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December

A Message From Our CEO

December 3rd was International Day of Persons with Disabilities, promoting awareness of individuals with disabilities. The observance of International Day of Persons with Disabilities is a time to gain further understanding of disability issues, increase awareness of the needs of this population and reduce stigma in order to create a community that values the contributions of all of our community members.

Integral Care serves individuals living with intellectual and developmental disabilities. An intellectual or developmental disability, also called IDD, includes chronic conditions that usually last throughout a person's lifetime, some of which may be severe. Intellectual disabilities appear before age 18 and are characterized by limitations in both intellectual functioning and adaptive behavior like social skills. Developmental disabilities can be cognitive and/or physical. Developmental disabilities appear before age 22. Some largely physical developmental disabilities include cerebral palsy and epilepsy. Downs syndrome and fetal alcohol syndrome are conditions that involve physical and intellectual disability.

Last month, Integral Care hosted an IDD forum focused on promoting Strength Through Community. The forum included speakers and panelists from the Texas Council, Disability Rights Texas, Texas Workforce Commission and ARCIL, Inc. This discussion was a great opportunity to share valuable information on access, eligibility and resources for the IDD community. Topics covered included a legislative update, transition services, vocational rehabilitation and Preadmission Screening and Resident Review (PASRR) eligibility. PASRR is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care. The forum Q&A is available here with more information.

During this past 85th legislative session, IDD services unfortunately saw little advancement.

The legislature provided no funding to move individuals off interest lists and into services for the next 2 years. Currently thousands of people are on interest lists for services.
The hourly rate for attendant and transportation services in Home and Community Based Services (HCS) and Texas Home Living (TxHmL) was cut by 21%.

Local IDD Authorities (LIDDA) will continue to support individuals with IDD in the absence of interest list waiver slots, connecting them to Community First Choice (CFC) and General Revenue-funded services. As the LIDDA for Travis County, many of Integral Care's programs help keep individuals with IDD living in their own homes, in family homes or group homes in the community.

According to Open Minds, a top resource in Mental Health best practices, the continuing trend in the area of IDD is in the community. The number of institutionalized individuals living with developmental disabilities dropped dramatically in the last 50 years from a high of 194,650 in 1967 to 21,203 in 2015. This change has been due to an increased focus on moving individuals out of institutions and into the community. Although the move to home-based services comes with challenges, including service delivery models, mobile technology and critical workforce issues, it allows individuals with IDD to be integrated into our communities.

A healthy community creates opportunities for everyone to share their gifts and talents and make meaningful contributions. Integral Care is proud to partner with others working in the area of IDD - individuals living with IDD, families, and other organizations - to continue to raise awareness and create opportunities for a healthy and safe life.

David Evans

Chief Executive Officer

Intervention Specialists Team

Formed one year ago, Integral Care's Crisis Intervention Specialists (CIS) Team helps children and adults living with IDD who have also experienced or are at risk of experiencing a mental health crisis. The team provides crisis prevention support and services for up to 90 days. The team is a small powerhouse of three - Sarah Kuykendall who holds in Master of Science in Psychology, Madison Juarez, M.Ed. in Counseling and Retisha Winton, Masters in Social Work. Since its inception, the team has provided care for 110 clients.

Sarah, Madison and Retisha's work involves examining and assessing what triggers a crisis. Contributing factors may be environmental or situational. A change in diet, boredom, new staff at a group home or the death of a loved one can all trigger a crisis. Once the trigger has been determined, the team works with the individual and their caregivers to formulate crisis prevention strategies.

The key to their work is identifying how to prevent repeat crises. For the individual with IDD, that could mean getting a better understanding of their emotions. For caregivers, it could be education, developing plans for coping and/or de-escalation strategies. According to Sarah,

"There is no set model for the help we provide. Our work is informed by multiple models. It's a case-by-case, person-centered approach based on the client's history, diagnosis, level of intellectual ability and the given situation."

Travis County Sheriff's Office

Integral Care and the Travis County Sheriff's Office (TCSO) are long-time partners in providing crisis support to our community. In 2006, we started formulating the Mobile Crisis Outreach Team (MCOT) with TCSO as well as Austin Police Department. The Mobile Crisis Outreach Team works together with law enforcement to safely respond on-scene to individuals in our community experiencing a mental health crisis. The collaboration extends beyond crisis response. Integral Care provides mental health training to TCSO officers on a regular basis. In fact, 28 training sessions have occurred in the last 6 months alone.

We also have a collaboration with the Travis County Jail. Our joint effort ensures jail diversion and reduced recidivism for individuals with mental illness, substance use disorder and/or IDD.

We have a presence at central booking.
We work with the jail to organize planned discharges so that individuals can successfully transition back to the community.
We have staff stationed at the jail to ensure continuity of care for homeless clients and to connect others to much needed care.
We assess people in jail who may be more appropriate for our Competency Restoration program.

The strong bond with TCSO grew nearly a year ago when TCSO law enforcement officers began to receive training for responding to situations involving individuals with IDD. Trainings provide valuable education about intellectual and developmental disabilities, various crisis scenarios and de-escalation skills tailored to the IDD population. The collaboration between Integral Care and TCSO results in a reduced number of individuals with IDD in our jails.

Integral Care is grateful to TCSO and its officers who work every day to keep our entire community safe.

December

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