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Nursing Facility Administrator Regulation - S.B. 84

by Senator Moncrief, et al.

House Sponsors: Representative Junell, et al.

§ Abolishes the Texas Board of Nursing Facility Administrators and transfers all authority, duties, obligations, and responsibilities to the Texas Department of Human Services (DHS).

§ Provides that if the federal government issues a ruling that the system established under this bill does not comply with federal regulations, the Texas Board of Nursing Facility Administrators is established within the Texas Department of Human Services.


Children/Long-Term Care Institutions - S.B. 118

by Senator Zaffirini

House Sponsor: Representative Naishtat

§ Requires certain agencies or institutions to notify a local community resource coordination group or other entities when a child with a developmental disability is initially placed in an institution.

§ Allows each entity receiving notice of the child's placement to contact the person making the placement to ensure that the child's family members are aware of alternative services, available placement options, and opportunities for permanency planning.

§ Requires the Health and Human Services Commission (HHSC) and each appropriate health and human services agency to develop procedures to ensure that permanency planning is provided for each child residing in an institution on a temporary or long-term basis, or for whom institutional care is sought.


Nursing Home Regulation - S.B. 190

by Senator Zaffirini, et al.

House Sponsors: Representatives Naishtat and Hilderbran

Quality of Care

§ Establishes minimum acceptable levels of care for nursing homes and similar institutions. States that a violation of a minimum acceptable level of care is forbidden by law.

§ Requires each institution, at a minimum, to provide quality care in accordance with rules and standards, which are at least as stringent as standards imposed by federal law.

§ Requires regulation of the construction, maintenance, and operation of institutions in a manner that protects the residents of the institutions.

§ Requires DHS and the Office of the Attorney General (OAG) to prepare an annual report on their responsibilities, as prescribed by the Legislative Budget Board and State Auditor.

§ Requires each institution to have a licensed nursing facility administrator and establishes the administrator's responsibilities

§ Requires DHS to deposit collected fees or penalties in the general revenue fund, and allows for their use only for nursing home administration and enforcement. Prohibits collection of investigation and attorney's fees unless penalties are also collected.

§ Establishes license renewal application requirements for institutions, including information required to substantiate five years of satisfactory compliance history.

§ Increases the license fees for institutions. Authorizes DHS board to establish a fee for background examinations.

§ Requires each institution to post, in a public area, notice that various reports on its performance are available, as well as notice that DHS and Texas Board of Nursing Facility Administrators can provide other reports.

§ Requires institutions to have a medical director and a director of nursing services and adds responsibilities of an attending physician (allows responsibilities to be performed by physician assistant or nurse practitioner). Requires institutions to use appropriate pediatric consultative services and nursing services for a resident younger than 18 years of age.

§ Establishes required nursing services, and sets required medical and dental examinations. Establishes quality of life and quality of care standards, rights of residents, complaint inspections, medication administration, pharmacist services, legislative oversight by the long-term care legislative oversight committee, and rights of employees.

§ Prohibits a person convicted of certain offenses from being employed in a position that involves direct contact with a consumer in a facility.

§ Prohibits a nursing facility from admitting a resident whose needs cannot be met through service from the facility's staff or in cooperation with community resources or other providers under contract. Requires the nursing facility to provide a written statement to DHS of the reasons for the refusal, or be subject to monetary penalties.

§ Requires DHS to establish procedures for controlling the number of Medicaid beds, decertifying unused Medicaid beds, and reallocating them to other nursing facilities.

§ Prohibits use of state funds to pay the facility, if federal matching funds cannot be used.

Enforcement and Penalties

§ Requires DHS to conduct two unannounced inspections of each facility each license period.

§ Increases the penalty for disclosing an unannounced visit of a nursing home from a Class B misdemeanor to a third degree felony.

§ Authorizes DHS, after providing notice and opportunity for a hearing, to exclude a person from eligibility for a license if the person has repeatedly or substantially failed to comply with rules and standards. Requires exclusion for a period of between two and 10 years.

§ Authorizes DHS to seek a temporary restraining order for a violation or threatened violation if DHS reasonably believes that it creates an immediate threat to the health and safety of a resident. Authorizes DHS to seek an injunction to restrain a person from a violation or threatened violation if it reasonably believes that the violation or threatened violation creates a threat to a resident's health and safety.

§ Increases civil penalties for a violation if DHS determines the violation threatens the health and safety of a resident. Authorizes any party to a suit to request a jury. Authorizes the state to seek satisfaction from any owner, controlling person, or affiliate if a person who is liable fails to pay any amount. Provides that penalties are not an allowable cost for reimbursement by Medicaid.

§ Authorizes DHS to assess an administrative penalties against persons who violate requirements of nursing home regulation or who impede an investigation of a violation.

§ Prohibits DHS from assessing an administrative penalty if the institution corrects certain violations within 45 days.

§ Prohibits DHS from assessing more than one monetary penalty for a violation arising out the same act or failure to act, except in specific situations. Authorizes the commissioner to immediately suspend admissions in certain situations and requires institutions to post notice of suspension.

§ Requires the OAG to work with DHS on all legal proceedings, and requires the commissioner to approve all settlements.

§ Establishes a cause of action if an employer retaliates against a person for reporting abuse or neglect, or cooperating in an investigation. Also prohibits an institution from retaliating or discriminating against a resident for making a complaint or filing a grievance.

§ Prohibits an institution or DHS from electing arbitration in case of emergency or a closing order.

