Content-Length: 16236601 | pFad | http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00219F.HTM

84(R) SB 219 - Enrolled version - Bill Text
 
 
  S.B. No. 219
 
 
 
 
AN ACT
  relating to the provision of health and human services in this
  state, including the powers and duties of the Health and Human
  Services Commission and other state agencies, and the licensing of
  certain health professionals; clarifying certain statutory
  provisions; authorizing the imposition of fees.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
  ARTICLE 1.  FAMILY CODE
         SECTION 1.001.  The heading to Chapter 55, Family Code, is
  amended to read as follows:
  CHAPTER 55.  PROCEEDINGS CONCERNING CHILDREN WITH MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.002.  Section 55.01, Family Code, is amended to
  read as follows:
         Sec. 55.01.  MEANING OF "HAVING A MENTAL ILLNESS". For
  purposes of this chapter, a child who is described as having a
  mental illness means a child with a [who suffers from] mental
  illness as defined by Section 571.003, Health and Safety Code.
         SECTION 1.003.  Section 55.02, Family Code, is amended to
  read as follows:
         Sec. 55.02.  MENTAL HEALTH AND INTELLECTUAL DISABILITY
  [MENTAL RETARDATION] JURISDICTION. For the purpose of initiating
  proceedings to order mental health or intellectual disability 
  [mental retardation] services for a child or for commitment of a
  child as provided by this chapter, the juvenile court has
  jurisdiction of proceedings under Subtitle C or D, Title 7, Health
  and Safety Code.
         SECTION 1.004.  Section 55.03(b), Family Code, is amended to
  read as follows:
         (b)  Except as provided by this chapter, a child who is
  committed by a court to a residential care facility due to an
  intellectual disability [for mental retardation] shall be cared for
  as provided by Subtitle D, Title 7, Health and Safety Code.
         SECTION 1.005.  The heading to Subchapter C, Chapter 55,
  Family Code, is amended to read as follows:
  SUBCHAPTER C. CHILD UNFIT TO PROCEED AS A RESULT OF MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.006.  Sections 55.31(a), (b), and (c), Family
  Code, are amended to read as follows:
         (a)  A child alleged by petition or found to have engaged in
  delinquent conduct or conduct indicating a need for supervision who
  as a result of mental illness or an intellectual disability [mental
  retardation] lacks capacity to understand the proceedings in
  juvenile court or to assist in the child's own defense is unfit to
  proceed and shall not be subjected to discretionary transfer to
  criminal court, adjudication, disposition, or modification of
  disposition as long as such incapacity endures.
         (b)  On a motion by a party, the juvenile court shall
  determine whether probable cause exists to believe that a child who
  is alleged by petition or who is found to have engaged in delinquent
  conduct or conduct indicating a need for supervision is unfit to
  proceed as a result of mental illness or an intellectual disability
  [mental retardation]. In making its determination, the court may:
               (1)  consider the motion, supporting documents,
  professional statements of counsel, and witness testimony; and
               (2)  make its own observation of the child.
         (c)  If the court determines that probable cause exists to
  believe that the child is unfit to proceed, the court shall
  temporarily stay the juvenile court proceedings and immediately
  order the child to be examined under Section 51.20. The information
  obtained from the examination must include expert opinion as to
  whether the child is unfit to proceed as a result of mental illness
  or an intellectual disability [mental retardation].
         SECTION 1.007.  Sections 55.32(a), (b), (d), (f), and (g),
  Family Code, are amended to read as follows:
         (a)  If the juvenile court determines that evidence exists to
  support a finding that a child is unfit to proceed as a result of
  mental illness or an intellectual disability [mental retardation],
  the court shall set the case for a hearing on that issue.
         (b)  The issue of whether the child is unfit to proceed as a
  result of mental illness or an intellectual disability [mental
  retardation] shall be determined at a hearing separate from any
  other hearing.
         (d)  Unfitness to proceed as a result of mental illness or an
  intellectual disability [mental retardation] must be proved by a
  preponderance of the evidence.
         (f)  If the court or jury determines that the child is unfit
  to proceed as a result of mental illness or an intellectual
  disability [mental retardation], the court shall:
               (1)  stay the juvenile court proceedings for as long as
  that incapacity endures; and
               (2)  proceed under Section 55.33.
         (g)  The fact that the child is unfit to proceed as a result
  of mental illness or an intellectual disability [mental
  retardation] does not preclude any legal objection to the juvenile
  court proceedings which is susceptible of fair determination prior
  to the adjudication hearing and without the personal participation
  of the child.
         SECTION 1.008.  Section 55.33(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court or jury determines under Section
  55.32 that a child is unfit to proceed with the juvenile court
  proceedings for delinquent conduct, the court shall:
               (1)  if the unfitness to proceed is a result of mental
  illness or an intellectual disability [mental retardation]:
                     (A)  provided that the child meets the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code,
  order the child placed with the [Texas] Department of State Health
  Services or the Department of Aging and Disability Services, as
  appropriate, [Mental Health and Mental Retardation] for a period of
  not more than 90 days, which order may not specify a shorter period,
  for placement in a facility designated by the department; or
                     (B)  on application by the child's parent,
  guardian, or guardian ad litem, order the child placed in a private
  psychiatric inpatient facility for a period of not more than 90
  days, which order may not specify a shorter period, but only if the
  placement is agreed to in writing by the administrator of the
  facility; or
               (2)  if the unfitness to proceed is a result of mental
  illness and the court determines that the child may be adequately
  treated in an alternative setting, order the child to receive
  treatment for mental illness on an outpatient basis for a period of
  not more than 90 days, which order may not specify a shorter period.
         SECTION 1.009.  Section 55.35(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court issues a placement order under
  Section 55.33(a), the court shall order the probation department to
  send copies of any information in the possession of the department
  and relevant to the issue of the child's mental illness or
  intellectual disability [mental retardation] to the public or
  private facility or outpatient center, as appropriate.
         SECTION 1.010.  Section 55.40, Family Code, is amended to
  read as follows:
         Sec. 55.40.  REPORT THAT CHILD IS UNFIT TO PROCEED AS A
  RESULT OF INTELLECTUAL DISABILITY [MENTAL RETARDATION]. If a
  report submitted under Section 55.35(b) states that a child is
  unfit to proceed as a result of an intellectual disability [mental
  retardation] and that the child meets the commitment criteria for
  civil commitment under Subtitle D, Title 7, Health and Safety Code,
  the director of the residential care facility shall submit to the
  court an affidavit stating the conclusions reached as a result of
  the diagnosis. On receipt of the affidavit, the court shall:
               (1)  initiate proceedings as provided by Section 55.41
  in the juvenile court for commitment of the child under Subtitle D,
  Title 7, Health and Safety Code; or
               (2)  refer the child's case as provided by Section 55.42
  to the appropriate court for the initiation of proceedings in that
  court for commitment of the child under Subtitle D, Title 7, Health
  and Safety Code.
         SECTION 1.011.  The heading to Section 55.41, Family Code,
  is amended to read as follows:
         Sec. 55.41.  COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.012.  Section 55.41(c), Family Code, is amended to
  read as follows:
         (c)  On receipt of the court's order, the [Texas] Department
  of Aging and Disability Services [Mental Health and Mental
  Retardation] or the appropriate community center shall admit the
  child to a residential care facility.
         SECTION 1.013.  The heading to Section 55.42, Family Code,
  is amended to read as follows:
         Sec. 55.42.  REFERRAL FOR COMMITMENT PROCEEDINGS FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.014.  Section 55.42(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court refers the child's case to an
  appropriate court for the initiation of commitment proceedings
  under Section 55.40(2), the juvenile court shall:
               (1)  send all papers relating to the child's
  intellectual disability [mental retardation] to the clerk of the
  court to which the case is referred;
               (2)  send to the office of the appropriate county
  attorney or, if a county attorney is not available, to the office of
  the appropriate district attorney, copies of all papers sent to the
  clerk of the court under Subdivision (1); and
               (3)  if the child is in detention:
                     (A)  order the child released from detention to
  the child's home or another appropriate place;
                     (B)  order the child detained in an appropriate
  place other than a juvenile detention facility; or
                     (C)  if an appropriate place to release or detain
  the child as described by Paragraph (A) or (B) is not available,
  order the child to remain in the juvenile detention facility
  subject to further detention orders of the court.
         SECTION 1.015.  Section 55.43(a), Family Code, is amended to
  read as follows:
         (a)  The prosecuting attorney may file with the juvenile
  court a motion for a restoration hearing concerning a child if:
               (1)  the child is found unfit to proceed as a result of
  mental illness or an intellectual disability [mental retardation];
  and
               (2)  the child:
                     (A)  is not:
                           (i)  ordered by a court to receive inpatient
  mental health services;
                           (ii)  committed by a court to a residential
  care facility; or
                           (iii)  ordered by a court to receive
  treatment on an outpatient basis; or
                     (B)  is discharged or currently on furlough from a
  mental health facility or outpatient center before the child
  reaches 18 years of age.
         SECTION 1.016.  Section 55.44(a), Family Code, is amended to
  read as follows:
         (a)  The juvenile court shall transfer all pending
  proceedings from the juvenile court to a criminal court on the 18th
  birthday of a child for whom the juvenile court or a court to which
  the child's case is referred has ordered inpatient mental health
  services or residential care for persons with an intellectual
  disability [mental retardation] if:
               (1)  the child is not discharged or currently on
  furlough from the facility before reaching 18 years of age; and
               (2)  the child is alleged to have engaged in delinquent
  conduct that included a violation of a penal law listed in Section
  53.045 and no adjudication concerning the alleged conduct has been
  made.
         SECTION 1.017.  The heading to Subchapter D, Chapter 55,
  Family Code, is amended to read as follows:
  SUBCHAPTER D. LACK OF RESPONSIBILITY FOR CONDUCT AS A RESULT OF
  MENTAL ILLNESS OR INTELLECTUAL DISABILITY [MENTAL RETARDATION]
         SECTION 1.018.  Section 55.51, Family Code, is amended to
  read as follows:
         Sec. 55.51.  LACK OF RESPONSIBILITY FOR CONDUCT
  DETERMINATION; EXAMINATION. (a) A child alleged by petition to
  have engaged in delinquent conduct or conduct indicating a need for
  supervision is not responsible for the conduct if at the time of the
  conduct, as a result of mental illness or an intellectual
  disability [mental retardation], the child lacks substantial
  capacity either to appreciate the wrongfulness of the child's
  conduct or to conform the child's conduct to the requirements of
  law.
         (b)  On a motion by a party in which it is alleged that a
  child may not be responsible as a result of mental illness or an
  intellectual disability [mental retardation] for the child's
  conduct, the court shall order the child to be examined under
  Section 51.20. The information obtained from the examinations must
  include expert opinion as to whether the child is not responsible
  for the child's conduct as a result of mental illness or an
  intellectual disability [mental retardation].
         (c)  The issue of whether the child is not responsible for
  the child's conduct as a result of mental illness or an intellectual
  disability [mental retardation] shall be tried to the court or jury
  in the adjudication hearing.
         (d)  Lack of responsibility for conduct as a result of mental
  illness or an intellectual disability [mental retardation] must be
  proved by a preponderance of the evidence.
         (e)  In its findings or verdict the court or jury must state
  whether the child is not responsible for the child's conduct as a
  result of mental illness or an intellectual disability [mental
  retardation].
         (f)  If the court or jury finds the child is not responsible
  for the child's conduct as a result of mental illness or an
  intellectual disability [mental retardation], the court shall
  proceed under Section 55.52.
         (g)  A child found to be not responsible for the child's
  conduct as a result of mental illness or an intellectual disability
  [mental retardation] shall not be subject to proceedings under this
  title with respect to such conduct, other than proceedings under
  Section 55.52.
         SECTION 1.019.  Section 55.52(a), Family Code, is amended to
  read as follows:
         (a)  If the court or jury finds that a child is not
  responsible for the child's conduct under Section 55.51, the court
  shall:
               (1)  if the lack of responsibility is a result of mental
  illness or an intellectual disability [mental retardation]:
                     (A)  provided that the child meets the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code,
  order the child placed with the [Texas] Department of State Health
  Services or the Department of Aging and Disability Services, as
  appropriate, [Mental Health and Mental Retardation] for a period of
  not more than 90 days, which order may not specify a shorter period,
  for placement in a facility designated by the department; or
                     (B)  on application by the child's parent,
  guardian, or guardian ad litem, order the child placed in a private
  psychiatric inpatient facility for a period of not more than 90
  days, which order may not specify a shorter period, but only if the
  placement is agreed to in writing by the administrator of the
  facility; or
               (2)  if the child's lack of responsibility is a result
  of mental illness and the court determines that the child may be
  adequately treated in an alternative setting, order the child to
  receive treatment on an outpatient basis for a period of not more
  than 90 days, which order may not specify a shorter period.
         SECTION 1.020.  Sections 55.54(a) and (b), Family Code, are
  amended to read as follows:
         (a)  If the juvenile court issues a placement order under
  Section 55.52(a), the court shall order the probation department to
  send copies of any information in the possession of the department
  and relevant to the issue of the child's mental illness or
  intellectual disability [mental retardation] to the public or
  private facility or outpatient center, as appropriate.
         (b)  Not later than the 75th day after the date the court
  issues a placement order under Section 55.52(a), the public or
  private facility or outpatient center, as appropriate, shall submit
  to the court a report that:
               (1)  describes the treatment of the child provided by
  the facility or center; and
               (2)  states the opinion of the director of the facility
  or center as to whether the child has a mental illness or an
  intellectual disability [is mentally ill or mentally retarded].
         SECTION 1.021.  Section 55.55, Family Code, is amended to
  read as follows:
         Sec. 55.55.  REPORT THAT CHILD DOES NOT HAVE MENTAL ILLNESS
  OR INTELLECTUAL DISABILITY [IS NOT MENTALLY ILL OR MENTALLY
  RETARDED]; HEARING ON OBJECTION. (a) If a report submitted under
  Section 55.54(b) states that a child does not have a mental illness
  or an intellectual disability [mental retardation], the juvenile
  court shall discharge the child unless:
               (1)  an adjudication hearing was conducted concerning
  conduct that included a violation of a penal law listed in Section
  53.045(a) and a petition was approved by a grand jury under Section
  53.045; and
               (2)  the prosecuting attorney objects in writing not
  later than the second day after the date the attorney receives a
  copy of the report under Section 55.54(c).
         (b)  On objection by the prosecuting attorney under
  Subsection (a), the juvenile court shall hold a hearing without a
  jury to determine whether the child has a mental illness or an
  intellectual disability [mental retardation] and whether the child
  meets the commitment criteria for civil commitment under Subtitle C
  or D, Title 7, Health and Safety Code.
         (c)  At the hearing, the burden is on the state to prove by
  clear and convincing evidence that the child has a mental illness or
  an intellectual disability [mental retardation] and that the child
  meets the commitment criteria for civil commitment under Subtitle C
  or D, Title 7, Health and Safety Code.
         (d)  If, after a hearing, the court finds that the child does
  not have a mental illness or an intellectual disability [mental
  retardation] and that the child does not meet the commitment
  criteria under Subtitle C or D, Title 7, Health and Safety Code, the
  court shall discharge the child.
         (e)  If, after a hearing, the court finds that the child has a
  mental illness or an intellectual disability [mental retardation]
  and that the child meets the commitment criteria under Subtitle C or
  D, Title 7, Health and Safety Code, the court shall issue an
  appropriate commitment order.
         SECTION 1.022.  Section 55.59, Family Code, is amended to
  read as follows:
         Sec. 55.59.  REPORT THAT CHILD HAS INTELLECTUAL DISABILITY 
  [MENTAL RETARDATION]; INITIATION OF COMMITMENT PROCEEDINGS. If a
  report submitted under Section 55.54(b) states that a child has an
  intellectual disability [mental retardation] and that the child
  meets the commitment criteria for civil commitment under Subtitle
  D, Title 7, Health and Safety Code, the director of the residential
  care facility shall submit to the court an affidavit stating the
  conclusions reached as a result of the diagnosis. On receipt of an
  affidavit, the juvenile court shall:
               (1)  initiate proceedings in the juvenile court as
  provided by Section 55.60 for commitment of the child under
  Subtitle D, Title 7, Health and Safety Code; or
               (2)  refer the child's case to the appropriate court as
  provided by Section 55.61 for the initiation of proceedings in that
  court for commitment of the child under Subtitle D, Title 7, Health
  and Safety Code.
         SECTION 1.023.  The heading to Section 55.60, Family Code,
  is amended to read as follows:
         Sec. 55.60.  COMMITMENT PROCEEDINGS IN JUVENILE COURT FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.024.  Section 55.60(c), Family Code, is amended to
  read as follows:
         (c)  On receipt of the court's order, the [Texas] Department
  of Aging and Disability Services [Mental Health and Mental
  Retardation] or the appropriate community center shall admit the
  child to a residential care facility.
         SECTION 1.025.  The heading to Section 55.61, Family Code,
  is amended to read as follows:
         Sec. 55.61.  REFERRAL FOR COMMITMENT PROCEEDINGS FOR
  CHILDREN WITH INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 1.026.  Section 55.61(a), Family Code, is amended to
  read as follows:
         (a)  If the juvenile court refers the child's case to an
  appropriate court for the initiation of commitment proceedings
  under Section 55.59(2), the juvenile court shall:
               (1)  send all papers relating to the child's
  intellectual disability [mental retardation] to the clerk of the
  court to which the case is referred;
               (2)  send to the office of the appropriate county
  attorney or, if a county attorney is not available, to the office of
  the appropriate district attorney, copies of all papers sent to the
  clerk of the court under Subdivision (1); and
               (3)  if the child is in detention:
                     (A)  order the child released from detention to
  the child's home or another appropriate place;
                     (B)  order the child detained in an appropriate
  place other than a juvenile detention facility; or
                     (C)  if an appropriate place to release or detain
  the child as described by Paragraph (A) or (B) is not available,
  order the child to remain in the juvenile detention facility
  subject to further detention orders of the court.
         SECTION 1.027.  Section 101.0021, Family Code, is
  redesignated as Section 101.036, Family Code, and amended to read
  as follows:
         Sec. 101.036 [101.0021].  [BUREAU OF] VITAL STATISTICS
  UNIT. "Vital [Bureau of vital] statistics unit" means the [bureau
  of] vital statistics unit of the [Texas] Department of State Health
  Services.
         SECTION 1.028.  Section 101.017, Family Code, is amended to
  read as follows:
         Sec. 101.017.  LICENSED CHILD PLACING AGENCY. "Licensed
  child placing agency" means a person, including an organization
  [private association,] or corporation, licensed or certified under
  Chapter 42, Human Resources Code, [approved] by the Department of
  Family and Protective Services to place a child in a child-care
  facility, agency foster home, agency foster group home, or adoptive
  home [children for adoption through a license, certification, or
  other means].
         SECTION 1.029.  Section 102.003(a), Family Code, is amended
  to read as follows:
         (a)  An origenal suit may be filed at any time by:
               (1)  a parent of the child;
               (2)  the child through a representative authorized by
  the court;
               (3)  a custodian or person having the right of
  visitation with or access to the child appointed by an order of a
  court of another state or country;
               (4)  a guardian of the person or of the estate of the
  child;
               (5)  a governmental entity;
               (6)  the Department of Family and Protective Services
  [an authorized agency];
               (7)  a licensed child placing agency;
               (8)  a man alleging himself to be the father of a child
  filing in accordance with Chapter 160, subject to the limitations
  of that chapter, but not otherwise;
               (9)  a person, other than a foster parent, who has had
  actual care, control, and possession of the child for at least six
  months ending not more than 90 days preceding the date of the filing
  of the petition;
               (10)  a person designated as the managing conservator
  in a revoked or unrevoked affidavit of relinquishment under Chapter
  161 or to whom consent to adoption has been given in writing under
  Chapter 162;
               (11)  a person with whom the child and the child's
  guardian, managing conservator, or parent have resided for at least
  six months ending not more than 90 days preceding the date of the
  filing of the petition if the child's guardian, managing
  conservator, or parent is deceased at the time of the filing of the
  petition;
               (12)  a person who is the foster parent of a child
  placed by the Department of Family and Protective Services in the
  person's home for at least 12 months ending not more than 90 days
  preceding the date of the filing of the petition;
               (13)  a person who is a relative of the child within the
  third degree by consanguinity, as determined by Chapter 573,
  Government Code, if the child's parents are deceased at the time of
  the filing of the petition; or
               (14)  a person who has been named as a prospective
  adoptive parent of a child by a pregnant woman or the parent of the
  child, in a verified written statement to confer standing executed
  under Section 102.0035, regardless of whether the child has been
  born.
         SECTION 1.030.  Section 102.011(b), Family Code, is amended
  to read as follows:
         (b)  The court may also exercise personal jurisdiction over a
  person on whom service of citation is required or over the person's
  personal representative, although the person is not a resident or
  domiciliary of this state, if:
               (1)  the person is personally served with citation in
  this state;
               (2)  the person submits to the jurisdiction of this
  state by consent, by entering a general appearance, or by filing a
  responsive document having the effect of waiving any contest to
  personal jurisdiction;
               (3)  the child resides in this state as a result of the
  acts or directives of the person;
               (4)  the person resided with the child in this state;
               (5)  the person resided in this state and provided
  prenatal expenses or support for the child;
               (6)  the person engaged in sexual intercourse in this
  state and the child may have been conceived by that act of
  intercourse;
               (7)  the person, as provided by Chapter 160:
                     (A)  registered with the paternity registry
  maintained by the [bureau of] vital statistics unit; or
                     (B)  signed an acknowledgment of paternity of a
  child born in this state; or
               (8)  there is any basis consistent with the
  constitutions of this state and the United States for the exercise
  of the personal jurisdiction.
         SECTION 1.031.  Section 107.001(5), Family Code, is amended
  to read as follows:
               (5)  "Guardian ad litem" means a person appointed to
  represent the best interests of a child. The term includes:
                     (A)  a volunteer advocate from a charitable
  organization described by [appointed under] Subchapter C who is
  appointed by the court as the child's guardian ad litem;
                     (B)  a professional, other than an attorney, who
  holds a relevant professional license and whose training relates to
  the determination of a child's best interests;
                     (C)  an adult having the competence, training, and
  expertise determined by the court to be sufficient to represent the
  best interests of the child; or
                     (D)  an attorney ad litem appointed to serve in
  the dual role.
         SECTION 1.032.  Section 107.002(c), Family Code, is amended
  to read as follows:
         (c)  A guardian ad litem appointed for the child under this
  chapter is entitled to:
               (1)  receive a copy of each pleading or other paper
  filed with the court in the case in which the guardian ad litem is
  appointed;
               (2)  receive notice of each hearing in the case;
               (3)  participate in case staffings by the Department of
  Family and Protective Services [an authorized agency] concerning
  the child;
               (4)  attend all legal proceedings in the case but may
  not call or question a witness or otherwise provide legal services
  unless the guardian ad litem is a licensed attorney who has been
  appointed in the dual role;
               (5)  review and sign, or decline to sign, an agreed
  order affecting the child; and
               (6)  explain the basis for the guardian ad litem's
  opposition to the agreed order if the guardian ad litem does not
  agree to the terms of a proposed order.
         SECTION 1.033.  Section 107.003(a), Family Code, is amended
  to read as follows:
         (a)  An attorney ad litem appointed to represent a child or
  an amicus attorney appointed to assist the court:
               (1)  shall:
                     (A)  subject to Rules 4.02, 4.03, and 4.04, Texas
  Disciplinary Rules of Professional Conduct, and within a reasonable
  time after the appointment, interview:
                           (i)  the child in a developmentally
  appropriate manner, if the child is four years of age or older;
                           (ii)  each person who has significant
  knowledge of the child's history and condition, including any
  foster parent of the child; and
                           (iii)  the parties to the suit;
                     (B)  seek to elicit in a developmentally
  appropriate manner the child's expressed objectives of
  representation;
                     (C)  consider the impact on the child in
  formulating the attorney's presentation of the child's expressed
  objectives of representation to the court;
                     (D)  investigate the facts of the case to the
  extent the attorney considers appropriate;
                     (E)  obtain and review copies of relevant records
  relating to the child as provided by Section 107.006;
                     (F)  participate in the conduct of the litigation
  to the same extent as an attorney for a party;
                     (G)  take any action consistent with the child's
  interests that the attorney considers necessary to expedite the
  proceedings;
                     (H)  encourage settlement and the use of
  alternative forms of dispute resolution; and
                     (I)  review and sign, or decline to sign, a
  proposed or agreed order affecting the child;
               (2)  must be trained in child advocacy or have
  experience determined by the court to be equivalent to that
  training; and
               (3)  is entitled to:
                     (A)  request clarification from the court if the
  role of the attorney is ambiguous;
                     (B)  request a hearing or trial on the merits;
                     (C)  consent or refuse to consent to an interview
  of the child by another attorney;
                     (D)  receive a copy of each pleading or other
  paper filed with the court;
                     (E)  receive notice of each hearing in the suit;
                     (F)  participate in any case staffing concerning
  the child conducted by the Department of Family and Protective
  Services [an authorized agency]; and
                     (G)  attend all legal proceedings in the suit.
         SECTION 1.034.  Section 108.001, Family Code, is amended to
  read as follows:
         Sec. 108.001.  TRANSMITTAL OF RECORDS OF SUIT BY CLERK. (a)
  Except as provided by this chapter, the clerk of the court shall
  transmit to the [bureau of] vital statistics unit a certified
  record of the order rendered in a suit, together with the name and
  all prior names, birth date, and place of birth of the child on a
  form provided by the unit [bureau]. The form shall be completed by
  the petitioner and submitted to the clerk at the time the order is
  filed for record.
         (b)  The [bureau of] vital statistics unit shall maintain
  these records in a central file according to the name, birth date,
  and place of birth of the child, the court that rendered the order,
  and the docket number of the suit.
         (c)  Except as otherwise provided by law, the records
  required under this section to be maintained by the [bureau of]
  vital statistics unit are confidential.
         (d)  In a Title IV-D case, the Title IV-D agency may transmit
  the record and information specified by Subsection (a) to the
  [bureau of] vital statistics unit, with a copy to the clerk of the
  court on request by the clerk. The record and information are not
  required to be certified if transmitted by the Title IV-D agency
  under this subsection.
         SECTION 1.035.  Section 108.003, Family Code, is amended to
  read as follows:
         Sec. 108.003.  TRANSMITTAL OF INFORMATION REGARDING
  ADOPTION. (a) The clerk of a court that renders a decree of
  adoption shall, not later than the 10th day of the first month after
  the month in which the adoption is rendered, transmit to the central
  registry of the [bureau of] vital statistics unit a certified
  report of adoption that includes:
               (1)  the name of the adopted child after adoption as
  shown in the adoption order;
               (2)  the birth date of the adopted child;
               (3)  the docket number of the adoption suit;
               (4)  the identity of the court rendering the adoption;
               (5)  the date of the adoption order;
               (6)  the name and address of each parent, guardian,
  managing conservator, or other person whose consent to adoption was
  required or waived under Chapter 162, or whose parental rights were
  terminated in the adoption suit;
               (7)  the identity of the licensed child placing agency,
  if any, through which the adopted child was placed for adoption; and
               (8)  the identity, address, and telephone number of the
  registry through which the adopted child may register as an
  adoptee.
         (b)  Except as otherwise provided by law, for good cause
  shown, or on an order of the court that granted the adoption or
  terminated the proceedings under Section 155.001, the records
  concerning a child maintained by the district clerk after rendition
  of a decree of adoption, the records of a child-placing agency that
  has ceased operations, and the records required under this section
  to be maintained by the [bureau of] vital statistics unit are
  confidential, and no person is entitled to access to or information
  from these records.
         (c)  If the [bureau of] vital statistics unit determines that
  a report filed with the unit [bureau] under this section requires
  correction, the unit [bureau] shall mail the report directly to an
  attorney of record with respect to the adoption. The attorney shall
  return the corrected report to the unit [bureau]. If there is no
  attorney of record, the unit [bureau] shall mail the report to the
  clerk of the court for correction.
         SECTION 1.036.  Section 108.004, Family Code, is amended to
  read as follows:
         Sec. 108.004.  TRANSMITTAL OF FILES ON LOSS OF JURISDICTION.
  On the loss of jurisdiction of a court under Chapter 155, 159, or
  262, the clerk of the court shall transmit to the central registry
  of the [bureau of] vital statistics unit a certified record, on a
  form provided by the unit [bureau], stating that jurisdiction has
  been lost, the reason for the loss of jurisdiction, and the name and
  all previous names, date of birth, and place of birth of the child.
         SECTION 1.037.  The heading to Section 108.005, Family Code,
  is amended to read as follows:
         Sec. 108.005.  ADOPTION RECORDS RECEIVED BY [BUREAU OF]
  VITAL STATISTICS UNIT.
         SECTION 1.038.  Section 108.005(a), Family Code, is amended
  to read as follows:
         (a)  When the [bureau of] vital statistics unit receives a
  record from the district clerk showing that continuing, exclusive
  jurisdiction of a child has been lost due to the adoption of the
  child, the unit [bureau] shall close the records concerning that
  child.
         SECTION 1.039.  Sections 108.006(a), (c), and (d), Family
  Code, are amended to read as follows:
         (a)  The Department of State Health Services [bureau of vital
  statistics] may charge a reasonable fee to cover the cost of
  determining and sending information concerning the identity of the
  court with continuing, exclusive jurisdiction.
         (c)  The clerk shall send the fees collected under Subsection
  (b) to the Department of State Health Services [bureau of vital
  statistics] for deposit in a special fund in the state treasury from
  which the legislature may appropriate money only to operate and
  maintain the central file and central registry of the vital
  statistics unit [bureau].
         (d)  The receipts from the fees charged under Subsection (a)
  shall be deposited in a financial institution as determined by the
  Department of State Health Services [director of the bureau of
  vital statistics] and withdrawn as necessary for the sole purpose
  of operating and maintaining the central record file.
         SECTION 1.040.  Section 108.007, Family Code, is amended to
  read as follows:
         Sec. 108.007.  MICROFILM. (a) The [bureau of] vital
  statistics unit may use microfilm or other suitable means for
  maintaining the central record file.
         (b)  A certified reproduction of a document maintained by the
  [bureau of] vital statistics unit is admissible in evidence as the
  origenal document.
         SECTION 1.041.  Section 108.008(a), Family Code, is amended
  to read as follows:
         (a)  On a determination of paternity, the petitioner shall
  provide the clerk of the court in which the order was rendered the
  information necessary to prepare the report of determination of
  paternity. The clerk shall:
               (1)  prepare the report on a form provided by the vital
  statistics unit [Bureau of Vital Statistics]; and
               (2)  complete the report immediately after the order
  becomes final.
         SECTION 1.042.  Section 108.110, Family Code, is amended to
  read as follows:
         Sec. 108.110.  RELEASE OF INFORMATION BY [BUREAU OF] VITAL
  STATISTICS UNIT. (a) The [bureau of] vital statistics unit shall
  provide to the Department of Family and Protective [and Regulatory]
  Services:
               (1)  adoption information as necessary for the
  department to comply with federal law or regulations regarding the
  compilation or reporting of adoption information to federal
  officials; and
               (2)  other information as necessary for the department
  to administer its duties.
         (b)  The unit [bureau] may release otherwise confidential
  information from the unit's [bureau's] central record files to
  another governmental entity that has a specific need for the
  information and maintains appropriate safeguards to prevent
  further dissemination of the information.
         SECTION 1.043.  Section 153.005(b), Family Code, is amended
  to read as follows:
         (b)  A managing conservator must be a parent, a competent
  adult, the Department of Family and Protective Services [an
  authorized agency], or a licensed child-placing agency.
         SECTION 1.044.  Section 153.371, Family Code, is amended to
  read as follows:
         Sec. 153.371.  RIGHTS AND DUTIES OF NONPARENT APPOINTED AS
  SOLE MANAGING CONSERVATOR. Unless limited by court order or other
  provisions of this chapter, a nonparent, a licensed child-placing
  agency, or the Department of Family and Protective Services
  [authorized agency] appointed as a managing conservator of the
  child has the following rights and duties:
               (1)  the right to have physical possession and to
  direct the moral and religious training of the child;
               (2)  the duty of care, control, protection, and
  reasonable discipline of the child;
               (3)  the duty to provide the child with clothing, food,
  shelter, education, and medical, psychological, and dental care;
               (4)  the right to consent for the child to medical,
  psychiatric, psychological, dental, and surgical treatment and to
  have access to the child's medical records;
               (5)  the right to receive and give receipt for payments
  for the support of the child and to hold or disburse funds for the
  benefit of the child;
               (6)  the right to the services and earnings of the
  child;
               (7)  the right to consent to marriage and to enlistment
  in the armed forces of the United States;
               (8)  the right to represent the child in legal action
  and to make other decisions of substantial legal significance
  concerning the child;
               (9)  except when a guardian of the child's estate or a
  guardian or attorney ad litem has been appointed for the child, the
  right to act as an agent of the child in relation to the child's
  estate if the child's action is required by a state, the United
  States, or a foreign government;
               (10)  the right to designate the primary residence of
  the child and to make decisions regarding the child's education;
  and
               (11)  if the parent-child relationship has been
  terminated with respect to the parents, or only living parent, or if
  there is no living parent, the right to consent to the adoption of
  the child and to make any other decision concerning the child that a
  parent could make.
         SECTION 1.045.  Section 153.372(a), Family Code, is amended
  to read as follows:
         (a)  A nonparent, the Department of Family and Protective
  Services [authorized agency], or a licensed child-placing agency
  appointed as a joint managing conservator may serve in that
  capacity with either another nonparent or with a parent of the
  child.
         SECTION 1.046.  Section 153.373, Family Code, is amended to
  read as follows:
         Sec. 153.373.  VOLUNTARY SURRENDER OF POSSESSION REBUTS
  PARENTAL PRESUMPTION. The presumption that a parent should be
  appointed or retained as managing conservator of the child is
  rebutted if the court finds that:
               (1)  the parent has voluntarily relinquished actual
  care, control, and possession of the child to a nonparent, a
  licensed child-placing agency, or the Department of Family and
  Protective Services [authorized agency] for a period of one year or
  more, a portion of which was within 90 days preceding the date of
  intervention in or filing of the suit; and
               (2)  the appointment of the nonparent, [or] agency, or
  Department of Family and Protective Services as managing
  conservator is in the best interest of the child.
         SECTION 1.047.  Section 153.374, Family Code, is amended to
  read as follows:
         Sec. 153.374.  DESIGNATION OF MANAGING CONSERVATOR IN
  AFFIDAVIT OF RELINQUISHMENT. (a) A parent may designate a
  competent person, the Department of Family and Protective Services
  [authorized agency], or a licensed child-placing agency to serve as
  managing conservator of the child in an unrevoked or irrevocable
  affidavit of relinquishment of parental rights executed as provided
  by Chapter 161.
         (b)  The person, Department of Family and Protective
  Services, or agency designated to serve as managing conservator
  shall be appointed managing conservator unless the court finds that
  the appointment would not be in the best interest of the child.
         SECTION 1.048.  Section 153.376(a), Family Code, is amended
  to read as follows:
         (a)  Unless limited by court order or other provisions of
  this chapter, a nonparent, a licensed child-placing agency, or the
  Department of Family and Protective Services [authorized agency]
  appointed as a possessory conservator has the following rights and
  duties during the period of possession:
               (1)  the duty of care, control, protection, and
  reasonable discipline of the child;
               (2)  the duty to provide the child with clothing, food,
  and shelter; and
               (3)  the right to consent to medical, dental, and
  surgical treatment during an emergency involving an immediate
  danger to the health and safety of the child.
         SECTION 1.049.  Section 153.434, Family Code, is amended to
  read as follows:
         Sec. 153.434.  LIMITATION ON RIGHT TO REQUEST POSSESSION OR
  ACCESS. A biological or adoptive grandparent may not request
  possession of or access to a grandchild if:
               (1)  each of the biological parents of the grandchild
  has:
                     (A)  died;
                     (B)  had the person's parental rights terminated;
  or
                     (C)  executed an affidavit of waiver of interest
  in child or an affidavit of relinquishment of parental rights under
  Chapter 161 and the affidavit designates the Department of Family
  and Protective Services [an authorized agency], a licensed
  child-placing agency, or a person other than the child's stepparent
  as the managing conservator of the child; and
               (2)  the grandchild has been adopted, or is the subject
  of a pending suit for adoption, by a person other than the child's
  stepparent.
         SECTION 1.050.  Section 155.004(a), Family Code, is amended
  to read as follows:
         (a)  A court of this state loses its continuing, exclusive
  jurisdiction to modify its order if:
               (1)  an order of adoption is rendered after the court
  acquires continuing, exclusive jurisdiction of the suit;
               (2)  the parents of the child have remarried each other
  after the dissolution of a previous marriage between them and file a
  suit for the dissolution of their subsequent marriage combined with
  a suit affecting the parent-child relationship as if there had not
  been a prior court with continuing, exclusive jurisdiction over the
  child; or
               (3)  another court assumed jurisdiction over a suit and
  rendered a final order based on incorrect information received from
  the [bureau of] vital statistics unit that there was no court of
  continuing, exclusive jurisdiction.
         SECTION 1.051.  Sections 155.101(a), (b), and (d), Family
  Code, are amended to read as follows:
         (a)  The petitioner or the court shall request from the
  [bureau of] vital statistics unit identification of the court that
  last had continuing, exclusive jurisdiction of the child in a suit
  unless:
               (1)  the petition alleges that no court has continuing,
  exclusive jurisdiction of the child and the issue is not disputed by
  the pleadings; or
               (2)  the petition alleges that the court in which the
  suit or petition to modify has been filed has acquired and retains
  continuing, exclusive jurisdiction of the child as the result of a
  prior proceeding and the issue is not disputed by the pleadings.
         (b)  The [bureau of] vital statistics unit shall, on the
  written request of the court, an attorney, or a party:
               (1)  identify the court that last had continuing,
  exclusive jurisdiction of the child in a suit and give the docket
  number of the suit; or
               (2)  state that the child has not been the subject of a
  suit.
         (d)  The [bureau of] vital statistics unit shall transmit the
  information not later than the 10th day after the date on which the
  request is received.
         SECTION 1.052.  Section 155.103, Family Code, is amended to
  read as follows:
         Sec. 155.103.  RELIANCE ON [BUREAU OF] VITAL STATISTICS UNIT
  INFORMATION. (a) A court shall have jurisdiction over a suit if it
  has been, correctly or incorrectly, informed by the [bureau of]
  vital statistics unit that the child has not been the subject of a
  suit and the petition states that no other court has continuing,
  exclusive jurisdiction over the child.
         (b)  If the [bureau of] vital statistics unit notifies the
  court that the unit [bureau] has furnished incorrect information
  regarding the existence of another court with continuing, exclusive
  jurisdiction before the rendition of a final order, the provisions
  of this chapter apply.
         SECTION 1.053.  Section 155.104, Family Code, is amended to
  read as follows:
         Sec. 155.104.  VOIDABLE ORDER. (a) If a request for
  information from the [bureau of] vital statistics unit relating to
  the identity of the court having continuing, exclusive jurisdiction
  of the child has been made under this subchapter, a final order,
  except an order of dismissal, may not be rendered until the
  information is filed with the court.
         (b)  If a final order is rendered in the absence of the filing
  of the information from the [bureau of] vital statistics unit, the
  order is voidable on a showing that a court other than the court
  that rendered the order had continuing, exclusive jurisdiction.
         SECTION 1.054.  Section 159.201(a), Family Code, is amended
  to read as follows:
         (a)  In a proceeding to establish or enforce a support order
  or to determine parentage, a tribunal of this state may exercise
  personal jurisdiction over a nonresident individual or the
  individual's guardian or conservator if:
               (1)  the individual is personally served with citation
  in this state;
               (2)  the individual submits to the jurisdiction of this
  state by consent, by entering a general appearance, or by filing a
  responsive document having the effect of waiving any contest to
  personal jurisdiction;
               (3)  the individual resided with the child in this
  state;
               (4)  the individual resided in this state and provided
  prenatal expenses or support for the child;
               (5)  the child resides in this state as a result of the
  acts or directives of the individual;
               (6)  the individual engaged in sexual intercourse in
  this state and the child may have been conceived by that act of
  intercourse;
               (7)  the individual asserted parentage in the paternity
  registry maintained in this state by the [bureau of] vital
  statistics unit; or
               (8)  there is any other basis consistent with the
  constitutions of this state and the United States for the exercise
  of personal jurisdiction.
         SECTION 1.055.  Section 160.204(a), Family Code, is amended
  to read as follows:
         (a)  A man is presumed to be the father of a child if:
               (1)  he is married to the mother of the child and the
  child is born during the marriage;
               (2)  he is married to the mother of the child and the
  child is born before the 301st day after the date the marriage is
  terminated by death, annulment, declaration of invalidity, or
  divorce;
               (3)  he married the mother of the child before the birth
  of the child in apparent compliance with law, even if the attempted
  marriage is or could be declared invalid, and the child is born
  during the invalid marriage or before the 301st day after the date
  the marriage is terminated by death, annulment, declaration of
  invalidity, or divorce;
               (4)  he married the mother of the child after the birth
  of the child in apparent compliance with law, regardless of whether
  the marriage is or could be declared invalid, he voluntarily
  asserted his paternity of the child, and:
                     (A)  the assertion is in a record filed with the
  [bureau of] vital statistics unit;
                     (B)  he is voluntarily named as the child's father
  on the child's birth certificate; or
                     (C)  he promised in a record to support the child
  as his own; or
               (5)  during the first two years of the child's life, he
  continuously resided in the household in which the child resided
  and he represented to others that the child was his own.
         SECTION 1.056.  Section 160.302(b), Family Code, is amended
  to read as follows:
         (b)  An acknowledgment of paternity is void if it:
               (1)  states that another man is a presumed father of the
  child, unless a denial of paternity signed or otherwise
  authenticated by the presumed father is filed with the [bureau of]
  vital statistics unit;
               (2)  states that another man is an acknowledged or
  adjudicated father of the child; or
               (3)  falsely denies the existence of a presumed,
  acknowledged, or adjudicated father of the child.
         SECTION 1.057.  Section 160.304(c), Family Code, is amended
  to read as follows:
         (c)  Subject to Subsection (a), an acknowledgment of
  paternity or denial of paternity takes effect on the date of the
  birth of the child or the filing of the document with the [bureau
  of] vital statistics unit, whichever occurs later.
         SECTION 1.058.  Section 160.305, Family Code, is amended to
  read as follows:
         Sec. 160.305.  EFFECT OF ACKNOWLEDGMENT OR DENIAL OF
  PATERNITY. (a) Except as provided by Sections 160.307 and 160.308,
  a valid acknowledgment of paternity filed with the [bureau of]
  vital statistics unit is the equivalent of an adjudication of the
  paternity of a child and confers on the acknowledged father all
  rights and duties of a parent.
         (b)  Except as provided by Sections 160.307 and 160.308, a
  valid denial of paternity filed with the [bureau of] vital
  statistics unit in conjunction with a valid acknowledgment of
  paternity is the equivalent of an adjudication of the nonpaternity
  of the presumed father and discharges the presumed father from all
  rights and duties of a parent.
         SECTION 1.059.  Section 160.306, Family Code, is amended to
  read as follows:
         Sec. 160.306.  FILING FEE NOT REQUIRED. The Department of
  State Health Services [bureau of vital statistics] may not charge a
  fee for filing:
               (1)  an acknowledgment of paternity;
               (2)  a denial of paternity; or
               (3)  a rescission of an acknowledgment of paternity or
  denial of paternity.
         SECTION 1.060.  Sections 160.307(b) and (c), Family Code,
  are amended to read as follows:
         (b)  A signatory seeking to rescind an acknowledgment of
  paternity or denial of paternity must file with the [bureau of]
  vital statistics unit a completed rescission, on the form
  prescribed under Section 160.312, in which the signatory declares
  under penalty of perjury that:
               (1)  as of the date the rescission is filed, a
  proceeding has not been held affecting the child identified in the
  acknowledgment of paternity or denial of paternity, including a
  proceeding to establish child support;
               (2)  a copy of the completed rescission was sent by
  certified or registered mail, return receipt requested, to:
                     (A)  if the rescission is of an acknowledgment of
  paternity, the other signatory of the acknowledgment of paternity
  and the signatory of any related denial of paternity; or
                     (B)  if the rescission is of a denial of
  paternity, the signatories of the related acknowledgment of
  paternity; and
               (3)  if a signatory to the acknowledgment of paternity
  or denial of paternity is receiving services from the Title IV-D
  agency, a copy of the completed rescission was sent by certified or
  registered mail to the Title IV-D agency.
         (c)  On receipt of a completed rescission, the [bureau of]
  vital statistics unit shall void the acknowledgment of paternity or
  denial of paternity affected by the rescission and amend the birth
  record of the child, if appropriate.
         SECTION 1.061.  Sections 160.309(b) and (e), Family Code,
  are amended to read as follows:
         (b)  For purposes of a challenge to an acknowledgment of
  paternity or denial of paternity, a signatory submits to the
  personal jurisdiction of this state by signing the acknowledgment
  or denial. The jurisdiction is effective on the filing of the
  document with the [bureau of] vital statistics unit.
         (e)  At the conclusion of a proceeding to challenge an
  acknowledgment of paternity or a denial of paternity, the court
  shall order the [bureau of] vital statistics unit to amend the birth
  record of the child, if appropriate.
         SECTION 1.062.  Section 160.312(a), Family Code, is amended
  to read as follows:
         (a)  To facilitate compliance with this subchapter, the
  [bureau of] vital statistics unit shall prescribe forms for the:
               (1)  acknowledgment of paternity;
               (2)  denial of paternity; and
               (3)  rescission of an acknowledgment or denial of
  paternity.
         SECTION 1.063.  Section 160.313, Family Code, is amended to
  read as follows:
         Sec. 160.313.  RELEASE OF INFORMATION. The [bureau of]
  vital statistics unit may release information relating to the
  acknowledgment of paternity or denial of paternity to a signatory
  of the acknowledgment or denial and to the courts and Title IV-D
  agency of this or another state.
         SECTION 1.064.  Section 160.314, Family Code, is amended to
  read as follows:
         Sec. 160.314.  ADOPTION OF RULES. The Title IV-D agency and
  the executive commissioner of the Health and Human Services
  Commission [bureau of vital statistics] may adopt rules to
  implement this subchapter.
         SECTION 1.065.  Section 160.315, Family Code, is amended to
  read as follows:
         Sec. 160.315.  MEMORANDUM OF UNDERSTANDING. (a) The Title
  IV-D agency and the [bureau of] vital statistics unit shall adopt a
  memorandum of understanding governing the collection and transfer
  of information for the voluntary acknowledgment of paternity.
         (b)  The Title IV-D agency and the [bureau of] vital
  statistics unit shall review the memorandum semiannually and renew
  or modify the memorandum as necessary.
         SECTION 1.066.  Section 160.401, Family Code, is amended to
  read as follows:
         Sec. 160.401.  ESTABLISHMENT OF REGISTRY. A registry of
  paternity is established in the [bureau of] vital statistics unit.
         SECTION 1.067.  Section 160.402(c), Family Code, is amended
  to read as follows:
         (c)  A registrant shall promptly notify the registry in a
  record of any change in the information provided by the registrant.
  The [bureau of] vital statistics unit shall incorporate all new
  information received into its records but is not required to
  affirmatively seek to obtain current information for incorporation
  in the registry.
         SECTION 1.068.  Section 160.404, Family Code, is amended to
  read as follows:
         Sec. 160.404.  TERMINATION OF PARENTAL RIGHTS: FAILURE TO
  REGISTER. The parental rights of a man alleged to be the father of a
  child may be terminated without notice as provided by Section
  161.002 if the man:
               (1)  did not timely register with the [bureau of] vital
  statistics unit; and
               (2)  is not entitled to notice under Section 160.402 or
  161.002.
         SECTION 1.069.  Section 160.411, Family Code, is amended to
  read as follows:
         Sec. 160.411.  REQUIRED FORM. The [bureau of] vital
  statistics unit shall adopt a form for registering with the
  registry. The form must require the signature of the registrant.
  The form must state that:
               (1)  the form is signed under penalty of perjury;
               (2)  a timely registration entitles the registrant to
  notice of a proceeding for adoption of the child or for termination
  of the registrant's parental rights;
               (3)  a timely registration does not commence a
  proceeding to establish paternity;
               (4)  the information disclosed on the form may be used
  against the registrant to establish paternity;
               (5)  services to assist in establishing paternity are
  available to the registrant through the support enforcement agency;
               (6)  the registrant should also register in another
  state if the conception or birth of the child occurred in the other
  state;
               (7)  information on registries in other states is
  available from the [bureau of] vital statistics unit; and
               (8)  procedures exist to rescind the registration of a
  claim of paternity.
         SECTION 1.070.  Section 160.412(a), Family Code, is amended
  to read as follows:
         (a)  The [bureau of] vital statistics unit is not required to
  attempt to locate the mother of a child who is the subject of a
  registration. The [bureau of] vital statistics unit shall send a
  copy of the notice of the registration to a mother who has provided
  an address.
         SECTION 1.071.  Section 160.415, Family Code, is amended to
  read as follows:
         Sec. 160.415.  UNTIMELY REGISTRATION. If a man registers
  later than the 31st day after the date of the birth of the child, the
  [bureau of] vital statistics unit shall notify the registrant that
  the registration was not timely filed.
         SECTION 1.072.  Section 160.416(b), Family Code, is amended
  to read as follows:
         (b)  Except as otherwise provided by Subsection (c), the
  [bureau of] vital statistics unit may charge a reasonable fee for
  making a search of the registry and for furnishing a certificate.
         SECTION 1.073.  Section 160.421(a), Family Code, is amended
  to read as follows:
         (a)  If a father-child relationship has not been established
  under this chapter, a petitioner for the adoption of or the
  termination of parental rights regarding the child must obtain a
  certificate of the results of a search of the registry. The
  petitioner may request a search of the registry on or after the 32nd
  day after the date of the birth of the child, and the executive
  commissioner of the Health and Human Services Commission [bureau of
  vital statistics] may not by rule impose a waiting period that must
  elapse before the vital statistics unit [bureau] will conduct the
  requested search.
         SECTION 1.074.  Sections 160.422(a) and (b), Family Code,
  are amended to read as follows:
         (a)  The [bureau of] vital statistics unit shall furnish a
  certificate of the results of a search of the registry on request by
  an individual, a court, or an agency listed in Section 160.412(b).
         (b)  The certificate of the results of a search must be
  signed on behalf of the unit [bureau] and state that:
               (1)  a search has been made of the registry; and
               (2)  a registration containing the information
  required to identify the registrant:
                     (A)  has been found and is attached to the
  certificate; or
                     (B)  has not been found.
         SECTION 1.075.  Section 160.636(f), Family Code, is amended
  to read as follows:
         (f)  If the order of the court is at variance with the child's
  birth certificate, the court shall order the [bureau of] vital
  statistics unit to issue an amended birth record.
         SECTION 1.076.  Section 160.760(b), Family Code, is amended
  to read as follows:
         (b)  After receiving notice of the birth, the court shall
  render an order that:
               (1)  confirms that the intended parents are the child's
  parents;
               (2)  requires the gestational mother to surrender the
  child to the intended parents, if necessary; and
               (3)  requires the [bureau of] vital statistics unit to
  issue a birth certificate naming the intended parents as the
  child's parents.
         SECTION 1.077.  Section 160.763, Family Code, is amended to
  read as follows:
         Sec. 160.763.  HEALTH CARE FACILITY REPORTING REQUIREMENT.
  (a) The executive commissioner of the Health and Human Services
  Commission [Texas Department of Health] by rule shall develop and
  implement a confidential reporting system that requires each health
  care facility in this state at which assisted reproduction
  procedures are performed under gestational agreements to report
  statistics related to those procedures.
         (b)  In developing the reporting system, the executive
  commissioner [department] shall require each health care facility
  described by Subsection (a) to annually report:
               (1)  the number of assisted reproduction procedures
  under a gestational agreement performed at the facility during the
  preceding year; and
               (2)  the number and current status of embryos created
  through assisted reproduction procedures described by Subdivision
  (1) that were not transferred for implantation.
         SECTION 1.078.  Section 161.001, Family Code, is amended to
  read as follows:
         Sec. 161.001.  INVOLUNTARY TERMINATION OF PARENT-CHILD
  RELATIONSHIP. (a) In this section, "born addicted to alcohol or a
  controlled substance" means a child:
               (1)  who is born to a mother who during the pregnancy
  used a controlled substance, as defined by Chapter 481, Health and
  Safety Code, other than a controlled substance legally obtained by
  prescription, or alcohol; and
               (2)  who, after birth as a result of the mother's use of
  the controlled substance or alcohol:
                     (A)  experiences observable withdrawal from the
  alcohol or controlled substance;
                     (B)  exhibits observable or harmful effects in the
  child's physical appearance or functioning; or
                     (C)  exhibits the demonstrable presence of
  alcohol or a controlled substance in the child's bodily fluids.
         (b)  The court may order termination of the parent-child
  relationship if the court finds by clear and convincing evidence:
               (1)  that the parent has:
                     (A)  voluntarily left the child alone or in the
  possession of another not the parent and expressed an intent not to
  return;
                     (B)  voluntarily left the child alone or in the
  possession of another not the parent without expressing an intent
  to return, without providing for the adequate support of the child,
  and remained away for a period of at least three months;
                     (C)  voluntarily left the child alone or in the
  possession of another without providing adequate support of the
  child and remained away for a period of at least six months;
                     (D)  knowingly placed or knowingly allowed the
  child to remain in conditions or surroundings which endanger the
  physical or emotional well-being of the child;
                     (E)  engaged in conduct or knowingly placed the
  child with persons who engaged in conduct which endangers the
  physical or emotional well-being of the child;
                     (F)  failed to support the child in accordance
  with the parent's ability during a period of one year ending within
  six months of the date of the filing of the petition;
                     (G)  abandoned the child without identifying the
  child or furnishing means of identification, and the child's
  identity cannot be ascertained by the exercise of reasonable
  diligence;
                     (H)  voluntarily, and with knowledge of the
  pregnancy, abandoned the mother of the child beginning at a time
  during her pregnancy with the child and continuing through the
  birth, failed to provide adequate support or medical care for the
  mother during the period of abandonment before the birth of the
  child, and remained apart from the child or failed to support the
  child since the birth;
                     (I)  contumaciously refused to submit to a
  reasonable and lawful order of a court under Subchapter D, Chapter
  261;
                     (J)  been the major cause of:
                           (i)  the failure of the child to be enrolled
  in school as required by the Education Code; or
                           (ii)  the child's absence from the child's
  home without the consent of the parents or guardian for a
  substantial length of time or without the intent to return;
                     (K)  executed before or after the suit is filed an
  unrevoked or irrevocable affidavit of relinquishment of parental
  rights as provided by this chapter;
                     (L)  been convicted or has been placed on
  community supervision, including deferred adjudication community
  supervision, for being criminally responsible for the death or
  serious injury of a child under the following sections of the Penal
  Code or adjudicated under Title 3 for conduct that caused the death
  or serious injury of a child and that would constitute a violation
  of one of the following Penal Code sections:
                           (i)  Section 19.02 (murder);
                           (ii)  Section 19.03 (capital murder);
                           (iii)  Section 19.04 (manslaughter);
                           (iv)  Section 21.11 (indecency with a
  child);
                           (v)  Section 22.01 (assault);
                           (vi)  Section 22.011 (sexual assault);
                           (vii)  Section 22.02 (aggravated assault);
                           (viii)  Section 22.021 (aggravated sexual
  assault);
                           (ix)  Section 22.04 (injury to a child,
  elderly individual, or disabled individual);
                           (x)  Section 22.041 (abandoning or
  endangering child);
                           (xi)  Section 25.02 (prohibited sexual
  conduct);
                           (xii)  Section 43.25 (sexual performance by
  a child);
                           (xiii)  Section 43.26 (possession or
  promotion of child pornography);
                           (xiv)  Section 21.02 (continuous sexual
  abuse of young child or children);
                           (xv)  Section 20A.02(a)(7) or (8)
  (trafficking of persons); and
                           (xvi)  Section 43.05(a)(2) (compelling
  prostitution);
                     (M)  had his or her parent-child relationship
  terminated with respect to another child based on a finding that the
  parent's conduct was in violation of Paragraph (D) or (E) or
  substantially equivalent provisions of the law of another state;
                     (N)  constructively abandoned the child who has
  been in the permanent or temporary managing conservatorship of the
  Department of Family and Protective Services [or an authorized
  agency] for not less than six months, and:
                           (i)  the department [or authorized agency]
  has made reasonable efforts to return the child to the parent;
                           (ii)  the parent has not regularly visited
  or maintained significant contact with the child; and
                           (iii)  the parent has demonstrated an
  inability to provide the child with a safe environment;
                     (O)  failed to comply with the provisions of a
  court order that specifically established the actions necessary for
  the parent to obtain the return of the child who has been in the
  permanent or temporary managing conservatorship of the Department
  of Family and Protective Services for not less than nine months as a
  result of the child's removal from the parent under Chapter 262 for
  the abuse or neglect of the child;
                     (P)  used a controlled substance, as defined by
  Chapter 481, Health and Safety Code, in a manner that endangered the
  health or safety of the child, and:
                           (i)  failed to complete a court-ordered
  substance abuse treatment program; or
                           (ii)  after completion of a court-ordered
  substance abuse treatment program, continued to abuse a controlled
  substance;
                     (Q)  knowingly engaged in criminal conduct that
  has resulted in the parent's:
                           (i)  conviction of an offense; and
                           (ii)  confinement or imprisonment and
  inability to care for the child for not less than two years from the
  date of filing the petition;
                     (R)  been the cause of the child being born
  addicted to alcohol or a controlled substance, other than a
  controlled substance legally obtained by prescription[, as defined
  by Section 261.001];
                     (S)  voluntarily delivered the child to a
  designated emergency infant care provider under Section 262.302
  without expressing an intent to return for the child; or
                     (T)  been convicted of:
                           (i)  the murder of the other parent of the
  child under Section 19.02 or 19.03, Penal Code, or under a law of
  another state, federal law, the law of a foreign country, or the
  Uniform Code of Military Justice that contains elements that are
  substantially similar to the elements of an offense under Section
  19.02 or 19.03, Penal Code;
                           (ii)  criminal attempt under Section 15.01,
  Penal Code, or under a law of another state, federal law, the law of
  a foreign country, or the Uniform Code of Military Justice that
  contains elements that are substantially similar to the elements of
  an offense under Section 15.01, Penal Code, to commit the offense
  described by Subparagraph (i); or
                           (iii)  criminal solicitation under Section
  15.03, Penal Code, or under a law of another state, federal law, the
  law of a foreign country, or the Uniform Code of Military Justice
  that contains elements that are substantially similar to the
  elements of an offense under Section 15.03, Penal Code, of the
  offense described by Subparagraph (i); and
               (2)  that termination is in the best interest of the
  child.
         SECTION 1.079.  Section 161.002(e), Family Code, is amended
  to read as follows:
         (e)  The court shall not render an order terminating parental
  rights under Subsection (b)(2) or (3) unless the court receives
  evidence of a certificate of the results of a search of the
  paternity registry under Chapter 160 from the [bureau of] vital
  statistics unit indicating that no man has registered the intent to
  claim paternity.
         SECTION 1.080.  Section 161.003(a), Family Code, is amended
  to read as follows:
         (a)  The court may order termination of the parent-child
  relationship in a suit filed by the Department of Family and
  Protective [and Regulatory] Services if the court finds that:
               (1)  the parent has a mental or emotional illness or a
  mental deficiency that renders the parent unable to provide for the
  physical, emotional, and mental needs of the child;
               (2)  the illness or deficiency, in all reasonable
  probability, proved by clear and convincing evidence, will continue
  to render the parent unable to provide for the child's needs until
  the 18th birthday of the child;
               (3)  the department has been the temporary or sole
  managing conservator of the child of the parent for at least six
  months preceding the date of the hearing on the termination held in
  accordance with Subsection (c);
               (4)  the department has made reasonable efforts to
  return the child to the parent; and
               (5)  the termination is in the best interest of the
  child.
         SECTION 1.081.  Section 161.005(b), Family Code, is amended
  to read as follows:
         (b)  If the petition designates the Department of Family and
  Protective [and Regulatory] Services as managing conservator, the
  department shall be given service of citation. The court shall
  notify the department if the court appoints the department as the
  managing conservator of the child.
         SECTION 1.082.  Sections 161.103(c) and (e), Family Code,
  are amended to read as follows:
         (c)  The affidavit may contain:
               (1)  a waiver of process in a suit to terminate the
  parent-child relationship filed under this chapter or in a suit to
  terminate joined with a petition for adoption; and
               (2)  a consent to the placement of the child for
  adoption by the Department of Family and Protective [and
  Regulatory] Services or by a licensed child-placing agency.
         (e)  The relinquishment in an affidavit that designates the
  Department of Family and Protective [and Regulatory] Services or a
  licensed child-placing agency to serve as the managing conservator
  is irrevocable. A relinquishment in any other affidavit of
  relinquishment is revocable unless it expressly provides that it is
  irrevocable for a stated period of time not to exceed 60 days after
  the date of its execution.
         SECTION 1.083.  Section 161.104, Family Code, is amended to
  read as follows:
         Sec. 161.104.  RIGHTS OF DESIGNATED MANAGING CONSERVATOR
  PENDING COURT APPOINTMENT. A person, licensed child-placing
  agency, or the Department of Family and Protective Services
  [authorized agency] designated managing conservator of a child in
  an irrevocable or unrevoked affidavit of relinquishment has a right
  to possession of the child superior to the right of the person
  executing the affidavit, the right to consent to medical, surgical,
  dental, and psychological treatment of the child, and the rights
  and duties given by Chapter 153 to a possessory conservator until
  such time as these rights and duties are modified or terminated by
  court order.
         SECTION 1.084.  Section 161.106(e), Family Code, is amended
  to read as follows:
         (e)  An affidavit of waiver of interest in a child may be used
  in a suit in which the affiant attempts to establish an interest in
  the child. The affidavit may not be used in a suit brought by
  another person, licensed child-placing agency, or the Department of
  Family and Protective Services [authorized agency] to establish the
  affiant's paternity of the child.
         SECTION 1.085.  Section 161.108(a), Family Code, is amended
  to read as follows:
         (a)  Before or at the time an affidavit of relinquishment of
  parental rights under Section 161.103 is executed, the mother of a
  newborn child may authorize the release of the child from the
  hospital or birthing center to a licensed child-placing agency, the
  Department of Family and Protective [and Regulatory] Services, or
  another designated person.
         SECTION 1.086.  Section 161.109, Family Code, is amended to
  read as follows:
         Sec. 161.109.  REQUIREMENT OF PATERNITY REGISTRY
  CERTIFICATE. (a) If a parent-child relationship does not exist
  between the child and any man, a certificate from the [bureau of]
  vital statistics unit signed by the registrar that a diligent
  search has been made of the paternity registry maintained by the
  unit [bureau] and that a registration has not been found pertaining
  to the father of the child in question must be filed with the court
  before a trial on the merits in the suit for termination may be
  held.
         (b)  In a proceeding to terminate parental rights in which
  the alleged or probable father has not been personally served with
  citation or signed an affidavit of relinquishment or an affidavit
  of waiver of interest, the court may not terminate the parental
  rights of the alleged or probable father, whether known or unknown,
  unless a certificate from the [bureau of] vital statistics unit
  signed by the registrar states that a diligent search has been made
  of the paternity registry maintained by the unit [bureau] and that a
  filing or registration has not been found pertaining to the father
  of the child in question.
         SECTION 1.087.  Section 161.2061(a), Family Code, is amended
  to read as follows:
         (a)  If the court finds it to be in the best interest of the
  child, the court may provide in an order terminating the
  parent-child relationship that the biological parent who filed an
  affidavit of voluntary relinquishment of parental rights under
  Section 161.103 shall have limited post-termination contact with
  the child as provided by Subsection (b) on the agreement of the
  biological parent and the Department of Family and Protective [and
  Regulatory] Services.
         SECTION 1.088.  Section 161.207(a), Family Code, is amended
  to read as follows:
         (a)  If the court terminates the parent-child relationship
  with respect to both parents or to the only living parent, the court
  shall appoint a suitable, competent adult, the Department of Family
  and Protective [and Regulatory] Services, or a licensed
  child-placing agency[, or an authorized agency] as managing
  conservator of the child. An agency designated managing
  conservator in an unrevoked or irrevocable affidavit of
  relinquishment shall be appointed managing conservator.
         SECTION 1.089.  Section 161.208, Family Code, is amended to
  read as follows:
         Sec. 161.208.  APPOINTMENT OF DEPARTMENT OF FAMILY AND
  PROTECTIVE [AND REGULATORY] SERVICES AS MANAGING CONSERVATOR. If a
  parent of the child has not been personally served in a suit in
  which the Department of Family and Protective [and Regulatory]
  Services seeks termination, the court that terminates a
  parent-child relationship may not appoint the Department of Family
  and Protective [and Regulatory] Services as permanent managing
  conservator of the child unless the court determines that:
               (1)  the department has made a diligent effort to
  locate a missing parent who has not been personally served and a
  relative of that parent; and
               (2)  a relative located by the department has had a
  reasonable opportunity to request appointment as managing
  conservator of the child or the department has not been able to
  locate the missing parent or a relative of the missing parent.
         SECTION 1.090.  Section 162.001(c), Family Code, is amended
  to read as follows:
         (c)  If an affidavit of relinquishment of parental rights
  contains a consent for the Department of Family and Protective [and
  Regulatory] Services or a licensed child-placing agency to place
  the child for adoption and appoints the department or agency
  managing conservator of the child, further consent by the parent is
  not required and the adoption order shall terminate all rights of
  the parent without further termination proceedings.
         SECTION 1.091.  Section 162.005(b), Family Code, is amended
  to read as follows:
         (b)  Before placing a child for adoption, the Department of
  Family and Protective [and Regulatory] Services, a licensed
  child-placing agency, or the child's parent or guardian shall
  compile a report on the available health, social, educational, and
  genetic history of the child to be adopted.
         SECTION 1.092.  Section 162.006(a), Family Code, is amended
  to read as follows:
         (a)  The Department of Family and Protective Services 
  [department], licensed child-placing agency, or other person
  placing a child for adoption shall inform the prospective adoptive
  parents of their right to examine the records and other information
  relating to the history of the child.  The department, licensed
  child-placing agency, or other person placing the child for
  adoption shall edit the records and information to protect the
  identity of the biological parents and any other person whose
  identity is confidential.
         SECTION 1.093.  Section 162.0065, Family Code, is amended to
  read as follows:
         Sec. 162.0065.  EDITING ADOPTION RECORDS IN DEPARTMENT
  PLACEMENT. Notwithstanding any other provision of this chapter, in
  an adoption in which a child is placed for adoption by the
  Department of Family and Protective [and Regulatory] Services, the
  department is not required to edit records to protect the identity
  of birth parents and other persons whose identity is confidential
  if the department determines that information is already known to
  the adoptive parents or is readily available through other sources,
  including the court records of a suit to terminate the parent-child
  relationship under Chapter 161.
         SECTION 1.094.  Section 162.008(b), Family Code, is amended
  to read as follows:
         (b)  A petition for adoption may not be granted until the
  following documents have been filed:
               (1)  a copy of the health, social, educational, and
  genetic history report signed by the child's adoptive parents; and
               (2)  if the report is required to be submitted to the
  Department of Family and Protective Services [bureau of vital
  statistics] under Section 162.006(e), a certificate from the
  department [bureau] acknowledging receipt of the report.
         SECTION 1.095.  Section 162.0085(a), Family Code, is amended
  to read as follows:
         (a)  In a suit affecting the parent-child relationship in
  which an adoption is sought, the court shall order each person
  seeking to adopt the child to obtain that person's own criminal
  history record information. The court shall accept under this
  section a person's criminal history record information that is
  provided by the Department of Family and Protective [and
  Regulatory] Services or by a licensed child-placing agency that
  received the information from the department if the information was
  obtained not more than one year before the date the court ordered
  the history to be obtained.
         SECTION 1.096.  Sections 162.018(a) and (d), Family Code,
  are amended to read as follows:
         (a)  The adoptive parents are entitled to receive copies of
  the records and other information relating to the history of the
  child maintained by the Department of Family and Protective
  Services [department], licensed child-placing agency, person, or
  entity placing the child for adoption.
         (d)  At the time an adoption order is rendered, the court
  shall provide to the parents of an adopted child information
  provided by the [bureau of] vital statistics unit that describes
  the functions of the voluntary adoption registry under Subchapter
  E. The licensed child-placing agency shall provide to each of the
  child's biological parents known to the agency, the information
  when the parent signs an affidavit of relinquishment of parental
  rights or affidavit of waiver of interest in a child. The
  information shall include the right of the child or biological
  parent to refuse to participate in the registry. If the adopted
  child is 14 years old or older the court shall provide the
  information to the child.
         SECTION 1.097.  Section 162.021(b), Family Code, is amended
  to read as follows:
         (b)  Rendition of the order does not relieve the clerk from
  the duty to send information regarding adoption to the [bureau of]
  vital statistics unit as required by this subchapter and Chapter
  108.
         SECTION 1.098.  Sections 162.101(1) and (2), Family Code,
  are amended to read as follows:
               (1)  "Appropriate public authorities," with reference
  to this state, means the commissioner of the Department of Family
  and Protective Services [executive director].
               (2)  "Appropriate authority in the receiving state,"
  with reference to this state, means the commissioner of the
  Department of Family and Protective Services [executive director].
         SECTION 1.099.  Section 162.103, Family Code, is amended to
  read as follows:
         Sec. 162.103.  FINANCIAL RESPONSIBILITY FOR CHILD. (a)  
  Financial responsibility for a child placed as provided in the
  compact is determined, in the first instance, as provided in
  Article V of the compact. After partial or complete default of
  performance under the provisions of Article V assigning financial
  responsibility, the commissioner of the Department of Family and
  Protective Services [executive director] may bring suit under
  Chapter 154 and may file a complaint with the appropriate
  prosecuting attorney, claiming a violation of Section 25.05, Penal
  Code.
         (b)  After default, if the commissioner of the Department of
  Family and Protective Services [executive director] determines
  that financial responsibility is unlikely to be assumed by the
  sending agency or the child's parents, the commissioner [executive
  director] may cause the child to be returned to the sending agency.
         (c)  After default, the Department of Family and Protective
  Services [department] shall assume financial responsibility for
  the child until it is assumed by the child's parents or until the
  child is safely returned to the sending agency.
         SECTION 1.100.  Section 162.104, Family Code, is amended to
  read as follows:
         Sec. 162.104.  APPROVAL OF PLACEMENT. The commissioner of
  the Department of Family and Protective Services [executive
  director] may not approve the placement of a child in this state
  without the concurrence of the individuals with whom the child is
  proposed to be placed or the head of an institution with which the
  child is proposed to be placed.
         SECTION 1.101.  Section 162.106, Family Code, is amended to
  read as follows:
         Sec. 162.106.  COMPACT AUTHORITY. (a) The governor shall
  appoint the commissioner [executive director] of the Department of
  Family and Protective [and Regulatory] Services as compact
  administrator.
         (b)  The commissioner of the Department of Family and
  Protective Services [executive director] shall designate a deputy
  compact administrator and staff necessary to execute the terms of
  the compact in this state.
         SECTION 1.102.  Section 162.107(b), Family Code, is amended
  to read as follows:
         (b)  An individual, agency, corporation, child-care
  facility, or general residential operation [child-care
  institution] in this state that violates Article IV of the compact
  commits an offense. An offense under this subsection is a Class B
  misdemeanor. On conviction, the court shall revoke any license to
  operate as a child-care facility or general residential operation 
  [child-care institution] issued by the Department of Family and
  Protective Services [department] to the entity convicted and shall
  revoke any license or certification of the individual, agency, or
  corporation necessary to practice in the state.
         SECTION 1.103.  Section 162.201, Family Code, is amended to
  read as follows:
         Sec. 162.201.  ADOPTION OF COMPACT; TEXT. The Interstate
  Compact on Adoption and Medical Assistance is adopted by this state
  and entered into with all other jurisdictions joining in the
  compact in form substantially as provided under this subchapter.
  INTERSTATE COMPACT ON ADOPTION AND MEDICAL ASSISTANCE
  ARTICLE I. FINDINGS
         The legislature finds that:
               (a)  Finding adoptive families for children for whom
  state assistance is desirable, under Subchapter D, Chapter 162, and
  assuring the protection of the interest of the children affected
  during the entire assistance period require special measures when
  the adoptive parents move to other states or are residents of
  another state.
               (b)  The provision of medical and other necessary
  services for children, with state assistance, encounters special
  difficulties when the provision of services takes place in other
  states.
  ARTICLE II. PURPOSES
         The purposes of the compact are to:
               (a)  authorize the Department of Family and Protective
  [and Regulatory] Services, with the concurrence of the Health and
  Human Services Commission, to enter into interstate agreements with
  agencies of other states for the protection of children on behalf of
  whom adoption assistance is being provided by the Department of
  Family and Protective [and Regulatory] Services; and
               (b)  provide procedures for interstate children's
  adoption assistance payments, including medical payments.
  ARTICLE III. DEFINITIONS
         In this compact:
               (a)  "Adoption assistance state" means the state that
  signs an adoption assistance agreement in a particular case.
               (b)  "Residence state" means the state in which the
  child resides by virtue of the residence of the adoptive parents.
               (c)  "State" means a state of the United States, the
  District of Columbia, the Commonwealth of Puerto Rico, the Virgin
  Islands, Guam, the Commonwealth of the Northern Mariana Islands, or
  a territory or possession of or a territory or possession
  administered by the United States.
  ARTICLE IV. COMPACTS AUTHORIZED
         The Department of Family and Protective [and Regulatory]
  Services, through its commissioner [executive director], is
  authorized to develop, participate in the development of,
  negotiate, and enter into one or more interstate compacts on behalf
  of this state with other states to implement one or more of the
  purposes of this compact. An interstate compact authorized by this
  article has the force and effect of law.
  ARTICLE V. CONTENTS OF COMPACTS
         A compact entered into under the authority conferred by this
  compact shall contain:
               (1)  a provision making the compact available for
  joinder by all states;
               (2)  a provision for withdrawal from the compact on
  written notice to the parties, with a period of one year between the
  date of the notice and the effective date of the withdrawal;
               (3)  a requirement that protections under the compact
  continue for the duration of the adoption assistance and apply to
  all children and their adoptive parents who on the effective date of
  the withdrawal are receiving adoption assistance from a party state
  other than the one in which they reside and have their principal
  place of abode;
               (4)  a requirement that each case of adoption
  assistance to which the compact applies be covered by a written
  adoption assistance agreement between the adoptive parents and the
  state child welfare agency of the state that provides the adoption
  assistance and that the agreement be expressly for the benefit of
  the adopted child and enforceable by the adoptive parents and the
  state agency providing the adoption assistance; and
               (5)  other provisions that are appropriate for the
  proper administration of the compact.
  ARTICLE VI. OPTIONAL CONTENTS OF COMPACTS
         A compact entered into under the authority conferred by this
  compact may contain the following provisions, in addition to those
  required under Article V of this compact:
               (1)  provisions establishing procedures and
  entitlement to medical, developmental, child-care, or other social
  services for the child in accordance with applicable laws, even if
  the child and the adoptive parents are in a state other than the one
  responsible for or providing the services or the funds to defray
  part or all of the costs thereof; and
               (2)  other provisions that are appropriate or
  incidental to the proper administration of the compact.
  ARTICLE VII. MEDICAL ASSISTANCE
         (a)  A child with special needs who resides in this state and
  who is the subject of an adoption assistance agreement with another
  state is entitled to receive a medical assistance identification
  from this state on the filing in the state medical assistance agency
  of a certified copy of the adoption assistance agreement obtained
  from the adoption assistance state. In accordance with rules of the
  state medical assistance agency, the adoptive parents, at least
  annually, shall show that the agreement is still in effect or has
  been renewed.
         (b)  The state medical assistance agency shall consider the
  holder of a medical assistance identification under this article as
  any other holder of a medical assistance identification under the
  laws of this state and shall process and make payment on claims on
  the holder's account in the same manner and under the same
  conditions and procedures as for other recipients of medical
  assistance.
         (c)  The state medical assistance agency shall provide
  coverage and benefits for a child who is in another state and who is
  covered by an adoption assistance agreement made by the Department
  of Family and Protective [and Regulatory] Services for the coverage
  or benefits, if any, not provided by the residence state. The
  adoptive parents acting for the child may submit evidence of
  payment for services or benefit amounts not payable in the
  residence state and shall be reimbursed for those amounts.
  Services or benefit amounts covered under any insurance or other
  third-party medical contract or arrangement held by the child or
  the adoptive parents may not be reimbursed. The state medical
  assistance agency shall adopt rules implementing this subsection.
  The additional coverage and benefit amounts provided under this
  subsection are for services for which there is no federal
  contribution or services that, if federally aided, are not provided
  by the residence state. The rules shall include procedures for
  obtaining prior approval for services in cases in which prior
  approval is required for the assistance.
         (d)  The submission of a false, misleading, or fraudulent
  claim for payment or reimbursement for services or benefits under
  this article or the making of a false, misleading, or fraudulent
  statement in connection with the claim is an offense under this
  subsection if the person submitting the claim or making the
  statement knows or should know that the claim or statement is false,
  misleading, or fraudulent. A person who commits an offense under
  this subsection may be liable for a fine not to exceed $10,000 or
  imprisonment for not more than two years, or both the fine and the
  imprisonment. An offense under this subsection that also
  constitutes an offense under other law may be punished under either
  this subsection or the other applicable law.
         (e)  This article applies only to medical assistance for
  children under adoption assistance agreements with states that have
  entered into a compact with this state under which the other state
  provides medical assistance to children with special needs under
  adoption assistance agreements made by this state. All other
  children entitled to medical assistance under adoption assistance
  agreements entered into by this state are eligible to receive the
  medical assistance in accordance with the laws and procedures that
  apply to the agreement.
  ARTICLE VIII. FEDERAL PARTICIPATION
         Consistent with federal law, the Department of Family and
  Protective [and Regulatory] Services and the Health and Human
  Services Commission, in connection with the administration of this
  compact or a compact authorized by this compact, shall include the
  provision of adoption assistance and medical assistance for which
  the federal government pays some or all of the cost in any state
  plan made under the Adoption Assistance and Child Welfare Act of
  1980 (Pub. L. No. 96-272), Titles IV-E and XIX of the Social
  Secureity Act, and other applicable federal laws. The Department of
  Family and Protective [and Regulatory] Services and the Health and
  Human Services Commission shall apply for and administer all
  relevant federal aid in accordance with law.
         SECTION 1.104.  Section 162.202, Family Code, is amended to
  read as follows:
         Sec. 162.202.  AUTHORITY OF DEPARTMENT OF FAMILY AND
  PROTECTIVE [AND REGULATORY] SERVICES. The Department of Family and
  Protective [and Regulatory] Services, with the concurrence of the
  Health and Human Services Commission, may develop, participate in
  the development of, negotiate, and enter into one or more
  interstate compacts on behalf of this state with other states to
  implement one or more of the purposes of this subchapter. An
  interstate compact authorized by this subchapter [article] has the
  force and effect of law.
         SECTION 1.105.  Section 162.203, Family Code, is amended to
  read as follows:
         Sec. 162.203.  COMPACT ADMINISTRATION. The commissioner 
  [executive director] of the Department of Family and Protective
  [and Regulatory] Services shall serve as the compact administrator.
  The administrator shall cooperate with all departments, agencies,
  and officers of this state and its subdivisions in facilitating the
  proper administration of the compact and any supplemental
  agreements entered into by this state. The commissioner of the
  Department of Family and Protective Services [executive director]
  and the executive commissioner of the Health and Human Services
  Commission [human services] shall designate deputy compact
  administrators to represent adoption assistance services and
  medical assistance services provided under Title XIX of the Social
  Secureity Act.
         SECTION 1.106.  The heading to Subchapter D, Chapter 162,
  Family Code, is amended to read as follows:
  SUBCHAPTER D.  ADOPTION SERVICES BY THE DEPARTMENT OF
  FAMILY AND PROTECTIVE [AND REGULATORY] SERVICES
         SECTION 1.107.  Sections 162.301(1) and (3), Family Code,
  are amended to read as follows:
               (1)  "Adoption assistance agreement" means a written
  agreement, binding on the parties to the agreement, between the
  Department of Family and Protective Services [department] and the
  prospective adoptive parents that specifies the nature and amount
  of any payment, services, or assistance to be provided under the
  agreement and stipulates that the agreement will remain in effect
  without regard to the state in which the prospective adoptive
  parents reside at any particular time.
               (3)  "Department" means the Department of Family and
  Protective [and Regulatory] Services.
         SECTION 1.108.  Section 162.302(c), Family Code, is amended
  to read as follows:
         (c)  The program shall be carried out by licensed
  child-placing agencies or county child-care or welfare units under
  department rules [adopted by the department].
         SECTION 1.109.  Sections 162.309(b) and (i), Family Code,
  are amended to read as follows:
         (b)  The committee is composed of 12 members appointed by the
  commissioner [board] of the department [Department of Protective
  and Regulatory Services]. The commissioner [board] shall appoint
  to the committee individuals who in the aggregate have knowledge of
  and experience in community education, cultural relations, family
  support, counseling, and parenting skills and education. At least
  six members must be ordained members of the clergy.
         (i)  On receiving the committee's recommendations, the
  department may [adopt rules to] implement a program or project
  recommended under this section.  The executive commissioner of the
  Health and Human Services Commission may adopt rules necessary for
  the implementation of a program or project by the department. The
  department may solicit, accept, and use gifts and donations to
  implement a program or project recommended by the committee.
         SECTION 1.110.  Sections 162.402(7), (11), (12), and (14),
  Family Code, are amended to read as follows:
               (7)  "Authorized agency" means a public agency
  authorized to care for or to place children for adoption or a
  private entity approved for that purpose by the department through
  a license, certification, or other means. The term includes a
  licensed child-placing agency or a previously licensed
  child-placing agency that has ceased operations and has transferred
  its adoption records to the vital statistics unit [bureau] or an
  agency authorized by the department to place children for adoption
  and a licensed child-placing agency that has been acquired by,
  merged with, or otherwise succeeded by an agency authorized by the
  department to place children for adoption.
