We LOVE the Permanency Planning language in Texas statute (added in 2001) that says that children belong in families, that any institutional placement is to be considered temporary and that alternatives will be provided and considered every six months. This way the family knows when the child goes in that it isn’t going to be forever.

 

The statute also requires a semi-annual review and report on all children residing in institutions, type of institution, what supports assisted the children to return to the community and what supports are unavailable but necessary for the child to return to the community. This is my favorite report of all of the state reports. This data has been invaluable in tracking outcomes and linking budget cuts to increased institutional placements for children. Those reports also led to a number of budget riders that allow children to use waiver programs that they might not be eligible for but has the service that they need to be able to leave the institution.

 

As Roger said, EveryChild, Inc. is the entity that has the contract referred in Sec. 531.055 (d) that does all permanency plan for the children in nursing homes. As of September 2014 Texas had 42 children in nursing facilities. We’re now trying to get them more access to the 94 children in state operated ICFs. We’re lucky that they have staff who are engaged in policy change as well. 

We set-aside waivers services to divert all people from admission to a state-operated ICF as a result of the DOJ’s involvement.

Children still must enter a nursing facility for at least 30 days to establish Medicaid eligibility and then access community based waiver services. That process usually lasts longer than 30 days because Medicaid application and enrollment takes so long here. Our Medically Depend Children’s Program (MDCP) has a seldom used process where the child only enters the facility for some part of two days (usually a parent stays with them). They have to be extremely medically fragile, such that they could not tolerate a 30 days nursing home stay. These children usually have trachs, weakened immune systems and/or g-tubes. Getting nursing home diversion is next on our list.

 

SB 368 (2001) http://www.capitol.state.tx.us/tlodocs/77R/billtext/html/SB00368F.htm

 

 

It’s nice to hear that others look at Texas for something good at least occasionally!  Thanks Debra!

 

We also are pretty positive about the efforts of EveryChild.  We provided initially funding for EveryChild to get started and it now sustains its efforts with contracts from state agencies.  EveryChild has developed innovative models of developing intense family supports that help natural families stay together; alternate family models for situations when the natural family isn’t able to provide the involvement needed; at times a shared family relationship, etc.  More good info on their website at:  http://www.everychildtexas.org/

 

Eric, I’ll send you something separately as well.  Just wanted others to know if this “project”.  Successful long after funding ended.  Yea! 

Roger

 

 

Hi Eric,   Florida is not so fortunate to have the agreement of the state agencies and legislators on this issue.  The federal Department of Justice is suing Florida on this issue.  We have done a lot of research into other states.  We really like the Texas model.  While that model has focused more on moving the kids out of institutions, they may be able to provide insight into their efforts on this issue.   Everychild Texas is the organization taking the lead to work with families to get them out of the nursing homes (and other institutional settings).    Attached is the report we did on other states which includes some discussion of the Texas model.  I can give you the person we have been working with at Everychild Texas, if you would like.

 

 

Debra

 

 

 

Many of you know that our DD Network has been working for 10 years to get kids out of institutions and nursing homes.  The institution part is complete.  There are about 50 kids in nursing homes in the state.  We now have consensus from the state agencies, legislators and the Governor to support moving these kids out and into stable loving families.  We have one challenge after we complete this:  how do we keep kids from being admitted into nursing homes.  I am wondering if any states have legislation or rules (other than PASRR) to address this.  Any help is appreciated.

 

Eric

 

Eric E. Jacobson

Executive Director

 

 

Georgia Council on Developmental Disabilities

2 Peachtree Street, Suite 26.200 Atlanta, GA 30303

O: (404) 657-2120  C:  (404) 805-9739

www.gcdd.org