
community members. The Mental Retardation/Developmental Disabilities Urgent
Issues Matrix (CAN, 2001, May) represents the first identification of urgent
issues; solutions and actions recommended to effectively address the issues
related to mental retardation/ developmental disabilities. Where possible,
human and financial investment opportunities and existing resources have
been identified to assist in attaining the desired results. The solutions
and actions identified in the matrix are designed to provide a blueprint
for mental retardation/developmental disabilities services planning. This
MR/DD Needs Assessment provided the opportunity to expand on the solution,
actions, opportunities, and efforts identified in the original statement
of the urgent issues and the matrix. Additionally, data and specific strategies
are added to link current issues with the recommendations and best practices
outlined in Section VII.
The preliminary planning recommendations that follow are based upon literature,
data for Travis County, focus groups, input from community members, and the
Mental Retardation/Developmental Disabilities Planning Partnership. These
recommendations attempt to address the needs of persons with MR/DD and the
community to improve public mental health in Travis County.
RECOMMENDATION 1:
DECREASE THE NUMBER OF PEOPLE ON MR/DD
WAITING LISTS IN THE TRAVIS COUNTY AREA.
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ISSUE
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A large number of people are on waiting lists to receive MR/DD services
and supports. Without services and supports the quality of each individual's
life is decreased and the burden of emotional and financial support
falls on families, employers (absenteeism, loss of productivity, etc.
due to family members providing care giving services), and the community
at large through tax dollars being spent for more costly services (institution
vs. community-based services; crisis vs. preventative services, etc.).
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DATA
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- Current projections indicate 1,000 people are on MR/DD waiting
lists.
- Average cost per person is $47,291 a year.
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STRATEGIES
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ESTIMATED
COSTS
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1.1: Fund an additional 1,000 people currently waiting for services
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$47,291 per person times 1,000 persons = $47,291,000
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1.2: If 1:1 cannot be achieved, focus on reducing the waiting list
by 10 percent each year.
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$47,291 per person times 100 persons (10%) = $4,729,100
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The cost of serving persons with MR/DD who are on waiting lists represents
the lack of sufficient funding to serve those who need these services in
Travis County. The anticipation that sufficient resources are not available
to fund these services is a present reality. Though the ultimate goal would
be to remove all persons from the waiting lists, it is practical to begin
with a specific recommendation with the goal of reducing the waiting lists.
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RECOMMENDATION 2:
INCREASE EMPLOYMENT AND VOLUNTEER OPTIONS
FOR PERSONS WITH MR/DD.
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ISSUE
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Over the past 15 years, there have been significant changes in the
way people with MR/DD are employed. Most notable is the shift from
facility-based services (sheltered workshops) to community-integrated
employment using supported employment practices. Overall, people with
any level of disability are less likely to be employed than those without
a disability and/or endure a greatly reduced earning capacity. Adults
with learning disabilities are thought to drop out of job training
efforts because the programs are not designed to meet their learning
needs. Two out of three unemployed people with disabilities would prefer
to be working.
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DATA
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- Individuals with disabilities participating in supported employment
increased their annual earnings 490 percent. On average, hourly earnings
increased from $0.84 to $4.13.
- The average cost of a supported employment placement to the federal/state
vocational rehabilitation program is $4,000; half of all placements
cost less than $3,000 per individual.
- The cost of placing an individual into competitive employment
with support is $4,200 compared to the $7,400 annual cost of keeping
an individual in a day program.
- 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.
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STRATEGIES
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EST. COSTS
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2.1: Conduct a public awareness campaign targeting potential employers
and volunteer agencies to expand knowledge about this potential workforce.
Informing employers of job carving possibilities and technology assistance
through one-on-one work with specialized job development and placement
staff and that on-the-job coaching provides opportunities for people
with disabilities and their work colleagues to transition successfully.
