By: Lucio S.B. No. 492 (In the Senate - Filed February 11, 2013; February 13, 2013, read first time and referred to Committee on Health and Human Services; March 26, 2013, reported adversely, with favorable Committee Substitute by the following vote: Yeas 8, Nays 0; March 26, 2013, sent to printer.) COMMITTEE SUBSTITUTE FOR S.B. No. 492 By: Deuell A BILL TO BE ENTITLED AN ACT relating to the licensing and regulation of prescribed pediatric extended care centers; providing penalties; imposing fees. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: SECTION 1. Subtitle B, Title 4, Health and Safety Code, is amended by adding Chapter 248A to read as follows: CHAPTER 248A. PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS SUBCHAPTER A. GENERAL PROVISIONS Sec. 248A.001. DEFINITIONS. In this chapter: (1) "Basic services" includes: (A) the development, implementation, and monitoring of a comprehensive protocol of care that: (i) is provided to a medically dependent or technologically dependent minor; (ii) is developed in conjunction with the minor's parent or legal guardian; and (iii) specifies the medical, nursing, psychosocial, therapeutic, and developmental services required by the minor served; and (B) the caregiver training needs of the minor's parent or legal guardian. (2) "Center" means a prescribed pediatric extended care center. (3) "Commission" means the Health and Human Services Commission. (4) "Commissioner" means the commissioner of aging and disability services. (5) "Controlling person" has the meaning assigned by Section 248A.0012. (6) "Department" means the Department of Aging and Disability Services. (7) "Executive commissioner" means the executive commissioner of the commission. (8) "Medically dependent or technologically dependent minor" means a minor who because of an acute, chronic, or intermittent medically complex or fragile condition or disability requires ongoing, technology-based skilled nursing supervision prescribed by the minor's physician to avert death or further disability or the routine use of a medical device to compensate for a deficit in a life-sustaining body function. The term does not include minor or occasional medical conditions that do not require continuous nursing care, including asthma or diabetes, or a condition that requires an epinephrine injection. (9) "Minor" means an individual younger than 21 years of age. (10) "Prescribed pediatric extended care center" means a facility operated for profit or on a nonprofit basis that provides nonresidential basic services to four or more medically dependent or technologically dependent minors who require the services of the facility and who are not related by blood, marriage, or adoption to the owner or operator of the facility. Sec. 248A.0012. CONTROLLING PERSON. (a) A person is a controlling person if the person has the ability, acting alone or in concert with others, to directly or indirectly influence, direct, or cause the direction of the management of, expenditure of money for, or policies of a center or other person. (b) For purposes of this chapter, "controlling person" includes: (1) a management company, landlord, or other business entity that operates or contracts with another person for the operation of a center; (2) any person who is a controlling person of a management company or other business entity that operates a center or that contracts with another person for the operation of a center; and (3) any other person who, because of a personal, familial, or other relationship with the owner, manager, landlord, tenant, or provider of a center, is in a position of actual control of or authority with respect to the center, regardless of whether the person is formally named as an owner, manager, director, officer, provider, consultant, contractor, or employee of the center. (c) Notwithstanding any other provision of this section, for purposes of this chapter, a controlling person of a center or of a management company or other business entity described by Subsection (b)(1) that is a publicly traded corporation or is controlled by a publicly traded corporation means an officer or director of the corporation. The term does not include a shareholder or lender of the publicly traded corporation. (d) A controlling person described by Subsection (b)(3) does not include a person, including an employee, lender, secured creditor, or landlord, who does not exercise any formal or actual influence or control over the operation of a center. (e) The executive commissioner may adopt rules that define the ownership interests and other relationships that qualify a person as a controlling person under this section. Sec. 248A.002. EXEMPTIONS. This chapter does not apply to: (1) a facility operated by the United States government or a federal agency; or (2) a health facility otherwise licensed under this subtitle. Sec. 248A.003. CONFLICT WITH LOCAL LAWS. To the extent of any conflict between the standards adopted under this chapter and a standard required in a local, county, or municipal ordinance, this chapter controls. SUBCHAPTER B. LICENSING OF CENTERS Sec. 248A.051. LICENSE REQUIRED; PREMISES RESTRICTION. (a) A person may not own or operate a prescribed pediatric extended care center in this state unless the person holds a license issued under