By: Moncrief, et al. S.B. No. 94
A BILL TO BE ENTITLED
AN ACT
1-1 relating to home health services; providing administrative
1-2 penalties.
1-3 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-4 SECTION 1. Section 142.001, Health and Safety Code, is
1-5 amended to read as follows:
1-6 Sec. 142.001. DEFINITIONS. In this chapter:
1-7 (1) "Administrative support site" means a facility or
1-8 site where a home and community support services agency performs
1-9 administrative and other support functions but does not provide
1-10 direct home health, hospice, or personal assistance services.
1-11 (2) "Alternate delivery site" means a facility or
1-12 site, including a residential unit or an inpatient unit:
1-13 (A) that is owned or operated by a hospice;
1-14 (B) that is not the hospice's principal place of
1-15 business;
1-16 (C) that is located in the geographical area
1-17 served by the hospice; and
1-18 (D) from which the hospice provides hospice
1-19 services.
1-20 (3) "Bereavement" means the process by which a
1-21 survivor of a deceased person mourns and experiences grief.
1-22 (4) "Bereavement services" means support services
1-23 offered to a family during bereavement.
1-24 (5) "Branch office" means a facility or site in the
2-1 geographical area served by a home and community support agency
2-2 where home health or personal assistance services are delivered or
2-3 active client records are maintained.
2-4 (6) "Certified agency" means a home and community
2-5 support services agency that:
2-6 (A) provides a home health service; and
2-7 (B) is certified by an official of the
2-8 Department of Health and Human Services as in compliance with
2-9 conditions of participation in Title XVIII, Social Security Act (42
2-10 U.S.C. Section 1395 et seq.).
2-11 (7) "Certified home health services" means home health
2-12 services that are provided by a certified agency.
2-13 (8) "Chief financial officer" means an individual who
2-14 is responsible for supervising and managing all financial
2-15 activities for a home and community support services agency.
2-16 (9) "Controlling person" means a person who controls a
2-17 home and community support services agency or other person as
2-18 described by Section 142.0012.
2-19 (10) "Council" means the Home and Community Support
2-20 Services Advisory Council.
2-21 (11) [(10)] "Counselor" means an individual qualified
2-22 under Medicare standards to provide counseling services, including
2-23 bereavement, dietary, spiritual, and other counseling services, to
2-24 both the client and the family.
2-25 (12) [(11)] "Home and community support services
2-26 agency" means a person who provides home health, hospice, or
3-1 personal assistance services for pay or other consideration in a
3-2 client's residence, an independent living environment, or another
3-3 appropriate location.
3-4 (13) [(12)] "Home health service" means the provision
3-5 of one or more of the following health services required by an
3-6 individual in a residence or independent living environment:
3-7 (A) nursing;
3-8 (B) physical, occupational, speech, or
3-9 respiratory therapy;
3-10 (C) medical social service;
3-11 (D) intravenous therapy;
3-12 (E) dialysis;
3-13 (F) service provided by unlicensed personnel
3-14 under the delegation of a licensed health professional;
3-15 (G) the furnishing of medical equipment and
3-16 supplies, excluding drugs and medicines; or
3-17 (H) nutritional counseling.
3-18 (14) [(13)] "Hospice" means a person licensed under
3-19 this chapter to provide hospice services, including a person who
3-20 owns or operates a residential unit or an inpatient unit.
3-21 (15) [(14)] "Hospice services" means services,
3-22 including services provided by unlicensed personnel under the
3-23 delegation of a registered nurse or physical therapist, provided to
3-24 a client or a client's family as part of a coordinated program
3-25 consistent with the standards and rules adopted under this chapter.
3-26 These services include palliative care for terminally ill clients
4-1 and support services for clients and their families that:
4-2 (A) are available 24 hours a day, seven days a
4-3 week, during the last stages of illness, during death, and during
4-4 bereavement;
4-5 (B) are provided by a medically directed
4-6 interdisciplinary team; and
4-7 (C) may be provided in a home, nursing home,
4-8 residential unit, or inpatient unit according to need. These
4-9 services do not include inpatient care normally provided in a
4-10 licensed hospital to a terminally ill person who has not elected to
4-11 be a hospice client.
