Texas 2009 - 81st Regular

Texas House Bill HB4688 Latest Draft

Bill / Introduced Version Filed 02/01/2025

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                            By: Herrero H.B. No. 4688


 A BILL TO BE ENTITLED
 AN ACT
 relating to the protection and care of individuals with mental
 retardation who reside in a state developmental center.
 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 SECTION 27. Article 2.12, Code of Criminal Procedure, is
 amended to read as follows:
 Art. 2.12. WHO ARE PEACE OFFICERS. The following are peace
 officers:
 (1) sheriffs, their deputies, and those reserve
 deputies who hold a permanent peace officer license issued under
 Chapter 1701, Occupations Code;
 (2) constables, deputy constables, and those reserve
 deputy constables who hold a permanent peace officer license issued
 under Chapter 1701, Occupations Code;
 (3) marshals or police officers of an incorporated
 city, town, or village, and those reserve municipal police officers
 who hold a permanent peace officer license issued under Chapter
 1701, Occupations Code;
 (4) rangers and officers commissioned by the Public
 Safety Commission and the Director of the Department of Public
 Safety;
 (5) investigators of the district attorneys', criminal
 district attorneys', and county attorneys' offices;
 (6) law enforcement agents of the Texas Alcoholic
 Beverage Commission;
 (7) each member of an arson investigating unit
 commissioned by a city, a county, or the state;
 (8) officers commissioned under Section 37.081,
 Education Code, or Subchapter E, Chapter 51, Education Code;
 (9) officers commissioned by the General Services
 Commission;
 (10) law enforcement officers commissioned by the
 Parks and Wildlife Commission;
 (11) airport police officers commissioned by a city
 with a population of more than 1.18 million that operates an airport
 that serves commercial air carriers;
 (12) airport security personnel commissioned as peace
 officers by the governing body of any political subdivision of this
 state, other than a city described by Subdivision (11), that
 operates an airport that serves commercial air carriers;
 (13) municipal park and recreational patrolmen and
 security officers;
 (14) security officers and investigators commissioned
 as peace officers by the comptroller;
 (15) officers commissioned by a water control and
 improvement district under Section 49.216, Water Code;
 (16) officers commissioned by a board of trustees
 under Chapter 54, Transportation Code;
 (17) investigators commissioned by the Texas Medical
 Board;
 (18) officers commissioned by the board of managers of
 the Dallas County Hospital District, the Tarrant County Hospital
 District, or the Bexar County Hospital District under Section
 281.057, Health and Safety Code;
 (19) county park rangers commissioned under
 Subchapter E, Chapter 351, Local Government Code;
 (20) investigators employed by the Texas Racing
 Commission;
 (21) officers commissioned under Chapter 554,
 Occupations Code;
 (22) officers commissioned by the governing body of a
 metropolitan rapid transit authority under Section 451.108,
 Transportation Code, or by a regional transportation authority
 under Section 452.110, Transportation Code;
 (23) investigators commissioned by the attorney
 general under Section 402.009, Government Code;
 (24) security officers and investigators commissioned
 as peace officers under Chapter 466, Government Code;
 (25) an officer employed by the Department of State
 Health Services under Section 431.2471, Health and Safety Code;
 (26) officers appointed by an appellate court under
 Subchapter F, Chapter 53, Government Code;
 (27) officers commissioned by the state fire marshal
 under Chapter 417, Government Code;
 (28) an investigator commissioned by the commissioner
 of insurance under Section 701.104, Insurance Code;
 (29) apprehension specialists and inspectors general
 commissioned by the Texas Youth Commission as officers under
 Sections 61.0451 and 61.0931, Human Resources Code;
 (30) officers appointed by the inspector general of
 the Texas Department of Criminal Justice under Section 493.019,
 Government Code;
 (31) investigators commissioned by the Commission on
 Law Enforcement Officer Standards and Education under Section
 1701.160, Occupations Code;
 (32) commission investigators commissioned by the
 Texas Private Security Board under Section 1702.061(f),
 Occupations Code;
 (33) the fire marshal and any officers, inspectors, or
 investigators commissioned by an emergency services district under
 Chapter 775, Health and Safety Code;
 (34) officers commissioned by the State Board of
 Dental Examiners under Section 254.013, Occupations Code, subject
 to the limitations imposed by that section; [and]
 (35) investigators commissioned by the Texas Juvenile
 Probation Commission as officers under Section 141.055, Human
 Resources Code; and
 (36) officers commissioned by the office of inspector
 general established under Subchapter R, Chapter 531, Government
 Code.
 SECTION 28. Sections 531.102 and 531.1021, Government Code,
 are repealed.
 SECTION 29. Section 411.086, Government Code, is amended to
 read as follows:
 Sec. 411.083. DISSEMINATION OF CRIMINAL HISTORY RECORD
 INFORMATION. (a) Criminal history record information maintained
 by the department is confidential information for the use of the
 department and, except as provided by this subchapter, may not be
 disseminated by the department.
 (b) The department shall grant access to criminal history
 record information to:
 (1) criminal justice agencies;
 (2) noncriminal justice agencies authorized by
 federal statute or executive order or by state statute to receive
 criminal history record information;
 (3) the person who is the subject of the criminal
 history record information;
 (4) a person working on a research or statistical
 project that:
 (A) is funded in whole or in part by state funds;
 or
 (B) meets the requirements of Part 22, Title 28,
 Code of Federal Regulations, and is approved by the department;
 (5) an individual or an agency that has a specific
 agreement with a criminal justice agency to provide services
 required for the administration of criminal justice under that
 agreement, if the agreement:
 (A) specifically authorizes access to
 information;
 (B) limits the use of information to the purposes
 for which it is given;
 (C) ensures the security and confidentiality of
 the information; and
 (D) provides for sanctions if a requirement
 imposed under Paragraph (A), (B), or (C) is violated;
 (6) an individual or an agency that has a specific
 agreement with a noncriminal justice agency to provide services
 related to the use of criminal history record information
 disseminated under this subchapter, if the agreement:
 (A) specifically authorizes access to
 information;
 (B) limits the use of information to the purposes
 for which it is given;
 (C) ensures the security and confidentiality of
 the information; and
 (D) provides for sanctions if a requirement
 imposed under Paragraph (A), (B), or (C) is violated;
 (7) a county or district clerk's office; [and]
 (8) the Office of Court Administration of the Texas
 Judicial System; and
 (9)  officers commissioned by the office of inspector
 general established under Subchapter R, Chapter 531, Government
 Code.
 (c) The department may disseminate criminal history record
 information under Subsection (b)(1) only for a criminal justice
 purpose. The department may disseminate criminal history record
 information under Subsection (b)(2) only for a purpose specified in
 the statute or order. The department may disseminate criminal
 history record information under Subsection (b)(4), (5), or (6)
 only for a purpose approved by the department and only under rules
 adopted by the department. The department may disseminate criminal
 history record information under Subsection (b)(7) only to the
 extent necessary for a county or district clerk to perform a duty
 imposed by law to collect and report criminal court disposition
 information. Criminal history record information disseminated to a
 clerk under Subsection (b)(7) may be used by the clerk only to
 ensure that information reported by the clerk to the department is
 accurate and complete. The dissemination of information to a clerk
 under Subsection (b)(7) does not affect the authority of the clerk
 to disclose or use information submitted by the clerk to the
 department. The department may disseminate criminal history record
 information under Subsection (b)(8) only to the extent necessary
 for the office of court administration to perform a duty imposed by
 law to compile court statistics or prepare reports. The office of
 court administration may disclose criminal history record
 information obtained from the department under Subsection (b)(8) in
 a statistic compiled by the office or a report prepared by the
 office, but only in a manner that does not identify the person who
 is the subject of the information.
 (d) The department is not required to release or disclose
 criminal history record information to any person that is not in
 compliance with rules adopted by the department under this
 subchapter or rules adopted by the Federal Bureau of Investigation
 that relate to the dissemination or use of criminal history record
 information.
 SECTION 1. Section 261.404, Family Code, is amended by
 adding Subsection (b-1) to read as follows:
 (b-1)  If an investigation under this section reveals
 evidence of abuse, neglect, or exploitation of a resident or client
 of a state developmental center as defined by Section 531.002,
 Health and Safety Code and a caseworker of the department or a
 supervisor of a caseworker believes that the abuse, neglect, or
 exploitation is a criminal offense, the caseworker or supervisor
 shall immediately notify the Health and Human Services Commission's
 office of inspector general and promptly provide the Health and
 Human Services Commission's office of inspector general with a copy
 of the department's investigation report.
 SECTION 2. Subchapter F, Chapter 411, Government Code, is
 amended by adding Section 411.1144 to read as follows:
 SECTION 3. Subchapter C, Chapter 531, Government Code, is
 amended by adding Section 531.1022 to read as follows:
 Sec. 531.1022.  ASSISTING CERTAIN INVESTIGATIONS BY LAW
 ENFORCEMENT.  (a)  The office of inspector general shall employ and
 commission peace officers for the sole purpose of assisting a state
 or local law enforcement agency in the investigation of an alleged
 criminal offense involving a resident or client of a state
 developmental center as defined by Section 531.002, Health and
 Safety Code.
 (b)  The office of inspector general shall prepare a final
 report for each investigation conducted under this section.  The
 office shall ensure that the report does not contain identifying
 information of an individual mentioned in the report.  The final
 report must include:
 (1)  a summary of the activities performed by the
 office of inspector general in conducting the investigation;
 (2)  a statement regarding whether the investigation
 resulted in a finding that an alleged criminal offense was
 committed; and
 (3)  a description of the alleged criminal offense that
 was committed.
 (c)  The office of inspector general shall deliver the final
 report to the:
 (1) executive commissioner;
 (2)  commissioner of the Department of Aging and
 Disability Services;
 (3)  commissioner of the Department of Family and
 Protective Services;
 (4) Aging and Disability Services Council;
 (5) governor;
 (6) lieutenant governor;
 (7) speaker of the house of representatives;
 (8)  standing committees of the senate and house of
 representatives with primary jurisdiction over state developmental
 centers;
 (9) state auditor;
 (10)  alleged victim and the alleged victim's legally
 authorized representative; and
 (11)  office of the independent ombudsman for state
 developmental centers.
 (d)  A final report regarding an investigation is subject to
 required disclosure under Chapter 552.  All information and
 materials compiled by the office of inspector general in connection
 with an investigation are confidential, and not subject to
 disclosure under Chapter 552, and not subject to disclosure,
 discovery, subpoena, or other means of legal compulsion for their
 release to anyone other than the office or its employees or agents
 involved in the investigation conducted by the office, except that
 this information may be disclosed to the office of the attorney
 general, the state auditor's office, and law enforcement agencies.
 (e)  The office of inspector general shall prepare an annual
 status report of its activities under this section.  The annual
 report may not contain identifying information of an individual
 mentioned in the report.  The annual status report must include
 information that is aggregated and disaggregated by individual
 state developmental center.
 (1)  the number and type of alleged offenses
 investigated by the office;
 (2)  the number and type of alleged offenses involving
 an employee of a state developmental center;
 (3)  the relationship of an alleged victim to an
 alleged perpetrator;
 (4)  the number of investigations conducted that
 involve the suicide, death, or hospitalization of an alleged
 victim; and
 (5)  the number of completed investigations in which
 commission of the alleged offense was confirmed or unsubstantiated
 or in which the investigation was inconclusive, and a description
 of the reason that allegations were unsubstantiated or the
 investigation was inconclusive.
 (f) The office of inspector general shall:
 (1) submit the annual status report to the:
 (A) executive commissioner;
 (B)  commissioner of the Department of Aging and
 Disability Services;
 (C)  commissioner of the Department of Family and
 Protective Services;
 (D) Aging and Disability Services Council;
 (E) Family and Protective Services Council;
 (F) governor;
 (G) lieutenant governor;
 (H) speaker of the house of representatives;
 (I)  standing committees of the senate and house
 of representatives with primary jurisdiction over state
 developmental centers;
 (J) state auditor; and
 (K) comptroller; and
 (2)  publish the report on the Internet website of the
 office of inspector general.
 (g)  An annual status report submitted under this section is
 public information under Chapter 552.
 SECTION 4. Chapter 531, Government Code, is amended by
 adding Subchapter R to read as follows:
 SUBCHAPTER R.  INSPECTOR GENERAL
 Sec. 531.701. DEFINITIONS. In this subchapter:
 (1)  "Fraud" has the meaning assigned by Section
 531.1011.
 (2)  "Inspector general" means the inspector general
 appointed under this subchapter.
 (3) "Office" means the Office of Inspector General.
 (4)  "Provider" has the meaning assigned by Section
 531.1011.
 (5)  "Review" includes an inspection, investigation,
 audit, or similar activity.
 (6)  "State funds" or "state money" includes federal
 funds or money received and appropriated by the state or for which
 the state has oversight responsibility.
 Sec. 531.702.  REFERENCE IN OTHER LAW.  Notwithstanding any
 other provision of law, a reference in law or rule to the
 commission's office of inspector general or the commission's office
 of investigations and enforcement means the Office of Inspector
 General.
 Sec. 531.703.  OFFICE OF INSPECTOR GENERAL; ADMINISTRATIVE
 ATTACHMENT.  (a)  The office of inspector general is responsible
 for:
 (1)  the investigation of fraud, waste, and abuse in
 the provision or funding of health or human services by this state;
 (2)  the enforcement of state law relating to the
 provision of those services to protect the public; and
 (3)  the investigation, prevention and detection of
 crime relating to the provision of those services.
 (b)  The office is part of the single state Medicaid agency
 and is administratively attached to the commission.  The commission
 shall provide to the office administrative support services from
 the commission and from health and human services agencies.
 Sec. 531.704.  SERVICE LEVEL AGREEMENT; FUNDS.  (a)  The
 commission and the office shall enter into a service level
 agreement that establishes the performance standards and
 deliverables with regard to administrative support by the
 commission.
 (b)  The service level agreement must be reviewed at least
 annually to ensure that services and deliverables are provided in
 accordance with the agreement.
 (c)  The commission shall request, apply for, and receive for
 the office any appropriations or other money from this state or the
 federal government, and shall disburse all such funds to the office
 as appropriated.
 (d)  The commission shall provide to the office for the state
 fiscal biennium beginning September 1, 2009, the same level of
 administrative support the commission provided to the office
 established under former Section 531.102 for the state fiscal
 biennium beginning September 1, 2007.  This subsection expires
 January 1, 2012.
 Sec. 531.705.  DUTIES OF COMMISSION.  (a)  The commission
 shall:
 (1)  provide administrative assistance to the office;
 and
 (2)  coordinate administrative responsibilities with
 the office to avoid unnecessary duplication of duties.
 (b)  The commission may not take an action that affects or
 relates to the validity, status, or terms of an interagency
 agreement or a contract to which the office is a party without the
 office's approval.
 Sec. 531.706.  INDEPENDENCE OF OFFICE.  (a)  Except as
 otherwise provided by this chapter, the office and inspector
 general operate independently of the commission.
 (b)  The inspector general, not the executive commissioner,
 supervises the office staff and manages the operations of the
 office.
 (c)  The inspector general shall have operational authority
 over and responsibility for the:
 (1)  management of the daily operations of the office,
 including the organization and management of the office and office
 operating procedures;
 (2) allocation of resources within the office;
 (3) personnel and employment policies;
 (4)  contracting, purchasing, and related policies,
 subject to other laws relating to state agency contracting and
 purchasing;
 (5) information resources systems used by the office;
 (6) location of office facilities;
 (7)  coordination of office activities with activities
 of other state agencies, including other health and human services
 agencies.
 Sec. 531.707.  INSPECTOR GENERAL: APPOINTMENT AND TERM.  (a)
 The governor shall appoint an inspector general to serve as
 director of the office.
 (b)  The inspector general reports to the governor and serves
 a two-year term that expires on February 1 of each odd-numbered
 year.
 (c) The inspector general is a state officer.
 Section 531.708.  CONFLICT OF INTEREST.  (a)  The inspector
 general may not serve as an ex officio member on the governing body
 of a governmental entity.
 (b)  The inspector general may not have a financial interest
 in the transactions of the office, a health and human services
 agency, or a health or human services provider.
 Section 531.709.   RULEMAKING BY INSPECTOR GENERAL.  (a)
 Notwithstanding Section 531.0055 (e) and any other law, the
 inspector general shall adopt the rules necessary to administer the
 functions of the office, including rules to address the imposition
 of sanctions and penalties for violations and due process
 requirements for imposing sanctions and penalties, as well as rules
 relating to the eligibility of providers and contractors to
 participate in health and human services programs.
 (b)  A rule, standard, or form adopted by the executive
 commissioner, the commission, or a health and human services agency
 that is necessary to accomplish the duties of the office is
 considered to also be a rule, standard, or form of the office and
 remains in effect as a rule, standard, or form of the office until
 changed by the inspector general.
 (c)  The office may submit proposed rules and adopted rules
 to the commission for publication.  The executive commissioner or
 commission may not amend or modify a rule submitted by the office.
 (d)  The rules must include standards for the office that
 emphasize:
 (1)  coordinating investigative efforts to
 aggressively recover money;
 (2)  allocating resources to cases that have the
 strongest supportive evidence and the greatest potential for
 recovery of money; and
 (3)  maximizing opportunities for referral of cases to
 the office of the attorney general.
 Sec. 531.710. EMPLOYEES; MEDICAL REVIEW OFFICER; TRAINING.
 (a) The inspector general may employ personnel as necessary
 to implement the duties of the office.
 (b)  The inspector general shall employ a physician as the
 medical review officer to perform reviews and provide information
 and consultation as appropriate when the matter at issue involves
 or requires medical expertise.
 (c)  The inspector general shall train office personnel to
 pursue priority Medicaid and other health and human services fraud,
 waste, and abuse cases efficiently and as necessary.
 (d)  The inspector general may contract with certified
 public accountants, management consultants, or other professional
 experts necessary to enable the inspector general and office
 personnel to independently perform the functions of the inspector
 general's office.
 (e)  The inspector general may require employees of health
 and human services agencies to provide assistance to the office in
 connection with the office's duties relating to the investigation
 of fraud, waste, and abuse in the provision of health and human
 services.
 Sec. 531.711.  REVIEW AUTHORITY.  (a)  The inspector general
 may any activity or operation of a health and human services agency,
 health or human services provider, or person in this state that is
 related to the investigation, detection, or prevention of fraud,
 waste, abuse or employee misconduct in a state or state-funded
 health or human services program.  A review may include an
 inspection, investigation, audit, or other similar activity [or
 other] inquiring[y] into a specific act or allegation of, or a
 specific financial transaction or practice that may involve,
 impropriety, malfeasance, or nonfeasance in the obligation,
 spending, receipt, or other use of state money.
 (b)  The executive commissioner, the commission, or a health
 and human services agency of this state may not impair, prohibit, or
 attempt to influence the inspector general in initiating,
 conducting, or completing a review.
 (c)  The inspector general may conduct reviews, including
 financial or performance audits regarding the use and effectiveness
 of state funds, including contract and grant funds, administered by
 a person or state agency receiving the funds in connection with a
 state or state-funded health or human services program.
 Sec. 531.712.  INITIATION OF REVIEW.  The inspector general
 may initiate a review:
 (1) on the inspector general's own initiative;
 (2)  at the request of the commission or executive
 commissioner; or
 (3)  based on a complaint from any source concerning a
 matter described by Section 531.711.
 Sec. 531.713.  INTEGRITY REVIEW.  (a)  The office shall
 conduct an integrity review to determine whether there is
 sufficient basis to warrant a full investigation on receipt of any
 complaint of fraud, waste, or abuse of funds in the state Medicaid
 program from any source.
 (b)  An integrity review must begin not later than the 30th
 day after the date the office receives a complaint or has reason to
 believe that Medicaid fraud, waste, or abuse has occurred. An
 integrity review shall be completed not later than the 90th day
 after the date the review began.
 (c)  If the findings of an integrity review give the office
 reason to believe that an incident of fraud involving possible
 criminal conduct has occurred in the state Medicaid program, the
 office must take the following action, as appropriate, not later
 than the 30th day after the completion of the integrity review:
 (1)  if a provider is suspected of fraud involving
 criminal conduct, the office must refer the case to the state's
 Medicaid fraud control unit, provided that the criminal referral
 does not preclude the office from continuing its investigation of
 the provider or preclude the imposition of appropriate
 administrative or civil sanctions; or
 (2)  if there is reason to believe that a recipient of
 funds has defrauded the Medicaid program, the office may conduct a
 full investigation of the suspected fraud.
 Sec. 531.714.  ACCESS TO INFORMATION.  (a)  To further a
 review conducted by the office, the inspector general is entitled
 to full and unrestricted access to all offices, limited-access or
 restricted areas, employees, books, papers, records, documents,
 equipment, computers, databases, systems, accounts, reports,
 vouchers, or other information, including confidential
 information, electronic data, and internal records relevant to the
 functions of the office, maintained by a person, health and human
 services agency, or health or human services provider in connection
 with a state or state-funded health or human services program.
 (b)  The inspector general may not access data or other
 information the release of which is restricted under federal law
 unless the office is in compliance with all applicable federal
 regulations governing such access.
 Sec. 531.715.  COOPERATION REQUIRED.  To further a review
 conducted by the inspector general's office, the inspector general
 may require medical or other professional assistance from the
 executive commissioner, the commission, a health and human services
 agency, or an auditor, accountant, or other employee of the
 commission or agency.
 Sec. 531.716.  REFERRAL TO STATE MEDICAID FRAUD CONTROL
 UNIT.  (a)  At the time the office learns or has reason to suspect
 that a health or human services provider 's records related to
 participation in the state Medicaid program are being withheld,
 concealed, destroyed, fabricated, or in any way falsified, the
 office shall immediately refer the case to the state's Medicaid
 fraud control unit.
 (b)  A criminal referral under Subsection (a) does not
 preclude the office from continuing its investigation of a health
 or human services provider or the imposition of appropriate
 administrative or civil sanctions.
