83(R) SB 492 - Enrolled version

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	S.B. No. 492




	AN ACT
	relating to the licensing and regulation of prescribed pediatric
	extended care centers; providing penalties; imposing fees.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1. Subtitle B, Title 4, Health and Safety Code, is
	amended by adding Chapter 248A to read as follows:
	CHAPTER 248A. PRESCRIBED PEDIATRIC EXTENDED CARE CENTERS
	SUBCHAPTER A. GENERAL PROVISIONS
	Sec. 248A.001. DEFINITIONS. In this chapter:
	(1) "Basic services" includes:
	(A) the development, implementation, and
	monitoring of a comprehensive protocol of care that:
	(i) is provided to a medically dependent or
	technologically dependent minor;
	(ii) is developed in conjunction with the
	minor's parent or legal guardian; and
	(iii) specifies the medical, nursing,
	psychosocial, therapeutic, and developmental services required by
	the minor served; and
	(B) the caregiver training needs of the minor's
	parent or legal guardian.
	(2) "Center" means a prescribed pediatric extended
	care center.
	(3) "Commission" means the Health and Human Services
	Commission.
	(4) "Commissioner" means the commissioner of aging and
	disability services.
	(5) "Controlling person" has the meaning assigned by
	Section 248A.0012.
	(6) "Department" means the Department of Aging and
	Disability Services.
	(7) "Executive commissioner" means the executive
	commissioner of the commission.
	(8) "Medically dependent or technologically dependent
	minor" means a minor who because of an acute, chronic, or
	intermittent medically complex or fragile condition or disability
	requires ongoing, technology-based skilled nursing care prescribed
	by the minor's physician to avert death or further disability or the
	routine use of a medical device to compensate for a deficit in a
	life-sustaining body function. The term does not include minor or
	occasional medical conditions that do not require continuous
	nursing care, including asthma or diabetes, or a condition that
	requires an epinephrine injection.
	(9) "Minor" means an individual younger than 21 years
	of age.
	(10) "Prescribed pediatric extended care center"
	means a facility operated for profit or on a nonprofit basis that
	provides nonresidential basic services to four or more medically
	dependent or technologically dependent minors who require the
	services of the facility and who are not related by blood, marriage,
	or adoption to the owner or operator of the facility.
	Sec. 248A.0012. CONTROLLING PERSON. (a) A person is a
	controlling person if the person has the ability, acting alone or in
	concert with others, to directly or indirectly influence, direct,
	or cause the direction of the management of, expenditure of money
	for, or policies of a center or other person.
	(b) For purposes of this chapter, "controlling person"
	includes:
	(1) a management company, landlord, or other business
	entity that operates or contracts with another person for the
	operation of a center;
	(2) any person who is a controlling person of a
	management company or other business entity that operates a center
	or that contracts with another person for the operation of a center;
	and
	(3) any other person who, because of a personal,
	familial, or other relationship with the owner, manager, landlord,
	tenant, or provider of a center, is in a position of actual control
	of or authority with respect to the center, regardless of whether
	the person is formally named as an owner, manager, director,
	officer, provider, consultant, contractor, or employee of the
	center.
	(c) Notwithstanding any other provision of this section,
	for purposes of this chapter, a controlling person of a center or of
	a management company or other business entity described by
	Subsection (b)(1) that is a publicly traded corporation or is
	controlled by a publicly traded corporation means an officer or
	director of the corporation. The term does not include a
	shareholder or lender of the publicly traded corporation.
	(d) A controlling person described by Subsection (b)(3)
	does not include a person, including an employee, lender, secured
	creditor, or landlord, who does not exercise any formal or actual
	influence or control over the operation of a center.
	(e) The executive commissioner may adopt rules that define
	the ownership interests and other relationships that qualify a
	person as a controlling person under this section.
	Sec. 248A.002. EXEMPTIONS. This chapter does not apply to:
	(1) a facility operated by the United States
	government or a federal agency; or
	(2) a health facility otherwise licensed under this
	subtitle.
	Sec. 248A.003. CONFLICT WITH LOCAL LAWS. To the extent of
	any conflict between the standards adopted under this chapter and a
	standard required in a local, county, or municipal ordinance, this
	chapter controls.