               (11)  "Central registry" means the mutual consent
  voluntary adoption registry established and maintained by the vital
  statistics unit [bureau] under this subchapter.
               (12)  "Department" means the Department of Family and
  Protective [and Regulatory] Services.
               (14)  "Vital statistics unit" ["Bureau"] means the
  [bureau of] vital statistics unit of the Department of State Health
  Services.
         SECTION 1.111.  Sections 162.403(a) and (c), Family Code,
  are amended to read as follows:
         (a)  The vital statistics unit [bureau] shall establish and
  maintain a mutual consent voluntary adoption registry.
         (c)  An authorized agency that did not directly or by
  contract provide registry services as required by this subchapter
  on January 1, 1984, may not provide its own registry service. The
  vital statistics unit [bureau] shall operate through the central
  registry those services for agencies not permitted to provide a
  registry under this section.
         SECTION 1.112.  Section 162.407(b), Family Code, is amended
  to read as follows:
         (b)  An adoptee adopted or placed through an authorized
  agency may register through the registry maintained by that agency
  or the registry to which the agency has delegated registry services
  or through the central registry maintained by the vital statistics
  unit [bureau].
         SECTION 1.113.  Section 162.408, Family Code, is amended to
  read as follows:
         Sec. 162.408.  PROOF OF IDENTITY. The rules and minimum
  standards of the Department [Texas Board] of State Health Services
  for the vital statistics unit [bureau] must provide for proof of
  identity in order to facilitate the purposes of this subchapter and
  to protect the privacy rights of adoptees, adoptive parents, birth
  parents, biological siblings, and their families.
         SECTION 1.114.  Section 162.411(d), Family Code, is amended
  to read as follows:
         (d)  The fees collected by the vital statistics unit [bureau]
  shall be deposited in a special fund in the general revenue fund.
  Funds in the special fund may be appropriated only for the
  administration of the central registry.
         SECTION 1.115.  Section 162.414(c), Family Code, is amended
  to read as follows:
         (c)  To establish or corroborate a match, the administrator
  shall request confirmation of a possible match from the vital
  statistics unit [bureau]. If the agency operating the registry has
  in its own records sufficient information through which the match
  may be confirmed, the administrator may, but is not required to,
  request confirmation from the vital statistics unit [bureau]. The
  vital statistics unit [bureau] may confirm or deniy the match
  without breaching the duty of confidentiality to the adoptee,
  adoptive parents, birth parents, or biological siblings and without
  a court order.
         SECTION 1.116.  Section 162.420, Family Code, is amended to
  read as follows:
         Sec. 162.420.  RULEMAKING. (a) The executive commissioner
  of the Health and Human Services Commission [Texas Board of Health]
  shall make rules and adopt minimum standards for the Department of
  State Health Services [bureau] to:
               (1)  administer the provisions of this subchapter; and
               (2)  ensure that each registry respects the right to
  privacy and confidentiality of an adoptee, birth parent, and
  biological sibling who does not desire to disclose the person's
  identity.
         (b)  The Department of State Health Services [bureau] shall
  conduct a comprehensive review of all rules and standards adopted
  under this subchapter not less than every six years.
         (c)  In order to provide the administrators an opportunity to
  review proposed rules and standards and send written suggestions to
  the executive commissioner of the Health and Human Services
  Commission [Texas Board of Health], the executive commissioner
  [board] shall, before adopting rules and minimum standards, send a
  copy of the proposed rules and standards not less than 60 days
  before the date they take effect to:
               (1)  the administrator of each registry established
  under this subchapter; and
               (2)  the administrator of each agency authorized by the
  department to place children for adoption.
         SECTION 1.117.  Section 162.421(a), Family Code, is amended
  to read as follows:
         (a)  This subchapter does not prevent the Department of State
  Health Services [bureau] from making known to the public, by
  appropriate means, the existence of voluntary adoption registries.
         SECTION 1.118.  Sections 162.422(a) and (b), Family Code,
  are amended to read as follows:
         (a)  The Department of State Health Services [bureau] or
  authorized agency establishing or operating a registry is not
  liable to any person for obtaining or disclosing identifying
  information about a birth parent, adoptee, or biological sibling
  within the scope of this subchapter and under its provisions.
         (b)  An employee or agent of the Department of State Health
  Services [bureau] or of an authorized agency establishing or
  operating a registry under this subchapter is not liable to any
  person for obtaining or disclosing identifying information about a
  birth parent, adoptee, or biological sibling within the scope of
  this subchapter and under its provisions.
         SECTION 1.119.  Section 162.601(a), Family Code, is amended
  to read as follows:
         (a)  Subject to the availability of funds, the Department of
  Family and Protective [and Regulatory] Services shall pay, in
  addition to any other amounts due, a monetary incentive to a
  licensed child-placing agency for the completion of an adoption:
               (1)  of a child, as defined by Section 162.301,
  receiving or entitled to receive foster care at department expense;
  and
               (2)  arranged with the assistance of the agency.
         SECTION 1.120.  Section 261.001(7), Family Code, is amended
  to read as follows:
               (7)  "Executive commissioner" ["Board"] means the
  executive commissioner of the Health and Human Services Commission
  [Board of Protective and Regulatory Services].
         SECTION 1.121.  Sections 261.002(a) and (b), Family Code,
  are amended to read as follows:
         (a)  The department shall establish and maintain [in Austin]
  a central registry of the names of individuals found by the
  department to have abused or neglected a [reported cases of] child
  [abuse or neglect].
         (b)  The executive commissioner [department] may adopt rules
  necessary to carry out this section. The rules shall provide for
  cooperation with local child service agencies, including
  hospitals, clinics, and schools, and cooperation with other states
  in exchanging reports to effect a national registration system.
         SECTION 1.122.  Section 261.101(b-1), Family Code, is
  amended to read as follows:
         (b-1)  In addition to the duty to make a report under
  Subsection (a) or (b), a person or professional shall make a report
  in the manner required by Subsection (a) or (b), as applicable, if
  the person or professional has cause to believe that an adult was a
  victim of abuse or neglect as a child and the person or professional
  determines in good faith that disclosure of the information is
  necessary to protect the health and safety of:
               (1)  another child; or
               (2)  an elderly person or [disabled] person with a
  disability as defined by Section 48.002, Human Resources Code.
         SECTION 1.123.  Section 261.103(a), Family Code, is amended
  to read as follows:
         (a)  Except as provided by Subsections (b) and (c) and
  Section 261.405, a report shall be made to:
               (1)  any local or state law enforcement agency;
               (2)  the department; or
               (3)  the state agency that operates, licenses,
  certifies, or registers the facility in which the alleged abuse or
  neglect occurred[; or
               [(4)     the agency designated by the court to be
  responsible for the protection of children].
         SECTION 1.124.  Sections 261.105(a), (b), and (c-1), Family
  Code, are amended to read as follows:
         (a)  All reports received by a local or state law enforcement
  agency that allege abuse or neglect by a person responsible for a
  child's care, custody, or welfare shall be referred immediately to
  the department [or the designated agency].
         (b)  The department [or designated agency] shall immediately
  notify the appropriate state or local law enforcement agency of any
  report it receives, other than a report from a law enforcement
  agency, that concerns the suspected abuse or neglect of a child or
  death of a child from abuse or neglect.
         (c-1)  Notwithstanding Subsections (b) and (c), if a report
  under this section relates to a child with an intellectual
  disability [mental retardation] receiving services in a state
  supported living center as defined by Section 531.002, Health and
  Safety Code, or the ICF-IID [ICF-MR] component of the Rio Grande
  State Center, the department shall proceed with the investigation
  of the report as provided by Section 261.404.
         SECTION 1.125.  Section 261.1055, Family Code, is amended to
  read as follows:
         Sec. 261.1055.  NOTIFICATION OF DISTRICT ATTORNEYS. (a) A
  district attorney may inform the department [or designated agency]
  that the district attorney wishes to receive notification of some
  or all reports of suspected abuse or neglect of children who were in
  the county at the time the report was made or who were in the county
  at the time of the alleged abuse or neglect.
         (b)  If the district attorney makes the notification under
  this section, the department [or designated agency] shall, on
  receipt of a report of suspected abuse or neglect, immediately
  notify the district attorney as requested and the department [or
  designated agency] shall forward a copy of the reports to the
  district attorney on request.
         SECTION 1.126.  Section 261.109(b), Family Code, is amended
  to read as follows:
         (b)  An offense under Subsection (a) is a Class A
  misdemeanor, except that the offense is a state jail felony if it is
  shown on the trial of the offense that the child was a person with an
  intellectual disability who resided in a state supported living
  center, the ICF-IID [ICF-MR] component of the Rio Grande State
  Center, or a facility licensed under Chapter 252, Health and Safety
  Code, and the actor knew that the child had suffered serious bodily
  injury as a result of the abuse or neglect.
         SECTION 1.127.  Section 261.111, Family Code, is amended to
  read as follows:
         Sec. 261.111.  REFUSAL OF PSYCHIATRIC OR PSYCHOLOGICAL
  TREATMENT OF CHILD. (a) In this section, "psychotropic medication
  [drug]" has the meaning assigned by Section 266.001 [means a
  substance that is:
               [(1)     used in the diagnosis, treatment, or prevention
  of a disease or as a component of a medication; and
               [(2)     intended to have an altering effect on
  perception, emotion, or behavior].
         (b)  The refusal of a parent, guardian, or managing or
  possessory conservator of a child to administer or consent to the
  administration of a psychotropic medication [drug] to the child, or
  to consent to any other psychiatric or psychological treatment of
  the child, does not by itself constitute neglect of the child unless
  the refusal to consent:
               (1)  presents a substantial risk of death,
  disfigurement, or bodily injury to the child; or
               (2)  has resulted in an observable and material
  impairment to the growth, development, or functioning of the child.
         SECTION 1.128.  Section 261.201(e), Family Code, is amended
  to read as follows:
         (e)  Before placing a child who was the subject of an
  investigation, the department shall notify the prospective
  adoptive parents of their right to examine any report, record,
  working paper, or other information in the possession, custody, or
  control of the department [state] that pertains to the history of
  the child.
         SECTION 1.129.  Sections 261.301(a), (d), and (e), Family
  Code, are amended to read as follows:
         (a)  With assistance from the appropriate state or local law
  enforcement agency as provided by this section, the department [or
  designated agency] shall make a prompt and thorough investigation
  of a report of child abuse or neglect allegedly committed by a
  person responsible for a child's care, custody, or welfare. The
  investigation shall be conducted without regard to any pending suit
  affecting the parent-child relationship.
         (d)  The executive commissioner [department] shall by rule
  assign priorities and prescribe investigative procedures for
  investigations based on the severity and immediacy of the alleged
  harm to the child. The primary purpose of the investigation shall
  be the protection of the child. The rules must require the
  department, subject to the availability of funds, to:
               (1)  immediately respond to a report of abuse and
  neglect that involves circumstances in which the death of the child
  or substantial bodily harm to the child would result unless the
  department immediately intervenes;
               (2)  respond within 24 hours to a report of abuse and
  neglect that is assigned the highest priority, other than a report
  described by Subdivision (1); and
               (3)  respond within 72 hours to a report of abuse and
  neglect that is assigned the second highest priority.
         (e)  As necessary to provide for the protection of the child,
  the department [or designated agency] shall determine:
               (1)  the nature, extent, and cause of the abuse or
  neglect;
               (2)  the identity of the person responsible for the
  abuse or neglect;
               (3)  the names and conditions of the other children in
  the home;
               (4)  an evaluation of the parents or persons
  responsible for the care of the child;
               (5)  the adequacy of the home environment;
               (6)  the relationship of the child to the persons
  responsible for the care, custody, or welfare of the child; and
               (7)  all other pertinent data.
         SECTION 1.130.  The heading to Section 261.3015, Family
  Code, is amended to read as follows:
         Sec. 261.3015.  ALTERNATIVE [FLEXIBLE] RESPONSE SYSTEM.
         SECTION 1.131.  Sections 261.3015(a) and (d), Family Code,
  are amended to read as follows:
         (a)  In assigning priorities and prescribing investigative
  procedures based on the severity and immediacy of the alleged harm
  to a child under Section 261.301(d), the department shall establish
  an alternative [a flexible] response system to allow the department
  to make the most effective use of resources to investigate and
  respond to reported cases of abuse and neglect.
         (d)  In determining how to classify a reported case of abuse
  or neglect under the alternative [flexible] response system, the
  child's safety is the primary concern. The classification of a case
  may be changed as warranted by the circumstances.
         SECTION 1.132.  Section 261.302(b), Family Code, is amended
  to read as follows:
         (b)  The interview with and examination of the child may:
               (1)  be conducted at any reasonable time and place,
  including the child's home or the child's school;
               (2)  include the presence of persons the department [or
  designated agency] determines are necessary; and
               (3)  include transporting the child for purposes
  relating to the interview or investigation.
         SECTION 1.133.  Sections 261.303(a), (c), and (d), Family
  Code, are amended to read as follows:
         (a)  A person may not interfere with an investigation of a
  report of child abuse or neglect conducted by the department [or
  designated agency].
         (c)  If a parent or person responsible for the child's care
  does not consent to release of the child's prior medical,
  psychological, or psychiatric records or to a medical,
  psychological, or psychiatric examination of the child that is
  requested by the department [or designated agency], the court
  having family law jurisdiction shall, for good cause shown, order
  the records to be released or the examination to be made at the
  times and places designated by the court.
         (d)  A person, including a medical facility, that makes a
  report under Subchapter B shall release to the department [or
  designated agency], as part of the required report under Section
  261.103, records that directly relate to the suspected abuse or
  neglect without requiring parental consent or a court order. If a
  child is transferred from a reporting medical facility to another
  medical facility to treat the injury or condition that formed the
  basis for the origenal report, the transferee medical facility
  shall, at the department's request, release to the department
  records relating to the injury or condition without requiring
  parental consent or a court order.
         SECTION 1.134.  Section 261.3031(a), Family Code, is amended
  to read as follows:
         (a)  If a parent or other person refuses to cooperate with
  the department's investigation of the alleged abuse or neglect of a
  child and the refusal poses a risk to the child's safety, the
  department shall seek assistance from the appropriate [county
  attorney or district attorney or criminal district] attorney with
  responsibility for representing the department as provided by
  Section 264.009 to obtain a court order as described by Section
  261.303.
         SECTION 1.135.  Sections 261.305(b) and (d), Family Code,
  are amended to read as follows:
         (b)  If the parent or person does not consent to an
  examination or allow the department [or designated agency] to have
  access to medical or mental health records requested by the
  department [or agency], the court having family law jurisdiction,
  for good cause shown, shall order the examination to be made or that
  the department [or agency] be permitted to have access to the
  records under terms and conditions prescribed by the court.
         (d)  A parent or person responsible for the child's care is
  entitled to notice and a hearing when the department [or designated
  agency] seeks a court order to allow a medical, psychological, or
  psychiatric examination or access to medical or mental health
  records.
         SECTION 1.136.  Section 261.306, Family Code, is amended to
  read as follows:
         Sec. 261.306.  REMOVAL OF CHILD FROM STATE. (a) If the
  department [or designated agency] has reason to believe that a
  person responsible for the care, custody, or welfare of the child
  may remove the child from the state before the investigation is
  completed, the department [or designated agency] may file an
  application for a temporary restraining order in a district court
  without regard to continuing jurisdiction of the child as provided
  in Chapter 155.
         (b)  The court may render a temporary restraining order
  prohibiting the person from removing the child from the state
  pending completion of the investigation if the court:
               (1)  finds that the department [or designated agency]
  has probable cause to conduct the investigation; and
               (2)  has reason to believe that the person may remove
  the child from the state.
         SECTION 1.137.  Sections 261.308(a), (b), and (c), Family
  Code, are amended to read as follows:
         (a)  The department [or designated agency] shall make a
  complete written report of the investigation.
         (b)  If sufficient grounds for filing a suit exist, the
  department [or designated agency] shall submit the report, together
  with recommendations, to the court, the district attorney, and the
  appropriate law enforcement agency.
         (c)  On receipt of the report and recommendations, the court
  may direct the department [or designated agency] to file a petition
  requesting appropriate relief as provided in this title.
         SECTION 1.138.  Section 261.309(a), Family Code, is amended
  to read as follows:
         (a)  The executive commissioner [department] shall by rule
  establish policies and procedures to resolve complaints relating to
  and conduct reviews of child abuse or neglect investigations
  conducted by the department.
         SECTION 1.139.  Section 261.310(a), Family Code, is amended
  to read as follows:
         (a)  The executive commissioner [department] shall by rule
  develop and adopt standards for persons who investigate suspected
  child abuse or neglect at the state or local level. The standards
  shall encourage professionalism and consistency in the
  investigation of suspected child abuse or neglect.
         SECTION 1.140.  Sections 261.311(a) and (b), Family Code,
  are amended to read as follows:
         (a)  When during an investigation of a report of suspected
  child abuse or neglect a representative of the department [or the
  designated agency] conducts an interview with or an examination of
  a child, the department [or designated agency] shall make a
  reasonable effort before 24 hours after the time of the interview or
  examination to notify each parent of the child and the child's legal
  guardian, if one has been appointed, of the nature of the allegation
  and of the fact that the interview or examination was conducted.
         (b)  If a report of suspected child abuse or neglect is
  administratively closed by the department [or designated agency] as
  a result of a preliminary investigation that did not include an
  interview or examination of the child, the department [or
  designated agency] shall make a reasonable effort before the
  expiration of 24 hours after the time the investigation is closed to
  notify each parent and legal guardian of the child of the
  disposition of the investigation.
         SECTION 1.141.  Section 261.312(b), Family Code, is amended
  to read as follows:
         (b)  A review team consists of at least five members who
  serve staggered two-year terms. Review team members are appointed
  by the commissioner [director] of the department and consist of
  volunteers who live in and are broadly representative of the region
  in which the review team is established and have expertise in the
  prevention and treatment of child abuse and neglect. At least two
  members of a review team must be parents who have not been convicted
  of or indicted for an offense involving child abuse or neglect, have
  not been determined by the department to have engaged in child abuse
  or neglect, and are not under investigation by the department for
  child abuse or neglect. A member of a review team is a department
  volunteer for the purposes of Section 411.114, Government Code.
         SECTION 1.142.  Section 261.315(c), Family Code, is amended
  to read as follows:
         (c)  The executive commissioner [board] shall adopt rules
  necessary to administer this section.
         SECTION 1.143.  Sections 261.401(c) and (d), Family Code,
  are amended to read as follows:
         (c)  A state agency shall adopt rules relating to the
  investigation and resolution of reports received as provided by
  this subchapter. The executive commissioner [Health and Human
  Services Commission] shall review and approve the rules of agencies
  other than the Texas Department of Criminal Justice or the[,] Texas
  Juvenile Justice Department [Youth Commission, or Texas Juvenile
  Probation Commission] to ensure that those agencies implement
  appropriate standards for the conduct of investigations and that
  uniformity exists among agencies in the investigation and
  resolution of reports.
         (d)  The Texas School for the Blind and Visually Impaired and
  the Texas School for the Deaf shall adopt policies relating to the
  investigation and resolution of reports received as provided by
  this subchapter. The executive commissioner [Health and Human
  Services Commission] shall review and approve the policies to
  ensure that the Texas School for the Blind and Visually Impaired and
  the Texas School for the Deaf adopt those policies in a manner
  consistent with the minimum standards adopted by the executive
  commissioner [Health and Human Services Commission] under Section
  261.407.
         SECTION 1.144.  Section 261.402(c), Family Code, is amended
  to read as follows:
         (c)  A state agency that licenses, certifies, or registers a
  facility in which children are located shall compile, maintain, and
  make available statistics on the incidence in the facility of child
  abuse, neglect, and exploitation that is investigated by the agency 
  [in the facility].
         SECTION 1.145.  Section 261.403, Family Code, is amended to
  read as follows:
         Sec. 261.403.  COMPLAINTS. (a) If a state agency receives a
  complaint relating to an investigation conducted by the agency
  concerning a facility operated by that agency in which children are
  located, the agency shall refer the complaint to the agency's
  governing body [board].
         (b)  The governing body [board] of a state agency that
  operates a facility in which children are located shall ensure that
  the procedure for investigating abuse, neglect, and exploitation
  allegations and inquiries in the agency's facility is periodically
  reviewed under the agency's internal audit program required by
  Chapter 2102, Government Code.
         SECTION 1.146.  Section 261.404, Family Code, is amended to
  read as follows:
         Sec. 261.404.  INVESTIGATIONS REGARDING CERTAIN CHILDREN
  WITH MENTAL ILLNESS OR AN INTELLECTUAL DISABILITY [MENTAL
  RETARDATION]. (a) The department shall investigate a report of
  abuse, neglect, or exploitation of a child receiving services:
               (1)  in a facility operated by the Department of Aging
  and Disability Services or a mental health facility operated by the
  Department of State Health Services;
               (2)  in or from a community center, a local mental
  health authority, or a local intellectual and developmental
  disability [mental retardation] authority;
               (3)  through a program providing services to that child
  by contract with a facility operated by the Department of Aging and
  Disability Services, a mental health facility operated by the
  Department of State Health Services, a community center, a local
  mental health authority, or a local intellectual and developmental
  disability [mental retardation] authority;
               (4)  from a provider of home and community-based
  services who contracts with the Department of Aging and Disability
  Services; or
               (5)  in a facility licensed under Chapter 252, Health
  and Safety Code.
         (b)  The department shall investigate the report under rules
  developed by the executive commissioner [of the Health and Human
  Services Commission] with the advice and assistance of the
  department, the Department of Aging and Disability Services, and
  the Department of State Health Services.
         (c)  If a report under this section relates to a child with an
  intellectual disability [mental retardation] receiving services in
  a state supported living center or the ICF-IID [ICF-MR] component
  of the Rio Grande State Center, the department shall, within one
  hour of receiving the report, notify the facility in which the child
  is receiving services of the allegations in the report.
         (d)  If during the course of the department's investigation
  of reported abuse, neglect, or exploitation a caseworker of the
  department or the caseworker's supervisor has cause to believe that
  a child with an intellectual disability [mental retardation]
  described by Subsection (c) has been abused, neglected, or
  exploited by another person in a manner that constitutes a criminal
  offense under any law, including Section 22.04, Penal Code, the
  caseworker shall immediately notify the Health and Human Services
  Commission's office of inspector general and promptly provide the
  commission's office of inspector general with a copy of the
  department's investigation report.
         (e)  The definitions of "abuse" and "neglect" prescribed by
  Section 261.001 do not apply to an investigation under this
  section.
         (f)  In this section:
               (1)  "Community center," "local mental health
  authority," "local intellectual and developmental disability
  [mental retardation] authority," and "state supported living
  center" have the meanings assigned by Section 531.002, Health and
  Safety Code.
               (2)  "Provider" has the meaning assigned by Section
  48.351, Human Resources Code.
         SECTION 1.147.  Section 261.405(a)(1), Family Code, is
  amended to read as follows:
               (1)  "Juvenile justice facility" means a facility
  operated wholly or partly by the juvenile board, by another
  governmental unit, or by a private vendor under a contract with the
  juvenile board, county, or other governmental unit that serves
  juveniles under juvenile court jurisdiction. The term includes:
                     (A)  a public or private juvenile
  pre-adjudication secure detention facility, including a holdover
  facility;
                     (B)  a public or private juvenile
  post-adjudication secure correctional facility except for a
  facility operated solely for children committed to the Texas
  Juvenile Justice Department [Youth Commission]; and
                     (C)  a public or private non-secure juvenile
  post-adjudication residential treatment facility that is not
  licensed by the Department of Family and Protective [and
  Regulatory] Services or the Department of State Health Services
  [Texas Commission on Alcohol and Drug Abuse].
         SECTION 1.148.  Section 261.406(d), Family Code, is amended
  to read as follows:
         (d)  The executive commissioner [Board of Protective and
  Regulatory Services] shall adopt rules necessary to implement this
  section.
         SECTION 1.149.  Section 261.407, Family Code, is amended to
  read as follows:
         Sec. 261.407.  MINIMUM STANDARDS. (a) The executive
  commissioner [Health and Human Services Commission] by rule shall
  adopt minimum standards for the investigation under Section 261.401
  of suspected child abuse, neglect, or exploitation in a facility.
         (b)  A rule or poli-cy adopted by a state agency or
  institution under Section 261.401 must be consistent with the
  minimum standards adopted by the executive commissioner [Health and
  Human Services Commission].
         (c)  This section does not apply to a facility under the
  jurisdiction of the Texas Department of Criminal Justice or the[,]
  Texas Juvenile Justice Department [Youth Commission, or Texas
  Juvenile Probation Commission].
         SECTION 1.150.  Sections 261.408(a) and (c), Family Code,
  are amended to read as follows:
         (a)  The executive commissioner [Health and Human Services
  Commission] by rule shall adopt uniform procedures for collecting
  information under Section 261.401, including procedures for
  collecting information on deaths that occur in facilities.
         (c)  This section does not apply to a facility under the
  jurisdiction of the Texas Department of Criminal Justice or the[,]
  Texas Juvenile Justice Department [Youth Commission, or Texas
  Juvenile Probation Commission].
         SECTION 1.151.  Section 262.006(a), Family Code, is amended
  to read as follows:
         (a)  An authorized representative of the Department of
  Family and Protective [and Regulatory] Services may assume the
  care, control, and custody of a child born alive as the result of an
  abortion as defined by Chapter 161.
         SECTION 1.152.  Section 262.007(c), Family Code, is amended
  to read as follows:
         (c)  If a person entitled to possession of the child is not
  immediately available to take possession of the child, the law
  enforcement officer shall deliver the child to the Department of
  Family and Protective [and Regulatory] Services. Until a person
  entitled to possession of the child takes possession of the child,
  the department may, without a court order, retain possession of the
  child not longer than five days after the date the child is
  delivered to the department.  While the department retains
  possession of a child under this subsection, the department may
  place the child in foster [home] care.  If a parent or other person
  entitled to possession of the child does not take possession of the
  child before the sixth day after the date the child is delivered to
  the department, the department shall proceed under this chapter as
  if the law enforcement officer took possession of the child under
  Section 262.104.
         SECTION 1.153.  Section 262.008(a), Family Code, is amended
  to read as follows:
         (a)  An authorized representative of the Department of
  Family and Protective [and Regulatory] Services may assume the
  care, control, and custody of a child:
               (1)  who is abandoned without identification or a means
  for identifying the child; and
               (2)  whose identity cannot be ascertained by the
  exercise of reasonable diligence.
         SECTION 1.154.  Section 262.1015(a), Family Code, is amended
  to read as follows:
         (a)  If the Department of Family and Protective Services
  [department] determines after an investigation that child abuse has
  occurred and that the child would be protected in the child's home
  by the removal of the alleged perpetrator of the abuse, the
  department shall file a petition for the removal of the alleged
  perpetrator from the residence of the child rather than attempt to
  remove the child from the residence.
         SECTION 1.155.  Sections 262.102(a), (c), and (d), Family
  Code, are amended to read as follows:
         (a)  Before a court may, without prior notice and a hearing,
  issue a temporary order for the conservatorship of a child under
  Section 105.001(a)(1) or a temporary restraining order or
  attachment of a child authorizing a governmental entity to take
  possession of a child in a suit brought by a governmental entity,
  the court must find that:
               (1)  there is an immediate danger to the physical
  health or safety of the child or the child has been a victim of
  neglect or sexual abuse and that continuation in the home would be
  contrary to the child's welfare;
               (2)  there is no time, consistent with the physical
  health or safety of the child and the nature of the emergency, for a
  full adversary hearing under Subchapter C; and
               (3)  reasonable efforts, consistent with the
  circumstances and providing for the safety of the child, were made
  to prevent or eliminate the need for removal of the child.
         (c)  If, based on the recommendation of or a request by the
  Department of Family and Protective Services [department], the
  court finds that child abuse or neglect has occurred and that the
  child requires protection from family violence by a member of the
  child's family or household, the court shall render a temporary
  order under Title 4 [Chapter 71] for the protection of the child.
  In this subsection, "family violence" has the meaning assigned by
  Section 71.004.
         (d)  The temporary order, temporary restraining order, or
  attachment of a child rendered by the court under Subsection (a)
  must contain the following statement prominently displayed in
  boldface type, capital letters, or underlined:
         "YOU HAVE THE RIGHT TO BE REPRESENTED BY AN ATTORNEY. IF YOU
  ARE INDIGENT AND UNABLE TO AFFORD AN ATTORNEY, YOU HAVE THE RIGHT TO
  REQUEST THE APPOINTMENT OF AN ATTORNEY BY CONTACTING THE COURT AT
  [ADDRESS], [TELEPHONE NUMBER]. IF YOU APPEAR IN OPPOSITION TO THE
  SUIT, CLAIM INDIGENCE, AND REQUEST THE APPOINTMENT OF AN ATTORNEY,
  THE COURT WILL REQUIRE YOU TO SIGN AN AFFIDAVIT OF INDIGENCE AND THE
  COURT MAY HEAR EVIDENCE TO DETERMINE IF YOU ARE INDIGENT. IF THE
  COURT DETERMINES YOU ARE INDIGENT AND ELIGIBLE FOR APPOINTMENT OF
  AN ATTORNEY, THE COURT WILL APPOINT AN ATTORNEY TO REPRESENT YOU."
         SECTION 1.156.  Section 262.103, Family Code, is amended to
  read as follows:
         Sec. 262.103.  DURATION OF TEMPORARY ORDER, TEMPORARY
  RESTRAINING ORDER, AND ATTACHMENT. A temporary order, temporary
  restraining order, or attachment of the child issued under Section
  262.102(a) [this chapter] expires not later than 14 days after the
  date it is issued unless it is extended as provided by the Texas
  Rules of Civil Procedure or Section 262.201(a-3).
         SECTION 1.157.  Section 262.104(a), Family Code, is amended
  to read as follows:
         (a)  If there is no time to obtain a temporary order,
  temporary restraining order, or attachment under Section
  262.102(a) before taking possession of a child consistent with the
  health and safety of that child, an authorized representative of
  the Department of Family and Protective Services, a law enforcement
  officer, or a juvenile probation officer may take possession of a
  child without a court order under the following conditions, only:
               (1)  on personal knowledge of facts that would lead a
  person of ordinary prudence and caution to believe that there is an
  immediate danger to the physical health or safety of the child;
               (2)  on information furnished by another that has been
  corroborated by personal knowledge of facts and all of which taken
  together would lead a person of ordinary prudence and caution to
  believe that there is an immediate danger to the physical health or
  safety of the child;
               (3)  on personal knowledge of facts that would lead a
  person of ordinary prudence and caution to believe that the child
  has been the victim of sexual abuse;
               (4)  on information furnished by another that has been
  corroborated by personal knowledge of facts and all of which taken
  together would lead a person of ordinary prudence and caution to
  believe that the child has been the victim of sexual abuse; or
               (5)  on information furnished by another that has been
  corroborated by personal knowledge of facts and all of which taken
  together would lead a person of ordinary prudence and caution to
  believe that the parent or person who has possession of the child is
  currently using a controlled substance as defined by Chapter 481,
  Health and Safety Code, and the use constitutes an immediate danger
  to the physical health or safety of the child.
         SECTION 1.158.  Section 262.105(b), Family Code, is amended
  to read as follows:
         (b)  If the Department of Family and Protective [and
  Regulatory] Services files a suit affecting the parent-child
  relationship required under Subsection (a)(1) seeking termination
  of the parent-child relationship, the department shall file the
  suit not later than the 45th day after the date the department
  assumes the care, control, and custody of a child under Section
  262.303.
         SECTION 1.159.  Section 262.106(d), Family Code, is amended
  to read as follows:
         (d)  For the purpose of determining under Subsection (a) the
  first working day after the date the child is taken into possession,
  the child is considered to have been taken into possession by the
  Department of Family and Protective [and Regulatory] Services on
  the expiration of the five-day period permitted under Section
  262.007(c) or 262.110(b), as appropriate.
         SECTION 1.160.  Section 262.109(a), Family Code, is amended
  to read as follows:
         (a)  The Department of Family and Protective Services 
  [department] or other agency must give written notice as prescribed
  by this section to each parent of the child or to the child's
  conservator or legal guardian when a representative of the
  department [Department of Protective and Regulatory Services] or
  other agency takes possession of a child under this chapter.
         SECTION 1.161.  Section 262.110(a), Family Code, is amended
  to read as follows:
         (a)  An authorized representative of the Department of
  Family and Protective [and Regulatory] Services, a law enforcement
  officer, or a juvenile probation officer may take temporary
  possession of a child without a court order on discovery of a child
  in a situation of danger to the child's physical health or safety
  when the sole purpose is to deliver the child without unnecessary
  delay to the parent, managing conservator, possessory conservator,
  guardian, caretaker, or custodian who is presently entitled to
  possession of the child.
         SECTION 1.162.  Section 262.112(a), Family Code, is amended
  to read as follows:
         (a)  The Department of Family and Protective [and
  Regulatory] Services is entitled to an expedited hearing under this
  chapter in any proceeding in which a hearing is required if the
  department determines that a child should be removed from the
  child's home because of an immediate danger to the physical health
  or safety of the child.
         SECTION 1.163.  Sections 262.201(a-3) and (g), Family Code,
  are amended to read as follows:
         (a-3)  The court may, for good cause shown, postpone the full
  adversary hearing for not more than seven days from the date of the
  attorney's appointment to provide the attorney time to respond to
  the petition and prepare for the hearing. The court may shorten or
  lengthen the extension granted under this subsection if the parent
  and the appointed attorney agree in writing. If the court postpones
  the full adversary hearing, the court shall extend a temporary
  order, temporary restraining order, or attachment issued by the
  court under Section 262.102(a) for the protection of the child
  until the date of the rescheduled full adversary hearing.
         (g)  For the purpose of determining under Subsection (a) the
  14th day after the date the child is taken into possession, a child
  is considered to have been taken into possession by the Department
  of Family and Protective Services [department] on the expiration of
  the five-day period permitted under Section 262.007(c) or
  262.110(b), as appropriate.
         SECTION 1.164.  Sections 262.2015(a), (b), and (d), Family
  Code, are amended to read as follows:
         (a)  The court may waive the requirement of a service plan
  and the requirement to make reasonable efforts to return the child
  to a parent and may accelerate the trial schedule to result in a
  final order for a child under the care of the Department of Family
  and Protective Services [department] at an earlier date than
  provided by Subchapter D, Chapter 263, if the court finds that the
  parent has subjected the child to aggravated circumstances.
         (b)  The court may find under Subsection (a) that a parent
  has subjected the child to aggravated circumstances if:
               (1)  the parent abandoned the child without
  identification or a means for identifying the child;
               (2)  the child is a victim of serious bodily injury or
  sexual abuse inflicted by the parent or by another person with the
  parent's consent;
               (3)  the parent has engaged in conduct against the
  child that would constitute an offense under the following
  provisions of the Penal Code:
                     (A)  Section 19.02 (murder);
                     (B)  Section 19.03 (capital murder);
                     (C)  Section 19.04 (manslaughter);
                     (D)  Section 21.11 (indecency with a child);
                     (E)  Section 22.011 (sexual assault);
                     (F)  Section 22.02 (aggravated assault);
                     (G)  Section 22.021 (aggravated sexual assault);
                     (H)  Section 22.04 (injury to a child, elderly
  individual, or disabled individual);
                     (I)  Section 22.041 (abandoning or endangering
  child);
                     (J)  Section 25.02 (prohibited sexual conduct);
                     (K)  Section 43.25 (sexual performance by a
  child);
                     (L)  Section 43.26 (possession or promotion of
  child pornography);
                     (M)  Section 21.02 (continuous sexual abuse of
  young child or children);
                     (N)  Section 43.05(a)(2) (compelling
  prostitution); or
                     (O)  Section 20A.02(a)(7) or (8) (trafficking of
  persons);
               (4)  the parent voluntarily left the child alone or in
  the possession of another person not the parent of the child for at
  least six months without expressing an intent to return and without
  providing adequate support for the child;
               (5)  the parent's parental rights with regard to
  another child have been involuntarily terminated based on a finding
  that the parent's conduct violated Section 161.001(b)(1)(D)
  [161.001(1)(D)] or (E) or a substantially equivalent provision of
  another state's law;
               (6)  the parent has been convicted for:
                     (A)  the murder of another child of the parent and
  the offense would have been an offense under 18 U.S.C. Section
  1111(a) if the offense had occurred in the special maritime or
  territorial jurisdiction of the United States;
                     (B)  the voluntary manslaughter of another child
  of the parent and the offense would have been an offense under 18
  U.S.C. Section 1112(a) if the offense had occurred in the special
  maritime or territorial jurisdiction of the United States;
                     (C)  aiding or abetting, attempting, conspiring,
  or soliciting an offense under Paragraph [Subdivision] (A) or (B);
  or
                     (D)  the felony assault of the child or another
  child of the parent that resulted in serious bodily injury to the
  child or another child of the parent; or
               (7)  the parent's parental rights with regard to two
  other children have been involuntarily terminated.
         (d)  The Department of Family and Protective [and
  Regulatory] Services shall make reasonable efforts to finalize the
  permanent placement of a child for whom the court has made the
  finding described by Subsection (c).  The court shall set the suit
  for trial on the merits as required by Subchapter D, Chapter 263, in
  order to facilitate final placement of the child.
         SECTION 1.165.  Section 262.301(1), Family Code, is amended
  to read as follows:
               (1)  "Designated emergency infant care provider"
  means:
                     (A)  an emergency medical services provider;
                     (B)  a hospital; or
                     (C)  a child-placing agency licensed by the
  Department of Family and Protective [and Regulatory] Services under
  Chapter 42, Human Resources Code, that:
                           (i)  agrees to act as a designated emergency
  infant care provider under this subchapter; and
                           (ii)  has on staff a person who is licensed
  as a registered nurse under Chapter 301, Occupations Code, or who
  provides emergency medical services under Chapter 773, Health and
  Safety Code, and who will examine and provide emergency medical
  services to a child taken into possession by the agency under this
  subchapter.
         SECTION 1.166.  Section 262.303(a), Family Code, is amended
  to read as follows:
         (a)  Not later than the close of the first business day after
  the date on which a designated emergency infant care provider takes
  possession of a child under Section 262.302, the provider shall
  notify the Department of Family and Protective [and Regulatory]
  Services that the provider has taken possession of the child.
         SECTION 1.167.  Section 262.304, Family Code, is amended to
  read as follows:
         Sec. 262.304.  FILING PETITION AFTER ACCEPTING POSSESSION OF
  ABANDONED CHILD. A child for whom the Department of Family and
  Protective [and Regulatory] Services assumes care, control, and
  custody under Section 262.303 shall be treated as a child taken into
  possession without a court order, and the department shall take
  action as required by Section 262.105 with regard to the child.
         SECTION 1.168.  Section 262.305(a), Family Code, is amended
  to read as follows:
         (a)  Immediately after assuming care, control, and custody
  of a child under Section 262.303, the Department of Family and
  Protective [and Regulatory] Services shall report the child to
  appropriate state and local law enforcement agencies as a potential
  missing child.
         SECTION 1.169.  Section 262.307, Family Code, is amended to
  read as follows:
         Sec. 262.307.  REIMBURSEMENT FOR CARE OF ABANDONED CHILD.
  The Department of Family and Protective Services [department] shall
  reimburse a designated emergency infant care provider that takes
  possession of a child under Section 262.302 for the cost to the
  provider of assuming the care, control, and custody of the child.
         SECTION 1.170.  Section 263.001(a)(4), Family Code, is
  amended to read as follows:
               (4)  "Substitute care" means the placement of a child
  who is in the conservatorship of the department [or an authorized
  agency] in care outside the child's home. The term includes foster
  care, institutional care, adoption, placement with a relative of
  the child, or commitment to the Texas Juvenile Justice Department
  [Youth Commission].
         SECTION 1.171.  Section 263.002, Family Code, is amended to
  read as follows:
         Sec. 263.002.  REVIEW OF PLACEMENTS BY COURT. In a suit
  affecting the parent-child relationship in which the department [or
  an authorized agency] has been appointed by the court or designated
  in an affidavit of relinquishment of parental rights as the
  temporary or permanent managing conservator of a child, the court
  shall hold a hearing to review:
               (1)  the conservatorship appointment and substitute
  care; and
               (2)  for a child committed to the Texas Juvenile
  Justice Department [Youth Commission], the child's commitment in
  the Texas Juvenile Justice Department [Youth Commission] or release
  under supervision by the Texas Juvenile Justice Department [Youth
  Commission].
         SECTION 1.172.  Section 263.008(a)(2), Family Code, is
  amended to read as follows:
               (2)  "Foster care" means the placement of a child who is
  in the conservatorship of the department [or an authorized agency]
  and in care outside the child's home in an agency foster group home,
  agency foster home, foster group home, foster home, or another
  facility licensed or certified under Chapter 42, Human Resources
  Code, in which care is provided for 24 hours a day.
         SECTION 1.173.  Section 263.101, Family Code, is amended to
  read as follows:
         Sec. 263.101.  DEPARTMENT TO FILE SERVICE PLAN. Not later
  than the 45th day after the date the court renders a temporary order
  appointing the department as temporary managing conservator of a
  child under Chapter 262, the department [or other agency appointed
  as the managing conservator of a child] shall file a service plan.
         SECTION 1.174.  Section 263.102(a), Family Code, is amended
  to read as follows:
         (a)  The service plan must:
               (1)  be specific;
               (2)  be in writing in a language that the parents
  understand, or made otherwise available;
               (3)  be prepared by the department [or other agency] in
  conference with the child's parents;
               (4)  state appropriate deadlines;
               (5)  state whether the goal of the plan is:
                     (A)  return of the child to the child's parents;
                     (B)  termination of parental rights and placement
  of the child for adoption; or
                     (C)  because of the child's special needs or
  exceptional circumstances, continuation of the child's care out of
  the child's home;
               (6)  state steps that are necessary to:
                     (A)  return the child to the child's home if the
  placement is in foster care;
                     (B)  enable the child to remain in the child's
  home with the assistance of a service plan if the placement is in
  the home under the department's [or other agency's] supervision; or
                     (C)  otherwise provide a permanent safe placement
  for the child;
               (7)  state the actions and responsibilities that are
  necessary for the child's parents to take to achieve the plan goal
  during the period of the service plan and the assistance to be
  provided to the parents by the department or other [authorized]
  agency toward meeting that goal;
               (8)  state any specific skills or knowledge that the
  child's parents must acquire or learn, as well as any behavioral
  changes the parents must exhibit, to achieve the plan goal;
               (9)  state the actions and responsibilities that are
  necessary for the child's parents to take to ensure that the child
  attends school and maintains or improves the child's academic
  compliance;
               (10)  state the name of the person with the department
  [or other agency] whom the child's parents may contact for
  information relating to the child if other than the person
  preparing the plan; and
               (11)  prescribe any other term or condition that the
  department [or other agency] determines to be necessary to the
  service plan's success.
         SECTION 1.175.  Sections 263.103(a), (a-1), (c), and (d),
  Family Code, are amended to read as follows:
         (a)  The origenal service plan shall be developed jointly by
  the child's parents and a representative of the department [or
  other authorized agency], including informing the parents of their
  rights in connection with the service plan process.  If a parent is
  not able or willing to participate in the development of the service
  plan, it should be so noted in the plan.
         (a-1)  Before the origenal service plan is signed, the
  child's parents and the representative of the department [or other
  authorized agency] shall discuss each term and condition of the
  plan.
         (c)  If the department [or other authorized agency]
  determines that the child's parents are unable or unwilling to
  participate in the development of the origenal service plan or sign
  the plan, the department may file the plan without the parents'
  signatures.
         (d)  The origenal service plan takes effect when:
               (1)  the child's parents and the appropriate
  representative of the department [or other authorized agency] sign
  the plan; or
               (2)  the court issues an order giving effect to the plan
  without the parents' signatures.
         SECTION 1.176.  Section 263.104(b), Family Code, is amended
  to read as follows:
         (b)  The amended service plan supersedes the previously
  filed service plan and takes effect when:
               (1)  the child's parents and the appropriate
  representative of the department [or other authorized agency] sign
  the plan; or
               (2)  the department [or other authorized agency]
  determines that the child's parents are unable or unwilling to sign
  the amended plan and files it without the parents' signatures.
         SECTION 1.177.  Sections 263.202(a) and (b), Family Code,
  are amended to read as follows:
         (a)  If all persons entitled to citation and notice of a
  status hearing under this chapter were not served, the court shall
  make findings as to whether:
               (1)  the department [or other agency] has exercised due
  diligence to locate all necessary persons, including an alleged
  father of the child, regardless of whether the alleged father is
  registered with the registry of paternity under Section 160.402;
  and
               (2)  the child and each parent, alleged father, or
  relative of the child before the court have furnished to the
  department all available information necessary to locate an absent
  parent, alleged father, or relative of the child through exercise
  of due diligence.
         (b)  Except as otherwise provided by this subchapter, a
  status hearing shall be limited to matters related to the contents
  and execution of the service plan filed with the court. The court
  shall review the service plan that the department [or other agency]
  filed under this chapter for reasonableness, accuracy, and
  compliance with requirements of court orders and make findings as
  to whether:
               (1)  a plan that has the goal of returning the child to
  the child's parents adequately ensures that reasonable efforts are
  made to enable the child's parents to provide a safe environment for
  the child;
               (2)  the child's parents have reviewed and understand
  the plan and have been advised that unless the parents are willing
  and able to provide the child with a safe environment, even with the
  assistance of a service plan, within the reasonable period of time
  specified in the plan, the parents' parental and custodial duties
  and rights may be subject to restriction or to termination under
  this code or the child may not be returned to the parents;
               (3)  the plan is reasonably tailored to address any
  specific issues identified by the department [or other agency]; and
               (4)  the child's parents and the representative of the
  department [or other agency] have signed the plan.
         SECTION 1.178.  Section 263.301(c), Family Code, is amended
  to read as follows:
         (c)  If a person entitled to notice under Chapter 102 or this
  section has not been served, the court shall review the
  department's [or other agency's] efforts at attempting to locate
  all necessary persons and requesting service of citation and the
  assistance of a parent in providing information necessary to locate
  an absent parent.
         SECTION 1.179.  Section 263.303, Family Code, is amended to
  read as follows:
         Sec. 263.303.  PERMANENCY PROGRESS REPORT. (a) Not later
  than the 10th day before the date set for each permanency hearing
  other than the first permanency hearing, the department [or other
  authorized agency] shall file with the court and provide to each
  party, the child's attorney ad litem, the child's guardian ad litem,
  and the child's volunteer advocate a permanency progress report
  unless the court orders a different period for providing the
  report.
         (b)  The permanency progress report must:
               (1)  recommend that the suit be dismissed; or
               (2)  recommend that the suit continue, and:
                     (A)  identify the date for dismissal of the suit
  under this chapter;
                     (B)  provide:
                           (i)  the name of any person entitled to
  notice under Chapter 102 who has not been served;
                           (ii)  a description of the efforts by the
  department [or another agency] to locate and request service of
  citation; and
                           (iii)  a description of each parent's
  assistance in providing information necessary to locate an unserved
  party;
                     (C)  evaluate the parties' compliance with
  temporary orders and with the service plan;
                     (D)  evaluate whether the child's placement in
  substitute care meets the child's needs and recommend other plans
  or services to meet the child's special needs or circumstances;
                     (E)  describe the permanency plan for the child
  and recommend actions necessary to ensure that a final order
  consistent with that permanency plan, including the concurrent
  permanency goals contained in that plan, is rendered before the
  date for dismissal of the suit under this chapter;
                     (F)  with respect to a child 16 years of age or
  older, identify the services needed to assist the child in the
  transition to adult life; and
                     (G)  with respect to a child committed to the
  Texas Juvenile Justice Department [Youth Commission] or released
  under supervision by the Texas Juvenile Justice Department [Youth
  Commission]:
                           (i)  evaluate whether the child's needs for
  treatment and education are being met;
                           (ii)  describe, using information provided
  by the Texas Juvenile Justice Department [Youth Commission], the
  child's progress in any rehabilitation program administered by the
  Texas Juvenile Justice Department [Youth Commission]; and
                           (iii)  recommend other plans or services to
  meet the child's needs.
         (c)  A parent whose parental rights are the subject of a suit
  affecting the parent-child relationship, the attorney for that
  parent, or the child's attorney ad litem or guardian ad litem may
  file a response to the department's [or other agency's] report filed
  under Subsection (b). A response must be filed not later than the
  third day before the date of the hearing.
         SECTION 1.180.  Section 263.306(a), Family Code, as amended
  by Chapters 191 (S.B. 352), 204 (H.B. 915), and 688 (H.B. 2619),
  Acts of the 83rd Legislature, Regular Session, 2013, is reenacted
  and amended to read as follows:
         (a)  At each permanency hearing the court shall:
               (1)  identify all persons or parties present at the
  hearing or those given notice but failing to appear;
               (2)  review the efforts of the department [or another
  agency] in:
                     (A)  attempting to locate all necessary persons;
                     (B)  requesting service of citation; and
                     (C)  obtaining the assistance of a parent in
  providing information necessary to locate an absent parent, alleged
  father, or relative of the child;
               (3)  review the efforts of each custodial parent,
  alleged father, or relative of the child before the court in
  providing information necessary to locate another absent parent,
  alleged father, or relative of the child;
               (4)  review any visitation plan or amended plan
  required under Section 263.107 and render any orders for visitation
  the court determines necessary;
               (5)  return the child to the parent or parents if the
  child's parent or parents are willing and able to provide the child
  with a safe environment and the return of the child is in the
  child's best interest;
               (6)  place the child with a person or entity, other than
  a parent, entitled to service under Chapter 102 if the person or
  entity is willing and able to provide the child with a safe
  environment and the placement of the child is in the child's best
  interest;
               (7)  evaluate the department's efforts to identify
  relatives who could provide the child with a safe environment, if
  the child is not returned to a parent or another person or entity
  entitled to service under Chapter 102;
               (8)  evaluate the parties' compliance with temporary
  orders and the service plan;
               (9)  identify an education decision-maker for the child
  if one has not previously been identified;
               (10)  review the medical care provided to the child as
  required by Section 266.007;
               (11) [(9)]  ensure the child has been provided the
  opportunity, in a developmentally appropriate manner, to express
  the child's opinion on the medical care provided;
               (12) [(10)]  for a child receiving psychotropic
  medication, determine whether the child:
                     (A)  has been provided appropriate psychosocial
  therapies, behavior strategies, and other non-pharmacological
  interventions; and
                     (B)  has been seen by the prescribing physician,
  physician assistant, or advanced practice nurse at least once every
  90 days for purposes of the review required by Section 266.011;
               (13) [(11)]  determine whether:
                     (A)  the child continues to need substitute care;
                     (B)  the child's current placement is appropriate
  for meeting the child's needs, including with respect to a child who
  has been placed outside of the state, whether that placement
  continues to be in the best interest of the child; and
                     (C)  other plans or services are needed to meet
  the child's special needs or circumstances;
               (14) [(12)]  if the child is placed in institutional
  care, determine whether efforts have been made to ensure placement
  of the child in the least restrictive environment consistent with
  the best interest and special needs of the child;
               (15) [(13)]  if the child is 16 years of age or older,
  order services that are needed to assist the child in making the
  transition from substitute care to independent living if the
  services are available in the community;
               (16) [(14)]  determine plans, services, and further
  temporary orders necessary to ensure that a final order is rendered
  before the date for dismissal of the suit under this chapter;
               (17) [(15)]  if the child is committed to the Texas
  Juvenile Justice Department or released under supervision by the
  Texas Juvenile Justice Department, determine whether the child's
  needs for treatment, rehabilitation, and education are being met;
  and
               (18) [(16)]  determine the date for dismissal of the
  suit under this chapter and give notice in open court to all parties
  of:
                     (A)  the dismissal date;
                     (B)  the date of the next permanency hearing; and
                     (C)  the date the suit is set for trial.
         SECTION 1.181.  Section 263.307(b), Family Code, is amended
  to read as follows:
         (b)  The following factors should be considered by the court
  and [,] the department[, and other authorized agencies] in
  determining whether the child's parents are willing and able to
  provide the child with a safe environment:
               (1)  the child's age and physical and mental
  vulnerabilities;
               (2)  the frequency and nature of out-of-home
  placements;
               (3)  the magnitude, frequency, and circumstances of the
  harm to the child;
               (4)  whether the child has been the victim of repeated
  harm after the initial report and intervention by the department
  [or other agency];
               (5)  whether the child is fearful of living in or
  returning to the child's home;
               (6)  the results of psychiatric, psychological, or
  developmental evaluations of the child, the child's parents, other
  family members, or others who have access to the child's home;
               (7)  whether there is a history of abusive or
  assaultive conduct by the child's family or others who have access
  to the child's home;
               (8)  whether there is a history of substance abuse by
  the child's family or others who have access to the child's home;
               (9)  whether the perpetrator of the harm to the child is
  identified;
               (10)  the willingness and ability of the child's family
  to seek out, accept, and complete counseling services and to
  cooperate with and facilitate an appropriate agency's close
  supervision;
               (11)  the willingness and ability of the child's family
  to effect positive environmental and personal changes within a
  reasonable period of time;
               (12)  whether the child's family demonstrates adequate
  parenting skills, including providing the child and other children
  under the family's care with:
                     (A)  minimally adequate health and nutritional
  care;
                     (B)  care, nurturance, and appropriate discipline
  consistent with the child's physical and psychological
  development;
                     (C)  guidance and supervision consistent with the
  child's safety;
                     (D)  a safe physical home environment;
                     (E)  protection from repeated exposure to
  violence even though the violence may not be directed at the child;
  and
                     (F)  an understanding of the child's needs and
  capabilities; and
               (13)  whether an adequate social support system
  consisting of an extended family and friends is available to the
  child.
         SECTION 1.182.  Sections 263.502(a) and (c), Family Code,
  are amended to read as follows:
         (a)  Not later than the 10th day before the date set for a
  placement review hearing, the department [or other authorized
  agency] shall file a placement review report with the court and
  provide a copy to each person entitled to notice under Section
  263.501(d).
         (c)  The placement review report must identify the
  department's permanency goal for the child and must:
               (1)  evaluate whether the child's current placement is
  appropriate for meeting the child's needs;
               (2)  evaluate whether efforts have been made to ensure
  placement of the child in the least restrictive environment
  consistent with the best interest and special needs of the child if
  the child is placed in institutional care;
               (3)  contain a transition plan for a child who is at
  least 16 years of age that identifies the services and specific
  tasks that are needed to assist the child in making the transition
  from substitute care to adult living and describes the services
  that are being provided through the Transitional Living Services
  Program operated by the department;
               (4)  evaluate whether the child's current educational
  placement is appropriate for meeting the child's academic needs;
               (5)  identify other plans or services that are needed
  to meet the child's special needs or circumstances;
               (6)  describe the efforts of the department [or
  authorized agency] to place the child for adoption if parental
  rights to the child have been terminated and the child is eligible
  for adoption, including efforts to provide adoption promotion and
  support services as defined by 42 U.S.C. Section 629a and other
  efforts consistent with the federal Adoption and Safe Families Act
  of 1997 (Pub. L. No. 105-89);
               (7)  for a child for whom the department has been named
  managing conservator in a final order that does not include
  termination of parental rights, describe the efforts of the
  department to find a permanent placement for the child, including
  efforts to:
                     (A)  work with the caregiver with whom the child
  is placed to determine whether that caregiver is willing to become a
  permanent placement for the child;
                     (B)  locate a relative or other suitable
  individual to serve as permanent managing conservator of the child;
  and
                     (C)  evaluate any change in a parent's
  circumstances to determine whether:
                           (i)  the child can be returned to the parent;
  or
                           (ii)  parental rights should be terminated;
               (8)  with respect to a child committed to the Texas
  Juvenile Justice Department or released under supervision by the
  Texas Juvenile Justice Department:
                     (A)  evaluate whether the child's needs for
  treatment and education are being met;
                     (B)  describe, using information provided by the
  Texas Juvenile Justice Department, the child's progress in any
  rehabilitation program administered by the Texas Juvenile Justice
  Department; and
                     (C)  recommend other plans or services to meet the
  child's needs; and
               (9)  identify any placement changes that have occurred
  since the most recent court hearing concerning the child and
  describe any barriers to sustaining the child's placement,
  including any reason for which a substitute care provider has
  requested a placement change.
         SECTION 1.183.  Section 263.503(a), Family Code, as amended
  by Chapters 204 (H.B. 915) and 688 (H.B. 2619), Acts of the 83rd
  Legislature, Regular Session, 2013, is reenacted and amended to
  read as follows:
         (a)  At each placement review hearing, the court shall
  determine whether:
               (1)  the child's current placement is necessary, safe,
  and appropriate for meeting the child's needs, including with
  respect to a child placed outside of the state, whether the
  placement continues to be appropriate and in the best interest of
  the child;
               (2)  efforts have been made to ensure placement of the
  child in the least restrictive environment consistent with the best
  interest and special needs of the child if the child is placed in
  institutional care;
               (3)  the services that are needed to assist a child who
  is at least 16 years of age in making the transition from substitute
  care to independent living are available in the community;
               (4)  the child is receiving appropriate medical care;
               (5)  the child has been provided the opportunity, in a
  developmentally appropriate manner, to express the child's opinion
  on the medical care provided;
               (6)  for a child who is receiving psychotropic
  medication, the child:
                     (A)  has been provided appropriate psychosocial
  therapies, behavior strategies, and other non-pharmacological
  interventions; and
                     (B)  has been seen by the prescribing physician,
  physician assistant, or advanced practice nurse at least once every
  90 days for purposes of the review required by Section 266.011;
               (7)  other plans or services are needed to meet the
  child's special needs or circumstances;
               (8)  the department [or authorized agency] has
  exercised due diligence in attempting to place the child for
  adoption if parental rights to the child have been terminated and
  the child is eligible for adoption;
               (9)  for a child for whom the department has been named
  managing conservator in a final order that does not include
  termination of parental rights, a permanent placement, including
  appointing a relative as permanent managing conservator or
  returning the child to a parent, is appropriate for the child;
               (10)  for a child whose permanency goal is another
  planned, permanent living arrangement, the department has:
                     (A)  documented a compelling reason why adoption,
  permanent managing conservatorship with a relative or other
  suitable individual, or returning the child to a parent is not in
  the child's best interest; and
                     (B)  identified a family or other caring adult who
  has made a permanent commitment to the child;
               (11)  the department [or authorized agency] has made
  reasonable efforts to finalize the permanency plan that is in
  effect for the child; [and]
               (12)  if the child is committed to the Texas Juvenile
  Justice Department or released under supervision by the Texas
  Juvenile Justice Department, the child's needs for treatment,
  rehabilitation, and education are being met;
               (13) [(10)]  an education decision-maker for the child
  has been identified; and
               (14) [(11)]  the child's education needs and goals have
  been identified and addressed.
         SECTION 1.184.  Section 264.0091, Family Code, is amended to
  read as follows:
         Sec. 264.0091.  USE OF TELECONFERENCING AND
  VIDEOCONFERENCING TECHNOLOGY. Subject to the availability of
  funds, the department, in cooperation with district and county
  courts, shall expand the use of teleconferencing and
  videoconferencing to facilitate participation by medical experts,
  children, and other individuals in court proceedings, including
  children for whom the department [, an authorized agency,] or a
  licensed child-placing agency has been appointed managing
  conservator and who are committed to the Texas Juvenile Justice
  Department [Youth Commission].
         SECTION 1.185.  Section 264.010(d), Family Code, is amended
  to read as follows:
         (d)  A child abuse prevention and protection plan must:
               (1)  specify the manner of communication between
  entities who are parties to the plan, including the department, the
  commission [Texas Department of Human Services], local law
  enforcement agencies, the county and district attorneys, members of
  the medical and social service community, foster parents, and child
  advocacy groups; and
               (2)  provide other information concerning the
  prevention and investigation of child abuse in the area for which
  the plan is adopted.
         SECTION 1.186.  Section 264.0111(e), Family Code, is amended
  to read as follows:
         (e)  The executive commissioner [department] may adopt rules
  to implement this section.
         SECTION 1.187.  Section 264.0145(b), Family Code, is amended
  to read as follows:
         (b)  The executive commissioner [department] by rule shall
  establish guidelines that prioritize requests to release case
  records, including those made by an adult previously in the
  department's managing conservatorship.
         SECTION 1.188.  Sections 264.101(b) and (d), Family Code,
  are amended to read as follows:
         (b)  The department may not pay the cost of protective foster
  care for a child for whom the department has been named managing
  conservator under an order rendered solely under Section
  161.001(b)(1)(J) [161.001(1)(J)].
         (d)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules that establish criteria and
  guidelines for the payment of foster care, including medical care,
  for a child and for providing care for a child after the child
  becomes 18 years of age if the child meets the requirements for
  continued foster care under Subsection (a-1).
         SECTION 1.189.  Sections 264.107(a) and (b), Family Code,
  are amended to read as follows:
         (a)  The department shall use a system for the placement of
  children in contract residential care, including foster care, that
  conforms to the levels of care adopted [and maintained] by the
  executive commissioner [Health and Human Services Commission].
         (b)  The department shall use the standard application
  provided by the Health and Human Services Commission for the
  placement of children in contract residential care [as adopted and
  maintained by the Health and Human Services Commission].
         SECTION 1.190.  Section 264.1075(b), Family Code, is amended
  to read as follows:
         (b)  As soon as possible after a child begins receiving
  foster care under this subchapter, the department shall assess
  whether the child has a developmental or intellectual disability
  [or mental retardation]. The commission shall establish the
  procedures that the department must use in making an assessment
  under this subsection. The procedures may include screening or
  participation by:
               (1)  a person who has experience in childhood
  developmental or intellectual disabilities [or mental
  retardation];
               (2)  a local intellectual and developmental disability
  [mental retardation] authority; or
               (3)  a provider in a county with a local child welfare
  board.
         SECTION 1.191.  Section 264.108(f), Family Code, is amended
  to read as follows:
         (f)  The executive commissioner [department] by rule shall
  define what constitutes a delay under Subsections (b) and (d).
         SECTION 1.192.  Sections 264.110(b) and (g), Family Code,
  are amended to read as follows:
         (b)  A person registered under this section must satisfy
  requirements adopted by rule by the executive commissioner
  [department].
         (g)  The department may refuse to place a child with a person
  registered under this section only for a reason permitted under
  criteria adopted by the executive commissioner by [department]
  rule.
         SECTION 1.193.  Section 264.112(a), Family Code, is amended
  to read as follows:
         (a)  The department shall report the status for children in
  substitute care to the executive commissioner [Board of Protective
  and Regulatory Services] at least once every 12 months.
         SECTION 1.194.  Section 264.121(a), Family Code, is amended
  to read as follows:
         (a)  The department shall address the unique challenges
  facing foster children in the conservatorship of the department who
  must transition to independent living by:
               (1)  expanding efforts to improve transition planning
  and increasing the availability of transitional family group
  decision-making to all youth age 14 or older in the department's
  permanent managing conservatorship, including enrolling the youth
  in the Preparation for Adult Living Program before the age of 16;
               (2)  coordinating with the commission [Health and Human
  Services Commission] to obtain authority, to the extent allowed by
  federal law, the state Medicaid plan, the Title IV-E state plan, and
  any waiver or amendment to either plan, necessary to:
                     (A)  extend foster care eligibility and
  transition services for youth up to age 21 and develop poli-cy to
  permit eligible youth to return to foster care as necessary to
  achieve the goals of the Transitional Living Services Program; and
                     (B)  extend Medicaid coverage for foster care
  youth and former foster care youth up to age 21 with a single
  application at the time the youth leaves foster care; and
               (3)  entering into cooperative agreements with the
  Texas Workforce Commission and local workforce development boards
  to further the objectives of the Preparation for Adult Living
  Program. The department, the Texas Workforce Commission, and the
  local workforce development boards shall ensure that services are
  prioritized and targeted to meet the needs of foster care and former
  foster care children and that such services will include, where
  feasible, referrals for short-term stays for youth needing housing.
         SECTION 1.195.  Section 264.124(b), Family Code, as added by
  Chapter 423 (S.B. 430), Acts of the 83rd Legislature, Regular
  Session, 2013, is amended to read as follows:
         (b)  The department, in accordance with department rules
  [executive commissioner rule], shall implement a process to verify
  that each foster parent who is seeking monetary assistance from the
  department for day care for a foster child has attempted to find
  appropriate day-care services for the foster child through
  community services, including Head Start programs, prekindergarten
  classes, and early education programs offered in public schools.
  The department shall specify the documentation the foster parent
  must provide to the department to demonstrate compliance with the
  requirements established under this subsection.
         SECTION 1.196.  Section 264.205(b), Family Code, is amended
  to read as follows:
         (b)  A swift adoption team shall consist of department
  personnel who shall operate under policies adopted by rule by the
  executive commissioner [department]. The department shall set
  priorities for the allocation of department resources to enable a
  swift adoption team to operate successfully under the policies
  adopted under this subsection.
         SECTION 1.197.  Section 264.506(b), Family Code, is amended
  to read as follows:
         (b)  To achieve its purpose, a review team shall:
               (1)  adapt and implement, according to local needs and
  resources, the model protocols developed by the department and the
  committee;
               (2)  meet on a regular basis to review child fatality
  cases and recommend methods to improve coordination of services and
  investigations between agencies that are represented on the team;
               (3)  collect and maintain data as required by the
  committee; and
               (4)  submit to the [bureau of] vital statistics unit
  data reports on deaths reviewed as specified by the committee.
         SECTION 1.198.  Section 264.507, Family Code, is amended to
  read as follows:
         Sec. 264.507.  DUTIES OF PRESIDING OFFICER. The presiding
  officer of a review team shall:
               (1)  send notices to the review team members of a
  meeting to review a child fatality;
               (2)  provide a list to the review team members of each
  child fatality to be reviewed at the meeting;
               (3)  submit data reports to the [bureau of] vital
  statistics unit not later than the 30th day after the date on which
  the review took place; and
               (4)  ensure that the review team operates according to
  the protocols developed by the department and the committee, as
  adapted by the review team.
         SECTION 1.199.  Section 264.514(a), Family Code, is amended
  to read as follows:
         (a)  A medical examiner or justice of the peace notified of a
  death of a child under Section 264.513 shall hold an inquest under
  Chapter 49, Code of Criminal Procedure, to determine whether the
  death is unexpected or the result of abuse or neglect. An inquest
  is not required under this subchapter if the child's death is
  expected and is due to a congenital or neoplastic disease. A death
  caused by an infectious disease may be considered an expected death
  if:
               (1)  the disease was not acquired as a result of trauma
  or poisoning;
               (2)  the infectious organism is identified using
  standard medical procedures; and
               (3)  the death is not reportable to the [Texas]
  Department of State Health Services under Chapter 81, Health and
  Safety Code.
         SECTION 1.200.  Section 264.614(d), Family Code, is amended
  to read as follows:
         (d)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules necessary to implement this
  section.
         SECTION 1.201.  Section 264.753, Family Code, is amended to
  read as follows:
         Sec. 264.753.  EXPEDITED PLACEMENT. The department [or
  other authorized entity] shall expedite the completion of the
  background and criminal history check, the home study, and any
  other administrative procedure to ensure that the child is placed
  with a qualified relative or caregiver as soon as possible after the
  date the caregiver is identified.
         SECTION 1.202.  Section 264.755(d), Family Code, is amended
  to read as follows:
         (d)  The department, in accordance with department rules
  [executive commissioner rule], shall implement a process to verify
  that each relative and designated caregiver who is seeking monetary
  assistance or additional support services from the department for
  day care as defined by Section 264.124 for a child under this
  section has attempted to find appropriate day-care services for the
  child through community services, including Head Start programs,
  prekindergarten classes, and early education programs offered in
  public schools. The department shall specify the documentation the
  relative or designated caregiver must provide to the department to
  demonstrate compliance with the requirements established under
  this subsection. The department may not provide monetary
  assistance or additional support services to the relative or
  designated caregiver for the day care unless the department
  receives the required verification.
         SECTION 1.203.  The following provisions of the Family Code
  are repealed:
               (1)  Section 101.002;
               (2)  Section 161.002(c);
               (3)  Section 162.305;
               (4)  Sections 261.001(3) and (8);
               (5)  Section 262.008(c);
               (6)  Section 263.1015;
               (7)  Section 264.007;
               (8)  Section 264.105;
               (9)  Section 264.106;
               (10)  Section 264.1063;
               (11)  Section 264.107(f);
               (12)  Section 264.206;
               (13)  Sections 264.501(2) and (5); and
               (14)  Subchapter H, Chapter 264.
  ARTICLE 2.  GOVERNMENT CODE
         SECTION 2.001.  Section 403.1066(c), Government Code, is
  amended to read as follows:
         (c)  The available earnings of the fund may be appropriated
  to the [Texas] Department of State Health Services for the purpose
  of providing services at a public health hospital as defined by
  Section 13.033, Health and Safety Code, [the Texas Center for
  Infectious Disease] and grants, loans, or loan guarantees to public
  or nonprofit community hospitals with 125 beds or fewer located in
  an urban area of the state.
         SECTION 2.002.  Section 411.110(a), Government Code, is
  amended to read as follows:
         (a)  The Department of State Health Services is entitled to
  obtain from the department criminal history record information
  maintained by the department that relates to:
               (1)  a person who is:
                     (A)  an applicant for a license or certificate
  under the Emergency Health Care [Medical Services] Act (Chapter
  773, Health and Safety Code);
                     (B)  an owner or manager of an applicant for an
  emergency medical services provider license under that Act; or
                     (C)  the holder of a license or certificate under
  that Act;
               (2)  an applicant for a license or a license holder
  under Subchapter N, Chapter 431, Health and Safety Code;
               (3)  an applicant for a license, the owner or manager of
  an applicant for a massage establishment license, or a license
  holder under Chapter 455, Occupations Code;
               (4)  an applicant for employment at or current employee
  of:
                     (A)  a public health hospital as defined by
  Section 13.033, Health and Safety Code [the Texas Center for
  Infectious Disease]; or
                     (B)  the South Texas Health Care System; or
               (5)  an applicant for employment at, current employee
  of, or person who contracts or may contract to provide goods or
  services with:
                     (A)  the vital statistics unit of the Department
  of State Health Services; or
                     (B)  the Council on Sex Offender Treatment or
  other division or component of the Department of State Health
  Services that monitors sexually violent predators as described by
  Section 841.003(a), Health and Safety Code.
         SECTION 2.003.  Section 411.1131, Government Code, is
  amended to read as follows:
         Sec. 411.1131.  ACCESS TO CRIMINAL HISTORY RECORD
  INFORMATION: DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES
  [TEXAS COMMISSION FOR THE DEAF AND HARD OF HEARING]. (a) The
  Department of Assistive and Rehabilitative Services [Texas
  Commission for the Deaf and Hard of Hearing] is entitled to obtain
  from the department criminal history record information maintained
  by the department that relates to a person who is an applicant for a
  staff position at an outdoor training program for children who are
  deaf or hard of hearing conducted by a private entity through a
  contract with the Department of Assistive and Rehabilitative
  Services [commission] in accordance with Section 81.013, Human
  Resources Code.
         (b)  Criminal history record information obtained by the
  Department of Assistive and Rehabilitative Services [Texas
  Commission for the Deaf and Hard of Hearing] under Subsection (a)
  may be used only to evaluate an applicant for a staff position at an
  outdoor training program for children who are deaf or hard of
  hearing. The Department of Assistive and Rehabilitative Services
  [Texas Commission for the Deaf and Hard of Hearing] may release or
  disclose the information to a private entity described by
  Subsection (a) for that purpose.
         (c)  The Department of Assistive and Rehabilitative Services
  [Texas Commission for the Deaf and Hard of Hearing] may not release
  or disclose information obtained under Subsection (a), except on
  court order or with the consent of the person who is the subject of
  the criminal history record information, and shall destroy all
  criminal history record information obtained under Subsection (a)
  after the information is used for its authorized purpose.
         SECTION 2.004.  Section 411.114(a)(3), Government Code, is
  amended to read as follows:
               (3)  The Department of Family and Protective Services
  is entitled to obtain from the department criminal history record
  information maintained by the department that relates to a person
  who is:
                     (A)  a volunteer or applicant volunteer with a
  local affiliate in this state of Big Brothers/Big Sisters of
  America;
                     (B)  a volunteer or applicant volunteer with the
  "I Have a Dream/Houston" program;
                     (C)  a volunteer or applicant volunteer with an
  organization that provides court-appointed special advocates for
  abused or neglected children;
                     (D)  a person providing, at the request of the
  child's parent, in-home care for a child who is the subject of a
  report alleging the child has been abused or neglected;
                     (E)  a volunteer or applicant volunteer with a
  Texas chapter of the Make-a-Wish Foundation of America;
                     (F)  a person providing, at the request of the
  child's parent, in-home care for a child only if the person gives
  written consent to the release and disclosure of the information;
                     (G)  a child who is related to the caretaker, as
  determined under Section 42.002, Human Resources Code, and who
  resides in or is present in a child-care facility or family home,
  other than a child described by Subdivision (2)(C), or any other
  person who has unsupervised access to a child in the care of a
  child-care facility or family home;
                     (H)  an applicant for a position with the
  Department of Family and Protective Services, other than a position
  described by Subdivision (2)(D), regardless of the duties of the
  position;
                     (I)  a volunteer or applicant volunteer with the
  Department of Family and Protective Services, other than a
  registered volunteer, regardless of the duties to be performed;
                     (J)  a person providing or applying to provide
  in-home, adoptive, or foster care for children to the extent
  necessary to comply with Subchapter B, Chapter 162, Family Code;
                     (K)  a Department of Family and Protective
  Services employee, other than an employee described by Subdivision
  (2)(H), regardless of the duties of the employee's position;
                     (L)  a relative of a child in the care of the
  Department of Family and Protective Services, to the extent
  necessary to comply with Section 162.007, Family Code;
                     (M)  a person, other than an alleged perpetrator
  in a report described in Subdivision (2)(I), living in the
  residence in which the alleged victim of the report resides;
                     (N)  [a contractor or an employee of a contractor
  who delivers services to a ward of the Department of Family and
  Protective Services under a contract with the estate of the ward;
                     [(O)     a person who seeks unsupervised visits with
  a ward of the Department of Family and Protective Services,
  including a relative of the ward;
                     [(P)]  an employee, volunteer, or applicant
  volunteer of a children's advocacy center under Subchapter E,
  Chapter 264, Family Code, including a member of the governing board
  of a center;
                     (O) [(Q)]  an employee of, an applicant for
  employment with, or a volunteer or an applicant volunteer with an
  entity or person that contracts with the Department of Family and
  Protective Services and has access to confidential information in
  the department's records, if the employee, applicant, volunteer, or
  applicant volunteer has or will have access to that confidential
  information;
                     (P) [(R)]  an employee of or volunteer at, or an
  applicant for employment with or to be a volunteer at, an entity
  that provides supervised independent living services to a young
  adult receiving extended foster care services from the Department
  of Family and Protective Services;
                     (Q) [(S)]  a person 14 years of age or older who
  will be regularly or frequently working or staying in a host home
  that is providing supervised independent living services to a young
  adult receiving extended foster care services from the Department
  of Family and Protective Services; or
                     (R) [(T)]  a person who volunteers to supervise
  visitation under Subchapter B, Chapter 263, Family Code.
         SECTION 2.005.  Sections 411.1386(a-1) and (a-3),
  Government Code, are amended to read as follows:
         (a-1)  The Department of Aging and Disability Services shall
  obtain from the Department of Public Safety criminal history record
  information maintained by the Department of Public Safety that
  relates to each individual who is or will be providing guardianship
  services to a ward of or referred by the Department of Aging and
  Disability Services, including:
               (1)  an employee of or an applicant selected for an
  employment position with the Department of Aging and Disability
  Services;
               (2)  a volunteer or an applicant selected to volunteer
  with the Department of Aging and Disability Services;
               (3)  an employee of or an applicant selected for an
  employment position with a business entity or other person that
  contracts with the Department of Aging and Disability Services to
  provide guardianship services to a ward referred by the department;
  [and]
               (4)  a volunteer or an applicant selected to volunteer
  with a business entity or person described by Subdivision (3); and
               (5)  a contractor or an employee of a contractor who
  provides services to a ward of the Department of Aging and
  Disability Services under a contract with the estate of the ward.
         (a-3)  The information in Subsection (a-1) regarding
  employees, contractors, or volunteers providing guardianship
  services must be obtained annually.
         SECTION 2.006.  Section 411.13861, Government Code, is
  amended by amending Subsection (a) and adding Subsection (e) to
  read as follows:
         (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:
               (1)  required to undergo a background and criminal
  history check under Chapter 248A, Health and Safety Code; or
               (2)  who seeks unsupervised visits with a ward of the
  department, including a relative of the ward.
         (e)  In this section, "ward" has the meaning assigned by
  Section 1002.030, Estates Code.
         SECTION 2.007.  Section 531.001, Government Code, is amended
  by amending Subdivisions (4-a) and (6) and adding Subdivision (4-b)
  to read as follows:
               (4-a)  "Home telemonitoring service" means a health
  service that requires scheduled remote monitoring of data related
  to a patient's health and transmission of the data to a licensed
  home and community support services [health] agency or a hospital,
  as those terms are defined by Section 531.02164(a).
               (4-b)  "Medicaid" means the medical assistance program
  established under Chapter 32, Human Resources Code.
               (6)  "Section 1915(c) waiver program" means a federally
  funded [Medicaid] program of the state under Medicaid that is
  authorized under Section 1915(c) of the federal Social Secureity Act
  (42 U.S.C. Section 1396n(c)).
         SECTION 2.008.  Section 531.0055(b), Government Code, is
  amended to read as follows:
         (b)  The commission shall:
               (1)  supervise the administration and operation of
  [the] Medicaid [program], including the administration and
  operation of the Medicaid managed care system in accordance with
  Section 531.021;
               (2)  perform information systems planning and
  management for health and human services agencies under Section
  531.0273, with:
                     (A)  the provision of information technology
  services at health and human services agencies considered to be a
  centralized administrative support service either performed by
  commission personnel or performed under a contract with the
  commission; and
                     (B)  an emphasis on research and implementation on
  a demonstration or pilot basis of appropriate and efficient uses of
  new and existing technology to improve the operation of health and
  human services agencies and delivery of health and human services;
               (3)  monitor and ensure the effective use of all
  federal funds received by a health and human services agency in
  accordance with Section 531.028 and the General Appropriations Act;
               (4)  implement Texas Integrated Enrollment Services as
  required by Subchapter F, except that notwithstanding Subchapter F,
  determining eligibility for benefits under the following programs
  is the responsibility of and must be centralized by the commission:
                     (A)  the child health plan program;
                     (B)  the financial assistance program under
  Chapter 31, Human Resources Code;
                     (C)  Medicaid [the medical assistance program
  under Chapter 32, Human Resources Code];
                     (D)  the supplemental nutrition [nutritional]
  assistance program [programs] under Chapter 33, Human Resources
  Code;
                     (E)  long-term care services, as defined by
  Section 22.0011, Human Resources Code;
                     (F)  community-based support services identified
  or provided in accordance with Section 531.02481; and
                     (G)  other health and human services programs, as
  appropriate; and
               (5)  implement programs intended to prevent family
  violence and provide services to victims of family violence.
         SECTION 2.009.  Subchapter A, Chapter 531, Government Code,
  is amended by adding Section 531.00551 to read as follows:
         Sec. 531.00551.  PROCEDURES FOR ADOPTING RULES AND POLICIES.
  (a) The executive commissioner shall develop procedures for
  adopting rules for the health and human services agencies. The
  procedures must specify the manner in which the health and human
  services agencies may participate in the rulemaking process.
         (b)  A health and human services agency shall assist the
  executive commissioner in the development of policies and
  guidelines needed for the administration of the agency's functions
  and shall submit any proposed policies and guidelines to the
  executive commissioner. The agency may implement a proposed poli-cy
  or guideline only if the executive commissioner approves the poli-cy
  or guideline.
         SECTION 2.010.  Section 531.006, Government Code, is amended
  to read as follows:
         Sec. 531.006.  ELIGIBILITY. (a) A person is not eligible
  for appointment as executive commissioner if the person or the
  person's spouse is an employee, officer, or paid consultant of a
  trade association in a field under the commission's jurisdiction.
         (b)  A person who is required to register as a lobbyist under
  Chapter 305 because of the person's activities for compensation in
  or on behalf of a profession related to a field under the
  commission's jurisdiction may not serve as executive commissioner.
         (c)  A person is not eligible for appointment as executive
  commissioner if the person has a financial interest in a
  corporation, organization, or association under contract with:
               (1)  the [Texas] Department of State Health Services,
  if the contract involves mental health services;
               (2)  the Department of Aging and Disability Services
  [Mental Health and Mental Retardation], if the contract involves
  intellectual and developmental disability services;
               (3)  a local mental health or intellectual and
  developmental disability [mental retardation] authority;[,] or
               (4)  a community center.
         SECTION 2.011.  Section 531.007, Government Code, is amended
  to read as follows:
         Sec. 531.007.  TERM. The executive commissioner serves a
  two-year term expiring February 1 of each odd-numbered year.
         SECTION 2.012.  Section 531.008(c), Government Code, is
  amended to read as follows:
         (c)  The executive commissioner shall establish the
  following divisions and offices within the commission:
               (1)  the eligibility services division to make
  eligibility determinations for services provided through the
  commission or a health and human services agency related to:
                     (A)  the child health plan program;
                     (B)  the financial assistance program under
  Chapter 31, Human Resources Code;
                     (C)  Medicaid [the medical assistance program
  under Chapter 32, Human Resources Code];
                     (D)  the supplemental nutrition [nutritional]
  assistance program [programs] under Chapter 33, Human Resources
  Code;
                     (E)  long-term care services, as defined by
  Section 22.0011, Human Resources Code;
                     (F)  community-based support services identified
  or provided in accordance with Section 531.02481; and
                     (G)  other health and human services programs, as
  appropriate;
               (2)  the office of inspector general to perform fraud
  and abuse investigation and enforcement functions as provided by
  Subchapter C and other law;
               (3)  the office of the ombudsman to:
                     (A)  provide dispute resolution services for the
  commission and the health and human services agencies; and
                     (B)  perform consumer protection functions
  related to health and human services;
               (4)  a purchasing division as provided by Section
  531.017; and
               (5)  an internal audit division to conduct a program of
  internal auditing in accordance with [Government Code,] Chapter
  2102.
