74R8585 DAK-D
          By McDonald, Coleman                                  H.B. No. 1409
          Substitute the following for H.B. No. 1409:
          By Van de Putte                                   C.S.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:
   2-23              (1)  Central Education Agency;
   2-24              (2)  Health and Human Services Commission;
   2-25              (3)  Department of Protective and Regulatory Services;
    3-1              (4)  Interagency Council on Early Childhood
    3-2  Intervention Services;
    3-3              (5)  Texas Commission on Alcohol and Drug Abuse;
    3-4              (6)  Texas Commission for the Blind;
    3-5              (7)  Texas Department of Health;
    3-6              (8)  Texas Department of Human Services;
    3-7              (9)  Texas Department of Mental Health and Mental
    3-8  Retardation;
    3-9              (10)  Texas Juvenile Probation Commission;
   3-10              (11)  Texas Youth Commission;
   3-11              (12)  Texas Employment Commission; and
   3-12              (13)  Children's Trust Fund of Texas Council.
   3-13        (b)  The executive director, commissioner, or other executive
   3-14  head of an agency shall designate an employee of the agency to
   3-15  represent the agency, under the direction of the executive head,
   3-16  and assist the agency in carrying out the objectives of Subsection
   3-17  (f).
   3-18        (c)  The commissioner of health and human services and the
   3-19  commissioner of education shall regularly meet with the agency
   3-20  representatives to determine the progress made toward realizing the
   3-21  goals of Subsection (f).
   3-22        (d)  The representatives of the agencies shall meet at the
   3-23  call of the commissioner.
   3-24        (e)  Each agency is responsible for the expenses of that
   3-25  agency's representative.  An agency representative does not receive
    4-1  any additional compensation for representing the agency or for
    4-2  carrying out other duties under this chapter.
    4-3        (f)  The agencies shall collaborate under the direction of
    4-4  the commissioner to accomplish the following objectives:
    4-5              (1)  the establishment of a system to encourage and
    4-6  support the development of local child and family commissions
    4-7  throughout the state that includes the elimination of
    4-8  administrative or regulatory barriers and the provision of adequate
    4-9  technical assistance to those commissions;
   4-10              (2)  the development of a blueprint for children that
   4-11  establishes goals for children, that includes short-range and
   4-12  long-range strategies treating education, health and human
   4-13  services, and juvenile justice issues, and that accomplishes the
   4-14  purposes prescribed by Section 72.001;
   4-15              (3)  the definition of common, uniform, cross-agency
   4-16  outcome measures and a system of evaluation to measure the effects
   4-17  of agency programs for children and families;
   4-18              (4)  the initiation of strategies for refinancing
   4-19  children's services administered by state agencies to ensure the
   4-20  most effective use of federal, state, and local funds;
   4-21              (5)  the submission of a quarterly report to the board
   4-22  on progress in meeting the objectives of this subsection; and
   4-23              (6)  the response to other issues considering the
   4-24  recommendations of the board.
   4-25        (g)  The executive director, commissioner, or other executive
    5-1  head of each agency shall ensure that the strategic plan, budget,
    5-2  and performance measures of the agency reflect the joint
    5-3  responsibilities listed in Subsection (f).
    5-4        (h)  The commissioner may solicit the participation of other
    5-5  agencies involved in child and family issues, including
    5-6  institutions of higher education, to accomplish the purposes of
    5-7  this section.
    5-8            (Sections 72.023-72.030 reserved for expansion
    5-9           SUBCHAPTER C.  LOCAL CHILD AND FAMILY COMMISSIONS
   5-10        Sec. 72.031.  DEFINITION.  In this subchapter, "local
   5-11  commission" means a local child and family commission certified by
   5-12  the commission under this subchapter.
   5-13        Sec. 72.032.  CERTIFICATION OF LOCAL COMMISSIONS.  (a)  The
   5-14  commission shall annually solicit applications for new local
   5-15  commissions.  A commissioners court of a county, governing body of
   5-16  a municipality, council of governments, regional planning body or
   5-17  similar entity, or charitable organization that solicits
   5-18  contributions for health and human services may submit a proposal
   5-19  for a local commission.  The commission may accept only one
   5-20  proposal from each county.
   5-21        (b)  A proposal submitted under this section must:
   5-22              (1)  demonstrate that the applicant has consulted with
   5-23  local governments and other public entities, nonprofit
   5-24  organizations, voluntary associations, representatives of
   5-25  low-income persons, and other groups involved in providing health
    6-1  and human services or funding for those services about the needs of
    6-2  the community and how to meet those needs; and
    6-3              (2)  identify the proposed membership of the local
    6-4  commission.
