Texas 2009 - 81st Regular

Texas House Bill HB1589 Compare Versions

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1	1	81R3822 UM-D
2	2	By: Rose H.B. No. 1589
3	3
4	4
5	5	A BILL TO BE ENTITLED
6	6	AN ACT
7	7	relating to the creation of a strategic plan to reform long-term
8	8	services and supports for individuals with disabilities.
9	9	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
10	10	SECTION 1. Subtitle I, Title 4, Government Code, is amended
11	11	by adding Chapter 536 to read as follows:
12	12	CHAPTER 536. STRATEGIC PLAN REGARDING LONG-TERM SERVICES AND
13	13	SUPPORTS FOR INDIVIDUALS WITH DISABILITIES
14	14	Sec. 536.001. PURPOSE; INTENT. (a) The purpose of this
15	15	chapter is to develop a comprehensive plan to reform and rebalance
16	16	Texas' system of long-term services and supports for people with
17	17	disabilities, including individuals who are eligible for ICF-MR
18	18	services.
19	19	(b) It is the intent of the legislature that the system
20	20	analysis and planning effort prescribed by this chapter encompass
21	21	services for individuals with disabilities across different
22	22	programs and settings.
23	23	(c) It is the intent of the legislature that the reformed
24	24	system:
25	25	(1) be based on principles of self-determination;
26	26	(2) include person-centered planning and maximize
27	27	opportunities for consumer direction for all eligible individuals;
28	28	(3) provide and expand timely access to services in
29	29	the consumer's setting of choice, whether in the community or in an
30	30	institution;
31	31	(4) base service provision on functional need;
32	32	(5) simplify and streamline community-based services
33	33	to ensure that, to the extent possible, individuals have access to
34	34	the same array of services regardless of an individual's
35	35	disability;
36	36	(6) improve the quality of services delivered across
37	37	programs and settings, with particular attention given to services
38	38	delivered to consumers in state schools and state centers;
39	39	(7) strengthen oversight of community-based services;
40	40	and
41	41	(8) increase the cost-effectiveness and
42	42	sustainability of long-term care services and supports.
43	43	Sec. 536.002. PRINCIPLES OF SELF-DETERMINATION. For
44	44	purposes of this chapter, "self-determination" includes the
45	45	following principles:
46	46	(1) freedom, the opportunity to choose where and with
47	47	whom one lives and how one organizes all important aspects of one's
48	48	life with freely chosen assistance as needed;
49	49	(2) authority, the ability to control some targeted
50	50	amount of public dollars;
51	51	(3) support, the ability to organize support in ways
52	52	that are unique to the individual;
53	53	(4) responsibility, the obligation to use public
54	54	dollars wisely and to contribute to one's community; and
55	55	(5) confirmation, the recognition that individuals
56	56	with disabilities must be a major part of the redesign of the human
57	57	services system of long-term care.
58	58	Sec. 536.003. CREATION OF STRATEGIC PLAN. The commission
59	59	shall create a strategic plan for reform of the services and
60	60	supports available for persons with disabilities, including
61	61	individuals eligible for ICF-MR services. The commission shall
62	62	develop the plan using a clearly defined process that allows
63	63	ongoing and meaningful statewide public involvement.
