83R6876 KKR-D

By: Kolkhorst H.B. No. 3195

A BILL TO BE ENTITLED

AN ACT

relating to the review of certain administrative hearings conducted by health and human services agencies.

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

SECTION 1. Section 531.019, Government Code, is amended by amending Subsections (c) and (e) and adding Subsections (c-1) and (c-2) to read as follows:

(c) Before an applicant for or recipient of public assistance benefits may appeal a decision of a hearing officer for the commission or a health and human services agency related to those benefits, the applicant or recipient must request an administrative review by an appropriate attorney of the commission or a health and human services agency, as applicable, in accordance with rules of the executive commissioner. Subject to Subsection (c-1), not [Not] later than the 15th business day after the date the attorney receives the request for administrative review, the attorney shall complete an administrative review of the decision and notify the applicant or recipient in writing of the results of that review.

(c-1) If the attorney performing the administrative review under Subsection (c) determines that the hearing officer's decision resulted in an exception to the affected agency's or program's policies, the attorney shall forward, not later than the 15th business day after making that determination, the decision to the executive commissioner or commissioner for a final review under Subsection (c-2).

(c-2) The executive commissioner or commissioner, not later than the fifth business day after the date of receipt of a decision under Subsection (c-1), shall complete a review of the decision to determine if the decision should be affirmed or reversed and notify the applicant or recipient in writing of the results of that review.

(e) For purposes of Section 2001.171, an applicant for or recipient of public assistance benefits has exhausted all available administrative remedies and a decision, including a decision under Section 31.034 or 32.035, Human Resources Code, is final and appealable on the date that, after a hearing:

(1) the hearing officer for the commission or a health and human services agency reaches a final decision related to the benefits; [and]

(2) the appropriate attorney completes an administrative review of the decision and notifies the applicant or recipient in writing of the results of that review; and

(3) if applicable, the executive commissioner or the commissioner completes a final review of the decision and notifies the applicant or recipient in writing of the results of that review.

SECTION 2. Subchapter A, Chapter 531, Government Code, is amended by adding Section 531.01905 to read as follows:

Sec. 531.01905. ADMINISTRATIVE REVIEW OF FAIR HEARING DECISIONS. (a) In this section:

(1) "Administrative review" means a desk review performed by an attorney for the commission or a health and human services agency of a fair hearing decision related to benefits provided under an assistance program under Chapter 31, 32, or 33, Human Resources Code.

(2) "Fair hearing" means an informal proceeding held before an impartial hearing officer of the commission in which an applicant or client appeals an agency decision.

(3) "Procedural review" means a desk review performed by an attorney for the commission or a health and human services agency of a fair hearing decision related to an agency program other than an assistance program under Chapter 31, 32, or 33, Human Resources Code.

(b) If an administrative or procedural review shows that a fair hearing decision resulted in an exception to the affected agency's or program's policies, the attorney performing the review shall forward the decision to the executive commissioner or commissioner, as applicable, of the agency, who shall review the decision.

(c) The executive commissioner or commissioner, as applicable, of the agency, not later than the fifth business day after receipt of a fair hearing decision forwarded under Subsection (b), shall complete a review of the decision to determine if the decision should be affirmed or reversed and notify the affected benefits applicant or recipient in writing of the results of that review.

(d) If after review the executive commissioner or commissioner, as applicable, of the agency affirms a fair hearing decision forwarded under Subsection (b), the decision is effective for not more than 12 months after the date of the fair hearing decision.

(e) Not later than September 1 of each even-numbered year, the executive commissioner and the commissioner of each health and human services agency shall each provide a report to the standing committees of the senate and house of representatives having primary jurisdiction over health and human services agency programs that states:

(1) the number of decisions reviewed by the executive commissioner or commissioner, as applicable, during the preceding two-year period;

(2) the number of reviewed decisions affirmed by the executive commissioner or commissioner, as applicable, during the preceding two-year period; and

(3) the total cost to the agency resulting from the decisions affirmed by the executive commissioner or commissioner, as applicable, during the preceding two-year period.

SECTION 3. Section 531.019, Government Code, as amended by this Act, and Section 531.01905, Government Code, as added by this Act, apply only to a fair hearing decision made on or after the effective date of this Act. A fair hearing decision made before the effective date of this Act is governed by the law in effect on the date the decision was made, and the former law is continued in effect for that purpose.

SECTION 4. The executive commissioner of the Health and Human Services Commission and the commissioners of each health and human services agency, as defined by Section 531.001, Government Code, shall submit the initial reports required by Section 531.01905(e), Government Code, as added by this Act, on or before September 1, 2014.

SECTION 5. If before implementing any provision of this Act a state agency determines that a waiver or authorization from a federal agency is necessary for implementation of that provision, the agency affected by the provision shall request the waiver or authorization and may delay implementing that provision until the waiver or authorization is granted.

SECTION 6. This Act takes effect September 1, 2013.