1-1 By: McDonald, Coleman, et al. H.B. No. 1409 1-2 (Senate Sponsor - Turner) 1-3 (In the Senate - Received from the House March 29, 1995; 1-4 March 29, 1995, read first time and referred to Committee on 1-5 Criminal Justice; April 5, 1995, reported adversely, with favorable 1-6 Committee Substitute by the following vote: Yeas 4, Nays 0; 1-7 April 5, 1995, sent to printer.) 1-8 COMMITTEE SUBSTITUTE FOR H.B. No. 1409 By: Turner 1-9 A BILL TO BE ENTITLED 1-10 AN ACT 1-11 relating to children and family issues, including health and human 1-12 services issues. 1-13 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-14 SECTION 1. Subtitle B, Title 3, Human Resources Code, is 1-15 amended by adding Chapter 72 to read as follows: 1-16 CHAPTER 72. LOCAL AND STATE COORDINATION OF DELIVERY OF 1-17 SERVICES TO CHILDREN AND FAMILIES 1-18 SUBCHAPTER A. GENERAL PROVISIONS 1-19 Sec. 72.001. PURPOSE. The purpose of this chapter is to 1-20 improve child and family services by encouraging local solutions, 1-21 building partnerships between the state and local communities, and 1-22 eliminating regulatory barriers which prevent public, private, and 1-23 non-profit programs from working together. By improving child and 1-24 family services, the Legislature hopes to increase the likelihood 1-25 that Texas children will: 1-26 (1) live in stable, nurturing, and supportive 1-27 families; 1-28 (2) be mentally and physically healthy; 1-29 (3) enter school able to learn to their fullest 1-30 potential and be able to succeed in school; and 1-31 (4) develop into productive, law-abiding citizens. 1-32 Sec. 72.002. DEFINITIONS. In this chapter: 1-33 (1) "Board" means the Legislative Health and Human 1-34 Services Board created under Chapter 330, Government Code. 1-35 (2) "Child" means a person younger than 19 years of 1-36 age. 1-37 (3) "Commission" means the Health and Human Services 1-38 Commission. 1-39 (4) "Commissioner" means the commissioner of health 1-40 and human services. 1-41 (Sections 72.003-72.020 reserved for expansion 1-42 SUBCHAPTER B. STATE PARTICIPATION IN PARTNERSHIP 1-43 FOR SERVICES TO CHILDREN AND FAMILIES 1-44 Sec. 72.021. DESIGNATED STATE AGENCY. (a) The Health and 1-45 Human Services Commission is the state agency responsible for 1-46 providing leadership to ensure that the purposes of this chapter 1-47 are realized. 1-48 (b) The commission may require health and human service, 1-49 education, and juvenile justice agencies listed under Section 1-50 72.022(a) to provide staff and other administrative support as 1-51 necessary to assist the commission in discharging its 1-52 responsibilities under this section. 1-53 Sec. 72.022. RESPONSIBILITIES OF STATE AGENCIES. (a) In 1-54 conjunction with the commissioner of health and human services, the 1-55 executive director, commissioner, or other executive head, as 1-56 appropriate, of the following state agencies shall ensure that the 1-57 agency cooperates with the commissioner to accomplish the 1-58 objectives of this chapter except when those objectives conflict 1-59 with rules adopted by the elected or appointed board of the agency: 1-60 (1) Central Education Agency; 1-61 (2) Health and Human Services Commission; 1-62 (3) Department of Protective and Regulatory Services; 1-63 (4) Interagency Council on Early Childhood 1-64 Intervention Services; 1-65 (5) Texas Commission on Alcohol and Drug Abuse; 1-66 (6) Texas Commission for the Blind; 1-67 (7) Texas Department of Health; 1-68 (8) Texas Department of Human Services; 2-1 (9) Texas Department of Mental Health and Mental 2-2 Retardation; 2-3 (10) Texas Juvenile Probation Commission; 2-4 (11) Texas Youth Commission; 2-5 (12) Texas Employment Commission; and 2-6 (13) Children's Trust Fund of Texas Council. 2-7 (b) The executive director, commissioner, or other executive 2-8 head of an agency shall designate an employee of the agency to 2-9 represent the agency, under the direction of the executive head, 2-10 and assist the agency in carrying out the objectives of Subsection 2-11 (f). 2-12 (c) The commissioner of health and human services and the 2-13 commissioner of education shall regularly meet with the agency 2-14 representatives to determine the progress made toward accomplishing 2-15 the goals of Subsection (f). 2-16 (d) The representatives of the agencies shall meet at the 2-17 call of the commissioner of health and human services. 