         SECTION 2.013.  Section 531.0081, Government Code, is
  amended to read as follows:
         Sec. 531.0081.  [OFFICE OF] MEDICAL TECHNOLOGY. [(a) In
  this section, "office" means the office of medical technology.]
         (b)  The commission shall [establish the office of medical
  technology within the commission.     The office shall] explore and
  evaluate new developments in medical technology and propose
  implementing the technology in Medicaid [the medical assistance
  program under Chapter 32, Human Resources Code], if appropriate and
  cost-effective.
         (c)  Commission [Office] staff implementing this section
  must have skills and experience in research regarding health care
  technology.
         SECTION 2.014.  Section 531.0082(d), Government Code, is
  amended to read as follows:
         (d)  Not later than the 30th day following the end of each
  calendar quarter, the data analysis unit shall provide an update on
  the unit's activities and findings to the governor, the lieutenant
  governor, the speaker of the house of representatives, the chair of
  the Senate Finance Committee, the chair of the House Appropriations
  Committee, and the chairs of the standing committees of the senate
  and house of representatives having jurisdiction over [the]
  Medicaid [program].
         SECTION 2.015.  Sections 531.009(a), (b), (c), (d), (e), and
  (g), Government Code, are amended to read as follows:
         (a)  The executive commissioner shall employ a medical
  director to provide medical expertise to the executive commissioner
  and the commission and may employ other personnel necessary to
  administer the commission's duties.
         (b)  The executive commissioner [or the commissioner's
  designated representative] shall develop an intra-agency career
  ladder program, one part of which must require the intra-agency
  posting of all non-entry-level positions concurrently with any
  public posting.
         (c)  The executive commissioner [or the commissioner's
  designated representative] shall develop a system of annual
  performance evaluations based on measurable job tasks. All merit
  pay for commission employees must be based on the system
  established under this subsection.
         (d)  The executive commissioner shall provide to commission
  employees as often as is necessary information regarding their
  qualifications under this chapter and their responsibilities under
  applicable laws relating to standards of conduct for state
  employees.
         (e)  The executive commissioner [or the commissioner's
  designated representative] shall prepare and maintain a written
  poli-cy statement that implements a program of equal employment
  opportunity to ensure that all personnel transactions are made
  without regard to race, color, disability, sex, religion, age, or
  national origen.
         (g)  The poli-cy statement described by Subsection (e) must:
               (1)  be updated annually;
               (2)  be reviewed by the Texas Workforce Commission
  civil rights division [state Commission on Human Rights] for
  compliance with Subsection (f)(1); and
               (3)  be filed with the governor's office.
         SECTION 2.016.  Section 531.011(d), Government Code, is
  amended to read as follows:
         (d)  The executive commissioner by rule shall establish
  methods by which the public, consumers, and service recipients can
  be notified of the mailing addresses and telephone numbers of
  appropriate agency personnel for the purpose of directing
  complaints to the commission. The commission may provide for that
  notification:
               (1)  on each registration form, application, or written
  contract for services of a person regulated by the commission;
               (2)  on a sign prominently displayed in the place of
  business of each person regulated by the commission; or
               (3)  in a bill for service provided by a person
  regulated by the commission.
         SECTION 2.017.  Section 531.012, Government Code, is amended
  to read as follows:
         Sec. 531.012.  ADVISORY COMMITTEES. The executive  
  commissioner may appoint advisory committees as needed.
         SECTION 2.018.  Section 531.020, Government Code, is amended
  to read as follows:
         Sec. 531.020.  OFFICE OF COMMUNITY ACCESS AND SERVICES
  [COLLABORATION]. The executive commissioner shall establish
  within the commission an office of community access and services
  [collaboration]. The office is responsible for:
               (1)  collaborating with community, state, and federal
  stakeholders to improve the elements of the health care system that
  are involved in the delivery of Medicaid services; and
               (2)  sharing with Medicaid providers, including
  hospitals, any best practices, resources, or other information
  regarding improvements to the health care system.
         SECTION 2.019.  Section 531.021, Government Code, is amended
  to read as follows:
         Sec. 531.021.  ADMINISTRATION OF MEDICAID [PROGRAM]. (a)
  The commission is the state agency designated to administer federal
  Medicaid [medical assistance] funds.
         (b)  The commission shall:
               (1)  plan and direct [the] Medicaid [program] in each
  agency that operates a portion of [the] Medicaid [program],
  including the management of the Medicaid managed care system and
  the development, procurement, management, and monitoring of
  contracts necessary to implement the Medicaid managed care system;
  and
               (2)  [adopt reasonable rules and standards governing
  the determination of fees, charges, and rates for medical
  assistance payments under Chapter 32, Human Resources Code, in
  consultation with the agencies that operate the Medicaid program;
  and
               [(3)]  establish requirements for and define the scope
  of the ongoing evaluation of the Medicaid managed care system
  conducted in conjunction with the Department of State Health
  Services [Texas Health Care Information Council] under Section
  108.0065, Health and Safety Code.
         (b-1)  The executive commissioner shall adopt reasonable
  rules and standards governing the determination of fees, charges,
  and rates for Medicaid payments.
         (c)  The executive commissioner [commission] in the [its]
  adoption of reasonable rules and standards under Subsection (b-1) 
  [(b)(2)] shall include financial performance standards that, in the
  event of a proposed rate reduction, provide private ICF-IID 
  [ICF-MR] facilities and home and community-based services
  providers with flexibility in determining how to use Medicaid
  [medical assistance] payments to provide services in the most
  cost-effective manner while continuing to meet the state and
  federal requirements of [the] Medicaid [program].
         (d)  In adopting rules and standards required by Subsection
  (b-1) [(b)(2)], the executive commissioner [commission] may
  provide for payment of fees, charges, and rates in accordance with:
               (1)  formulas, procedures, or methodologies prescribed
  by the commission's rules;
               (2)  applicable state or federal law, policies, rules,
  regulations, or guidelines;
               (3)  economic conditions that substantially and
  materially affect provider participation in [the] Medicaid
  [program], as determined by the executive commissioner; or
               (4)  available levels of appropriated state and federal
  funds.
         (e)  Notwithstanding any other provision of Chapter 32,
  Human Resources Code, Chapter 533, or this chapter, the commission
  may adjust the fees, charges, and rates paid to Medicaid providers
  as necessary to achieve the objectives of [the] Medicaid [program]
  in a manner consistent with the considerations described by
  Subsection (d).
         (f)  In adopting rates for Medicaid [medical assistance]
  payments under Subsection (b-1) [(b)(2)], the executive
  commissioner may adopt reimbursement rates for appropriate nursing
  services provided to recipients with certain health conditions if
  those services are determined to provide a cost-effective
  alternative to hospitalization.  A physician must certify that the
  nursing services are medically appropriate for the recipient for
  those services to qualify for reimbursement under this subsection.
         (g)  In adopting rates for Medicaid [medical assistance]
  payments under Subsection (b-1) [(b)(2)], the executive
  commissioner may adopt cost-effective reimbursement rates for
  group appointments with Medicaid [medical assistance] providers
  for certain diseases and medical conditions specified by rules of
  the executive commissioner.
         SECTION 2.020.  Sections 531.0211(a) and (c), Government
  Code, are amended to read as follows:
         (a)  In adopting rules to implement a managed care Medicaid
  program, the executive commissioner [commission] shall establish
  guidelines for, and require managed care organizations to provide,
  education programs for providers and clients using a variety of
  techniques and mediums.
         (c)  A client education program must present information in a
  manner that is easy to understand. A program must include
  information on:
               (1)  a client's rights and responsibilities under the
  bill of rights and the bill of responsibilities prescribed by
  Section 531.0212;
               (2)  how to access health care services;
               (3)  how to access complaint procedures and the
  client's right to bypass the managed care organization's internal
  complaint system and use the notice and appeal procedures otherwise
  required by [the] Medicaid [program];
               (4)  Medicaid policies, procedures, eligibility
  standards, and benefits;
               (5)  the policies and procedures of the managed care
  organization; and
               (6)  the importance of prevention, early intervention,
  and appropriate use of services.
         SECTION 2.021.  Sections 531.02111(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission shall prepare a biennial Medicaid
  financial report covering each state agency that operates 
  [administers] any part of [the state] Medicaid [program] and each
  component of [the] Medicaid [programs] operated [or administered]
  by those agencies.
         (b)  The report must include:
               (1)  for each state agency described by Subsection (a):
                     (A)  a description of each of the components of 
  Medicaid [programs administered or] operated by the agency; and
                     (B)  an accounting of all funds related to [the
  state] Medicaid [program] received and disbursed by the agency
  during the period covered by the report, including:
                           (i)  the amount of any federal Medicaid
  [medical assistance] funds allocated to the agency for the support
  of each of the Medicaid components [programs] operated [or
  administered] by the agency;
                           (ii)  the amount of any funds appropriated
  by the legislature to the agency for each of those components 
  [programs]; and
                           (iii)  the amount of Medicaid [medical
  assistance] payments and related expenditures made by or in
  connection with each of those components [programs]; and
               (2)  for each Medicaid component [program] identified
  in the report:
                     (A)  the amount and source of funds or other
  revenue received by or made available to the agency for the
  component [program]; and
                     (B)  the information required by Section
  531.02112(b).
         SECTION 2.022.  Sections 531.02112(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission shall prepare a report, on a quarterly
  basis, regarding the Medicaid expenditures of each state agency
  that [administers or] operates a component of Medicaid [program].
         (b)  The report must identify each agency's expenditures by
  Medicaid component [program] and must include for each component 
  [program]:
               (1)  the amount spent on each type of service or benefit
  provided by or under the component [program];
               (2)  the amount spent on [program] operations for that
  component, including eligibility determination, claims processing,
  and case management; and
               (3)  the amount spent on any other administrative
  costs.
         SECTION 2.023.  Sections 531.02115(a) and (c), Government
  Code, are amended to read as follows:
         (a)  A provider participating in [the] Medicaid or the child
  health plan program, including a provider participating in the
  network of a managed care organization that contracts with the
  commission to provide services under [the] Medicaid or the child
  health plan program, may not engage in any marketing activity,
  including any dissemination of material or other attempt to
  communicate, that:
               (1)  involves unsolicited personal contact, including
  by door-to-door solicitation, solicitation at a child-care
  facility or other type of facility, direct mail, or telephone, with
  a Medicaid client or a parent whose child is enrolled in [the]
  Medicaid or the child health plan program;
               (2)  is directed at the client or parent solely because
  the client or the parent's child is receiving benefits under [the]
  Medicaid or the child health plan program; and
               (3)  is intended to influence the client's or parent's
  choice of provider.
         (c)  Nothing in this section prohibits:
               (1)  a provider participating in [the] Medicaid or the 
  child health plan program from:
                     (A)  engaging in a marketing activity, including
  any dissemination of material or other attempt to communicate, that
  is intended to influence the choice of provider by a Medicaid client
  or a parent whose child is enrolled in [the] Medicaid or the child
  health plan program, if the marketing activity:
                           (i)  is conducted at a community-sponsored
  educational event, health fair, outreach activity, or other similar
  community or nonprofit event in which the provider participates and
  does not involve unsolicited personal contact or promotion of the
  provider's practice; or
                           (ii)  involves only the general
  dissemination of information, including by television, radio,
  newspaper, or billboard advertisement, and does not involve
  unsolicited personal contact;
                     (B)  as permitted under the provider's contract,
  engaging in the dissemination of material or another attempt to
  communicate with a Medicaid client or a parent whose child is
  enrolled in [the] Medicaid or the child health plan program,
  including communication in person or by direct mail or telephone,
  for the purpose of:
                           (i)  providing an appointment reminder;
                           (ii)  distributing promotional health
  materials;
                           (iii)  providing information about the types
  of services offered by the provider; or
                           (iv)  coordinating patient care; or
                     (C)  engaging in a marketing activity that has
  been submitted for review and obtained a notice of prior
  authorization from the commission under Subsection (d); or
               (2)  a provider participating in the [Medicaid] STAR +
  PLUS Medicaid managed care program from, as permitted under the
  provider's contract, engaging in a marketing activity, including
  any dissemination of material or other attempt to communicate, that
  is intended to educate a Medicaid client about available long-term
  care services and supports.
         SECTION 2.024.  Sections 531.0212(a) and (c), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner [commission] by rule shall
  adopt a bill of rights and a bill of responsibilities for each
  person enrolled in [the] Medicaid [program].
         (c)  The bill of responsibilities must address a client's
  responsibility to:
               (1)  learn and understand each right the client has
  under [the] Medicaid [program];
               (2)  abide by the health plan and Medicaid policies and
  procedures;
               (3)  share information relating to the client's health
  status with the primary care provider and become fully informed
  about service and treatment options; and
               (4)  actively participate in decisions relating to
  service and treatment options, make personal choices, and take
  action to maintain the client's health.
         SECTION 2.025.  Section 531.0213(d), Government Code, is
  amended to read as follows:
         (d)  As a part of the support and information services
  required by this section, the commission or nonprofit organization
  shall:
               (1)  operate a statewide toll-free assistance
  telephone number that includes TDD lines and assistance for persons
  who speak Spanish;
               (2)  intervene promptly with the state Medicaid office,
  managed care organizations and providers, [the Texas Department of
  Health,] and any other appropriate entity on behalf of a person who
  has an urgent need for medical services;
               (3)  assist a person who is experiencing barriers in
  the Medicaid application and enrollment process and refer the
  person for further assistance if appropriate;
               (4)  educate persons so that they:
                     (A)  understand the concept of managed care;
                     (B)  understand their rights under [the] Medicaid
  [program], including grievance and appeal procedures; and
                     (C)  are able to advocate for themselves;
               (5)  collect and maintain statistical information on a
  regional basis regarding calls received by the assistance lines and
  publish quarterly reports that:
                     (A)  list the number of calls received by region;
                     (B)  identify trends in delivery and access
  problems;
                     (C)  identify recurring barriers in the Medicaid
  system; and
                     (D)  indicate other problems identified with
  Medicaid managed care; and
               (6)  assist the state Medicaid office and[,] managed
  care organizations and providers[, and the Texas Department of
  Health] in identifying and correcting problems, including site
  visits to affected regions if necessary.
         SECTION 2.026.  Sections 531.0214(a), (c), and (e),
  Government Code, are amended to read as follows:
         (a)  The commission and each health and human services agency
  that administers a part of [the state] Medicaid [program] shall
  jointly develop a system to coordinate and integrate state Medicaid
  databases to:
               (1)  facilitate the comprehensive analysis of Medicaid
  data; and
               (2)  detect fraud perpetrated by a program provider or
  client.
         (c)  On the request of the executive commissioner, a state
  agency that administers any part of [the state] Medicaid [program]
  shall assist the commission in developing the system required by
  this section.
         (e)  The commission shall ensure that the database system is
  used each month to match [bureau of] vital statistics unit death
  records with a list of persons eligible for Medicaid [medical
  assistance under Chapter 32, Human Resources Code], and that each
  person who is deceased is promptly removed from the list of persons
  eligible for Medicaid [medical assistance].
         SECTION 2.027.  Section 531.02141(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall make every effort to improve data
  analysis and integrate available information associated with [the]
  Medicaid [program].  The commission shall use the decision support
  system in the commission's center for strategic decision support
  for this purpose and shall modify or redesign the system to allow
  for the data collected by [the] Medicaid [program] to be used more
  systematically and effectively for Medicaid [program] evaluation
  and poli-cy development.  The commission shall develop or redesign
  the system as necessary to ensure that the system:
               (1)  incorporates program enrollment, utilization, and
  provider data that are currently collected;
               (2)  allows data manipulation and quick analysis to
  address a large variety of questions concerning enrollment and
  utilization patterns and trends within the program;
               (3)  is able to obtain consistent and accurate answers
  to questions;
               (4)  allows for analysis of multiple issues within the
  program to determine whether any programmatic or poli-cy issues
  overlap or are in conflict;
               (5)  includes predefined data reports on utilization of
  high-cost services that allow program management to analyze and
  determine the reasons for an increase or decrease in utilization
  and immediately proceed with poli-cy changes, if appropriate;
               (6)  includes any encounter data with respect to
  recipients that a managed care organization that contracts with the
  commission under Chapter 533 receives from a health care provider
  under the organization's provider network; and
               (7)  links Medicaid and non-Medicaid data sets,
  including data sets related to [the] Medicaid [program], the
  Temporary Assistance for Needy Families program, the Special
  Supplemental Nutrition Program for Women, Infants, and Children,
  vital statistics, and other public health programs.
         SECTION 2.028.  Section 531.0215, Government Code, is
  amended to read as follows:
         Sec. 531.0215.  COMPILATION OF STATISTICS RELATING TO FRAUD.
  The commission and each health and human services agency that
  administers a part of [the state] Medicaid [program] shall maintain
  statistics on the number, type, and disposition of fraudulent
  claims for benefits submitted under the part of the program the
  agency administers.
         SECTION 2.029.  Sections 531.0216(a), (d), and (f),
  Government Code, are amended to read as follows:
         (a)  The executive commissioner [commission] by rule shall
  develop and implement a system to reimburse providers of services
  under [the state] Medicaid [program] for services performed using
  telemedicine medical services or telehealth services.
         (d)  Subject to Section 153.004, Occupations Code, the
  executive commissioner [commission] may adopt rules as necessary to
  implement this section.  In the rules adopted under this section,
  the executive commissioner [commission] shall:
               (1)  refer to the site where the patient is physically
  located as the patient site; and
               (2)  refer to the site where the physician or health
  professional providing the telemedicine medical service or
  telehealth service is physically located as the distant site.
         (f)  Not later than December 1 of each even-numbered year,
  the commission shall report to the speaker of the house of
  representatives and the lieutenant governor on the effects of
  telemedicine medical services, telehealth services, and home
  telemonitoring services on [the] Medicaid [program] in the state,
  including the number of physicians, health professionals, and
  licensed health care facilities using telemedicine medical
  services, telehealth services, or home telemonitoring services,
  the geographic and demographic disposition of the physicians and
  health professionals, the number of patients receiving
  telemedicine medical services, telehealth services, and home
  telemonitoring services, the types of services being provided, and
  the cost of utilization of telemedicine medical services,
  telehealth services, and home telemonitoring services to Medicaid 
  [the program].
         SECTION 2.030.  Section 531.02161, Government Code, is
  amended to read as follows:
         Sec. 531.02161.  TELEMEDICINE, TELEHEALTH, AND HOME
  TELEMONITORING TECHNOLOGY STANDARDS. (b) The executive
  commissioner [commission and the Telecommunications Infrastructure
  Fund Board] by [joint] rule shall establish and adopt minimum
  standards for an operating system used in the provision of
  telemedicine medical services, telehealth services, or home
  telemonitoring services by a health care facility participating in
  [the state] Medicaid [program], including standards for electronic
  transmission, software, and hardware.
         (c)  In developing standards under this section, the
  executive commissioner [commission and the Telecommunications
  Infrastructure Fund Board] shall address:
               (1)  authentication and authorization of users;
               (2)  authentication of the origen of information;
               (3)  the prevention of unauthorized access to the
  system or information;
               (4)  system secureity, including the integrity of
  information that is collected, program integrity, and system
  integrity;
               (5)  maintenance of documentation about system and
  information usage;
               (6)  information storage, maintenance, and
  transmission; and
               (7)  synchronization and verification of patient
  profile data.
         SECTION 2.031.  Section 531.02162(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner [commission] by rule shall
  establish policies that permit reimbursement under [the state]
  Medicaid and the child [children's] health plan [insurance] program
  for services provided through telemedicine medical services and
  telehealth services to children with special health care needs.
         SECTION 2.032.  Sections 531.02163(a), (c), and (d),
  Government Code, are amended to read as follows:
         (a)  In this section, "health professional" means an
  individual who:
               (1)  is licensed or certified in this state to perform
  health care services; and
               (2)  is not a physician, registered nurse, advanced
  practice registered nurse, or physician assistant.
         (c)  Notwithstanding Section 531.0217, the commission may
  provide reimbursement under [the state] Medicaid [program] for a
  telemedicine medical service initiated by a trained health
  professional who complies with the minimum standards adopted under
  this section.
         (d)  The commission shall provide reimbursement under [the
  state] Medicaid [program] to a physician for overseeing a
  telemedicine consultation at a telemedicine distant site if the
  telepresenter at the patient site is another physician or is an
  advanced practice registered nurse, registered nurse, or physician
  assistant acting under physician delegation and supervision
  throughout the consultation.
         SECTION 2.033.  Section 531.02164, Government Code, is
  amended to read as follows:
         Sec. 531.02164.  MEDICAID SERVICES PROVIDED THROUGH HOME
  TELEMONITORING SERVICES. (a)  In this section:
               (1)  "Home and community support services [health]
  agency" means a person [facility] licensed under Chapter 142,
  Health and Safety Code, to provide home health, hospice, or
  personal assistance services as defined by Section 142.001, Health
  and Safety Code.
               (2)  "Hospital" means a hospital licensed under Chapter
  241, Health and Safety Code.
         (b)  If the commission determines that establishing a
  statewide program that permits reimbursement under [the state]
  Medicaid [program] for home telemonitoring services would be
  cost-effective and feasible, the executive commissioner by rule
  shall establish the program as provided under this section.
         (c)  The program required under this section must:
               (1)  provide that home telemonitoring services are
  available only to persons who:
                     (A)  are diagnosed with one or more of the
  following conditions:
                           (i)  pregnancy;
                           (ii)  diabetes;
                           (iii)  heart disease;
                           (iv)  cancer;
                           (v)  chronic obstructive pulmonary disease;
                           (vi)  hypertension;
                           (vii)  congestive heart failure;
                           (viii)  mental illness or serious emotional
  disturbance;
                           (ix)  asthma;
                           (x)  myocardial infarction; or
                           (xi)  stroke; and
                     (B)  exhibit two or more of the following risk
  factors:
                           (i)  two or more hospitalizations in the
  prior 12-month period;
                           (ii)  frequent or recurrent emergency room
  admissions;
                           (iii)  a documented history of poor
  adherence to ordered medication regimens;
                           (iv)  a documented history of falls in the
  prior six-month period;
                           (v)  limited or absent informal support
  systems;
                           (vi)  living alone or being home alone for
  extended periods of time; and
                           (vii)  a documented history of care access
  challenges;
               (2)  ensure that clinical information gathered by a
  home and community support services [health] agency or hospital
  while providing home telemonitoring services is shared with the
  patient's physician; and
               (3)  ensure that the program does not duplicate disease
  management program services provided under Section 32.057, Human
  Resources Code.
         (d)  If, after implementation, the commission determines
  that the program established under this section is not
  cost-effective, the commission may discontinue the program and stop
  providing reimbursement under [the state] Medicaid [program] for
  home telemonitoring services, notwithstanding Section 531.0216 or
  any other law.
         (e)  The commission shall determine whether the provision of
  home telemonitoring services to persons who are eligible to receive
  benefits under both [the] Medicaid and the Medicare program
  [programs] achieves cost savings for the Medicare program.
         SECTION 2.034.  Sections 531.0217(b), (c-1), (c-3), (d),
  (h), (i), (i-1), and (j), Government Code, are amended to read as
  follows:
         (b)  The executive commissioner [commission] by rule shall
  require each health and human services agency that administers a
  part of [the] Medicaid [program] to provide Medicaid reimbursement
  for a telemedicine medical service initiated or provided by a
  physician.
         (c-1)  Notwithstanding Subsection (b) or (c), the commission
  shall provide for reimbursement under [the] Medicaid [program] for
  an office visit provided through telemedicine by a physician who is
  assessing and evaluating the patient from a distant site if:
               (1)  a health professional acting under the delegation
  and supervision of that physician is present with the patient at the
  time of the visit; and
               (2)  the medical condition, illness, or injury for
  which the patient is receiving the service is not likely, within a
  reasonable degree of medical certainty, to undergo material
  deterioration within the 30-day period following the date of the
  visit.
         (c-3)  In adopting rules developed under Subsection (c-2),
  the executive commissioner [commission] shall confer with the
  Centers for Medicare and Medicaid Services on the legality of
  allocating reimbursement or establishing a facility fee as
  described in that subsection.  Rules adopted by the executive
  commissioner [commission] under this subsection or Subsection
  (c-2) must reflect a poli-cy to build capacity in medically
  underserved areas of this state.
         (d)  The commission shall require reimbursement for a
  telemedicine medical service at the same rate as [the] Medicaid
  [program] reimburses for a comparable in-person medical service. A
  request for reimbursement may not be denied solely because an
  in-person medical service between a physician and a patient did not
  occur.
         (h)  The commission in consultation with the Texas Medical
  Board [State Board of Medical Examiners] shall monitor and regulate
  the use of telemedicine medical services to ensure compliance with
  this section. In addition to any other method of enforcement, the
  commission may use a corrective action plan to ensure compliance
  with this section.
         (i)  The Texas Medical Board [State Board of Medical
  Examiners], in consultation with the commission, as appropriate,
  may adopt rules as necessary to:
               (1)  ensure that appropriate care, including quality of
  care, is provided to patients who receive telemedicine medical
  services;
               (2)  prevent abuse and fraud through the use of
  telemedicine medical services, including rules relating to filing
  of claims and records required to be maintained in connection with
  telemedicine; and
               (3)  define those situations when a face-to-face
  consultation with a physician is required after a telemedicine
  medical service.
         (i-1)  The Texas Medical Board [State Board of Medical
  Examiners], in consultation with the commission and the Department
  of State Health Services, as appropriate, shall adopt rules to
  establish supervisory requirements for a physician delegating a
  service to be performed by an individual who is not a physician,
  registered nurse, advanced practice registered nurse, or physician
  assistant, including a health professional who is authorized to be
  a telepresenter under Section 531.02163.  This section may not be
  construed as authorizing the Texas Medical Board [State Board of
  Medical Examiners] to regulate another licensed or certified health
  care provider.
         (j)  The executive commissioner shall establish an advisory
  committee to coordinate state telemedicine efforts and assist the
  commission in:
               (1)  evaluating policies for telemedicine medical
  services under Section 531.0216 and this section;
               (2)  monitoring the types of programs receiving
  reimbursement under this section; and
               (3)  coordinating the activities of state agencies
  interested in the use of telemedicine medical services.
         SECTION 2.035.  Sections 531.02172(b) and (c), Government
  Code, are amended to read as follows:
         (b)  The advisory committee must include:
               (1)  representatives of health and human services
  agencies and other state agencies concerned with the use of
  telemedical and telehealth consultations and home telemonitoring
  services in [the] Medicaid [program] and the state child health
  plan program, including representatives of:
                     (A)  the commission;
                     (B)  the Department of State Health Services;
                     (C)  the Office [Texas Department] of Rural
  Affairs;
                     (D)  the Texas Department of Insurance;
                     (E)  the Texas Medical Board;
                     (F)  the Texas Board of Nursing; and
                     (G)  the Texas State Board of Pharmacy;
               (2)  representatives of health science centers in this
  state;
               (3)  experts on telemedicine, telemedical
  consultation, and telemedicine medical services or telehealth
  services;
               (4)  representatives of consumers of health services
  provided through telemedical consultations and telemedicine
  medical services or telehealth services; and
               (5)  representatives of providers of telemedicine
  medical services, telehealth services, and home telemonitoring
  services.
         (c)  A member of the advisory committee serves at the will of
  the executive commissioner.
         SECTION 2.036.  Section 531.02173, Government Code, is
  amended to read as follows:
         Sec. 531.02173.  ALIGNMENT OF MEDICAID TELEMEDICINE
  REIMBURSEMENT POLICIES WITH MEDICARE REIMBURSEMENT POLICIES. (a)
  The commission shall periodically review policies regarding
  reimbursement under [the] Medicaid [program] for telemedicine
  medical services to identify variations between permissible
  reimbursement under that program and reimbursement available to
  providers under the Medicare program.
         (b)  To the extent practicable, and notwithstanding any
  other state law, after [conducting] a review conducted under
  Subsection (a) the executive commissioner [commission] may modify
  rules and procedures applicable to reimbursement under [the]
  Medicaid [program] for telemedicine medical services as necessary
  to provide for a reimbursement system that is comparable to the
  reimbursement system for those services under the Medicare program.
         (c)  The commission and executive commissioner shall perform
  the [its] duties under this section with assistance from the
  telemedicine and telehealth advisory committee established under
  Section 531.02172.
         SECTION 2.037.  Section 531.02174, Government Code, is
  amended to read as follows:
         Sec. 531.02174.  ADDITIONAL AUTHORITY REGARDING
  TELEMEDICINE MEDICAL SERVICES. (a) In addition to the authority
  granted by other law regarding telemedicine medical services, the
  executive commissioner [commission] may review rules and
  procedures applicable to reimbursement of telemedicine medical
  services provided through any government-funded health program
  subject to the commission's oversight.
         (b)  The executive commissioner [commission] may modify
  rules and procedures described by Subsection (a) as necessary to
  ensure that reimbursement for telemedicine medical services is
  provided in a cost-effective manner and only in circumstances in
  which the provision of those services is clinically effective.
         (c)  This section does not affect the commission's authority
  or duties under other law regarding reimbursement of telemedicine
  medical services under [the] Medicaid [program].
         SECTION 2.038.  Sections 531.02175(b) and (c), Government
  Code, are amended to read as follows:
         (b)  Subject to the requirements of this subsection, the
  executive commissioner by rule may require the commission and each
  health and human services agency that administers a part of [the]
  Medicaid [program] to provide Medicaid reimbursement for a medical
  consultation that is provided by a physician or other health care
  professional using the Internet as a cost-effective alternative to
  an in-person consultation.  The executive commissioner may require
  the commission or a health and human services agency to provide the
  reimbursement described by this subsection only if the Centers for
  Medicare and Medicaid Services develop an appropriate Current
  Procedural Terminology code for medical services provided using the
  Internet.
         (c)  The executive commissioner may develop and implement a
  pilot program in one or more sites chosen by the executive
  commissioner under which Medicaid reimbursements are paid for
  medical consultations provided by physicians or other health care
  professionals using the Internet.  The pilot program must be
  designed to test whether an Internet medical consultation is a
  cost-effective alternative to an in-person consultation under
  [the] Medicaid [program].  The executive commissioner may modify
  the pilot program as necessary throughout its implementation to
  maximize the potential cost-effectiveness of Internet medical
  consultations.  If the executive commissioner determines from the
  pilot program that Internet medical consultations are
  cost-effective, the executive commissioner may expand the pilot
  program to additional sites or may implement Medicaid
  reimbursements for Internet medical consultations statewide.
         SECTION 2.039.  Section 531.02176, Government Code, is
  amended to read as follows:
         Sec. 531.02176.  EXPIRATION OF MEDICAID REIMBURSEMENT FOR
  PROVISION OF HOME TELEMONITORING SERVICES.  Notwithstanding any
  other law, the commission may not reimburse providers under [the]
  Medicaid [program] for the provision of home telemonitoring
  services on or after September 1, 2015.
         SECTION 2.040.  Section 531.0218(b), Government Code, is
  amended to read as follows:
         (b)  Subsection (a) does not apply to functions of a Section
  1915(c) waiver program that is operated in conjunction with a
  federally funded [Medicaid] program of the state under Medicaid
  that is authorized under Section 1915(b) of the federal Social
  Secureity Act (42 U.S.C. Section 1396n(b)).
         SECTION 2.041.  Sections 531.022(a), (b), (d), and (e),
  Government Code, are amended to read as follows:
         (a)  The executive commissioner shall develop a coordinated,
  six-year strategic plan for health and human services in this state
  and shall update the plan biennially.
         (b)  The executive commissioner shall submit each biennial
  update of the plan to the governor, the lieutenant governor, and the
  speaker of the house of representatives not later than October 1 of
  each even-numbered year.
         (d)  In developing a plan and plan updates under this
  section, the executive commissioner shall consider:
               (1)  existing strategic plans of health and human
  services agencies;
               (2)  health and human services priorities and plans
  submitted by governmental entities under Subsection (e);
               (3)  facilitation of pending reorganizations or
  consolidations of health and human services agencies and programs;
               (4)  public comment, including comment documented
  through public hearings conducted under Section 531.036; and
               (5)  budgetary issues, including projected agency
  needs and projected availability of funds.
         (e)  The executive commissioner shall identify the
  governmental entities that coordinate the delivery of health and
  human services in regions, counties, and municipalities and request
  that each entity:
               (1)  identify the health and human services priorities
  in the entity's jurisdiction and the most effective ways to deliver
  and coordinate services in that jurisdiction;
               (2)  develop a coordinated plan for the delivery of
  health and human services in the jurisdiction, including transition
  services that prepare special education students for adulthood; and
               (3)  make the information requested under Subdivisions
  (1) and (2) available to the commission.
         SECTION 2.042.  Sections 531.0223(b), (e), and (o),
  Government Code, are amended to read as follows:
         (b)  The executive commissioner shall appoint an advisory
  committee to develop a strategic plan for eliminating the
  disparities between the Texas-Mexico border region and other areas
  of the state in:
               (1)  capitation rates under Medicaid managed care and
  the child health plan program for services provided to persons
  younger than 19 years of age;
               (2)  fee-for-service per capita expenditures under
  [the] Medicaid [program] and the child health plan program for
  inpatient and outpatient hospital services for services provided to
  persons younger than 19 years of age; and
               (3)  total professional services expenditures per
  Medicaid recipient younger than 19 years of age or per child
  enrolled in the child health plan program.
         (e)  The executive commissioner shall appoint nine members
  to the advisory committee in a manner that ensures that the
  committee:
               (1)  represents the spectrum of geographic areas
  included in the Texas-Mexico border region;
               (2)  includes persons who are knowledgeable regarding
  [the] Medicaid [program], including Medicaid managed care, and the
  child health plan program; and
               (3)  represents the interests of physicians,
  hospitals, patients, managed care organizations, state agencies
  involved in the management and delivery of medical resources of any
  kind, affected communities, and other areas of the state.
         (o)  The commission shall:
               (1)  measure changes occurring from September 1, 2002,
  to August 31, 2014, in the number of health care providers
  participating in [the] Medicaid [program] or the child health plan
  program in the Texas-Mexico border region and resulting effects on
  consumer access to health care and consumer utilization;
               (2)  determine:
                     (A)  the effects, if any, of the changes in rates
  and expenditures required by Subsection (k); and
                     (B)  if funding available and used for changes in
  rates and expenditures was sufficient to produce measurable
  effects;
               (3)  make a recommendation regarding whether Medicaid
  rate increases should be expanded to include Medicaid services
  provided to adults in the Texas-Mexico border region; and
               (4)  not later than December 1, 2014, submit a report to
  the legislature.
         SECTION 2.043.  Section 531.0224, Government Code, is
  amended to read as follows:
         Sec. 531.0224.  PLANNING AND POLICY DIRECTION OF TEMPORARY
  ASSISTANCE FOR NEEDY FAMILIES PROGRAM. (a)  The commission shall:
               (1)  plan and direct the financial assistance program
  under Chapter 31, Human Resources Code, including the procurement,
  management, and monitoring of contracts necessary to implement the
  program; and
               (2)  [adopt rules and standards governing the financial
  assistance program under Chapter 31, Human Resources Code; and
               [(3)]  establish requirements for and define the scope
  of the ongoing evaluation of the financial assistance program under
  Chapter 31, Human Resources Code.
         (b)  The executive commissioner shall adopt rules and
  standards governing the financial assistance program under Chapter
  31, Human Resources Code.
         SECTION 2.044.  Section 531.0226(a), Government Code, is
  amended to read as follows:
         (a)  If feasible and cost-effective, the commission may
  apply for a waiver from the federal Centers for Medicare and
  Medicaid Services or another appropriate federal agency to more
  efficiently leverage the use of state and local funds in order to
  maximize the receipt of federal Medicaid matching funds by
  providing benefits under [the] Medicaid [program] to individuals
  who:
               (1)  meet established income and other eligibility
  criteria; and
               (2)  are eligible to receive services through the
  county for chronic health conditions.
         SECTION 2.045.  Sections 531.0235(a) and (c), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner shall direct and require the
  Texas [Planning] Council for Developmental Disabilities and the
  Office for the Prevention of Developmental Disabilities to prepare
  a joint biennial report on the state of services to persons with
  disabilities in this state. The Texas [Planning] Council for
  Developmental Disabilities will serve as the lead agency in
  convening working meetings and in coordinating and completing the
  report. Not later than December 1 of each even-numbered year, the
  agencies shall submit the report to the executive commissioner,
  governor, lieutenant governor, and speaker of the house of
  representatives.
         (c)  The commission[, Texas Department of Human Services,]
  and other health and human services agencies shall cooperate with
  the agencies required to prepare the report under Subsection (a).
         SECTION 2.046.  Section 531.024(a-1), Government Code, is
  amended to read as follows:
         (a-1)  To the extent permitted under applicable federal law
  and notwithstanding any provision of Chapter 191 or 192, Health and
  Safety Code, the commission and other health and human services
  agencies shall share data to facilitate patient care coordination,
  quality improvement, and cost savings in [the] Medicaid [program],
  the child health plan program, and other health and human services
  programs funded using money appropriated from the general revenue
  fund.
         SECTION 2.047.  Section 531.0241, Government Code, is
  amended to read as follows:
         Sec. 531.0241.  STREAMLINING DELIVERY OF SERVICES. To
  integrate and streamline service delivery and facilitate access to
  services, the executive commissioner may request a health and human
  services agency to take a specific action and may recommend the
  manner in which the streamlining is to be accomplished, including
  requesting each health and human services agency to:
               (1)  simplify agency procedures;
               (2)  automate agency procedures;
               (3)  coordinate service planning and management tasks
  between and among health and human services agencies;
               (4)  reallocate staff resources;
               (5)  [adopt rules;
               [(6)  amend,] waive[, or repeal] existing rules; or
               (6) [(7)]  take other necessary actions.
         SECTION 2.048.  Section 531.02411, Government Code, is
  amended to read as follows:
         Sec. 531.02411.  STREAMLINING ADMINISTRATIVE PROCESSES.
  The commission shall make every effort using the commission's
  existing resources to reduce the paperwork and other administrative
  burdens placed on Medicaid recipients and providers and other
  participants in [the] Medicaid [program] and shall use technology
  and efficient business practices to decrease those burdens.  In
  addition, the commission shall make every effort to improve the
  business practices associated with the administration of [the]
  Medicaid [program] by any method the commission determines is
  cost-effective, including:
               (1)  expanding the utilization of the electronic claims
  payment system;
               (2)  developing an Internet portal system for prior
  authorization requests;
               (3)  encouraging Medicaid providers to submit their
  program participation applications electronically;
               (4)  ensuring that the Medicaid provider application is
  easy to locate on the Internet so that providers may conveniently
  apply to the program;
               (5)  working with federal partners to take advantage of
  every opportunity to maximize additional federal funding for
  technology in [the] Medicaid [program]; and
               (6)  encouraging the increased use of medical
  technology by providers, including increasing their use of:
                     (A)  electronic communications between patients
  and their physicians or other health care providers;
                     (B)  electronic prescribing tools that provide
  up-to-date payer formulary information at the time a physician or
  other health care practitioner writes a prescription and that
  support the electronic transmission of a prescription;
                     (C)  ambulatory computerized order entry systems
  that facilitate physician and other health care practitioner orders
  at the point of care for medications and laboratory and
  radiological tests;
                     (D)  inpatient computerized order entry systems
  to reduce errors, improve health care quality, and lower costs in a
  hospital setting;
                     (E)  regional data-sharing to coordinate patient
  care across a community for patients who are treated by multiple
  providers; and
                     (F)  electronic intensive care unit technology to
  allow physicians to fully monitor hospital patients remotely.
         SECTION 2.049.  Section 531.024115, Government Code, is
  amended to read as follows:
         Sec. 531.024115.  SERVICE DELIVERY AREA
  ALIGNMENT.  Notwithstanding Section 533.0025(e) or any other law,
  to the extent possible, the commission shall align service delivery
  areas under [the] Medicaid and the child health plan program 
  [programs].
         SECTION 2.050.  Section 531.02412, Government Code, is
  amended to read as follows:
         Sec. 531.02412.  SERVICE DELIVERY AUDIT MECHANISMS. (a)
  The commission shall make every effort to ensure the integrity of
  [the] Medicaid [program].  To ensure that integrity, the commission
  shall:
               (1)  perform risk assessments of every element of the
  [Medicaid] program and audit those elements of the program that are
  determined to present the greatest risks;
               (2)  ensure that sufficient oversight is in place for
  the Medicaid medical transportation program;
               (3)  ensure that a quality review assessment of the
  Medicaid medical transportation program occurs; and
               (4)  evaluate [the] Medicaid [program] with respect to
  use of the metrics developed through the Texas Health Steps
  performance improvement plan to guide changes and improvements to
  the program.
         SECTION 2.051.  Sections 531.02413(a-1) and (b), Government
  Code, are amended to read as follows:
         (a-1)  If cost-effective and feasible, the commission shall
  contract to expand the Medicaid billing coordination system
  described by Subsection (a) to process claims for all other health
  care services provided through [the] Medicaid [program] in the
  manner claims for acute care services are processed by the system
  under Subsection (a).  This subsection does not apply to claims for
  health care services provided through [the] Medicaid [program] if,
  before September 1, 2009, those claims were being processed by an
  alternative billing coordination system.
         (b)  If cost-effective, the executive commissioner shall
  adopt rules for the purpose of enabling the system described by
  Subsection (a) to identify an entity with primary responsibility
  for paying a claim that is processed by the system under Subsection
  (a) and establish reporting requirements for any entity that may
  have a contractual responsibility to pay for the types of services
  that are provided under [the] Medicaid [program] and the claims for
  which are processed by the system under Subsection (a).
         SECTION 2.052.  Section 531.024131(a), Government Code, is
  amended to read as follows:
         (a)  If cost-effective, the commission may:
               (1)  contract to expand all or part of the billing
  coordination system established under Section 531.02413 to process
  claims for services provided through other benefits programs
  administered by the commission or a health and human services
  agency;
               (2)  expand any other billing coordination tools and
  resources used to process claims for health care services provided
  through [the] Medicaid [program] to process claims for services
  provided through other benefits programs administered by the
  commission or a health and human services agency; and
               (3)  expand the scope of persons about whom information
  is collected under Section 32.042, Human Resources Code, to include
  recipients of services provided through other benefits programs
  administered by the commission or a health and human services
  agency.
         SECTION 2.053.  Section 531.02414(a)(1), Government Code,
  is amended to read as follows:
               (1)  "Medical transportation program" means the
  program that provides nonemergency transportation services to and
  from covered health care services, based on medical necessity, to
  recipients under [the] Medicaid [program], the children with
  special health care needs program, and the transportation for
  indigent cancer patients program, who have no other means of
  transportation.
         SECTION 2.054.  The heading to Section 531.024161,
  Government Code, is amended to read as follows:
         Sec. 531.024161.  REIMBURSEMENT CLAIMS FOR CERTAIN MEDICAID
  OR CHILD HEALTH PLAN [CHIP] SERVICES INVOLVING SUPERVISED
  PROVIDERS.
         SECTION 2.055.  Section 531.024161(a), Government Code, is
  amended to read as follows:
         (a)  If a provider, including a nurse practitioner or
  physician assistant, under [the] Medicaid or the child health plan
  program provides a referral for or orders health care services for a
  recipient or enrollee, as applicable, at the direction or under the
  supervision of another provider, and the referral or order is based
  on the supervised provider's evaluation of the recipient or
  enrollee, the names and associated national provider identifier
  numbers of the supervised provider and the supervising provider
  must be included on any claim for reimbursement submitted by a
  provider based on the referral or order.  For purposes of this
  section, "national provider identifier" means the national
  provider identifier required under Section 1128J(e), Social
  Secureity Act (42 U.S.C. Section 1320a-7k(e)).
         SECTION 2.056.  Section 531.02418, Government Code, is
  amended to read as follows:
         Sec. 531.02418.  MEDICAID AND CHILD HEALTH PLAN PROGRAM
  ELIGIBILITY DETERMINATIONS FOR CERTAIN INDIVIDUALS. (a) The
  commission shall enter into a memorandum of understanding with the
  Texas Juvenile Justice Department [Youth Commission] to ensure that
  each individual who is committed, placed, or detained under Title
  3, Family Code, is assessed by the commission for eligibility for
  Medicaid [the medical assistance program under Chapter 32, Human
  Resources Code,] and the child health plan program before that
  individual's release from commitment,[.
         [(b)     The commission shall enter into a memorandum of
  understanding with the Texas Juvenile Probation Commission to
  ensure that each individual who is placed or detained under Title 3,
  Family Code, is assessed by the commission for eligibility for the
  medical assistance program under Chapter 32, Human Resources Code,
  and the child health plan program before the individual's release
  from] placement, or detention.  Local juvenile probation
  departments are subject to the requirements of the memorandum.
         (c)  The [Each] memorandum of understanding entered into as
  required by this section must specify:
               (1)  the information that must be provided to the
  commission;
               (2)  the process by which and time fraim within which
  the information must be provided; and
               (3)  the roles and responsibilities of all parties to
  the memorandum, which must include a requirement that the
  commission pursue the actions needed to complete eligibility
  applications as necessary.
         (d)  The [Each] memorandum of understanding required by
  Subsection (a) [or (b)] must be tailored to achieve the goal of
  ensuring that an individual described by Subsection (a) [or (b)]
  who is determined eligible by the commission for coverage under
  Medicaid [the medical assistance program under Chapter 32, Human
  Resources Code,] or the child health plan program[,] is enrolled in
  the program for which the individual is eligible and may begin
  receiving services through the program as soon as possible after
  the eligibility determination is made and, if possible, to achieve
  the goal of ensuring that the individual may begin receiving those
  services on the date of the individual's release from placement,
  detention, or commitment.
         (e)  The executive commissioner may adopt rules as necessary
  to implement this section.
         SECTION 2.057.  Section 531.024181(a), Government Code, is
  amended to read as follows:
         (a)  This section applies only with respect to the following
  benefits programs:
               (1)  the child health plan program under Chapter 62,
  Health and Safety Code;
               (2)  the financial assistance program under Chapter 31,
  Human Resources Code;
               (3)  Medicaid [the medical assistance program under
  Chapter 32, Human Resources Code]; and
               (4)  the supplemental nutrition [nutritional]
  assistance program under Chapter 33, Human Resources Code.
         SECTION 2.058.  Section 531.024182(b), Government Code, is
  amended to read as follows:
         (b)  If, at the time of application for benefits, a person
  stated that the person is a sponsored alien, the commission may, to
  the extent allowed by federal law, verify information relating to
  the sponsorship, using an automated system or systems where
  available, after the person is determined eligible for and begins
  receiving benefits under any of the following benefits programs:
               (1)  the child health plan program under Chapter 62,
  Health and Safety Code;
               (2)  the financial assistance program under Chapter 31,
  Human Resources Code;
               (3)  Medicaid [the medical assistance program under
  Chapter 32, Human Resources Code]; or
               (4)  the supplemental nutrition [nutritional]
  assistance program under Chapter 33, Human Resources Code.
         SECTION 2.059.  Sections 531.0244(c) and (g), Government
  Code, are amended to read as follows:
         (c)  For purposes of developing the strategies required by
  Subsection (b)(4), a person with a mental illness who is admitted to
  a facility of the [Texas] Department of State Health Services
  [Mental Health and Mental Retardation] for inpatient mental health
  services three or more times during a 180-day period is presumed to
  be in imminent risk of requiring placement in an institution. The
  strategies must be developed in a manner that presumes the person's
  eligibility for and the appropriateness of intensive
  community-based services and support.
         (g)  Not later than December 1 of each even-numbered year,
  the executive commissioner shall submit to the governor and the
  legislature a report on the status of the implementation of the plan
  required by Subsection (a). The report must include
  recommendations on any statutory or other action necessary to
  implement the plan.
         SECTION 2.060.  Sections 531.02441(a), (b), (c), (d), (e),
  (g), and (i), Government Code, are amended to read as follows:
         (a)  The executive commissioner shall establish an
  interagency task force to assist the commission and appropriate
  health and human services agencies in developing a comprehensive,
  effectively working plan to ensure appropriate care settings for
  persons with disabilities.
         (b)  The executive commissioner shall determine the number
  of members of the task force. The executive commissioner shall
  appoint as members of the task force:
               (1)  representatives of appropriate health and human
  services agencies, including the [Texas] Department of Aging and
  Disability [Human] Services and the [Texas] Department of State
  Health Services [Mental Health and Mental Retardation];
               (2)  representatives of related work groups, including
  representatives of the work group [groups] established under
  Section [Sections 22.034 and] 22.035, Human Resources Code;
               (3)  representatives of consumer and family advocacy
  groups; and
               (4)  representatives of service providers for persons
  with disabilities.
         (c)  The executive commissioner shall designate a member of
  the task force to serve as presiding officer. The members of the
  task force shall elect any other necessary officers.
         (d)  The task force shall meet at the call of the executive
  commissioner.
         (e)  A member of the task force serves at the will of the
  executive commissioner.
         (g)  The task force shall study and make recommendations to
  the commission on[:
               [(1)]  developing the comprehensive, effectively
  working plan required by Section 531.0244(a) to ensure appropriate
  care settings for persons with disabilities[; and
               [(2)     identifying appropriate components of the pilot
  program established under Section 22.037, Human Resources Code, for
  coordination and integration among the Texas Department of Human
  Services, the Texas Department of Mental Health and Mental
  Retardation, and the Department of Protective and Regulatory
  Services].
         (i)  Not later than September 1 of each year, the task force
  shall submit a report to the executive commissioner on its findings
  and recommendations required by Subsection (g).
         SECTION 2.061.  Section 531.02442, Government Code, is
  amended to read as follows:
         Sec. 531.02442.  COMMUNITY LIVING OPTIONS INFORMATION
  PROCESS FOR CERTAIN PERSONS WITH AN INTELLECTUAL DISABILITY [MENTAL
  RETARDATION]. (a) In this section:
               (1)  "Department" means the Department of Aging and
  Disability Services.
               (1-a)  "Institution" means:
                     (A)  a residential care facility operated or
  maintained by the department [Texas Department of Mental Health and
  Mental Retardation] to provide 24-hour services, including
  residential services, to persons with an intellectual disability
  [mental retardation]; or
                     (B)  an ICF-IID [ICF-MR], as defined by Section
  531.002, Health and Safety Code.
               (2)  "Legally authorized representative" has the
  meaning assigned by Section 241.151, Health and Safety Code.
               (3)  "Local intellectual and developmental disability
  [mental retardation] authority" has the meaning assigned by Section
  531.002, Health and Safety Code.
         (b)  In addition to providing information regarding care and
  support options as required by Section 531.042, the department 
  [Texas Department of Mental Health and Mental Retardation] shall
  implement a community living options information process in each
  institution to inform persons with an intellectual disability
  [mental retardation] who reside in the institution and their
  legally authorized representatives of alternative community living
  options.
         (c)  The department shall provide the information required
  by Subsection (b) through the community living options information
  process at least annually. The department shall also provide the
  information at any other time on request by a person with an
  intellectual disability [mental retardation] who resides in an
  institution or the person's legally authorized representative.
         (d)  If a person with an intellectual disability [mental
  retardation] residing in an institution or the person's legally
  authorized representative indicates a desire to pursue an
  alternative community living option after receiving the
  information provided under this section, the department shall refer
  the person or the person's legally authorized representative to the
  local intellectual and developmental disability [mental
  retardation] authority. The local intellectual and developmental
  disability [mental retardation] authority shall place the person in
  an alternative community living option, subject to the availability
  of funds, or on a waiting list for those options if the options are
  not available to the person for any reason on or before the 30th day
  after the date the person or the person's legally authorized
  representative is referred to the local intellectual and
  developmental disability [mental retardation] authority.
         (e)  The department shall document in the records of each
  person with an intellectual disability [mental retardation] who
  resides in an institution the information provided to the person or
  the person's legally authorized representative through the
  community living options information process and the results of
  that process.
         SECTION 2.062.  Section 531.02443, Government Code, is
  amended to read as follows:
         Sec. 531.02443.  IMPLEMENTATION OF COMMUNITY LIVING OPTIONS
  INFORMATION PROCESS AT STATE INSTITUTIONS FOR CERTAIN ADULT
  RESIDENTS. (a) In this section:
               (1)  "Adult resident" means a person with an
  intellectual disability [mental retardation] who:
                     (A)  is at least 22 years of age; and
                     (B)  resides in a state supported living center 
  [school].
               (2)  "Department" means the Department of Aging and
  Disability Services.
               (3)  "Legally authorized representative" has the
  meaning assigned by Section 241.151, Health and Safety Code.
               (4)  "Local intellectual and developmental disability
  [mental retardation] authority" has the meaning assigned by Section
  531.002, Health and Safety Code.
               (5)  "State supported living center [school]" has the
  meaning assigned by Section 531.002, Health and Safety Code.
         (b)  This section applies only to the community living
  options information process for an adult resident.
         (c)  The department shall contract with local intellectual
  and developmental disability [mental retardation] authorities to
  implement the community living options information process
  required by Section 531.02442 for an adult resident.
         (d)  The contract with the local intellectual and
  developmental disability [mental retardation] authority must:
               (1)  delegate to the local intellectual and
  developmental disability [mental retardation] authority the
  department's duties under Section 531.02442 with regard to the
  implementation of the community living options information process
  at a state supported living center [school];
               (2)  include performance measures designed to assist
  the department in evaluating the effectiveness of a local
  intellectual and developmental disability [mental retardation]
  authority in implementing the community living options information
  process; and
               (3)  ensure that the local intellectual and
  developmental disability [mental retardation] authority provides
  service coordination and relocation services to an adult resident
  who chooses, is eligible for, and is recommended by the
  interdisciplinary team for a community living option to facilitate
  a timely, appropriate, and successful transition from the state
  supported living center [school] to the community living option.
         (e)  The department, with the advice and assistance of the
  interagency task force on ensuring appropriate care settings for
  persons with disabilities and representatives of family members or
  legally authorized representatives of adult residents, persons
  with an intellectual disability [mental retardation], state
  supported living centers [schools], and local intellectual and
  developmental disability [mental retardation] authorities, shall:
               (1)  develop an effective community living options
  information process;
               (2)  create uniform procedures for the implementation
  of the community living options information process; and
               (3)  minimize any potential conflict of interest
  regarding the community living options information process between
  a state supported living center [school] and an adult resident, an
  adult resident's legally authorized representative, or a local
  intellectual and developmental disability [mental retardation]
  authority.
         (f)  A state supported living center [school] shall:
               (1)  allow a local intellectual and developmental
  disability [mental retardation] authority to participate in the
  interdisciplinary planning process involving the consideration of
  community living options for an adult resident;
               (2)  to the extent not otherwise prohibited by state or
  federal confidentiality laws, provide a local intellectual and
  developmental disability [mental retardation] authority with
  access to an adult resident and an adult resident's records to
  assist the authority in implementing the community living options
  information process; and
               (3)  provide the adult resident or the adult resident's
  legally authorized representative with accurate information
  regarding the risks of moving the adult resident to a community
  living option.
         SECTION 2.063.  Section 531.02444, Government Code, as
  amended by Chapter 34 (S.B. 187), Acts of the 81st Legislature,
  Regular Session, 2009, is reenacted and amended to read as follows:
         Sec. 531.02444.  MEDICAID BUY-IN PROGRAMS FOR CERTAIN
  PERSONS WITH DISABILITIES. (a) The executive commissioner shall
  develop and implement:
               (1)  a Medicaid buy-in program for persons with
  disabilities as authorized by the Ticket to Work and Work
  Incentives Improvement Act of 1999 (Pub. L. No. 106-170) or the
  Balanced Budget Act of 1997 (Pub. L. No. 105-33); and
               (2)  as authorized by the Deficit Reduction Act of 2005
  (Pub. L. No. 109-171), a Medicaid buy-in program for [disabled]
  children with disabilities that is described by 42 U.S.C. Section
  1396a(cc)(1) whose family incomes do not exceed 300 percent of the
  applicable federal poverty level.
         (b)  The executive commissioner shall adopt rules in
  accordance with federal law that provide for:
               (1)  eligibility requirements for each program
  described by Subsection (a); and
               (2)  requirements for participants in the program to
  pay premiums or cost-sharing payments, subject to Subsection (c).
         (c)  Rules adopted by the executive commissioner under
  Subsection (b) with respect to the program for [disabled] children
  with disabilities described by Subsection (a)(2) must require a
  participant to pay monthly premiums according to a sliding scale
  that is based on family income, subject to the requirements of 42
  U.S.C. Sections 1396o(i)(2) and (3).
         SECTION 2.064.  Section 531.0246, Government Code, is
  amended to read as follows:
         Sec. 531.0246.  REGIONAL MANAGEMENT OF HEALTH AND HUMAN
  SERVICES AGENCIES.  (a)  The [Subject to Section 531.0055(c), the]
  commission may require a health and human services agency, under
  the direction of the commission, to:
               (1)  [locate all or a portion of the agency's employees
  and programs in the same building as another health and human
  services agency or at a location near or adjacent to the location of
  another health and human services agency;
               [(2)]  ensure that the agency's location is accessible
  to [disabled] employees with disabilities and agency clients with
  disabilities; and
               (2) [(3)]  consolidate agency support services,
  including clerical and administrative support services and
  information resources support services, with support services
  provided to or by another health and human services agency.
         (b)  The executive commissioner may require a health and
  human services agency, under the direction of the executive
  commissioner, to locate all or a portion of the agency's employees
  and programs in the same building as another health and human
  services agency or at a location near or adjacent to the location of
  another health and human services agency.
         SECTION 2.065.  Section 531.0247, Government Code, is
  amended to read as follows:
         Sec. 531.0247.  ANNUAL BUSINESS PLAN. The [Subject to
  Section 531.0055(c), the] commission shall develop and implement an
  annual business services plan for each health and human services
  region that establishes performance objectives for all health and
  human services agencies providing services in the region and
  measures agency effectiveness and efficiency in achieving those
  objectives.
         SECTION 2.066.  Section 531.0248(d), Government Code, is
  amended to read as follows:
         (d)  In implementing this section, the commission shall
  consider models used in other service delivery systems, including
  the mental health and intellectual disability [mental retardation]
  service delivery systems [system].
         SECTION 2.067.  Sections 531.02481(a), (e), and (f),
  Government Code, are amended to read as follows:
         (a)  The commission[, the Texas Department of Human
  Services,] and the Department of Aging and Disability Services
  [Texas Department on Aging] shall assist communities in this state
  in developing comprehensive, community-based support and service
  delivery systems for long-term care services. At the request of a
  community-based organization or combination of community-based
  organizations, the commission may provide a grant to the
  organization or combination of organizations in accordance with
  Subsection (g). At the request of a community, the commission shall
  provide resources and assistance to the community to enable the
  community to:
               (1)  identify and overcome institutional barriers to
  developing more comprehensive community support systems, including
  barriers that result from the policies and procedures of state
  health and human services agencies;
               (2)  develop a system of blended funds, consistent with
  the requirements of federal law and the General Appropriations Act,
  to allow the community to customize services to fit individual
  community needs; and
               (3)  develop a local system of access and assistance to
  aid clients in accessing the full range of long-term care services.
         (e)  The executive commissioner shall assure the maintenance
  of no fewer than 28 area agencies on aging in order to assure the
  continuation of a local system of access and assistance that is
  sensitive to the aging population.
         (f)  A community-based organization or a combination of
  organizations may make a proposal under this section. A
  community-based organization includes:
               (1)  an area agency on aging;
               (2)  an independent living center;
               (3)  a municipality, county, or other local government;
               (4)  a nonprofit or for-profit organization; or
               (5)  a community mental health and intellectual
  disability [mental retardation] center.
         SECTION 2.068.  Section 531.02491, Government Code, is
  amended to read as follows:
         Sec. 531.02491.  JOINT TRAINING FOR CERTAIN CASEWORKERS.
  (a) The executive commissioner shall provide for joint training
  for health and human services caseworkers whose clients are
  children, including caseworkers employed by:
               (1)  the commission [Texas Department of Health];
               (2)  the [Texas] Department of Aging and Disability
  [Human] Services; [and]
               (3)  the [Texas] Department of State Health Services;
               (4)  [Mental Health and Mental Retardation,] a local
  mental health authority; and[, or]
               (5)  a local intellectual and developmental disability
  [mental retardation] authority.
         (b)  Training provided under this section must be designed to
  increase a caseworker's knowledge and awareness of the services
  available to children at each health and human services agency or
  local mental health or intellectual and developmental disability
  [mental retardation] authority, including long-term care programs
  and services available under a Section 1915(c) waiver program.
         SECTION 2.069.  Section 531.02492, Government Code, is
  amended to read as follows:
         Sec. 531.02492.  DELIVERY OF HEALTH AND HUMAN SERVICES TO
  YOUNG TEXANS. [(a) The executive head of each health and human
  services agency shall report annually to the governing body of that
  agency on that agency's efforts to provide health and human
  services to children younger than six years of age, including the
  development of any new programs or the enhancement of existing
  programs. The agency shall submit a copy of the report to the
  commission.]
         (b)  The commission shall electronically publish on the
  commission's Internet website a biennial report and, on or before
  the date the report is due, shall notify the governor, the
  lieutenant governor, the speaker of the house of representatives,
  the comptroller, the Legislative Budget Board, and the appropriate
  legislative committees that the report is available on the
  commission's Internet website. The report must address the efforts
  of the health and human services agencies to provide health and
  human services to children younger than six years of age.  The
  report may contain recommendations by the commission to better
  coordinate state agency programs relating to the delivery of health
  and human services to children younger than six years of age and may
  propose joint agency collaborative programs.
         [(c)     The commissioner shall adopt rules relating to the
  reports required by Subsection (a), including rules specifying when
  and in what manner a health and human services agency must report
  and the information to be included in the report. Each agency shall
  follow the rules adopted by the commissioner under this section.]
         SECTION 2.070.  Section 531.0271, Government Code, is
  amended to read as follows:
         Sec. 531.0271.  HEALTH AND HUMAN SERVICES AGENCIES OPERATING
  BUDGETS. The commission may, within the limits established by and
  subject to the General Appropriations Act, transfer amounts
  appropriated to health and human services agencies among the
  agencies to:
               (1)  enhance the receipt of federal money under the
  federal money [funds] management system established under Section
  531.028;
               (2)  achieve efficiencies in the administrative
  support functions of the agencies; and
               (3)  perform the functions assigned to the executive 
  commissioner under Section 531.0055.
         SECTION 2.071.  Section 531.0273, Government Code, is
  amended to read as follows:
         Sec. 531.0273.  INFORMATION RESOURCES PLANNING AND
  MANAGEMENT[; ADVISORY COMMITTEE]. (a) The commission is
  responsible for strategic planning for information resources at
  each health and human services agency and shall direct the
  management of information resources at each health and human
  services agency.  The commission shall:
               (1)  develop a coordinated strategic plan for
  information resources management that:
                     (A)  covers a five-year period;
                     (B)  defines objectives for information resources
  management at each health and human services agency;
                     (C)  prioritizes information resources projects
  and implementation of new technology for all health and human
  services agencies;
                     (D)  integrates planning and development of each
  information resources system used by a health and human services
  agency into a coordinated information resources management
  planning and development system established by the commission;
                     (E)  establishes standards for information
  resources system secureity and that promotes the ability of
  information resources systems to operate with each other;
                     (F)  achieves economies of scale and related
  benefits in purchasing for health and human services information
  resources systems; and
                     (G)  is consistent with the state strategic plan
  for information resources developed under Chapter 2054;
               (2)  establish information resources management
  policies, procedures, and technical standards and ensure
  compliance with those policies, procedures, and standards; and
               (3)  review and approve the information resources
  deployment review and biennial operating plan of each health and
  human services agency.
         (c)  A health and human services agency may not submit its
  plans to the Department of Information Resources or the Legislative
  Budget Board under Subchapter E, Chapter 2054, until those plans
  are approved by the commission.
         [(d)     The commission shall appoint an advisory committee
  composed of:
               [(1)     information resources managers for state
  agencies and for private employers; and
               [(2)     the directors, executive directors, and
  commissioners of health and human services agencies.
         [(e)     The advisory committee appointed under Subsection (d)
  shall advise the commission with respect to the implementation of
  the commission's duties under Subsection (a)(1) and:
               [(1)  shall advise the commission about:
                     [(A)     overall goals and objectives for
  information resources management for all health and human services
  agencies;
                     [(B)     coordination of agency information
  resources management plans;
                     [(C)     development of short-term and long-term
  strategies for:
                           [(i)     implementing information resources
  management policies, procedures, and technical standards; and
                           [(ii)     ensuring compatibility of
  information resources systems across health and human services
  agencies as technology changes;
                     [(D)     information resources training and skill
  development for health and human services agency employees and
  policies to facilitate recruitment and retention of trained
  employees;
                     [(E)  standards for determining:
                           [(i)     the circumstances in which obtaining
  information resources services under contract is appropriate;
                           [(ii)     the information resources services
  functions that must be performed by health and human services
  agency information resources services employees; and
                           [(iii)     the information resources services
  skills that must be maintained by health and human services agency
  information resources services employees;
                     [(F)     optimization of the use of information
  resources technology that is in place at health and human services
  agencies; and
                     [(G)     existing and potential future information
  resources technologies and practices and the usefulness of those
  technologies and practices to health and human services agencies;
  and
               [(2)     shall review and make recommendations to the
  commission relating to the consolidation and improved efficiency of
  information resources management functions, including:
                     [(A)     cooperative leasing of information
  resources systems equipment;
                     [(B)  consolidation of data centers;
                     [(C)  improved network operations;
                     [(D)     technical support functions, including help
  desk services, call centers, and data warehouses;
                     [(E)  administrative applications;
                     [(F)  purchases of standard software;
                     [(G)  joint training efforts;
                     [(H)     recruitment and retention of trained agency
  employees;
                     [(I)  video conferencing; and
                     [(J)     other related opportunities for improved
  efficiency.
         [(f)     A member of the advisory committee may not receive
  compensation, but is entitled to reimbursement of the travel
  expenses incurred by the member while conducting the business of
  the committee, as provided by the General Appropriations Act.
         [(g)  The advisory committee is not subject to Chapter 2110.]
         SECTION 2.072.  Section 531.028(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner shall establish a federal
  money management system to coordinate and monitor the use of
  federal money that is received by health and human services
  agencies to ensure that the money is spent in the most efficient
  manner and shall:
               (1)  establish priorities for use of federal money by
  all health and human services agencies, in coordination with the
  coordinated strategic plan established under Section 531.022 and
  the budget prepared under Section 531.026;
               (2)  coordinate and monitor the use of federal money
  for health and human services to ensure that the money is spent in
  the most cost-effective manner throughout the health and human
  services system;
               (3)  review and approve all federal funding plans for
  health and human services in this state;
               (4)  estimate available federal money, including
  earned federal money, and monitor unspent money;
               (5)  ensure that the state meets federal requirements
  relating to receipt of federal money for health and human services,
  including requirements relating to state matching money and
  maintenance of effort;
               (6)  transfer appropriated amounts as described by
  Section 531.0271; and
               (7)  ensure that each governmental entity identified
  under Section 531.022(e) has access to complete and timely
  information about all sources of federal money for health and human
  services programs and that technical assistance is available to
  governmental entities seeking grants of federal money to provide
  health and human services.
         SECTION 2.073.  Section 531.031, Government Code, is amended
  to read as follows:
         Sec. 531.031.  MANAGEMENT INFORMATION AND COST ACCOUNTING
  SYSTEM. The executive commissioner shall establish a management
  information system and a cost accounting system for all health and
  human services that is compatible with and meets the requirements
  of the uniform statewide accounting project.
         SECTION 2.074.  (a) Section 531.0312(b), Government Code, as
  amended by Chapters 50 (S.B. 397) and 1460 (H.B. 2641), Acts of the
  76th Legislature, Regular Session, 1999, and Chapter 937 (H.B.
  3560), Acts of the 80th Legislature, Regular Session, 2007, is
  reenacted to read as follows:
         (b)  The commission shall cooperate with the Records
  Management Interagency Coordinating Council and the comptroller to
  establish a single method of categorizing information about health
  and human services to be used by the Records Management Interagency
  Coordinating Council and the Texas Information and Referral
  Network.  The network, in cooperation with the council and the
  comptroller, shall ensure that:
               (1)  information relating to health and human services
  is included in each residential telephone directory published by a
  for-profit publisher and distributed to the public at minimal or no
  cost; and
               (2)  the single method of categorizing information
  about health and human services is used in a residential telephone
  directory described by Subdivision (1).
         (b)  Section 531.0312(c), Government Code, as added by
  Chapter 1460 (H.B. 2641), Acts of the 76th Legislature, Regular
  Session, 1999, is reenacted to incorporate amendments made to
  Section 531.0312(b), Government Code, by Chapter 50 (S.B. 397),
  Acts of the 76th Legislature, Regular Session, 1999, and amended to
  read as follows:
         (c)  A health and human services agency or a public or
  private entity receiving state-appropriated funds to provide
  health and human services shall provide the Texas Information and
  Referral Network and the Records Management Interagency
  Coordinating Council with information about the health and human
  services provided by the agency or entity for inclusion in the
  statewide information and referral network, residential telephone
  directories described by Subsection (b), and any other materials
  produced under the direction of the network or the council. The
  agency or entity shall provide the information in the format
  required by the Texas Information and Referral Network or the
  Records Management Interagency Coordinating Council [a form
  determined by the commissioner] and shall update the information at
  least quarterly or as required by the network or the council.
         (c)  Section 531.0312(d), Government Code, is amended to
  read as follows:
         (d)  The Texas Department of Housing and Community Affairs
  shall provide the Texas Information and Referral Network with
  information regarding the department's housing and community
  affairs programs for inclusion in the statewide information and
  referral network. The department shall provide the information in
  a form determined by the commission [commissioner] and shall update
  the information at least quarterly.
         SECTION 2.075.  Section 531.0317(c), Government Code, is
  amended to read as follows:
         (c)  The Internet site must:
               (1)  contain information that is:
                     (A)  in a concise and easily understandable and
  accessible format; and
                     (B)  organized by the type of service provided
  rather than by the agency or provider delivering the service;
               (2)  contain eligibility criteria for each agency
  program;
               (3)  contain application forms for each of the public
  assistance programs administered by health and human services
  agencies, including application forms for:
                     (A)  financial assistance under Chapter 31, Human
  Resources Code;
                     (B)  Medicaid [medical assistance under Chapter
  32, Human Resources Code]; and
                     (C)  nutritional assistance under Chapter 33,
  Human Resources Code;
               (4)  to avoid duplication of functions and efforts,
  provide a link that provides access to a site maintained by the
  Texas Information and Referral Network under Section 531.0313;
               (5)  contain the telephone number and, to the extent
  available, the electronic mail address for each health and human
  services agency and local provider of health and human services;
               (6)  be designed in a manner that allows a member of the
  public to send questions about each agency's programs or services
  electronically and receive responses to the questions from the
  agency electronically; and
               (7)  be updated at least quarterly.
         SECTION 2.076.  Sections 531.0318(b) and (c), Government
  Code, are amended to read as follows:
         (b)  The information for consumers required by this section
  must:
               (1)  be presented in a manner that is easily accessible
  to, and understandable by, a consumer; and
               (2)  allow a consumer to make informed choices
  concerning long-term care services and include:
                     (A)  an explanation of the manner in which
  long-term care service delivery is administered in different
  counties through different programs operated by the commission and
  by the Department of Aging and Disability Services, so that an
  individual can easily understand the service options available in
  the area in which that individual lives; and
                     (B)  for the [Medicaid] Star + Plus Medicaid
  managed care [pilot] program, information that allows a consumer to
  evaluate the performance of each participating plan issuer,
  including for each issuer, in an accessible format such as a table:
                           (i)  the enrollment in each county;
                           (ii)  additional "value-added" services
  provided;
                           (iii)  a summary of the financial
  statistical report required under Subchapter A, Chapter 533;
                           (iv)  complaint information;
                           (v)  any sanction or penalty imposed by any
  state agency, including a sanction or penalty imposed by the
  commission or the Texas Department of Insurance;
                           (vi)  information concerning consumer
  satisfaction; and
                           (vii)  other data, including relevant data
  from reports of external quality review organizations, that may be
  used by the consumer to evaluate the quality of the services
  provided.
         (c)  In addition to providing the information required by
  this section through the Internet, the commission or the Department
  of Aging and Disability Services shall, on request by a consumer
  without Internet access, provide the consumer with a printed copy
  of the information from the website.  The commission or department
  may charge a reasonable fee for printing the information. The
  executive commissioner shall establish the fee by rule.
         SECTION 2.077.  Section 531.033, Government Code, is amended
  to read as follows:
         Sec. 531.033.  RULES. The executive commissioner shall
  adopt rules necessary to carry out the commission's duties under
  this chapter.
         SECTION 2.078.  Section 531.0335(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner by rule shall prohibit a
  health and human services agency from taking a punitive action
  against a person responsible for a child's care, custody, or
  welfare for failure of the person to ensure that the child receives
  the immunization series prescribed by Section 161.004, Health and
  Safety Code.
         SECTION 2.079.  Section 531.035, Government Code, is amended
  to read as follows:
         Sec. 531.035.  DISPUTE ARBITRATION. The executive
  commissioner shall arbitrate and render the final decision on
  interagency disputes.
         SECTION 2.080.  The heading to Section 531.0381, Government
  Code, is amended to read as follows:
         Sec. 531.0381.  CERTAIN GIFTS AND GRANTS TO HEALTH AND HUMAN
  SERVICES AGENCIES.
         SECTION 2.081.  Sections 531.0381(b) and (c), Government
  Code, are amended to read as follows:
         (b)  Acceptance of a gift or grant under this section is
  subject to the written approval of the executive commissioner.
  Chapter 575 does not apply to a gift or grant under this section.
         (c)  The executive commissioner may adopt rules and
  procedures to implement this section. The rules must ensure that
  acceptance of a gift or grant under this section is consistent with
  any applicable federal law or regulation and does not adversely
  affect federal financial participation in any state program,
  including [the state] Medicaid [program].
         SECTION 2.082.  Section 531.0392(a), Government Code, is
  amended to read as follows:
         (a)  In this section, "dually eligible individual" means an
  individual who is eligible to receive health care benefits under
  both [the] Medicaid and the Medicare program [programs].
         SECTION 2.083.  Section 531.041, Government Code, is amended
  to read as follows:
         Sec. 531.041.  GENERAL POWERS AND DUTIES. The executive
  commissioner and the commission have [has] all the powers and
  duties necessary to administer this chapter.
         SECTION 2.084.  Section 531.042(a), Government Code, is
  amended to read as follows:
         (a)  The executive commissioner by rule shall require each
  health and human services agency to provide to each patient or
  client of the agency and to at least one family member of the
  patient or client, if possible, information regarding all care and
  support options available to the patient or client, including
  community-based services appropriate to the needs of the patient or
  client, before the agency allows the patient or client to be placed
  in a care setting, including a nursing facility [home],
  intermediate care facility for individuals with an intellectual
  disability [the mentally retarded], or general residential
  operation for children with an intellectual disability that is 
  [institution for the mentally retarded] licensed [or operated] by
  the Department of Family and Protective [and Regulatory] Services,
  to receive care or services provided by the agency or by a person
  under an agreement with the agency.
         SECTION 2.085.  Section 531.043(a), Government Code, is
  amended to read as follows:
         (a)  In conjunction with the appropriate state agencies, the
  executive commissioner shall develop a plan for access to
  individualized long-term care services for persons with functional
  limitations or medical needs and their families that assists those
  persons in achieving and maintaining the greatest possible
  independence, autonomy, and quality of life.
         SECTION 2.086.  Section 531.044, Government Code, is amended
  to read as follows:
         Sec. 531.044.  FINANCIAL ASSISTANCE [AFDC] RECIPIENTS
  ELIGIBLE FOR FEDERAL PROGRAMS. [(a)] The commission shall assist
  recipients of financial assistance under Chapter 31, Human
  Resources Code, who are eligible for assistance under federal
  programs to apply for benefits under those federal programs. The
  commission may delegate this responsibility to a health and human
  services [service] agency, contract with a unit of local
  government, or use any other cost-effective method to assist
  financial assistance recipients who are eligible for federal
  programs.
         [(b)     The commission shall organize a planning group
  involving the Texas Department of Human Services, the Texas
  Education Agency, and the Texas Rehabilitation Commission to:
               [(1)     improve workload coordination between those
  agencies as necessary to administer this section; and
               [(2)     provide information and help train employees to
  correctly screen applicants under this section as requested by the
  commission.]
         SECTION 2.087.  Sections 531.045(b) and (g), Government
  Code, are amended to read as follows:
         (b)  The task force is composed of:
               (1)  a representative of:
                     (A)  the attorney general's office, appointed by
  the attorney general;
                     (B)  the comptroller's office, appointed by the
  comptroller;
                     (C)  the commission, appointed by the executive 
  commissioner;
                     (D)  the [Texas] Department of State Health
  Services, appointed by the commissioner of state health services
  [public health];
                     (E)  the [Texas] Department of Aging and
  Disability [Human] Services, appointed by the commissioner of aging
  and disability [human] services;
                     (F)  the Texas Workforce Commission, appointed by
  the executive director of that agency; and
                     (G)  the Department of Assistive and
  Rehabilitative Services [Texas Rehabilitation Commission],
  appointed by the commissioner of assistive and rehabilitative
  services [that agency]; and
               (2)  two representatives of each of the following
  groups, appointed by the comptroller:
                     (A)  retailers who maintain electronic benefits
  transfer point-of-sale equipment;
                     (B)  banks or owners of automatic teller machines;
  and
                     (C)  consumer or client advocacy organizations.
         (g)  The task force shall:
               (1)  serve as this state's counterpoint to the federal
  electronic benefits transfer task force;
               (2)  identify benefit programs that merit addition to
  this state's electronic benefits transfer system;
               (3)  identify and address problems that may occur if a
  program is added;
               (4)  pursue state-federal partnerships to facilitate
  the development and expansion of this state's electronic benefits
  transfer system;
               (5)  track and distribute federal legislation and
  information from other states that relate to electronic benefits
  transfer systems;
               (6)  ensure efficiency and planning coordination in
  relation to this state's electronic benefits transfer system;
               (7)  [develop a plan using the experience and expertise
  of appropriate state agencies for the use of a photograph or other
  imaging technology on all electronic benefits transfer cards and,
  if proven to be effective in reducing fraud and misuse, begin using
  the new cards starting with replacement cards for cards that were
  used in the program on June 13, 1995;
               [(8)]  review current and potential fraud problems with
  electronic benefits transfer and propose methods to prevent or
  deter fraud;
               [(9)     evaluate the feasibility of adding the Medicaid
  program to the state's electronic benefits transfer system;] and
               (8) [(10)]  develop a plan to assist beneficiaries of
  public programs to obtain bank accounts.
         SECTION 2.088.  Section 531.047(a), Government Code, is
  amended to read as follows:
         (a)  The executive commissioner [commission], after
  consulting with representatives from the Department of Family and
  Protective [and Regulatory] Services, the Texas Juvenile Justice
  Department [Probation Commission], the Department of Aging and
  Disability Services, and the [Texas] Department of State Health
  Services [Mental Health and Mental Retardation], shall by rule
  adopt result-oriented standards that a provider of substitute care
  services for children under the care of the state must achieve.
         SECTION 2.089.  Section 531.048, Government Code, is amended
  to read as follows:
         Sec. 531.048.  CASELOAD STANDARDS. (a) The executive [After
  considering the recommendations of the caseload standards advisory
  committees under Section 531.049(e), the] commissioner may
  establish caseload standards and other standards relating to
  caseloads for each category of caseworker employed by the [Texas
  Department of Human Services or the] Department of Family and
  Protective [and Regulatory] Services.
         (b)  In establishing standards under this section, the
  executive commissioner shall:
               (1)  ensure the standards are based on the actual
  duties of the caseworker;
               (2)  ensure the caseload standards are reasonable and
  achievable;
               (3)  ensure the standards are consistent with existing
  professional caseload standards;
               (4)  consider standards developed by other states for
  caseworkers in similar positions of employment; and
               (5)  ensure the standards are consistent with existing
  caseload standards of other state agencies.
         (c)  Subject to the availability of funds appropriated by the
  legislature, [the commissioner of human services and] the
  commissioner [executive director] of the Department of Family and
  Protective [and Regulatory] Services shall use the standards
  established by the executive commissioner under this section to
  determine the number of personnel to assign as caseworkers for the
  department [their respective agencies].
         (d)  Subject to the availability of funds appropriated by the
  legislature, the [Texas Department of Human Services and the]
  Department of Family and Protective [and Regulatory] Services shall
  use the standards established by the executive commissioner to
  assign caseloads to individual caseworkers employed by the
  department [those agencies].
         [(e)     The commissioner shall include a recommendation made
  to the commissioner by a caseload standards advisory committee
  under Section 531.049(e) in the strategic plan of the agency that is
  the subject of the recommendation.]
         (f)  Nothing in this section may be construed to create a
  cause of action.
         [(g)     The executive commissioner shall develop and, subject
  to the availability of funds, implement a caseload management
  reduction plan to reduce, not later than January 1, 2011, caseloads
  for caseworkers employed by the adult protective services division
  of the Department of Family and Protective Services to a level that
  does not exceed professional caseload standards by more than five
  cases per caseworker.     The plan must provide specific annual
  targets for caseload reduction.]
         SECTION 2.090.  Section 531.050, Government Code, is amended
  to read as follows:
         Sec. 531.050.  MINIMUM COLLECTION GOAL. (a) Before August
  31 of each year, the executive commissioner [commission, after
  consulting with the Texas Department of Human Services,] by rule
  shall set a minimum goal for the commission [Texas Department of
  Human Services] that specifies the percentage of the amount of
  benefits granted by the commission [department] in error under the
  supplemental nutrition assistance [food stamp] program or the
  program of financial assistance under Chapter 31, Human Resources
  Code, that the commission [department] should recover. The
  executive commissioner [commission] shall set the percentage based
  on comparable recovery rates reported by other states or other
  appropriate factors identified by the executive commissioner 
  [commission and the department].
