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INTRODUCED
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HOUSE COMMITTEE
SUBSTITUTE
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SECTION 1. Section 142.001,
Health and Safety Code, is amended by adding Subdivisions (11-c) and (11-d)
and amending Subdivisions (12) and (23) to read as follows:
(11-c) "Habilitation"
means a service that allows an individual
to reside successfully in a community setting by training the individual to
acquire, retain, and improve self-help, socialization, and daily living
skills or assisting the individual with activities of daily living. The
term includes habilitation training.
(11-d) "Habilitation training" means interacting
face-to-face with an individual who is awake to train the individual in:
(A) self-care;
(B) personal hygiene;
(C) household tasks;
(D) mobility;
(E) money management;
(F) community integration;
(G) use of adaptive equipment;
(H) management of caregivers;
(I) personal decision making;
(J) interpersonal communication;
(K) reduction of maladaptive behaviors;
(L) socialization and the development of relationships;
(M) participation in leisure and recreational activities;
(N) use of natural supports and community services typically
available to the public;
(O) self-administration of medication; and
(P) strategies to restore or compensate for reduced cognitive
skills.
(12) "Home and
community support services agency" means a person who provides home
health, hospice, habilitation, or personal assistance services for
pay or other consideration in a client's residence, an independent living
environment, or another appropriate location.
(23) "Place of
business" means an office of a home and community support services
agency that maintains client records or directs home health, hospice, habilitation,
or personal assistance services. The term does not include an
administrative support site.
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SECTION 1. Section 142.001,
Health and Safety Code, is amended by adding Subdivision (11-c) and
amending Subdivisions (12) and (23) to read as follows:
(11-c)
"Habilitation" means habilitation
services, as defined by Section 534.001, Government Code, delivered by a
licensed home and community support services agency.
(12) "Home and
community support services agency" means a person who provides home
health, hospice, habilitation, or personal assistance services for
pay or other consideration in a client's residence, an independent living
environment, or another appropriate location.
(23) "Place of
business" means an office of a home and community support services
agency that maintains client records or directs home health, hospice, habilitation,
or personal assistance services. The term does not include an
administrative support site.
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SECTION 2. Section 142.0011,
Health and Safety Code, is amended to read as follows:
Sec. 142.0011. SCOPE,
PURPOSE, AND IMPLEMENTATION. (a) The purpose of this chapter is to ensure
that home and community support services agencies in this state deliver the
highest possible quality of care. This chapter and the rules adopted under
this chapter establish minimum standards for acceptable quality of care,
and a violation of a minimum standard established or adopted under this
chapter is a violation of law. For purposes of this chapter, components of
quality of care include:
(1) client independence and
self-determination;
(2) humane treatment;
(3) continuity of care;
(4) coordination of
services;
(5) professionalism of
service providers;
(6) quality of life; [and]
(7) client satisfaction with
services; and
(8) person-centered
service delivery.
(b) The department shall
protect clients of home and community support services agencies by
regulating those agencies and:
(1) adopting rules relating
to quality of care and quality of life;
(2) strictly monitoring
factors relating to the health, safety, welfare, and dignity of each
client;
(3) imposing prompt and
effective remedies for violations of this chapter and rules and standards
adopted under this chapter;
(4) enabling agencies to
provide person-centered services that allow clients to maintain the
highest possible degree of independence and self-determination; and
(5) providing the public
with helpful and understandable information relating to agencies in this
state.
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SECTION 2. Section 142.0011,
Health and Safety Code, as amended by S.B. 219, Acts of the 84th
Legislature, Regular Session, 2015, is amended to read as follows:
Sec. 142.0011. SCOPE,
PURPOSE, AND IMPLEMENTATION. (a) The purpose of this chapter is to ensure
that home and community support services agencies in this state deliver the
highest possible quality of care. This chapter and the rules adopted under
this chapter establish minimum standards for acceptable quality of care,
and a violation of a minimum standard established or adopted under this
chapter is a violation of law. For purposes of this chapter, components of
quality of care include:
(1) client independence and
self-determination;
(2) humane treatment;
(3) continuity of care;
(4) coordination of
services;
(5) professionalism of
service providers;
(6) quality of life; [and]
(7) client satisfaction with
services; and
(8) person-centered
service delivery.
(b) The executive
commissioner shall protect clients of home and community support services
agencies by adopting rules relating to quality of care and quality of life.
