1-1     By:  Moncrief, et al.                                   S.B. No. 93
 1-2           (In the Senate - Filed December 14, 1998; January 26, 1999,
 1-3     read first time and referred to Committee on Health Services;
 1-4     March 4, 1999, reported adversely, with favorable Committee
 1-5     Substitute by the following vote:  Yeas 5, Nays 0; March 4, 1999,
 1-6     sent to printer.)
 1-7     COMMITTEE SUBSTITUTE FOR S.B. No. 93                  By:  Moncrief
 1-8                            A BILL TO BE ENTITLED
 1-9                                   AN ACT
1-10     relating to the regulation of assisted living facilities and
1-11     requiring disclosures by certain other facilities serving persons
1-12     who are elderly or disabled.
1-13           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-14           SECTION 1.  AMENDMENT.  Chapter 247, Health and Safety Code,
1-15     is amended to read as follows:
1-16          CHAPTER 247.  ASSISTED LIVING [PERSONAL CARE] FACILITIES
1-17                      SUBCHAPTER A.  GENERAL PROVISIONS
1-18           Sec. 247.001.  SHORT TITLE.  This chapter may be cited as the
1-19     Assisted Living [Personal Care] Facility Licensing Act.
1-20           Sec. 247.0011.  SCOPE, PURPOSE, AND IMPLEMENTATION.  (a)  The
1-21     purpose of this chapter is to ensure that assisted living
1-22     facilities in this state deliver the highest possible quality of
1-23     care.  This chapter and the rules adopted under this chapter
1-24     establish minimum acceptable levels of care, and a violation of a
1-25     minimum acceptable level of care established under this chapter is
1-26     a violation of law.  For purposes of this chapter, components of
1-27     quality of care include:
1-28                 (1)  resident independence and self-determination;
1-29                 (2)  humane treatment;
1-30                 (3)  conservative intervention;
1-31                 (4)  access to care;
1-32                 (5)  continuity of care;
1-33                 (6)  coordination of services;
1-34                 (7)  safe surroundings;
1-35                 (8)  professionalism of service providers;
1-36                 (9)  participation in useful studies; and
1-37                 (10)  quality of life.
1-38           (b)  The department shall protect residents of assisted
1-39     living facilities by:
1-40                 (1)  adopting rules relating to quality of care and
1-41     quality of life;
1-42                 (2)  adopting rules relating to the assessment of the
1-43     condition and service needs of each resident;
1-44                 (3)  promoting policies that maximize the dignity,
1-45     autonomy, privacy, and independence of each resident;
1-46                 (4)  regulating the construction, maintenance, and
1-47     operation of assisted living facilities;
1-48                 (5)  strictly monitoring factors relating to the
1-49     health, safety, welfare, and dignity of each resident;
1-50                 (6)  imposing prompt and effective remedies for
1-51     violations of this chapter and rules and standards adopted under
1-52     this chapter;
1-53                 (7)  providing a residential environment that allows
1-54     residents to maintain the highest possible degree of independence
1-55     and self-determination; and
1-56                 (8)  providing the public with helpful and
1-57     understandable information relating to the operation of assisted
1-58     living facilities in this state.
1-59           (c)  Assisted living services are driven by a service
1-60     philosophy that emphasizes personal dignity, autonomy,
1-61     independence, and privacy.  Assisted living services should enhance
1-62     a person's ability to age in place in a residential setting while
1-63     receiving increasing or decreasing levels of service as the
1-64     person's needs change.
 2-1           Sec. 247.002.  DEFINITIONS.  In this chapter:
 2-2                 (1)  "Assisted living facility" means an establishment
 2-3     that:
 2-4                       (A)  furnishes, in one or more facilities, food
 2-5     and shelter to four or more persons who are unrelated to the
 2-6     proprietor of the establishment; and
 2-7                       (B)  provides personal care services.
 2-8                 (2)  "Board" means the Texas Board of Human Services.
 2-9                 (3)  "Controlling person" means a person who controls
2-10     an assisted living facility or other person as described by Section
2-11     247.005.
2-12                 (4) [(2)]  "Department" means the Texas Department of
2-13     Human Services.
2-14                 (5) [(3)  "Personal care facility" means an
2-15     establishment, including a board and care home, that:]
2-16                       [(A)  furnishes, in one or more facilities, food
2-17     and shelter to four or more persons who are unrelated to the
2-18     proprietor of the establishment; and]
2-19                       [(B)  provides personal care services.]
2-20                 [(4)]  "Personal care services" means:
2-21                       (A)  assistance with meals, dressing, movement,
2-22     bathing, or other personal needs or maintenance;
2-23                       (B)  the administration of medication by a person
2-24     licensed to administer medication or the assistance with or
2-25     supervision of medication; or
2-26                       (C)  general supervision or oversight of the
2-27     physical and mental well-being of a person who needs assistance to
2-28     maintain a private and independent residence in an assisted living
2-29     [a personal care] facility or who needs assistance to manage the
2-30     person's personal life, regardless of whether a guardian has been
2-31     appointed for the person.
2-32                 (6) [(5)]  "Qualified religious society" means a
2-33     church, synagogue, or other organization or association that is
2-34     organized primarily for religious purposes and that:
2-35                       (A)  has been in existence in this state for at
2-36     least 35 years; and
2-37                       (B)  does not distribute any of its income to its
2-38     members, officers, or governing body other than as reasonable
2-39     compensation for services or reimbursement of expenses.
2-40           Sec. 247.003.  APPLICATION OF OTHER LAW.  (a)  Except as
2-41     provided by Subsection (b), Chapter 242 does not apply to an
2-42     assisted living [a personal care] facility licensed under this
2-43     chapter.
2-44           (b)  Subchapter D, Chapter 242, applies to an assisted living
2-45     [a personal care] facility, and the department shall administer and
2-46     enforce that subchapter for an assisted living [a personal care]
2-47     facility in the same manner it is administered and enforced for a
2-48     nursing home.
2-49           Sec. 247.004.  EXEMPTIONS.  This chapter does not apply to:
2-50                 (1)  a boarding facility that has rooms for rent and
2-51     that may offer community meals, light housework, meal preparation,
2-52     transportation, grocery shopping, money management, or laundry
2-53     services but that does not provide personal care services;
2-54                 (2)  an establishment conducted by or for the adherents
2-55     of the Church of Christ, Scientist, for the purpose of providing
2-56     facilities for the care or treatment of the sick who depend
2-57     exclusively on prayer or spiritual means for healing without the
2-58     use of any drug or material remedy if the establishment complies
2-59     with local safety, sanitary, and quarantine ordinances and
2-60     regulations; [or]
2-61                 (3)  a facility conducted by or for the adherents of a
2-62     qualified religious society classified as a tax-exempt organization
2-63     under an Internal Revenue Service group exemption ruling for the
2-64     purpose of providing personal care services without charge solely
2-65     for the society's professed members or ministers in retirement, if
2-66     the facility complies with local safety, sanitation, and quarantine
2-67     ordinances and regulations; or
2-68                 (4)  a facility that provides personal care services
2-69     only to persons enrolled in a program that is funded in whole or in
 3-1     part by the Texas Department of Mental Health and Mental
 3-2     Retardation and that is monitored by the Texas Department of Mental
 3-3     Health and Mental Retardation or its designated local authority in
 3-4     accordance with standards set by the Texas Department of Mental
 3-5     Health and Mental Retardation.
