1-1     By:  Madla, Moncrief                                  S.B. No. 1247

 1-2           (In the Senate - Filed March 12, 1997; March 17, 1997, read

 1-3     first time and referred to Committee on Health and Human Services;

 1-4     April 7, 1997, reported adversely, with favorable Committee

 1-5     Substitute by the following vote:  Yeas 11, Nays 0; April 7, 1997,

 1-6     sent to printer.)

 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 1247                   By:  Madla

 1-8                            A BILL TO BE ENTITLED

 1-9                                   AN ACT

1-10     relating to regulation of a home and community support services

1-11     agency; providing an administrative penalty.

1-12           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

1-13           SECTION 1.  Section 142.001, Health and Safety Code, is

1-14     amended by adding a new Subdivision (8) and renumbering existing

1-15     Subdivisions (8) through (28) to read as follows:

1-16                 (8)  "Chief financial officer" means an individual who

1-17     is responsible for supervising and managing all financial

1-18     activities for a home and community support services agency.

1-19                 (9)  "Council" means the Home and Community Support

1-20     Services Advisory Council.

1-21                 (10) [(9)]  "Counselor" means an individual qualified

1-22     under Medicare standards to provide counseling services, including

1-23     bereavement, dietary, spiritual, and other counseling services, to

1-24     both the client and the family.

1-25                 (11) [(10)]  "Home and community support services

1-26     agency" means a person who provides home health, hospice, or

1-27     personal assistance services for pay or other consideration in a

1-28     client's residence, an independent living environment, or another

1-29     appropriate location.

1-30                 (12) [(11)]  "Home health service" means the provision

1-31     of one or more of the following health services required by an

1-32     individual in a residence or independent living environment:

1-33                       (A)  nursing;

1-34                       (B)  physical, occupational, speech, or

1-35     respiratory therapy;

1-36                       (C)  medical social service;

1-37                       (D)  intravenous therapy;

1-38                       (E)  dialysis;

1-39                       (F)  service provided by unlicensed personnel

1-40     under the delegation of a licensed health professional;

1-41                       (G)  the furnishing of medical equipment and

1-42     supplies, excluding drugs and medicines; or

1-43                       (H)  nutritional counseling.

1-44                 (13) [(12)]  "Hospice" means a person licensed under

1-45     this chapter to provide hospice services, including a person who

1-46     owns or operates a residential unit or an inpatient unit.

1-47                 (14) [(13)]  "Hospice services" means services,

1-48     including services provided by unlicensed personnel under the

1-49     delegation of a registered nurse or physical therapist, provided to

1-50     a client or a client's family as part of a coordinated program

1-51     consistent with the standards and rules adopted under this chapter.

1-52     These services include palliative care for terminally ill clients

1-53     and support services for clients and their families that:

1-54                       (A)  are available 24 hours a day, seven days a

1-55     week, during the last stages of illness, during death, and during

1-56     bereavement;

1-57                       (B)  are provided by a medically directed

1-58     interdisciplinary team; and

1-59                       (C)  may be provided in a home, nursing home,

1-60     residential unit, or inpatient unit according to need.  These

1-61     services do not include inpatient care normally provided in a

1-62     licensed hospital to a terminally ill person who has not elected to

1-63     be a hospice client.

1-64                 (15) [(14)]  "Inpatient unit" means a facility that

 2-1     provides a continuum of medical or nursing care and other hospice

 2-2     services to clients admitted into the unit and that is in

 2-3     compliance with:

 2-4                       (A)  the conditions of participation for

 2-5     inpatient units adopted under Title XVIII, Social Security Act (42

 2-6     U.S.C. Section 1395 et seq.); and

 2-7                       (B)  standards adopted under this chapter.

 2-8                 (16) [(15)]  "Independent living environment" means:

 2-9                       (A)  a client's individual residence, which may

2-10     include a group home or foster home; or

2-11                       (B)  other settings where a client participates

2-12     in activities, including school, work, or church.

2-13                 (17) [(16)]  "Interdisciplinary team" means a group of

2-14     individuals who work together in a coordinated manner to provide

2-15     hospice services and must include a physician, registered nurse,

2-16     social worker, and counselor.

2-17                 (18) [(17)]  "Investigation" means an inspection or

2-18     survey conducted by a representative of the department to determine

2-19     if a licensee is in compliance with this chapter.

