By:  Davila                                           H.B. No. 2485
       73R5558 KLL-F
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the establishment and powers and duties of a healthy
    1-3  start pilot program.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Subtitle B, Title 2, Health and Safety Code, is
    1-6  amended by adding Chapter 45 to read as follows:
    1-7               CHAPTER 45.  HEALTHY START PILOT PROGRAM
    1-8                   SUBCHAPTER A.  GENERAL PROVISIONS
    1-9        Sec. 45.001.  DEFINITIONS.  In this chapter:
   1-10              (1)  "Program" means the healthy start pilot program
   1-11  established under this chapter.
   1-12              (2)  "Resource mother" means a person providing
   1-13  resource mother services.
   1-14              (3)  "Resource mother services" means services to
   1-15  provide pregnant women and new mothers with information and access
   1-16  to health care, social services, and related services through home
   1-17  visits by women who have experience as mothers and who know about
   1-18  services available to pregnant women and new mothers.
   1-19        Sec. 45.002.  HEALTHY START PILOT PROGRAM.  (a)  The
   1-20  department shall establish a healthy start pilot program to provide
   1-21  services to families and children during the prenatal through
   1-22  preschool years.
   1-23        (b)  The goal of the program is to prevent child abuse and
   1-24  neglect.  The program shall be designed to:
    2-1              (1)  promote optimal child development;
    2-2              (2)  improve family coping skills and functioning; and
    2-3              (3)  promote positive parenting skills and
    2-4  intrafamilial interaction.
    2-5        (c)  The program shall provide:
    2-6              (1)  infant mortality prevention services;
    2-7              (2)  prenatal to preschool family and child protection
    2-8  services; and
    2-9              (3)  resource mother services.
   2-10        (d)  To the extent possible, the department shall develop and
   2-11  implement the services required under this section to facilitate
   2-12  the coordination of those services.
   2-13              SUBCHAPTER B.  INFANT MORTALITY PREVENTION
   2-14        Sec. 45.011.  INFANT MORTALITY PREVENTION PILOT PROJECT.  (a)
   2-15  As part of the program, the department shall establish an infant
   2-16  mortality prevention pilot project.
   2-17        (b)  The project must begin operation not later than June 1,
   2-18  1994, and must operate in two counties identified by the board as
   2-19  having the highest infant mortality rates in the state.
   2-20        Sec. 45.012.  PILOT PROJECT SERVICES.  The infant mortality
   2-21  prevention pilot project shall:
   2-22              (1)  identify barriers to positive birth outcomes;
   2-23              (2)  encourage collaboration and cooperation among
   2-24  providers of health care, social services, and other services to
   2-25  pregnant women and women of childbearing years;
   2-26              (3)  encourage pregnant women and women of childbearing
   2-27  years to seek health care and other services that result in
    3-1  positive birth outcomes; and
    3-2              (4)  develop an inventory of existing community
    3-3  resources, including public and private organizations, that provide
    3-4  infant mortality prevention services in the targeted counties.
    3-5        Sec. 45.013.  RESOURCE MOTHER SERVICES.  The pilot project
    3-6  shall provide resource mother services.
    3-7        Sec. 45.014.  COUPON BONUS PROGRAM.  (a)  The pilot project
    3-8  shall collaborate with local chambers of commerce, businesses, and
    3-9  other public or private civic organizations to establish a coupon
   3-10  bonus program to encourage pregnant women to seek prenatal care and
   3-11  to encourage women with children who are less than one year of age
   3-12  to use periodic health screening, diagnosis, and treatment
   3-13  services.
   3-14        (b)  The coupon bonus program shall provide for:
   3-15              (1)  the distribution of coupons for goods or services
   3-16  to pregnant women and to women with children who are less than one
   3-17  year of age residing in the targeted counties; and
   3-18              (2)  validation of the coupons by health care providers
   3-19  following the provision of prenatal care or the provision of health
   3-20  screening, diagnosis, and treatment services to a child who is less
   3-21  than one year of age.
   3-22              SUBCHAPTER C.  PRENATAL TO PRESCHOOL FAMILY
   3-23                     AND CHILD PROTECTION SERVICES
   3-24        Sec. 45.021.  PRENATAL TO PRESCHOOL FAMILY AND CHILD
   3-25  PROTECTION SERVICES PILOT  PROJECT.  (a)  As part of the program,
   3-26  the department shall establish a prenatal to preschool family and
   3-27  child protection services pilot project.
    4-1        (b)  The pilot project must begin operation not later than
    4-2  June 1, 1994, and must operate in at least six counties selected by
    4-3  the board, including the two counties participating in the infant
    4-4  mortality prevention pilot project under Section 45.011.  In
    4-5  selecting participating counties under this subsection, other than
    4-6  the counties participating in the infant mortality prevention pilot
    4-7  project, the board shall consult with the grant recipient selected
    4-8  under Section 45.027.
    4-9        (c)  The project shall be administered by a grant recipient
   4-10  selected under Section 45.027.
   4-11        Sec. 45.022.  HOSPITAL-BASED SCREENING.  (a)  The prenatal to
   4-12  preschool family and child protection services pilot project shall
   4-13  provide systematic hospital-based screening for high-risk families
   4-14  of newborns in the selected counties.
