Texas 2015 - 84th Regular

Texas Senate Bill SB204 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
	1	+	84R30188 GCB-D
1	2		By: Hinojosa, et al. S.B. No. 204
2		-	(In the Senate - Filed March 5, 2015; March 9, 2015, read
3		-	first time and referred to Committee on Health and Human Services;
4		-	April 7, 2015, reported adversely, with favorable Committee
5		-	Substitute by the following vote: Yeas 9, Nays 0; April 7, 2015,
6		-	sent to printer.)
7		-	Click here to see the committee vote
8		-	COMMITTEE SUBSTITUTE FOR S.B. No. 204 By: Schwertner
	3	+	(Raymond)
	4	+	Substitute the following for S.B. No. 204: No.
9	5
10	6
11	7		A BILL TO BE ENTITLED
12	8		AN ACT
13		-	relating to the functions ~~and operations~~ of the Department of ~~Aging~~
14		-	and Disability Services; increasing penalties.
	9	+	relating to the continuation of the functions of the Department of
	10	+	Aging and Disability Services; increasing penalties.
15	11		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
16		-	SECTION 1. Subchapter A, Chapter 142, Health and Safety
	12	+	SECTION 1. Section 81.042(e), Health and Safety Code, is
	13	+	amended to read as follows:
	14	+	(e) The following persons shall report to the local health
	15	+	authority or the department a suspected case of a reportable
	16	+	disease and all information known concerning the person who has or
	17	+	is suspected of having the disease if a report is not made as
	18	+	required by Subsections (a)-(d):
	19	+	(1) a professional registered nurse;
	20	+	(2) an administrator or director of a public or
	21	+	private temporary or permanent child-care facility;
	22	+	(3) an administrator or director of a nursing home,
	23	+	personal care home, adult respite care center, or adult day
	24	+	services facility [day-care center];
	25	+	(4) an administrator of a home health agency;
	26	+	(5) an administrator or health official of a public or
	27	+	private institution of higher education;
	28	+	(6) an owner or manager of a restaurant, dairy, or
	29	+	other food handling or processing establishment or outlet;
	30	+	(7) a superintendent, manager, or health official of a
	31	+	public or private camp, home, or institution;
	32	+	(8) a parent, guardian, or householder;
	33	+	(9) a health professional;
	34	+	(10) an administrator or health official of a penal or
	35	+	correctional institution; or
	36	+	(11) emergency medical service personnel, a peace
	37	+	officer, or a firefighter.
	38	+	SECTION 2. Subchapter A, Chapter 142, Health and Safety
17	39		Code, is amended by adding Section 142.0125 to read as follows:
18	40		Sec. 142.0125. PROGRESSIVE SANCTIONS. (a) The executive
19	41		commissioner by rule shall create a matrix of progressive sanctions
20	42		that the department must use to assess penalty amounts and impose
21	43		disciplinary actions under this chapter appropriately and fairly
22	44		for a violation of a law, rule, standard, or order adopted or
23	45		license issued under this chapter or for a violation of other law
24	46		for which this chapter provides a sanction.
25	47		(b) The matrix of progressive sanctions adopted under this
26	48		section must provide for increases in amounts of administrative
27	49		penalties based on type, frequency, and seriousness of violations
28	50		and must provide guidance for determining appropriate and graduated
29	51		administrative penalties to assess under this chapter to deter
30	52		future violations, including guidance on considering the factors
31	53		listed in this chapter for determining the amount of a penalty.
	54	+	(b-1) The matrix of progressive sanctions adopted under
	55	+	this section must provide for imposing lesser sanctions for lesser
	56	+	violations, which may include violations that:
	57	+	(1) are technical, clerical, or de minimis in nature;
	58	+	(2) do not involve abuse, neglect, or exploitation of
	59	+	a client; and
	60	+	(3) do not cause injury or impairment to a client or
	61	+	cause the death of a client.
32	62		(c) The matrix of progressive sanctions adopted under this
33	63		section must provide for imposing stronger sanctions, including
34	64		license suspension or revocation, for more serious violations or
35	65		for repeated violations as appropriate to deter future serious or
36	66		repeated violations. The matrix of progressive sanctions must
37	67		describe appropriate time frames to be used in determining whether
38	68		a home and community support services agency has committed repeated
39	69		violations or has engaged in a pattern of repeated violations, such
40	70		as repeated violations found in consecutive regular inspections.
41		-	SECTION 2. Sections 142.017(b) and (j), Health and Safety
	71	+	SECTION 3. Sections 142.017(b) and (j), Health and Safety
42	72		Code, are amended to read as follows:
43	73		(b) The penalty shall be not less than $100 or more than
44	74		$5,000 [$1,000] for each violation. Each day of a violation that
45	75		occurs before the day on which the person receives written notice of
46	76		the violation from the department does not constitute a separate
47	77		violation and shall be considered to be one violation. Each day of
48	78		a continuing violation that occurs after the day on which the person
49	79		receives written notice of the violation from the department
50	80		constitutes a separate violation.
51	81		(j) The executive commissioner by rule shall define the
52	82		types of minor violations an agency may correct under Subsection
53	83		(e) before the department may assess an administrative penalty.
54	84		The executive commissioner shall ensure that all other violations
55	85		are not subject to a right to correct [The department may assess an
56	86		administrative penalty without providing a reasonable period of
57	87		time to the agency to correct the violation if the violation:
58	88		[(1) results in serious harm or death;
59	89		[(2) constitutes a serious threat to health or safety;
60	90		[(3) substantially limits the agency's capacity to
61	91		provide care;
62	92		[(4) is a violation in which a person:
63	93		[(A) makes a false statement, that the person
64	94		knows or should know is false, of a material fact:
65	95		[(i) on an application for issuance or
66	96		renewal of a license or in an attachment to the application; or
67	97		[(ii) with respect to a matter under
68	98		investigation by the department;
69	99		[(B) refuses to allow a representative of the
70	100		department to inspect a book, record, or file required to be
71	101		maintained by an agency;
72	102		[(C) wilfully interferes with the work of a
73	103		representative of the department or the enforcement of this
74	104		chapter;
75	105		[(D) wilfully interferes with a representative
76	106		of the department preserving evidence of a violation of this
77	107		chapter or a rule, standard, or order adopted or license issued
78	108		under this chapter;
79	109		[(E) fails to pay a penalty assessed by the
80	110		department under this chapter not later than the 10th day after the
81	111		date the assessment of the penalty becomes final; or
82	112		[(F) fails to submit:
83	113		[(i) a plan of correction not later than the
84	114		10th day after the date the person receives a statement of licensing
85	115		violations; or
86	116		[(ii) an acceptable plan of correction not
87	117		later than the 30th day after the date the person receives
88	118		notification from the department that the previously submitted plan
89	119		of correction is not acceptable;
90	120		[(5) is a violation of Section 142.0145; or
91	121		[(6) involves the rights of the elderly under Chapter
92	122		102, Human Resources Code].
93		-	SECTION 3. Section 242.061, Health and Safety Code, is
94		-	amended by adding Subsections (c-1), (c-2), and (e) to read as
95		-	follows:
96		-	(c-1) The department shall revoke the license of an
97		-	institution that violates this chapter or a rule, standard, or
98		-	order adopted or license issued under this chapter in a manner that
99		-	causes immediate jeopardy to health and safety on three separate
100		-	days within a 24-month period.
101		-	(c-2) In the case of revocation of a license under
102		-	Subsection (c-1), to ensure the health and safety of residents of
	123	+	SECTION 4. Section 164.003(5), Health and Safety Code, as
	124	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	125	+	Session, 2015, is amended to read as follows:
	126	+	(5) "Mental health facility" means:
	127	+	(A) a "mental health facility" as defined by
	128	+	Section 571.003;
	129	+	(B) a residential treatment facility, other than
	130	+	a mental health facility, in which persons are treated for
	131	+	emotional problems or disorders in a 24-hour supervised living
	132	+	environment; and
	133	+	(C) an adult day services [day-care] facility as
	134	+	defined by Section 103.003, Human Resources Code.
	135	+	SECTION 5. (a) It is the intent of the legislature that
	136	+	Section 242.061, Health and Safety Code, as amended by this
	137	+	section, establish a ceiling or maximum number of violations
	138	+	related to the abuse and neglect of a resident that a facility can
	139	+	commit before the executive commissioner is required to revoke the
	140	+	facility's license. The changes in law made by this section are not
	141	+	intended to limit or diminish the department's permissive authority
	142	+	to revoke a license under Chapter 242, Health and Safety Code.
	143	+	(b) Section 242.061, Health and Safety Code, is amended by
	144	+	amending Subsection (a) and adding Subsections (a-1), (a-2), (a-3),
	145	+	(c-1), (e), and (e-1) to read as follows:
	146	+	(a) In this section:
	147	+	(1) "Abuse" has the meaning assigned by Section
	148	+	260A.001.
	149	+	(2) "Immediate threat to health and safety" means a
	150	+	situation in which immediate corrective action is necessary because
	151	+	the facility's noncompliance with one or more requirements has
	152	+	caused, or is likely to cause, serious injury, harm, impairment, or
	153	+	death to a resident.
	154	+	(3) "Neglect" has the meaning assigned by Section
	155	+	260A.001.
	156	+	(a-1) The department, after providing notice and
	157	+	opportunity for a hearing to the applicant or license holder, may
	158	+	deny, suspend, or revoke a license if the department finds that the
	159	+	applicant, the license holder, or any other person described by
	160	+	Section 242.032(d) has:
	161	+	(1) violated this chapter or a rule, standard, or
	162	+	order adopted or license issued under this chapter in either a
	163	+	repeated or substantial manner;
	164	+	(2) committed any act described by Sections
	165	+	242.066(a)(2)-(6); or
	166	+	(3) failed to comply with Section 242.074.
