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.