The Mental Retardation Authority
The Mental Retardation Authority (MRA) serves as the entry point for residents of Dallas County for eligibility and determination in accordance with state law and the Department of Aging and Disability Services. The Service Coordination unit provides assistance for an individual in accessing medical, social, educational, and other appropriate services and supports. External and Internal Provider services are contracted and monitored by the MRA.
Provider services and supports may include community support, respite, specialized therapies, employment assistance, supported employment, behavioral support, vocational training, day habilitation, in home family support and Home Community Based Services (HCS)/Texas Home Living Services.
Hours of Operation:
Monday-Friday - 8:00 a.m. - 5:00 p.m.
Services: Eligibility Determination Unit (EDU) is the central intake site for people with mental retardation, pervasive developmental disorders, or a related condition residing in Dallas County. EDU provides information, screening, assessment, and referral.
Description of Core Services and Program Activities: EDU provides information to potential consumers and will assess consumer to determine eligibility for services. Additional activities include referring individuals to other agencies or service providers. Consumers are seen by EDU Psychologists for a Determination of Mental Retardation in accordance with the Persons with Mental Retardation ACT (PMRA). EDU staff may also provide assessments relevant to guardianship issues, and to court-orders pursuant to Section 55.03 of the Texas Family Code and to Article 46.02 of the Texas Code of Criminal Procedures.
Admission Criteria: Any person found to be functioning in the range of mental retardation and/or diagnosed with autism, a Pervasive Developmental Disorder or a related condition and residing in Dallas County will be evaluated by EDU.
WHAT WE DO
The Eligibility Determination Unit (EDU) determines whether consumers are eligible for Mental Retardation Services by conducting a Determination of Mental Retardation Evaluation (DMR). A Texas Department of Mental Health and Mental Retardation (TDMHMR) certified psychologist or Licensed Psychologist performs this assessment in accordance with the “Diagnostic Eligibility Rule” (formerly “The DMR Rule”). The DMR Rule is published in the Texas Administrative Code (TAC), Rules of the Texas Department of Mental Health and Mental Retardation, Title 40, Part I, Chapter 5, Subchapter D.
WHO QUALIFIES FOR SERVICES
Any Dallas County resident who is at least three (3) years of age and is believed to have one or more of the following may apply for a DMR evaluation:
- Mental Retardation
- Pervasive Developmental Disorder: Autistic Disorder, Asperger’s Disorder, Rett’s Disorder, Childhood Disintegrative Disorder, or Pervasive Developmental Disorder – NOS
- Related Condition: Traumatic Brain Injury, Cerebral Palsy, etc. And moderate to severe deficits in adaptive behavior.
WHAT IS MENTAL RETARDATION?
Mental Retardation is a developmental disability that is expected to be lifelong and to require ongoing services. The DMR rule defines Mental Retardation as “Significantly sub average general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (birth to 18 years of age)”.
WHAT IS PERVASIVE DEVELOPMENTAL DISORDER?
Pervasive Developmental Disorders are a class of developmental disorders that are also expected to be lifelong and to require ongoing services similar to those needed by persons with mental retardation. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) states that:
“Pervasive Developmental Disorders are characterized by severe and pervasive impairment in several areas of development: reciprocal social interaction skills, communication skills, or the presence of stereotyped behavior, interests, and activities.”
Autistic Disorder is probably the most familiar of the Pervasive Developmental Disorders. Mental Retardation and other developmental disorders are frequently seen together in the same consumer. For example, the DSM IV-R states that 75% of children with Autistic Disorder function intellectually in the range of mental retardation.
WHAT IS A RELATED CONDITION?
A Related Condition (RC) is a severe and chronic disability that is attributable to Cerebral Palsy, Epilepsy, or any other condition, other than mental illness, found to be closely related to mental retardation because the condition results in impairment of adaptive behavior similar to that of persons with mental retardation, and requires treatment similar to those required for persons with mental retardation, and the condition manifested prior to the age of twenty-two (22) and will continue indefinitely.
HOW TO ACCESS THIS SERVICE
The parent, legal guardian, primary caregiver, or consumer may request a DMR by calling Metrocare Services and requesting to speak to an Intake Specialist @ (214) 333-7000.
