S.B. No. 219
 
 
 
 
AN ACT
  relating to the provision of health and human services in this
  state, including the powers and duties of the Health and Human
  Services Commission and other state agencies, and the licensing of
  certain health professionals; clarifying certain statutory
  provisions; authorizing the imposition of fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
  ARTICLE 1.  FAMILY CODE
         SECTION 1.001.  The heading to Chapter 55, Family Code, is
  amended to read as follows:
  CHAPTER 55.  PROCEEDINGS CONCERNING CHILDREN WITH MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.002.  Section 55.01, Family Code, is amended to
  read as follows:
         Sec. 55.01.  MEANING OF "HAVING A MENTAL ILLNESS". For
  purposes of this chapter, a child who is described as having a
  mental illness means a child with a [who suffers from] mental
  illness as defined by Section 571.003, Health and Safety Code.
         SECTION 1.003.  Section 55.02, Family Code, is amended to
  read as follows:
         Sec. 55.02.  MENTAL HEALTH AND INTELLECTUAL DISABILITY
  [MENTAL RETARDATION] JURISDICTION. For the purpose of initiating
  proceedings to order mental health or intellectual disability 
  [mental retardation] services for a child or for commitment of a
  child as provided by this chapter, the juvenile court has
  jurisdiction of proceedings under Subtitle C or D, Title 7, Health
  and Safety Code.
         SECTION 1.004.  Section 55.03(b), Family Code, is amended to
  read as follows:
         (b)  Except as provided by this chapter, a child who is
  committed by a court to a residential care facility due to an
  intellectual disability [for mental retardation] shall be cared for
  as provided by Subtitle D, Title 7, Health and Safety Code.
         SECTION 1.005.  The heading to Subchapter C, Chapter 55,
  Family Code, is amended to read as follows:
  SUBCHAPTER C. CHILD UNFIT TO PROCEED AS A RESULT OF MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.006.  Sections 55.31(a), (b), and (c), Family
  Code, are amended to read as follows:
         (a)  A child alleged by petition or found to have engaged in
  delinquent conduct or conduct indicating a need for supervision who
  as a result of mental illness or an intellectual disability [mental
  retardation] lacks capacity to understand the proceedings in
  juvenile court or to assist in the child's own defense is unfit to
  proceed and shall not be subjected to discretionary transfer to
  criminal court, adjudication, disposition, or modification of
  disposition as long as such incapacity endures.
         (b)  On a motion by a party, the juvenile court shall
  determine whether probable cause exists to believe that a child who
  is alleged by petition or who is found to have engaged in delinquent
  conduct or conduct indicating a need for supervision is unfit to
  proceed as a result of mental illness or an intellectual disability
  [mental retardation]. In making its determination, the court may:
               (1)  consider the motion, supporting documents,
  professional statements of counsel, and witness testimony; and
               (2)  make its own observation of the child.
         (c)  If the court determines that probable cause exists to
  believe that the child is unfit to proceed, the court shall
  temporarily stay the juvenile court proceedings and immediately
  order the child to be examined under Section 51.20. The information
  obtained from the examination must include expert opinion as to
  whether the child is unfit to proceed as a result of mental illness
  or an intellectual disability [mental retardation].
         SECTION 1.007.  Sections 55.32(a), (b), (d), (f), and (g),
  Family Code, are amended to read as follows:
         (a)  If the juvenile court determines that evidence exists to
  support a finding that a child is unfit to proceed as a result of
  mental illness or an intellectual disability [mental retardation],
  the court shall set the case for a hearing on that issue.
         (b)  The issue of whether the child is unfit to proceed as a
  result of mental illness or an intellectual disability [mental
  retardation] shall be determined at a hearing separate from any
  other hearing.
         (d)  Unfitness to proceed as a result of mental illness or an
  intellectual disability [mental retardation] must be proved by a
  preponderance of the evidence.
         (f)  If the court or jury determines that the child is unfit
  to proceed as a result of mental illness or an intellectual
  disability [mental retardation], the court shall:
               (1)  stay the juvenile court proceedings for as long as
  that incapacity endures; and
               (2)  proceed under Section 55.33.
