SERVICES FOR ADULTS WITH MENTAL RETARDATION AND DEVELOPMENTAL DISABILITIES

PROGRAM MISSION: To promote the highest reasonable level of self-sufficiency and independence for adults with mental retardation and developmental disabilities through services that promote consumers' skill building and optimal health, safety, and psycho-social functioning. This is achieved through the provision of individualized case management and support services intended to provide individual choice and linkages to community based programs.

• Client Services Coordination (Case Management) is the single point of entry for all Mental Retardation/Developmental Disabilities services. The goal of Client Services Coordination is to arrange, authorize, coordinate, and link supports and services for eligible Arlington County adults with mental retardation and developmental disabilities. Case managers monitor the delivery of services to individuals to assure that quality standards are met and assist eligible special education graduates from the schools to transition to the world of work or adult services.

• Vocational/Day Programs and Transportation Services enable adults with mental retardation and developmental disabilities to prepare for and engage in meaningful training, work and employment designed to increase their options for functional and economic self-sufficiency. These provide a range of service options including sheltered employment or training, competitive job placements and job coach supports; group supported employment enclaves in community business settings, mobile work crews, and day support services. A process of privatization for services previously provided through the Woodmont Center, with the exception of the Woodmont Weavers, was completed on September 30, 2004 and resulted in a vendor-operated Community Integration Center (CIC) in Arlington, based on the recommendation of the Woodmont Workgroup and the Arlington Community Services Board.

• Residential Services prevent homelessness or institutionalization for adults with mental retardation through the development and provision of an array of community-based residential services and support. These services provide training which maximizes consumers' self-sufficiency and assists them in increasing community daily living skills. The level of supervision and support provided in each service model varies depending on the needs of the consumers. These range from 24-hour supervision in a group home setting to drop-in staff support in an apartment or private home. A respite program is available that provides short-term, periodic care for adults in the temporary absence of their families or other care providers. In addition to the $1.6 million vendors receive through the County, Medicaid Waiver revenue is also generated to support these services, and is paid directly by the state to the contract service providers.

• The Family Support Program provides financial assistance to families who care for a family member with mental retardation/developmental disabilities in their home. Families purchase items or services for which there are limited sources of community or private funding and which provide support to the families in the maintenance of the consumer in the home. Purchases may include respite care services, assistive technology, personal care services, certain health or therapeutic services, and other items or services that support the independence of the consumer or ease the caretaking requirements of the family.

SIGNIFICANT BUDGET HIGHLIGHTS:

• Personnel costs include normal merit step increases, the addition of a 0.5 FTE case manager to support ten new school graduates ($27,405), and an internal reallocation of a 0.5 FTE from the Behavioral Health Care Division ($26,793) to support accounting functions.

• The non-personnel costs include an increase for transportation required by contract for one vendor ($15,022); an increase in transportation costs for the new graduates ($37,370); shifting of expenses that are reimbursed to a nonprofit vendor to the nonprofit expenses ($28,700); and a increase in telephone charges ($5,325).

• The expense for nonprofits reflects an increase due to the addition of funding for vocational services for ten new school graduates ($234,518), an increase for regional vocational vendors required by contract ($61,470), and the transfer of $28,700 from non-personnel.

• The Medicaid State Plan Option revenue was increased to more accurately reflect prior year actuals.

• Medicaid Waiver revenue is decreased to reflect the current number of persons eligible for Medicaid Waiver services in the Woodmont Weavers Program.

PERFORMANCE MEASURES:

Client Services Coordination/Case Management

• The state case management satisfaction surveys are given to a sample of consumers, consistent with state criteria. This survey is based on a calendar year; therefore, the results for 2004 are not yet available.

• The decrease in community-based consumers in FY 2004 reflects deaths of consumers and relocation of consumers out of the area.

Vocational/Day Programs/Transportation Services

• Sixty-two of 158 client files were sampled, representing all contract agencies, to determine percentage of client goals and objectives met. Vendor staff training in Objective Writing and Individual Service Plan Development was provided in FY 2004. Continued assistance will be given to vendors in FY 2005.

• Average hourly earning rates, which are sub-minimum wage for some types of employment, are computed in accordance with Department of Labor standards for productivity percentage/rate as compared to productivity norms for task performance. Consumers average less than full time employment (ranging from 12 to 30 hours weekly) because of varying subcontract work available.

• In FY 2004, satisfaction surveys were sent to all consumers, families and or advocates who receive vocational services. Sixty-three (63) or 40% were returned.

• Satisfaction surveys were sent to 67 of 71 consumers who received transportation services in FY 2004. Of these, thirty-six (36) responded for a return rate of 54%.

Residential Services

• Client objectives met is based on a sample of 62 consumers representing seven of seven contract agencies; percentages indicate the success that consumers have had in meeting objectives of their Individual Service Plans. Vendor staff training in Objective Writing and Individual Service Plan Development was provided in FY 2004. Continued assistance will be given to vendors in FY 2005.

• Satisfaction Ratings are derived from a Consumer Satisfaction Survey provided to families, guardians, and advocates of consumers who received residential services. The survey contains questions related to service quality, staff knowledge and helpfulness, recommendation of the service to others, meeting of needs, and comfort in expressing concerns about the program. Thirty-two of the 82 surveys or 39% were returned in FY 2004.

• Total clients served represents an unduplicated count of the number of consumers served in all residential services, including respite services and in-home supports. Two Intermediate Care Facilities for the Mentally Retarded (ICFs/MR) will open in FY 2005, funded by Medicaid. In addition, nine new Medicaid Waiver slots were allocated to Arlington County.

FUTURE BUDGET CONSIDERATIONS:

• Arlington has 58 individuals with mental retardation/developmental disabilities who are in need of residential services. Eleven (11) are on the state's Urgent Needs Wait List for Medicaid Waiver and 19 of the 58 consumers are not eligible for Medicaid Waiver funding.

• The number of new graduates with a diagnosis of mental retardation/developmental disabilities for FY 2007 – FY 2011 is projected to range between 11 and 24 each year.

• The Mental Retardation/Developmental Disabilities non-profits providers network in Northern Virginia is increasingly facing budgetary shortages which impact staffing and the delivery of services to this population within the state funding and Medicaid Waiver rate structure.