1 REPORT AND RECOMMENDATIONS OF THE NORTHWEST HABILITATION SERVICES TASK FORCE Prepared for the Missouri Mental Health Commission July 2014
A Change in Services through Marshall Habilitation Center (MHC) and Higginsville Habilitation Center (HHC) 2 Services provided through Habilitation Centers have changed over the past 20 years as a result of more options available to individuals and their families. MHC and HHC campuses were originally designed for a combined census of over 1,100 individuals, who lived directly on those campuses. MHC and HHC have provided community living options through the Home and Community Based Waiver for over 20 years. In September 2013, the combined campus census was 113. In September 2013, the combined community census was 141. Today there are many empty or sparsely used buildings between the campuses, particularly at MHC.
September 2013 Census of Marshall Habilitation Center (MHC) and Higginsville Habilitation Center (HHC) 3 Campus Community Total HHC 44 78 122 MHC 69 63 132 Total 113 141 254
Creation of the Northwest Habilitation Services Task Force 4 Given the changes in campus settings and national and state policies regarding how services should be delivered to people with Intellectual and Developmental Disabilities, the Mental Health Commission recognized the need for a thorough review of how services are delivered at MHC and HHC. The Commission believed that such a review should be guided by the people and communities most affected, and in September 2013 proposed the creation of the Northwest Habilitation Services Task Force. The Commission requested that the Task Force provide a redesign proposal no later than August 2014.
Charge of the Task Force 5 The Commission Requested Recommendations Regarding: The location and size of on-campus services as determined appropriate for those individuals in need of such services; The best configuration and administrative support for individuals on and off campus; How existing facilities should be used to achieve the above goals; How any freed resources should be used to enhance campus and community- based services in the Northwest area; and What should happen to state property no longer needed to operate redesigned programs.
The Task Force 6 The Task Force was established with 13 members with varied backgrounds and roles. The commencement meeting was held on October 8, 2013. The Task Force members agreed that meetings would be held twice a month and would alternate between the campuses of MHC and HHC. All meetings were considered open public meetings. AFSCME and SEIU were active participants throughout the process. Senator David Pearce, Representative Dean Dohrman and Representative Glen Kolkmeyer were engaged with the Task Force and participated in meetings and tours. In addition to open meetings, the Task Force met with individuals, staff, community members and other stake holders throughout the process.
The Task Force 7 The Task Force worked in four core phases: Touring both campuses and collecting information regarding their demographics, services, operation, needs and ICF/IDD regulations; Visiting homes in both communities and collecting information regarding their demographics, services, operation, needs and Medicaid Waiver Guidelines; Examining and discussing information collected; discussing various campus structure possibilities; discussing various service design options; and the impact all of these options would have on the individuals, staff and communities and other factors; and Preparing the final report and recommendations.
The Marshall and Higginsville Habilitation Centers 8 MHC and HHC Facts: Are located approximately 30 miles apart, connected by Missouri Highway 20. Provide similar services under both the ICF/IDD and Medicaid Waiver programs. Have similar administrative structures. Share several critical positions. Have a number of unique differences in physical structure and age of campus, as well as some program services. Are not locked facilities.
MHC Campus Information 9 Background MHC first opened its doors in 1901as the “Missouri Colony for Feebleminded and Epileptic”. It soon became a self sustaining community of approximately 1,100 people. Hospital Bakery Produce Farm Dairy Farm Fire Department and Security Department Employed 900 staff at its peak. In 1976, acquired ICF/MR Certification. In 1983, was renamed the Marshall Habilitation Center.
MHC Campus Information 10 Physical: 235 Acres 53 buildings totaling 589,494 square feet on campus 6 very large buildings no longer in use or functional 2 very large buildings used for administrative offices 34 groups homes with 14 in use in September 2013 Includes a large lake with several shelter houses Two baseball fields Gymnasium Tudor House – former superintendents house and MHC historical museum
MHC Campus Information 11 Services: 310 employees for ICF/IDD services, including 50 administrative and support staff shared with waiver and crisis programs Day habilitation and work skills center - manager shared with HHC Activities programs, including local community involvement Behavioral and psychology department - CBA shared with HHC Dietitian utilized from HHC Speech pathologist utilized from HHC Dentist shared with HHC Medical department with round the clock nursing on site and physician access Contract services: Physician, two nurse practitioners, psychiatrist, physical therapy, occupational therapy
MHC Home and Community Based Waiver Information (HCBW) 12 213 employees for HCBW services, including 50 administrative and support staff shared with campus and crisis programs Began providing HCBW services in 1991 18 homes in Marshall, Mo Currently assisting 20 individuals to find housing outside of Marshall
HHC Campus Information 13 Background HHC first opened its doors in 1956 as an educational branch of the Marshall State School and Hospital and was called the Higginsville State School and Hospital. In the early 1970’s, it was separated from Marshall and census peaked to 466. In 1968, the indoor natatorium was built. In 1976, a portion of the campus was certified by Title XIX (ICF/MR) with complete certification being acquired 1982. In 1983, the Mental Health Commission renamed Higginsville Habilitation Center. In 1991, Community Services Unit was established In 2008, HHC admitted first crisis admission.
HHC Campus Information 14 Physical: 190 Acres 16 buildings totaling 209,236 square feet on campus 6 group homes 3 dormitory buildings Administration and medical building Work skills building Day program and therapy services building Natatorium (indoor swimming facility) Gymnasium Dietary facility Laundry facility Maintenance facilities Canteen All buildings are in use today. Most are in good structural repair but some are in need of modifications that would significantly improve the services to the aging population now and in the future.
HHC Campus Information 15 Services: 274 employees for ICF/IDD services, including 37 administrative and support staff shared with waiver and crisis programs Day habilitation and work skills center – manager utilized from MHC Activities programs, including local community involvement Nursing staff around the clock Behavioral and psychological supports Dietitian shared with MHC Therapy department, including physical therapy, occupational therapy Speech pathologist shared with MHC Dentist utilized from MHC Behavior and psychology department - CBA utilized from MHC Medical department with round the clock nursing on site and physician access Physician and nurse practitioner on staff Contracted psychiatrist
HHC Home and Community Based Waiver Information 16 198 employees for HCBW services, including 27 administrative and support staff shared with campus and crisis programs. In December 1991, Higginsville Community Services was established as an integral part of Higginsville Habilitation Center’s organizational structure. In 1993, the Community Services Unit became its own unit of Higginsville Habilitation Center with its own staff. Supports branched out to persons living not only in Higginsville but to Warrensburg as the number of individuals choosing community supports was increasing rapidly. In 1998, the Community Services Unit became less closely tied to Higginsville Habilitation Center’s operation. A director was appointed. It was given the name Northwest Community Services. Shortly thereafter, it became the supporting agency for more than 50 individuals in Higginsville, Independence, Warrensburg, Corder, Lexington and Boonville. In July 2002, NWCS resumed its directorship once again through Higginsville Habilitation Center but remained dedicated to the HCBW Principles.
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