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Legislative News:

DADS Legislative Summaries: http://www.dads.state.tx.us/news_info/publications/legislative/index.html

Highlights

HB 2439, Truitt
Relating to the functions of local mental health and mental retardation authorities.

Requires an MRA and MHA to take into account a variety of factors (e.g., public input, ultimate cost-benefit, consumer choice, and best use of public money) in procuring services for its local service area.

• Permits an MRA to serve as a provider of an Intermediate Care Facilities for Persons with Mental Retardation (ICF/MR) and related waiver programs services only if:
1. the MRA complies with the limitations of Section 533.0355(d) of the Texas Health and Safety Code described below; or
2. the programs are necessary to ensure the availability of services and the MRA demonstrates that there is not a willing ICF/MR and related waiver program provider where the service is needed.
• Requires HHSC to adopt rules establishing the roles and responsibilities of MRAs including rules about access and intake, eligibility functions, enrollment, utilization management, service coordination, general revenue funded services, local planning functions, and accountability;
• Requires an MRA to offer a state school as an option among residential services offered to a person who meets the state school admission criteria.
• Requires an MRA in establishing its role as a qualified service provider of ICF/MR and waiver services, to: {limitations of Section 533.0355(d)}
1. base the MRA’s provider capacity on August 2004 enrollment levels and if the enrollment levels exceed that to reduce levels by attrition; and
2. base any increase in the MRA’s provider capacity on: state-mandated conversion from ICF/MR to a waiver program allowing for a permanent increase in provider capacity; the MRA’s voluntary conversion from ICF/MR to a waiver program allowing for a temporary increase in provider capacity, to be reduced by attrition; the MRA’s refinancing from general revenue funded services to a Medicaid program allowing for a temporary increase in provider capacity, to be reduced by attrition; or other extenuating circumstances approved and monitored by DADS that do not promote the MRA’s provider role and may include the need to accommodate a family/consumer-specific circumstance and choice.

HB 52, Chavez
Relating to the personal needs allowance for certain Medicaid recipients who are residents of long-term care facilities.

Currently the Personal Needs Allowance (PNA) being paid is $60, but the minimum amount in statute is $45. House Bill 52 raises the minimum amount required for PNA in statute to $60.

SB 27, Nelson
Relating to the community living options information process and to a pilot program to educate residents and families of residents of nursing homes and intermediate care facilities for the mentally retarded about advance care planning.

• Requires DADS to contract with local MRAs to implement the Community Living Options Information Process for adult residents of state schools. The contract must:
1. delegate DADS' duties as to implementation of the Community Living Options Information Process to the MRA;
2. include performance measures to evaluate the effectiveness of the MRAs in implementing the Information Process; and
3. ensure that the MRA provides service coordination and relocation services to an adult resident who chooses, is eligible for, and is recommended for a community living option.
• Requires that DADS work with the interagency task force on ensuring appropriate care settings for persons with disabilities (the existing Promoting Independence Advisory Committee), as well as residents’ family members or legally authorized representatives (LAR), persons with mental retardation, state schools and MRAs to:
1. develop an effective Information Process;
2. create uniform procedures for the implementation of the process; and
3. minimize any potential conflict of interest regarding the Information Process between a state school and an adult resident, the resident's LAR, or a local authority.
• Requires that the local MRA be allowed to participate in the planning process involving the consideration of community living options for an adult resident.
• State schools must:
1. provide the MRA with access to an adult resident and the resident's records as necessary, and as permitted by applicable state and federal confidentiality laws, to implement the Information Process; and
2. provide the adult resident or the resident's LAR with accurate information regarding the risks of moving the resident to a community living option.
• Requires DADS to develop and implement a pilot program to educate nursing facility residents, ICF/MR residents, and their families about advance care planning. The ultimate goal of the program is to increase the use of advanced directives. The program must include components dealing with:
1. the legal issues associated with advanced directives;
2. health care choices available to individuals with terminal or irreversible conditions;
3. the proper completion of an advanced directive; and
4. the importance of discussing advance directives with family, friends, and health care providers.
• Requires DADS to submit a report to the Governor, Lt. Governor, Speaker and legislative oversight committees by October 1, 2010, which includes an evaluation of the pilot program’s effectiveness and a recommendation to continue, expand, or eliminate the program. The provisions regarding the pilot program expire September 1, 2011.

SB 199, Nelson
Relating to certain convictions barring employment at certain facilities serving the elderly or persons with disabilities.

• Amends the list of offenses for which conviction makes an individual permanently ineligible for employment in certain facilities. In particular, the bill adds the offenses of:
1. indecent exposure;
2. improper relationship between educator and student;
3. improper photography or visual recording;
4. deadly conduct;
5. aggravated sexual assault;
6. terroristic threat;
7. online solicitation of a minor;
8. money laundering;
9. Medicaid fraud; and
10. cruelty to animals.
• Amends the list of offenses for which conviction makes an individual ineligible for employment in a covered facility for five years from the conviction date. The bill adds to the current list of offenses:
1. false identification as a peace officer, and
2. some forms of disorderly conduct: discharges a firearm in a public place other than a public road or a sport shooting range; displays a firearm or other deadly weapon in a public place in a manner calculated to alarm; and discharges a firearm on or across a public road.
• Provides that a person will not be considered to have been convicted of an offense if that person was placed on deferred adjudication community supervision, successfully completed the period of supervision, and received a dismissal and discharge.

SB 1766, Watson
Relating to expansion of the use of consumer direction for delivery of certain services to persons with disabilities and elderly persons.

• Replaces the voucher program currently required in law with consumer direction models and expands the use of consumer direction for delivery of certain Medicaid services. The section is expanded to include elderly persons as well as disabled persons.
• Requires the development and oversight of a "consumer direction model" under which a person or LAR controls the development and implementation of the individual service plan or controls the persons who directly deliver the services.
• Requires the Consumer-Directed Services work group to add advocates for consumers of services provided through consumer direction and, in coordination with HHSC, to decide which services are appropriate for delivery through consumer direction.
• Requires that the consumer or LAR be provided with adequate and appropriate information and that the consumer or LAR sign a statement acknowledging receipt of the information. Requires that the services not being delivered through consumer direction are provided by a provider agency chosen by the consumer or LAR.
• Establishes additional work group duties, including advising appropriate agencies about delivery of services through consumer direction in all long-term services and support programs and assisting in the development and implementation of the consumer direction models and expansion of service delivery through consumer direction. Other new duties include making recommendations to:
1. expand consumer direction service delivery to other programs;
2. expand the array of services delivered through consumer direction;
3. increase the use of consumer direction models;
4. optimize the provider base of consumer direction; and
5. expand access to support advisors for consumers receiving services through consumer direction.
• Requires the work group to monitor national research for best practices in self- determination and consumer direction and develop recommendations and provide assistance regarding consumer outreach to increase informed choices, skills, opportunities and supports to lead self-determined lives by using consumer direction models.

The Legislature will convene for the 81st Regular Session on January 13, 2009.

Related Texas Legislature Committees

House Committee on Appropriations-S/C on Health & Human Services (C034)