         (g)  The fact that the child is unfit to proceed as a result
  of mental illness or an intellectual disability [mental
  retardation] does not preclude any legal objection to the juvenile
  court proceedings which is susceptible of fair determination prior
  to the adjudication hearing and without the personal participation
  of the child.
         SECTION 1.008.  Section 55.33(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court or jury determines under Section
  55.32 that a child is unfit to proceed with the juvenile court
  proceedings for delinquent conduct, the court shall:
               (1)  if the unfitness to proceed is a result of mental
  illness or an intellectual disability [mental retardation]:
                     (A)  provided that the child meets the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code,
  order the child placed with the [Texas] Department of State Health
  Services or the Department of Aging and Disability Services, as
  appropriate, [Mental Health and Mental Retardation] for a period of
  not more than 90 days, which order may not specify a shorter period,
  for placement in a facility designated by the department; or
                     (B)  on application by the child's parent,
  guardian, or guardian ad litem, order the child placed in a private
  psychiatric inpatient facility for a period of not more than 90
  days, which order may not specify a shorter period, but only if the
  placement is agreed to in writing by the administrator of the
  facility; or
               (2)  if the unfitness to proceed is a result of mental
  illness and the court determines that the child may be adequately
  treated in an alternative setting, order the child to receive
  treatment for mental illness on an outpatient basis for a period of
  not more than 90 days, which order may not specify a shorter period.
         SECTION 1.009.  Section 55.35(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court issues a placement order under
  Section 55.33(a), the court shall order the probation department to
  send copies of any information in the possession of the department
  and relevant to the issue of the child's mental illness or
  intellectual disability [mental retardation] to the public or
  private facility or outpatient center, as appropriate.
         SECTION 1.010.  Section 55.40, Family Code, is amended to
  read as follows:
         Sec. 55.40.  REPORT THAT CHILD IS UNFIT TO PROCEED AS A
  RESULT OF INTELLECTUAL DISABILITY [MENTAL RETARDATION]. If a
  report submitted under Section 55.35(b) states that a child is
  unfit to proceed as a result of an intellectual disability [mental
  retardation] and that the child meets the commitment criteria for
  civil commitment under Subtitle D, Title 7, Health and Safety Code,
  the director of the residential care facility shall submit to the
  court an affidavit stating the conclusions reached as a result of
  the diagnosis. On receipt of the affidavit, the court shall:
               (1)  initiate proceedings as provided by Section 55.41
  in the juvenile court for commitment of the child under Subtitle D,
  Title 7, Health and Safety Code; or
               (2)  refer the child's case as provided by Section 55.42
  to the appropriate court for the initiation of proceedings in that
  court for commitment of the child under Subtitle D, Title 7, Health
  and Safety Code.
         SECTION 1.011.  The heading to Section 55.41, Family Code,
  is amended to read as follows:
         Sec. 55.41.  COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.012.  Section 55.41(c), Family Code, is amended to
  read as follows:
         (c)  On receipt of the court's order, the [Texas] Department
  of Aging and Disability Services [Mental Health and Mental
  Retardation] or the appropriate community center shall admit the
  child to a residential care facility.
         SECTION 1.013.  The heading to Section 55.42, Family Code,
  is amended to read as follows:
         Sec. 55.42.  REFERRAL FOR COMMITMENT PROCEEDINGS FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.014.  Section 55.42(a), Family Code, is amended to
  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 55.40(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 1.015.  Section 55.43(a), Family Code, is amended to
  read as follows:
         (a)  The prosecuting attorney may file with the juvenile
  court a motion for a restoration hearing concerning a child if:
               (1)  the child is found unfit to proceed as a result of
  mental illness or an intellectual disability [mental retardation];
  and
               (2)  the child:
                     (A)  is not:
                           (i)  ordered by a court to receive inpatient
  mental health services;
                           (ii)  committed by a court to a residential
  care facility; or
                           (iii)  ordered by a court to receive
  treatment on an outpatient basis; or
                     (B)  is discharged or currently on furlough from a
  mental health facility or outpatient center before the child
  reaches 18 years of age.
