Intellectual and Developmental Disability Services Margo Childs

Intellectual and Developmental
Disability Services
Margo Childs, M.A.
MHMRA of Harris County
TERMINOLOGY
Mental
Retardation
“MR”
Autism
Pervasive Developmental Disorder
Asperger’s Disorder
Co-Occurring
IDD + Mental Illness
Intellectual &
Developmental
Disability
“IDD” or “ID”
Autism Spectrum
Disorder
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
195,000
33,732
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
ICF-IID
Public/Private
State Supported
Living Centers
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
DSRIP In-Home
Wrap-Around
• 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
• Provide clinical and
community supports to
people in crisis and to
prevent crises by
facilitating access to
resources
IDD/ASD Safety Net Services
DSRIP STARS
• Double the current clinic
capacity and improve
access to care for people
with ID/ASD and cooccurring behavioral
health needs
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
[email protected]