2-18 (e) Each agency is responsible for the expenses of that 2-19 agency's representative. An agency representative does not receive 2-20 any additional compensation for representing the agency or for 2-21 carrying out other duties under this chapter. 2-22 (f) The agencies shall collaborate under the direction of 2-23 the commissioner to accomplish the following objectives: 2-24 (1) establishing a system for encouraging and 2-25 supporting the development of local child and family commissions 2-26 throughout the state by, among other means, eliminating 2-27 administrative or regulatory barriers and providing sufficient 2-28 technical assistance to those commissions; 2-29 (2) developing a blueprint for children that 2-30 establishes goals for children, including short-range and 2-31 long-range strategies addressing education, health and human 2-32 services, and juvenile justice issues, and that accomplishes the 2-33 purposes prescribed by Section 72.001; 2-34 (3) defining common, uniform, cross-agency outcome 2-35 measures and a system of evaluation to measure the effects of state 2-36 agency programs for children and families; 2-37 (4) initiating strategies for refinancing children's 2-38 services administered by state agencies to ensure the most 2-39 effective use of federal, state, and local funds; 2-40 (5) submitting a quarterly report to the board on 2-41 progress in meeting the objectives of this subsection; and 2-42 (6) promptly responding, in consultation with the 2-43 board, to other relevant issues which may arise. 2-44 (g) The executive director, commissioner, or other executive 2-45 head of each agency shall ensure that the strategic plan, budget, 2-46 and performance measures of the agency reflect the joint 2-47 responsibilities listed in Subsection (f). 2-48 (h) The commissioner may solicit the participation of other 2-49 agencies involved in child and family issues, including 2-50 institutions of higher education, to accomplish the purposes of 2-51 this section. 2-52 (Sections 72.023-72.030 reserved for expansion 2-53 SUBCHAPTER C. LOCAL CHILD AND FAMILY COMMISSIONS 2-54 Sec. 72.031. DEFINITION. In this subchapter, "local 2-55 commission" means a local child and family commission certified by 2-56 the commission under this subchapter. 2-57 Sec. 72.032. CERTIFICATION OF LOCAL COMMISSIONS. (a) The 2-58 commission may annually solicit applications for new local 2-59 commissions from counties which have not established a local 2-60 commission. A commissioners court of a county, governing body of a 2-61 municipality, council of governments, regional planning body or 2-62 similar entity, charitable organization that solicits contributions 2-63 for health and human services, or an existing child and family 2-64 commission that meets the requirements of Section 72.033 may submit 2-65 a proposal for a local commission. The commission may accept only 2-66 one proposal from each county. 2-67 (b) A proposal submitted under this section must: 2-68 (1) demonstrate that the proposal is a collaborative 2-69 initiative among entities contributing significant funding for 2-70 child and family services within the county; 3-1 (2) demonstrate that the applicant has consulted with 3-2 local governments and other public entities, nonprofit 3-3 organizations, voluntary associations, representatives of 3-4 low-income persons, and other groups involved in providing health 3-5 and human services or funding for those services about the needs of 3-6 the community and how to meet those needs; and 3-7 (3) identify the proposed membership of the local 3-8 commission. 3-9 (c) The commission shall adopt rules for providing technical 3-10 support to the local commissions, assisting them in eliminating 3-11 administrative and regulatory barriers, and certifying and 3-12 monitoring the operation of local commissions. 3-13 (d) A local commission may serve one or more counties, but a 3-14 county may not be served by more than one local commission. 3-15 (e) Subject to available funding, the Health and Human 3-16 Services Commission shall certify a local commission after 3-17 receiving a proposal which conforms to the rules adopted by the 3-18 commission. A local commission is established upon certification 3-19 by the Health and Human Services Commission. 