1-1 By: Zaffirini S.B. No. 368
1-2 (In the Senate - Filed January 24, 2001; January 25, 2001,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 10, 2001, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 7, Nays 0;
1-6 April 10, 2001, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 368 By: Nelson
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to permanency planning procedures for children in state
1-11 institutions.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subchapter D, Chapter 531, Government Code, as
1-14 added by Chapter 241, Acts of the 75th Legislature, Regular
1-15 Session, 1997, is amended to read as follows:
1-16 SUBCHAPTER D. PERMANENCY PLANNING
1-17 Sec. 531.151. DEFINITIONS. In this subchapter:
1-18 (1) "Child" means a person with a developmental
1-19 disability who is younger than 22 years of age.
1-20 (2) "Community resource coordination group" means a
1-21 coordination group established under the memorandum of
1-22 understanding adopted under Section 264.003, Family Code.
1-23 (3) "Institution" means:
1-24 (A) an ICF-MR, as defined by Section 531.002,
1-25 Health and Safety Code;
1-26 (B) a group home operated under the authority of
1-27 the Texas Department of Mental Health and Mental Retardation,
1-28 including a residential service provider under a Medicaid waiver
1-29 program authorized under Section 1915(c) of the federal Social
1-30 Security Act (42 U.S.C. Section 1396n), as amended, that provides
1-31 services at a residence other than the child's home or foster home;
1-32 (C) a foster group home or an agency foster
1-33 group home as defined by Section 42.002, Human Resources Code;
1-34 (D) a nursing facility;
1-35 (E) an institution for the mentally retarded
1-36 [(C) a residential facility] licensed by the Department of
1-37 Protective and Regulatory Services; or
1-38 (F) [(D)] another residential arrangement other
1-39 than a foster home as defined by Section 42.002, Human Resources
1-40 Code, that provides care to four or more children who are unrelated
1-41 to each other.
1-42 (4) [(2)] "Permanency planning" means a philosophy and
1-43 planning process that focuses on the outcome of family support by
1-44 facilitating a permanent living arrangement with the primary
1-45 feature of an enduring and nurturing parental relationship.
1-46 Sec. 531.152. POLICY STATEMENT. It is the policy of the
1-47 state to strive to ensure that the basic needs for safety,
1-48 security, and stability are met for each child in Texas. A
1-49 successful family is the most efficient and effective way to meet
1-50 those needs. The state and local communities must work together to
1-51 provide encouragement and support for well-functioning families and
1-52 ensure that each child receives the benefits of being a part of a
1-53 successful permanent family as soon as possible.
1-54 Sec. 531.153. DEVELOPMENT OF PERMANENCY PLAN. (a) To
1-55 further the policy stated in Section 531.152 and except as provided
1-56 by Subsection (b), the commission and each appropriate health and
1-57 human services agency shall develop procedures to ensure that a
1-58 permanency plan is developed for each child who resides [residing]
1-59 in an institution in this state on a temporary or long-term basis
1-60 or with respect to [for] whom the commission or appropriate health
1-61 and human services agency is notified in advance that institutional
1-62 care is sought.
1-63 (b) The Department of Protective and Regulatory Services
1-64 shall develop a permanency plan as required by this subchapter for
2-1 each child who resides in an institution in this state for whom the
2-2 department has been appointed permanent managing conservator. The
2-3 department is not required to develop a permanency plan under this
2-4 subchapter for a child for whom the department has been appointed
2-5 temporary managing conservator, but may incorporate the
2-6 requirements of this subchapter in a permanency plan developed for
2-7 the child under Section 263.3025, Family Code.
2-8 (c) In developing procedures under Subsection (a), the
2-9 commission and other appropriate health and human services agencies
2-10 shall develop to the extent possible uniform procedures applicable
2-11 to each of the agencies and each child who is the subject of a
2-12 permanency plan that promote efficiency for the agencies and
2-13 stability for each child.
2-14 (d) In implementing permanency planning procedures under
2-15 Subsection (a) to develop a permanency plan for each child, the
2-16 Texas Department of Human Services, the Texas Department of Mental
2-17 Health and Mental Retardation, and the Department of Protective and
2-18 Regulatory Services may:
2-19 (1) delegate each department's duty to develop a
2-20 permanency plan to a local mental retardation authority, as defined
2-21 by Section 531.002, Health and Safety Code, or enter into a
2-22 memorandum of understanding with the local mental retardation
2-23 authority to develop the permanency plan for each child who resides
2-24 in an institution in this state or with respect to whom the
2-25 department is notified in advance that institutional care is
2-26 sought;
2-27 (2) contract with a private entity, other than an
2-28 entity that provides mental retardation services to a child who
2-29 resides in an institution in this state or with respect to whom the
2-30 department is notified in advance that institutional care is
2-31 sought, to develop a permanency plan for that child; or
2-32 (3) engage in other appropriate activities to minimize
2-33 the potential conflicts of interest that, in developing the plan,
2-34 may exist or arise between:
2-35 (A) the child's mental retardation services
2-36 provider, if applicable; and
2-37 (B) the best interest of the child.
