BILL ANALYSIS



C.S.H.B. 3118
By: Coleman
05-01-95
Committee Report (Substituted)


BACKGROUND

     Texas entered the Intermediate Care Facilities for people with
mental retardation (ICF/MR) program in 1974 to draw matching
federal funds through the Medicaid program, as well as to improve
staff ratios in MHMR state schools.  Originally identified with
nursing facilities as providing large facility-based long-term
services for people with mental retardation, state laws
establishing regulation under the ICF/MR program were incorporated
in Chapter 242 of the Health and Safety Code, the nursing facility
statute.

     Over the years, national trends and changes in philosophy
regarding services to people with mental retardation changed
dramatically.  The ICF/MR program no longer shares many
characteristics with the Medicaid nursing home program, having
moved away from large, congregate settings to community-based homes
of six beds or less.  These small facilities not only offer room
and board, but also provide active treatment to help clients
function as independently as possible.  In contrast, the trend in
services for residents of nursing facilities has changed little
over the years, except to emphasize medical care and treatment in
these larger institutional settings.

     In FY 1994, the ICF-MR community-based program served over
7,000 clients at an annual expense of about $211 million.  The more
institutional-type state schools served another 6,200 persons and
generated $238 million in federal matching funds.


PURPOSE

     H.B. 3118 would remove the ICF/MR program from the nursing
facility statute and create a new chapter in the Health and Safety
Code, Chapter 251, to support current best practices in delivering
services to people with mental retardation.  The bill would provide
licensing requirements and set minimum standards governing ICF/MR
homes.  Standards contained in H.B. 3118 derive from current
licensing standards.  Minimum modifications were made in the
language to ensure that standards reflect current trends in
services to persons with mental retardation and current federal
requirements.

RULEMAKING AUTHORITY

     It is the committee's opinion that H.B. 3118 expressly grants
rulemaking authority to the Texas Board of Human Services in
SECTION 1 of the bill.


SECTION BY SECTION ANALYSIS

Section 1.  Amends Subtitle B, Title 4, Health and Safety Code, by
adding new Chapter 251, as follows:

CHAPTER 251.  INTERMEDIATE CARE FACILITIES FOR THE MENTALLY
RETARDED

     SUBCHAPTER A: GENERAL PROVISIONS

Section 251.001  PURPOSE.  Specifies the purpose of the new chapter
as promoting public health, safety, and welfare by developing,
establishing, and enforcing standards for services to persons
residing in ICFs/MR.

Section 251.002  DEFINITIONS.  Provides definitions for "board,"
"Department" (meaning Dept. of Human Services [DHS]), "designee,"
"facility," "governmental unit," "person," and "resident."

Section 251.003  EXEMPTIONS.  Specifies certain entities as exempt
from regulation under this chapter, including training,
habilitation, rehabilitation, or education programs; programs
operated by another state agency or federal agency; and programs
certified by other state or federal agencies.

Section 251.004  FEDERAL FUNDS.  Permits DHS to use of funds
allocated by the federal government for administrative expenses.

Section 251.005  LANGUAGE REQUIREMENTS PROHIBITED.  Prohibits
facilities from allowing residents or employees to communicate in
the person's native language.

Section 251.006  RIGHTS OF RESIDENTS.  Requires facilities to
enforce Chapter 102, Human Resources Code, relating to resident
rights.

Section 251.007  PAPERWORK REDUCTION RULES.  (a)  Permits DHS and
any designee to:

     (1)  adopt rules reducing paperwork that facilities must
complete and retain; and
     (2)  attempt to minimize paperwork requirements of state
     and federal laws unless resident safety would be
     jeopardized.

(b)  Requires DHS, any designee and facilities to work together to
review rules and propose changes to paperwork requirements.

Section 251.008  RULES.  Authorizes DHS to adopt rules necessary
for the administration and implementation of this Chapter,
including rules for:

     (1)  Secs. 251.031-.033 (requirements for related fees
     and denial, suspension or revocation of license); and
     (2)  Secs. 251.038-.041 (requirements for inspections and
surveys).

Section 251.009  CONSULTATION AND COORDINATION.  (a)  Requires DHS,
whenever possible, to use and consult with state and local agencies
and use Dept. facilities to perform functions under this chapter
and establish and maintain standards for humane treatment of
residents.

(b)  Permits DHS to cooperate with local public health officials
and delegate to them the power to make inspections and
recommendations to the Dept.

