Intellectual and Developmental Disability Services Margo Childs, M.A. MHMRA of Harris County
TERMINOLOGY Mental Intellectual & Retardation Developmental MR Disability IDD or ID Autism Pervasive Developmental Disorder Autism Spectrum Asperger s Disorder Disorder Co-Occurring IDD + Mental Illness Dual Diagnosis
WHAT IS IDD?
WHAT IS IDD? A permanent condition originating sometime between birth and age 18. The person's general intellectual functioning is significantly below average and his or her adaptive behavior does not meet the level of personal independence and social responsibility expected of the person's age and culture. Found among all races and cultures. An estimated 2.5% of the population has IDD
INTELLECTUAL AND DEVELOPMENTAL DISORDER: NOT THE SAME AS MENTAL ILLNESS IDD and mental illness are not the same condition, although they can occur in the same person. Unlike mental illness, IDD is always associated with limited intellectual capacity, occurs before age 18, and a permanent condition. Mental illness is not associated with a particular level of intelligence, it may occur in a person at any age, and it is often temporary and treatable. Like all other persons, individuals with IDD can become mentally ill and they can be treated for their mental illness.
WHAT ARE AUTISM SPECTRUM DISORDERS? A group of developmental disabilities defined by significant impairments in social interaction and communication and the presence of unusual behaviors and interests. Many people with ASDs also have unusual ways of learning, paying attention, or reacting to different sensations. Thinking and learning abilities can vary from gifted to severely challenged. Begins before the age of 3 but may be first diagnosed well into childhood and lasts throughout a person's life. Occurs in all racial, ethnic, and socioeconomic groups and is 4 times more likely to occur in boys than girls.
IDENTIFICATION Autism Characteristics Social impairment Limited interests and preoccupations Repetitive routines or rituals Speech and language peculiarities Nonverbal communication problems Motor clumsiness Walking on toes Switching lights on and off Jumping, rocking, clapping, chin tapping, head banging, spinning Fascination with colorful and shiny objects
WHAT IS MHMRA OF HARRIS COUNTY?
THE DEVELOPMENT OF COMMUNITY SYSTEMS Prior to the 1960s, state institutions were the only source of support and treatment available to people with serious mental disabilities. In 1963, President John F. Kennedy proposed a new program which included community mental health centers. In October of 1963, he signed the Community Mental Health Center Act into law. In 1965, Texas passed the Texas Mental Health and Mental Retardation (MHMR) Act. In 1966, Texas developed the Texas State Plan to Combat Mental Retardation
REDUCTION IN INSTITUTIONAL CENSUS 2009 1967 33,732 195,000
THE MHMR SYSTEM IN TEXAS 39 MHMRs contracting with DADS Serve as Local Authority - Mandated Eligibility Determination of Intellectual Disability (DID) Authorization of services funded by state dollars Service Coordination Linkage and Referral Continuity of Service Transition from institutional care Provides direct services Highly variable from one MHMR to another Only mandated service is Respite Cannot duplicate services paid by another agency, such as TEA
MHMRA OF HARRIS COUNTY Mental Health Mental Retardation Authority of Harris County (HCMHMRA) was created on November 19, 1965. It is one of the larger MHMR centers in the country. It provides services in over fifty sites throughout Harris County. 713-970-7000
NETWORK SUPPORTS CONCEPT Individuals living in the community State Supported Living Centers ICF-IID Public/Private NETWORK SUPPORTS State Hospitals HCS/TXHML Public/Private Other Personal Care Homes Independent Living Private Psychiatric Beds
WHAT SERVICES ARE AVAILABLE?
BABIES & CHILDREN Early Childhood Intervention (ECI) Provides services designed to assist parents in addressing the needs of children under the age of 3 with delayed development and/or certain medical diagnoses which will result in delayed development. Services offered include evaluation and assessment, occupational and physical therapy, speech-language therapy, service coordination, family counseling and education, and developmental services. Services are provided in child's home or community settings (daycare, foster parent, grandparent, etc.). ABA-Skills Intervention Program (SkIP) video Designed for children ages 3-10 years old with autism or developmental disabilities and delays in language, motor skills, academic skills, play skills, as well as, inappropriate classroom behaviors. Skip utilizes Applied Behavior Analysis (ABA) techniques such as discrete trial teaching, positive reinforcement, and extensive data collection to increase the students' skills set. Goals of SkIP are to recreate a preschool and elementary school environment to better teach the children how to appropriately integrate into a typical classroom setting. Transition Services A coordinated set of activities for students aimed at promoting a successful transition from school to post-school activities, programs and independent involvement within the community.
