Hcs 521 Memo

HARRIS COUNTY HOSPITAL DISTRICT

Administration Building

Suite 280, Room 2

2525 Holly Hall Street

Houston, TX 77054

From: James S. Wilson, Sr. Management Accountant

Financial Planning and Budgets

To: Mr. Albert Hawkins, Executive Commissioner

Texas Health and Human Services Commission

Brown-Heatly Building

4900 N. Lamar Blvd

Austin, TX 78751-2316

Date: October 29, 2007

SUBJ: Implementing Texas Senate Bill 1188

Dear Mr. Hawkins,

I am writing to request that the Texas Health and Human Services Commission review the Summary of Comments and Recommendations Pertaining to the Recommendations Report Received from State Agency Staff and Stakeholders in response to Senate Bill1188 that directs the HHSC to assess, review and undertake optimization of case management programs and services across the HHSC enterprise. It is my professional opinion that the State Agency Staff and Stakeholders' recommendations pertaining to Case Manager Qualifications, Common Intake Tools, and Duplication of Services be reviewed, amended, and instituted post haste in support of the goals and requirements of the legislation.

Given that case managers assume responsibilities for the health and safety of clients, minimum educational standards should be adopted and enforced for the hiring of case management staff. Currently, qualification requirements vary across programs. Program requirements for case manager qualifications range from a high school education to graduate-level education with experience; some programs require medical or other licensed professionals such as Registered Nurses or licensed social workers. At a minimum, stakeholders recommend case management staff should possess a four-year college degree, with those programs requiring more qualifications continuing to do so. However, prior to implementation, a review of costs associated with increasing case manager qualifications should be conducted. Compensation and reimbursement rates and policies may have to be adjusted to allow for the changes in the minimum qualifications of case management staff.

Based on the design and function of the case management program in Texas, the level of coordination between programs, departments and other non-governmental agencies varies widely. It appears that direct service duplication is minimal; however, programs