this chapter. (b) A separate license is required for each center located on separate premises, regardless of whether the centers are under the ownership or operation of the same person. (c) A person may not operate a center on the same premises as a child-care facility licensed under Chapter 42, Human Resources Code. Sec. 248A.052. APPLICATION; ISSUANCE. (a) An applicant for a prescribed pediatric extended care center license shall submit to the department in accordance with executive commissioner rules: (1) a sworn application on the form prescribed by the department; (2) a letter of credit as prescribed by the department to demonstrate the applicant's financial viability; and (3) the required fees. (b) The application must contain: (1) the location of the premises of the center for which the license is sought; (2) documentation, signed by the appropriate local government official, stating the location and use of the premises meet local zoning requirements; (3) the name, address, and social security number of, and background and criminal history check information for: (A) the applicant; (B) the administrator responsible for daily operations of the center; (C) the financial officer responsible for financial operations of the center; and (D) each controlling person; (4) the name, address, and federal employer identification number or taxpayer identification number of the applicant and of each controlling person, if the applicant or controlling person is not an individual; (5) the business name of the center; (6) the maximum patient capacity requested for the center; and (7) a sworn affidavit that the applicant has complied with this chapter and rules adopted under this chapter. (c) The department shall issue a license to a center under this chapter if the department determines that the applicant and the center meet the requirements of this chapter and the rules and standards adopted under this chapter. The license must include: (1) the license holder's name; (2) the location of the premises of the center; and (3) a statement indicating the center provides services to minors for 12 hours or less in a 24-hour period and does not provide 24-hour care. Sec. 248A.053. LICENSE TERM; RENEWAL; NOTIFICATION. (a) A license issued under this chapter expires on the second anniversary of the date of issuance. (b) A person applying to renew a center license shall: (1) submit a renewal application to the department on the form prescribed by the department at least 60 days but not more than 120 days before expiration of the license; (2) submit the renewal fee in the amount required by the department; and (3) comply with any other requirements specified by executive commissioner rule. (c) The department shall assess a $50 per day late fee to a license holder who submits a renewal application after the date required by Subsection (b)(1), except that the total amount of a late fee may not exceed the lesser of 50 percent of the license renewal fee or $500. (d) At least 120 days before expiration of a center license, the department shall notify the owner or operator of the center of the license expiration. Sec. 248A.054. LICENSE NOT TRANSFERABLE OR ASSIGNABLE. A license under this chapter is issued to the license holder named on the license at the location of the premises listed on the license and is not transferable or assignable. SUBCHAPTER C. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER, COMMISSION, AND DEPARTMENT Sec. 248A.101. ADOPTION OF RULES AND STANDARDS. (a) The executive commissioner shall adopt rules necessary to implement this chapter. (b) To protect the health and safety of the public and ensure the health, safety, and comfort of the minors served by a center, the rules must establish minimum center standards, including: (1) standards relating to the issuance, renewal, denial, suspension, probation, and revocation of a license to operate a center; (2) standards relating to the provision of family-centered basic services that include individualized medical, developmental, and family training services; (3) based on the size of the building and the number of minors served, building construction and renovation standards, including standards for plumbing, electrical, glass, manufactured buildings, accessibility for the physically disabled, and fire protection; (4) based on the size of the building and the number of minors served, building maintenance conditions relating to plumbing, heating, lighting, ventilation, adequate space, fire protection, and other conditions; (5) standards relating to the minimum number of and qualifications required for personnel who provide personal care or basic services to the minors served; (6) standards relating to the sanitary conditions within a center and its surroundings, including water supply, sewage disposal, food handling, and general hygiene; (7) standards relating to the programs offered by the center to promote and maintain the health and development of the minors served and to meet the training needs of the minors' parents or legal guardians; (8) standards relating to physician-prescribed supportive or ancillary services; (9) standards relating to transportation services; and (10) standards relating to maintenance of patient medical records and program records in accordance with