77R10778 KLA-D                           
         By Maxey                                              H.B. No. 2717
         Substitute the following for H.B. No. 2717:
         By Chavez                                         C.S.H.B. No. 2717
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to permanency planning procedures for children in state
 1-3     institutions.
 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-5           SECTION 1. Subchapter D, Chapter 531, Government Code, as
 1-6     added by Chapter 241, Acts of the 75th Legislature, Regular
 1-7     Session, 1997, is amended to read as follows:
 1-8                     SUBCHAPTER D.  PERMANENCY PLANNING
 1-9           Sec. 531.151.  DEFINITIONS. In this subchapter:
1-10                 (1)  "Child" means a person with a developmental
1-11     disability who is younger than 22 years of age.
1-12                 (2)  "Community resource coordination group" means a
1-13     coordination group established under the memorandum of
1-14     understanding adopted under Section 264.003, Family Code.
1-15                 (3)  "Institution" means:
1-16                       (A)  an ICF-MR, as defined by Section 531.002,
1-17     Health and Safety Code;
1-18                       (B)  a group home operated under the authority of
1-19     the Texas Department of Mental Health and Mental Retardation,
1-20     including a residential service provider under a Medicaid waiver
1-21     program  authorized under Section 1915(c) of the federal Social
1-22     Security Act (42 U.S.C. Section 1396n), as amended, that provides
1-23     services at a residence other than the child's home or foster home;
1-24                       (C)  a foster group home or an agency foster
 2-1     group home as defined by Section 42.002, Human Resources Code;
 2-2                       (D)  a nursing facility;
 2-3                       (E)  an institution for the mentally retarded
 2-4     [(C)  a residential facility] licensed by the Department of
 2-5     Protective and Regulatory Services; or
 2-6                       (F) [(D)]  another residential arrangement other
 2-7     than a foster home as defined by Section 42.002, Human Resources
 2-8     Code, that provides care to four or more children who are unrelated
 2-9     to each other.
2-10                 (4) [(2)]  "Permanency planning" means a philosophy and
2-11     planning process that focuses on the outcome of family support by
2-12     facilitating a permanent living arrangement with the primary
2-13     feature of an enduring and nurturing parental relationship.
2-14           Sec. 531.152.  POLICY STATEMENT. It is the policy of the
2-15     state to strive to ensure that the basic needs for safety,
2-16     security, and stability are met for each child in Texas.  A
2-17     successful family is the most efficient and effective way to meet
2-18     those needs.  The state and local communities must work together to
2-19     provide encouragement and support for well-functioning families and
2-20     ensure that each child receives the benefits of being a part of a
2-21     successful permanent family as soon as possible.
2-22           Sec. 531.153.  DEVELOPMENT OF PERMANENCY PLAN. (a)  To
2-23     further the policy stated in Section 531.152 and except as provided
2-24     by Subsection (b), the commission and each appropriate health and
2-25     human services agency shall develop procedures to ensure that a
2-26     permanency plan is developed for each child who resides [residing]
2-27     in an institution in this state on a temporary or long-term basis
 3-1     or with respect to [for] whom the commission or appropriate health
 3-2     and human services agency is notified in advance that institutional
 3-3     care is sought.
 3-4           (b)  The Department of Protective and Regulatory Services
 3-5     shall develop a permanency plan as required by this subchapter for
 3-6     each child who resides in an institution in this state for whom the
 3-7     department has been appointed permanent managing conservator.  The
 3-8     department is not required to develop a permanency plan under this
 3-9     subchapter for a child for whom the department has been appointed
3-10     temporary managing conservator, but may incorporate the
3-11     requirements of this subchapter in a permanency plan developed for
3-12     the child under Section 263.3025, Family Code.
3-13           (c)  In developing procedures under Subsection (a), the
3-14     commission and other appropriate health and human services agencies
3-15     shall develop to the extent possible uniform procedures applicable
3-16     to each of the agencies and each child who is the subject of a
3-17     permanency plan that promote efficiency for the agencies and
3-18     stability for each child.
