77R7316 KKA-D                           
         By Maxey                                              H.B. No. 1213
         Substitute the following for H.B. No. 1213:
         By Villarreal                                     C.S.H.B. No. 1213
                                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.