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Editor性视界传媒檚 note: This is the first of two stories about services in the Longview area for people with intellectual and developmental disabilities.

The idea of living in a home in a neighborhood is something people commonly take for granted. But for adults with intellectual and developmental disabilities, it is a luxury 性视界传媒� one many of them never knew.

For decades, however, Concord Manor and its staff made such a possibility into a reality for those adults in Longview.

The brick residence at 414 S. Center St. was a group home, a place where people with intellectual or developmental disabilities got the help they need to live their day-to-day lives. Direct care workers provided around-the-clock services for residents, helping them bathe, dress, eat and perform other day-to-day tasks they can性视界传媒檛 do independently.

Group homes offer better care than people with mental disabilities used to receive, and that care has continued to evolve: In recent years, state and national health leaders have touted programs, which allow people to live in smaller group homes, live with a family or live independently, in some cases.

性视界传媒淚t kind of doesn性视界传媒檛 get better than that,性视界传媒� said Inman White, executive director of , the region性视界传媒檚 mental health authority. 性视界传媒淚t性视界传媒檚 a strong model, a good model.性视界传媒�

But while those services mark an advancement in care, they with intellectual and developmental disabilities, many of whom wait years to receive services. Meanwhile, hundreds of Texas group homes have closed because of staffing and funding shortages.

Concord, which closed March 18, was the last group home operated by Community Healthcore.

Nevertheless, people who help Texans with mental disabilities say they性视界传媒檙e hopeful that state leaders will improve the services available for some of the state性视界传媒檚 most vulnerable residents.

性视界传媒淢ore and more policymakers seem to be aware of the issues of folks with IDD in their constituency, and so I think that性视界传媒檚 a good thing,性视界传媒� said Jeff Miller, a policy specialist with the Disability Rights Texas advocacy organization. 性视界传媒淭hey性视界传媒檙e looking for answers, and they性视界传媒檙e trying to come up with some creative solutions to deal with this.性视界传媒�

性视界传媒榃e have come so far性视界传媒�The week after Concord Manor closed, White sat down in a conference room alongside fellow Community Healthcore leaders. The organization provides services to people with mental health issues and mental disabilities.

For years, the agency operated group homes, including Concord, as part of its services for people with intellectual and developmental disabilities. The conference room talk focused on how that kind of care has changed in the past several decades. White was Concord性视界传媒檚 program director earlier in his career.

性视界传媒淚t性视界传媒檚 emotional from the standpoint of recognizing the progress,性视界传媒� White said. His voice softened. 性视界传媒淲e性视界传媒檝e come so far.性视界传媒�

For most of human history, societies and governments have struggled to care for people with , ranging from serious forms of autism spectrum disorder and Down syndrome to brain injuries and cerebral palsy. From the in America, people with intellectual and developmental disabilities 性视界传媒� commonly referred to at the time as 性视界传媒渞etardation性视界传媒� 性视界传媒� were housed in large institutions called state schools.

性视界传媒淭hey were understaffed, underfunded, and they didn性视界传媒檛 do assessments on individuals to even determine what degree of disability they had,性视界传媒� said Sandra Taylor, who oversees intellectual and developmental disability services for Community Healthcore. 性视界传媒淭hey would put everybody in the same room, and the conditions were just horrible.性视界传媒�

Change began thanks to President John F. Kennedy. , had intellectual and developmental disabilities, and her life inspired Kennedy and federal leaders to improve the quality of care for people with those disabilities 性视界传媒� namely by getting them out of large, lifeless institutions and into community-based settings, Taylor said.

That性视界传媒檚 how group homes such as Concord, which are classified as intermediate care facilities, came to be. Most group homes are operated by private providers, while some have been operated by entities such as Community Healthcore.

The group home program is one of several that people with intellectual and developmental disabilities in Texas can take part in. The state also has 13 state-supported living centers, which are large, campus-style intermediate care facilities with comprehensive services for residents.

Group homes are funded by Medicaid, a state-federal partnership that provides healthcare to millions of poor and disabled Americans, via programs, which 性视界传媒渨aive性视界传媒� requirements for institutionalization, as part of the the program.

Group homes such as Concord, which housed 12 people, once were the preferred place for people to live. But now, healthcare leaders believe group homes with four or fewer residents are better places to live, and the Home and Community-based Services program also allows people the chance to get the help they need to live with their own family, with a host family or, in some cases, independently.

All of those changes are aimed at giving people a better quality of life, White said.

性视界传媒淵ou really want people to be able to live with families,性视界传媒� he said. 性视界传媒淚性视界传媒檝e heard it said that nobody really grows up with the dream of going to live in a group home. I hadn性视界传媒檛 thought about it until I heard it, but once I heard it, I couldn性视界传媒檛 un-hear it. People with intellectual disabilities have the same dreams and aspirations that everybody else does.性视界传媒�

At the time of its closure, Concord性视界传媒檚 10 residents were transferred to other group homes in the area or began receiving in-home services. About 30 or 40 group home providers operate in Community Healthcore性视界传媒檚 nine-county region.

But the closure of Concord and other group homes in the state can性视界传媒檛 be attributed entirely to access to better services.