2-20                 (19) [(18)]  "Palliative care" means intervention

2-21     services that focus primarily on the reduction or abatement of

2-22     physical, psychosocial, and spiritual symptoms of a terminal

2-23     illness.

2-24                 (20) [(19)]  "Person" means an individual, corporation,

2-25     or association.

2-26                 (21) [(20)]  "Personal assistance service" means

2-27     routine ongoing care or services required by an individual in a

2-28     residence or independent living environment that enable the

2-29     individual to engage in the activities of daily living or to

2-30     perform the physical functions required for independent living,

2-31     including respite services.  The term includes health-related

2-32     services performed under circumstances that are defined as not

2-33     constituting the practice of professional nursing by the Board of

2-34     Nurse Examiners through a memorandum of understanding with the

2-35     department in accordance with Section 142.016 and health-related

2-36     tasks provided by unlicensed personnel under the delegation of a

2-37     registered nurse.

2-38                 (22) [(21)]  "Place of business" means an office of a

2-39     home and community support services agency that maintains client

2-40     records or directs home health, hospice, or personal assistance

2-41     services.  The term does not include an administrative support

2-42     site.

2-43                 (23) [(22)]  "Residence" means a place where a person

2-44     resides and includes a home, a nursing home, a convalescent home,

2-45     or a residential unit.

2-46                 (24) [(23)]  "Residential unit" means a facility that

2-47     provides living quarters and hospice services to clients admitted

2-48     into the unit and that is in compliance with standards adopted

2-49     under this chapter.

2-50                 (25) [(24)]  "Respite services" means support options

2-51     that are provided temporarily for the purpose of relief for a

2-52     primary caregiver in providing care to individuals of all ages with

2-53     disabilities or at risk of abuse or neglect.

2-54                 (26) [(25)]  "Social worker" means an individual

2-55     certified as a social worker under Chapter 50, Human Resources

2-56     Code.

2-57                 (27) [(26)]  "Support services" means social,

2-58     spiritual, and emotional care provided to a client and a client's

2-59     family by a hospice.

2-60                 (28) [(27)]  "Terminal illness" means an illness for

2-61     which there is a limited prognosis if the illness runs its usual

2-62     course.

2-63                 (29) [(28)]  "Volunteer" means an individual who

2-64     provides assistance to a home and community support services agency

2-65     without compensation other than reimbursement for actual expenses.

2-66           SECTION 2.  Section 142.004, Health and Safety Code, is

2-67     amended by amending Subsections (a) and (c) and adding Subsections

2-68     (e) and (f) to read as follows:

2-69           (a)  An applicant for a license to provide home health,

 3-1     hospice, or personal assistance services must:

 3-2                 (1)  file a written application on a form prescribed by

 3-3     the department indicating the type of service the applicant wishes

 3-4     to provide;

 3-5                 (2)  [file with the application:]

 3-6                       [(A)  the name of the owner of the applicant or a

 3-7     list of the names of persons who own at least a 10 percent interest

 3-8     in the applicant; and]

 3-9                       [(B)  a list of any businesses with which the

3-10     applicant subcontracts and in which the owner or owners of the

3-11     applicant hold at least five percent of the ownership; or]

3-12                       [(C)  if the applicant is a direct or indirect

3-13     subsidiary of a publicly held corporation, the name of that

3-14     publicly held corporation and the names of each subsidiary of the

3-15     publicly held corporation that owns an interest in the applicant;]

3-16                 [(3)]  cooperate with any surveys required by the

3-17     department for a license; and

3-18                 (3) [(4)]  pay the license fee prescribed by this

3-19     chapter.

3-20           (c)  The board by rule shall require that, at a minimum,

3-21     before the department may approve a license application, [other

3-22     than an application for a renewal or branch office or alternate

3-23     delivery site license,] the applicant must provide to the

3-24     department:

3-25                 (1)  documentation establishing that, at a minimum, the

3-26     applicant has sufficient financial resources to provide the

3-27     services required by this chapter and by the department during the

3-28     term of the license;

3-29                 (2)  a list of the management personnel for the

3-30     proposed home and community support services agency, a description

3-31     of personnel qualifications, and a plan for providing continuing

3-32     training and education for the personnel during the term of the

3-33     license;

3-34                 (3)  documentation establishing that the applicant is

3-35     capable of meeting the minimum standards established by the board

3-36     relating to the quality of care; [and]

3-37                 (4)  a plan that provides for the orderly transfer of

3-38     care of the applicant's clients if the applicant cannot maintain or

3-39     deliver home health, hospice, or personal assistance services under

3-40     the license; and

3-41                 (5)  identifying information on the home and community

3-42     support services agency owner, administrator, and chief financial

3-43     officer to enable the department to conduct criminal background

3-44     checks on those persons.

