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