JKC C.S.H.B. 2409 75(R)BILL ANALYSIS



HUMAN SERVICES
H.B. 2409
By: Coleman
4-28-97
Committee Report (Substituted)


BACKGROUND

A basic problem with the long term care system is that unlike 
nursing facilities, adult foster care 
homes personal homes run by the owner or someone hired by the 
owner to provide minimal 
supervision to residents are not required to be licensed either 
through state or federal statutes. In 
early 1994, under a Medicaid nursing facility waiver, the Texas 
Department of Human Services 
(DHS) began placing people who qualified medically and 
financially into adult foster care homes. 
Licensing standards would protect the health and safety of 
individuals who chose to live in this 
setting.

Currently, the following conditions exist in adult foster care 
homes:

(1)Reporting of suspected resident abuse or neglect is not 
required.
(2)Maintenance of resident medical records and monitoring of each 
resident's condition are not 
required.
(3)There are no limitations on the appropriateness of the setting 
for the medical needs of residents.
(4)Minimum employee training standards and continuing education 
in areas such as geriatrics are 
not required.
(5)Persons convicted of certain types of felonies are not 
prohibited from being care givers.

PURPOSE

This bill would create a licensing program for adult foster care 
homes and  provide criminal penalties 
for: (1) failure to report abuse or neglect in an adult foster 
care home; and (2) malicious reporting 
of abuse or neglect in an adult foster care home.

RULEMAKING AUTHORITY

SECTION 2. Sec. 252.005.Gives the board the authority to adopt 
rules necessary to implement 
this chapter, including issuance, renewal, denial, suspension, 
and 
revocation of a license to operate an adult foster care home.

SECTION 2.Sec. 252.006.Outlines the minimum standards that DHS 
must adopt, by rule, in 
order to protect the health and safety of a resident in an adult 
foster 
care home.

SECTION 2.Sec. 252.010 (d) Authorizes DHS to adopt rules to 
provide for the relocation of 
residents from an adult foster care home that is closed or 
whose 
license is suspended.

SECTION BY SECTION ANALYSIS

SECTION 1.Amends Chapter 102.001(4), Human Resources Code, as 
follows:

(4)Definition of "Person providing services" would be expanded 
to include personal 
care services and adult foster care home services.

SECTION  2. Amends Subtitle B, Title 4, Health and Safety Code, 
to add Chapter 252 as follows:

 Chapter 252. Adult Foster Care Homes

Sec. 252.001.Definitions.

"Adult foster care home" means an establishment providing room 
and board to one 
or more elderly persons unrelated to the proprietor that receives 
reimbursement under 
the state Medicaid program and is not otherwise required to be 
licensed.

"Board" means the Texas Board of Human Services.

"Department" means the Texas Department of Human Services 
(DHS).

"Elderly person" means a person at least 65 years years of age.

Sec. 252.002.Licensure Required.

Requires a license to operate an adult foster care home.

Sec. 252.003.License Application.

Provides for license application, issuance, and a nonrefundable 
license fee.

Sec. 252.004.Issuance and Renewal of License.

Directs DHS to issue and renew licenses and sets requirements for 
renewal.  Further, 
each license expires two years following issuance.

Sec. 252.005.Adoption of Rules; Fees.

Gives the board the authority to adopt rules necessary to 
implement this chapter, 
including issuance, renewal, denial, suspension, and revocation 
of a license to operate 
an adult foster care home.  Also requires fees, which are to be 
set by DHS, to be 
sufficient to cover the costs of administering this chapter. 

Sec. 252.006.Standards.

Outlines the minimum standards that DHS must adopt, by rule, in 
order to protect the 
health and safety of a resident in an adult foster care home:

(1)differentiate adult foster care homes from other licensed 
institutions;
(2)quality care and protection;
(3)minimum fire safety and emergency;
(4)limitation on acuity levels of resident's medical 
conditions;
(5)monitoring of residents' health and medical condition and 
maintenance of 
medical records;
(6)residents' rights;
(7)reporting abuse and neglect;
(8)employee criminal history checks;
(9)employee training; and
(10) employee continuing education.

Sec. 252.007. Inspections.

Allows DHS to inspect adult foster care homes at reasonable 
times, with assistance 
from the Texas Department on Aging (TDOA).

Sec. 252.008.Assistance by Department.

Allows DHS, with assistance from TDOA, to provide assistance to 
adult foster care 
providers, including training and the development of a provider's 
handbook.

Sec. 252.009.Denial, Suspension, or Revocation of License.

After providing notice and opportunity of hearing, DHS may deny, 
suspend, or 
revoke a license if the provider has failed to comply with the 
requirements 
established under this chapter.  Denial, suspension, revocation, 
and appeal are 
governed by the procedures for a contested case hearing under 
Chapter 2001, 
Government Code.

Sec. 252.010.Emergency Suspension or Closing Order.

Requires DHS to suspend an adult foster care home license or 
order an immediate 
closing in the case of a violation of DHS standards and immediate 
threat to resident 
health and safety.  This order is immediately effective on the 
date of the receipt of the 
written notice or on the date specified by the order.  Further, 
DHS is authorized to 
provide, by rule, for the relocation of residents from a home 
that is closed or whose 
license is suspended.

SECTION  3.Effective Date: September 1, 1997, except the 
licensing requirement in Sec. 252.002, 
Health and Safety Code, which takes effect January 1, 1998.  

SECTION 4.Emergency clause.

COMPARISON OF ORIGINAL TO SUBSTITUTE

SECTION 2.Sec. 252.005, Adoption of Rules; Fees.  (b) The word 
"may" in the original is 
replaced by "shall" in the substitute.

Subchapter B, Sections 252.101-115, Reports of Abuse and Neglect, 
are deleted from 
the substitute. Therefore, there is no need to differentiate 
between Subchapters A and 
B.  Consequently, language referring to Subchapter A, General 
Provisions, is deleted