Texas 2021 - 87th Regular

Texas House Bill HB3720 Compare Versions

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1		-	H.B. No. 3720
	1	+	By: Frank, et al. (Senate Sponsor - Kolkhorst) H.B. No. 3720
	2	+	(In the Senate - Received from the House May 17, 2021;
	3	+	May 17, 2021, read first time and referred to Committee on Health &
	4	+	Human Services; May 21, 2021, reported favorably by the following
	5	+	vote: Yeas 9, Nays 0; May 21, 2021, sent to printer.)
	6	+	Click here to see the committee vote
2	7
3	8
	9	+	A BILL TO BE ENTITLED
4	10		AN ACT
5		-	relating to long-term care facilities for and Medicaid waiver
6		-	programs available to certain individuals, including individuals
7		-	with intellectual and developmental disabilities.
	11	+	relating to interest lists and eligibility criteria for certain
	12	+	Medicaid waiver programs.
8	13		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
9		-	SECTION 1. Section 531.0581(b), Government Code, is amended
10		-	to read as follows:
11		-	(b) The executive commissioner shall establish a Long-Term
12		-	Care Facilities Council as a permanent advisory committee to the
13		-	commission. The council is composed of the following members
14		-	appointed by the executive commissioner:
15		-	(1) at least one member who is a for-profit nursing
16		-	facility provider;
17		-	(2) at least one member who is a nonprofit nursing
18		-	facility provider;
19		-	(3) at least one member who is an assisted living
20		-	services provider;
21		-	(4) at least one member responsible for survey
22		-	enforcement within the state survey and certification agency;
23		-	(5) at least one member responsible for survey
24		-	inspection within the state survey and certification agency;
25		-	(6) at least one member of the state agency
26		-	responsible for informal dispute resolution;
27		-	(7) at least one member with expertise in Medicaid
28		-	quality-based payment systems for long-term care facilities;
29		-	(8) at least one member who is a practicing medical
30		-	director of a long-term care facility; [and]
31		-	(9) at least one member who is a physician with
32		-	expertise in infectious disease or public health; and
33		-	(10) at least one member who is a community-based
34		-	provider at an intermediate care facility for individuals with
35		-	intellectual or developmental disabilities licensed under Chapter
36		-	252, Health and Safety Code.
37		-	SECTION 2. Subchapter B, Chapter 531, Government Code, is
38		-	amended by adding Section 531.06011 to read as follows:
	14	+	SECTION 1. Subchapter B, Chapter 531, Government Code, is
	15	+	amended by adding Sections 531.06011 and 531.06035 to read as
	16	+	follows:
39	17		Sec. 531.06011. CERTAIN MEDICAID WAIVER PROGRAMS: INTEREST
40	18		LIST MANAGEMENT. (a) This section applies only with respect to the
41	19		following waiver programs:
42	20		(1) the community living assistance and support
43	21		services (CLASS) waiver program;
44	22		(2) the home and community-based services (HCS) waiver
45	23		program;
46	24		(3) the deaf-blind with multiple disabilities (DBMD)
47	25		waiver program;
48	26		(4) the Texas home living (TxHmL) waiver program;
49	27		(5) the medically dependent children (MDCP) waiver
50	28		program; and
51	29		(6) the STAR+PLUS home and community-based services
52	30		(HCBS) program.
53	31		(b) The commission, in consultation with the Intellectual
54	32		and Developmental Disability System Redesign Advisory Committee
55	33		established under Section 534.053, the state Medicaid managed care
56	34		advisory committee, and interested stakeholders, shall develop a
57	35		questionnaire to be completed by or on behalf of an individual who
58	36		requests to be placed on or is currently on an interest list for a
59	37		waiver program.
60	38		(c) The questionnaire developed under Subsection (b) must,
61	39		at a minimum, request the following information about an individual
62	40		seeking or receiving services under a waiver program:
63	41		(1) contact information for the individual or the
64	42		individual's parent or other legally authorized representative;
65	43		(2) the individual's general demographic information;
66	44		(3) the individual's living arrangement;
67	45		(4) the types of assistance the individual requires;
68	46		(5) the individual's current caregiver supports and
69	47		circumstances that may cause the individual to lose those supports;
70	48		and
71	49		(6) when the delivery of services under a waiver
72	50		program should begin to ensure the individual's health and welfare
73	51		and that the individual receives services and supports in the least
74	52		restrictive setting possible.