3-20 Sec. 72.033. MEMBERSHIP OF LOCAL COMMISSIONS. (a) A local 3-21 commission must include: 3-22 (1) a member of the governing body of the most 3-23 populous municipality located in the county and a member of the 3-24 governing body of one other municipality located in the county; 3-25 (2) a member of the commissioners court of the county; 3-26 (3) a superintendent or elected school board member 3-27 from any participating public school district in the county; 3-28 (4) a member of the juvenile board which serves the 3-29 county or chief juvenile probation officer within the county; 3-30 (5) not fewer than two parents who are current or 3-31 former recipients of child and family services; 3-32 (6) representatives from business, religious, civic, 3-33 and community-based organizations; 3-34 (7) a representative of a charitable organization that 3-35 solicits contributions for health and human services; 3-36 (8) the executive director of the local mental health 3-37 authority or the executive director's designee; 3-38 (9) the regional administrator of the Texas Department 3-39 of Health or the regional administrator's designee; 3-40 (10) a child protective services administrator or 3-41 designee; 3-42 (11) a representative of the Head Start grantee if 3-43 there is such a grantee in the county; 3-44 (12) the local coordinator for the Department of Human 3-45 Services Child Care Management Service or designee; and 3-46 (13) a member of any other entity that submits the 3-47 proposal for a local commission under Section 72.032(a). 3-48 (b) A local commission may appoint such advisory committees 3-49 as necessary to satisfy requirements for federal funds, to qualify 3-50 representation in the event a local commission is established by 3-51 two or more counties, or to serve specific neighborhoods or 3-52 communities. 3-53 (c) An applicant for certification under Section 72.032 3-54 shall attempt to ensure participation on the local commission by 3-55 women and minorities, including African Americans, Hispanic 3-56 Americans, native Americans, and Asian Americans. 3-57 Sec. 72.034. ADMINISTRATION OF LOCAL COMMISSIONS. (a) The 3-58 members of a local commission serve staggered two-year terms with 3-59 as near as possible to half of the members' terms expiring 3-60 February 1 of each year. The members shall draw lots at the first 3-61 commission meeting to determine the length of each member's initial 3-62 term and the year when each member's term expires. The members 3-63 shall choose new members by vote before the outgoing members leave 3-64 office. At all times the membership of a local commission shall be 3-65 as designated in Section 72.033. 3-66 (b) Members of a local commission serve without 3-67 compensation, but a member may be reimbursed for actual expenses 3-68 incurred in the performance of the member's official duties. 3-69 Expenses under this subsection must be reported in the local 3-70 commission's records and must be approved by the commission. 4-1 Sec. 72.035. POWERS, DUTIES, AND RESPONSIBILITIES OF LOCAL 4-2 COMMISSIONS. (a) A local commission shall: 4-3 (1) facilitate and reward collaboration between child 4-4 and family service providers; 4-5 (2) assess the need for child and family services and 4-6 available resources in the community served by the local 4-7 commission; 4-8 (3) monitor the effectiveness and efficiency with 4-9 which public and private organizations that received public money 4-10 deliver child and family services; 4-11 (4) develop and submit to the commission local 4-12 strategic plans for services for children and families that are 4-13 related to the purposes of this chapter listed under Section 4-14 72.001, including local budgetary priorities and proposals for 4-15 alternative delivery systems; 4-16 (5) mobilize public, business, and voluntary agency 4-17 partnerships and promote the use of individual volunteers; 4-18 (6) foster the development of new services to meet 4-19 family needs more effectively, including services aimed at 4-20 preventing child abuse, poverty, malnutrition, failure in school, 4-21 juvenile delinquency, and other social ills; 4-22 (7) ensure fiscal efficiency by maximizing the use of 4-23 local, state, and federal funds, as appropriate; and 4-24 (8) measure program effectiveness and ensure fiscal 4-25 accountability in the delivery of child and family services. 4-26 (b) A local commission has all of the powers necessary for 4-27 the effective operation of the local commission, including the 4-28 power to: 4-29 (1) contract for assistance in administration or 4-30 management of the commission and for services to administer its 4-31 funds; 4-32 (2) pay all operating expenses by warrants drawn on 4-33 funds available for that purpose; and 4-34 (3) accept gifts and grants from any source to finance 4-35 its programs and facilities. 