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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
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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)
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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.
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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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