Lakes Regional MHMR Center. Lakes Regional MHMR Center DSRIP Project IDD/ASD Treatment and Behavioral Intervention Center

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1 Center DSRIP Project IDD/ASD Treatment and Behavioral Intervention Center Region: 18 DSRIP Category: 1-11 Expand Behavioral Health Services Provide early intervention or intensive wraparound services and supports for a targeted behavioral health population, including people with co-occurring disorders, to reduce unnecessary use of more expensive services in a specified setting. Project/Intervention Title: Early Intervention Day Treatment and Outreach for Autism Spectrum (ASD) and Related Intellectual Developmental Disabilities (IDD) RHP Performing Provider: Center: Texas Provider Identifier: TPI _ Project Lead Laurie White, Director of IDD Provider Services Specific expertise and competencies available: Organization Center Lakes Regional / Consultants Individual Last Name White Dittlinger Individual First Name Laurie Laura DCI Global Clem Jeff Expertise/Competency IDD/Behavioral Health Experience Board Certified Behavioral Analyst Video Conferencing/ Telemedicine Systems/Networking ETBHN Angie Hardy Telemedicine Provider Brief Description/Delivery System Solution Proposed: The proposed treatment program will be an early intervention center to house a Day Treatment Center for Children with Autism and related Intellectual Developmental Disabilities (IDD), in addition to Applied Behavioral Analysis (ABA) Outreach Services in Rockwall County. The Day Treatment would provide individualized ABA intervention with a 1:1 ratio. Outreach would consist of interventions for behavior challenges within the Autism Spectrum Disorder/Intellectual Developmental Disabilities (ASD/IDD) population, with a focus on parent training and generalization to the home, community and school environments. Page1

2 Goal(s): Expand the capacity of behavioral health services to better meet the needs of the patient population and community so that care can be better coordinated and the patient can be treated as a whole person, potentially leading to better outcomes and experience of care. Expected Outcomes: Provide empirical, evidence-based, and highly effective treatment to individuals with ASD/IDD. Reduce the rate of psychiatric admissions for the target population Serve as a community expert resource and support to parents or families of individuals with autism, as well as a resource to consultants, school districts, and other private or public agencies serving individuals with developmental disabilities. Establish a data tracking methodology to support efficacy of the Center s presence in the community. Maintain a cooperative environment for research to further benefit the advances in autism treatment though the use of applied behavioral analysis. Decrease barriers to access of ASD/IDD services by increasing interpretation services as needed. Establish ongoing collaboration with the Rockwall ISD, Helping Hands, the ARC, Lake Point Special Needs Services and Texas A&M Commerce. Baseline Data of Project as applicable/starting Point: Currently there is a lack of dedicated ASD services and supports for young children and transitional-age youth with developmental disabilities in Rockwall County. Lakes Regional IDD Behavioral Services currently utilizes 1 BCBA to provide approximately 3 hrs per month maximum of in-home ABA therapy (per person) to a caseload of twenty (20) ASD/IDD individuals throughout 12 counties. Lakes Regional s IDD Behavioral Outreach waiting list comprises 60 individuals with Autism and related IDD. The expected wait time for services is approximately 6 months. Intra-agency needs survey reveals 100(+) clients/families indicated a need for Behavioral Outreach Services. Historically, 50-75% of individuals with autism also have some degree of mental retardation (Freeman, 1997: Rapin, 1997). Chasson, Harris and Neely (2007) found that after three years of early intensive behavioral intervention that the state could save on average $84,300 per child in special education costs. Combined with actual costs incurred by families, this could result in a savings of $208,500 per child. They also suggest that the up-front costs of implementing ABA programs will be covered within five years. Challenges/Community Need: Accessibility to ABA is limited to those who can afford to pay for it out of pocket, or those who have private insurance which covers Applied Behavioral Analysis. Even with private insurance, many parents pay $12,000 - $15,000 out of pocket per year in deductible and patient co-pay percentages. The 81st Texas legislative session established requirements for insurance coverage for ABA therapy for children from the age of diagnosis through the tenth birthday, but many insurance companies have discovered methods to avoid coverage for this underserved Page2