4-36 Sec. 72.036. LOCAL GRANTS; NOTICE. (a) A municipality, 4-37 county, or political subdivision may provide a grant to a local 4-38 commission to achieve the purposes of this chapter. 4-39 (b) A local commission shall allow adequate notice and 4-40 opportunity for public comment, including comments from the 4-41 entities listed in Section 72.032(b)(1), before contracting for 4-42 services. 4-43 Sec. 72.037. ANNUAL AUDIT. (a) A local commission shall 4-44 contract with an independent auditor for an annual financial audit. 4-45 (b) The state auditor shall, with the advice of the 4-46 commission, develop standardized forms and schedules for a local 4-47 commission to use in conducting an annual financial audit. A local 4-48 commission shall use the forms and schedules developed by the state 4-49 auditor for its annual financial audit. 4-50 Sec. 72.038. LIMITATION OF LIABILITY. (a) A local 4-51 commission is a governmental unit for purposes of Chapter 101, 4-52 Civil Practice and Remedies Code. 4-53 (b) A member of a local commission is not liable for civil 4-54 damages for any act performed in good faith in the execution of 4-55 duties as a commission member or for an action taken by the 4-56 commission. 4-57 (Sections 72.039-72.050 reserved for expansion 4-58 SUBCHAPTER D. STATE GRANTS AND STATE AGENCY COOPERATION 4-59 Sec. 72.051. FUNDS AVAILABILITY. (a) In conjunction with 4-60 the agencies listed under Section 72.022(a) and with the consent of 4-61 the Legislative Budget Board, the commission shall develop a budget 4-62 mechanism to combine state and federal funds to provide grants to 4-63 local child and family commissions established under Subchapter C. 4-64 (b) The Legislative Budget Board, at the request of the 4-65 commission, may transfer appropriations from state child-serving 4-66 agencies to the commission in accordance with Subsection (a)(1). 4-67 (c) The commission shall promulgate rules for the 4-68 distribution of grant funds that may be appropriated by the 4-69 legislature for local child and family commissions. Funds 4-70 appropriated for local commissions may be used for grants under 5-1 this Section or for grants under Section 72.052. 5-2 (d) A grant to a local child and family commission made 5-3 under this section must: 5-4 (1) be distributed locally for services that promote 5-5 the social, emotional, or physical well-being of children and 5-6 promote family support; and 5-7 (2) be matched by local resources, in cash or in kind, 5-8 equal to at least one-quarter of the grant amount, except as 5-9 provided by Subsection (e). 5-10 (e) The commission by rule shall provide for the 5-11 distribution of available funds based on a county's child 5-12 population and per capita income. 5-13 (f) The commission may modify the match amount required by 5-14 Subsection (c) if the modification is necessary to accomplish the 5-15 effective distribution of funds. If the commission modifies the 5-16 match formula, the modification shall apply to all applicants for 5-17 funds under this section. 5-18 (g) The commission may retain not more than two percent of 5-19 any funds appropriated for state grants under this section and may 5-20 use those funds only for the administration of the grant program at 5-21 the state level and for carrying out the duties prescribed by 5-22 Section 72.022. 5-23 (h) The value of an in-kind match of local resources made 5-24 under Subsection (c)(2) is equal to the fair market value of the 5-25 resources received. 5-26 Sec. 72.052. COMMUNITY ASSISTANCE GRANTS. (a) The 5-27 commission by rule may provide a procedure by which it may make a 5-28 one-time assistance grant to a local community on its certification 5-29 to provide an incentive to establish a local child and family 5-30 commission and support its initial operation. 5-31 (b) If funds are available, the commission may provide an 5-32 assistance grant to a local community on certification of a local 5-33 child and family commission. A grant under this subsection: 5-34 (1) must be in proportion to the child population of 5-35 the county, not to exceed $50,000 in a large urban area; and 5-36 (2) must be matched by local resources, in cash or in 5-37 kind, equal to at least one-half of the amount of the assistance 5-38 grant. 5-39 (c) The value of an in-kind match of local resources made 5-40 under Subsection (b)(2) is equal to the fair market value of the 5-41 resources received. 5-42 Sec. 72.053. COOPERATION WITH STATE AGENCIES; PERSONNEL. 5-43 (a) A local child and family commission shall cooperate with the 5-44 commission in setting performance standards and evaluating results 5-45 for child and family programs for which the local commission and 5-46 the commission are responsible. 5-47 (b) The commission may assist local child and family 5-48 commissions in coordinating the efforts of state employees involved 5-49 in child and family programs developed by local commissions. 5-50 (Sections 72.054-72.070 reserved for expansion 5-51 SUBCHAPTER E. MISCELLANEOUS PROVISIONS 5-52 Sec. 72.071. COLLABORATION AGREEMENTS. (a) State and local 5-53 agencies that serve children and families, including local child 5-54 and family commissions established under Subchapter C, may enter 5-55 into collaboration agreements to accomplish the purposes prescribed 5-56 by Section 72.001. 5-57 (b) A collaboration agreement may involve education, 5-58 vocational rehabilitation, health, mental health, employment and 5-59 training, child welfare, social services, juvenile justice, and 5-60 other services or programs designated by the commission. 5-61 Sec. 72.072. FUNDS. All funds received by the commission 5-62 under this chapter are subject to Subchapter F, Chapter 404, 5-63 Government Code. 5-64 SECTION 2. Chapter 32, Health and Safety Code, is amended by 5-65 adding Section 32.022 to read as follows: 5-66 Sec. 32.022. PRENATAL CARE PUBLIC AWARENESS PROGRAM. 5-67 (a) The department shall establish a program to promote public 5-68 awareness of the importance of prenatal care. 5-69 (b) The public awareness program shall: 5-70 (1) focus on the benefits of early and ongoing 6-1 prenatal care, including the reduction of low birth weights and 6-2 infant mortality; and 6-3 (2) target low-income areas of the state. 6-4 (c) The public awareness program shall not provide 6-5 counseling or referral regarding abortion or abortion services. 6-6 (d) To conduct the public awareness program required by this 6-7 section, the department shall utilize, among other resources, the 6-8 network of local coalitions developed by the department to promote 6-9 its immunization public awareness program. 6-10 SECTION 3. (a) The commissioner of health and human 6-11 services, in collaboration with the state agencies listed in this 6-12 section and the Regional Administration for Children and Families 6-13 Head Start Bureau shall coordinate the program services, 6-14 eligibility requirements, funding, enrollment periods, fees, and 6-15 administrative functions of the following programs by no later than 6-16 December 1, 1996: 6-17 (1) the child care programs of the Texas Department of 6-18 Human Services; 6-19 (2) the prekindergarten programs of the Central 6-20 Education Agency; and 6-21 (3) the federal Head Start programs. 6-22 (b) The commissioner of health and human services shall 6-23 report the results of the initiative prescribed by this Act to 6-24 coordinate the delivery of services to children and families to the 6-25 legislature on or before December 1, 1996. 6-26 SECTION 4. (a) The Texas Department of Health shall develop 6-27 a plan to increase accessibility of dental services for children 6-28 that targets children who are eligible for but are not receiving 6-29 medical assistance. In developing the plan, the department shall: 6-30 (1) explore the extent of services needed to reach all 6-31 eligible children; 6-32 (2) determine the most appropriate age to target 6-33 children for preventive services; 6-34 (3) determine how to better use preventive care; 6-35 (4) examine the expansion of school-based services for 6-36 early diagnostic screening; 6-37 (5) consider the need for dental equipment, including 6-38 mobile units, portable equipment, and computer equipment; 6-39 (6) consider involving private practitioners by 6-40 exploring the following possibilities: 6-41 (A) increasing compensation for services; 6-42 (B) forgiving school loans for participating 6-43 dentists; 6-44 (C) requiring 40 hours a year of mandatory 6-45 services for children in the early and periodic screening, 6-46 diagnosis, and treatment program or for other children eligible for 6-47 state services; and 6-48 (D) creating a formal structure to bring 6-49 dentists into schools; 6-50 (7) investigate alternative methods to educate parents 6-51 about the causes and prevention of baby bottle tooth decay; and 6-52 (8) consider requiring fluoridation of all major water 6-53 supplies. 