H.B. No. 3720
AN ACT
relating to long-term care facilities for and Medicaid waiver
programs available to certain individuals, including individuals
with intellectual and developmental disabilities.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 531.0581(b), Government Code, is amended
to read as follows:
(b) The executive commissioner shall establish a Long-Term
Care Facilities Council as a permanent advisory committee to the
commission. The council is composed of the following members
appointed by the executive commissioner:
(1) at least one member who is a for-profit nursing
facility provider;
(2) at least one member who is a nonprofit nursing
facility provider;
(3) at least one member who is an assisted living
services provider;
(4) at least one member responsible for survey
enforcement within the state survey and certification agency;
(5) at least one member responsible for survey
inspection within the state survey and certification agency;
(6) at least one member of the state agency
responsible for informal dispute resolution;
(7) at least one member with expertise in Medicaid
quality-based payment systems for long-term care facilities;
(8) at least one member who is a practicing medical
director of a long-term care facility; [and]
(9) at least one member who is a physician with
expertise in infectious disease or public health; and
(10) at least one member who is a community-based
provider at an intermediate care facility for individuals with
intellectual or developmental disabilities licensed under Chapter
252, Health and Safety Code.
SECTION 2. Subchapter B, Chapter 531, Government Code, is
amended by adding Section 531.06011 to read as follows:
Sec. 531.06011. CERTAIN MEDICAID WAIVER PROGRAMS: INTEREST
LIST MANAGEMENT. (a) This section applies only with respect to the
following waiver programs:
(1) the community living assistance and support
services (CLASS) waiver program;
(2) the home and community-based services (HCS) waiver
program;
(3) the deaf-blind with multiple disabilities (DBMD)
waiver program;
(4) the Texas home living (TxHmL) waiver program;
(5) the medically dependent children (MDCP) waiver
program; and
(6) the STAR+PLUS home and community-based services
(HCBS) program.
(b) The commission, in consultation with the Intellectual
and Developmental Disability System Redesign Advisory Committee
established under Section 534.053, the state Medicaid managed care
advisory committee, and interested stakeholders, shall develop a
questionnaire to be completed by or on behalf of an individual who
requests to be placed on or is currently on an interest list for a
waiver program.
(c) The questionnaire developed under Subsection (b) must,
at a minimum, request the following information about an individual
seeking or receiving services under a waiver program:
(1) contact information for the individual or the
individual's parent or other legally authorized representative;
(2) the individual's general demographic information;
(3) the individual's living arrangement;
(4) the types of assistance the individual requires;
(5) the individual's current caregiver supports and
circumstances that may cause the individual to lose those supports;
and
(6) when the delivery of services under a waiver
program should begin to ensure the individual's health and welfare
and that the individual receives services and supports in the least
restrictive setting possible.
(d) If an individual is on a waiver program's interest list
and the individual or the individual's parent or other legally
authorized representative does not respond to a written or verbal
request made by the commission to update information concerning the
individual or otherwise fails to maintain contact with the
commission, the commission:
(1) shall designate the individual's status on the
interest list as inactive until the individual or the individual's
parent or other legally authorized representative notifies the
commission that the individual is still interested in receiving
services under the waiver program; and
(2) at the time the individual or the individual's
parent or other legally authorized representative provides notice
to the commission under Subdivision (1), shall designate the
individual's status on the interest list as active and restore the
individual to the position on the list that corresponds with the
date the individual was initially placed on the list.
(e) The commission's designation of an individual's status
on an interest list as inactive under Subsection (d) may not result
in the removal of the individual from that list or any other waiver
program interest list.
(f) Not later than September 1 of each year, the commission
shall provide to the Intellectual and Developmental Disability
System Redesign Advisory Committee established under Section
534.053, or, if that advisory committee is abolished, an
appropriate stakeholder advisory committee, as determined by the
executive commissioner, the number of individuals, including
individuals whose status is designated as inactive by the
commission, who are on an interest list to receive services under a
waiver program.