	SUBCHAPTER B. LICENSING OF CENTERS
	Sec. 248A.051. LICENSE REQUIRED; PREMISES RESTRICTION.
	(a) A person may not own or operate a prescribed pediatric
	extended care center in this state unless the person holds a license
	issued under this chapter.
	(b) A separate license is required for each center located
	on separate premises, regardless of whether the centers are under
	the ownership or operation of the same person.
	(c) A person may not operate a center on the same premises
	as:
	(1) a child-care facility licensed under Chapter 42,
	Human Resources Code; or
	(2) any other facility licensed by the department or
	the Department of State Health Services.
	Sec. 248A.052. APPLICATION; ISSUANCE. (a) An applicant
	for a prescribed pediatric extended care center license shall
	submit to the department in accordance with executive commissioner
	rules:
	(1) a sworn application on the form prescribed by the
	department;
	(2) a letter of credit as prescribed by the department
	to demonstrate the applicant's financial viability; and
	(3) the required fees.
	(b) The application must contain:
	(1) the location of the premises of the center for
	which the license is sought;
	(2) documentation, signed by the appropriate local
	government official, stating the location and use of the premises
	meet local zoning requirements;
	(3) the name, address, and social security number of,
	and background and criminal history check information for:
	(A) the applicant;
	(B) the administrator responsible for daily
	operations of the center;
	(C) the financial officer responsible for
	financial operations of the center; and
	(D) each controlling person;
	(4) the name, address, and federal employer
	identification number or taxpayer identification number of the
	applicant and of each controlling person, if the applicant or
	controlling person is not an individual;
	(5) the business name of the center;
	(6) the maximum patient capacity requested for the
	center; and
	(7) a sworn affidavit that the applicant has complied
	with this chapter and rules adopted under this chapter.
	(c) The department shall issue a license to a center under
	this chapter if the department determines that the applicant and
	the center meet the requirements of this chapter and the rules and
	standards adopted under this chapter. The license must include:
	(1) the license holder's name;
	(2) the location of the premises of the center; and
	(3) a statement indicating the center provides
	services to minors for 12 hours or less in a 24-hour period and does
	not provide 24-hour care.
	Sec. 248A.053. LICENSE TERM; RENEWAL; NOTIFICATION. (a) A
	license issued under this chapter expires on the second anniversary
	of the date of issuance.
	(b) A person applying to renew a center license shall:
	(1) submit a renewal application to the department on
	the form prescribed by the department at least 60 days but not more
	than 120 days before expiration of the license;
	(2) submit the renewal fee in the amount required by
	the department; and
	(3) comply with any other requirements specified by
	executive commissioner rule.
	(c) The department shall assess a $50 per day late fee to a
	license holder who submits a renewal application after the date
	required by Subsection (b)(1), except that the total amount of a
	late fee may not exceed the lesser of 50 percent of the license
	renewal fee or $500.
	(d) At least 120 days before expiration of a center license,
	the department shall notify the owner or operator of the center of
	the license expiration.
	Sec. 248A.054. LICENSE NOT TRANSFERABLE OR ASSIGNABLE. A
	license under this chapter is issued to the license holder named on
	the license at the location of the premises listed on the license
	and is not transferable or assignable.
	SUBCHAPTER C. POWERS AND DUTIES OF
	EXECUTIVE COMMISSIONER, COMMISSION, AND DEPARTMENT
	Sec. 248A.101. ADOPTION OF RULES AND STANDARDS. (a) The
	executive commissioner shall adopt rules necessary to implement
	this chapter.
	(b) To protect the health and safety of the public and
	ensure the health, safety, and comfort of the minors served by a
	center, the rules must establish minimum center standards,
	including:
	(1) standards relating to the issuance, renewal,
	denial, suspension, probation, and revocation of a license to
	operate a center;
	(2) standards relating to the provision of
	family-centered basic services that include individualized
	medical, developmental, and family training services;
	(3) based on the size of the building and the number of
	minors served, building construction and renovation standards,
	including standards for plumbing, electrical, glass, manufactured
	buildings, accessibility for the physically disabled, and fire
	protection;
	(4) based on the size of the building and the number of
	minors served, building maintenance conditions relating to
	plumbing, heating, lighting, ventilation, adequate space, fire
	protection, and other conditions;
	(5) standards relating to the minimum number of and
	qualifications required for personnel who provide personal care or
	basic services to the minors served;
	(6) standards relating to the sanitary conditions
	within a center and its surroundings, including water supply,
	sewage disposal, food handling, and general hygiene;
	(7) standards relating to the programs offered by the
	center to promote and maintain the health and development of the
	minors served and to meet the training needs of the minors' parents
	or legal guardians;
	(8) standards relating to physician-prescribed
	supportive services;
	(9) standards relating to transportation services;
	and
	(10) standards relating to maintenance of patient
	medical records and program records in accordance with other law
	and with accepted professional standards and practices.