6-54 (b) Using existing departmental resources, the department 6-55 shall prepare the plan required by this section and the projected 6-56 budget for that plan not later than September 1, 1996. The Texas 6-57 Board of Health may appoint a special task force to help the 6-58 department in preparing this plan. The department shall present 6-59 the plan and budget to the 75th Legislature. 6-60 (c) This section expires June 1, 1997. 6-61 SECTION 5. (a) The Texas Department of Mental Health and 6-62 Mental Retardation, Central Education Agency, and the Department of 6-63 Protective and Regulatory Services shall jointly develop a plan for 6-64 providing services to children with severe mental or emotional 6-65 disorders who require residential treatment. The plan must 6-66 provide: 6-67 (1) that residential treatment and related services 6-68 for children be provided regionally; 6-69 (2) for a child who has a functional family to remain 6-70 in parental custody while receiving treatment or related services; 7-1 (3) for coordination of state mental health facilities 7-2 and community service providers; 7-3 (4) specific legislative recommendations for statutory 7-4 authority to pool funds used by various state agencies to provide 7-5 residential treatment and related services to children; 7-6 (5) to the extent practicable, that funds available 7-7 under Title IV-E, federal Social Security Act (42 U.S.C. Section 7-8 670 et seq.), pay for services for those children who are 7-9 Medicaid-eligible and in need of residential treatment; and 7-10 (6) that third-party payor financial resources are 7-11 exhausted before state money is used. 7-12 (b) In developing the plan, the Texas Department of Mental 7-13 Health and Mental Retardation shall consider whether to include in 7-14 the plan provisions: 7-15 (1) to establish and employ indicators to identify 7-16 children with mental or emotional disorders who would be better 7-17 served outside of the home; 7-18 (2) to use community mental health centers or 7-19 community resource coordinating groups to review children's cases 7-20 individually; 7-21 (3) to create therapeutic group homes in communities; 7-22 and 7-23 (4) for payment of services on a sliding scale. 7-24 (c) The Texas Department of Mental Health and Mental 7-25 Retardation shall complete the plan, together with an estimated 7-26 budget and recommendations for statutory changes necessary or 7-27 convenient to implement the plan, not later than January 15, 1997. 7-28 On completion, the department shall submit the plan to the governor 7-29 and the legislature. 7-30 (d) This section expires June 1, 1997. 7-31 SECTION 6. (a) The comptroller shall establish a pilot 7-32 project to determine the effectiveness of using investment 7-33 budgeting to measure the cost-effectiveness of certain children's 7-34 prevention services. 7-35 (b) As part of the investment budgeting process, the 7-36 comptroller shall: 7-37 (1) establish clear visions and goals and measurable 7-38 outcomes that clarify those visions and goals; 7-39 (2) establish and estimate the value of the outcomes 7-40 the comptroller wants to achieve; 7-41 (3) estimate the unit cost of achieving those 7-42 outcomes; and 7-43 (4) compute the anticipated return on investing in 7-44 programs to achieve those outcomes. 7-45 (c) The comptroller shall consider including the children's 7-46 immunization programs in determining which children's prevention 7-47 services will be examined in the pilot project. 7-48 (d) Not later than January 15, 1997, the comptroller shall 7-49 submit to the governor and the 75th Legislature a report concerning 7-50 the effectiveness of the pilot project. 7-51 (e) This section expires September 1, 1997. 7-52 SECTION 7. The Texas Department of Health shall establish 7-53 the prenatal care public awareness program required by Section 7-54 32.022, Health and Safety Code, as added by this Act, not later 7-55 than January 1, 1996. 7-56 SECTION 8. This Act takes effect September 1, 1995. 7-57 SECTION 9. The importance of this legislation and the 7-58 crowded condition of the calendars in both houses create an 7-59 emergency and an imperative public necessity that the 7-60 constitutional rule requiring bills to be read on three several 7-61 days in each house be suspended, and this rule is hereby suspended. 7-62 * * * * *