BILL ANALYSIS

 

 

Senate Research Center

C.S.S.B. 1552

86R21175 GCB-F

By: Lucio

 

Health & Human Services

 

4/23/2019

 

Committee Report (Substituted)

 

 

 

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

 

The Office of the Independent Ombudsman for State Supported Living Centers was created to protect the rights and welfare of residents and families of the 12 state supported living centers (SSLCs) and the intermediate care facility (ICF) component of the Rio Grande Center. The independent ombudsman recently issued a report concerning SSLCs.

 

In the reports, the ombudsman highlights how residents of the SSLCs often present challenging and complex issues, including significant behavioral challenges and health concerns, as well as complex issues resulting from aging. Although some centers have developed and implemented specialized training for their staff to better support the unique needs of their center's residents, regrettably other centers have not undertaken such proactive measures. The ombudsman reported that in Texas there are no standard training requirements, either locally or statewide, for SSLCs.

 

Similarly, in terms of rights and due process for SSLCs residents, the ombudsman reported systemic issues in SSLCs violating residents' rights by failing to obtain consent for restrictions prior to their implementing restrictions. Related due process issues are also a concern with SSLCs in relation clients and their families being informed on how to file complaints.

 

In order to address these concerns, S.B. 1552 directs the Health and Human Services Commission to address the need for state-mandated specialized training for all centers and staff who provide support to various types of populations such as alleged offenders, including alleged sexual offenders, adolescents, and geriatric or aging populations. Furthermore, S.B. 1552 directs the SSLC State Office (State Office) to develop formal processes, procedures to ensure centers are fully compliant with the established Rights Policy. Additionally, develop at the State Office a formal strategy to educate residents, guardians, and direct support staff of residents' rights, restrictions, and the process to file a complaint. (Original Author's/Sponsor's Statement of Intent)

 

C.S.S.B. 1552 amends current law relating to state supported living centers.

 

RULEMAKING AUTHORITY

 

Rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 2 (Section 555.024, Health and Safety Code) of this bill.

 

SECTION BY SECTION ANALYSIS

 

SECTION 1. Amends Subchapter A, Chapter 555, Health and Safety Code, by adding Section 555.004, as follows:

 

Sec. 555.004. ADDITIONAL METHODS TO PROTECT RIGHTS OF CENTER RESIDENTS AND CLIENTS. Requires the executive commissioner of the Health and Human Services Commission (executive commissioner), in addition to other methods required by law, rule, or policy to protect the rights of residents in centers, to:

 

(1) develop formal methods to more fully educate executives, administrators, supervisors, and direct care professionals working at centers, residents of centers, guardians of those residents, and other actively involved persons on:

 

(A) the rights of residents;

 

(B) the health and medical obligations and responsibilities and the legal obligations and responsibilities toward residents of a center's executives, administrators, supervisors, and direct care professionals;

 

(C) the types of specific needs and complex behavioral challenges of various populations of residents that may require additional support services, attention and specialized training, including:

 

(i) alleged criminal offenders, including sex offenders;

 

(ii) residents living with dementia;

 

(iii) residents living with trauma;

 

(iv) aging or older residents; and

 

(v) adolescent residents;

 

(D) the circumstances under which a resident's or other person's rights are authorized to be restricted, the circumstances under which a resident's or other person's rights are prohibited from being restricted, and the processes and procedures that are required to be followed by the center and center staff to restrict a right; and

 

(E) the manner in which a person may file a complaint; and

 

(2) specify processes and procedures that center staff are required to follow, including the completed and documented training center staff must receive to ensure that centers fully comply with laws, rules, and policies relating to:

 

(A) the rights of residents and clients;

 

(B) the circumstances under which a resident's or other person's rights are authorized to be restricted, the circumstances under which a resident's or other person's rights are prohibited from being restricted, and the processes and procedures that are required to be followed by the center and center staff to restrict a right;

 

(C) the types of specific needs and complex behavioral challenges of various populations of residents and clients that may require additional support services, attention and specialized training, including:

 

(i) alleged criminal offenders, including sex offenders;

 

(ii) residents living with dementia;

 

(iii) residents living with trauma;

 

(iv) aging or older residents; and

 

(v) adolescent residents;

 

(D) the manner in which a person may file a complaint; and

 

(3) establish formal practices, processes, and policies to implement statewide and local recruitment strategies for hiring direct care professionals, including the evaluation of recruiting practices for hiring center staff statewide and at each center and the development of action plans for when vacancy levels for direct care professional professionals reach an established threshold, to ensure:

 

(A) adequate staff coverage and an adequate ratio of direct care professionals to residents;

 

(B) residents' protection and safety; and

 

(C) residents' ability to exercise their rights.

 

SECTION 2. Amends Section 555.024, Health and Safety Code, by adding Subsections (d-1) and (f), as follows:

 

(d-1) Requires each state supported living center (center), in addition to the training provided to direct care professionals under Subsections (a) (relating to requiring center employees to undergo certain training before performing duties on their own), (c) (relating to requiring direct care professionals to undergo specified certain training for direct care professionals in addition to the training under Subsection (a)), and (d) (relating to requiring the executive commissioner to adopt rules requiring all center employees to undergo refresher training on a regular basis), to develop and implement additional initial and refresher specialized training for all executives, administrators, supervisors, and direct care professionals to support populations of residents and clients that may require additional support services, attention, and specialized training, including:

 

(1) alleged criminal offenders, including sex offenders;

 

(2) residents living with dementia;

 

(3) residents living with trauma;

 

(4) aging or older residents; and

 

(5) adolescent residents.

 

(f) Requires the executive commissioner by rule to develop standards for the training provided to executives, administrators, supervisors, and direct care professionals under this section, including the length of the training and the manner in which the training is provided. Requires the executive commissioner, in developing standards relating to the manner in which training is provided, to ensure that person‑centered thinking is used as a foundation for all training, and that all training is competency-based, trauma‑informed, and, to the extent possible, provided in an interactive manner such as on a one-on-one basis, by a group discussion, or by a demonstration.

 

SECTION 3. Requires the executive commissioner to comply with Section 555.004, Health and Safety Code, as added by this Act, as soon as possible after the effective date of this Act.

 

SECTION 4. (a) Requires each center, not later than January 1, 2020, to develop and implement the additional training required by Section 555.024(d-1), Health and Safety Code, as added by this Act. Requires each center to ensure that each direct care employee receives the additional training, regardless of when the employee was hired, not later than September 1, 2020.

 

(b) Requires the executive commissioner, not later than January 1, 2020, to develop the training standards required by Section 555.024(f), Health and Safety Code, as added by this Act. Requires the executive commissioner to ensure that each center implements the training standards as soon as possible.

 

SECTION 5. Effective date: upon passage or September 1, 2019.