By WILLIAM K. ALCORN
VINDICATOR HEALTH WRITER
THE LIFE EXPECTANCY AND MEDICAL involvement of mentally retarded Mahoning County residents have increased dramatically over the last quarter century.
Along with that increased longevity has come a proportionate increase in the length, complexity and cost of needed services.
The change in the profile of the MRDD client is particularly evident among school-age and senior clients.
There are more older clients who need services, said Larry Duck, superintendent of the Mahoning County Mental Retardation and Developmental Disabilities Board.
Programs: The board has responded to the changes with programs and facilities to serve families and their children from before birth to retirement," he said. "We now deal with many of our clients all their lives."
Growing is the Adult Services Retirement Program at Leonard Kirtz School, which is geared for clients 55 and older.
The adult day program emphasizes recreation, arts, leisure activities and socialization. Clients may also participate in various activities available in school-age departments, such as homemaking, industrial technology, physical education and swimming.
In the school-age program, most of the students lining up for the school buses to take them home are in wheelchairs.
Fifteen years ago, said James Dolak, Kirtz school principal, there were probably only four or five wheelchairs in the whole building. Today, of the 79 school-age clients, more than 50 percent are in wheelchairs, he said.
The public schools are doing a good job with the less-medically involved mentally retarded students, so the students coming to Leonard Kirtz are generally lower functioning. Years ago, before medical and technical advances, some of the kids at the school now would not have survived.
Despite their often severe handicaps, Dolak said the school believes every client has the ability to learn and do something.
"We're vocationally oriented, not academically oriented, and we try to help students learn something they can do as an adult," Dolak said.
Needs: But the ramifications of the increased survival rate is that now students generally have more medical needs, such as tube feeding, suctioning and therapies, requiring a lot more nurses and therapists on staff, Dolak said.
Another growing aspect of the MRDD program is supported living for adults, Duck said.
Supportive living: A combination of clients living longer, and institutions being closed, left a void that the Mental Retardation and Developmental Disabilities Board is filling with supportive living for 150 clients.
The range of cost per client for supportive living is $5,000 to $115,000 per year, which pays for such things as buildings, rent and attendants, who become substitute caregivers. The average annual cost per client is about $67,000, Duck said.
One of the major aspects of the board's program are its sheltered workshops. The board provides services for more than 1,000 clients, including 600 in adult services, 510 of which are in its three sheltered workshops operated by Mahoning Adult Services Corp. (MASCO).
Duck said there are 70 clients on the workshop waiting list "that we have to get to."
New buildings: To accommodate the growing numbers of clients and services, the board is in the process of acquiring two buildings on Javit Court previously occupied by Gateways to Better Living.
Building 153, at 153 Javit Court, is a 17,000-square-foot structure previously used to house Gateway's intermediate care program for county MRDD clients.
The board will assume a 20-year $453,000 "use mortgage," under which it will pay no money as long as the building is used for approved purposes. Duck estimated, however, it would cost $300,000 to $400,000 to remodel the building before it is occupied a year from now.
Building 153 will house offices; the adult retirement program, which when moved from Kirtz School will make room for expansion of the early childhood program there; and a program for multiple severely disabled clients who are not capable of working in the regular workshop, Duck said.
Also, the board plans to purchase Building 130, at 130 Javit Court, for $160,000. The 6,000-square-foot facility will provide more program and office space.
To make room for even more adult programming, the board is also discussing building a new building, buying a building or adding on to the MASCO workshop on Bev Road. "I think the most likely scenario is adding on to Bev Road," Duck said.
Funding: To meet the increasing cost of adult clients, the board plans to take advantage of changes in the state's waiver program, under which federal supportive living money can be gotten through Medicaid with a 40-percent local match. Therefore, Duck said, the $2.2 million in local money now used for residential supportive living will grow to about $5 million when the local money is used to leverage federal dollars.
The annual county MRDD budget is $22.7 million, about $16 million of which comes from two local levies.
"We are so thankful" for the community's support, said Becky Borman, a habilitation specialist who heads the retirement program for senior clients. "I've been in the program since 1970. We have grown from one building, the school, and no wheelchairs to a facility that serves families who have children at risk from before birth to the retirement program," she said.