 3-6           Sec. 247.005.  CONTROLLING PERSON.  (a)  A person is a
 3-7     controlling person if the person, acting alone or with others, has
 3-8     the ability to directly or indirectly influence, direct, or cause
 3-9     the direction of the management, expenditure of money, or policies
3-10     of an assisted living facility or other person.
3-11           (b)  For purposes of this chapter, "controlling person"
3-12     includes:
3-13                 (1)  a management company, landlord, or other business
3-14     entity that operates or contracts with others for the operation of
3-15     an assisted living facility;
3-16                 (2)  a person who is a controlling person of a
3-17     management company or other business entity that operates an
3-18     assisted living facility or that contracts with another person for
3-19     the operation of an assisted living facility; and
3-20                 (3)  any other individual who, because of a personal,
3-21     familial, or other relationship with the owner, manager, landlord,
3-22     tenant, or provider of an assisted living facility, is in a
3-23     position of actual control or authority with respect to the
3-24     facility, without regard to whether the individual is formally
3-25     named as an owner, manager, director, officer, provider,
3-26     consultant, contractor, or employee of the facility.
3-27           (c)  A controlling person described by Subsection (b)(3) does
3-28     not include an employee, lender, secured creditor, landlord, or
3-29     other person who does not exercise formal or actual influence or
3-30     control over the operation of an assisted living facility.
3-31           (d)  The department may adopt rules that specify the
3-32     ownership interests and other relationships that qualify a person
3-33     as a controlling person.
3-34               SUBCHAPTER B.  LICENSING, FEES, AND INSPECTIONS
3-35           Sec. 247.021.  LICENSE REQUIRED.  (a)  A person may not
3-36     establish or operate an assisted living [a personal care] facility
3-37     without a license issued under this chapter.
3-38           (b)  A person establishing or operating a facility that is
3-39     not required to be licensed under this chapter may not use the term
3-40     "assisted living" in referring to the facility or the services
3-41     provided at the facility.
3-42           (c)  A person establishing or operating a facility that is
3-43     not required to be licensed but who elects to obtain a license
3-44     under this chapter may use the term "assisted living" in referring
3-45     to the facility or the services provided at the facility.
3-46           (d)  The department by rule shall establish procedures to
3-47     issue a six-month provisional license to existing facilities with
3-48     residents.  The department may issue a provisional license only if:
3-49                 (1)  the facility is in compliance with resident care
3-50     standards;
3-51                 (2)  the facility voluntarily discloses that the
3-52     facility needs additional time to comply with life safety code and
3-53     physical plant standards;
3-54                 (3)  the disclosure is made in writing by certified
3-55     mail to the department;
3-56                 (4)  an investigation of the violation was not
3-57     initiated and the violation was not independently detected by the
3-58     department; and
3-59                 (5)  the disclosure is made promptly after knowledge of
3-60     the information disclosed is obtained by the facility.
3-61           (e) [(c)]  If, at the end of the six-month provisional
3-62     license period, the facility does not meet life safety code and
3-63     physical plant standards, the department may not issue a license to
3-64     the facility.
3-65           Sec. 247.022.  LICENSE APPLICATION.  (a)  An applicant for an
3-66     assisted living [a personal care] facility license must submit an
3-67     application to the department on a form prescribed by the
3-68     department.
3-69           (b)  Each application must be accompanied by a nonrefundable
 4-1     license fee in an amount set by the board.
 4-2           (c)  The department may provide technical assistance to an
 4-3     applicant by making brief inspections of the assisted living
 4-4     [personal care] facility proposed to be licensed and making
 4-5     recommendations concerning actions necessary to meet standards for
 4-6     assisted living [personal care] facilities.
 4-7           Sec. 247.023.  ISSUANCE AND RENEWAL OF LICENSE.  (a)  The
 4-8     department shall issue a license if, after inspection and
 4-9     investigation, it finds that the applicant, [and] the assisted
4-10     living [personal care] facility, and all controlling persons with
4-11     respect to the applicant or facility meet the requirements of this
4-12     chapter and the standards adopted under this chapter.
4-13           (b)  To renew a license, the license holder must submit to
4-14     the department the annual license renewal fee.
4-15           (c)  The board may require participation in a continuing
4-16     education program as a condition of renewal of a license.  The
4-17     board shall adopt rules to implement this subsection.
4-18           Sec. 247.0231.  COMPLIANCE RECORD IN OTHER STATES.  The
4-19     department may require an applicant or license holder to provide
4-20     the department with information relating to compliance by the
4-21     applicant, the license holder, or a controlling person with respect
4-22     to the applicant or license holder with regulatory requirements in
4-23     another state in which the applicant, license holder, or
4-24     controlling person operates or operated an assisted living
4-25     facility.
4-26           Sec. 247.024.  FEES; DISPOSITION OF REVENUE.  (a)  The board
4-27     shall set license fees imposed by this chapter:
4-28                 (1)  on the basis of the number of beds in assisted
4-29     living facilities required to pay the fee; and
4-30                 (2)  in amounts reasonable and necessary to defray the
4-31     cost of administering this chapter, but not to exceed $750[:]
4-32                 [(1)  $300 for a personal care facility that has not
4-33     more than 10 beds;]
4-34                 [(2)  $350 for a personal care facility that has not
4-35     less than 11 or more than 20 beds; and]
4-36                 [(3)  $400 for a personal care facility that has 21 or
4-37     more beds].
4-38           (b)  The board shall establish by rule a base fee schedule
4-39     and a per bed fee schedule.
4-40           (c)  All fees or penalties collected under this chapter shall
4-41     be deposited in the state treasury to the credit of the general
4-42     revenue fund and shall be appropriated to the department only to
4-43     administer and enforce this chapter.
4-44           (d) [(c)]  Investigation fees or attorney's fees may not be
4-45     assessed against or collected from an assisted living [a personal
4-46     care] facility by or on behalf of the department or another state
4-47     agency unless the department or other state agency assesses and
4-48     collects a penalty authorized by this chapter from the facility.
4-49           Sec. 247.025.  ADOPTION OF RULES.  The board shall adopt
4-50     rules necessary to implement this chapter, including requirements
4-51     for the issuance, renewal, denial, suspension, and revocation of a
4-52     license to operate an assisted living [a personal care] facility.
4-53           Sec. 247.026.  STANDARDS.  (a)  The board by rule shall
4-54     prescribe minimum standards to protect the health and safety of an
4-55     assisted living [a personal care] facility resident.
4-56           (b)  The standards must:
4-57                 (1)  clearly differentiate an assisted living [a
4-58     personal care] facility from an institution required to be licensed
4-59     under Chapter 242;
4-60                 (2)  ensure quality care and protection of the
4-61     residents' health and safety without excessive cost; and
4-62                 (3)  require an assisted living [a personal care]
4-63     facility to:
4-64                       (A)  indicate [use its license number] in all
4-65     advertisements, solicitations, and promotional materials that the
4-66     facility is licensed by the department or that an application for a
4-67     license is pending before the department; and
4-68                       (B)  provide each prospective resident or
4-69     prospective resident's representative, as appropriate, with a
 5-1     consumer disclosure statement in a standard form adopted by the
 5-2     department.
 5-3           (c)  The board shall require an assisted living facility that
 5-4     provides brain injury rehabilitation services to include in the
 5-5     facility's consumer disclosure statement a specific statement that
 5-6     licensure as an assisted living facility does not indicate state
 5-7     review, approval, or endorsement of the facility's rehabilitation
 5-8     services.