(c)  Permits DHS to coordinate personnel and facilities with local
agencies and provide advice for local officials who decide to
supplement the state program with additional rules to meet local
conditions.

Section 251.010  CHANGE OF ADMINISTRATORS.  Requires facilities
hiring new administrators to notify DHS of the change and pay a $20
administrative fee to DHS.

     SUBCHAPTER B:  LICENSING, FEES, AND INSPECTIONS

Section 251.031  LICENSE REQUIRED.  Requires license to operate an
ICF/MR.

Section 251.032  LICENSE APPLICATION.  (a)  Requires application
for license to be made on form provided by DHS and be accompanied
by a license fee.

(b)  Requires application to contain information as required by
DHS, including affirmative evidence of ability to comply with
standards and rules.

Section 251.033  ISSUANCE AND RENEWAL OF LICENSE.  (a)  Requires
DHS to issue license if applicant and facility meet requirements.

(b)  Permits DHS to issue license only for premises and persons or
governmental unit named in application; and maximum number of beds
specified in the application.

(c)  Prohibits transfer or assignment of license.
(d)  Permits licenses to be renewed every two years after an
inspection, filing and approval of renewal report, and payment of
renewal fee.

(e)  Requires renewal report above to follow DHS rules regarding
form and submission date.
(f)  Prohibits DHS from issuing licenses unless licensed beds are
also approved under the state's plan for long-term care facilities
for persons with MR.

Section 251.034  MINIMUM STANDARDS.  Permits the Board of Human
Service to adopt, public and enforce minimum standards for ICFs/MR
relating to construction or remodeling issues, sanitary conditions,
essential equipment, reporting and investigation of injuries and
accidents, behavior management, control of communicable disease,
use and administration of medication, in conformity with applicable
law and rules for pharmacy services, nutrition support, employee
training, quality and quantity of staff, and quality of resident
life.

Section 251.035  REASONABLE TIME TO COMPLY.  Requires the Board of
Human Services by rule to permit a reasonable amount of time to
comply with rules or standards.

Section 251.036  FIRE SAFETY REQUIREMENTS.  (a)  Requires
facilities to comply with fire safety requirements.

(b)  Directs the Board, by rule, to adopt fire safety standards
which are the same as fire safety standards established by an
edition of the life Safety Code of the Nat'l Fire Protection Ass'n,
similar to that designated by federal law, and may be different for
facilities or portions of facilities at different times.

(c)  Prohibits the Board from adopting more stringent fire safety
standards than those required by federal law and regulation.
(d)  Requires licensed facilities to comply with fire safety
standards imposed by municipal ordinance applicable to the facility
on that date.

(e)  Declares that rules adopted for fire safety do not prevent
licensed facilities from voluntarily conforming to standards
compatible with, equal to, or more stringent than those adopted by
the Board.

(f)  Permits municipalities to enact additional and more stringent
fire safety standards for new construction begun on or after Sept.
1, 1995.

Section 251.037  POSTING.  Requires facilities to post prominently
their licenses, signs specifying complaint procedures, notice that
DHS inspections and reports are available for inspection and the
toll-free number for information about the facility, and summaries
of recent facility investigations.

Section 251.038  INSPECTIONS.  (a)  Permits DHS or its designee to
make inspections, surveys, or investigations needed and enter the
premises for those purposes according to board rules.

(b)  Entitles DHS access to books, records and other documents as
necessary for enforcement.

(c)  Declares that holding or applying for a license amounts to
consent for DHS to enter and inspect the premises of the facility.

(d)  Requires DHS to set procedures to preserve relevant evidence
of conditions found during inspections, surveys, or investigations,
including photography.

(e)  When photographing residents, DHS must maintain privacy of the
resident.

(f)  Declares that facilities, officers or employees of the
facility, and resident's attending physician are not civilly liable
for surrendering confidential information.

(g)  Requires DHS to establish a clear form summarizing each
inspection report and complaint investigation report.

(h)  Requires DHS to establish proper procedures to ensure that
copies of forms and reports are available to consumers and service
recipients, as appropriate.

Section 251.039  UNANNOUNCED INSPECTIONS.  (a)  Requires DHS to
conduct at least two unannounced inspections of each facility
during each licensing period.

(b)  Requires DHS to randomly select a sufficient percentage of
facilities for unannounced, but cursory inspections held between 5
p.m. and 8 a.m.

(c)  Permits DHS to require additional inspections.

(d)  As appropriate, DHS may invite at least one citizen advocate
to participate in inspections.

