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Wednesday, July 29, 1998

Committee adopts recommendations on assisted living, home care

By PEGGY FIKAC Associated Press Writer

AUSTIN (AP) - Frail elderly people and other Texans in assisted-living facilities or served by home health care agencies would get stronger state oversight and their families could more easily get information or lodge complaints under recommendations approved Tuesday by a Senate committee.

"We are going to ensure the care of Texans - our mothers, our fathers, sons and daughters," said Sen. Mike Moncrief, D-Fort Worth, chairman of the Senate Interim Committee on Home Health and Assisted Living Facilities.

As evidence of the need for change, he cited in a column published Tuesday instances of death and poor treatment of people living in personal care facilities.

"After 10 months of investigating and researching unlicensed personal care homes in Texas, I am sorry to say that this story is repeated almost daily somewhere in our state," Moncrief said.

Among recommendations approved by the committee were proposals to consolidate oversight that currently is distributed among multiple state agencies, develop a plan for a single system to take abuse complaints, and impose stricter licensing requirements on assisted-living facilities.

Assisted-living facilities currently aren't defined in state law, which instead refers to personal care facilities that provide meals, lodging and personal care services to four or more unrelated adults.

Under a committee recommendation, personal care facilities would be called assisted-living facilities and they would have to be licensed if they had at least three people in them.

Such facilities are separate from nursing homes, which fall under federal standards and generally involve some sort of 24-hour skilled nursing, according to committee staff.

Texas currently has an estimated 4,000 unlicensed assisted-living facilities, along with more than 900 personal care facilities licensed by the Texas Department of Human Services, Moncrief said.

Most such facilities don't directly receive government funds but are financed by the individuals who live in them, perhaps by Social Security checks, according to staff.

Home health agencies provide care in private homes or at assisted-living facilities. The state in 1997 spent $687 million on such services in 1997, mainly in federal Medicaid money.

Sen. Drew Nixon, a committee member who voted for nearly all the recommendations, opposed the proposal to license assisted-living facilities that serve at least three rather than four people.

Nixon, R-Carthage, said abuse cases should be addressed. But he said he had spoken with someone who runs a small facility, and that he is concerned that the prospect of extra paperwork from licensing requirements would mean shutdowns.

"You're going to run a lot of the smaller ones out of business," he said. "If these people are no longer out there to take care of this group of individuals, where are they going to go? ... A box under the street?"

A staff member said there is little in the way of reporting requirements in connection with licensing of assisted-living facilities. The recommendation was approved 3-1, with Sens. Gonzalo Barrientos, D-Austin, and Jane Nelson, R-Flower Mound, joining Moncrief in endorsing it.

Sara Speights of the Texas Association for Home Care Inc. said of the recommendations, "In general, I think they're good."

She said the committee worked to balance regulation with ensuring "the middle-class elderly and the poor elderly can still have access to home-care services."