By: Zaffirini S.B. No. 60
A BILL TO BE ENTITLED
AN ACT
relating to the provision of public mental health and related
services for persons needing the services of more than one agency.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. PROVISION OF SERVICES FOR PERSONS WITH
MULTIAGENCY NEEDS. Chapter 531, Government Code, is amended by
adding Subchapter K to read as follows:
SUBCHAPTER K. PROVISION OF SERVICES FOR PERSONS
WITH MULTIAGENCY NEEDS
Sec. 531.401. DEFINITIONS. (a) In this subchapter:
(1) "Systems of care agency" includes each health and
human services agency, the Health and Human Services Commission,
the Texas Council on Offenders with Mental Impairments, the Texas
Department of Housing and Community Affairs, the Texas Education
Agency, the Texas Juvenile Probation Commission, the Texas
Workforce Commission, and the Texas Youth Commission.
(2) "Systems of care services" means a comprehensive
state system of mental health services and other necessary and
related services that is organized as a coordinated network to meet
the multiple and changing needs of persons who receive those
services and of their families.
(b) Persons who receive systems of care services include
children at risk of residential placement, incarceration, or
reincarceration because of a severe emotional disturbance,
including:
(1) students in a special education program under
Subchapter A, Chapter 29, Education Code; and
(2) children with a severe emotional disturbance and:
(A) a substance abuse disorder; or
(B) a developmental disability.
Sec. 531.402. EXECUTIVE COUNCIL MEMBERSHIP. (a) The
systems of care executive council is composed of 21 members as
described by this section.
(b) The commissioner of health and human services and the
commissioner of education serve as ex officio members. Service on
the systems of care executive council is an additional duty of the
positions of those commissioners. The ex officio members have
voting authority.
(c) The commissioner of health and human services shall
appoint 12 members, each of whom must be the administrative head of
a systems of care agency.
(d) The governor shall appoint two members, one of whom must
be appointed from a list of nominees submitted to the governor by
the speaker of the house of representatives. The governor may
reject one or more of the nominees on the list. If the governor
rejects all the nominees on the list, the speaker shall submit to
the governor a new list of different nominees.
(e) The lieutenant governor shall appoint one member.
(f) The commissioner of health and human services and the
commissioner of education, acting jointly, shall appoint the
following members:
(1) one member who must be a judge of a state juvenile
court;
(2) one member who must be a representative of a group
that advocates on behalf of at least one of the population groups
served by a systems of care agency;
(3) one member who must be a representative of a group
that advocates on behalf of family members of at least one of the
population groups served by a systems of care agency; and
(4) one member who must be a representative of a group
that advocates on behalf of local communities affected by the
decisions of at least one systems of care agency.
(g) The appointed members of the systems of care executive
council serve two-year terms expiring February 1 of each
odd-numbered year.
Sec. 531.403. EXECUTIVE COUNCIL OFFICERS; MEETINGS. (a)
The systems of care executive council shall elect from its members a
presiding officer, an assistant presiding officer, and other
officers the council considers necessary to perform the council's
duties. The assistant presiding officer shall preside over
meetings in the presiding officer's absence.
(b) The systems of care executive council shall meet at
least three times each year at the call of the presiding officer.
Sec. 531.404. EXECUTIVE COUNCIL DUTIES. The systems of
care executive council shall:
(1) approve and oversee the implementation of program
and fiscal policies developed by the systems of care policy team;
(2) review and take appropriate action on
recommendations that the policy team presents to the council;
(3) approve and oversee the actions of the policy
team, systems of care community teams, and systems of care
coordination and assessment teams;
(4) ensure that systems of care agencies have adequate
administrative support to provide systems of care services;
(5) oversee the distribution and use of funding for
systems of care services; and
(6) issue a biennial report to the governor, the
senate, and the house of representatives that includes:
(A) legislative proposals relating to systems of
care services; and
(B) an evaluation of the provision of systems of
care services.
Sec. 531.405. POLICY TEAM MEMBERSHIP AND OFFICERS;
MEETINGS. (a) The systems of care policy team is composed of the
following members who are appointed by the systems of care
executive council and serve at the will of the executive council:
(1) one or more members of the senior staff of each
systems of care agency;
(2) the judge of a juvenile or domestic relations
court;
(3) a representative of an organization whose
membership is composed primarily of persons representing county
governments; and
(4) one or more representatives of:
(A) an organization that supports families of
persons with mental illness;
(B) a private organization that provides
services to persons with mental illness;
(C) a group that advocates on behalf of:
(i) at least one of the population groups
served by a systems of care agency; or
(ii) family members of at least one of the
population groups served by a systems of care agency; and
(D) local communities affected by the decisions
of at least one systems of care agency.