Section 251.040  DISCLOSURE OF UNANNOUNCED INSPECTIONS; CRIMINAL
PENALTY.  
(a)  Provides an offense when a person intentionally, knowingly, or
recklessly discloses to an unauthorized person information about
unannounced inspections.

(b)  Defines "unauthorized" person to include DHS, the AG,
representatives of Medicaid-survey teams, and other persons
authorized by law to enter or accompany an inspector.

(c)  Declares an offense under this section to be a Class B
misdemeanor.

(d)  Prohibits a person convicted herein from state employment.

Section 251.041  LICENSING SURVEYS.  Requires DHS to send teams to
conduct surveys to validate findings of licensing surveys, to
assure fair and consistent surveys; requires facilities to correct
deficiencies cited by the team, but does not subject them to
punitive action for the deficiencies.

     SUBSECTION C: GENERAL ENFORCEMENT

Section 251.061  EMERGENCY SUSPENSION OR CLOSING ORDER.  (a) 
Requires DHS to suspend a facility license if:

     (1)  DHS finds the facility operating in violation of the
standards herein; and
     (2)  such violation creates an immediate threat to the health
and safety of a resident.

(b)  Requires the Board of Human Services by rule to provide
placement for residents displaced during license suspension or
closure.

(c)  Declares an order suspending or closing a facility to be
effective on the date received by the license holder.

(d)  Declares an order suspending or closing a facility to be valid
for 10 days after the order's effective date.

Section 251.062  INJUNCTION.  (a)  Permits DHS to petition to the
district court for temporary restraining order to restrain a
continuing violation, upon a finding of immediate threat to 
residents' health and safety.

(b)  Permits the court to prohibit a continuing violation; restrain
or prevent operation without a license; or grant injunctive relief
as warranted, upon a finding that a violation has occurred.

(c)  Requires the AG, at DHS' request, to institute and conduct
suits authorized herein.

(d)  Requires suits for temporary restraining orders or other
injunctive relief to be brought in the county in which the alleged
violation occurred.

Section 251.063  LICENSE REQUIREMENTS: CRIMINAL PENALTY.  (a) 
Declares an offense if person violated Sec. 251.031 (license
requirement).

(b)  Sets fine for offense under this section of as much as $1,000
for the first offense, and as much as $500 for each subsequent
offense.

Section 251.064  CIVIL PENALTY.  (a)  Subjects person violating
this chapter or board rule to civil penalty of $100-$1,000 for each
violation, if resident health and safety is threatened.

(b)  Permits each day of continuing violation to constitute a
separate ground for recovery.

Section 251.065  ADMINISTRATIVE PENALTY.  (a)  Permits DHS to
assess administrative penalties for violations of this chapter or
board rules.

(b)  Requires DHS to establish gradations of penalties and amounts
in accordance with the relative seriousness of the violations.

(c)  Requires DHS to consider other matters when setting penalties,
including:
     (1)  gradations under (b) above;
     (2)  seriousness of the violation;
     (3)  history of previous violations;
     (4)  amount necessary to deter future violations;
     (5)  efforts to correct violation; and
     (6)  efforts by DHS to use other sanctions to ensure
compliance.

(d)  Sets maximum penalty at $5,000 for each violation, with each
day of continuing violation constituting a separate violation.

(e)  Requires DHS to establish rules governing the assessment of
administrative penalties, including notification of violation,
appeals and hearing processes, and payment and refund of the
penalty.

     SUBCHAPTER D: TRUSTEES FOR FACILITIES

Section 251.091  FINDINGS AND PURPOSE.  (a)  Declares that closing
of an ICF/MR may have an adverse effect on residents and families;
and may result in a lack of readily available funds to meet
residents' basic needs.

(b)  Declares purpose of this subchapter, as providing for
appointment of trustees to assume facility operations, and set up
a fund to assist court-appointed trustees in meeting residents'
basic needs.

Section 251.092  APPOINTMENT BY AGREEMENT.  (a)  Permits person
holding controlling interest in a facility to request DHS to assume
operations of the facility through appointment of a trustee.

(b)  Permits DHS to enter into an agreement providing for
appointment of a trustee to take charge of the facility, as
necessary.

(c)  Requires such agreements to specify all terms and conditions
of trustee's appointment and authority; and preserve all resident
rights granted by law.

(d)  Terminates such agreements at time specified by parties or
when either party notifies the other in writing.

