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