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Originally Processed With FOIA(s): FOIA Number: S S FOIA MARKER This is not a textual record. This is used as an administrative marker by the George Bush Presidential Library Staff. Record Group/Collection: Donated Historical Materials Collection/Office of Origin: Frieden, Lex, Collection Series: Government Records Subseries: Printed Material OA/ID Number: 52030 Folder ID Number: 52030-011 Folder Title: [Publications by State - Texas] "Joint Committee to Study Long-Term Care Alternatives" [1977] Stack: Row: Section: Shelf: Position: G 5 2 5 2 Joint Committee to Study Long-Term Care Alternatives STATE OF JOINT COMMITTEE TO STUDY LONG-TERM CARE ALTERNATIVES Suzette Ashworth, Director 230-S Exchange Park 7800 Shoal Creek Boulevard Austin, Texas 78757 (512) 459-4291 CONTENTS PANEL MEMBERS 1 SENATE BILL 548 4 EVALUATION DESIGN 9 PROGRAM DESCRIPTION 17 CURRENT STATUS 21 MARGIN INDEX back cover ii Panel Members PANEL MEMBERS: JOINT COMMITTEE TO STUDY LONG-TERM CARE ALTERNATIVES Senate Bill 548 of the 65th Legislature established a nine- member panel to guide the evaluation activities mandated by the legislation. The President of the Senate, William P. Hobby, and the Speaker of the House of Representatives, Billy Clayton, appointed three members each from their respective legislative bodies. The Board of the Texas Department of Human Resources (DHR) appointed the remaining three members. SENATE Sen. Chet Brooks, Chairman Sen. 0. H. Harris Sen. Bill Meier HOUSE OF REPRESENTATIVES Rep. Hugo Berlanga Rep. Frank Collazo, Jr. Rep. Mike Ezzell DEPARTMENT OF HUMAN RESOURCES Emmett W. Greif, M.D. Merle E. Springer Lloyd Sterling 2 Senate Bill 548 The State of Texas SECRETARY OF STATE I, MARK WHITE, Secretary of State of the State of Texas DO HEREBY CERTIFY that the attached is a true and correct copy of Senate Bill Number 548, passed by the 65th Legislature, Regular Session, 1977, signed by the Governor on May 27, 1977 and filed in this office on May 28, 1977. IN TESTIMONY WHEREOF, / have hereunto signed mv name officially and caused to be im- pressed hereon the Seal of State at my office in the City of Austin this 31st day of May A .D.19 77 Wash Make Secretary of State fecomes effective any 29,1977 4 Enrolled S.B. No. 548 1 AN ACT 2 relating to a report by the State Department of Public Welfare or 3 its successor agency on the alternate care program, containing an 4 evaluation of the program and recommendations and the effect on 5 nursing care costs under medical assistance programs; and declaring 6 an emergency. 7 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 8 Section 1. The State Department of Public Welfare or its 9 successor agency responsible for alternate care programs shall, 10 before January 1, 1979, report to the legislature on the alternate 11 care program. The reporting panel shall be made up of three 12 persons from the State Department of Public Welfare appointed by 13 the board of directors of the State Department of Public Welfare, 14 three members of the house of representatives to be appointed by 15 the speaker of the house, and three members of the senate to be 16 appointed by the lieutenant governor. The report must include a 17 complete evaluation of the effectiveness of the program and its 18 effect on the number of persons receiving and the quality of care 19 given under nursing home care programs. The report must also 20 contain recommendations relating to whether or not alternate care 21 is a suitable substitute for some kinds of nursing home care and 22 whether there is a continuing need for minimum level nursing care 23 programs, such as Intermediate Care Facility II programs. 24 Sec. 2. The importance of this legislation and the crowded 25 condition of the calendars in both houses create an emergency and 5 S.B. No. 548 1 an imperative public necessity that the constitutional rule 2 requiring bills to be read on three several days in each house be 3 suspended, and this rule is hereby suspended. 