4-12 (16) [(15)] "Inpatient unit" means a facility that
4-13 provides a continuum of medical or nursing care and other hospice
4-14 services to clients admitted into the unit and that is in
4-15 compliance with:
4-16 (A) the conditions of participation for
4-17 inpatient units adopted under Title XVIII, Social Security Act (42
4-18 U.S.C. Section 1395 et seq.); and
4-19 (B) standards adopted under this chapter.
4-20 (17) [(16)] "Independent living environment" means:
4-21 (A) a client's individual residence, which may
4-22 include a group home or foster home; or
4-23 (B) other settings where a client participates
4-24 in activities, including school, work, or church.
4-25 (18) [(17)] "Interdisciplinary team" means a group of
4-26 individuals who work together in a coordinated manner to provide
5-1 hospice services and must include a physician, registered nurse,
5-2 social worker, and counselor.
5-3 (19) [(18)] "Investigation" means an inspection or
5-4 survey conducted by a representative of the department to determine
5-5 if a licensee is in compliance with this chapter.
5-6 (20) [(19)] "Palliative care" means intervention
5-7 services that focus primarily on the reduction or abatement of
5-8 physical, psychosocial, and spiritual symptoms of a terminal
5-9 illness.
5-10 (21) [(20)] "Person" means an individual, corporation,
5-11 or association.
5-12 (22) [(21)] "Personal assistance service" means
5-13 routine ongoing care or services required by an individual in a
5-14 residence or independent living environment that enable the
5-15 individual to engage in the activities of daily living or to
5-16 perform the physical functions required for independent living,
5-17 including respite services. The term includes health-related
5-18 services performed under circumstances that are defined as not
5-19 constituting the practice of professional nursing by the Board of
5-20 Nurse Examiners through a memorandum of understanding with the
5-21 department in accordance with Section 142.016 and health-related
5-22 tasks provided by unlicensed personnel under the delegation of a
5-23 registered nurse.
5-24 (23) [(22)] "Place of business" means an office of a
5-25 home and community support services agency that maintains client
5-26 records or directs home health, hospice, or personal assistance
6-1 services. The term does not include an administrative support
6-2 site.
6-3 (24) [(23)] "Residence" means a place where a person
6-4 resides and includes a home, a nursing home, a convalescent home,
6-5 or a residential unit.
6-6 (25) [(24)] "Residential unit" means a facility that
6-7 provides living quarters and hospice services to clients admitted
6-8 into the unit and that is in compliance with standards adopted
6-9 under this chapter.
6-10 (26) [(25)] "Respite services" means support options
6-11 that are provided temporarily for the purpose of relief for a
6-12 primary caregiver in providing care to individuals of all ages with
6-13 disabilities or at risk of abuse or neglect.
6-14 (27) [(26)] "Social worker" means an individual
6-15 licensed [certified] as a social worker under Chapter 50, Human
6-16 Resources Code.
6-17 (28) [(27)] "Support services" means social,
6-18 spiritual, and emotional care provided to a client and a client's
6-19 family by a hospice.
6-20 (29) [(28)] "Terminal illness" means an illness for
6-21 which there is a limited prognosis if the illness runs its usual
6-22 course.
6-23 (30) [(29)] "Volunteer" means an individual who
6-24 provides assistance to a home and community support services agency
6-25 without compensation other than reimbursement for actual expenses.
