Minutes — August 2017 Committee of the Whole Meeting

2017 Council and Committee Meetings


Council Members Present

  • Mary Durheim, Council Chair
  • Patty Anderson, DRTx
  • Kimberly Blackmon
  • Mateo Delgado
  • Gladys Cortez
  • Kristen Cox
  • Sue Fielder, HHSC — Older Americans Act
  • Stephen Gersuk
  • Jennifer Kaut, TWC — Vocational Rehabilitation
  • Rachel Jew, DSHS/Maternal and Child Health
  • Ruth Mason
  • Ron Roberts, TEA — IDEA
  • Amy Sharp, UT CDS
  • Jami Snyder, HHSC — Medicaid
  • Meagan Sumbera, A&M CDD
  • Richard Tisch
  • John Thomas

Council Members Absent

  • Hunter Adkins
  • Kristine Clark
  • Scott McAvoy
  • Michael Peace
  • Dana Perry
  • Brandon Pharris
  • David Taylor
  • Lora Taylor

Guests Present

  • Jan Brown
  • Alfred Chavira
  • Ann Fontenot
  • Ted Johnson
  • Brooke Hohfeld
  • Amy Litzinger
  • Linda Litzinger
  • Stephanie Martinez
  • Karen McKinnon
  • Alexandra Noble
  • Kelsey Oliver
  • Rona Statman
  • Brian White

Staff Members Present

  • Beth Stalvey, Executive Director
  • Martha Cantu
  • Joanna Cordry
  • Cynthia Ellison
  • Danny Fikac
  • Ashley Ford
  • Maeve Hurson
  • Wendy Jones
  • Linda Logan
  • Jessica Ramos
  • Joshua Ryf
  • Koren Vogel

Call To Order

The Committee of the Whole of the Texas Council for Developmental Disabilities convened on Thursday, August 3, 2017, in the Chennault Room of the Hilton Austin Airport, 9515 Hotel Drive, Austin, TX 78719. Council Vice-Chair John Thomas called the meeting to order at 9:34 AM.

  1. Introductions
    Council members, staff and guests introduced themselves. Vice-Chair Thomas explained that Council Chair Mary Durheim requested he facilitate this quarter’s meetings.

  2. Public Comments
    No public comments were offered.

  3. 85th Texas Legislature Wrap-Up
    Public Policy Director Jessica Ramos discussed the results of the 85th legislative session. She first reviewed the impact that the FY 2018 — FY 2019 budget will have on people with disabilities including rate reductions to attendant care and habilitation services, changes in reimbursement methodology for pediatric therapy, and reductions to Early Childhood Intervention funding. Ramos further explained that Promoting Independence initiatives were not fully funded which could increase the number of State Supported Living Center (SSLC) admissions due to the lack of community waiver services. Although individuals who currently receive Medicaid waiver services should not lose those services, new recipients will not be added to the programs which will result in fewer individuals receiving services by the end of 2019 than in 2017. It is also expected that cost-saving measures will be proposed for SSLCs due to funding strategies that do not fully fund FY 2019 and the concern that the legislature will not address this at the beginning of the 86th session.

    Ramos next discussed the results of legislation in the TCDD Public Policy Priority areas of SSLCs, Community Living, Employment, and Education. She noted that the SSLC restructuring bill did not pass however bills to study water quality at SSLCs and the sale of SSLC services to individuals living in the community did pass. Changes to day-habilitation services did not pass. The Employment First Taskforce was discontinued and recommendations to eliminate state contracts for the purchasing of goods and services provided by sub-minimum wage employment also did not pass. Legislation to prohibit a cap on special education services did pass. Legislation to require emphasis on alternatives to guardianship during transition services for students was also enacted.

    Ramos also discussed the current special session which was called to address sunset legislation for the Medical Board. However, the Governor added other topics to the agenda including teacher pay raises and retirement as well as education vouchers for students with disabilities that could be funded by deferring payment for health and human services. It is unknown if the House and Senate will reach consensus on these topics.

