BILL ANALYSIS C.S.H.B. 1698 By: Maxey 03-23-95 Committee Report (Substituted) BACKGROUND Thousands of Texan who need long-term care services have placed their names on waiting lists maintained by the state's health and human services agencies. Some lists consist of clients who have been informed that they should expect to wait seven to ten years before becoming eligible for the particular services offered by the program. Recently, new forms of service delivery have been developed to respond to consumers' needs and desires for less restrictive and more appropriate environments, as well as to adapt to the rising costs associated with health care services. Many services are now available in both institutional and community-based settings, offering consumers a variety of choices. With the aging of Texas' population, lawmakers must seek more cost efficient and effective methods of service delivery in order to contain costs yet assist needy Texans. Workers at health and human services agencies should ensure that consumers, families and guardians receive information about all available long-term care options and fully understand the choices available to them, since such choices ultimately effect the method, quality and continuity of care provided to the client. PURPOSE H.B. No. 1698 seeks to establish a system to notify patients or clients of long-term care services about the community-based and residential-care settings available and the implications of those services. The Health and Human Services Comm'n would instruct workers at the agencies under its umbrella to inform clients of such options. RULEMAKING AUTHORITY As substituted, H.B. 1698 provides the Health & Human Services Commission with new rulemaking authority in Section 1, Sec. 22 (a) and (d). Subsection (b) establishes standards to be included in the rules delegated in subsection (a). Subsection (c) references the rules granted under (a). SECTION BY SECTION ANALYSIS SECTION 1: Amends Article 4413(502), Revised Statutes, by adding Section 22, as follows: Sec. 22. COMMUNITY SERVICES INFORMATION; REPORTS. (a) Directs the Health & Human Services Commissioner by rule to require each agency under its umbrella to inform clients about community-based long-term care services before placing them in long-term residential settings. (b) Establishes standards to be included in the rules adopted under subsection (a) requiring that the information provided to the patient or client must include options available through other state agencies or private providers; requires that such information must be offered in a manner that will maximize the client's understanding of all available options. If a person has a guardian, information must be provided to the guardian. (c) Requires health and human services agencies that provide information to clients or guardians must obtain a signed statement that the information required under subsections (a) and (b) has been received. The signed copy must be placed with the patient's case file. (d) Requires health & human services agencies to report annually and permits HHSC by rule to establish a reporting schedule regarding the number of community-based and residential-care placements made. SECTION 2: Emergency clause, effective in 90 days. COMPARISON OF ORIGINAL TO SUBSTITUTE The committee substitute made two small changes to H.B. 1698 as introduced. The phrase "outside of a residential-care setting" was deleted in the substitute and the word "the" in the original was changed to "all". SUMMARY OF COMMITTEE ACTION The House Human Services Committee convened in a public hearing on March 20, 1995. The Chairman laid out H.B. 1698 and recognized Rep. Maxey who offered a committee substitute for H.B. 1698. The following witnesses testified for H.B. 1698: Gary Dean Kay, The Texas Advocates, Austin, Gordon Israel, Draco Residences, Inc., Austin, Stephanie Thomas, ADAPT, Austin, Mary Jo Magruder, TX Planning Council for Developmental Disabilities, Mike Bright, ARC of Texas, Barrett Markland, Advocacy, Inc., Bob Kafka, ADAPT, Austin, Kevin Tracy, Texas Advocates, Jennifer McPhail, ADAPT, Danny Saenz, Austin, Karen Greebon, ADAPT, Rona Schnall, ADAPT, James Templeton, ADAPT, David Wittie, ADAPT, Wayne Spahn, ADAPT, and Kim Kirchoff, Texas Ass'n of Regional Councils. Debra Wanser, Texas Dept. of Health testified as neutral on H.B. 1698; no one testified against H.B. 1698. H.B. 1698 was left pending. In a formal meeting on March 23, 1995, the House Human Services Committee considered Chairman laid out H.B. 1698 by Maxey which had been pending. Rep. Maxey offered a committee substitute and it was adopted, hearing no objection. Rep. Naishtat moved to report H.B. 1698 favorably as substituted and send H.B. 1698 to the Committee on Local and Consent Calendars. The motion prevailed by a record vote of 7 ayes, 0 nays, 0 present not voting and 2 absent.