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AN ACT
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relating to the provision of health and human services in this |
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state, including the powers and duties of the Health and Human |
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Services Commission and other state agencies, and the licensing of |
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certain health professionals; clarifying certain statutory |
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provisions; authorizing the imposition of fees. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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ARTICLE 1. FAMILY CODE |
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SECTION 1.001. The heading to Chapter 55, Family Code, is |
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amended to read as follows: |
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CHAPTER 55. PROCEEDINGS CONCERNING CHILDREN WITH MENTAL ILLNESS |
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OR INTELLECTUAL DISABILITY [MENTAL RETARDATION] |
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SECTION 1.002. Section 55.01, Family Code, is amended to |
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read as follows: |
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Sec. 55.01. MEANING OF "HAVING A MENTAL ILLNESS". For |
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purposes of this chapter, a child who is described as having a |
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mental illness means a child with a [who suffers from] mental |
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illness as defined by Section 571.003, Health and Safety Code. |
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SECTION 1.003. Section 55.02, Family Code, is amended to |
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read as follows: |
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Sec. 55.02. MENTAL HEALTH AND INTELLECTUAL DISABILITY |
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[MENTAL RETARDATION] JURISDICTION. For the purpose of initiating |
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proceedings to order mental health or intellectual disability |
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[mental retardation] services for a child or for commitment of a |
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child as provided by this chapter, the juvenile court has |
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jurisdiction of proceedings under Subtitle C or D, Title 7, Health |
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and Safety Code. |
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SECTION 1.004. Section 55.03(b), Family Code, is amended to |
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read as follows: |
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(b) Except as provided by this chapter, a child who is |
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committed by a court to a residential care facility due to an |
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intellectual disability [for mental retardation] shall be cared for |
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as provided by Subtitle D, Title 7, Health and Safety Code. |
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SECTION 1.005. The heading to Subchapter C, Chapter 55, |
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Family Code, is amended to read as follows: |
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SUBCHAPTER C. CHILD UNFIT TO PROCEED AS A RESULT OF MENTAL ILLNESS |
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OR INTELLECTUAL DISABILITY [MENTAL RETARDATION] |
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SECTION 1.006. Sections 55.31(a), (b), and (c), Family |
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Code, are amended to read as follows: |
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(a) A child alleged by petition or found to have engaged in |
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delinquent conduct or conduct indicating a need for supervision who |
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as a result of mental illness or an intellectual disability [mental
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retardation] lacks capacity to understand the proceedings in |
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juvenile court or to assist in the child's own defense is unfit to |
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proceed and shall not be subjected to discretionary transfer to |
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criminal court, adjudication, disposition, or modification of |
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disposition as long as such incapacity endures. |
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(b) On a motion by a party, the juvenile court shall |
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determine whether probable cause exists to believe that a child who |
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is alleged by petition or who is found to have engaged in delinquent |
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conduct or conduct indicating a need for supervision is unfit to |
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proceed as a result of mental illness or an intellectual disability |
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[mental retardation]. In making its determination, the court may: |
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(1) consider the motion, supporting documents, |
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professional statements of counsel, and witness testimony; and |
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(2) make its own observation of the child. |
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(c) If the court determines that probable cause exists to |
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believe that the child is unfit to proceed, the court shall |
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temporarily stay the juvenile court proceedings and immediately |
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order the child to be examined under Section 51.20. The information |
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obtained from the examination must include expert opinion as to |
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whether the child is unfit to proceed as a result of mental illness |
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or an intellectual disability [mental retardation]. |
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SECTION 1.007. Sections 55.32(a), (b), (d), (f), and (g), |
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Family Code, are amended to read as follows: |
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(a) If the juvenile court determines that evidence exists to |
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support a finding that a child is unfit to proceed as a result of |
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mental illness or an intellectual disability [mental retardation], |
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the court shall set the case for a hearing on that issue. |
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(b) The issue of whether the child is unfit to proceed as a |
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result of mental illness or an intellectual disability [mental
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retardation] shall be determined at a hearing separate from any |
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other hearing. |
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(d) Unfitness to proceed as a result of mental illness or an |
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intellectual disability [mental retardation] must be proved by a |
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preponderance of the evidence. |
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(f) If the court or jury determines that the child is unfit |
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to proceed as a result of mental illness or an intellectual |
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disability [mental retardation], the court shall: |
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(1) stay the juvenile court proceedings for as long as |
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that incapacity endures; and |
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(2) proceed under Section 55.33. |
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(g) The fact that the child is unfit to proceed as a result |
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of mental illness or an intellectual disability [mental
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retardation] does not preclude any legal objection to the juvenile |
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court proceedings which is susceptible of fair determination prior |
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to the adjudication hearing and without the personal participation |
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of the child. |
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SECTION 1.008. Section 55.33(a), Family Code, is amended to |
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read as follows: |
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(a) If the juvenile court or jury determines under Section |
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55.32 that a child is unfit to proceed with the juvenile court |
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proceedings for delinquent conduct, the court shall: |
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(1) if the unfitness to proceed is a result of mental |
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illness or an intellectual disability [mental retardation]: |
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(A) provided that the child meets the commitment |
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criteria under Subtitle C or D, Title 7, Health and Safety Code, |
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order the child placed with the [Texas] Department of State Health |
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Services or the Department of Aging and Disability Services, as |
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appropriate, [Mental Health and Mental Retardation] for a period of |
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not more than 90 days, which order may not specify a shorter period, |
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for placement in a facility designated by the department; or |
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(B) on application by the child's parent, |
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guardian, or guardian ad litem, order the child placed in a private |
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psychiatric inpatient facility for a period of not more than 90 |
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days, which order may not specify a shorter period, but only if the |
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placement is agreed to in writing by the administrator of the |
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facility; or |
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(2) if the unfitness to proceed is a result of mental |
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illness and the court determines that the child may be adequately |
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treated in an alternative setting, order the child to receive |
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treatment for mental illness on an outpatient basis for a period of |
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not more than 90 days, which order may not specify a shorter period. |
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SECTION 1.009. Section 55.35(a), Family Code, is amended to |
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read as follows: |
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(a) If the juvenile court issues a placement order under |
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Section 55.33(a), the court shall order the probation department to |
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send copies of any information in the possession of the department |
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and relevant to the issue of the child's mental illness or |
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intellectual disability [mental retardation] to the public or |
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private facility or outpatient center, as appropriate. |
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SECTION 1.010. Section 55.40, Family Code, is amended to |
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read as follows: |
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Sec. 55.40. REPORT THAT CHILD IS UNFIT TO PROCEED AS A |
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RESULT OF INTELLECTUAL DISABILITY [MENTAL RETARDATION]. If a |
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report submitted under Section 55.35(b) states that a child is |
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unfit to proceed as a result of an intellectual disability [mental
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retardation] and that the child meets the commitment criteria for |
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civil commitment under Subtitle D, Title 7, Health and Safety Code, |
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the director of the residential care facility shall submit to the |
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court an affidavit stating the conclusions reached as a result of |
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the diagnosis. On receipt of the affidavit, the court shall: |
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(1) initiate proceedings as provided by Section 55.41 |
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in the juvenile court for commitment of the child under Subtitle D, |
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Title 7, Health and Safety Code; or |
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(2) refer the child's case as provided by Section 55.42 |
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to the appropriate court for the initiation of proceedings in that |
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court for commitment of the child under Subtitle D, Title 7, Health |
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and Safety Code. |
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SECTION 1.011. The heading to Section 55.41, Family Code, |
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is amended to read as follows: |
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Sec. 55.41. COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR |
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CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION]. |
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SECTION 1.012. Section 55.41(c), Family Code, is amended to |
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read as follows: |
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(c) On receipt of the court's order, the [Texas] Department |
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of Aging and Disability Services [Mental Health and Mental
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Retardation] or the appropriate community center shall admit the |
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child to a residential care facility. |
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SECTION 1.013. The heading to Section 55.42, Family Code, |
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is amended to read as follows: |
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Sec. 55.42. REFERRAL FOR COMMITMENT PROCEEDINGS FOR |
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CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION]. |
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SECTION 1.014. Section 55.42(a), Family Code, is amended to |
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read as follows: |
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(a) If the juvenile court refers the child's case to an |
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appropriate court for the initiation of commitment proceedings |
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under Section 55.40(2), the juvenile court shall: |
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(1) send all papers relating to the child's |
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intellectual disability [mental retardation] to the clerk of the |
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court to which the case is referred; |
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(2) send to the office of the appropriate county |
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attorney or, if a county attorney is not available, to the office of |
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the appropriate district attorney, copies of all papers sent to the |
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clerk of the court under Subdivision (1); and |
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(3) if the child is in detention: |
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(A) order the child released from detention to |
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the child's home or another appropriate place; |
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(B) order the child detained in an appropriate |
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place other than a juvenile detention facility; or |
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(C) if an appropriate place to release or detain |
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the child as described by Paragraph (A) or (B) is not available, |
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order the child to remain in the juvenile detention facility |
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subject to further detention orders of the court. |
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SECTION 1.015. Section 55.43(a), Family Code, is amended to |
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read as follows: |
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(a) The prosecuting attorney may file with the juvenile |
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court a motion for a restoration hearing concerning a child if: |
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(1) the child is found unfit to proceed as a result of |
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mental illness or an intellectual disability [mental retardation]; |
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and |
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(2) the child: |
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(A) is not: |
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(i) ordered by a court to receive inpatient |
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mental health services; |
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(ii) committed by a court to a residential |
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care facility; or |
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(iii) ordered by a court to receive |
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treatment on an outpatient basis; or |
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(B) is discharged or currently on furlough from a |
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mental health facility or outpatient center before the child |
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reaches 18 years of age. |
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SECTION 1.016. Section 55.44(a), Family Code, is amended to |
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read as follows: |
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(a) The juvenile court shall transfer all pending |
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proceedings from the juvenile court to a criminal court on the 18th |
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birthday of a child for whom the juvenile court or a court to which |
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the child's case is referred has ordered inpatient mental health |
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services or residential care for persons with an intellectual |
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disability [mental retardation] if: |
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(1) the child is not discharged or currently on |
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furlough from the facility before reaching 18 years of age; and |
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(2) the child is alleged to have engaged in delinquent |
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conduct that included a violation of a penal law listed in Section |
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53.045 and no adjudication concerning the alleged conduct has been |
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made. |
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SECTION 1.017. The heading to Subchapter D, Chapter 55, |
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Family Code, is amended to read as follows: |
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SUBCHAPTER D. LACK OF RESPONSIBILITY FOR CONDUCT AS A RESULT OF |
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MENTAL ILLNESS OR INTELLECTUAL DISABILITY [MENTAL RETARDATION] |
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SECTION 1.018. Section 55.51, Family Code, is amended to |
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read as follows: |
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Sec. 55.51. LACK OF RESPONSIBILITY FOR CONDUCT |
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DETERMINATION; EXAMINATION. (a) A child alleged by petition to |
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have engaged in delinquent conduct or conduct indicating a need for |
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supervision is not responsible for the conduct if at the time of the |
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conduct, as a result of mental illness or an intellectual |
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disability [mental retardation], the child lacks substantial |
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capacity either to appreciate the wrongfulness of the child's |
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conduct or to conform the child's conduct to the requirements of |
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law. |
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(b) On a motion by a party in which it is alleged that a |
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child may not be responsible as a result of mental illness or an |
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intellectual disability [mental retardation] for the child's |
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conduct, the court shall order the child to be examined under |
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Section 51.20. The information obtained from the examinations must |
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include expert opinion as to whether the child is not responsible |
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for the child's conduct as a result of mental illness or an |
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intellectual disability [mental retardation]. |
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(c) The issue of whether the child is not responsible for |
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the child's conduct as a result of mental illness or an intellectual |
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disability [mental retardation] shall be tried to the court or jury |
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in the adjudication hearing. |
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(d) Lack of responsibility for conduct as a result of mental |
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illness or an intellectual disability [mental retardation] must be |
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proved by a preponderance of the evidence. |
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(e) In its findings or verdict the court or jury must state |
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whether the child is not responsible for the child's conduct as a |
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result of mental illness or an intellectual disability [mental
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retardation]. |
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(f) If the court or jury finds the child is not responsible |
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for the child's conduct as a result of mental illness or an |
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intellectual disability [mental retardation], the court shall |
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proceed under Section 55.52. |
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(g) A child found to be not responsible for the child's |
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conduct as a result of mental illness or an intellectual disability |
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[mental retardation] shall not be subject to proceedings under this |
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title with respect to such conduct, other than proceedings under |
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Section 55.52. |
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SECTION 1.019. Section 55.52(a), Family Code, is amended to |
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read as follows: |
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(a) If the court or jury finds that a child is not |
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responsible for the child's conduct under Section 55.51, the court |
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shall: |
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(1) if the lack of responsibility is a result of mental |
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illness or an intellectual disability [mental retardation]: |
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(A) provided that the child meets the commitment |
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criteria under Subtitle C or D, Title 7, Health and Safety Code, |
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order the child placed with the [Texas] Department of State Health |
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Services or the Department of Aging and Disability Services, as |
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appropriate, [Mental Health and Mental Retardation] for a period of |
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not more than 90 days, which order may not specify a shorter period, |
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for placement in a facility designated by the department; or |
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(B) on application by the child's parent, |
|
guardian, or guardian ad litem, order the child placed in a private |
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psychiatric inpatient facility for a period of not more than 90 |
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days, which order may not specify a shorter period, but only if the |
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placement is agreed to in writing by the administrator of the |
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facility; or |
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(2) if the child's lack of responsibility is a result |
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of mental illness and the court determines that the child may be |
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adequately treated in an alternative setting, order the child to |
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receive treatment on an outpatient basis for a period of not more |
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than 90 days, which order may not specify a shorter period. |
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SECTION 1.020. Sections 55.54(a) and (b), Family Code, are |
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amended to read as follows: |
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(a) If the juvenile court issues a placement order under |
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Section 55.52(a), the court shall order the probation department to |
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send copies of any information in the possession of the department |
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and relevant to the issue of the child's mental illness or |
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intellectual disability [mental retardation] to the public or |
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private facility or outpatient center, as appropriate. |
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(b) Not later than the 75th day after the date the court |
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issues a placement order under Section 55.52(a), the public or |
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private facility or outpatient center, as appropriate, shall submit |
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to the court a report that: |
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(1) describes the treatment of the child provided by |
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the facility or center; and |
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(2) states the opinion of the director of the facility |
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or center as to whether the child has a mental illness or an |
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intellectual disability [is mentally ill or mentally retarded]. |
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SECTION 1.021. Section 55.55, Family Code, is amended to |
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read as follows: |
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Sec. 55.55. REPORT THAT CHILD DOES NOT HAVE MENTAL ILLNESS |
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OR INTELLECTUAL DISABILITY [IS NOT MENTALLY ILL OR MENTALLY
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RETARDED]; HEARING ON OBJECTION. (a) If a report submitted under |
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Section 55.54(b) states that a child does not have a mental illness |
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or an intellectual disability [mental retardation], the juvenile |
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court shall discharge the child unless: |
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(1) an adjudication hearing was conducted concerning |
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conduct that included a violation of a penal law listed in Section |
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53.045(a) and a petition was approved by a grand jury under Section |
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53.045; and |
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(2) the prosecuting attorney objects in writing not |
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later than the second day after the date the attorney receives a |
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copy of the report under Section 55.54(c). |
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(b) On objection by the prosecuting attorney under |
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Subsection (a), the juvenile court shall hold a hearing without a |
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jury to determine whether the child has a mental illness or an |
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intellectual disability [mental retardation] and whether the child |
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meets the commitment criteria for civil commitment under Subtitle C |
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or D, Title 7, Health and Safety Code. |
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(c) At the hearing, the burden is on the state to prove by |
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clear and convincing evidence that the child has a mental illness or |
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an intellectual disability [mental retardation] and that the child |
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meets the commitment criteria for civil commitment under Subtitle C |
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or D, Title 7, Health and Safety Code. |
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(d) If, after a hearing, the court finds that the child does |
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not have a mental illness or an intellectual disability [mental
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retardation] and that the child does not meet the commitment |
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criteria under Subtitle C or D, Title 7, Health and Safety Code, the |
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court shall discharge the child. |
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(e) If, after a hearing, the court finds that the child has a |
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mental illness or an intellectual disability [mental retardation] |
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and that the child meets the commitment criteria under Subtitle C or |
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D, Title 7, Health and Safety Code, the court shall issue an |
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appropriate commitment order. |
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SECTION 1.022. Section 55.59, Family Code, is amended to |
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read as follows: |
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Sec. 55.59. REPORT THAT CHILD HAS INTELLECTUAL DISABILITY |
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[MENTAL RETARDATION]; INITIATION OF COMMITMENT PROCEEDINGS. If a |
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report submitted under Section 55.54(b) states that a child has an |
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intellectual disability [mental retardation] and that the child |
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meets the commitment criteria for civil commitment under Subtitle |
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D, Title 7, Health and Safety Code, the director of the residential |
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care facility shall submit to the court an affidavit stating the |
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conclusions reached as a result of the diagnosis. On receipt of an |
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affidavit, the juvenile court shall: |
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(1) initiate proceedings in the juvenile court as |
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provided by Section 55.60 for commitment of the child under |
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Subtitle D, Title 7, Health and Safety Code; or |
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(2) refer the child's case to the appropriate court as |
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provided by Section 55.61 for the initiation of proceedings in that |
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court for commitment of the child under Subtitle D, Title 7, Health |
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and Safety Code. |
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SECTION 1.023. The heading to Section 55.60, Family Code, |
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is amended to read as follows: |
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Sec. 55.60. COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR |
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CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION]. |
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SECTION 1.024. Section 55.60(c), Family Code, is amended to |
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read as follows: |
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(c) On receipt of the court's order, the [Texas] Department |
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of Aging and Disability Services [Mental Health and Mental
|
|
Retardation] or the appropriate community center shall admit the |
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child to a residential care facility. |
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SECTION 1.025. The heading to Section 55.61, Family Code, |
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is amended to read as follows: |
|
Sec. 55.61. REFERRAL FOR COMMITMENT PROCEEDINGS FOR |
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CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION]. |
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SECTION 1.026. Section 55.61(a), Family Code, is amended to |
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read as follows: |
|
(a) If the juvenile court refers the child's case to an |
|
appropriate court for the initiation of commitment proceedings |
|
under Section 55.59(2), the juvenile court shall: |
|
(1) send all papers relating to the child's |
|
intellectual disability [mental retardation] to the clerk of the |
|
court to which the case is referred; |
|
(2) send to the office of the appropriate county |
|
attorney or, if a county attorney is not available, to the office of |
|
the appropriate district attorney, copies of all papers sent to the |
|
clerk of the court under Subdivision (1); and |
|
(3) if the child is in detention: |
|
(A) order the child released from detention to |
|
the child's home or another appropriate place; |
|
(B) order the child detained in an appropriate |
|
place other than a juvenile detention facility; or |
|
(C) if an appropriate place to release or detain |
|
the child as described by Paragraph (A) or (B) is not available, |
|
order the child to remain in the juvenile detention facility |
|
subject to further detention orders of the court. |
|
SECTION 1.027. Section 101.0021, Family Code, is |
|
redesignated as Section 101.036, Family Code, and amended to read |
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as follows: |
|
Sec. 101.036 [101.0021]. [BUREAU OF] VITAL STATISTICS |
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UNIT. "Vital [Bureau of vital] statistics unit" means the [bureau
|
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of] vital statistics unit of the [Texas] Department of State Health |
|
Services. |
|
SECTION 1.028. Section 101.017, Family Code, is amended to |
|
read as follows: |
|
Sec. 101.017. LICENSED CHILD PLACING AGENCY. "Licensed |
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child placing agency" means a person, including an organization |
|
[private association,] or corporation, licensed or certified under |
|
Chapter 42, Human Resources Code, [approved] by the Department of |
|
Family and Protective Services to place a child in a child-care |
|
facility, agency foster home, agency foster group home, or adoptive |
|
home [children for adoption through a license, certification, or
|
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other means]. |
|
SECTION 1.029. Section 102.003(a), Family Code, is amended |
|
to read as follows: |
|
(a) An original suit may be filed at any time by: |
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(1) a parent of the child; |
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(2) the child through a representative authorized by |
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the court; |
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(3) a custodian or person having the right of |
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visitation with or access to the child appointed by an order of a |
|
court of another state or country; |
|
(4) a guardian of the person or of the estate of the |
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child; |
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(5) a governmental entity; |
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(6) the Department of Family and Protective Services |
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[an authorized agency]; |
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(7) a licensed child placing agency; |
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(8) a man alleging himself to be the father of a child |
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filing in accordance with Chapter 160, subject to the limitations |
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of that chapter, but not otherwise; |
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(9) a person, other than a foster parent, who has had |
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actual care, control, and possession of the child for at least six |
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months ending not more than 90 days preceding the date of the filing |
|
of the petition; |
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(10) a person designated as the managing conservator |
|
in a revoked or unrevoked affidavit of relinquishment under Chapter |
|
161 or to whom consent to adoption has been given in writing under |
|
Chapter 162; |
|
(11) a person with whom the child and the child's |
|
guardian, managing conservator, or parent have resided for at least |
|
six months ending not more than 90 days preceding the date of the |
|
filing of the petition if the child's guardian, managing |
|
conservator, or parent is deceased at the time of the filing of the |
|
petition; |
|
(12) a person who is the foster parent of a child |
|
placed by the Department of Family and Protective Services in the |
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person's home for at least 12 months ending not more than 90 days |
|
preceding the date of the filing of the petition; |
|
(13) a person who is a relative of the child within the |
|
third degree by consanguinity, as determined by Chapter 573, |
|
Government Code, if the child's parents are deceased at the time of |
|
the filing of the petition; or |
|
(14) a person who has been named as a prospective |
|
adoptive parent of a child by a pregnant woman or the parent of the |
|
child, in a verified written statement to confer standing executed |
|
under Section 102.0035, regardless of whether the child has been |
|
born. |
|
SECTION 1.030. Section 102.011(b), Family Code, is amended |
|
to read as follows: |
|
(b) The court may also exercise personal jurisdiction over a |
|
person on whom service of citation is required or over the person's |
|
personal representative, although the person is not a resident or |
|
domiciliary of this state, if: |
|
(1) the person is personally served with citation in |
|
this state; |
|
(2) the person submits to the jurisdiction of this |
|
state by consent, by entering a general appearance, or by filing a |
|
responsive document having the effect of waiving any contest to |
|
personal jurisdiction; |
|
(3) the child resides in this state as a result of the |
|
acts or directives of the person; |
|
(4) the person resided with the child in this state; |
|
(5) the person resided in this state and provided |
|
prenatal expenses or support for the child; |
|
(6) the person engaged in sexual intercourse in this |
|
state and the child may have been conceived by that act of |
|
intercourse; |
|
(7) the person, as provided by Chapter 160: |
|
(A) registered with the paternity registry |
|
maintained by the [bureau of] vital statistics unit; or |
|
(B) signed an acknowledgment of paternity of a |
|
child born in this state; or |
|
(8) there is any basis consistent with the |
|
constitutions of this state and the United States for the exercise |
|
of the personal jurisdiction. |
|
SECTION 1.031. Section 107.001(5), Family Code, is amended |
|
to read as follows: |
|
(5) "Guardian ad litem" means a person appointed to |
|
represent the best interests of a child. The term includes: |
|
(A) a volunteer advocate from a charitable |
|
organization described by [appointed under] Subchapter C who is |
|
appointed by the court as the child's guardian ad litem; |
|
(B) a professional, other than an attorney, who |
|
holds a relevant professional license and whose training relates to |
|
the determination of a child's best interests; |
|
(C) an adult having the competence, training, and |
|
expertise determined by the court to be sufficient to represent the |
|
best interests of the child; or |
|
(D) an attorney ad litem appointed to serve in |
|
the dual role. |
|
SECTION 1.032. Section 107.002(c), Family Code, is amended |
|
to read as follows: |
|
(c) A guardian ad litem appointed for the child under this |
|
chapter is entitled to: |
|
(1) receive a copy of each pleading or other paper |
|
filed with the court in the case in which the guardian ad litem is |
|
appointed; |
|
(2) receive notice of each hearing in the case; |
|
(3) participate in case staffings by the Department of |
|
Family and Protective Services [an authorized agency] concerning |
|
the child; |
|
(4) attend all legal proceedings in the case but may |
|
not call or question a witness or otherwise provide legal services |
|
unless the guardian ad litem is a licensed attorney who has been |
|
appointed in the dual role; |
|
(5) review and sign, or decline to sign, an agreed |
|
order affecting the child; and |
|
(6) explain the basis for the guardian ad litem's |
|
opposition to the agreed order if the guardian ad litem does not |
|
agree to the terms of a proposed order. |
|
SECTION 1.033. Section 107.003(a), Family Code, is amended |
|
to read as follows: |
|
(a) An attorney ad litem appointed to represent a child or |
|
an amicus attorney appointed to assist the court: |
|
(1) shall: |
|
(A) subject to Rules 4.02, 4.03, and 4.04, Texas |
|
Disciplinary Rules of Professional Conduct, and within a reasonable |
|
time after the appointment, interview: |
|
(i) the child in a developmentally |
|
appropriate manner, if the child is four years of age or older; |
|
(ii) each person who has significant |
|
knowledge of the child's history and condition, including any |
|
foster parent of the child; and |
|
(iii) the parties to the suit; |
|
(B) seek to elicit in a developmentally |
|
appropriate manner the child's expressed objectives of |
|
representation; |
|
(C) consider the impact on the child in |
|
formulating the attorney's presentation of the child's expressed |
|
objectives of representation to the court; |
|
(D) investigate the facts of the case to the |
|
extent the attorney considers appropriate; |
|
(E) obtain and review copies of relevant records |
|
relating to the child as provided by Section 107.006; |
|
(F) participate in the conduct of the litigation |
|
to the same extent as an attorney for a party; |
|
(G) take any action consistent with the child's |
|
interests that the attorney considers necessary to expedite the |
|
proceedings; |
|
(H) encourage settlement and the use of |
|
alternative forms of dispute resolution; and |
|
(I) review and sign, or decline to sign, a |
|
proposed or agreed order affecting the child; |
|
(2) must be trained in child advocacy or have |
|
experience determined by the court to be equivalent to that |
|
training; and |
|
(3) is entitled to: |
|
(A) request clarification from the court if the |
|
role of the attorney is ambiguous; |
|
(B) request a hearing or trial on the merits; |
|
(C) consent or refuse to consent to an interview |
|
of the child by another attorney; |
|
(D) receive a copy of each pleading or other |
|
paper filed with the court; |
|
(E) receive notice of each hearing in the suit; |
|
(F) participate in any case staffing concerning |
|
the child conducted by the Department of Family and Protective |
|
Services [an authorized agency]; and |
|
(G) attend all legal proceedings in the suit. |
|
SECTION 1.034. Section 108.001, Family Code, is amended to |
|
read as follows: |
|
Sec. 108.001. TRANSMITTAL OF RECORDS OF SUIT BY CLERK. (a) |
|
Except as provided by this chapter, the clerk of the court shall |
|
transmit to the [bureau of] vital statistics unit a certified |
|
record of the order rendered in a suit, together with the name and |
|
all prior names, birth date, and place of birth of the child on a |
|
form provided by the unit [bureau]. The form shall be completed by |
|
the petitioner and submitted to the clerk at the time the order is |
|
filed for record. |
|
(b) The [bureau of] vital statistics unit shall maintain |
|
these records in a central file according to the name, birth date, |
|
and place of birth of the child, the court that rendered the order, |
|
and the docket number of the suit. |
|
(c) Except as otherwise provided by law, the records |
|
required under this section to be maintained by the [bureau of] |
|
vital statistics unit are confidential. |
|
(d) In a Title IV-D case, the Title IV-D agency may transmit |
|
the record and information specified by Subsection (a) to the |
|
[bureau of] vital statistics unit, with a copy to the clerk of the |
|
court on request by the clerk. The record and information are not |
|
required to be certified if transmitted by the Title IV-D agency |
|
under this subsection. |
|
SECTION 1.035. Section 108.003, Family Code, is amended to |
|
read as follows: |
|
Sec. 108.003. TRANSMITTAL OF INFORMATION REGARDING |
|
ADOPTION. (a) The clerk of a court that renders a decree of |
|
adoption shall, not later than the 10th day of the first month after |
|
the month in which the adoption is rendered, transmit to the central |
|
registry of the [bureau of] vital statistics unit a certified |
|
report of adoption that includes: |
|
(1) the name of the adopted child after adoption as |
|
shown in the adoption order; |
|
(2) the birth date of the adopted child; |
|
(3) the docket number of the adoption suit; |
|
(4) the identity of the court rendering the adoption; |
|
(5) the date of the adoption order; |
|
(6) the name and address of each parent, guardian, |
|
managing conservator, or other person whose consent to adoption was |
|
required or waived under Chapter 162, or whose parental rights were |
|
terminated in the adoption suit; |
|
(7) the identity of the licensed child placing agency, |
|
if any, through which the adopted child was placed for adoption; and |
|
(8) the identity, address, and telephone number of the |
|
registry through which the adopted child may register as an |
|
adoptee. |
|
(b) Except as otherwise provided by law, for good cause |
|
shown, or on an order of the court that granted the adoption or |
|
terminated the proceedings under Section 155.001, the records |
|
concerning a child maintained by the district clerk after rendition |
|
of a decree of adoption, the records of a child-placing agency that |
|
has ceased operations, and the records required under this section |
|
to be maintained by the [bureau of] vital statistics unit are |
|
confidential, and no person is entitled to access to or information |
|
from these records. |
|
(c) If the [bureau of] vital statistics unit determines that |
|
a report filed with the unit [bureau] under this section requires |
|
correction, the unit [bureau] shall mail the report directly to an |
|
attorney of record with respect to the adoption. The attorney shall |
|
return the corrected report to the unit [bureau]. If there is no |
|
attorney of record, the unit [bureau] shall mail the report to the |
|
clerk of the court for correction. |
|
SECTION 1.036. Section 108.004, Family Code, is amended to |
|
read as follows: |
|
Sec. 108.004. TRANSMITTAL OF FILES ON LOSS OF JURISDICTION. |
|
On the loss of jurisdiction of a court under Chapter 155, 159, or |
|
262, the clerk of the court shall transmit to the central registry |
|
of the [bureau of] vital statistics unit a certified record, on a |
|
form provided by the unit [bureau], stating that jurisdiction has |
|
been lost, the reason for the loss of jurisdiction, and the name and |
|
all previous names, date of birth, and place of birth of the child. |
|
SECTION 1.037. The heading to Section 108.005, Family Code, |
|
is amended to read as follows: |
|
Sec. 108.005. ADOPTION RECORDS RECEIVED BY [BUREAU OF] |
|
VITAL STATISTICS UNIT. |
|
SECTION 1.038. Section 108.005(a), Family Code, is amended |
|
to read as follows: |
|
(a) When the [bureau of] vital statistics unit receives a |
|
record from the district clerk showing that continuing, exclusive |
|
jurisdiction of a child has been lost due to the adoption of the |
|
child, the unit [bureau] shall close the records concerning that |
|
child. |
|
SECTION 1.039. Sections 108.006(a), (c), and (d), Family |
|
Code, are amended to read as follows: |
|
(a) The Department of State Health Services [bureau of vital
|
|
statistics] may charge a reasonable fee to cover the cost of |
|
determining and sending information concerning the identity of the |
|
court with continuing, exclusive jurisdiction. |
|
(c) The clerk shall send the fees collected under Subsection |
|
(b) to the Department of State Health Services [bureau of vital
|
|
statistics] for deposit in a special fund in the state treasury from |
|
which the legislature may appropriate money only to operate and |
|
maintain the central file and central registry of the vital |
|
statistics unit [bureau]. |
|
(d) The receipts from the fees charged under Subsection (a) |
|
shall be deposited in a financial institution as determined by the |
|
Department of State Health Services [director of the bureau of
|
|
vital statistics] and withdrawn as necessary for the sole purpose |
|
of operating and maintaining the central record file. |
|
SECTION 1.040. Section 108.007, Family Code, is amended to |
|
read as follows: |
|
Sec. 108.007. MICROFILM. (a) The [bureau of] vital |
|
statistics unit may use microfilm or other suitable means for |
|
maintaining the central record file. |
|
(b) A certified reproduction of a document maintained by the |
|
[bureau of] vital statistics unit is admissible in evidence as the |
|
original document. |
|
SECTION 1.041. Section 108.008(a), Family Code, is amended |
|
to read as follows: |
|
(a) On a determination of paternity, the petitioner shall |
|
provide the clerk of the court in which the order was rendered the |
|
information necessary to prepare the report of determination of |
|
paternity. The clerk shall: |
|
(1) prepare the report on a form provided by the vital |
|
statistics unit [Bureau of Vital Statistics]; and |
|
(2) complete the report immediately after the order |
|
becomes final. |
|
SECTION 1.042. Section 108.110, Family Code, is amended to |
|
read as follows: |
|
Sec. 108.110. RELEASE OF INFORMATION BY [BUREAU OF] VITAL |
|
STATISTICS UNIT. (a) The [bureau of] vital statistics unit shall |
|
provide to the Department of Family and Protective [and Regulatory] |
|
Services: |
|
(1) adoption information as necessary for the |
|
department to comply with federal law or regulations regarding the |
|
compilation or reporting of adoption information to federal |
|
officials; and |
|
(2) other information as necessary for the department |
|
to administer its duties. |
|
(b) The unit [bureau] may release otherwise confidential |
|
information from the unit's [bureau's] central record files to |
|
another governmental entity that has a specific need for the |
|
information and maintains appropriate safeguards to prevent |
|
further dissemination of the information. |
|
SECTION 1.043. Section 153.005(b), Family Code, is amended |
|
to read as follows: |
|
(b) A managing conservator must be a parent, a competent |
|
adult, the Department of Family and Protective Services [an
|
|
authorized agency], or a licensed child-placing agency. |
|
SECTION 1.044. Section 153.371, Family Code, is amended to |
|
read as follows: |
|
Sec. 153.371. RIGHTS AND DUTIES OF NONPARENT APPOINTED AS |
|
SOLE MANAGING CONSERVATOR. Unless limited by court order or other |
|
provisions of this chapter, a nonparent, a licensed child-placing |
|
agency, or the Department of Family and Protective Services |
|
[authorized agency] appointed as a managing conservator of the |
|
child has the following rights and duties: |
|
(1) the right to have physical possession and to |
|
direct the moral and religious training of the child; |
|
(2) the duty of care, control, protection, and |
|
reasonable discipline of the child; |
|
(3) the duty to provide the child with clothing, food, |
|
shelter, education, and medical, psychological, and dental care; |
|
(4) the right to consent for the child to medical, |
|
psychiatric, psychological, dental, and surgical treatment and to |
|
have access to the child's medical records; |
|
(5) the right to receive and give receipt for payments |
|
for the support of the child and to hold or disburse funds for the |
|
benefit of the child; |
|
(6) the right to the services and earnings of the |
|
child; |
|
(7) the right to consent to marriage and to enlistment |
|
in the armed forces of the United States; |
|
(8) the right to represent the child in legal action |
|
and to make other decisions of substantial legal significance |
|
concerning the child; |
|
(9) except when a guardian of the child's estate or a |
|
guardian or attorney ad litem has been appointed for the child, the |
|
right to act as an agent of the child in relation to the child's |
|
estate if the child's action is required by a state, the United |
|
States, or a foreign government; |
|
(10) the right to designate the primary residence of |
|
the child and to make decisions regarding the child's education; |
|
and |
|
(11) if the parent-child relationship has been |
|
terminated with respect to the parents, or only living parent, or if |
|
there is no living parent, the right to consent to the adoption of |
|
the child and to make any other decision concerning the child that a |
|
parent could make. |
|
SECTION 1.045. Section 153.372(a), Family Code, is amended |
|
to read as follows: |
|
(a) A nonparent, the Department of Family and Protective |
|
Services [authorized agency], or a licensed child-placing agency |
|
appointed as a joint managing conservator may serve in that |
|
capacity with either another nonparent or with a parent of the |
|
child. |
|
SECTION 1.046. Section 153.373, Family Code, is amended to |
|
read as follows: |
|
Sec. 153.373. VOLUNTARY SURRENDER OF POSSESSION REBUTS |
|
PARENTAL PRESUMPTION. The presumption that a parent should be |
|
appointed or retained as managing conservator of the child is |
|
rebutted if the court finds that: |
|
(1) the parent has voluntarily relinquished actual |
|
care, control, and possession of the child to a nonparent, a |
|
licensed child-placing agency, or the Department of Family and |
|
Protective Services [authorized agency] for a period of one year or |
|
more, a portion of which was within 90 days preceding the date of |
|
intervention in or filing of the suit; and |
|
(2) the appointment of the nonparent, [or] agency, or |
|
Department of Family and Protective Services as managing |
|
conservator is in the best interest of the child. |
|
SECTION 1.047. Section 153.374, Family Code, is amended to |
|
read as follows: |
|
Sec. 153.374. DESIGNATION OF MANAGING CONSERVATOR IN |
|
AFFIDAVIT OF RELINQUISHMENT. (a) A parent may designate a |
|
competent person, the Department of Family and Protective Services |
|
[authorized agency], or a licensed child-placing agency to serve as |
|
managing conservator of the child in an unrevoked or irrevocable |
|
affidavit of relinquishment of parental rights executed as provided |
|
by Chapter 161. |
|
(b) The person, Department of Family and Protective |
|
Services, or agency designated to serve as managing conservator |
|
shall be appointed managing conservator unless the court finds that |
|
the appointment would not be in the best interest of the child. |
|
SECTION 1.048. Section 153.376(a), Family Code, is amended |
|
to read as follows: |
|
(a) Unless limited by court order or other provisions of |
|
this chapter, a nonparent, a licensed child-placing agency, or the |
|
Department of Family and Protective Services [authorized agency] |
|
appointed as a possessory conservator has the following rights and |
|
duties during the period of possession: |
|
(1) the duty of care, control, protection, and |
|
reasonable discipline of the child; |
|
(2) the duty to provide the child with clothing, food, |
|
and shelter; and |
|
(3) the right to consent to medical, dental, and |
|
surgical treatment during an emergency involving an immediate |
|
danger to the health and safety of the child. |
|
SECTION 1.049. Section 153.434, Family Code, is amended to |
|
read as follows: |
|
Sec. 153.434. LIMITATION ON RIGHT TO REQUEST POSSESSION OR |
|
ACCESS. A biological or adoptive grandparent may not request |
|
possession of or access to a grandchild if: |
|
(1) each of the biological parents of the grandchild |
|
has: |
|
(A) died; |
|
(B) had the person's parental rights terminated; |
|
or |
|
(C) executed an affidavit of waiver of interest |
|
in child or an affidavit of relinquishment of parental rights under |
|
Chapter 161 and the affidavit designates the Department of Family |
|
and Protective Services [an authorized agency], a licensed |
|
child-placing agency, or a person other than the child's stepparent |
|
as the managing conservator of the child; and |
|
(2) the grandchild has been adopted, or is the subject |
|
of a pending suit for adoption, by a person other than the child's |
|
stepparent. |
|
SECTION 1.050. Section 155.004(a), Family Code, is amended |
|
to read as follows: |
|
(a) A court of this state loses its continuing, exclusive |
|
jurisdiction to modify its order if: |
|
(1) an order of adoption is rendered after the court |
|
acquires continuing, exclusive jurisdiction of the suit; |
|
(2) the parents of the child have remarried each other |
|
after the dissolution of a previous marriage between them and file a |
|
suit for the dissolution of their subsequent marriage combined with |
|
a suit affecting the parent-child relationship as if there had not |
|
been a prior court with continuing, exclusive jurisdiction over the |
|
child; or |
|
(3) another court assumed jurisdiction over a suit and |
|
rendered a final order based on incorrect information received from |
|
the [bureau of] vital statistics unit that there was no court of |
|
continuing, exclusive jurisdiction. |
|
SECTION 1.051. Sections 155.101(a), (b), and (d), Family |
|
Code, are amended to read as follows: |
|
(a) The petitioner or the court shall request from the |
|
[bureau of] vital statistics unit identification of the court that |
|
last had continuing, exclusive jurisdiction of the child in a suit |
|
unless: |
|
(1) the petition alleges that no court has continuing, |
|
exclusive jurisdiction of the child and the issue is not disputed by |
|
the pleadings; or |
|
(2) the petition alleges that the court in which the |
|
suit or petition to modify has been filed has acquired and retains |
|
continuing, exclusive jurisdiction of the child as the result of a |
|
prior proceeding and the issue is not disputed by the pleadings. |
|
(b) The [bureau of] vital statistics unit shall, on the |
|
written request of the court, an attorney, or a party: |
|
(1) identify the court that last had continuing, |
|
exclusive jurisdiction of the child in a suit and give the docket |
|
number of the suit; or |
|
(2) state that the child has not been the subject of a |
|
suit. |
|
(d) The [bureau of] vital statistics unit shall transmit the |
|
information not later than the 10th day after the date on which the |
|
request is received. |
|
SECTION 1.052. Section 155.103, Family Code, is amended to |
|
read as follows: |
|
Sec. 155.103. RELIANCE ON [BUREAU OF] VITAL STATISTICS UNIT |
|
INFORMATION. (a) A court shall have jurisdiction over a suit if it |
|
has been, correctly or incorrectly, informed by the [bureau of] |
|
vital statistics unit that the child has not been the subject of a |
|
suit and the petition states that no other court has continuing, |
|
exclusive jurisdiction over the child. |
|
(b) If the [bureau of] vital statistics unit notifies the |
|
court that the unit [bureau] has furnished incorrect information |
|
regarding the existence of another court with continuing, exclusive |
|
jurisdiction before the rendition of a final order, the provisions |
|
of this chapter apply. |
|
SECTION 1.053. Section 155.104, Family Code, is amended to |
|
read as follows: |
|
Sec. 155.104. VOIDABLE ORDER. (a) If a request for |
|
information from the [bureau of] vital statistics unit relating to |
|
the identity of the court having continuing, exclusive jurisdiction |
|
of the child has been made under this subchapter, a final order, |
|
except an order of dismissal, may not be rendered until the |
|
information is filed with the court. |
|
(b) If a final order is rendered in the absence of the filing |
|
of the information from the [bureau of] vital statistics unit, the |
|
order is voidable on a showing that a court other than the court |
|
that rendered the order had continuing, exclusive jurisdiction. |
|
SECTION 1.054. Section 159.201(a), Family Code, is amended |
|
to read as follows: |
|
(a) In a proceeding to establish or enforce a support order |
|
or to determine parentage, a tribunal of this state may exercise |
|
personal jurisdiction over a nonresident individual or the |
|
individual's guardian or conservator if: |
|
(1) the individual is personally served with citation |
|
in this state; |
|
(2) the individual submits to the jurisdiction of this |
|
state by consent, by entering a general appearance, or by filing a |
|
responsive document having the effect of waiving any contest to |
|
personal jurisdiction; |
|
(3) the individual resided with the child in this |
|
state; |
|
(4) the individual resided in this state and provided |
|
prenatal expenses or support for the child; |
|
(5) the child resides in this state as a result of the |
|
acts or directives of the individual; |
|
(6) the individual engaged in sexual intercourse in |
|
this state and the child may have been conceived by that act of |
|
intercourse; |
|
(7) the individual asserted parentage in the paternity |
|
registry maintained in this state by the [bureau of] vital |
|
statistics unit; or |
|
(8) there is any other basis consistent with the |
|
constitutions of this state and the United States for the exercise |
|
of personal jurisdiction. |
|
SECTION 1.055. Section 160.204(a), Family Code, is amended |
|
to read as follows: |
|
(a) A man is presumed to be the father of a child if: |
|
(1) he is married to the mother of the child and the |
|
child is born during the marriage; |
|
(2) he is married to the mother of the child and the |
|
child is born before the 301st day after the date the marriage is |
|
terminated by death, annulment, declaration of invalidity, or |
|
divorce; |
|
(3) he married the mother of the child before the birth |
|
of the child in apparent compliance with law, even if the attempted |
|
marriage is or could be declared invalid, and the child is born |
|
during the invalid marriage or before the 301st day after the date |
|
the marriage is terminated by death, annulment, declaration of |
|
invalidity, or divorce; |
|
(4) he married the mother of the child after the birth |
|
of the child in apparent compliance with law, regardless of whether |
|
the marriage is or could be declared invalid, he voluntarily |
|
asserted his paternity of the child, and: |
|
(A) the assertion is in a record filed with the |
|
[bureau of] vital statistics unit; |
|
(B) he is voluntarily named as the child's father |
|
on the child's birth certificate; or |
|
(C) he promised in a record to support the child |
|
as his own; or |
|
(5) during the first two years of the child's life, he |
|
continuously resided in the household in which the child resided |
|
and he represented to others that the child was his own. |
|
SECTION 1.056. Section 160.302(b), Family Code, is amended |
|
to read as follows: |
|
(b) An acknowledgment of paternity is void if it: |
|
(1) states that another man is a presumed father of the |
|
child, unless a denial of paternity signed or otherwise |
|
authenticated by the presumed father is filed with the [bureau of] |
|
vital statistics unit; |
|
(2) states that another man is an acknowledged or |
|
adjudicated father of the child; or |
|
(3) falsely denies the existence of a presumed, |
|
acknowledged, or adjudicated father of the child. |
|
SECTION 1.057. Section 160.304(c), Family Code, is amended |
|
to read as follows: |
|
(c) Subject to Subsection (a), an acknowledgment of |
|
paternity or denial of paternity takes effect on the date of the |
|
birth of the child or the filing of the document with the [bureau
|
|
of] vital statistics unit, whichever occurs later. |
|
SECTION 1.058. Section 160.305, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.305. EFFECT OF ACKNOWLEDGMENT OR DENIAL OF |
|
PATERNITY. (a) Except as provided by Sections 160.307 and 160.308, |
|
a valid acknowledgment of paternity filed with the [bureau of] |
|
vital statistics unit is the equivalent of an adjudication of the |
|
paternity of a child and confers on the acknowledged father all |
|
rights and duties of a parent. |
|
(b) Except as provided by Sections 160.307 and 160.308, a |
|
valid denial of paternity filed with the [bureau of] vital |
|
statistics unit in conjunction with a valid acknowledgment of |
|
paternity is the equivalent of an adjudication of the nonpaternity |
|
of the presumed father and discharges the presumed father from all |
|
rights and duties of a parent. |
|
SECTION 1.059. Section 160.306, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.306. FILING FEE NOT REQUIRED. The Department of |
|
State Health Services [bureau of vital statistics] may not charge a |
|
fee for filing: |
|
(1) an acknowledgment of paternity; |
|
(2) a denial of paternity; or |
|
(3) a rescission of an acknowledgment of paternity or |
|
denial of paternity. |
|
SECTION 1.060. Sections 160.307(b) and (c), Family Code, |
|
are amended to read as follows: |
|
(b) A signatory seeking to rescind an acknowledgment of |
|
paternity or denial of paternity must file with the [bureau of] |
|
vital statistics unit a completed rescission, on the form |
|
prescribed under Section 160.312, in which the signatory declares |
|
under penalty of perjury that: |
|
(1) as of the date the rescission is filed, a |
|
proceeding has not been held affecting the child identified in the |
|
acknowledgment of paternity or denial of paternity, including a |
|
proceeding to establish child support; |
|
(2) a copy of the completed rescission was sent by |
|
certified or registered mail, return receipt requested, to: |
|
(A) if the rescission is of an acknowledgment of |
|
paternity, the other signatory of the acknowledgment of paternity |
|
and the signatory of any related denial of paternity; or |
|
(B) if the rescission is of a denial of |
|
paternity, the signatories of the related acknowledgment of |
|
paternity; and |
|
(3) if a signatory to the acknowledgment of paternity |
|
or denial of paternity is receiving services from the Title IV-D |
|
agency, a copy of the completed rescission was sent by certified or |
|
registered mail to the Title IV-D agency. |
|
(c) On receipt of a completed rescission, the [bureau of] |
|
vital statistics unit shall void the acknowledgment of paternity or |
|
denial of paternity affected by the rescission and amend the birth |
|
record of the child, if appropriate. |
|
SECTION 1.061. Sections 160.309(b) and (e), Family Code, |
|
are amended to read as follows: |
|
(b) For purposes of a challenge to an acknowledgment of |
|
paternity or denial of paternity, a signatory submits to the |
|
personal jurisdiction of this state by signing the acknowledgment |
|
or denial. The jurisdiction is effective on the filing of the |
|
document with the [bureau of] vital statistics unit. |
|
(e) At the conclusion of a proceeding to challenge an |
|
acknowledgment of paternity or a denial of paternity, the court |
|
shall order the [bureau of] vital statistics unit to amend the birth |
|
record of the child, if appropriate. |
|
SECTION 1.062. Section 160.312(a), Family Code, is amended |
|
to read as follows: |
|
(a) To facilitate compliance with this subchapter, the |
|
[bureau of] vital statistics unit shall prescribe forms for the: |
|
(1) acknowledgment of paternity; |
|
(2) denial of paternity; and |
|
(3) rescission of an acknowledgment or denial of |
|
paternity. |
|
SECTION 1.063. Section 160.313, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.313. RELEASE OF INFORMATION. The [bureau of] |
|
vital statistics unit may release information relating to the |
|
acknowledgment of paternity or denial of paternity to a signatory |
|
of the acknowledgment or denial and to the courts and Title IV-D |
|
agency of this or another state. |
|
SECTION 1.064. Section 160.314, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.314. ADOPTION OF RULES. The Title IV-D agency and |
|
the executive commissioner of the Health and Human Services |
|
Commission [bureau of vital statistics] may adopt rules to |
|
implement this subchapter. |
|
SECTION 1.065. Section 160.315, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.315. MEMORANDUM OF UNDERSTANDING. (a) The Title |
|
IV-D agency and the [bureau of] vital statistics unit shall adopt a |
|
memorandum of understanding governing the collection and transfer |
|
of information for the voluntary acknowledgment of paternity. |
|
(b) The Title IV-D agency and the [bureau of] vital |
|
statistics unit shall review the memorandum semiannually and renew |
|
or modify the memorandum as necessary. |
|
SECTION 1.066. Section 160.401, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.401. ESTABLISHMENT OF REGISTRY. A registry of |
|
paternity is established in the [bureau of] vital statistics unit. |
|
SECTION 1.067. Section 160.402(c), Family Code, is amended |
|
to read as follows: |
|
(c) A registrant shall promptly notify the registry in a |
|
record of any change in the information provided by the registrant. |
|
The [bureau of] vital statistics unit shall incorporate all new |
|
information received into its records but is not required to |
|
affirmatively seek to obtain current information for incorporation |
|
in the registry. |
|
SECTION 1.068. Section 160.404, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.404. TERMINATION OF PARENTAL RIGHTS: FAILURE TO |
|
REGISTER. The parental rights of a man alleged to be the father of a |
|
child may be terminated without notice as provided by Section |
|
161.002 if the man: |
|
(1) did not timely register with the [bureau of] vital |
|
statistics unit; and |
|
(2) is not entitled to notice under Section 160.402 or |
|
161.002. |
|
SECTION 1.069. Section 160.411, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.411. REQUIRED FORM. The [bureau of] vital |
|
statistics unit shall adopt a form for registering with the |
|
registry. The form must require the signature of the registrant. |
|
The form must state that: |
|
(1) the form is signed under penalty of perjury; |
|
(2) a timely registration entitles the registrant to |
|
notice of a proceeding for adoption of the child or for termination |
|
of the registrant's parental rights; |
|
(3) a timely registration does not commence a |
|
proceeding to establish paternity; |
|
(4) the information disclosed on the form may be used |
|
against the registrant to establish paternity; |
|
(5) services to assist in establishing paternity are |
|
available to the registrant through the support enforcement agency; |
|
(6) the registrant should also register in another |
|
state if the conception or birth of the child occurred in the other |
|
state; |
|
(7) information on registries in other states is |
|
available from the [bureau of] vital statistics unit; and |
|
(8) procedures exist to rescind the registration of a |
|
claim of paternity. |
|
SECTION 1.070. Section 160.412(a), Family Code, is amended |
|
to read as follows: |
|
(a) The [bureau of] vital statistics unit is not required to |
|
attempt to locate the mother of a child who is the subject of a |
|
registration. The [bureau of] vital statistics unit shall send a |
|
copy of the notice of the registration to a mother who has provided |
|
an address. |
|
SECTION 1.071. Section 160.415, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.415. UNTIMELY REGISTRATION. If a man registers |
|
later than the 31st day after the date of the birth of the child, the |
|
[bureau of] vital statistics unit shall notify the registrant that |
|
the registration was not timely filed. |
|
SECTION 1.072. Section 160.416(b), Family Code, is amended |
|
to read as follows: |
|
(b) Except as otherwise provided by Subsection (c), the |
|
[bureau of] vital statistics unit may charge a reasonable fee for |
|
making a search of the registry and for furnishing a certificate. |
|
SECTION 1.073. Section 160.421(a), Family Code, is amended |
|
to read as follows: |
|
(a) If a father-child relationship has not been established |
|
under this chapter, a petitioner for the adoption of or the |
|
termination of parental rights regarding the child must obtain a |
|
certificate of the results of a search of the registry. The |
|
petitioner may request a search of the registry on or after the 32nd |
|
day after the date of the birth of the child, and the executive |
|
commissioner of the Health and Human Services Commission [bureau of
|
|
vital statistics] may not by rule impose a waiting period that must |
|
elapse before the vital statistics unit [bureau] will conduct the |
|
requested search. |
|
SECTION 1.074. Sections 160.422(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) The [bureau of] vital statistics unit shall furnish a |
|
certificate of the results of a search of the registry on request by |
|
an individual, a court, or an agency listed in Section 160.412(b). |
|
(b) The certificate of the results of a search must be |
|
signed on behalf of the unit [bureau] and state that: |
|
(1) a search has been made of the registry; and |
|
(2) a registration containing the information |
|
required to identify the registrant: |
|
(A) has been found and is attached to the |
|
certificate; or |
|
(B) has not been found. |
|
SECTION 1.075. Section 160.636(f), Family Code, is amended |
|
to read as follows: |
|
(f) If the order of the court is at variance with the child's |
|
birth certificate, the court shall order the [bureau of] vital |
|
statistics unit to issue an amended birth record. |
|
SECTION 1.076. Section 160.760(b), Family Code, is amended |
|
to read as follows: |
|
(b) After receiving notice of the birth, the court shall |
|
render an order that: |
|
(1) confirms that the intended parents are the child's |
|
parents; |
|
(2) requires the gestational mother to surrender the |
|
child to the intended parents, if necessary; and |
|
(3) requires the [bureau of] vital statistics unit to |
|
issue a birth certificate naming the intended parents as the |
|
child's parents. |
|
SECTION 1.077. Section 160.763, Family Code, is amended to |
|
read as follows: |
|
Sec. 160.763. HEALTH CARE FACILITY REPORTING REQUIREMENT. |
|
(a) The executive commissioner of the Health and Human Services |
|
Commission [Texas Department of Health] by rule shall develop and |
|
implement a confidential reporting system that requires each health |
|
care facility in this state at which assisted reproduction |
|
procedures are performed under gestational agreements to report |
|
statistics related to those procedures. |
|
(b) In developing the reporting system, the executive |
|
commissioner [department] shall require each health care facility |
|
described by Subsection (a) to annually report: |
|
(1) the number of assisted reproduction procedures |
|
under a gestational agreement performed at the facility during the |
|
preceding year; and |
|
(2) the number and current status of embryos created |
|
through assisted reproduction procedures described by Subdivision |
|
(1) that were not transferred for implantation. |
|
SECTION 1.078. Section 161.001, Family Code, is amended to |
|
read as follows: |
|
Sec. 161.001. INVOLUNTARY TERMINATION OF PARENT-CHILD |
|
RELATIONSHIP. (a) In this section, "born addicted to alcohol or a |
|
controlled substance" means a child: |
|
(1) who is born to a mother who during the pregnancy |
|
used a controlled substance, as defined by Chapter 481, Health and |
|
Safety Code, other than a controlled substance legally obtained by |
|
prescription, or alcohol; and |
|
(2) who, after birth as a result of the mother's use of |
|
the controlled substance or alcohol: |
|
(A) experiences observable withdrawal from the |
|
alcohol or controlled substance; |
|
(B) exhibits observable or harmful effects in the |
|
child's physical appearance or functioning; or |
|
(C) exhibits the demonstrable presence of |
|
alcohol or a controlled substance in the child's bodily fluids. |
|
(b) The court may order termination of the parent-child |
|
relationship if the court finds by clear and convincing evidence: |
|
(1) that the parent has: |
|
(A) voluntarily left the child alone or in the |
|
possession of another not the parent and expressed an intent not to |
|
return; |
|
(B) voluntarily left the child alone or in the |
|
possession of another not the parent without expressing an intent |
|
to return, without providing for the adequate support of the child, |
|
and remained away for a period of at least three months; |
|
(C) voluntarily left the child alone or in the |
|
possession of another without providing adequate support of the |
|
child and remained away for a period of at least six months; |
|
(D) knowingly placed or knowingly allowed the |
|
child to remain in conditions or surroundings which endanger the |
|
physical or emotional well-being of the child; |
|
(E) engaged in conduct or knowingly placed the |
|
child with persons who engaged in conduct which endangers the |
|
physical or emotional well-being of the child; |
|
(F) failed to support the child in accordance |
|
with the parent's ability during a period of one year ending within |
|
six months of the date of the filing of the petition; |
|
(G) abandoned the child without identifying the |
|
child or furnishing means of identification, and the child's |
|
identity cannot be ascertained by the exercise of reasonable |
|
diligence; |
|
(H) voluntarily, and with knowledge of the |
|
pregnancy, abandoned the mother of the child beginning at a time |
|
during her pregnancy with the child and continuing through the |
|
birth, failed to provide adequate support or medical care for the |
|
mother during the period of abandonment before the birth of the |
|
child, and remained apart from the child or failed to support the |
|
child since the birth; |
|
(I) contumaciously refused to submit to a |
|
reasonable and lawful order of a court under Subchapter D, Chapter |
|
261; |
|
(J) been the major cause of: |
|
(i) the failure of the child to be enrolled |
|
in school as required by the Education Code; or |
|
(ii) the child's absence from the child's |
|
home without the consent of the parents or guardian for a |
|
substantial length of time or without the intent to return; |
|
(K) executed before or after the suit is filed an |
|
unrevoked or irrevocable affidavit of relinquishment of parental |
|
rights as provided by this chapter; |
|
(L) been convicted or has been placed on |
|
community supervision, including deferred adjudication community |
|
supervision, for being criminally responsible for the death or |
|
serious injury of a child under the following sections of the Penal |
|
Code or adjudicated under Title 3 for conduct that caused the death |
|
or serious injury of a child and that would constitute a violation |
|
of one of the following Penal Code sections: |
|
(i) Section 19.02 (murder); |
|
(ii) Section 19.03 (capital murder); |
|
(iii) Section 19.04 (manslaughter); |
|
(iv) Section 21.11 (indecency with a |
|
child); |
|
(v) Section 22.01 (assault); |
|
(vi) Section 22.011 (sexual assault); |
|
(vii) Section 22.02 (aggravated assault); |
|
(viii) Section 22.021 (aggravated sexual |
|
assault); |
|
(ix) Section 22.04 (injury to a child, |
|
elderly individual, or disabled individual); |
|
(x) Section 22.041 (abandoning or |
|
endangering child); |
|
(xi) Section 25.02 (prohibited sexual |
|
conduct); |
|
(xii) Section 43.25 (sexual performance by |
|
a child); |
|
(xiii) Section 43.26 (possession or |
|
promotion of child pornography); |
|
(xiv) Section 21.02 (continuous sexual |
|
abuse of young child or children); |
|
(xv) Section 20A.02(a)(7) or (8) |
|
(trafficking of persons); and |
|
(xvi) Section 43.05(a)(2) (compelling |
|
prostitution); |
|
(M) had his or her parent-child relationship |
|
terminated with respect to another child based on a finding that the |
|
parent's conduct was in violation of Paragraph (D) or (E) or |
|
substantially equivalent provisions of the law of another state; |
|
(N) constructively abandoned the child who has |
|
been in the permanent or temporary managing conservatorship of the |
|
Department of Family and Protective Services [or an authorized
|
|
agency] for not less than six months, and: |
|
(i) the department [or authorized agency] |
|
has made reasonable efforts to return the child to the parent; |
|
(ii) the parent has not regularly visited |
|
or maintained significant contact with the child; and |
|
(iii) the parent has demonstrated an |
|
inability to provide the child with a safe environment; |
|
(O) failed to comply with the provisions of a |
|
court order that specifically established the actions necessary for |
|
the parent to obtain the return of the child who has been in the |
|
permanent or temporary managing conservatorship of the Department |
|
of Family and Protective Services for not less than nine months as a |
|
result of the child's removal from the parent under Chapter 262 for |
|
the abuse or neglect of the child; |
|
(P) used a controlled substance, as defined by |
|
Chapter 481, Health and Safety Code, in a manner that endangered the |
|
health or safety of the child, and: |
|
(i) failed to complete a court-ordered |
|
substance abuse treatment program; or |
|
(ii) after completion of a court-ordered |
|
substance abuse treatment program, continued to abuse a controlled |
|
substance; |
|
(Q) knowingly engaged in criminal conduct that |
|
has resulted in the parent's: |
|
(i) conviction of an offense; and |
|
(ii) confinement or imprisonment and |
|
inability to care for the child for not less than two years from the |
|
date of filing the petition; |
|
(R) been the cause of the child being born |
|
addicted to alcohol or a controlled substance, other than a |
|
controlled substance legally obtained by prescription[, as defined
|
|
by Section 261.001]; |
|
(S) voluntarily delivered the child to a |
|
designated emergency infant care provider under Section 262.302 |
|
without expressing an intent to return for the child; or |
|
(T) been convicted of: |
|
(i) the murder of the other parent of the |
|
child under Section 19.02 or 19.03, Penal Code, or under a law of |
|
another state, federal law, the law of a foreign country, or the |
|
Uniform Code of Military Justice that contains elements that are |
|
substantially similar to the elements of an offense under Section |
|
19.02 or 19.03, Penal Code; |
|
(ii) criminal attempt under Section 15.01, |
|
Penal Code, or under a law of another state, federal law, the law of |
|
a foreign country, or the Uniform Code of Military Justice that |
|
contains elements that are substantially similar to the elements of |
|
an offense under Section 15.01, Penal Code, to commit the offense |
|
described by Subparagraph (i); or |
|
(iii) criminal solicitation under Section |
|
15.03, Penal Code, or under a law of another state, federal law, the |
|
law of a foreign country, or the Uniform Code of Military Justice |
|
that contains elements that are substantially similar to the |
|
elements of an offense under Section 15.03, Penal Code, of the |
|
offense described by Subparagraph (i); and |
|
(2) that termination is in the best interest of the |
|
child. |
|
SECTION 1.079. Section 161.002(e), Family Code, is amended |
|
to read as follows: |
|
(e) The court shall not render an order terminating parental |
|
rights under Subsection (b)(2) or (3) unless the court receives |
|
evidence of a certificate of the results of a search of the |
|
paternity registry under Chapter 160 from the [bureau of] vital |
|
statistics unit indicating that no man has registered the intent to |
|
claim paternity. |
|
SECTION 1.080. Section 161.003(a), Family Code, is amended |
|
to read as follows: |
|
(a) The court may order termination of the parent-child |
|
relationship in a suit filed by the Department of Family and |
|
Protective [and Regulatory] Services if the court finds that: |
|
(1) the parent has a mental or emotional illness or a |
|
mental deficiency that renders the parent unable to provide for the |
|
physical, emotional, and mental needs of the child; |
|
(2) the illness or deficiency, in all reasonable |
|
probability, proved by clear and convincing evidence, will continue |
|
to render the parent unable to provide for the child's needs until |
|
the 18th birthday of the child; |
|
(3) the department has been the temporary or sole |
|
managing conservator of the child of the parent for at least six |
|
months preceding the date of the hearing on the termination held in |
|
accordance with Subsection (c); |
|
(4) the department has made reasonable efforts to |
|
return the child to the parent; and |
|
(5) the termination is in the best interest of the |
|
child. |
|
SECTION 1.081. Section 161.005(b), Family Code, is amended |
|
to read as follows: |
|
(b) If the petition designates the Department of Family and |
|
Protective [and Regulatory] Services as managing conservator, the |
|
department shall be given service of citation. The court shall |
|
notify the department if the court appoints the department as the |
|
managing conservator of the child. |
|
SECTION 1.082. Sections 161.103(c) and (e), Family Code, |
|
are amended to read as follows: |
|
(c) The affidavit may contain: |
|
(1) a waiver of process in a suit to terminate the |
|
parent-child relationship filed under this chapter or in a suit to |
|
terminate joined with a petition for adoption; and |
|
(2) a consent to the placement of the child for |
|
adoption by the Department of Family and Protective [and
|
|
Regulatory] Services or by a licensed child-placing agency. |
|
(e) The relinquishment in an affidavit that designates the |
|
Department of Family and Protective [and Regulatory] Services or a |
|
licensed child-placing agency to serve as the managing conservator |
|
is irrevocable. A relinquishment in any other affidavit of |
|
relinquishment is revocable unless it expressly provides that it is |
|
irrevocable for a stated period of time not to exceed 60 days after |
|
the date of its execution. |
|
SECTION 1.083. Section 161.104, Family Code, is amended to |
|
read as follows: |
|
Sec. 161.104. RIGHTS OF DESIGNATED MANAGING CONSERVATOR |
|
PENDING COURT APPOINTMENT. A person, licensed child-placing |
|
agency, or the Department of Family and Protective Services |
|
[authorized agency] designated managing conservator of a child in |
|
an irrevocable or unrevoked affidavit of relinquishment has a right |
|
to possession of the child superior to the right of the person |
|
executing the affidavit, the right to consent to medical, surgical, |
|
dental, and psychological treatment of the child, and the rights |
|
and duties given by Chapter 153 to a possessory conservator until |
|
such time as these rights and duties are modified or terminated by |
|
court order. |
|
SECTION 1.084. Section 161.106(e), Family Code, is amended |
|
to read as follows: |
|
(e) An affidavit of waiver of interest in a child may be used |
|
in a suit in which the affiant attempts to establish an interest in |
|
the child. The affidavit may not be used in a suit brought by |
|
another person, licensed child-placing agency, or the Department of |
|
Family and Protective Services [authorized agency] to establish the |
|
affiant's paternity of the child. |
|
SECTION 1.085. Section 161.108(a), Family Code, is amended |
|
to read as follows: |
|
(a) Before or at the time an affidavit of relinquishment of |
|
parental rights under Section 161.103 is executed, the mother of a |
|
newborn child may authorize the release of the child from the |
|
hospital or birthing center to a licensed child-placing agency, the |
|
Department of Family and Protective [and Regulatory] Services, or |
|
another designated person. |
|
SECTION 1.086. Section 161.109, Family Code, is amended to |
|
read as follows: |
|
Sec. 161.109. REQUIREMENT OF PATERNITY REGISTRY |
|
CERTIFICATE. (a) If a parent-child relationship does not exist |
|
between the child and any man, a certificate from the [bureau of] |
|
vital statistics unit signed by the registrar that a diligent |
|
search has been made of the paternity registry maintained by the |
|
unit [bureau] and that a registration has not been found pertaining |
|
to the father of the child in question must be filed with the court |
|
before a trial on the merits in the suit for termination may be |
|
held. |
|
(b) In a proceeding to terminate parental rights in which |
|
the alleged or probable father has not been personally served with |
|
citation or signed an affidavit of relinquishment or an affidavit |
|
of waiver of interest, the court may not terminate the parental |
|
rights of the alleged or probable father, whether known or unknown, |
|
unless a certificate from the [bureau of] vital statistics unit |
|
signed by the registrar states that a diligent search has been made |
|
of the paternity registry maintained by the unit [bureau] and that a |
|
filing or registration has not been found pertaining to the father |
|
of the child in question. |
|
SECTION 1.087. Section 161.2061(a), Family Code, is amended |
|
to read as follows: |
|
(a) If the court finds it to be in the best interest of the |
|
child, the court may provide in an order terminating the |
|
parent-child relationship that the biological parent who filed an |
|
affidavit of voluntary relinquishment of parental rights under |
|
Section 161.103 shall have limited post-termination contact with |
|
the child as provided by Subsection (b) on the agreement of the |
|
biological parent and the Department of Family and Protective [and
|
|
Regulatory] Services. |
|
SECTION 1.088. Section 161.207(a), Family Code, is amended |
|
to read as follows: |
|
(a) If the court terminates the parent-child relationship |
|
with respect to both parents or to the only living parent, the court |
|
shall appoint a suitable, competent adult, the Department of Family |
|
and Protective [and Regulatory] Services, or a licensed |
|
child-placing agency[, or an authorized agency] as managing |
|
conservator of the child. An agency designated managing |
|
conservator in an unrevoked or irrevocable affidavit of |
|
relinquishment shall be appointed managing conservator. |
|
SECTION 1.089. Section 161.208, Family Code, is amended to |
|
read as follows: |
|
Sec. 161.208. APPOINTMENT OF DEPARTMENT OF FAMILY AND |
|
PROTECTIVE [AND REGULATORY] SERVICES AS MANAGING CONSERVATOR. If a |
|
parent of the child has not been personally served in a suit in |
|
which the Department of Family and Protective [and Regulatory] |
|
Services seeks termination, the court that terminates a |
|
parent-child relationship may not appoint the Department of Family |
|
and Protective [and Regulatory] Services as permanent managing |
|
conservator of the child unless the court determines that: |
|
(1) the department has made a diligent effort to |
|
locate a missing parent who has not been personally served and a |
|
relative of that parent; and |
|
(2) a relative located by the department has had a |
|
reasonable opportunity to request appointment as managing |
|
conservator of the child or the department has not been able to |
|
locate the missing parent or a relative of the missing parent. |
|
SECTION 1.090. Section 162.001(c), Family Code, is amended |
|
to read as follows: |
|
(c) If an affidavit of relinquishment of parental rights |
|
contains a consent for the Department of Family and Protective [and
|
|
Regulatory] Services or a licensed child-placing agency to place |
|
the child for adoption and appoints the department or agency |
|
managing conservator of the child, further consent by the parent is |
|
not required and the adoption order shall terminate all rights of |
|
the parent without further termination proceedings. |
|
SECTION 1.091. Section 162.005(b), Family Code, is amended |
|
to read as follows: |
|
(b) Before placing a child for adoption, the Department of |
|
Family and Protective [and Regulatory] Services, a licensed |
|
child-placing agency, or the child's parent or guardian shall |
|
compile a report on the available health, social, educational, and |
|
genetic history of the child to be adopted. |
|
SECTION 1.092. Section 162.006(a), Family Code, is amended |
|
to read as follows: |
|
(a) The Department of Family and Protective Services |
|
[department], licensed child-placing agency, or other person |
|
placing a child for adoption shall inform the prospective adoptive |
|
parents of their right to examine the records and other information |
|
relating to the history of the child. The department, licensed |
|
child-placing agency, or other person placing the child for |
|
adoption shall edit the records and information to protect the |
|
identity of the biological parents and any other person whose |
|
identity is confidential. |
|
SECTION 1.093. Section 162.0065, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.0065. EDITING ADOPTION RECORDS IN DEPARTMENT |
|
PLACEMENT. Notwithstanding any other provision of this chapter, in |
|
an adoption in which a child is placed for adoption by the |
|
Department of Family and Protective [and Regulatory] Services, the |
|
department is not required to edit records to protect the identity |
|
of birth parents and other persons whose identity is confidential |
|
if the department determines that information is already known to |
|
the adoptive parents or is readily available through other sources, |
|
including the court records of a suit to terminate the parent-child |
|
relationship under Chapter 161. |
|
SECTION 1.094. Section 162.008(b), Family Code, is amended |
|
to read as follows: |
|
(b) A petition for adoption may not be granted until the |
|
following documents have been filed: |
|
(1) a copy of the health, social, educational, and |
|
genetic history report signed by the child's adoptive parents; and |
|
(2) if the report is required to be submitted to the |
|
Department of Family and Protective Services [bureau of vital
|
|
statistics] under Section 162.006(e), a certificate from the |
|
department [bureau] acknowledging receipt of the report. |
|
SECTION 1.095. Section 162.0085(a), Family Code, is amended |
|
to read as follows: |
|
(a) In a suit affecting the parent-child relationship in |
|
which an adoption is sought, the court shall order each person |
|
seeking to adopt the child to obtain that person's own criminal |
|
history record information. The court shall accept under this |
|
section a person's criminal history record information that is |
|
provided by the Department of Family and Protective [and
|
|
Regulatory] Services or by a licensed child-placing agency that |
|
received the information from the department if the information was |
|
obtained not more than one year before the date the court ordered |
|
the history to be obtained. |
|
SECTION 1.096. Sections 162.018(a) and (d), Family Code, |
|
are amended to read as follows: |
|
(a) The adoptive parents are entitled to receive copies of |
|
the records and other information relating to the history of the |
|
child maintained by the Department of Family and Protective |
|
Services [department], licensed child-placing agency, person, or |
|
entity placing the child for adoption. |
|
(d) At the time an adoption order is rendered, the court |
|
shall provide to the parents of an adopted child information |
|
provided by the [bureau of] vital statistics unit that describes |
|
the functions of the voluntary adoption registry under Subchapter |
|
E. The licensed child-placing agency shall provide to each of the |
|
child's biological parents known to the agency, the information |
|
when the parent signs an affidavit of relinquishment of parental |
|
rights or affidavit of waiver of interest in a child. The |
|
information shall include the right of the child or biological |
|
parent to refuse to participate in the registry. If the adopted |
|
child is 14 years old or older the court shall provide the |
|
information to the child. |
|
SECTION 1.097. Section 162.021(b), Family Code, is amended |
|
to read as follows: |
|
(b) Rendition of the order does not relieve the clerk from |
|
the duty to send information regarding adoption to the [bureau of] |
|
vital statistics unit as required by this subchapter and Chapter |
|
108. |
|
SECTION 1.098. Sections 162.101(1) and (2), Family Code, |
|
are amended to read as follows: |
|
(1) "Appropriate public authorities," with reference |
|
to this state, means the commissioner of the Department of Family |
|
and Protective Services [executive director]. |
|
(2) "Appropriate authority in the receiving state," |
|
with reference to this state, means the commissioner of the |
|
Department of Family and Protective Services [executive director]. |
|
SECTION 1.099. Section 162.103, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.103. FINANCIAL RESPONSIBILITY FOR CHILD. (a) |
|
Financial responsibility for a child placed as provided in the |
|
compact is determined, in the first instance, as provided in |
|
Article V of the compact. After partial or complete default of |
|
performance under the provisions of Article V assigning financial |
|
responsibility, the commissioner of the Department of Family and |
|
Protective Services [executive director] may bring suit under |
|
Chapter 154 and may file a complaint with the appropriate |
|
prosecuting attorney, claiming a violation of Section 25.05, Penal |
|
Code. |
|
(b) After default, if the commissioner of the Department of |
|
Family and Protective Services [executive director] determines |
|
that financial responsibility is unlikely to be assumed by the |
|
sending agency or the child's parents, the commissioner [executive
|
|
director] may cause the child to be returned to the sending agency. |
|
(c) After default, the Department of Family and Protective |
|
Services [department] shall assume financial responsibility for |
|
the child until it is assumed by the child's parents or until the |
|
child is safely returned to the sending agency. |
|
SECTION 1.100. Section 162.104, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.104. APPROVAL OF PLACEMENT. The commissioner of |
|
the Department of Family and Protective Services [executive
|
|
director] may not approve the placement of a child in this state |
|
without the concurrence of the individuals with whom the child is |
|
proposed to be placed or the head of an institution with which the |
|
child is proposed to be placed. |
|
SECTION 1.101. Section 162.106, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.106. COMPACT AUTHORITY. (a) The governor shall |
|
appoint the commissioner [executive director] of the Department of |
|
Family and Protective [and Regulatory] Services as compact |
|
administrator. |
|
(b) The commissioner of the Department of Family and |
|
Protective Services [executive director] shall designate a deputy |
|
compact administrator and staff necessary to execute the terms of |
|
the compact in this state. |
|
SECTION 1.102. Section 162.107(b), Family Code, is amended |
|
to read as follows: |
|
(b) An individual, agency, corporation, child-care |
|
facility, or general residential operation [child-care
|
|
institution] in this state that violates Article IV of the compact |
|
commits an offense. An offense under this subsection is a Class B |
|
misdemeanor. On conviction, the court shall revoke any license to |
|
operate as a child-care facility or general residential operation |
|
[child-care institution] issued by the Department of Family and |
|
Protective Services [department] to the entity convicted and shall |
|
revoke any license or certification of the individual, agency, or |
|
corporation necessary to practice in the state. |
|
SECTION 1.103. Section 162.201, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.201. ADOPTION OF COMPACT; TEXT. The Interstate |
|
Compact on Adoption and Medical Assistance is adopted by this state |
|
and entered into with all other jurisdictions joining in the |
|
compact in form substantially as provided under this subchapter. |
|
INTERSTATE COMPACT ON ADOPTION AND MEDICAL ASSISTANCE |
|
ARTICLE I. FINDINGS |
|
The legislature finds that: |
|
(a) Finding adoptive families for children for whom |
|
state assistance is desirable, under Subchapter D, Chapter 162, and |
|
assuring the protection of the interest of the children affected |
|
during the entire assistance period require special measures when |
|
the adoptive parents move to other states or are residents of |
|
another state. |
|
(b) The provision of medical and other necessary |
|
services for children, with state assistance, encounters special |
|
difficulties when the provision of services takes place in other |
|
states. |
|
ARTICLE II. PURPOSES |
|
The purposes of the compact are to: |
|
(a) authorize the Department of Family and Protective |
|
[and Regulatory] Services, with the concurrence of the Health and |
|
Human Services Commission, to enter into interstate agreements with |
|
agencies of other states for the protection of children on behalf of |
|
whom adoption assistance is being provided by the Department of |
|
Family and Protective [and Regulatory] Services; and |
|
(b) provide procedures for interstate children's |
|
adoption assistance payments, including medical payments. |
|
ARTICLE III. DEFINITIONS |
|
In this compact: |
|
(a) "Adoption assistance state" means the state that |
|
signs an adoption assistance agreement in a particular case. |
|
(b) "Residence state" means the state in which the |
|
child resides by virtue of the residence of the adoptive parents. |
|
(c) "State" means a state of the United States, the |
|
District of Columbia, the Commonwealth of Puerto Rico, the Virgin |
|
Islands, Guam, the Commonwealth of the Northern Mariana Islands, or |
|
a territory or possession of or a territory or possession |
|
administered by the United States. |
|
ARTICLE IV. COMPACTS AUTHORIZED |
|
The Department of Family and Protective [and Regulatory] |
|
Services, through its commissioner [executive director], is |
|
authorized to develop, participate in the development of, |
|
negotiate, and enter into one or more interstate compacts on behalf |
|
of this state with other states to implement one or more of the |
|
purposes of this compact. An interstate compact authorized by this |
|
article has the force and effect of law. |
|
ARTICLE V. CONTENTS OF COMPACTS |
|
A compact entered into under the authority conferred by this |
|
compact shall contain: |
|
(1) a provision making the compact available for |
|
joinder by all states; |
|
(2) a provision for withdrawal from the compact on |
|
written notice to the parties, with a period of one year between the |
|
date of the notice and the effective date of the withdrawal; |
|
(3) a requirement that protections under the compact |
|
continue for the duration of the adoption assistance and apply to |
|
all children and their adoptive parents who on the effective date of |
|
the withdrawal are receiving adoption assistance from a party state |
|
other than the one in which they reside and have their principal |
|
place of abode; |
|
(4) a requirement that each case of adoption |
|
assistance to which the compact applies be covered by a written |
|
adoption assistance agreement between the adoptive parents and the |
|
state child welfare agency of the state that provides the adoption |
|
assistance and that the agreement be expressly for the benefit of |
|
the adopted child and enforceable by the adoptive parents and the |
|
state agency providing the adoption assistance; and |
|
(5) other provisions that are appropriate for the |
|
proper administration of the compact. |
|
ARTICLE VI. OPTIONAL CONTENTS OF COMPACTS |
|
A compact entered into under the authority conferred by this |
|
compact may contain the following provisions, in addition to those |
|
required under Article V of this compact: |
|
(1) provisions establishing procedures and |
|
entitlement to medical, developmental, child-care, or other social |
|
services for the child in accordance with applicable laws, even if |
|
the child and the adoptive parents are in a state other than the one |
|
responsible for or providing the services or the funds to defray |
|
part or all of the costs thereof; and |
|
(2) other provisions that are appropriate or |
|
incidental to the proper administration of the compact. |
|
ARTICLE VII. MEDICAL ASSISTANCE |
|
(a) A child with special needs who resides in this state and |
|
who is the subject of an adoption assistance agreement with another |
|
state is entitled to receive a medical assistance identification |
|
from this state on the filing in the state medical assistance agency |
|
of a certified copy of the adoption assistance agreement obtained |
|
from the adoption assistance state. In accordance with rules of the |
|
state medical assistance agency, the adoptive parents, at least |
|
annually, shall show that the agreement is still in effect or has |
|
been renewed. |
|
(b) The state medical assistance agency shall consider the |
|
holder of a medical assistance identification under this article as |
|
any other holder of a medical assistance identification under the |
|
laws of this state and shall process and make payment on claims on |
|
the holder's account in the same manner and under the same |
|
conditions and procedures as for other recipients of medical |
|
assistance. |
|
(c) The state medical assistance agency shall provide |
|
coverage and benefits for a child who is in another state and who is |
|
covered by an adoption assistance agreement made by the Department |
|
of Family and Protective [and Regulatory] Services for the coverage |
|
or benefits, if any, not provided by the residence state. The |
|
adoptive parents acting for the child may submit evidence of |
|
payment for services or benefit amounts not payable in the |
|
residence state and shall be reimbursed for those amounts. |
|
Services or benefit amounts covered under any insurance or other |
|
third-party medical contract or arrangement held by the child or |
|
the adoptive parents may not be reimbursed. The state medical |
|
assistance agency shall adopt rules implementing this subsection. |
|
The additional coverage and benefit amounts provided under this |
|
subsection are for services for which there is no federal |
|
contribution or services that, if federally aided, are not provided |
|
by the residence state. The rules shall include procedures for |
|
obtaining prior approval for services in cases in which prior |
|
approval is required for the assistance. |
|
(d) The submission of a false, misleading, or fraudulent |
|
claim for payment or reimbursement for services or benefits under |
|
this article or the making of a false, misleading, or fraudulent |
|
statement in connection with the claim is an offense under this |
|
subsection if the person submitting the claim or making the |
|
statement knows or should know that the claim or statement is false, |
|
misleading, or fraudulent. A person who commits an offense under |
|
this subsection may be liable for a fine not to exceed $10,000 or |
|
imprisonment for not more than two years, or both the fine and the |
|
imprisonment. An offense under this subsection that also |
|
constitutes an offense under other law may be punished under either |
|
this subsection or the other applicable law. |
|
(e) This article applies only to medical assistance for |
|
children under adoption assistance agreements with states that have |
|
entered into a compact with this state under which the other state |
|
provides medical assistance to children with special needs under |
|
adoption assistance agreements made by this state. All other |
|
children entitled to medical assistance under adoption assistance |
|
agreements entered into by this state are eligible to receive the |
|
medical assistance in accordance with the laws and procedures that |
|
apply to the agreement. |
|
ARTICLE VIII. FEDERAL PARTICIPATION |
|
Consistent with federal law, the Department of Family and |
|
Protective [and Regulatory] Services and the Health and Human |
|
Services Commission, in connection with the administration of this |
|
compact or a compact authorized by this compact, shall include the |
|
provision of adoption assistance and medical assistance for which |
|
the federal government pays some or all of the cost in any state |
|
plan made under the Adoption Assistance and Child Welfare Act of |
|
1980 (Pub. L. No. 96-272), Titles IV-E and XIX of the Social |
|
Security Act, and other applicable federal laws. The Department of |
|
Family and Protective [and Regulatory] Services and the Health and |
|
Human Services Commission shall apply for and administer all |
|
relevant federal aid in accordance with law. |
|
SECTION 1.104. Section 162.202, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.202. AUTHORITY OF DEPARTMENT OF FAMILY AND |
|
PROTECTIVE [AND REGULATORY] SERVICES. The Department of Family and |
|
Protective [and Regulatory] Services, with the concurrence of the |
|
Health and Human Services Commission, may develop, participate in |
|
the development of, negotiate, and enter into one or more |
|
interstate compacts on behalf of this state with other states to |
|
implement one or more of the purposes of this subchapter. An |
|
interstate compact authorized by this subchapter [article] has the |
|
force and effect of law. |
|
SECTION 1.105. Section 162.203, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.203. COMPACT ADMINISTRATION. The commissioner |
|
[executive director] of the Department of Family and Protective |
|
[and Regulatory] Services shall serve as the compact administrator. |
|
The administrator shall cooperate with all departments, agencies, |
|
and officers of this state and its subdivisions in facilitating the |
|
proper administration of the compact and any supplemental |
|
agreements entered into by this state. The commissioner of the |
|
Department of Family and Protective Services [executive director] |
|
and the executive commissioner of the Health and Human Services |
|
Commission [human services] shall designate deputy compact |
|
administrators to represent adoption assistance services and |
|
medical assistance services provided under Title XIX of the Social |
|
Security Act. |
|
SECTION 1.106. The heading to Subchapter D, Chapter 162, |
|
Family Code, is amended to read as follows: |
|
SUBCHAPTER D. ADOPTION SERVICES BY THE DEPARTMENT OF |
|
FAMILY AND PROTECTIVE [AND REGULATORY] SERVICES |
|
SECTION 1.107. Sections 162.301(1) and (3), Family Code, |
|
are amended to read as follows: |
|
(1) "Adoption assistance agreement" means a written |
|
agreement, binding on the parties to the agreement, between the |
|
Department of Family and Protective Services [department] and the |
|
prospective adoptive parents that specifies the nature and amount |
|
of any payment, services, or assistance to be provided under the |
|
agreement and stipulates that the agreement will remain in effect |
|
without regard to the state in which the prospective adoptive |
|
parents reside at any particular time. |
|
(3) "Department" means the Department of Family and |
|
Protective [and Regulatory] Services. |
|
SECTION 1.108. Section 162.302(c), Family Code, is amended |
|
to read as follows: |
|
(c) The program shall be carried out by licensed |
|
child-placing agencies or county child-care or welfare units under |
|
department rules [adopted by the department]. |
|
SECTION 1.109. Sections 162.309(b) and (i), Family Code, |
|
are amended to read as follows: |
|
(b) The committee is composed of 12 members appointed by the |
|
commissioner [board] of the department [Department of Protective
|
|
and Regulatory Services]. The commissioner [board] shall appoint |
|
to the committee individuals who in the aggregate have knowledge of |
|
and experience in community education, cultural relations, family |
|
support, counseling, and parenting skills and education. At least |
|
six members must be ordained members of the clergy. |
|
(i) On receiving the committee's recommendations, the |
|
department may [adopt rules to] implement a program or project |
|
recommended under this section. The executive commissioner of the |
|
Health and Human Services Commission may adopt rules necessary for |
|
the implementation of a program or project by the department. The |
|
department may solicit, accept, and use gifts and donations to |
|
implement a program or project recommended by the committee. |
|
SECTION 1.110. Sections 162.402(7), (11), (12), and (14), |
|
Family Code, are amended to read as follows: |
|
(7) "Authorized agency" means a public agency |
|
authorized to care for or to place children for adoption or a |
|
private entity approved for that purpose by the department through |
|
a license, certification, or other means. The term includes a |
|
licensed child-placing agency or a previously licensed |
|
child-placing agency that has ceased operations and has transferred |
|
its adoption records to the vital statistics unit [bureau] or an |
|
agency authorized by the department to place children for adoption |
|
and a licensed child-placing agency that has been acquired by, |
|
merged with, or otherwise succeeded by an agency authorized by the |
|
department to place children for adoption. |
|
(11) "Central registry" means the mutual consent |
|
voluntary adoption registry established and maintained by the vital |
|
statistics unit [bureau] under this subchapter. |
|
(12) "Department" means the Department of Family and |
|
Protective [and Regulatory] Services. |
|
(14) "Vital statistics unit" ["Bureau"] means the |
|
[bureau of] vital statistics unit of the Department of State Health |
|
Services. |
|
SECTION 1.111. Sections 162.403(a) and (c), Family Code, |
|
are amended to read as follows: |
|
(a) The vital statistics unit [bureau] shall establish and |
|
maintain a mutual consent voluntary adoption registry. |
|
(c) An authorized agency that did not directly or by |
|
contract provide registry services as required by this subchapter |
|
on January 1, 1984, may not provide its own registry service. The |
|
vital statistics unit [bureau] shall operate through the central |
|
registry those services for agencies not permitted to provide a |
|
registry under this section. |
|
SECTION 1.112. Section 162.407(b), Family Code, is amended |
|
to read as follows: |
|
(b) An adoptee adopted or placed through an authorized |
|
agency may register through the registry maintained by that agency |
|
or the registry to which the agency has delegated registry services |
|
or through the central registry maintained by the vital statistics |
|
unit [bureau]. |
|
SECTION 1.113. Section 162.408, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.408. PROOF OF IDENTITY. The rules and minimum |
|
standards of the Department [Texas Board] of State Health Services |
|
for the vital statistics unit [bureau] must provide for proof of |
|
identity in order to facilitate the purposes of this subchapter and |
|
to protect the privacy rights of adoptees, adoptive parents, birth |
|
parents, biological siblings, and their families. |
|
SECTION 1.114. Section 162.411(d), Family Code, is amended |
|
to read as follows: |
|
(d) The fees collected by the vital statistics unit [bureau] |
|
shall be deposited in a special fund in the general revenue fund. |
|
Funds in the special fund may be appropriated only for the |
|
administration of the central registry. |
|
SECTION 1.115. Section 162.414(c), Family Code, is amended |
|
to read as follows: |
|
(c) To establish or corroborate a match, the administrator |
|
shall request confirmation of a possible match from the vital |
|
statistics unit [bureau]. If the agency operating the registry has |
|
in its own records sufficient information through which the match |
|
may be confirmed, the administrator may, but is not required to, |
|
request confirmation from the vital statistics unit [bureau]. The |
|
vital statistics unit [bureau] may confirm or deny the match |
|
without breaching the duty of confidentiality to the adoptee, |
|
adoptive parents, birth parents, or biological siblings and without |
|
a court order. |
|
SECTION 1.116. Section 162.420, Family Code, is amended to |
|
read as follows: |
|
Sec. 162.420. RULEMAKING. (a) The executive commissioner |
|
of the Health and Human Services Commission [Texas Board of Health] |
|
shall make rules and adopt minimum standards for the Department of |
|
State Health Services [bureau] to: |
|
(1) administer the provisions of this subchapter; and |
|
(2) ensure that each registry respects the right to |
|
privacy and confidentiality of an adoptee, birth parent, and |
|
biological sibling who does not desire to disclose the person's |
|
identity. |
|
(b) The Department of State Health Services [bureau] shall |
|
conduct a comprehensive review of all rules and standards adopted |
|
under this subchapter not less than every six years. |
|
(c) In order to provide the administrators an opportunity to |
|
review proposed rules and standards and send written suggestions to |
|
the executive commissioner of the Health and Human Services |
|
Commission [Texas Board of Health], the executive commissioner |
|
[board] shall, before adopting rules and minimum standards, send a |
|
copy of the proposed rules and standards not less than 60 days |
|
before the date they take effect to: |
|
(1) the administrator of each registry established |
|
under this subchapter; and |
|
(2) the administrator of each agency authorized by the |
|
department to place children for adoption. |
|
SECTION 1.117. Section 162.421(a), Family Code, is amended |
|
to read as follows: |
|
(a) This subchapter does not prevent the Department of State |
|
Health Services [bureau] from making known to the public, by |
|
appropriate means, the existence of voluntary adoption registries. |
|
SECTION 1.118. Sections 162.422(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) The Department of State Health Services [bureau] or |
|
authorized agency establishing or operating a registry is not |
|
liable to any person for obtaining or disclosing identifying |
|
information about a birth parent, adoptee, or biological sibling |
|
within the scope of this subchapter and under its provisions. |
|
(b) An employee or agent of the Department of State Health |
|
Services [bureau] or of an authorized agency establishing or |
|
operating a registry under this subchapter is not liable to any |
|
person for obtaining or disclosing identifying information about a |
|
birth parent, adoptee, or biological sibling within the scope of |
|
this subchapter and under its provisions. |
|
SECTION 1.119. Section 162.601(a), Family Code, is amended |
|
to read as follows: |
|
(a) Subject to the availability of funds, the Department of |
|
Family and Protective [and Regulatory] Services shall pay, in |
|
addition to any other amounts due, a monetary incentive to a |
|
licensed child-placing agency for the completion of an adoption: |
|
(1) of a child, as defined by Section 162.301, |
|
receiving or entitled to receive foster care at department expense; |
|
and |
|
(2) arranged with the assistance of the agency. |
|
SECTION 1.120. Section 261.001(7), Family Code, is amended |
|
to read as follows: |
|
(7) "Executive commissioner" ["Board"] means the |
|
executive commissioner of the Health and Human Services Commission |
|
[Board of Protective and Regulatory Services]. |
|
SECTION 1.121. Sections 261.002(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) The department shall establish and maintain [in Austin] |
|
a central registry of the names of individuals found by the |
|
department to have abused or neglected a [reported cases of] child |
|
[abuse or neglect]. |
|
(b) The executive commissioner [department] may adopt rules |
|
necessary to carry out this section. The rules shall provide for |
|
cooperation with local child service agencies, including |
|
hospitals, clinics, and schools, and cooperation with other states |
|
in exchanging reports to effect a national registration system. |
|
SECTION 1.122. Section 261.101(b-1), Family Code, is |
|
amended to read as follows: |
|
(b-1) In addition to the duty to make a report under |
|
Subsection (a) or (b), a person or professional shall make a report |
|
in the manner required by Subsection (a) or (b), as applicable, if |
|
the person or professional has cause to believe that an adult was a |
|
victim of abuse or neglect as a child and the person or professional |
|
determines in good faith that disclosure of the information is |
|
necessary to protect the health and safety of: |
|
(1) another child; or |
|
(2) an elderly person or [disabled] person with a |
|
disability as defined by Section 48.002, Human Resources Code. |
|
SECTION 1.123. Section 261.103(a), Family Code, is amended |
|
to read as follows: |
|
(a) Except as provided by Subsections (b) and (c) and |
|
Section 261.405, a report shall be made to: |
|
(1) any local or state law enforcement agency; |
|
(2) the department; or |
|
(3) the state agency that operates, licenses, |
|
certifies, or registers the facility in which the alleged abuse or |
|
neglect occurred[; or
|
|
[(4)
the agency designated by the court to be
|
|
responsible for the protection of children]. |
|
SECTION 1.124. Sections 261.105(a), (b), and (c-1), Family |
|
Code, are amended to read as follows: |
|
(a) All reports received by a local or state law enforcement |
|
agency that allege abuse or neglect by a person responsible for a |
|
child's care, custody, or welfare shall be referred immediately to |
|
the department [or the designated agency]. |
|
(b) The department [or designated agency] shall immediately |
|
notify the appropriate state or local law enforcement agency of any |
|
report it receives, other than a report from a law enforcement |
|
agency, that concerns the suspected abuse or neglect of a child or |
|
death of a child from abuse or neglect. |
|
(c-1) Notwithstanding Subsections (b) and (c), if a report |
|
under this section relates to a child with an intellectual |
|
disability [mental retardation] receiving services in a state |
|
supported living center as defined by Section 531.002, Health and |
|
Safety Code, or the ICF-IID [ICF-MR] component of the Rio Grande |
|
State Center, the department shall proceed with the investigation |
|
of the report as provided by Section 261.404. |
|
SECTION 1.125. Section 261.1055, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.1055. NOTIFICATION OF DISTRICT ATTORNEYS. (a) A |
|
district attorney may inform the department [or designated agency] |
|
that the district attorney wishes to receive notification of some |
|
or all reports of suspected abuse or neglect of children who were in |
|
the county at the time the report was made or who were in the county |
|
at the time of the alleged abuse or neglect. |
|
(b) If the district attorney makes the notification under |
|
this section, the department [or designated agency] shall, on |
|
receipt of a report of suspected abuse or neglect, immediately |
|
notify the district attorney as requested and the department [or
|
|
designated agency] shall forward a copy of the reports to the |
|
district attorney on request. |
|
SECTION 1.126. Section 261.109(b), Family Code, is amended |
|
to read as follows: |
|
(b) An offense under Subsection (a) is a Class A |
|
misdemeanor, except that the offense is a state jail felony if it is |
|
shown on the trial of the offense that the child was a person with an |
|
intellectual disability who resided in a state supported living |
|
center, the ICF-IID [ICF-MR] component of the Rio Grande State |
|
Center, or a facility licensed under Chapter 252, Health and Safety |
|
Code, and the actor knew that the child had suffered serious bodily |
|
injury as a result of the abuse or neglect. |
|
SECTION 1.127. Section 261.111, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.111. REFUSAL OF PSYCHIATRIC OR PSYCHOLOGICAL |
|
TREATMENT OF CHILD. (a) In this section, "psychotropic medication |
|
[drug]" has the meaning assigned by Section 266.001 [means a
|
|
substance that is:
|
|
[(1)
used in the diagnosis, treatment, or prevention
|
|
of a disease or as a component of a medication; and
|
|
[(2)
intended to have an altering effect on
|
|
perception, emotion, or behavior]. |
|
(b) The refusal of a parent, guardian, or managing or |
|
possessory conservator of a child to administer or consent to the |
|
administration of a psychotropic medication [drug] to the child, or |
|
to consent to any other psychiatric or psychological treatment of |
|
the child, does not by itself constitute neglect of the child unless |
|
the refusal to consent: |
|
(1) presents a substantial risk of death, |
|
disfigurement, or bodily injury to the child; or |
|
(2) has resulted in an observable and material |
|
impairment to the growth, development, or functioning of the child. |
|
SECTION 1.128. Section 261.201(e), Family Code, is amended |
|
to read as follows: |
|
(e) Before placing a child who was the subject of an |
|
investigation, the department shall notify the prospective |
|
adoptive parents of their right to examine any report, record, |
|
working paper, or other information in the possession, custody, or |
|
control of the department [state] that pertains to the history of |
|
the child. |
|
SECTION 1.129. Sections 261.301(a), (d), and (e), Family |
|
Code, are amended to read as follows: |
|
(a) With assistance from the appropriate state or local law |
|
enforcement agency as provided by this section, the department [or
|
|
designated agency] shall make a prompt and thorough investigation |
|
of a report of child abuse or neglect allegedly committed by a |
|
person responsible for a child's care, custody, or welfare. The |
|
investigation shall be conducted without regard to any pending suit |
|
affecting the parent-child relationship. |
|
(d) The executive commissioner [department] shall by rule |
|
assign priorities and prescribe investigative procedures for |
|
investigations based on the severity and immediacy of the alleged |
|
harm to the child. The primary purpose of the investigation shall |
|
be the protection of the child. The rules must require the |
|
department, subject to the availability of funds, to: |
|
(1) immediately respond to a report of abuse and |
|
neglect that involves circumstances in which the death of the child |
|
or substantial bodily harm to the child would result unless the |
|
department immediately intervenes; |
|
(2) respond within 24 hours to a report of abuse and |
|
neglect that is assigned the highest priority, other than a report |
|
described by Subdivision (1); and |
|
(3) respond within 72 hours to a report of abuse and |
|
neglect that is assigned the second highest priority. |
|
(e) As necessary to provide for the protection of the child, |
|
the department [or designated agency] shall determine: |
|
(1) the nature, extent, and cause of the abuse or |
|
neglect; |
|
(2) the identity of the person responsible for the |
|
abuse or neglect; |
|
(3) the names and conditions of the other children in |
|
the home; |
|
(4) an evaluation of the parents or persons |
|
responsible for the care of the child; |
|
(5) the adequacy of the home environment; |
|
(6) the relationship of the child to the persons |
|
responsible for the care, custody, or welfare of the child; and |
|
(7) all other pertinent data. |
|
SECTION 1.130. The heading to Section 261.3015, Family |
|
Code, is amended to read as follows: |
|
Sec. 261.3015. ALTERNATIVE [FLEXIBLE] RESPONSE SYSTEM. |
|
SECTION 1.131. Sections 261.3015(a) and (d), Family Code, |
|
are amended to read as follows: |
|
(a) In assigning priorities and prescribing investigative |
|
procedures based on the severity and immediacy of the alleged harm |
|
to a child under Section 261.301(d), the department shall establish |
|
an alternative [a flexible] response system to allow the department |
|
to make the most effective use of resources to investigate and |
|
respond to reported cases of abuse and neglect. |
|
(d) In determining how to classify a reported case of abuse |
|
or neglect under the alternative [flexible] response system, the |
|
child's safety is the primary concern. The classification of a case |
|
may be changed as warranted by the circumstances. |
|
SECTION 1.132. Section 261.302(b), Family Code, is amended |
|
to read as follows: |
|
(b) The interview with and examination of the child may: |
|
(1) be conducted at any reasonable time and place, |
|
including the child's home or the child's school; |
|
(2) include the presence of persons the department [or
|
|
designated agency] determines are necessary; and |
|
(3) include transporting the child for purposes |
|
relating to the interview or investigation. |
|
SECTION 1.133. Sections 261.303(a), (c), and (d), Family |
|
Code, are amended to read as follows: |
|
(a) A person may not interfere with an investigation of a |
|
report of child abuse or neglect conducted by the department [or
|
|
designated agency]. |
|
(c) If a parent or person responsible for the child's care |
|
does not consent to release of the child's prior medical, |
|
psychological, or psychiatric records or to a medical, |
|
psychological, or psychiatric examination of the child that is |
|
requested by the department [or designated agency], the court |
|
having family law jurisdiction shall, for good cause shown, order |
|
the records to be released or the examination to be made at the |
|
times and places designated by the court. |
|
(d) A person, including a medical facility, that makes a |
|
report under Subchapter B shall release to the department [or
|
|
designated agency], as part of the required report under Section |
|
261.103, records that directly relate to the suspected abuse or |
|
neglect without requiring parental consent or a court order. If a |
|
child is transferred from a reporting medical facility to another |
|
medical facility to treat the injury or condition that formed the |
|
basis for the original report, the transferee medical facility |
|
shall, at the department's request, release to the department |
|
records relating to the injury or condition without requiring |
|
parental consent or a court order. |
|
SECTION 1.134. Section 261.3031(a), Family Code, is amended |
|
to read as follows: |
|
(a) If a parent or other person refuses to cooperate with |
|
the department's investigation of the alleged abuse or neglect of a |
|
child and the refusal poses a risk to the child's safety, the |
|
department shall seek assistance from the appropriate [county
|
|
attorney or district attorney or criminal district] attorney with |
|
responsibility for representing the department as provided by |
|
Section 264.009 to obtain a court order as described by Section |
|
261.303. |
|
SECTION 1.135. Sections 261.305(b) and (d), Family Code, |
|
are amended to read as follows: |
|
(b) If the parent or person does not consent to an |
|
examination or allow the department [or designated agency] to have |
|
access to medical or mental health records requested by the |
|
department [or agency], the court having family law jurisdiction, |
|
for good cause shown, shall order the examination to be made or that |
|
the department [or agency] be permitted to have access to the |
|
records under terms and conditions prescribed by the court. |
|
(d) A parent or person responsible for the child's care is |
|
entitled to notice and a hearing when the department [or designated
|
|
agency] seeks a court order to allow a medical, psychological, or |
|
psychiatric examination or access to medical or mental health |
|
records. |
|
SECTION 1.136. Section 261.306, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.306. REMOVAL OF CHILD FROM STATE. (a) If the |
|
department [or designated agency] has reason to believe that a |
|
person responsible for the care, custody, or welfare of the child |
|
may remove the child from the state before the investigation is |
|
completed, the department [or designated agency] may file an |
|
application for a temporary restraining order in a district court |
|
without regard to continuing jurisdiction of the child as provided |
|
in Chapter 155. |
|
(b) The court may render a temporary restraining order |
|
prohibiting the person from removing the child from the state |
|
pending completion of the investigation if the court: |
|
(1) finds that the department [or designated agency] |