3-19           (d)  In implementing permanency planning procedures under
3-20     Subsection (a) to develop a permanency plan for each child, the
3-21     Texas Department of Human Services, the Texas Department of Mental
3-22     Health and Mental Retardation, and the Department of Protective and
3-23     Regulatory Services may:
3-24                 (1)  delegate each department's duty to develop a
3-25     permanency plan to a local mental retardation authority, as defined
3-26     by Section 531.002, Health and Safety Code, or enter into a
3-27     memorandum of understanding with the local mental retardation
 4-1     authority to develop the permanency plan for each child who resides
 4-2     in an institution in this state or with respect to whom the
 4-3     department is notified in advance that institutional care is
 4-4     sought;
 4-5                 (2)  contract with a private entity, other than an
 4-6     entity that provides mental retardation services to a child who
 4-7     resides in an institution in this state or with respect to whom the
 4-8     department is notified in advance that institutional care is
 4-9     sought, to develop a permanency plan for that child; or
4-10                 (3)  engage in other appropriate activities to minimize
4-11     the potential conflicts of interest that, in developing the plan,
4-12     may exist or arise between:
4-13                       (A)  the child's mental retardation services
4-14     provider, if applicable; and
4-15                       (B)  the best interest of the child.
4-16           (e)  The Texas Department of Human Services, the Texas
4-17     Department of Mental Health and Mental Retardation, and the
4-18     Department of Protective and Regulatory Services may solicit and
4-19     accept gifts, grants, and donations to support the development of
4-20     permanency plans for children residing in institutions by
4-21     individuals or organizations not employed by or affiliated with
4-22     those institutions.
4-23           (f)  A health and human services agency that contracts with a
4-24     private entity under Subsection (d) to develop a permanency plan
4-25     shall ensure that the entity is provided training regarding the
4-26     permanency planning philosophy under Section 531.151 and available
4-27     resources that will assist a child residing in an institution in
 5-1     making a successful transition to a community-based residence.
 5-2           Sec. 531.154.  NOTIFICATION REQUIRED. (a)  Not later than the
 5-3     third day after the date a child is initially placed in an
 5-4     institution, the institution shall notify:
 5-5                 (1)  the Texas Department of Human Services, if the
 5-6     child is placed in a nursing home;
 5-7                 (2)  the local mental retardation authority, as defined
 5-8     by Section 531.002, Health and Safety Code, where the institution
 5-9     is located, if the child:
5-10                       (A)  is placed in an ICF-MR, as defined by
5-11     Section 531.002, Health and Safety Code; or
5-12                       (B)  is placed by a state or local child
5-13     protective services agency in an institution for the mentally
5-14     retarded licensed by the Department of Protective and Regulatory
5-15     Services;
5-16                 (3)  the community resource coordination group in the
5-17     county of residence of a parent or guardian of the child;
5-18                 (4)  if the child is at least three years of age, the
5-19     school district for the area in which the institution is located;
5-20     and
5-21                 (5)  if the child is less than three years of age, the
5-22     local early intervention program for the area in which the
5-23     institution is located.
5-24           (b)  The Texas Department of Human Services shall notify the
5-25     local mental retardation authority, as defined by Section 531.002,
5-26     Health and Safety Code, of a child's placement in a nursing home if
5-27     the child is known or suspected to suffer from mental retardation
 6-1     or another disability for which the child may receive services
 6-2     through the Texas Department of Mental Health and Mental
 6-3     Retardation.
 6-4           Sec. 531.155.  OFFER OF SERVICES. Each entity receiving
 6-5     notice of the initial placement of a child in an institution under
 6-6     Section 531.154 may contact the child's parent or guardian to
 6-7     ensure that the parent or guardian is aware of:
 6-8                 (1)  services and support that could provide
 6-9     alternatives to placement of the child in the institution;
6-10                 (2)  available placement options; and
6-11                 (3)  opportunities for permanency planning.