3-45           (e)  A home and community support services agency owned or

3-46     operated by a state agency directly providing services is not

3-47     required to provide the information described in Subsections (c)(1)

3-48     and (5).

3-49           (f)  The department shall evaluate and consider all

3-50     information collected during the application process.

3-51           SECTION 3.  Subsection (a), Section 142.010, Health and

3-52     Safety Code, is amended to read as follows:

3-53           (a)  The board shall set license fees for home and community

3-54     support services agencies in amounts that are reasonable to meet

3-55     the costs of administering this chapter, except that the fees may

3-56     not be less than $300 [$200] or more than $1,000 for a license to

3-57     provide home health, hospice, or personal assistance services.

3-58           SECTION 4.  Subsection (c), Section 142.015, Health and

3-59     Safety Code, is amended to read as follows:

3-60           (c)  The council shall advise the department on licensing

3-61     standards and on the implementation of this chapter.  At each

3-62     meeting of the council, the department shall provide an analysis of

3-63     enforcement actions taken under this chapter, including the type of

3-64     enforcement action, the results of the action, and the basis for

3-65     the action.  The council may advise the department on its

3-66     implementation of the enforcement provisions of this chapter.

3-67           SECTION 5.  Subchapter A, Chapter 142, Health and Safety

3-68     Code, is amended by adding Sections 142.017 through 142.0175 to

3-69     read as follows:

 4-1           Sec. 142.017.  ADMINISTRATIVE PENALTY.  (a)  The department

 4-2     may assess an administrative penalty against a person who violates

 4-3     this chapter or a rule adopted under this chapter.

 4-4           (b)  The penalty shall be not less than $100 or more than

 4-5     $1,000 for each violation.  Each day of a violation that occurs

 4-6     before the day on which the person receives written notice of the

 4-7     violation from the department does not constitute a separate

 4-8     violation and shall be considered as one violation.  Each day of a

 4-9     continuing violation that occurs after the day on which the person

4-10     receives written notice of the violation from the department

4-11     constitutes a separate violation.

4-12           (c)  The department by rule shall establish a schedule of

4-13     penalties for each possible violation that is appropriate and

4-14     graduated according to the seriousness of the violation.  The

4-15     schedule shall include a period of time for correction by the home

4-16     and community support services agency of violations which did not

4-17     adversely affect patient health and safety.

4-18           (d)  In determining the amount of an administrative penalty

4-19     assessed under this section, the department shall by rule specify

4-20     violations constituting grounds for an administrative penalty.  In

4-21     establishing rules under this section, the department shall

4-22     consider:

4-23                 (1)  the seriousness of the violation, including the

4-24     nature, circumstances, extent, and gravity of the violation and the

4-25     hazard or potential hazard of the violation to the health or safety

4-26     of clients;

4-27                 (2)  the history of previous violations;

4-28                 (3)  the amount necessary to deter future violations;

4-29                 (4)  efforts made to correct the violation; and

4-30                 (5)  any other matters that justice may require.

4-31           (e)  An administrative penalty may not be assessed for minor

4-32     violations unless those violations are of a continuing nature or

4-33     were not corrected.

4-34           (f)  The department shall establish a system to ensure

4-35     standard and consistent application of penalties regardless of the

4-36     home and community support services agency location.

4-37           (g)  All proceedings for the assessment of an administrative

4-38     penalty under this chapter are subject to Chapter 2001, Government

4-39     Code.

4-40           Sec. 142.0171.  NOTICE; REQUEST FOR HEARING.  (a)  If, after

4-41     investigation of a possible violation and the facts surrounding

4-42     that possible violation, the department determines that a violation

4-43     has occurred, the department shall give written notice of the

4-44     violation to the person alleged to have committed the violation.

