During the 82nd Legislative Session, the Legislature passed House Bill 1, the Fiscal Year (FY) 2012–2013 biennial budget. The budget provides $175 billion in federal and state funds. When compared to the FY 2010–11 biennial budget, the FY 2012–13 budget includes a decrease of $9 billion in state (also known as General Revenue, or GR) funds. The Legislature also left an estimated $5 billion in Medicaid entitlement programs unfunded until the beginning of the next legislative session in 2013. Below is a summary of how select disability-related services and programs were addressed in the budget. Also included is a comparison of how much funding services and programs received between the FY 2010–11 and FY 2012–13 budgets.
Department of Aging and Disability Services
When appropriations for the 13 community waivers are combined, appropriations for FY 2012–2013 are significantly reduced. However, the Legislature expects the number of people served in these programs to remain at August 2011 levels. The Department of Aging and Disability Services (DADS) is expected to find ways to contain costs through utilization review, caps, and service limitations. Services considered non-essential are reduced to the 90th percentile in the following waiver programs:
- Community Based Alternatives (CBA)
- Community Living Assistance and Support Services (CLASS)
- Home and Community-based Services (HCS)
- Medically Dependent Children Program (MDCP)
CLASS specialized therapies are reduced to the 75th percentile. Provider rates were cut from 3% to 26.4% depending on the program. Currently over 130,000 individuals are on interest lists, which are expected to continue to grow.
The FY 2012–13 budget included $1.6 billion for HCS and would provide services for 20,539 people. The FY 2010–11 budget included $1.55 billion and would provide services for 18,722 people.
Intellectual Disabilities Community Services
Intellectual Disabilities (ID) Community Services, also knows as “safety net” services, were cut significantly. Local authorities use these funds for a wide range of services to support individuals to live in the community while waiting for — or ineligible for — waiver services. When the Legislature cut funding in 2003, there was a 50% increase in admissions of children into State Supported Living Centers (SSLCs). The Legislature’s intent this session was for DADS to refinance many individuals into the Texas Home Living (TxHmL) waiver program.
The FY 2012–13 budget included $150 million for ID Community Services and would provide services for 9,955 people. The FY 2010–11 budget included $204 million and would provide services for 12,725 people.
This waiver program supports people who live in their own homes or with their families. Funding was increased from $21 million to $99 million to include many individuals previously receiving assistance from ID “safety net” community services. However, many individuals receiving safety net services are not eligible for this waiver.
The FY 2012–13 budget included $99.2 million for TxHmL and would provide services for 5,738 people. The FY 2010–11 budget included $21.9 million and would provide services for 994 people.
In-Home Family Support
The In-Home Family Support (IHFS) program is level funded. IHFS provides support to families who would otherwise turn to institutional services.
The FY 2012–13 budget included $9.97 million for IHFS and would provide services for 5,375 people. The FY 2010–11 budget included $9.97 million and would provide services for 5,491 people.
ID In-Home and Family Support
Funding for IHFS services for individuals with ID was eliminated. The FY 2010-11 budget included $11.4 million for IHFS and would provide services for 3,060 people.
Promoting Independence Services
Funding for these services that allow children and adults to stay in the community or transition from institutions to community was reduced by one-third.
The FY 2012–13 budget included $156.9 million for Promoting Independence Services and would provide services for 6,863 people. The FY 2010–11 budget included $236 million and would provide services for 6,301 people.
Intermediate Care Facility/ID Services
The reduction in funding for Intermediate Care Facility (ICF)/ID Services program is greater than the reduction in the number of people served. DADS will be required to reduce provider reimbursement rates, likely causing some providers to no longer participate in the program.
The FY 2012–13 budget included $594.1 million for ICF/ID Services and would provide services for 5,766 people. The FY 2010–11 budget included $653 million and would provide services for 6,063 people.
Funding increased to maintain all 13 Texas state-operated institutions, but there is a goal to reduce census of those facilities by approximately 740 individuals to 3,595 by the end of FY 2013.
The FY 2012–13 budget included $1.3 billion for SSLCs and would provide services for 3,713 people. The FY 2010–11 budget included $1.13 billion and would provide services for 4,338 people.
The budget passed during the 82nd legislative session is short an expected $4.8 billion that will be needed to fund Medicaid programs.