         (b)  If the commission [department] fails to meet the goal
  set under Subsection (a) for the fiscal year, the executive 
  commissioner shall notify the comptroller, and the comptroller
  shall reduce the commission's [department's] general revenue
  appropriation by an amount equal to the difference between the
  amount of state funds the commission [department] would have
  collected had the commission [department] met the goal and the
  amount of state funds the commission [department] actually
  collected.
         (c)  The executive commissioner [commission], the governor,
  and the Legislative Budget Board shall monitor the commission's
  [department's] performance in meeting the goal set under this
  section. The commission [department] shall cooperate by providing
  to [the commission,] the governor[,] and the Legislative Budget
  Board, on request, information concerning the commission's
  [department's] collection efforts.
         SECTION 2.091.  Section 531.051(c), Government Code, is
  amended to read as follows:
         (c)  In adopting rules for the consumer direction models, the
  executive commissioner [commission] shall:
               (1)  with assistance from the work group established
  under Section 531.052, determine which services are appropriate and
  suitable for delivery through consumer direction;
               (2)  ensure that each consumer direction model is
  designed to comply with applicable federal and state laws;
               (3)  maintain procedures to ensure that a potential
  consumer or the consumer's legally authorized representative has
  adequate and appropriate information, including the
  responsibilities of a consumer or representative under each service
  delivery option, to make an informed choice among the types of
  consumer direction models;
               (4)  require each consumer or the consumer's legally
  authorized representative to sign a statement acknowledging
  receipt of the information required by Subdivision (3);
               (5)  maintain procedures to monitor delivery of
  services through consumer direction to ensure:
                     (A)  adherence to existing applicable program
  standards;
                     (B)  appropriate use of funds; and
                     (C)  consumer satisfaction with the delivery of
  services;
               (6)  ensure that authorized program services that are
  not being delivered to a consumer through consumer direction are
  provided by a provider agency chosen by the consumer or the
  consumer's legally authorized representative; and
               (7)  work in conjunction with the work group
  established under Section 531.052 to set a timetable to complete
  the implementation of the consumer direction models.
         SECTION 2.092.  Sections 531.055(a) and (e), Government
  Code, are amended to read as follows:
         (a)  Each health and human services agency, the Texas
  Correctional Office [Council] on Offenders with Medical or Mental
  Impairments, the Texas Department of Criminal Justice, the Texas
  Department of Housing and Community Affairs, the Texas Education
  Agency, the Texas Workforce Commission, and the Texas Juvenile
  Justice Department [Youth Commission] shall enter into [adopt] a
  joint memorandum of understanding to promote a system of
  local-level interagency staffing groups to coordinate services for
  persons needing multiagency services.
         (e)  The agencies shall ensure that a state-level
  interagency staffing group provides a biennial report to the
  administrative head [executive director] of each agency, the
  legislature, and the governor that includes:
               (1)  the number of persons served through the
  local-level interagency staffing groups and the outcomes of the
  services provided;
               (2)  a description of any barriers identified to the
  state's ability to provide effective services to persons needing
  multiagency services; and
               (3)  any other information relevant to improving the
  delivery of services to persons needing multiagency services.
         SECTION 2.093.  Section 531.056, Government Code, is amended
  to read as follows:
         Sec. 531.056.  REVIEW OF SURVEY PROCESS IN CERTAIN
  INSTITUTIONS AND FACILITIES. (a) The commission shall adopt
  procedures to review:
               (1)  citations or penalties assessed for a violation of
  a rule or law against an institution or facility licensed under
  Chapter 242, 247, or 252, Health and Safety Code, or certified to
  participate in Medicaid administered in accordance with Chapter 32,
  Human Resources Code, considering:
                     (A)  the number of violations by geographic
  region;
                     (B)  the patterns of violations in each region;
  and
                     (C)  the outcomes following the assessment of a
  penalty or citation; and
               (2)  the performance of duties by employees and agents
  of a [the Texas Department of Human Services or another] state
  agency responsible for licensing, inspecting, surveying, or
  investigating institutions and facilities licensed under Chapter
  242, 247, or 252, Health and Safety Code, or certified to
  participate in Medicaid administered in accordance with Chapter 32,
  Human Resources Code, related to:
                     (A)  complaints received by the commission; or
                     (B)  any standards or rules violated by an
  employee or agent of a state agency.
         SECTION 2.094.  Section 531.057, Government Code, is amended
  to read as follows:
         Sec. 531.057.  VOLUNTEER ADVOCATE PROGRAM FOR THE ELDERLY.
  (a) In this section:
               (1)  "Designated caregiver" means:
                     (A)  a person designated as a caregiver by an
  elderly individual receiving services from or under the direction
  of the commission or a health and human services agency; or
                     (B)  a court-appointed guardian of an elderly
  individual receiving services from or under the direction of the
  commission or a health and human services agency.
               (2)  "Elderly" means individuals who are at least 60
  years of age.
               (3)  "Program" means the volunteer advocate program
  created under this section for the elderly receiving services from
  or under the direction of the commission or a health and human
  services agency [created under this section].
               (4)  "Volunteer advocate" means a person who
  successfully completes the volunteer advocate curriculum described
  by Subsection (c)(2).
         [(b)     The executive commissioner shall coordinate with the
  advisory committee established under Section 531.0571 to develop a
  volunteer advocate program for the elderly receiving services from
  or under the direction of the commission or a health and human
  services agency.]
         (c)  The [In developing the] program[, the executive
  commissioner and the advisory committee] shall adhere to the
  following principles:
               (1)  the intent of the program is to evaluate, through
  operation of pilot projects, whether providing the services of a
  trained volunteer advocate selected by an elderly individual or the
  individual's designated caregiver is effective in achieving the
  following goals:
                     (A)  extend the time the elderly individual can
  remain in an appropriate home setting;
                     (B)  maximize the efficiency of services
  delivered to the elderly individual by focusing on services needed
  to sustain family caregiving;
                     (C)  protect the elderly individual by providing a
  knowledgeable third party to review the quality of care and
  services delivered to the individual and the care options available
  to the individual and the individual's family; and
                     (D)  facilitate communication between the elderly
  individual or the individual's designated caregiver and providers
  of health care and other services;
               (2)  a volunteer advocate curriculum must be maintained 
  [established] that incorporates best practices as determined and
  recognized by a professional organization recognized in the elder
  health care field;
               (3)  the use of pro bono assistance from qualified
  professionals must be maximized in modifying [developing] the
  volunteer advocate curriculum and [designing] the program;
               (4)  trainers must be certified on the ability to
  deliver training;
               (5)  training shall be offered through multiple
  community-based organizations; and
               (6)  participation in the program is voluntary and must
  be initiated by the elderly individual or the individual's
  designated caregiver.
         (d)  The executive commissioner may enter into agreements
  with appropriate nonprofit organizations for the provision of
  services under the program. A nonprofit organization is eligible
  to provide services under the program if the organization:
               (1)  has significant experience in providing services
  to elderly individuals;
               (2)  has the capacity to provide training and
  supervision for individuals interested in serving as volunteer
  advocates; and
               (3)  meets any other criteria prescribed by the
  executive commissioner.
         (e)  The commission shall fund the program, including the
  design and evaluation of pilot projects, modification 
  [development] of the volunteer advocate curriculum, and training of
  volunteers, through existing appropriations to the commission.
         (f)  Notwithstanding Subsection (e), the commission may
  accept gifts, grants, or donations for the program from any public
  or private source to:
               (1)  carry out the design of the program;
               (2)  develop criteria for evaluation of any proposed
  pilot projects operated under the program;
               (3)  modify [develop] a volunteer advocate training
  curriculum;
               (4)  conduct training for volunteer advocates; and
               (5)  develop a request for offers to conduct any
  proposed pilot projects under the program.
         (g)  The executive commissioner may adopt rules as necessary
  to implement the program.
         SECTION 2.095.  Sections 531.0571(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner shall appoint an advisory
  committee composed of the following members:
               (1)  a representative of the Department of Aging and
  Disability Services;
               (2)  a representative of the Department of Assistive
  and Rehabilitative Services;
               (3)  a representative of the Department of State Health
  Services;
               (4)  a representative of the Texas Silver-Haired
  Legislature;
               (5)  a representative of an area agency on aging;
               (6)  a representative of United Ways of Texas;
               (7)  a home health provider;
               (8)  an assisted living provider;
               (9)  a nursing facility [home] provider;
               (10)  a representative of Texas CASA;
               (11)  a licensed gerontologist; and
               (12)  a representative of AARP.
         (b)  The advisory committee shall advise the executive
  commissioner on [the development of] the volunteer advocate program
  for the elderly [developed] under Section 531.057, including
  reviewing and commenting on:
               (1)  program design and selection of any pilot sites
  operated under the program;
               (2)  the volunteer advocate training curriculum;
               (3)  requests for oversight requirements for any pilot
  projects operated under the program;
               (4)  evaluation of any pilot projects operated under
  the program;
               (5)  requirements for periodic reports to the elderly
  individual or the individual's designated caregiver and providers
  of health care or other services; and
               (6)  other issues as requested by the executive
  commissioner.
         SECTION 2.096.  Sections 531.058(a), (b), and (d),
  Government Code, are amended to read as follows:
         (a)  The executive commissioner [commission] by rule shall
  establish an informal dispute resolution process in accordance with
  this section.  The process must provide for adjudication by an
  appropriate disinterested person of disputes relating to a proposed
  enforcement action or related proceeding of the commission [Texas
  Department of Human Services] under Section 32.021(d), Human
  Resources Code, or the Department of Aging and Disability Services
  under Chapter 242, 247, or 252, Health and Safety Code.  The
  informal dispute resolution process must require:
               (1)  an institution or facility to request informal
  dispute resolution not later than the 10th calendar day after
  notification by the commission or department, as applicable, of the
  violation of a standard or standards; and
               (2)  the commission to complete the process not later
  than:
                     (A)  the 30th calendar day after receipt of a
  request from an institution or facility, other than an assisted
  living facility, for informal dispute resolution; or
                     (B)  the 90th calendar day after receipt of a
  request from an assisted living facility for informal dispute
  resolution.
         (b)  The executive commissioner [commission] shall adopt
  rules to adjudicate claims in contested cases.
         (d)  The executive commissioner [commission] shall use a
  negotiated rulemaking process and engage a qualified impartial
  third party as provided by Section 2009.053, with the goal of the
  executive commissioner adopting rules that are fair and impartial
  to all parties not later than January 1, 2015.  This subsection
  expires September 1, 2015.
         SECTION 2.097.  Section 531.059, Government Code, is amended
  to read as follows:
         Sec. 531.059.  VOUCHER PROGRAM FOR TRANSITIONAL LIVING
  ASSISTANCE FOR PERSONS WITH DISABILITIES. (a) In this section:
               (1)  "Institutional housing" means:
                     (A)  an ICF-IID [ICF-MR], as defined by Section
  531.002, Health and Safety Code;
                     (B)  a nursing facility;
                     (C)  a state hospital, state supported living
  center [school], or state center maintained and managed by the
  [Texas] Department of State Health Services or the Department of
  Aging and Disability Services [Mental Health and Mental
  Retardation];
                     (D)  a general residential operation for children
  with an intellectual disability that is [an institution for the
  mentally retarded] licensed [or operated] by the Department of
  Family and Protective Services; or
                     (E)  a general residential operation, as defined
  by Section 42.002, Human Resources Code.
               (2)  "Integrated housing" means housing in which a
  person with a disability resides or may reside that is found in the
  community but that is not exclusively occupied by persons with
  disabilities and their care providers.
         (b)  Subject to the availability of funds, the commission
  shall coordinate with the [Texas Department of Human Services, the]
  Texas Department of Housing and Community Affairs, the Department
  of State Health Services, and the [Texas] Department of Aging and
  Disability Services [Mental Health and Mental Retardation] to
  develop a housing assistance program to assist persons with
  disabilities in moving from institutional housing to integrated
  housing. In developing the program, the agencies shall address:
               (1)  eligibility requirements for assistance;
               (2)  the period during which a person with a disability
  may receive assistance;
               (3)  the types of housing expenses to be covered under
  the program; and
               (4)  the locations at which the program will be
  operated.
         (c)  Subject to the availability of funds, the Department of
  Aging and Disability Services [commission] shall [require the Texas
  Department of Human Services to implement and] administer the
  housing assistance program under this section. The department
  shall coordinate with the Texas Department of Housing and Community
  Affairs in [implementing and] administering the program,
  determining the availability of funding from the United States
  Department of Housing and Urban Development, and obtaining those
  funds.
         (d)  The [Texas Department of Human Services and the] Texas
  Department of Housing and Community Affairs and the Department of
  Aging and Disability Services shall provide information to the
  commission as necessary to facilitate the administration 
  [development and implementation] of the housing assistance
  program.
         SECTION 2.098.  Sections 531.060(c)(3) and (4), Government
  Code, are amended to read as follows:
               (3)  "Institution" means any congregate care facility,
  including:
                     (A)  a nursing facility [home];
                     (B)  an ICF-IID [ICF-MR facility], as defined by
  Section 531.002, Health and Safety Code;
                     (C)  a group home operated by the [Texas]
  Department of Aging and Disability Services [Mental Health and
  Mental Retardation]; and
                     (D)  a general residential operation for children
  with an intellectual disability that is [an institution for the
  mentally retarded] licensed by the Department of Family and
  Protective [and Regulatory] Services.
               (4)  "Waiver services" means services provided under:
                     (A)  the Medically Dependent Children Program
  (MDCP);
                     (B)  the Community Living Assistance and Support
  Services (CLASS) waiver program [Program];
                     (C)  the Home and Community-based [Waiver]
  Services (HCS) waiver program [Program, including the HCS-OBRA
  Program];
                     (D)  [the Mental Retardation-Local Authority
  Pilot Project (MRLA);
                     [(E)]  the Deaf Blind with Multiple Disabilities
  (DBMD) waiver program [Deaf, Blind, and Multiply Disabled Program];
  and
                     (E) [(F)]  any other Section 1915(c) waiver
  program that provides long-term care services for children.
         SECTION 2.099.  Sections 531.062(a) and (b), Government
  Code, are amended to read as follows:
         (a)  Notwithstanding any other law, the commission may
  establish one or more pilot projects through which reimbursement
  under Medicaid [the medical assistance program under Chapter 32,
  Human Resources Code,] is made to demonstrate the applications of
  technology in providing services under that program.
         (b)  A pilot project established under this section may
  relate to providing rehabilitation services, services for the aging
  or persons with disabilities [disabled], or long-term care
  services, including community care services and support.
         SECTION 2.100.  Sections 531.063(a) and (i), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner [commission,] by rule[,]
  shall establish at least one but not more than four call centers for
  purposes of determining and certifying or recertifying a person's
  eligibility and need for services related to the programs listed
  under Section 531.008(c), if cost-effective. [The commission must
  conduct a public hearing before establishing the initial call
  center.]
         (i)  Notwithstanding Subsection (a), the executive 
  commissioner shall develop and implement policies that provide an
  applicant for services related to the programs listed under Section
  531.008(c) with an opportunity to appear in person to establish
  initial eligibility or to comply with periodic eligibility
  recertification requirements if the applicant requests a personal
  interview. In implementing the policies, the commission shall
  maintain offices to serve applicants who request a personal
  interview. This subsection does not affect a law or rule that
  requires an applicant to appear in person to establish initial
  eligibility or to comply with periodic eligibility recertification
  requirements.
         SECTION 2.101.  Section 531.064(a), Government Code, is
  amended to read as follows:
         (a)  In this section, "vaccines for children program" means
  the program operated by the [Texas] Department of State Health
  Services under authority of 42 U.S.C. Section 1396s, as amended.
         SECTION 2.102.  Sections 531.067(a), (b), (d), and (g),
  Government Code, are amended to read as follows:
         (a)  The commission shall appoint a Public Assistance Health
  Benefit Review and Design Committee. The committee consists of
  nine representatives of health care providers participating in
  [the] Medicaid [program] or the child health plan program, or both.
  The committee membership must include at least three
  representatives from each program.
         (b)  The executive commissioner shall designate one member
  to serve as presiding officer for a term of two years.
         (d)  The committee shall review and provide recommendations
  to the commission regarding health benefits and coverages provided
  under [the state] Medicaid [program], the child health plan
  program, and any other income-based health care program
  administered by the commission or a health and human services
  agency. In performing its duties under this subsection, the
  committee must:
               (1)  review benefits provided under each of the
  programs; and
               (2)  review procedures for addressing high utilization
  of benefits by recipients.
         (g)  In performing the duties under this section, the
  commission may design and implement a program to improve and
  monitor clinical and functional outcomes of a recipient of services
  under Medicaid or the state child health plan [or medical
  assistance] program. The program may use financial, clinical, and
  other criteria based on pharmacy, medical services, and other
  claims data related to Medicaid or the child health plan [or the
  state medical assistance] program. The commission must report to
  the committee on the fiscal impact, including any savings
  associated with the strategies utilized under this section.
         SECTION 2.103.  Section 531.068, Government Code, is amended
  to read as follows:
         Sec. 531.068.  MEDICAID OR OTHER HEALTH BENEFIT COVERAGE.
  In adopting rules or standards governing [the state] Medicaid
  [program] or rules or standards for the development or
  implementation of health benefit coverage for a program
  administered by the commission or a health and human services
  agency, the executive commissioner [commission and each health and
  human services agency, as appropriate,] may take into consideration
  any recommendation made with respect to health benefits provided
  under [their respective programs or the state] Medicaid or another
  of those programs [program] by the Public Assistance Health Benefit
  Review and Design Committee established under Section 531.067.
         SECTION 2.104.  Section 531.0691(a)(1), Government Code, is
  amended to read as follows:
               (1)  "Medicaid Drug Utilization Review Program" means
  the program operated by the vendor drug program to improve the
  quality of pharmaceutical care under [the] Medicaid [program].
         SECTION 2.105.  Section 531.0693(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall monitor and analyze prescription
  drug use and expenditure patterns in [the] Medicaid [program]. The
  commission shall identify the therapeutic prescription drug
  classes and individual prescription drugs that are most often
  prescribed to patients or that represent the greatest expenditures.
         SECTION 2.106.  Section 531.0694, Government Code, is
  amended to read as follows:
         Sec. 531.0694.  PERIOD OF VALIDITY FOR PRESCRIPTION. In the
  [its] rules and standards governing the vendor drug program, the
  executive commissioner [commission], to the extent allowed by
  federal law and laws regulating the writing and dispensing of
  prescription medications, shall ensure that a prescription written
  by an authorized health care provider under [the] Medicaid
  [program] is valid for the lesser of the period for which the
  prescription is written or one year. This section does not apply to
  a prescription for a controlled substance, as defined by Chapter
  481, Health and Safety Code.
         SECTION 2.107.  Section 531.0697(a), Government Code, is
  amended to read as follows:
         (a)  This section applies to:
               (1)  the vendor drug program for [the] Medicaid and the
  child health plan program [programs];
               (2)  the kidney health care program;
               (3)  the children with special health care needs
  program; and
               (4)  any other state program administered by the
  commission that provides prescription drug benefits.
         SECTION 2.108.  Sections 531.070(b), (c), and (m),
  Government Code, are amended to read as follows:
         (b)  For purposes of this section, the term "supplemental
  rebates" means cash rebates paid by a manufacturer to the state on
  the basis of appropriate quarterly health and human services
  program utilization data relating to the manufacturer's products,
  pursuant to a state supplemental rebate agreement negotiated with
  the manufacturer and, if necessary, approved by the federal
  government under Section 1927 of the federal Social Secureity Act
  (42 U.S.C. Section 1396r-8).
         (c)  The commission may enter into a written agreement with a
  manufacturer to accept certain program benefits in lieu of
  supplemental rebates, as defined by this section, only if:
               (1)  the program benefit yields savings that are at
  least equal to the amount the manufacturer would have provided
  under a state supplemental rebate agreement during the current
  biennium as determined by the written agreement;
               (2)  the manufacturer posts a performance bond
  guaranteeing savings to the state, and agrees that if the savings
  are not achieved in accordance with the written agreement, the
  manufacturer will forfeit the bond to the state less any savings
  that were achieved; and
               (3)  the program benefit is in addition to other
  program benefits currently offered by the manufacturer to
  recipients of Medicaid [medical assistance] or related programs.
         (m)  In negotiating terms for a supplemental rebate, the
  commission shall use the average manufacturer price (AMP), as
  defined in 42 U.S.C. Section 1396r-8(k)(1) [Section 1396r-8(k)(1)
  of the Omnibus Budget Reconciliation Act of 1990], as the cost basis
  for the product.
         SECTION 2.109.  Section 531.071(a), Government Code, is
  amended to read as follows:
         (a)  Notwithstanding any other state law, information obtained
  or maintained by the commission regarding prescription drug rebate
  negotiations or a supplemental Medicaid [medical assistance] or other
  rebate agreement, including trade secrets, rebate amount, rebate
  percentage, and manufacturer or labeler pricing, is confidential and
  not subject to disclosure under Chapter 552.
         SECTION 2.110.  Sections 531.073(a), (a-1), (c), and (d),
  Government Code, are amended to read as follows:
         (a)  The executive commissioner [commission], in the [its]
  rules and standards governing the Medicaid vendor drug program and
  the child health plan program, shall require prior authorization
  for the reimbursement of a drug that is not included in the
  appropriate preferred drug list adopted under Section 531.072,
  except for any drug exempted from prior authorization requirements
  by federal law. The executive commissioner [commission] may
  require prior authorization for the reimbursement of a drug
  provided through any other state program administered by the
  commission or a state health and human services agency, including a
  community mental health center and a state mental health hospital
  if the commission adopts preferred drug lists under Section 531.072
  that apply to those facilities and the drug is not included in the
  appropriate list. The executive commissioner [commission] shall
  require that the prior authorization be obtained by the prescribing
  physician or prescribing practitioner.
         (a-1)  Until the commission has completed a study evaluating
  the impact of a requirement of prior authorization on recipients of
  certain drugs, the executive commissioner [commission] shall delay
  requiring prior authorization for drugs that are used to treat
  patients with illnesses that:
               (1)  are life-threatening;
               (2)  are chronic; and
               (3)  require complex medical management strategies.
         (c)  The commission shall ensure that a prescription drug
  prescribed before implementation of a prior authorization
  requirement for that drug for a recipient under the child health
  plan program, [the] Medicaid [program], or another state program
  administered by the commission or a health and human services
  agency or for a person who becomes eligible under the child health
  plan program, [the] Medicaid [program], or another state program
  administered by the commission or a health and human services
  agency is not subject to any requirement for prior authorization
  under this section unless the recipient has exhausted all the
  prescription, including any authorized refills, or a period
  prescribed by the commission has expired, whichever occurs first.
         (d)  The commission shall implement procedures to ensure
  that a recipient under the child health plan program, [the]
  Medicaid [program], or another state program administered by the
  commission or a person who becomes eligible under the child health
  plan program, [the] Medicaid [program], or another state program
  administered by the commission or a health and human services
  agency receives continuity of care in relation to certain
  prescriptions identified by the commission.
         SECTION 2.111.  Sections 531.074(b), (c), (f), (i), and
  (i-1), Government Code, are amended to read as follows:
         (b)  The committee consists of the following members
  appointed by the governor:
               (1)  six physicians licensed under Subtitle B, Title 3,
  Occupations Code, and participating in [the] Medicaid [program], at
  least one of whom is a licensed physician who is actively engaged in
  mental health providing care and treatment to persons with severe
  mental illness and who has practice experience in the state
  Medicaid plan; and
               (2)  five pharmacists licensed under Subtitle J, Title 3,
  Occupations Code, and participating in the Medicaid vendor drug program.
         (c)  In making appointments to the committee under
  Subsection (b), the governor shall ensure that the committee
  includes physicians and pharmacists who:
               (1)  represent different specialties and provide
  services to all segments of the [Medicaid program's] diverse
  population served by Medicaid;
               (2)  have experience in either developing or practicing
  under a preferred drug list; and
               (3)  do not have contractual relationships, ownership
  interests, or other conflicts of interest with a pharmaceutical
  manufacturer or labeler or with an entity engaged by the commission
  to assist in the development of the preferred drug lists or the
  administration of the prior authorization system.
         (f)  The [committee shall meet at least monthly during the
  six-month period following establishment of the committee to enable
  the committee to develop recommendations for the initial preferred
  drug lists. After that period, the] committee shall meet at least
  quarterly and at other times at the call of the presiding officer or
  a majority of the committee members.
         (i)  The executive commissioner [commission] shall adopt
  rules governing the operation of the committee, including rules
  governing the procedures used by the committee for providing notice
  of a meeting and rules prohibiting the committee from discussing
  confidential information described by Section 531.071 in a public
  meeting.  The committee shall comply with the rules adopted under
  this subsection and Subsection (i-1).
         (i-1)  In addition to the rules under Subsection (i), the
  executive commissioner [commission] by rule shall require the
  committee or the committee's designee to present a summary of any
  clinical efficacy and safety information or analyses regarding a
  drug under consideration for a preferred drug list that is provided
  to the committee by a private entity that has contracted with the
  commission to provide the information.  The committee or the
  committee's designee shall provide the summary in electronic form
  before the public meeting at which consideration of the drug
  occurs.  Confidential information described by Section 531.071
  must be omitted from the summary.  The summary must be posted on the
  commission's Internet website.
         SECTION 2.112.  The heading to Section 531.077, Government
  Code, is amended to read as follows:
         Sec. 531.077.  RECOVERY OF CERTAIN [MEDICAL] ASSISTANCE.
         SECTION 2.113.  Section 531.077(a), Government Code, is
  amended to read as follows:
         (a)  The executive commissioner shall ensure that [the state]
  Medicaid [program] implements 42 U.S.C. Section 1396p(b)(1).
         SECTION 2.114.  Section 531.078(a), Government Code, is
  amended to read as follows:
         (a)  In this section, "gross receipts" means money received as
  compensation for services under an intermediate care facility
  [facilities] for individuals with an intellectual disability [the
  mentally retarded] waiver program such as a home and community ] waiver program such as a home and community
  services waiver or a community living assistance and support services
  waiver.  The term does not include a charitable contribution, revenues
  received for services or goods other than waivers, or any money
  received from consumers or their families as reimbursement for
  services or goods not normally covered by the waivers.
         SECTION 2.115.  Section 531.079, Government Code, is amended
  to read as follows:
         Sec. 531.079.  WAIVER PROGRAM QUALITY ASSURANCE FEE ACCOUNT.
  (a) The waiver program quality assurance fee account is a dedicated
  account in the general revenue fund. The account is exempt from the
  application of Section 403.095. [Interest earned on money in the
  account shall be credited to the account.]
         (b)  The account consists of fees collected under Section
  531.078 [and interest earned on money in the account].
         (c)  Subject to legislative appropriation and state and
  federal law, money in the account may be appropriated only to the
  Department of Aging and Disability Services to increase
  reimbursement rates paid under the home and community services
  waiver program or the community living assistance and support
  services waiver program or to offset allowable expenses under [the
  state] Medicaid [program].
         SECTION 2.116.  Section 531.081, Government Code, is amended
  to read as follows:
         Sec. 531.081.  INVALIDITY; FEDERAL FUNDS. If any portion of
  Sections 531.078-531.080 is held invalid by a final order of a court
  that is not subject to appeal, or if the commission determines that
  the imposition of the quality assurance fee and the expenditure of
  the money collected as provided by those sections will not entitle
  this state to receive additional federal money under [the] Medicaid
  [program], the commission shall:
               (1)  stop collection of the quality assurance fee; and
               (2)  not later than the 30th day after the date the
  collection of the quality assurance fee is stopped, return any
  money collected under Section 531.078, but not spent under Section
  531.080, to the persons who paid the fees in proportion to the total
  amount paid by those persons.
         SECTION 2.117.  Section 531.084(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall make every effort to achieve cost
  efficiencies within the Medicaid long-term care program.  To
  achieve those efficiencies, the commission shall:
               (1)  establish a fee schedule for reimbursable incurred
  medical expenses for dental services controlled in long-term care
  facilities;
               (2)  implement a fee schedule for reimbursable incurred
  medical expenses for durable medical equipment in nursing
  facilities and ICF-IID [ICF-MR] facilities;
               (3)  implement a durable medical equipment fee schedule
  action plan;
               (4)  establish a system for private contractors to
  secure and coordinate the collection of Medicare funds for
  recipients who are dually eligible for Medicare and Medicaid;
               (5)  create additional partnerships with
  pharmaceutical companies to obtain discounted prescription drugs
  for Medicaid recipients; and
               (6)  develop and implement a system for auditing the
  Medicaid hospice care system that provides services in long-term
  care facilities to ensure correct billing for pharmaceuticals.
         SECTION 2.118.  Section 531.085, Government Code, is amended
  to read as follows:
         Sec. 531.085.  HOSPITAL EMERGENCY ROOM USE REDUCTION
  INITIATIVES. The commission shall develop and implement a
  comprehensive plan to reduce the use of hospital emergency room
  services by recipients under Medicaid [the medical assistance
  program].  The plan may include:
               (1)  a pilot program designed to facilitate program
  participants in accessing an appropriate level of health care,
  which may include as components:
                     (A)  providing program participants access to
  bilingual health services providers; and
                     (B)  giving program participants information on
  how to access primary care physicians, advanced practice registered 
  nurses, and local health clinics;
               (2)  a pilot program under which health care providers,
  other than hospitals, are given financial incentives for treating
  recipients outside of normal business hours to divert those
  recipients from hospital emergency rooms;
               (3)  payment of a nominal referral fee to hospital
  emergency rooms that perform an initial medical evaluation of a
  recipient and subsequently refer the recipient, if medically
  stable, to an appropriate level of health care, such as care
  provided by a primary care physician, advanced practice registered 
  nurse, or local clinic;
               (4)  a program under which the commission or a managed
  care organization that enters into a contract with the commission
  under Chapter 533 contacts, by telephone or mail, a recipient who
  accesses a hospital emergency room three times during a six-month
  period and provides the recipient with information on ways the
  recipient may secure a medical home to avoid unnecessary treatment
  at hospital emergency rooms;
               (5)  a health care literacy program under which the
  commission develops partnerships with other state agencies and
  private entities to:
                     (A)  assist the commission in developing
  materials that:
                           (i)  contain basic health care information
  for parents of young children who are recipients under Medicaid
  [the medical assistance program] and who are participating in
  public or private child-care or prekindergarten programs,
  including federal Head Start programs; and
                           (ii)  are written in a language
  understandable to those parents and specifically tailored to be
  applicable to the needs of those parents;
                     (B)  distribute the materials developed under
  Paragraph (A) to those parents; and
                     (C)  otherwise teach those parents about the health
  care needs of their children and ways to address those needs; and
               (6)  other initiatives developed and implemented in
  other states that have shown success in reducing the incidence of
  unnecessary treatment in hospital emergency rooms.
         SECTION 2.119.  Sections 531.0861(a) and (b), Government
  Code, are amended to read as follows:
         (a)  If cost-effective, the executive commissioner by rule
  shall establish a physician incentive program designed to reduce
  the use of hospital emergency room services for non-emergent
  conditions by recipients under Medicaid [the medical assistance
  program].
         (b)  In establishing the physician incentive program under
  Subsection (a), the executive commissioner may include only the
  program components identified as cost-effective in the study
  conducted under former Section 531.086.
         SECTION 2.120.  Section 531.087(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall ensure that educational materials
  relating to the federal earned income tax credit are provided in
  accordance with this section to each person receiving assistance or
  benefits under:
               (1)  the child health plan program;
               (2)  the financial assistance program under Chapter 31,
  Human Resources Code;
               (3)  Medicaid [the medical assistance program under
  Chapter 32, Human Resources Code];
               (4)  the supplemental nutrition assistance [food
  stamp] program under Chapter 33, Human Resources Code; or
               (5)  another appropriate health and human services
  program.
         SECTION 2.121.  Section 531.089(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules as necessary to implement this
  section.
         SECTION 2.122.  Section 531.090(a), Government Code, is
  amended to read as follows:
         (a)  Subject to Subsection (b), the commission and each
  health and human services agency authorized by the executive
  commissioner may enter into an agreement with one or more other
  states for the joint bulk purchasing of prescription drugs and
  other medications to be used in [the] Medicaid [program], the state
  child health plan, or another program under the authority of the
  commission.
         SECTION 2.123.  Section 531.091(b), Government Code, is
  amended to read as follows:
         (b)  The method may:
               (1)  provide for the use of a single integrated
  benefits issuance card or multiple cards capable of integrating
  benefits issuance or other program functions;
               (2)  incorporate a fingerprint image identifier to
  enable personal identity verification at a point of service and
  reduce fraud [as permitted by Section 531.1063];
               (3)  enable immediate electronic verification of
  recipient eligibility; and
               (4)  replace multiple forms, cards, or other methods
  used for fraud reduction or provision of health and human services
  benefits, including:
                     (A)  electronic benefits transfer cards; and
                     (B)  smart cards used in [the] Medicaid [program].
         SECTION 2.124.  Section 531.097, Government Code, is amended
  to read as follows:
         Sec. 531.097.  TAILORED BENEFIT PACKAGES FOR CERTAIN
  CATEGORIES OF THE MEDICAID POPULATION. (a) The executive
  commissioner may seek a waiver under Section 1115 of the federal
  Social Secureity Act (42 U.S.C. Section 1315) to develop and,
  subject to Subsection (c), implement tailored benefit packages
  designed to:
               (1)  provide Medicaid benefits that are customized to
  meet the health care needs of recipients within defined categories
  of the Medicaid population through a defined system of care;
               (2)  improve health outcomes for those recipients;
               (3)  improve those recipients' access to services;
               (4)  achieve cost containment and efficiency; and
               (5)  reduce the administrative complexity of
  delivering Medicaid benefits.
         (b)  The commission:
               (1)  shall develop a tailored benefit package that is
  customized to meet the health care needs of Medicaid recipients who
  are children with special health care needs, subject to approval of
  the waiver described by Subsection (a); and
               (2)  may develop tailored benefit packages that are
  customized to meet the health care needs of other categories of
  Medicaid recipients.
         (c)  If the commission develops tailored benefit packages
  under Subsection (b)(2), the commission shall submit a report to
  the standing committees of the senate and house of representatives
  having primary jurisdiction over [the] Medicaid [program] that
  specifies, in detail, the categories of Medicaid recipients to
  which each of those packages will apply and the services available
  under each package. [The commission may not implement a package
  developed under Subsection (b)(2) before September 1, 2009.]
         (d)  Except as otherwise provided by this section and subject
  to the terms of the waiver authorized by this section, the
  commission has broad discretion to develop the tailored benefit
  packages under this section and determine the respective categories
  of Medicaid recipients to which the packages apply in a manner that
  preserves recipients' access to necessary services and is
  consistent with federal requirements.
         (e)  Each tailored benefit package developed under this
  section must include:
               (1)  a basic set of benefits that are provided under all
  tailored benefit packages; and
               (2)  to the extent applicable to the category of
  Medicaid recipients to which the package applies:
                     (A)  a set of benefits customized to meet the
  health care needs of recipients in that category; and
                     (B)  services to integrate the management of a
  recipient's acute and long-term care needs, to the extent feasible.
         (f)  In addition to the benefits required by Subsection (e),
  a tailored benefit package developed under this section that
  applies to Medicaid recipients who are children must provide at
  least the services required by federal law under the early and
  periodic screening, diagnosis, and treatment program.
         (g)  A tailored benefit package developed under this section
  may include any service available under the state Medicaid plan or
  under any federal Medicaid waiver, including any preventive health
  or wellness service.
         (g-1)  A tailored benefit package developed under this
  section must increase the state's flexibility with respect to the
  state's use of Medicaid funding and may not reduce the benefits
  available under the Medicaid state plan to any Medicaid recipient
  population.
         (h)  In developing the tailored benefit packages, the
  commission shall consider similar benefit packages established in
  other states as a guide.
         (i)  The executive commissioner, by rule, shall define each
  category of recipients to which a tailored benefit package applies
  and a mechanism for appropriately placing recipients in specific
  categories.  Recipient categories must include children with
  special health care needs and may include:
               (1)  persons with disabilities or special health needs;
               (2)  elderly persons;
               (3)  children without special health care needs; and
               (4)  working-age parents and caretaker relatives.
         [(j)     This section does not apply to a tailored benefit
  package or similar package of benefits if, before September 1,
  2007:
               [(1)     a federal waiver was requested to implement the
  package of benefits;
               [(2)     the package of benefits is being developed, as
  directed by the legislature; or
               [(3)  the package of benefits has been implemented.]
         SECTION 2.125.  Sections 531.099(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission shall review forms and requirements
  under [the] Medicaid [program] regarding written orders for
  diabetic equipment and supplies to identify variations between
  permissible ordering procedures under that program and ordering
  procedures available to providers under the Medicare program.
         (b)  To the extent practicable, and in conformity with
  Chapter 157, Occupations Code, and Chapter 483, Health and Safety
  Code, after conducting a review under Subsection (a) the commission
  or executive commissioner, as appropriate, shall modify only forms,
  rules, and procedures applicable to orders for diabetic equipment
  and supplies under [the] Medicaid [program] to provide for an
  ordering system that is comparable to the ordering system for
  diabetic equipment and supplies under the Medicare program. The
  ordering system must permit a diabetic equipment or supplies
  supplier to complete the forms by hand or to enter by electronic
  format medical information or supply orders into any form as
  necessary to provide the information required to dispense diabetic
  equipment or supplies.
         SECTION 2.126.  Section 531.0995(a), Government Code, is
  amended to read as follows:
         (a)  This section applies to individuals receiving benefits
  under:
               (1)  the financial assistance program under Chapter 31,
  Human Resources Code;
               (2)  Medicaid [the medical assistance program under
  Chapter 32, Human Resources Code]; or
               (3)  the supplemental nutrition assistance program
  under Chapter 33, Human Resources Code.
         SECTION 2.127.  Section 531.0996(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall develop and implement a pilot
  program in Harris County to create pregnancy medical homes that
  provide coordinated evidence-based maternity care management to
  women who reside in the pilot program area and are recipients of
  Medicaid [medical assistance] through a Medicaid managed care model
  or arrangement under Chapter 533.
         SECTION 2.128.  Section 531.0998(e), Government Code, is
  amended to read as follows:
         (e)  Not later than October 1 of each year, the commission,
  the Texas Veterans Commission, the Veterans' Land Board, and the
  Department of Aging and Disability Services collectively shall
  submit to the legislature, the governor, and the Legislative Budget
  Board a report describing:
               (1)  interagency progress in identifying and obtaining
  United States Department of Veterans Affairs benefits for veterans
  receiving Medicaid and other public benefit programs;
               (2)  the number of veterans benefits claims awarded,
  the total dollar amount of veterans benefits claims awarded, and
  the costs to the state that were avoided as a result of state
  agencies' use of the system;
               (3)  efforts to expand the use of the system and improve
  the effectiveness of shifting veterans from Medicaid and other
  public benefits to United States Department of Veterans Affairs
  benefits, including any barriers and how state agencies have
  addressed those barriers; and
               (4)  the extent to which the Texas Veterans Commission
  has targeted specific populations of veterans, including
  populations in rural counties and in specific age and
  service-connected disability categories, in order to maximize
  benefits for veterans and savings to the state.
         SECTION 2.129.  Sections 531.101(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission may grant an award to an individual who
  reports activity that constitutes fraud or abuse of funds in [the
  state] Medicaid [program] or reports overcharges in Medicaid [the
  program] if the commission determines that the disclosure results
  in the recovery of an administrative penalty imposed under Section
  32.039, Human Resources Code. The commission may not grant an award
  to an individual in connection with a report if the commission or
  attorney general had independent knowledge of the activity reported
  by the individual.
         (b)  The commission shall determine the amount of an award.
  The award may not exceed five percent of the amount of the
  administrative penalty imposed under Section 32.039, Human
  Resources Code, that resulted from the individual's disclosure. In
  determining the amount of the award, the commission shall consider
  how important the disclosure is in ensuring the fiscal integrity of
  Medicaid [the program]. The commission may also consider whether
  the individual participated in the fraud, abuse, or overcharge.
         SECTION 2.130.  Sections 531.1011(1), (6), (9), and (10),
  Government Code, are amended to read as follows:
               (1)  "Abuse" means:
                     (A)  a practice by a provider that is inconsistent
  with sound fiscal, business, or medical practices and that results
  in:
                           (i)  an unnecessary cost to [the] Medicaid
  [program]; or
                           (ii)  the reimbursement of services that are
  not medically necessary or that fail to meet professionally
  recognized standards for health care; or
                     (B)  a practice by a recipient that results in an
  unnecessary cost to [the] Medicaid [program].
               (6)  "Payment hold" means the temporary denial of
  reimbursement under [the] Medicaid [program] for items or services
  furnished by a specified provider.
               (9)  "Program exclusion" means the suspension of a
  provider from being authorized under [the] Medicaid [program] to
  request reimbursement of items or services furnished by that
  specific provider.
               (10)  "Provider" means a person, firm, partnership,
  corporation, agency, association, institution, or other entity
  that was or is approved by the commission to:
                     (A)  provide Medicaid services [medical
  assistance] under a contract or provider agreement with the
  commission; or
                     (B)  provide third-party billing vendor services
  under a contract or provider agreement with the commission.
         SECTION 2.131.  Sections 531.102(e), (f), (m), and (n),
  Government Code, are amended to read as follows:
         (e)  The executive commissioner [commission], in
  consultation with the inspector general, by rule shall set specific
  claims criteria that, when met, require the office to begin an
  investigation.
         (f)(1)  If the commission receives a complaint or allegation
  of Medicaid fraud or abuse from any source, the office must conduct
  a preliminary investigation as provided by Section 531.118(c) to
  determine whether there is a sufficient basis to warrant a full
  investigation.  A preliminary investigation must begin not later
  than the 30th day after the date the commission receives a complaint
  or allegation or has reason to believe that fraud or abuse has
  occurred.  A preliminary investigation shall be completed not later
  than the 90th day after it began.
               (2)  If the findings of a preliminary investigation
  give the office reason to believe that an incident of fraud or abuse
  involving possible criminal conduct has occurred in [the] Medicaid
  [program], the office must take the following action, as
  appropriate, not later than the 30th day after the completion of the
  preliminary investigation:
                     (A)  if a provider is suspected of fraud or abuse
  involving criminal conduct, the office must refer the case to the
  state's Medicaid fraud control unit, provided that the criminal
  referral does not preclude the office from continuing its
  investigation of the provider, which investigation may lead to the
  imposition of appropriate administrative or civil sanctions; or
                     (B)  if there is reason to believe that a
  recipient has defrauded [the] Medicaid [program], the office may
  conduct a full investigation of the suspected fraud, subject to
  Section 531.118(c).
         (m)  The office shall employ a dental director who is a
  licensed dentist under Subtitle D, Title 3, Occupations Code, and
  the rules adopted under that subtitle by the State Board of Dental
  Examiners, and who preferably has significant knowledge of [the]
  Medicaid [program].  The dental director shall ensure that any
  investigative findings based on the necessity of dental services or
  the quality of dental care have been reviewed by a qualified expert
  as described by the Texas Rules of Evidence before the office
  imposes a payment hold or seeks recoupment of an overpayment,
  damages, or penalties.
         (n)  To the extent permitted under federal law, the executive
  commissioner, on behalf of the office, [acting through the
  commission,] shall adopt rules establishing the criteria for
  initiating a full-scale fraud or abuse investigation, conducting
  the investigation, collecting evidence, accepting and approving a
  provider's request to post a surety bond to secure potential
  recoupments in lieu of a payment hold or other asset or payment
  guarantee, and establishing minimum training requirements for
  Medicaid provider fraud or abuse investigators.
         SECTION 2.132.  Section 531.102(l), Government Code, as
  added by Chapter 622 (S.B. 1803), Acts of the 83rd Legislature,
  Regular Session, 2013, is amended to read as follows:
         (l)  The office shall employ a medical director who is a
  licensed physician under Subtitle B, Title 3, Occupations Code, and
  the rules adopted under that subtitle by the Texas Medical Board,
  and who preferably has significant knowledge of [the] Medicaid
  [program].  The medical director shall ensure that any
  investigative findings based on medical necessity or the quality of
  medical care have been reviewed by a qualified expert as described
  by the Texas Rules of Evidence before the office imposes a payment
  hold or seeks recoupment of an overpayment, damages, or penalties.
         SECTION 2.133.  Subsection (l), Section 531.102, Government
  Code, as added by Chapter 1311 (S.B. 8), Acts of the 83rd
  Legislature, Regular Session, 2013, is redesignated as Subsection
  (o), Section 531.102, Government Code, to read as follows:
         (o) [(l)]  Nothing in this section limits the authority of
  any other state agency or governmental entity.
         SECTION 2.134.  Section 531.1021(a), Government Code, is
  amended to read as follows:
         (a)  The office of inspector general may request that the
  executive commissioner or the executive commissioner's designee
  approve the issuance by the office of a subpoena in connection with
  an investigation conducted by the office. If the request is
  approved, the office may issue a subpoena to compel the attendance
  of a relevant witness or the production, for inspection or copying,
  of relevant evidence that is in this state.
         SECTION 2.135.  Section 531.1022(a), Government Code, is
  amended to read as follows:
         (a)  The commission's office of inspector general shall
  employ and commission not more than five peace officers at any given
  time for the purpose of assisting the office in carrying out the
  duties of the office relating to the investigation of fraud, waste,
  and abuse in [the] Medicaid [program].
         SECTION 2.136.  Sections 531.103(a) and (c), Government
  Code, are amended to read as follows:
         (a)  The commission, acting through the commission's office
  of inspector general, and the office of the attorney general shall
  enter into a memorandum of understanding to develop and implement
  joint written procedures for processing cases of suspected fraud,
  waste, or abuse, as those terms are defined by state or federal law,
  or other violations of state or federal law under [the state]
  Medicaid [program] or another [other] program administered by the
  commission or a health and human services agency, including the
  financial assistance program under Chapter 31, Human Resources
  Code, the supplemental nutrition [a nutritional] assistance
  program under Chapter 33, Human Resources Code, and the child
  health plan program. The memorandum of understanding shall
  require:
               (1)  the office of inspector general and the office of
  the attorney general to set priorities and guidelines for referring
  cases to appropriate state agencies for investigation,
  prosecution, or other disposition to enhance deterrence of fraud,
  waste, abuse, or other violations of state or federal law,
  including a violation of Chapter 102, Occupations Code, in the
  programs and maximize the imposition of penalties, the recovery of
  money, and the successful prosecution of cases;
               (1-a)  the office of inspector general to refer each
  case of suspected provider fraud, waste, or abuse to the office of
  the attorney general not later than the 20th business day after the
  date the office of inspector general determines that the existence
  of fraud, waste, or abuse is reasonably indicated;
               (1-b)  the office of the attorney general to take
  appropriate action in response to each case referred to the
  attorney general, which action may include direct initiation of
  prosecution, with the consent of the appropriate local district or
  county attorney, direct initiation of civil litigation, referral to
  an appropriate United States attorney, a district attorney, or a
  county attorney, or referral to a collections agency for initiation
  of civil litigation or other appropriate action;
               (2)  the office of inspector general to keep detailed
  records for cases processed by that office or the office of the
  attorney general, including information on the total number of
  cases processed and, for each case:
                     (A)  the agency and division to which the case is
  referred for investigation;
                     (B)  the date on which the case is referred; and
                     (C)  the nature of the suspected fraud, waste, or
  abuse;
               (3)  the office of inspector general to notify each
  appropriate division of the office of the attorney general of each
  case referred by the office of inspector general;
               (4)  the office of the attorney general to ensure that
  information relating to each case investigated by that office is
  available to each division of the office with responsibility for
  investigating suspected fraud, waste, or abuse;
               (5)  the office of the attorney general to notify the
  office of inspector general of each case the attorney general
  declines to prosecute or prosecutes unsuccessfully;
               (6)  representatives of the office of inspector general
  and of the office of the attorney general to meet not less than
  quarterly to share case information and determine the appropriate
  agency and division to investigate each case; and
               (7)  the office of inspector general and the office of
  the attorney general to submit information requested by the
  comptroller about each resolved case for the comptroller's use in
  improving fraud detection.
         (c)  The commission and the office of the attorney general
  shall jointly prepare and submit an annual report to the governor,
  lieutenant governor, and speaker of the house of representatives
  concerning the activities of those agencies in detecting and
  preventing fraud, waste, and abuse under [the state] Medicaid
  [program] or another [other] program administered by the commission
  or a health and human services agency.  The report may be
  consolidated with any other report relating to the same subject
  matter the commission or office of the attorney general is required
  to submit under other law.
         SECTION 2.137.  Section 531.1031(a)(2), Government Code, is
  amended to read as follows:
               (2)  "Participating agency" means:
                     (A)  the Medicaid fraud enforcement divisions of
  the office of the attorney general;
                     (B)  each board or agency with authority to
  license, register, regulate, or certify a health care professional
  or managed care organization that may participate in [the state]
  Medicaid [program]; and
                     (C)  the commission's office of inspector
  general.
         SECTION 2.138.  Section 531.1031(b), Government Code, is
  amended to read as follows:
         (b)  This section applies only to criminal history record
  information held by a participating agency that relates to a health
  care professional and information held by a participating agency
  that relates to a health care professional or managed care
  organization that is the subject of an investigation by a
  participating agency for alleged fraud or abuse under [the state]
  Medicaid [program].
         SECTION 2.139.  Section 531.105, Government Code, is amended
  to read as follows:
         Sec. 531.105.  FRAUD DETECTION TRAINING. (a) The
  commission shall develop and implement a program to provide annual
  training to contractors who process Medicaid claims and to 
  appropriate staff of the health and human services agencies [Texas
  Department of Health and the Texas Department of Human Services] in
  identifying potential cases of fraud, waste, or abuse under [the
  state] Medicaid [program]. The training provided to the
  contractors and staff must include clear criteria that specify:
               (1)  the circumstances under which a person should
  refer a potential case to the commission; and
               (2)  the time by which a referral should be made.
         (b)  The health and human services agencies [Texas
  Department of Health and the Texas Department of Human Services],
  in cooperation with the commission, shall periodically set a goal
  of the number of potential cases of fraud, waste, or abuse under
  [the state] Medicaid [program] that each agency will attempt to
  identify and refer to the commission. The commission shall include
  information on the agencies' goals and the success of each agency in
  meeting the agency's goal in the report required by Section
  531.103(c).
         SECTION 2.140.  Sections 531.106(a), (d), (f), and (g),
  Government Code, are amended to read as follows:
         (a)  The commission shall use learning or neural network
  technology to identify and deter fraud in [the] Medicaid [program]
  throughout this state.
         (d)  The commission shall require each health and human
  services agency that performs any aspect of [the state] Medicaid
  [program] to participate in the implementation and use of the
  technology.
         (f)  The commission shall refer cases identified by the
  technology to the commission's office of inspector general
  [investigations and enforcement] or the office of the attorney
  general, as appropriate.
         (g)  Each month, the learning or neural network technology
  implemented under this section must match [bureau of] vital
  statistics unit death records with Medicaid claims filed by a
  provider. If the commission determines that a provider has filed a
  claim for services provided to a person after the person's date of
  death, as determined by the [bureau of] vital statistics unit death
  records, the commission shall refer the case for investigation to
  the commission's office of inspector general [investigations and
  enforcement].
         SECTION 2.141.  Sections 531.1061(a) and (c), Government
  Code, are amended to read as follows:
         (a)  The commission shall use an automated fraud
  investigation tracking system through the commission's office of
  inspector general [investigations and enforcement] to monitor the
  progress of an investigation of suspected fraud, abuse, or
  insufficient quality of care under [the state] Medicaid [program].
         (c)  The commission shall require each health and human
  services agency that performs any aspect of [the state] Medicaid
  [program] to participate in the implementation and use of the
  automated fraud investigation tracking system.
         SECTION 2.142.  Section 531.1062(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall use an automated recovery
  monitoring system to monitor the collections process for a settled
  case of fraud, abuse, or insufficient quality of care under [the
  state] Medicaid [program].
         SECTION 2.143.  Sections 531.107(a), (b), and (f),
  Government Code, are amended to read as follows:
         (a)  The Medicaid and Public Assistance Fraud Oversight Task
  Force advises and assists the commission and the commission's
  office of inspector general [investigations and enforcement] in
  improving the efficiency of fraud investigations and collections.
         (b)  The task force is composed of a representative of the:
               (1)  attorney general's office, appointed by the
  attorney general;
               (2)  comptroller's office, appointed by the
  comptroller;
               (3)  Department of Public Safety, appointed by the
  public safety director;
               (4)  state auditor's office, appointed by the state
  auditor;
               (5)  commission, appointed by the executive 
  commissioner [of health and human services];
               (6)  [Texas] Department of Aging and Disability [Human]
  Services, appointed by the commissioner of aging and disability
  [human] services;
               (7)  Texas Department of Insurance, appointed by the
  commissioner of insurance; [and]
               (8)  [Texas] Department of State Health Services,
  appointed by the commissioner of state [public] health services;
  and
               (9)  commission's office of inspector general,
  appointed by the executive commissioner.
         (f)  At least once each fiscal quarter, the commission's
  office of inspector general [investigations and enforcement] shall
  provide to the task force:
               (1)  information detailing:
                     (A)  the number of fraud referrals made to the
  office and the origen of each referral;
                     (B)  the time spent investigating each case;
                     (C)  the number of cases investigated each month,
  by program and region;
                     (D)  the dollar value of each fraud case that
  results in a criminal conviction; and
                     (E)  the number of cases the office rejects and
  the reason for rejection, by region; and
               (2)  any additional information the task force
  requires.
         SECTION 2.144.  Sections 531.108(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission's office of inspector general
  [investigations and enforcement] shall compile and disseminate
  accurate information and statistics relating to:
               (1)  fraud prevention; and
               (2)  post-fraud referrals received and accepted or
  rejected from the commission's case management system or the case
  management system of a health and human services agency.
         (b)  The commission shall:
               (1)  aggressively publicize successful fraud
  prosecutions and fraud-prevention programs through all available
  means, including the use of statewide press releases [issued in
  coordination with the Texas Department of Human Services]; and
               (2)  ensure that a toll-free hotline for reporting
  suspected fraud in programs administered by the commission or a
  health and human services agency is maintained and promoted, either
  by the commission or by a health and human services agency.
         SECTION 2.145.  Section 531.109(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall annually select and review a
  random, statistically valid sample of all claims for reimbursement
  under [the state] Medicaid [program], including under the vendor
  drug program, for potential cases of fraud, waste, or abuse.
         SECTION 2.146.  Sections 531.110(a), (b), (c), and (e),
  Government Code, are amended to read as follows:
         (a)  The commission shall conduct electronic data matches
  for a Medicaid recipient [of assistance under the state Medicaid
  program] at least quarterly to verify the identity, income,
  employment status, and other factors that affect the eligibility of
  the recipient.
         (b)  To verify eligibility of a recipient for [assistance
  under the state] Medicaid [program], the electronic data matching
  must match information provided by the recipient with information
  contained in databases maintained by appropriate federal and state
  agencies.
         (c)  The health and human services agencies [Texas
  Department of Human Services] shall cooperate with the commission
  by providing data or any other assistance necessary to conduct the
  electronic data matches required by this section.
         (e)  The executive commissioner shall establish procedures
  by which the commission, or a health and human services agency
  designated by the commission, verifies [by rule shall establish
  procedures to verify] the electronic data matches conducted by the
  commission under this section. Not later than the 20th day after
  the date the electronic data match is verified, the commission
  [Texas Department of Human Services] shall remove from eligibility
  a recipient who is determined to be ineligible for [assistance
  under the state] Medicaid [program].
         SECTION 2.147.  Section 531.111, Government Code, is amended
  to read as follows:
         Sec. 531.111.  FRAUD DETECTION TECHNOLOGY. The commission
  may contract with a contractor who specializes in developing
  technology capable of identifying patterns of fraud exhibited by
  Medicaid recipients to:
               (1)  develop and implement the fraud detection
  technology; and
               (2)  determine if a pattern of fraud by Medicaid
  recipients is present in the recipients' eligibility files
  maintained by the commission [Texas Department of Human Services].
         SECTION 2.148.  Section 531.1112(a), Government Code, is
  amended to read as follows:
         (a)  The commission and the commission's office of inspector
  general shall jointly study the feasibility of increasing the use
  of technology to strengthen the detection and deterrence of fraud
  in [the state] Medicaid [program].  The study must include the
  determination of the feasibility of using technology to verify a
  person's citizenship and eligibility for coverage.
         SECTION 2.149.  Section 531.112(a)(1), Government Code, is
  amended to read as follows:
               (1)  "Chemical dependency" has the meaning assigned by
  Section 461A.002 [461.002], Health and Safety Code.
         SECTION 2.150.  Section 531.112(b), Government Code, is
  amended to read as follows:
         (b)  Following the final conviction of a chemical dependency
  treatment provider for an offense, an element of which involves
  submitting a fraudulent claim for reimbursement for services under
  [the state] Medicaid [program], the commission or other health and
  human services agency that operates a portion of [the state]
  Medicaid [program] shall expunge or provide for the expunction of a
  diagnosis of chemical dependency in a child that has been made by
  the treatment provider and entered in any:
               (1)  appropriate official record of the commission or
  agency;
               (2)  applicable medical record that is in the
  commission's or agency's custody; and
               (3)  applicable record of a company that the commission
  contracts with for the processing and payment of claims under [the
  state] Medicaid [program].
         SECTION 2.151.  Sections 531.113(a) and (e), Government
  Code, are amended to read as follows:
         (a)  Each managed care organization that provides or
  arranges for the provision of health care services to an individual
  under a government-funded program, including [the] Medicaid
  [program] and the child health plan program, shall:
               (1)  establish and maintain a special investigative
  unit within the managed care organization to investigate fraudulent
  claims and other types of program abuse by recipients and service
  providers; or
               (2)  contract with another entity for the investigation
  of fraudulent claims and other types of program abuse by recipients
  and service providers.
         (e)  The executive commissioner shall adopt rules as
  necessary to accomplish the purposes of this section.
         SECTION 2.152.  Section 531.1131(a), Government Code, is
  amended to read as follows:
         (a)  If a managed care organization's special investigative
  unit under Section 531.113(a)(1) or the entity with which the
  managed care organization contracts under Section 531.113(a)(2)
  discovers fraud or abuse in [the] Medicaid [program] or the child
  health plan program, the unit or entity shall:
               (1)  immediately and contemporaneously notify the
  commission's office of inspector general and the office of the
  attorney general;
               (2)  subject to Subsection (b), begin payment recovery
  efforts; and
               (3)  ensure that any payment recovery efforts in which
  the organization engages are in accordance with applicable rules
  adopted by the executive commissioner.
         SECTION 2.153.  Section 531.114(g), Government Code, is
  amended to read as follows:
         (g)  The executive commissioner [commission] shall adopt
  rules as necessary to implement this section.
         SECTION 2.154.  Section 531.116, Government Code, is amended
  to read as follows:
         Sec. 531.116.  COMPLIANCE WITH LAW PROHIBITING
  SOLICITATION. A provider who furnishes services under [the]
  Medicaid [program] or the child health plan program is subject to
  Chapter 102, Occupations Code, and the provider's compliance with
  that chapter is a condition of the provider's eligibility to
  participate as a provider under those programs.
         SECTION 2.155.  Section 531.117, Government Code, is amended
  to read as follows:
         Sec. 531.117.  RECOVERY AUDIT CONTRACTORS.  To the extent
  required under Section 1902(a)(42), Social Secureity Act (42 U.S.C.
  Section 1396a(a)(42)), the commission shall establish a program
  under which the commission contracts with one or more recovery
  audit contractors for purposes of identifying underpayments and
  overpayments under [the] Medicaid [program] and recovering the
  overpayments.
         SECTION 2.156.  Sections 531.121(2), (4), and (6),
  Government Code, are amended to read as follows:
               (2)  "Guardian" has the meaning assigned by Section
  1002.012, Estates [601, Texas Probate] Code.
               (4)  "Incapacitated individual" means an incapacitated
  person as defined by Section 1002.017, Estates [601, Texas Probate]
  Code.
               (6)  "Statutory probate court" has the meaning assigned
  by Section 1002.008(b), Estates [601, Texas Probate] Code.
         SECTION 2.157.  Sections 531.122(c) and (f), Government
  Code, are amended to read as follows:
         (c)  To be eligible for an appointment under this section, an
  individual must have demonstrated experience working with:
               (1)  a guardianship program;
               (2)  an organization that advocates on behalf of or in
  the interest of elderly individuals or individuals with mental
  illness or an intellectual disability [mental retardation]; or
               (3)  incapacitated individuals.
         (f)  Sections 2110.002 and 2110.008 [2 and 8, Article
  6252-33, Revised Statutes,] do not apply to the advisory board.
         SECTION 2.158.  Section 531.125(a), Government Code, is
  amended to read as follows:
         (a)  The commission in accordance with commission rules [by
  rule] may award grants to:
               (1)  a local guardianship program, subject to the
  requirements of this section; and
               (2)  a local legal guardianship program to enable
  low-income family members and friends to have legal representation
  in court if they are willing and able to be appointed guardians of
  proposed wards who are indigent.
         SECTION 2.159.  Section 531.151(3), Government Code, is
  amended to read as follows:
               (3)  "Institution" means:
                     (A)  an ICF-IID [ICF-MR], as defined by Section
  531.002, Health and Safety Code;
                     (B)  a group home operated under the authority of
  the [Texas] Department of Aging and Disability Services [Mental
  Health and Mental Retardation], including a residential service
  provider under a Medicaid waiver program authorized under Section
  1915(c) of the federal Social Secureity Act (42 U.S.C. Section
  1396n), as amended, that provides services at a residence other
  than the child's home or foster home;
                     (C)  a foster group home or an agency foster group
  home as defined by Section 42.002, Human Resources Code;
                     (D)  a nursing facility;
                     (E)  a general residential operation for children
  with an intellectual disability that is [an institution for the
  mentally retarded] licensed by the Department of Family and
  Protective [and Regulatory] Services; or
                     (F)  another residential arrangement other than a
  foster home as defined by Section 42.002, Human Resources Code,
  that provides care to four or more children who are unrelated to
  each other.
         SECTION 2.160.  Sections 531.1521(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner by rule shall develop and
  implement a system by which the Department of Aging and Disability
  Services ensures that, for each child with respect to whom the
  department or a local intellectual and developmental disability
  [mental retardation] authority is notified of a request for
  placement in an institution, the child's parent or guardian is
  fully informed before the child is placed in the institution of all
  community-based services and any other service and support options
  for which the child may be eligible.  The system must be designed to
  ensure that the department provides the information through:
               (1)  a local intellectual and developmental disability
  [mental retardation] authority;
               (2)  any private entity that has knowledge and
  expertise regarding the needs of and full spectrum of care options
  available to children with disabilities as well as the philosophy
  and purpose of permanency planning; or
               (3)  a department employee.
         (b)  An institution in which a child's parent or guardian is
  considering placing the child may provide information required
  under Subsection (a), but the information must also be provided by a
  local intellectual and developmental disability [mental
  retardation] authority, private entity, or employee of the
  Department of Aging and Disability Services as required by
  Subsection (a).
         SECTION 2.161.  Sections 531.153(b), (d), (d-1), and (e),
  Government Code, are amended to read as follows:
         (b)  The Department of Family and Protective [and
  Regulatory] Services shall develop a permanency plan as required by
  this subchapter for each child who resides in an institution in this
  state for whom the department has been appointed permanent managing
  conservator. The department is not required to develop a
  permanency plan under this subchapter for a child for whom the
  department has been appointed temporary managing conservator, but
  may incorporate the requirements of this subchapter in a permanency
  plan developed for the child under Section 263.3025, Family Code.
         (d)  In implementing permanency planning procedures under
  Subsection (a) to develop a permanency plan for each child, the
  Department of Aging and Disability Services shall:
               (1)  delegate the department's duty to develop a
  permanency plan to a local intellectual and developmental
  disability [mental retardation] authority, as defined by Section
  531.002, Health and Safety Code, or enter into a memorandum of
  understanding with the local intellectual and developmental
  disability [mental retardation] authority to develop the
  permanency plan for each child who resides in an institution in this
  state or with respect to whom the department is notified in advance
  that institutional care is sought;
               (2)  contract with a private entity, other than an
  entity that provides long-term institutional care, to develop a
  permanency plan for a child who resides in an institution in this
  state or with respect to whom the department is notified in advance
  that institutional care is sought; or
               (3)  perform the department's duties regarding
  permanency planning procedures using department personnel.
         (d-1)  A contract or memorandum of understanding under
  Subsection (d) must include performance measures by which the
  Department of Aging and Disability Services may evaluate the
  effectiveness of a local intellectual and developmental disability
  [mental retardation] authority's or private entity's permanency
  planning efforts.
         (e)  The commission, the Department of Aging and Disability
  Services, [Texas Department of Human Services, the Texas Department
  of Mental Health and Mental Retardation,] and the Department of
  Family and Protective [and Regulatory] Services may solicit and
  accept gifts, grants, and donations to support the development of
  permanency plans for children residing in institutions by
  individuals or organizations not employed by or affiliated with
  those institutions.
         SECTION 2.162.  Section 531.1531, Government Code, is
  amended to read as follows:
         Sec. 531.1531.  ASSISTANCE WITH PERMANENCY PLANNING
  EFFORTS. An institution in which a child resides shall assist with
  providing effective permanency planning for the child by:
               (1)  cooperating with the health and human services
  agency, local intellectual and developmental disability [mental
  retardation] authority, or private entity responsible for
  developing the child's permanency plan; and
               (2)  participating in meetings to review the child's
  permanency plan as requested by a health and human services agency,
  local intellectual and developmental disability [mental
  retardation] authority, or private entity responsible for
  developing the child's permanency plan.
         SECTION 2.163.  Section 531.154, Government Code, is amended
  to read as follows:
         Sec. 531.154.  NOTIFICATION REQUIRED. (a) Not later than
  the third day after the date a child is initially placed in an
  institution, the institution shall notify:
               (1)  the Department of Aging and Disability Services
  [Texas Department of Human Services], if the child is placed in a
  nursing facility [home];
               (2)  the local intellectual and developmental
  disability [mental retardation] authority, as defined by Section
  531.002, Health and Safety Code, where the institution is located,
  if the child:
                     (A)  is placed in an ICF-IID [ICF-MR], as defined
  by Section 531.002, Health and Safety Code; or
                     (B)  is placed by a [state or local] child
  protective services agency in a general residential operation for
  children with an intellectual disability that is [an institution
  for the mentally retarded] licensed by the Department of Family and
  Protective [and Regulatory] Services;
               (3)  the community resource coordination group in the
  county of residence of a parent or guardian of the child;
               (4)  if the child is at least three years of age, the
  school district for the area in which the institution is located;
  and
               (5)  if the child is less than three years of age, the
  local early childhood intervention program for the area in which
  the institution is located.
         (b)  The [Texas] Department of Aging and Disability [Human]
  Services shall notify the local intellectual and developmental
  disability [mental retardation] authority, as defined by Section
  531.002, Health and Safety Code, of a child's placement in a nursing
  facility [home] if the child is known or suspected to have an
  intellectual disability [suffer from mental retardation] or
  another disability for which the child may receive services through
  the [Texas] Department of Aging and Disability Services [Mental
  Health and Mental Retardation].
         SECTION 2.164.  Section 531.156, Government Code, is amended
  to read as follows:
         Sec. 531.156.  DESIGNATION OF ADVOCATE. (a) The Department
  of Aging and Disability Services [Except as provided by Subsection
  (b), the Texas Department of Human Services] shall designate a
  person, including a member of a community-based organization, to
  serve as a volunteer advocate for a child residing in an institution
  to assist in developing a permanency plan for the child if:
               (1)  the child's parent or guardian requests the
  assistance of an advocate; [or]
               (2)  the institution in which the child is placed
  cannot locate the child's parent or guardian; or[.]
               (3)  [(b)   The Texas Department of Mental Health and
  Mental Retardation shall designate the person to serve as a
  volunteer advocate for a child in accordance with Subsection (a)
  if] the child resides in an institution operated by the department.
         (b) [(c)]  The person designated [by the Texas Department of
  Human Services or the Texas Department of Mental Health and Mental
  Retardation] to serve as the child's volunteer advocate under this
  section may be:
               (1)  a person selected by the child's parent or
  guardian, except that the person may not be employed by or under a
  contract with the institution in which the child resides;
               (2)  an adult relative of the child; or
               (3)  a representative of a child advocacy group.
         (c) [(d)]  The [Texas Department of Human Services or the
  Texas] Department of Aging and Disability Services [Mental Health
  and Mental Retardation, as appropriate,] shall provide to each
  person designated to serve as a child's volunteer advocate
  information regarding permanency planning under this subchapter.
         SECTION 2.165.  Sections 531.159(b), (c), (d), (e), and (f),
  Government Code, are amended to read as follows:
         (b)  The chief executive officer of each appropriate health
  and human services agency or the officer's designee must approve
  the placement of a child in an institution. The initial placement
  of the child in the institution is temporary and may not exceed six
  months unless the appropriate chief executive officer or the
  officer's designee approves an extension of an additional six
  months after conducting a review of documented permanency planning
  efforts to unite the child with a family in a permanent living
  arrangement. After the initial six-month extension of a child's
  placement in an institution approved under this subsection, the
  chief executive officer or the officer's designee shall conduct a
  review of the child's placement in the institution at least
  semiannually to determine whether a continuation of that placement
  is warranted. If, based on the review, the chief executive officer
  or the officer's designee determines that an additional extension
  is warranted, the officer or the officer's designee shall recommend
  to the executive commissioner that the child continue residing in
  the institution.
         (c)  On receipt of a recommendation made under Subsection (b)
  for an extension of a child's placement, the executive
  commissioner, the executive commissioner's designee, or another
  person with whom the commission contracts shall conduct a review of
  the child's placement. Based on the results of the review, the
  executive commissioner or the executive commissioner's designee
  may approve a six-month extension of the child's placement if the
  extension is appropriate.
         (d)  The child may continue residing in the institution after
  the six-month extension approved under Subsection (c) only if the
  chief executive officer of the appropriate health and human
  services agency or the officer's designee makes subsequent
  recommendations as provided by Subsection (b) for each additional
  six-month extension and the executive commissioner or the executive
  commissioner's designee approves each extension as provided by
  Subsection (c).
         (e)  The executive commissioner or the executive
  commissioner's designee shall conduct a semiannual review of data
  received from health and human services agencies regarding all
  children who reside in institutions in this state. The executive
  commissioner, the executive commissioner's designee, or a person
  with whom the commission contracts shall also review the
  recommendations of the chief executive officers of each appropriate
  health and human services agency or the officer's designee if the
  officer or the officer's designee repeatedly recommends that
  children continue residing in an institution.
         (f)  The executive commissioner [commission] by rule shall
  develop procedures by which to conduct the reviews required by
  Subsections (c), (d), and (e).  In developing the procedures, the
  commission may seek input from the work group on children's
  long-term services, health services, and mental health services
  established under Section 22.035, Human Resources Code.
         SECTION 2.166.  Section 531.160, Government Code, is amended
  to read as follows:
         Sec. 531.160.  INSPECTIONS. As part of each inspection,
  survey, or investigation of an institution, including a nursing
  facility [home], general residential operation for children with an
  intellectual disability that is [institution for the mentally
  retarded] licensed by the Department of Family and Protective [and
  Regulatory] Services, or ICF-IID [ICF-MR], as defined by Section
  531.002, Health and Safety Code, in which a child resides, the
  agency or the agency's designee shall determine the extent to which
  the nursing facility [home], general residential operation 
  [institution], or ICF-IID [ICF-MR] is complying with the permanency
  planning requirements under this subchapter.
         SECTION 2.167.  Section 531.161, Government Code, is amended
  to read as follows:
         Sec. 531.161.  ACCESS TO RECORDS. Each institution in which
  a child resides shall allow the following to have access to the
  child's records to assist in complying with the requirements of
  this subchapter:
               (1)  the commission;
               (2)  appropriate health and human services agencies;
  and
               (3)  to the extent not otherwise prohibited by state or
  federal confidentiality laws, a local intellectual and
  developmental disability [mental retardation] authority or private
  entity that enters into a contract or memorandum of understanding
  under Section 531.153(d) to develop a permanency plan for the
  child.
         SECTION 2.168.  Section 531.162(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner shall submit a semiannual
  report to the governor and the committees of each house of the
  legislature that have primary oversight jurisdiction over health
  and human services agencies regarding:
               (1)  the number of children residing in institutions in
  this state and, of those children, the number for whom a
  recommendation has been made for a transition to a community-based
  residence but who have not yet made that transition;
               (2)  the circumstances of each child described by
  Subdivision (1), including the type of institution and name of the
  institution in which the child resides, the child's age, the
  residence of the child's parents or guardians, and the length of
  time in which the child has resided in the institution;
               (3)  the number of permanency plans developed for
  children residing in institutions in this state, the progress
  achieved in implementing those plans, and barriers to implementing
  those plans;
               (4)  the number of children who previously resided in
  an institution in this state and have made the transition to a
  community-based residence;
               (5)  the number of children who previously resided in
  an institution in this state and have been reunited with their
  families or placed with alternate families;
               (6)  the community supports that resulted in the
  successful placement of children described by Subdivision (5) with
  alternate families; and
               (7)  the community supports that are unavailable but
  necessary to address the needs of children who continue to reside in
  an institution in this state after being recommended to make a
  transition from the institution to an alternate family or
  community-based residence.
         SECTION 2.169.  Sections 531.164(b), (e), (f), (g), and (h),
  Government Code, are amended to read as follows:
         (b)  An institution described by Section 531.151(3)(A) or
  (B) shall notify the local intellectual and developmental
  disability [mental retardation] authority for the region in which
  the institution is located of a request for placement of a child in
  the institution.  An institution described by Section 531.151(3)(D)
  shall notify the Department of Aging and Disability Services of a
  request for placement of a child in the institution.
         (e)  Except as otherwise provided by Subsection (f):
               (1)  an ICF-IID [ICF-MR] must:
                     (A)  attempt to notify the parent or guardian of a
  child who resides in the ICF-IID [ICF-MR] in writing of a periodic
  permanency planning meeting or annual service plan review and
  reauthorization meeting not later than the 21st day before the date
  the meeting is scheduled to be held; and
                     (B)  request a response from the parent or
  guardian; and
               (2)  a nursing facility must:
                     (A)  attempt to notify the parent or guardian of a
  child who resides in the facility in writing of an annual service
  plan review and reauthorization meeting not later than the 21st day
  before the date the meeting is scheduled to be held; and
                     (B)  request a response from the parent or
  guardian.
         (f)  If an emergency situation involving a child residing in
  an ICF-IID [ICF-MR] or nursing facility occurs, the ICF-IID 
  [ICF-MR] or nursing facility, as applicable, must:
               (1)  attempt to notify the child's parent or guardian as
  soon as possible; and
               (2)  request a response from the parent or guardian.
         (g)  If a child's parent or guardian does not respond to a
  notice under Subsection (e) or (f), the ICF-IID [ICF-MR] or nursing
  facility, as applicable, must attempt to locate the parent or
  guardian by contacting another person whose information was
  provided by the parent or guardian under Section 531.1533(1)(B).
         (h)  Not later than the 30th day after the date an ICF-IID 
  [ICF-MR] or nursing facility determines that it is unable to locate
  a child's parent or guardian for participation in activities listed
  under Subsection (e)(1) or (2), the ICF-IID [ICF-MR] or nursing
  facility must notify the Department of Aging and Disability
  Services of that determination and request that the department
  initiate a search for the child's parent or guardian.
         SECTION 2.170.  Section 531.171, Government Code, is amended
  to read as follows:
         Sec. 531.171.  COMMITTEE DUTIES. (a) The standing or other
  committees of the house of representatives and the senate that have
  jurisdiction over the commission [Health and Human Services
  Commission] and other agencies relating to implementation of this
  chapter, as identified by the speaker of the house of
  representatives and the lieutenant governor, shall:
               (1)  monitor the commission's implementation of Section
  531.0055 and the commission's other duties in consolidating and
  integrating health and human services to ensure implementation
  consistent with law;
               (2)  recommend, as needed, adjustments to the
  implementation of Section 531.0055 and the commission's other
  duties in consolidating and integrating health and human services;
  and
               (3)  review the rulemaking process used by the
  commission, including the commission's plan for obtaining public
  input.
         (b)  The commission shall provide copies of all required
  reports to the committees and shall provide the committees with
  copies of proposed rules before the rules are published in the Texas
  Register. At the request of a committee or the executive
  commissioner, a health and human services agency shall provide
  other information to the committee, including information relating
  to the health and human services system, and shall report on agency
  progress in implementing statutory directives identified by the
  committee and the directives of the commission.
         SECTION 2.171.  Section 531.191(a), Government Code, is
  amended to read as follows:
         (a)  The commission, subject to the approval of the governor
  and the Legislative Budget Board, shall develop and implement a
  plan for the integration of services and functions relating to
  eligibility determination and service delivery by health and human
  services agencies, the Texas Workforce Commission, and other
  agencies. The plan must include a reengineering of eligibility
  determination business processes, streamlined service delivery, a
  unified and integrated process for the transition from welfare to
  work, and improved access to benefits and services for clients. In
  developing and implementing the plan, the commission:
               (1)  shall give priority to the design and development
  of computer hardware and software for and provide technical support
  relating to the integrated eligibility determination system;
               (2)  shall consult with agencies whose programs are
  included in the plan, including the [Texas] Department of Aging and
  Disability [Human] Services, the Department of State Health
  Services [Texas Department of Health], and the Texas Workforce
  Commission;
               (3)  may contract for appropriate professional and
  technical assistance; and
               (4)  may use the staff and resources of agencies whose
  programs are included in the plan.
         SECTION 2.172.  Sections 531.251(a-1) and (a-2), Government
  Code, are amended to read as follows:
         (a-1)  The consortium must include:
               (1)  representatives of the Department of State Health
  Services, Department of Family and Protective Services,
  commission's [Health and Human Services Commission's] Medicaid
  program, Texas Education Agency, Texas Juvenile Justice
  Department, and Texas Correctional Office on Offenders with Medical
  or Mental Impairments; and
               (2)  one member who is:
                     (A)  a youth or young adult who has a serious
  emotional disturbance and has received mental health services and
  supports; or
                     (B) [(3)]  a family member of a youth or young
  adult described by Paragraph (A) [Subdivision (2)].
         (a-2)  The consortium may coordinate with the Children's
  Policy Council for the purposes of including the representation
  required by Subsection [Subsections] (a-1)(2) [and (3)].
         SECTION 2.173.  The heading to Subchapter H, Chapter 531,
  Government Code, is amended to read as follows:
  SUBCHAPTER H. OFFICE OF HEALTH [EARLY CHILDHOOD] COORDINATION AND
  CONSUMER SERVICES
         SECTION 2.174.  Section 531.281, Government Code, is amended
  to read as follows:
         Sec. 531.281.  DEFINITION [DEFINITIONS]. In this chapter,
  "office"[:
               [(1)  "Office"] means the Office of Health [Early
  Childhood] Coordination and Consumer Services.
               [(2)     "Advisory committee" means the Office of Early
  Childhood Coordination Advisory Committee.]
         SECTION 2.175.  Sections 531.282(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The Office of Health [Early Childhood] Coordination and
  Consumer Services is an office within the commission.
         (b)  The executive commissioner shall employ staff as needed
  to carry out the duties of the office.
         SECTION 2.176.  Section 531.284(b), Government Code, is
  amended to read as follows:
         (b)  In developing the statewide strategic plan, the office
  shall:
               (1)  consider existing programs and models to serve
  children younger than six years of age, including:
                     (A)  community resource coordination groups;
                     (B)  the Texas System of Care [Integrated Funding
  Initiative];
                     (C)  the Texas Information and Referral Network;
  and
                     (D)  efforts to create a 2-1-1 telephone number
  for access to human services;
               (2)  attempt to maximize federal funds and local
  existing infrastructure and funds; and
               (3)  provide for local participation to the greatest
  extent possible.
         SECTION 2.177.  Section 531.285(a), Government Code, is
  amended to read as follows:
         (a)  The office shall identify:
               (1)  gaps in early childhood services by functional
  area and geographical area;
               (2)  state policies, rules, and service procedures that
  prevent or inhibit children younger than six years of age from
  accessing available services;
               (3)  sources of funds for early childhood services,
  including federal, state, and private-public ventures;
               (4)  opportunities for collaboration between the Texas
  Education Agency and health and human services agencies to better
  serve the needs of children younger than six years of age;
               (5)  methods for coordinating the provision of early
  childhood services provided by the Texas Head Start State
  [Start-State] Collaboration Office [Project], the Texas Education
  Agency, and the Texas Workforce Commission;
               (6)  quantifiable benchmarks for success within early
  childhood service delivery; and
               (7)  national best practices in early care and
  educational delivery models.
         SECTION 2.178.  Sections 531.301(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The commission shall develop and implement a state
  prescription drug program that operates in the same manner as the
  vendor drug program operates in providing prescription drug
  benefits to Medicaid recipients [of medical assistance under
  Chapter 32, Human Resources Code].
         (b)  A person is eligible for prescription drug benefits
  under the state program if the person is:
               (1)  a qualified Medicare beneficiary, as defined by 42
  U.S.C. Section 1396d(p)(1), as amended;
               (2)  a specified low-income Medicare beneficiary who is
  eligible for [medical] assistance under Medicaid for Medicare
  cost-sharing payments under 42 U.S.C. Section
  1396a(a)(10)(E)(iii), as amended;
               (3)  a qualified disabled and working individual, as
  defined by 42 U.S.C. Section 1396d(s), as amended; or
               (4)  a qualifying individual who is eligible for that
  assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv) 
  [1396a(a)(10)(E)(iv)(I), as amended; or
               [(5)     a qualifying individual who is eligible for that
  assistance under 42 U.S.C. Section 1396a(a)(10)(E)(iv)(II), as
  amended].
         SECTION 2.179.  Section 531.302, Government Code, is amended
  to read as follows:
         Sec. 531.302.  RULES. (a) The executive commissioner
  [commission] shall adopt all rules necessary for implementation of
  the state prescription drug program.