         SECTION 1.016.  Section 55.44(a), Family Code, is amended to
  read as follows:
         (a)  The juvenile court shall transfer all pending
  proceedings from the juvenile court to a criminal court on the 18th
  birthday of a child for whom the juvenile court or a court to which
  the child's case is referred has ordered inpatient mental health
  services or residential care for persons with an intellectual
  disability [mental retardation] if:
               (1)  the child is not discharged or currently on
  furlough from the facility before reaching 18 years of age; and
               (2)  the child is alleged to have engaged in delinquent
  conduct that included a violation of a penal law listed in Section
  53.045 and no adjudication concerning the alleged conduct has been
  made.
         SECTION 1.017.  The heading to Subchapter D, Chapter 55,
  Family Code, is amended to read as follows:
  SUBCHAPTER D. LACK OF RESPONSIBILITY FOR CONDUCT AS A RESULT OF
  MENTAL ILLNESS OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.018.  Section 55.51, Family Code, is amended to
  read as follows:
         Sec. 55.51.  LACK OF RESPONSIBILITY FOR CONDUCT
  DETERMINATION; EXAMINATION. (a) A child alleged by petition to
  have engaged in delinquent conduct or conduct indicating a need for
  supervision is not responsible for the conduct if at the time of the
  conduct, as a result of mental illness or an intellectual
  disability [mental retardation], the child lacks substantial
  capacity either to appreciate the wrongfulness of the child's
  conduct or to conform the child's conduct to the requirements of
  law.
         (b)  On a motion by a party in which it is alleged that a
  child may not be responsible as a result of mental illness or an
  intellectual disability [mental retardation] for the child's
  conduct, the court shall order the child to be examined under
  Section 51.20. The information obtained from the examinations must
  include expert opinion as to whether the child is not responsible
  for the child's conduct as a result of mental illness or an
  intellectual disability [mental retardation].
         (c)  The issue of whether the child is not responsible for
  the child's conduct as a result of mental illness or an intellectual
  disability [mental retardation] shall be tried to the court or jury
  in the adjudication hearing.
         (d)  Lack of responsibility for conduct as a result of mental
  illness or an intellectual disability [mental retardation] must be
  proved by a preponderance of the evidence.
         (e)  In its findings or verdict the court or jury must state
  whether the child is not responsible for the child's conduct as a
  result of mental illness or an intellectual disability [mental
  retardation].
         (f)  If the court or jury finds the child is not responsible
  for the child's conduct as a result of mental illness or an
  intellectual disability [mental retardation], the court shall
  proceed under Section 55.52.
         (g)  A child found to be not responsible for the child's
  conduct as a result of mental illness or an intellectual disability
  [mental retardation] shall not be subject to proceedings under this
  title with respect to such conduct, other than proceedings under
  Section 55.52.
         SECTION 1.019.  Section 55.52(a), Family Code, is amended to
  read as follows:
         (a)  If the court or jury finds that a child is not
  responsible for the child's conduct under Section 55.51, the court
  shall:
               (1)  if the lack of responsibility is a result of mental
  illness or an intellectual disability [mental retardation]:
                     (A)  provided that the child meets the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code,
  order the child placed with the [Texas] Department of State Health
  Services or the Department of Aging and Disability Services, as
  appropriate, [Mental Health and Mental Retardation] for a period of
  not more than 90 days, which order may not specify a shorter period,
  for placement in a facility designated by the department; or
                     (B)  on application by the child's parent,
  guardian, or guardian ad litem, order the child placed in a private
  psychiatric inpatient facility for a period of not more than 90
  days, which order may not specify a shorter period, but only if the
  placement is agreed to in writing by the administrator of the
  facility; or
               (2)  if the child's lack of responsibility is a result
  of mental illness and the court determines that the child may be
  adequately treated in an alternative setting, order the child to
  receive treatment on an outpatient basis for a period of not more
  than 90 days, which order may not specify a shorter period.
         SECTION 1.020.  Sections 55.54(a) and (b), Family Code, are
  amended to read as follows:
         (a)  If the juvenile court issues a placement order under
  Section 55.52(a), the court shall order the probation department to
  send copies of any information in the possession of the department
  and relevant to the issue of the child's mental illness or
  intellectual disability [mental retardation] to the public or
  private facility or outpatient center, as appropriate.
