Senate Health and Human Services Committee
Senate Bill 602
April 5, 2017
Thank you for the opportunity to provide public testimony in support of Senate Bill 602 relating to the establishment of a restructuring commission to evaluate each state supported living center. My name is Ruth Mason. I am a governor-appointed member of the Texas Council for Developmental Disabilities from Houston and I’m William’s mom. My son, William, is 26 years old and uses the Home and Community-based Services (HCS) waiver.
The Council is established by federal law and is governed by 27 board members, appointed by the Governor, 60% of whom 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.
Last summer, I was diagnosed with motor neuron disease. When the neurologist gave me the diagnosis, I began to repeat, “How can I help people if I am dying?” Before I was diagnosed with ALS, I was an advocate monitoring in the SSLCs for abuse, neglect and exploitation. I gave the residents, staff and guardians my word that if I stopped coming to the SSLCs, I would continue to advocate for them at the Capitol.
In the summer of 2014, the Sunset Advisory Commission Report included the following statement: “SSLCs have higher rates of confirmed abuse, neglect and exploitation than community group homes.” They recommended a Closure Commission to study the quality of services provided by the facilities and their ability to meet the minimum standards. The recommendation would have directed DADS/HHSC to improve the remaining seven SSLCs.
Since the Commission filed the report in 2014, the SSLCs rate per year for each person has risen by over 26% to an annual cost of almost $300,000 per year.
The Office of the Independent Ombudsman reports that during a 6 month period in 2015, there were 1,617 Unusual Incident Reports filed that include an “event or situation that seriously threatens the health, safety or life of individuals.”
In a recent DOJ Report for one of the SSLCs, the monitors repeatedly noted concern that the nurses were not adhering to basic nursing protocols.
In 2016, lead comparable to levels in Flint, Michigan was found in three of the SSLCs.
The DOJ Settlement Agreement in 2009 is simply a requirement to follow basic standards of care. None of the 13 SSLCs in Texas are near the 70% compliance required by the DOJ Settlement Agreement.
I know you’re also taking up a proposal to sell SSLC services to people in the community [SB 547]. Any SSLC service provided to HCBS waiver participants should prove substantial compliance under the DOJ agreement for the service made available. Implementation without meeting this stipulation could put SSLC residents at risk by stretching staff resources to provide these new services. Furthermore, the sections of the facility being used for community services should be required to meet accessibility standards under Americans with Disabilities Act, and clinics located at SSLCs should be required to meet the same clinical, regulatory and building standards required for any new community based facility. The restructuring commission proposed in SB 602 could provide recommendations regarding if and where the sale of services to community based waiver participants could be appropriate.
It is troubling to hear proposals for the construction of new SSLCs during budget discussions, particularly from the Texas House of Representatives. Texas does not require 13 SSLCs for the 2,795 people expected to continue to choose to use them as anticipated in the in the 2018-2019 budget. Texas should plan for consolidation and closure, rather than the construction of new facilities that would reproduce the same quality of service and be subject to Department of Justice oversight.
The Council continues to support a moratorium on admissions and other recommendations to reduce the SSLC infrastructure and rebalance the long-term services and supports system. Texas must act to modernize the IDD service system and reduce reliance on SSLCs. In conclusion, I support the establishment of a Restructuring Commission to evaluate each State Supported Living Center for closure, consolidation, or downsizing while building up the network of community supports and services.
Thank you for the opportunity to provide input on behalf of the Texas Council for Developmental Disabilities.
Attachment — SSLCs: Consolidate state supported living centers and improve community services for Texans with IDD Fact Sheet (PDF, 2 pages, 373 KB)