(c) The department shall
protect clients of home and community support services agencies by:
(1) regulating those
agencies;
(2) strictly monitoring
factors relating to the health, safety, welfare, and dignity of each
client;
(3) imposing prompt and
effective remedies for violations of this chapter and rules and standards
adopted under this chapter;
(4) enabling agencies to
provide person-centered services that allow clients to maintain the
highest possible degree of independence and self-determination; and
(5) providing the public
with helpful and understandable information relating to agencies in this
state.
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SECTION 3. Section
142.002(a), Health and Safety Code, is amended to read as follows:
(a) Except as provided by
Section 142.003, a person, including a health care facility licensed under
this code, may not engage in the business of providing home health,
hospice, habilitation, or personal assistance services, or represent
to the public that the person is a provider of home health, hospice, habilitation,
or personal assistance services for pay without a home and community
support services agency license authorizing the person to perform those
services issued by the department for each place of business from which
home health, hospice, habilitation, or personal assistance services
are directed. A certified agency must have a license to provide certified
home health services.
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SECTION 3. Same as introduced
version.
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SECTION 4. Section
142.003(a), Health and Safety Code, is amended to read as follows:
(a) The following persons
need not be licensed under this chapter:
(1) a physician, dentist,
registered nurse, occupational therapist, or physical therapist licensed
under the laws of this state who provides home health services to a client
only as a part of and incidental to that person's private office practice;
(2) a registered nurse,
licensed vocational nurse, physical therapist, occupational therapist,
speech therapist, medical social worker, or any other health care
professional as determined by the department who provides home health
services as a sole practitioner;
(3) a registry that operates
solely as a clearinghouse to put consumers in contact with persons who
provide home health, hospice, habilitation, or personal assistance services
and that does not maintain official client records, direct client services,
or compensate the person who is providing the service;
(4) an individual whose
permanent residence is in the client's residence;
(5) an employee of a person
licensed under this chapter who provides home health, hospice, habilitation,
or personal assistance services only as an employee of the license holder
and who receives no benefit for providing the services, other than wages
from the license holder;
(6) a home, nursing home,
convalescent home, assisted living facility, special care facility, or
other institution for individuals who are elderly or who have disabilities
that provides home health or personal assistance services only to residents
of the home or institution;
(7) a person who provides
one health service through a contract with a person licensed under this
chapter;
(8) a durable medical
equipment supply company;
(9) a pharmacy or wholesale
medical supply company that does not furnish services, other than supplies,
to a person at the person's house;
(10) a hospital or other
licensed health care facility that provides home health or personal
assistance services only to inpatient residents of the hospital or
facility;
(11) a person providing home
health or personal assistance services to an injured employee under Title
5, Labor Code;
(12) a visiting nurse
service that:
(A) is conducted by and for
the adherents of a well-recognized church or religious denomination; and
(B) provides nursing
services by a person exempt from licensing by Section 301.004, Occupations
Code, because the person furnishes nursing care in which treatment is only
by prayer or spiritual means;
(13) an individual hired and
paid directly by the client or the client's family or legal guardian to
provide home health or personal assistance services;
(14) a business, school,
camp, or other organization that provides home health or personal
assistance services, incidental to the organization's primary purpose, to
individuals employed by or participating in programs offered by the
business, school, or camp that enable the individual to participate fully
in the business's, school's, or camp's programs;
(15) a person or
organization providing sitter-companion services or chore or household
services that do not involve personal care, health, or health-related
services;
(16) a licensed health care
facility that provides hospice services under a contract with a hospice;
(17) a person delivering
residential acquired immune deficiency syndrome hospice care who is
licensed and designated as a residential AIDS hospice under Chapter 248;
(18) the Texas Department of
Criminal Justice;
(19) a person that provides
home health, hospice, habilitation, or personal assistance services
only to persons receiving benefits under:
(A) the home and
community-based services (HCS) waiver program;
(B) the Texas home living
(TxHmL) waiver program; or
(C) Section 534.152,
Government Code; or
(20) an individual who
provides home health or personal assistance services as the employee of a
consumer or an entity or employee of an entity acting as a consumer's
fiscal agent under Section 531.051, Government Code.