    6-5        (c)  The commission shall adopt rules governing the
    6-6  certification and operation of local commissions and the method of
    6-7  selection of local commission members.
    6-8        (d)  A local commission may serve one or more counties, but a
    6-9  county may not be served by more than one local commission.
   6-10        (e)  If the commission receives a proposal for a local
   6-11  commission that conforms to commission rules, the commission shall
   6-12  certify that local commission.  A local commission is established
   6-13  when it is certified by the commission.
   6-14        (f)  Certification by the commission under Subsection (e) is
   6-15  subject to:
   6-16              (1)  an express appropriation for that purpose; or
   6-17              (2)  an appropriation funding the grant program under
   6-18  Subchapter D.
   6-19        Sec. 72.033.  MEMBERSHIP OF LOCAL COMMISSIONS.  (a)  A local
   6-20  commission must include:
   6-21              (1)  a member of the governing body of the most
   6-22  populous municipality located in the county and a member of the
   6-23  governing body of one other municipality located in the county;
   6-24              (2)  a member of the commissioners court of the county;
   6-25              (3)  a school superintendent from a school district in
    7-1  the county;
    7-2              (4)  a representative chosen by the local juvenile
    7-3  board;
    7-4              (5)  the executive director of the local mental health
    7-5  authority or the executive director's designee;
    7-6              (6)  a child protective services administrator
    7-7  designated by the regional office of the Department of Protective
    7-8  and Regulatory Services;
    7-9              (7)  the regional administrator of the Texas Department
   7-10  of Health or the regional administrator's designee;
   7-11              (8)  a representative of a charitable organization that
   7-12  solicits contributions for health and human services;
   7-13              (9)  not fewer than two representatives of civic,
   7-14  religious, or community-based organizations; and
   7-15              (10)  a person eligible for child and family services.
   7-16        (b)  Representatives of agencies or organizations that
   7-17  provide services may not constitute a majority of the membership of
   7-18  a local commission.
   7-19        (c)  An applicant for certification under Section 72.032
   7-20  shall attempt to ensure participation on the local commission by
   7-21  women and minorities, including African Americans, Hispanic
   7-22  Americans, Native Americans, and Asian Americans.
   7-23        (d)  The commission by rule may:
   7-24              (1)  specify additional qualifications for members of
   7-25  local commissions if necessary to qualify for federal funds; and
    8-1              (2)  modify the membership requirements for a local
    8-2  commission established jointly by two or more counties.
    8-3        Sec. 72.034.  ADMINISTRATION OF LOCAL COMMISSIONS.  (a)  The
    8-4  members of a local commission serve staggered two-year terms with
    8-5  as near as possible to half of the members' terms expiring February
    8-6  1 of each year.  The members shall draw lots at the first
    8-7  commission meeting to determine the length of each member's initial
    8-8  term and the member's terms that expire each year.  The members
    8-9  shall choose new members by vote before the outgoing members leave
   8-10  office.
   8-11        (b)  Members of a local commission serve without
   8-12  compensation, but a member may be reimbursed for actual expenses
   8-13  incurred in the performance of the member's official duties.
   8-14  Expenses under this subsection must be reported in the local
   8-15  commission's records and must be approved by the commission.
   8-16        Sec. 72.035.  POWERS, DUTIES, AND RESPONSIBILITIES OF LOCAL
   8-17  COMMISSIONS.  (a)  A local commission shall:
   8-18              (1)  assess the need for child and family services and
   8-19  available resources in the community served by the local
   8-20  commission;
   8-21              (2)  monitor the effectiveness and efficiency with
   8-22  which public and private organizations that receive public money
   8-23  deliver child and family services;
   8-24              (3)  develop and submit to the commission local
   8-25  strategic plans for services for children and families that are
    9-1  related to the purposes of this chapter listed under Section
    9-2  72.001, including local budgetary priorities and proposals for
    9-3  alternative delivery systems;
    9-4              (4)  mobilize public, business, and voluntary agency
    9-5  partnerships and promote the use of individual volunteers;
    9-6              (5)  foster the development of new services to meet
    9-7  family needs more effectively, including services aimed at
    9-8  preventing child abuse, poverty, malnutrition, failure in school,
    9-9  juvenile delinquency, and other social ills;
   9-10              (6)  ensure fiscal efficiency by maximizing the use of
   9-11  local, state, and federal funds, as appropriate; and
   9-12              (7)  ensure program effectiveness and fiscal
   9-13  accountability in the delivery of child and family services.
