Texas Community Integration Project
- 18,000 individuals have transitioned out of nursing facilities using Community Transition Teams
- 2,500 people have transitioned out of Intermediate Care Facilities (ICF) for Individuals with an Intellectual Disability or Related Conditions programs and nursing facilities into the community
- Community Integration advocates collaborated with more than 1,587 community partners
- 5,780 people received systems advocacy trainings
- 4,960 people were trained on formal and informal community supports
- Person-directed approaches are more widely understood, expected, and implemented within the service delivery system and guardianship programs
- Child Protective Service workers, key state agency staff, and families are more knowledgeable of the programs and services available for children
- Individuals have a greater opportunity to know their options for choosing where to live
- Community Integration Advocates cover all 254 counties of Texas
A Supreme Court ruling states that unnecessary institutionalization of persons with intellectual and developmental disabilities (IDD) in state institutions constitutes unlawful discrimination under the Americans with Disabilities Act (ADA). States must provide community-based services for those who would be entitled to institutional services if placement is deemed to be appropriate, affected persons do not oppose treatment, and placement can be reasonably accommodated. Development of a coordinated response to this decision will facilitate Texans’ ability to receive services in the most integrated setting.
Increase the number of people recommended for community placement and the number of individuals who move into community settings. Improve the process by which people living in institutions are notified about and provided with community support services.
Advocacy, Inc. developed community partnerships statewide to resolve individual and systemic barriers to transitioning individuals from institutional settings to the community. The organization established designated regional community integration advocates.
Providers utilized project staff to address individual case-level situations in order to support transitions to the community. Continued presence in a variety of institutional settings created opportunities to develop working relationships with local agencies responsible for Medicaid determination, community-based services, and adult and child protective services. Individuals at imminent risk of harm in poor quality facilities, or when their facilities closed, were identified and protected through increased regulatory oversight. Individuals were able to transition to safe settings in the communities of their choosing.
Project staff participated in direct training and individual assistance to increase awareness of support needs and how to address those needs in the community. Staff worked with area agencies on aging, Independent Living Centers (ILCs), and local mental authorities to increase their understanding of available options. The project also worked with facilities, community providers, individuals, and families to address unique, complex, and/or intensive service needs within existing programs.
Program staff addressed barriers to increase the capacity of community providers to deliver supports to individuals choosing to live in the community. This included establishing individual level-of-need assignments, addressing home modifications, obtaining housing vouchers, establishing home services, obtaining family-based alternatives for children, and establishing medical necessity determinations. Rates of recommendation for community placement were greatly increased.
The project worked to increase the understanding of residents in institutions, as well as people with IDD and their families, of the options available to make informed choices about where to live. Project staff worked to make the Community Living Options process meaningful to individuals with IDD and their families by enhancing materials and processes and attending quarterly Community Living Options meetings.
A focus was placed on communication needs of individuals so they can express their preferences and have an effective means of communication before and after relocating to the community. Communication assessments were requested and provided, with certain individuals receiving new therapies, equipment, and training for themselves and their staff.
Project staff also provided input into the Texas Department of Human Services’ implementation of the newly developed Promoting Independence Plan, which addresses systemic barriers and helps prevent unnecessary institutionalization.