	(c) The executive commissioner by rule shall authorize the
	commissioner to grant a waiver from compliance with standards
	adopted under Subsection (b)(3), (4), or (6) to a center located in
	a municipality that adopts a code to regulate any of those standards
	if the commissioner determines the applicable municipal code
	standards exceed the corresponding standards adopted under
	Subsection (b)(3), (4), or (6).
	Sec. 248A.102. INSPECTIONS; CORRECTIVE ACTION PLAN.
	(a) The department may inspect a center, including its records, at
	reasonable times as necessary to ensure compliance with this
	chapter and the rules adopted under this chapter. The center shall
	provide the department with access to all center records.
	(b) The department shall inspect a center before issuing or
	renewing a license under this chapter.
	(c) The department may require a center that undergoes an
	inspection to:
	(1) take appropriate corrective action necessary to
	comply with the requirements of this chapter and rules adopted
	under this chapter; and
	(2) submit a corrective action plan to the department
	for approval.
	(d) A center shall make available to any person on request a
	copy of each inspection report pertaining to the center that has
	been issued by the department. Before making an inspection report
	available under this subsection, the center shall redact from the
	report any information that is confidential under other law.
	Sec. 248A.103. FEES. (a) The executive commissioner shall
	set fees imposed by this chapter in amounts reasonable and
	necessary to cover the cost of administering this chapter.
	(b) A fee collected under this chapter shall be deposited in
	the state treasury to the credit of the general revenue fund and
	shall be appropriated to the department to administer and enforce
	this chapter.
	(c) A fee collected under this chapter is nonrefundable.
	Sec. 248A.104. COMMISSION DUTIES. The commission shall
	designate a center licensed under this chapter as a health care
	services provider under the medical assistance program established
	under Chapter 32, Human Resources Code.
	SUBCHAPTER D. CENTER REGULATION
	Sec. 248A.151. ADMISSION CRITERIA FOR MINOR CLIENT. (a) A
	center may not admit a minor client to the center unless:
	(1) the client is a medically dependent or
	technologically dependent minor;
	(2) the minor's prescribing physician issues a
	prescription ordering care at a center;
	(3) the minor's parent or legal guardian consents to
	the minor's admission to the center; and
	(4) the admission is voluntary based on the parent's or
	legal guardian's preference in both managed care and non-managed
	care service delivery systems.
	(b) An admission authorized under this section is not
	intended to supplant the right to a Medicaid private duty nursing
	benefit, when medically necessary.
	Sec. 248A.152. RESTRICTIONS ON HOURS, SERVICES, AND PATIENT
	CAPACITY. (a) A center may not provide services to a minor for
	more than 12 hours in any 24-hour period.
	(b) A center may not provide services other than services
	regulated under this chapter and executive commissioner rule.
	(c) The maximum patient capacity at a center may not exceed
	60.
	Sec. 248A.153. LICENSE DISPLAY. Each center licensed under
	this chapter shall display the center's license in a conspicuous
	location readily visible to a person entering the center.
	Sec. 248A.154. MAINTENANCE OF RECORDS. Each center shall
	maintain at the center the medical and other records required by
	this chapter and by rules adopted under this chapter.
	Sec. 248A.155. COMPLAINTS. A person may file a complaint
	with the department against a center licensed or required to be
	licensed under this chapter. The department shall investigate the
	complaint in accordance with the complaint procedures established
	under Chapter 161, Human Resources Code.
	Sec. 248A.156. COMPLIANCE WITH OTHER LAW. (a) A center
	shall comply with Chapter 260A and rules adopted under that
	chapter.