(b) Each member of the systems of care policy team appointed
under Subsection (a)(4)(A) must also be a member of the family of a
person with mental illness.
(c) The systems of care policy team shall elect from its
members a presiding officer, an assistant presiding officer, and
other officers the policy team considers necessary to perform the
policy team's duties. The assistant presiding officer shall
preside over meetings in the presiding officer's absence.
(d) The systems of care policy team shall meet at least once
in each quarter of the calendar year at the call of the presiding
officer.
Sec. 531.406. POLICY TEAM DUTIES. The systems of care
policy team shall:
(1) develop policies for integrating the services
provided to persons who need the services of more than one systems
of care agency;
(2) develop procedures for distributing and
monitoring the use of funds for systems of care services;
(3) develop methods for collecting, analyzing, and
reporting data that can be used by each systems of care agency to
evaluate systems of care services;
(4) develop methods that the systems of care executive
council and each systems of care agency can use to evaluate:
(A) the provision of systems of care services;
and
(B) the outcome of those services for the persons
who receive them;
(5) make recommendations to the systems of care
executive council regarding policies, procedures, and methods
developed under this section;
(6) provide training for and technical assistance to
governmental entities involved in providing systems of care
services;
(7) establish work groups to study issues relating to
the implementation of this subchapter and the provision of systems
of care services and submit the recommendations of those groups to
the systems of care executive council;
(8) issue a biennial report to the systems of care
executive council that evaluates the provision of systems of care
services using the methods developed under this section and
includes:
(A) the number of persons who received systems of
care services during the reporting period and the outcome of the
services provided;
(B) recommendations for improving the
coordination of:
(i) funding for systems of care services;
and
(ii) the provision of services by systems
of care agencies;
(C) a description of any barriers to the ability
of a systems of care agency to provide effective systems of care
services and recommendations for overcoming those barriers; and
(D) any other information relevant to improving
the provision of services to persons with multiagency needs; and
(9) perform other duties that the systems of care
executive council may assign.
Sec. 531.407. ADMINISTRATIVE SUPPORT FROM COMMISSION. The
commission shall provide administrative support to the systems of
care executive council and policy team to assist the executive
council and policy team in performing their duties.
Sec. 531.408. SELECTION OF AREAS SERVED BY COMMUNITY TEAMS.
(a) The commission by rule shall establish a request-for-proposal
process to select a municipality, a county, or two or more
contiguous counties as an area served by a systems of care community
team described by Section 531.409. The process must provide that
one or more representatives of a governmental entity in a
municipality or county may submit a proposal.
(b) The commission and the systems of care policy team shall
develop criteria to evaluate proposals for areas to be served by
systems of care community teams.
Sec. 531.409. COMMUNITY TEAM MEMBERSHIP. A systems of care
community team is composed of the following members who are
appointed by the representatives who submit a proposal for the team
under Section 531.408(a) and serve at the will of those
representatives:
(1) one or more representatives from a systems of care
agency office that is located in a municipality or county in an area
selected to be served by a community team;
(2) one or more representatives of the governing body
of that municipality or county;
(3) the judge of a juvenile or domestic relations
court; and
(4) one or more representatives of:
(A) an organization that supports families of
persons with mental illness;
(B) a private organization that provides
services to persons with mental illness;
(C) a group that advocates on behalf of:
(i) at least one of the population groups
served by a systems of care agency; or
(ii) family members of at least one of the
population groups served by a systems of care agency; and
(D) local communities affected by the decisions
of at least one systems of care agency.
Sec. 531.410. COMMUNITY TEAM POWERS AND DUTIES. (a) A
systems of care community team shall:
(1) establish procedures for:
(A) referring persons and their families to the
systems of care coordination and assessment team; and
(B) authorizing funding for services that those
persons and their families may receive;
(2) monitor the provision of services to persons
needing the services of more than one systems of care agency; and
(3) collect, analyze, and monitor data that relates to
systems of care services and report that analysis to the systems of
care policy team.
(b) The systems of care community team may designate one or
more persons to provide support services to a person who is referred
to the systems of care coordination and assessment team and the
person's family. Those support services are in addition to the
services provided in the plan described by Section 531.411(b)(1).
(c) A systems of care community team member described by
Section 531.409(1) may use resources from the agency that the
member represents to address problems identified by the community
team or by the systems of care policy team.
