H.B. No. 3720         AN ACT   relating to long-term care facilities for and Medicaid waiver   programs available to certain individuals, including individuals   with intellectual and developmental disabilities.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          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.          SECTION 2.  Subchapter B, Chapter 531, Government Code, is   amended by adding Section 531.06011 to read as follows:          Sec. 531.06011.  CERTAIN MEDICAID WAIVER PROGRAMS: INTEREST   LIST MANAGEMENT. (a)  This section applies only with respect to the   following waiver programs:                (1)  the community living assistance and support   services (CLASS) waiver program;                (2)  the home and community-based services (HCS) waiver   program;                (3)  the deaf-blind with multiple disabilities (DBMD)   waiver program;                (4)  the Texas home living (TxHmL) waiver program;                (5)  the medically dependent children (MDCP) waiver   program; and                (6)  the STAR+PLUS home and community-based services   (HCBS) program.          (b)  The commission, in consultation with the Intellectual   and Developmental Disability System Redesign Advisory Committee   established under Section 534.053, the state Medicaid managed care   advisory committee, and interested stakeholders, shall develop a   questionnaire to be completed by or on behalf of an individual who   requests to be placed on or is currently on an interest list for a   waiver program.          (c)  The questionnaire developed under Subsection (b) must,   at a minimum, request the following information about an individual   seeking or receiving services under a waiver program:                (1)  contact information for the individual or the   individual's parent or other legally authorized representative;                (2)  the individual's general demographic information;                (3)  the individual's living arrangement;                (4)  the types of assistance the individual requires;                (5)  the individual's current caregiver supports and   circumstances that may cause the individual to lose those supports;   and                (6)  when the delivery of services under a waiver   program should begin to ensure the individual's health and welfare   and that the individual receives services and supports in the least   restrictive setting possible.          (d)  If an individual is on a waiver program's interest list   and the individual or the individual's parent or other legally   authorized representative does not respond to a written or verbal   request made by the commission to update information concerning the   individual or otherwise fails to maintain contact with the   commission, the commission:                (1)  shall designate the individual's status on the   interest list as inactive until the individual or the individual's   parent or other legally authorized representative notifies the   commission that the individual is still interested in receiving   services under the waiver program; and                (2)  at the time the individual or the individual's   parent or other legally authorized representative provides notice   to the commission under Subdivision (1), shall designate the   individual's status on the interest list as active and restore the   individual to the position on the list that corresponds with the   date the individual was initially placed on the list.          (e)  The commission's designation of an individual's status   on an interest list as inactive under Subsection (d) may not result   in the removal of the individual from that list or any other waiver   program interest list.          (f)  Not later than September 1 of each year, the commission   shall provide to the Intellectual and Developmental Disability   System Redesign Advisory Committee established under Section   534.053, or, if that advisory committee is abolished, an   appropriate stakeholder advisory committee, as determined by the   executive commissioner, the number of individuals, including   individuals whose status is designated as inactive by the   commission, who are on an interest list to receive services under a   waiver program.          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 5.  As soon as practicable after the effective date   of this Act, the Health and Human Services Commission shall develop   the questionnaire required by Section 531.06011(b), Government   Code, as added by this Act.          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.          SECTION 8.  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 9.  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 10.  This Act takes effect September 1, 2021.       ______________________________ ______________________________      President of the Senate Speaker of the House                   I certify that H.B. No. 3720 was passed by the House on May   14, 2021, by the following vote:  Yeas 141, Nays 1, 3 present, not   voting; that the House refused to concur in Senate amendments to   H.B. No. 3720 on May 28, 2021, and requested the appointment of a   conference committee to consider the differences between the two   houses; and that the House adopted the conference committee report   on H.B. No. 3720 on May 30, 2021, by the following vote:  Yeas 140,   Nays 1, 2 present, not voting.     ______________________________   Chief Clerk of the House               I certify that H.B. No. 3720 was passed by the Senate, with   amendments, on May 24, 2021, by the following vote:  Yeas 30, Nays   0; at the request of the House, the Senate appointed a conference   committee to consider the differences between the two houses; and   that the Senate adopted the conference committee report on H.B. No.   3720 on May 30, 2021, by the following vote:  Yeas 31, Nays 0.     ______________________________   Secretary of the Senate      APPROVED: __________________                   Date                       __________________                 Governor