75		-	(d) If an individual is on a waiver program's interest list
	53	+	(d) Subject to the availability of funds, the commission
	54	+	shall require all individuals on an interest list to annually
	55	+	update the questionnaire developed under Subsection (b).
	56	+	(e) If the commission determines that it is feasible, the
	57	+	commission shall develop an online portal to allow an individual or
	58	+	an individual's parent or other legally authorized representative
	59	+	to:
	60	+	(1) request placement on a waiver program interest
	61	+	list; and
	62	+	(2) complete and update the questionnaire developed
	63	+	under Subsection (b).
	64	+	(f) If an individual is on a waiver program's interest list
76	65		and the individual or the individual's parent or other legally
77	66		authorized representative does not respond to a written or verbal
78	67		request made by the commission to update information concerning the
79	68		individual or otherwise fails to maintain contact with the
80	69		commission, the commission:
81	70		(1) shall designate the individual's status on the
82	71		interest list as inactive until the individual or the individual's
83	72		parent or other legally authorized representative notifies the
84	73		commission that the individual is still interested in receiving
85	74		services under the waiver program; and
86	75		(2) at the time the individual or the individual's
87	76		parent or other legally authorized representative provides notice
88	77		to the commission under Subdivision (1), shall designate the
89	78		individual's status on the interest list as active and restore the
90	79		individual to the position on the list that corresponds with the
91	80		date the individual was initially placed on the list.
92		-	(e) The commission's designation of an individual's status
93		-	on an interest list as inactive under Subsection (d) may not result
	81	+	(g) The commission's designation of an individual's status
	82	+	on an interest list as inactive under Subsection (f) may not result
94	83		in the removal of the individual from that list or any other waiver
95	84		program interest list.
96		-	(f) Not later than September 1 of each year, the commission
	85	+	(h) Not later than September 1 of each year, the commission
97	86		shall provide to the Intellectual and Developmental Disability
98	87		System Redesign Advisory Committee established under Section
99	88		534.053, or, if that advisory committee is abolished, an
100	89		appropriate stakeholder advisory committee, as determined by the
101	90		executive commissioner, the number of individuals, including
102	91		individuals whose status is designated as inactive by the
103	92		commission, who are on an interest list to receive services under a
104	93		waiver program.
105		-	SECTION 3. Section 252.065(b), Health and Safety Code, is
106		-	amended to read as follows:
107		-	(b) The penalty for a facility with fewer than 60 beds shall
108		-	be not less than $100 or more than $1,000 for each violation. The
109		-	penalty for a facility with 60 beds or more shall be not less than
110		-	$100 or more than $5,000 for each violation. Each day a violation
111		-	occurs or continues is a separate violation for purposes of
112		-	imposing a penalty. The total amount of penalties [a penalty]
113		-	assessed under this subsection for an on-site regulatory visit or
114		-	complaint investigation, regardless of the duration of any ongoing
115		-	violations, [for each day a violation occurs or continues] may not
116		-	exceed:
117		-	(1) $5,000 for a facility with fewer than 60 beds; and
118		-	(2) $25,000 for a facility with 60 beds or more.