6-26 SECTION 2. Subchapter A, Chapter 142, Health and Safety
7-1 Code, is amended by adding Sections 142.0011 and 142.0012 to read
7-2 as follows:
7-3 Sec. 142.0011. SCOPE, PURPOSE, AND IMPLEMENTATION. (a) The
7-4 purpose of this chapter is to ensure that home and community
7-5 support services agencies in this state deliver the highest
7-6 possible quality of care. This chapter and the rules adopted under
7-7 this chapter establish minimum standards for acceptable quality of
7-8 care, and a violation of a minimum standard established or adopted
7-9 under this chapter is a violation of law. For purposes of this
7-10 chapter, components of quality of care include:
7-11 (1) client independence and self-determination;
7-12 (2) humane treatment;
7-13 (3) continuity of care;
7-14 (4) coordination of services;
7-15 (5) professionalism of service providers;
7-16 (6) quality of life; and
7-17 (7) client satisfaction with services.
7-18 (b) The department shall protect clients of home and
7-19 community support services agencies by regulating those agencies
7-20 and:
7-21 (1) adopting rules relating to quality of care and
7-22 quality of life;
7-23 (2) strictly monitoring factors relating to the
7-24 health, safety, welfare, and dignity of each client;
7-25 (3) imposing prompt and effective remedies for
7-26 violations of this chapter and rules and standards adopted under
8-1 this chapter;
8-2 (4) enabling agencies to provide services that allow
8-3 clients to maintain the highest possible degree of independence and
8-4 self-determination; and
8-5 (5) providing the public with helpful and
8-6 understandable information relating to agencies in this state.
8-7 Sec. 142.0012. CONTROLLING PERSON. (a) A person is a
8-8 controlling person if the person, acting alone or with others, has
8-9 the ability to directly or indirectly influence, direct, or cause
8-10 the direction of the management, expenditure of money, or policies
8-11 of a home and community support services agency or other person.
8-12 (b) For purposes of this chapter, "controlling person"
8-13 includes:
8-14 (1) a management company or other business entity that
8-15 operates or contracts with others for the operation of a home and
8-16 community support services agency;
8-17 (2) a person who is a controlling person of a
8-18 management company or other business entity that operates a home
8-19 and community support services agency or that contracts with
8-20 another person for the operation of a home and community support
8-21 services agency; and
8-22 (3) any other individual who, because of a personal,
8-23 familial, or other relationship with the owner, manager, or
8-24 provider of a home and community support services agency, is in a
8-25 position of actual control or authority with respect to the agency,
8-26 without regard to whether the individual is formally named as an
9-1 owner, manager, director, officer, provider, consultant,
9-2 contractor, or employee of the agency.
9-3 (c) A controlling person described by Subsection (b)(3) does
9-4 not include an employee, lender, secured creditor, or other person
9-5 who does not exercise formal or actual influence or control over
9-6 the operation of a home and community support services agency.
9-7 (d) The department may adopt rules that specify the
9-8 ownership interests and other relationships that qualify a person
9-9 as a controlling person.
9-10 SECTION 3. Subsection (a), Section 142.003, Health and
9-11 Safety Code, is amended to read as follows:
9-12 (a) The following persons need not be licensed under this
9-13 chapter:
9-14 (1) a physician, dentist, registered nurse, or
9-15 physical therapist licensed under the laws of this state who
9-16 provides home health services to a client only as a part of and
9-17 incidental to that person's private office practice;
9-18 (2) a registered nurse, licensed vocational nurse,
9-19 physical therapist, occupational therapist, speech therapist,
9-20 medical social worker, or any other health care professional as
9-21 determined by the department who provides home health services as a
9-22 sole practitioner;
9-23 (3) a registry that operates solely as a clearinghouse
9-24 to put consumers in contact with persons who provide home health,
9-25 hospice, or personal assistance services and that does not maintain
9-26 official client records, direct client services, or compensate the
10-1 person who is providing the service;
10-2 (4) an individual whose permanent residence is in the
10-3 client's residence;
10-4 (5) an employee of a person licensed under this
10-5 chapter who provides home health, hospice, or personal assistance
10-6 services only as an employee of the license holder and who receives
