HBA-DMD S.B. 369 76(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 369 By: Zaffirini Human Services 5/5/1999 Engrossed BACKGROUND AND PURPOSE The Texas Department of Human Services (department) is primarily responsible for determining eligibility for and accessability to long-term care and public assistance benefits. The agency administers more than 30 state and federally-funded programs designed to help support selfsufficiency, provide long-term care services, and provide domestic violence education to low income families and children, persons who are elderly or disabled, and victims of family violence. The department is subject to the Texas Sunset Act and will be abolished on September 1, 1999, unless continued by the legislature. After its review of the department, the Sunset Advisory Commission recommended continuation and several statutory modifications. S.B. 369 changes the department's expiration date from September 1, 1999, to September 1, 2011. This bill modifies the composition of the Texas Board of Human Services (board). This bill also requires the Commissioner of Human Services (commissioner) and the administrator of each local administrative unit of the department to enter into a regional performance agreement that includes goals, objectives, and performance criteria. In addition, this bill requires the department to develop and implement a system to limit the number of direct providers of department community care services. S.B. 369 requires the department to assist a recipient of financial assistance in assessing the needs of the recipient and the recipient's family that, if addressed, would help the recipient and the recipient's family to attain and retain the capability of independence and self-care. This bill also requires the department to inform an applicant for medical assistance seeking nursing facility care of any community care services that may be available to the applicant as an alternative to nursing facility care. It requires the department to compile and periodically update regulatory and service quality information regarding nursing facilities for review by the public. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Department of Human Services in SECTIONS 5, 12, and 13 (Sections 22.0071, 32.0212, and 32.0251, Human Resources Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Section 21.002, Human Resources Code, to provide that the Texas Department of Human Services (department) is abolished and this title excluding any chapter that relates to a state agency other than the department expires September 1, 2011, rather than 1999, unless continued in existence. Deletes the provision providing for the expiration of Chapter 40 (Department of Protective and Regulatory Services; Child Welfare and Protective Services), Human Resources Code. SECTION 2. Amends Sections 21.003(b) and (d), Human Resources Code, to provide that the composition of the Texas Board of Human Services (board) must include one licensed physician with expertise in geriatrics and one other health care professional who is licensed, certified, or regulated by a health care regulatory agency. Requires the governor to designate a board member as the presiding officer of the board to serve in that capacity at the will of the governor. Deletes the requirement for the board to elect a presiding officer. SECTION 3. Amends Chapter 21, Human Resources Code, by adding Section 21.0033, to set forth standard Sunset language regarding board member training. SECTION 4. Amends Chapter 21, Human Resource Code, by adding Section 21.0061, as follows: Sec. 21.0061. REGIONAL PERFORMANCE AGREEMENTS WITH LOCAL ADMINISTRATIVE UNITS. (a) Requires the Commissioner of Human Services (commissioner) and the administrator of each local administrative unit of the department to enter into a regional performance agreement that includes goals, objectives, and performance criteria established by the commissioner under Subsection (b) for the unit. (b) Requires the commissioner to establish and biennially update goals, objectives, and performance criteria for each local administrative unit of the department. Sets provisions that must be included in the goals, objectives, and performance criteria. (c) Specifies requirements for the commissioner when developing the goals, objectives, and performance criteria under Subsection (b). (d) Requires the commissioner to assess the performance of each local administrative unit based on the goals, objectives, and performance criteria in the regional performance agreement between the commissioner and the administrator of that unit. Requires the commissioner to include the results of each assessment in the report on the operation and administration of the department required under Section 21.011 (Reports), Human Resources Code. (e) Requires the commissioner to consider the goals, objectives. and performance criteria in each regional performance agreement and the performance of each local administrative unit based on those standards when evaluating and establishing regional funding allocations. (f) Requires the department to inform health and human services agencies and the general public in each region of the contents of the performance agreement for that region. SECTION 5. Amends Chapter 22, Human Resources Code, by adding Section 22.0071, as follows: Sec. 22.0071. CONTRACTS FOR COMMUNITY CARE SERVICES. Requires the department, by rule, to develop and implement a system to limit the number of direct providers of department community care services. Requires the department to ensure that a sufficient number of director providers are available for certain purposes when developing the system. Specifies provisions that must be included in a contract for the delivery of community care services under a department program. Requires the department to monitor a community care provider's performance under a contract for the delivery of community care services. Specifies requirements for the department when monitoring the performance. SECTION 6. Amends Section 22.018, Human Resources Code, as follows: Sec. 22.018. New title: COOPERATION WITH STATE OFFICE OF ADMINISTRATIVE HEARINGS. (a) Requires the department and the chief administrative law judge of the State Office of Administrative Hearings to adopt a memorandum of understanding under which the State Office of Administrative Hearings conducts all contested case hearings authorized or required by law to be conducted by the department under the administrative procedure law, Chapter 2001 (Administrative Procedure), Government Code. Deletes text requiring the department to establish and maintain a hearings division to administer each hearing. (b) Requires the memorandum of understanding to require the chief administrative law judge, the department, and the commissioner to cooperate in connection with a contested case hearing and authorizes the memorandum of understanding to authorize the State Office of Administrative Hearings to perform any administrative act, including giving of notice, that is required to be performed by the department or commissioner. Deletes text providing that neither the department nor the department's legal division may directly or indirectly influence a decision or the decision-making process of the hearings division. (c) Requires the memorandum of understanding to address whether the administrative law judge who conducts a contested case hearing for the State Office of Administrative Hearings on behalf of the department is required to enter the final decision in the case after completion of the hearing or propose a decision to the department or the commissioner for final consideration. (d) Requires the department by interagency contract to reimburse the State Office of Administrative Hearings for the costs incurred in conducting contested case hearings for the department. Authorizes the department to pay an hourly fee for the costs of conducting those hearings or a fixed annual fee negotiated biennially by the department and the State Office of Administrative Hearings to coincide with the department's legislative appropriations request. (e) Provides that a reference in law to the hearings division of the department is considered to be a reference to the State Office of Administrative Hearings when used in relation to a contested case hearing under the administrative procedure law, Chapter 2001, Government Code. SECTION 7. Amends Section 31.0032, Human Resources Code, by adding Subsection (d), to require the department to give the highest priority to the administrative processing of sanctions or penalties under this section so that the department's records of the affected person promptly reflect application of the sanctions or penalties. SECTION 8. Amends the heading to Section 31.0095, Human Resources Code, as follows: Sec. 31.0095. New title: EMPLOYABILITY NEEDS ASSESSMENT. SECTION 9. Amends the heading to Section 31.010, Human Resources Code, as follows: Sec. 31.010. New title: SUPPORT SERVICES RELATED TO EMPLOYABILITY OF A RECIPIENT. SECTION 10. Amends Subchapter A, Chapter 31, Human Resources Code, by adding Section 31.011, as follows: Sec. 31.011. PERSONAL AND FAMILIAL NEEDS ASSESSMENT AND SUPPORT SERVICES. (a) Requires the department to assist a recipient of financial assistance in assessing the needs, other than employability needs assessed under Section 31.0095, of the recipient and the recipient's family that, if addressed, would help the recipient and the recipient's family to attain and retain the capability of independence and self-care. (b) Requires the department, based on the needs assessment under this section, to refer the recipient and the recipient's family to appropriate preventive and support services provided by the department or any other public or private entity. Specifies the preventive and support services to which the department is authorized to refer a recipient and a recipient's family under this section. SECTION 11. Amends Subchapter A, Chapter 31, Human Resources Code, by adding Section 31.0127, as follows: Sec. 31.0127. COORDINATION OF SERVICES TO TANF CLIENTS. (a) Provides that in order to ensure efficient delivery of appropriate programs and services, the Health and Human Services Commission (commission) is the state agency designated to coordinate between the department and a state agency providing child care services, Temporary Assistance for Needy Families work programs, and Food Stamp Employment and Training services to an individual or family who has been referred for programs and services by the department. (b) Requires the commission to require a state agency that is providing programs and services subject to coordination under Subsection (a) to comply with Chapter 531 (Health and Human Services Commission), Government Code, with regard to planning for the coordinated delivery of programs and services, rulemaking, expenditure of funds, data collection and reporting, and evaluations with regard to those programs and services. (c) Requires the commission and a state agency that is providing programs and services subject to coordination under Subsection (a), not later than October 1, 1999, to jointly develop and adopt a memorandum of understanding outlining measures to be taken to increase the number of individuals receiving Temporary Assistance for Needy Families cash assistance utilizing the Job Training Partnership Act program or its successor program. (d) Requires the commission, by January 15 of each odd-numbered year, to provide a report containing specified information to the governor, the lieutenant governor, and the speaker of the house of representatives. (e) Provides that if the change in law made by this section with regard to any program or service conflicts with federal law or would have the effect of invalidating an exemption granted under federal law, the state agency is not required to comply with this section with regard to that program or service. (f) Sets forth that this section does not authorize the commission to change the allocation or disbursement of funds allocated to the state under the Workforce Investment Act of 1998 (29 U.S.C. Section 2801 et