   4-15        (b)  Hospital-based screening shall be accomplished by a
   4-16  resource mother, who shall examine hospital admissions data
   4-17  relating to childbirth for high-risk families identified by risk
   4-18  indicators under rules adopted by the board.
   4-19        (c)  A resource mother shall interview a woman who is a
   4-20  member of the high-risk family identified under Subsection (b) to
   4-21  encourage the woman to accept resource mother services.
   4-22        Sec. 45.023.  RESOURCE MOTHER SERVICES.  (a)  The prenatal to
   4-23  preschool family and child protection services pilot project shall
   4-24  provide resource mother services to women who accept the services
   4-25  under Section 45.022.
   4-26        (b)  The services provided under this section shall include
   4-27  home visits by a resource mother to assess the needs of the family
    5-1  and to refer the family to appropriate health and social services.
    5-2  The resource mother shall identify the specific needs of the family
    5-3  to ensure that appropriate services are used and that the services
    5-4  are used with the appropriate frequency.  The resource mother shall
    5-5  coordinate the use of these services.
    5-6        (c)  The resource mother shall assist participating families
    5-7  in selecting a primary care provider to promote preventive health
    5-8  care and positive child development.  The resource mother shall:
    5-9              (1)  monitor the scheduling and completion of health
   5-10  care visits and the availability of transportation for the visits;
   5-11              (2)  review the results of the visits; and
   5-12              (3)  coordinate future visits or referrals to necessary
   5-13  services.
   5-14        (d)  The resource mother shall provide continuous follow-up
   5-15  with the family until the child born at the time the family was
   5-16  identified as a high-risk family under Section 45.022 reaches the
   5-17  age of five.
   5-18        Sec. 45.024.  TRAINING PROGRAMS.  The prenatal to preschool
   5-19  family and child protection services pilot project shall provide a
   5-20  structured training program in the dynamics of abuse and neglect.
   5-21  The training program shall establish uniform standards for delivery
   5-22  of services under this subchapter.
   5-23        Sec. 45.025.  INTERAGENCY AGREEMENT.  The department may
   5-24  enter into an interagency agreement with the Texas Department of
   5-25  Human Services governing referral of high-risk families identified
   5-26  under Section 45.022 to programs or services provided by the Texas
   5-27  Department of Human Services.
    6-1        Sec. 45.026.  CRISIS CHILD CARE.  The prenatal to preschool
    6-2  family and child protection services pilot project shall provide
    6-3  crisis child care to participants in the pilot project through
    6-4  existing child care services.
    6-5        Sec. 45.027.  ADMINISTRATION OF PILOT PROJECT; REQUEST FOR
    6-6  PROPOSALS.  (a)  The board shall adopt rules governing the awarding
    6-7  of a grant to a statewide child abuse prevention organization for
    6-8  the development and implementation of the prenatal to preschool
    6-9  family and child protection services pilot project.
   6-10        (b)  The rules must include criteria for the awarding of the
   6-11  grant.  The criteria must include a requirement that the grant
   6-12  recipient provide $1 for the operation of the program for each $2
   6-13  granted by the state.
   6-14        (c)  The department shall develop a request for proposal in
   6-15  connection with awarding the grant and shall make the request for
   6-16  proposal available to any organization requesting it before
   6-17  December 1, 1993.  Proposals must be received by the department not
   6-18  later than February 1, 1994.
   6-19        Sec. 45.028.  DUTIES OF GRANT RECIPIENT.  The recipient of
   6-20  the grant under Section 45.027 shall:
   6-21              (1)  implement the prenatal to preschool family and
   6-22  child protection services pilot project as required by this
   6-23  subchapter;
   6-24              (2)  coordinate the pilot project with the infant
   6-25  mortality prevention pilot project;
   6-26              (3)  use existing programs and services to implement
   6-27  the program; and
    7-1              (4)  use nonprofit home health programs in the
    7-2  development and implementation of the program.
    7-3                 SUBCHAPTER D.  TERMINATION OF PROGRAM
    7-4        Sec. 45.051.  TERMINATION OF PILOT PROJECTS.  The pilot
    7-5  projects established under this chapter terminate August 31, 1997.
    7-6        Sec. 45.052.  REPORT.  (a)  The department shall prepare a
    7-7  written report on the effectiveness of the pilot projects and shall
    7-8  file a copy of this report with the governor and each house of the
    7-9  legislature not later than February 1 of each odd-numbered year.
   7-10        (b)  The report shall include an evaluation of the prenatal
   7-11  to preschool family and child protection services pilot project and
   7-12  its effects on the reduction in risk factors for its participants
   7-13  and recommendations for changes in or expansion of the pilot
   7-14  project.
   7-15        (c)  This chapter expires  September 1, 1997.
   7-16        SECTION 2.  The importance of this legislation and the
   7-17  crowded condition of the calendars in both houses create an
   7-18  emergency and an imperative public necessity that the
   7-19  constitutional rule requiring bills to be read on three several
   7-20  days in each house be suspended, and this rule is hereby suspended,
   7-21  and that this Act take effect and be in force from and after its
   7-22  passage, and it is so enacted.