	(b) An owner, center employee, or other person subject to
	Chapter 260A shall comply with that chapter and rules adopted under
	that chapter.
	Sec. 248A.157. CLOSING OF CENTER. At least 30 days before
	the date a center voluntarily discontinues operation, the owner or
	operator of the center shall inform the parent or legal guardian of
	each minor client to whom the center is providing services of:
	(1) the discontinuance; and
	(2) the proposed time of the discontinuance.
	SUBCHAPTER E. GENERAL ENFORCEMENT
	Sec. 248A.201. DENIAL, SUSPENSION, OR REVOCATION OF
	LICENSE. (a) The department may deny, suspend, or revoke a
	license issued under this chapter for:
	(1) a violation of this chapter or a rule or standard
	adopted under this chapter;
	(2) an intentional or negligent act by the center or an
	employee of the center that the department determines significantly
	affects the health or safety of a minor served by the center;
	(3) use of drugs or intoxicating liquors to an extent
	that affects the license holder's or applicant's professional
	competence;
	(4) a felony conviction, including a finding or
	verdict of guilty, an admission of guilt, or a plea of nolo
	contendere, in this state or in any other state of any person
	required to undergo a background and criminal history check under
	this chapter;
	(5) fraudulent acts, including acts relating to
	Medicaid fraud and obtaining or attempting to obtain a license by
	fraud or deception; or
	(6) a license revocation, suspension, or other
	disciplinary action taken against the license holder or any person
	listed in the application in another state.
	(b) Except as provided by Section 248A.203, the procedures
	by which the department denies, suspends, or revokes a license and
	by which those actions are appealed are governed by the procedures
	for a contested case hearing under Chapter 2001, Government Code.
	Sec. 248A.202. PROBATION. (a) If the department finds
	that a center is in repeated noncompliance with this chapter, rules
	adopted under this chapter, or a corrective action plan, but that
	the noncompliance does not endanger a minor served by the center or
	the public health and safety, the department may schedule the
	center for probation rather than suspending or revoking the
	center's license.
	(b) The department shall provide notice to the center of the
	probation and of the items of noncompliance not later than the 10th
	day before the date the probation period begins.
	(c) The department shall designate a period of not less than
	30 days during which the center will remain under probation. During
	the probation period, the center must correct the items that were in
	noncompliance and report the corrections to the department for
	approval.
	(d) The department may suspend or revoke the license of a
	center that does not correct items that were in noncompliance or
	does not comply with this chapter or the rules adopted under this
	chapter within the applicable probation period.
	Sec. 248A.203. EMERGENCY SUSPENSION. (a) The department
	may issue an emergency order to suspend a license issued under this
	chapter if the department has reasonable cause to believe that the
	conduct of a license holder creates an immediate danger to a minor
	served by the center or the public health and safety. An emergency
	suspension is effective immediately without a hearing on notice to
	the license holder.
	(b) On written request of the license holder, the department
	shall conduct a hearing not earlier than the 10th day or later than
	the 30th day after the date the hearing request is received to
	determine if the emergency suspension is to be continued, modified,
	or rescinded.
	(c) The hearing and any appeal are governed by the
	department's rules for a contested case hearing and by Chapter
	2001, Government Code.
	Sec. 248A.204. INJUNCTION. (a) The department may
	petition a district court for a temporary restraining order to
	restrain a continuing violation of this chapter or a rule or
	standard adopted under this chapter if the department finds that
	the violation creates an immediate threat to the health and safety
	of the minors served by a center.
	(b) A district court, on petition of the department and on a
	finding by the court that a person is violating this chapter or the
	rules adopted under this chapter, may by injunction:
	(1) prohibit the person from continuing the violation;
	(2) restrain or prevent the establishment or operation
	of a center without a license issued under this chapter; or
	(3) grant any other injunctive relief warranted by the
	facts.
	(c) The attorney general may institute and conduct a suit
	authorized by this section at the request of the department. The
	attorney general and the department may recover reasonable expenses
	incurred in obtaining relief under this section, including court
	costs, reasonable attorney's fees, investigation costs, witness
	fees, and deposition expenses.
	(d) Venue for a suit brought under this section is in the
	county in which the center is located or in Travis County.
