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

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