   9-14        (b)  A local commission has all of the powers necessary for
   9-15  the effective operation of the local commission, including the
   9-16  power to:
   9-17              (1)  contract for assistance in administration or
   9-18  management of the commission, and for services to administer its
   9-19  funds;
   9-20              (2)  pay all operating expenses by warrants drawn on
   9-21  funds available for that purpose; and
   9-22              (3)  accept gifts and grants from any source to finance
   9-23  its programs and facilities.
   9-24        Sec. 72.036.  LOCAL GRANTS; NOTICE.  (a)  A municipality,
   9-25  county, or political subdivision may provide a grant to a local
   10-1  commission to achieve the purposes of this chapter.
   10-2        (b)  A local commission shall allow adequate notice and
   10-3  opportunity for public comment, including comments from the
   10-4  entities listed in Section 72.032(b)(1) before contracting for
   10-5  services.
   10-6        Sec. 72.037.  ANNUAL AUDIT.  (a)  A local commission shall
   10-7  contract with an independent auditor for an annual financial audit.
   10-8        (b)  The state auditor shall, with the advice of the
   10-9  commission, develop standardized forms and schedules for a local
  10-10  commission to use in conducting an annual financial audit.  A local
  10-11  commission shall use the forms and schedules developed by the state
  10-12  auditor for its annual financial audit.
  10-13        Sec. 72.038.  LIMITATION OF LIABILITY.  (a)  A local
  10-14  commission is a governmental unit for purposes of Chapter 101,
  10-15  Civil Practice and Remedies Code.
  10-16        (b)  A member of a local commission is not liable for civil
  10-17  damages for any act performed in good faith in the execution of
  10-18  duties as a commission member or for an action taken by the
  10-19  commission.
  10-20            (Sections 72.039-72.050 reserved for expansion
  10-21       SUBCHAPTER D.  STATE GRANTS AND STATE AGENCY COOPERATION
  10-22        Sec. 72.051.  FUNDS AVAILABILITY.  (a)  In conjunction with
  10-23  the agencies listed under Section 72.022(a) and the Legislative
  10-24  Budget Board, the commission shall develop a budget mechanism to:
  10-25              (1)  combine state and federal funds to provide grants
   11-1  to local child and family commissions established under Subchapter
   11-2  C; and
   11-3              (2)  distribute grant funds that may be appropriated by
   11-4  the legislature for local child and family commissions.
   11-5        (b)  The Legislative Budget Board, at the request of the
   11-6  commission, may transfer appropriations from state child-serving
   11-7  agencies to the commission in accordance with Subsection (a)(1).
   11-8        (c)  A grant to a local child and family commission made
   11-9  under this section must:
  11-10              (1)  be distributed locally for services that promote
  11-11  the social, emotional, or physical well-being of children and
  11-12  promote family support; and
  11-13              (2)  be matched by local resources, in cash or in kind,
  11-14  equal to at least one-quarter of the grant amount, except as
  11-15  provided by Subsection (e).
  11-16        (d)  The commission by rule shall provide for the
  11-17  distribution of available funds based on a county's child
  11-18  population and per capita income.
  11-19        (e)  The commission may modify the match amount required by
  11-20  Subsection (c) if the modification is necessary to accomplish the
  11-21  effective distribution of funds.  If the commission modifies the
  11-22  match formula, the modification shall apply to all applicants for
  11-23  funds under this section.
  11-24        (f)  The commission may retain not more than two percent of
  11-25  any funds appropriated for state grants under this section and may
   12-1  use those funds only for the administration of the grant program at
   12-2  the state level and for carrying out the duties prescribed by
   12-3  Section 72.022.
   12-4        Sec. 72.052.  COMMUNITY ASSISTANCE GRANTS.  (a)  The
   12-5  commission by rule shall provide a procedure by which it may make a
   12-6  small assistance grant to a local community on its certification to
   12-7  provide an incentive to establish a local child and family
   12-8  commission and support its initial operation.
   12-9        (b)  If funds are available, the commission may provide an
  12-10  assistance grant to a local community on certification of a local
  12-11  child and family commission.  A grant under this subsection:
  12-12              (1)  must be in proportion to the child population of
  12-13  the county, not to exceed $50,000 in a large urban area;
  12-14              (2)  must be matched by local resources, in cash or in
  12-15  kind, equal to at least one-half of the amount of the assistance
  12-16  grant; and
  12-17              (3)  may not be for a period greater than one year.