Consumers provide their own transportation to and from the DMR appointment. In special cases, consumers may be able to make transportation arrangements.
FEES YOU MAY HAVE TO PAY FOR THIS SERVICE
Once a referral for services is received by the EDU, an Intake Specialist is assigned. The Intake Specialist contacts the consumer or the consumer’s caregiver(s) and explains the DMR process (see below: “HOW DOES THE DMR PROCESS WORK?”). This explanation includes a preliminary financial screening. If more information is needed, the Intake Specialist may arrange a telephone consultation with a Metrocare Services financial counselor. In any event, a formal financial assessment will be conducted in a face-to-face interview with a financial counselor. The financial assessment determines whether co-payments or other fees apply and whether Metrocare Services is a part of your Insurance Provider Network. At that time, you will need to bring with you all necessary supporting documents. There are two options for scheduling the financial assessment:
- Wait until you come in for your DMR evaluation and see a financial counselor, or
- Make a separate appointment to see the financial counselor prior to the date on which the DMR appointment is scheduled.
HOW DOES THE DMR PROCESS WORK?
STEP 1: Call Metrocare Services Eligibility Determination Unit at (214) 333-7000 and tell them you would like to apply for mental retardation services.
STEP 2: An Intake Specialist is assigned to contact the person requesting the DMR.
STEP 3: The Intake Specialist contacts the person requesting the DMR. The Intake Specialist explains what types of documents are needed and how you can obtain them. The Intake Specialist will also discuss what fees may apply, if any, based on individual circumstances. If further clarification is needed, a telephone consultation may be arranged with a Metrocare Services financial counselor.
STEP 4: Once the Eligibility Determination Unit has received all the necessary documents, the Intake Specialist contacts the consumer to schedule the assessment.
STEP 5: A DMR Certified Psychologist or Licensed Psychologist conducts the Eligibility Determination assessment. A financial counselor also completes a questionnaire that establishes how services will be funded, unless this has been completed beforehand (please see the above heading “Fees You May Have To Pay For This Service”).
STEP 6: If a person is found eligible for Mental Retardation Services, the psychologist will forward the DMR and financial information to the MR Service Coordination unit for admission to services.
ABOUT THE DMR EVALUATION
The DMR evaluation is conducted by a DMR Certified Psychologist or Licensed Psychologist and typically consists of the following:
Review of Past Testing: The psychologist will review previous evaluation reports to help understand the individual’s historic levels of functioning. The review of past testing may also reveal improving or declining levels of functioning over time. Previous test results are also used to verify that the diagnostic criteria for Mental Retardation existed before 18 years of age.
Interview: This typically includes the consumer and caregiver. The psychologist will usually ask about developmental history, family history, educational history, physical/medical problems, psychiatric history, problem behaviors, services needed, and other concerns the family and consumer have.
Adaptive Behavior Assessment: The psychologist administers an adaptive behavior assessment. The adaptive behavior assessment is performed by interviewing a person who is familiar with the consumer’s communication, self-help, and social skills. The individual’s adaptive behavior level is then compared to what is typically expected of persons in his/her age group to determine if the individual’s adaptive behavior level falls within the range of mental retardation.
Intellectual Assessment: The psychologist administers an intelligence test (IQ) to determine if the individual’s level of intellectual functioning falls within the range of mental retardation. The IQ test is given to the individual directly and requires the individual to solve a variety of problems that measure reasoning abilities.
WHAT DOCUMENTATION DO I NEED?
Proof of Dallas County Residency: Utility bills or a tax statement.
Proof of Income: Paycheck stub, IRS W-2 form (for consumer if 18 years of age or older, for the parent/guardian if under 18 years of age).
Proof of any Insurance Coverage: Medicaid, SSI, or other insurance card.
Proof of Guardianship or Power of Attorney: If you are the individual’s Legal Guardian, bring a copy of the guardianship letter from the court.