         (b)  Not later than the 75th day after the date the court
  issues a placement order under Section 55.52(a), the public or
  private facility or outpatient center, as appropriate, shall submit
  to the court a report that:
               (1)  describes the treatment of the child provided by
  the facility or center; and
               (2)  states the opinion of the director of the facility
  or center as to whether the child has a mental illness or an
  intellectual disability [is mentally ill or mentally retarded].
         SECTION 1.021.  Section 55.55, Family Code, is amended to
  read as follows:
         Sec. 55.55.  REPORT THAT CHILD DOES NOT HAVE MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [IS NOT MENTALLY ILL OR MENTALLY
  RETARDED]; HEARING ON OBJECTION. (a) If a report submitted under
  Section 55.54(b) states that a child does not have a mental illness
  or an intellectual disability [mental retardation], the juvenile
  court shall discharge the child unless:
               (1)  an adjudication hearing was conducted concerning
  conduct that included a violation of a penal law listed in Section
  53.045(a) and a petition was approved by a grand jury under Section
  53.045; and
               (2)  the prosecuting attorney objects in writing not
  later than the second day after the date the attorney receives a
  copy of the report under Section 55.54(c).
         (b)  On objection by the prosecuting attorney under
  Subsection (a), the juvenile court shall hold a hearing without a
  jury to determine whether the child has a mental illness or an
  intellectual disability [mental retardation] and whether the child
  meets the commitment criteria for civil commitment under Subtitle C
  or D, Title 7, Health and Safety Code.
         (c)  At the hearing, the burden is on the state to prove by
  clear and convincing evidence that the child has a mental illness or
  an intellectual disability [mental retardation] and that the child
  meets the commitment criteria for civil commitment under Subtitle C
  or D, Title 7, Health and Safety Code.
         (d)  If, after a hearing, the court finds that the child does
  not have a mental illness or an intellectual disability [mental
  retardation] and that the child does not meet the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code, the
  court shall discharge the child.
         (e)  If, after a hearing, the court finds that the child has a
  mental illness or an intellectual disability [mental retardation]
  and that the child meets the commitment criteria under Subtitle C or
  D, Title 7, Health and Safety Code, the court shall issue an
  appropriate commitment order.
         SECTION 1.022.  Section 55.59, Family Code, is amended to
  read as follows:
         Sec. 55.59.  REPORT THAT CHILD HAS INTELLECTUAL DISABILITY 
  [MENTAL RETARDATION]; INITIATION OF COMMITMENT PROCEEDINGS. If a
  report submitted under Section 55.54(b) states that a child has an
  intellectual disability [mental retardation] and that the child
  meets the commitment criteria for civil commitment under Subtitle
  D, Title 7, Health and Safety Code, the director of the residential
  care facility shall submit to the court an affidavit stating the
  conclusions reached as a result of the diagnosis. On receipt of an
  affidavit, the juvenile court shall:
               (1)  initiate proceedings in the juvenile court as
  provided by Section 55.60 for commitment of the child under
  Subtitle D, Title 7, Health and Safety Code; or
               (2)  refer the child's case to the appropriate court as
  provided by Section 55.61 for the initiation of proceedings in that
  court for commitment of the child under Subtitle D, Title 7, Health
  and Safety Code.
         SECTION 1.023.  The heading to Section 55.60, Family Code,
  is amended to read as follows:
         Sec. 55.60.  COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.024.  Section 55.60(c), Family Code, is amended to
  read as follows:
         (c)  On receipt of the court's order, the [Texas] Department
  of Aging and Disability Services [Mental Health and Mental
  Retardation] or the appropriate community center shall admit the
  child to a residential care facility.
