1-1  By:  Davila (Senate Sponsor - Ellis)                  H.B. No. 2485
    1-2        (In the Senate - Received from the House May 17, 1993;
    1-3  May 19, 1993, read first time and referred to Committee on Health
    1-4  and Human Services; May 25, 1993, reported favorably by the
    1-5  following vote:  Yeas 6, Nays 2; May 25, 1993, sent to printer.)
    1-6                            COMMITTEE VOTE
    1-7                          Yea     Nay      PNV      Absent 
    1-8        Zaffirini          x                               
    1-9        Ellis              x                               
   1-10        Madla              x                               
   1-11        Moncrief           x                               
   1-12        Nelson             x                               
   1-13        Patterson                  x                       
   1-14        Shelley                    x                       
   1-15        Truan              x                               
   1-16        Wentworth                                      x   
   1-17                         A BILL TO BE ENTITLED
   1-18                                AN ACT
   1-19  relating to the establishment and powers and duties of a healthy
   1-20  start pilot program modeled after the Hawaii healthy start program.
   1-21        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
   1-22        SECTION 1.  Subtitle B, Title 2, Health and Safety Code, is
   1-23  amended by adding Chapter 45 to read as follows:
   1-24               CHAPTER 45.  HEALTHY START PILOT PROGRAM
   1-25                   SUBCHAPTER A.  GENERAL PROVISIONS
   1-26        Sec. 45.001.  DEFINITIONS.  In this chapter:
   1-27              (1)  "Program" means the healthy start pilot program
   1-28  established under this chapter.
   1-29              (2)  "Family support worker" means a person providing
   1-30  home-based family support services.
   1-31              (3)  "Home-based family support services" means
   1-32  services to provide pregnant women and new parents with information
   1-33  and access to health care, social services, and related services
   1-34  through home visits by workers trained in the Hawaii healthy start
   1-35  model.
   1-36              (4)  "High risk" means at risk of child abuse or
   1-37  neglect as determined by a valid and reliable assessment
   1-38  instrument.
   1-39        Sec. 45.002.  HEALTHY START PILOT PROGRAM.  (a)  The
   1-40  department shall establish a healthy start pilot program modeled
   1-41  after the Hawaii healthy start program to provide services to
   1-42  families and children during the prenatal through preschool years.
   1-43        (b)  The goal of the program is to prevent child abuse and
   1-44  neglect.  The program shall be designed to:
   1-45              (1)  promote optimal child development;
   1-46              (2)  improve family coping skills and functioning; and
   1-47              (3)  promote positive parenting skills and
   1-48  intrafamilial interaction.
   1-49        (c)  The program shall provide:
   1-50              (1)  prenatal to preschool family and children's
   1-51  services;
   1-52              (2)  home-based family support; and
   1-53              (3)  referral to community services.
   1-54              SUBCHAPTER B.  PRENATAL TO PRESCHOOL FAMILY
   1-55                        AND CHILDREN'S SERVICES
   1-56        Sec. 45.021.  PRENATAL TO PRESCHOOL FAMILY AND CHILDREN'S
   1-57  SERVICES PILOT  PROJECT.  (a)  As part of the program, the
   1-58  department shall establish a prenatal to preschool family and
   1-59  children's services pilot project.
   1-60        (b)  The pilot project must begin operation not later than
   1-61  January 1, 1994.
   1-62        (c)  The project shall be administered by a grant recipient
   1-63  selected under Section 45.026.
   1-64        Sec. 45.022.  HEALTH FACILITIES SCREENING.  (a)  The prenatal
   1-65  to preschool family and children's services pilot project shall
   1-66  provide systematic clinic-based or hospital-based screening for
   1-67  high-risk families of newborns in selected counties.
   1-68        (b)  Health facility screening shall be accomplished by a
    2-1  family support worker, who shall examine patient records for
    2-2  evidence of child abuse or neglect risk indicators.
    2-3        (c)  A family support worker shall interview a mother who is
    2-4  a member of a high-risk family identified under Subsection (b) to
    2-5  encourage participation in the program.
    2-6        Sec. 45.023.  FAMILY SUPPORT WORKER.  (a)  The prenatal to
    2-7  preschool family and children's services pilot project shall
    2-8  provide home-based family support services to families who accept
    2-9  the services under Section 45.022.
   2-10        (b)  The services provided under this section shall include
   2-11  home visits by a family support worker to assess the needs of the
   2-12  family and to refer the family to appropriate services.  The family
   2-13  support worker shall identify the specific needs of the family to
   2-14  ensure that appropriate services are used and that the services are
   2-15  used with the appropriate frequency.  The family support worker
   2-16  shall coordinate the use of these services.