	Sec. 248A.205. CIVIL PENALTY. (a) A person who violates
	this chapter or a rule or standard adopted under this chapter or who
	fails to comply with a corrective action plan submitted under this
	chapter is liable for a civil penalty of not more than $500 for each
	violation if the department determines the violation threatens the
	health and safety of a minor served by the center.
	(b) Each day a violation continues constitutes a separate
	violation for the purposes of this section.
	(c) The attorney general may sue to collect the penalty.
	The attorney general and the department may recover reasonable
	expenses incurred in obtaining relief under this section, including
	court costs, reasonable attorney's fees, investigation costs,
	witness fees, and deposition expenses.
	(d) All penalties collected under this section shall be
	deposited in the state treasury in the general revenue fund.
	Sec. 248A.206. CRIMINAL PENALTY. (a) A person commits an
	offense if the person knowingly establishes or operates a center
	without the appropriate license issued under this chapter.
	(b) An offense under this section is a Class B misdemeanor.
	(c) Each day a violation continues constitutes a separate
	offense.
	SUBCHAPTER F. ADMINISTRATIVE PENALTY
	Sec. 248A.251. IMPOSITION OF PENALTY. The commissioner may
	impose an administrative penalty on a person licensed under this
	chapter who violates this chapter or a rule or standard adopted or
	order issued under this chapter.
	Sec. 248A.252. AMOUNT OF PENALTY. (a) The amount of the
	penalty may not exceed $500 for each violation, and each day a
	violation continues or occurs is a separate violation for purposes
	of imposing a penalty.
	(b) The amount shall be based on:
	(1) the seriousness of the violation, including the
	nature, circumstances, extent, and gravity of the violation;
	(2) the threat to health or safety caused by the
	violation;
	(3) any previous violations;
	(4) the amount necessary to deter a future violation;
	(5) the efforts made by the violator to correct the
	violation; and
	(6) any other matter that justice may require.
	Sec. 248A.253. REPORT AND NOTICE OF VIOLATION AND PENALTY.
	(a) If the department initially determines that a violation
	occurred, the department shall give written notice of the report to
	the person.
	(b) The notice must:
	(1) include a brief summary of the alleged violation;
	(2) state the amount of the recommended penalty; and
	(3) inform the person of the person's right to a
	hearing on the occurrence of the violation, the amount of the
	penalty, or both.
	Sec. 248A.254. PENALTY TO BE PAID OR HEARING REQUESTED.
	(a) Not later than the 20th day after the date the person receives
	the notice sent under Section 248A.253, the person in writing may:
	(1) accept the determination and recommended penalty
	of the department; or
	(2) make a request for a hearing on the occurrence of
	the violation, the amount of the penalty, or both.
	(b) If the person accepts the determination and recommended
	penalty or if the person fails to respond to the notice, the
	commissioner by order shall approve the determination and impose
	the recommended penalty.
	Sec. 248A.255. HEARING. (a) If the person requests a
	hearing, the commissioner shall refer the matter to the State
	Office of Administrative Hearings, which shall promptly set a
	hearing date and give written notice of the time and place of the
	hearing to the person. An administrative law judge of the State
	Office of Administrative Hearings shall conduct the hearing.
	(b) The administrative law judge shall make findings of fact
	and conclusions of law and promptly issue to the commissioner a
	proposal for a decision about the occurrence of the violation and
	the amount of a proposed penalty.
	Sec. 248A.256. DECISION BY COMMISSIONER. (a) Based on the
	findings of fact, conclusions of law, and proposal for a decision,
	the commissioner by order may:
	(1) find that a violation occurred and impose a
	penalty; or
	(2) find that a violation did not occur.
	(b) The notice of the commissioner's order under Subsection
	(a) that is sent to the person in accordance with Chapter 2001,
	Government Code, must include a statement of the right of the person
	to judicial review of the order.
	Sec. 248A.257. OPTIONS FOLLOWING DECISION: PAY OR APPEAL.
	Not later than the 30th day after the date the order of the
	commissioner imposing an administrative penalty under Section
	248A.256 becomes final, the person shall:
	(1) pay the penalty; or
	(2) file a petition for judicial review of the
	commissioner's order contesting the occurrence of the violation,
	the amount of the penalty, or both.