 5-9           (d)  The board may prescribe different levels of minimum
5-10     standards for assisted living [personal care] facilities according
5-11     to the number of residents, the type of residents, the level of
5-12     personal care provided, and other distinctions the board considers
5-13     relevant.
5-14           (e) [(d)]  Local health and safety standards adopted by the
5-15     municipality in which an assisted living [a personal care] facility
5-16     is located do not apply to the facility unless the standards
5-17     specifically state that they apply to assisted living [personal
5-18     care] facilities.
5-19           (f) [(e)]  The board by rule shall prescribe minimum
5-20     standards requiring appropriate training in geriatric care for each
5-21     individual who provides services to geriatric residents as an
5-22     employee of an assisted living [a personal care] facility and who
5-23     holds a license or certificate issued by an agency of this state
5-24     that authorizes the person to provide the services.  The minimum
5-25     standards may require that each licensed or certified individual
5-26     complete an appropriate program of continuing education or
5-27     in-service training, as determined by board rule, on a schedule
5-28     determined by board rule.
5-29           (g) [(f)]  Any individual otherwise qualified, who has been
5-30     employed by a licensed assisted living [personal care] facility for
5-31     at least 90 days, shall be eligible to be certified as a medication
5-32     aide following completion of the required course of study and
5-33     successful completion of any required examination.
5-34           (h)  An individual may not serve as the manager of an
5-35     assisted living facility that has 17 beds or more unless the
5-36     individual:
5-37                 (1)  has an associate's degree in nursing, health care
5-38     management, or a related field from a public or private institution
5-39     of higher education;
5-40                 (2)  has a bachelor's degree from a public or private
5-41     institution of higher education; or
5-42                 (3)  has at least one year of experience working in
5-43     management or in the health care industry.
5-44           (i)  The board by rule shall require each manager of an
5-45     assisted living facility that has 17 beds or more to complete at
5-46     least one educational course on the management of assisted living
5-47     facilities not later than the first anniversary of the date the
5-48     manager begins employment in that capacity.
5-49           Sec. 247.0261.  EARLY COMPLIANCE REVIEW.  (a)  The department
5-50     by rule shall adopt a procedure under which a person proposing to
5-51     construct or modify an assisted living facility may submit building
5-52     plans to the department for review for compliance with the
5-53     department's architectural requirements before beginning
5-54     construction or modification.  In adopting the procedure, the
5-55     department shall set reasonable deadlines by which the department
5-56     must complete review of submitted plans.
5-57           (b)  The department shall, within 30 days, review plans
5-58     submitted under this section for compliance with the department's
5-59     architectural requirements and inform the person of the results of
5-60     the review.  If the plans comply with the department's
5-61     architectural requirements, the department may not subsequently
5-62     change the architectural requirements applicable to the project
5-63     unless:
5-64                 (1)  the change is required by federal law; or
5-65                 (2)  the person fails to complete the project within a
5-66     reasonable time.
5-67           (c)  The department may charge a reasonable fee for
5-68     conducting a review under this section.
5-69           (d)  A fee collected under this section shall be deposited in
 6-1     the general revenue fund to the credit of the assisted living
 6-2     account and shall be appropriated only to the department to conduct
 6-3     reviews under this section.
 6-4           (e)  The review procedure provided by this section does not
 6-5     include review of building plans for compliance with the Texas
 6-6     Accessibility Standards as administered and enforced by the Texas
 6-7     Department of Licensing and Regulation.
 6-8           Sec. 247.027.  INSPECTIONS.  In addition to the inspection
 6-9     required under Section 247.023(a), the department may inspect an
6-10     assisted living [a personal care] facility annually and may inspect
6-11     a facility at other reasonable times as necessary to assure
6-12     compliance with this chapter.
6-13           Sec. 247.0271.  INSPECTOR TRAINING.  (a)  The department
6-14     shall develop and implement a training program to provide
6-15     specialized training to department employees who inspect assisted
6-16     living facilities under this chapter.  The training must emphasize
6-17     the distinction between an assisted living facility and an
6-18     institution licensed under Chapter 242.
6-19           (b)  In developing and updating the training program required
6-20     by this section, the department shall consult with operators of
6-21     assisted living facilities and consumers of personal care services
6-22     provided by assisted living facilities or legal representatives of
6-23     those consumers.
6-24           Sec. 247.028.  ASSISTANCE BY DEPARTMENT.  The department may
6-25     provide assistance to an assisted living [a personal care]
6-26     facility, including the provision of training materials, the
6-27     coordination of training conferences and workshops with other state
6-28     agencies, and the development of a provider's handbook explaining
6-29     assisted living [personal care] facility rules.
6-30           Sec. 247.029.  FACILITIES FOR PERSONS WITH ALZHEIMER'S
6-31     DISEASE.  (a)  The board by rule shall establish a classification
6-32     and license for a facility that advertises, markets, or otherwise
6-33     promotes that the facility provides personal care services to
6-34     residents who have Alzheimer's disease or related disorders.  A
6-35     facility is not required to be classified under this section to
6-36     provide care or treatment to residents who have Alzheimer's disease
6-37     or related disorders.
6-38           (b)  The board shall adopt minimum standards for an assisted
6-39     living [a personal care] facility classified under this section.
6-40           (c)  An individual may not serve as the manager of an
6-41     assisted living facility classified under this section or as the
6-42     supervisor of an assisted living facility unit classified under
6-43     this section unless the individual is at least 21 years of age and
6-44     has:
6-45                 (1)  a bachelor's degree from a public or private
6-46     institution of higher education in psychology, gerontology,
6-47     nursing, or a related field; or
6-48                 (2)  at least one year of experience working with
6-49     persons with dementia.
6-50           Sec. 247.030.  FACILITIES FOR SUPERVISION OF MEDICATION AND
6-51     GENERAL WELFARE.  (a)  The board by rule shall establish a
6-52     classification and license for a facility that provides only
6-53     medication supervision and general supervision of residents'
6-54     welfare.
6-55           (b)  The board shall adopt minimum standards for an assisted
6-56     living facility classified under this section, including standards
6-57     imposing adequate requirements relating to medication supervision.
6-58     The board shall modify standards generally applicable to a facility
6-59     licensed under this chapter as necessary for a facility classified
6-60     under this section to reflect the level of services provided by the
6-61     facility.
6-62           Sec. 247.031 [247.029].  MUNICIPAL ENFORCEMENT.  The
6-63     governing body of a municipality by ordinance may:
6-64                 (1)  prohibit a person who does not hold a license
6-65     issued under this chapter from establishing or operating an
6-66     assisted living [a personal care] facility within the municipality;
6-67     and
6-68                 (2)  establish a procedure for emergency closure of a
6-69     facility in circumstances in which:
 7-1                       (A)  the facility is established or operating in
 7-2     violation of Section 247.021; and
 7-3                       (B)  the continued operation of the facility
 7-4     creates an immediate threat to the health and safety of a resident
 7-5     of the facility.
 7-6                     SUBCHAPTER C.  GENERAL ENFORCEMENT
 7-7           Sec. 247.041.  DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
 7-8     (a)  The department may deny, suspend, or revoke a license for a
 7-9     violation of this chapter or a rule adopted under this chapter.
7-10           (b)  The denial, suspension, or revocation of a license by
7-11     the department and the appeal from that action are governed by the
7-12     procedures for a contested case hearing under Chapter 2001,
7-13     Government Code.
7-14           Sec. 247.042.  EMERGENCY SUSPENSION OR CLOSING ORDER.