	167	+	(a-2) Except as provided by Subsection (a-3) or (e-1), the
	168	+	executive commissioner shall revoke a license under Subsection
	169	+	(a-1) if the department finds that:
	170	+	(1) the license holder has committed three violations
	171	+	described by Subsection (a-1), within a 24-month period, that
	172	+	constitute an immediate threat to health and safety related to the
	173	+	abuse or neglect of a resident; and
	174	+	(2) each of the violations described by Subdivision
	175	+	(1) is reported in connection with a separate survey, inspection,
	176	+	or investigation visit that occurred on separate entrance and exit
	177	+	dates.
	178	+	(a-3) The executive commissioner may not revoke a license
	179	+	under Subsection (a-2) due to a violation described by Subsection
	180	+	(a-2)(1), if:
	181	+	(1) the violation and the determination of immediate
	182	+	threat to health and safety are not included on the written list of
	183	+	violations left with the facility at the time of the initial exit
	184	+	conference under Section 242.0445(b) for a survey, inspection, or
	185	+	investigation;
	186	+	(2) the violation is not included on the final
	187	+	statement of violations described by Section 242.0445; or
	188	+	(3) the violation has been reviewed under the informal
	189	+	dispute resolution process established by Section 531.058,
	190	+	Government Code, and a determination was made that:
	191	+	(A) the violation should be removed from the
	192	+	license holder's record; or
	193	+	(B) the violation is reduced in severity so that
	194	+	the violation is no longer cited as an immediate threat to health
	195	+	and safety related to the abuse or neglect of a resident.
	196	+	(c-1) In the case of revocation of a license under
	197	+	Subsection (a-2), to ensure the health and safety of residents of
103	198		the institution, the department may:
104	199		(1) request the appointment of a trustee to operate
105	200		the institution under Subchapter D;
106		-	(2) obtain a new operator for the institution; or
	201	+	(2) assist with obtaining a new operator for the
	202	+	institution; or
107	203		(3) assist with the relocation of residents to another
108	204		institution.
109		-	(e) In this section, "immediate jeopardy to health and
110		-	safety" means a situation in which immediate corrective action is
111		-	necessary because the institution's noncompliance with one or more
112		-	requirements has caused, or is likely to cause, serious injury,
113		-	harm, impairment, or death to a resident receiving care in the
114		-	institution.
115		-	SECTION 4. Subchapter C, Chapter 242, Health and Safety
	205	+	(e) The executive commissioner may stay a license
	206	+	revocation required by Subsection (a-2) if the executive
	207	+	commissioner determines that the stay would not jeopardize the
	208	+	health and safety of the residents of the facility or place the
	209	+	residents at risk of abuse or neglect. The executive commissioner
	210	+	by rule shall establish criteria under which a license revocation
	211	+	may be stayed under this subsection. The executive commissioner
	212	+	shall follow negotiated rulemaking procedures prescribed by
	213	+	Chapter 2008, Government Code, for the adoption of rules
	214	+	establishing the criteria. The criteria established must permit
	215	+	the executive commissioner to stay a license revocation of a
	216	+	nursing facility for which the department has deployed a rapid
	217	+	response team under Section 255.004, if the facility has cooperated
	218	+	with the rapid response team and demonstrated improvement in
	219	+	quality of care, as determined by the rapid response team.
	220	+	(e-1) The executive commissioner may stay a license
	221	+	revocation required by Subsection (a-2) for a veterans home, as
	222	+	defined by Section 164.002, Natural Resources Code, if the
	223	+	Veterans' Land Board contracts with a different entity to operate
	224	+	the veterans home than the entity that operated the home during the
	225	+	period in which the violations described by Subsection (a-2)
	226	+	occurred.
	227	+	SECTION 6. Subchapter C, Chapter 242, Health and Safety
116	228		Code, is amended by adding Section 242.0613 to read as follows:
117	229		Sec. 242.0613. PROGRESSIVE SANCTIONS. (a) The executive
118	230		commissioner by rule shall create a matrix of progressive sanctions
119	231		that the department must use to assess penalty amounts and impose
120	232		disciplinary actions under this chapter appropriately and fairly
121	233		for a violation of a law, rule, standard, or order adopted or
122	234		license issued under this chapter or for a violation of other law
123	235		for which this chapter provides a sanction.
124	236		(b) The matrix of progressive sanctions adopted under this
125	237		section must provide for increases in amounts of administrative
126	238		penalties based on type, frequency, and seriousness of violations
127	239		and must provide guidance for determining appropriate and graduated
128	240		administrative penalties to assess under this chapter to deter
129	241		future violations, including guidance on considering the factors
130	242		listed in this chapter for determining the amount of a penalty.
131	243		(c) The matrix of progressive sanctions adopted under this
132	244		section must provide for imposing stronger sanctions, including
133	245		license suspension or revocation, for more serious violations or
134	246		for repeated violations as appropriate to deter future serious or
135	247		repeated violations. The matrix of progressive sanctions must
136	248		describe appropriate time frames to be used in determining whether
137	249		a facility has committed repeated violations or has engaged in a
138	250		pattern of repeated violations, such as repeated violations found
139	251		in consecutive regular inspections.
140		-	SECTION 5. Section 242.0665(b), Health and Safety Code, is
	252	+	SECTION 7. Section 242.0615(a), Health and Safety Code, is
	253	+	amended to read as follows:
	254	+	(a) The department, after providing notice and opportunity
	255	+	for a hearing, may exclude a person from eligibility for a license
	256	+	under this chapter if the person or any person described by Section
	257	+	242.032(d) has substantially failed to comply with this chapter and
	258	+	the rules adopted under this chapter. The authority granted by this
	259	+	subsection is in addition to the authority to deny issuance of a
	260	+	license under Section 242.061(a-1) [242.061(a)].
	261	+	SECTION 8. Section 242.0665(b), Health and Safety Code, is
141	262		amended to read as follows:
142	263		(b) The executive commissioner by rule shall define types of
143	264		minor violations a facility may correct under Subsection (a) before
144	265		the department may assess an administrative penalty. The executive
145	266		commissioner shall ensure that all other violations are not subject
146	267		to a right to correct [Subsection (a) does not apply:
147	268		[(1) to a violation that the department determines:
148	269		[(A) results in serious harm to or death of a
149	270		resident;
150	271		[(B) constitutes a serious threat to the health
151	272		or safety of a resident; or
152	273		[(C) substantially limits the institution's
153	274		capacity to provide care;
154	275		[(2) to a violation described by Sections
155	276		242.066(a)(2)-(7);
156	277		[(3) to a violation of Section 260A.014 or 260A.015;
157	278		or
158	279		[(4) to a violation of a right of a resident adopted
159	280		under Subchapter L].
160		-	SECTION 6. Subchapter C, Chapter 247, Health and Safety
	281	+	SECTION 9. Subchapter C, Chapter 247, Health and Safety
161	282		Code, is amended by adding Section 247.0415 to read as follows:
162	283		Sec. 247.0415. PROGRESSIVE SANCTIONS. (a) The executive
163	284		commissioner by rule shall create a matrix of progressive sanctions
164	285		that the department must use to assess penalty amounts and impose
165	286		disciplinary actions under this chapter appropriately and fairly
166	287		for a violation of a law, rule, standard, or order adopted or
167	288		license issued under this chapter or for a violation of other law
168	289		for which this chapter provides a sanction.
169	290		(b) The matrix of progressive sanctions adopted under this
170	291		section must provide for increases in amounts of administrative
171	292		penalties based on type, frequency, and seriousness of violations
172	293		and must provide guidance for determining appropriate and graduated
173	294		administrative penalties to assess under this chapter to deter
174	295		future violations, including guidance on considering the factors
175	296		listed in this chapter for determining the amount of a penalty.
176	297		(c) The matrix of progressive sanctions adopted under this
177	298		section must provide for imposing stronger sanctions, including
178	299		license suspension or revocation, for more serious violations or
179	300		for repeated violations as appropriate to deter future serious or
180	301		repeated violations. The matrix of progressive sanctions must
181	302		describe appropriate time frames to be used in determining whether
182	303		an assisted living facility has committed repeated violations or
183	304		has engaged in a pattern of repeated violations, such as repeated
184	305		violations found in consecutive regular inspections.
185		-	SECTION 7. Section 247.0451(b), Health and Safety Code, is
	306	+	SECTION 10. Section 247.0451(b), Health and Safety Code, is
186	307		amended to read as follows:
187	308		(b) Except as provided by Section 247.0452(c), the penalty
188	309		may not exceed $5,000 [$1,000] for each violation. Each day a
189		-	violation occurs or continues is a separate violation for purposes
190		-	of imposing a penalty.
191		-	SECTION 8. Section 247.0452(b), Health and Safety Code, is
	310	+	violation occurs or continues after the date the department
	311	+	provides written notification of the violation is considered a
	312	+	separate violation. The violation is considered a single violation
	313	+	for any days of violation that occurred on or before the date the
	314	+	department provides written notification of the violation.
