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Delivery of Services to Mentally Retarded Children and Adults in Five States

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Delivery of Services to Mentally Retarded Children and Adults in Five States DOCUMENT RESUME ED 052 578 EC 032 759 AUTHOR Mayeda, Tadashi A. TITLE Delivery of Services to Mentally Retarded Children and Adults in Five States. INSTITUTION President's Committee on Mental Retardation, Washington, D.C. PUB DATE Jan 71 NOTE 151p. EDRS PRICE EDRS Price MF-$0.65 HC-$6.58 DESCRIPTORS *Mentally Handicapped, Program Descriptions, *Services, State Legislation, *State Programs, *State Surveys ABSTRACT The report describes the delivery of services to the mentally retarded in the states of California, Colorado, North Carolina, Ohio, and Washington. Reported are such data as number of residents in state institutions and per 100,000 population, number of 24-hour car- community placements, enrollees in special education programs and sheltered workshops, and costs of each. A program model is presented and used as a gauge of the effectiveness of state programs. No one state ranks consistently high or low in all categories of service. Rather, a high-low randomness is evident among the states and among departments and agencies in any one state. Following a discussion comparing the planning, coordination, and organization of services in the five states, each state program is examined. The following topics are covered as they relate to services for the mentally retarded: demographic data, local governments and districts, revenue and expenditures, state organization, planning and planning coordination, legislation, and the various types of services provided (residential institutions, community centers, day care sheltered workshops, rehabilitation, medical services, social services, special education, and others). (KW) EC032759 c0 AUG 1 1871 ti tlr. 14'N o Delivery of Services to Mentally Retarded Children and Adults in Five States eAfrAt The President's Committee on Mental Retardation Washington, D. C. 20201 c0 EC032759 tr% nJ i.t1 iCS 'LW DELIVERY OF SERVICES TO MENTALLY RETARDED CHILDREN & ADULTS IN FIVE STATES U.S. DEPARTMENT OF HEALTH. EOUCATION & WELFARE OFFICE OF EOUCATION THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OR OPINIONS STATED DO NOT NECES- SARILY REPRESENT OFFICIAL OFFICE OF EDU- CATION POSITION OR POLICY Prepared for the President's Committee on Mental Retardation (Contract No. HEW-03-70-113) by Tadashi A. Mayeda Ontario, California January, 1971 TABLE OF CONTENTS Page Section Section I Introduction 1 Section II Program Model 4 Section III Planning, Coordination and Organization 9 Section IV State Programs 26 1.California 32 2.Colorado 60 3.Ohio 78 4. North Carolina 103 5. Washington 1.27 LIST OF ILLUSTRATIONS Figure No. pace Figure 1. General Program Objectives 6 Figure 2. Concept of Providing Care 10 Figure 3. The Planning-Implementation Cycle 13 Figure 4. Regional Configurations 15 Figure 5. Estimated Program Requirements 17 Figure 6. Key Factors in Planning and Delivering Service 19 Figure 7. Resources 21 Figure 8. Relationships of State and Local Organizations 23 Figure 9. Area, Population, and Income 29 Figure 10. State Services in Selected Categories 30 ii4 SECTION I - INTRODUCTION A six-month study and analysis of stage systems for delivering services to mentally retarded children and adults in five states was conducted on behalf of the President's Committee on Mental Retardation during the early and latter months of 1970.The objective of the study was to understand the problems and interpret the needs of state agencies and departments in providing diversified and integrated services to the mentally retarded. The study was conducted in California, Colorado, North Carolina, Ohio and Washington. These states were chosen because of their variations in size, population, population density per square mile of land, revenue, expenditure obligations, legis- lative mechanism t,state and local government relationships, and various other factors which describe the environment in which service programs for the mentally retarded are developed. The study revealed that the five states have a high-low scattering of capabilities. No one state ranks consistently high in all categories of service nor does another rank consistently low. An up-and-down randomness appears among the states and sometimes among agencies and departments in any one state. The capabilities to which the study was addressed included such numerically definable entities as the number of residents in state institutions, the number of residents per 100, 000 population, the number of 24-hour care community placements, the number of such placements per 100, 000 population, enrollees in special education classes, the census of sheltered workshops, and the costs associated with each. -2- Most of these