By Zaffirini S.B. No. 367
77R1627 KLA-D
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to ensuring an appropriate care setting for a person with
1-3 a disability.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subchapter B, Chapter 531, Government Code, is
1-6 amended by adding Sections 531.0244, 531.02441, and 531.02442 to
1-7 read as follows:
1-8 Sec. 531.0244. ENSURING APPROPRIATE CARE SETTING FOR PERSONS
1-9 WITH DISABILITIES. (a) The commission and appropriate health and
1-10 human services agencies shall implement a plan that provides a
1-11 system of services and support that fosters independence and
1-12 productivity and provides meaningful opportunities for a person
1-13 with a disability to live in the community.
1-14 (b) The plan required by Subsection (a) must require
1-15 appropriate health and human services agencies to:
1-16 (1) provide to a person with a disability living in an
1-17 institution information regarding care and support options
1-18 available to the person, including community-based services
1-19 appropriate to the needs of the person;
1-20 (2) facilitate a timely and appropriate transfer of a
1-21 person with a disability from an institution to an appropriate
1-22 setting in the community, if the person chooses to live in the
1-23 community and the person's treating professional determines the
1-24 transfer is medically appropriate; and
2-1 (3) develop strategies to prevent the unnecessary
2-2 placement in an institution of a person with a disability who is
2-3 living in the community but is in imminent risk of requiring
2-4 placement in an institution because of a lack of community
2-5 services.
2-6 (c) Not later than December 1 of each even-numbered year,
2-7 the commissioner shall submit to the governor and the legislature a
2-8 report on the status of the implementation of the plan required by
2-9 Subsection (a). The report must include recommendations on any
2-10 statutory or other action necessary to implement the plan.
2-11 Sec. 531.02441. INTERAGENCY WORK GROUP ON ENSURING
2-12 APPROPRIATE CARE SETTINGS FOR PERSONS WITH DISABILITIES. (a) The
2-13 commissioner shall establish an interagency work group to assist
2-14 the commission and appropriate health and human services agencies
2-15 in developing a plan to ensure appropriate care settings for
2-16 persons with disabilities.
2-17 (b) The commissioner shall determine the number of members
2-18 of the work group. The commissioner shall appoint as members of
2-19 the work group:
2-20 (1) representatives of appropriate health and human
2-21 services agencies; and
2-22 (2) representatives of other related work groups,
2-23 including representatives of the work groups established under
2-24 Sections 22.034 and 22.035, Human Resources Code.
2-25 (c) The commissioner shall designate a member of the work
2-26 group to serve as presiding officer. The members of the work group
2-27 shall elect any other necessary officers.
3-1 (d) The work group shall meet at the call of the presiding
3-2 officer.
3-3 (e) A member of the work group serves at the will of the
3-4 commissioner.
3-5 (f) A member of the work group may not receive compensation
3-6 for serving on the work group, but is entitled to reimbursement for
3-7 travel expenses incurred by the member while conducting the
3-8 business of the work group, as provided by the General
3-9 Appropriations Act.
3-10 (g) The work group shall study and make recommendations to
3-11 the commission on:
3-12 (1) developing the plan required by Section
3-13 531.0244(a) to ensure appropriate care settings for persons with
3-14 disabilities; and
3-15 (2) identifying appropriate components of the pilot
3-16 program established under Section 22.037, Human Resources Code, for
3-17 coordination and integration between the Texas Department of Human
3-18 Services and the Texas Department of Mental Health and Mental
3-19 Retardation.
3-20 (h) Not later than September 1 of each year, the work group
3-21 shall report to the commissioner on its findings and
3-22 recommendations.
3-23 (i) The work group is not subject to Chapter 2110.
3-24 Sec. 531.02442. ADVISORY COMMITTEE ON ENSURING APPROPRIATE
3-25 CARE SETTINGS FOR PERSONS WITH DISABILITIES. (a) The commissioner
3-26 shall establish an advisory committee to advise the commissioner
3-27 and appropriate health and human services agencies on ensuring
4-1 appropriate care settings for persons with disabilities.
