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House Interim Committee on Human Services
Charges

Study long-term care, including possible managed care approaches involving community-based providers; the efficient use and geographic distribution of Medicaid facilities; the effects of the revised enforcement rules for Medicaid facilities; and issues related to management contracts and services relating to abuse, neglect, and exploitation of the elderly.

Monitor the implementation of House Bill 1863, passed by the 74th Legislature.

Conduct active oversight of agencies under the committee's jurisdiction.
Recommendations

  • Direct Department of Human Services (DHS) and the appropriate state agencies to develop a voucher system of long-term care services as a pilot program.

  • Create a statewide guardianship program.

  • Direct DHS to spend money resulting from Medicaid penalties and deposited in the trust fund on the Texas Department on Aging (TDoA) State Ombudsman program.

  • Direct DHS to eliminate or modify the moratorium on Medicaid nursing home beds to improve the quality of and competition among facilities.

  • Direct Texas Health and Human Service Commission (HHSC) or other agency to head an interagency group consisting of consumers, DHS, TDoA, Texas Department of Mental Health and Mental Retardation (TXMHMR) and other appropriate agencies to develop a long-term care capacity plan for nursing home beds (both Medicare and Medicaid), personal care facilities, adult day care, and other long-term care services.

  • Encourage the education of health care professionals now practicing, as well as those in training, on issues relating to elderly and disabled Texans.

  • Update Chapter 102, Human Resources Code, to ensure protection of the rights of the elderly.

  • Update Chapter 121, Human Resources Code, to ensure the protection of the rights and responsibilities of the handicapped.

  • Direct DHS, TDoA, and other appropriate agencies to develop a uniform functional assessment tool for the long-term care system.

  • Establish a single point of entry for the Texas long-term care system.

  • Educate the public as to the availability and benefits of long-term care insurance.

  • Expand the Options for Independent Living program at the TDoA to reduce nursing facility placements and qualification of additional persons for Medicaid services.

  • Improve enforcement of laws and regulations in nursing homes and personal care homes.

  • Increase the amount of civil penalties assessed against and collected from nursing facilities.

  • Implement a cost reimbursement system that rewards quality of care without impacting overall costs to the state.

  • Clarify the state's ability to implement strict nursing home standards.

  • Expand the accessibility of personal assistance services, including respite services.

  • Implement a mechanism or gatekeeping function to assist and support families considering placement of a child in institutional care.

  • Strengthen the law to enhance the ability of regulators and the Attorney General's Office in dealing with unlicensed personal care homes.

  • Facilitate a pilot project between TDoA and the Texas Commission for the Deaf and Hard of Hearing to provide case management services to a target population of deaf and hard of hearing senior Texans.

  • Develop a consumer-friendly assessment document to assist consumers and families in determining the quality of care in nursing facilities.

  • Strengthen the state's ability to deal with unlicensed personal care homes.

  • The committee endorses the House Public Health Committee's recommendation on certified nurse aid ratios.