By McDonald, Coleman, et al. H.B. No. 1409 A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to children and family issues, including health and human 1-3 services issues. 1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-5 SECTION 1. Subtitle B, Title 3, Human Resources Code, is 1-6 amended by adding Chapter 72 to read as follows: 1-7 CHAPTER 72. LOCAL AND STATE COORDINATION OF DELIVERY OF 1-8 SERVICES TO CHILDREN AND FAMILIES 1-9 SUBCHAPTER A. GENERAL PROVISIONS 1-10 Sec. 72.001. PURPOSE. The purpose of this chapter is to 1-11 ensure that all children will: 1-12 (1) live in stable, nurturing, and supportive 1-13 families; 1-14 (2) be mentally and physically healthy; 1-15 (3) enter school able to learn to their fullest 1-16 potential and be able to succeed in school; and 1-17 (4) develop into productive, law-abiding citizens. 1-18 Sec. 72.002. DEFINITIONS. In this chapter: 1-19 (1) "Board" means the Legislative Health and Human 1-20 Services Board created under Chapter 330, Government Code. 1-21 (2) "Child" means a person younger than 19 years of 1-22 age. 1-23 (3) "Commission" means the Health and Human Services 2-1 Commission. 2-2 (4) "Commissioner" means the commissioner of health 2-3 and human services. 2-4 (Sections 72.003-72.020 reserved for expansion 2-5 SUBCHAPTER B. STATE PARTICIPATION IN PARTNERSHIP 2-6 FOR SERVICES TO CHILDREN AND FAMILIES 2-7 Sec. 72.021. DESIGNATED STATE AGENCY. (a) The Health and 2-8 Human Services Commission is the state agency responsible for 2-9 providing leadership to ensure that the purposes of this chapter 2-10 are realized. 2-11 (b) The commission may require health and human service, 2-12 education, and juvenile justice agencies listed under Section 2-13 72.022(a) to provide staff and other administrative support as 2-14 necessary to assist the commission in discharging its 2-15 responsibilities under this section. 2-16 Sec. 72.022. RESPONSIBILITIES OF STATE AGENCIES. (a) In 2-17 conjunction with the commissioner of health and human services, the 2-18 executive director, commissioner, or other executive head, as 2-19 appropriate, of the following state agencies shall ensure that the 2-20 agency under the person's direction adopts and implements the 2-21 policies and procedures necessary to accomplish the objectives of 2-22 this chapter except where those policies and procedures conflict 2-23 with rules adopted by the elected board of the agency: 2-24 (1) Central Education Agency; 2-25 (2) Health and Human Services Commission; 3-1 (3) Department of Protective and Regulatory Services; 3-2 (4) Interagency Council on Early Childhood 3-3 Intervention Services; 3-4 (5) Texas Commission on Alcohol and Drug Abuse; 3-5 (6) Texas Commission for the Blind; 3-6 (7) Texas Department of Health; 3-7 (8) Texas Department of Human Services; 3-8 (9) Texas Department of Mental Health and Mental 3-9 Retardation; 3-10 (10) Texas Juvenile Probation Commission; 3-11 (11) Texas Youth Commission; 3-12 (12) Texas Employment Commission; and 3-13 (13) Children's Trust Fund of Texas Council. 3-14 (b) The executive director, commissioner, or other executive 3-15 head of an agency shall designate an employee of the agency to 3-16 represent the agency, under the direction of the executive head, 3-17 and assist the agency in carrying out the objectives of Subsection 3-18 (f). 3-19 (c) The commissioner of health and human services and the 3-20 commissioner of education shall regularly meet with the agency 3-21 representatives to determine the progress made toward realizing the 3-22 goals of Subsection (f). 3-23 (d) The representatives of the agencies shall meet at the 3-24 call of the commissioner. 3-25 (e) Each agency is responsible for the expenses of that 4-1 agency's representative. An agency representative does not receive 4-2 any additional compensation for representing the agency or for 4-3 carrying out other duties under this chapter. 4-4 (f) The agencies shall collaborate under the direction of 4-5 the commissioner to accomplish the following objectives: 4-6 (1) the establishment of a system to encourage and 4-7 support the development of local child and family commissions 4-8 throughout the state that includes the elimination of 4-9 administrative or regulatory barriers and the provision of adequate 4-10 technical assistance to those commissions; 4-11 (2) the development of a blueprint for children that 4-12 establishes goals for children, that includes short-range and 4-13 long-range strategies treating education, health and human 4-14 services, and juvenile justice issues, and that accomplishes the 4-15 purposes prescribed by Section 72.001; 4-16 (3) the definition of common, uniform, cross-agency 4-17 outcome measures and a system of evaluation to measure the effects 4-18 of agency programs for children and families; 4-19 (4) the initiation of strategies for refinancing 4-20 children's services administered by state agencies to ensure the 4-21 most effective use of federal, state, and local funds; 4-22 (5) the submission of a quarterly report to the board 4-23 on progress in meeting the objectives of this subsection; and 4-24 (6) the response to other issues considering the 4-25 recommendations of the board. 