2001 Developmental Disabilities Assessment

IX. PRELIMINARY PLANNING AND RECOMMENDATIONS

RECOMMENDATION 1	RECOMMENDATION 2
RECOMMENDATION 3	RECOMMENDATION 4
RECOMMENDATION 5	RECOMMENDATION 6

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.

ISSUE
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.).
DATA
Current projections indicate 1,000 people are on MR/DD waiting lists. Average cost per person is $47,291 a year.
STRATEGIES	ESTIMATED COSTS
1.1: Fund an additional 1,000 people currently waiting for services	$47,291 per person times 1,000 persons = $47,291,000
1.2: If 1:1 cannot be achieved, focus on reducing the waiting list by 10 percent each year.	$47,291 per person times 100 persons (10%) = $4,729,100

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.

ISSUE
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.
DATA
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.
STRATEGIES	EST. COSTS
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.	$504,000 TV Production $288,000 Radio $180,000 Billboard $25,000 Print
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.	$6.00 - $8.00 an hour per paid Intern
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.	Utilize existing resources
2.4: Offer job carving assistance and assistive technology/job adaption assistance for community employers that work in specialized job developers.	$8,000 to $11,000 per person
2.5: Continue to fund job placement and follow along services for 10% reduction in waiting lists.	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.

ISSUE
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.
DATA
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
STRATEGIES	EST. COSTS
3.1: Create a resource center where donation of sponsorships, tickets, club memberships, and season tickets can be distributed to persons with MR/DD.	Utilize existing resources
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	Utilize existing resources
3.3: Increase training opportunities for people with disabilities, which promote inclusion in the family and community through local services.	Utilize existing resources
3.4: Availability of trained, consistent personal assistants may be necessary to provide full access to a range of community opportunities for some people.	Use resources with ACC and Texas Workforce Commission (Grant)
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.	$20-$40 a day, per person or $15-$25 an hour
3.6 Utilize minimal standards and certification processes to ensure that programs in Travis County provide a quality service for persons with MR/DD.	$10,000 -$25,000 per organization
3.7: Provide licensed and credentialed staff to develop accreditation standards consistent with individualized supports for community integrated day activities	To Be Determined
3.8: Provide therapeutic day "camp" scholarships	$250 - $400 per person
3.9: Provide therapeutic overnight and week long "camp" scholarships	$1,000 - $1,500 per person
3.10: Provide training and technical assistance to school personnel on individualized supports and inclusive practices.	To Be Determined
3.11: Continue to provide enhanced Health Care Services for specialized populations	To Be Determined
3.12: Provide additional assistive technologies	To Be Determined

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RECOMMENDATION 4: INCREASE RESOURCES AND RESPONSE TIME FOR PERSONS WITH MR/DD WHO ARE IN CRISIS.

ISSUE
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.
DATA
N/A
STRATEGIES	EST. COSTS
4.1: It is proposed that this area be studied in depth, with additional data gathered.	Utilize existing resources
4.2: Access to crisis services could be increased through use of a standardized phone number and triage method.	Utilize existing resources
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.	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.

ISSUE
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.
DATA
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
STRATEGIES	EST. COSTS
5.1: A drop-in respite center is needed to support families in their care giving responsibilities.	$125,000 - $180,000 per year
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.	Utilize existing resources
5.3: Continue to expand support and specialized assistance in developing functional skills, and learning activities for daily living.	Utilize existing resources
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.	To Be Determined
5.5: Increase child care for children with disabilities.	To Be Determined
5.6: Develop and Ombudsman/Navigator position for Travis County	To Be Determined

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RECOMMENDATION 6: IMPROVE CONSISTENCY, AVAILABILITY AND QUALITY OF DATA WITHIN THE COMMUNITY.

ISSUE
Currently, there is not a broad community process for continually tracking MR/DD indicators in Travis County.
DATA
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.
STRATEGIES	EST. COSTS
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.	To Be Determined
6.2: Determine technology and resource needs to improve data collection.	To Be Determined

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