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A Blog by Art Dykstra


From My Pad to Yours is about leadership and other topics, and is written by Art Dykstra, the CEO of Trinity Services, Inc.

Some Solutions to the Crisis in Services for People with Disabilities

by Art Dykstra | May 10, 2017

In last week's blog entry, I painted a bleak though accurate picture of what human service organizations are facing as they try to serve people with disabilities in Illinois. Fortunately, we do not have to remain mired in these depressing facts. Many of those who face these difficult conditions have offered a variety of excellent recommendations to help ease this service crisis. One initiative already made by the Illinois Crisis Prevention Network involves 17 recommendations presented to the Department of Human Services and the Developmental Disabilities Division in this state. They are as follows:

  • Community providers are experiencing increased difficulty in recruiting direct support staff, primarily because of the low entry wage level. This clearly impacts the ability to serve those with behavioral and medical challenges.
  • A number of problematic living situations leading to crisis service referrals are the result of incompatible housemates living together. A survey across providers and service coordination agencies should be conducted to determine the scope and extent of this situation.
  • The Illinois service and support system should consider partnerships with hospital or treatment centers to offer short-term inpatient stabilization for people experiencing a psychiatric crisis or in need of significant medication adjustments.
  • An integrated information tracking system should be fully implemented across the service coordination system that would allow for a better understanding of available resources and needed services statewide. This system would be used to match a person with complex behavioral or medical needs with a provider that has the necessary experience, supports and services.
  • The Illinois service and support system should include specialized homes for people with high intensity or high frequency behavioral challenges, especially for those whose behavior decreases the quality of life for their housemates.
  • People living in community residential settings with medical needs, especially under the CILA program, would benefit from the presence of additional registered nurses.
  • Specialized CILA homes for people with complex medical issues would allow people to remain in the community and decrease admission to nursing facilities.
  • With additional funding, service coordination agencies should employ a senior staff member with knowledge and expertise in behavioral programming. This person could serve as an internal resource to other staff.
  • A number of people with challenging behavior have been discharged from SODCs to community providers who lack the capacity or experience to serve them. Greater attention must be paid to the matching-choice process to ensure successful residential placement.
  • Many young adults have aged out of the DCFS system and entered the adult DHS-DDD system. Because of their behavioral issues and impaired judgement, a number of these people would have benefited from an appropriate level of appointed guardianship. The DCFS/DHS-DDD transition process should address this issue in a timely manner.
  • Legislation should be introduced to create a fund within DHS-DDD to reimburse providers for the cost of extensive property damage and destruction caused by people with challenging behaviors. Current statistics indicate that 46% of the people referred to ICPN engaged in such behavior.
  • There is much unevenness across the system with respect to the appropriate use of emergency departments and community hospitals. This issue also extends to short-term psychiatric hospitalizations. Efforts to address this situation could begin with a meeting of relevant stakeholders.
  • People who are dually diagnosed often benefit from structured psychosocial rehabilitation programs and individual therapy. Mental health providers should be encouraged to develop specialized day services for people with a dual diagnosis that would be available to people across provider agencies.
  • Hospitals often serve as the point of discharge for people who have significant behavioral and medical issues. Due to current rules and regulations, the person and provider cannot participate in residential visits, resulting in placements that may not meet the specific needs of the person. Rules and regulations should be modified to allow for more residential planning.
  • Major advances in the development and use of assistive technology have improved the lives of people with a wide range of developmental and intellectual disabilities. Funding based on financial need, specifically for assistive technology, should be sought for people and families.
  • Direct care staff are the greatest resource for a person, family and community provider. Ongoing training for direct care staff, in addition to their pre-service training, is essential to their professional development and growth, and reduces the likelihood of turnover while improving the quality of services provided. This additional training should be adequately reimbursed.

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