|
has probable cause to conduct the investigation; and |
|
(2) has reason to believe that the person may remove |
|
the child from the state. |
|
SECTION 1.137. Sections 261.308(a), (b), and (c), Family |
|
Code, are amended to read as follows: |
|
(a) The department [or designated agency] shall make a |
|
complete written report of the investigation. |
|
(b) If sufficient grounds for filing a suit exist, the |
|
department [or designated agency] shall submit the report, together |
|
with recommendations, to the court, the district attorney, and the |
|
appropriate law enforcement agency. |
|
(c) On receipt of the report and recommendations, the court |
|
may direct the department [or designated agency] to file a petition |
|
requesting appropriate relief as provided in this title. |
|
SECTION 1.138. Section 261.309(a), Family Code, is amended |
|
to read as follows: |
|
(a) The executive commissioner [department] shall by rule |
|
establish policies and procedures to resolve complaints relating to |
|
and conduct reviews of child abuse or neglect investigations |
|
conducted by the department. |
|
SECTION 1.139. Section 261.310(a), Family Code, is amended |
|
to read as follows: |
|
(a) The executive commissioner [department] shall by rule |
|
develop and adopt standards for persons who investigate suspected |
|
child abuse or neglect at the state or local level. The standards |
|
shall encourage professionalism and consistency in the |
|
investigation of suspected child abuse or neglect. |
|
SECTION 1.140. Sections 261.311(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) When during an investigation of a report of suspected |
|
child abuse or neglect a representative of the department [or the
|
|
designated agency] conducts an interview with or an examination of |
|
a child, the department [or designated agency] shall make a |
|
reasonable effort before 24 hours after the time of the interview or |
|
examination to notify each parent of the child and the child's legal |
|
guardian, if one has been appointed, of the nature of the allegation |
|
and of the fact that the interview or examination was conducted. |
|
(b) If a report of suspected child abuse or neglect is |
|
administratively closed by the department [or designated agency] as |
|
a result of a preliminary investigation that did not include an |
|
interview or examination of the child, the department [or
|
|
designated agency] shall make a reasonable effort before the |
|
expiration of 24 hours after the time the investigation is closed to |
|
notify each parent and legal guardian of the child of the |
|
disposition of the investigation. |
|
SECTION 1.141. Section 261.312(b), Family Code, is amended |
|
to read as follows: |
|
(b) A review team consists of at least five members who |
|
serve staggered two-year terms. Review team members are appointed |
|
by the commissioner [director] of the department and consist of |
|
volunteers who live in and are broadly representative of the region |
|
in which the review team is established and have expertise in the |
|
prevention and treatment of child abuse and neglect. At least two |
|
members of a review team must be parents who have not been convicted |
|
of or indicted for an offense involving child abuse or neglect, have |
|
not been determined by the department to have engaged in child abuse |
|
or neglect, and are not under investigation by the department for |
|
child abuse or neglect. A member of a review team is a department |
|
volunteer for the purposes of Section 411.114, Government Code. |
|
SECTION 1.142. Section 261.315(c), Family Code, is amended |
|
to read as follows: |
|
(c) The executive commissioner [board] shall adopt rules |
|
necessary to administer this section. |
|
SECTION 1.143. Sections 261.401(c) and (d), Family Code, |
|
are amended to read as follows: |
|
(c) A state agency shall adopt rules relating to the |
|
investigation and resolution of reports received as provided by |
|
this subchapter. The executive commissioner [Health and Human
|
|
Services Commission] shall review and approve the rules of agencies |
|
other than the Texas Department of Criminal Justice or the[,] Texas |
|
Juvenile Justice Department [Youth Commission, or Texas Juvenile
|
|
Probation Commission] to ensure that those agencies implement |
|
appropriate standards for the conduct of investigations and that |
|
uniformity exists among agencies in the investigation and |
|
resolution of reports. |
|
(d) The Texas School for the Blind and Visually Impaired and |
|
the Texas School for the Deaf shall adopt policies relating to the |
|
investigation and resolution of reports received as provided by |
|
this subchapter. The executive commissioner [Health and Human
|
|
Services Commission] shall review and approve the policies to |
|
ensure that the Texas School for the Blind and Visually Impaired and |
|
the Texas School for the Deaf adopt those policies in a manner |
|
consistent with the minimum standards adopted by the executive |
|
commissioner [Health and Human Services Commission] under Section |
|
261.407. |
|
SECTION 1.144. Section 261.402(c), Family Code, is amended |
|
to read as follows: |
|
(c) A state agency that licenses, certifies, or registers a |
|
facility in which children are located shall compile, maintain, and |
|
make available statistics on the incidence in the facility of child |
|
abuse, neglect, and exploitation that is investigated by the agency |
|
[in the facility]. |
|
SECTION 1.145. Section 261.403, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.403. COMPLAINTS. (a) If a state agency receives a |
|
complaint relating to an investigation conducted by the agency |
|
concerning a facility operated by that agency in which children are |
|
located, the agency shall refer the complaint to the agency's |
|
governing body [board]. |
|
(b) The governing body [board] of a state agency that |
|
operates a facility in which children are located shall ensure that |
|
the procedure for investigating abuse, neglect, and exploitation |
|
allegations and inquiries in the agency's facility is periodically |
|
reviewed under the agency's internal audit program required by |
|
Chapter 2102, Government Code. |
|
SECTION 1.146. Section 261.404, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.404. INVESTIGATIONS REGARDING CERTAIN CHILDREN |
|
WITH MENTAL ILLNESS OR AN INTELLECTUAL DISABILITY [MENTAL
|
|
RETARDATION]. (a) The department shall investigate a report of |
|
abuse, neglect, or exploitation of a child receiving services: |
|
(1) in a facility operated by the Department of Aging |
|
and Disability Services or a mental health facility operated by the |
|
Department of State Health Services; |
|
(2) in or from a community center, a local mental |
|
health authority, or a local intellectual and developmental |
|
disability [mental retardation] authority; |
|
(3) through a program providing services to that child |
|
by contract with a facility operated by the Department of Aging and |
|
Disability Services, a mental health facility operated by the |
|
Department of State Health Services, a community center, a local |
|
mental health authority, or a local intellectual and developmental |
|
disability [mental retardation] authority; |
|
(4) from a provider of home and community-based |
|
services who contracts with the Department of Aging and Disability |
|
Services; or |
|
(5) in a facility licensed under Chapter 252, Health |
|
and Safety Code. |
|
(b) The department shall investigate the report under rules |
|
developed by the executive commissioner [of the Health and Human
|
|
Services Commission] with the advice and assistance of the |
|
department, the Department of Aging and Disability Services, and |
|
the Department of State Health Services. |
|
(c) If a report under this section relates to a child with an |
|
intellectual disability [mental retardation] receiving services in |
|
a state supported living center or the ICF-IID [ICF-MR] component |
|
of the Rio Grande State Center, the department shall, within one |
|
hour of receiving the report, notify the facility in which the child |
|
is receiving services of the allegations in the report. |
|
(d) If during the course of the department's investigation |
|
of reported abuse, neglect, or exploitation a caseworker of the |
|
department or the caseworker's supervisor has cause to believe that |
|
a child with an intellectual disability [mental retardation] |
|
described by Subsection (c) has been abused, neglected, or |
|
exploited by another person in a manner that constitutes a criminal |
|
offense under any law, including Section 22.04, Penal Code, the |
|
caseworker shall immediately notify the Health and Human Services |
|
Commission's office of inspector general and promptly provide the |
|
commission's office of inspector general with a copy of the |
|
department's investigation report. |
|
(e) The definitions of "abuse" and "neglect" prescribed by |
|
Section 261.001 do not apply to an investigation under this |
|
section. |
|
(f) In this section: |
|
(1) "Community center," "local mental health |
|
authority," "local intellectual and developmental disability |
|
[mental retardation] authority," and "state supported living |
|
center" have the meanings assigned by Section 531.002, Health and |
|
Safety Code. |
|
(2) "Provider" has the meaning assigned by Section |
|
48.351, Human Resources Code. |
|
SECTION 1.147. Section 261.405(a)(1), Family Code, is |
|
amended to read as follows: |
|
(1) "Juvenile justice facility" means a facility |
|
operated wholly or partly by the juvenile board, by another |
|
governmental unit, or by a private vendor under a contract with the |
|
juvenile board, county, or other governmental unit that serves |
|
juveniles under juvenile court jurisdiction. The term includes: |
|
(A) a public or private juvenile |
|
pre-adjudication secure detention facility, including a holdover |
|
facility; |
|
(B) a public or private juvenile |
|
post-adjudication secure correctional facility except for a |
|
facility operated solely for children committed to the Texas |
|
Juvenile Justice Department [Youth Commission]; and |
|
(C) a public or private non-secure juvenile |
|
post-adjudication residential treatment facility that is not |
|
licensed by the Department of Family and Protective [and
|
|
Regulatory] Services or the Department of State Health Services |
|
[Texas Commission on Alcohol and Drug Abuse]. |
|
SECTION 1.148. Section 261.406(d), Family Code, is amended |
|
to read as follows: |
|
(d) The executive commissioner [Board of Protective and
|
|
Regulatory Services] shall adopt rules necessary to implement this |
|
section. |
|
SECTION 1.149. Section 261.407, Family Code, is amended to |
|
read as follows: |
|
Sec. 261.407. MINIMUM STANDARDS. (a) The executive |
|
commissioner [Health and Human Services Commission] by rule shall |
|
adopt minimum standards for the investigation under Section 261.401 |
|
of suspected child abuse, neglect, or exploitation in a facility. |
|
(b) A rule or policy adopted by a state agency or |
|
institution under Section 261.401 must be consistent with the |
|
minimum standards adopted by the executive commissioner [Health and
|
|
Human Services Commission]. |
|
(c) This section does not apply to a facility under the |
|
jurisdiction of the Texas Department of Criminal Justice or the[,] |
|
Texas Juvenile Justice Department [Youth Commission, or Texas
|
|
Juvenile Probation Commission]. |
|
SECTION 1.150. Sections 261.408(a) and (c), Family Code, |
|
are amended to read as follows: |
|
(a) The executive commissioner [Health and Human Services
|
|
Commission] by rule shall adopt uniform procedures for collecting |
|
information under Section 261.401, including procedures for |
|
collecting information on deaths that occur in facilities. |
|
(c) This section does not apply to a facility under the |
|
jurisdiction of the Texas Department of Criminal Justice or the[,] |
|
Texas Juvenile Justice Department [Youth Commission, or Texas
|
|
Juvenile Probation Commission]. |
|
SECTION 1.151. Section 262.006(a), Family Code, is amended |
|
to read as follows: |
|
(a) An authorized representative of the Department of |
|
Family and Protective [and Regulatory] Services may assume the |
|
care, control, and custody of a child born alive as the result of an |
|
abortion as defined by Chapter 161. |
|
SECTION 1.152. Section 262.007(c), Family Code, is amended |
|
to read as follows: |
|
(c) If a person entitled to possession of the child is not |
|
immediately available to take possession of the child, the law |
|
enforcement officer shall deliver the child to the Department of |
|
Family and Protective [and Regulatory] Services. Until a person |
|
entitled to possession of the child takes possession of the child, |
|
the department may, without a court order, retain possession of the |
|
child not longer than five days after the date the child is |
|
delivered to the department. While the department retains |
|
possession of a child under this subsection, the department may |
|
place the child in foster [home] care. If a parent or other person |
|
entitled to possession of the child does not take possession of the |
|
child before the sixth day after the date the child is delivered to |
|
the department, the department shall proceed under this chapter as |
|
if the law enforcement officer took possession of the child under |
|
Section 262.104. |
|
SECTION 1.153. Section 262.008(a), Family Code, is amended |
|
to read as follows: |
|
(a) An authorized representative of the Department of |
|
Family and Protective [and Regulatory] Services may assume the |
|
care, control, and custody of a child: |
|
(1) who is abandoned without identification or a means |
|
for identifying the child; and |
|
(2) whose identity cannot be ascertained by the |
|
exercise of reasonable diligence. |
|
SECTION 1.154. Section 262.1015(a), Family Code, is amended |
|
to read as follows: |
|
(a) If the Department of Family and Protective Services |
|
[department] determines after an investigation that child abuse has |
|
occurred and that the child would be protected in the child's home |
|
by the removal of the alleged perpetrator of the abuse, the |
|
department shall file a petition for the removal of the alleged |
|
perpetrator from the residence of the child rather than attempt to |
|
remove the child from the residence. |
|
SECTION 1.155. Sections 262.102(a), (c), and (d), Family |
|
Code, are amended to read as follows: |
|
(a) Before a court may, without prior notice and a hearing, |
|
issue a temporary order for the conservatorship of a child under |
|
Section 105.001(a)(1) or a temporary restraining order or |
|
attachment of a child authorizing a governmental entity to take |
|
possession of a child in a suit brought by a governmental entity, |
|
the court must find that: |
|
(1) there is an immediate danger to the physical |
|
health or safety of the child or the child has been a victim of |
|
neglect or sexual abuse and that continuation in the home would be |
|
contrary to the child's welfare; |
|
(2) there is no time, consistent with the physical |
|
health or safety of the child and the nature of the emergency, for a |
|
full adversary hearing under Subchapter C; and |
|
(3) reasonable efforts, consistent with the |
|
circumstances and providing for the safety of the child, were made |
|
to prevent or eliminate the need for removal of the child. |
|
(c) If, based on the recommendation of or a request by the |
|
Department of Family and Protective Services [department], the |
|
court finds that child abuse or neglect has occurred and that the |
|
child requires protection from family violence by a member of the |
|
child's family or household, the court shall render a temporary |
|
order under Title 4 [Chapter 71] for the protection of the child. |
|
In this subsection, "family violence" has the meaning assigned by |
|
Section 71.004. |
|
(d) The temporary order, temporary restraining order, or |
|
attachment of a child rendered by the court under Subsection (a) |
|
must contain the following statement prominently displayed in |
|
boldface type, capital letters, or underlined: |
|
"YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY. IF YOU |
|
ARE INDIGENT AND UNABLE TO AFFORD AN ATTORNEY, YOU HAVE THE RIGHT TO |
|
REQUEST THE APPOINTMENT OF AN ATTORNEY BY CONTACTING THE COURT AT |
|
[ADDRESS], [TELEPHONE NUMBER]. IF YOU APPEAR IN OPPOSITION TO THE |
|
SUIT, CLAIM INDIGENCE, AND REQUEST THE APPOINTMENT OF AN ATTORNEY, |
|
THE COURT WILL REQUIRE YOU TO SIGN AN AFFIDAVIT OF INDIGENCE AND THE |
|
COURT MAY HEAR EVIDENCE TO DETERMINE IF YOU ARE INDIGENT. IF THE |
|
COURT DETERMINES YOU ARE INDIGENT AND ELIGIBLE FOR APPOINTMENT OF |
|
AN ATTORNEY, THE COURT WILL APPOINT AN ATTORNEY TO REPRESENT YOU." |
|
SECTION 1.156. Section 262.103, Family Code, is amended to |
|
read as follows: |
|
Sec. 262.103. DURATION OF TEMPORARY ORDER, TEMPORARY |
|
RESTRAINING ORDER, AND ATTACHMENT. A temporary order, temporary |
|
restraining order, or attachment of the child issued under Section |
|
262.102(a) [this chapter] expires not later than 14 days after the |
|
date it is issued unless it is extended as provided by the Texas |
|
Rules of Civil Procedure or Section 262.201(a-3). |
|
SECTION 1.157. Section 262.104(a), Family Code, is amended |
|
to read as follows: |
|
(a) If there is no time to obtain a temporary order, |
|
temporary restraining order, or attachment under Section |
|
262.102(a) before taking possession of a child consistent with the |
|
health and safety of that child, an authorized representative of |
|
the Department of Family and Protective Services, a law enforcement |
|
officer, or a juvenile probation officer may take possession of a |
|
child without a court order under the following conditions, only: |
|
(1) on personal knowledge of facts that would lead a |
|
person of ordinary prudence and caution to believe that there is an |
|
immediate danger to the physical health or safety of the child; |
|
(2) on information furnished by another that has been |
|
corroborated by personal knowledge of facts and all of which taken |
|
together would lead a person of ordinary prudence and caution to |
|
believe that there is an immediate danger to the physical health or |
|
safety of the child; |
|
(3) on personal knowledge of facts that would lead a |
|
person of ordinary prudence and caution to believe that the child |
|
has been the victim of sexual abuse; |
|
(4) on information furnished by another that has been |
|
corroborated by personal knowledge of facts and all of which taken |
|
together would lead a person of ordinary prudence and caution to |
|
believe that the child has been the victim of sexual abuse; or |
|
(5) on information furnished by another that has been |
|
corroborated by personal knowledge of facts and all of which taken |
|
together would lead a person of ordinary prudence and caution to |
|
believe that the parent or person who has possession of the child is |
|
currently using a controlled substance as defined by Chapter 481, |
|
Health and Safety Code, and the use constitutes an immediate danger |
|
to the physical health or safety of the child. |
|
SECTION 1.158. Section 262.105(b), Family Code, is amended |
|
to read as follows: |
|
(b) If the Department of Family and Protective [and
|
|
Regulatory] Services files a suit affecting the parent-child |
|
relationship required under Subsection (a)(1) seeking termination |
|
of the parent-child relationship, the department shall file the |
|
suit not later than the 45th day after the date the department |
|
assumes the care, control, and custody of a child under Section |
|
262.303. |
|
SECTION 1.159. Section 262.106(d), Family Code, is amended |
|
to read as follows: |
|
(d) For the purpose of determining under Subsection (a) the |
|
first working day after the date the child is taken into possession, |
|
the child is considered to have been taken into possession by the |
|
Department of Family and Protective [and Regulatory] Services on |
|
the expiration of the five-day period permitted under Section |
|
262.007(c) or 262.110(b), as appropriate. |
|
SECTION 1.160. Section 262.109(a), Family Code, is amended |
|
to read as follows: |
|
(a) The Department of Family and Protective Services |
|
[department] or other agency must give written notice as prescribed |
|
by this section to each parent of the child or to the child's |
|
conservator or legal guardian when a representative of the |
|
department [Department of Protective and Regulatory Services] or |
|
other agency takes possession of a child under this chapter. |
|
SECTION 1.161. Section 262.110(a), Family Code, is amended |
|
to read as follows: |
|
(a) An authorized representative of the Department of |
|
Family and Protective [and Regulatory] Services, a law enforcement |
|
officer, or a juvenile probation officer may take temporary |
|
possession of a child without a court order on discovery of a child |
|
in a situation of danger to the child's physical health or safety |
|
when the sole purpose is to deliver the child without unnecessary |
|
delay to the parent, managing conservator, possessory conservator, |
|
guardian, caretaker, or custodian who is presently entitled to |
|
possession of the child. |
|
SECTION 1.162. Section 262.112(a), Family Code, is amended |
|
to read as follows: |
|
(a) The Department of Family and Protective [and
|
|
Regulatory] Services is entitled to an expedited hearing under this |
|
chapter in any proceeding in which a hearing is required if the |
|
department determines that a child should be removed from the |
|
child's home because of an immediate danger to the physical health |
|
or safety of the child. |
|
SECTION 1.163. Sections 262.201(a-3) and (g), Family Code, |
|
are amended to read as follows: |
|
(a-3) The court may, for good cause shown, postpone the full |
|
adversary hearing for not more than seven days from the date of the |
|
attorney's appointment to provide the attorney time to respond to |
|
the petition and prepare for the hearing. The court may shorten or |
|
lengthen the extension granted under this subsection if the parent |
|
and the appointed attorney agree in writing. If the court postpones |
|
the full adversary hearing, the court shall extend a temporary |
|
order, temporary restraining order, or attachment issued by the |
|
court under Section 262.102(a) for the protection of the child |
|
until the date of the rescheduled full adversary hearing. |
|
(g) For the purpose of determining under Subsection (a) the |
|
14th day after the date the child is taken into possession, a child |
|
is considered to have been taken into possession by the Department |
|
of Family and Protective Services [department] on the expiration of |
|
the five-day period permitted under Section 262.007(c) or |
|
262.110(b), as appropriate. |
|
SECTION 1.164. Sections 262.2015(a), (b), and (d), Family |
|
Code, are amended to read as follows: |
|
(a) The court may waive the requirement of a service plan |
|
and the requirement to make reasonable efforts to return the child |
|
to a parent and may accelerate the trial schedule to result in a |
|
final order for a child under the care of the Department of Family |
|
and Protective Services [department] at an earlier date than |
|
provided by Subchapter D, Chapter 263, if the court finds that the |
|
parent has subjected the child to aggravated circumstances. |
|
(b) The court may find under Subsection (a) that a parent |
|
has subjected the child to aggravated circumstances if: |
|
(1) the parent abandoned the child without |
|
identification or a means for identifying the child; |
|
(2) the child is a victim of serious bodily injury or |
|
sexual abuse inflicted by the parent or by another person with the |
|
parent's consent; |
|
(3) the parent has engaged in conduct against the |
|
child that would constitute an offense under the following |
|
provisions of the Penal Code: |
|
(A) Section 19.02 (murder); |
|
(B) Section 19.03 (capital murder); |
|
(C) Section 19.04 (manslaughter); |
|
(D) Section 21.11 (indecency with a child); |
|
(E) Section 22.011 (sexual assault); |
|
(F) Section 22.02 (aggravated assault); |
|
(G) Section 22.021 (aggravated sexual assault); |
|
(H) Section 22.04 (injury to a child, elderly |
|
individual, or disabled individual); |
|
(I) Section 22.041 (abandoning or endangering |
|
child); |
|
(J) Section 25.02 (prohibited sexual conduct); |
|
(K) Section 43.25 (sexual performance by a |
|
child); |
|
(L) Section 43.26 (possession or promotion of |
|
child pornography); |
|
(M) Section 21.02 (continuous sexual abuse of |
|
young child or children); |
|
(N) Section 43.05(a)(2) (compelling |
|
prostitution); or |
|
(O) Section 20A.02(a)(7) or (8) (trafficking of |
|
persons); |
|
(4) the parent voluntarily left the child alone or in |
|
the possession of another person not the parent of the child for at |
|
least six months without expressing an intent to return and without |
|
providing adequate support for the child; |
|
(5) the parent's parental rights with regard to |
|
another child have been involuntarily terminated based on a finding |
|
that the parent's conduct violated Section 161.001(b)(1)(D) |
|
[161.001(1)(D)] or (E) or a substantially equivalent provision of |
|
another state's law; |
|
(6) the parent has been convicted for: |
|
(A) the murder of another child of the parent and |
|
the offense would have been an offense under 18 U.S.C. Section |
|
1111(a) if the offense had occurred in the special maritime or |
|
territorial jurisdiction of the United States; |
|
(B) the voluntary manslaughter of another child |
|
of the parent and the offense would have been an offense under 18 |
|
U.S.C. Section 1112(a) if the offense had occurred in the special |
|
maritime or territorial jurisdiction of the United States; |
|
(C) aiding or abetting, attempting, conspiring, |
|
or soliciting an offense under Paragraph [Subdivision] (A) or (B); |
|
or |
|
(D) the felony assault of the child or another |
|
child of the parent that resulted in serious bodily injury to the |
|
child or another child of the parent; or |
|
(7) the parent's parental rights with regard to two |
|
other children have been involuntarily terminated. |
|
(d) The Department of Family and Protective [and
|
|
Regulatory] Services shall make reasonable efforts to finalize the |
|
permanent placement of a child for whom the court has made the |
|
finding described by Subsection (c). The court shall set the suit |
|
for trial on the merits as required by Subchapter D, Chapter 263, in |
|
order to facilitate final placement of the child. |
|
SECTION 1.165. Section 262.301(1), Family Code, is amended |
|
to read as follows: |
|
(1) "Designated emergency infant care provider" |
|
means: |
|
(A) an emergency medical services provider; |
|
(B) a hospital; or |
|
(C) a child-placing agency licensed by the |
|
Department of Family and Protective [and Regulatory] Services under |
|
Chapter 42, Human Resources Code, that: |
|
(i) agrees to act as a designated emergency |
|
infant care provider under this subchapter; and |
|
(ii) has on staff a person who is licensed |
|
as a registered nurse under Chapter 301, Occupations Code, or who |
|
provides emergency medical services under Chapter 773, Health and |
|
Safety Code, and who will examine and provide emergency medical |
|
services to a child taken into possession by the agency under this |
|
subchapter. |
|
SECTION 1.166. Section 262.303(a), Family Code, is amended |
|
to read as follows: |
|
(a) Not later than the close of the first business day after |
|
the date on which a designated emergency infant care provider takes |
|
possession of a child under Section 262.302, the provider shall |
|
notify the Department of Family and Protective [and Regulatory] |
|
Services that the provider has taken possession of the child. |
|
SECTION 1.167. Section 262.304, Family Code, is amended to |
|
read as follows: |
|
Sec. 262.304. FILING PETITION AFTER ACCEPTING POSSESSION OF |
|
ABANDONED CHILD. A child for whom the Department of Family and |
|
Protective [and Regulatory] Services assumes care, control, and |
|
custody under Section 262.303 shall be treated as a child taken into |
|
possession without a court order, and the department shall take |
|
action as required by Section 262.105 with regard to the child. |
|
SECTION 1.168. Section 262.305(a), Family Code, is amended |
|
to read as follows: |
|
(a) Immediately after assuming care, control, and custody |
|
of a child under Section 262.303, the Department of Family and |
|
Protective [and Regulatory] Services shall report the child to |
|
appropriate state and local law enforcement agencies as a potential |
|
missing child. |
|
SECTION 1.169. Section 262.307, Family Code, is amended to |
|
read as follows: |
|
Sec. 262.307. REIMBURSEMENT FOR CARE OF ABANDONED CHILD. |
|
The Department of Family and Protective Services [department] shall |
|
reimburse a designated emergency infant care provider that takes |
|
possession of a child under Section 262.302 for the cost to the |
|
provider of assuming the care, control, and custody of the child. |
|
SECTION 1.170. Section 263.001(a)(4), Family Code, is |
|
amended to read as follows: |
|
(4) "Substitute care" means the placement of a child |
|
who is in the conservatorship of the department [or an authorized
|
|
agency] in care outside the child's home. The term includes foster |
|
care, institutional care, adoption, placement with a relative of |
|
the child, or commitment to the Texas Juvenile Justice Department |
|
[Youth Commission]. |
|
SECTION 1.171. Section 263.002, Family Code, is amended to |
|
read as follows: |
|
Sec. 263.002. REVIEW OF PLACEMENTS BY COURT. In a suit |
|
affecting the parent-child relationship in which the department [or
|
|
an authorized agency] has been appointed by the court or designated |
|
in an affidavit of relinquishment of parental rights as the |
|
temporary or permanent managing conservator of a child, the court |
|
shall hold a hearing to review: |
|
(1) the conservatorship appointment and substitute |
|
care; and |
|
(2) for a child committed to the Texas Juvenile |
|
Justice Department [Youth Commission], the child's commitment in |
|
the Texas Juvenile Justice Department [Youth Commission] or release |
|
under supervision by the Texas Juvenile Justice Department [Youth
|
|
Commission]. |
|
SECTION 1.172. Section 263.008(a)(2), Family Code, is |
|
amended to read as follows: |
|
(2) "Foster care" means the placement of a child who is |
|
in the conservatorship of the department [or an authorized agency] |
|
and in care outside the child's home in an agency foster group home, |
|
agency foster home, foster group home, foster home, or another |
|
facility licensed or certified under Chapter 42, Human Resources |
|
Code, in which care is provided for 24 hours a day. |
|
SECTION 1.173. Section 263.101, Family Code, is amended to |
|
read as follows: |
|
Sec. 263.101. DEPARTMENT TO FILE SERVICE PLAN. Not later |
|
than the 45th day after the date the court renders a temporary order |
|
appointing the department as temporary managing conservator of a |
|
child under Chapter 262, the department [or other agency appointed
|
|
as the managing conservator of a child] shall file a service plan. |
|
SECTION 1.174. Section 263.102(a), Family Code, is amended |
|
to read as follows: |
|
(a) The service plan must: |
|
(1) be specific; |
|
(2) be in writing in a language that the parents |
|
understand, or made otherwise available; |
|
(3) be prepared by the department [or other agency] in |
|
conference with the child's parents; |
|
(4) state appropriate deadlines; |
|
(5) state whether the goal of the plan is: |
|
(A) return of the child to the child's parents; |
|
(B) termination of parental rights and placement |
|
of the child for adoption; or |
|
(C) because of the child's special needs or |
|
exceptional circumstances, continuation of the child's care out of |
|
the child's home; |
|
(6) state steps that are necessary to: |
|
(A) return the child to the child's home if the |
|
placement is in foster care; |
|
(B) enable the child to remain in the child's |
|
home with the assistance of a service plan if the placement is in |
|
the home under the department's [or other agency's] supervision; or |
|
(C) otherwise provide a permanent safe placement |
|
for the child; |
|
(7) state the actions and responsibilities that are |
|
necessary for the child's parents to take to achieve the plan goal |
|
during the period of the service plan and the assistance to be |
|
provided to the parents by the department or other [authorized] |
|
agency toward meeting that goal; |
|
(8) state any specific skills or knowledge that the |
|
child's parents must acquire or learn, as well as any behavioral |
|
changes the parents must exhibit, to achieve the plan goal; |
|
(9) state the actions and responsibilities that are |
|
necessary for the child's parents to take to ensure that the child |
|
attends school and maintains or improves the child's academic |
|
compliance; |
|
(10) state the name of the person with the department |
|
[or other agency] whom the child's parents may contact for |
|
information relating to the child if other than the person |
|
preparing the plan; and |
|
(11) prescribe any other term or condition that the |
|
department [or other agency] determines to be necessary to the |
|
service plan's success. |
|
SECTION 1.175. Sections 263.103(a), (a-1), (c), and (d), |
|
Family Code, are amended to read as follows: |
|
(a) The original service plan shall be developed jointly by |
|
the child's parents and a representative of the department [or
|
|
other authorized agency], including informing the parents of their |
|
rights in connection with the service plan process. If a parent is |
|
not able or willing to participate in the development of the service |
|
plan, it should be so noted in the plan. |
|
(a-1) Before the original service plan is signed, the |
|
child's parents and the representative of the department [or other
|
|
authorized agency] shall discuss each term and condition of the |
|
plan. |
|
(c) If the department [or other authorized agency] |
|
determines that the child's parents are unable or unwilling to |
|
participate in the development of the original service plan or sign |
|
the plan, the department may file the plan without the parents' |
|
signatures. |
|
(d) The original service plan takes effect when: |
|
(1) the child's parents and the appropriate |
|
representative of the department [or other authorized agency] sign |
|
the plan; or |
|
(2) the court issues an order giving effect to the plan |
|
without the parents' signatures. |
|
SECTION 1.176. Section 263.104(b), Family Code, is amended |
|
to read as follows: |
|
(b) The amended service plan supersedes the previously |
|
filed service plan and takes effect when: |
|
(1) the child's parents and the appropriate |
|
representative of the department [or other authorized agency] sign |
|
the plan; or |
|
(2) the department [or other authorized agency] |
|
determines that the child's parents are unable or unwilling to sign |
|
the amended plan and files it without the parents' signatures. |
|
SECTION 1.177. Sections 263.202(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) If all persons entitled to citation and notice of a |
|
status hearing under this chapter were not served, the court shall |
|
make findings as to whether: |
|
(1) the department [or other agency] has exercised due |
|
diligence to locate all necessary persons, including an alleged |
|
father of the child, regardless of whether the alleged father is |
|
registered with the registry of paternity under Section 160.402; |
|
and |
|
(2) the child and each parent, alleged father, or |
|
relative of the child before the court have furnished to the |
|
department all available information necessary to locate an absent |
|
parent, alleged father, or relative of the child through exercise |
|
of due diligence. |
|
(b) Except as otherwise provided by this subchapter, a |
|
status hearing shall be limited to matters related to the contents |
|
and execution of the service plan filed with the court. The court |
|
shall review the service plan that the department [or other agency] |
|
filed under this chapter for reasonableness, accuracy, and |
|
compliance with requirements of court orders and make findings as |
|
to whether: |
|
(1) a plan that has the goal of returning the child to |
|
the child's parents adequately ensures that reasonable efforts are |
|
made to enable the child's parents to provide a safe environment for |
|
the child; |
|
(2) the child's parents have reviewed and understand |
|
the plan and have been advised that unless the parents are willing |
|
and able to provide the child with a safe environment, even with the |
|
assistance of a service plan, within the reasonable period of time |
|
specified in the plan, the parents' parental and custodial duties |
|
and rights may be subject to restriction or to termination under |
|
this code or the child may not be returned to the parents; |
|
(3) the plan is reasonably tailored to address any |
|
specific issues identified by the department [or other agency]; and |
|
(4) the child's parents and the representative of the |
|
department [or other agency] have signed the plan. |
|
SECTION 1.178. Section 263.301(c), Family Code, is amended |
|
to read as follows: |
|
(c) If a person entitled to notice under Chapter 102 or this |
|
section has not been served, the court shall review the |
|
department's [or other agency's] efforts at attempting to locate |
|
all necessary persons and requesting service of citation and the |
|
assistance of a parent in providing information necessary to locate |
|
an absent parent. |
|
SECTION 1.179. Section 263.303, Family Code, is amended to |
|
read as follows: |
|
Sec. 263.303. PERMANENCY PROGRESS REPORT. (a) Not later |
|
than the 10th day before the date set for each permanency hearing |
|
other than the first permanency hearing, the department [or other
|
|
authorized agency] shall file with the court and provide to each |
|
party, the child's attorney ad litem, the child's guardian ad litem, |
|
and the child's volunteer advocate a permanency progress report |
|
unless the court orders a different period for providing the |
|
report. |
|
(b) The permanency progress report must: |
|
(1) recommend that the suit be dismissed; or |
|
(2) recommend that the suit continue, and: |
|
(A) identify the date for dismissal of the suit |
|
under this chapter; |
|
(B) provide: |
|
(i) the name of any person entitled to |
|
notice under Chapter 102 who has not been served; |
|
(ii) a description of the efforts by the |
|
department [or another agency] to locate and request service of |
|
citation; and |
|
(iii) a description of each parent's |
|
assistance in providing information necessary to locate an unserved |
|
party; |
|
(C) evaluate the parties' compliance with |
|
temporary orders and with the service plan; |
|
(D) evaluate whether the child's placement in |
|
substitute care meets the child's needs and recommend other plans |
|
or services to meet the child's special needs or circumstances; |
|
(E) describe the permanency plan for the child |
|
and recommend actions necessary to ensure that a final order |
|
consistent with that permanency plan, including the concurrent |
|
permanency goals contained in that plan, is rendered before the |
|
date for dismissal of the suit under this chapter; |
|
(F) with respect to a child 16 years of age or |
|
older, identify the services needed to assist the child in the |
|
transition to adult life; and |
|
(G) with respect to a child committed to the |
|
Texas Juvenile Justice Department [Youth Commission] or released |
|
under supervision by the Texas Juvenile Justice Department [Youth
|
|
Commission]: |
|
(i) evaluate whether the child's needs for |
|
treatment and education are being met; |
|
(ii) describe, using information provided |
|
by the Texas Juvenile Justice Department [Youth Commission], the |
|
child's progress in any rehabilitation program administered by the |
|
Texas Juvenile Justice Department [Youth Commission]; and |
|
(iii) recommend other plans or services to |
|
meet the child's needs. |
|
(c) A parent whose parental rights are the subject of a suit |
|
affecting the parent-child relationship, the attorney for that |
|
parent, or the child's attorney ad litem or guardian ad litem may |
|
file a response to the department's [or other agency's] report filed |
|
under Subsection (b). A response must be filed not later than the |
|
third day before the date of the hearing. |
|
SECTION 1.180. Section 263.306(a), Family Code, as amended |
|
by Chapters 191 (S.B. 352), 204 (H.B. 915), and 688 (H.B. 2619), |
|
Acts of the 83rd Legislature, Regular Session, 2013, is reenacted |
|
and amended to read as follows: |
|
(a) At each permanency hearing the court shall: |
|
(1) identify all persons or parties present at the |
|
hearing or those given notice but failing to appear; |
|
(2) review the efforts of the department [or another
|
|
agency] in: |
|
(A) attempting to locate all necessary persons; |
|
(B) requesting service of citation; and |
|
(C) obtaining the assistance of a parent in |
|
providing information necessary to locate an absent parent, alleged |
|
father, or relative of the child; |
|
(3) review the efforts of each custodial parent, |
|
alleged father, or relative of the child before the court in |
|
providing information necessary to locate another absent parent, |
|
alleged father, or relative of the child; |
|
(4) review any visitation plan or amended plan |
|
required under Section 263.107 and render any orders for visitation |
|
the court determines necessary; |
|
(5) return the child to the parent or parents if the |
|
child's parent or parents are willing and able to provide the child |
|
with a safe environment and the return of the child is in the |
|
child's best interest; |
|
(6) place the child with a person or entity, other than |
|
a parent, entitled to service under Chapter 102 if the person or |
|
entity is willing and able to provide the child with a safe |
|
environment and the placement of the child is in the child's best |
|
interest; |
|
(7) evaluate the department's efforts to identify |
|
relatives who could provide the child with a safe environment, if |
|
the child is not returned to a parent or another person or entity |
|
entitled to service under Chapter 102; |
|
(8) evaluate the parties' compliance with temporary |
|
orders and the service plan; |
|
(9) identify an education decision-maker for the child |
|
if one has not previously been identified; |
|
(10) review the medical care provided to the child as |
|
required by Section 266.007; |
|
(11) [(9)] ensure the child has been provided the |
|
opportunity, in a developmentally appropriate manner, to express |
|
the child's opinion on the medical care provided; |
|
(12) [(10)] for a child receiving psychotropic |
|
medication, determine whether the child: |
|
(A) has been provided appropriate psychosocial |
|
therapies, behavior strategies, and other non-pharmacological |
|
interventions; and |
|
(B) has been seen by the prescribing physician, |
|
physician assistant, or advanced practice nurse at least once every |
|
90 days for purposes of the review required by Section 266.011; |
|
(13) [(11)] determine whether: |
|
(A) the child continues to need substitute care; |
|
(B) the child's current placement is appropriate |
|
for meeting the child's needs, including with respect to a child who |
|
has been placed outside of the state, whether that placement |
|
continues to be in the best interest of the child; and |
|
(C) other plans or services are needed to meet |
|
the child's special needs or circumstances; |
|
(14) [(12)] if the child is placed in institutional |
|
care, determine whether efforts have been made to ensure placement |
|
of the child in the least restrictive environment consistent with |
|
the best interest and special needs of the child; |
|
(15) [(13)] if the child is 16 years of age or older, |
|
order services that are needed to assist the child in making the |
|
transition from substitute care to independent living if the |
|
services are available in the community; |
|
(16) [(14)] determine plans, services, and further |
|
temporary orders necessary to ensure that a final order is rendered |
|
before the date for dismissal of the suit under this chapter; |
|
(17) [(15)] if the child is committed to the Texas |
|
Juvenile Justice Department or released under supervision by the |
|
Texas Juvenile Justice Department, determine whether the child's |
|
needs for treatment, rehabilitation, and education are being met; |
|
and |
|
(18) [(16)] determine the date for dismissal of the |
|
suit under this chapter and give notice in open court to all parties |
|
of: |
|
(A) the dismissal date; |
|
(B) the date of the next permanency hearing; and |
|
(C) the date the suit is set for trial. |
|
SECTION 1.181. Section 263.307(b), Family Code, is amended |
|
to read as follows: |
|
(b) The following factors should be considered by the court |
|
and [,] the department[, and other authorized agencies] in |
|
determining whether the child's parents are willing and able to |
|
provide the child with a safe environment: |
|
(1) the child's age and physical and mental |
|
vulnerabilities; |
|
(2) the frequency and nature of out-of-home |
|
placements; |
|
(3) the magnitude, frequency, and circumstances of the |
|
harm to the child; |
|
(4) whether the child has been the victim of repeated |
|
harm after the initial report and intervention by the department |
|
[or other agency]; |
|
(5) whether the child is fearful of living in or |
|
returning to the child's home; |
|
(6) the results of psychiatric, psychological, or |
|
developmental evaluations of the child, the child's parents, other |
|
family members, or others who have access to the child's home; |
|
(7) whether there is a history of abusive or |
|
assaultive conduct by the child's family or others who have access |
|
to the child's home; |
|
(8) whether there is a history of substance abuse by |
|
the child's family or others who have access to the child's home; |
|
(9) whether the perpetrator of the harm to the child is |
|
identified; |
|
(10) the willingness and ability of the child's family |
|
to seek out, accept, and complete counseling services and to |
|
cooperate with and facilitate an appropriate agency's close |
|
supervision; |
|
(11) the willingness and ability of the child's family |
|
to effect positive environmental and personal changes within a |
|
reasonable period of time; |
|
(12) whether the child's family demonstrates adequate |
|
parenting skills, including providing the child and other children |
|
under the family's care with: |
|
(A) minimally adequate health and nutritional |
|
care; |
|
(B) care, nurturance, and appropriate discipline |
|
consistent with the child's physical and psychological |
|
development; |
|
(C) guidance and supervision consistent with the |
|
child's safety; |
|
(D) a safe physical home environment; |
|
(E) protection from repeated exposure to |
|
violence even though the violence may not be directed at the child; |
|
and |
|
(F) an understanding of the child's needs and |
|
capabilities; and |
|
(13) whether an adequate social support system |
|
consisting of an extended family and friends is available to the |
|
child. |
|
SECTION 1.182. Sections 263.502(a) and (c), Family Code, |
|
are amended to read as follows: |
|
(a) Not later than the 10th day before the date set for a |
|
placement review hearing, the department [or other authorized
|
|
agency] shall file a placement review report with the court and |
|
provide a copy to each person entitled to notice under Section |
|
263.501(d). |
|
(c) The placement review report must identify the |
|
department's permanency goal for the child and must: |
|
(1) evaluate whether the child's current placement is |
|
appropriate for meeting the child's needs; |
|
(2) evaluate whether efforts have been made to ensure |
|
placement of the child in the least restrictive environment |
|
consistent with the best interest and special needs of the child if |
|
the child is placed in institutional care; |
|
(3) contain a transition plan for a child who is at |
|
least 16 years of age that identifies the services and specific |
|
tasks that are needed to assist the child in making the transition |
|
from substitute care to adult living and describes the services |
|
that are being provided through the Transitional Living Services |
|
Program operated by the department; |
|
(4) evaluate whether the child's current educational |
|
placement is appropriate for meeting the child's academic needs; |
|
(5) identify other plans or services that are needed |
|
to meet the child's special needs or circumstances; |
|
(6) describe the efforts of the department [or
|
|
authorized agency] to place the child for adoption if parental |
|
rights to the child have been terminated and the child is eligible |
|
for adoption, including efforts to provide adoption promotion and |
|
support services as defined by 42 U.S.C. Section 629a and other |
|
efforts consistent with the federal Adoption and Safe Families Act |
|
of 1997 (Pub. L. No. 105-89); |
|
(7) for a child for whom the department has been named |
|
managing conservator in a final order that does not include |
|
termination of parental rights, describe the efforts of the |
|
department to find a permanent placement for the child, including |
|
efforts to: |
|
(A) work with the caregiver with whom the child |
|
is placed to determine whether that caregiver is willing to become a |
|
permanent placement for the child; |
|
(B) locate a relative or other suitable |
|
individual to serve as permanent managing conservator of the child; |
|
and |
|
(C) evaluate any change in a parent's |
|
circumstances to determine whether: |
|
(i) the child can be returned to the parent; |
|
or |
|
(ii) parental rights should be terminated; |
|
(8) with respect to a child committed to the Texas |
|
Juvenile Justice Department or released under supervision by the |
|
Texas Juvenile Justice Department: |
|
(A) evaluate whether the child's needs for |
|
treatment and education are being met; |
|
(B) describe, using information provided by the |
|
Texas Juvenile Justice Department, the child's progress in any |
|
rehabilitation program administered by the Texas Juvenile Justice |
|
Department; and |
|
(C) recommend other plans or services to meet the |
|
child's needs; and |
|
(9) identify any placement changes that have occurred |
|
since the most recent court hearing concerning the child and |
|
describe any barriers to sustaining the child's placement, |
|
including any reason for which a substitute care provider has |
|
requested a placement change. |
|
SECTION 1.183. Section 263.503(a), Family Code, as amended |
|
by Chapters 204 (H.B. 915) and 688 (H.B. 2619), Acts of the 83rd |
|
Legislature, Regular Session, 2013, is reenacted and amended to |
|
read as follows: |
|
(a) At each placement review hearing, the court shall |
|
determine whether: |
|
(1) the child's current placement is necessary, safe, |
|
and appropriate for meeting the child's needs, including with |
|
respect to a child placed outside of the state, whether the |
|
placement continues to be appropriate and in the best interest of |
|
the child; |
|
(2) efforts have been made to ensure placement of the |
|
child in the least restrictive environment consistent with the best |
|
interest and special needs of the child if the child is placed in |
|
institutional care; |
|
(3) the services that are needed to assist a child who |
|
is at least 16 years of age in making the transition from substitute |
|
care to independent living are available in the community; |
|
(4) the child is receiving appropriate medical care; |
|
(5) the child has been provided the opportunity, in a |
|
developmentally appropriate manner, to express the child's opinion |
|
on the medical care provided; |
|
(6) for a child who is receiving psychotropic |
|
medication, the child: |
|
(A) has been provided appropriate psychosocial |
|
therapies, behavior strategies, and other non-pharmacological |
|
interventions; and |
|
(B) has been seen by the prescribing physician, |
|
physician assistant, or advanced practice nurse at least once every |
|
90 days for purposes of the review required by Section 266.011; |
|
(7) other plans or services are needed to meet the |
|
child's special needs or circumstances; |
|
(8) the department [or authorized agency] has |
|
exercised due diligence in attempting to place the child for |
|
adoption if parental rights to the child have been terminated and |
|
the child is eligible for adoption; |
|
(9) for a child for whom the department has been named |
|
managing conservator in a final order that does not include |
|
termination of parental rights, a permanent placement, including |
|
appointing a relative as permanent managing conservator or |
|
returning the child to a parent, is appropriate for the child; |
|
(10) for a child whose permanency goal is another |
|
planned, permanent living arrangement, the department has: |
|
(A) documented a compelling reason why adoption, |
|
permanent managing conservatorship with a relative or other |
|
suitable individual, or returning the child to a parent is not in |
|
the child's best interest; and |
|
(B) identified a family or other caring adult who |
|
has made a permanent commitment to the child; |
|
(11) the department [or authorized agency] has made |
|
reasonable efforts to finalize the permanency plan that is in |
|
effect for the child; [and] |
|
(12) if the child is committed to the Texas Juvenile |
|
Justice Department or released under supervision by the Texas |
|
Juvenile Justice Department, the child's needs for treatment, |
|
rehabilitation, and education are being met; |
|
(13) [(10)] an education decision-maker for the child |
|
has been identified; and |
|
(14) [(11)] the child's education needs and goals have |
|
been identified and addressed. |
|
SECTION 1.184. Section 264.0091, Family Code, is amended to |
|
read as follows: |
|
Sec. 264.0091. USE OF TELECONFERENCING AND |
|
VIDEOCONFERENCING TECHNOLOGY. Subject to the availability of |
|
funds, the department, in cooperation with district and county |
|
courts, shall expand the use of teleconferencing and |
|
videoconferencing to facilitate participation by medical experts, |
|
children, and other individuals in court proceedings, including |
|
children for whom the department [, an authorized agency,] or a |
|
licensed child-placing agency has been appointed managing |
|
conservator and who are committed to the Texas Juvenile Justice |
|
Department [Youth Commission]. |
|
SECTION 1.185. Section 264.010(d), Family Code, is amended |
|
to read as follows: |
|
(d) A child abuse prevention and protection plan must: |
|
(1) specify the manner of communication between |
|
entities who are parties to the plan, including the department, the |
|
commission [Texas Department of Human Services], local law |
|
enforcement agencies, the county and district attorneys, members of |
|
the medical and social service community, foster parents, and child |
|
advocacy groups; and |
|
(2) provide other information concerning the |
|
prevention and investigation of child abuse in the area for which |
|
the plan is adopted. |
|
SECTION 1.186. Section 264.0111(e), Family Code, is amended |
|
to read as follows: |
|
(e) The executive commissioner [department] may adopt rules |
|
to implement this section. |
|
SECTION 1.187. Section 264.0145(b), Family Code, is amended |
|
to read as follows: |
|
(b) The executive commissioner [department] by rule shall |
|
establish guidelines that prioritize requests to release case |
|
records, including those made by an adult previously in the |
|
department's managing conservatorship. |
|
SECTION 1.188. Sections 264.101(b) and (d), Family Code, |
|
are amended to read as follows: |
|
(b) The department may not pay the cost of protective foster |
|
care for a child for whom the department has been named managing |
|
conservator under an order rendered solely under Section |
|
161.001(b)(1)(J) [161.001(1)(J)]. |
|
(d) The executive commissioner [of the Health and Human
|
|
Services Commission] may adopt rules that establish criteria and |
|
guidelines for the payment of foster care, including medical care, |
|
for a child and for providing care for a child after the child |
|
becomes 18 years of age if the child meets the requirements for |
|
continued foster care under Subsection (a-1). |
|
SECTION 1.189. Sections 264.107(a) and (b), Family Code, |
|
are amended to read as follows: |
|
(a) The department shall use a system for the placement of |
|
children in contract residential care, including foster care, that |
|
conforms to the levels of care adopted [and maintained] by the |
|
executive commissioner [Health and Human Services Commission]. |
|
(b) The department shall use the standard application |
|
provided by the Health and Human Services Commission for the |
|
placement of children in contract residential care [as adopted and
|
|
maintained by the Health and Human Services Commission]. |
|
SECTION 1.190. Section 264.1075(b), Family Code, is amended |
|
to read as follows: |
|
(b) As soon as possible after a child begins receiving |
|
foster care under this subchapter, the department shall assess |
|
whether the child has a developmental or intellectual disability |
|
[or mental retardation]. The commission shall establish the |
|
procedures that the department must use in making an assessment |
|
under this subsection. The procedures may include screening or |
|
participation by: |
|
(1) a person who has experience in childhood |
|
developmental or intellectual disabilities [or mental
|
|
retardation]; |
|
(2) a local intellectual and developmental disability |
|
[mental retardation] authority; or |
|
(3) a provider in a county with a local child welfare |
|
board. |
|
SECTION 1.191. Section 264.108(f), Family Code, is amended |
|
to read as follows: |
|
(f) The executive commissioner [department] by rule shall |
|
define what constitutes a delay under Subsections (b) and (d). |
|
SECTION 1.192. Sections 264.110(b) and (g), Family Code, |
|
are amended to read as follows: |
|
(b) A person registered under this section must satisfy |
|
requirements adopted by rule by the executive commissioner |
|
[department]. |
|
(g) The department may refuse to place a child with a person |
|
registered under this section only for a reason permitted under |
|
criteria adopted by the executive commissioner by [department] |
|
rule. |
|
SECTION 1.193. Section 264.112(a), Family Code, is amended |
|
to read as follows: |
|
(a) The department shall report the status for children in |
|
substitute care to the executive commissioner [Board of Protective
|
|
and Regulatory Services] at least once every 12 months. |
|
SECTION 1.194. Section 264.121(a), Family Code, is amended |
|
to read as follows: |
|
(a) The department shall address the unique challenges |
|
facing foster children in the conservatorship of the department who |
|
must transition to independent living by: |
|
(1) expanding efforts to improve transition planning |
|
and increasing the availability of transitional family group |
|
decision-making to all youth age 14 or older in the department's |
|
permanent managing conservatorship, including enrolling the youth |
|
in the Preparation for Adult Living Program before the age of 16; |
|
(2) coordinating with the commission [Health and Human
|
|
Services Commission] to obtain authority, to the extent allowed by |
|
federal law, the state Medicaid plan, the Title IV-E state plan, and |
|
any waiver or amendment to either plan, necessary to: |
|
(A) extend foster care eligibility and |
|
transition services for youth up to age 21 and develop policy to |
|
permit eligible youth to return to foster care as necessary to |
|
achieve the goals of the Transitional Living Services Program; and |
|
(B) extend Medicaid coverage for foster care |
|
youth and former foster care youth up to age 21 with a single |
|
application at the time the youth leaves foster care; and |
|
(3) entering into cooperative agreements with the |
|
Texas Workforce Commission and local workforce development boards |
|
to further the objectives of the Preparation for Adult Living |
|
Program. The department, the Texas Workforce Commission, and the |
|
local workforce development boards shall ensure that services are |
|
prioritized and targeted to meet the needs of foster care and former |
|
foster care children and that such services will include, where |
|
feasible, referrals for short-term stays for youth needing housing. |
|
SECTION 1.195. Section 264.124(b), Family Code, as added by |
|
Chapter 423 (S.B. 430), Acts of the 83rd Legislature, Regular |
|
Session, 2013, is amended to read as follows: |
|
(b) The department, in accordance with department rules |
|
[executive commissioner rule], shall implement a process to verify |
|
that each foster parent who is seeking monetary assistance from the |
|
department for day care for a foster child has attempted to find |
|
appropriate day-care services for the foster child through |
|
community services, including Head Start programs, prekindergarten |
|
classes, and early education programs offered in public schools. |
|
The department shall specify the documentation the foster parent |
|
must provide to the department to demonstrate compliance with the |
|
requirements established under this subsection. |
|
SECTION 1.196. Section 264.205(b), Family Code, is amended |
|
to read as follows: |
|
(b) A swift adoption team shall consist of department |
|
personnel who shall operate under policies adopted by rule by the |
|
executive commissioner [department]. The department shall set |
|
priorities for the allocation of department resources to enable a |
|
swift adoption team to operate successfully under the policies |
|
adopted under this subsection. |
|
SECTION 1.197. Section 264.506(b), Family Code, is amended |
|
to read as follows: |
|
(b) To achieve its purpose, a review team shall: |
|
(1) adapt and implement, according to local needs and |
|
resources, the model protocols developed by the department and the |
|
committee; |
|
(2) meet on a regular basis to review child fatality |
|
cases and recommend methods to improve coordination of services and |
|
investigations between agencies that are represented on the team; |
|
(3) collect and maintain data as required by the |
|
committee; and |
|
(4) submit to the [bureau of] vital statistics unit |
|
data reports on deaths reviewed as specified by the committee. |
|
SECTION 1.198. Section 264.507, Family Code, is amended to |
|
read as follows: |
|
Sec. 264.507. DUTIES OF PRESIDING OFFICER. The presiding |
|
officer of a review team shall: |
|
(1) send notices to the review team members of a |
|
meeting to review a child fatality; |
|
(2) provide a list to the review team members of each |
|
child fatality to be reviewed at the meeting; |
|
(3) submit data reports to the [bureau of] vital |
|
statistics unit not later than the 30th day after the date on which |
|
the review took place; and |
|
(4) ensure that the review team operates according to |
|
the protocols developed by the department and the committee, as |
|
adapted by the review team. |
|
SECTION 1.199. Section 264.514(a), Family Code, is amended |
|
to read as follows: |
|
(a) A medical examiner or justice of the peace notified of a |
|
death of a child under Section 264.513 shall hold an inquest under |
|
Chapter 49, Code of Criminal Procedure, to determine whether the |
|
death is unexpected or the result of abuse or neglect. An inquest |
|
is not required under this subchapter if the child's death is |
|
expected and is due to a congenital or neoplastic disease. A death |
|
caused by an infectious disease may be considered an expected death |
|
if: |
|
(1) the disease was not acquired as a result of trauma |
|
or poisoning; |
|
(2) the infectious organism is identified using |
|
standard medical procedures; and |
|
(3) the death is not reportable to the [Texas] |
|
Department of State Health Services under Chapter 81, Health and |
|
Safety Code. |
|
SECTION 1.200. Section 264.614(d), Family Code, is amended |
|
to read as follows: |
|
(d) The executive commissioner [of the Health and Human
|
|
Services Commission] shall adopt rules necessary to implement this |
|
section. |
|
SECTION 1.201. Section 264.753, Family Code, is amended to |
|
read as follows: |
|
Sec. 264.753. EXPEDITED PLACEMENT. The department [or
|
|
other authorized entity] shall expedite the completion of the |
|
background and criminal history check, the home study, and any |
|
other administrative procedure to ensure that the child is placed |
|
with a qualified relative or caregiver as soon as possible after the |
|
date the caregiver is identified. |
|
SECTION 1.202. Section 264.755(d), Family Code, is amended |
|
to read as follows: |
|
(d) The department, in accordance with department rules |
|
[executive commissioner rule], shall implement a process to verify |
|
that each relative and designated caregiver who is seeking monetary |
|
assistance or additional support services from the department for |
|
day care as defined by Section 264.124 for a child under this |
|
section has attempted to find appropriate day-care services for the |
|
child through community services, including Head Start programs, |
|
prekindergarten classes, and early education programs offered in |
|
public schools. The department shall specify the documentation the |
|
relative or designated caregiver must provide to the department to |
|
demonstrate compliance with the requirements established under |
|
this subsection. The department may not provide monetary |
|
assistance or additional support services to the relative or |
|
designated caregiver for the day care unless the department |
|
receives the required verification. |
|
SECTION 1.203. The following provisions of the Family Code |
|
are repealed: |
|
(1) Section 101.002; |
|
(2) Section 161.002(c); |
|
(3) Section 162.305; |
|
(4) Sections 261.001(3) and (8); |
|
(5) Section 262.008(c); |
|
(6) Section 263.1015; |
|
(7) Section 264.007; |
|
(8) Section 264.105; |
|
(9) Section 264.106; |
|
(10) Section 264.1063; |
|
(11) Section 264.107(f); |
|
(12) Section 264.206; |
|
(13) Sections 264.501(2) and (5); and |
|
(14) Subchapter H, Chapter 264. |
|
ARTICLE 2. GOVERNMENT CODE |
|
SECTION 2.001. Section 403.1066(c), Government Code, is |
|
amended to read as follows: |
|
(c) The available earnings of the fund may be appropriated |
|
to the [Texas] Department of State Health Services for the purpose |
|
of providing services at a public health hospital as defined by |
|
Section 13.033, Health and Safety Code, [the Texas Center for
|
|
Infectious Disease] and grants, loans, or loan guarantees to public |
|
or nonprofit community hospitals with 125 beds or fewer located in |
|
an urban area of the state. |
|
SECTION 2.002. Section 411.110(a), Government Code, is |
|
amended to read as follows: |
|
(a) The Department of State Health Services is entitled to |
|
obtain from the department criminal history record information |
|
maintained by the department that relates to: |
|
(1) a person who is: |
|
(A) an applicant for a license or certificate |
|
under the Emergency Health Care [Medical Services] Act (Chapter |
|
773, Health and Safety Code); |
|
(B) an owner or manager of an applicant for an |
|
emergency medical services provider license under that Act; or |
|
(C) the holder of a license or certificate under |
|
that Act; |
|
(2) an applicant for a license or a license holder |
|
under Subchapter N, Chapter 431, Health and Safety Code; |
|
(3) an applicant for a license, the owner or manager of |
|
an applicant for a massage establishment license, or a license |
|
holder under Chapter 455, Occupations Code; |
|
(4) an applicant for employment at or current employee |
|
of: |
|
(A) a public health hospital as defined by |
|
Section 13.033, Health and Safety Code [the Texas Center for
|
|
Infectious Disease]; or |
|
(B) the South Texas Health Care System; or |
|
(5) an applicant for employment at, current employee |
|
of, or person who contracts or may contract to provide goods or |
|
services with: |
|
(A) the vital statistics unit of the Department |
|
of State Health Services; or |
|
(B) the Council on Sex Offender Treatment or |
|
other division or component of the Department of State Health |
|
Services that monitors sexually violent predators as described by |
|
Section 841.003(a), Health and Safety Code. |
|
SECTION 2.003. Section 411.1131, Government Code, is |
|
amended to read as follows: |
|
Sec. 411.1131. ACCESS TO CRIMINAL HISTORY RECORD |
|
INFORMATION: DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES |
|
[TEXAS COMMISSION FOR THE DEAF AND HARD OF HEARING]. (a) The |
|
Department of Assistive and Rehabilitative Services [Texas
|
|
Commission for the Deaf and Hard of Hearing] is entitled to obtain |
|
from the department criminal history record information maintained |
|
by the department that relates to a person who is an applicant for a |
|
staff position at an outdoor training program for children who are |
|
deaf or hard of hearing conducted by a private entity through a |
|
contract with the Department of Assistive and Rehabilitative |
|
Services [commission] in accordance with Section 81.013, Human |
|
Resources Code. |
|
(b) Criminal history record information obtained by the |
|
Department of Assistive and Rehabilitative Services [Texas
|
|
Commission for the Deaf and Hard of Hearing] under Subsection (a) |
|
may be used only to evaluate an applicant for a staff position at an |
|
outdoor training program for children who are deaf or hard of |
|
hearing. The Department of Assistive and Rehabilitative Services |
|
[Texas Commission for the Deaf and Hard of Hearing] may release or |
|
disclose the information to a private entity described by |
|
Subsection (a) for that purpose. |
|
(c) The Department of Assistive and Rehabilitative Services |
|
[Texas Commission for the Deaf and Hard of Hearing] may not release |
|
or disclose information obtained under Subsection (a), except on |
|
court order or with the consent of the person who is the subject of |
|
the criminal history record information, and shall destroy all |
|
criminal history record information obtained under Subsection (a) |
|
after the information is used for its authorized purpose. |
|
SECTION 2.004. Section 411.114(a)(3), Government Code, is |
|
amended to read as follows: |
|
(3) The Department of Family and Protective Services |
|
is entitled to obtain from the department criminal history record |
|
information maintained by the department that relates to a person |
|
who is: |
|
(A) a volunteer or applicant volunteer with a |
|
local affiliate in this state of Big Brothers/Big Sisters of |
|
America; |
|
(B) a volunteer or applicant volunteer with the |
|
"I Have a Dream/Houston" program; |
|
(C) a volunteer or applicant volunteer with an |
|
organization that provides court-appointed special advocates for |
|
abused or neglected children; |
|
(D) a person providing, at the request of the |
|
child's parent, in-home care for a child who is the subject of a |
|
report alleging the child has been abused or neglected; |
|
(E) a volunteer or applicant volunteer with a |
|
Texas chapter of the Make-a-Wish Foundation of America; |
|
(F) a person providing, at the request of the |
|
child's parent, in-home care for a child only if the person gives |
|
written consent to the release and disclosure of the information; |
|
(G) a child who is related to the caretaker, as |
|
determined under Section 42.002, Human Resources Code, and who |
|
resides in or is present in a child-care facility or family home, |
|
other than a child described by Subdivision (2)(C), or any other |
|
person who has unsupervised access to a child in the care of a |
|
child-care facility or family home; |
|
(H) an applicant for a position with the |
|
Department of Family and Protective Services, other than a position |
|
described by Subdivision (2)(D), regardless of the duties of the |
|
position; |
|
(I) a volunteer or applicant volunteer with the |
|
Department of Family and Protective Services, other than a |
|
registered volunteer, regardless of the duties to be performed; |
|
(J) a person providing or applying to provide |
|
in-home, adoptive, or foster care for children to the extent |
|
necessary to comply with Subchapter B, Chapter 162, Family Code; |
|
(K) a Department of Family and Protective |
|
Services employee, other than an employee described by Subdivision |
|
(2)(H), regardless of the duties of the employee's position; |
|
(L) a relative of a child in the care of the |
|
Department of Family and Protective Services, to the extent |
|
necessary to comply with Section 162.007, Family Code; |
|
(M) a person, other than an alleged perpetrator |
|
in a report described in Subdivision (2)(I), living in the |
|
residence in which the alleged victim of the report resides; |
|
(N) [a contractor or an employee of a contractor
|
|
who delivers services to a ward of the Department of Family and
|
|
Protective Services under a contract with the estate of the ward;
|
|
[(O)
a person who seeks unsupervised visits with
|
|
a ward of the Department of Family and Protective Services,
|
|
including a relative of the ward;
|
|
[(P)] an employee, volunteer, or applicant |
|
volunteer of a children's advocacy center under Subchapter E, |
|
Chapter 264, Family Code, including a member of the governing board |
|
of a center; |
|
(O) [(Q)] an employee of, an applicant for |
|
employment with, or a volunteer or an applicant volunteer with an |
|
entity or person that contracts with the Department of Family and |
|
Protective Services and has access to confidential information in |
|
the department's records, if the employee, applicant, volunteer, or |
|
applicant volunteer has or will have access to that confidential |
|
information; |
|
(P) [(R)] an employee of or volunteer at, or an |
|
applicant for employment with or to be a volunteer at, an entity |
|
that provides supervised independent living services to a young |
|
adult receiving extended foster care services from the Department |
|
of Family and Protective Services; |
|
(Q) [(S)] a person 14 years of age or older who |
|
will be regularly or frequently working or staying in a host home |
|
that is providing supervised independent living services to a young |
|
adult receiving extended foster care services from the Department |
|
of Family and Protective Services; or |
|
(R) [(T)] a person who volunteers to supervise |
|
visitation under Subchapter B, Chapter 263, Family Code. |
|
SECTION 2.005. Sections 411.1386(a-1) and (a-3), |
|
Government Code, are amended to read as follows: |
|
(a-1) The Department of Aging and Disability Services shall |
|
obtain from the Department of Public Safety criminal history record |
|
information maintained by the Department of Public Safety that |
|
relates to each individual who is or will be providing guardianship |
|
services to a ward of or referred by the Department of Aging and |
|
Disability Services, including: |
|
(1) an employee of or an applicant selected for an |
|
employment position with the Department of Aging and Disability |
|
Services; |
|
(2) a volunteer or an applicant selected to volunteer |
|
with the Department of Aging and Disability Services; |
|
(3) an employee of or an applicant selected for an |
|
employment position with a business entity or other person that |
|
contracts with the Department of Aging and Disability Services to |
|
provide guardianship services to a ward referred by the department; |
|
[and] |
|
(4) a volunteer or an applicant selected to volunteer |
|
with a business entity or person described by Subdivision (3); and |
|
(5) a contractor or an employee of a contractor who |
|
provides services to a ward of the Department of Aging and |
|
Disability Services under a contract with the estate of the ward. |
|
(a-3) The information in Subsection (a-1) regarding |
|
employees, contractors, or volunteers providing guardianship |
|
services must be obtained annually. |
|
SECTION 2.006. Section 411.13861, Government Code, is |
|
amended by amending Subsection (a) and adding Subsection (e) to |
|
read as follows: |
|
(a) The Department of Aging and Disability Services is |
|
entitled to obtain from the Department of Public Safety criminal |
|
history record information maintained by the Department of Public |
|
Safety that relates to a person: |
|
(1) required to undergo a background and criminal |
|
history check under Chapter 248A, Health and Safety Code; or |
|
(2) who seeks unsupervised visits with a ward of the |
|
department, including a relative of the ward. |
|
(e) In this section, "ward" has the meaning assigned by |
|
Section 1002.030, Estates Code. |
|
SECTION 2.007. Section 531.001, Government Code, is amended |
|
by amending Subdivisions (4-a) and (6) and adding Subdivision (4-b) |
|
to read as follows: |
|
(4-a) "Home telemonitoring service" means a health |
|
service that requires scheduled remote monitoring of data related |
|
to a patient's health and transmission of the data to a licensed |
|
home and community support services [health] agency or a hospital, |
|
as those terms are defined by Section 531.02164(a). |
|
(4-b) "Medicaid" means the medical assistance program |
|
established under Chapter 32, Human Resources Code. |
|
(6) "Section 1915(c) waiver program" means a federally |
|
funded [Medicaid] program of the state under Medicaid that is |
|
authorized under Section 1915(c) of the federal Social Security Act |
|
(42 U.S.C. Section 1396n(c)). |
|
SECTION 2.008. Section 531.0055(b), Government Code, is |
|
amended to read as follows: |
|
(b) The commission shall: |
|
(1) supervise the administration and operation of |
|
[the] Medicaid [program], including the administration and |
|
operation of the Medicaid managed care system in accordance with |
|
Section 531.021; |
|
(2) perform information systems planning and |
|
management for health and human services agencies under Section |
|
531.0273, with: |
|
(A) the provision of information technology |
|
services at health and human services agencies considered to be a |
|
centralized administrative support service either performed by |
|
commission personnel or performed under a contract with the |
|
commission; and |
|
(B) an emphasis on research and implementation on |
|
a demonstration or pilot basis of appropriate and efficient uses of |
|
new and existing technology to improve the operation of health and |
|
human services agencies and delivery of health and human services; |
|
(3) monitor and ensure the effective use of all |
|
federal funds received by a health and human services agency in |
|
accordance with Section 531.028 and the General Appropriations Act; |
|
(4) implement Texas Integrated Enrollment Services as |
|
required by Subchapter F, except that notwithstanding Subchapter F, |
|
determining eligibility for benefits under the following programs |
|
is the responsibility of and must be centralized by the commission: |
|
(A) the child health plan program; |
|
(B) the financial assistance program under |
|
Chapter 31, Human Resources Code; |
|
(C) Medicaid [the medical assistance program
|
|
under Chapter 32, Human Resources Code]; |
|
(D) the supplemental nutrition [nutritional] |
|
assistance program [programs] under Chapter 33, Human Resources |
|
Code; |
|
(E) long-term care services, as defined by |
|
Section 22.0011, Human Resources Code; |
|
(F) community-based support services identified |
|
or provided in accordance with Section 531.02481; and |
|
(G) other health and human services programs, as |
|
appropriate; and |
|
(5) implement programs intended to prevent family |
|
violence and provide services to victims of family violence. |
|
SECTION 2.009. Subchapter A, Chapter 531, Government Code, |
|
is amended by adding Section 531.00551 to read as follows: |
|
Sec. 531.00551. PROCEDURES FOR ADOPTING RULES AND POLICIES. |
|
(a) The executive commissioner shall develop procedures for |
|
adopting rules for the health and human services agencies. The |
|
procedures must specify the manner in which the health and human |
|
services agencies may participate in the rulemaking process. |
|
(b) A health and human services agency shall assist the |
|
executive commissioner in the development of policies and |
|
guidelines needed for the administration of the agency's functions |
|
and shall submit any proposed policies and guidelines to the |
|
executive commissioner. The agency may implement a proposed policy |
|
or guideline only if the executive commissioner approves the policy |
|
or guideline. |
|
SECTION 2.010. Section 531.006, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.006. ELIGIBILITY. (a) A person is not eligible |
|
for appointment as executive commissioner if the person or the |
|
person's spouse is an employee, officer, or paid consultant of a |
|
trade association in a field under the commission's jurisdiction. |
|
(b) A person who is required to register as a lobbyist under |
|
Chapter 305 because of the person's activities for compensation in |
|
or on behalf of a profession related to a field under the |
|
commission's jurisdiction may not serve as executive commissioner. |
|
(c) A person is not eligible for appointment as executive |
|
commissioner if the person has a financial interest in a |
|
corporation, organization, or association under contract with: |
|
(1) the [Texas] Department of State Health Services, |
|
if the contract involves mental health services; |
|
(2) the Department of Aging and Disability Services |
|
[Mental Health and Mental Retardation], if the contract involves |
|
intellectual and developmental disability services; |
|
(3) a local mental health or intellectual and |
|
developmental disability [mental retardation] authority;[,] or |
|
(4) a community center. |
|
SECTION 2.011. Section 531.007, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.007. TERM. The executive commissioner serves a |
|
two-year term expiring February 1 of each odd-numbered year. |
|
SECTION 2.012. Section 531.008(c), Government Code, is |
|
amended to read as follows: |
|
(c) The executive commissioner shall establish the |
|
following divisions and offices within the commission: |
|
(1) the eligibility services division to make |
|
eligibility determinations for services provided through the |
|
commission or a health and human services agency related to: |
|
(A) the child health plan program; |
|
(B) the financial assistance program under |
|
Chapter 31, Human Resources Code; |
|
(C) Medicaid [the medical assistance program
|
|
under Chapter 32, Human Resources Code]; |
|
(D) the supplemental nutrition [nutritional] |
|
assistance program [programs] under Chapter 33, Human Resources |
|
Code; |
|
(E) long-term care services, as defined by |
|
Section 22.0011, Human Resources Code; |
|
(F) community-based support services identified |
|
or provided in accordance with Section 531.02481; and |
|
(G) other health and human services programs, as |
|
appropriate; |
|
(2) the office of inspector general to perform fraud |
|
and abuse investigation and enforcement functions as provided by |
|
Subchapter C and other law; |
|
(3) the office of the ombudsman to: |
|
(A) provide dispute resolution services for the |
|
commission and the health and human services agencies; and |
|
(B) perform consumer protection functions |
|
related to health and human services; |
|
(4) a purchasing division as provided by Section |
|
531.017; and |
|
(5) an internal audit division to conduct a program of |
|
internal auditing in accordance with [Government Code,] Chapter |
|
2102. |
|
SECTION 2.013. Section 531.0081, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0081. [OFFICE OF] MEDICAL TECHNOLOGY. [(a) In
|
|
this section, "office" means the office of medical technology.] |
|
(b) The commission shall [establish the office of medical
|
|
technology within the commission.
The office shall] explore and |
|
evaluate new developments in medical technology and propose |
|
implementing the technology in Medicaid [the medical assistance
|
|
program under Chapter 32, Human Resources Code], if appropriate and |
|
cost-effective. |
|
(c) Commission [Office] staff implementing this section |
|
must have skills and experience in research regarding health care |
|
technology. |
|
SECTION 2.014. Section 531.0082(d), Government Code, is |
|
amended to read as follows: |
|
(d) Not later than the 30th day following the end of each |
|
calendar quarter, the data analysis unit shall provide an update on |
|
the unit's activities and findings to the governor, the lieutenant |
|
governor, the speaker of the house of representatives, the chair of |
|
the Senate Finance Committee, the chair of the House Appropriations |
|
Committee, and the chairs of the standing committees of the senate |
|
and house of representatives having jurisdiction over [the] |
|
Medicaid [program]. |
|
SECTION 2.015. Sections 531.009(a), (b), (c), (d), (e), and |
|
(g), Government Code, are amended to read as follows: |
|
(a) The executive commissioner shall employ a medical |
|
director to provide medical expertise to the executive commissioner |
|
and the commission and may employ other personnel necessary to |
|
administer the commission's duties. |
|
(b) The executive commissioner [or the commissioner's
|
|
designated representative] shall develop an intra-agency career |
|
ladder program, one part of which must require the intra-agency |
|
posting of all non-entry-level positions concurrently with any |
|
public posting. |
|
(c) The executive commissioner [or the commissioner's
|
|
designated representative] shall develop a system of annual |
|
performance evaluations based on measurable job tasks. All merit |
|
pay for commission employees must be based on the system |
|
established under this subsection. |
|
(d) The executive commissioner shall provide to commission |
|
employees as often as is necessary information regarding their |
|
qualifications under this chapter and their responsibilities under |
|
applicable laws relating to standards of conduct for state |
|
employees. |
|
(e) The executive commissioner [or the commissioner's
|
|
designated representative] shall prepare and maintain a written |
|
policy statement that implements a program of equal employment |
|
opportunity to ensure that all personnel transactions are made |
|
without regard to race, color, disability, sex, religion, age, or |
|
national origin. |
|
(g) The policy statement described by Subsection (e) must: |
|
(1) be updated annually; |
|
(2) be reviewed by the Texas Workforce Commission |
|
civil rights division [state Commission on Human Rights] for |
|
compliance with Subsection (f)(1); and |
|
(3) be filed with the governor's office. |
|
SECTION 2.016. Section 531.011(d), Government Code, is |
|
amended to read as follows: |
|
(d) The executive commissioner by rule shall establish |
|
methods by which the public, consumers, and service recipients can |
|
be notified of the mailing addresses and telephone numbers of |
|
appropriate agency personnel for the purpose of directing |
|
complaints to the commission. The commission may provide for that |
|
notification: |
|
(1) on each registration form, application, or written |
|
contract for services of a person regulated by the commission; |
|
(2) on a sign prominently displayed in the place of |
|
business of each person regulated by the commission; or |
|
(3) in a bill for service provided by a person |
|
regulated by the commission. |
|
SECTION 2.017. Section 531.012, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.012. ADVISORY COMMITTEES. The executive |
|
commissioner may appoint advisory committees as needed. |
|
SECTION 2.018. Section 531.020, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.020. OFFICE OF COMMUNITY ACCESS AND SERVICES |
|
[COLLABORATION]. The executive commissioner shall establish |
|
within the commission an office of community access and services |
|
[collaboration]. The office is responsible for: |
|
(1) collaborating with community, state, and federal |
|
stakeholders to improve the elements of the health care system that |
|
are involved in the delivery of Medicaid services; and |
|
(2) sharing with Medicaid providers, including |
|
hospitals, any best practices, resources, or other information |
|
regarding improvements to the health care system. |
|
SECTION 2.019. Section 531.021, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.021. ADMINISTRATION OF MEDICAID [PROGRAM]. (a) |
|
The commission is the state agency designated to administer federal |
|
Medicaid [medical assistance] funds. |
|
(b) The commission shall: |
|
(1) plan and direct [the] Medicaid [program] in each |
|
agency that operates a portion of [the] Medicaid [program], |
|
including the management of the Medicaid managed care system and |
|
the development, procurement, management, and monitoring of |
|
contracts necessary to implement the Medicaid managed care system; |
|
and |
|
(2) [adopt reasonable rules and standards governing
|
|
the determination of fees, charges, and rates for medical
|
|
assistance payments under Chapter 32, Human Resources Code, in
|
|
consultation with the agencies that operate the Medicaid program;
|
|
and
|
|
[(3)] establish requirements for and define the scope |
|
of the ongoing evaluation of the Medicaid managed care system |
|
conducted in conjunction with the Department of State Health |
|
Services [Texas Health Care Information Council] under Section |
|
108.0065, Health and Safety Code. |
|
(b-1) The executive commissioner shall adopt reasonable |
|
rules and standards governing the determination of fees, charges, |
|
and rates for Medicaid payments. |
|
(c) The executive commissioner [commission] in the [its] |
|
adoption of reasonable rules and standards under Subsection (b-1) |
|
[(b)(2)] shall include financial performance standards that, in the |
|
event of a proposed rate reduction, provide private ICF-IID |
|
[ICF-MR] facilities and home and community-based services |
|
providers with flexibility in determining how to use Medicaid |
|
[medical assistance] payments to provide services in the most |
|
cost-effective manner while continuing to meet the state and |
|
federal requirements of [the] Medicaid [program]. |
|
(d) In adopting rules and standards required by Subsection |
|
(b-1) [(b)(2)], the executive commissioner [commission] may |
|
provide for payment of fees, charges, and rates in accordance with: |
|
(1) formulas, procedures, or methodologies prescribed |
|
by the commission's rules; |
|
(2) applicable state or federal law, policies, rules, |
|
regulations, or guidelines; |
|
(3) economic conditions that substantially and |
|
materially affect provider participation in [the] Medicaid |
|
[program], as determined by the executive commissioner; or |
|
(4) available levels of appropriated state and federal |
|
funds. |
|
(e) Notwithstanding any other provision of Chapter 32, |
|
Human Resources Code, Chapter 533, or this chapter, the commission |
|
may adjust the fees, charges, and rates paid to Medicaid providers |
|
as necessary to achieve the objectives of [the] Medicaid [program] |
|
in a manner consistent with the considerations described by |
|
Subsection (d). |
|
(f) In adopting rates for Medicaid [medical assistance] |
|
payments under Subsection (b-1) [(b)(2)], the executive |
|
commissioner may adopt reimbursement rates for appropriate nursing |
|
services provided to recipients with certain health conditions if |
|
those services are determined to provide a cost-effective |
|
alternative to hospitalization. A physician must certify that the |
|
nursing services are medically appropriate for the recipient for |
|
those services to qualify for reimbursement under this subsection. |
|
(g) In adopting rates for Medicaid [medical assistance] |
|
payments under Subsection (b-1) [(b)(2)], the executive |
|
commissioner may adopt cost-effective reimbursement rates for |
|
group appointments with Medicaid [medical assistance] providers |
|
for certain diseases and medical conditions specified by rules of |
|
the executive commissioner. |
|
SECTION 2.020. Sections 531.0211(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) In adopting rules to implement a managed care Medicaid |
|
program, the executive commissioner [commission] shall establish |
|
guidelines for, and require managed care organizations to provide, |
|
education programs for providers and clients using a variety of |
|
techniques and mediums. |
|
(c) A client education program must present information in a |
|
manner that is easy to understand. A program must include |
|
information on: |
|
(1) a client's rights and responsibilities under the |
|
bill of rights and the bill of responsibilities prescribed by |
|
Section 531.0212; |
|
(2) how to access health care services; |
|
(3) how to access complaint procedures and the |
|
client's right to bypass the managed care organization's internal |
|
complaint system and use the notice and appeal procedures otherwise |
|
required by [the] Medicaid [program]; |
|
(4) Medicaid policies, procedures, eligibility |
|
standards, and benefits; |
|
(5) the policies and procedures of the managed care |
|
organization; and |
|
(6) the importance of prevention, early intervention, |
|
and appropriate use of services. |
|
SECTION 2.021. Sections 531.02111(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall prepare a biennial Medicaid |
|
financial report covering each state agency that operates |
|
[administers] any part of [the state] Medicaid [program] and each |
|
component of [the] Medicaid [programs] operated [or administered] |
|
by those agencies. |
|
(b) The report must include: |
|
(1) for each state agency described by Subsection (a): |
|
(A) a description of each of the components of |
|
Medicaid [programs administered or] operated by the agency; and |
|
(B) an accounting of all funds related to [the
|
|
state] Medicaid [program] received and disbursed by the agency |
|
during the period covered by the report, including: |
|
(i) the amount of any federal Medicaid |
|
[medical assistance] funds allocated to the agency for the support |
|
of each of the Medicaid components [programs] operated [or
|
|
administered] by the agency; |
|
(ii) the amount of any funds appropriated |
|
by the legislature to the agency for each of those components |
|
[programs]; and |
|
(iii) the amount of Medicaid [medical
|
|
assistance] payments and related expenditures made by or in |
|
connection with each of those components [programs]; and |
|
(2) for each Medicaid component [program] identified |
|
in the report: |
|
(A) the amount and source of funds or other |
|
revenue received by or made available to the agency for the |
|
component [program]; and |
|
(B) the information required by Section |
|
531.02112(b). |
|
SECTION 2.022. Sections 531.02112(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall prepare a report, on a quarterly |
|
basis, regarding the Medicaid expenditures of each state agency |
|
that [administers or] operates a component of Medicaid [program]. |
|
(b) The report must identify each agency's expenditures by |
|
Medicaid component [program] and must include for each component |
|
[program]: |
|
(1) the amount spent on each type of service or benefit |
|
provided by or under the component [program]; |
|
(2) the amount spent on [program] operations for that |
|
component, including eligibility determination, claims processing, |
|
and case management; and |
|
(3) the amount spent on any other administrative |
|
costs. |
|
SECTION 2.023. Sections 531.02115(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) A provider participating in [the] Medicaid or the child |
|
health plan program, including a provider participating in the |
|
network of a managed care organization that contracts with the |
|
commission to provide services under [the] Medicaid or the child |
|
health plan program, may not engage in any marketing activity, |
|
including any dissemination of material or other attempt to |
|
communicate, that: |
|
(1) involves unsolicited personal contact, including |
|
by door-to-door solicitation, solicitation at a child-care |
|
facility or other type of facility, direct mail, or telephone, with |
|
a Medicaid client or a parent whose child is enrolled in [the] |
|
Medicaid or the child health plan program; |
|
(2) is directed at the client or parent solely because |
|
the client or the parent's child is receiving benefits under [the] |
|
Medicaid or the child health plan program; and |
|
(3) is intended to influence the client's or parent's |
|
choice of provider. |
|
(c) Nothing in this section prohibits: |
|
(1) a provider participating in [the] Medicaid or the |
|
child health plan program from: |
|
(A) engaging in a marketing activity, including |
|
any dissemination of material or other attempt to communicate, that |
|
is intended to influence the choice of provider by a Medicaid client |
|
or a parent whose child is enrolled in [the] Medicaid or the child |
|
health plan program, if the marketing activity: |
|
(i) is conducted at a community-sponsored |
|
educational event, health fair, outreach activity, or other similar |
|
community or nonprofit event in which the provider participates and |
|
does not involve unsolicited personal contact or promotion of the |
|
provider's practice; or |
|
(ii) involves only the general |
|
dissemination of information, including by television, radio, |
|
newspaper, or billboard advertisement, and does not involve |
|
unsolicited personal contact; |
|
(B) as permitted under the provider's contract, |
|
engaging in the dissemination of material or another attempt to |
|
communicate with a Medicaid client or a parent whose child is |
|
enrolled in [the] Medicaid or the child health plan program, |
|
including communication in person or by direct mail or telephone, |
|
for the purpose of: |
|
(i) providing an appointment reminder; |
|
(ii) distributing promotional health |
|
materials; |
|
(iii) providing information about the types |
|
of services offered by the provider; or |
|
(iv) coordinating patient care; or |
|
(C) engaging in a marketing activity that has |
|
been submitted for review and obtained a notice of prior |
|
authorization from the commission under Subsection (d); or |
|
(2) a provider participating in the [Medicaid] STAR + |
|
PLUS Medicaid managed care program from, as permitted under the |
|
provider's contract, engaging in a marketing activity, including |
|
any dissemination of material or other attempt to communicate, that |
|
is intended to educate a Medicaid client about available long-term |
|
care services and supports. |
|
SECTION 2.024. Sections 531.0212(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner [commission] by rule shall |
|
adopt a bill of rights and a bill of responsibilities for each |
|
person enrolled in [the] Medicaid [program]. |
|
(c) The bill of responsibilities must address a client's |
|
responsibility to: |
|
(1) learn and understand each right the client has |
|
under [the] Medicaid [program]; |
|
(2) abide by the health plan and Medicaid policies and |
|
procedures; |
|
(3) share information relating to the client's health |
|
status with the primary care provider and become fully informed |
|
about service and treatment options; and |
|
(4) actively participate in decisions relating to |
|
service and treatment options, make personal choices, and take |
|
action to maintain the client's health. |
|
SECTION 2.025. Section 531.0213(d), Government Code, is |
|
amended to read as follows: |
|
(d) As a part of the support and information services |
|
required by this section, the commission or nonprofit organization |
|
shall: |
|
(1) operate a statewide toll-free assistance |
|
telephone number that includes TDD lines and assistance for persons |
|
who speak Spanish; |
|
(2) intervene promptly with the state Medicaid office, |
|
managed care organizations and providers, [the Texas Department of
|
|
Health,] and any other appropriate entity on behalf of a person who |
|
has an urgent need for medical services; |
|
(3) assist a person who is experiencing barriers in |
|
the Medicaid application and enrollment process and refer the |
|
person for further assistance if appropriate; |
|
(4) educate persons so that they: |
|
(A) understand the concept of managed care; |
|
(B) understand their rights under [the] Medicaid |
|
[program], including grievance and appeal procedures; and |
|
(C) are able to advocate for themselves; |
|
(5) collect and maintain statistical information on a |
|
regional basis regarding calls received by the assistance lines and |
|
publish quarterly reports that: |
|
(A) list the number of calls received by region; |
|
(B) identify trends in delivery and access |
|
problems; |
|
(C) identify recurring barriers in the Medicaid |
|
system; and |
|
(D) indicate other problems identified with |
|
Medicaid managed care; and |
|
(6) assist the state Medicaid office and[,] managed |
|
care organizations and providers[, and the Texas Department of
|
|
Health] in identifying and correcting problems, including site |
|
visits to affected regions if necessary. |
|
SECTION 2.026. Sections 531.0214(a), (c), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The commission and each health and human services agency |
|
that administers a part of [the state] Medicaid [program] shall |
|
jointly develop a system to coordinate and integrate state Medicaid |
|
databases to: |
|
(1) facilitate the comprehensive analysis of Medicaid |
|
data; and |
|
(2) detect fraud perpetrated by a program provider or |
|
client. |
|
(c) On the request of the executive commissioner, a state |
|
agency that administers any part of [the state] Medicaid [program] |
|
shall assist the commission in developing the system required by |
|
this section. |
|
(e) The commission shall ensure that the database system is |
|
used each month to match [bureau of] vital statistics unit death |
|
records with a list of persons eligible for Medicaid [medical
|
|
assistance under Chapter 32, Human Resources Code], and that each |
|
person who is deceased is promptly removed from the list of persons |
|
eligible for Medicaid [medical assistance]. |
|
SECTION 2.027. Section 531.02141(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall make every effort to improve data |
|
analysis and integrate available information associated with [the] |
|
Medicaid [program]. The commission shall use the decision support |
|
system in the commission's center for strategic decision support |
|
for this purpose and shall modify or redesign the system to allow |
|
for the data collected by [the] Medicaid [program] to be used more |
|
systematically and effectively for Medicaid [program] evaluation |
|
and policy development. The commission shall develop or redesign |
|
the system as necessary to ensure that the system: |
|
(1) incorporates program enrollment, utilization, and |
|
provider data that are currently collected; |
|
(2) allows data manipulation and quick analysis to |
|
address a large variety of questions concerning enrollment and |
|
utilization patterns and trends within the program; |
|
(3) is able to obtain consistent and accurate answers |
|
to questions; |
|
(4) allows for analysis of multiple issues within the |
|
program to determine whether any programmatic or policy issues |
|
overlap or are in conflict; |
|
(5) includes predefined data reports on utilization of |
|
high-cost services that allow program management to analyze and |
|
determine the reasons for an increase or decrease in utilization |
|
and immediately proceed with policy changes, if appropriate; |
|
(6) includes any encounter data with respect to |
|
recipients that a managed care organization that contracts with the |
|
commission under Chapter 533 receives from a health care provider |
|
under the organization's provider network; and |
|
(7) links Medicaid and non-Medicaid data sets, |
|
including data sets related to [the] Medicaid [program], the |
|
Temporary Assistance for Needy Families program, the Special |
|
Supplemental Nutrition Program for Women, Infants, and Children, |
|
vital statistics, and other public health programs. |
|
SECTION 2.028. Section 531.0215, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0215. COMPILATION OF STATISTICS RELATING TO FRAUD. |
|
The commission and each health and human services agency that |
|
administers a part of [the state] Medicaid [program] shall maintain |
|
statistics on the number, type, and disposition of fraudulent |
|
claims for benefits submitted under the part of the program the |
|
agency administers. |
|
SECTION 2.029. Sections 531.0216(a), (d), and (f), |
|
Government Code, are amended to read as follows: |
|
(a) The executive commissioner [commission] by rule shall |
|
develop and implement a system to reimburse providers of services |
|
under [the state] Medicaid [program] for services performed using |
|
telemedicine medical services or telehealth services. |
|
(d) Subject to Section 153.004, Occupations Code, the |
|
executive commissioner [commission] may adopt rules as necessary to |
|
implement this section. In the rules adopted under this section, |
|
the executive commissioner [commission] shall: |
|
(1) refer to the site where the patient is physically |
|
located as the patient site; and |
|
(2) refer to the site where the physician or health |
|
professional providing the telemedicine medical service or |
|
telehealth service is physically located as the distant site. |
|
(f) Not later than December 1 of each even-numbered year, |
|
the commission shall report to the speaker of the house of |
|
representatives and the lieutenant governor on the effects of |
|
telemedicine medical services, telehealth services, and home |
|
telemonitoring services on [the] Medicaid [program] in the state, |
|
including the number of physicians, health professionals, and |
|
licensed health care facilities using telemedicine medical |
|
services, telehealth services, or home telemonitoring services, |
|
the geographic and demographic disposition of the physicians and |
|
health professionals, the number of patients receiving |
|
telemedicine medical services, telehealth services, and home |
|
telemonitoring services, the types of services being provided, and |
|
the cost of utilization of telemedicine medical services, |
|
telehealth services, and home telemonitoring services to Medicaid |
|
[the program]. |
|
SECTION 2.030. Section 531.02161, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02161. TELEMEDICINE, TELEHEALTH, AND HOME |
|
TELEMONITORING TECHNOLOGY STANDARDS. (b) The executive |
|
commissioner [commission and the Telecommunications Infrastructure
|
|
Fund Board] by [joint] rule shall establish and adopt minimum |
|
standards for an operating system used in the provision of |
|
telemedicine medical services, telehealth services, or home |
|
telemonitoring services by a health care facility participating in |
|
[the state] Medicaid [program], including standards for electronic |
|
transmission, software, and hardware. |
|
(c) In developing standards under this section, the |
|
executive commissioner [commission and the Telecommunications
|
|
Infrastructure Fund Board] shall address: |
|
(1) authentication and authorization of users; |
|
(2) authentication of the origin of information; |
|
(3) the prevention of unauthorized access to the |
|
system or information; |
|
(4) system security, including the integrity of |
|
information that is collected, program integrity, and system |
|
integrity; |
|
(5) maintenance of documentation about system and |
|
information usage; |
|
(6) information storage, maintenance, and |
|
transmission; and |
|
(7) synchronization and verification of patient |
|
profile data. |
|
SECTION 2.031. Section 531.02162(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner [commission] by rule shall |
|
establish policies that permit reimbursement under [the state] |
|
Medicaid and the child [children's] health plan [insurance] program |
|
for services provided through telemedicine medical services and |
|
telehealth services to children with special health care needs. |
|
SECTION 2.032. Sections 531.02163(a), (c), and (d), |
|
Government Code, are amended to read as follows: |
|
(a) In this section, "health professional" means an |
|
individual who: |
|
(1) is licensed or certified in this state to perform |
|
health care services; and |
|
(2) is not a physician, registered nurse, advanced |
|
practice registered nurse, or physician assistant. |
|
(c) Notwithstanding Section 531.0217, the commission may |
|
provide reimbursement under [the state] Medicaid [program] for a |
|
telemedicine medical service initiated by a trained health |
|
professional who complies with the minimum standards adopted under |
|
this section. |
|
(d) The commission shall provide reimbursement under [the
|
|
state] Medicaid [program] to a physician for overseeing a |
|
telemedicine consultation at a telemedicine distant site if the |
|
telepresenter at the patient site is another physician or is an |
|
advanced practice registered nurse, registered nurse, or physician |
|
assistant acting under physician delegation and supervision |
|
throughout the consultation. |
|
SECTION 2.033. Section 531.02164, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02164. MEDICAID SERVICES PROVIDED THROUGH HOME |
|
TELEMONITORING SERVICES. (a) In this section: |
|
(1) "Home and community support services [health] |
|
agency" means a person [facility] licensed under Chapter 142, |
|
Health and Safety Code, to provide home health, hospice, or |
|
personal assistance services as defined by Section 142.001, Health |
|
and Safety Code. |
|
(2) "Hospital" means a hospital licensed under Chapter |
|
241, Health and Safety Code. |
|
(b) If the commission determines that establishing a |
|
statewide program that permits reimbursement under [the state] |
|
Medicaid [program] for home telemonitoring services would be |
|
cost-effective and feasible, the executive commissioner by rule |
|
shall establish the program as provided under this section. |
|
(c) The program required under this section must: |
|
(1) provide that home telemonitoring services are |
|
available only to persons who: |
|
(A) are diagnosed with one or more of the |
|
following conditions: |
|
(i) pregnancy; |
|
(ii) diabetes; |
|
(iii) heart disease; |
|
(iv) cancer; |
|
(v) chronic obstructive pulmonary disease; |
|
(vi) hypertension; |
|
(vii) congestive heart failure; |
|
(viii) mental illness or serious emotional |
|
disturbance; |
|
(ix) asthma; |
|
(x) myocardial infarction; or |
|
(xi) stroke; and |
|
(B) exhibit two or more of the following risk |
|
factors: |
|
(i) two or more hospitalizations in the |
|
prior 12-month period; |
|
(ii) frequent or recurrent emergency room |
|
admissions; |
|
(iii) a documented history of poor |
|
adherence to ordered medication regimens; |
|
(iv) a documented history of falls in the |
|
prior six-month period; |
|
(v) limited or absent informal support |
|
systems; |
|
(vi) living alone or being home alone for |
|
extended periods of time; and |
|
(vii) a documented history of care access |
|
challenges; |
|
(2) ensure that clinical information gathered by a |
|
home and community support services [health] agency or hospital |
|
while providing home telemonitoring services is shared with the |
|
patient's physician; and |
|
(3) ensure that the program does not duplicate disease |
|
management program services provided under Section 32.057, Human |
|
Resources Code. |
|
(d) If, after implementation, the commission determines |
|
that the program established under this section is not |
|
cost-effective, the commission may discontinue the program and stop |
|
providing reimbursement under [the state] Medicaid [program] for |
|
home telemonitoring services, notwithstanding Section 531.0216 or |
|
any other law. |
|
(e) The commission shall determine whether the provision of |
|
home telemonitoring services to persons who are eligible to receive |
|
benefits under both [the] Medicaid and the Medicare program |
|
[programs] achieves cost savings for the Medicare program. |
|
SECTION 2.034. Sections 531.0217(b), (c-1), (c-3), (d), |
|
(h), (i), (i-1), and (j), Government Code, are amended to read as |
|
follows: |
|
(b) The executive commissioner [commission] by rule shall |
|
require each health and human services agency that administers a |
|
part of [the] Medicaid [program] to provide Medicaid reimbursement |
|
for a telemedicine medical service initiated or provided by a |
|
physician. |
|
(c-1) Notwithstanding Subsection (b) or (c), the commission |
|
shall provide for reimbursement under [the] Medicaid [program] for |
|
an office visit provided through telemedicine by a physician who is |
|
assessing and evaluating the patient from a distant site if: |
|
(1) a health professional acting under the delegation |
|
and supervision of that physician is present with the patient at the |
|
time of the visit; and |
|
(2) the medical condition, illness, or injury for |
|
which the patient is receiving the service is not likely, within a |
|
reasonable degree of medical certainty, to undergo material |
|
deterioration within the 30-day period following the date of the |
|
visit. |
|
(c-3) In adopting rules developed under Subsection (c-2), |
|
the executive commissioner [commission] shall confer with the |
|
Centers for Medicare and Medicaid Services on the legality of |
|
allocating reimbursement or establishing a facility fee as |
|
described in that subsection. Rules adopted by the executive |
|
commissioner [commission] under this subsection or Subsection |
|
(c-2) must reflect a policy to build capacity in medically |
|
underserved areas of this state. |
|
(d) The commission shall require reimbursement for a |
|
telemedicine medical service at the same rate as [the] Medicaid |
|
[program] reimburses for a comparable in-person medical service. A |
|
request for reimbursement may not be denied solely because an |
|
in-person medical service between a physician and a patient did not |
|
occur. |
|
(h) The commission in consultation with the Texas Medical |
|
Board [State Board of Medical Examiners] shall monitor and regulate |
|
the use of telemedicine medical services to ensure compliance with |
|
this section. In addition to any other method of enforcement, the |
|
commission may use a corrective action plan to ensure compliance |
|
with this section. |
|
(i) The Texas Medical Board [State Board of Medical
|
|
Examiners], in consultation with the commission, as appropriate, |
|
may adopt rules as necessary to: |
|
(1) ensure that appropriate care, including quality of |
|
care, is provided to patients who receive telemedicine medical |
|
services; |
|
(2) prevent abuse and fraud through the use of |
|
telemedicine medical services, including rules relating to filing |
|
of claims and records required to be maintained in connection with |
|
telemedicine; and |
|
(3) define those situations when a face-to-face |
|
consultation with a physician is required after a telemedicine |
|
medical service. |
|
(i-1) The Texas Medical Board [State Board of Medical
|
|
Examiners], in consultation with the commission and the Department |
|
of State Health Services, as appropriate, shall adopt rules to |
|
establish supervisory requirements for a physician delegating a |
|
service to be performed by an individual who is not a physician, |
|
registered nurse, advanced practice registered nurse, or physician |
|
assistant, including a health professional who is authorized to be |
|
a telepresenter under Section 531.02163. This section may not be |
|
construed as authorizing the Texas Medical Board [State Board of
|
|
Medical Examiners] to regulate another licensed or certified health |
|
care provider. |
|
(j) The executive commissioner shall establish an advisory |
|
committee to coordinate state telemedicine efforts and assist the |
|
commission in: |
|
(1) evaluating policies for telemedicine medical |
|
services under Section 531.0216 and this section; |
|
(2) monitoring the types of programs receiving |
|
reimbursement under this section; and |
|
(3) coordinating the activities of state agencies |
|
interested in the use of telemedicine medical services. |
|
SECTION 2.035. Sections 531.02172(b) and (c), Government |
|
Code, are amended to read as follows: |
|
(b) The advisory committee must include: |
|
(1) representatives of health and human services |
|
agencies and other state agencies concerned with the use of |
|
telemedical and telehealth consultations and home telemonitoring |
|
services in [the] Medicaid [program] and the state child health |
|
plan program, including representatives of: |
|
(A) the commission; |
|
(B) the Department of State Health Services; |
|
(C) the Office [Texas Department] of Rural |
|
Affairs; |
|
(D) the Texas Department of Insurance; |
|
(E) the Texas Medical Board; |
|
(F) the Texas Board of Nursing; and |
|
(G) the Texas State Board of Pharmacy; |
|
(2) representatives of health science centers in this |
|
state; |
|
(3) experts on telemedicine, telemedical |
|
consultation, and telemedicine medical services or telehealth |
|
services; |
|
(4) representatives of consumers of health services |
|
provided through telemedical consultations and telemedicine |
|
medical services or telehealth services; and |
|
(5) representatives of providers of telemedicine |
|
medical services, telehealth services, and home telemonitoring |
|
services. |
|
(c) A member of the advisory committee serves at the will of |
|
the executive commissioner. |
|
SECTION 2.036. Section 531.02173, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02173. ALIGNMENT OF MEDICAID TELEMEDICINE |
|
REIMBURSEMENT POLICIES WITH MEDICARE REIMBURSEMENT POLICIES. (a) |
|
The commission shall periodically review policies regarding |
|
reimbursement under [the] Medicaid [program] for telemedicine |
|
medical services to identify variations between permissible |
|
reimbursement under that program and reimbursement available to |
|
providers under the Medicare program. |
|
(b) To the extent practicable, and notwithstanding any |
|
other state law, after [conducting] a review conducted under |
|
Subsection (a) the executive commissioner [commission] may modify |
|
rules and procedures applicable to reimbursement under [the] |
|
Medicaid [program] for telemedicine medical services as necessary |
|
to provide for a reimbursement system that is comparable to the |
|
reimbursement system for those services under the Medicare program. |
|
(c) The commission and executive commissioner shall perform |
|
the [its] duties under this section with assistance from the |
|
telemedicine and telehealth advisory committee established under |
|
Section 531.02172. |
|
SECTION 2.037. Section 531.02174, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02174. ADDITIONAL AUTHORITY REGARDING |
|
TELEMEDICINE MEDICAL SERVICES. (a) In addition to the authority |
|
granted by other law regarding telemedicine medical services, the |
|
executive commissioner [commission] may review rules and |
|
procedures applicable to reimbursement of telemedicine medical |
|
services provided through any government-funded health program |
|
subject to the commission's oversight. |
|
(b) The executive commissioner [commission] may modify |
|
rules and procedures described by Subsection (a) as necessary to |
|
ensure that reimbursement for telemedicine medical services is |
|
provided in a cost-effective manner and only in circumstances in |
|
which the provision of those services is clinically effective. |
|
(c) This section does not affect the commission's authority |
|
or duties under other law regarding reimbursement of telemedicine |
|
medical services under [the] Medicaid [program]. |
|
SECTION 2.038. Sections 531.02175(b) and (c), Government |
|
Code, are amended to read as follows: |
|
(b) Subject to the requirements of this subsection, the |
|
executive commissioner by rule may require the commission and each |
|
health and human services agency that administers a part of [the] |
|
Medicaid [program] to provide Medicaid reimbursement for a medical |
|
consultation that is provided by a physician or other health care |
|
professional using the Internet as a cost-effective alternative to |
|
an in-person consultation. The executive commissioner may require |
|
the commission or a health and human services agency to provide the |
|
reimbursement described by this subsection only if the Centers for |
|
Medicare and Medicaid Services develop an appropriate Current |
|
Procedural Terminology code for medical services provided using the |
|
Internet. |
|
(c) The executive commissioner may develop and implement a |
|
pilot program in one or more sites chosen by the executive |
|
commissioner under which Medicaid reimbursements are paid for |
|
medical consultations provided by physicians or other health care |
|
professionals using the Internet. The pilot program must be |
|
designed to test whether an Internet medical consultation is a |
|
cost-effective alternative to an in-person consultation under |
|
[the] Medicaid [program]. The executive commissioner may modify |
|
the pilot program as necessary throughout its implementation to |
|
maximize the potential cost-effectiveness of Internet medical |
|
consultations. If the executive commissioner determines from the |
|
pilot program that Internet medical consultations are |
|
cost-effective, the executive commissioner may expand the pilot |
|
program to additional sites or may implement Medicaid |
|
reimbursements for Internet medical consultations statewide. |
|
SECTION 2.039. Section 531.02176, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02176. EXPIRATION OF MEDICAID REIMBURSEMENT FOR |
|
PROVISION OF HOME TELEMONITORING SERVICES. Notwithstanding any |
|
other law, the commission may not reimburse providers under [the] |
|
Medicaid [program] for the provision of home telemonitoring |
|
services on or after September 1, 2015. |
|
SECTION 2.040. Section 531.0218(b), Government Code, is |
|
amended to read as follows: |
|
(b) Subsection (a) does not apply to functions of a Section |
|
1915(c) waiver program that is operated in conjunction with a |
|
federally funded [Medicaid] program of the state under Medicaid |
|
that is authorized under Section 1915(b) of the federal Social |
|
Security Act (42 U.S.C. Section 1396n(b)). |
|
SECTION 2.041. Sections 531.022(a), (b), (d), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The executive commissioner shall develop a coordinated, |
|
six-year strategic plan for health and human services in this state |
|
and shall update the plan biennially. |
|
(b) The executive commissioner shall submit each biennial |
|
update of the plan to the governor, the lieutenant governor, and the |
|
speaker of the house of representatives not later than October 1 of |
|
each even-numbered year. |
|
(d) In developing a plan and plan updates under this |
|
section, the executive commissioner shall consider: |
|
(1) existing strategic plans of health and human |
|
services agencies; |
|
(2) health and human services priorities and plans |
|
submitted by governmental entities under Subsection (e); |
|
(3) facilitation of pending reorganizations or |
|
consolidations of health and human services agencies and programs; |
|
(4) public comment, including comment documented |
|
through public hearings conducted under Section 531.036; and |
|
(5) budgetary issues, including projected agency |
|
needs and projected availability of funds. |
|
(e) The executive commissioner shall identify the |
|
governmental entities that coordinate the delivery of health and |
|
human services in regions, counties, and municipalities and request |
|
that each entity: |
|
(1) identify the health and human services priorities |
|
in the entity's jurisdiction and the most effective ways to deliver |
|
and coordinate services in that jurisdiction; |
|
(2) develop a coordinated plan for the delivery of |
|
health and human services in the jurisdiction, including transition |
|
services that prepare special education students for adulthood; and |
|
(3) make the information requested under Subdivisions |
|
(1) and (2) available to the commission. |
|
SECTION 2.042. Sections 531.0223(b), (e), and (o), |
|
Government Code, are amended to read as follows: |
|
(b) The executive commissioner shall appoint an advisory |
|
committee to develop a strategic plan for eliminating the |
|
disparities between the Texas-Mexico border region and other areas |
|
of the state in: |
|
(1) capitation rates under Medicaid managed care and |
|
the child health plan program for services provided to persons |
|
younger than 19 years of age; |
|
(2) fee-for-service per capita expenditures under |
|
[the] Medicaid [program] and the child health plan program for |
|
inpatient and outpatient hospital services for services provided to |
|
persons younger than 19 years of age; and |
|
(3) total professional services expenditures per |
|
Medicaid recipient younger than 19 years of age or per child |
|
enrolled in the child health plan program. |
|
(e) The executive commissioner shall appoint nine members |
|
to the advisory committee in a manner that ensures that the |
|
committee: |
|
(1) represents the spectrum of geographic areas |
|
included in the Texas-Mexico border region; |
|
(2) includes persons who are knowledgeable regarding |
|
[the] Medicaid [program], including Medicaid managed care, and the |
|
child health plan program; and |
|
(3) represents the interests of physicians, |
|
hospitals, patients, managed care organizations, state agencies |
|
involved in the management and delivery of medical resources of any |
|
kind, affected communities, and other areas of the state. |
|
(o) The commission shall: |
|
(1) measure changes occurring from September 1, 2002, |
|
to August 31, 2014, in the number of health care providers |
|
participating in [the] Medicaid [program] or the child health plan |
|
program in the Texas-Mexico border region and resulting effects on |
|
consumer access to health care and consumer utilization; |
|
(2) determine: |
|
(A) the effects, if any, of the changes in rates |
|
and expenditures required by Subsection (k); and |
|
(B) if funding available and used for changes in |
|
rates and expenditures was sufficient to produce measurable |
|
effects; |
|
(3) make a recommendation regarding whether Medicaid |
|
rate increases should be expanded to include Medicaid services |
|
provided to adults in the Texas-Mexico border region; and |
|
(4) not later than December 1, 2014, submit a report to |
|
the legislature. |
|
SECTION 2.043. Section 531.0224, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0224. PLANNING AND POLICY DIRECTION OF TEMPORARY |
|
ASSISTANCE FOR NEEDY FAMILIES PROGRAM. (a) The commission shall: |
|
(1) plan and direct the financial assistance program |
|
under Chapter 31, Human Resources Code, including the procurement, |
|
management, and monitoring of contracts necessary to implement the |
|
program; and |
|
(2) [adopt rules and standards governing the financial
|
|
assistance program under Chapter 31, Human Resources Code; and
|
|
[(3)] establish requirements for and define the scope |
|
of the ongoing evaluation of the financial assistance program under |
|
Chapter 31, Human Resources Code. |
|
(b) The executive commissioner shall adopt rules and |
|
standards governing the financial assistance program under Chapter |
|
31, Human Resources Code. |
|
SECTION 2.044. Section 531.0226(a), Government Code, is |
|
amended to read as follows: |
|
(a) If feasible and cost-effective, the commission may |
|
apply for a waiver from the federal Centers for Medicare and |
|
Medicaid Services or another appropriate federal agency to more |
|
efficiently leverage the use of state and local funds in order to |
|
maximize the receipt of federal Medicaid matching funds by |
|
providing benefits under [the] Medicaid [program] to individuals |
|
who: |
|
(1) meet established income and other eligibility |
|
criteria; and |
|
(2) are eligible to receive services through the |
|
county for chronic health conditions. |
|
SECTION 2.045. Sections 531.0235(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner shall direct and require the |
|
Texas [Planning] Council for Developmental Disabilities and the |
|
Office for the Prevention of Developmental Disabilities to prepare |
|
a joint biennial report on the state of services to persons with |
|
disabilities in this state. The Texas [Planning] Council for |
|
Developmental Disabilities will serve as the lead agency in |
|
convening working meetings and in coordinating and completing the |
|
report. Not later than December 1 of each even-numbered year, the |
|
agencies shall submit the report to the executive commissioner, |
|
governor, lieutenant governor, and speaker of the house of |
|
representatives. |
|
(c) The commission[, Texas Department of Human Services,] |
|
and other health and human services agencies shall cooperate with |
|
the agencies required to prepare the report under Subsection (a). |
|
SECTION 2.046. Section 531.024(a-1), Government Code, is |
|
amended to read as follows: |
|
(a-1) To the extent permitted under applicable federal law |
|
and notwithstanding any provision of Chapter 191 or 192, Health and |
|
Safety Code, the commission and other health and human services |
|
agencies shall share data to facilitate patient care coordination, |
|
quality improvement, and cost savings in [the] Medicaid [program], |
|
the child health plan program, and other health and human services |
|
programs funded using money appropriated from the general revenue |
|
fund. |
|
SECTION 2.047. Section 531.0241, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0241. STREAMLINING DELIVERY OF SERVICES. To |
|
integrate and streamline service delivery and facilitate access to |
|
services, the executive commissioner may request a health and human |
|
services agency to take a specific action and may recommend the |
|
manner in which the streamlining is to be accomplished, including |
|
requesting each health and human services agency to: |
|
(1) simplify agency procedures; |
|
(2) automate agency procedures; |
|
(3) coordinate service planning and management tasks |
|
between and among health and human services agencies; |
|
(4) reallocate staff resources; |
|
(5) [adopt rules;
|
|
[(6) amend,] waive[, or repeal] existing rules; or |
|
(6) [(7)] take other necessary actions. |
|
SECTION 2.048. Section 531.02411, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02411. STREAMLINING ADMINISTRATIVE PROCESSES. |
|
The commission shall make every effort using the commission's |
|
existing resources to reduce the paperwork and other administrative |
|
burdens placed on Medicaid recipients and providers and other |
|
participants in [the] Medicaid [program] and shall use technology |
|
and efficient business practices to decrease those burdens. In |
|
addition, the commission shall make every effort to improve the |
|
business practices associated with the administration of [the] |
|
Medicaid [program] by any method the commission determines is |
|
cost-effective, including: |
|
(1) expanding the utilization of the electronic claims |
|
payment system; |
|
(2) developing an Internet portal system for prior |
|
authorization requests; |
|
(3) encouraging Medicaid providers to submit their |
|
program participation applications electronically; |
|
(4) ensuring that the Medicaid provider application is |
|
easy to locate on the Internet so that providers may conveniently |
|
apply to the program; |
|
(5) working with federal partners to take advantage of |
|
every opportunity to maximize additional federal funding for |
|
technology in [the] Medicaid [program]; and |
|
(6) encouraging the increased use of medical |
|
technology by providers, including increasing their use of: |
|
(A) electronic communications between patients |
|
and their physicians or other health care providers; |
|
(B) electronic prescribing tools that provide |
|
up-to-date payer formulary information at the time a physician or |
|
other health care practitioner writes a prescription and that |
|
support the electronic transmission of a prescription; |
|
(C) ambulatory computerized order entry systems |
|
that facilitate physician and other health care practitioner orders |
|
at the point of care for medications and laboratory and |
|
radiological tests; |
|
(D) inpatient computerized order entry systems |
|
to reduce errors, improve health care quality, and lower costs in a |
|
hospital setting; |
|
(E) regional data-sharing to coordinate patient |
|
care across a community for patients who are treated by multiple |
|
providers; and |
|
(F) electronic intensive care unit technology to |
|
allow physicians to fully monitor hospital patients remotely. |
|
SECTION 2.049. Section 531.024115, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.024115. SERVICE DELIVERY AREA |
|
ALIGNMENT. Notwithstanding Section 533.0025(e) or any other law, |
|
to the extent possible, the commission shall align service delivery |
|
areas under [the] Medicaid and the child health plan program |
|
[programs]. |
|
SECTION 2.050. Section 531.02412, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02412. SERVICE DELIVERY AUDIT MECHANISMS. (a) |
|
The commission shall make every effort to ensure the integrity of |
|
[the] Medicaid [program]. To ensure that integrity, the commission |
|
shall: |
|
(1) perform risk assessments of every element of the |
|
[Medicaid] program and audit those elements of the program that are |
|
determined to present the greatest risks; |
|
(2) ensure that sufficient oversight is in place for |
|
the Medicaid medical transportation program; |
|
(3) ensure that a quality review assessment of the |
|
Medicaid medical transportation program occurs; and |
|
(4) evaluate [the] Medicaid [program] with respect to |
|
use of the metrics developed through the Texas Health Steps |
|
performance improvement plan to guide changes and improvements to |
|
the program. |
|
SECTION 2.051. Sections 531.02413(a-1) and (b), Government |
|
Code, are amended to read as follows: |
|
(a-1) If cost-effective and feasible, the commission shall |
|
contract to expand the Medicaid billing coordination system |
|
described by Subsection (a) to process claims for all other health |
|
care services provided through [the] Medicaid [program] in the |
|
manner claims for acute care services are processed by the system |
|
under Subsection (a). This subsection does not apply to claims for |
|
health care services provided through [the] Medicaid [program] if, |
|
before September 1, 2009, those claims were being processed by an |
|
alternative billing coordination system. |
|
(b) If cost-effective, the executive commissioner shall |
|
adopt rules for the purpose of enabling the system described by |
|
Subsection (a) to identify an entity with primary responsibility |
|
for paying a claim that is processed by the system under Subsection |
|
(a) and establish reporting requirements for any entity that may |
|
have a contractual responsibility to pay for the types of services |
|
that are provided under [the] Medicaid [program] and the claims for |
|
which are processed by the system under Subsection (a). |
|
SECTION 2.052. Section 531.024131(a), Government Code, is |
|
amended to read as follows: |
|
(a) If cost-effective, the commission may: |
|
(1) contract to expand all or part of the billing |
|
coordination system established under Section 531.02413 to process |
|
claims for services provided through other benefits programs |
|
administered by the commission or a health and human services |
|
agency; |
|
(2) expand any other billing coordination tools and |
|
resources used to process claims for health care services provided |
|
through [the] Medicaid [program] to process claims for services |
|
provided through other benefits programs administered by the |
|
commission or a health and human services agency; and |
|
(3) expand the scope of persons about whom information |
|
is collected under Section 32.042, Human Resources Code, to include |
|
recipients of services provided through other benefits programs |
|
administered by the commission or a health and human services |
|
agency. |
|
SECTION 2.053. Section 531.02414(a)(1), Government Code, |
|
is amended to read as follows: |
|
(1) "Medical transportation program" means the |
|
program that provides nonemergency transportation services to and |
|
from covered health care services, based on medical necessity, to |
|
recipients under [the] Medicaid [program], the children with |
|
special health care needs program, and the transportation for |
|
indigent cancer patients program, who have no other means of |
|
transportation. |
|
SECTION 2.054. The heading to Section 531.024161, |
|
Government Code, is amended to read as follows: |
|
Sec. 531.024161. REIMBURSEMENT CLAIMS FOR CERTAIN MEDICAID |
|
OR CHILD HEALTH PLAN [CHIP] SERVICES INVOLVING SUPERVISED |
|
PROVIDERS. |
|
SECTION 2.055. Section 531.024161(a), Government Code, is |
|
amended to read as follows: |
|
(a) If a provider, including a nurse practitioner or |
|
physician assistant, under [the] Medicaid or the child health plan |
|
program provides a referral for or orders health care services for a |
|
recipient or enrollee, as applicable, at the direction or under the |
|
supervision of another provider, and the referral or order is based |
|
on the supervised provider's evaluation of the recipient or |
|
enrollee, the names and associated national provider identifier |
|
numbers of the supervised provider and the supervising provider |
|
must be included on any claim for reimbursement submitted by a |
|
provider based on the referral or order. For purposes of this |
|
section, "national provider identifier" means the national |
|
provider identifier required under Section 1128J(e), Social |
|
Security Act (42 U.S.C. Section 1320a-7k(e)). |
|
SECTION 2.056. Section 531.02418, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02418. MEDICAID AND CHILD HEALTH PLAN PROGRAM |
|
ELIGIBILITY DETERMINATIONS FOR CERTAIN INDIVIDUALS. (a) The |
|
commission shall enter into a memorandum of understanding with the |
|
Texas Juvenile Justice Department [Youth Commission] to ensure that |
|
each individual who is committed, placed, or detained under Title |
|
3, Family Code, is assessed by the commission for eligibility for |
|
Medicaid [the medical assistance program under Chapter 32, Human
|
|
Resources Code,] and the child health plan program before that |
|
individual's release from commitment,[.