other law and with accepted professional standards and practices. (c) The executive commissioner by rule shall authorize the commissioner to grant a waiver from compliance with standards adopted under Subsection (b)(3), (4), or (6) to a center located in a municipality that adopts a code to regulate any of those standards if the commissioner determines the applicable municipal code standards exceed the corresponding standards adopted under Subsection (b)(3), (4), or (6). Sec. 248A.102. INSPECTIONS; CORRECTIVE ACTION PLAN. (a) The department may inspect a center, including its records, at reasonable times as necessary to ensure compliance with this chapter and the rules adopted under this chapter. The center shall provide the department with access to all center records. (b) The department shall inspect a center before issuing or renewing a license under this chapter. (c) The department may require a center that undergoes an inspection to: (1) take appropriate corrective action necessary to comply with the requirements of this chapter and rules adopted under this chapter; and (2) submit a corrective action plan to the department for approval. (d) A center shall make available to any person on request a copy of each inspection report pertaining to the center that has been issued by the department. Before making an inspection report available under this subsection, the center shall redact from the report any information that is confidential under other law. Sec. 248A.103. FEES. (a) The executive commissioner shall set fees imposed by this chapter in amounts reasonable and necessary to cover the cost of administering this chapter. (b) A fee collected under this chapter shall be deposited in the state treasury to the credit of the general revenue fund and shall be appropriated to the department to administer and enforce this chapter. (c) A fee collected under this chapter is nonrefundable. Sec. 248A.104. COMMISSION DUTIES. The commission shall designate a center licensed under this chapter as a health care services provider under the medical assistance program established under Chapter 32, Human Resources Code. SUBCHAPTER D. CENTER REGULATION Sec. 248A.151. ADMISSION CRITERIA FOR MINOR CLIENT. A center may not admit a minor client to the center unless: (1) the client is a medically dependent or technologically dependent minor; (2) the minor's prescribing physician issues a prescription ordering care at a center; (3) the minor's parent or legal guardian consents to the minor's admission to the center; and (4) the admission is voluntary based on the parent's or legal guardian's preference in both managed care and non-managed care service delivery systems. Sec. 248A.152. RESTRICTIONS ON HOURS, SERVICES, AND PATIENT CAPACITY. (a) A center may not provide services to a minor for more than 12 hours in any 24-hour period. (b) A center may not provide services other than services regulated under this chapter and executive commissioner rule. (c) The maximum patient capacity at a center may not exceed 60. Sec. 248A.153. LICENSE DISPLAY. Each center licensed under this chapter shall display the center's license in a conspicuous location readily visible to a person entering the center. Sec. 248A.154. MAINTENANCE OF RECORDS. Each center shall maintain at the center the medical and other records required by this chapter and by rules adopted under this chapter. Sec. 248A.155. COMPLAINTS. A person may file a complaint with the department against a center licensed or required to be licensed under this chapter. The department shall investigate the complaint in accordance with the complaint procedures established under Chapter 1001. Sec. 248A.156. COMPLIANCE WITH OTHER LAW. (a) A center shall comply with Chapter 260A and rules adopted under that chapter. (b) An owner, center employee, or other person subject to Chapter 260A shall comply with that chapter and rules adopted under that chapter. Sec. 248A.157. CLOSING OF CENTER. At least 30 days before the date a center voluntarily discontinues operation, the owner or operator of the center shall inform the parent or legal guardian of each minor client to whom the center is providing services of: (1) the discontinuance; and (2) the proposed time of the discontinuance. SUBCHAPTER E. GENERAL ENFORCEMENT Sec. 248A.201. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE. (a) The department may deny, suspend, or revoke a license issued under this chapter for: (1) a violation of this chapter or a rule or standard adopted under this chapter; (2) an intentional or negligent act by the center or an employee of the center that the department determines significantly affects the health or safety of a minor served by the center; (3) use of drugs or intoxicating liquors to an extent that affects the license holder's or applicant's professional competence; (4) a felony conviction, including a finding or verdict of guilty, an admission of guilt, or a plea of nolo contendere, in this state or in any other state of any person required to undergo a background and criminal history check under this chapter; (5) fraudulent acts, including acts relating to Medicaid fraud and obtaining or attempting to obtain a license by fraud or deception; or (6) a license revocation, suspension, or other disciplinary action taken