5-1 (g) The executive director, commissioner, or other executive 5-2 head of each agency shall ensure that the strategic plan, budget, 5-3 and performance measures of the agency reflect the joint 5-4 responsibilities listed in Subsection (f). 5-5 (h) The commissioner may solicit the participation of other 5-6 agencies involved in child and family issues, including 5-7 institutions of higher education, to accomplish the purposes of 5-8 this section. 5-9 (Sections 72.023-72.030 reserved for expansion 5-10 SUBCHAPTER C. LOCAL CHILD AND FAMILY COMMISSIONS 5-11 Sec. 72.031. DEFINITION. In this subchapter, "local 5-12 commission" means a local child and family commission certified by 5-13 the commission under this subchapter. 5-14 Sec. 72.032. CERTIFICATION OF LOCAL COMMISSIONS. (a) The 5-15 commission shall annually solicit applications for new local 5-16 commissions. A commissioners court of a county may submit a 5-17 proposal for a local commission. 5-18 (b) A proposal submitted under this section must: 5-19 (1) demonstrate that the applicant has consulted with 5-20 local governments and other public entities, nonprofit 5-21 organizations, voluntary associations, representatives of 5-22 low-income persons, and other groups involved in providing health 5-23 and human services or funding for those services about the needs of 5-24 the community and how to meet those needs; and 5-25 (2) identify the proposed membership of the local 6-1 commission. 6-2 (c) The commission shall adopt rules to provide technical 6-3 support to the local commissions and assist them to eliminate 6-4 administrative and regulatory barriers. 6-5 (d) A local commission may serve one or more counties, but a 6-6 county may not be served by more than one local commission. 6-7 Sec. 72.033. MEMBERSHIP OF LOCAL COMMISSIONS. (a) The 6-8 commissioners court of the county or counties served by the local 6-9 commission shall appoint the following to the local commission: 6-10 (1) a member of the governing body of the most 6-11 populous municipality located in the county and a member of the 6-12 governing body of one other municipality located in the county; 6-13 (2) a member of the commissioners court of the county; 6-14 (3) an elected school board member from any 6-15 participating public school district in the county; 6-16 (4) a member of the local juvenile board; 6-17 (5) a child protective services administrator; 6-18 (6) a representative from a civic, religious, or 6-19 community-based organization; 6-20 (7) an appointee from the Head Start agency; and 6-21 (8) a member of any other entity that submits the 6-22 proposal for a local commission under Section 72.032(a). 6-23 (b) The local commission may appoint such advisory 6-24 committees as necessary to satisfy requirements for federal funds 6-25 and to qualify representation in the incident where a local 7-1 commission is established by two or more counties. 7-2 (c) The commissioners court shall select new members for the 7-3 local commission as needed. At all times the membership of the 7-4 local commission shall be as designated in Section 72.033. 7-5 Sec. 72.034. ADMINISTRATION OF LOCAL COMMISSIONS. Members 7-6 of a local commission serve without compensation, but a member may 7-7 be reimbursed for actual expenses incurred in the performance of 7-8 the member's official duties. Expenses under this subsection must 7-9 be reported in the local commission's records and must be approved 7-10 by the commission. 7-11 Sec. 72.035. POWERS, DUTIES, AND RESPONSIBILITIES OF LOCAL 7-12 COMMISSIONS. (a) A local commission shall: 7-13 (1) assess the need for child and family services and 7-14 available resources in the community served by the local 7-15 commission; 7-16 (2) monitor the effectiveness and efficiency with 7-17 which public and private organizations that receive public money 7-18 deliver child and family services; 7-19 (3) develop and submit to the commission local 7-20 strategic plans for services for children and families that are 7-21 related to the purposes of this chapter listed under Section 7-22 72.001, including local budgetary priorities and proposals for 7-23 alternative delivery systems; 7-24 (4) mobilize public, business, and voluntary agency 7-25 partnerships and promote the use of individual volunteers; 8-1 (5) foster the development of new services to meet 8-2 family needs more effectively, including services aimed at 8-3 preventing child abuse, poverty, malnutrition, failure in school, 8-4 juvenile delinquency, and other social ills; 8-5 (6) ensure fiscal efficiency by maximizing the use of 8-6 local, state, and federal funds, as appropriate; and 8-7 (7) ensure program effectiveness and fiscal 8-8 accountability in the delivery of child and family services. 