7-15     (a)  If the department finds an assisted living [a personal care]
7-16     facility operating in violation of the standards prescribed under
7-17     this chapter and the violations create an immediate threat to the
7-18     health and safety of a resident in the facility, the department
7-19     shall suspend the license or order immediate closing of all or part
7-20     of the facility.
7-21           (b)  The order suspending a license under Subsection (a) is
7-22     effective immediately on written notice to the license holder or on
7-23     the date specified in the order.
7-24           (c)  The order suspending the license and ordering closure of
7-25     all or part of an assisted living [a personal care] facility is
7-26     valid for 10 days after its effective date.
7-27           (d)  The department shall provide for the relocation of
7-28     residents of an assisted living [a personal care] facility that is
7-29     closed.  The relocation may not be to a facility with a more
7-30     restrictive environment unless all other reasonable alternatives
7-31     are exhausted.  Relocation procedures shall be adopted as part of
7-32     the memorandum of understanding adopted under Section 247.061
7-33     [247.062].
7-34           Sec. 247.043.  INVESTIGATION OF ABUSE, EXPLOITATION, OR
7-35     NEGLECT.  (a)  The department shall conduct a preliminary
7-36     investigation of each allegation of abuse, exploitation, or neglect
7-37     of a resident of an assisted living [a personal care] facility to
7-38     determine if there is evidence to corroborate the allegation.  If
7-39     the department determines that there is evidence to corroborate the
7-40     allegation, the department shall conduct a thorough investigation
7-41     of the allegation.
7-42           (b)  If the thorough investigation reveals that abuse,
7-43     exploitation, or neglect has occurred, the department shall:
7-44                 (1)  implement enforcement measures, including closing
7-45     the facility, revoking the facility's license, relocating
7-46     residents, and making referrals to law enforcement agencies;
7-47                 (2)  notify the Department of Protective and Regulatory
7-48     Services of the results of the investigation;
7-49                 (3)  notify a health and human services agency, as
7-50     defined by Section 531.001, Government Code, that contracts with
7-51     the facility for the delivery of personal care services of the
7-52     results of the investigation; and
7-53                 (4)  provide to a contracting health and human services
7-54     agency access to the department's documents or records relating to
7-55     the investigation.
7-56           (c)  Providing access to a confidential document or record
7-57     under Subsection (b)(4) does not constitute a waiver of
7-58     confidentiality.
7-59           Sec. 247.044.  INJUNCTION.  (a)  The department may petition
7-60     a district court for a temporary restraining order to restrain a
7-61     continuing violation of the standards or licensing requirements
7-62     provided under this chapter if the department finds that:
7-63                 (1)  the violation creates an immediate threat to the
7-64     health and safety of the assisted living [personal care] facility
7-65     residents; or
7-66                 (2)  the facility is operating without a license.
7-67           (b)  A district court, on petition of the department and on a
7-68     finding by the court that a person is violating the standards or
7-69     licensing requirements provided under this chapter, may by
 8-1     injunction:
 8-2                 (1)  prohibit a person from continuing a violation of
 8-3     the standards or licensing requirements provided under this
 8-4     chapter;
 8-5                 (2)  restrain the establishment or operation of an
 8-6     assisted living [a personal care] facility without a license issued
 8-7     under this chapter; or
 8-8                 (3)  grant any other injunctive relief warranted by the
 8-9     facts.
8-10           (c)  The department may petition a district court for a
8-11     temporary restraining order to inspect a facility allegedly
8-12     required to be licensed and operating without a license when
8-13     admission to the facility cannot be obtained.  If it is shown that
8-14     admission to the facility cannot be obtained, the court shall order
8-15     the facility to allow the department admission to the facility.
8-16           (d)  The attorney general or local prosecuting attorney may
8-17     institute and conduct a suit authorized by this section at the
8-18     request of the department.
8-19           (e)  Venue for a suit brought under this section is in the
8-20     county in which the assisted living [personal care] facility is
8-21     located or in Travis County.
8-22           Sec. 247.045.  CIVIL PENALTIES.  (a)  Except as provided by
8-23     Subsections [Subsection] (b) and (c), a person who violates this
8-24     chapter or who fails to comply with a rule adopted under this
8-25     chapter and whose violation is determined by the department to
8-26     threaten the health and safety of a resident of an assisted living
8-27     [a personal care] facility is subject to a civil penalty of not
8-28     less than $100 nor more than $10,000 for each act of violation.
8-29     Each day of a continuing violation constitutes a separate ground of
8-30     recovery.
8-31           (b)  A person is subject to a civil penalty if the person:
8-32                 (1)  is in violation of Section 247.021; or
8-33                 (2)  has been determined to be in violation of Section
8-34     247.021 and violates any other provision of this chapter or fails
8-35     to comply with a rule adopted under this chapter.
8-36           [(b)  A person who does not possess a license for a personal
8-37     care facility as required by Section 247.021 is subject to a civil
8-38     penalty of not less than $1,000 nor more than $10,000 for each act
8-39     of violation.  Each day of a continuing violation constitutes a
8-40     separate ground for recovery.]
8-41           (c)  The amount of a civil penalty under Subsection (b) may
8-42     not be less than $1,000 or more than $10,000 for each act of
8-43     violation.  Each day of a continuing violation constitutes a
8-44     separate ground of recovery.
8-45           (d)  The attorney general may institute and conduct a suit to
8-46     collect a penalty and fees under this section at the request of the
8-47     department.  [(c)]  If the attorney general fails to take action
8-48     within 30 days of referral from the department, the department
8-49     shall refer the case to the local district attorney, county
8-50     attorney, or city attorney.  The district attorney, county
8-51     attorney, or city attorney shall file suit in a district court to
8-52     collect and retain the penalty.
8-53           (e) [(d)]  Investigation and attorney's fees may not be
8-54     assessed or collected by or on behalf of the department or other
8-55     state agency unless the department or other state agency assesses
8-56     and collects a penalty described under this chapter.
8-57           (f) [(e)]  The department and attorney general, or other
8-58     legal representative as described in Subsection (d) [(c)], shall
8-59     work in close cooperation throughout any legal proceedings
8-60     requested by the department.
8-61           (g) [(f)]  The commissioner of human services must approve
8-62     any settlement agreement to a suit brought under this chapter.
8-63           Sec. 247.046.  COOPERATION AMONG AGENCIES.  The board, the
8-64     Department of Protective and Regulatory Services, and the attorney
8-65     general shall adopt by rule a memorandum of understanding that:
8-66                 (1)  defines each agency's responsibilities concerning
8-67     assisted living [personal care] facilities and coordinates each
8-68     agency's activities;
8-69                 (2)  details coordinated procedures to be used by each
 9-1     agency in responding to complaints relating to neglect or abuse of
 9-2     residents of facilities, to substandard facilities, and to
 9-3     unlicensed facilities;
 9-4                 (3)  identifies enforcement needs each agency may have
 9-5     in order to perform its duties under the memorandum of
 9-6     understanding, including any need for access to information or to
 9-7     facilities under investigation or operating under a plan of
 9-8     correction; and
 9-9                 (4)  provides a plan for correcting violations in
9-10     substandard or unlicensed assisted living [personal care]
9-11     facilities that specifies the conditions under which it is
9-12     appropriate to impose such a plan and that outlines a schedule of
9-13     implementation for the plan.
