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Legislative Agenda »
on Elder Abuse
1. Dedicated Funding Stream for Local Guardianship Programs. Submitted by Texas Guardianship Association, this proposal would add a $20 fee to all probate filings in Texas with collected funds to be sent to HHSC for distribution to established local guardianship programs to handle existing caseloads with preference to those programs that are also obtaining funding from county treasuries. Local guardianship programs provide guardians to make medical, residential and financial decisions for incapacitated adults who do not have suitable family members to serve as their guardians.
2. Contract Funding for Money Management Programs. This was a request made in response to DADS Legislative Appropriations Request for FY2008-09. DADS Commissioner Addie Horn responded that DADS doesn’t believe that money management is within their guardianship duties as assigned by the 2005 legislature. However, HHSC has committed to use some of its grant funding to fund money management programs. This proposal would request HHSC to begin providing money management contracts with local guardianship/money management programs, so that money management services would be available throughout the Texas as a less restrictive alternative to guardianship services.
3. Utility Assistance for Seniors of Lesser Means. The Senior Source has submitted this proposal to reinstate the Lite Up Texas Fund which used to provide assistance to pay the electric bills of seniors of lesser means. Texans currently pay a surcharge on their electric bills, and this money was swept into the general revenue fund during a past legislative session. This proposal would reinstate the Lite Up Texas Fund as a dedicated fund used for utility assistance for seniors of lesser means and would provide that it cannot be swept into general revenue in the future.
4. State Court Judicial Review. Texas Legal Services Center has submitted a proposal that would provide that state courts can judicially review final administrative decisions regarding eligibility for Medicaid, Food Stamps and TANF. Currently, rejection of these benefits by a state administrative department may only be appealed to Federal courts at great expense. State court judicial review is especially appropriate as a program integrity tool as eligibility determinations initially begin through Call Centers which have no proven track record.
5. Alzheimer’s Classification, Training & Education. The Alzheimer’s Coalition of Texas has proposed that Alzheimer’s disease be moved from the bottom of the TILE system to a TILE ranking that more accurately reflects the reasonable costs for nursing facilities to provide quality care. This proposal would result in nursing facilities receiving more reimbursement from Medicaid for providing care to its residents who suffer from Alzheimer’s disease. The proposal would also increase Alzheimer’s related education and training requirements for assisted living facilities and for nursing facilities. One-half of all elderly nursing home and assisted living residents suffer from Alzheimer’s disease.
6. Adult Protective Services Support. The Gray Panthers proposed that TSAC support all exceptional items requested by APS in its FY07-08 legislative appropriations request (LAR). It is expected that the LAR will request a restoration of current funding as each agency has been asked to reduce its baseline budgets by 10%. Reports of abuse, neglect and exploitation to APS and the resulting investigations have far exceeded expectations, and APS caseworkers are handling caseloads as high as 100 clients per worker. Failure of the State to name a guardian of last resort has resulted in APS having to continue to monitor cases which have been rejected for guardianship by DADS.
7. Requiring Licensure for Lodge Homes for Seniors with Mental Disabilities. In El Paso, Judge Max Higgs has begun investigations into various unlicensed lodge homes that provide residences for persons with mental illness including many seniors who have dual diagnosis of dementia and mental illness. These lodge homes are currently not required by law to be licensed because they do not provide “personal care” as defined by the Texas Health & Safety Code. The lodge homes have begun a practice of becoming representative payee for a resident’s social security payments and then not providing sufficient funds to the resident to enable the resident to eat and dress. This proposal would require that any such “lodge home” be licensed by the State if it becomes a representative payee of social security payments. In other words, “personal care” would be amended in the Health & Safety Code to include providing representative payee services in conjunction with residential services.
8. Increasing Personal Needs Allowance to $75 per Month. Currently, residents of nursing facilities who are on Medicaid receive a personal needs allowance of $60 per month to buy clothing and personal care items. The personal needs allowance was reduced to $45 by past legislatures and was raised to $60 per month by the Legislative Budget Board with budget execution funds last year. Each year, a bill is presented to reduce the personal needs allowance below $60 per month. TSAC should pursue the passage of a bill that would increase the personal needs allowance to $75 per month so that seniors in nursing facilities are able to buy the clothing and personal care items they need to preserve their dignity.
9. Funding for Pilot Project -Ombudsmen Program at Assisted Living Facilities. DADS currently sponsors an Ombudsmen Program at nursing facilities across the State. These Ombudsmen act as advocates for the residents in these facilities. Many residents of assisted living facilities have cognitive impairments and need advocates to make sure that their rights are not violated and that they are receiving the care that they need. This proposal would be to request the legislature to fund a pilot project supervised by DADS where Ombudsmen would be assigned to a few large assisted living facilities in various parts of the State.
10. Increased Community Care Funding. DADS should continuously pursue and encourage the growth of long term care alternatives to nursing facilities. Funding for care in the community should increase by a certain percentage each year until there is no longer a waiting list for Community Based Assistance. Services to persons in the community provide more dignity and independence and are less costly than services in facilities. Residents in the community are able to visit their own doctors, attend their own church, and attend their own senior centers.
11. Geriatric Training Requirement for Doctors. Each state regulatory agency that licenses health care practitioners shall adopt rules to approve training in gerontology as a requirement for continuing education for physicians and other health care practitioners.