Department of Assistive and Rehabilitative Services
Early Childhood Intervention
The Early Childhood Intervention (ECI) program provides services to children with developmental delays that assist eligible children to gain skills or improve development. Funding was reduced by $30 million from FY 2010-11. The Department of Assistive and Rehabilitative Services (DARS) is therefore changing from a “months-based” to the “percentage-based” calculation of a developmental delay and restructuring Family Cost Share. Children will continue to receive an average of two hours of direct service per month, which is below the level recommended by experts.
The FY 2012–13 budget included $342.1 million for ECI and would provide services for 26,052 people. The FY 2010–11 budget included $373.9 million and would provide services for 32,245 people.
The DARS Autism Program provides intensive, evidence-based treatment to children age 3–8 with a diagnosis of Autism Spectrum Disorder. Autism Program funding was not cut, but this program serves only 180 children. The Texas Education Agency (TEA) reports there are over 15,000 students with autism in public schools.
The FY 2012–13 budget included $6.6 million for the Autism Program and would provide services for 180 people. The FY 2010–11 budget included $6.6 million and would provide services for 180 people.
The Vocational Rehabilitation (VR) Program helps people with disabilities prepare for, find, or keep employment. HB 1 reduces funding for VR which will result in fewer people gaining successful employment. With fewer funds for the program, there will be no funds for anticipated caseload growth during the biennium. State funds provided are insufficient to “match” all of the federal dollars available to Texas.
The FY 2012–13 budget included $421.9 million for VR and would provide services for 85,187 people. The FY 2010–11 budget included $456.3 million and would provide services for 88,025 people.
Independent Living Centers
The proposed budget for Independent Living Centers (ILCs) allows the current network of ILCs to maintain current levels of services, but does not expand the number of the centers. Funding was maintained at FY 2010–11 levels.
The FY 2012–13 budget included $5.4 million for ILCs and would provide services for 6,632 people. The FY 2010–11 budget included $5.4 million and would provide services for 6,632 people.
Independent Living Services
Although HB 1 does not fully fund the Independent Living Services (ILS) program, DARS is expected to serve slightly more individuals in the two-year biennium by reducing the annual service budget for individuals in the program, resulting in fewer services provided.
The FY 2012–13 budget included $13.4 million for ILS and would provide services for 1,890 people. The FY 2010–11 budget included $14.2 million and would provide services for 1,785 people.
Comprehensive Rehabilitation Services
Individuals with a traumatic brain injury or spinal cord injury can receive post-acute rehabilitative services in the Comprehensive Rehabilitation Services (CRS) program. HB 1 slightly reduces funding to the CRS program. However, separate legislation calls for CRS to receive 9.8% of the surcharges on felony and misdemeanors charges (up from 5.3218%). This is likely to provide an estimated $19.47 million for each year of the biennium.
The FY 2012–13 budget included $34.2 million for CRS and would provide services for 426 people. The FY 2010–11 budget included $34.4 million and would provide services for 583 people.
DARS’s evaluation of the ECI program determined that the amount of direct service hours currently received by children in the program is not sufficient for desired outcomes. Children who do not receive adequate early intervention often require more costly services, provided through special education, Medicaid, etc.
Department of Family and Protective Services
Adult Protective Services
HB 1 provides an increase in funding due to increased federal funds. The overall funding increase will allow the Department of Family and Protective Services (DFPS) to improve the timeliness of due process cases and restore emergency client services. Adult Protective Services (APS) mental health and MR (ID) investigators have the ability to provide emergency services to persons receiving HCS services to protect a client from serious harm or death. Services may include paying an electric bill or fixing a window so the client can remain in their own home.
The FY 2012–13 budget included $135.1 million for APS. The FY 2010–11 budget included $134.4 million.
Child Protective Services
HB 1 fully funds foster care, adoption subsidy, and permanency care assistance caseloads using FY 2010–11 rates. HB 1 also maintains FY 2010–11 funding levels for the relative and other designated caregiver program (Kinship Care). If caseloads grow more than what is appropriated, Child Protective Services (CPS) staff will not be able to devote the necessary time and effort to ensure that all children on their caseloads are safe from abuse and neglect.
The FY 2012–13 budget included $2.3 billion for CPS. The FY 2010–11 budget included $2.3 billion.
