December 2003 NACBHDD Newsletter
The monthly newsletter for the National Association of County Behavioral Health and Developmental Disabilities Directors
In this Issue...
NACBHD Organizational Update
Moving Ahead
The last newsletter (September 2003) described NACBHD’s accomplishments over the past few years, the very significant increase in membership, and a list
of achievements that have allowed NACBD to become highly visible in the national policy arena. Recently the Board of Directors unanimously voted to hire
a full-time director, a position that will afford the organization an even fuller time commitment to local and national policy issues, and to commence
final negotiations with the National Association of Counties (NACo) to house that director and related management support.
A Special Note of Thanks
As the organization makes this transition, NACBHD wishes to express its deep appreciation to our current Executive Director, Thomas Bryant, MD, JD, who
has spearheaded NACBHD’s growth, both in terms of membership and visibility in the national policy arena. In explaining the growth of the organization,
several Board members note that NACBHD started out, quite literally, with a handful of members. The organization membership is now 336, and NACBHD
currently enjoys a role as a partner in the Campaign for Mental Health Reform, has established ongoing representation at the annual Rosalynn Carter
Symposium on Mental Health Policy, and has a strong and growing relationship with SAMHSA and CMS, among other achievements that benefit all NACBHD member
organizations. Dr. Bryant also heads Nonprofit Management Associates, Inc., and in this capacity, has several other national associations as clients.
The Board looks forward to his continuing leadership with NACBHD through the County Behavioral Health Institute, which will focus on developing future
behavioral health leadership at the county level.
NACBHD also wishes to thank both Kemp Baker and Gwen Samelson for their tireless work on the daily logistics of the organization. They have deftly managed all aspects of “keeping the organization running” – from membership to conference planning and beyond. Kemp Baker also served on the planning committee for the Carter Center Symposium (see article below), at which NACBHD enjoyed substantial representation for the first time.
How Things Will Work: A Collaborative NACBHD/NACo Relationship
NACBHD’s new full-time Executive Director will report directly to Deborah Donaldson, NACBHD Board President, and the NACBHD Board. Donaldson says the
full-time Executive Director will be valuable in his or her ability to “spend a lot of time on the Hill and monitor all the current issues, look at
implementation, and be an important ‘player’ in the process.” The Executive Director position is now being advertised, and the Board has received
several resumes.
The move to a formalized relationship with NACo is positive for both NACBHD and NACo, says Donaldson, with NACo excited about housing NACBHD’s Executive Director and hoping to make this a model relationship for other affiliates. Donaldson notes that both parties can look forward to “cooperation and collaboration.”
NACo will make its benefits package available to the Executive Director. In terms of staff and logistical arrangements, NACo has offered what Donaldson calls a “menu” of choices for staff and logistical support, including conference support, IT, web development, and accounting; or NACBHD can hire its own support in these areas. Once a full-time Executive Director is in place, decisions will be made based on budget review and what is needed.
NACBHD and NACo Collaboration on Policy Issues is Already in Place
While logistical arrangements between NACBHD and NACo are still being worked out, a relationship already exists in the area of policy and legislative
issues. NACo has several steering committees which develop NACo’s policy and legislative positions. (For complete information on NACo, see
www.naco.org.)
One of NACo’s steering committees, the Health Committee, considers issues related to health care financing and delivery, Medicaid, Medicare, mental health, substance abuse, and developmental disabilities, among other issues. NACo’s Behavioral Health Subcommittee is part of NACo’s Health Committee, and is chaired by NACBHD’s David Wiebe. (Wiebe, Executive Director of Johnson County Mental Health Center in Mission, Kansas, chairs NACBHD’s Medicaid Committee.) Other NACBHD members also serve on NACo’s Health Committee, including Deborah Donaldson, NACBHD Board President and Director, Human Serivces, Sedgwick County, Kansas; James Stewart, immediate past President of the NACBHD Board and Executive Director, Henrico, VA, Area Mental Health & Mental Retardation Board; Lynn Ferrell, Chair of NACBHD’s Developmental Disabilities Committee, and Executive Director, Polk County Health Services, Des Moines, Iowa; and William Harper, Chair of NACBHD’s Membership and Services Committee and Executive Director, Lorain County Mental Health Board, are also members of the NACo steering committee.
