JKC C.S.H.B. 663 75(R) BILL ANALYSIS HUMAN SERVICES C.S.H.B. 663 By: Maxey 03-24-97 Committee Report (Substituted) BACKGROUND Traditionally, service needs of an individual have been measured by the agency to which the individual has presented him/herself. Each agency has developed its own set of criteria on which the determination of "service eligibility" has been made. Advocates for and consumers of longterm care services have agreed that the needs of individuals, regardless of age, are functionally more similar than dissimilar. Most individuals requesting long-term care have some need for personal assistance services. Personal assistance service is a term broad enough to include: physical assistance for those with physical disabilities to assistance in decision-making for those who have permanent cognitive disabilities (mental retardation) or transitory cognitive disabilities (mental illness). The need for a particular type of assistance is defined by the consumer, and the training required of those providing personal assistance may be specific for the individual or disability group. Therefore, the functional need for services may be assessed based on the function that is identified as being lacking or needing personal intervention to accomplish. Such an approach demystifies the "uniqueness" of "specialness" of one disability's group's needs for services over another. By identifying all the long-term care needs of individuals and working with all disability special interest groups and stakeholders, the cross-disability assessment process, proposed in HB 663, would incorporate and describe the needs of all long-term care services recipients, based on function rather than on label, medical diagnosis, I.Q., or age. This cross-disability assessment process should result in long-term services which are more fairly and equitably assessed, due to the administration of one process rather than several individual processes from each independent agency providing services. PURPOSE HB 663 would require the development of a pilot study, spearheaded by the Health and Human Services Commission, of a cross-disability functional assessment process for use by those agencies currently providing long-term case services to Texans eligible for publicly-funded services. The design of the pilot study will assure that persons of all ages with different medical diagnoses and conditions will be assessed on functional needs for support rather than on their medical diagnosis/condition or the single agency from which their services have historically been provided. RULEMAKING AUTHORITY It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency or institution. SECTION BY SECTION ANALYSIS SECTION 1.Definitions. (1)"Commission" means Health and Human Services Commission. (2)"Pilot program" means the pilot program for consistent functional needs assessment established under this Act. SECTION 2.Pilot Program For Consistent Functional Needs Assessment. (a)Requires the commission to develop a functional needs assessment pilot program to determine its feasibility for use by long-term care service programs. The consistent functional needs assessment process must be appropriate to the needs of the long-term care service populations and must be based on the functional needs of an individual, rather than the origin of the individual's disability or the individual 's diagnosis or age. (b)In developing the consistent functional needs assessment process, the commission is required to consult with advocates and families of individuals in long-term care service programs and relevant providers and affected state agencies. (c)Requires the commission to use a test population in the pilot program that is representative of of populations seeking long-term care services in the state. SECTION 3. Gifts and Grants. Requires the commission to solicit and accept funds and resources to develop, implement and administer the pilot program. SECTION 4.Report to Legislature. (a)No later than November 1, 1998, the commission shall report the preliminary results of the pilot program to the legislature. (b)No later than November 1, 2000, the commission shall report to the legislature on the feasibility of implementation of the consistent functional needs assessment process developed under this act. SECTION 5.This Act expires September 1, 2001. SECTION 6.Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE The Committee Substitute inserts a new section entitled "Gifts and Grants," which requires the Health and Human Services Commission to seek funding and other resources to develop, implement and administer the program. The subsequent sections are renumbered accordingly.