By Maxey H.B. No. 1213 77R7316 KKA-D A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to creation and implementation by the Health and Human 1-3 Services Commission of family-based alternatives to the 1-4 institutionalization of children. 1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-6 SECTION 1. Subchapter B, Chapter 531, Government Code, is 1-7 amended by adding Section 531.055 to read as follows: 1-8 Sec. 531.055. FAMILY-BASED ALTERNATIVES FOR CHILDREN. (a) 1-9 The purpose of the system of family-based alternatives required by 1-10 this section is to further the state's policy of providing for a 1-11 child's basic needs for safety, security, and stability through 1-12 ensuring that a child becomes a part of a successful permanent 1-13 family as soon as possible. 1-14 (b) In achieving the purpose described by Subsection (a), 1-15 the system is intended to be operated in a manner that recognizes 1-16 that parents are a valued and integral part of the process 1-17 established under the system. The system shall encourage parents to 1-18 participate in all decisions affecting their children and shall 1-19 respect the authority of parents, other than parents whose parental 1-20 rights have been terminated, to make decisions regarding their 1-21 children. 1-22 (c) In this section: 1-23 (1) "Child" means a person younger than 22 years of 1-24 age who has a physical or developmental disability or who is 2-1 medically fragile. 2-2 (2) "Family-based alternative" means a family setting 2-3 in which the family provider or providers are specially trained to 2-4 provide support and in-home care for children with disabilities or 2-5 children who are medically fragile. 2-6 (3) "Institution" means any congregate care facility, 2-7 including: 2-8 (A) a nursing home; 2-9 (B) an ICF-MR facility, as defined by Section 2-10 531.002, Health and Safety Code; 2-11 (C) a group home operated by the Texas 2-12 Department of Mental Health and Mental Retardation; and 2-13 (D) an institution for the mentally retarded 2-14 licensed by the Department of Protective and Regulatory Services. 2-15 (4) "Waiver services" means services provided under: 2-16 (A) the Medically Dependent Children Program; 2-17 (B) the Community Living Assistance and Support 2-18 Services Program; 2-19 (C) the Home and Community-based Waiver Services 2-20 Program, including the HCS-OBRA Program; 2-21 (D) the Mental Retardation-Local Authority Pilot 2-22 Project (MRLA); 2-23 (E) the Deaf, Blind, and Multiply Disabled 2-24 Program; and 2-25 (F) any other Section 1915(c) waiver program 2-26 that provides long-term care services for children. 2-27 (d) The commission shall contract with a community 3-1 organization, including a faith-based community organization, or a 3-2 nonprofit organization for the development and implementation of a 3-3 system under which a child who cannot reside with the child's birth 3-4 family may receive necessary services in a family-based alternative 3-5 instead of an institution. To be eligible for the contract under 3-6 this subsection, an organization must possess knowledge regarding 3-7 the support needs of children with disabilities and their families. 3-8 For purposes of this subsection, a community organization, 3-9 including a faith-based community organization, or a nonprofit 3-10 organization does not include: 3-11 (1) any governmental entity; or 3-12 (2) any quasi-governmental entity to which a state 3-13 agency delegates its authority and responsibility for planning, 3-14 supervising, providing, or ensuring the provision of state 3-15 services. 3-16 (e) The contractor may subcontract for one or more 3-17 components of implementation of the system with: 3-18 (1) community organizations, including faith-based 3-19 community organizations; 3-20 (2) nonprofit organizations; 3-21 (3) governmental entities; or 3-22 (4) quasi-governmental entities to which state 3-23 agencies delegate authority and responsibility for planning, 3-24 supervising, providing, or ensuring the provision of state 3-25 services. 3-26 (f) The commission shall begin implementation of the system 3-27 in areas of this state with high numbers of children who reside in 4-1 institutions. 4-2 (g) Each affected health and human services agency shall 4-3 cooperate with the contractor and any subcontractors and take all 4-4 action necessary to implement the system and comply with the 4-5 requirements of this section. The commission has final authority 4-6 to make any decisions and resolve any disputes regarding the 4-7 system. 4-8 (h) The system may be administered in cooperation with 4-9 public and private entities. 4-10 (i) The system must provide for: 4-11 (1) recruiting and training alternative families to 4-12 provide services for children; 4-13 (2) comprehensively assessing each child in need of 4-14 services and each alternative family available to provide services, 4-15 as necessary to identify the most appropriate alternative family 4-16 for placement of the child; 4-17 (3) providing to a child's parents or guardian 4-18 information regarding the availability of a family-based 4-19 alternative; 4-20 (4) identifying each child residing in an institution 4-21 and offering support services, including waiver services, that 4-22 would enable the child to return to the child's birth family or be 4-23 placed in a family-based alternative; and 4-24 (5) determining through a child's permanency plan 4-25 other circumstances in which the child must be offered waiver 4-26 services, including circumstances in which changes in an 4-27 institution's status affect the child's placement or the quality of 5-1 services received by the child. 