Social service agencies call for more funds for disabled Texans

From The Houston Chronicle:

AUSTIN — As pressure grows over systems that are failing to protect disabled Texans in institutionalized care and abused children in foster care, agency leaders are calling for a major infusion of new spending.

The social services budgetary requests for the 2010-11 fiscal years include salary increases for state employees in key positions, higher reimbursement rates for nursing homes and medical providers, and expanded mental health and substance abuse programs to divert low-level offenders from county jails.

"We have some critical needs in health and human services," said Albert Hawkins, executive commissioner of the Health and Human Services Commission. "And we're carrying those priorities forward in our legislative appropriations request."

Hawkins wants 10 percent raises for about 40,000 state employees. These workers do a variety of jobs, including caring for persons with mental illness or mental retardation, monitoring children who have been removed from their families because of abuse or neglect, and determining eligibility for safety net programs.

Turnover in many of those jobs ranges from 30 percent to 40 percent.

For example, annual starting salaries for direct care workers at state facilities for persons with mental retardation are between $20,500 and $23,600.

"I think with higher pay we can probably raise the quality of staff we are able to attract in those jobs. That results in better services to our clients and consumers," Hawkins said.

Rep. John Davis, R-Houston, said higher pay may be needed, although he would prefer merit raises to across-the-board pay hikes. He said that reducing turnover can save money in the long run because of the cost of training new workers.

"If we can increase those salaries and keep the higher retention, that's smart money," said Davis, who serves on the budget-writing House Appropriations Committee.

Hawkins also wants to increase rates for a variety of private providers, including doctors, foster parents, nursing homes and community group homes.

Raising state salaries and increasing provider rates will be costly, Hawkins said. His estimates are expected next month.

The needs are real, but with $3 billion in additional Medicaid costs expected over the next two-year budget cycle, it's unclear how many new initiatives will be funded next session.

Although lawmakers are expecting to enter the session next year with a budget surplus, social services — which accounts for about one-third of all state spending — will be competing with public education, higher education, corrections and transportation.

Last week the state Insurance Commission told lawmakers that about $800 million will be needed in the 2010-11 budget to cover losses from the state-backed windstorm insurance pool because of the tremendous damage to coastal property done by Hurricane Ike.

Lawmakers may be persuaded to boost social services spending by federal investigations and reviews.

The focus is on a U.S. Justice Department civil rights investigation into conditions at state facilities serving 4,800 persons with mental retardation. Last month, the 3-year-old federal probe was expanded from two institutions to the entire system of 11 state schools and two smaller state centers.

An earlier Justice Department report on Lubbock State School and newspaper reviews of employee discipline records at other facilities found disturbing patterns of abuse, neglect and exploitation.

Lawmakers have increased funding for community living options during the past two sessions, but waiting lists have remained stubbornly long because of population growth. This year, Hawkins is asking lawmakers to budget $474.4 million to increase capacity of community services.

Another area where the federal government is pressuring Texas to do better involves high caseloads that prevent child welfare workers from making monthly visits with children and parents. Texas paid a $4 million fine for insufficient caseworker visits stemming from a 2002 review, and preliminary results from a second review this year again found the state deficient.

To address the issue, Hawkins is asking for about 240 new caseworkers. He said that would help Texas meet federal standards that call for monthly face-to-face visits of 95 percent of children in custody of Child Protective Services and their parents.