HBA-CCH H.B. 2717 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2717 By: Maxey Human Services 3/21/2001 Introduced BACKGROUND AND PURPOSE Currently, there are more than 1,200 children under the age of 21 residing in various Texas institutions, including intermediate care facilities for people with mental retardation (ICF-MRs) and nursing homes. As an alternative to institutionalization, permanency planning is a process undertaken on behalf of children with developmental disabilities that attempts to ensure that all children live with a family. Unfortunately, the Children's Long-term Care Policy Council concluded that the absence of standardized rules, regulations, and polices among health and human service agencies present barriers to implementing sound permanency planning. Furthermore, many institutions may not be aware of current permanency planning requirements and may not know how to develop a permanency plan. House Bill 2717 requires HHSC and other agencies to develop uniform permanency planning procedures. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS House Bill 2717 amends the Government Code to require the Health and Human Services Commission (HHSC) and other appropriate health and human service agencies (agencies) to develop uniform procedures regarding a permanency plan for each child younger than 22 years of age in an institution in Texas. The bill authorizes the Texas Department of Human Services (DHS), the Texas Department of Mental Health and Mental Retardation (MHMR), and the Department of Protective and Regulatory Services (PRS) to delegate each department's duty to develop a permanency plan to a local mental retardation authority or enter into a memorandum of understanding with the local mental retardation authority to develop a permanency plan for each child who is institutionalized or for whom institutionalized care is sought, or contract with a private entity, other than an entity that provides mental retardation services to such a child, to develop a permanency plan for that child. The bill requires an agency that contracts with a private entity to develop a permanency plan to ensure that the entity is provided training in permanency planning and the available resources to assist a child in an institution in making a successful transition to a community-based residence (Sec.531.153). House Bill 2717 sets forth notification procedures regarding the initial placement of a child in an institution (Secs. 531.154 and 531.155). The bill requires DHS or MHMR, as appropriate, to designate a person to serve as a volunteer advocate for a child residing in an institution to assist in developing a permanency plan for the child if the child's parent or guardian requests the assistance, or the institution in which the child is placed cannot locate the child's parent or guardian. The bill sets forth provisions regarding who may serve as an advocate, and requires DHS or MHMR, as appropriate, to provide each advocate with information regarding permanency planning (Sec. 531.156). The bill requires a state agency that receives notice of a child's placement in an institution to ensure that the child is also placed on a waiting list for Medicaid waiver program services no later than 24 hours after the child is initially placed in the institution. The bill requires the parent or guardian of a child placed on a waiting list to determine whether to accept waiver program services when those services are available (Sec. 531.157). HHSC and each appropriate health and human services agency shall require a person who develops a permanency plan for a child residing in an institution to identify and document in the child's permanency plan all ongoing permanency planning efforts at least once during each calendar quarter. The bill provides that the chief executive officer of each agency or the officer's designee (CEO) must approve the placement of a child in an institution. The initial placement of the child in the institution is temporary. The bill requires the CEO to review the child's placement and documented permanency planning efforts at least every calendar quarter and must approve an extension for the child to continue residing in the institution. The commissioner of health and human services (commissioner) is required to review the placement of each child who resides in an institution no later than each six-month anniversary of the date of the child's initial placement. The child may continue to reside in the institution only if the placement is approved by the commissioner on or before each six-month anniversary (Sec.531.159). The bill requires each agency or the agency's designee to determine the extent to which a nursing home, institution, or ICF-MR is complying with the permanency planning requirements as a part of each inspection, survey, or investigation of those institutions (Sec. 531.160). The bill requires the commissioner to submit a semiannual report to the governor and the committees of each house of the legislature that have primary oversight jurisdiction over the health and human services agencies regarding permanency planning efforts and specifies the content of the report (Sec. 531.161). The bill requires the commissioner to conduct a study regarding the method of reimbursement provided for permanency planning activities and modify it as necessary to enhance those activities to support the development of permanency plans (SECTION 2). The provisions of this bill do not affect responsibilities imposed by federal or other state law on a physician or other professional (Sec. 531.162). H.B. 2717 amends the Health and Safety Code to repeal existing provisions regarding permanency planing for children placed in a convalescent or nursing home or related institution (SECTION 3). EFFECTIVE DATE September 1, 2001.