 Sec. 531.717.  HOLD ON CLAIM REIMBURSEMENT PAYMENT;
 EXCLUSION FROM PROGRAMS.  (a)  In addition to other instances
 authorized under state or federal law, the office shall impose
 without prior notice a hold on payment of claims for reimbursement
 submitted by a health or human services provider to compel
 production of records related to participation in the state
 Medicaid program or on request of the state's Medicaid fraud
 control unit, as applicable.
 (b)  The office must notify the health or human services
 provider of the hold on payment not later than the fifth working day
 after the date the payment hold is imposed.
 (c)  The office shall, in consultation with the state's
 Medicaid fraud control unit, establish guidelines under which holds
 on payment or exclusions from a state or state-funded program:
 (1)  may permissively be imposed on a health or human
 services provider; or
 (2) shall automatically be imposed on a provider.
 (d)  A health or human services provider subject to a hold on
 payment or excluded from a program under this section is entitled to
 a hearing on the hold or exclusion.  A hearing under this subsection
 is a contested case hearing under Chapter 2001. The State Office of
 Administrative Hearings shall conduct the hearing.  After the
 hearing, the office, subject to judicial review, shall make a final
 determination.  The commission, a health and human services agency,
 and the office of the attorney general are entitled to intervene as
 parties in the contested case.
 Sec. 531.718.  REQUEST FOR EXPEDITED HEARING.  (a)  On timely
 written request by a health or human services provider subject to a
 hold on payment under Section 531.717, other than a hold requested
 by the state's Medicaid fraud control unit, the office shall file a
 request with the State Office of Administrative Hearings for an
 expedited administrative hearing regarding the hold.
 (b)  The health or human services provider must request an
 expedited hearing not later than the 10th day after the date the
 provider receives notice from the office under Section 531.717(b).
 (c)  The office may enter into a memorandum of understanding
 with the State Office of Administrative Hearings to facilitate the
 docketing and hearing of contested case hearings.
 Sec. 531.719.  INFORMAL RESOLUTION.  (a)  The inspector
 general shall adopt rules that allow a health or human services
 provider subject to a hold on payment under Section 531.717, other
 than a hold requested by the state's Medicaid fraud control unit, to
 seek an informal resolution of the issues identified by the office
 in the notice provided under that section.
 (b)  A health or human services provider must seek an
 informal resolution not later than the 10th day after the date the
 provider receives notice from the office under Section 531.717(b).
 (c)  A health or human services provider's decision to seek
 an informal resolution does not extend the time by which the
 provider must request an expedited administrative hearing under
 Section 531.718.
 (d)  A hearing initiated under Section 531.717 shall be
 stayed at the office's request until the informal resolution
 process is completed.
 Sec. 531.720.  EMPLOYEE REPORTS.  The inspector general may
 require employees at the commission or a health and human services
 agency to report to the office information regarding fraud, waste,
 misuse or abuse of funds or resources, corruption, or illegal acts.
 Sec. 531.721.  SUBPOENAS.  (a)  The inspector general may
 issue a subpoena to compel the attendance of a relevant witness or
 the production, for inspection or copying, of relevant evidence in
 connection with a review conducted under this subchapter.
 (b)  A subpoena may be served personally or by certified
 mail.
 (c)  If a person fails to comply with a subpoena, the
 inspector general, acting through the attorney general, may file
 suit to enforce the subpoena in a district court in this state.
 (d)  On finding that good cause exists for issuing the
 subpoena, the court shall order the person to comply with the
 subpoena.  The court may hold in contempt a person who fails to obey
 the court order.
 (e)  The reimbursement of the expenses of a witness whose
 attendance is compelled under this section is governed by Section
 2001.103.
 Sec. 531.722.  INTERNAL AUDITOR.  (a)  In this section,
 "internal auditor" means a person appointed under Section 2102.006.
 (b)  The internal auditor for a health and human services
 agency shall provide the inspector general with a copy of the
 agency's internal audit plan to:
 (1)  assist in the coordination of efforts between the
 inspector general and the internal auditor; and
 (2)  limit duplication of effort regarding reviews by
 the inspector general and internal auditor.
 (c)  The internal auditor shall provide to the inspector
 general all final audit reports concerning audits of any:
 (1) part or division of the agency;
 (2) contract, procurement, or grant; and
 (3) program conducted by the agency.
 Sec. 531.723.  COOPERATION WITH LAW ENFORCEMENT OFFICIALS
 AND OTHER ENTITIES.  (a)  The inspector general may provide
 information and evidence relating to criminal acts to the state
 auditor's office and appropriate law enforcement officials.
 (b)  The inspector general may refer matters for further
 civil, criminal, and administrative action to appropriate
 administrative and prosecutorial agencies, including the attorney
 general.
 (c)  The inspector general may enter into a memorandum of
 understanding with a law enforcement or prosecutorial agency,
 including the office of the attorney general, to assist in
 conducting a review under this subchapter.
 Sec. 531.724.  COOPERATION AND COORDINATION WITH STATE
 AUDITOR.
 (a)  The state auditor may, on request of the inspector
 general, provide appropriate information or other assistance to the
 inspector general or office, as determined by the state auditor.
 (b)  The inspector general may meet with the state auditor's
 office to coordinate a review conducted under this subchapter,
 share information, or schedule work plans.
 (c)  The state auditor is entitled to access all information
 maintained by the inspector general, including vouchers,
 electronic data, internal records, and information obtained under
 Section 531.714 or subject to Section 531.731.
 (d)  Any information obtained or provided by the state
 auditor under this section is confidential and not subject to
 disclosure under Chapter 552.
 Sec. 531.725.  PREVENTION.  (a)  The inspector general may
 recommend to the commission and executive commissioner policies on:
 (1)  promoting economical and efficient administration
 of state funds administered by an individual or entity that
 received the funds from a health and human services agency; and
 (2)  preventing and detecting fraud, waste, and abuse
 in the administration of those funds.
 (b)  The inspector general may provide training or other
 education regarding the prevention of fraud, waste, or abuse to
 employees of a health and human services agency.  The training or
 education provided must be approved by the presiding officer of the
 agency.
 Sec. 531.726.  RULEMAKING BY EXECUTIVE COMMISSIONER.  The
 executive commissioner may adopt rules governing a health and human
 services agency's response to reports and referrals from the
 inspector general on issues identified by the inspector general
 related to the agency or a contractor of the agency.
 Sec. 531.727.  ALLEGATIONS OF MISCONDUCT AGAINST PRESIDING
 OFFICER.  If a review by the inspector general involves allegations
 that a presiding officer of a health and human services agency has
 engaged in misconduct, the inspector general shall report to the
 governor during the review until the report is completed or the
 review is closed without a finding.
 Sec. 531.728.  PERIODIC REPORTING TO STATE AUDITOR AND
 EXECUTIVE COMMISSIONER REQUIRED.  The inspector general shall
 timely inform the state auditor and the executive commissioner of
 the initiation of a review of a health and human services agency
 program and the ongoing status of each review.
 Sec. 531.729.  REPORTING OFFICE FINDINGS.  The inspector
 general shall report the findings of any review or investigation
 conducted by the office to:
 (1) the executive commissioner;
 (2) the governor;
 (3) the lieutenant governor;
 (4) the speaker of the house of representatives;
 (5) the state auditor's office; and
 (6)  appropriate law enforcement and prosecutorial
 agencies, including the office of the attorney general, if the
 findings suggest the probability of criminal conduct.
 Sec. 531.730.  FLAGRANT VIOLATIONS; IMMEDIATE REPORT.  The
 inspector general shall immediately report to the executive
 commissioner, the governor 's general counsel, and the state
 auditor a problem deemed by the inspector general to be
 particularly serious or flagrant, and relating to the
 administration of a program, operation of a health and human
 services agency, or interference with an inspector general review.
 Sec. 531.731.  INFORMATION CONFIDENTIAL.  (a)  Except as
 provided by this section, Sections 531.103 531.729, and 531.733,
 all information and material compiled or maintained by the
 inspector general during a review under this subchapter is:
 (1)  confidential and not subject to disclosure under
 Chapter 552; and
 (2)  not subject to disclosure, discovery, subpoena, or
 other means of legal compulsion for release to anyone other than the
 state auditor's office, the commission, or the office or its agents
 involved in the review related to that information or material.
 (b)  Subsection (a) applies to information the inspector
 general is required to disclose under Sections 531.727, 531.728,
 531.730, and 531.732.
 (c)  As the inspector general determines appropriate based
 on evidence sufficient to support an allegation, information
 relating to a review may be disclosed to:
 (1) a law enforcement agency;
 (2) the attorney general's office;
 (3) the state auditor's office; or
 (4) the commission; or
 (5) a licensing or regulatory agency.
 (d)  A person that receives information under Subsections
 (b) and (c) may not disclose the information except to the extent
 that disclosure is consistent with the authorized purpose for which
 the person first obtained the information.
 Sec. 531.732. DRAFT OF FINAL REPORT; AGENCY RESPONSE.
 (a)  Except in cases in which the office has determined that
 potential fraud, waste, or abuse exists, or a criminal violation
 has occurred, the office shall provide a draft of the final report
 of any review of the operations of a health and human services
 agency to the presiding officer of the agency before publishing the
 office's final report.
 (b)  The health and human services agency may provide a
 response to the office 's draft report in the manner prescribed by
 the office not later than the 10th day after the date the draft
 report is received by the agency.  The inspector general by rule
 shall specify the format and requirements of the agency response.
 (c)  Notwithstanding Subsection (a), the office may not
 provide a draft report to the presiding officer of the agency if in
 the inspector general's opinion providing the draft report could
 negatively affect any anticipated civil or criminal proceedings.
 (d)  The office may include any portion of the agency's
 response in the office's final report.
 Sec. 531.733.  FINAL REVIEW REPORTS; AGENCY RESPONSE.  (a)
 The inspector general shall prepare a final report for each review
 conducted under this subchapter.  The final report must include:
 (1)  a summary of the activities performed by the
 inspector general in conducting the review;
 (2)  a determination of whether wrongdoing was found;
 and
 (3) a description of any findings of wrongdoing.
 (b)  The inspector general's final review reports are
 subject to disclosure under Chapter 552.
 (c)  All working papers and other documents related to
 compiling the final review reports remain confidential and are not
 subject to disclosure under Chapter 552.
 (d)  Not later than the 60th day after the date the office
 issues a final report that identifies deficiencies or
 inefficiencies in, or recommends corrective measures in the
 operations of, a health and human services agency, the agency shall
 file a response that includes:
 (1)  an implementation plan and timeline for
 implementing corrective measures; or
 (2)  the agency's rationale for declining to implement
 corrective measures for the identified deficiencies or
 inefficiencies or the office's recommended corrective measures, as
 applicable.
 Sec. 531.734.  STATE AUDITOR AUDITS, INVESTIGATIONS, AND
 ACCESS TO INFORMATION NOT IMPAIRED.  This subchapter or other law
 related to the operation of the inspector general does not prohibit
 the state auditor from conducting an audit, investigation, or other
 review or from having full and complete access to all records and
 other information including witnesses and electronic data, that the
 state auditor considers necessary for the audit, investigation, or
 other review.