	Sec. 248A.258. STAY OF ENFORCEMENT OF PENALTY. (a) Within
	the period prescribed by Section 248A.257, a person who files a
	petition for judicial review may:
	(1) stay enforcement of the penalty by:
	(A) paying the penalty to the court for placement
	in an escrow account in the court registry; or
	(B) giving the court a supersedeas bond approved
	by the court that:
	(i) is for the amount of the penalty; and
	(ii) is effective until all judicial review
	of the commissioner's order is final; or
	(2) request the court to stay enforcement of the
	penalty by:
	(A) filing with the court a sworn affidavit of
	the person stating that the person is financially unable to pay the
	penalty and is financially unable to give the supersedeas bond; and
	(B) sending a copy of the affidavit to the
	commissioner by certified mail.
	(b) If the commissioner receives a copy of an affidavit
	under Subsection (a)(2), the commissioner may file with the court,
	not later than the fifth day after the date the copy is received, a
	contest to the affidavit. The court shall hold a hearing on the
	facts alleged in the affidavit as soon as practicable and shall stay
	the enforcement of the penalty on finding that the alleged facts are
	true. The person who files an affidavit has the burden of proving
	that the person is financially unable to pay the penalty and to give
	a supersedeas bond.
	Sec. 248A.259. COLLECTION OF PENALTY. (a) If the person
	does not pay the penalty and the enforcement of the penalty is not
	stayed, the penalty may be collected.
	(b) The attorney general may sue to collect the penalty and
	may recover reasonable expenses, including attorney's fees,
	incurred in recovering the penalty.
	(c) A penalty collected under this subchapter shall be
	deposited in the state treasury in the general revenue fund.
	Sec. 248A.260. DECISION BY COURT. (a) If the court
	sustains the finding that a violation occurred, the court may
	uphold or reduce the amount of the penalty and order the person to
	pay the full or reduced amount of the penalty.
	(b) If the court does not sustain the finding that a
	violation occurred, the court shall order that a penalty is not
	owed.
	Sec. 248A.261. REMITTANCE OF PENALTY AND INTEREST. (a) If
	the person paid the penalty and if the amount of the penalty is
	reduced or the penalty is not upheld by the court, the court shall
	order, when the court's judgment becomes final, that the
	appropriate amount plus accrued interest be remitted to the person
	not later than the 30th day after the date the judgment of the court
	becomes final.
	(b) The interest accrues at the rate charged on loans to
	depository institutions by the New York Federal Reserve Bank.
	(c) The interest shall be paid for the period beginning on
	the date the penalty is paid and ending on the date the penalty is
	remitted.
	Sec. 248A.262. RELEASE OF BOND. (a) If the person gave a
	supersedeas bond and the penalty is not upheld by the court, the
	court shall order, when the court's judgment becomes final, the
	release of the bond.
	(b) If the person gave a supersedeas bond and the amount of
	the penalty is reduced, the court shall order the release of the
	bond after the person pays the reduced amount.
	Sec. 248A.263. ADMINISTRATIVE PROCEDURE. A proceeding to
	impose the penalty is considered to be a contested case under
	Chapter 2001, Government Code.
	SECTION 2. Subchapter F, Chapter 411, Government Code, is
	amended by adding Section 411.13861 to read as follows:
	Sec. 411.13861. ACCESS TO CRIMINAL HISTORY RECORD
	INFORMATION: DEPARTMENT OF AGING AND DISABILITY SERVICES.
	(a) The Department of Aging and Disability Services is entitled to
	obtain from the Department of Public Safety criminal history record
	information maintained by the Department of Public Safety that
	relates to a person required to undergo a background and criminal
	history check under Chapter 248A, Health and Safety Code.
	(b) Criminal history record information obtained under
	Subsection (a) is for the exclusive use of the Department of Aging
	and Disability Services and is privileged and confidential.
	(c) Criminal history record information obtained under
	Subsection (a) may not be released or disclosed to any person or
	agency except on court order or with the consent of the person who
	is the subject of the information. The Department of Aging and
	Disability Services may destroy the criminal history record
	information after the information is used for the purposes
	authorized by this section.
	(d) This section does not prohibit the Department of Aging
	and Disability Services from obtaining and using criminal history
	record information as provided by other law.
