The Texas Legislative Budget Board published a report (find it here: http://www.lbb.state.tx.us/Health_Services/State_Supported_Living_Centers.pdf) on what used to be known as the State Schools, now known as the State Supported Living Centers (SSLCs). It’s a report essentially calling for two things: first, a closing of some of the SSLCs especially as resident populations are decreasing and second, a rethinking of how those SSLCs provide services.
Closing Selected SSLCs:
The report makes a number of strong arguments for closing some of the SSLCs:
• First, Texas essentially operates two systems for care of the intellectually and developmentally disabled. The first is the SSLC, the second is a community placement option. Other states primarily operate the community model. By operating two systems, Texas is unable to see any cost-savings from the community model.
• Second, the SSLC makes up almost 35% of the costs while serving less than 15% of the clients.
• SSLC facilities range in age from being almost 100 years old to being 33 years old. This means that they have enormous maintenance and operational costs associated with them. In fact, some of the facilities have needs that exceed the values of the buildings.
• Third, the census of the SSLCs has been in sharp decline over the past 30 years, but the SSLCs have not been downsized to reflect this, as a result there has been little cost savings from the decline.
• Fourth, despite significant investments in facilities, safety, training, and staffing DADS has not been able to address the deficiencies in the SSLCs that were cited by the Department of Justice. All the monitoring reports that have been published have mentioned that the staff have good intentions, but the deficiencies are still present. The LBB report states that the incidents of abuse, neglect, and exploitation have increased from 427 in 2006 to 705 in 2010 (which is the highest number of incidents since 2006).
• Fifth, despite investments and training the average turnover rate of staff in the SSLCs is still increasing, which affects the quality of care.
The LBB’s recommendation is to close on or more, these are reflected as riders in both HB1 (http://www.lbb.state.tx.us/Bill_82/1_Recommend/Bill-82-1_House_Recommend.pdf) and SB1 (http://www.lbb.state.tx.us/Bill_82/1_Recommend/Bill-82-1_Senate_Recommend.pdf). The LBB recommends setting up a process for closing the SSLCs both now and in the future.
Rethinking SSLC Provided Services:
Essentially, the LBB is arguing that DADS is using an outdated approach to operating the SSLCs and providing care to residents. They use the example of the state of Kansas as an example of how to modernize these services. In summary, the recommendations are:
• Flatten the organizational chart in the SSLCs
• Decentralize the running of the SSLCs to provide more choices to residents and to the SSLCs
• Make programs and services less medically-oriented and more person-oriented so that the residents are part of the decision-making process
• Seek better employment for the residents than is the current practice
HB1 and SB1 have a rider for DADS to hire a consultant that would change the culture of how DADS operates the SSLCs.
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