81R3928 UM-D

By: Davis of Harris H.B. No. 620

A BILL TO BE ENTITLED

AN ACT

relating to behavioral health services for children and establishment of the Children's Behavioral Health Council.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 531.251, Government Code, is amended to read as follows:

Sec. 531.251. TEXAS INTEGRATED FUNDING INITIATIVE PILOT PROJECT [CONSORTIUM]; DEFINITION; EXPANSION PLAN. (a) In this subchapter, "council" means the Children's Behavioral Health Council established under Section 531.425.

(a-1) The council [commission] shall [form a consortium to] develop criteria for and implement the expansion of the Texas Integrated Funding Initiative pilot project and [to] develop local mental health care systems in communities for minors who are receiving residential mental health services or who are at risk of residential placement to receive mental health services. [The consortium must include representatives of the Texas Department of Mental Health and Mental Retardation, Department of Protective and Regulatory Services, Texas Education Agency, Texas Youth Commission, Texas Juvenile Probation Commission, and Texas Commission on Alcohol and Drug Abuse and an equal number of family advocates.]

(b) The commission and the council [consortium] shall:

(1) develop a model and guidelines for the delivery of mental health services and support to a minor, initiated before the person's 18th birthday, including best practices in the financing, administration, governance, and delivery of those services;

(2) establish a plan to expand the Texas Integrated Funding Initiative so that the initiative may operate in up to six communities; and

(3) identify appropriate sources of state and federal funding to finance mental health services under the initiative from a central fund for expansion communities.

SECTION 2. Section 531.252(b), Government Code, is amended to read as follows:

(b) The commission and the council [consortium] shall develop criteria to evaluate proposals for selecting expansion communities to participate in the expanded initiative. The criteria must:

(1) reflect the underlying principles of the Texas Integrated Funding Initiative;

(2) emphasize services that are culturally competent, family-centered, and seamless;

(3) identify populations to be served under the proposals;

(4) establish for the expansion communities service outcome goals related to minors who are receiving residential mental health services or who are at risk of residential placement to receive mental health services, including:

(A) decreasing incidents of abuse or neglect of the minors;

(B) reducing recidivism rates of juvenile offenders;

(C) increasing school attendance and progress of the minors;

(D) reducing the rate of placement of the minors in residential treatment;

(E) increasing the rate of reunification of the minors with their families;

(F) improving the emotional, behavioral, and social adjustment of the minors; and

(G) improving the stability of placements of the minors;

(5) provide for locations of participating communities in urban, suburban, and rural settings; and

(6) specify information that must be provided in a proposal for a community, including:

(A) information on the costs of the activities proposed; and

(B) the characteristics of minors in the community who are in residential care for mental health services or who are at risk of being placed in residential care to receive mental health services.

SECTION 3. Section 531.253, Government Code, is amended to read as follows:

Sec. 531.253. SELECTION OF EXPANSION COMMUNITIES. The commission and the council [consortium] shall review proposals for expansion communities and approve participation of not more than six communities to participate in the initiative. The selected communities must be those that best meet the criteria developed under Section 531.252.

SECTION 4. Section 531.254, Government Code, is amended to read as follows:

Sec. 531.254. SYSTEM DEVELOPMENT COLLABORATION. The commission, the council [consortium], and the expansion communities shall collaborate to develop and shall share technical assistance and training resources to aid communities in developing local systems for delivering mental health services to minors.

SECTION 5. Sections 531.255(a), (b), and (c), Government Code, are amended to read as follows:

(a) The commission and the council [Texas Department of Mental Health and Mental Retardation] jointly shall monitor the progress of the expansion communities.

(b) The commission, the council [consortium], and the expansion communities shall collaborate to develop a system to evaluate the success of the expansion communities in achieving outcome goals for the minors the communities serve, including outcome goals developed under Section 531.252. An evaluation under the system must include information on cost avoidance and net savings that result from participation in the initiative.

(c) Each expansion community shall identify the baseline information to compare with the information on outcomes in evaluating the achievements of the community. A community is responsible for collecting and reporting outcome information to the commission and the council in accordance with the requirements of the evaluation system developed under Subsection (b).

SECTION 6. Section 531.421, Government Code, is amended by adding Subdivision (3-a) to read as follows:

(3-a) "Council" means the Children's Behavioral Health Council established under Section 531.425.

SECTION 7. Section 531.422(c), Government Code, is amended to read as follows:

(c) Each community resource coordination group shall submit the report described by Subsection (b) to the council [consortium]. The council [consortium] shall provide a deadline to each group for submitting the reports. The time frame for completing the reports must be coordinated with any regional reviews by the commission of the delivery of related services.

SECTION 8. Section 531.423, Government Code, is amended to read as follows:

Sec. 531.423. SUMMARY REPORT BY COUNCIL [TEXAS INTEGRATED FUNDING INITIATIVE CONSORTIUM]. (a) The council [consortium] shall create a summary report based on the evaluations in the reports submitted to the council [consortium] by community resource coordination groups under Section 531.422. The council's [consortium's] report must include recommendations for policy and statutory changes at each agency that is involved in the provision of systems of care services and the outcome expected from implementing each recommendation.

(b) The council [consortium] shall coordinate, where appropriate, the recommendations in the report created under this section with recommendations in the assessment developed under Chapter 23, S.B. No. 491, Acts of the 78th Legislature, Regular Session, 2003, and with the continuum of care developed under Section 533.040(d), Health and Safety Code [S.B. No. 490, Acts of the 78th Legislature, Regular Session, 2003].