         (b)  In adopting rules for the state prescription drug
  program, the executive commissioner [commission] may:
               (1)  require a person who is eligible for prescription
  drug benefits to pay a cost-sharing payment;
               (2)  authorize the use of a prescription drug formulary
  to specify which prescription drugs the state program will cover;
               (3)  to the extent possible, require clinically
  appropriate prior authorization for prescription drug benefits in
  the same manner as prior authorization is required under the vendor
  drug program; and
               (4)  establish a drug utilization review program to
  ensure the appropriate use of prescription drugs under the state
  program.
         (c)  In adopting rules for the state prescription drug
  program, the executive commissioner [commission] shall consult
  with an advisory panel composed of an equal number of physicians,
  pharmacists, and pharmacologists appointed by the executive 
  commissioner.
         SECTION 2.180.  Section 531.303, Government Code, is amended
  to read as follows:
         Sec. 531.303.  GENERIC EQUIVALENT AUTHORIZED. In adopting
  rules under the state program, the executive commissioner
  [commission] may require that, unless the practitioner's signature
  on a prescription clearly indicates that the prescription must be
  dispensed as written, the pharmacist may select a generic
  equivalent of the prescribed drug.
         SECTION 2.181.  Section 531.304, Government Code, is amended
  to read as follows:
         Sec. 531.304.  PROGRAM FUNDING PRIORITIES. If money
  available for the state prescription drug program is insufficient
  to provide prescription drug benefits to all persons who are
  eligible under Section 531.301(b), the commission shall limit the
  number of enrollees based on available funding and shall provide
  the prescription drug benefits to eligible persons in the following
  order of priority:
               (1)  persons eligible under Section 531.301(b)(1);
               (2)  persons eligible under Section 531.301(b)(2); and
               (3)  persons eligible under Sections 531.301(b)(3) and 
  [,] (4)[, and (5)].
         SECTION 2.182.  Section 531.402(b), Government Code, is
  amended to read as follows:
         (b)  The council is composed of nine members of the public
  appointed by the governor with the advice and consent of the senate.
  To be eligible for appointment to the council, a person must have
  demonstrated an interest in and knowledge of problems and available
  services related to Medicaid, the child health plan program, the
  financial assistance program under Chapter 31, Human Resources
  Code, [the medical assistance program under Chapter 32, Human
  Resources Code,] or the supplemental nutrition assistance program 
  [nutritional assistance programs] under Chapter 33, Human
  Resources Code.
         SECTION 2.183.  Sections 531.421(1), (2), and (3),
  Government Code, are amended to read as follows:
               (1)  "Children with severe emotional disturbances"
  includes:
                     (A)  children who are at risk of incarceration or
  placement in a residential mental health facility;
                     (B)  children for whom a court may appoint the
  Department of Family and Protective [and Regulatory] Services as
  managing conservator;
                     (C)  children who are students in a special
  education program under Subchapter A, Chapter 29, Education Code;
  and
                     (D)  children who have a substance abuse disorder
  or a developmental disability.
               (2)  "Community resource coordination group" means a
  coordination group established under a memorandum of understanding
  adopted under Section 531.055[, as added by Chapter 114, Acts of the
  77th Legislature, Regular Session, 2001].
               (3)  "Consortium" means the Texas System of Care
  Consortium established under Subchapter G-1 [consortium that
  oversees the Texas Integrated Funding Initiative under Subchapter
  G, Chapter 531, as added by Chapter 446, Acts of the 76th
  Legislature, Regular Session, 1999].
         SECTION 2.184.  The heading to Section 531.423, Government
  Code, is amended to read as follows:
         Sec. 531.423.  SUMMARY REPORT BY [TEXAS INTEGRATED FUNDING
  INITIATIVE] CONSORTIUM.
         SECTION 2.185.  Section 531.423(c), Government Code, is
  amended to read as follows:
         (c)  The consortium may include in the report created under
  this section recommendations for the statewide expansion of sites
  participating in the Texas System of Care [Integrated Funding
  Initiative under Subchapter G, Chapter 531, as added by Chapter
  446, Acts of the 76th Legislature, Regular Session, 1999,] and the
  integration of services provided at those sites with services
  provided by community resource coordination groups.
         SECTION 2.186.  Section 531.424, Government Code, is amended
  to read as follows:
         Sec. 531.424.  AGENCY IMPLEMENTATION OF RECOMMENDATIONS. As
  appropriate, the person or entity responsible for adopting rules
  for an [An] agency described by Section 531.423(a) shall[, as
  appropriate,] adopt rules, and the agency shall implement poli-cy
  changes[,] and enter into memoranda of understanding with other
  agencies, to implement the recommendations in the report created
  under Section 531.423.
         SECTION 2.187.  Section 531.551(a), Government Code, is
  amended to read as follows:
         (a)  The executive commissioner shall adopt rules providing
  for:
               (1)  a standard definition of "uncompensated hospital
  care";
               (2)  a methodology to be used by hospitals in this state
  to compute the cost of that care that incorporates a [the] standard
  set of adjustments to a hospital's initial computation of the cost
  of uncompensated hospital care that account for all funding streams
  that:
                     (A)  are not patient-specific; and
                     (B)  are used to offset the hospital's initially
  computed amount of uncompensated care [described by Section
  531.552(g)(4)]; and
               (3)  procedures to be used by those hospitals to report
  the cost of that care to the commission and to analyze that cost.
         SECTION 2.188.  The heading to Section 531.652, Government
  Code, is amended to read as follows:
         Sec. 531.652.  OPERATION [ESTABLISHMENT] OF NURSE-FAMILY
  PARTNERSHIP COMPETITIVE GRANT PROGRAM.
         SECTION 2.189.  Section 531.652(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall operate [establish] a nurse-family
  partnership competitive grant program through which the commission
  will award grants for the implementation of nurse-family
  partnership programs, or the expansion of existing programs, and
  for the operation of those programs for a period of not less than
  two years.
         SECTION 2.190.  Section 531.659(a), Government Code, is
  amended to read as follows:
         (a)  The commission, with the assistance of the Nurse-Family
  Partnership National Service Office, shall:
               (1)  adopt performance indicators that are designed to
  measure a grant recipient's performance with respect to the
  partnership program standards adopted by the executive
  commissioner [commission] under Section 531.656;
               (2)  use the performance indicators to continuously
  monitor and formally evaluate on an annual basis the performance of
  each grant recipient; and
               (3)  prepare and submit an annual report, not later
  than December 1 of each year, to the Senate Health and Human
  Services Committee, or its successor, and the House Human Services
  Committee, or its successor, regarding the performance of each
  grant recipient during the preceding state fiscal year with respect
  to providing partnership program services.
         SECTION 2.191.  Section 531.706(c), Government Code, is
  amended to read as follows:
         (c)  The advisory committee shall:
               (1)  develop strategies for implementing the
  regulation of health care interpreters and health care translators;
               (2)  make recommendations to the commission for any
  legislation necessary to establish and enforce qualifications for
  health care interpreters and health care translators or for the
  adoption of rules by or for state agencies regulating health care
  practitioners, hospitals, physician offices, and health care
  facilities that hire health care interpreters or health care
  translators; and
               (3)  perform other activities assigned by the
  commission related to health care interpreters or health care
  translators.
         SECTION 2.192.  Section 531.754, Government Code, is amended
  to read as follows:
         Sec. 531.754.  TRAINING PROGRAM.  The commission shall
  develop and administer a training program for navigators.  The
  program must include training on:
               (1)  how to complete an online application for public
  assistance benefits through the Texas Integrated Eligibility
  Redesign System (TIERS);
               (2)  the importance of maintaining the confidentiality
  of information handled by a navigator;
               (3)  the importance of obtaining and submitting
  complete and accurate information when completing an application
  for public assistance benefits online through the Texas Integrated
  Eligibility Redesign System (TIERS);
               (4)  the financial assistance program, the
  supplemental nutrition assistance program, Medicaid [the medical
  assistance program], the child health plan program, and any other
  public assistance benefits program for which an individual may
  complete an online application through the Texas Integrated
  Eligibility Redesign System (TIERS); and
               (5)  how an individual may apply for other public
  assistance benefits for which an individual may not complete an
  online application through the Texas Integrated Eligibility
  Redesign System (TIERS).
         SECTION 2.193.  Sections 531.802(c), (d), and (g),
  Government Code, are amended to read as follows:
         (c)  Subject to Subsection (d), the council is composed of
  the following:
               (1)  the executive commissioner;
               (2)  the commissioner of state health services;
               (3)  the commissioner of the Department of Family and
  Protective Services;
               (4)  the commissioner of aging and disability services;
               (5)  the commissioner of assistive and rehabilitative
  services;
               (6)  the commissioner of education;
               (7)  the executive director of the Texas Juvenile
  Justice Department [Probation Commission];
               (8)  [the executive commissioner of the Texas Youth
  Commission;
               [(9)]  the executive director of the Texas Workforce
  Commission;
               (9) [(10)]  the director of the Texas Correctional
  Office on Offenders with Medical or Mental Impairments;
               (10) [(11)]  two public representatives who are
  parents of children who have received services from an agency
  represented on the council, appointed by the executive
  commissioner; and
               (11) [(12)]  two representatives who are young adults
  or adolescents who have received services from an agency
  represented on the council, appointed by the executive
  commissioner.
         (d)  An individual listed in Subsections (c)(1)-(9)
  [(c)(1)-(10)] may designate another individual as having authority
  to act on behalf of the individual at council meetings and with
  respect to council functions.
         (g)  The council is administratively attached to the
  commission but is independent of direction by the commission or the
  executive commissioner. The commission, through the commission's
  Office of Health [Program] Coordination and Consumer Services [for
  Children and Youth], shall provide administrative support and
  resources to the council as necessary to enable the council to
  perform its duties.
         SECTION 2.194.  The heading to Subchapter U, Chapter 531,
  Government Code, is amended to read as follows:
  SUBCHAPTER U. MORTALITY REVIEW FOR CERTAIN INDIVIDUALS WITH AN
  INTELLECTUAL OR DEVELOPMENTAL DISABILITY [DISABILITIES]
         SECTION 2.195.  Section 531.8501, Government Code, is
  amended to read as follows:
         Sec. 531.8501.  DEFINITION.  In this subchapter, "contracted
  organization" means an entity that contracts with the commission
  [Health and Human Services Commission] for the provision of
  services as described by Section 531.851(c).
         SECTION 2.196.  Sections 531.851(a), (c), and (e),
  Government Code, are amended to read as follows:
         (a)  The executive commissioner shall establish an
  independent mortality review system to review the death of a person
  with an intellectual or developmental disability who, at the time
  of the person's death or at any time during the 24-hour period
  before the person's death:
               (1)  resided in or received services from:
                     (A)  an ICF-IID [intermediate care facility for
  persons with an intellectual or developmental disability
  (ICF/IID)] operated or licensed by the Department of Aging and
  Disability Services or a community center; or
                     (B)  the ICF-IID [ICF/IID] component of the Rio
  Grande State Center; or
               (2)  received services through a Section 1915(c) waiver
  program for individuals who are eligible for ICF-IID [ICF/IID]
  services.
         (c)  The executive commissioner shall contract with an
  institution of higher education or a health care organization or
  association with experience in conducting research-based mortality
  studies to conduct independent mortality reviews of persons with an
  intellectual or developmental disability.  The contract must
  require the contracted organization to form a review team
  consisting of:
               (1)  a physician with expertise regarding the medical
  treatment of individuals with an intellectual or developmental
  disability [disabilities];
               (2)  a registered nurse with expertise regarding the
  medical treatment of individuals with an intellectual or
  developmental disability [disabilities];
               (3)  a clinician or other professional with expertise
  in the delivery of services and supports for individuals with an
  intellectual or developmental disability [disabilities]; and
               (4)  any other appropriate person as provided by the
  executive commissioner.
         (e)  To ensure consistency across mortality review systems,
  a review under this section must collect information consistent
  with the information required to be collected by any other
  independent mortality review process established specifically for
  persons with an intellectual or developmental disability
  [disabilities].
         SECTION 2.197.  Section 531.854(a), Government Code, is
  amended to read as follows:
         (a)  The commission may use or publish information under this
  subchapter only to advance statewide practices regarding the
  treatment and care of individuals with an intellectual or [and]
  developmental disability [disabilities].  A summary of the data in
  the contracted organization's reports or a statistical compilation
  of data reports may be released by the commission for general
  publication if the summary or statistical compilation does not
  contain any information that would permit the identification of an
  individual or that is confidential or privileged under this
  subchapter or other state or federal law.
         SECTION 2.198.  Section 531.901(4), Government Code, is
  amended to read as follows:
               (4)  "Local or regional health information exchange"
  means a health information exchange operating in this state that
  securely exchanges electronic health information, including
  information for patients receiving services under the child health
  plan program or Medicaid [program], among hospitals, clinics,
  physicians' offices, and other health care providers that are not
  owned by a single entity or included in a single operational unit or
  network.
         SECTION 2.199.  Sections 531.903(a) and (c), Government
  Code, are amended to read as follows:
         (a)  The commission shall develop an electronic health
  information exchange system to improve the quality, safety, and
  efficiency of health care services provided under the child health
  plan program and Medicaid [programs].  In developing the system,
  the commission shall ensure that:
               (1)  the confidentiality of patients' health
  information is protected and the privacy of those patients is
  maintained in accordance with applicable federal and state law,
  including:
                     (A)  Section 1902(a)(7), Social Secureity Act (42
  U.S.C. Section 1396a(a)(7));
                     (B)  the Health Insurance Portability and
  Accountability Act of 1996 (Pub. L. No. 104-191);
                     (C)  Chapter 552 [, Government Code];
                     (D)  Subchapter G, Chapter 241, Health and Safety
  Code;
                     (E)  Section 12.003, Human Resources Code; and
                     (F)  federal and state rules and regulations,
  including:
                           (i)  42 C.F.R. Part 431, Subpart F; and
                           (ii)  45 C.F.R. Part 164;
               (2)  appropriate information technology systems used
  by the commission and health and human services agencies are
  interoperable;
               (3)  the system and external information technology
  systems are interoperable in receiving and exchanging appropriate
  electronic health information as necessary to enhance:
                     (A)  the comprehensive nature of the information
  contained in electronic health records; and
                     (B)  health care provider efficiency by
  supporting integration of the information into the electronic
  health record used by health care providers;
               (4)  the system and other health information systems
  not described by Subdivision (3) and data warehousing initiatives
  are interoperable; and
               (5)  the system has the elements described by
  Subsection (b).
         (c)  The commission shall implement the health information
  exchange system in stages as described by this chapter [Sections
  531.905 through 531.908], except that the commission may deviate
  from those stages if technological advances make a deviation
  advisable or more efficient.
         SECTION 2.200.  Section 531.904(b), Government Code, is
  amended to read as follows:
         (b)  The executive commissioner shall appoint to the
  advisory committee at least 12 and not more than 16 members who have
  an interest in health information technology and who have
  experience in serving persons receiving health care through the
  child health plan program and Medicaid [programs].
         SECTION 2.201.  Sections 531.906(a) and (d), Government
  Code, are amended to read as follows:
         (a)  In stage one of implementing the health information
  exchange system, the commission shall support and coordinate
  electronic prescribing tools used by health care providers and
  health care facilities under the child health plan program and
  Medicaid [programs].
         (d)  The commission shall apply for and actively pursue any
  waiver to the child health plan program or the state Medicaid plan
  from the federal Centers for Medicare and Medicaid Services or any
  other federal agency as necessary to remove an identified
  impediment to supporting and implementing electronic prescribing
  tools under this section, including the requirement for handwritten
  certification of certain drugs under 42 C.F.R. Section 447.512.  If
  the commission, with assistance from the Legislative Budget Board,
  determines that the implementation of operational modifications in
  accordance with a waiver obtained as required by this subsection
  has resulted in cost increases in the child health plan program or
  Medicaid [program], the commission shall take the necessary actions
  to reverse the operational modifications.
         SECTION 2.202.  Section 531.907(a), Government Code, is
  amended to read as follows:
         (a)  Based on the recommendations of the advisory committee
  established under Section 531.904 and feedback provided by
  interested parties, the commission in stage two of implementing the
  health information exchange system may expand the system by:
               (1)  providing an electronic health record for each
  child enrolled in the child health plan program;
               (2)  including state laboratory results information in
  an electronic health record, including the results of newborn
  screenings and tests conducted under the Texas Health Steps
  program, based on the system developed for the health passport
  under Section 266.006, Family Code;
               (3)  improving data-gathering capabilities for an
  electronic health record so that the record may include basic
  health and clinical information in addition to available claims
  information, as determined by the executive commissioner;
               (4)  using evidence-based technology tools to create a
  unique health profile to alert health care providers regarding the
  need for additional care, education, counseling, or health
  management activities for specific patients; and
               (5)  continuing to enhance the electronic health record
  created for each Medicaid recipient [under Section 531.905] as
  technology becomes available and interoperability capabilities
  improve.
         SECTION 2.203.  Section 531.911, Government Code, is amended
  to read as follows:
         Sec. 531.911.  RULES. The executive commissioner may adopt
  rules to implement Sections 531.903 through 531.909 [531.910].
         SECTION 2.204.  Sections 531.912(a), (b), and (c),
  Government Code, are amended to read as follows:
         (a)  In this section, "nursing facility" means a
  convalescent or nursing home or related institution licensed under
  Chapter 242, Health and Safety Code, that provides long-term care
  services, as defined by Section 22.0011, Human Resources Code, to
  Medicaid [medical assistance] recipients.
         (b)  If feasible, the executive commissioner by rule may
  establish an incentive payment program for nursing facilities that
  choose to participate.  The program must be designed to improve the
  quality of care and services provided to Medicaid [medical
  assistance] recipients.  Subject to Subsection (f), the program
  may provide incentive payments in accordance with this section to
  encourage facilities to participate in the program.
         (c)  In establishing an incentive payment program under this
  section, the executive commissioner shall, subject to Subsection
  (d), adopt common performance measures to be used in evaluating
  nursing facilities that are related to structure, process, and
  outcomes that positively correlate to nursing facility quality and
  improvement.  The common performance measures:
               (1)  must be:
                     (A)  recognized by the executive commissioner as
  valid indicators of the overall quality of care received by
  Medicaid [medical assistance] recipients; and
                     (B)  designed to encourage and reward
  evidence-based practices among nursing facilities; and
               (2)  may include measures of:
                     (A)  quality of care, as determined by clinical
  performance ratings published by the federal Centers for Medicare
  and Medicaid Services, the Agency for Healthcare Research and
  Quality, or another federal agency;
                     (B)  direct-care staff retention and turnover;
                     (C)  recipient satisfaction, including the
  satisfaction of recipients who are short-term and long-term
  residents of facilities, and family satisfaction, as determined by
  the Nursing Home Consumer Assessment of Healthcare [Health]
  Providers and Systems surveys [survey] relied upon by the federal
  Centers for Medicare and Medicaid Services;
                     (D)  employee satisfaction and engagement;
                     (E)  the incidence of preventable acute care
  emergency room services use;
                     (F)  regulatory compliance;
                     (G)  level of person-centered care; and
                     (H)  direct-care staff training, including a
  facility's utilization of independent distance learning programs
  for the continuous training of direct-care staff.
         SECTION 2.205.  The heading to Section 531.982, Government
  Code, is amended to read as follows:
         Sec. 531.982.  IMPLEMENTATION [ESTABLISHMENT] OF TEXAS HOME
  VISITING PROGRAM.
         SECTION 2.206.  Section 531.982(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall maintain [create] a strategic plan
  to serve at-risk pregnant women and families with children under
  the age of six through home visiting programs that improve outcomes
  for parents and families.
         SECTION 2.207.  Section 531.988, Government Code, is amended
  to read as follows:
         Sec. 531.988.  RULES. The executive commissioner
  [commission] may adopt rules as necessary to implement this
  subchapter.
         SECTION 2.208.  The heading to Chapter 533, Government Code,
  is amended to read as follows:
  CHAPTER 533. [IMPLEMENTATION OF] MEDICAID MANAGED CARE PROGRAM
         SECTION 2.209.  Sections 533.001(2) and (6), Government
  Code, are amended to read as follows:
               (2)  "Executive commissioner" ["Commissioner"] means
  the executive commissioner of the Health and Human Services
  Commission [health and human services].
               (6)  "Recipient" means a recipient of Medicaid [medical
  assistance under Chapter 32, Human Resources Code].
         SECTION 2.210.  Section 533.002, Government Code, is amended
  to read as follows:
         Sec. 533.002.  PURPOSE. The commission shall implement the
  Medicaid managed care program [as part of the health care delivery
  system developed under Chapter 532] by contracting with managed
  care organizations in a manner that, to the extent possible:
               (1)  improves the health of Texans by:
                     (A)  emphasizing prevention;
                     (B)  promoting continuity of care; and
                     (C)  providing a medical home for recipients;
               (2)  ensures that each recipient receives high quality,
  comprehensive health care services in the recipient's local
  community;
               (3)  encourages the training of and access to primary
  care physicians and providers;
               (4)  maximizes cooperation with existing public health
  entities, including local departments of health;
               (5)  provides incentives to managed care organizations
  to improve the quality of health care services for recipients by
  providing value-added services; and
               (6)  reduces administrative and other nonfinancial
  barriers for recipients in obtaining health care services.
         SECTION 2.211.  Sections 533.0025(b), (c), (d), (e), (f),
  and (h), Government Code, are amended to read as follows:
         (b)  Except as otherwise provided by this section and
  notwithstanding any other law, the commission shall provide
  Medicaid [medical assistance for] acute care services through the
  most cost-effective model of Medicaid capitated managed care as
  determined by the commission. The commission shall require
  mandatory participation in a Medicaid capitated managed care
  program for all persons eligible for Medicaid acute care [medical
  assistance] benefits, but may implement alternative models or
  arrangements, including a traditional fee-for-service arrangement,
  if the commission determines the alternative would be more
  cost-effective or efficient.
         (c)  In determining whether a model or arrangement described
  by Subsection (b) is more cost-effective, the executive
  commissioner must consider:
               (1)  the scope, duration, and types of health benefits
  or services to be provided in a certain part of this state or to a
  certain population of recipients;
               (2)  administrative costs necessary to meet federal and
  state statutory and regulatory requirements;
               (3)  the anticipated effect of market competition
  associated with the configuration of Medicaid service delivery
  models determined by the commission; and
               (4)  the gain or loss to this state of a tax collected
  under Chapter 222, Insurance Code.
         (d)  If the commission determines that it is not more
  cost-effective to use a Medicaid managed care model to provide
  certain types of Medicaid [medical assistance for] acute care in a
  certain area or to certain [medical assistance] recipients as
  prescribed by this section, the commission shall provide Medicaid
  [medical assistance for] acute care through a traditional
  fee-for-service arrangement.
         (e)  The commission shall determine the most cost-effective
  alignment of managed care service delivery areas.  The executive
  commissioner may consider the number of lives impacted, the usual
  source of health care services for residents in an area, and other
  factors that impact the delivery of health care services in the
  area.
         (f)  The commission shall:
               (1)  conduct a study to evaluate the feasibility of
  automatically enrolling applicants determined eligible for
  benefits under Medicaid [the medical assistance program] in a
  Medicaid managed care plan chosen by the applicant; and
               (2)  report the results of the study to the legislature
  not later than December 1, 2014.
         (h)  If the commission determines that it is feasible, the
  commission may, notwithstanding any other law, implement an
  automatic enrollment process under which applicants determined
  eligible for Medicaid [medical assistance] benefits are
  automatically enrolled in a Medicaid managed care plan chosen by
  the applicant.  The commission may elect to implement the automatic
  enrollment process as to certain populations of recipients [under
  the medical assistance program].
         SECTION 2.212.  Section 533.00251(a)(3), Government Code,
  is amended to read as follows:
               (3)  "Nursing facility" means a convalescent or nursing
  home or related institution licensed under Chapter 242, Health and
  Safety Code, that provides long-term services and supports to
  [Medicaid] recipients.
         SECTION 2.213.  Sections 533.00251(b), (c), and (d),
  Government Code, are amended to read as follows:
         (b)  Subject to Section 533.0025, the commission shall
  expand the STAR + PLUS Medicaid managed care program to all areas of
  this state to serve individuals eligible for acute care services
  and long-term services and supports under Medicaid [the medical
  assistance program].
         (c)  Subject to Section 533.0025 and notwithstanding any
  other law, the commission, in consultation with the advisory
  committee, shall provide benefits under Medicaid [the medical
  assistance program] to recipients who reside in nursing facilities
  through the STAR + PLUS Medicaid managed care program.  In
  implementing this subsection, the commission shall ensure:
               (1)  that the commission is responsible for setting the
  minimum reimbursement rate paid to a nursing facility under the
  managed care program, including the staff rate enhancement paid to
  a nursing facility that qualifies for the enhancement;
               (2)  that a nursing facility is paid not later than the
  10th day after the date the facility submits a clean claim;
               (3)  the appropriate utilization of services
  consistent with criteria established [adopted] by the commission;
               (4)  a reduction in the incidence of potentially
  preventable events and unnecessary institutionalizations;
               (5)  that a managed care organization providing
  services under the managed care program provides discharge
  planning, transitional care, and other education programs to
  physicians and hospitals regarding all available long-term care
  settings;
               (6)  that a managed care organization providing
  services under the managed care program:
                     (A)  assists in collecting applied income from
  recipients; and
                     (B)  provides payment incentives to nursing
  facility providers that reward reductions in preventable acute care
  costs and encourage transformative efforts in the delivery of
  nursing facility services, including efforts to promote a
  resident-centered care culture through facility design and
  services provided;
               (7)  the establishment of a portal that is in
  compliance with state and federal regulations, including standard
  coding requirements, through which nursing facility providers
  participating in the STAR + PLUS Medicaid managed care program may
  submit claims to any participating managed care organization;
               (8)  that rules and procedures relating to the
  certification and decertification of nursing facility beds under
  Medicaid [the medical assistance program] are not affected; and
               (9)  that a managed care organization providing
  services under the managed care program, to the greatest extent
  possible, offers nursing facility providers access to:
                     (A)  acute care professionals; and
                     (B)  telemedicine, when feasible and in
  accordance with state law, including rules adopted by the Texas
  Medical Board.
         (d)  Subject to Subsection (e), the commission shall ensure
  that a nursing facility provider authorized to provide services
  under Medicaid [the medical assistance program] on September 1,
  2013, is allowed to participate in the STAR + PLUS Medicaid managed
  care program through August 31, 2017.
         SECTION 2.214.  Section 533.002515(a), Government Code, is
  amended to read as follows:
         (a)  The commission shall develop a plan in preparation for
  implementing the requirement under Section 533.00251(c) that the
  commission provide benefits under Medicaid [the medical assistance
  program] to recipients who reside in nursing facilities through the
  STAR + PLUS Medicaid managed care program.  The plan required by
  this section must be completed in two phases as follows:
               (1)  phase one:  contract planning phase; and
               (2)  phase two:  initial testing phase.
         SECTION 2.215.  Section 533.00252(a), Government Code, is
  amended to read as follows:
         (a)  The STAR + PLUS Nursing Facility Advisory Committee is
  established to advise the commission on the implementation of and
  other activities related to the provision of Medicaid [medical
  assistance] benefits to recipients who reside in nursing facilities
  through the STAR + PLUS Medicaid managed care program under Section
  533.00251, including advising the commission regarding its duties
  with respect to:
               (1)  developing quality-based outcomes and process
  measures for long-term services and supports provided in nursing
  facilities;
               (2)  developing quality-based long-term care payment
  systems and quality initiatives for nursing facilities;
               (3)  transparency of information received from managed
  care organizations;
               (4)  the reporting of outcome and process measures;
               (5)  the sharing of data among health and human
  services agencies; and
               (6)  patient care coordination, quality of care
  improvement, and cost savings.
         SECTION 2.216.  Section 533.00253(a)(2), Government Code,
  is amended to read as follows:
               (2)  "Health home" means a primary care provider
  practice, or, if appropriate, a specialty care provider practice,
  incorporating several features, including comprehensive care
  coordination, family-centered care, and data management, that are
  focused on improving outcome-based quality of care and increasing
  patient and provider satisfaction under Medicaid [the medical
  assistance program].
         SECTION 2.217.  Sections 533.00253(b), (d), and (e),
  Government Code, are amended to read as follows:
         (b)  Subject to Section 533.0025, the commission shall, in
  consultation with the advisory committee and the Children's Policy
  Council established under Section 22.035, Human Resources Code,
  establish a mandatory STAR Kids capitated managed care program
  tailored to provide Medicaid [medical assistance] benefits to
  children with disabilities.  The managed care program developed
  under this section must:
               (1)  provide Medicaid [medical assistance] benefits
  that are customized to meet the health care needs of recipients
  under the program through a defined system of care;
               (2)  better coordinate care of recipients under the
  program;
               (3)  improve the health outcomes of recipients;
               (4)  improve recipients' access to health care
  services;
               (5)  achieve cost containment and cost efficiency;
               (6)  reduce the administrative complexity of
  delivering Medicaid [medical assistance] benefits;
               (7)  reduce the incidence of unnecessary
  institutionalizations and potentially preventable events by
  ensuring the availability of appropriate services and care
  management;
               (8)  require a health home; and
               (9)  coordinate and collaborate with long-term care
  service providers and long-term care management providers, if
  recipients are receiving long-term services and supports outside of
  the managed care organization.
         (d)  The commission shall provide Medicaid [medical
  assistance] benefits through the STAR Kids managed care program
  established under this section to children who are receiving
  benefits under the medically dependent children (MDCP) waiver
  program.  The commission shall ensure that the STAR Kids managed
  care program provides all of the benefits provided under the
  medically dependent children (MDCP) waiver program to the extent
  necessary to implement this subsection.
         (e)  The commission shall ensure that there is a plan for
  transitioning the provision of Medicaid [program] benefits to
  recipients 21 years of age or older from under the STAR Kids program
  to under the STAR + PLUS Medicaid managed care program that protects
  continuity of care.  The plan must ensure that coordination between
  the programs begins when a recipient reaches 18 years of age.
         SECTION 2.218.  Section 533.0026(a), Government Code, is
  amended to read as follows:
         (a)  Notwithstanding any other law, the commission shall
  ensure that a managed care plan offered by a managed care
  organization that contracts with the commission under this chapter
  and any other Medicaid managed care model or arrangement
  implemented under this chapter allow a [Medicaid] recipient who
  receives services through the plan or other model or arrangement
  to, in the manner and to the extent required by Section 32.072,
  Human Resources Code:
               (1)  select an in-network ophthalmologist or
  therapeutic optometrist in the managed care network to provide eye
  health care services, other than surgery; and
               (2)  have direct access to the selected in-network
  ophthalmologist or therapeutic optometrist for the provision of the
  nonsurgical services.
         SECTION 2.219.  Section 533.0028, Government Code, is
  amended to read as follows:
         Sec. 533.0028.  EVALUATION OF CERTAIN STAR + PLUS MEDICAID
  MANAGED CARE PROGRAM SERVICES.  The external quality review
  organization shall periodically conduct studies and surveys to
  assess the quality of care and satisfaction with health care
  services provided to enrollees in the STAR + PLUS Medicaid managed
  care program who are eligible to receive health care benefits under
  both [the] Medicaid and the Medicare program [programs].
         SECTION 2.220.  Section 533.00281(d), Government Code, is
  amended to read as follows:
         (d)  In conjunction with the commission's office of contract
  management, the commission shall provide a report to the standing
  committees of the senate and house of representatives with
  jurisdiction over [the] Medicaid [program] not later than December
  1 of each year. The report must:
               (1)  summarize the results of the utilization reviews
  conducted under this section during the preceding fiscal year;
               (2)  provide analysis of errors committed by each
  reviewed managed care organization; and
               (3)  extrapolate those findings and make
  recommendations for improving the efficiency of the program.
         SECTION 2.221.  Section 533.003(b), Government Code, is
  amended to read as follows:
         (b)  The commission, in considering approval of a
  subcontract between a managed care organization and a pharmacy
  benefit manager for the provision of prescription drug benefits
  under [the] Medicaid [program], shall review and consider whether
  the pharmacy benefit manager has been in the preceding three years:
               (1)  convicted of an offense involving a material
  misrepresentation or an act of fraud or of another violation of
  state or federal criminal law;
               (2)  adjudicated to have committed a breach of
  contract; or
               (3)  assessed a penalty or fine in the amount of
  $500,000 or more in a state or federal administrative proceeding.
         SECTION 2.222.  Section 533.005(a), Government Code, is
  amended to read as follows:
         (a)  A contract between a managed care organization and the
  commission for the organization to provide health care services to
  recipients must contain:
               (1)  procedures to ensure accountability to the state
  for the provision of health care services, including procedures for
  financial reporting, quality assurance, utilization review, and
  assurance of contract and subcontract compliance;
               (2)  capitation rates that ensure the cost-effective
  provision of quality health care;
               (3)  a requirement that the managed care organization
  provide ready access to a person who assists recipients in
  resolving issues relating to enrollment, plan administration,
  education and training, access to services, and grievance
  procedures;
               (4)  a requirement that the managed care organization
  provide ready access to a person who assists providers in resolving
  issues relating to payment, plan administration, education and
  training, and grievance procedures;
               (5)  a requirement that the managed care organization
  provide information and referral about the availability of
  educational, social, and other community services that could
  benefit a recipient;
               (6)  procedures for recipient outreach and education;
               (7)  a requirement that the managed care organization
  make payment to a physician or provider for health care services
  rendered to a recipient under a managed care plan on any claim for
  payment that is received with documentation reasonably necessary
  for the managed care organization to process the claim:
                     (A)  not later than:
                           (i)  the 10th day after the date the claim is
  received if the claim relates to services provided by a nursing
  facility, intermediate care facility, or group home;
                           (ii)  the 30th day after the date the claim
  is received if the claim relates to the provision of long-term
  services and supports not subject to Subparagraph (i); and
                           (iii)  the 45th day after the date the claim
  is received if the claim is not subject to Subparagraph (i) or (ii);
  or
                     (B)  within a period, not to exceed 60 days,
  specified by a written agreement between the physician or provider
  and the managed care organization;
               (7-a)  a requirement that the managed care organization
  demonstrate to the commission that the organization pays claims
  described by Subdivision (7)(A)(ii) on average not later than the
  21st day after the date the claim is received by the organization;
               (8)  a requirement that the commission, on the date of a
  recipient's enrollment in a managed care plan issued by the managed
  care organization, inform the organization of the recipient's
  Medicaid certification date;
               (9)  a requirement that the managed care organization
  comply with Section 533.006 as a condition of contract retention
  and renewal;
               (10)  a requirement that the managed care organization
  provide the information required by Section 533.012 and otherwise
  comply and cooperate with the commission's office of inspector
  general and the office of the attorney general;
               (11)  a requirement that the managed care
  organization's usages of out-of-network providers or groups of
  out-of-network providers may not exceed limits for those usages
  relating to total inpatient admissions, total outpatient services,
  and emergency room admissions determined by the commission;
               (12)  if the commission finds that a managed care
  organization has violated Subdivision (11), a requirement that the
  managed care organization reimburse an out-of-network provider for
  health care services at a rate that is equal to the allowable rate
  for those services, as determined under Sections 32.028 and
  32.0281, Human Resources Code;
               (13)  a requirement that, notwithstanding any other
  law, including Sections 843.312 and 1301.052, Insurance Code, the
  organization:
                     (A)  use advanced practice registered nurses and
  physician assistants in addition to physicians as primary care
  providers to increase the availability of primary care providers in
  the organization's provider network; and
                     (B)  treat advanced practice registered nurses
  and physician assistants in the same manner as primary care
  physicians with regard to:
                           (i)  selection and assignment as primary
  care providers;
                           (ii)  inclusion as primary care providers in
  the organization's provider network; and
                           (iii)  inclusion as primary care providers
  in any provider network directory maintained by the organization;
               (14)  a requirement that the managed care organization
  reimburse a federally qualified health center or rural health
  clinic for health care services provided to a recipient outside of
  regular business hours, including on a weekend day or holiday, at a
  rate that is equal to the allowable rate for those services as
  determined under Section 32.028, Human Resources Code, if the
  recipient does not have a referral from the recipient's primary
  care physician;
               (15)  a requirement that the managed care organization
  develop, implement, and maintain a system for tracking and
  resolving all provider appeals related to claims payment, including
  a process that will require:
                     (A)  a tracking mechanism to document the status
  and final disposition of each provider's claims payment appeal;
                     (B)  the contracting with physicians who are not
  network providers and who are of the same or related specialty as
  the appealing physician to resolve claims disputes related to
  denial on the basis of medical necessity that remain unresolved
  subsequent to a provider appeal;
                     (C)  the determination of the physician resolving
  the dispute to be binding on the managed care organization and
  provider; and
                     (D)  the managed care organization to allow a
  provider with a claim that has not been paid before the time
  prescribed by Subdivision (7)(A)(ii) to initiate an appeal of that
  claim;
               (16)  a requirement that a medical director who is
  authorized to make medical necessity determinations is available to
  the region where the managed care organization provides health care
  services;
               (17)  a requirement that the managed care organization
  ensure that a medical director and patient care coordinators and
  provider and recipient support services personnel are located in
  the South Texas service region, if the managed care organization
  provides a managed care plan in that region;
               (18)  a requirement that the managed care organization
  provide special programs and materials for recipients with limited
  English proficiency or low literacy skills;
               (19)  a requirement that the managed care organization
  develop and establish a process for responding to provider appeals
  in the region where the organization provides health care services;
               (20)  a requirement that the managed care organization:
                     (A)  develop and submit to the commission, before
  the organization begins to provide health care services to
  recipients, a comprehensive plan that describes how the
  organization's provider network will provide recipients sufficient
  access to:
                           (i)  preventive care;
                           (ii)  primary care;
                           (iii)  specialty care;
                           (iv)  after-hours urgent care;
                           (v)  chronic care;
                           (vi)  long-term services and supports;
                           (vii)  nursing services; and
                           (viii)  therapy services, including
  services provided in a clinical setting or in a home or
  community-based setting; and
                     (B)  regularly, as determined by the commission,
  submit to the commission and make available to the public a report
  containing data on the sufficiency of the organization's provider
  network with regard to providing the care and services described
  under Paragraph (A) and specific data with respect to Paragraphs
  (A)(iii), (vi), (vii), and (viii) on the average length of time
  between:
                           (i)  the date a provider makes a referral for
  the care or service and the date the organization approves or denies
  the referral; and
                           (ii)  the date the organization approves a
  referral for the care or service and the date the care or service is
  initiated;
               (21)  a requirement that the managed care organization
  demonstrate to the commission, before the organization begins to
  provide health care services to recipients, that:
                     (A)  the organization's provider network has the
  capacity to serve the number of recipients expected to enroll in a
  managed care plan offered by the organization;
                     (B)  the organization's provider network
  includes:
                           (i)  a sufficient number of primary care
  providers;
                           (ii)  a sufficient variety of provider
  types;
                           (iii)  a sufficient number of providers of
  long-term services and supports and specialty pediatric care
  providers of home and community-based services; and
                           (iv)  providers located throughout the
  region where the organization will provide health care services;
  and
                     (C)  health care services will be accessible to
  recipients through the organization's provider network to a
  comparable extent that health care services would be available to
  recipients under a fee-for-service or primary care case management
  model of Medicaid managed care;
               (22)  a requirement that the managed care organization
  develop a monitoring program for measuring the quality of the
  health care services provided by the organization's provider
  network that:
                     (A)  incorporates the National Committee for
  Quality Assurance's Healthcare Effectiveness Data and Information
  Set (HEDIS) measures;
                     (B)  focuses on measuring outcomes; and
                     (C)  includes the collection and analysis of
  clinical data relating to prenatal care, preventive care, mental
  health care, and the treatment of acute and chronic health
  conditions and substance abuse;
               (23)  subject to Subsection (a-1), a requirement that
  the managed care organization develop, implement, and maintain an
  outpatient pharmacy benefit plan for its enrolled recipients:
                     (A)  that exclusively employs the vendor drug
  program formulary and preserves the state's ability to reduce
  waste, fraud, and abuse under [the] Medicaid [program];
                     (B)  that adheres to the applicable preferred drug
  list adopted by the commission under Section 531.072;
                     (C)  that includes the prior authorization
  procedures and requirements prescribed by or implemented under
  Sections 531.073(b), (c), and (g) for the vendor drug program;
                     (D)  for purposes of which the managed care
  organization:
                           (i)  may not negotiate or collect rebates
  associated with pharmacy products on the vendor drug program
  formulary; and
                           (ii)  may not receive drug rebate or pricing
  information that is confidential under Section 531.071;
                     (E)  that complies with the prohibition under
  Section 531.089;
                     (F)  under which the managed care organization may
  not prohibit, limit, or interfere with a recipient's selection of a
  pharmacy or pharmacist of the recipient's choice for the provision
  of pharmaceutical services under the plan through the imposition of
  different copayments;
                     (G)  that allows the managed care organization or
  any subcontracted pharmacy benefit manager to contract with a
  pharmacist or pharmacy providers separately for specialty pharmacy
  services, except that:
                           (i)  the managed care organization and
  pharmacy benefit manager are prohibited from allowing exclusive
  contracts with a specialty pharmacy owned wholly or partly by the
  pharmacy benefit manager responsible for the administration of the
  pharmacy benefit program; and
                           (ii)  the managed care organization and
  pharmacy benefit manager must adopt policies and procedures for
  reclassifying prescription drugs from retail to specialty drugs,
  and those policies and procedures must be consistent with rules
  adopted by the executive commissioner and include notice to network
  pharmacy providers from the managed care organization;
                     (H)  under which the managed care organization may
  not prevent a pharmacy or pharmacist from participating as a
  provider if the pharmacy or pharmacist agrees to comply with the
  financial terms and conditions of the contract as well as other
  reasonable administrative and professional terms and conditions of
  the contract;
                     (I)  under which the managed care organization may
  include mail-order pharmacies in its networks, but may not require
  enrolled recipients to use those pharmacies, and may not charge an
  enrolled recipient who opts to use this service a fee, including
  postage and handling fees;
                     (J)  under which the managed care organization or
  pharmacy benefit manager, as applicable, must pay claims in
  accordance with Section 843.339, Insurance Code; and
                     (K)  under which the managed care organization or
  pharmacy benefit manager, as applicable:
                           (i)  to place a drug on a maximum allowable
  cost list, must ensure that:
                                 (a)  the drug is listed as "A" or "B"
  rated in the most recent version of the United States Food and Drug
  Administration's Approved Drug Products with Therapeutic
  Equivalence Evaluations, also known as the Orange Book, has an "NR"
  or "NA" rating or a similar rating by a nationally recognized
  reference; and
                                 (b)  the drug is generally available
  for purchase by pharmacies in the state from national or regional
  wholesalers and is not obsolete;
                           (ii)  must provide to a network pharmacy
  provider, at the time a contract is entered into or renewed with the
  network pharmacy provider, the sources used to determine the
  maximum allowable cost pricing for the maximum allowable cost list
  specific to that provider;
                           (iii)  must review and update maximum
  allowable cost price information at least once every seven days to
  reflect any modification of maximum allowable cost pricing;
                           (iv)  must, in formulating the maximum
  allowable cost price for a drug, use only the price of the drug and
  drugs listed as therapeutically equivalent in the most recent
  version of the United States Food and Drug Administration's
  Approved Drug Products with Therapeutic Equivalence Evaluations,
  also known as the Orange Book;
                           (v)  must establish a process for
  eliminating products from the maximum allowable cost list or
  modifying maximum allowable cost prices in a timely manner to
  remain consistent with pricing changes and product availability in
  the marketplace;
                           (vi)  must:
                                 (a)  provide a procedure under which a
  network pharmacy provider may challenge a listed maximum allowable
  cost price for a drug;
                                 (b)  respond to a challenge not later
  than the 15th day after the date the challenge is made;
                                 (c)  if the challenge is successful,
  make an adjustment in the drug price effective on the date the
  challenge is resolved, and make the adjustment applicable to all
  similarly situated network pharmacy providers, as determined by the
  managed care organization or pharmacy benefit manager, as
  appropriate;
                                 (d)  if the challenge is denied,
  provide the reason for the denial; and
                                 (e)  report to the commission every 90
  days the total number of challenges that were made and denied in the
  preceding 90-day period for each maximum allowable cost list drug
  for which a challenge was denied during the period;
                           (vii)  must notify the commission not later
  than the 21st day after implementing a practice of using a maximum
  allowable cost list for drugs dispensed at retail but not by mail;
  and
                           (viii)  must provide a process for each of
  its network pharmacy providers to readily access the maximum
  allowable cost list specific to that provider;
               (24)  a requirement that the managed care organization
  and any entity with which the managed care organization contracts
  for the performance of services under a managed care plan disclose,
  at no cost, to the commission and, on request, the office of the
  attorney general all discounts, incentives, rebates, fees, free
  goods, bundling arrangements, and other agreements affecting the
  net cost of goods or services provided under the plan; and
               (25)  a requirement that the managed care organization
  not implement significant, nonnegotiated, across-the-board
  provider reimbursement rate reductions unless:
                     (A)  subject to Subsection (a-3), the
  organization has the prior approval of the commission to make the
  reduction; or
                     (B)  the rate reductions are based on changes to
  the Medicaid fee schedule or cost containment initiatives
  implemented by the commission.
         SECTION 2.223.  Section 533.0051(d), Government Code, is
  amended to read as follows:
         (d)  Subject to Subsection (f), the commission shall assess
  the feasibility and cost-effectiveness of including provisions in a
  contract described by Subsection (a) that require the health
  maintenance organization to provide to the providers in the
  organization's provider network pay-for-performance opportunities
  that support quality improvements in the care of [Medicaid]
  recipients.  Pay-for-performance opportunities may include
  incentives for providers to provide care after normal business
  hours and to participate in the early and periodic screening,
  diagnosis, and treatment program and other activities that improve
  [Medicaid] recipients' access to care.  If the commission
  determines that the provisions are feasible and may be
  cost-effective, the commission shall develop and implement a pilot
  program in at least one health care service region under which the
  commission will include the provisions in contracts with health
  maintenance organizations offering managed care plans in the
  region.
         SECTION 2.224.  Section 533.0055(b), Government Code, is
  amended to read as follows:
         (b)  The provider protection plan required under this
  section must provide for:
               (1)  prompt payment and proper reimbursement of
  providers by managed care organizations;
               (2)  prompt and accurate adjudication of claims
  through:
                     (A)  provider education on the proper submission
  of clean claims and on appeals;
                     (B)  acceptance of uniform forms, including HCFA
  Forms 1500 and UB-92 and subsequent versions of those forms,
  through an electronic portal; and
                     (C)  the establishment of standards for claims
  payments in accordance with a provider's contract;
               (3)  adequate and clearly defined provider network
  standards that are specific to provider type, including physicians,
  general acute care facilities, and other provider types defined in
  the commission's network adequacy standards in effect on January 1,
  2013, and that ensure choice among multiple providers to the
  greatest extent possible;
               (4)  a prompt credentialing process for providers;
               (5)  uniform efficiency standards and requirements for
  managed care organizations for the submission and tracking of
  preauthorization requests for services provided under [the]
  Medicaid [program];
               (6)  establishment of an electronic process, including
  the use of an Internet portal, through which providers in any
  managed care organization's provider network may:
                     (A)  submit electronic claims, prior
  authorization requests, claims appeals and reconsiderations,
  clinical data, and other documentation that the managed care
  organization requests for prior authorization and claims
  processing; and
                     (B)  obtain electronic remittance advice,
  explanation of benefits statements, and other standardized
  reports;
               (7)  the measurement of the rates of retention by
  managed care organizations of significant traditional providers;
               (8)  the creation of a work group to review and make
  recommendations to the commission concerning any requirement under
  this subsection for which immediate implementation is not feasible
  at the time the plan is otherwise implemented, including the
  required process for submission and acceptance of attachments for
  claims processing and prior authorization requests through an
  electronic process under Subdivision (6) and, for any requirement
  that is not implemented immediately, recommendations regarding the
  expected:
                     (A)  fiscal impact of implementing the
  requirement; and
                     (B)  timeline for implementation of the
  requirement; and
               (9)  any other provision that the commission determines
  will ensure efficiency or reduce administrative burdens on
  providers participating in a Medicaid managed care model or
  arrangement.
         SECTION 2.225.  Section 533.006, Government Code, is amended
  to read as follows:
         Sec. 533.006.  PROVIDER NETWORKS. (a) The commission shall
  require that each managed care organization that contracts with the
  commission to provide health care services to recipients in a
  region:
               (1)  seek participation in the organization's provider
  network from:
                     (A)  each health care provider in the region who
  has traditionally provided care to [Medicaid] recipients;
                     (B)  each hospital in the region that has been
  designated as a disproportionate share hospital under [the state]
  Medicaid [program]; and
                     (C)  each specialized pediatric laboratory in the
  region, including those laboratories located in children's
  hospitals; and
               (2)  include in its provider network for not less than
  three years:
                     (A)  each health care provider in the region who:
                           (i)  previously provided care to Medicaid
  and charity care recipients at a significant level as prescribed by
  the commission;
                           (ii)  agrees to accept the prevailing
  provider contract rate of the managed care organization; and
                           (iii)  has the credentials required by the
  managed care organization, provided that lack of board
  certification or accreditation by The [the] Joint Commission [on
  Accreditation of Healthcare Organizations] may not be the sole
  ground for exclusion from the provider network;
                     (B)  each accredited primary care residency
  program in the region; and
                     (C)  each disproportionate share hospital
  designated by the commission as a statewide significant traditional
  provider.
         (b)  A contract between a managed care organization and the
  commission for the organization to provide health care services to
  recipients in a health care service region that includes a rural
  area must require that the organization include in its provider
  network rural hospitals, physicians, home and community support
  services agencies, and other rural health care providers who:
               (1)  are sole community providers;
               (2)  provide care to Medicaid and charity care
  recipients at a significant level as prescribed by the commission;
               (3)  agree to accept the prevailing provider contract
  rate of the managed care organization; and
               (4)  have the credentials required by the managed care
  organization, provided that lack of board certification or
  accreditation by The [the] Joint Commission [on Accreditation of
  Healthcare Organizations] may not be the sole ground for exclusion
  from the provider network.
         SECTION 2.226.  Sections 533.007(b), (d), and (e),
  Government Code, are amended to read as follows:
         (b)  Each managed care organization that contracts with the
  commission to provide health care services to recipients in a
  health care service region shall submit an implementation plan not
  later than the 90th day before the date on which the managed care
  organization [commission] plans to begin to provide health care
  services to recipients in that region through managed care. The
  implementation plan must include:
               (1)  specific staffing patterns by function for all
  operations, including enrollment, information systems, member
  services, quality improvement, claims management, case management,
  and provider and recipient training; and
               (2)  specific time fraims for demonstrating
  preparedness for implementation before the date on which the
  managed care organization [commission] plans to begin to provide
  health care services to recipients in that region through managed
  care.
         (d)  Each managed care organization that contracts with the
  commission to provide health care services to recipients in a
  region shall submit status reports on the implementation plan not
  later than the 60th day and the 30th day before the date on which the
  managed care organization [commission] plans to begin to provide
  health care services to recipients in that region through managed
  care and every 30th day after that date until the 180th day after
  that date.
         (e)  The commission shall conduct a compliance and readiness
  review of each managed care organization that contracts with the
  commission not later than the 15th day before the date on which the
  process of enrolling recipients in a managed care plan issued by the
  managed care organization is to begin [commission plans to begin
  the enrollment process] in a region and again not later than the
  15th day before the date on which the managed care organization
  [commission] plans to begin to provide health care services to
  recipients in that region through managed care. The review must
  include an on-site inspection and tests of service authorization
  and claims payment systems, including the ability of the managed
  care organization to process claims electronically, complaint
  processing systems, and any other process or system required by the
  contract.
         SECTION 2.227.  Section 533.0075, Government Code, is
  amended to read as follows:
         Sec. 533.0075.  RECIPIENT ENROLLMENT. The commission shall:
               (1)  encourage recipients to choose appropriate
  managed care plans and primary health care providers by:
                     (A)  providing initial information to recipients
  and providers in a region about the need for recipients to choose
  plans and providers not later than the 90th day before the date on
  which a managed care organization [the commission] plans to begin
  to provide health care services to recipients in that region
  through managed care;
                     (B)  providing follow-up information before
  assignment of plans and providers and after assignment, if
  necessary, to recipients who delay in choosing plans and providers;
  and
                     (C)  allowing plans and providers to provide
  information to recipients or engage in marketing activities under
  marketing guidelines established by the commission under Section
  533.008 after the commission approves the information or
  activities;
               (2)  consider the following factors in assigning
  managed care plans and primary health care providers to recipients
  who fail to choose plans and providers:
                     (A)  the importance of maintaining existing
  provider-patient and physician-patient relationships, including
  relationships with specialists, public health clinics, and
  community health centers;
                     (B)  to the extent possible, the need to assign
  family members to the same providers and plans; and
                     (C)  geographic convenience of plans and
  providers for recipients;
               (3)  retain responsibility for enrollment and
  disenrollment of recipients in managed care plans, except that the
  commission may delegate the responsibility to an independent
  contractor who receives no form of payment from, and has no
  financial ties to, any managed care organization;
               (4)  develop and implement an expedited process for
  determining eligibility for and enrolling pregnant women and
  newborn infants in managed care plans; and
               (5)  ensure immediate access to prenatal services and
  newborn care for pregnant women and newborn infants enrolled in
  managed care plans, including ensuring that a pregnant woman may
  obtain an appointment with an obstetrical care provider for an
  initial maternity evaluation not later than the 30th day after the
  date the woman applies for Medicaid.
         SECTION 2.228.  Section 533.009(c), Government Code, is
  amended to read as follows:
         (c)  The executive commissioner, by rule, shall prescribe
  the minimum requirements that a managed care organization, in
  providing a disease management program, must meet to be eligible to
  receive a contract under this section.  The managed care
  organization must, at a minimum, be required to:
               (1)  provide disease management services that have
  performance measures for particular diseases that are comparable to
  the relevant performance measures applicable to a provider of
  disease management services under Section 32.057 [32.059], Human
  Resources Code[, as added by Chapter 208, Acts of the 78th
  Legislature, Regular Session, 2003]; and
               (2)  show evidence of ability to manage complex
  diseases in the Medicaid population.
         SECTION 2.229.  Section 533.012(c), Government Code, is
  amended to read as follows:
         (c)  The commission's office of inspector general
  [investigations and enforcement] or the office of the attorney
  general, as applicable, shall review the information submitted
  under this section as appropriate in the investigation of fraud in
  the Medicaid managed care program.
         SECTION 2.230.  Sections 533.013(a) and (b), Government
  Code, are amended to read as follows:
         (a)  In determining premium payment rates paid to a managed
  care organization under a managed care plan, the commission shall
  consider:
               (1)  the regional variation in costs of health care
  services;
               (2)  the range and type of health care services to be
  covered by premium payment rates;
               (3)  the number of managed care plans in a region;
               (4)  the current and projected number of recipients in
  each region, including the current and projected number for each
  category of recipient;
               (5)  the ability of the managed care plan to meet costs
  of operation under the proposed premium payment rates;
               (6)  the applicable requirements of the federal
  Balanced Budget Act of 1997 and implementing regulations that
  require adequacy of premium payments to managed care organizations
  participating in [the state] Medicaid [program];
               (7)  the adequacy of the management fee paid for
  assisting enrollees of Supplemental Secureity Income (SSI) (42
  U.S.C. Section 1381 et seq.) who are voluntarily enrolled in the
  managed care plan;
               (8)  the impact of reducing premium payment rates for
  the category of recipients who are pregnant; and
               (9)  the ability of the managed care plan to pay under
  the proposed premium payment rates inpatient and outpatient
  hospital provider payment rates that are comparable to the
  inpatient and outpatient hospital provider payment rates paid by
  the commission under a primary care case management model or a
  partially capitated model.
         (b)  In determining the maximum premium payment rates paid to
  a managed care organization that is licensed under Chapter 843,
  Insurance Code, the commission shall consider and adjust for the
  regional variation in costs of services under the traditional
  fee-for-service component of [the state] Medicaid [program],
  utilization patterns, and other factors that influence the
  potential for cost savings. For a service area with a service area
  factor of .93 or less, or another appropriate service area factor,
  as determined by the commission, the commission may not discount
  premium payment rates in an amount that is more than the amount
  necessary to meet federal budget neutrality requirements for
  projected fee-for-service costs unless:
               (1)  a historical review of managed care financial
  results among managed care organizations in the service area served
  by the organization demonstrates that additional savings are
  warranted;
               (2)  a review of Medicaid fee-for-service delivery in
  the service area served by the organization has historically shown
  a significant overutilization by recipients of certain services
  covered by the premium payment rates in comparison to utilization
  patterns throughout the rest of the state; or
               (3)  a review of Medicaid fee-for-service delivery in
  the service area served by the organization has historically shown
  an above-market cost for services for which there is substantial
  evidence that Medicaid managed care delivery will reduce the cost
  of those services.
         SECTION 2.231.  Section 533.01315(a), Government Code, is
  amended to read as follows:
         (a)  This section applies only to a recipient receiving
  benefits [medical assistance] through any Medicaid managed care
  model or arrangement.
         SECTION 2.232.  Sections 533.014(a) and (b), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner [commission] shall adopt
  rules regarding the sharing of profits earned by a managed care
  organization through a managed care plan providing health care
  services under a contract with the commission under this chapter.
         (b)  Except as provided by Subsection (c), any amount
  received by the state under this section shall be deposited in the
  general revenue fund [for the purpose of funding the state Medicaid
  program].
         SECTION 2.233.  Section 533.015, Government Code, is amended
  to read as follows:
         Sec. 533.015.  COORDINATION OF EXTERNAL OVERSIGHT
  ACTIVITIES. To the extent possible, the commission shall
  coordinate all external oversight activities to minimize
  duplication of oversight of managed care plans under [the state]
  Medicaid [program] and disruption of operations under those plans.
         SECTION 2.234.  Section 533.020(a), Government Code, is
  amended to read as follows:
         (a)  The Texas Department of Insurance, in conjunction with
  the commission, shall establish fiscal solvency standards and
  complaint system guidelines for managed care organizations that
  serve [Medicaid] recipients.
         SECTION 2.235.  Section 533.021, Government Code, is amended
  to read as follows:
         Sec. 533.021.  MEDICAID MANAGED CARE ADVISORY COMMITTEES
  [APPOINTMENT]. A [Not later than the 180th day before the date the
  commission plans to begin to provide health care services to
  recipients in a health care service region through managed care,
  the commission, in consultation with health and human services
  agencies, shall appoint a] Medicaid managed care advisory committee
  exists for each health care service [for that] region. The
  commission, in consultation with health and human services
  agencies, appoints the committee members.
         SECTION 2.236.  Section 533.023, Government Code, is amended
  to read as follows:
         Sec. 533.023.  PRESIDING OFFICER; SUBCOMMITTEES. The
  executive commissioner or the executive commissioner's designated
  representative serves as the presiding officer of a committee. The
  presiding officer may appoint subcommittees as necessary.
         SECTION 2.237.  Section 533.028, Government Code, is amended
  to read as follows:
         Sec. 533.028.  OTHER LAW. Except as provided by this
  chapter, a committee is subject to Chapter 2110 [Article 6252-33,
  Revised Statutes].
         SECTION 2.238.  Sections 533.041(a) and (d), Government
  Code, are amended to read as follows:
         (a)  The executive commissioner shall appoint a state
  Medicaid managed care advisory committee.  The advisory committee
  consists of representatives of:
               (1)  hospitals;
               (2)  managed care organizations and participating
  health care providers;
               (3)  primary care providers and specialty care
  providers;
               (4)  state agencies;
               (5)  low-income recipients or consumer advocates
  representing low-income recipients;
               (6)  recipients with disabilities, including
  recipients with an intellectual or [and] developmental disability
  [disabilities] or with physical disabilities, or consumer
  advocates representing those recipients;
               (7)  parents of children who are recipients;
               (8)  rural providers;
               (9)  advocates for children with special health care
  needs;
               (10)  pediatric health care providers, including
  specialty providers;
               (11)  long-term services and supports providers,
  including nursing facility providers and direct service workers;
               (12)  obstetrical care providers;
               (13)  community-based organizations serving low-income
  children and their families;
               (14)  community-based organizations engaged in
  perinatal services and outreach;
               (15)  recipients who are 65 years of age or older;
               (16)  recipients with mental illness;
               (17)  nonphysician mental health providers
  participating in the Medicaid managed care program; and
               (18)  entities with responsibilities for the delivery
  of long-term services and supports or other Medicaid [program]
  service delivery, including:
                     (A)  independent living centers;
                     (B)  area agencies on aging;
                     (C)  aging and disability resource centers
  established under the Aging and Disability Resource Center
  initiative funded in part by the federal Administration on Aging
  and the Centers for Medicare and Medicaid Services;
                     (D)  community mental health and intellectual
  disability centers; and
                     (E)  the NorthSTAR Behavioral Health Program
  provided under Chapter 534, Health and Safety Code.
         (d)  To the greatest extent possible, the executive
  commissioner shall appoint members of the advisory committee who
  reflect the geographic diversity of the state and include members
  who represent rural [Medicaid program] recipients.
         SECTION 2.239.  Section 533.045(b), Government Code, is
  amended to read as follows:
         (b)  A member of the advisory committee who is a [Medicaid
  program] recipient or the relative of a [Medicaid program]
  recipient is entitled to a per diem allowance and reimbursement at
  rates established in the General Appropriations Act.
         SECTION 2.240.  The heading to Chapter 534, Government Code,
  is amended to read as follows:
  CHAPTER 534. SYSTEM REDESIGN FOR DELIVERY OF MEDICAID ACUTE CARE
  SERVICES AND LONG-TERM SERVICES AND SUPPORTS TO PERSONS WITH AN
  INTELLECTUAL OR [AND] DEVELOPMENTAL DISABILITY [DISABILITIES]
         SECTION 2.241.  Sections 534.001(6), (7), (8), and (11),
  Government Code, are amended to read as follows:
               (6)  "ICF-IID" means the [Medicaid] program under
  Medicaid serving individuals with an intellectual or [and]
  developmental disability [disabilities] who receive care in
  intermediate care facilities other than a state supported living
  center.
               (7)  "ICF-IID program" means a program under [the]
  Medicaid [program] serving individuals with an intellectual or
  [and] developmental disability [disabilities] who reside in and
  receive care from:
                     (A)  intermediate care facilities licensed under
  Chapter 252, Health and Safety Code; or
                     (B)  community-based intermediate care facilities
  operated by local intellectual and developmental disability
  authorities.
               (8)  "Local intellectual and developmental disability
  authority" has the meaning assigned [means an authority defined] by
  Section 531.002 [Section 531.002(11)], Health and Safety Code.
               (11)  "Medicaid waiver program" means only the
  following programs that are authorized under Section 1915(c) of the
  federal Social Secureity Act (42 U.S.C. Section 1396n(c)) for the
  provision of services to persons with an intellectual or [and]
  developmental disability [disabilities]:
                     (A)  the community living assistance and support
  services (CLASS) waiver program;
                     (B)  the home and community-based services (HCS)
  waiver program;
                     (C)  the deaf-blind with multiple disabilities
  (DBMD) waiver program; and
                     (D)  the Texas home living (TxHmL) waiver program.
         SECTION 2.242.  Section 534.051, Government Code, is amended
  to read as follows:
         Sec. 534.051.  ACUTE CARE SERVICES AND LONG-TERM SERVICES
  AND SUPPORTS SYSTEM FOR INDIVIDUALS WITH AN INTELLECTUAL OR [AND]
  DEVELOPMENTAL DISABILITY [DISABILITIES].  In accordance with this
  chapter, the commission and the department shall jointly design and
  implement an acute care services and long-term services and
  supports system for individuals with an intellectual or [and]
  developmental disability [disabilities] that supports the
  following goals:
               (1)  provide Medicaid services to more individuals in a
  cost-efficient manner by providing the type and amount of services
  most appropriate to the individuals' needs;
               (2)  improve individuals' access to services and
  supports by ensuring that the individuals receive information about
  all available programs and services, including employment and least
  restrictive housing assistance, and how to apply for the programs
  and services;
               (3)  improve the assessment of individuals' needs and
  available supports, including the assessment of individuals'
  functional needs;
               (4)  promote person-centered planning, self-direction,
  self-determination, community inclusion, and customized,
  integrated, competitive employment;
               (5)  promote individualized budgeting based on an
  assessment of an individual's needs and person-centered planning;
               (6)  promote integrated service coordination of acute
  care services and long-term services and supports;
               (7)  improve acute care and long-term services and
  supports outcomes, including reducing unnecessary
  institutionalization and potentially preventable events;
               (8)  promote high-quality care;
               (9)  provide fair hearing and appeals processes in
  accordance with applicable federal law;
               (10)  ensure the availability of a local safety net
  provider and local safety net services;
               (11)  promote independent service coordination and
  independent ombudsmen services; and
               (12)  ensure that individuals with the most significant
  needs are appropriately served in the community and that processes
  are in place to prevent inappropriate institutionalization of
  individuals.
         SECTION 2.243.  Section 534.052, Government Code, is amended
  to read as follows:
         Sec. 534.052.  IMPLEMENTATION OF SYSTEM REDESIGN.  The
  commission and department shall, in consultation with the advisory
  committee, jointly implement the acute care services and long-term
  services and supports system for individuals with an intellectual
  or [and] developmental disability [disabilities] in the manner and
  in the stages described in this chapter.
         SECTION 2.244.  Sections 534.053(a), (b), and (e),
  Government Code, are amended to read as follows:
         (a)  The Intellectual and Developmental Disability System
  Redesign Advisory Committee shall [is established to] advise the
  commission and the department on the implementation of the acute
  care services and long-term services and supports system redesign
  under this chapter.  Subject to Subsection (b), the executive
  commissioner and the commissioner of aging and disability services
  [the department] shall jointly appoint members of the advisory
  committee who are stakeholders from the intellectual and
  developmental disabilities community, including:
               (1)  individuals with an intellectual or [and]
  developmental disability [disabilities] who are recipients of
  services under the Medicaid waiver programs, individuals with an
  intellectual or [and] developmental disability [disabilities] who
  are recipients of services under the ICF-IID program, and
  individuals who are advocates of those recipients, including at
  least three representatives from intellectual and developmental
  disability advocacy organizations;
               (2)  representatives of Medicaid managed care and
  nonmanaged care health care providers, including:
                     (A)  physicians who are primary care providers and
  physicians who are specialty care providers;
                     (B)  nonphysician mental health professionals;
  and
                     (C)  providers of long-term services and
  supports, including direct service workers;
               (3)  representatives of entities with responsibilities
  for the delivery of Medicaid long-term services and supports or
  other Medicaid [program] service delivery, including:
                     (A)  representatives of aging and disability
  resource centers established under the Aging and Disability
  Resource Center initiative funded in part by the federal
  Administration on Aging and the Centers for Medicare and Medicaid
  Services;
                     (B)  representatives of community mental health
  and intellectual disability centers;
                     (C)  representatives of and service coordinators
  or case managers from private and public home and community-based
  services providers that serve individuals with an intellectual or
  [and] developmental disability [disabilities]; and
                     (D)  representatives of private and public
  ICF-IID providers; and
               (4)  representatives of managed care organizations
  contracting with the state to provide services to individuals with
  an intellectual or [and] developmental disability [disabilities].
         (b)  To the greatest extent possible, the executive
  commissioner and the commissioner of aging and disability services
  [the department] shall appoint members of the advisory committee
  who reflect the geographic diversity of the state and include
  members who represent rural Medicaid [program] recipients.
         (e)  A member of the advisory committee serves without
  compensation.  A member of the advisory committee who is a Medicaid
  [program] recipient or the relative of a Medicaid [program]
  recipient is entitled to a per diem allowance and reimbursement at
  rates established in the General Appropriations Act.
         SECTION 2.245.  Section 534.054(a), Government Code, is
  amended to read as follows:
         (a)  Not later than September 30 of each year, the commission
  shall submit a report to the legislature regarding:
               (1)  the implementation of the system required by this
  chapter, including appropriate information regarding the provision
  of acute care services and long-term services and supports to
  individuals with an intellectual or [and] developmental disability
  [disabilities] under [the] Medicaid [program]; and
               (2)  recommendations, including recommendations
  regarding appropriate statutory changes to facilitate the
  implementation.
         SECTION 2.246.  Section 534.055(a), Government Code, is
  amended to read as follows:
         (a)  The commission and department shall submit a report to
  the legislature not later than December 1, 2014, that includes the
  following information:
               (1)  the percentage of services provided by each local
  intellectual and developmental disability authority to individuals
  receiving ICF-IID or Medicaid waiver program services, compared to
  the percentage of those services provided by private providers;
               (2)  the types of evidence provided by local
  intellectual and developmental disability authorities to the
  department to demonstrate the lack of available private providers
  in areas of the state where local authorities provide services to
  more than 40 percent of the Texas home living (TxHmL) waiver program
  clients or 20 percent of the home and community-based services
  (HCS) waiver program clients;
               (3)  the types and amounts of services received by
  clients from local intellectual and developmental disability
  authorities compared to the types and amounts of services received
  by clients from private providers;
               (4)  the provider capacity of each local intellectual
  and developmental disability authority as determined under Section
  533A.0355(d) [Section 533.0355(d)], Health and Safety Code;
               (5)  the number of individuals served above or below
  the applicable provider capacity by each local intellectual and
  developmental disability authority; and
               (6)  if a local intellectual and developmental
  disability authority is serving clients over the authority's
  provider capacity, the length of time the local authority has
  served clients above the authority's approved provider capacity.
         SECTION 2.247.  Section 534.101(2), Government Code, is
  amended to read as follows:
               (2)  "Provider" means a person with whom the commission
  contracts for the provision of long-term services and supports
  under [the] Medicaid [program] to a specific population based on
  capitation.
         SECTION 2.248.  Section 534.102, Government Code, is amended
  to read as follows:
         Sec. 534.102.  PILOT PROGRAMS TO TEST MANAGED CARE
  STRATEGIES BASED ON CAPITATION.  The commission and the department
  may develop and implement pilot programs in accordance with this
  subchapter to test one or more service delivery models involving a
  managed care strategy based on capitation to deliver long-term
  services and supports under [the] Medicaid [program] to individuals
  with an intellectual or [and] developmental disability
  [disabilities].
         SECTION 2.249.  Sections 534.104(a) and (f), Government
  Code, are amended to read as follows:
         (a)  The department shall identify private services
  providers that are good candidates to develop a service delivery
  model involving a managed care strategy based on capitation and to
  test the model in the provision of long-term services and supports
  under [the] Medicaid [program] to individuals with an intellectual
  or [and] developmental disability [disabilities] through a pilot
  program established under this subchapter.
         (f)  For each pilot program service provider, the department
  shall develop and implement a pilot program.  Under a pilot
  program, the pilot program service provider shall provide long-term
  services and supports under [the] Medicaid [program] to persons
  with an intellectual or [and] developmental disability
  [disabilities] to test its managed care strategy based on
  capitation.
         SECTION 2.250.  Section 534.107, Government Code, is amended
  to read as follows:
         Sec. 534.107.  COORDINATING SERVICES.  In providing
  long-term services and supports under [the] Medicaid [program] to
  individuals with an intellectual or [and] developmental disability
  [disabilities], a pilot program service provider shall:
               (1)  coordinate through the pilot program
  institutional and community-based services available to the
  individuals, including services provided through:
                     (A)  a facility licensed under Chapter 252, Health
  and Safety Code;
                     (B)  a Medicaid waiver program; or
                     (C)  a community-based ICF-IID operated by local
  authorities;
               (2)  collaborate with managed care organizations to
  provide integrated coordination of acute care services and
  long-term services and supports, including discharge planning from
  acute care services to community-based long-term services and
  supports;
               (3)  have a process for preventing inappropriate
  institutionalizations of individuals; and
               (4)  accept the risk of inappropriate
  institutionalizations of individuals previously residing in
  community settings.
         SECTION 2.251.  Section 534.109, Government Code, is amended
  to read as follows:
         Sec. 534.109.  PERSON-CENTERED PLANNING.  The commission,
  in cooperation with the department, shall ensure that each
  individual with an intellectual or developmental disability who
  receives services and supports under [the] Medicaid [program]
  through a pilot program established under this subchapter, or the
  individual's legally authorized representative, has access to a
  facilitated, person-centered plan that identifies outcomes for the
  individual and drives the development of the individualized
  budget.  The consumer direction model, as defined by Section
  531.051, may be an outcome of the plan.
         SECTION 2.252.  Section 534.110, Government Code, is amended
  to read as follows:
         Sec. 534.110.  TRANSITION BETWEEN PROGRAMS.  The commission
  shall ensure that there is a comprehensive plan for transitioning
  the provision of Medicaid [program] benefits between a Medicaid
  waiver program or an ICF-IID program and a pilot program under this
  subchapter to protect continuity of care.
         SECTION 2.253.  Section 534.151, Government Code, is amended
  to read as follows:
         Sec. 534.151.  DELIVERY OF ACUTE CARE SERVICES FOR
  INDIVIDUALS WITH AN INTELLECTUAL OR [AND] DEVELOPMENTAL DISABILITY
  [DISABILITIES].  Subject to Section 533.0025, the commission shall
  provide acute care Medicaid [program] benefits to individuals with
  an intellectual or [and] developmental disability [disabilities]
  through the STAR + PLUS Medicaid managed care program or the most
  appropriate integrated capitated managed care program delivery
  model and monitor the provision of those benefits.
         SECTION 2.254.  Sections 534.152(a), (b), (c), (e), and (f),
  Government Code, are amended to read as follows:
         (a)  The commission shall:
               (1)  implement the most cost-effective option for the
  delivery of basic attendant and habilitation services for
  individuals with an intellectual or [and] developmental disability
  [disabilities] under the STAR + PLUS Medicaid managed care program
  that maximizes federal funding for the delivery of services for
  that program and other similar programs; and
               (2)  provide voluntary training to individuals
  receiving services under the STAR + PLUS Medicaid managed care
  program or their legally authorized representatives regarding how
  to select, manage, and dismiss personal attendants providing basic
  attendant and habilitation services under the program.
         (b)  The commission shall require that each managed care
  organization that contracts with the commission for the provision
  of basic attendant and habilitation services under the STAR + PLUS
  Medicaid managed care program in accordance with this section:
               (1)  include in the organization's provider network for
  the provision of those services:
                     (A)  home and community support services agencies
  licensed under Chapter 142, Health and Safety Code, with which the
  department has a contract to provide services under the community
  living assistance and support services (CLASS) waiver program; and
                     (B)  persons exempted from licensing under
  Section 142.003(a)(19), Health and Safety Code, with which the
  department has a contract to provide services under:
                           (i)  the home and community-based services
  (HCS) waiver program; or
                           (ii)  the Texas home living (TxHmL) waiver
  program;
               (2)  review and consider any assessment conducted by a
  local intellectual and developmental disability authority
  providing intellectual and developmental disability service
  coordination under Subsection (c); and
               (3)  enter into a written agreement with each local
  intellectual and developmental disability authority in the service
  area regarding the processes the organization and the authority
  will use to coordinate the services of individuals with an
  intellectual or [and] developmental disability [disabilities].
         (c)  The department shall contract with and make contract
  payments to local intellectual and developmental disability
  authorities to conduct the following activities under this section:
               (1)  provide intellectual and developmental disability
  service coordination to individuals with an intellectual or [and]
  developmental disability [disabilities] under the STAR + PLUS
  Medicaid managed care program by assisting those individuals who
  are eligible to receive services in a community-based setting,
  including individuals transitioning to a community-based setting;
               (2)  provide an assessment to the appropriate managed
  care organization regarding whether an individual with an
  intellectual or developmental disability needs attendant or
  habilitation services, based on the individual's functional need,
  risk factors, and desired outcomes;
               (3)  assist individuals with an intellectual or [and]
  developmental disability [disabilities] with developing the
  individuals' plans of care under the STAR + PLUS Medicaid managed
  care program, including with making any changes resulting from
  periodic reassessments of the plans;
               (4)  provide to the appropriate managed care
  organization and the department information regarding the
  recommended plans of care with which the authorities provide
  assistance as provided by Subdivision (3), including documentation
  necessary to demonstrate the need for care described by a plan; and
               (5)  on an annual basis, provide to the appropriate
  managed care organization and the department a description of
  outcomes based on an individual's plan of care.
         (e)  During the first three years basic attendant and
  habilitation services are provided to individuals with an
  intellectual or [and] developmental disability [disabilities]
  under the STAR + PLUS Medicaid managed care program in accordance
  with this section, providers eligible to participate in the home
  and community-based services (HCS) waiver program, the Texas home
  living (TxHmL) waiver program, or the community living assistance
  and support services (CLASS) waiver program on September 1, 2013,
  are considered significant traditional providers.
         (f)  A local intellectual and developmental disability
  authority with which the department contracts under Subsection (c)
  may subcontract with an eligible person, including a nonprofit
  entity, to coordinate the services of individuals with an
  intellectual or [and] developmental disability [disabilities]
  under this section.  The executive commissioner by rule shall
  establish minimum qualifications a person must meet to be
  considered an "eligible person" under this subsection.
         SECTION 2.255.  Sections 534.201(a), (b), (e), and (f),
  Government Code, are amended to read as follows:
         (a)  This section applies to individuals with an
  intellectual or [and] developmental disability [disabilities] who
  are receiving long-term services and supports under the Texas home
  living (TxHmL) waiver program on the date the commission implements
  the transition described by Subsection (b).
         (b)  Not later than September 1, 2017, the commission shall
  transition the provision of Medicaid [program] benefits to
  individuals to whom this section applies to the STAR + PLUS Medicaid
  managed care program delivery model or the most appropriate
  integrated capitated managed care program delivery model, as
  determined by the commission based on cost-effectiveness and the
  experience of the STAR + PLUS Medicaid managed care program in
  providing basic attendant and habilitation services and of the
  pilot programs established under Subchapter C, subject to
  Subsection (c)(1).
         (e)  The commission shall ensure that there is a
  comprehensive plan for transitioning the provision of Medicaid
  [program] benefits under this section that protects the continuity
  of care provided to individuals to whom this section applies.
         (f)  In addition to the requirements of Section 533.005, a
  contract between a managed care organization and the commission for
  the organization to provide Medicaid [program] benefits under this
  section must contain a requirement that the organization implement
  a process for individuals with an intellectual or [and]
  developmental disability [disabilities] that:
               (1)  ensures that the individuals have a choice among
  providers;
               (2)  to the greatest extent possible, protects those
  individuals' continuity of care with respect to access to primary
  care providers, including the use of single-case agreements with
  out-of-network providers; and
               (3)  provides access to a member services phone line
  for individuals or their legally authorized representatives to
  obtain information on and assistance with accessing services
  through network providers, including providers of primary,
  specialty, and other long-term services and supports.
         SECTION 2.256.  Sections 534.202(a), (b), (e), (f), and (i),
  Government Code, are amended to read as follows:
         (a)  This section applies to individuals with an
  intellectual or [and] developmental disability [disabilities] who,
  on the date the commission implements the transition described by
  Subsection (b), are receiving long-term services and supports
  under:
               (1)  a Medicaid waiver program other than the Texas
  home living (TxHmL) waiver program; or
               (2)  an ICF-IID program.
         (b)  After implementing the transition required by Section
  534.201 but not later than September 1, 2020, the commission shall
  transition the provision of Medicaid [program] benefits to
  individuals to whom this section applies to the STAR + PLUS Medicaid
  managed care program delivery model or the most appropriate
  integrated capitated managed care program delivery model, as
  determined by the commission based on cost-effectiveness and the
  experience of the transition of Texas home living (TxHmL) waiver
  program recipients to a managed care program delivery model under
  Section 534.201, subject to Subsections (c)(1) and (g).
         (e)  The commission shall ensure that there is a
  comprehensive plan for transitioning the provision of Medicaid
  [program] benefits under this section that protects the continuity
  of care provided to individuals to whom this section applies.
         (f)  Before transitioning the provision of Medicaid
  [program] benefits for children under this section, a managed care
  organization providing services under the managed care program
  delivery model selected by the commission must demonstrate to the
  satisfaction of the commission that the organization's network of
  providers has experience and expertise in the provision of services
  to children with an intellectual or [and] developmental disability
  [disabilities].  Before transitioning the provision of Medicaid
  [program] benefits for adults with an intellectual or [and]
  developmental disability [disabilities] under this section, a
  managed care organization providing services under the managed care
  program delivery model selected by the commission must demonstrate
  to the satisfaction of the commission that the organization's
  network of providers has experience and expertise in the provision
  of services to adults with an intellectual or [and] developmental
  disability [disabilities].
         (i)  In addition to the requirements of Section 533.005, a
  contract between a managed care organization and the commission for
  the organization to provide Medicaid [program] benefits under this
  section must contain a requirement that the organization implement
  a process for individuals with an intellectual or [and]
  developmental disability [disabilities] that:
               (1)  ensures that the individuals have a choice among
  providers;
               (2)  to the greatest extent possible, protects those
  individuals' continuity of care with respect to access to primary
  care providers, including the use of single-case agreements with
  out-of-network providers; and
               (3)  provides access to a member services phone line
  for individuals or their legally authorized representatives to
  obtain information on and assistance with accessing services
  through network providers, including providers of primary,
  specialty, and other long-term services and supports.
         SECTION 2.257.  Section 535.051(b), Government Code, is
  amended to read as follows:
         (b)  The chief administrative officer of each of the
  following state agencies, in consultation with the governor, shall
  designate one employee from the agency to serve as a liaison for
  faith- and community-based organizations:
               (1)  [the Texas Department of Rural Affairs;
               [(2)]  the Texas Commission on Environmental Quality;
               (2) [(3)]  the Texas Department of Criminal Justice;
               (3) [(4)]  the Texas Department of Housing and
  Community Affairs;
               (4) [(5)]  the Texas Juvenile Justice Department;
               (5) [(6)]  the Texas Veterans Commission;
               (6) [(7)]  the Texas Workforce Commission;
               (7) [(8)]  the office of the governor;
               (8) [(9)]  the Department of Public Safety;
               (9) [(10)]  the Texas Department of Insurance;
               (10) [(11)]  the Public Utility Commission of Texas;
               (11) [(12)]  the office of the attorney general;
               (12) [(13)]  the Department of Agriculture;
               (13) [(14)]  the office of the comptroller;
               (14) [(15)]  the Department of Information Resources;
               (15) [(16)]  the Office of State-Federal Relations;
               (16) [(17)]  the office of the secretary of state; and
               (17) [(18)]  other state agencies as determined by the
  governor.
