Missouri's Olmstead Implementation

Activity No. 3:  Identify the number of individuals with disabilities in the State of Missouri that are institutionalized.

Department of Mental Health, Division of Alcohol and Drug Abuse
Department of Mental Health, Comprehensive Psychiatric Services
Department of Mental Health, Division of Mental Retardation/Developmental Disabilities
Department of Social Services, Division of Aging

This activity focused on identifying the number of individuals with disabilities in the State of Missouri that are institutionalized.  Each of the agencies that participated in this Commission and its activities did not have individuals in institutional settings.  The Division of Aging in the Department of Social Services paid for services in institutional settings.  The Department of Mental Health also funded institutional programs for the individuals they served.  The following describe these programs. 

One critical finding was that agency staff need to better define the term "institutionalization" and review how to more precisely measure these placement activities.  The Commission found that there is a wealth of data on state operated facilities, but incomplete or conflicting information on publicly funded placements in private facilities.  State agencies must act aggressively to review this population and the programs that serve them.

Department of Mental Health - Division of Alcohol and Drug Abuse

The Division of Alcohol and Drug Abuse projects that 9,187 will be served in community-based residential rehabilitation during FY'01.  In residential treatment programs, a person receives around-the-clock care, seven days a week.  Residential rehabilitation includes assessment, individual and group counseling, family counseling, participation in self-help groups, and other supportive measures designed to help a person live an alcohol and drug-free life.

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Department of Mental Health - Comprehensive Psychiatric Services

The state-operated psychiatric facilities were treating 1429 individuals on June 1, 2000.  Of these individuals, only 319 were classified as either voluntary or voluntary by guardian.  Over two-thirds of the 319 individuals were committed by guardians (221 individuals or 69.2%) and 98 (30.8%) had committed by themselves.  Of those committed voluntarily 53 (54.1%) have resided in the facility for less than six months and 44 (45.9%) for greater than six months.  Of those who are committed by guardians, the majority had resided in state-operated inpatient facilities for more than six months (55.7%).  For those under 18 years of age, however, 89.2% (73 out of 82 youth) had been in the state-operated facility for less than six months.  Table 1 describes these findings.

Table 1. State-Operated Inpatient Facilities (as of June 1, 2000)"
Comprehensive Psychiatric Services

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Department of Mental Health - Division of Mental Retardation/Developmental Disabilities

The Division of MR/DD operates six habilitation centers throughout the state which provide institutional care for persons with mental retardation or developmental disabilities.  During the past year, 1,322 consumers resided in these facilities.  Figure 1 presents the FY 2000 consumer counts for habilitation centers.  Approximately one-fourth of the residents reside in each of three habilitation centers:  Bellefontaine (29.2%),  Marshall (25.6%) and St. Louis DDTC (24.4%).

A comparison of those living in institutions with those in community placement can be found on Table 2.

Table 2. Persons Served in Institutional and Community Settings
Division of Mental Retardation/Developmental Disabilities

The budget allocations for FY 2001 for state habilitation centers can be found on Table 3.

Table 3. Budget Allocations for FY'01 for State Habilitation Centers.
Division of Mental Retardation/Developmental Disabilities

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Department of Social Services - Division of Aging

The total number of Department of Social Services Division of Aging Medicaid Recipients in facilities is 26,111. The core appropriations for the current year were $454,890,068. Of these funds, 31.0% were from state General Revenue ($140,888,000), 61.2% from federal sources ($278,402,068) and 7.8% from other state funding ($35,600,000).  See Figure 2.

[ Index | Acknowledgements | Introduction | Activity 1 | Activity 2 | Activity 3 | Activity 4 | Activity 5 | Activity 6 | Activity 7 | Activity 8 ]

[Olmstead]