Bob Egnew, NACBHD’s legislative policy consultant, comments on the already positive relationship between NACo and NACBHD, pointing to NACo’s adoption of NACBHD’s Medicaid Reform Principles. The behavioral health policy relationship between the organizations continues with another important NACBHD contribution -- Egnew will help rewrite the behavioral healthcare platform for NACo.
Look for continuing organizational updates in future issues of the newsletter.
Transforming Mental Health Care in America:
Planning on Implementation of Commission Report Begins
The week of November 3 was a milestone in terms of initial planning for the implementation of the Final Report of the President’s Commission on Mental Health: Achieving the Promise: Transforming Mental Health Care in America. As NACBHD’s Executive Director, Thomas Bryant, says “The Commission had a coming out party that week.” The report received significant discussion and attention in two nationally prominent arenas – testimony before the Subcommittee on Substance Abuse of the Senate Committee on Health, Education, Labor, & Pensions, November 4, and in-depth discussion at the Nineteenth Annual Rosalynn Carter Symposium on Mental Health Policy, November 5 and 6. Meanwhile, work on the Campaign for Mental Health Reform continues. NACBHD had some role or representation in all three areas. An update on each event and NACBHD’s involvement is detailed below.
Nineteenth Annual Rosalynn Carter Symposium on Mental Health Policy
While the week was an important one for the Commission report, it was also a milestone week for NACBHD. The invitation only symposium, “The President’s
New Freedom Commission on Mental Health: Transforming the Vision” brought together 150-200 leaders in mental health policy from across the country,
including a number of NACBHD representatives. For the first time, county representation at the invitation only symposium was significant, with 12
NACBHD members invited to attend. In the past, only NACBHD’s current President was invited. Attendees will stay involved with the Symposium, and will
be invited to attend yearly. NACBHD members present included Thomas Bryant, Bob Egnew, Policy Consultant, Deborah Donaldson, Board President, David
Wiebe Medicaid Committee, Chair, Sherry Knapp, Board secretary, Gary Weiskopf, Co-chair of the Conference Program, and Sandra Naylor-Goodwin, Board
member.
Bryant calls the conference an “excellent symposium with the major players from mental health organizations and government there.” Other attendees, in addition to Mrs. Carter, Chair of the Center’s Mental Health Task Force, and Thomas Bournemann, Ed.D., Director of the Carter Center Mental Health Program, included Michael Hogan, Ph.D, Chair of the President’ Commission, as well as several other commissioners, SAMHSA administrator Charles Curie and Kathryn Power, Director, Center for Mental Health Services, SAMHSA, who is charged with developing an action plan for SAMHSA’s overview of the implementation of the recommendations. Thomas Insel, M.D., Director, National Institute of Mental Health, and David Satcher, M.D., Ph.D., former surgeon general. (For the agenda and a full list of attendees, see www.cartercenter.org)
NACBHD Representatives Reflect on the Symposium
Deborah Donaldson notes that after being in the field for many years, it “was a pleasure to learn something new.” Sandra Naylor-Goodwin reports that
much instructive information was presented and discussed, including the need for a social marketing campaign. Both hope that the action steps can be
moved forward and that the report will make a difference.
Campaign for Mental Health Reform Representation at the Symposium
Bill Emmet, Project Director for the Campaign for Mental Health Reform, says that the Campaign was “happy our efforts were mentioned by lots of presenters”
at the symposium. Emmet characterized the symposium as an opportunity to examine mechanisms for implementing the recommendations of the Commission. While
the symposium did not resolve what the action steps would be for implementing the recommendations, provocative presentations and instructive information
were presented. Emmet cited the public health perspective from Dr. Mark Rosenberg, Executive Director of the Task Force for Child Survival and Development,
a nonprofit public health organization. Dr. Rosenberg worked with the CDC for 20 years on the eradication of smallpox, and effectively addressed the value
of campaigns and coalitions in addressing and moving forward public health issues and striking a balance between being “small and nimble” and large and
inclusive. Emmet says that the Campaign wants to be “inclusive and nimble,” and that the structure and composition of the Campaign reflect that, with a
tight steering group, active partners (including NACBHD) intimately involved in policy development and strategic planning. The partners meet every two
weeks. “It remains incumbent on us as advocates outside the federal government to find ways to work with Congress to implement the recommendations. The
bulk of the work needs to be done. Good relationships were built and ideas advanced.”
