• Report in PDF format
• Executive Summary
• Preface
• Introduction
• Background
• Promoting Independence Advisory Committee
• 2010 Promoting Independence Plan Recommendations
• Promoting Independence and Relocation Snapshot Data
• Interest List Funding
• Community Services 2012-2013 Funds and 2012-2013 Requested Funds and Average Monthly Caseloads
• Legislative Appropriations Request Exceptional Items
• 2008 Promoting Independence Plan Status Update
• Children's Issues
• Housing Issues
• Workforce
• Grants/Innovations Supporting Promoting Independence
• Conclusion
• Appendix A
• Appendix B
• Appendix C
• Appendix D
• Appendix E
• Appendix F
• Appendix G
• Appendix H
• Appendix I
• Appendix J
• 2010 Revised PI Plan home

• Doing business with DADS home

• Help for Texans
• Learn about DADS
• Doing business with DADS
• Rules and statutes
• DADS home

Introduction

The Texas Promoting Independence Plan (Plan) serves several purposes within the state. First, the Plan provides the comprehensive working plan called for as a response to the U.S. Supreme Court ruling in Olmstead v. L.C, (1999). Additionally, the Plan assists with the implementation efforts of the community-based alternatives Executive Order, RP-13, issued by Governor Rick Perry. [18] The Plan Revision also meets the requirements of the report referenced in S.B. 367, 77th Legislature, Regular Session, 2001, which directs the Health and Human Services Commission (HHSC) to report the status of the implementation of a plan to ensure appropriate care settings for individuals with disabilities, the provision of a system of services and supports that foster independence and productivity, including meaningful opportunities for an individual with a disability to live in the most appropriate care setting. [19] Finally, the Plan serves as an analysis of the availability, application, and efficacy of existing community-based supports for individuals with disabilities. [20]

The overarching Promoting Independence Initiative (Initiative) and the Plan are far-reaching in their scope and implementation efforts. The Initiative includes all long-term services and supports and the state’s efforts to enhance its community-based services options. The goal is to ensure that the long-term services and supports system in Texas effectively fosters independence for all individuals who are aging and/or with a disability and provides opportunities for individuals to have a quality life in the setting of their choice. The underlying theme of the Initiative is individual choice and the opportunity to live in the most integrated setting.

The Plan articulates a value base that serves as the framework for future system improvements:

• Individuals should be well informed about their program options, including community-based programs, and allowed the opportunity to make choices among affordable services and supports.
• Families’ desire to care for their children with disabilities at home should be recognized and encouraged by the state.
• Services and supports should be built around a shared responsibility among families, state and local government, the private sector, and community-based organizations, including faith-based organizations.
• Programs should be flexible, designed to encourage and facilitate integration into the community, and accommodate the needs of individuals.
• Programs should foster hope, dignity, respect, and independence for the individual.

The State of Texas has made significant progress since the inception of the original Plan in January 2001. Texas’ Plan is nationally recognized as one of the most proactive responses to Olmstead throughout the United States [21] and Texas was awarded the Council of State Governments national 2006 Innovation Award for its “money follows the person” policy. Within the state, the Promoting Independence Advisory Committee (Committee) is acknowledged as one of the leading forums in providing policy leadership and oversight of the long-term services and supports system.

Since 2001, Texas has made significant progress in evolving its health and human services system from an institutional-based to a community-based system. This progress has been achieved through appropriations and policies instituted by the past previous legislatures, and policy by the health and human services system. In 2000, Texas had 76,350 institutionally-based residents [22] versus 66,209 as of August 31, 2010. 

The Initiative has achieved an equally important goal of increasing awareness about community-based options and ensuring that the directives made by the two Executive Orders and S.B. 367, 77th Legislature, Regular Session, 2001, are incorporated in overall policy development.  The Initiative is more than just a philosophy in the state of Texas; it is practiced in the reality of state policy and program development.

Recognizing the significant progress that has been achieved, the Initiative and Plan remain necessary and relevant components for maintaining an emphasis on community-based services, meeting the state’s statutes, and complying with the requirements under Olmstead. While approximately 72 percent of all individuals are now being served in community settings, [23] 108,433 individuals (unduplicated count) remain on the Department of Aging and Disabilities Services (DADS) and HHSC interest lists as of August 31, 2010; and increase of 22,588 individuals since October 2008. [24]  These are individuals who have shown interest in community services; however, they have not been assessed for eligibility and may not meet all community financial/functional criteria.  The Plan is dedicated to building upon previous achievements, advocating for the ultimate goal of individual self-determination, and availability of community-based options.

Footnotes

18. Executive Order RP-13 follows Executive Order GWB 99-2 as the second community-based alternatives Executive Order.  These orders required the state to review all long-term care services and supports, make appropriate recommendations, and implement specific gubernatorial directives.  See Appendix B.
19. S.B. 367 (77th Legislature, Regular Session, 2001), Subchapter B, Chapter 531, Government Code.
20. Executive Order GWB 99-2, see Appendix B.
21. As requested, Texas presented at several national conferences during the last two years including the National Academy of State Health Policy, National Association of State Units on Aging and Disabilities, and conferences sponsored by the Centers for Medicare and Medicaid Services.
22. 2001 Promoting Independence Plan.  Institutions covered in this number include nursing facilities, large (14 or more beds) intermediate care facilities for persons with mental retardation, State Mental Retardation Facilities, and State Mental Health Facilities.
23. DADS 2012-2013 Legislative Appropriations Request.
24. See DADS website at: http://www.dads.state.tx.us/services/interestlist/index.html.

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Updated: May 24, 2011