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.