4-2 (b) The advisory committee consists of 12 members appointed
4-3 by the commissioner as follows:
4-4 (1) seven representatives of consumer or family
4-5 advocacy groups;
4-6 (2) three representatives of community-based services
4-7 providers for persons with disabilities;
4-8 (3) one representative of the Texas Department of
4-9 Mental Health and Mental Retardation; and
4-10 (4) one representative of the Texas Department of
4-11 Human Services.
4-12 (c) The advisory committee shall advise the commission and
4-13 appropriate health and human services agencies with respect to
4-14 implementing the plan required by Section 531.0244(a), giving
4-15 primary consideration to:
4-16 (1) methods to identify and assess each person who
4-17 resides in an institution but chooses to live in the community and
4-18 for whom a transfer from an institution to the community is
4-19 medically appropriate, as determined by the person's treating
4-20 professional;
4-21 (2) determining the availability of community care and
4-22 support options for persons described by Subdivision (1);
4-23 (3) identifying and addressing barriers to
4-24 implementation of the plan; and
4-25 (4) identifying funding options for the plan.
4-26 (d) A member of the advisory committee may not receive
4-27 compensation for serving on the committee, but is entitled to
5-1 reimbursement for travel expenses incurred by the member while
5-2 conducting the business of the committee, as provided by the
5-3 General Appropriations Act.
5-4 (e) The advisory committee is not subject to Chapter 2110.
5-5 SECTION 2. Section 531.042, Government Code, is amended to
5-6 read as follows:
5-7 Sec. 531.042. [COMMUNITY-BASED SERVICES] INFORMATION AND
5-8 ASSISTANCE REGARDING CARE AND SUPPORT OPTIONS; REPORTS. (a) The
5-9 commissioner by rule shall require each health and human services
5-10 agency to provide to each patient or client of the agency
5-11 information regarding all care and support options available to the
5-12 patient or client, including community-based services appropriate
5-13 to the needs of the patient or client, before the agency allows the
5-14 patient or client to be placed in a care setting, including a
5-15 nursing home or intermediate care facility for the mentally
5-16 retarded, to receive care or services provided by the agency or by
5-17 a person under an agreement with the agency.
5-18 (b) The rules must require each health and human services
5-19 agency to provide information about all [community-based] long-term
5-20 care options and long-term support options available to the patient
5-21 or client, including community-based options and options available
5-22 through another agency or a private provider. The information must
5-23 be provided in a manner designed to maximize the patient's or
5-24 client's understanding of all available options. If the patient or
5-25 client has a guardian, the information must also be provided to the
5-26 guardian. An agency may obtain the assistance of a private
5-27 provider, including a community-based organization, in providing
6-1 patients, clients, or guardians with information as provided by
6-2 commission rules.
6-3 (c) A health and human services agency that provides a
6-4 patient, client, or guardian with information as provided by
6-5 commission rules shall obtain a statement signed by the patient or
6-6 client, and, if the patient or client has a guardian, by the
6-7 patient's or client's guardian, that the patient or client has been
6-8 informed about all care and support options available to the
6-9 patient or client, including community-based care and support
6-10 options, as required by commission rules. The agency shall retain a
6-11 copy of each signed statement in the patient's or client's case
6-12 records.
6-13 (d) A health and human services agency that provides a
6-14 patient, client, or guardian with information regarding care and
6-15 support options available to the patient or client shall assist the
6-16 patient, client, or guardian in taking advantage of an option
6-17 selected by the patient, client, or guardian.
6-18 (e) Each health and human services agency annually and as
6-19 provided by commission rule shall report to the legislature
6-20 [commission] the number of community-based service placements and
6-21 residential-care placements the agency makes.
6-22 SECTION 3. Subchapter B, Chapter 531, Government Code, is
6-23 amended by adding Section 531.055 to read as follows:
6-24 Sec. 531.055. VOUCHER PROGRAM FOR TRANSITIONAL LIVING
6-25 ASSISTANCE FOR PERSONS WITH DISABILITIES. (a) In this section:
6-26 (1) "Institutional housing setting" means:
6-27 (A) an ICF-MR, as defined by Section 531.002,
7-1 Health and Safety Code;
7-2 (B) a nursing facility; or
7-3 (C) a state hospital, state school, or state
7-4 center maintained and managed by the Texas Department of Mental
7-5 Health and Mental Retardation.