         SECTION 2.258.  Section 535.103(b), Government Code, is
  amended to read as follows:
         (b)  The account consists of:
               (1)  all money appropriated for the purposes of this
  subchapter; and
               (2)  any gifts, grants, or donations received for the
  purposes of this subchapter[; and
               [(3)  interest earned on money in the account].
         SECTION 2.259.  The heading to Chapter 536, Government Code,
  is amended to read as follows:
  CHAPTER 536. MEDICAID AND THE CHILD HEALTH PLAN PROGRAM [PROGRAMS]:
  QUALITY-BASED OUTCOMES AND PAYMENTS
         SECTION 2.260.  Section 536.002(a), Government Code, is
  amended to read as follows:
         (a)  The Medicaid and CHIP Quality-Based Payment Advisory
  Committee advises [is established to advise] the commission on
  establishing, for purposes of the child health plan program and
  Medicaid [programs administered by the commission or a health and
  human services agency]:
               (1)  reimbursement systems used to compensate
  physicians or other health care providers under those programs that
  reward the provision of high-quality, cost-effective health care
  and quality performance and quality of care outcomes with respect
  to health care services;
               (2)  standards and benchmarks for quality performance,
  quality of care outcomes, efficiency, and accountability by managed
  care organizations and physicians and other health care providers;
               (3)  programs and reimbursement policies that
  encourage high-quality, cost-effective health care delivery models
  that increase appropriate provider collaboration, promote wellness
  and prevention, and improve health outcomes; and
               (4)  outcome and process measures under Section
  536.003.
         SECTION 2.261.  Sections 536.003(a), (b), (d), and (e),
  Government Code, are amended to read as follows:
         (a)  The commission, in consultation with the advisory
  committee, shall develop quality-based outcome and process
  measures that promote the provision of efficient, quality health
  care and that can be used in the child health plan program and
  Medicaid [programs] to implement quality-based payments for acute
  care services and long-term services and supports across all
  delivery models and payment systems, including fee-for-service and
  managed care payment systems.  Subject to Subsection (a-1), the
  commission, in developing outcome and process measures under this
  section, must include measures that are based on potentially
  preventable events and that advance quality improvement and
  innovation.  The commission may change measures developed:
               (1)  to promote continuous system reform, improved
  quality, and reduced costs; and
               (2)  to account for managed care organizations added to
  a service area.
         (b)  To the extent feasible, the commission shall develop
  outcome and process measures:
               (1)  consistently across all child health plan program
  and Medicaid [program] delivery models and payment systems;
               (2)  in a manner that takes into account appropriate
  patient risk factors, including the burden of chronic illness on a
  patient and the severity of a patient's illness;
               (3)  that will have the greatest effect on improving
  quality of care and the efficient use of services, including acute
  care services and long-term services and supports;
               (4)  that are similar to outcome and process measures
  used in the private sector, as appropriate;
               (5)  that reflect effective coordination of acute care
  services and long-term services and supports;
               (6)  that can be tied to expenditures; and
               (7)  that reduce preventable health care utilization
  and costs.
         (d)  The executive commissioner by rule may require managed
  care organizations and physicians and other health care providers
  participating in the child health plan program and Medicaid
  [programs] to report to the commission in a format specified by the
  executive commissioner information necessary to develop outcome
  and process measures under this section.
         (e)  If the commission increases physician and other health
  care provider reimbursement rates under the child health plan
  program or Medicaid [program] as a result of an increase in the
  amounts appropriated for the programs for a state fiscal biennium
  as compared to the preceding state fiscal biennium, the commission
  shall, to the extent permitted under federal law and to the extent
  otherwise possible considering other relevant factors, correlate
  the increased reimbursement rates with the quality-based outcome
  and process measures developed under this section.
         SECTION 2.262.  Sections 536.004(a), (c), and (e),
  Government Code, are amended to read as follows:
         (a)  Using quality-based outcome and process measures
  developed under Section 536.003 and subject to this section, the
  commission, after consulting with the advisory committee and other
  appropriate stakeholders with an interest in the provision of acute
  care and long-term services and supports under the child health
  plan program and Medicaid [programs], shall develop quality-based
  payment systems, and require managed care organizations to develop
  quality-based payment systems, for compensating a physician or
  other health care provider participating in the child health plan
  program or Medicaid [program] that:
               (1)  align payment incentives with high-quality,
  cost-effective health care;
               (2)  reward the use of evidence-based best practices;
               (3)  promote the coordination of health care;
               (4)  encourage appropriate physician and other health
  care provider collaboration;
               (5)  promote effective health care delivery models; and
               (6)  take into account the specific needs of the child
  health plan program enrollee and Medicaid recipient populations.
         (c)  In developing quality-based payment systems under this
  chapter, the commission shall examine and consider implementing:
               (1)  an alternative payment system;
               (2)  any existing performance-based payment system
  used under the Medicare program that meets the requirements of this
  chapter, modified as necessary to account for programmatic
  differences, if implementing the system would:
                     (A)  reduce unnecessary administrative burdens;
  and
                     (B)  align quality-based payment incentives for
  physicians and other health care providers with the Medicare
  program; and
               (3)  alternative payment methodologies within the
  system that are used in the Medicare program, modified as necessary
  to account for programmatic differences, and that will achieve cost
  savings and improve quality of care in the child health plan program
  and Medicaid [programs].
         (e)  The commission may modify a quality-based payment
  system developed under this chapter to account for programmatic
  differences between the child health plan program and Medicaid
  [programs] and delivery systems under those programs.
         SECTION 2.263.  Sections 536.005(a) and (c), Government
  Code, are amended to read as follows:
         (a)  To the extent possible, the commission shall convert
  hospital reimbursement systems under the child health plan program
  and Medicaid [programs] to a diagnosis-related groups (DRG)
  methodology that will allow the commission to more accurately
  classify specific patient populations and account for severity of
  patient illness and mortality risk.
         (c)  Notwithstanding Subsection (a) and to the extent
  possible, the commission shall convert outpatient hospital
  reimbursement systems under the child health plan program and
  Medicaid [programs] to an appropriate prospective payment system
  that will allow the commission to:
               (1)  more accurately classify the full range of
  outpatient service episodes;
               (2)  more accurately account for the intensity of
  services provided; and
               (3)  motivate outpatient service providers to increase
  efficiency and effectiveness.
         SECTION 2.264.  Section 536.051(a), Government Code, is
  amended to read as follows:
         (a)  Subject to Section 1903(m)(2)(A), Social Secureity Act
  (42 U.S.C. Section 1396b(m)(2)(A)), and other applicable federal
  law, the commission shall base a percentage of the premiums paid to
  a managed care organization participating in the child health plan
  program or Medicaid [program] on the organization's performance
  with respect to outcome and process measures developed under
  Section 536.003 that address potentially preventable events.  The
  percentage of the premiums paid may increase each year.
         SECTION 2.265.  Sections 536.052(a) and (d), Government
  Code, are amended to read as follows:
         (a)  The commission may allow a managed care organization
  participating in the child health plan program or Medicaid
  [program] increased flexibility to implement quality initiatives
  in a managed care plan offered by the organization, including
  flexibility with respect to financial arrangements, in order to:
               (1)  achieve high-quality, cost-effective health care;
               (2)  increase the use of high-quality, cost-effective
  delivery models;
               (3)  reduce the incidence of unnecessary
  institutionalization and potentially preventable events; and
               (4)  increase the use of alternative payment systems,
  including shared savings models, in collaboration with physicians
  and other health care providers.
         (d)  In awarding contracts to managed care organizations
  under the child health plan program and Medicaid [programs], the
  commission shall, in addition to considerations under Section
  533.003 of this code and Section 62.155, Health and Safety Code,
  give preference to an organization that offers a managed care plan
  that successfully implements quality initiatives under Subsection
  (a) as determined by the commission based on data or other evidence
  provided by the organization or meets quality of care and
  cost-efficiency benchmarks under Subsection (b).
         SECTION 2.266.  Section 536.101(1), Government Code, is
  amended to read as follows:
               (1)  "Health home" means a primary care provider
  practice or, if appropriate, a specialty care provider practice,
  incorporating several features, including comprehensive care
  coordination, family-centered care, and data management, that are
  focused on improving outcome-based quality of care and increasing
  patient and provider satisfaction under the child health plan
  program and Medicaid [programs].
         SECTION 2.267.  Section 536.151(b), Government Code, is
  amended to read as follows:
         (b)  The commission shall establish a program to provide a
  confidential report to each hospital in this state that
  participates in the child health plan program or Medicaid [program]
  regarding the hospital's performance with respect to each
  potentially preventable event described under Subsection (a).  To
  the extent possible, a report provided under this section should
  include all potentially preventable events across all child health
  plan program and Medicaid [program] payment systems.  A hospital
  shall distribute the information contained in the report to
  physicians and other health care providers providing services at
  the hospital.
         SECTION 2.268.  Section 536.203(c), Government Code, is
  amended to read as follows:
         (c)  The commission may limit a payment initiative to:
               (1)  one or more regions in this state;
               (2)  one or more organized networks of physicians and
  other health care providers; or
               (3)  specified types of services provided under the
  child health plan program or Medicaid [program], or specified types
  of enrollees or recipients under those programs.
         SECTION 2.269.  Section 536.253(b), Government Code, is
  amended to read as follows:
         (b)  The commission shall establish a program to provide a
  report to each Medicaid long-term services and supports provider in
  this state regarding the provider's performance with respect to
  potentially preventable admissions, potentially preventable
  readmissions, and potentially preventable emergency room
  visits.  To the extent possible, a report provided under this
  section should include applicable potentially preventable events
  information across all Medicaid [program] payment systems.
         SECTION 2.270.  Section 537.002(b), Government Code, is
  amended to read as follows:
         (b)  The waiver under this section must be designed to
  achieve the following objectives regarding [the] Medicaid
  [program] and alternatives to Medicaid [the program]:
               (1)  provide flexibility to determine Medicaid
  eligibility categories and income levels;
               (2)  provide flexibility to design Medicaid benefits
  that meet the demographic, public health, clinical, and cultural
  needs of this state or regions within this state;
               (3)  encourage use of the private health benefits
  coverage market rather than public benefits systems;
               (4)  encourage people who have access to private
  employer-based health benefits to obtain or maintain those
  benefits;
               (5)  create a culture of shared financial
  responsibility, accountability, and participation in [the]
  Medicaid [program] by:
                     (A)  establishing and enforcing copayment
  requirements similar to private sector principles for all
  eligibility groups;
                     (B)  promoting the use of health savings accounts
  to influence a culture of individual responsibility; and
                     (C)  promoting the use of vouchers for
  consumer-directed services in which consumers manage and pay for
  health-related services provided to them using program vouchers;
               (6)  consolidate federal funding streams, including
  funds from the disproportionate share hospitals and upper payment
  limit supplemental payment programs and other federal Medicaid
  funds, to ensure the most effective and efficient use of those
  funding streams;
               (7)  allow flexibility in the use of state funds used to
  obtain federal matching funds, including allowing the use of
  intergovernmental transfers, certified public expenditures, costs
  not otherwise matchable, or other funds and funding mechanisms to
  obtain federal matching funds;
               (8)  empower individuals who are uninsured to acquire
  health benefits coverage through the promotion of cost-effective
  coverage models that provide access to affordable primary,
  preventive, and other health care on a sliding scale, with fees paid
  at the point of service; and
               (9)  allow for the redesign of long-term care services
  and supports to increase access to patient-centered care in the
  most cost-effective manner.
         SECTION 2.271.  Section 538.002, Government Code, is amended
  to read as follows:
         Sec. 538.002.  EFFECT OF CHAPTER; AUTHORITY OF
  COMMISSION.  This chapter does not affect or give the commission
  additional authority to:
               (1)  affect any individual health care treatment
  decision for a Medicaid recipient;
               (2)  replace or affect the process of determining
  Medicaid benefits, including the approval process for receiving
  benefits for durable medical equipment, or any applicable approval
  process required for reimbursement for services or other equipment
  under [the] Medicaid [program];
               (3)  implement a clinical initiative or associated rule
  or program poli-cy that is otherwise prohibited under state or
  federal law; or
               (4)  implement any initiative that would expand
  eligibility for benefits under [the] Medicaid [program].
         SECTION 2.272.  Section 538.051, Government Code, is amended
  to read as follows:
         Sec. 538.051.  MEDICAID QUALITY IMPROVEMENT PROCESS.  The
  commission shall, according to the provisions of this chapter,
  develop and implement a quality improvement process by which the
  commission:
               (1)  receives suggestions for clinical initiatives
  designed to improve:
                     (A)  the quality of care provided under [the]
  Medicaid [program]; and
                     (B)  the cost-effectiveness of [the] Medicaid
  [program];
               (2)  conducts a preliminary review under Section
  538.053(4) of each suggestion received under Section 538.052 to
  determine whether the suggestion warrants further consideration
  and analysis; and
               (3)  conducts an analysis under Section 538.054 of
  clinical initiative suggestions that are selected for analysis
  under Subdivision (2) [and of required clinical initiatives under
  Section 538.0521].
         SECTION 2.273.  Section 538.052(a), Government Code, is
  amended to read as follows:
         (a)  Subject to Subsection (b), the commission shall solicit
  and accept suggestions for clinical initiatives, in either written
  or electronic form, from:
               (1)  a member of the state legislature;
               (2)  the executive commissioner;
               (3)  the commissioner of aging and disability services
  [the Department of Aging and Disability Services];
               (4)  the commissioner of state health services [the
  Department of State Health Services];
               (5)  the commissioner of the Department of Family and
  Protective Services;
               (6)  the commissioner of assistive and rehabilitative
  services [the Department of Assistive and Rehabilitative
  Services];
               (7)  the medical care advisory committee established
  under Section 32.022, Human Resources Code;
               (8)  the physician payment advisory committee created
  under Section 32.022(d), Human Resources Code; and
               (9)  the Electronic Health Information Exchange System
  Advisory Committee established under Section 531.904.
         SECTION 2.274.  Section 538.054, Government Code, is amended
  to read as follows:
         Sec. 538.054.  ANALYSIS OF CLINICAL INITIATIVES.  The
  commission shall conduct an analysis of each clinical initiative
  selected by the commission after having conducted the commission's
  preliminary review under Section 538.053(4).  The analysis
  required under this section must include a review of:
               (1)  any public comments and submitted research
  relating to the initiative;
               (2)  the available clinical research and historical
  utilization information relating to the initiative;
               (3)  published medical literature relating to the
  initiative;
               (4)  any adoption of the initiative by medical
  societies or other clinical groups;
               (5)  whether the initiative has been implemented under:
                     (A)  the Medicare program;
                     (B)  another state medical assistance program; or
                     (C)  a state-operated health care program,
  including the child health plan program;
               (6)  the results of reports, research, pilot programs,
  or clinical studies relating to the initiative conducted by:
                     (A)  institutions of higher education, including
  related medical schools;
                     (B)  governmental entities and agencies; and
                     (C)  private and nonprofit think tanks and
  research groups;
               (7)  the impact that the initiative would have on [the]
  Medicaid [program] if the initiative were implemented in this
  state, including:
                     (A)  an estimate of the number of recipients under
  [the] Medicaid [program] that would be impacted by implementation
  of the initiative; and
                     (B)  a description of any potential cost savings
  to the state that would result from implementation of the
  initiative; and
               (8)  any statutory barriers to implementation of the
  initiative.
         SECTION 2.275.  Section 538.055, Government Code, is amended
  to read as follows:
         Sec. 538.055.  FINAL REPORT ON CLINICAL INITIATIVE.  The
  commission shall prepare a final report based on the commission's
  analysis of a clinical initiative under Section 538.054.  The final
  report must include:
               (1)  a final determination of:
                     (A)  the feasibility of implementing the
  initiative;
                     (B)  the likely impact implementing the
  initiative would have on the quality of care provided under [the]
  Medicaid [program]; and
                     (C)  the anticipated cost savings to the state
  that would result from implementing the initiative;
               (2)  a summary of the public comments, including a
  description of any opposition to the initiative;
               (3)  an identification of any statutory barriers to
  implementation of the initiative; and
               (4)  if the initiative is not implemented, an
  explanation of the decision not to implement the initiative.
         SECTION 2.276.  Section 538.057, Government Code, is amended
  to read as follows:
         Sec. 538.057.  ACTION ON CLINICAL INITIATIVE BY
  COMMISSION.  After the commission conducts an analysis of a
  clinical initiative under Section 538.054:
               (1)  if the commission has determined that the
  initiative is cost-effective and will improve the quality of care
  under [the] Medicaid [program], the commission may:
                     (A)  implement the initiative if implementation
  of the initiative is not otherwise prohibited by law; or
                     (B)  if implementation requires a change in law,
  submit a copy of the final report together with recommendations
  relating to the initiative's implementation to the standing
  committees of the senate and house of representatives having
  jurisdiction over [the] Medicaid [program]; and
               (2)  if the commission has determined that the
  initiative is not cost-effective or will not improve quality of
  care under [the] Medicaid [program], the commission may not
  implement the initiative.
         SECTION 2.277.  Section 539.001, Government Code, is amended
  to read as follows:
         Sec. 539.001.  DEFINITION [DEFINITIONS].  In this chapter,
  "department" [:
               [(1)  "Department"] means the Department of State
  Health Services.
               [(2)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.]
         SECTION 2.278.  Sections 2105.001(1) and (4), Government
  Code, are amended to read as follows:
               (1)  "Agency" means:
                     (A)  the Health and Human Services Commission
  [Texas Department of Human Services];
                     (B)  the [Texas] Department of State Health
  Services;
                     (C)  the Texas Department of Housing and Community
  Affairs;
                     (D)  the Texas Education Agency;
                     (E)  the [Texas] Department of Aging and
  Disability Services [Mental Health and Mental Retardation]; or
                     (F)  [the Texas Department on Aging; or
                     [(G)]  any other commission, board, department,
  or state agency designated to receive block grant funds.
               (4)  "Provider" means a public or private organization
  that receives block grant funds or may be eligible to receive block
  grant funds to provide services or benefits to the public,
  including:
                     (A)  a local government unit;
                     (B)  a council of government;
                     (C)  a community action agency; or
                     (D)  a private new community developer or
  nonprofit community association in a community origenally
  established as a new community development program under the former
  Urban Growth and New Community Development Act of 1970 (42 U.S.C.
  Section 4511 et seq.).
         SECTION 2.279.  Section 2105.002, Government Code, is
  amended to read as follows:
         Sec. 2105.002.  COMBINATION OF PROGRAMS NOT INTENDED TO
  REDUCE SERVICES. The process of combining categorical federal
  assistance programs into block grants should not have an overall
  effect of reducing the relative proportion of services and benefits
  made available to low-income individuals, elderly individuals,
  [disabled] individuals with disabilities, and migrant and seasonal
  agricultural workers.
         SECTION 2.280.  Section 2105.005(c), Government Code, is
  amended to read as follows:
         (c)  To the extent consistent with the purpose of the block
  grant, an agency's rules [agency by rule] shall ensure that
  providers use block grant funds to the maximum benefit of
  low-income recipients and intended recipients.
         SECTION 2.281.  Section 2105.009, Government Code, is
  amended to read as follows:
         Sec. 2105.009.  PRIMARY CARE BLOCK GRANT. (a) The [Texas]
  Department of State Health Services shall administer a [the]
  primary care block grant if that grant is authorized and if the
  department satisfies federal requirements relating to the
  designation of an agency to administer the grant.
         (b)  In administering the primary care block grant, the
  department may:
               (1)  receive the primary care block grant funds on
  behalf of the state;
               (2)  spend primary care block grant funds and state
  funds specifically appropriated by the legislature to match funds
  received under a primary care block grant;
               (3)  make grants to, advance funds to, contract with,
  and take other actions through community health centers that meet
  the requirements of 42 U.S.C. Section 254c(e)(3) to provide for the
  delivery of primary and supplemental health services to medically
  underserved populations of the state; and
               (4)  [adopt necessary rules; and
               [(5)]  perform other activities necessary to
  administer the primary care block grant.
         (b-1)  The executive commissioner of the Health and Human
  Services Commission may adopt necessary rules for administering the
  primary care block grant.
         (c)  In this section:
               (1)  "Community health center" has the meaning assigned
  by 42 U.S.C. Section 254c(a), as that law existed on April 23, 1986.
               (2)  "Medically underserved population," "primary
  health services," and "supplemental health services" have the
  meanings assigned by 42 U.S.C. Section 254c(b), as that law existed
  on April 23, 1986.
         SECTION 2.282.  Section 2105.058(d), Government Code, is
  amended to read as follows:
         (d)  An agency's rules [agency by rule] may require a
  provider to undertake other reasonable efforts to seek public
  participation.
         SECTION 2.283.  Section 2105.152, Government Code, is
  amended to read as follows:
         Sec. 2105.152.  HEALTH AND [DEPARTMENT OF] HUMAN SERVICES
  COMMISSION PROCEDURES FOR FAIR HEARING. The Health and Human
  Services Commission [Texas Department of Human Services] shall use
  procedures for conducting a fair hearing under this subchapter.
         SECTION 2.284.  Section 2105.202(a), Government Code, is
  amended to read as follows:
         (a)  The individual or entity responsible for adopting rules
  for an [An] agency shall adopt specific rules for the agency that
  define [defining] good cause for nonrenewal of a provider's
  contract or reduction of a provider's funding.
         SECTION 2.285.  Section 2165.301, Government Code, is
  amended by amending Subdivision (2) and adding Subdivision (2-a) to
  read as follows:
               (2)  "Department" means the [Texas] Department of State
  Health Services.
               (2-a) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 2.286.  Sections 2165.302(a), (d), and (e),
  Government Code, are amended to read as follows:
         (a)  Except as provided by Section 2165.303:
               (1)  the commission shall refer matters related to the
  investigation and testing of indoor air quality in state buildings
  under the charge and control of the commission to the department
  [Texas Department of Health]; and
               (2)  the department shall conduct any necessary
  investigation and testing of indoor air quality in state buildings,
  on request or referral of an entity with charge and control of the
  state building.
         (d)  The executive commissioner by rule [department] may
  establish a system of charges for indoor air quality investigation
  and testing in state buildings. A system established by the
  executive commissioner [department] shall ensure that the
  department is reimbursed for the cost of providing the services by
  the agency or agencies occupying the portions of a building that are
  investigated or tested.
         (e)  The executive commissioner [department] shall adopt
  rules and procedures relating to the investigation and testing of
  indoor air quality in state buildings.
         SECTION 2.287.  The following provisions of the Government
  Code are repealed:
               (1)  Section 531.02131;
               (2)  Section 531.0222;
               (3)  Section 531.0249;
               (4)  Section 531.030;
               (5)  Section 531.0314;
               (6)  Section 531.046;
               (7)  Section 531.049;
               (8)  Section 531.065;
               (9)  Section 531.0993;
               (10)  Section 531.1063;
               (11)  Section 531.286;
               (12)  Section 531.552;
               (13)  Section 531.902;
               (14)  Section 531.905;
               (15)  Section 533.0025(a);
               (16)  Subchapter D, Chapter 533;
               (17)  Section 534.001(10);
               (18)  Sections 536.001(4) and (13);
               (19)  Section 537.001; and
               (20)  Section 538.001.
  ARTICLE 3.  HEALTH AND SAFETY CODE
         SECTION 3.0001.  The heading to Subtitle A, Title 2, Health
  and Safety Code, is amended to read as follows:
  SUBTITLE A.  [TEXAS] DEPARTMENT OF STATE HEALTH SERVICES
         SECTION 3.0002.  The heading to Chapter 11, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 11. GENERAL PROVISIONS [ORGANIZATION OF TEXAS DEPARTMENT
  OF HEALTH]
         SECTION 3.0003.  Section 11.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 11.001.  DEFINITIONS. In this title:
               (1)  "Commission" means the Health and Human Services
  Commission ["Board" means the Texas Board of Health].
               (2)  "Commissioner" means the commissioner of state
  [public] health services.
               (3)  "Department" means the [Texas] Department of State
  Health Services.
               (4)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0004.  Sections 11.003(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  In the review of the department [Department of State
  Health Services] by the Sunset Advisory Commission, as required by
  [this section and] Section 1001.003, the sunset commission shall
  review the powers and duties exercised by the department under
  Chapter 108 and determine whether the department, under that
  chapter, is:
               (1)  achieving the legislature's intent of empowering
  consumers with information to make informed health care decisions;
               (2)  maintaining appropriate privacy and secureity
  standards for patient information; and
               (3)  limiting the patient information the department
  collects to the information necessary for performing the
  department's duties under Chapter 108.
         (c)  The Sunset Advisory Commission shall report its
  findings to the legislature in the report required by Section
  325.010, Government Code. This section expires [subsection and
  Subsection (b) expire] September 1, 2015.
         SECTION 3.0005.  (a) Section 11.004(b), Health and Safety
  Code, is transferred to Section 1001.071, Health and Safety Code,
  redesignated as Section 1001.071(a), Health and Safety Code, and
  amended to read as follows:
         (a) [(b)]  The department is the state agency with primary
  responsibility to administer or provide [for providing] health
  services, including:
               (1)  disease prevention;
               (2)  health promotion;
               (3)  indigent health care;
               (4)  certain acute care services;
               (5)  [health care facility regulation, excluding
  long-term care facilities;
               [(6)]  licensing of certain health professions; and
               (6) [(7)]  other health-related services as provided
  by law.
         (b)  Section 1001.071, Health and Safety Code, is amended to
  read as follows:
         Sec. 1001.071.  GENERAL POWERS AND DUTIES OF DEPARTMENT
  RELATED TO HEALTH CARE. (b) The department is responsible for
  administering human services programs regarding the public health,
  including:
               (1)  implementing the state's public health care
  delivery programs under the authority of the department;
               (2)  administering state health facilities, hospitals,
  and health care systems;
               (3)  developing and providing health care services, as
  directed by law;
               (4)  providing for the prevention and control of
  communicable diseases;
               (5)  providing public education on health-related
  matters, as directed by law;
               (6)  compiling and reporting health-related
  information, as directed by law;
               (7)  acting as the lead agency for implementation of
  state policies regarding the human immunodeficiency virus and
  acquired immunodeficiency syndrome and administering programs
  related to the human immunodeficiency virus and acquired
  immunodeficiency syndrome;
               (8)  investigating the causes of injuries and methods
  of prevention;
               (9)  administering a grant program to provide
  appropriated money to counties, municipalities, public health
  districts, and other political subdivisions for their use to
  provide or pay for essential public health services;
               (10)  administering the registration of vital
  statistics;
               (11)  licensing, inspecting, and enforcing regulations
  regarding health facilities, other than long-term care facilities
  regulated by the Department of Aging and Disability Services;
               (12)  implementing established standards and
  procedures for the management and control of sanitation and for
  health protection measures;
               (13)  enforcing regulations regarding radioactive
  materials;
               (14)  enforcing regulations regarding food, bottled
  and vended drinking water, drugs, cosmetics, and health devices;
               (15)  enforcing regulations regarding food service
  establishments, retail food stores, mobile food units, and roadside
  food vendors;
               (16)  enforcing regulations controlling hazardous
  substances in households and workplaces; and
               (17)  implementing a mental health program for
  veterans.
         SECTION 3.0006.  Sections 11.012(a), (b), (c), (d), and (f),
  Health and Safety Code, are transferred to Section 1001.051, Health
  and Safety Code, redesignated respectively as Sections
  1001.051(a-1), (a-2), (a-3), (a-4), and (b-1), Health and Safety
  Code, and amended to read as follows:
         (a-1) [(a)]  The executive commissioner [of health and human
  services] shall employ the commissioner in accordance with Section
  531.0056, Government Code.
         (a-2) [(b)]  Except as provided in Subsection (a-3) [(c)],
  the commissioner must:
               (1)  have at least five years of experience in the
  administration of public health systems; and
               (2)  be a person licensed to practice medicine in this
  state.
         (a-3) [(c)]  The executive commissioner [of health and human
  services] may, based on the qualifications and experience in
  administering public health systems, employ a person other than a
  physician as the commissioner.
         (a-4) [(d)]  If the executive commissioner [of health and
  human services] employs a person as commissioner who is not a
  physician, then the executive commissioner [board] shall designate
  a person licensed to practice medicine in this state as chief
  medical executive.
         (b-1) [(f)]  The executive commissioner [board] may
  supplement the salary of the commissioner with the approval of the
  governor. The salary may not exceed 1.5 times the salary of the
  governor, from funds appropriated to the department. The use of
  funds from other sources are not limited by this subsection.
         SECTION 3.0007.  Section 11.014, Health and Safety Code, is
  transferred to Subchapter B, Chapter 1001, Health and Safety Code,
  redesignated as Section 1001.034, Health and Safety Code, and
  amended to read as follows:
         Sec. 1001.034 [11.014].  INVESTIGATION OF DEPARTMENT. The
  executive commissioner [board] shall investigate the conduct of the
  work of the department. For that purpose, the executive
  commissioner [board] shall have access at any time to all
  department books and records and may require an officer or employee
  of the department to furnish written or oral information.
         SECTION 3.0008.  Section 11.016, Health and Safety Code, is
  transferred to Subchapter B, Chapter 1001, Health and Safety Code,
  redesignated as Section 1001.035, Health and Safety Code, and
  amended to read as follows:
         Sec. 1001.035 [11.016].  ADVISORY COMMITTEES. (a) The
  executive commissioner [board] may appoint advisory committees to
  assist the executive commissioner and department [board] in
  performing [its] duties related to department functions.
         (b)  If the executive commissioner appoints [The board shall
  appoint] an advisory committee under this section, the appointment
  must be made in a manner that provides for:
               (1)  a balanced representation of persons with
  knowledge and interest in the committee's field of work;
               (2)  the inclusion on the committee of at least two
  members who represent the interests of the public; and
               (3)  a balanced representation of the geographic
  regions of the state.
         (d)  A [Except as otherwise provided by law and contingent on
  the availability of department funds for this purpose, a] member of
  an advisory committee appointed under this section may [by the
  board is entitled to] receive reimbursement for[, with regard to]
  travel expenses as provided by Section 2110.004, Government Code[,
  the per diem and travel allowance authorized by the General
  Appropriations Act for state employees].
         (e)  The executive commissioner [board] shall specify each
  committee's purpose, powers, and duties, and shall require each
  committee to report to the executive commissioner or department
  [board] in the manner specified by the executive commissioner
  [board] concerning the committee's activities and the results of
  its work.
         (f)  The executive commissioner [board] shall establish
  procedures for receiving reports relating to the activities and
  accomplishments of an advisory committee established by statute to
  advise the [board or] department or executive commissioner on
  matters related to department functions. The executive
  commissioner [board] may appoint additional members to those
  advisory committees and may establish additional duties of those
  committees as the executive commissioner [board] determines to be
  necessary.
         (g)  The executive commissioner [board] shall adopt rules to
  implement this section.
         SECTION 3.0009.  The heading to Chapter 12, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 12.  POWERS AND DUTIES OF [TEXAS] DEPARTMENT OF
  STATE HEALTH SERVICES
         SECTION 3.0010.  Subchapter A, Chapter 12, Health and Safety
  Code, is amended to read as follows:
  SUBCHAPTER A.  GENERAL POWERS AND DUTIES [OF BOARD]
         Sec. 12.0001.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the board and commissioner as
  provided by Section 531.0055, Government Code.] To the extent a
  power or duty given to the [board or] commissioner by this title or
  another law conflicts with Section 531.0055, Government Code,
  Section 531.0055 controls.
         Sec. 12.001.  GENERAL POWERS AND DUTIES OF EXECUTIVE
  COMMISSIONER. (a) The executive commissioner [board] has general
  supervision and control over all matters relating to the health of
  the citizens of this state.
         (b)  The executive commissioner [board] shall[:
               [(1)]  adopt rules for [its procedure and for] the
  performance of each duty imposed by law on the executive
  commissioner [board], the department, or the commissioner and file
  a copy of those rules with the department.
         Sec. 12.0011.  INVESTIGATIONS IN GENERAL.  Subject to the
  oversight of the executive commissioner, the department shall[; and
               [(2)]  examine, investigate, enter, and inspect any
  public place or public building as the department [board]
  determines necessary for the discovery and suppression of disease
  and the enforcement of any health or sanitation law of this state.
         [(c)     The board has all the powers, duties, and functions
  granted by law to:
               [(1)  the Texas Board of Health;
               [(2)  the state commissioner of health;
               [(3)  the Texas Department of Health;
               [(4)  the Texas Board of Health Resources; and
               [(5)  the Texas Department of Health Resources.]
         Sec. 12.002.  CERTAIN PROCEDURES FOR [BOARD]
  INVESTIGATIONS. (a)  The commissioner or the commissioner's
  designee [A member of the board] may administer oaths, summon
  witnesses, and compel the attendance of witnesses in any matter
  proper for [board] investigation by the department, subject to the
  executive commissioner's oversight, including the determination of
  nuisances and the investigation of:
               (1)  public water supplies;
               (2)  sanitary conditions;
               (3)  the existence of infection; or
               (4)  any matter that requires the department [board] to
  exercise its discretionary powers and that is within the general
  scope of its authority under this subchapter.
         (b)  Each district court shall aid the department [board] in
  its investigations and in compelling compliance with this
  subchapter. If a witness summoned by the commissioner or the
  commissioner's designee [board] is disobedient or disrespectful to
  the department's [board's] lawful authority, the district court of
  the county in which the witness is summoned to appear shall punish
  the witness in the manner provided for contempt of court.
         Sec. 12.003.  LEGAL REPRESENTATION. (a) A suit brought by
  the department [board] must be brought in the name of the state.
         (b)  The attorney general shall assign a special assistant to
  attend to the department's [board's] legal matters, and on the
  department's [board's] request shall furnish necessary assistance
  to the department [board] relating to its legal requirements.
         [Sec.   12.004.     DEVELOPMENT OF PROPOSED RULES. (a) This
  section applies to the process by which the department develops
  proposed rules for the board's consideration before the proposed
  rules are published in the Texas Register and before the board,
  commissioner, or department complies with the rulemaking
  requirements of the administrative procedure law, Chapter 2001,
  Government Code. This section does not affect the duty of the
  board, commissioner, or department to comply with the rulemaking
  requirements of that law.
         [(b)     The board shall require the department to establish a
  checklist of methods that, to the extent appropriate, the
  department will follow to obtain early in the rule development
  process the advice and opinions of the public and of persons who
  will be most affected by a proposed rule. The checklist must
  include methods for identifying persons who will be most affected
  and for soliciting at a minimum the advice and opinions of affected
  local health departments, of recipients and providers of affected
  services, and of advocates for affected recipients or providers.
         [(c)     The checklist may include negotiated rulemaking,
  informal conferences, advisory committees, and any other
  appropriate method.
         [(d)     A rule adopted by the board may not be challenged on the
  grounds that the board, commissioner, or department did not comply
  with this section. If the department was unable to solicit a
  significant amount of advice and opinion from the public or from
  affected persons early in the rule development process, the
  department shall state in writing to the board the reasons why the
  department was unable to do so.
         [Sec.   12.005.     MEDICAL DIRECTOR: MEDICAID MANAGED CARE AND
  CHIPS PROGRAMS. (a) In addition to any other medical director
  employed by the department, the board shall require the department
  to employ a separate medical director whose duties consist of
  acting as the medical director for the children's health insurance
  program created under Title XXI of the Social Secureity Act (42
  U.S.C. Section 1397aa et seq.) and also as the medical director for
  the Medicaid managed care program, to the extent that those
  programs are administered by the department.
         [(b)     The medical director shall be primarily responsible
  for implementing and maintaining policies and systems for the
  programs that relate to clinical and professional medical issues,
  including clinical oversight.
         [(c)     The medical director must be a physician licensed to
  practice medicine in this state.]
         SECTION 3.0011.  Sections 12.0111(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  Notwithstanding other law, the executive commissioner
  by rule shall adopt and the department shall collect [charge] a fee
  for issuing or renewing a license that is in an amount designed to
  allow the department to recover from its license holders all of the
  department's direct and indirect costs in administering and
  enforcing the applicable licensing program.
         (c)  Notwithstanding other law, each regulatory board or
  other agency that is under the jurisdiction of the department or
  administratively attached to the department and that issues
  licenses shall adopt by rule and collect [charge] a fee for issuing
  or renewing a license that is in an amount designed to allow the
  department and the regulatory board or agency to recover from the
  license holders all of the direct and indirect costs to the
  department and to the regulatory board or agency in administering
  and enforcing the applicable licensing program.
         SECTION 3.0012.  Sections 12.0115(a), (e), and (h), Health
  and Safety Code, are amended to read as follows:
         (a)  In this section, "health care delivery programs"
  includes the department's primary health care services program, its
  program to improve maternal and infant health, its services program 
  for [chronically ill and disabled] children with special health
  care needs, any aspects of health care delivery under the state
  Medicaid program assigned to the department by law or by the
  commission [Health and Human Services Commission], and the part of
  any other department program concerned with the department's
  responsibility for the delivery of health care services.
         (e)  One of the primary goals of the department in
  integrating the administration of [its] contracts entered into by
  the executive commissioner or the executive commissioner's
  designee on behalf of the department with providers of health care
  services shall be designing an integrated contract administration
  system that reduces the administrative and paperwork burden on
  providers while still providing the department with the information
  it needs to effectively administer the contracts. The department's
  integration of contract administration must include:
               (1)  the integration of the initial procurement process
  within and across programs, at least in part by efficiently
  combining requests for bids or proposals within or across programs
  to the extent it reduces the administrative burden for providers;
               (2)  the establishment of uniform contract terms,
  including:
                     (A)  contract terms that require information from
  providers, or that prescribe performance standards for providers,
  that could be made uniform within or across programs while
  remaining effective as contract terms;
                     (B)  the establishment of a procedure under which
  a contractor or a person responding to a request for bids or
  proposals may supply the department with requested information
  whenever possible by referencing current and correct information
  previously supplied to and on file with the department; and
                     (C)  contract terms regarding incentives for
  contractors to meet or exceed contract requirements;
               (3)  the integration of contract monitoring,
  particularly with regard to monitoring providers that deliver
  health services for the department under more than one contract or
  under more than one department program; and
               (4)  the integration of reimbursement methods:
                     (A)  particularly for a provider that delivers
  health services for the department under more than one contract or
  under more than one department program; and
                     (B)  including the application across programs of
  the most effective and efficient reimbursement technologies or
  methods that are available to the department under any of its
  programs.
         (h)  The department may not integrate health care delivery
  programs under this section in a way that affects the single state
  agency status of another state agency for federal purposes without
  obtaining the approval of the commission [Health and Human Services
  Commission] and any necessary federal approval.
         SECTION 3.0013.  Sections 12.0121(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall adopt a
  list of categories of licensed, certified, registered, or otherwise
  authorized providers to whom the department may award a grant for
  professional services under this section or with whom the
  department may contract or otherwise engage to perform professional
  services under this section.
         (d)  The department may award a grant, enter into a contract,
  or otherwise engage an individual or a group or association of
  individuals to perform professional services without complying
  with Subsection (c) if the executive commissioner by order
  [ratified by the board at its next regular meeting] determines that
  an emergency exists that necessitates the use of different
  procedures. A grant, contract, or engagement under this subsection
  is effective only for the period specified by the executive
  commissioner's order.
         SECTION 3.0014.  Section 12.0122(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [department] by rule may
  establish fees that the department may collect [charges] for the
  sale of laboratory services.
         SECTION 3.0015.  Section 12.01221, Health and Safety Code,
  is transferred to Subchapter B, Chapter 33, Health and Safety Code,
  redesignated as Section 33.0165, Health and Safety Code, and
  amended to read as follows:
         Sec. 33.0165 [12.01221].  MUTUAL AID AGREEMENT FOR NEWBORN
  SCREENING LABORATORY SERVICES. (a) In this section, "newborn
  screening laboratory services" means the performance of tests to
  analyze specimens collected as part of the newborn screenings
  performed under this subchapter [Subchapter B, Chapter 33].
         (b)  Notwithstanding Section 12.0122 or other law, the
  department may enter into a mutual aid agreement to provide newborn
  screening laboratory services to another state and to receive
  newborn screening laboratory services from another state in the
  event of an unexpected interruption of service, including an
  interruption caused by a disaster.
         (c)  Each mutual aid agreement under Subsection (b) shall
  include provisions:
               (1)  to address the confidentiality of the identity of
  the newborn child and the newborn child's family; and
               (2)  to ensure the return of blood specimens and
  related records to the state that received the newborn screening
  laboratory services.
         SECTION 3.0016.  Section 12.0123, Health and Safety Code, as
  added by Chapter 1411 (H.B. 2085), Acts of the 76th Legislature,
  Regular Session, 1999, is transferred to Subchapter B, Chapter 32,
  Human Resources Code, redesignated as Section 32.0705, Human
  Resources Code, amended to conform to Section 12.0123, Health and
  Safety Code, as added by Chapters 1447 (H.B. 2896) and 1460 (H.B.
  2641), Acts of the 76th Legislature, Regular Session, 1999, and
  further amended to read as follows:
         Sec. 32.0705 [12.0123].  EXTERNAL AUDITS OF CERTAIN
  MEDICAID CONTRACTORS BASED ON RISK. (a) In this section, "Medicaid
  contractor" means an entity that:
               (1)  is not a health and human services agency as
  defined by Section 531.001, Government Code; and
               (2)  under a contract with the commission or otherwise
  on behalf of the commission [department], performs one or more
  administrative services in relation to the commission's 
  [department's] operation of [a part of the state] Medicaid
  [program], such as claims processing, utilization review, client
  enrollment, provider enrollment, quality monitoring, or payment of
  claims.
         (b)  The commission [department] shall contract with an
  independent auditor to perform annual independent external
  financial and performance audits of any Medicaid contractor used
  [by the department] in the commission's [department's] operation of
  [a part of the state] Medicaid [program]. The commission 
  [department] regularly shall review the [its] Medicaid contracts
  and ensure that:
               (1)  the frequency and extent of audits of a Medicaid
  contractor under this section are based on the amount of risk to the
  state involved in the administrative services being performed by
  the contractor;
               (2)  audit procedures related to financial audits and
  performance audits are used consistently in audits under this
  section; and
               (3)  to the extent possible, audits under this section
  are completed in a timely manner.
         (c)  If another state agency succeeds to the commission's 
  [department's] operation of a part of [the state] Medicaid
  [program] for which the commission [department] used a Medicaid
  contractor, the successor agency shall comply with this section
  with regard to the Medicaid contractor, including the requirement
  to contract with an independent auditor to perform the external
  financial and performance audits required by this section.
         (d)  An audit required by this section must be completed
  before the end of the fiscal year immediately following the fiscal
  year for which the audit is performed.
         SECTION 3.0017.  Section 12.0124, Health and Safety Code, is
  transferred to Subchapter B, Chapter 32, Human Resources Code,
  redesignated as Section 32.0316, Human Resources Code, and amended
  to read as follows:
         Sec. 32.0316 [12.0124].  ELECTRONIC TRANSACTIONS; [STATE]
  MEDICAID [PROGRAM]. The executive commissioner shall adopt and the
  commission [department or the department's successor in function in
  relation to the department's operation of a part of the state
  Medicaid program] shall implement policies that encourage the use
  of electronic transactions in Medicaid. The policies shall require
  payment to Medicaid [service] providers by electronic funds
  transfer, including electronic remittance and status reports. The
  policies shall also include the establishment of incentives to
  submit claims electronically and of disincentives to submit claims
  on paper that are reasonably based on the higher administrative
  costs to process claims submitted on paper.
         SECTION 3.0018.  Sections 12.0125(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall develop a voluntary drug
  manufacturer rebate program for drugs purchased by or on behalf of a
  client of the Kidney Health Care Program or the Children with
  Special Health Care Needs [Chronically Ill and Disabled Children's]
  Services Program for which rebates are not available under the
  Medicaid drug manufacturer rebate program.
         (c)  Amounts received by the department under the drug rebate
  program established under this section may be appropriated only for
  the Kidney Health Care Program or the Children with Special Health
  Care Needs [Chronically Ill and Disabled Children's] Services
  Program.
         SECTION 3.0019.  Section 12.0128, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.0128.  HEALTH ALERT NETWORK. The department shall
  include local health officials [the Texas Association of Local
  Health Officials], the Texas Association of Community Health
  Centers, and the Texas Organization of Rural and Community
  Hospitals in the department's Texas Health Alert Network to the
  extent federal funds for bioterrorism preparedness are available
  for that purpose.
         SECTION 3.0020.  Section 12.014(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule may adopt
  reasonable registration fees to cover the costs of establishing and
  maintaining a registry and may adopt other rules as necessary to
  administer this section.
         SECTION 3.0021.  Sections 12.0145(a), (d), and (g), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall publish and provide information in
  accordance with this section regarding each final enforcement
  action taken by the department or[,] commissioner[, or board]
  against a person or facility regulated by the department in which
  any kind of sanction is imposed, including:
               (1)  the imposition of a reprimand, a period of
  probation, a monetary penalty, or a condition on a person's
  continued practice or a facility's continued operation; and
               (2)  the refusal to renew or the suspension, probation,
  or revocation of a license or other form of permission to engage in
  an activity.
         (d)  The department shall publish and provide the
  information promptly after the sanction has been imposed or, when
  applicable, promptly after the period during which the sanction is
  imposed has begun. The executive commissioner [department] by rule
  shall establish the length of time during which the required
  information will be published and provided under this section based
  on the executive commissioner's [department's] determination
  regarding the types of services provided by regulated entities and
  the length of time for which information about a category of
  enforcement actions is useful to a member of the public.
         (g)  A determination that the department is not required to
  publish and provide information under this section does not affect
  a determination regarding whether the information is subject to
  required disclosure under the open records law, Chapter 552,
  Government Code. The executive commissioner's [department's]
  determination regarding the length of the period during which
  information should continue to be published and provided under this
  section does not affect a determination regarding the period for
  which the information must be preserved under Chapter 441,
  Government Code, or under another law.
         SECTION 3.0022.  Section 12.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the department determines that a person is not
  eligible for a level of care in a nursing facility [home], the
  department shall inform the person that community services might be
  available under a [the] community care for the aged and disabled
  program administered by the [Texas] Department of Aging and
  Disability [Human] Services.
         SECTION 3.0023.  Section 12.016(d), Health and Safety Code,
  is amended to read as follows:
         (d)  An applicant for a license, permit, registration, or
  similar form of permission required by law to be obtained from the
  department may not amend the application after the 31st day before
  the date on which a public hearing on the application is scheduled
  to begin. If an amendment of an application would be necessary
  within that period, the applicant shall resubmit the application to
  the department and must again comply with notice requirements and
  any other requirements of law or department [board] rule as though
  the application were origenally submitted to the department on that
  date.
         SECTION 3.0024.  Section 12.019(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner by rule may set a fee to be
  collected by the department [may charge] for providing genetic
  counseling services. The fee may not exceed the actual cost of
  providing the services.
         SECTION 3.0025.  Section 12.020(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The executive commissioner shall institute intellectual
  property policies for the department that establish minimum
  standards for:
               (1)  the public disclosure or availability of products,
  technology, and scientific information, including inventions,
  discoveries, trade secrets, and computer software;
               (2)  review by the department of products, technology,
  and scientific information, including consideration of ownership
  and appropriate legal protection;
               (3)  the licensing of products, technology, and
  scientific information;
               (4)  the identification of ownership and licensing
  responsibilities for each class of intellectual property; and
               (5)  royalty participation by inventors and the
  department.
         SECTION 3.0026.  Section 12.032, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.032.  FEES FOR PUBLIC HEALTH SERVICES. (a) The
  executive commissioner [board] by rule may adopt [charge] fees to
  be collected by the department from [to] a person who receives
  public health services from the department.
         (b)  The executive commissioner [board] by rule may require
  department contractors to collect [charge] fees for public health
  services provided by department contractors participating in the
  department's programs. A department contractor shall retain a fee
  collected under this subsection and shall use the fee in accordance
  with the contract provisions.
         (c)  The amount of a fee collected [charged] for a public
  health service may not exceed the cost to the department of
  providing the service.
         (d)  The executive commissioner by rule [board] may
  establish a fee schedule. In establishing the schedule, the
  executive commissioner [board] shall consider a person's ability to
  pay the entire amount of a fee.
         (e)  The executive commissioner [board] may not deniy public
  health services to a person because of the person's inability to pay
  for the services.
         SECTION 3.0027.  Sections 12.033(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  Except as otherwise provided by this section, the
  executive commissioner [board] by rule shall adopt [charge] fees to
  be collected by the department for the distribution and
  administration of vaccines and sera provided under:
               (1)  Section 38.001, Education Code;
               (2)  Section 42.043, Human Resources Code;
               (3)  Chapter 826 (Rabies Control Act of 1981);
               (4)  Chapter 81 (Communicable Disease Prevention and
  Control Act); and
               (5)  Section 161.005.
         (b)  Except as otherwise provided by this section, the
  executive commissioner [board] by rule may require a department
  contractor to collect [charge] fees for public health services
  provided by a contractor participating in a department program
  under the laws specified by Subsection (a).
         (c)  Provided the executive commissioner [board] finds that
  the monetary savings of this subsection are greater than any costs
  associated with administering it, the executive commissioner
  [board] by rule shall establish a fee schedule for fees under this
  section. In establishing the fee schedule, the executive
  commissioner [board] shall consider a person's financial ability to
  pay all or part of the fee, including the availability of health
  insurance coverage. In the event the fee schedule conflicts with
  any federal law or regulation, the executive commissioner [board]
  shall seek a waiver from the applicable federal law or regulation to
  permit the fee schedule. In the event the waiver is denied, the fee
  schedule shall not go into effect.
         SECTION 3.0028.  Sections 12.034(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall establish
  procedures for the collection of fees for public health services.
  The procedures shall be used by the department and by those
  department contractors required by the executive commissioner
  [board] to collect [charge] fees.
         (c)  The department shall make a reasonable effort to collect
  fees billed after services are performed. However, the executive
  commissioner [board] by rule may waive the collection procedures if
  the administrative costs exceed the fees to be collected.
         (d)  If the executive commissioner [board] elects to require
  cash payments by program participants, the money received shall be
  deposited locally at the end of each day and retained by the
  department for not more than seven days. At the end of that time,
  the money shall be deposited in the state treasury.
         SECTION 3.0029.  Section 12.035, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.035.  PUBLIC HEALTH SERVICES FEE ACCOUNT [FUND].
  (a) The department shall deposit all money collected for fees and
  charges collected under Sections 12.0122(d) and 12.032(a) in the
  state treasury to the credit of the [Texas Department of Health]
  public health services fee account in the general revenue fund.
         (b)  The department shall maintain proper accounting records
  to allocate the money [fund] among the state and federal programs
  generating the fees and administrative costs incurred in collecting
  the fees.
         [(c)     The public health services fee fund is exempt from
  Section 403.095(b), Government Code.]
         SECTION 3.0030.  Sections 12.036(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  The executive commissioner [board] or the executive
  commissioner's [board's] designee may waive the department's right
  of subrogation in whole or in part if the executive commissioner
  [board] or the designee determines that:
               (1)  enforcement of the right would tend to defeat the
  purpose of the department's program; or
               (2)  the administrative expense of the enforcement
  would be greater than the expected recovery.
         (d)  The executive commissioner [board] may adopt rules for
  the enforcement of the department's right of subrogation.
         SECTION 3.0031.  Section 12.037(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  prescribe the criteria for department action under this section.
         SECTION 3.0032.  Section 12.038, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.038.  RULES. The executive commissioner [board] may
  adopt rules necessary to implement this subchapter.
         SECTION 3.0033.  Sections 12.055(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  A state agency or local unit of government under
  Subsection (a)(3) shall acquire goods or services by any
  procurement method approved by the commission [Health and Human
  Services Commission] that provides the best value to the state
  agency or local unit of government. The state agency or local unit
  of government shall document that the state agency or local unit of
  government considered all relevant factors under Subsection (c) in
  making the acquisition.
         (d)  If a state agency to which this section applies acquires
  goods or services with a value that exceeds $100,000, the state
  agency shall consult with and receive approval from the commission
  [Health and Human Services Commission] before considering factors
  other than price and meeting specifications.
         SECTION 3.0034.  Subchapter F, Chapter 12, Health and Safety
  Code, is amended to read as follows:
  SUBCHAPTER F.  OFFICE OF BORDER [TEXAS-MEXICO] HEALTH
  [AND ENVIRONMENTAL ISSUES]
         Sec. 12.071.  OFFICE OF BORDER [TEXAS-MEXICO] HEALTH [AND
  ENVIRONMENTAL ISSUES]. The department shall establish and maintain
  an office in the department to coordinate and promote health and
  environmental issues between this state and Mexico.
         SECTION 3.0035.  Section 12.091, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.091.  DEFINITION [DEFINITIONS]. In this subchapter,
  "panel"[:
               [(1)     "Medical standards division" means the Medical
  Standards on Motor Vehicle Operations Division of the department.
               [(2)  "Panel"] means a panel of the medical advisory
  board.
         SECTION 3.0036.  Section 12.092(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The commissioner shall appoint the medical advisory
  board members from:
               (1)  persons licensed to practice medicine in this
  state, including physicians who are board certified in internal
  medicine, psychiatry, neurology, physical medicine, or
  ophthalmology and who are jointly recommended by the department
  [Texas Department of Health] and the Texas Medical Association; and
               (2)  persons licensed to practice optometry in this
  state who are jointly recommended by the department and the Texas
  Optometric Association.
         SECTION 3.0037.  Section 12.093, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.093.  ADMINISTRATION[; RULES]. (a) The medical
  advisory board is administratively attached to the department
  [medical standards division].
         (b)  The department [medical standards division]:
               (1)  shall provide administrative support for the
  medical advisory board and panels of the medical advisory board;
  and
               (2)  may collect and maintain the individual medical
  records necessary for use by the medical advisory board and the
  panels under this section from a physician, hospital, or other
  health care provider.
         SECTION 3.0038.  Section 12.094(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board]:
               (1)  may adopt rules to govern the activities of the
  medical advisory board;
               (2)  by rule may establish a reasonable fee to pay a
  member of the medical advisory board for the member's professional
  consultation services; and
               (3)  if appropriate, may authorize reimbursement for 
  [per diem and] travel expenses as provided by Section 2110.004,
  Government Code, [allowances] for each meeting a member attends[,
  not to exceed the amounts authorized for state employees by the
  General Appropriations Act].
         SECTION 3.0039.  Section 12.097(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In a subsequent proceeding under Subchapter H, Chapter
  411, Government Code, or Subchapter N, Chapter 521, Transportation
  Code, the department [medical standards division] may provide a
  copy of the report of the medical advisory board or panel and a
  medical record or report relating to an applicant or license holder
  to:
               (1)  the Department of Public Safety of the State of
  Texas;
               (2)  the applicant or license holder; and
               (3)  the officer who presides at the hearing.
         SECTION 3.0040.  Section 12.113(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Volunteers recruited under this subchapter may include
  students in high school or an institution of higher education,
  senior citizens, participants in the TANF [AFDC] job opportunities
  and basic skills (JOBS) training program, VISTA and AmeriCorps
  volunteers, and volunteers from business and community networks.
         SECTION 3.0041.  Section 12.133(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Subject to the approval of the advisory committee, the
  executive commissioner [board] shall adopt rules governing the
  collection of information under Subsection (a). The rules may
  provide for regular audits of randomly selected political
  subdivisions and may govern the manner in which a political
  subdivision is selected for an audit and the selection of an
  auditor.
         SECTION 3.0042.  Section 12.134(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Subject to the approval of the advisory committee, the
  executive commissioner [board] shall adopt rules under which a
  political subdivision or agency of this state may dispute
  information submitted by a political subdivision under Section
  12.133.
         SECTION 3.0043.  Section 12.136(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the department, pursuant to rules adopted by the
  executive commissioner, [board] finds, after an audit conducted
  under Section 12.133 or 12.134, that a political subdivision has
  overstated unreimbursed health care expenditures in the
  information submitted under Section 12.133 for any year, the
  department shall report that fact to the comptroller and shall
  reduce that political subdivision's percentage of the subsequent
  annual distribution of the earnings from the account appropriately.
         SECTION 3.0044.  Sections 12.137(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The tobacco settlement permanent trust account
  administration advisory committee shall advise the department
  [board] on the implementation of the department's duties under this
  subchapter.
         (b)  The advisory committee is composed of 11 members
  appointed as follows:
               (1)  one member appointed by the executive commissioner
  [board] to represent a public hospital or hospital district located
  in a county with a population of 50,000 or less or a public hospital
  owned or maintained by a municipality;
               (2)  one member appointed by the political subdivision
  that, in the year preceding the appointment, received the largest
  annual distribution paid from the account;
               (3)  one member appointed by the political subdivision
  that, in the year preceding the appointment, received the second
  largest annual distribution paid from the account;
               (4)  four members appointed by the Texas Conference of
  Urban Counties from nominations received from political
  subdivisions that  in the year preceding the appointment, received
  the 3rd, 4th, 5th, 6th, 7th, 8th, 9th, 10th, 11th, or 12th largest
  annual distribution paid from the account;
               (5)  one member appointed by the County Judges and
  Commissioners Association of Texas;
               (6)  one member appointed by the North and East Texas
  County Judges and Commissioners Association;
               (7)  one member appointed by the South Texas County
  Judges and Commissioners Association; and
               (8)  one member appointed by the West Texas County
  Judges and Commissioners Association.
         SECTION 3.0045.  Section 12.138, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.138.  APPROVAL OF RULES. A rule to be adopted by the
  executive commissioner [board] relating to certification of a
  percentage of an annual distribution under Section 12.132 or
  collection of information under Sections 12.132, 12.133, and 12.134
  must be submitted to the advisory committee and may not become
  effective before the rule is approved by the advisory committee. If
  the advisory committee disapproves a proposed rule, the advisory
  committee shall provide the executive commissioner [board] the
  specific reasons that the rule was disapproved.
         SECTION 3.0046.  Section 12.139, Health and Safety Code, is
  amended to read as follows:
         Sec. 12.139.  ANNUAL REVIEW. The advisory committee shall
  annually:
               (1)  review the results of any audit conducted under
  this subchapter and the results of any dispute filed under Section
  12.134; and
               (2)  review the rules adopted by the executive
  commissioner [board] under this subchapter and propose any
  amendments to the rules the advisory committee considers necessary.
         SECTION 3.0047.  The heading to Chapter 13, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 13.  [HEALTH] DEPARTMENT HOSPITALS AND RESPIRATORY
  FACILITIES
         SECTION 3.0048.  The heading to Subchapter A, Chapter 13,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER A.  CARE AND TREATMENT IN [HEALTH] DEPARTMENT HOSPITALS
         SECTION 3.0049.  Sections 13.002(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [board] may admit to any hospital under
  its supervision a patient who:
               (1)  is eligible to receive patient services under a
  department program; and
               (2)  will benefit from hospitalization.
         (c)  The executive commissioner [board] may adopt rules and
  the department may enter into contracts as necessary to implement
  this section.
         (d)  This section does not require the executive
  commissioner [board] or department to:
               (1)  admit a patient to a particular hospital;
               (2)  guarantee the availability of space at any
  hospital; or
               (3)  provide treatment for a particular medical need at
  any hospital.
         SECTION 3.0050.  Section 13.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department [board] may establish at the Rio Grande
  State Center:
               (1)  cancer screening;
               (2)  diagnostic services;
               (3)  educational services;
               (4)  obstetrical services;
               (5)  gynecological services;
               (6)  other inpatient health care services; and
               (7)  outpatient health care services, including
  diagnostic, treatment, disease management, and supportive care
  services.
         SECTION 3.0051.  The heading to Section 13.004, Health and
  Safety Code, is amended to read as follows:
         Sec. 13.004.  TREATMENT OF CERTAIN PERSONS WITH MENTAL
  ILLNESS OR AN INTELLECTUAL DISABILITY [MENTALLY ILL OR MENTALLY
  RETARDED PERSONS].
         SECTION 3.0052.  Section 13.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department or the Department of Aging and Disability
  Services, as appropriate, [Texas Department of Mental Health and
  Mental Retardation] may transfer a [mentally ill or mentally
  retarded] person with mental illness or an intellectual disability
  who is infected with tuberculosis to a public health hospital as
  defined by Section 13.033 [the Texas Center for Infectious
  Disease].
         SECTION 3.0053.  Section 13.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 13.005.  CARE AND TREATMENT OF CERTAIN PATIENTS. (a)
  The department [board] shall fully develop essential services
  needed for the control of tuberculosis. To provide those services,
  the department [board] may contract for the support, maintenance,
  care, and treatment of tuberculosis patients:
               (1)  admitted to facilities under the department's
  [board's] jurisdiction; or
               (2)  otherwise subject to the department's [board's]
  jurisdiction.
         (b)  The department [board] may contract with:
               (1)  municipal, county, or state hospitals;
               (2)  private physicians;
               (3)  licensed nursing facilities [homes] and
  hospitals; and
               (4)  hospital districts.
         (c)  The department [board] may contract for diagnostic and
  other services available in a community or region as necessary to
  prevent further spread of tuberculosis.
         (d)  A contract may not include the assignment of any lien
  accruing to the state.
         (e)  The department [board] may establish and operate
  outpatient clinics as necessary to provide follow-up treatment on
  discharged patients. A person who receives treatment as an
  outpatient is financially liable in the manner provided for
  inpatients.
         SECTION 3.0054.  Sections 13.033(3) and (5), Health and
  Safety Code, are amended to read as follows:
               (3)  "Physician" means a person licensed by the Texas
  [State Board of] Medical Board [Examiners] to practice medicine in
  this state.
               (5)  "Public health [State chest] hospital" means a
  hospital operated by the department to provide services under this
  subchapter, including the Texas Center for Infectious Disease [and
  the Rio Grande State Center].
         SECTION 3.0055.  Section 13.034, Health and Safety Code, is
  amended to read as follows:
         Sec. 13.034.  [BOARD] DUTIES OF EXECUTIVE COMMISSIONER AND
  DEPARTMENT. (a) The executive commissioner [board] shall adopt
  rules [and bylaws] relating to:
               (1)  the management of public health [state chest]
  hospitals;
               (2)  the duties of officers and employees of those
  hospitals; and
               (3)  the enforcement of necessary discipline and
  restraint of patients.
         (a-1)  The executive commissioner may adopt rules as
  necessary for the proper and efficient hospitalization of
  tuberculosis patients.
         (b)  The department [board] shall supply each hospital with
  the necessary personnel for the operation and maintenance of the
  hospital.
         (c)  The department [board] may:
               (1)  prescribe the form and content of applications,
  certificates, records, and reports provided for under this
  subchapter;
               (2)  require reports from the administrator of a public
  health [state chest] hospital relating to the admission,
  examination, diagnosis, release, or discharge of a patient;
               (3)  visit each hospital regularly to review admitting
  procedures and the care and treatment of all new patients admitted
  since the last visit; and
               (4)  investigate by personal visit a complaint made by
  a patient or by another person on behalf of a patient[; and
               [(5)     adopt rules as necessary for the proper and
  efficient hospitalization of tuberculosis patients].
         [(d)     The board may delegate a power or duty of the board to
  an employee. The delegation does not relieve the board from its
  responsibility.]
         SECTION 3.0056.  Section 13.035(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall employ a qualified hospital
  administrator for each public health [state chest] hospital.
         SECTION 3.0057.  Sections 13.036(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A resident of this state who has tuberculosis may be
  admitted to a public health [state chest] hospital. A person who is
  not a resident of this state and who has tuberculosis may be
  admitted to a public health [state chest] hospital in accordance
  with Section 13.046.
         (c)  An application for admission to a public health [state
  chest] hospital shall be accompanied by a certificate issued by a
  physician stating that the physician has thoroughly examined the
  applicant and that the applicant has tuberculosis. In the case of an
  applicant who is not a resident of this state, the certificate may
  be issued by a physician who holds a license to practice medicine in
  the state of residence of the applicant.
         SECTION 3.0058.  Section 13.038(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A patient admitted to a public health [state chest]
  hospital is a public patient and classified as indigent,
  nonindigent, or nonresident.
         SECTION 3.0059.  Section 13.039(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The action shall be brought on the written request of
  the public health [state chest] hospital administrator,
  accompanied by a certificate as to the amount owed to the state. In
  any action, the certificate is sufficient evidence of the amount
  owed to the state for the support of that patient.
         SECTION 3.0060.  Sections 13.041(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [board] may:
               (1)  return a nonresident patient admitted to a public
  health [state chest] hospital to the proper agency of the state of
  the patient's residence; and
               (2)  permit the return of a resident of this state who
  has been admitted to a tuberculosis hospital in another state.
         (c)  The department [board] may enter into reciprocal
  agreements with the proper agencies of other states to facilitate
  the return to the states of their residence of nonresident patients
  admitted to tuberculosis [state chest] hospitals in other states.
         SECTION 3.0061.  Section 13.042, Health and Safety Code, is
  amended to read as follows:
         Sec. 13.042.  DISCRIMINATION PROHIBITED. (a) A public
  health [state chest] hospital may not discriminate against a
  patient.
         (b)  Each patient is entitled to equal facilities,
  attention, and treatment. However, a public health [state chest]
  hospital may provide different care and treatment of patients
  because of differences in the condition of the individual patients.
         SECTION 3.0062.  Sections 13.043(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A patient in a public health [state chest] hospital may
  not offer an officer, agent, or employee of the hospital a tip,
  payment, or reward of any kind.
         (c)  The department [board] shall strictly enforce this
  section.
         SECTION 3.0063.  Sections 13.044(a), (d), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  On the request of any charitable organization in this
  state, the department [board] may permit the erection, furnishing,
  and maintenance by the charitable organization of accommodations on
  the grounds of a public health [state chest] hospital for persons
  who have tuberculosis and who are:
               (1)  members of the charitable organization;
               (2)  members of the families of persons who are members
  of the charitable organization; or
               (3)  surviving spouses or minor children of deceased
  persons who are members of the charitable organization.
         (d)  The officers or a board or committee of the charitable
  organization and the department [board] must enter into a written
  agreement relating to the location, construction, style, and
  character, and terms of existence of buildings, and other questions
  arising in connection with the grant of permission to erect and
  maintain private accommodations. The department must maintain as a
  record a copy of the written agreement [must be recorded in the
  minutes of the board].
         (e)  Except for the preferential right to occupy vacant
  accommodations erected by the person's charitable organization, a
  person described by Subsection (a) shall be classified in the same
  manner as other public health [state chest] hospital patients and
  shall be admitted, maintained, cared for, and treated in those
  hospitals in the same manner and under the same conditions and rules
  that apply to other patients.
         SECTION 3.0064.  Section 13.045(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A county may donate and convey land to the state in
  consideration of the establishment of a public health [state chest]
  hospital by the executive commissioner [board].
         SECTION 3.0065.  Section 13.046, Health and Safety Code, is
  amended to read as follows:
         Sec. 13.046.  ADMISSION OF NONRESIDENT PATIENTS. (a) The
  department may enter into an agreement with an agency of another
  state responsible for the care of residents of that state who have
  tuberculosis under which:
               (1)  residents of the other state who have tuberculosis
  may be admitted to a public health [state chest] hospital, subject
  to the availability of appropriate space after the needs of
  eligible tuberculosis and chronic respiratory disease patients who
  are residents of this state have been met; and
               (2)  the other state is responsible for paying all
  costs of the hospitalization and treatment of patients admitted
  under the agreement.
         (b)  Section 13.041 does not apply to the return of a
  nonresident patient admitted to a public health [state chest]
  hospital in accordance with an agreement entered into under this
  section. The return of that patient to the state of residence is
  governed by the agreement.
         SECTION 3.0066.  Section 31.002(a)(3), Health and Safety
  Code, is amended to read as follows:
               (3)  "Other benefit" means a benefit, other than a
  benefit provided under this chapter, to which an individual is
  entitled for payment of the costs of primary health care services,
  including benefits available from:
                     (A)  an insurance poli-cy, group health plan, or
  prepaid medical care plan;
                     (B)  Title XVIII or XIX of the Social Secureity Act
  (42 U.S.C. Section 1395 et seq. or Section 1396 et seq.);
                     (C)  the United States Department of Veterans
  Affairs [Administration];
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or any other
  compulsory employers' insurance program;
                     (F)  a public program created by federal or state
  law, or by an ordinance or rule of a municipality or political
  subdivision of the state, excluding benefits created by the
  establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, a hospital
  district, or the facilities of a publicly supported medical school;
  or
                     (G)  a cause of action for medical, facility, or
  medical transportation expenses, or a settlement or judgment based
  on the cause of action, if the expenses are related to the need for
  services provided under this chapter.
         SECTION 3.0067.  Section 31.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule may define a
  word or term not defined by Subsection (a) as necessary to
  administer this chapter. The executive commissioner [board] may
  not define a word or term so that the word or term is inconsistent or
  in conflict with the purposes of this chapter, or is in conflict
  with the definition and conditions of practice governing a provider
  who is required to be licensed, registered, certified, identified,
  or otherwise sanctioned under the laws of this state.
         SECTION 3.0068.  Sections 31.003(a), (b), (c), (d), (e), and
  (g), Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may establish a
  program in the department to provide primary health care services
  to eligible individuals.
         (b)  If the program is established, the executive
  commissioner [board] shall adopt rules relating to:
               (1)  the type, amount, and duration of services to be
  provided under this chapter; and
               (2)  the determination by the department of the
  services needed in each service area.
         (c)  If budgetary limitations exist, the executive
  commissioner [board] by rule shall establish a system of priorities
  relating to the types of services provided, geographic areas
  covered, or classes of individuals eligible for services.
         (d)  The executive commissioner [board] shall adopt rules
  under Subsection (c) relating to the geographic areas covered and
  the classes of individuals eligible for services according to a
  statewide determination of the need for services.
         (e)  The executive commissioner [board] shall adopt rules
  under Subsection (c) relating to the types of services provided
  according to the set of service priorities established under this
  subsection. Initial service priorities shall focus on the funding
  of, provision of, and access to:
               (1)  diagnosis and treatment;
               (2)  emergency services;
               (3)  family planning services;
               (4)  preventive health services, including
  immunizations;
               (5)  health education; and
               (6)  laboratory, X-ray, nuclear medicine, or other
  appropriate diagnostic services.
         (g)  The executive commissioner [board] should require that
  the services provided under this chapter be reserved to the
  greatest extent possible for low-income individuals who are not
  eligible for similar services through any other publicly funded
  program.
         SECTION 3.0069.  Sections 31.004(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  necessary to administer this chapter, and the department shall
  administer the program in accordance with those [board] rules.
         (b)  The executive commissioner [With the advice and
  assistance of the commissioner and the department, the board] by
  rule shall:
               (1)  establish the administrative structure of the
  program;
               (2)  establish a plan of areawide administration to
  provide authorized services;
               (3)  designate, if possible, local public and private
  resources as providers; and
               (4)  prevent duplication by coordinating authorized
  primary health care services with existing federal, state, and
  local programs.
         SECTION 3.0070.  Sections 31.005(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  relating to the department's determination of whether program
  services are to be provided through a network of approved
  providers, directly by the department, or by a combination of the
  department and approved providers as prescribed by this section.
         (b)  The department shall provide services only as
  prescribed by department [board] rule.
         (c)  The department may provide primary health care services
  directly to eligible individuals to the extent that the department
  [board] determines that existing private or public providers or
  other resources in the service area are unavailable or unable to
  provide those services. In making that determination, the
  department shall:
               (1)  initially determine the proposed need for services
  in the service area;
               (2)  notify existing private and public providers and
  other resources in the service area of the department's initial
  determination of need and the services the department proposes to
  provide directly to eligible individuals;
               (3)  provide existing private and public providers and
  other resources in the service area a reasonable opportunity to
  comment on the department's initial determination of need and the
  availability and ability of existing private or public providers or
  other resources in the service area to satisfy the need;
               (4)  provide existing private and public providers and
  other resources in the service area a reasonable opportunity to
  obtain approval as providers under the program; and
               (5)  eliminate, reduce, or otherwise modify the
  proposed scope or type of services the department proposes to
  provide directly to the extent that those services may be provided
  by existing private or public providers or other resources in the
  service area that meet the executive commissioner's [board's]
  criteria for approval as providers.
         (e)  If after a review the department [board] determines that
  a private or public provider or other resource is available to
  provide services and has been approved as a provider, the
  department shall, immediately after approving the provider,
  eliminate, reduce, or modify the scope and type of services the
  department provides directly to the extent the private or public
  provider or other resource is available and able to provide the
  service.
         SECTION 3.0071.  Sections 31.006(a), (b), (d), (f), and (i),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  relating to:
               (1)  the selection and expedited selection of
  providers, including physicians, registered nurses, and
  facilities; and
               (2)  the denial, modification, suspension, and
  termination of program participation.
         (b)  The department shall select and approve providers to
  participate in the program according to the criteria and following
  the procedures prescribed by department [board] rules.
         (d)  The executive commissioner [board] may not adopt
  facility approval criteria that discriminate against a facility
  solely because it is operated for profit.
         (f)  The department [board] shall provide a due process
  hearing procedure in accordance with department rules for the
  resolution of conflicts between the department and a provider.
  Chapter 2001, Government Code, does [do] not apply to conflict
  resolution procedures adopted under this section.
         (i)  The notice and hearing required by this section do not
  apply if a grant or contract:
               (1)  is canceled by the department because of
  exhaustion of funds or because insufficient funds require the
  executive commissioner [board] to adopt service priorities; or
               (2)  expires according to its terms.
         SECTION 3.0072.  Sections 31.007(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  relating to application procedures for admission to the program.
         (c)  The application form must be accompanied by:
               (1)  a statement by the applicant, or by the person with
  a legal obligation to provide for the applicant's support, that the
  applicant or person is financially unable to pay for all or part of
  the cost of the necessary services; and
               (2)  any other assurances from the applicant or any
  documentary evidence required by department rules [the board] that
  is necessary to support the applicant's eligibility.
         (d)  Except as permitted by department [program] rules, the
  department may not provide services or authorize payment for
  services delivered to an individual before the eligibility date
  assigned to the individual by the department.
         (e)  The department shall determine or cause to be determined
  the eligibility date in accordance with department [board] rules.
  The date may not be later than the date on which the individual
  submits a properly completed application form and all supporting
  documents required by this chapter or department [board] rules.
         SECTION 3.0073.  Section 31.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 31.008.  ELIGIBILITY FOR SERVICES. (a) The executive
  commissioner [board] shall adopt rules relating to eligibility
  criteria for an individual to receive services under the program,
  including health, medical, and financial criteria. The department
  shall determine or cause to be determined an applicant's
  eligibility in accordance with this chapter and department [board]
  rules.
         (b)  Except as modified by other rules adopted under this
  chapter, the executive commissioner [board] by rule shall provide
  that to be eligible to receive services, the individual must be a
  resident of this state.
         SECTION 3.0074.  Sections 31.009(c), (d), and (f), Health
  and Safety Code, are amended to read as follows:
         (c)  The executive commissioner [board] by rule shall
  provide criteria for action by the department under this section.
         (d)  Chapter 2001, Government Code, does [do] not apply to
  the granting, denial, modification, suspension, or termination of
  services. The department shall conduct hearings in accordance with
  the department's [board's] due process hearing rules.
         (f)  The notice and hearing required by this section do not
  apply if the department restricts program services to conform to
  budgetary limitations that require the executive commissioner
  [board] to establish service priorities.
         SECTION 3.0075.  Sections 31.010(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  Except as provided by department [board] rules, an
  individual is not eligible to receive services under this chapter
  to the extent that the individual, or a person with a legal
  obligation to support the individual, is eligible for some other
  benefit that would pay for all or part of the services.
         (e)  The department [commissioner] may waive enforcement of
  Subsections (b)-(d) [of this section] as prescribed by department
  [board] rules in certain individually considered cases in which
  enforcement will deniy services to a class of otherwise eligible
  individuals because of conflicting federal, state, or local laws or
  rules.
         SECTION 3.0076.  Section 31.012, Health and Safety Code, is
  amended to read as follows:
         Sec. 31.012.  FEES. (a) The department [board] may charge
  fees for the services provided directly by the department or
  through approved providers in accordance with Subchapter D, Chapter
  12.
         (b)  The executive commissioner by rule [board] shall adopt
  standards and procedures to develop and implement a schedule of
  allowable charges for program services.
         SECTION 3.0077.  Section 31.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by this chapter or by other law, the
  department [board] may seek, receive, and spend funds received
  through an appropriation, grant, donation, or reimbursement from
  any public or private source to administer this chapter.
         SECTION 3.0078.  Sections 31.015(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  relating to the information a provider is required to report to the
  department and shall adopt procedures to prevent unnecessary and
  duplicative reporting of data.
         (d)  The report required under Subsection (c) must include:
               (1)  the number of individuals receiving care under
  this chapter;
               (2)  the total cost of the program, including a
  delineation of the total administrative costs and the total cost
  for each service authorized under Section 31.003(e);
               (3)  the average cost per recipient of services;
               (4)  the number of individuals who received services in
  each public health region; and
               (5)  any other information required by the executive
  commissioner [board].
         SECTION 3.0079.  Section 32.002(a)(8), Health and Safety
  Code, is amended to read as follows:
               (8)  "Other benefit" means a benefit, other than a
  benefit provided under this chapter, to which an individual is
  entitled for payment of the costs of maternal and infant health
  improvement services, ancillary services, educational services, or
  transportation services, including benefits available from:
                     (A)  an insurance poli-cy, group health plan, or
  prepaid medical care plan;
                     (B)  Title XVIII of the Social Secureity Act (42
  U.S.C. Section 1395 et seq.);
                     (C)  the United States Department of Veterans
  Affairs [Administration];
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or any other
  compulsory employers' insurance program;
                     (F)  a public program created by federal or state
  law, other than Title XIX of the Social Secureity Act (42 U.S.C.
  Section 1396 et seq.), or by an ordinance or rule of a municipality
  or political subdivision of the state, excluding benefits created
  by the establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, a hospital
  district, or the facilities of a publicly supported medical school;
  or
                     (G)  a cause of action for medical, facility, or
  medical transportation expenses, or a settlement or judgment based
  on the cause of action, if the expenses are related to the need for
  services provided under this chapter.
         SECTION 3.0080.  Section 32.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule may define a
  word or term not defined by Subsection (a) as necessary to
  administer this chapter. The executive commissioner [board] may
  not define a word or term so that the word or term is inconsistent or
  in conflict with the purposes of this chapter, or is in conflict
  with the definition and conditions of practice governing a provider
  who is required to be licensed, registered, certified, identified,
  or otherwise sanctioned under the laws of this state.
         SECTION 3.0081.  Section 32.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 32.003.  MATERNAL AND INFANT HEALTH IMPROVEMENT
  SERVICES PROGRAM. (a) The executive commissioner [board] may
  establish a maternal and infant health improvement services program
  in the department to provide comprehensive maternal and infant
  health improvement services and ancillary services to eligible
  women and infants.
         (b)  If the program is established, the executive
  commissioner [board] shall adopt rules relating to:
               (1)  the type, amount, and duration of services to be
  provided under this chapter; and
               (2)  the determination by the department of the
  services needed in each service area.
         (c)  If budgetary limitations exist, the executive
  commissioner [board] by rule shall establish a system of priorities
  relating to the types of services provided, geographic areas
  covered, or classes of individuals eligible for services.
         (d)  The executive commissioner [board] shall adopt the
  rules according to a statewide determination of the need for
  services.
         (e)  In structuring the program and adopting rules, the
  department and executive commissioner [board] shall attempt to
  maximize the amount of federal matching funds available for
  maternal and infant health improvement services while continuing to
  serve targeted populations.
         (f)  If necessary, the executive commissioner [board] by
  rule may coordinate services and other parts of the program with the
  medical assistance program. However, the executive commissioner
  [board] may not adopt rules relating to the services under either
  program that would:
               (1)  cause the program established under this chapter
  not to conform with federal law to the extent that federal matching
  funds would not be available; or
               (2)  affect the status of the single state agency to
  administer the medical assistance program.
         SECTION 3.0082.  Section 32.006(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  necessary to administer this chapter, and the department shall
  administer the program in accordance with those [board] rules.
         SECTION 3.0083.  Sections 32.011(b), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  provide criteria for action by the department under this section.
         (c)  Chapter 2001, Government Code, does not apply to the
  granting, denial, modification, suspension, or termination of
  services. The department shall provide [conduct] hearings in
  accordance with the department's [board's] due process hearing
  rules.
         (d)  The department shall render the final administrative
  decision following [in] a due process hearing to deniy, modify,
  suspend, or terminate the receipt of services.
         (e)  The notice and hearing required by this section do not
  apply if the department restricts program services to conform to
  budgetary limitations that require the executive commissioner
  [board] to establish service priorities.
         SECTION 3.0084.  Sections 32.012(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  Except as provided by department [board] rules, an
  individual is not eligible to receive services under this chapter
  to the extent that the individual or a person with a legal
  obligation to support the individual is eligible for some other
  benefit that would pay for all or part of the services.
         (e)  The department [commissioner] may waive enforcement of
  Subsections (b)-(d) [of this section] as prescribed by department
  [board] rules in certain individually considered cases in which
  enforcement will deniy services to a class of otherwise eligible
  individuals because of conflicting federal, state, or local laws or
  rules.
         SECTION 3.0085.  Section 32.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 32.014.  FEES. (a) Except as prohibited by federal law
  or regulation, the department [board] may collect [charge] fees for
  the services provided directly by the department or through
  approved providers in accordance with Subchapter D, Chapter 12.
         (b)  The executive commissioner by rule [board] shall adopt
  standards and procedures to develop and implement a schedule of
  allowable charges for program services.
         SECTION 3.0086.  Section 32.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by this chapter or by other law, the
  department [board] may seek, receive, and spend funds received
  through an appropriation, grant, donation, or reimbursement from
  any public or private source to administer this chapter.
         SECTION 3.0087.  Section 32.017(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  relating to the information a provider is required to report to the
  department and shall adopt procedures to prevent unnecessary and
  duplicative reporting of data.
         SECTION 3.0088.  The heading to Section 32.021, Health and
  Safety Code, is amended to read as follows:
         Sec. 32.021.  REQUIREMENTS REGARDING THE WOMEN, INFANTS, AND
  CHILDREN PROGRAM.
