7/12/19 Dallas News Editorial

Title online: Why is Texas all but forcing the developmentally disabled into bad state institutions?

Title in the paper: Texas' Neediest Deserve the Best


Texans with intellectual or developmental disabilities often have a choice: Add their name to a 10-year waitlist for services in their community in places like group homes or get a spot in a more restrictive state-supported institution immediately. Most choose to wait.


The state of Texas prioritizes funding for state-supported institutions over community-based services for developmentally disabled citizens. But these institutions are fraught with problems, and few choose them. In order to serve its citizens and use public funds more responsibly, the state needs to reconsider its priorities.


More than half a million people in Texas have an intellectual or developmental disability, encompassing a range of illnesses and abilities. Most need significant support to live. Many can’t get jobs without that support, and some need full-time care. This level of care is financially inaccessible for all but the wealthiest families, so many turn to the state.


State support takes two basic forms: community-based care and institutions often far from home. Community-based care includes group homes in or near an individual’s community, in-home care for families who want to live together, and support for individuals living alone or with other I/DD patients.


To fund community-based care, families apply for Medicaid, but the state needs to support these applications before the federal government will release funds. Almost 140,000 people are on the waitlist to receive these services. Most will wait more than a decade.

In contrast, state-run institutions are well-funded and old-school. There are 13 in Texas, mostly in rural communities. They can serve up to 660 patients and follow a traditional model of pre-set schedules, group activities and near-constant supervision.


It's widely accepted that community-based services provide superior care and better outcomes. They allow more freedom, proximity to family and greater integration into society. They treat people with disabilities like citizens, not outcasts.


Issues with Texas' state-supported living centers have made headlines in the past. In 2009, a Justice Department investigation found years of abuse and neglect at these centers. Dallas Morning News and Texas Tribune investigations in the years since have detailed further instances of mistreatment. On a more fundamental level, living in an institution means less freedom and fewer options.


These kinds of institutions are declining across the country; the market demand has all but vanished.


But Texas still prioritizes them. Each of Texas' 13 state-supported living centers is under capacity. Of the 12 state-supported centers for which Texas Health and Human Services releases data, none is even 70% full.


Despite a precipitous drop in demand for these services, the state increases funding for institutions 25% every two years, according to the Texas Council for Developmental Disability.


The state's own sunshine coalition recommended shutting down one institution and perhaps more in the future, but the Legislature rejected the recommendation, citing job loss. Moving away from institutions is politically unpopular, but it's incredibly necessary.


More than 140,000 families languish on a waitlist while services go unused. Clearly we need to put our money elsewhere.


LeoGrande Online Response: Thank you to the Editorial Board for presenting this issue in a clear, concise way. Increasing funding for services for people with disabilities gives these citizens the opportunities to thrive in our communities, not segregated away from them. This is what is necessary. The "Best" isn't necessary for most people with or without disabilities. For more information about housing for people with disabilities please see txcpsh.org

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