C.S.H.B. 1698
By: Maxey
Committee Report (Substituted)


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

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.


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.


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 1:  Amends Article 4413(502), Revised Statutes, by adding
Section 22, as follows:


(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.


The committee substitute made two small changes to H.B. 1698 as
The phrase "outside of a residential-care setting" was deleted in
the substitute and the word "the" in the original was changed to


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.