 Sec. 531.735.  AUTHORITY OF STATE AUDITOR TO CONDUCT TIMELY
 AUDITS NOT IMPAIRED.  This chapter or other law related to the
 operation of the inspector general does not take precedence over
 the authority of the state auditor to conduct an audit under Chapter
 321 or other law.
 Sec. 531.736.  BUDGET.  (a)  The inspector general shall
 submit a budget in accordance with the reporting requirements of
 the General Appropriations Act.
 (b)  The inspector general shall submit to the commission a
 legislative appropriations request and an operating budget in
 accordance with the service level agreement entered into under
 Section 531.704 and applicable law.
 (c)  The commission shall submit the office's appropriations
 request and, if required by or under law, operating budget to the
 legislature.  The request or budget is not subject to review,
 alteration, or modification by the commission or executive
 commissioner before submission to the legislature.
 Sec. 531.737.  COSTS.  (a)  The inspector general shall
 maintain information regarding the cost of reviews.
 (b)  The inspector general may cooperate with appropriate
 administrative and prosecutorial agencies, including the office of
 the attorney general, in recovering costs incurred under this
 subchapter from nongovernmental entities, including contractors or
 individuals involved in:
 (1)  violations of applicable state or federal rules or
 statutes;
 (2) abusive or willful misconduct; or
 (3)  violations of a provider contract or program
 policy.
 (c)  In criminal cases the inspector general and the Office
 of Attorney General shall cooperate to ensure that all appropriate
 evidence is submitted to the court in all criminal prosecutions
 towards ensuring that restitution is ordered, to include the
 overpayment and the costs incurred under this subchapter, as a
 condition of probation or as a condition of parole.
 Sec. 531.738.  ADMINISTRATIVE OR CIVIL PENALTY; INJUNCTION.
 (a)  The office may:
 (1)  act for a health and human services agency in the
 assessment by the office of administrative or civil penalties the
 agency is authorized to assess under applicable law; and
 (2)  request that the attorney general obtain an
 injunction to prevent a person from disposing of an asset
 identified by the office as potentially subject to recovery by the
 office due to the person's fraud, waste, or abuse.
 (b)  If the office imposes an administrative or civil penalty
 under Subsection (a) for a health and human services agency:
 (1)  the health and human services agency may not
 impose an administrative or civil penalty against the same person
 for the same violation; and
 (2)  the office shall impose the penalty under
 applicable rules of the office, this subchapter, and applicable
 laws and rules governing the imposition of a penalty by the health
 and human services agency.
 Sec. 531.739.  PEACE OFFICER INVESTIGATORS.  (a)  An
 investigator assigned to conduct investigations for the office may
 be a commissioned peace officer.  The number of commissioned peace
 officers assigned to conduct investigations may not exceed 15
 percent of the office's full-time equivalent positions.
 (b)  A commissioned peace officer or otherwise designated
 law enforcement officer employed by the office is not entitled to
 supplemental benefits from the law enforcement and custodial
 officer supplemental retirement fund unless the officer transfers
 from a position, without a break in service, that qualifies for
 supplemental retirement benefits from the fund.
 SECTION 2. Section 531.001, Government Code, is amended by
 adding Subdivision (4-a) to read as follows:
 (4-a)  "Office of inspector general" means the office
 of inspector general established under Subchapter R.
 SECTION 3. Section 531.008(c), Government Code, is amended
 to read as follows:
 (c) The executive commissioner shall establish the
 following divisions and offices within the commission:
 (1) the eligibility services division to make
 eligibility determinations for services provided through the
 commission or a health and human services agency related to:
 (A) the child health plan program;
 (B) the financial assistance program under
 Chapter 31, Human Resources Code;
 (C) the medical assistance program under Chapter
 32, Human Resources Code;
 (D) the nutritional assistance programs under
 Chapter 33, Human Resources Code;
 (E) long-term care services, as defined by
 Section 22.0011, Human Resources Code;
 (F) community-based support services identified
 or provided in accordance with Section 531.02481; and
 (G) other health and human services programs, as
 appropriate;
 (2) [the office of inspector general to perform fraud
 and abuse investigation and enforcement functions as provided by
 Subchapter C and other law;
 [(3)] the office of the ombudsman to:
 (A) provide dispute resolution services for the
 commission and the health and human services agencies; and
 (B) perform consumer protection functions
 related to health and human services;
 (3) [(4)] a purchasing division as provided by Section
 531.017; and
 (4) [(5)] an internal audit division to conduct a
 program of internal auditing in accordance with [Government Code,]
 Chapter 2102.
 SECTION 4. Sections 531.103(a), (c), and (d), Government
 Code, are amended to read as follows:
 (a) The [commission, acting through the commission's]
 office of inspector general[,] and the office of the attorney
 general shall enter into a memorandum of understanding to develop
 and implement joint written procedures for processing cases of
 suspected fraud, waste, or abuse, as those terms are defined by
 state or federal law, or other violations of state or federal law
 under the state Medicaid program or other program administered by
 the commission or a health and human services agency, including the
 financial assistance program under Chapter 31, Human Resources
 Code, a nutritional assistance program under Chapter 33, Human
 Resources Code, and the child health plan program. The memorandum
 of understanding shall require:
 (1) the office of inspector general and the office of
 the attorney general to set priorities and guidelines for referring
 cases to appropriate state agencies for investigation,
 prosecution, or other disposition to enhance deterrence of fraud,
 waste, abuse, or other violations of state or federal law,
 including a violation of Chapter 102, Occupations Code, in the
 programs and maximize the imposition of penalties, the recovery of
 money, and the successful prosecution of cases;
 (1-a) the office of inspector general to refer each
 case of suspected provider fraud, waste, or abuse to the office of
 the attorney general not later than the 20th business day after the
 date the office of inspector general determines that the existence
 of fraud, waste, or abuse is reasonably indicated;
 (1-b) the office of the attorney general to take
 appropriate action in response to each case referred to the
 attorney general, which action may include direct initiation of
 prosecution, with the consent of the appropriate local district or
 county attorney, direct initiation of civil litigation, referral to
 an appropriate United States attorney, a district attorney, or a
 county attorney, or referral to a collections agency for initiation
 of civil litigation or other appropriate action;
 (2) the office of inspector general to keep detailed
 records for cases processed by that office or the office of the
 attorney general, including information on the total number of
 cases processed and, for each case:
 (A) the agency and division to which the case is
 referred for investigation;
 (B) the date on which the case is referred; and
 (C) the nature of the suspected fraud, waste, or
 abuse;
 (3) the office of inspector general to notify each
 appropriate division of the office of the attorney general of each
 case referred by the office of inspector general;
 (4) the office of the attorney general to ensure that
 information relating to each case investigated by that office is
 available to each division of the office with responsibility for
 investigating suspected fraud, waste, or abuse;
 (5) the office of the attorney general to notify the
 office of inspector general of each case the attorney general
 declines to prosecute or prosecutes unsuccessfully;
 (6) representatives of the office of inspector general
 and of the office of the attorney general to meet not less than
 quarterly to share case information and determine the appropriate
 agency and division to investigate each case; and
 (7) the office of inspector general and the office of
 the attorney general to submit information requested by the
 comptroller about each resolved case for the comptroller's use in
 improving fraud detection.
 (c) The office of inspector general [commission] and the
 office of the attorney general shall jointly prepare and submit a
 semiannual report to the governor, lieutenant governor, speaker of
 the house of representatives, and comptroller concerning the
 activities of the office of the attorney general and the office of
 inspector general [those agencies] in detecting and preventing
 fraud, waste, and abuse under the state Medicaid program or other
 program administered by the commission or a health and human
 services agency. The report may be consolidated with any other
 report relating to the same subject matter the office of inspector
 general [commission] or office of the attorney general is required
 to submit under other law.
 (d) The office of inspector general [commission] and the
 office of the attorney general may not assess or collect
 investigation and attorney's fees on behalf of any state agency
 unless the office of inspector general, the office of the attorney
 general, or another [other] state agency collects a penalty,
 restitution, or other reimbursement payment to the state.
 SECTION 5. Section 531.1031(a)(2), Government Code, is
 amended o read as follows:
 (2) "Participating agency" means:
 (A) the Medicaid fraud enforcement divisions of
 the office of the attorney general; [and]
 (B) each board or agency with authority to
 license, register, regulate, or certify a health care professional
 or managed care organization that may participate in the state
 Medicaid program; and
 (C) the office of inspector general.
 SECTION 6. Section 531.104(a), Government Code, is amended
 to read as follows:
 (a) The office of inspector general [commission] and the
 attorney general shall execute a memorandum of understanding under
 which the office [commission] shall provide investigative support
 as required to the attorney general in connection with cases under
 Subchapter B, Chapter 36, Human Resources Code. Under the
 memorandum of understanding, the office [commission] shall assist
 in performing preliminary investigations and ongoing
 investigations for actions prosecuted by the attorney general under
 Subchapter C, Chapter 36, Human Resources Code.
 SECTION 7. Section 531.105, Government Code, is amended to
 read as follows:
 Sec. 531.105. FRAUD DETECTION TRAINING. [(a)] The office
 of inspector general [commission] shall develop and implement a
 program to provide annual training to contractors who process
 Medicaid claims and appropriate staff of the health and human
 services agencies [Texas Department of Health and the Texas
 Department of Human Services] in identifying potential cases of
 fraud, waste, or abuse under the state Medicaid program. The
 training provided to the contractors and staff must include clear
 criteria that specify:
 (1) the circumstances under which a person should
 refer a potential case to the office [commission]; and
 (2) the time by which a referral should be made.
 [(b)     The Texas Department of Health and the Texas Department
 of Human Services, in cooperation with the commission, shall
 periodically set a goal of the number of potential cases of fraud,
 waste, or abuse under the state Medicaid program that each agency
 will attempt to identify and refer to the commission. The
 commission shall include information on the agencies' goals and the
 success of each agency in meeting the agency's goal in the report
 required by Section 531.103(c).]
 SECTION 8. Sections 531.106(f) and (g), Government Code,
 are amended to read as follows:
 (f) Cases [The commission shall refer cases] identified by
 the technology shall be referred to the [commission's] office of
 inspector general [investigations and enforcement] or the office of
 the attorney general, as appropriate.
 (g) Each month, the learning or neural network technology
 implemented under this section must match bureau of vital
 statistics death records with Medicaid claims filed by a provider.
 If the commission or the office of inspector general determines
 that a provider has filed a claim for services provided to a person
 after the person's date of death, as determined by the bureau of
 vital statistics death records, [the commission shall refer] the
 case shall be referred for investigation to the office of inspector
 general or the office of the attorney general, as appropriate [to
 the commission's office of investigations and enforcement].
 SECTION 9. Section 531.1061, Government Code, is amended to
 read as follows:
 Sec. 531.1061. FRAUD INVESTIGATION TRACKING SYSTEM. (a)
 The office of inspector general [commission] shall use an automated
 fraud investigation tracking system [through the commission's
 office of investigations and enforcement] to monitor the progress
 of an investigation of suspected fraud, waste, abuse, or
 insufficient quality of care under the state Medicaid program.