10-7 no benefit for providing the services, other than wages from the
10-8 license holder;
10-9 (6) a home, nursing home, convalescent home, assisted
10-10 living [personal care] facility, special care facility, or other
10-11 institution for individuals who are elderly or who have
10-12 disabilities that provides home health or personal assistance
10-13 services only to residents of the home or institution;
10-14 (7) a person who provides one health service through a
10-15 contract with a person licensed under this chapter;
10-16 (8) a durable medical equipment supply company;
10-17 (9) a pharmacy or wholesale medical supply company
10-18 that does not furnish services, other than supplies, to a person at
10-19 the person's house;
10-20 (10) a hospital or other licensed health care facility
10-21 that provides home health or personal assistance services only to
10-22 inpatient residents of the hospital or facility;
10-23 (11) a person providing home health or personal
10-24 assistance services to an injured employee under Title 5, Labor
10-25 Code [the Texas Workers' Compensation Act (Article 8308-1.01 et
10-26 seq., Vernon's Texas Civil Statutes)];
11-1 (12) a visiting nurse service that:
11-2 (A) is conducted by and for the adherents of a
11-3 well-recognized church or religious denomination; and
11-4 (B) provides nursing services by a person exempt
11-5 from licensing by Article 4528, Revised Statutes, because the
11-6 person furnishes nursing care in which treatment is only by prayer
11-7 or spiritual means;
11-8 (13) an individual hired and paid directly by the
11-9 client or the client's family or legal guardian to provide home
11-10 health or personal assistance services;
11-11 (14) a business, school, camp, or other organization
11-12 that provides home health or personal assistance services,
11-13 incidental to the organization's primary purpose, to individuals
11-14 employed by or participating in programs offered by the business,
11-15 school, or camp that enable the individual to participate fully in
11-16 the business's, school's, or camp's programs;
11-17 (15) a person or organization providing
11-18 sitter-companion services or chore or household services that do
11-19 not involve personal care, health, or health-related services;
11-20 (16) a licensed health care facility that provides
11-21 hospice services under a contract with a hospice;
11-22 (17) a person delivering residential acquired immune
11-23 deficiency syndrome hospice care who is licensed and designated as
11-24 a residential AIDS hospice under Chapter 248; or
11-25 (18) the Texas Department of Criminal Justice.
11-26 SECTION 4. Subsections (c) and (d), Section 142.004, Health
12-1 and Safety Code, are amended to read as follows:
12-2 (c) The board by rule shall require that, at a minimum,
12-3 before the department may approve a license application, the
12-4 applicant must provide to the department:
12-5 (1) documentation establishing that, at a minimum, the
12-6 applicant has sufficient financial resources to provide the
12-7 services required by this chapter and by the department during the
12-8 term of the license;
12-9 (2) a list of the management personnel for the
12-10 proposed home and community support services agency, a description
12-11 of personnel qualifications, and a plan for providing continuing
12-12 training and education for the personnel during the term of the
12-13 license;
12-14 (3) documentation establishing that the applicant is
12-15 capable of meeting the minimum standards established by the board
12-16 relating to the quality of care;
12-17 (4) a plan that provides for the orderly transfer of
12-18 care of the applicant's clients if the applicant cannot maintain or
12-19 deliver home health, hospice, or personal assistance services under
12-20 the license; [and]
12-21 (5) identifying information on the home and community
12-22 support services agency owner, administrator, and chief financial
12-23 officer to enable the department to conduct criminal background
12-24 checks on those persons;
12-25 (6) identification of any controlling person with
12-26 respect to the applicant; and
13-1 (7) documentation relating to any controlling person
13-2 identified under Subdivision (6), if requested by the department
13-3 and relevant to the controlling person's compliance with any
13-4 applicable licensing standard required or adopted by the board
13-5 under this chapter.
13-6 (d) Information received by the department relating to the
13-7 competence and financial resources of the applicant or a
13-8 controlling person with respect to the applicant is confidential
13-9 and may not be disclosed to the public.