64	64	Sec. 536.004. CONTENTS OF STRATEGIC PLAN. (a) The
65	65	strategic plan required by this chapter must:
66	66	(1) assess the need for services and supports based on
67	67	current interest lists, national trends, best practices, consumer
68	68	satisfaction surveys, and any other relevant data;
69	69	(2) prescribe methods to expand timely access to
70	70	community-based services by:
71	71	(A) eliminating wait times for services of
72	72	greater than two years;
73	73	(B) transferring funds from institutional to
74	74	community-based strategies where appropriate;
75	75	(C) developing community-based provider
76	76	capacity;
77	77	(D) providing incentives for ICF-MR providers to
78	78	transition to serving consumers in the most integrated setting;
79	79	(E) improving and expanding behavioral supports
80	80	in the community for adults and children; and
81	81	(F) applying "Money Follows the Person" methods
82	82	of financing for persons residing in state schools, state centers,
83	83	or public or private ICF-MRs;
84	84	(3) analyze current utilization management methods
85	85	for community-based services and determine necessary modifications
86	86	to ensure more timely access to services;
87	87	(4) examine local access issues for community-based
88	88	services and identify appropriate solutions;
89	89	(5) examine the current functional eligibility
90	90	criteria, functional assessment tools, and service planning
91	91	reimbursement methodology for the home and community-based
92	92	services waiver system and determine appropriate methods to modify
93	93	those protocols so individuals can access needed services,
94	94	regardless of the program in which the individual is enrolled;
95	95	(6) prescribe methods to redesign the home and
96	96	community-based services waiver system across all programs by:
97	97	(A) simplifying and streamlining the
98	98	administrative, policy, and regulatory processes to the extent
99	99	possible;
100	100	(B) ensuring that person-centered plans and
101	101	philosophy match utilization review and utilization management
102	102	methods and philosophy;
103	103	(C) permitting, to the extent allowed by federal
104	104	law, flexibility in the development of a consumer's individualized
105	105	service plan based on the needs of the consumer rather than the
106	106	consumer's disability label or diagnosis;
107	107	(D) ensuring that a consumer's individualized
108	108	service plan can be modified when the consumer's support needs
109	109	change; and
110	110	(E) implementing other strategies to streamline
111	111	services for consumers with a disability who are eligible for
112	112	waiver services;
113	113	(7) prescribe methods to improve services delivered to
114	114	consumers in state schools and state centers;
115	115	(8) prescribe methods to reduce reliance on
116	116	institutional placements of consumers;
117	117	(9) prescribe methods to end institutional placements
118	118	of individuals who are younger than 22 years of age;
119	119	(10) prescribe methods to consolidate and close state
120	120	schools and state centers in accordance with Subsection (b);
121	121	(11) prescribe methods to downsize large and
122	122	medium-sized public and private ICF-MRs;
123	123	(12) prescribe methods to improve the quality of
124	124	services provided to consumers by:
125	125	(A) examining current methods and processes
126	126	related to the quality of services and identifying which methods or
127	127	processes:
128	128	(i) need further enhancements;
129	129	(ii) need to be developed; or
130	130	(iii) are effective and should be
131	131	considered for implementation across all services;
132	132	(B) increasing oversight and accountability in
133	133	community-based settings;
134	134	(C) developing an appropriate population of
135	135	qualified direct services workers in the community;
136	136	(D) developing and making available alternatives
137	137	to guardianship for consumers who need support in their
138	138	decision-making; and
139	139	(E) identifying quality measures, including
140	140	timeliness of service delivery, number of consumers served, and
141	141	types of services being received, and providing a process by which
142	142	this information is reported to the legislature on an annual basis;
143	143	and
144	144	(13) identify barriers to system reform and make
145	145	recommendations to eliminate or address barriers to system reform,
146	146	including any necessary statutory amendment.
147	147	(b) The strategic plan must prescribe a method that will
148	148	result in the consolidation and closure of state school and state
149	149	center facilities through a reduction in the number of consumers
150	150	placed in those facilities. In determining the method for
151	151	consolidating and closing state school and state center facilities,
152	152	the plan must:
153	153	(1) establish a goal of reducing, within eight years
154	154	of the submission of the strategic plan, the utilization rate of
155	155	state schools and other facilities with 16 or more beds to not more
156	156	than the average national utilization rate;
157	157	(2) establish benchmarks that will demonstrate
158	158	measurable progress during the eight-year period following the
159	159	submission of the strategic plan toward the reduction of the
160	160	utilization rate of state schools and other facilities with 16 or
161	161	more beds;
162	162	(3) reflect the recommendations of a steering
163	163	committee that includes:
164	164	(A) as appointed by the speaker of the house of