6 S.H. No. 548 WPHolly President of and SAFFED J. terr Spedker Clayton of the House I hereby certify 0.1. No. 544 passer the senate on March 16, 1977, on the following VOTA: Yeas 2h, laws 0; May 12, 1977, sellate concurred in house assendments by the following verse: Yeas 30, Lays U. Secretary of the Senate : hereo: certify that S.R. No. 548 passed the house, with amendments, or MAY 10, 1971, my 5 non-record vote. English Chief Clerk of the House Approved: 27 Date 1977 Linen FILED IN THE OFFICE OF THE SE BETARY OF %overn MAY 28 1977 Mark White Secretary of State 7 Evaluation Design EVALUATION DESIGN (Adopted November 17, 1977) BACKGROUND Senate Bill 548 Senate Bill 548, passed by the 65th Legislature in May, 1977, requires the Texas Department of Human Resources (DHR) to report to the legislature before January 1, 1979, on the alternate care programs sponsored by the Department. Specifically, the bill requires the report to evaluate the follow- ing issues: The effectiveness of the alternate care program The effect of the alternate care program on the number of persons receiving nursing home care and on the quality of care under the nursing home care program. 1 The bill also requires recommendations about the following ques- tions: Is community care a suitable substitute for some forms of nursing home care? Is there a continuing need for minimum-level nursing care pro- grams, such as Intermediate Care Facility (ICF) II? Medicaid Task Force In addition to the mandate represented by Senate Bill 548, the Texas State Board of Public Welfare in January, 1977, organized a 47- member citizens committee, the Task Force for Evaluation of Medicaid in Texas, to find ways to enable the Medicaid program to operate within its financial constraints. The report of the Nursing Homes and In-Homes Care Subcommittee of the task force noted that over one-half of the State's Medicaid outlay was for various aspects of care for the elderly, and yet large numbers of senior citizens were receiving inadequate services, or none at all. To improve this situation, the subcommittee made 18 recom- mendations, the first of which called for a major study to further define the extent of an alternate care program. 1. With the enactment of Senate Bill 9 in July, 1977, and following further clarification in the form of a letter of October 21, 1977, from Senator Brooks to Commissioner Chapman, the quality of care given under the nursing home care program has been excluded from the scope of this study. 9 Overview of the Present Study In response to these directives, the Department will conduct a comprehensive study of the alternate care programs under its aegis de- signed to serve elderly and disabled Texans. Findings of the study will be submitted to a reporting panel 2 The panel will issue the final report to the legislature and will formulate the recommendations as required in Senate Bill 548. The study will contain two major components. The first is a comparative evaluation of alternate care, which will provide information on four closely defined and interrelated questions about the program. The study's second component will gather information across a broader spectrum, which is equally important to decisions about the program's future direc- tions. Comparative Evaluation. The four closely defined questions about alternate care may be restated as follows: How effective is the alternate care program? What is the program's effect on the number of people receiving nursing home care? Is alternate care a suitable substitute for some kinds of nurs- ing home care? Is there a continuing need for minimum-level nursing home care? The methods by which these questions will be answered are discussed in detail in the following subsection (subsection 2). Environmental Analysis. The study's second component, which in- volves gathering data over a broad range, is referred to as an "Environmental Analysis" and is discussed in detail in subsection 3. Briefly, the Envi- ronmental Analysis will provide information on availability of resources, utilization of services, and projected costs and demand for services. A fourth element will consist of input gathered at public hearings from a diverse body of persons interested in alternate care programs. 2. The panel is chaired by Senator Chet Brooks of Pasadena. Senate members are Senator 0. H. (Ike) Harris of Dallas and Senator Bill Meier of Euless. Panel members from the House of Representatives are Rep. Hugo Berlanga of Corpus Christi, Rep. Frank Collazo, Jr. of Port Arthur, and Rep. Mike Ezzell of Snyder. DHR members are Emmett Greif, M.D., Merle Springer, and Lloyd Sterling. 