Emmet notes that he heard several issues discussed most frequently:
Outcomes of the Symposium
And Bryant reports, the Commission itself will have an informal six-month reunion shortly to discuss the implementation issues of the report.
The Campaign for Mental Health Reform
Bill Emmet, project director for the Campaign for Mental Health Reform, and a project director at the National Association of State Mental Health
Program Directors, talked with NACBHD about the Campaign and the Commission’s report. The Campaign “has been organized as the mental health
community’s united voice on federal policy.” And, in an unprecedented collaboration of national mental health organizations, the Campaign and its
partners, including NACBHD, are working together to make “access, recovery, coherence, and quality in the mental health services the hallmarks of
our nation’s mental health system,” (www.mhreform.org), including advancing the goals and
recommendations of the President’s Commission on Mental Health. (For more information about the Campaign, see the Campaign’s website, noted above, and
the September issue of the NACBHDD Newsletter.)
November 4 Subcommittee on Substance Abuse Hearing
Emmet says the November 4 Subcommittee on Substance Abuse Services Hearing on the Final Report of the President’s Commission “was a good step forward.”
Those testifying included Michael Faenza, President and CEO of the National Mental Health Association, who testified on behalf of the Campaign; SAMHSA
administrator Charles Curie; Carlos Brandenburg, administrator of the Nevada Division of Mental Health and Developmental Services; and Steve Mayberg,
Director of the California Department of Mental Health, and a Commission member. Parent Ann Buchanan provided the consumer perspective. Emmet cited
Mayberg’s testimony as excellent in terms of helping senators see the “meat” of the Commission’s recommendations. He felt that the hearing went very
well and that the interest of Senator DeWine, Chair of the Subcommittee, was apparent. It “appeared to be the first step toward more hearings.”
Testimony from the Campaign
Faenza’s testimony is reflective of the Campaign position and is the up-to-date word from the Campaign. The Campaign partners, including NACBHD,
contributed to his testimony.
In his testimony, Faenza referred to Congress making mental health care a funding priority, as well as a legislative priority. Emmet says this reflects the concern that while the today’s fragmentation is largely attributable to the fragmentation in funding streams and that while funding properly directed will make a big difference, at the end of the day, there is just not enough money in the mental health system. Congress cannot come up with theoretical fix without an appropriate level of funding.
Faenza also referred in his testimony to “urging other committee chairmen to make mental health reform a priority that moves us toward cross-system coordination and integration.” Emmet says Senator DeWine is in a good position to do this. In addition to chairing the HELP committee, he is involved in the justice arena as a member of the Judiciary Committee. Other relevant committees can also look at issues from the mental health perspective.
While there are no hearings scheduled for the immediate future, Emmet is “sure that different representatives of the Campaign will be working on a schedule with the Subcommittee staff.” Since the Congressional session is coming to an end, another hearing is not expected until 2004. To view the testimony from the November 4 hearing, see www.labor.senate.gov/testimony.
Next Steps for the Campaign
The Campaign is continuing “to hammer away” at specific action through regular meetings with the Campaign’s partners every two weeks, says Emmet. As
a Campaign partner, NACBHD continues to be involved in these meetings regularly. The Campaign is currently concentrating on federal policy and working
with different agencies, such as SAMHSA, “both to support SAMHSA in its action agenda [for implementation] and put our thoughts into how agencies should
pick up the report and run with it.” The Campaign is also in the process of seeking funding that would support an effort to make a real difference on a
broader scale, in such areas as public opinion research and “getting the message before policymakers.” For information on the Campaign and its partners,
see www.mhreform.org.
NACBHD Members Receive HHS/SAMHSA Awards
Several NACBHD member organizations recently received significant grant awards from SAMHSA.
Columbia Center for Living, $6.6 million over six years, to improve services for youth with severe emotional disturbances and their families. Sharon Guidera, Executive Director, Mid-Columbia Center for Living, The Dalles, Oregon, and NACBHD member, is the principal investigator. Guidera says, “The best part of getting these [awards] at the local level is that is where services are delivered.” Wrap-around services will be delivered by Individual Care Teams using a Family Decision Support Model, emphasizing the family’s role as primary care provider and decision maker. Expanded mental health and transitional services will be included – outreach, early intervention, school and home-based services, crisis respite, intensive day treatment, co-occurring services, vocational, housing, and independent living.
