Public Comment on House Bill 1585

Public Policy Input — 2019


TCDD logo   Mary Durheim, Chair
Andrew D. Crim, Vice Chair
Beth Stalvey, MPH, PhD, Executive Director

6201 E. Oltorf, Suite 600
Austin, TX 78741-7509
  Phone: (512) 437-5432
Toll Free: (800) 262-0334
Fax: (512) 437-5434

House Human Services Committee

Public Comment on House Bill 1585
A Study On Interest Or Other Waiting Lists Maintained For
Medicaid Programs Providing Services To Persons With
Intellectual And Developmental Disabilities

March 19, 2019

Thank you for the opportunity to provide comments on House Bill 1585, which would require a study on interest or other waiting lists maintained for certain Medicaid programs providing services to persons with intellectual and developmental disabilities. The Texas Council for Developmental Disabilities (TCDD) is established by state and federal law and is governed by 27 board members, appointed by the Governor, 60% of whom are individuals with developmental disabilities or family members of individuals with disabilities. TCDD’s purpose in law is to encourage policy change so that people with disabilities have opportunities to be fully included in their communities and exercise control over their own lives.

Medicaid Home and Community Based Services (HCBS) waivers are vital to the population of Texans with intellectual and developmental disabilities (IDD). The programs provide critical long-term services and supports which generally are not covered by private insurance, such as personal attendant services, nursing, and employment support; their utilization brings about positive outcomes for the state, including decreased hospitalization, increased employment, and overall higher quality of life among HCBS waiver recipients.

Unfortunately, insufficient appropriations have resulted in interest lists for the waivers numbering over 140,000 unduplicated Texans, and individuals can wait up to 13 years to begin receiving services. Confronted with such long waits, individuals are more likely to experience negative health outcomes, crisis, and institutionalization. With this in mind, Cecile Young, then-Acting Executive Commissioner of the Texas Health and Human Services Commission (HHSC), remarked that, “funding additional Medicaid waiver slots and reducing interest lists are the agency’s top priority for the 86th Legislative Session.”1 In the event that lawmakers do not provide the necessary funding to eliminate the HCBS interest lists, it is wholly appropriate—and essential—for lawmakers to call for a study on the matter, to determine what strategies might be employed to furnish these vital services to Texans with IDD in a timely manner.

HB 1585 is consistent with the following TCDD policy priority:
Reduce the number of people on HCBS waiver interest lists by providing adequate Medicaid funding to enable appropriate placements in waiver programs. Ensuring the availability, timeliness, and quality of services and supports in integrated community settings reduces reliance on costly institutional services.

Please contact me for additional information or other assistance (512) 437-5417.

Respectfully submitted,

Scott Daigle
Public Policy Director
Texas Council for Developmental Disabilities

1. Young, C. (2018). Administrator’s Statement, HHSC Legislative Appropriations Request for Fiscal Years 2020-2021.