	SECTION 3. Subdivision (3), Section 250.001, Health and
	Safety Code, is amended to read as follows:
	(3) "Facility" means:
	(A) a nursing home, custodial care home, or other
	institution licensed by the Department of Aging and Disability
	Services under Chapter 242;
	(B) an assisted living facility licensed by the
	Department of Aging and Disability Services under Chapter 247;
	(C) a home and community support services agency
	licensed under Chapter 142;
	(D) an adult day care facility licensed by the
	Department of Aging and Disability Services under Chapter 103,
	Human Resources Code;
	(E) a facility for persons with mental
	retardation licensed under Chapter 252;
	(F) an adult foster care provider that contracts
	with the Department of Aging and Disability Services;
	(G) a facility that provides mental health
	services and that is operated by or contracts with the Department of
	State Health Services;
	(H) a local mental health or mental retardation
	authority designated under Section 533.035;
	(I) a person exempt from licensing under Section
	142.003(a)(19); [or]
	(J) a special care facility licensed by the
	Department of State Health Services under Chapter 248; or
	(K) a prescribed pediatric extended care center
	licensed by the Department of Aging and Disability Services under
	Chapter 248A.
	SECTION 4. Subdivision (4), Section 253.001, Health and
	Safety Code, is amended to read as follows:
	(4) "Facility" means:
	(A) a facility:
	(i) licensed by the department; or
	(ii) licensed under Chapter 252;
	(B) an adult foster care provider that contracts
	with the department; [or]
	(C) a home and community support services agency
	licensed by the department under Chapter 142; or
	(D) a prescribed pediatric extended care center
	licensed under Chapter 248A.
	SECTION 5. Subdivisions (5) and (7), Section 260A.001,
	Health and Safety Code, are amended to read as follows:
	(5) "Facility" means:
	(A) an institution as that term is defined by
	Section 242.002; [~~and~~]
	(B) an assisted living facility as that term is
	defined by Section 247.002; and
	(C) a prescribed pediatric extended care center
	as that term is defined by Section 248A.001.
	(7) "Resident" means an individual, including a
	patient, who resides in or receives services from a facility.
	SECTION 6. Section 32.024, Human Resources Code, is amended
	by adding Subsection (jj) to read as follows:
	(jj) The department shall establish a separate provider
	type for prescribed pediatric extended care centers licensed under
	Chapter 248A, Health and Safety Code, for purposes of enrollment as
	a provider for and reimbursement under the medical assistance
	program.
	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. (a) Not later than July 1, 2014, the executive
	commissioner of the Health and Human Services Commission shall
	adopt the rules required by Subchapter C, Chapter 248A, Health and
	Safety Code, as added by this Act.
	(b) Notwithstanding Section 248A.051, Health and Safety
	Code, as added by this Act, a person is not required to hold a
	prescribed pediatric extended care center license until January 1,
	2015.
	(c) When determining an initial reimbursement rate for
	licensed prescribed pediatric extended care centers that are
	enrolled in the medical assistance program, the executive
	commissioner of the Health and Human Services Commission shall
	establish a reimbursement rate that, when converted to an hourly
	rate, is not more than 70 percent of the average hourly unit rate
	for private duty nursing services provided under the Texas Health
	Steps Comprehensive Care Program.
	SECTION 9. (a) Except as provided by Subsection (b) of
	this section, this Act takes effect September 1, 2013.
	(b) Subchapters E and F, Chapter 248A, Health and Safety
	Code, as added by this Act, take effect January 1, 2015.





	______________________________	______________________________
	President of the Senate	Speaker of the House

	I hereby certify that S.B. No. 492 passed the Senate on
	April 3, 2013, by the following vote: Yeas 31, Nays 0; and that
	the Senate concurred in House amendments on May 24, 2013, by the
	following vote: Yeas 30, Nays 1.


	______________________________
	Secretary of the Senate

	I hereby certify that S.B. No. 492 passed the House, with
	amendments, on May 22, 2013, by the following vote: Yeas 106,
	Nays 40, one present not voting.


	______________________________
	Chief Clerk of the House



	Approved:

	______________________________
	Date


	______________________________
	Governor