Copies of Previous Evaluation Reports: If the individual has received Special Education services, send copies of their Full Individual Evaluations (FIE’s) and Comprehensive Individual Assessments (CIA’s) ahead of time for review. You will need to request both FIE’s and CIA’s because FIE’s have only been done since about the year 2000. Prior to that, the evaluations were called CIA’s (see terminology section below). If you do not have copies of these evaluations, you may be able to get them from the school district. Also, send copies of any other evaluations, including psychological evaluations by private psychologists, and other agencies' medical and developmental evaluations
MORE ABOUT OBTAINING SCHOOL RECORDS
Legal Guardian: It is important for parents and others who were given guardianship of minor children to understand that they are not automatically the legal guardians, even of their own child, once that child becomes an adult on the child’s 18th birthday. This is true regardless of how severely impaired their child may be. A legal guardian has legal authority to make certain decisions on behalf of the other person, whether that other person agrees with those decisions or not. Most people with mental retardation do not need legal guardians. However, for those who do, in order to be the legal guardian of anyone 18 years of age or older, a hearing must be held in a probate court to determine the extent to which the person who is said to need a guardian is capable of managing his/her own affairs. The court will then determine if that person needs a guardian and what decisions the guardian may make on behalf of that person. Guardianship must be renewed yearly with the issuing court. Once a person reaches his/her 18th birthday, only someone with power of attorney or a legal guardian may request the consumer’s school records. A power of attorney is not the same thing as a legal guardianship (see “Power of Attorney” below).
Full Individual Evaluation (FIE): Previously, this evaluation was known as a CIA. Texas public schools changed the name from CIA to FIE several years ago. An FIE is an evaluation conducted by professionals in order to determine whether a student qualifies for special education services and to identify areas of strength and need. The FIE consists of evaluations in the following seven areas:
- Reason for referral
- Speech and language
- Intelligence (IQ testing) and adaptive behavior
- Academic achievement
The FIE is conducted every three (3) years for special education students. The school may elect not to perform new testing every time an FIE is due. However, the parent may disagree and ask that new testing be performed.
Admission, Review, and Dismissal (ARD): A meeting involving school personnel, assessment professionals, the student, and the parents for purposes of educational placement, program planning, and to address other needs or difficulties the student has. An ARD report is written after the meeting and the student/parent receive a copy. ARD reports usually do not contain test results.
Individual Education Plan (IEP): A written educational program plan that spells out instructional goals and objectives and the criteria for mastery. The IEP is developed based on information supplied by the FIE and input from ARD committee members. The student and/or parents receive a copy of the IEP. An IEP usually does NOT contain test results.
State Audit Folder: The Texas Education Agency (TEA) requires the school to maintain copies of the student’s special education documents, including CIA’s, FIE’s, ARD reports and IEP’s in a file called a State Audit Folder. School personnel may have to go to the State Audit Folder to retrieve copies of older documents. Records in the State Audit Folder must be retained for five (5) years after a student graduates or leaves the school district.
Texas Education Agency: The state agency that regulates the public school system in the State of Texas. Problems that cannot be resolved with the school or school district itself can be appealed to the TEA.
Who can obtain confidential records?
The parent/legal guardian of a minor child has a legal right to review and obtain copies of their child’s special education records. The school cannot legally refuse to release copies of CIA’s, FIE’s, ARD reports, or IEP’s to the parent/legal guardian of a minor child.
Once a student has passed his/her 18th birthday, he/she is automatically considered to be a legally competent adult. In order to respect the consumer’s right to confidentiality, at the age of majority (18 years of age) the school can require the now legally-competent adult student to give written consent to release records, even to the consumer’s parent. Once the consumer reaches 18 years of age, the parent is no longer legally entitled to obtain school records, unless the parent has one of the following:
- Legal guardianship
- Written consent from their son or daughter to do so
The school must have written consent from the proper person in order to release records to Metrocare Services. The following people may give consent to the school to release information to Metrocare Services:
- The parent or guardian of a minor child (For consumers 18 years of age and older)
- The consumer himself or herself
- A consumer’s legal guardian
Anyone authorized to obtain school records must use a “consent to release information” form in order to have records released directly from the school to Metrocare Services. It makes no difference whether the form used is a Metrocare Services or school district form. Metrocare Services consent forms may be obtained from the Intake Specialist. School district consent forms may be obtained from the school or the school district's main office.