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By Michelle M. Martinez
AMERICAN-STATESMAN STAFF
Saturday, May 7, 2005
Lawmakers crafting budget plan to end health and human services wait lists in 20 years
The House-Senate committee negotiating the state budget has tentatively adopted a plan that over 20 years would eliminate the waiting list for Texans who are disabled or elderly and who seek care services.
More than 100,000 people are on waiting lists -- most for years -- for five state programs that provide basic care and improve the quality of life for those who would rather live at home instead of in a state institution or a nursing home. Some have been waiting for more than a decade.
The 10-member budget conference committee is considering adding $139 million in general revenue to the 2006-07 budget as the first step toward serving all the people on the waiting lists within 20 years. Future Legislatures would have to reduce the total number of names on the list by 20 percent each biennium to reach that goal.
Initially, the Senate adopted a budget that would eliminate the waiting lists within 40 years. The House budget didn't include any money to cut into the existing lists, although both chambers' budgets included about $47 million in general revenue -- state taxpayer money -- to keep the list from growing any more.
Representatives of advocacy groups for people with disabilities say the latest proposal is progress, but it's not good enough.
"It has to be meaningful; it has to be significant," said Amy Mizcles, director of governmental affairs for the Arc of Texas, a nonprofit organization that represents people with mental retardation and developmental disabilities. "What we need is a 10-year plan."
Texans with disabilities became so frustrated by the lengthy wait for community services that they sued the state in 2002, hoping to force officials to revamp the system so people could expect a more reasonable wait.
The lawsuit, which is scheduled to be heard in April in federal district court in Austin, was filed on behalf of more than 30,000 people waiting for services under two programs, said Mike Bright, executive director of the Arc of Texas, one of the plaintiffs.
Sen. Judith Zaffirini, D-Laredo, an advocate of eliminating the lists, is hopeful she can persuade committee members to pony up more money for care services.
"My number one priority . . . is to adopt the 10-year plan," she said. "Now, whether I will succeed remains to be seen, but I am making every effort."
Zaffirini estimates that it would cost about $258 million in general revenue each biennium to get rid of the waiting lists in 10 years. That is the same plan the Health and Human Services Commission has recommended.
Hundreds of people with mental retardation, autism, cerebral palsy and other disabilities have brought their personal stories to the Capitol throughout the session, hoping to influence lawmakers.
Bob Kafka, a disabled Texan and a leader of the Community First Coalition, said it is difficult for families to make a living when they must care for a disabled child or an elderly parent. The community programs offer some relief because they provide basic services, such as feeding and bathing, as well as services that enable people with disabilities to live on their own.
"Some of the people have already been on those lists for almost a decade," said Kafka, whose coalition is made up of groups that represent older and disabled Texans. "We have individuals who have been on . . . as many as 15 years already."
Mizcles estimated that the average wait for the people her organization represents is between six and eight years.
Federal law requires each state to provide institutional care for people with disabilities who are eligible for Medicaid, the federal-state health insurance for the poorest people. Medicaid recipients aren't entitled to community-based services, although the federal government has created a waiver system to allow Medicaid money to be used for that purpose.
Comparing the wait in Texas to that in other states is difficult because states define care programs differently, said Anne Dunkelberg, assistant director of the Center for Public Policy Priorities, which advocates for low- and middle-income Texans.