  12-18        Sec. 72.053.  COOPERATION WITH STATE AGENCIES; PERSONNEL.
  12-19  (a)  A local child and family commission shall cooperate with the
  12-20  commission in setting performance standards and evaluating results
  12-21  for child and family programs for which the local commission and
  12-22  the commission have responsibilities.
  12-23        (b)  The commission shall assist local child and family
  12-24  commissions in obtaining state employees to work under local
  12-25  supervision while engaged in programs serving children and
   13-1  families.
   13-2        (c)  A state agency must receive approval for a new program
   13-3  in the health and human services area in a community that has a
   13-4  local child and family commission.
   13-5            (Sections 72.054-72.070 reserved for expansion
   13-6                SUBCHAPTER E.  MISCELLANEOUS PROVISIONS
   13-7        Sec. 72.071.  COLLABORATION AGREEMENTS.  (a)  State and local
   13-8  agencies that serve children and families, including local child
   13-9  and family commissions established under Subchapter C, may enter
  13-10  into collaboration agreements to accomplish the purposes prescribed
  13-11  by Section 72.001.
  13-12        (b)  A collaboration agreement may involve education,
  13-13  vocational rehabilitation, health, mental health, employment and
  13-14  training, child welfare, social services, juvenile justice, and
  13-15  other services or programs designated by the commission.
  13-16        Sec. 72.072.  FUNDS.  All funds received by the commission
  13-17  under this chapter are subject to Subchapter F, Chapter 404,
  13-18  Government Code.
  13-19        SECTION 2.  Chapter 32, Health and Safety Code, is amended by
  13-20  adding Section 32.022 to read as follows:
  13-21        Sec. 32.022.  PRENATAL CARE PUBLIC AWARENESS PROGRAM.  (a)
  13-22  The department shall establish a program to promote public
  13-23  awareness of the importance of prenatal care.
  13-24        (b)  The public awareness program shall:
  13-25              (1)  focus on the benefits of early and ongoing
   14-1  prenatal care, including the reduction of low birth weights and
   14-2  infant mortality; and
   14-3              (2)  target low-income areas of the state.
   14-4        (c)  To conduct the public awareness program required by this
   14-5  section, the department shall utilize, among other resources, the
   14-6  network of local coalitions developed by the department to promote
   14-7  its immunization public awareness program.
   14-8        SECTION 3.  (a)  In accordance with Section 72.022, Human
   14-9  Resources Code, as added by this Act, the commissioner of health
  14-10  and human services, in collaboration with the agencies listed in
  14-11  Section 72.022(a), Human Resources Code, shall coordinate the
  14-12  program services, eligibility requirements, funding, enrollment
  14-13  periods, fees, and administrative functions of the following
  14-14  programs by no later than December 1, 1997:
  14-15              (1)  the child care programs of the Texas Department of
  14-16  Human Services;
  14-17              (2)  the prekindergarten programs of the Central
  14-18  Education Agency; and
  14-19              (3)  the federal Head Start programs.
  14-20        (b)  The commissioner of health and human services shall
  14-21  report the results of the initiative prescribed by this Act to
  14-22  coordinate the delivery of services to children and families to the
  14-23  legislature on or before December 1, 1997.
  14-24        SECTION 4.  (a)  The Texas Department of Health shall develop
  14-25  a plan to increase accessibility of dental services for children
   15-1  that targets children who are eligible for but are not receiving
   15-2  medical assistance.  In developing the plan, the department shall:
   15-3              (1)  explore the extent of services needed to reach all
   15-4  eligible children;
   15-5              (2)  determine the most appropriate age to target
   15-6  children for preventive services;
   15-7              (3)  determine how to better use preventive care;
   15-8              (4)  examine the expansion of school-based services for
   15-9  early diagnostic screening;
  15-10              (5)  consider the need for dental equipment, including
  15-11  mobile units, portable equipment, and computer equipment;
  15-12              (6)  consider involving private practitioners by
  15-13  exploring the following possibilities:
  15-14                    (A)  increasing compensation for services;
  15-15                    (B)  forgiving school loans for participating
  15-16  dentists;
  15-17                    (C)  requiring 40 hours a year of mandatory
  15-18  services for children in the early and periodic screening,
  15-19  diagnosis, and treatment program or for other children eligible for
  15-20  state services; and
  15-21                    (D)  creating a formal structure to bring
  15-22  dentists into schools;
  15-23              (7)  investigate alternative methods to educate parents
  15-24  about the causes and prevention of baby bottle tooth decay; and
  15-25              (8)  consider requiring fluoridation of all major water
   16-1  supplies.
