An Overview of the Department of Assistive and Rehabilitative Services (DARS)

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1 An Overview of the Department of Assistive and Rehabilitative Services (DARS) House Committee on Human Services Veronda L Durden, Commissioner February 16, 2015

2 Mission and Responsibilities Mission To work in partnership with Texans with disabilities and families with children who have developmental delays to improve the quality of their lives and to enable their full participation in society. DARS provided services to almost 530,000 Texans in FY ,627 Texans were employed through our Vocational Rehabilitation services 43,411 Texans received communication access services through the Deaf and Hard of Hearing Services 119 Texans operated businesses in the Business Enterprises of Texas program, producing more than $67.5 million in sales 3,916 Texans were screened and 125 received treatment through the Blindness Education, Screening and Treatment program 69,740 children were referred for Early Childhood Intervention services 295 children were served in the Autism Program 323,528 SSI/SSDI disability cases were processed by Disability Determination Services Of the agency s 3,178 FTEs, we employ more than 2,800 staff located in 146 field offices around the state. 2

3 DARS Organization 3

4 Early Childhood Intervention Early Childhood Intervention (ECI) serves children birth to 36 months of age and their families in all Texas counties through 49 local contractors Texas has provided early intervention services for children for 33 years ECI became a state program in 1981, 5 years before the federal program was initiated ECI eligibility is based on a Medically diagnosed condition Developmental delay Hearing or visual impairment ECI services enhance the development of infants and toddlers with disabilities and minimize their potential for developmental delay. The services Are based on an individualized plan developed by a multidisciplinary team Are family-centered and delivered in familiar settings Include assistance to transition to the public school system Reduce educational costs by minimizing the need for special education services as children with disabilities reach school age 4

5 Autism Program Autism Spectrum Disorder (ASD) is the fastest-growing developmental disability in the United States The Autism Program was created in 2007 through a transfer of the Health and Human Services Commission at the direction of the Governor and Legislative Budget Board The program serves children with ASD through contracts with community organizations in eight areas of Texas Austin, Corpus Christi, Dallas, El Paso, Ft Worth, Houston, Rosenberg, and San Antonio The Autism Program serves children who are Three through fifteen years of age Have a diagnosis on the autism spectrum The Autism Program provides two classifications of applied behavioral analysis (ABA) treatment comprehensive and focused Comprehensive treatment treats multiple developmental and behavioral needs Focused treatment targeted to address specific outcomes instead of all developmental needs of the child 5

6 Autism Program DARS awarded a contract to Texas State University to conduct an innovative pilot project to provide Responsive Interaction Parent Training (RIPT) to the parents of children ages 3 through 15 who have ASD RIPT teaches parents special ways to interact with their child with an ASD and evaluates the parent s efforts to provide additional instructions Parents will be empowered to positively impact the learning, language development, and social behavior of their children There is no cost to families to participate in the pilot Initial pilot phase runs from October 15, 2014 through August 31, 2015 DARS will contract with an independent evaluator to validate the outcomes and effectiveness of the pilot If successful, the intervention can be replicated at a lesser cost than other treatments for children with an ASD 6

7 Autism Program HHSC Executive Commissioner Janek directed transfer of the support for the Texas Council on Autism and Pervasive Developmental Disorders (Autism Council) and the Texas Autism Research and Resource Center (TARRC) from DADS to DARS effective September 1, 2014 The TARRC was created by HB 1574, 81 st Legislature, Regular Session, 2009, to coordinate resources for individuals with an ASD and their families TARRC s primary purposes are to Disseminate information and research on ASD Conduct training and development activities for persons who may interact with an individual with an ASD in the course of their employment Coordinate with local entities that provide services Provide support to families affected by ASD DARS will create an Office of Autism Services which will bridge the gap between the services of the TARRC, DARS programs, and other state agencies serving Texans with ASD with the policy and service coordination mandates of the Autism Council Consolidating autism services at DARS will increase the visibility of the function and consumer access to services Current staffing and funding levels would remain the same 7

