By:  Maxey                                            H.C.R. No. 21
       73R2380 SMC-D
                                 CONCURRENT RESOLUTION
    1-1        WHEREAS, New drugs and aggressive medical treatment have
    1-2  transformed acquired immune deficiency syndrome (AIDS) from a
    1-3  progressive and terminal disease into a chronic disease that causes
    1-4  a person with AIDS to alternate between periods of acute illness
    1-5  and periods of relative health; and
    1-6        WHEREAS, Persons in an acute phase of AIDS are usually too
    1-7  ill to care for themselves because the conditions common to AIDS
    1-8  may render them unable to feed themselves, to take medications, and
    1-9  to provide proper medical treatment and basic hygiene for
   1-10  themselves; and
   1-11        WHEREAS, AIDS patients often remain in hospitals for long
   1-12  periods of time because they cannot otherwise get appropriate
   1-13  skilled nursing care; public health nurses cannot handle the volume
   1-14  of home visits the AIDS population requires and private nursing
   1-15  services are not affordable for most people afflicted with the
   1-16  disease; and
   1-17        WHEREAS, Traditional nursing homes for the elderly are often
   1-18  not a viable option because nursing staffs may lack the specialized
   1-19  training needed to manage the disease; and
   1-20        WHEREAS, The reliance on hospitals to handle 24-hour skilled
   1-21  care of people with AIDS is very costly and, since people with AIDS
   1-22  are often uninsured, this cost burden falls directly or indirectly
   1-23  on the public; and
   1-24        WHEREAS, Studies have shown that people are better able to
    2-1  cope with disabling illnesses if they can exercise some control
    2-2  over their lives; such control is often not possible in a general
    2-3  hospital setting where hospital policies dictate mealtimes,
    2-4  visiting hours, and sleep patterns; and
    2-5        WHEREAS, Persons with AIDS are likely to experience many
    2-6  acute episodes that call for hospital-level diagnosis and
    2-7  intervention, followed by a treatment regimen involving skilled
    2-8  nursing care and, because there is no alternative, that care is
    2-9  being provided in hospitals, the most expensive of all settings;
   2-10  and
   2-11        WHEREAS, Christopher House, Inc., is a nonprofit organization
   2-12  that was formed in 1989 to develop a residential, intermediate care
   2-13  center for people with AIDS in Austin, Texas; and
   2-14        WHEREAS, The concept behind Christopher House grew out of a
   2-15  keen awareness of the gap for AIDS services in the health care
   2-16  delivery system; the organization's founders recognized that a
   2-17  residential, skilled-care center designed especially for people
   2-18  with AIDS could greatly reduce hospital stays and, at the same
   2-19  time, provide a more humane setting for care; and
   2-20        WHEREAS, Since its inception, Christopher House has made
   2-21  enormous progress toward opening such a center by designing a model
   2-22  program for cost effective AIDS care; and
   2-23        WHEREAS, The organization has received financial support from
   2-24  local health care providers, state and national charitable
   2-25  foundations, private businesses, and many individual donors; and
   2-26        WHEREAS, This worthy project has won the unqualified support
   2-27  of the Austin medical community, area AIDS service providers, the
    3-1  Austin/Travis County HIV Commission, state and local elected
    3-2  officials, and a wide range of other community groups; and
    3-3        WHEREAS, Austin needs an alternative to long-term
    3-4  hospitalization for people with AIDS; the Centers for Disease
    3-5  Control has projected that a total of 6,000 to 10,000 cases of AIDS
    3-6  will occur in the Capital City over the next 10 years; and
    3-7        WHEREAS, Christopher House will be a state-licensed 15-bed
    3-8  skilled nursing facility that will serve as an intermediary between
    3-9  hospital and home care, providing residential care to its residents
   3-10  in a manner that will balance patients' need for privacy, dignity,
   3-11  and autonomy with their need for quick access to skilled nursing
   3-12  care; and
   3-13        WHEREAS, Rider 22(e) to the appropriation to the Texas
   3-14  Department of Human Services in the General Appropriations Act
   3-15  provides that the department shall not contract additional Medicaid
   3-16  beds in counties where the average occupancy rate of available beds
   3-17  for each of the previous six months has been less than 85 percent,
   3-18  which is often the case in Travis County; and
   3-19        WHEREAS, The legislature never intended for residences such
   3-20  as the Christopher House to be included in the application of Rider
   3-21  22(e) and this situation indeed warrants clarification; now,
   3-22  therefore, be it
   3-23        RESOLVED, That the 73rd Legislature of the State of Texas
   3-24  hereby direct the Texas Department of Human Services to exempt
   3-25  Christopher House, Inc., from the nursing home bed occupancy rules
   3-26  of Rider 22(e) to the appropriation to the Texas Department of
   3-27  Human Services in the General Appropriations Act and upon
    4-1  completion of the 15-bed facility in Austin, the organization be
    4-2  allowed to contract with the Texas Medical Assistance (Medicaid)
    4-3  program to provide care for AIDS patients; and, be it further
    4-4        RESOLVED, That an official copy of this resolution be
    4-5  forwarded to the commissioner of the Texas Department of Human
    4-6  Services as a formal expression of the sentiment of the Legislature
    4-7  of the State of Texas.