Section 251.093  INVOLUNTARY APPOINTMENT.  Permits DHS to ask the
AG to bring an action on behalf of the state for appointment of a
trustee to operate a facility if:

     (1)  the facility is operating without a license;
     (2)  DHS has suspended or revoked the license;
     (3)  license suspension or revocation procedures are
     pending and DHS determines that an imminent threat to
     resident health and safety exists;
     (4)  DHS determines that an emergency exists presenting
     an immediate threat to resident health & safety; or
     (5)  facility is closing and arrangements for resident
     relocation have not been made before closure.

(b)  Permits a trustee only to ensure an orderly and safe
relocation of residents.
(c)  Requires the court, after a hearing, to appoint a trustee to
take charge of the facility
(d)  Requires the court to appoint as trustee a person whose
background includes mental retardation service administration.

(e)  Declares venue to be in Travis County.

Section 251.094  FEE; RELEASE OF FUNDS.  (a)  Entitles a trustee to
a reasonable fee, determined by the court.

(b)  Permits trustee to petition the court to order the release of
payments owed to the trustee for care and services provided to
residents, including payments withheld by DHS.

(c)  Defines withheld payments to include payments withheld by
governmental agencies or other entities during the appointment of
the trustee, such as Medicaid, insurance, third party payments, or
medical expenses borne by residents.

Section 251.095  EMERGENCY ASSISTANCE FUNDS; ADDITIONAL LICENSING
FEE.  (a)  Permits DHS to collect an annual fee to be used for
emergency assistance funds.

(b)  Requires the annual fee to be the amount prescribed in Section
242.097(b) for deposit in the  nursing and convalescent home trust
fund under Section 242.096, Health & Safety Code.

(c)  Permits DHS to disburse funds from the trust fund to
facilities in accordance with purposes in Sec. 242.096.

(d)  Permits court to order DHS to disburse emergency assistance
funds to ICFs/MR pursuant to Sec. 242.096(c).

Section 251.096  REIMBURSEMENT.  (a)  Requires facilities receiving
emergency assistance funds to reimburse DHS for the funds received,
plus interest.

(b)  States that interest begins to accrue on the date which funds
are disbursed to the facility, at a rate of interest set by Art.
5069.1.05, V.T.C.S.

(c)  Designates facility owners when trustees are appointed to be
responsible to pay the reimbursement.

(d)  Declares delinquent any amount remaining unreimbursed on the
first anniversary of the date on which funds were received; permits
DHS to determine the facility to be ineligible for a Medicaid
contract.

(e)  Requires DHS to deposit the reimbursement and interest
received in the trust fund.

(f)  Requires the AG to institute an action to collect funds due at
DHS' request; venue is in Travis County.

Section 251.097  NOTIFICATION OF CLOSING.  (a)  Requires facilities
to notify residents and families of closing within a reasonable
time before closing.

(b)  Requires facility to notify residents orally or in writing,
upon notice from DHS about an involuntary closing.

(c)  Requires facility to notify residents within one week of the
decision to close, if closing is voluntary.

     SUBCHAPTER E:  REPORTS OF ABUSE AND NEGLECT

Section 251.121  DEFINITIONS.  Establishes definition of
"designated agency," meaning an agency designated by the court to
be responsible for the protection of a resident who is the subject
of a report of abuse or neglect.

Section 251.122  REPORTING OF ABUSE AND NEGLECT.  (a)  Requires
persons having cause to believe that a resident's physical or
mental health or welfare has been or may be adversely affected by
abuse or neglect to report the abuse or neglect to DHS, to a
designated agency, or to both, as specified in DHS rules.

(b)  Requires employees at each facility to sign a statement
recognizing the employees' criminal liability for failure to report
abuse or neglect.

(c)  Requires persons to make oral reports immediately upon
learning of abuse or neglect, and make written reports by the 5th
day after the oral report is made.

Section 251.123  CONTENTS OF REPORT.  (a)  Declares nonaccusatory
reports of abuse and neglect, reflecting the person's own belief.

(b)  Requires report to contain name and address of resident and
person responsible for care of resident, and other relevant
information.

Section 251.124  ANONYMOUS REPORTS OF ABUSE OR NEGLECT.  (a) 
Requires that anonymous reports be received and acted on in same
manner as acknowledged reports.

(b)  Requires state or local law enforcement agencies receiving
reports of abuse or neglect to refer cases to DHS or the designated
agency.

Section 251.125  INVESTIGATION AND REPORT OF RECEIVING AGENCY.  (a) 
Requires DHS or its designee to make thorough investigations
promptly after receiving report.