(d) At the request of the systems of care community team,
the commission shall designate one or more employees of the
commission to assist the team in carrying out the team's duties.
Sec. 531.411. COORDINATION AND ASSESSMENT TEAM MEMBERSHIP;
DUTIES. (a) A systems of care coordination and assessment team is
composed of a number of members who are appointed by a systems of
care community team and serve at the will of the community team.
(b) The systems of care coordination and assessment team
shall:
(1) develop and implement a plan for providing
services from systems of care agencies to a person who is referred
to the team and the person's family;
(2) collect, analyze, and monitor data that relates to
systems of care services provided to persons referred to the team
and their families and report that analysis to the systems of care
community team; and
(3) perform other duties that the systems of care
community team may assign.
Sec. 531.412. TEAM ACTIONS SUBJECT TO EXECUTIVE COUNCIL
APPROVAL. The actions of the systems of care policy team, a
systems of care community team, and a systems of care coordination
and assessment team are subject to approval by the systems of care
executive council.
Sec. 531.413. REIMBURSEMENT FOR EXPENSES. (a) An appointed
member of the systems of care executive council, the systems of care
policy team, a systems of care community team, or a systems of care
coordination and assessment team may not receive compensation for
service on the council or team but is entitled to reimbursement of
the travel expenses incurred by the member while conducting the
business of the council or team, as provided by the General
Appropriations Act.
(b) The reimbursement may be paid from:
(1) available funds of the systems of care agency with
which the member is employed or that the member represents, in the
case of a person whose membership on the council or team is a result
of being an employee or representative of that agency; or
(2) available funds of the commission, in the case of
other members of the council or team.
Sec. 531.414. SYSTEMS OF CARE TRUST FUND. The systems of
care trust fund is created as a trust fund with the comptroller and
shall be administered by the Health and Human Services Commission
as a trustee on behalf of the systems of care agencies.
Sec. 531.415. EXPANSION OF SYSTEMS OF CARE SERVICES; MERGER
OF LOCAL GROUPS. (a) The systems of care executive council shall
develop a plan for the statewide expansion of systems of care
services and teams where needed in accordance with this subchapter.
The plan must provide for:
(1) merging an area served by a community resource
coordination group established under a memorandum of understanding
under Section 531.055, as added by Chapter 114, Acts of the 77th
Legislature, Regular Session, 2001, into an area served by a
systems of care community team; and
(2) completing the expansion on or before September 1,
2011.
(b) A reference in another statute to a systems of care
community team includes within its meaning a community resource
coordination group established under a memorandum of understanding
under Section 531.055, as added by Chapter 114, Acts of the 77th
Legislature, Regular Session, 2001.
(c) A reference in another statute to a community resource
coordination group established under a memorandum of understanding
under Section 531.055, as added by Chapter 114, Acts of the 77th
Legislature, Regular Session, 2001, includes within its meaning a
systems of care community team.
(d) This section expires September 1, 2011.
Sec. 531.416. MERGER OF TEXAS INTEGRATED FUNDING
INITIATIVE. (a) The systems of care policy team shall develop and
implement a plan to merge each site participating in the Texas
Integrated Funding Initiative under former Subchapter G, Chapter
531, as added by Chapter 446, Acts of the 76th Legislature, Regular
Session, 1999, into an area served by a systems of care community
team.
(b) The plan must provide for the merger to be complete not
later than September 1, 2011. The plan also must ensure that:
(1) the same population groups served under the Texas
Integrated Funding Initiative are served under this subchapter; and
(2) the availability and quality of services provided
to those population groups do not decrease.
(c) This section expires September 1, 2011.
SECTION 2. MEMORANDUM OF UNDERSTANDING TO IMPLEMENT
PROVISION OF MULTIAGENCY SERVICES. Section 531.055, Government
Code, as added by Chapter 114, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
Sec. 531.055. MEMORANDUM OF UNDERSTANDING ON THE PROVISION
OF SERVICES FOR PERSONS NEEDING MULTIAGENCY SERVICES. (a) In this
section, "systems of care agency" and "systems of care services"
have the meanings assigned by Section 531.401.
(b) Each systems of care [health and human services]
agency[, the Texas Council on Offenders with Mental Impairments,
the Texas Department of Criminal Justice, the Texas Department of
Housing and Community Affairs, the Texas Education Agency, the
Texas Workforce Commission, and the Texas Youth Commission] shall
adopt a joint memorandum of understanding to establish [promote] a
system in accordance with Subchapter K that coordinates the
provision of [local-level interagency staffing groups to
coordinate] services for persons needing multiagency services.