seq.) in a manner that would result in the loss of exemption status. SECTION 12. Amends Subchapter B, Chapter 32, Human Resources Code, by adding Section 32.0212, as follows: Sec. 32.0212. CONTRACTS FOR NURSING FACILITY CARE. Requires the department, by rule, to develop minimum contract performance standards for a nursing facility that contracts with the department for the delivery of medical assistance. Requires the department, when developing the minimum performance standards, to use all appropriate performance data collected by the department or another agency. (b) Provides that a contract with the department for the delivery of medical assistance by a nursing facility must include the performance standards developed under Subsection (a). (c) Requires the department, by rule, to develop and implement a quality assessment process to evaluate the performance of a nursing facility that contracts with the department for the delivery of medical assistance. Requires the department, when developing the process, to use all appropriate performance data collected by the department or any other agency. (d) Requires the department to promptly address a nursing facility's failure to meet minimum performance standards, if necessary, by imposing penalties and sanctions, including termination of the facility's contract, as authorized under the contract or as provided by law. SECTION 13. Amends Subchapter B, Chapter 32, Human Resources Code, by adding Section 32.0251, as follows: Sec. 32.0251. COMMUNITY CARE SERVICES FOR THE ELDERLY AND DISABLED. (a) Requires the department to inform an applicant for medical assistance seeking nursing facility care of any community care services that may be available to the applicant as an alternative to nursing facility care. (b) Requires the department, by rule, to develop and implement a process of presumptive eligibility determination for appropriate elderly or disabled applicants for community care services. (c) Requires the department to design a plan of care for an applicant for community care services based on the needs of the applicant identified by the department. Requires the plan of care to be adjusted promptly as necessary based on any change in the applicant's physical condition or need for services, whether identified by the department during a periodic reassessment of the applicant's condition or at any other time. (d) Requires the department to maintain a waiting list for the services, if community care services are not readily available for an elderly or disabled applicant because of a high demand for services. Requires the department to collect from each applicant who is placed on the waiting list appropriate information to facilitate contacting the applicant when the services become available and to allow efficient enrollment of the applicant in those services. SECTION 14. Amends the chapter heading to Chapter 51, Human Resources Code, to read as follows: CHAPTER 51. New heading: FAMILY VIOLENCE CENTERS SECTION 15. Amends Section 51.002, Human Resources Code, to define "family violence shelter," "family violence residential center" and "family violence," to modify the definition of "family violence shelter center" and to delete the definition of "victim of family violence." SECTION 16. Amends Section 51.003, Human Resources Code, to authorize the department to contract for, rather than to authorize the contract to require, the provision of public education, consultation to the department, research, evaluation, and liaison and training for other professionals who work with victims of family violence, including professionals in the criminal justice, medical, and social services fields, and for community or civic groups. Requires the department to award all contracts through a competitive bidding process unless that process would not be cost-effective. Makes conforming and nonsubstantive changes. SECTION 17. Amends Section 51.004, Human Resources Code, to specify the conditions under which a family violence center, rather than a public or private nonprofit organization, may be eligible for a contract with the department. Specifies the conditions under which a family violence nonresidential center is eligible for a contract under Section 51.003(a). Requires the department, upon determining that a family violence nonresidential center provides services that would not be otherwise available in the service area, to include the family violence nonresidential center in the noncompetitive procurement procedure. Redesignates existing Subsection (c) to Subsection (d). Makes conforming and nonsubstantive changes. SECTION 18. Amends Section 51.005, Human Resources Code, to make conforming changes. SECTION 19. Amends Section 51.006, Human Resources Code, to make a conforming change. SECTION 20. Amends Section 51.007, Human Resources Code, to make a conforming change. SECTION 21. Amends Chapter 51, Human Resources Code, by adding Section 51.012, as follows: Sec. 51.012. COORDINATION OF SERVICES. Requires the department and the Department of Protective and Regulatory Services to coordinate the provision of violence prevention services for children and youth. SECTION 22. Amends Subchapter C, Chapter 242, Health and Safety Code, by adding Section 242.0611, as follows: Sec. 242.0611. RULE-BASED CRITERIA FOR ENFORCEMENT REMEDIES. Requires the department to develop criteria, published in rules, regarding circumstances that trigger the imposition of each of the remedies available to the department. SECTION 23. Amends Section 242.309, Health and Safety Code, as added by Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective until federal determination of failure to comply with federal regulations), as follows: Sec. 242.309. PROVISIONAL LICENSE. (a) Requires the board to issue a provisional license to an applicant currently licensed in another jurisdiction who seeks a license in this state and who meets specified requirements. Deletes text requiring the department to grant a provisional license under this subchapter. Modifies the requirements for an applicant who is seeking a