13-10 SECTION 5. Subchapter A, Chapter 142, Health and Safety
13-11 Code, is amended by adding Section 142.005 to read as follows:
13-12 Sec. 142.005. COMPLIANCE RECORD IN OTHER STATES. The
13-13 department may require an applicant or license holder to provide
13-14 the department with information relating to compliance by the
13-15 applicant, the license holder, or a controlling person with respect
13-16 to the applicant or license holder with regulatory requirements in
13-17 any other state in which the applicant, license holder, or
13-18 controlling person operates or operated a home and community
13-19 support services agency.
13-20 SECTION 6. Subsection (a), Section 142.006, Health and
13-21 Safety Code, is amended to read as follows:
13-22 (a) The department shall issue a home and community support
13-23 services agency license to provide home health, hospice, or
13-24 personal assistance services for each place of business to an
13-25 applicant if:
13-26 (1) the [each] applicant [who]:
14-1 (A) [(1)] qualifies for the license to provide
14-2 the type of service that is to be offered by the applicant;
14-3 (B) [(2)] submits an application and license fee
14-4 as required by this chapter; and
14-5 (C) [(3)] complies with all applicable licensing
14-6 standards required or adopted by the board under this chapter; and
14-7 (2) any controlling person with respect to the
14-8 applicant complies with all applicable licensing standards required
14-9 or adopted by the board under this chapter.
14-10 SECTION 7. Subsection (d), Section 142.009, Health and
14-11 Safety Code, is amended to read as follows:
14-12 (d) The reports, records, and working papers used or
14-13 developed in an investigation made under this section are
14-14 confidential and may not be released or made public except:
14-15 (1) to a state or federal agency;
14-16 (2) to federal, state, or local law enforcement
14-17 personnel;
14-18 (3) with the consent of each person identified in the
14-19 information released;
14-20 (4) in civil or criminal litigation matters or
14-21 licensing proceedings as otherwise allowed by law or judicial rule;
14-22 [or]
14-23 (5) on a form developed by the department that
14-24 identifies any deficiencies found without identifying a person,
14-25 other than the home and community support services agency;
14-26 (6) on a form required by a federal agency if:
15-1 (A) the information does not reveal the identity
15-2 of an individual, including a patient or a physician or other
15-3 medical practitioner;
15-4 (B) the service provider subject to the
15-5 investigation had a reasonable opportunity to review the
15-6 information and offer comments to be included with the information
15-7 released or made public; and
15-8 (C) the release of the information complies with
15-9 any other federal requirement; or
15-10 (7) as provided by Section 142.0092.
15-11 SECTION 8. Subchapter A, Chapter 142, Health and Safety
15-12 Code, is amended by adding Sections 142.0091, 142.0092, 142.0093,
15-13 and 142.0094 to read as follows:
15-14 Sec. 142.0091. SURVEYOR TRAINING. (a) The department shall
15-15 provide specialized training to representatives of the department
15-16 who survey home and community support services agencies. The
15-17 training must include information relating to:
15-18 (1) the conduct of appropriate surveys that do not
15-19 focus exclusively on medical standards under an acute care model;
15-20 and
15-21 (2) acceptable delegation of nursing tasks.
15-22 (b) In developing and updating the training required by this
15-23 section, the department shall consult with and include providers of
15-24 home health, hospice, and personal assistance services, recipients
15-25 of those services and their family members, and representatives of
15-26 appropriate advocacy organizations.
16-1 Sec. 142.0092. CONSUMER COMPLAINT DATA. (a) The department
16-2 shall maintain records or documents relating to complaints directed
16-3 to the department by consumers of home health, hospice, or personal
16-4 assistance services. The department shall organize the records or
16-5 documents according to standard, statewide categories as determined
16-6 by the department. In determining appropriate categories, the
16-7 department shall make distinctions based on factors useful to the
16-8 public in assessing the quality of services provided by a home and
16-9 community support services agency, including whether the complaint:
16-10 (1) was determined to be valid or invalid;
16-11 (2) involved significant physical harm or death to a
16-12 patient;
16-13 (3) involved financial exploitation of a patient; or
16-14 (4) resulted in any sanction imposed against the
16-15 agency.