(c) The council [consortium] may include in the report created under this section recommendations for the statewide expansion of sites participating in the Texas Integrated Funding Initiative under Subchapter G-1 [G, Chapter 531, as added by Chapter 446, Acts of the 76th Legislature, Regular Session, 1999,] and the integration of services provided at those sites with services provided by community resource coordination groups.

(d) The council [consortium] shall provide a copy of the report created under this section to each agency for which the report makes a recommendation and to other agencies as appropriate.

SECTION 9. Subchapter L, Chapter 531, Government Code, is amended by adding Sections 531.425, 531.426, 531.427, and 531.428 to read as follows:

Sec. 531.425. CHILDREN'S BEHAVIORAL HEALTH COUNCIL. (a) The Children's Behavioral Health Council is established to provide a coordinated, comprehensive, interagency approach to the development and delivery of behavioral health services to children.

(b) The council is composed of one representative from each of the following state agencies, appointed by the chief administrative officer of the respective agency:

(1) the Health and Human Services Commission;

(2) the Department of State Health Services;

(3) the Department of Family and Protective Services;

(4) the Department of Assistive and Rehabilitative Services;

(5) the Department of Aging and Disability Services;

(6) the Texas Education Agency;

(7) the Texas Correctional Office on Offenders with Medical or Mental Impairments;

(8) the Texas Juvenile Probation Commission; and

(9) the Texas Youth Commission.

(c) The members of the council shall annually elect one member to serve as chairperson.

(d) The council, with the advice of the advisory committee established under Section 531.426, shall:

(1) develop and implement coordinated state policies to improve the behavioral health of children;

(2) develop a coordinated system for planning and budgeting that establishes priorities and strategies for the coordinated delivery of behavioral health services to children;

(3) develop a coordinated system to track and report spending on behavioral health services for children by agencies represented by a member of the council;

(4) administer state grants for development of local systems of care services;

(5) develop a plan to support the statewide expansion of local systems of care services;

(6) provide technical assistance and training to local providers of systems of care services;

(7) design an integrated funding structure for the provision of behavioral health services for children in accordance with Section 531.427; and

(8) assess the provision of behavioral health services to children to eliminate duplication of efforts and identify opportunities to consolidate those efforts.

(e) The council is administratively attached to the commission. The commission shall provide administrative support and resources to the council as necessary to enable the council to perform its duties.

(f) The council is not subject to Chapter 2110.

Sec. 531.426. CHILDREN'S BEHAVIORAL HEALTH ADVISORY COMMITTEE. (a) The commission shall establish the Children's Behavioral Health Advisory Committee to assist the council in the performance of its duties.

(b) The governor shall appoint to the advisory committee representatives from advocacy groups and organizations with expertise in behavioral health issues involving children and from other family advocates. The governor shall appoint as many members to the advisory committee as the council considers necessary to assist the council in performing its duties, but not less than the number of agency representatives on the council.

(c) The advisory committee shall elect one member to serve as chairperson, and shall meet in accordance with commission rules.

(d) A member of the advisory committee may not receive compensation for serving on the committee, but is entitled to reimbursement for travel expenses incurred while conducting the business of the committee, as provided by the General Appropriations Act.

(e) The commission shall provide administrative support and resources to the advisory committee as necessary to enable the committee to perform its duties.

(f) The committee is not subject to Chapter 2110.

Sec. 531.427. INTEGRATED FUNDING STRUCTURE FOR CERTAIN BEHAVIORAL HEALTH SERVICES. (a) The council shall design an integrated cross-agency funding structure for the provision of behavioral health services to children.

(b) In creating the funding structure, the council shall consider:

(1) the use of existing categorical or noncategorical federal, state, and local funds;

(2) the use of blended or braided funding arrangements;

(3) which funds should be included in the funding structure and how the funds should be structured; and

(4) the persons that should control and manage the funds, including managed care financing structures.

(c) The council may hire a consultant to assist with designing the funding structure.

(d) Not later than June 1, 2010, the council shall submit a report to the governor and the Legislative Budget Board that:

(1) describes the funding structure designed by the council; and

(2) identifies the steps necessary to implement the structure, including identification of necessary statutory changes or federal approvals.

(e) Subsection (d) and this subsection expire September 1, 2010.

Sec. 531.428. HOME AND COMMUNITY SERVICES FOR CHILDREN WITH SEVERE EMOTIONAL DISTURBANCES. (a) The commission shall maximize funding for home and community-based services for children with severe emotional disturbances by providing those services, to the greatest extent possible, through a Section 1915(c) waiver program or other Medicaid program. Not later than September 1, 2010, the commission shall identify each service the commission anticipates could be delivered cost-effectively in that manner using existing resources and seek federal approval as necessary to permit the delivery of services in that manner.

(b) Notwithstanding any other provision of this section, the commission may implement maximization financing strategies at a location providing systems of care services.

SECTION 10. Section 531.421(3), Government Code, is repealed.

SECTION 11. Not later than October 1, 2009, the chief administrative officer of each agency listed in Section 531.425(b), Government Code, as added by this Act, shall appoint the agency's representative to the Children's Behavioral Health Council established by that section.

SECTION 12. (a) Not later than November 1, 2009, the governor shall appoint the initial members of the Children's Behavioral Health Advisory Committee created by Section 531.426, Government Code, as added by this Act.

(b) In making initial appointments, the governor must include the public members serving immediately before the effective date of this Act on the Texas Integrated Funding Initiative Consortium, as formed under Section 531.251, Government Code, as that section existed before amendment by this Act, provided that those members wish to continue to serve.

SECTION 13. The changes in law made by this Act to Subchapter G-1, Chapter 531, Government Code, do 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.

SECTION 14. This Act takes effect September 1, 2009.