(b)  Declares primary purpose of investigations to be resident
protection.

(c)  Requires DHS or its designee, in investigations to determine
the nature, extent and cause of the abuse and neglect, identity of
the person responsible, names and conditions of other residents,
evaluation of persons responsible for care of residents, adequacy
of facility environment, and any other information required by the
Dept.

(d)  Permits investigators to visit the resident's facility and
interview the resident, if appropriate.

(e)  Requires a probate or county court, in cases where DHS
attempts to perform an on-site investigation and cannot gain entry,
to order the person responsible for the resident's care to allow
admission and interview of the resident.

(f)  Requires DHS, before completing an investigation, to file a
petition for temporary care and protection of the resident if
immediate removal is necessary.

(g)  Requires DHS or its designee to make a written report of the
investigation for submission to the DA and appropriate law
enforcement agencies, and to DHS if necessary.


Section 251.126  CONFIDENTIALITY.  Deems reports, records, or
working papers used or developed in investigations to be
confidential, for disclosure only for purposes consistent with
Board rules.

Section 251.127  IMMUNITY.  (a)  Provides immunity from civil or
criminal liability for persons who report acts of abuse or neglect
that might result from making the report.

(b)  Extends immunity to participation in judicial proceedings
arising therefrom.

(c)  Disallows immunity protection to persons reporting in
violation of Sec. 251.131, below.

Section 251.128  PRIVILEGED COMMUNICATIONS.  Prohibits exclusion of
evidence in cases involving resident abuse or neglect or the cause
of abuse or neglect on the grounds of privileged communication,
except in the case of attorney-client privilege.

Section 251.129  CENTRAL REGISTRY.  (a)  Requires DHS to maintain
in Austin a central registry of reported cases of resident abuse or
neglect.

(b)  Permits Board of Human Services to adopt rules necessary to
maintain the registry.

(c)  Requires Board rules to provide for cooperation with hospitals
and clinics in exchanging reports of abuse or neglect.

Section 251.130  FAILURE TO REPORT; CRIMINAL PENALTY.  (a) 
Declares an offense in cases involving a person who has cause to
believe that a resident's physical or mental health or welfare has
been or may be further adversely affected and knowingly fails to
report.

(b)  Deems offense to be Class A misdemeanor.

Section 251.131  BAD FAITH, MALICIOUS, OR RECKLESS REPORTING;
CRIMINAL PENALTY.  (a)  Declares an offense in cases involving a
person who reports under this Subchapter in bad faith, maliciously,
or recklessly.

(b)  Deems offense to be Class A misdemeanor.

(c)  Allows criminal penalty provided herein to be assessed in
addition to civil penalties.

Section 251.132  SUIT FOR RETALIATION.  (a)  Provides cause of
action against a facility or  owners or employees of facility, in
cases of suspension or termination of employment or disciplinary
action resulting from reporting abuse or neglect.

(b)  Permits the petitioner to recover actual damages, exemplary
damages, court costs and attorney's fees.

(c)  Entitles wrongfully suspended or terminated employee to
reinstatement to the former position.

(d)  Requires petitioner to bring suit or notify TEC (TX Employment
Commission) of intent to sue within 90 days of suspension or
termination.  Requires suit to be brought within 90 days after
notice to TEC; requires TEC to notify facility of intent to sue.

(e)  Places burden of proof on petitioner, except for rebuttable
presumption if that suspension or termination occurred within 60
days of report of abuse or neglect.

(f)  Permits suit to be brought in district court in county of
plaintiff's residence; plaintiff's employment by defendant, or
defendant's place of business.

(g)  Requires facilities to require employees to sign a statement
that employee understands his or her rights herein.  If no
signature is obtained, the periods prescribed in this section to
not apply, and petitioner must bring suit within two years or
suspension or termination.

Section 251.133  REPORTS RELATING TO RESIDENT DEATHS.  (a) 
Requires licensed facilities to submit reports to DHS concerning
resident deaths, within 10 working days of the last day of each
month in which a resident death occurs; deaths must also be
reporting within 24 hours of transfer from facility to hospital.

(b)  Requires facilities to report on DHS form, including
information on person's name and social security number.

(c)  Requires DHS to correlate reports derived herein with death
certification information.

(d)  Deems records under this section confidential, unless
specified otherwise by Board rule and not subject to the Open
Records Act.

     SUBCHAPTER F:  MEDICATION

Section 251.151  ADMINISTRATION OF MEDICATION.  Requires DHS to
establish necessary rules for the administration of medication in
ICFs/MR.

