"…You feel like a mule sometimes, like everything is on your back and just (doing) one thing (after) another is so hard…In a period of time of about five years, I honestly thought I was going to go insane, because all I was doing was this, just running from one spot to another. Doing this is tough."
"I think one of the most clear examples…is when you're on an airplane and they tell you, if the masks drop down, put it on your face first and then assist the person who's with you…we're so busy getting the mask on the other guy that most of us are suffocating under the pressure of what's going on because we either don't have time, can't find time, don't have the support, don't know about the support."
— statements from caregivers attending the Capital Area Council of Government focus group
Caregivers and providers participating in the focus group sessions indicated that they often found it difficult to obtain integrated information and to coordinate services for the care receiver. Many focus group participants indicated that they were often required to complete multiple forms and provide the same information for several agencies because agencies do not share information. They also reported that:
In response to many of these issues, DADS is taking steps to help identify ways to improve coordination of services at the local level to ensure greater accessibility to DADS programs and other services and supports .
In December 2005, working closely with community stakeholders, DADS began an initiative to design a new integrated and comprehensive service delivery system for Texans who are aging and/or are in need of long-term care disability supports and services. As part of this project, DADS staff applied for and received a three-year grant to pilot up to three ADRCs in Texas through a grant jointly funded by the AoA and the Centers for Medicare and Medicaid Services. The purpose of ADRCs is to organize, simplify and ensure access to aging and disability services for older individuals, individuals with disabilities and those with mental retardation, and the caregivers who care for them.
ADRCs provide information, referral and counseling for public and private pay individuals, community awareness of public and private long-term care options, help for individuals in assessing their eligibility for benefits, case management, coordination with Medicaid eligibility determination, and individual plans for long-term care needs. ADRCs can also provide short-term service coordination, working with individuals to develop a person-centered plan and to assist in the selection of services and supports and providers. DADS began with three ADRC pilot sites — one serving Bexar County, one located in Milam County that serves a seven-county area, and one serving Tarrant County. The project expanded in 2009 to include sites in five additional areas of the state; one each in Houston/Harris County, Dallas County, Lubbock County, East Texas (serving six counties), and North/Central Texas (serving four counties). Also in September 2009, DADS received from AoA a new grant to expand the ADRC program. Funding will provide for the establishment of a new ADRC site (to be determined in 2010), as well as develop a five-year plan to make ADRCs statewide in Texas.
Beginning in 2007, staff from DADS' Access and Intake division worked with AAAs, mental retardation authorities, and regional and local services staff to plan and convene a series of community roundtables in 16 locations throughout the state.
The goal of these roundtables was to determine what can be done at the state and local level to integrate these agencies' services (and access processes) in a way that makes the most sense to consumers. The series continued throughout 2008 and was completed in the spring of 2009. The roundtables have assisted DADS in finding ways to coordinate services for shared stakeholders (including caregivers) between the participating agencies.
Examples of local commitments made by agencies at several of the roundtables included memoranda of agreement, which streamlined referral protocols among the DADS local partners, including:
These initiatives should help increase consumer awareness of available services, and help Texas' state and local services become more accessible.
Similarly to the identified need for information, stakeholders participating in the focus groups recognized the importance of coordinating needed services for care receivers and caregivers. Experiences with repetitive application processes and lack of communication between service providers led participants to put forward the following recommendations:
Updated: April 11, 2012