	315	+	SECTION 11. Section 247.0452(b), Health and Safety Code, is
192	316		amended to read as follows:
193	317		(b) The executive commissioner by rule shall define the
194	318		types of minor violations an assisted living facility may correct
195	319		under Subsection (a) before the department may assess an
196	320		administrative penalty. The executive commissioner shall ensure
197	321		that all other violations are not subject to a right to
198	322		correct [Subsection (a) does not apply:
199	323		[(1) to a violation that the department determines
200	324		results in serious harm to or death of a resident;
201	325		[(2) to a violation described by Sections
202	326		247.0451(a)(2)-(7) or a violation of Section 260A.014 or 260A.015;
203	327		[(3) to a second or subsequent violation of:
204	328		[(A) a right of the same resident under Section
205	329		247.064; or
206	330		[(B) the same right of all residents under
207	331		Section 247.064; or
208	332		[(4) to a violation described by Section 247.066,
209	333		which contains its own right to correct provisions].
210		-	SECTION 9. Subchapter C, Chapter 252, Health and Safety
	334	+	SECTION 12. Section 247.051(a), Health and Safety Code, as
	335	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	336	+	Session, 2015, is amended to read as follows:
	337	+	(a) The executive commissioner by rule shall establish an
	338	+	informal dispute resolution process to address disputes between a
	339	+	facility and the department concerning a statement of violations
	340	+	prepared by the department in accordance with this section. The
	341	+	process must provide for adjudication by an appropriate
	342	+	disinterested person of disputes relating to a statement of
	343	+	violations. The informal dispute resolution process must require:
	344	+	(1) the assisted living facility to request informal
	345	+	dispute resolution not later than the 10th day after the date of
	346	+	notification by the department of the violation of a standard or
	347	+	standards;
	348	+	(2) that the [commission to complete the] process be
	349	+	completed not later than the 90th day after the date of receipt of a
	350	+	request from the assisted living facility for informal dispute
	351	+	resolution;
	352	+	(3) that, not later than the 10th business day after
	353	+	the date an assisted living facility requests an informal dispute
	354	+	resolution, the department forward to the assisted living facility
	355	+	a copy of all information that is referred to in the disputed
	356	+	statement of violations or on which a citation is based in
	357	+	connection with the survey, inspection, investigation, or other
	358	+	visit, excluding:
	359	+	(A) the name of any complainant, witness, or
	360	+	informant;
	361	+	(B) any information that would reasonably lead to
	362	+	the identification of a complainant, witness, or informant;
	363	+	(C) information obtained from or contained in the
	364	+	records of the facility;
	365	+	(D) information that is publicly available; or
	366	+	(E) information that is confidential by law;
	367	+	(4) that [the commission to give] full consideration
	368	+	is given to all [factual] arguments raised during the informal
	369	+	dispute resolution process that:
	370	+	(A) are supported by references to specific
	371	+	information that the facility or department relies on to dispute or
	372	+	support findings in the statement of violations; and
	373	+	(B) are provided by the proponent of the argument
	374	+	[to the commission] and the opposing party;
	375	+	(5) that full consideration is given during the
	376	+	informal dispute resolution process [staff give full
	377	+	consideration] to the information provided by the assisted living
	378	+	facility and the department;
	379	+	(6) that ex parte communications concerning the
	380	+	substance of any argument relating to a survey, inspection,
	381	+	investigation, visit, or statement of violations under
	382	+	consideration not occur between the informal dispute resolution
	383	+	staff and the assisted living facility or the department; and
	384	+	(7) that the assisted living facility and the
	385	+	department be given a reasonable opportunity to submit arguments
	386	+	and information supporting the position of the assisted living
	387	+	facility or the department and to respond to arguments and
	388	+	information presented against them.
	389	+	SECTION 13. Section 250.001(3), Health and Safety Code, as
	390	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	391	+	Session, 2015, is amended to read as follows:
	392	+	(3) "Facility" means:
	393	+	(A) a nursing facility, custodial care home, or
	394	+	other institution licensed by the Department of Aging and
	395	+	Disability Services under Chapter 242;
	396	+	(B) an assisted living facility licensed by the
	397	+	Department of Aging and Disability Services under Chapter 247;
	398	+	(C) a home and community support services agency
	399	+	licensed under Chapter 142;
	400	+	(D) an adult day services [care] facility
	401	+	licensed by the Department of Aging and Disability Services under
	402	+	Chapter 103, Human Resources Code;
	403	+	(E) an ICF-IID licensed under Chapter 252;
	404	+	(F) an adult foster care provider that contracts
	405	+	with the Department of Aging and Disability Services;
	406	+	(G) a facility that provides mental health
	407	+	services and that is operated by or contracts with the Department of
	408	+	State Health Services;
	409	+	(H) a local mental health authority designated
	410	+	under Section 533.035 or a local intellectual and developmental
	411	+	disability authority designated under Section 533.035;
	412	+	(I) a person exempt from licensing under Section
	413	+	142.003(a)(19);
	414	+	(J) a special care facility licensed by the
	415	+	Department of State Health Services under Chapter 248;
	416	+	(K) a mental health service unit of a hospital
	417	+	licensed under Chapter 241; or
	418	+	(L) a prescribed pediatric extended care center
	419	+	licensed by the Department of Aging and Disability Services under
	420	+	Chapter 248A.
	421	+	SECTION 14. Subchapter C, Chapter 252, Health and Safety
211	422		Code, is amended by adding Section 252.0615 to read as follows:
212	423		Sec. 252.0615. PROGRESSIVE SANCTIONS. (a) The executive
213	424		commissioner by rule shall create a matrix of progressive sanctions
214	425		that the department must use to assess penalty amounts and impose
215	426		disciplinary actions under this chapter appropriately and fairly
216	427		for a violation of a law, rule, standard, or order adopted or
217	428		license issued under this chapter or for a violation of other law
218	429		for which this chapter provides a sanction.
219	430		(b) The matrix of progressive sanctions adopted under this
220	431		section must provide for increases in amounts of administrative
221	432		penalties based on type, frequency, and seriousness of violations
222	433		and must provide guidance for determining appropriate and graduated
223	434		administrative penalties to assess under this chapter to deter
224	435		future violations, including guidance on considering the factors
225	436		listed in this chapter for determining the amount of a penalty.
226	437		(c) The matrix of progressive sanctions adopted under this
227	438		section must provide for imposing stronger sanctions, including
228	439		license suspension or revocation, for more serious violations or
229	440		for repeated violations as appropriate to deter future serious or
230	441		repeated violations. The matrix of progressive sanctions must
231	442		describe appropriate time frames to be used in determining whether
232	443		a facility has committed repeated violations or has engaged in a
233	444		pattern of repeated violations, such as repeated violations found
234	445		in consecutive regular inspections.
235		-	SECTION 10. Section 252.065, Health and Safety Code, is
	446	+	SECTION 15. Section 252.065, Health and Safety Code, is
236	447		amended by amending Subsection (b) and Subsection (e), as amended
237	448		by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, to
238	449		read as follows:
239	450		(b) The penalty for a facility with fewer than 60 beds shall
240	451		be not less than $100 or more than $1,000 for each violation. The
241	452		penalty for a facility with 60 beds or more shall be not less than
242	453		$100 or more than $5,000 for each violation. [The total amount of
243	454		the penalty assessed for a violation continuing or occurring on
244	455		separate days under this subsection may not exceed $5,000 for a
245	456		facility with fewer than 60 beds or $25,000 for a facility with 60
246	457		beds or more.] Each day a violation occurs or continues is a
247	458		separate violation for purposes of imposing a penalty.
248	459		(e) The executive commissioner by rule shall provide the
249	460		facility with a reasonable period of time, not less than 45 days,
250	461		following the first day of a violation to correct the violation
251	462		before the department may assess an administrative penalty if a
252	463		plan of correction has been implemented. The executive
253	464		commissioner by rule shall define the types of minor violations a
254	465		facility may correct before the department may assess an
255	466		administrative penalty. The executive commissioner shall ensure
256	467		that all other violations are not subject to a right to correct
257	468		[This subsection does not apply to a violation described by
258	469		Subsections (a)(2)-(8) or to a violation that the department
259	470		determines:
260	471		[(1) has resulted in serious harm to or the death of a
261	472		resident;
262	473		[(2) constitutes a serious threat to the health or
263	474		safety of a resident; or
264	475		[(3) substantially limits the institution's capacity
265	476		to provide care].
266		-	SECTION 11. Subchapter B, Chapter 533A, Health and Safety
	477	+	SECTION 16. Section 255.003, Health and Safety Code, is
	478	+	amended by amending Subsections (b), (e), and (j) and adding
	479	+	Subsections (b-1) and (i-1) to read as follows:
	480	+	(b) Monitoring [Priority for monitoring] visits shall be
	481	+	given to long-term care facilities:
	482	+	(1) with a history of patient care deficiencies; or
	483	+	(2) that are identified as medium risk through the
	484	+	department's early warning system.
	485	+	(b-1) A long-term care facility may request a monitoring
	486	+	visit under this section.
	487	+	(e) Quality-of-care monitors shall assess:
	488	+	(1) the overall quality of life in the long-term care
	489	+	facility; and
	490	+	(2) specific conditions in the facility directly
	491	+	related to patient care, including conditions identified through
	492	+	the long-term care facility's quality measure reports based on
	493	+	Minimum Data Set Resident Assessments.
	494	+	(i-1) The department shall schedule a follow-up visit not
	495	+	later than the 45th day after the date of an initial monitoring
	496	+	visit conducted under this section.
	497	+	(j) Conditions observed by the quality-of-care monitor that
	498	+	create an immediate threat to the health or safety of a resident
	499	+	shall be reported immediately to the long-term care facility
	500	+	administrator, to the regional office supervisor for appropriate
	501	+	action, and, as appropriate or as required by law, to law
	502	+	enforcement, adult protective services, other divisions of the
	503	+	department, or other responsible agencies.
