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.