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.