|
|
[(b)
The commission shall enter into a memorandum of
|
|
understanding with the Texas Juvenile Probation Commission to
|
|
ensure that each individual who is placed or detained under Title 3,
|
|
Family Code, is assessed by the commission for eligibility for the
|
|
medical assistance program under Chapter 32, Human Resources Code,
|
|
and the child health plan program before the individual's release
|
|
from] placement, or detention. Local juvenile probation |
|
departments are subject to the requirements of the memorandum. |
|
(c) The [Each] memorandum of understanding entered into as |
|
required by this section must specify: |
|
(1) the information that must be provided to the |
|
commission; |
|
(2) the process by which and time frame within which |
|
the information must be provided; and |
|
(3) the roles and responsibilities of all parties to |
|
the memorandum, which must include a requirement that the |
|
commission pursue the actions needed to complete eligibility |
|
applications as necessary. |
|
(d) The [Each] memorandum of understanding required by |
|
Subsection (a) [or (b)] must be tailored to achieve the goal of |
|
ensuring that an individual described by Subsection (a) [or (b)] |
|
who is determined eligible by the commission for coverage under |
|
Medicaid [the medical assistance program under Chapter 32, Human
|
|
Resources Code,] or the child health plan program[,] is enrolled in |
|
the program for which the individual is eligible and may begin |
|
receiving services through the program as soon as possible after |
|
the eligibility determination is made and, if possible, to achieve |
|
the goal of ensuring that the individual may begin receiving those |
|
services on the date of the individual's release from placement, |
|
detention, or commitment. |
|
(e) The executive commissioner may adopt rules as necessary |
|
to implement this section. |
|
SECTION 2.057. Section 531.024181(a), Government Code, is |
|
amended to read as follows: |
|
(a) This section applies only with respect to the following |
|
benefits programs: |
|
(1) the child health plan program under Chapter 62, |
|
Health and Safety Code; |
|
(2) the financial assistance program under Chapter 31, |
|
Human Resources Code; |
|
(3) Medicaid [the medical assistance program under
|
|
Chapter 32, Human Resources Code]; and |
|
(4) the supplemental nutrition [nutritional] |
|
assistance program under Chapter 33, Human Resources Code. |
|
SECTION 2.058. Section 531.024182(b), Government Code, is |
|
amended to read as follows: |
|
(b) If, at the time of application for benefits, a person |
|
stated that the person is a sponsored alien, the commission may, to |
|
the extent allowed by federal law, verify information relating to |
|
the sponsorship, using an automated system or systems where |
|
available, after the person is determined eligible for and begins |
|
receiving benefits under any of the following benefits programs: |
|
(1) the child health plan program under Chapter 62, |
|
Health and Safety Code; |
|
(2) the financial assistance program under Chapter 31, |
|
Human Resources Code; |
|
(3) Medicaid [the medical assistance program under
|
|
Chapter 32, Human Resources Code]; or |
|
(4) the supplemental nutrition [nutritional] |
|
assistance program under Chapter 33, Human Resources Code. |
|
SECTION 2.059. Sections 531.0244(c) and (g), Government |
|
Code, are amended to read as follows: |
|
(c) For purposes of developing the strategies required by |
|
Subsection (b)(4), a person with a mental illness who is admitted to |
|
a facility of the [Texas] Department of State Health Services |
|
[Mental Health and Mental Retardation] for inpatient mental health |
|
services three or more times during a 180-day period is presumed to |
|
be in imminent risk of requiring placement in an institution. The |
|
strategies must be developed in a manner that presumes the person's |
|
eligibility for and the appropriateness of intensive |
|
community-based services and support. |
|
(g) Not later than December 1 of each even-numbered year, |
|
the executive commissioner shall submit to the governor and the |
|
legislature a report on the status of the implementation of the plan |
|
required by Subsection (a). The report must include |
|
recommendations on any statutory or other action necessary to |
|
implement the plan. |
|
SECTION 2.060. Sections 531.02441(a), (b), (c), (d), (e), |
|
(g), and (i), Government Code, are amended to read as follows: |
|
(a) The executive commissioner shall establish an |
|
interagency task force to assist the commission and appropriate |
|
health and human services agencies in developing a comprehensive, |
|
effectively working plan to ensure appropriate care settings for |
|
persons with disabilities. |
|
(b) The executive commissioner shall determine the number |
|
of members of the task force. The executive commissioner shall |
|
appoint as members of the task force: |
|
(1) representatives of appropriate health and human |
|
services agencies, including the [Texas] Department of Aging and |
|
Disability [Human] Services and the [Texas] Department of State |
|
Health Services [Mental Health and Mental Retardation]; |
|
(2) representatives of related work groups, including |
|
representatives of the work group [groups] established under |
|
Section [Sections 22.034 and] 22.035, Human Resources Code; |
|
(3) representatives of consumer and family advocacy |
|
groups; and |
|
(4) representatives of service providers for persons |
|
with disabilities. |
|
(c) The executive commissioner shall designate a member of |
|
the task force to serve as presiding officer. The members of the |
|
task force shall elect any other necessary officers. |
|
(d) The task force shall meet at the call of the executive |
|
commissioner. |
|
(e) A member of the task force serves at the will of the |
|
executive commissioner. |
|
(g) The task force shall study and make recommendations to |
|
the commission on[:
|
|
[(1)] developing the comprehensive, effectively |
|
working plan required by Section 531.0244(a) to ensure appropriate |
|
care settings for persons with disabilities[; and
|
|
[(2)
identifying appropriate components of the pilot
|
|
program established under Section 22.037, Human Resources Code, for
|
|
coordination and integration among the Texas Department of Human
|
|
Services, the Texas Department of Mental Health and Mental
|
|
Retardation, and the Department of Protective and Regulatory
|
|
Services]. |
|
(i) Not later than September 1 of each year, the task force |
|
shall submit a report to the executive commissioner on its findings |
|
and recommendations required by Subsection (g). |
|
SECTION 2.061. Section 531.02442, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02442. COMMUNITY LIVING OPTIONS INFORMATION |
|
PROCESS FOR CERTAIN PERSONS WITH AN INTELLECTUAL DISABILITY [MENTAL
|
|
RETARDATION]. (a) In this section: |
|
(1) "Department" means the Department of Aging and |
|
Disability Services. |
|
(1-a) "Institution" means: |
|
(A) a residential care facility operated or |
|
maintained by the department [Texas Department of Mental Health and
|
|
Mental Retardation] to provide 24-hour services, including |
|
residential services, to persons with an intellectual disability |
|
[mental retardation]; or |
|
(B) an ICF-IID [ICF-MR], as defined by Section |
|
531.002, Health and Safety Code. |
|
(2) "Legally authorized representative" has the |
|
meaning assigned by Section 241.151, Health and Safety Code. |
|
(3) "Local intellectual and developmental disability |
|
[mental retardation] authority" has the meaning assigned by Section |
|
531.002, Health and Safety Code. |
|
(b) In addition to providing information regarding care and |
|
support options as required by Section 531.042, the department |
|
[Texas Department of Mental Health and Mental Retardation] shall |
|
implement a community living options information process in each |
|
institution to inform persons with an intellectual disability |
|
[mental retardation] who reside in the institution and their |
|
legally authorized representatives of alternative community living |
|
options. |
|
(c) The department shall provide the information required |
|
by Subsection (b) through the community living options information |
|
process at least annually. The department shall also provide the |
|
information at any other time on request by a person with an |
|
intellectual disability [mental retardation] who resides in an |
|
institution or the person's legally authorized representative. |
|
(d) If a person with an intellectual disability [mental
|
|
retardation] residing in an institution or the person's legally |
|
authorized representative indicates a desire to pursue an |
|
alternative community living option after receiving the |
|
information provided under this section, the department shall refer |
|
the person or the person's legally authorized representative to the |
|
local intellectual and developmental disability [mental
|
|
retardation] authority. The local intellectual and developmental |
|
disability [mental retardation] authority shall place the person in |
|
an alternative community living option, subject to the availability |
|
of funds, or on a waiting list for those options if the options are |
|
not available to the person for any reason on or before the 30th day |
|
after the date the person or the person's legally authorized |
|
representative is referred to the local intellectual and |
|
developmental disability [mental retardation] authority. |
|
(e) The department shall document in the records of each |
|
person with an intellectual disability [mental retardation] who |
|
resides in an institution the information provided to the person or |
|
the person's legally authorized representative through the |
|
community living options information process and the results of |
|
that process. |
|
SECTION 2.062. Section 531.02443, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02443. IMPLEMENTATION OF COMMUNITY LIVING OPTIONS |
|
INFORMATION PROCESS AT STATE INSTITUTIONS FOR CERTAIN ADULT |
|
RESIDENTS. (a) In this section: |
|
(1) "Adult resident" means a person with an |
|
intellectual disability [mental retardation] who: |
|
(A) is at least 22 years of age; and |
|
(B) resides in a state supported living center |
|
[school]. |
|
(2) "Department" means the Department of Aging and |
|
Disability Services. |
|
(3) "Legally authorized representative" has the |
|
meaning assigned by Section 241.151, Health and Safety Code. |
|
(4) "Local intellectual and developmental disability |
|
[mental retardation] authority" has the meaning assigned by Section |
|
531.002, Health and Safety Code. |
|
(5) "State supported living center [school]" has the |
|
meaning assigned by Section 531.002, Health and Safety Code. |
|
(b) This section applies only to the community living |
|
options information process for an adult resident. |
|
(c) The department shall contract with local intellectual |
|
and developmental disability [mental retardation] authorities to |
|
implement the community living options information process |
|
required by Section 531.02442 for an adult resident. |
|
(d) The contract with the local intellectual and |
|
developmental disability [mental retardation] authority must: |
|
(1) delegate to the local intellectual and |
|
developmental disability [mental retardation] authority the |
|
department's duties under Section 531.02442 with regard to the |
|
implementation of the community living options information process |
|
at a state supported living center [school]; |
|
(2) include performance measures designed to assist |
|
the department in evaluating the effectiveness of a local |
|
intellectual and developmental disability [mental retardation] |
|
authority in implementing the community living options information |
|
process; and |
|
(3) ensure that the local intellectual and |
|
developmental disability [mental retardation] authority provides |
|
service coordination and relocation services to an adult resident |
|
who chooses, is eligible for, and is recommended by the |
|
interdisciplinary team for a community living option to facilitate |
|
a timely, appropriate, and successful transition from the state |
|
supported living center [school] to the community living option. |
|
(e) The department, with the advice and assistance of the |
|
interagency task force on ensuring appropriate care settings for |
|
persons with disabilities and representatives of family members or |
|
legally authorized representatives of adult residents, persons |
|
with an intellectual disability [mental retardation], state |
|
supported living centers [schools], and local intellectual and |
|
developmental disability [mental retardation] authorities, shall: |
|
(1) develop an effective community living options |
|
information process; |
|
(2) create uniform procedures for the implementation |
|
of the community living options information process; and |
|
(3) minimize any potential conflict of interest |
|
regarding the community living options information process between |
|
a state supported living center [school] and an adult resident, an |
|
adult resident's legally authorized representative, or a local |
|
intellectual and developmental disability [mental retardation] |
|
authority. |
|
(f) A state supported living center [school] shall: |
|
(1) allow a local intellectual and developmental |
|
disability [mental retardation] authority to participate in the |
|
interdisciplinary planning process involving the consideration of |
|
community living options for an adult resident; |
|
(2) to the extent not otherwise prohibited by state or |
|
federal confidentiality laws, provide a local intellectual and |
|
developmental disability [mental retardation] authority with |
|
access to an adult resident and an adult resident's records to |
|
assist the authority in implementing the community living options |
|
information process; and |
|
(3) provide the adult resident or the adult resident's |
|
legally authorized representative with accurate information |
|
regarding the risks of moving the adult resident to a community |
|
living option. |
|
SECTION 2.063. Section 531.02444, Government Code, as |
|
amended by Chapter 34 (S.B. 187), Acts of the 81st Legislature, |
|
Regular Session, 2009, is reenacted and amended to read as follows: |
|
Sec. 531.02444. MEDICAID BUY-IN PROGRAMS FOR CERTAIN |
|
PERSONS WITH DISABILITIES. (a) The executive commissioner shall |
|
develop and implement: |
|
(1) a Medicaid buy-in program for persons with |
|
disabilities as authorized by the Ticket to Work and Work |
|
Incentives Improvement Act of 1999 (Pub. L. No. 106-170) or the |
|
Balanced Budget Act of 1997 (Pub. L. No. 105-33); and |
|
(2) as authorized by the Deficit Reduction Act of 2005 |
|
(Pub. L. No. 109-171), a Medicaid buy-in program for [disabled] |
|
children with disabilities that is described by 42 U.S.C. Section |
|
1396a(cc)(1) whose family incomes do not exceed 300 percent of the |
|
applicable federal poverty level. |
|
(b) The executive commissioner shall adopt rules in |
|
accordance with federal law that provide for: |
|
(1) eligibility requirements for each program |
|
described by Subsection (a); and |
|
(2) requirements for participants in the program to |
|
pay premiums or cost-sharing payments, subject to Subsection (c). |
|
(c) Rules adopted by the executive commissioner under |
|
Subsection (b) with respect to the program for [disabled] children |
|
with disabilities described by Subsection (a)(2) must require a |
|
participant to pay monthly premiums according to a sliding scale |
|
that is based on family income, subject to the requirements of 42 |
|
U.S.C. Sections 1396o(i)(2) and (3). |
|
SECTION 2.064. Section 531.0246, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0246. REGIONAL MANAGEMENT OF HEALTH AND HUMAN |
|
SERVICES AGENCIES. (a) The [Subject to Section 531.0055(c), the] |
|
commission may require a health and human services agency, under |
|
the direction of the commission, to: |
|
(1) [locate all or a portion of the agency's employees
|
|
and programs in the same building as another health and human
|
|
services agency or at a location near or adjacent to the location of
|
|
another health and human services agency;
|
|
[(2)] ensure that the agency's location is accessible |
|
to [disabled] employees with disabilities and agency clients with |
|
disabilities; and |
|
(2) [(3)] consolidate agency support services, |
|
including clerical and administrative support services and |
|
information resources support services, with support services |
|
provided to or by another health and human services agency. |
|
(b) The executive commissioner may require a health and |
|
human services agency, under the direction of the executive |
|
commissioner, to locate all or a portion of the agency's employees |
|
and programs in the same building as another health and human |
|
services agency or at a location near or adjacent to the location of |
|
another health and human services agency. |
|
SECTION 2.065. Section 531.0247, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0247. ANNUAL BUSINESS PLAN. The [Subject to
|
|
Section 531.0055(c), the] commission shall develop and implement an |
|
annual business services plan for each health and human services |
|
region that establishes performance objectives for all health and |
|
human services agencies providing services in the region and |
|
measures agency effectiveness and efficiency in achieving those |
|
objectives. |
|
SECTION 2.066. Section 531.0248(d), Government Code, is |
|
amended to read as follows: |
|
(d) In implementing this section, the commission shall |
|
consider models used in other service delivery systems, including |
|
the mental health and intellectual disability [mental retardation] |
|
service delivery systems [system]. |
|
SECTION 2.067. Sections 531.02481(a), (e), and (f), |
|
Government Code, are amended to read as follows: |
|
(a) The commission[, the Texas Department of Human
|
|
Services,] and the Department of Aging and Disability Services |
|
[Texas Department on Aging] shall assist communities in this state |
|
in developing comprehensive, community-based support and service |
|
delivery systems for long-term care services. At the request of a |
|
community-based organization or combination of community-based |
|
organizations, the commission may provide a grant to the |
|
organization or combination of organizations in accordance with |
|
Subsection (g). At the request of a community, the commission shall |
|
provide resources and assistance to the community to enable the |
|
community to: |
|
(1) identify and overcome institutional barriers to |
|
developing more comprehensive community support systems, including |
|
barriers that result from the policies and procedures of state |
|
health and human services agencies; |
|
(2) develop a system of blended funds, consistent with |
|
the requirements of federal law and the General Appropriations Act, |
|
to allow the community to customize services to fit individual |
|
community needs; and |
|
(3) develop a local system of access and assistance to |
|
aid clients in accessing the full range of long-term care services. |
|
(e) The executive commissioner shall assure the maintenance |
|
of no fewer than 28 area agencies on aging in order to assure the |
|
continuation of a local system of access and assistance that is |
|
sensitive to the aging population. |
|
(f) A community-based organization or a combination of |
|
organizations may make a proposal under this section. A |
|
community-based organization includes: |
|
(1) an area agency on aging; |
|
(2) an independent living center; |
|
(3) a municipality, county, or other local government; |
|
(4) a nonprofit or for-profit organization; or |
|
(5) a community mental health and intellectual |
|
disability [mental retardation] center. |
|
SECTION 2.068. Section 531.02491, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02491. JOINT TRAINING FOR CERTAIN CASEWORKERS. |
|
(a) The executive commissioner shall provide for joint training |
|
for health and human services caseworkers whose clients are |
|
children, including caseworkers employed by: |
|
(1) the commission [Texas Department of Health]; |
|
(2) the [Texas] Department of Aging and Disability |
|
[Human] Services; [and] |
|
(3) the [Texas] Department of State Health Services; |
|
(4) [Mental Health and Mental Retardation,] a local |
|
mental health authority; and[, or] |
|
(5) a local intellectual and developmental disability |
|
[mental retardation] authority. |
|
(b) Training provided under this section must be designed to |
|
increase a caseworker's knowledge and awareness of the services |
|
available to children at each health and human services agency or |
|
local mental health or intellectual and developmental disability |
|
[mental retardation] authority, including long-term care programs |
|
and services available under a Section 1915(c) waiver program. |
|
SECTION 2.069. Section 531.02492, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.02492. DELIVERY OF HEALTH AND HUMAN SERVICES TO |
|
YOUNG TEXANS. [(a) The executive head of each health and human
|
|
services agency shall report annually to the governing body of that
|
|
agency on that agency's efforts to provide health and human
|
|
services to children younger than six years of age, including the
|
|
development of any new programs or the enhancement of existing
|
|
programs. The agency shall submit a copy of the report to the
|
|
commission.] |
|
(b) The commission shall electronically publish on the |
|
commission's Internet website a biennial report and, on or before |
|
the date the report is due, shall notify the governor, the |
|
lieutenant governor, the speaker of the house of representatives, |
|
the comptroller, the Legislative Budget Board, and the appropriate |
|
legislative committees that the report is available on the |
|
commission's Internet website. The report must address the efforts |
|
of the health and human services agencies to provide health and |
|
human services to children younger than six years of age. The |
|
report may contain recommendations by the commission to better |
|
coordinate state agency programs relating to the delivery of health |
|
and human services to children younger than six years of age and may |
|
propose joint agency collaborative programs. |
|
[(c)
The commissioner shall adopt rules relating to the
|
|
reports required by Subsection (a), including rules specifying when
|
|
and in what manner a health and human services agency must report
|
|
and the information to be included in the report. Each agency shall
|
|
follow the rules adopted by the commissioner under this section.] |
|
SECTION 2.070. Section 531.0271, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0271. HEALTH AND HUMAN SERVICES AGENCIES OPERATING |
|
BUDGETS. The commission may, within the limits established by and |
|
subject to the General Appropriations Act, transfer amounts |
|
appropriated to health and human services agencies among the |
|
agencies to: |
|
(1) enhance the receipt of federal money under the |
|
federal money [funds] management system established under Section |
|
531.028; |
|
(2) achieve efficiencies in the administrative |
|
support functions of the agencies; and |
|
(3) perform the functions assigned to the executive |
|
commissioner under Section 531.0055. |
|
SECTION 2.071. Section 531.0273, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0273. INFORMATION RESOURCES PLANNING AND |
|
MANAGEMENT[; ADVISORY COMMITTEE]. (a) The commission is |
|
responsible for strategic planning for information resources at |
|
each health and human services agency and shall direct the |
|
management of information resources at each health and human |
|
services agency. The commission shall: |
|
(1) develop a coordinated strategic plan for |
|
information resources management that: |
|
(A) covers a five-year period; |
|
(B) defines objectives for information resources |
|
management at each health and human services agency; |
|
(C) prioritizes information resources projects |
|
and implementation of new technology for all health and human |
|
services agencies; |
|
(D) integrates planning and development of each |
|
information resources system used by a health and human services |
|
agency into a coordinated information resources management |
|
planning and development system established by the commission; |
|
(E) establishes standards for information |
|
resources system security and that promotes the ability of |
|
information resources systems to operate with each other; |
|
(F) achieves economies of scale and related |
|
benefits in purchasing for health and human services information |
|
resources systems; and |
|
(G) is consistent with the state strategic plan |
|
for information resources developed under Chapter 2054; |
|
(2) establish information resources management |
|
policies, procedures, and technical standards and ensure |
|
compliance with those policies, procedures, and standards; and |
|
(3) review and approve the information resources |
|
deployment review and biennial operating plan of each health and |
|
human services agency. |
|
(c) A health and human services agency may not submit its |
|
plans to the Department of Information Resources or the Legislative |
|
Budget Board under Subchapter E, Chapter 2054, until those plans |
|
are approved by the commission. |
|
[(d)
The commission shall appoint an advisory committee
|
|
composed of:
|
|
[(1)
information resources managers for state
|
|
agencies and for private employers; and
|
|
[(2)
the directors, executive directors, and
|
|
commissioners of health and human services agencies.
|
|
[(e)
The advisory committee appointed under Subsection (d)
|
|
shall advise the commission with respect to the implementation of
|
|
the commission's duties under Subsection (a)(1) and:
|
|
[(1) shall advise the commission about:
|
|
[(A)
overall goals and objectives for
|
|
information resources management for all health and human services
|
|
agencies;
|
|
[(B)
coordination of agency information
|
|
resources management plans;
|
|
[(C)
development of short-term and long-term
|
|
strategies for:
|
|
[(i)
implementing information resources
|
|
management policies, procedures, and technical standards; and
|
|
[(ii)
ensuring compatibility of
|
|
information resources systems across health and human services
|
|
agencies as technology changes;
|
|
[(D)
information resources training and skill
|
|
development for health and human services agency employees and
|
|
policies to facilitate recruitment and retention of trained
|
|
employees;
|
|
[(E) standards for determining:
|
|
[(i)
the circumstances in which obtaining
|
|
information resources services under contract is appropriate;
|
|
[(ii)
the information resources services
|
|
functions that must be performed by health and human services
|
|
agency information resources services employees; and
|
|
[(iii)
the information resources services
|
|
skills that must be maintained by health and human services agency
|
|
information resources services employees;
|
|
[(F)
optimization of the use of information
|
|
resources technology that is in place at health and human services
|
|
agencies; and
|
|
[(G)
existing and potential future information
|
|
resources technologies and practices and the usefulness of those
|
|
technologies and practices to health and human services agencies;
|
|
and
|
|
[(2)
shall review and make recommendations to the
|
|
commission relating to the consolidation and improved efficiency of
|
|
information resources management functions, including:
|
|
[(A)
cooperative leasing of information
|
|
resources systems equipment;
|
|
[(B) consolidation of data centers;
|
|
[(C) improved network operations;
|
|
[(D)
technical support functions, including help
|
|
desk services, call centers, and data warehouses;
|
|
[(E) administrative applications;
|
|
[(F) purchases of standard software;
|
|
[(G) joint training efforts;
|
|
[(H)
recruitment and retention of trained agency
|
|
employees;
|
|
[(I) video conferencing; and
|
|
[(J)
other related opportunities for improved
|
|
efficiency.
|
|
[(f)
A member of the advisory committee may not receive
|
|
compensation, but is entitled to reimbursement of the travel
|
|
expenses incurred by the member while conducting the business of
|
|
the committee, as provided by the General Appropriations Act.
|
|
[(g) The advisory committee is not subject to Chapter 2110.] |
|
SECTION 2.072. Section 531.028(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner shall establish a federal |
|
money management system to coordinate and monitor the use of |
|
federal money that is received by health and human services |
|
agencies to ensure that the money is spent in the most efficient |
|
manner and shall: |
|
(1) establish priorities for use of federal money by |
|
all health and human services agencies, in coordination with the |
|
coordinated strategic plan established under Section 531.022 and |
|
the budget prepared under Section 531.026; |
|
(2) coordinate and monitor the use of federal money |
|
for health and human services to ensure that the money is spent in |
|
the most cost-effective manner throughout the health and human |
|
services system; |
|
(3) review and approve all federal funding plans for |
|
health and human services in this state; |
|
(4) estimate available federal money, including |
|
earned federal money, and monitor unspent money; |
|
(5) ensure that the state meets federal requirements |
|
relating to receipt of federal money for health and human services, |
|
including requirements relating to state matching money and |
|
maintenance of effort; |
|
(6) transfer appropriated amounts as described by |
|
Section 531.0271; and |
|
(7) ensure that each governmental entity identified |
|
under Section 531.022(e) has access to complete and timely |
|
information about all sources of federal money for health and human |
|
services programs and that technical assistance is available to |
|
governmental entities seeking grants of federal money to provide |
|
health and human services. |
|
SECTION 2.073. Section 531.031, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.031. MANAGEMENT INFORMATION AND COST ACCOUNTING |
|
SYSTEM. The executive commissioner shall establish a management |
|
information system and a cost accounting system for all health and |
|
human services that is compatible with and meets the requirements |
|
of the uniform statewide accounting project. |
|
SECTION 2.074. (a) Section 531.0312(b), Government Code, as |
|
amended by Chapters 50 (S.B. 397) and 1460 (H.B. 2641), Acts of the |
|
76th Legislature, Regular Session, 1999, and Chapter 937 (H.B. |
|
3560), Acts of the 80th Legislature, Regular Session, 2007, is |
|
reenacted to read as follows: |
|
(b) The commission shall cooperate with the Records |
|
Management Interagency Coordinating Council and the comptroller to |
|
establish a single method of categorizing information about health |
|
and human services to be used by the Records Management Interagency |
|
Coordinating Council and the Texas Information and Referral |
|
Network. The network, in cooperation with the council and the |
|
comptroller, shall ensure that: |
|
(1) information relating to health and human services |
|
is included in each residential telephone directory published by a |
|
for-profit publisher and distributed to the public at minimal or no |
|
cost; and |
|
(2) the single method of categorizing information |
|
about health and human services is used in a residential telephone |
|
directory described by Subdivision (1). |
|
(b) Section 531.0312(c), Government Code, as added by |
|
Chapter 1460 (H.B. 2641), Acts of the 76th Legislature, Regular |
|
Session, 1999, is reenacted to incorporate amendments made to |
|
Section 531.0312(b), Government Code, by Chapter 50 (S.B. 397), |
|
Acts of the 76th Legislature, Regular Session, 1999, and amended to |
|
read as follows: |
|
(c) A health and human services agency or a public or |
|
private entity receiving state-appropriated funds to provide |
|
health and human services shall provide the Texas Information and |
|
Referral Network and the Records Management Interagency |
|
Coordinating Council with information about the health and human |
|
services provided by the agency or entity for inclusion in the |
|
statewide information and referral network, residential telephone |
|
directories described by Subsection (b), and any other materials |
|
produced under the direction of the network or the council. The |
|
agency or entity shall provide the information in the format |
|
required by the Texas Information and Referral Network or the |
|
Records Management Interagency Coordinating Council [a form
|
|
determined by the commissioner] and shall update the information at |
|
least quarterly or as required by the network or the council. |
|
(c) Section 531.0312(d), Government Code, is amended to |
|
read as follows: |
|
(d) The Texas Department of Housing and Community Affairs |
|
shall provide the Texas Information and Referral Network with |
|
information regarding the department's housing and community |
|
affairs programs for inclusion in the statewide information and |
|
referral network. The department shall provide the information in |
|
a form determined by the commission [commissioner] and shall update |
|
the information at least quarterly. |
|
SECTION 2.075. Section 531.0317(c), Government Code, is |
|
amended to read as follows: |
|
(c) The Internet site must: |
|
(1) contain information that is: |
|
(A) in a concise and easily understandable and |
|
accessible format; and |
|
(B) organized by the type of service provided |
|
rather than by the agency or provider delivering the service; |
|
(2) contain eligibility criteria for each agency |
|
program; |
|
(3) contain application forms for each of the public |
|
assistance programs administered by health and human services |
|
agencies, including application forms for: |
|
(A) financial assistance under Chapter 31, Human |
|
Resources Code; |
|
(B) Medicaid [medical assistance under Chapter
|
|
32, Human Resources Code]; and |
|
(C) nutritional assistance under Chapter 33, |
|
Human Resources Code; |
|
(4) to avoid duplication of functions and efforts, |
|
provide a link that provides access to a site maintained by the |
|
Texas Information and Referral Network under Section 531.0313; |
|
(5) contain the telephone number and, to the extent |
|
available, the electronic mail address for each health and human |
|
services agency and local provider of health and human services; |
|
(6) be designed in a manner that allows a member of the |
|
public to send questions about each agency's programs or services |
|
electronically and receive responses to the questions from the |
|
agency electronically; and |
|
(7) be updated at least quarterly. |
|
SECTION 2.076. Sections 531.0318(b) and (c), Government |
|
Code, are amended to read as follows: |
|
(b) The information for consumers required by this section |
|
must: |
|
(1) be presented in a manner that is easily accessible |
|
to, and understandable by, a consumer; and |
|
(2) allow a consumer to make informed choices |
|
concerning long-term care services and include: |
|
(A) an explanation of the manner in which |
|
long-term care service delivery is administered in different |
|
counties through different programs operated by the commission and |
|
by the Department of Aging and Disability Services, so that an |
|
individual can easily understand the service options available in |
|
the area in which that individual lives; and |
|
(B) for the [Medicaid] Star + Plus Medicaid |
|
managed care [pilot] program, information that allows a consumer to |
|
evaluate the performance of each participating plan issuer, |
|
including for each issuer, in an accessible format such as a table: |
|
(i) the enrollment in each county; |
|
(ii) additional "value-added" services |
|
provided; |
|
(iii) a summary of the financial |
|
statistical report required under Subchapter A, Chapter 533; |
|
(iv) complaint information; |
|
(v) any sanction or penalty imposed by any |
|
state agency, including a sanction or penalty imposed by the |
|
commission or the Texas Department of Insurance; |
|
(vi) information concerning consumer |
|
satisfaction; and |
|
(vii) other data, including relevant data |
|
from reports of external quality review organizations, that may be |
|
used by the consumer to evaluate the quality of the services |
|
provided. |
|
(c) In addition to providing the information required by |
|
this section through the Internet, the commission or the Department |
|
of Aging and Disability Services shall, on request by a consumer |
|
without Internet access, provide the consumer with a printed copy |
|
of the information from the website. The commission or department |
|
may charge a reasonable fee for printing the information. The |
|
executive commissioner shall establish the fee by rule. |
|
SECTION 2.077. Section 531.033, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.033. RULES. The executive commissioner shall |
|
adopt rules necessary to carry out the commission's duties under |
|
this chapter. |
|
SECTION 2.078. Section 531.0335(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner by rule shall prohibit a |
|
health and human services agency from taking a punitive action |
|
against a person responsible for a child's care, custody, or |
|
welfare for failure of the person to ensure that the child receives |
|
the immunization series prescribed by Section 161.004, Health and |
|
Safety Code. |
|
SECTION 2.079. Section 531.035, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.035. DISPUTE ARBITRATION. The executive |
|
commissioner shall arbitrate and render the final decision on |
|
interagency disputes. |
|
SECTION 2.080. The heading to Section 531.0381, Government |
|
Code, is amended to read as follows: |
|
Sec. 531.0381. CERTAIN GIFTS AND GRANTS TO HEALTH AND HUMAN |
|
SERVICES AGENCIES. |
|
SECTION 2.081. Sections 531.0381(b) and (c), Government |
|
Code, are amended to read as follows: |
|
(b) Acceptance of a gift or grant under this section is |
|
subject to the written approval of the executive commissioner. |
|
Chapter 575 does not apply to a gift or grant under this section. |
|
(c) The executive commissioner may adopt rules and |
|
procedures to implement this section. The rules must ensure that |
|
acceptance of a gift or grant under this section is consistent with |
|
any applicable federal law or regulation and does not adversely |
|
affect federal financial participation in any state program, |
|
including [the state] Medicaid [program]. |
|
SECTION 2.082. Section 531.0392(a), Government Code, is |
|
amended to read as follows: |
|
(a) In this section, "dually eligible individual" means an |
|
individual who is eligible to receive health care benefits under |
|
both [the] Medicaid and the Medicare program [programs]. |
|
SECTION 2.083. Section 531.041, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.041. GENERAL POWERS AND DUTIES. The executive |
|
commissioner and the commission have [has] all the powers and |
|
duties necessary to administer this chapter. |
|
SECTION 2.084. Section 531.042(a), Government Code, is |
|
amended to read as follows: |
|
(a) The executive commissioner by rule shall require each |
|
health and human services agency to provide to each patient or |
|
client of the agency and to at least one family member of the |
|
patient or client, if possible, information regarding all care and |
|
support options available to the patient or client, including |
|
community-based services appropriate to the needs of the patient or |
|
client, before the agency allows the patient or client to be placed |
|
in a care setting, including a nursing facility [home], |
|
intermediate care facility for individuals with an intellectual |
|
disability [the mentally retarded], or general residential |
|
operation for children with an intellectual disability that is |
|
[institution for the mentally retarded] licensed [or operated] by |
|
the Department of Family and Protective [and Regulatory] Services, |
|
to receive care or services provided by the agency or by a person |
|
under an agreement with the agency. |
|
SECTION 2.085. Section 531.043(a), Government Code, is |
|
amended to read as follows: |
|
(a) In conjunction with the appropriate state agencies, the |
|
executive commissioner shall develop a plan for access to |
|
individualized long-term care services for persons with functional |
|
limitations or medical needs and their families that assists those |
|
persons in achieving and maintaining the greatest possible |
|
independence, autonomy, and quality of life. |
|
SECTION 2.086. Section 531.044, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.044. FINANCIAL ASSISTANCE [AFDC] RECIPIENTS |
|
ELIGIBLE FOR FEDERAL PROGRAMS. [(a)] The commission shall assist |
|
recipients of financial assistance under Chapter 31, Human |
|
Resources Code, who are eligible for assistance under federal |
|
programs to apply for benefits under those federal programs. The |
|
commission may delegate this responsibility to a health and human |
|
services [service] agency, contract with a unit of local |
|
government, or use any other cost-effective method to assist |
|
financial assistance recipients who are eligible for federal |
|
programs. |
|
[(b)
The commission shall organize a planning group
|
|
involving the Texas Department of Human Services, the Texas
|
|
Education Agency, and the Texas Rehabilitation Commission to:
|
|
[(1)
improve workload coordination between those
|
|
agencies as necessary to administer this section; and
|
|
[(2)
provide information and help train employees to
|
|
correctly screen applicants under this section as requested by the
|
|
commission.] |
|
SECTION 2.087. Sections 531.045(b) and (g), Government |
|
Code, are amended to read as follows: |
|
(b) The task force is composed of: |
|
(1) a representative of: |
|
(A) the attorney general's office, appointed by |
|
the attorney general; |
|
(B) the comptroller's office, appointed by the |
|
comptroller; |
|
(C) the commission, appointed by the executive |
|
commissioner; |
|
(D) the [Texas] Department of State Health |
|
Services, appointed by the commissioner of state health services |
|
[public health]; |
|
(E) the [Texas] Department of Aging and |
|
Disability [Human] Services, appointed by the commissioner of aging |
|
and disability [human] services; |
|
(F) the Texas Workforce Commission, appointed by |
|
the executive director of that agency; and |
|
(G) the Department of Assistive and |
|
Rehabilitative Services [Texas Rehabilitation Commission], |
|
appointed by the commissioner of assistive and rehabilitative |
|
services [that agency]; and |
|
(2) two representatives of each of the following |
|
groups, appointed by the comptroller: |
|
(A) retailers who maintain electronic benefits |
|
transfer point-of-sale equipment; |
|
(B) banks or owners of automatic teller machines; |
|
and |
|
(C) consumer or client advocacy organizations. |
|
(g) The task force shall: |
|
(1) serve as this state's counterpoint to the federal |
|
electronic benefits transfer task force; |
|
(2) identify benefit programs that merit addition to |
|
this state's electronic benefits transfer system; |
|
(3) identify and address problems that may occur if a |
|
program is added; |
|
(4) pursue state-federal partnerships to facilitate |
|
the development and expansion of this state's electronic benefits |
|
transfer system; |
|
(5) track and distribute federal legislation and |
|
information from other states that relate to electronic benefits |
|
transfer systems; |
|
(6) ensure efficiency and planning coordination in |
|
relation to this state's electronic benefits transfer system; |
|
(7) [develop a plan using the experience and expertise
|
|
of appropriate state agencies for the use of a photograph or other
|
|
imaging technology on all electronic benefits transfer cards and,
|
|
if proven to be effective in reducing fraud and misuse, begin using
|
|
the new cards starting with replacement cards for cards that were
|
|
used in the program on June 13, 1995;
|
|
[(8)] review current and potential fraud problems with |
|
electronic benefits transfer and propose methods to prevent or |
|
deter fraud; |
|
[(9)
evaluate the feasibility of adding the Medicaid
|
|
program to the state's electronic benefits transfer system;] and |
|
(8) [(10)] develop a plan to assist beneficiaries of |
|
public programs to obtain bank accounts. |
|
SECTION 2.088. Section 531.047(a), Government Code, is |
|
amended to read as follows: |
|
(a) The executive commissioner [commission], after |
|
consulting with representatives from the Department of Family and |
|
Protective [and Regulatory] Services, the Texas Juvenile Justice |
|
Department [Probation Commission], the Department of Aging and |
|
Disability Services, and the [Texas] Department of State Health |
|
Services [Mental Health and Mental Retardation], shall by rule |
|
adopt result-oriented standards that a provider of substitute care |
|
services for children under the care of the state must achieve. |
|
SECTION 2.089. Section 531.048, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.048. CASELOAD STANDARDS. (a) The executive [After
|
|
considering the recommendations of the caseload standards advisory
|
|
committees under Section 531.049(e), the] commissioner may |
|
establish caseload standards and other standards relating to |
|
caseloads for each category of caseworker employed by the [Texas
|
|
Department of Human Services or the] Department of Family and |
|
Protective [and Regulatory] Services. |
|
(b) In establishing standards under this section, the |
|
executive commissioner shall: |
|
(1) ensure the standards are based on the actual |
|
duties of the caseworker; |
|
(2) ensure the caseload standards are reasonable and |
|
achievable; |
|
(3) ensure the standards are consistent with existing |
|
professional caseload standards; |
|
(4) consider standards developed by other states for |
|
caseworkers in similar positions of employment; and |
|
(5) ensure the standards are consistent with existing |
|
caseload standards of other state agencies. |
|
(c) Subject to the availability of funds appropriated by the |
|
legislature, [the commissioner of human services and] the |
|
commissioner [executive director] of the Department of Family and |
|
Protective [and Regulatory] Services shall use the standards |
|
established by the executive commissioner under this section to |
|
determine the number of personnel to assign as caseworkers for the |
|
department [their respective agencies]. |
|
(d) Subject to the availability of funds appropriated by the |
|
legislature, the [Texas Department of Human Services and the] |
|
Department of Family and Protective [and Regulatory] Services shall |
|
use the standards established by the executive commissioner to |
|
assign caseloads to individual caseworkers employed by the |
|
department [those agencies]. |
|
[(e)
The commissioner shall include a recommendation made
|
|
to the commissioner by a caseload standards advisory committee
|
|
under Section 531.049(e) in the strategic plan of the agency that is
|
|
the subject of the recommendation.] |
|
(f) Nothing in this section may be construed to create a |
|
cause of action. |
|
[(g)
The executive commissioner shall develop and, subject
|
|
to the availability of funds, implement a caseload management
|
|
reduction plan to reduce, not later than January 1, 2011, caseloads
|
|
for caseworkers employed by the adult protective services division
|
|
of the Department of Family and Protective Services to a level that
|
|
does not exceed professional caseload standards by more than five
|
|
cases per caseworker.
The plan must provide specific annual
|
|
targets for caseload reduction.] |
|
SECTION 2.090. Section 531.050, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.050. MINIMUM COLLECTION GOAL. (a) Before August |
|
31 of each year, the executive commissioner [commission, after
|
|
consulting with the Texas Department of Human Services,] by rule |
|
shall set a minimum goal for the commission [Texas Department of
|
|
Human Services] that specifies the percentage of the amount of |
|
benefits granted by the commission [department] in error under the |
|
supplemental nutrition assistance [food stamp] program or the |
|
program of financial assistance under Chapter 31, Human Resources |
|
Code, that the commission [department] should recover. The |
|
executive commissioner [commission] shall set the percentage based |
|
on comparable recovery rates reported by other states or other |
|
appropriate factors identified by the executive commissioner |
|
[commission and the department]. |
|
(b) If the commission [department] fails to meet the goal |
|
set under Subsection (a) for the fiscal year, the executive |
|
commissioner shall notify the comptroller, and the comptroller |
|
shall reduce the commission's [department's] general revenue |
|
appropriation by an amount equal to the difference between the |
|
amount of state funds the commission [department] would have |
|
collected had the commission [department] met the goal and the |
|
amount of state funds the commission [department] actually |
|
collected. |
|
(c) The executive commissioner [commission], the governor, |
|
and the Legislative Budget Board shall monitor the commission's |
|
[department's] performance in meeting the goal set under this |
|
section. The commission [department] shall cooperate by providing |
|
to [the commission,] the governor[,] and the Legislative Budget |
|
Board, on request, information concerning the commission's |
|
[department's] collection efforts. |
|
SECTION 2.091. Section 531.051(c), Government Code, is |
|
amended to read as follows: |
|
(c) In adopting rules for the consumer direction models, the |
|
executive commissioner [commission] shall: |
|
(1) with assistance from the work group established |
|
under Section 531.052, determine which services are appropriate and |
|
suitable for delivery through consumer direction; |
|
(2) ensure that each consumer direction model is |
|
designed to comply with applicable federal and state laws; |
|
(3) maintain procedures to ensure that a potential |
|
consumer or the consumer's legally authorized representative has |
|
adequate and appropriate information, including the |
|
responsibilities of a consumer or representative under each service |
|
delivery option, to make an informed choice among the types of |
|
consumer direction models; |
|
(4) require each consumer or the consumer's legally |
|
authorized representative to sign a statement acknowledging |
|
receipt of the information required by Subdivision (3); |
|
(5) maintain procedures to monitor delivery of |
|
services through consumer direction to ensure: |
|
(A) adherence to existing applicable program |
|
standards; |
|
(B) appropriate use of funds; and |
|
(C) consumer satisfaction with the delivery of |
|
services; |
|
(6) ensure that authorized program services that are |
|
not being delivered to a consumer through consumer direction are |
|
provided by a provider agency chosen by the consumer or the |
|
consumer's legally authorized representative; and |
|
(7) work in conjunction with the work group |
|
established under Section 531.052 to set a timetable to complete |
|
the implementation of the consumer direction models. |
|
SECTION 2.092. Sections 531.055(a) and (e), Government |
|
Code, are amended to read as follows: |
|
(a) Each health and human services agency, the Texas |
|
Correctional Office [Council] on Offenders with Medical or Mental |
|
Impairments, the Texas Department of Criminal Justice, the Texas |
|
Department of Housing and Community Affairs, the Texas Education |
|
Agency, the Texas Workforce Commission, and the Texas Juvenile |
|
Justice Department [Youth Commission] shall enter into [adopt] a |
|
joint memorandum of understanding to promote a system of |
|
local-level interagency staffing groups to coordinate services for |
|
persons needing multiagency services. |
|
(e) The agencies shall ensure that a state-level |
|
interagency staffing group provides a biennial report to the |
|
administrative head [executive director] of each agency, the |
|
legislature, and the governor that includes: |
|
(1) the number of persons served through the |
|
local-level interagency staffing groups and the outcomes of the |
|
services provided; |
|
(2) a description of any barriers identified to the |
|
state's ability to provide effective services to persons needing |
|
multiagency services; and |
|
(3) any other information relevant to improving the |
|
delivery of services to persons needing multiagency services. |
|
SECTION 2.093. Section 531.056, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.056. REVIEW OF SURVEY PROCESS IN CERTAIN |
|
INSTITUTIONS AND FACILITIES. (a) The commission shall adopt |
|
procedures to review: |
|
(1) citations or penalties assessed for a violation of |
|
a rule or law against an institution or facility licensed under |
|
Chapter 242, 247, or 252, Health and Safety Code, or certified to |
|
participate in Medicaid administered in accordance with Chapter 32, |
|
Human Resources Code, considering: |
|
(A) the number of violations by geographic |
|
region; |
|
(B) the patterns of violations in each region; |
|
and |
|
(C) the outcomes following the assessment of a |
|
penalty or citation; and |
|
(2) the performance of duties by employees and agents |
|
of a [the Texas Department of Human Services or another] state |
|
agency responsible for licensing, inspecting, surveying, or |
|
investigating institutions and facilities licensed under Chapter |
|
242, 247, or 252, Health and Safety Code, or certified to |
|
participate in Medicaid administered in accordance with Chapter 32, |
|
Human Resources Code, related to: |
|
(A) complaints received by the commission; or |
|
(B) any standards or rules violated by an |
|
employee or agent of a state agency. |
|
SECTION 2.094. Section 531.057, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.057. VOLUNTEER ADVOCATE PROGRAM FOR THE ELDERLY. |
|
(a) In this section: |
|
(1) "Designated caregiver" means: |
|
(A) a person designated as a caregiver by an |
|
elderly individual receiving services from or under the direction |
|
of the commission or a health and human services agency; or |
|
(B) a court-appointed guardian of an elderly |
|
individual receiving services from or under the direction of the |
|
commission or a health and human services agency. |
|
(2) "Elderly" means individuals who are at least 60 |
|
years of age. |
|
(3) "Program" means the volunteer advocate program |
|
created under this section for the elderly receiving services from |
|
or under the direction of the commission or a health and human |
|
services agency [created under this section]. |
|
(4) "Volunteer advocate" means a person who |
|
successfully completes the volunteer advocate curriculum described |
|
by Subsection (c)(2). |
|
[(b)
The executive commissioner shall coordinate with the
|
|
advisory committee established under Section 531.0571 to develop a
|
|
volunteer advocate program for the elderly receiving services from
|
|
or under the direction of the commission or a health and human
|
|
services agency.] |
|
(c) The [In developing the] program[, the executive
|
|
commissioner and the advisory committee] shall adhere to the |
|
following principles: |
|
(1) the intent of the program is to evaluate, through |
|
operation of pilot projects, whether providing the services of a |
|
trained volunteer advocate selected by an elderly individual or the |
|
individual's designated caregiver is effective in achieving the |
|
following goals: |
|
(A) extend the time the elderly individual can |
|
remain in an appropriate home setting; |
|
(B) maximize the efficiency of services |
|
delivered to the elderly individual by focusing on services needed |
|
to sustain family caregiving; |
|
(C) protect the elderly individual by providing a |
|
knowledgeable third party to review the quality of care and |
|
services delivered to the individual and the care options available |
|
to the individual and the individual's family; and |
|
(D) facilitate communication between the elderly |
|
individual or the individual's designated caregiver and providers |
|
of health care and other services; |
|
(2) a volunteer advocate curriculum must be maintained |
|
[established] that incorporates best practices as determined and |
|
recognized by a professional organization recognized in the elder |
|
health care field; |
|
(3) the use of pro bono assistance from qualified |
|
professionals must be maximized in modifying [developing] the |
|
volunteer advocate curriculum and [designing] the program; |
|
(4) trainers must be certified on the ability to |
|
deliver training; |
|
(5) training shall be offered through multiple |
|
community-based organizations; and |
|
(6) participation in the program is voluntary and must |
|
be initiated by the elderly individual or the individual's |
|
designated caregiver. |
|
(d) The executive commissioner may enter into agreements |
|
with appropriate nonprofit organizations for the provision of |
|
services under the program. A nonprofit organization is eligible |
|
to provide services under the program if the organization: |
|
(1) has significant experience in providing services |
|
to elderly individuals; |
|
(2) has the capacity to provide training and |
|
supervision for individuals interested in serving as volunteer |
|
advocates; and |
|
(3) meets any other criteria prescribed by the |
|
executive commissioner. |
|
(e) The commission shall fund the program, including the |
|
design and evaluation of pilot projects, modification |
|
[development] of the volunteer advocate curriculum, and training of |
|
volunteers, through existing appropriations to the commission. |
|
(f) Notwithstanding Subsection (e), the commission may |
|
accept gifts, grants, or donations for the program from any public |
|
or private source to: |
|
(1) carry out the design of the program; |
|
(2) develop criteria for evaluation of any proposed |
|
pilot projects operated under the program; |
|
(3) modify [develop] a volunteer advocate training |
|
curriculum; |
|
(4) conduct training for volunteer advocates; and |
|
(5) develop a request for offers to conduct any |
|
proposed pilot projects under the program. |
|
(g) The executive commissioner may adopt rules as necessary |
|
to implement the program. |
|
SECTION 2.095. Sections 531.0571(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner shall appoint an advisory |
|
committee composed of the following members: |
|
(1) a representative of the Department of Aging and |
|
Disability Services; |
|
(2) a representative of the Department of Assistive |
|
and Rehabilitative Services; |
|
(3) a representative of the Department of State Health |
|
Services; |
|
(4) a representative of the Texas Silver-Haired |
|
Legislature; |
|
(5) a representative of an area agency on aging; |
|
(6) a representative of United Ways of Texas; |
|
(7) a home health provider; |
|
(8) an assisted living provider; |
|
(9) a nursing facility [home] provider; |
|
(10) a representative of Texas CASA; |
|
(11) a licensed gerontologist; and |
|
(12) a representative of AARP. |
|
(b) The advisory committee shall advise the executive |
|
commissioner on [the development of] the volunteer advocate program |
|
for the elderly [developed] under Section 531.057, including |
|
reviewing and commenting on: |
|
(1) program design and selection of any pilot sites |
|
operated under the program; |
|
(2) the volunteer advocate training curriculum; |
|
(3) requests for oversight requirements for any pilot |
|
projects operated under the program; |
|
(4) evaluation of any pilot projects operated under |
|
the program; |
|
(5) requirements for periodic reports to the elderly |
|
individual or the individual's designated caregiver and providers |
|
of health care or other services; and |
|
(6) other issues as requested by the executive |
|
commissioner. |
|
SECTION 2.096. Sections 531.058(a), (b), and (d), |
|
Government Code, are amended to read as follows: |
|
(a) The executive commissioner [commission] by rule shall |
|
establish an informal dispute resolution process in accordance with |
|
this section. The process must provide for adjudication by an |
|
appropriate disinterested person of disputes relating to a proposed |
|
enforcement action or related proceeding of the commission [Texas
|
|
Department of Human Services] under Section 32.021(d), Human |
|
Resources Code, or the Department of Aging and Disability Services |
|
under Chapter 242, 247, or 252, Health and Safety Code. The |
|
informal dispute resolution process must require: |
|
(1) an institution or facility to request informal |
|
dispute resolution not later than the 10th calendar day after |
|
notification by the commission or department, as applicable, of the |
|
violation of a standard or standards; and |
|
(2) the commission to complete the process not later |
|
than: |
|
(A) the 30th calendar day after receipt of a |
|
request from an institution or facility, other than an assisted |
|
living facility, for informal dispute resolution; or |
|
(B) the 90th calendar day after receipt of a |
|
request from an assisted living facility for informal dispute |
|
resolution. |
|
(b) The executive commissioner [commission] shall adopt |
|
rules to adjudicate claims in contested cases. |
|
(d) The executive commissioner [commission] shall use a |
|
negotiated rulemaking process and engage a qualified impartial |
|
third party as provided by Section 2009.053, with the goal of the |
|
executive commissioner adopting rules that are fair and impartial |
|
to all parties not later than January 1, 2015. This subsection |
|
expires September 1, 2015. |
|
SECTION 2.097. Section 531.059, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.059. VOUCHER PROGRAM FOR TRANSITIONAL LIVING |
|
ASSISTANCE FOR PERSONS WITH DISABILITIES. (a) In this section: |
|
(1) "Institutional housing" means: |
|
(A) an ICF-IID [ICF-MR], as defined by Section |
|
531.002, Health and Safety Code; |
|
(B) a nursing facility; |
|
(C) a state hospital, state supported living |
|
center [school], or state center maintained and managed by the |
|
[Texas] Department of State Health Services or the Department of |
|
Aging and Disability Services [Mental Health and Mental
|
|
Retardation]; |
|
(D) a general residential operation for children |
|
with an intellectual disability that is [an institution for the
|
|
mentally retarded] licensed [or operated] by the Department of |
|
Family and Protective Services; or |
|
(E) a general residential operation, as defined |
|
by Section 42.002, Human Resources Code. |
|
(2) "Integrated housing" means housing in which a |
|
person with a disability resides or may reside that is found in the |
|
community but that is not exclusively occupied by persons with |
|
disabilities and their care providers. |
|
(b) Subject to the availability of funds, the commission |
|
shall coordinate with the [Texas Department of Human Services, the] |
|
Texas Department of Housing and Community Affairs, the Department |
|
of State Health Services, and the [Texas] Department of Aging and |
|
Disability Services [Mental Health and Mental Retardation] to |
|
develop a housing assistance program to assist persons with |
|
disabilities in moving from institutional housing to integrated |
|
housing. In developing the program, the agencies shall address: |
|
(1) eligibility requirements for assistance; |
|
(2) the period during which a person with a disability |
|
may receive assistance; |
|
(3) the types of housing expenses to be covered under |
|
the program; and |
|
(4) the locations at which the program will be |
|
operated. |
|
(c) Subject to the availability of funds, the Department of |
|
Aging and Disability Services [commission] shall [require the Texas
|
|
Department of Human Services to implement and] administer the |
|
housing assistance program under this section. The department |
|
shall coordinate with the Texas Department of Housing and Community |
|
Affairs in [implementing and] administering the program, |
|
determining the availability of funding from the United States |
|
Department of Housing and Urban Development, and obtaining those |
|
funds. |
|
(d) The [Texas Department of Human Services and the] Texas |
|
Department of Housing and Community Affairs and the Department of |
|
Aging and Disability Services shall provide information to the |
|
commission as necessary to facilitate the administration |
|
[development and implementation] of the housing assistance |
|
program. |
|
SECTION 2.098. Sections 531.060(c)(3) and (4), Government |
|
Code, are amended to read as follows: |
|
(3) "Institution" means any congregate care facility, |
|
including: |
|
(A) a nursing facility [home]; |
|
(B) an ICF-IID [ICF-MR facility], as defined by |
|
Section 531.002, Health and Safety Code; |
|
(C) a group home operated by the [Texas] |
|
Department of Aging and Disability Services [Mental Health and
|
|
Mental Retardation]; and |
|
(D) a general residential operation for children |
|
with an intellectual disability that is [an institution for the
|
|
mentally retarded] licensed by the Department of Family and |
|
Protective [and Regulatory] Services. |
|
(4) "Waiver services" means services provided under: |
|
(A) the Medically Dependent Children Program |
|
(MDCP); |
|
(B) the Community Living Assistance and Support |
|
Services (CLASS) waiver program [Program]; |
|
(C) the Home and Community-based [Waiver] |
|
Services (HCS) waiver program [Program, including the HCS-OBRA
|
|
Program]; |
|
(D) [the Mental Retardation-Local Authority
|
|
Pilot Project (MRLA);
|
|
[(E)] the Deaf Blind with Multiple Disabilities |
|
(DBMD) waiver program [Deaf, Blind, and Multiply Disabled Program]; |
|
and |
|
(E) [(F)] any other Section 1915(c) waiver |
|
program that provides long-term care services for children. |
|
SECTION 2.099. Sections 531.062(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) Notwithstanding any other law, the commission may |
|
establish one or more pilot projects through which reimbursement |
|
under Medicaid [the medical assistance program under Chapter 32,
|
|
Human Resources Code,] is made to demonstrate the applications of |
|
technology in providing services under that program. |
|
(b) A pilot project established under this section may |
|
relate to providing rehabilitation services, services for the aging |
|
or persons with disabilities [disabled], or long-term care |
|
services, including community care services and support. |
|
SECTION 2.100. Sections 531.063(a) and (i), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner [commission,] by rule[,] |
|
shall establish at least one but not more than four call centers for |
|
purposes of determining and certifying or recertifying a person's |
|
eligibility and need for services related to the programs listed |
|
under Section 531.008(c), if cost-effective. [The commission must
|
|
conduct a public hearing before establishing the initial call
|
|
center.] |
|
(i) Notwithstanding Subsection (a), the executive |
|
commissioner shall develop and implement policies that provide an |
|
applicant for services related to the programs listed under Section |
|
531.008(c) with an opportunity to appear in person to establish |
|
initial eligibility or to comply with periodic eligibility |
|
recertification requirements if the applicant requests a personal |
|
interview. In implementing the policies, the commission shall |
|
maintain offices to serve applicants who request a personal |
|
interview. This subsection does not affect a law or rule that |
|
requires an applicant to appear in person to establish initial |
|
eligibility or to comply with periodic eligibility recertification |
|
requirements. |
|
SECTION 2.101. Section 531.064(a), Government Code, is |
|
amended to read as follows: |
|
(a) In this section, "vaccines for children program" means |
|
the program operated by the [Texas] Department of State Health |
|
Services under authority of 42 U.S.C. Section 1396s, as amended. |
|
SECTION 2.102. Sections 531.067(a), (b), (d), and (g), |
|
Government Code, are amended to read as follows: |
|
(a) The commission shall appoint a Public Assistance Health |
|
Benefit Review and Design Committee. The committee consists of |
|
nine representatives of health care providers participating in |
|
[the] Medicaid [program] or the child health plan program, or both. |
|
The committee membership must include at least three |
|
representatives from each program. |
|
(b) The executive commissioner shall designate one member |
|
to serve as presiding officer for a term of two years. |
|
(d) The committee shall review and provide recommendations |
|
to the commission regarding health benefits and coverages provided |
|
under [the state] Medicaid [program], the child health plan |
|
program, and any other income-based health care program |
|
administered by the commission or a health and human services |
|
agency. In performing its duties under this subsection, the |
|
committee must: |
|
(1) review benefits provided under each of the |
|
programs; and |
|
(2) review procedures for addressing high utilization |
|
of benefits by recipients. |
|
(g) In performing the duties under this section, the |
|
commission may design and implement a program to improve and |
|
monitor clinical and functional outcomes of a recipient of services |
|
under Medicaid or the state child health plan [or medical
|
|
assistance] program. The program may use financial, clinical, and |
|
other criteria based on pharmacy, medical services, and other |
|
claims data related to Medicaid or the child health plan [or the
|
|
state medical assistance] program. The commission must report to |
|
the committee on the fiscal impact, including any savings |
|
associated with the strategies utilized under this section. |
|
SECTION 2.103. Section 531.068, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.068. MEDICAID OR OTHER HEALTH BENEFIT COVERAGE. |
|
In adopting rules or standards governing [the state] Medicaid |
|
[program] or rules or standards for the development or |
|
implementation of health benefit coverage for a program |
|
administered by the commission or a health and human services |
|
agency, the executive commissioner [commission and each health and
|
|
human services agency, as appropriate,] may take into consideration |
|
any recommendation made with respect to health benefits provided |
|
under [their respective programs or the state] Medicaid or another |
|
of those programs [program] by the Public Assistance Health Benefit |
|
Review and Design Committee established under Section 531.067. |
|
SECTION 2.104. Section 531.0691(a)(1), Government Code, is |
|
amended to read as follows: |
|
(1) "Medicaid Drug Utilization Review Program" means |
|
the program operated by the vendor drug program to improve the |
|
quality of pharmaceutical care under [the] Medicaid [program]. |
|
SECTION 2.105. Section 531.0693(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall monitor and analyze prescription |
|
drug use and expenditure patterns in [the] Medicaid [program]. The |
|
commission shall identify the therapeutic prescription drug |
|
classes and individual prescription drugs that are most often |
|
prescribed to patients or that represent the greatest expenditures. |
|
SECTION 2.106. Section 531.0694, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.0694. PERIOD OF VALIDITY FOR PRESCRIPTION. In the |
|
[its] rules and standards governing the vendor drug program, the |
|
executive commissioner [commission], to the extent allowed by |
|
federal law and laws regulating the writing and dispensing of |
|
prescription medications, shall ensure that a prescription written |
|
by an authorized health care provider under [the] Medicaid |
|
[program] is valid for the lesser of the period for which the |
|
prescription is written or one year. This section does not apply to |
|
a prescription for a controlled substance, as defined by Chapter |
|
481, Health and Safety Code. |
|
SECTION 2.107. Section 531.0697(a), Government Code, is |
|
amended to read as follows: |
|
(a) This section applies to: |
|
(1) the vendor drug program for [the] Medicaid and the |
|
child health plan program [programs]; |
|
(2) the kidney health care program; |
|
(3) the children with special health care needs |
|
program; and |
|
(4) any other state program administered by the |
|
commission that provides prescription drug benefits. |
|
SECTION 2.108. Sections 531.070(b), (c), and (m), |
|
Government Code, are amended to read as follows: |
|
(b) For purposes of this section, the term "supplemental |
|
rebates" means cash rebates paid by a manufacturer to the state on |
|
the basis of appropriate quarterly health and human services |
|
program utilization data relating to the manufacturer's products, |
|
pursuant to a state supplemental rebate agreement negotiated with |
|
the manufacturer and, if necessary, approved by the federal |
|
government under Section 1927 of the federal Social Security Act |
|
(42 U.S.C. Section 1396r-8). |
|
(c) The commission may enter into a written agreement with a |
|
manufacturer to accept certain program benefits in lieu of |
|
supplemental rebates, as defined by this section, only if: |
|
(1) the program benefit yields savings that are at |
|
least equal to the amount the manufacturer would have provided |
|
under a state supplemental rebate agreement during the current |
|
biennium as determined by the written agreement; |
|
(2) the manufacturer posts a performance bond |
|
guaranteeing savings to the state, and agrees that if the savings |
|
are not achieved in accordance with the written agreement, the |
|
manufacturer will forfeit the bond to the state less any savings |
|
that were achieved; and |
|
(3) the program benefit is in addition to other |
|
program benefits currently offered by the manufacturer to |
|
recipients of Medicaid [medical assistance] or related programs. |
|
(m) In negotiating terms for a supplemental rebate, the |
|
commission shall use the average manufacturer price (AMP), as |
|
defined in 42 U.S.C. Section 1396r-8(k)(1) [Section 1396r-8(k)(1)
|
|
of the Omnibus Budget Reconciliation Act of 1990], as the cost basis |
|
for the product. |
|
SECTION 2.109. Section 531.071(a), Government Code, is |
|
amended to read as follows: |
|
(a) Notwithstanding any other state law, information obtained |
|
or maintained by the commission regarding prescription drug rebate |
|
negotiations or a supplemental Medicaid [medical assistance] or other |
|
rebate agreement, including trade secrets, rebate amount, rebate |
|
percentage, and manufacturer or labeler pricing, is confidential and |
|
not subject to disclosure under Chapter 552. |
|
SECTION 2.110. Sections 531.073(a), (a-1), (c), and (d), |
|
Government Code, are amended to read as follows: |
|
(a) The executive commissioner [commission], in the [its] |
|
rules and standards governing the Medicaid vendor drug program and |
|
the child health plan program, shall require prior authorization |
|
for the reimbursement of a drug that is not included in the |
|
appropriate preferred drug list adopted under Section 531.072, |
|
except for any drug exempted from prior authorization requirements |
|
by federal law. The executive commissioner [commission] may |
|
require prior authorization for the reimbursement of a drug |
|
provided through any other state program administered by the |
|
commission or a state health and human services agency, including a |
|
community mental health center and a state mental health hospital |
|
if the commission adopts preferred drug lists under Section 531.072 |
|
that apply to those facilities and the drug is not included in the |
|
appropriate list. The executive commissioner [commission] shall |
|
require that the prior authorization be obtained by the prescribing |
|
physician or prescribing practitioner. |
|
(a-1) Until the commission has completed a study evaluating |
|
the impact of a requirement of prior authorization on recipients of |
|
certain drugs, the executive commissioner [commission] shall delay |
|
requiring prior authorization for drugs that are used to treat |
|
patients with illnesses that: |
|
(1) are life-threatening; |
|
(2) are chronic; and |
|
(3) require complex medical management strategies. |
|
(c) The commission shall ensure that a prescription drug |
|
prescribed before implementation of a prior authorization |
|
requirement for that drug for a recipient under the child health |
|
plan program, [the] Medicaid [program], or another state program |
|
administered by the commission or a health and human services |
|
agency or for a person who becomes eligible under the child health |
|
plan program, [the] Medicaid [program], or another state program |
|
administered by the commission or a health and human services |
|
agency is not subject to any requirement for prior authorization |
|
under this section unless the recipient has exhausted all the |
|
prescription, including any authorized refills, or a period |
|
prescribed by the commission has expired, whichever occurs first. |
|
(d) The commission shall implement procedures to ensure |
|
that a recipient under the child health plan program, [the] |
|
Medicaid [program], or another state program administered by the |
|
commission or a person who becomes eligible under the child health |
|
plan program, [the] Medicaid [program], or another state program |
|
administered by the commission or a health and human services |
|
agency receives continuity of care in relation to certain |
|
prescriptions identified by the commission. |
|
SECTION 2.111. Sections 531.074(b), (c), (f), (i), and |
|
(i-1), Government Code, are amended to read as follows: |
|
(b) The committee consists of the following members |
|
appointed by the governor: |
|
(1) six physicians licensed under Subtitle B, Title 3, |
|
Occupations Code, and participating in [the] Medicaid [program], at |
|
least one of whom is a licensed physician who is actively engaged in |
|
mental health providing care and treatment to persons with severe |
|
mental illness and who has practice experience in the state |
|
Medicaid plan; and |
|
(2) five pharmacists licensed under Subtitle J, Title 3, |
|
Occupations Code, and participating in the Medicaid vendor drug program. |
|
(c) In making appointments to the committee under |
|
Subsection (b), the governor shall ensure that the committee |
|
includes physicians and pharmacists who: |
|
(1) represent different specialties and provide |
|
services to all segments of the [Medicaid program's] diverse |
|
population served by Medicaid; |
|
(2) have experience in either developing or practicing |
|
under a preferred drug list; and |
|
(3) do not have contractual relationships, ownership |
|
interests, or other conflicts of interest with a pharmaceutical |
|
manufacturer or labeler or with an entity engaged by the commission |
|
to assist in the development of the preferred drug lists or the |
|
administration of the prior authorization system. |
|
(f) The [committee shall meet at least monthly during the
|
|
six-month period following establishment of the committee to enable
|
|
the committee to develop recommendations for the initial preferred
|
|
drug lists. After that period, the] committee shall meet at least |
|
quarterly and at other times at the call of the presiding officer or |
|
a majority of the committee members. |
|
(i) The executive commissioner [commission] shall adopt |
|
rules governing the operation of the committee, including rules |
|
governing the procedures used by the committee for providing notice |
|
of a meeting and rules prohibiting the committee from discussing |
|
confidential information described by Section 531.071 in a public |
|
meeting. The committee shall comply with the rules adopted under |
|
this subsection and Subsection (i-1). |
|
(i-1) In addition to the rules under Subsection (i), the |
|
executive commissioner [commission] by rule shall require the |
|
committee or the committee's designee to present a summary of any |
|
clinical efficacy and safety information or analyses regarding a |
|
drug under consideration for a preferred drug list that is provided |
|
to the committee by a private entity that has contracted with the |
|
commission to provide the information. The committee or the |
|
committee's designee shall provide the summary in electronic form |
|
before the public meeting at which consideration of the drug |
|
occurs. Confidential information described by Section 531.071 |
|
must be omitted from the summary. The summary must be posted on the |
|
commission's Internet website. |
|
SECTION 2.112. The heading to Section 531.077, Government |
|
Code, is amended to read as follows: |
|
Sec. 531.077. RECOVERY OF CERTAIN [MEDICAL] ASSISTANCE. |
|
SECTION 2.113. Section 531.077(a), Government Code, is |
|
amended to read as follows: |
|
(a) The executive commissioner shall ensure that [the state] |
|
Medicaid [program] implements 42 U.S.C. Section 1396p(b)(1). |
|
SECTION 2.114. Section 531.078(a), Government Code, is |
|
amended to read as follows: |
|
(a) In this section, "gross receipts" means money received as |
|
compensation for services under an intermediate care facility |
|
[facilities] for individuals with an intellectual disability [the
|
|
mentally retarded] waiver program such as a home and community ] waiver program such as a home and community |
|
services waiver or a community living assistance and support services |
|
waiver. The term does not include a charitable contribution, revenues |
|
received for services or goods other than waivers, or any money |
|
received from consumers or their families as reimbursement for |
|
services or goods not normally covered by the waivers. |
|
SECTION 2.115. Section 531.079, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.079. WAIVER PROGRAM QUALITY ASSURANCE FEE ACCOUNT. |
|
(a) The waiver program quality assurance fee account is a dedicated |
|
account in the general revenue fund. The account is exempt from the |
|
application of Section 403.095. [Interest earned on money in the
|
|
account shall be credited to the account.] |
|
(b) The account consists of fees collected under Section |
|
531.078 [and interest earned on money in the account]. |
|
(c) Subject to legislative appropriation and state and |
|
federal law, money in the account may be appropriated only to the |
|
Department of Aging and Disability Services to increase |
|
reimbursement rates paid under the home and community services |
|
waiver program or the community living assistance and support |
|
services waiver program or to offset allowable expenses under [the
|
|
state] Medicaid [program]. |
|
SECTION 2.116. Section 531.081, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.081. INVALIDITY; FEDERAL FUNDS. If any portion of |
|
Sections 531.078-531.080 is held invalid by a final order of a court |
|
that is not subject to appeal, or if the commission determines that |
|
the imposition of the quality assurance fee and the expenditure of |
|
the money collected as provided by those sections will not entitle |
|
this state to receive additional federal money under [the] Medicaid |
|
[program], the commission shall: |
|
(1) stop collection of the quality assurance fee; and |
|
(2) not later than the 30th day after the date the |
|
collection of the quality assurance fee is stopped, return any |
|
money collected under Section 531.078, but not spent under Section |
|
531.080, to the persons who paid the fees in proportion to the total |
|
amount paid by those persons. |
|
SECTION 2.117. Section 531.084(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall make every effort to achieve cost |
|
efficiencies within the Medicaid long-term care program. To |
|
achieve those efficiencies, the commission shall: |
|
(1) establish a fee schedule for reimbursable incurred |
|
medical expenses for dental services controlled in long-term care |
|
facilities; |
|
(2) implement a fee schedule for reimbursable incurred |
|
medical expenses for durable medical equipment in nursing |
|
facilities and ICF-IID [ICF-MR] facilities; |
|
(3) implement a durable medical equipment fee schedule |
|
action plan; |
|
(4) establish a system for private contractors to |
|
secure and coordinate the collection of Medicare funds for |
|
recipients who are dually eligible for Medicare and Medicaid; |
|
(5) create additional partnerships with |
|
pharmaceutical companies to obtain discounted prescription drugs |
|
for Medicaid recipients; and |
|
(6) develop and implement a system for auditing the |
|
Medicaid hospice care system that provides services in long-term |
|
care facilities to ensure correct billing for pharmaceuticals. |
|
SECTION 2.118. Section 531.085, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.085. HOSPITAL EMERGENCY ROOM USE REDUCTION |
|
INITIATIVES. The commission shall develop and implement a |
|
comprehensive plan to reduce the use of hospital emergency room |
|
services by recipients under Medicaid [the medical assistance
|
|
program]. The plan may include: |
|
(1) a pilot program designed to facilitate program |
|
participants in accessing an appropriate level of health care, |
|
which may include as components: |
|
(A) providing program participants access to |
|
bilingual health services providers; and |
|
(B) giving program participants information on |
|
how to access primary care physicians, advanced practice registered |
|
nurses, and local health clinics; |
|
(2) a pilot program under which health care providers, |
|
other than hospitals, are given financial incentives for treating |
|
recipients outside of normal business hours to divert those |
|
recipients from hospital emergency rooms; |
|
(3) payment of a nominal referral fee to hospital |
|
emergency rooms that perform an initial medical evaluation of a |
|
recipient and subsequently refer the recipient, if medically |
|
stable, to an appropriate level of health care, such as care |
|
provided by a primary care physician, advanced practice registered |
|
nurse, or local clinic; |
|
(4) a program under which the commission or a managed |
|
care organization that enters into a contract with the commission |
|
under Chapter 533 contacts, by telephone or mail, a recipient who |
|
accesses a hospital emergency room three times during a six-month |
|
period and provides the recipient with information on ways the |
|
recipient may secure a medical home to avoid unnecessary treatment |
|
at hospital emergency rooms; |
|
(5) a health care literacy program under which the |
|
commission develops partnerships with other state agencies and |
|
private entities to: |
|
(A) assist the commission in developing |
|
materials that: |
|
(i) contain basic health care information |
|
for parents of young children who are recipients under Medicaid |
|
[the medical assistance program] and who are participating in |
|
public or private child-care or prekindergarten programs, |
|
including federal Head Start programs; and |
|
(ii) are written in a language |
|
understandable to those parents and specifically tailored to be |
|
applicable to the needs of those parents; |
|
(B) distribute the materials developed under |
|
Paragraph (A) to those parents; and |
|
(C) otherwise teach those parents about the health |
|
care needs of their children and ways to address those needs; and |
|
(6) other initiatives developed and implemented in |
|
other states that have shown success in reducing the incidence of |
|
unnecessary treatment in hospital emergency rooms. |
|
SECTION 2.119. Sections 531.0861(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) If cost-effective, the executive commissioner by rule |
|
shall establish a physician incentive program designed to reduce |
|
the use of hospital emergency room services for non-emergent |
|
conditions by recipients under Medicaid [the medical assistance
|
|
program]. |
|
(b) In establishing the physician incentive program under |
|
Subsection (a), the executive commissioner may include only the |
|
program components identified as cost-effective in the study |
|
conducted under former Section 531.086. |
|
SECTION 2.120. Section 531.087(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall ensure that educational materials |
|
relating to the federal earned income tax credit are provided in |
|
accordance with this section to each person receiving assistance or |
|
benefits under: |
|
(1) the child health plan program; |
|
(2) the financial assistance program under Chapter 31, |
|
Human Resources Code; |
|
(3) Medicaid [the medical assistance program under
|
|
Chapter 32, Human Resources Code]; |
|
(4) the supplemental nutrition assistance [food
|
|
stamp] program under Chapter 33, Human Resources Code; or |
|
(5) another appropriate health and human services |
|
program. |
|
SECTION 2.121. Section 531.089(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner [of the Health and Human
|
|
Services Commission] may adopt rules as necessary to implement this |
|
section. |
|
SECTION 2.122. Section 531.090(a), Government Code, is |
|
amended to read as follows: |
|
(a) Subject to Subsection (b), the commission and each |
|
health and human services agency authorized by the executive |
|
commissioner may enter into an agreement with one or more other |
|
states for the joint bulk purchasing of prescription drugs and |
|
other medications to be used in [the] Medicaid [program], the state |
|
child health plan, or another program under the authority of the |
|
commission. |
|
SECTION 2.123. Section 531.091(b), Government Code, is |
|
amended to read as follows: |
|
(b) The method may: |
|
(1) provide for the use of a single integrated |
|
benefits issuance card or multiple cards capable of integrating |
|
benefits issuance or other program functions; |
|
(2) incorporate a fingerprint image identifier to |
|
enable personal identity verification at a point of service and |
|
reduce fraud [as permitted by Section 531.1063]; |
|
(3) enable immediate electronic verification of |
|
recipient eligibility; and |
|
(4) replace multiple forms, cards, or other methods |
|
used for fraud reduction or provision of health and human services |
|
benefits, including: |
|
(A) electronic benefits transfer cards; and |
|
(B) smart cards used in [the] Medicaid [program]. |
|
SECTION 2.124. Section 531.097, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.097. TAILORED BENEFIT PACKAGES FOR CERTAIN |
|
CATEGORIES OF THE MEDICAID POPULATION. (a) The executive |
|
commissioner may seek a waiver under Section 1115 of the federal |
|
Social Security Act (42 U.S.C. Section 1315) to develop and, |
|
subject to Subsection (c), implement tailored benefit packages |
|
designed to: |
|
(1) provide Medicaid benefits that are customized to |
|
meet the health care needs of recipients within defined categories |
|
of the Medicaid population through a defined system of care; |
|
(2) improve health outcomes for those recipients; |
|
(3) improve those recipients' access to services; |
|
(4) achieve cost containment and efficiency; and |
|
(5) reduce the administrative complexity of |
|
delivering Medicaid benefits. |
|
(b) The commission: |
|
(1) shall develop a tailored benefit package that is |
|
customized to meet the health care needs of Medicaid recipients who |
|
are children with special health care needs, subject to approval of |
|
the waiver described by Subsection (a); and |
|
(2) may develop tailored benefit packages that are |
|
customized to meet the health care needs of other categories of |
|
Medicaid recipients. |
|
(c) If the commission develops tailored benefit packages |
|
under Subsection (b)(2), the commission shall submit a report to |
|
the standing committees of the senate and house of representatives |
|
having primary jurisdiction over [the] Medicaid [program] that |
|
specifies, in detail, the categories of Medicaid recipients to |
|
which each of those packages will apply and the services available |
|
under each package. [The commission may not implement a package
|
|
developed under Subsection (b)(2) before September 1, 2009.] |
|
(d) Except as otherwise provided by this section and subject |
|
to the terms of the waiver authorized by this section, the |
|
commission has broad discretion to develop the tailored benefit |
|
packages under this section and determine the respective categories |
|
of Medicaid recipients to which the packages apply in a manner that |
|
preserves recipients' access to necessary services and is |
|
consistent with federal requirements. |
|
(e) Each tailored benefit package developed under this |
|
section must include: |
|
(1) a basic set of benefits that are provided under all |
|
tailored benefit packages; and |
|
(2) to the extent applicable to the category of |
|
Medicaid recipients to which the package applies: |
|
(A) a set of benefits customized to meet the |
|
health care needs of recipients in that category; and |
|
(B) services to integrate the management of a |
|
recipient's acute and long-term care needs, to the extent feasible. |
|
(f) In addition to the benefits required by Subsection (e), |
|
a tailored benefit package developed under this section that |
|
applies to Medicaid recipients who are children must provide at |
|
least the services required by federal law under the early and |
|
periodic screening, diagnosis, and treatment program. |
|
(g) A tailored benefit package developed under this section |
|
may include any service available under the state Medicaid plan or |
|
under any federal Medicaid waiver, including any preventive health |
|
or wellness service. |
|
(g-1) A tailored benefit package developed under this |
|
section must increase the state's flexibility with respect to the |
|
state's use of Medicaid funding and may not reduce the benefits |
|
available under the Medicaid state plan to any Medicaid recipient |
|
population. |
|
(h) In developing the tailored benefit packages, the |
|
commission shall consider similar benefit packages established in |
|
other states as a guide. |
|
(i) The executive commissioner, by rule, shall define each |
|
category of recipients to which a tailored benefit package applies |
|
and a mechanism for appropriately placing recipients in specific |
|
categories. Recipient categories must include children with |
|
special health care needs and may include: |
|
(1) persons with disabilities or special health needs; |
|
(2) elderly persons; |
|
(3) children without special health care needs; and |
|
(4) working-age parents and caretaker relatives. |
|
[(j)
This section does not apply to a tailored benefit
|
|
package or similar package of benefits if, before September 1,
|
|
2007:
|
|
[(1)
a federal waiver was requested to implement the
|
|
package of benefits;
|
|
[(2)
the package of benefits is being developed, as
|
|
directed by the legislature; or
|
|
[(3) the package of benefits has been implemented.] |
|
SECTION 2.125. Sections 531.099(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall review forms and requirements |
|
under [the] Medicaid [program] regarding written orders for |
|
diabetic equipment and supplies to identify variations between |
|
permissible ordering procedures under that program and ordering |
|
procedures available to providers under the Medicare program. |
|
(b) To the extent practicable, and in conformity with |
|
Chapter 157, Occupations Code, and Chapter 483, Health and Safety |
|
Code, after conducting a review under Subsection (a) the commission |
|
or executive commissioner, as appropriate, shall modify only forms, |
|
rules, and procedures applicable to orders for diabetic equipment |
|
and supplies under [the] Medicaid [program] to provide for an |
|
ordering system that is comparable to the ordering system for |
|
diabetic equipment and supplies under the Medicare program. The |
|
ordering system must permit a diabetic equipment or supplies |
|
supplier to complete the forms by hand or to enter by electronic |
|
format medical information or supply orders into any form as |
|
necessary to provide the information required to dispense diabetic |
|
equipment or supplies. |
|
SECTION 2.126. Section 531.0995(a), Government Code, is |
|
amended to read as follows: |
|
(a) This section applies to individuals receiving benefits |
|
under: |
|
(1) the financial assistance program under Chapter 31, |
|
Human Resources Code; |
|
(2) Medicaid [the medical assistance program under
|
|
Chapter 32, Human Resources Code]; or |
|
(3) the supplemental nutrition assistance program |
|
under Chapter 33, Human Resources Code. |
|
SECTION 2.127. Section 531.0996(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall develop and implement a pilot |
|
program in Harris County to create pregnancy medical homes that |
|
provide coordinated evidence-based maternity care management to |
|
women who reside in the pilot program area and are recipients of |
|
Medicaid [medical assistance] through a Medicaid managed care model |
|
or arrangement under Chapter 533. |
|
SECTION 2.128. Section 531.0998(e), Government Code, is |
|
amended to read as follows: |
|
(e) Not later than October 1 of each year, the commission, |
|
the Texas Veterans Commission, the Veterans' Land Board, and the |
|
Department of Aging and Disability Services collectively shall |
|
submit to the legislature, the governor, and the Legislative Budget |
|
Board a report describing: |
|
(1) interagency progress in identifying and obtaining |
|
United States Department of Veterans Affairs benefits for veterans |
|
receiving Medicaid and other public benefit programs; |
|
(2) the number of veterans benefits claims awarded, |
|
the total dollar amount of veterans benefits claims awarded, and |
|
the costs to the state that were avoided as a result of state |
|
agencies' use of the system; |
|
(3) efforts to expand the use of the system and improve |
|
the effectiveness of shifting veterans from Medicaid and other |
|
public benefits to United States Department of Veterans Affairs |
|
benefits, including any barriers and how state agencies have |
|
addressed those barriers; and |
|
(4) the extent to which the Texas Veterans Commission |
|
has targeted specific populations of veterans, including |
|
populations in rural counties and in specific age and |
|
service-connected disability categories, in order to maximize |
|
benefits for veterans and savings to the state. |
|
SECTION 2.129. Sections 531.101(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission may grant an award to an individual who |
|
reports activity that constitutes fraud or abuse of funds in [the
|
|
state] Medicaid [program] or reports overcharges in Medicaid [the
|
|
program] if the commission determines that the disclosure results |
|
in the recovery of an administrative penalty imposed under Section |
|
32.039, Human Resources Code. The commission may not grant an award |
|
to an individual in connection with a report if the commission or |
|
attorney general had independent knowledge of the activity reported |
|
by the individual. |
|
(b) The commission shall determine the amount of an award. |
|
The award may not exceed five percent of the amount of the |
|
administrative penalty imposed under Section 32.039, Human |
|
Resources Code, that resulted from the individual's disclosure. In |
|
determining the amount of the award, the commission shall consider |
|
how important the disclosure is in ensuring the fiscal integrity of |
|
Medicaid [the program]. The commission may also consider whether |
|
the individual participated in the fraud, abuse, or overcharge. |
|
SECTION 2.130. Sections 531.1011(1), (6), (9), and (10), |
|
Government Code, are amended to read as follows: |
|
(1) "Abuse" means: |
|
(A) a practice by a provider that is inconsistent |
|
with sound fiscal, business, or medical practices and that results |
|
in: |
|
(i) an unnecessary cost to [the] Medicaid |
|
[program]; or |
|
(ii) the reimbursement of services that are |
|
not medically necessary or that fail to meet professionally |
|
recognized standards for health care; or |
|
(B) a practice by a recipient that results in an |
|
unnecessary cost to [the] Medicaid [program]. |
|
(6) "Payment hold" means the temporary denial of |
|
reimbursement under [the] Medicaid [program] for items or services |
|
furnished by a specified provider. |
|
(9) "Program exclusion" means the suspension of a |
|
provider from being authorized under [the] Medicaid [program] to |
|
request reimbursement of items or services furnished by that |
|
specific provider. |
|
(10) "Provider" means a person, firm, partnership, |
|
corporation, agency, association, institution, or other entity |
|
that was or is approved by the commission to: |
|
(A) provide Medicaid services [medical
|
|
assistance] under a contract or provider agreement with the |
|
commission; or |
|
(B) provide third-party billing vendor services |
|
under a contract or provider agreement with the commission. |
|
SECTION 2.131. Sections 531.102(e), (f), (m), and (n), |
|
Government Code, are amended to read as follows: |
|
(e) The executive commissioner [commission], in |
|
consultation with the inspector general, by rule shall set specific |
|
claims criteria that, when met, require the office to begin an |
|
investigation. |
|
(f)(1) If the commission receives a complaint or allegation |
|
of Medicaid fraud or abuse from any source, the office must conduct |
|
a preliminary investigation as provided by Section 531.118(c) to |
|
determine whether there is a sufficient basis to warrant a full |
|
investigation. A preliminary investigation must begin not later |
|
than the 30th day after the date the commission receives a complaint |
|
or allegation or has reason to believe that fraud or abuse has |
|
occurred. A preliminary investigation shall be completed not later |
|
than the 90th day after it began. |
|
(2) If the findings of a preliminary investigation |
|
give the office reason to believe that an incident of fraud or abuse |
|
involving possible criminal conduct has occurred in [the] Medicaid |
|
[program], the office must take the following action, as |
|
appropriate, not later than the 30th day after the completion of the |
|
preliminary investigation: |
|
(A) if a provider is suspected of fraud or abuse |
|
involving criminal conduct, the office must refer the case to the |
|
state's Medicaid fraud control unit, provided that the criminal |
|
referral does not preclude the office from continuing its |
|
investigation of the provider, which investigation may lead to the |
|
imposition of appropriate administrative or civil sanctions; or |
|
(B) if there is reason to believe that a |
|
recipient has defrauded [the] Medicaid [program], the office may |
|
conduct a full investigation of the suspected fraud, subject to |
|
Section 531.118(c). |
|
(m) The office shall employ a dental director who is a |
|
licensed dentist under Subtitle D, Title 3, Occupations Code, and |
|
the rules adopted under that subtitle by the State Board of Dental |
|
Examiners, and who preferably has significant knowledge of [the] |
|
Medicaid [program]. The dental director shall ensure that any |
|
investigative findings based on the necessity of dental services or |
|
the quality of dental care have been reviewed by a qualified expert |
|
as described by the Texas Rules of Evidence before the office |
|
imposes a payment hold or seeks recoupment of an overpayment, |
|
damages, or penalties. |
|
(n) To the extent permitted under federal law, the executive |
|
commissioner, on behalf of the office, [acting through the
|
|
commission,] shall adopt rules establishing the criteria for |
|
initiating a full-scale fraud or abuse investigation, conducting |
|
the investigation, collecting evidence, accepting and approving a |
|
provider's request to post a surety bond to secure potential |
|
recoupments in lieu of a payment hold or other asset or payment |
|
guarantee, and establishing minimum training requirements for |
|
Medicaid provider fraud or abuse investigators. |
|
SECTION 2.132. Section 531.102(l), Government Code, as |
|
added by Chapter 622 (S.B. 1803), Acts of the 83rd Legislature, |
|
Regular Session, 2013, is amended to read as follows: |
|
(l) The office shall employ a medical director who is a |
|
licensed physician under Subtitle B, Title 3, Occupations Code, and |
|
the rules adopted under that subtitle by the Texas Medical Board, |
|
and who preferably has significant knowledge of [the] Medicaid |
|
[program]. The medical director shall ensure that any |
|
investigative findings based on medical necessity or the quality of |
|
medical care have been reviewed by a qualified expert as described |
|
by the Texas Rules of Evidence before the office imposes a payment |
|
hold or seeks recoupment of an overpayment, damages, or penalties. |
|
SECTION 2.133. Subsection (l), Section 531.102, Government |
|
Code, as added by Chapter 1311 (S.B. 8), Acts of the 83rd |
|
Legislature, Regular Session, 2013, is redesignated as Subsection |
|
(o), Section 531.102, Government Code, to read as follows: |
|
(o) [(l)] Nothing in this section limits the authority of |
|
any other state agency or governmental entity. |
|
SECTION 2.134. Section 531.1021(a), Government Code, is |
|
amended to read as follows: |
|
(a) The office of inspector general may request that the |
|
executive commissioner or the executive commissioner's designee |
|
approve the issuance by the office of a subpoena in connection with |
|
an investigation conducted by the office. If the request is |
|
approved, the office may issue a subpoena to compel the attendance |
|
of a relevant witness or the production, for inspection or copying, |
|
of relevant evidence that is in this state. |
|
SECTION 2.135. Section 531.1022(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission's office of inspector general shall |
|
employ and commission not more than five peace officers at any given |
|
time for the purpose of assisting the office in carrying out the |
|
duties of the office relating to the investigation of fraud, waste, |
|
and abuse in [the] Medicaid [program]. |
|
SECTION 2.136. Sections 531.103(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) The commission, acting through the commission's office |
|
of inspector general, and the office of the attorney general shall |
|
enter into a memorandum of understanding to develop and implement |
|
joint written procedures for processing cases of suspected fraud, |
|
waste, or abuse, as those terms are defined by state or federal law, |
|
or other violations of state or federal law under [the state] |
|
Medicaid [program] or another [other] program administered by the |
|
commission or a health and human services agency, including the |
|
financial assistance program under Chapter 31, Human Resources |
|
Code, the supplemental nutrition [a nutritional] assistance |
|
program under Chapter 33, Human Resources Code, and the child |
|
health plan program. The memorandum of understanding shall |
|
require: |
|
(1) the office of inspector general and the office of |
|
the attorney general to set priorities and guidelines for referring |
|
cases to appropriate state agencies for investigation, |
|
prosecution, or other disposition to enhance deterrence of fraud, |
|
waste, abuse, or other violations of state or federal law, |
|
including a violation of Chapter 102, Occupations Code, in the |
|
programs and maximize the imposition of penalties, the recovery of |
|
money, and the successful prosecution of cases; |
|
(1-a) the office of inspector general to refer each |
|
case of suspected provider fraud, waste, or abuse to the office of |
|
the attorney general not later than the 20th business day after the |
|
date the office of inspector general determines that the existence |
|
of fraud, waste, or abuse is reasonably indicated; |
|
(1-b) the office of the attorney general to take |
|
appropriate action in response to each case referred to the |
|
attorney general, which action may include direct initiation of |
|
prosecution, with the consent of the appropriate local district or |
|
county attorney, direct initiation of civil litigation, referral to |
|
an appropriate United States attorney, a district attorney, or a |
|
county attorney, or referral to a collections agency for initiation |
|
of civil litigation or other appropriate action; |
|
(2) the office of inspector general to keep detailed |
|
records for cases processed by that office or the office of the |
|
attorney general, including information on the total number of |
|
cases processed and, for each case: |
|
(A) the agency and division to which the case is |
|
referred for investigation; |
|
(B) the date on which the case is referred; and |
|
(C) the nature of the suspected fraud, waste, or |
|
abuse; |
|
(3) the office of inspector general to notify each |
|
appropriate division of the office of the attorney general of each |
|
case referred by the office of inspector general; |
|
(4) the office of the attorney general to ensure that |
|
information relating to each case investigated by that office is |
|
available to each division of the office with responsibility for |
|
investigating suspected fraud, waste, or abuse; |
|
(5) the office of the attorney general to notify the |
|
office of inspector general of each case the attorney general |
|
declines to prosecute or prosecutes unsuccessfully; |
|
(6) representatives of the office of inspector general |
|
and of the office of the attorney general to meet not less than |
|
quarterly to share case information and determine the appropriate |
|
agency and division to investigate each case; and |
|
(7) the office of inspector general and the office of |
|
the attorney general to submit information requested by the |
|
comptroller about each resolved case for the comptroller's use in |
|
improving fraud detection. |
|
(c) The commission and the office of the attorney general |
|
shall jointly prepare and submit an annual report to the governor, |
|
lieutenant governor, and speaker of the house of representatives |
|
concerning the activities of those agencies in detecting and |
|
preventing fraud, waste, and abuse under [the state] Medicaid |
|
[program] or another [other] program administered by the commission |
|
or a health and human services agency. The report may be |
|
consolidated with any other report relating to the same subject |
|
matter the commission or office of the attorney general is required |
|
to submit under other law. |
|
SECTION 2.137. Section 531.1031(a)(2), Government Code, is |
|
amended to read as follows: |
|
(2) "Participating agency" means: |
|
(A) the Medicaid fraud enforcement divisions of |
|
the office of the attorney general; |
|
(B) each board or agency with authority to |
|
license, register, regulate, or certify a health care professional |
|
or managed care organization that may participate in [the state] |
|
Medicaid [program]; and |
|
(C) the commission's office of inspector |
|
general. |
|
SECTION 2.138. Section 531.1031(b), Government Code, is |
|
amended to read as follows: |
|
(b) This section applies only to criminal history record |
|
information held by a participating agency that relates to a health |
|
care professional and information held by a participating agency |
|
that relates to a health care professional or managed care |
|
organization that is the subject of an investigation by a |
|
participating agency for alleged fraud or abuse under [the state] |
|
Medicaid [program]. |
|
SECTION 2.139. Section 531.105, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.105. FRAUD DETECTION TRAINING. (a) The |
|
commission shall develop and implement a program to provide annual |
|
training to contractors who process Medicaid claims and to |
|
appropriate staff of the health and human services agencies [Texas
|
|
Department of Health and the Texas Department of Human Services] in |
|
identifying potential cases of fraud, waste, or abuse under [the
|
|
state] Medicaid [program]. The training provided to the |
|
contractors and staff must include clear criteria that specify: |
|
(1) the circumstances under which a person should |
|
refer a potential case to the commission; and |
|
(2) the time by which a referral should be made. |
|
(b) The health and human services agencies [Texas
|
|
Department of Health and the Texas Department of Human Services], |
|
in cooperation with the commission, shall periodically set a goal |
|
of the number of potential cases of fraud, waste, or abuse under |
|
[the state] Medicaid [program] that each agency will attempt to |
|
identify and refer to the commission. The commission shall include |
|
information on the agencies' goals and the success of each agency in |
|
meeting the agency's goal in the report required by Section |
|
531.103(c). |
|
SECTION 2.140. Sections 531.106(a), (d), (f), and (g), |
|
Government Code, are amended to read as follows: |
|
(a) The commission shall use learning or neural network |
|
technology to identify and deter fraud in [the] Medicaid [program] |
|
throughout this state. |
|
(d) The commission shall require each health and human |
|
services agency that performs any aspect of [the state] Medicaid |
|
[program] to participate in the implementation and use of the |
|
technology. |
|
(f) The commission shall refer cases identified by the |
|
technology to the commission's office of inspector general |
|
[investigations and enforcement] or the office of the attorney |
|
general, as appropriate. |
|
(g) Each month, the learning or neural network technology |
|
implemented under this section must match [bureau of] vital |
|
statistics unit death records with Medicaid claims filed by a |
|
provider. If the commission determines that a provider has filed a |
|
claim for services provided to a person after the person's date of |
|
death, as determined by the [bureau of] vital statistics unit death |
|
records, the commission shall refer the case for investigation to |
|
the commission's office of inspector general [investigations and
|
|
enforcement]. |
|
SECTION 2.141. Sections 531.1061(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall use an automated fraud |
|
investigation tracking system through the commission's office of |
|
inspector general [investigations and enforcement] to monitor the |
|
progress of an investigation of suspected fraud, abuse, or |
|
insufficient quality of care under [the state] Medicaid [program]. |
|
(c) The commission shall require each health and human |
|
services agency that performs any aspect of [the state] Medicaid |
|
[program] to participate in the implementation and use of the |
|
automated fraud investigation tracking system. |
|
SECTION 2.142. Section 531.1062(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall use an automated recovery |
|
monitoring system to monitor the collections process for a settled |
|
case of fraud, abuse, or insufficient quality of care under [the
|
|
state] Medicaid [program]. |
|
SECTION 2.143. Sections 531.107(a), (b), and (f), |
|
Government Code, are amended to read as follows: |
|
(a) The Medicaid and Public Assistance Fraud Oversight Task |
|
Force advises and assists the commission and the commission's |
|
office of inspector general [investigations and enforcement] in |
|
improving the efficiency of fraud investigations and collections. |
|
(b) The task force is composed of a representative of the: |
|
(1) attorney general's office, appointed by the |
|
attorney general; |
|
(2) comptroller's office, appointed by the |
|
comptroller; |
|
(3) Department of Public Safety, appointed by the |
|
public safety director; |
|
(4) state auditor's office, appointed by the state |
|
auditor; |
|
(5) commission, appointed by the executive |
|
commissioner [of health and human services]; |
|
(6) [Texas] Department of Aging and Disability [Human] |
|
Services, appointed by the commissioner of aging and disability |
|
[human] services; |
|
(7) Texas Department of Insurance, appointed by the |
|
commissioner of insurance; [and] |
|
(8) [Texas] Department of State Health Services, |
|
appointed by the commissioner of state [public] health services; |
|
and |
|
(9) commission's office of inspector general, |
|
appointed by the executive commissioner. |
|
(f) At least once each fiscal quarter, the commission's |
|
office of inspector general [investigations and enforcement] shall |
|
provide to the task force: |
|
(1) information detailing: |
|
(A) the number of fraud referrals made to the |
|
office and the origin of each referral; |
|
(B) the time spent investigating each case; |
|
(C) the number of cases investigated each month, |
|
by program and region; |
|
(D) the dollar value of each fraud case that |
|
results in a criminal conviction; and |
|
(E) the number of cases the office rejects and |
|
the reason for rejection, by region; and |
|
(2) any additional information the task force |
|
requires. |
|
SECTION 2.144. Sections 531.108(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission's office of inspector general |
|
[investigations and enforcement] shall compile and disseminate |
|
accurate information and statistics relating to: |
|
(1) fraud prevention; and |
|
(2) post-fraud referrals received and accepted or |
|
rejected from the commission's case management system or the case |
|
management system of a health and human services agency. |
|
(b) The commission shall: |
|
(1) aggressively publicize successful fraud |
|
prosecutions and fraud-prevention programs through all available |
|
means, including the use of statewide press releases [issued in
|
|
coordination with the Texas Department of Human Services]; and |
|
(2) ensure that a toll-free hotline for reporting |
|
suspected fraud in programs administered by the commission or a |
|
health and human services agency is maintained and promoted, either |
|
by the commission or by a health and human services agency. |
|
SECTION 2.145. Section 531.109(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall annually select and review a |
|
random, statistically valid sample of all claims for reimbursement |
|
under [the state] Medicaid [program], including under the vendor |
|
drug program, for potential cases of fraud, waste, or abuse. |
|
SECTION 2.146. Sections 531.110(a), (b), (c), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The commission shall conduct electronic data matches |
|
for a Medicaid recipient [of assistance under the state Medicaid
|
|
program] at least quarterly to verify the identity, income, |
|
employment status, and other factors that affect the eligibility of |
|
the recipient. |
|
(b) To verify eligibility of a recipient for [assistance
|
|
under the state] Medicaid [program], the electronic data matching |
|
must match information provided by the recipient with information |
|
contained in databases maintained by appropriate federal and state |
|
agencies. |
|
(c) The health and human services agencies [Texas
|
|
Department of Human Services] shall cooperate with the commission |
|
by providing data or any other assistance necessary to conduct the |
|
electronic data matches required by this section. |
|
(e) The executive commissioner shall establish procedures |
|
by which the commission, or a health and human services agency |
|
designated by the commission, verifies [by rule shall establish
|
|
procedures to verify] the electronic data matches conducted by the |
|
commission under this section. Not later than the 20th day after |
|
the date the electronic data match is verified, the commission |
|
[Texas Department of Human Services] shall remove from eligibility |
|
a recipient who is determined to be ineligible for [assistance
|
|
under the state] Medicaid [program]. |
|
SECTION 2.147. Section 531.111, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.111. FRAUD DETECTION TECHNOLOGY. The commission |
|
may contract with a contractor who specializes in developing |
|
technology capable of identifying patterns of fraud exhibited by |
|
Medicaid recipients to: |
|
(1) develop and implement the fraud detection |
|
technology; and |
|
(2) determine if a pattern of fraud by Medicaid |
|
recipients is present in the recipients' eligibility files |
|
maintained by the commission [Texas Department of Human Services]. |
|
SECTION 2.148. Section 531.1112(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission and the commission's office of inspector |
|
general shall jointly study the feasibility of increasing the use |
|
of technology to strengthen the detection and deterrence of fraud |
|
in [the state] Medicaid [program]. The study must include the |
|
determination of the feasibility of using technology to verify a |
|
person's citizenship and eligibility for coverage. |
|
SECTION 2.149. Section 531.112(a)(1), Government Code, is |
|
amended to read as follows: |
|
(1) "Chemical dependency" has the meaning assigned by |
|
Section 461A.002 [461.002], Health and Safety Code. |
|
SECTION 2.150. Section 531.112(b), Government Code, is |
|
amended to read as follows: |
|
(b) Following the final conviction of a chemical dependency |
|
treatment provider for an offense, an element of which involves |
|
submitting a fraudulent claim for reimbursement for services under |
|
[the state] Medicaid [program], the commission or other health and |
|
human services agency that operates a portion of [the state] |
|
Medicaid [program] shall expunge or provide for the expunction of a |
|
diagnosis of chemical dependency in a child that has been made by |
|
the treatment provider and entered in any: |
|
(1) appropriate official record of the commission or |
|
agency; |
|
(2) applicable medical record that is in the |
|
commission's or agency's custody; and |
|
(3) applicable record of a company that the commission |
|
contracts with for the processing and payment of claims under [the
|
|
state] Medicaid [program]. |
|
SECTION 2.151. Sections 531.113(a) and (e), Government |
|
Code, are amended to read as follows: |
|
(a) Each managed care organization that provides or |
|
arranges for the provision of health care services to an individual |
|
under a government-funded program, including [the] Medicaid |
|
[program] and the child health plan program, shall: |
|
(1) establish and maintain a special investigative |
|
unit within the managed care organization to investigate fraudulent |
|
claims and other types of program abuse by recipients and service |
|
providers; or |
|
(2) contract with another entity for the investigation |
|
of fraudulent claims and other types of program abuse by recipients |
|
and service providers. |
|
(e) The executive commissioner shall adopt rules as |
|
necessary to accomplish the purposes of this section. |
|
SECTION 2.152. Section 531.1131(a), Government Code, is |
|
amended to read as follows: |
|
(a) If a managed care organization's special investigative |
|
unit under Section 531.113(a)(1) or the entity with which the |
|
managed care organization contracts under Section 531.113(a)(2) |
|
discovers fraud or abuse in [the] Medicaid [program] or the child |
|
health plan program, the unit or entity shall: |
|
(1) immediately and contemporaneously notify the |
|
commission's office of inspector general and the office of the |
|
attorney general; |
|
(2) subject to Subsection (b), begin payment recovery |
|
efforts; and |
|
(3) ensure that any payment recovery efforts in which |
|
the organization engages are in accordance with applicable rules |
|
adopted by the executive commissioner. |
|
SECTION 2.153. Section 531.114(g), Government Code, is |
|
amended to read as follows: |
|
(g) The executive commissioner [commission] shall adopt |
|
rules as necessary to implement this section. |
|
SECTION 2.154. Section 531.116, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.116. COMPLIANCE WITH LAW PROHIBITING |
|
SOLICITATION. A provider who furnishes services under [the] |
|
Medicaid [program] or the child health plan program is subject to |
|
Chapter 102, Occupations Code, and the provider's compliance with |
|
that chapter is a condition of the provider's eligibility to |
|
participate as a provider under those programs. |
|
SECTION 2.155. Section 531.117, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.117. RECOVERY AUDIT CONTRACTORS. To the extent |
|
required under Section 1902(a)(42), Social Security Act (42 U.S.C. |
|
Section 1396a(a)(42)), the commission shall establish a program |
|
under which the commission contracts with one or more recovery |
|
audit contractors for purposes of identifying underpayments and |
|
overpayments under [the] Medicaid [program] and recovering the |
|
overpayments. |
|
SECTION 2.156. Sections 531.121(2), (4), and (6), |
|
Government Code, are amended to read as follows: |
|
(2) "Guardian" has the meaning assigned by Section |
|
1002.012, Estates [601, Texas Probate] Code. |
|
(4) "Incapacitated individual" means an incapacitated |
|
person as defined by Section 1002.017, Estates [601, Texas Probate] |
|
Code. |
|
(6) "Statutory probate court" has the meaning assigned |
|
by Section 1002.008(b), Estates [601, Texas Probate] Code. |
|
SECTION 2.157. Sections 531.122(c) and (f), Government |
|
Code, are amended to read as follows: |
|
(c) To be eligible for an appointment under this section, an |
|
individual must have demonstrated experience working with: |
|
(1) a guardianship program; |
|
(2) an organization that advocates on behalf of or in |
|
the interest of elderly individuals or individuals with mental |
|
illness or an intellectual disability [mental retardation]; or |
|
(3) incapacitated individuals. |
|
(f) Sections 2110.002 and 2110.008 [2 and 8, Article
|
|
6252-33, Revised Statutes,] do not apply to the advisory board. |
|
SECTION 2.158. Section 531.125(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission in accordance with commission rules [by
|
|
rule] may award grants to: |
|
(1) a local guardianship program, subject to the |
|
requirements of this section; and |
|
(2) a local legal guardianship program to enable |
|
low-income family members and friends to have legal representation |
|
in court if they are willing and able to be appointed guardians of |
|
proposed wards who are indigent. |
|
SECTION 2.159. Section 531.151(3), Government Code, is |
|
amended to read as follows: |
|
(3) "Institution" means: |
|
(A) an ICF-IID [ICF-MR], as defined by Section |
|
531.002, Health and Safety Code; |
|
(B) a group home operated under the authority of |
|
the [Texas] Department of Aging and Disability Services [Mental
|
|
Health and Mental Retardation], including a residential service |
|
provider under a Medicaid waiver program authorized under Section |
|
1915(c) of the federal Social Security Act (42 U.S.C. Section |
|
1396n), as amended, that provides services at a residence other |
|
than the child's home or foster home; |
|
(C) a foster group home or an agency foster group |
|
home as defined by Section 42.002, Human Resources Code; |
|
(D) a nursing facility; |
|
(E) a general residential operation for children |
|
with an intellectual disability that is [an institution for the
|
|
mentally retarded] licensed by the Department of Family and |
|
Protective [and Regulatory] Services; or |
|
(F) another residential arrangement other than a |
|
foster home as defined by Section 42.002, Human Resources Code, |
|
that provides care to four or more children who are unrelated to |
|
each other. |
|
SECTION 2.160. Sections 531.1521(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner by rule shall develop and |
|
implement a system by which the Department of Aging and Disability |
|
Services ensures that, for each child with respect to whom the |
|
department or a local intellectual and developmental disability |
|
[mental retardation] authority is notified of a request for |
|
placement in an institution, the child's parent or guardian is |
|
fully informed before the child is placed in the institution of all |
|
community-based services and any other service and support options |
|
for which the child may be eligible. The system must be designed to |
|
ensure that the department provides the information through: |
|
(1) a local intellectual and developmental disability |
|
[mental retardation] authority; |
|
(2) any private entity that has knowledge and |
|
expertise regarding the needs of and full spectrum of care options |
|
available to children with disabilities as well as the philosophy |
|
and purpose of permanency planning; or |
|
(3) a department employee. |
|
(b) An institution in which a child's parent or guardian is |
|
considering placing the child may provide information required |
|
under Subsection (a), but the information must also be provided by a |
|
local intellectual and developmental disability [mental
|
|
retardation] authority, private entity, or employee of the |
|
Department of Aging and Disability Services as required by |
|
Subsection (a). |
|
SECTION 2.161. Sections 531.153(b), (d), (d-1), and (e), |
|
Government Code, are amended to read as follows: |
|
(b) The Department of Family and Protective [and
|
|
Regulatory] Services shall develop a permanency plan as required by |
|
this subchapter for each child who resides in an institution in this |
|
state for whom the department has been appointed permanent managing |
|
conservator. The department is not required to develop a |
|
permanency plan under this subchapter for a child for whom the |
|
department has been appointed temporary managing conservator, but |
|
may incorporate the requirements of this subchapter in a permanency |
|
plan developed for the child under Section 263.3025, Family Code. |
|
(d) In implementing permanency planning procedures under |
|
Subsection (a) to develop a permanency plan for each child, the |
|
Department of Aging and Disability Services shall: |
|
(1) delegate the department's duty to develop a |
|
permanency plan to a local intellectual and developmental |
|
disability [mental retardation] authority, as defined by Section |
|
531.002, Health and Safety Code, or enter into a memorandum of |
|
understanding with the local intellectual and developmental |
|
disability [mental retardation] authority to develop the |
|
permanency plan for each child who resides in an institution in this |
|
state or with respect to whom the department is notified in advance |
|
that institutional care is sought; |
|
(2) contract with a private entity, other than an |
|
entity that provides long-term institutional care, to develop a |
|
permanency plan for a child who resides in an institution in this |
|
state or with respect to whom the department is notified in advance |
|
that institutional care is sought; or |
|
(3) perform the department's duties regarding |
|
permanency planning procedures using department personnel. |
|
(d-1) A contract or memorandum of understanding under |
|
Subsection (d) must include performance measures by which the |
|
Department of Aging and Disability Services may evaluate the |
|
effectiveness of a local intellectual and developmental disability |
|
[mental retardation] authority's or private entity's permanency |
|
planning efforts. |
|
(e) The commission, the Department of Aging and Disability |
|
Services, [Texas Department of Human Services, the Texas Department
|
|
of Mental Health and Mental Retardation,] and the Department of |
|
Family and Protective [and Regulatory] Services may solicit and |
|
accept gifts, grants, and donations to support the development of |
|
permanency plans for children residing in institutions by |
|
individuals or organizations not employed by or affiliated with |
|
those institutions. |
|
SECTION 2.162. Section 531.1531, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.1531. ASSISTANCE WITH PERMANENCY PLANNING |
|
EFFORTS. An institution in which a child resides shall assist with |
|
providing effective permanency planning for the child by: |
|
(1) cooperating with the health and human services |
|
agency, local intellectual and developmental disability [mental
|
|
retardation] authority, or private entity responsible for |
|
developing the child's permanency plan; and |
|
(2) participating in meetings to review the child's |
|
permanency plan as requested by a health and human services agency, |
|
local intellectual and developmental disability [mental
|
|
retardation] authority, or private entity responsible for |
|
developing the child's permanency plan. |
|
SECTION 2.163. Section 531.154, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.154. NOTIFICATION REQUIRED. (a) Not later than |
|
the third day after the date a child is initially placed in an |
|
institution, the institution shall notify: |
|
(1) the Department of Aging and Disability Services |
|
[Texas Department of Human Services], if the child is placed in a |
|
nursing facility [home]; |
|
(2) the local intellectual and developmental |
|
disability [mental retardation] authority, as defined by Section |
|
531.002, Health and Safety Code, where the institution is located, |
|
if the child: |
|
(A) is placed in an ICF-IID [ICF-MR], as defined |
|
by Section 531.002, Health and Safety Code; or |
|
(B) is placed by a [state or local] child |
|
protective services agency in a general residential operation for |
|
children with an intellectual disability that is [an institution
|
|
for the mentally retarded] licensed by the Department of Family and |
|
Protective [and Regulatory] Services; |
|
(3) the community resource coordination group in the |
|
county of residence of a parent or guardian of the child; |
|
(4) if the child is at least three years of age, the |
|
school district for the area in which the institution is located; |
|
and |
|
(5) if the child is less than three years of age, the |
|
local early childhood intervention program for the area in which |
|
the institution is located. |
|
(b) The [Texas] Department of Aging and Disability [Human] |
|
Services shall notify the local intellectual and developmental |
|
disability [mental retardation] authority, as defined by Section |
|
531.002, Health and Safety Code, of a child's placement in a nursing |
|
facility [home] if the child is known or suspected to have an |
|
intellectual disability [suffer from mental retardation] or |
|
another disability for which the child may receive services through |
|
the [Texas] Department of Aging and Disability Services [Mental
|
|
Health and Mental Retardation]. |
|
SECTION 2.164. Section 531.156, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.156. DESIGNATION OF ADVOCATE. (a) The Department |
|
of Aging and Disability Services [Except as provided by Subsection
|
|
(b), the Texas Department of Human Services] shall designate a |
|
person, including a member of a community-based organization, to |
|
serve as a volunteer advocate for a child residing in an institution |
|
to assist in developing a permanency plan for the child if: |
|
(1) the child's parent or guardian requests the |
|
assistance of an advocate; [or] |
|
(2) the institution in which the child is placed |
|
cannot locate the child's parent or guardian; or[.] |
|
(3) [(b)
The Texas Department of Mental Health and
|
|
Mental Retardation shall designate the person to serve as a
|
|
volunteer advocate for a child in accordance with Subsection (a)
|
|
if] the child resides in an institution operated by the department. |
|
(b) [(c)] The person designated [by the Texas Department of
|
|
Human Services or the Texas Department of Mental Health and Mental
|
|
Retardation] to serve as the child's volunteer advocate under this |
|
section may be: |
|
(1) a person selected by the child's parent or |
|
guardian, except that the person may not be employed by or under a |
|
contract with the institution in which the child resides; |
|
(2) an adult relative of the child; or |
|
(3) a representative of a child advocacy group. |
|
(c) [(d)] The [Texas Department of Human Services or the
|
|
Texas] Department of Aging and Disability Services [Mental Health
|
|
and Mental Retardation, as appropriate,] shall provide to each |
|
person designated to serve as a child's volunteer advocate |
|
information regarding permanency planning under this subchapter. |
|
SECTION 2.165. Sections 531.159(b), (c), (d), (e), and (f), |
|
Government Code, are amended to read as follows: |
|
(b) The chief executive officer of each appropriate health |
|
and human services agency or the officer's designee must approve |
|
the placement of a child in an institution. The initial placement |
|
of the child in the institution is temporary and may not exceed six |
|
months unless the appropriate chief executive officer or the |
|
officer's designee approves an extension of an additional six |
|
months after conducting a review of documented permanency planning |
|
efforts to unite the child with a family in a permanent living |
|
arrangement. After the initial six-month extension of a child's |
|
placement in an institution approved under this subsection, the |
|
chief executive officer or the officer's designee shall conduct a |
|
review of the child's placement in the institution at least |
|
semiannually to determine whether a continuation of that placement |
|
is warranted. If, based on the review, the chief executive officer |
|
or the officer's designee determines that an additional extension |
|
is warranted, the officer or the officer's designee shall recommend |
|
to the executive commissioner that the child continue residing in |
|
the institution. |
|
(c) On receipt of a recommendation made under Subsection (b) |
|
for an extension of a child's placement, the executive |
|
commissioner, the executive commissioner's designee, or another |
|
person with whom the commission contracts shall conduct a review of |
|
the child's placement. Based on the results of the review, the |
|
executive commissioner or the executive commissioner's designee |
|
may approve a six-month extension of the child's placement if the |
|
extension is appropriate. |
|
(d) The child may continue residing in the institution after |
|
the six-month extension approved under Subsection (c) only if the |
|
chief executive officer of the appropriate health and human |
|
services agency or the officer's designee makes subsequent |
|
recommendations as provided by Subsection (b) for each additional |
|
six-month extension and the executive commissioner or the executive |
|
commissioner's designee approves each extension as provided by |
|
Subsection (c). |
|
(e) The executive commissioner or the executive |
|
commissioner's designee shall conduct a semiannual review of data |
|
received from health and human services agencies regarding all |
|
children who reside in institutions in this state. The executive |
|
commissioner, the executive commissioner's designee, or a person |
|
with whom the commission contracts shall also review the |
|
recommendations of the chief executive officers of each appropriate |
|
health and human services agency or the officer's designee if the |
|
officer or the officer's designee repeatedly recommends that |
|
children continue residing in an institution. |
|
(f) The executive commissioner [commission] by rule shall |
|
develop procedures by which to conduct the reviews required by |
|
Subsections (c), (d), and (e). In developing the procedures, the |
|
commission may seek input from the work group on children's |
|
long-term services, health services, and mental health services |
|
established under Section 22.035, Human Resources Code. |
|
SECTION 2.166. Section 531.160, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.160. INSPECTIONS. As part of each inspection, |
|
survey, or investigation of an institution, including a nursing |
|
facility [home], general residential operation for children with an |
|
intellectual disability that is [institution for the mentally
|
|
retarded] licensed by the Department of Family and Protective [and
|
|
Regulatory] Services, or ICF-IID [ICF-MR], as defined by Section |
|
531.002, Health and Safety Code, in which a child resides, the |
|
agency or the agency's designee shall determine the extent to which |
|
the nursing facility [home], general residential operation |
|
[institution], or ICF-IID [ICF-MR] is complying with the permanency |
|
planning requirements under this subchapter. |
|
SECTION 2.167. Section 531.161, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.161. ACCESS TO RECORDS. Each institution in which |
|
a child resides shall allow the following to have access to the |
|
child's records to assist in complying with the requirements of |
|
this subchapter: |
|
(1) the commission; |
|
(2) appropriate health and human services agencies; |
|
and |
|
(3) to the extent not otherwise prohibited by state or |
|
federal confidentiality laws, a local intellectual and |
|
developmental disability [mental retardation] authority or private |
|
entity that enters into a contract or memorandum of understanding |
|
under Section 531.153(d) to develop a permanency plan for the |
|
child. |
|
SECTION 2.168. Section 531.162(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner shall submit a semiannual |
|
report to the governor and the committees of each house of the |
|
legislature that have primary oversight jurisdiction over health |
|
and human services agencies regarding: |
|
(1) the number of children residing in institutions in |
|
this state and, of those children, the number for whom a |
|
recommendation has been made for a transition to a community-based |
|
residence but who have not yet made that transition; |
|
(2) the circumstances of each child described by |
|
Subdivision (1), including the type of institution and name of the |
|
institution in which the child resides, the child's age, the |
|
residence of the child's parents or guardians, and the length of |
|
time in which the child has resided in the institution; |
|
(3) the number of permanency plans developed for |
|
children residing in institutions in this state, the progress |
|
achieved in implementing those plans, and barriers to implementing |
|
those plans; |
|
(4) the number of children who previously resided in |
|
an institution in this state and have made the transition to a |
|
community-based residence; |
|
(5) the number of children who previously resided in |
|
an institution in this state and have been reunited with their |
|
families or placed with alternate families; |
|
(6) the community supports that resulted in the |
|
successful placement of children described by Subdivision (5) with |
|
alternate families; and |
|
(7) the community supports that are unavailable but |
|
necessary to address the needs of children who continue to reside in |
|
an institution in this state after being recommended to make a |
|
transition from the institution to an alternate family or |
|
community-based residence. |
|
SECTION 2.169. Sections 531.164(b), (e), (f), (g), and (h), |
|
Government Code, are amended to read as follows: |
|
(b) An institution described by Section 531.151(3)(A) or |
|
(B) shall notify the local intellectual and developmental |
|
disability [mental retardation] authority for the region in which |
|
the institution is located of a request for placement of a child in |
|
the institution. An institution described by Section 531.151(3)(D) |
|
shall notify the Department of Aging and Disability Services of a |
|
request for placement of a child in the institution. |
|
(e) Except as otherwise provided by Subsection (f): |
|
(1) an ICF-IID [ICF-MR] must: |
|
(A) attempt to notify the parent or guardian of a |
|
child who resides in the ICF-IID [ICF-MR] in writing of a periodic |
|
permanency planning meeting or annual service plan review and |
|
reauthorization meeting not later than the 21st day before the date |
|
the meeting is scheduled to be held; and |
|
(B) request a response from the parent or |
|
guardian; and |
|
(2) a nursing facility must: |
|
(A) attempt to notify the parent or guardian of a |
|
child who resides in the facility in writing of an annual service |
|
plan review and reauthorization meeting not later than the 21st day |
|
before the date the meeting is scheduled to be held; and |
|
(B) request a response from the parent or |
|
guardian. |
|
(f) If an emergency situation involving a child residing in |
|
an ICF-IID [ICF-MR] or nursing facility occurs, the ICF-IID |
|
[ICF-MR] or nursing facility, as applicable, must: |
|
(1) attempt to notify the child's parent or guardian as |
|
soon as possible; and |
|
(2) request a response from the parent or guardian. |
|
(g) If a child's parent or guardian does not respond to a |
|
notice under Subsection (e) or (f), the ICF-IID [ICF-MR] or nursing |
|
facility, as applicable, must attempt to locate the parent or |
|
guardian by contacting another person whose information was |
|
provided by the parent or guardian under Section 531.1533(1)(B). |
|
(h) Not later than the 30th day after the date an ICF-IID |
|
[ICF-MR] or nursing facility determines that it is unable to locate |
|
a child's parent or guardian for participation in activities listed |
|
under Subsection (e)(1) or (2), the ICF-IID [ICF-MR] or nursing |
|
facility must notify the Department of Aging and Disability |
|
Services of that determination and request that the department |
|
initiate a search for the child's parent or guardian. |
|
SECTION 2.170. Section 531.171, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.171. COMMITTEE DUTIES. (a) The standing or other |
|
committees of the house of representatives and the senate that have |
|
jurisdiction over the commission [Health and Human Services
|
|
Commission] and other agencies relating to implementation of this |
|
chapter, as identified by the speaker of the house of |
|
representatives and the lieutenant governor, shall: |
|
(1) monitor the commission's implementation of Section |
|
531.0055 and the commission's other duties in consolidating and |
|
integrating health and human services to ensure implementation |
|
consistent with law; |
|
(2) recommend, as needed, adjustments to the |
|
implementation of Section 531.0055 and the commission's other |
|
duties in consolidating and integrating health and human services; |
|
and |
|
(3) review the rulemaking process used by the |
|
commission, including the commission's plan for obtaining public |
|
input. |
|
(b) The commission shall provide copies of all required |
|
reports to the committees and shall provide the committees with |
|
copies of proposed rules before the rules are published in the Texas |
|
Register. At the request of a committee or the executive |
|
commissioner, a health and human services agency shall provide |
|
other information to the committee, including information relating |
|
to the health and human services system, and shall report on agency |
|
progress in implementing statutory directives identified by the |
|
committee and the directives of the commission. |
|
SECTION 2.171. Section 531.191(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission, subject to the approval of the governor |
|
and the Legislative Budget Board, shall develop and implement a |
|
plan for the integration of services and functions relating to |
|
eligibility determination and service delivery by health and human |
|
services agencies, the Texas Workforce Commission, and other |
|
agencies. The plan must include a reengineering of eligibility |
|
determination business processes, streamlined service delivery, a |
|
unified and integrated process for the transition from welfare to |
|
work, and improved access to benefits and services for clients. In |
|
developing and implementing the plan, the commission: |
|
(1) shall give priority to the design and development |
|
of computer hardware and software for and provide technical support |
|
relating to the integrated eligibility determination system; |
|
(2) shall consult with agencies whose programs are |
|
included in the plan, including the [Texas] Department of Aging and |
|
Disability [Human] Services, the Department of State Health |
|
Services [Texas Department of Health], and the Texas Workforce |
|
Commission; |
|
(3) may contract for appropriate professional and |
|
technical assistance; and |
|
(4) may use the staff and resources of agencies whose |
|
programs are included in the plan. |
|
SECTION 2.172. Sections 531.251(a-1) and (a-2), Government |
|
Code, are amended to read as follows: |
|
(a-1) The consortium must include: |
|
(1) representatives of the Department of State Health |
|
Services, Department of Family and Protective Services, |
|
commission's [Health and Human Services Commission's] Medicaid |
|
program, Texas Education Agency, Texas Juvenile Justice |
|
Department, and Texas Correctional Office on Offenders with Medical |
|
or Mental Impairments; and |
|
(2) one member who is: |
|
(A) a youth or young adult who has a serious |
|
emotional disturbance and has received mental health services and |
|
supports; or |
|
(B) [(3)] a family member of a youth or young |
|
adult described by Paragraph (A) [Subdivision (2)]. |
|
(a-2) The consortium may coordinate with the Children's |
|
Policy Council for the purposes of including the representation |
|
required by Subsection [Subsections] (a-1)(2) [and (3)]. |
|
SECTION 2.173. The heading to Subchapter H, Chapter 531, |
|
Government Code, is amended to read as follows: |
|
SUBCHAPTER H. OFFICE OF HEALTH [EARLY CHILDHOOD] COORDINATION AND |
|
CONSUMER SERVICES |
|
SECTION 2.174. Section 531.281, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.281. DEFINITION [DEFINITIONS]. In this chapter, |
|
"office"[:
|
|
[(1) "Office"] means the Office of Health [Early
|
|
Childhood] Coordination and Consumer Services. |
|
[(2)
"Advisory committee" means the Office of Early
|
|
Childhood Coordination Advisory Committee.] |
|
SECTION 2.175. Sections 531.282(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The Office of Health [Early Childhood] Coordination and |
|
Consumer Services is an office within the commission. |
|
(b) The executive commissioner shall employ staff as needed |
|
to carry out the duties of the office. |
|
SECTION 2.176. Section 531.284(b), Government Code, is |
|
amended to read as follows: |
|
(b) In developing the statewide strategic plan, the office |
|
shall: |
|
(1) consider existing programs and models to serve |
|
children younger than six years of age, including: |
|
(A) community resource coordination groups; |
|
(B) the Texas System of Care [Integrated Funding
|
|
Initiative]; |
|
(C) the Texas Information and Referral Network; |
|
and |
|
(D) efforts to create a 2-1-1 telephone number |
|
for access to human services; |
|
(2) attempt to maximize federal funds and local |
|
existing infrastructure and funds; and |
|
(3) provide for local participation to the greatest |
|
extent possible. |
|
SECTION 2.177. Section 531.285(a), Government Code, is |
|
amended to read as follows: |
|
(a) The office shall identify: |
|
(1) gaps in early childhood services by functional |
|
area and geographical area; |
|
(2) state policies, rules, and service procedures that |
|
prevent or inhibit children younger than six years of age from |
|
accessing available services; |
|
(3) sources of funds for early childhood services, |
|
including federal, state, and private-public ventures; |
|
(4) opportunities for collaboration between the Texas |
|