8 Blind Children s Vocational Discovery and Development Program The Blind Children s Vocational Discovery and Development Program (BCVDDP) serves children, birth through age 22 who are blind or who have a severe vision loss, and their families The goal of the program is to ensure that children with blindness or a severe vision loss start early in developing the skills necessary to eventually lead independent and productive lives The BCVDDP Provides tools, equipment, and training to help children develop the confidence and competence needed to be an active part of their community Works closely with schools to monitor the child s progress Provides training in food preparation, money management, recreational activities, grooming, and other daily living activities Provides information and referral to families about other resources, including vocational rehabilitation The state of Texas has funded services for children who are blind since

9 Vocational Rehabilitation The Vocational Rehabilitation (VR) Program assists Texans with preparing for, finding, and maintaining employment The VR Program serves consumers who Have a physical, mental, or visual disability that is a substantial impediment to employment Require VR services in order to obtain or keep a job Are presumed to be able to benefit from services VR services include Counseling and guidance to plan and achieve vocational goals Training to learn job skills and appropriate work behaviors Training in skills of daily living for individuals who are blind or visually impaired Treatment and/or therapy to lessen or remove the disability Assistive and rehabilitation technology devices to improve functioning About 700 VR Counselors, located in DARS field offices across the state, provide direct services to consumers As part of the VR Program, counselors also provide transition planning services to eligible students with disabilities to assist with the transition from high school to work, training or higher education The Criss Cole Rehabilitation Center (CCRC) is a residential facility in Austin providing intensive training for VR consumers who are blind or visually impaired to develop the confidence, skills, and techniques needed to prepare for, find, or maintain employment 9

10 Business Enterprises of Texas Business Enterprises of Texas (BET) licenses persons who are blind to operate vending and food service facilities on federal, state, and other properties The program is carried out under the authority of the Randolph- Sheppard Act, enacted in 1936 The first BET facility opened at the Amarillo Post Office in 1936 and the Texas Commission for the Blind was appointed as the licensing agency for the program BET operates approximately 120 business facilities including Lackland Air Force Base (San Antonio) Internal Revenue Service snack bar (Austin) NASA Snack Bar (Houston) Alfred Hughes Prison Vending (Gatesville) 10

11 Independent Living Services The Independent Living Services (ILS) Program provides services to eligible Texans with significant physical or mental disabilities, including blindness, helping them improve their ability to function independently in their home and the community through Counseling and guidance Durable medical equipment Rehabilitation technology Independent skills training Group training to encourage self-confidence One-on-one in-home adaptive skills training Peer support development The state ILS program was created in 1978 and has remained consistent in its focus on self-advocacy and inclusion, as directed in the federal Rehabilitation Act of 1973 Services are provided by DARS staff across the state 11

12 Centers for Independent Living Centers for Independent Living are consumer-controlled, communitybased, cross-disability, non-residential, nonprofit organizations that Assist consumers to live independently in their communities Decrease dependence on family members and long-term government funded programs Improve the ability to perform activities of daily living Core services are Information and referral Independent living skills training Peer counseling Individual and systems advocacy To be eligible for services from a center, a consumer must have a significant disability that substantially limits the ability to function independently in the home, family, or community DARS provides funding for 15 of the 27 centers in Texas that currently provide services to people with disabilities in 157 counties 12

13 Comprehensive Rehabilitation Services The Comprehensive Rehabilitative Services (CRS) Program helps survivors of traumatic brain and/or spinal cord injuries regain functionality and independence CRS consumers must have a traumatic brain injury, a traumatic spinal cord injury, or both, and be At least 16 years old Medically stable Willing to participate in services The CRS Program was created in 1985 by the 69 th Legislature to provide inpatient medical rehabilitation CRS provides time-limited services through contracts with local providers and include In-patient Comprehensive Medical Rehabilitation - Medical experts provide consumers with therapy, medical care, and other help Outpatient Services - Therapists help consumers increase their ability to perform daily living activities through therapies including physical, occupational, speech, and/or cognitive rehabilitation Post-Acute Traumatic Brain Injury Services - These services help consumers deal with forgetfulness or difficulties in solving problems and other mental or thought issues related to their injury and are offered on a residential (overnight stay) and non-residential basis 13

14 Blindness Education, Screening, and Treatment Blindness, Education, Screening, and Treatment (BEST) provides blindness prevention services to adult Texans The program was created in 1997 and is funded entirely with a $1 donation from the initial application or renewal of driver s license and identification cards BEST services include Non-diagnostic vision screening services Treatment services for persons with qualifying eye conditions who do not have insurance or other resources to pay for services BEST eligibility treatment requirements Referral from physician or optometrist for eye medical treatment Texas resident A qualifying eye disease Vision screenings are provided at locations across the state and, if necessary, individuals are referred to an eye care professional for treatment 14

