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.