	504	+	SECTION 17. Section 255.004, Health and Safety Code, is
	505	+	amended by amending Subsection (a) and adding Subsections (a-1) and
	506	+	(a-2) to read as follows:
	507	+	(a) In this section:
	508	+	(1) "Abuse" has the meaning assigned by Section
	509	+	260A.001.
	510	+	(2) "Immediate threat to health and safety" means a
	511	+	situation in which immediate corrective action is necessary because
	512	+	the facility's noncompliance with one or more requirements has
	513	+	caused, or is likely to cause, serious injury, harm, impairment, or
	514	+	death to a resident.
	515	+	(3) "Neglect" has the meaning assigned by Section
	516	+	260A.001.
	517	+	(a-1) The department shall create rapid response teams
	518	+	composed of health care experts that can visit a long-term care
	519	+	facility that:
	520	+	(1) is [facilities] identified as high risk through
	521	+	the department's early warning system; or
	522	+	(2) if the long-term care facility is a nursing
	523	+	institution, has committed three violations described by Section
	524	+	242.061(a-1), within a 24-month period, that constitute an
	525	+	immediate threat to health and safety related to the abuse or
	526	+	neglect of a resident.
	527	+	(a-2) A long-term care facility shall cooperate with a rapid
	528	+	response team deployed under this section to improve the quality of
	529	+	care provided at the facility.
	530	+	SECTION 18. Subchapter B, Chapter 533A, Health and Safety
267	531		Code, as added by S.B. 219, Acts of the 84th Legislature, Regular
268	532		Session, 2015, is amended by adding Section 533A.044 to read as
269	533		follows:
270	534		Sec. 533A.044. CRISIS INTERVENTION TEAMS. (a) In this
271	535		section, "crisis intervention team" means a team of individuals
272	536		specially trained to provide services and support to persons with
273	537		an intellectual or developmental disability who have behavioral
274	538		health needs and who are at risk of institutionalization.
275	539		(b) The department shall evaluate the effectiveness of
276	540		various models of crisis intervention teams that are funded under a
277	541		waiver under Section 1115 of the federal Social Security Act (42
278	542		U.S.C. Section 1315) and operated by a local intellectual and
279	543		developmental disability authority.
280	544		(c) Not later than March 1, 2016, the department shall
281	545		select for implementation one or more models for crisis
282	546		intervention teams the department determines best provide
283	547		comprehensive, cost-effective support.
284	548		(d) The department shall determine the areas in this state
285	549		in which local intellectual and developmental disability
286		-	authorities do not operate crisis intervention teams and, subject
287		-	to available funding, shall implement in each area a team that
288		-	operates in accordance with a model selected for implementation
289		-	under this section.
290		-	SECTION 12. Chapter 555, Health and Safety Code, is amended
	550	+	authorities do not operate crisis intervention teams. Subject to
	551	+	available funding, the department shall develop a statewide system
	552	+	of locally managed crisis intervention teams by:
	553	+	(1) expanding existing teams to reach other local
	554	+	service areas; or
	555	+	(2) implementing new teams that operate in accordance
	556	+	with a model selected under Subsection (c).
	557	+	SECTION 19. Chapter 555, Health and Safety Code, is amended
291	558		by adding Subchapter F to read as follows:
292	559		SUBCHAPTER F. STATE SUPPORTED LIVING CENTER RESTRUCTURING AND
293	560		CLOSURES
294	561		Sec. 555.201. STATE SUPPORTED LIVING CENTER RESTRUCTURING
295	562		COMMISSION. (a) In this subchapter, "restructuring commission"
296	563		means the state supported living center restructuring commission.
297	564		(b) The restructuring commission consists of five members
298	565		appointed by the governor and the following three nonvoting ex
299	566		officio members:
300	567		(1) the executive commissioner or the executive
301	568		commissioner's designee;
302	569		(2) the executive director of the Texas Facilities
303	570		Commission or the executive director's designee; and
304	571		(3) the commissioner of the General Land Office or the
305	572		commissioner's designee.
306	573		(c) The restructuring commission is established to evaluate
307	574		each state supported living center in the state to determine
308	575		whether closure of the center is recommended to maintain only the
309	576		number of centers necessary to meet the level of need in the state.
310	577		In evaluating each state supported living center, the restructuring
311	578		commission shall consider:
312	579		(1) the quality of services provided by the center,
313		-	including the center's ~~most recent certification inspections~~ and
314		-	~~the center's~~ ability to meet the minimum ICF-IID standards;
	580	+	including the center's regulatory compliance and the center's
	581	+	ability to meet the minimum ICF-IID standards;
315	582		(2) the costs of operating the center;
316	583		(3) the center's compliance with the 2009 settlement
317		-	agreement between the department and the United States ~~Department~~
318		-	of Justice regarding services provided to individuals ~~with an~~
319		-	intellectual or developmental disability in state-operated
	584	+	agreement, as amended, between the department and the United States
	585	+	Department of Justice regarding services provided to individuals
	586	+	with an intellectual or developmental disability in state-operated
320	587		facilities;
321	588		(4) the availability of community service providers in
322	589		the area served by the center;
323	590		(5) the specialty services provided at the center,
324	591		including the ability of the center to serve alleged offenders or
325	592		high-risk residents;
326	593		(6) the availability of employment opportunities for
327	594		center employees if the center closes;
328	595		(7) any infrastructure deficiency costs relating to
329	596		the center;
330	597		(8) the property value of, the market demand for, and
331	598		any deed restrictions applicable to property and facilities of the
332	599		center;
333	600		(9) whether closure of the center would adversely
334	601		affect the geographic distribution of centers in the state;
335	602		(10) the availability and capacity of service
336	603		providers and resources in the community capable of delivering the
337	604		quality and level of care each resident of the center would require
338		-	following the center's closure; and
339		-	(11) any other criteria the restructuring commission
	605	+	following the center's closure;
	606	+	(11) closure costs; and
	607	+	(12) any other criteria the restructuring commission
340	608		considers appropriate.
	609	+	(c-1) The restructuring commission shall hold public
	610	+	hearings throughout the state in a manner that accommodates
	611	+	individuals with disabilities and their families to solicit input
	612	+	during the evaluation process under Subsection (c).
341	613		(d) Not later than December 1, 2016, the restructuring
342	614		commission shall submit to the governor, the lieutenant governor,
343	615		the speaker of the house of representatives, and the presiding
344	616		officers of the standing committees of the senate and house of
345	617		representatives having primary jurisdiction over intellectual and
346	618		developmental disability issues a report detailing the
347	619		restructuring commission's evaluation of each state supported
348	620		living center and, if applicable, proposing the closure of certain
349	621		centers.
350		-	(e) The restructuring commission is abolished and this
	622	+	(e) A member of the restructuring commission may not:
	623	+	(1) have a direct or indirect interest in any contract
	624	+	or proposed contract with a licensed provider of ICF-IID services,
	625	+	or other provider of services to individuals with an intellectual
	626	+	or developmental disability;
	627	+	(2) acquire a direct or indirect pecuniary interest in
	628	+	any provider of ICF-IID services, or other provider of services to
	629	+	individuals with an intellectual or developmental disability;
	630	+	(3) have a financial interest in the closure of a state
	631	+	supported living center;
	632	+	(4) be an agent, paid consultant, officer, or employee
	633	+	of a state supported living center, state center, local authority,
	634	+	licensed provider of ICF-IID services, or other provider of
	635	+	services to individuals with an intellectual or developmental
	636	+	disability;
	637	+	(5) have a financial interest in a state supported
	638	+	living center, state center, local authority, licensed provider of
	639	+	ICF-IID services, or other provider of services to individuals with
	640	+	an intellectual or developmental disability;
	641	+	(6) be an officer, employee, or paid consultant of a
	642	+	trade association in the field of residential services for
	643	+	individuals with an intellectual or developmental disability;
	644	+	(7) be a resident of a state supported living center;
	645	+	or
	646	+	(8) be related within the second degree by affinity or
	647	+	consanguinity, as determined under Chapter 573, Government Code, to
	648	+	a person who is an officer, employee, paid consultant, or resident
	649	+	of a state supported living center, state center, local authority,
	650	+	licensed provider of ICF-IID services, or other provider of
	651	+	services to individuals with an intellectual or developmental
	652	+	disability.
	653	+	(f) The restructuring commission is abolished and this
351	654		section expires January 1, 2017.
352	655		Sec. 555.202. RECOMMENDED CLOSURES OF STATE SUPPORTED
353	656		LIVING CENTERS. (a) If the restructuring commission proposes the
354	657		closure of one or more state supported living centers, the 85th
355	658		Legislature shall consider legislation proposing the closure of the
356	659		centers recommended for closure. In considering the proposed
357	660		legislation described by this subsection, members of the
358	661		legislature may not propose amendments to the legislation.
359	662		(b) If the legislation described by Subsection (a) is
360	663		enacted and becomes law, the department shall ensure that each
361	664		state supported living center approved by the legislature for
362	665		closure under Subsection (a) is closed not later than August 31,
363	666		2025.
364	667		(c) This subchapter expires September 1, 2025.
365	668		Sec. 555.203. CLOSURE OF AUSTIN STATE SUPPORTED LIVING
366	669		CENTER. (a) The department shall establish a closure plan for the
367	670		Austin State Supported Living Center. The plan must provide for
368	671		closure of the facility and operations of the Austin State
369	672		Supported Living Center not later than August 31, 2017.
370	673		(b) The closure plan must provide procedures to transition
371		-	to the community each resident for whom transition to the community
372		-	is practicable while maintaining respect for resident choice.