     SUBCHAPTER G: RESPITE CARE

Section 251.181  DEFINITIONS.  Includes definitions of "plan of
care" and "respite care."

Section 251.182  RESPITE CARE.  (a)  Permits licensed facilities to
provide respite care for persons with MR or related conditions
without regard to whether person is eligible for intermediate care
services under federal law.

(b)  Permits Board to adopt rules to regulate respite care in
ICFs/MR.

Section 251.183  PLAN OF CARE.  (a)  Requires facility and person
arranging care to agree on the plan of care to be filed at the
facility before person's admission.

(b)  Requires plan of care to be signed by a licensed physician, if
medical care is needed, or person arranging for respite care.

(c)  Permits facility to keep an agreed plan of care for 6 months;
permits facility to admit the person as frequently as necessary and
space is available.

Section 251.184  NOTIFICATION.  Requires facilities offering
respite care to notify DHS.

Section 251.185  INSPECTIONS.  Requires DHS, at time of licensing
or other times as necessary, to inspect a facility's records,
services, physical accommodations, and plans of care for compliance
with Board rules.

Section 251.186  SUSPENSION.  (a)  Permits DHS to require a
facility to cease providing respite care if facility does not meet
standards.

(b)  Permits DHS to suspend a license if facility continues to
provide care after written notice to cease has been received.

SECTION 2.  Amends Sec. 242.002(6), Health & Safety Code, by
striking from the definition of "institution," intermediate care
facilities (ICFs/MR).

SECTION 3.   Amends Sec. 242.003, Health & Safety Code, by adding
to the list of exemptions from licensing a new subsection (8),
designating facilities licensed under Chapter 251.

SECTION 4.  (a)  Effective date, Sept. 1, 1995, except for (b).

(b)  Section 2, changing the definition of "institution," takes
effect on Jan. 1, 1996.

SECTION 5.  (a)  Requires facilities to be licensed under Chapter
251 by January 1, 1996; allows facilities required to be licensed
under Chapter 251, but already holding license under Chapter 242,
to continue operating until December 31, 1995, or the date on which
the license is subject to renewal.

(b)  Prohibits ICF/MR licenses issued under Chapter 242 from
renewal after Dec. 1, 1995.

SECTION 6.  Emergency clause.


COMPARISON OF ORIGINAL TO SUBSTITUTE

     The committee substitute put the filed bill in Legislative
Counsel form.  In the process, many sections were renumbered. 
Numerous other small changes were incorporated after negotiations
between DHS, the TX Dept. of Mental Health and Mental Retardation,
which sets policy for people with mental retardation and operates
state schools and ICFs/MR, and providers, permitting the Board of
Human Services broad rulemaking authority with regard to licensing,
health and safety standards, employee conduct, reports of abuse and
neglect, inspections of facilities, and penalties for violations of
the law, among others.

     The committee substitute also added new Section 2, striking
the definition of ICF/MR from Chapter 242, Health and Safety Code;
new Section 3 adding ICFs/MR to the list of exemptions in Chapter
242, Health and Safety Code; and establishing a new effective date,
allowing existing facilities to operate under old rules until
December 31, 1995.


SUMMARY OF COMMITTEE ACTION

     The Human Services Committee convened in a public hearing on
April 24, 1995, and the Chairman laid out H.B. 3118 by Rep.
Coleman.  Rep. Maxey offered a committee substitute for H.B. 3118. 
The following witnesses testified for H.B. 3118:

Carole L. Smith, Private Providers Ass'n of Texas
Gordon Israel, representing himself and Draco Residences, Inc.
Barrett Markland, Advocacy, Inc.

The following witness testified as neutral on H.B. 3118:  Penny
Steele, Texas Dept. of Mental Health & Mental Retardation.  No one
testified against H.B. 3118.  The substitute was withdrawn and H.B.
3118 was left pending.

     In a formal meeting on May 1, the committee took up H.B. 3118
which had been pending. Rep. Maxey offered a committee substitute
and moved adoption.  Hearing no objection, the committee substitute
for H.B. 3118 was adopted.  The Chairman recognized Rep. Maxey to
move that the committee report to the full House H.B. 3118
favorably as substituted and send the bill to the Committee on the
Local and Consent Calendars.  Rep. Naishtat seconded the motion. 
The motion prevailed by a record vote of 8 Ayes, 0 Nays, 0 PNV, 1
Absent.