By: Ellis, Lucio S.B. No. 1060
(In the Senate - Filed February 23, 2009; March 13, 2009,
read first time and referred to Committee on Health and Human
Services; May 1, 2009, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 8, Nays 1;
May 1, 2009, sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 1060 By: Deuell
A BILL TO BE ENTITLED
AN ACT
relating to the creation of a strategic plan to reform long-term
services and supports for individuals with disabilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Subtitle I, Title 4, Government Code, is amended
by adding Chapter 536 to read as follows:
CHAPTER 536. STRATEGIC PLAN REGARDING LONG-TERM SERVICES AND
SUPPORTS FOR INDIVIDUALS WITH DISABILITIES
Sec. 536.001. PURPOSE; INTENT. (a) The purpose of this
chapter is to develop a comprehensive plan to reform and rebalance
Texas' system of long-term services and supports for individuals
with disabilities, including individuals who are eligible for
ICF-MR services.
(b) It is the intent of the legislature that the system
analysis and planning effort prescribed by this chapter encompass
services for individuals with disabilities across different
programs and settings.
(c) It is the intent of the legislature that the reformed
system:
(1) be based on principles of self-determination;
(2) include person-centered planning and maximize
opportunities for consumer direction for all eligible individuals;
(3) provide and expand timely access to services and
supports in the individual's setting of choice, whether in the
community or in an institution;
(4) base service provision on functional need;
(5) simplify and streamline community-based services
to ensure that, to the extent possible, all individuals have access
to the same array of services regardless of an individual's
disability;
(6) improve the quality of services delivered across
programs and settings, with particular attention given to services
delivered to individuals in state schools and state centers;
(7) strengthen oversight of community-based services;
and
(8) increase the cost-effectiveness and
sustainability of long-term care services and supports.
Sec. 536.002. PRINCIPLES OF SELF-DETERMINATION. For
purposes of this chapter, "self-determination" includes the
following principles:
(1) freedom, the opportunity to choose where and with
whom one lives and how one organizes all important aspects of one's
life with freely chosen assistance as needed;
(2) authority, the ability to control some targeted
amount of public dollars;
(3) support, the ability to organize support in ways
that are unique to the individual;
(4) responsibility, the obligation to use public
dollars wisely and to contribute to one's community; and
(5) confirmation, the recognition that individuals
with disabilities must be a major part of the redesign of the human
services system of long-term care.
Sec. 536.003. CREATION OF STRATEGIC PLAN. The commission
shall create a strategic plan for reform of the services and
supports available for individuals with disabilities, including
individuals eligible for ICF-MR services. The commission shall
develop the plan with the input of the strategic plan advisory
committee using a clearly defined process that allows ongoing and
meaningful statewide public involvement.
Sec. 536.004. STRATEGIC PLAN ADVISORY COMMITTEE. (a) The
strategic plan advisory committee is established to provide
information and assist the commission in the creation of the
strategic plan under this chapter.
(b) The advisory committee is composed of the following
members, appointed by the executive commissioner:
(1) one representative of each of the following:
(A) the commission;
(B) the Department of Aging and Disability
Services;
(C) the Department of State Health Services; and
(D) local mental retardation authorities;
(2) one representative who is a direct care employee
of a state school;
(3) two representatives of community service
providers;
(4) two representatives of an advocacy group for
persons with disabilities; and
(5) two representatives who are family members of
individuals residing in a state school.
(c) The advisory committee shall study and make
recommendations to the commission regarding any issues the
commission considers relevant in relation to:
(1) the proximity of state schools to other state
schools and the geographical distribution of state schools;
(2) the proximity of state schools to community
services providers and the geographical distribution of those
providers;
(3) the administrative costs of each state school;
(4) the availability of other employment
opportunities in the area of each state school for employees
displaced by potential consolidation, including additional
employees that may be needed by community services providers if a
state school is consolidated;
(5) the condition of existing state school structures
and existing community services providers;
(6) the ease of client transfer capability;
(7) the capacity of state schools to accommodate
individuals transferred from a facility that may be identified for
consolidation;
(8) the capacity of local community services providers
to accommodate individuals served by each state school;
(9) identification of specialty programs and services
available at each state school and whether those programs and
services are available at other state schools or from local
community services providers;
(10) the history of incidents of abuse, neglect, or
exploitation in each state school and in community-based services;
(11) the economic impact of expanding community
programs in the area of each state school, particularly in
historically underserved areas of the state;
(12) the economic impact of potential consolidation of
each state school; and
(13) any other relevant information as determined by
the advisory committee.
(d) The advisory committee may solicit public testimony and
input while performing the advisory committee's duties under this
chapter.
Sec. 536.005. CONTENTS OF STRATEGIC PLAN. The strategic
plan required by this chapter must:
(1) assess the need for services and supports based on
current interest lists, national trends, best practices, consumer
satisfaction surveys, and any other relevant data;
(2) prescribe methods to expand timely access to
community-based services by:
(A) eliminating wait times for services of
greater than two years;
(B) developing community-based provider
capacity;
(C) improving and expanding positive behavioral
supports in the community for adults and children; and
(D) applying "Money Follows the Person" methods
of financing for individuals residing in state schools, state
centers, or public or private ICF-MRs;
(3) analyze current utilization management methods
for community-based services and determine necessary modifications
to ensure more timely access to services;
(4) examine local access issues for community-based
services and identify appropriate solutions;
(5) examine the current functional eligibility
criteria, functional assessment tools, and service planning
reimbursement methodology for the home and community-based
services waiver system and determine appropriate methods to modify
those protocols so individuals can access needed services,
regardless of the program in which the individual is enrolled;
(6) prescribe methods to redesign the home and
community-based services waiver system across all programs by:
(A) simplifying and streamlining the
administrative, policy, and regulatory processes to the extent
possible;
(B) ensuring that person-centered plans and
philosophy match utilization review and utilization management
methods and philosophy;
(C) permitting, to the extent allowed by federal
law, flexibility in the development of an individualized service
plan based on the needs of the individual rather than the
individual's disability label or diagnosis;
(D) ensuring that an individualized service plan
can be modified when the individual's support needs change; and
(E) implementing other strategies to streamline
services for individuals with a disability who are eligible for
waiver services;
(7) prescribe methods to improve services delivered to
individuals in state schools and state centers;
(8) prescribe methods to reduce reliance on
institutional placements of individuals;
(9) prescribe methods to improve the quality of
services provided to individuals by:
(A) examining current methods and processes
related to the quality of services and identifying which methods or
processes:
(i) need further enhancements;
(ii) need to be developed; or
(iii) are effective and should be
considered for implementation across all services;
(B) increasing oversight and accountability in
community-based settings;
(C) developing an appropriate population of
qualified direct services workers in the community who are
appropriately compensated; and
(D) identifying quality measures, including
timeliness of service delivery, number of individuals served, and
types of services being received, and providing a process by which
this information is reported to the legislature on an annual basis;
and
(10) identify barriers to system reform and make
recommendations to eliminate or address barriers to system reform,
including any necessary statutory amendment.
SECTION 2. Not later than December 1, 2010, the Health and
Human Services Commission shall submit the strategic plan required
by Chapter 536, Government Code, as added by this Act, to the
presiding officers of the Senate Committee on Health and Human
Services and the House Human Services Committee.
SECTION 3. This Act takes effect immediately if it receives
a vote of two-thirds of all the members elected to each house, as
provided by Section 39, Article III, Texas Constitution. If this
Act does not receive the vote necessary for immediate effect, this
Act takes effect September 1, 2009.
* * * * *