9-14           Sec. 247.047 [247.046].  TRANSITION.  The department shall
9-15     grant to a personal care facility licensed on or before December
9-16     31, 1990, under Chapter 242 a temporary permit to continue
9-17     operation until the department performs any inspection or
9-18     investigation required by this chapter.
9-19           Sec. 247.048.  REGIONAL TRAINING FOR AGENCIES AND LOCAL
9-20     GOVERNMENTS.  The department periodically shall conduct regional
9-21     training programs for representatives of local governments and
9-22     appropriate state agencies relating to assisted living facility
9-23     concerns.  The training programs must provide to participants
9-24     information relating to the assisted living facility industry,
9-25     including information on:
9-26                 (1)  the general characteristics of assisted living
9-27     facilities and residents of those facilities;
9-28                 (2)  the different types of assisted living facilities;
9-29                 (3)  the laws applicable to assisted living facilities;
9-30     and
9-31                 (4)  the authority of the department and other entities
9-32     to enforce applicable laws.
9-33            SUBCHAPTER D.  ADVISORY COMMITTEE ON ASSISTED LIVING
9-34                         [PERSONAL CARE] FACILITIES
9-35           Sec. 247.051.  ADVISORY COMMITTEE.  (a)  The Advisory
9-36     Committee on Assisted Living [Personal Care] Facilities consists of
9-37     nine members appointed by the board.  The commissioner of human
9-38     services shall appoint two [one] staff members [member] from the
9-39     department to serve as [a] nonvoting advisory members [member].  In
9-40     appointing staff members under this subsection, the commissioner
9-41     shall appoint one member as a representative of long-term care
9-42     policy and one member as a representative of long-term care
9-43     regulation.
9-44           (b)  The board shall appoint the advisory committee to
9-45     provide for a balanced representation of personal care providers
9-46     and consumers and shall appoint one member who has expertise in
9-47     life safety code regulations.  At least one of the provider members
9-48     must be representative of a nonprofit facility, and at least one
9-49     member must be a family member of a resident of a facility.
9-50           (c)  The committee shall elect the presiding officer from
9-51     among its members.
9-52           (d)  The committee shall advise the department on standards
9-53     for licensing assisted living [personal care] facilities and on the
9-54     implementation of this chapter.
9-55                   SUBCHAPTER E.  MISCELLANEOUS PROVISIONS
9-56           Sec. 247.061.  [PILOT PROGRAM:  OFFICE OF PERSONAL CARE
9-57     FACILITY OMBUDSMAN.  (a)  The Texas Department on Aging, under its
9-58     office of long-term care ombudsman, shall establish and operate a
9-59     pilot program providing a personal care facility ombudsman in one
9-60     or more counties.]
9-61           [(b)  The department may operate the office directly or by
9-62     contract or memorandum of agreement with a public agency or other
9-63     appropriate private nonprofit organization, including an
9-64     organization for family members of persons with mental illness or
9-65     an advocacy group concerning mental health, disabilities, or senior
9-66     citizens.]
9-67           [(c)  The pilot program shall recruit volunteers and citizen
9-68     organizations to participate in the ombudsman program.]
9-69           [(d)  The office shall provide training to ombudsmen,
 10-1    including training in mental illness and special needs of the
 10-2    elderly or disabled.]
 10-3          [(e)  An ombudsman in the pilot program may not make
 10-4    investigations.]
 10-5          [(f)  The Texas Department on Aging and the department shall
 10-6    cooperate in developing guidelines for the pilot program.]
 10-7          [Sec. 247.062.]  COORDINATION BETWEEN AGENCIES.  (a)  The
 10-8    department and the attorney general shall adopt by rule a
 10-9    memorandum of understanding that:
10-10                (1)  defines each agency's responsibilities concerning
10-11    assisted living [personal care] facilities;
10-12                (2)  outlines and coordinates procedures to be used by
10-13    those agencies in responding to complaints concerning assisted
10-14    living [personal care] facilities; and
10-15                (3)  provides a plan for correcting violations or
10-16    deficiencies in assisted living [personal care] facilities.
10-17          (b)  The department shall prepare the initial draft of the
10-18    memorandum of understanding and shall facilitate and ensure its
10-19    adoption.
10-20          Sec. 247.062 [247.063].  DIRECTORY OF ASSISTED LIVING
10-21    [PERSONAL CARE] FACILITIES; CONSUMERS' GUIDE.  (a)  The department
10-22    shall prepare a directory of assisted living [personal care]
10-23    facilities that includes the name of the owner, the address and
10-24    telephone number of the facility, the number of beds in the
10-25    facility, and the facility's accessibility to disabled persons.
10-26          (b)  The department shall revise the directory annually and
10-27    shall make it available to the public.
10-28          (c)  The department shall prepare a consumers' guide to
10-29    assisted living [personal care] facilities and make it available to
10-30    the public.  The consumers' guide shall provide information on
10-31    licensing requirements for assisted living [personal care]
10-32    facilities, a brief description of minimum standards for
10-33    facilities, a copy of the residents' bill of rights, a copy of the
10-34    providers' bill of rights, and any other information that the
10-35    department determines may be useful to the public.
10-36          Sec. 247.063 [247.064].  REFERRALS.  (a)  If the Texas
10-37    Department of Mental Health and Mental Retardation or a local
10-38    mental health or mental retardation authority refers a patient or
10-39    client to an assisted living [a personal care] facility, the
10-40    referral may not be made to a [personal care] facility that is not
10-41    licensed under this chapter.
10-42          (b)  If the Texas Department of Mental Health and Mental
10-43    Retardation or a local mental health or mental retardation
10-44    authority gains knowledge of an assisted living [a personal care]
10-45    facility that is not operated or licensed by the Texas Department
10-46    of Mental Health and Mental Retardation, the authority, or the
10-47    Texas Department of Human Services and that has four or more
10-48    residents who are unrelated to the proprietor of the facility, the
10-49    Texas Department of Mental Health and Mental Retardation or the
10-50    authority shall report the name, address, and telephone number of
10-51    the facility to the Texas Department of Human Services.
10-52          Sec. 247.0631.  ACCESS.  An employee of the Texas Department
10-53    of Mental Health and Mental Retardation or an employee of a local
10-54    mental health and mental retardation authority may enter an
10-55    assisted living facility as necessary to provide services to a
10-56    resident of the facility.
10-57          Sec. 247.064 [247.065].  RESIDENTS' BILL OF RIGHTS.
10-58    (a)  Each assisted living [personal care] facility shall post a
10-59    residents' bill of rights in a prominent place in the facility.
10-60          (b)  The residents' bill of rights must provide that each
10-61    resident in the assisted living [personal care] facility has the
10-62    right to:
10-63                (1)  manage the resident's financial affairs;
10-64                (2)  determine the resident's dress, hair style, or
10-65    other personal effects according to individual preference, except
10-66    that the resident has the responsibility to maintain personal
10-67    hygiene;
10-68                (3)  retain and use personal property in the resident's
10-69    immediate living quarters and to have an individual locked cabinet
 11-1    in which to keep personal property;
 11-2                (4)  receive and send unopened mail;
 11-3                (5)  unaccompanied access to a telephone at a
 11-4    reasonable hour or in case of an emergency or personal crisis;
 11-5                (6)  privacy;
 11-6                (7)  unrestricted communication, including personal
 11-7    visitation with any person of the resident's choice, at any
 11-8    reasonable hour, including family members and representatives of
 11-9    advocacy groups and community service organizations;
11-10                (8)  make contacts with the community and to achieve
11-11    the highest level of independence, autonomy, and interaction with
11-12    the community of which the resident is capable;
11-13                (9)  present grievances on behalf of the resident or
11-14    others to the operator, state agencies, or other persons without
11-15    threat of reprisal in any manner;
11-16                (10)  a safe and decent living environment and
11-17    considerate and respectful care that recognizes the dignity and
11-18    individuality of the resident;
11-19                (11)  refuse to perform services for the facility,
11-20    except as contracted for by the resident and operator;
11-21                (12)  practice the religion of the resident's choice;
11-22                (13)  leave the facility temporarily or permanently,
11-23    subject to contractual or financial obligations; and
11-24                (14)  not be deprived of any constitutional, civil, or
11-25    legal right solely by reason of residence in an assisted living [a
11-26    personal care] facility.