	674	+	each resident of the Austin State Supported Living Center to the
	675	+	community or to another state supported living center, taking into
	676	+	consideration:
	677	+	(1) whether the resident's care team recommends
	678	+	placement in the community;
	679	+	(2) whether a community placement is available for the
	680	+	resident; and
	681	+	(3) the resident's choice.
373	682		(c) The department may award one-time retention bonuses to
374		-	each ~~direct support professional,~~ ~~qualified intellectual~~
375		-	~~disability professional,~~ ~~social worker,~~ and ~~case manager~~ who agrees
376		-	~~to continue to provide services~~ at the Austin State Supported
377		-	~~Living Center until the center is~~ closed.
	683	+	each person who holds a position designated as eligible for a bonus
	684	+	by the commissioner and who agrees to continue to provide services
	685	+	at the Austin State Supported Living Center until the center is
	686	+	closed.
378	687		(d) The proceeds from the closure, including from the sale
379	688		or lease of facilities or other property, may be appropriated only
380	689		for services for persons with an intellectual or developmental
381	690		disability, including persons with a dual diagnosis of an
382	691		intellectual or developmental disability and mental illness.
383	692		(e) Not later than August 31, 2018, the department shall
384	693		evaluate the closure process, including how well the closure plan
385	694		worked, and, if appropriate, establish policies for improving the
386	695		closure process for future closures of other state supported living
387	696		centers.
388	697		(f) This section expires September 1, 2018.
389		-	SECTION 13. Section 531.0318, Government Code, is amended
390		-	by adding Subsections (b-1), (d), and (e) to read as follows:
391		-	(b-1) The information for consumers required by this
392		-	section must include for each provider of long-term care services:
	698	+	SECTION 20. Section 531.0318, Government Code, is amended
	699	+	by adding Subsections (b-1), (b-2), (d), and (e) to read as follows:
	700	+	(b-1) Except as provided by Subsection (b-2), the
	701	+	information for consumers required by this section must include for
	702	+	each provider of long-term care services:
393	703		(1) a rating assigned by the Department of Aging and
394	704		Disability Services indicating the quality of the care provided or,
395	705		alternatively, a link to a rating assigned a provider on an Internet
396	706		website maintained by the federal government;
397	707		(2) information concerning quality of care, as that
398	708		information becomes available;
399	709		(3) staffing information, if available, including for
400	710		each year the number of staff members who began employment with the
401	711		provider during that year and the number of staff members who ceased
402	712		employment with the provider during that year;
403	713		(4) the ratio of staff members to residents; and
404	714		(5) the provider's regulatory performance, as
405	715		available.
	716	+	(b-2) Subsection (b-1)(1) does not apply to, and the
	717	+	Department of Aging and Disability Services is not required to
	718	+	include the information described by that subsection for, a
	719	+	facility licensed under Chapter 247, Health and Safety Code.
406	720		(d) The Department of Aging and Disability Services shall
407	721		immediately post notice on the department's Internet website when a
408	722		provider of long-term care services loses its Medicaid
409	723		certification.
410	724		(e) The Department of Aging and Disability Services shall
411	725		periodically solicit input regarding the content of the information
412	726		required under this section and the usability and accessibility of
413	727		the website on which the information is located from consumers,
414	728		consumer advocates, long-term care services providers, and the
415	729		general public.
416		-	SECTION 14. Subchapter D, Chapter 48, Human Resources Code,
	730	+	SECTION 21. Section 531.058(a), Government Code, as amended
	731	+	by S.B. No. 219, Acts of the 84th Legislature, Regular Session,
	732	+	2015, and Section 531.058(c), Government Code, are amended to read
	733	+	as follows:
	734	+	(a) The executive commissioner by rule shall establish an
	735	+	informal dispute resolution process in accordance with this
	736	+	section. The process must provide for adjudication by an
	737	+	appropriate disinterested person of disputes relating to a proposed
	738	+	enforcement action or related proceeding of the commission under
	739	+	Section 32.021(d), Human Resources Code, or the Department of Aging
	740	+	and Disability Services under Chapter 242, 247, or 252, Health and
	741	+	Safety Code. The informal dispute resolution process must require:
	742	+	(1) an institution or facility to request informal
	743	+	dispute resolution not later than the 10th calendar day after
	744	+	notification by the commission or department, as applicable, of the
	745	+	violation of a standard or standards; and
	746	+	(2) the completion of [commission to complete] the
	747	+	process not later than:
	748	+	(A) the 30th calendar day after receipt of a
	749	+	request from an institution or facility, other than an assisted
	750	+	living facility, for informal dispute resolution; or
	751	+	(B) the 90th calendar day after receipt of a
	752	+	request from an assisted living facility for informal dispute
	753	+	resolution.
	754	+	(c) The commission may not delegate its responsibility to
	755	+	administer the informal dispute resolution process established by
	756	+	this section to another state agency. This section does not apply
	757	+	to the informal dispute resolution process established by Section
	758	+	247.051, Health and Safety Code, applicable to assisted living
	759	+	facilities licensed under Chapter 247, Health and Safety Code.
	760	+	SECTION 22. Section 531.058, Government Code, is amended by
	761	+	adding Subsection (a-1) to read as follows:
	762	+	(a-1) As part of the informal dispute resolution process
	763	+	established under this section, the commission shall contract with
	764	+	an appropriate disinterested person who is a nonprofit organization
	765	+	to adjudicate disputes between an institution or facility licensed
	766	+	under Chapter 242, Health and Safety Code, and the Department of
	767	+	Aging and Disability Services concerning a statement of violations
	768	+	prepared by the department in connection with a survey conducted by
	769	+	the department of the institution or facility. Section 2009.053
	770	+	does not apply to the selection of an appropriate disinterested
	771	+	person under this subsection. The person with whom the commission
	772	+	contracts shall adjudicate all disputes described by this
	773	+	subsection.
	774	+	SECTION 23. Section 531.951(a), Government Code, is amended
	775	+	to read as follows:
	776	+	(a) This subchapter applies only to the final licensing,
	777	+	listing, or registration decisions of a health and human services
	778	+	agency with respect to a person under the law authorizing the agency
	779	+	to regulate the following types of persons:
	780	+	(1) a youth camp licensed under Chapter 141, Health
	781	+	and Safety Code;
	782	+	(2) a home and community support services agency
	783	+	licensed under Chapter 142, Health and Safety Code;
	784	+	(3) a hospital licensed under Chapter 241, Health and
	785	+	Safety Code;
	786	+	(4) an institution licensed under Chapter 242, Health
	787	+	and Safety Code;
	788	+	(5) an assisted living facility licensed under Chapter
	789	+	247, Health and Safety Code;
	790	+	(6) a special care facility licensed under Chapter
	791	+	248, Health and Safety Code;
	792	+	(7) an intermediate care facility licensed under
	793	+	Chapter 252, Health and Safety Code;
	794	+	(8) a chemical dependency treatment facility licensed
	795	+	under Chapter 464, Health and Safety Code;
	796	+	(9) a mental hospital or mental health facility
	797	+	licensed under Chapter 577, Health and Safety Code;
	798	+	(10) a child-care facility or child-placing agency
	799	+	licensed under or a family home listed or registered under Chapter
	800	+	42, Human Resources Code; or
	801	+	(11) an adult day services [day-care] facility
	802	+	licensed under Chapter 103, Human Resources Code.
	803	+	SECTION 24. Subchapter D, Chapter 48, Human Resources Code,
417	804		is amended by adding Section 48.15221 to read as follows:
418	805		Sec. 48.15221. REPORTS CONCERNING DAY HABILITATION
419	806		SERVICES PROVIDERS. (a) In this section, "day habilitation
420	807		services" and "day habilitation services provider" have the
421	808		meanings assigned by Section 161.401.
422	809		(b) The department shall prepare and submit to the
423	810		Department of Aging and Disability Services an annual report of the
424	811		number of investigations arising from a report of abuse, neglect,
425	812		or exploitation of a person with an intellectual or developmental
426	813		disability that was allegedly committed by or on the premises of a
427	814		day habilitation services provider, and whether the investigation
428	815		concluded that the report of alleged abuse, neglect, or
429	816		exploitation was confirmed, unconfirmed, inconclusive, or
430	817		unfounded.
431	818		(c) The duty to prepare and submit a report under Subsection
432	819		(b) does not affect the duty of the department to investigate and
433	820		hold accountable a community-based intellectual and developmental
434	821		disabilities services provider or intermediate care facility for
435	822		any abuse, neglect, or exploitation of a person who receives day
436	823		habilitation services from the provider.
437		-	SECTION 15. Chapter 103, Human Resources Code, is amended
	824	+	SECTION 25. The heading to Chapter 103, Human Resources
	825	+	Code, is amended to read as follows:
	826	+	CHAPTER 103. ADULT DAY SERVICES [CARE]
	827	+	SECTION 26. Section 103.001, Human Resources Code, as
	828	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	829	+	Session, 2015, is amended to read as follows:
	830	+	Sec. 103.001. PURPOSE. It is the purpose of this chapter to
	831	+	establish programs of quality adult day services [care and day
	832	+	health care] that will enable persons with disabilities who have
	833	+	medical or functional impairments and elderly persons to maintain
	834	+	maximum independence and to prevent premature or inappropriate
	835	+	institutionalization. It is the purpose of this chapter to provide
	836	+	adequately regulated supervision for elderly persons and persons
	837	+	with disabilities while enabling them to remain in a family
	838	+	environment and affording the family a measure of normality in its
	839	+	daily activities. The legislature intends to provide for the
	840	+	development of policies and programs that will:
	841	+	(1) provide alternatives to institutionalization;
	842	+	(2) establish facilities for adult day services [care
	843	+	and day health care] throughout the state that offer services and
	844	+	are accessible to economically disadvantaged persons; and
	845	+	(3) prevent inappropriate institutionalization.