StrugglesWhile smaller group homes and other community-based services might be the best forms of care people can receive, nearly 176,000 Texans with mental disabilities are , before they can get those services, according to a December 2024 report by the Arc of Texas, an organization advocating for Texans with disabilities.

Under Medicaid, state leaders determine how much money they性视界传媒檒l pump into the system, which determines how many people can get services and the amount of service available, said Miller, of Disability Rights Texas.

People who need services for intellectual and developmental disabilities can sign up for those services, but they性视界传媒檙e made available on a first-come, first-served basis, Miller said. (Individuals in crisis, however, can be moved up the list.)

性视界传媒淭hat性视界传媒檚 why, right now, we have about 170,000 people on seven different interest lists,性视界传媒� he said.

While Texas has a larger population than most other states, 性视界传媒渘o one has a wait list to the extent that Texas does,性视界传媒� Miller said.

Staffing shortages and low reimbursement rates from Medicaid have resulted in the closure of hundreds of Texas group homes in the past few years, with , according to data from Time to Care Texas, a coalition advocating for better pay for direct care workers.

In Texas, the base wage for people who work in group homes, called direct care workers, and those who work in a client性视界传媒檚 home, called personal care attendants, is . That rate is less than workers would make at fast food restaurants, Miller said.

And the work is harder: Direct care workers and personal attendants are responsible for administering patients性视界传媒� medications, bathing them, cleaning up feces and urine, lifting the patients and more 性视界传媒� every day, as often as needed. Direct care workers often work more than 40 hours per week.

性视界传媒淚t性视界传媒檚 been really, really difficult for providers, community providers, to find anybody that will work or, once they hire them, to keep them employed,性视界传媒� Miller said.

Unlike other group homes, Concord didn性视界传媒檛 struggle with staffing shortages because Community Healthcore had enough funding to pay direct care workers at least $16 per hour. However, that level of pay is a 性视界传媒渓uxury性视界传媒� that most providers don性视界传媒檛 have. Community Healthcore is a large institution that could move money from other programs, White said.

性视界传媒淭he challenge with Concord has always been being able to provide the services that people require and need within the rate that is offered to provide the services,性视界传媒� White said. 性视界传媒淭he services can be very expensive, very comprehensive, very good, very individualized.性视界传媒�

While the wait list for services is long, White and Miller said state leaders性视界传媒� decision to let people in crisis access services sooner is an improvement. Miller said he hopes state officials will modify the system to mirror Louisiana性视界传媒檚, which gives people services based on their need when they sign up, not on a first-come, first-served basis.

性视界传媒淚f Texas is willing to make the same expenditure in terms of resources and time and money, I think we could look at reshaping our interest list in providing services for folks at the same time,性视界传媒� Miller said. 性视界传媒淚 just oftentimes fear that Texas gets ahead of itself, and we don性视界传媒檛 spend the time and money that we need to upfront. We try to fix it later.性视界传媒�

While state funding could be increased, proposed cuts to Medicaid on the federal level also could impact services. Republicans in the U.S. House are , up to $880 billion, as they work to reduce federal spending.

性视界传媒楾hey touch your heart性视界传媒�Texas lawmakers are considering increasing pay for direct care workers during the ongoing legislative session, Miller said. Proposals in the Texas House and Senate range between and $17.50 per hour. Lawmakers also are evaluating ways to improve coordination between state agencies that serve people with mental disabilities.

性视界传媒淚 see something like that coming out of this session, where we do take a deeper look into the services that are being provided and figure out, is there a way to do it better?性视界传媒� Miller said.

Pay, however, can only go so far toward solving staffing shortages. Being a direct care worker takes something training can性视界传媒檛 provide: heart.

性视界传媒淚f you don性视界传媒檛 see the value of it, you don性视界传媒檛 last long, and it really shows itself in a hurry,性视界传媒� said Taylor, with Community Healthcore. 性视界传媒淏ut those who really have a heart for the individuals, they tend to do very well in this field.

性视界传媒淥nce you have worked with individuals with developmental disabilities, they touch your heart, and it性视界传媒檚 something magical that happens to you. But it starts with the organization that you性视界传媒檙e a part of, that recognizes our role and the importance of our role.性视界传媒�

Taylor and White characterized Concord as a place that lived up to its name. Concord means 性视界传媒渁greement性视界传媒� and 性视界传媒渉armony,性视界传媒� per the Merriam-Webster性视界传媒檚 Dictionary. Workers there tried to foster that kind of atmosphere.

性视界传媒淭hose individuals who work with the [residents] were amazing workers,性视界传媒� Taylor said. 性视界传媒淚t was more than just a job. There were some individuals at Concord [whose] families were not involved with them. So, the workers became their families, and we celebrated birthdays. We celebrated anniversaries. We bought Christmas gifts. We made certain that they didn性视界传媒檛 want for anything.性视界传媒�

Challenges remain in serving Texans with mental disabilities, White said. But in his decades of service, he性视界传媒檚 seen a lot of positive changes, too. After all, when Concord was opened, the idea of having programs to let people live with their families or on their own was unfathomable.

性视界传媒淕iven time and a little grace, generally, things do get better,性视界传媒� he said. 性视界传媒淔ortunately, this is a story of that happening.性视界传媒