87R30440 KKR-D
 
  By: Frank H.R. No. 2027
 
 
R E S O L U T I O N
 
         BE IT RESOLVED by the House of Representatives of the State of
  Texas, 87th Legislature, Regular Session, 2021, That House Rule 13,
  Section 9(a), be suspended in part as provided by House Rule 13,
  Section 9(f), to enable the conference committee appointed to
  resolve the differences on House Bill 3720 (long-term care
  facilities for and Medicaid waiver programs available to certain
  individuals, including individuals with intellectual and
  developmental disabilities) to consider and take action on the
  following matters:
         (1)  House Rule 13, Section 9(a)(2), is suspended to permit
  the committee to omit text not in disagreement by omitting proposed
  Section 531.06035, Government Code, and the transition language
  associated with that section. The omitted text imposes a duty on
  the Health and Human Services Commission to conduct a medical
  necessity assessment of a child who receives Supplemental Security
  Income (SSI) before placing the child on the interest list for the
  medically dependent children (MDCP) program.
         Explanation: The omission of the text is necessary to remove
  the duty imposed on the Health and Human Services Commission to
  conduct certain medical necessity assessments of a child who
  receives Supplemental Security Income (SSI) before placing the
  child on the interest list for the medically dependent children
  (MDCP) program.
         (2)  House Rule 13, Section 9(a)(4), is suspended to permit
  the committee to add text on a matter not included in either the
  house or senate version of the bill by adding the following new
  SECTION to the bill:
         SECTION 1.  Section 531.0581(b), Government Code, is amended
  to read as follows:
         (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; and
               (10)  at least one member who is a community-based
  provider at an intermediate care facility for individuals with
  intellectual or developmental disabilities licensed under Chapter
  252, Health and Safety Code.
         Explanation: This addition is necessary to change the
  composition of the Texas Long-Term Care Facilities Council to
  include at least one member who is a community-based provider at
  certain intermediate care facilities.
         (3)  House Rule 13, Section 9(a)(4), is suspended to permit
  the committee to add text on a matter not included in either the
  house or senate version of the bill by adding the following new
  SECTIONS to the bill:
         SECTION 3.  Section 252.065(b), Health and Safety Code, is
  amended to read as follows:
         (b)  The penalty for a facility with fewer than 60 beds shall
  be not less than $100 or more than $1,000 for each violation. The
  penalty for a facility with 60 beds or more shall be not less than
  $100 or more than $5,000 for each violation. Each day a violation
  occurs or continues is a separate violation for purposes of
  imposing a penalty. The total amount of penalties [a penalty]
  assessed under this subsection for an on-site regulatory visit or
  complaint investigation, regardless of the duration of any ongoing
  violations, [for each day a violation occurs or continues] may not
  exceed:
               (1)  $5,000 for a facility with fewer than 60 beds; and
               (2)  $25,000 for a facility with 60 beds or more.
         SECTION 4.  Section 161.089, Human Resources Code, is
  amended by amending Subsection (c) and adding Subsection (c-1) to
  read as follows:
         (c)  After consulting with appropriate stakeholders, the
  executive commissioner shall develop and adopt rules regarding the
  imposition of administrative penalties under this section. The
  rules must:
               (1)  specify the types of violations that warrant
  imposition of an administrative penalty;
               (2)  establish a schedule of progressive
  administrative penalties in accordance with the relative type,
  frequency, and seriousness of a violation;
               (3)  prescribe reasonable amounts to be imposed for
  each violation giving rise to an administrative penalty, subject to
  Subdivision (4);
               (4)  authorize the imposition of an administrative
  penalty in an amount not to exceed $5,000 for each violation;
               (5)  provide that a provider commits a separate
  violation each day the provider continues to violate the law or
  rule;
               (6)  ensure standard and consistent application of
  administrative penalties throughout the state; [and]
               (7)  provide for an administrative appeals process to
  adjudicate claims and appeals relating to the imposition of an
  administrative penalty under this section that is in accordance
  with Chapter 2001, Government Code; and
               (8)  ensure standard and consistent interpretation of
  service delivery rules and consistent application of
  administrative penalties throughout this state.
         (c-1)  On adoption of the rules under Subsection (c), the
  executive commissioner shall develop interpretative guidelines for
  regulatory staff and providers regarding the imposition of
  administrative penalties under this section.
         SECTION 6.  Not later than December 1, 2021, the executive
  commissioner of the Health and Human Services Commission shall
  adopt the rules necessary to implement Section 252.065(b), Health
  and Safety Code, as amended by this Act, and Section 161.089, Human
  Resources Code, as amended by this Act.
         SECTION 7.  The Health and Human Services Commission may not
  assess a penalty under Section 161.089, Human Resources Code, as
  amended by this Act, until the executive commissioner of the Health
  and Human Services Commission:
               (1)  adopts the rules necessary to implement Section
  161.089(c)(8), Human Resources Code, as added by this Act; and
               (2)  develops the interpretive guidelines required by
  Section 161.089(c-1), Human Resources Code, as added by this Act.
         Explanation: The changes are necessary to implement certain
  changes to law relating to the imposition of administrative
  penalties against certain long-term care facilities, including a
  change to the amount of an administrative penalty for certain
  violations committed by intermediate care facilities for
  individuals with an intellectual disability and a change to ensure
  the executive commissioner of the Health and Human Services
  Commission adopts standard and consistent rules relating to the
  interpretation and consistent application of administrative
  penalties against certain long-term care facilities.