Texas State Health Plan: 1987-1988 Page: 67
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CHAPTER X
HABILITATION AND
REHABILITATIONPRIORITY Fragmentation of the habilitation/rehabilitation
ISSUE delivery systems.
PROBLEM STATEMENT: State and community-level agencies need to estab-
lish and coordinate networks in administrative and delivery services.BACKGROUND AND POLICY ANALYSIS
This issue deals with the discontinuity of the various
parts of the habilitation and rehabilitation (H&R)
health care delivery system. A lack of clarity and
specificity exists in the jurisdiction among the various
state agencies responsible for H&R services.
System components include facilities, services
offered, the supply of properly trained professionals,
administrative support, equipment and demographic
surveys to locate eligible clients. While some H&R
agencies function independently providing services
for individuals with a single well-defined disability,
coordination of H&R services often break down
when individuals with multiple disabilities must be
served.
Definitions of the individual disabilities have not
been closely made to ensure which organizations will
serve which populations. Providers of H&R services
are divided into public or private sectors, then state
or local levels. Then, they may be categorized by the
various legal mandates defining "eligible clients,"
definitions of "disabling conditions" and varying
economic eligibility requirements for different
programs. Providers may operate their programs
with little or no interaction, due to the laws which
authorize andfundthem.
Three factors also compound the problems created
by fragmentation: population growth, the aging of
the population, and the increase in the incidence of
multiple disabilities. Consequently, more money is
needed to provide necessary services.
How well fragmentation can be remedied will be
directly related to the dollar savings made possible
by such efforts. Now is the time to conserve moneyand stretch the coverage of services. The expected
benefits will affect the eligible clients under all health
and human services programs which offer H&R
services. No additional costs should be incurred,
and in fact, considerable savings can be expected.
Mechanisms for coordinating H&R services are
available through the Human Services Interagency
Committee (HSIC), the SHCC, the Health and Human
Services Coordinating Council (HHSCC), and the
Council on Disabilities. These organizations are
mandated to plan the delivery of and coordinate
health and human services in the state (Exhibits A
and B).
INTERVENTION ALTERNATIVES
Fragmentation of the H&R delivery system can be
overcome by coordinating the operations of the state
agencies concerned and the voluntary cooperation
of the private sector. Two alternatives for accomp-
lishing this are as follows:
Alternative 1: Request the HHSCC to make a com-
parative analysis of all H&R programs offered by
member agencies. The HHSCC should develop an
action plan to coordinate and/or combine as many
services as the analysis indicates is feasible. If
necessary, legislative action should clarify health and
human services agencies' mandates, client eligibility
requirements, and standardize the definitions of
disabling conditions. The rules and regulations
should be altered to permit interdisciplinary treatment
of those with multiple disabling conditions.
Legislation could also authorize state agencies to
share facilities, administrative costs, and personnel.1987-88 TEXAS STATE HEALTH PLAN
67
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1987-1988, report, 1986; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586615/m1/79/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.