Schools, public health, juvenile services, early childhood services, child and family commissions, La Clinicia, and other community members assisted in planning and pledged matching funds for the grant. Thirty community partners provided a monetary or in-kind match in different areas. For example, one school is funding a child mental health therapist, and another is providing space for services. A focus of the grant will be to figure out sustained funding for year seven of the program.
The award allows for the hiring of 15 full-time employees, a significant contribution in a small rural area, and in a state with one of the highest rates of unemployment. (Guidera notes that 14 fte’s were lost last year due to state budget problems, and that they are looking to hire back employees, apart from what is being received through the grant.)
The Mid-Columbia STAR Project in Eastern Oregon, $200,000 for the first year. Sharon Guidera is also the principal investigator for this grant. A collaborative effort between the Mid-Columbia Center for Living, a consortium of treatment providers in 13 rural counties, the regional Addiction Technology Transfer Center, and a local research agency, the project is part of SAMHSA’s Strengthening Treatment Access and Retention program (STAR), which facilitates organizations’ administrative and clinical practices. Quality improvement methods, such as performance modeling are used. The program is expected to receive $200,000 in each of the following two years.
In the first year, partners and families will work on an integrated model to see that services are: 1) user-friendly, 2) not duplicated, and 3) modeled on evidence-based practices. Because no show and cancellation rates are highest at the earliest phases of agency contact, often due to lingering issues of stigma, evidence-based practices will be used to reassess the initial contact, screening, and treatment procedures to increase retention of those seeking services. In addition, they will focus on delivering good outcomes for consumers and how they might make this portable to different populations. A local and national evaluation will be undertaken to address the design’s effectiveness.
“There is no way most local communities could put together systems of care services without these types of funds, “ says Guidera. She encourages colleagues to take a look at these grant possibilities – she says it is promising that a rural entity, such as hers, received such significant funding. The total population is about 55,000 across four counties, which are considered frontier counties, over a 5,000 square mile area.
California Department of Mental Health, $325,000 for the first year. The project will focus on a statewide infrastructure for evidence-based practices and provide training and technical assistance for the implementation of the Integrated Treatment for Co-occurring Disorders Resource Kit in eight sites in four counties. Funding at $325,000 is expected for each of the second and third years of the project. Sandra Naylor-Goodwin, Executive Director of the California Institute for Mental Health, says “One of our goals is not only to implement, but to evaluate what have to do to adapt” these services. “For us, one of the complaints is that the kits have not been tested in multicultural populations. This is a real opportunity to look at what it takes to adapt these kits.” Seven of the sites are multicultural; one site is entirely Hispanic.
Ohio Department of Mental Health, $323,250 for the first year. Bill Harper, Executive Director, Lorain County Mental Health Board and NACBHD Board member, forwarded information about this award, which will implement and evaluate the Supported Employment Resource Kit and focus on increasing employment for people with co-occurring substance abuse and mental illness. For year two, the program is expected to receive $324,450, and for year three, it is expected to receive $324,780. The Lorain, Columbiana, Richland, and Franklin boards will be the sites for the first year of the grant.
From the Hill: Report from NACBHD’s Director of Public Policy, Robert Egnew
As was predicted, the 108th Congress is struggling to end its first session without any light at the end of tunnel. While gridlock did not really occur, there were significant policy issues that overshadowed everything else. The war in Iraq and the related funding bill has begun to create divisions even within the Republican Party, particularly in the Senate. There is a growing uneasiness with the mounting federal debit which crosses over party and philosophical lines. Finally, consensus on the Medicare Pharmacy Bill has proven elusive and created divisions between Republicans and Democrats and between the House and the Senate. The first session will probably end on a contentious note.
Where does that leave behavioral health issues when all the dust is settled? The latest rumors are these:
The Outlook for the Next Congressional Session
One of the bigger questions is what lies ahead during the next session of the 108th Congress? The federal deficit will begin to play a significant role
in forestalling any major changes in policy and any chances of federal bailout of the states, which occurred last year with the increase in the federal
matching share of Medicaid, which ends June 2004. The President Commission’s finding that would require any additional funding is going to be very
difficult to implement. The division in Congress and the upcoming elections will also make it increasingly difficult for any consensus to be reached --
so all and all it looks like another difficult and challenging year ahead.