2-38 (e) The Texas Department of Human Services, the Texas
2-39 Department of Mental Health and Mental Retardation, and the
2-40 Department of Protective and Regulatory Services may solicit and
2-41 accept gifts, grants, and donations to support the development of
2-42 permanency plans for children residing in institutions by
2-43 individuals or organizations not employed by or affiliated with
2-44 those institutions.
2-45 (f) A health and human services agency that contracts with a
2-46 private entity under Subsection (d) to develop a permanency plan
2-47 shall ensure that the entity is provided training regarding the
2-48 permanency planning philosophy under Section 531.151 and available
2-49 resources that will assist a child residing in an institution in
2-50 making a successful transition to a community-based residence.
2-51 Sec. 531.154. NOTIFICATION REQUIRED. (a) Not later than
2-52 the third day after the date a child is initially placed in an
2-53 institution, the institution shall notify:
2-54 (1) the Texas Department of Human Services, if the
2-55 child is placed in a nursing home;
2-56 (2) the local mental retardation authority, as defined
2-57 by Section 531.002, Health and Safety Code, where the institution
2-58 is located, if the child:
2-59 (A) is placed in an ICF-MR, as defined by
2-60 Section 531.002, Health and Safety Code; or
2-61 (B) is placed by a state or local child
2-62 protective services agency in an institution for the mentally
2-63 retarded licensed by the Department of Protective and Regulatory
2-64 Services;
2-65 (3) the community resource coordination group in the
2-66 county of residence of a parent or guardian of the child;
2-67 (4) if the child is at least three years of age, the
2-68 school district for the area in which the institution is located;
2-69 and
3-1 (5) if the child is less than three years of age, the
3-2 local early intervention program for the area in which the
3-3 institution is located.
3-4 (b) The Texas Department of Human Services shall notify the
3-5 local mental retardation authority, as defined by Section 531.002,
3-6 Health and Safety Code, of a child's placement in a nursing home if
3-7 the child is known or suspected to suffer from mental retardation
3-8 or another disability for which the child may receive services
3-9 through the Texas Department of Mental Health and Mental
3-10 Retardation.
3-11 Sec. 531.155. OFFER OF SERVICES. Each entity receiving
3-12 notice of the initial placement of a child in an institution under
3-13 Section 531.154 may contact the child's parent or guardian to
3-14 ensure that the parent or guardian is aware of:
3-15 (1) services and support that could provide
3-16 alternatives to placement of the child in the institution;
3-17 (2) available placement options; and
3-18 (3) opportunities for permanency planning.
3-19 Sec. 531.156. DESIGNATION OF ADVOCATE. (a) Except as
3-20 provided by Subsection (b), the Texas Department of Human Services
3-21 shall designate a person, including a member of a community-based
3-22 organization, to serve as a volunteer advocate for a child residing
3-23 in an institution to assist in developing a permanency plan for the
3-24 child if:
3-25 (1) the child's parent or guardian requests the
3-26 assistance of an advocate; or
3-27 (2) the institution in which the child is placed
3-28 cannot locate the child's parent or guardian.
3-29 (b) The Texas Department of Mental Health and Mental
3-30 Retardation shall designate the person to serve as a volunteer
3-31 advocate for a child in accordance with Subsection (a) if the child
3-32 resides in an institution operated by the department.
3-33 (c) The person designated by the Texas Department of Human
3-34 Services or the Texas Department of Mental Health and Mental
3-35 Retardation to serve as the child's volunteer advocate under this
3-36 section may be:
3-37 (1) a person selected by the child's parent or
3-38 guardian, except that the person may not be employed by or under a
3-39 contract with the institution in which the child resides;
3-40 (2) an adult relative of the child; or
3-41 (3) a representative of a child advocacy group.
3-42 (d) The Texas Department of Human Services or the Texas
3-43 Department of Mental Health and Mental Retardation, as appropriate,
3-44 shall provide to each person designated to serve as a child's
3-45 volunteer advocate information regarding permanency planning under
3-46 this subchapter.
3-47 Sec. 531.157. COMMUNITY-BASED SERVICES. A state agency that
3-48 receives notice of a child's placement in an institution shall
3-49 ensure that, on or before the third day after the date the agency
3-50 is notified of the child's placement in the institution, the child
3-51 is also placed on a waiting list for waiver program services under
3-52 Section 1915(c) of the federal Social Security Act (42 U.S.C.
3-53 Section 1396n), as amended, appropriate to the child's needs.