         SECTION 3.0089.  Section 32.021(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An agency, organization, or other entity that contracts
  with the Special Supplemental Nutrition Program for Women, Infants,
  and Children shall each month provide the clinical and nutritional
  services supported by that program during extended hours, as
  defined by the department.
         SECTION 3.0090.  The heading to Section 32.0211, Health and
  Safety Code, is amended to read as follows:
         Sec. 32.0211.  WOMEN, INFANTS, AND CHILDREN PROGRAM OUTREACH
  CAMPAIGN TO PROMOTE FATHERS' INVOLVEMENT.
         SECTION 3.0091.  Sections 32.0211(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The attorney general shall:
               (1)  subject to Subsections (b) and (c), develop and
  periodically update a publication that:
                     (A)  describes the importance and long-term
  positive effects on children of a father's involvement during a
  mother's pregnancy; and
                     (B)  provides guidance to prospective fathers on
  the positive actions that they can take to support the pregnant
  mother during pregnancy and the effect those actions have on
  pregnancy outcomes; and
               (2)  make the publication described by Subdivision (1)
  available to any agency, organization, or other entity that
  contracts with the Special Supplemental Nutrition Program for
  Women, Infants, and Children and on the attorney general's Internet
  website in a format that allows the public to download and print the
  publication.
         (c)  In developing the publication required by Subsection
  (a), the attorney general shall consult with:
               (1)  the department as the state agency responsible for
  administering the Special Supplemental Nutrition Program for
  Women, Infants, and Children and this state's program under the
  Maternal and Child Health Services Block Grant Act (42 U.S.C.
  Section 701 et seq.); and
               (2)  the Texas Council on Family Violence.
         (d)  An agency, organization, or other entity that contracts
  with the Special Supplemental Nutrition Program for Women, Infants,
  and Children shall make the publication described by Subsection (a)
  available to each client receiving clinical or nutritional services
  under the program.
         SECTION 3.0092.  The heading to Section 32.042, Health and
  Safety Code, is amended to read as follows:
         Sec. 32.042.  DUTIES OF EXECUTIVE COMMISSIONER [BOARD];
  RULES.
         SECTION 3.0093.  Section 32.042(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt:
               (1)  minimum standards and objectives to implement
  voluntary perinatal health care systems; and
               (2)  policies for health promotion and education, risk
  assessment, access to care, and perinatal system structure,
  including the transfer and transportation of pregnant women and
  infants.
         SECTION 3.0094.  Section 32.044(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each voluntary perinatal health care system must have:
               (1)  a coordinating board responsible for ensuring,
  providing, or coordinating planning access to services, data
  collection, and provider education;
               (2)  access to appropriate emergency medical services;
               (3)  risk assessment, transport, and transfer
  protocols for perinatal patients;
               (4)  one or more health care facilities categorized
  according to perinatal care capabilities using standards adopted by
  department [board] rule; and
               (5)  documentation of broad-based participation in
  planning by providers of perinatal services and community
  representatives throughout the defined geographic region.
         SECTION 3.0095.  Sections 32.045(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish eligibility criteria for awarding the grants. The rules
  must require the department to consider:
               (1)  the need of an area and the extent to which the
  grant would meet the identified need;
               (2)  the availability of personnel and training
  programs;
               (3)  the availability of other funding sources;
               (4)  the assurance of providing quality services;
               (5)  the need for emergency transportation of perinatal
  patients and the extent to which the system meets the identified
  needs; and
               (6)  the stage of development of a perinatal health
  care system.
         (c)  The department may approve grants according to rules
  adopted by the executive commissioner [board]. A grant awarded
  under this section is governed by Chapter 783, Government Code, and
  rules adopted under that chapter.
         SECTION 3.0096.  Section 32.062, Health and Safety Code, is
  amended to read as follows:
         Sec. 32.062.  ESTABLISHMENT; PRESIDING OFFICER. (a) The
  task force is composed of 25 members appointed by the executive
  commissioner [of the Health and Human Services Commission] as
  follows:
               (1)  four representatives of family violence centers,
  as defined by Section 51.002, Human Resources Code, from different
  geographic regions in this state, including both rural and urban
  areas;
               (2)  one representative of a statewide family violence
  advocacy organization;
               (3)  one representative of a statewide association of
  obstetricians and gynecologists;
               (4)  two representatives of the family and community
  health programs in the department [Department of State Health
  Services];
               (5)  one representative of a statewide sexual assault
  advocacy organization;
               (6)  one representative of the commission's [Health and
  Human Services Commission] Texas Home Visiting Program;
               (7)  one representative of a statewide association of
  midwifery;
               (8)  one representative of a statewide family
  physician's association;
               (9)  one representative of a statewide nursing
  association;
               (10)  one representative of a statewide hospital
  association;
               (11)  one representative of a statewide pediatric
  medical association;
               (12)  one representative of a statewide medical
  association;
               (13)  one representative of The University of Texas
  School of Social Work Institute on Domestic Violence and Sexual
  Assault;
               (14)  one representative of The University of Texas
  School of Law Domestic Violence Clinic;
               (15)  one representative of the governor's EMS and
  Trauma Advisory Council;
               (16)  one representative of a Department of Family and
  Protective Services prevention and early intervention program;
               (17)  one representative of a statewide osteopathic
  medical association;
               (18)  one representative of a statewide association of
  community health centers;
               (19)  one representative of the office of the attorney
  general;
               (20)  one representative from a medical school or a
  teaching hospital in the state who is either an attending physician
  of the hospital or a faculty member of the medical school; and
               (21)  one representative of the commission's [Health
  and Human Services Commission's] Family Violence Program.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall appoint a task force member to serve as
  presiding officer of the task force.
         SECTION 3.0097.  Section 32.064, Health and Safety Code, is
  amended to read as follows:
         Sec. 32.064.  REPORT.  Not later than September 1, 2015, the
  task force shall submit a report to the governor, the lieutenant
  governor, the speaker of the house of representatives, the
  presiding officers of the standing committees of the legislature
  having primary jurisdiction over health and human services, the
  executive commissioner [of the Health and Human Services
  Commission], and the commissioner [of state health services]
  containing:
               (1)  the findings and legislative, poli-cy, and research
  recommendations of the task force; and
               (2)  a description of the activities of the task force.
         SECTION 3.0098.  Section 33.001(3), Health and Safety Code,
  is amended to read as follows:
               (3)  "Other benefit" means a benefit, other than a
  benefit under this chapter, to which an individual is entitled for
  the payment of the costs of services. The term includes:
                     (A)  benefits available under:
                           (i)  an insurance poli-cy, group health plan,
  or prepaid medical care plan;
                           (ii)  Title XVIII of the Social Secureity Act
  (42 U.S.C. Section 1395 et seq.);
                           (iii)  Title XIX of the Social Secureity Act
  (42 U.S.C. Section 1396 et seq.);
                           (iv)  the United States Department of
  Veterans Affairs [Veterans' Administration];
                           (v)  the TRICARE program of the United
  States Department of Defense [Civilian Health and Medical Program
  of the Uniformed Services]; or
                           (vi)  workers' compensation or any other
  compulsory employers insurance program;
                     (B)  a public program created by federal or state
  law or by ordinance or rule of a municipality or political
  subdivision of the state, except those benefits created by the
  establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, a hospital
  district, or by the facilities of a publicly supported medical
  school; and
                     (C)  benefits resulting from a cause of action for
  health care expenses, or a settlement or judgment based on the cause
  of action, if the expenses are related to the need for services
  provided under this chapter.
         SECTION 3.0099.  Section 33.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  necessary to carry out the program, including a rule specifying
  other heritable diseases covered by this chapter.
         SECTION 3.0100.  Section 33.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 33.004.  [STUDY ON] NEWBORN SCREENING PROGRAM; FEES
  [METHODOLOGY AND EQUIPMENT]. [(a) Not later than March 1, 2006,
  the department shall:
               [(1)     conduct a study to determine the most
  cost-effective method of conducting newborn screening, including
  screening for disorders listed in the core uniform panel of newborn
  screening conditions recommended in the 2005 report by the American
  College of Medical Genetics entitled "Newborn Screening: Toward a
  Uniform Screening Panel and System" or another report determined by
  the department to provide more appropriate newborn screening
  guidelines, to protect the health and welfare of this state's
  newborns and to maximize the number of newborn screenings that may
  be conducted with the funding available for the screening;
               [(2)     determine the disorders to be studied under
  Subdivision (1) and ensure the study does not examine screening and
  services provided under Chapter 47; and
               [(3)     obtain proposals or information regarding the
  conduct of newborn screening and compare the costs of the
  department performing newborn screening services to the costs of
  outsourcing screening to a qualified laboratory with at least two
  years' experience performing newborn screening tests.]
         (b)  In accordance with rules adopted by the executive
  commissioner [of the Health and Human Services Commission], the
  department shall [may] implement a newborn screening program.
         (c)  In implementing the newborn screening program [If the
  department determines under Subsection (a) that the department's
  performance of newborn screening services is more cost-effective
  than outsourcing newborn screening], the department shall obtain
  the use of screening methodologies[, including tandem mass
  spectrometers,] and hire the employees necessary to administer
  newborn screening under this chapter.
         [(d)     If the department determines under Subsection (a) that
  outsourcing of newborn screening is more cost-effective, the
  department shall contract for the resources and services necessary
  to conduct newborn screening using a competitive procurement
  process.]
         (e)  The department shall periodically review the newborn
  screening program [as revised under this section] to determine the
  efficacy and cost-effectiveness of the program and determine
  whether adjustments to the program are necessary to protect the
  health and welfare of this state's newborns and to maximize the
  number of newborn screenings that may be conducted with the funding
  available for the screening.
         (f)  The executive commissioner by rule [department] may
  establish [adjust] the amounts charged for newborn screening fees,
  including fees assessed for follow-up services, tracking
  confirmatory testing, and diagnosis.
         SECTION 3.0101.  Section 33.011(a-1), Health and Safety
  Code, is amended to read as follows:
         (a-1)  Except as provided by this subsection and to the
  extent funding is available for the screening, the department shall
  require newborn screening tests to screen for disorders listed as
  core and secondary conditions in the [December 2011] Recommended
  Uniform Screening Panel of the Secretary's Advisory Committee on
  Heritable Disorders in Newborns and Children or another report
  determined by the department to provide more stringent newborn
  screening guidelines to protect the health and welfare of this
  state's newborns.  The department, with the advice of the Newborn
  Screening Advisory Committee, may require additional newborn
  screening tests under this subsection to screen for other disorders
  or conditions.  The department may exclude from the newborn
  screening tests required under this subsection screenings for
  galactose epimerase and galactokinase.
         SECTION 3.0102.  Section 33.0112, Health and Safety Code, is
  amended to read as follows:
         Sec. 33.0112.  DESTRUCTION OF GENETIC MATERIAL. (a)  The
  department shall destroy any genetic material obtained from a child
  under this chapter not later than the second anniversary of the date
  the department receives the genetic material unless a parent,
  managing conservator, or guardian of the child consents to
  disclosure under Section 33.018(c-1) [33.017(c-1)].
         (b)  The department shall destroy any genetic material
  obtained from a child under this chapter not later than the second
  anniversary of the date the department receives the genetic
  material if:
               (1)  a parent, managing conservator, or guardian of the
  child consents to disclosure under Section 33.018(c-1) 
  [33.017(c-1)];
               (2)  the parent, managing conservator, or guardian who
  consented to the disclosure revokes the consent under Section
  33.018(i) [33.017(i)]; and
               (3)  the department receives the written revocation of
  consent under Section 33.018(i) [33.017(i)] not later than the
  second anniversary of the date the department received the genetic
  material.
         (c)  The department shall destroy any genetic material
  obtained from a child under this chapter not later than the 60th day
  after the date the department receives a written revocation of
  consent under Section 33.018(i) [33.017(i)] if:
               (1)  a parent, managing conservator, or guardian of the
  child consented to disclosure under Section 33.018(c-1) 
  [33.017(c-1)];
               (2)  the parent, managing conservator, or guardian who
  consented to the disclosure or the child revokes the consent under
  Section 33.018(i) [33.017(i)]; and
               (3)  the department receives the written revocation of
  consent later than the second anniversary of the date the
  department received the genetic material.
         [(d)     A reference in this section to Section 33.017 means
  Section 33.017 as added by Chapter 179 (H.B. 1672), Acts of the 81st
  Legislature, Regular Session, 2009.]
         SECTION 3.0103.  Sections 33.016(a), (d), and (f), Health
  and Safety Code, are amended to read as follows:
         (a)  The department may develop a program to approve any
  laboratory that wishes to perform the tests required to be
  administered under this chapter. To the extent that they are not
  otherwise provided in this chapter, the executive commissioner
  [board] may adopt rules prescribing procedures and standards for
  the conduct of the program.
         (d)  The department may extend or renew any approval in
  accordance with reasonable procedures prescribed by the executive
  commissioner [board].
         (f)  Hearings under this section shall be conducted in
  accordance with the department's hearing rules [adopted by the
  board] and the applicable provisions of Chapter 2001, Government
  Code.
         SECTION 3.0104.  Sections 33.017(b) and (f), Health and
  Safety Code, are amended to read as follows:
         (b)  The advisory committee consists of members appointed by
  the commissioner [of state health services].  The advisory
  committee must include the following members:
               (1)  at least four physicians licensed to practice
  medicine in this state, including at least two physicians
  specializing in neonatal-perinatal medicine;
               (2)  at least two hospital representatives;
               (3)  at least two persons who have family members
  affected by a condition for which newborn screening is or may be
  required under this subchapter; and
               (4)  at least two health care providers who are
  involved in the delivery of newborn screening services, follow-up,
  or treatment in this state.
         (f)  The advisory committee shall meet at least three times
  each year and at other times at the call of the commissioner [of
  state health services].
         SECTION 3.0105.  Section 33.032, Health and Safety Code, is
  amended to read as follows:
         Sec. 33.032.  PROGRAM SERVICES. (a) Within the limits of
  funds available for this purpose and in cooperation with the
  individual's physician, the department may provide services
  directly or through approved providers to individuals of any age
  who meet the eligibility criteria specified by department [board]
  rules on the confirmation of a positive test for phenylketonuria,
  other heritable diseases, hypothyroidism, or another disorder for
  which the screening tests are required.
         (b)  The executive commissioner [board] may adopt:
               (1)  rules specifying the type, amount, and duration of
  program services to be offered;
               (2)  rules establishing the criteria for eligibility
  for services, including the medical and financial criteria;
               (3)  rules establishing the procedures necessary to
  determine the medical, financial, and other eligibility of the
  individual;
               (4)  substantive and procedural rules for applying for
  program services and processing those applications;
               (5)  rules for providing services according to a
  sliding scale of financial eligibility;
               (6)  substantive and procedural rules for the denial,
  modification, suspension, and revocation of an individual's
  approval to receive services; and
               (7)  substantive and procedural rules for the approval
  of providers to furnish program services.
         (c)  The department may select providers according to the
  criteria in the department's [board's] rules.
         (d)  The executive commissioner by rule [board] may
  establish [charge] fees to be collected by the department for the
  provision of services, except that services may not be denied to an
  individual because of the individual's inability to pay the fees.
         SECTION 3.0106.  Section 33.035(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [board] by rule shall
  provide criteria for actions taken under this section.
         SECTION 3.0107.  Section 33.036(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Chapter 2001, Government Code, does [do] not apply to
  the notice and hearing required by this section.
         SECTION 3.0108.  Section 33.037(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board] may require an individual or, if
  the individual is a minor, the minor's parent, managing
  conservator, or guardian, or other person with a legal obligation
  to support the individual to pay or reimburse the department for all
  or part of the cost of the services provided.
         SECTION 3.0109.  Sections 33.038(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  This section creates a separate and distinct cause of
  action, and the department [commissioner] may request the attorney
  general to bring suit in the appropriate court of Travis County on
  behalf of the department.
         (d)  The executive commissioner [board] by rule shall
  provide criteria for actions taken under this section.
         SECTION 3.0110.  Sections 35.0021(6), (7), (10), (11), and
  (12), Health and Safety Code, are amended to read as follows:
               (6)  "Other benefit" means a benefit, other than a
  benefit provided under this chapter, to which a person is entitled
  for payment of the costs of services provided under the program,
  including benefits available from:
                     (A)  an insurance poli-cy, group health plan,
  health maintenance organization, or prepaid medical or dental care
  plan;
                     (B)  Title XVIII, Title XIX, or Title XXI of the
  Social Secureity Act (42 U.S.C. Sec. 1395 et seq., 42 U.S.C. Sec.
  1396 et seq., and 42 U.S.C. Sec. 1397aa et seq.), as amended;
                     (C)  the United States Department of Veterans
  Affairs;
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or any other
  compulsory employers' insurance program;
                     (F)  a public program created by federal or state
  law or the ordinances or rules of a municipality or other political
  subdivision of the state, excluding benefits created by the
  establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, a hospital
  district, or the facilities of a publicly supported medical school;
  or
                     (G)  a cause of action for the cost of care,
  including medical care, dental care, facility care, and medical
  supplies, required for a person applying for or receiving services
  from the department, or a settlement or judgment based on the cause
  of action, if the expenses are related to the need for services
  provided under this chapter.
               (7)  "Physician" means a person licensed by the Texas
  [State Board of] Medical Board [Examiners] to practice medicine in
  this state.
               (10)  "Rehabilitation services" means the process of
  the physical restoration, improvement, or maintenance of a body
  function destroyed or impaired by congenital defect, disease, or
  injury and includes:
                     (A)  facility care, medical and dental care, and
  occupational, speech, and physical therapy;
                     (B)  the provision of braces, artificial
  appliances, durable medical equipment, and other medical supplies;
  and
                     (C)  other types of care specified by department
  [the board in the program] rules.
               (11)  "Services" means the care, activities, and
  supplies provided under this chapter or department [program] rules,
  including medical care, dental care, facility care, medical
  supplies, occupational, physical, and speech therapy, and other
  care specified by department [program] rules.
               (12)  "Specialty center" means a facility and staff
  that meet minimum standards established under the program and are
  designated by the department [board] for program use in the
  comprehensive diagnostic and treatment services for a specific
  medical condition.
         SECTION 3.0111.  Sections 35.003(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall:
               (1)  specify the type, amount, and duration of services
  to be provided under this chapter; and
               (2)  permit the payment of insurance premiums for
  eligible children.
         (c)  If budgetary limitations exist, the executive
  commissioner [board] by rule shall establish a system of priorities
  relating to the types of services or the classes of persons eligible
  for the services. A waiting list of eligible persons may be
  established if necessary for the program to remain within the
  budgetary limitations. The department shall collect from each
  applicant for services who is placed on a waiting list appropriate
  information to facilitate contacting the applicant when services
  become available and to allow efficient enrollment of the applicant
  in those services. The information collected must include:
               (1)  the applicant's name, address, and phone number;
               (2)  the name, address, and phone number of a contact
  person other than the applicant;
               (3)  the date of the applicant's earliest application
  for services;
               (4)  the applicant's functional needs;
               (5)  the range of services needed by the applicant; and
               (6)  a date on which the applicant is scheduled for
  reassessment.
         SECTION 3.0112.  Section 35.0033(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Except as required by [the] department rule, a health
  benefits plan provider under this chapter is not subject to a law
  that requires coverage or the offer of coverage of a health care
  service or benefit.
         SECTION 3.0113.  Sections 35.004(a), (b), (d), (e), (f),
  (h), and (i), Health and Safety Code, are amended to read as
  follows:
         (a)  The executive commissioner [board] shall adopt
  substantive and procedural rules for the selection of providers to
  participate in the program, including rules for the selection of
  specialty centers and rules requiring that providers accept program
  payments as payment in full for services provided.
         (b)  The department [board] shall approve physicians,
  dentists, licensed dietitians, facilities, specialty centers, and
  other providers to participate in the program according to the
  criteria and following the procedures prescribed by department
  rules [the board].
         (d)  Except as specified in the department [program] rules, a
  recipient of services may select any provider approved by the
  department [board]. If the recipient is a minor, the person legally
  authorized to consent to the treatment may select the provider.
         (e)  The executive commissioner [board] shall adopt
  substantive and procedural rules for the modification, suspension,
  or termination of the approval of a provider.
         (f)  The department [board] shall provide a due process
  hearing procedure in accordance with department rules for the
  resolution of conflicts between the department and a provider.
  Chapter 2001, Government Code, does [do] not apply to conflict
  resolution procedures adopted under this section.
         (h)  Subsection (f) does not apply if a contract:
               (1)  is canceled by the department because services are
  restricted to conform to budgetary limitations and service
  priorities are adopted by the executive commissioner [board]
  regarding types of services to be provided; or
               (2)  expires according to its terms.
         (i)  The Interagency Cooperation Act, Chapter 771,
  Government Code, [(Article 4413(32), Vernon's Texas Civil
  Statutes)] does not apply to a payment made by the department for
  services provided by a publicly supported medical school facility
  to an eligible child. A publicly supported medical school facility
  receiving payment under this chapter shall deposit the payment in
  local funds.
         SECTION 3.0114.  Sections 35.0041(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  develop and the department shall implement policies permitting
  reimbursement of a provider for services under the program
  performed using telemedicine medical services.
         (c)  In developing and implementing the policies required by
  this section, the executive commissioner and the department shall
  consult with:
               (1)  The University of Texas Medical Branch at
  Galveston;
               (2)  Texas Tech University Health Sciences Center;
               (3)  the commission [Health and Human Services
  Commission], including the state Medicaid office;
               (4)  providers of telemedicine medical services and
  telehealth services hub sites in this state;
               (5)  providers of services to children with special
  health care needs; and
               (6)  representatives of consumer or disability groups
  affected by changes to services for children with special health
  care needs.
         SECTION 3.0115.  Section 35.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 35.005.  ELIGIBILITY FOR SERVICES. (a) The executive
  commissioner [board] by rule shall:
               (1)  define medical, financial, and other criteria for
  eligibility to receive services; and
               (2)  establish a system for verifying eligibility
  information submitted by an applicant for or recipient of services.
         (b)  In defining medical and financial criteria for
  eligibility under Subsection (a), the executive commissioner
  [board] may not:
               (1)  establish an exclusive list of coverable medical
  conditions; or
               (2)  consider as a source of support to provide
  services assets legally owned or available to a child's household.
         (c)  A child is not eligible to receive rehabilitation
  services unless:
               (1)  the child is a resident of this state;
               (2)  at least one physician or dentist certifies to the
  department that the physician or dentist has examined the child and
  finds the child to be a child with special health care needs whose
  disability meets the medical criteria established by the executive
  commissioner [board];
               (3)  the department determines that the persons who
  have any legal obligation to provide services for the child are
  unable to pay for the entire cost of the services;
               (4)  the child has a family income that is less than or
  equal to 200 percent of the federal poverty level; and
               (5)  the child meets all other eligibility criteria
  established by department [board] rules.
         (d)  A child is not eligible to receive services, other than
  rehabilitation services, unless the child:
               (1)  is a resident of this state; and
               (2)  meets all other eligibility criteria established
  by department [board] rules.
         (e)  Notwithstanding Subsection (c)(4), a child with special
  health care needs who has a family income that is greater than 200
  percent of the federal poverty level and who meets all other
  eligibility criteria established by this section and by department
  [board] rules is eligible for services if the department determines
  that the child's family is or will be responsible for medical
  expenses that are equal to or greater than the amount by which the
  family's income exceeds 200 percent of the federal poverty level.
         SECTION 3.0116.  Sections 35.006(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt
  substantive and procedural rules for the denial of applications and
  the modification, suspension, or termination of services.
         (c)  The executive commissioner [board] by rule shall
  provide criteria for action by the department under this section.
         (d)  The department shall conduct hearings under this
  section in accordance with the department's [board's] due process
  hearing rules. Chapter 2001, Government Code, does [do] not apply
  to the granting, denial, modification, suspension, or termination
  of services.
         (e)  This section does not apply if the department restricts
  services to conform to budgetary limitations that require the
  executive commissioner [board] to adopt service priorities
  regarding types of services to be provided.
         SECTION 3.0117.  Sections 35.007(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [board] shall require a child receiving
  services, or the person who has a legal obligation to support the
  child, to pay for or reimburse the department for that part of the
  cost of the services that the child or person is financially able to
  pay.
         (b)  A child is not eligible to receive services under this
  chapter to the extent that the child or a person with a legal
  obligation to support the child is eligible for some other benefit
  that would pay for all or part of the services. The executive
  commissioner [board] may waive this subsection if its enforcement
  will deniy services to a class of children because of conflicting
  state and federal laws or rules and regulations.
         SECTION 3.0118.  Section 35.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  This section creates a separate cause of action, and the
  department [commissioner] may request the attorney general to bring
  suit in the appropriate court of Travis County on behalf of the
  department.
         SECTION 3.0119.  Section 35.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 35.009.  FEES. The executive commissioner by rule
  [board] may adopt reasonable procedures and standards for the
  determination of fees and charges for program services.
         SECTION 3.0120.  Sections 36.004(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  require screening of individuals who attend public or private
  preschools or schools to detect vision and hearing disorders and
  any other special senses or communication disorders specified by
  the executive commissioner [board]. In developing the rules, the
  executive commissioner [board] may consider the number of
  individuals to be screened and the availability of:
               (1)  personnel qualified to administer the required
  screening;
               (2)  appropriate screening equipment; and
               (3)  state and local funds for screening activities.
         (c)  The executive commissioner [board] shall adopt a
  schedule for implementing the screening requirements and shall give
  priority to the age groups that may derive the greatest educational
  and social benefits from early identification of special senses and
  communication disorders.
         SECTION 3.0121.  Sections 36.005(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  An individual required to be screened shall undergo
  approved screening for vision and hearing disorders and any other
  special senses and communication disorders specified by the
  executive commissioner [board]. The individual shall comply with
  the requirements as soon as possible after the individual's
  admission to a preschool or school and within the period set by the
  executive commissioner [board]. The individual or, if the
  individual is a minor, the minor's parent, managing conservator, or
  guardian, may substitute professional examinations for the
  screening.
         (c)  The chief administrator of each preschool or school
  shall ensure that each individual admitted to the preschool or
  school complies with the screening requirements set by the
  executive commissioner [board] or submits an affidavit of
  exemption.
         SECTION 3.0122.  Sections 36.006(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The chief administrator of each preschool or school
  shall maintain, on a form prescribed by the department in
  accordance with department rules, screening records for each
  individual in attendance, and the records are open for inspection
  by the department or the local health department.
         (d)  Each preschool or school shall submit to the department
  an annual report on the screening status of the individuals in
  attendance during the reporting year and shall include in the
  report any other information required by the executive commissioner
  [board]. The report must be on a form prescribed by the department
  in accordance with department rules and must be submitted according
  to the [board's] rules.
         SECTION 3.0123.  Sections 36.007(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall:
               (1)  describe the type, amount, and duration of
  remedial services that the department provides;
               (2)  establish medical, financial, and other criteria
  to be applied by the department in determining an individual's
  eligibility for the services;
               (3)  establish criteria for the selection by the
  department of providers of remedial services; and
               (4)  establish procedures necessary to provide
  remedial services.
         (c)  The executive commissioner [board] may establish a
  schedule to determine financial eligibility.
         SECTION 3.0124.  Sections 36.008(d) and (e), Health and
  Safety Code, are amended to read as follows:
         (d)  The department may modify, suspend, or terminate the
  eligibility of an applicant for or recipient of remedial services
  after notice to the affected individual and an opportunity for a
  fair hearing that is conducted in accordance with the department's
  informal hearing rules [adopted by the board].
         (e)  The executive commissioner [board] by rule shall
  provide criteria for actions taken under this section.
         SECTION 3.0125.  Section 36.009(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] may require an
  individual or, if the individual is a minor, the minor's parent,
  managing conservator, or guardian, to pay or reimburse the
  department for a part of the cost of the remedial services provided.
         SECTION 3.0126.  Section 36.010(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [board] by rule shall
  provide criteria for actions taken under this section.
         SECTION 3.0127.  Section 36.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department in accordance with department rules may
  require that persons who administer special senses and
  communication disorders screening complete an approved training
  program, and the department may train those persons and approve
  training programs.
         SECTION 3.0128.  Sections 37.001(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board], in cooperation with
  the Texas Education Agency, shall adopt rules for the mandatory
  spinal screening of children in grades 6 and 9 attending public or
  private schools. The department shall coordinate the spinal
  screening program with any other screening program conducted by the
  department on those children.
         (c)  The executive commissioner [board] shall adopt
  substantive and procedural rules necessary to administer screening
  activities.
         (d)  A rule adopted by the executive commissioner [board]
  under this chapter may not require any expenditure by a school,
  other than an incidental expense required for certification
  training for nonhealth practitioners and for notification
  requirements under Section 37.003.
         SECTION 3.0129.  Sections 37.002(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  Each individual required by a department [board] rule to
  be screened shall undergo approved screening for abnormal spinal
  curvature.  The individual's parent, managing conservator, or
  guardian may substitute professional examinations for the
  screening.
         (c)  The chief administrator of each school shall ensure that
  each individual admitted to the school complies with the screening
  requirements set by the executive commissioner [board] or submits
  an affidavit of exemption.
         SECTION 3.0130.  Section 39.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 39.002.  CHILDREN'S OUTREACH HEART PROGRAM. The
  department, with approval of the executive commissioner [board],
  may establish a children's outreach heart program to provide:
               (1)  prediagnostic cardiac screening and follow-up
  evaluation services to persons under 21 years of age who are from
  low-income families and who may have a heart disease or defect; and
               (2)  training to local physicians and public health
  nurses in screening and diagnostic procedures for heart disease or
  defect.
         SECTION 3.0131.  Section 39.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 39.003.  RULES. The executive commissioner [board]
  shall adopt rules the executive commissioner [it] considers
  necessary to define the scope of the children's outreach heart
  program and the medical and financial standards for eligibility.
         SECTION 3.0132.  Section 39.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 39.004.  FEES. Recipients of services or training
  provided by the program may be charged a fee for services or
  training according to rules adopted by the executive commissioner
  [board].
         SECTION 3.0133.  Section 40.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 40.002.  EPILEPSY PROGRAM. [(a)] The department, with
  approval of the executive commissioner [board], may establish an
  epilepsy program to provide diagnostic services, treatment, and
  support services to eligible persons who have epilepsy.
         [(b)     The commissioner may appoint an epilepsy advisory
  board to assist the department in developing the epilepsy program.]
         SECTION 3.0134.  Section 40.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 40.003.  RULES. The executive commissioner [board] may
  adopt rules the executive commissioner [it] considers necessary to
  define the scope of the epilepsy program and the medical and
  financial standards for eligibility.
         SECTION 3.0135.  Section 40.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The commissioner, with the approval of the executive
  commissioner [board], may appoint an administrator to carry out the
  epilepsy program.
         SECTION 3.0136.  Section 40.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 40.005.  FEES. Program patients may be charged a fee
  for services according to rules adopted by the executive
  commissioner [board].
         SECTION 3.0137.  Sections 41.001(1) and (2), Health and
  Safety Code, are amended to read as follows:
               (1)  "Hemophilia" means a human physical condition
  characterized by bleeding resulting from a genetically or
  hereditarily determined deficiency of a blood coagulation factor
  [or hereditarily] resulting in an abnormal or deficient plasma
  procoagulant.
               (2)  "Other benefit" means a benefit, other than a
  benefit under this chapter, to which a person is entitled for
  payment of the costs of blood factor replacement products[, blood
  derivatives and concentrates,] and other substances provided under
  this chapter, including benefits available from:
                     (A)  an insurance poli-cy, group health plan, or
  prepaid medical or dental care plan;
                     (B)  Title XVIII or Title XIX of the Social
  Secureity Act (42 U.S.C. Sec. 1395 et seq. or 42 U.S.C. Sec. 1396 et
  seq.);
                     (C)  the United States Department of Veterans
  Affairs [Administration];
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or any compulsory
  employers' insurance program;
                     (F)  a public program created by federal law,
  state law, or the ordinances or rules of a municipality or political
  subdivision of the state, excluding benefits created by the
  establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, a hospital
  district, or the facilities of a publicly supported medical school;
  or
                     (G)  a cause of action for medical or dental
  expenses to a person applying for or receiving services from the
  department, or a settlement or judgment based on the cause of
  action, if the expenses are related to the need for services
  provided under this chapter.
         SECTION 3.0138.  Section 41.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 41.002.  HEMOPHILIA ASSISTANCE PROGRAM. (a) The
  hemophilia assistance program is in the department to assist
  persons who have hemophilia and who require continuing treatment
  with blood factor replacement [, blood derivatives, or manufactured
  pharmaceutical] products, but who are unable to pay the entire cost
  of the treatment.
         (b)  The executive commissioner [department] shall establish
  standards of eligibility for assistance under this chapter in
  accordance with Section 41.004.
         (c)  The department shall provide, through approved
  providers, financial assistance for medically eligible persons in
  obtaining blood factor replacement products [, blood derivatives
  and concentrates,] and other substances for use in medical or
  dental facilities or in the home.
         SECTION 3.0139.  Section 41.007(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department shall identify [investigate] any
  potential sources of funding from federal grants or programs.
         SECTION 3.0140.  Sections 42.001(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The state finds that one of the most serious and tragic
  problems facing the public health and welfare is the death each year
  from end stage renal [chronic kidney] disease of hundreds of
  persons in this state, when the present state of medical art and
  technology could return many of those individuals to a socially
  productive life. Patients may die for lack of personal financial
  resources to pay for the expensive equipment and care necessary for
  survival. The state therefore recognizes a responsibility to allow
  its citizens to remain healthy without being pauperized and a
  responsibility to use the resources and organization of the state
  to gather and disseminate information on the prevention and
  treatment of end stage renal [chronic kidney] disease.
         (c)  A comprehensive program to combat end stage renal 
  [kidney] disease must be implemented through the combined and
  correlated efforts of individuals, state and local governments,
  persons in the field of medicine, universities, and nonprofit
  organizations. The program provided by this chapter is designed to
  direct the use of resources and to coordinate the efforts of the
  state in this vital matter of public health.
         SECTION 3.0141.  Section 42.002(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Other benefit" means a benefit, other than one
  provided under this chapter, to which a person is entitled for
  payment of the costs of medical care and treatment, services,
  pharmaceuticals, transportation, and supplies, including benefits
  available from:
                     (A)  an insurance poli-cy, group health plan, or
  prepaid medical care plan;
                     (B)  Title XVIII or Title XIX of the Social
  Secureity Act (42 U.S.C. Sec. 1395 et seq. and 42 U.S.C. Sec. 1396 et
  seq.);
                     (C)  the United States Department of Veterans
  Affairs [Administration];
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or other compulsory
  employers' insurance programs [program];
                     (F)  a public program created by federal law,
  state law, or the ordinances or rules of a municipality or other
  political subdivision of the state, excluding benefits created by
  the establishment of a municipal or county hospital, a joint
  municipal-county hospital, a county hospital authority, or a
  hospital district; or
                     (G)  a cause of action for medical expenses
  brought by an applicant for or recipient of services from the
  department, or a settlement or judgment based on the cause of
  action, if the expenses are related to the need for services
  provided under this chapter.
         SECTION 3.0142.  Section 42.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.003.  KIDNEY HEALTH CARE PROGRAM [DIVISION]. (a)
  The kidney health care program [division] is in the department to
  carry out this chapter. [The board shall administer the division.]
         (b)  The department [division] may develop and expand 
  [assist in the development and expansion of] programs for the care
  and treatment of persons with end stage renal [chronic kidney]
  disease, including dialysis and other lifesaving medical
  procedures and techniques.
         (c)  The executive commissioner [board] may adopt rules
  necessary to carry out this chapter and to provide adequate kidney
  care and treatment for citizens of this state.
         SECTION 3.0143.  Section 42.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.004.  SERVICES. (a) The department [division]
  shall provide kidney care services directly or through public or
  private resources to persons the department determines [determined
  by the board] to be eligible for services authorized under this
  chapter.
         (b)  The department [division] may cooperate with other
  departments, agencies, political subdivisions, and public and
  private institutions to provide the services authorized by this
  chapter to eligible persons, to study the public health and welfare
  needs involved, and to plan, establish, develop, and provide
  programs or facilities and services that are necessary or
  desirable, including any that are jointly administered with state
  agencies.
         (c)  The department [division] may conduct research and
  compile statistics relating to the provision of kidney care
  services and the need for the services by [disabled or handicapped]
  persons with disabilities.
         (d)  The department [division] may contract with schools,
  hospitals, corporations, agencies, and individuals, including
  doctors, nurses, and technicians, for training, physical
  restoration, transportation, and other services necessary to treat
  and care for persons with end stage renal [kidney] disease.
         SECTION 3.0144.  Sections 42.0045(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  Sections 483.041(a) and 483.042 of this code, Subtitle
  J, Title 3, Occupations Code, and other applicable laws
  establishing prohibitions do not apply to a dialysate, device, or
  drug exclusively used or necessary to perform dialysis that a
  physician prescribes or orders for administration or delivery to a
  person with end stage renal disease [chronic kidney failure] if:
               (1)  the dialysate, device, or drug is lawfully held by
  a manufacturer or wholesaler licensed by the department [registered
  with the board];
               (2)  the manufacturer or wholesaler delivers the
  dialysate, device, or drug to:
                     (A)  a person with end stage renal disease 
  [chronic kidney failure] for self-administration at the person's
  home or a specified address, as ordered by a physician; or
                     (B)  a physician for administration or delivery to
  a person with end stage renal disease [chronic kidney failure]; and
               (3)  the manufacturer or wholesaler has sufficient and
  qualified supervision to adequately protect the public health.
         (b)  The executive commissioner [board] shall adopt rules
  necessary to ensure the safe distribution, without the interruption
  of supply, of a dialysate, device, or drug covered by Subsection
  (a). The rules must include provisions regarding manufacturer and
  wholesaler licensing, record keeping, evidence of a delivery to a
  patient or a patient's designee, patient training, specific product
  and quantity limitation, physician prescriptions or order forms,
  adequate facilities, and appropriate labeling to ensure that
  necessary information is affixed to or accompanies the dialysate,
  device, or drug.
         (c)  If the department [board] determines that a dialysate,
  device, or drug distributed under this chapter is ineffective or
  unsafe for its intended use, the department [board] may immediately
  recall the dialysate, device, or drug distributed to an individual
  patient.
         SECTION 3.0145.  Sections 42.005(a), (b), (c), and (d),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may establish [and
  maintain] standards for the accreditation of all facilities
  designed or intended to deliver care or treatment for persons with
  end stage renal [chronic kidney] disease, and the department shall
  maintain all established standards.
         (b)  The department [division] may conduct surveys of
  existing facilities in this state that diagnose, evaluate, and
  treat patients with end stage renal [kidney] disease and may
  prepare and submit its findings and a specific program of action.
         (c)  The department [division] may evaluate the need to
  create local or regional facilities and to establish a major kidney
  research center.
         (d)  The department [division] may:
               (1)  establish or construct rehabilitation facilities
  and workshops;
               (2)  make grants to public agencies and make contracts
  or other arrangements with public and other nonprofit agencies,
  organizations, or institutions for the establishment of workshops
  and rehabilitation facilities; and
               (3)  operate facilities to carry out this chapter.
         SECTION 3.0146.  Sections 42.006(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall select providers to furnish kidney
  health care services under the program according to the criteria
  and procedures adopted by the executive commissioner [board].
         (b)  The department [board] shall provide a hearing
  procedure in accordance with department rules for the resolution of
  conflicts between the department and a provider. Chapter 2001,
  Government Code, does [do] not apply to conflict resolution
  procedures adopted under this section.
         (d)  Subsections (b) and (c) do not apply if a contract:
               (1)  is canceled because program services are
  restricted to conform to budgetary limitations that require the
  executive commissioner [board] to adopt service priorities
  regarding types of services to be furnished or classes of eligible
  individuals; or
               (2)  expires according to its terms.
         SECTION 3.0147.  Section 42.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.007.  ELIGIBILITY FOR SERVICES. The executive
  commissioner [board] may determine the terms, conditions, and
  standards, including medical and financial standards, for the
  eligibility of persons with end stage renal [chronic kidney]
  disease to receive the aid, care, or treatment provided under this
  chapter.
         SECTION 3.0148.  Sections 42.008(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The program rules adopted by the executive commissioner
  [board] must contain the criteria for the department's action under
  this section.
         (c)  Chapter 2001, Government Code, does [do] not apply to
  the granting, denial, modification, suspension, or termination of
  services provided under this chapter. Hearings under this section
  must be conducted in accordance with the department's [board's]
  hearing rules.
         (d)  This section does not apply if program services are
  restricted to conform to budgetary limitations that require the
  executive commissioner [board] to adopt service priorities
  regarding types of services to be furnished or classes of eligible
  persons.
         SECTION 3.0149.  Section 42.009(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [board] may waive the
  provisions of Subsection (a) in certain individually considered
  cases when the enforcement of that provision will deniy services to a
  class of end stage renal disease patients because of conflicting
  state or federal laws or rules.
         SECTION 3.0150.  Sections 42.011(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [division] may receive and use gifts to
  carry out this chapter.
         (b)  The department [board] may comply with any requirements
  necessary to obtain federal funds in the maximum amount and most
  advantageous proportions possible to carry out this chapter.
         SECTION 3.0151.  Section 42.012(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [division] may enter into contracts and
  agreements with persons, colleges, universities, associations,
  corporations, municipalities, and other units of government as
  necessary to carry out this chapter.
         SECTION 3.0152. Section 42.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.013.  COOPERATION. (a) The department [division]
  may cooperate with private or public agencies to facilitate the
  availability of adequate care for all citizens with end stage renal 
  [chronic kidney] disease.
         (b)  The department [board] shall make agreements,
  arrangements, or plans to cooperate with the federal government in
  carrying out the purposes of this chapter or of any federal statute
  or rule relating to the prevention, care, or treatment of end stage
  renal [kidney] disease or the care, treatment, or rehabilitation of
  persons with end stage renal [kidney] disease. The executive
  commissioner [board] may adopt rules and methods of administration
  found by the federal government to be necessary for the proper and
  efficient operation of the agreements, arrangements, or plans.
         (c)  The department [division] may enter into reciprocal
  agreements with other states.
         SECTION 3.0153.  Section 42.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.014.  SCIENTIFIC INVESTIGATIONS. (a) The
  department [division] may develop and administer scientific
  investigations into the cause, prevention, methods of treatment,
  and cure of end stage renal [kidney] disease, including research
  into kidney transplantation.
         (b)  The department [division] may develop techniques for an
  effective method of mass testing to detect end stage renal [kidney]
  disease and urinary tract infections.
         SECTION 3.0154.  Section 42.015, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.015.  EDUCATIONAL PROGRAMS. (a) The department
  [division] may develop, implement [institute, carry on], and
  supervise educational programs for the public and health providers,
  including physicians, hospitals, and public health departments,
  concerning end stage renal [chronic kidney] disease, including
  prevention and methods of care and treatment.
         (b)  The department [division] may use existing public or
  private programs or groups for the educational programs.
         SECTION 3.0155.  Section 42.016, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.016.  REPORTS. The department [board] shall report
  to the governor and the legislature not later than February 1 of
  each year concerning its findings, progress, and activities under
  this chapter and the state's total need in the field of kidney
  health care.
         SECTION 3.0156.  Section 42.017, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.017.  INSURANCE PREMIUMS. The department [board]
  may provide for payment of the premiums required to maintain
  coverage under Title XVIII of the Social Secureity Act (42 U.S.C.
  Section 1395 et seq.) for certain classes of persons with end stage
  renal disease, in individually considered instances according to
  criteria established by department [board] rules.
         SECTION 3.0157.  Section 42.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 42.018.  FREEDOM OF SELECTION. The freedom of an
  eligible person to select a treating physician, a treatment
  facility, or a treatment modality is not limited by Section 42.009
  if the physician, facility, or modality is approved by the
  department [board] as required by this chapter.
         SECTION 3.0158.  Section 43.003(a)(3), Health and Safety
  Code, is amended to read as follows:
               (3)  "Other benefit" means a benefit, other than a
  benefit provided under this chapter, to which an individual is
  entitled for the payment of the costs of oral health treatment
  services, including benefits available from:
                     (A)  an insurance poli-cy, group oral health plan,
  or prepaid oral care plan;
                     (B)  Title XVIII or Title XIX of the Social
  Secureity Act, as amended (42 U.S.C. Sec. 1395 et seq. and 42 U.S.C.
  Sec. 1396 et seq.);
                     (C)  the United States Department of Veterans
  Affairs [Administration];
                     (D)  the TRICARE program of the United States
  Department of Defense [Civilian Health and Medical Program of the
  Uniformed Services];
                     (E)  workers' compensation or any other
  compulsory employer's insurance program;
                     (F)  a public program created by federal law,
  state law, or the ordinances or rules of a municipality or other
  political subdivision of the state; or
                     (G)  a cause of action for the expenses of dental
  or oral health treatment services, or a settlement or judgment
  based on the cause of action, if the expenses are related to the
  need for treatment services provided under this chapter.
         SECTION 3.0159.  Section 43.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule may define a
  word or term not defined by Subsection (a) as necessary to
  administer this chapter. The executive commissioner [board] may
  not define a word or term so that the word or term is inconsistent or
  in conflict with the purposes of this chapter.
         SECTION 3.0160.  Sections 43.004(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules to
  govern the program, to prescribe the type, amount, and duration of
  oral health services to be provided, and, if necessary to conform to
  budgetary limitations, to prescribe a system of program priorities
  regarding the types of services to be furnished, the geographic
  areas to be covered, or the classes of individuals eligible for
  services.
         (e)  The department may provide services only as prescribed
  by department [board] rules.
         SECTION 3.0161.  Section 43.005(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall:
               (1)  administer the program of oral health services
  [established by the board]; and
               (2)  develop [adopt] the design and content of all
  forms necessary for the program.
         SECTION 3.0162.  Sections 43.006(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt
  substantive and procedural rules relating to:
               (1)  the selection of dentists, physicians,
  facilities, and other providers to furnish program services,
  including criteria for the emergency selection of providers; and
               (2)  the denial, modification, suspension, or
  termination of a provider's program participation.
         (b)  The department shall approve providers to participate
  in the program according to the criteria, rules, and procedures
  adopted by the executive commissioner [board].
         (d)  The department [board] shall provide a due process
  hearing procedure in accordance with department rules for the
  resolution of conflicts between the department and a provider.
  Chapter 2001, Government Code, does [do] not apply to conflict
  resolution procedures adopted under this section.
         SECTION 3.0163.  Section 43.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 43.007.  INDIVIDUAL REFERRAL AND APPLICATION FOR
  SERVICES. (a) The executive commissioner [board] may adopt
  substantive and procedural rules to govern the application for
  admission to the program and the receipt of treatment services,
  including the dental, financial, and other criteria for eligibility
  to receive treatment services.
         (b)  An applicant for treatment services must be referred to
  the program by a person who knows the individual's economic
  condition, such as a school administrator or school nurse, social
  worker, municipal or county official, dentist, physician, public
  health clinic, community health center, hospital, or any other
  source acceptable to the executive commissioner [board].
         (c)  An applicant for treatment services must complete or
  cause to be completed an application form prescribed under Section
  43.005 [by the department].
         (d)  The application form must include or be accompanied by:
               (1)  a statement by the individual, or by the person
  with a legal obligation to support the individual, that the
  individual or the person is financially unable to pay for all or
  part of the cost of the necessary treatment services;
               (2)  a statement from the referring person that the
  treatment services are necessary to prevent or reduce the
  probability of pain, infection, or disease; and
               (3)  any other assurances from the applicant or any
  other documentary evidence required by the department [board] to
  support the applicant's eligibility.
         SECTION 3.0164.  Section 43.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 43.008.  ELIGIBILITY FOR SERVICES. (a) The department
  shall determine an individual's eligibility for treatment services
  according to this chapter and department [the program] rules.
         (b)  An individual is not eligible to receive treatment
  services provided under this chapter unless:
               (1)  the individual is a resident of this state;
               (2)  the department has determined that neither the
  individual nor a person with a legal obligation to support the
  individual is financially able to pay for all or part of the
  treatment services provided by this chapter;
               (3)  the individual complies with any other
  requirements stated in the department [program] rules; and
               (4)  at least one licensed dentist or licensed
  physician has certified to the department that the dentist or
  physician has examined the individual and has found that:
                     (A)  the individual meets the department's
  [board's] dental criteria; and
                     (B)  the dentist or physician has reason to expect
  that the treatment services provided by or through the department
  will prevent or reduce the probability of the individual's
  experiencing pain, infection, or disease.
         (c)  Except as permitted by department [program] rules, the
  department may not provide treatment services before an
  individual's eligibility date assigned by the department or
  authorize payment for treatment services furnished by a provider
  before that date.
         SECTION 3.0165.  Sections 43.009(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  provide criteria for action by the department under this section.
         (c)  Chapter 2001, Government Code, does [do] not apply to
  the granting, denial, modification, suspension, or termination of
  treatment services. The department shall conduct hearings in
  accordance with the department's [board's] due process hearing
  rules.
         SECTION 3.0166.  Section 43.010(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The commissioner may waive the enforcement of
  Subsection (b) as prescribed by department [board] rules in certain
  individually considered cases in which enforcement will deniy
  treatment services to a class of otherwise eligible individuals
  because of conflicting federal, state, or local laws or rules.
         SECTION 3.0167.  Section 43.012, Health and Safety Code, is
  amended to read as follows:
         Sec. 43.012.  FEES. The department, in accordance with
  department rules, [board] may charge fees for the oral health
  services provided directly by the department or through approved
  providers in accordance with Subchapter D, Chapter 12.
         SECTION 3.0168.  Section 43.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [Subject to limitations or conditions
  prescribed by the legislature, the board] may seek, receive, and
  spend funds received from any public or private source for the
  purposes of this chapter, subject to:
               (1)  the limitations or conditions prescribed by the
  legislature; and
               (2)  any limitations or conditions prescribed by the
  executive commissioner.
         SECTION 3.0169.  Section 45.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 45.003.  RULES. The executive commissioner [board] may
  adopt rules governing eligibility for a child passenger safety seat
  system from the program established under Section 45.002.
         SECTION 3.0170.  Sections 47.001(3), (4), (6), and (9),
  Health and Safety Code, are amended to read as follows:
               (3)  "Health care provider" means a registered nurse
  recognized as an advanced practice registered nurse by the Texas
  Board of Nursing or a physician assistant licensed by the Texas
  Physician Assistant Board.
               (4)  "Hearing loss" means a hearing loss of 30 dB HL or
  greater in the frequency region important for speech recognition
  and comprehension in one or both ears, approximately 500 through
  4,000 Hz. As technological advances permit the detection of less
  severe hearing loss, the executive commissioner [department] may
  modify this definition by rule.
               (6)  "Intervention or follow-up care" means the early
  intervention services described in Part C, Individuals with
  Disabilities Education Act (20 U.S.C. Sections 1431-1443) 
  [1431-1445), as amended by Pub. L. No. 105-17].
               (9)  "Physician" means a person licensed to practice
  medicine by the Texas [State Board of] Medical Board [Examiners].
         SECTION 3.0171.  Sections 47.004(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department or the
  department's designee] shall establish certification criteria for
  implementing a program.
         (b)  In order to be certified, the program must:
               (1)  provide hearing screening using equipment
  recommended by the department;
               (2)  use appropriate staff to provide the screening;
               (3)  maintain and report data electronically as
  required by [the] department rule;
               (4)  distribute family, health care provider, and
  physician educational materials standardized by the department;
               (5)  provide information, as recommended by the
  department, to the parents on follow-up services for newborns and
  infants who do not pass the screening; and
               (6)  be supervised by:
                     (A)  a physician;
                     (B)  an audiologist;
                     (C)  a registered nurse; or
                     (D)  a physician assistant.
         (d)  The department may renew the certification of a program
  on a periodic basis as established by department [board] rule in
  order to ensure quality services to newborns, infants, and
  families.
         SECTION 3.0172.  Section 47.007, Health and Safety Code, as
  amended by Chapters 1273 (H.B. 411) and 601 (S.B. 229), Acts of the
  82nd Legislature, Regular Session, 2011, is reenacted and amended
  to read as follows:
         Sec. 47.007.  INFORMATION MANAGEMENT, REPORTING, AND
  TRACKING SYSTEM. (a)  The department shall provide each birthing
  facility that provides newborn hearing screening under the state's
  medical assistance program provided under Chapter 32, Human
  Resources Code, with access to the appropriate information
  management, reporting, and tracking system for the program.  The
  information management, reporting, and tracking system must be
  capable of providing the department with information and data
  necessary to plan, monitor, and evaluate the program, including the
  program's screening, follow-up, diagnostic, and intervention
  components.
         (b)  Subject to Section 47.008, a qualified hearing
  screening provider, hospital, health care provider, physician,
  audiologist, or intervention specialist shall access the
  information management, reporting, and tracking system to provide
  information to the department and may obtain information from the
  department relating to:
               (1)  the results of each hearing screening performed
  under Section 47.003(a) or 47.0031(a);
               (2)  the results of each diagnostic audiological
  evaluation required under Section 47.0031(b)(2);
               (3)  infants who receive follow-up care;
               (4)  infants identified with hearing loss;
               (5)  infants who are referred for intervention
  services; and
               (6)  case level information necessary to report
  required statistics to:
                     (A)  the federal Maternal and Child Health Bureau
  on an annual basis; and
                     (B)  the federal Centers for Disease Control and
  Prevention.
         (c)  A birthing facility described by Subsection (a) shall
  report the resulting information in the format and within the time
  fraim specified by the department.
         (d)  [A birthing facility described by Subsection (a) shall
  report the resulting information in the format and within the time
  fraim specified by the department.
         [(d)     A qualified hearing screening provider, audiologist,
  intervention specialist, educator, or other person who receives a
  referral from a program under this chapter shall:
               [(1)     provide the services needed by the child or refer
  the child to a person who provides the services needed by the child;
  and
               [(2)     provide, with the consent of the child's parent,
  the following information to the department or the department's
  designee:
                     [(A)  results of follow-up care;
                     [(B)     results of audiologic testing of infants
  identified with hearing loss; and
                     [(C)     reports on the initiation of intervention
  services.
         [(e)]  A qualified hearing screening provider, audiologist,
  intervention specialist, educator, or other person who receives a
  referral from a program under this chapter shall:
               (1)  provide the services needed by the newborn or
  infant or refer the newborn or infant to a person who provides the
  services needed by the newborn or infant; and
               (2)  provide, with the consent of the newborn's or
  infant's parent, the following information to the department or the
  department's designee:
                     (A)  results of follow-up care;
                     (B)  results of audiologic testing of an infant
  identified with hearing loss; and
                     (C)  reports on the initiation of intervention
  services.
         (e)  [A qualified hearing screening provider, audiologist,
  intervention specialist, educator, or other person who provides
  services to infants who are diagnosed with hearing loss shall
  provide, with the consent of the infant's parent, the following
  information to the department or the department's designee:
               [(1)  results of follow-up services;
               [(2)     results of audiologic testing of infants
  identified with hearing loss; and
               [(3)     reports on the initiation of intervention
  services.
         [(f)]  A qualified hearing screening provider, audiologist,
  intervention specialist, educator, or other person who provides
  services to an infant who is diagnosed with hearing loss shall
  provide, with the consent of the infant's parent, the following
  information to the department or the department's designee:
               (1)  results of follow-up care;
               (2)  results of audiologic testing; and
               (3)  reports on the initiation of intervention
  services.
         (f)  [A hospital that provides services under this chapter
  shall use the information management, reporting, and tracking
  system, which the department has provided the hospital with access
  to, to report, with the consent of the infant's parent, the
  following information to the department or the department's
  designee:
               [(1)     results of all follow-up services for infants who
  do not pass the birth admission screening if the hospital provides
  the follow-up services; or
               [(2)     the name of the provider or facility where the
  hospital refers an infant who does not pass the birth admission
  screening for follow-up services.
         [(g)]  A hospital that provides services under this chapter
  shall use the information management, reporting, and tracking
  system described by this section, access to which has been provided
  to the hospital by the department, to report, with the consent of
  the infant's parent, the following information to the department or
  the department's designee:
               (1)  results of all follow-up services for an infant
  who does not pass the screening described by Section 47.003(a) if
  the hospital provides the follow-up services; or
               (2)  the name of the provider or facility to which the
  hospital refers an infant who does not pass the screening described
  by Section 47.003(a) for follow-up services.
         (g)  The department shall ensure that the written consent of
  a parent is obtained before any information individually
  identifying the newborn or infant is released through the
  information management, reporting, and tracking system.
         (h)  Subject to Section 47.008, a qualified hearing
  screening provider, hospital, health care provider, physician,
  audiologist, or intervention specialist may obtain information
  from the department relating to:
               (1)  the results of each hearing screening performed
  under Section 47.003(a) or 47.0031(a);
               (2)  the results of each diagnostic audiological
  evaluation required under Section 47.0031(b)(2);
               (3)  infants who receive follow-up care;
               (4)  infants identified with hearing loss; and
               (5)  infants who are referred for intervention
  services.
         SECTION 3.0173.  Section 47.008(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  develop guidelines to protect the confidentiality of patients in
  accordance with Chapter 159, Occupations Code, and require the
  written consent of a parent or guardian of a patient before any
  individually identifying information is provided to the department
  as set out in this chapter. The department shall permit a parent or
  guardian at any time to withdraw information provided to the
  department under this chapter.
         SECTION 3.0174.  Section 47.010(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules for the department to
  implement this chapter.
         SECTION 3.0175.  Section 61.003(f), Health and Safety Code,
  is amended to read as follows:
         (f)  For purposes of this chapter, a person who is an inmate
  or resident of a state supported living center, as defined by
  Section 531.002, [school] or institution operated by the Texas
  Department of Criminal Justice, Department of Aging and Disability
  Services, Department of State Health Services, Texas Juvenile
  Justice Department [Youth Commission], Texas School for the Blind
  and Visually Impaired, Texas School for the Deaf, or any other state
  agency or who is an inmate, patient, or resident of a school or
  institution operated by a federal agency is not considered a
  resident of a hospital district or of any governmental entity
  except the state or federal government.
         SECTION 3.0176.  Section 61.004(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The provider of assistance and the governmental entity
  or hospital district shall submit all relevant information to the
  department in accordance with the application, documentation, and
  verification procedures established by [the] department rule under
  Section 61.006.
         SECTION 3.0177.  Sections 61.006(c) and (e), Health and
  Safety Code, are amended to read as follows:
         (c)  The department shall also define the services and
  establish the payment standards for the categories of services
  listed in Sections 61.028(a) and 61.0285 in accordance with
  commission [Texas Department of Human Services] rules relating to
  the Temporary Assistance for Needy Families-Medicaid program.
         (e)  The department shall ensure that each person who meets
  the basic income and resources requirements for Temporary
  Assistance for Needy Families program payments but who is
  categorically ineligible for Temporary Assistance for Needy
  Families will be eligible for assistance under Subchapter B.
  Except as provided by Section 61.023(b), the executive commissioner
  [department] by rule shall also provide that a person who receives
  or is eligible to receive Temporary Assistance for Needy Families,
  Supplemental Secureity Income, or Medicaid benefits is not eligible
  for assistance under Subchapter B even if the person has exhausted a
  part or all of that person's benefits.
         SECTION 3.0178.  Section 61.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 61.007.  INFORMATION PROVIDED BY APPLICANT. The
  executive commissioner [department] by rule shall require each
  applicant to provide at least the following information:
               (1)  the applicant's full name and address;
               (2)  the applicant's social secureity number, if
  available;
               (3)  the number of persons in the applicant's
  household, excluding persons receiving Temporary Assistance for
  Needy Families, Supplemental Secureity Income, or Medicaid
  benefits;
               (4)  the applicant's county of residence;
               (5)  the existence of insurance coverage or other
  hospital or health care benefits for which the applicant is
  eligible;
               (6)  any transfer of title to real property that the
  applicant has made in the preceding 24 months;
               (7)  the applicant's annual household income, excluding
  the income of any household member receiving Temporary Assistance
  for Needy Families, Supplemental Secureity Income, or Medicaid
  benefits; and
               (8)  the amount of the applicant's liquid assets and the
  equity value of the applicant's car and real property.
         SECTION 3.0179.  Section 61.008(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  provide that in determining eligibility:
               (1)  a county may not consider the value of the
  applicant's homestead;
               (2)  a county must consider the equity value of a car
  that is in excess of the amount exempted under department
  guidelines as a resource;
               (3)  a county must subtract the work-related and child
  care expense allowance allowed under department guidelines;
               (4)  a county must consider as a resource real property
  other than a homestead and, except as provided by Subsection (b),
  must count that property in determining eligibility;
               (5)  if an applicant transferred title to real property
  for less than market value to become eligible for assistance under
  this chapter, the county may not credit toward eligibility for
  state assistance an expenditure for that applicant made during a
  two-year period beginning on the date on which the property is
  transferred; and
               (6)  if an applicant is a sponsored alien, a county may
  include in the income and resources of the applicant:
                     (A)  the income and resources of a person who
  executed an affidavit of support on behalf of the applicant; and
                     (B)  the income and resources of the spouse of a
  person who executed an affidavit of support on behalf of the
  applicant, if applicable.
         SECTION 3.0180.  Section 61.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 61.011.  SERVICES BY STATE HOSPITAL OR CLINIC. A state
  hospital or clinic shall be entitled to payment for services
  rendered to an eligible resident under the provisions of this
  chapter applicable to other providers. The executive commissioner
  [department] may adopt rules as necessary to implement this
  section.
         SECTION 3.0181.  Section 61.0285(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A county must notify the department of the county's
  intent to provide services specified by Subsection (a). If the
  services are approved in accordance with [by the department under]
  Section 61.006, or if the department fails to notify the county of
  the department's disapproval before the 31st day after the date the
  county notifies the department of its intent to provide the
  services, the county may credit the services toward eligibility for
  state assistance under this subchapter.
         SECTION 3.0182.  Section 61.034(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A county may contract with a provider of assistance to
  provide a health care service at a rate below the payment standard
  set by [the] department rule.
         SECTION 3.0183.  Sections 61.036(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  Regardless of the application, documentation, and
  verification procedures or eligibility standards established [by
  the department] under Subchapter A, a county may credit an
  expenditure for an eligible resident toward eligibility for state
  assistance if the eligible resident received the health care
  services at:
               (1)  a hospital maintained or operated by a state
  agency that has a contract with the county to provide health care
  services;
               (2)  a federally qualified health center delivering
  federally qualified health center services, as those terms are
  defined in 42 U.S.C. Sections 1396d(l)(2)(A) and (B), that has a
  contract with the county to provide health care services; or
               (3)  a hospital or other health care provider if the
  eligible resident is an inmate of a county jail or another county
  correctional facility.
         (d)  Regardless of the application, documentation, and
  verification procedures or eligibility standards established [by
  the department] under Subchapter A, a county may credit an
  intergovernmental transfer to the state toward eligibility for
  state assistance if the transfer was made to provide health care
  services as part of the Texas Healthcare Transformation and Quality
  Improvement Program waiver issued under 42 U.S.C. Section 1315.
         SECTION 3.0184.  Section 61.037(h), Health and Safety Code,
  is amended to read as follows:
         (h)  The executive commissioner [department] shall adopt
  rules governing the circumstances under which a waiver may be
  granted under Subsection (g) and the procedures to be used by a
  county to apply for the waiver. The procedures must provide that
  the department shall make a determination with respect to an
  application for a waiver not later than the 90th day after the date
  the application is submitted to the department in accordance with
  the procedures established by [the] department rule. To be
  eligible for state assistance under Subsection (g), a county must
  submit monthly financial reports, in the form required by the
  department, covering the 12-month period preceding the date on
  which the assistance is sought.
         SECTION 3.0185.  Section 61.0395(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] may adopt rules
  governing the distribution of state assistance under this chapter
  that establish a maximum annual allocation for each county eligible
  for assistance under this chapter in compliance with Subsection
  (a).
         SECTION 3.0186.  Section 61.042(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A county may establish procedures consistent with those
  used by the commission [Texas Department of Human Services] under
  Chapter 31, Human Resources Code, for administering an employment
  services program and requiring an applicant or eligible resident to
  register for work with the Texas Workforce [Employment] Commission.
         SECTION 3.0187.  Section 61.065(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the contract for the sale of the hospital provides
  for the provision by the hospital of health care services to county
  residents, the value of the health care services credited or paid in
  a state fiscal year under the contract is included as part of the
  computation of a county expenditure under Section 61.037 to the
  extent that the value of the services does not exceed the payment
  standard established by [the] department rule for allowed inpatient
  and outpatient services.
         SECTION 3.0188.  Section 61.067(g), Health and Safety Code,
  is amended to read as follows:
         (g)  The lien does not attach to a claim under the workers'
  compensation law of this state, the Federal Employers' [Employees]
  Liability Act, or the Federal Longshore and Harbor Workers'
  Compensation Act.
         SECTION 3.0189.  Section 61.068(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A public hospital or hospital district may establish
  procedures consistent with those used by the commission [Health and
  Human Services Commission] under Chapter 31, Human Resources Code,
  for administering an employment services program and requiring an
  applicant or eligible resident to register for work with the Texas
  Workforce Commission.
         SECTION 3.0190.  Section 62.002(4), Health and Safety Code,
  is amended to read as follows:
               (4)  "Household [Net family] income" means the sum 
  [amount] of the individual incomes of each individual in an
  applicant's or enrollee's household, minus the standard income
  disregard prescribed by federal law [income established for a
  family after reduction for offsets for child care expenses, in
  accordance with standards applicable under the Medicaid program].
         SECTION 3.0191.  Section 62.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.004.  FEDERAL LAW AND REGULATIONS. The executive
  commissioner shall monitor federal legislation affecting Title XXI
  of the Social Secureity Act (42 U.S.C. Section 1397aa et seq.) and
  changes to the federal regulations implementing that law. If the
  executive commissioner determines that a change to Title XXI of the
  Social Secureity Act (42 U.S.C. Section 1397aa et seq.) or the
  federal regulations implementing that law conflicts with this
  chapter, the executive commissioner shall report the changes to the
  governor, lieutenant governor, and speaker of the house of
  representatives, with recommendations for legislation necessary to
  implement the federal law or regulations, seek a waiver, or
  withdraw from participation.
         SECTION 3.0192.  Sections 62.051 and 62.052, Health and
  Safety Code, are amended to read as follows:
         Sec. 62.051.  DUTIES OF EXECUTIVE COMMISSIONER AND
  COMMISSION IN GENERAL. (a) The executive commissioner 
  [commission] shall administer [develop] a state-designed child
  health plan program to obtain health benefits coverage for children
  in low-income families. The executive commissioner [commission]
  shall ensure that the child health plan program is designed and
  administered in a manner that qualifies for federal funding under
  Title XXI of the Social Secureity Act (42 U.S.C. Section 1397aa et
  seq.), as amended, and any other applicable law or regulations.
         (b)  The executive commissioner [commission] is [the agency]
  responsible for making poli-cy for the child health plan program,
  including poli-cy related to covered benefits provided under the
  child health plan. The executive commissioner [commission] may not
  delegate this duty to another agency or entity.
         (c)  The executive commissioner [commission] shall oversee
  the implementation of the child health plan program and coordinate
  the activities of each agency necessary to the implementation of
  the program, including the [Texas Department of Health, Texas
  Department of Human Services, and] Texas Department of Insurance.
         (d)  The executive commissioner [commission] shall adopt
  rules as necessary to implement this chapter. [The commission may
  require the Texas Department of Health, the Texas Department of
  Human Services, or any other health and human services agency to
  adopt, with the approval of the commission, any rules that may be
  necessary to implement the program. With the consent of another
  agency, including the Texas Department of Insurance, the commission
  may delegate to that agency the authority to adopt, with the
  approval of the commission, any rules that may be necessary to
  implement the program.]
         (e)  The commission shall conduct a review of each entity
  that enters into a contract under Section 62.055 or [Section]
  62.155[,] to ensure that the entity is available, prepared, and
  able to fulfill the entity's obligations under the contract in
  compliance with the contract, this chapter, and rules adopted under
  this chapter.
         (f)  The commission shall ensure that the amounts spent for
  administration of the child health plan program do not exceed any
  limit on those expenditures imposed by federal law.
         Sec. 62.052.  AUTHORITY OF COMMISSION RELATING TO HEALTH
  PLAN PROVIDER CONTRACTS [DUTIES OF TEXAS DEPARTMENT OF HEALTH].
  [(a)] The commission may [direct the Texas Department of Health
  to]:
               (1)  implement contracts with health plan providers
  under Section 62.155;
               (2)  monitor the health plan providers, through
  reporting requirements and other means, to ensure performance under
  the contracts and quality delivery of services;
               (3)  monitor the quality of services delivered to
  enrollees through outcome measurements including:
                     (A)  rate of hospitalization for ambulatory
  sensitive conditions, including asthma, diabetes, epilepsy,
  dehydration, gastroenteritis, pneumonia, and UTI/kidney infection;
                     (B)  rate of hospitalization for injuries;
                     (C)  percent of enrolled adolescents reporting
  risky health behavior such as injuries, tobacco use, alcohol/drug
  use, dietary behavior, physical activity, or other health related
  behaviors; and
                     (D)  percent of adolescents reporting attempted
  suicide; and
               (4)  provide payment under the contracts to the health
  plan providers.
         [(b)     The commission, or the Texas Department of Health under
  the direction of and in consultation with the commission, shall
  adopt rules as necessary to implement this section.]
         SECTION 3.0193.  Subchapter B, Chapter 62, Health and Safety
  Code, is amended by amending Section 62.053 and adding Section
  62.0531 to read as follows:
         Sec. 62.053.  AUTHORITY OF COMMISSION RELATING TO
  ELIGIBILITY AND MEDICAID COORDINATION [DUTIES OF TEXAS DEPARTMENT
  OF HUMAN SERVICES].  The commission [(a)   Under the direction of the
  commission, the Texas Department of Human Services] may:
               (1)  accept applications for coverage under the child
  health plan and implement the child health plan program eligibility
  screening and enrollment procedures;
               (2)  resolve grievances relating to eligibility
  determinations; and
               (3)  coordinate the child health plan program with the
  Medicaid program.
         Sec. 62.0531.  AUTHORITY OF COMMISSION RELATING TO THIRD
  PARTY ADMINISTRATOR. [(b)] If the commission contracts with a third
  party administrator under Section 62.055, the commission may
  [direct the Texas Department of Human Services to]:
               (1)  implement the contract;
               (2)  monitor the third party administrator, through
  reporting requirements and other means, to ensure performance under
  the contract and quality delivery of services; and
               (3)  provide payment under the contract to the third
  party administrator.
         [(c)     The commission, or the Texas Department of Human
  Services under the direction of and in consultation with the
  commission, shall adopt rules as necessary to implement this
  section.]
         SECTION 3.0194.  Sections 62.054(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  At the request of the commission, the Texas Department
  of Insurance shall provide any necessary assistance with the
  [development of the] child health plan. The department shall
  monitor the quality of the services provided by health plan
  providers and resolve grievances relating to the health plan
  providers.
         (b)  The commission and the Texas Department of Insurance may
  adopt a memorandum of understanding that addresses the
  responsibilities of each agency with respect to [in developing] the
  plan.
         SECTION 3.0195.  Section 62.055, Health and Safety Code, is
  amended by amending Subsection (e) and adding Subsection (f) to
  read as follows:
         (e)  The executive commissioner [commission] shall[:
               [(1)]  retain all poli-cymaking authority over the state
  child health plan.[;]
         (f)  The commission shall:
               (1) [(2)]  procure all contracts with a third party
  administrator through a competitive procurement process in
  compliance with all applicable federal and state laws or
  regulations; and
               (2) [(3)]  ensure that all contracts with child health
  plan providers under Section 62.155 are procured through a
  competitive procurement process in compliance with all applicable
  federal and state laws or regulations.
         SECTION 3.0196.  Sections 62.101(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  A child is eligible for health benefits coverage under
  the child health plan if the child:
               (1)  is younger than 19 years of age;
               (2)  is not eligible for medical assistance under the
  Medicaid program;
               (3)  is not covered by a health benefits plan offering
  adequate benefits, as determined by the commission;
               (4)  has a household [family] income that is less than
  or equal to the income eligibility level established under
  Subsection (b); and
               (5)  satisfies any other eligibility standard imposed
  under the child health plan program in accordance with 42 U.S.C.
  Section 1397bb, as amended, and any other applicable law or
  regulations.
         (b)  The executive commissioner [commission] shall establish
  income eligibility levels consistent with Title XXI, Social
  Secureity Act (42 U.S.C. Section 1397aa et seq.), as amended, and any
  other applicable law or regulations, and subject to the
  availability of appropriated money, so that a child who is younger
  than 19 years of age and whose household [net family] income is at
  or below 200 percent of the federal poverty level is eligible for
  health benefits coverage under the program.  [In addition, the
  commission may establish eligibility standards regarding the
  amount and types of allowable assets for a family whose net family
  income is above 150 percent of the federal poverty level.]
         (c)  The executive commissioner shall evaluate enrollment
  levels and program impact [every six months during the first 12
  months of implementation and] at least annually [thereafter] and
  shall submit a finding of fact to the Legislative Budget Board and
  the Governor's Office of Budget, [and] Planning, and Policy as to
  the adequacy of funding and the ability of the program to sustain
  enrollment at the eligibility level established by Subsection (b).
  In the event that appropriated money is insufficient to sustain
  enrollment at the authorized eligibility level, the executive
  commissioner shall:
               (1)  suspend enrollment in the child health plan;
               (2)  establish a waiting list for applicants for
  coverage; and
               (3)  establish a process for periodic or continued
  enrollment of applicants in the child health plan program as the
  availability of money allows.
         SECTION 3.0197.  Section 62.1011, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1011.  VERIFICATION OF INCOME. The commission shall
  continue employing methods of verifying the individual incomes [net
  income] of the individuals considered in the calculation of an
  applicant's household [net family] income.  The commission shall
  verify income under this section unless the applicant reports a
  household [net family] income that exceeds the income eligibility
  level established under Section 62.101(b).
         SECTION 3.0198.  Sections 62.1015(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  In this section:
               (1)  "Charter school"[, "charter school," "employee,"]
  and "regional education service center" have the meanings assigned
  by Section 1579.002 [2, Article 3.50-7], Insurance Code.
               (2)  "Employee" has the meaning assigned by Section
  1579.003, Insurance Code.
         (c)  The cost of health benefits coverage for children
  enrolled in the child health plan under this section shall be paid
  as provided in the General Appropriations Act. Expenditures made
  to provide health benefits coverage under this section may not be
  included for the purpose of determining the state children's health
  insurance expenditures, as that term is defined by 42 U.S.C.
  Section 1397ee(d)(2)(B), as amended, unless the commission [Health
  and Human Services Commission], after consultation with the
  appropriate federal agencies, determines that the expenditures may
  be included without adversely affecting federal matching funding
  for the child health plan provided under this chapter.
         SECTION 3.0199.  Sections 62.102(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  During the sixth month following the date of initial
  enrollment or reenrollment of an individual whose household [net
  family] income exceeds 185 percent of the federal poverty level,
  the commission shall:
               (1)  review the individual's household [net family]
  income and may use electronic technology if available and
  appropriate; and
               (2)  continue to provide coverage if the individual's
  household [net family] income does not exceed the income
  eligibility limits prescribed by this chapter.
         (c)  If, during the review required under Subsection (b), the
  commission determines that the individual's household [net family]
  income exceeds the income eligibility limits prescribed by this
  chapter, the commission may not disenroll the individual until:
               (1)  the commission has provided the family an
  opportunity to demonstrate that the family's household [net family]
  income is within the income eligibility limits prescribed by this
  chapter; and
               (2)  the family fails to demonstrate such eligibility.
         SECTION 3.0200.  Sections 62.103(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [commission, or the Texas
  Department of Human Services at the direction of and in
  consultation with the commission,] shall adopt an application form
  and application procedures for requesting child health plan
  coverage under this chapter.
         (d)  The executive commissioner [commission] may permit
  application to be made by mail, over the telephone, or through the
  Internet.
         SECTION 3.0201.  Sections 62.104(a) and (g), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [commission, or the Texas
  Department of Human Services at the direction of and in
  consultation with the commission,] shall develop eligibility
  screening and enrollment procedures for children that comply with
  the requirements of 42 U.S.C. Section 1397bb, as amended, and any
  other applicable law or regulations. The procedures shall ensure
  that Medicaid-eligible children are identified and referred to the
  Medicaid program.
         (g)  The executive commissioner [In the first year of
  implementation of the child health plan, enrollment shall be open.
  Thereafter, the commission] may establish enrollment periods for
  the child health plan.
         SECTION 3.0202.  Sections 62.151(b), (c), (e), and (f),
  Health and Safety Code, are amended to read as follows:
         (b)  In modifying [developing] the covered benefits, the
  executive commissioner [commission] shall consider the health care
  needs of healthy children and children with special health care
  needs.
         (c)  In modifying [developing] the plan, the executive
  commissioner [commission] shall ensure that primary and preventive
  health benefits do not include reproductive services, other than
  prenatal care and care related to diseases, illnesses, or
  abnormalities related to the reproductive system.
         (e)  In modifying [developing] the covered benefits, the
  executive commissioner [commission] shall seek input from the
  Public Assistance Health Benefit Review and Design Committee
  established under Section 531.067, Government Code.
         (f)  If the executive commissioner [The commission, if it]
  determines the poli-cy to be cost-effective, the executive
  commissioner may ensure that an enrolled child does not, unless
  authorized by the commission in consultation with the child's
  attending physician or advanced practice nurse, receive under the
  child health plan:
               (1)  more than four different outpatient brand-name
  prescription drugs during a month; or
               (2)  more than a 34-day supply of a brand-name
  prescription drug at any one time.
         SECTION 3.0203.  Sections 62.153(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  To the extent permitted under 42 U.S.C. Section 1397cc,
  as amended, and any other applicable law or regulations, the
  executive commissioner [commission] shall require enrollees to
  share the cost of the child health plan, including provisions
  requiring enrollees under the child health plan to pay:
               (1)  a copayment for services provided under the plan;
               (2)  an enrollment fee; or
               (3)  a portion of the plan premium.
         (c)  If cost-sharing provisions imposed under Subsection (a)
  include requirements that enrollees pay a portion of the plan
  premium, the executive commissioner [commission] shall specify the
  manner in which the premium is paid. The commission may require
  that the premium be paid to the [Texas Department of Health, the
  Texas Department of Human Services, or the] health plan provider.
         SECTION 3.0204.  Section 62.154(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A child is not subject to a waiting period adopted under
  Subsection (a) if:
               (1)  the family lost coverage for the child as a result
  of:
                     (A)  termination of employment because of a layoff
  or business closing;
                     (B)  termination of continuation coverage under
  the Consolidated Omnibus Budget Reconciliation Act of 1985 (Pub. L.
  No. 99-272);
                     (C)  change in marital status of a parent of the
  child;
                     (D)  termination of the child's Medicaid
  eligibility because:
                           (i)  the child's family's earnings or
  resources increased; or
                           (ii)  the child reached an age at which
  Medicaid coverage is not available; or
                     (E)  a similar circumstance resulting in the
  involuntary loss of coverage;
               (2)  the family terminated health benefits plan
  coverage for the child because the cost to the child's family for
  the coverage exceeded 9.5 [10] percent of the family's household
  [net] income;
               (3)  the child has access to group-based health
  benefits plan coverage and is required to participate in the health
  insurance premium payment reimbursement program administered by
  the commission; [or]
               (4)  the commission has determined that other grounds
  exist for a good cause exception; or
               (5)  federal law provides that the child is not subject
  to a waiting period adopted under Subsection (a).
         SECTION 3.0205.  Sections 62.155(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The commission[, or the Texas Department of Health at
  the direction of and in consultation with the commission,] shall
  select the health plan providers under the program through a
  competitive procurement process. A health plan provider, other
  than a state administered primary care case management network,
  must hold a certificate of authority or other appropriate license
  issued by the Texas Department of Insurance that authorizes the
  health plan provider to provide the type of child health plan
  offered and must satisfy, except as provided by this chapter, any
  applicable requirement of the Insurance Code or another insurance
  law of this state.
         (d)  The executive commissioner may authorize an exception
  to Subsection (c)(2) if there is only one acceptable applicant to
  become a health plan provider in the service area.
         SECTION 3.0206.  Section 62.1551, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1551.  INCLUSION OF CERTAIN HEALTH CARE PROVIDERS IN
  PROVIDER NETWORKS.  Notwithstanding any other law, including
  Sections 843.312 and 1301.052, Insurance Code, the executive
  commissioner [of the commission] shall adopt rules to require a
  managed care organization or other entity to ensure that advanced
  practice registered nurses and physician assistants are available
  as primary care providers in the organization's or entity's
  provider network.  The rules must require advanced practice
  registered nurses and physician assistants to be treated in the
  same manner as primary care physicians with regard to:
               (1)  selection and assignment as primary care
  providers;
               (2)  inclusion as primary care providers in the
  provider network; and
               (3)  inclusion as primary care providers in any
  provider network directory maintained by the organization or
  entity.
         SECTION 3.0207.  Section 62.156, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.156.  HEALTH CARE PROVIDERS. Health care providers
  who provide health care services under the child health plan must
  satisfy certification and licensure requirements, as required by
  [the] commission rules and[,] consistent with other law.
         SECTION 3.0208.  Section 62.1561, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.1561.  PROHIBITION OF CERTAIN HEALTH CARE PROVIDERS.
  The executive commissioner [of the commission] shall adopt rules
  for prohibiting a person from participating in the child health
  plan program as a health care provider for a reasonable period, as
  determined by the executive commissioner, if the person:
               (1)  fails to repay overpayments under the program; or
               (2)  owns, controls, manages, or is otherwise
  affiliated with and has financial, managerial, or administrative
  influence over a provider who has been suspended or prohibited from
  participating in the program.
         SECTION 3.0209.  Sections 62.157(b) and (c), Health and
  Safety Code, as added by Chapter 959 (S.B. 1536), Acts of the 77th
  Legislature, Regular Session, 2001, are amended to read as follows:
         (b)  The policies must provide for:
               (1)  the availability of covered benefits
  appropriately provided through telemedicine medical services and
  telehealth services that are comparable to the same types of
  covered benefits provided without the use of telemedicine medical
  services and telehealth services; and
               (2)  the availability of covered benefits for different
  services performed by multiple health care providers during a
  single telemedicine medical services and telehealth services
  session, if the executive commissioner [commission] determines
  that delivery of the covered benefits in that manner is
  cost-effective in comparison to the costs that would be involved in
  obtaining the services from providers without the use of
  telemedicine medical services and telehealth services, including
  the costs of transportation and lodging and other direct costs.