10 COMPARATIVE EVALUATION OF ALTERNATE CARE The Comparative Evaluation will entail the collection and analysis of both analytic and descriptive data from numerous sources, including both recipients and nonrecipients in the eligible service population, providers and support staff involved in service delivery, and peripheral populations (e.g., families, physicians, and guardians of persons in the service population). Secondary data will also be utilized in the form of existing statistical reports and the reporting system implemented as a re- sult of the evaluation. Effectiveness of the Program The first step in assessing the impact of alternate care services on recipients will be accomplished by comparing representative numbers of clients and nonclients over a period of time. In June of 1976, over 4,100 recipients of Supplemental Security Income (SSI) throughout the State were interviewed concerning needs, health characteristics, functional levels, available resources, and other sociodemographic characteristics. Approxi- mately 12 percent of these recipients were DHR clients in the alternate care program at the time. Longitudinal information will be obtained through follow-up interviews with a stratified sample of these individuals. In addition, DHR records will be searched to determine any changes in status of all recipients involved in the 1976 survey. Possible status changes are: moved, institutionalized, or deceased. Data collected on the two groups will then be compared by key variables including living arrangement, health, functional capacity, and attitudes. The major question addressed will be, Do alternate care clients ex- hibit fewer negative status changes (functional or health deterioration, institutionalization, etc.) than similar SSI recipients not receiving alter- nate care services? Three Interrelated Questions The other three questions within the comparative evaluation are closely interrelated and will require the collection of data on and from all levels of nursing home residents in addition to the comparative data gathered from SSI recipients in the evaluation's first step. Effect of Alternate Care on Number and Type of Persons Receiving Nursing Home Care. Key characteristics of alternate care clients and nursing home patients will be ascertained, compared, and analyzed as an indicator of the alternate care program's effect on the number and types of individuals receiving nursing home care. Another possible indicator of the program's effect may be found in clients who had been receiving alter- nate care prior to entering a nursing home. If alternate care serves to delay the rate of institutionalization, alternate care clients should theo- retically require a higher level of care at the time of entry than do nonclients--the possible impact of alternate care thus being to allay the need for entry at lower levels of care. 11 Alternate Care as a Substitute for Some Nursing Home Care. The ques- tion of whether alternate care is a suitable substitute for some forms of nursing home care will also be approached initially through comparison of the two groups' key characteristics. Since previous studies indicate that these characteristics are very similar, it will be necessary to identify other variables that help determine why one person is a nursing home pa- tient and the other not. Information on resource availability, awareness of alternatives, the decision-making process of physicians, and attitudes and preferences of the family and the individual will be examined to meas- ure the impact of such variables upon the final determination. Need for a Minimum Level of Nursing Home Care. The question of whether there is a continuing need for minimum-level nursing home care will be examined by comparing characteristics and medical needs of patients in Inter- mediate Care Facility (ICF) II's and III's. The interrelationship of these care levels and the unique characteristics of patients in nursing homes that offer Skilled Nursing Care also will be identified for use in the formula- tion of the panel's final recommendations. Figure 1 represents the groups that constitute the basic design of the Comparative Evaluation. ENVIRONMENTAL ANALYSIS* An Environmental Analysis of the factors involved in the need for and delivery of alternate care and nursing home care will be included in the study's findings. This analysis will include demographic profiles of ser- vice populations and providers, and an identification of available resources. In addition, information will be gathered on alternate care programs in effect in other states or areas of the country for purposes of possible comparison and future adaptation. Availability of Resources Available community care and nursing home resources will be mapped statewide to identify the areas and extent of available