Prevention programs are designed to provide assistance to families so that children are not removed and placed in conservatorship. Without adequate funding for prevention programs, more children will be removed from their families and placed in foster care. Although HB 1 cut “Other At-Risk Prevention Programs,” an amendment was added to restore $4.6 million in general revenue to the program. Prevention programs include Family Strengthening Services, Youth Resiliency Services, Community-Based Child Abuse Prevention. and Statewide Youth Services Network.
The FY 2012–13 budget included $62 million for prevention programs. The FY 2010–11 budget included $88 million.
HB 1 includes an increase for childcare regulations to assist in timely due process hearings.
The FY 2012–13 budget included $73.6 million for childcare regulations. The FY 2010–11 budget included $68.7 million.
DFPS is charged with protecting all children and adults from abuse, neglect, and exploitation, including individuals with disabilities. Therefore, the budget does not reduce the number of children or adults served through DFPS. With less funding to serve the same or more people, DFPS will be forced to increase caseloads of its employees, which may negatively impact the quality of services provided.
Department of State Health Services
Adult Community Mental Health
Through the mental health (MH) block grant, the Department of State Health Services (DSHS) contracts with 37 community MH centers, also referred to as Local MH Authorities (LMHAs), to provide MH services and new generation medications statewide. Funding is restored to FY 2010–11 levels, but appears to be 4% less because Texas received one-time federal stimulus funds in FY 2010–11 and an increased federal share of funding. With restored funding, Texas ranks 51st in MH services with 10,000 individuals on waiting lists at the end of 2010.
The FY 2012–13 budget included $553.1 million for Adult Community MH and would provide services for 73,484 people. The FY 2010–11 budget included $578.9 million and would provide services for 73,484 people.
MH Crisis Services
This program provides MH crisis hotlines, emergency psychiatric stabilization, peer support services, and mobile crisis outreach teams that help prevent suicides and hospitalization. The lack of MH crisis services forces local police departments to jail or transport people in crises to local emergency rooms. Funding is restored with outpatient competency restoration.
The FY 2012–13 budget included $164.9 million for MH Crisis Services and would provide services for 10,000 people. The FY 2010–11 budget included $164.8 million and would provide services for 10,000 people.
Children’s Community MH
A child with an untreated MH disorder may endure unnecessary time in a hospital, delay in accessing medical treatment, misdiagnoses, difficulty in school, or removal from his/her family. This program received a $20.6 million increase over FY 2010–11 funding.
The FY 2012–13 budget included $153.5 million for Children’s Community MH and would provide services for 16,714 people. The FY 2010–11 budget included $132.9 million and would provide services for 12,206 people.
NorthSTAR managed care provides both MH and chemical dependency services for Medicaid and indigent eligible children and adults in Dallas, Ellis, Collin, Hunt, Navarro, Rockwall, and Kaufman counties. DSHS notes that the number of individuals served is not comparable to adult and children’s community MH because of the different service models. NorthSTAR received an increase of $23.7 million for expansion.
The FY 2012–13 budget included $225.2 million for NorthSTAR and would provide services for 27,169 people. The FY 2010–11 budget included $201.5 million and would provide services for 27,169 people.
The eight state-operated psychiatric hospitals, pediatric facility, and Rio Grande State Center will receive a 1% increase in funding to maintain current services and increase psychiatric salaries. Five community-based psychiatric hospitals operated in connection with LMHAs maintained FY 2010-11 funding. Montgomery County MH Treatment Facility received $30 million to add 100 beds to the state hospital forensic capacity. And Harris County received $9.9 million for a 20-bed competency restoration unit. A budget rider will privatize a state MH hospital if a 10% savings can be realized.
The FY 2012–13 budget included $890.8 million for MH hospitals and would provide services for 2,662 people. The FY 2010–11 budget included $839.1 million and would provide services for 2,562 people.
Children with Special Health Care Needs
The Children with Special Health Care Needs (CSHCN) program serves children with disabilities and people of any age with cystic fibrosis. Since funding was reduced, it is possible some children will lose services they are currently receiving. As of April 30, 2011, there were 982 children on the waiting list.
The FY 2012–13 budget included $71.3 million for CSHCN and would provide services for 900 people. The FY 2010–11 budget included $83.4 million and would provide services for 1,251 people.