11-27          (c)  The residents' bill of rights must be written in the
11-28    primary language of each resident of the facility and must also
11-29    provide the toll-free telephone number of the department for
11-30    reporting abuse or neglect.
11-31          (d)  The rights provided under this section do not take
11-32    precedence over health and safety rights of other residents of the
11-33    facility.
11-34          (e)  The department shall develop a residents' bill of rights
11-35    in accordance with this section and provide a copy to each
11-36    facility.  The copy shall be written in the primary language of
11-37    each resident of the facility.
11-38          Sec. 247.065 [247.066].  PROVIDERS' BILL OF RIGHTS.
11-39    (a)  Each assisted living [personal care] facility shall post a
11-40    providers' bill of rights in a prominent place in the facility.
11-41          (b)  The providers' bill of rights must provide that a
11-42    provider of personal care services has the right to:
11-43                (1)  be shown consideration and respect that recognizes
11-44    the dignity and individuality of the provider and assisted living
11-45    [personal care] facility;
11-46                (2)  terminate a resident's contract for just cause
11-47    after a written 30-day notice;
11-48                (3)  terminate a contract immediately, after notice to
11-49    the department, if the provider finds that a resident creates a
11-50    serious or immediate threat to the health, safety, or welfare of
11-51    other residents of the assisted living [personal care] facility;
11-52                (4)  present grievances, file complaints, or provide
11-53    information to state agencies or other persons without threat of
11-54    reprisal or retaliation;
11-55                (5)  refuse to perform services for the resident or the
11-56    resident's family other than those contracted for by the resident
11-57    and the provider;
11-58                (6)  contract with the community to achieve the highest
11-59    level of independence, autonomy, interaction, and services to
11-60    residents;
11-61                (7)  access to patient information concerning a client
11-62    referred to the facility, which must remain confidential as
11-63    provided by law;
11-64                (8)  refuse a person referred to the facility if the
11-65    referral is inappropriate;
11-66                (9)  maintain an environment free of weapons and drugs;
11-67    and
11-68                (10)  be made aware of a resident's problems, including
11-69    self-abuse, violent behavior, alcoholism, or drug abuse.
 12-1          Sec. 247.066.  APPROPRIATE PLACEMENT DETERMINATION.  (a)  The
 12-2    department may not require the removal and relocation of a resident
 12-3    of an assisted living facility if the resident's presence in the
 12-4    facility does not endanger other residents and the resident can
 12-5    receive adequate care at the facility through services:
 12-6                (1)  provided by the facility in accordance with its
 12-7    license; or
 12-8                (2)  obtained by the resident from other providers.
 12-9          (b)  In assessing whether a resident can receive adequate
12-10    care at a facility, the department shall consider all relevant
12-11    factors, including the placement preference expressed by the
12-12    resident with the agreement of the facility operator, the
12-13    resident's physician, and the resident's family members or other
12-14    representatives.
12-15          Sec. 247.067.  HEALTH CARE PROFESSIONALS.  (a)  In this
12-16    section, "health care professional" means an individual licensed,
12-17    certified, or otherwise authorized to administer health care, for
12-18    profit or otherwise, in the ordinary course of business or
12-19    professional practice.  The term includes a physician, registered
12-20    nurse, physical therapist, and occupational therapist.
12-21          (b)  A health care professional may provide services within
12-22    the professional's scope of practice to a resident of an assisted
12-23    living facility at the facility.  This subsection does not
12-24    authorize a health care professional to provide ongoing services to
12-25    a chronically ill resident comparable to the services available in
12-26    an institution licensed under Chapter 242.  A health care
12-27    professional providing services under this subsection shall
12-28    maintain medical records of those services in accordance with the
12-29    licensing, certification, or other regulatory standards applicable
12-30    to the health care professional under law.
12-31          Sec. 247.068.  RETALIATION PROHIBITED.  (a)  A person
12-32    licensed under this chapter may not retaliate against a person for
12-33    filing a complaint, presenting a grievance, or providing in good
12-34    faith information relating to personal care services provided by
12-35    the license holder.
12-36          (b)  This section does not prohibit a license holder from
12-37    terminating an employee for a reason other than retaliation.
12-38          SECTION 2.  AMENDMENT.  Subdivision (3), Section 250.001,
12-39    Health and Safety Code, is amended to read as follows:
12-40                (3)  "Facility" means:
12-41                      (A)  a nursing home, custodial care home, or
12-42    other institution licensed by the Texas Department of Human
12-43    Services under Chapter 242;
12-44                      (B)  an assisted living [a personal care]
12-45    facility licensed by the Texas Department of Human Services under
12-46    Chapter 247;
12-47                      (C)  a home health agency licensed [by the Texas
12-48    Department of Health] under Chapter 142;
12-49                      (D)  an adult day care facility [or adult day
12-50    health care facility] licensed by the Texas Department of Human
12-51    Services under Chapter 103, Human Resources Code;
12-52                      (E)  a facility for persons with mental
12-53    retardation licensed under Chapter 252 [or certified by the Texas
12-54    Department of Human Services];
12-55                      (F)  an unlicensed attendant care agency that
12-56    contracts with the Texas Department of Human Services;
12-57                      (G)  [an intermediate care facility for persons
12-58    with mental retardation that is certified by the Texas Department
12-59    of Human Services to participate in the Medicaid program under
12-60    Title XIX of the Social Security Act (42 U.S.C. Section 1396 et
12-61    seq.);]
12-62                      [(H)]  an adult foster care provider that
12-63    contracts with the Texas Department of Human Services; or
12-64                      (H) [(I)]  a facility that provides mental health
12-65    services and that is operated by or contracts with the Texas
12-66    Department of Mental Health and Mental Retardation.