   16-2        (b)  Using existing departmental resources, the department
   16-3  shall prepare the plan required by this section and the projected
   16-4  budget for that plan not later than September 1, 1996.  The Texas
   16-5  Board of Health may appoint a special task force to help the
   16-6  department in preparing this plan.  The department shall present
   16-7  the plan and budget to the 75th Legislature not later than
   16-8  February 1, 1997.
   16-9        (c)  This section expires June 1, 1997.
  16-10        SECTION 5.  (a)  The Texas Department of Mental Health and
  16-11  Mental Retardation shall develop a plan for providing services to
  16-12  children with severe mental or emotional disorders who require
  16-13  residential treatment.  The plan must provide:
  16-14              (1)  that residential treatment and related services
  16-15  for children be provided regionally;
  16-16              (2)  for a child who has a functional family to remain
  16-17  in parental custody while receiving treatment or related services;
  16-18              (3)  for coordination of state mental health facilities
  16-19  and community service providers;
  16-20              (4)  specific legislative recommendations for statutory
  16-21  authority to pool funds used by various state agencies to provide
  16-22  residential treatment and related services to children;
  16-23              (5)  to the extent practicable, that funds available
  16-24  under Title IV-E, federal Social Security Act (42 U.S.C. Section
  16-25  670 et seq.) pay for services for those children who are
   17-1  Medicaid-eligible and in need of residential treatment; and
   17-2              (6)  that third-party payor financial resources are
   17-3  exhausted before state money is used.
   17-4        (b)  In developing the plan, the Texas Department of Mental
   17-5  Health and Mental Retardation shall consider whether to include in
   17-6  the plan provisions:
   17-7              (1)  to establish and employ indicators to identify
   17-8  children with mental or emotional disorders who would be better
   17-9  served outside of the home;
  17-10              (2)  to use community mental health centers or
  17-11  community resources to review children's cases individually;
  17-12              (3)  to create therapeutic group homes in communities;
  17-13  and
  17-14              (4)  for payment of services on a sliding scale.
  17-15        (c)  The Texas Department of Mental Health and Mental
  17-16  Retardation shall complete the plan, together with an estimated
  17-17  budget and recommendations for statutory changes necessary or
  17-18  convenient to implement the plan, not later than January 15, 1997.
  17-19  On completion, the department shall submit the plan to the governor
  17-20  and the legislature.
  17-21        (d)  This section expires June 1, 1997.
  17-22        SECTION 6.  (a)  The comptroller shall establish a pilot
  17-23  project to determine the effectiveness of using investment
  17-24  budgeting to measure the cost-effectiveness of certain children's
  17-25  prevention services.
   18-1        (b)  As part of the investment budgeting process, the
   18-2  comptroller shall:
   18-3              (1)  establish clear visions and goals and measurable
   18-4  outcomes that clarify those visions and goals;
   18-5              (2)  establish and estimate the value of the outcomes
   18-6  the comptroller wants to achieve;
   18-7              (3)  estimate the unit cost of achieving those
   18-8  outcomes; and
   18-9              (4)  compute the anticipated return on investing in
  18-10  programs to achieve those outcomes.
  18-11        (c)  The comptroller shall consider including the children's
  18-12  immunization programs in determining which children's prevention
  18-13  services will be examined in the pilot project.
  18-14        (d)  Not later than January 15, 1997, the comptroller shall
  18-15  submit to the governor and the 75th Legislature a report concerning
  18-16  the effectiveness of the pilot project.
  18-17        (e)  This section expires September 1, 1997.
  18-18        SECTION 7.  The Texas Department of Health shall establish
  18-19  the prenatal care public awareness program required by Section
  18-20  32.022, Health and Safety Code, as added by this Act, not later
  18-21  than January 1, 1996.
  18-22        SECTION 8.  This Act takes effect September 1, 1995.
  18-23        SECTION 9.  The importance of this legislation and the
  18-24  crowded condition of the calendars in both houses create an
  18-25  emergency and an imperative public necessity that the
   19-1  constitutional rule requiring bills to be read on three several
   19-2  days in each house be suspended, and this rule is hereby suspended.