         SECTION 1.025.  The heading to Section 55.61, Family Code,
  is amended to read as follows:
         Sec. 55.61.  REFERRAL FOR COMMITMENT PROCEEDINGS FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.026.  Section 55.61(a), Family Code, is amended to
  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
  as follows:
         Sec. 101.036 [101.0021].  [BUREAU OF] VITAL STATISTICS
  UNIT. "Vital [Bureau of vital] statistics unit" means the [bureau
  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
  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
  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:
               (1)  a parent of the child;
               (2)  the child through a representative authorized by
  the court;
               (3)  a custodian or person having the right of
  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
  child;
               (5)  a governmental entity;
               (6)  the Department of Family and Protective Services
  [an authorized agency];
               (7)  a licensed child placing agency;
               (8)  a man alleging himself to be the father of a child
  filing in accordance with Chapter 160, subject to the limitations
  of that chapter, but not otherwise;
               (9)  a person, other than a foster parent, who has had
  actual care, control, and possession of the child for at least six
  months ending not more than 90 days preceding the date of the filing
  of the petition;
               (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
  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
  COMMISSIONER. (a) The executive commissioner [board] has general
  supervision and control over all matters relating to the health of
  the citizens of this state.
         (b)  The executive commissioner [board] shall[:
               [(1)]  adopt rules for [its procedure and for] the
  performance of each duty imposed by law on the executive
  commissioner [board], the department, or the commissioner and file
  a copy of those rules with the department.
         Sec. 12.0011.  INVESTIGATIONS IN GENERAL.  Subject to the
  oversight of the executive commissioner, the department shall[; and
               [(2)]  examine, investigate, enter, and inspect any
  public place or public building as the department [board]
  determines necessary for the discovery and suppression of disease
  and the enforcement of any health or sanitation law of this state.
         [(c)     The board has all the powers, duties, and functions
  granted by law to:
               [(1)  the Texas Board of Health;
               [(2)  the state commissioner of health;
               [(3)  the Texas Department of Health;
               [(4)  the Texas Board of Health Resources; and
               [(5)  the Texas Department of Health Resources.]
         Sec. 12.002.  CERTAIN PROCEDURES FOR [BOARD]
  INVESTIGATIONS. (a)  The commissioner or the commissioner's
  designee [A member of the board] may administer oaths, summon
  witnesses, and compel the attendance of witnesses in any matter
  proper for [board] investigation by the department, subject to the
  executive commissioner's oversight, including the determination of
  nuisances and the investigation of:
               (1)  public water supplies;
               (2)  sanitary conditions;
               (3)  the existence of infection; or
               (4)  any matter that requires the department [board] to
  exercise its discretionary powers and that is within the general
  scope of its authority under this subchapter.
         (b)  Each district court shall aid the department [board] in
  its investigations and in compelling compliance with this
  subchapter. If a witness summoned by the commissioner or the
  commissioner's designee [board] is disobedient or disrespectful to
  the department's [board's] lawful authority, the district court of
  the county in which the witness is summoned to appear shall punish
  the witness in the manner provided for contempt of court.
         Sec. 12.003.  LEGAL REPRESENTATION. (a) A suit brought by
  the department [board] must be brought in the name of the state.
         (b)  The attorney general shall assign a special assistant to
  attend to the department's [board's] legal matters, and on the
  department's [board's] request shall furnish necessary assistance
  to the department [board] relating to its legal requirements.
         [Sec.   12.004.     DEVELOPMENT OF PROPOSED RULES. (a) This
  section applies to the process by which the department develops
  proposed rules for the board's consideration before the proposed
  rules are published in the Texas Register and before the board,
  commissioner, or department complies with the rulemaking
  requirements of the administrative procedure law, Chapter 2001,
  Government Code. This section does not affect the duty of the
  board, commissioner, or department to comply with the rulemaking
  requirements of that law.
         [(b)     The board shall require the department to establish a
  checklist of methods that, to the extent appropriate, the
  department will follow to obtain early in the rule development
  process the advice and opinions of the public and of persons who
  will be most affected by a proposed rule. The checklist must
  include methods for identifying persons who will be most affected
  and for soliciting at a minimum the advice and opinions of affected
  local health departments, of recipients and providers of affected
  services, and of advocates for affected recipients or providers.
         [(c)     The checklist may include negotiated rulemaking,
  informal conferences, advisory committees, and any other
  appropriate method.
         [(d)     A rule adopted by the board may not be challenged on the
  grounds that the board, commissioner, or department did not comply
  with this section. If the department was unable to solicit a
  significant amount of advice and opinion from the public or from
  affected persons early in the rule development process, the
  department shall state in writing to the board the reasons why the
  department was unable to do so.
