Senator Eliot Shapleigh - El Paso, Texas

AUSTIN — As pressure grows over systems that are failing to protect disabled Texans in institutionalized care and abused children in foster care, agency leaders are calling for a major infusion of spending.

The social services budget requests for fiscal 2010-11 include salary increases for state employees in key positions, higher reimbursement rates for nursing homes and medical providers, and expanded mental health and substance abuse programs to divert low-level offenders from county jails.

“We have some critical needs in health and human services,” said Albert Hawkins, executive commissioner of the Health and Human Services Commission. “And we're carrying those priorities forward in our legislative appropriations request.”

Hawkins wants 10 percent raises for about 40,000 state employees. These workers do a variety of jobs, including caring for persons with mental illness or retardation, monitoring children who have been removed from their families due to abuse or neglect, and determining eligibility for safety net programs.

Turnover in many of the jobs ranges from 30 percent to 40 percent. Annual starting salaries for direct care workers at state facilities for people with mental retardation range from $20,500 to $23,600.

“I think with higher pay we can probably raise the quality of staff we are able to attract in those jobs,” Hawkins said. “That results in better services to our clients and consumers.”

Rep. John Davis, R-Houston, said higher pay may be needed, although he would prefer merit raises to across-the-board increases. He said reducing turnover can save money in the long run because of the cost of training new workers.

“If we can increase those salaries and keep the higher retention, that's smart money,” said Davis, who serves on the budget-writing House Appropriations Committee.

Hawkins also wants to increase rates for a variety of private providers, including doctors, foster parents, nursing homes and community group homes.

Raising state salaries and increasing provider rates will be costly, Hawkins said. His estimates are expected next month.

The needs are real, but with $3 billion in additional Medicaid costs expected over the next two-year budget cycle, it's unclear how many new initiatives will be funded next session.

Although lawmakers are expecting to enter the session next year with a budget surplus, social services — which accounts for about one-third of all state spending — will be competing with public education, higher education, corrections and transportation.

Lawmakers may be persuaded to boost social services spending by federal investigations and reviews.

That's what happened during the 2007 session, when legislators decided to settle a long-running federal class-action lawsuit by budgeting $700 million to improve health care for needy children.

This time, the focus is on a U.S. Justice Department civil rights investigation into conditions at state facilities serving 4,800 people with mental retardation. Last month, the three-year-old federal probe was expanded from two institutions to the entire system of 11 state schools and two smaller state centers.

An earlier Justice Department report on Lubbock State School and newspaper reviews of employee discipline records at other facilities found disturbing patterns of abuse, neglect and exploitation.

As part of the probe, federal investigators are looking at whether the state is heeding court rulings that it must serve intellectually disabled people in the least restrictive setting.

More than 82,000 disabled individuals are on waiting lists for various community services. Some have been waiting as long as nine years.

Lawmakers have increased funding for community living options in the past two sessions, but waiting lists have remained stubbornly long because of population growth. Hawkins is asking lawmakers to budget $474.4 million to increase capacity.

Sen. Judith Zaffirini, a longtime advocate for greater community services, said she was encouraged by the attention given to the waiting lists during a recent public hearing before the Senate Finance Committee.

“Because of this new interest and because of the understanding by more persons, perhaps we will be even more successful in 2009,” said Zaffirini, D-Laredo.

Another area where the federal government is pressuring Texas to do better involves high caseloads that prevent child welfare workers from making monthly visits to children and parents. Texas paid a $4 million fine for insufficient caseworker visits after a 2002 review, and preliminary results from a second review this year again found the state deficient.

To address the issue, Hawkins is asking for about 240 new caseworkers. He said that would help Texas meet federal standards that call for monthly face-to-face visits with 95 percent of children in the custody of Child Protective Services and with their parents.

Eva DeLuna Castro, a budget analyst with the Center for Public Policy Priorities, said major improvements in services often come when a lawsuit or investigation draws attention to a problem.

“A lot of these things if all approved at once would make for significant progress,” she said. “But they tend to get approved piecemeal or just by patching the most urgent holes in the system.”

When the media spotlight fades, she said, “people forget about the last horrible story.”