165	165	representatives:
166	166	(i) one member representing a district in
167	167	which a state school or state center is located; and
168	168	(ii) one member representing a district in
169	169	which no state school or state center is located;
170	170	(B) as appointed by the lieutenant governor:
171	171	(i) one senator representing a district in
172	172	which a state school or state center is located; and
173	173	(ii) one senator representing a district in
174	174	which no state school or state center is located;
175	175	(C) as appointed by the executive commissioner,
176	176	one representative of:
177	177	(i) providers of community-based services;
178	178	(ii) providers of ICF-MR services;
179	179	(iii) state school employees;
180	180	(iv) consumers;
181	181	(v) advocates for consumers;
182	182	(vi) advocates for consumers who are
183	183	children;
184	184	(vii) families of residents of a state
185	185	school located in a rural area;
186	186	(viii) families of residents of a state
187	187	school located in an urban area; and
188	188	(ix) local mental retardation authorities;
189	189	and
190	190	(D) for the purpose of providing assistance and
191	191	serving as a resource to the steering committee, representatives of
192	192	relevant agencies, including the Texas Department of Housing and
193	193	Community Affairs and other agencies other than the commission, as
194	194	determined by the other members of the steering committee;
195	195	(4) require the executive commissioner to appoint or
196	196	hire a person, who is not an employee of the Department of Aging and
197	197	Disability Services, to oversee the closure process;
198	198	(5) identify the number and location of state schools
199	199	and state centers that will be closed under the plan and the
200	200	timeline for each closure;
201	201	(6) establish guiding principles for state schools and
202	202	state centers that will be closed under the plan, including
203	203	guidelines for the future use of closed facilities and principles
204	204	addressing the needs of:
205	205	(A) residents and their families;
206	206	(B) employees; and
207	207	(C) affected communities;
208	208	(7) define transitional supports, including
209	209	employment supports, that will be made available to a state school
210	210	or state center resident who moves from a state school or state
211	211	center; and
212	212	(8) prescribe methods to provide consumers in state
213	213	schools or state centers who do not have a legally authorized
214	214	representative with access to alternatives to guardianship.
215	215	(c) The strategic plan must establish a timeline and defined
216	216	benchmarks for measuring progress in implementing the plan. The
217	217	executive commissioner shall ensure that the plan includes an
218	218	ongoing evaluation process that allows the plan to be amended in
219	219	response to needs identified by the process. The proposed timeline
220	220	and benchmarks must progressively move the state closer to the goal
221	221	of reducing the utilization rate of state schools and other
222	222	facilities with 16 or more beds to a rate that is not more than the
223	223	national utilization rate and to the goal of reducing wait times for
224	224	community-based services. The plan must require the commission to
225	225	inform the governor, the lieutenant governor, the speaker of the
226	226	house of representatives, the Legislative Budget Board, and the
227	227	standing committees of both houses of the legislature with
228	228	appropriate subject matter jurisdiction when significant revisions
229	229	to the strategic plan are made or when a proposed timeline is not
230	230	met.
231	231	(d) The executive commissioner, in developing the strategic
232	232	plan, shall consider the efforts of other states, Texas' settlement
233	233	of Lelsz v. Kavanagh, and any relevant directives or information
234	234	resulting from the investigation of state school or state center
235	235	facilities by the United States Department of Justice.
236	236	(e) The executive commissioner may contract with a
237	237	disinterested person with expertise in evaluating and planning
238	238	long-term care services and supports for persons with disabilities,
239	239	self-determination and consumer direction, and facilities
240	240	closures, to aid the commission in developing the plan required by
241	241	this chapter.
242	242	Sec. 536.005. CLOSURE OR CONSOLIDATION OF CERTAIN
243	243	FACILITIES. As soon as possible after the commission submits the
244	244	strategic plan required by this chapter, the executive commissioner
245	245	shall begin the facility closure process described by the plan. The
246	246	commission may begin the implementation of the plan and close or
247	247	consolidate a facility as described by the plan without additional
248	248	or specific legislative action.
249	249	SECTION 2. Not later than December 1, 2010, the Health and
250	250	Human Services Commission shall submit the strategic plan required
251	251	by Chapter 536, Government Code, as added by this Act, to the
252	252	presiding officers of the Senate Health and Human Services
253	253	Committee and the House Human Services Committee.
254	254	SECTION 3. This Act takes effect immediately if it receives
255	255	a vote of two-thirds of all the members elected to each house, as
256	256	provided by Section 39, Article III, Texas Constitution. If this
257	257	Act does not receive the vote necessary for immediate effect, this
258	258	Act takes effect September 1, 2009.