 (b) For each case of suspected fraud, waste, abuse, or
 insufficient quality of care identified by the learning or neural
 network technology required under Section 531.106, the automated
 fraud investigation tracking system must:
 (1) receive electronically transferred records
 relating to the identified case from the learning or neural network
 technology;
 (2) record the details and monitor the status of an
 investigation of the identified case, including maintaining a
 record of the beginning and completion dates for each phase of the
 case investigation;
 (3) generate documents and reports related to the
 status of the case investigation; and
 (4) generate standard letters to a provider regarding
 the status or outcome of an investigation.
 (c) Each [The commission shall require each] health and
 human services agency that performs any aspect of the state
 Medicaid program shall [to] participate in the implementation and
 use of the automated fraud investigation tracking system as
 directed by the office.
 SECTION 10. Section 531.1062(a), Government Code, is
 amended to read as follows:
 (a) The office of inspector general [commission] shall use
 an automated recovery monitoring system to monitor the collections
 process for a settled case of fraud, waste, abuse, or insufficient
 quality of care under the state Medicaid program.
 SECTION 11. Sections 531.107(a) and (f), Government Code,
 are amended to read as follows:
 (a) The Medicaid and Public Assistance Fraud Oversight Task
 Force advises and assists the [commission and the commission's]
 office of inspector general [investigations and enforcement] in
 improving the efficiency of fraud investigations and collections.
 (f) At least once each fiscal quarter, the [commission's]
 office of inspector general [investigations and enforcement] shall
 provide to the task force:
 (1) information detailing:
 (A) the number of fraud referrals made to the
 office and the origin of each referral;
 (B) the time spent investigating each case;
 (C) the number of cases investigated each month,
 by program and region;
 (D) the dollar value of each fraud case that
 results in a criminal conviction; and
 (E) the number of cases the office rejects and
 the reason for rejection, by region; and
 (2) any additional information the task force
 requires.
 SECTION 12. Sections 531.108 and 531.109, Government Code,
 are amended to read as follows:
 Sec. 531.108. FRAUD PREVENTION. (a) The [commission's]
 office of inspector general [investigations and enforcement] shall
 compile and disseminate accurate information and statistics
 relating to:
 (1) fraud prevention; and
 (2) post-fraud referrals received and accepted or
 rejected from the office's [commission's] case management system or
 the case management system of a health and human services agency.
 (b) The office of inspector general [commission] shall[:
 [(1)] aggressively publicize successful fraud
 prosecutions and fraud-prevention programs through all available
 means, including the use of statewide press releases [issued in
 coordination with the Texas Department of Human Services; and
 [(2)     ensure that a toll-free hotline for reporting
 suspected fraud in programs administered by the commission or a
 health and human services agency is maintained and promoted, either
 by the commission or by a health and human services agency].
 (c) The office of inspector general [commission] shall
 develop a cost-effective method of identifying applicants for
 public assistance in counties bordering other states and in
 metropolitan areas selected by the office [commission] who are
 already receiving benefits in other states. If economically
 feasible, the office [commission] may develop a computerized
 matching system.
 (d) The office of inspector general [commission] shall:
 (1) verify automobile information that is used as
 criteria for eligibility; and
 (2) establish a computerized matching system with the
 Texas Department of Criminal Justice to prevent an incarcerated
 individual from illegally receiving public assistance benefits
 administered by the commission.
 (e) The office of inspector general [commission] shall
 submit to the governor and Legislative Budget Board a semiannual
 report on the results of computerized matching of office and
 commission information with information from neighboring states,
 if any, and information from the Texas Department of Criminal
 Justice. The report may be consolidated with any other report
 relating to the same subject matter the office [commission] is
 required to submit under other law.
 Sec. 531.109. SELECTION AND REVIEW OF CLAIMS. (a) The
 office of inspector general [commission] shall annually select and
 review a random, statistically valid sample of all claims for
 reimbursement under the state Medicaid program, including the
 vendor drug program, for potential cases of fraud, waste, or abuse.
 (b) In conducting the annual review of claims under
 Subsection (a), the office of inspector general [commission] may
 directly contact a recipient by telephone or in person, or both, to
 verify that the services for which a claim for reimbursement was
 submitted by a provider were actually provided to the recipient.
 (c) Based on the results of the annual review of claims, the
 office of inspector general and the commission shall determine the
 types of claims at which office and commission resources for fraud,
 waste, and abuse detection should be primarily directed.
 SECTION 13. Sections 531.110(a), (c), (d), (e), and (f),
 Government Code, are amended to read as follows:
 (a) The office of inspector general [commission] shall
 conduct electronic data matches for a recipient of assistance under
 the state Medicaid program at least quarterly to verify the
 identity, income, employment status, and other factors that affect
 the eligibility of the recipient.
 (c) The commission and other health and human services
 agencies [Texas Department of Human Services] shall cooperate with
 the office of inspector general [commission] by providing data or
 any other assistance necessary to conduct the electronic data
 matches required by this section.
 (d) The office of inspector general [commission] may
 contract with a public or private entity to conduct the electronic
 data matches required by this section.
 (e) The office of inspector general [commission], or a
 health and human services agency designated by the office
 [commission], by rule shall establish procedures to verify the
 electronic data matches conducted by the office [commission] under
 this section. Not later than the 20th day after the date the
 electronic data match is verified, the commission and other health
 and human services agencies [Texas Department of Human Services]
 shall remove from eligibility a recipient who is determined to be
 ineligible for assistance under the state Medicaid program.
 (f) The office of inspector general [commission] shall
 report biennially to the legislature the results of the electronic
 data matching program. The report must include a summary of the
 number of applicants who were removed from eligibility for
 assistance under the state Medicaid program as a result of an
 electronic data match conducted under this section.
 SECTION 14. Section 531.1112, Government Code, is amended
 to read as follows:
 Sec. 531.1112. STUDY CONCERNING INCREASED USE OF TECHNOLOGY
 TO STRENGTHEN FRAUD DETECTION AND DETERRENCE; IMPLEMENTATION. (a)
 The commission and the [commission's] office of inspector general
 shall jointly study the feasibility of increasing the use of
 technology to strengthen the detection and deterrence of fraud in
 the state Medicaid program. The study must include the
 determination of the feasibility of using technology to verify a
 person's citizenship and eligibility for coverage.
 (b) The commission shall implement any methods the
 commission and the [commission's] office of inspector general
 determine are effective at strengthening fraud detection and
 deterrence.
 SECTION 15. Section 531.113, Government Code, is amended to
 read as follows:
 Sec. 531.113. MANAGED CARE ORGANIZATIONS: SPECIAL
 INVESTIGATIVE UNITS OR CONTRACTS. (a) Each managed care
 organization that provides or arranges for the provision of health
 care services to an individual under a government-funded program,
 including the Medicaid program and the child health plan program,
 shall:
 (1) establish and maintain a special investigative
 unit within the managed care organization to investigate fraudulent
 claims and other types of program waste or abuse by recipients and
 service providers; or
 (2) contract with another entity for the investigation
 of fraudulent claims and other types of program waste or abuse by
 recipients and service providers.
 (b) Each managed care organization subject to this section
 shall adopt a plan to prevent and reduce fraud, waste, and abuse and
 annually file that plan with the [commission's] office of inspector
 general for approval. The plan must include:
 (1) a description of the managed care organization's
 procedures for detecting and investigating possible acts of fraud,
 waste, or abuse;
 (2) a description of the managed care organization's
 procedures for the mandatory reporting of possible acts of fraud,
 waste, or abuse to the [commission's] office of inspector general;
 (3) a description of the managed care organization's
 procedures for educating and training personnel to prevent fraud,
 waste, and abuse;
 (4) the name, address, telephone number, and fax
 number of the individual responsible for carrying out the plan;
 (5) a description or chart outlining the
 organizational arrangement of the managed care organization's
 personnel responsible for investigating and reporting possible
 acts of fraud, waste, or abuse;
 (6) a detailed description of the results of
 investigations of fraud, waste, and abuse conducted by the managed
 care organization's special investigative unit or the entity with
 which the managed care organization contracts under Subsection
 (a)(2); and
 (7) provisions for maintaining the confidentiality of
 any patient information relevant to an investigation of fraud,
 waste, or abuse.
 (c) If a managed care organization contracts for the
 investigation of fraudulent claims and other types of program waste
 or abuse by recipients and service providers under Subsection
 (a)(2), the managed care organization shall file with the
 [commission's] office of inspector general:
 (1) a copy of the written contract;
 (2) the names, addresses, telephone numbers, and fax
 numbers of the principals of the entity with which the managed care
 organization has contracted; and
 (3) a description of the qualifications of the
 principals of the entity with which the managed care organization
 has contracted.
 (d) The [commission's] office of inspector general may
 review the records of a managed care organization to determine
 compliance with this section.
 (e) The inspector general [commissioner] shall adopt rules
 as necessary to accomplish the purposes of this section.
 SECTION 16. Sections 531.114(b) and (g), Government Code,
 are amended to read as follows:
 (b) If after an investigation the office of inspector
 general [commission] determines that a person violated Subsection
 (a), the office [commission] shall:
 (1) notify the person of the alleged violation not
 later than the 30th day after the date the office [commission]
 completes the investigation and provide the person with an
 opportunity for a hearing on the matter; or
 (2) refer the matter to the appropriate prosecuting
 attorney for prosecution.
 (g) The inspector general [commission] shall adopt rules as
 necessary to implement this section.
 SECTION 17. Section 533.005(a), Government Code, is amended
 to read as follows:
 (a) A contract between a managed care organization and the
 commission for the organization to provide health care services to
 recipients must contain:
 (1) procedures to ensure accountability to the state
 for the provision of health care services, including procedures for
 financial reporting, quality assurance, utilization review, and
 assurance of contract and subcontract compliance;
 (2) capitation rates that ensure the cost-effective
 provision of quality health care;
 (3) a requirement that the managed care organization
 provide ready access to a person who assists recipients in
 resolving issues relating to enrollment, plan administration,
 education and training, access to services, and grievance
 procedures;
 (4) a requirement that the managed care organization
 provide ready access to a person who assists providers in resolving
 issues relating to payment, plan administration, education and
 training, and grievance procedures;
 (5) a requirement that the managed care organization
 provide information and referral about the availability of
 educational, social, and other community services that could
 benefit a recipient;
 (6) procedures for recipient outreach and education;
 (7) a requirement that the managed care organization
 make payment to a physician or provider for health care services
 rendered to a recipient under a managed care plan not later than the
 45th day after the date a claim for payment is received with
 documentation reasonably necessary for the managed care
 organization to process the claim, or within a period, not to exceed
 60 days, specified by a written agreement between the physician or
 provider and the managed care organization;
 (8) a requirement that the commission, on the date of a
 recipient's enrollment in a managed care plan issued by the managed
 care organization, inform the organization of the recipient's
 Medicaid certification date;
 (9) a requirement that the managed care organization
 comply with Section 533.006 as a condition of contract retention
 and renewal;
 (10) a requirement that the managed care organization
 provide the information required by Section 533.012 and otherwise
 comply and cooperate with the [commission's] office of inspector
 general;
 (11) a requirement that the managed care
 organization's usages of out-of-network providers or groups of
 out-of-network providers may not exceed limits for those usages
 relating to total inpatient admissions, total outpatient services,
 and emergency room admissions determined by the commission;
 (12) if the commission finds that a managed care
 organization has violated Subdivision (11), a requirement that the
 managed care organization reimburse an out-of-network provider for
 health care services at a rate that is equal to the allowable rate
 for those services, as determined under Sections 32.028 and
 32.0281, Human Resources Code;
 (13) a requirement that the organization use advanced
 practice nurses in addition to physicians as primary care providers
 to increase the availability of primary care providers in the
 organization's provider network;
 (14) a requirement that the managed care organization
 reimburse the state for any overpayments resulting from fraud,
 waste or abuse in the Medicaid program, the child health plan
 program, or another government funded program.
