MHMR of the Concho Valley will hold a symposium on the collaborative conversations on Mental Health & Intellectual Disabilities – Navigating continuum of service and financial challenges for Intellectual and Developmental (IDD) care. It will be held Wednesday, Nov. 13, from 11:30 a.m. – 1:30 p.m. at the MHMR Concho Valley, Jack Ray Auditorium, 1501 West Beauregard Ave.
Community-based IDD services support people living in their own homes and in group homes, including assisting with daily, personal tasks (e.g., toileting, bathing), managing medications, cooking, and housekeeping. Many individuals have complex needs, including physical (e.g., paralysis, tube-fed, etc.), mental health, and behavior support needs. Non-degreed Direct Support Professionals (DSPs) provide most of these services and are not only entrusted with the lives and safety of the persons they serve, but they also support individuals with reaching their personalized goals. DSPs make it possible for persons with IDD to experience increased quality of life, opportunities to learn skills, and participate in their communities. Without enough DSPs, individuals with IDD and their families are struggling to find IDD providers with the capacity to serve additional residents.
State Rep. Drew Darby will be in attendance.
Community-based services for individuals with IDD are funded by federal Medicaid waivers, i.e., Home and Community Services (HCS), Texas Home Living Waiver (TXHML), Intermediate Care Facility (ICF/ID). These waivers are created based on a modeled rate which contains an embedded hourly wage amount along with other operational and overhead costs. Currently, the embedded rate is $10.60 per hour for DSPs. During the legislative session, rate increases up to $15 per hour were proposed and included in the budget requests negotiated in conference committee but failed to pass into the final budget. Prior to the 88th Legislative Session, the embedded rate was $8.11.
Due to the low rates in the IDD provider services system, both the public Community Center providers (MHMR Concho Valley) and the private industry providers are having recruiting issues causing service delivery insecurities. Many of the provider positions across the state are vacant which can result in residents in group homes being sent home to families for periods, shuffled off to other houses where staffing can be provided, or placed in unsafe situations where the clients are not being supervised by qualified staff. All providers are struggling with financial stability that border at a tipping point on becoming a terrible crisis in Texas.
Statewide, providers are struggling to provide basic IDD services and quality of care is suffering. Residential settings are staffed at dangerously low levels, with staff vacancy rates remaining at unmanageable levels: 31% in ICF and 30% in HCS across the state. HCS and ICF DSP staff average 60 hours on-duty per week. Providers across the state have been forced to temporarily close homes, sending individuals to other group homes or to stay with family members who are not equipped to provide this support. Individuals with IDD face traumatization as well as health and safety risks without a network of IDD services able to meet each individual’s unique needs. Providers like MHMR Concho Valley are holding the line to ensure our communities have quality IDD community-based services but they need local funding and improved waiver rates to ensure these much-needed and important services continue.
