83R1501 AED-D

By: Gonzales H.B. No. 1005

A BILL TO BE ENTITLED

AN ACT

relating to the certification of day habilitation services providers for individuals with intellectual disabilities.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. The purpose of this Act is to ensure that day habilitation services providers provide high-quality services.

SECTION 2. Chapter 161, Human Resources Code, is amended by adding Subchapter J to read as follows:

SUBCHAPTER J. DAY HABILITATION SERVICES PROVIDERS

Sec. 161.401. DEFINITIONS. In this subchapter:

(1) "Active treatment" means a continuous, aggressive, consistent implementation of a program of habilitation, including specialized and generic training, treatment, health services, and related services. Active treatment does not include services to maintain generally independent individuals who are able to function with little supervision or in the absence of a continuous active treatment program.

(2) "Client" means a person receiving services from a waiver provider or a facility.

(3) "Day habilitation services" means an active treatment provided by a waiver provider on a regularly scheduled basis primarily to individuals with an intellectual disability or a related condition.

(4) "Day habilitation services site" means a location at which a waiver provider provides day habilitation services.

(5) "Facility" means an intermediate care facility for individuals with an intellectual disability or a related condition that is licensed under Chapter 252, Health and Safety Code, or that is operated by or contracts with the department.

(6) "Intellectual disability" has the meaning assigned by Section 591.003, Health and Safety Code.

(7) "Related condition" means a severe and chronic disability that:

(A) is attributed to:

(i) cerebral palsy or epilepsy; or

(ii) any other condition, other than mental illness, found to be closely related to intellectual disability because the condition results in impairment of general intellectual functioning or adaptive behavior similar to that of individuals with intellectual disability, and requires treatment or services similar to those required for individuals with intellectual disability;

(B) is manifested before the individual reaches 22 years of age;

(C) is likely to continue indefinitely; and

(D) results in substantial functional limitation in at least three of the following areas of major life activity:

(i) self-care;

(ii) understanding and use of language;

(iii) learning;

(iv) mobility;

(v) self-direction; and

(vi) capacity for independent living.

(8) "Waiver provider" means a person who contracts with the department to provide federally funded Medicaid day habilitation services authorized under Section 1915(c) of the federal Social Security Act (42 U.S.C. Section 1396n(c)).

Sec. 161.402. DEPARTMENT DUTIES. The department shall adopt rules for implementing this subchapter and set standards for:

(1) the health and welfare of clients receiving day habilitation services;

(2) the quality of day habilitation services provided by a waiver provider;

(3) the adequate supervision of clients receiving day habilitation services;

(4) the qualifications of waiver provider staff providing day habilitation services; and

(5) the requirements to be a day habilitation services site.

Sec. 161.403. CERTIFICATION REQUIRED FOR WAIVER PROVIDERS. (a) The department may not pay a waiver provider for day habilitation services unless the waiver provider is:

(1) certified by the department as a day habilitation services provider under this subchapter; or

(2) licensed by the department as an adult day-care facility under Chapter 103.

(b) A facility may not contract with a waiver provider to provide day habilitation services unless the waiver provider is:

(1) certified by the department as a day habilitation services provider under this subchapter; or

(2) licensed by the department as an adult day-care facility under Chapter 103.

Sec. 161.404. CERTIFICATION REQUIREMENTS. (a) The department shall certify a waiver provider who meets the requirements prescribed by this subchapter as a day habilitation services provider.

(b) A waiver provider must obtain a separate certification for each day habilitation services site.

(c) A certification expires on the second anniversary of the date of issuance.

(d) The department shall adopt rules for procedures and standards for certification of day habilitation services providers.

Sec. 161.405. CERTIFICATION APPLICATION. (a) An applicant for certification as a day habilitation services provider must file an application on a form prescribed by the department together with a certification fee of $50.

(b) The applicant must provide evidence of the ability to comply with the requirements of the department.

(c) A waiver provider who is certified as a day habilitation services provider under this subchapter must file an application for renewal certification not later than the 60th day before the expiration date of the certification on a form prescribed by the department together with a renewal fee of $50.

(d) An applicant for certification renewal who submits an application later than the 60th day before the expiration date of the certification is subject to a late fee in accordance with department rules.

Sec. 161.406. REVIEWS AND COMPLAINTS. (a) The department may enter the premises of a day habilitation services site at reasonable times to conduct a review necessary to certify a waiver provider, renew a certification, or address a complaint, or to follow up on the death of a client or the observations, findings, or recommendations of the Department of Family and Protective Services resulting from an allegation of abuse, neglect, or exploitation.

(b) Any person may file with the department a complaint about a day habilitation services provider or a day habilitation services site, including a complaint relating to an alleged violation of a certification requirement. The department shall address the complaint and determine actions necessary to resolve the complaint.

Sec. 161.407. CERTIFICATION DENIAL, SUSPENSION, OR REVOCATION. (a) The department may deny, suspend, or revoke the certification of an applicant or holder of a certification who fails to comply with the rules or standards for certification required by this subchapter or adopted by the department.

(b) The denial, suspension, or revocation of a certification and the appeal from that action are governed by the procedures for a contested case hearing under Chapter 2001, Government Code.

Sec. 161.408. DISPOSITION OF FUNDS. All money collected under this subchapter shall be deposited to the credit of a special account in the general revenue fund and may be appropriated only to the department for the purpose of administering this subchapter, including conducting reviews under Section 161.406.

SECTION 3. Section 253.001(4), Health and Safety Code, is amended to read as follows:

(4) "Facility" means:

(A) a facility:

(i) licensed by the department; [or]

(ii) licensed under Chapter 252; or

(iii) that is a day habilitation services site of a day habilitation services provider certified under Subchapter J, Chapter 161, Human Resources Code;

(B) an adult foster care provider that contracts with the department; or

(C) a home and community support services agency licensed by the department under Chapter 142.

SECTION 4. (a) Not later than June 1, 2015, the executive commissioner of the Health and Human Services Commission shall adopt the rules required by Subchapter J, Chapter 161, Human Resources Code, as added by this Act.

(b) A day habilitation services provider that is subject to Subchapter J, Chapter 161, Human Resources Code, as added by this Act, is not required to be certified by the Department of Aging and Disability Services as required by that subchapter until July 1, 2015.

SECTION 5. This Act takes effect September 1, 2014.