8-9 (b) A local commission has all of the powers necessary for 8-10 the effective operation of the local commission, including the 8-11 power to: 8-12 (1) contract for assistance in administration or 8-13 management of the commission and for services to administer its 8-14 funds; 8-15 (2) pay all operating expenses by warrants drawn on 8-16 funds available for that purpose; and 8-17 (3) accept gifts and grants from any source to finance 8-18 its programs and facilities. 8-19 Sec. 72.036. LOCAL GRANTS; NOTICE. (a) A municipality, 8-20 county, or political subdivision may provide a grant to a local 8-21 commission to achieve the purposes of this chapter. 8-22 (b) A local commission shall allow adequate notice and 8-23 opportunity for public comment, including comments from the 8-24 entities listed in Section 72.032(b)(1), before contracting for 8-25 services. 9-1 Sec. 72.037. ANNUAL AUDIT. (a) A local commission shall 9-2 contract with an independent auditor for an annual financial audit. 9-3 (b) The state auditor shall, with the advice of the 9-4 commission, develop standardized forms and schedules for a local 9-5 commission to use in conducting an annual financial audit. A local 9-6 commission shall use the forms and schedules developed by the state 9-7 auditor for its annual financial audit. 9-8 Sec. 72.038. LIMITATION OF LIABILITY. (a) A local 9-9 commission is a governmental unit for purposes of Chapter 101, 9-10 Civil Practice and Remedies Code. 9-11 (b) A member of a local commission is not liable for civil 9-12 damages for any act performed in good faith in the execution of 9-13 duties as a commission member or for an action taken by the 9-14 commission. 9-15 (Sections 72.039-72.050 reserved for expansion 9-16 SUBCHAPTER D. STATE GRANTS AND STATE AGENCY COOPERATION 9-17 Sec. 72.051. FUNDS AVAILABILITY. (a) In conjunction with 9-18 the agencies listed under Section 72.022(a) and the Legislative 9-19 Budget Board, the commission shall develop a budget mechanism to: 9-20 (1) combine state and federal funds to provide grants 9-21 to local child and family commissions established under Subchapter 9-22 C; and 9-23 (2) distribute grant funds that may be appropriated by 9-24 the legislature for local child and family commissions. 9-25 (b) The Legislative Budget Board, at the request of the 10-1 commission, may transfer appropriations from state child-serving 10-2 agencies to the commission in accordance with Subsection (a)(1). 10-3 (c) A grant to a local child and family commission made 10-4 under this section must: 10-5 (1) be distributed locally for services that promote 10-6 the social, emotional, or physical well-being of children and 10-7 promote family support; and 10-8 (2) be matched by local resources, in cash or in kind, 10-9 equal to at least one-quarter of the grant amount, except as 10-10 provided by Subsection (e). 10-11 (d) The commission by rule shall provide for the 10-12 distribution of available funds based on a county's child 10-13 population and per capita income. 10-14 (e) The commission may modify the match amount required by 10-15 Subsection (c) if the modification is necessary to accomplish the 10-16 effective distribution of funds. If the commission modifies the 10-17 match formula, the modification shall apply to all applicants for 10-18 funds under this section. 10-19 (f) The commission may retain not more than two percent of 10-20 any funds appropriated for state grants under this section and may 10-21 use those funds only for the administration of the grant program at 10-22 the state level and for carrying out the duties prescribed by 10-23 Section 72.022. 10-24 (g) The value of an in-kind match of local resources made 10-25 under Subsection (c)(2) is equal to the fair market value of the 11-1 resources received, except that personal services may not be valued 11-2 for any purpose in an amount that exceeds $12 an hour. 11-3 Sec. 72.052. COMMUNITY ASSISTANCE GRANTS. (a) The 11-4 commission by rule shall provide a procedure by which it may make a 11-5 small assistance grant to a local community on its certification to 11-6 provide an incentive to establish a local child and family 11-7 commission and support its initial operation. 