The Arc of Texas 84th Legislature Priorities



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The Arc of Texas 84th Legislature Priorities Long Term Services and Supports (LTSS): Ensure that all state funding and policies for LTSS for persons with intellectual and developmental disabilities (I/DD) result in outcomes that enhance an individual s quality of life, economic security, and personal freedom. 1. Support legislation for funding and policies that increase community based longterm services and support services for Texans with intellectual and developmental disabilities (I/DD). Maximize the number of individuals with I/DD that have access to quality long-term services and supports in their communities. o Decrease the number of individuals on waiting lists for community based Medicaid Waivers by 10% per year of the biennium; o Expand the Community Living Options and Information Process (CLOIP) for all individuals residing in private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID); o Restore I/DD Safety Net funding; and o Increase access to innovative, best practice approaches that allow individuals with I/DD to live in their communities, including: - Individualized in home services and supports; - Employment and day activity supports that provide for full inclusion in the community that is typical for any citizen to work, learn and socialize; - Transportation options to improve access to and utilization of community resources; - Direct support and professional personnel who are trained, interested and reliable service providers who are compensated appropriately; - Assessment and planning processes that are person centered and includes all facets of a person s life; - Technology that is accessible, including training and support; and - Financial tools for long-term stability. Ensure that long-term services and support (LTSS) programs utilize selfdetermination strategies to allow people to have better control the resources allocated on their behalf to achieve real outcomes based on individualized budgets. Ensure the sufficient recruitment, retention, and training of, as well as appropriate pay for, the personnel who provide needed services and supports for individuals with I/DD. Intellectual Disability refers to a group of disorders characterized by significant limitations in intellectual functioning (reasoning, learning, problem solving) and adaptive behaviors (everyday social and practical skills). Intellectual disability originates before the age of 18. (AAIDD, 2013) Developmental Disability is a long term disability that can affect cognitive ability, physical functioning, or both. These disabilities appear before age 22 and are likely to be life-long. The term developmental disability encompasses intellectual disability but also includes physical disabilities. (NIH, 2013) For More Information Contact Jeff Miller Director of Governmental Affairs 1-800-252-9729 jmiller@thearcoftexas.org

2. Support legislation and policies that support best practice approaches that continue to shift the focus of Medicaid long-term services and supports from institutional to community based services and supports. Support Texas Sunset Commission recommendations to redirect services and expenditures from State Supported Living Centers (SSLC) to home and community-based supports for persons with intellectual and developmental disabilities; Support efforts to decrease the institutional bias in Medicaid long-term services and support programs; and Enhance statewide community provider capacity to provide residential and community based services for persons who are medically fragile or require intensive behavioral supports to prevent a placement or to move a person out of a state facility. 3. Support legislation for funding and policies that ensure that the transition to a managed care model for the delivery of long-term services and supports (LTSS) and acute care services appropriately protects the rights and needs of individuals with I/DD and increases the availability and quality of services for individuals. Retain the promises and protections from SB 7 for individuals with I/DD, including: Community-Based Long Term Services and Supports: Types of assistance that help an individual live independently. Supports range from bathing and eating to employment assistance, money management, etc. o Meaningful I/DD Redesign Advisory Committee input into the redesign of the long-term services and supports system; o Voluntary STAR+PLUS enrollment for DBMD, HCS, and CLASS waiver participants; and o Retaining the option for supplemental waiver services to supplement managed care services. o Requiring MCOs to contract with traditional providers and others already in the LTSS network o Maintaining an emphasis on self-direction and community inclusion. o Not requiring premiums to for medical or LTSS services. o Requiring an entity independent of the managed care organization (MCO) or service provider to conduct the initial functional needs assessment for people with I/DD. o Requiring additional reporting requirements about implementation and redesign. Support the adoption of a nationally recognized assessment tool (i.e. Supports Intensity Scale) specifically designed to evaluate the functional needs of individuals with intellectual and developmental disabilities, from birth to death; Support implementation of the Community First Choice Option (CFC); Support additional protections for individuals with I/DD in managed care plans including independent case management and an independent ombudsman program; Ensure managed care will include goals for integrated employment that address removal of systemic barriers and incentivize integrated employment through payment, policy, quality improvement, and network expectations: and Establish more accountability and measureable objectives for Managed Care Organizations (MCOs) as the state expands the managed care delivery system for long-term services and supports. 4. Support the continuation of a state agency to provide appropriate oversight of LTSS programs and facilitate the maximum independence of individuals with I/DD.

Early Intervention and Education: Improve the Texas early intervention and public education system by ensuring that funding, policies, accountability, and training promote inclusive education with individualized supports, services, and quality instruction for students with disabilities, to ensure post school success, including further education, employment and community living. 1. Support legislation for funding and policies that ensures access to high quality, research-based, family-centered early intervention services, including Early Childhood Intervention (ECI), for children with disabilities that maximize opportunities for children to experience family, school, and community participation. Ensure continuation of the Early Childhood Intervention model that provides developmental, evidencebased, family-centered and cost-effective services and supports in community based, natural environments. Ensure necessary funding to provide services to all children who are eligible and avoid further restricting of eligibility to make sure children with developmental delays and disabilities access services shown to alter their developmental trajectory. Increase the average number of service hours children receive to promote early success for children and better prepare them to enter other systems, such as schools. 2. Support legislation for funding and policies that ensures special and general education teachers and related services personnel are prepared to teach and support students effectively in inclusive settings. Early Childhood Intervention (ECI): ECI is a statewide program for families with children, birth to age three, with disabilities and developmental delays. ECI supports families to help their children reach their potential through developmental services. Services are provided by a variety of Develop minimum requirements for pre-service and in-service teacher training programs on effective research based inclusive local agencies and organizations across Texas. education teaching practices. Promote and use research based inclusive education teaching practices such as Universal Design for Learning, co-teaching, assistive technology, etc. Ensure that all curriculum is aligned with state and district grade level general education standards. Develop a process for recognizing, sharing and demonstrating innovative, successful, research based inclusive education teaching practices 3. Support legislation which promotes more effective student and parent participation in the admission, review, and dismissal (ARD) process. Develop and provide schools, parents and students with a best practices guide for promoting student and parent participation in the ARD process. Require that ARD committee meetings include the opportunity to: o Develop a mission statement for the individualized education plan (IEP) that focuses on long term goals for maximum independence for the student; and o Discuss and consider parent/student input (pre-ard questionnaires) regarding present levels of academic achievement and functional performance (PLAAFP) and student interests and strengths. Ensure implementation, use and effectiveness of Local Facilitated IEP and Statewide Independent Facilitated IEP programs