4-45     The notice shall include:

4-46                 (1)  a brief summary of the alleged violation;

4-47                 (2)  a statement of the amount of the proposed penalty

4-48     based on the factors listed in Subsection 142.017(d); and

4-49                 (3)  a statement of the person's right to a hearing on

4-50     the occurrence of the violation, the amount of the penalty, or both

4-51     the occurrence of the violation and the amount of the penalty.

4-52           (b)  Not later than the 20th day after the date on which the

4-53     notice is received, the person notified may accept the

4-54     determination of the department made under this section, including

4-55     the proposed penalty, or may make a written request for a hearing

4-56     on that determination.

4-57           (c)  If the person notified of the violation accepts the

4-58     determination of the department or if the person fails to respond

4-59     in a timely manner to the notice, the commissioner or the

4-60     commissioner's designee shall issue an order approving the

4-61     determination and ordering that the person pay the proposed

4-62     penalty.

4-63           Sec. 142.0172.  HEARING; ORDER.  (a)  If the person notified

4-64     requests a hearing, the department shall:

4-65                 (1)  set a hearing;

4-66                 (2)  give written notice of the hearing to the person;

4-67     and

4-68                 (3)  designate a hearings examiner to conduct the

4-69     hearing.

 5-1           (b)  The hearings examiner shall make findings of fact and

 5-2     conclusions of law and shall promptly issue to the commissioner or

 5-3     the commissioner's designee a proposal for decision as to the

 5-4     occurrence of the violation and a recommendation as to the amount

 5-5     of the proposed penalty if a penalty is determined to be warranted.

 5-6           (c)  Based on the findings of fact and conclusions of law and

 5-7     the recommendations of the hearings examiner, the commissioner or

 5-8     the commission's designee by order may find that a violation has

 5-9     occurred and may assess a penalty or may find that no violation has

5-10     occurred.

5-11           Sec. 142.0173.  NOTICE AND PAYMENT OF ADMINISTRATIVE PENALTY;

5-12     JUDICIAL REVIEW; REFUND.  (a)  The department shall give notice of

5-13     the order under Section 142.0172(c) to the person alleged to have

5-14     committed the violation.  The notice must include:

5-15                 (1)  separate statements of the findings of fact and

5-16     conclusions of law;

5-17                 (2)  the amount of any penalty assessed; and

5-18                 (3)  a statement of the right of the person to judicial

5-19     review of the order.

5-20           (b)  Not later than the 30th day after the date on which the

5-21     decision is final as provided by Chapter 2001, Government Code, the

5-22     person shall:

5-23                 (1)  pay the penalty;

5-24                 (2)  pay the amount of the penalty and file a petition

5-25     for judicial review contesting the occurrence of the violation, the

5-26     amount of the penalty, or both the occurrence of the violation and

5-27     the amount of the penalty; or

5-28                 (3)  without paying the penalty, file a petition for

5-29     judicial review contesting the occurrence of the violation, the

5-30     amount of the penalty, or both the occurrence of the violation and

5-31     the amount of the penalty.

5-32           (c)  Within the 30-day period, a person who acts under

5-33     Subsection (b)(3) may:

5-34                 (1)  stay enforcement of the penalty by:

5-35                       (A)  paying the penalty to the court for

5-36     placement in an escrow account; or

5-37                       (B)  giving to the court a supersedeas bond that

5-38     is approved by the court for the amount of the penalty and that is

5-39     effective until all judicial review of the order is final; or

5-40                 (2)  request the court to stay enforcement of the

5-41     penalty by:

5-42                       (A)  filing with the court a sworn affidavit of

5-43     the person stating that the person is financially unable to pay the

5-44     amount of the penalty and is financially unable to give the

5-45     supersedeas bond; and

5-46                       (B)  giving a copy of the affidavit to the

5-47     department by certified mail.

5-48           (d)  If the department receives a copy of an affidavit under

5-49     Subsection (c)(2), the department may file with the court, within

5-50     10 days after the date the copy is received, a contest to the

5-51     affidavit.  The court shall hold a hearing on the facts alleged in

5-52     the affidavit as soon as practicable and shall stay the enforcement

5-53     of the penalty on finding that the alleged facts are true.  The

5-54     person who files an affidavit has the burden of proving that the

5-55     person is financially unable to pay the penalty and to give a

5-56     supersedeas bond.

5-57           (e)  If the person does not pay the penalty and the

5-58     enforcement of the penalty is not stayed, the department may refer

5-59     the matter to the attorney general for collection of the penalty.