11-8 (b) If funds are available, the commission may provide an 11-9 assistance grant to a local community on certification of a local 11-10 child and family commission. A grant under this subsection: 11-11 (1) must be in proportion to the child population of 11-12 the county, not to exceed $50,000 in a large urban area; 11-13 (2) must be matched by local resources, in cash or in 11-14 kind, equal to at least one-half of the amount of the assistance 11-15 grant; and 11-16 (3) may not be for a period greater than one year. 11-17 (c) The value of an in-kind match of local resources made 11-18 under Subsection (b)(2) is equal to the fair market value of the 11-19 resources received, except that personal services may not be valued 11-20 for any purpose in an amount that exceeds $12 an hour. 11-21 Sec. 72.053. COOPERATION WITH STATE AGENCIES; PERSONNEL. 11-22 (a) A local child and family commission shall cooperate with the 11-23 commission in setting performance standards and evaluating results 11-24 for child and family programs for which the local commission and 11-25 the commission have responsibilities. 12-1 (b) The commission shall assist local child and family 12-2 commissions in obtaining state employees to work under local 12-3 supervision while engaged in programs serving children and 12-4 families. 12-5 (c) A state agency must receive approval for a new program 12-6 in the health and human services area in a community that has a 12-7 local child and family commission. 12-8 (Sections 72.054-72.070 reserved for expansion 12-9 SUBCHAPTER E. MISCELLANEOUS PROVISIONS 12-10 Sec. 72.071. COLLABORATION AGREEMENTS. (a) State and local 12-11 agencies that serve children and families, including local child 12-12 and family commissions established under Subchapter C, may enter 12-13 into collaboration agreements to accomplish the purposes prescribed 12-14 by Section 72.001. 12-15 (b) A collaboration agreement may involve education, 12-16 vocational rehabilitation, health, mental health, employment and 12-17 training, child welfare, social services, juvenile justice, and 12-18 other services or programs designated by the commission. 12-19 Sec. 72.072. FUNDS. All funds received by the commission 12-20 under this chapter are subject to Subchapter F, Chapter 404, 12-21 Government Code. 12-22 SECTION 2. Chapter 32, Health and Safety Code, is amended by 12-23 adding Section 32.022 to read as follows: 12-24 Sec. 32.022. PRENATAL CARE PUBLIC AWARENESS PROGRAM. (a) 12-25 The department shall establish a program to promote public 13-1 awareness of the importance of prenatal care. 13-2 (b) The public awareness program shall: 13-3 (1) focus on the benefits of early and ongoing 13-4 prenatal care, including the reduction of low birth weights and 13-5 infant mortality; and 13-6 (2) target low-income areas of the state. 13-7 (c) The public awareness program shall not provide 13-8 counseling or referral regarding abortion or abortion services. 13-9 (d) To conduct the public awareness program required by this 13-10 section, the department shall utilize, among other resources, the 13-11 network of local coalitions developed by the department to promote 13-12 its immunization public awareness program. 13-13 SECTION 3. (a) In accordance with Section 72.022, Human 13-14 Resources Code, as added by this Act, the commissioner of health 13-15 and human services, in collaboration with the agencies listed in 13-16 Section 72.022(a), Human Resources Code, shall coordinate the 13-17 program services, eligibility requirements, funding, enrollment 13-18 periods, fees, and administrative functions of the following 13-19 programs by no later than December 1, 1997: 13-20 (1) the child care programs of the Texas Department of 13-21 Human Services; 13-22 (2) the prekindergarten programs of the Central 13-23 Education Agency; and 13-24 (3) the federal Head Start programs. 13-25 (b) The commissioner of health and human services shall 14-1 report the results of the initiative prescribed by this Act to 14-2 coordinate the delivery of services to children and families to the 14-3 legislature on or before December 1, 1997. 14-4 SECTION 4. (a) The Texas Department of Health shall develop 14-5 a plan to increase accessibility of dental services for children 14-6 that targets children who are eligible for but are not receiving 14-7 medical assistance. In developing the plan, the department shall: 14-8 (1) explore the extent of services needed to reach all 14-9 eligible children; 14-10 (2) determine the most appropriate age to target 14-11 children for preventive services; 14-12 (3) determine how to better use preventive care; 14-13 (4) examine the expansion of school-based services for 14-14 early diagnostic screening; 14-15 (5) consider the need for dental equipment, including 14-16 mobile units, portable equipment, and computer equipment; 14-17 (6) consider involving private practitioners by 14-18 exploring the following possibilities: 14-19 (A) increasing compensation for services; 14-20 (B) forgiving school loans for participating 14-21 dentists; 14-22 (C) requiring 40 hours a year of mandatory 14-23 services for children in the early and periodic screening, 14-24 diagnosis, and treatment program or for other children eligible for 14-25 state services; and 15-1 (D) creating a formal structure to bring 15-2 dentists into schools; 15-3 (7) investigate alternative methods to educate parents 15-4 about the causes and prevention of baby bottle tooth decay; and 15-5 (8) consider requiring fluoridation of all major water 15-6 supplies. 