7-6 (2) "Integrated housing setting" means a
7-7 community-based housing setting in which a person with a disability
7-8 resides or may reside.
7-9 (b) The commission shall coordinate with the Texas
7-10 Department of Human Services, the Texas Department of Housing and
7-11 Community Affairs, and the Texas Department of Mental Health and
7-12 Mental Retardation to develop a housing assistance program to
7-13 assist persons with disabilities in moving from an institutional
7-14 housing setting to an integrated housing setting. In developing
7-15 the program, the agencies shall address:
7-16 (1) eligibility requirements for assistance;
7-17 (2) the period during which a person with a disability
7-18 may receive assistance;
7-19 (3) the types of housing expenses to be covered under
7-20 the program; and
7-21 (4) the locations at which the program will be
7-22 operated.
7-23 (c) The commission shall require the Texas Department of
7-24 Human Services to implement and administer the housing assistance
7-25 program under this section. The department may coordinate with the
7-26 Texas Department of Housing and Community Affairs in implementing
7-27 and administering the program.
8-1 (d) The Texas Department of Human Services shall provide
8-2 information to the commission as necessary to facilitate the
8-3 development and implementation of the housing assistance program.
8-4 SECTION 4. Chapter 22, Human Resources Code, is amended by
8-5 adding Sections 22.037 and 22.038 to read as follows:
8-6 Sec. 22.037. PILOT PROGRAM FOR COMMUNITY-BASED ALTERNATIVES
8-7 FOR PERSONS WITH DISABILITIES. (a) In this section, "institution"
8-8 means:
8-9 (1) an ICF-MR, as defined by Section 531.002, Health
8-10 and Safety Code;
8-11 (2) a nursing facility; or
8-12 (3) a state hospital, state school, or state center
8-13 maintained and managed by the Texas Department of Mental Health and
8-14 Mental Retardation.
8-15 (b) The department, in cooperation with the Texas Department
8-16 of Mental Health and Mental Retardation in accordance with the
8-17 memorandum of understanding adopted under Section 22.038, shall
8-18 develop and implement in at least five sites a pilot program to
8-19 provide a system of services and support that fosters independence
8-20 and productivity and provides meaningful opportunities for persons
8-21 with disabilities to live in the community. The department shall
8-22 determine the pilot sites.
8-23 (c) The pilot program, subject to the availability of funds,
8-24 shall include the following components:
8-25 (1) a comprehensive system of improved policies and
8-26 procedures to avoid inappropriately placing a person with a
8-27 disability in an institution, including policies and procedures
9-1 that require:
9-2 (A) a preadmission screening for the person that
9-3 includes the participation of hospital discharge staff and the
9-4 person's physician; and
9-5 (B) an analysis of the costs, benefits, and
9-6 effectiveness of placing the person in a community-based
9-7 alternative care setting;
9-8 (2) a program under which physicians who treat persons
9-9 with disabilities and hospital discharge staff are:
9-10 (A) trained and educated regarding the
9-11 availability of community-based alternatives to
9-12 institutionalization to reduce the number of persons
9-13 inappropriately placed in an institution;
9-14 (B) required to inform a person with a
9-15 disability of all care and support options available to the person,
9-16 including community-based care and support options, before the
9-17 person makes a decision regarding a long-term care placement; and
9-18 (C) required to contact and offer the assistance
9-19 of a permanency planning specialist to a person with a disability
9-20 before the person makes a decision regarding a long-term care
9-21 placement;
9-22 (3) a program, including a program implemented through
9-23 grants to community-based organizations, to provide a transition
9-24 case manager to assist a person with a disability in making a
9-25 transition from an institution to a community-based alternative
9-26 care setting;
9-27 (4) a program to provide grants to community-based
10-1 organizations to conduct outreach initiatives to identify persons
10-2 with disabilities who may inappropriately reside in an institution;
10-3 and
10-4 (5) a program under which presumptive eligibility is
10-5 authorized for community-based care and support programs for a
10-6 person with a disability.
