Commission Formally Recommends Closure of Some State Institutions

A Texas commission that reviews the efficiency of government agencies officially recommended Wednesday that lawmakers shutter an Austin-area institution for people with disabilities — and identify five more statewide for later closure.

The Texas Sunset Advisory Commission reviewed and tweaked a series of recommendations for lawmakers regarding several health and human service agencies ahead of the 2015 legislative session. In addition to the recommendation to close the Austin State-Supported Living Center, the commission advised the Legislature to deregulate at least 11 professions and create a policy to revoke the licenses of nursing homes that fail inspection.

Sunset members said the handling of the institution’s closure would hold special importance because it is the first of several living centers recommended for closure. 

“How Austin is closed and how that is received is going to be very important to the right-sizing that is in the next recommendation,” said Tom Luce, a public member of the commission, which is largely made up of lawmakers. 

The future of the facilities has been controversial for years. In 2009, Texas lawmakers agreed to a $112 million settlement with the U.S. Department of Justice over abuse and neglect at the facilities. Despite declining enrollment, high costs and calls for closure in favor of community-based care, families with relatives in the facilities and lawmakers who have them in their districts have fought to keep them open. 

“I hope all of us are concerned about closing it down in that there are families who are going to be affected,” said state Rep. Richard Peña Raymond, D-Laredo.

Sunset staffers had indicated that the state “can no longer afford” the cost of operating all 13 facilities, and the commission’s chairwoman, Sen. Jane Nelson, R-Flower Mound, indicated that lawmakers had long “struggled” with the facilities.

Sen. Juan “Chuy” Hinojosa, D-McAllen, said state-sponsored and private living centers both had a role to play in later reform efforts. “The reality is that we need both,” he said.

Meanwhile, supporters of the centers have said they will fight to keep them open, arguing that individuals with profound physical and behavioral disabilities are best cared for at the facilities. State lawmakers will have the final say on how or whether to implement the Sunset recommendations.

On a recommendation from state Rep. Four Price, R-Amarillo, the commission also adopted a recommendation to deregulate 11 professions of “low risk to public health,” including certified food handlers, contact lens dispensers and opticians. The recommendation is intended to reduce bureaucracy, Price said.

Other recommendations sought to increase scrutiny of certain private facilities. Sen. Charles Schwertner, R-Georgetown, successfully proposed a “three-strike” rule for nursing homes found to be in severe violation of state rules. Facilities found to have three violations within two years would have their licenses revoked. The recommendation was adopted unanimously, despite initial concerns raised by Hinojosa and state Rep. Harold Dutton Jr., D-Houston, that the rule could lead to unnecessary nursing home closures.

Schwertner said the proposed rule change stemmed from public safety concerns. “We have tried the carrot,” Schwertner said. “It’s just like a child, you’ve got the carrot and the stick, and unfortunately we need to strengthen the stick.” 

Texas Health Care Association President Kevin Warren said the recommendation would add "unnecessary layers of regulation" on an industry that is "one of the most heavily regulated settings in healthcare by both state and federal agencies."