For this weekly feature, the Texas Council for Developmental Disabilities (TCDD) profiles a noteworthy bill that is currently going through the legislative process. The bill may relate directly to TCDD’s Public Policy Priorities or another disability-related issue.
Bill: Senate Bill (SB) 50, relating to a competitive and integrated employment initiative for certain Medicaid recipients.
Bill Author: Sen. Judith Zaffirini, Senate District 21 (Laredo)
What does the bill do?
SB 50 seeks to improve and increase competitive integrated employment opportunities for individuals receiving services under the following waiver programs:
- The home and community-based services (HCS) waiver program,
- The Texas home living (TxHmL) waiver program,
- The deaf-blind with multiple disabilities (DBMD) waiver program,
- The community living assistance and support services (CLASS) waiver program, and
- The STAR+PLUS home and community-based services (HCBS) waiver program.
Under the terms of the bill, the Texas Health and Human Services Commission (HHSC) would develop a uniform process that complies with the state’s current Employment-First policy, which establishes that: “It is the policy of the state that earning a living wage through competitive employment in the general workforce is the priority and preferred outcome for working-age individuals with disabilities who receive public benefits.” The uniform process would assess the goals of, and the employment opportunities and services available to, an individual and have that information incorporated into their plan of care.
HHSC would establish performance measures and identify strategies to increase the number of individuals who receive employment services from the Texas Workforce Commission (TWC) or through a waiver program. The performance measures would ensure that a reasonable number of individuals receive such employment services by Dec. 31, 2023.
Lastly, the bill would require HHSC to submit a biennial report to state leaders indicating the number of individuals receiving employment services based on this initiative; whether those services were provided by TWC, through the individual’s waiver program, or both; and the number of individuals who have obtained competitive integrated employment through the initiative.
Competitive integrated employment is a term referencing full or part-time work in the community for which the person is paid at least minimum wage. Integrated settings are typical businesses in which individuals with disabilities work alongside people without disabilities, encounter members of the public, and are eligible for the same advancement opportunities as workers without disabilities.
Despite the state’s Employment-First policy, very few Texans with intellectual and developmental disabilities (IDD) served by the state’s waiver programs work in settings where they are integrated with people without disabilities.
Through competitive integrated employment, people with IDD gain an important entry into their communities, develop a sense of being valued, earn wages and job benefits, and have the opportunity to make meaningful contributions.
Statement from the bill author, Sen. Judith Zaffirini:
“Integrated employment is the best means for persons with intellectual and developmental disabilities to exercise their rights to self-determination and to build meaningful relationships with peers.”
Where is the bill in the process?
On Nov. 9, 2020, SB 50 was pre-filed for the 87th regular session. The bill is currently waiting to be referred to a committee.
Who supports the bill and why?
On April 16, 2019, the Senate Committee on Health & Human Services held a public hearing on a bill very similar to SB 50. The following groups registered their support for the legislation but did not provide testimony: Family to Family Network, the Autism Society of Texas, the Coalition of Texans with Disabilities, the Texas Council of Community Centers, Texas Parent to Parent, Easterseals Central Texas, and the Private Providers Association of Texas.
Who opposes the bill and why?
There was no opposition to the bill during the 2019 public hearing.
- The Arc of Texas: Lauren Gerken, speaking in her previous position as a TCDD Policy Fellow at The Arc of Texas (Gerken is currently a public policy analyst at TCDD), testified on the legislation in 2019: “[This bill] is addressing a large gap in employment for people with disabilities. When people enter a waiver program, they are offered a list of services that they are able to use; one of those groups is employment services, including employment assistance and supported employment. These [services] are designed to support people with disabilities in gaining and sustaining competitive integrated employment. We have found it’s desperately underutilized. The recent data from HHSC shows that only 1.7% of waiver recipients are utilizing employment services. This means that people may be gaining employment, but they’re likely not able to sustain it, because they’re not getting the supports that they need on the job.”
Though TCDD takes no formal position on SB 50, the Council lists the topic of Employment among its 2021 Public Policy Priorities. That priority reads as follows:
Texans with disabilities deserve access to competitive and integrated employment opportunities. Texas should strictly adhere to the state-adopted Employment First Policy by addressing barriers to community-based employment by expanding training, supported employment, and opportunities for advancement, including funding Medicaid waivers that offer employment supports.
How much will the bill cost?
In 2019, the Legislative Budget Board found that the cost of a bill very similar to SB 50 could not be determined. The board suggested that the cost per individual benefitting from the program could vary, and there could be offsets for reductions in other services.
Is there a House companion to the bill?
No identical bill has been filed in the House at this time.
For the latest information about where SB 50 is in the process, follow the bill on the Texas Legislature Online. To receive future legislative updates from TCDD, subscribe to TCDD eNews or follow us on Twitter.