(c) [(b)] The memorandum must:
(1) clarify the statutory responsibilities of each
agency in relation to persons needing multiagency services,
including subcategories for different services such as prevention,
family preservation and strengthening, aging in place, emergency
shelter, diagnosis and evaluation, residential care, after-care,
information and referral, medical care, and investigation
services;
(2) include a functional definition of "persons
needing multiagency services";
(3) outline the membership and[,] officers of the
systems of care executive council and teams established under
Subchapter K[, and necessary standing committees of local-level
interagency staffing groups];
(4) define procedures aimed at eliminating
duplication of services relating to assessment and diagnosis,
treatment, residential placement and care, and case management of
persons needing multiagency services;
(5) define procedures for addressing disputes between
systems of care [the] agencies that relate to the agencies' areas of
service responsibilities;
(6) [provide that each local-level interagency
staffing group includes:
[(A) a local representative of each agency;
[(B) representatives of local private sector
agencies; and
[(C) family members or caregivers of persons
needing multiagency services or other current or previous consumers
of multiagency services acting as general consumer advocates;
[(7)] provide that the local representative of each
agency has authority to contribute agency resources to solving
problems identified by [the] local-level systems of care teams
established under Subchapter K [interagency staffing group];
(7) [(8)] provide that if a person's needs exceed the
resources of a systems of care [an] agency, the agency may, with the
consent of the person's legal guardian, if applicable, submit a
referral on behalf of the person to a systems of care coordination
and assessment team established under Subchapter K, using referral
procedures established by a systems of care community team under
that subchapter [the local-level interagency staffing group for
consideration];
(8) [(9) provide that a local-level interagency
staffing group may be called together by a representative of any
member agency;
[(10)] provide that an agency representative may be
excused from attending a meeting of a systems of care team
established under Subchapter K if the team [staffing group]
determines that the [age or] needs of a [the] person to be
considered at the meeting are clearly not within the agency's
service responsibilities, provided that each agency representative
is encouraged to attend all meetings to contribute to the
collective ability of the team [staffing group] to address [solve]
a person's need for multiagency services;
(9) [(11) define the relationship between state-level
interagency staffing groups and local-level interagency staffing
groups in a manner that defines, supports, and maintains local
autonomy;
[(12)] provide that records that systems of care
agencies use or develop under Subchapter K and [are used or
developed by a local-level interagency staffing group or its
members] that relate to a particular person are confidential and
may not be released to any other person or agency except as provided
by this section or by other law; and
(10) [(13)] provide a procedure that permits systems
of care [the] agencies to share confidential information while
preserving the confidential nature of the information.
(d) Systems of care [(c) The] agencies [that participate in
the formulation of the memorandum of understanding] shall consult
with and solicit input from advocacy and consumer groups in
formulating the memorandum of understanding.
(e) Each systems of care agency shall conduct a biennial
review of the memorandum of understanding and propose necessary
changes to the memorandum. The agencies shall develop other
revisions as necessary to reflect major agency reorganizations or
other statutory changes affecting the agencies.
(f) [(d)] Each systems of care agency shall adopt the
memorandum of understanding and all revisions to the memorandum.
[The agencies shall develop revisions as necessary to reflect major
agency reorganizations or statutory changes affecting the
agencies.
[(e) The agencies shall ensure that a state-level
interagency staffing group provides a biennial report to the
executive director of each agency, the legislature, and the
governor that includes:
[(1) the number of persons served through the
local-level interagency staffing groups and the outcomes of the
services provided;
[(2) a description of any barriers identified to the
state's ability to provide effective services to persons needing
multiagency services; and
[(3) any other information relevant to improving the
delivery of services to persons needing multiagency services.]
SECTION 3. ADOPTION OF MEMORANDUM OF UNDERSTANDING. (a)
Each systems of care agency shall adopt the joint memorandum of
understanding, as provided by Section 531.055, Government Code, as
amended by this Act, on or before September 1, 2004.
(b) The memorandum of understanding adopted under Section
531.055, Government Code, as added by Chapter 114, Acts of the 77th
Legislature, Regular Session, 2001, remains in effect until the
memorandum of understanding adopted under Section 531.055,
Government Code, as amended by this Act, is adopted and takes
effect.