CHILDREN & ADULTS Community-Based Supports Team: Field-based crisis intervention services for individuals with IDD who are at risk of hospitalization, losing residential placement, dangerous living conditions, etc. Provides either short-term stabilization for the individual and the family or a referral to more appropriate services. IDD C&L Team - HCPC: Provides consultative services to physicians who treat individuals while they are admitted to the University of Texas Harris County Psychiatric Center (UTHCPC) or the NeuroPsychiatric Center (NPC). Services include assisting patients admitted to UTHCPC to apply for MHMRA IDD services; providing IDD consultation services to UTHCPC and NPC staff; providing liaison services between UTHCPC staff and MHMRA of Harris County; and providing liaison services between Harris County Probate Courts housed at UTHCPC and MHMRA of Harris County. Home & Community Based Services (HCS) video: Provides a comprehensive, community based service system for persons with IDD. An Individual Service Plan and Individual Plan of Care are developed for each person enrolled in the HCS program based upon the individual s needs and abilities. Individuals enrolled in the program may choose where and with whom they live, including the option of living with their natural family or in a companion foster care residence. Intermediate Care Intellectual Disability (ICF-IID): A Medicaid-certified program usually housing up to six individuals with IDD in a residential group home setting. The Individual Program Plans are structured to allow persons to acquire and master the skills necessary to participate in the mainstream of community living. The basic training areas include daily living skills, behavioral intervention, vocational training, and functional academic skills.
CHILDREN & ADULTS In-Home Respite Care: Designed to relieve family of continuous care, provides temporary/intermittent direct supervision of a child or adult in their usual residence. Clinical Out-of-Home Respite (COR): Designed to provide respite services to individuals away from their regular home during times of crisis, such as on-going display of challenging behaviors. Services are temporary and designed to transition the individual back home after a combination of respite and clinical services have occurred. Specialized Therapies & Rehabilitative Services (STARS): Provides psychiatric, nursing, behavior analytic, psychological and social work counseling services to children and adults with IDD including autism, and co-occurring psychiatric conditions or severe behaviors. Also provides consultative service to providers. Services offered include evaluation, diagnosis, medication stabilization and medication management, parent education about disabilities, psychotherapy and counseling, and applied behavior analysis. Texas Home Living Waiver (TxHML): Provides a wide variety of services and supports to individuals with IDD or a related condition so that they can continue to live with their families or in their own homes. Coffeehouse : Provides social skills and communication training for adults with Asperger s Disorder or autism and limited cognitive delays. Services include a "drop-in" model for people to attend discussions of relevant and interesting topics as their daily schedule allows, individualized treatment planning, nursing services, peer mentoring, and psychological support.
DSRIP Projects for ID Division DSRIP Consultation & Liaison Team Utilize a protocol for inpatient consultation and successful discharge of people with ID/ASD who need inpatient care; intended to reduce length of hospitalization, and institutionalization DSRIP In-Home Wrap-Around Provide clinical and community supports to people in crisis and to prevent crises by facilitating access to resources DSRIP STARS Double the current clinic capacity and improve access to care for people with ID/ASD and cooccurring behavioral health needs IDD/ASD Safety Net Services
Getting Help MHMRA of Harris County 713-970-7000 Ask for IDD Services
www.mhmraharris.org
How to Access Services Step 1: The parent, legal guardian, primary caregiver, or person in need of services can call MHMRA Access Center at (713) 970-7070. Step 2: Once the referral is received from the Access Center, an Eligibility Coordinator will explain what documents are needed and how you can get them. For more information click here. Step 3: After your documents are received, if necessary you will receive a Determination of Intellectual Disability Assessment (DID) to determine your eligibility for services. Step 4: A Business Office staff member will discuss possible fees that may apply and assist with obtaining benefits for which you may be eligible. Step 5: If you are eligible for services, a Service Coordinator will be assigned to help you and your family to understand your rights and available benefits
For more information, contact Margo Childs at 713-970-8237 or email margo.childs@mhmraharris.org