	846	+	SECTION 27. Section 103.002, Human Resources Code, is
	847	+	amended to read as follows:
	848	+	Sec. 103.002. SHORT TITLE. This chapter may be cited as the
	849	+	Adult Day Services [Care] Act.
	850	+	SECTION 28. Section 103.003(1), Human Resources Code, as
	851	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	852	+	Session, 2015, is amended to read as follows:
	853	+	(1) "Adult day services [day-care] facility" means a
	854	+	facility that provides services under an adult day services
	855	+	[day-care] program on a daily or regular basis but not overnight to
	856	+	four or more elderly persons or persons with disabilities who are
	857	+	not related by blood, marriage, or adoption to the owner of the
	858	+	facility.
	859	+	SECTION 29. Section 103.003(2), Human Resources Code, is
	860	+	amended to read as follows:
	861	+	(2) "Adult day services [day-care] program" means a
	862	+	structured, comprehensive program that is designed to meet the
	863	+	needs of adults with functional impairments through an individual
	864	+	plan of care by providing health, social, and related support
	865	+	services in a protective setting.
	866	+	SECTION 30. Section 103.0041(a), Human Resources Code, is
	867	+	amended to read as follows:
	868	+	(a) A person may not operate an adult day services
	869	+	[day-care] facility without a license issued under this chapter.
	870	+	SECTION 31. Section 103.006(a), Human Resources Code, is
	871	+	amended to read as follows:
	872	+	(a) The department shall issue a license to operate an adult
	873	+	day services [day-care] facility to a person who has met the
	874	+	application requirements and received approval after an on-site
	875	+	inspection.
	876	+	SECTION 32. Section 103.007(a), Human Resources Code, is
	877	+	amended to read as follows:
	878	+	(a) An applicant for a license to operate an adult day
	879	+	services [day-care] facility must file an application on a form
	880	+	prescribed by the department together with a license fee of $50.
	881	+	SECTION 33. Section 103.0075(a), Human Resources Code, as
	882	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	883	+	Session, 2015, is amended to read as follows:
	884	+	(a) The executive commissioner by rule shall adopt a
	885	+	procedure under which a person proposing to construct or modify an
	886	+	adult day services [day-care] facility may submit building plans to
	887	+	the department for review for compliance with the department's
	888	+	architectural requirements before beginning construction or
	889	+	modification. In adopting the procedure, the executive
	890	+	commissioner shall set reasonable deadlines by which the department
	891	+	must complete review of submitted plans.
	892	+	SECTION 34. Chapter 103, Human Resources Code, is amended
438	893		by adding Section 103.0085 to read as follows:
439	894		Sec. 103.0085. PROGRESSIVE SANCTIONS. (a) The executive
440	895		commissioner by rule shall create a matrix of progressive sanctions
441	896		that the department must use to assess penalty amounts and impose
442	897		disciplinary actions under this chapter appropriately and fairly
443	898		for a violation of a law, rule, standard, or order adopted or
444	899		license issued under this chapter or for a violation of other law
445	900		for which this chapter provides a sanction.
446	901		(b) The matrix of progressive sanctions adopted under this
447	902		section must provide for increases in amounts of administrative
448	903		penalties based on type, frequency, and seriousness of violations
449	904		and must provide guidance for determining appropriate and graduated
450	905		administrative penalties to assess under this chapter to deter
451	906		future violations, including guidance on considering the factors
452	907		listed in this chapter for determining the amount of a penalty.
453	908		(c) The matrix of progressive sanctions adopted under this
454	909		section must provide for imposing stronger sanctions, including
455	910		license suspension or revocation, for more serious violations or
456	911		for repeated violations as appropriate to deter future serious or
457	912		repeated violations. The matrix of progressive sanctions must
458	913		describe appropriate time frames to be used in determining whether
459		-	an adult day~~-care~~ facility has committed repeated violations or ~~has~~
460		-	engaged in a pattern of repeated violations, such as repeated
	914	+	an adult day services facility has committed repeated violations or
	915	+	has engaged in a pattern of repeated violations, such as repeated
461	916		violations found in consecutive regular inspections.
462		-	SECTION 16. Section 103.~~013~~(b), Human Resources Code, is
	917	+	SECTION 35. Section 103.0091(a), Human Resources Code, is
463	918		amended to read as follows:
464		-	(b) The executive commissioner by rule shall define the
465		-	types of minor violations an adult day-care facility may correct
466		-	under Subsection (a) before the department may assess an
467		-	administrative penalty. The executive commissioner shall ensure
468		-	that all other violations are not subject to a right to correct
469		-	[Subsection (a) does not apply to:
	919	+	(a) The department may petition a district court for a
	920	+	temporary restraining order to restrain a continuing violation of
	921	+	the standards or licensing requirements provided under this chapter
	922	+	if the department finds that the violation creates an immediate
	923	+	threat to the health and safety of the adult day services facility
	924	+	[day-care] residents.
	925	+	SECTION 36. Section 103.0092(a), Human Resources Code, is
	926	+	amended to read as follows:
	927	+	(a) If the department finds an adult day services [day-care]
	928	+	facility operating in violation of the standards prescribed by this
	929	+	chapter and the violations create an immediate threat to the health
	930	+	and safety of a resident in the facility, the department shall
	931	+	suspend the license or order immediate closing of all or part of the
	932	+	facility.
	933	+	SECTION 37. Section 103.011, Human Resources Code, is
	934	+	amended to read as follows:
	935	+	Sec. 103.011. RIGHTS OF THE ELDERLY. (a) In addition to
	936	+	other rights an individual attending an adult day services [care]
	937	+	facility has as a citizen, an individual who is 55 years of age or
	938	+	older has the rights prescribed by Chapter 102 of this code.
	939	+	(b) The department shall require each adult day services
	940	+	[care] facility to implement and enforce the applicable provisions
	941	+	of Chapter 102 of this code.
	942	+	SECTION 38. Section 103.012(a), Human Resources Code, is
	943	+	amended to read as follows:
	944	+	(a) The department may assess an administrative penalty
	945	+	against a person who:
	946	+	(1) violates this chapter, a rule, standard, or order
	947	+	adopted under this chapter, or a term of a license issued under this
	948	+	chapter;
	949	+	(2) makes a false statement of a material fact that the
	950	+	person knows or should know is false:
	951	+	(A) on an application for issuance or renewal of
	952	+	a license or in an attachment to the application; or
	953	+	(B) with respect to a matter under investigation
	954	+	by the department;
	955	+	(3) refuses to allow a representative of the
	956	+	department to inspect:
	957	+	(A) a book, record, or file required to be
	958	+	maintained by an adult day services [day-care] facility; or
	959	+	(B) any portion of the premises of an adult day
	960	+	services [day-care] facility;
	961	+	(4) wilfully interferes with the work of a
	962	+	representative of the department or the enforcement of this
	963	+	chapter;
	964	+	(5) wilfully interferes with a representative of the
	965	+	department preserving evidence of a violation of this chapter, a
	966	+	rule, standard, or order adopted under this chapter, or a term of a
	967	+	license issued under this chapter;
	968	+	(6) fails to pay a penalty assessed under this chapter
	969	+	not later than the 30th day after the date the assessment of the
	970	+	penalty becomes final; or
	971	+	(7) fails to notify the department of a change of
	972	+	ownership before the effective date of the change of ownership.
	973	+	SECTION 39. Section 103.013, Human Resources Code, is
	974	+	amended to read as follows:
	975	+	Sec. 103.013. RIGHT TO CORRECT BEFORE IMPOSITION OF
	976	+	ADMINISTRATIVE PENALTY. (a) The department may not collect an
	977	+	administrative penalty from an adult day services [day-care]
	978	+	facility under Section 103.012 if, not later than the 45th day after
	979	+	the date the facility receives notice under Section 103.014(c), the
	980	+	facility corrects the violation.
	981	+	(b) The executive commissioner of the Health and Human
	982	+	Services Commission by rule shall define types of minor violations
	983	+	an adult day services facility may correct under Subsection (a)
	984	+	before assessing an administrative penalty. The executive
	985	+	commissioner shall ensure that all other violations are not subject
	986	+	to a right to correct [Subsection (a) does not apply to:
470	987		[(1) a violation that the department determines:
471	988		[(A) results in serious harm to or death of a
472	989		person attending the facility;
473	990		[(B) constitutes a serious threat to the health
474	991		and safety of a person attending the facility; or
475	992		[(C) substantially limits the facility's
476	993		capacity to provide care;
477	994		[(2) a violation described by Sections
478	995		103.012(a)(2)-(7); or
479	996		[(3) a violation of Section 103.011].
480		-	SECTION 17. Section 161.080, Human Resources Code, is
	997	+	(c) An adult day services [day-care] facility that corrects
	998	+	a violation must maintain the correction. If the facility fails to
	999	+	maintain the correction until at least the first anniversary after
	1000	+	the date the correction was made, the department may assess and
	1001	+	collect an administrative penalty for the subsequent violation. An
	1002	+	administrative penalty assessed under this subsection is equal to
	1003	+	three times the amount of the original penalty assessed but not
	1004	+	collected. The department is not required to provide the facility
	1005	+	with an opportunity under this section to correct the subsequent
	1006	+	violation.
