Texas State Health Plan: 1985, Appendix A Page: 2
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to overwhelm the H&R services delivery system; and there is a lace of incidence/
prevalence rates for these disabling conditions. Exhibit 4 has been prepared
listing those disabling conditions for which we could locate current prevalence
rates, some national and some for Texas, with sources cited.
In the interest of reducing the scope of this study to a size more easily under-
stood, we have excluded an inventory of those medical services needed for long-
term physical disabilities. Such treatment is on the tertiary level and is not
within the category of primary medical care services. The same exclusion is
applied for those mental and emotional disabilities which require long term
institutionalization. These services are essential for the rehabilitation of
those severely disabled persons in need of extensive medical, surgical and
psychiatric treatment, but there does exist a fairly elaborate system of facili-
ties and trained staff to handle these situations. They may or may not be ade-
quate, but that question must be answered at a later date in another study.
The great majority of the disabled persons in Texas are those with conditions
which can be treated in community outpatient service settings, whether in a
hospital or a freestanding clinic. These are the people who require an
increased number and diversity of outpatient services in their rural commu-
nities, or at the very least, some practical means of accessing those services
they need, even if they are one or two counties away.
Table 2 lists the 1982 inventory of the hospitals and freestanding clinics in
each state planning region (SPR) which offers outpatient H&R services. This
Table also lists the 1985 estimates for the number of disabled persons excluding
age 65 and over, the number of 65 and over disabled, the grand total of disabled
persons, the 1989 estimates for total disabled persons, and the state totals for
the facilities and numbers of disabled persons.
The H&R outpatient services offered in these facilities are limited to audio
therapy, medical evaluation, medical supervision, occupational therapy, physical
therapy, prosthetics, psychiatric, psychological evaluation, recreational thera-
py, social case work, social evaluation, speech therapy, and vocational
services. These services are not offered in a full array in each outpatient
facility, the rule being only one or two such services except in the larger
hospital facilities where space, equipment and trained staff are available. The
most commonly offered outpatient services are: audio therapy, physical therapy;
and speech therapy.
The communities have very little to offer in the way of sheltered workshops;
education to reduce dependency like living skills, recreation and coping with
architectural barriers, prosthetics, orthotics, employment placement services,
community housing, manpower training, whether professional or volunteer, and the
extended services such as tele-communications, library, Client Assistance
Projects (CAPS), Community Alternative Service Systems (CASS) which are for the
developmentally disabled and respite care for the families of the disabled.
There is a great and growing need for community level outpatient services for
disabled persons. As the federal government withdraws it financial support,
there is a great challenge for community leaders. As the federal money disap-
pears, so does the political power which returns to the communities and the
state the power to tackle problems and create change at the local level. The
federal restraints will fade away and a large number of problems can he solved2
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1985, Appendix A, report, 1985; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586722/m1/82/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.