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$504,000 TV Production
$288,000 Radio
$180,000 Billboard
$25,000 Print
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2.2: Internships (20 paid and 20 unpaid) are needed to introduce people
to the world of work, and expanded volunteer opportunities would assist
in the development of work habits.
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$6.00 - $8.00 an hour per paid Intern
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2.3: Educate people with MR/DD and their families about the benefits
of work, and the options available to maintain health insurance and
other benefits while working.
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Utilize existing resources
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2.4: Offer job carving assistance and assistive technology/job adaption
assistance for community employers that work in specialized job developers.
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$8,000 to $11,000 per person
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2.5: Continue to fund job placement and follow along services for
10% reduction in waiting lists.
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Estimated Costs $4,000 per person x 100 persons. Coincides with average
costs in the data section and overall 10% waiting list reduction strategy
in Recommendation 1
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RECOMMENDATION 3:
INCREASE OPPORTUNITIES FOR PERSONS WITH MR/DD TO PARTICIPATE IN INCLUSIVE
SOCIAL, RECREATIONAL, ASSISTIVE TECHNOLOGY, AND MEANINGFUL DAY ACTIVITIES
WITHIN THEIR COMMUNITIES.
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ISSUE
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Many community recreational and social events are not accessible for
persons with limited mobility. Limited financial resources of the person
with MR/DD make many community events out of the realm of possibilities.
Public transportation is limited and special transit must be scheduled
in advance with no guarantee to arrive or be picked up on time.
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DATA
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- Only seven out of ten (69%) adults with disabilities socialize
with close friends, relatives, or neighbors at least once a week,
compared to more than eight out of ten (84%) adults who do not have
disabilities.
- About a third (33%) of adults with disabilities go to a restaurant
at least once a week, compared to six out of ten (60%) people without
disabilities. This 27 percent gap has widened since 1994 and is as
large as it was reported in 1986.
- Nationwide, there are just under 76,000 people waiting for day
programs. The lack of employment and meaningful day activities further
restricts the capacity of people with MR/DD to gather and engage
in community activities with other citizens
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STRATEGIES
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EST. COSTS
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3.1: Create a resource center where donation of sponsorships, tickets,
club memberships, and season tickets can be distributed to persons
with MR/DD.
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Utilize existing resources
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3.2: Capitol Metro to improve public transportation access and flexibility
of scheduling with the goal of transportation to meet the needs of
persons with MR/DD. Improve reliability by:§ Capitol Metro to
become a CAN partner§ Guarantee same day ridership§ Provide
training for public
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Utilize existing resources
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3.3: Increase training opportunities for people with disabilities,
which promote inclusion in the family and community through local services.
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Utilize existing resources
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3.4: Availability of trained, consistent personal assistants may be
necessary to provide full access to a range of community opportunities
for some people.
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Use resources with ACC and Texas Workforce Commission (Grant)
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3.5: For those people who are unable to or who choose not to work,
there are increased opportunities for involvement in day activities
or in a program, which are meaningful.
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$20-$40 a day, per person or $15-$25 an hour
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3.6 Utilize minimal standards and certification processes to
ensure that programs in Travis County provide a quality service for persons
with MR/DD.
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$10,000 -$25,000 per organization
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3.7: Provide licensed and credentialed staff to develop accreditation
standards consistent with individualized supports for community integrated
day activities
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To Be Determined
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3.8: Provide therapeutic day "camp" scholarships
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$250 - $400 per person
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3.9: Provide therapeutic overnight and week long "camp" scholarships
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$1,000 - $1,500 per person
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3.10: Provide training and technical assistance to school personnel
on individualized supports and inclusive practices.
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To Be Determined
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3.11: Continue to provide enhanced Health Care Services for
specialized populations
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To Be Determined
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3.12: Provide additional assistive technologies
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To Be Determined
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RECOMMENDATION 4:
INCREASE RESOURCES AND RESPONSE TIME FOR PERSONS WITH
MR/DD WHO ARE IN CRISIS.