against the license holder or any person listed in the application in another state. (b) Except as provided by Section 248A.203, the procedures by which the department denies, suspends, or revokes a license and by which those actions are appealed are governed by the procedures for a contested case hearing under Chapter 2001, Government Code. Sec. 248A.202. PROBATION. (a) If the department finds that a center is in repeated noncompliance with this chapter, rules adopted under this chapter, or a corrective action plan, but that the noncompliance does not endanger a minor served by the center or the public health and safety, the department may schedule the center for probation rather than suspending or revoking the center's license. (b) The department shall provide notice to the center of the probation and of the items of noncompliance not later than the 10th day before the date the probation period begins. (c) The department shall designate a period of not less than 30 days during which the center will remain under probation. During the probation period, the center must correct the items that were in noncompliance and report the corrections to the department for approval. (d) The department may suspend or revoke the license of a center that does not correct items that were in noncompliance or does not comply with this chapter or the rules adopted under this chapter within the applicable probation period. Sec. 248A.203. EMERGENCY SUSPENSION. (a) The department may issue an emergency order to suspend a license issued under this chapter if the department has reasonable cause to believe that the conduct of a license holder creates an immediate danger to a minor served by the center or the public health and safety. An emergency suspension is effective immediately without a hearing on notice to the license holder. (b) On written request of the license holder, the department shall conduct a hearing not earlier than the 10th day or later than the 30th day after the date the hearing request is received to determine if the emergency suspension is to be continued, modified, or rescinded. (c) The hearing and any appeal are governed by the department's rules for a contested case hearing and by Chapter 2001, Government Code. Sec. 248A.204. INJUNCTION. (a) The department may petition a district court for a temporary restraining order to restrain a continuing violation of this chapter or a rule or standard adopted under this chapter if the department finds that the violation creates an immediate threat to the health and safety of the minors served by a center. (b) A district court, on petition of the department and on a finding by the court that a person is violating this chapter or the rules adopted under this chapter, may by injunction: (1) prohibit the person from continuing the violation; (2) restrain or prevent the establishment or operation of a center without a license issued under this chapter; or (3) grant any other injunctive relief warranted by the facts. (c) The attorney general may institute and conduct a suit authorized by this section at the request of the department. The attorney general and the department may recover reasonable expenses incurred in obtaining relief under this section, including court costs, reasonable attorney's fees, investigation costs, witness fees, and deposition expenses. (d) Venue for a suit brought under this section is in the county in which the center is located or in Travis County. Sec. 248A.205. CIVIL PENALTY. (a) A person who violates this chapter or a rule or standard adopted under this chapter or who fails to comply with a corrective action plan submitted under this chapter is liable for a civil penalty of not more than $500 for each violation if the department determines the violation threatens the health and safety of a minor served by the center. (b) Each day a violation continues constitutes a separate violation for the purposes of this section. (c) The attorney general may sue to collect the penalty. The attorney general and the department may recover reasonable expenses incurred in obtaining relief under this section, including court costs, reasonable attorney's fees, investigation costs, witness fees, and deposition expenses. (d) All penalties collected under this section shall be deposited in the state treasury in the general revenue fund. Sec. 248A.206. CRIMINAL PENALTY. (a) A person commits an offense if the person knowingly establishes or operates a center without the appropriate license issued under this chapter. (b) An offense under this section is a Class B misdemeanor. (c) Each day a violation continues constitutes a separate offense. SUBCHAPTER F. ADMINISTRATIVE PENALTY Sec. 248A.251. IMPOSITION OF PENALTY. The commissioner may impose an administrative penalty on a person licensed under this chapter who violates this chapter or a rule or standard adopted or order issued under this chapter. Sec. 248A.252. AMOUNT OF PENALTY. (a) The amount of the penalty may not exceed $500 for each violation, and each day a violation continues or occurs is a separate violation for purposes of imposing a penalty. (b) The amount shall be based on: (1) the seriousness of the violation, including the nature, circumstances, extent, and gravity of the violation; (2) the threat to health or safety caused