4. Support legislation for funding and policies that promote the use and understanding of school-wide positive behavior supports to ensure students with disabilities receive a free appropriate public education (FAPE). Provide appropriate training for all school personnel to implement positive behavior interventions and supports (PBIS). Ensure students with disabilities are not subjected to unwarranted restraint, isolation or aversive behavior techniques. Ensure certified behavior specialists conduct or supervise school personnel who conduct functional behavior assessments and develop and implement individualized positive behavior Intervention plans when determined necessary by the ARD committee. 5. Support legislation for funding and policies that promote the effective transition of students with disabilities to postsecondary outcomes including further education, employment, and community living. Support legislation that requires TEA to adopt an Employment First Policy that includes services and supports to ensure integrated, competitive employment or self-employment for students; removal of conflicting rules, policies and practices; addresses gaps in services; identifies and improves the flow of services between the Health and Human Services Commission (HHSC) enterprise, the Texas Education Agency (TEA) and the Texas Workforce Commission (TWC); and, holds each agency accountable for delivery of services with meaningful employment outcomes. Ensure access and funding to individualized, inclusive, education throughout a student s educational career in age appropriate settings Ensure that students with disabilities are provided with opportunities for paid, competitive, and integrated employment in the community while they are in school. Ensure collaboration between students, parents, educators and health and human service agencies across the different ages and transitions, especially for students between ages 18 and 22. Ensure training for students, parents, educators, and health and human service agencies on the transition process including guardianship and alternatives to guardianship and accessing agency services. Promote use of person directed planning. Expand partnerships with schools, and post-secondary education institutions to increase the availability of and access to integrated post-secondary education opportunities for students with disabilities. Ensure implementation, use and effectiveness of school district transition designee and online transition and employment guide. Employment: Improve Employment of people with intellectual and/or developmental disabilities (I/DD) by ensuring that funding, policies, and training promote opportunities for individuals with I/DD to be employed in community settings alongside people without disabilities, earn competitive wages, are supported to make informed choices about their work and careers, and have the resources to seek, obtain, and be successful in community employment. Employment First: Employment First is both a policy and a philosophy that changes how employment services for Texans with disabilities are thought of, stating that competitive employment is the first and preferred outcome of services for people with developmental disabilities. It makes employment for all a top priority and results in having the same expectations, responsibilities, and standards for people with disabilities as all other working age people.

1. Support legislation that requires all Health and Human Services agencies to adopt an Employment First Policy that includes: Services and supports to ensure integrated, competitive employment or self-employment; Removal of conflicting rules, policies and practices; Addresses gaps in services; Identifies and improves the flow of services between the Health and Human Services Commission (HHSC) enterprise, the Texas Education Agency (TEA) and the Texas Workforce Commission (TWC); and, Holds each agency accountable for delivery of services with meaningful employment outcomes. 2. Support legislation and policies that require the Texas Workforce Commission and the Department of Assistive and Rehabilitation Services to build relationships with employers and the business community to promote, facilitate, and result in increased employment opportunities for persons with disabilities, including facilitating job development within the Economic Development and Tourism Division (EDT) of the Governor s Office. 3. Support legislation and policies that phase out the use of sub-minimum wage certificates and increase opportunities for competitive, integrated employment. 4. Support legislation and policies that ensure that employment supports and services use best practices. Assessing skills and interests; Matching jobs to skill sets and employer needs; Providing individualized and ongoing job supports; Designing job accommodations; Integrating people into the workforce; and Securing necessary ancillary services such as transportation. Guardianship: Improve the Texas guardianship process and access to alternatives to guardianship for persons with disabilities by supporting guardianship reform policies and laws. 1. Support legislation that improves the guardianship process. 2.Support legislation that improves and/or creates alternatives to guardianship, including supported decision making that supports self-determination and provides individuals with the supports and services they need to direct and make decisions about their own life. Alternatives to Guardianship: The majority of people with intellectual and/ or developmental disabilities can manage their own affairs with informal assistance and guidance from family, friends, and others (The Arc of the US). Alternatives to Guardianship help individuals with decision-making and other areas without restricting their full rights. Examples include: money management, representative payee, power of attorney. About The Arc of Texas The Arc of Texas represents, supports, and acts on behalf of 1.3 million Texans with intellectual and developmental disabilities and their families. We believe all people with intellectual and developmental disabilities have strengths, abilities, and inherent value; are equal before the law; and must be treated with dignity and respect. The Arc of Texas believes in self-determination by empowering people with the supports needed to make informed decisions and choices. The Arc of Texas continues to advocate for people with intellectual and developmental disabilities to be included in all aspects of society. Adopted by The Arc of Texas Board, June 2014