119		-	SECTION 4. Section 161.089, Human Resources Code, is
120		-	amended by amending Subsection (c) and adding Subsection (c-1) to
121		-	read as follows:
122		-	(c) After consulting with appropriate stakeholders, the
123		-	executive commissioner shall develop and adopt rules regarding the
124		-	imposition of administrative penalties under this section. The
125		-	rules must:
126		-	(1) specify the types of violations that warrant
127		-	imposition of an administrative penalty;
128		-	(2) establish a schedule of progressive
129		-	administrative penalties in accordance with the relative type,
130		-	frequency, and seriousness of a violation;
131		-	(3) prescribe reasonable amounts to be imposed for
132		-	each violation giving rise to an administrative penalty, subject to
133		-	Subdivision (4);
134		-	(4) authorize the imposition of an administrative
135		-	penalty in an amount not to exceed $5,000 for each violation;
136		-	(5) provide that a provider commits a separate
137		-	violation each day the provider continues to violate the law or
138		-	rule;
139		-	(6) ensure standard and consistent application of
140		-	administrative penalties throughout the state; [and]
141		-	(7) provide for an administrative appeals process to
142		-	adjudicate claims and appeals relating to the imposition of an
143		-	administrative penalty under this section that is in accordance
144		-	with Chapter 2001, Government Code; and
145		-	(8) ensure standard and consistent interpretation of
146		-	service delivery rules and consistent application of
147		-	administrative penalties throughout this state.
148		-	(c-1) On adoption of the rules under Subsection (c), the
149		-	executive commissioner shall develop interpretative guidelines for
150		-	regulatory staff and providers regarding the imposition of
151		-	administrative penalties under this section.
152		-	SECTION 5. As soon as practicable after the effective date
153		-	of this Act, the Health and Human Services Commission shall develop
154		-	the questionnaire required by Section 531.06011(b), Government
155		-	Code, as added by this Act.
156		-	SECTION 6. Not later than December 1, 2021, the executive
157		-	commissioner of the Health and Human Services Commission shall
158		-	adopt the rules necessary to implement Section 252.065(b), Health
159		-	and Safety Code, as amended by this Act, and Section 161.089, Human
160		-	Resources Code, as amended by this Act.
161		-	SECTION 7. The Health and Human Services Commission may not
162		-	assess a penalty under Section 161.089, Human Resources Code, as
163		-	amended by this Act, until the executive commissioner of the Health
164		-	and Human Services Commission:
165		-	(1) adopts the rules necessary to implement Section
166		-	161.089(c)(8), Human Resources Code, as added by this Act; and
167		-	(2) develops the interpretive guidelines required by
168		-	Section 161.089(c-1), Human Resources Code, as added by this Act.
169		-	SECTION 8. The Health and Human Services Commission is
170		-	required to implement a provision of this Act only if the
171		-	legislature appropriates money to the commission specifically for
172		-	that purpose. If the legislature does not appropriate money
173		-	specifically for that purpose, the commission may, but is not
174		-	required to, implement a provision of this Act using other
175		-	appropriations that are available for that purpose.
176		-	SECTION 9. If before implementing any provision of this Act
	94	+	Sec. 531.06035. MEDICALLY DEPENDENT CHILDREN WAIVER
	95	+	PROGRAM (MDCP) INTEREST LIST; MEDICAL NECESSITY ASSESSMENT
	96	+	REQUIRED. (a) This section applies only to a child who receives
	97	+	Supplemental Security Income (SSI) (42 U.S.C. Section 1381 et
	98	+	seq.).
	99	+	(b) If a child's parent or other legally authorized
	100	+	representative expresses interest in placing the child on the
	101	+	interest list for the medically dependent children (MDCP) waiver
	102	+	program, the commission shall conduct a medical necessity
	103	+	assessment of the child to ensure the child is eligible for services
	104	+	before placing the child on the program's interest list.
	105	+	SECTION 2. Subchapter B, Chapter 32, Human Resources Code,
	106	+	is amended by adding Section 32.0521 to read as follows:
	107	+	Sec. 32.0521. ELIGIBILITY FOR TEXAS HOME LIVING (TxHmL)
	108	+	WAIVER PROGRAM. (a) In this section:
	109	+	(1) "Related condition" means, consistent with 42
	110	+	C.F.R. Section 435.1010, a severe and chronic disability that:
	111	+	(A) is attributed to:
	112	+	(i) cerebral palsy or epilepsy; or
	113	+	(ii) any other condition, other than mental
	114	+	illness, found to be closely related to intellectual disability
	115	+	because the condition results in impairment of general intellectual
	116	+	functioning or adaptive behavior similar to that of individuals
	117	+	with intellectual disability, and requires treatment or services
	118	+	similar to those required for individuals with intellectual
	119	+	disability;
	120	+	(B) is manifested before the individual reaches
	121	+	22 years of age;
	122	+	(C) is likely to continue indefinitely; and
	123	+	(D) results in substantial functional limitation
	124	+	in at least three of the following areas of major life activity:
	125	+	(i) self-care;
	126	+	(ii) understanding and use of language;
	127	+	(iii) learning;
	128	+	(iv) mobility;
	129	+	(v) self-direction; and
	130	+	(vi) capacity for independent living.