16-16 (b) The department shall make the information maintained
16-17 under this section available to the public in a useful format that
16-18 does not identify individuals implicated in the complaints.
16-19 Sec. 142.0093. RETALIATION PROHIBITED. (a) A person
16-20 licensed under this chapter may not retaliate against another
16-21 person for filing a complaint, presenting a grievance, or providing
16-22 in good faith information relating to home health, hospice, or
16-23 personal assistance services provided by the license holder.
16-24 (b) This section does not prohibit a license holder from
16-25 terminating an employee for a reason other than retaliation.
16-26 Sec. 142.0094. USE OF REGULATORY SURVEY REPORTS AND OTHER
17-1 DOCUMENTS. (a) Except as otherwise provided by this section, a
17-2 survey report or other document prepared by the department that
17-3 relates to regulation of a home and community support services
17-4 agency is not admissible as evidence in a civil action to prove
17-5 that the agency violated a standard prescribed under this chapter.
17-6 (b) Subsection (a) does not:
17-7 (1) apply to the admissibility as evidence of
17-8 department survey reports or other documents in an enforcement
17-9 action in which the state or an agency or political subdivision of
17-10 the state is a party, including:
17-11 (A) an action seeking injunctive relief under
17-12 Section 142.013;
17-13 (B) an action seeking imposition of a civil
17-14 penalty under Section 142.014;
17-15 (C) a contested case hearing involving
17-16 imposition of an administrative penalty under Section 142.017; and
17-17 (D) a contested case hearing involving denial,
17-18 suspension, or revocation of a license issued under this chapter;
17-19 (2) apply to the admissibility as evidence of
17-20 department survey reports or other documents that are offered:
17-21 (A) to establish warning or notice to a home and
17-22 community support services agency of a relevant department
17-23 determination; or
17-24 (B) under any rule or evidentiary predicate of
17-25 the Texas Rules of Evidence;
17-26 (3) prohibit or limit the testimony of a department
18-1 employee, in accordance with the Texas Rules of Evidence, as to
18-2 observations, factual findings, conclusions, or determinations that
18-3 a home and community support services agency violated a standard
18-4 prescribed under this chapter if the observations, factual
18-5 findings, conclusions, or determinations were made in the discharge
18-6 of the employee's official duties for the department; or
18-7 (4) prohibit or limit the use of department survey
18-8 reports or other documents in depositions or other forms of
18-9 discovery conducted in connection with a civil action if use of the
18-10 survey reports or other documents appears reasonably calculated to
18-11 lead to the discovery of admissible evidence.
18-12 SECTION 9. Subsection (a), Section 142.011, Health and
18-13 Safety Code, is amended to read as follows:
18-14 (a) The department may deny a license application or suspend
18-15 or revoke the license of a person who:
18-16 (1) fails to comply with the rules or standards for
18-17 licensing required by this chapter; or
18-18 (2) engages in conduct that violates Section 161.091.
18-19 SECTION 10. Subsections (a) and (d), Section 142.017, Health
18-20 and Safety Code, are amended to read as follows:
18-21 (a) The department may assess an administrative penalty
18-22 against a person who violates:
18-23 (1) this chapter or a rule adopted under this chapter;
18-24 or
18-25 (2) Section 161.091, if the violation relates to the
18-26 provision of home health, hospice, or personal assistance services.
19-1 (d) The department by rule shall establish a schedule of
19-2 appropriate and graduated penalties for each violation based on:
19-3 (1) the seriousness of the violation, including the
19-4 nature, circumstances, extent, and gravity of the violation and the
19-5 hazard or safety of clients;
19-6 (2) the history of previous violations by the person
19-7 or a controlling person with respect to that person;
19-8 (3) whether the affected home and community support
19-9 services agency had identified the violation as a part of its
19-10 internal quality assurance process and had made appropriate
19-11 progress on correction;
19-12 (4) the amount necessary to deter future violations;
19-13 (5) efforts made to correct the violation; and
19-14 (6) any other matters that justice may require.
