Public Comment to the Legislative Budget Board

Public Input Provided in 2012

Regarding the Department of Aging and Disability Services FY 2014 – 2015 Legislative Appropriations Request

September 11, 2012

Thank you for the opportunity to provide input regarding the Department of Aging and Disability Services (DADS) FY 2014 – 2015 Legislative Appropriations Request (LAR). My name is Jessica Ramos, Public Policy Director for the Texas Council for Developmental Disabilities (TCDD). TCDD is established by federal law in the Developmental Disabilities Assistance and Bill of Rights Act and consists of a 27 member board, appointed by the Governor, 60 percent of who 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.

TCDD supports DADS proposed community expansion and promoting independence exceptional item requests in the 2014-2015 LAR. Texas lags the nation, and nearly all comparison states, in the number of persons who receive Medicaid developmental disabilities services. The 82nd Texas Legislature did not provide funds to expand Medicaid waiver programs, thus allowing movement from those interest lists to stagnate. At the same time, the Legislature also cut General Revenue provided to Local Authorities for safety-net services by 26 percent. Now, with 110,000 unduplicated Texans requesting services and wait times exceeding 10-years, TCDD strongly supports DADS request to fund the growing needs of persons on the Medicaid waiver interest lists as well as restoration of the General Revenue required by local authorities to respond to the crises for those that must continue to wait or simply are not eligible for any other service.

TCDD also supports the DADS exceptional item request to fund promoting independence diversion slots. We know that stagnant interest list reduction and reduced safety net funding will result in crises for more families that might not otherwise have presented themselves to the system. We appreciate that the agency increased this request to 300 from 240 slot request in the previous biennium. We are concerned that the promoting independence slot request for persons moving out of institutions remains unchanged from the 2012- 2013 biennial request and may not fully meet the needs of those in institutions. DADS is again requesting 400 slots for persons in Large Intermediate Care Facilities (ICFs) and State Supported Living Centers (SSLCs), despite the fact that the SSLC census is expected to decline more rapidly as result of more efficient policies implemented by DADS leadership to respond to residents requests for more timely transitions. Though the Texas system continues to emphasize the use of more expensive services more frequently than other states, funding community services for persons at risk of institutionalization not only helps the state to fulfill its commitment to serving persons in the least restrictive setting, but also serves as a rebalancing investment that makes the system more efficient in the long run.

It is surprising to see that the Promoting Independence request for youth aging out of Department of Family and Protective Services (DFPS) foster care did not increase despite the fact that we have heard that the current allocation does not fully meet current needs in this area. We would be remiss if we did not point out that, if the state’s policy is that children should grow up in families whenever possible, the 65 foster children with intellectual and developmental disabilities that are currently growing up in DFPS General Revenue Operation (GRO) facilities should be included in the Promoting Independence Plan to ensure that foster children in the conservatorship of the state have an opportunity to grow up in a family setting. The state’s commitment to providing long-term service and supports to youth aging out of the protective services system has been laudable and including children in long-term foster settings in the Promoting Independence Plan would be in keeping with the state’s leadership in this important area.

Finally, TCDD supports DADS efforts to maximize federal funding opportunities via Money Follows the Person, Balancing Incentives Program and Community First Choice option. These programs provide states with important opportunities to rebalance and modernize the system and have the potential to compliment the system that serves persons with disabilities. We look forward to providing input to DADS with other stakeholders as these programs move forward.