 (15) a requirement that the managed care organization
 reimburse a federally qualified health center or rural health
 clinic for health care services provided to a recipient outside of
 regular business hours, including on a weekend day or holiday, at a
 rate that is equal to the allowable rate for those services as
 determined under Section 32.028, Human Resources Code, if the
 recipient does not have a referral from the recipient's primary
 care physician; and
 (16) a requirement that the managed care organization
 develop, implement, and maintain a system for tracking and
 resolving all provider appeals related to claims payment, including
 a process that will require:
 (A) a tracking mechanism to document the status
 and final disposition of each provider's claims payment appeal;
 (B) the contracting with physicians who are not
 network providers and who are of the same or related specialty as
 the appealing physician to resolve claims disputes related to
 denial on the basis of medical necessity that remain unresolved
 subsequent to a provider appeal; and
 (C) the determination of the physician resolving
 the dispute to be binding on the managed care organization and
 provider.
 SECTION 18. Section 533.012(c), Government Code, is amended
 to read as follows:
 (c) The [commission's] office of inspector general
 [investigations and enforcement] shall review the information
 submitted under this section as appropriate in the investigation of
 fraud in the Medicaid managed care program.
 SECTION 4. Section 531.002(17), Health and Safety Code, is
 amended to read as follows:
 (17) "State developmental center [school]" means a
 state-supported and structured residential facility operated by
 the Department of Aging and Disability Services [department] to
 provide to clients with mental retardation a variety of services,
 including medical treatment, specialized therapy, and training in
 the acquisition of personal, social, and vocational skills.
 Sec. 531.0021.  REFERENCE TO STATE SCHOOL OR SUPERINTENDENT.
 (a)  A reference in law to a "state school" means a state
 development center.
 (b)  A reference in law to a "superintendent," to the extent
 the term is intended to refer to the person in charge of a state
 developmental center, means the director of a state developmental
 center.
 SECTION 6. Section 532.001(b), Health and Safety Code, is
 amended to read as follows:
 (b) The Department of Aging and Disability Services and the
 Department of State Health Services [department] also include
 [includes] community services operated by those departments [the
 department] and the following facilities, appropriate:
 (1) the central office of the department;
 (2) the Austin State Hospital;
 (3) the Big Spring State Hospital;
 (4) the Kerrville State Hospital;
 (5) the Rusk State Hospital;
 (6) the San Antonio State Hospital;
 (7) the Terrell State Hospital;
 (8) the North Texas State Hospital;
 (9) the Abilene State Developmental Center [School];
 (10) the Austin State Developmental Center [School];
 (11) the Brenham State Developmental Center [School];
 (12) the Corpus Christi State Developmental Center
 [School];
 (13) the Denton State Developmental Center [School];
 (14) the Lubbock State Developmental Center [School];
 (15) the Lufkin State Developmental Center [School];
 (16) the Mexia State Developmental Center [School];
 (17) the Richmond State Developmental Center
 [School];
 (18) the San Angelo State Developmental Center
 [School];
 (19) the San Antonio State Developmental Center
 [School];
 (20) the El Paso State Developmental Center;
 (21) the Rio Grande State Center; and
 (22) the Waco Center for Youth.
 SECTION 7. Section 551.022, Health and Safety Code, is
 amended by adding Subsection (e) to read as follows:
 (e)  This section does not apply to a state developmental
 center or the director of a state developmental center.
 SECTION 8. Subchapter B, Chapter 551, Health and Safety
 Code, is amended by adding Section 551.0225 to read as follows:
 Sec. 551.0225.  POWERS AND DUTIES OF STATE DEVELOPMENTAL
 CENTER DIRECTOR.  (a)  The director of a state developmental center
 is the administrative head of the center.
 (b)  The director of a state developmental center has the
 custody of and responsibility to care for the buildings, grounds,
 furniture, and other property relating to the center.
 (c) The director of a state developmental center shall:
 (1)  oversee the admission and discharge of residents
 and clients;
 (2)  keep a register of all residents and clients
 admitted to or discharged from the center;
 (3) supervise repairs and improvements to the center;
 (4)  ensure that center money is spent judiciously and
 economically;
 (5)  keep an accurate and detailed account of all money
 received and spent, stating the source of the money and on whom and
 the purpose for which the money is spent; and
 (6) keep a full record of the center's operations.
 (d)  In accordance with departmental rules and operating
 procedures, the director of a state developmental center may:
 (1)  establish policy to govern the state developmental
 center that the director considers will best promote the residents'
 interest and welfare;
 (2)  hire subordinate employees and set their salaries,
 in the absence of other law; and
 (3) dismiss a subordinate employee.
 SECTION 9. Subtitle B, Title 7, Health and Safety Code, is
 amended by adding Chapter 555 to read as follows:
 SECTION 5. Chapter 531, Health and Safety Code, is amended
 by adding Section 531.0021 to read as follows:
 CHAPTER 555.  STATE DEVELOPMENTAL CENTERS
 SUBCHAPTER A.  GENERAL PROVISIONS
 Sec. 555.001. DEFINITIONS. In this chapter:
 (1)  "Client" means a person with mental retardation
 who receives ICF-MR services from a state developmental center.
 (2)  "Commission" means the Health and Human Services
 Commission.
 (3)  "Complaint" means information received by the
 office of independent ombudsman regarding a possible violation of a
 right of a resident or client of a state developmental center and
 includes information received regarding a failure by a state
 developmental center to comply with the department's policies and
 procedures relating to the community living options information
 process or related laws.
 (4)  "Department" means the Department of Aging and
 Disability Services.
 (5)  "Developmental center employee" means an employee
 of a state developmental center.
 (6)  "Direct care employee" means a developmental
 center employee who provides direct delivery of services to a
 resident or client.
 (7)  "Executive commissioner" means the executive
 commissioner of the Health and Human Services Commission.
 (8)  "Independent ombudsman" means the individual who
 has been appointed to the office of independent ombudsman.
 (9)  "Office" means the office of independent ombudsman
 established under Subchapter C.
 (10)  "Resident" means a person with mental retardation
 who resides in a state developmental center.
 (11)  "State developmental center" has the meaning
 assigned by Section 531.002.
 Sec. 555.002.  STATE DEVELOPMENTAL CENTER FOR HIGH-RISK
 RESIDENTS.  (a)  The department shall establish a separate state
 developmental center for the care of residents who present a high
 risk of dangerous or violent behavior as provided by Subsections
 (b) and (c).  The department shall designate an existing state
 developmental center for those high-risk residents.
 (b) A resident is a high-risk resident if the person:
 (1)  was committed to or transferred to a state
 developmental center under Chapter 46B or 46C, Code of Criminal
 Procedure, as a result of being charged with or convicted of an
 offense listed in Subsection (c); or
 (2)  is a child committed to or transferred to a state
 developmental center under Chapter 55, Family Code, as a result of
 being alleged by petition or having been found to have engaged in
 delinquent conduct constituting an offense listed in Subsection
 (c).
 (c)  A resident may be considered a high-risk resident if the
 person:
 (1)  has inflicted, attempted to inflict, or made a
 serious threat of inflicting substantial physical harm to the
 resident's self or to another while committed to a state
 developmental center; or
 (2)  has been convicted of or charged with any of the
 following offenses:
 (A)  an offense under Chapter 19, Penal Code
 (criminal homicide);
 (B)  an offense under Chapter 20, Penal Code
 (kidnapping and unlawful restraint);
 (C)  an offense under Section 21.02, Penal Code
 (continuous sexual abuse of young child or children);
 (D)  an offense under Section 22.011, Penal Code
 (sexual assault);
 (E)  an offense under Section 22.02, Penal Code
 (aggravated assault);
 (F)  an offense under Section 22.021, Penal Code
 (aggravated sexual assault);
 (G)  an offense under Section 22.04, Penal Code
 (injury to a child, elderly individual, or disabled individual);
 (H)  an offense under Section 28.02, Penal Code
 (arson);
 (I)  an offense under Section 29.02, Penal Code
 (robbery);
 (J)  an offense under Section 29.03, Penal Code
 (aggravated robbery); or
 (K)  a conviction under the laws of another state,
 federal law, or the Uniform Code of Military Justice for an offense
 containing elements that are substantially similar to the elements
 of an offense listed by this subdivision.
 (d)  In establishing a state developmental center designated
 for high-risk residents, the department shall:
 (1)  transfer a high-risk resident already residing in
 a state developmental center to the designated state developmental
 center;
 (2)  place high-risk residents in separate homes at the
 designated state developmental center based on whether the
 high-risk resident is:
 (A)  an adult or a person younger than 18 years of
 age; or
 (B) male or female;
 (3)  place all high-risk residents committed to or
 transferred to a state developmental center in the designated state
 developmental center; and
 (4)  provide training regarding the service delivery
 system for high-risk residents to direct care employees of the
 designated state developmental center.
 (e)  A resident who is transferred to the designated state
 developmental center is entitled to an administrative hearing
 regarding a transfer of the resident as provided by Section
 594.014.
 (f)  The department shall ensure that the designated state
 developmental center complies with the requirements for ICF-MR
 certification under the Medicaid program as appropriate.
 [Sections 555.003-555.020 reserved for expansion]
 Sec. 555.024.  DEVELOPMENTAL CENTER EMPLOYEE TRAINING.  (a)
 Before a developmental center employee begins to perform the
 employee's duties without direct supervision, the department shall
 provide the employee with competency training and a course of
 instruction about the general duties of a developmental center
 employee.  The department shall ensure the basic developmental
 center employee competency course focuses on:
 (1)  the uniqueness of the individuals the
 developmental center employee serves;
 (2)  techniques for improving quality of life for and
 promoting the health and safety of individuals with mental
 retardation; and
 (3)  the conduct expected of developmental center
 employees.
 (b)  The department shall ensure the training required by
 Subsection (a) provides instruction and information regarding the
 following topics:
 (1)  the general operation and layout of the state
 developmental center, including armed intruder lock down
 procedures;
 (2) an introduction to mental retardation;
 (3)  an introduction to mental illness and dual
 diagnosis;
 (4)  the rights of individuals with mental retardation
 who receive services from the department;
 (5)  respecting personal choices made by residents and
 clients;
 (6) the safe and proper use of restraints;
 (7) recognizing and reporting:
 (A)  abuse, neglect, and exploitation of
 individuals with mental retardation;
 (B) unusual incidents;
 (C)  reasonable suspicion of illegal drug use in
 the workplace;
 (D) workplace violence; and
 (E) sexual harassment in the workplace;
 (8) preventing and treating infection;
 (9) first aid;
 (10) cardiopulmonary resuscitation;
 (11)  the Health Insurance Portability and
 Accountability Act of 1996 (29 U.S.C. Section 1181 et seq.); and
 (12) the rights of developmental center employees.