Education Agency and health and human services agencies to better |
|
serve the needs of children younger than six years of age; |
|
(5) methods for coordinating the provision of early |
|
childhood services provided by the Texas Head Start State |
|
[Start-State] Collaboration Office [Project], the Texas Education |
|
Agency, and the Texas Workforce Commission; |
|
(6) quantifiable benchmarks for success within early |
|
childhood service delivery; and |
|
(7) national best practices in early care and |
|
educational delivery models. |
|
SECTION 2.178. Sections 531.301(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall develop and implement a state |
|
prescription drug program that operates in the same manner as the |
|
vendor drug program operates in providing prescription drug |
|
benefits to Medicaid recipients [of medical assistance under
|
|
Chapter 32, Human Resources Code]. |
|
(b) A person is eligible for prescription drug benefits |
|
under the state program if the person is: |
|
(1) a qualified Medicare beneficiary, as defined by 42 |
|
U.S.C. Section 1396d(p)(1), as amended; |
|
(2) a specified low-income Medicare beneficiary who is |
|
eligible for [medical] assistance under Medicaid for Medicare |
|
cost-sharing payments under 42 U.S.C. Section |
|
1396a(a)(10)(E)(iii), as amended; |
|
(3) a qualified disabled and working individual, as |
|
defined by 42 U.S.C. Section 1396d(s), as amended; or |
|
(4) a qualifying individual who is eligible for that |
|
assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv) |
|
[1396a(a)(10)(E)(iv)(I), as amended; or
|
|
[(5)
a qualifying individual who is eligible for that
|
|
assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv)(II), as
|
|
amended]. |
|
SECTION 2.179. Section 531.302, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.302. RULES. (a) The executive commissioner |
|
[commission] shall adopt all rules necessary for implementation of |
|
the state prescription drug program. |
|
(b) In adopting rules for the state prescription drug |
|
program, the executive commissioner [commission] may: |
|
(1) require a person who is eligible for prescription |
|
drug benefits to pay a cost-sharing payment; |
|
(2) authorize the use of a prescription drug formulary |
|
to specify which prescription drugs the state program will cover; |
|
(3) to the extent possible, require clinically |
|
appropriate prior authorization for prescription drug benefits in |
|
the same manner as prior authorization is required under the vendor |
|
drug program; and |
|
(4) establish a drug utilization review program to |
|
ensure the appropriate use of prescription drugs under the state |
|
program. |
|
(c) In adopting rules for the state prescription drug |
|
program, the executive commissioner [commission] shall consult |
|
with an advisory panel composed of an equal number of physicians, |
|
pharmacists, and pharmacologists appointed by the executive |
|
commissioner. |
|
SECTION 2.180. Section 531.303, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.303. GENERIC EQUIVALENT AUTHORIZED. In adopting |
|
rules under the state program, the executive commissioner |
|
[commission] may require that, unless the practitioner's signature |
|
on a prescription clearly indicates that the prescription must be |
|
dispensed as written, the pharmacist may select a generic |
|
equivalent of the prescribed drug. |
|
SECTION 2.181. Section 531.304, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.304. PROGRAM FUNDING PRIORITIES. If money |
|
available for the state prescription drug program is insufficient |
|
to provide prescription drug benefits to all persons who are |
|
eligible under Section 531.301(b), the commission shall limit the |
|
number of enrollees based on available funding and shall provide |
|
the prescription drug benefits to eligible persons in the following |
|
order of priority: |
|
(1) persons eligible under Section 531.301(b)(1); |
|
(2) persons eligible under Section 531.301(b)(2); and |
|
(3) persons eligible under Sections 531.301(b)(3) and |
|
[,] (4)[, and (5)]. |
|
SECTION 2.182. Section 531.402(b), Government Code, is |
|
amended to read as follows: |
|
(b) The council is composed of nine members of the public |
|
appointed by the governor with the advice and consent of the senate. |
|
To be eligible for appointment to the council, a person must have |
|
demonstrated an interest in and knowledge of problems and available |
|
services related to Medicaid, the child health plan program, the |
|
financial assistance program under Chapter 31, Human Resources |
|
Code, [the medical assistance program under Chapter 32, Human
|
|
Resources Code,] or the supplemental nutrition assistance program |
|
[nutritional assistance programs] under Chapter 33, Human |
|
Resources Code. |
|
SECTION 2.183. Sections 531.421(1), (2), and (3), |
|
Government Code, are amended to read as follows: |
|
(1) "Children with severe emotional disturbances" |
|
includes: |
|
(A) children who are at risk of incarceration or |
|
placement in a residential mental health facility; |
|
(B) children for whom a court may appoint the |
|
Department of Family and Protective [and Regulatory] Services as |
|
managing conservator; |
|
(C) children who are students in a special |
|
education program under Subchapter A, Chapter 29, Education Code; |
|
and |
|
(D) children who have a substance abuse disorder |
|
or a developmental disability. |
|
(2) "Community resource coordination group" means a |
|
coordination group established under a memorandum of understanding |
|
adopted under Section 531.055[, as added by Chapter 114, Acts of the
|
|
77th Legislature, Regular Session, 2001]. |
|
(3) "Consortium" means the Texas System of Care |
|
Consortium established under Subchapter G-1 [consortium that
|
|
oversees the Texas Integrated Funding Initiative under Subchapter
|
|
G, Chapter 531, as added by Chapter 446, Acts of the 76th
|
|
Legislature, Regular Session, 1999]. |
|
SECTION 2.184. The heading to Section 531.423, Government |
|
Code, is amended to read as follows: |
|
Sec. 531.423. SUMMARY REPORT BY [TEXAS INTEGRATED FUNDING
|
|
INITIATIVE] CONSORTIUM. |
|
SECTION 2.185. Section 531.423(c), Government Code, is |
|
amended to read as follows: |
|
(c) The consortium may include in the report created under |
|
this section recommendations for the statewide expansion of sites |
|
participating in the Texas System of Care [Integrated Funding
|
|
Initiative under Subchapter G, Chapter 531, as added by Chapter
|
|
446, Acts of the 76th Legislature, Regular Session, 1999,] and the |
|
integration of services provided at those sites with services |
|
provided by community resource coordination groups. |
|
SECTION 2.186. Section 531.424, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.424. AGENCY IMPLEMENTATION OF RECOMMENDATIONS. As |
|
appropriate, the person or entity responsible for adopting rules |
|
for an [An] agency described by Section 531.423(a) shall[, as
|
|
appropriate,] adopt rules, and the agency shall implement policy |
|
changes[,] and enter into memoranda of understanding with other |
|
agencies, to implement the recommendations in the report created |
|
under Section 531.423. |
|
SECTION 2.187. Section 531.551(a), Government Code, is |
|
amended to read as follows: |
|
(a) The executive commissioner shall adopt rules providing |
|
for: |
|
(1) a standard definition of "uncompensated hospital |
|
care"; |
|
(2) a methodology to be used by hospitals in this state |
|
to compute the cost of that care that incorporates a [the] standard |
|
set of adjustments to a hospital's initial computation of the cost |
|
of uncompensated hospital care that account for all funding streams |
|
that: |
|
(A) are not patient-specific; and |
|
(B) are used to offset the hospital's initially |
|
computed amount of uncompensated care [described by Section
|
|
531.552(g)(4)]; and |
|
(3) procedures to be used by those hospitals to report |
|
the cost of that care to the commission and to analyze that cost. |
|
SECTION 2.188. The heading to Section 531.652, Government |
|
Code, is amended to read as follows: |
|
Sec. 531.652. OPERATION [ESTABLISHMENT] OF NURSE-FAMILY |
|
PARTNERSHIP COMPETITIVE GRANT PROGRAM. |
|
SECTION 2.189. Section 531.652(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall operate [establish] a nurse-family |
|
partnership competitive grant program through which the commission |
|
will award grants for the implementation of nurse-family |
|
partnership programs, or the expansion of existing programs, and |
|
for the operation of those programs for a period of not less than |
|
two years. |
|
SECTION 2.190. Section 531.659(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission, with the assistance of the Nurse-Family |
|
Partnership National Service Office, shall: |
|
(1) adopt performance indicators that are designed to |
|
measure a grant recipient's performance with respect to the |
|
partnership program standards adopted by the executive |
|
commissioner [commission] under Section 531.656; |
|
(2) use the performance indicators to continuously |
|
monitor and formally evaluate on an annual basis the performance of |
|
each grant recipient; and |
|
(3) prepare and submit an annual report, not later |
|
than December 1 of each year, to the Senate Health and Human |
|
Services Committee, or its successor, and the House Human Services |
|
Committee, or its successor, regarding the performance of each |
|
grant recipient during the preceding state fiscal year with respect |
|
to providing partnership program services. |
|
SECTION 2.191. Section 531.706(c), Government Code, is |
|
amended to read as follows: |
|
(c) The advisory committee shall: |
|
(1) develop strategies for implementing the |
|
regulation of health care interpreters and health care translators; |
|
(2) make recommendations to the commission for any |
|
legislation necessary to establish and enforce qualifications for |
|
health care interpreters and health care translators or for the |
|
adoption of rules by or for state agencies regulating health care |
|
practitioners, hospitals, physician offices, and health care |
|
facilities that hire health care interpreters or health care |
|
translators; and |
|
(3) perform other activities assigned by the |
|
commission related to health care interpreters or health care |
|
translators. |
|
SECTION 2.192. Section 531.754, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.754. TRAINING PROGRAM. The commission shall |
|
develop and administer a training program for navigators. The |
|
program must include training on: |
|
(1) how to complete an online application for public |
|
assistance benefits through the Texas Integrated Eligibility |
|
Redesign System (TIERS); |
|
(2) the importance of maintaining the confidentiality |
|
of information handled by a navigator; |
|
(3) the importance of obtaining and submitting |
|
complete and accurate information when completing an application |
|
for public assistance benefits online through the Texas Integrated |
|
Eligibility Redesign System (TIERS); |
|
(4) the financial assistance program, the |
|
supplemental nutrition assistance program, Medicaid [the medical
|
|
assistance program], the child health plan program, and any other |
|
public assistance benefits program for which an individual may |
|
complete an online application through the Texas Integrated |
|
Eligibility Redesign System (TIERS); and |
|
(5) how an individual may apply for other public |
|
assistance benefits for which an individual may not complete an |
|
online application through the Texas Integrated Eligibility |
|
Redesign System (TIERS). |
|
SECTION 2.193. Sections 531.802(c), (d), and (g), |
|
Government Code, are amended to read as follows: |
|
(c) Subject to Subsection (d), the council is composed of |
|
the following: |
|
(1) the executive commissioner; |
|
(2) the commissioner of state health services; |
|
(3) the commissioner of the Department of Family and |
|
Protective Services; |
|
(4) the commissioner of aging and disability services; |
|
(5) the commissioner of assistive and rehabilitative |
|
services; |
|
(6) the commissioner of education; |
|
(7) the executive director of the Texas Juvenile |
|
Justice Department [Probation Commission]; |
|
(8) [the executive commissioner of the Texas Youth
|
|
Commission;
|
|
[(9)] the executive director of the Texas Workforce |
|
Commission; |
|
(9) [(10)] the director of the Texas Correctional |
|
Office on Offenders with Medical or Mental Impairments; |
|
(10) [(11)] two public representatives who are |
|
parents of children who have received services from an agency |
|
represented on the council, appointed by the executive |
|
commissioner; and |
|
(11) [(12)] two representatives who are young adults |
|
or adolescents who have received services from an agency |
|
represented on the council, appointed by the executive |
|
commissioner. |
|
(d) An individual listed in Subsections (c)(1)-(9) |
|
[(c)(1)-(10)] may designate another individual as having authority |
|
to act on behalf of the individual at council meetings and with |
|
respect to council functions. |
|
(g) The council is administratively attached to the |
|
commission but is independent of direction by the commission or the |
|
executive commissioner. The commission, through the commission's |
|
Office of Health [Program] Coordination and Consumer Services [for
|
|
Children and Youth], shall provide administrative support and |
|
resources to the council as necessary to enable the council to |
|
perform its duties. |
|
SECTION 2.194. The heading to Subchapter U, Chapter 531, |
|
Government Code, is amended to read as follows: |
|
SUBCHAPTER U. MORTALITY REVIEW FOR CERTAIN INDIVIDUALS WITH AN |
|
INTELLECTUAL OR DEVELOPMENTAL DISABILITY [DISABILITIES] |
|
SECTION 2.195. Section 531.8501, Government Code, is |
|
amended to read as follows: |
|
Sec. 531.8501. DEFINITION. In this subchapter, "contracted |
|
organization" means an entity that contracts with the commission |
|
[Health and Human Services Commission] for the provision of |
|
services as described by Section 531.851(c). |
|
SECTION 2.196. Sections 531.851(a), (c), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The executive commissioner shall establish an |
|
independent mortality review system to review the death of a person |
|
with an intellectual or developmental disability who, at the time |
|
of the person's death or at any time during the 24-hour period |
|
before the person's death: |
|
(1) resided in or received services from: |
|
(A) an ICF-IID [intermediate care facility for
|
|
persons with an intellectual or developmental disability
|
|
(ICF/IID)] operated or licensed by the Department of Aging and |
|
Disability Services or a community center; or |
|
(B) the ICF-IID [ICF/IID] component of the Rio |
|
Grande State Center; or |
|
(2) received services through a Section 1915(c) waiver |
|
program for individuals who are eligible for ICF-IID [ICF/IID] |
|
services. |
|
(c) The executive commissioner shall contract with an |
|
institution of higher education or a health care organization or |
|
association with experience in conducting research-based mortality |
|
studies to conduct independent mortality reviews of persons with an |
|
intellectual or developmental disability. The contract must |
|
require the contracted organization to form a review team |
|
consisting of: |
|
(1) a physician with expertise regarding the medical |
|
treatment of individuals with an intellectual or developmental |
|
disability [disabilities]; |
|
(2) a registered nurse with expertise regarding the |
|
medical treatment of individuals with an intellectual or |
|
developmental disability [disabilities]; |
|
(3) a clinician or other professional with expertise |
|
in the delivery of services and supports for individuals with an |
|
intellectual or developmental disability [disabilities]; and |
|
(4) any other appropriate person as provided by the |
|
executive commissioner. |
|
(e) To ensure consistency across mortality review systems, |
|
a review under this section must collect information consistent |
|
with the information required to be collected by any other |
|
independent mortality review process established specifically for |
|
persons with an intellectual or developmental disability |
|
[disabilities]. |
|
SECTION 2.197. Section 531.854(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission may use or publish information under this |
|
subchapter only to advance statewide practices regarding the |
|
treatment and care of individuals with an intellectual or [and] |
|
developmental disability [disabilities]. A summary of the data in |
|
the contracted organization's reports or a statistical compilation |
|
of data reports may be released by the commission for general |
|
publication if the summary or statistical compilation does not |
|
contain any information that would permit the identification of an |
|
individual or that is confidential or privileged under this |
|
subchapter or other state or federal law. |
|
SECTION 2.198. Section 531.901(4), Government Code, is |
|
amended to read as follows: |
|
(4) "Local or regional health information exchange" |
|
means a health information exchange operating in this state that |
|
securely exchanges electronic health information, including |
|
information for patients receiving services under the child health |
|
plan program or Medicaid [program], among hospitals, clinics, |
|
physicians' offices, and other health care providers that are not |
|
owned by a single entity or included in a single operational unit or |
|
network. |
|
SECTION 2.199. Sections 531.903(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) The commission shall develop an electronic health |
|
information exchange system to improve the quality, safety, and |
|
efficiency of health care services provided under the child health |
|
plan program and Medicaid [programs]. In developing the system, |
|
the commission shall ensure that: |
|
(1) the confidentiality of patients' health |
|
information is protected and the privacy of those patients is |
|
maintained in accordance with applicable federal and state law, |
|
including: |
|
(A) Section 1902(a)(7), Social Security Act (42 |
|
U.S.C. Section 1396a(a)(7)); |
|
(B) the Health Insurance Portability and |
|
Accountability Act of 1996 (Pub. L. No. 104-191); |
|
(C) Chapter 552 [, Government Code]; |
|
(D) Subchapter G, Chapter 241, Health and Safety |
|
Code; |
|
(E) Section 12.003, Human Resources Code; and |
|
(F) federal and state rules and regulations, |
|
including: |
|
(i) 42 C.F.R. Part 431, Subpart F; and |
|
(ii) 45 C.F.R. Part 164; |
|
(2) appropriate information technology systems used |
|
by the commission and health and human services agencies are |
|
interoperable; |
|
(3) the system and external information technology |
|
systems are interoperable in receiving and exchanging appropriate |
|
electronic health information as necessary to enhance: |
|
(A) the comprehensive nature of the information |
|
contained in electronic health records; and |
|
(B) health care provider efficiency by |
|
supporting integration of the information into the electronic |
|
health record used by health care providers; |
|
(4) the system and other health information systems |
|
not described by Subdivision (3) and data warehousing initiatives |
|
are interoperable; and |
|
(5) the system has the elements described by |
|
Subsection (b). |
|
(c) The commission shall implement the health information |
|
exchange system in stages as described by this chapter [Sections
|
|
531.905 through 531.908], except that the commission may deviate |
|
from those stages if technological advances make a deviation |
|
advisable or more efficient. |
|
SECTION 2.200. Section 531.904(b), Government Code, is |
|
amended to read as follows: |
|
(b) The executive commissioner shall appoint to the |
|
advisory committee at least 12 and not more than 16 members who have |
|
an interest in health information technology and who have |
|
experience in serving persons receiving health care through the |
|
child health plan program and Medicaid [programs]. |
|
SECTION 2.201. Sections 531.906(a) and (d), Government |
|
Code, are amended to read as follows: |
|
(a) In stage one of implementing the health information |
|
exchange system, the commission shall support and coordinate |
|
electronic prescribing tools used by health care providers and |
|
health care facilities under the child health plan program and |
|
Medicaid [programs]. |
|
(d) The commission shall apply for and actively pursue any |
|
waiver to the child health plan program or the state Medicaid plan |
|
from the federal Centers for Medicare and Medicaid Services or any |
|
other federal agency as necessary to remove an identified |
|
impediment to supporting and implementing electronic prescribing |
|
tools under this section, including the requirement for handwritten |
|
certification of certain drugs under 42 C.F.R. Section 447.512. If |
|
the commission, with assistance from the Legislative Budget Board, |
|
determines that the implementation of operational modifications in |
|
accordance with a waiver obtained as required by this subsection |
|
has resulted in cost increases in the child health plan program or |
|
Medicaid [program], the commission shall take the necessary actions |
|
to reverse the operational modifications. |
|
SECTION 2.202. Section 531.907(a), Government Code, is |
|
amended to read as follows: |
|
(a) Based on the recommendations of the advisory committee |
|
established under Section 531.904 and feedback provided by |
|
interested parties, the commission in stage two of implementing the |
|
health information exchange system may expand the system by: |
|
(1) providing an electronic health record for each |
|
child enrolled in the child health plan program; |
|
(2) including state laboratory results information in |
|
an electronic health record, including the results of newborn |
|
screenings and tests conducted under the Texas Health Steps |
|
program, based on the system developed for the health passport |
|
under Section 266.006, Family Code; |
|
(3) improving data-gathering capabilities for an |
|
electronic health record so that the record may include basic |
|
health and clinical information in addition to available claims |
|
information, as determined by the executive commissioner; |
|
(4) using evidence-based technology tools to create a |
|
unique health profile to alert health care providers regarding the |
|
need for additional care, education, counseling, or health |
|
management activities for specific patients; and |
|
(5) continuing to enhance the electronic health record |
|
created for each Medicaid recipient [under Section 531.905] as |
|
technology becomes available and interoperability capabilities |
|
improve. |
|
SECTION 2.203. Section 531.911, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.911. RULES. The executive commissioner may adopt |
|
rules to implement Sections 531.903 through 531.909 [531.910]. |
|
SECTION 2.204. Sections 531.912(a), (b), and (c), |
|
Government Code, are amended to read as follows: |
|
(a) In this section, "nursing facility" means a |
|
convalescent or nursing home or related institution licensed under |
|
Chapter 242, Health and Safety Code, that provides long-term care |
|
services, as defined by Section 22.0011, Human Resources Code, to |
|
Medicaid [medical assistance] recipients. |
|
(b) If feasible, the executive commissioner by rule may |
|
establish an incentive payment program for nursing facilities that |
|
choose to participate. The program must be designed to improve the |
|
quality of care and services provided to Medicaid [medical
|
|
assistance] recipients. Subject to Subsection (f), the program |
|
may provide incentive payments in accordance with this section to |
|
encourage facilities to participate in the program. |
|
(c) In establishing an incentive payment program under this |
|
section, the executive commissioner shall, subject to Subsection |
|
(d), adopt common performance measures to be used in evaluating |
|
nursing facilities that are related to structure, process, and |
|
outcomes that positively correlate to nursing facility quality and |
|
improvement. The common performance measures: |
|
(1) must be: |
|
(A) recognized by the executive commissioner as |
|
valid indicators of the overall quality of care received by |
|
Medicaid [medical assistance] recipients; and |
|
(B) designed to encourage and reward |
|
evidence-based practices among nursing facilities; and |
|
(2) may include measures of: |
|
(A) quality of care, as determined by clinical |
|
performance ratings published by the federal Centers for Medicare |
|
and Medicaid Services, the Agency for Healthcare Research and |
|
Quality, or another federal agency; |
|
(B) direct-care staff retention and turnover; |
|
(C) recipient satisfaction, including the |
|
satisfaction of recipients who are short-term and long-term |
|
residents of facilities, and family satisfaction, as determined by |
|
the Nursing Home Consumer Assessment of Healthcare [Health] |
|
Providers and Systems surveys [survey] relied upon by the federal |
|
Centers for Medicare and Medicaid Services; |
|
(D) employee satisfaction and engagement; |
|
(E) the incidence of preventable acute care |
|
emergency room services use; |
|
(F) regulatory compliance; |
|
(G) level of person-centered care; and |
|
(H) direct-care staff training, including a |
|
facility's utilization of independent distance learning programs |
|
for the continuous training of direct-care staff. |
|
SECTION 2.205. The heading to Section 531.982, Government |
|
Code, is amended to read as follows: |
|
Sec. 531.982. IMPLEMENTATION [ESTABLISHMENT] OF TEXAS HOME |
|
VISITING PROGRAM. |
|
SECTION 2.206. Section 531.982(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall maintain [create] a strategic plan |
|
to serve at-risk pregnant women and families with children under |
|
the age of six through home visiting programs that improve outcomes |
|
for parents and families. |
|
SECTION 2.207. Section 531.988, Government Code, is amended |
|
to read as follows: |
|
Sec. 531.988. RULES. The executive commissioner |
|
[commission] may adopt rules as necessary to implement this |
|
subchapter. |
|
SECTION 2.208. The heading to Chapter 533, Government Code, |
|
is amended to read as follows: |
|
CHAPTER 533. [IMPLEMENTATION OF] MEDICAID MANAGED CARE PROGRAM |
|
SECTION 2.209. Sections 533.001(2) and (6), Government |
|
Code, are amended to read as follows: |
|
(2) "Executive commissioner" ["Commissioner"] means |
|
the executive commissioner of the Health and Human Services |
|
Commission [health and human services]. |
|
(6) "Recipient" means a recipient of Medicaid [medical
|
|
assistance under Chapter 32, Human Resources Code]. |
|
SECTION 2.210. Section 533.002, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.002. PURPOSE. The commission shall implement the |
|
Medicaid managed care program [as part of the health care delivery
|
|
system developed under Chapter 532] by contracting with managed |
|
care organizations in a manner that, to the extent possible: |
|
(1) improves the health of Texans by: |
|
(A) emphasizing prevention; |
|
(B) promoting continuity of care; and |
|
(C) providing a medical home for recipients; |
|
(2) ensures that each recipient receives high quality, |
|
comprehensive health care services in the recipient's local |
|
community; |
|
(3) encourages the training of and access to primary |
|
care physicians and providers; |
|
(4) maximizes cooperation with existing public health |
|
entities, including local departments of health; |
|
(5) provides incentives to managed care organizations |
|
to improve the quality of health care services for recipients by |
|
providing value-added services; and |
|
(6) reduces administrative and other nonfinancial |
|
barriers for recipients in obtaining health care services. |
|
SECTION 2.211. Sections 533.0025(b), (c), (d), (e), (f), |
|
and (h), Government Code, are amended to read as follows: |
|
(b) Except as otherwise provided by this section and |
|
notwithstanding any other law, the commission shall provide |
|
Medicaid [medical assistance for] acute care services through the |
|
most cost-effective model of Medicaid capitated managed care as |
|
determined by the commission. The commission shall require |
|
mandatory participation in a Medicaid capitated managed care |
|
program for all persons eligible for Medicaid acute care [medical
|
|
assistance] benefits, but may implement alternative models or |
|
arrangements, including a traditional fee-for-service arrangement, |
|
if the commission determines the alternative would be more |
|
cost-effective or efficient. |
|
(c) In determining whether a model or arrangement described |
|
by Subsection (b) is more cost-effective, the executive |
|
commissioner must consider: |
|
(1) the scope, duration, and types of health benefits |
|
or services to be provided in a certain part of this state or to a |
|
certain population of recipients; |
|
(2) administrative costs necessary to meet federal and |
|
state statutory and regulatory requirements; |
|
(3) the anticipated effect of market competition |
|
associated with the configuration of Medicaid service delivery |
|
models determined by the commission; and |
|
(4) the gain or loss to this state of a tax collected |
|
under Chapter 222, Insurance Code. |
|
(d) If the commission determines that it is not more |
|
cost-effective to use a Medicaid managed care model to provide |
|
certain types of Medicaid [medical assistance for] acute care in a |
|
certain area or to certain [medical assistance] recipients as |
|
prescribed by this section, the commission shall provide Medicaid |
|
[medical assistance for] acute care through a traditional |
|
fee-for-service arrangement. |
|
(e) The commission shall determine the most cost-effective |
|
alignment of managed care service delivery areas. The executive |
|
commissioner may consider the number of lives impacted, the usual |
|
source of health care services for residents in an area, and other |
|
factors that impact the delivery of health care services in the |
|
area. |
|
(f) The commission shall: |
|
(1) conduct a study to evaluate the feasibility of |
|
automatically enrolling applicants determined eligible for |
|
benefits under Medicaid [the medical assistance program] in a |
|
Medicaid managed care plan chosen by the applicant; and |
|
(2) report the results of the study to the legislature |
|
not later than December 1, 2014. |
|
(h) If the commission determines that it is feasible, the |
|
commission may, notwithstanding any other law, implement an |
|
automatic enrollment process under which applicants determined |
|
eligible for Medicaid [medical assistance] benefits are |
|
automatically enrolled in a Medicaid managed care plan chosen by |
|
the applicant. The commission may elect to implement the automatic |
|
enrollment process as to certain populations of recipients [under
|
|
the medical assistance program]. |
|
SECTION 2.212. Section 533.00251(a)(3), Government Code, |
|
is amended to read as follows: |
|
(3) "Nursing facility" means a convalescent or nursing |
|
home or related institution licensed under Chapter 242, Health and |
|
Safety Code, that provides long-term services and supports to |
|
[Medicaid] recipients. |
|
SECTION 2.213. Sections 533.00251(b), (c), and (d), |
|
Government Code, are amended to read as follows: |
|
(b) Subject to Section 533.0025, the commission shall |
|
expand the STAR + PLUS Medicaid managed care program to all areas of |
|
this state to serve individuals eligible for acute care services |
|
and long-term services and supports under Medicaid [the medical
|
|
assistance program]. |
|
(c) Subject to Section 533.0025 and notwithstanding any |
|
other law, the commission, in consultation with the advisory |
|
committee, shall provide benefits under Medicaid [the medical
|
|
assistance program] to recipients who reside in nursing facilities |
|
through the STAR + PLUS Medicaid managed care program. In |
|
implementing this subsection, the commission shall ensure: |
|
(1) that the commission is responsible for setting the |
|
minimum reimbursement rate paid to a nursing facility under the |
|
managed care program, including the staff rate enhancement paid to |
|
a nursing facility that qualifies for the enhancement; |
|
(2) that a nursing facility is paid not later than the |
|
10th day after the date the facility submits a clean claim; |
|
(3) the appropriate utilization of services |
|
consistent with criteria established [adopted] by the commission; |
|
(4) a reduction in the incidence of potentially |
|
preventable events and unnecessary institutionalizations; |
|
(5) that a managed care organization providing |
|
services under the managed care program provides discharge |
|
planning, transitional care, and other education programs to |
|
physicians and hospitals regarding all available long-term care |
|
settings; |
|
(6) that a managed care organization providing |
|
services under the managed care program: |
|
(A) assists in collecting applied income from |
|
recipients; and |
|
(B) provides payment incentives to nursing |
|
facility providers that reward reductions in preventable acute care |
|
costs and encourage transformative efforts in the delivery of |
|
nursing facility services, including efforts to promote a |
|
resident-centered care culture through facility design and |
|
services provided; |
|
(7) the establishment of a portal that is in |
|
compliance with state and federal regulations, including standard |
|
coding requirements, through which nursing facility providers |
|
participating in the STAR + PLUS Medicaid managed care program may |
|
submit claims to any participating managed care organization; |
|
(8) that rules and procedures relating to the |
|
certification and decertification of nursing facility beds under |
|
Medicaid [the medical assistance program] are not affected; and |
|
(9) that a managed care organization providing |
|
services under the managed care program, to the greatest extent |
|
possible, offers nursing facility providers access to: |
|
(A) acute care professionals; and |
|
(B) telemedicine, when feasible and in |
|
accordance with state law, including rules adopted by the Texas |
|
Medical Board. |
|
(d) Subject to Subsection (e), the commission shall ensure |
|
that a nursing facility provider authorized to provide services |
|
under Medicaid [the medical assistance program] on September 1, |
|
2013, is allowed to participate in the STAR + PLUS Medicaid managed |
|
care program through August 31, 2017. |
|
SECTION 2.214. Section 533.002515(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission shall develop a plan in preparation for |
|
implementing the requirement under Section 533.00251(c) that the |
|
commission provide benefits under Medicaid [the medical assistance
|
|
program] to recipients who reside in nursing facilities through the |
|
STAR + PLUS Medicaid managed care program. The plan required by |
|
this section must be completed in two phases as follows: |
|
(1) phase one: contract planning phase; and |
|
(2) phase two: initial testing phase. |
|
SECTION 2.215. Section 533.00252(a), Government Code, is |
|
amended to read as follows: |
|
(a) The STAR + PLUS Nursing Facility Advisory Committee is |
|
established to advise the commission on the implementation of and |
|
other activities related to the provision of Medicaid [medical
|
|
assistance] benefits to recipients who reside in nursing facilities |
|
through the STAR + PLUS Medicaid managed care program under Section |
|
533.00251, including advising the commission regarding its duties |
|
with respect to: |
|
(1) developing quality-based outcomes and process |
|
measures for long-term services and supports provided in nursing |
|
facilities; |
|
(2) developing quality-based long-term care payment |
|
systems and quality initiatives for nursing facilities; |
|
(3) transparency of information received from managed |
|
care organizations; |
|
(4) the reporting of outcome and process measures; |
|
(5) the sharing of data among health and human |
|
services agencies; and |
|
(6) patient care coordination, quality of care |
|
improvement, and cost savings. |
|
SECTION 2.216. Section 533.00253(a)(2), Government Code, |
|
is amended to read as follows: |
|
(2) "Health home" means a primary care provider |
|
practice, or, if appropriate, a specialty care provider practice, |
|
incorporating several features, including comprehensive care |
|
coordination, family-centered care, and data management, that are |
|
focused on improving outcome-based quality of care and increasing |
|
patient and provider satisfaction under Medicaid [the medical
|
|
assistance program]. |
|
SECTION 2.217. Sections 533.00253(b), (d), and (e), |
|
Government Code, are amended to read as follows: |
|
(b) Subject to Section 533.0025, the commission shall, in |
|
consultation with the advisory committee and the Children's Policy |
|
Council established under Section 22.035, Human Resources Code, |
|
establish a mandatory STAR Kids capitated managed care program |
|
tailored to provide Medicaid [medical assistance] benefits to |
|
children with disabilities. The managed care program developed |
|
under this section must: |
|
(1) provide Medicaid [medical assistance] benefits |
|
that are customized to meet the health care needs of recipients |
|
under the program through a defined system of care; |
|
(2) better coordinate care of recipients under the |
|
program; |
|
(3) improve the health outcomes of recipients; |
|
(4) improve recipients' access to health care |
|
services; |
|
(5) achieve cost containment and cost efficiency; |
|
(6) reduce the administrative complexity of |
|
delivering Medicaid [medical assistance] benefits; |
|
(7) reduce the incidence of unnecessary |
|
institutionalizations and potentially preventable events by |
|
ensuring the availability of appropriate services and care |
|
management; |
|
(8) require a health home; and |
|
(9) coordinate and collaborate with long-term care |
|
service providers and long-term care management providers, if |
|
recipients are receiving long-term services and supports outside of |
|
the managed care organization. |
|
(d) The commission shall provide Medicaid [medical
|
|
assistance] benefits through the STAR Kids managed care program |
|
established under this section to children who are receiving |
|
benefits under the medically dependent children (MDCP) waiver |
|
program. The commission shall ensure that the STAR Kids managed |
|
care program provides all of the benefits provided under the |
|
medically dependent children (MDCP) waiver program to the extent |
|
necessary to implement this subsection. |
|
(e) The commission shall ensure that there is a plan for |
|
transitioning the provision of Medicaid [program] benefits to |
|
recipients 21 years of age or older from under the STAR Kids program |
|
to under the STAR + PLUS Medicaid managed care program that protects |
|
continuity of care. The plan must ensure that coordination between |
|
the programs begins when a recipient reaches 18 years of age. |
|
SECTION 2.218. Section 533.0026(a), Government Code, is |
|
amended to read as follows: |
|
(a) Notwithstanding any other law, the commission shall |
|
ensure that a managed care plan offered by a managed care |
|
organization that contracts with the commission under this chapter |
|
and any other Medicaid managed care model or arrangement |
|
implemented under this chapter allow a [Medicaid] recipient who |
|
receives services through the plan or other model or arrangement |
|
to, in the manner and to the extent required by Section 32.072, |
|
Human Resources Code: |
|
(1) select an in-network ophthalmologist or |
|
therapeutic optometrist in the managed care network to provide eye |
|
health care services, other than surgery; and |
|
(2) have direct access to the selected in-network |
|
ophthalmologist or therapeutic optometrist for the provision of the |
|
nonsurgical services. |
|
SECTION 2.219. Section 533.0028, Government Code, is |
|
amended to read as follows: |
|
Sec. 533.0028. EVALUATION OF CERTAIN STAR + PLUS MEDICAID |
|
MANAGED CARE PROGRAM SERVICES. The external quality review |
|
organization shall periodically conduct studies and surveys to |
|
assess the quality of care and satisfaction with health care |
|
services provided to enrollees in the STAR + PLUS Medicaid managed |
|
care program who are eligible to receive health care benefits under |
|
both [the] Medicaid and the Medicare program [programs]. |
|
SECTION 2.220. Section 533.00281(d), Government Code, is |
|
amended to read as follows: |
|
(d) In conjunction with the commission's office of contract |
|
management, the commission shall provide a report to the standing |
|
committees of the senate and house of representatives with |
|
jurisdiction over [the] Medicaid [program] not later than December |
|
1 of each year. The report must: |
|
(1) summarize the results of the utilization reviews |
|
conducted under this section during the preceding fiscal year; |
|
(2) provide analysis of errors committed by each |
|
reviewed managed care organization; and |
|
(3) extrapolate those findings and make |
|
recommendations for improving the efficiency of the program. |
|
SECTION 2.221. Section 533.003(b), Government Code, is |
|
amended to read as follows: |
|
(b) The commission, in considering approval of a |
|
subcontract between a managed care organization and a pharmacy |
|
benefit manager for the provision of prescription drug benefits |
|
under [the] Medicaid [program], shall review and consider whether |
|
the pharmacy benefit manager has been in the preceding three years: |
|
(1) convicted of an offense involving a material |
|
misrepresentation or an act of fraud or of another violation of |
|
state or federal criminal law; |
|
(2) adjudicated to have committed a breach of |
|
contract; or |
|
(3) assessed a penalty or fine in the amount of |
|
$500,000 or more in a state or federal administrative proceeding. |
|
SECTION 2.222. Section 533.005(a), Government Code, is |
|
amended to read as follows: |
|
(a) A contract between a managed care organization and the |
|
commission for the organization to provide health care services to |
|
recipients must contain: |
|
(1) procedures to ensure accountability to the state |
|
for the provision of health care services, including procedures for |
|
financial reporting, quality assurance, utilization review, and |
|
assurance of contract and subcontract compliance; |
|
(2) capitation rates that ensure the cost-effective |
|
provision of quality health care; |
|
(3) a requirement that the managed care organization |
|
provide ready access to a person who assists recipients in |
|
resolving issues relating to enrollment, plan administration, |
|
education and training, access to services, and grievance |
|
procedures; |
|
(4) a requirement that the managed care organization |
|
provide ready access to a person who assists providers in resolving |
|
issues relating to payment, plan administration, education and |
|
training, and grievance procedures; |
|
(5) a requirement that the managed care organization |
|
provide information and referral about the availability of |
|
educational, social, and other community services that could |
|
benefit a recipient; |
|
(6) procedures for recipient outreach and education; |
|
(7) a requirement that the managed care organization |
|
make payment to a physician or provider for health care services |
|
rendered to a recipient under a managed care plan on any claim for |
|
payment that is received with documentation reasonably necessary |
|
for the managed care organization to process the claim: |
|
(A) not later than: |
|
(i) the 10th day after the date the claim is |
|
received if the claim relates to services provided by a nursing |
|
facility, intermediate care facility, or group home; |
|
(ii) the 30th day after the date the claim |
|
is received if the claim relates to the provision of long-term |
|
services and supports not subject to Subparagraph (i); and |
|
(iii) the 45th day after the date the claim |
|
is received if the claim is not subject to Subparagraph (i) or (ii); |
|
or |
|
(B) within a period, not to exceed 60 days, |
|
specified by a written agreement between the physician or provider |
|
and the managed care organization; |
|
(7-a) a requirement that the managed care organization |
|
demonstrate to the commission that the organization pays claims |
|
described by Subdivision (7)(A)(ii) on average not later than the |
|
21st day after the date the claim is received by the organization; |
|
(8) a requirement that the commission, on the date of a |
|
recipient's enrollment in a managed care plan issued by the managed |
|
care organization, inform the organization of the recipient's |
|
Medicaid certification date; |
|
(9) a requirement that the managed care organization |
|
comply with Section 533.006 as a condition of contract retention |
|
and renewal; |
|
(10) a requirement that the managed care organization |
|
provide the information required by Section 533.012 and otherwise |
|
comply and cooperate with the commission's office of inspector |
|
general and the office of the attorney general; |
|
(11) a requirement that the managed care |
|
organization's usages of out-of-network providers or groups of |
|
out-of-network providers may not exceed limits for those usages |
|
relating to total inpatient admissions, total outpatient services, |
|
and emergency room admissions determined by the commission; |
|
(12) if the commission finds that a managed care |
|
organization has violated Subdivision (11), a requirement that the |
|
managed care organization reimburse an out-of-network provider for |
|
health care services at a rate that is equal to the allowable rate |
|
for those services, as determined under Sections 32.028 and |
|
32.0281, Human Resources Code; |
|
(13) a requirement that, notwithstanding any other |
|
law, including Sections 843.312 and 1301.052, Insurance Code, the |
|
organization: |
|
(A) use advanced practice registered nurses and |
|
physician assistants in addition to physicians as primary care |
|
providers to increase the availability of primary care providers in |
|
the organization's provider network; and |
|
(B) treat advanced practice registered nurses |
|
and physician assistants in the same manner as primary care |
|
physicians with regard to: |
|
(i) selection and assignment as primary |
|
care providers; |
|
(ii) inclusion as primary care providers in |
|
the organization's provider network; and |
|
(iii) inclusion as primary care providers |
|
in any provider network directory maintained by the organization; |
|
(14) a requirement that the managed care organization |
|
reimburse a federally qualified health center or rural health |
|
clinic for health care services provided to a recipient outside of |
|
regular business hours, including on a weekend day or holiday, at a |
|
rate that is equal to the allowable rate for those services as |
|
determined under Section 32.028, Human Resources Code, if the |
|
recipient does not have a referral from the recipient's primary |
|
care physician; |
|
(15) a requirement that the managed care organization |
|
develop, implement, and maintain a system for tracking and |
|
resolving all provider appeals related to claims payment, including |
|
a process that will require: |
|
(A) a tracking mechanism to document the status |
|
and final disposition of each provider's claims payment appeal; |
|
(B) the contracting with physicians who are not |
|
network providers and who are of the same or related specialty as |
|
the appealing physician to resolve claims disputes related to |
|
denial on the basis of medical necessity that remain unresolved |
|
subsequent to a provider appeal; |
|
(C) the determination of the physician resolving |
|
the dispute to be binding on the managed care organization and |
|
provider; and |
|
(D) the managed care organization to allow a |
|
provider with a claim that has not been paid before the time |
|
prescribed by Subdivision (7)(A)(ii) to initiate an appeal of that |
|
claim; |
|
(16) a requirement that a medical director who is |
|
authorized to make medical necessity determinations is available to |
|
the region where the managed care organization provides health care |
|
services; |
|
(17) a requirement that the managed care organization |
|
ensure that a medical director and patient care coordinators and |
|
provider and recipient support services personnel are located in |
|
the South Texas service region, if the managed care organization |
|
provides a managed care plan in that region; |
|
(18) a requirement that the managed care organization |
|
provide special programs and materials for recipients with limited |
|
English proficiency or low literacy skills; |
|
(19) a requirement that the managed care organization |
|
develop and establish a process for responding to provider appeals |
|
in the region where the organization provides health care services; |
|
(20) a requirement that the managed care organization: |
|
(A) develop and submit to the commission, before |
|
the organization begins to provide health care services to |
|
recipients, a comprehensive plan that describes how the |
|
organization's provider network will provide recipients sufficient |
|
access to: |
|
(i) preventive care; |
|
(ii) primary care; |
|
(iii) specialty care; |
|
(iv) after-hours urgent care; |
|
(v) chronic care; |
|
(vi) long-term services and supports; |
|
(vii) nursing services; and |
|
(viii) therapy services, including |
|
services provided in a clinical setting or in a home or |
|
community-based setting; and |
|
(B) regularly, as determined by the commission, |
|
submit to the commission and make available to the public a report |
|
containing data on the sufficiency of the organization's provider |
|
network with regard to providing the care and services described |
|
under Paragraph (A) and specific data with respect to Paragraphs |
|
(A)(iii), (vi), (vii), and (viii) on the average length of time |
|
between: |
|
(i) the date a provider makes a referral for |
|
the care or service and the date the organization approves or denies |
|
the referral; and |
|
(ii) the date the organization approves a |
|
referral for the care or service and the date the care or service is |
|
initiated; |
|
(21) a requirement that the managed care organization |
|
demonstrate to the commission, before the organization begins to |
|
provide health care services to recipients, that: |
|
(A) the organization's provider network has the |
|
capacity to serve the number of recipients expected to enroll in a |
|
managed care plan offered by the organization; |
|
(B) the organization's provider network |
|
includes: |
|
(i) a sufficient number of primary care |
|
providers; |
|
(ii) a sufficient variety of provider |
|
types; |
|
(iii) a sufficient number of providers of |
|
long-term services and supports and specialty pediatric care |
|
providers of home and community-based services; and |
|
(iv) providers located throughout the |
|
region where the organization will provide health care services; |
|
and |
|
(C) health care services will be accessible to |
|
recipients through the organization's provider network to a |
|
comparable extent that health care services would be available to |
|
recipients under a fee-for-service or primary care case management |
|
model of Medicaid managed care; |
|
(22) a requirement that the managed care organization |
|
develop a monitoring program for measuring the quality of the |
|
health care services provided by the organization's provider |
|
network that: |
|
(A) incorporates the National Committee for |
|
Quality Assurance's Healthcare Effectiveness Data and Information |
|
Set (HEDIS) measures; |
|
(B) focuses on measuring outcomes; and |
|
(C) includes the collection and analysis of |
|
clinical data relating to prenatal care, preventive care, mental |
|
health care, and the treatment of acute and chronic health |
|
conditions and substance abuse; |
|
(23) subject to Subsection (a-1), a requirement that |
|
the managed care organization develop, implement, and maintain an |
|
outpatient pharmacy benefit plan for its enrolled recipients: |
|
(A) that exclusively employs the vendor drug |
|
program formulary and preserves the state's ability to reduce |
|
waste, fraud, and abuse under [the] Medicaid [program]; |
|
(B) that adheres to the applicable preferred drug |
|
list adopted by the commission under Section 531.072; |
|
(C) that includes the prior authorization |
|
procedures and requirements prescribed by or implemented under |
|
Sections 531.073(b), (c), and (g) for the vendor drug program; |
|
(D) for purposes of which the managed care |
|
organization: |
|
(i) may not negotiate or collect rebates |
|
associated with pharmacy products on the vendor drug program |
|
formulary; and |
|
(ii) may not receive drug rebate or pricing |
|
information that is confidential under Section 531.071; |
|
(E) that complies with the prohibition under |
|
Section 531.089; |
|
(F) under which the managed care organization may |
|
not prohibit, limit, or interfere with a recipient's selection of a |
|
pharmacy or pharmacist of the recipient's choice for the provision |
|
of pharmaceutical services under the plan through the imposition of |
|
different copayments; |
|
(G) that allows the managed care organization or |
|
any subcontracted pharmacy benefit manager to contract with a |
|
pharmacist or pharmacy providers separately for specialty pharmacy |
|
services, except that: |
|
(i) the managed care organization and |
|
pharmacy benefit manager are prohibited from allowing exclusive |
|
contracts with a specialty pharmacy owned wholly or partly by the |
|
pharmacy benefit manager responsible for the administration of the |
|
pharmacy benefit program; and |
|
(ii) the managed care organization and |
|
pharmacy benefit manager must adopt policies and procedures for |
|
reclassifying prescription drugs from retail to specialty drugs, |
|
and those policies and procedures must be consistent with rules |
|
adopted by the executive commissioner and include notice to network |
|
pharmacy providers from the managed care organization; |
|
(H) under which the managed care organization may |
|
not prevent a pharmacy or pharmacist from participating as a |
|
provider if the pharmacy or pharmacist agrees to comply with the |
|
financial terms and conditions of the contract as well as other |
|
reasonable administrative and professional terms and conditions of |
|
the contract; |
|
(I) under which the managed care organization may |
|
include mail-order pharmacies in its networks, but may not require |
|
enrolled recipients to use those pharmacies, and may not charge an |
|
enrolled recipient who opts to use this service a fee, including |
|
postage and handling fees; |
|
(J) under which the managed care organization or |
|
pharmacy benefit manager, as applicable, must pay claims in |
|
accordance with Section 843.339, Insurance Code; and |
|
(K) under which the managed care organization or |
|
pharmacy benefit manager, as applicable: |
|
(i) to place a drug on a maximum allowable |
|
cost list, must ensure that: |
|
(a) the drug is listed as "A" or "B" |
|
rated in the most recent version of the United States Food and Drug |
|
Administration's Approved Drug Products with Therapeutic |
|
Equivalence Evaluations, also known as the Orange Book, has an "NR" |
|
or "NA" rating or a similar rating by a nationally recognized |
|
reference; and |
|
(b) the drug is generally available |
|
for purchase by pharmacies in the state from national or regional |
|
wholesalers and is not obsolete; |
|
(ii) must provide to a network pharmacy |
|
provider, at the time a contract is entered into or renewed with the |
|
network pharmacy provider, the sources used to determine the |
|
maximum allowable cost pricing for the maximum allowable cost list |
|
specific to that provider; |
|
(iii) must review and update maximum |
|
allowable cost price information at least once every seven days to |
|
reflect any modification of maximum allowable cost pricing; |
|
(iv) must, in formulating the maximum |
|
allowable cost price for a drug, use only the price of the drug and |
|
drugs listed as therapeutically equivalent in the most recent |
|
version of the United States Food and Drug Administration's |
|
Approved Drug Products with Therapeutic Equivalence Evaluations, |
|
also known as the Orange Book; |
|
(v) must establish a process for |
|
eliminating products from the maximum allowable cost list or |
|
modifying maximum allowable cost prices in a timely manner to |
|
remain consistent with pricing changes and product availability in |
|
the marketplace; |
|
(vi) must: |
|
(a) provide a procedure under which a |
|
network pharmacy provider may challenge a listed maximum allowable |
|
cost price for a drug; |
|
(b) respond to a challenge not later |
|
than the 15th day after the date the challenge is made; |
|
(c) if the challenge is successful, |
|
make an adjustment in the drug price effective on the date the |
|
challenge is resolved, and make the adjustment applicable to all |
|
similarly situated network pharmacy providers, as determined by the |
|
managed care organization or pharmacy benefit manager, as |
|
appropriate; |
|
(d) if the challenge is denied, |
|
provide the reason for the denial; and |
|
(e) report to the commission every 90 |
|
days the total number of challenges that were made and denied in the |
|
preceding 90-day period for each maximum allowable cost list drug |
|
for which a challenge was denied during the period; |
|
(vii) must notify the commission not later |
|
than the 21st day after implementing a practice of using a maximum |
|
allowable cost list for drugs dispensed at retail but not by mail; |
|
and |
|
(viii) must provide a process for each of |
|
its network pharmacy providers to readily access the maximum |
|
allowable cost list specific to that provider; |
|
(24) a requirement that the managed care organization |
|
and any entity with which the managed care organization contracts |
|
for the performance of services under a managed care plan disclose, |
|
at no cost, to the commission and, on request, the office of the |
|
attorney general all discounts, incentives, rebates, fees, free |
|
goods, bundling arrangements, and other agreements affecting the |
|
net cost of goods or services provided under the plan; and |
|
(25) a requirement that the managed care organization |
|
not implement significant, nonnegotiated, across-the-board |
|
provider reimbursement rate reductions unless: |
|
(A) subject to Subsection (a-3), the |
|
organization has the prior approval of the commission to make the |
|
reduction; or |
|
(B) the rate reductions are based on changes to |
|
the Medicaid fee schedule or cost containment initiatives |
|
implemented by the commission. |
|
SECTION 2.223. Section 533.0051(d), Government Code, is |
|
amended to read as follows: |
|
(d) Subject to Subsection (f), the commission shall assess |
|
the feasibility and cost-effectiveness of including provisions in a |
|
contract described by Subsection (a) that require the health |
|
maintenance organization to provide to the providers in the |
|
organization's provider network pay-for-performance opportunities |
|
that support quality improvements in the care of [Medicaid] |
|
recipients. Pay-for-performance opportunities may include |
|
incentives for providers to provide care after normal business |
|
hours and to participate in the early and periodic screening, |
|
diagnosis, and treatment program and other activities that improve |
|
[Medicaid] recipients' access to care. If the commission |
|
determines that the provisions are feasible and may be |
|
cost-effective, the commission shall develop and implement a pilot |
|
program in at least one health care service region under which the |
|
commission will include the provisions in contracts with health |
|
maintenance organizations offering managed care plans in the |
|
region. |
|
SECTION 2.224. Section 533.0055(b), Government Code, is |
|
amended to read as follows: |
|
(b) The provider protection plan required under this |
|
section must provide for: |
|
(1) prompt payment and proper reimbursement of |
|
providers by managed care organizations; |
|
(2) prompt and accurate adjudication of claims |
|
through: |
|
(A) provider education on the proper submission |
|
of clean claims and on appeals; |
|
(B) acceptance of uniform forms, including HCFA |
|
Forms 1500 and UB-92 and subsequent versions of those forms, |
|
through an electronic portal; and |
|
(C) the establishment of standards for claims |
|
payments in accordance with a provider's contract; |
|
(3) adequate and clearly defined provider network |
|
standards that are specific to provider type, including physicians, |
|
general acute care facilities, and other provider types defined in |
|
the commission's network adequacy standards in effect on January 1, |
|
2013, and that ensure choice among multiple providers to the |
|
greatest extent possible; |
|
(4) a prompt credentialing process for providers; |
|
(5) uniform efficiency standards and requirements for |
|
managed care organizations for the submission and tracking of |
|
preauthorization requests for services provided under [the] |
|
Medicaid [program]; |
|
(6) establishment of an electronic process, including |
|
the use of an Internet portal, through which providers in any |
|
managed care organization's provider network may: |
|
(A) submit electronic claims, prior |
|
authorization requests, claims appeals and reconsiderations, |
|
clinical data, and other documentation that the managed care |
|
organization requests for prior authorization and claims |
|
processing; and |
|
(B) obtain electronic remittance advice, |
|
explanation of benefits statements, and other standardized |
|
reports; |
|
(7) the measurement of the rates of retention by |
|
managed care organizations of significant traditional providers; |
|
(8) the creation of a work group to review and make |
|
recommendations to the commission concerning any requirement under |
|
this subsection for which immediate implementation is not feasible |
|
at the time the plan is otherwise implemented, including the |
|
required process for submission and acceptance of attachments for |
|
claims processing and prior authorization requests through an |
|
electronic process under Subdivision (6) and, for any requirement |
|
that is not implemented immediately, recommendations regarding the |
|
expected: |
|
(A) fiscal impact of implementing the |
|
requirement; and |
|
(B) timeline for implementation of the |
|
requirement; and |
|
(9) any other provision that the commission determines |
|
will ensure efficiency or reduce administrative burdens on |
|
providers participating in a Medicaid managed care model or |
|
arrangement. |
|
SECTION 2.225. Section 533.006, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.006. PROVIDER NETWORKS. (a) The commission shall |
|
require that each managed care organization that contracts with the |
|
commission to provide health care services to recipients in a |
|
region: |
|
(1) seek participation in the organization's provider |
|
network from: |
|
(A) each health care provider in the region who |
|
has traditionally provided care to [Medicaid] recipients; |
|
(B) each hospital in the region that has been |
|
designated as a disproportionate share hospital under [the state] |
|
Medicaid [program]; and |
|
(C) each specialized pediatric laboratory in the |
|
region, including those laboratories located in children's |
|
hospitals; and |
|
(2) include in its provider network for not less than |
|
three years: |
|
(A) each health care provider in the region who: |
|
(i) previously provided care to Medicaid |
|
and charity care recipients at a significant level as prescribed by |
|
the commission; |
|
(ii) agrees to accept the prevailing |
|
provider contract rate of the managed care organization; and |
|
(iii) has the credentials required by the |
|
managed care organization, provided that lack of board |
|
certification or accreditation by The [the] Joint Commission [on
|
|
Accreditation of Healthcare Organizations] may not be the sole |
|
ground for exclusion from the provider network; |
|
(B) each accredited primary care residency |
|
program in the region; and |
|
(C) each disproportionate share hospital |
|
designated by the commission as a statewide significant traditional |
|
provider. |
|
(b) A contract between a managed care organization and the |
|
commission for the organization to provide health care services to |
|
recipients in a health care service region that includes a rural |
|
area must require that the organization include in its provider |
|
network rural hospitals, physicians, home and community support |
|
services agencies, and other rural health care providers who: |
|
(1) are sole community providers; |
|
(2) provide care to Medicaid and charity care |
|
recipients at a significant level as prescribed by the commission; |
|
(3) agree to accept the prevailing provider contract |
|
rate of the managed care organization; and |
|
(4) have the credentials required by the managed care |
|
organization, provided that lack of board certification or |
|
accreditation by The [the] Joint Commission [on Accreditation of
|
|
Healthcare Organizations] may not be the sole ground for exclusion |
|
from the provider network. |
|
SECTION 2.226. Sections 533.007(b), (d), and (e), |
|
Government Code, are amended to read as follows: |
|
(b) Each managed care organization that contracts with the |
|
commission to provide health care services to recipients in a |
|
health care service region shall submit an implementation plan not |
|
later than the 90th day before the date on which the managed care |
|
organization [commission] plans to begin to provide health care |
|
services to recipients in that region through managed care. The |
|
implementation plan must include: |
|
(1) specific staffing patterns by function for all |
|
operations, including enrollment, information systems, member |
|
services, quality improvement, claims management, case management, |
|
and provider and recipient training; and |
|
(2) specific time frames for demonstrating |
|
preparedness for implementation before the date on which the |
|
managed care organization [commission] plans to begin to provide |
|
health care services to recipients in that region through managed |
|
care. |
|
(d) Each managed care organization that contracts with the |
|
commission to provide health care services to recipients in a |
|
region shall submit status reports on the implementation plan not |
|
later than the 60th day and the 30th day before the date on which the |
|
managed care organization [commission] plans to begin to provide |
|
health care services to recipients in that region through managed |
|
care and every 30th day after that date until the 180th day after |
|
that date. |
|
(e) The commission shall conduct a compliance and readiness |
|
review of each managed care organization that contracts with the |
|
commission not later than the 15th day before the date on which the |
|
process of enrolling recipients in a managed care plan issued by the |
|
managed care organization is to begin [commission plans to begin
|
|
the enrollment process] in a region and again not later than the |
|
15th day before the date on which the managed care organization |
|
[commission] plans to begin to provide health care services to |
|
recipients in that region through managed care. The review must |
|
include an on-site inspection and tests of service authorization |
|
and claims payment systems, including the ability of the managed |
|
care organization to process claims electronically, complaint |
|
processing systems, and any other process or system required by the |
|
contract. |
|
SECTION 2.227. Section 533.0075, Government Code, is |
|
amended to read as follows: |
|
Sec. 533.0075. RECIPIENT ENROLLMENT. The commission shall: |
|
(1) encourage recipients to choose appropriate |
|
managed care plans and primary health care providers by: |
|
(A) providing initial information to recipients |
|
and providers in a region about the need for recipients to choose |
|
plans and providers not later than the 90th day before the date on |
|
which a managed care organization [the commission] plans to begin |
|
to provide health care services to recipients in that region |
|
through managed care; |
|
(B) providing follow-up information before |
|
assignment of plans and providers and after assignment, if |
|
necessary, to recipients who delay in choosing plans and providers; |
|
and |
|
(C) allowing plans and providers to provide |
|
information to recipients or engage in marketing activities under |
|
marketing guidelines established by the commission under Section |
|
533.008 after the commission approves the information or |
|
activities; |
|
(2) consider the following factors in assigning |
|
managed care plans and primary health care providers to recipients |
|
who fail to choose plans and providers: |
|
(A) the importance of maintaining existing |
|
provider-patient and physician-patient relationships, including |
|
relationships with specialists, public health clinics, and |
|
community health centers; |
|
(B) to the extent possible, the need to assign |
|
family members to the same providers and plans; and |
|
(C) geographic convenience of plans and |
|
providers for recipients; |
|
(3) retain responsibility for enrollment and |
|
disenrollment of recipients in managed care plans, except that the |
|
commission may delegate the responsibility to an independent |
|
contractor who receives no form of payment from, and has no |
|
financial ties to, any managed care organization; |
|
(4) develop and implement an expedited process for |
|
determining eligibility for and enrolling pregnant women and |
|
newborn infants in managed care plans; and |
|
(5) ensure immediate access to prenatal services and |
|
newborn care for pregnant women and newborn infants enrolled in |
|
managed care plans, including ensuring that a pregnant woman may |
|
obtain an appointment with an obstetrical care provider for an |
|
initial maternity evaluation not later than the 30th day after the |
|
date the woman applies for Medicaid. |
|
SECTION 2.228. Section 533.009(c), Government Code, is |
|
amended to read as follows: |
|
(c) The executive commissioner, by rule, shall prescribe |
|
the minimum requirements that a managed care organization, in |
|
providing a disease management program, must meet to be eligible to |
|
receive a contract under this section. The managed care |
|
organization must, at a minimum, be required to: |
|
(1) provide disease management services that have |
|
performance measures for particular diseases that are comparable to |
|
the relevant performance measures applicable to a provider of |
|
disease management services under Section 32.057 [32.059], Human |
|
Resources Code[, as added by Chapter 208, Acts of the 78th
|
|
Legislature, Regular Session, 2003]; and |
|
(2) show evidence of ability to manage complex |
|
diseases in the Medicaid population. |
|
SECTION 2.229. Section 533.012(c), Government Code, is |
|
amended to read as follows: |
|
(c) The commission's office of inspector general |
|
[investigations and enforcement] or the office of the attorney |
|
general, as applicable, shall review the information submitted |
|
under this section as appropriate in the investigation of fraud in |
|
the Medicaid managed care program. |
|
SECTION 2.230. Sections 533.013(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) In determining premium payment rates paid to a managed |
|
care organization under a managed care plan, the commission shall |
|
consider: |
|
(1) the regional variation in costs of health care |
|
services; |
|
(2) the range and type of health care services to be |
|
covered by premium payment rates; |
|
(3) the number of managed care plans in a region; |
|
(4) the current and projected number of recipients in |
|
each region, including the current and projected number for each |
|
category of recipient; |
|
(5) the ability of the managed care plan to meet costs |
|
of operation under the proposed premium payment rates; |
|
(6) the applicable requirements of the federal |
|
Balanced Budget Act of 1997 and implementing regulations that |
|
require adequacy of premium payments to managed care organizations |
|
participating in [the state] Medicaid [program]; |
|
(7) the adequacy of the management fee paid for |
|
assisting enrollees of Supplemental Security Income (SSI) (42 |
|
U.S.C. Section 1381 et seq.) who are voluntarily enrolled in the |
|
managed care plan; |
|
(8) the impact of reducing premium payment rates for |
|
the category of recipients who are pregnant; and |
|
(9) the ability of the managed care plan to pay under |
|
the proposed premium payment rates inpatient and outpatient |
|
hospital provider payment rates that are comparable to the |
|
inpatient and outpatient hospital provider payment rates paid by |
|
the commission under a primary care case management model or a |
|
partially capitated model. |
|
(b) In determining the maximum premium payment rates paid to |
|
a managed care organization that is licensed under Chapter 843, |
|
Insurance Code, the commission shall consider and adjust for the |
|
regional variation in costs of services under the traditional |
|
fee-for-service component of [the state] Medicaid [program], |
|
utilization patterns, and other factors that influence the |
|
potential for cost savings. For a service area with a service area |
|
factor of .93 or less, or another appropriate service area factor, |
|
as determined by the commission, the commission may not discount |
|
premium payment rates in an amount that is more than the amount |
|
necessary to meet federal budget neutrality requirements for |
|
projected fee-for-service costs unless: |
|
(1) a historical review of managed care financial |
|
results among managed care organizations in the service area served |
|
by the organization demonstrates that additional savings are |
|
warranted; |
|
(2) a review of Medicaid fee-for-service delivery in |
|
the service area served by the organization has historically shown |
|
a significant overutilization by recipients of certain services |
|
covered by the premium payment rates in comparison to utilization |
|
patterns throughout the rest of the state; or |
|
(3) a review of Medicaid fee-for-service delivery in |
|
the service area served by the organization has historically shown |
|
an above-market cost for services for which there is substantial |
|
evidence that Medicaid managed care delivery will reduce the cost |
|
of those services. |
|
SECTION 2.231. Section 533.01315(a), Government Code, is |
|
amended to read as follows: |
|
(a) This section applies only to a recipient receiving |
|
benefits [medical assistance] through any Medicaid managed care |
|
model or arrangement. |
|
SECTION 2.232. Sections 533.014(a) and (b), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner [commission] shall adopt |
|
rules regarding the sharing of profits earned by a managed care |
|
organization through a managed care plan providing health care |
|
services under a contract with the commission under this chapter. |
|
(b) Except as provided by Subsection (c), any amount |
|
received by the state under this section shall be deposited in the |
|
general revenue fund [for the purpose of funding the state Medicaid
|
|
program]. |
|
SECTION 2.233. Section 533.015, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.015. COORDINATION OF EXTERNAL OVERSIGHT |
|
ACTIVITIES. To the extent possible, the commission shall |
|
coordinate all external oversight activities to minimize |
|
duplication of oversight of managed care plans under [the state] |
|
Medicaid [program] and disruption of operations under those plans. |
|
SECTION 2.234. Section 533.020(a), Government Code, is |
|
amended to read as follows: |
|
(a) The Texas Department of Insurance, in conjunction with |
|
the commission, shall establish fiscal solvency standards and |
|
complaint system guidelines for managed care organizations that |
|
serve [Medicaid] recipients. |
|
SECTION 2.235. Section 533.021, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.021. MEDICAID MANAGED CARE ADVISORY COMMITTEES |
|
[APPOINTMENT]. A [Not later than the 180th day before the date the
|
|
commission plans to begin to provide health care services to
|
|
recipients in a health care service region through managed care,
|
|
the commission, in consultation with health and human services
|
|
agencies, shall appoint a] Medicaid managed care advisory committee |
|
exists for each health care service [for that] region. The |
|
commission, in consultation with health and human services |
|
agencies, appoints the committee members. |
|
SECTION 2.236. Section 533.023, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.023. PRESIDING OFFICER; SUBCOMMITTEES. The |
|
executive commissioner or the executive commissioner's designated |
|
representative serves as the presiding officer of a committee. The |
|
presiding officer may appoint subcommittees as necessary. |
|
SECTION 2.237. Section 533.028, Government Code, is amended |
|
to read as follows: |
|
Sec. 533.028. OTHER LAW. Except as provided by this |
|
chapter, a committee is subject to Chapter 2110 [Article 6252-33,
|
|
Revised Statutes]. |
|
SECTION 2.238. Sections 533.041(a) and (d), Government |
|
Code, are amended to read as follows: |
|
(a) The executive commissioner shall appoint a state |
|
Medicaid managed care advisory committee. The advisory committee |
|
consists of representatives of: |
|
(1) hospitals; |
|
(2) managed care organizations and participating |
|
health care providers; |
|
(3) primary care providers and specialty care |
|
providers; |
|
(4) state agencies; |
|
(5) low-income recipients or consumer advocates |
|
representing low-income recipients; |
|
(6) recipients with disabilities, including |
|
recipients with an intellectual or [and] developmental disability |
|
[disabilities] or with physical disabilities, or consumer |
|
advocates representing those recipients; |
|
(7) parents of children who are recipients; |
|
(8) rural providers; |
|
(9) advocates for children with special health care |
|
needs; |
|
(10) pediatric health care providers, including |
|
specialty providers; |
|
(11) long-term services and supports providers, |
|
including nursing facility providers and direct service workers; |
|
(12) obstetrical care providers; |
|
(13) community-based organizations serving low-income |
|
children and their families; |
|
(14) community-based organizations engaged in |
|
perinatal services and outreach; |
|
(15) recipients who are 65 years of age or older; |
|
(16) recipients with mental illness; |
|
(17) nonphysician mental health providers |
|
participating in the Medicaid managed care program; and |
|
(18) entities with responsibilities for the delivery |
|
of long-term services and supports or other Medicaid [program] |
|
service delivery, including: |
|
(A) independent living centers; |
|
(B) area agencies on aging; |
|
(C) aging and disability resource centers |
|
established under the Aging and Disability Resource Center |
|
initiative funded in part by the federal Administration on Aging |
|
and the Centers for Medicare and Medicaid Services; |
|
(D) community mental health and intellectual |
|
disability centers; and |
|
(E) the NorthSTAR Behavioral Health Program |
|
provided under Chapter 534, Health and Safety Code. |
|
(d) To the greatest extent possible, the executive |
|
commissioner shall appoint members of the advisory committee who |
|
reflect the geographic diversity of the state and include members |
|
who represent rural [Medicaid program] recipients. |
|
SECTION 2.239. Section 533.045(b), Government Code, is |
|
amended to read as follows: |
|
(b) A member of the advisory committee who is a [Medicaid
|
|
program] recipient or the relative of a [Medicaid program] |
|
recipient is entitled to a per diem allowance and reimbursement at |
|
rates established in the General Appropriations Act. |
|
SECTION 2.240. The heading to Chapter 534, Government Code, |
|
is amended to read as follows: |
|
CHAPTER 534. SYSTEM REDESIGN FOR DELIVERY OF MEDICAID ACUTE CARE |
|
SERVICES AND LONG-TERM SERVICES AND SUPPORTS TO PERSONS WITH AN |
|
INTELLECTUAL OR [AND] DEVELOPMENTAL DISABILITY [DISABILITIES] |
|
SECTION 2.241. Sections 534.001(6), (7), (8), and (11), |
|
Government Code, are amended to read as follows: |
|
(6) "ICF-IID" means the [Medicaid] program under |
|
Medicaid serving individuals with an intellectual or [and] |
|
developmental disability [disabilities] who receive care in |
|
intermediate care facilities other than a state supported living |
|
center. |
|
(7) "ICF-IID program" means a program under [the] |
|
Medicaid [program] serving individuals with an intellectual or |
|
[and] developmental disability [disabilities] who reside in and |
|
receive care from: |
|
(A) intermediate care facilities licensed under |
|
Chapter 252, Health and Safety Code; or |
|
(B) community-based intermediate care facilities |
|
operated by local intellectual and developmental disability |
|
authorities. |
|
(8) "Local intellectual and developmental disability |
|
authority" has the meaning assigned [means an authority defined] by |
|
Section 531.002 [Section 531.002(11)], Health and Safety Code. |
|
(11) "Medicaid waiver program" means only the |
|
following programs that are authorized under Section 1915(c) of the |
|
federal Social Security Act (42 U.S.C. Section 1396n(c)) for the |
|
provision of services to persons with an intellectual or [and] |
|
developmental disability [disabilities]: |
|
(A) the community living assistance and support |
|
services (CLASS) waiver program; |
|
(B) the home and community-based services (HCS) |
|
waiver program; |
|
(C) the deaf-blind with multiple disabilities |
|
(DBMD) waiver program; and |
|
(D) the Texas home living (TxHmL) waiver program. |
|
SECTION 2.242. Section 534.051, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.051. ACUTE CARE SERVICES AND LONG-TERM SERVICES |
|
AND SUPPORTS SYSTEM FOR INDIVIDUALS WITH AN INTELLECTUAL OR [AND] |
|
DEVELOPMENTAL DISABILITY [DISABILITIES]. In accordance with this |
|
chapter, the commission and the department shall jointly design and |
|
implement an acute care services and long-term services and |
|
supports system for individuals with an intellectual or [and] |
|
developmental disability [disabilities] that supports the |
|
following goals: |
|
(1) provide Medicaid services to more individuals in a |
|
cost-efficient manner by providing the type and amount of services |
|
most appropriate to the individuals' needs; |
|
(2) improve individuals' access to services and |
|
supports by ensuring that the individuals receive information about |
|
all available programs and services, including employment and least |
|
restrictive housing assistance, and how to apply for the programs |
|
and services; |
|
(3) improve the assessment of individuals' needs and |
|
available supports, including the assessment of individuals' |
|
functional needs; |
|
(4) promote person-centered planning, self-direction, |
|
self-determination, community inclusion, and customized, |
|
integrated, competitive employment; |
|
(5) promote individualized budgeting based on an |
|
assessment of an individual's needs and person-centered planning; |
|
(6) promote integrated service coordination of acute |
|
care services and long-term services and supports; |
|
(7) improve acute care and long-term services and |
|
supports outcomes, including reducing unnecessary |
|
institutionalization and potentially preventable events; |
|
(8) promote high-quality care; |
|
(9) provide fair hearing and appeals processes in |
|
accordance with applicable federal law; |
|
(10) ensure the availability of a local safety net |
|
provider and local safety net services; |
|
(11) promote independent service coordination and |
|
independent ombudsmen services; and |
|
(12) ensure that individuals with the most significant |
|
needs are appropriately served in the community and that processes |
|
are in place to prevent inappropriate institutionalization of |
|
individuals. |
|
SECTION 2.243. Section 534.052, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.052. IMPLEMENTATION OF SYSTEM REDESIGN. The |
|
commission and department shall, in consultation with the advisory |
|
committee, jointly implement the acute care services and long-term |
|
services and supports system for individuals with an intellectual |
|
or [and] developmental disability [disabilities] in the manner and |
|
in the stages described in this chapter. |
|
SECTION 2.244. Sections 534.053(a), (b), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The Intellectual and Developmental Disability System |
|
Redesign Advisory Committee shall [is established to] advise the |
|
commission and the department on the implementation of the acute |
|
care services and long-term services and supports system redesign |
|
under this chapter. Subject to Subsection (b), the executive |
|
commissioner and the commissioner of aging and disability services |
|
[the department] shall jointly appoint members of the advisory |
|
committee who are stakeholders from the intellectual and |
|
developmental disabilities community, including: |
|
(1) individuals with an intellectual or [and] |
|
developmental disability [disabilities] who are recipients of |
|
services under the Medicaid waiver programs, individuals with an |
|
intellectual or [and] developmental disability [disabilities] who |
|
are recipients of services under the ICF-IID program, and |
|
individuals who are advocates of those recipients, including at |
|
least three representatives from intellectual and developmental |
|
disability advocacy organizations; |
|
(2) representatives of Medicaid managed care and |
|
nonmanaged care health care providers, including: |
|
(A) physicians who are primary care providers and |
|
physicians who are specialty care providers; |
|
(B) nonphysician mental health professionals; |
|
and |
|
(C) providers of long-term services and |
|
supports, including direct service workers; |
|
(3) representatives of entities with responsibilities |
|
for the delivery of Medicaid long-term services and supports or |
|
other Medicaid [program] service delivery, including: |
|
(A) representatives of aging and disability |
|
resource centers established under the Aging and Disability |
|
Resource Center initiative funded in part by the federal |
|
Administration on Aging and the Centers for Medicare and Medicaid |
|
Services; |
|
(B) representatives of community mental health |
|
and intellectual disability centers; |
|
(C) representatives of and service coordinators |
|
or case managers from private and public home and community-based |
|
services providers that serve individuals with an intellectual or |
|
[and] developmental disability [disabilities]; and |
|
(D) representatives of private and public |
|
ICF-IID providers; and |
|
(4) representatives of managed care organizations |
|
contracting with the state to provide services to individuals with |
|
an intellectual or [and] developmental disability [disabilities]. |
|
(b) To the greatest extent possible, the executive |
|
commissioner and the commissioner of aging and disability services |
|
[the department] shall appoint members of the advisory committee |
|
who reflect the geographic diversity of the state and include |
|
members who represent rural Medicaid [program] recipients. |
|
(e) A member of the advisory committee serves without |
|
compensation. A member of the advisory committee who is a Medicaid |
|
[program] recipient or the relative of a Medicaid [program] |
|
recipient is entitled to a per diem allowance and reimbursement at |
|
rates established in the General Appropriations Act. |
|
SECTION 2.245. Section 534.054(a), Government Code, is |
|
amended to read as follows: |
|
(a) Not later than September 30 of each year, the commission |
|
shall submit a report to the legislature regarding: |
|
(1) the implementation of the system required by this |
|
chapter, including appropriate information regarding the provision |
|
of acute care services and long-term services and supports to |
|
individuals with an intellectual or [and] developmental disability |
|
[disabilities] under [the] Medicaid [program]; and |
|
(2) recommendations, including recommendations |
|
regarding appropriate statutory changes to facilitate the |
|
implementation. |
|
SECTION 2.246. Section 534.055(a), Government Code, is |
|
amended to read as follows: |
|
(a) The commission and department shall submit a report to |
|
the legislature not later than December 1, 2014, that includes the |
|
following information: |
|
(1) the percentage of services provided by each local |
|
intellectual and developmental disability authority to individuals |
|
receiving ICF-IID or Medicaid waiver program services, compared to |
|
the percentage of those services provided by private providers; |
|
(2) the types of evidence provided by local |
|
intellectual and developmental disability authorities to the |
|
department to demonstrate the lack of available private providers |
|
in areas of the state where local authorities provide services to |
|
more than 40 percent of the Texas home living (TxHmL) waiver program |
|
clients or 20 percent of the home and community-based services |
|
(HCS) waiver program clients; |
|
(3) the types and amounts of services received by |
|
clients from local intellectual and developmental disability |
|
authorities compared to the types and amounts of services received |
|
by clients from private providers; |
|
(4) the provider capacity of each local intellectual |
|
and developmental disability authority as determined under Section |
|
533A.0355(d) [Section 533.0355(d)], Health and Safety Code; |
|
(5) the number of individuals served above or below |
|
the applicable provider capacity by each local intellectual and |
|
developmental disability authority; and |
|
(6) if a local intellectual and developmental |
|
disability authority is serving clients over the authority's |
|
provider capacity, the length of time the local authority has |
|
served clients above the authority's approved provider capacity. |
|
SECTION 2.247. Section 534.101(2), Government Code, is |
|
amended to read as follows: |
|
(2) "Provider" means a person with whom the commission |
|
contracts for the provision of long-term services and supports |
|
under [the] Medicaid [program] to a specific population based on |
|
capitation. |
|
SECTION 2.248. Section 534.102, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.102. PILOT PROGRAMS TO TEST MANAGED CARE |
|
STRATEGIES BASED ON CAPITATION. The commission and the department |
|
may develop and implement pilot programs in accordance with this |
|
subchapter to test one or more service delivery models involving a |
|
managed care strategy based on capitation to deliver long-term |
|
services and supports under [the] Medicaid [program] to individuals |
|
with an intellectual or [and] developmental disability |
|
[disabilities]. |
|
SECTION 2.249. Sections 534.104(a) and (f), Government |
|
Code, are amended to read as follows: |
|
(a) The department shall identify private services |
|
providers that are good candidates to develop a service delivery |
|
model involving a managed care strategy based on capitation and to |
|
test the model in the provision of long-term services and supports |
|
under [the] Medicaid [program] to individuals with an intellectual |
|
or [and] developmental disability [disabilities] through a pilot |
|
program established under this subchapter. |
|
(f) For each pilot program service provider, the department |
|
shall develop and implement a pilot program. Under a pilot |
|
program, the pilot program service provider shall provide long-term |
|
services and supports under [the] Medicaid [program] to persons |
|
with an intellectual or [and] developmental disability |
|
[disabilities] to test its managed care strategy based on |
|
capitation. |
|
SECTION 2.250. Section 534.107, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.107. COORDINATING SERVICES. In providing |
|
long-term services and supports under [the] Medicaid [program] to |
|
individuals with an intellectual or [and] developmental disability |
|
[disabilities], a pilot program service provider shall: |
|
(1) coordinate through the pilot program |
|
institutional and community-based services available to the |
|
individuals, including services provided through: |
|
(A) a facility licensed under Chapter 252, Health |
|
and Safety Code; |
|
(B) a Medicaid waiver program; or |
|
(C) a community-based ICF-IID operated by local |
|
authorities; |
|
(2) collaborate with managed care organizations to |
|
provide integrated coordination of acute care services and |
|
long-term services and supports, including discharge planning from |
|
acute care services to community-based long-term services and |
|
supports; |
|
(3) have a process for preventing inappropriate |
|
institutionalizations of individuals; and |
|
(4) accept the risk of inappropriate |
|
institutionalizations of individuals previously residing in |
|
community settings. |
|
SECTION 2.251. Section 534.109, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.109. PERSON-CENTERED PLANNING. The commission, |
|
in cooperation with the department, shall ensure that each |
|
individual with an intellectual or developmental disability who |
|
receives services and supports under [the] Medicaid [program] |
|
through a pilot program established under this subchapter, or the |
|
individual's legally authorized representative, has access to a |
|
facilitated, person-centered plan that identifies outcomes for the |
|
individual and drives the development of the individualized |
|
budget. The consumer direction model, as defined by Section |
|
531.051, may be an outcome of the plan. |
|
SECTION 2.252. Section 534.110, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.110. TRANSITION BETWEEN PROGRAMS. The commission |
|
shall ensure that there is a comprehensive plan for transitioning |
|
the provision of Medicaid [program] benefits between a Medicaid |
|
waiver program or an ICF-IID program and a pilot program under this |
|
subchapter to protect continuity of care. |
|
SECTION 2.253. Section 534.151, Government Code, is amended |
|
to read as follows: |
|
Sec. 534.151. DELIVERY OF ACUTE CARE SERVICES FOR |
|
INDIVIDUALS WITH AN INTELLECTUAL OR [AND] DEVELOPMENTAL DISABILITY |
|
[DISABILITIES]. Subject to Section 533.0025, the commission shall |
|
provide acute care Medicaid [program] benefits to individuals with |
|
an intellectual or [and] developmental disability [disabilities] |
|
through the STAR + PLUS Medicaid managed care program or the most |
|
appropriate integrated capitated managed care program delivery |
|
model and monitor the provision of those benefits. |
|
SECTION 2.254. Sections 534.152(a), (b), (c), (e), and (f), |
|
Government Code, are amended to read as follows: |
|
(a) The commission shall: |
|
(1) implement the most cost-effective option for the |
|
delivery of basic attendant and habilitation services for |
|
individuals with an intellectual or [and] developmental disability |
|
[disabilities] under the STAR + PLUS Medicaid managed care program |
|
that maximizes federal funding for the delivery of services for |
|
that program and other similar programs; and |
|
(2) provide voluntary training to individuals |
|
receiving services under the STAR + PLUS Medicaid managed care |
|
program or their legally authorized representatives regarding how |
|
to select, manage, and dismiss personal attendants providing basic |
|
attendant and habilitation services under the program. |
|
(b) The commission shall require that each managed care |
|
organization that contracts with the commission for the provision |
|
of basic attendant and habilitation services under the STAR + PLUS |
|
Medicaid managed care program in accordance with this section: |
|
(1) include in the organization's provider network for |
|
the provision of those services: |
|
(A) home and community support services agencies |
|
licensed under Chapter 142, Health and Safety Code, with which the |
|
department has a contract to provide services under the community |
|
living assistance and support services (CLASS) waiver program; and |
|
(B) persons exempted from licensing under |
|
Section 142.003(a)(19), Health and Safety Code, with which the |
|
department has a contract to provide services under: |
|
(i) the home and community-based services |
|
(HCS) waiver program; or |
|
(ii) the Texas home living (TxHmL) waiver |
|
program; |
|
(2) review and consider any assessment conducted by a |
|
local intellectual and developmental disability authority |
|
providing intellectual and developmental disability service |
|
coordination under Subsection (c); and |
|
(3) enter into a written agreement with each local |
|
intellectual and developmental disability authority in the service |
|
area regarding the processes the organization and the authority |
|
will use to coordinate the services of individuals with an |
|
intellectual or [and] developmental disability [disabilities]. |
|
(c) The department shall contract with and make contract |
|
payments to local intellectual and developmental disability |
|
authorities to conduct the following activities under this section: |
|
(1) provide intellectual and developmental disability |
|
service coordination to individuals with an intellectual or [and] |
|
developmental disability [disabilities] under the STAR + PLUS |
|
Medicaid managed care program by assisting those individuals who |
|
are eligible to receive services in a community-based setting, |
|
including individuals transitioning to a community-based setting; |
|
(2) provide an assessment to the appropriate managed |
|
care organization regarding whether an individual with an |
|
intellectual or developmental disability needs attendant or |
|
habilitation services, based on the individual's functional need, |
|
risk factors, and desired outcomes; |
|
(3) assist individuals with an intellectual or [and] |
|
developmental disability [disabilities] with developing the |
|
individuals' plans of care under the STAR + PLUS Medicaid managed |
|
care program, including with making any changes resulting from |
|
periodic reassessments of the plans; |
|
(4) provide to the appropriate managed care |
|
organization and the department information regarding the |
|
recommended plans of care with which the authorities provide |
|
assistance as provided by Subdivision (3), including documentation |
|
necessary to demonstrate the need for care described by a plan; and |
|
(5) on an annual basis, provide to the appropriate |
|
managed care organization and the department a description of |
|
outcomes based on an individual's plan of care. |
|
(e) During the first three years basic attendant and |
|
habilitation services are provided to individuals with an |
|
intellectual or [and] developmental disability [disabilities] |
|
under the STAR + PLUS Medicaid managed care program in accordance |
|
with this section, providers eligible to participate in the home |
|
and community-based services (HCS) waiver program, the Texas home |
|
living (TxHmL) waiver program, or the community living assistance |
|
and support services (CLASS) waiver program on September 1, 2013, |
|
are considered significant traditional providers. |
|
(f) A local intellectual and developmental disability |
|
authority with which the department contracts under Subsection (c) |
|
may subcontract with an eligible person, including a nonprofit |
|
entity, to coordinate the services of individuals with an |
|
intellectual or [and] developmental disability [disabilities] |
|
under this section. The executive commissioner by rule shall |
|
establish minimum qualifications a person must meet to be |
|
considered an "eligible person" under this subsection. |
|
SECTION 2.255. Sections 534.201(a), (b), (e), and (f), |
|
Government Code, are amended to read as follows: |
|
(a) This section applies to individuals with an |
|
intellectual or [and] developmental disability [disabilities] who |
|
are receiving long-term services and supports under the Texas home |
|
living (TxHmL) waiver program on the date the commission implements |
|
the transition described by Subsection (b). |
|
(b) Not later than September 1, 2017, the commission shall |
|
transition the provision of Medicaid [program] benefits to |
|
individuals to whom this section applies to the STAR + PLUS Medicaid |
|
managed care program delivery model or the most appropriate |
|
integrated capitated managed care program delivery model, as |
|
determined by the commission based on cost-effectiveness and the |
|
experience of the STAR + PLUS Medicaid managed care program in |
|
providing basic attendant and habilitation services and of the |
|
pilot programs established under Subchapter C, subject to |
|
Subsection (c)(1). |
|
(e) The commission shall ensure that there is a |
|
comprehensive plan for transitioning the provision of Medicaid |
|
[program] benefits under this section that protects the continuity |
|
of care provided to individuals to whom this section applies. |
|
(f) In addition to the requirements of Section 533.005, a |
|
contract between a managed care organization and the commission for |
|
the organization to provide Medicaid [program] benefits under this |
|
section must contain a requirement that the organization implement |
|
a process for individuals with an intellectual or [and] |
|
developmental disability [disabilities] that: |
|
(1) ensures that the individuals have a choice among |
|
providers; |
|
(2) to the greatest extent possible, protects those |
|
individuals' continuity of care with respect to access to primary |
|
care providers, including the use of single-case agreements with |
|
out-of-network providers; and |
|
(3) provides access to a member services phone line |
|
for individuals or their legally authorized representatives to |
|
obtain information on and assistance with accessing services |
|
through network providers, including providers of primary, |
|
specialty, and other long-term services and supports. |
|
SECTION 2.256. Sections 534.202(a), (b), (e), (f), and (i), |
|
Government Code, are amended to read as follows: |
|
(a) This section applies to individuals with an |
|
intellectual or [and] developmental disability [disabilities] who, |
|
on the date the commission implements the transition described by |
|
Subsection (b), are receiving long-term services and supports |
|
under: |
|
(1) a Medicaid waiver program other than the Texas |
|
home living (TxHmL) waiver program; or |
|
(2) an ICF-IID program. |
|
(b) After implementing the transition required by Section |
|
534.201 but not later than September 1, 2020, the commission shall |
|
transition the provision of Medicaid [program] benefits to |
|
individuals to whom this section applies to the STAR + PLUS Medicaid |
|
managed care program delivery model or the most appropriate |
|
integrated capitated managed care program delivery model, as |
|
determined by the commission based on cost-effectiveness and the |
|
experience of the transition of Texas home living (TxHmL) waiver |
|
program recipients to a managed care program delivery model under |
|
Section 534.201, subject to Subsections (c)(1) and (g). |
|
(e) The commission shall ensure that there is a |
|
comprehensive plan for transitioning the provision of Medicaid |
|
[program] benefits under this section that protects the continuity |
|
of care provided to individuals to whom this section applies. |
|
(f) Before transitioning the provision of Medicaid |
|
[program] benefits for children under this section, a managed care |
|
organization providing services under the managed care program |
|
delivery model selected by the commission must demonstrate to the |
|
satisfaction of the commission that the organization's network of |
|
providers has experience and expertise in the provision of services |
|
to children with an intellectual or [and] developmental disability |
|
[disabilities]. Before transitioning the provision of Medicaid |
|
[program] benefits for adults with an intellectual or [and] |
|
developmental disability [disabilities] under this section, a |
|
managed care organization providing services under the managed care |
|
program delivery model selected by the commission must demonstrate |
|
to the satisfaction of the commission that the organization's |
|
network of providers has experience and expertise in the provision |
|
of services to adults with an intellectual or [and] developmental |
|
disability [disabilities]. |
|
(i) In addition to the requirements of Section 533.005, a |
|
contract between a managed care organization and the commission for |
|
the organization to provide Medicaid [program] benefits under this |
|
section must contain a requirement that the organization implement |
|
a process for individuals with an intellectual or [and] |
|
developmental disability [disabilities] that: |
|
(1) ensures that the individuals have a choice among |
|
providers; |
|
(2) to the greatest extent possible, protects those |
|
individuals' continuity of care with respect to access to primary |
|
care providers, including the use of single-case agreements with |
|
out-of-network providers; and |
|
(3) provides access to a member services phone line |
|
for individuals or their legally authorized representatives to |
|
obtain information on and assistance with accessing services |
|
through network providers, including providers of primary, |
|
specialty, and other long-term services and supports. |
|
SECTION 2.257. Section 535.051(b), Government Code, is |
|
amended to read as follows: |
|
(b) The chief administrative officer of each of the |
|
following state agencies, in consultation with the governor, shall |
|
designate one employee from the agency to serve as a liaison for |
|
faith- and community-based organizations: |
|
(1) [the Texas Department of Rural Affairs;
|
|
[(2)] the Texas Commission on Environmental Quality; |
|
(2) [(3)] the Texas Department of Criminal Justice; |
|
(3) [(4)] the Texas Department of Housing and |
|
Community Affairs; |
|
(4) [(5)] the Texas Juvenile Justice Department; |
|
(5) [(6)] the Texas Veterans Commission; |
|
(6) [(7)] the Texas Workforce Commission; |
|
(7) [(8)] the office of the governor; |
|
(8) [(9)] the Department of Public Safety; |
|
(9) [(10)] the Texas Department of Insurance; |
|
(10) [(11)] the Public Utility Commission of Texas; |
|
(11) [(12)] the office of the attorney general; |
|
(12) [(13)] the Department of Agriculture; |
|
(13) [(14)] the office of the comptroller; |
|
(14) [(15)] the Department of Information Resources; |
|
(15) [(16)] the Office of State-Federal Relations; |
|
(16) [(17)] the office of the secretary of state; and |
|
(17) [(18)] other state agencies as determined by the |
|
governor. |
|
SECTION 2.258. Section 535.103(b), Government Code, is |
|
amended to read as follows: |
|
(b) The account consists of: |
|
(1) all money appropriated for the purposes of this |
|
subchapter; and |
|
(2) any gifts, grants, or donations received for the |
|
purposes of this subchapter[; and
|
|
[(3) interest earned on money in the account]. |
|
SECTION 2.259. The heading to Chapter 536, Government Code, |
|
is amended to read as follows: |
|
CHAPTER 536. MEDICAID AND THE CHILD HEALTH PLAN PROGRAM [PROGRAMS]: |
|
QUALITY-BASED OUTCOMES AND PAYMENTS |
|
SECTION 2.260. Section 536.002(a), Government Code, is |
|
amended to read as follows: |
|
(a) The Medicaid and CHIP Quality-Based Payment Advisory |
|
Committee advises [is established to advise] the commission on |
|
establishing, for purposes of the child health plan program and |
|
Medicaid [programs administered by the commission or a health and
|
|
human services agency]: |
|
(1) reimbursement systems used to compensate |
|
physicians or other health care providers under those programs that |
|
reward the provision of high-quality, cost-effective health care |
|
and quality performance and quality of care outcomes with respect |
|
to health care services; |
|
(2) standards and benchmarks for quality performance, |
|
quality of care outcomes, efficiency, and accountability by managed |
|
care organizations and physicians and other health care providers; |
|
(3) programs and reimbursement policies that |
|
encourage high-quality, cost-effective health care delivery models |
|
that increase appropriate provider collaboration, promote wellness |
|
and prevention, and improve health outcomes; and |
|
(4) outcome and process measures under Section |
|
536.003. |
|
SECTION 2.261. Sections 536.003(a), (b), (d), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) The commission, in consultation with the advisory |
|
committee, shall develop quality-based outcome and process |
|
measures that promote the provision of efficient, quality health |
|
care and that can be used in the child health plan program and |
|
Medicaid [programs] to implement quality-based payments for acute |
|
care services and long-term services and supports across all |
|
delivery models and payment systems, including fee-for-service and |
|
managed care payment systems. Subject to Subsection (a-1), the |
|
commission, in developing outcome and process measures under this |
|
section, must include measures that are based on potentially |
|
preventable events and that advance quality improvement and |
|
innovation. The commission may change measures developed: |
|
(1) to promote continuous system reform, improved |
|
quality, and reduced costs; and |
|
(2) to account for managed care organizations added to |
|
a service area. |
|
(b) To the extent feasible, the commission shall develop |
|
outcome and process measures: |
|
(1) consistently across all child health plan program |
|
and Medicaid [program] delivery models and payment systems; |
|
(2) in a manner that takes into account appropriate |
|
patient risk factors, including the burden of chronic illness on a |
|
patient and the severity of a patient's illness; |
|
(3) that will have the greatest effect on improving |
|
quality of care and the efficient use of services, including acute |
|
care services and long-term services and supports; |
|
(4) that are similar to outcome and process measures |
|
used in the private sector, as appropriate; |
|
(5) that reflect effective coordination of acute care |
|
services and long-term services and supports; |
|
(6) that can be tied to expenditures; and |
|
(7) that reduce preventable health care utilization |
|
and costs. |
|
(d) The executive commissioner by rule may require managed |
|
care organizations and physicians and other health care providers |
|
participating in the child health plan program and Medicaid |
|
[programs] to report to the commission in a format specified by the |
|
executive commissioner information necessary to develop outcome |
|
and process measures under this section. |
|
(e) If the commission increases physician and other health |
|
care provider reimbursement rates under the child health plan |
|
program or Medicaid [program] as a result of an increase in the |
|
amounts appropriated for the programs for a state fiscal biennium |
|
as compared to the preceding state fiscal biennium, the commission |
|
shall, to the extent permitted under federal law and to the extent |
|
otherwise possible considering other relevant factors, correlate |
|
the increased reimbursement rates with the quality-based outcome |
|
and process measures developed under this section. |
|
SECTION 2.262. Sections 536.004(a), (c), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) Using quality-based outcome and process measures |
|
developed under Section 536.003 and subject to this section, the |
|
commission, after consulting with the advisory committee and other |
|
appropriate stakeholders with an interest in the provision of acute |
|
care and long-term services and supports under the child health |
|
plan program and Medicaid [programs], shall develop quality-based |
|
payment systems, and require managed care organizations to develop |
|
quality-based payment systems, for compensating a physician or |
|
other health care provider participating in the child health plan |
|
program or Medicaid [program] that: |
|
(1) align payment incentives with high-quality, |
|
cost-effective health care; |
|
(2) reward the use of evidence-based best practices; |
|
(3) promote the coordination of health care; |
|
(4) encourage appropriate physician and other health |
|
care provider collaboration; |
|
(5) promote effective health care delivery models; and |
|
(6) take into account the specific needs of the child |
|
health plan program enrollee and Medicaid recipient populations. |
|
(c) In developing quality-based payment systems under this |
|
chapter, the commission shall examine and consider implementing: |
|
(1) an alternative payment system; |
|
(2) any existing performance-based payment system |
|
used under the Medicare program that meets the requirements of this |
|
chapter, modified as necessary to account for programmatic |
|
differences, if implementing the system would: |
|
(A) reduce unnecessary administrative burdens; |
|
and |
|
(B) align quality-based payment incentives for |
|
physicians and other health care providers with the Medicare |
|
program; and |
|
(3) alternative payment methodologies within the |
|
system that are used in the Medicare program, modified as necessary |
|
to account for programmatic differences, and that will achieve cost |
|
savings and improve quality of care in the child health plan program |
|
and Medicaid [programs]. |
|
(e) The commission may modify a quality-based payment |
|
system developed under this chapter to account for programmatic |
|
differences between the child health plan program and Medicaid |
|
[programs] and delivery systems under those programs. |
|
SECTION 2.263. Sections 536.005(a) and (c), Government |
|
Code, are amended to read as follows: |
|
(a) To the extent possible, the commission shall convert |
|
hospital reimbursement systems under the child health plan program |
|
and Medicaid [programs] to a diagnosis-related groups (DRG) |
|
methodology that will allow the commission to more accurately |
|
classify specific patient populations and account for severity of |
|
patient illness and mortality risk. |
|
(c) Notwithstanding Subsection (a) and to the extent |
|
possible, the commission shall convert outpatient hospital |
|
reimbursement systems under the child health plan program and |
|
Medicaid [programs] to an appropriate prospective payment system |
|
that will allow the commission to: |
|
(1) more accurately classify the full range of |
|
outpatient service episodes; |
|
(2) more accurately account for the intensity of |
|
services provided; and |
|
(3) motivate outpatient service providers to increase |
|
efficiency and effectiveness. |
|
SECTION 2.264. Section 536.051(a), Government Code, is |
|
amended to read as follows: |
|
(a) Subject to Section 1903(m)(2)(A), Social Security Act |
|
(42 U.S.C. Section 1396b(m)(2)(A)), and other applicable federal |
|
law, the commission shall base a percentage of the premiums paid to |
|
a managed care organization participating in the child health plan |
|
program or Medicaid [program] on the organization's performance |
|
with respect to outcome and process measures developed under |
|
Section 536.003 that address potentially preventable events. The |
|
percentage of the premiums paid may increase each year. |
|
SECTION 2.265. Sections 536.052(a) and (d), Government |
|
Code, are amended to read as follows: |
|
(a) The commission may allow a managed care organization |
|
participating in the child health plan program or Medicaid |
|
[program] increased flexibility to implement quality initiatives |
|
in a managed care plan offered by the organization, including |
|
flexibility with respect to financial arrangements, in order to: |
|
(1) achieve high-quality, cost-effective health care; |
|
(2) increase the use of high-quality, cost-effective |
|
delivery models; |
|
(3) reduce the incidence of unnecessary |
|
institutionalization and potentially preventable events; and |
|
(4) increase the use of alternative payment systems, |
|
including shared savings models, in collaboration with physicians |
|
and other health care providers. |
|
(d) In awarding contracts to managed care organizations |
|
under the child health plan program and Medicaid [programs], the |
|
commission shall, in addition to considerations under Section |
|
533.003 of this code and Section 62.155, Health and Safety Code, |
|
give preference to an organization that offers a managed care plan |
|
that successfully implements quality initiatives under Subsection |
|
(a) as determined by the commission based on data or other evidence |
|
provided by the organization or meets quality of care and |
|
cost-efficiency benchmarks under Subsection (b). |
|
SECTION 2.266. Section 536.101(1), Government Code, is |
|
amended to read as follows: |
|
(1) "Health home" means a primary care provider |
|
practice or, if appropriate, a specialty care provider practice, |
|
incorporating several features, including comprehensive care |
|
coordination, family-centered care, and data management, that are |
|
focused on improving outcome-based quality of care and increasing |
|
patient and provider satisfaction under the child health plan |
|
program and Medicaid [programs]. |
|
SECTION 2.267. Section 536.151(b), Government Code, is |
|
amended to read as follows: |
|
(b) The commission shall establish a program to provide a |
|
confidential report to each hospital in this state that |
|
participates in the child health plan program or Medicaid [program] |
|
regarding the hospital's performance with respect to each |
|
potentially preventable event described under Subsection (a). To |
|
the extent possible, a report provided under this section should |
|
include all potentially preventable events across all child health |
|
plan program and Medicaid [program] payment systems. A hospital |
|
shall distribute the information contained in the report to |
|
physicians and other health care providers providing services at |
|
the hospital. |
|
SECTION 2.268. Section 536.203(c), Government Code, is |
|
amended to read as follows: |
|
(c) The commission may limit a payment initiative to: |
|
(1) one or more regions in this state; |
|
(2) one or more organized networks of physicians and |
|
other health care providers; or |
|
(3) specified types of services provided under the |
|
child health plan program or Medicaid [program], or specified types |
|
of enrollees or recipients under those programs. |
|
SECTION 2.269. Section 536.253(b), Government Code, is |
|
amended to read as follows: |
|
(b) The commission shall establish a program to provide a |
|
report to each Medicaid long-term services and supports provider in |
|
this state regarding the provider's performance with respect to |
|
potentially preventable admissions, potentially preventable |
|
readmissions, and potentially preventable emergency room |
|
visits. To the extent possible, a report provided under this |
|
section should include applicable potentially preventable events |
|
information across all Medicaid [program] payment systems. |
|
SECTION 2.270. Section 537.002(b), Government Code, is |
|
amended to read as follows: |
|
(b) The waiver under this section must be designed to |
|
achieve the following objectives regarding [the] Medicaid |
|
[program] and alternatives to Medicaid [the program]: |
|
(1) provide flexibility to determine Medicaid |
|
eligibility categories and income levels; |
|
(2) provide flexibility to design Medicaid benefits |
|
that meet the demographic, public health, clinical, and cultural |
|
needs of this state or regions within this state; |
|
(3) encourage use of the private health benefits |
|
coverage market rather than public benefits systems; |
|
(4) encourage people who have access to private |
|
employer-based health benefits to obtain or maintain those |
|
benefits; |
|
(5) create a culture of shared financial |
|
responsibility, accountability, and participation in [the] |
|
Medicaid [program] by: |
|
(A) establishing and enforcing copayment |
|
requirements similar to private sector principles for all |
|
eligibility groups; |
|
(B) promoting the use of health savings accounts |
|
to influence a culture of individual responsibility; and |
|
(C) promoting the use of vouchers for |
|
consumer-directed services in which consumers manage and pay for |
|
health-related services provided to them using program vouchers; |
|
(6) consolidate federal funding streams, including |
|
funds from the disproportionate share hospitals and upper payment |
|
limit supplemental payment programs and other federal Medicaid |
|
funds, to ensure the most effective and efficient use of those |
|
funding streams; |
|
(7) allow flexibility in the use of state funds used to |
|
obtain federal matching funds, including allowing the use of |
|
intergovernmental transfers, certified public expenditures, costs |
|
not otherwise matchable, or other funds and funding mechanisms to |
|
obtain federal matching funds; |
|
(8) empower individuals who are uninsured to acquire |
|
health benefits coverage through the promotion of cost-effective |
|
coverage models that provide access to affordable primary, |
|
preventive, and other health care on a sliding scale, with fees paid |
|
at the point of service; and |
|
(9) allow for the redesign of long-term care services |
|
and supports to increase access to patient-centered care in the |
|
most cost-effective manner. |
|
SECTION 2.271. Section 538.002, Government Code, is amended |
|
to read as follows: |
|
Sec. 538.002. EFFECT OF CHAPTER; AUTHORITY OF |
|
COMMISSION. This chapter does not affect or give the commission |
|
additional authority to: |
|
(1) affect any individual health care treatment |
|
decision for a Medicaid recipient; |
|
(2) replace or affect the process of determining |
|
Medicaid benefits, including the approval process for receiving |
|
benefits for durable medical equipment, or any applicable approval |
|
process required for reimbursement for services or other equipment |
|
under [the] Medicaid [program]; |
|
(3) implement a clinical initiative or associated rule |
|
or program policy that is otherwise prohibited under state or |
|
federal law; or |
|
(4) implement any initiative that would expand |
|
eligibility for benefits under [the] Medicaid [program]. |
|
SECTION 2.272. Section 538.051, Government Code, is amended |
|
to read as follows: |
|
Sec. 538.051. MEDICAID QUALITY IMPROVEMENT PROCESS. The |
|
commission shall, according to the provisions of this chapter, |
|
develop and implement a quality improvement process by which the |
|
commission: |
|
(1) receives suggestions for clinical initiatives |
|
designed to improve: |
|
(A) the quality of care provided under [the] |
|
Medicaid [program]; and |
|
(B) the cost-effectiveness of [the] Medicaid |
|
[program]; |
|
(2) conducts a preliminary review under Section |
|
538.053(4) of each suggestion received under Section 538.052 to |
|
determine whether the suggestion warrants further consideration |
|
and analysis; and |
|
(3) conducts an analysis under Section 538.054 of |
|
clinical initiative suggestions that are selected for analysis |
|
under Subdivision (2) [and of required clinical initiatives under
|
|
Section 538.0521]. |
|
SECTION 2.273. Section 538.052(a), Government Code, is |
|
amended to read as follows: |
|
(a) Subject to Subsection (b), the commission shall solicit |
|
and accept suggestions for clinical initiatives, in either written |
|
or electronic form, from: |
|
(1) a member of the state legislature; |
|
(2) the executive commissioner; |
|
(3) the commissioner of aging and disability services |
|
[the Department of Aging and Disability Services]; |
|
(4) the commissioner of state health services [the
|
|
Department of State Health Services]; |
|
(5) the commissioner of the Department of Family and |
|
Protective Services; |
|
(6) the commissioner of assistive and rehabilitative |
|
services [the Department of Assistive and Rehabilitative
|
|
Services]; |
|
(7) the medical care advisory committee established |
|
under Section 32.022, Human Resources Code; |
|
(8) the physician payment advisory committee created |
|
under Section 32.022(d), Human Resources Code; and |
|
(9) the Electronic Health Information Exchange System |
|
Advisory Committee established under Section 531.904. |
|
SECTION 2.274. Section 538.054, Government Code, is amended |
|
to read as follows: |
|
Sec. 538.054. ANALYSIS OF CLINICAL INITIATIVES. The |
|
commission shall conduct an analysis of each clinical initiative |
|
selected by the commission after having conducted the commission's |
|
preliminary review under Section 538.053(4). The analysis |
|
required under this section must include a review of: |
|
(1) any public comments and submitted research |
|
relating to the initiative; |
|
(2) the available clinical research and historical |
|
utilization information relating to the initiative; |
|
(3) published medical literature relating to the |
|
initiative; |
|
(4) any adoption of the initiative by medical |
|
societies or other clinical groups; |
|
(5) whether the initiative has been implemented under: |
|
(A) the Medicare program; |
|
(B) another state medical assistance program; or |
|
(C) a state-operated health care program, |
|
including the child health plan program; |
|
(6) the results of reports, research, pilot programs, |
|
or clinical studies relating to the initiative conducted by: |
|
(A) institutions of higher education, including |
|
related medical schools; |
|
(B) governmental entities and agencies; and |
|
(C) private and nonprofit think tanks and |
|
research groups; |
|
(7) the impact that the initiative would have on [the] |
|
Medicaid [program] if the initiative were implemented in this |
|
state, including: |
|
(A) an estimate of the number of recipients under |
|
[the] Medicaid [program] that would be impacted by implementation |
|
of the initiative; and |
|
(B) a description of any potential cost savings |
|
to the state that would result from implementation of the |
|
initiative; and |
|
(8) any statutory barriers to implementation of the |
|
initiative. |
|
SECTION 2.275. Section 538.055, Government Code, is amended |
|
to read as follows: |
|
Sec. 538.055. FINAL REPORT ON CLINICAL INITIATIVE. The |
|
commission shall prepare a final report based on the commission's |
|
analysis of a clinical initiative under Section 538.054. The final |
|
report must include: |
|
(1) a final determination of: |
|
(A) the feasibility of implementing the |
|
initiative; |
|
(B) the likely impact implementing the |
|
initiative would have on the quality of care provided under [the] |
|
Medicaid [program]; and |
|
(C) the anticipated cost savings to the state |
|
that would result from implementing the initiative; |
|
(2) a summary of the public comments, including a |
|
description of any opposition to the initiative; |
|
(3) an identification of any statutory barriers to |
|
implementation of the initiative; and |
|
(4) if the initiative is not implemented, an |
|
explanation of the decision not to implement the initiative. |
|
SECTION 2.276. Section 538.057, Government Code, is amended |
|
to read as follows: |
|
Sec. 538.057. ACTION ON CLINICAL INITIATIVE BY |
|
COMMISSION. After the commission conducts an analysis of a |
|
clinical initiative under Section 538.054: |
|
(1) if the commission has determined that the |
|
initiative is cost-effective and will improve the quality of care |
|
under [the] Medicaid [program], the commission may: |
|
(A) implement the initiative if implementation |
|
of the initiative is not otherwise prohibited by law; or |
|
(B) if implementation requires a change in law, |
|
submit a copy of the final report together with recommendations |
|
relating to the initiative's implementation to the standing |
|
committees of the senate and house of representatives having |
|
jurisdiction over [the] Medicaid [program]; and |
|
(2) if the commission has determined that the |
|
initiative is not cost-effective or will not improve quality of |
|
care under [the] Medicaid [program], the commission may not |
|
implement the initiative. |
|
SECTION 2.277. Section 539.001, Government Code, is amended |
|
to read as follows: |
|
Sec. 539.001. DEFINITION [DEFINITIONS]. In this chapter, |
|
"department" [:
|
|
[(1) "Department"] means the Department of State |
|
Health Services. |
|
[(2)
"Executive commissioner" means the executive
|
|
commissioner of the Health and Human Services Commission.] |
|
SECTION 2.278. Sections 2105.001(1) and (4), Government |
|
Code, are amended to read as follows: |
|
(1) "Agency" means: |
|
(A) the Health and Human Services Commission |
|
[Texas Department of Human Services]; |
|
(B) the [Texas] Department of State Health |
|
Services; |
|
(C) the Texas Department of Housing and Community |
|
Affairs; |
|
(D) the Texas Education Agency; |
|
(E) the [Texas] Department of Aging and |
|
Disability Services [Mental Health and Mental Retardation]; or |
|
(F) [the Texas Department on Aging; or
|
|
[(G)] any other commission, board, department, |
|
or state agency designated to receive block grant funds. |
|
(4) "Provider" means a public or private organization |
|
that receives block grant funds or may be eligible to receive block |
|
grant funds to provide services or benefits to the public, |
|
including: |
|
(A) a local government unit; |
|
(B) a council of government; |
|
(C) a community action agency; or |
|
(D) a private new community developer or |
|
nonprofit community association in a community originally |
|
established as a new community development program under the former |
|
Urban Growth and New Community Development Act of 1970 (42 U.S.C. |
|
Section 4511 et seq.). |
|
SECTION 2.279. Section 2105.002, Government Code, is |
|
amended to read as follows: |
|
Sec. 2105.002. COMBINATION OF PROGRAMS NOT INTENDED TO |
|
REDUCE SERVICES. The process of combining categorical federal |
|
assistance programs into block grants should not have an overall |
|
effect of reducing the relative proportion of services and benefits |
|
made available to low-income individuals, elderly individuals, |
|
[disabled] individuals with disabilities, and migrant and seasonal |
|
agricultural workers. |
|
SECTION 2.280. Section 2105.005(c), Government Code, is |
|
amended to read as follows: |
|
(c) To the extent consistent with the purpose of the block |
|
grant, an agency's rules [agency by rule] shall ensure that |
|
providers use block grant funds to the maximum benefit of |
|
low-income recipients and intended recipients. |
|
SECTION 2.281. Section 2105.009, Government Code, is |
|
amended to read as follows: |
|
Sec. 2105.009. PRIMARY CARE BLOCK GRANT. (a) The [Texas] |
|
Department of State Health Services shall administer a [the] |
|
primary care block grant if that grant is authorized and if the |
|
department satisfies federal requirements relating to the |
|
designation of an agency to administer the grant. |
|
(b) In administering the primary care block grant, the |
|
department may: |
|
(1) receive the primary care block grant funds on |
|
behalf of the state; |
|
(2) spend primary care block grant funds and state |
|
funds specifically appropriated by the legislature to match funds |
|
received under a primary care block grant; |
|
(3) make grants to, advance funds to, contract with, |
|
and take other actions through community health centers that meet |
|
the requirements of 42 U.S.C. Section 254c(e)(3) to provide for the |
|
delivery of primary and supplemental health services to medically |
|
underserved populations of the state; and |
|
(4) [adopt necessary rules; and
|
|
[(5)] perform other activities necessary to |
|
administer the primary care block grant. |
|
(b-1) The executive commissioner of the Health and Human |
|
Services Commission may adopt necessary rules for administering the |
|
primary care block grant. |
|
(c) In this section: |
|
(1) "Community health center" has the meaning assigned |
|
by 42 U.S.C. Section 254c(a), as that law existed on April 23, 1986. |
|
(2) "Medically underserved population," "primary |
|
health services," and "supplemental health services" have the |
|
meanings assigned by 42 U.S.C. Section 254c(b), as that law existed |
|
on April 23, 1986. |
|
SECTION 2.282. Section 2105.058(d), Government Code, is |
|
amended to read as follows: |
|
(d) An agency's rules [agency by rule] may require a |
|
provider to undertake other reasonable efforts to seek public |
|
participation. |
|
SECTION 2.283. Section 2105.152, Government Code, is |
|
amended to read as follows: |
|
Sec. 2105.152. HEALTH AND [DEPARTMENT OF] HUMAN SERVICES |
|
COMMISSION PROCEDURES FOR FAIR HEARING. The Health and Human |
|
Services Commission [Texas Department of Human Services] shall use |
|
procedures for conducting a fair hearing under this subchapter. |
|
SECTION 2.284. Section 2105.202(a), Government Code, is |
|
amended to read as follows: |
|
(a) The individual or entity responsible for adopting rules |
|
for an [An] agency shall adopt specific rules for the agency that |
|
define [defining] good cause for nonrenewal of a provider's |
|
contract or reduction of a provider's funding. |
|
SECTION 2.285. Section 2165.301, Government Code, is |
|
amended by amending Subdivision (2) and adding Subdivision (2-a) to |
|
read as follows: |
|
(2) "Department" means the [Texas] Department of State |
|
Health Services. |
|
(2-a) "Executive commissioner" means the executive |
|
commissioner of the Health and Human Services Commission. |
|
SECTION 2.286. Sections 2165.302(a), (d), and (e), |
|
Government Code, are amended to read as follows: |
|
(a) Except as provided by Section 2165.303: |
|
(1) the commission shall refer matters related to the |
|
investigation and testing of indoor air quality in state buildings |
|
under the charge and control of the commission to the department |
|
[Texas Department of Health]; and |
|
(2) the department shall conduct any necessary |
|
investigation and testing of indoor air quality in state buildings, |
|
on request or referral of an entity with charge and control of the |
|
state building. |
|
(d) The executive commissioner by rule [department] may |
|
establish a system of charges for indoor air quality investigation |
|
and testing in state buildings. A system established by the |
|
executive commissioner [department] shall ensure that the |
|
department is reimbursed for the cost of providing the services by |
|
the agency or agencies occupying the portions of a building that are |
|
investigated or tested. |
|
(e) The executive commissioner [department] shall adopt |
|
rules and procedures relating to the investigation and testing of |
|
indoor air quality in state buildings. |
|
SECTION 2.287. The following provisions of the Government |
|
Code are repealed: |
|
(1) Section 531.02131; |
|
(2) Section 531.0222; |
|
(3) Section 531.0249; |
|
(4) Section 531.030; |
|
(5) Section 531.0314; |
|
(6) Section 531.046; |
|
(7) Section 531.049; |
|
(8) Section 531.065; |
|
(9) Section 531.0993; |
|
(10) Section 531.1063; |
|
(11) Section 531.286; |
|
(12) Section 531.552; |
|
(13) Section 531.902; |
|
(14) Section 531.905; |
|
(15) Section 533.0025(a); |
|
(16) Subchapter D, Chapter 533; |
|
(17) Section 534.001(10); |
|
(18) Sections 536.001(4) and (13); |
|
(19) Section 537.001; and |
|
(20) Section 538.001. |
|
ARTICLE 3. HEALTH AND SAFETY CODE |
|
SECTION 3.0001. The heading to Subtitle A, Title 2, Health |
|
and Safety Code, is amended to read as follows: |
|
SUBTITLE A. [TEXAS] DEPARTMENT OF STATE HEALTH SERVICES |
|
SECTION 3.0002. The heading to Chapter 11, Health and |
|
Safety Code, is amended to read as follows: |
|
CHAPTER 11. GENERAL PROVISIONS [ORGANIZATION OF TEXAS DEPARTMENT
|
|
OF HEALTH] |
|
SECTION 3.0003. Section 11.001, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 11.001. DEFINITIONS. In this title: |
|
(1) "Commission" means the Health and Human Services |
|
Commission ["Board" means the Texas Board of Health]. |
|
(2) "Commissioner" means the commissioner of state |
|
[public] health services. |
|
(3) "Department" means the [Texas] Department of State |
|
Health Services. |
|
(4) "Executive commissioner" means the executive |
|
commissioner of the Health and Human Services Commission. |
|
SECTION 3.0004. Sections 11.003(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) In the review of the department [Department of State
|
|
Health Services] by the Sunset Advisory Commission, as required by |
|
[this section and] Section 1001.003, the sunset commission shall |
|
review the powers and duties exercised by the department under |
|
Chapter 108 and determine whether the department, under that |
|
chapter, is: |
|
(1) achieving the legislature's intent of empowering |
|
consumers with information to make informed health care decisions; |
|
(2) maintaining appropriate privacy and security |
|
standards for patient information; and |
|
(3) limiting the patient information the department |
|
collects to the information necessary for performing the |
|
department's duties under Chapter 108. |
|
(c) The Sunset Advisory Commission shall report its |
|
findings to the legislature in the report required by Section |
|
325.010, Government Code. This section expires [subsection and
|
|
Subsection (b) expire] September 1, 2015. |
|
SECTION 3.0005. (a) Section 11.004(b), Health and Safety |
|
Code, is transferred to Section 1001.071, Health and Safety Code, |
|
redesignated as Section 1001.071(a), Health and Safety Code, and |
|
amended to read as follows: |
|
(a) [(b)] The department is the state agency with primary |
|
responsibility to administer or provide [for providing] health |
|
services, including: |
|
(1) disease prevention; |
|
(2) health promotion; |
|
(3) indigent health care; |
|
(4) certain acute care services; |
|
(5) [health care facility regulation, excluding
|
|
long-term care facilities;
|
|
[(6)] licensing of certain health professions; and |
|
(6) [(7)] other health-related services as provided |
|
by law. |
|
(b) Section 1001.071, Health and Safety Code, is amended to |
|
read as follows: |
|
Sec. 1001.071. GENERAL POWERS AND DUTIES OF DEPARTMENT |
|
RELATED TO HEALTH CARE. (b) The department is responsible for |
|
administering human services programs regarding the public health, |
|
including: |
|
(1) implementing the state's public health care |
|
delivery programs under the authority of the department; |
|
(2) administering state health facilities, hospitals, |
|
and health care systems; |
|
(3) developing and providing health care services, as |
|
directed by law; |
|
(4) providing for the prevention and control of |
|
communicable diseases; |
|
(5) providing public education on health-related |
|
matters, as directed by law; |
|
(6) compiling and reporting health-related |
|
information, as directed by law; |
|
(7) acting as the lead agency for implementation of |
|
state policies regarding the human immunodeficiency virus and |
|
acquired immunodeficiency syndrome and administering programs |
|
related to the human immunodeficiency virus and acquired |
|
immunodeficiency syndrome; |
|
(8) investigating the causes of injuries and methods |
|
of prevention; |
|
(9) administering a grant program to provide |
|
appropriated money to counties, municipalities, public health |
|
districts, and other political subdivisions for their use to |
|
provide or pay for essential public health services; |
|
(10) administering the registration of vital |
|
statistics; |
|
(11) licensing, inspecting, and enforcing regulations |
|
regarding health facilities, other than long-term care facilities |
|
regulated by the Department of Aging and Disability Services; |
|
(12) implementing established standards and |
|
procedures for the management and control of sanitation and for |
|
health protection measures; |
|
(13) enforcing regulations regarding radioactive |
|
materials; |
|
(14) enforcing regulations regarding food, bottled |
|
and vended drinking water, drugs, cosmetics, and health devices; |
|
(15) enforcing regulations regarding food service |
|
establishments, retail food stores, mobile food units, and roadside |
|
food vendors; |
|
(16) enforcing regulations controlling hazardous |
|
substances in households and workplaces; and |
|
(17) implementing a mental health program for |
|
veterans. |
|
SECTION 3.0006. Sections 11.012(a), (b), (c), (d), and (f), |
|
Health and Safety Code, are transferred to Section 1001.051, Health |
|
and Safety Code, redesignated respectively as Sections |
|
1001.051(a-1), (a-2), (a-3), (a-4), and (b-1), Health and Safety |
|
Code, and amended to read as follows: |
|
(a-1) [(a)] The executive commissioner [of health and human
|
|
services] shall employ the commissioner in accordance with Section |
|
531.0056, Government Code. |
|
(a-2) [(b)] Except as provided in Subsection (a-3) [(c)], |
|
the commissioner must: |
|
(1) have at least five years of experience in the |
|
administration of public health systems; and |
|
(2) be a person licensed to practice medicine in this |
|
state. |
|
(a-3) [(c)] The executive commissioner [of health and human
|
|
services] may, based on the qualifications and experience in |
|
administering public health systems, employ a person other than a |
|
physician as the commissioner. |
|
(a-4) [(d)] If the executive commissioner [of health and
|
|
human services] employs a person as commissioner who is not a |
|
physician, then the executive commissioner [board] shall designate |
|
a person licensed to practice medicine in this state as chief |
|
medical executive. |
|
(b-1) [(f)] The executive commissioner [board] may |
|
supplement the salary of the commissioner with the approval of the |
|
governor. The salary may not exceed 1.5 times the salary of the |
|
governor, from funds appropriated to the department. The use of |
|
funds from other sources are not limited by this subsection. |
|
SECTION 3.0007. Section 11.014, Health and Safety Code, is |
|
transferred to Subchapter B, Chapter 1001, Health and Safety Code, |
|
redesignated as Section 1001.034, Health and Safety Code, and |
|
amended to read as follows: |
|
Sec. 1001.034 [11.014]. INVESTIGATION OF DEPARTMENT. The |
|
executive commissioner [board] shall investigate the conduct of the |
|
work of the department. For that purpose, the executive |
|
commissioner [board] shall have access at any time to all |
|
department books and records and may require an officer or employee |
|
of the department to furnish written or oral information. |
|
SECTION 3.0008. Section 11.016, Health and Safety Code, is |
|
transferred to Subchapter B, Chapter 1001, Health and Safety Code, |
|
redesignated as Section 1001.035, Health and Safety Code, and |
|
amended to read as follows: |
|
Sec. 1001.035 [11.016]. ADVISORY COMMITTEES. (a) The |
|
executive commissioner [board] may appoint advisory committees to |
|
assist the executive commissioner and department [board] in |
|
performing [its] duties related to department functions. |
|
(b) If the executive commissioner appoints [The board shall
|
|
appoint] an advisory committee under this section, the appointment |
|
must be made in a manner that provides for: |
|
(1) a balanced representation of persons with |
|
knowledge and interest in the committee's field of work; |
|
(2) the inclusion on the committee of at least two |
|
members who represent the interests of the public; and |
|
(3) a balanced representation of the geographic |
|
regions of the state. |
|
(d) A [Except as otherwise provided by law and contingent on
|
|
the availability of department funds for this purpose, a] member of |
|
an advisory committee appointed under this section may [by the
|
|
board is entitled to] receive reimbursement for[, with regard to] |
|
travel expenses as provided by Section 2110.004, Government Code[,
|
|
the per diem and travel allowance authorized by the General
|
|
Appropriations Act for state employees]. |
|
(e) The executive commissioner [board] shall specify each |
|
committee's purpose, powers, and duties, and shall require each |
|
committee to report to the executive commissioner or department |
|
[board] in the manner specified by the executive commissioner |
|
[board] concerning the committee's activities and the results of |
|
its work. |
|
(f) The executive commissioner [board] shall establish |
|
procedures for receiving reports relating to the activities and |
|
accomplishments of an advisory committee established by statute to |
|
advise the [board or] department or executive commissioner on |
|
matters related to department functions. The executive |
|
commissioner [board] may appoint additional members to those |
|
advisory committees and may establish additional duties of those |
|
committees as the executive commissioner [board] determines to be |
|
necessary. |
|
(g) The executive commissioner [board] shall adopt rules to |
|
implement this section. |
|
SECTION 3.0009. The heading to Chapter 12, Health and |
|
Safety Code, is amended to read as follows: |
|
CHAPTER 12. POWERS AND DUTIES OF [TEXAS] DEPARTMENT OF |
|
STATE HEALTH SERVICES |
|
SECTION 3.0010. Subchapter A, Chapter 12, Health and Safety |
|
Code, is amended to read as follows: |
|
SUBCHAPTER A. GENERAL POWERS AND DUTIES [OF BOARD] |
|
Sec. 12.0001. COMMISSIONER'S POWERS AND DUTIES; EFFECT OF |
|
CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
|
|
SERVICES]. [The commissioner of health and human services has the
|
|
powers and duties relating to the board and commissioner as
|
|
provided by Section 531.0055, Government Code.] To the extent a |
|
power or duty given to the [board or] commissioner by this title or |
|
another law conflicts with Section 531.0055, Government Code, |
|
Section 531.0055 controls. |
|
Sec. 12.001. GENERAL POWERS AND DUTIES OF EXECUTIVE |
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COMMISSIONER. (a) The executive commissioner [board] has general |
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supervision and control over all matters relating to the health of |
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the citizens of this state. |
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(b) The executive commissioner [board] shall[:
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[(1)] adopt rules for [its procedure and for] the |
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performance of each duty imposed by law on the executive |
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commissioner [board], the department, or the commissioner and file |
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a copy of those rules with the department. |
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Sec. 12.0011. INVESTIGATIONS IN GENERAL. Subject to the |
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oversight of the executive commissioner, the department shall[; and
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[(2)] examine, investigate, enter, and inspect any |
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public place or public building as the department [board] |
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determines necessary for the discovery and suppression of disease |
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and the enforcement of any health or sanitation law of this state. |
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[(c)
The board has all the powers, duties, and functions
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granted by law to:
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[(1) the Texas Board of Health;
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[(2) the state commissioner of health;
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[(3) the Texas Department of Health;
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[(4) the Texas Board of Health Resources; and
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[(5) the Texas Department of Health Resources.] |
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Sec. 12.002. CERTAIN PROCEDURES FOR [BOARD] |
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INVESTIGATIONS. (a) The commissioner or the commissioner's |
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designee [A member of the board] may administer oaths, summon |
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witnesses, and compel the attendance of witnesses in any matter |
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proper for [board] investigation by the department, subject to the |
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executive commissioner's oversight, including the determination of |
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nuisances and the investigation of: |
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(1) public water supplies; |
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(2) sanitary conditions; |
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(3) the existence of infection; or |
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(4) any matter that requires the department [board] to |
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exercise its discretionary powers and that is within the general |
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scope of its authority under this subchapter. |
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(b) Each district court shall aid the department [board] in |
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its investigations and in compelling compliance with this |
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subchapter. If a witness summoned by the commissioner or the |
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commissioner's designee [board] is disobedient or disrespectful to |
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the department's [board's] lawful authority, the district court of |
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the county in which the witness is summoned to appear shall punish |
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the witness in the manner provided for contempt of court. |
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Sec. 12.003. LEGAL REPRESENTATION. (a) A suit brought by |
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the department [board] must be brought in the name of the state. |
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(b) The attorney general shall assign a special assistant to |
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attend to the department's [board's] legal matters, and on the |
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department's [board's] request shall furnish necessary assistance |
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to the department [board] relating to its legal requirements. |
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[Sec.