by the violation; (3) any previous violations; (4) the amount necessary to deter a future violation; (5) the efforts made by the violator to correct the violation; and (6) any other matter that justice may require. Sec. 248A.253. REPORT AND NOTICE OF VIOLATION AND PENALTY. (a) If the department initially determines that a violation occurred, the department shall give written notice of the report to the person. (b) The notice must: (1) include a brief summary of the alleged violation; (2) state the amount of the recommended penalty; and (3) inform the person of the person's right to a hearing on the occurrence of the violation, the amount of the penalty, or both. Sec. 248A.254. PENALTY TO BE PAID OR HEARING REQUESTED. (a) Not later than the 20th day after the date the person receives the notice sent under Section 248A.253, the person in writing may: (1) accept the determination and recommended penalty of the department; or (2) make a request for a hearing on the occurrence of the violation, the amount of the penalty, or both. (b) If the person accepts the determination and recommended penalty or if the person fails to respond to the notice, the commissioner by order shall approve the determination and impose the recommended penalty. Sec. 248A.255. HEARING. (a) If the person requests a hearing, the commissioner shall refer the matter to the State Office of Administrative Hearings, which shall promptly set a hearing date and give written notice of the time and place of the hearing to the person. An administrative law judge of the State Office of Administrative Hearings shall conduct the hearing. (b) The administrative law judge shall make findings of fact and conclusions of law and promptly issue to the commissioner a proposal for a decision about the occurrence of the violation and the amount of a proposed penalty. Sec. 248A.256. DECISION BY COMMISSIONER. (a) Based on the findings of fact, conclusions of law, and proposal for a decision, the commissioner by order may: (1) find that a violation occurred and impose a penalty; or (2) find that a violation did not occur. (b) The notice of the commissioner's order under Subsection (a) that is sent to the person in accordance with Chapter 2001, Government Code, must include a statement of the right of the person to judicial review of the order. Sec. 248A.257. OPTIONS FOLLOWING DECISION: PAY OR APPEAL. Not later than the 30th day after the date the order of the commissioner imposing an administrative penalty under Section 248A.256 becomes final, the person shall: (1) pay the penalty; or (2) file a petition for judicial review of the commissioner's order contesting the occurrence of the violation, the amount of the penalty, or both. Sec. 248A.258. STAY OF ENFORCEMENT OF PENALTY. (a) Within the period prescribed by Section 248A.257, a person who files a petition for judicial review may: (1) stay enforcement of the penalty by: (A) paying the penalty to the court for placement in an escrow account in the court registry; or (B) giving the court a supersedeas bond approved by the court that: (i) is for the amount of the penalty; and (ii) is effective until all judicial review of the commissioner's order is final; or (2) request the court to stay enforcement of the penalty by: (A) filing with the court a sworn affidavit of the person stating that the person is financially unable to pay the penalty and is financially unable to give the supersedeas bond; and (B) sending a copy of the affidavit to the commissioner by certified mail. (b) If the commissioner receives a copy of an affidavit under Subsection (a)(2), the commissioner may file with the court, not later than the fifth day after the date the copy is received, a contest to the affidavit. The court shall hold a hearing on the facts alleged in the affidavit as soon as practicable and shall stay the enforcement of the penalty on finding that the alleged facts are true. The person who files an affidavit has the burden of proving that the person is financially unable to pay the penalty and to give a supersedeas bond. Sec. 248A.259. COLLECTION OF PENALTY. (a) If the person does not pay the penalty and the enforcement of the penalty is not stayed, the penalty may be collected. (b) The attorney general may sue to collect the penalty and may recover reasonable expenses, including attorney's fees, incurred in recovering the penalty. (c) A penalty collected under this subchapter shall be deposited in the state treasury in the general revenue fund. Sec. 248A.260. DECISION BY COURT. (a) If the court sustains the finding that a violation occurred, the court may uphold or reduce the amount of the penalty and order the person to pay the full or reduced amount of the penalty. (b) If the court does not sustain the finding that a violation occurred, the court shall order that a penalty is not owed. Sec. 248A.261. REMITTANCE OF PENALTY AND INTEREST. (a) If the person paid the penalty and if the amount of the penalty is reduced or the penalty is not upheld by the court, the court shall order, when the court's judgment becomes final, that the appropriate amount plus accrued interest be remitted to the person not later than the 30th day after the date the judgment of the court becomes final. (b) The interest accrues at the rate charged on loans to depository