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SECTION 4. Section
142.003(a), Health and Safety Code, is amended to read as follows:
(a) The following persons
need not be licensed under this chapter:
(1) a physician, dentist,
registered nurse, occupational therapist, or physical therapist licensed
under the laws of this state who provides home health services to a client
only as a part of and incidental to that person's private office practice;
(2) a registered nurse,
licensed vocational nurse, physical therapist, occupational therapist,
speech therapist, medical social worker, or any other health care
professional as determined by the department who provides home health
services as a sole practitioner;
(3) a registry that operates
solely as a clearinghouse to put consumers in contact with persons who
provide home health, hospice, habilitation, or personal assistance
services and that does not maintain official client records, direct client
services, or compensate the person who is providing the service;
(4) an individual whose
permanent residence is in the client's residence;
(5) an employee of a person
licensed under this chapter who provides home health, hospice, habilitation,
or personal assistance services only as an employee of the license holder
and who receives no benefit for providing the services, other than wages
from the license holder;
(6) a home, nursing home,
convalescent home, assisted living facility, special care facility, or
other institution for individuals who are elderly or who have disabilities
that provides home health or personal assistance services only to residents
of the home or institution;
(7) a person who provides
one health service through a contract with a person licensed under this
chapter;
(8) a durable medical
equipment supply company;
(9) a pharmacy or wholesale
medical supply company that does not furnish services, other than supplies,
to a person at the person's house;
(10) a hospital or other
licensed health care facility that provides home health or personal
assistance services only to inpatient residents of the hospital or
facility;
(11) a person providing home
health or personal assistance services to an injured employee under Title
5, Labor Code;
(12) a visiting nurse
service that:
(A) is conducted by and for
the adherents of a well-recognized church or religious denomination; and
(B) provides nursing
services by a person exempt from licensing by Section 301.004, Occupations
Code, because the person furnishes nursing care in which treatment is only
by prayer or spiritual means;
(13) an individual hired and
paid directly by the client or the client's family or legal guardian to
provide home health or personal assistance services;
(14) a business, school,
camp, or other organization that provides home health or personal
assistance services, incidental to the organization's primary purpose, to
individuals employed by or participating in programs offered by the
business, school, or camp that enable the individual to participate fully
in the business's, school's, or camp's programs;
(15) a person or
organization providing sitter-companion services or chore or household
services that do not involve personal care, health, or health-related
services;
(16) a licensed health care
facility that provides hospice services under a contract with a hospice;
(17) a person delivering
residential acquired immune deficiency syndrome hospice care who is
licensed and designated as a residential AIDS hospice under Chapter 248;
(18) the Texas Department of
Criminal Justice;
(19) a person that provides
home health, hospice, habilitation, or personal assistance services
only to persons receiving benefits under:
(A) the home and community-based
services (HCS) waiver program;
(B) the Texas home living
(TxHmL) waiver program; [or]
(C)
the STAR + PLUS or other Medicaid managed care program under the
program's HCS or TxHmL certification; or
(D) Section 534.152,
Government Code; or
(20) an individual who
provides home health or personal assistance services as the employee of a
consumer or an entity or employee of an entity acting as a consumer's
fiscal agent under Section 531.051, Government Code.
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SECTION 5. Sections
142.004(a) and (c), Health and Safety Code, are amended to read as follows:
(a) An applicant for a
license to provide home health, hospice, habilitation, or personal
assistance services must:
(1) file a written
application on a form prescribed by the department indicating the type of
service the applicant wishes to provide;
(2) cooperate with any
surveys required by the department for a license; and
(3) pay the license fee
prescribed by this chapter.
(c) The board by rule shall
require that, at a minimum, before the department may approve a license
application, the applicant must provide to the department:
(1) documentation
establishing that, at a minimum, the applicant has sufficient financial
resources to provide the services required by this chapter and by the
department during the term of the license;
(2) a list of the management
personnel for the proposed home and community support services agency, a
description of personnel qualifications, and a plan for providing
continuing training and education for the personnel during the term of the
license;
(3) documentation
establishing that the applicant is capable of meeting the minimum standards
established by the board relating to the quality of care;
(4) a plan that provides for
the orderly transfer of care of the applicant's clients if the applicant
cannot maintain or deliver home health, hospice, habilitation, or
personal assistance services under the license;
(5) identifying information
on the home and community support services agency owner, administrator, and
chief financial officer to enable the department to conduct criminal
background checks on those persons;
(6) identification of any
controlling person with respect to the applicant; and
(7) documentation relating
to any controlling person identified under Subdivision (6), if requested by
the department and relevant to the controlling person's compliance with any
applicable licensing standard required or adopted by the board under this
chapter.
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SECTION 5. Sections
142.004(a) and (c), Health and Safety Code, are amended to conform to S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, and further
amended to read as follows:
(a) An applicant for a
license to provide home health, hospice, habilitation, or personal
assistance services must:
(1) file a written
application on a form prescribed by the department indicating the type of
service the applicant wishes to provide;
(2) cooperate with any
surveys required by the department for a license; and
(3) pay the license fee
prescribed by this chapter.