         [Sec.   12.005.     MEDICAL DIRECTOR: MEDICAID MANAGED CARE AND
  CHIPS PROGRAMS. (a) In addition to any other medical director
  employed by the department, the board shall require the department
  to employ a separate medical director whose duties consist of
  acting as the medical director for the children's health insurance
  program created under Title XXI of the Social Security Act (42
  U.S.C. Section 1397aa et seq.) and also as the medical director for
  the Medicaid managed care program, to the extent that those
  programs are administered by the department.
         [(b)     The medical director shall be primarily responsible
  for implementing and maintaining policies and systems for the
  programs that relate to clinical and professional medical issues,
  including clinical oversight.
         [(c)     The medical director must be a physician licensed to
  practice medicine in this state.]
         SECTION 3.0011.  Sections 12.0111(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  Notwithstanding other law, the executive commissioner
  by rule shall adopt and the department shall collect [charge] a fee
  for issuing or renewing a license that is in an amount designed to
  allow the department to recover from its license holders all of the
  department's direct and indirect costs in administering and
  enforcing the applicable licensing program.
         (c)  Notwithstanding other law, each regulatory board or
  other agency that is under the jurisdiction of the department or
  administratively attached to the department and that issues
  licenses shall adopt by rule and collect [charge] a fee for issuing
  or renewing a license that is in an amount designed to allow the
  department and the regulatory board or agency to recover from the
  license holders all of the direct and indirect costs to the
  department and to the regulatory board or agency in administering
  and enforcing the applicable licensing program.
         SECTION 3.0012.  Sections 12.0115(a), (e), and (h), Health
  and Safety Code, are amended to read as follows:
         (a)  In this section, "health care delivery programs"
  includes the department's primary health care services program, its
  program to improve maternal and infant health, its services program 
  for [chronically ill and disabled] children with special health
  care needs, any aspects of health care delivery under the state
  Medicaid program assigned to the department by law or by the
  commission [Health and Human Services Commission], and the part of
  any other department program concerned with the department's
  responsibility for the delivery of health care services.
         (e)  One of the primary goals of the department in
  integrating the administration of [its] contracts entered into by
  the executive commissioner or the executive commissioner's
  designee on behalf of the department with providers of health care
  services shall be designing an integrated contract administration
  system that reduces the administrative and paperwork burden on
  providers while still providing the department with the information
  it needs to effectively administer the contracts. The department's
  integration of contract administration must include:
               (1)  the integration of the initial procurement process
  within and across programs, at least in part by efficiently
  combining requests for bids or proposals within or across programs
  to the extent it reduces the administrative burden for providers;
               (2)  the establishment of uniform contract terms,
  including:
                     (A)  contract terms that require information from
  providers, or that prescribe performance standards for providers,
  that could be made uniform within or across programs while
  remaining effective as contract terms;
                     (B)  the establishment of a procedure under which
  a contractor or a person responding to a request for bids or
  proposals may supply the department with requested information
  whenever possible by referencing current and correct information
  previously supplied to and on file with the department; and
                     (C)  contract terms regarding incentives for
  contractors to meet or exceed contract requirements;
               (3)  the integration of contract monitoring,
  particularly with regard to monitoring providers that deliver
  health services for the department under more than one contract or
  under more than one department program; and
               (4)  the integration of reimbursement methods:
                     (A)  particularly for a provider that delivers
  health services for the department under more than one contract or
  under more than one department program; and
                     (B)  including the application across programs of
  the most effective and efficient reimbursement technologies or
  methods that are available to the department under any of its
  programs.
         (h)  The department may not integrate health care delivery
  programs under this section in a way that affects the single state
  agency status of another state agency for federal purposes without
  obtaining the approval of the commission [Health and Human Services
  Commission] and any necessary federal approval.
         SECTION 3.0013.  Sections 12.0121(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall adopt a
  list of categories of licensed, certified, registered, or otherwise
  authorized providers to whom the department may award a grant for
  professional services under this section or with whom the
  department may contract or otherwise engage to perform professional
  services under this section.
