BILL ANALYSIS S.B. 1343 By: Ellis, Gallegos, Truan (Van de Putte, Coleman) 05-17-95 Committee Report (Unamended) BACKGROUND In Texas, many children are regularly and severely mistreated by family members or family acquaintances, and reports of child abuse continue to rise. Early treatment of child abuse has been shown to be a cost-effective, pro-active measure that not only helps victims and prevents further harm to them, but also prevents revictimization and intergenerational transmission of abuse. Hawaii has established a child abuse prevention program called Healthy Start/Healthy Families, with a success rate of more than 95 percent among program participants. PURPOSE S.B. 1343 would require the Texas Department of Health to establish a healthy start/healthy families program to provide services to families and children during the prenatal period, from birth through five years of age, or both. RULEMAKING AUTHORITY It is the committee's opinion that this bill grants additional rulemaking authority to the Texas Board of Health (board) under SECTION 1 (Section 46.007, Title 2B, Health and Safety Code). SECTION BY SECTION ANALYSIS SECTION 1. Amends Title 2B, Health and Safety Code, by adding Chapter 46, as follows: CHAPTER 46. HEALTHY START/HEALTHY FAMILIES PROGRAM Sec. 46.001. DEFINITIONS. Defines "family assessment process," "family assessment worker," "family support worker," "home-based family support services," and "program." Sec. 46.002. HEALTHY START/HEALTHY FAMILIES PROGRAM. (a) Requires the Texas Department of Health (department) to establish a healthy start/healthy families pilot program (program) modeled after the Hawaii healthy start program to provide services to single women and their children during the prenatal period, from birth through five years of age, or both. Requires the department, subject to the availability of funding, to establish the pilot program in five communities of varying population size. (b) Provides that the goal of the program is to prevent child abuse and neglect. States that the program shall be designed to promote optimal child development, improve family coping skills and functioning, promote positive parenting skills and intrafamilial interaction, ensure 100 percent immunization rates, and increase school readiness. (c) Requires the program to provide family and children's services, home-based family support, and referral to community services and to individuals providing those services. (d) Requires the program to be administered by a grant recipient selected under Section 46.007 of this Act. Sec. 46.003. PROGRAM OBJECTIVES. Sets forth the goals of the program. Sec. 46.004. HEALTH FACILITIES ASSESSMENTS; FAMILY ASSESSMENT PROCESS. (a) Requires the program to provide systematic clinic-based or hospital-based assessment of all births in the target area in selected counties. (b) Requires an assessment to be accomplished by a family assessment worker who visits briefly with the parents and obtains written permission to examine patient records to assess if there are obvious environmental stresses that would warrant a full assessment interview. (c) Requires a family assessment worker, if a full assessment is warranted, to visit with the parents to determine the type of support the family needs, and to explain and encourage participation in the program. (d) Requires the family assessment worker, before the family elects to participate in the program, to inform the participants of their rights concerning involvement in the program, and to fully disclose the support services the program offers. Sec. 46.005. FAMILY SUPPORT WORKER. (a) Requires the program to provide home-based family support services to families who accept the services under Section 46.004. (b) Requires the services provided under this section to include home visits by a family support worker to assess the needs of the family and to refer the family to appropriate services. Requires the family support worker to identify the specific needs of the family in order to ensure that appropriate services are used and that the services are used with appropriate frequency. Requires the family support worker to coordinate the use of these services. (c) Requires the family support worker to assist participating families in selecting a primary health care provider to promote preventive health care and positive child development. Requires the family support worker to monitor the scheduling and completion of health care visits and the availability of transportation for the visits, review the results of the visits, and coordinate future visits or referrals to necessary services. (d) Requires the family support worker to provide continuous follow-up with the family until the child born at the time the family accepts the services under Section 46.004 reaches the age of six. Sec. 46.006. TRAINING PROGRAM. Requires the program to provide a structured training program with trainers certified by the Hawaii healthy start training program. Requires the training program to establish uniform standards for delivery of services under this chapter. Sec. 46.007. GRANT. (a) Requires the Texas Board of Health (board), subject to the availability of funds appropriated by the legislature, to adopt rules governing the establishment of a grant to a community agency or nonprofit organization, which serves youths and has experience in providing child abuse prevention services or related services, for the development and implementation of the program. (b) Authorizes a local governmental unit or a private entity to provide matching funds to a grant recipient under this section. Sec. 46.008. DUTIES OF GRANT RECIPIENT. Requires the recipient of the grant under Section 46.007 to implement the program as required by this chapter and collaborate with existing community programs and services to implement the program. Sec. 46.009. EVALUATION OF PROGRAM. Requires the department to conduct or arrange for an independent evaluation of the program based on the Hawaii healthy start program evaluation guidelines. Requires the department to make recommendations on further implementation of the program. SECTION 2. Requires the healthy start/healthy families program required by Chapter 46, Health and Safety Code, as added by this Act, to begin operations not later than January 1, 1996. SECTION 3. Emergency clause. Effective date: upon passage. SUMMARY OF COMMITTEE ACTION S.B. 1343 was considered by the Public Health Committee in a formal meeting on May 17, 1995. The bill was reported favorably without amendment and with the recommendation that it do pass and be printed by a record vote 5 ayes, 1 nay, 0 PNV, and 3 absent.