§ Requires DHS to terminate a facility's provider agreement if DHS has imposed three Category 2 or 3 remedies on the facility within a 24-month period.


Convictions Which Bar Employment at Nursing Homes - S.B. 262

by Senator Sibley

House Sponsors: Representatives Counts and Naishtat

§ Adds the following convictions to the list of convictions barring employment from a position involving direct contact with a consumer in a nursing home or other related facility: sexual assault; aggravated assault; injury to a child, elderly individual, or disabled individual; abandoning or endangering a child; or aiding a suicide.


Consumers Guide for Senior Citizens - S.B. 273

by Senator Zaffirini, et al.

House Sponsor: Representative Cuellar, et al.

§ Requires the comptroller to develop and update annually a consumers guide for senior citizens designed to assist senior citizens and their families in making informed choices regarding available senior services. Also makes the guide available to users on the Internet.

§ Creates an interagency work group to assist the comptroller in developing the consumers guide. Requires the work group to consult with consumer and provider groups involved in the delivery of long-term care services.

§ Requires the comptroller to make the guide available to the public through the Internet, and to local and state agencies in electronic format.

§ Requires the Texas Department on Aging to lead a group of state agencies formed to identify and address in cooperative efforts all major public policy issues relating to the aging of Texas residents.

§ Requires the comptroller to provide an opportunity to consumer and provider groups involved in the delivery of long-term care services to review and comment on the guide.


Studying Federal Waivers for Long Term Care Medicaid Programs - H.B. 460

by Representative Maxey, et al.

Senate Sponsor: Senator Moncrief

§ Requires the commissioner of health and human services to report to the legislature on the feasibility and advisability of replacing waivers for administering federally funded Medicaid programs supporting long-term care services with a single waiver in order to minimize administrative duplication, maximize services provided, and provide flexibility to Texas.

§ Requires the commissioner to consider waivers with respect to specific programs in multiple agencies.


Increasing Medicaid Beds for Nursing Homes - H.B. 606

by Representative Zbranek, et al.

Senate Sponsor: Senator Moncrief

§ Authorizes the commissioners court of a county in which not more than two nursing facilities are Medicaid certified, to request that DHS contract for up to 120 additional Medicaid beds per year, regardless of current Medicaid occupancy rates in the county. Prohibits DHS from contracting more than 500 additional nursing home beds statewide in a calendar year.

§ Requires the commissioners court requesting additional Medicaid beds to publish notice in the Texas Register and a local newspaper. Requires the notice to include certain information.


Needs Assessment for Long-Term Care Services - H.B. 663

by Representative Maxey, et al.

Senate Sponsor: Senator Moncrief

§ Requires HHSC, subject to adequate funding from solicitation, to develop a pilot program to determine the feasibility of a consistent functional needs assessment process to be used by long-term care services programs.

§ Requires HHSC to consult with advocacy groups, providers, representatives of state agencies, and other appropriate individuals and entities in developing the consistent functional needs assessment process.

§ Requires HHSC to report results of the pilot program to the legislature.


Pilot Program for Treating Alzheimer's Patients - H.B. 2509

by Representative Hilderbran

Senate Sponsor: Senator Zaffirini

§ Requires DHS, in cooperation with an advisory committee, to develop and implement a pilot program for the treatment of individuals diagnosed with Alzheimer's disease.

§ Requires DHS to appoint an advisory committee to assist in developing and implementing the pilot program.

§ Provides that the pilot program may not make eligible for medical assistance any individual who would not otherwise be eligible.

§ Authorizes DHS to seek and accept a gift, grant, or donation from any person for purposes of developing and implementing the pilot program provided that the person does not have a contested case pending before any agency participating in the pilot program.


Special Licenses for Personal Care Facilities - H.B. 2510

by Representative Hilderbran

Senate Sponsor: Senator Zaffirini

§ Requires the Board of Human Services (board) to establish a classification and license for a facility that advertises, markets, or otherwise promotes that the facility provides personal care services to residents who have Alzheimer's disease or related disorders.

§ Requires the board to adopt minimum standards for a defined personal care facility.


Regulating Personal Care Facilities - H.B. 2601

by Representatives Wohlgemuth and Hilderbran

Senate Sponsor: Senator Carona

§ Requires all fees or penalties collected from the regulation of personal care facilities to be deposited in the general revenue fund.

§ Prohibits assessing or collecting investigation fees or attorney's fees from a personal care facility unless DHS or other state agency assesses and collects a penalty from the facility.

§ Provides that state standards must require a personal care facility to use its license number in all advertising, solicitation, or promotional materials

§ Authorizes DHS to petition a district court for a temporary restraining order if a facility is operating without a license.

§ Adds civil penalties for a person who is operating a personal care facility without a license, or who has been determined to be operating a facility without a license and violates or fails to comply with other provisions.

§ Requires the Texas Board of Human Services, the Department of Protective and Regulatory Services, and the attorney general to adopt a memorandum of understanding to improve agency cooperation on investigating complaints, enforcement actions, and correcting violations in substandard or unlicensed personal care facilities.


Rights of the Elderly - H.B. 3100

by Representatives Jesse Jones and Chavez

Senate Sponsor: Senator Truan

§ Recommends changes that would recognize the right of the elderly to a greater amount of self-determination.

§ Prohibits a person providing services to the elderly from denying rights of the elderly.

§ Provides that an elderly individual, as defined by the Human Resources Code, is not affected by the change made in this legislation.