  4. Health and Fitness Panel
    Grants Management Specialist Wendy Jones introduced Brian White of the Texas Statewide Independent Living Council (SILC) and Alfred Chivera of Any Baby Can who gave presentations on their Health and Fitness projects. White discussed the Texas SILC project that worked with five Centers for Independent Living (CILs) to identify consumers and develop an Independent Living Plan (ILP) to determine and track health and fitness goals. Consumers had access to an Independent Living Specialist and a Health and Fitness Specialist to help achieve the goals of the ILP. The CILs partnered with 41 different entities to provide services, 27 health specific programs and policies were implemented or improved, and almost 1,000 consumers received services or training as a result of the project.

    Chavira discussed the Any Baby Can project which included a three-month nutrition and fitness program for individuals with disabilities and their family members. The curriculum was based on state standards to increase activity levels. Chavira also addressed the obesity rate which is 58% higher in adults and 38% higher in children with disabilities.

    Council members engaged in small group discussion regarding health and fitness and how to address disparities that may exist due to geographic area, age, race/ethnicity, language barriers, income, and education. Members discussed lessons learned from these projects and how the Council can further address systems change on this issue. Feedback included interest in projects that address healthy nutrition.

  5. How Medicaid Works
    Executive Director Beth Stalvey noted that Medicaid reform continues to be a topic of discussion at the federal level regardless of a specific bill to repeal, replace, or change the Affordable Care Act and that Public Policy Director Ramos would provide more detail.

    Stalvey then discussed the President’s budget proposal for Fiscal Year 2018 as well as a recommendation to reorganize programs under the Administration on Community Living (ACL). The proposal is to combine Developmental Disabilities (DD) Councils with SILCs and Traumatic Brain Injury Advisory Boards into a new federal office entitled Partnerships for Innovation, Inclusion and Independence (P3I) with a budget of $45 million for all states and territories. ACL has asked for input on the proposed P3I structure and an email address has been set up to receive those comments through August 11, 2017. The Congressional House budget proposal however maintains DD Councils within the current DD Act network that includes University Centers for Excellence in Developmental Disabilities and Protection and Advocacy agencies and recommends DD Council funding at the current level of $73 million across all states and territories. Stalvey noted that Disability Rights Texas, Texas Center for Disability Studies, and Texas A&M Center on Disability and Development are submitting joint comments on how this proposal would impact DD Act implementation and that TCDD should also consider submitting input to ACL on this topic.. Members discussed the success of Council initiatives and the impact of grant projects. Stalvey noted that further discussion on this topic would continue at the informal work session following the Committee meetings.

    Ramos then discussed Medicaid noting that 1 in 7 Texans rely on Medicaid for health coverage or long-term services and supports and that over 10 million people in the United States receive Medicaid services due to their disabilities. Ramos explained the partnership between federal and state government to provide these services is 60% federal funding and 40% state funding. Federal regulations mandate the minimum of who is covered and the minimum of what services are provided with the states providing additional services with a match in federal dollars. She noted that individuals that are required to be covered are children, pregnant women, some older adults, and people with disabilities with Texas providing additional services for long-term care and pregnant women up to 198% of the federal poverty rate. Ramos further discussed the eligibility of the different groups based on poverty rates as well as the percentage of expenses for each group and the treatments and services covered by Medicaid.

    Ramos then discussed federal proposals for funding Medicaid through Block Grants or Per Capita Caps. A Block Grant is a set amount of money for each state and is determined in advance but the formula to determine the amount is unknown. It is possible that Texas could receive less money than smaller states because Medicaid services in Texas were not previously expanded. This grant would not include additional match based on the state’s expense and the amount of the grant would be lowered over time with the state expected to make up the difference. The state would then determine how to spend the allotment. A Per Capita Cap is similar to a block grant but is based on a set amount for each person who is eligible and limits the amount of services that a person can receive. Both policies would eliminate the current federal match to state dollars and reduce the amount of funding that states receive. Reduced funding, would impact availability of Medicaid services including Home and Community Based Services.


Council Vice-Chair Thomas adjourned the Committee of the Whole at 1:45 PM.

Beth Stalvey, Secretary to the Council