services. Services stemming from sources other than DHR also will be identified, and mechanisms designed to coordinate or link service delivery will be noted. Target popu- lations and service priorities of both the community care and nursing home programs will be identified to determine possible gaps or overlaps of these resources. Service Mix and Utilization The types of services offered within the alternate care program and nursing homes and their distribution pattern will be analyzed and described. Particular attention will be devoted to community profiles of four low- resource counties (counties with few care alternatives) and to four high- resource counties (counties offering a number of service providers and a range of services). *This component's name later was changed to "Resource Inventory." 12 Skilled Nursing Patients SSI Recipients Nonclients of Alternate Care Change in status ICF III from original sur- Patients vey (June 1976- January 1978) SSI Recipients (DHR Alternate Care Clients) ICF II Patients Level at which alternate care clients enter institutional care Legend = personal interviews = secondary data Figure 1. . Comparative Evaluation Groups 13 In these areas, interviews will be conducted with physicians, key rela- tives of both alternate care clients and nursing home patients, and service providers. Attention also will be directed at the decision-making process in- volved in choosing either alternate care or placement in a nursing home. Areas of inquiry will include awareness of services, preferences, economic considerations, and other factors important in arriving at the placement decision. Projected Costs and Caseload Data representing past and anticipated trends in the expenditures and caseloads of the alternate care and institutional programs will be developed. Per capita costs and other comparative cost information will also be produced. Trends and projections for the elderly population of Texas will be presented in conjunction with projected income distribution patterns by age group. These elements, combined with data from prior years, will offer some indication of the future need for these programs in the State. Public Hearings and Site Visits To futher augment the technical evaluation, the reporting panel elected to sponsor public hearings and site visits. The public hearings will pro- vide an opportunity for testimony from all concerned parties on a broad range of issues. The site visits will provide panel members with an oppor- tunity for first-hand experience and interaction with both recipients and providers. Hearings. The public hearings will provide a forum for views on care of the elderly from providers, recipients, professional associations, ad- vocate groups, and the general public. Specifically, the following types of persons will be invited to give testimony. Service Providers--including nursing home operators, hospital administrators, physicians, home health care providers, adult day care center operators, foster home providers, and others Recipients and the General Public--including nursing home patients, clients receiving home health and community care services, family members, and others Experts and Staff--including gerontological experts, representa- tives from educational and research groups, agency staff, and others Testimony received at the public hearings will be analyzed and presented as part of the Environmental Analysis. Site Visits. Site visits will provide panel members an opportunity for first-hand observation of recipients and service providers. Such personal interaction will better clarify the specific needs of the elderly 14 and will help to explain the kinds of community and institutional care that are being provided. Visits to recipients homes and to congregate facilities will provide direct input from recipients in a way that otherwise would be difficult to obtain. Visits can be expected to include the following types of sites or activities: family care, chore and homemaker care, foster care homes, Meals-on-Wheels programs, ICF II and III nursing homes, rehabilita- tive day care centers, home health nursing care operations, adult day- activity centers, and hospital discharge-planning units. Table 1 summarizes the locations and dates of hearings and visits. TABLE 1 LOCATIONS AND DATES OF PUBLIC HEARINGS AND SITE VISITS LOCATION DATE Harlingen January 12-13, 1978 San Antonio February 22, 1978 Dallas March 6-7, 1978 Longview March 8, 1978 Port Arthur April 13-14, 1978 Big Spring