SECTION 4. FUNDING PLAN FOR PROVISION OF MULTIAGENCY
SERVICES. (a) The systems of care executive council created by
Section 531.402, Government Code, as added by this Act, shall
develop a plan for funding systems of care services and teams
established under Subchapter K, Chapter 531, Government Code, as
added by this Act, using all available state and federal money,
including money used to fund a community resource coordination
group established under a memorandum of understanding adopted under
Section 531.055, Government Code, as added by Chapter 114, Acts of
the 77th Legislature, Regular Session, 2001, or a site
participating in the Texas Integrated Funding Initiative under
Subchapter G, Chapter 531, Government Code, as added by Chapter
446, Acts of the 76th Legislature, Regular Session, 1999, as that
subchapter existed before its repeal by this Act.
(b) The systems of care executive council shall report on
the plan to the legislature not later than September 1, 2004.
SECTION 5. REPEALER; CONFORMING AMENDMENTS. (a) Section
242.801(2), Health and Safety Code, is repealed.
(b) Subchapter G, Chapter 531, Government Code, as added by
Chapter 446, Acts of the 76th Legislature, Regular Session, 1999,
is repealed. This subsection does not affect the funding for or
provision of services by a community participating in the Texas
Integrated Funding Initiative under that subchapter before the
effective date of this Act, and that subchapter is continued in
effect for those purposes.
(c) Section 531.151(2), Government Code, is amended to read
as follows:
(2) "Coordination and assessment team" ["Community
resource coordination group"] means a systems of care coordination
and assessment team established under Subchapter K [coordination
group established under the memorandum of understanding adopted
under Section 264.003, Family Code].
(d) Section 531.154(a), Government Code, is amended to read
as follows:
(a) Not later than the third day after the date a child is
initially placed in an institution, the institution shall notify:
(1) the Texas Department of Human Services, if the
child is placed in a nursing home;
(2) the local mental retardation authority, as defined
by Section 531.002, Health and Safety Code, where the institution
is located, if the child:
(A) is placed in an ICF-MR, as defined by Section
531.002, Health and Safety Code; or
(B) is placed by a state or local child
protective services agency in an institution for the mentally
retarded licensed by the Department of Protective and Regulatory
Services;
(3) the coordination and assessment team [community
resource coordination group] in the county of residence of a parent
or guardian of the child;
(4) if the child is at least three years of age, the
school district for the area in which the institution is located;
and
(5) if the child is less than three years of age, the
local early intervention program for the area in which the
institution is located.
(e) Section 531.158, Government Code, is amended to read as
follows:
Sec. 531.158. LOCAL PERMANENCY PLANNING SITES. The
commission shall develop an implementation system that consists
initially of four or more local sites and that is designed to
coordinate planning for a permanent living arrangement and
relationship for a child with a family. In developing the system,
the commission shall:
(1) include criteria to identify children who need
permanency plans;
(2) require the establishment of a permanency plan for
each child who lives outside the child's family or for whom care or
protection is sought in an institution;
(3) include a process to determine the agency or
entity responsible for developing and overseeing implementation of
a child's permanency plan;
(4) identify, blend, and use funds from all available
sources to provide customized services and programs to implement a
child's permanency plan;
(5) clarify and expand the role of a local
coordination and assessment team [community resource coordination
group] in ensuring accountability for a child who resides in an
institution or who is at risk of being placed in an institution;
(6) require reporting of each placement or potential
placement of a child in an institution or other living arrangement
outside of the child's home; and
(7) assign in each local permanency planning site area
a single gatekeeper for all children in the area for whom placement
in an institution through a program funded by the state is sought
with authority to ensure that:
(A) family members of each child are aware of:
(i) intensive services that could prevent
placement of the child in an institution; and
(ii) available placement options; and
(B) permanency planning is initiated for each
child.
(f) Section 531.284(b), Government Code, is amended to read
as follows:
(b) In developing the statewide strategic plan, the office
shall:
(1) consider existing programs and models to serve
children younger than six years of age, including:
(A) systems of care coordination and assessment
teams established under Subchapter K [community resource
coordination groups];
(B) the Texas Integrated Funding Initiative;
(C) the Texas Information and Referral Network;
and
(D) efforts to create a 2-1-1 telephone number
for access to human services;
(2) attempt to maximize federal funds and local
existing infrastructure and funds; and
(3) provide for local participation to the greatest
extent possible.
SECTION 6. INITIAL APPOINTEES TO EXECUTIVE COUNCIL. The
initial appointees to the systems of care executive council created
by Section 531.402, Government Code, as added by this Act, serve
terms expiring February 1, 2005.
SECTION 7. EFFECTIVE DATE. This Act takes effect September
1, 2003.