MINUTES 
          
                     SENATE INTERIM COMMITTEE ON HOME HEALTH 
                         AND ASSISTED LIVING FACILITIES 
                          Wednesday, February 18, 1998 
                                     9:30 am 
                University of Texas-M. D. Anderson Cancer Center 
                                Hickey Auditorium 
                             1515 Holcombe Boulevard 
                              Houston, Texas 77030 
          
                                      ***** 
          
         Pursuant to a notice posted in accordance with Senate Rule  
         11.11, a public hearing of the Senate Interim Committee on  
         Home Health and Assisted Living Facilities was held on  
         Wednesday, February 18, 1998 in Houston, Texas.   
          
                                      ***** 
          
         MEMBERS PRESENT:                        MEMBERS ABSENT: 
         Senator Mike Moncrief                   Senator Mario  
         Gallegos, Jr. 
         Senator Gonzalo Barrientos              Senator Jane Nelson 
         Senator Drew Nixon 
          
                                      ***** 
          
         After standing in recess on February 17, 1998 the Committee  
         reconvened at 9:30 a.m. to transact the following business:    
          
         The following members arrived after the hearing had  
         reconvened:    
         Senator Gonzalo Barrientos 
         Senator Drew Nixon 
          
         Chairman Moncrief introduced and welcomed Representative Scott  
         Hochberg, District 132, 
         Houston, Texas. 
          
         The Chair welcomed invited speakers, guests and the public.   
         The Chair announced that the purpose of the hearing was to  
         focus on local perspectives regarding personal care facilities  
         and to hear public testimony. 
          
         The Chair then called a panel to testify about local  
         governments and personal care facilities.  The panel members  
         were: 
               
              Tim Austin, City of Houston, Senior Assistant City  
         Attorney; Division Chief of  
                   Neighborhood Protection Division 
              Ellen MacDonald, R.N.C., M.N., L.N.F.A., Program  
         Director, Long Term Care Ombudsman 
  
                   Program, Harris County; Associate Director of  
         Community Affairs, the U. T. 
                   Houston Center on Aging 
              Emma J. Smith, President-Elect, Houston Association of  
         Residential Care Homes 
              Sid Holliday, Provider, Galveston 
          
         The panel testified and responded to questions from Members of  
         the Committee.  The Chair thanked and dismissed the panel. 
          
         The Chair then called for public testimony.  The following  
         persons provided oral testimony: 
          
              Mark E. Price, Attorney, Houston, Texas 
              D'Juana Tomlin, Home Health Care/Elderly Advocate,  
         Trinity Homecare, Channelview,          Texas 
              Marie Therese McBride, Self, Houston, Texas 
              Jan Duck, Texas Occupational Therapy Association,  
         Houston, Texas 
              Cathy Pham, Vuong Nham and Vu Thuc, Houston, Texas 
              Alice Y. Huynh, Dau Ngoc Nguyen, Houston, Texas 
              Steven Winnett, National Intervention, Inc., Pasadena,  
         Texas 
              B. Carol Henderson, G. C. Allied Home Health, Missouri  
         City, Texas  
              Roberta Reitz, Self, Houston, Texas 
              Vicki Smith, Home Health Care, Buna, Texas 
              Lucena M. DeVilla, Medical Insights, Inc., Houston, Texas 
              Laurence LeMon, Jr., Medical Insights, Inc., Houston,  
         Texas 
              C. W. "Mat" Mathews, Texas Organization of Residential  
         Care Homes, Del Valle, Texas 
              Diana Deaton, Texas Assisted Living Association, Austin,  
         Texas 
              Jo Nell Werlinger, Valued Care Home Health Service,  
         Houston, Texas 
              Carol A. Anderson Bell, Self, Arlington, Texas 
              Kathy Maxey, Texas Association for Home Care/Girling  
         Health Care, Temple, Texas 
              Lovelyn Yemi-Ese, Home Health Agency, Houston, Texas 
               
         The Chair called George D. Cato, Texas Department of Health,  
         Office of General Counsel, 
         to respond to questions from Committee Members regarding a  
         Texas Department of Health form requesting criminal history  
         checks.  The Chair thanked and dismissed the witness. 
         On motion of Chairman Moncrief and by unanimous consent, a  
         letter from Richard R. Scott, Sr. 
         was ordered to be entered into the Committee minutes as  
         follows:  
          
