87R5399 JG-D
By: Campos H.B. No. 1323
A BILL TO BE ENTITLED
AN ACT
relating to a state plan and requirements for nursing facilities to
provide care for persons with Alzheimer's disease and related
disorders.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Effective September 1, 2031, Section 242.032(c),
Health and Safety Code, is amended to read as follows:
(c) The applicant or license holder must furnish evidence to
affirmatively establish the applicant's or license holder's ability
to comply with:
(1) minimum standards of medical care, nursing care,
and financial condition; [and]
(2) standards for the specialized care and treatment
of persons with Alzheimer's disease and related disorders; and
(3) any other applicable state or federal standard.
SECTION 2. Effective September 1, 2031, Section 242.037,
Health and Safety Code, is amended by amending Subsection (e) and
adding Subsection (f-1) to read as follows:
(e) In addition to standards or rules required by other
provisions of this chapter, the executive commissioner shall adopt
and publish and the department shall enforce minimum standards
relating to:
(1) the construction of an institution, including
plumbing, heating, lighting, ventilation, and other housing
conditions, to ensure the residents' health, safety, comfort, and
protection from fire hazard;
(2) the regulation of the number and qualification of
all personnel, including management and nursing personnel,
responsible for any part of the care given to the residents;
(3) requirements for in-service education of all
employees who have any contact with the residents;
(4) [training on the care of persons with Alzheimer's
disease and related disorders for employees who work with those
persons;
[(5)] sanitary and related conditions in an
institution and its surroundings, including water supply, sewage
disposal, food handling, and general hygiene in order to ensure the
residents' health, safety, and comfort;
(5) [(6)] the nutritional needs of each resident
according to good nutritional practice or the recommendations of
the physician attending the resident;
(6) [(7)] equipment essential to the residents' health
and welfare;
(7) [(8)] the use and administration of medication in
conformity with applicable law and rules;
(8) [(9)] care and treatment of residents and any
other matter related to resident health, safety, and welfare;
(9) [(10)] licensure of institutions; and
(10) [(11)] implementation of this chapter.
(f-1) The executive commissioner shall adopt, publish, and
enforce standards for the specialized care and treatment of persons
with Alzheimer's disease and related disorders, including training
requirements for nursing facility employees who provide that
specialized care or treatment. The executive commissioner by rule
shall adopt and modify as necessary to conform to changes in medical
practice a definition of "Alzheimer's disease and related
disorders," and may adopt by reference a definition published in a
generally accepted clinical resource for medical professionals.
The commission may periodically modify the standards as the
executive commissioner determines appropriate.
SECTION 3. The heading to Section 242.040, Health and
Safety Code, is amended to read as follows:
Sec. 242.040. CERTIFICATION REQUIREMENTS TO PROVIDE [OF
INSTITUTIONS THAT] CARE FOR PERSONS WITH ALZHEIMER'S DISEASE AND
RELATED DISORDERS.
SECTION 4. Section 242.040, Health and Safety Code, is
amended by amending Subsections (a), (b), (c), (e), and (f) and
adding Subsections (b-1) and (b-2) to read as follows:
(a) The commission [department] shall establish a system
for certifying nursing facilities [institutions] that meet
standards adopted by the executive commissioner concerning the
specialized care and treatment of persons with Alzheimer's disease
and related disorders. The commission may periodically modify the
system and standards as the executive commissioner determines
appropriate.
(b) A nursing facility may not [An institution is not
required to be certified under this section in order to] provide
care and treatment for [of] persons with Alzheimer's disease and
related disorders unless the facility holds a certification issued
under this section.
(b-1) Notwithstanding Subsection (b) and subject to
Subsection (b-2), a nursing facility is not required to hold a
certification issued under this section to provide care and
treatment for persons with Alzheimer's disease and related
disorders before January 1, 2031.
(b-2) A nursing facility that is initially licensed under
this chapter on or after January 1, 2023, must hold a certification
issued under this section to provide care and treatment for persons
with Alzheimer's disease and related disorders.
(c) The executive commissioner by rule shall [may] adopt
standards for the specialized care and treatment of persons with
Alzheimer's disease and related disorders and provide procedures
for nursing facilities [institutions] applying for certification
under this section. The rules must provide for a three-year
certification period.
(e) A nursing facility [An institution] may not advertise or
otherwise communicate that the facility [institution] is certified
by the commission [department] to provide specialized care for
persons with Alzheimer's disease or related disorders unless the
facility [institution] is certified under this section.