3-54 Sec. 531.158. LOCAL PERMANENCY PLANNING SITES. The
3-55 commission shall develop an implementation system that consists
3-56 initially of four or more local sites and that is designed to
3-57 coordinate planning for a permanent living arrangement and
3-58 relationship for a child with a family. In developing the system,
3-59 the commission shall:
3-60 (1) include criteria to identify children who need
3-61 permanency plans;
3-62 (2) require the establishment of a permanency plan for
3-63 each child who lives outside the child's family or for whom care or
3-64 protection is sought in an institution;
3-65 (3) include a process to determine the agency or
3-66 entity responsible for developing and overseeing implementation of
3-67 a child's permanency plan;
3-68 (4) identify, blend, and use funds from all available
3-69 sources to provide customized services and programs to implement a
4-1 child's permanency plan;
4-2 (5) clarify and expand the role of a local community
4-3 resource coordination group in ensuring accountability for a child
4-4 who resides in an institution or who is at risk of being placed in
4-5 an institution;
4-6 (6) require reporting of each placement or potential
4-7 placement of a child in an institution or other living arrangement
4-8 outside of the child's home; and
4-9 (7) assign in each local permanency planning site area
4-10 a single gatekeeper for all children in the area for whom placement
4-11 in an institution through a program funded by the state is sought
4-12 with authority to ensure that:
4-13 (A) family members of each child are aware of:
4-14 (i) intensive services that could prevent
4-15 placement of the child in an institution; and
4-16 (ii) available placement options; and
4-17 (B) permanency planning is initiated for each
4-18 child.
4-19 Sec. 531.159. MONITORING OF PERMANENCY PLANNING EFFORTS.
4-20 (a) The commission and each appropriate health and human services
4-21 agency shall require a person who develops a permanency plan for a
4-22 child residing in an institution to identify and document in the
4-23 child's permanency plan all ongoing permanency planning efforts at
4-24 least semiannually to ensure that, as soon as possible, the child
4-25 will benefit from a permanent living arrangement with an enduring
4-26 and nurturing parental relationship.
4-27 (b) The chief executive officer of each appropriate health
4-28 and human services agency or the officer's designee must approve
4-29 the placement of a child in an institution. The initial placement
4-30 of the child in the institution is temporary and may not exceed six
4-31 months unless the appropriate chief executive officer or the
4-32 officer's designee approves an extension of an additional six
4-33 months after conducting a review of documented permanency planning
4-34 efforts to unite the child with a family in a permanent living
4-35 arrangement. After the initial six-month extension of a child's
4-36 placement in an institution approved under this subsection, the
4-37 chief executive officer or the officer's designee shall conduct a
4-38 review of the child's placement in the institution at least
4-39 semiannually to determine whether a continuation of that placement
4-40 is warranted. If, based on the review, the chief executive officer
4-41 or the officer's designee determines that an additional extension
4-42 is warranted, the officer or the officer's designee shall recommend
4-43 to the commissioner that the child continue residing in the
4-44 institution.
4-45 (c) On receipt of a recommendation made under Subsection (b)
4-46 for an extension of a child's placement, the commissioner, the
4-47 commissioner's designee, or another person with whom the commission
4-48 contracts shall conduct a review of the child's placement. Based
4-49 on the results of the review, the commissioner or the
4-50 commissioner's designee may approve a six-month extension of the
4-51 child's placement if the extension is appropriate.
4-52 (d) The child may continue residing in the institution after
4-53 the six-month extension approved under Subsection (c) only if the
4-54 chief executive officer of the appropriate health and human
4-55 services agency or the officer's designee makes subsequent
4-56 recommendations as provided by Subsection (b) for each additional
4-57 six-month extension and the commissioner or the commissioner's
4-58 designee approves each extension as provided by Subsection (c).
4-59 (e) The commissioner or the commissioner's designee shall
4-60 conduct a semiannual review of data received from health and human
4-61 services agencies regarding all children who reside in institutions
4-62 in this state. The commissioner, the commissioner's designee, or a
4-63 person with whom the commission contracts shall also review the
4-64 recommendations of the chief executive officers of each appropriate
4-65 health and human services agency or the officer's designee if the
4-66 officer or the officer's designee repeatedly recommends that
4-67 children continue residing in an institution.
4-68 (f) The commission by rule shall develop procedures by which
4-69 to conduct the reviews required by Subsections (c), (d), and (e).
5-1 In developing the procedures, the commission shall seek input from
5-2 the work group on children's long-term care and health programs
5-3 established under Section 22.035, Human Resources Code.