May 26, 1978 E1 Paso July 6-7, 1978 TASK SCHEDULE The study's multifaceted approach, utilizing both original and exist- ing data, with heavy emphasis on comparative and output measures, will not only answer the mandate of Senate Bill 548 but also will provide valu- able information on the alternate care program to the administrative staff within the Department of Human Resources. The collection of secondary data for the development of the Environ- mental Analysis began in October 1977 and will continue through the summer of 1978. Collection of primary data will extend from January through July of 1978. The initial draft of the findings will be submitted to the panel by October 1, 1978--subject to the panel members' review and revisions. 15 Program Description PROGRAM DESCRIPTION COMMUNITY CARE FOR THE AGED, BLIND, AND DISABLED (CCABD) The CCABD program's main goal is to help aged, blind, and disabled persons remain independent and self-sufficient for as long as possible. In order to accomplish this goal, the program provides a variety of services within the home and community. Protective services are designed to prevent or remedy neglect, abuse, or exploitation. In-home services, provided to the client in his home, consist of the following: -- Chore services (ordinary household tasks) - Family care services (ordinary household tasks) --- Homemaker services (personal care to the client and some household tasks) -- Home-delivered meals Out-of-home services, provided in the community but not to the client's home, include the following: Day activity services (personal care in a group setting) - Congregate meals Foster family homes (a room and board environment in certified homes) -- Health-related services (generally include information and referral assistance to medical facilities or home health agencies) Funding The CCABD program is a social service provided through Title XX funds. The State pays 25 percent of the total and the Federal government pays the remaining 75 percent. Eligibility The CCABD program is directed to serve current, former, and potential recipients of Supplemental Security Income (SSI). Historically, the 17 program has concentrated on the lowest income level, the current SSI recipient. With the service demand exceeding funding levels, the CCABD program was forced to establish the following service priorities for recipients of SSI and Medical Assistance Only (MAO) : 1. SSI or MAO* clients who are leaving a nursing home 2. SSI or MAO clients age 65 or over who will either have to enter a nursing home within 30 days or who are in a life-endangering situation 3. SSI or MAO clients age 18-64 in the same conditions as Priority 2 4. Income-eligible aged, blind, or disabled adults in the same conditions as Priority 2 and 3 Utilization FY 1977 34,000 clients per month $54.1 million annual budget Current Status Funding. Title XX funds have a fixed ceiling beyond which the expenditures will not be matched. Texas funds five social service programs out of Title XX money and is now spending at the ceiling. Contracting. Due to Social Security Administration rulings, it is now necessary to contract with agencies to provide the in-home services that were once provided by individuals under individual service contracts. INSTITUTIONAL CARE The Institutional Care program is designed to provide nursing facility care to individuals whose health problems require medically oriented care that can best be delivered in an institutional setting. Levels of Service The Institutional Care program offers four different levels of service. *MAO and "income-eligible" are roughly equivalent in that they earn more then SSI recipients are allowed to but less than 65 percent of the State's median income. 18 1. Intermediate Care Facility (ICF) II--for people who need help in daily living but who do not need more than simple medical care. ICF II patients mostly need supervision by a licensed nurse on a daily basis and help for their safety and well- being because they cannot live alone or independently. 