12.004.
DEVELOPMENT OF PROPOSED RULES. (a) This
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section applies to the process by which the department develops
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proposed rules for the board's consideration before the proposed
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rules are published in the Texas Register and before the board,
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commissioner, or department complies with the rulemaking
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requirements of the administrative procedure law, Chapter 2001,
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Government Code. This section does not affect the duty of the
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board, commissioner, or department to comply with the rulemaking
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requirements of that law.
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[(b)
The board shall require the department to establish a
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checklist of methods that, to the extent appropriate, the
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department will follow to obtain early in the rule development
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process the advice and opinions of the public and of persons who
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will be most affected by a proposed rule. The checklist must
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include methods for identifying persons who will be most affected
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and for soliciting at a minimum the advice and opinions of affected
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local health departments, of recipients and providers of affected
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services, and of advocates for affected recipients or providers.
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[(c)
The checklist may include negotiated rulemaking,
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informal conferences, advisory committees, and any other
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appropriate method.
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[(d)
A rule adopted by the board may not be challenged on the
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grounds that the board, commissioner, or department did not comply
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with this section. If the department was unable to solicit a
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significant amount of advice and opinion from the public or from
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affected persons early in the rule development process, the
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department shall state in writing to the board the reasons why the
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department was unable to do so.
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[Sec.
12.005.
MEDICAL DIRECTOR: MEDICAID MANAGED CARE AND
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CHIPS PROGRAMS. (a) In addition to any other medical director
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employed by the department, the board shall require the department
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to employ a separate medical director whose duties consist of
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acting as the medical director for the children's health insurance
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program created under Title XXI of the Social Security Act (42
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U.S.C. Section 1397aa et seq.) and also as the medical director for
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the Medicaid managed care program, to the extent that those
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programs are administered by the department.
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[(b)
The medical director shall be primarily responsible
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for implementing and maintaining policies and systems for the
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programs that relate to clinical and professional medical issues,
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including clinical oversight.
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[(c)
The medical director must be a physician licensed to
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practice medicine in this state.] |
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SECTION 3.0011. Sections 12.0111(b) and (c), Health and |
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Safety Code, are amended to read as follows: |
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(b) Notwithstanding other law, the executive commissioner |
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by rule shall adopt and the department shall collect [charge] a fee |
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for issuing or renewing a license that is in an amount designed to |
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allow the department to recover from its license holders all of the |
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department's direct and indirect costs in administering and |
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enforcing the applicable licensing program. |
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(c) Notwithstanding other law, each regulatory board or |
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other agency that is under the jurisdiction of the department or |
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administratively attached to the department and that issues |
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licenses shall adopt by rule and collect [charge] a fee for issuing |
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or renewing a license that is in an amount designed to allow the |
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department and the regulatory board or agency to recover from the |
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license holders all of the direct and indirect costs to the |
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department and to the regulatory board or agency in administering |
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and enforcing the applicable licensing program. |
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SECTION 3.0012. Sections 12.0115(a), (e), and (h), Health |
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and Safety Code, are amended to read as follows: |
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(a) In this section, "health care delivery programs" |
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includes the department's primary health care services program, its |
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program to improve maternal and infant health, its services program |
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for [chronically ill and disabled] children with special health |
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care needs, any aspects of health care delivery under the state |
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Medicaid program assigned to the department by law or by the |
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commission [Health and Human Services Commission], and the part of |
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any other department program concerned with the department's |
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responsibility for the delivery of health care services. |
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(e) One of the primary goals of the department in |
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integrating the administration of [its] contracts entered into by |
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the executive commissioner or the executive commissioner's |
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designee on behalf of the department with providers of health care |
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services shall be designing an integrated contract administration |
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system that reduces the administrative and paperwork burden on |
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providers while still providing the department with the information |
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it needs to effectively administer the contracts. The department's |
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integration of contract administration must include: |
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(1) the integration of the initial procurement process |
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within and across programs, at least in part by efficiently |
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combining requests for bids or proposals within or across programs |
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to the extent it reduces the administrative burden for providers; |
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(2) the establishment of uniform contract terms, |
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including: |
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(A) contract terms that require information from |
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providers, or that prescribe performance standards for providers, |
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that could be made uniform within or across programs while |
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remaining effective as contract terms; |
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(B) the establishment of a procedure under which |
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a contractor or a person responding to a request for bids or |
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proposals may supply the department with requested information |
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whenever possible by referencing current and correct information |
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previously supplied to and on file with the department; and |
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(C) contract terms regarding incentives for |
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contractors to meet or exceed contract requirements; |
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(3) the integration of contract monitoring, |
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particularly with regard to monitoring providers that deliver |
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health services for the department under more than one contract or |
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under more than one department program; and |
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(4) the integration of reimbursement methods: |
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(A) particularly for a provider that delivers |
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health services for the department under more than one contract or |
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under more than one department program; and |
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(B) including the application across programs of |
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the most effective and efficient reimbursement technologies or |
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methods that are available to the department under any of its |
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programs. |
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(h) The department may not integrate health care delivery |
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programs under this section in a way that affects the single state |
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agency status of another state agency for federal purposes without |
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obtaining the approval of the commission [Health and Human Services
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Commission] and any necessary federal approval. |
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SECTION 3.0013. Sections 12.0121(b) and (d), Health and |
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Safety Code, are amended to read as follows: |
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(b) The executive commissioner [board] by rule shall adopt a |
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list of categories of licensed, certified, registered, or otherwise |
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authorized providers to whom the department may award a grant for |
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professional services under this section or with whom the |
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department may contract or otherwise engage to perform professional |
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services under this section. |
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(d) The department may award a grant, enter into a contract, |
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or otherwise engage an individual or a group or association of |
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individuals to perform professional services without complying |
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with Subsection (c) if the executive commissioner by order |
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[ratified by the board at its next regular meeting] determines that |
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an emergency exists that necessitates the use of different |
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procedures. A grant, contract, or engagement under this subsection |
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is effective only for the period specified by the executive |
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commissioner's order. |
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SECTION 3.0014. Section 12.0122(d), Health and Safety Code, |
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is amended to read as follows: |
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(d) The executive commissioner [department] by rule may |
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establish fees that the department may collect [charges] for the |
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sale of laboratory services. |
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SECTION 3.0015. Section 12.01221, Health and Safety Code, |
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is transferred to Subchapter B, Chapter 33, Health and Safety Code, |
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redesignated as Section 33.0165, Health and Safety Code, and |
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amended to read as follows: |
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Sec. 33.0165 [12.01221]. MUTUAL AID AGREEMENT FOR NEWBORN |
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SCREENING LABORATORY SERVICES. (a) In this section, "newborn |
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screening laboratory services" means the performance of tests to |
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analyze specimens collected as part of the newborn screenings |
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performed under this subchapter [Subchapter B, Chapter 33]. |
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(b) Notwithstanding Section 12.0122 or other law, the |
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department may enter into a mutual aid agreement to provide newborn |
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screening laboratory services to another state and to receive |
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newborn screening laboratory services from another state in the |
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event of an unexpected interruption of service, including an |
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interruption caused by a disaster. |
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(c) Each mutual aid agreement under Subsection (b) shall |
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include provisions: |
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(1) to address the confidentiality of the identity of |
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the newborn child and the newborn child's family; and |
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(2) to ensure the return of blood specimens and |
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related records to the state that received the newborn screening |
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laboratory services. |
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SECTION 3.0016. Section 12.0123, Health and Safety Code, as |
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added by Chapter 1411 (H.B. 2085), Acts of the 76th Legislature, |
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Regular Session, 1999, is transferred to Subchapter B, Chapter 32, |
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Human Resources Code, redesignated as Section 32.0705, Human |
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Resources Code, amended to conform to Section 12.0123, Health and |
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Safety Code, as added by Chapters 1447 (H.B. 2896) and 1460 (H.B. |
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2641), Acts of the 76th Legislature, Regular Session, 1999, and |
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further amended to read as follows: |
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Sec. 32.0705 [12.0123]. EXTERNAL AUDITS OF CERTAIN |
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MEDICAID CONTRACTORS BASED ON RISK. (a) In this section, "Medicaid |
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contractor" means an entity that: |
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(1) is not a health and human services agency as |
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defined by Section 531.001, Government Code; and |
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(2) under a contract with the commission or otherwise |
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on behalf of the commission [department], performs one or more |
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administrative services in relation to the commission's |
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[department's] operation of [a part of the state] Medicaid |
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[program], such as claims processing, utilization review, client |
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enrollment, provider enrollment, quality monitoring, or payment of |
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claims. |
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(b) The commission [department] shall contract with an |
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independent auditor to perform annual independent external |
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financial and performance audits of any Medicaid contractor used |
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[by the department] in the commission's [department's] operation of |
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[a part of the state] Medicaid [program]. The commission |
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[department] regularly shall review the [its] Medicaid contracts |
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and ensure that: |
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(1) the frequency and extent of audits of a Medicaid |
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contractor under this section are based on the amount of risk to the |
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state involved in the administrative services being performed by |
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the contractor; |
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(2) audit procedures related to financial audits and |
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performance audits are used consistently in audits under this |
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section; and |
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(3) to the extent possible, audits under this section |
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are completed in a timely manner. |
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(c) If another state agency succeeds to the commission's |
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[department's] operation of a part of [the state] Medicaid |
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[program] for which the commission [department] used a Medicaid |
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contractor, the successor agency shall comply with this section |
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with regard to the Medicaid contractor, including the requirement |
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to contract with an independent auditor to perform the external |
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financial and performance audits required by this section. |
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(d) An audit required by this section must be completed |
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before the end of the fiscal year immediately following the fiscal |
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year for which the audit is performed. |
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SECTION 3.0017. Section 12.0124, Health and Safety Code, is |
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transferred to Subchapter B, Chapter 32, Human Resources Code, |
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redesignated as Section 32.0316, Human Resources Code, and amended |
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to read as follows: |
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Sec. 32.0316 [12.0124]. ELECTRONIC TRANSACTIONS; [STATE] |
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MEDICAID [PROGRAM]. The executive commissioner shall adopt and the |
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commission [department or the department's successor in function in
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relation to the department's operation of a part of the state
|
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Medicaid program] shall implement policies that encourage the use |
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of electronic transactions in Medicaid. The policies shall require |
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payment to Medicaid [service] providers by electronic funds |
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transfer, including electronic remittance and status reports. The |
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policies shall also include the establishment of incentives to |
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submit claims electronically and of disincentives to submit claims |
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on paper that are reasonably based on the higher administrative |
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costs to process claims submitted on paper. |
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SECTION 3.0018. Sections 12.0125(a) and (c), Health and |
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Safety Code, are amended to read as follows: |
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(a) The department shall develop a voluntary drug |
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manufacturer rebate program for drugs purchased by or on behalf of a |
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client of the Kidney Health Care Program or the Children with |
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Special Health Care Needs [Chronically Ill and Disabled Children's] |
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Services Program for which rebates are not available under the |
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Medicaid drug manufacturer rebate program. |
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(c) Amounts received by the department under the drug rebate |
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program established under this section may be appropriated only for |
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the Kidney Health Care Program or the Children with Special Health |
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Care Needs [Chronically Ill and Disabled Children's] Services |
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Program. |
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SECTION 3.0019. Section 12.0128, Health and Safety Code, is |
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amended to read as follows: |
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Sec. 12.0128. HEALTH ALERT NETWORK. The department shall |
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include local health officials [the Texas Association of Local
|
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Health Officials], the Texas Association of Community Health |
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Centers, and the Texas Organization of Rural and Community |
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Hospitals in the department's Texas Health Alert Network to the |
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extent federal funds for bioterrorism preparedness are available |
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for that purpose. |
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SECTION 3.0020. Section 12.014(b), Health and Safety Code, |
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is amended to read as follows: |
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(b) The executive commissioner [board] by rule may adopt |
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reasonable registration fees to cover the costs of establishing and |
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maintaining a registry and may adopt other rules as necessary to |
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administer this section. |
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SECTION 3.0021. Sections 12.0145(a), (d), and (g), Health |
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and Safety Code, are amended to read as follows: |
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(a) The department shall publish and provide information in |
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accordance with this section regarding each final enforcement |
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action taken by the department or[,] commissioner[, or board] |
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against a person or facility regulated by the department in which |
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any kind of sanction is imposed, including: |
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(1) the imposition of a reprimand, a period of |
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probation, a monetary penalty, or a condition on a person's |
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continued practice or a facility's continued operation; and |
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(2) the refusal to renew or the suspension, probation, |
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or revocation of a license or other form of permission to engage in |
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an activity. |
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(d) The department shall publish and provide the |
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information promptly after the sanction has been imposed or, when |
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applicable, promptly after the period during which the sanction is |
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imposed has begun. The executive commissioner [department] by rule |
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shall establish the length of time during which the required |
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information will be published and provided under this section based |
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on the executive commissioner's [department's] determination |
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regarding the types of services provided by regulated entities and |
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the length of time for which information about a category of |
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enforcement actions is useful to a member of the public. |
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(g) A determination that the department is not required to |
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publish and provide information under this section does not affect |
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a determination regarding whether the information is subject to |
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required disclosure under the open records law, Chapter 552, |
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Government Code. The executive commissioner's [department's] |
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determination regarding the length of the period during which |
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information should continue to be published and provided under this |
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section does not affect a determination regarding the period for |
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which the information must be preserved under Chapter 441, |
|
Government Code, or under another law. |
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SECTION 3.0022. Section 12.015(a), Health and Safety Code, |
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is amended to read as follows: |
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(a) If the department determines that a person is not |
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eligible for a level of care in a nursing facility [home], the |
|
department shall inform the person that community services might be |
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available under a [the] community care for the aged and disabled |
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program administered by the [Texas] Department of Aging and |
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Disability [Human] Services. |
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SECTION 3.0023. Section 12.016(d), Health and Safety Code, |
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is amended to read as follows: |
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(d) An applicant for a license, permit, registration, or |
|
similar form of permission required by law to be obtained from the |
|
department may not amend the application after the 31st day before |
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the date on which a public hearing on the application is scheduled |
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to begin. If an amendment of an application would be necessary |
|
within that period, the applicant shall resubmit the application to |
|
the department and must again comply with notice requirements and |
|
any other requirements of law or department [board] rule as though |
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the application were originally submitted to the department on that |
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date. |
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SECTION 3.0024. Section 12.019(a), Health and Safety Code, |
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is amended to read as follows: |
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(a) The executive commissioner by rule may set a fee to be |
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collected by the department [may charge] for providing genetic |
|
counseling services. The fee may not exceed the actual cost of |
|
providing the services. |
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SECTION 3.0025. Section 12.020(e), Health and Safety Code, |
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is amended to read as follows: |
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(e) The executive commissioner shall institute intellectual |
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property policies for the department that establish minimum |
|
standards for: |
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(1) the public disclosure or availability of products, |
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technology, and scientific information, including inventions, |
|
discoveries, trade secrets, and computer software; |
|
(2) review by the department of products, technology, |
|
and scientific information, including consideration of ownership |
|
and appropriate legal protection; |
|
(3) the licensing of products, technology, and |
|
scientific information; |
|
(4) the identification of ownership and licensing |
|
responsibilities for each class of intellectual property; and |
|
(5) royalty participation by inventors and the |
|
department. |
|
SECTION 3.0026. Section 12.032, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.032. FEES FOR PUBLIC HEALTH SERVICES. (a) The |
|
executive commissioner [board] by rule may adopt [charge] fees to |
|
be collected by the department from [to] a person who receives |
|
public health services from the department. |
|
(b) The executive commissioner [board] by rule may require |
|
department contractors to collect [charge] fees for public health |
|
services provided by department contractors participating in the |
|
department's programs. A department contractor shall retain a fee |
|
collected under this subsection and shall use the fee in accordance |
|
with the contract provisions. |
|
(c) The amount of a fee collected [charged] for a public |
|
health service may not exceed the cost to the department of |
|
providing the service. |
|
(d) The executive commissioner by rule [board] may |
|
establish a fee schedule. In establishing the schedule, the |
|
executive commissioner [board] shall consider a person's ability to |
|
pay the entire amount of a fee. |
|
(e) The executive commissioner [board] may not deny public |
|
health services to a person because of the person's inability to pay |
|
for the services. |
|
SECTION 3.0027. Sections 12.033(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) Except as otherwise provided by this section, the |
|
executive commissioner [board] by rule shall adopt [charge] fees to |
|
be collected by the department for the distribution and |
|
administration of vaccines and sera provided under: |
|
(1) Section 38.001, Education Code; |
|
(2) Section 42.043, Human Resources Code; |
|
(3) Chapter 826 (Rabies Control Act of 1981); |
|
(4) Chapter 81 (Communicable Disease Prevention and |
|
Control Act); and |
|
(5) Section 161.005. |
|
(b) Except as otherwise provided by this section, the |
|
executive commissioner [board] by rule may require a department |
|
contractor to collect [charge] fees for public health services |
|
provided by a contractor participating in a department program |
|
under the laws specified by Subsection (a). |
|
(c) Provided the executive commissioner [board] finds that |
|
the monetary savings of this subsection are greater than any costs |
|
associated with administering it, the executive commissioner |
|
[board] by rule shall establish a fee schedule for fees under this |
|
section. In establishing the fee schedule, the executive |
|
commissioner [board] shall consider a person's financial ability to |
|
pay all or part of the fee, including the availability of health |
|
insurance coverage. In the event the fee schedule conflicts with |
|
any federal law or regulation, the executive commissioner [board] |
|
shall seek a waiver from the applicable federal law or regulation to |
|
permit the fee schedule. In the event the waiver is denied, the fee |
|
schedule shall not go into effect. |
|
SECTION 3.0028. Sections 12.034(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall establish |
|
procedures for the collection of fees for public health services. |
|
The procedures shall be used by the department and by those |
|
department contractors required by the executive commissioner |
|
[board] to collect [charge] fees. |
|
(c) The department shall make a reasonable effort to collect |
|
fees billed after services are performed. However, the executive |
|
commissioner [board] by rule may waive the collection procedures if |
|
the administrative costs exceed the fees to be collected. |
|
(d) If the executive commissioner [board] elects to require |
|
cash payments by program participants, the money received shall be |
|
deposited locally at the end of each day and retained by the |
|
department for not more than seven days. At the end of that time, |
|
the money shall be deposited in the state treasury. |
|
SECTION 3.0029. Section 12.035, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.035. PUBLIC HEALTH SERVICES FEE ACCOUNT [FUND]. |
|
(a) The department shall deposit all money collected for fees and |
|
charges collected under Sections 12.0122(d) and 12.032(a) in the |
|
state treasury to the credit of the [Texas Department of Health] |
|
public health services fee account in the general revenue fund. |
|
(b) The department shall maintain proper accounting records |
|
to allocate the money [fund] among the state and federal programs |
|
generating the fees and administrative costs incurred in collecting |
|
the fees. |
|
[(c)
The public health services fee fund is exempt from
|
|
Section 403.095(b), Government Code.] |
|
SECTION 3.0030. Sections 12.036(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) The executive commissioner [board] or the executive |
|
commissioner's [board's] designee may waive the department's right |
|
of subrogation in whole or in part if the executive commissioner |
|
[board] or the designee determines that: |
|
(1) enforcement of the right would tend to defeat the |
|
purpose of the department's program; or |
|
(2) the administrative expense of the enforcement |
|
would be greater than the expected recovery. |
|
(d) The executive commissioner [board] may adopt rules for |
|
the enforcement of the department's right of subrogation. |
|
SECTION 3.0031. Section 12.037(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
prescribe the criteria for department action under this section. |
|
SECTION 3.0032. Section 12.038, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.038. RULES. The executive commissioner [board] may |
|
adopt rules necessary to implement this subchapter. |
|
SECTION 3.0033. Sections 12.055(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) A state agency or local unit of government under |
|
Subsection (a)(3) shall acquire goods or services by any |
|
procurement method approved by the commission [Health and Human
|
|
Services Commission] that provides the best value to the state |
|
agency or local unit of government. The state agency or local unit |
|
of government shall document that the state agency or local unit of |
|
government considered all relevant factors under Subsection (c) in |
|
making the acquisition. |
|
(d) If a state agency to which this section applies acquires |
|
goods or services with a value that exceeds $100,000, the state |
|
agency shall consult with and receive approval from the commission |
|
[Health and Human Services Commission] before considering factors |
|
other than price and meeting specifications. |
|
SECTION 3.0034. Subchapter F, Chapter 12, Health and Safety |
|
Code, is amended to read as follows: |
|
SUBCHAPTER F. OFFICE OF BORDER [TEXAS-MEXICO] HEALTH |
|
[AND ENVIRONMENTAL ISSUES] |
|
Sec. 12.071. OFFICE OF BORDER [TEXAS-MEXICO] HEALTH [AND
|
|
ENVIRONMENTAL ISSUES]. The department shall establish and maintain |
|
an office in the department to coordinate and promote health and |
|
environmental issues between this state and Mexico. |
|
SECTION 3.0035. Section 12.091, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.091. DEFINITION [DEFINITIONS]. In this subchapter, |
|
"panel"[:
|
|
[(1)
"Medical standards division" means the Medical
|
|
Standards on Motor Vehicle Operations Division of the department.
|
|
[(2) "Panel"] means a panel of the medical advisory |
|
board. |
|
SECTION 3.0036. Section 12.092(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The commissioner shall appoint the medical advisory |
|
board members from: |
|
(1) persons licensed to practice medicine in this |
|
state, including physicians who are board certified in internal |
|
medicine, psychiatry, neurology, physical medicine, or |
|
ophthalmology and who are jointly recommended by the department |
|
[Texas Department of Health] and the Texas Medical Association; and |
|
(2) persons licensed to practice optometry in this |
|
state who are jointly recommended by the department and the Texas |
|
Optometric Association. |
|
SECTION 3.0037. Section 12.093, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.093. ADMINISTRATION[; RULES]. (a) The medical |
|
advisory board is administratively attached to the department |
|
[medical standards division]. |
|
(b) The department [medical standards division]: |
|
(1) shall provide administrative support for the |
|
medical advisory board and panels of the medical advisory board; |
|
and |
|
(2) may collect and maintain the individual medical |
|
records necessary for use by the medical advisory board and the |
|
panels under this section from a physician, hospital, or other |
|
health care provider. |
|
SECTION 3.0038. Section 12.094(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board]: |
|
(1) may adopt rules to govern the activities of the |
|
medical advisory board; |
|
(2) by rule may establish a reasonable fee to pay a |
|
member of the medical advisory board for the member's professional |
|
consultation services; and |
|
(3) if appropriate, may authorize reimbursement for |
|
[per diem and] travel expenses as provided by Section 2110.004, |
|
Government Code, [allowances] for each meeting a member attends[,
|
|
not to exceed the amounts authorized for state employees by the
|
|
General Appropriations Act]. |
|
SECTION 3.0039. Section 12.097(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) In a subsequent proceeding under Subchapter H, Chapter |
|
411, Government Code, or Subchapter N, Chapter 521, Transportation |
|
Code, the department [medical standards division] may provide a |
|
copy of the report of the medical advisory board or panel and a |
|
medical record or report relating to an applicant or license holder |
|
to: |
|
(1) the Department of Public Safety of the State of |
|
Texas; |
|
(2) the applicant or license holder; and |
|
(3) the officer who presides at the hearing. |
|
SECTION 3.0040. Section 12.113(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Volunteers recruited under this subchapter may include |
|
students in high school or an institution of higher education, |
|
senior citizens, participants in the TANF [AFDC] job opportunities |
|
and basic skills (JOBS) training program, VISTA and AmeriCorps |
|
volunteers, and volunteers from business and community networks. |
|
SECTION 3.0041. Section 12.133(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Subject to the approval of the advisory committee, the |
|
executive commissioner [board] shall adopt rules governing the |
|
collection of information under Subsection (a). The rules may |
|
provide for regular audits of randomly selected political |
|
subdivisions and may govern the manner in which a political |
|
subdivision is selected for an audit and the selection of an |
|
auditor. |
|
SECTION 3.0042. Section 12.134(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Subject to the approval of the advisory committee, the |
|
executive commissioner [board] shall adopt rules under which a |
|
political subdivision or agency of this state may dispute |
|
information submitted by a political subdivision under Section |
|
12.133. |
|
SECTION 3.0043. Section 12.136(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) If the department, pursuant to rules adopted by the |
|
executive commissioner, [board] finds, after an audit conducted |
|
under Section 12.133 or 12.134, that a political subdivision has |
|
overstated unreimbursed health care expenditures in the |
|
information submitted under Section 12.133 for any year, the |
|
department shall report that fact to the comptroller and shall |
|
reduce that political subdivision's percentage of the subsequent |
|
annual distribution of the earnings from the account appropriately. |
|
SECTION 3.0044. Sections 12.137(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The tobacco settlement permanent trust account |
|
administration advisory committee shall advise the department |
|
[board] on the implementation of the department's duties under this |
|
subchapter. |
|
(b) The advisory committee is composed of 11 members |
|
appointed as follows: |
|
(1) one member appointed by the executive commissioner |
|
[board] to represent a public hospital or hospital district located |
|
in a county with a population of 50,000 or less or a public hospital |
|
owned or maintained by a municipality; |
|
(2) one member appointed by the political subdivision |
|
that, in the year preceding the appointment, received the largest |
|
annual distribution paid from the account; |
|
(3) one member appointed by the political subdivision |
|
that, in the year preceding the appointment, received the second |
|
largest annual distribution paid from the account; |
|
(4) four members appointed by the Texas Conference of |
|
Urban Counties from nominations received from political |
|
subdivisions that in the year preceding the appointment, received |
|
the 3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th, or 12th largest |
|
annual distribution paid from the account; |
|
(5) one member appointed by the County Judges and |
|
Commissioners Association of Texas; |
|
(6) one member appointed by the North and East Texas |
|
County Judges and Commissioners Association; |
|
(7) one member appointed by the South Texas County |
|
Judges and Commissioners Association; and |
|
(8) one member appointed by the West Texas County |
|
Judges and Commissioners Association. |
|
SECTION 3.0045. Section 12.138, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.138. APPROVAL OF RULES. A rule to be adopted by the |
|
executive commissioner [board] relating to certification of a |
|
percentage of an annual distribution under Section 12.132 or |
|
collection of information under Sections 12.132, 12.133, and 12.134 |
|
must be submitted to the advisory committee and may not become |
|
effective before the rule is approved by the advisory committee. If |
|
the advisory committee disapproves a proposed rule, the advisory |
|
committee shall provide the executive commissioner [board] the |
|
specific reasons that the rule was disapproved. |
|
SECTION 3.0046. Section 12.139, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 12.139. ANNUAL REVIEW. The advisory committee shall |
|
annually: |
|
(1) review the results of any audit conducted under |
|
this subchapter and the results of any dispute filed under Section |
|
12.134; and |
|
(2) review the rules adopted by the executive |
|
commissioner [board] under this subchapter and propose any |
|
amendments to the rules the advisory committee considers necessary. |
|
SECTION 3.0047. The heading to Chapter 13, Health and |
|
Safety Code, is amended to read as follows: |
|
CHAPTER 13. [HEALTH] DEPARTMENT HOSPITALS AND RESPIRATORY |
|
FACILITIES |
|
SECTION 3.0048. The heading to Subchapter A, Chapter 13, |
|
Health and Safety Code, is amended to read as follows: |
|
SUBCHAPTER A. CARE AND TREATMENT IN [HEALTH] DEPARTMENT HOSPITALS |
|
SECTION 3.0049. Sections 13.002(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department [board] may admit to any hospital under |
|
its supervision a patient who: |
|
(1) is eligible to receive patient services under a |
|
department program; and |
|
(2) will benefit from hospitalization. |
|
(c) The executive commissioner [board] may adopt rules and |
|
the department may enter into contracts as necessary to implement |
|
this section. |
|
(d) This section does not require the executive |
|
commissioner [board] or department to: |
|
(1) admit a patient to a particular hospital; |
|
(2) guarantee the availability of space at any |
|
hospital; or |
|
(3) provide treatment for a particular medical need at |
|
any hospital. |
|
SECTION 3.0050. Section 13.003(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department [board] may establish at the Rio Grande |
|
State Center: |
|
(1) cancer screening; |
|
(2) diagnostic services; |
|
(3) educational services; |
|
(4) obstetrical services; |
|
(5) gynecological services; |
|
(6) other inpatient health care services; and |
|
(7) outpatient health care services, including |
|
diagnostic, treatment, disease management, and supportive care |
|
services. |
|
SECTION 3.0051. The heading to Section 13.004, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 13.004. TREATMENT OF CERTAIN PERSONS WITH MENTAL |
|
ILLNESS OR AN INTELLECTUAL DISABILITY [MENTALLY ILL OR MENTALLY
|
|
RETARDED PERSONS]. |
|
SECTION 3.0052. Section 13.004(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department or the Department of Aging and Disability |
|
Services, as appropriate, [Texas Department of Mental Health and
|
|
Mental Retardation] may transfer a [mentally ill or mentally
|
|
retarded] person with mental illness or an intellectual disability |
|
who is infected with tuberculosis to a public health hospital as |
|
defined by Section 13.033 [the Texas Center for Infectious
|
|
Disease]. |
|
SECTION 3.0053. Section 13.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 13.005. CARE AND TREATMENT OF CERTAIN PATIENTS. (a) |
|
The department [board] shall fully develop essential services |
|
needed for the control of tuberculosis. To provide those services, |
|
the department [board] may contract for the support, maintenance, |
|
care, and treatment of tuberculosis patients: |
|
(1) admitted to facilities under the department's |
|
[board's] jurisdiction; or |
|
(2) otherwise subject to the department's [board's] |
|
jurisdiction. |
|
(b) The department [board] may contract with: |
|
(1) municipal, county, or state hospitals; |
|
(2) private physicians; |
|
(3) licensed nursing facilities [homes] and |
|
hospitals; and |
|
(4) hospital districts. |
|
(c) The department [board] may contract for diagnostic and |
|
other services available in a community or region as necessary to |
|
prevent further spread of tuberculosis. |
|
(d) A contract may not include the assignment of any lien |
|
accruing to the state. |
|
(e) The department [board] may establish and operate |
|
outpatient clinics as necessary to provide follow-up treatment on |
|
discharged patients. A person who receives treatment as an |
|
outpatient is financially liable in the manner provided for |
|
inpatients. |
|
SECTION 3.0054. Sections 13.033(3) and (5), Health and |
|
Safety Code, are amended to read as follows: |
|
(3) "Physician" means a person licensed by the Texas |
|
[State Board of] Medical Board [Examiners] to practice medicine in |
|
this state. |
|
(5) "Public health [State chest] hospital" means a |
|
hospital operated by the department to provide services under this |
|
subchapter, including the Texas Center for Infectious Disease [and
|
|
the Rio Grande State Center]. |
|
SECTION 3.0055. Section 13.034, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 13.034. [BOARD] DUTIES OF EXECUTIVE COMMISSIONER AND |
|
DEPARTMENT. (a) The executive commissioner [board] shall adopt |
|
rules [and bylaws] relating to: |
|
(1) the management of public health [state chest] |
|
hospitals; |
|
(2) the duties of officers and employees of those |
|
hospitals; and |
|
(3) the enforcement of necessary discipline and |
|
restraint of patients. |
|
(a-1) The executive commissioner may adopt rules as |
|
necessary for the proper and efficient hospitalization of |
|
tuberculosis patients. |
|
(b) The department [board] shall supply each hospital with |
|
the necessary personnel for the operation and maintenance of the |
|
hospital. |
|
(c) The department [board] may: |
|
(1) prescribe the form and content of applications, |
|
certificates, records, and reports provided for under this |
|
subchapter; |
|
(2) require reports from the administrator of a public |
|
health [state chest] hospital relating to the admission, |
|
examination, diagnosis, release, or discharge of a patient; |
|
(3) visit each hospital regularly to review admitting |
|
procedures and the care and treatment of all new patients admitted |
|
since the last visit; and |
|
(4) investigate by personal visit a complaint made by |
|
a patient or by another person on behalf of a patient[; and
|
|
[(5)
adopt rules as necessary for the proper and
|
|
efficient hospitalization of tuberculosis patients]. |
|
[(d)
The board may delegate a power or duty of the board to
|
|
an employee. The delegation does not relieve the board from its
|
|
responsibility.] |
|
SECTION 3.0056. Section 13.035(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department shall employ a qualified hospital |
|
administrator for each public health [state chest] hospital. |
|
SECTION 3.0057. Sections 13.036(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A resident of this state who has tuberculosis may be |
|
admitted to a public health [state chest] hospital. A person who is |
|
not a resident of this state and who has tuberculosis may be |
|
admitted to a public health [state chest] hospital in accordance |
|
with Section 13.046. |
|
(c) An application for admission to a public health [state
|
|
chest] hospital shall be accompanied by a certificate issued by a |
|
physician stating that the physician has thoroughly examined the |
|
applicant and that the applicant has tuberculosis. In the case of an |
|
applicant who is not a resident of this state, the certificate may |
|
be issued by a physician who holds a license to practice medicine in |
|
the state of residence of the applicant. |
|
SECTION 3.0058. Section 13.038(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A patient admitted to a public health [state chest] |
|
hospital is a public patient and classified as indigent, |
|
nonindigent, or nonresident. |
|
SECTION 3.0059. Section 13.039(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The action shall be brought on the written request of |
|
the public health [state chest] hospital administrator, |
|
accompanied by a certificate as to the amount owed to the state. In |
|
any action, the certificate is sufficient evidence of the amount |
|
owed to the state for the support of that patient. |
|
SECTION 3.0060. Sections 13.041(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department [board] may: |
|
(1) return a nonresident patient admitted to a public |
|
health [state chest] hospital to the proper agency of the state of |
|
the patient's residence; and |
|
(2) permit the return of a resident of this state who |
|
has been admitted to a tuberculosis hospital in another state. |
|
(c) The department [board] may enter into reciprocal |
|
agreements with the proper agencies of other states to facilitate |
|
the return to the states of their residence of nonresident patients |
|
admitted to tuberculosis [state chest] hospitals in other states. |
|
SECTION 3.0061. Section 13.042, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 13.042. DISCRIMINATION PROHIBITED. (a) A public |
|
health [state chest] hospital may not discriminate against a |
|
patient. |
|
(b) Each patient is entitled to equal facilities, |
|
attention, and treatment. However, a public health [state chest] |
|
hospital may provide different care and treatment of patients |
|
because of differences in the condition of the individual patients. |
|
SECTION 3.0062. Sections 13.043(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A patient in a public health [state chest] hospital may |
|
not offer an officer, agent, or employee of the hospital a tip, |
|
payment, or reward of any kind. |
|
(c) The department [board] shall strictly enforce this |
|
section. |
|
SECTION 3.0063. Sections 13.044(a), (d), and (e), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) On the request of any charitable organization in this |
|
state, the department [board] may permit the erection, furnishing, |
|
and maintenance by the charitable organization of accommodations on |
|
the grounds of a public health [state chest] hospital for persons |
|
who have tuberculosis and who are: |
|
(1) members of the charitable organization; |
|
(2) members of the families of persons who are members |
|
of the charitable organization; or |
|
(3) surviving spouses or minor children of deceased |
|
persons who are members of the charitable organization. |
|
(d) The officers or a board or committee of the charitable |
|
organization and the department [board] must enter into a written |
|
agreement relating to the location, construction, style, and |
|
character, and terms of existence of buildings, and other questions |
|
arising in connection with the grant of permission to erect and |
|
maintain private accommodations. The department must maintain as a |
|
record a copy of the written agreement [must be recorded in the
|
|
minutes of the board]. |
|
(e) Except for the preferential right to occupy vacant |
|
accommodations erected by the person's charitable organization, a |
|
person described by Subsection (a) shall be classified in the same |
|
manner as other public health [state chest] hospital patients and |
|
shall be admitted, maintained, cared for, and treated in those |
|
hospitals in the same manner and under the same conditions and rules |
|
that apply to other patients. |
|
SECTION 3.0064. Section 13.045(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A county may donate and convey land to the state in |
|
consideration of the establishment of a public health [state chest] |
|
hospital by the executive commissioner [board]. |
|
SECTION 3.0065. Section 13.046, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 13.046. ADMISSION OF NONRESIDENT PATIENTS. (a) The |
|
department may enter into an agreement with an agency of another |
|
state responsible for the care of residents of that state who have |
|
tuberculosis under which: |
|
(1) residents of the other state who have tuberculosis |
|
may be admitted to a public health [state chest] hospital, subject |
|
to the availability of appropriate space after the needs of |
|
eligible tuberculosis and chronic respiratory disease patients who |
|
are residents of this state have been met; and |
|
(2) the other state is responsible for paying all |
|
costs of the hospitalization and treatment of patients admitted |
|
under the agreement. |
|
(b) Section 13.041 does not apply to the return of a |
|
nonresident patient admitted to a public health [state chest] |
|
hospital in accordance with an agreement entered into under this |
|
section. The return of that patient to the state of residence is |
|
governed by the agreement. |
|
SECTION 3.0066. Section 31.002(a)(3), Health and Safety |
|
Code, is amended to read as follows: |
|
(3) "Other benefit" means a benefit, other than a |
|
benefit provided under this chapter, to which an individual is |
|
entitled for payment of the costs of primary health care services, |
|
including benefits available from: |
|
(A) an insurance policy, group health plan, or |
|
prepaid medical care plan; |
|
(B) Title XVIII or XIX of the Social Security Act |
|
(42 U.S.C. Section 1395 et seq. or Section 1396 et seq.); |
|
(C) the United States Department of Veterans |
|
Affairs [Administration]; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or any other |
|
compulsory employers' insurance program; |
|
(F) a public program created by federal or state |
|
law, or by an ordinance or rule of a municipality or political |
|
subdivision of the state, excluding benefits created by the |
|
establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, a hospital |
|
district, or the facilities of a publicly supported medical school; |
|
or |
|
(G) a cause of action for medical, facility, or |
|
medical transportation expenses, or a settlement or judgment based |
|
on the cause of action, if the expenses are related to the need for |
|
services provided under this chapter. |
|
SECTION 3.0067. Section 31.002(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] by rule may define a |
|
word or term not defined by Subsection (a) as necessary to |
|
administer this chapter. The executive commissioner [board] may |
|
not define a word or term so that the word or term is inconsistent or |
|
in conflict with the purposes of this chapter, or is in conflict |
|
with the definition and conditions of practice governing a provider |
|
who is required to be licensed, registered, certified, identified, |
|
or otherwise sanctioned under the laws of this state. |
|
SECTION 3.0068. Sections 31.003(a), (b), (c), (d), (e), and |
|
(g), Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] may establish a |
|
program in the department to provide primary health care services |
|
to eligible individuals. |
|
(b) If the program is established, the executive |
|
commissioner [board] shall adopt rules relating to: |
|
(1) the type, amount, and duration of services to be |
|
provided under this chapter; and |
|
(2) the determination by the department of the |
|
services needed in each service area. |
|
(c) If budgetary limitations exist, the executive |
|
commissioner [board] by rule shall establish a system of priorities |
|
relating to the types of services provided, geographic areas |
|
covered, or classes of individuals eligible for services. |
|
(d) The executive commissioner [board] shall adopt rules |
|
under Subsection (c) relating to the geographic areas covered and |
|
the classes of individuals eligible for services according to a |
|
statewide determination of the need for services. |
|
(e) The executive commissioner [board] shall adopt rules |
|
under Subsection (c) relating to the types of services provided |
|
according to the set of service priorities established under this |
|
subsection. Initial service priorities shall focus on the funding |
|
of, provision of, and access to: |
|
(1) diagnosis and treatment; |
|
(2) emergency services; |
|
(3) family planning services; |
|
(4) preventive health services, including |
|
immunizations; |
|
(5) health education; and |
|
(6) laboratory, X-ray, nuclear medicine, or other |
|
appropriate diagnostic services. |
|
(g) The executive commissioner [board] should require that |
|
the services provided under this chapter be reserved to the |
|
greatest extent possible for low-income individuals who are not |
|
eligible for similar services through any other publicly funded |
|
program. |
|
SECTION 3.0069. Sections 31.004(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules |
|
necessary to administer this chapter, and the department shall |
|
administer the program in accordance with those [board] rules. |
|
(b) The executive commissioner [With the advice and
|
|
assistance of the commissioner and the department, the board] by |
|
rule shall: |
|
(1) establish the administrative structure of the |
|
program; |
|
(2) establish a plan of areawide administration to |
|
provide authorized services; |
|
(3) designate, if possible, local public and private |
|
resources as providers; and |
|
(4) prevent duplication by coordinating authorized |
|
primary health care services with existing federal, state, and |
|
local programs. |
|
SECTION 3.0070. Sections 31.005(a), (b), (c), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules |
|
relating to the department's determination of whether program |
|
services are to be provided through a network of approved |
|
providers, directly by the department, or by a combination of the |
|
department and approved providers as prescribed by this section. |
|
(b) The department shall provide services only as |
|
prescribed by department [board] rule. |
|
(c) The department may provide primary health care services |
|
directly to eligible individuals to the extent that the department |
|
[board] determines that existing private or public providers or |
|
other resources in the service area are unavailable or unable to |
|
provide those services. In making that determination, the |
|
department shall: |
|
(1) initially determine the proposed need for services |
|
in the service area; |
|
(2) notify existing private and public providers and |
|
other resources in the service area of the department's initial |
|
determination of need and the services the department proposes to |
|
provide directly to eligible individuals; |
|
(3) provide existing private and public providers and |
|
other resources in the service area a reasonable opportunity to |
|
comment on the department's initial determination of need and the |
|
availability and ability of existing private or public providers or |
|
other resources in the service area to satisfy the need; |
|
(4) provide existing private and public providers and |
|
other resources in the service area a reasonable opportunity to |
|
obtain approval as providers under the program; and |
|
(5) eliminate, reduce, or otherwise modify the |
|
proposed scope or type of services the department proposes to |
|
provide directly to the extent that those services may be provided |
|
by existing private or public providers or other resources in the |
|
service area that meet the executive commissioner's [board's] |
|
criteria for approval as providers. |
|
(e) If after a review the department [board] determines that |
|
a private or public provider or other resource is available to |
|
provide services and has been approved as a provider, the |
|
department shall, immediately after approving the provider, |
|
eliminate, reduce, or modify the scope and type of services the |
|
department provides directly to the extent the private or public |
|
provider or other resource is available and able to provide the |
|
service. |
|
SECTION 3.0071. Sections 31.006(a), (b), (d), (f), and (i), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules |
|
relating to: |
|
(1) the selection and expedited selection of |
|
providers, including physicians, registered nurses, and |
|
facilities; and |
|
(2) the denial, modification, suspension, and |
|
termination of program participation. |
|
(b) The department shall select and approve providers to |
|
participate in the program according to the criteria and following |
|
the procedures prescribed by department [board] rules. |
|
(d) The executive commissioner [board] may not adopt |
|
facility approval criteria that discriminate against a facility |
|
solely because it is operated for profit. |
|
(f) The department [board] shall provide a due process |
|
hearing procedure in accordance with department rules for the |
|
resolution of conflicts between the department and a provider. |
|
Chapter 2001, Government Code, does [do] not apply to conflict |
|
resolution procedures adopted under this section. |
|
(i) The notice and hearing required by this section do not |
|
apply if a grant or contract: |
|
(1) is canceled by the department because of |
|
exhaustion of funds or because insufficient funds require the |
|
executive commissioner [board] to adopt service priorities; or |
|
(2) expires according to its terms. |
|
SECTION 3.0072. Sections 31.007(a), (c), (d), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules |
|
relating to application procedures for admission to the program. |
|
(c) The application form must be accompanied by: |
|
(1) a statement by the applicant, or by the person with |
|
a legal obligation to provide for the applicant's support, that the |
|
applicant or person is financially unable to pay for all or part of |
|
the cost of the necessary services; and |
|
(2) any other assurances from the applicant or any |
|
documentary evidence required by department rules [the board] that |
|
is necessary to support the applicant's eligibility. |
|
(d) Except as permitted by department [program] rules, the |
|
department may not provide services or authorize payment for |
|
services delivered to an individual before the eligibility date |
|
assigned to the individual by the department. |
|
(e) The department shall determine or cause to be determined |
|
the eligibility date in accordance with department [board] rules. |
|
The date may not be later than the date on which the individual |
|
submits a properly completed application form and all supporting |
|
documents required by this chapter or department [board] rules. |
|
SECTION 3.0073. Section 31.008, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 31.008. ELIGIBILITY FOR SERVICES. (a) The executive |
|
commissioner [board] shall adopt rules relating to eligibility |
|
criteria for an individual to receive services under the program, |
|
including health, medical, and financial criteria. The department |
|
shall determine or cause to be determined an applicant's |
|
eligibility in accordance with this chapter and department [board] |
|
rules. |
|
(b) Except as modified by other rules adopted under this |
|
chapter, the executive commissioner [board] by rule shall provide |
|
that to be eligible to receive services, the individual must be a |
|
resident of this state. |
|
SECTION 3.0074. Sections 31.009(c), (d), and (f), Health |
|
and Safety Code, are amended to read as follows: |
|
(c) The executive commissioner [board] by rule shall |
|
provide criteria for action by the department under this section. |
|
(d) Chapter 2001, Government Code, does [do] not apply to |
|
the granting, denial, modification, suspension, or termination of |
|
services. The department shall conduct hearings in accordance with |
|
the department's [board's] due process hearing rules. |
|
(f) The notice and hearing required by this section do not |
|
apply if the department restricts program services to conform to |
|
budgetary limitations that require the executive commissioner |
|
[board] to establish service priorities. |
|
SECTION 3.0075. Sections 31.010(b) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) Except as provided by department [board] rules, an |
|
individual is not eligible to receive services under this chapter |
|
to the extent that the individual, or a person with a legal |
|
obligation to support the individual, is eligible for some other |
|
benefit that would pay for all or part of the services. |
|
(e) The department [commissioner] may waive enforcement of |
|
Subsections (b)-(d) [of this section] as prescribed by department |
|
[board] rules in certain individually considered cases in which |
|
enforcement will deny services to a class of otherwise eligible |
|
individuals because of conflicting federal, state, or local laws or |
|
rules. |
|
SECTION 3.0076. Section 31.012, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 31.012. FEES. (a) The department [board] may charge |
|
fees for the services provided directly by the department or |
|
through approved providers in accordance with Subchapter D, Chapter |
|
12. |
|
(b) The executive commissioner by rule [board] shall adopt |
|
standards and procedures to develop and implement a schedule of |
|
allowable charges for program services. |
|
SECTION 3.0077. Section 31.013(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Except as provided by this chapter or by other law, the |
|
department [board] may seek, receive, and spend funds received |
|
through an appropriation, grant, donation, or reimbursement from |
|
any public or private source to administer this chapter. |
|
SECTION 3.0078. Sections 31.015(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
relating to the information a provider is required to report to the |
|
department and shall adopt procedures to prevent unnecessary and |
|
duplicative reporting of data. |
|
(d) The report required under Subsection (c) must include: |
|
(1) the number of individuals receiving care under |
|
this chapter; |
|
(2) the total cost of the program, including a |
|
delineation of the total administrative costs and the total cost |
|
for each service authorized under Section 31.003(e); |
|
(3) the average cost per recipient of services; |
|
(4) the number of individuals who received services in |
|
each public health region; and |
|
(5) any other information required by the executive |
|
commissioner [board]. |
|
SECTION 3.0079. Section 32.002(a)(8), Health and Safety |
|
Code, is amended to read as follows: |
|
(8) "Other benefit" means a benefit, other than a |
|
benefit provided under this chapter, to which an individual is |
|
entitled for payment of the costs of maternal and infant health |
|
improvement services, ancillary services, educational services, or |
|
transportation services, including benefits available from: |
|
(A) an insurance policy, group health plan, or |
|
prepaid medical care plan; |
|
(B) Title XVIII of the Social Security Act (42 |
|
U.S.C. Section 1395 et seq.); |
|
(C) the United States Department of Veterans |
|
Affairs [Administration]; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or any other |
|
compulsory employers' insurance program; |
|
(F) a public program created by federal or state |
|
law, other than Title XIX of the Social Security Act (42 U.S.C. |
|
Section 1396 et seq.), or by an ordinance or rule of a municipality |
|
or political subdivision of the state, excluding benefits created |
|
by the establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, a hospital |
|
district, or the facilities of a publicly supported medical school; |
|
or |
|
(G) a cause of action for medical, facility, or |
|
medical transportation expenses, or a settlement or judgment based |
|
on the cause of action, if the expenses are related to the need for |
|
services provided under this chapter. |
|
SECTION 3.0080. Section 32.002(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] by rule may define a |
|
word or term not defined by Subsection (a) as necessary to |
|
administer this chapter. The executive commissioner [board] may |
|
not define a word or term so that the word or term is inconsistent or |
|
in conflict with the purposes of this chapter, or is in conflict |
|
with the definition and conditions of practice governing a provider |
|
who is required to be licensed, registered, certified, identified, |
|
or otherwise sanctioned under the laws of this state. |
|
SECTION 3.0081. Section 32.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 32.003. MATERNAL AND INFANT HEALTH IMPROVEMENT |
|
SERVICES PROGRAM. (a) The executive commissioner [board] may |
|
establish a maternal and infant health improvement services program |
|
in the department to provide comprehensive maternal and infant |
|
health improvement services and ancillary services to eligible |
|
women and infants. |
|
(b) If the program is established, the executive |
|
commissioner [board] shall adopt rules relating to: |
|
(1) the type, amount, and duration of services to be |
|
provided under this chapter; and |
|
(2) the determination by the department of the |
|
services needed in each service area. |
|
(c) If budgetary limitations exist, the executive |
|
commissioner [board] by rule shall establish a system of priorities |
|
relating to the types of services provided, geographic areas |
|
covered, or classes of individuals eligible for services. |
|
(d) The executive commissioner [board] shall adopt the |
|
rules according to a statewide determination of the need for |
|
services. |
|
(e) In structuring the program and adopting rules, the |
|
department and executive commissioner [board] shall attempt to |
|
maximize the amount of federal matching funds available for |
|
maternal and infant health improvement services while continuing to |
|
serve targeted populations. |
|
(f) If necessary, the executive commissioner [board] by |
|
rule may coordinate services and other parts of the program with the |
|
medical assistance program. However, the executive commissioner |
|
[board] may not adopt rules relating to the services under either |
|
program that would: |
|
(1) cause the program established under this chapter |
|
not to conform with federal law to the extent that federal matching |
|
funds would not be available; or |
|
(2) affect the status of the single state agency to |
|
administer the medical assistance program. |
|
SECTION 3.0082. Section 32.006(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules |
|
necessary to administer this chapter, and the department shall |
|
administer the program in accordance with those [board] rules. |
|
SECTION 3.0083. Sections 32.011(b), (c), (d), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
provide criteria for action by the department under this section. |
|
(c) Chapter 2001, Government Code, does not apply to the |
|
granting, denial, modification, suspension, or termination of |
|
services. The department shall provide [conduct] hearings in |
|
accordance with the department's [board's] due process hearing |
|
rules. |
|
(d) The department shall render the final administrative |
|
decision following [in] a due process hearing to deny, modify, |
|
suspend, or terminate the receipt of services. |
|
(e) The notice and hearing required by this section do not |
|
apply if the department restricts program services to conform to |
|
budgetary limitations that require the executive commissioner |
|
[board] to establish service priorities. |
|
SECTION 3.0084. Sections 32.012(b) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) Except as provided by department [board] rules, an |
|
individual is not eligible to receive services under this chapter |
|
to the extent that the individual or a person with a legal |
|
obligation to support the individual is eligible for some other |
|
benefit that would pay for all or part of the services. |
|
(e) The department [commissioner] may waive enforcement of |
|
Subsections (b)-(d) [of this section] as prescribed by department |
|
[board] rules in certain individually considered cases in which |
|
enforcement will deny services to a class of otherwise eligible |
|
individuals because of conflicting federal, state, or local laws or |
|
rules. |
|
SECTION 3.0085. Section 32.014, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 32.014. FEES. (a) Except as prohibited by federal law |
|
or regulation, the department [board] may collect [charge] fees for |
|
the services provided directly by the department or through |
|
approved providers in accordance with Subchapter D, Chapter 12. |
|
(b) The executive commissioner by rule [board] shall adopt |
|
standards and procedures to develop and implement a schedule of |
|
allowable charges for program services. |
|
SECTION 3.0086. Section 32.015(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Except as provided by this chapter or by other law, the |
|
department [board] may seek, receive, and spend funds received |
|
through an appropriation, grant, donation, or reimbursement from |
|
any public or private source to administer this chapter. |
|
SECTION 3.0087. Section 32.017(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
relating to the information a provider is required to report to the |
|
department and shall adopt procedures to prevent unnecessary and |
|
duplicative reporting of data. |
|
SECTION 3.0088. The heading to Section 32.021, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 32.021. REQUIREMENTS REGARDING THE WOMEN, INFANTS, AND |
|
CHILDREN PROGRAM. |
|
SECTION 3.0089. Section 32.021(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) An agency, organization, or other entity that contracts |
|
with the Special Supplemental Nutrition Program for Women, Infants, |
|
and Children shall each month provide the clinical and nutritional |
|
services supported by that program during extended hours, as |
|
defined by the department. |
|
SECTION 3.0090. The heading to Section 32.0211, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 32.0211. WOMEN, INFANTS, AND CHILDREN PROGRAM OUTREACH |
|
CAMPAIGN TO PROMOTE FATHERS' INVOLVEMENT. |
|
SECTION 3.0091. Sections 32.0211(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The attorney general shall: |
|
(1) subject to Subsections (b) and (c), develop and |
|
periodically update a publication that: |
|
(A) describes the importance and long-term |
|
positive effects on children of a father's involvement during a |
|
mother's pregnancy; and |
|
(B) provides guidance to prospective fathers on |
|
the positive actions that they can take to support the pregnant |
|
mother during pregnancy and the effect those actions have on |
|
pregnancy outcomes; and |
|
(2) make the publication described by Subdivision (1) |
|
available to any agency, organization, or other entity that |
|
contracts with the Special Supplemental Nutrition Program for |
|
Women, Infants, and Children and on the attorney general's Internet |
|
website in a format that allows the public to download and print the |
|
publication. |
|
(c) In developing the publication required by Subsection |
|
(a), the attorney general shall consult with: |
|
(1) the department as the state agency responsible for |
|
administering the Special Supplemental Nutrition Program for |
|
Women, Infants, and Children and this state's program under the |
|
Maternal and Child Health Services Block Grant Act (42 U.S.C. |
|
Section 701 et seq.); and |
|
(2) the Texas Council on Family Violence. |
|
(d) An agency, organization, or other entity that contracts |
|
with the Special Supplemental Nutrition Program for Women, Infants, |
|
and Children shall make the publication described by Subsection (a) |
|
available to each client receiving clinical or nutritional services |
|
under the program. |
|
SECTION 3.0092. The heading to Section 32.042, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 32.042. DUTIES OF EXECUTIVE COMMISSIONER [BOARD]; |
|
RULES. |
|
SECTION 3.0093. Section 32.042(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] by rule shall adopt: |
|
(1) minimum standards and objectives to implement |
|
voluntary perinatal health care systems; and |
|
(2) policies for health promotion and education, risk |
|
assessment, access to care, and perinatal system structure, |
|
including the transfer and transportation of pregnant women and |
|
infants. |
|
SECTION 3.0094. Section 32.044(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Each voluntary perinatal health care system must have: |
|
(1) a coordinating board responsible for ensuring, |
|
providing, or coordinating planning access to services, data |
|
collection, and provider education; |
|
(2) access to appropriate emergency medical services; |
|
(3) risk assessment, transport, and transfer |
|
protocols for perinatal patients; |
|
(4) one or more health care facilities categorized |
|
according to perinatal care capabilities using standards adopted by |
|
department [board] rule; and |
|
(5) documentation of broad-based participation in |
|
planning by providers of perinatal services and community |
|
representatives throughout the defined geographic region. |
|
SECTION 3.0095. Sections 32.045(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
establish eligibility criteria for awarding the grants. The rules |
|
must require the department to consider: |
|
(1) the need of an area and the extent to which the |
|
grant would meet the identified need; |
|
(2) the availability of personnel and training |
|
programs; |
|
(3) the availability of other funding sources; |
|
(4) the assurance of providing quality services; |
|
(5) the need for emergency transportation of perinatal |
|
patients and the extent to which the system meets the identified |
|
needs; and |
|
(6) the stage of development of a perinatal health |
|
care system. |
|
(c) The department may approve grants according to rules |
|
adopted by the executive commissioner [board]. A grant awarded |
|
under this section is governed by Chapter 783, Government Code, and |
|
rules adopted under that chapter. |
|
SECTION 3.0096. Section 32.062, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 32.062. ESTABLISHMENT; PRESIDING OFFICER. (a) The |
|
task force is composed of 25 members appointed by the executive |
|
commissioner [of the Health and Human Services Commission] as |
|
follows: |
|
(1) four representatives of family violence centers, |
|
as defined by Section 51.002, Human Resources Code, from different |
|
geographic regions in this state, including both rural and urban |
|
areas; |
|
(2) one representative of a statewide family violence |
|
advocacy organization; |
|
(3) one representative of a statewide association of |
|
obstetricians and gynecologists; |
|
(4) two representatives of the family and community |
|
health programs in the department [Department of State Health
|
|
Services]; |
|
(5) one representative of a statewide sexual assault |
|
advocacy organization; |
|
(6) one representative of the commission's [Health and
|
|
Human Services Commission] Texas Home Visiting Program; |
|
(7) one representative of a statewide association of |
|
midwifery; |
|
(8) one representative of a statewide family |
|
physician's association; |
|
(9) one representative of a statewide nursing |
|
association; |
|
(10) one representative of a statewide hospital |
|
association; |
|
(11) one representative of a statewide pediatric |
|
medical association; |
|
(12) one representative of a statewide medical |
|
association; |
|
(13) one representative of The University of Texas |
|
School of Social Work Institute on Domestic Violence and Sexual |
|
Assault; |
|
(14) one representative of The University of Texas |
|
School of Law Domestic Violence Clinic; |
|
(15) one representative of the governor's EMS and |
|
Trauma Advisory Council; |
|
(16) one representative of a Department of Family and |
|
Protective Services prevention and early intervention program; |
|
(17) one representative of a statewide osteopathic |
|
medical association; |
|
(18) one representative of a statewide association of |
|
community health centers; |
|
(19) one representative of the office of the attorney |
|
general; |
|
(20) one representative from a medical school or a |
|
teaching hospital in the state who is either an attending physician |
|
of the hospital or a faculty member of the medical school; and |
|
(21) one representative of the commission's [Health
|
|
and Human Services Commission's] Family Violence Program. |
|
(b) The executive commissioner [of the Health and Human
|
|
Services Commission] shall appoint a task force member to serve as |
|
presiding officer of the task force. |
|
SECTION 3.0097. Section 32.064, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 32.064. REPORT. Not later than September 1, 2015, the |
|
task force shall submit a report to the governor, the lieutenant |
|
governor, the speaker of the house of representatives, the |
|
presiding officers of the standing committees of the legislature |
|
having primary jurisdiction over health and human services, the |
|
executive commissioner [of the Health and Human Services
|
|
Commission], and the commissioner [of state health services] |
|
containing: |
|
(1) the findings and legislative, policy, and research |
|
recommendations of the task force; and |
|
(2) a description of the activities of the task force. |
|
SECTION 3.0098. Section 33.001(3), Health and Safety Code, |
|
is amended to read as follows: |
|
(3) "Other benefit" means a benefit, other than a |
|
benefit under this chapter, to which an individual is entitled for |
|
the payment of the costs of services. The term includes: |
|
(A) benefits available under: |
|
(i) an insurance policy, group health plan, |
|
or prepaid medical care plan; |
|
(ii) Title XVIII of the Social Security Act |
|
(42 U.S.C. Section 1395 et seq.); |
|
(iii) Title XIX of the Social Security Act |
|
(42 U.S.C. Section 1396 et seq.); |
|
(iv) the United States Department of |
|
Veterans Affairs [Veterans' Administration]; |
|
(v) the TRICARE program of the United |
|
States Department of Defense [Civilian Health and Medical Program
|
|
of the Uniformed Services]; or |
|
(vi) workers' compensation or any other |
|
compulsory employers insurance program; |
|
(B) a public program created by federal or state |
|
law or by ordinance or rule of a municipality or political |
|
subdivision of the state, except those benefits created by the |
|
establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, a hospital |
|
district, or by the facilities of a publicly supported medical |
|
school; and |
|
(C) benefits resulting from a cause of action for |
|
health care expenses, or a settlement or judgment based on the cause |
|
of action, if the expenses are related to the need for services |
|
provided under this chapter. |
|
SECTION 3.0099. Section 33.002(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
necessary to carry out the program, including a rule specifying |
|
other heritable diseases covered by this chapter. |
|
SECTION 3.0100. Section 33.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 33.004. [STUDY ON] NEWBORN SCREENING PROGRAM; FEES |
|
[METHODOLOGY AND EQUIPMENT]. [(a) Not later than March 1, 2006,
|
|
the department shall:
|
|
[(1)
conduct a study to determine the most
|
|
cost-effective method of conducting newborn screening, including
|
|
screening for disorders listed in the core uniform panel of newborn
|
|
screening conditions recommended in the 2005 report by the American
|
|
College of Medical Genetics entitled "Newborn Screening: Toward a
|
|
Uniform Screening Panel and System" or another report determined by
|
|
the department to provide more appropriate newborn screening
|
|
guidelines, to protect the health and welfare of this state's
|
|
newborns and to maximize the number of newborn screenings that may
|
|
be conducted with the funding available for the screening;
|
|
[(2)
determine the disorders to be studied under
|
|
Subdivision (1) and ensure the study does not examine screening and
|
|
services provided under Chapter 47; and
|
|
[(3)
obtain proposals or information regarding the
|
|
conduct of newborn screening and compare the costs of the
|
|
department performing newborn screening services to the costs of
|
|
outsourcing screening to a qualified laboratory with at least two
|
|
years' experience performing newborn screening tests.] |
|
(b) In accordance with rules adopted by the executive |
|
commissioner [of the Health and Human Services Commission], the |
|
department shall [may] implement a newborn screening program. |
|
(c) In implementing the newborn screening program [If the
|
|
department determines under Subsection (a) that the department's
|
|
performance of newborn screening services is more cost-effective
|
|
than outsourcing newborn screening], the department shall obtain |
|
the use of screening methodologies[, including tandem mass
|
|
spectrometers,] and hire the employees necessary to administer |
|
newborn screening under this chapter. |
|
[(d)
If the department determines under Subsection (a) that
|
|
outsourcing of newborn screening is more cost-effective, the
|
|
department shall contract for the resources and services necessary
|
|
to conduct newborn screening using a competitive procurement
|
|
process.] |
|
(e) The department shall periodically review the newborn |
|
screening program [as revised under this section] to determine the |
|
efficacy and cost-effectiveness of the program and determine |
|
whether adjustments to the program are necessary to protect the |
|
health and welfare of this state's newborns and to maximize the |
|
number of newborn screenings that may be conducted with the funding |
|
available for the screening. |
|
(f) The executive commissioner by rule [department] may |
|
establish [adjust] the amounts charged for newborn screening fees, |
|
including fees assessed for follow-up services, tracking |
|
confirmatory testing, and diagnosis. |
|
SECTION 3.0101. Section 33.011(a-1), Health and Safety |
|
Code, is amended to read as follows: |
|
(a-1) Except as provided by this subsection and to the |
|
extent funding is available for the screening, the department shall |
|
require newborn screening tests to screen for disorders listed as |
|
core and secondary conditions in the [December 2011] Recommended |
|
Uniform Screening Panel of the Secretary's Advisory Committee on |
|
Heritable Disorders in Newborns and Children or another report |
|
determined by the department to provide more stringent newborn |
|
screening guidelines to protect the health and welfare of this |
|
state's newborns. The department, with the advice of the Newborn |
|
Screening Advisory Committee, may require additional newborn |
|
screening tests under this subsection to screen for other disorders |
|
or conditions. The department may exclude from the newborn |
|
screening tests required under this subsection screenings for |
|
galactose epimerase and galactokinase. |
|
SECTION 3.0102. Section 33.0112, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 33.0112. DESTRUCTION OF GENETIC MATERIAL. (a) The |
|
department shall destroy any genetic material obtained from a child |
|
under this chapter not later than the second anniversary of the date |
|
the department receives the genetic material unless a parent, |
|
managing conservator, or guardian of the child consents to |
|
disclosure under Section 33.018(c-1) [33.017(c-1)]. |
|
(b) The department shall destroy any genetic material |
|
obtained from a child under this chapter not later than the second |
|
anniversary of the date the department receives the genetic |
|
material if: |
|
(1) a parent, managing conservator, or guardian of the |
|
child consents to disclosure under Section 33.018(c-1) |
|
[33.017(c-1)]; |
|
(2) the parent, managing conservator, or guardian who |
|
consented to the disclosure revokes the consent under Section |
|
33.018(i) [33.017(i)]; and |
|
(3) the department receives the written revocation of |
|
consent under Section 33.018(i) [33.017(i)] not later than the |
|
second anniversary of the date the department received the genetic |
|
material. |
|
(c) The department shall destroy any genetic material |
|
obtained from a child under this chapter not later than the 60th day |
|
after the date the department receives a written revocation of |
|
consent under Section 33.018(i) [33.017(i)] if: |
|
(1) a parent, managing conservator, or guardian of the |
|
child consented to disclosure under Section 33.018(c-1) |
|
[33.017(c-1)]; |
|
(2) the parent, managing conservator, or guardian who |
|
consented to the disclosure or the child revokes the consent under |
|
Section 33.018(i) [33.017(i)]; and |
|
(3) the department receives the written revocation of |
|
consent later than the second anniversary of the date the |
|
department received the genetic material. |
|
[(d)
A reference in this section to Section 33.017 means
|
|
Section 33.017 as added by Chapter 179 (H.B. 1672), Acts of the 81st
|
|
Legislature, Regular Session, 2009.] |
|
SECTION 3.0103. Sections 33.016(a), (d), and (f), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department may develop a program to approve any |
|
laboratory that wishes to perform the tests required to be |
|
administered under this chapter. To the extent that they are not |
|
otherwise provided in this chapter, the executive commissioner |
|
[board] may adopt rules prescribing procedures and standards for |
|
the conduct of the program. |
|
(d) The department may extend or renew any approval in |
|
accordance with reasonable procedures prescribed by the executive |
|
commissioner [board]. |
|
(f) Hearings under this section shall be conducted in |
|
accordance with the department's hearing rules [adopted by the
|
|
board] and the applicable provisions of Chapter 2001, Government |
|
Code. |
|
SECTION 3.0104. Sections 33.017(b) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The advisory committee consists of members appointed by |
|
the commissioner [of state health services]. The advisory |
|
committee must include the following members: |
|
(1) at least four physicians licensed to practice |
|
medicine in this state, including at least two physicians |
|
specializing in neonatal-perinatal medicine; |
|
(2) at least two hospital representatives; |
|
(3) at least two persons who have family members |
|
affected by a condition for which newborn screening is or may be |
|
required under this subchapter; and |
|
(4) at least two health care providers who are |
|
involved in the delivery of newborn screening services, follow-up, |
|
or treatment in this state. |
|
(f) The advisory committee shall meet at least three times |
|
each year and at other times at the call of the commissioner [of
|
|
state health services]. |
|
SECTION 3.0105. Section 33.032, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 33.032. PROGRAM SERVICES. (a) Within the limits of |
|
funds available for this purpose and in cooperation with the |
|
individual's physician, the department may provide services |
|
directly or through approved providers to individuals of any age |
|
who meet the eligibility criteria specified by department [board] |
|
rules on the confirmation of a positive test for phenylketonuria, |
|
other heritable diseases, hypothyroidism, or another disorder for |
|
which the screening tests are required. |
|
(b) The executive commissioner [board] may adopt: |
|
(1) rules specifying the type, amount, and duration of |
|
program services to be offered; |
|
(2) rules establishing the criteria for eligibility |
|
for services, including the medical and financial criteria; |
|
(3) rules establishing the procedures necessary to |
|
determine the medical, financial, and other eligibility of the |
|
individual; |
|
(4) substantive and procedural rules for applying for |
|
program services and processing those applications; |
|
(5) rules for providing services according to a |
|
sliding scale of financial eligibility; |
|
(6) substantive and procedural rules for the denial, |
|
modification, suspension, and revocation of an individual's |
|
approval to receive services; and |
|
(7) substantive and procedural rules for the approval |
|
of providers to furnish program services. |
|
(c) The department may select providers according to the |
|
criteria in the department's [board's] rules. |
|
(d) The executive commissioner by rule [board] may |
|
establish [charge] fees to be collected by the department for the |
|
provision of services, except that services may not be denied to an |
|
individual because of the individual's inability to pay the fees. |
|
SECTION 3.0106. Section 33.035(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The executive commissioner [board] by rule shall |
|
provide criteria for actions taken under this section. |
|
SECTION 3.0107. Section 33.036(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) Chapter 2001, Government Code, does [do] not apply to |
|
the notice and hearing required by this section. |
|
SECTION 3.0108. Section 33.037(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department [board] may require an individual or, if |
|
the individual is a minor, the minor's parent, managing |
|
conservator, or guardian, or other person with a legal obligation |
|
to support the individual to pay or reimburse the department for all |
|
or part of the cost of the services provided. |
|
SECTION 3.0109. Sections 33.038(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) This section creates a separate and distinct cause of |
|
action, and the department [commissioner] may request the attorney |
|
general to bring suit in the appropriate court of Travis County on |
|
behalf of the department. |
|
(d) The executive commissioner [board] by rule shall |
|
provide criteria for actions taken under this section. |
|
SECTION 3.0110. Sections 35.0021(6), (7), (10), (11), and |
|
(12), Health and Safety Code, are amended to read as follows: |
|
(6) "Other benefit" means a benefit, other than a |
|
benefit provided under this chapter, to which a person is entitled |
|
for payment of the costs of services provided under the program, |
|
including benefits available from: |
|
(A) an insurance policy, group health plan, |
|
health maintenance organization, or prepaid medical or dental care |
|
plan; |
|
(B) Title XVIII, Title XIX, or Title XXI of the |
|
Social Security Act (42 U.S.C. Sec. 1395 et seq., 42 U.S.C. Sec. |
|
1396 et seq., and 42 U.S.C. Sec. 1397aa et seq.), as amended; |
|
(C) the United States Department of Veterans |
|
Affairs; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or any other |
|
compulsory employers' insurance program; |
|
(F) a public program created by federal or state |
|
law or the ordinances or rules of a municipality or other political |
|
subdivision of the state, excluding benefits created by the |
|
establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, a hospital |
|
district, or the facilities of a publicly supported medical school; |
|
or |
|
(G) a cause of action for the cost of care, |
|
including medical care, dental care, facility care, and medical |
|
supplies, required for a person applying for or receiving services |
|
from the department, or a settlement or judgment based on the cause |
|
of action, if the expenses are related to the need for services |
|
provided under this chapter. |
|
(7) "Physician" means a person licensed by the Texas |
|
[State Board of] Medical Board [Examiners] to practice medicine in |
|
this state. |
|
(10) "Rehabilitation services" means the process of |
|
the physical restoration, improvement, or maintenance of a body |
|
function destroyed or impaired by congenital defect, disease, or |
|
injury and includes: |
|
(A) facility care, medical and dental care, and |
|
occupational, speech, and physical therapy; |
|
(B) the provision of braces, artificial |
|
appliances, durable medical equipment, and other medical supplies; |
|
and |
|
(C) other types of care specified by department |
|
[the board in the program] rules. |
|
(11) "Services" means the care, activities, and |
|
supplies provided under this chapter or department [program] rules, |
|
including medical care, dental care, facility care, medical |
|
supplies, occupational, physical, and speech therapy, and other |
|
care specified by department [program] rules. |
|
(12) "Specialty center" means a facility and staff |
|
that meet minimum standards established under the program and are |
|
designated by the department [board] for program use in the |
|
comprehensive diagnostic and treatment services for a specific |
|
medical condition. |
|
SECTION 3.0111. Sections 35.003(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall: |
|
(1) specify the type, amount, and duration of services |
|
to be provided under this chapter; and |
|
(2) permit the payment of insurance premiums for |
|
eligible children. |
|
(c) If budgetary limitations exist, the executive |
|
commissioner [board] by rule shall establish a system of priorities |
|
relating to the types of services or the classes of persons eligible |
|
for the services. A waiting list of eligible persons may be |
|
established if necessary for the program to remain within the |
|
budgetary limitations. The department shall collect from each |
|
applicant for services who is placed on a waiting list appropriate |
|
information to facilitate contacting the applicant when services |
|
become available and to allow efficient enrollment of the applicant |
|
in those services. The information collected must include: |
|
(1) the applicant's name, address, and phone number; |
|
(2) the name, address, and phone number of a contact |
|
person other than the applicant; |
|
(3) the date of the applicant's earliest application |
|
for services; |
|
(4) the applicant's functional needs; |
|
(5) the range of services needed by the applicant; and |
|
(6) a date on which the applicant is scheduled for |
|
reassessment. |
|
SECTION 3.0112. Section 35.0033(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Except as required by [the] department rule, a health |
|
benefits plan provider under this chapter is not subject to a law |
|
that requires coverage or the offer of coverage of a health care |
|
service or benefit. |
|
SECTION 3.0113. Sections 35.004(a), (b), (d), (e), (f), |
|
(h), and (i), Health and Safety Code, are amended to read as |
|
follows: |
|
(a) The executive commissioner [board] shall adopt |
|
substantive and procedural rules for the selection of providers to |
|
participate in the program, including rules for the selection of |
|
specialty centers and rules requiring that providers accept program |
|
payments as payment in full for services provided. |
|
(b) The department [board] shall approve physicians, |
|
dentists, licensed dietitians, facilities, specialty centers, and |
|
other providers to participate in the program according to the |
|
criteria and following the procedures prescribed by department |
|
rules [the board]. |
|
(d) Except as specified in the department [program] rules, a |
|
recipient of services may select any provider approved by the |
|
department [board]. If the recipient is a minor, the person legally |
|
authorized to consent to the treatment may select the provider. |
|
(e) The executive commissioner [board] shall adopt |
|
substantive and procedural rules for the modification, suspension, |
|
or termination of the approval of a provider. |
|
(f) The department [board] shall provide a due process |
|
hearing procedure in accordance with department rules for the |
|
resolution of conflicts between the department and a provider. |
|
Chapter 2001, Government Code, does [do] not apply to conflict |
|
resolution procedures adopted under this section. |
|
(h) Subsection (f) does not apply if a contract: |
|
(1) is canceled by the department because services are |
|
restricted to conform to budgetary limitations and service |
|
priorities are adopted by the executive commissioner [board] |
|
regarding types of services to be provided; or |
|
(2) expires according to its terms. |
|
(i) The Interagency Cooperation Act, Chapter 771, |
|
Government Code, [(Article 4413(32), Vernon's Texas Civil
|
|
Statutes)] does not apply to a payment made by the department for |
|
services provided by a publicly supported medical school facility |
|
to an eligible child. A publicly supported medical school facility |
|
receiving payment under this chapter shall deposit the payment in |
|
local funds. |
|
SECTION 3.0114. Sections 35.0041(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [department] by rule shall |
|
develop and the department shall implement policies permitting |
|
reimbursement of a provider for services under the program |
|
performed using telemedicine medical services. |
|
(c) In developing and implementing the policies required by |
|
this section, the executive commissioner and the department shall |
|
consult with: |
|
(1) The University of Texas Medical Branch at |
|
Galveston; |
|
(2) Texas Tech University Health Sciences Center; |
|
(3) the commission [Health and Human Services
|
|
Commission], including the state Medicaid office; |
|
(4) providers of telemedicine medical services and |
|
telehealth services hub sites in this state; |
|
(5) providers of services to children with special |
|
health care needs; and |
|
(6) representatives of consumer or disability groups |
|
affected by changes to services for children with special health |
|
care needs. |
|
SECTION 3.0115. Section 35.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 35.005. ELIGIBILITY FOR SERVICES. (a) The executive |
|
commissioner [board] by rule shall: |
|
(1) define medical, financial, and other criteria for |
|
eligibility to receive services; and |
|
(2) establish a system for verifying eligibility |
|
information submitted by an applicant for or recipient of services. |
|
(b) In defining medical and financial criteria for |
|
eligibility under Subsection (a), the executive commissioner |
|
[board] may not: |
|
(1) establish an exclusive list of coverable medical |
|
conditions; or |
|
(2) consider as a source of support to provide |
|
services assets legally owned or available to a child's household. |
|
(c) A child is not eligible to receive rehabilitation |
|
services unless: |
|
(1) the child is a resident of this state; |
|
(2) at least one physician or dentist certifies to the |
|
department that the physician or dentist has examined the child and |
|
finds the child to be a child with special health care needs whose |
|
disability meets the medical criteria established by the executive |
|
commissioner [board]; |
|
(3) the department determines that the persons who |
|
have any legal obligation to provide services for the child are |
|
unable to pay for the entire cost of the services; |
|
(4) the child has a family income that is less than or |
|
equal to 200 percent of the federal poverty level; and |
|
(5) the child meets all other eligibility criteria |
|
established by department [board] rules. |
|
(d) A child is not eligible to receive services, other than |
|
rehabilitation services, unless the child: |
|
(1) is a resident of this state; and |
|
(2) meets all other eligibility criteria established |
|
by department [board] rules. |
|
(e) Notwithstanding Subsection (c)(4), a child with special |
|
health care needs who has a family income that is greater than 200 |
|
percent of the federal poverty level and who meets all other |
|
eligibility criteria established by this section and by department |
|
[board] rules is eligible for services if the department determines |
|
that the child's family is or will be responsible for medical |
|
expenses that are equal to or greater than the amount by which the |
|
family's income exceeds 200 percent of the federal poverty level. |
|
SECTION 3.0116. Sections 35.006(a), (c), (d), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt |
|
substantive and procedural rules for the denial of applications and |
|
the modification, suspension, or termination of services. |
|
(c) The executive commissioner [board] by rule shall |
|
provide criteria for action by the department under this section. |
|
(d) The department shall conduct hearings under this |
|
section in accordance with the department's [board's] due process |
|
hearing rules. Chapter 2001, Government Code, does [do] not apply |
|
to the granting, denial, modification, suspension, or termination |
|
of services. |
|
(e) This section does not apply if the department restricts |
|
services to conform to budgetary limitations that require the |
|
executive commissioner [board] to adopt service priorities |
|
regarding types of services to be provided. |
|
SECTION 3.0117. Sections 35.007(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department [board] shall require a child receiving |
|
services, or the person who has a legal obligation to support the |
|
child, to pay for or reimburse the department for that part of the |
|
cost of the services that the child or person is financially able to |
|
pay. |
|
(b) A child is not eligible to receive services under this |
|
chapter to the extent that the child or a person with a legal |
|
obligation to support the child is eligible for some other benefit |
|
that would pay for all or part of the services. The executive |
|
commissioner [board] may waive this subsection if its enforcement |
|
will deny services to a class of children because of conflicting |
|
state and federal laws or rules and regulations. |
|
SECTION 3.0118. Section 35.008(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) This section creates a separate cause of action, and the |
|
department [commissioner] may request the attorney general to bring |
|
suit in the appropriate court of Travis County on behalf of the |
|
department. |
|
SECTION 3.0119. Section 35.009, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 35.009. FEES. The executive commissioner by rule |
|
[board] may adopt reasonable procedures and standards for the |
|
determination of fees and charges for program services. |
|
SECTION 3.0120. Sections 36.004(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] by rule shall |
|
require screening of individuals who attend public or private |
|
preschools or schools to detect vision and hearing disorders and |
|
any other special senses or communication disorders specified by |
|
the executive commissioner [board]. In developing the rules, the |
|
executive commissioner [board] may consider the number of |
|
individuals to be screened and the availability of: |
|
(1) personnel qualified to administer the required |
|
screening; |
|
(2) appropriate screening equipment; and |
|
(3) state and local funds for screening activities. |
|
(c) The executive commissioner [board] shall adopt a |
|
schedule for implementing the screening requirements and shall give |
|
priority to the age groups that may derive the greatest educational |
|
and social benefits from early identification of special senses and |
|
communication disorders. |
|
SECTION 3.0121. Sections 36.005(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) An individual required to be screened shall undergo |
|
approved screening for vision and hearing disorders and any other |
|
special senses and communication disorders specified by the |
|
executive commissioner [board]. The individual shall comply with |
|
the requirements as soon as possible after the individual's |
|
admission to a preschool or school and within the period set by the |
|
executive commissioner [board]. The individual or, if the |
|
individual is a minor, the minor's parent, managing conservator, or |
|
guardian, may substitute professional examinations for the |
|
screening. |
|
(c) The chief administrator of each preschool or school |
|
shall ensure that each individual admitted to the preschool or |
|
school complies with the screening requirements set by the |
|
executive commissioner [board] or submits an affidavit of |
|
exemption. |
|
SECTION 3.0122. Sections 36.006(a) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The chief administrator of each preschool or school |
|
shall maintain, on a form prescribed by the department in |
|
accordance with department rules, screening records for each |
|
individual in attendance, and the records are open for inspection |
|
by the department or the local health department. |
|
(d) Each preschool or school shall submit to the department |
|
an annual report on the screening status of the individuals in |
|
attendance during the reporting year and shall include in the |
|
report any other information required by the executive commissioner |
|
[board]. The report must be on a form prescribed by the department |
|
in accordance with department rules and must be submitted according |
|
to the [board's] rules. |
|
SECTION 3.0123. Sections 36.007(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall: |
|
(1) describe the type, amount, and duration of |
|
remedial services that the department provides; |
|
(2) establish medical, financial, and other criteria |
|
to be applied by the department in determining an individual's |
|
eligibility for the services; |
|
(3) establish criteria for the selection by the |
|
department of providers of remedial services; and |
|
(4) establish procedures necessary to provide |
|
remedial services. |
|
(c) The executive commissioner [board] may establish a |
|
schedule to determine financial eligibility. |
|
SECTION 3.0124. Sections 36.008(d) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(d) The department may modify, suspend, or terminate the |
|
eligibility of an applicant for or recipient of remedial services |
|
after notice to the affected individual and an opportunity for a |
|
fair hearing that is conducted in accordance with the department's |
|
informal hearing rules [adopted by the board]. |
|
(e) The executive commissioner [board] by rule shall |
|
provide criteria for actions taken under this section. |
|
SECTION 3.0125. Section 36.009(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] may require an |
|
individual or, if the individual is a minor, the minor's parent, |
|
managing conservator, or guardian, to pay or reimburse the |
|
department for a part of the cost of the remedial services provided. |
|
SECTION 3.0126. Section 36.010(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The executive commissioner [board] by rule shall |
|
provide criteria for actions taken under this section. |
|
SECTION 3.0127. Section 36.011(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department in accordance with department rules may |
|
require that persons who administer special senses and |
|
communication disorders screening complete an approved training |
|
program, and the department may train those persons and approve |
|
training programs. |
|
SECTION 3.0128. Sections 37.001(b), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board], in cooperation with |
|
the Texas Education Agency, shall adopt rules for the mandatory |
|
spinal screening of children in grades 6 and 9 attending public or |
|
private schools. The department shall coordinate the spinal |
|
screening program with any other screening program conducted by the |
|
department on those children. |
|
(c) The executive commissioner [board] shall adopt |
|
substantive and procedural rules necessary to administer screening |
|
activities. |
|
(d) A rule adopted by the executive commissioner [board] |
|
under this chapter may not require any expenditure by a school, |
|
other than an incidental expense required for certification |
|
training for nonhealth practitioners and for notification |
|
requirements under Section 37.003. |
|
SECTION 3.0129. Sections 37.002(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) Each individual required by a department [board] rule to |
|
be screened shall undergo approved screening for abnormal spinal |
|
curvature. The individual's parent, managing conservator, or |
|
guardian may substitute professional examinations for the |
|
screening. |
|
(c) The chief administrator of each school shall ensure that |
|
each individual admitted to the school complies with the screening |
|
requirements set by the executive commissioner [board] or submits |
|
an affidavit of exemption. |
|
SECTION 3.0130. Section 39.002, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 39.002. CHILDREN'S OUTREACH HEART PROGRAM. The |
|
department, with approval of the executive commissioner [board], |
|
may establish a children's outreach heart program to provide: |
|
(1) prediagnostic cardiac screening and follow-up |
|
evaluation services to persons under 21 years of age who are from |
|
low-income families and who may have a heart disease or defect; and |
|
(2) training to local physicians and public health |
|
nurses in screening and diagnostic procedures for heart disease or |
|
defect. |
|
SECTION 3.0131. Section 39.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 39.003. RULES. The executive commissioner [board] |
|
shall adopt rules the executive commissioner [it] considers |
|
necessary to define the scope of the children's outreach heart |
|
program and the medical and financial standards for eligibility. |
|
SECTION 3.0132. Section 39.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 39.004. FEES. Recipients of services or training |
|
provided by the program may be charged a fee for services or |
|
training according to rules adopted by the executive commissioner |
|
[board]. |
|
SECTION 3.0133. Section 40.002, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 40.002. EPILEPSY PROGRAM. [(a)] The department, with |
|
approval of the executive commissioner [board], may establish an |
|
epilepsy program to provide diagnostic services, treatment, and |
|
support services to eligible persons who have epilepsy. |
|
[(b)
The commissioner may appoint an epilepsy advisory
|
|
board to assist the department in developing the epilepsy program.] |
|
SECTION 3.0134. Section 40.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 40.003. RULES. The executive commissioner [board] may |
|
adopt rules the executive commissioner [it] considers necessary to |
|
define the scope of the epilepsy program and the medical and |
|
financial standards for eligibility. |
|
SECTION 3.0135. Section 40.004(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The commissioner, with the approval of the executive |
|
commissioner [board], may appoint an administrator to carry out the |
|
epilepsy program. |
|
SECTION 3.0136. Section 40.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 40.005. FEES. Program patients may be charged a fee |
|
for services according to rules adopted by the executive |
|
commissioner [board]. |
|
SECTION 3.0137. Sections 41.001(1) and (2), Health and |
|
Safety Code, are amended to read as follows: |
|
(1) "Hemophilia" means a human physical condition |
|
characterized by bleeding resulting from a genetically or |
|
hereditarily determined deficiency of a blood coagulation factor |
|
[or hereditarily] resulting in an abnormal or deficient plasma |
|
procoagulant. |
|
(2) "Other benefit" means a benefit, other than a |
|
benefit under this chapter, to which a person is entitled for |
|
payment of the costs of blood factor replacement products[, blood
|
|
derivatives and concentrates,] and other substances provided under |
|
this chapter, including benefits available from: |
|
(A) an insurance policy, group health plan, or |
|
prepaid medical or dental care plan; |
|
(B) Title XVIII or Title XIX of the Social |
|
Security Act (42 U.S.C. Sec. 1395 et seq. or 42 U.S.C. Sec. 1396 et |
|
seq.); |
|
(C) the United States Department of Veterans |
|
Affairs [Administration]; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or any compulsory |
|
employers' insurance program; |
|
(F) a public program created by federal law, |
|
state law, or the ordinances or rules of a municipality or political |
|
subdivision of the state, excluding benefits created by the |
|
establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, a hospital |
|
district, or the facilities of a publicly supported medical school; |
|
or |
|
(G) a cause of action for medical or dental |
|
expenses to a person applying for or receiving services from the |
|
department, or a settlement or judgment based on the cause of |
|
action, if the expenses are related to the need for services |
|
provided under this chapter. |
|
SECTION 3.0138. Section 41.002, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 41.002. HEMOPHILIA ASSISTANCE PROGRAM. (a) The |
|
hemophilia assistance program is in the department to assist |
|
persons who have hemophilia and who require continuing treatment |
|
with blood factor replacement [, blood derivatives, or manufactured
|
|
pharmaceutical] products, but who are unable to pay the entire cost |
|
of the treatment. |
|
(b) The executive commissioner [department] shall establish |
|
standards of eligibility for assistance under this chapter in |
|
accordance with Section 41.004. |
|
(c) The department shall provide, through approved |
|
providers, financial assistance for medically eligible persons in |
|
obtaining blood factor replacement products [, blood derivatives
|
|
and concentrates,] and other substances for use in medical or |
|
dental facilities or in the home. |
|
SECTION 3.0139. Section 41.007(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department shall identify [investigate] any |
|
potential sources of funding from federal grants or programs. |
|
SECTION 3.0140. Sections 42.001(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The state finds that one of the most serious and tragic |
|
problems facing the public health and welfare is the death each year |
|
from end stage renal [chronic kidney] disease of hundreds of |
|
persons in this state, when the present state of medical art and |
|
technology could return many of those individuals to a socially |
|
productive life. Patients may die for lack of personal financial |
|
resources to pay for the expensive equipment and care necessary for |
|
survival. The state therefore recognizes a responsibility to allow |
|
its citizens to remain healthy without being pauperized and a |
|
responsibility to use the resources and organization of the state |
|
to gather and disseminate information on the prevention and |
|
treatment of end stage renal [chronic kidney] disease. |
|
(c) A comprehensive program to combat end stage renal |
|
[kidney] disease must be implemented through the combined and |
|
correlated efforts of individuals, state and local governments, |
|
persons in the field of medicine, universities, and nonprofit |
|
organizations. The program provided by this chapter is designed to |
|
direct the use of resources and to coordinate the efforts of the |
|
state in this vital matter of public health. |
|
SECTION 3.0141. Section 42.002(2), Health and Safety Code, |
|
is amended to read as follows: |
|
(2) "Other benefit" means a benefit, other than one |
|
provided under this chapter, to which a person is entitled for |
|
payment of the costs of medical care and treatment, services, |
|
pharmaceuticals, transportation, and supplies, including benefits |
|
available from: |
|
(A) an insurance policy, group health plan, or |
|
prepaid medical care plan; |
|
(B) Title XVIII or Title XIX of the Social |
|
Security Act (42 U.S.C. Sec. 1395 et seq. and 42 U.S.C. Sec. 1396 et |
|
seq.); |
|
(C) the United States Department of Veterans |
|
Affairs [Administration]; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or other compulsory |
|
employers' insurance programs [program]; |
|
(F) a public program created by federal law, |
|
state law, or the ordinances or rules of a municipality or other |
|
political subdivision of the state, excluding benefits created by |
|
the establishment of a municipal or county hospital, a joint |
|
municipal-county hospital, a county hospital authority, or a |
|
hospital district; or |
|
(G) a cause of action for medical expenses |
|
brought by an applicant for or recipient of services from the |
|
department, or a settlement or judgment based on the cause of |
|
action, if the expenses are related to the need for services |
|
provided under this chapter. |
|
SECTION 3.0142. Section 42.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.003. KIDNEY HEALTH CARE PROGRAM [DIVISION]. (a) |
|
The kidney health care program [division] is in the department to |
|
carry out this chapter. [The board shall administer the division.] |
|
(b) The department [division] may develop and expand |
|
[assist in the development and expansion of] programs for the care |
|
and treatment of persons with end stage renal [chronic kidney] |
|
disease, including dialysis and other lifesaving medical |
|
procedures and techniques. |
|
(c) The executive commissioner [board] may adopt rules |
|
necessary to carry out this chapter and to provide adequate kidney |
|
care and treatment for citizens of this state. |
|
SECTION 3.0143. Section 42.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.004. SERVICES. (a) The department [division] |
|
shall provide kidney care services directly or through public or |
|
private resources to persons the department determines [determined
|
|
by the board] to be eligible for services authorized under this |
|
chapter. |
|
(b) The department [division] may cooperate with other |
|
departments, agencies, political subdivisions, and public and |
|
private institutions to provide the services authorized by this |
|
chapter to eligible persons, to study the public health and welfare |
|
needs involved, and to plan, establish, develop, and provide |
|
programs or facilities and services that are necessary or |
|
desirable, including any that are jointly administered with state |
|
agencies. |
|
(c) The department [division] may conduct research and |
|
compile statistics relating to the provision of kidney care |
|
services and the need for the services by [disabled or handicapped] |
|
persons with disabilities. |
|
(d) The department [division] may contract with schools, |
|
hospitals, corporations, agencies, and individuals, including |
|
doctors, nurses, and technicians, for training, physical |
|
restoration, transportation, and other services necessary to treat |
|
and care for persons with end stage renal [kidney] disease. |
|
SECTION 3.0144. Sections 42.0045(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) Sections 483.041(a) and 483.042 of this code, Subtitle |
|
J, Title 3, Occupations Code, and other applicable laws |
|
establishing prohibitions do not apply to a dialysate, device, or |
|
drug exclusively used or necessary to perform dialysis that a |
|
physician prescribes or orders for administration or delivery to a |
|
person with end stage renal disease [chronic kidney failure] if: |
|
(1) the dialysate, device, or drug is lawfully held by |
|
a manufacturer or wholesaler licensed by the department [registered
|
|
with the board]; |
|
(2) the manufacturer or wholesaler delivers the |
|
dialysate, device, or drug to: |
|
(A) a person with end stage renal disease |
|
[chronic kidney failure] for self-administration at the person's |
|
home or a specified address, as ordered by a physician; or |
|
(B) a physician for administration or delivery to |
|
a person with end stage renal disease [chronic kidney failure]; and |
|
(3) the manufacturer or wholesaler has sufficient and |
|
qualified supervision to adequately protect the public health. |
|
(b) The executive commissioner [board] shall adopt rules |
|
necessary to ensure the safe distribution, without the interruption |
|
of supply, of a dialysate, device, or drug covered by Subsection |
|
(a). The rules must include provisions regarding manufacturer and |
|
wholesaler licensing, record keeping, evidence of a delivery to a |
|
patient or a patient's designee, patient training, specific product |
|
and quantity limitation, physician prescriptions or order forms, |
|
adequate facilities, and appropriate labeling to ensure that |
|
necessary information is affixed to or accompanies the dialysate, |
|
device, or drug. |
|
(c) If the department [board] determines that a dialysate, |
|
device, or drug distributed under this chapter is ineffective or |
|
unsafe for its intended use, the department [board] may immediately |
|
recall the dialysate, device, or drug distributed to an individual |
|
patient. |
|
SECTION 3.0145. Sections 42.005(a), (b), (c), and (d), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] may establish [and
|
|
maintain] standards for the accreditation of all facilities |
|
designed or intended to deliver care or treatment for persons with |
|
end stage renal [chronic kidney] disease, and the department shall |
|
maintain all established standards. |
|
(b) The department [division] may conduct surveys of |
|
existing facilities in this state that diagnose, evaluate, and |
|
treat patients with end stage renal [kidney] disease and may |
|
prepare and submit its findings and a specific program of action. |
|
(c) The department [division] may evaluate the need to |
|
create local or regional facilities and to establish a major kidney |
|
research center. |
|
(d) The department [division] may: |
|
(1) establish or construct rehabilitation facilities |
|
and workshops; |
|
(2) make grants to public agencies and make contracts |
|
or other arrangements with public and other nonprofit agencies, |
|
organizations, or institutions for the establishment of workshops |
|
and rehabilitation facilities; and |
|
(3) operate facilities to carry out this chapter. |
|
SECTION 3.0146. Sections 42.006(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department shall select providers to furnish kidney |
|
health care services under the program according to the criteria |
|
and procedures adopted by the executive commissioner [board]. |
|
(b) The department [board] shall provide a hearing |
|
procedure in accordance with department rules for the resolution of |
|
conflicts between the department and a provider. Chapter 2001, |
|
Government Code, does [do] not apply to conflict resolution |
|
procedures adopted under this section. |
|
(d) Subsections (b) and (c) do not apply if a contract: |
|
(1) is canceled because program services are |
|
restricted to conform to budgetary limitations that require the |
|
executive commissioner [board] to adopt service priorities |
|
regarding types of services to be furnished or classes of eligible |
|
individuals; or |
|
(2) expires according to its terms. |
|
SECTION 3.0147. Section 42.007, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.007. ELIGIBILITY FOR SERVICES. The executive |
|
commissioner [board] may determine the terms, conditions, and |
|
standards, including medical and financial standards, for the |
|
eligibility of persons with end stage renal [chronic kidney] |
|
disease to receive the aid, care, or treatment provided under this |
|
chapter. |
|
SECTION 3.0148. Sections 42.008(b), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(b) The program rules adopted by the executive commissioner |
|
[board] must contain the criteria for the department's action under |
|
this section. |
|
(c) Chapter 2001, Government Code, does [do] not apply to |
|
the granting, denial, modification, suspension, or termination of |
|
services provided under this chapter. Hearings under this section |
|
must be conducted in accordance with the department's [board's] |
|
hearing rules. |
|
(d) This section does not apply if program services are |
|
restricted to conform to budgetary limitations that require the |
|
executive commissioner [board] to adopt service priorities |
|
regarding types of services to be furnished or classes of eligible |
|
persons. |
|
SECTION 3.0149. Section 42.009(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The executive commissioner [board] may waive the |
|
provisions of Subsection (a) in certain individually considered |
|
cases when the enforcement of that provision will deny services to a |
|
class of end stage renal disease patients because of conflicting |
|
state or federal laws or rules. |
|
SECTION 3.0150. Sections 42.011(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department [division] may receive and use gifts to |
|
carry out this chapter. |
|
(b) The department [board] may comply with any requirements |
|
necessary to obtain federal funds in the maximum amount and most |
|
advantageous proportions possible to carry out this chapter. |
|
SECTION 3.0151. Section 42.012(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department [division] may enter into contracts and |
|
agreements with persons, colleges, universities, associations, |
|
corporations, municipalities, and other units of government as |
|
necessary to carry out this chapter. |
|
SECTION 3.0152. Section 42.013, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.013. COOPERATION. (a) The department [division] |
|
may cooperate with private or public agencies to facilitate the |
|
availability of adequate care for all citizens with end stage renal |
|
[chronic kidney] disease. |
|
(b) The department [board] shall make agreements, |
|
arrangements, or plans to cooperate with the federal government in |
|
carrying out the purposes of this chapter or of any federal statute |
|
or rule relating to the prevention, care, or treatment of end stage |
|
renal [kidney] disease or the care, treatment, or rehabilitation of |
|
persons with end stage renal [kidney] disease. The executive |
|
commissioner [board] may adopt rules and methods of administration |
|
found by the federal government to be necessary for the proper and |
|
efficient operation of the agreements, arrangements, or plans. |
|
(c) The department [division] may enter into reciprocal |
|
agreements with other states. |
|
SECTION 3.0153. Section 42.014, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.014. SCIENTIFIC INVESTIGATIONS. (a) The |
|
department [division] may develop and administer scientific |
|
investigations into the cause, prevention, methods of treatment, |
|
and cure of end stage renal [kidney] disease, including research |
|
into kidney transplantation. |
|
(b) The department [division] may develop techniques for an |
|
effective method of mass testing to detect end stage renal [kidney] |
|
disease and urinary tract infections. |
|
SECTION 3.0154. Section 42.015, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.015. EDUCATIONAL PROGRAMS. (a) The department |
|
[division] may develop, implement [institute, carry on], and |
|
supervise educational programs for the public and health providers, |
|
including physicians, hospitals, and public health departments, |
|
concerning end stage renal [chronic kidney] disease, including |
|
prevention and methods of care and treatment. |
|
(b) The department [division] may use existing public or |
|
private programs or groups for the educational programs. |
|
SECTION 3.0155. Section 42.016, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.016. REPORTS. The department [board] shall report |
|
to the governor and the legislature not later than February 1 of |
|
each year concerning its findings, progress, and activities under |
|
this chapter and the state's total need in the field of kidney |
|
health care. |
|
SECTION 3.0156. Section 42.017, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.017. INSURANCE PREMIUMS. The department [board] |
|
may provide for payment of the premiums required to maintain |
|
coverage under Title XVIII of the Social Security Act (42 U.S.C. |
|
Section 1395 et seq.) for certain classes of persons with end stage |
|
renal disease, in individually considered instances according to |
|
criteria established by department [board] rules. |
|
SECTION 3.0157. Section 42.018, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 42.018. FREEDOM OF SELECTION. The freedom of an |
|
eligible person to select a treating physician, a treatment |
|
facility, or a treatment modality is not limited by Section 42.009 |
|
if the physician, facility, or modality is approved by the |
|
department [board] as required by this chapter. |
|
SECTION 3.0158. Section 43.003(a)(3), Health and Safety |
|
Code, is amended to read as follows: |
|
(3) "Other benefit" means a benefit, other than a |
|
benefit provided under this chapter, to which an individual is |
|
entitled for the payment of the costs of oral health treatment |
|
services, including benefits available from: |
|
(A) an insurance policy, group oral health plan, |
|
or prepaid oral care plan; |
|
(B) Title XVIII or Title XIX of the Social |
|
Security Act, as amended (42 U.S.C. Sec. 1395 et seq. and 42 U.S.C. |
|
Sec. 1396 et seq.); |
|
(C) the United States Department of Veterans |
|
Affairs [Administration]; |
|
(D) the TRICARE program of the United States |
|
Department of Defense [Civilian Health and Medical Program of the
|
|
Uniformed Services]; |
|
(E) workers' compensation or any other |
|
compulsory employer's insurance program; |
|
(F) a public program created by federal law, |
|
state law, or the ordinances or rules of a municipality or other |
|
political subdivision of the state; or |
|
(G) a cause of action for the expenses of dental |
|
or oral health treatment services, or a settlement or judgment |
|
based on the cause of action, if the expenses are related to the |
|
need for treatment services provided under this chapter. |
|
SECTION 3.0159. Section 43.003(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] by rule may define a |
|
word or term not defined by Subsection (a) as necessary to |
|
administer this chapter. The executive commissioner [board] may |
|
not define a word or term so that the word or term is inconsistent or |
|
in conflict with the purposes of this chapter. |
|
SECTION 3.0160. Sections 43.004(b) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules to |
|
govern the program, to prescribe the type, amount, and duration of |
|
oral health services to be provided, and, if necessary to conform to |
|
budgetary limitations, to prescribe a system of program priorities |
|
regarding the types of services to be furnished, the geographic |
|
areas to be covered, or the classes of individuals eligible for |
|
services. |
|
(e) The department may provide services only as prescribed |
|
by department [board] rules. |
|
SECTION 3.0161. Section 43.005(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department shall: |
|
(1) administer the program of oral health services |
|
[established by the board]; and |
|
(2) develop [adopt] the design and content of all |
|
forms necessary for the program. |
|
SECTION 3.0162. Sections 43.006(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] may adopt |
|
substantive and procedural rules relating to: |
|
(1) the selection of dentists, physicians, |
|
facilities, and other providers to furnish program services, |
|
including criteria for the emergency selection of providers; and |
|
(2) the denial, modification, suspension, or |
|
termination of a provider's program participation. |
|
(b) The department shall approve providers to participate |
|
in the program according to the criteria, rules, and procedures |
|
adopted by the executive commissioner [board]. |
|
(d) The department [board] shall provide a due process |
|
hearing procedure in accordance with department rules for the |
|
resolution of conflicts between the department and a provider. |
|
Chapter 2001, Government Code, does [do] not apply to conflict |
|
resolution procedures adopted under this section. |
|
SECTION 3.0163. Section 43.007, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 43.007. INDIVIDUAL REFERRAL AND APPLICATION FOR |
|
SERVICES. (a) The executive commissioner [board] may adopt |
|
substantive and procedural rules to govern the application for |
|
admission to the program and the receipt of treatment services, |
|
including the dental, financial, and other criteria for eligibility |
|
to receive treatment services. |
|
(b) An applicant for treatment services must be referred to |
|
the program by a person who knows the individual's economic |
|
condition, such as a school administrator or school nurse, social |
|
worker, municipal or county official, dentist, physician, public |
|
health clinic, community health center, hospital, or any other |
|
source acceptable to the executive commissioner [board]. |
|
(c) An applicant for treatment services must complete or |
|
cause to be completed an application form prescribed under Section |
|
43.005 [by the department]. |
|
(d) The application form must include or be accompanied by: |
|
(1) a statement by the individual, or by the person |
|
with a legal obligation to support the individual, that the |
|
individual or the person is financially unable to pay for all or |
|
part of the cost of the necessary treatment services; |
|
(2) a statement from the referring person that the |
|
treatment services are necessary to prevent or reduce the |
|
probability of pain, infection, or disease; and |
|
(3) any other assurances from the applicant or any |
|
other documentary evidence required by the department [board] to |
|
support the applicant's eligibility. |
|
SECTION 3.0164. Section 43.008, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 43.008. ELIGIBILITY FOR SERVICES. (a) The department |
|
shall determine an individual's eligibility for treatment services |
|
according to this chapter and department [the program] rules. |
|
(b) An individual is not eligible to receive treatment |
|
services provided under this chapter unless: |
|
(1) the individual is a resident of this state; |
|
(2) the department has determined that neither the |
|
individual nor a person with a legal obligation to support the |
|
individual is financially able to pay for all or part of the |
|
treatment services provided by this chapter; |
|
(3) the individual complies with any other |
|
requirements stated in the department [program] rules; and |
|
(4) at least one licensed dentist or licensed |
|
physician has certified to the department that the dentist or |
|
physician has examined the individual and has found that: |
|
(A) the individual meets the department's |
|
[board's] dental criteria; and |
|
(B) the dentist or physician has reason to expect |
|
that the treatment services provided by or through the department |
|
will prevent or reduce the probability of the individual's |
|
experiencing pain, infection, or disease. |
|
(c) Except as permitted by department [program] rules, the |
|
department may not provide treatment services before an |
|
individual's eligibility date assigned by the department or |
|
authorize payment for treatment services furnished by a provider |
|
before that date. |
|
SECTION 3.0165. Sections 43.009(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
provide criteria for action by the department under this section. |
|
(c) Chapter 2001, Government Code, does [do] not apply to |
|
the granting, denial, modification, suspension, or termination of |
|
treatment services. The department shall conduct hearings in |
|
accordance with the department's [board's] due process hearing |
|
rules. |
|
SECTION 3.0166. Section 43.010(e), Health and Safety Code, |
|
is amended to read as follows: |
|
(e) The commissioner may waive the enforcement of |
|
Subsection (b) as prescribed by department [board] rules in certain |
|
individually considered cases in which enforcement will deny |
|
treatment services to a class of otherwise eligible individuals |
|
because of conflicting federal, state, or local laws or rules. |
|
SECTION 3.0167. Section 43.012, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 43.012. FEES. The department, in accordance with |
|
department rules, [board] may charge fees for the oral health |
|
services provided directly by the department or through approved |
|
providers in accordance with Subchapter D, Chapter 12. |
|
SECTION 3.0168. Section 43.013(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department [Subject to limitations or conditions
|
|
prescribed by the legislature, the board] may seek, receive, and |
|
spend funds received from any public or private source for the |
|
purposes of this chapter, subject to: |
|
(1) the limitations or conditions prescribed by the |
|
legislature; and |
|
(2) any limitations or conditions prescribed by the |
|
executive commissioner. |
|
SECTION 3.0169. Section 45.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 45.003. RULES. The executive commissioner [board] may |
|
adopt rules governing eligibility for a child passenger safety seat |
|
system from the program established under Section 45.002. |
|
SECTION 3.0170. Sections 47.001(3), (4), (6), and (9), |
|
Health and Safety Code, are amended to read as follows: |
|
(3) "Health care provider" means a registered nurse |
|
recognized as an advanced practice registered nurse by the Texas |
|
Board of Nursing or a physician assistant licensed by the Texas |
|
Physician Assistant Board. |
|
(4) "Hearing loss" means a hearing loss of 30 dB HL or |
|
greater in the frequency region important for speech recognition |
|
and comprehension in one or both ears, approximately 500 through |
|
4,000 Hz. As technological advances permit the detection of less |
|
severe hearing loss, the executive commissioner [department] may |
|
modify this definition by rule. |
|
(6) "Intervention or follow-up care" means the early |
|
intervention services described in Part C, Individuals with |
|
Disabilities Education Act (20 U.S.C. Sections 1431-1443) |
|
[1431-1445), as amended by Pub. L. No. 105-17]. |
|
(9) "Physician" means a person licensed to practice |
|
medicine by the Texas [State Board of] Medical Board [Examiners]. |
|
SECTION 3.0171. Sections 47.004(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [department or the
|
|
department's designee] shall establish certification criteria for |
|
implementing a program. |
|
(b) In order to be certified, the program must: |
|
(1) provide hearing screening using equipment |
|
recommended by the department; |
|
(2) use appropriate staff to provide the screening; |
|
(3) maintain and report data electronically as |
|
required by [the] department rule; |
|
(4) distribute family, health care provider, and |
|
physician educational materials standardized by the department; |
|
(5) provide information, as recommended by the |
|
department, to the parents on follow-up services for newborns and |
|
infants who do not pass the screening; and |
|
(6) be supervised by: |
|
(A) a physician; |
|
(B) an audiologist; |
|
(C) a registered nurse; or |
|
(D) a physician assistant. |
|
(d) The department may renew the certification of a program |
|
on a periodic basis as established by department [board] rule in |
|
order to ensure quality services to newborns, infants, and |
|
families. |
|
SECTION 3.0172. Section 47.007, Health and Safety Code, as |
|
amended by Chapters 1273 (H.B. 411) and 601 (S.B. 229), Acts of the |
|
82nd Legislature, Regular Session, 2011, is reenacted and amended |
|
to read as follows: |
|
Sec. 47.007. INFORMATION MANAGEMENT, REPORTING, AND |
|
TRACKING SYSTEM. (a) The department shall provide each birthing |
|
facility that provides newborn hearing screening under the state's |
|
medical assistance program provided under Chapter 32, Human |
|
Resources Code, with access to the appropriate information |
|
management, reporting, and tracking system for the program. The |
|
information management, reporting, and tracking system must be |
|
capable of providing the department with information and data |
|
necessary to plan, monitor, and evaluate the program, including the |
|
program's screening, follow-up, diagnostic, and intervention |
|
components. |
|
(b) Subject to Section 47.008, a qualified hearing |
|
screening provider, hospital, health care provider, physician, |
|
audiologist, or intervention specialist shall access the |
|
information management, reporting, and tracking system to provide |
|
information to the department and may obtain information from the |
|
department relating to: |
|
(1) the results of each hearing screening performed |
|
under Section 47.003(a) or 47.0031(a); |
|
(2) the results of each diagnostic audiological |
|
evaluation required under Section 47.0031(b)(2); |
|
(3) infants who receive follow-up care; |
|
(4) infants identified with hearing loss; |
|
(5) infants who are referred for intervention |
|
services; and |
|
(6) case level information necessary to report |
|
required statistics to: |
|
(A) the federal Maternal and Child Health Bureau |
|
on an annual basis; and |
|
(B) the federal Centers for Disease Control and |
|
Prevention. |
|
(c) A birthing facility described by Subsection (a) shall |
|
report the resulting information in the format and within the time |
|
frame specified by the department. |
|
(d) [A birthing facility described by Subsection (a) shall
|
|
report the resulting information in the format and within the time
|
|
frame specified by the department.