NACBHD Events
NACBHD’s Legislative Conference
Timely Information in an Interactive Format
NACBHD’s Legislative Conference is scheduled for February 26-28, 2004, at the Jury’s Hotel in Washington, DC. This year’s conference continues
a NACBHD tradition of giving members “useful information so that they can advocate for what they want and need,” according to Conference Program Director
Co-Chair George Braunstein. As an added bonus, Braunstein says this year’s conference will be “more interactive,” giving members an opportunity for
dialogue with speakers and sharing of ideas. NACBHD looks forward to welcoming SAMHSA administrator Charles Curie and his senior staff to the conference.
We are also pleased to announce that we have invited other key national partners in the policy arena to the conference, including senior CMS officials
and representatives from NAMI and the ARC. Registration and hotel information, and a preview of the agenda follow below.
Hotel Reservations and Conference Registration
Hotel reservations should be made directly with the Jurys Hotel at (202) 483-1350 or
www.juryswashingtondc.com. Information and instructions regarding conference registration
will be emailed to members in the coming weeks.
Preview of the Agenda
NACBHD’s Policy Positions
The following is a summary of NACBHD’s policy positions on current legislative issues:
Ninth Annual NACBHD Conference Set for July 15-17
The 9th Annual NACBHD Conference is scheduled for July 15-17, 2004, at the Ritz Carlton Hotel, in Phoenix, Arizona. Hotel arrangements will be announced in the next newsletter.
Housing Alert: HUD SuperNOFA Information and Resources
The HUD SuperNOFA
The Department of Housing and Urban Development (HUD) SuperNOFA (Notice of Funding Availability) announcement for people who are homeless and disabled
comes out yearly in the Spring. While there is no exact date projected for the announcement, Emily Cooper, Associate at the Technical Assistance
Collaborative, Inc. (TAC), advises those interested in this funding opportunity to check the HUD website weekly
(www.hud.gov/offices/adm/grants/fundsavail), or subscribe to the TAC
listserve, or other housing listserves. (See Housing resource list below.)
Because the Bush administration has a goal of ending chronic homelessness in 10 ten years, Cooper says there are a fair amount of announcements related to funding opportunities from the federal government. The SuperNOFA will include requirements for applicants to discuss how to end chronic homelessness in their area.
The last year has seen a real emphasis on ending chronic homelessness, according to Cooper, including homelessness for individuals with severe disabilities, those who have been living on the streets or in emergency shelters for a year or more, or who have had four episodes of homelessness over the past three years. These populations have received focus because they use the majority of public resources, such as hospitals and jails, and a focus on housing is more cost-effective.
An Emphasis on Housing, Not Just Services
And Cooper notes, Congress has been pushing HUD to focus on housing for the homeless, and is requiring that HUD focus 30% of homeless funding on housing,
not just services. Therefore, there may be more opportunities to address housing for people with disabilities, because there has been bonus money available
since 1999. Counties should ensure that their local group is applying for these bonuses as part of the SuperNOFA.
Partner with Housing Agencies and Disability Groups
In addition, Cooper encourages county authorities “to make partnerships with housing agencies at the county level as well as with disability groups at
this level. Those folks who create partnerships across disabilities are often most successful.” Cooper says that much of HUD funding is difficult to
use for one disability group, so that it is useful to create local cross-disability advocacy efforts.
Housing Resources
In addition, information on delivery of services for people who are homeless and have serious mental illness can be found at the National Resource Center on Homelessness and Mental Illness, which offers training, technical assistance, referrals, and a resource library. www.nrchmi.samhsa.gov.
Developmental Disabilities: Recent News, Conferences, and Resources
From Mike Chambers, former chair of NACBHD’s Developmental Disabilities Committee, and Executive Director of the MH/MR Program Administration Association of Pennsylvania:
Suing the state for benefits provided under federal Medicaid law: information on a Pennsylvania case
Mike Chambers forwarded the following information on Sabree v. Richman from the Brain Injury Association of Pennsylvania (BIAPA).
RE: Sabree v. Richman
Hello Members & Friends of the Brain Injury Association of Pennsylvania,
Today I had the pleasure of attending oral argument in a very important case for those needing Medicaid services from the state of Pennsylvania. This case is trying to establish the right of an individual to sue the state for denying benefits provided under federal Medicaid law.
