TEXAS

The stakeholder task force, created in December 2002, meets at least quarterly to monitor implementation of the Promoting Independence Plan initiative, which is Texas' Olmstead plan. The Promoting Independence Plan is updated every two years. The December 2002 update is located at http://www.hhsc.state.tx.us/pubs/tpip02/02_12TPIPrev.html.

In the past year, the task force has monitored the health and human services agencies' implementation of recommendations from the Promoting Independence Plan; reviewed the work of Texas Department of Human Services relocation specialists and permanency planning contracts; formed subwork groups to assist with the overall continued development of the Promoting Independence Plan; and made further advisory recommendations to ensure the comprehensiveness and effectiveness of the plan. The Texas Department of Human Services contracted with the University of Texas to evaluate the activities of the plan.

The 2003 Legislature enacted House Bill 1 to inform the department that it must "grandfather" those individuals who are receiving services in a medical assistance waiver program when continuation of these services is necessary for the individual to live in the most integrated setting appropriate to his/her needs and the department continues to comply with the cost effectiveness requirements from the Centers for Medicare and Medicaid Service.

Enacted on June 10, 2003, House Bill 2292 directs the Texas health and human services agencies to consolidate organizational structures and function, eliminate duplicate administrative systems, and streamline processes and procedures that guide the delivery of health and human services. The operations of the existing twelve health and human services agencies will be realigned by consolidating similar functions within five agencies.

Rider 28 of the appropriations act reinforces the state's commitment to "money follows the person." It allows the state's original strategy, known as Rider 37, for moving people-and the money spent on them-from institutions to the community. The modification set forth in Rider 28 places some limitations on funds that can be transferred to community services.

The Texas Department of Human Services received a total of $1,330,185 in federal grants to support its Promoting Independence efforts. The Money Follows the Person Initiative was awarded $730,422 for the establishment of service coordination workgroups at a statewide level. The Community-Integration Personal Assistance Services and Supports (C-PASS) program received $599,763 to conduct research and further extend support systems to individuals whose interested in hiring, training and managing their own personal attendants.

The Texas Department of Mental Health and Mental Retardation (TDMHMR) also received federal grant funds in the amount of $500,000 in October 2003, for "Quality Assurance and Quality Improvement in Home and Community-Based Services." TDMHMR will use the funds to address processes for quality improvement across all TDMHMR waiver programs. The project will enhance Texas' Promoting Independence Plan and initiative by ensuring that quality long-term services and supports are received by individuals who make the transition from institutions to the community.

In additional, Texas received $93,600 in federal grant funds for "Community-Based Treatment Alternatives for Children" to determine the feasibility of and the most appropriate plan for using a 1915(c) Medicaid waiver. The primary goals of this project are to 1) provide quality, evidenced-based treatment to children with severe emotional disturbances in their homes and communities; and (2) serve more eligible children than is feasible without intensive home and community-based services.

All of the above grant funds may be expended over a 36-month period.

The Texas Department of Mental Health and Mental Retardation developed a new Medicaid waiver, the Texas Home Living Program, to cover essential services in order to provide community-based services for people who are waiting for the broader home and community-based services waiver. Approval is pending from the federal government.

The task force also will continue ongoing to monitoring of implementation of recommendations.