(c) The executive
commissioner by rule shall require that, at a minimum, before the
department may approve a license application, the applicant must provide to
the department:
(1) documentation
establishing that, at a minimum, the applicant has sufficient financial
resources to provide the services required by this chapter and by the
department during the term of the license;
(2) a list of the management
personnel for the proposed home and community support services agency, a
description of personnel qualifications, and a plan for providing
continuing training and education for the personnel during the term of the
license;
(3) documentation
establishing that the applicant is capable of meeting the minimum standards
established by the executive commissioner relating to the quality of care;
(4) a plan that provides for
the orderly transfer of care of the applicant's clients if the applicant
cannot maintain or deliver home health, hospice, habilitation, or
personal assistance services under the license;
(5) identifying information
on the home and community support services agency owner, administrator, and
chief financial officer to enable the department to conduct criminal
background checks on those persons;
(6) identification of any
controlling person with respect to the applicant; and
(7) documentation relating
to any controlling person identified under Subdivision (6), if requested by
the department and relevant to the controlling person's compliance with any
applicable licensing standard required or adopted under this chapter.
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SECTION 6. Sections
142.006(a) and (g), Health and Safety Code, are amended to read as follows:
(a) The department shall
issue a home and community support services agency license to provide home
health, hospice, habilitation, or personal assistance services for
each place of business to an applicant if:
(1) the applicant:
(A) qualifies for the
license to provide the type of service that is to be offered by the
applicant;
(B) submits an application
and license fee as required by this chapter; and
(C) complies with all
applicable licensing standards required or adopted by the board under this
chapter; and
(2) any controlling person
with respect to the applicant complies with all applicable licensing
standards required or adopted by the board under this chapter.
(g) The license must
designate the types of services that the home and community support
services agency is authorized to provide at or from the designated place of
business. The types of services that may be designated include dialysis
and habilitation.
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SECTION 6. Sections
142.006(a) and (g), Health and Safety Code, are amended to conform to S.B.
219, Acts of the 84th Legislature, Regular Session, 2015, and further
amended to read as follows:
(a) The department shall
issue a home and community support services agency license to provide home
health, hospice, habilitation, or personal assistance services for
each place of business to an applicant if:
(1) the applicant:
(A) qualifies for the
license to provide the type of service that is to be offered by the
applicant;
(B) submits an application
and license fee as required by this chapter; and
(C) complies with all
applicable licensing standards required or adopted under this chapter; and
(2) any controlling person
with respect to the applicant complies with all applicable licensing
standards required or adopted under this chapter.
(g) The license must
designate the types of services that the home and community support
services agency is authorized to provide at or from the designated place of
business. The types of services that may be designated include dialysis
and habilitation.
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SECTION 7. Sections
142.009(b) and (c), Health and Safety Code, are amended to read as follows:
(b) A home and community support
services agency shall provide each person who receives home health,
hospice, habilitation, or personal assistance services with a
written statement that contains the name, address, and telephone number of
the department and a statement that informs the recipient that a complaint
against a home and community support services agency may be directed to the
department.
(c) The department or its
authorized representative shall investigate each complaint received
regarding the provision of home health, hospice, habilitation, or
personal assistance services, including any allegation of abuse, neglect,
or exploitation of a child under the age of 18, and may, as a part of the
investigation:
(1) conduct an unannounced
survey of a place of business, including an inspection of medical and
personnel records, if the department has reasonable cause to believe that
the place of business is in violation of this chapter or a rule adopted
under this chapter;
(2) conduct an interview
with a recipient of home health, hospice, habilitation, or personal
assistance services, which may be conducted in the recipient's home if the
recipient consents;
(3) conduct an interview
with a family member of a recipient of home health, hospice, habilitation,
or personal assistance services who is deceased or other person who may
have knowledge of the care received by the deceased recipient of the home
health, hospice, habilitation, or personal assistance services; or
(4) interview a physician or
other health care practitioner, including a member of the personnel of a
home and community support services agency, who cares for a recipient of
home health, hospice, habilitation, or personal assistance services.
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SECTION 7. Same as introduced
version.
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SECTION 8. Sections
142.0091(a) and (b), Health and Safety Code, are amended to read as
follows:
(a) The department shall
provide specialized training to representatives of the department who
survey home and community support services agencies. The training must
include information relating to:
(1) the conduct of
appropriate surveys that do not focus exclusively on medical standards
under an acute care model; [and]
(2) acceptable delegation of
nursing tasks; and
(3) the provision of
person-centered services.