SECTION 3. Section 252.065(b), Health and Safety Code, is
amended to read as follows:
(b) The penalty for a facility with fewer than 60 beds shall
be not less than $100 or more than $1,000 for each violation. The
penalty for a facility with 60 beds or more shall be not less than
$100 or more than $5,000 for each violation. Each day a violation
occurs or continues is a separate violation for purposes of
imposing a penalty. The total amount of penalties [a penalty]
assessed under this subsection for an on-site regulatory visit or
complaint investigation, regardless of the duration of any ongoing
violations, [for each day a violation occurs or continues] may not
exceed:
(1) $5,000 for a facility with fewer than 60 beds; and
(2) $25,000 for a facility with 60 beds or more.
SECTION 4. Section 161.089, Human Resources Code, is
amended by amending Subsection (c) and adding Subsection (c-1) to
read as follows:
(c) After consulting with appropriate stakeholders, the
executive commissioner shall develop and adopt rules regarding the
imposition of administrative penalties under this section. The
rules must:
(1) specify the types of violations that warrant
imposition of an administrative penalty;
(2) establish a schedule of progressive
administrative penalties in accordance with the relative type,
frequency, and seriousness of a violation;
(3) prescribe reasonable amounts to be imposed for
each violation giving rise to an administrative penalty, subject to
Subdivision (4);
(4) authorize the imposition of an administrative
penalty in an amount not to exceed $5,000 for each violation;
(5) provide that a provider commits a separate
violation each day the provider continues to violate the law or
rule;
(6) ensure standard and consistent application of
administrative penalties throughout the state; [and]
(7) provide for an administrative appeals process to
adjudicate claims and appeals relating to the imposition of an
administrative penalty under this section that is in accordance
with Chapter 2001, Government Code; and
(8) ensure standard and consistent interpretation of
service delivery rules and consistent application of
administrative penalties throughout this state.
(c-1) On adoption of the rules under Subsection (c), the
executive commissioner shall develop interpretative guidelines for
regulatory staff and providers regarding the imposition of
administrative penalties under this section.
SECTION 5. As soon as practicable after the effective date
of this Act, the Health and Human Services Commission shall develop
the questionnaire required by Section 531.06011(b), Government
Code, as added by this Act.
SECTION 6. Not later than December 1, 2021, the executive
commissioner of the Health and Human Services Commission shall
adopt the rules necessary to implement Section 252.065(b), Health
and Safety Code, as amended by this Act, and Section 161.089, Human
Resources Code, as amended by this Act.
SECTION 7. The Health and Human Services Commission may not
assess a penalty under Section 161.089, Human Resources Code, as
amended by this Act, until the executive commissioner of the Health
and Human Services Commission:
(1) adopts the rules necessary to implement Section
161.089(c)(8), Human Resources Code, as added by this Act; and
(2) develops the interpretive guidelines required by
Section 161.089(c-1), Human Resources Code, as added by this Act.
SECTION 8. The Health and Human Services Commission is
required to implement a provision of this Act only if the
legislature appropriates money to the commission specifically for
that purpose. If the legislature does not appropriate money
specifically for that purpose, the commission may, but is not
required to, implement a provision of this Act using other
appropriations that are available for that purpose.
SECTION 9. If before implementing any provision of this Act
a state agency determines that a waiver or authorization from a
federal agency is necessary for implementation of that provision,
the agency affected by the provision shall request the waiver or
authorization and may delay implementing that provision until the
waiver or authorization is granted.
SECTION 10. This Act takes effect September 1, 2021.
______________________________ ______________________________
President of the Senate Speaker of the House
I certify that H.B. No. 3720 was passed by the House on May
14, 2021, by the following vote: Yeas 141, Nays 1, 3 present, not
voting; that the House refused to concur in Senate amendments to
H.B. No. 3720 on May 28, 2021, and requested the appointment of a
conference committee to consider the differences between the two
houses; and that the House adopted the conference committee report
on H.B. No. 3720 on May 30, 2021, by the following vote: Yeas 140,
Nays 1, 2 present, not voting.
______________________________
Chief Clerk of the House
I certify that H.B. No. 3720 was passed by the Senate, with
amendments, on May 24, 2021, by the following vote: Yeas 30, Nays
0; at the request of the House, the Senate appointed a conference
committee to consider the differences between the two houses; and
that the Senate adopted the conference committee report on H.B. No.
3720 on May 30, 2021, by the following vote: Yeas 31, Nays 0.
______________________________
Secretary of the Senate
APPROVED: __________________
Date
__________________
Governor