	1007	+	SECTION 40. Sections 103.014(c) and (e), Human Resources
	1008	+	Code, are amended to read as follows:
	1009	+	(c) The department shall give written notice of the report
	1010	+	to the person charged with the violation not later than the 10th day
	1011	+	after the date on which the report is issued. The notice must
	1012	+	include:
	1013	+	(1) a brief summary of the charges;
	1014	+	(2) a statement of the amount of penalty recommended;
	1015	+	(3) a statement of whether the violation is subject to
	1016	+	correction under Section 103.013 and, if the violation is subject
	1017	+	to correction under that section, a statement of:
	1018	+	(A) the date on which the adult day services
	1019	+	[day-care] facility must file a plan of correction with the
	1020	+	department that the department shall review and may approve, if
	1021	+	satisfactory; and
	1022	+	(B) the date on which the plan of correction must
	1023	+	be completed to avoid assessment of the penalty; and
	1024	+	(4) a statement that the person charged has a right to
	1025	+	a hearing on the occurrence of the violation, the amount of the
	1026	+	penalty, or both.
	1027	+	(e) If the violation is subject to correction under Section
	1028	+	103.013, the adult day services [day-care] facility shall submit a
	1029	+	plan of correction to the department for approval not later than the
	1030	+	10th day after the date on which the notice under Subsection (c) is
	1031	+	received.
	1032	+	SECTION 41. Section 161.080, Human Resources Code, is
481	1033		amended by adding Subsection (c) to read as follows:
482	1034		(c) The executive commissioner by rule shall establish a
483	1035		list of services a state supported living center may provide under a
484	1036		contract described by Subsection (a) and a schedule of fees the
485	1037		state supported living center may charge for those services. In
486	1038		establishing the schedule of fees for services, the executive
487	1039		commissioner shall use the reimbursement rate for the applicable
488		-	service under the Medicaid program or modify that rate with a
489		-	written justification for the modification.
490		-	SECTION 18. Chapter 161, Human Resources Code, is amended
	1040	+	service under the Medicaid program.
	1041	+	SECTION 42. Chapter 161, Human Resources Code, is amended
491	1042		by adding Subchapter J to read as follows:
492	1043		SUBCHAPTER J. POWERS AND DUTIES RELATING TO DAY HABILITATION
493	1044		SERVICES PROVIDERS
494	1045		Sec. 161.401. DEFINITIONS. In this subchapter:
495	1046		(1) "Day habilitation services" means services to
496	1047		assist persons with an intellectual or developmental disability in
497	1048		acquiring, retaining, and improving the self-help, socialization,
498	1049		and adaptive skills necessary to reside successfully in the
499		-	community, including prevocational, educational, and supported
500		-	employment services.
	1050	+	community, including prevocational and educational services.
501	1051		(2) "Day habilitation services provider" means a
502	1052		person who contracts with a community-based intellectual and
503	1053		developmental disabilities services provider or intermediate care
504	1054		facility to provide federally funded Medicaid day habilitation
505	1055		services authorized under Section 1915(c) of the federal Social
506	1056		Security Act (42 U.S.C. Section 1396n(c)).
507	1057		Sec. 161.402. DAY HABILITATION SERVICES PROVIDER
508	1058		INFORMATION TRACKING. (a) Each community-based intellectual and
509	1059		developmental disabilities services provider and intermediate care
510	1060		facility shall annually submit to the department a report
511	1061		providing:
512	1062		(1) an estimate of the number of clients receiving day
513	1063		habilitation services for each month of that year;
514	1064		(2) the physical address of each day habilitation
515	1065		services provider that provided those services;
516	1066		(3) the services provided to those clients; and
517	1067		(4) an estimate of monthly expenditures for the
518	1068		provision of those services to those clients.
519	1069		(b) The department shall maintain information obtained
520	1070		during a department inspection of a day habilitation services
521	1071		provider concerning conduct or conditions that would constitute a
522	1072		violation of federal or state law or of department rules applicable
523	1073		to the community-based intellectual and developmental disabilities
524	1074		services provider or intermediate care facility with which the day
525	1075		habilitation services provider contracts.
526	1076		(c) The department shall maintain information concerning an
527	1077		investigation of abuse, neglect, or exploitation concerning a day
528	1078		habilitation services provider that the department receives from
529	1079		the Department of Family and Protective Services under Section
530	1080		48.15221.
531	1081		Sec. 161.403. DAY HABILITATION PROGRAM ADVISORY COMMITTEE.
532	1082		(a) Not later than September 1, 2015, the department shall
533	1083		establish a day habilitation program advisory committee composed of
534	1084		members that represent community-based waiver providers, owners of
535	1085		day habilitation services providers, and advocates for persons with
536	1086		an intellectual or developmental disability.
537	1087		(b) The day habilitation program advisory committee shall
538	1088		consider and make recommendations concerning whether the provision
539	1089		of day habilitation services in this state should be redesigned and
540	1090		whether day habilitation services providers should be subject to
541	1091		regulation, including by licensure or certification.
542	1092		(c) In considering the redesign of the provision of day
543	1093		habilitation services in this state, the day habilitation program
544	1094		advisory committee shall examine whether day habilitation service
545	1095		providers currently comply with the requirements of 42 C.F.R.
546	1096		Section 441.301.
547	1097		(d) The day habilitation program advisory committee shall
548	1098		also consider and make recommendations concerning issues relevant
549	1099		to the provision of day habilitation services, including the
550	1100		appropriate funding for services, reimbursable settings and
551	1101		services, staff-to-client ratio requirements, safety requirements,
552	1102		and other required or applicable standards.
553	1103		(e) Not later than September 1, 2016, the day habilitation
554	1104		program advisory committee shall submit to the governor, the
555	1105		lieutenant governor, the speaker of the house of representatives,
556	1106		and the presiding officers of the standing committees of the senate
557	1107		and house of representatives having primary jurisdiction over
558	1108		intellectual and developmental disability issues a report
559	1109		containing the committee's recommendations concerning the redesign
560	1110		of the provision of day habilitation services in this state and the
561	1111		necessity for regulation, licensure, or certification of day
562	1112		habilitation services providers.
563	1113		(f) The day habilitation program advisory committee is
564	1114		abolished and this section expires December 31, 2016.
565		-	SECTION 19. Section 101A.158, Human Resources Code, as
566		-	added by S.B. 219, Acts of the 84th Legislature, Regular Session,
567		-	2015, is repealed.
568		-	SECTION 20. (a) Not later than September 1, 2016, the
	1115	+	SECTION 43. (a) Subchapter A, Chapter 161, Human Resources
	1116	+	Code, is amended by adding Sections 161.0031 and 161.004 to read as
	1117	+	follows:
	1118	+	Sec. 161.0031. INAPPLICABILITY OF CERTAIN LAW.
	1119	+	Notwithstanding Section 161.003, Section 325.017, Government Code,
	1120	+	does not apply to the department.
	1121	+	Sec. 161.004. MEANING OF CERTAIN REFERENCES IN LAW. (a) A
	1122	+	reference in this chapter or in any other law to the department in
	1123	+	relation to a function transferred under Section 161.012 means the
	1124	+	commission or the division of the commission performing the
	1125	+	function after its transfer.
	1126	+	(b) In this chapter or in any other law and notwithstanding
	1127	+	any other law, a reference to any of the following state agencies or
	1128	+	to the chief executive officer or governing body of any of the
	1129	+	following state agencies in relation to a function transferred to
	1130	+	the commission under Section 161.012 from the department that the
	1131	+	department assumed in accordance with Chapter 198 (H.B. 2292), Acts
	1132	+	of the 78th Legislature, Regular Session, 2003, means the executive
	1133	+	commissioner, the commission, or the division of the commission
	1134	+	performing the function after its transfer to the commission:
	1135	+	(1) the Texas Department on Aging;
	1136	+	(2) the Texas Department of Human Services; and
	1137	+	(3) the Texas Department of Mental Health and Mental
	1138	+	Retardation.
	1139	+	(c) A reference in this chapter or in any other law to the
	1140	+	commissioner in relation to a function transferred under Section
	1141	+	161.012 means the executive commissioner, the executive
	1142	+	commissioner's designee, or the director of the division of the
	1143	+	commission performing the function after its transfer.
	1144	+	(d) A reference in this chapter or in any other law to the
	1145	+	council in relation to a function after its transfer under Section
	1146	+	161.012 means the executive commissioner or the executive
	1147	+	commissioner's designee, as appropriate, and a function previously
	1148	+	performed by the council is a function of that appropriate person.
	1149	+	(b) Chapter 161, Human Resources Code, is amended by adding
	1150	+	Subchapter A-1 to read as follows:
	1151	+	SUBCHAPTER A-1. TRANSFER OF AGING AND DISABILITY SERVICES TO
	1152	+	COMMISSION
	1153	+	Sec. 161.011. DEFINITIONS. In this subchapter:
	1154	+	(1) "Administrative support services" has the meaning
	1155	+	assigned by Section 531.0055(d), Government Code.
	1156	+	(2) "Function" includes a power, duty, program, or
	1157	+	activity of a state agency or entity.
	1158	+	Sec. 161.012. TRANSFER OF AGING AND DISABILITY SERVICES TO
	1159	+	COMMISSION. (a) Not later than September 1, 2016, the following
	1160	+	functions are transferred to the commission as provided by this
	1161	+	subchapter:
	1162	+	(1) appropriate department administrative support
	1163	+	services functions, as determined by the executive commissioner in
	1164	+	consultation with the department;
	1165	+	(2) all department client services functions, as
	1166	+	defined by the executive commissioner by rule; and
	1167	+	(3) all functions of the council.
	1168	+	(b) On or after September 1, 2016, but not later than
	1169	+	September 1, 2017, all functions, including administrative support
	1170	+	services functions, that remained with the department after the
	1171	+	initial transfer of functions under Subsection (a) are transferred
	1172	+	to the commission.