provisional license to conform to the addition of an applicant licensed in another jurisdiction. Makes conforming and nonsubstantive changes. (b) Authorizes the board to waive, rather than authorizes an applicant to be excused from, the requirement of Subsection (a) for an applicant if the board, rather than department, determines that compliance with that subsection would be a hardship to the applicant. Makes nonsubstantive changes. (c) Requires the board to issue a license under this subchapter to the provisional license holder if the provisional license holder is eligible to be licensed under Section 242.306, (Examination), Health and Safety Code, rather than if the holder passes the examination required by 242.306(c) (License Application; Qualifications), or the provisional license holder passes the part of the examination under Section 242.307 that relates to the applicant's knowledge and understanding of the laws and rules relating to the practice of nursing facility administration in this state. Makes conforming and nonsubstantive changes. (d) Provides that the board must approve or deny, rather than requires the department to complete the processing of, a provisional license holder's application for a license no later than 180 days after the date the provisional license is issued. Authorizes the board, rather than the department, to extend the 180-day period if the results of an examination have not been received by the board before the end of that period. Deletes text authorizing the board to extend this time in order to receive the results of a national examination or other examination administered or graded by an outside organization recognized by the department. (e) Authorizes the board to establish a fee for provisional licenses in an amount reasonable and necessary to cover the cost of issuing the license. SECTION 24. Amends Section 242.310, Health and Safety Code, as added by Section 1.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective until federal determination of failure to comply with federal regulations), as follows: Sec. 242.310. LICENSE RENEWAL. (a) Prohibits a person whose license has expired from engaging in activities that require a license until the license has been renewed. Makes nonsubstantive changes. (b) Authorizes a person whose license has been expired for 90 days or less to renew the license by paying to the department a renewal fee that is equal to one and a half times, rather than one-half, the normally required renewal fee. Makes conforming and nonsubstantive changes. (c) Authorizes a person whose license has been expired for more than 90 days but less than one year to renew the license by paying to the department a renewal fee that is equal to two times the normally required renewal fee, rather than all unpaid renewal fees and a fee that is equal to the examination fee for the license. (d) Authorizes a person whose license has been expired for one year or more to obtain a new license by complying with the requirements and procedures, including the examination requirements, for obtaining an original license. (e) Provides that a person licensed in this state, who moved to another state, and has been licensed and practicing in the other state for at least two years must pay to the department a fee that is equal to two times the normally required renewal fee for the license, rather than must pay the examination fee. Makes conforming and nonsubstantive changes. (f) Requires the department, no later than 31 days, rather than at least 30 days, before the date a person's license is scheduled to expire, to send written notice of the impending expiration to the person at the person's last known address according to the records of the department. Makes conforming and nonsubstantive changes. SECTION 25. Amends Section 242.314, Health and Safety Code, as added by Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective upon federal determination of failure to comply with federal regulations), as follows: Sec. 242.314. PROVISIONAL LICENSE. (a) Requires the board to issue a provisional license to an applicant currently licensed in another jurisdiction who seeks a license in this state and who meets specified requirements. Deletes text requiring the department to grant a provisional license under this subchapter. Makes conforming and nonsubstantive changes. (b) Authorizes the board to waive, rather than authorizes an applicant to be excused from, the requirement of Subsection (a) for an applicant if the board, rather than department, determines that compliance with that subsection would be a hardship to the applicant. Makes nonsubstantive changes. (c) Requires the board to issue a license under this subchapter to the provisional license holder if the provisional license holder is eligible to be licensed under Section 242.311, rather than if the holder passes the examination required by242.311(c), or the provisional license holder passes the part of the examination under Section 242.312 that relates to the applicant's knowledge and understanding of the laws and rules relating to the practice of nursing facility administration in this state. Makes conforming and nonsubstantive changes. (d) Provides that the board must approve or deny, rather than requires the board to complete the processing of, a provisional license holder's application for a license no later than 180 days after the date the provisional license is issued. Authorizes the board to extend the 180-day period if the results of an examination have not been received by the board before the end of that period. Deletes text authorizing the board to extend this time in order to receive the results of a national examination or other examination administered or graded by an outside organization recognized by the board. (e) Authorizes the board to establish a fee for provisional licenses in an amount reasonable and necessary to cover the cost of issuing the license. SECTION 26. Amends Section 242.315, Health and Safety Code, as added by Section 2.01, Chapter 1280, Acts of the 75th Legislature, Regular Session, 