19-15 SECTION 11. Subchapter A, Chapter 142, Health and Safety
19-16 Code, is amended by adding Sections 142.018 and 142.019 to read as
19-17 follows:
19-18 Sec. 142.018. REPORTS OF ABUSE, EXPLOITATION, OR NEGLECT.
19-19 (a) In this section, "abuse," "exploitation," and "neglect" have
19-20 the meanings assigned by Section 48.002, Human Resources Code.
19-21 (b) A home and community support services agency that has
19-22 cause to believe that a person receiving services from the agency
19-23 has been abused, exploited, or neglected by an employee of the
19-24 agency shall report the information to:
19-25 (1) the department; and
19-26 (2) the Department of Protective and Regulatory
20-1 Services or other appropriate state agency as required by Sections
20-2 48.036 and 48.082, Human Resources Code.
20-3 (c) This section does not affect the duty or authority of
20-4 any state agency to conduct an investigation of alleged abuse,
20-5 exploitation, or neglect as provided by other law.
20-6 Sec. 142.019. CERTAIN PHYSICIAN REFERRALS PROHIBITED. A
20-7 physician may not refer a patient to a home and community support
20-8 services agency if the referral violates 42 U.S.C. Section 1395nn
20-9 and its subsequent amendments.
20-10 SECTION 12. Subchapter C, Chapter 48, Human Resources Code,
20-11 is amended by adding Section 48.0381 to read as follows:
20-12 Sec. 48.0381. NOTIFICATION OF LICENSING OR CONTRACTING
20-13 AGENCY. (a) On determining after an investigation that an elderly
20-14 or disabled person has been abused, exploited, or neglected by an
20-15 employee of a home and community support services agency licensed
20-16 under Chapter 142, Health and Safety Code, the department shall:
20-17 (1) notify the state agency responsible for licensing
20-18 the home and community support services agency of the department's
20-19 determination;
20-20 (2) notify any health and human services agency, as
20-21 defined by Section 531.001, Government Code, that contracts with
20-22 the home and community support services agency for the delivery of
20-23 health care services of the department's determination; and
20-24 (3) provide to the licensing state agency and any
20-25 contracting health and human services agency access to the
20-26 department's records or documents relating to the department's
21-1 investigation.
21-2 (b) Providing access to a confidential record or document
21-3 under this section does not constitute a waiver of confidentiality.
21-4 SECTION 13. If, before implementing any provision of this
21-5 Act, a state agency determines that a waiver or authorization from
21-6 a federal agency is necessary for implementation of that provision,
21-7 the agency affected by the provision shall request the waiver or
21-8 authorization and may delay implementing that provision until the
21-9 waiver or authorization is granted.
21-10 SECTION 14. To the extent of any conflict, this Act prevails
21-11 over another Act of the 76th Legislature, Regular Session, 1999,
21-12 relating to nonsubstantive additions to and corrections in enacted
21-13 codes.
21-14 SECTION 15. (a) This Act takes effect September 1, 1999.
21-15 (b) Subsection (a), Section 142.011, and Subsections (a) and
21-16 (d), Section 142.017, Health and Safety Code, as amended by this
21-17 Act, apply only to conduct occurring on or after the effective date
21-18 of this Act. Conduct occurring before the effective date of this
21-19 Act is covered by the law in effect when the conduct occurred, and
21-20 the former law is continued in effect for that purpose.
21-21 SECTION 16. The importance of this legislation and the
21-22 crowded condition of the calendars in both houses create an
21-23 emergency and an imperative public necessity that the
21-24 constitutional rule requiring bills to be read on three several
21-25 days in each house be suspended, and this rule is hereby suspended.