Texas Institutions

It should be a sobering reminder to us that, when the pioneers in our field undertook this task, despite the greatest good will and thoughtful deliberation they led to the development of modern institutional settings. In offering enormous benefits, their work led to the loss of everything important to their beneficiaries.”  Burton Blatt

Texas Institutions: What we know…

SUNSET COMMISSION REPORT RECOMMENDS CLOSING 6 SSLCs

Guest Column: CLOSE DANGEROUS STATE DISABLED CENTERS

Appeared in the Texas Tribune on September 24, 2013
For information regarding the quality of services in Texas SSLCs visit the
DADS Quality Reporting System Site.

Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) – a state operated facility that provides 24 hour residential and habilitation services for qualified individuals.

There are two types of ICF-IID in Texas.

  • Community-based home (small up to 8 people / medium 9 to 13 people & large 14+ people)
  • State Supported Living Center (SSLC) – a large institution for approximately 60 – 500 residents. Texas operates 13 SSLCs.

Nursing Facility (NF) – a residential facility that provides services for individuals whose medical condition regularly requires the skills of licensed nurses.

Disability Rights Texas Press Release: State of Texas, Lawsuit Plaintiffs Reach Interim Agreement Expanding Community Services And Opportunities For Persons With Intellectual And Developmental Disabilities In Nursing Facilities.

A Closer LOOK!

Texas SSLCs have and continue to be monitored as part of a settlement agreement with the Department of Justice, Office of Civil Rights for “serious deficiencies at multiple facilities, a long history of abuse, neglect, and exploitation and failure to serve Facility residents in the most integrated setting appropriate to their individual needs.”

2006 CRIPA Investigation – Lubbock State School
December 2008 CRIPA Investigation – Texas State Schools
Department of Justice 2009 Complaint

Reports of abuse, neglect, and exploitation continue. Below are reports from the Office of Inspector General (OIG) for State Supported Living Centers Texas Health and Human Services Commission and Office of the Independent Ombudsman (OIO) State Supported Living Centers.

  • OIG Annual Status Report – SSLC FY 2010
  • OIG Annual Status Report – SSLC FY 2011
  • OIO Annual Report 2010
  • OIO Annual Report 2011
  • OIO Annual Report 2012
  • OIO Annual Report 2013
  • OIO Annual Report 2014
  • OIO Biannual Report – SSLC December 2011 – May 2012
  • OIO Biannual Report – SSLC June 2012 – November 2012
  • OIO Biannual Report – SSLC December 2012 – May 2013
  • OIO Biannual Report – SSLC June 2013 – November 2013
  • OIO Biannual Report – SSLC December 2103 – May 2014
  • OIO Biannual Report – SSLC June 2014 – November 2014

DADS Legislative Presentation Charge #9 (July 2012)
DADS Annual Report: Obstacles to Community Referral and Transition State Supported Living Centers Fiscal Year 2014

NOTE: The Olmstead decision requires states to eliminate unnecessary segregation of persons with disabilities and to ensure that persons with disabilities receive services in the most integrated setting appropriate to their needs. For more information about the Olmstead decision, visit http://www.ada.gov/olmstead/index.htm.


SSLC Demographics (As of October 31, 2013) 

Resident Population

3524     Total SSLC resident population

379      Abilene
284      Austin
289      Brenham
241      Corpus Christie
490      Denton
116      El Paso
206      Lubbock
342      Lufkin
325      Mexia
336      Richmond
65        Rio Grande
215      San Angelo
246      San Antonio

Alleged offenders

257     Residents

Number of residents by age

206      Ages < 21
2037    Ages 22-54
1281    Ages 55+

Number of residents by Level of IDD

5        Borderline
527     Mild
502     Moderate
567     Severe
1894   Profound
29      Unspecified

Number of residents by Health Status

1173    Moderate
339      Severe
63%     Of SSLC residents have behavioral health challenges (As of May 2013)
1468     No Legal Guardian Assigned

Facility Maintenance Costs

$576,722,818     Estimated SSLC maintenance costs projections for FY 2013 – 2019

Monthly Costs of Care

SSLC monthly costs of care are considerably higher than community-based services through a Texas Medicaid Waiver program.

Program  Exp 2011 Est 2012 Bud 2013 BL 2014 BL 2015 P – C  +/-
CBA P) 22,810

C) $1,567.58

P) 14,441

C) $1,479.05

P) 9,794

C) $1,378.36

P) 9,816

C) $1,378.36

P) 9,816

C) $1,378.36

P) – 12,994

C) – $189.22

CLASS P) 4,630

C) $3,478.19

P) 4,676

C) $3,203.09

P) 4,655

C) $3,203.09

P) 4,655

C) $3,203.09

P) 4,655

C) $3,203.09

P) + 25

C) – $275.10

DBMD P) 153

C) $4,192.90

P) 158

C) $4,191.69

P) 158

C) $4,191.29

P) 158

C) $4,191.29

P) 158

C) $4,191.29

P) + 5

C) – $1.61

HCS (Avg.) P) 19,485

C) $3,465.31

P) 19,893

C) $3,423.61

P) 20,471

C) $3,449.22

P) 20,511

C) $3,449.22

P) 20,511

C) $3,449.22

P) + 1026

C) – $16.09

MDCP P) 2,437

C) $1,486.36

P) 2,355

C) $1,477.06

P) 2,404

C) $1437.76

P) 2,404

C) $1437.76

P) 2,404

C) $1437.76

P) – 33

C) – $48.60

TxHmL P) 911

C) $678.94

P) 4,200

C) $778.18

P) 5,738

C) $800.00

P) 5,738

C) $800.00

P) 5,738

C) $800.00

P) + 4827

C) + $121.06

SSLC P) 4,072

C) $13,546.00

P) 3,875

C) $14,507.00

P) 3,628

C) $15,181.00

P) 3,381

C) 16,382.00

P) 3,134

C) $17,673.00

P) – 938

C) + $4,127.00

KEY:

P) – Participants
C) – Monthly Costs of Care
CBA – Community Based Alternatives
CLASS – Community Living Assistance and Support Services
DBMD – Deaf/Blind Multiple Disabilities
HCS – Home and Community Based Services
MDCP – Medically Dependent Children’s Program
TxHmL – Texas Home Living
SSLC – State Supported Living Center

The institutional bias in Texas must change, and systems reform must be implemented if the state is going to improve access to community-based long-term care services and outcomes for its citizens who live life with a disability label.

Historically, the Texas Legislature has adopted a state budget that preserves the expensive, unsafe system of institutions despite declining resident populations, increased costs, and widespread abuse while simultaneously cutting cost-effective community services for persons with disabilities.

While Texas has moved some individuals who have a disability into community-based placements, they are still accepting SSLC admissions and are considerably slower at reducing the use of large congregate institutions, such as State Supported Living Centers (SSLC) and other ICF/IID facilities.


Information on this page was obtained from the following sources…

  • DADS 2014/2015 Legislative Appropriations Request (LAR)
  • Office of Independent Ombudsman Biannual Report (June 2012 – November 2012)
  • Office of Independent Ombudsman Biannual Report December 2012 – May 2013)
  • Office of Independent Ombudsman Biannual Report (June 2013 – November 2013)
  • State Supported Living Centers Long-Range Planning Report for 2010 – 2012

This page was updated on 2/19/2014