6-12           Sec. 531.156.  DESIGNATION OF ADVOCATE. (a)  Except as
6-13     provided by Subsection (b), the Texas Department of Human Services
6-14     shall designate a person, including a member of a community-based
6-15     organization, to serve as a volunteer advocate for a child residing
6-16     in an institution to assist in developing a permanency plan for the
6-17     child if:
6-18                 (1)  the child's parent or guardian requests the
6-19     assistance of an advocate; or
6-20                 (2)  the institution in which the child is placed
6-21     cannot locate the child's parent or guardian.
6-22           (b)  The Texas Department of Mental Health and Mental
6-23     Retardation shall designate the person to serve as a volunteer
6-24     advocate for a child in accordance with Subsection (a) if the child
6-25     resides in an institution operated by the department.
6-26           (c)  The person designated by the Texas Department of Human
6-27     Services or the Texas Department of Mental Health and Mental
 7-1     Retardation to serve as the child's volunteer advocate under this
 7-2     section may be:
 7-3                 (1)  a person selected by the child's parent or
 7-4     guardian, except that the person may not be employed by or under a
 7-5     contract with the institution in which the child resides;
 7-6                 (2)  an adult relative of the child; or
 7-7                 (3)  a representative of a child advocacy group.
 7-8           (d)  The Texas Department of Human Services or the Texas
 7-9     Department of Mental Health and Mental Retardation, as appropriate,
7-10     shall provide to each person designated to serve as a child's
7-11     volunteer advocate information regarding permanency planning under
7-12     this subchapter.
7-13           Sec. 531.157.  COMMUNITY-BASED SERVICES. A state agency that
7-14     receives notice of a child's placement in an institution shall
7-15     ensure that, on or before the third day after the date the agency
7-16     is notified of the child's placement in the institution, the child
7-17     is also placed on a waiting list for waiver program services under
7-18     Section 1915(c) of the federal Social Security Act (42 U.S.C.
7-19     Section 1396n), as amended, appropriate to the child's needs.
7-20           Sec. 531.158.  LOCAL PERMANENCY PLANNING SITES. The
7-21     commission shall develop an implementation system that consists
7-22     initially of four or more local sites and that is designed to
7-23     coordinate planning for a permanent living arrangement and
7-24     relationship for a child with a family.  In developing the system,
7-25     the commission shall:
7-26                 (1)  include criteria to identify children who need
7-27     permanency plans;
 8-1                 (2)  require the establishment of a permanency plan for
 8-2     each child who lives outside the child's family or for whom care or
 8-3     protection is sought in an institution;
 8-4                 (3)  include a process to determine the agency or
 8-5     entity responsible for developing and overseeing implementation of
 8-6     a child's permanency plan;
 8-7                 (4)  identify, blend, and use funds from all available
 8-8     sources to provide customized services and programs to implement a
 8-9     child's permanency plan;
8-10                 (5)  clarify and expand the role of a local community
8-11     resource coordination group in ensuring accountability for a child
8-12     who resides in an institution or who is at risk of being placed in
8-13     an institution;
8-14                 (6)  require reporting of each placement or potential
8-15     placement of a child in an institution or other living arrangement
8-16     outside of the child's home; and
8-17                 (7)  assign in each local permanency planning site area
8-18     a single gatekeeper for all children in the area for whom placement
8-19     in an institution through a program funded by the state is sought
8-20     with authority to ensure that:
8-21                       (A)  family members of each child are aware of:
8-22                             (i)  intensive services that could prevent
8-23     placement of the child in an institution; and
8-24                             (ii)  available placement options; and
8-25                       (B)  permanency planning is initiated for each
8-26     child.
8-27           Sec. 531.159.  MONITORING OF PERMANENCY PLANNING EFFORTS. (a)
 9-1     The commission and each appropriate health and human services
 9-2     agency shall require a person who develops a permanency plan for a
 9-3     child residing in an institution to identify and document in the
 9-4     child's permanency plan all ongoing permanency planning efforts at
 9-5     least semiannually to ensure that, as soon as possible, the child
 9-6     will benefit from a permanent living arrangement with an enduring
 9-7     and nurturing parental relationship.