   2-17        (c)  The family support worker shall assist participating
   2-18  families in selecting a primary health care provider to promote
   2-19  preventive health care and positive child development.  The family
   2-20  support worker shall:
   2-21              (1)  monitor the scheduling and completion of health
   2-22  care visits and the availability of transportation for the visits;
   2-23              (2)  review the results of the visits; and
   2-24              (3)  coordinate future visits or referrals to necessary
   2-25  services.
   2-26        (d)  The family support worker shall provide continuous
   2-27  follow-up with the family until the child born at the time the
   2-28  family was identified as a high-risk family under Section 45.022
   2-29  reaches the age of five.
   2-30        Sec. 45.024.  TRAINING PROGRAMS.  The prenatal to preschool
   2-31  family and children's services pilot project shall provide a
   2-32  structured training program modeled after the Hawaii healthy start
   2-33  training program.  The training program shall establish uniform
   2-34  standards for delivery of services under this subchapter.
   2-35        Sec. 45.025.  INTERAGENCY AGREEMENT.  The department may
   2-36  enter into an interagency agreement with other state agencies to
   2-37  facilitate coordination and increase the likelihood of healthy
   2-38  outcomes for families at high risk for abuse or neglect.
   2-39        Sec. 45.026.  ADMINISTRATION OF PILOT PROJECT.  The board
   2-40  shall adopt rules governing the establishment of a grant to a child
   2-41  abuse prevention organization for the development and
   2-42  implementation of the prenatal to preschool family and children's
   2-43  services pilot project.
   2-44        Sec. 45.027.  DUTIES OF GRANT RECIPIENT.  The recipient of
   2-45  the grant under Section 45.026 shall:
   2-46              (1)  implement the prenatal to preschool family and
   2-47  children's services pilot project as required by this subchapter;
   2-48  and
   2-49              (2)  use existing programs and services to implement
   2-50  the project.
   2-51                 SUBCHAPTER C.  TERMINATION OF PROGRAM
   2-52        Sec. 45.051.  TERMINATION OF PILOT PROJECT.  The pilot
   2-53  project established under this chapter terminates August 31, 1999.
   2-54        Sec. 45.052.  REPORT.  (a)  The department shall prepare a
   2-55  written report on the effectiveness of the pilot project and shall
   2-56  file a copy of this report with the governor and each house of the
   2-57  legislature not later than February 1 of each odd-numbered year.
   2-58        (b)  The department shall conduct or arrange for an
   2-59  independent evaluation of the project based on the Hawaii healthy
   2-60  start program evaluation guidelines.  The department shall make
   2-61  recommendations on further implementation of the healthy start
   2-62  program.
   2-63        (c)  This chapter expires  September 1, 1999.
   2-64        SECTION 2.  The importance of this legislation and the
   2-65  crowded condition of the calendars in both houses create an
   2-66  emergency and an imperative public necessity that the
   2-67  constitutional rule requiring bills to be read on three several
   2-68  days in each house be suspended, and this rule is hereby suspended,
   2-69  and that this Act take effect and be in force from and after its
   2-70  passage, and it is so enacted.
    3-1                               * * * * *
    3-2                                                         Austin,
    3-3  Texas
    3-4                                                         May 25, 1993
    3-5  Hon. Bob Bullock
    3-6  President of the Senate
    3-7  Sir:
    3-8  We, your Committee on Health and Human Services to which was
    3-9  referred H.B. No. 2485, have had the same under consideration, and
   3-10  I am instructed to report it back to the Senate with the
   3-11  recommendation that it do pass and be printed.
   3-12                                                         Zaffirini,
   3-13  Chair
   3-14                               * * * * *
   3-15                               WITNESSES
   3-16                                                  FOR   AGAINST  ON
   3-17  ___________________________________________________________________
   3-18  Name:  Diana Davila                              x
   3-19  Representing:  Texas State Representative
   3-20  City:  Austin, Texas
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   3-22  Name:  Boyd Graves                                             x
   3-23  Representing:  TX Dept. of Human Services
   3-24  City:  Austin, Texas
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   3-26  Name:  Winifred Conlon                           x
   3-27  Representing:  TX State Foster Parents
   3-28  City:  Austin, Texas
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   3-30  Name:  Wendall Telton                                          x
   3-31  Representing:  TX Coal. for Prev. of Chi. AB
   3-32  City:  Austin, Texas
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   3-34  Name:  Rogene Gee Calvert                                      x
   3-35  Representing:  Child Abuse Prevention Net.
   3-36  City:  Houston, Texas
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