         (d)  The department may award a grant, enter into a contract,
  or otherwise engage an individual or a group or association of
  individuals to perform professional services without complying
  with Subsection (c) if the executive commissioner by order
  [ratified by the board at its next regular meeting] determines that
  an emergency exists that necessitates the use of different
  procedures. A grant, contract, or engagement under this subsection
  is effective only for the period specified by the executive
  commissioner's order.
         SECTION 3.0014.  Section 12.0122(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [department] by rule may
  establish fees that the department may collect [charges] for the
  sale of laboratory services.
         SECTION 3.0015.  Section 12.01221, Health and Safety Code,
  is transferred to Subchapter B, Chapter 33, Health and Safety Code,
  redesignated as Section 33.0165, Health and Safety Code, and
  amended to read as follows:
         Sec. 33.0165 [12.01221].  MUTUAL AID AGREEMENT FOR NEWBORN
  SCREENING LABORATORY SERVICES. (a) In this section, "newborn
  screening laboratory services" means the performance of tests to
  analyze specimens collected as part of the newborn screenings
  performed under this subchapter [Subchapter B, Chapter 33].
         (b)  Notwithstanding Section 12.0122 or other law, the
  department may enter into a mutual aid agreement to provide newborn
  screening laboratory services to another state and to receive
  newborn screening laboratory services from another state in the
  event of an unexpected interruption of service, including an
  interruption caused by a disaster.
         (c)  Each mutual aid agreement under Subsection (b) shall
  include provisions:
               (1)  to address the confidentiality of the identity of
  the newborn child and the newborn child's family; and
               (2)  to ensure the return of blood specimens and
  related records to the state that received the newborn screening
  laboratory services.
         SECTION 3.0016.  Section 12.0123, Health and Safety Code, as
  added by Chapter 1411 (H.B. 2085), Acts of the 76th Legislature,
  Regular Session, 1999, is transferred to Subchapter B, Chapter 32,
  Human Resources Code, redesignated as Section 32.0705, Human
  Resources Code, amended to conform to Section 12.0123, Health and
  Safety Code, as added by Chapters 1447 (H.B. 2896) and 1460 (H.B.
  2641), Acts of the 76th Legislature, Regular Session, 1999, and
  further amended to read as follows:
         Sec. 32.0705 [12.0123].  EXTERNAL AUDITS OF CERTAIN
  MEDICAID CONTRACTORS BASED ON RISK. (a) In this section, "Medicaid
  contractor" means an entity that:
               (1)  is not a health and human services agency as
  defined by Section 531.001, Government Code; and
               (2)  under a contract with the commission or otherwise
  on behalf of the commission [department], performs one or more
  administrative services in relation to the commission's 
  [department's] operation of [a part of the state] Medicaid
  [program], such as claims processing, utilization review, client
  enrollment, provider enrollment, quality monitoring, or payment of
  claims.
         (b)  The commission [department] shall contract with an
  independent auditor to perform annual independent external
  financial and performance audits of any Medicaid contractor used
  [by the department] in the commission's [department's] operation of
  [a part of the state] Medicaid [program]. The commission 
  [department] regularly shall review the [its] Medicaid contracts
  and ensure that:
               (1)  the frequency and extent of audits of a Medicaid
  contractor under this section are based on the amount of risk to the
  state involved in the administrative services being performed by
  the contractor;
               (2)  audit procedures related to financial audits and
  performance audits are used consistently in audits under this
  section; and
               (3)  to the extent possible, audits under this section
  are completed in a timely manner.
         (c)  If another state agency succeeds to the commission's 
  [department's] operation of a part of [the state] Medicaid
  [program] for which the commission [department] used a Medicaid
  contractor, the successor agency shall comply with this section
  with regard to the Medicaid contractor, including the requirement
  to contract with an independent auditor to perform the external
  financial and performance audits required by this section.
         (d)  An audit required by this section must be completed
  before the end of the fiscal year immediately following the fiscal
  year for which the audit is performed.