institutions by the New York Federal Reserve Bank. (c) The interest shall be paid for the period beginning on the date the penalty is paid and ending on the date the penalty is remitted. Sec. 248A.262. RELEASE OF BOND. (a) If the person gave a supersedeas bond and the penalty is not upheld by the court, the court shall order, when the court's judgment becomes final, the release of the bond. (b) If the person gave a supersedeas bond and the amount of the penalty is reduced, the court shall order the release of the bond after the person pays the reduced amount. Sec. 248A.263. ADMINISTRATIVE PROCEDURE. A proceeding to impose the penalty is considered to be a contested case under Chapter 2001, Government Code. SECTION 2. Subchapter F, Chapter 411, Government Code, is amended by adding Section 411.13861 to read as follows: Sec. 411.13861. ACCESS TO CRIMINAL HISTORY RECORD INFORMATION: DEPARTMENT OF AGING AND DISABILITY SERVICES. (a) The Department of Aging and Disability Services shall obtain from the Department of Public Safety criminal history record information maintained by the Department of Public Safety that relates to a person required to undergo a background and criminal history check under Chapter 248A, Health and Safety Code. (b) Criminal history record information obtained under Subsection (a) is for the exclusive use of the Department of Aging and Disability Services and is privileged and confidential. (c) Criminal history record information obtained under Subsection (a) may not be released or disclosed to any person or agency except on court order or with the consent of the person who is the subject of the information. The Department of Aging and Disability Services may destroy the criminal history record information after the information is used for the purposes authorized by this section. (d) This section does not prohibit the Department of Aging and Disability Services from obtaining and using criminal history record information as provided by other law. SECTION 3. Subdivision (3), Section 250.001, Health and Safety Code, is amended to read as follows: (3) "Facility" means: (A) a nursing home, custodial care home, or other institution licensed by the Department of Aging and Disability Services under Chapter 242; (B) an assisted living facility licensed by the Department of Aging and Disability Services under Chapter 247; (C) a home and community support services agency licensed under Chapter 142; (D) an adult day care facility licensed by the Department of Aging and Disability Services under Chapter 103, Human Resources Code; (E) a facility for persons with mental retardation licensed under Chapter 252; (F) an adult foster care provider that contracts with the Department of Aging and Disability Services; (G) a facility that provides mental health services and that is operated by or contracts with the Department of State Health Services; (H) a local mental health or mental retardation authority designated under Section 533.035; (I) a person exempt from licensing under Section 142.003(a)(19); [or] (J) a special care facility licensed by the Department of State Health Services under Chapter 248; or (K) a prescribed pediatric extended care center licensed by the Department of Aging and Disability Services under Chapter 248A. SECTION 4. Subdivision (4), Section 253.001, Health and Safety Code, is amended to read as follows: (4) "Facility" means: (A) a facility: (i) licensed by the department; or (ii) licensed under Chapter 252; (B) an adult foster care provider that contracts with the department; [or] (C) a home and community support services agency licensed by the department under Chapter 142; or (D) a prescribed pediatric extended care center licensed under Chapter 248A. SECTION 5. Subdivisions (5) and (7), Section 260A.001, Health and Safety Code, are amended to read as follows: (5) "Facility" means: (A) an institution as that term is defined by Section 242.002; [and] (B) an assisted living facility as that term is defined by Section 247.002; and (C) a prescribed pediatric extended care center as that term is defined by Section 248A.001. (7) "Resident" means an individual, including a patient, who resides in or receives services from a facility. SECTION 6. Section 32.024, Human Resources Code, is amended by adding Subsection (jj) to read as follows: (jj) The department shall establish a separate provider type for prescribed pediatric extended care centers licensed under Chapter 248A, Health and Safety Code, for purposes of enrollment as a provider for and reimbursement under the medical assistance program. SECTION 7. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted. SECTION 8. (a) Not later than July 1, 2014, the executive commissioner of the Health and Human Services Commission shall adopt the rules required by Subchapter C, Chapter 248A, Health and Safety Code, as added by this Act. (b) Notwithstanding Section 248A.051, Health and Safety Code, as added by this Act, a person is not required to hold a prescribed pediatric extended care center license until January 1, 2015. SECTION 9. (a) Except as provided by Subsection (b) of this section, this Act takes effect September 1, 2013. (b) Subchapters E and F, Chapter 248A, Health and Safety Code, as added by this Act, take effect January 1, 2015. * * * * *