Office of House Bill AnalysisH.B. 967
By: Naishtat
Human Services


In L.C. and E.W. v. Olmstead (1999), the U.S. Supreme Court ruled that
states must provide communitybased services for persons with a disability
when it is medically appropriate and desired by the persons with a
disability.  In response to the ruling, the governor issued an executive
order affirming that Texas is committed to providing community-based
alternatives for persons with disabilities.  House Bill 967 sets forth
Texas's comprehensive response to the Olmstead ruling by clarifying the
state's responsibilities to provide meaningful community alternatives for
persons with disabilities, assigning responsibilities to relevant agencies,
authorizing contracts with community-based organizations, establishing
agency workgroups, an advisory committee, and a housing assistance program,
setting agency reporting and implementation requirements, and developing a
pilot program to assess the delivery of long-term care. 


It is the opinion of the Office of House Bill Analysis that rulemaking
authority is expressly delegated to the commissioner of health and human
services in SECTION 2 (Section 531.042, Government Code) and SECTION 5, The
Health and Human Services Commission in SECTION 2 (Section 531.042,
Government Code), the Texas Department of Human Services in SECTION 4
(Sections 22.037 and 22.038, Human Resources Code), and the Texas
Department of Mental Health and Mental Retardation in SECTION 4 (Section
22.038, Human Resources Code) of this bill. 


House Bill 967 amends the Government and Human Resources codes to require
the Health and Human Services Commission (HHSC) and appropriate health and
human services agencies to implement a plan that fosters independence,
productivity, and meaningful opportunities for a person with a disability
to live in an appropriate setting in the community.  The bill provides that
the plan  require appropriate health and human services agencies to inform
a person living in an institution of the care and support options available
to the person in the community, facilitate a timely and appropriate
transfer to a community setting, and develop strategies to prevent the
unnecessary placement in an institution of a person who is at risk of
institutionalization because of a lack of community services (Sec.
531.0244, Government Code). 

The bill requires the Department of Human Services (DHS) in cooperation
with the Texas Department of Mental Health and Mental Retardation (MHMR) to
develop and implement a pilot program in at least five sites, no later than
September 1, 2003.  The bill requires the program subject to the
availability of funds to include: 

 _a comprehensive system of improved policies and procedures to avoid
inappropriately placing a person with a disability in an institution; 
 _a program under which physicians and hospital discharge staff are
trained, required to inform a person with a disability of all care and
support options available to the person, and required to contact and offer
the assistance of a permanency planning specialist regarding
community-based alternatives to institutionalization; 
  _a program to provide a transition case manager to assist a person with a
disability in making a transition to a community-based alternative;  
 _a program to provide grants to community-based organizations to conduct
outreach initiatives to identify persons who may be inappropriately
residing in an institution and; 
 _a program under which a person with a disability is presumed eligible for
community-based care (Sec. 22.037, Human Resources Code and SECTIONS 6 and

The bill also requires DHS and MHMR to adopt a memorandum of understanding,
no later than December 1, 2002 to implement the pilot program that defines
each agency's responsibilities and provides for interagency coordination.
No later than September 1 of each year, DHS and MHMR are required to review
and update the memorandum.  Each agency is required to adopt, by rule, the
memorandum of understanding and all revisions of the memorandum (Sec.
22.038, Human Resources Code and SECTION 8).  DHS is required, by rule, to
establish qualifications for a person not affiliated with DHS, MHMR, or a
state school who implements a component of the pilot program by providing
outreach services to a resident of a state school.  The bill provides that
DHS shall require that the person meet those qualifications and ensure that
the resident's guardian is present during each contact between that person
and the resident. DHS is required to implement each component of the pilot
program if and only if  the legislature appropriates sufficient money (Sec.
22.037, Human Resources Code). 

H.B. 967 requires the commissioner of health and human services
(commissioner) to establish an interagency work group and an advisory
committee to assist and advise HHSC and appropriate agencies in developing
a plan to ensure an appropriate care setting for persons with disabilities
no later than December 1, 2001. The bill sets forth provisions regarding
the membership and the administration of the work group and the advisory
committee.  The work group is required to study and make various
recommendations to HHSC on developing the plan and identifying appropriate
components of the pilot program for coordination and integration between
DHS and MHMR.  The bill requires the advisory committee to advise the
commission and appropriate agencies with respect to implementing the plan
(Secs. 531.02441 and 531.02442, Government Code and SECTION 5). 

The bill requires the commissioner to adopt rules no later than December 1,
2001 to require each health and human services agency to provide each
patient or client of the agency with information regarding all long-term
care and support options before the agency allows the patient or client to
be placed in a care setting.  Agencies are required to provide, no later
than March 1, 2002, the information to each patient or client in a care
setting on September 1, 2001.  The bill authorizes an agency to obtain the
assistance of a private provider, including a community-based organization,
in providing patients, clients, or guardians with information as provided
by HHSC rules.  An agency that provides a patient, client, or guardian with
information regarding care and support options available to the patient or
client is required to assist the person in taking advantage of an option
selected (Sec. 531.042, Government Code, and SECTIONS 5 and 6). 

The bill requires HHSC to coordinate with DHS, the Texas Department of
Housing and Community Affairs (TDHCA), and MHMR to develop a housing
assistance program (program) to assist persons with disabilities in
transferring from an institution to an integrated housing setting. HHSC
shall require DHS to implement and administer the program, and authorizes
DHS to coordinate with TDHCA in this process. DHS is required to provide
information to HHSC as necessary to facilitate the programs' development
and implementation (Sec. 531.055, Government Code). 

The bill sets forth deadlines and content and distribution requirements for
reports that agencies and the workgroup are required to submit about the
implementation of these provisions (Secs. 531.0244, 531.02441, and 531.042,
Government Code, Sec. 22.037, Human Resources Code and SECTIONS 7 and 8). 


September 1, 2001.