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.