(b) In developing and updating
the training required by Subsection (a), the department shall consult with
and include providers of home health, hospice, habilitation, and
personal assistance services, recipients of those services and their family
members, and representatives of appropriate advocacy organizations.
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SECTION 8. Same as introduced
version.
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SECTION 9. Section
142.0092(a), Health and Safety Code, is amended to read as follows:
(a) The department shall
maintain records or documents relating to complaints directed to the
department by consumers of home health, hospice, habilitation, or
personal assistance services. The department shall organize the records or
documents according to standard, statewide categories as determined by the
department. In determining appropriate categories, the department shall
make distinctions based on factors useful to the public in assessing the
quality of services provided by a home and community support services
agency, including whether the complaint:
(1) was determined to be
valid or invalid;
(2) involved significant
physical harm or death to a patient;
(3) involved financial
exploitation of a patient; or
(4) resulted in any sanction
imposed against the agency.
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SECTION 9. Same as introduced
version.
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SECTION 10. Section
142.0093(a), Health and Safety Code, is amended to read as follows:
(a) A person licensed under
this chapter may not retaliate against another person for filing a
complaint, presenting a grievance, or providing in good faith information
relating to home health, hospice, habilitation, or personal
assistance services provided by the license holder.
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SECTION 10. Same as
introduced version.
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SECTION 11. Section
142.010(a), Health and Safety Code, is amended to read as follows:
(a) The department shall set
license fees for home and community support services agencies in amounts
that are reasonable to meet the costs of administering this chapter, except
that the fees may not be less than $600 or more than $2,000 for a license
to provide home health, hospice, habilitation, or personal
assistance services.
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SECTION 11. Section
142.010(a), Health and Safety Code, as amended by S.B. 219, Acts of the
84th Legislature, Regular Session, 2015, is amended to read as follows:
(a) The executive
commissioner by rule shall set license fees for home and community support
services agencies in amounts that are reasonable to meet the costs of
administering this chapter, except that the fees may not be less than $600
or more than $2,000 for a license to provide home health, hospice, habilitation,
or personal assistance services.
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SECTION 12. Sections
142.012(b) and (e), Health and Safety Code, are amended to read as follows:
(b) The executive
commissioner by rule shall set minimum standards for home and community
support services agencies licensed under this chapter that relate to:
(1) qualifications for
professional and nonprofessional personnel, including volunteers;
(2) supervision of
professional and nonprofessional personnel, including volunteers;
(3) the provision and
coordination of treatment and services, including support and bereavement
services, as appropriate;
(4) the management,
ownership, and organizational structure, including lines of authority and
delegation of responsibility and, as appropriate, the composition of an
interdisciplinary team;
(5) clinical and business
records;
(6) financial ability to
carry out the functions as proposed;
(7) safety, fire prevention,
and sanitary standards for residential units and inpatient units; and
(8) any other aspects of home
health, hospice, habilitation, or personal assistance services as
necessary to protect the public.
(e) The department shall
require each person or home and community support services agency providing
home health, hospice, habilitation, or personal assistance services
to implement and enforce the applicable provisions of Chapter 102, Human
Resources Code.
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SECTION 12. Same as
introduced version.
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SECTION 13. Section
142.014(a), Health and Safety Code, is amended to read as follows:
(a) A person who engages in
the business of providing home health, hospice, habilitation, or
personal assistance service, or represents to the public that the person is
a provider of home health, hospice, habilitation, and personal
assistance services for pay, without a license issued under this chapter
authorizing the services that are being provided is liable for a civil
penalty of not less than $1,000 or more than $2,500 for each day of
violation. Penalties may be appropriated only to the department and to
administer this chapter.
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SECTION 13. Same as
introduced version.
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SECTION 14. Section
142.017(a), Health and Safety Code, is amended to read as follows:
(a) The department may
assess an administrative penalty against a person who violates:
(1) this chapter or a rule
adopted under this chapter; or
(2) Section 102.001,
Occupations Code, if the violation relates to the provision of home health,
hospice, habilitation, or personal assistance services.
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SECTION 14. Same as
introduced version.
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SECTION 15. (a) Not later
than December 1, 2015, the executive commissioner of the Health and Human
Services Commission shall adopt the rules necessary to implement the
changes in law made by this Act.
(b) Notwithstanding Section
142.017, Health and Safety Code, as amended by this Act, a person is not
required to hold a license under Chapter 142, Health and Safety Code, to
engage in the business of habilitation services until January 1, 2016.
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SECTION 15. Same as
introduced version.
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SECTION 16. This Act takes
effect September 1, 2015.
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SECTION 16. Same as
introduced version.
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