                    To Whom It May Concern: 
          
              I am a 63 year old C-7 quadriplegic unable to turn or  
         change position without help which 
  
              causes me to have many skin problems.  I live at home  
         because there is no other way.     Nursing homes, assisted  
         living centers, and any other method of living I have checked  
         into 
              are priced beyond reach for me.  Several years ago  
         Medicare told me that I had no need for      a wheel chair or  
         bathroom equipment.  Up until this time I had been totally  
         independent, but    without the proper equipment I had to turn  
         to Home Health Care.  I can no longer get in and  out of bed  
         by myself, get dressed or take care of my bowel program.  I  
         have limited use of      my right hand and arm.  My left hand  
         and arm has a full range of motion but it is weak.  I  have a  
         phone and computer that I use to communicate with others and  
         can call for help if     necessary. I am paralyzed from mid  
         chest down.  I am just a little richer than dirt, so I am not     
         eligible for a provider.  I have tried to hire someone to come  
         in to help me but there is no way  that I could afford this.   
         If  I don't have help from Home Health, I will either have to  
         stay up   twenty four hours a day, or stay in bed twenty four  
         hours a day.  Blood draws and other     sampling is a must for  
         people like me.  I am Home Bound in every sense of the word.   
         I am      sure that Medicare wouldn't want to pay an expensive  
         two way ambulance trip just for me      to go and get a blood  
         sample drawn or have my catheter changed.  I need nurses to  
         maintain  my catheter which often leaks and occasionally get  
         stopped up and causes my blood pressure 
              to go up dangerously high.  Without Home Health I would  
         be going to the hospital 
              emergency room several times a week.  My only way of  
         transportation is an ambulance 
              which will cost Medicare more money to take care of.  As  
         I stated before I live alone,  
              without Home Health I will just be here unable to get up  
         to get food, or drink, unable to use  
              the bathroom, or get a bath and maintain the quality of  
         life that I have at this time.  Please 
              give me some suggestions as to how to survive this  
         situation...Don't shut the system down,  
              clean it up, cut out the fraud. 
          
              Thanks, 
              Richard R. Scott, Sr. 
              4218 Roving Meadows 
              Crosby, Texas 77532 
          
         The following persons registered, but did not testify: 
               
              Diane C. Davis, Texas Health and Human Services  
         Commission, Austin, Texas 
              Charlotte Dokes, Texas Health and Human Services  
         Commission, Austin, Texas 
              Thuy Morton, Hoang Tri, Houston, Texas 
              Barbara Smith, Texas Department of Protective and  
         Regulatory Services, Adult  
          
                   Protective Services, Houston, Texas 
              Jan McLaughlin, Texas Department of Protective and  
         Regulatory Services, Houston, Texas 
              Sam G. Wynn, Jr., U. S. Department of Health Care  
         Financing Administration, Dallas, 
                   Texas 
              Charles R. Springer, Regional Home Care &  
         Spring/Woodlands, Spring, Texas 
               
         The following persons submitted written testimony: 
          
              Kathleen DeSilva, Coalition of Texans with Disabilities  
         Personal Assistance Services, 
                   Houston, Texas 
              Julia Finch, Self, Pasadena, Texas 
              Charla Kulcak, Home Health Advantage of Texas, Inc.,  
         Richmond 
              Steve Roberts, First Trinity Home Health Care, Houston,  
         Texas 
              Nancy L. Stone, Visiting Nurse Association of Houston,  
         Inc., Houston, Texas 
          
         The Chair recalled George D. Cato, Texas Department of Health,  
         Office of General Counsel, to brief the Committee on the  
         criminal history check form and to respond to questions from  
         Committee Members.  The Chair thanked and dismissed the  
         witness. 
          
         There being no further business, at 3:05 p.m. Senator Moncrief  
         announced that the Committee would stand recessed subject to  
         the call of the Chair.  Without objection, it was so ordered. 
          
         _____________________ 
         Senator Mike Moncrief, Chair 
          
         _____________________ 
         Judy Daugherty, Clerk