The Crisis for IDD in Washington State
The lack of home and community-based services and supports for our high-needs Autism and/or IDD population who experience significant challenging behaviors in Washington has reached a crisis. Individuals in the undeserved population and their families are often isolated, excluded and suffering in silence. Their high-needs and significant safety concerns exceed what the overwhelmed parents and family can provide, safely in the family home.
Parents are told to call 911 or take their loved-one directly to the Emergency Department.
Most EDs are not equipped to handle IDD population experiencing challenging behaviors.
If phychriactic in-paitient placement is deemed necessary:
No placement available
Inapprpriate hospital/medical stay
Physical ao pharmaceutical retraints used
Return home unsafe with overwhelmed parents
Cycle repeats
Traumatizing, impact individual family
“There is no where to go when my child is experiancing a behavior crisis” (fear, society does not care, hopelessness)
Out-of-state placement
Understand the Barriers
Long wait times for services
Access to services
Family circumstances
Readiness level
Loss of income/strain
Language barrier
Cultural consideration
Fear, overwhelmed, isolation
Sometimes the most helpful thing you can do is:
Witness
Remind parents they are not alone
Help them find their people
It’s not just you — these barriers are real
Help parents put their energy towards beneficial actions
Long haul persistence
Combat self-care
Mindfulness
Crisis Services: In Active Crisis
Limited for IDD population
Call 911
Emergency Department
Notify Providers: PCP, Specialists, Med provider, Therapists, Teachers, WISE CM, etc.
DDA and Medicard: Notify and involve case managers
Initiate community care planning meetings
Help parents underatnd, access, and maximize what is avalible
Persistence
Chain of command
Contact advocacy: understanding rights and possible legal support
Crisis line: limited knowledge of IDD population and often tell parents to contact DDA
In-paitient psychiatric facilities: Can’t always accommodates SCBs and high needs
PBMU Children’s : Short-term stabilization, not long-term therapy, cutoff age 17
CPS/DCYF might defer to DDA
Resources to Prevent Crisis- not in active crisis
ABA: Difficult to obtain. Long wait times. Be pleasantly persistent.
DDA: Maximize what is available
Depending on Waiver: Respite, Assistive, Technology, Caregiver hours, Community Guide, Specialized Habilitation, Staff and Family Counseling, BEST team if in King county, and Intensive Habilitation Service. Positive Behavior Supports have been dropped from all waivers. DDA can no longer provide this service.
Enhanced Respite limited offerings and long wait times.
RHCs (Fircrest, Yakima School) closed to children
Still very important to notify and involve DDA if family in crisis
WISe: Wrap Around with Intensive Services
Medicaid- eligible children, youth, and their families with intensive mental health care needs. Emerging Autism and IDD knowledge and expertise.
Medicaid
Medication management
Mental health therapy: CBT, DBT, Trauma-focused
Case Manager
Private Insurance
if enrolled in DDA, might have private plan as primary insurance
WA State Mental Health Referral Line: Outpaitient MH providers
Children’s Crisis Response Outreach System(CCORS)
King COunty only
Short-term, goal-focused, in-house
BeST Team/DDA
King County only
Short-term, goal-focused
Other Recommended Therapies
Speech, ACC, OT, Socila Skills, Community Participation
Education/School/IEP
Raise concerns and seek collaboration
Request Functional Behavior Assessment with corresponding Behavior plan
Washington Autism Alliance
PAVEWA.org
WA State Education Ombuds
Your local ARC
CPS Home Builders: mixed reviews from parents
Out-of-home placement
Medicaid, long wait, limited choice, out of state, limited accountability, out of state
Public School, long wait, limited choice, out of state
DDA, unable to provide residential if needs exceed safety in home community