|
|
[(d)
A qualified hearing screening provider, audiologist,
|
|
intervention specialist, educator, or other person who receives a
|
|
referral from a program under this chapter shall:
|
|
[(1)
provide the services needed by the child or refer
|
|
the child to a person who provides the services needed by the child;
|
|
and
|
|
[(2)
provide, with the consent of the child's parent,
|
|
the following information to the department or the department's
|
|
designee:
|
|
[(A) results of follow-up care;
|
|
[(B)
results of audiologic testing of infants
|
|
identified with hearing loss; and
|
|
[(C)
reports on the initiation of intervention
|
|
services.
|
|
[(e)] A qualified hearing screening provider, audiologist, |
|
intervention specialist, educator, or other person who receives a |
|
referral from a program under this chapter shall: |
|
(1) provide the services needed by the newborn or |
|
infant or refer the newborn or infant to a person who provides the |
|
services needed by the newborn or infant; and |
|
(2) provide, with the consent of the newborn's or |
|
infant's parent, the following information to the department or the |
|
department's designee: |
|
(A) results of follow-up care; |
|
(B) results of audiologic testing of an infant |
|
identified with hearing loss; and |
|
(C) reports on the initiation of intervention |
|
services. |
|
(e) [A qualified hearing screening provider, audiologist,
|
|
intervention specialist, educator, or other person who provides
|
|
services to infants who are diagnosed with hearing loss shall
|
|
provide, with the consent of the infant's parent, the following
|
|
information to the department or the department's designee:
|
|
[(1) results of follow-up services;
|
|
[(2)
results of audiologic testing of infants
|
|
identified with hearing loss; and
|
|
[(3)
reports on the initiation of intervention
|
|
services.
|
|
[(f)] A qualified hearing screening provider, audiologist, |
|
intervention specialist, educator, or other person who provides |
|
services to an infant who is diagnosed with hearing loss shall |
|
provide, with the consent of the infant's parent, the following |
|
information to the department or the department's designee: |
|
(1) results of follow-up care; |
|
(2) results of audiologic testing; and |
|
(3) reports on the initiation of intervention |
|
services. |
|
(f) [A hospital that provides services under this chapter
|
|
shall use the information management, reporting, and tracking
|
|
system, which the department has provided the hospital with access
|
|
to, to report, with the consent of the infant's parent, the
|
|
following information to the department or the department's
|
|
designee:
|
|
[(1)
results of all follow-up services for infants who
|
|
do not pass the birth admission screening if the hospital provides
|
|
the follow-up services; or
|
|
[(2)
the name of the provider or facility where the
|
|
hospital refers an infant who does not pass the birth admission
|
|
screening for follow-up services.
|
|
[(g)] A hospital that provides services under this chapter |
|
shall use the information management, reporting, and tracking |
|
system described by this section, access to which has been provided |
|
to the hospital by the department, to report, with the consent of |
|
the infant's parent, the following information to the department or |
|
the department's designee: |
|
(1) results of all follow-up services for an infant |
|
who does not pass the screening described by Section 47.003(a) if |
|
the hospital provides the follow-up services; or |
|
(2) the name of the provider or facility to which the |
|
hospital refers an infant who does not pass the screening described |
|
by Section 47.003(a) for follow-up services. |
|
(g) The department shall ensure that the written consent of |
|
a parent is obtained before any information individually |
|
identifying the newborn or infant is released through the |
|
information management, reporting, and tracking system. |
|
(h) Subject to Section 47.008, a qualified hearing |
|
screening provider, hospital, health care provider, physician, |
|
audiologist, or intervention specialist may obtain information |
|
from the department relating to: |
|
(1) the results of each hearing screening performed |
|
under Section 47.003(a) or 47.0031(a); |
|
(2) the results of each diagnostic audiological |
|
evaluation required under Section 47.0031(b)(2); |
|
(3) infants who receive follow-up care; |
|
(4) infants identified with hearing loss; and |
|
(5) infants who are referred for intervention |
|
services. |
|
SECTION 3.0173. Section 47.008(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [department] by rule shall |
|
develop guidelines to protect the confidentiality of patients in |
|
accordance with Chapter 159, Occupations Code, and require the |
|
written consent of a parent or guardian of a patient before any |
|
individually identifying information is provided to the department |
|
as set out in this chapter. The department shall permit a parent or |
|
guardian at any time to withdraw information provided to the |
|
department under this chapter. |
|
SECTION 3.0174. Section 47.010(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [of the Health and Human
|
|
Services Commission] may adopt rules for the department to |
|
implement this chapter. |
|
SECTION 3.0175. Section 61.003(f), Health and Safety Code, |
|
is amended to read as follows: |
|
(f) For purposes of this chapter, a person who is an inmate |
|
or resident of a state supported living center, as defined by |
|
Section 531.002, [school] or institution operated by the Texas |
|
Department of Criminal Justice, Department of Aging and Disability |
|
Services, Department of State Health Services, Texas Juvenile |
|
Justice Department [Youth Commission], Texas School for the Blind |
|
and Visually Impaired, Texas School for the Deaf, or any other state |
|
agency or who is an inmate, patient, or resident of a school or |
|
institution operated by a federal agency is not considered a |
|
resident of a hospital district or of any governmental entity |
|
except the state or federal government. |
|
SECTION 3.0176. Section 61.004(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The provider of assistance and the governmental entity |
|
or hospital district shall submit all relevant information to the |
|
department in accordance with the application, documentation, and |
|
verification procedures established by [the] department rule under |
|
Section 61.006. |
|
SECTION 3.0177. Sections 61.006(c) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) The department shall also define the services and |
|
establish the payment standards for the categories of services |
|
listed in Sections 61.028(a) and 61.0285 in accordance with |
|
commission [Texas Department of Human Services] rules relating to |
|
the Temporary Assistance for Needy Families-Medicaid program. |
|
(e) The department shall ensure that each person who meets |
|
the basic income and resources requirements for Temporary |
|
Assistance for Needy Families program payments but who is |
|
categorically ineligible for Temporary Assistance for Needy |
|
Families will be eligible for assistance under Subchapter B. |
|
Except as provided by Section 61.023(b), the executive commissioner |
|
[department] by rule shall also provide that a person who receives |
|
or is eligible to receive Temporary Assistance for Needy Families, |
|
Supplemental Security Income, or Medicaid benefits is not eligible |
|
for assistance under Subchapter B even if the person has exhausted a |
|
part or all of that person's benefits. |
|
SECTION 3.0178. Section 61.007, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 61.007. INFORMATION PROVIDED BY APPLICANT. The |
|
executive commissioner [department] by rule shall require each |
|
applicant to provide at least the following information: |
|
(1) the applicant's full name and address; |
|
(2) the applicant's social security number, if |
|
available; |
|
(3) the number of persons in the applicant's |
|
household, excluding persons receiving Temporary Assistance for |
|
Needy Families, Supplemental Security Income, or Medicaid |
|
benefits; |
|
(4) the applicant's county of residence; |
|
(5) the existence of insurance coverage or other |
|
hospital or health care benefits for which the applicant is |
|
eligible; |
|
(6) any transfer of title to real property that the |
|
applicant has made in the preceding 24 months; |
|
(7) the applicant's annual household income, excluding |
|
the income of any household member receiving Temporary Assistance |
|
for Needy Families, Supplemental Security Income, or Medicaid |
|
benefits; and |
|
(8) the amount of the applicant's liquid assets and the |
|
equity value of the applicant's car and real property. |
|
SECTION 3.0179. Section 61.008(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [department] by rule shall |
|
provide that in determining eligibility: |
|
(1) a county may not consider the value of the |
|
applicant's homestead; |
|
(2) a county must consider the equity value of a car |
|
that is in excess of the amount exempted under department |
|
guidelines as a resource; |
|
(3) a county must subtract the work-related and child |
|
care expense allowance allowed under department guidelines; |
|
(4) a county must consider as a resource real property |
|
other than a homestead and, except as provided by Subsection (b), |
|
must count that property in determining eligibility; |
|
(5) if an applicant transferred title to real property |
|
for less than market value to become eligible for assistance under |
|
this chapter, the county may not credit toward eligibility for |
|
state assistance an expenditure for that applicant made during a |
|
two-year period beginning on the date on which the property is |
|
transferred; and |
|
(6) if an applicant is a sponsored alien, a county may |
|
include in the income and resources of the applicant: |
|
(A) the income and resources of a person who |
|
executed an affidavit of support on behalf of the applicant; and |
|
(B) the income and resources of the spouse of a |
|
person who executed an affidavit of support on behalf of the |
|
applicant, if applicable. |
|
SECTION 3.0180. Section 61.011, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 61.011. SERVICES BY STATE HOSPITAL OR CLINIC. A state |
|
hospital or clinic shall be entitled to payment for services |
|
rendered to an eligible resident under the provisions of this |
|
chapter applicable to other providers. The executive commissioner |
|
[department] may adopt rules as necessary to implement this |
|
section. |
|
SECTION 3.0181. Section 61.0285(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A county must notify the department of the county's |
|
intent to provide services specified by Subsection (a). If the |
|
services are approved in accordance with [by the department under] |
|
Section 61.006, or if the department fails to notify the county of |
|
the department's disapproval before the 31st day after the date the |
|
county notifies the department of its intent to provide the |
|
services, the county may credit the services toward eligibility for |
|
state assistance under this subchapter. |
|
SECTION 3.0182. Section 61.034(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A county may contract with a provider of assistance to |
|
provide a health care service at a rate below the payment standard |
|
set by [the] department rule. |
|
SECTION 3.0183. Sections 61.036(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) Regardless of the application, documentation, and |
|
verification procedures or eligibility standards established [by
|
|
the department] under Subchapter A, a county may credit an |
|
expenditure for an eligible resident toward eligibility for state |
|
assistance if the eligible resident received the health care |
|
services at: |
|
(1) a hospital maintained or operated by a state |
|
agency that has a contract with the county to provide health care |
|
services; |
|
(2) a federally qualified health center delivering |
|
federally qualified health center services, as those terms are |
|
defined in 42 U.S.C. Sections 1396d(l)(2)(A) and (B), that has a |
|
contract with the county to provide health care services; or |
|
(3) a hospital or other health care provider if the |
|
eligible resident is an inmate of a county jail or another county |
|
correctional facility. |
|
(d) Regardless of the application, documentation, and |
|
verification procedures or eligibility standards established [by
|
|
the department] under Subchapter A, a county may credit an |
|
intergovernmental transfer to the state toward eligibility for |
|
state assistance if the transfer was made to provide health care |
|
services as part of the Texas Healthcare Transformation and Quality |
|
Improvement Program waiver issued under 42 U.S.C. Section 1315. |
|
SECTION 3.0184. Section 61.037(h), Health and Safety Code, |
|
is amended to read as follows: |
|
(h) The executive commissioner [department] shall adopt |
|
rules governing the circumstances under which a waiver may be |
|
granted under Subsection (g) and the procedures to be used by a |
|
county to apply for the waiver. The procedures must provide that |
|
the department shall make a determination with respect to an |
|
application for a waiver not later than the 90th day after the date |
|
the application is submitted to the department in accordance with |
|
the procedures established by [the] department rule. To be |
|
eligible for state assistance under Subsection (g), a county must |
|
submit monthly financial reports, in the form required by the |
|
department, covering the 12-month period preceding the date on |
|
which the assistance is sought. |
|
SECTION 3.0185. Section 61.0395(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [department] may adopt rules |
|
governing the distribution of state assistance under this chapter |
|
that establish a maximum annual allocation for each county eligible |
|
for assistance under this chapter in compliance with Subsection |
|
(a). |
|
SECTION 3.0186. Section 61.042(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A county may establish procedures consistent with those |
|
used by the commission [Texas Department of Human Services] under |
|
Chapter 31, Human Resources Code, for administering an employment |
|
services program and requiring an applicant or eligible resident to |
|
register for work with the Texas Workforce [Employment] Commission. |
|
SECTION 3.0187. Section 61.065(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) If the contract for the sale of the hospital provides |
|
for the provision by the hospital of health care services to county |
|
residents, the value of the health care services credited or paid in |
|
a state fiscal year under the contract is included as part of the |
|
computation of a county expenditure under Section 61.037 to the |
|
extent that the value of the services does not exceed the payment |
|
standard established by [the] department rule for allowed inpatient |
|
and outpatient services. |
|
SECTION 3.0188. Section 61.067(g), Health and Safety Code, |
|
is amended to read as follows: |
|
(g) The lien does not attach to a claim under the workers' |
|
compensation law of this state, the Federal Employers' [Employees] |
|
Liability Act, or the Federal Longshore and Harbor Workers' |
|
Compensation Act. |
|
SECTION 3.0189. Section 61.068(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A public hospital or hospital district may establish |
|
procedures consistent with those used by the commission [Health and
|
|
Human Services Commission] under Chapter 31, Human Resources Code, |
|
for administering an employment services program and requiring an |
|
applicant or eligible resident to register for work with the Texas |
|
Workforce Commission. |
|
SECTION 3.0190. Section 62.002(4), Health and Safety Code, |
|
is amended to read as follows: |
|
(4) "Household [Net family] income" means the sum |
|
[amount] of the individual incomes of each individual in an |
|
applicant's or enrollee's household, minus the standard income |
|
disregard prescribed by federal law [income established for a
|
|
family after reduction for offsets for child care expenses, in
|
|
accordance with standards applicable under the Medicaid program]. |
|
SECTION 3.0191. Section 62.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.004. FEDERAL LAW AND REGULATIONS. The executive |
|
commissioner shall monitor federal legislation affecting Title XXI |
|
of the Social Security Act (42 U.S.C. Section 1397aa et seq.) and |
|
changes to the federal regulations implementing that law. If the |
|
executive commissioner determines that a change to Title XXI of the |
|
Social Security Act (42 U.S.C. Section 1397aa et seq.) or the |
|
federal regulations implementing that law conflicts with this |
|
chapter, the executive commissioner shall report the changes to the |
|
governor, lieutenant governor, and speaker of the house of |
|
representatives, with recommendations for legislation necessary to |
|
implement the federal law or regulations, seek a waiver, or |
|
withdraw from participation. |
|
SECTION 3.0192. Sections 62.051 and 62.052, Health and |
|
Safety Code, are amended to read as follows: |
|
Sec. 62.051. DUTIES OF EXECUTIVE COMMISSIONER AND |
|
COMMISSION IN GENERAL. (a) The executive commissioner |
|
[commission] shall administer [develop] a state-designed child |
|
health plan program to obtain health benefits coverage for children |
|
in low-income families. The executive commissioner [commission] |
|
shall ensure that the child health plan program is designed and |
|
administered in a manner that qualifies for federal funding under |
|
Title XXI of the Social Security Act (42 U.S.C. Section 1397aa et |
|
seq.), as amended, and any other applicable law or regulations. |
|
(b) The executive commissioner [commission] is [the agency] |
|
responsible for making policy for the child health plan program, |
|
including policy related to covered benefits provided under the |
|
child health plan. The executive commissioner [commission] may not |
|
delegate this duty to another agency or entity. |
|
(c) The executive commissioner [commission] shall oversee |
|
the implementation of the child health plan program and coordinate |
|
the activities of each agency necessary to the implementation of |
|
the program, including the [Texas Department of Health, Texas
|
|
Department of Human Services, and] Texas Department of Insurance. |
|
(d) The executive commissioner [commission] shall adopt |
|
rules as necessary to implement this chapter. [The commission may
|
|
require the Texas Department of Health, the Texas Department of
|
|
Human Services, or any other health and human services agency to
|
|
adopt, with the approval of the commission, any rules that may be
|
|
necessary to implement the program. With the consent of another
|
|
agency, including the Texas Department of Insurance, the commission
|
|
may delegate to that agency the authority to adopt, with the
|
|
approval of the commission, any rules that may be necessary to
|
|
implement the program.] |
|
(e) The commission shall conduct a review of each entity |
|
that enters into a contract under Section 62.055 or [Section] |
|
62.155[,] to ensure that the entity is available, prepared, and |
|
able to fulfill the entity's obligations under the contract in |
|
compliance with the contract, this chapter, and rules adopted under |
|
this chapter. |
|
(f) The commission shall ensure that the amounts spent for |
|
administration of the child health plan program do not exceed any |
|
limit on those expenditures imposed by federal law. |
|
Sec. 62.052. AUTHORITY OF COMMISSION RELATING TO HEALTH |
|
PLAN PROVIDER CONTRACTS [DUTIES OF TEXAS DEPARTMENT OF HEALTH]. |
|
[(a)] The commission may [direct the Texas Department of Health
|
|
to]: |
|
(1) implement contracts with health plan providers |
|
under Section 62.155; |
|
(2) monitor the health plan providers, through |
|
reporting requirements and other means, to ensure performance under |
|
the contracts and quality delivery of services; |
|
(3) monitor the quality of services delivered to |
|
enrollees through outcome measurements including: |
|
(A) rate of hospitalization for ambulatory |
|
sensitive conditions, including asthma, diabetes, epilepsy, |
|
dehydration, gastroenteritis, pneumonia, and UTI/kidney infection; |
|
(B) rate of hospitalization for injuries; |
|
(C) percent of enrolled adolescents reporting |
|
risky health behavior such as injuries, tobacco use, alcohol/drug |
|
use, dietary behavior, physical activity, or other health related |
|
behaviors; and |
|
(D) percent of adolescents reporting attempted |
|
suicide; and |
|
(4) provide payment under the contracts to the health |
|
plan providers. |
|
[(b)
The commission, or the Texas Department of Health under
|
|
the direction of and in consultation with the commission, shall
|
|
adopt rules as necessary to implement this section.] |
|
SECTION 3.0193. Subchapter B, Chapter 62, Health and Safety |
|
Code, is amended by amending Section 62.053 and adding Section |
|
62.0531 to read as follows: |
|
Sec. 62.053. AUTHORITY OF COMMISSION RELATING TO |
|
ELIGIBILITY AND MEDICAID COORDINATION [DUTIES OF TEXAS DEPARTMENT
|
|
OF HUMAN SERVICES]. The commission [(a)
Under the direction of the
|
|
commission, the Texas Department of Human Services] may: |
|
(1) accept applications for coverage under the child |
|
health plan and implement the child health plan program eligibility |
|
screening and enrollment procedures; |
|
(2) resolve grievances relating to eligibility |
|
determinations; and |
|
(3) coordinate the child health plan program with the |
|
Medicaid program. |
|
Sec. 62.0531. AUTHORITY OF COMMISSION RELATING TO THIRD |
|
PARTY ADMINISTRATOR. [(b)] If the commission contracts with a third |
|
party administrator under Section 62.055, the commission may |
|
[direct the Texas Department of Human Services to]: |
|
(1) implement the contract; |
|
(2) monitor the third party administrator, through |
|
reporting requirements and other means, to ensure performance under |
|
the contract and quality delivery of services; and |
|
(3) provide payment under the contract to the third |
|
party administrator. |
|
[(c)
The commission, or the Texas Department of Human
|
|
Services under the direction of and in consultation with the
|
|
commission, shall adopt rules as necessary to implement this
|
|
section.] |
|
SECTION 3.0194. Sections 62.054(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) At the request of the commission, the Texas Department |
|
of Insurance shall provide any necessary assistance with the |
|
[development of the] child health plan. The department shall |
|
monitor the quality of the services provided by health plan |
|
providers and resolve grievances relating to the health plan |
|
providers. |
|
(b) The commission and the Texas Department of Insurance may |
|
adopt a memorandum of understanding that addresses the |
|
responsibilities of each agency with respect to [in developing] the |
|
plan. |
|
SECTION 3.0195. Section 62.055, Health and Safety Code, is |
|
amended by amending Subsection (e) and adding Subsection (f) to |
|
read as follows: |
|
(e) The executive commissioner [commission] shall[:
|
|
[(1)] retain all policymaking authority over the state |
|
child health plan.[;] |
|
(f) The commission shall: |
|
(1) [(2)] procure all contracts with a third party |
|
administrator through a competitive procurement process in |
|
compliance with all applicable federal and state laws or |
|
regulations; and |
|
(2) [(3)] ensure that all contracts with child health |
|
plan providers under Section 62.155 are procured through a |
|
competitive procurement process in compliance with all applicable |
|
federal and state laws or regulations. |
|
SECTION 3.0196. Sections 62.101(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) A child is eligible for health benefits coverage under |
|
the child health plan if the child: |
|
(1) is younger than 19 years of age; |
|
(2) is not eligible for medical assistance under the |
|
Medicaid program; |
|
(3) is not covered by a health benefits plan offering |
|
adequate benefits, as determined by the commission; |
|
(4) has a household [family] income that is less than |
|
or equal to the income eligibility level established under |
|
Subsection (b); and |
|
(5) satisfies any other eligibility standard imposed |
|
under the child health plan program in accordance with 42 U.S.C. |
|
Section 1397bb, as amended, and any other applicable law or |
|
regulations. |
|
(b) The executive commissioner [commission] shall establish |
|
income eligibility levels consistent with Title XXI, Social |
|
Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any |
|
other applicable law or regulations, and subject to the |
|
availability of appropriated money, so that a child who is younger |
|
than 19 years of age and whose household [net family] income is at |
|
or below 200 percent of the federal poverty level is eligible for |
|
health benefits coverage under the program. [In addition, the
|
|
commission may establish eligibility standards regarding the
|
|
amount and types of allowable assets for a family whose net family
|
|
income is above 150 percent of the federal poverty level.] |
|
(c) The executive commissioner shall evaluate enrollment |
|
levels and program impact [every six months during the first 12
|
|
months of implementation and] at least annually [thereafter] and |
|
shall submit a finding of fact to the Legislative Budget Board and |
|
the Governor's Office of Budget, [and] Planning, and Policy as to |
|
the adequacy of funding and the ability of the program to sustain |
|
enrollment at the eligibility level established by Subsection (b). |
|
In the event that appropriated money is insufficient to sustain |
|
enrollment at the authorized eligibility level, the executive |
|
commissioner shall: |
|
(1) suspend enrollment in the child health plan; |
|
(2) establish a waiting list for applicants for |
|
coverage; and |
|
(3) establish a process for periodic or continued |
|
enrollment of applicants in the child health plan program as the |
|
availability of money allows. |
|
SECTION 3.0197. Section 62.1011, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.1011. VERIFICATION OF INCOME. The commission shall |
|
continue employing methods of verifying the individual incomes [net
|
|
income] of the individuals considered in the calculation of an |
|
applicant's household [net family] income. The commission shall |
|
verify income under this section unless the applicant reports a |
|
household [net family] income that exceeds the income eligibility |
|
level established under Section 62.101(b). |
|
SECTION 3.0198. Sections 62.1015(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) In this section: |
|
(1) "Charter school"[, "charter school," "employee,"] |
|
and "regional education service center" have the meanings assigned |
|
by Section 1579.002 [2, Article 3.50-7], Insurance Code. |
|
(2) "Employee" has the meaning assigned by Section |
|
1579.003, Insurance Code. |
|
(c) The cost of health benefits coverage for children |
|
enrolled in the child health plan under this section shall be paid |
|
as provided in the General Appropriations Act. Expenditures made |
|
to provide health benefits coverage under this section may not be |
|
included for the purpose of determining the state children's health |
|
insurance expenditures, as that term is defined by 42 U.S.C. |
|
Section 1397ee(d)(2)(B), as amended, unless the commission [Health
|
|
and Human Services Commission], after consultation with the |
|
appropriate federal agencies, determines that the expenditures may |
|
be included without adversely affecting federal matching funding |
|
for the child health plan provided under this chapter. |
|
SECTION 3.0199. Sections 62.102(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) During the sixth month following the date of initial |
|
enrollment or reenrollment of an individual whose household [net
|
|
family] income exceeds 185 percent of the federal poverty level, |
|
the commission shall: |
|
(1) review the individual's household [net family] |
|
income and may use electronic technology if available and |
|
appropriate; and |
|
(2) continue to provide coverage if the individual's |
|
household [net family] income does not exceed the income |
|
eligibility limits prescribed by this chapter. |
|
(c) If, during the review required under Subsection (b), the |
|
commission determines that the individual's household [net family] |
|
income exceeds the income eligibility limits prescribed by this |
|
chapter, the commission may not disenroll the individual until: |
|
(1) the commission has provided the family an |
|
opportunity to demonstrate that the family's household [net family] |
|
income is within the income eligibility limits prescribed by this |
|
chapter; and |
|
(2) the family fails to demonstrate such eligibility. |
|
SECTION 3.0200. Sections 62.103(a) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [commission, or the Texas
|
|
Department of Human Services at the direction of and in
|
|
consultation with the commission,] shall adopt an application form |
|
and application procedures for requesting child health plan |
|
coverage under this chapter. |
|
(d) The executive commissioner [commission] may permit |
|
application to be made by mail, over the telephone, or through the |
|
Internet. |
|
SECTION 3.0201. Sections 62.104(a) and (g), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [commission, or the Texas
|
|
Department of Human Services at the direction of and in
|
|
consultation with the commission,] shall develop eligibility |
|
screening and enrollment procedures for children that comply with |
|
the requirements of 42 U.S.C. Section 1397bb, as amended, and any |
|
other applicable law or regulations. The procedures shall ensure |
|
that Medicaid-eligible children are identified and referred to the |
|
Medicaid program. |
|
(g) The executive commissioner [In the first year of
|
|
implementation of the child health plan, enrollment shall be open.
|
|
Thereafter, the commission] may establish enrollment periods for |
|
the child health plan. |
|
SECTION 3.0202. Sections 62.151(b), (c), (e), and (f), |
|
Health and Safety Code, are amended to read as follows: |
|
(b) In modifying [developing] the covered benefits, the |
|
executive commissioner [commission] shall consider the health care |
|
needs of healthy children and children with special health care |
|
needs. |
|
(c) In modifying [developing] the plan, the executive |
|
commissioner [commission] shall ensure that primary and preventive |
|
health benefits do not include reproductive services, other than |
|
prenatal care and care related to diseases, illnesses, or |
|
abnormalities related to the reproductive system. |
|
(e) In modifying [developing] the covered benefits, the |
|
executive commissioner [commission] shall seek input from the |
|
Public Assistance Health Benefit Review and Design Committee |
|
established under Section 531.067, Government Code. |
|
(f) If the executive commissioner [The commission, if it] |
|
determines the policy to be cost-effective, the executive |
|
commissioner may ensure that an enrolled child does not, unless |
|
authorized by the commission in consultation with the child's |
|
attending physician or advanced practice nurse, receive under the |
|
child health plan: |
|
(1) more than four different outpatient brand-name |
|
prescription drugs during a month; or |
|
(2) more than a 34-day supply of a brand-name |
|
prescription drug at any one time. |
|
SECTION 3.0203. Sections 62.153(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) To the extent permitted under 42 U.S.C. Section 1397cc, |
|
as amended, and any other applicable law or regulations, the |
|
executive commissioner [commission] shall require enrollees to |
|
share the cost of the child health plan, including provisions |
|
requiring enrollees under the child health plan to pay: |
|
(1) a copayment for services provided under the plan; |
|
(2) an enrollment fee; or |
|
(3) a portion of the plan premium. |
|
(c) If cost-sharing provisions imposed under Subsection (a) |
|
include requirements that enrollees pay a portion of the plan |
|
premium, the executive commissioner [commission] shall specify the |
|
manner in which the premium is paid. The commission may require |
|
that the premium be paid to the [Texas Department of Health, the
|
|
Texas Department of Human Services, or the] health plan provider. |
|
SECTION 3.0204. Section 62.154(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A child is not subject to a waiting period adopted under |
|
Subsection (a) if: |
|
(1) the family lost coverage for the child as a result |
|
of: |
|
(A) termination of employment because of a layoff |
|
or business closing; |
|
(B) termination of continuation coverage under |
|
the Consolidated Omnibus Budget Reconciliation Act of 1985 (Pub. L. |
|
No. 99-272); |
|
(C) change in marital status of a parent of the |
|
child; |
|
(D) termination of the child's Medicaid |
|
eligibility because: |
|
(i) the child's family's earnings or |
|
resources increased; or |
|
(ii) the child reached an age at which |
|
Medicaid coverage is not available; or |
|
(E) a similar circumstance resulting in the |
|
involuntary loss of coverage; |
|
(2) the family terminated health benefits plan |
|
coverage for the child because the cost to the child's family for |
|
the coverage exceeded 9.5 [10] percent of the family's household |
|
[net] income; |
|
(3) the child has access to group-based health |
|
benefits plan coverage and is required to participate in the health |
|
insurance premium payment reimbursement program administered by |
|
the commission; [or] |
|
(4) the commission has determined that other grounds |
|
exist for a good cause exception; or |
|
(5) federal law provides that the child is not subject |
|
to a waiting period adopted under Subsection (a). |
|
SECTION 3.0205. Sections 62.155(a) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The commission[, or the Texas Department of Health at
|
|
the direction of and in consultation with the commission,] shall |
|
select the health plan providers under the program through a |
|
competitive procurement process. A health plan provider, other |
|
than a state administered primary care case management network, |
|
must hold a certificate of authority or other appropriate license |
|
issued by the Texas Department of Insurance that authorizes the |
|
health plan provider to provide the type of child health plan |
|
offered and must satisfy, except as provided by this chapter, any |
|
applicable requirement of the Insurance Code or another insurance |
|
law of this state. |
|
(d) The executive commissioner may authorize an exception |
|
to Subsection (c)(2) if there is only one acceptable applicant to |
|
become a health plan provider in the service area. |
|
SECTION 3.0206. Section 62.1551, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.1551. INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN |
|
PROVIDER NETWORKS. Notwithstanding any other law, including |
|
Sections 843.312 and 1301.052, Insurance Code, the executive |
|
commissioner [of the commission] shall adopt rules to require a |
|
managed care organization or other entity to ensure that advanced |
|
practice registered nurses and physician assistants are available |
|
as primary care providers in the organization's or entity's |
|
provider network. The rules must require advanced practice |
|
registered nurses and physician assistants to be treated in the |
|
same manner as primary care physicians with regard to: |
|
(1) selection and assignment as primary care |
|
providers; |
|
(2) inclusion as primary care providers in the |
|
provider network; and |
|
(3) inclusion as primary care providers in any |
|
provider network directory maintained by the organization or |
|
entity. |
|
SECTION 3.0207. Section 62.156, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.156. HEALTH CARE PROVIDERS. Health care providers |
|
who provide health care services under the child health plan must |
|
satisfy certification and licensure requirements, as required by |
|
[the] commission rules and[,] consistent with other law. |
|
SECTION 3.0208. Section 62.1561, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.1561. PROHIBITION OF CERTAIN HEALTH CARE PROVIDERS. |
|
The executive commissioner [of the commission] shall adopt rules |
|
for prohibiting a person from participating in the child health |
|
plan program as a health care provider for a reasonable period, as |
|
determined by the executive commissioner, if the person: |
|
(1) fails to repay overpayments under the program; or |
|
(2) owns, controls, manages, or is otherwise |
|
affiliated with and has financial, managerial, or administrative |
|
influence over a provider who has been suspended or prohibited from |
|
participating in the program. |
|
SECTION 3.0209. Sections 62.157(b) and (c), Health and |
|
Safety Code, as added by Chapter 959 (S.B. 1536), Acts of the 77th |
|
Legislature, Regular Session, 2001, are amended to read as follows: |
|
(b) The policies must provide for: |
|
(1) the availability of covered benefits |
|
appropriately provided through telemedicine medical services and |
|
telehealth services that are comparable to the same types of |
|
covered benefits provided without the use of telemedicine medical |
|
services and telehealth services; and |
|
(2) the availability of covered benefits for different |
|
services performed by multiple health care providers during a |
|
single telemedicine medical services and telehealth services |
|
session, if the executive commissioner [commission] determines |
|
that delivery of the covered benefits in that manner is |
|
cost-effective in comparison to the costs that would be involved in |
|
obtaining the services from providers without the use of |
|
telemedicine medical services and telehealth services, including |
|
the costs of transportation and lodging and other direct costs. |
|
(c) In developing the policies required by Subsection (a), |
|
the executive commissioner [commission] shall consult with: |
|
(1) The University of Texas Medical Branch at |
|
Galveston; |
|
(2) Texas Tech University Health Sciences Center; |
|
(3) the [Texas] Department of State Health Services; |
|
(4) providers of telemedicine hub sites in this state; |
|
(5) providers of services to children with special |
|
health care needs; and |
|
(6) representatives of consumer or disability groups |
|
affected by changes to services for children with special health |
|
care needs. |
|
SECTION 3.0210. Section 62.157, Health and Safety Code, as |
|
added by Chapter 1255 (S.B. 789), Acts of the 77th Legislature, |
|
Regular Session, 2001, is redesignated as Section 62.1571, Health |
|
and Safety Code, and amended to read as follows: |
|
Sec. 62.1571 [62.157]. TELEMEDICINE MEDICAL SERVICES. (a) |
|
In providing covered benefits to a child, a health plan provider |
|
must permit benefits to be provided through telemedicine medical |
|
services in accordance with policies developed by the commission. |
|
(b) The policies must provide for: |
|
(1) the availability of covered benefits |
|
appropriately provided through telemedicine medical services that |
|
are comparable to the same types of covered benefits provided |
|
without the use of telemedicine medical services; and |
|
(2) the availability of covered benefits for different |
|
services performed by multiple health care providers during a |
|
single session of telemedicine medical services, if the executive |
|
commissioner [commission] determines that delivery of the covered |
|
benefits in that manner is cost-effective in comparison to the |
|
costs that would be involved in obtaining the services from |
|
providers without the use of telemedicine medical services, |
|
including the costs of transportation and lodging and other direct |
|
costs. |
|
(c) In developing the policies required by Subsection (a), |
|
the executive commissioner [commission] shall consult with the |
|
telemedicine and telehealth advisory committee. |
|
(d) In this section, "telemedicine medical service" has the |
|
meaning assigned by Section 531.001, Government [57.042,
|
|
Utilities] Code. |
|
SECTION 3.0211. Section 62.159, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 62.159. DISEASE MANAGEMENT SERVICES. (a) In this |
|
section, "disease management services" means services to assist a |
|
child manage a disease or other chronic health condition, such as |
|
heart disease, diabetes, respiratory illness, end-stage renal |
|
disease, HIV infection, or AIDS, and with respect to which the |
|
executive commissioner [commission] identifies populations for |
|
which disease management would be cost-effective. |
|
(b) The child health plan must provide disease management |
|
services or coverage for disease management services in the manner |
|
required by the executive commissioner [commission], including: |
|
(1) patient self-management education; |
|
(2) provider education; |
|
(3) evidence-based models and minimum standards of |
|
care; |
|
(4) standardized protocols and participation |
|
criteria; and |
|
(5) physician-directed or physician-supervised care. |
|
SECTION 3.0212. Section 63.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 63.003. HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN |
|
CHILDREN. The executive commissioner [commission] shall develop |
|
and implement a program to provide health benefits plan coverage |
|
for a child who: |
|
(1) is a qualified alien, as that term is defined by 8 |
|
U.S.C. Section 1641(b); |
|
(2) is younger than 19 years of age; |
|
(3) entered the United States after August 22, 1996; |
|
(4) has resided in the United States for less than five |
|
years; and |
|
(5) meets the income eligibility requirement of, but |
|
is not eligible for assistance under: |
|
(A) the child health plan program under Chapter |
|
62; or |
|
(B) the medical assistance program under Chapter |
|
32, Human Resources Code. |
|
SECTION 3.0213. Section 63.005(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Except as required by the executive commissioner |
|
[commission], a health benefits plan provider under this chapter is |
|
not subject to a law that requires coverage or the offer of coverage |
|
of a health care service or benefit. |
|
SECTION 3.0214. Section 63.006, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 63.006. COST-SHARING PAYMENTS. (a) Except as provided |
|
by Subsection (b), the executive commissioner [commission] may not |
|
require a child who is provided health benefits plan coverage under |
|
Section 63.003 and who meets the income eligibility requirement of |
|
the medical assistance program under Chapter 32, Human Resources |
|
Code, to pay a premium, deductible, coinsurance, or other |
|
cost-sharing payment as a condition of health benefits plan |
|
coverage under this chapter. |
|
(b) The executive commissioner [commission] may require a |
|
child described by Subsection (a) to pay a copayment as a condition |
|
of health benefits plan coverage under this chapter that is equal to |
|
any copayment required under the child health plan program under |
|
Chapter 62. |
|
(c) The executive commissioner [commission] may require a |
|
child who is provided health benefits plan coverage under Section |
|
63.003 and who meets the income eligibility requirement of the |
|
child health plan program under Chapter 62 to pay a premium, |
|
deductible, coinsurance, or other cost-sharing payment as a |
|
condition of health benefits plan coverage under this chapter. The |
|
payment must be equal to any premium, deductible, coinsurance, or |
|
other cost-sharing payment required under the child health plan |
|
program under Chapter 62. |
|
SECTION 3.0215. Section 64.001, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 64.001. TEACHING HOSPITAL ACCOUNT. The [Texas] |
|
Department of State Health Services state-owned multi-categorical |
|
teaching hospital account is an account in the general revenue |
|
fund. Money in the account may be appropriated only to the |
|
department to provide funding for indigent health care. |
|
SECTION 3.0216. Section 81.003(5), Health and Safety Code, |
|
is amended to read as follows: |
|
(5) "Physician" means a person licensed to practice |
|
medicine by the Texas [State Board of] Medical Board [Examiners]. |
|
SECTION 3.0217. Sections 81.004(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] may adopt rules |
|
necessary for the effective administration and implementation of |
|
this chapter. |
|
(c) A designee of the executive commissioner [board] may |
|
exercise a power granted to or perform a duty imposed on the |
|
executive commissioner [board] under this chapter except as |
|
otherwise required by law. |
|
SECTION 3.0218. Section 81.008, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.008. COMMUNICABLE DISEASE IN ANIMALS; EXCHANGE OF |
|
INFORMATION. The Texas Animal Health Commission and the Texas A&M |
|
University Veterinary Medical Diagnostic Laboratory shall each |
|
adopt by rule a memorandum of understanding, adopted also by rule by |
|
the executive commissioner, governing the [with the department to] |
|
exchange of information on communicable diseases in animals between |
|
the department and those entities. |
|
SECTION 3.0219. Sections 81.010(c), (e), (h), (i), and (k), |
|
Health and Safety Code, are amended to read as follows: |
|
(c) The council consists of one representative from each of |
|
the following agencies appointed by the executive director or |
|
commissioner of each agency: |
|
(1) the Department of State Health Services; |
|
(2) the Department of Aging and Disability Services; |
|
(3) the Department of Assistive and Rehabilitative |
|
Services; |
|
(4) the Department of Family and Protective Services; |
|
(5) [the Texas Youth Commission;
|
|
[(6)] the Texas Department of Criminal Justice; |
|
(6) [(7)] the Texas Juvenile Justice Department |
|
[Probation Commission]; |
|
(7) [(8)] the Texas Medical Board; |
|
(8) [(9)] the Texas Board of Nursing; |
|
(9) [(10)] the State Board of Dental Examiners; |
|
(10) [(11)] the Health and Human Services Commission; |
|
(11) [(12)] the Texas Workforce Commission; and |
|
(12) [(13)] the Texas Higher Education Coordinating |
|
Board. |
|
(e) The representative from the commission [Health and
|
|
Human Services Commission] serves as chairperson of the council. |
|
(h) The council shall: |
|
(1) coordinate communication among the member |
|
agencies listed in Subsection (c) concerning each agency's programs |
|
in providing services related to AIDS, HIV, and hepatitis; |
|
(2) develop a plan that facilitates coordination of |
|
agency programs based on statistical information regarding this |
|
state for: |
|
(A) prevention of AIDS, HIV infection, and |
|
hepatitis; and |
|
(B) provision of services to individuals who have |
|
hepatitis or are infected with HIV; |
|
(3) identify all statewide plans related to AIDS, HIV, |
|
and hepatitis; |
|
(4) compile a complete inventory of all federal, |
|
state, and local money spent in this state on HIV infection, AIDS, |
|
and hepatitis prevention and health care services, including |
|
services provided through or covered under Medicaid and Medicare; |
|
(5) identify the areas with respect to which state |
|
agencies interact on HIV, AIDS, and hepatitis issues and the policy |
|
issues arising from that interaction; |
|
(6) assess gaps in prevention and health care services |
|
for HIV infection, AIDS, and hepatitis in this state, including |
|
gaps in services that result from provision of services by |
|
different state agencies, and develop strategies to address these |
|
gaps through service coordination; |
|
(7) identify barriers to prevention and health care |
|
services for HIV infection, AIDS, and hepatitis faced by |
|
marginalized populations; |
|
(8) identify the unique health care service and other |
|
service needs of persons who are infected with HIV or who have AIDS |
|
or hepatitis; |
|
(9) evaluate the level of service and quality of |
|
health care in this state for persons who are infected with HIV or |
|
who have AIDS or hepatitis as compared to national standards; |
|
(10) identify issues that emerge related to HIV, AIDS, |
|
and hepatitis and the potential impact on delivery of prevention |
|
and health care services; and |
|
(11) provide the information required under |
|
Subdivisions (1) through (10) to the department [Department of
|
|
State Health Services]. |
|
(i) Not later than September 1 of each year, the department |
|
[Department of State Health Services] shall file a report with the |
|
legislature and the governor containing policy recommendations |
|
based on information reported to the council in Subsection (h) |
|
relating to: |
|
(1) prevention of AIDS, HIV infection, and hepatitis; |
|
and |
|
(2) delivery of health services to individuals who |
|
have AIDS or hepatitis or are infected with HIV. |
|
(k) The commission [Health and Human Services Commission] |
|
shall provide administrative support to the council. |
|
SECTION 3.0220. Section 81.021, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.021. PROTECTION OF PUBLIC HEALTH [BOARD'S DUTY]. |
|
The executive commissioner and department [board] shall exercise |
|
their powers [its power] in matters relating to protecting the |
|
public health to prevent the introduction of disease into the |
|
state. |
|
SECTION 3.0221. Section 81.023, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.023. IMMUNIZATION. (a) The department [board] |
|
shall develop immunization requirements for children. |
|
(b) The department [board] shall cooperate with the |
|
Department of Family and Protective [and Regulatory] Services in |
|
formulating and implementing the immunization requirements for |
|
children admitted to child-care facilities. |
|
(c) The department [board] shall cooperate with the State |
|
Board of Education in formulating and implementing immunization |
|
requirements for students admitted to public or private primary or |
|
secondary schools. |
|
SECTION 3.0222. Section 81.024, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.024. REPORTS BY DEPARTMENT [BOARD]. The department |
|
[board] shall provide regular reports of the incidence, prevalence, |
|
and medical and economic effects of each disease that the |
|
department [board] determines is a threatening risk to the public |
|
health. A disease may be a risk because of its indirect |
|
complications. |
|
SECTION 3.0223. Section 81.041, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.041. REPORTABLE DISEASES. (a) The executive |
|
commissioner [board] shall identify each communicable disease or |
|
health condition that shall be reported under this chapter. |
|
(b) The executive commissioner [board] shall classify each |
|
reportable disease according to its nature and the severity of its |
|
effect on the public health. |
|
(c) The executive commissioner [board] shall maintain and |
|
revise as necessary the list of reportable diseases. |
|
(d) The executive commissioner [board] may establish |
|
registries for reportable diseases and other communicable diseases |
|
and health conditions. The provision to the department of |
|
information relating to a communicable disease or health condition |
|
that is not classified as reportable is voluntary only. |
|
(e) Acquired immune deficiency syndrome and human |
|
immunodeficiency virus infection are reportable diseases under |
|
this chapter for which the executive commissioner [board] shall |
|
require reports. |
|
(f) In a public health disaster, the commissioner may |
|
require reports of communicable diseases or other health conditions |
|
from providers without the adoption of a [board] rule or other |
|
action by the executive commissioner. The commissioner shall issue |
|
appropriate instructions relating to complying with the reporting |
|
requirements of this section. |
|
SECTION 3.0224. Sections 81.042(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) A local school authority shall report a child attending |
|
school who is suspected of having a reportable disease. The |
|
executive commissioner [board] by rule shall establish procedures |
|
to determine if a child should be suspected and reported and to |
|
exclude the child from school pending appropriate medical diagnosis |
|
or recovery. |
|
(d) A person in charge of a clinical or hospital laboratory, |
|
blood bank, mobile unit, or other facility in which a laboratory |
|
examination of a specimen derived from a human body yields |
|
microscopical, cultural, serological, or other evidence of a |
|
reportable disease shall report the findings, in accordance with |
|
this section and procedures adopted by the executive commissioner |
|
[board], in the jurisdiction in which: |
|
(1) the physician's office is located, if the |
|
laboratory examination was requested by a physician; or |
|
(2) the laboratory is located, if the laboratory |
|
examination was not requested by a physician. |
|
SECTION 3.0225. Section 81.043(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A [Except as provided by Subsection (c), a] health |
|
authority shall report reportable diseases to the department's |
|
central office at least as frequently as the interval set by |
|
department [board] rule. |
|
SECTION 3.0226. Sections 81.044(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall prescribe the |
|
form and method of reporting under this chapter, which may be in |
|
writing, by telephone, by electronic data transmission, or by other |
|
means. |
|
(b) The executive commissioner [board] may require the |
|
reports to contain any information relating to a case that is |
|
necessary for the purposes of this chapter, including: |
|
(1) the patient's name, address, age, sex, race, and |
|
occupation; |
|
(2) the date of onset of the disease or condition; |
|
(3) the probable source of infection; and |
|
(4) the name of the attending physician or dentist. |
|
(d) For a case of acquired immune deficiency syndrome or |
|
human immunodeficiency virus infection, the executive commissioner |
|
[department] shall require the reports to contain: |
|
(1) the information described by Subsection (b); and |
|
(2) the patient's ethnicity, national origin, and city |
|
and county of residence. |
|
SECTION 3.0227. Sections 81.048(a) and (g), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall: |
|
(1) designate certain reportable diseases for |
|
notification under this section; and |
|
(2) define the conditions that constitute possible |
|
exposure to those diseases. |
|
(g) A hospital that gives notice of a possible exposure |
|
under Subsection (c) or a local health authority that receives |
|
notice of a possible exposure under Subsection (c) may give notice |
|
of the possible exposure to a person other than emergency medical |
|
personnel, a peace officer, a detention officer, a county jailer, |
|
or a fire fighter if the person demonstrates that the person was |
|
exposed to the reportable disease while providing emergency care. |
|
The executive commissioner [of the Health and Human Services
|
|
Commission] shall adopt rules to implement this subsection. |
|
SECTION 3.0228. Sections 81.050(a), (b), (c), (d), (e), |
|
(g), (j), (k), and (l), Health and Safety Code, are amended to read |
|
as follows: |
|
(a) The executive commissioner [board] by rule shall |
|
prescribe the criteria that constitute exposure to reportable |
|
diseases[, including HIV infection]. The criteria must be based on |
|
activities that the United States Public Health Service determines |
|
pose a risk of infection. |
|
(b) A person whose occupation or whose volunteer service is |
|
included in one or more of the following categories may request the |
|
department or a health authority to order testing of another person |
|
who may have exposed the person to a reportable disease[, including
|
|
HIV infection]: |
|
(1) a law enforcement officer; |
|
(2) a fire fighter; |
|
(3) an emergency medical service employee or |
|
paramedic; |
|
(4) a correctional officer; |
|
(5) an employee, contractor, or volunteer, other than |
|
a correctional officer, who performs a service in a correctional |
|
facility as defined by Section 1.07, Penal Code, or a secure |
|
correctional facility or secure detention facility as defined by |
|
Section 51.02, Family Code; or |
|
(6) an employee of a juvenile probation department. |
|
(c) A request under this section may be made only if the |
|
person: |
|
(1) has experienced the exposure in the course of the |
|
person's employment or volunteer service; |
|
(2) believes that the exposure places the person at |
|
risk of a reportable disease[, including HIV infection]; and |
|
(3) presents to the department or health authority a |
|
sworn affidavit that delineates the reasons for the request. |
|
(d) The department or the department's designee who meets |
|
the minimum training requirements prescribed by department [board] |
|
rule shall review the person's request and inform the person |
|
whether the request meets the criteria establishing risk of |
|
infection with a reportable disease[, including HIV infection]. |
|
(e) The department or the department's designee shall give |
|
the person who is subject to the order prompt and confidential |
|
written notice of the order. The order must: |
|
(1) state the grounds and provisions of the order, |
|
including the factual basis for its issuance; |
|
(2) refer the person to appropriate health care |
|
facilities where the person can be tested for reportable diseases[,
|
|
including HIV infection]; and |
|
(3) inform the person who is subject to the order of |
|
that person's right to refuse to be tested and the authority of the |
|
department or health authority to ask for a court order requiring |
|
the test. |
|
(g) In reviewing the order, the court shall determine |
|
whether exposure occurred and whether that exposure presents a |
|
possible risk of infection as defined by department [board] rule. |
|
The attorney for the state and the attorney for the person subject |
|
to the order may introduce evidence at the hearing in support of or |
|
opposition to the testing of the person. On conclusion of the |
|
hearing, the court shall either issue an appropriate order |
|
requiring counseling and testing of the person for reportable |
|
diseases[, including HIV infection,] or refuse to issue the order |
|
if the court has determined that the counseling and testing of the |
|
person is unnecessary. The court may assess court costs against the |
|
person who requested the test if the court finds that there was not |
|
reasonable cause for the request. |
|
(j) For the purpose of qualifying for workers' compensation |
|
or any other similar benefits for compensation, an employee who |
|
claims a possible work-related exposure to a reportable disease[,
|
|
including HIV infection,] must provide the employer with a sworn |
|
affidavit of the date and circumstances of the exposure and |
|
document that, not later than the 10th day after the date of the |
|
exposure, the employee had a test result that indicated an absence |
|
of the reportable disease[, including HIV infection]. |
|
(k) A person listed in Subsection (b) who may have been |
|
exposed to a reportable disease[, including HIV infection,] may not |
|
be required to be tested. |
|
(l) In this section, ["HIV" and] "test result" has [have] |
|
the meaning [meanings] assigned by Section 81.101. |
|
SECTION 3.0229. Section 81.051(j), Health and Safety Code, |
|
is amended to read as follows: |
|
(j) A partner notification program shall routinely evaluate |
|
the performance of counselors and other program personnel to ensure |
|
that high quality services are being delivered. A program shall |
|
adopt quality assurance and training guidelines according to |
|
recommendations of the Centers for Disease Control and Prevention |
|
of the United States Public Health Service for professionals |
|
participating in the program. |
|
SECTION 3.0230. Section 81.062(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A witness or deponent who is not a party and who is |
|
subpoenaed or otherwise compelled to appear at a hearing or |
|
proceeding under this section conducted outside the witness's or |
|
deponent's county of residence is entitled to a travel and per diem |
|
allowance. The executive commissioner [board] by rule shall set |
|
the allowance in an amount not to exceed the travel and per diem |
|
allowance authorized for state employees traveling in this state on |
|
official business. |
|
SECTION 3.0231. Section 81.064(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department or a health authority may enter at |
|
reasonable times and inspect within reasonable limits a public |
|
place in the performance of that person's duty to prevent or control |
|
the entry into or spread in this state of communicable disease by |
|
enforcing this chapter or the rules [of the board] adopted under |
|
this chapter. |
|
SECTION 3.0232. Section 81.081, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.081. DEPARTMENT'S [BOARD'S] DUTY. The department |
|
[board] shall impose control measures to prevent the spread of |
|
disease in the exercise of its power to protect the public health. |
|
SECTION 3.0233. Sections 81.082(a) and (c-1), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A health authority has supervisory authority and |
|
control over the administration of communicable disease control |
|
measures in the health authority's jurisdiction unless |
|
specifically preempted by the department. Control measures imposed |
|
by a health authority must be consistent with, and at least as |
|
stringent as, the control measure standards in rules adopted by the |
|
executive commissioner [board]. |
|
(c-1) A health authority may designate health care |
|
facilities within the health authority's jurisdiction that are |
|
capable of providing services for the examination, observation, |
|
quarantine, isolation, treatment, or imposition of control |
|
measures during a public health disaster or during an area |
|
quarantine under Section 81.085. A health authority may not |
|
designate a nursing facility [home] or other institution licensed |
|
under Chapter 242. |
|
SECTION 3.0234. Section 81.084(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The department or health authority shall remove the |
|
quarantine and return control of the property to the person who owns |
|
or controls it if the control measures are effective. If the |
|
control measures are ineffective or if there is not a technically |
|
feasible control measure available for use, the department or |
|
health authority may continue the quarantine and order the person |
|
who owns or controls the property: |
|
(1) to destroy the property, other than land, in a |
|
manner that disinfects or decontaminates the property to prevent |
|
the spread of infection or contamination; |
|
(2) if the property is land, to securely fence the |
|
perimeter of the land or any part of the land that is infected or |
|
contaminated; or |
|
(3) to securely seal off an infected or contaminated |
|
structure or other property on land to prevent entry into the |
|
infected or contaminated area until the quarantine is removed by |
|
the department [board] or health authority. |
|
SECTION 3.0235. Sections 81.086(d), (e), and (h), Health |
|
and Safety Code, are amended to read as follows: |
|
(d) The owner or operator of a carrier or conveyance placed |
|
in quarantine by order of the department or health authority, or of |
|
a county or district court under Section 81.083 or 81.084, shall |
|
bear the expense of the control measures employed to disinfect or |
|
decontaminate the carrier or conveyance. The department or health |
|
authority, as appropriate, shall charge and be reimbursed for the |
|
cost of control measures performed by the department's or health |
|
authority's employees. The department [board] shall deposit the |
|
reimbursements to the credit of the general revenue fund to be used |
|
to administer this chapter. A health authority shall distribute |
|
the reimbursements to each county, municipality, or other |
|
governmental entity in an amount proportional to that entity's |
|
contribution to the quarantine and control expense. |
|
(e) The owner or claimant of cargo or an object on board the |
|
carrier or conveyance shall pay the expense of the control measures |
|
employed in the manner provided by Section 81.084. The cost of |
|
services rendered or provided by the department [board] or health |
|
authority is subject to reimbursement as provided by Subsection |
|
(d). |
|
(h) If the department or health authority has reasonable |
|
cause to believe that a carrier or conveyance is transporting cargo |
|
or an object that is or may be infected or contaminated with a |
|
communicable disease, the department or health authority may: |
|
(1) require that the cargo or object be transported in |
|
secure confinement or sealed in a car, trailer, hold, or |
|
compartment, as appropriate, that is secured on the order and |
|
instruction of the department [board] or health authority, if the |
|
cargo or object is being transported through this state; |
|
(2) require that the cargo or object be unloaded at an |
|
alternate location equipped with adequate investigative and |
|
disease control facilities if the cargo or object is being |
|
transported to an intermediate or ultimate destination in this |
|
state that cannot provide the necessary facilities; and |
|
(3) investigate and, if necessary, quarantine the |
|
cargo or object and impose any required control measure as |
|
authorized by Section 81.084. |
|
SECTION 3.0236. Sections 81.091(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) A physician, nurse, midwife, or other person in |
|
attendance at childbirth shall use or cause to be used prophylaxis |
|
approved by the executive commissioner [board] to prevent |
|
ophthalmia neonatorum. |
|
(c) Subject to the availability of funds, the department |
|
shall furnish prophylaxis approved by the executive commissioner |
|
[board] free of charge to: |
|
(1) health care providers if the newborn's financially |
|
responsible adult is unable to pay; and |
|
(2) a midwife identified under Chapter 203, |
|
Occupations Code, who requests prophylaxis for administration |
|
under standing delegation orders issued by a licensed physician |
|
under Subsection (b) and subject to the provisions of Subchapter A, |
|
Chapter 157, Occupations Code. |
|
(d) If a physician is not available to issue a standing |
|
delegation order or if no physician will agree to issue a standing |
|
delegation order, a midwife shall administer or cause to be |
|
administered by an appropriately trained and licensed individual |
|
prophylaxis approved by the executive commissioner [Texas Board of
|
|
Health] to prevent ophthalmia neonatorum to each infant that the |
|
midwife delivers. |
|
SECTION 3.0237. Section 81.0955(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A hospital, certified emergency medical services |
|
personnel, or a physician on behalf of the person exposed, |
|
following a report of the exposure incident, shall take reasonable |
|
steps to test the deceased person for communicable diseases. The |
|
hospital, certified emergency medical services personnel, or |
|
physician shall provide the test results to the department or to the |
|
local health authority responsible for following the procedures |
|
prescribed by Section 81.050(h) to inform the person exposed and, |
|
if applicable, the next of kin of the deceased person regarding the |
|
test results. The hospital, certified emergency medical services |
|
personnel, or physician shall follow applicable reporting |
|
requirements prescribed by Subchapter C. This subsection does not |
|
impose a duty on a hospital, certified emergency medical services |
|
personnel, or a physician to provide any further testing, |
|
treatment, or services or to perform further procedures. The |
|
executive commissioner [of the Health and Human Services
|
|
Commission] shall adopt rules to implement this subsection. |
|
SECTION 3.0238. Sections 81.101(1) and (4), Health and |
|
Safety Code, are amended to read as follows: |
|
(1) "AIDS" means acquired immune deficiency syndrome |
|
as defined by the Centers for Disease Control and Prevention of the |
|
United States Public Health Service. |
|
(4) "Blood bank" means a blood bank, blood center, |
|
regional collection center, tissue bank, transfusion service, or |
|
other similar facility licensed by the Center for [Bureau of] |
|
Biologics Evaluation and Research of the United States Food and |
|
Drug Administration, accredited for membership in the AABB |
|
(formerly known as the American Association of Blood Banks), or |
|
qualified for membership in the American Association of Tissue |
|
Banks. |
|
SECTION 3.0239. Sections 81.102(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) A person may not require another person to undergo a |
|
medical procedure or test designed to determine or help determine |
|
if a person has AIDS or HIV infection, antibodies to HIV, or |
|
infection with any other probable causative agent of AIDS unless: |
|
(1) the medical procedure or test is required under |
|
Subsection (d), under Section 81.050, or under Article 21.31, Code |
|
of Criminal Procedure; |
|
(2) the medical procedure or test is required under |
|
Section 81.090, and no objection has been made under Section |
|
81.090(l); |
|
(3) the medical procedure or test is authorized under |
|
Chapter 545, Insurance Code; |
|
(4) a medical procedure is to be performed on the |
|
person that could expose health care personnel to AIDS or HIV |
|
infection, according to department rules [board guidelines] |
|
defining the conditions that constitute possible exposure to AIDS |
|
or HIV infection, and there is sufficient time to receive the test |
|
result before the procedure is conducted; or |
|
(5) the medical procedure or test is necessary: |
|
(A) as a bona fide occupational qualification and |
|
there is not a less discriminatory means of satisfying the |
|
occupational qualification; |
|
(B) to screen blood, blood products, body fluids, |
|
organs, or tissues to determine suitability for donation; |
|
(C) in relation to a particular person under this |
|
chapter; |
|
(D) to manage accidental exposure to blood or |
|
other body fluids, but only if the test is conducted under written |
|
infectious disease control protocols adopted by the health care |
|
agency or facility; |
|
(E) to test residents and clients of residential |
|
facilities of the department or the Department of Aging and |
|
Disability Services [Texas Department of Mental Health and Mental
|
|
Retardation], but only if: |
|
(i) the test result would change the |
|
medical or social management of the person tested or others who |
|
associated with that person; and |
|
(ii) the test is conducted in accordance |
|
with guidelines adopted by the residential facility or rules of the |
|
appropriate department [Texas Department of Mental Health and
|
|
Mental Retardation and approved by the department]; or |
|
(F) to test residents and clients of residential |
|
facilities of the Texas Juvenile Justice Department [Youth
|
|
Commission], but only if: |
|
(i) the test result would change the |
|
medical or social management of the person tested or others who |
|
associate with that person; and |
|
(ii) the test is conducted in accordance |
|
with guidelines adopted by the Texas Juvenile Justice Department |
|
[Youth Commission]. |
|
(c) Protocols adopted under Subsection (a)(5)(D) |
|
[(a)(4)(D)] must clearly establish procedural guidelines with |
|
criteria for testing that respect the rights of the person with the |
|
infection and the person who may be exposed to that infection. The |
|
protocols may not require the person who may have been exposed to be |
|
tested and must ensure the confidentiality of the person with the |
|
infection in accordance with this chapter. |
|
(d) The executive commissioner [board] may adopt emergency |
|
rules for mandatory testing for HIV infection if the commissioner |
|
files a certificate of necessity with the executive commissioner |
|
[board] that contains supportive findings of medical and scientific |
|
fact and that declares a sudden and imminent threat to public |
|
health. The rules must provide for: |
|
(1) the narrowest application of HIV testing necessary |
|
for the protection of the public health; |
|
(2) procedures and guidelines to be followed by an |
|
affected entity or state agency that clearly specify the need and |
|
justification for the testing, specify methods to be used to assure |
|
confidentiality, and delineate responsibility and authority for |
|
carrying out the recommended actions; |
|
(3) counseling of persons with seropositive test |
|
results; and |
|
(4) confidentiality regarding persons tested and |
|
their test results. |
|
SECTION 3.0240. Section 81.107(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) In a case of accidental exposure to blood or other body |
|
fluids under Section 81.102(a)(5)(D) [81.102(a)(4)(D)], the health |
|
care agency or facility may test a person who may have exposed the |
|
health care worker to HIV without the person's specific consent to |
|
the test. |
|
SECTION 3.0241. Section 81.108, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.108. TESTING BY INSURERS. The Insurance Code and |
|
any rules adopted by the commissioner of insurance for the Texas |
|
Department [State Board] of Insurance exclusively govern all |
|
practices of insurers in testing applicants to show or help show |
|
whether a person has AIDS or HIV infection, antibodies to HIV, or |
|
infection with any other probable causative agent of AIDS. |
|
SECTION 3.0242. Section 81.159(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The commissioner shall designate health care facilities |
|
throughout the state that are capable of providing services for the |
|
examination, observation, isolation, or treatment of persons |
|
having or suspected of having a communicable disease. However, the |
|
commissioner may not designate: |
|
(1) a nursing facility [home] or custodial care home |
|
required to be licensed under Chapter 242; or |
|
(2) an ICF-IID [intermediate care facility for the
|
|
mentally retarded] required to be licensed under Chapter 252. |
|
SECTION 3.0243. Section 81.166(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The notification of probable cause hearing shall read as |
|
follows: |
|
(Style of Case) |
|
NOTIFICATION OF PROBABLE CAUSE HEARING |
|
On this the _____ day of _________________, 20__ [19__], the |
|
undersigned hearing officer heard evidence concerning the need for |
|
protective custody of ___________ (hereinafter referred to as |
|
proposed patient). The proposed patient was given the opportunity |
|
to challenge the allegations that the proposed patient [(s)he] |
|
presents a substantial risk of serious harm to self or others. |
|
The proposed patient and the proposed patient's [his or her] |
|
attorney _________________________ have been given written notice |
|
that the proposed patient was placed under an order of protective |
|
custody and the reasons for such order on ___________ (date of |
|
notice). |
|
I have examined the affidavit of medical evaluation and |
|
________________ (other evidence considered). Based on this |
|
evidence, I find that there is probable cause to believe that the |
|
proposed patient presents a substantial risk of serious harm to |
|
self [himself or herself] (yes ____ or no ____) or others (yes ____ |
|
or no ____) such that the proposed patient [(s)he] cannot be at |
|
liberty pending final hearing because the proposed patient [(s)he] |
|
is infected with or is reasonably suspected of being infected with a |
|
communicable disease that presents an immediate threat to the |
|
public health and the proposed patient [(s)he] has failed or |
|
refused to comply with the orders of the health authority or the |
|
[Texas] Department of State Health Services delivered on __________ |
|
(date of service) ____________. |
|
SECTION 3.0244. Section 81.178(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The appropriate courts of this state retain |
|
jurisdiction to inquire at any time into the person's [mental] |
|
condition and the necessity of the person's continued commitment. |
|
SECTION 3.0245. Sections 81.211(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) In the case of a person who is not a resident of this |
|
state and who may be admitted to a public health [state chest] |
|
hospital in accordance with Section 13.046, the attorney general, |
|
at the request of the department, shall file a copy of an order |
|
issued by a court of another state that authorizes the commitment of |
|
the person to a health care facility for inpatient care in the |
|
manner provided by Chapter 35, Civil Practice and Remedies Code, |
|
for enforcement of foreign judgments. |
|
(b) The application must be filed with the district court in |
|
the county in which the public health [state chest] hospital to |
|
which the person will be admitted is located. |
|
SECTION 3.0246. Section 81.304, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 81.304. MINIMUM STANDARDS. The executive commissioner |
|
[board] by rule shall adopt minimum standards to implement the |
|
exposure control plan and the other provisions of this subchapter. |
|
The rules shall be analogous to standards adopted by the federal |
|
Occupational Safety and Health Administration. Each governmental |
|
unit shall comply with the minimum standards adopted under this |
|
subchapter. |
|
SECTION 3.0247. Section 81.305(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] by rule shall |
|
recommend that governmental units implement needleless systems and |
|
sharps with engineered sharps injury protection for employees. |
|
SECTION 3.0248. Sections 81.306(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] by rule shall |
|
require that information concerning exposure incidents be recorded |
|
in a written or electronic sharps injury log to be maintained by a |
|
governmental unit. This information must be reported to the |
|
department and must include: |
|
(1) the date and time of the exposure incident; |
|
(2) the type and brand of sharp involved in the |
|
exposure incident; and |
|
(3) a description of the exposure incident, including: |
|
(A) the job classification or title of the |
|
exposed employee; |
|
(B) the department or work area where the |
|
exposure incident occurred; |
|
(C) the procedure that the exposed employee was |
|
performing at the time of the incident; |
|
(D) how the incident occurred; |
|
(E) the employee's body part that was involved in |
|
the exposure incident; and |
|
(F) whether the sharp had engineered sharps |
|
injury protection and, if so, whether the protective mechanism was |
|
activated and whether the injury occurred before, during, or after |
|
the activation of the protective mechanism. |
|
(c) All information and materials obtained or compiled by |
|
the department in connection with a report under this section are |
|
confidential and not subject to disclosure under Chapter 552, |
|
Government Code, and not subject to disclosure, discovery, |
|
subpoena, or other means of legal compulsion for their release by |
|
the department. The department shall make available, in aggregate |
|
form, the information described in Section 81.305(b) and this |
|
section, provided that the name and other information identifying |
|
the facility is deleted and the information is provided according |
|
to public health regions established by the executive commissioner |
|
[department]. |
|
SECTION 3.0249. Sections 81.307(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department, in accordance with rules adopted by the |
|
executive commissioner [board], shall implement a registration |
|
program for existing needleless systems and sharps with engineered |
|
sharps injury protection. |
|
(c) The department shall collect [charge] a fee to register |
|
a device in an amount established by rule by the executive |
|
commissioner [board]. The fees collected under this section may be |
|
appropriated only to the department to implement this subchapter. |
|
SECTION 3.0250. Section 81.352(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [department] shall adopt |
|
rules to govern: |
|
(1) the form and content of the sign required by |
|
Subsection (a) and the manner and place of posting of the sign; and |
|
(2) the form and content of the written warning |
|
required by Subsection (a). |
|
SECTION 3.0251. Sections 81.353(a) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department may assess an administrative penalty if a |
|
person violates this subchapter [section] or a rule adopted under |
|
this subchapter [section]. |
|
(d) The enforcement of the penalty may be stayed during the |
|
time the order is under judicial review if the person pays the |
|
penalty to the clerk of the court or files a supersedeas bond with |
|
the court in the amount of the penalty. A person who cannot afford |
|
to pay the penalty or file the bond may stay the enforcement by |
|
filing an affidavit in the manner required by the Texas Rules of |
|
Civil Procedure for a party who cannot afford to file security for |
|
costs, subject to the right of the department [board] to contest the |
|
affidavit as provided by those rules. |
|
SECTION 3.0252. Section 82.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 82.004. REGISTRY REQUIRED. The department [board] |
|
shall maintain a cancer registry for the state. |
|
SECTION 3.0253. Section 82.005(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The cancer registry must include: |
|
(1) a record of the cases of cancer that occur in the |
|
state; and |
|
(2) information concerning cancer cases as the |
|
executive commissioner [board] considers necessary and appropriate |
|
for the recognition, prevention, cure, or control of cancer. |
|
SECTION 3.0254. Section 82.006, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 82.006. EXECUTIVE COMMISSIONER AND DEPARTMENT [BOARD] |
|
POWERS. (a) To implement this chapter, the executive commissioner |
|
[board] may [:
|
|
[(1)] adopt rules that the executive commissioner |
|
[board] considers necessary. [;] |
|
(b) To implement this chapter, the department may: |
|
(1) [(2)] execute contracts considered [that the
|
|
board considers] necessary; |
|
(2) [(3)] receive the data from medical records of |
|
cases of cancer that are in the custody or under the control of |
|
clinical laboratories, health care facilities, and health care |
|
practitioners to record and analyze the data directly related to |
|
those diseases; |
|
(3) [(4)] compile and publish statistical and other |
|
studies derived from the patient data obtained under this chapter |
|
to provide, in an accessible form, information that is useful to |
|
physicians, other medical personnel, and the general public; |
|
(4) [(5)] comply with requirements as necessary to |
|
obtain federal funds in the maximum amounts and most advantageous |
|
proportions possible; |
|
(5) [(6)] receive and use gifts made for the purpose |
|
of this chapter; and |
|
(6) [(7)] limit cancer reporting activities under |
|
this chapter to specified geographic areas of the state to ensure |
|
optimal use of funds available for obtaining the data. |
|
SECTION 3.0255. Sections 82.008(a), (b), and (e), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) To ensure an accurate and continuing source of data |
|
concerning cancer, each health care facility, clinical laboratory, |
|
and health care practitioner shall furnish to the department [board
|
|
or its representative], on request, data the executive commissioner |
|
[board] considers necessary and appropriate that is derived from |
|
each medical record pertaining to a case of cancer that is in the |
|
custody or under the control of the health care facility, clinical |
|
laboratory, or health care practitioner. The department may not |
|
request data that is more than three years old unless the department |
|
is investigating a possible cancer cluster. |
|
(b) A health care facility, clinical laboratory, or health |
|
care practitioner shall furnish the data requested under Subsection |
|
(a) in a reasonable format prescribed by [the] department rule and |
|
within six months of the patient's admission, diagnosis, or |
|
treatment for cancer unless a different period is prescribed by the |
|
United States Department of Health and Human Services. |
|
(e) The executive commissioner [board] shall adopt |
|
procedures that ensure adequate notice is given to the health care |
|
facility, clinical laboratory, or health care practitioner before |
|
the department accesses data under Subsection (d). |
|
SECTION 3.0256. Section 82.009(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Medical or epidemiological information may be released: |
|
(1) for statistical purposes in a manner that prevents |
|
identification of individuals, health care facilities, clinical |
|
laboratories, or health care practitioners; |
|
(2) with the consent of each person identified in the |
|
information; or |
|
(3) to promote cancer research, including release of |
|
information to other cancer registries and appropriate state and |
|
federal agencies, under rules adopted by the executive commissioner |
|
[board] to ensure confidentiality as required by state and federal |
|
laws. |
|
SECTION 3.0257. Section 82.011, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 82.011. EXAMINATION AND SUPERVISION NOT REQUIRED. |
|
This chapter does not require an individual to submit to any medical |
|
examination or supervision or to examination or supervision by the |
|
department [board or its representatives]. |
|
SECTION 3.0258. Sections 84.003(b), (c), (d), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(b) Blood lead levels in adults are laboratory findings that |
|
are reportable to the department as provided by department [board] |
|
rule. |
|
(c) The executive commissioner [board] may adopt rules that |
|
require other occupational conditions to be reported under this |
|
chapter. Before the executive commissioner [board] requires |
|
another occupational condition to be reported, the executive |
|
commissioner [board] must find that the condition: |
|
(1) has a well-understood etiology; |
|
(2) results predominantly from occupational |
|
exposures; and |
|
(3) is preventable. |
|
(d) The executive commissioner [board] shall maintain a |
|
list of reportable conditions. |
|
(e) The executive commissioner [board] shall adopt rules |
|
necessary to administer and implement this chapter. |
|
SECTION 3.0259. Section 84.004(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [board] shall prescribe the |
|
form and method of reporting. The executive commissioner [board] |
|
may require the reports to contain any information necessary to |
|
achieve the purposes of this chapter, including the person's name, |
|
address, age, sex, race, occupation, employer, and attending |
|
physician. |
|
SECTION 3.0260. Section 84.005(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department may seek, receive, and spend any funds |
|
received through appropriations, grants, or donations from public |
|
or private sources for the purpose of identifying, reporting, or |
|
preventing those occupational conditions that have been determined |
|
by the executive commissioner [board] to be injurious or to be a |
|
threat to the public health, subject to any limitations or |
|
conditions prescribed by the legislature. |
|
SECTION 3.0261. Section 84.006(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
establishing procedures to ensure that all information and records |
|
maintained by the department under this chapter are kept |
|
confidential and protected from release to unauthorized persons. |
|
SECTION 3.0262. Section 84.007(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) In performing the department's [commissioner's] duty to |
|
prevent an occupational condition, the department's [commissioner
|
|
or the commissioner's] designee may enter at reasonable times and |
|
inspect within reasonable limits all or any part of an area, |
|
structure, or conveyance, regardless of ownership, that is not used |
|
for private residential purposes. |
|
SECTION 3.0263. Sections 85.002(1), (2), and (6), Health |
|
and Safety Code, are amended to read as follows: |
|
(1) "AIDS" means acquired immune deficiency syndrome |
|
as defined by the Centers for Disease Control and Prevention of the |
|
United States Public Health Service. |
|
(2) "Communicable disease" has the meaning assigned by |
|
Section 81.003 [(Communicable Disease Prevention and Control
|
|
Act)]. |
|
(6) "Testing program" means a [medical] program using |
|
a diagnostic test approved by the United States Food and Drug |
|
Administration to indicate the presence of HIV [to test for AIDS,
|
|
HIV infection, antibodies to HIV, or infection with any other
|
|
probable causative agent of AIDS]. |
|
SECTION 3.0264. The heading to Subchapter A, Chapter 85, |
|
Health and Safety Code, is amended to read as follows: |
|
SUBCHAPTER A. GENERAL PROVISIONS AND EDUCATIONAL MATERIALS |
|
[EDUCATION PROGRAMS] |
|
SECTION 3.0265. Sections 85.004 and 85.005, Health and |
|
Safety Code, are amended to read as follows: |
|
Sec. 85.004. EDUCATIONAL MATERIALS [EDUCATION PROGRAMS]. |
|
(a) The department shall develop model educational materials |
|
[education programs] to be available on the department's Internet |
|
website to educate the public about AIDS and HIV infection. |
|
(b) The [As part of the programs, the department shall
|
|
develop a model] educational materials must: |
|
(1) include information [pamphlet] about methods of |
|
transmission and prevention of HIV infection, [about] state laws |
|
relating to the transmission, and [to] conduct that may result in |
|
the transmission of HIV; and [.] |
|
(2) [(c) The programs must] be scientifically |
|
accurate and factually correct and designed to: |
|
(A) [(1)] communicate to the public knowledge |
|
about methods of transmission and prevention of HIV infection; and |
|
(B) [(2)] educate the public about transmission |
|
risks in social, employment, and educational situations[;
|
|
[(3)
educate health care workers and health facility
|
|
employees about methods of transmission and prevention in their
|
|
particular workplace environments; and
|
|
[(4)
educate the public about state laws relating to
|
|
the transmission and conduct that may result in the transmission of
|
|
HIV]. |
|
Sec. 85.005. EDUCATIONAL MATERIALS DESIGNED FOR CERTAIN |
|
PERSONS; SPECIFIC INFORMATION [SPECIAL COMPONENTS OF EDUCATION
|
|
PROGRAMS]. (a) The department shall include in the educational |
|
materials specific information [education programs special
|
|
components] designed to reach: |
|
(1) persons with behavior conducive to HIV |
|
transmission; |
|
(2) persons younger than 18 years of age; and |
|
(3) minority groups. |
|
(b) In developing educational materials [designing
|
|
education programs] for ethnic minorities and in assisting local |
|
community organizations in developing educational materials |
|
[education programs] for minority groups, the department shall |
|
ensure that the educational materials [programs] reflect the nature |
|
and spread of HIV infection in minorities in this state. |
|
SECTION 3.0266. The heading to Section 85.006, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 85.006. EDUCATIONAL MATERIALS [EDUCATION PROGRAMS] |
|
FOR [DISABLED] PERSONS WITH DISABILITIES. |
|
SECTION 3.0267. Sections 85.006(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department shall develop and promote the |
|
availability of educational materials concerning HIV [education] |
|
and prevention of HIV infection [programs] specifically designed to |
|
address the concerns of persons with physical or mental |
|
disabilities. |
|
(b) In developing [designing] those educational materials |
|
[programs], the department shall consult persons with disabilities |
|
or consult experts in the appropriate professional disciplines. |
|
SECTION 3.0268. The heading to Section 85.007, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 85.007. EDUCATIONAL MATERIALS [EDUCATION PROGRAMS] |
|
FOR MINORS. |
|
SECTION 3.0269. Sections 85.007(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department shall give priority to developing model |
|
educational materials for education programs for persons younger |
|
than 18 years of age. |
|
(c) In addition, the educational materials [in the
|
|
education program] intended for persons younger than 18 years of |
|
age must: |
|
(1) teach that sexual activity before marriage is |
|
likely to have harmful psychological and physical consequences; |
|
(2) teach adolescents ways to recognize and respond to |
|
unwanted physical and verbal sexual advances; |
|
(3) teach that the use of alcohol or drugs increases a |
|
person's vulnerability to unwanted sexual advances; and |
|
(4) emphasize the importance of attaining |
|
self-sufficiency before engaging in sexual activity. |
|
SECTION 3.0270. Sections 85.008, 85.009, 85.010, and |
|
85.011, Health and Safety Code, are amended to read as follows: |
|
Sec. 85.008. PROMOTION [DISTRIBUTION] OF AVAILABILITY OF |
|
EDUCATIONAL MATERIALS [EDUCATION PROGRAMS]. [(a)] The department |
|
shall determine where HIV education efforts are needed in this |
|
state and shall promote the availability of educational materials |
|
on the department's Internet website [initiate programs] in those |
|
areas [by identifying local resources]. |
|
[(b)
The department shall assist communities, especially
|
|
those in rural areas, in establishing self-sustaining education
|
|
programs, using public and private resources.] |
|
Sec. 85.009. AVAILABILITY OF EDUCATIONAL MATERIALS |
|
[EDUCATION PROGRAMS AVAILABLE ON REQUEST]. The department shall |
|
make the educational materials [the education programs] available |
|
on the department's Internet website for [to] local governments and |
|
private businesses [on request]. |
|
Sec. 85.010. EDUCATIONAL COURSE FOR EMPLOYEES AND CLIENTS |
|
OF HEALTH CARE FACILITIES. A health care facility licensed by the |
|
department or [,] the [Texas] Department of Aging and Disability |
|
Services [Mental Health and Mental Retardation, or the Texas
|
|
Department of Human Services] shall require its employees to |
|
complete an educational course about HIV infection based on the |
|
model educational materials [education programs] developed by the |
|
department. |
|
Sec. 85.011. CONTRACTS FOR EDUCATIONAL MATERIALS |
|
[EDUCATION PROGRAMS]. (a) The department may contract with any |
|
person, other than a person who advocates or promotes conduct that |
|
violates state law, for the design and[,] development[, and
|
|
distribution] of educational materials [education programs]. |
|
(b) This section does not restrict the inclusion in |
|
educational materials of [an education program from providing] |
|
accurate information about different ways to reduce the risk of |
|
exposure to or the transmission of HIV. |
|
SECTION 3.0271. Sections 85.012(b) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The model workplace guidelines must include provisions |
|
stating that: |
|
(1) all employees will receive some education about |
|
methods of transmission and prevention of HIV infection and related |
|
conditions; |
|
(2) accommodations will be made to keep persons with |
|
HIV infection employed and productive for as long as possible; |
|
(3) the confidentiality of employee medical records |
|
will be protected; |
|
(4) HIV-related policies will be consistent with |
|
current information from public health authorities, such as the |
|
Centers for Disease Control and Prevention of the United States |
|
Public Health Service, and with state and federal law and |
|
regulations; |
|
(5) persons with HIV infection are entitled to the |
|
same rights and opportunities as persons with other communicable |
|
diseases; and |
|
(6) employers and employees should not engage in |
|
discrimination against persons with HIV infection unless based on |
|
accurate scientific information. |
|
(e) Employers should be encouraged to adopt HIV-related |
|
workplace guidelines that incorporate, at a minimum, the guidelines |
|
established by the department [board] under this section. |
|
SECTION 3.0272. Section 85.015(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Subsection (a)(2) does not restrict the inclusion in |
|
educational materials of [an education program from providing] |
|
accurate information about ways to reduce the risk of exposure to or |
|
transmission of HIV. |
|
SECTION 3.0273. Section 85.016, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 85.016. RULES. The executive commissioner [board] may |
|
adopt rules necessary to implement Subchapters A through F. |
|
SECTION 3.0274. Sections 85.032 and 85.033, Health and |
|
Safety Code, are amended to read as follows: |
|
Sec. 85.032. RULES; PROGRAM STRUCTURE. (a) The executive |
|
commissioner [board] may adopt rules relating to: |
|
(1) the services that may be furnished under the |
|
program; |
|
(2) a system of priorities regarding the types of |
|
services provided, geographic areas covered, or classes of |
|
individuals or communities targeted for services under the program; |
|
and |
|
(3) a process for resolving conflicts between the |
|
department and a program receiving money under this subchapter. |
|
(b) Executive commissioner [Board] or department actions |
|
relating to service, geographic, and other priorities shall be |
|
based on the set of priorities and guidelines established under |
|
this section. |
|
(c) In structuring the program and adopting rules, the |
|
department and the executive commissioner, as appropriate, [board] |
|
shall attempt to: |
|
(1) coordinate the use of federal, local, and private |
|
funds; |
|
(2) encourage the provision of community-based |
|
services; |
|
(3) address needs that are not met by other sources of |
|
funding; |
|
(4) provide funding as extensively as possible across |
|
the regions of the state in amounts that reflect regional needs; and |
|
(5) encourage cooperation among local service |
|
providers. |
|
Sec. 85.033. COORDINATION OF SERVICES. (a) To prevent |
|
unnecessary duplication of services, the executive commissioner |
|
[board] and the department shall seek to coordinate the services |
|
provided by eligible programs under Subchapters A through G with |
|
existing federal, state, and local programs. |
|
(b) The department shall consult with the [Texas] |
|
Department of Aging and Disability [Human] Services and the |
|
commission to ensure that programs funded under this subchapter |
|
complement and do not unnecessarily duplicate services provided |
|
through the [Texas] Department of Aging and Disability [Human] |
|
Services and the commission. |
|
SECTION 3.0275. Section 85.041(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] may adopt rules |
|
relating to the information a program is required to report to the |
|
department and shall adopt procedures and forms for reporting the |
|
information to prevent unnecessary and duplicative reporting of |
|
data. |
|
SECTION 3.0276. Section 85.044, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 85.044. ADVISORY COMMITTEE. The executive |
|
commissioner [board] may appoint an advisory committee to assist in |
|
the development of procedures and guidelines required by this |
|
subchapter. |
|
SECTION 3.0277. Section 85.061(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The program shall assist hospital districts, local |
|
health departments, public or nonprofit hospitals and clinics, |
|
nonprofit community organizations, and HIV-infected individuals in |
|
the purchase of medications approved by the commissioner [board] |
|
that have been shown to be effective in reducing hospitalizations |
|
due to HIV-related conditions. |
|
SECTION 3.0278. Section 85.062(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) To be eligible for the program, an individual: |
|
(1) must not be eligible for Medicaid benefits; |
|
(2) must meet financial eligibility criteria set by |
|
department [board] rule; |
|
(3) must not qualify for any other state or federal |
|
program available for financing the purchase of the prescribed |
|
medication; and |
|
(4) must be diagnosed by a licensed physician as |
|
having AIDS or an HIV-related condition or illness of at least the |
|
minimal severity set by the executive commissioner [board]. |
|
SECTION 3.0279. Section 85.063, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 85.063. PROCEDURES AND ELIGIBILITY GUIDELINES. The |
|
executive commissioner [board] by rule shall establish: |
|
(1) application and distribution procedures; |
|
(2) eligibility guidelines to ensure the most |
|
appropriate distribution of funds available each year; and |
|
(3) appellate procedures to resolve any eligibility or |
|
funding conflicts. |
|
SECTION 3.0280. Section 85.064(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The department shall deposit money received under this |
|
section in the state treasury to the credit of the general revenue |
|
fund [HIV medication fund and to the credit of a special account in
|
|
that fund that shall be established for each entity sending funds
|
|
under this section]. |
|
SECTION 3.0281. Section 85.081(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department shall develop, and the executive |
|
commissioner shall adopt, model protocols for counseling and |
|
testing related to HIV infection. The protocols shall be made |
|
available to health care providers on request. |
|
SECTION 3.0282. Section 85.087(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The executive commissioner by rule [board] shall set the |
|
fee in an amount that is reasonable and necessary to cover the costs |
|
of providing the course. |
|
SECTION 3.0283. Section 85.088(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) State-funded primary health, women's reproductive |
|
health, and sexually transmitted disease clinics shall: |
|
(1) make available to patients and clients information |
|
and educational materials concerning the prevention of HIV |
|
infection; and |
|
(2) provide or refer patients and clients to |
|
voluntary[, anonymous,] and affordable counseling and HIV testing |
|
services, including the patient's or client's choice of anonymous |
|
or confidential HIV testing or counseling [programs concerning HIV
|
|
infection or provide referrals to those programs]. |
|
SECTION 3.0284. Sections 85.111(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) Each state agency annually shall provide to each state |
|
employee [an] educational information [pamphlet] about: |
|
(1) methods of transmission and prevention of HIV |
|
infection; |
|
(2) state laws relating to the transmission of HIV |
|
infection; and |
|
(3) conduct that may result in the transmission of HIV |
|
infection. |
|
(b) The educational information [pamphlet] shall be |
|
provided to a newly hired state employee on the first day of |
|
employment. |
|
(c) The educational information [pamphlet] shall be based |
|
on the model developed by the department and shall include the |
|
workplace guidelines adopted by the state agency. |
|
SECTION 3.0285. Section 85.113, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 85.113. WORKPLACE GUIDELINES FOR STATE CONTRACTORS. |
|
An entity that contracts with or is funded by any of the following |
|
state agencies to operate a program involving direct client contact |
|
shall adopt and implement workplace guidelines similar to the |
|
guidelines adopted by the agency that funds or contracts with the |
|
entity: |
|
(1) the Department of Assistive and Rehabilitative |
|
Services [Texas Commission on Alcohol and Drug Abuse;
|
|
[(2) the Texas Commission for the Blind;
|
|
[(3)
the Texas Commission for the Deaf and Hard of
|
|
Hearing]; |
|
(2) [(4)] the Texas Juvenile Justice Department |
|
[Probation Commission]; |
|
(3) [(5)] the Texas Department of Criminal Justice; |
|
(4) [(6) the Texas Youth Commission;
|
|
[(7)] the department; |
|
(5) [(8)] the [Texas] Department of Aging and |
|
Disability [Human] Services; and |
|
(6) [(9)] the commission [Texas Department of Mental
|
|
Health and Mental Retardation; and
|
|
[(10) the Texas Rehabilitation Commission]. |
|
SECTION 3.0286. Section 85.114(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Education available under this section shall be based on |
|
the model educational materials [education program] developed by |
|
the department and tailored to the cultural, educational, language, |
|
and developmental needs of the clients, inmates, patients, or |
|
residents, including the use of Braille or telecommunication |
|
devices for the deaf. |
|
SECTION 3.0287. Sections 85.116(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
prescribe the criteria that constitute possible exposure to HIV |
|
under this section. The criteria must be based on activities the |
|
United States Public Health Service determines pose a risk of HIV |
|
infection. |
|
(d) The cost of a state employee's testing and counseling |
|
shall be paid from funds appropriated for payment of workers' |
|
compensation benefits to state employees. The State Office of Risk |
|
Management [director of the workers' compensation division of the
|
|
attorney general's office] shall adopt rules necessary to |
|
administer this subsection. |
|
SECTION 3.0288. Section 85.201(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The legislature finds that: |
|
(1) the Centers for Disease Control and Prevention of |
|
the United States Public Health Service have made recommendations |
|
for preventing transmission of human immunodeficiency virus (HIV) |
|
and hepatitis B virus (HBV) to patients in the health care setting; |
|
(2) the Centers for Disease Control and Prevention of |
|
the United States Public Health Service have found that when health |
|
care workers adhere to recommended infection-control procedures, |
|
the risk of transmitting HBV from an infected health care worker to |
|
a patient is small, and the risk of transmitting HIV is likely to be |
|
even smaller; |
|
(3) the risk of transmission of HIV and HBV in health |
|
care settings will be minimized if health care workers adhere to the |
|
Centers for Disease Control and Prevention of the United States |
|
Public Health Service recommendations; and |
|
(4) health care workers who perform exposure-prone |
|
procedures should know their HIV antibody status; health care |
|
workers who perform exposure-prone procedures and who do not have |
|
serologic evidence of immunity to HBV from vaccination or from |
|
previous infection should know their HBsAg status and, if that is |
|
positive, should also know their HBeAg status. |
|
SECTION 3.0289. Section 85.202(4), Health and Safety Code, |
|
is amended to read as follows: |
|
(4) "Universal precautions" means procedures for |
|
disinfection and sterilization of reusable medical devices and the |
|
appropriate use of infection control, including hand washing, the |
|
use of protective barriers, and the use and disposal of needles and |
|
other sharp instruments as those procedures are defined by the |
|
Centers for Disease Control and Prevention of the United States |
|
Public Health Service. |
|
SECTION 3.0290. Sections 85.257(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) Counseling provided by a service provider, including |
|
written information provided under Subsection (a) and referrals, |
|
must conform with counseling protocols adopted by the executive |
|
commissioner [board]. Except as provided by Section 85.256, the |
|
counseling protocols must be consistent with the requirements of |
|
Section 81.109 and the protocols adopted under Section 85.081. |
|
(d) Counseling provided by a service provider under this |
|
section must be provided in English and in Spanish. The department |
|
[board] may require a service provider to provide counseling in |
|
another language if the department [board] finds that the service |
|
provider is marketing home collection kits in a community in which a |
|
significant portion of the population speaks a language other than |
|
English or Spanish. |
|
SECTION 3.0291. Section 85.258(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) In addition to the labeling requirements in Subsections |
|
(a) and (b), a home collection kit labeled in Spanish must also be |
|
available. The department [board] may require a service provider |
|
to label a home collection kit in another language if the department |
|
[board] finds that the service provider is marketing home |
|
collection kits in a community in which a significant portion of the |
|
population speaks a language other than English or Spanish. |
|
SECTION 3.0292. Section 85.275(f), Health and Safety Code, |
|
is amended to read as follows: |
|
(f) The assistant presiding officer shall: |
|
(1) perform the duties of the presiding officer if the |
|
presiding officer is absent or is not able to perform those duties |
|
because of disability [becomes disabled]; and |
|
(2) complete the unexpired portion of the presiding |
|
officer's term if the office of the presiding officer becomes |
|
vacant. |
|
SECTION 3.0293. Section 87.001(7), Health and Safety Code, |
|
is amended to read as follows: |
|
(7) "Health facility" includes: |
|
(A) a general or special hospital licensed by the |
|
department under Chapter 241; |
|
(B) a physician-owned or physician-operated |
|
clinic; |
|
(C) a publicly or privately funded medical |
|
school; |
|
(D) a state hospital operated by the department |
|
or a state supported living center operated [school maintained and
|
|
managed] by the [Texas] Department of Aging and Disability Services |
|
[Mental Health and Mental Retardation]; |
|
(E) a genetic evaluation and counseling center; |
|
(F) a public health clinic conducted by a local |
|
health unit, health department, or public health district organized |
|
and recognized under Chapter 121; |
|
(G) a physician peer review organization; and |
|
(H) another facility specified by department |
|
[board] rule. |
|
SECTION 3.0294. Sections 87.002(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) The department may release medical, epidemiological, or |
|
toxicological information: |
|
(1) for statistical purposes, if released in a manner |
|
that prevents the identification of any person; |
|
(2) with the consent of each person identified in the |
|
information or, if the person is a minor, the minor's parents, |
|
managing conservator, guardian, or other person who is legally |
|
authorized to consent; |
|
(3) to medical personnel, appropriate state agencies, |
|
health authorities, regional directors, and public officers of |
|
counties and municipalities as necessary to comply with this |
|
chapter and department [board] rules relating to the |
|
identification, monitoring, and referral of children with birth |
|
defects; |
|
(4) to appropriate federal agencies, such as the |
|
Centers for Disease Control and Prevention of the United States |
|
Public Health Service; or |
|
(5) to medical personnel to the extent necessary to |
|
protect the health or life of the child identified in the |
|
information. |
|
(d) The executive commissioner [A board member], the |
|
commissioner, another employee of the department, or an authorized |
|
agent may not be examined in a civil, criminal, special, or other |
|
proceeding as to the existence or contents of pertinent records of |
|
or reports or information about a child identified or monitored for |
|
a birth defect by the department without the consent of the child's |
|
parents, managing conservator, guardian, or other person |
|
authorized by law of this state or another state or by a court order |
|
to give consent. |
|
SECTION 3.0295. Section 87.021, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 87.021. SURVEILLANCE PROGRAM; REGISTRY ESTABLISHED. |
|
(a) The executive commissioner [board] shall establish in the |
|
department a program to: |
|
(1) identify and investigate certain birth defects in |
|
children; and |
|
(2) maintain a central registry of cases of birth |
|
defects. |
|
(b) The executive commissioner [board] may authorize the |
|
department to implement a statewide program or to limit the program |
|
to a part or all of one or more public health regions, depending on |
|
the funding available to the department. In establishing the |
|
program, the executive commissioner [board] shall consider: |
|
(1) the number and geographic distribution of births |
|
in the state; |
|
(2) the trained personnel and other departmental |
|
resources that may be assigned to the program activities; and |
|
(3) the occurrence or probable occurrence of an urgent |
|
situation that requires or will require an unusual commitment of |
|
the department's personnel and other resources. |
|
(c) The [board and the] department shall design the program |
|
so that the program will: |
|
(1) provide information to identify risk factors and |
|
causes of birth defects; |
|
(2) provide information on other possible causes of |
|
birth defects; |
|
(3) provide for the development of strategies to |
|
prevent birth defects; |
|
(4) provide for interview studies about the causes of |
|
birth defects; |
|
(5) together with other departmental programs, |
|
contribute birth defects data to a central registry; |
|
(6) provide for the appointment of authorized agents |
|
to collect birth defects information; and |
|
(7) provide for the active collection of birth defects |
|
information. |
|
(d) The executive commissioner [board] shall adopt rules to |
|
govern the operation of the program and carry out the intent of this |
|
chapter. At a minimum, the rules shall: |
|
(1) use a medically recognized system to specify the |
|
birth defects to be identified and investigated; |
|
(2) select a system for classifying the birth defects |
|
according to the public health significance of each defect to |
|
prioritize the use of resources; |
|
(3) develop a system to select and specify the cases to |
|
be investigated; |
|
(4) specify a system for selecting the demographic |
|
areas in which the department may undertake investigations; and |
|
(5) prescribe the training and experience a person |
|
must have for appointment as an authorized agent of the department. |
|
(e) In adopting the rules required by Subsection (d), the |
|
executive commissioner [board] shall consider at least: |
|
(1) the known incidence and prevalence rates of a |
|
birth defect in the state or portions of the state; |
|
(2) the known incidence and prevalence rates of a |
|
particular birth defect in specific population groups who live in |
|
the state or portions of the state; |
|
(3) the morbidity and mortality resulting from the |
|
birth defect; and |
|
(4) the existence, cost, and availability of a |
|
strategy to prevent and treat the birth defect. |
|
(f) In addition to providing for the active collection of |
|
birth defects information under Subsection (c)(7), the [board and
|
|
the] department may design the program to also provide for the |
|
passive collection of that information. |
|
SECTION 3.0296. Section 87.022, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 87.022. DATA COLLECTION. (a) To ensure an accurate |
|
source of data necessary to investigate the incidence, prevalence, |
|
and trends of birth defects, the executive commissioner [board] may |
|
require a health facility, health professional, or midwife to make |
|
available for review by the department or by an authorized agent |
|
medical records or other information that is in the facility's, |
|
professional's, or midwife's custody or control and that relates to |
|
the occurrence of a birth defect specified by the executive |
|
commissioner [board]. |
|
(b) The executive commissioner [board] by rule shall |
|
prescribe the manner in which records and other information are |
|
made available to the department. |
|
(c) The executive commissioner [board] shall adopt |
|
procedural rules to facilitate cooperation between the health care |
|
facility, health professional, or midwife and a department employee |
|
or authorized agent, including rules for notice, requests for |
|
medical records, times for record reviews, and record management |
|
during review. |
|
SECTION 3.0297. Section 87.023, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 87.023. REFERRAL FOR SERVICES. A child who meets the |
|
medical criteria prescribed by department [board] rule, and the |
|
child's family, shall be referred to the department's case |
|
management program for guidance in applying for financial or |
|
medical assistance available through existing state and federal |
|
programs. |
|
SECTION 3.0298. Sections 87.061(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The department shall use the registry to: |
|
(1) investigate the causes of birth defects and other |
|
health conditions as authorized by Texas statutes; |
|
(2) design and evaluate measures to prevent the |
|
occurrence of birth defects and other health conditions; and |
|
(3) conduct other investigations and activities |
|
necessary for the executive commissioner [board] and department to |
|
fulfill their obligation to protect the health of the public. |
|
(c) The department may store in the central registry |
|
information that is obtained from the section of the birth |
|
certificate entitled "For Medical and Health Use Only." This |
|
information may be used only as provided by Section 192.002(b), |
|
[191.002(b),] relating to the form and contents of the birth |
|
certificate. |
|
SECTION 3.0299. Section 87.063(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The commissioner and the department's committee for the |
|
protection of human subjects shall review each research proposal |
|
that requests the use of information in the central registry. The |
|
executive commissioner [board] shall adopt rules establishing |
|
criteria to be used in deciding if the research design should be |
|
approved. A proposal that meets the approval criteria is |
|
considered to establish a valid interest as required by Section |
|
87.062(a), and the commissioner and the committee shall authorize |
|
the researcher to review the records relevant to the research |
|
proposal and to contact cases and controls. |
|
SECTION 3.0300. Sections 88.001(6), (7), (9), and (11), |
|
Health and Safety Code, are amended to read as follows: |
|
(6) "Reference level" ["Blood lead levels of concern"] |
|
means the presence of blood lead concentrations suspected to be |
|
associated with mental and physical disorders due to absorption, |
|
ingestion, or inhalation of lead as specified in the most recent |
|
reference value [criteria] issued by the [United States Department
|
|
of Health and Human Services, United States Public Health Service,] |
|
Centers for Disease Control and Prevention of the United States |
|
Public Health Service. |
|
(7) "Lead poisoning" means the presence of a confirmed |
|
venous blood level established by department [board] rule in the |
|
range specified for medical evaluation and possible pharmacologic |
|
treatment in the most recent criteria issued by the [United States
|
|
Department of Health and Human Services, United States Public
|
|
Health Service,] Centers for Disease Control and Prevention of the |
|
United States Public Health Service. |
|
(9) "Physician" means a person licensed to practice |
|
medicine by the Texas [State Board of] Medical Board [Examiners]. |
|
(11) "Regional director" means a physician appointed |
|
under Section 121.007 [by the board] as the chief administrative |
|
officer of a public health region as designated under Chapter 121. |
|
SECTION 3.0301. Sections 88.002(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) Except as specifically authorized by this chapter, |
|
reports, records, and information furnished to a health authority, |
|
a regional director, or the department that relate to cases or |
|
suspected cases of children with reportable blood lead levels [of
|
|
concern or
lead poisoning] are confidential and may be used only for |
|
the purposes of this chapter. |
|
(b) Reports, records, and information relating to cases or |
|
suspected cases of childhood lead poisoning and children with |
|
reportable blood lead levels [of concern] are not public |
|
information under the open records law, Chapter 552, Government |
|
Code, and may not be released or made public on subpoena or |
|
otherwise except as provided by this chapter. |
|
(d) The commissioner, a regional director or other |
|
department employee, a health authority or employee of a public |
|
health district, a health authority or employee of a county or |
|
municipal health department, or a public official of a county or |
|
municipality may not be examined in a civil, criminal, special, or |
|
other proceeding as to the existence or contents of pertinent |
|
records of or reports or information about a child identified, |
|
examined, or treated for lead poisoning or about a child possessing |
|
reportable blood lead levels [of concern] by the department, a |
|
public health district, a local health department, or a health |
|
authority without the consent of the child's parents, managing |
|
conservator, guardian, or other person authorized by law to give |
|
consent. |
|
SECTION 3.0302. Section 88.0025, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 88.0025. CHILDHOOD LEAD POISONING PREVENTION. The |
|
executive commissioner may adopt [board may implement] policies and |
|
procedures to promote the elimination of childhood lead poisoning |
|
within the state, and the department shall implement all adopted |
|
policies and procedures. The executive commissioner [board] may |
|
adopt measures to: |
|
(1) significantly reduce the incidence of childhood |
|
lead poisoning throughout the state; |
|
(2) improve public awareness of lead safety issues and |
|
educate both property owners and tenants about practices that can |
|
reduce the incidence of lead poisoning; and |
|
(3) encourage the testing of children likely to suffer |
|
the consequences of lead poisoning so that prompt diagnosis and |
|
treatment and the prevention of harm are possible. |
|
SECTION 3.0303. Section 88.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 88.003. REPORTABLE HEALTH CONDITION. (a) Childhood |
|
blood lead levels that exceed the reference level [of concern] are |
|
reportable. |
|
(b) The executive commissioner [board] by rule may |
|
designate: |
|
(1) blood lead concentrations in children that must be |
|
reported; and |
|
(2) the ages of children for whom the reporting |
|
requirements apply. |
|
(c) The executive commissioner [board] may adopt rules that |
|
establish a registry of children with blood lead levels that exceed |
|
the reference level [of concern] and lead poisoning. |
|
SECTION 3.0304. Section 88.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) A person |
|
required to report childhood blood lead levels [of concern] shall |
|
report to the department in the manner specified by department |
|
[board] rule. Except as provided by this section, a person required |
|
by this section to report must make the report immediately after the |
|
person gains knowledge of [the case or suspected case of] a child |
|
with a reportable blood lead level [of concern]. |
|
(b) A physician shall report a case or suspected case of |
|
childhood lead poisoning or of a child with a reportable blood lead |
|
level [of concern] after the physician's first examination of a |
|
child for whom reporting is required by this chapter or department |
|
[board] rule. |
|
(c) A person in charge of an independent clinical |
|
laboratory, a hospital or clinic laboratory, or other facility in |
|
which a laboratory examination of a specimen derived from the human |
|
body yields evidence of a child with a reportable blood lead level |
|
[of concern] shall report the findings to the department as |
|
required by department [board] rule. |
|
(d) If a report is not made as required by Subsection (b) or |
|
(c), the following persons shall report [a case or suspected case of
|
|
a child with lead poisoning or] a child's reportable blood lead |
|
level [of concern] and all information known concerning the child: |
|
(1) the administrator of a hospital licensed under |
|
Chapter 241; |
|
(2) a [professional] registered nurse; |
|
(3) an administrator or director of a public or |
|
private child care facility; |
|
(4) an administrator of a home and community support |
|
services [health] agency; |
|
(5) an administrator or health official of a public or |
|
private institution of higher education; |
|
(6) a superintendent, manager, or health official of a |
|
public or private camp, home, or institution; |
|
(7) a parent, managing conservator, or guardian; and |
|
(8) a health professional. |
|
SECTION 3.0305. Sections 88.005(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall prescribe the |
|
form and method of reporting under this chapter, including a report |
|
in writing, by telephone, or by electronic data transmission. |
|
(b) The executive commissioner by rule [Board rules] may |
|
require the reports to contain any information relating to a case |
|
that is necessary for the purposes of this chapter, including: |
|
(1) the child's name, address, age, sex, and race; |
|
(2) the child's blood lead concentration; |
|
(3) the procedure used to determine the child's blood |
|
lead concentration; and |
|
(4) the name of the attending physician. |
|
SECTION 3.0306. Section 88.006(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A physician who attends a child during the child's |
|
hospitalization shall immediately notify the department if the |
|
physician knows or suspects that the child has lead poisoning or a |
|
blood lead level that exceeds the reference level [of concern] and |
|
the physician believes the lead poisoning or blood lead level [of
|
|
concern] resulted from the child's exposure to a dangerous level of |
|
lead that may be a threat to the public health. |
|
SECTION 3.0307. Section 88.007, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 88.007. DEPARTMENT RULES FOR FOLLOW-UP CARE; |
|
COORDINATION OF CARE. (a) The executive commissioner [department] |
|
may adopt rules establishing standards for follow-up care provided |
|
to children with a confirmed blood lead level that exceeds the |
|
reference level [of concern]. |
|
(b) Rules adopted under this section must meet any federal |
|
requirements for coordinated follow-up care for children with |
|
confirmed blood lead levels that exceed the reference level [of
|
|
concern] and may include, in a manner consistent with current |
|
federal guidelines: |
|
(1) an environmental lead investigation of all or |
|
parts of a child's home environment, child-care facility, or |
|
child-occupied facility that may be a source of a lead hazard |
|
causing or contributing to the child's lead exposure; and |
|
(2) guidance to parents, guardians, and consulting |
|
physicians on how to eliminate or control lead exposures that may be |
|
contributing to the child's blood lead level. |
|
SECTION 3.0308. Section 88.009, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 88.009. ENVIRONMENTAL LEAD INVESTIGATION PROCEDURES. |
|
The executive commissioner [department] may adopt rules |
|
establishing procedures for environmental lead investigations of |
|
dwellings and other premises subject to this chapter. The rules |
|
must meet, but may not exceed, any requirements established under |
|
regulations adopted by the federal Environmental Protection Agency |
|
under Subchapter IV, Toxic Substances Control Act (15 U.S.C. |
|
Section 2681 et seq.). |
|
SECTION 3.0309. Section 89.001(5), Health and Safety Code, |
|
is amended to read as follows: |
|
(5) "Jail" means: |
|
(A) a county jail; or |
|
(B) a facility for the confinement of persons |
|
accused of an offense that is: |
|
(i) operated by a municipality or a vendor |
|
under contract with a municipality under Subchapter F [E], Chapter |
|
351, Local Government Code; or |
|
(ii) operated by a vendor under contract |
|
with a community supervision and corrections department under |
|
Chapter 76, Government Code. |
|
SECTION 3.0310. Section 89.011(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The governing body of a jail or community corrections |
|
facility, through the community supervision and corrections |
|
department, shall require that each employee or volunteer working |
|
or providing services in a jail or a community corrections |
|
facility, who meets the screening guidelines prescribed by |
|
department [board] rule, present to the governing body a |
|
certificate signed by a physician that states that: |
|
(1) the employee or volunteer has been tested for |
|
tuberculosis infection in accordance with department [board] |
|
rules; and |
|
(2) the results of the test indicate that the person |
|
does not have tuberculosis. |
|
SECTION 3.0311. Section 89.051(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Each inmate in a jail or community corrections facility |
|
shall undergo a screening test for tuberculosis infection approved |
|
by the executive commissioner [board] if: |
|
(1) the inmate will probably be confined in jail or a |
|
community corrections facility for more than seven days; and |
|
(2) the inmate meets the screening guidelines |
|
prescribed by department [board] rules. |
|
SECTION 3.0312. Section 89.073, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 89.073. ADOPTION OF LOCAL STANDARDS. (a) The |
|
standards prescribed by this chapter and the rules adopted by the |
|
executive commissioner [board] relating to screening tests or |
|
examinations for tuberculosis required for certain employees and |
|
volunteers are minimum standards. |
|
(b) With the prior approval of the department: |
|
(1) a governing body may adopt and enforce standards |
|
for carrying out this chapter if the standards are compatible with |
|
and equal to or more stringent than the standards prescribed by this |
|
chapter and department [the board's] rules; and |
|
(2) a private facility may adopt and enforce standards |
|
for carrying out this chapter if the standards are compatible with |
|
and equal to or more stringent than the standards prescribed by this |
|
chapter and department [the board's] rules. |
|
(c) The executive commissioner [board] shall adopt |
|
substantive and procedural rules to govern the submission of |
|
standards adopted under Subsection (b). At a minimum these rules |
|
must contain: |
|
(1) a procedure for the submission of standards for |
|
departmental review; and |
|
(2) an internal departmental appeal process by which a |
|
governing body or private entity may seek a review of the |
|
department's decision to reject proposed standards. |
|
SECTION 3.0313. Section 89.101(1), Health and Safety Code, |
|
is amended to read as follows: |
|
(1) "Corrections facility" means: |
|
(A) a jail or community corrections facility, |
|
without regard to whether the jail or facility satisfies the |
|
requirements of Section 89.002; |
|
(B) any correctional facility operated by or |
|
under contract with a division of the Texas Department of Criminal |
|
Justice; or |
|
(C) a detention facility operated by the Texas |
|
Juvenile Justice Department [Youth Commission]. |
|
SECTION 3.0314. Section 92.002, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 92.002. REPORTABLE INJURY; RULES. (a) Spinal cord |
|
injuries, traumatic brain injuries, and submersion injuries are |
|
reportable to the department. The executive commissioner [board] |
|
by rule shall define those terms for reporting purposes. |
|
(b) The executive commissioner [board] may adopt rules that |
|
require other injuries to be reported under this subchapter. |
|
(c) The executive commissioner [board] shall maintain and |
|
revise, as necessary, the list of reportable injuries. |
|
(d) The executive commissioner [board] shall adopt rules |
|
necessary to administer this subchapter. |
|
SECTION 3.0315. Section 92.003(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The department [board] shall prescribe the form and |
|
method of reporting. The department [board] may require the |
|
reports to contain any information, including the person's name, |
|
address, age, sex, race, occupation, employer, and attending |
|
physician, necessary to achieve the purposes of this subchapter. |
|
SECTION 3.0316. Section 92.004(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department may seek, receive, and spend any funds |
|
received through appropriations, grants, donations, or |
|
contributions from public or private sources for the purpose of |
|
identifying, reporting, or preventing those injuries [that have
|
|
been] determined by the executive commissioner [board] to be |
|
harmful or to be a threat to the public health. |
|
SECTION 3.0317. Sections 92.006(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
establishing procedures to ensure that all information and records |
|
maintained by the department under this subchapter are kept |
|
confidential and protected from release to unauthorized persons. |
|
(c) The commissioner [director], the commissioner's |
|
[director's] designee, the executive commissioner, or an employee |
|
of the department or commission may not be examined in a judicial or |
|
other proceeding about the existence or contents of pertinent |
|
records of, investigation reports of, or reports or information |
|
about a person examined or treated for an injury without that |
|
person's consent. |
|
SECTION 3.0318. Sections 92.007(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The department [director or the director's designee] |
|
may enter at reasonable times and inspect within reasonable limits |
|
a public place or building, including a public conveyance, in the |
|
department's [director's] duty to prevent an injury. |
|
(c) The department [director or the director's designee] |
|
may not enter a private residence to conduct an investigation about |
|
the causes of injuries without first receiving permission from a |
|
lawful adult occupant of the residence. |
|
SECTION 3.0319. Section 92.010, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 92.010. COORDINATION WITH DEPARTMENT OF ASSISTIVE AND |
|
REHABILITATIVE SERVICES [TEXAS REHABILITATION COMMISSION]. The |
|
department and the Department of Assistive and Rehabilitative |
|
Services [Texas Rehabilitation Commission] shall enter into a |
|
memorandum of understanding to: |
|
(1) exchange relevant injury data on an ongoing basis |
|
notwithstanding Section 92.006; |
|
(2) maintain the confidentiality of injury data |
|
provided to the department by the Department of Assistive and |
|
Rehabilitative Services [commission] in accordance with Section |
|
92.006 and Section 111.057, Human Resources Code; and |
|
(3) cooperate in conducting investigations of spinal |
|
cord and traumatic brain injuries. |
|
SECTION 3.0320. Section 92.011(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department and the Texas Traumatic Brain Injury |
|
Advisory Council established [within the department] under |
|
Subchapter B shall: |
|
(1) exchange relevant injury data on an ongoing basis |
|
to the extent allowed by Section 92.006; |
|
(2) maintain the confidentiality of injury data |
|
provided to the council by the department in accordance with |
|
Section 92.006; |
|
(3) permit the council to review and comment on the |
|
department's [board's] rules under Section 92.002(b) before the |
|
rules are proposed; and |
|
(4) cooperate in conducting investigations of |
|
traumatic brain injuries. |
|
SECTION 3.0321. Section 92.052, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 92.052. ADVISORY COUNCIL[; ASSOCIATED AGENCY]. [(a)] |
|
The Texas Traumatic Brain Injury Advisory Council is an advisory |
|
council within the commission [department]. |
|
[(b)
Notwithstanding Subsection (a), if, as a result of
|
|
legislation enacted in the 78th Legislature, Regular Session, 2003,
|
|
a state agency other than the department is designated to serve as
|
|
the agency with primary responsibility in relation to persons with
|
|
physical disabilities, the council is an advisory council within
|
|
that state agency and a reference in this chapter to the department
|
|
means that agency.] |
|
SECTION 3.0322. Section 92.053(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The council is composed of 21 [22] members appointed as |
|
follows: |
|
(1) eight public consumer members appointed by the |
|
executive commissioner [of health and human services], at least |
|
three of whom must be individuals related to persons with a |
|
traumatic brain injury and at least three of whom must be persons |
|
with a brain injury; |
|
(2) six professional members appointed by the |
|
executive commissioner [of health and human services], each of whom |
|
must have special training and interest in the care, treatment, or |
|
rehabilitation of persons with a traumatic brain injury, with one |
|
representative each from: |
|
(A) acute hospital trauma units; |
|
(B) the National Institute on [for] Disability |
|
and Rehabilitation Research Traumatic Brain Injury Model System in |
|
this state; |
|
(C) acute or post-acute rehabilitation |
|
facilities; |
|
(D) community-based services; |
|
(E) faculties of institutions of higher |
|
education; and |
|
(F) providers in the areas of physical therapy, |
|
occupational therapy, or cognitive rehabilitation; and |
|
(3) seven [eight] state agency members, with one |
|
representative from each of the following agencies appointed by the |
|
chief executive officer of the agency: |
|
(A) [Texas] Department of State Health Services; |
|
(B) [Texas] Department of Aging and Disability |
|
[Human] Services; |
|
(C) Department of Assistive and Rehabilitative |
|
Services [Texas Department of Mental Health and Mental Retardation;
|
|
[(D) Texas Rehabilitation Commission]; |
|
(D) [(E)] Health and Human Services Commission; |
|
(E) [(F)] Texas Education Agency; |
|
(F) [(G)] Texas [Planning] Council for |
|
Developmental Disabilities; and |
|
(G) [(H)] Texas Department of Insurance. |
|
SECTION 3.0323. Section 92.057, Health and Safety Code, is |
|
amended by amending Subsections (b) and (c) and adding Subsection |
|
(b-1) to read as follows: |
|
(b) Except as provided by Subsection (b-1), a [A] member who |
|
is a representative of a state agency shall be reimbursed for travel |
|
expenses incurred while conducting council business from the funds |
|
of the agency the person represents in accordance with the General |
|
Appropriations Act. |
|
(b-1) A member who is a representative of a health and human |
|
services agency listed by Section 531.001(4), Government Code, |
|
shall be reimbursed for travel expenses incurred while conducting |
|
council business from the funds of the commission in accordance |
|
with the General Appropriations Act. |
|
(c) If money is available for this purpose in the account |
|
established under Section 92.062(b), the commission [department] |
|
shall reimburse a public consumer member for the member's actual |
|
and necessary expenses incurred in performing council duties, |
|
including travel, meals, lodging, respite care for a dependent with |
|
a disability, and telephone long-distance charges. |
|
SECTION 3.0324. Section 92.060, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 92.060. COMMISSION DUTIES [OF THE DEPARTMENT]. (a) |
|
The commission [department] shall: |
|
(1) provide administrative support services to the |
|
council; |
|
(2) accept gifts and grants on behalf of the council |
|
from any public or private entity; |
|
(3) receive, deposit, and disburse gifts and grants |
|
for the council in accordance with this subchapter and provide |
|
other administrative services in support of the council as |
|
requested by and negotiated with the council; and |
|
(4) enter into a memorandum of understanding with the |
|
council that delineates the responsibilities of the commission |
|
[department] and the council under this subchapter and amend the |
|
memorandum as necessary to reflect changes in those |
|
responsibilities. |
|
(b) The executive commissioner [board] may adopt rules as |
|
necessary to implement the commission's [department's] duties under |
|
this subchapter and federal developmental disability laws. |
|
SECTION 3.0325. Section 92.062(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The [health and human services] commission shall |
|
deposit any money received under Subsection (a) to the credit of the |
|
Texas Traumatic Brain Injury Advisory Council account. The Texas |
|
Traumatic Brain Injury Advisory Council account is an account in |
|
the general revenue fund that may be appropriated only for the |
|
purpose of carrying out this subchapter. |
|
SECTION 3.0326. Section 93.013(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The council may receive gifts and grants from any public |
|
or private source to perform its duties under this chapter. The |
|
department shall accept the gifts on behalf of the council [and
|
|
shall deposit any funds accepted under this section to the credit of
|
|
a special account in the general revenue fund as required by Section
|
|
93.014]. |
|
SECTION 3.0327. Section 93.014, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 93.014. FUNDS FOR CLINICAL RESEARCH [HEART DISEASE
|
|
AND STROKE RESOURCE FUND. (a) The heart disease and stroke
|
|
resource fund is an account of the general revenue fund]. |
|
[(b)
The legislature may appropriate money deposited to the
|
|
credit of the heart disease and stroke resource fund only to the
|
|
council for:
|
|
[(1)
heart disease and stroke prevention, research,
|
|
and medical care for heart attack and stroke victims; and
|
|
[(2)
grants to nonprofit heart disease and stroke
|
|
organizations.
