HBA-DMH H.B. 2258 77(R)    BILL ANALYSIS


Office of House Bill AnalysisH.B. 2258
By: Maxey
Human Services
6/12/2001
Enrolled

BACKGROUND AND PURPOSE 

In 1999, the United States Supreme Court ruled in L.C. and E.W. v Olmstead
that, in most cases, states must provide community-based services for
disabled persons if treatment professionals determine that community-based
services are appropriate and the person does not object to such placement.
In response to this ruling, Governor George W. Bush issued an executive
order directing the Health and Human Services Commission (HHSC) to conduct
a comprehensive review of all services and support available to disabled
persons in Texas.  HHSC has been working with the Texas Department of Human
Services (DHS) and the Texas Department of Mental Health and Mental
Retardation (MHMR) to identify individuals within their respective
residential programs who may be eligible and who are interested in
transitioning into the community.  The number of nursing home residents who
would need mental health and mental retardation services from MHMR as well
as services from DHS related to their medical needs to successfully
transition into a community based setting is unknown.  It is essential that
residents with mental illness or mental retardation be identified to
facilitate the development of transition plans which incorporate services
from both agencies.  House Bill 2258 requires DHS to develop a process to
identify nursing home residents with a mental illness or mental retardation
and share that information with MHMR.  

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

ANALYSIS

House Bill 2258 amends the Health and Safety Code to require each nursing
home resident who is considering making a transition to a community-based
care setting to be identified to determine the presence of a mental illness
or mental retardation.  The bill requires the Texas Department of Human
Services (DHS) to use an identification process that is at least as
effective as the mental health and mental retardation identification
process established by federal law.  The bill prohibits the results of the
identification process from being used to prevent a resident from remaining
in the nursing home unless the nursing home is unable to provide adequate
care for the resident. 

The bill requires DHS to compile and provide to the Texas Department of
Mental Health and Mental Retardation (MHMR) information regarding each
resident identified as having a mental illness or mental retardation before
the resident makes a transition from the nursing home to a community-based
care setting. The bill requires MHMR to use the information provided by DHS
to determine the need for and funding levels of mental health and mental
retardation services for residents making a transition from a nursing home
to a community-based care setting, to provide the services to an identified
resident after the transition, and to refer an identified resident to a
local mental health or mental retardation authority or private provider for
additional mental health or mental retardation services.  These provisions
do not authorize DHS to decide for a resident of a nursing home that the
resident will make a transition from the nursing home to a community-based
care setting. 

EFFECTIVE DATE

September 1, 2001.