	131	+	(2) "Section 1915(c) waiver program" has the meaning
	132	+	assigned by Section 531.001, Government Code.
	133	+	(b) To the extent allowed by federal law, an individual is
	134	+	financially eligible to participate in the Texas home living
	135	+	(TxHmL) waiver program if the individual's income is not more than
	136	+	the special income limit established by the commission for other
	137	+	Section 1915(c) waiver programs, including the home and
	138	+	community-based services (HCS) waiver program.
	139	+	(c) To the extent permitted by federal law, the commission
	140	+	shall expand medical eligibility criteria under the Texas home
	141	+	living (TxHmL) waiver program to ensure that an individual is
	142	+	medically eligible to participate in the waiver program if the
	143	+	individual:
	144	+	(1) has a primary diagnosis by a licensed physician of
	145	+	a related condition that is included on the list of diagnostic codes
	146	+	for persons with related conditions that are approved by the
	147	+	commission; and
	148	+	(2) has moderate to extreme deficits in adaptive
	149	+	behavior, as determined by commission rule, obtained by
	150	+	administering a standardized assessment of adaptive behavior.
	151	+	SECTION 3. As soon as practicable after the effective date
	152	+	of this Act, the Health and Human Services Commission shall:
	153	+	(1) develop the questionnaire required by Section
	154	+	531.06011(b), Government Code, as added by this Act, and, subject
	155	+	to the availability of funds, implement Subsection (d) of that
	156	+	section not later than September 1, 2024;
	157	+	(2) determine the feasibility of developing an online
	158	+	portal under Section 531.06011(e), Government Code, as added by
	159	+	this Act, and if feasible, develop and implement the online portal;
	160	+	and
	161	+	(3) as appropriate, conduct a medical necessity
	162	+	assessment of each child who is on the interest list for the
	163	+	medically dependent children (MDCP) waiver program on the effective
	164	+	date of this Act to ensure the child's eligibility for program
	165	+	services.
	166	+	SECTION 4. If before implementing any provision of this Act
177	167		a state agency determines that a waiver or authorization from a
178	168		federal agency is necessary for implementation of that provision,
179	169		the agency affected by the provision shall request the waiver or
180	170		authorization and may delay implementing that provision until the
181	171		waiver or authorization is granted.
182		-	SECTION 10. This Act takes effect September 1, 2021.
183		-	______________________________ ______________________________
184		-	President of the Senate Speaker of the House
185		-	I certify that H.B. No. 3720 was passed by the House on May
186		-	14, 2021, by the following vote: Yeas 141, Nays 1, 3 present, not
187		-	voting; that the House refused to concur in Senate amendments to
188		-	H.B. No. 3720 on May 28, 2021, and requested the appointment of a
189		-	conference committee to consider the differences between the two
190		-	houses; and that the House adopted the conference committee report
191		-	on H.B. No. 3720 on May 30, 2021, by the following vote: Yeas 140,
192		-	Nays 1, 2 present, not voting.
193		-	______________________________
194		-	Chief Clerk of the House
195		-	I certify that H.B. No. 3720 was passed by the Senate, with
196		-	amendments, on May 24, 2021, by the following vote: Yeas 30, Nays
197		-	0; at the request of the House, the Senate appointed a conference
198		-	committee to consider the differences between the two houses; and
199		-	that the Senate adopted the conference committee report on H.B. No.
200		-	3720 on May 30, 2021, by the following vote: Yeas 31, Nays 0.
201		-	______________________________
202		-	Secretary of the Senate
203		-	APPROVED: __________________
204		-	Date
205		-	__________________
206		-	Governor
	172	+	SECTION 5. This Act takes effect September 1, 2021.
	173	+	* * * * *