10-7 (d) The department by rule shall establish qualifications
10-8 for a person not affiliated with the department, the Texas
10-9 Department of Mental Health and Mental Retardation, or a state
10-10 school who implements a component of the pilot program by providing
10-11 outreach services to a resident of a state school. The department
10-12 shall require that the person meet those qualifications and shall
10-13 ensure that the resident's guardian is present during each contact
10-14 between that person and the resident.
10-15 (e) The department shall implement each component of the
10-16 pilot program described by Subsection (c) for which the legislature
10-17 appropriates sufficient money. The department is not required to
10-18 implement a component if the legislature does not appropriate
10-19 sufficient money for that component.
10-20 (f) Not later than January 15, 2005, the department shall
10-21 submit a report concerning the effectiveness of the pilot program
10-22 to the presiding officers of both houses of the legislature and to
10-23 the governor. The report must include:
10-24 (1) an evaluation of the strengths and weaknesses of
10-25 each implemented component of the pilot program;
10-26 (2) a recommendation regarding the feasibility of
10-27 expanding the pilot program statewide; and
11-1 (3) a recommendation regarding adopting improved
11-2 policies and procedures with statewide applicability, as determined
11-3 from the information obtained in operating the pilot program, to
11-4 ensure appropriate care settings for persons with disabilities.
11-5 Sec. 22.038. MEMORANDUM OF UNDERSTANDING ON PILOT PROGRAM
11-6 FOR COMMUNITY-BASED ALTERNATIVES FOR PERSONS WITH DISABILITIES. (a)
11-7 The department and the Texas Department of Mental Health and Mental
11-8 Retardation shall adopt a memorandum of understanding to implement
11-9 the pilot program under Section 22.037.
11-10 (b) The memorandum of understanding must:
11-11 (1) define the responsibilities of each agency in
11-12 implementing the components of the pilot program; and
11-13 (2) provide for interagency coordination and
11-14 integration with respect to appropriate components of the pilot
11-15 program, including any components:
11-16 (A) that serve persons for whom both agencies
11-17 otherwise provide services;
11-18 (B) for which coordination and integration
11-19 between the agencies will result in the more efficient
11-20 accomplishment of the goals of the plan implemented under Section
11-21 531.0244, Government Code; or
11-22 (C) that are recommended by the interagency work
11-23 group under Section 531.02441, Government Code, for coordination
11-24 and integration.
11-25 (c) Not later than September 1 of each year, the department
11-26 and the Texas Department of Mental Health and Mental Retardation
11-27 shall review and update the memorandum.
12-1 (d) Each agency by rule shall adopt the memorandum of
12-2 understanding and all revisions to the memorandum.
12-3 SECTION 5. Not later than December 1, 2001, the commissioner
12-4 of health and human services shall:
12-5 (1) establish the interagency work group under Section
12-6 531.02441, Government Code, as added by this Act;
12-7 (2) establish the advisory committee under Section
12-8 531.02442, Government Code, as added by this Act; and
12-9 (3) adopt rules under Section 531.042, Government
12-10 Code, as amended by this Act.
12-11 SECTION 6. Notwithstanding Section 531.042(a), Government
12-12 Code, as amended by this Act, not later than March 1, 2002, each
12-13 health and human services agency shall provide to each patient or
12-14 client of the agency who is in a care setting on the effective date
12-15 of this Act and to the patient's or client's guardian, if any, the
12-16 information required by Section 531.042, Government Code, as
12-17 amended by this Act, and shall obtain the statement required by
12-18 that section.
12-19 SECTION 7. Not later than September 1, 2003, the Texas
12-20 Department of Human Services shall, subject to the availability of
12-21 funds, implement the pilot program under Section 22.037, Human
12-22 Resources Code, as added by this Act.
12-23 SECTION 8. Not later than December 1, 2002, the Texas
12-24 Department of Human Services and the Texas Department of Mental
12-25 Health and Mental Retardation shall adopt the memorandum of
12-26 understanding under Section 22.038, Human Resources Code, as added
12-27 by this Act.
13-1 SECTION 9. This Act takes effect September 1, 2001.