Texas has ongoing initiatives to downsize the number of residents living in its’ 13 State Supported Living Centers (SSLCs) to ensure that people with intellectual and developmental disabilities (IDD) can live in the least restrictive environment possible. Successfully transitioning services from large state-run institutions to community based settings requires a concerted effort and frequent stakeholder feedback. By examining census data, referral outcomes, and community transition return rates, service systems can be improved and effectively coordinated.
Census Management of SSLCs
Overall, the census of SSLCs has continued to decrease with total reduction of 35 percent between 2007 and 2015. Since 2006, Austin SSLC has seen the largest reduction in census (56%) followed by Mexia (48%). Excluding Rio Grande, San Antonio SSLC had the lowest percentage (21%) of decrease.
Every year, SSLC residents and their legally authorized representatives participate in the Community Living Options Information Process (CLOIP). CLOIP provides opportunities to learn about other living arrangements and make preferences known. When an SSLC resident or their legally authorized representative (LAR) indicates an interest in community transition, the interdisciplinary team (IDT) evaluates and either recommends or does not recommend the person for transition. In the best case scenario, the person’s request should be honored within six of months of the IDT’s recommendation. LAR objection is the most common reason that individuals who are recommended for community transition do not move to the community. IDT decisions are the next most common barrier. An IDT may decline to recommend a person for community transition based on inaccurate assessments of the level of individual medical and behavioral support needs or the capacity of the community to support those needs.
In direct response to the Supreme Court’s Olmstead decision, Texas initiated the Promoting Independence Plan to offer community options so individuals could choose to live in the most integrated setting appropriate to their needs. Most referrals result in transition, however LAR choice and IDT decision frequently prevent community transition from happening. Just 32 percent of total referrals in FY 2015 have resulted in transitions so far, a 30 percent reduction in comparison to 62 percent of referrals resulting in transitions in FY 2014.
After a person transitions into a community-setting, monitoring visits are conducted at 7, 45, and 90 days to assess whether the supports and services remain in-place to facilitate a successful transition to an alternative community setting. If the IDT becomes aware of an event that might disrupt community transition within the first 12 months, it will meet with the post-move monitor, admission/placement coordinator, and the local IDD authority to address the event.
Community transitions are generally successful. With an average return rate of 5 percent since 2006, an overwhelming majority of people choosing a different living option are gaining independence outside of an institutional setting.