|
|
[(c)] The council shall develop a policy governing the award |
|
of funds for clinical research that follows scientific peer review |
|
guidelines for primary and secondary prevention of heart disease or |
|
stroke or that follows other review procedures that are designed to |
|
distribute those funds on the basis of scientific merit. |
|
[(d)
Interest earned from the investment of the heart
|
|
disease and stroke resource fund shall be deposited to the credit of
|
|
the fund.] |
|
SECTION 3.0328. Section 94.004(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The department may charge a fee for the course to |
|
persons other than employees of entities receiving state or federal |
|
funds for hepatitis C counseling and testing programs through a |
|
contract with the department. The executive commissioner by rule |
|
[board] shall set the fee in an amount necessary to cover the costs |
|
of providing the course. |
|
SECTION 3.0329. Section 95.002(f), Health and Safety Code, |
|
is amended to read as follows: |
|
(f) The office shall: |
|
(1) provide educational and other material to assist |
|
local risk assessment activities; |
|
(2) monitor the quality of risk assessment activities |
|
provided under this chapter; and |
|
(3) consult with the Texas Board of Nursing [Nurse
|
|
Examiners] to determine the training requirements necessary for a |
|
nurse or other person to conduct risk assessment activities under |
|
this chapter. |
|
SECTION 3.0330. Section 95.051, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 95.051. DEFINITION [DEFINITIONS]. In this subchapter, |
|
"public[:
|
|
[(1)
"Department" means the Department of State Health
|
|
Services.
|
|
[(2)
"Executive commissioner" means the executive
|
|
commissioner of the Health and Human Services Commission.
|
|
[(3) "Public] health district" means a district |
|
created under Chapter 121. |
|
SECTION 3.0331. Section 95A.001, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 95A.001. DEFINITION [DEFINITIONS]. In this chapter, |
|
"council"[:
|
|
[(1)
"Commission" means the Health and Human Services
|
|
Commission.
|
|
[(2) "Council"] means the Texas Diabetes Council. |
|
SECTION 3.0332. Section 96.001(3), Health and Safety Code, |
|
is amended to read as follows: |
|
(3) "Health facility" includes: |
|
(A) a general or special hospital licensed by the |
|
department under Chapter 241; |
|
(B) a physician-owned or physician-operated |
|
clinic; |
|
(C) a publicly or privately funded medical |
|
school; |
|
(D) a state hospital operated [or state school
|
|
maintained and managed] by the department or a state supported |
|
living center operated by [Department of State Health Services or] |
|
the Department of Aging and Disability Services; |
|
(E) a public health clinic conducted by a local |
|
health unit, health department, or public health district organized |
|
and recognized under Chapter 121; and |
|
(F) another facility specified by a rule adopted |
|
by the executive commissioner. |
|
SECTION 3.0333. Section 98.110(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Notwithstanding any other law, the department may |
|
disclose information reported by health care facilities under |
|
Section 98.103 or 98.1045 to other programs within the department, |
|
to the commission [Health and Human Services Commission], to other |
|
health and human services agencies, as defined by Section 531.001, |
|
Government Code, and to the federal Centers for Disease Control and |
|
Prevention, or any other agency of the United States Department of |
|
Health and Human Services, for public health research or analysis |
|
purposes only, provided that the research or analysis relates to |
|
health care-associated infections or preventable adverse events. |
|
The privilege and confidentiality provisions contained in this |
|
chapter apply to such disclosures. |
|
SECTION 3.0334. Sections 101.001(1) and (3), Health and |
|
Safety Code, are amended to read as follows: |
|
(1) "Alzheimer's disease and related disorders support |
|
group" means a local, state, or national organization that: |
|
(A) is established to provide support services to |
|
aid persons with [victims of] Alzheimer's disease and related |
|
disorders and their caregivers; |
|
(B) encourages research into the cause, |
|
prevention, treatment, and care of persons with [victims of] |
|
Alzheimer's disease and related disorders; and |
|
(C) is dedicated to the development of essential |
|
services for persons with [victims of] Alzheimer's disease and |
|
related disorders and their caregivers. |
|
(3) "Primary family caregiver" means an individual who |
|
is a relative of a person with [victim of] Alzheimer's disease or |
|
related disorders, who has or has had a major responsibility for |
|
care and supervision of the person [victim], and who is not a |
|
professional health care provider paid to care for the person |
|
[victim]. |
|
SECTION 3.0335. Section 101.002(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The Texas Council on Alzheimer's Disease and Related |
|
Disorders is composed of: |
|
(1) five public members, one of whom is an individual |
|
related to a person with [victim of] Alzheimer's disease or related |
|
disorders but who is not a primary family caregiver, one of whom is |
|
a primary family caregiver, two of whom are members of an |
|
Alzheimer's disease and related disorders support group, and one of |
|
whom is an interested citizen; |
|
(2) seven professional members with special training |
|
and interest in Alzheimer's disease and related disorders, with one |
|
representative each from nursing facilities [homes], physicians, |
|
nurses, public hospitals, private hospitals, home health agencies, |
|
and faculty of institutions of higher education; and |
|
(3) the [chief executive officer or the officer's
|
|
designated] representative from the commission, department, and |
|
[Texas] Department of [on] Aging and Disability Services designated |
|
by the executive commissioner or commissioner of each agency, as |
|
applicable[, Texas Department of Human Services, Texas Department
|
|
of Mental Health and Mental Retardation, and Long-Term Care
|
|
Coordinating Council for the Elderly]. |
|
SECTION 3.0336. Section 101.007(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The council shall: |
|
(1) advise the department [board] and recommend needed |
|
action for the benefit of persons with [victims of] Alzheimer's |
|
disease and related disorders and for their caregivers; |
|
(2) coordinate public and private family support |
|
networking systems for primary family caregivers; |
|
(3) disseminate information on services and related |
|
activities for persons with [victims of] Alzheimer's disease and |
|
related disorders to the medical and health care community, the |
|
academic community, primary family caregivers, advocacy |
|
associations, and the public; |
|
(4) coordinate a volunteer assistance program |
|
primarily for in-home and respite care services; |
|
(5) encourage research to benefit persons with |
|
[victims of] Alzheimer's disease and related disorders; |
|
(6) recommend to the department [board] disbursement |
|
of grants and funds available for the council; and |
|
(7) facilitate coordination of state agency services |
|
and activities relating to persons with [victims of] Alzheimer's |
|
disease and related disorders. |
|
SECTION 3.0337. Section 101.008, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 101.008. DUTIES OF DEPARTMENT. The department shall: |
|
(1) provide administrative assistance, services, and |
|
materials to the council; |
|
(2) accept, deposit, and disburse funds made available |
|
to the council at the direction of the executive commissioner |
|
[board]; |
|
(3) accept gifts and grants on behalf of the council |
|
from any public or private entity; |
|
(4) maintain a population data base of persons with |
|
[victims of] Alzheimer's disease and related disorders in this |
|
state; and |
|
(5) apply for and receive on behalf of the council any |
|
appropriations, gifts, or other funds from the state or federal |
|
government or any other public or private entity, subject to |
|
limitations and conditions prescribed by legislative |
|
appropriation. |
|
SECTION 3.0338. Section 101.009(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department [board] shall deposit any money received |
|
under Subsection (a) in the state treasury [to the credit of the
|
|
Alzheimer's disease and related disorders council fund] to be used |
|
for the purposes of this chapter. |
|
SECTION 3.0339. Section 101.010, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 101.010. REPORT. Before September 1 of each |
|
even-numbered year, the council shall submit a biennial report of |
|
the council's activities and recommendations to the governor, |
|
lieutenant governor, speaker of the house of representatives, and |
|
members of the legislature[, Long-Term Care Coordinating Council
|
|
for the Elderly, and board]. |
|
SECTION 3.0340. Sections 103.002(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The Texas Diabetes Council is composed of 11 citizen |
|
members appointed from the public and one representative each from |
|
the department, the commission [Health and Human Services
|
|
Commission], and the Department of Assistive and Rehabilitative |
|
Services. |
|
(b) The governor, with the advice and consent of the senate, |
|
shall appoint the following citizen members: |
|
(1) a licensed physician with a specialization in |
|
treating diabetes; |
|
(2) a registered nurse with a specialization in |
|
diabetes education and training; |
|
(3) a registered and licensed dietitian with a |
|
specialization in the diabetes education field; |
|
(4) a person with experience and training in public |
|
health policy; |
|
(5) three consumer members, with special |
|
consideration given to persons active in the Texas affiliates of |
|
the Juvenile Diabetes Research Foundation (JDRF) or the American |
|
Diabetes Association; and |
|
(6) four members from the general public with |
|
expertise or demonstrated commitment to diabetes issues. |
|
(c) The commissioner, executive commissioner, and |
|
commissioner of assistive and rehabilitative services [chairman of
|
|
the board of each agency listed in Subsection (a)] shall appoint |
|
that agency's representative to the council. Agency |
|
representatives shall be nonvoting members of the council. |
|
SECTION 3.0341. Section 103.008(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) If the office of a member who is an agency |
|
representative becomes vacant, the commissioner or executive |
|
commissioner, as appropriate, [chairman of the board] of that |
|
agency shall appoint an agency representative to serve for the |
|
remainder of that member's term. |
|
SECTION 3.0342. Section 103.009, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 103.009. REIMBURSEMENT. [(a)] The department shall |
|
reimburse council and advisory committee members for travel and |
|
other necessary expenses incurred in performing official duties as |
|
provided by Section 2110.004, Government Code [at the same rate
|
|
provided for state employees in the General Appropriations Act]. |
|
[(b)
Funds for travel reimbursement shall be appropriated
|
|
to the department.] |
|
SECTION 3.0343. Section 103.013(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The council shall make written recommendations for |
|
performing its duties under this chapter to the executive |
|
commissioner [board] and the legislature. If the council considers |
|
a recommendation that will affect an agency not represented on the |
|
council, the council shall seek the advice and assistance of the |
|
agency before taking action on the recommendation. The council's |
|
recommendations shall be implemented by the agencies affected by |
|
the recommendations. |
|
SECTION 3.0344. Section 103.0131(a), Health and Safety |
|
Code, is amended to read as follows: |
|
(a) In conjunction with developing each state plan |
|
described in Section 103.013, the council shall conduct a statewide |
|
assessment of existing programs for the prevention of diabetes and |
|
treatment of individuals with diabetes that are administered by the |
|
commission [Health and Human Services Commission] or a health and |
|
human services agency, as defined by Section 531.001, Government |
|
Code. As part of the assessment, the council shall collect data |
|
regarding: |
|
(1) the number of individuals served by the programs; |
|
(2) the areas where services to prevent diabetes and |
|
treat individuals with diabetes are unavailable; and |
|
(3) the number of health care providers treating |
|
individuals with diabetes under the programs. |
|
SECTION 3.0345. Section 103.015(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The council may receive gifts and grants from any public |
|
or private source to perform its duties under this chapter. The |
|
department shall accept the gifts on behalf of the council and shall |
|
deposit any funds accepted under this section to the credit of [a
|
|
special account in] the general revenue fund. |
|
SECTION 3.0346. Sections 103.017(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department, commission, and [the] Department of |
|
Assistive and Rehabilitative Services[, and the Health and Human
|
|
Services Commission] shall work with the council to jointly |
|
develop, produce, and implement a general public awareness strategy |
|
focusing on diabetes, its complications, and techniques for |
|
achieving good management. Each agency shall pay for the costs of |
|
producing and disseminating information on diabetes to clients |
|
served by that agency. |
|
(c) The department, commission, and [the] Department of |
|
Assistive and Rehabilitative Services[, and the Health and Human
|
|
Services Commission] may jointly develop and implement a statewide |
|
plan for conducting regional training sessions for public and |
|
private service providers, including institutional health care |
|
providers, who have routine contact with persons with diabetes. |
|
SECTION 3.0347. Section 103A.007, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 103A.007. DUTIES OF COUNCIL. The council using |
|
existing resources may conduct studies and advise the department, |
|
the commission [Health and Human Services Commission], and the |
|
Texas Department of Insurance on: |
|
(1) public use data, outcome data, and other |
|
information submitted to or collected by the department under |
|
Chapter 108 or other law related to hemophilia or other bleeding or |
|
clotting disorders and the department's disclosure and |
|
dissemination of that information within and outside the |
|
department; and |
|
(2) other issues that affect the health and wellness |
|
of persons living with hemophilia or other bleeding or clotting |
|
disorders. |
|
SECTION 3.0348. Section 104.011(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The statewide health coordinating council is composed |
|
of 17 members determined as follows: |
|
(1) the executive commissioner or a representative |
|
designated by the executive commissioner; |
|
(2) the chair of the Texas Higher Education |
|
Coordinating Board or a representative designated by the presiding |
|
officer; |
|
(3) the commissioner or a representative designated by |
|
the commissioner; |
|
(4) the commissioner [presiding officer] of aging [the
|
|
Department of Aging] and disability services [Disability Services] |
|
or a representative designated by the commissioner of aging and |
|
disability services [presiding officer]; and |
|
(5) the following members appointed by the governor: |
|
(A) three health care professionals from the |
|
allied health, dental, medical, mental health, and pharmacy |
|
professions, no two of whom may be from the same profession; |
|
(B) one registered nurse; |
|
(C) two representatives of a university or |
|
health-related institution of higher education; |
|
(D) one representative of a junior or community |
|
college with a nursing program; |
|
(E) one hospital administrator; |
|
(F) one managed care administrator; and |
|
(G) four public members. |
|
SECTION 3.0349. Section 104.0112(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) If the executive commissioner has knowledge that a |
|
potential ground for removal exists, the executive commissioner |
|
shall notify the presiding officer of the council of the potential |
|
ground. The presiding officer shall then notify the governor and |
|
the attorney general that a potential ground for removal exists. If |
|
the potential ground for removal involves the presiding officer, |
|
the executive commissioner shall notify the next highest ranking |
|
officer of the council, who shall then notify the governor and the |
|
attorney general that a potential ground for removal exists. |
|
SECTION 3.0350. Section 104.023, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 104.023. REVIEW OF STATE HEALTH PLAN. The statewide |
|
health coordinating council shall submit the state health plan to |
|
the commission [Health and Human Services Commission] for review |
|
and comment before the plan is sent to the governor. |
|
SECTION 3.0351. Section 104.043(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) If the department does not receive necessary data from |
|
an entity as required by department [the executive commissioner's] |
|
rules, the department shall send to the entity a notice requiring |
|
the entity to submit the data not later than the 30th day after the |
|
date on which the entity receives the notice. |
|
SECTION 3.0352. Section 105.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 105.005. RULES. The executive commissioner [of the
|
|
Health and Human Services Commission] may adopt rules to govern the |
|
reporting and collection of data. |
|
SECTION 3.0353. Section 107A.001, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 107A.001. CENTER FOR ELIMINATION OF |
|
DISPROPORTIONALITY AND DISPARITIES. The executive commissioner |
|
[of the Health and Human Services Commission] shall maintain a |
|
center for elimination of disproportionality and disparities in the |
|
commission [Health and Human Services Commission] to: |
|
(1) assume a leadership role in working or contracting |
|
with state and federal agencies, universities, private interest |
|
groups, communities, foundations, and offices of minority health to |
|
develop health initiatives to decrease or eliminate health and |
|
health access disparities among racial, multicultural, |
|
disadvantaged, ethnic, and regional populations, including |
|
appropriate language services; and |
|
(2) maximize use of existing resources without |
|
duplicating existing efforts. |
|
SECTION 3.0354. Section 107A.003, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 107A.003. FUNDING. The commission [Health and Human
|
|
Services Commission] may distribute to the center unobligated and |
|
unexpended appropriations to be used to carry out its powers. |
|
SECTION 3.0355. Chapter 108, Health and Safety Code, is |
|
amended to read as follows: |
|
CHAPTER 108. [TEXAS] HEALTH CARE DATA COLLECTION [INFORMATION
|
|
COUNCIL] |
|
Sec. 108.001. DEPARTMENT DUTIES [CREATION OF COUNCIL]. The |
|
department [Texas Health Care Information Council] shall |
|
administer this chapter and report to the governor, the |
|
legislature, and the public. |
|
Sec. 108.002. DEFINITIONS. In this chapter: |
|
(1) "Accurate and consistent data" means data that has |
|
been edited by the department [council] and subject to provider |
|
validation and certification. |
|
[(2) "Board" means the Texas Board of Health.] |
|
(3) "Certification" means the process by which a |
|
provider confirms the accuracy and completeness of the data set |
|
required to produce the public use data file in accordance with |
|
department [council] rule. |
|
(4) "Charge" or "rate" means the amount billed by a |
|
provider for specific procedures or services provided to a patient |
|
before any adjustment for contractual allowances. The term does |
|
not include copayment charges to enrollees in health benefit plans |
|
charged by providers paid by capitation or salary. |
|
(4-a) "Commission" means the Health and Human Services |
|
Commission. |
|
(6) "Data" means information collected under Section |
|
108.0065 or 108.009 in the form initially received. |
|
[(7)
"Department" means the Department of State Health
|
|
Services.] |
|
(8) "Edit" means to use an electronic standardized |
|
process developed and implemented by department [council] rule to |
|
identify potential errors and mistakes in data elements by |
|
reviewing data fields for the presence or absence of data and the |
|
accuracy and appropriateness of data. |
|
[(8-a)
"Executive commissioner" means the executive
|
|
commissioner of the Health and Human Services Commission.] |
|
(9) "Health benefit plan" means a plan provided by: |
|
(A) a health maintenance organization; or |
|
(B) an approved nonprofit health corporation |
|
that is certified under Section 162.001, Occupations Code, and that |
|
holds a certificate of authority issued by the commissioner of |
|
insurance under Chapter 844, Insurance Code. |
|
(10) "Health care facility" means: |
|
(A) a hospital; |
|
(B) an ambulatory surgical center licensed under |
|
Chapter 243; |
|
(C) a chemical dependency treatment facility |
|
licensed under Chapter 464; |
|
(D) a renal dialysis facility; |
|
(E) a birthing center; |
|
(F) a rural health clinic; |
|
(G) a federally qualified health center as |
|
defined by 42 U.S.C. Section 1396d(l)(2)(B); or |
|
(H) a free-standing imaging center. |
|
(11) "Health maintenance organization" means an |
|
organization as defined in Section 843.002, Insurance Code. |
|
(12) "Hospital" means a public, for-profit, or |
|
nonprofit institution licensed or owned by this state that is a |
|
general or special hospital, private mental hospital, chronic |
|
disease hospital, or other type of hospital. |
|
(13) "Outcome data" means measures related to the |
|
provision of care, including: |
|
(A) patient demographic information; |
|
(B) patient length of stay; |
|
(C) mortality; |
|
(D) co-morbidity; |
|
(E) complications; and |
|
(F) charges. |
|
(14) "Physician" means an individual licensed under |
|
the laws of this state to practice medicine under Subtitle B, Title |
|
3, Occupations Code. |
|
(15) "Provider" means a physician or health care |
|
facility. |
|
(16) "Provider quality" means the extent to which a |
|
provider renders care that, within the capabilities of modern |
|
medicine, obtains for patients medically acceptable health |
|
outcomes and prognoses, after severity adjustment. |
|
(17) "Public use data" means patient level data |
|
relating to individual hospitalizations that has not been |
|
summarized or analyzed, that has had patient identifying |
|
information removed, that identifies physicians only by use of |
|
uniform physician identifiers, and that is severity and risk |
|
adjusted, edited, and verified for accuracy and consistency. |
|
Public use data may exclude some data elements submitted to the |
|
department [council]. |
|
(19) "Severity adjustment" means a method to stratify |
|
patient groups by degrees of illness and mortality. |
|
(20) "Uniform patient identifier" means a number |
|
assigned by the department [council] to an individual patient and |
|
composed of numeric, alpha, or alphanumeric characters. |
|
(21) "Uniform physician identifier" means a number |
|
assigned by the department [council] to an individual physician and |
|
composed of numeric, alpha, or alphanumeric characters. |
|
(22) "Validation" means the process by which a |
|
provider verifies the accuracy and completeness of data and |
|
corrects any errors identified before certification in accordance |
|
with department [council] rule. |
|
[Sec. 108.0026.
TRANSFER OF DUTIES; REFERENCE TO COUNCIL.
|
|
(a)
The powers and duties of the Texas Health Care Information
|
|
Council under this chapter were transferred to the Department of
|
|
State Health Services in accordance with Section 1.19, Chapter 198
|
|
(H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003.
|
|
[(b)
In this chapter or other law, a reference to the Texas
|
|
Health Care Information Council means the Department of State
|
|
Health Services.
|
|
[Sec.
108.003.
COUNCIL COMPOSITION; EXPENSES. (a) The
|
|
council is composed of four ex officio state agency members and 15
|
|
members appointed by the governor in accordance with this section.
|
|
[(b) The ex officio members of the council are:
|
|
[(1)
the commissioner of public health or the
|
|
commissioner's designee;
|
|
[(2)
the commissioner of health and human services or
|
|
the commissioner's designee;
|
|
[(3)
the commissioner of insurance or the
|
|
commissioner's designee; and
|
|
[(4)
the public insurance counsel or the counsel's
|
|
designee.
|
|
[(c)
The governor shall appoint the following members of the
|
|
council:
|
|
[(1)
three representatives of the business community,
|
|
with at least one representing small businesses, who are purchasers
|
|
of health care but who are not involved in the provision of health
|
|
care or health insurance;
|
|
[(2)
two representatives from labor, one of whom is
|
|
not directly involved with management of health care benefits;
|
|
[(3)
two representatives of consumers who are not
|
|
professionally involved in the purchase, provision,
|
|
administration, or review of health care or health care insurance;
|
|
[(4) two representatives of hospitals;
|
|
[(5)
one representative of health maintenance
|
|
organizations;
|
|
[(6)
three representatives of physicians who are
|
|
involved in direct patient care; and
|
|
[(7)
two members who are not professionally involved
|
|
in the purchase, provision, administration, or utilization review
|
|
of health care or health care insurance and who have expertise in:
|
|
[(A) health planning;
|
|
[(B) health economics;
|
|
[(C) provider quality assurance;
|
|
[(D) information systems; or
|
|
[(E)
the reimbursement of medical education and
|
|
research costs.
|
|
[(d)
The chairman is appointed by and serves at the pleasure
|
|
of the governor. Members annually shall elect a vice chairman.
|
|
[(e)
A majority of voting members constitutes a quorum for
|
|
the transaction of any business. An act by the majority of the
|
|
voting members present at any meeting at which there is a quorum is
|
|
considered to be an act of the council.
|
|
[(f)
The council may appoint committees and may elect any
|
|
officers subordinate to those provided for in Subsection (d).
|
|
[(g)
The council shall appoint technical advisory
|
|
committees and shall consult with the appropriate technical
|
|
advisory committee with respect to a rule before the rule is finally
|
|
adopted by the council. The council is not required to consult with
|
|
a technical advisory committee before adopting an emergency rule in
|
|
accordance with Section 2001.034, Government Code. The council
|
|
shall submit an emergency rule adopted by the council to the
|
|
appropriate advisory committee for review not later than the first
|
|
advisory committee meeting that occurs after the rule is adopted.
|
|
The council may consult with the appropriate technical advisory
|
|
committee with respect to other formal action of the council. A
|
|
technical advisory committee may consult with other professionals
|
|
as necessary. Chapter 2110, Government Code, does not apply to an
|
|
advisory committee appointed under this subsection. The technical
|
|
advisory committees shall include:
|
|
[(1)
a technical advisory committee that includes,
|
|
among other individuals, at least five practicing physicians
|
|
licensed in this state to provide advice and recommendations to the
|
|
council on the development and implementation of the methodology
|
|
and the interpretation of a provider quality report and data under
|
|
Section 108.010;
|
|
[(2)
a technical advisory committee composed of at
|
|
least five practicing physicians licensed in this state who have
|
|
been actively engaged in organized peer review at a hospital in this
|
|
state to provide advice, recommendations, and peer review expertise
|
|
to the council on:
|
|
[(A)
the use of peer review in the determination
|
|
of quality inpatient care;
|
|
[(B)
the development and interpretation of data
|
|
elements necessary to the determination of quality inpatient care;
|
|
and
|
|
[(C)
the development and format of reports and
|
|
information relating to provider quality;
|
|
[(3)
a technical advisory committee that includes
|
|
providers and consumers to provide advice and recommendations to
|
|
the council relating to education about the development and
|
|
dissemination of provider reports and data;
|
|
[(4)
a technical advisory committee that includes
|
|
representatives of consumers and each type of issuer of health
|
|
benefit plans to assist the council in complying with Section
|
|
108.009(o); and
|
|
[(5)
a technical advisory committee composed of
|
|
providers, consumers, and individuals who have expertise in
|
|
hospital information systems, health information management,
|
|
quality management, and security of confidential data.
|
|
[(h)
A member of the council may not receive compensation
|
|
for service on the council. However, the member shall be reimbursed
|
|
for the member's actual and necessary meals, lodging,
|
|
transportation, and incidental expenses if incurred while
|
|
performing council business.
|
|
[(i)
A member of an advisory committee appointed by the
|
|
council may not receive compensation or reimbursement of any
|
|
expense incurred while serving on the committee.
|
|
[(j)
Appointments to the council shall be made without
|
|
regard to the race, color, disability, sex, religion, age, or
|
|
national origin of appointees. Additionally, in making the
|
|
appointments to the council, the governor shall consider
|
|
geographical representation.
|
|
[(k)
A person may not serve as a member of the council if the
|
|
person is required to register as a lobbyist under Chapter 305,
|
|
Government Code, because of the person's activities for
|
|
compensation on behalf of a profession related to the operation of
|
|
the council.
|
|
[Sec.
108.004.
MEETINGS. (a) The council, council
|
|
committees, and technical advisory committees are subject to the
|
|
open meetings law, Chapter 551, Government Code.
|
|
[(b)
The council shall meet as often as necessary, but not
|
|
less often than quarterly, to perform its duties under this
|
|
chapter.
|
|
[(c)
The council shall publish a notice of its meetings in
|
|
the Texas Register.
|
|
[Sec.
108.0045.
OPEN RECORDS. Subject to the restrictions
|
|
of this chapter, the council is subject to the open records law,
|
|
Chapter 552, Government Code.
|
|
[Sec.
108.005.
TERMS. (a) The terms of the agency members
|
|
are concurrent with their terms of office. The appointed council
|
|
members serve six-year staggered terms, with the terms of five
|
|
members expiring September 1 of each odd-numbered year.
|
|
[(b)
An appointed member may not serve more than two full
|
|
consecutive terms.
|
|
[(c)
It is a ground for removal from the council if a member
|
|
of the council:
|
|
[(1)
does not have at the time of appointment the
|
|
qualifications required by Section 108.003;
|
|
[(2)
does not maintain during service the
|
|
qualifications required by Section 108.003;
|
|
[(3)
cannot discharge the member's duties for a
|
|
substantial part of the term for which the member is appointed
|
|
because of illness or disability; or
|
|
[(4)
fails to attend at least one-half of the
|
|
regularly scheduled meetings that the member is eligible to attend
|
|
during a calendar year.] |
|
Sec. 108.006. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER |
|
AND DEPARTMENT [COUNCIL]. (a) The department [council] shall |
|
develop a statewide health care data collection system to collect |
|
health care charges, utilization data, provider quality data, and |
|
outcome data to facilitate the promotion and accessibility of |
|
cost-effective, good quality health care. The executive |
|
commissioner or department, as applicable, [council] shall perform |
|
the following duties: |
|
(1) the department shall direct the collection, |
|
dissemination, and analysis of data under this chapter; |
|
(2) [contract with] the department shall [to] collect |
|
the data under this chapter; |
|
(3) the executive commissioner shall adopt policies |
|
and rules necessary to carry out this chapter, including rules |
|
concerning data collection requirements; |
|
(4) the department shall build on and not duplicate |
|
other data collection required by state or federal law, by an |
|
accreditation organization, or by department [board] rule; |
|
(5) working with appropriate agencies, the |
|
department, with the approval of the executive commissioner, shall |
|
review public health data collection programs in this state and |
|
recommend, where appropriate, consolidation of the programs and any |
|
legislation necessary to effect the consolidation; |
|
(6) the department shall assure that public use data |
|
is made available and accessible to interested persons; |
|
(7) the executive commissioner shall prescribe by rule |
|
the process for providers to submit data consistent with Section |
|
108.009; |
|
(8) the executive commissioner shall adopt by rule and |
|
the department shall implement a methodology to collect and |
|
disseminate data reflecting provider quality in accordance with |
|
Section 108.010; |
|
(9) the department shall make reports to the |
|
legislature, the governor, and the public on: |
|
(A) the charges and rate of change in the charges |
|
for health care services in this state; |
|
(B) the effectiveness of the department |
|
[council] in carrying out the legislative intent of this chapter; |
|
(C) if applicable, any recommendations on the |
|
need for further legislation; and |
|
(D) the quality and effectiveness of health care |
|
and access to health care for all citizens of this state; |
|
(10) the department shall develop an annual work plan |
|
and establish priorities to accomplish its duties; |
|
(11) the department shall provide consumer education |
|
on the interpretation and understanding of the public use or |
|
provider quality data before the data is disseminated to the |
|
public; |
|
(12) the department shall work with the commission |
|
[Health and Human Services Commission] and each health and human |
|
services agency that administers a part of the state Medicaid |
|
program to avoid duplication of expenditures of state funds for |
|
computer systems, staff, or services in the collection and analysis |
|
of data relating to the state Medicaid program; |
|
(13) the department shall work with the Department of |
|
Information Resources in developing and implementing the statewide |
|
health care data collection system and maintain consistency with |
|
Department of Information Resources standards; and |
|
(14) the department shall develop and implement a |
|
health care information plan [to be used by the department] to: |
|
(A) support public health and preventative |
|
health initiatives; |
|
(B) assist in the delivery of primary and |
|
preventive health care services; |
|
(C) facilitate the establishment of appropriate |
|
benchmark data to measure performance improvements; |
|
(D) establish and maintain a systematic approach |
|
to the collection, storage, and analysis of health care data for |
|
longitudinal, epidemiological, and policy impact studies; and |
|
(E) develop and use system-based protocols to |
|
identify individuals and populations at risk. |
|
(b) The department [council] may: |
|
(1) employ a [or contract with the department to
|
|
employ an executive] director and other staff, including |
|
administrative personnel, necessary to comply with this chapter and |
|
rules adopted under this chapter; |
|
(2) engage professional consultants as it considers |
|
necessary to the performance of its duties; and |
|
(3) [adopt rules clarifying which health care
|
|
facilities must provide data under this chapter; and
|
|
[(4)] apply for and receive any appropriation, |
|
donation, or other funds from the state or federal government or any |
|
other public or private source, subject to Section 108.015 and |
|
limitations and conditions provided by legislative appropriation. |
|
(b-1) The executive commissioner may adopt rules clarifying |
|
which health care facilities must provide data under this chapter. |
|
(c) The department [council] may not establish or recommend |
|
rates of payment for health care services. |
|
(d) The department [council] may not take an action that |
|
affects or relates to the validity, status, or terms of an |
|
interagency agreement [or a contract with the department] without |
|
the executive commissioner's [board's] approval. |
|
(e) In the collection of data, the department [council] |
|
shall consider the research and initiatives being pursued by the |
|
United States Department of Health and Human Services, the National |
|
Committee for Quality Assurance, and The [the] Joint Commission [on
|
|
Accreditation of Healthcare Organizations] to reduce potential |
|
duplication or inconsistencies. The executive commissioner |
|
[council] may not adopt rules that conflict with or duplicate any |
|
federally mandated data collection programs or requirements of |
|
comparable scope. |
|
(f) The executive commissioner [council] shall prescribe by |
|
rule a public use data file minimum data set that maintains patient |
|
confidentiality and establishes data accuracy and consistency. |
|
(g) The public use data file minimum data set as defined by |
|
department [council] rule is subject to annual review by the |
|
department [council with the assistance of the advisory committee
|
|
under Section 108.003(g)(5)]. The purpose of the review is to |
|
evaluate requests to modify the existing minimum data set and |
|
editing process. A decision to modify the minimum data set by the |
|
addition or deletion of data elements shall include consideration |
|
of the value of the specific data to be added or deleted and the |
|
technical feasibility of establishing data accuracy and |
|
consistency. The department [council] may also consider the costs |
|
to the department [council] and providers associated with modifying |
|
the minimum data set. |
|
(h) In accordance with Section 108.0135, the department |
|
[council] may release data collected under Section 108.009 that is |
|
not included in the public use data file minimum data set |
|
established under Subsection (f). |
|
[Sec.
108.0062.
DRUG PURCHASING COOPERATIVES. (a) The
|
|
council shall develop criteria for evaluating drug purchasing
|
|
cooperatives that purchase drugs on behalf of consumers and create
|
|
an evaluation form for consumers to evaluate drug purchasing
|
|
cooperatives.
|
|
[(b)
The council shall distribute the evaluation forms to
|
|
the department, local health departments, the Texas Department of
|
|
Insurance, and the consumer protection division of the office of
|
|
the attorney general.
|
|
[(c)
The council shall compile the information from
|
|
completed evaluation forms and make the information available to
|
|
the public.] |
|
Sec. 108.0065. POWERS AND DUTIES OF COMMISSION AND |
|
DEPARTMENT [COUNCIL] RELATING TO MEDICAID MANAGED CARE. (a) In |
|
this section,[:
|
|
[(1)
"Commission" means the Health and Human Services
|
|
Commission.
|
|
[(2)] "Medicaid managed care organization" means a |
|
managed care organization, as defined by Section 533.001, |
|
Government Code, that is contracting with the commission to |
|
implement the Medicaid managed care program under Chapter 533, |
|
Government Code. |
|
(b) The commission may direct the department [council] to |
|
collect data under this chapter with respect to Medicaid managed |
|
care organizations. The department [council] shall coordinate the |
|
collection of the data with the collection of data for health |
|
benefit plan providers, but with the approval of the commission may |
|
collect data in addition to the data otherwise required of health |
|
benefit plan providers. |
|
(c) Each Medicaid managed care organization shall provide |
|
to the department the data required by the executive commissioner |
|
[council] in the form required by the executive commissioner |
|
[council] or, if the data is also being submitted to the commission |
|
[or Medicaid operating agency], in the form required by the |
|
commission [or Medicaid operating agency]. |
|
(d) Dissemination of data collected under this section is |
|
subject to Sections 108.010, 108.011, 108.012, 108.013, 108.014, |
|
and 108.0141. |
|
(e) The commission shall analyze the data collected in |
|
accordance with this section and shall use the data to: |
|
(1) evaluate the effectiveness and efficiency of the |
|
Medicaid managed care system; |
|
(2) determine the extent to which Medicaid managed |
|
care does or does not serve the needs of Medicaid recipients in this |
|
state; and |
|
(3) assess the cost-effectiveness of the Medicaid |
|
managed care system in comparison to the fee-for-service system, |
|
considering any improvement in the quality of care provided. |
|
(h) The commission, using existing funds, may contract with |
|
an entity to comply with the requirements under Subsection (e). |
|
Sec. 108.007. REVIEW POWERS. (a) The [council, through
|
|
the] department, [and] subject to reasonable rules and guidelines, |
|
may: |
|
(1) inspect documents and records used by data sources |
|
that are required to compile data and reports; and |
|
(2) compel providers to produce accurate documents and |
|
records. |
|
(b) The department [council] may enter into a memorandum of |
|
understanding with a state agency, including the division of the |
|
commission [Health and Human Services Commission] responsible for |
|
the state Medicaid program, or with a school of public health or |
|
another institution of higher education, to share data and |
|
expertise, to obtain data for the department [council], or to make |
|
data available to the department [council]. An agreement entered |
|
into under this subsection must protect patient confidentiality. |
|
[Sec.
108.008.
DUTIES OF DEPARTMENT. (a) The department,
|
|
as the state health planning and development agency under Chapter
|
|
104, is responsible for the collection of data under Chapter 311.
|
|
[(b) The department shall:
|
|
[(1)
contract with the council to collect data under
|
|
this chapter;
|
|
[(2)
provide administrative assistance to the
|
|
council;
|
|
[(3)
coordinate administrative responsibilities with
|
|
the council to avoid unnecessary duplication of the collection of
|
|
data and other duties;
|
|
[(4)
on request of the council, give the council
|
|
access to data collected by the department;
|
|
[(5)
submit or assist in the council's budget request
|
|
to the legislature; and
|
|
[(6)
work with the Department of Information Resources
|
|
in developing and implementing the statewide health care data
|
|
collection system and maintain consistency with Department of
|
|
Information Resources standards.
|
|
[(c)
The department may not take an action that affects or
|
|
relates to the validity, status, or terms of an interagency
|
|
agreement or a contract with the council without the council's
|
|
approval.
|
|
[Sec.
108.0081.
MEMORANDUM OF UNDERSTANDING. The council
|
|
and the department shall enter into a memorandum of understanding
|
|
to implement the department's duties under Section 108.008(b). The
|
|
memorandum of understanding must address:
|
|
[(1) payroll and travel reimbursement services;
|
|
[(2) purchasing services;
|
|
[(3) personnel services;
|
|
[(4) budget management services;
|
|
[(5) computer support and maintenance services;
|
|
[(6) meeting coordination services;
|
|
[(7)
any other administrative support or other
|
|
services to be provided by the department for the council; and
|
|
[(8)
the manner in which the council will reimburse
|
|
the department for the cost of services provided by the department
|
|
for the council.] |
|
Sec. 108.0085. DUTIES OF ATTORNEY GENERAL. The attorney |
|
general shall furnish the department [council] with advice and |
|
legal assistance that may be required to implement this chapter. |
|
Sec. 108.009. DATA SUBMISSION AND COLLECTION. (a) The |
|
department [council] may collect, and, except as provided by |
|
Subsection [Subsections (c) and] (d), providers shall submit to the |
|
department [council] or another entity as determined by the |
|
department [council], all data required by this section. The data |
|
shall be collected according to uniform submission formats, coding |
|
systems, and other technical specifications necessary to make the |
|
incoming data substantially valid, consistent, compatible, and |
|
manageable using electronic data processing, if available. |
|
(b) The executive commissioner [council] shall adopt rules |
|
to implement the data submission requirements imposed by Subsection |
|
(a) in appropriate stages to allow for the development of efficient |
|
systems for the collection and submission of the data. A rule |
|
adopted by the executive commissioner [council] that requires |
|
submission of a data element that, before adoption of the rule, was |
|
not required to be submitted may not take effect before the 90th day |
|
after the date the rule is adopted and must take effect not later |
|
than the first anniversary after the date the rule is adopted. |
|
(d) The department [council] may not collect data from |
|
individual physicians or from an entity that is composed entirely |
|
of physicians and that is a professional association organized |
|
under the former Texas Professional Association Act (Article 1528f, |
|
Vernon's Texas Civil Statutes) or formed under the Texas |
|
Professional Association Law, as described by Section 1.008(l), |
|
Business Organizations Code, a limited liability partnership |
|
organized under former Section 3.08, Texas Revised Partnership Act |
|
(Article 6132b-3.08, Vernon's Texas Civil Statutes), or formed as |
|
described by Subchapter J, Chapter 152, Business Organizations |
|
Code, or a limited liability company organized under the former |
|
Texas Limited Liability Company Act (Article 1528n, Vernon's Texas |
|
Civil Statutes) or formed under the Texas Limited Liability Company |
|
Law, as described by Section 1.008(e), Business Organizations Code, |
|
except to the extent the entity owns and operates a health care |
|
facility in this state. This subsection does not prohibit the |
|
release of data about physicians using uniform physician |
|
identifiers that has been collected from a health care facility |
|
under this chapter. |
|
(e) The department [council] shall establish [the
|
|
department as] the single collection point for receipt of data from |
|
providers. With the approval of the executive commissioner |
|
[council and the board], the department may transfer collection of |
|
any data required to be collected by the department under any other |
|
law to the statewide health care data collection system. |
|
(f) The executive commissioner [council] may not require |
|
providers to submit data more frequently than quarterly, but |
|
providers may submit data on a more frequent basis. |
|
(g) The department [council] shall coordinate data |
|
collection with the data collection formats used by federally |
|
qualified health centers. To satisfy the requirements of this |
|
chapter: |
|
(1) a federally qualified health center shall submit |
|
annually to the department [council] a copy of the Medicaid cost |
|
report of federally qualified health centers; and |
|
(2) a provider receiving federal funds under 42 U.S.C. |
|
Section 254b or[,] 254c[, or 256] shall submit annually to the |
|
department [council] a copy of the Uniform Data System [Bureau of
|
|
Common Reporting Requirements] data report developed by the United |
|
States Department of [Public] Health and Human Services [Service]. |
|
(h) The department shall coordinate data collection with |
|
the data submission formats used by hospitals and other providers. |
|
The department shall accept data in the format developed by the |
|
American National Standards Institute or its successor or other |
|
nationally accepted standardized forms that hospitals and other |
|
providers use for other complementary purposes. |
|
(i) The executive commissioner [council] shall develop by |
|
rule reasonable alternate data submission procedures for providers |
|
that do not possess electronic data processing capacity. |
|
(k) The department [council] shall collect health care data |
|
elements relating to payer type, the racial and ethnic background |
|
of patients, and the use of health care services by consumers. The |
|
department [council] shall prioritize data collection efforts on |
|
inpatient and outpatient surgical and radiological procedures from |
|
hospitals, ambulatory surgical centers, and free-standing imaging |
|
[radiology] centers. |
|
(m) To the extent feasible, the department [council] shall |
|
obtain from public records the information that is available from |
|
those records. |
|
(o) A provider of a health benefit plan shall annually |
|
submit to the department [council] aggregate data by service area |
|
required by the Healthcare Effectiveness [Health Plan Employer] |
|
Data and Information Set (HEDIS) as operated by the National |
|
Committee for Quality Assurance. The department [council] may |
|
approve the submission of data in accordance with other methods |
|
generally used by the health benefit plan industry. If the |
|
Healthcare Effectiveness [Health Plan Employer] Data and |
|
Information Set does not generally apply to a health benefit plan, |
|
the department [council] shall require submission of data in |
|
accordance with other methods. This subsection does not relieve a |
|
health care facility that provides services under a health benefit |
|
plan from the requirements of this chapter. Information submitted |
|
under this section is subject to Section 108.011 but is not subject |
|
to Section 108.010. |
|
Sec. 108.010. COLLECTION AND DISSEMINATION OF PROVIDER |
|
QUALITY DATA. (a) Subject to Section 108.009, the department |
|
[council] shall collect data reflecting provider quality based on a |
|
methodology and review process established through the executive |
|
commissioner's [council's] rulemaking process. The methodology |
|
shall identify and measure quality standards and adhere to any |
|
federal mandates. |
|
(b) The department [council] shall study and analyze |
|
initial methodologies for obtaining provider quality data, |
|
including outcome data. |
|
(c) The department [council] shall test the methodology by |
|
collecting provider quality data for one year, subject to Section |
|
108.009. The department [council] may test using pilot |
|
methodologies. After collecting provider quality data for one |
|
year, the department [council] shall report findings applicable to |
|
a provider to that provider and allow the provider to review and |
|
comment on the initial provider quality data applicable to that |
|
provider. The department [council] shall verify the accuracy of |
|
the data during this review and revision process. After the review |
|
and revision process, provider quality data for subsequent reports |
|
shall be published and made available to the public, on a time |
|
schedule the department [council] considers appropriate. |
|
(d) If the department [council] determines that provider |
|
quality data to be published under Subsection (c) does not provide |
|
the intended result or is inaccurate or inappropriate for |
|
dissemination, the department [council] is not required to publish |
|
the data or reports based in whole or in part on the data. This |
|
subsection does not affect the release of public use data in |
|
accordance with Section 108.011 or the release of information |
|
submitted under Section 108.009(o). |
|
(e) The executive commissioner [council] shall adopt rules |
|
allowing a provider to submit concise written comments regarding |
|
any specific provider quality data to be released concerning the |
|
provider. The department [council] shall make the comments |
|
available to the public at the office of the department [council] |
|
and in an electronic form accessible through the Internet. The |
|
comments shall be attached to any public release of provider |
|
quality data. Providers shall submit the comments to the |
|
department [council] to be attached to the public release of |
|
provider quality data in the same format as the provider quality |
|
data that is to be released. |
|
(f) The methodology adopted [by the council] for measuring |
|
quality shall include case-mix qualifiers, severity adjustment |
|
factors, adjustments for medical education and research, and any |
|
other factors necessary to accurately reflect provider quality. |
|
(g) In addition to the requirements of this section, any |
|
release of provider quality data shall comply with Sections |
|
108.011(e) and (f). |
|
(h) A provider quality data report may not identify an |
|
individual physician by name, but must identify the physician by |
|
the uniform physician identifier designated by the department |
|
[council] under Section 108.011(c). |
|
(i) The department [council] shall release provider quality |
|
data in an aggregate form without uniform physician identifiers |
|
when[:
|
|
[(1)
the data relates to providers described by
|
|
Section 108.0025(1); or
|
|
[(2)] the cell size of the data is below the minimum |
|
size established by department [council] rule that would enable |
|
identification of an individual patient or physician. |
|
Sec. 108.011. DISSEMINATION OF PUBLIC USE DATA AND |
|
DEPARTMENT [COUNCIL] PUBLICATIONS. (a) The department [council] |
|
shall promptly provide public use data and data collected in |
|
accordance with Section 108.009(o) to those requesting it. The |
|
public use data does not include provider quality data prescribed |
|
by Section 108.010 or confidential data prescribed by Section |
|
108.013. |
|
(b) Subject to the restrictions on access to department |
|
[council] data prescribed by Sections 108.010 and 108.013, and |
|
using the public use data and other data, records, and matters of |
|
record available to it, the department [council] shall prepare and |
|
issue reports to the governor, the legislature, and the public as |
|
provided by this section and Section 108.006(a). The department |
|
[council] must issue the reports at least annually. |
|
(c) Subject to the restrictions on access to department |
|
[council] data prescribed by Sections 108.010 and 108.013, the |
|
department [council] shall use public use data to prepare and issue |
|
reports that provide information relating to providers, such as the |
|
incidence rate of selected medical or surgical procedures. The |
|
reports must provide the data in a manner that identifies |
|
individual providers, including individual physicians, and that |
|
identifies and compares data elements for all providers. |
|
Individual physicians may not be identified by name, but shall be |
|
identified by uniform physician identifiers. The executive |
|
commissioner [council] by rule shall designate the characters to be |
|
used as uniform physician identifiers. |
|
(c-1) The department [council] shall use public use data to |
|
prepare and issue reports that provide information for review and |
|
analysis by the commission [Health and Human Services Commission] |
|
relating to services that are provided in a niche hospital, as |
|
defined by Section 105.002, Occupations Code, and that are provided |
|
by a physician with an ownership interest in the niche hospital. |
|
(c-2) Subsection (c-1) does not apply to an ownership |
|
interest in publicly available shares of a registered investment |
|
company, such as a mutual fund, that owns publicly traded equity |
|
securities or debt obligations issued by a niche hospital or an |
|
entity that owns the niche hospital. |
|
(d) The executive commissioner [council] shall adopt |
|
procedures to establish the accuracy and consistency of the public |
|
use data before releasing the public use data to the public. The |
|
department may adopt additional procedures as the department |
|
determines necessary. |
|
(e) If public use data is requested from the department |
|
[council] about a specific provider, the department [council] shall |
|
notify the provider about the release of the data. This subsection |
|
does not authorize the provider to interfere with the release of |
|
that data. |
|
(f) A report issued by the department [council] shall |
|
include a reasonable review and comment period for the affected |
|
providers before public release of the report. |
|
(g) The executive commissioner [council] shall adopt rules |
|
allowing a provider to submit concise written comments regarding |
|
any specific public use data to be released concerning the |
|
provider. The department [council] shall make the comments |
|
available to the public at [and] the office of the department |
|
[council] and in an electronic form accessible through the |
|
Internet. The comments shall be attached to any public release of |
|
the public use data. Providers shall submit the comments to the |
|
department [council] to be attached to the public release of public |
|
use data in the same format as the public use data that is to be |
|
released. |
|
(h) Tapes containing public use data and provider quality |
|
reports that are released to the public must include general |
|
consumer education material, including an explanation of the |
|
benefits and limitations of the information provided in the public |
|
use data and provider quality reports. |
|
(i) The department [council] shall release public use data |
|
in an aggregate form without uniform physician identifiers when[:
|
|
[(1)
the data relates to providers described by
|
|
Section 108.0025(1); or
|
|
[(2)] the cell size of the data is below the minimum |
|
size established by department [council] rule that would enable |
|
identification of an individual patient or physician. |
|
Sec. 108.012. COMPUTER ACCESS TO DATA. (a) The department |
|
[council] shall provide a means for computer-to-computer access to |
|
the public use data. All reports shall maintain patient |
|
confidentiality as provided by Section 108.013. |
|
(b) The department [council] may charge a person requesting |
|
public use or provider quality data a fee for the data. The fees may |
|
reflect the quantity of information provided and the expense |
|
incurred by the department [council] in collecting and providing |
|
the data. The executive commissioner by rule [and] shall [be] set |
|
the fees at a level that will raise revenue sufficient for the |
|
operation of the department [council]. The department [council] |
|
may not charge a fee for providing public use data to another state |
|
agency. |
|
Sec. 108.013. CONFIDENTIALITY AND GENERAL ACCESS TO DATA. |
|
(a) The data received by the department under this chapter shall be |
|
used by the department and commission for the benefit of the public. |
|
Subject to specific limitations established by this chapter and |
|
department [executive commissioner] rule, the department shall |
|
make determinations on requests for information in favor of access. |
|
(b) The executive commissioner by rule shall designate the |
|
characters to be used as uniform patient identifiers. The basis for |
|
assignment of the characters and the manner in which the characters |
|
are assigned are confidential. |
|
(c) Unless specifically authorized by this chapter, the |
|
department may not release and a person or entity may not gain |
|
access to any data obtained under this chapter: |
|
(1) that could reasonably be expected to reveal the |
|
identity of a patient; |
|
(2) that could reasonably be expected to reveal the |
|
identity of a physician; |
|
(3) disclosing provider discounts or differentials |
|
between payments and billed charges; |
|
(4) relating to actual payments to an identified |
|
provider made by a payer; or |
|
(5) submitted to the department in a uniform |
|
submission format that is not included in the public use data set |
|
established under Sections 108.006(f) and (g), except in accordance |
|
with Section 108.0135. |
|
(d) Except as provided by this section, all data collected |
|
and used by the department under this chapter is subject to the |
|
confidentiality provisions and criminal penalties of: |
|
(1) Section 311.037; |
|
(2) Section 81.103; and |
|
(3) Section 159.002, Occupations Code. |
|
(e) Data on patients and compilations produced from the data |
|
collected that identify patients are not: |
|
(1) subject to discovery, subpoena, or other means of |
|
legal compulsion for release to any person or entity except as |
|
provided by this section; or |
|
(2) admissible in any civil, administrative, or |
|
criminal proceeding. |
|
(f) Data on physicians and compilations produced from the |
|
data collected that identify physicians are not: |
|
(1) subject to discovery, subpoena, or other means of |
|
legal compulsion for release to any person or entity except as |
|
provided by this section; or |
|
(2) admissible in any civil, administrative, or |
|
criminal proceeding. |
|
(g) Unless specifically authorized by this chapter, the |
|
department may not release data elements in a manner that will |
|
reveal the identity of a patient. The department may not release |
|
data elements in a manner that will reveal the identity of a |
|
physician. |
|
(h) Subsections (c) and (g) do not prohibit the release of a |
|
uniform physician identifier in conjunction with associated public |
|
use data in accordance with Section 108.011 or a provider quality |
|
report in accordance with Section 108.010. |
|
(i) Notwithstanding any other law and except as provided by |
|
this section, the department may not provide information made |
|
confidential by this section to any other agency of this state. |
|
(j) The executive commissioner shall by rule develop and |
|
implement a mechanism to comply with Subsections (c)(1) and (2). |
|
(k) The department may disclose data collected under this |
|
chapter that is not included in public use data to any department or |
|
commission program if the disclosure is reviewed and approved by |
|
the institutional review board under Section 108.0135. |
|
(l) Confidential data collected under this chapter that is |
|
disclosed to a department or commission program remains subject to |
|
the confidentiality provisions of this chapter and other applicable |
|
law. The department shall identify the confidential data that is |
|
disclosed to a program under Subsection (k). The program shall |
|
maintain the confidentiality of the disclosed confidential data. |
|
(m) The following provisions do not apply to the disclosure |
|
of data to a department or commission program: |
|
(1) Section 81.103; |
|
(2) Sections 108.010(g) and (h); |
|
(3) Sections 108.011(e) and (f); |
|
(4) Section 311.037; and |
|
(5) Section 159.002, Occupations Code. |
|
(n) Nothing in this section authorizes the disclosure of |
|
physician identifying data. |
|
Sec. 108.0131. LIST OF PURCHASERS OR RECIPIENTS OF DATA. |
|
The department shall post on the department's Internet website a |
|
list of each entity that purchases or receives data collected under |
|
this chapter. |
|
Sec. 108.0135. INSTITUTIONAL REVIEW BOARD. (a) The |
|
department shall establish an institutional review board to review |
|
and approve requests for access to data not contained in public use |
|
data. The members of the institutional review board must have |
|
experience and expertise in ethics, patient confidentiality, and |
|
health care data. |
|
(b) To assist the institutional review board in determining |
|
whether to approve a request for information, the executive |
|
commissioner shall adopt rules similar to the federal Centers for |
|
Medicare and Medicaid Services' guidelines on releasing data. |
|
(c) A request for information other than public use data |
|
must be made on the form prescribed by the department. |
|
(d) Any approval to release information under this section |
|
must require that the confidentiality provisions of this chapter be |
|
maintained and that any subsequent use of the information conform |
|
to the confidentiality provisions of this chapter. |
|
Sec. 108.014. CIVIL PENALTY. (a) A person who knowingly or |
|
negligently releases data in violation of this chapter is liable |
|
for a civil penalty of not more than $10,000. |
|
(b) A person who fails to supply available data under |
|
Sections 108.009 and 108.010 is liable for a civil penalty of not |
|
less than $1,000 or more than $10,000 for each act of violation. |
|
(c) The attorney general, at the request of the department |
|
[council], shall enforce this chapter. The venue of an action |
|
brought under this section is in Travis County. |
|
(d) A civil penalty recovered in a suit instituted by the |
|
attorney general under this chapter shall be deposited in the |
|
general revenue fund to the credit of the health care information |
|
account. |
|
Sec. 108.0141. CRIMINAL PENALTY. (a) A person who |
|
knowingly accesses data in violation of this chapter or who with |
|
criminal negligence releases data in violation of this chapter |
|
commits an offense. |
|
(b) An offense under this section is a state jail felony. |
|
Sec. 108.015. CONFLICT OF INTEREST. The department |
|
[council] may not accept a donation from a person required to |
|
provide data under this chapter or from a person or business entity |
|
who provides goods or services to the department [council] for |
|
compensation. |
|
Sec. 108.016. SUNSET REVIEW. Unless continued in existence |
|
in accordance with Chapter 325, Government Code (Texas Sunset Act), |
|
after the review required by Section 11.003(b), this chapter |
|
expires September 1, 2015. |
|
SECTION 3.0356. Section 114.002, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 114.002. INTERAGENCY OBESITY COUNCIL. The council is |
|
composed of the commissioner, the commissioner of agriculture, [the
|
|
commissioner of state health services,] and the commissioner of |
|
education, or a staff member designated by each of those |
|
commissioners. |
|
SECTION 3.0357. Section 114.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 114.005. REVIEW OF AGENCY PROGRAMS. The council shall |
|
review the status of the programs of the department, the Department |
|
of Agriculture, [the Department of State Health Services,] and the |
|
Texas Education Agency that promote better health and nutrition and |
|
prevent obesity among children and adults in this state. |
|
SECTION 3.0358. Section 114.006(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The council shall provide to the department [Department
|
|
of State Health Services] information on effective strategies for |
|
employers to use to promote workplace wellness, including |
|
information on the projected costs and benefits. The department |
|
[Department of State Health Services] shall post the information on |
|
its Internet website. |
|
SECTION 3.0359. Section 114.007(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) A report submitted by the council under Subsection (a) |
|
must include the following information regarding the |
|
evidence-based public health awareness plan under Section 114.006: |
|
(1) a cost estimate for an ongoing program to |
|
implement the plan; |
|
(2) projected benefits of the program; |
|
(3) a summary of the information provided to the |
|
department [Department of State Health Services] for its Internet |
|
website; and |
|
(4) recommendations for goals and future legislation. |
|
SECTION 3.0360. Section 115.007(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The task force consists of: |
|
(1) the commissioner, the executive director or |
|
director, or a deputy or assistant commissioner of: |
|
(A) the commission, designated by the executive |
|
commissioner; |
|
(B) the Department of Aging and Disability |
|
Services, designated by the commissioner of aging and disability |
|
services [that agency]; |
|
(C) the Department of Assistive and |
|
Rehabilitative Services, designated by the commissioner of |
|
assistive and rehabilitative services [that agency]; |
|
(D) the division of early childhood intervention |
|
services, designated by the commissioner of assistive and |
|
rehabilitative services [the Department of Assistive and
|
|
Rehabilitative Services]; |
|
(E) the Department of Family and Protective |
|
Services, designated by the commissioner of family and protective |
|
services [that agency]; |
|
(F) the department [Department of State Health
|
|
Services], designated by the commissioner [of that agency]; |
|
(G) the Texas Education Agency, designated by the |
|
commissioner of education [that agency]; |
|
(H) the Texas Juvenile Justice Department [Youth
|
|
Commission], designated by the executive director [commissioner] |
|
of that agency; and |
|
(I) [the Texas Juvenile Probation Commission,
|
|
designated by the executive director of that agency; and
|
|
[(J)] the Texas Correctional Office on Offenders |
|
with Medical or Mental Impairments, designated by the director of |
|
that office; and |
|
(2) eight nonvoting members who are: |
|
(A) a representative of a local mental health |
|
authority or a local intellectual and developmental disability |
|
[mental retardation] authority, appointed by the governor; |
|
(B) two members of the house of representatives, |
|
appointed by the speaker of the house of representatives; |
|
(C) two senators, appointed by the lieutenant |
|
governor; and |
|
(D) three parents or consumer advocates, one each |
|
appointed by the commission, the Texas Education Agency, and the |
|
Texas Juvenile Justice Department [Youth Commission]. |
|
SECTION 3.0361. Section 121.002(2), Health and Safety Code, |
|
is amended to read as follows: |
|
(2) "Physician" means a person licensed to practice |
|
medicine by the Texas Medical [State] Board [of Medical Examiners]. |
|
SECTION 3.0362. Section 121.003(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The governing bodies of municipalities and the |
|
commissioners courts of counties may cooperate with one another in |
|
making necessary improvements and providing services to promote the |
|
public health in accordance with Chapter 791, Government Code [The
|
|
Interlocal Cooperation Act (Article 4413(32c), Vernon's Texas
|
|
Civil Statutes)]. |
|
SECTION 3.0363. Section 121.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 121.004. LOCAL HEALTH UNITS. A local health unit is a |
|
division of municipal or county government that provides public |
|
health services but does not provide each service listed [required
|
|
of a local health department] under Section 121.006(d) [121.032(a)] |
|
or required of a public health district under Section 121.043(a). |
|
SECTION 3.0364. Section 121.005(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The executive commissioner [board] may adopt rules |
|
necessary to implement this section. |
|
SECTION 3.0365. Section 121.006(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) Chapter 783, Government Code, [The Uniform Grant and
|
|
Contract Management Act of 1981 (Article 4413(32g), Vernon's Texas
|
|
Civil Statutes)] and standards adopted under that chapter [Act] |
|
control, if applicable, if the local health unit, local health |
|
department, or public health district receives state support for |
|
the provision of public health services. |
|
SECTION 3.0366. Section 121.0065(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) The executive commissioner [board] shall adopt rules |
|
governing: |
|
(1) the allocation formula for grants awarded under |
|
this section; |
|
(2) the manner in which a municipality, county, public |
|
health district, or other political subdivision applies for a |
|
grant; |
|
(3) the procedures for awarding grants; and |
|
(4) the minimum essential public health services to be |
|
provided under the grant and other standards applicable to the |
|
services to be provided under the grant. |
|
SECTION 3.0367. Section 121.007, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 121.007. PUBLIC HEALTH REGIONS. (a) The department |
|
[board] may designate geographic areas of the state as public |
|
health regions to provide public health services. |
|
(b) The department [board] shall appoint a physician to |
|
serve as regional director for each public health region. The |
|
regional director is the chief administrative officer of the |
|
region. The department [board] shall establish the qualifications |
|
and terms of employment of a regional director. |
|
(c) The department [board or its designee] may require a |
|
regional director to perform the duties of a health authority. The |
|
regional director may perform those duties, as authorized by the |
|
department [board or commissioner], in a jurisdiction in the region |
|
in which the health authority fails to perform duties prescribed |
|
[by the board] under Section 121.024. The regional director shall |
|
perform the duties of a health authority in a jurisdiction in the |
|
region in which there is not a health authority. |
|
SECTION 3.0368. Section 121.008(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department [board] shall hold an annual conference |
|
for health authorities and for directors of local health |
|
departments and public health districts. The commissioner or the |
|
commissioner's designee shall preside over the conference. |
|
SECTION 3.0369. Section 121.022(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) To be qualified to serve as a health authority, the |
|
appointee must: |
|
(1) take and subscribe to the official oath; and |
|
(2) file a copy of the oath and appointment with the |
|
department [board]. |
|
SECTION 3.0370. Sections 121.024(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) A health authority shall perform each duty that is: |
|
(1) necessary to implement and enforce a law to |
|
protect the public health; or |
|
(2) prescribed by the department [board]. |
|
(c) The duties of a health authority include: |
|
(1) establishing, maintaining, and enforcing |
|
quarantine in the health authority's jurisdiction; |
|
(2) aiding the department [board] in relation to local |
|
quarantine, inspection, disease prevention and suppression, birth |
|
and death statistics, and general sanitation in the health |
|
authority's jurisdiction; |
|
(3) reporting the presence of contagious, infectious, |
|
and dangerous epidemic diseases in the health authority's |
|
jurisdiction to the department [board] in the manner and at the |
|
times prescribed by the department [board]; |
|
(4) reporting to the department [board] on any subject |
|
on which it is proper for the department [board] to direct that a |
|
report be made; and |
|
(5) aiding the department [board] in the enforcement |
|
of the following in the health authority's jurisdiction: |
|
(A) proper rules, requirements, and ordinances; |
|
(B) sanitation laws; |
|
(C) quarantine rules; and |
|
(D) vital statistics collections. |
|
SECTION 3.0371. Sections 121.029(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A health authority, unless otherwise restricted by law, |
|
may delegate a power or duty imposed on the health authority by the |
|
department [board], or by this or any other law, to a properly |
|
qualified physician to act while the health authority is absent or |
|
incapacitated. |
|
(b) The physician designated by the health authority must: |
|
(1) meet the qualifications set out in Section |
|
121.022(a); |
|
(2) be appointed as a designee in the same manner as |
|
the appointment of the health authority; |
|
(3) take, subscribe, and file the official oath and |
|
appointment with the department [board] as required by Section |
|
121.022(b); and |
|
(4) file a certified copy of the written delegation |
|
with the department [board]. |
|
SECTION 3.0372. Section 121.033(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) A director of a local health department who is not a |
|
physician shall appoint a physician as the health authority in the |
|
local health department's jurisdiction, subject to the approval of |
|
the governing body or the commissioners court, as appropriate, and |
|
the department [board]. |
|
SECTION 3.0373. Sections 121.0331(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A health authority, unless otherwise restricted by law, |
|
may delegate a power or duty imposed on the health authority by the |
|
department [board], or by this or any other law, to a properly |
|
qualified physician who is employed by the municipality's or |
|
county's local health department to act while the health authority |
|
is absent or incapacitated. |
|
(b) The physician designated by the health authority must: |
|
(1) meet the qualifications set out in Section |
|
121.022(a); |
|
(2) be appointed as a designee in the same manner as |
|
the appointment of the health authority; |
|
(3) take, subscribe, and file the official oath and |
|
appointment with the department [board] as required by Section |
|
121.022(b); and |
|
(4) file a certified copy of the written delegation |
|
with the department [board]. |
|
SECTION 3.0374. Section 121.043(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) For purposes of Section 121.005, a public health |
|
district shall be identified by its program of public health |
|
services and shall, at a minimum, provide the services listed [for a
|
|
local health department] under Section 121.006(d) [121.032(b)]. |
|
SECTION 3.0375. Section 121.045(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) A director of a public health district who is not a |
|
physician shall appoint a physician as the health authority for the |
|
district, subject to the approval of the members and the department |
|
[board]. |
|
SECTION 3.0376. Sections 121.0451(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A health authority, unless otherwise restricted by law, |
|
may delegate a power or duty imposed on the health authority by the |
|
department [board], or by this or any other law, to a properly |
|
qualified physician who is employed by the public health district |
|
to act while the health authority is absent or incapacitated. |
|
(b) The physician designated by the health authority must: |
|
(1) meet the qualifications set out in Section |
|
121.022(a); |
|
(2) be appointed as a designee in the same manner as |
|
the appointment of the health authority; |
|
(3) take, subscribe, and file the official oath and |
|
appointment with the department [board] as required by Section |
|
121.022(b); and |
|
(4) file a certified copy of the written delegation |
|
with the department [board]. |
|
SECTION 3.0377. Section 122.008(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A nurse employed under Subsection (a) shall: |
|
(1) investigate the health conditions and sanitary |
|
surroundings of the schools and the personal, physical, and health |
|
condition of students in the schools; |
|
(2) cooperate with the department [Texas Department of
|
|
Health] and local health authorities; and |
|
(3) perform other duties required by the commissioners |
|
court. |
|
SECTION 3.0378. Sections 141.002(2) and (5), Health and |
|
Safety Code, are amended to read as follows: |
|
(2) "Day camp" includes any camp that primarily |
|
operates during any portion of the day between 7 a.m. and 10 p.m. |
|
for a period of four or more consecutive days but may incidentally |
|
offer not more than two overnight stays each camp session. The term |
|
does not include a facility required to be licensed with the |
|
Department of Family and Protective [and Regulatory] Services. |
|
(5) "Youth camp" means a facility or property, other |
|
than a facility required to be licensed by the Department of Family |
|
and Protective [and Regulatory] Services, that: |
|
(A) has the general characteristics of a day |
|
camp, resident camp, or travel camp; |
|
(B) is used primarily or partially for |
|
recreational, athletic, religious, or educational activities; and |
|
(C) accommodates at least five minors who attend |
|
or temporarily reside at the camp for all or part of at least four |
|
days. |
|
SECTION 3.0379. Section 141.0035, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 141.0035. LICENSE FEES. (a) The executive |
|
commissioner [board] by rule shall establish the amount of the fee |
|
for obtaining or renewing a license under this chapter. The |
|
executive commissioner [board] shall set the fee in a reasonable |
|
amount designed to recover the direct and indirect costs to the |
|
department of administering and enforcing this chapter. The |
|
executive commissioner [board] may set fees in a different amount |
|
for resident youth camps and day youth camps to reflect differences |
|
in the costs of administering and enforcing this chapter for |
|
resident and day camps. |
|
(b) Before the executive commissioner adopts or amends |
|
[adopting or amending] a rule under Subsection (a), the department |
|
[board] shall solicit comments and information from the operators |
|
of affected youth camps and allow affected youth camp operators the |
|
opportunity to meet with appropriate department staff who are |
|
involved with the rulemaking process. |
|
SECTION 3.0380. Section 141.004(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) To obtain a license, a person must submit a license |
|
application accompanied by a license fee in an amount set by the |
|
executive commissioner by rule [board]. |
|
SECTION 3.0381. Section 141.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 141.005. LICENSE RENEWAL. (a) A person holding a |
|
license issued under this chapter must renew the license annually |
|
by submitting a renewal application on a date determined by |
|
department [board] rule on a form provided by the department. |
|
(b) The application must be accompanied by a renewal fee in |
|
an amount set by the executive commissioner by rule [board]. |
|
(c) The department may not renew the license of a youth camp |
|
which has not corrected deficiencies before the application for |
|
renewal is submitted. The executive commissioner [board] shall |
|
adopt substantive and procedural rules for the submission by a |
|
youth camp operator of evidence that a deficiency or deficiencies |
|
have been corrected. |
|
SECTION 3.0382. Sections 141.007(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) An employee or agent who enters a youth camp to |
|
investigate and inspect conditions shall notify the person in |
|
charge of the camp of the inspector's presence and shall present |
|
proper credentials. The department may exercise the remedies |
|
authorized by Section 141.015(b) [141.014(b)] if the employee or |
|
agent is not allowed to enter. |
|
(c) The executive commissioner [department] may prescribe |
|
reasonable record-keeping requirements for licensed youth camps, |
|
including a requirement that the youth camp keep records relating |
|
to matters involving the health and safety of campers. An employee |
|
or agent of the department may examine, during regular business |
|
hours, any records relating to the health and safety of campers. |
|
SECTION 3.0383. Section 141.008(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] may adopt rules to |
|
implement this chapter. In adopting the rules the executive |
|
commissioner [board] shall comply with Subchapter B, Chapter 2001, |
|
Government Code, including Sections 2001.032(b) and 2001.033, |
|
Government Code. In developing the rules to be adopted by the |
|
executive commissioner, the department [board] shall consult |
|
parents, youth camp operators, and appropriate public and private |
|
officials and organizations. |
|
SECTION 3.0384. Section 141.009, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 141.009. STANDARDS. The executive commissioner |
|
[board] by rule shall establish health and safety standards for |
|
youth camps. The standards may relate to: |
|
(1) adequate and proper supervision at all times of |
|
camp activities; |
|
(2) qualifications for directors, supervisors, and |
|
staff and sufficient numbers of those persons; |
|
(3) proper safeguards for sanitation and public |
|
health; |
|
(4) adequate medical services for personal health and |
|
first aid; |
|
(5) proper procedures for food preparation, handling, |
|
and mass feeding; |
|
(6) healthful and sufficient water supply; |
|
(7) proper waste disposal; |
|
(8) proper water safety procedures for swimming pools, |
|
lakes, and waterways; |
|
(9) safe boating equipment; |
|
(10) proper maintenance and safe use of motor |
|
vehicles; |
|
(11) safe buildings and physical facilities; |
|
(12) proper fire precautions; |
|
(13) safe and proper recreational and other equipment; |
|
(14) proper regard for density and use of the |
|
premises; and |
|
(15) records of criminal convictions of camp |
|
personnel. |
|
SECTION 3.0385. Sections 141.0095(d) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(d) In accordance with this section and the criteria and |
|
guidelines developed by the training advisory committee |
|
established under Section 141.0096, the executive commissioner [of
|
|
the Health and Human Services Commission] by rule shall establish |
|
criteria and guidelines for training and examination programs on |
|
sexual abuse and child molestation. The department may approve |
|
training and examination programs offered by trainers under |
|
contract with youth camps or by online training organizations or |
|
may approve programs offered in another format authorized by the |
|
department. |
|
(f) The department may assess a fee in the amount set by the |
|
executive commissioner by rule as necessary to cover the costs of |
|
administering this section to each person that applies for the |
|
department's approval of a training and examination program on |
|
sexual abuse and child molestation under this section. |
|
SECTION 3.0386. Sections 141.0096(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department shall appoint a training advisory |
|
committee to advise the department and the executive commissioner |
|
[of the Health and Human Services Commission] in the development of |
|
criteria and guidelines for the training and examination program on |
|
sexual abuse and child molestation required under Section 141.0095 |
|
and to perform any other functions requested by the department. |
|
(b) The training advisory committee consists of not more |
|
than nine members selected by the commissioner [of state health
|
|
services] as follows: |
|
(1) at least two members who represent the general |
|
public; and |
|
(2) other members, who include experienced camping |
|
professionals representing the camping communities of this state, |
|
representatives of youth camps selected by the department, and |
|
representatives of the Council on Sex Offender Treatment |
|
established under Chapter 110, Occupations Code. |
|
(c) The training advisory committee shall meet at the call |
|
of the commissioner [of state health services]. |
|
SECTION 3.0387. Sections 141.010(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The executive commissioner [board] shall appoint a |
|
committee to advise the executive commissioner [board] in the |
|
development of standards and procedures, make recommendations to |
|
the executive commissioner [board] regarding the content of the |
|
rules adopted to implement this chapter [Act], and perform any |
|
other functions requested by the executive commissioner [board] in |
|
the implementation and administration of the chapter [Act]. |
|
(b) The advisory committee may not exceed nine members, at |
|
least two of whom shall be members of the general public. The other |
|
members should be experienced camping professionals who represent |
|
the camping communities of the state. In making the appointments, |
|
the executive commissioner [board] shall attempt to reflect the |
|
geographic diversity of the state in proportion to the number of |
|
camps licensed by the department in each geographic area of the |
|
state. |
|
(d) A vacancy on the advisory committee is filled by the |
|
executive commissioner [board] in the same manner as other |
|
appointments to the advisory committee. |
|
SECTION 3.0388. The heading to Section 141.013, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 141.013. [BOARD] HEARINGS. |
|
SECTION 3.0389. Section 141.013(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The department [board] may: |
|
(1) call and conduct hearings; |
|
(2) administer oaths; |
|
(3) receive evidence; |
|
(4) issue subpoenas for witnesses, papers, and |
|
documents related to the hearing; and |
|
(5) make findings of fact and decisions concerning the |
|
administration of this chapter and rules adopted under this |
|
chapter. |
|
SECTION 3.0390. Sections 141.016(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department [commissioner] may assess an |
|
administrative penalty if a person violates this chapter [Act] or a |
|
rule or order adopted or license issued under this chapter [Act]. |
|
(b) In determining the amount of the penalty, the department |
|
[commissioner] shall consider: |
|
(1) the person's previous violations; |
|
(2) the seriousness of the violation; |
|
(3) any hazard to the health and safety of the public; |
|
(4) the person's demonstrated good faith; and |
|
(5) such other matters as justice may require. |
|
SECTION 3.0391. Sections 141.017(b), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(b) If a hearing is held, the administrative law judge |
|
[commissioner] shall make findings of fact and shall issue a |
|
written proposal for decision regarding the occurrence of the |
|
violation and the amount of the penalty that may be warranted. |
|
(c) If the person charged with the violation does not |
|
request a hearing, the department [commissioner] may assess a |
|
penalty after determining that a violation has occurred and the |
|
amount of the penalty that may be warranted. |
|
(d) After making a determination under this section that a |
|
penalty is to be assessed against a person, the department |
|
[commissioner] shall issue an order requiring that the person pay |
|
the penalty. |
|
SECTION 3.0392. Section 141.018, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 141.018. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not |
|
later than the 30th day after the date an order finding that a |
|
violation has occurred is issued, the department [commissioner] |
|
shall inform the person against whom the order is issued of the |
|
amount of the penalty for the violation. |
|
(b) Not later than the 30th day after the date on which a |
|
decision or order charging a person with a penalty is final, the |
|
person shall: |
|
(1) pay the penalty in full; or |
|
(2) file a petition for [if the person seeks] judicial |
|
review of the department's order contesting the amount of the |
|
penalty, the fact of the violation, or both. |
|
(b-1) Within the period prescribed by Subsection (b), a |
|
person who files a petition for judicial review may: |
|
(1) stay enforcement of the penalty by: |
|
(A) paying [send the amount of] the penalty to |
|
the court [commissioner] for placement in an escrow account; or |
|
(B) posting [post] with the court [commissioner] |
|
a supersedeas bond for the amount of the penalty; or |
|
(2) request that the department stay enforcement of |
|
the penalty by: |
|
(A) filing with the court a sworn affidavit of |
|
the person stating that the person is financially unable to pay the |
|
penalty and is financially unable to give the supersedeas bond; and |
|
(B) sending a copy of the affidavit to the |
|
department. |
|
(b-2) If the department receives a copy of an affidavit |
|
under Subsection (b-1)(2), the department may file with the court, |
|
within five days after the date the copy is received, a contest to |
|
the affidavit. The court shall hold a hearing on the facts alleged |
|
in the affidavit as soon as practicable and shall stay the |
|
enforcement of the penalty on finding that the alleged facts are |
|
true. The person who files an affidavit has the burden of proving |
|
that the person is financially unable to pay the penalty or to give |
|
a supersedeas bond. |
|
(c) A bond posted under this section must be in a form |
|
approved by the court [commissioner] and be effective until all |
|
judicial review of the order or decision is final. |
|
(d) A person who does not send money to, [the commissioner
|
|
or] post the bond with, or file the affidavit with the court within |
|
the period prescribed by Subsection (b) waives all rights to |
|
contest the violation or the amount of the penalty. |
|
SECTION 3.0393. Section 141.019, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 141.019. REFUND OF ADMINISTRATIVE PENALTY. On [Not
|
|
later than the 30th day after] the date the court's judgment [of a
|
|
judicial determination] that an administrative penalty against a |
|
person should be reduced or not assessed becomes final, the court |
|
[commissioner] shall order that: |
|
(1) [remit to the person] the appropriate amount of |
|
any penalty payment plus accrued interest be remitted to the person |
|
not later than the 30th day after that date; or |
|
(2) [execute a release of] the bond be released, if the |
|
person has posted a bond. |
|
SECTION 3.0394. Section 141.020, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 141.020. RECOVERY OF ADMINISTRATIVE PENALTY BY |
|
ATTORNEY GENERAL. The attorney general at the request of the |
|
department [commissioner] may bring a civil action to recover an |
|
administrative penalty under this chapter. |
|
SECTION 3.0395. Sections 142.001(6) and (22), Health and |
|
Safety Code, are amended to read as follows: |
|
(6) "Certified agency" means a home and community |
|
support services agency, or a portion of the agency, that: |
|
(A) provides a home health service; and |
|
(B) is certified by an official of the United |
|
States Department of Health and Human Services as in compliance |
|
with conditions of participation in Title XVIII, Social Security |
|
Act (42 U.S.C. Section 1395 et seq.). |
|
(22) "Personal assistance service" means routine |
|
ongoing care or services required by an individual in a residence or |
|
independent living environment that enable the individual to engage |
|
in the activities of daily living or to perform the physical |
|
functions required for independent living, including respite |
|
services. The term includes: |
|
(A) personal care; |
|
(B) health-related services performed under |
|
circumstances that are defined as not constituting the practice of |
|
professional nursing by the Texas Board of Nursing under the terms |
|
of [through] a memorandum of understanding executed by [with] the |
|
board and the department [in accordance with Section 142.016]; and |
|
(C) health-related tasks provided by unlicensed |
|
personnel under the delegation of a registered nurse or that a |
|
registered nurse determines do not require delegation. |
|
SECTION 3.0396. Section 142.0011, Health and Safety Code, |
|
is amended by amending Subsection (b) and adding Subsection (c) to |
|
read as follows: |
|
(b) The executive commissioner [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. |
|
(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 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. |
|
SECTION 3.0397. Section 142.0012(d), Health and Safety |
|
Code, is amended to read as follows: |
|
(d) The executive commissioner [department] may adopt rules |
|
that specify the ownership interests and other relationships that |
|
qualify a person as a controlling person. |
|
SECTION 3.0398. Section 142.004(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [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 |
|
executive commissioner [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, 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. |
|
SECTION 3.0399. Sections 142.006(a), (b), and (c), 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, 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. |
|
(b) A license issued under this chapter expires two years |
|
after the date of issuance. The executive commissioner [of the
|
|
Health and Human Services Commission] by rule may adopt a system |
|
under which licenses expire on various dates during the two-year |
|
period. For the year in which a license expiration date is changed, |
|
the department shall prorate the license fee on a monthly basis. |
|
Each license holder shall pay only that portion of the license fee |
|
allocable to the number of months for which the license is valid. A |
|
license holder shall pay the total license renewal fee at the time |
|
of renewal. The department may issue an initial license for a |
|
shorter term to conform expiration dates for a locality or an |
|
applicant. The department may issue a temporary license to an |
|
applicant for an initial license. |
|
(c) The department may find that a home and community |
|
support services agency has satisfied the requirements for |
|
licensing if the agency is accredited by an accreditation |
|
organization, such as The [the] Joint Commission [on Accreditation
|
|
of Healthcare Organizations] or the Community Health Accreditation |
|
Program, and the department finds that the accreditation |
|
organization has standards that meet or exceed the requirements for |
|
licensing under this chapter. A license fee is required of the home |
|
and community support services agency at the time of a license |
|
application. |
|
SECTION 3.0400. Section 142.008(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
establish eligibility requirements for a branch office license. |
|
SECTION 3.0401. Section 142.0085(b), Health and Safety |
|
Code, is amended to read as follows: |
|
(b) The executive commissioner [board] by rule shall |
|
establish standards required for the issuance of an alternate |
|
delivery site license. |
|
SECTION 3.0402. Sections 142.009(h) and (l), Health and |
|
Safety Code, are amended to read as follows: |
|
(h) Except for the investigation of complaints, a home and |
|
community support services agency licensed by the department under |
|
this chapter is not subject to additional surveys relating to home |
|
health, hospice, or personal assistance services while the agency |
|
maintains accreditation for the applicable service from The [the] |
|
Joint Commission [for Accreditation of Healthcare Organizations], |
|
the Community Health Accreditation Program, or other accreditation |
|
organizations that meet or exceed the regulations adopted under |
|
this chapter. Each provider must submit to the department |
|
documentation from the accrediting body indicating that the |
|
provider is accredited when the provider is applying for the |
|
initial license and annually when the license is renewed. |
|
(l) The department and other state agencies that are under |
|
the commission [Health and Human Services Commission] and that |
|
contract with home and community support services agencies to |
|
deliver services for which a license is required under this chapter |
|
shall execute a memorandum of understanding that establishes |
|
procedures to eliminate or reduce duplication of standards or |
|
conflicts between standards and of functions in license, |
|
certification, or compliance surveys and complaint investigations. |
|
[The Health and Human Services Commission shall review the
|
|
recommendation of the council relating to the memorandum of
|
|
understanding before considering approval.] The memorandum of |
|
understanding must be approved by the commission. |
|
SECTION 3.0403. Sections 142.010(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The executive commissioner by rule [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, or |
|
personal assistance services. |
|
(b) The executive commissioner [board] shall consider the |
|
size of the home and community support services agency, the number |
|
of clients served, the number of services provided, and the |
|
necessity for review of other accreditation documentation in |
|
determining the amount collected by the department for [of] initial |
|
and renewal license fees. |
|
SECTION 3.0404. Section 142.0104(a), Health and Safety |
|
Code, is amended to read as follows: |
|
(a) If certain application information as specified by |
|
department [executive commissioner] rule changes after the |
|
applicant submits an application to the department for a license |
|
under this chapter or after the department issues the license, the |
|
license holder shall report the change to the department and pay a |
|
fee not to exceed $50 not later than the time specified by |
|
department [executive commissioner] rule. |
|
SECTION 3.0405. Section 142.011(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) A person whose application is denied or whose license is |
|
suspended or revoked is entitled to a hearing [before the
|
|
department] if the person submits a written request to the |
|
commission [department]. Chapter 2001, Government Code, and the |
|
department's rules for contested case hearings apply to hearings |
|
conducted under this section and to appeals from department |
|
decisions. |
|
SECTION 3.0406. Sections 142.017(c), (d), (e), and (g), |
|
Health and Safety Code, are amended to read as follows: |
|
(c) The executive commissioner [department] by rule shall |
|
specify each violation for which the department may assess an |
|
administrative penalty [may be assessed]. In determining which |
|
violations warrant penalties, the department shall consider: |
|
(1) the seriousness of the violation, including the |
|
nature, circumstances, extent, and gravity of the violation and the |
|
hazard of the violation to the health or safety of clients; and |
|
(2) whether the affected home and community support |
|
services agency had identified the violation as a part of its |
|
internal quality assurance process and had made appropriate |
|
progress on correction. |
|
(d) The executive commissioner [department] by rule shall |
|
establish a schedule of appropriate and graduated penalties for |
|
each violation based on: |
|
(1) the seriousness of the violation, including the |
|
nature, circumstances, extent, and gravity of the violation and the |
|
hazard or safety of clients; |
|
(2) the history of previous violations by the person |
|
or a controlling person with respect to that person; |
|
(3) whether the affected home and community support |
|
services agency had identified the violation as a part of its |
|
internal quality assurance process and had made appropriate |
|
progress on correction; |
|
(4) the amount necessary to deter future violations; |
|
(5) efforts made to correct the violation; and |
|
(6) any other matters that justice may require. |
|
(e) Except as provided by Subsection (j), the executive |
|
commissioner [department] by rule shall provide the home and |
|
community support services agency with a reasonable period of time |
|
following the first day of a violation to correct the violation |
|
before the department assesses [assessing] an administrative |
|
penalty if a plan of correction has been implemented. |
|
(g) The executive commissioner [department] shall establish |
|
a system to ensure standard and consistent application of penalties |
|
regardless of the home and community support services agency |
|
location. |
|
SECTION 3.0407. Section 142.0171(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) If the person notified of the violation accepts the |
|
determination of the department or if the person fails to respond in |
|
a timely manner to the notice, the department [commissioner or the
|
|
commissioner's designee] shall [issue an] order [approving the
|
|
determination and ordering that] the person to pay the proposed |
|
penalty. |
|
SECTION 3.0408. Section 142.0172, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 142.0172. HEARING; ORDER. (a) If the person notified |
|
requests a hearing, the department shall refer the case to the State |
|
Office of Administrative Hearings and an administrative law judge |
|
of that office shall conduct the hearing. |
|
(a-1) The department shall[:
|
|
[(1) set a hearing;
|
|
[(2)] give written notice of the hearing to the |
|
person[; and
|
|
[(3)
designate a hearings examiner to conduct the
|
|
hearing]. |
|
(b) The administrative law judge [hearings examiner] shall |
|
make findings of fact and conclusions of law and shall promptly |
|
issue to the department [commissioner or the commissioner's
|
|
designee] a proposal for decision as to the occurrence of the |
|
violation and a recommendation as to the amount of the proposed |
|
penalty if a penalty is determined to be warranted. |
|
(c) Based on the findings of fact and conclusions of law and |
|
the recommendations of the administrative law judge [hearings
|
|
examiner], the department [commissioner or the commissioner's
|
|
designee] by order may find that a violation has occurred and may |
|
assess a penalty or may find that no violation has occurred. |
|
SECTION 3.0409. Sections 142.018(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) In this section, "abuse," "exploitation," and "neglect" |
|
have the meanings applicable through a rule adopted by the |
|
executive commissioner [of the Health and Human Services
|
|
Commission] under Section 48.002(c), Human Resources Code, except |
|
that if the executive commissioner has not adopted applicable rules |
|
under that section, the statutory definitions of those terms under |
|
Section 48.002(a), Human Resources Code, shall be used. |
|
(b) A home and community support services agency that has |
|
cause to believe that a person receiving services from the agency |
|
has been abused, exploited, or neglected by an employee of the |
|
agency shall report the information to: |
|
(1) the department; and |
|
(2) the Department of Family and Protective [and
|
|
Regulatory] Services or other appropriate state agency as required |
|
by Section 48.051, Human Resources Code. |
|
SECTION 3.0410. Section 142.021, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 142.021. ADMINISTRATION OF MEDICATION. A person may |
|
not administer medication to a client of a home and community |
|
support services agency unless the person: |
|
(1) holds a license under state law that authorizes |
|
the person to administer medication; |
|
(2) holds a permit issued under Section 142.025 and |
|
acts under the delegated authority of a person who holds a license |
|
under state law that authorizes the person to administer |
|
medication; |
|
(3) administers a medication to a client of a home and |
|
community support service agency in accordance with rules of the |
|
Texas Board of Nursing that permit delegation of the administration |
|
of medication to a person not holding a permit under Section |
|
142.025; or |
|
(4) administers noninjectable medication under |
|
circumstances authorized by the memorandum of understanding |
|
executed by the department and the Texas Board of Nursing [adopted
|
|
under Section 142.016]. |
|
SECTION 3.0411. Section 142.023, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 142.023. RULES FOR ADMINISTRATION OF MEDICATION. The |
|
executive commissioner [board] by rule shall establish: |
|
(1) minimum requirements for the issuance, denial, |
|
renewal, suspension, emergency suspension, and revocation of a |
|
permit to a home health medication aide; |
|
(2) curricula to train a home health medication aide; |
|
(3) minimum standards for the approval of home health |
|
medication aide training programs and for rescinding approval; |
|
(4) the acts and practices that are allowed or |
|
prohibited to a permit holder; and |
|
(5) minimum standards for on-site supervision of a |
|
permit holder by a registered nurse. |
|
SECTION 3.0412. Section 142.024(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) An application for the approval of a home health |
|
medication aide training program must be made to the department on a |
|
form prescribed by the department and under department rules |
|
[prescribed by the board]. |
|
SECTION 3.0413. Sections 142.025(a) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) To be issued or to have renewed a home health medication |
|
aide permit, a person shall apply to the department on a form |
|
prescribed by the department and under department rules [adopted by
|
|
the board]. |
|
(d) The department shall issue a permit or renew a permit to |
|
an applicant who: |
|
(1) meets the minimum requirements adopted under |
|
Section 142.023; |
|
(2) successfully completes the examination or the |
|
continuing education requirements; and |
|
(3) pays a nonrefundable application fee specified in |
|
department rules [determined by the board]. |
|
SECTION 3.0414. Section 142.026(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner by rule [board] shall set the |
|
fees in amounts reasonable and necessary to recover the amount |
|
projected by the department as required to administer its functions |
|
under this subchapter. The fees may not exceed: |
|
(1) $25 for a combined permit application and |
|
examination fee; and |
|
(2) $15 for a renewal permit application fee. |
|
SECTION 3.0415. Section 144.013(f), Health and Safety Code, |
|
is amended to read as follows: |
|
(f) If the department denies an application twice, the |
|
application is canceled. The applicant is entitled to a hearing |
|
[before the commissioner] on the denial if the applicant requests |
|
the hearing not later than the 30th day after the date of the second |
|
denial. |
|
SECTION 3.0416. Section 144.021(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) As a condition of licensure, the department, in |
|
accordance with department rules, may prescribe other reasonable |
|
and appropriate construction, operational, maintenance, and |
|
inspection requirements to ensure compliance with this chapter and |
|
other applicable rules [of the department]. |
|
SECTION 3.0417. Section 144.022(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Each licensed rendering establishment, related station, |
|
or dead animal hauler shall have a dead animal log that meets the |
|
requirements prescribed by [the] department rule. The name of the |
|
licensed rendering establishment, related station, or dead animal |
|
hauler must be on the front of the log. |
|
SECTION 3.0418. Section 144.026(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) Liquid waste shall be treated in the manner required by |
|
the department and disposed of in a manner approved by [the] |
|
department rule. |
|
SECTION 3.0419. Section 144.043(e), Health and Safety Code, |
|
is amended to read as follows: |
|
(e) If the department denies an application twice, the |
|
application is canceled. The applicant is entitled to a hearing |
|
[before the commissioner] on the denial if the applicant requests |
|
the hearing not later than the 30th day after the date of the second |
|
denial. |
|
SECTION 3.0420. Sections 144.063(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The term of a [An operating] license issued under this |
|
chapter is two years [is valid for one year and may be renewed
|
|
annually by the license holder]. The executive commissioner by |
|
rule [department] shall set a [an annual] renewal fee. |
|
(c) A license holder may renew a license by paying the |
|
renewal fee to the department on or before the expiration date of |
|
the license [January 1 of each year]. On receipt of the fee, the |
|
license is automatically renewed [for the next calendar year]. |
|
SECTION 3.0421. Section 144.064, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.064. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE |
|
OR PERMIT; REINSTATEMENT. (a) The department [commissioner] may |
|
deny, suspend, or revoke an operating license, construction permit, |
|
or renewal of an operating license or construction permit if the |
|
department [commissioner] finds that: |
|
(1) the license holder or permit holder has violated |
|
this chapter or a rule or order adopted under this chapter or did |
|
not exercise due care to prevent the violation; or |
|
(2) a fact or condition exists that would have |
|
justified the denial of the license or permit application if the |
|
fact or condition was known at the time the original application was |
|
filed. |
|
(b) On the discovery of such a violation, the department |
|
[commissioner] shall notify the license holder or permit holder of |
|
the violation. If the license holder or permit holder fails to make |
|
the necessary corrections, the department shall notify the license |
|
holder or permit holder of a hearing to suspend or revoke the |
|
license or permit. |
|
(c) The department [commissioner] may reinstate a suspended |
|
license or permit, or may issue a new license or permit to a person |
|
whose license or permit has been revoked, if a ground to deny the |
|
original license or permit application does not exist. |
|
SECTION 3.0422. Section 144.072(e), Health and Safety Code, |
|
is amended to read as follows: |
|
(e) The executive commissioner [department] by rule shall |
|
set the fees authorized by this chapter in amounts that allow the |
|
department to recover the annual expenditures of state funds by the |
|
department in: |
|
(1) reviewing and acting on a license renewal or |
|
registration; |
|
(2) amending a license, renewal license, or |
|
registration; |
|
(3) inspecting a licensed facility or vehicles and |
|
equipment regulated under this chapter; and |
|
(4) implementing and enforcing this chapter, |
|
including a rule or order adopted or a license issued under this |
|
chapter. |
|
SECTION 3.0423. Section 144.073, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.073. FEES [ACCOUNT]. All fees collected under |
|
this chapter are payable to the department and shall be deposited to |
|
the credit of the [rendering fee account in the] general revenue |
|
fund[. Money in the account may be appropriated only to the
|
|
department] to be used to process and investigate applications |
|
filed under this chapter and to administer this chapter. |
|
SECTION 3.0424. Section 144.074, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.074. ADOPTION OF RULES. The executive |
|
commissioner [board] may adopt rules consistent with this chapter |
|
as necessary for the enforcement of this chapter. |
|
SECTION 3.0425. Section 144.076, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.076. PUBLIC RECORDS. The transcript of any |
|
hearing held by the State Office of Administrative Hearings |
|
[commissioner] and findings made by the administrative law judge |
|
[commissioner] or the department under this chapter are public |
|
records open to inspection at all reasonable times. |
|
SECTION 3.0426. Sections 144.081(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department [commissioner] may assess an |
|
administrative penalty against a person who violates this chapter, |
|
a rule adopted [by the board] under the authority of this chapter, |
|
or an order or license issued under this chapter. |
|
(b) In determining the amount of the penalty, the department |
|
[commissioner] shall consider: |
|
(1) the person's previous violations; |
|
(2) the seriousness of the violation; |
|
(3) any hazard to the health and safety of the public; |
|
(4) the person's demonstrated good faith; and |
|
(5) such other matters as justice may require. |
|
SECTION 3.0427. Sections 144.082(b), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(b) If a hearing is held, the administrative law judge |
|
[commissioner] shall make findings of fact and shall issue a |
|
written proposal for decision regarding the occurrence of the |
|
violation and the amount of the penalty that may be warranted. |
|
(c) If the person notified of the violation does not request |
|
a hearing, the department [commissioner] may assess a penalty after |
|
determining that a violation has occurred and the amount of the |
|
penalty that may be warranted. |
|
(d) After making a determination under this section that a |
|
penalty is to be assessed against a person, the department |
|
[commissioner] shall issue an order requiring that the person pay |
|
the penalty. |
|
SECTION 3.0428. Section 144.083, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 144.083. PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not |
|
later than the 30th day after the date an order finding that a |
|
violation has occurred is issued, the department [commissioner] |
|
shall inform the person against whom the order is issued of the |
|
amount of the penalty for the violation. |
|
(b) Not later than the 30th day after the date on which a |
|
decision or order charging a person with a penalty is final, the |
|
person shall: |
|
(1) pay the penalty in full; or |
|
(2) file a petition for [if the person seeks] judicial |
|
review of the department's order contesting the amount of the |
|
penalty, the fact of the violation, or both. |
|
(b-1) Within the period prescribed by Subsection (b), a |
|
person who files a petition for judicial review may: |
|
(1) stay enforcement of the penalty by: |
|
(A) paying [send the amount of] the penalty to |
|
the court [commissioner] for placement in an escrow account; or |
|
(B) posting [post] with the court [commissioner] |
|
a supersedeas bond for the amount of the penalty; or |
|
(2) request that the department stay enforcement of |
|
the penalty by: |
|
(A) filing with the court a sworn affidavit of |
|
the person stating that the person is financially unable to pay the |
|
penalty and is financially unable to give the supersedeas bond; and |
|
(B) sending a copy of the affidavit to the |
|
department. |
|
(b-2) If the department receives a copy of an affidavit |
|
under Subsection (b-1)(2), the department may file with the court, |
|
within five days after the date the copy is received, a contest to |
|
the affidavit. The court shall hold a hearing on the facts alleged |
|
in the affidavit as soon as practicable and shall stay the |
|
enforcement of the penalty on finding that the alleged facts are |
|
true. The person who files an affidavit has the burden of proving |
|
that the person is financially unable to pay the penalty or to give |
|
a supersedeas bond. |
|
(c) A bond posted under this section must be in a form |
|
approved by the court [commissioner] and be effective until all |
|
judicial review of the order or decision is final. |
|
(d) A person who does not send money to, [the commissioner
|
|
or] post the bond with, or file the affidavit with the court within |
|
the period prescribed by Subsection (b) waives all rights to |
|
contest the violation or the amount of the penalty. |
|
SECTION 3.0429. Section 144.084, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.084. REFUND OF ADMINISTRATIVE PENALTY. On [Not
|
|
later than the 30th day after] the date the court's judgment [of a
|
|
judicial determination] that an administrative penalty against a |
|
person should be reduced or not assessed becomes final, the court |
|
[commissioner] shall order that: |
|
(1) [remit to the person] the appropriate amount of |
|
any penalty payment plus accrued interest be remitted to the person |
|
not later than the 30th day after that date; or |
|
(2) [execute a release of] the bond be released, if the |
|
person has posted a bond. |
|
SECTION 3.0430. Section 144.085, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 144.085. RECOVERY OF ADMINISTRATIVE PENALTY BY |
|
ATTORNEY GENERAL. The attorney general at the request of the |
|
department [commissioner] may bring a civil action to recover an |
|
administrative penalty under this subchapter. |
|
SECTION 3.0431. Section 145.004(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department [Texas Department of Health] may enforce |
|
Chapter 431 against a person who adulterates or misbrands a tanning |
|
device. The department may investigate a person accused of |
|
adulterating or misbranding a tanning device. For the purposes of |
|
this subsection, a tanning device is adulterated or misbranded if |
|
the tanning device would be an adulterated or misbranded device |
|
under Section 431.111 or 431.112[, Health and Safety Code]. |
|
SECTION 3.0432. Section 145.006, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 145.006. WARNING SIGNS. (a) A tanning facility shall |
|
post a warning sign in a conspicuous location where it is readily |
|
visible by persons entering the establishment. The executive |
|
commissioner [board] by rule shall specify the size, design, and |
|
graphic design of the sign. The sign must have dimensions of at |
|
least 11 inches by 17 inches and must contain the following wording: |
|
Repeated exposure to ultraviolet radiation may cause chronic |
|
sun damage characterized by wrinkling, dryness, fragility, |
|
bruising of the skin, and skin cancer. |
|
DANGER: ULTRAVIOLET RADIATION |
|
Failure to use protective eyewear may result in severe burns |
|
or permanent injury to the eyes. |
|
Medications or cosmetics may increase your sensitivity to |
|
ultraviolet radiation. Consult a physician before using a sunlamp |
|
if you are using medications, have a history of skin problems, or |
|
believe you are especially sensitive to sunlight. Pregnant women |
|
or women taking oral contraceptives who use this product may |
|
develop discolored skin. |
|
A customer may call the [Texas] Department of State Health |
|
Services at (insert toll-free telephone number) to report an |
|
alleged injury regarding this tanning facility. |
|
IF YOU DO NOT TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM USE OF AN |
|
ULTRAVIOLET LAMP OR SUNLAMP. |
|
(b) A tanning facility operator shall also post a warning |
|
sign at each tanning device in a conspicuous location that is |
|
readily visible to a person about to use the device. The executive |
|
commissioner [board] by rule shall specify the size, design, and |
|
graphic design of the sign. The sign must have dimensions of at |
|
least 11 inches by 17 inches and must contain the following wording: |
|
DANGER: ULTRAVIOLET RADIATION |
|
1. Follow the manufacturer's instructions for use of this |
|
device. |
|
2. Avoid too frequent or lengthy exposure. As with natural |
|
sunlight, exposure can cause serious eye and skin injuries and |
|
allergic reactions. Repeated exposure may cause skin cancer. |
|
3. Wear protective eyewear. Failure to use protective |
|
eyewear may result in severe burns or permanent damage to the eyes. |
|
4. Do not sunbathe before or after exposure to ultraviolet |
|
radiation from sunlamps. |
|
5. Medications or cosmetics may increase your sensitivity |
|
to ultraviolet radiation. Consult a physician before using a |
|
sunlamp if you are using medication, have a history of skin |
|
problems, or believe you are especially sensitive to sunlight. |
|
Pregnant women or women using oral contraceptives who use this |
|
product may develop discolored skin. |
|
A customer may call the [Texas] Department of State Health |
|
Services at (insert toll-free telephone number) to report an |
|
alleged injury regarding this tanning device. |
|
IF YOU DO NOT TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM USE OF |
|
THIS DEVICE. |
|
(c) The department [Texas Department of Health] shall |
|
include with a license application and an application for renewal |
|
of a license a description of the design standards required for |
|
signs under this section. |
|
SECTION 3.0433. Sections 145.008(i), (j), and (k), Health |
|
and Safety Code, are amended to read as follows: |
|
(i) A record of each customer using a tanning device shall |
|
be maintained at the tanning facility at least until the third |