 (c)  In addition to the training required by Subsection (a)
 and before a direct care employee begins to perform the direct care
 employee's duties without direct supervision, the department shall
 provide a direct care employee with training and instructional
 information regarding the following topics:
 (1)  prevention and management of aggressive or
 high-risk behavior;
 (2)  observing and reporting changes in behavior,
 appearance, or health of residents and clients;
 (3) positive behavior support;
 (4) emergency response;
 (5) person-directed plans;
 (6) seizure safety;
 (7) techniques for:
 (A) lifting;
 (B) positioning; and
 (C) movement and mobility;
 (8) working with aging residents and clients;
 (9) assisting residents and clients:
 (A) who have a visual impairment;
 (B) who have a hearing deficit; or
 (C)  who require the use of adaptive devices and
 specialized equipment;
 (10)  communicating with residents and clients who use
 augmentative and alternative devices for communication;
 (11)  assisting residents and clients with personal
 hygiene;
 (12) recognizing appropriate food textures;
 (13)  using proper feeding techniques to assist
 residents and clients with meals; and
 (14) physical and nutritional management plans.
 Sec. 555.025.  VIDEO SURVEILLANCE.  (a)  In this section,
 "private space" means a place in a state developmental center in
 which a resident or client has a reasonable expectation of privacy,
 including:
 (1) a bedroom;
 (2) a bathroom;
 (3)  a place in which a resident or client receives
 medical or nursing services;
 (4)  a place in which a resident or client meets
 privately with visitors; or
 (5)  a place in which a resident or client privately
 makes phone calls.
 (b)  The department shall install and operate video
 surveillance equipment in a state developmental center for the
 purpose of detecting and preventing the exploitation or abuse of
 residents and clients.
 (c)  The department may not install or operate video
 surveillance equipment in a private space or in a location in which
 video surveillance equipment can capture images within a private
 space.
 (d)  The department shall ensure the use of video
 surveillance equipment under this section complies with federal
 requirements for ICF-MR certification.
 SUBCHAPTER C.  OFFICE OF INDEPENDENT OMBUDSMAN FOR STATE
 DEVELOPMENTAL CENTERS
 Sec. 555.051.  ESTABLISHMENT; PURPOSE.  The office of
 independent ombudsman is established for the purpose of
 investigating, evaluating, and securing the rights of the residents
 and clients of state developmental centers.  The office is
 administratively attached to the department.  The department shall
 provide administrative support and resources to the office as
 necessary for the office to perform its duties.
 Sec. 555.052.  INDEPENDENCE.  The independent ombudsman in
 the performance of the ombudsman's duties and powers under this
 subchapter acts independently of the department.
 Sec. 555.053.  APPOINTMENT OF INDEPENDENT OMBUDSMAN.  The
 governor shall appoint the independent ombudsman.
 Sec. 555.054.  ASSISTANT OMBUDSMEN.  The independent
 ombudsman shall:
 (1)  hire assistant ombudsmen to perform, under the
 direction of the independent ombudsman, the same duties and
 exercise the same powers as the independent ombudsman; and
 (2)  station an assistant ombudsman at each state
 developmental center.
 Sec. 555.055.  CONFLICT OF INTEREST.  A person may not serve
 as independent ombudsman or as an assistant ombudsman if the person
 or the person's spouse:
 (1)  is employed by or participates in the management
 of a business entity or other organization receiving funds from the
 department;
 (2)  owns or controls, directly or indirectly, any
 interest in a business entity or other organization receiving funds
 from the department; or
 (3)  is required to register as a lobbyist under
 Chapter 305, Government Code, because of the person's activities or
 compensation on behalf of a profession related to the operation of
 the department.
 Sec. 555.056. REPORT.  (a)  The independent ombudsman shall
 submit on a biannual basis to the governor, the lieutenant
 governor, and the speaker of the house of representatives a report
 that is both aggregated and disaggregated by individual state
 developmental center and describes:
 (1) the work of the independent ombudsman;
 (2)  the results of any review or investigation
 undertaken by the independent ombudsman, including reviews or
 investigation of services contracted by the department; and
 (3)  any recommendations that the independent
 ombudsman has in relation to the duties of the independent
 ombudsman.
 (b)  The independent ombudsman shall ensure that information
 submitted in a report under Subsection (a) does not permit the
 identification of an individual.
 (c)  The independent ombudsman shall immediately report to
 the governor, lieutenant governor, and speaker of the house of
 representatives any particularly serious or flagrant:
 (1)  case of abuse or injury of a resident or client
 about which the independent ombudsman is made aware;
 (2)  problem concerning the administration of a state
 developmental center program or operation; or
 (3)  interference by a state developmental center, the
 department, or the commission with an investigation conducted by
 the independent ombudsman.
 Sec. 555.057.  COMMUNICATION AND CONFIDENTIALITY.  (a)  The
 department shall allow any resident or client, authorized
 representative of a resident or client, family member of a resident
 or client, or other interested party to communicate with the
 independent ombudsman or an assistant ombudsman.  The
 communication:
 (1)  may be in person, by mail, or by any other means;
 and
 (2) is confidential and privileged.
 (b)  The records of the independent ombudsman are
 confidential, except that the independent ombudsman shall:
 (1)  report to the Department of Family and Protective
 Services regarding a communication that may involve the abuse,
 neglect, or exploitation of a resident or client;
 (2)  report to the regulatory services division of the
 department regarding a communication that may involve a violation
 of an ICF-MR standard or condition of participation; and
 (3)  disclose the ombudsman's nonprivileged records if
 required by a court order on a showing of good cause.
 (c)  The independent ombudsman may make reports relating to
 an investigation conducted by the ombudsman public after the
 investigation is complete but only if the name and any other
 personally identifiable information of a resident or client,
 authorized representative of a resident or client, family member of
 a resident or client, state developmental center, and employee of a
 state developmental center are redacted from the report and remain
 confidential.
 (d)  The name, address, or other personally identifiable
 information of a person who files a complaint with the office of
 independent ombudsman, information generated by the office of
 independent ombudsman in the course of an investigation, and
 confidential records obtained by the office of independent
 ombudsman are confidential and not subject to disclosure under
 Chapter 552, Government Code, except as provided by this section.
 Sec. 555.058.  PROMOTION OF AWARENESS OF OFFICE.  The
 independent ombudsman shall promote awareness among the public,
 residents, clients, and employees of state developmental centers
 of:
 (1) how the office may be contacted;
 (2) the purpose of the office; and
 (3) the services the office provides.
 Sec. 555.059.  DUTIES AND POWERS.  (a)  The independent
 ombudsman shall:
 (1)  evaluate the delivery of services to residents and
 clients to ensure that the rights of residents and clients are fully
 observed;
 (2)  refer a complaint alleging the abuse, neglect, or
 exploitation of a resident or client to the Department of Family and
 Protective Services for investigation;
 (3)  refer a complaint alleging a possible violation of
 an ICF-MR standard or condition of participation to the regulatory
 services division of the department;
 (4)  refer a complaint alleging a criminal offense,
 other than an allegation of abuse, neglect, or exploitation of a
 resident or client, to the commission's office of inspector
 general;
 (5)  conduct investigations of complaints, other than
 complaints alleging criminal offenses or the abuse, neglect, or
 exploitation of a resident or client, if the office determines
 that:
 (A)  a resident or client or the resident's or
 client's family may be in need of assistance from the office; or
 (B)  a complaint raises the possibility of a
 systemic issue in the state developmental center's provision of
 services;
 (6)  conduct semiannual on-site audits, including
 meetings with residents and employees of the state developmental
 center, of each state developmental center's policies, practices,
 and procedures to ensure that each resident and client is
 encouraged to exercise the resident's or client's rights,
 including:
 (A) the right to file a complaint; and
 (B) the right to due process;
 (7)  prepare and deliver an annual report regarding the
 findings of each audit to the:
 (A) executive commissioner;
 (B) commissioner;
 (C) Aging and Disability Services Council;
 (D) governor;
 (E) lieutenant governor;
 (F) speaker of the house of representatives;
 (G)  standing committees of the senate and house
 of representatives with primary jurisdiction over state
 developmental centers; and
 (H) state auditor;
 (8)  require a state developmental center to provide
 access to all records, data, and other information under the
 control of the center that the independent ombudsman determines is
 necessary to investigate a complaint or to conduct an audit under
 this section;
 (9)  review all final reports produced by the
 Department of Family and Protective Services and the regulatory
 services division of the department regarding a complaint referred
 by the independent ombudsman;
 (10)  provide assistance to a resident, client,
 authorized representative of a resident or client, or family member
 of a resident or client who the independent ombudsman determines is
 in need of assistance, including advocating with an agency,
 provider, or other person in the best interests of the resident or
 client; and
 (11)  make appropriate referrals under any of the
 duties and powers listed in this subsection.
 (b)  The independent ombudsman may apprise a person who is
 interested in a resident's or client's welfare of the rights of the
 resident or client.
 (c)  To assess whether a resident's or client's rights have
 been violated, the independent ombudsman may, in any matter that
 does not involve an alleged criminal offense or the abuse, neglect,
 or exploitation of a resident or client, contact or consult with an
 administrator, employee, resident, client, family member of a
 resident or client, expert, or other individual in the course of the
 investigation or to secure information.
 (d)  Notwithstanding any other provision of this chapter,
 the independent ombudsman may not investigate an alleged criminal
 offense or the alleged abuse, neglect, or exploitation of a
 resident or client.
 Sec. 555.060.  RETALIATION PROHIBITED.  The department or a
 state developmental center may not retaliate against a department
 employee or employee of a state developmental center who in good
 faith makes a complaint to the office of independent ombudsman or
 cooperates with the office in an investigation.
 Sec. 555.061.  TOLL-FREE NUMBER.  (a)  The office shall
 establish a permanent, toll-free number for the purpose of
 receiving any information concerning the violation of a right of a
 resident or client.
 (b) The office shall ensure that:
 (1)  the toll-free number is prominently displayed in
 the main administration area of a state developmental center and in
 each home in which a resident lives or a client receives services;
 and
 (2)  a resident, a client, the authorized
 representative of a resident, and an employee of a state
 developmental center have confidential access to a telephone for
 the purpose of calling the toll-free number.
 SECTION 19. Section 21.014(b), Human Resources Code, is
 amended to read as follows:
 (b) The [person employed by the department as] inspector
 general appointed under Subchapter R, Chapter 531, Government Code,
 shall make reports to and consult with the agency director
 [chairman of the board] regarding:
 (1) the selection of internal audit topics;
 (2) the establishment of internal audit priorities;
 and
 (3) the findings of each regular or special internal
 audit initiative.
 SECTION 20. Section 32.003, Human Resources Code, is
 amended by adding Subdivision (5) to read as follows:
 (5)  "Office of inspector general" means the office of
 inspector general established under Subchapter R, Chapter 531,
 Government Code.