 9-8           (b)  The chief executive officer of each appropriate health
 9-9     and human services agency or the officer's designee must approve
9-10     the placement of a child in an institution.  The initial placement
9-11     of the child in the institution is temporary and may not exceed six
9-12     months unless the appropriate chief executive officer or the
9-13     officer's designee approves an extension of an additional six
9-14     months after conducting a review of documented permanency planning
9-15     efforts to unite the child with a family in a permanent living
9-16     arrangement.  After the initial six-month extension of a child's
9-17     placement in an institution approved under this subsection, the
9-18     chief executive officer or the officer's designee shall conduct a
9-19     review of the child's placement in the institution at least
9-20     semiannually to determine whether a continuation of that placement
9-21     is warranted.  If, based on the review, the chief executive officer
9-22     or the officer's designee determines that an additional extension
9-23     is warranted, the officer or the officer's designee shall recommend
9-24     to the commissioner that the child continue residing in the
9-25     institution.
9-26           (c)  On receipt of a recommendation made under Subsection (b)
9-27     for an extension of a child's placement, the commissioner, the
 10-1    commissioner's designee, or another person with whom the commission
 10-2    contracts shall conduct a review of the child's placement.  Based
 10-3    on the results of the review, the commissioner or the
 10-4    commissioner's designee may approve a six-month extension of the
 10-5    child's placement if the extension is appropriate.
 10-6          (d)  The child may continue residing in the institution after
 10-7    the six-month extension approved under Subsection (c) only if the
 10-8    chief executive officer of the appropriate health and human
 10-9    services agency or the officer's designee makes subsequent
10-10    recommendations as provided by Subsection (b) for each additional
10-11    six-month extension, and the commissioner or the commissioner's
10-12    designee approves each extension as provided by Subsection (c).
10-13          (e)  The commissioner or the commissioner's designee shall
10-14    conduct a semiannual review of data received from health and human
10-15    services agencies regarding all children who reside in institutions
10-16    in this state.  The commissioner, the commissioner's designee, or a
10-17    person with whom the commission contracts shall also review the
10-18    recommendations of the chief executive officers of each appropriate
10-19    health and human services agency or the officer's designee if the
10-20    officer or the officer's designee repeatedly recommends that
10-21    children continue residing in an institution.
10-22          (f)  The commission by rule shall develop procedures by which
10-23    to conduct the reviews required by Subsections (c), (d), and (e).
10-24    In developing the procedures, the commission shall seek input from
10-25    the work group on children's long-term care and health programs
10-26    established under Section 22.035, Human Resources Code.
10-27          Sec. 531.160.  INSPECTIONS. As part of each inspection,
 11-1    survey, or investigation of an institution, including a nursing
 11-2    home, institution for the mentally retarded licensed by the
 11-3    Department of Protective and Regulatory Services, or ICF-MR, as
 11-4    defined by Section 531.002, Health and Safety Code, in which a
 11-5    child resides, the agency or the agency's designee shall determine
 11-6    the extent to which the nursing home, institution, or ICF-MR is
 11-7    complying with the permanency planning requirements under this
 11-8    subchapter.
 11-9          Sec. 531.161.  ACCESS TO RECORDS. Each institution in which a
11-10    child resides shall allow the commission and appropriate health and
11-11    human services agencies access to the child's records to assist the
11-12    commission or agency in complying with the requirements of this
11-13    subchapter.