         SECTION 3.0017.  Section 12.0124, Health and Safety Code, is
  transferred to Subchapter B, Chapter 32, Human Resources Code,
  redesignated as Section 32.0316, Human Resources Code, and amended
  to read as follows:
         Sec. 32.0316 [12.0124].  ELECTRONIC TRANSACTIONS; [STATE]
  MEDICAID [PROGRAM]. The executive commissioner shall adopt and the
  commission [department or the department's successor in function in
  relation to the department's operation of a part of the state
  Medicaid program] shall implement policies that encourage the use
  of electronic transactions in Medicaid. The policies shall require
  payment to Medicaid [service] providers by electronic funds
  transfer, including electronic remittance and status reports. The
  policies shall also include the establishment of incentives to
  submit claims electronically and of disincentives to submit claims
  on paper that are reasonably based on the higher administrative
  costs to process claims submitted on paper.
         SECTION 3.0018.  Sections 12.0125(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall develop a voluntary drug
  manufacturer rebate program for drugs purchased by or on behalf of a
  client of the Kidney Health Care Program or the Children with
  Special Health Care Needs [Chronically Ill and Disabled Children's]
  Services Program for which rebates are not available under the
  Medicaid drug manufacturer rebate program.
         (c)  Amounts received by the department under the drug rebate
  program established under this section may be appropriated only for
  the Kidney Health Care Program or the Children with Special Health
  Care Needs [Chronically Ill and Disabled Children's] Services
  Program.
         SECTION 3.0019.  Section 12.0128, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.0128.  HEALTH ALERT NETWORK. The department shall
  include local health officials [the Texas Association of Local
  Health Officials], the Texas Association of Community Health
  Centers, and the Texas Organization of Rural and Community
  Hospitals in the department's Texas Health Alert Network to the
  extent federal funds for bioterrorism preparedness are available
  for that purpose.
         SECTION 3.0020.  Section 12.014(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule may adopt
  reasonable registration fees to cover the costs of establishing and
  maintaining a registry and may adopt other rules as necessary to
  administer this section.
         SECTION 3.0021.  Sections 12.0145(a), (d), and (g), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall publish and provide information in
  accordance with this section regarding each final enforcement
  action taken by the department or[,] commissioner[, or board]
  against a person or facility regulated by the department in which
  any kind of sanction is imposed, including:
               (1)  the imposition of a reprimand, a period of
  probation, a monetary penalty, or a condition on a person's
  continued practice or a facility's continued operation; and
               (2)  the refusal to renew or the suspension, probation,
  or revocation of a license or other form of permission to engage in
  an activity.
         (d)  The department shall publish and provide the
  information promptly after the sanction has been imposed or, when
  applicable, promptly after the period during which the sanction is
  imposed has begun. The executive commissioner [department] by rule
  shall establish the length of time during which the required
  information will be published and provided under this section based
  on the executive commissioner's [department's] determination
  regarding the types of services provided by regulated entities and
  the length of time for which information about a category of
  enforcement actions is useful to a member of the public.
         (g)  A determination that the department is not required to
  publish and provide information under this section does not affect
  a determination regarding whether the information is subject to
  required disclosure under the open records law, Chapter 552,
  Government Code. The executive commissioner's [department's]
  determination regarding the length of the period during which
  information should continue to be published and provided under this
  section does not affect a determination regarding the period for
  which the information must be preserved under Chapter 441,
  Government Code, or under another law.
         SECTION 3.0022.  Section 12.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the department determines that a person is not
  eligible for a level of care in a nursing facility [home], the
  department shall inform the person that community services might be
  available under a [the] community care for the aged and disabled
  program administered by the [Texas] Department of Aging and
  Disability [Human] Services.
         SECTION 3.0023.  Section 12.016(d), Health and Safety Code,
  is amended to read as follows:
         (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
  the date on which a public hearing on the application is scheduled
  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
  the application were originally submitted to the department on that
  date.
         SECTION 3.0024.  Section 12.019(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner by rule may set a fee to be
  collected by the department [may charge] for providing genetic
  counseling services. The fee may not exceed the actual cost of
  providing the services.
         SECTION 3.0025.  Section 12.020(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The executive commissioner shall institute intellectual
  property policies for the department that establish minimum
  standards for:
               (1)  the public disclosure or availability of products,
  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