2. Intermediate Care Facility III--for persons unable to care for themselves who need the services of a licensed nurse on a day- to-day basis. ICF III patients require some regular medical treatment but not to the degree of those who need skilled nursing care. 3. Skilled Nursing Care--for persons whose condition requires care under the direction of a registered nurse, 24 hours a day. 4. Intermediate Care Facility for the Mentally Retarded--provided through the State Schools and some private nursing homes. Patients are admitted to a nursing facility only upon the recom- mendation of a qualified physician and are reviewed periodically in order to be certified for a continuation of stay. Funding Institutional Care is a medical service provided for by Title XIX (Medicaid) funds. At present the State pays 39 percent of the total and the Federal government pays 61 percent. Eligibility All Medicaid recipients are eligible for Institutional Care. This includes SSI recipients and those individuals with resources and monthly incomes low enough to qualify them for Medical Assistance Only. Utilization FY 1977 61,000 ICF and Skilled patients monthly $362.4 million annual budget 19 Current Status CURRENT STATUS-AUGUST 1978 In response to Senate Bill 548, an evaluation design was developed by support staff, presented to the reporting panel, and adopted in Nov- ember of 1977. The evaluation contains several components aimed at responding to the study's mandate: surveys that compare alternate care clients and nursing home patients; an analysis of the decision-making process that takes place when persons are placed in nursing homes; and a description of the services available to elderly and handicapped Texans and the environment--social, economic, and demographic--in which those services are delivered. This technical evaluation is augmented by input received at a series of seven public hearings and site visits spon- sored by the reporting panel. Figure 2 is a current time schedule, summarizing the status of major evaluation components. As indicated, technical reports are scheduled for production during August and September, with the final report and panel recommendations due for review in mid-October. Table 2 lists the major surveys conducted in response to S.B. 548, their sample sizes, completion rates, and current status. Table 3 describes the type of witness and general focus of testimony in each of the seven public hearings. 21 Figure 2. Project Time Schedule PROJECT COMPONENT GALENDAR YEAR 1978 JFMAMJJASON D SSI/ABD CLIENT SURVEY NURSING HOME ANALYSIS & SURVEY --Records Analysis --Personal Interviews ANALYSIS OF DECISION-MAKING PROCESS --Physicians --Service Providers --DHR Program Staff RESOURCE INVENTORY --Availability of Services --Service Trends in Other States 22 --Population & Cost Projections MEETINGS --Public Hearings & Site Visits --Quarterly Panel Meetings --Symposium/Seminar DOCUMENTATION --Technical Reports --Final Report (DRAFT) --Panel Recommendations --Printing & Distribution LEGEND = Sample, Instrumentation, Pretest, Training 11111 Prospective Time Period = Data Collection = Report Analysis = Approx. Date TABLE 2. MAJOR SURVEYS IN RESPONSE TO S.B. 548 Data Collection Size of Present Completion Survey Technique Sample Area Status Rate SSI/Community Care personal data Total=87.4% Client Survey interview 1,764 statewide analysis Community Care Client=93.8% Nursing Home sample data Records Analysis of files 14,000 statewide interpretation 100% Nursing Home personal data Patient Survey interview 157 statewide collection incomplete Physicians' Survey mailout eight report questionnaire 2,656 counties development 32% Providers' Survey mailout report questionnaire 123 statewide development 70% Staff Survey mailout report questionnaire 76 statewide development 88% TABLE 3. TESTIMONY AT PUBLIC HEARINGS ON LONG-TERM CARE ALTERNATIVES LOCATION OF HEARING TYPE OF WITNESS Har- San Long- Port Big E1 Dallas lingen Antonio view Arthur Spring Paso PROVIDERS Community/Home Care Public 7 3 8 11 12 6 11 Private/Voluntary 4 3 2 1 1 0 1 Individual 6 2 9 24 22 0 2 Nursing Homes 1 0 2 4 1 1 1 CONSUMERS Recipients/Pvt. Citizens 231 14 72 70 221 4 15 Advocacy Groups Handicapped 2 3 2 2 3 0 0 Elderly 0 3 4 2 2 0 4 FEDERAL GOV'T AGENCIES 0 0 1 0 0 0 0 STATE GOV'T AGENCIES Health 0 0 0 0 0 0 0 Social Services (DHR) 1 1 1 4 3 1 2 Mental Health, Retardation. 1 4 0 2 2 0 0 Aging 0 0 0 0 0 0 0 Other 0 0 0 0 0 0 0 LOCAL PLANNING AGENCIES HSAs 0 0 0 0 0 0 0 AAAs 0 1 0 2 2 0 0 COGs 0 0 0 0 3 1 0 Other 0 0 0 0 1 0 2 COMMUNITY ORGANIZATIONS Voluntary 0 2 4 0 0 0 2 Church-Affiliated 0 1 2 2 4 0 1 Community Action Agency 0 0 0 2 1 0 0 ELECTED OFFICIALS State 0 0 0 0 0 0 0 District 0 1 0 0 0 0 0 City/County 0 1 0 0 2 1 0 LABOR UNIONS 1 0 1 0 0 0 0 HEALTH PROFESSIONS 1 1 3 0 1 0 0 THIRD-PARTY PAYOR 0 0 0 0 0 0 0 EDUCATORS/RESEARCHERS 0 2 2 1 1 2 0 OTHER 0 0 0 0 0 2 0 TOTAL 262 46 113 127 282 18 41 Oral 44 40 42 70 107