PEIMS Database 10/29/04
Categories are not mutually exclusive
87 1,318 97 131 2,004 258 698 12,807 0 2000 4000 6000 8000 10000 12000 14000 ORTHOPEDIC IMPAIRMENT OTHER HEALTH IMPAIRMENT AUDITORY IMPAIRMENT VISUAL IMPAIRMENT MENTAL RETARDATION EMOTIONAL DISTURBANCE LEARNING DISABILITY SPEECH IMPAIRMENT
Data from the CARE Database
The Client Assignment and Registration (CARE) System registers and tracks
individuals receiving services from Texas Health and Human Services Commission (HHSC) through the mental health and mental retardation service delivery system. The database is used as the common information system to record, collect, and generate reports concerning services and supports provided for people with disabilities within this system. A central mainframe CARE system database is the operational repository for statewide individual information. A separate Consumer Analysis Data Warehouse contains completed and static operational information for reporting purposes. (Willetta Stevenson-Leach, personal communication). For purposes of this report, a file was created that included all individuals who had been diagnosed with an ASD, using DSM criteria, between October 1999 and August 1, 2005.
When interpreting these data, it is important to remember that they reflect an unduplicated count of individuals recorded in the CARE system who received services between October 1, 1999 and August 1, 2005. It does not include individuals on interest lists, or individuals who receive private mental health/mental retardation services. Texas was in the process of combining mental retardation services with other health and human
services at the time of this report, and the agency databases were not fully integrated. Therefore, the numbers shown here represent only persons served by an MRA during the defined period of time. Because the CARE database was not integrated with other agency databases, information about clients who have an ASD and have received services through another agency are not included in the CARE database, and thus not included in this count.
What is the prevalence of ASD by geographic region in Texas?
Between October 1, 1999 and August 1, 2005, 5,664 individuals were listed with an ASD as their latest diagnosis in the CARE database. The largest numbers of individuals were found concentrated in Harris County (n=1374), Dallas Metro Care (n=497), Tarrant County (n=481) and the Center for Health Care Services in San Antonio (n=468). These four sites account for approximately half the cases in the system. (Note: Those individuals who were located out-of-state, deceased or whose latest county of residence was unknown were eliminated from this analysis.) The following table ranks the Mental Health/Mental Retardation (MHMR) centers from those with the lowest numbers of individuals to the highest. In interpreting this data, it is important to remember that most of the MHMR
centers serve multiple counties in the state; all 254 counties of Texas are served by one of these centers. The chart identifies the city where the MHMR center is headquartered; however, the offices may not be centrally located in a very large catchment area. While it is not surprising that the MHMR centers in larger metropolitan areas served greater numbers of individuals with ASDs, it is interesting that 15 centers served fewer than 50 individuals over the six year period in question. To provide a perspective on the total population served by the catchment areas of the MHMR centers, the total number of people served between September 1, 2004 and August 31, 2005 is provided. It is important to remember, however, that the number of individuals with ASDs reported in the chart is the total number served between October 1, 1999 and August 1, 2005.
