By Maxey H.B. No. 1213 77R5673 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 this section: 1-15 (1) "Child" means a person younger than 22 years of 1-16 age with a physical or developmental disability. 1-17 (2) "Family-based alternative" means a permanent 1-18 living arrangement with the primary feature of an enduring and 1-19 nurturing parental relationship. 1-20 (3) "Institution" means any congregate care facility, 1-21 including: 1-22 (A) a nursing home; 1-23 (B) an ICF-MR facility, as defined by Section 1-24 531.002, Health and Safety Code; 2-1 (C) a group home operated by the Texas 2-2 Department of Mental Health and Mental Retardation; and 2-3 (D) an institution for the mentally retarded 2-4 licensed by the Department of Protective and Regulatory Services. 2-5 (4) "Waiver services" means services provided under: 2-6 (A) the Medically Dependent Children Program; 2-7 (B) the Community Living Assistance and Support 2-8 Services Program; 2-9 (C) the Home and Community-based Waiver Services 2-10 Program, including the HCS-OBRA Program; 2-11 (D) the Mental Retardation-Local Authority Pilot 2-12 Project (MRLA); 2-13 (E) the Deaf, Blind, and Multiply Disabled 2-14 Program; and 2-15 (F) any other Section 1915(c) waiver program 2-16 that provides long-term care services for children. 2-17 (c) The commission shall contract with community 2-18 organizations, including faith-based community organizations, or 2-19 nonprofit organizations for the development and implementation of a 2-20 system under which a child who cannot reside with the child's birth 2-21 family may receive necessary services in a family-based alternative 2-22 instead of an institution. To be eligible for a contract under 2-23 this subsection, an organization must possess knowledge regarding 2-24 the support needs of children with disabilities and their families. 2-25 For purposes of this subsection, a community organization, 2-26 including a faith-based community organization, or a nonprofit 2-27 organization does not include any governmental entity or 3-1 quasi-governmental entity to which a state agency delegates its 3-2 authority and responsibility for planning, supervising, providing, 3-3 or ensuring the provision of state services. 3-4 (d) The commission shall begin implementation of the system 3-5 in areas of this state with high numbers of children who reside in 3-6 institutions. 3-7 (e) Each affected health and human services agency shall 3-8 cooperate with the contractors and take all action necessary to 3-9 implement the system and comply with the requirements of this 3-10 section. The commission has final authority to make any decisions 3-11 and resolve any disputes regarding the system. 3-12 (f) The system must provide for: 3-13 (1) recruiting and training alternative families to 3-14 provide services for children; 3-15 (2) comprehensively assessing each child in need of 3-16 services and each alternative family available to provide services, 3-17 as necessary to identify the most appropriate alternative family 3-18 for placement of the child; 3-19 (3) providing to a child's parents or guardian 3-20 information regarding the availability of a family-based 3-21 alternative; 3-22 (4) making available transition and ongoing long-term 3-23 care support services for each child served under the system and 3-24 all persons associated with the child, including the alternative 3-25 family with whom the child is placed and the child's birth family; 3-26 (5) identifying each child residing in an institution 3-27 and offering support services, including waiver services, that 4-1 would enable the child to return to the child's birth family or be 4-2 placed in a family-based alternative; and 4-3 (6) determining through a child's permanency plan 4-4 other circumstances in which the child must be offered waiver 4-5 services, including circumstances in which changes in an 4-6 institution's status affect the child's placement or the quality of 4-7 services received by the child. 4-8 (g) In complying with the requirement imposed by Subsection 4-9 (f)(3), the commission shall ensure that the procedures for 4-10 providing information to parents or a guardian permit and encourage 4-11 the participation of an individual who is not affiliated with the 4-12 institution in which the child resides or with an institution in 4-13 which the child could be placed. 4-14 (h) In designing the system, the commission shall consider 4-15 and, when appropriate, incorporate current research and 4-16 recommendations developed by other public and private entities 4-17 involved in analyzing public policy relating to children residing 4-18 in institutions. 4-19 (i) As necessary to implement this section, the commission 4-20 shall: 4-21 (1) ensure that waiver services are available 4-22 immediately to each eligible child; 4-23 (2) ensure that service definitions applicable to 4-24 waiver services are modified as necessary to permit the provision 4-25 of waiver services through family-based alternatives; 4-26 (3) ensure that procedures are implemented for making 4-27 a level of care determination for each child and identifying the 5-1 most appropriate waiver service for the child, including procedures 5-2 under which the director of long-term care for the commission, 5-3 after considering any preference of the child's birth family or 5-4 alternative family, resolves disputes among agencies about the most 5-5 appropriate waiver service; and 5-6 (4) require that the health and human services agency 5-7 responsible for providing a specific waiver service to a child also 5-8 assume responsibility for identifying any necessary transition 5-9 activities or services. 5-10 (j) Not later than January 1 of each year, the commission 5-11 shall report to the legislature on the implementation of the 5-12 system. The report must include a statement of: 5-13 (1) the number of children currently receiving care in 5-14 an institution; 5-15 (2) the number of children placed in a family-based 5-16 alternative under the system during the preceding year; 5-17 (3) the number of children who left an institution 5-18 during the preceding year under an arrangement other than a 5-19 family-based alternative under the system or for another reason 5-20 unrelated to the availability of a family-based alternative under 5-21 the system; 5-22 (4) the number of children waiting for an available 5-23 placement in a family-based alternative under the system; and 5-24 (5) the number of alternative families trained and 5-25 available to accept placement of a child under the system. 5-26 SECTION 2. Effective September 1, 2003, or a later date on 5-27 which the Texas Department of Aging and Disability Services assumes 6-1 the functions of the Texas Department on Aging, as provided by 6-2 Chapter 1505, Acts of the 76th Legislature, Regular Session, 1999, 6-3 a reference in Section 531.055, Government Code, as added by this 6-4 Act, to the commission means the Texas Department of Aging and 6-5 Disability Services. This section of this Act has no effect if the 6-6 Texas Department of Aging and Disability Services does not assume 6-7 the functions of the Texas Department on Aging. 6-8 SECTION 3. Notwithstanding Section 531.055(j), Government 6-9 Code, as added by this Act, the Health and Human Services 6-10 Commission shall submit the report required by that section 6-11 beginning with the report due on January 1, 2003. 6-12 SECTION 4. The Health and Human Services Commission shall: 6-13 (1) take all action necessary to ensure that requests 6-14 for proposals necessary to implement Section 531.055, Government 6-15 Code, as added by this Act, are issued as soon as possible after 6-16 the effective date of this Act; and 6-17 (2) include implementation timelines in any contract 6-18 executed by the commission after receiving responses to the 6-19 requests for proposals. 6-20 SECTION 5. If, before implementing any provision of this Act, 6-21 a state agency determines that a waiver or authorization from a 6-22 federal agency is necessary for implementation of that provision, 6-23 the agency affected by the provision shall request the waiver or 6-24 authorization and may delay implementing that provision until the 6-25 waiver or authorization is granted. 6-26 SECTION 6. This Act takes effect September 1, 2001.