DSHS, in coordination with TEA, will develop a Comprehensive Suicide Prevention Program for public school students in middle and high school.
Texas Department of Housing and Community Affairs
The Texas Department of Housing and Community Affairs (TDHCA) is the state’s public housing authority, with 98% of its funding coming from the U.S. Department of Housing and Urban Development (HUD) to address the needs for low-income and unique housing needs. Funding goes to communities, low-income housing developers, and individuals for new construction, renovation, or rehabilitation of single and multi-family affordable housing. The TDHCA FY 2012-13 overall budget returns to $379 million, the FY 2008-09 level prior to federal stimulus funds. TDHCA provides programs that address unique housing needs, including the needs of people with developmental disabilities.
Housing Trust Fund
The Housing Trust Fund (HTF) was established by the 72nd Texas Legislature to address affordable housing needs that cannot be produced solely with existing federal resources. This program grew to $22 million in FY 2010–11. The budget for FY 2012–13 is cut by 60% after $1.2 million was transferred to the Veterans Commission for veteran’s housing needs, leaving $10 million for the HTF programs that currently include rural capacity building, homebuyer assistance, bootstrap loans, disaster recovery gap assistance, affordable housing match, HTF homeownership, and the Amy Young Barrier Removal Program.
The FY 2012–13 budget included $11.3 million for HTF. The FY 2010–11 budget included $22 million.
Studies show that people with disabilities are over-represented within the homeless population. They are more likely to have repeated episodes of homelessness and remain homeless for longer periods of time. The TDHCA Homeless Housing and Services Program (HHSP) request for a second year of $20 million to be distributed among Texas’ eight largest urban areas to help address homelessness was deleted, although the budget authorizes the Governor’s Enterprise Fund to transfer up to $10 million from unused funds.
The FY 2012–13 budget provided no funding for HHSP. The FY 2010–11 budget included $20 million.
The Bootstrap Loan Program is a self-help construction program, like Habitat for Humanity, which is designed to provide very low-income families an opportunity to help themselves through the form of sweat equity. Texas state law requires $3 million per year be available for this program, however HB 1 provides only $3 million for the biennium.
Texas Education Agency
Public Education Funding
Public education programs will receive nearly $4 billion less for FY 2012–13. These reductions are spread over two years with a 6% across-the-board cut in FY 2012 and a $2 billion reduction in FY 2013. In addition, a new school funding formula reduces funding for some schools more than others. Since more than 80% of education costs are personnel-related, districts across the state are expected to reduce the number of educators, which will result in larger class sizes. Many special programs will not be funded, and pre-kindergarten could be cut from full-day classes to only a half-day. The amount of funding available for public education is also dependent upon the amount of local revenue raised from property taxes.
The FY 2012–13 budget provided $25 billion for public education programs and funding for 110,463 full-time employees (FTEs) working in special education. The FY 2010–11 budget provided $22 million and funding for 128,471 FTEs working in special education.
Early Childhood School Readiness Program
This program provides an educational component for 45,000 students in public pre-kindergarten, Head Start, university early childhood programs, or private non-profit early childhood programs where there is an integrated program with a public school. Funding was reduced by more than 50%. Schools will compete for grants to implement early childhood readiness.
The FY 2012–13 budget included $7 million for the Early Childhood School Readiness Program. The FY 2010–11 budget included $15 million.
Pre-Kindergarten Early Start Grant Programs
The Texas Education Code allows the Commissioner of Education to make grants to expand or implement Kindergarten and Pre-Kindergarten programs. In FY 2010–2011, 63,758 students attended public pre-kindergarten. HB 1 does not appropriate certain funds, but provides direction to TEA to use funds in the Foundation School Program Operations to certify each year of the biennium the maximum pre-kindergarten expenditures allowable under federal law as maintenance of effort for Temporary Assistance for Needy Families (TANF) and the state match for the Child Care Development Fund.
The amount of funding the FY 2012–13 budget included for the Pre-Kindergarten Early Start Grant Programs is unknown. The FY 2010–11 budget included $25 million.
Each school district will determine how to respond to reductions in state revenue for the FY 2012–2013 biennium. Although special education services are not addressed specifically, any reductions to public education funding will likely impact students with disabilities in public schools.