Table 2. Individuals with a diagnosis of an Autism Spectrum Disorder who Received Services from the Texas Health and Human Services Commission from October 1999 through August of 2005
# of Clients Total # of
Community Centers (headquartered in) w/ASD
Served
Clients Served 9/1/04-
10/99-8/05 8/31/05
Central Plains Center (Plainview) 10 164
Camino Real Community MHMR Center (Lytle) 35 166
Gulf Bend MHMR Center (Victoria) 14 198
MHMR Services of Texoma (Sherman) 28 199
Northeast Texas MHMR Center (Texarkana) 23 219
ACCESS (Jacksonville) 21 245
Border Region MHMR (Laredo) 51 294
Pecan Valley MHMR Region (Stephenville) 41 302
Coastal Plains Community MHMR Center (Portland) 37 341 Central Counties Center for MHMR Services (Temple) 66 348
The Center for Life Resource (Brownwood) 0 365
Lifepath Systems (McKinney) 52 393
West Texas Centers for MHMR (Big Spring) 28 399
Helen Farabee Regional MHMR Center (Wichita Falls) 35 429 Permian Basin Community Centers for MHMR (Midland) 34 451
Tri-County MHMR Services (Conroe) 98 451
Andrews Center (Tyler) 73 458
Gulf Coast Center (Galveston) 82 550
Sabine Valley Center (Longview) 80 594
Lakes Regional MHMR Center (Terrell) 73 620
Texas Panhandle MHMR (Amarillo) 55 719
MHMRA of Brazos Valley (Bryan) 48 729
MHMR Services for the Concho Valley (San Angelo) 36 755
Tropical Texas Center for MHMR (Edinburg) 216 780
Spindletop MHMR Services (Beaumont) 148 909
Hill Country Community MHMR Center (Kerrville) 135 939
El Paso Community MHMR Center (El Paso) 195 965
Burke Center (Lufkin) 70 1,043
MHMR Center of Nueces County (Corpus Christi) 98 1,046
Betty Hardwick Center (Abilene) 43 1,046
Heart of Texas Region MHMR Center (Waco) 81 1,109
Bluebonnet Trails Community MHMR Center (Round Rock) 164 1,135
Lubbock Regional MHMR Center (Lubbock) 67 1,197
Denton County MHMR Center (Denton) 83 1,362
Texana MHMR Center (Rosenberg) 214 1,489
Austin-Travis County MHMR Center (Austin) 252 1,717
Dallas MetroCare Services (Dallas) 497 2,405
MHMR of Tarrant County (Fort Worth) 481 2,487
Center for Health Care Services (San Antonio) 468 2,767 MHMR Authority of Harris County (Houston) 1,374 3,456
TOTAL 5,664 35,922
What are the differences in ASD prevalence by gender?
Seventy-seven percent of the individuals identified with an ASD diagnosiswere male and 23% were female.
Figure 14 Gender Care Database N = 5664 77% 23% Male Female
What are the differences in ASD prevalence by race/ethnicity?
Half of those diagnosed with autism in the CARE system were non-Hispanic Whites. One fourth was Hispanic, 18% were African-American and the remaining 6% were other ethnic/racial groups.
Table 3. Race/Ethnicity of Individuals with an ASD Diagnosis in the CARE System
Race/Ethnicity Percent of individuals with
an Diagnosis of ASD Percent of All Texans
Asian 2.6 2.7 Black 18.3 11.5 Hispanic 25.8 32.0 Indian 0.1 0.6 Non-Hispanic White 49.9 39.0 Other 3.1 14.2 Data for all Texans taken from the 2000 Census at http://quickfacts.census.gov
What are the differences in ASD prevalence by type of services received or interest list status?
Community MHMR centers are locally staffed and governed by a local board of trustees. The centers are responsible for the provision of a wide range of services as a condition for receiving state funds. These services include case management, emergency services, medical treatment, and respite care. Other services that may be provided are work- related activities including vocational training, vocational assessments, sheltered workshops, supported work programs, and job placement. Short-term and long-term residential care and developmental programs may also be a part of services. Eighty-three percent of individuals with an ASD diagnosis received services from a MHMR center. Forty-five percent received Medicaid-funded Mental Health/Mental Retardation case management or Mental Health rehabilitation services through a MHMR center. Less than 10% were listed in other programs. Only 6 % were served in state operated mental retardation facilities, 4% in state operated mental health facilities and 8% in a community Intermediate Care Facility/Mental
currently enrolled or on the interest list for mental retardation services.
The interest lists consist of applicants for community-based services through the Community-Based Alternatives (CBA) program, Community Living Assistance and Support Services (CLASS) program, Deaf/Blind with Multiple Disabilities (DB/MD) program, Home and Community Services (HCS) program, and the Medically Dependent Children’s Program (MDCP). These individuals have not been determined to be eligible for services, but as funding is increased to serve more people in these programs, eligibility is determined and applicants are enrolled.
Figure 15.