81R5657 UM-D By: Madden H.B. No. 1729 A BILL TO BE ENTITLED AN ACT relating to certain requirements regarding the provision of home and community-based services under the Medicaid program. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Section 242.003, Health and Safety Code, is amended to read as follows: Sec. 242.003. EXEMPTIONS. Except as otherwise provided, this chapter does not apply to: (1) a hotel or other similar place that furnishes only food, lodging, or both, to its guests; (2) a hospital; (3) an establishment conducted by or for the adherents of a well-recognized church or religious denomination for the purpose of providing facilities for the care or treatment of the sick who depend exclusively on prayer or spiritual means for healing, without the use of any drug or material remedy, if the establishment complies with safety, sanitary, and quarantine laws and rules; (4) an establishment that furnishes, in addition to food, shelter, and laundry, only baths and massages; (5) an institution operated by a person licensed by the Texas Board of Chiropractic Examiners; (6) a facility that: (A) primarily engages in training, habilitation, rehabilitation, or education of clients or residents; (B) is operated under the jurisdiction of a state or federal agency, including the Department of Assistive and Rehabilitative Services, Department of Aging and Disability Services, Department of State Health Services, Health and Human Services Commission [Texas Rehabilitation Commission, Texas Department of Mental Health and Mental Retardation, Texas Department of Human Services, Texas Commission for the Blind, Texas Commission on Alcohol and Drug Abuse], [institutional division of the] Texas Department of Criminal Justice, and Department of Veterans Affairs [the Veteran's Administration]; and (C) is certified through inspection or evaluation as meeting the standards established by the state or federal agency; (7) a foster care type residential facility that serves fewer than five persons and operates under rules adopted by the Texas Department of Human Services or the executive commissioner of the Health and Human Services Commission, as applicable; [and] (8) a facility licensed under Chapter 252 or exempt from licensure under Section 252.003; or (9) a home described by Section 161.081, Human Resources Code. SECTION 2. Section 247.004, Health and Safety Code, is amended to read as follows: Sec. 247.004. EXEMPTIONS. This chapter does not apply to: (1) a boarding facility that has rooms for rent and that may offer community meals, light housework, meal preparation, transportation, grocery shopping, money management, or laundry services but that does not provide personal care services; (2) an establishment conducted by or for the adherents of the Church of Christ, Scientist, for the purpose of providing facilities for the care or treatment of the sick who depend exclusively on prayer or spiritual means for healing without the use of any drug or material remedy if the establishment complies with local safety, sanitary, and quarantine ordinances and regulations; (3) a facility conducted by or for the adherents of a qualified religious society classified as a tax-exempt organization under an Internal Revenue Service group exemption ruling for the purpose of providing personal care services without charge solely for the society's professed members or ministers in retirement, if the facility complies with local safety, sanitation, and quarantine ordinances and regulations; [or] (4) a facility that provides personal care services only to persons enrolled in a program that is funded in whole or in part by the Texas Department of Mental Health and Mental Retardation and that is monitored by the Texas Department of Mental Health and Mental Retardation or its designated local authority in accordance with standards set by the Texas Department of Mental Health and Mental Retardation; or (5) a home described by Section 161.081, Human Resources Code. SECTION 3. Section 252.003, Health and Safety Code, is amended to read as follows: Sec. 252.003. EXEMPTIONS. Except as otherwise provided by this chapter, this chapter does not apply to an establishment that: (1) provides training, habilitation, rehabilitation, or education to individuals with mental retardation or a related condition; (2) is operated under the jurisdiction of a state or federal agency, including the Department of Assistive and Rehabilitative Services, Department of Aging and Disability Services, Department of State Health Services, Health and Human Services Commission [department, the Texas Rehabilitation Commission, the Texas Department of Mental Health and Mental Retardation, the Texas Commission for the Blind, the Texas Commission on Alcohol and Drug Abuse], [the institutional division of the] Texas Department of Criminal Justice, and Department of Veterans Affairs [or the Veterans' Administration]; (3) is certified through inspection or evaluation as meeting the standards established by the state or federal agency; [and] (4) is conducted by or for the adherents of a well-recognized church or religious denomination for the purpose of providing facilities for the care or treatment of the sick who depend exclusively on prayer or spiritual means for healing, without the use of any drug or material remedy, if the establishment complies with safety, sanitary, and quarantine laws and rules; or (5) is a home described by Section 161.081, Human Resources Code. SECTION 4. Subchapter D, Chapter 161, Human Resources Code, is amended by adding Section 161.081 to read as follows: Sec. 161.081. HOME AND COMMUNITY-BASED SERVICES PROVIDERS; NUMBER OF RESIDENTS ALLOWED. (a) In this section, "home and community-based services" means the services described by 42 U.S.C. Section 1396n(c) that are provided by a person under a contract with the department. (b) A person certified by the department to provide home and community-based services may provide services in homes in which six or fewer individuals receiving similar services reside, but only if a direct services provider does not reside in the home. (c) A home in which six or fewer individuals receiving similar services reside and in which at least one individual is receiving services from a home and community-based services program provider, but in which a direct services provider does not reside, is exempt from licensing under Chapter 242, 247, or 252, Health and Safety Code. SECTION 5. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted. SECTION 6. This Act takes effect September 1, 2009.