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Sunset Self-Evlauation Report, DADS, September 2013

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Sunset Self-Evlauation Report, DADS, September 2013 TABLE OF CONTENTS Page I. AGENCY CONTACT INFORMATION ..................................................................................... 2 II. KEY FUNCTIONS AND PERFORMANCE ................................................................................ 4 III. HISTORY AND MAJOR EVENTS .......................................................................................... 37 IV. POLICYMAKING STRUCTURE ............................................................................................. 47 V. FUNDING ........................................................................................................................... 54 VI. ORGANIZATION ................................................................................................................. 68 VII. GUIDE TO AGENCY PROGRAMS ........................................................................................ 74 Access, Intake, and Eligibility Services ....................................................................... 75 Community-based Services ......................................................................................... 78 Medicaid Waiver Programs .................................................................................. 80 State Plan Entitlement Programs .......................................................................... 94 Non-Medicaid Programs ..................................................................................... 105 Facility-based Services .............................................................................................. 120 Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions (ICF/IID) Program ................................................................. 122 Nursing Facility Program..................................................................................... 129 Area Agencies on Aging (AAAs) ................................................................................. 135 Local Authorities ....................................................................................................... 144 Medicaid Estate Recovery Program .......................................................................... 153 Guardianship Services ............................................................................................... 159 Community Outreach, Engagement, and Volunteerism .......................................... 165 Quality of Long-term Services and Supports ............................................................ 180 TABLE OF CONTENTS DADS Regulatory Services ................................................................................................ 194 Licensing and Credentialing ...................................................................................... 210 Survey Operations ..................................................................................................... 221 Enforcement ............................................................................................................. 230 State Supported Living Centers ............................................................................... 239 Operational Support ............................................................................................... 247 VIII. STATUTORY AUTHORITY AND RECENT LEGISLATION ..................................................... 251 IX. MAJOR ISSUES ................................................................................................................. 265 Issue #1: Pertaining to Assistive Technology ............................................................ 266 Issue #2: Pertaining to the Coordination of Autism Services ................................... 268 Issue #3: Pertaining to the Role of Aging and Disability Resource Centers .............. 272 Issue #4: Pertaining to Behavioral Support and Health Services in Communities ... 274 Issue #5: Pertaining to State Supported Living Center Census ................................. 277 Issue #6: Pertaining to Services for High-risk Alleged Offenders ............................. 279 Issue #7: Pertaining to the Role of Medication Aides ............................................... 281 Issue #8: Pertaining to the Role of the Long-term Care Ombudsman Program ....... 283 X. OTHER CONTACTS ........................................................................................................... 286 XI. ADDITIONAL INFORMATION ........................................................................................... 305 XII. AGENCY COMMENTS ...................................................................................................... 314 ATTACHMENTS ............................................................................................................................ 318 TABLE OF CONTENTS DADS I. AGENCY CONTACT INFORMATION 1 DADS I. AGENCY CONTACT INFORMATION Texas Department of Aging and Disability Services Exhibit 1: Agency Contacts Telephone & Name Address E-mail Address Fax Numbers HHS Kyle Janek, 4900 N. Lamar [email protected]. tx.us Executive M.D. Blvd. 512-424-6502 Commissioner Austin, TX Brown-Heatly Building Agency Head Commissioner 701 W. 51st 512-438-3030 [email protected] Jon Street 512-438-4220 Weizenbaum Austin, TX 78751 Winters Building [email protected] us HHS Sunset Kelly Garcia 4900 N. Lamar 512-487-3395 Liaison Blvd. Austin, TX Brown-Heatly Building Agency’s Wes Yeager 701 W. 51st 512-438-4296 [email protected] Sunset Liaison Street 512-438-4392 Austin, TX 78751 Winters Building Agency’s Diana Conces 701 W. 51st 512-438-4718 [email protected] Project Street 512-438-4392 Manager Austin, TX 78751 Winters Building I. AGENCY CONTACT INFORMATION 2 DADS II. KEY FUNCTIONS AND PERFORMANCE 3 DADS II. KEY FUNCTIONS AND PERFORMANCE A. Provide an overview of your agency’s mission, objectives, and key functions. MISSION The Department of Aging and Disability Services’ (DADS) mission is to provide a comprehensive array of aging and disability services, supports, and opportunities that are easily accessed in local communities. OBJECTIVES To fulfill its mission, DADS completes the following main objectives. Intake, Access, and Eligibility. Activities delivered by local entities and/or the State to promote eligibility determination and access to appropriate services and supports and the monitoring of those services and supports. Community Services and Supports − Entitlement. Provide Medicaid-covered services and supports in homes and community settings which will enable older Texans, individuals with disabilities, and others who qualify for nursing facility services but can be served at home or in the community to maintain their independence and prevent institutionalization. Community Services and Supports − Waivers. Provide services and supports through Medicaid waivers in homes and community settings which will enable older Texans, individuals with disabilities, and others who qualify for nursing facility services but can be served at home or in the community to maintain their independence and prevent institutionalization. Community Services and Supports − Non-Medicaid. Provide non-Medicaid services and supports in homes and community settings to enable older Texans, individuals with disabilities, and others to maintain their independence and prevent institutionalization. Program of All-inclusive Care for the Elderly. Promote the development of integrated managed care systems for older Texans and individuals with disabilities. Nursing Facility and Hospice Payments. Provide payments that will promote quality of care for individuals with medical problems who require nursing facility or hospice services. Intermediate Care Facilities for Individuals with an Intellectual Disability (ICF/IID). Provide residential services and supports for individuals with intellectual and developmental disabilities (IDD) living in ICFs/IID. State Supported Living Centers Services. Provide specialized assessment, treatment, support and medical services in State Supported Living Center and State Center programs for individuals with IDD. Capital Repairs and Renovations. Efficiently manage and improve the assets and infrastructure of State facilities. II. KEY FUNCTIONS AND PERFORMANCE 4 DADS Regulation, Certification and Outreach. Provide licensing, certification, and contract enrollment services, and also financial monitoring and complaint investigation, to ensure that residential facilities, home and community support services agencies and individuals providing services in facilities or home settings comply with state and federal standards and that individuals receive high-quality services and are protected from abuse, neglect and exploitation. General Program Support. Assure the efficient quality and effective administration of services provided to aging individuals and individuals with disabilities (includes Central Administration, Information Technology Program Support and Regional Administration). KEY FUNCTIONS DADS oversees a continuum of long-term services and supports available to older Texans and those with disabilities in community-based and institutional settings. As the second largest state agency and the largest of the five HHS agencies, DADS fiscal year 2013 budget is approximately $6.2 billion, and the agency employs over 17,300 individuals, among whom 1,700 (10 percent) are field staff, 1,511 (9 percent) are state office staff, and 12,582 (73 percent) work in State Supported
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