Texas State Health Plan: 1985, Appendix A Page: 2
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based services, congregate living arrangements, supervised living and nursing
home care. Review of current services available to the elderly and disabled
indicates a gradually increasing array of service options, but there are still
gaps in this continuum of services and gaps in the availability of services to
all persons regardless of income levels.
There has been a rapid expansion in home health care and homemaker services in
Texas. Table 1 indicates that there were 392 licensed home health agencies in
Texas in 1982. These agencies provided 2,948,270 home visits. Review of the
visits show that they were provided unevenly among the various state planning
regions (SPR). In January 1984, there were over 700 licensed home health agen-
cies. Determination of need for future services will need to be established
based upon additional utilization data for 1983.
Table 2 illustrates the facilities licensed as adult day care and adult day
health care facilities licensed as of January 1, 1984. The table indicates that
the services are in short supply and unevenly distributed within the state.
While other adult day care services exist, only facilities under contract to
TDHR are required to obtain a license.
Nutritional programs include home-delivered meals (meals-on-wheels) and congre-
gate meals. The 28 Area Agencies on Aging under the Older Americans Act, provide
nutritional services at 831 sites. TDHR also provides nutritional services
under Title XX.
Personal care homes and the number of beds available have increased. During
1983, an estimated 787 nursing home beds were converted to personal care beds.
Table 3 shows that there were 2,462 licensed personal care beds on January 1,
1984. The table shows that 1356 of these beds were located in wings of 50
nursing homes with 1106 beds in 23 freestanding personal care homes. Five SPRs
are without personal care beds. The need for additional personal care beds is
illustrated by the selection of this concern as the key issue to be developed in
the SHP. Also, personal care homes which provide services mainly for the
mentally retarded need to be separated from those which provide services for the
elderly.
The TDHR is currently providing state funds for the reimbursement for 406
clients under a supervised living program as illustrated in Table 4. The beds
in the program are licensed as personal care or custodial care beds.
While the number of licensed custodial beds has rapidly decreased since Medicaid
reimbursement was discontinued except for clients "grandfathered" in, there
remained 1188 on January 1, 1984. Table 5 shows the SPR location of these beds.
Fifteen SPRs were without custodial beds on January 1, 1984. Custodial beds are
included with nursing home beds in the bed projections included in Chapter 9.
Table 5 also illustrates the Medicare-Medicaid certification of nursing and
custodial beds and presents a beds per population 65 years and older ratio for
each SPR. Only 1.2% of the licensed nursing-custodial beds were custodial beds.
Identification of Key Issue
In order to identify major concerns of long term care, 41 state agencies, state
associations and other organizations and the executive directors of the 24 Coun-2
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Texas. Statewide Health Coordinating Council. Texas State Health Plan: 1985, Appendix A, report, 1985; Austin, Texas. (https://texashistory.unt.edu/ark:/67531/metapth1586722/m1/58/: accessed July 16, 2024), University of North Texas Libraries, The Portal to Texas History, https://texashistory.unt.edu; crediting UNT Libraries Government Documents Department.