5-2 (j) In complying with the requirement imposed by Subsection 5-3 (i)(3), the commission shall ensure that the procedures for 5-4 providing information to parents or a guardian permit and encourage 5-5 the participation of an individual who is not affiliated with the 5-6 institution in which the child resides or with an institution in 5-7 which the child could be placed. 5-8 (k) In placing a child in a family-based alternative, the 5-9 system may use a variety of placement options, including an 5-10 arrangement in which shared parenting occurs between the 5-11 alternative family and the child's birth family. Regardless of the 5-12 option used, a family-based alternative placement must be designed 5-13 to be a long-term arrangement, except in cases in which the child's 5-14 birth family chooses to return the child to their home. In cases 5-15 in which the birth family's parental rights have been terminated, 5-16 adoption of the child by the child's alternative family is an 5-17 available option. 5-18 (l) The commission or the contractor may solicit and accept 5-19 gifts, grants, and donations to support the system's functions 5-20 under this section. 5-21 (m) In designing the system, the commission shall consider 5-22 and, when appropriate, incorporate current research and 5-23 recommendations developed by other public and private entities 5-24 involved in analyzing public policy relating to children residing 5-25 in institutions. 5-26 (n) As necessary to implement this section, the commission 5-27 shall: 6-1 (1) ensure that an appropriate number of openings for 6-2 waiver services that become available as a result of funding for 6-3 the purpose of transferring persons with disabilities into 6-4 community-based services are made available to both children and 6-5 adults; 6-6 (2) ensure that service definitions applicable to 6-7 waiver services are modified as necessary to permit the provision 6-8 of waiver services through family-based alternatives; 6-9 (3) ensure that procedures are implemented for making 6-10 a level of care determination for each child and identifying the 6-11 most appropriate waiver service for the child, including procedures 6-12 under which the director of long-term care for the commission, 6-13 after considering any preference of the child's birth family or 6-14 alternative family, resolves disputes among agencies about the most 6-15 appropriate waiver service; and 6-16 (4) require that the health and human services agency 6-17 responsible for providing a specific waiver service to a child also 6-18 assume responsibility for identifying any necessary transition 6-19 activities or services. 6-20 (o) Not later than January 1 of each year, the commission 6-21 shall report to the legislature on the implementation of the 6-22 system. The report must include a statement of: 6-23 (1) the number of children currently receiving care in 6-24 an institution; 6-25 (2) the number of children placed in a family-based 6-26 alternative under the system during the preceding year; 6-27 (3) the number of children who left an institution 7-1 during the preceding year under an arrangement other than a 7-2 family-based alternative under the system or for another reason 7-3 unrelated to the availability of a family-based alternative under 7-4 the system; 7-5 (4) the number of children waiting for an available 7-6 placement in a family-based alternative under the system; and 7-7 (5) the number of alternative families trained and 7-8 available to accept placement of a child under the system. 7-9 SECTION 2. Effective September 1, 2003, or a later date on 7-10 which the Texas Department of Aging and Disability Services assumes 7-11 the functions of the Texas Department on Aging, as provided by 7-12 Chapter 1505, Acts of the 76th Legislature, Regular Session, 1999, 7-13 a reference in Section 531.055, Government Code, as added by this 7-14 Act, to the commission means the Texas Department of Aging and 7-15 Disability Services. This section of this Act has no effect if the 7-16 Texas Department of Aging and Disability Services does not assume 7-17 the functions of the Texas Department on Aging. 7-18 SECTION 3. Notwithstanding Section 531.055(o), Government 7-19 Code, as added by this Act, the Health and Human Services 7-20 Commission shall submit the report required by that section 7-21 beginning with the report due on January 1, 2003. 7-22 SECTION 4. The Health and Human Services Commission shall: 7-23 (1) take all action necessary to ensure that requests 7-24 for proposals necessary to implement Section 531.055, Government 7-25 Code, as added by this Act, are issued as soon as possible after 7-26 the effective date of this Act; and 7-27 (2) include implementation timelines in any contract 8-1 executed by the commission after receiving responses to the 8-2 requests for proposals. 8-3 SECTION 5. If, before implementing any provision of this Act, 8-4 a state agency determines that a waiver or authorization from a 8-5 federal agency is necessary for implementation of that provision, 8-6 the agency affected by the provision shall request the waiver or 8-7 authorization and may delay implementing that provision until the 8-8 waiver or authorization is granted. 8-9 SECTION 6. This Act takes effect September 1, 2001.