15 Deaf and Hard of Hearing Services The DARS Office for Deaf and Hard of Hearing (DHHS) works with Texans of all ages who are deaf or hard of hearing to eliminate communication barriers and ensure their equal access and participation in society DARS contracts with community-based agencies for services around the state for individuals who are deaf or hard of hearing, these Resource Specialist Contractor services include Providing information about and referral to community resources Helping consumers access technology and other services and programs they need to more fully participate in their communities and obtain or maintain employment Through the Board for Evaluation of Interpreters, DARS operates a voluntary interpreter certification program, which tests and rates sign language interpreters and issues certificates as appropriate The DARS Specialized Telecommunications Assistance Program (STAP) provides financial assistance for the purchase of specialized assistive equipment or services for Texans whose disability interferes with their ability to access the telephone network 15

16 Disability Determination Services Disability Determination Services (DDS) makes disability determinations for Texans with severe disabilities who apply for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) DDS is 100% funded by the Social Security Administration (SSA) Texans with physical and/or mental impairments apply for benefits at their local SSA field office, and their applications are forwarded to DDS, which determines whether the applicant is disabled, according to federal criteria SSA makes the final decision about whether a person is eligible to receive benefits 16

17 FY Accomplishments Early Childhood Intervention Implemented Rider 31 (SB 1, 83 rd Legislative Session) and modified family cost share (FCS) so families with adjusted gross income over 400% of the federal poverty level now pay the full cost of services, not to exceed 5% of their adjusted monthly gross income Completed report required by SB 1060 (83 rd Legislative Session) to evaluate the cost-effectiveness of the FCS provisions Conducted a quantitative and qualitative analysis of the costeffectiveness of the FCS system Results of the analysis demonstrated that the current FCS system is cost-effective as it generates revenue in excess of the cost of collection 17

18 FY Accomplishments Autism Implemented Special Provisions Related to All Health and Human Services Agencies, Section 57(a) (SB 1, 83 rd Legislative Session) to develop a plan to increase the number of children served in the program Following the recommendations of a University of Texas at Austin study DARS modified the Autism Program to include two applied behavior analysis (ABA) services for children Comprehensive ABA services for children aged 3-5 years are provided at a higher intensity level targeted to address multiple developmental delays Focused ABA services for children aged 3-15 years are provided at a lower intensity level targeted to address only one or two developmental delays at a much lower treatment cost In October, 2014, DARS awarded a contract to Texas State University to conduct a pilot project to develop and implement an innovative treatment service for the parents of children ages 3 through 15 who have an autism spectrum disorder (ASD) if effective the treatment services can be replicated at a lesser cost than other treatments Expanded service area to include El Paso and Corpus Christi 18

19 FY Accomplishments Comprehensive Rehabilitation Services (CRS) Implemented Special Provisions Related to All Health and Human Services Agencies, Section 58 (SB 1, 83 rd Legislative Session) to reduce the CRS program waiting list DARS conducted a cross-agency CRS project to improve cost projections and budgeting processes, increase accountability, manage the waiting list, enhance data collection and outcome measurement, implement improvements to service delivery structure, better define service array, develop a uniform rate setting methodology, and recommend a utilization review process Deaf and Hard of Hearing Services (DHHS) Implemented Special Provisions Related to All Health and Human Services Agencies, 57(b) (SB 1, 83 rd Legislative Session) Awarded two additional hearing loss resource specialists contracts, one each in the Gulf Coast and Lower Rio Grande Valley HHS Regions Increased the number of trainings for individuals who are interested in becoming certified interpreters and for certified interpreters interested in achieving higher levels of certification or specialty certification Developing a court interpreter performance test and medical interpreter test in FY

20 FY Accomplishments Centers for Independent Living (CILs) Submitted Rider 30 (SB 1, 83rd Legislative Session) report that included strategies to improve the measurement, collection, and reporting of outcome data related to CILs Disability Determination Services (DDS) Exceeded or maintained national performance standards while operating under a federal hiring freeze Vocational Rehabilitation (VR) Implemented a strategy for assisting federal contractors to hire individuals with disabilities 20