12-67          SECTION 3.  AMENDMENT.  Section 36.002, Human Resources Code,
12-68    is amended to read as follows:
12-69          Sec. 36.002.  UNLAWFUL ACTS.  A person commits an unlawful
 13-1    act if the person:
 13-2                (1)  knowingly or intentionally makes or causes to be
 13-3    made a false statement or misrepresentation of a material fact:
 13-4                      (A)  on an application for a contract, benefit,
 13-5    or payment under the Medicaid program; or
 13-6                      (B)  that is intended to be used to determine a
 13-7    person's eligibility for a benefit or payment under the Medicaid
 13-8    program;
 13-9                (2)  knowingly or intentionally conceals or fails to
13-10    disclose an event:
13-11                      (A)  that the person knows affects the initial or
13-12    continued right to a benefit or payment under the Medicaid program
13-13    of:
13-14                            (i)  the person; or
13-15                            (ii)  another person on whose behalf the
13-16    person has applied for a benefit or payment or is receiving a
13-17    benefit or payment; and
13-18                      (B)  to permit a person to receive a benefit or
13-19    payment that is not authorized or that is greater than the payment
13-20    or benefit that is authorized;
13-21                (3)  knowingly or intentionally applies for and
13-22    receives a benefit or payment on behalf of another person under the
13-23    Medicaid program and converts any part of the benefit or payment to
13-24    a use other than for the benefit of the person on whose behalf it
13-25    was received;
13-26                (4)  knowingly or intentionally makes, causes to be
13-27    made, induces, or seeks to induce the making of a false statement
13-28    or misrepresentation of material fact concerning:
13-29                      (A)  the conditions or operation of a facility in
13-30    order that the facility may qualify for certification or
13-31    recertification required by the Medicaid program, including
13-32    certification or recertification as:
13-33                            (i)  a hospital;
13-34                            (ii)  a nursing facility or skilled nursing
13-35    facility;
13-36                            (iii)  a hospice;
13-37                            (iv)  an intermediate care facility for the
13-38    mentally retarded;
13-39                            (v)  an assisted living [a personal care]
13-40    facility; or
13-41                            (vi)  a home health agency; or
13-42                      (B)  information required to be provided by a
13-43    federal or state law, rule, regulation, or provider agreement
13-44    pertaining to the Medicaid program;
13-45                (5)  except as authorized under the Medicaid program,
13-46    knowingly or intentionally charges, solicits, accepts, or receives,
13-47    in addition to an amount paid under the Medicaid program, a gift,
13-48    money, a donation, or other consideration as a condition to the
13-49    provision of a service or continued service to a Medicaid recipient
13-50    if the cost of the service provided to the Medicaid recipient is
13-51    paid for, in whole or in part, under the Medicaid program;
13-52                (6)  knowingly or intentionally presents or causes to
13-53    be presented a claim for payment under the Medicaid program for a
13-54    product provided or a service rendered by a person who:
13-55                      (A)  is not licensed to provide the product or
13-56    render the service, if a license is required; or
13-57                      (B)  is not licensed in the manner claimed;
13-58                (7)  knowingly or intentionally makes a claim under the
13-59    Medicaid program for:
13-60                      (A)  a service or product that has not been
13-61    approved or acquiesced in by a treating physician or health care
13-62    practitioner;
13-63                      (B)  a service or product that is substantially
13-64    inadequate or inappropriate when compared to generally recognized
13-65    standards within the particular discipline or within the health
13-66    care industry; or
13-67                      (C)  a product that has been adulterated,
13-68    debased, mislabeled, or that is otherwise inappropriate;
13-69                (8)  makes a claim under the Medicaid program and
 14-1    knowingly or intentionally fails to indicate the type of license
 14-2    and the identification number of the licensed health care provider
 14-3    who actually provided the service;
 14-4                (9)  knowingly or intentionally enters into an
 14-5    agreement, combination, or conspiracy to defraud the state by
 14-6    obtaining or aiding another person in obtaining an unauthorized
 14-7    payment or benefit from the Medicaid program or a fiscal agent; or
 14-8                (10)  is a managed care organization that contracts
 14-9    with the Health and Human Services Commission or other state agency
14-10    to provide or arrange to provide health care benefits or services
14-11    to individuals eligible under the Medicaid program and knowingly or
14-12    intentionally:
14-13                      (A)  fails to provide to an individual a health
14-14    care benefit or service that the organization is required to
14-15    provide under the contract;
14-16                      (B)  fails to provide to the commission or
14-17    appropriate state agency information required to be provided by
14-18    law, commission or agency rule, or contractual provision;
14-19                      (C)  engages in a fraudulent activity in
14-20    connection with the enrollment of an individual eligible under the
14-21    Medicaid program in the organization's managed care plan or in
14-22    connection with marketing the organization's services to an
14-23    individual eligible under the Medicaid program; or
14-24                      (D)  obstructs an investigation by the attorney
14-25    general of an alleged unlawful act under this section.
14-26          SECTION 4.  AMENDMENT.  Title 6, Human Resources Code, is
14-27    amended by adding Chapter 105 to read as follows:
14-28           CHAPTER 105.  RESIDENTIAL FACILITIES FOR THE ELDERLY
14-29          Sec. 105.001.  DEFINITIONS.  In this chapter:
14-30                (1)  "Establishment" means a facility providing
14-31    sleeping accommodations to two or more qualifying adult residents,
14-32    at least 80 percent of whom are 65 years of age or older or are
14-33    disabled, and offering, for a fee, one or more supportive services
14-34    through contract with an agency licensed under Chapter 142, Health
14-35    and Safety Code, or with another entity.
14-36                (2)  "Qualifying adult resident" means an adult
14-37    resident of a facility who is not related within the second degree
14-38    by consanguinity or affinity to:
14-39                      (A)  a person who has an ownership interest in
14-40    the facility; or
14-41                      (B)  at least one other resident of the facility.
14-42                (3)  "Supportive services" means medical services,
14-43    health-related services, or personal care services as defined by
14-44    Section 247.002, Health and Safety Code.
14-45          Sec. 105.002.  EXEMPT FACILITIES.  The following facilities
14-46    are exempt from the application of this chapter:
14-47                (1)  housing in which all supportive services are
14-48    arranged directly by the residents themselves and are provided by
14-49    outside entities;
14-50                (2)  nursing facilities licensed under Chapter 242,
14-51    Health and Safety Code; and
14-52                (3)  continuing care facilities regulated by the Texas
14-53    Department of Insurance under Chapter 246, Health and Safety Code.
14-54          Sec. 105.003.  DISCLOSURE REQUIRED IN CONTRACT.  An
14-55    establishment that is not required to be licensed as an assisted
14-56    living facility under Chapter 247, Health and Safety Code, shall
14-57    execute a contract with each of its residents that contains, in
14-58    addition to other required information, the following elements:
14-59                (1)  the name, street address, and mailing address of
14-60    the establishment;
14-61                (2)  the name and mailing address of at least one
14-62    person authorized to act on behalf of the owner or owners or
14-63    management agent of the establishment;
14-64                (3)  a statement describing the licensure status of the
14-65    establishment;
14-66                (4)  the name, mailing address, and telephone number of
14-67    any provider, including any individual or entity, regardless of
14-68    whether licensed, providing supportive services under a contract
14-69    with the establishment;
 15-1                (5)  the term of the contract;
 15-2                (6)  a description of the services to be provided that
 15-3    are included in the base monthly rate to be paid by the resident;
 15-4                (7)  a description of any additional services available
 15-5    for an additional fee from a provider through a contract with the
 15-6    establishment;
 15-7                (8)  a provision requiring the establishment to provide
 15-8    written notice of any change in fee schedules that outline the cost
 15-9    of additional services not later than the 31st day before the
15-10    effective date of the change;
15-11                (9)  a description of the process by which the contract
15-12    may be modified, amended, or terminated;
15-13                (10)  a description of the complaint resolution process
15-14    available to residents;
15-15                (11)  the name, street address, mailing address, and
15-16    telephone number of the resident's designated representative, if
15-17    any;
15-18                (12)  a description of the billing and payment
15-19    procedures and requirements;
15-20                (13)  a statement ensuring the ability and right of
15-21    residents to receive services from providers with whom the
15-22    establishment does not have a contract; and
15-23                (14)  a statement identifying the life safety and fire
15-24    codes met by the building and a statement indicating whether those
15-25    codes are comparable to the codes with which an assisted living
15-26    facility licensed under Chapter 247, Health and Safety Code, must
15-27    comply.