1997 (effective upon federal determination of failure to comply with federal regulations), as follows: Sec. 242.315. LICENSE RENEWAL. (a) Prohibits a person whose license has expired from engaging in activities that require a license until the license has been renewed. Makes conforming and nonsubstantive changes. (b) Authorizes a person whose license has been expired for 90 days or less to renew the license by paying to the board a renewal fee that is equal to one and a half times the normally required fee, rather than a renewal fee and a fee that is one-half of the examination fee for the license. Makes conforming and nonsubstantive changes. (c) Authorizes a person whose license has been expired for more than 90 days but less than one year to renew the license by paying to the board a renewal fee that is equal to two times the normally required renewal fee, rather than all unpaid fees and a fee that is equal to the examination fee for the license. Makes conforming and nonsubstantive changes. (d) Authorizes a person whose license has been expired for one year or more to obtain a new license by complying with the requirements and procedures, including the examination requirements, for obtaining an original license. Makes conforming and nonsubstantive changes. (e) Provides that a person licensed in this state, who moved to another state, and has been licensed and practicing in the other state for at least two years must pay to the department a fee that is equal to two times the normally required renewal fee for the license, rather than must pay the examination fee. Makes conforming and nonsubstantive changes. (f) Requires the department, no later than 31 days, rather than at least 30 days, before the date a person's license is scheduled to expire, to send written notice of the impending expiration to the person at the person's last known address according to the records of the department. Makes conforming and nonsubstantive changes. SECTION 27. Amends Chapter 242, Health and Safety Code, by adding Subchapter Q, as follows: SUBCHAPTER Q. PUBLIC ACCESS TO QUALITY OF SERVICE INFORMATION Sec. 242.901. COMPILATION OF QUALITY OF SERVICE INFORMATION. (a) Requires the department to compile and periodically update regulatory and service quality information regarding nursing facilities licensed under this chapter for review by the public. Requires the department to consult with nursing facility residents, their families, nursing facility providers, and advocacy groups in determining the types of information to compile. Provides that this subsection applies only to regulatory and service quality information that is public information subject to public disclosure under Chapter 552 (Public Information), Government Code. (b) Requires the department to compile the compilation required under Subsection (a) in a format that is readily accessible to and understandable by a member of the general public. (c) Specifies additional information compiled under Subsection (a) that must be included for public benefit. (d) Provides that the cost incurred by a nursing facility in maintaining and reporting regulatory and service quality information required under this section is an allowable cost for reimbursement under the state Medicaid program. Sec. 242.902. ACCESS TO QUALITY OF SERVICE INFORMATION. Requires the department to provides access to the information compiled under Section 242.901 through a toll-free line and the Internet, or other electronic means. SECTION 28. Amends Section 30.05(b)(3), Penal Code, to modify the definition of "shelter center." SECTION 29. Repealer: Section 32.025(c) (Application for Medical Assistance), Human Resources Code, relating to informing clients of community care services of other available services. SECTION 30. Makes application of this Act prospective, as it applies to the qualifications for a license issued by the department. SECTION 31. (a) Provides that the changes in law made by this Act to the qualifications of and the prohibitions applying to members of the board do not affect the entitlement of a member serving on the board immediately before September 1, 1999, to continue to carry out the functions of the board for the remainder of the member's term. Provides that the changes in law apply only to a member appointed on or after September 1, 1999. Provides that this Act does not prohibit a person who is a member of the board on September 1, 1999, from being reappointed to the board if the person has the qualifications required for membership under Section 21.003, Human Resources Code, as amended by this Act. (b) Requires the governor, when filling the first two vacancies on the board that occur after the effective date of this Act, to ensure that the composition of the board after those vacancies are filled complies with the requirements of Subsection (b), Section 21.003, Human Resources Code, as amended by this Act. SECTION 32. (a) Requires the department, no later than January 1, 2000, to develop and implement the system required by Subsection (a), Section 22.0071, Human Resources Code, as added by this Act. Makes application of this Act prospective, as it applies to a contract. SECTION 33. (a) Makes application of this Act prospective, as it applies to a contested case hearing conducted by the State Office of Administrative Hearings on behalf of the Texas Department of Human Services, on January 1, 2000. (b) Authorizes the commissioner and the chief administrative law judge of the State Office of Administrative Hearings to agree to transfer contested cases pending before the department to the State Office of Administrative Hearings before January 1, 2000. SECTION 34. Makes application of Section 32.0212, Human Resources Code, as added by this Act, prospective. SECTION 35. Provides that 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 is required to request the waiver or authorization and the agency is authorized to delay implementing that provision until the waiver or authorization is granted. SECTION 36.Effective date: September 1, 1999. SECTION 37.Emergency clause.