11-14          Sec. 531.162 [531.155].  PERMANENCY REPORTING. (a)  For each
11-15    of the local permanency planning sites, the commission shall
11-16    develop a reporting system under which each appropriate health and
11-17    human services agency responsible for permanency planning under
11-18    this subchapter is required to provide to the commission
11-19    semiannually:
11-20                (1)  the number of permanency plans developed by the
11-21    agency for children residing in institutions or children at risk of
11-22    being placed in institutions;
11-23                (2)  progress achieved in implementing permanency
11-24    plans;
11-25                (3)  the number of children served by the agency
11-26    residing in institutions;
11-27                (4)  the number of children served by the agency at
 12-1    risk of being placed in an institution served by the local
 12-2    permanency planning sites;
 12-3                (5)  the number of children served by the agency
 12-4    reunited with their families or placed with alternate permanent
 12-5    families; and
 12-6                (6)  cost data related to the development and
 12-7    implementation of permanency plans.
 12-8          (b)  The commissioner shall submit a semiannual report to the
 12-9    governor and the committees of each house of the legislature that
12-10    have primary oversight jurisdiction over health and human services
12-11    agencies regarding:
12-12                (1)  the number of children residing in institutions in
12-13    this state and, of those children, the number for whom a
12-14    recommendation has been made for a transition to a community-based
12-15    residence but who have not yet made that transition;
12-16                (2)  the circumstances of each child described by
12-17    Subdivision (1), including the type of institution and name of the
12-18    institution in which the child resides, the child's age, the
12-19    residence of the child's parents or guardians, and the length of
12-20    time in which the child has resided in the institution;
12-21                (3)  the number of permanency plans developed for
12-22    children residing in institutions in this state, the progress
12-23    achieved in implementing those plans, and barriers to implementing
12-24    those plans;
12-25                (4)  the number of children who previously resided in
12-26    an institution in this state and have made the transition to a
12-27    community-based residence;
 13-1                (5)  the number of children who previously resided in
 13-2    an institution in this state and have been reunited with their
 13-3    families or placed with alternate families;
 13-4                (6)  the community supports that resulted in the
 13-5    successful placement of children described by Subdivision (5) with
 13-6    alternate families; and
 13-7                (7)  the community supports that are unavailable but
 13-8    necessary to address the needs of children who continue to reside
 13-9    in an institution in this state after being recommended to make a
13-10    transition from the institution to an alternate family or
13-11    community-based residence.
13-12          Sec. 531.163.  EFFECT ON OTHER LAW. This subchapter does not
13-13    affect responsibilities imposed by federal or other state law on a
13-14    physician or other professional.
13-15          SECTION 2. (a)  The Health and Human Services Commission
13-16    shall conduct a study regarding:
13-17                (1)  the feasibility of bifurcating the reimbursement
13-18    provided for permanency planning activities under Chapter 531,
13-19    Government Code, from the reimbursement provided to an institution
13-20    in which a child resides for the care of that child; and
13-21                (2)  alternate mechanisms for providing reimbursement
13-22    for permanency planning activities that will enhance those
13-23    activities.
13-24          (b)  Based on the results of the study conducted under this
13-25    section, the commission by rule shall modify the method of
13-26    reimbursement provided for permanency planning activities to
13-27    incorporate modifications determined to be effective in enhancing
 14-1    those activities.
 14-2          SECTION 3. Subchapter O, Chapter 242, Health and Safety Code,
 14-3    as added by Chapter 913, Acts of the 75th Legislature, Regular
 14-4    Session, 1997, is repealed.
 14-5          SECTION 4. Notwithstanding Section 6 of this Act, the
 14-6    commissioner of health and human services and each appropriate
 14-7    health and human services agency, as defined by Section 531.001,
 14-8    Government Code, shall begin conducting the reviews required by
 14-9    Section 531.159, Government Code, as added by this Act, not later
14-10    than March 1, 2002.
14-11          SECTION 5. If before implementing any provision of this Act a
14-12    state agency determines that a waiver or authorization from a
14-13    federal agency is necessary for implementation of that provision,
14-14    the agency affected by the provision shall request the waiver or
14-15    authorization and may delay implementing that provision until the
14-16    waiver or authorization is granted.
14-17          SECTION 6. This Act takes effect September 1, 2001.