15-28          SECTION 5.  AMENDMENT.  Section 123.004, Human Resources
15-29    Code, is amended to read as follows:
15-30          Sec. 123.004.  QUALIFICATION AS COMMUNITY HOME.  To qualify
15-31    as a community home, an entity must comply with Sections 123.005
15-32    through 123.008 and be:
15-33                (1)  a community-based residential home operated by:
15-34                      (A)  the Texas Department of Mental Health and
15-35    Mental Retardation;
15-36                      (B)  a community center organized under
15-37    Subchapter A, Chapter 534, Health and Safety Code, that provides
15-38    services to persons with disabilities;
15-39                      (C)  an entity subject to the Texas Non-Profit
15-40    Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil
15-41    Statutes); or
15-42                      (D)  an entity certified by the Texas Department
15-43    of Human Services as a provider under the medical assistance
15-44    program serving persons in intermediate care facilities for persons
15-45    with mental retardation; or
15-46                (2)  an assisted living [a personal care] facility
15-47    licensed under Chapter 247, Health and Safety Code, provided that
15-48    the exterior structure retains compatibility with the surrounding
15-49    residential dwellings.
15-50          SECTION 6.  REFERENCE TO PERSONAL CARE FACILITY.  (a)  A
15-51    reference in law to a personal care facility means an assisted
15-52    living facility, as defined by Section 247.002, Health and Safety
15-53    Code, as amended by this Act.
15-54          (b)  A reference in law to the Advisory Committee on Personal
15-55    Care Facilities means the Advisory Committee on Assisted Living
15-56    Facilities established under Section 247.051, Health and Safety
15-57    Code, as amended by this Act.
15-58          SECTION 7.  ENFORCEMENT OF LICENSURE REQUIREMENT.  (a)  Not
15-59    later than January 1, 2000, the Texas Department of Human Services
15-60    shall:
15-61                (1)  identify unlicensed facilities in this state that
15-62    are required to be licensed under Chapter 247, Health and Safety
15-63    Code, as amended by this Act; and
15-64                (2)  take action to enforce the licensure requirements.
15-65          (b)  Not later than December 1, 2000, the department shall
15-66    submit to the governor and the legislature a report describing the
15-67    results of the  department's efforts under this section.  The
15-68    report must include:
15-69                (1)  the number of facilities identified;
 16-1                (2)  the geographical distribution of those facilities;
 16-2    and
 16-3                (3)  the results of the department's efforts to enforce
 16-4    licensure of those facilities.
 16-5          (c)  This section takes effect on the first date that it may
 16-6    take effect under Section 39, Article III, Texas Constitution.
 16-7          SECTION 8.  WORK GROUP ON TEXAS ACCESSIBILITY STANDARDS.
 16-8    (a)  As soon as possible after the effective date of this section,
 16-9    the Texas Department of Human Services and the Texas Department of
16-10    Licensing and Regulation shall form a joint work group to study and
16-11    make recommendations not later than September 1, 2000, to those
16-12    agencies concerning the application of the Texas Accessibility
16-13    Standards and other architectural requirements to facilities
16-14    required to be licensed under Chapter 247, Health and Safety Code.
16-15          (b)  The work group shall:
16-16                (1)  review bathroom accessibility standards applicable
16-17    to a facility and make suggestions regarding any necessary changes
16-18    to those standards;
16-19                (2)  determine whether the architectural reviews of a
16-20    facility currently conducted separately by each agency could be
16-21    consolidated into a single review;
16-22                (3)  develop standard information materials that
16-23    address architectural requirements applicable to construction or
16-24    modification of a facility; and
16-25                (4)  address any other issue relating to architectural
16-26    standards applicable to a facility.
16-27          (c)  The agencies shall include in the work group
16-28    representatives of developers and providers of facilities and
16-29    consumers of personal care services provided by facilities.
16-30          (d)  The members of the work group shall elect a presiding
16-31    officer and any other necessary officers for the work group.
16-32          (e)  The work group shall meet at the call of the presiding
16-33    officer.
16-34          (f)  A member of the work group receives no compensation for
16-35    serving on the work group.
16-36          (g)  The work group is not subject to Chapter 2110,
16-37    Government Code.
16-38          (h)  The work group dissolves and this section expires
16-39    September 1, 2001.
16-40          (i)  This section takes effect on the first date that it may
16-41    take effect under Section 39, Article III, Texas Constitution.
16-42          SECTION 9.  COMMUNITY-BASED ALTERNATIVES PROGRAM RATE METHOD.
16-43    (a)  As soon as possible after the effective date of this section,
16-44    the Texas Department of Human Services by rule shall develop and
16-45    implement a new reimbursement method for personal care services
16-46    funded through the community-based alternatives program that is
16-47    based on the type of service provided in addition to the number of
16-48    clients occupying a room.
16-49          (b)  This section takes effect on the first date that it may
16-50    take effect under Section 39, Article III, Texas Constitution.
16-51          SECTION 10.  DEADLINE:  CONSUMER DISCLOSURE STATEMENT.  Not
16-52    later than September 1, 1999, the Texas Department of Human
16-53    Services shall adopt the consumer disclosure statement required by
16-54    Paragraph (B), Subdivision (3), Subsection (b), Section 247.026,
16-55    Health and Safety Code, as added by this Act.
16-56          SECTION 11.  TRANSITION:  REQUIRED EDUCATIONAL COURSE FOR
16-57    MANAGERS OF CERTAIN FACILITIES.  Subsection (i), Section 247.026,
16-58    Health and Safety Code, as added by this Act, applies only to a
16-59    person who begins employment as a manager of an assisted living
16-60    facility on or after the effective date of this Act.  A person who
16-61    begins employment as a manager of an assisted living facility
16-62    before the effective date of this Act is governed by the law in
16-63    effect on the date that the person begins employment, and that law
16-64    is continued in effect for that purpose.
16-65          SECTION 12.  LEGISLATIVE INTENT.  Subsection (d), Section
16-66    247.045, Health and Safety Code, as amended by this Act, is
16-67    intended to emphasize the authority of the attorney general to
16-68    institute and conduct a suit to collect a penalty and fees.  The
16-69    amendment may not be construed to mean that the attorney general
 17-1    lacked that authority before the effective date of this Act.
 17-2          SECTION 13.  WAIVERS.  If, before implementing any provision
 17-3    of this Act, a state agency determines that a waiver or
 17-4    authorization from a federal agency is necessary for implementation
 17-5    of that provision, the agency affected by the provision shall
 17-6    request the waiver or authorization and may delay implementing that
 17-7    provision until the waiver or authorization is granted.
 17-8          SECTION 14.  CONFLICTS.  To the extent of any conflict, this
 17-9    Act prevails over another Act of the 76th Legislature, Regular
17-10    Session, 1999, relating to nonsubstantive additions to and
17-11    corrections in enacted codes.
17-12          SECTION 15.  EFFECTIVE DATE.  Except as otherwise provided by
17-13    this Act, this Act takes effect September 1, 1999.
17-14          SECTION 16.  EMERGENCY.  The importance of this legislation
17-15    and the crowded condition of the calendars in both houses create an
17-16    emergency and an imperative public necessity that the
17-17    constitutional rule requiring bills to be read on three several
17-18    days in each house be suspended, and this rule is hereby suspended,
17-19    and that this Act take effect and be in force according to its
17-20    terms, and it is so enacted.
17-21                                 * * * * *