 SECTION 21. Section 32.0291, Human Resources Code, is
 amended to read as follows:
 Sec. 32.0291. PREPAYMENT REVIEWS AND POSTPAYMENT HOLDS.
 (a) Notwithstanding any other law, the office of inspector
 general or department may:
 (1) perform a prepayment review of a claim for
 reimbursement under the medical assistance program to determine
 whether the claim involves fraud, waste, or abuse; and
 (2) as necessary to perform that review, withhold
 payment of the claim for not more than five working days without
 notice to the person submitting the claim.
 (b) Notwithstanding any other law, the office of inspector
 general [department] may impose a postpayment hold on payment of
 future claims submitted by a provider if the office [department]
 has prima facie evidence that the provider has committed fraud,
 waste, abuse, or wilful misrepresentation regarding a claim for
 reimbursement or cost report under the medical assistance program.
 The office [department] must notify the provider of the postpayment
 hold not later than the fifth working day after the date the hold is
 imposed.
 (c) On timely written request by a provider subject to a
 postpayment hold under Subsection (b), the office of inspector
 general [department] shall file a request with the State Office of
 Administrative Hearings for an expedited administrative hearing
 regarding the hold. The provider must request an expedited hearing
 under this subsection not later than the 10th day after the date the
 provider receives notice from the office of inspector general
 [department] under Subsection (b). The office of inspector general
 [department] shall discontinue the hold unless the office
 [department] makes a prima facie showing at the hearing that the
 evidence relied on by the office of inspector general [department]
 in imposing the hold is relevant, credible, and material to the
 issue of fraud, waste, abuse, or wilful misrepresentation.
 (d) The inspector general [department] shall adopt rules
 that allow a provider subject to a postpayment hold under
 Subsection (b) to seek an informal resolution of the issues
 identified by the office of inspector general [department] in the
 notice provided under that subsection. A provider must seek an
 informal resolution under this subsection not later than the
 deadline prescribed by Subsection (c). A provider's decision to
 seek an informal resolution under this subsection does not extend
 the time by which the provider must request an expedited
 administrative hearing under Subsection (c). However, a hearing
 initiated under Subsection (c) shall be stayed at the office's
 [department's] request until the informal resolution process is
 completed.
 SECTION 22. Section 32.032, Human Resources Code, is
 amended to read as follows:
 Sec. 32.032. PREVENTION AND DETECTION OF FRAUD, WASTE, AND
 ABUSE. The inspector general [department] shall adopt reasonable
 rules for minimizing the opportunity for fraud, waste, and abuse,
 for establishing and maintaining methods for detecting and
 identifying situations in which a question of fraud, waste, or
 abuse in the program may exist, and for referring cases where fraud,
 waste, or abuse appears to exist to the appropriate law enforcement
 agencies for prosecution.
 SECTION 23. Sections 32.0321(a) through (d), Human
 Resources Code, are amended to read as follows:
 (a) The office of inspector general [department] by rule may
 recommend to the department and the department by rule may require
 that each provider of medical assistance in a provider type that has
 demonstrated significant potential for fraud, waste, or abuse to
 file with the department a surety bond in a reasonable amount. The
 office and the department by rule shall each require a provider of
 medical assistance to file with the department a surety bond in a
 reasonable amount if the office [department] identifies a pattern
 of suspected fraud, waste, or abuse involving criminal conduct
 relating to the provider's services under the medical assistance
 program that indicates the need for protection against potential
 future acts of fraud, waste, or abuse.
 (b) The bond under Subsection (a) must be payable to the
 department to compensate the department for damages resulting from
 or penalties or fines imposed in connection with an act of fraud,
 waste, or abuse committed by the provider under the medical
 assistance program.
 (c) Subject to Subsection (d) or (e), the office of
 inspector general and the department by rule may require each
 provider of medical assistance that establishes a resident's trust
 fund account to post a surety bond to secure the account. The bond
 must be payable to the department to compensate residents of the
 bonded provider for trust funds that are lost, stolen, or otherwise
 unaccounted for if the provider does not repay any deficiency in a
 resident's trust fund account to the person legally entitled to
 receive the funds.
 (d) The office of inspector general and the department may
 not require the amount of a surety bond posted for a single facility
 provider under Subsection (c) to exceed the average of the total
 average monthly balance of all the provider's resident trust fund
 accounts for the 12-month period preceding the bond issuance or
 renewal date.
 SECTION 24. Section 32.0322(a), Human Resources Code, is
 amended to read as follows:
 (a) The office of inspector general and the department may
 obtain from any law enforcement or criminal justice agency the
 criminal history record information that relates to a provider
 under the medical assistance program or a person applying to enroll
 as a provider under the medical assistance program.
 SECTION 25. Section 32.070(d), Human Resources Code, is
 amended to read as follows:
 (d) This section does not apply to a computerized audit
 conducted using the Medicaid Fraud Detection Audit System or an
 audit or investigation of fraud, waste, and abuse conducted by the
 Medicaid fraud control unit of the office of the attorney general,
 the office of the state auditor, the office of [the] inspector
 general, or the Office of Inspector General in the United States
 Department of Health and Human Services.
 SECTION 26. Section 33.015(e), Human Resources Code, is
 amended to read as follows:
 (e) The department shall require a person exempted under
 this section from making a personal appearance at department
 offices to provide verification of the person's entitlement to the
 exemption on initial eligibility certification and on each
 subsequent periodic eligibility recertification. If the person
 does not provide verification and the department considers the
 verification necessary to protect the integrity of the food stamp
 program, the department shall initiate a fraud referral to the
 [department's] office of inspector general established under
 Subchapter R, Chapter 531, Government Code.
 SECTION 10. Section 48.252, Human Resources Code, is
 amended by adding Subsection (d) to read as follows:
 (d)  If an investigation under this section reveals evidence
 of the abuse, neglect, or exploitation of a resident or client of a
 state developmental center as defined by Section 531.002, Health
 and Safety Code, and a caseworker of the department or a supervisor
 of a caseworker believes that the abuse, neglect, or exploitation
 is a criminal offense, the caseworker or supervisor shall
 immediately notify the Health and Human Services Commission's
 office of inspector general and promptly provide the Health and
 Human Services Commission's office of inspector general with a copy
 of the department's investigation report.
 SECTION 11. Section 161.052, Human Resources Code, is
 amended by amending Subsection (b) and adding Subsection (e) to
 read as follows:
 (b) The executive commissioner shall prepare and by rule
 adopt personnel standards. The executive commissioner shall adopt
 personnel standards for direct care employees at state
 developmental centers that are designed to ensure the safety of and
 a high standard of care for residents of a state developmental
 center.
 (e)  Subject to the availability of funds, the department
 shall prescribe the number of direct care employees at state
 developmental centers and the salaries for those employees
 necessary to attract and maintain quality employees.  The
 commissioner shall ensure that policies regarding employees at
 state developmental centers are designed to reduce turnover and
 ensure continuity of care for residents.
 SECTION 12. (a) As soon as possible after the effective
 date of this Act, and subject to the availability of funds, the
 Department of Aging and Disability Services shall hire additional
 direct care employees at state developmental centers and increase
 the salaries for all direct care employees as necessary to attract
 and maintain quality employees.
 (b) Not later than December 1, 2009, the Health and Human
 Services Commission's office of inspector general shall begin
 employing peace officers as required by Section 531.1022,
 Government Code, as added by this Act.
 (c) Not later than September 1, 2014, the Department of
 Aging and Disability Services shall designate a state developmental
 center for high-risk residents as required by Section 555.002,
 Health and Safety Code, as added by this Act.
 (d) Not later than January 1, 2010, the Department of Aging
 and Disability Services shall develop the training required by
 Section 555.024, Health and Safety Code, as added by this Act.
 (e) The Department of Aging and Disability Services shall
 ensure that all developmental center employees and direct care
 employees receive the training required by Section 555.024, Health
 and Safety Code, as added by this Act, regardless of when the
 employee was hired, not later than September 1, 2010.
 (g) Not later than December 1, 2009, the governor shall
 appoint the independent ombudsman as required by Section 555.053,
 Health and Safety Code, as added by this Act.
 SECTION 14. (a) The change in law made by Section
 551.022(e), Health and Safety Code, as added by this Act, and the
 change in law made by Section 551.0225, Health and Safety Code, as
 added by this Act, apply to the dismissal of an employee of a state
 developmental center hired on or after the effective date of this
 Act.
 (b) The dismissal of an employee of a state developmental
 center hired before the effective date of this Act is governed by
 the law in effect when the employee was hired, and the former law is
 continued in effect for that purpose.
 SECTION 15. This Act takes effect immediately if it
 receives a vote of two-thirds of all the members elected to each
 house, as provided by Section 39, Article III, Texas Constitution.
 If this Act does not receive the vote necessary for immediate
 effect, this Act takes effect September 1, 2009.
 SECTION 30. (a) The repeal by this Act of Section 531.102,
 Government Code, does not affect the validity of a complaint,
 investigation, or other proceeding initiated under that section
 before the effective date of this Act. A complaint, investigation,
 or other proceeding initiated under that section is continued in
 accordance with the changes in law made by this Act.
 (b) The repeal by this Act of Section 531.1021, Government
 Code, does not affect the validity of a subpoena issued under that
 section before the effective date of this Act. A subpoena issued
 under that section before the effective date of this Act is governed
 by the law that existed when the subpoena was issued, and the former
 law is continued in effect for that purpose.
 SECTION 3031. (a) The person serving as inspector general
 under Section 531.102(a-1), Government Code, on the effective date
 of this Act shall serve as the inspector general appointed under
 Subchapter R, Chapter 531, Government Code, as added by this Act,
 until February 1, 2011, and may be reappointed under Subchapter R,
 Chapter 531, if the person has the qualifications required under
 that subchapter.
 (b) Not later than February 1, 2011, the governor shall
 appoint an inspector general for the Office of Inspector General
 under Subchapter R, Chapter 531, Government Code, as added by this
 Act, to a term expiring February 1, 2013.
 SECTION 32. On the effective date of this Act:
 (1) all functions, activities, employees, rules,
 forms, money, property, contracts, memorandums of understanding,
 records, and obligations of the office of inspector general under
 Section 531.102(a-1), Government Code, become functions,
 activities, employees, rules, forms, money, property, contracts,
 memorandums of understanding, records, and obligations of the
 Office of Inspector General established under Subchapter R, Chapter
 531, Government Code, as added by this Act, without a change in
 status; and
 (2) all money appropriated or budgeted for the office
 of inspector general under Section 531.102(a-1), Government Code,
 including money for providing administrative support, is
 considered appropriated for the use of the Office of Inspector
 General established under Subchapter R, Chapter 531, Government
 Code, as added by this Act.
 SECTION 33. If before implementing any provision of this
 Act a state office or agency determines that a waiver or
 authorization from a federal agency is necessary for implementation
 of that provision, the office or 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 34. This Act takes effect immediately if it
 receives a vote of two-thirds of all the members elected to each
 house, as provided by Section 39, Article III, Texas Constitution.
 If this Act does not receive the vote necessary for immediate
 effect, this Act takes effect September 1, 2009.