|
anniversary of the date of the customer's last use of a tanning |
|
device. The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall prescribe the form and content |
|
of the records. The record shall include: |
|
(1) the date and time of the customer's use of a |
|
tanning device; |
|
(2) the length of time the tanning device was used; |
|
(3) any injury or illness resulting from the use of a |
|
tanning device; |
|
(4) any written informed consent statement required to |
|
be signed under Subsection (e); |
|
(5) the customer's skin type, as determined by the |
|
customer by using the Fitzpatrick scale for classifying a skin |
|
type; |
|
(6) whether the customer has a family history of skin |
|
cancer; and |
|
(7) whether the customer has a past medical history of |
|
skin cancer. |
|
(j) An operator shall keep an incident log at each tanning |
|
facility. The log shall be maintained at the tanning facility at |
|
least until the third anniversary of the date of an incident. The |
|
executive commissioner [board] by rule shall prescribe the form and |
|
content of the log. The log shall include each: |
|
(1) alleged injury; |
|
(2) use of a tanning device by a customer not wearing |
|
protective eyewear; |
|
(3) mechanical problem with a tanning device; and |
|
(4) customer complaint. |
|
(k) The department [Texas Department of Health] shall |
|
provide to each applicant for an original or renewal license a |
|
written copy of the Fitzpatrick scale. |
|
SECTION 3.0434. Sections 145.009(a), (c), (d), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) A person may not operate a tanning facility unless the |
|
person holds a license issued by the department to operate the |
|
facility. Unless revoked or suspended, a license is valid until the |
|
second [first] anniversary of the date the license was issued. A |
|
separate license is required for each tanning facility. |
|
(c) The department [board annually] shall renew licenses |
|
after application for renewal is made on forms provided by the |
|
department for this purpose and after receipt of renewal fees. |
|
(d) The executive commissioner [department] by rule may |
|
adopt a system under which licenses expire on various dates during |
|
the year. As part of this system the license fees and [the annual] |
|
renewal fees may be prorated on a monthly basis to reflect the |
|
actual number of months the license is valid. |
|
(e) The department may revoke, suspend, suspend on an |
|
emergency basis, or probate by an emergency order of the |
|
commissioner, or the commissioner's designee, a license to operate |
|
a tanning facility for: |
|
(1) a failure to pay a license fee or [an annual] |
|
renewal fee for a license; |
|
(2) an applicant's acquisition or attempted |
|
acquisition of a license by fraud or deception; |
|
(3) a violation of this chapter; |
|
(4) a violation of a rule of the department adopted |
|
under this chapter; or |
|
(5) a violation of an order issued under this chapter. |
|
SECTION 3.0435. Sections 145.010(a), (b), (c), and (e), |
|
Health and Safety Code, are amended to read as follows: |
|
(a) The department [board] shall collect a fee for: |
|
(1) a license issued or renewed; or |
|
(2) a license that is modified. |
|
(b) The department [board] may charge prorated [or annual] |
|
fees. |
|
(c) The executive commissioner [board] by rule shall set the |
|
fees for issuance or renewal of a license in the amounts prescribed |
|
by Section 12.0111 and for modification of a license in an amount |
|
[in amounts] that allows [allow] the department to recover not less |
|
than 50 percent of the costs to the department in: |
|
(1) reviewing and acting on a license application; |
|
(2) modifying [or renewing] a license; |
|
(3) inspecting a licensed facility; and |
|
(4) implementing and enforcing this chapter or rules |
|
relating to this chapter. |
|
(e) A license fee received by the department shall be |
|
deposited in the state treasury to the credit of the food and drug |
|
registration account in the general revenue fund. The fees are |
|
dedicated to the department for the administration and enforcement |
|
of this chapter. |
|
SECTION 3.0436. Section 145.011(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] may adopt rules as |
|
necessary to implement this chapter. |
|
SECTION 3.0437. Section 145.012(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) If an emergency order is issued without a hearing, the |
|
department shall refer the matter to the State Office of |
|
Administrative Hearings. An administrative law judge of that |
|
office shall determine a time and place for a hearing and hold the |
|
hearing [at which the emergency order is affirmed, modified, or set
|
|
aside]. The hearing shall be held under rules of the department. |
|
SECTION 3.0438. Sections 145.0121(a) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) If it appears that a person has violated or is violating |
|
this chapter or an order issued or a rule adopted under this |
|
chapter, the department [commissioner] may request the attorney |
|
general or the district or county attorney or the municipal |
|
attorney of a municipality in the jurisdiction where the violation |
|
is alleged to have occurred or may occur to institute a civil suit |
|
for: |
|
(1) an order enjoining the violation; |
|
(2) a permanent or temporary injunction, a temporary |
|
restraining order, or other appropriate remedy if the department |
|
shows that the person has engaged in or is engaging in a violation; |
|
(3) the assessment and recovery of a civil penalty; or |
|
(4) both injunctive relief and a civil penalty. |
|
(f) The department [commissioner] or the attorney general |
|
may each recover reasonable expenses incurred in obtaining |
|
injunctive relief or a civil penalty under this section, including |
|
investigation and court costs, reasonable attorney's fees, witness |
|
fees, and other expenses. The expenses recovered by the department |
|
[commissioner] under this section shall be used for the |
|
administration and enforcement of this chapter. The expenses |
|
recovered by the attorney general shall be used by the attorney |
|
general. |
|
SECTION 3.0439. Sections 145.0122(a), (d), (e), (f), (g), |
|
(h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are |
|
amended to read as follows: |
|
(a) The department [board or the board's designee] may |
|
impose an administrative penalty against a person licensed or |
|
regulated under this chapter who violates this chapter or a rule or |
|
order adopted under this chapter. |
|
(d) If the department [commissioner or the commissioner's
|
|
designee] determines a violation has occurred, the department shall |
|
give to the person written notice [commissioner or the
|
|
commissioner's designee may issue to the board or the board's
|
|
designee a report] that states the facts on which the determination |
|
is based and the department's [commissioner's or the designee's] |
|
recommendation on the imposition of a penalty[, including a
|
|
recommendation on the amount of the penalty]. |
|
[(e)
Within 14 days after the date the report is issued, the
|
|
commissioner or the commissioner's designee shall give written
|
|
notice of the report to the person.] The notice may be given by |
|
certified mail. The notice must include a brief summary of the |
|
alleged violation and a statement of the amount of the recommended |
|
penalty and must inform the person that the person has a right to a |
|
hearing on the occurrence of the violation, the amount of the |
|
penalty, or both the occurrence of the violation and the amount of |
|
the penalty. |
|
(f) Within 20 days after the date the person receives the |
|
notice, the person in writing may accept the determination and |
|
recommended penalty of the department [commissioner or the
|
|
commissioner's designee] or may make a written request for a |
|
hearing on the occurrence of the violation, the amount of the |
|
penalty, or both the occurrence of the violation and the amount of |
|
the penalty. |
|
(g) If the person accepts the determination and recommended |
|
penalty of the department [commissioner or the commissioner's
|
|
designee], the department [board] by order shall [approve the
|
|
determination and] impose the recommended penalty. |
|
(h) If the person requests a hearing or fails to respond |
|
timely to the notice, the department shall refer the matter to the |
|
State Office of Administrative Hearings [commissioner or the
|
|
commissioner's designee shall set a hearing] and shall give notice |
|
of the hearing to the person. The hearing shall be held by an |
|
administrative law judge of that office [the department]. The |
|
administrative law judge shall make findings of fact and |
|
conclusions of law and promptly issue to the department [board] a |
|
written proposal for a decision about the occurrence of the |
|
violation and the amount of a proposed penalty. Based on the |
|
findings of fact, conclusions of law, and proposal for a decision, |
|
the department [board] by order may find that a violation has |
|
occurred and impose a penalty or may find that no violation |
|
occurred. |
|
(i) The notice of the department's [board's] order given to |
|
the person under Chapter 2001, Government Code, must include a |
|
statement of the right of the person to judicial review of the |
|
order. |
|
(j) Within 30 days after the date the department's [board's] |
|
order becomes final as provided by Section 2001.144, Government |
|
Code, the person shall: |
|
(1) pay the amount of the penalty; |
|
(2) pay the amount of the penalty and file a petition |
|
for judicial review contesting the occurrence of the violation, the |
|
amount of the penalty, or both the occurrence of the violation and |
|
the amount of the penalty; or |
|
(3) without paying the amount of the penalty, file a |
|
petition for judicial review in a district court in Travis County |
|
contesting the occurrence of the violation, the amount of the |
|
penalty, or both the occurrence of the violation and the amount of |
|
the penalty. |
|
(k) Within the 30-day period, a person who acts under |
|
Subsection (j)(3) may: |
|
(1) stay enforcement of the penalty by: |
|
(A) paying the amount of the penalty to the court |
|
for placement in an escrow account; or |
|
(B) giving to the court a supersedeas bond that |
|
is approved by the court for the amount of the penalty and that is |
|
effective until all judicial review of the department's [board's] |
|
order is final; or |
|
(2) request the court to stay enforcement of the |
|
penalty by: |
|
(A) filing with the court a sworn affidavit of |
|
the person stating that the person is financially unable to pay the |
|
amount of the penalty and is financially unable to give the |
|
supersedeas bond; and |
|
(B) giving a copy of the affidavit to the |
|
department [commissioner] by certified mail. |
|
(l) If the department [commissioner] receives a copy of an |
|
affidavit under Subsection (k)(2), the department [commissioner] |
|
may file with the court, not later than the fifth day after the date |
|
the copy is received, a contest to the affidavit. The court shall |
|
hold a hearing on the facts alleged in the affidavit as soon as |
|
practicable and shall stay the enforcement of the penalty on |
|
finding that the alleged facts are true. The person who files an |
|
affidavit has the burden of proving that the person is financially |
|
unable to pay the amount of the penalty and give a supersedeas bond. |
|
(m) If the person does not pay the amount of the penalty and |
|
the enforcement of the penalty is not stayed, the department |
|
[commissioner] may refer the matter to the attorney general for |
|
collection of the amount of the penalty. |
|
(n) Judicial review of the department's order [of the
|
|
board]: |
|
(1) is instituted by filing a petition as provided by |
|
Subchapter G, Chapter 2001, Government Code; and |
|
(2) is under the substantial evidence rule. |
|
SECTION 3.0440. Section 146.0025(a), Health and Safety |
|
Code, is amended to read as follows: |
|
(a) This chapter does not apply to: |
|
(1) a medical facility licensed under other law; |
|
(2) an office or clinic of a person licensed by the |
|
Texas [State Board of] Medical Board [Examiners]; |
|
(3) a person who performs only ear piercing; or |
|
(4) a facility in which only ear piercing is |
|
performed. |
|
SECTION 3.0441. Section 146.003(b), Health and Safety Code, |
|
as amended by Chapters 516 (S.B. 61) and 1528 (S.B. 932), Acts of |
|
the 76th Legislature, Regular Session, 1999, is reenacted to read |
|
as follows: |
|
(b) The department may issue a license or temporary location |
|
license for a tattoo or body piercing studio after determining that |
|
the studio is in compliance with applicable statutes, rules, and |
|
zoning codes. |
|
SECTION 3.0442. Section 146.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 146.004. LICENSE TERM; RENEWAL. (a) A tattoo studio |
|
or body piercing studio license is valid for two years [one year] |
|
from the date of issuance. A temporary tattooing or body piercing |
|
location license is valid for a specified period not to exceed seven |
|
days. |
|
(b) A tattoo studio or body piercing studio license may be |
|
renewed [annually] on payment of the required renewal fee. |
|
SECTION 3.0443. Section 146.0041(a), Health and Safety |
|
Code, is amended to read as follows: |
|
(a) The department may refuse to issue an original or |
|
renewal tattoo studio or body piercing studio license if it has |
|
reasonable grounds to believe and finds that any of the following |
|
circumstances exist: |
|
(1) the applicant has been convicted of a violation of |
|
this chapter during the two years immediately preceding the filing |
|
of the application; |
|
(2) three years have not elapsed since the |
|
termination, by pardon or otherwise, of a sentence imposed on the |
|
applicant for a conviction associated with tattooing or body |
|
piercing; |
|
(3) the applicant violated or caused to be violated a |
|
provision of this chapter or a rule [of the department] adopted |
|
under this chapter involving moral turpitude during the six months |
|
immediately preceding the filing of the application; |
|
(4) the applicant failed to answer or falsely or |
|
incorrectly answered a question in an original or renewal |
|
application; |
|
(5) the applicant is indebted to the state for a fee or |
|
penalty imposed by this chapter or by rule [of the department] |
|
adopted under this chapter; |
|
(6) the applicant is a minor; or |
|
(7) the applicant does not provide an adequate |
|
building available at the address for which the license is sought |
|
before conducting any activity authorized by the license. |
|
SECTION 3.0444. Section 146.0042(b), Health and Safety |
|
Code, is amended to read as follows: |
|
(b) The department may suspend for not more than 60 days or |
|
revoke an original or renewal tattoo studio or body piercing studio |
|
license if it is found, after notice and hearing, that any of the |
|
following is true: |
|
(1) the license holder has been finally convicted of a |
|
violation of this chapter; |
|
(2) the license holder violated a provision of this |
|
chapter or a rule [of the department] adopted under this chapter; |
|
(3) the license holder made a false or misleading |
|
statement in connection with the original or renewal application, |
|
either in the formal application itself or in any other written |
|
instrument relating to the application submitted to the department; |
|
(4) the license holder is indebted to the state for |
|
fees or payment of penalties imposed by this chapter or by a rule |
|
[of the department] adopted under this chapter; |
|
(5) the license holder knowingly misrepresented to a |
|
customer or the public any tattoo or body piercing jewelry sold by |
|
the license holder; or |
|
(6) the license holder was intoxicated on the licensed |
|
premises. |
|
SECTION 3.0445. Section 146.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 146.005. FEES. [(a)] The executive commissioner by |
|
rule [board] shall set license and registration fees and license |
|
and registration renewal fees in amounts necessary for the |
|
department to administer this chapter. |
|
[(b)
Fees collected under this section may only be
|
|
appropriated to the department to administer and enforce this
|
|
chapter.] |
|
SECTION 3.0446. Section 146.007(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The [board, commissioner, and] department may enforce |
|
Chapter 431 in relation to a drug, cosmetic, or device that is used |
|
in tattooing and that is not otherwise subject to that chapter as if |
|
the drug, cosmetic, or device satisfied the definitions assigned |
|
those terms under Section 431.002. |
|
SECTION 3.0447. Section 146.010(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] by rule shall |
|
establish sanitation requirements for tattoo and body piercing |
|
studios and any other necessary requirements relating to the |
|
building or part of the building in which a tattoo or body piercing |
|
studio is located. |
|
SECTION 3.0448. Section 146.013(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A tattooist shall maintain a permanent record of each |
|
person tattooed by the tattooist for a period established by |
|
department rule [the board]. A person who performs body piercing |
|
shall maintain a permanent record of each individual whose body is |
|
pierced by the person for a period established by department rule |
|
[the board]. |
|
SECTION 3.0449. Section 146.015(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The executive commissioner [board] shall adopt rules to |
|
implement this chapter. |
|
SECTION 3.0450. Section 146.017(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The refusal to issue a license, the suspension or |
|
revocation of a license, and any appeals are governed by the |
|
department's [board's] formal hearing procedures and the procedures |
|
for a contested case hearing under Chapter 2001, Government Code. A |
|
person may appeal a final decision of the department as provided by |
|
that chapter. |
|
SECTION 3.0451. Sections 146.019(a), (d), (e), (f), (g), |
|
(h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are |
|
amended to read as follows: |
|
(a) The department [commissioner] may impose an |
|
administrative penalty against a person who violates a rule adopted |
|
under Section 146.007 or an order adopted or license issued under |
|
this chapter. |
|
(d) The department [commissioner who determines that a
|
|
violation has occurred] shall issue an order that states the facts |
|
on which a [the] determination that a violation occurred is based, |
|
including an assessment of the penalty. |
|
(e) The department [Within 14 days after the date the report
|
|
is issued, the commissioner] shall give written notice of the order |
|
[report] to the person. The notice may be given by certified mail. |
|
The notice must include a brief summary of the alleged violation and |
|
a statement of the amount of the recommended penalty and must inform |
|
the person that the person has a right to a hearing on the |
|
occurrence of the violation, the amount of the penalty, or both the |
|
occurrence of the violation and the amount of the penalty. |
|
(f) Within 20 days after the date the person receives the |
|
notice, the person in writing may accept the determination and |
|
recommended penalty of the department [commissioner] or may make |
|
written request for a hearing on the occurrence of the violation, |
|
the amount of the penalty, or both the occurrence of the violation |
|
and the amount of the penalty. |
|
(g) If the person accepts the determination and recommended |
|
penalty of the department [commissioner], the department |
|
[commissioner] by order shall [approve the determination and] |
|
impose the recommended penalty. |
|
(h) If the person requests a hearing or fails to respond |
|
timely to the notice, the department [commissioner] shall refer the |
|
case to the State Office of Administrative Hearings and [set a
|
|
hearing and give notice of the hearing to the person. The hearing
|
|
shall be held by] an administrative law judge of that office shall |
|
hold the hearing. The department shall give written notice of the |
|
hearing to the person [the State Office of Administrative
|
|
Hearings]. The administrative law judge shall make findings of |
|
fact and conclusions of law and promptly issue to the department |
|
[commissioner] a proposal for a decision about the occurrence of |
|
the violation and the amount of a proposed penalty. Based on the |
|
findings of fact, conclusions of law, and proposal for a decision, |
|
the department [commissioner] by order may find that a violation |
|
has occurred and impose a penalty or may find that no violation |
|
occurred. |
|
(i) The notice of the department's [commissioner's] order |
|
given to the person under Chapter 2001, Government Code, must |
|
include a statement of the right of the person to judicial review of |
|
the order. |
|
(j) Within 30 days after the date the department's |
|
[commissioner's] order is final as provided by Subchapter F, |
|
Chapter 2001, Government Code, the person shall: |
|
(1) pay the amount of the penalty; |
|
(2) pay the amount of the penalty and file a petition |
|
for judicial review contesting the occurrence of the violation, the |
|
amount of the penalty, or both the occurrence of the violation and |
|
the amount of the penalty; or |
|
(3) without paying the amount of the penalty, file a |
|
petition for judicial review contesting the occurrence of the |
|
violation, the amount of the penalty, or both the occurrence of the |
|
violation and the amount of the penalty. |
|
(k) Within the 30-day period, a person who acts under |
|
Subsection (j)(3) [of this section] may: |
|
(1) stay enforcement of the penalty by: |
|
(A) paying the amount of the penalty to the court |
|
for placement in an escrow account; or |
|
(B) giving to the court a supersedeas bond |
|
approved by the court for the amount of the penalty and that is |
|
effective until all judicial review of the department's |
|
[commissioner's] order is final; or |
|
(2) request the court to stay enforcement of the |
|
penalty by: |
|
(A) filing with the court a sworn affidavit of |
|
the person stating that the person is financially unable to pay the |
|
amount of the penalty and is financially unable to give the |
|
supersedeas bond; and |
|
(B) giving a copy of the affidavit to the |
|
department [commissioner] by certified mail. |
|
(l) The department on receipt of [commissioner who
|
|
receives] a copy of an affidavit under Subsection (k)(2) [of this
|
|
section] may file, with the court within five days after the date |
|
the copy is received, a contest to the affidavit. The court shall |
|
hold a hearing on the facts alleged in the affidavit as soon as |
|
practicable and shall stay the enforcement of the penalty on |
|
finding that the alleged facts are true. The person who files an |
|
affidavit has the burden of proving that the person is financially |
|
unable to pay the amount of the penalty and to give a supersedeas |
|
bond. |
|
(m) If the person does not pay the amount of the penalty and |
|
the enforcement of the penalty is not stayed, the department |
|
[commissioner] may refer the matter to the attorney general for |
|
collection of the amount of the penalty. |
|
(n) Judicial review of the order of the department |
|
[commissioner]: |
|
(1) is instituted by filing a petition as provided by |
|
Subchapter G, Chapter 2001, Government Code [and its subsequent
|
|
amendments]; and |
|
(2) is under the substantial evidence rule. |
|
SECTION 3.0452. Section 146.024, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 146.024. REGISTRATION TERM; RENEWAL. (a) A tattooist |
|
or body piercer registration is valid for two years [one year] from |
|
the date of issuance. |
|
(b) A tattooist or body piercer registration may be renewed |
|
[annually] on: |
|
(1) payment of the required renewal fee; and |
|
(2) submission of proof of completion of a training |
|
course approved by the department that includes not less than four |
|
hours related to bloodborne pathogens, infection control, and |
|
aseptic technique. |
|
SECTION 3.0453. Sections 146.025(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The department may approve a course of instruction based |
|
on any standards set by the executive commissioner [department] to |
|
reasonably ensure that a tattooist or body piercer develops the job |
|
skills and knowledge necessary to protect public health and safety. |
|
(d) The executive commissioner [department] by rule shall |
|
set a fee in an amount reasonable and necessary to cover the cost to |
|
the department of reviewing the course content and issuing the |
|
approval. |
|
SECTION 3.0454. Section 161.001(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A person who administers or authorizes the |
|
administration of a vaccine or immunizing agent is not liable for an |
|
injury caused by the vaccine or immunizing agent if the |
|
immunization is required by department rule [the board] or is |
|
otherwise required by law or other rules [rule]. |
|
SECTION 3.0455. Sections 161.004(a) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) Every child in the state shall be immunized against |
|
vaccine preventable diseases caused by infectious agents in |
|
accordance with the immunization schedule adopted in department |
|
rules [by the board]. |
|
(f) The executive commissioner [board] shall adopt rules |
|
that are necessary to administer this section. |
|
SECTION 3.0456. Sections 161.005(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) On admission of a child to a mental health facility of |
|
the department, a state supported living center of the [Texas] |
|
Department of Aging and Disability Services, or a facility of |
|
[Mental Health and Mental Retardation,] the Texas Department of |
|
Criminal Justice[,] or the Texas Juvenile Justice Department [Youth
|
|
Commission], the facility physician shall review the immunization |
|
history of the child and administer any needed vaccinations or |
|
refer the child for immunization. |
|
(b) The department and the executive commissioner [board] |
|
have the same powers and duties under this section as the department |
|
and the executive commissioner [those entities] have under Sections |
|
38.001 and 51.933, Education Code. In addition, the provisions of |
|
those sections relating to provisional admissions and exceptions |
|
apply to this section. |
|
SECTION 3.0457. Sections 161.0051(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [board] by rule may require |
|
nursing facilities [homes] to offer, in accordance with an |
|
immunization schedule adopted in department rules [by the board], |
|
immunizations to elderly residents or to staff who are in contact |
|
with elderly residents against diseases that the executive |
|
commissioner [board] determines to be: |
|
(1) caused by infectious agents; |
|
(2) potentially deadly; and |
|
(3) preventable by vaccine. |
|
(c) The executive commissioner [board] by rule shall |
|
require nursing homes to offer, in accordance with an immunization |
|
schedule adopted in department rules [by the board]: |
|
(1) pneumococcal vaccine to elderly residents; and |
|
(2) influenza vaccine to elderly residents and to |
|
staff who are in contact with elderly residents. |
|
SECTION 3.0458. Sections 161.0052(b), (c), (d), (f), and |
|
(h), Health and Safety Code, are amended to read as follows: |
|
(b) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall require a hospital to inform |
|
each elderly person admitted to the hospital for a period of 24 |
|
hours or more that the pneumococcal and influenza vaccines are |
|
available. If the elderly person requests a vaccine, and if a |
|
physician, or an advanced nurse practitioner or physician assistant |
|
on behalf of a physician, determines that the vaccine is in the |
|
person's best interest, the hospital must make the vaccination |
|
available to the person before the person is discharged from the |
|
hospital. |
|
(c) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall require an end stage renal |
|
disease facility to offer, to the extent possible as determined by |
|
the facility, the opportunity to receive the pneumococcal and |
|
influenza vaccines to each elderly person who receives ongoing care |
|
at the facility if a physician, or an advanced nurse practitioner or |
|
physician assistant on behalf of a physician, determines that the |
|
vaccine is in the person's best interest. If the facility decides |
|
it is not feasible to offer the vaccine, the facility must provide |
|
the person with information on other options for obtaining the |
|
vaccine. |
|
(d) The Texas [State Board of] Medical Board [Examiners] by |
|
rule shall require a physician responsible for the management of a |
|
physician's office that provides ongoing medical care to elderly |
|
persons to offer, to the extent possible as determined by the |
|
physician, the opportunity to receive the pneumococcal and |
|
influenza vaccines to each elderly person who receives ongoing care |
|
at the office. If the physician decides it is not feasible to offer |
|
the vaccine, the physician must provide the person with information |
|
on other options for obtaining the vaccine. |
|
(f) In adopting rules under this section, the executive |
|
commissioner [of the Health and Human Services Commission] and the |
|
Texas [State Board of] Medical Board [Examiners] shall consider the |
|
recommendations of the Advisory Committee on Immunization |
|
Practices of the Centers for Disease Control and Prevention. |
|
(h) The department shall make available to hospitals and end |
|
stage renal disease facilities, and the Texas [State Board of] |
|
Medical Board [Examiners] shall make available to physicians' |
|
offices, educational and informational materials concerning |
|
vaccination against influenza virus and pneumococcal disease. |
|
SECTION 3.0459. Sections 161.007(a), (a-3), and (k), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department, for the primary purpose of establishing |
|
and maintaining a single repository of accurate, complete, and |
|
current immunization records to be used in aiding, coordinating, |
|
and promoting efficient and cost-effective communicable disease |
|
prevention and control efforts, shall establish and maintain an |
|
immunization registry. The executive commissioner [of the Health
|
|
and Human Services Commission] by rule shall develop guidelines to: |
|
(1) protect the confidentiality of patients in |
|
accordance with Section 159.002, Occupations Code; |
|
(2) inform the individual or the individual's legally |
|
authorized representative about the registry and that registry |
|
information may be released under Section 161.00735; |
|
(3) require the written or electronic consent of the |
|
individual or the individual's legally authorized representative |
|
before any information relating to the individual is included in |
|
the registry; |
|
(4) permit the individual or the individual's legally |
|
authorized representative to withdraw consent for the individual to |
|
be included in the registry; and |
|
(5) determine the process by which consent is |
|
verified, including affirmation by a health care provider, birth |
|
registrar, regional health information exchange, or local |
|
immunization registry that consent has been obtained. |
|
(a-3) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall develop guidelines and |
|
procedures for obtaining consent from an individual after the |
|
individual's 18th birthday, including procedures for retaining |
|
immunization information in a separate database that is |
|
inaccessible by any person other than the department during the |
|
one-year period during which an 18-year-old may consent to |
|
inclusion in the registry under Subsection (a-2). |
|
(k) The executive commissioner [of the Health and Human
|
|
Services Commission] shall adopt rules to implement this section. |
|
SECTION 3.0460. Sections 161.00705(e) and (i), Health and |
|
Safety Code, are amended to read as follows: |
|
(e) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall determine the period during |
|
which the information collected under this section must remain in |
|
the immunization registry following the end of the disaster, public |
|
health emergency, terrorist attack, hostile military or |
|
paramilitary action, or extraordinary law enforcement emergency. |
|
(i) The executive commissioner [of the Health and Human
|
|
Services Commission] shall adopt rules necessary to implement this |
|
section. |
|
SECTION 3.0461. Section 161.00706(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) The executive commissioner [of the Health and Human
|
|
Services Commission] shall: |
|
(1) develop rules to ensure that immunization history |
|
submitted under Subsection (a)(2) is medically verified |
|
immunization information; |
|
(2) develop guidelines for use by the department in |
|
informing first responders about the registry and that registry |
|
information may be released under Section 161.00735; and |
|
(3) adopt rules necessary for the implementation of |
|
this section. |
|
SECTION 3.0462. Section 161.0072(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) The executive commissioner [board] shall develop rules |
|
to ensure that the immunization history submitted by an individual |
|
or the individual's legally authorized representative is medically |
|
verified immunization information. |
|
SECTION 3.0463. Sections 161.00735(e) and (h), Health and |
|
Safety Code, are amended to read as follows: |
|
(e) The executive commissioner [of the Health and Human
|
|
Services Commission,] by rule[,] shall determine the period during |
|
which the information collected under Subsection (c) must remain in |
|
the immunization registry following the end of the disaster. |
|
(h) The executive commissioner [of the Health and Human
|
|
Services Commission] shall make every effort to enter into a |
|
memorandum of agreement with each state to which residents of this |
|
state are likely to evacuate in a disaster on: |
|
(1) the release and use of registry information under |
|
this section to the appropriate health authority or local health |
|
authority of that state, including the length of time the |
|
information may be retained by that state; and |
|
(2) the receipt and use of information submitted by |
|
the health authority or local health authority of that state for |
|
inclusion in the registry under this section. |
|
SECTION 3.0464. Section 161.008(h), Health and Safety Code, |
|
is amended to read as follows: |
|
(h) The executive commissioner [of the Health and Human
|
|
Services Commission] shall adopt rules to implement this section. |
|
SECTION 3.0465. Section 161.0105(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) The immunity created by this section is in addition to |
|
any immunity created by Sections 161.001 and 161.007(i) |
|
[161.007(g)]. |
|
SECTION 3.0466. Section 161.0107(c), Health and Safety |
|
Code, is amended to read as follows: |
|
(c) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall specify: |
|
(1) the fields necessary to populate the immunization |
|
registry, including a field that indicates the patient's consent to |
|
be listed in the immunization registry has been obtained; and |
|
(2) the data standards that must be used for |
|
electronic submission of immunization information. |
|
SECTION 3.0467. Section 161.0109(b), Health and Safety |
|
Code, is amended to read as follows: |
|
(b) The department shall collaborate with the Cancer |
|
Prevention and Research Institute of Texas [Cancer Council] or its |
|
successor entity to develop educational programs for parents |
|
regarding human papillomavirus and promoting awareness of a minor's |
|
need for preventive services for cervical cancer and its |
|
precursors. |
|
SECTION 3.0468. Section 161.021(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Unless prohibited by other law, a person, including a |
|
hospital, sanatorium, nursing facility [home], rest home, medical |
|
society, cancer registry, or other organization, may provide |
|
interviews, reports, statements, memoranda, or other information |
|
relating to the condition and treatment of any person, to be used in |
|
a study to reduce morbidity or mortality or to identify persons who |
|
may need immunization, to: |
|
(1) the department; |
|
(2) a person that makes inquiries under immunization |
|
surveys conducted for the department; |
|
(3) a medical organization; |
|
(4) a hospital; |
|
(5) a hospital committee; or |
|
(6) a cancer registry, including a cancer registry of |
|
a cancer treatment center [as defined by Section 82.002]. |
|
SECTION 3.0469. Section 161.0213, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 161.0213. CONFIDENTIALITY. Reports, records, and |
|
information furnished to the commissioner or the commissioner's |
|
designee or the Texas [Natural Resource Conservation] Commission on |
|
Environmental Quality that relate to an epidemiologic or |
|
toxicologic investigation of human illnesses or conditions and of |
|
environmental exposures that are harmful or believed to be harmful |
|
to the public health are not public information under Chapter 552, |
|
Government Code, and are subject to the same confidentiality |
|
requirements as described by Section 81.046. |
|
SECTION 3.0470. Sections 161.0315(c) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) A hospital district may require in a contract with a |
|
health care facility described by Subsection (b) a provision that |
|
allows the governing body of the district to appoint a specified |
|
number of members to the facility's medical peer review committee |
|
or medical committee to evaluate medical and health care services |
|
for which the district contracts with the facility to provide. The |
|
governing body of a hospital district may receive a report from the |
|
facility's medical peer review committee or medical committee under |
|
this section in a closed meeting. A report, information, or a |
|
record that the district receives from the facility related to a |
|
review action conducted under the terms of the contract is: |
|
(1) confidential; |
|
(2) not subject to disclosure under Chapter 552, |
|
Government Code; and |
|
(3) subject to the same confidentiality and disclosure |
|
requirements to which a report, information, or record of a medical |
|
peer review committee under Section 160.007 [160.006], Occupations |
|
Code, is subject. |
|
(e) The governing body of a hospital district may receive a |
|
report under Subsection (d)(3) in a closed meeting. A report, |
|
information, or a record that the hospital district receives under |
|
Subsection (d)(3) is: |
|
(1) confidential; |
|
(2) not subject to disclosure under Chapter 552, |
|
Government Code; and |
|
(3) subject to the same confidentiality and disclosure |
|
requirements to which a report, information, or record of a medical |
|
peer review committee under Section 160.007 [160.006], Occupations |
|
Code, is subject. |
|
SECTION 3.0471. Section 161.083(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Pursuant to federal regulation under 21 C.F.R. Section |
|
1140.14(b) [897.14(b)], a person may not sell, give, or cause to be |
|
sold or given a cigarette or tobacco product to someone who is |
|
younger than 27 years of age unless the person to whom the cigarette |
|
or tobacco product was sold or given presents an apparently valid |
|
proof of identification. |
|
SECTION 3.0472. Section 161.101(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [board] shall adopt rules to |
|
implement this section. |
|
SECTION 3.0473. Sections 161.131(1) and (8), Health and |
|
Safety Code, are amended to read as follows: |
|
(1) "Abuse" has the meaning assigned by the federal |
|
Protection and Advocacy for [Mentally Ill] Individuals with Mental |
|
Illness Act [of 1986] (42 U.S.C. Section 10801 et seq.). |
|
(8) "Neglect" has the meaning assigned by the federal |
|
Protection and Advocacy for [Mentally Ill] Individuals with Mental |
|
Illness Act [of 1986] (42 U.S.C. Section 10801 et seq.). |
|
SECTION 3.0474. Sections 161.132(d) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(d) The executive commissioner by rule for the department |
|
and the Department of Aging and Disability Services, and [Texas
|
|
Board of Mental Health and Mental Retardation, Texas Board of
|
|
Health, Texas Commission on Alcohol and Drug Abuse, and] each state |
|
health care regulatory agency by rule, shall: |
|
(1) prescribe procedures for the investigation of |
|
reports received under Subsection (a) or (b) and for coordination |
|
with and referral of reports to law enforcement agencies or other |
|
appropriate agencies; and |
|
(2) prescribe follow-up procedures to ensure that a |
|
report referred to another agency receives appropriate action. |
|
(f) The executive commissioner by rule and each [Each] state |
|
health care regulatory agency by rule shall provide for appropriate |
|
disciplinary action against a health care professional licensed by |
|
the agency who fails to report as required by this section. |
|
SECTION 3.0475. Section 161.133, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 161.133. [MEMORANDUM OF UNDERSTANDING ON] INSERVICE |
|
TRAINING. (a) The executive commissioner [Texas Board of Mental
|
|
Health and Mental Retardation, Texas Board of Health, and Texas
|
|
Commission on Alcohol and Drug Abuse] by rule shall require [adopt a
|
|
joint memorandum of understanding that requires] each inpatient |
|
mental health facility, treatment facility, or hospital that |
|
provides comprehensive medical rehabilitation services to annually |
|
provide as a condition of continued licensure a minimum of eight |
|
hours of inservice training designed to assist employees and health |
|
care professionals associated with the facility in identifying |
|
patient abuse or neglect and illegal, unprofessional, or unethical |
|
conduct by or in the facility. |
|
(b) The rules [memorandum] must prescribe: |
|
(1) minimum standards for the training program; and |
|
(2) a means for monitoring compliance with the |
|
requirement. |
|
(c) The department [Each agency] shall review and the |
|
executive commissioner shall modify the rules [memorandum] as |
|
necessary not later than the last month of each state fiscal year. |
|
SECTION 3.0476. Section 161.134(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A hospital, mental health facility, or treatment |
|
facility may not suspend or terminate the employment of or |
|
discipline or otherwise discriminate against an employee for |
|
reporting to the employee's supervisor, an administrator of the |
|
facility, a state regulatory agency, or a law enforcement agency a |
|
violation of law, including a violation of this chapter, a rule |
|
adopted under this chapter, or a rule of another agency [adopted by
|
|
the Texas Board of Mental Health and Mental Retardation, the Texas
|
|
Board of Health, or the Texas Commission on Alcohol and Drug Abuse]. |
|
SECTION 3.0477. Sections 161.135(a) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A hospital, mental health facility, or treatment |
|
facility may not retaliate against a person who is not an employee |
|
for reporting a violation of law, including a violation of this |
|
chapter, a rule adopted under this chapter, or a rule of another |
|
agency [adopted by the Texas Board of Mental Health and Mental
|
|
Retardation, the Texas Board of Health, or the Texas Commission on
|
|
Alcohol and Drug Abuse]. |
|
(c) A person suing under this section has the burden of |
|
proof, except that it is a rebuttable presumption that the |
|
plaintiff was retaliated against if: |
|
(1) before the 60th day after the date on which the |
|
plaintiff made a report in good faith, the hospital, mental health |
|
facility, or treatment facility: |
|
(A) discriminates in violation of Section |
|
161.134 against a relative who is an employee of the facility; |
|
(B) transfers, disciplines, suspends, |
|
terminates, or otherwise discriminates against the person or a |
|
relative who is a volunteer in the facility or who is employed under |
|
the patient work program administered by the department [Texas
|
|
Department of Mental Health and Mental Retardation]; |
|
(C) commits or threatens to commit, without |
|
justification, the person or a relative of the person; or |
|
(D) transfers, discharges, punishes, or |
|
restricts the privileges of the person or a relative of the person |
|
who is receiving inpatient or outpatient services in the facility; |
|
or |
|
(2) a person expected to testify on behalf of the |
|
plaintiff is intentionally made unavailable through an action of |
|
the facility, including a discharge, resignation, or transfer. |
|
SECTION 3.0478. Sections 161.301(a), (b), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department [commissioner] shall develop and |
|
implement a public awareness campaign designed to reduce tobacco |
|
use by minors in this state. The campaign may use advertisements or |
|
similar media to provide educational information about tobacco use. |
|
(b) The department [commissioner] may contract with another |
|
person to develop and implement the public awareness campaign. The |
|
contract shall be awarded on the basis of competitive bids. |
|
(d) The department [commissioner] may not award a contract |
|
under Subsection (b) to: |
|
(1) a person or entity that is required to register |
|
with the Texas Ethics Commission under Chapter 305, Government |
|
Code, except as provided by Subsection (f); |
|
(2) any partner, employee, employer, relative, |
|
contractor, consultant, or related entity of a person or entity |
|
described by Subdivision (1) and not described by Subsection (f); |
|
or |
|
(3) a person or entity who has been hired to represent |
|
associations or other entities for the purpose of affecting the |
|
outcome of legislation, agency rules, or other government policies |
|
through grassroots or media campaigns. |
|
SECTION 3.0479. Section 161.352(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [department] by rule shall |
|
establish the time for filing an annual report under this section |
|
and shall prescribe the form for the report. |
|
SECTION 3.0480. Section 161.353(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Each manufacturer shall assign a nicotine yield rating |
|
to each cigarette or tobacco product distributed in this state. The |
|
rating shall be assigned in accordance with department standards |
|
[adopted by the department]. |
|
SECTION 3.0481. Section 161.402, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 161.402. MATERIAL SAFETY DATA SHEET REQUIRED; ASBESTOS |
|
INSTALLATION OR REINSTALLATION PROHIBITED. The executive |
|
commissioner [board] shall adopt rules designating the materials or |
|
replacement parts for which a person must obtain a material safety |
|
data sheet before installing the materials or parts in a public |
|
building. A person may not install materials or replacement parts |
|
in a public building if: |
|
(1) the person does not obtain a required material |
|
safety data sheet; or |
|
(2) the materials or parts, according to the material |
|
safety data sheet, contain more than one percent asbestos and there |
|
is an alternative material or part. |
|
SECTION 3.0482. Section 161.501(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A hospital, birthing center, physician, nurse midwife, |
|
or midwife who provides prenatal care to a pregnant woman during |
|
gestation or at delivery of an infant shall: |
|
(1) provide the woman and the father of the infant, if |
|
possible, or another adult caregiver for the infant, with a |
|
resource pamphlet that includes: |
|
(A) a list of the names, addresses, and phone |
|
numbers of professional organizations that provide postpartum |
|
counseling and assistance to parents relating to postpartum |
|
depression and other emotional trauma associated with pregnancy and |
|
parenting; |
|
(B) information regarding the prevention of |
|
shaken baby syndrome including: |
|
(i) techniques for coping with anger caused |
|
by a crying baby; |
|
(ii) different methods for preventing a |
|
person from shaking a newborn, infant, or other young child; |
|
(iii) the dangerous effects of shaking a |
|
newborn, infant, or other young child; and |
|
(iv) the symptoms of shaken baby syndrome |
|
and who to contact, as recommended by the American Academy of |
|
Pediatrics, if a parent suspects or knows that a baby has been |
|
shaken in order to receive prompt medical treatment; |
|
(C) a list of diseases for which a child is |
|
required by state law to be immunized and the appropriate schedule |
|
for the administration of those immunizations; |
|
(D) the appropriate schedule for follow-up |
|
procedures for newborn screening; |
|
(E) information regarding sudden infant death |
|
syndrome, including current recommendations for infant sleeping |
|
conditions to lower the risk of sudden infant death syndrome; and |
|
(F) educational information in both English and |
|
Spanish on pertussis disease and the availability of a vaccine to |
|
protect against pertussis, including information on the Centers for |
|
Disease Control and Prevention recommendation that parents receive |
|
Tdap during the postpartum period to protect newborns from the |
|
transmission of pertussis; |
|
(2) if the woman is a recipient of medical assistance |
|
under Chapter 32, Human Resources Code, provide the woman and the |
|
father of the infant, if possible, or another adult caregiver with a |
|
resource guide that includes information in both English and |
|
Spanish relating to the development, health, and safety of a child |
|
from birth until age five, including information relating to: |
|
(A) selecting and interacting with a primary |
|
health care practitioner and establishing a "medical home" for the |
|
child; |
|
(B) dental care; |
|
(C) effective parenting; |
|
(D) child safety; |
|
(E) the importance of reading to a child; |
|
(F) expected developmental milestones; |
|
(G) health care resources available in the state; |
|
(H) selecting appropriate child care; and |
|
(I) other resources available in the state; |
|
(3) document in the woman's record that the woman |
|
received the resource pamphlet described in Subdivision (1) and the |
|
resource guide described in Subdivision (2), if applicable; and |
|
(4) retain the documentation for at least five years |
|
in the hospital's, birthing center's, physician's, nurse midwife's, |
|
or midwife's records. |
|
SECTION 3.0483. The heading to Section 161.502, Health and |
|
Safety Code, is amended to read as follows: |
|
Sec. 161.502. DUTIES OF DEPARTMENT, EXECUTIVE |
|
COMMISSIONER, AND COMMISSION. |
|
SECTION 3.0484. Sections 161.502(c) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) The executive commissioner [Health and Human Services
|
|
Commission] shall develop specific performance measures by which |
|
the commission may evaluate the effectiveness of the resource guide |
|
under Section 161.501(a)(2) in: |
|
(1) reducing costs to the state; and |
|
(2) improving outcomes for children. |
|
(d) Not later than December 1 of each even-numbered year, |
|
the commission [Health and Human Services Commission] shall submit |
|
a report to the legislature on the effectiveness of the resource |
|
guide under Section 161.501(a)(2), including legislative |
|
recommendations concerning the guide. |
|
SECTION 3.0485. Section 161.551, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 161.551. DEFINITIONS. (a) In this subchapter, |
|
"servicemember" [:
|
|
[(1)
"Commission" means the Health and Human Services
|
|
Commission.
|
|
[(2)
"Department" means the Department of State Health
|
|
Services.
|
|
[(3) "Servicemember"] means a member or former member |
|
of the state military forces or a component of the United States |
|
armed forces, including a reserve component. |
|
(b) In this section, "state military forces" has the meaning |
|
assigned by Section 437.001, Government Code. |
|
SECTION 3.0486. Sections 162.001(1) and (2), Health and |
|
Safety Code, are amended to read as follows: |
|
(1) "Blood bank" means a facility that obtains blood |
|
from voluntary donors, as that term is defined by the United States |
|
Food and Drug Administration, the AABB (formerly known as the |
|
American Association of Blood Banks), and the American Red Cross |
|
Blood Services and that is registered or licensed by the Center for |
|
[Office of] Biologics Evaluation and Research of the United States |
|
Food and Drug Administration and accredited by the AABB [American
|
|
Association of Blood Banks] or the American Red Cross Blood |
|
Services, or is qualified for membership in the American |
|
Association of Tissue Banks. The term includes a blood center, |
|
regional collection center, tissue bank, and transfusion service. |
|
(2) "AIDS" means acquired immune deficiency syndrome |
|
as defined by the Centers for Disease Control and Prevention of the |
|
United States Public Health Service. |
|
SECTION 3.0487. Section 162.002(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) For each donation of blood, a blood bank shall require |
|
the donor to submit to tests for communicable [infectious] |
|
diseases, including tests for AIDS, HIV, or hepatitis, and |
|
serological tests for contagious venereal diseases. |
|
SECTION 3.0488. Section 162.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 162.004. DISCLOSURE REQUIRED BY LAW. A blood bank |
|
shall disclose all information required by law, including HIV test |
|
results, to: |
|
(1) the department and a local health authority as |
|
required under Chapter 81 (Communicable Disease Prevention and |
|
Control Act); |
|
(2) the Centers for Disease Control and Prevention of |
|
the United States Public Health Service, as required by federal law |
|
or regulation; or |
|
(3) any other local, state, or federal entity, as |
|
required by law, rule, or regulation. |
|
SECTION 3.0489. Sections 162.006(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A blood bank may report to other blood banks the name of |
|
a donor with a possible communicable [infectious] disease according |
|
to positive blood test results. |
|
(b) A blood bank that reports a donor's name to other blood |
|
banks under this section may not disclose the communicable |
|
[infectious] disease that the donor has or is suspected of having. |
|
SECTION 3.0490. Section 162.007(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A blood bank shall report blood test results for blood |
|
confirmed as HIV positive by the normal procedures blood banks |
|
presently use or found to be contaminated by any other communicable |
|
[infectious] disease to: |
|
(1) the hospital or other facility in which the blood |
|
was transfused or provided; |
|
(2) the physician who transfused the infected blood; |
|
or |
|
(3) the recipient of the blood. |
|
SECTION 3.0491. Section 162.016, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 162.016. BE A BLOOD DONOR ACCOUNT; DEDICATION. (a) |
|
The be a blood donor account is a separate account in the general |
|
revenue fund. The account is composed of: |
|
(1) money deposited to the credit of the account under |
|
Section 504.641, Transportation Code; and |
|
(2) gifts, grants, donations, and legislative |
|
appropriations. |
|
(b) The department administers the account. |
|
(b-1) The department [and] may spend money credited to the |
|
account or money deposited to the associated trust fund account |
|
created under Section 504.6012, Transportation Code, only to: |
|
(1) make grants to nonprofit blood centers in this |
|
state for programs to recruit and retain volunteer blood donors; |
|
and |
|
(2) defray the cost of administering the account. |
|
(c) The department [board:
|
|
[(1)] may accept gifts, grants, and donations from any |
|
source for the benefit of the account. The executive commissioner |
|
of the Health and Human Services Commission [; and
|
|
[(2)] by rule shall establish guidelines for spending |
|
money described by Subsection (b-1) [credited to the account]. |
|
SECTION 3.0492. Section 162.018, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 162.018. BROCHURE ON UMBILICAL CORD BLOOD OPTIONS. |
|
(a) The executive commissioner [of the Health and Human Services
|
|
Commission] shall prepare and update as necessary a brochure based |
|
on nationally accepted, peer reviewed, scientific research |
|
information regarding stem cells contained in the umbilical cord |
|
blood after delivery of an infant. The information in the brochure |
|
must include: |
|
(1) the current and potential uses, risks, and |
|
benefits of stem cells contained in umbilical cord blood to a |
|
potential recipient of donated stem cells, including a biological |
|
family member, extended family member, or nonrelated individual; |
|
(2) the options available for future use or storage of |
|
umbilical cord blood after delivery of an infant, including: |
|
(A) discarding the stem cells; |
|
(B) donating the stem cells to a public umbilical |
|
cord blood bank; |
|
(C) storing the stem cells in a private family |
|
umbilical cord blood bank for use by immediate and extended family |
|
members; and |
|
(D) storing the stem cells for immediate and |
|
extended family use through a family or sibling donor banking |
|
program that provides free collection, processing, and storage when |
|
a medical need exists; |
|
(3) the medical process used to collect umbilical cord |
|
blood after delivery of an infant; |
|
(4) any risk associated with umbilical cord blood |
|
collection to the mother and the infant; |
|
(5) any costs that may be incurred by a pregnant woman |
|
who chooses to donate or store umbilical cord blood after delivery |
|
of the woman's infant; and |
|
(6) the average cost of public and private umbilical |
|
cord blood banking. |
|
(b) The department [Department of State Health Services] |
|
shall make the brochure available on the department's website and |
|
shall distribute the brochure on request to physicians or other |
|
persons permitted by law to attend a pregnant woman during |
|
gestation or at delivery of an infant. |
|
SECTION 3.0493. Section 164.003(5), Health and Safety Code, |
|
is amended to read as follows: |
|
(5) "Mental health facility" means: |
|
(A) a "mental health facility" as defined by |
|
Section 571.003; |
|
(B) a residential treatment facility, other than |
|
a mental health facility, in which persons are treated for |
|
emotional problems or disorders in a 24-hour supervised living |
|
environment; and |
|
(C) an adult day-care facility [or adult day
|
|
health care facility] as defined by Section 103.003, Human |
|
Resources Code. |
|
SECTION 3.0494. Section 164.004, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 164.004. EXEMPTIONS. This chapter does not apply to: |
|
(1) a treatment facility: |
|
(A) operated by the department [Texas Department
|
|
of Mental Health and Mental Retardation], a federal agency, or a |
|
political subdivision; or |
|
(B) funded by the department [Texas Commission on
|
|
Alcohol and Drug Abuse]; |
|
(2) a community center established under Subchapter A, |
|
Chapter 534, or a facility operated by a community center; or |
|
(3) a facility owned and operated by a nonprofit or |
|
not-for-profit organization offering counseling concerning family |
|
violence, help for runaway children, or rape. |
|
SECTION 3.0495. Section 164.006, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 164.006. SOLICITING AND CONTRACTING WITH CERTAIN |
|
REFERRAL SOURCES. A treatment facility or a person employed or |
|
under contract with a treatment facility, if acting on behalf of the |
|
treatment facility, may not: |
|
(1) contact a referral source or potential client for |
|
the purpose of soliciting, directly or indirectly, a referral of a |
|
patient to the treatment facility without disclosing its soliciting |
|
agent's, employee's, or contractor's affiliation with the treatment |
|
facility; |
|
(2) offer to provide or provide mental health or |
|
chemical dependency services to a public or private school in this |
|
state, on a part-time or full-time basis, the services of any of its |
|
employees or agents who make, or are in a position to make, a |
|
referral, if the services are provided on an individual basis to |
|
individual students or their families. Nothing herein prohibits a |
|
treatment facility from: |
|
(A) offering or providing educational programs |
|
in group settings to public schools in this state if the affiliation |
|
between the educational program and the treatment facility is |
|
disclosed; |
|
(B) providing counseling services to a public |
|
school in this state in an emergency or crisis situation if the |
|
services are provided in response to a specific request by a school; |
|
provided that, under no circumstances may a student be referred to |
|
the treatment facility offering the services; or |
|
(C) entering into a contract under Section |
|
464.020 with the board of trustees of a school district with a |
|
disciplinary alternative education program, or with the board's |
|
designee, for the provision of chemical dependency treatment |
|
services; |
|
(3) provide to an entity of state or local government, |
|
on a part-time or full-time basis, the mental health or chemical |
|
dependency services of any of its employees, agents, or contractors |
|
who make or are in a position to make referrals unless: |
|
(A) the treatment facility discloses to the |
|
governing authority of the entity: |
|
(i) the employee's, agent's, or |
|
contractor's relationship to the facility; and |
|
(ii) the fact that the employee, agent, or |
|
contractor might make a referral, if permitted, to the facility; |
|
and |
|
(B) the employee, agent, or contractor makes a |
|
referral only if: |
|
(i) the treatment facility obtains the |
|
governing authority's authorization in writing for the employee, |
|
agent, or contractor to make the referrals; and |
|
(ii) the employee, agent, or contractor |
|
discloses to the prospective patient the employee's, agent's, or |
|
contractor's relationship to the facility at initial contact; or |
|
(4) in relation to intervention and assessment |
|
services, contract with, offer to remunerate, or remunerate a |
|
person who operates an intervention and assessment service that |
|
makes referrals to a treatment facility for inpatient treatment of |
|
mental illness or chemical dependency unless the intervention and |
|
assessment service is: |
|
(A) operated by a community mental health and |
|
intellectual disability [mental retardation] center funded by the |
|
department and the Department of Aging and Disability Services |
|
[Texas Department of Mental Health and Mental Retardation]; |
|
(B) operated by a county or regional medical |
|
society; |
|
(C) a qualified mental health referral service as |
|
defined by Section 164.007; or |
|
(D) owned and operated by a nonprofit or |
|
not-for-profit organization offering counseling concerning family |
|
violence, help for runaway children, or rape. |
|
SECTION 3.0496. Section 164.007(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A qualified mental health referral service means a |
|
service that conforms to all of the following standards: |
|
(1) the referral service does not exclude as a |
|
participant in the referral service an individual who meets the |
|
qualifications for participation and qualifications for |
|
participation cannot be based in whole or in part on an individual's |
|
or entity's affiliation or nonaffiliation with other participants |
|
in the referral service; |
|
(2) a payment the participant makes to the referral |
|
service is assessed equally against and collected equally from all |
|
participants, and is only based on the cost of operating the |
|
referral service and not on the volume or value of any referrals to |
|
or business otherwise generated by the participants of the referral |
|
service; |
|
(3) the referral service imposes no requirements on |
|
the manner in which the participant provides services to a referred |
|
person, except that the referral service may require that the |
|
participant charge the person referred at the same rate as it |
|
charges other persons not referred by the referral service, or that |
|
these services be furnished free of charge or at a reduced charge; |
|
(4) a referral made to a mental health professional or |
|
chemical dependency treatment facility is made only in accordance |
|
with Subdivision (1) and the referral service does not make |
|
referrals to mental health facilities other than facilities |
|
maintained or operated by the department [Texas Department of
|
|
Mental Health and Mental Retardation], community mental health [and
|
|
mental retardation] centers, or other political subdivisions, |
|
provided that a physician may make a referral directly to any mental |
|
health facility; |
|
(5) the referral service is staffed by appropriately |
|
licensed and trained mental health professionals and a person who |
|
makes assessments for the need for treatment of mental illness or |
|
chemical dependency is a mental health professional as defined by |
|
this chapter; |
|
(6) in response to each inquiry or after personal |
|
assessment, the referral service makes referrals, on a clinically |
|
appropriate, rotational basis, to at least three mental health |
|
professionals or chemical dependency treatment facilities whose |
|
practice addresses or facilities are located in the county of |
|
residence of the person seeking the referral or assessment, but if |
|
there are not three providers in the inquirer's county of |
|
residence, the referral service may include additional providers |
|
from other counties nearest the inquirer's county of residence; |
|
(7) no information that identifies the person seeking |
|
a referral, such as name, address, or telephone number, is used, |
|
maintained, distributed, or provided for a purpose other than |
|
making the requested referral or for administrative functions |
|
necessary to operating the referral service; |
|
(8) the referral service makes the following |
|
disclosures to each person seeking a referral: |
|
(A) the manner in which the referral service |
|
selects the group of providers participating in the referral |
|
service; |
|
(B) whether the provider participant has paid a |
|
fee to the referral service; |
|
(C) the manner in which the referral service |
|
selects a particular provider from its list of provider |
|
participants to which to make a referral; |
|
(D) the nature of the relationship or any |
|
affiliation between the referral service and the group of provider |
|
participants to whom it could make a referral; and |
|
(E) the nature of any restriction that would |
|
exclude a provider from continuing as a provider participant; |
|
(9) the referral service maintains each disclosure in |
|
a written record certifying that the disclosure has been made and |
|
the record certifying that the disclosure has been made is signed by |
|
either the person seeking a referral or by the person making the |
|
disclosure on behalf of the referral service; and |
|
(10) if the referral service refers callers to a 1-900 |
|
telephone number or another telephone number that requires the |
|
payment of a toll or fee payable to or collected by the referral |
|
service, the referral service discloses the per minute charge. |
|
SECTION 3.0497. Section 164.009(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A treatment facility may not admit a patient to its |
|
facilities without fully disclosing to the patient or, if the |
|
patient is a minor, the patient's parent, managing conservator, or |
|
guardian, in, if possible, the primary language of the patient, |
|
managing conservator, or guardian, as the case may be, the |
|
following information in writing before admission: |
|
(1) the treatment facility's estimated average daily |
|
charge for inpatient treatment with an explanation that the patient |
|
may be billed separately for services provided by mental health |
|
professionals; |
|
(2) the name of the attending physician, if the |
|
treatment facility is a mental health facility, or the name of the |
|
attending mental health professional, if the facility is a chemical |
|
dependency facility; and |
|
(3) the current "patient's bill of rights" as adopted |
|
by the executive commissioner [Texas Department of Mental Health
|
|
and Mental Retardation, the Texas Commission on Alcohol and Drug
|
|
Abuse, or the Texas Department of Health] that sets out |
|
restrictions to the patient's freedom that may be imposed on the |
|
patient during the patient's stay in a treatment facility. |
|
SECTION 3.0498. Section 164.014, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 164.014. RULE-MAKING AUTHORITY. The executive |
|
commissioner [Texas Commission on Alcohol and Drug Abuse and Texas
|
|
Board of Mental Health and Mental Retardation] may adopt rules |
|
interpreting the provisions of this chapter relating to the |
|
activities of a chemical dependency facility or mental health |
|
facility under the department's [its] jurisdiction. |
|
SECTION 3.0499. Section 166.002(12), Health and Safety |
|
Code, is amended to read as follows: |
|
(12) "Physician" means: |
|
(A) a physician licensed by the Texas Medical |
|
[State] Board [of Medical Examiners]; or |
|
(B) a properly credentialed physician who holds a |
|
commission in the uniformed services of the United States and who is |
|
serving on active duty in this state. |
|
SECTION 3.0500. Section 166.004(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) In this section, "health care provider" means: |
|
(1) a hospital; |
|
(2) an institution licensed under Chapter 242, |
|
including a skilled nursing facility; |
|
(3) a home and community support services agency; |
|
(4) an assisted living [a personal care] facility; |
|
and |
|
(5) a special care facility. |
|
SECTION 3.0501. Section 166.011(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [of the Health and Human
|
|
Services Commission] by rule shall modify the advance directive |
|
forms required under this chapter as necessary to provide for the |
|
use of a digital or electronic signature that complies with the |
|
requirements of this section. |
|
SECTION 3.0502. Section 166.039(g), Health and Safety Code, |
|
is amended to read as follows: |
|
(g) A person listed in Subsection (b) who wishes to |
|
challenge a treatment decision made under this section must apply |
|
for temporary guardianship under Chapter 1251, Estates [Section
|
|
875, Texas Probate] Code. The court may waive applicable fees in |
|
that proceeding. |
|
SECTION 3.0503. Sections 166.046(b) and (c), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The patient or the person responsible for the health |
|
care decisions of the individual who has made the decision |
|
regarding the directive or treatment decision: |
|
(1) may be given a written description of the ethics or |
|
medical committee review process and any other policies and |
|
procedures related to this section adopted by the health care |
|
facility; |
|
(2) shall be informed of the committee review process |
|
not less than 48 hours before the meeting called to discuss the |
|
patient's directive, unless the time period is waived by mutual |
|
agreement; |
|
(3) at the time of being so informed, shall be |
|
provided: |
|
(A) a copy of the appropriate statement set forth |
|
in Section 166.052; and |
|
(B) a copy of the registry list of health care |
|
providers and referral groups that have volunteered their readiness |
|
to consider accepting transfer or to assist in locating a provider |
|
willing to accept transfer that is posted on the website maintained |
|
by the department [Texas Health Care Information Council] under |
|
Section 166.053; and |
|
(4) is entitled to: |
|
(A) attend the meeting; and |
|
(B) receive a written explanation of the decision |
|
reached during the review process. |
|
(c) The written explanation required by Subsection |
|
(b)(4)(B) [(b)(2)(B)] must be included in the patient's medical |
|
record. |
|
SECTION 3.0504. Sections 166.052(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) In cases in which the attending physician refuses to |
|
honor an advance directive or treatment decision requesting the |
|
provision of life-sustaining treatment, the statement required by |
|
Section 166.046(b)(3)(A) [166.046(b)(2)(A)] shall be in |
|
substantially the following form: |
|
When There Is A Disagreement About Medical Treatment: The |
|
Physician Recommends Against Life-Sustaining Treatment That You |
|
Wish To Continue |
|
You have been given this information because you have |
|
requested life-sustaining treatment,* which the attending |
|
physician believes is not appropriate. This information is being |
|
provided to help you understand state law, your rights, and the |
|
resources available to you in such circumstances. It outlines the |
|
process for resolving disagreements about treatment among |
|
patients, families, and physicians. It is based upon Section |
|
166.046 of the Texas Advance Directives Act, codified in Chapter |
|
166 of the Texas Health and Safety Code. |
|
When an attending physician refuses to comply with an advance |
|
directive or other request for life-sustaining treatment because of |
|
the physician's judgment that the treatment would be inappropriate, |
|
the case will be reviewed by an ethics or medical committee. |
|
Life-sustaining treatment will be provided through the review. |
|
You will receive notification of this review at least 48 |
|
hours before a meeting of the committee related to your case. You |
|
are entitled to attend the meeting. With your agreement, the |
|
meeting may be held sooner than 48 hours, if possible. |
|
You are entitled to receive a written explanation of the |
|
decision reached during the review process. |
|
If after this review process both the attending physician and |
|
the ethics or medical committee conclude that life-sustaining |
|
treatment is inappropriate and yet you continue to request such |
|
treatment, then the following procedure will occur: |
|
1. The physician, with the help of the health care facility, |
|
will assist you in trying to find a physician and facility willing |
|
to provide the requested treatment. |
|
2. You are being given a list of health care providers and |
|
referral groups that have volunteered their readiness to consider |
|
accepting transfer, or to assist in locating a provider willing to |
|
accept transfer, maintained by the Department of State Health |
|
Services [Texas Health Care Information Council]. You may wish to |
|
contact providers or referral groups on the list or others of your |
|
choice to get help in arranging a transfer. |
|
3. The patient will continue to be given life-sustaining |
|
treatment until he or she can be transferred to a willing provider |
|
for up to 10 days from the time you were given the committee's |
|
written decision that life-sustaining treatment is not |
|
appropriate. |
|
4. If a transfer can be arranged, the patient will be |
|
responsible for the costs of the transfer. |
|
5. If a provider cannot be found willing to give the requested |
|
treatment within 10 days, life-sustaining treatment may be |
|
withdrawn unless a court of law has granted an extension. |
|
6. You may ask the appropriate district or county court to |
|
extend the 10-day period if the court finds that there is a |
|
reasonable expectation that a physician or health care facility |
|
willing to provide life-sustaining treatment will be found if the |
|
extension is granted. |
|
*"Life-sustaining treatment" means treatment that, based on |
|
reasonable medical judgment, sustains the life of a patient and |
|
without which the patient will die. The term includes both |
|
life-sustaining medications and artificial life support, such as |
|
mechanical breathing machines, kidney dialysis treatment, and |
|
artificial nutrition and hydration. The term does not include the |
|
administration of pain management medication or the performance of |
|
a medical procedure considered to be necessary to provide comfort |
|
care, or any other medical care provided to alleviate a patient's |
|
pain. |
|
(b) In cases in which the attending physician refuses to |
|
comply with an advance directive or treatment decision requesting |
|
the withholding or withdrawal of life-sustaining treatment, the |
|
statement required by Section 166.046(b)(3)(A) shall be in |
|
substantially the following form: |
|
When There Is A Disagreement About Medical Treatment: The |
|
Physician Recommends Life-Sustaining Treatment That You Wish To |
|
Stop |
|
You have been given this information because you have |
|
requested the withdrawal or withholding of life-sustaining |
|
treatment* and the attending physician refuses to comply with that |
|
request. The information is being provided to help you understand |
|
state law, your rights, and the resources available to you in such |
|
circumstances. It outlines the process for resolving disagreements |
|
about treatment among patients, families, and physicians. It is |
|
based upon Section 166.046 of the Texas Advance Directives Act, |
|
codified in Chapter 166 of the Texas Health and Safety Code. |
|
When an attending physician refuses to comply with an advance |
|
directive or other request for withdrawal or withholding of |
|
life-sustaining treatment for any reason, the case will be reviewed |
|
by an ethics or medical committee. Life-sustaining treatment will |
|
be provided through the review. |
|
You will receive notification of this review at least 48 |
|
hours before a meeting of the committee related to your case. You |
|
are entitled to attend the meeting. With your agreement, the |
|
meeting may be held sooner than 48 hours, if possible. |
|
You are entitled to receive a written explanation of the |
|
decision reached during the review process. |
|
If you or the attending physician do not agree with the |
|
decision reached during the review process, and the attending |
|
physician still refuses to comply with your request to withhold or |
|
withdraw life-sustaining treatment, then the following procedure |
|
will occur: |
|
1. The physician, with the help of the health care facility, |
|
will assist you in trying to find a physician and facility willing |
|
to withdraw or withhold the life-sustaining treatment. |
|
2. You are being given a list of health care providers and |
|
referral groups that have volunteered their readiness to consider |
|
accepting transfer, or to assist in locating a provider willing to |
|
accept transfer, maintained by the Department of State Health |
|
Services [Texas Health Care Information Council]. You may wish to |
|
contact providers or referral groups on the list or others of your |
|
choice to get help in arranging a transfer. |
|
*"Life-sustaining treatment" means treatment that, based on |
|
reasonable medical judgment, sustains the life of a patient and |
|
without which the patient will die. The term includes both |
|
life-sustaining medications and artificial life support, such as |
|
mechanical breathing machines, kidney dialysis treatment, and |
|
artificial nutrition and hydration. The term does not include the |
|
administration of pain management medication or the performance of |
|
a medical procedure considered to be necessary to provide comfort |
|
care, or any other medical care provided to alleviate a patient's |
|
pain. |
|
SECTION 3.0505. Sections 166.053(a), (c), and (d), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) The department [Texas Health Care Information Council] |
|
shall maintain a registry listing the identity of and contact |
|
information for health care providers and referral groups, situated |
|
inside and outside this state, that have voluntarily notified the |
|
department [council] they may consider accepting or may assist in |
|
locating a provider willing to accept transfer of a patient under |
|
Section 166.045 or 166.046. |
|
(c) The department [Texas Health Care Information Council] |
|
shall post the current registry list on its website in a form |
|
appropriate for easy comprehension by patients and persons |
|
responsible for the health care decisions of patients [and shall
|
|
provide a clearly identifiable link from its home page to the
|
|
registry page]. The list shall separately indicate those providers |
|
and groups that have indicated their interest in assisting the |
|
transfer of: |
|
(1) those patients on whose behalf life-sustaining |
|
treatment is being sought; |
|
(2) those patients on whose behalf the withholding or |
|
withdrawal of life-sustaining treatment is being sought; and |
|
(3) patients described in both Subdivisions (1) and |
|
(2). |
|
(d) The registry list described in this section shall |
|
include the following disclaimer: |
|
"This registry lists providers and groups that have |
|
indicated to the Department of State Health Services [Texas Health
|
|
Care Information Council] their interest in assisting the transfer |
|
of patients in the circumstances described, and is provided for |
|
information purposes only. Neither the Department of State Health |
|
Services [Texas Health Care Information Council] nor the State of |
|
Texas endorses or assumes any responsibility for any |
|
representation, claim, or act of the listed providers or groups." |
|
SECTION 3.0506. Sections 166.081(2), (6), and (10), Health |
|
and Safety Code, are amended to read as follows: |
|
(2) "DNR identification device" means an |
|
identification device specified by department rule [the board] |
|
under Section 166.101 that is worn for the purpose of identifying a |
|
person who has executed or issued an out-of-hospital DNR order or on |
|
whose behalf an out-of-hospital DNR order has been executed or |
|
issued under this subchapter. |
|
(6) "Out-of-hospital DNR order": |
|
(A) means a legally binding out-of-hospital |
|
do-not-resuscitate order, in the form specified by department rule |
|
[the board] under Section 166.083, prepared and signed by the |
|
attending physician of a person, that documents the instructions of |
|
a person or the person's legally authorized representative and |
|
directs health care professionals acting in an out-of-hospital |
|
setting not to initiate or continue the following life-sustaining |
|
treatment: |
|
(i) cardiopulmonary resuscitation; |
|
(ii) advanced airway management; |
|
(iii) artificial ventilation; |
|
(iv) defibrillation; |
|
(v) transcutaneous cardiac pacing; and |
|
(vi) other life-sustaining treatment |
|
specified by department rule [the board] under Section 166.101(a); |
|
and |
|
(B) does not include authorization to withhold |
|
medical interventions or therapies considered necessary to provide |
|
comfort care or to alleviate pain or to provide water or nutrition. |
|
(10) "Statewide out-of-hospital DNR protocol" means a |
|
set of statewide standardized procedures adopted by the executive |
|
commissioner [board] under Section 166.101(a) for withholding |
|
cardiopulmonary resuscitation and certain other life-sustaining |
|
treatment by health care professionals acting in out-of-hospital |
|
settings. |
|
SECTION 3.0507. Sections 166.082(a) and (f), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) A competent person may at any time execute a written |
|
out-of-hospital DNR order directing health care professionals |
|
acting in an out-of-hospital setting to withhold cardiopulmonary |
|
resuscitation and certain other life-sustaining treatment |
|
designated by department rule [the board]. |
|
(f) The executive commissioner [board], on the |
|
recommendation of the department, shall by rule adopt procedures |
|
for the disposition and maintenance of records of an original |
|
out-of-hospital DNR order and any copies of the order. |
|
SECTION 3.0508. Sections 166.083(a), (b), and (c), Health |
|
and Safety Code, are amended to read as follows: |
|
(a) A written out-of-hospital DNR order shall be in the |
|
standard form specified by department [board] rule as recommended |
|
by the department. |
|
(b) The standard form of an out-of-hospital DNR order |
|
specified by department rule [the board] must, at a minimum, |
|
contain the following: |
|
(1) a distinctive single-page format that readily |
|
identifies the document as an out-of-hospital DNR order; |
|
(2) a title that readily identifies the document as an |
|
out-of-hospital DNR order; |
|
(3) the printed or typed name of the person; |
|
(4) a statement that the physician signing the |
|
document is the attending physician of the person and that the |
|
physician is directing health care professionals acting in |
|
out-of-hospital settings, including a hospital emergency |
|
department, not to initiate or continue certain life-sustaining |
|
treatment on behalf of the person, and a listing of those procedures |
|
not to be initiated or continued; |
|
(5) a statement that the person understands that the |
|
person may revoke the out-of-hospital DNR order at any time by |
|
destroying the order and removing the DNR identification device, if |
|
any, or by communicating to health care professionals at the scene |
|
the person's desire to revoke the out-of-hospital DNR order; |
|
(6) places for the printed names and signatures of the |
|
witnesses or the notary public's acknowledgment and for the printed |
|
name and signature of the attending physician of the person and the |
|
medical license number of the attending physician; |
|
(7) a separate section for execution of the document |
|
by the legal guardian of the person, the person's proxy, an agent of |
|
the person having a medical power of attorney, or the attending |
|
physician attesting to the issuance of an out-of-hospital DNR order |
|
by nonwritten means of communication or acting in accordance with a |
|
previously executed or previously issued directive to physicians |
|
under Section 166.082(c) that includes the following: |
|
(A) a statement that the legal guardian, the |
|
proxy, the agent, the person by nonwritten means of communication, |
|
or the physician directs that each listed life-sustaining treatment |
|
should not be initiated or continued in behalf of the person; and |
|
(B) places for the printed names and signatures |
|
of the witnesses and, as applicable, the legal guardian, proxy, |
|
agent, or physician; |
|
(8) a separate section for execution of the document |
|
by at least one qualified relative of the person when the person |
|
does not have a legal guardian, proxy, or agent having a medical |
|
power of attorney and is incompetent or otherwise mentally or |
|
physically incapable of communication, including: |
|
(A) a statement that the relative of the person |
|
is qualified to make a treatment decision to withhold |
|
cardiopulmonary resuscitation and certain other designated |
|
life-sustaining treatment under Section 166.088 and, based on the |
|
known desires of the person or a determination of the best interest |
|
of the person, directs that each listed life-sustaining treatment |
|
should not be initiated or continued in behalf of the person; and |
|
(B) places for the printed names and signatures |
|
of the witnesses and qualified relative of the person; |
|
(9) a place for entry of the date of execution of the |
|
document; |
|
(10) a statement that the document is in effect on the |
|
date of its execution and remains in effect until the death of the |
|
person or until the document is revoked; |
|
(11) a statement that the document must accompany the |
|
person during transport; |
|
(12) a statement regarding the proper disposition of |
|
the document or copies of the document, as the executive |
|
commissioner [board] determines appropriate; and |
|
(13) a statement at the bottom of the document, with |
|
places for the signature of each person executing the document, |
|
that the document has been properly completed. |
|
(c) The executive commissioner [board] may, by rule and as |
|
recommended by the department, modify the standard form of the |
|
out-of-hospital DNR order described by Subsection (b) in order to |
|
accomplish the purposes of this subchapter. |
|
SECTION 3.0509. Sections 166.088(e) and (g), Health and |
|
Safety Code, are amended to read as follows: |
|
(e) The fact that an adult person has not executed or issued |
|
an out-of-hospital DNR order does not create a presumption that the |
|
person does not want a treatment decision made to withhold |
|
cardiopulmonary resuscitation and certain other designated |
|
life-sustaining treatment designated by department rule [the
|
|
board]. |
|
(g) A person listed in Section 166.039(b) who wishes to |
|
challenge a decision made under this section must apply for |
|
temporary guardianship under Chapter 1251, Estates [Section 875,
|
|
Texas Probate] Code. The court may waive applicable fees in that |
|
proceeding. |
|
SECTION 3.0510. Section 166.089(h), Health and Safety Code, |
|
is amended to read as follows: |
|
(h) An out-of-hospital DNR order executed or issued and |
|
documented or evidenced in the manner prescribed by this subchapter |
|
is valid and shall be honored by responding health care |
|
professionals unless the person or persons found at the scene: |
|
(1) identify themselves as the declarant or as the |
|
attending physician, legal guardian, qualified relative, or agent |
|
of the person having a medical power of attorney who executed or |
|
issued the out-of-hospital DNR order on behalf of the person; and |
|
(2) request that cardiopulmonary resuscitation or |
|
certain other life-sustaining treatment designated by department |
|
rule [the board] be initiated or continued. |
|
SECTION 3.0511. Section 166.090(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) A person who has a valid out-of-hospital DNR order under |
|
this subchapter may wear a DNR identification device around the |
|
neck or on the wrist as prescribed by department [board] rule |
|
adopted under Section 166.101. |
|
SECTION 3.0512. Section 166.092(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) An oral revocation under Subsection (a)(3) or (a)(4) |
|
takes effect only when the declarant or a person who identifies |
|
himself or herself as the legal guardian, a qualified relative, or |
|
the agent of the declarant having a medical power of attorney who |
|
executed the out-of-hospital DNR order communicates the intent to |
|
revoke the order to the responding health care professionals or the |
|
attending physician at the scene. The responding health care |
|
professionals shall record the time, date, and place of the |
|
revocation in accordance with the statewide out-of-hospital DNR |
|
protocol and rules adopted by the executive commissioner [board] |
|
and any applicable local out-of-hospital DNR protocol. The |
|
attending physician or the physician's designee shall record in the |
|
person's medical record the time, date, and place of the revocation |
|
and, if different, the time, date, and place that the physician |
|
received notice of the revocation. The attending physician or the |
|
physician's designee shall also enter the word "VOID" on each page |
|
of the copy of the order in the person's medical record. |
|
SECTION 3.0513. Section 166.094, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 166.094. LIMITATION ON LIABILITY FOR WITHHOLDING |
|
CARDIOPULMONARY RESUSCITATION AND CERTAIN OTHER LIFE-SUSTAINING |
|
PROCEDURES. (a) A health care professional or health care facility |
|
or entity that in good faith causes cardiopulmonary resuscitation |
|
or certain other life-sustaining treatment designated by |
|
department rule [the board] to be withheld from a person in |
|
accordance with this subchapter is not civilly liable for that |
|
action. |
|
(b) A health care professional or health care facility or |
|
entity that in good faith participates in withholding |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board] from a person |
|
in accordance with this subchapter is not civilly liable for that |
|
action. |
|
(c) A health care professional or health care facility or |
|
entity that in good faith participates in withholding |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board] from a person |
|
in accordance with this subchapter is not criminally liable or |
|
guilty of unprofessional conduct as a result of that action. |
|
(d) A health care professional or health care facility or |
|
entity that in good faith causes or participates in withholding |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board] from a person |
|
in accordance with this subchapter and rules adopted under this |
|
subchapter is not in violation of any other licensing or regulatory |
|
laws or rules of this state and is not subject to any disciplinary |
|
action or sanction by any licensing or regulatory agency of this |
|
state as a result of that action. |
|
SECTION 3.0514. Section 166.096, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 166.096. HONORING OUT-OF-HOSPITAL DNR ORDER DOES NOT |
|
CONSTITUTE OFFENSE OF AIDING SUICIDE. A person does not commit an |
|
offense under Section 22.08, Penal Code, by withholding |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board] from a person |
|
in accordance with this subchapter. |
|
SECTION 3.0515. Section 166.097(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) A person is subject to prosecution for criminal homicide |
|
under Chapter 19, Penal Code, if the person, with the intent to |
|
cause cardiopulmonary resuscitation or certain other |
|
life-sustaining treatment designated by department rule [the
|
|
board] to be withheld from another person contrary to the other |
|
person's desires, falsifies or forges an out-of-hospital DNR order |
|
or intentionally conceals or withholds personal knowledge of a |
|
revocation and thereby directly causes cardiopulmonary |
|
resuscitation and certain other life-sustaining treatment |
|
designated by department rule [the board] to be withheld from the |
|
other person with the result that the other person's death is |
|
hastened. |
|
SECTION 3.0516. Section 166.098, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 166.098. PREGNANT PERSONS. A person may not withhold |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board] under this |
|
subchapter from a person known by the responding health care |
|
professionals to be pregnant. |
|
SECTION 3.0517. Sections 166.100 and 166.101, Health and |
|
Safety Code, are amended to read as follows: |
|
Sec. 166.100. LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED. |
|
This subchapter does not impair or supersede any legal right or |
|
responsibility a person may have under a constitution, other |
|
statute, regulation, or court decision to effect the withholding of |
|
cardiopulmonary resuscitation or certain other life-sustaining |
|
treatment designated by department rule [the board]. |
|
Sec. 166.101. DUTIES OF DEPARTMENT AND EXECUTIVE |
|
COMMISSIONER [BOARD]. (a) The executive commissioner [board] |
|
shall, on the recommendation of the department, adopt all |
|
reasonable and necessary rules to carry out the purposes of this |
|
subchapter, including rules: |
|
(1) adopting a statewide out-of-hospital DNR order |
|
protocol that sets out standard procedures for the withholding of |
|
cardiopulmonary resuscitation and certain other life-sustaining |
|
treatment by health care professionals acting in out-of-hospital |
|
settings; |
|
(2) designating life-sustaining treatment that may be |
|
included in an out-of-hospital DNR order, including all procedures |
|
listed in Sections 166.081(6)(A)(i) through (v); and |
|
(3) governing recordkeeping in circumstances in which |
|
an out-of-hospital DNR order or DNR identification device is |
|
encountered by responding health care professionals. |
|
(b) The rules adopted [by the board] under Subsection (a) |
|
are not effective until approved by the Texas Medical [State] Board |
|
[of Medical Examiners]. |
|
(c) Local emergency medical services authorities may adopt |
|
local out-of-hospital DNR order protocols if the local protocols do |
|
not conflict with the statewide out-of-hospital DNR order protocol |
|
adopted by the executive commissioner [board]. |
|
(d) The executive commissioner [board] by rule shall |
|
specify a distinctive standard design for a necklace and a bracelet |
|
DNR identification device that signifies, when worn by a person, |
|
that the possessor has executed or issued a valid out-of-hospital |
|
DNR order under this subchapter or is a person for whom a valid |
|
out-of-hospital DNR order has been executed or issued. |
|
(e) The department shall report to the executive |
|
commissioner [board] from time to time regarding issues identified |
|
in emergency medical services responses in which an out-of-hospital |
|
DNR order or DNR identification device is encountered. The report |
|
may contain recommendations to the executive commissioner [board] |
|
for necessary modifications to the form of the standard |
|
out-of-hospital DNR order or the designated life-sustaining |
|
procedures listed in the standard out-of-hospital DNR order, the |
|
statewide out-of-hospital DNR order protocol, or the DNR |
|
identification devices. |
|
SECTION 3.0518. Section 171.012(a-1), Health and Safety |
|
Code, is amended to read as follows: |
|
(a-1) During a visit made to a facility to fulfill the |
|
requirements of Subsection (a), the facility and any person at the |
|
facility may not accept any form of payment, deposit, or exchange or |
|
make any financial agreement for an abortion or abortion-related |
|
services other than for payment of a service required by Subsection |
|
(a). The amount charged for a service required by Subsection (a) |
|
may not exceed the reimbursement rate established for the service |
|
by the executive commissioner [Health and Human Services
|
|
Commission] for statewide medical reimbursement programs. |
|
SECTION 3.0519. Section 171.0124, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 171.0124. EXCEPTION FOR MEDICAL EMERGENCY. A |
|
physician may perform an abortion without obtaining informed |
|
consent under this subchapter in a medical emergency. A physician |
|
who performs an abortion in a medical emergency shall: |
|
(1) include in the patient's medical records a |
|
statement signed by the physician certifying the nature of the |
|
medical emergency; and |
|
(2) not later than the 30th day after the date the |
|
abortion is performed, certify to the department [Department of
|
|
State Health Services] the specific medical condition that |
|
constituted the emergency. |
|
SECTION 3.0520. Section 171.014(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The department shall annually review the materials to |
|
determine if changes to the contents of the materials are |
|
necessary. The executive commissioner [department] shall adopt |
|
rules necessary for considering and making changes to the |
|
materials. |
|
SECTION 3.0521. Section 181.053, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 181.053. NONPROFIT AGENCIES. The executive |
|
commissioner [department] shall by rule exempt from this chapter a |
|
nonprofit agency that pays for health care services or prescription |
|
drugs for an indigent person only if the agency's primary business |
|
is not the provision of health care or reimbursement for health care |
|
services. |
|
SECTION 3.0522. Section 181.102(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) For purposes of Subsection (a), the executive |
|
commissioner, in consultation with the department [Department of
|
|
State Health Services], the Texas Medical Board, and the Texas |
|
Department of Insurance, by rule may recommend a standard |
|
electronic format for the release of requested health records. The |
|
standard electronic format recommended under this section must be |
|
consistent, if feasible, with federal law regarding the release of |
|
electronic health records. |
|
SECTION 3.0523. Section 181.103, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 181.103. CONSUMER INFORMATION WEBSITE. The attorney |
|
general shall maintain an Internet website that provides: |
|
(1) information concerning a consumer's privacy rights |
|
regarding protected health information under federal and state law; |
|
(2) a list of the state agencies, including the |
|
department [Department of State Health Services], the Texas Medical |
|
Board, and the Texas Department of Insurance, that regulate covered |
|
entities in this state and the types of entities each agency |
|
regulates; |
|
(3) detailed information regarding each agency's |
|
complaint enforcement process; and |
|
(4) contact information, including the address of the |
|
agency's Internet website, for each agency listed under Subdivision |
|
(2) for reporting a violation of this chapter. |
|
SECTION 3.0524. Section 182.053(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The governor shall also appoint at least two ex officio, |
|
nonvoting members representing the department [Department of State
|
|
Health Services]. |
|
SECTION 3.0525. Section 182.103(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The corporation shall comply with all state and federal |
|
laws and rules relating to the transmission of health information, |
|
including Chapter 181, and rules adopted under that chapter, and |
|
the Health Insurance Portability and Accountability Act of 1996 |
|
(Pub. L. No. 104-191) and rules adopted under that Act. |
|
SECTION 3.0526. Section 182.108(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The commission shall review and the executive |
|
commissioner by rule shall adopt acceptable standards submitted for |
|
ratification under Subsection (a). |
|
SECTION 3.0527. Section 191.001, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 191.001. DEFINITIONS. In this title: |
|
(1) ["Board" means the Texas Board of Health.
|
|
[(2)] "Department" means the [Texas] Department of |
|
State Health Services. |
|
(2) "Executive commissioner" means the executive |
|
commissioner of the Health and Human Services Commission. |
|
(3) "Vital statistics unit" means the vital statistics |
|
unit established in the Department of State Health Services. |
|
SECTION 3.0528. Subchapter A, Chapter 191, Health and |
|
Safety Code, is amended by adding Section 191.0011 to read as |
|
follows: |
|
Sec. 191.0011. REFERENCE IN OTHER LAW. A reference in other |
|
law to the bureau of vital statistics of the department or of the |
|
former Texas Department of Health means the vital statistics unit |
|
established in the department. |
|
SECTION 3.0529. Section 191.002(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department shall: |
|
(1) establish a [bureau of] vital statistics unit in |
|
the department with suitable offices that are properly equipped for |
|
the preservation of its official records; |
|
(2) establish a statewide system of vital statistics; |
|
(3) provide instructions and prescribe forms for |
|
collecting, recording, transcribing, compiling, and preserving |
|
vital statistics; |
|
(4) require the enforcement of this title and rules |
|
adopted under this title; |
|
(5) prepare, print, and supply to local registrars |
|
forms for registering, recording, and preserving returns or |
|
otherwise carrying out the purposes of this title; and |
|
(6) propose legislation necessary for the purposes of |
|
this title. |
|
SECTION 3.0530. Section 191.003, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 191.003. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER |
|
AND DEPARTMENT [BOARD]. (a) The executive commissioner [board] |
|
shall[:
|
|
[(1)] adopt necessary rules for collecting, |
|
recording, transcribing, compiling, and preserving vital |
|
statistics. |
|
(a-1) The department shall: |
|
(1) [; (2)] supervise the [bureau of] vital |
|
statistics unit; and |
|
(2) [(3)] appoint the director of the [bureau of] |
|
vital statistics unit. |
|
(b) In an emergency, the executive commissioner [board] may |
|
suspend any part of this title that hinders the uniform and |
|
efficient registration of vital events and may substitute emergency |
|
rules designed to expedite that registration under disaster |
|
conditions. |
|
SECTION 3.0531. Section 191.004(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The director of the [bureau of] vital statistics unit is |
|
the state registrar of vital statistics. The director must be a |
|
competent vital statistician. |
|
SECTION 3.0532. Sections 191.0045(a), (b), (c), (d), (e), |
|
and (g), Health and Safety Code, are amended to read as follows: |
|
(a) The department [bureau of vital statistics] may collect |
|
[charge] fees for providing services to the public and performing |
|
other activities in connection with maintenance of the vital |
|
statistics system, including: |
|
(1) performing searches of birth, death, fetal death, |
|
marriage, divorce, annulment, and other records; |
|
(2) preparing and issuing copies and certified copies |
|
of birth, death, fetal death, marriage, divorce, annulment, and |
|
other records; and |
|
(3) filing a record, amendment, or affidavit under |
|
this title. |
|
(b) The executive commissioner [board] by rule may |
|
prescribe a schedule of fees for vital statistics services. The |
|
aggregate of the amounts of the fees may not exceed the cost of |
|
administering the vital statistics system. |
|
(c) The department [bureau of vital statistics] shall |
|
refund to an applicant any fee received for services that the |
|
department [bureau] cannot perform. If the money has been |
|
deposited to the credit of the vital statistics account in the |
|
general revenue fund, the comptroller shall issue a warrant against |
|
the fund for refund of the payment on presentation of a claim signed |
|
by the state registrar. |
|
(d) A local registrar or county clerk who issues a certified |
|
copy of a birth or death certificate shall collect [charge] the same |
|
fees as collected [charged] by the department [bureau of vital
|
|
statistics], including the additional fee required under |
|
Subsection (e), except as provided by Subsections (g) and (h). |
|
(e) In addition to fees charged [collected] by the |
|
department [bureau of vital statistics] under Subsection (b), the |
|
department [bureau] shall collect an additional $2 fee for each of |
|
the following: |
|
(1) issuing a certified copy of a certificate of |
|
birth; |
|
(2) issuing a wallet-sized certification of birth; and |
|
(3) conducting a search for a certificate of birth. |
|
(g) A local registrar or county clerk that on March 31, |
|
1995, was collecting [charging] a fee for the issuance of a |
|
certified copy of a birth certificate that exceeded the fee |
|
collected [charged] by the department [bureau of vital statistics] |
|
for the same type of certificate may continue to do so but shall not |
|
raise this fee until the fee collected [charged] by the department |
|
[bureau] exceeds the fee collected [charged] by the local registrar |
|
or county clerk. A local registrar or county clerk to which this |
|
subsection applies shall collect [charge] the additional fee as |
|
required under Subsection (e). |
|
SECTION 3.0533. Section 191.0047, Health and Safety Code, |
|
is amended to read as follows: |
|
Sec. 191.0047. BIRTH INFORMATION FOR DEPARTMENT OF FAMILY |
|
AND PROTECTIVE SERVICES. (a) The department [Department of State
|
|
Health Services] shall implement an efficient and effective method |
|
to verify birth information or provide a certified copy of a birth |
|
record necessary to provide services for the benefit of a minor |
|
being served by the Department of Family and Protective Services. |
|
(b) The department [Department of State Health Services] |
|
shall enter into a memorandum of understanding with the Department |
|
of Family and Protective Services to implement this section. |
|
Subject to Subsection (c), the terms of the memorandum of |
|
understanding must include methods for reimbursing the department |
|
[Department of State Health Services] in an amount that is not more |
|
than the actual costs the department incurs in verifying the birth |
|
information or providing the birth record to the Department of |
|
Family and Protective Services. |
|
(c) The department [Department of State Health Services] |
|
may not collect a fee or other amount for verification of birth |
|
information or provision of a certified copy of the birth record |
|
under Subsection (a) for a child in the managing conservatorship of |
|
the Department of Family and Protective Services if parental rights |
|
to the child have been terminated and the child is eligible for |
|
adoption. |
|
SECTION 3.0534. Section 191.0048(b), Health and Safety |
|
Code, is amended to read as follows: |
|
(b) On each paper or electronic application form for a copy |
|
or certified copy of a birth, marriage, or divorce record, the |
|
department [bureau of vital statistics] shall include a printed box |
|
for the applicant to check indicating that the applicant wishes to |
|
make a voluntary contribution of $5 to promote healthy early |
|
childhood by supporting the Texas Home Visiting Program |
|
administered by the Office of Early Childhood Coordination of the |
|
Health and Human Services Commission. |
|
SECTION 3.0535. Section 191.005, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 191.005. VITAL STATISTICS ACCOUNT [FUND]. (a) The |
|
vital statistics account [fund] is an account in the general |
|
revenue fund in the state treasury. |
|
(b) The legislature shall make appropriations to the |
|
department from the vital statistics account [fund] to be used to |
|
defray expenses incurred in the administration and enforcement of |
|
the system of vital statistics. |
|
(c) All fees collected by the department under this chapter |
|
[bureau of vital statistics] shall be deposited to the credit of the |
|
vital statistics account [fund]. |
|
SECTION 3.0536. Section 191.021(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) To facilitate registration, the department [board] may |
|
combine or divide registration districts. |
|
SECTION 3.0537. Section 191.022(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The local registrar shall sign each report made to the |
|
department [bureau of vital statistics]. |
|
SECTION 3.0538. Section 191.025(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) A local registrar shall supply forms of certificates to |
|
persons who need them. The executive commissioner [board] shall |
|
establish and promulgate rules for strict accountability of birth |
|
certificates to prevent birth certificate fraud. |
|
SECTION 3.0539. Sections 191.026(c) and (e), Health and |
|
Safety Code, are amended to read as follows: |
|
(c) The local registrar shall copy in the record book |
|
required under Section 191.025 each certificate that the local |
|
registrar registers, unless the local registrar keeps duplicates |
|
under Subsection (d) or makes photographic duplications as |
|
authorized by Chapter [181 or] 201, Local Government Code, or the |
|
provisions of Chapter 204, Local Government Code, derived from |
|
former Chapter 181, Local Government Code. Except as provided by |
|
Subsection (e), the copies shall be permanently preserved in the |
|
local registrar's office as the local record, in the manner |
|
directed by the state registrar. |
|
(e) The local registrar may, after the first anniversary of |
|
the date of registration of a birth, death, or fetal death, destroy |
|
the permanent record of the birth, death, or fetal death maintained |
|
by the local registrar if: |
|
(1) the local registrar has access to electronic |
|
records of births, deaths, and fetal deaths maintained by the |
|
[bureau of] vital statistics unit; and |
|
(2) before destroying the records, the local registrar |
|
certifies to the state registrar that each record maintained by the |
|
local office that is to be destroyed has been verified against the |
|
records contained in the unit's [bureau's] database and that each |
|
record is included in the database or otherwise accounted for. |
|
SECTION 3.0540. Section 191.032(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The executive commissioner [board] shall adopt rules |
|
necessary to implement this section. |
|
SECTION 3.0541. Section 191.033(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The state registrar may attach to the original record an |
|
addendum that sets out any information received by the state |
|
registrar that may contradict the information in a birth, death, or |
|
fetal death record required to be maintained in the [bureau of] |
|
vital statistics unit. |
|
SECTION 3.0542. Section 191.051(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) Subject to department [board] rules controlling the |
|
accessibility of vital records, the state registrar shall supply to |
|
a properly qualified applicant, on request, a certified copy of a |
|
record, or part of a record, of a birth, death, or fetal death |
|
registered under this title. |
|
SECTION 3.0543. Section 191.056(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) The department [bureau of vital statistics] may |
|
contract with the national agency to have copies of vital records |
|
that are filed with the vital statistics unit [bureau] transcribed |
|
for that agency. |
|
SECTION 3.0544. Section 191.057(b), Health and Safety Code, |
|
is amended to read as follows: |
|
(b) If the [bureau of] vital statistics unit or any local |
|
registration official receives an application for a certified copy |
|
of a birth, death, or fetal death record to which an addendum has |
|
been attached under Section 191.033, the application shall be sent |
|
immediately to the state registrar. After examining the |
|
application, the original record, and the addendum, the state |
|
registrar may refuse to issue a certified copy of the record or part |
|
of the record to the applicant. |
|
SECTION 3.0545. Sections 192.002(b) and (d), Health and |
|
Safety Code, are amended to read as follows: |
|
(b) The section of the birth certificate entitled "For |
|
Medical and Health Use Only" is not part of the legal birth |
|
certificate. Information held by the department under that section |
|
of the certificate is confidential. That information may not be |
|
released or made public on subpoena or otherwise, except that |
|
release may be made for statistical purposes only so that no person, |
|
patient, or facility is identified, or to medical personnel of a |
|
health care entity, as that term is defined in Subtitle B, Title 3, |
|
Occupations Code, or to a faculty member at a medical school, as |
|
that term is defined in Section 61.501, Education Code, for |
|
statistical or medical research, or to appropriate state or federal |
|
agencies for statistical research. The executive commissioner |
|
[board] may adopt rules to implement this subsection. |
|
(d) The social security numbers of the mother and father |
|
recorded on the form shall be made available to the United States |
|
[federal] Social Security Administration. |
|
SECTION 3.0546. Sections 192.0021(a) and (b), Health and |
|
Safety Code, are amended to read as follows: |
|
(a) The department shall promote and sell copies of an |
|
heirloom birth certificate. The department shall solicit donated |
|
designs for the certificate from Texas artists and select the best |
|
donated designs for the form of the certificate. An heirloom birth |
|
certificate must contain the same information as, and have the same |
|
effect of, a certified copy of another birth record. The executive |
|
commissioner by rule [department] shall prescribe a fee for the |
|
issuance of an heirloom birth certificate in an amount that does not |
|
exceed $50. The heirloom birth certificate must be printed on |
|
high-quality paper with the appearance of parchment not smaller |
|
than 11 inches by 14 inches. |
|
(b) The department shall deposit 50 percent of the proceeds |
|
from the sale of heirloom birth certificates to the credit of the |
|
childhood immunization account and the other 50 percent to the |
|
credit of the undedicated portion of the general revenue fund. The |
|
childhood immunization account is an account in the general revenue |
|
fund. Money in the account may be used only by the department |
|
[Department of State Health Services] for: |
|
(1) making grants to fund childhood immunizations and |
|
related education programs; and |
|
(2) administering this section. |
|
SECTION 3.0547. Sections 192.0022(b), (c), (f), (g), (h), |
|
and (i), Health and Safety Code, are amended to read as follows: |
|
(b) The person who is required to file a fetal death |
|
certificate under Section 193.002 shall advise the parent or |
|
parents of a stillborn child: |
|
(1) that a parent may, but is not required to, request |
|
the preparation of a certificate of birth resulting in stillbirth; |
|
(2) that a parent may obtain a certificate of birth |
|
resulting in stillbirth by contacting the [bureau of] vital |
|
statistics unit to request the certificate and paying the required |
|
fee; and |
|
(3) regarding the way or ways in which a parent may |
|
contact the [bureau of] vital statistics unit to request the |
|
certificate. |
|
(c) A parent may provide a name for a stillborn child on the |
|
request for a certificate of birth resulting in stillbirth. If the |
|
requesting parent does not wish to provide a name, the [bureau of] |
|
vital statistics unit shall fill in the certificate with the name |
|
"baby boy" or "baby girl" and the last name of the parent. The name |
|
of the stillborn child provided on or later added by amendment to |
|
the certificate of birth resulting in stillbirth shall be the same |
|
name as placed on the original or amended fetal death certificate. |
|
(f) The department [bureau of vital statistics] may not use |
|
a certificate of birth resulting in stillbirth to calculate live |
|
birth statistics. |
|
(g) On issuance of a certificate of birth resulting in |
|
stillbirth to a parent who has requested the certificate as |
|
provided by this section, the [bureau of] vital statistics unit |
|
shall file an exact copy of the certificate with the local registrar |
|
of the registration district in which the stillbirth occurred. The |
|
local registrar shall file the certificate of birth resulting in |
|
stillbirth with the fetal death certificate. |
|
(h) A parent may request the [bureau of] vital statistics |
|
unit to issue a certificate of birth resulting in stillbirth |
|
without regard to the date on which the fetal death certificate was |
|
issued. |
|
(i) The executive commissioner [of the Health and Human
|
|
Services Commission] may adopt rules necessary to administer this |
|
section. |
|
SECTION 3.0548. Section 192.005(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) The items on a birth certificate relating to the child's |
|
father shall be completed only if: |
|
(1) the child's mother was married to the father: |
|
(A) at the time of the child's conception; |
|
(B) at the time of the child's birth; or |
|
(C) after the child's birth; |
|
(2) paternity is established by order of a court of |
|
competent jurisdiction; or |
|
(3) a valid acknowledgment of paternity executed by |
|
the father has been filed with the [bureau of] vital statistics unit |
|
as provided by Subchapter D, Chapter 160, Family Code. |
|
SECTION 3.0549. Sections 192.006(c), (d), and (e), Health |
|
and Safety Code, are amended to read as follows: |
|
(c) The state registrar shall require proof of the change in |
|
status that the executive commissioner [board] by rule may |
|
prescribe. |
|
(d) Supplementary birth certificates and applications for |
|
supplementary birth certificates shall be prepared and filed in |
|
accordance with department [board] rules. |
|
(e) In accordance with department [board] rules, a |
|
supplementary birth certificate may be filed for a person whose |
|
parentage has been determined by an acknowledgment of paternity. |
|
SECTION 3.0550. Section 192.008(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) The executive commissioner [board] shall adopt rules |
|
and procedures to ensure that birth records and indexes under the |
|
control of the department or local registrars and accessible to the |
|
public do not contain information or cross-references through which |
|
the confidentiality of adoption placements may be directly or |
|
indirectly violated. The rules and procedures may not interfere |
|
with the registries established under Subchapter E, Chapter 162, |
|
Family Code, or with a court order under this section. |
|
SECTION 3.0551. Section 192.009(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) If the department [bureau of vital statistics] |
|
determines that a certificate filed with the state registrar under |
|
this section requires correction, the department [bureau] shall |
|
mail the certificate directly to an attorney of record with respect |
|
to the petition of adoption, annulment of adoption, or revocation |
|
of adoption. The attorney shall return the corrected certificate to |
|
the department [bureau]. If there is no attorney of record, the |
|
department [bureau] shall mail the certificate to the clerk of the |
|
court for correction. |
|
SECTION 3.0552. Section 192.010, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 192.010. CHANGE OF NAME. (a) Subject to department |
|
[board] rules, an adult whose name is changed by court order, or the |
|
legal representative of any person whose name is changed by court |
|
order, may request that the state registrar attach an amendment |
|
showing the change to the person's original birth record. |
|
(b) The state registrar shall require proof of the change of |
|
name that the executive commissioner [board] by rule may prescribe. |
|
SECTION 3.0553. Section 192.012(a), Health and Safety Code, |
|
is amended to read as follows: |
|
(a) If the mother of a child is not married to the father of |
|
the child, a person listed in Section 192.003 who is responsible for |
|
filing the birth certificate shall: |
|
(1) provide an opportunity for the child's mother and |
|
putative father to sign an acknowledgment of paternity as provided |
|
by Subchapter D [C], Chapter 160, Family Code; and |
|
(2) provide oral and written information to the |
|
child's mother and putative father about: |
|
(A) establishing paternity, including an |
|
explanation of the rights and responsibilities that result from |
|
acknowledging paternity; and |
|
(B) the availability of child support services. |
|
SECTION 3.0554. Section 192.021(c), Health and Safety Code, |
|
is amended to read as follows: |
|
(c) Registration under this section is subject to |
|
department [board] rules. |
|
SECTION 3.0555. Section 192.022, Health and Safety Code, is |
|
amended to read as follows: |
|
Sec. 192.022. DELAY OF ONE YEAR OR MORE: APPLICATION FILED |
|
WITH STATE REGISTRAR. Subject to department [board] rules, an |
|
application to file a delayed birth certificate for a birth in this |
|
state not registered before the one-year anniversary of the date of |
|
birth shall be made to the state registrar. |
|
SECTION 3.0556. Section 193.001(d), Health and Safety Code, |
|
is amended to read as follows: |
|
(d) The department [bureau of vital statistics] and each |
|
local registrar shall make the information provided under |
|
Subsection (c) available to the public and may collect [charge] a |
|
fee in an amount prescribed under Section 191.0045 for providing |
|
|