5-60           (f)  Judicial review of the order:

5-61                 (1)  is instituted by filing a petition as provided by

5-62     Subchapter G, Chapter 2001, Government Code; and

5-63                 (2)  is under the substantial evidence rule.

5-64           (g)  If the court sustains the occurrence of the violation,

5-65     the court may uphold or reduce the amount of the penalty and order

5-66     the person to pay the full or reduced amount of the penalty.  If

5-67     the court does not sustain the occurrence of the violation, the

5-68     court shall order that no penalty is owed.

5-69           (h)  When the judgment of the court becomes final, the court

 6-1     shall proceed under this subsection.  If the person paid the amount

 6-2     of the penalty under Subsection (b)(2) and if that amount is

 6-3     reduced or is not upheld by the court, the court shall order that

 6-4     the department pay the appropriate amount plus accrued interest to

 6-5     the person.  The rate of the interest is the rate charged on loans

 6-6     to depository institutions by the New York Federal Reserve Bank,

 6-7     and the interest shall be paid for the period beginning on the date

 6-8     the penalty was paid and ending on the date the penalty is

 6-9     remitted.  If the person paid the penalty under Subsection

6-10     (c)(1)(A), or gave a supersedeas bond, and if the amount of the

6-11     penalty is not upheld by the court, the court shall order the

6-12     release of the escrow account or bond.  If the person paid the

6-13     penalty under Subsection (c)(1)(A) and the amount of the penalty is

6-14     reduced, the court shall order that the amount of the penalty be

6-15     paid to the department from the escrow account and that the

6-16     remainder of the account be released.  If the person gave a

6-17     supersedeas bond and if the amount of the penalty is reduced, the

6-18     court shall order the release of the bond after the person pays the

6-19     amount.

6-20           Sec. 142.0174.  PENALTY DEPOSITED TO STATE TREASURY.  An

6-21     administrative penalty collected under this subchapter shall be

6-22     deposited in the state treasury to the credit of the general

6-23     revenue fund.

6-24           Sec. 142.0175.  EXPENSES AND COSTS FOR COLLECTION OF CIVIL OR

6-25     ADMINISTRATIVE PENALTY.  (a)  If the attorney general brings an

6-26     action against a person under Section 142.013 or 142.014 or to

6-27     enforce an administrative penalty assessed under Section 142.0173

6-28     and an injunction is granted against the person or the person is

6-29     found liable for a civil or administrative penalty, the attorney

6-30     general may recover, on behalf of the attorney general and the

6-31     department, reasonable expenses and costs.

6-32           (c)  For purposes of this section, reasonable expenses and

6-33     costs include expenses incurred by the department and the attorney

6-34     general in the investigation, initiation, and prosecution of an

6-35     action, including reasonable investigative costs, attorney's fees,

6-36     witness fees, and deposition expenses.

6-37           SECTION 6.  Section 142.021, Health and Safety Code, is

6-38     amended to read as follows:

6-39           Sec. 142.021.  ADMINISTRATION OF MEDICATION.  A person may

6-40     not administer medication to a client of a home and community

6-41     support services agency unless the person:

6-42                 (1)  holds a license under state law that authorizes

6-43     the person to administer medication;

6-44                 (2)  holds a permit issued under Section 142.025 and

6-45     acts under the delegated authority of a person who holds a license

6-46     under state law that authorizes the person to administer

6-47     medication;

6-48                 (3)  acts under the delegated authority of a physician

6-49     [performs duties as a qualified dialysis technician within the

6-50     scope authorized by board rules];

6-51                 (4)  administers a medication to a client of a home and

6-52     community support service agency in accordance with rules of the

6-53     Board of Nurse Examiners that permit delegation of the

6-54     administration of medication to a person not holding a permit under

6-55     Section 142.025; or

6-56                 (5)  administers noninjectable medication under

6-57     circumstances authorized by the memorandum of understanding adopted

6-58     under Section 142.016.

6-59           SECTION 7.  This Act takes effect September 1, 1997.

6-60           SECTION 8.  The importance of this legislation and the

6-61     crowded condition of the calendars in both houses create an

6-62     emergency and an imperative public necessity that the

6-63     constitutional rule requiring bills to be read on three several

6-64     days in each house be suspended, and this rule is hereby suspended.

6-65                                  * * * * *