1. Presenter – Alexandra Andrews, MA Health Care Advocacy Program Coordinator at Advocacy Denver

2.  Formerly the Arc of Denver; still an Arc Chapter.  Non-profit, civil rights, advocacy organization serving people with I/DD of all ages.  Assistance/Guidance provided in many areas:  Housing, transportation, financial stability, legal services for special education, employment, and health care.  Initiate public policy change in order to promote positive solutions.

3.  Guide adults with I/DD through the health care system.  Serve both English and Spanish speaking individuals.  Provide health and wellness education.  Track gaps in the health care system.  Collaborate with other individuals and organizations to educate and assist in legislative and system changes.

4. Intellectual disability – is a below average cognitive ability with 3 characteristics:  I.Q. is between 70-75 or below  Significant limitations in adaptive behaviors (the ability to adapt and carry on everyday life activities such as self-care, socializing, communicating, etc.)  The onset of the disability occurs before age 18. Developmental Disability – includes people who have an ID, autism, cerebral palsy, severe seizure disorder, or a severe head injury. Under federal law, DD means a severe, chronic disability of an individual that:  is attributable to a mental or physical impairment or both.  is manifested before 22 yo.  is likely to continue indefinitely  results in substantial functional limitations in 3 or more major life areas.

5.  I/DD comprise 2% to 3% of the general population.  They represent 4% to 10% of the prison population, with an even greater number of those in juvenile facilities and in jails  (Petersilia, 2000).

6. As suspects, individuals may:  Not want their disability to be recognized and try to cover it up.  Not understand their rights  Not understand commands, instructions, etc.  Be overwhelmed by police presence  Act upset at being detained and/or try to run away  Say what they think officers want to hear  Have difficulty describing facts or details of offense  Be the first to leave the scene of the crime, and the first to get caught  Be confused about who is responsible for the crime and “confess” even though innocent  (Leigh Ann Davis, 2009)

7.  Typically, the perpetrators with I/DD are:  Male  Older than other offenders  Exhibit long-standing and continuing serious behavioral disturbance (independent of their psychiatric diagnosis or level of involvement with the criminal justice system)  Require supported or custodial accommodation, despite only mild or borderline levels of ID.  Although only one-third have a diagnosable major psychiatric disorder, three-quarters have had prior or current contact with psychiatric services and two-thirds suffer chronic medical illness.  (W. Glaser & D. Florio, 2004).

8.  “Despite increased prevalence of psychiatric disorder amongst offenders with an intellectual disability (ID), there is very little known about the characteristics and needs of those with dual disability”  “The multiple services provided to this group have been ad hoc, poorly coordinated and sometimes dangerously inappropriate. A service provision model is required which must be integrative and consistent.”  (W. Glaser & D. Florio, 2004).

9.  Mental health services are provided in prison and jail, but infrequently meet the needs of people with I/DD.  Follow-up after incarceration is limited.  Police and mental health providers have limited training dealing with people who are dually diagnosed.

10.  Improvements have been achieved in other states for people with I/DD and MI.  Better utilization of Home and Community-Based Medicaid Waivers  Increased state funding for crisis services and increased access to mental health services.  1915(k) Community First Choice personal care plans  Money Follows the Person  Balancing Incentives Payments programs  The Health Home, optional Medicaid state plan Further Recommendations in: “Including Individuals with I/DD and Co-Occuring Mental Illness”, NADD, 2011.

11.  Alexandra Andrews, MA  303.974.2520 (office)  aandrews@advocacydenver.org aandrews@advocacydenver.org  Advocacy Referral Line – 303.974.2530  Website – www.advocacydenver.orgwww.advocacydenver.org