S.B. No. 1519
 
 
 
 
AN ACT
  relating to establishing a council on long-term care facilities and
  to a dispute resolution process regarding those facilities.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Section 531.058(a-1), Government Code, as
  amended by Chapters 590 (S.B. 924) and 836 (H.B. 2025), Acts of the
  85th Legislature, Regular Session, 2017, is reenacted and amended
  to read as follows:
         (a-1)  As part of the informal dispute resolution process
  established under this section, the commission shall contract with
  an appropriate disinterested person to adjudicate disputes between
  an institution or facility licensed under Chapter 242, Health and
  Safety Code, or a facility licensed under Chapter 247, Health and
  Safety Code, and the commission concerning a statement of
  violations prepared by the commission in connection with a survey
  conducted by the commission of the institution or facility.
  Section 2009.053 does not apply to the selection of an appropriate
  disinterested person under this subsection. The person with whom
  the commission contracts shall adjudicate all disputes described by
  this subsection. The informal dispute resolution process for the
  statement of violations must require:
               (1)  the surveyor who conducted the survey for which
  the statement was prepared to be available to clarify or answer
  questions related to the facility or the statement that are asked by
  the person reviewing the dispute or by the facility; and
               (2)  the commission's review of the institution's or
  facility's informal dispute resolution request to be conducted by a
  registered nurse with long-term care experience for a standard of
  care violation.
         SECTION 2.  Subchapter B, Chapter 531, Government Code, is
  amended by adding Section 531.0581 to read as follows:
         Sec. 531.0581.  LONG-TERM CARE FACILITIES COUNCIL.  (a)  In
  this section:
               (1)  "Council" means the Long-Term Care Facilities
  Council.
               (2)  "Long-term care facility" means a facility subject
  to regulation under Section 32.021(d), Human Resources Code, or
  Chapter 242, 247, or 252, Health and Safety Code.
         (b)  The executive commissioner shall establish a Long-Term
  Care Facilities Council as a permanent advisory committee to the
  commission.  The council is composed of the following members
  appointed by the executive commissioner:
               (1)  at least one member who is a for-profit nursing
  facility provider;
               (2)  at least one member who is a nonprofit nursing
  facility provider;
               (3)  at least one member who is an assisted living
  services provider;
               (4)  at least one member responsible for survey
  enforcement within the state survey and certification agency;
               (5)  at least one member responsible for survey
  inspection within the state survey and certification agency;
               (6)  at least one member of the state agency
  responsible for informal dispute resolution;
               (7)  at least one member with expertise in Medicaid
  quality-based payment systems for long-term care facilities;
               (8)  at least one member who is a practicing medical
  director of a long-term care facility; and
               (9)  at least one member who is a physician with
  expertise in infectious disease or public health.
         (c)  The executive commissioner shall designate a member of
  the council to serve as presiding officer. The members of the
  council shall elect any other necessary officers.
         (d)  A member of the council serves at the will of the
  executive commissioner.
         (e)  The council shall meet at the call of the executive
  commissioner.
         (f)  A member of the council is not entitled to reimbursement
  of expenses or to compensation for service on the council.
         (g)  The council shall study and make recommendations
  regarding a consistent survey and informal dispute resolution
  process for long-term care facilities, Medicaid quality-based
  payment systems for those facilities, and the allocation of
  Medicaid beds in those facilities.  The council shall:
               (1)  study and make recommendations regarding best
  practices and protocols to make survey, inspection, and informal
  dispute resolution processes more efficient and less burdensome on
  long-term care facilities;
               (2)  recommend uniform standards for those processes;
               (3)  study and make recommendations regarding Medicaid
  quality-based payment systems and a rate-setting methodology for
  long-term care facilities; and
               (4)  study and make recommendations relating to the
  allocation of and need for Medicaid beds in long-term care
  facilities, including studying and making recommendations relating
  to:
                     (A)  the effectiveness of rules adopted by the
  executive commissioner relating to the procedures for certifying
  and decertifying Medicaid beds in long-term care facilities; and
                     (B)  the need for modifications to those rules to
  better control the procedures for certifying and decertifying
  Medicaid beds in long-term care facilities.
         (h)  Not later than January 1 of each odd-numbered year, the
  council shall submit a report on the council's findings and
  recommendations to the executive commissioner, the governor, the
  lieutenant governor, the speaker of the house of representatives,
  and the chairs of the appropriate legislative committees.
         (i)  Chapter 2110 does not apply to the council.
         SECTION 3.  Section 242.0445, Health and Safety Code, is
  amended by adding Subsection (a-1) to read as follows:
         (a-1)  If the commission or the commission's representative
  conducting an inspection, survey, or investigation under Section
  242.043 or 242.044 identifies a violation that constitutes
  immediate jeopardy to the health or safety of a resident:
               (1)  the commission shall immediately notify the
  facility's management of the violation; and
               (2)  a commission representative shall remain in or be
  accessible to the facility until the commission receives the
  facility's plan of removal related to the violation.
         SECTION 4.  (a)  In this section:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Long-Term Care Facilities Council" means the
  council established under Section 531.0581, Government Code, as
  added by this Act.
               (3)  "Long-term care facility" has the meaning assigned
  by Section 531.0581, Government Code, as added by this Act.
         (b)  Not later than September 1, 2021, the Long-Term Care
  Facilities Council shall assess the impact the implementation of
  Section 2, Chapter 1117 (H.B. 3523), Acts of the 84th Legislature,
  Regular Session, 2015, which amended Section 533.00251(c),
  Government Code, effective September 1, 2021, would have on
  long-term care facilities and make a recommendation to the
  commission regarding its implementation.  Notwithstanding that
  section, if the council advises that implementing that section
  would have a significant impact on long-term care facilities, the
  commission may delay the implementation of that section until
  September 1, 2023, provided that the commission publishes notice of
  that delay in the Texas Register as soon as practicable.
         (c)  This section expires September 1, 2023.
         SECTION 5.  Not later than December 1, 2019, the executive
  commissioner of the Health and Human Services Commission shall
  establish the Long-Term Care Facilities Council and appoint the
  council members as required by Section 531.0581, Government Code,
  as added by this Act.
         SECTION 6.  The Health and Human Services Commission is
  required to implement a provision of this Act only if the
  legislature appropriates money to the commission specifically for
  that purpose. If the legislature does not appropriate money
  specifically for that purpose, the commission may, but is not
  required to, implement a provision of this Act using other
  appropriations that are available for that purpose.
         SECTION 7.  If before implementing any provision of this Act
  a state agency determines that a waiver or authorization from a
  federal agency is necessary for implementation of that provision,
  the agency affected by the provision shall request the waiver or
  authorization and may delay implementing that provision until the
  waiver or authorization is granted.
         SECTION 8.  This Act takes effect immediately if it receives
  a vote of two-thirds of all the members elected to each house, as
  provided by Section 39, Article III, Texas Constitution. If this
  Act does not receive the vote necessary for immediate effect, this
  Act takes effect September 1, 2019.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1519 passed the Senate on
  May 3, 2019, by the following vote: Yeas 31, Nays 0; and that the
  Senate concurred in House amendments on May 25, 2019, by the
  following vote: Yeas 30, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1519 passed the House, with
  amendments, on May 22, 2019, by the following vote: Yeas 107,
  Nays 36, two present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor