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A BILL TO BE ENTITLED
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AN ACT
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relating to Medicaid beds in nursing facilities. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 32.0213, Human Resources Code, is |
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amended by adding Subsections (g) through (u) to read as follows: |
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(g) Notwithstanding Subsection (f), the commission may not |
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exempt applicants for Medicaid beds from the requirements of |
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Subsection (d) on or after September 1, 2017, and before September |
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1, 2021. |
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(h) Except as provided in Subsection (i), the commission may |
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not contract for new nursing facility beds under Medicaid unless |
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the statewide occupancy rate of certified Medicaid beds is more |
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than 90 percent, as determined by the commission annually on |
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September 1. |
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(i) Notwithstanding Subsection (h), the commission may |
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contract for new Medicaid beds in the following types of nursing |
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facilities: |
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(1) subject to Subsection (k), that is under |
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development on September 1, 2017, and for which there has been filed |
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with the commission an application for Medicaid beds; |
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(2) subject to Subsections (m), (n), (o), and (p), a |
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small house nursing facility; |
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(3) subject to Subsections (q) and (r), a replacement |
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nursing facility, without regard to whether the nursing facility is |
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under development or has been constructed on September 1, 2017; |
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(4) subject to Subsection (s), a nursing facility |
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located in a county where the occupancy rate of certified Medicaid |
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beds is more than 85 percent, as determined by the commission on |
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September 1 and March 1 of a particular year; and |
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(5) subject to Subsection (t), a nursing facility |
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without any unoccupied Medicaid beds for the purpose of providing a |
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temporary Medicaid bed for a resident of the nursing facility who |
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has exhausted the resident's resources and, as a result, is newly |
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eligible for Medicaid. |
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(j) Deadlines and any other time limitations relating to the |
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commission's allocation or certification of Medicaid beds for |
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nursing facilities not yet under development on September 1, 2017, |
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and prohibited under Subsection (h) are tolled until September 1, |
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2021. |
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(k) For purposes of Subsections (i)(1) and (j): |
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(1) a nursing facility is considered under development |
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if: |
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(A) funding to construct the nursing facility has |
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been secured and is being used to construct the nursing facility; |
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(B) any zoning requirements relating to the |
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construction of the nursing facility have been met; |
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(C) complete construction design plans for the |
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nursing facility have been submitted to the appropriate |
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governmental entities regulating fire and building safety not later |
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than September 1, 2017; and |
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(D) ongoing construction activities are |
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occurring at the nursing facility site; and |
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(2) the commission, in the commission's sole |
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discretion, shall determine whether an applicant for Medicaid beds |
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meets the requirements of this subsection. |
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(l) The construction design plans described in Subsection |
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(k)(1)(c) must be an accurate and true depiction of the nursing |
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facility that is being constructed but may be modified in order to |
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make technical changes, correct errors and omissions, or comply |
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with zoning or other requirements of a governmental entity. |
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(m) The executive commissioner by rule shall define "small |
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house nursing facility" for purposes of this section. |
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(n) The commission may not contract under Subsection (i)(2) |
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for more than: |
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(1) 50 Medicaid beds per small house nursing facility |
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per year; and |
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(2) a total of 100 new Medicaid beds for small house |
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nursing facilities statewide per year. |
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(o) The commission shall approve completed applications for |
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Medicaid beds by or on behalf of small house nursing facilities |
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under Subsection (i)(2) in the order in which the applications are |
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received by the commission. |
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(p) The commission shall rescind approval of an application |
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described by Subsection (o) if: |
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(1) the small house nursing facility is not |
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operational on the anniversary of the date the facility's |
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application was approved; and |
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(2) the commission has previously denied an |
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application for additional Medicaid beds by or on behalf of another |
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small house nursing facility because of the limitation on the total |
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number of Medicaid beds contained in Subsection (n)(2). |
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(q) The commission may contract for Medicaid beds in a |
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replacement nursing facility under Subsection (i)(3) only if: |
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(1) the replacement nursing facility: |
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(A) is licensed under Chapter 242, Health and |
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Safety Code; and |
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(B) is located in the same county as the nursing |
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facility that is being replaced; and |
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(2) the nursing facility that is being replaced: |
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(A) is licensed under Chapter 242, Health and |
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Safety Code, on September 1, 2017; and |
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(B) surrenders the license described by |
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Paragraph (A) not later than the 60th day after the date the |
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replacement nursing facility is licensed under Chapter 242, Health |
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and Safety Code. |
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(r) The commission may not contract for more Medicaid beds |
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for a replacement nursing facility under Subsection (i)(3) than |
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were contracted for the nursing facility that the replacement |
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nursing facility replaced. |
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(s) The commission may not contract under Subsection (i)(4) |
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for: |
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(1) more than 50 Medicaid beds per nursing facility; |
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or |
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(2) a number of Medicaid beds that would result in a |
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countywide occupancy rate of certified Medicaid beds that is below |
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the statewide occupancy rate. |
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(t) The executive commissioner by rule shall develop a |
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process for contracting for temporary Medicaid beds under |
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Subsection (i)(5). |
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(u) Subsections (g) through (t) and this subsection expire |
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September 1, 2021. |
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SECTION 2. Section 32.0244, Human Resources Code, is |
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amended by adding Subsection (e) to read as follows: |
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(e) Notwithstanding Subsections (a) through (d), the |
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commission may not contract for new nursing facility beds under |
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this section on or after September 1, 2017, and before September 1, |
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2021. This subsection expires September 1, 2021. |
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SECTION 3. Section 32.0245, Human Resources Code, is |
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amended to read as follows: |
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Sec. 32.0245. NURSING FACILITY BEDS FOR CERTAIN FACILITIES |
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TREATING ALZHEIMER'S DISEASE. (a) The commission shall waive for a |
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nursing facility a restriction imposed by state law on the |
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authority to contract under the state Medicaid program for nursing |
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facility beds based on the percentage of beds that are occupied in a |
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geographical area if the facility: |
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(1) is affiliated with a medical school operated by |
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the state; |
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(2) is participating in a research program for the |
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care and treatment of persons with Alzheimer's disease; and |
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(3) is designed to separate and treat Alzheimer's |
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disease by stage or functional level. |
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(b) Notwithstanding Subsection (a), the commission may not |
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waive a restriction on the commission's authority to contract for |
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nursing facility beds under this section on or after September 1, |
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2017, and before September 1, 2021. This subsection expires |
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September 1, 2021. |
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SECTION 4. If before implementing any provision of this Act |
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a state agency determines that a waiver or authorization from a |
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federal agency is necessary for implementation of that provision, |
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the agency affected by the provision shall request the waiver or |
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authorization and may delay implementing that provision until the |
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waiver or authorization is granted. |
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SECTION 5. This Act takes effect September 1, 2017. |