3 Medicaid and CHIPS do not cover ABA therapy for Outreach or Day Treatment. Autism-specific treatment in outlying and rural areas to persons of cultural diversity that are low-income and under-insured is often limited, fragmented, costly or inaccessible. Lack of infrastructure to meet targeted treatment needs of young children and transitional youth with ASD/IDD. As a result of a needs assessment conducted in April 2010, IDD Lakes services secured (1) Applied Behavioral Analysis and launched a Behavioral Outreach program that spans 12-counties. The BCBA maintains a caseload of individuals with ASD/IDD. In most instances the BCBA is limited to providing (1) in-home/community session per month to individuals and families that require more frequent treatment sessions. Inter-related Projects 11.2 Enhance service availability With development, the Autism Connections Center Day Treatment and Outreach Program plans to extend community services to include training, consultation, and crisis/outreach response services in the community or site-based treatment setting. Justification of Project Valuation: The Texas Education Agency reports that there were more than 4.7 million children and young adults in public schools as of October Approximately 456,600 (about 9.6 percent of the total) were receiving special education services. Of these, 26,003 individuals had an Autism Spectrum Disorder diagnosis, representing 0.55 percent of the total number enrolled in public schools. More recently released research (Dawson, Geraldine, ) estimates that the cost for treating/providing care for persons with Autism (most of it spent on caring for adults with Autism in institutional settings) is 136 billion annually. In Texas, children and adults with Autism requiring institutionalization cost the state of Texas between $ per day ($39,129 annually) and $ per day ($151, annually) (depending on level of need), long term. For a twenty year institutionalization at the highest rate, the state of Texas will pay $3,029,792. Children with autism or PDD who participate in early intensive Intervention based on the principles of applied behavior analysis (ABA) achieve normal or near-normal functioning (Lovaas, 1987; McEachin, Smith, & Lovaas, 1993) or significant gains in measured intelligence or other aspects of development (Anderson, Avery, DiPietro, Edwards, & Christian, 1987; Birnbrauer & Leach, 1993; Fenske, Zalenski, Krantz, & McClannahan, 1985). Page3

4 PROJECT/INTERVENTION TITLE: IDD/ASD Treatment and Behavior Intervention Center RHP Performing Provider Responsible for the Project: Center Provider No: TPI Year 2 Year 3 Year 4 Year 5 1. Process Assess need and capacity for intensive treatment and behavior intervention for the target population with ASD in the targeted area, to reduce use of more expensive services in a specified setting. Needs assessment. Assessment Rationale: Early intervention and supports can reduce unnecessary use of more expensive services for this 2. Process Develop business operations plan to outline: A) Obtain building space for clinic B) Purchase necessary clinic equipment/materials; C) Develop implementation schedule for hiring and training staff. Completed business operations plan. 3. Process Hire personnel and/or teams to support and manage the project. HR documentation and records. HR Records Rationale: Increasing availability of service providers will reduce unnecessary and costly admissions. 4. Process Participate in a collaborative in the community. MOU s with collaborative agencies or established documentation of participation MOU s or established participation document Rationale: Increasing community collaboration decreases barriers to care for the target 5. Process Measure: Implement intensive treatment and behavior intervention program for the target population with ASD in the targeted area. Submission of implementation plan and evidence of implementation. Implementation plan and implementation documentation 6. Improvement health care encounters by 20% compared to baseline Clinic Rationale: Expanding behavioral health care capacity reduces unnecessary and costly admissions. 7. Improvement health care encounters by 30% compared to baseline. Clinic Rationale: Expanding behavioral health care capacity reduces unnecessary and costly admissions 8. Improvement health care encounters by 40% compared to baseline. Clinic Page4

5 Business Plan Rationale: Establishing a business plan links project goals to budgetary need to ensure successful project completion and an increase in behavioral health encounters for target population Rationale: Expanding behavioral health care capacity reduces unnecessary and costly admissions Funding (Max) : Funding : Funding: Funding: Year 2 Estimated Total DSRIP Funding (add each milestone): Year 3 Estimated Total DSRIP Funding: Year 4 Estimated Total DSRIP Funding: Year 5 Estimated Total DSRIP Funding: TOTAL EST DSRIP FUNDING FOR 4 YEARS (add amounts of Funding for Years 2-5): Estimated State Match (IGT) Estimated Available State Match (does not need to match Est DSRIP Funding): Estimated Available State Estimated Available State TDB Pending Estimated Available State Source of State Lakes Regional MHMR Page5