5-4 Sec. 531.160. INSPECTIONS. As part of each inspection,
5-5 survey, or investigation of an institution, including a nursing
5-6 home, institution for the mentally retarded licensed by the
5-7 Department of Protective and Regulatory Services, or ICF-MR, as
5-8 defined by Section 531.002, Health and Safety Code, in which a
5-9 child resides, the agency or the agency's designee shall determine
5-10 the extent to which the nursing home, institution, or ICF-MR is
5-11 complying with the permanency planning requirements under this
5-12 subchapter.
5-13 Sec. 531.161. ACCESS TO RECORDS. Each institution in which
5-14 a child resides shall allow the commission and appropriate health
5-15 and human services agencies access to the child's records to assist
5-16 the commission or agency in complying with the requirements of this
5-17 subchapter.
5-18 Sec. 531.162 [531.155]. PERMANENCY REPORTING. (a) For each
5-19 of the local permanency planning sites, the commission shall
5-20 develop a reporting system under which each appropriate health and
5-21 human services agency responsible for permanency planning under
5-22 this subchapter is required to provide to the commission
5-23 semiannually:
5-24 (1) the number of permanency plans developed by the
5-25 agency for children residing in institutions or children at risk of
5-26 being placed in institutions;
5-27 (2) progress achieved in implementing permanency
5-28 plans;
5-29 (3) the number of children served by the agency
5-30 residing in institutions;
5-31 (4) the number of children served by the agency at
5-32 risk of being placed in an institution served by the local
5-33 permanency planning sites;
5-34 (5) the number of children served by the agency
5-35 reunited with their families or placed with alternate permanent
5-36 families; and
5-37 (6) cost data related to the development and
5-38 implementation of permanency plans.
5-39 (b) The commissioner shall submit a semiannual report to the
5-40 governor and the committees of each house of the legislature that
5-41 have primary oversight jurisdiction over health and human services
5-42 agencies regarding:
5-43 (1) the number of children residing in institutions in
5-44 this state and, of those children, the number for whom a
5-45 recommendation has been made for a transition to a community-based
5-46 residence but who have not yet made that transition;
5-47 (2) the circumstances of each child described by
5-48 Subdivision (1), including the type of institution and name of the
5-49 institution in which the child resides, the child's age, the
5-50 residence of the child's parents or guardians, and the length of
5-51 time in which the child has resided in the institution;
5-52 (3) the number of permanency plans developed for
5-53 children residing in institutions in this state, the progress
5-54 achieved in implementing those plans, and barriers to implementing
5-55 those plans;
5-56 (4) the number of children who previously resided in
5-57 an institution in this state and have made the transition to a
5-58 community-based residence;
5-59 (5) the number of children who previously resided in
5-60 an institution in this state and have been reunited with their
5-61 families or placed with alternate families;
5-62 (6) the community supports that resulted in the
5-63 successful placement of children described by Subdivision (5) with
5-64 alternate families; and
5-65 (7) the community supports that are unavailable but
5-66 necessary to address the needs of children who continue to reside
5-67 in an institution in this state after being recommended to make a
5-68 transition from the institution to an alternate family or
5-69 community-based residence.
6-1 Sec. 531.163. EFFECT ON OTHER LAW. This subchapter does not
6-2 affect responsibilities imposed by federal or other state law on a
6-3 physician or other professional.
6-4 SECTION 2. (a) The Health and Human Services Commission
6-5 shall conduct a study regarding:
6-6 (1) the feasibility of bifurcating the reimbursement
6-7 provided for permanency planning activities under Chapter 531,
6-8 Government Code, from the reimbursement provided to an institution
6-9 in which a child resides for the care of that child; and
6-10 (2) alternate mechanisms for providing reimbursement
6-11 for permanency planning activities that will enhance those
6-12 activities.
6-13 (b) Based on the results of the study conducted under this
6-14 section, the Health and Human Services commission by rule shall
6-15 modify the method of reimbursement provided for permanency planning
6-16 activities to incorporate modifications determined to be effective
6-17 in enhancing those activities.
6-18 SECTION 3. Subchapter O, Chapter 242, Health and Safety
6-19 Code, as added by Chapter 913, Acts of the 75th Legislature,
6-20 Regular Session, 1997, is repealed.
6-21 SECTION 4. Notwithstanding Section 6 of this Act, the
6-22 commissioner of health and human services and each appropriate
6-23 health and human services agency, as defined by Section 531.001,
6-24 Government Code, shall begin conducting the reviews required by
6-25 Section 531.159, Government Code, as added by this Act, not later
6-26 than March 1, 2002.
6-27 SECTION 5. If before implementing any provision of this Act
6-28 a state agency determines that a waiver or authorization from a
6-29 federal agency is necessary for implementation of that provision,
6-30 the agency affected by the provision shall request the waiver or
6-31 authorization and may delay implementing that provision until the
6-32 waiver or authorization is granted.
6-33 SECTION 6. This Act takes effect September 1, 2001.
6-34 * * * * *