(f) The executive commissioner by rule shall adopt a system
under which an appropriate number of certifications issued by the
commission [department] expire on staggered dates occurring in each
three-year period. If the expiration date of a certification
changes as a result of this subsection, the commission [department]
shall prorate the certification fee relating to that certification
as appropriate. To the extent possible, the system must align the
expiration date for a nursing facility's certification under this
section with the expiration date for the facility's license under
this chapter.
SECTION 5. Subchapter B, Chapter 242, Health and Safety
Code, is amended by adding Section 242.0405 to read as follows:
Sec. 242.0405. STATE PLAN FOR CERTIFICATION OF NURSING
FACILITIES TO PROVIDE CARE FOR PERSONS WITH ALZHEIMER'S DISEASE AND
RELATED DISORDERS. (a) The commission shall develop a state plan
to certify each nursing facility in this state under Section
242.040 to provide care and treatment for persons with Alzheimer's
disease and related disorders by January 1, 2031, and after that
date require as part of licensure under this chapter that the
facilities comply with the standards formerly required for
certification under Section 242.040. The executive commissioner
must approve the state plan and shall adopt rules for implementing
the approved state plan.
(b) In developing the state plan, the commission shall:
(1) conduct a study on certifying each nursing
facility in this state under Section 242.040 by January 1, 2031; and
(2) determine and consider in implementing the state
plan the:
(A) costs and challenges;
(B) legal and technical issues; and
(C) scheduling factors and time considerations.
(c) The state plan must require that:
(1) at least 10 percent of the total number of nursing
facilities in this state be certified under Section 242.040 by
January 1, 2023;
(2) at least 25 percent of the total number of
facilities in this state be certified under Section 242.040 by
January 1, 2025;
(3) at least 50 percent of the total number of
facilities in this state be certified under Section 242.040 by
January 1, 2027;
(4) at least 75 percent of the total number of
facilities in this state be certified under Section 242.040 by
January 1, 2029; and
(5) each facility in this state as part of the
facility's license qualification meets the standards for
certification under Section 242.040 by January 1, 2031.
(d) The state plan may provide for reimbursement to nursing
facilities that become certified under Section 242.040 in amounts
based on the following schedule:
(1) for a facility that is certified by January 1,
2023, the state plan may provide for 100 percent reimbursement of
the certification costs;
(2) for a facility that is certified by January 1,
2025, the state plan may reimburse the facility in an amount not to
exceed 75 percent reimbursement of the certification costs;
(3) for a facility that is certified by January 1,
2027, the state plan may reimburse the facility in an amount not to
exceed 50 percent reimbursement of the certification costs; and
(4) for a facility that is certified by January 1,
2029, the state plan may reimburse the facility in an amount not to
exceed 25 percent reimbursement of the certification costs.
(e) The commission may use existing resources and solicit
and accept gifts, grants, and donations from any source to
implement the state plan.
(f) This section expires September 1, 2033.
SECTION 6. Section 242.202, Health and Safety Code, is
amended by amending Subsection (d) and adding Subsection (d-1) to
read as follows:
(d) The disclosure statement must contain the following
categories of information:
(1) the nursing facility's [institution's] philosophy
of care;
(2) [whether the institution is certified under
Section 242.040 for the provision of specialized care and treatment
of residents with Alzheimer's disease and related disorders;
[(3)] the preadmission, admission, and discharge
process;
(3) [(4)] resident assessment, care planning, and
implementation of the care plan;
(4) [(5)] staffing patterns, such as
resident-to-staff ratios, and staff training;
(5) [(6)] the physical environment of the facility
[institution];
(6) [(7)] resident activities;
(7) [(8)] program costs;
(8) [(9)] systems for evaluation of the facility's
[institution's] programs for residents;
(9) [(10)] family involvement in resident care; and
(10) [(11)] the toll-free telephone number maintained
by the department for acceptance of complaints against the facility
[institution].
(d-1) Before January 1, 2031, the disclosure statement must
also include a statement on whether the nursing facility is
certified under Section 242.040 for the provision of specialized
care and treatment of residents with Alzheimer's disease and
related disorders. This subsection expires September 1, 2031.
SECTION 7. Effective September 1, 2031, the following
provisions of the Health and Safety Code are repealed:
(1) Section 242.040;
(2) Section 242.041; and
(3) Section 242.201.
SECTION 8. Not later than September 1, 2022, the Health and
Human Services Commission shall develop, and the executive
commissioner of the commission shall approve and adopt, rules for
implementing the state plan required by Section 242.0405, Health
and Safety Code, as added by this Act.
SECTION 9. As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission shall adopt the rules necessary to implement
the changes in law made by this Act.
SECTION 10. Except as otherwise provided by this Act, this
Act takes effect September 1, 2021.