This is the case of Sabree v. Richman, which was filed to eliminate the waiting list for services in the mental retardation system in Pennsylvania. Since there was a disagreement about a matter of law at the District Court level, the case was appealed to the next level, the 3rd Circuit. This is matter for federal court as the state is being sued for failure to follow federal law.
The argument in this case was heard in the federal building near 6th & Race Streets in Philadelphia. The lawyers for Sabree were Steve Gold and the Disability Law Project. The lawyer for the state of Pennsylvania was Doris Leich. The case was heard by a panel of three federal judges. There were about 40 people in the audience to listen to this oral argument. They got up and left as soon as it was over.
For those who may not have attended an oral argument previously, both sides send in thick documents for the judges to read ahead of time. Then, a date and time are set for the judges to ask questions. The judges will question each lawyer for at least 15 minutes. The lawyers must have a planned speech, but they hardly get to use it - as the judges constantly interrupt them. The questions are fast and furious and cover whatever the judges want to talk about.
Today, Steve Gold explained to the judges that the lower court was wrong to prevent individuals from suing the state. Steve argued that federal Medicaid law entitles all Medicaid-eligible persons to benefits and to the right to sue for missing benefits. In this situation, persons with mental retardation are eligible for Medicaid benefits but have been on the waiting list for years and there is no end in sight. Steve argued that individuals must be entitled to sue the state for missing benefits, to prevent the state from providing only some of the services, to some of the people, some of the time - at their own discretion.
Doris Leich, for the state, explained that Medicaid-eligible individuals do not have the right to sue the state for benefits under Medicaid - and that all persons are not entitled to receive all services for which they are eligible under Medicaid. Also, Doris argued that federal monitoring and administrative hearings are enough to insure reasonable compliance with federal Medicaid law, without giving individuals the right to sue the state.
Now we must wait for the written decision of the three judges, which will be written up by their law clerks.
Barb Dively
BIAPA Public Affairs Chair
NADD Winter Teleconference Series
The National Association for the Dually Diagnosed (NADD) is offering a winter teleconference series featuring experts in dual diagnosis. NADD is an organization for professionals, care providers, and families devoted to “understanding of and services for individuals who have developmental disabilities and mental health needs.” For information on educational services, training materials, conferences, and consultation services, and other resources related to the mental health needs of persons with mental retardation, see www.thenadd.org.
Those interested in the teleconferences can participate from their offices at different participation levels including: beginner, intermediate, and advanced.
Conference times are: 3:00 - 4:00 p.m. Eastern; 2:00 - 3:00 p.m. Central; 1:00 - 2:00 p.m. Mountain; and 12:00 - 1:00 p.m. Pacific.
Teleconference Schedule
For brochures and registration, contact NADD at www.thenadd.org.
National Council on Disability Releases Statement on MiCASSA
The National Council on Disability (NCD) recently released a statement on the Medicaid Community-based Attendant Services and Supports Act (MiCASSA), and on Olmstead implementation. The MiCASSA statement contains recommendations from the NCD to the federal government regarding MiCASSA and Olmstead. For the full statement see www.ncd.gov/newsroom. A report entitled, “Olmstead: Reclaiming Institutionalized Lives,” is also available from NCD via the website.
Government Accounting Office Releases Report on States Using Mediation and Other Strategies to Resolve Special Education Conflicts
The Federal Government Accounting Office has released the report, Special Education: Numbers of Formal Disputes Are Generally Low and States Are Using Mediation and Other Strategies to Resolve Conflicts. GAO-03-897, September 9. To access the report see, www.gao.gov/atext/d03897.txt.
Developmental Disabilities Resources
AAPD and Justice for All
The American Association of People with Disabilities (AAPD) is the “largest nonprofit cross-disability member organization in the United States.” AAPD
works with other disability organizations for implementation of disability laws, particularly the ADA of 1990 and the Rehabilitation Act of 1973. Its
email network, Justice For All, “works to get the word out from Washington, DC to the grassroots.” For information or to sign up for the email network,
see www.jfanow.org.
Online Resource for Person-Centered DD Resources
Quality Mall (www.qualitymall.org) provides information about person-centered supports for
people with developmental disabilities, including conference presentations, funding opportunities, and featured products. The "Residential Services
for Persons with Developmental Disabilities: Status and Trends Through 2002" or RISP Report, a recent featured product, provides national and state-by-state
statistics on the number of people with intellectual and developmental disabilities (ID/DD) who receive residential services, and the cost of those
services.