15-7 (b) Using existing departmental resources, the department 15-8 shall prepare the plan required by this section and the projected 15-9 budget for that plan not later than September 1, 1996. The Texas 15-10 Board of Health may appoint a special task force to help the 15-11 department in preparing this plan. The department shall present 15-12 the plan and budget to the 75th Legislature not later than 15-13 February 1, 1997. 15-14 (c) This section expires June 1, 1997. 15-15 SECTION 5. (a) The Texas Department of Mental Health and 15-16 Mental Retardation shall develop a plan for providing services to 15-17 children with severe mental or emotional disorders who require 15-18 residential treatment. The plan must provide: 15-19 (1) that residential treatment and related services 15-20 for children be provided regionally; 15-21 (2) for a child who has a functional family to remain 15-22 in parental custody while receiving treatment or related services; 15-23 (3) for coordination of state mental health facilities 15-24 and community service providers; 15-25 (4) specific legislative recommendations for statutory 16-1 authority to pool funds used by various state agencies to provide 16-2 residential treatment and related services to children; 16-3 (5) to the extent practicable, that funds available 16-4 under Title IV-E, federal Social Security Act (42 U.S.C. Section 16-5 670 et seq.), pay for services for those children who are 16-6 Medicaid-eligible and in need of residential treatment; and 16-7 (6) that third-party payor financial resources are 16-8 exhausted before state money is used. 16-9 (b) In developing the plan, the Texas Department of Mental 16-10 Health and Mental Retardation shall consider whether to include in 16-11 the plan provisions: 16-12 (1) to establish and employ indicators to identify 16-13 children with mental or emotional disorders who would be better 16-14 served outside of the home; 16-15 (2) to use community mental health centers or 16-16 community resources to review children's cases individually; 16-17 (3) to create therapeutic group homes in communities; 16-18 and 16-19 (4) for payment of services on a sliding scale. 16-20 (c) The Texas Department of Mental Health and Mental 16-21 Retardation shall complete the plan, together with an estimated 16-22 budget and recommendations for statutory changes necessary or 16-23 convenient to implement the plan, not later than January 15, 1997. 16-24 On completion, the department shall submit the plan to the governor 16-25 and the legislature. 17-1 (d) This section expires June 1, 1997. 17-2 SECTION 6. (a) The comptroller shall establish a pilot 17-3 project to determine the effectiveness of using investment 17-4 budgeting to measure the cost-effectiveness of certain children's 17-5 prevention services. 17-6 (b) As part of the investment budgeting process, the 17-7 comptroller shall: 17-8 (1) establish clear visions and goals and measurable 17-9 outcomes that clarify those visions and goals; 17-10 (2) establish and estimate the value of the outcomes 17-11 the comptroller wants to achieve; 17-12 (3) estimate the unit cost of achieving those 17-13 outcomes; and 17-14 (4) compute the anticipated return on investing in 17-15 programs to achieve those outcomes. 17-16 (c) The comptroller shall consider including the children's 17-17 immunization programs in determining which children's prevention 17-18 services will be examined in the pilot project. 17-19 (d) Not later than January 15, 1997, the comptroller shall 17-20 submit to the governor and the 75th Legislature a report concerning 17-21 the effectiveness of the pilot project. 17-22 (e) This section expires September 1, 1997. 17-23 SECTION 7. The Texas Department of Health shall establish 17-24 the prenatal care public awareness program required by Section 17-25 32.022, Health and Safety Code, as added by this Act, not later 18-1 than January 1, 1996. 18-2 SECTION 8. This Act takes effect September 1, 1995. 18-3 SECTION 9. The importance of this legislation and the 18-4 crowded condition of the calendars in both houses create an 18-5 emergency and an imperative public necessity that the 18-6 constitutional rule requiring bills to be read on three several 18-7 days in each house be suspended, and this rule is hereby suspended.