data areavailable and the states can beranked according to statistical and data have to accomplishments. However,statistics are not always meaningful be interpreted in the contextof the concept of care beingdeveloped by the state. Two states, for example,hold to the premise that a seriesof small institutions dispersed throughout the states canprovide a service in addition tothat which can increase its overall be provided by communityfacilities.One of these states plans to institutional census; the otherplans to reduce census slightlybelow current levels. The remaining three states holdto the view that institutionalizationis a state facility is undesirable and thatresidence in a facility locatedwithin a community offers greater promise to theindividual.In one case, therefore, theinstitutional census Statistics should be will rise.In the other four, the overall censuswill decline. interpreted accordingly. numerical terms. For The study also addressedcapabilities not easily described in example, the statistics of servicesbeing provided to the mentallyretarded are hazy States cannot ire. the areas of welfare,rehabilitation, and pre-school programs. accurately count the numbersof mentally retarded personsreceiving welfare services. Additionally, rehabilitation andpre-school services to the mentallyretarded are discharged from only partially accurate.Statistics are valid only for those persons state mental retardationfacilities who receive services fromwelfare placement groups, for those personsenrolled in sheltered workshops,and for those children in pre-school classes known tobe developmentally deficient.Unless the individuals retardation is a require- are clearly identified asbeing mentally retarded and mental Labeling for the sole ment for enrollment, noactual sei:vice counts can be made. that it is unlikely that purpose of determiningeligibility is so patently undesirable complete statistics will ever beavailable. The study relied to a certain extent onstatistics. To a greater extent,it relied on model described in the following a comparison ofstate activities with the program section. The purpose of thecomparison was to find out where stateservices were number of strong and where they werelacking or weak. The study revealed a promising state ventures onbehalf of the mentally retarded.These are not listed as such in anysingle sectiou but are. interspersedthroughout the report. -3- Despite the fact that all states have made commendable progress in providing services to the mentally retarded particularly during the past ten years, their ventures have been limited to only a part of the broad front of the problem. In the period before the birth of a child, more has to be done with monitoring or intervening in high risk situations. Daring the period between birth and school years, casefinding should be more vigorous and intervention programs should be mounted for all children considered to be at risk. During the school years, a stronger tie should be developed between the school, the community facility and the parent. The parent should be recognized and developed as a strong resource. For a problem as complex as mental retardation all nursery, pre-school, and special class teachers must be trained and certified to teach these children.Training should be offered to foster b.ome parents and all other caretakers of mentally retarded children. Youth and young adult programs must be strengthened because of the many transi- tional problems that appear at this time. Very often, youths are too old for school but not yet ready for anything else.Sheltering programs must be broadened.In all aspects, adult programs must be expanded. Above all, the states must be encouraged to attack the problems of the inner city, rural areas, and the migrant populations.All states have reported difficulties in these areas despite efforts to the contrary. On these and other crucial problems, the states need assistance. 7 -4- SECTION II - PROGRAM MODEL The Panel, commissioned by the President in the early 60's to look into the lack of attention of the nation to the problems and needs of the mentally retarded or those who were exposed to situations potentially leading to developmental deficit, provides a. guideline for the study of delivery of service programs. The Panel's report to the Presidententitled, "A Proposed Program for National Action to Combat Mental Retardation" laid out the fundamental strategy along a broad front for an attack against the problem. Almost ten years later, that strategy appears to sound and is used, in this report, as a gauge or theeffectiveness of state programs. The Panel's strategy covered the following subjects:(1) research in the causes of retardation and in methods of care, rehabilitation, and learning; (2) preventative health measures; (3) educational programs and enriched programs
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