(a) The purpose of the system of family-based alternatives required by this section is to further the state’s policy of providing for a child’s basic needs for safety, security, and stability through ensuring that a child becomes a part of a successful permanent family as soon as possible.
(b) In achieving the purpose described by Subsection (a), the system is intended to be operated in a manner that recognizes that parents are a valued and integral part of the process established under the system. The system shall encourage parents to participate in all decisions affecting their children and shall respect the authority of parents, other than parents whose parental rights have been terminated, to make decisions regarding their children.

(c) In this section:
(1) “Child” means a person younger than 22 years of age who has a physical or developmental disability or who is medically fragile.
(2) “Family-based alternative” means a family setting in which the family provider or providers are specially trained to provide support and in-home care for children with disabilities or children who are medically fragile.
(3) “Institution” means any congregate care facility, including:
(A) a nursing facility;
(B) an ICF-IID, as defined by § 531.002, Health and Safety Code;
(C) a group home operated by the Department of Aging and Disability Services; and
(D) a general residential operation for children with an intellectual disability that is licensed by the Department of Family and Protective Services.
(4) “Waiver services” means services provided under:
(A) the Medically Dependent Children Program (MDCP);
(B) the Community Living Assistance and Support Services (CLASS) waiver program;
(C) the Home and Community-based Services (HCS) waiver program;
(D) the Deaf Blind with Multiple Disabilities (DBMD) waiver program; and
(E) any other Section 1915(c) waiver program that provides long-term care services for children.
(d) The commission shall contract with a community organization, including a faith-based community organization, or a nonprofit organization for the development and implementation of a system under which a child who cannot reside with the child’s birth family may receive necessary services in a family-based alternative instead of an institution. To be eligible for the contract under this subsection, an organization must possess knowledge regarding the support needs of children with disabilities and their families. For purposes of this subsection, a community organization, including a faith-based community organization, or a nonprofit organization does not include:
(1) any governmental entity; or
(2) any quasi-governmental entity to which a state agency delegates its authority and responsibility for planning, supervising, providing, or ensuring the provision of state services.
(e) The contractor may subcontract for one or more components of implementation of the system with:
(1) community organizations, including faith-based community organizations;
(2) nonprofit organizations;
(3) governmental entities; or
(4) quasi-governmental entities to which state agencies delegate authority and responsibility for planning, supervising, providing, or ensuring the provision of state services.
(f) The commission shall begin implementation of the system in areas of this state with high numbers of children who reside in institutions.
(g) Each affected health and human services agency shall cooperate with the contractor and any subcontractors and take all action necessary to implement the system and comply with the requirements of this section. The commission has final authority to make any decisions and resolve any disputes regarding the system.
(h) The system may be administered in cooperation with public and private entities.
(i) The system must provide for:
(1) recruiting and training alternative families to provide services for children;
(2) comprehensively assessing each child in need of services and each alternative family available to provide services, as necessary to identify the most appropriate alternative family for placement of the child;
(3) providing to a child’s parents or guardian information regarding the availability of a family-based alternative;
(4) identifying each child residing in an institution and offering support services, including waiver services, that would enable the child to return to the child’s birth family or be placed in a family-based alternative; and
(5) determining through a child’s permanency plan other circumstances in which the child must be offered waiver services, including circumstances in which changes in an institution’s status affect the child’s placement or the quality of services received by the child.
(j) In complying with the requirement imposed by Subsection (i)(3), the commission shall ensure that the procedures for providing information to parents or a guardian permit and encourage the participation of an individual who is not affiliated with the institution in which the child resides or with an institution in which the child could be placed.
(k) In placing a child in a family-based alternative, the system may use a variety of placement options, including an arrangement in which shared parenting occurs between the alternative family and the child’s birth family. Regardless of the option used, a family-based alternative placement must be designed to be a long-term arrangement, except in cases in which the child’s birth family chooses to return the child to their home. In cases in which the birth family’s parental rights have been terminated, adoption of the child by the child’s alternative family is an available option.
(l) The commission or the contractor may solicit and accept gifts, grants, and donations to support the system’s functions under this section.
(m) In designing the system, the commission shall consider and, when appropriate, incorporate current research and recommendations developed by other public and private entities involved in analyzing public policy relating to children residing in institutions.
(n) As necessary to implement this section, the commission shall:
(1) ensure that an appropriate number of openings for waiver services that become available as a result of funding for the purpose of transferring persons with disabilities into community-based services are made available to both children and adults;
(2) ensure that service definitions applicable to waiver services are modified as necessary to permit the provision of waiver services through family-based alternatives;
(3) ensure that procedures are implemented for making a level of care determination for each child and identifying the most appropriate waiver service for the child, including procedures under which the director of long-term care for the commission, after considering any preference of the child’s birth family or alternative family, resolves disputes among agencies about the most appropriate waiver service; and
(4) require that the health and human services agency responsible for providing a specific waiver service to a child also assume responsibility for identifying any necessary transition activities or services.
(o) Not later than January 1 of each year, the commission shall report to the legislature on the implementation of the system. The report must include a statement of:
(1) the number of children currently receiving care in an institution;
(2) the number of children placed in a family-based alternative under the system during the preceding year;
(3) the number of children who left an institution during the preceding year under an arrangement other than a family-based alternative under the system or for another reason unrelated to the availability of a family-based alternative under the system;
(4) the number of children waiting for an available placement in a family-based alternative under the system; and
(5) the number of alternative families trained and available to accept placement of a child under the system.

Text of section effective until April 01, 2025