TribBlog: LBB: State Must Improve Care For Disabled

The way Texas is currently providing care for people with disabilities — keeping all its state institutions in operation, despite increasing demand for community-based care — is not cost effective, and should be changed, according to an analysis released by the Legislative Budget Board on Wednesday. 

The LBB says the solution is to close at least one of Texas' 13 state-supported living centers promptly, then to direct the agency that oversees them to set up a continuous review of their necessity. 

"Decreasing the number of residents instead of closing facilities has resulted in a costly arrangement of dual-funded systems of care," the report notes. "...Closing at least one institution... would enable the state to concentrate resources on persons remaining in the system and redirect savings to expansion of community programs."

Many of the report's recommendations will present an "I told you so" for advocates for shuttering the state-supported living centers, who have long made this same argument. 

Among the findings: 

— Texas has more people with disabilities living in institutions than any state, and a disproportionate amount of the U.S. total (12 percent). 

— Though the census of Texas' state-supported living centers has dropped by nearly 26 percent since 1996, the same number of facilities (13) remain in operation. 

— Confirmed allegations of abuse and neglect there have risen 65 percent since fiscal year 2006, and recruitment and retention of quality employees continues to be a problem, despite increased appropriations to the agency that oversees the facilities. 

— The state-supported living centers have aging infrastructure, and required a combined $18 million in the last biennium to maintain. 

The LBB recommends closing at least one state-supported living center by May 31, 2013. They also want one full-time employee to direct the closure process. They don't recommend a specific institution for closure, though they do compare the potential cost savings by facility. Over the next biennium, shuttering one facility could save anywhere between $4 million and $15 million, savings largely dependent on the census and security level of the institution.