	1173	+	Sec. 161.013. EFFECT OF TRANSFERS. (a) All of the
	1174	+	following that relate to a function that is transferred under
	1175	+	Section 161.012 are transferred to the commission on the date the
	1176	+	related function is transferred to the commission:
	1177	+	(1) all obligations and contracts, including
	1178	+	obligations and contracts related to a grant program;
	1179	+	(2) all property and records in the custody of the
	1180	+	department or council from which the function is transferred;
	1181	+	(3) all funds appropriated by the legislature and
	1182	+	other money;
	1183	+	(4) all complaints, investigations, or contested
	1184	+	cases that are pending before the department or the commissioner,
	1185	+	without change in status; and
	1186	+	(5) all necessary personnel, as determined by the
	1187	+	executive commissioner.
	1188	+	(b) A rule, policy, or form adopted by or on behalf of the
	1189	+	department or council that relates to a function that is
	1190	+	transferred under Section 161.012 becomes a rule, policy, or form
	1191	+	of the commission on transfer of the related function and remains in
	1192	+	effect:
	1193	+	(1) until altered by the executive commissioner or
	1194	+	commission, as appropriate; or
	1195	+	(2) unless it conflicts with a rule, policy, or form of
	1196	+	the commission.
	1197	+	(c) A license, permit, or certification in effect that was
	1198	+	issued by the department that relates to a function that is
	1199	+	transferred under Section 161.012 is continued in effect as a
	1200	+	license, permit, or certification of the commission on transfer of
	1201	+	the related function until the license, permit, or certification
	1202	+	expires, is suspended or revoked, or otherwise becomes invalid.
	1203	+	Sec. 161.014. APPLICABILITY OF FORMER LAW. An action
	1204	+	brought or proceeding commenced before the date of a transfer
	1205	+	prescribed by this subchapter, including a contested case or a
	1206	+	remand of an action or proceeding by a reviewing court, is governed
	1207	+	by the laws and rules applicable to the action or proceeding before
	1208	+	the transfer.
	1209	+	Sec. 161.015. AUTHORITY OF DEPARTMENT. The powers and
	1210	+	authority of the department with respect to a function are not
	1211	+	reduced or otherwise limited until the date the function is
	1212	+	transferred in accordance with this subchapter, notwithstanding
	1213	+	Section 161.003 or any other law.
	1214	+	Sec. 161.016. EXPIRATION OF SUBCHAPTER. This subchapter
	1215	+	expires September 1, 2019.
	1216	+	(c) Section 161.003, Human Resources Code, as amended by
	1217	+	S.B. No. 219, Acts of the 84th Legislature, Regular Session, 2015,
	1218	+	is amended to read as follows:
	1219	+	Sec. 161.003. SUNSET PROVISION. The department is subject
	1220	+	to Chapter 325, Government Code (Texas Sunset Act). Unless
	1221	+	continued in existence as provided by that chapter, the department
	1222	+	is abolished [and this chapter expires] September 1, 2015.
	1223	+	(d) As soon as appropriate under Subchapter A-1, Chapter
	1224	+	161, Human Resources Code, as added by this section, and in a manner
	1225	+	that minimizes disruption of services, the Health and Human
	1226	+	Services Commission shall take appropriate action to be designated
	1227	+	as the state agency responsible under federal law for any state or
	1228	+	federal program that is transferred to the commission in accordance
	1229	+	with that subchapter and for which federal law requires the
	1230	+	designation of a responsible state agency.
	1231	+	(e) Effective September 1, 2016, the following provisions
	1232	+	of the Human Resources Code, including provisions amended by S.B.
	1233	+	No. 219, Acts of the 84th Legislature, Regular Session, 2015, are
	1234	+	repealed:
	1235	+	(1) Section 161.021;
	1236	+	(2) Section 161.022;
	1237	+	(3) Section 161.023;
	1238	+	(4) Section 161.024;
	1239	+	(5) Section 161.025;
	1240	+	(6) Section 161.026;
	1241	+	(7) Section 161.027;
	1242	+	(8) Section 161.028;
	1243	+	(9) Section 161.029; and
	1244	+	(10) Section 161.030.
	1245	+	(f) Effective September 1, 2017, the following provisions
	1246	+	of the Human Resources Code, including provisions added or amended
	1247	+	by S.B. No. 219, Acts of the 84th Legislature, Regular Session,
	1248	+	2015, are repealed:
	1249	+	(1) Section 161.002;
	1250	+	(2) Section 161.032;
	1251	+	(3) Section 161.051;
	1252	+	(4) Section 161.052;
	1253	+	(5) Section 161.053;
	1254	+	(6) Section 161.054;
	1255	+	(7) Section 161.055;
	1256	+	(8) Section 161.056;
	1257	+	(9) Section 161.0711;
	1258	+	(10) Section 161.0712; and
	1259	+	(11) Section 161.072.
	1260	+	(g) Notwithstanding Subsections (e) and (f) of this
	1261	+	section, the implementation of a provision repealed by one of those
	1262	+	subsections ceases on the date all functions of the Department of
	1263	+	Aging and Disability Services or the Aging and Disability Services
	1264	+	Council are transferred to the Health and Human Services Commission
	1265	+	as provided by Subchapter A-1, Chapter 161, Human Resources Code,
	1266	+	as added by this section, to the extent the department or council is
	1267	+	responsible for the provision's implementation.
	1268	+	(h) This section takes effect only if the Department of
	1269	+	Aging and Disability Services is not continued in existence by any
	1270	+	legislation of the 84th Legislature, Regular Session, 2015.
	1271	+	(i) Subject to Subsection (h) of this section, this section
	1272	+	takes effect September 1, 2015.
	1273	+	SECTION 44. The following laws are repealed:
	1274	+	(1) Section 247.051(b), Health and Safety Code, as
	1275	+	amended by S.B. No. 219, Acts of the 84th Legislature, Regular
	1276	+	Session, 2015; and
	1277	+	(2) Section 101A.158, Human Resources Code, as added
	1278	+	by S.B. No. 219, Acts of the 84th Legislature, Regular Session,
	1279	+	2015.
	1280	+	SECTION 45. (a) Not later than September 1, 2016, the
569	1281		executive commissioner of the Health and Human Services Commission
570	1282		shall adopt by rule the matrices of progressive sanctions required
571	1283		by Sections 142.0125, 242.0613, 247.0415, and 252.0615, Health and
572	1284		Safety Code, and Section 103.0085, Human Resources Code, as added
573		-	by this Act.
	1285	+	by this Act. Before the executive commissioner of the Health and
	1286	+	Human Services Commission publishes a notice of a proposed rule
	1287	+	under this subsection, the executive commissioner shall solicit
	1288	+	input from stakeholders concerning the development of those rules.
574	1289		(b) Not later than September 1, 2015, the governor shall
575	1290		appoint five members of the state supported living center
576	1291		restructuring commission, as required by Section 555.201, Health
577	1292		and Safety Code, as added by this Act.
578	1293		(c) Not later than September 1, 2016, the executive
579	1294		commissioner of the Health and Human Services Commission shall
580	1295		adopt the rule listing services a state supported living center may
581	1296		provide under a contract and the schedule of fees for those services
582	1297		as required by Section 161.080, Human Resources Code, as amended by
583	1298		this Act.
584		-	SECTION 21. This Act takes effect immediately if it
585		-	receives a vote of two-thirds of all the members elected to each
586		-	house, as provided by Section 39, Article III, Texas Constitution.
587		-	If this Act does not receive the vote necessary for immediate
588		-	effect, this Act takes effect September 1, 2015.
589		-	* * * * *
	1299	+	SECTION 46. (a) As soon as possible after the effective
	1300	+	date of this Act, the Department of Aging and Disability Services or
	1301	+	the Health and Human Services Commission, as appropriate, shall
	1302	+	apply for any waiver or other authorization from a federal agency
	1303	+	that is necessary to implement this Act. The department and
	1304	+	commission may delay implementing this Act until the waiver or
	1305	+	authorization is granted.
	1306	+	(b) As soon as practicable after the effective date of this
	1307	+	Act:
	1308	+	(1) the executive commissioner of the Health and Human
	1309	+	Services Commission shall adopt the rules necessary to implement
	1310	+	Section 531.058(a-1), Government Code, as added by this Act; and
	1311	+	(2) the Department of Aging and Disability Services
	1312	+	and the Health and Human Services Commission shall, as appropriate,
	1313	+	revise or enter into a memorandum of understanding as required by a
	1314	+	federal agency that is necessary to implement Section 531.058(a-1),
	1315	+	Government Code, as added by this Act.
	1316	+	SECTION 47. Sections 242.061(a-2) and (a-3), Health and
	1317	+	Safety Code, as added by this Act, apply only to a violation
	1318	+	committed on or after September 1, 2016. A violation committed
	1319	+	before September 1, 2016, is governed by the law in effect on the
	1320	+	date the violation was committed, and the former law is continued in
	1321	+	effect for that purpose. For purposes of this section, a violation
	1322	+	was committed before September 1, 2016, if any element of the
	1323	+	violation occurred before that date.
	1324	+	SECTION 48. (a) Except as otherwise provided by this Act,
	1325	+	including Subsection (b) of this section, this Act takes effect
	1326	+	immediately if it receives a vote of two-thirds of all the members
	1327	+	elected to each house, as provided by Section 39, Article III, Texas
	1328	+	Constitution. If this Act does not receive the vote necessary for
	1329	+	immediate effect, this Act takes effect September 1, 2015.
	1330	+	(b) Sections 242.061(a-2) and (a-3), Health and Safety
	1331	+	Code, as added by this Act, take effect September 1, 2016.