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ISSUE
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There are limited resources available for persons with MR/DD and their
families who are in crisis. The public safety system and out-of-home
placements are used many times simply because there are no alternatives.
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DATA
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N/A
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STRATEGIES
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EST. COSTS
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4.1: It is proposed that this area be studied in depth, with additional
data gathered.
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Utilize existing resources
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4.2: Access to crisis services could be increased through use
of a standardized phone number and triage method.
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Utilize existing resources
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4.3: Training in crisis response for persons with MR/DD is
needed for organizations and individuals who are involved with this group,
for families and other caregivers, and for providers of residential services.
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To Be Determined
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RECOMMENDATION 5:
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.
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ISSUE
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Relief from care giving responsibilities is essential for families
of both children and adults with MR/DD. The Travis County community needs
a broad continuum of respite alternatives, and out-of-home options available
for respite are few. Given the disparities in education and employment,
there is a sizable gap in the income of people with MR/DD. People with
MR may live with their parents, a spouse, or family members, in an apartment
with a friend, or in a small group home on any street in Austin. Many
children and adults also reside in congregate and institutional settings
such as nursing homes, the Austin State School, and other large group
facilities. Income is always a major factor in where people with or without
disabilities reside. Supports that allow persons with MR/DD to live in
their own homes or their family homes are increasing and helping to provide
some relief. People who are judged as easy targets are often preyed upon,
both within and outside the home or living environment. A comprehensive
assessment of the number of children and families with disabilities that
need childcare services in Travis County is not available. There are
multiple agencies with missions that serve specific disabilities. There
is no single access point for services. In this system an ombudsman/navigator
is needed to assist in accessing and navigating through the myriad of
agencies.
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DATA
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- In 1998, there were approximately 27,670 children and adolescents
with MR in the Texas public school system.
- Public data shows that an additional 2,948 public school students
with MR/DD will need services during the 2000 - 2001 school year.
- A third (34%) of adults with disabilities live in poverty households
with an income of $15,000 or less, compared to only 12 percent of
those without disabilities
- Children and adults with MR/DD may experience violence and abuse
at least twice as often in comparison with the general public. When
considering multiple perpetrators, research suggests that people
with disabilities may be abused 3 to 10 times as often as their peer
without disabilities
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STRATEGIES
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EST. COSTS
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5.1: A drop-in respite center is needed to support families in their
care giving responsibilities.
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$125,000 - $180,000 per year
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5.2: Develop a larger network of trained providers, not only to provide
modeling and support in the areas of parent coaching and behavior coaching,
but also to provide attendant care services for persons who require
personal assistance.
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Utilize existing resources
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5.3: Continue to expand support and specialized assistance in developing
functional skills, and learning activities for daily living.
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Utilize existing resources
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5.4: Many agencies and organizations include people with MR/DD
in their scope of services, and it is challenging to know of all the
resources, there is a need to publish a comprehensive resource map.
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To Be Determined
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5.5: Increase child care for children with disabilities.
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To Be Determined
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5.6: Develop and Ombudsman/Navigator position for Travis County
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To Be Determined
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RECOMMENDATION 6:
IMPROVE CONSISTENCY, AVAILABILITY AND
QUALITY OF DATA WITHIN THE COMMUNITY.
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ISSUE
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Currently, there is not a broad community process for continually
tracking MR/DD indicators in Travis County.
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DATA
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- Many individual public and private MR/DD provider agencies and
programs are tracking their own performance and reflect only snapshots
of the community as a whole.
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STRATEGIES
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EST. COSTS
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6.1: Coordinate with consumers of MR/DD services and supports,
local MR/DD organizations, advocates, funders, and community leaders
to identify and select Travis County MR/DD indicators that can be tracked
and analyzed to evaluate the status of the community and make improved
planning decisions.
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To Be Determined
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6.2: Determine technology and resource needs to improve data
collection.
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To Be Determined
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