Minutes — November 2018 Committee of the Whole Meeting

Attendance

  • Committee Members Present
  • John Thomas, Council Vice-Chair
  • Hunter Adkins
  • Patty Anderson, DRTX
  • Kimberly Blackmon
  • Kristine Clark
  • Gladys Cortez
  • Kristen Cox
  • Andrew Crim
  • Stephen Gersuk
  • Katlyn Le, DSHS
  • Scott McAvoy
  • Meagan Orsag, A&M CDD
  • Michael Peace
  • Dana Perry
  • Justin Porter, TEA
  • Lora Taylor
  • Richard Tisch
  • Dana Williamson, HHSC/Medicaid
  • Nina Zuna, TCDS
  • Council Members Present
  • Mary Durheim, Council Chair
  • Mateo Delgado
  • Vacant – HHSC/Older Americans Act
  • Jennifer Hines, TWC
  • Ruth Mason
  • Brandon Pharris
  • Guests Present
  • Ricardo Atkinson
  • Jan Brown
  • Maverick Crawford
  • Ivy Goldstein, DSHS/Maternal and Child Health
  • Colleen Horton
  • Linda Litzinger
  • Ginger Mayeaux
  • Stephanie Martinez
  • Dr. Joshua Rotenberg
  • Coline Sperling
  • Cristiana Voorhies
  • Christa Walikonis
  • Mary Jane Williams
  • Tiffany Williams
  • Alicja Zapalska
  • Staff Present
  • Beth Stalvey, Executive Director
  • Martha Cantu
  • Joanna Cordry
  • Scott Daigle
  • Cynthia Ellison
  • Danny Fikac
  • Ashley Ford
  • Robert Garcia
  • Le Lien
  • Linda Logan
  • Joshua Ryf
  • Koren Vogel

Call to Order

The Committee of the Whole of the Texas Council for Developmental Disabilities convened on Thursday, November 8, 2018, in the Ballroom D-E of the Embassy Suites Austin Central, 5901 North IH-35, Austin, TX 78823. Council Vice-Chair Chair John Thomas called the meeting to order at 1:39 PM.

  1. Introductions
  2. Council members, staff and guests introduced themselves.
  1. Public Comments
  2. Public comments were offered by Maverick Crawford who introduced himself as an individual with autism and a current Partners in Policymaking participant. Crawford discussed his interest in increased advocacy efforts for individuals with autism specifically centered around suicide prevention. He noted the increased rate of suicide and suicide attempts for individuals with autism. He also noted that he was the author of a book available through Amazon entitled “Overcoming the Odds: My Journey to Finding Personal Strength and Triumph”.
  1. Legislative Update
  2. Public Policy Director Scott Daigle gave a presentation on the 2018 midterm elections and how the results may impact the Texas Legislature. He noted a massive voter turnout in Texas which was almost equal to the 2016 general election and almost double that of the 2014 midterm elections. He noted that while all the statewide seats were maintained by the incumbents, there were significant turnovers in the Texas Senate and House of Representatives. Daigle discussed how the outgoing members had previously voted on disability issues and the opportunity to educate new members on the issues. He also noted there will be a new Speaker of the House and significant changes in committee chair positions but that it will be weeks into the session before these chair positions are announced.
  1. TCDD Policy Roundtable Discussions
  2. Dr. Joshua Rotenberg, MD, Pediatric Neurologist
  3. Council Member Lora Taylor introduced Dr. Joshua Rotenberg who is the neurologist for her daughter Julie and is the prescribing physician for Julie’s Cannabidiol (CBD) treatment. Taylor described Julie’s improvement from the CDB treatment including a reduction in seizures as well as the side effects of other medications. Rotenberg discussed the use of CBD to treat epilepsy and reminded members that this was not a discussion on recreational marijuana use. He reported that 1.2% of the United States population has epilepsy which equals to about 339,000 individuals in Texas and is as common as asthma. He noted that with the current rules of the Compassionate Use Program (CUP) in Texas, about 135,000 individuals qualify for treatment with low tetrahydrocannabinol (THC)-CBD. He explained that the standards to qualify for treatment is for a patient to have refractory or intractable epilepsy and has had “failures” with two other anti-seizure medicines. He noted that failure is vague and could mean uncontrolled seizures or adverse side effects. He noted that there are critical time frames during the brain’s development and prolonged seizures for children while exploring other anti-seizure medications can be detrimental.
  4.  
  5. Council members participated in round-table discussions on all the TCDD Public Priority Issue areas. These include: Home and Community-Based Services, Community Attendant Rates and Wages, Least Restrictive Environment, Accessible Transportation, Accessible Parking, Employment First, and Healthcare.
  6.  
  7. Public Policy Director Daigle discussed with members the format of the legislative meet and greet that is being coordinated during the February meetings. Council members will choose a specific Policy Priority area to provide education. Members were asked to provide their selections to Daigle following the meeting.
  1. Changing Expectations: Looking Beyond “Behaviors” to Mental Health, Wellness, and Recovery for Individuals with Intellectual Disabilities – Colleen Horton
    Executive Director Beth Stalvey introduced Colleen Horton, Director of Policy at the Hogg Foundation for Mental Health and asked members to consider the information in her presentation as the Council considers future activities surrounding mental health and individuals with intellectual and developmental disabilities (I/DD). Horton noted that the objectives for her presentation to:
  2.  
    • Recognize the need for quality mental health services for individuals with I/DD
    • Recognize the current system limitations related to mental health services for individuals with I/DD
    • Identify the challenges in diagnosing and treating individuals with co-occurring I/DD and mental health conditions
    • Understand the impact of trauma on individuals with I/DD
    • Recognize the paradigm shift that needs to occur
  3.  
  4. Horton reported that national core indicators show that approximated 34% of individuals with I/DD have a co-occurring mental health condition. Horton further discussed how “behaviors” are often attributed to an individual’s disability and the focus becomes managing the behavior instead of recognizing a traumatic event or perceived threat that could lead to the behavior. She discussed the science of trauma and the concepts of trauma-informed care and offered a toolkit developed by the Hogg Foundation in partnership with the National Child Traumatic Stress Network. “Road to Recovery – Supporting Children with Intellectual Disabilities Who Have Experienced Trauma” is available online.
  5.  
  6. Horton highlighted efforts that are taking place in Texas including trainings through the Hogg Foundation and Health and Human Services Commission (HHSC), establishing a Statewide Behavioral Health Strategic Plan, and recommendations for funding for services in the HHSC legislative appropriations request. She recommended cross-division/agency collaborations to further address this issue and the need for funding to maintain and expand I/DD Crisis Continuum of Care. She further suggested a culture shift in treatment from asking “what’s wrong” to “what has happened” and to expect trauma-informed care and other evidence-based mental health treatment including early identification and treatment.
  7.  
  8. Members had further discussion on next steps which included teacher and provider training to recognize mental health issues in individuals with I/DD. It was noted that with the current focus on school safety and mental health issues, this creates an opportunity to include individuals with I/DD into those conversations.

Adjourn

Council Vice-Chair Thomas adjourned the Committee of the Whole at 5:15 PM