By: Zaffirini S.B. No. 421
(In the Senate - Filed February 7, 2013; February 13, 2013,
read first time and referred to Committee on Health and Human
Services; April 8, 2013, reported adversely, with favorable
Committee Substitute by the following vote: Yeas 8, Nays 0;
April 8, 2013, sent to printer.)
COMMITTEE SUBSTITUTE FOR S.B. No. 421 By: Zaffirini
A BILL TO BE ENTITLED
AN ACT
relating to the Texas System of Care and the development of local
mental health systems of care for certain children.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. The heading to Subchapter G-1, Chapter 531,
Government Code, is amended to read as follows:
SUBCHAPTER G-1. DEVELOPING LOCAL MENTAL HEALTH [CARE] SYSTEMS OF
CARE FOR CERTAIN CHILDREN
SECTION 2. Section 531.251, Government Code, is amended to
read as follows:
Sec. 531.251. TEXAS SYSTEM OF CARE [PILOT PROJECT]
CONSORTIUM[; EXPANSION PLAN]. (a) The commission shall form a
consortium to have responsibility [develop criteria] for and
oversight over a state system of care [implement the expansion of
the Texas Integrated Funding Initiative pilot project and] to
develop local mental health systems of care [systems] in
communities for minors who are receiving residential mental health
services or inpatient mental health hospitalization or who are at
risk of being removed from the minor's home and placed in a more
restrictive environment to receive mental health services,
including an inpatient mental health hospital, a residential
treatment facility, or a facility or program operated by the
Department of Family and Protective Services or an agency that is
part of the juvenile justice system [placement to receive mental
health services].
(a-1) The consortium must include:
(1) representatives of the [Texas] Department of State
[Mental] Health Services [and Mental Retardation], Department of
Family and Protective [and Regulatory] Services, Health and Human
Services Commission's Medicaid program, Texas Education Agency,
[Texas Youth Commission,] Texas Juvenile Justice Department
[Probation Commission], and Texas Correctional Office on Offenders
with Medical or Mental Impairments;
(2) one youth or young adult who has a serious
emotional disturbance and has received mental health services and
supports; or
(3) a family member of a youth or young adult described
by Subdivision (2) [Commission on Alcohol and Drug Abuse and an
equal number of family advocates].
(a-2) The consortium may coordinate with the Children's
Policy Council for the purposes of including the representation
required by Subsections (a-1)(2) and (3).
(b) The commission and the consortium shall:
(1) maintain [develop] a comprehensive plan [model and
guidelines] for the delivery of mental health services and supports
[support] to a minor and a minor's family using a system of care
framework[, initiated before the person's 18th birthday],
including best practices in the financing, administration,
governance, and delivery of those services;
(2) implement strategies [establish a plan] to expand
the use of system of care practices [Texas Integrated Funding
Initiative so that the initiative may operate] in the planning and
delivery of services throughout the state [up to six communities];
[and]
(3) identify appropriate local, [sources of] state,
and federal funding sources to finance infrastructure and mental
health services needed to support state and local system of care
efforts; and
(4) develop an evaluation system to measure outcomes
of state and local system of care efforts [under the initiative from
a central fund for expansion communities].
(b-1) Not later than November 1 of each even-numbered year,
the consortium shall submit a report to the legislature and the
Council on Children and Families that contains an evaluation of the
outcomes of the Texas System of Care and recommendations on
strengthening state policies and practices that support local
systems of care, including recommendations relating to:
(1) methods to increase access to effective and
coordinated services and supports;
(2) methods to increase community capacity to
implement local systems of care through training and technical
assistance;
(3) use of cross-system performance and outcome data
to make informed decisions at individual and system levels; and
(4) strategies to maximize public and private funding
at the local, state, and federal levels.
SECTION 3. Section 531.252, Government Code, is amended to
read as follows:
Sec. 531.252. PROPOSALS FOR LOCAL SYSTEM OF CARE GRANTS
[EXPANSION COMMUNITIES]. (a) The commission by rule may [shall]
establish a request-for-proposal process to select [expansion]
communities to implement a local system of care as funding is
available [participate in the initiative].
(b) The commission and the 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 provided in the
community, strengths-based, culturally and linguistically
competent, family-driven [family-centered], and youth-guided
[seamless];
(2) [(3)] identify populations to be served under the
proposals;
(3) [(4)] establish [for the expansion communities]
service outcome goals for the grant communities;
(4) require demonstration of the capacity to collect
data related to minors who are receiving [residential] mental
health services in residential facilities or inpatient mental
health hospitals or who are at risk of residential placement to
receive mental health services or inpatient mental health
hospitalization, including data relating to whether the system of
care is:
(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 or inpatient mental health
hospitalization;
(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 or inpatient mental health
hospitals for mental health services or who are at risk of being
placed in residential care or inpatient mental health hospitals to
receive mental health services.
(c) Populations to be served, as identified under
Subsection (b)(2) [(b)(3)], must include youth at risk of
residential placement, inpatient mental health hospitalization,
incarceration, or reincarceration because of severe emotional
disturbance, including:
(1) students in a special education program under
Subchapter A, Chapter 29, Education Code; and
(2) youth with a severe emotional disturbance and a
co-occurring:
(A) substance abuse disorder; or
(B) developmental disability.
[(d) Outcome criteria established under Subsection (b)(4)
must be consistent with outcome measures used in evaluations of
individualized children's services projects in other states.]
SECTION 4. Section 531.255, Government Code, is amended to
read as follows:
Sec. 531.255. EVALUATION. [(a)] The commission and the
[Texas] Department of State [Mental] Health Services [and Mental
Retardation] jointly shall monitor the progress of the grant
[expansion] communities, including monitoring cost avoidance and
the net savings that result from implementing a local system of
care.
[(b) The commission, the 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 in accordance with the requirements of the evaluation
system developed under Subsection (b).
[(d) To the extent practicable, an expansion community
shall use instruments to measure outcomes that have known
reliability and validity and that allow comparisons with similar
projects in other states and with national evaluation efforts.]
SECTION 5. Section 531.257, Government Code, is amended to
read as follows:
Sec. 531.257. TECHNICAL ASSISTANCE FOR GRANT PROJECTS. The
commission may provide technical assistance to a community that
receives a grant under Section 531.252 [531.256].
SECTION 6. Sections 531.253, 531.254, 531.256, and 531.258,
Government Code, are repealed.
SECTION 7. This Act takes effect September 1, 2013.
* * * * *