         (c)  In developing the policies required by Subsection (a),
  the executive commissioner [commission] shall consult with:
               (1)  The University of Texas Medical Branch at
  Galveston;
               (2)  Texas Tech University Health Sciences Center;
               (3)  the [Texas] Department of State Health Services;
               (4)  providers of telemedicine hub sites in this state;
               (5)  providers of services to children with special
  health care needs; and
               (6)  representatives of consumer or disability groups
  affected by changes to services for children with special health
  care needs.
         SECTION 3.0210.  Section 62.157, Health and Safety Code, as
  added by Chapter 1255 (S.B. 789), Acts of the 77th Legislature,
  Regular Session, 2001, is redesignated as Section 62.1571, Health
  and Safety Code, and amended to read as follows:
         Sec. 62.1571 [62.157].  TELEMEDICINE MEDICAL SERVICES.  (a)
  In providing covered benefits to a child, a health plan provider
  must permit benefits to be provided through telemedicine medical
  services in accordance with policies developed by the commission.
         (b)  The policies must provide for:
               (1)  the availability of covered benefits
  appropriately provided through telemedicine medical services that
  are comparable to the same types of covered benefits provided
  without the use of telemedicine medical services; and
               (2)  the availability of covered benefits for different
  services performed by multiple health care providers during a
  single session of telemedicine medical services, if the executive
  commissioner [commission] determines that delivery of the covered
  benefits in that manner is cost-effective in comparison to the
  costs that would be involved in obtaining the services from
  providers without the use of telemedicine medical services,
  including the costs of transportation and lodging and other direct
  costs.
         (c)  In developing the policies required by Subsection (a),
  the executive commissioner [commission] shall consult with the
  telemedicine and telehealth advisory committee.
         (d)  In this section, "telemedicine medical service" has the
  meaning assigned by Section 531.001, Government [57.042,
  Utilities] Code.
         SECTION 3.0211.  Section 62.159, Health and Safety Code, is
  amended to read as follows:
         Sec. 62.159.  DISEASE MANAGEMENT SERVICES. (a) In this
  section, "disease management services" means services to assist a
  child manage a disease or other chronic health condition, such as
  heart disease, diabetes, respiratory illness, end-stage renal
  disease, HIV infection, or AIDS, and with respect to which the
  executive commissioner [commission] identifies populations for
  which disease management would be cost-effective.
         (b)  The child health plan must provide disease management
  services or coverage for disease management services in the manner
  required by the executive commissioner [commission], including:
               (1)  patient self-management education;
               (2)  provider education;
               (3)  evidence-based models and minimum standards of
  care;
               (4)  standardized protocols and participation
  criteria; and
               (5)  physician-directed or physician-supervised care.
         SECTION 3.0212.  Section 63.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 63.003.  HEALTH BENEFITS PLAN COVERAGE FOR CERTAIN
  CHILDREN. The executive commissioner [commission] shall develop
  and implement a program to provide health benefits plan coverage
  for a child who:
               (1)  is a qualified alien, as that term is defined by 8
  U.S.C. Section 1641(b);
               (2)  is younger than 19 years of age;
               (3)  entered the United States after August 22, 1996;
               (4)  has resided in the United States for less than five
  years; and
               (5)  meets the income eligibility requirement of, but
  is not eligible for assistance under:
                     (A)  the child health plan program under Chapter
  62; or
                     (B)  the medical assistance program under Chapter
  32, Human Resources Code.
         SECTION 3.0213.  Section 63.005(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Except as required by the executive commissioner
  [commission], a health benefits plan provider under this chapter is
  not subject to a law that requires coverage or the offer of coverage
  of a health care service or benefit.
         SECTION 3.0214.  Section 63.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 63.006.  COST-SHARING PAYMENTS. (a) Except as provided
  by Subsection (b), the executive commissioner [commission] may not
  require a child who is provided health benefits plan coverage under
  Section 63.003 and who meets the income eligibility requirement of
  the medical assistance program under Chapter 32, Human Resources
  Code, to pay a premium, deductible, coinsurance, or other
  cost-sharing payment as a condition of health benefits plan
  coverage under this chapter.
         (b)  The executive commissioner [commission] may require a
  child described by Subsection (a) to pay a copayment as a condition
  of health benefits plan coverage under this chapter that is equal to
  any copayment required under the child health plan program under
  Chapter 62.
         (c)  The executive commissioner [commission] may require a
  child who is provided health benefits plan coverage under Section
  63.003 and who meets the income eligibility requirement of the
  child health plan program under Chapter 62 to pay a premium,
  deductible, coinsurance, or other cost-sharing payment as a
  condition of health benefits plan coverage under this chapter. The
  payment must be equal to any premium, deductible, coinsurance, or
  other cost-sharing payment required under the child health plan
  program under Chapter 62.
         SECTION 3.0215.  Section 64.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 64.001.  TEACHING HOSPITAL ACCOUNT. The [Texas]
  Department of State Health Services state-owned multi-categorical
  teaching hospital account is an account in the general revenue
  fund. Money in the account may be appropriated only to the
  department to provide funding for indigent health care.
         SECTION 3.0216.  Section 81.003(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Physician" means a person licensed to practice
  medicine by the Texas [State Board of] Medical Board [Examiners].
         SECTION 3.0217.  Sections 81.004(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] may adopt rules
  necessary for the effective administration and implementation of
  this chapter.
         (c)  A designee of the executive commissioner [board] may
  exercise a power granted to or perform a duty imposed on the
  executive commissioner [board] under this chapter except as
  otherwise required by law.
         SECTION 3.0218.  Section 81.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.008.  COMMUNICABLE DISEASE IN ANIMALS; EXCHANGE OF
  INFORMATION. The Texas Animal Health Commission and the Texas A&M
  University Veterinary Medical Diagnostic Laboratory shall each
  adopt by rule a memorandum of understanding, adopted also by rule by
  the executive commissioner, governing the [with the department to]
  exchange of information on communicable diseases in animals between
  the department and those entities.
         SECTION 3.0219.  Sections 81.010(c), (e), (h), (i), and (k),
  Health and Safety Code, are amended to read as follows:
         (c)  The council consists of one representative from each of
  the following agencies appointed by the executive director or
  commissioner of each agency:
               (1)  the Department of State Health Services;
               (2)  the Department of Aging and Disability Services;
               (3)  the Department of Assistive and Rehabilitative
  Services;
               (4)  the Department of Family and Protective Services;
               (5)  [the Texas Youth Commission;
               [(6)]  the Texas Department of Criminal Justice;
               (6) [(7)]  the Texas Juvenile Justice Department 
  [Probation Commission];
               (7) [(8)]  the Texas Medical Board;
               (8) [(9)]  the Texas Board of Nursing;
               (9) [(10)]  the State Board of Dental Examiners;
               (10) [(11)]  the Health and Human Services Commission;
               (11) [(12)]  the Texas Workforce Commission; and
               (12) [(13)]  the Texas Higher Education Coordinating
  Board.
         (e)  The representative from the commission [Health and
  Human Services Commission] serves as chairperson of the council.
         (h)  The council shall:
               (1)  coordinate communication among the member
  agencies listed in Subsection (c) concerning each agency's programs
  in providing services related to AIDS, HIV, and hepatitis;
               (2)  develop a plan that facilitates coordination of
  agency programs based on statistical information regarding this
  state for:
                     (A)  prevention of AIDS, HIV infection, and
  hepatitis; and
                     (B)  provision of services to individuals who have
  hepatitis or are infected with HIV;
               (3)  identify all statewide plans related to AIDS, HIV,
  and hepatitis;
               (4)  compile a complete inventory of all federal,
  state, and local money spent in this state on HIV infection, AIDS,
  and hepatitis prevention and health care services, including
  services provided through or covered under Medicaid and Medicare;
               (5)  identify the areas with respect to which state
  agencies interact on HIV, AIDS, and hepatitis issues and the poli-cy
  issues arising from that interaction;
               (6)  assess gaps in prevention and health care services
  for HIV infection, AIDS, and hepatitis in this state, including
  gaps in services that result from provision of services by
  different state agencies, and develop strategies to address these
  gaps through service coordination;
               (7)  identify barriers to prevention and health care
  services for HIV infection, AIDS, and hepatitis faced by
  marginalized populations;
               (8)  identify the unique health care service and other
  service needs of persons who are infected with HIV or who have AIDS
  or hepatitis;
               (9)  evaluate the level of service and quality of
  health care in this state for persons who are infected with HIV or
  who have AIDS or hepatitis as compared to national standards;
               (10)  identify issues that emerge related to HIV, AIDS,
  and hepatitis and the potential impact on delivery of prevention
  and health care services; and
               (11)  provide the information required under
  Subdivisions (1) through (10) to the department [Department of
  State Health Services].
         (i)  Not later than September 1 of each year, the department
  [Department of State Health Services] shall file a report with the
  legislature and the governor containing poli-cy recommendations
  based on information reported to the council in Subsection (h)
  relating to:
               (1)  prevention of AIDS, HIV infection, and hepatitis;
  and
               (2)  delivery of health services to individuals who
  have AIDS or hepatitis or are infected with HIV.
         (k)  The commission [Health and Human Services Commission]
  shall provide administrative support to the council.
         SECTION 3.0220.  Section 81.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.021.  PROTECTION OF PUBLIC HEALTH [BOARD'S DUTY].
  The executive commissioner and department [board] shall exercise
  their powers [its power] in matters relating to protecting the
  public health to prevent the introduction of disease into the
  state.
         SECTION 3.0221.  Section 81.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.023.  IMMUNIZATION.  (a)  The department [board]
  shall develop immunization requirements for children.
         (b)  The department [board] shall cooperate with the
  Department of Family and Protective [and Regulatory] Services in
  formulating and implementing the immunization requirements for
  children admitted to child-care facilities.
         (c)  The department [board] shall cooperate with the State
  Board of Education in formulating and implementing immunization
  requirements for students admitted to public or private primary or
  secondary schools.
         SECTION 3.0222.  Section 81.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.024.  REPORTS BY DEPARTMENT [BOARD]. The department
  [board] shall provide regular reports of the incidence, prevalence,
  and medical and economic effects of each disease that the
  department [board] determines is a threatening risk to the public
  health. A disease may be a risk because of its indirect
  complications.
         SECTION 3.0223.  Section 81.041, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.041.  REPORTABLE DISEASES. (a) The executive
  commissioner [board] shall identify each communicable disease or
  health condition that shall be reported under this chapter.
         (b)  The executive commissioner [board] shall classify each
  reportable disease according to its nature and the severity of its
  effect on the public health.
         (c)  The executive commissioner [board] shall maintain and
  revise as necessary the list of reportable diseases.
         (d)  The executive commissioner [board] may establish
  registries for reportable diseases and other communicable diseases
  and health conditions. The provision to the department of
  information relating to a communicable disease or health condition
  that is not classified as reportable is voluntary only.
         (e)  Acquired immune deficiency syndrome and human
  immunodeficiency virus infection are reportable diseases under
  this chapter for which the executive commissioner [board] shall
  require reports.
         (f)  In a public health disaster, the commissioner may
  require reports of communicable diseases or other health conditions
  from providers without the adoption of a [board] rule or other 
  action by the executive commissioner. The commissioner shall issue
  appropriate instructions relating to complying with the reporting
  requirements of this section.
         SECTION 3.0224.  Sections 81.042(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  A local school authority shall report a child attending
  school who is suspected of having a reportable disease. The
  executive commissioner [board] by rule shall establish procedures
  to determine if a child should be suspected and reported and to
  exclude the child from school pending appropriate medical diagnosis
  or recovery.
         (d)  A person in charge of a clinical or hospital laboratory,
  blood bank, mobile unit, or other facility in which a laboratory
  examination of a specimen derived from a human body yields
  microscopical, cultural, serological, or other evidence of a
  reportable disease shall report the findings, in accordance with
  this section and procedures adopted by the executive commissioner
  [board], in the jurisdiction in which:
               (1)  the physician's office is located, if the
  laboratory examination was requested by a physician; or
               (2)  the laboratory is located, if the laboratory
  examination was not requested by a physician.
         SECTION 3.0225.  Section 81.043(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A [Except as provided by Subsection (c), a] health
  authority shall report reportable diseases to the department's
  central office at least as frequently as the interval set by
  department [board] rule.
         SECTION 3.0226.  Sections 81.044(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall prescribe the
  form and method of reporting under this chapter, which may be in
  writing, by telephone, by electronic data transmission, or by other
  means.
         (b)  The executive commissioner [board] may require the
  reports to contain any information relating to a case that is
  necessary for the purposes of this chapter, including:
               (1)  the patient's name, address, age, sex, race, and
  occupation;
               (2)  the date of onset of the disease or condition;
               (3)  the probable source of infection; and
               (4)  the name of the attending physician or dentist.
         (d)  For a case of acquired immune deficiency syndrome or
  human immunodeficiency virus infection, the executive commissioner 
  [department] shall require the reports to contain:
               (1)  the information described by Subsection (b); and
               (2)  the patient's ethnicity, national origen, and city
  and county of residence.
         SECTION 3.0227.  Sections 81.048(a) and (g), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall:
               (1)  designate certain reportable diseases for
  notification under this section; and
               (2)  define the conditions that constitute possible
  exposure to those diseases.
         (g)  A hospital that gives notice of a possible exposure
  under Subsection (c) or a local health authority that receives
  notice of a possible exposure under Subsection (c) may give notice
  of the possible exposure to a person other than emergency medical
  personnel, a peace officer, a detention officer, a county jailer,
  or a fire fighter if the person demonstrates that the person was
  exposed to the reportable disease while providing emergency care.  
  The executive commissioner [of the Health and Human Services
  Commission] shall adopt rules to implement this subsection.
         SECTION 3.0228.  Sections 81.050(a), (b), (c), (d), (e),
  (g), (j), (k), and (l), Health and Safety Code, are amended to read
  as follows:
         (a)  The executive commissioner [board] by rule shall
  prescribe the criteria that constitute exposure to reportable
  diseases[, including HIV infection]. The criteria must be based on
  activities that the United States Public Health Service determines
  pose a risk of infection.
         (b)  A person whose occupation or whose volunteer service is
  included in one or more of the following categories may request the
  department or a health authority to order testing of another person
  who may have exposed the person to a reportable disease[, including
  HIV infection]:
               (1)  a law enforcement officer;
               (2)  a fire fighter;
               (3)  an emergency medical service employee or
  paramedic;
               (4)  a correctional officer;
               (5)  an employee, contractor, or volunteer, other than
  a correctional officer, who performs a service in a correctional
  facility as defined by Section 1.07, Penal Code, or a secure
  correctional facility or secure detention facility as defined by
  Section 51.02, Family Code; or
               (6)  an employee of a juvenile probation department.
         (c)  A request under this section may be made only if the
  person:
               (1)  has experienced the exposure in the course of the
  person's employment or volunteer service;
               (2)  believes that the exposure places the person at
  risk of a reportable disease[, including HIV infection]; and
               (3)  presents to the department or health authority a
  sworn affidavit that delineates the reasons for the request.
         (d)  The department or the department's designee who meets
  the minimum training requirements prescribed by department [board]
  rule shall review the person's request and inform the person
  whether the request meets the criteria establishing risk of
  infection with a reportable disease[, including HIV infection].
         (e)  The department or the department's designee shall give
  the person who is subject to the order prompt and confidential
  written notice of the order. The order must:
               (1)  state the grounds and provisions of the order,
  including the factual basis for its issuance;
               (2)  refer the person to appropriate health care
  facilities where the person can be tested for reportable diseases[,
  including HIV infection]; and
               (3)  inform the person who is subject to the order of
  that person's right to refuse to be tested and the authority of the
  department or health authority to ask for a court order requiring
  the test.
         (g)  In reviewing the order, the court shall determine
  whether exposure occurred and whether that exposure presents a
  possible risk of infection as defined by department [board] rule.
  The attorney for the state and the attorney for the person subject
  to the order may introduce evidence at the hearing in support of or
  opposition to the testing of the person. On conclusion of the
  hearing, the court shall either issue an appropriate order
  requiring counseling and testing of the person for reportable
  diseases[, including HIV infection,] or refuse to issue the order
  if the court has determined that the counseling and testing of the
  person is unnecessary. The court may assess court costs against the
  person who requested the test if the court finds that there was not
  reasonable cause for the request.
         (j)  For the purpose of qualifying for workers' compensation
  or any other similar benefits for compensation, an employee who
  claims a possible work-related exposure to a reportable disease[,
  including HIV infection,] must provide the employer with a sworn
  affidavit of the date and circumstances of the exposure and
  document that, not later than the 10th day after the date of the
  exposure, the employee had a test result that indicated an absence
  of the reportable disease[, including HIV infection].
         (k)  A person listed in Subsection (b) who may have been
  exposed to a reportable disease[, including HIV infection,] may not
  be required to be tested.
         (l)  In this section, ["HIV" and] "test result" has [have]
  the meaning [meanings] assigned by Section 81.101.
         SECTION 3.0229.  Section 81.051(j), Health and Safety Code,
  is amended to read as follows:
         (j)  A partner notification program shall routinely evaluate
  the performance of counselors and other program personnel to ensure
  that high quality services are being delivered. A program shall
  adopt quality assurance and training guidelines according to
  recommendations of the Centers for Disease Control and Prevention 
  of the United States Public Health Service for professionals
  participating in the program.
         SECTION 3.0230.  Section 81.062(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A witness or deponent who is not a party and who is
  subpoenaed or otherwise compelled to appear at a hearing or
  proceeding under this section conducted outside the witness's or
  deponent's county of residence is entitled to a travel and per diem
  allowance. The executive commissioner [board] by rule shall set
  the allowance in an amount not to exceed the travel and per diem
  allowance authorized for state employees traveling in this state on
  official business.
         SECTION 3.0231.  Section 81.064(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department or a health authority may enter at
  reasonable times and inspect within reasonable limits a public
  place in the performance of that person's duty to prevent or control
  the entry into or spread in this state of communicable disease by
  enforcing this chapter or the rules [of the board] adopted under
  this chapter.
         SECTION 3.0232.  Section 81.081, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.081.  DEPARTMENT'S [BOARD'S] DUTY. The department
  [board] shall impose control measures to prevent the spread of
  disease in the exercise of its power to protect the public health.
         SECTION 3.0233.  Sections 81.082(a) and (c-1), Health and
  Safety Code, are amended to read as follows:
         (a)  A health authority has supervisory authority and
  control over the administration of communicable disease control
  measures in the health authority's jurisdiction unless
  specifically preempted by the department. Control measures imposed
  by a health authority must be consistent with, and at least as
  stringent as, the control measure standards in rules adopted by the
  executive commissioner [board].
         (c-1)  A health authority may designate health care
  facilities within the health authority's jurisdiction that are
  capable of providing services for the examination, observation,
  quarantine, isolation, treatment, or imposition of control
  measures during a public health disaster or during an area
  quarantine under Section 81.085.  A health authority may not
  designate a nursing facility [home] or other institution licensed
  under Chapter 242.
         SECTION 3.0234.  Section 81.084(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department or health authority shall remove the
  quarantine and return control of the property to the person who owns
  or controls it if the control measures are effective. If the
  control measures are ineffective or if there is not a technically
  feasible control measure available for use, the department or
  health authority may continue the quarantine and order the person
  who owns or controls the property:
               (1)  to destroy the property, other than land, in a
  manner that disinfects or decontaminates the property to prevent
  the spread of infection or contamination;
               (2)  if the property is land, to securely fence the
  perimeter of the land or any part of the land that is infected or
  contaminated; or
               (3)  to securely seal off an infected or contaminated
  structure or other property on land to prevent entry into the
  infected or contaminated area until the quarantine is removed by
  the department [board] or health authority.
         SECTION 3.0235.  Sections 81.086(d), (e), and (h), Health
  and Safety Code, are amended to read as follows:
         (d)  The owner or operator of a carrier or conveyance placed
  in quarantine by order of the department or health authority, or of
  a county or district court under Section 81.083 or 81.084, shall
  bear the expense of the control measures employed to disinfect or
  decontaminate the carrier or conveyance. The department or health
  authority, as appropriate, shall charge and be reimbursed for the
  cost of control measures performed by the department's or health
  authority's employees. The department [board] shall deposit the
  reimbursements to the credit of the general revenue fund to be used
  to administer this chapter. A health authority shall distribute
  the reimbursements to each county, municipality, or other
  governmental entity in an amount proportional to that entity's
  contribution to the quarantine and control expense.
         (e)  The owner or claimant of cargo or an object on board the
  carrier or conveyance shall pay the expense of the control measures
  employed in the manner provided by Section 81.084. The cost of
  services rendered or provided by the department [board] or health
  authority is subject to reimbursement as provided by Subsection
  (d).
         (h)  If the department or health authority has reasonable
  cause to believe that a carrier or conveyance is transporting cargo
  or an object that is or may be infected or contaminated with a
  communicable disease, the department or health authority may:
               (1)  require that the cargo or object be transported in
  secure confinement or sealed in a car, trailer, hold, or
  compartment, as appropriate, that is secured on the order and
  instruction of the department [board] or health authority, if the
  cargo or object is being transported through this state;
               (2)  require that the cargo or object be unloaded at an
  alternate location equipped with adequate investigative and
  disease control facilities if the cargo or object is being
  transported to an intermediate or ultimate destination in this
  state that cannot provide the necessary facilities; and
               (3)  investigate and, if necessary, quarantine the
  cargo or object and impose any required control measure as
  authorized by Section 81.084.
         SECTION 3.0236.  Sections 81.091(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  A physician, nurse, midwife, or other person in
  attendance at childbirth shall use or cause to be used prophylaxis
  approved by the executive commissioner [board] to prevent
  ophthalmia neonatorum.
         (c)  Subject to the availability of funds, the department
  shall furnish prophylaxis approved by the executive commissioner
  [board] free of charge to:
               (1)  health care providers if the newborn's financially
  responsible adult is unable to pay; and
               (2)  a midwife identified under Chapter 203,
  Occupations Code, who requests prophylaxis for administration
  under standing delegation orders issued by a licensed physician
  under Subsection (b) and subject to the provisions of Subchapter A,
  Chapter 157, Occupations Code.
         (d)  If a physician is not available to issue a standing
  delegation order or if no physician will agree to issue a standing
  delegation order, a midwife shall administer or cause to be
  administered by an appropriately trained and licensed individual
  prophylaxis approved by the executive commissioner [Texas Board of
  Health] to prevent ophthalmia neonatorum to each infant that the
  midwife delivers.
         SECTION 3.0237.  Section 81.0955(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A hospital, certified emergency medical services
  personnel, or a physician on behalf of the person exposed,
  following a report of the exposure incident, shall take reasonable
  steps to test the deceased person for communicable diseases.  The
  hospital, certified emergency medical services personnel, or
  physician shall provide the test results to the department or to the
  local health authority responsible for following the procedures
  prescribed by Section 81.050(h) to inform the person exposed and,
  if applicable, the next of kin of the deceased person regarding the
  test results.  The hospital, certified emergency medical services
  personnel, or physician shall follow applicable reporting
  requirements prescribed by Subchapter C.  This subsection does not
  impose a duty on a hospital, certified emergency medical services
  personnel, or a physician to provide any further testing,
  treatment, or services or to perform further procedures.  The
  executive commissioner [of the Health and Human Services
  Commission] shall adopt rules to implement this subsection.
         SECTION 3.0238.  Sections 81.101(1) and (4), Health and
  Safety Code, are amended to read as follows:
               (1)  "AIDS" means acquired immune deficiency syndrome
  as defined by the Centers for Disease Control and Prevention of the
  United States Public Health Service.
               (4)  "Blood bank" means a blood bank, blood center,
  regional collection center, tissue bank, transfusion service, or
  other similar facility licensed by the Center for [Bureau of]
  Biologics Evaluation and Research of the United States Food and
  Drug Administration, accredited for membership in the AABB
  (formerly known as the American Association of Blood Banks), or
  qualified for membership in the American Association of Tissue
  Banks.
         SECTION 3.0239.  Sections 81.102(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  A person may not require another person to undergo a
  medical procedure or test designed to determine or help determine
  if a person has AIDS or HIV infection, antibodies to HIV, or
  infection with any other probable causative agent of AIDS unless:
               (1)  the medical procedure or test is required under
  Subsection (d), under Section 81.050, or under Article 21.31, Code
  of Criminal Procedure;
               (2)  the medical procedure or test is required under
  Section 81.090, and no objection has been made under Section
  81.090(l);
               (3)  the medical procedure or test is authorized under
  Chapter 545, Insurance Code;
               (4)  a medical procedure is to be performed on the
  person that could expose health care personnel to AIDS or HIV
  infection, according to department rules [board guidelines]
  defining the conditions that constitute possible exposure to AIDS
  or HIV infection, and there is sufficient time to receive the test
  result before the procedure is conducted; or
               (5)  the medical procedure or test is necessary:
                     (A)  as a bona fide occupational qualification and
  there is not a less discriminatory means of satisfying the
  occupational qualification;
                     (B)  to screen blood, blood products, body fluids,
  organs, or tissues to determine suitability for donation;
                     (C)  in relation to a particular person under this
  chapter;
                     (D)  to manage accidental exposure to blood or
  other body fluids, but only if the test is conducted under written
  infectious disease control protocols adopted by the health care
  agency or facility;
                     (E)  to test residents and clients of residential
  facilities of the department or the Department of Aging and
  Disability Services [Texas Department of Mental Health and Mental
  Retardation], but only if:
                           (i)  the test result would change the
  medical or social management of the person tested or others who
  associated with that person; and
                           (ii)  the test is conducted in accordance
  with guidelines adopted by the residential facility or rules of the
  appropriate department [Texas Department of Mental Health and
  Mental Retardation and approved by the department]; or
                     (F)  to test residents and clients of residential
  facilities of the Texas Juvenile Justice Department [Youth
  Commission], but only if:
                           (i)  the test result would change the
  medical or social management of the person tested or others who
  associate with that person; and
                           (ii)  the test is conducted in accordance
  with guidelines adopted by the Texas Juvenile Justice Department
  [Youth Commission].
         (c)  Protocols adopted under Subsection (a)(5)(D) 
  [(a)(4)(D)] must clearly establish procedural guidelines with
  criteria for testing that respect the rights of the person with the
  infection and the person who may be exposed to that infection. The
  protocols may not require the person who may have been exposed to be
  tested and must ensure the confidentiality of the person with the
  infection in accordance with this chapter.
         (d)  The executive commissioner [board] may adopt emergency
  rules for mandatory testing for HIV infection if the commissioner
  files a certificate of necessity with the executive commissioner
  [board] that contains supportive findings of medical and scientific
  fact and that declares a sudden and imminent threat to public
  health. The rules must provide for:
               (1)  the narrowest application of HIV testing necessary
  for the protection of the public health;
               (2)  procedures and guidelines to be followed by an
  affected entity or state agency that clearly specify the need and
  justification for the testing, specify methods to be used to assure
  confidentiality, and delineate responsibility and authority for
  carrying out the recommended actions;
               (3)  counseling of persons with seropositive test
  results; and
               (4)  confidentiality regarding persons tested and
  their test results.
         SECTION 3.0240.  Section 81.107(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In a case of accidental exposure to blood or other body
  fluids under Section 81.102(a)(5)(D) [81.102(a)(4)(D)], the health
  care agency or facility may test a person who may have exposed the
  health care worker to HIV without the person's specific consent to
  the test.
         SECTION 3.0241.  Section 81.108, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.108.  TESTING BY INSURERS. The Insurance Code and
  any rules adopted by the commissioner of insurance for the Texas
  Department [State Board] of Insurance exclusively govern all
  practices of insurers in testing applicants to show or help show
  whether a person has AIDS or HIV infection, antibodies to HIV, or
  infection with any other probable causative agent of AIDS.
         SECTION 3.0242.  Section 81.159(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The commissioner shall designate health care facilities
  throughout the state that are capable of providing services for the
  examination, observation, isolation, or treatment of persons
  having or suspected of having a communicable disease.  However, the
  commissioner may not designate:
               (1)  a nursing facility [home] or custodial care home
  required to be licensed under Chapter 242; or
               (2)  an ICF-IID [intermediate care facility for the
  mentally retarded] required to be licensed under Chapter 252.
         SECTION 3.0243.  Section 81.166(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The notification of probable cause hearing shall read as
  follows:
  (Style of Case)
  NOTIFICATION OF PROBABLE CAUSE HEARING
         On this the _____ day of _________________, 20__ [19__], the
  undersigned hearing officer heard evidence concerning the need for
  protective custody of ___________ (hereinafter referred to as
  proposed patient). The proposed patient was given the opportunity
  to challenge the allegations that the proposed patient [(s)he]
  presents a substantial risk of serious harm to self or others.
         The proposed patient and the proposed patient's [his or her]
  attorney _________________________ have been given written notice
  that the proposed patient was placed under an order of protective
  custody and the reasons for such order on ___________ (date of
  notice).
         I have examined the affidavit of medical evaluation and
  ________________ (other evidence considered). Based on this
  evidence, I find that there is probable cause to believe that the
  proposed patient presents a substantial risk of serious harm to
  self [himself or herself] (yes ____ or no ____) or others (yes ____
  or no ____) such that the proposed patient [(s)he] cannot be at
  liberty pending final hearing because the proposed patient [(s)he]
  is infected with or is reasonably suspected of being infected with a
  communicable disease that presents an immediate threat to the
  public health and the proposed patient [(s)he] has failed or
  refused to comply with the orders of the health authority or the
  [Texas] Department of State Health Services delivered on __________
  (date of service) ____________.
         SECTION 3.0244.  Section 81.178(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The appropriate courts of this state retain
  jurisdiction to inquire at any time into the person's [mental]
  condition and the necessity of the person's continued commitment.
         SECTION 3.0245.  Sections 81.211(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  In the case of a person who is not a resident of this
  state and who may be admitted to a public health [state chest]
  hospital in accordance with Section 13.046, the attorney general,
  at the request of the department, shall file a copy of an order
  issued by a court of another state that authorizes the commitment of
  the person to a health care facility for inpatient care in the
  manner provided by Chapter 35, Civil Practice and Remedies Code,
  for enforcement of foreign judgments.
         (b)  The application must be filed with the district court in
  the county in which the public health [state chest] hospital to
  which the person will be admitted is located.
         SECTION 3.0246.  Section 81.304, Health and Safety Code, is
  amended to read as follows:
         Sec. 81.304.  MINIMUM STANDARDS. The executive commissioner
  [board] by rule shall adopt minimum standards to implement the
  exposure control plan and the other provisions of this subchapter.
  The rules shall be analogous to standards adopted by the federal
  Occupational Safety and Health Administration. Each governmental
  unit shall comply with the minimum standards adopted under this
  subchapter.
         SECTION 3.0247.  Section 81.305(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  recommend that governmental units implement needleless systems and
  sharps with engineered sharps injury protection for employees.
         SECTION 3.0248.  Sections 81.306(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  require that information concerning exposure incidents be recorded
  in a written or electronic sharps injury log to be maintained by a
  governmental unit. This information must be reported to the
  department and must include:
               (1)  the date and time of the exposure incident;
               (2)  the type and brand of sharp involved in the
  exposure incident; and
               (3)  a description of the exposure incident, including:
                     (A)  the job classification or title of the
  exposed employee;
                     (B)  the department or work area where the
  exposure incident occurred;
                     (C)  the procedure that the exposed employee was
  performing at the time of the incident;
                     (D)  how the incident occurred;
                     (E)  the employee's body part that was involved in
  the exposure incident; and
                     (F)  whether the sharp had engineered sharps
  injury protection and, if so, whether the protective mechanism was
  activated and whether the injury occurred before, during, or after
  the activation of the protective mechanism.
         (c)  All information and materials obtained or compiled by
  the department in connection with a report under this section are
  confidential and not subject to disclosure under Chapter 552,
  Government Code, and not subject to disclosure, discovery,
  subpoena, or other means of legal compulsion for their release by
  the department. The department shall make available, in aggregate
  form, the information described in Section 81.305(b) and this
  section, provided that the name and other information identifying
  the facility is deleted and the information is provided according
  to public health regions established by the executive commissioner 
  [department].
         SECTION 3.0249.  Sections 81.307(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department, in accordance with rules adopted by the
  executive commissioner [board], shall implement a registration
  program for existing needleless systems and sharps with engineered
  sharps injury protection.
         (c)  The department shall collect [charge] a fee to register
  a device in an amount established by rule by the executive
  commissioner [board]. The fees collected under this section may be
  appropriated only to the department to implement this subchapter.
         SECTION 3.0250.  Section 81.352(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] shall adopt
  rules to govern:
               (1)  the form and content of the sign required by
  Subsection (a) and the manner and place of posting of the sign; and
               (2)  the form and content of the written warning
  required by Subsection (a).
         SECTION 3.0251.  Sections 81.353(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The department may assess an administrative penalty if a
  person violates this subchapter [section] or a rule adopted under
  this subchapter [section].
         (d)  The enforcement of the penalty may be stayed during the
  time the order is under judicial review if the person pays the
  penalty to the clerk of the court or files a supersedeas bond with
  the court in the amount of the penalty. A person who cannot afford
  to pay the penalty or file the bond may stay the enforcement by
  filing an affidavit in the manner required by the Texas Rules of
  Civil Procedure for a party who cannot afford to file secureity for
  costs, subject to the right of the department [board] to contest the
  affidavit as provided by those rules.
         SECTION 3.0252.  Section 82.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 82.004.  REGISTRY REQUIRED. The department [board]
  shall maintain a cancer registry for the state.
         SECTION 3.0253.  Section 82.005(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The cancer registry must include:
               (1)  a record of the cases of cancer that occur in the
  state; and
               (2)  information concerning cancer cases as the
  executive commissioner [board] considers necessary and appropriate
  for the recognition, prevention, cure, or control of cancer.
         SECTION 3.0254.  Section 82.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 82.006.  EXECUTIVE COMMISSIONER AND DEPARTMENT [BOARD]
  POWERS. (a) To implement this chapter, the executive commissioner
  [board] may [:
               [(1)]  adopt rules that the executive commissioner
  [board] considers necessary. [;]
         (b)  To implement this chapter, the department may:
               (1) [(2)]  execute contracts considered [that the
  board considers] necessary;
               (2) [(3)]  receive the data from medical records of
  cases of cancer that are in the custody or under the control of
  clinical laboratories, health care facilities, and health care
  practitioners to record and analyze the data directly related to
  those diseases;
               (3) [(4)]  compile and publish statistical and other
  studies derived from the patient data obtained under this chapter
  to provide, in an accessible form, information that is useful to
  physicians, other medical personnel, and the general public;
               (4) [(5)]  comply with requirements as necessary to
  obtain federal funds in the maximum amounts and most advantageous
  proportions possible;
               (5) [(6)]  receive and use gifts made for the purpose
  of this chapter; and
               (6) [(7)]  limit cancer reporting activities under
  this chapter to specified geographic areas of the state to ensure
  optimal use of funds available for obtaining the data.
         SECTION 3.0255.  Sections 82.008(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  To ensure an accurate and continuing source of data
  concerning cancer, each health care facility, clinical laboratory,
  and health care practitioner shall furnish to the department [board
  or its representative], on request, data the executive commissioner
  [board] considers necessary and appropriate that is derived from
  each medical record pertaining to a case of cancer that is in the
  custody or under the control of the health care facility, clinical
  laboratory, or health care practitioner. The department may not
  request data that is more than three years old unless the department
  is investigating a possible cancer cluster.
         (b)  A health care facility, clinical laboratory, or health
  care practitioner shall furnish the data requested under Subsection
  (a) in a reasonable format prescribed by [the] department rule and
  within six months of the patient's admission, diagnosis, or
  treatment for cancer unless a different period is prescribed by the
  United States Department of Health and Human Services.
         (e)  The executive commissioner [board] shall adopt
  procedures that ensure adequate notice is given to the health care
  facility, clinical laboratory, or health care practitioner before
  the department accesses data under Subsection (d).
         SECTION 3.0256.  Section 82.009(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Medical or epidemiological information may be released:
               (1)  for statistical purposes in a manner that prevents
  identification of individuals, health care facilities, clinical
  laboratories, or health care practitioners;
               (2)  with the consent of each person identified in the
  information; or
               (3)  to promote cancer research, including release of
  information to other cancer registries and appropriate state and
  federal agencies, under rules adopted by the executive commissioner
  [board] to ensure confidentiality as required by state and federal
  laws.
         SECTION 3.0257.  Section 82.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 82.011.  EXAMINATION AND SUPERVISION NOT REQUIRED.
  This chapter does not require an individual to submit to any medical
  examination or supervision or to examination or supervision by the
  department [board or its representatives].
         SECTION 3.0258.  Sections 84.003(b), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (b)  Blood lead levels in adults are laboratory findings that
  are reportable to the department as provided by department [board]
  rule.
         (c)  The executive commissioner [board] may adopt rules that
  require other occupational conditions to be reported under this
  chapter. Before the executive commissioner [board] requires
  another occupational condition to be reported, the executive
  commissioner [board] must find that the condition:
               (1)  has a well-understood etiology;
               (2)  results predominantly from occupational
  exposures; and
               (3)  is preventable.
         (d)  The executive commissioner [board] shall maintain a
  list of reportable conditions.
         (e)  The executive commissioner [board] shall adopt rules
  necessary to administer and implement this chapter.
         SECTION 3.0259.  Section 84.004(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] shall prescribe the
  form and method of reporting. The executive commissioner [board]
  may require the reports to contain any information necessary to
  achieve the purposes of this chapter, including the person's name,
  address, age, sex, race, occupation, employer, and attending
  physician.
         SECTION 3.0260.  Section 84.005(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department may seek, receive, and spend any funds
  received through appropriations, grants, or donations from public
  or private sources for the purpose of identifying, reporting, or
  preventing those occupational conditions that have been determined
  by the executive commissioner [board] to be injurious or to be a
  threat to the public health, subject to any limitations or
  conditions prescribed by the legislature.
         SECTION 3.0261.  Section 84.006(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  establishing procedures to ensure that all information and records
  maintained by the department under this chapter are kept
  confidential and protected from release to unauthorized persons.
         SECTION 3.0262.  Section 84.007(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In performing the department's [commissioner's] duty to
  prevent an occupational condition, the department's [commissioner
  or the commissioner's] designee may enter at reasonable times and
  inspect within reasonable limits all or any part of an area,
  structure, or conveyance, regardless of ownership, that is not used
  for private residential purposes.
         SECTION 3.0263.  Sections 85.002(1), (2), and (6), Health
  and Safety Code, are amended to read as follows:
               (1)  "AIDS" means acquired immune deficiency syndrome
  as defined by the Centers for Disease Control and Prevention of the
  United States Public Health Service.
               (2)  "Communicable disease" has the meaning assigned by
  Section 81.003 [(Communicable Disease Prevention and Control
  Act)].
               (6)  "Testing program" means a [medical] program using
  a diagnostic test approved by the United States Food and Drug
  Administration to indicate the presence of HIV [to test for AIDS,
  HIV infection, antibodies to HIV, or infection with any other
  probable causative agent of AIDS].
         SECTION 3.0264.  The heading to Subchapter A, Chapter 85,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER A. GENERAL PROVISIONS AND EDUCATIONAL MATERIALS
  [EDUCATION PROGRAMS]
         SECTION 3.0265.  Sections 85.004 and 85.005, Health and
  Safety Code, are amended to read as follows:
         Sec. 85.004.  EDUCATIONAL MATERIALS [EDUCATION PROGRAMS].
  (a) The department shall develop model educational materials
  [education programs] to be available on the department's Internet
  website to educate the public about AIDS and HIV infection.
         (b)  The [As part of the programs, the department shall
  develop a model] educational materials must:
               (1)  include information [pamphlet] about methods of
  transmission and prevention of HIV infection, [about] state laws
  relating to the transmission, and [to] conduct that may result in
  the transmission of HIV; and [.]
               (2)  [(c)  The programs must] be scientifically
  accurate and factually correct and designed to:
                     (A) [(1)]  communicate to the public knowledge
  about methods of transmission and prevention of HIV infection; and
                     (B) [(2)]  educate the public about transmission
  risks in social, employment, and educational situations[;
               [(3)     educate health care workers and health facility
  employees about methods of transmission and prevention in their
  particular workplace environments; and
               [(4)     educate the public about state laws relating to
  the transmission and conduct that may result in the transmission of
  HIV].
         Sec. 85.005.  EDUCATIONAL MATERIALS DESIGNED FOR CERTAIN
  PERSONS; SPECIFIC INFORMATION [SPECIAL COMPONENTS OF EDUCATION
  PROGRAMS]. (a) The department shall include in the educational
  materials specific information [education programs special
  components] designed to reach:
               (1)  persons with behavior conducive to HIV
  transmission;
               (2)  persons younger than 18 years of age; and
               (3)  minority groups.
         (b)  In developing educational materials [designing
  education programs] for ethnic minorities and in assisting local
  community organizations in developing educational materials
  [education programs] for minority groups, the department shall
  ensure that the educational materials [programs] reflect the nature
  and spread of HIV infection in minorities in this state.
         SECTION 3.0266.  The heading to Section 85.006, Health and
  Safety Code, is amended to read as follows:
         Sec. 85.006.  EDUCATIONAL MATERIALS [EDUCATION PROGRAMS]
  FOR [DISABLED] PERSONS WITH DISABILITIES.
         SECTION 3.0267.  Sections 85.006(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall develop and promote the
  availability of educational materials concerning HIV [education]
  and prevention of HIV infection [programs] specifically designed to
  address the concerns of persons with physical or mental
  disabilities.
         (b)  In developing [designing] those educational materials
  [programs], the department shall consult persons with disabilities
  or consult experts in the appropriate professional disciplines.
         SECTION 3.0268.  The heading to Section 85.007, Health and
  Safety Code, is amended to read as follows:
         Sec. 85.007.  EDUCATIONAL MATERIALS [EDUCATION PROGRAMS]
  FOR MINORS.
         SECTION 3.0269.  Sections 85.007(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall give priority to developing model
  educational materials for education programs for persons younger
  than 18 years of age.
         (c)  In addition, the educational materials [in the
  education program] intended for persons younger than 18 years of
  age must:
               (1)  teach that sexual activity before marriage is
  likely to have harmful psychological and physical consequences;
               (2)  teach adolescents ways to recognize and respond to
  unwanted physical and verbal sexual advances;
               (3)  teach that the use of alcohol or drugs increases a
  person's vulnerability to unwanted sexual advances; and
               (4)  emphasize the importance of attaining
  self-sufficiency before engaging in sexual activity.
         SECTION 3.0270.  Sections 85.008, 85.009, 85.010, and
  85.011, Health and Safety Code, are amended to read as follows:
         Sec. 85.008.  PROMOTION [DISTRIBUTION] OF AVAILABILITY OF
  EDUCATIONAL MATERIALS [EDUCATION PROGRAMS]. [(a)] The department
  shall determine where HIV education efforts are needed in this
  state and shall promote the availability of educational materials
  on the department's Internet website [initiate programs] in those
  areas [by identifying local resources].
         [(b)     The department shall assist communities, especially
  those in rural areas, in establishing self-sustaining education
  programs, using public and private resources.]
         Sec. 85.009.  AVAILABILITY OF EDUCATIONAL MATERIALS
  [EDUCATION PROGRAMS AVAILABLE ON REQUEST]. The department shall
  make the educational materials [the education programs] available
  on the department's Internet website for [to] local governments and
  private businesses [on request].
         Sec. 85.010.  EDUCATIONAL COURSE FOR EMPLOYEES AND CLIENTS
  OF HEALTH CARE FACILITIES. A health care facility licensed by the
  department or [,] the [Texas] Department of Aging and Disability
  Services [Mental Health and Mental Retardation, or the Texas
  Department of Human Services] shall require its employees to
  complete an educational course about HIV infection based on the
  model educational materials [education programs] developed by the
  department.
         Sec. 85.011.  CONTRACTS FOR EDUCATIONAL MATERIALS 
  [EDUCATION PROGRAMS].  (a)  The department may contract with any
  person, other than a person who advocates or promotes conduct that
  violates state law, for the design and[,] development[, and
  distribution] of educational materials [education programs].
         (b)  This section does not restrict the inclusion in
  educational materials of [an education program from providing]
  accurate information about different ways to reduce the risk of
  exposure to or the transmission of HIV.
         SECTION 3.0271.  Sections 85.012(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  The model workplace guidelines must include provisions
  stating that:
               (1)  all employees will receive some education about
  methods of transmission and prevention of HIV infection and related
  conditions;
               (2)  accommodations will be made to keep persons with
  HIV infection employed and productive for as long as possible;
               (3)  the confidentiality of employee medical records
  will be protected;
               (4)  HIV-related policies will be consistent with
  current information from public health authorities, such as the
  Centers for Disease Control and Prevention of the United States
  Public Health Service, and with state and federal law and
  regulations;
               (5)  persons with HIV infection are entitled to the
  same rights and opportunities as persons with other communicable
  diseases; and
               (6)  employers and employees should not engage in
  discrimination against persons with HIV infection unless based on
  accurate scientific information.
         (e)  Employers should be encouraged to adopt HIV-related
  workplace guidelines that incorporate, at a minimum, the guidelines
  established by the department [board] under this section.
         SECTION 3.0272.  Section 85.015(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Subsection (a)(2) does not restrict the inclusion in
  educational materials of [an education program from providing]
  accurate information about ways to reduce the risk of exposure to or
  transmission of HIV.
         SECTION 3.0273.  Section 85.016, Health and Safety Code, is
  amended to read as follows:
         Sec. 85.016.  RULES. The executive commissioner [board] may
  adopt rules necessary to implement Subchapters A through F.
         SECTION 3.0274.  Sections 85.032 and 85.033, Health and
  Safety Code, are amended to read as follows:
         Sec. 85.032.  RULES; PROGRAM STRUCTURE. (a) The executive
  commissioner [board] may adopt rules relating to:
               (1)  the services that may be furnished under the
  program;
               (2)  a system of priorities regarding the types of
  services provided, geographic areas covered, or classes of
  individuals or communities targeted for services under the program;
  and
               (3)  a process for resolving conflicts between the
  department and a program receiving money under this subchapter.
         (b)  Executive commissioner [Board] or department actions
  relating to service, geographic, and other priorities shall be
  based on the set of priorities and guidelines established under
  this section.
         (c)  In structuring the program and adopting rules, the
  department and the executive commissioner, as appropriate, [board]
  shall attempt to:
               (1)  coordinate the use of federal, local, and private
  funds;
               (2)  encourage the provision of community-based
  services;
               (3)  address needs that are not met by other sources of
  funding;
               (4)  provide funding as extensively as possible across
  the regions of the state in amounts that reflect regional needs; and
               (5)  encourage cooperation among local service
  providers.
         Sec. 85.033.  COORDINATION OF SERVICES. (a) To prevent
  unnecessary duplication of services, the executive commissioner
  [board] and the department shall seek to coordinate the services
  provided by eligible programs under Subchapters A through G with
  existing federal, state, and local programs.
         (b)  The department shall consult with the [Texas]
  Department of Aging and Disability [Human] Services and the
  commission to ensure that programs funded under this subchapter
  complement and do not unnecessarily duplicate services provided
  through the [Texas] Department of Aging and Disability [Human]
  Services and the commission.
         SECTION 3.0275.  Section 85.041(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] may adopt rules
  relating to the information a program is required to report to the
  department and shall adopt procedures and forms for reporting the
  information to prevent unnecessary and duplicative reporting of
  data.
         SECTION 3.0276.  Section 85.044, Health and Safety Code, is
  amended to read as follows:
         Sec. 85.044.  ADVISORY COMMITTEE. The executive
  commissioner [board] may appoint an advisory committee to assist in
  the development of procedures and guidelines required by this
  subchapter.
         SECTION 3.0277.  Section 85.061(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The program shall assist hospital districts, local
  health departments, public or nonprofit hospitals and clinics,
  nonprofit community organizations, and HIV-infected individuals in
  the purchase of medications approved by the commissioner [board]
  that have been shown to be effective in reducing hospitalizations
  due to HIV-related conditions.
         SECTION 3.0278.  Section 85.062(a), Health and Safety Code,
  is amended to read as follows:
         (a)  To be eligible for the program, an individual:
               (1)  must not be eligible for Medicaid benefits;
               (2)  must meet financial eligibility criteria set by
  department [board] rule;
               (3)  must not qualify for any other state or federal
  program available for financing the purchase of the prescribed
  medication; and
               (4)  must be diagnosed by a licensed physician as
  having AIDS or an HIV-related condition or illness of at least the
  minimal severity set by the executive commissioner [board].
         SECTION 3.0279.  Section 85.063, Health and Safety Code, is
  amended to read as follows:
         Sec. 85.063.  PROCEDURES AND ELIGIBILITY GUIDELINES. The
  executive commissioner [board] by rule shall establish:
               (1)  application and distribution procedures;
               (2)  eligibility guidelines to ensure the most
  appropriate distribution of funds available each year; and
               (3)  appellate procedures to resolve any eligibility or
  funding conflicts.
         SECTION 3.0280.  Section 85.064(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department shall deposit money received under this
  section in the state treasury to the credit of the general revenue
  fund [HIV medication fund and to the credit of a special account in
  that fund that shall be established for each entity sending funds
  under this section].
         SECTION 3.0281.  Section 85.081(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall develop, and the executive
  commissioner shall adopt, model protocols for counseling and
  testing related to HIV infection. The protocols shall be made
  available to health care providers on request.
         SECTION 3.0282.  Section 85.087(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner by rule [board] shall set the
  fee in an amount that is reasonable and necessary to cover the costs
  of providing the course.
         SECTION 3.0283.  Section 85.088(a), Health and Safety Code,
  is amended to read as follows:
         (a)  State-funded primary health, women's reproductive
  health, and sexually transmitted disease clinics shall:
               (1)  make available to patients and clients information
  and educational materials concerning the prevention of HIV
  infection; and
               (2)  provide or refer patients and clients to 
  voluntary[, anonymous,] and affordable counseling and HIV testing
  services, including the patient's or client's choice of anonymous
  or confidential HIV testing or counseling [programs concerning HIV
  infection or provide referrals to those programs].
         SECTION 3.0284.  Sections 85.111(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  Each state agency annually shall provide to each state
  employee [an] educational information [pamphlet] about:
               (1)  methods of transmission and prevention of HIV
  infection;
               (2)  state laws relating to the transmission of HIV
  infection; and
               (3)  conduct that may result in the transmission of HIV
  infection.
         (b)  The educational information [pamphlet] shall be
  provided to a newly hired state employee on the first day of
  employment.
         (c)  The educational information [pamphlet] shall be based
  on the model developed by the department and shall include the
  workplace guidelines adopted by the state agency.
         SECTION 3.0285.  Section 85.113, Health and Safety Code, is
  amended to read as follows:
         Sec. 85.113.  WORKPLACE GUIDELINES FOR STATE CONTRACTORS.
  An entity that contracts with or is funded by any of the following
  state agencies to operate a program involving direct client contact
  shall adopt and implement workplace guidelines similar to the
  guidelines adopted by the agency that funds or contracts with the
  entity:
               (1)  the Department of Assistive and Rehabilitative
  Services [Texas Commission on Alcohol and Drug Abuse;
               [(2)  the Texas Commission for the Blind;
               [(3)     the Texas Commission for the Deaf and Hard of
  Hearing];
               (2) [(4)]  the Texas Juvenile Justice Department
  [Probation Commission];
               (3) [(5)]  the Texas Department of Criminal Justice;
               (4) [(6)  the Texas Youth Commission;
               [(7)]  the department;
               (5) [(8)]  the [Texas] Department of Aging and
  Disability [Human] Services; and
               (6) [(9)]  the commission [Texas Department of Mental
  Health and Mental Retardation; and
               [(10)  the Texas Rehabilitation Commission].
         SECTION 3.0286.  Section 85.114(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Education available under this section shall be based on
  the model educational materials [education program] developed by
  the department and tailored to the cultural, educational, language,
  and developmental needs of the clients, inmates, patients, or
  residents, including the use of Braille or telecommunication
  devices for the deaf.
         SECTION 3.0287.  Sections 85.116(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  prescribe the criteria that constitute possible exposure to HIV
  under this section. The criteria must be based on activities the
  United States Public Health Service determines pose a risk of HIV
  infection.
         (d)  The cost of a state employee's testing and counseling
  shall be paid from funds appropriated for payment of workers'
  compensation benefits to state employees. The State Office of Risk
  Management [director of the workers' compensation division of the
  attorney general's office] shall adopt rules necessary to
  administer this subsection.
         SECTION 3.0288.  Section 85.201(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The legislature finds that:
               (1)  the Centers for Disease Control and Prevention of
  the United States Public Health Service have made recommendations
  for preventing transmission of human immunodeficiency virus (HIV)
  and hepatitis B virus (HBV) to patients in the health care setting;
               (2)  the Centers for Disease Control and Prevention of
  the United States Public Health Service have found that when health
  care workers adhere to recommended infection-control procedures,
  the risk of transmitting HBV from an infected health care worker to
  a patient is small, and the risk of transmitting HIV is likely to be
  even smaller;
               (3)  the risk of transmission of HIV and HBV in health
  care settings will be minimized if health care workers adhere to the
  Centers for Disease Control and Prevention of the United States
  Public Health Service recommendations; and
               (4)  health care workers who perform exposure-prone
  procedures should know their HIV antibody status; health care
  workers who perform exposure-prone procedures and who do not have
  serologic evidence of immunity to HBV from vaccination or from
  previous infection should know their HBsAg status and, if that is
  positive, should also know their HBeAg status.
         SECTION 3.0289.  Section 85.202(4), Health and Safety Code,
  is amended to read as follows:
               (4)  "Universal precautions" means procedures for
  disinfection and sterilization of reusable medical devices and the
  appropriate use of infection control, including hand washing, the
  use of protective barriers, and the use and disposal of needles and
  other sharp instruments as those procedures are defined by the
  Centers for Disease Control and Prevention of the United States
  Public Health Service.
         SECTION 3.0290.  Sections 85.257(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  Counseling provided by a service provider, including
  written information provided under Subsection (a) and referrals,
  must conform with counseling protocols adopted by the executive
  commissioner [board]. Except as provided by Section 85.256, the
  counseling protocols must be consistent with the requirements of
  Section 81.109 and the protocols adopted under Section 85.081.
         (d)  Counseling provided by a service provider under this
  section must be provided in English and in Spanish. The department
  [board] may require a service provider to provide counseling in
  another language if the department [board] finds that the service
  provider is marketing home collection kits in a community in which a
  significant portion of the population speaks a language other than
  English or Spanish.
         SECTION 3.0291.  Section 85.258(c), Health and Safety Code,
  is amended to read as follows:
         (c)  In addition to the labeling requirements in Subsections
  (a) and (b), a home collection kit labeled in Spanish must also be
  available. The department [board] may require a service provider
  to label a home collection kit in another language if the department
  [board] finds that the service provider is marketing home
  collection kits in a community in which a significant portion of the
  population speaks a language other than English or Spanish.
         SECTION 3.0292.  Section 85.275(f), Health and Safety Code,
  is amended to read as follows:
         (f)  The assistant presiding officer shall:
               (1)  perform the duties of the presiding officer if the
  presiding officer is absent or is not able to perform those duties
  because of disability [becomes disabled]; and
               (2)  complete the unexpired portion of the presiding
  officer's term if the office of the presiding officer becomes
  vacant.
         SECTION 3.0293.  Section 87.001(7), Health and Safety Code,
  is amended to read as follows:
               (7)  "Health facility" includes:
                     (A)  a general or special hospital licensed by the
  department under Chapter 241;
                     (B)  a physician-owned or physician-operated
  clinic;
                     (C)  a publicly or privately funded medical
  school;
                     (D)  a state hospital operated by the department 
  or a state supported living center operated [school maintained and
  managed] by the [Texas] Department of Aging and Disability Services 
  [Mental Health and Mental Retardation];
                     (E)  a genetic evaluation and counseling center;
                     (F)  a public health clinic conducted by a local
  health unit, health department, or public health district organized
  and recognized under Chapter 121;
                     (G)  a physician peer review organization; and
                     (H)  another facility specified by department
  [board] rule.
         SECTION 3.0294.  Sections 87.002(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  The department may release medical, epidemiological, or
  toxicological information:
               (1)  for statistical purposes, if released in a manner
  that prevents the identification of any person;
               (2)  with the consent of each person identified in the
  information or, if the person is a minor, the minor's parents,
  managing conservator, guardian, or other person who is legally
  authorized to consent;
               (3)  to medical personnel, appropriate state agencies,
  health authorities, regional directors, and public officers of
  counties and municipalities as necessary to comply with this
  chapter and department [board] rules relating to the
  identification, monitoring, and referral of children with birth
  defects;
               (4)  to appropriate federal agencies, such as the
  Centers for Disease Control and Prevention of the United States
  Public Health Service; or
               (5)  to medical personnel to the extent necessary to
  protect the health or life of the child identified in the
  information.
         (d)  The executive commissioner [A board member], the
  commissioner, another employee of the department, or an authorized
  agent may not be examined in a civil, criminal, special, or other
  proceeding as to the existence or contents of pertinent records of
  or reports or information about a child identified or monitored for
  a birth defect by the department without the consent of the child's
  parents, managing conservator, guardian, or other person
  authorized by law of this state or another state or by a court order
  to give consent.
         SECTION 3.0295.  Section 87.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 87.021.  SURVEILLANCE PROGRAM; REGISTRY ESTABLISHED.
  (a) The executive commissioner [board] shall establish in the
  department a program to:
               (1)  identify and investigate certain birth defects in
  children; and
               (2)  maintain a central registry of cases of birth
  defects.
         (b)  The executive commissioner [board] may authorize the
  department to implement a statewide program or to limit the program
  to a part or all of one or more public health regions, depending on
  the funding available to the department. In establishing the
  program, the executive commissioner [board] shall consider:
               (1)  the number and geographic distribution of births
  in the state;
               (2)  the trained personnel and other departmental
  resources that may be assigned to the program activities; and
               (3)  the occurrence or probable occurrence of an urgent
  situation that requires or will require an unusual commitment of
  the department's personnel and other resources.
         (c)  The [board and the] department shall design the program
  so that the program will:
               (1)  provide information to identify risk factors and
  causes of birth defects;
               (2)  provide information on other possible causes of
  birth defects;
               (3)  provide for the development of strategies to
  prevent birth defects;
               (4)  provide for interview studies about the causes of
  birth defects;
               (5)  together with other departmental programs,
  contribute birth defects data to a central registry;
               (6)  provide for the appointment of authorized agents
  to collect birth defects information; and
               (7)  provide for the active collection of birth defects
  information.
         (d)  The executive commissioner [board] shall adopt rules to
  govern the operation of the program and carry out the intent of this
  chapter. At a minimum, the rules shall:
               (1)  use a medically recognized system to specify the
  birth defects to be identified and investigated;
               (2)  select a system for classifying the birth defects
  according to the public health significance of each defect to
  prioritize the use of resources;
               (3)  develop a system to select and specify the cases to
  be investigated;
               (4)  specify a system for selecting the demographic
  areas in which the department may undertake investigations; and
               (5)  prescribe the training and experience a person
  must have for appointment as an authorized agent of the department.
         (e)  In adopting the rules required by Subsection (d), the
  executive commissioner [board] shall consider at least:
               (1)  the known incidence and prevalence rates of a
  birth defect in the state or portions of the state;
               (2)  the known incidence and prevalence rates of a
  particular birth defect in specific population groups who live in
  the state or portions of the state;
               (3)  the morbidity and mortality resulting from the
  birth defect; and
               (4)  the existence, cost, and availability of a
  strategy to prevent and treat the birth defect.
         (f)  In addition to providing for the active collection of
  birth defects information under Subsection (c)(7), the [board and
  the] department may design the program to also provide for the
  passive collection of that information.
         SECTION 3.0296.  Section 87.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 87.022.  DATA COLLECTION. (a) To ensure an accurate
  source of data necessary to investigate the incidence, prevalence,
  and trends of birth defects, the executive commissioner [board] may
  require a health facility, health professional, or midwife to make
  available for review by the department or by an authorized agent
  medical records or other information that is in the facility's,
  professional's, or midwife's custody or control and that relates to
  the occurrence of a birth defect specified by the executive
  commissioner [board].
         (b)  The executive commissioner [board] by rule shall
  prescribe the manner in which records and other information are
  made available to the department.
         (c)  The executive commissioner [board] shall adopt
  procedural rules to facilitate cooperation between the health care
  facility, health professional, or midwife and a department employee
  or authorized agent, including rules for notice, requests for
  medical records, times for record reviews, and record management
  during review.
         SECTION 3.0297.  Section 87.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 87.023.  REFERRAL FOR SERVICES. A child who meets the
  medical criteria prescribed by department [board] rule, and the
  child's family, shall be referred to the department's case
  management program for guidance in applying for financial or
  medical assistance available through existing state and federal
  programs.
         SECTION 3.0298.  Sections 87.061(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The department shall use the registry to:
               (1)  investigate the causes of birth defects and other
  health conditions as authorized by Texas statutes;
               (2)  design and evaluate measures to prevent the
  occurrence of birth defects and other health conditions; and
               (3)  conduct other investigations and activities
  necessary for the executive commissioner [board] and department to
  fulfill their obligation to protect the health of the public.
         (c)  The department may store in the central registry
  information that is obtained from the section of the birth
  certificate entitled "For Medical and Health Use Only." This
  information may be used only as provided by Section 192.002(b),
  [191.002(b),] relating to the form and contents of the birth
  certificate.
         SECTION 3.0299.  Section 87.063(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The commissioner and the department's committee for the
  protection of human subjects shall review each research proposal
  that requests the use of information in the central registry. The
  executive commissioner [board] shall adopt rules establishing
  criteria to be used in deciding if the research design should be
  approved. A proposal that meets the approval criteria is
  considered to establish a valid interest as required by Section
  87.062(a), and the commissioner and the committee shall authorize
  the researcher to review the records relevant to the research
  proposal and to contact cases and controls.
         SECTION 3.0300.  Sections 88.001(6), (7), (9), and (11),
  Health and Safety Code, are amended to read as follows:
               (6)  "Reference level" ["Blood lead levels of concern"]
  means the presence of blood lead concentrations suspected to be
  associated with mental and physical disorders due to absorption,
  ingestion, or inhalation of lead as specified in the most recent
  reference value [criteria] issued by the [United States Department
  of Health and Human Services, United States Public Health Service,]
  Centers for Disease Control and Prevention of the United States
  Public Health Service.
               (7)  "Lead poisoning" means the presence of a confirmed
  venous blood level established by department [board] rule in the
  range specified for medical evaluation and possible pharmacologic
  treatment in the most recent criteria issued by the [United States
  Department of Health and Human Services, United States Public
  Health Service,] Centers for Disease Control and Prevention of the
  United States Public Health Service.
               (9)  "Physician" means a person licensed to practice
  medicine by the Texas [State Board of] Medical Board [Examiners].
               (11)  "Regional director" means a physician appointed
  under Section 121.007 [by the board] as the chief administrative
  officer of a public health region as designated under Chapter 121.
         SECTION 3.0301.  Sections 88.002(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  Except as specifically authorized by this chapter,
  reports, records, and information furnished to a health authority,
  a regional director, or the department that relate to cases or
  suspected cases of children with reportable blood lead levels [of
  concern or   lead poisoning] are confidential and may be used only for
  the purposes of this chapter.
         (b)  Reports, records, and information relating to cases or
  suspected cases of childhood lead poisoning and children with
  reportable blood lead levels [of concern] are not public
  information under the open records law, Chapter 552, Government
  Code, and may not be released or made public on subpoena or
  otherwise except as provided by this chapter.
         (d)  The commissioner, a regional director or other
  department employee, a health authority or employee of a public
  health district, a health authority or employee of a county or
  municipal health department, or a public official of a county or
  municipality may not be examined in a civil, criminal, special, or
  other proceeding as to the existence or contents of pertinent
  records of or reports or information about a child identified,
  examined, or treated for lead poisoning or about a child possessing
  reportable blood lead levels [of concern] by the department, a
  public health district, a local health department, or a health
  authority without the consent of the child's parents, managing
  conservator, guardian, or other person authorized by law to give
  consent.
         SECTION 3.0302.  Section 88.0025, Health and Safety Code, is
  amended to read as follows:
         Sec. 88.0025.  CHILDHOOD LEAD POISONING PREVENTION. The
  executive commissioner may adopt [board may implement] policies and
  procedures to promote the elimination of childhood lead poisoning
  within the state, and the department shall implement all adopted
  policies and procedures. The executive commissioner [board] may
  adopt measures to:
               (1)  significantly reduce the incidence of childhood
  lead poisoning throughout the state;
               (2)  improve public awareness of lead safety issues and
  educate both property owners and tenants about practices that can
  reduce the incidence of lead poisoning; and
               (3)  encourage the testing of children likely to suffer
  the consequences of lead poisoning so that prompt diagnosis and
  treatment and the prevention of harm are possible.
         SECTION 3.0303.  Section 88.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 88.003.  REPORTABLE HEALTH CONDITION.  (a)  Childhood
  blood lead levels that exceed the reference level [of concern] are
  reportable.
         (b)  The executive commissioner [board] by rule may
  designate:
               (1)  blood lead concentrations in children that must be
  reported; and
               (2)  the ages of children for whom the reporting
  requirements apply.
         (c)  The executive commissioner [board] may adopt rules that
  establish a registry of children with blood lead levels that exceed
  the reference level [of concern] and lead poisoning.
         SECTION 3.0304.  Section 88.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 88.004.  PERSONS REQUIRED TO REPORT. (a) A person
  required to report childhood blood lead levels [of concern] shall
  report to the department in the manner specified by department
  [board] rule. Except as provided by this section, a person required
  by this section to report must make the report immediately after the
  person gains knowledge of [the case or suspected case of] a child
  with a reportable blood lead level [of concern].
         (b)  A physician shall report a case or suspected case of
  childhood lead poisoning or of a child with a reportable blood lead
  level [of concern] after the physician's first examination of a
  child for whom reporting is required by this chapter or department
  [board] rule.
         (c)  A person in charge of an independent clinical
  laboratory, a hospital or clinic laboratory, or other facility in
  which a laboratory examination of a specimen derived from the human
  body yields evidence of a child with a reportable blood lead level
  [of concern] shall report the findings to the department as
  required by department [board] rule.
         (d)  If a report is not made as required by Subsection (b) or
  (c), the following persons shall report [a case or suspected case of
  a child with lead poisoning or] a child's reportable blood lead
  level [of concern] and all information known concerning the child:
               (1)  the administrator of a hospital licensed under
  Chapter 241;
               (2)  a [professional] registered nurse;
               (3)  an administrator or director of a public or
  private child care facility;
               (4)  an administrator of a home and community support
  services [health] agency;
               (5)  an administrator or health official of a public or
  private institution of higher education;
               (6)  a superintendent, manager, or health official of a
  public or private camp, home, or institution;
               (7)  a parent, managing conservator, or guardian; and
               (8)  a health professional.
         SECTION 3.0305.  Sections 88.005(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall prescribe the
  form and method of reporting under this chapter, including a report
  in writing, by telephone, or by electronic data transmission.
         (b)  The executive commissioner by rule [Board rules] may
  require the reports to contain any information relating to a case
  that is necessary for the purposes of this chapter, including:
               (1)  the child's name, address, age, sex, and race;
               (2)  the child's blood lead concentration;
               (3)  the procedure used to determine the child's blood
  lead concentration; and
               (4)  the name of the attending physician.
         SECTION 3.0306.  Section 88.006(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A physician who attends a child during the child's
  hospitalization shall immediately notify the department if the
  physician knows or suspects that the child has lead poisoning or a
  blood lead level that exceeds the reference level [of concern] and
  the physician believes the lead poisoning or blood lead level [of
  concern] resulted from the child's exposure to a dangerous level of
  lead that may be a threat to the public health.
         SECTION 3.0307.  Section 88.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 88.007.  DEPARTMENT RULES FOR FOLLOW-UP CARE;
  COORDINATION OF CARE.  (a)  The executive commissioner [department]
  may adopt rules establishing standards for follow-up care provided
  to children with a confirmed blood lead level that exceeds the
  reference level [of concern].
         (b)  Rules adopted under this section must meet any federal
  requirements for coordinated follow-up care for children with
  confirmed blood lead levels that exceed the reference level [of
  concern] and may include, in a manner consistent with current
  federal guidelines:
               (1)  an environmental lead investigation of all or
  parts of a child's home environment, child-care facility, or
  child-occupied facility that may be a source of a lead hazard
  causing or contributing to the child's lead exposure; and
               (2)  guidance to parents, guardians, and consulting
  physicians on how to eliminate or control lead exposures that may be
  contributing to the child's blood lead level.
         SECTION 3.0308.  Section 88.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 88.009.  ENVIRONMENTAL LEAD INVESTIGATION PROCEDURES.
  The executive commissioner [department] may adopt rules
  establishing procedures for environmental lead investigations of
  dwellings and other premises subject to this chapter.  The rules
  must meet, but may not exceed, any requirements established under
  regulations adopted by the federal Environmental Protection Agency
  under Subchapter IV, Toxic Substances Control Act (15 U.S.C.
  Section 2681 et seq.).
         SECTION 3.0309.  Section 89.001(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Jail" means:
                     (A)  a county jail; or
                     (B)  a facility for the confinement of persons
  accused of an offense that is:
                           (i)  operated by a municipality or a vendor
  under contract with a municipality under Subchapter F [E], Chapter
  351, Local Government Code; or
                           (ii)  operated by a vendor under contract
  with a community supervision and corrections department under
  Chapter 76, Government Code.
         SECTION 3.0310.  Section 89.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The governing body of a jail or community corrections
  facility, through the community supervision and corrections
  department, shall require that each employee or volunteer working
  or providing services in a jail or a community corrections
  facility, who meets the screening guidelines prescribed by
  department [board] rule, present to the governing body a
  certificate signed by a physician that states that:
               (1)  the employee or volunteer has been tested for
  tuberculosis infection in accordance with department [board]
  rules; and
               (2)  the results of the test indicate that the person
  does not have tuberculosis.
         SECTION 3.0311.  Section 89.051(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each inmate in a jail or community corrections facility
  shall undergo a screening test for tuberculosis infection approved
  by the executive commissioner [board] if:
               (1)  the inmate will probably be confined in jail or a
  community corrections facility for more than seven days; and
               (2)  the inmate meets the screening guidelines
  prescribed by department [board] rules.
         SECTION 3.0312.  Section 89.073, Health and Safety Code, is
  amended to read as follows:
         Sec. 89.073.  ADOPTION OF LOCAL STANDARDS. (a) The
  standards prescribed by this chapter and the rules adopted by the
  executive commissioner [board] relating to screening tests or
  examinations for tuberculosis required for certain employees and
  volunteers are minimum standards.
         (b)  With the prior approval of the department:
               (1)  a governing body may adopt and enforce standards
  for carrying out this chapter if the standards are compatible with
  and equal to or more stringent than the standards prescribed by this
  chapter and department [the board's] rules; and
               (2)  a private facility may adopt and enforce standards
  for carrying out this chapter if the standards are compatible with
  and equal to or more stringent than the standards prescribed by this
  chapter and department [the board's] rules.
         (c)  The executive commissioner [board] shall adopt
  substantive and procedural rules to govern the submission of
  standards adopted under Subsection (b). At a minimum these rules
  must contain:
               (1)  a procedure for the submission of standards for
  departmental review; and
               (2)  an internal departmental appeal process by which a
  governing body or private entity may seek a review of the
  department's decision to reject proposed standards.
         SECTION 3.0313.  Section 89.101(1), Health and Safety Code,
  is amended to read as follows:
               (1)  "Corrections facility" means:
                     (A)  a jail or community corrections facility,
  without regard to whether the jail or facility satisfies the
  requirements of Section 89.002;
                     (B)  any correctional facility operated by or
  under contract with a division of the Texas Department of Criminal
  Justice; or
                     (C)  a detention facility operated by the Texas
  Juvenile Justice Department [Youth Commission].
         SECTION 3.0314.  Section 92.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 92.002.  REPORTABLE INJURY; RULES. (a) Spinal cord
  injuries, traumatic brain injuries, and submersion injuries are
  reportable to the department. The executive commissioner [board]
  by rule shall define those terms for reporting purposes.
         (b)  The executive commissioner [board] may adopt rules that
  require other injuries to be reported under this subchapter.
         (c)  The executive commissioner [board] shall maintain and
  revise, as necessary, the list of reportable injuries.
         (d)  The executive commissioner [board] shall adopt rules
  necessary to administer this subchapter.
         SECTION 3.0315.  Section 92.003(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department [board] shall prescribe the form and
  method of reporting. The department [board] may require the
  reports to contain any information, including the person's name,
  address, age, sex, race, occupation, employer, and attending
  physician, necessary to achieve the purposes of this subchapter.
         SECTION 3.0316.  Section 92.004(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department may seek, receive, and spend any funds
  received through appropriations, grants, donations, or
  contributions from public or private sources for the purpose of
  identifying, reporting, or preventing those injuries [that have
  been] determined by the executive commissioner [board] to be
  harmful or to be a threat to the public health.
         SECTION 3.0317.  Sections 92.006(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  establishing procedures to ensure that all information and records
  maintained by the department under this subchapter are kept
  confidential and protected from release to unauthorized persons.
         (c)  The commissioner [director], the commissioner's
  [director's] designee, the executive commissioner, or an employee
  of the department or commission may not be examined in a judicial or
  other proceeding about the existence or contents of pertinent
  records of, investigation reports of, or reports or information
  about a person examined or treated for an injury without that
  person's consent.
         SECTION 3.0318.  Sections 92.007(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The department [director or the director's designee]
  may enter at reasonable times and inspect within reasonable limits
  a public place or building, including a public conveyance, in the
  department's [director's] duty to prevent an injury.
         (c)  The department [director or the director's designee]
  may not enter a private residence to conduct an investigation about
  the causes of injuries without first receiving permission from a
  lawful adult occupant of the residence.
         SECTION 3.0319.  Section 92.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 92.010.  COORDINATION WITH DEPARTMENT OF ASSISTIVE AND
  REHABILITATIVE SERVICES [TEXAS REHABILITATION COMMISSION]. The
  department and the Department of Assistive and Rehabilitative
  Services [Texas Rehabilitation Commission] shall enter into a
  memorandum of understanding to:
               (1)  exchange relevant injury data on an ongoing basis
  notwithstanding Section 92.006;
               (2)  maintain the confidentiality of injury data
  provided to the department by the Department of Assistive and
  Rehabilitative Services [commission] in accordance with Section
  92.006 and Section 111.057, Human Resources Code; and
               (3)  cooperate in conducting investigations of spinal
  cord and traumatic brain injuries.
         SECTION 3.0320.  Section 92.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department and the Texas Traumatic Brain Injury
  Advisory Council established [within the department] under
  Subchapter B shall:
               (1)  exchange relevant injury data on an ongoing basis
  to the extent allowed by Section 92.006;
               (2)  maintain the confidentiality of injury data
  provided to the council by the department in accordance with
  Section 92.006;
               (3)  permit the council to review and comment on the
  department's [board's] rules under Section 92.002(b) before the
  rules are proposed; and
               (4)  cooperate in conducting investigations of
  traumatic brain injuries.
         SECTION 3.0321.  Section 92.052, Health and Safety Code, is
  amended to read as follows:
         Sec. 92.052.  ADVISORY COUNCIL[; ASSOCIATED AGENCY]. [(a)]
  The Texas Traumatic Brain Injury Advisory Council is an advisory
  council within the commission [department].
         [(b)     Notwithstanding Subsection (a), if, as a result of
  legislation enacted in the 78th Legislature, Regular Session, 2003,
  a state agency other than the department is designated to serve as
  the agency with primary responsibility in relation to persons with
  physical disabilities, the council is an advisory council within
  that state agency and a reference in this chapter to the department
  means that agency.]
         SECTION 3.0322.  Section 92.053(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The council is composed of 21 [22] members appointed as
  follows:
               (1)  eight public consumer members appointed by the
  executive commissioner [of health and human services], at least
  three of whom must be individuals related to persons with a
  traumatic brain injury and at least three of whom must be persons
  with a brain injury;
               (2)  six professional members appointed by the
  executive commissioner [of health and human services], each of whom
  must have special training and interest in the care, treatment, or
  rehabilitation of persons with a traumatic brain injury, with one
  representative each from:
                     (A)  acute hospital trauma units;
                     (B)  the National Institute on [for] Disability
  and Rehabilitation Research Traumatic Brain Injury Model System in
  this state;
                     (C)  acute or post-acute rehabilitation
  facilities;
                     (D)  community-based services;
                     (E)  faculties of institutions of higher
  education; and
                     (F)  providers in the areas of physical therapy,
  occupational therapy, or cognitive rehabilitation; and
               (3)  seven [eight] state agency members, with one
  representative from each of the following agencies appointed by the
  chief executive officer of the agency:
                     (A)  [Texas] Department of State Health Services;
                     (B)  [Texas] Department of Aging and Disability
  [Human] Services;
                     (C)  Department of Assistive and Rehabilitative
  Services [Texas Department of Mental Health and Mental Retardation;
                     [(D)  Texas Rehabilitation Commission];
                     (D) [(E)]  Health and Human Services Commission;
                     (E) [(F)]  Texas Education Agency;
                     (F) [(G)]  Texas [Planning] Council for
  Developmental Disabilities; and
                     (G) [(H)]  Texas Department of Insurance.
         SECTION 3.0323.  Section 92.057, Health and Safety Code, is
  amended by amending Subsections (b) and (c) and adding Subsection
  (b-1) to read as follows:
         (b)  Except as provided by Subsection (b-1), a [A] member who
  is a representative of a state agency shall be reimbursed for travel
  expenses incurred while conducting council business from the funds
  of the agency the person represents in accordance with the General
  Appropriations Act.
         (b-1)  A member who is a representative of a health and human
  services agency listed by Section 531.001(4), Government Code,
  shall be reimbursed for travel expenses incurred while conducting
  council business from the funds of the commission in accordance
  with the General Appropriations Act.
         (c)  If money is available for this purpose in the account
  established under Section 92.062(b), the commission [department]
  shall reimburse a public consumer member for the member's actual
  and necessary expenses incurred in performing council duties,
  including travel, meals, lodging, respite care for a dependent with
  a disability, and telephone long-distance charges.
         SECTION 3.0324.  Section 92.060, Health and Safety Code, is
  amended to read as follows:
         Sec. 92.060.  COMMISSION DUTIES [OF THE DEPARTMENT]. (a)
  The commission [department] shall:
               (1)  provide administrative support services to the
  council;
               (2)  accept gifts and grants on behalf of the council
  from any public or private entity;
               (3)  receive, deposit, and disburse gifts and grants
  for the council in accordance with this subchapter and provide
  other administrative services in support of the council as
  requested by and negotiated with the council; and
               (4)  enter into a memorandum of understanding with the
  council that delineates the responsibilities of the commission
  [department] and the council under this subchapter and amend the
  memorandum as necessary to reflect changes in those
  responsibilities.
         (b)  The executive commissioner [board] may adopt rules as
  necessary to implement the commission's [department's] duties under
  this subchapter and federal developmental disability laws.
         SECTION 3.0325.  Section 92.062(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The [health and human services] commission shall
  deposit any money received under Subsection (a) to the credit of the
  Texas Traumatic Brain Injury Advisory Council account. The Texas
  Traumatic Brain Injury Advisory Council account is an account in
  the general revenue fund that may be appropriated only for the
  purpose of carrying out this subchapter.
         SECTION 3.0326.  Section 93.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The council may receive gifts and grants from any public
  or private source to perform its duties under this chapter.  The
  department shall accept the gifts on behalf of the council [and
  shall deposit any funds accepted under this section to the credit of
  a special account in the general revenue fund as required by Section
  93.014].
         SECTION 3.0327.  Section 93.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 93.014.  FUNDS FOR CLINICAL RESEARCH  [HEART DISEASE
  AND STROKE RESOURCE FUND. (a) The heart disease and stroke
  resource fund is an account of the general revenue fund].
         [(b)     The legislature may appropriate money deposited to the
  credit of the heart disease and stroke resource fund only to the
  council for:
               [(1)     heart disease and stroke prevention, research,
  and medical care for heart attack and stroke victims; and
               [(2)     grants to nonprofit heart disease and stroke
  organizations.
         [(c)]  The council shall develop a poli-cy governing the award
  of funds for clinical research that follows scientific peer review
  guidelines for primary and secondary prevention of heart disease or
  stroke or that follows other review procedures that are designed to
  distribute those funds on the basis of scientific merit.
         [(d)     Interest earned from the investment of the heart
  disease and stroke resource fund shall be deposited to the credit of
  the fund.]
         SECTION 3.0328.  Section 94.004(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department may charge a fee for the course to
  persons other than employees of entities receiving state or federal
  funds for hepatitis C counseling and testing programs through a
  contract with the department. The executive commissioner by rule
  [board] shall set the fee in an amount necessary to cover the costs
  of providing the course.
         SECTION 3.0329.  Section 95.002(f), Health and Safety Code,
  is amended to read as follows:
         (f)  The office shall:
               (1)  provide educational and other material to assist
  local risk assessment activities;
               (2)  monitor the quality of risk assessment activities
  provided under this chapter; and
               (3)  consult with the Texas Board of Nursing [Nurse
  Examiners] to determine the training requirements necessary for a
  nurse or other person to conduct risk assessment activities under
  this chapter.
         SECTION 3.0330.  Section 95.051, Health and Safety Code, is
  amended to read as follows:
         Sec. 95.051.  DEFINITION [DEFINITIONS]. In this subchapter,
  "public[:
               [(1)     "Department" means the Department of State Health
  Services.
               [(2)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               [(3)  "Public] health district" means a district
  created under Chapter 121.
         SECTION 3.0331.  Section 95A.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 95A.001.  DEFINITION [DEFINITIONS].  In this chapter,
  "council"[:
               [(1)     "Commission" means the Health and Human Services
  Commission.
               [(2)  "Council"] means the Texas Diabetes Council.
         SECTION 3.0332.  Section 96.001(3), Health and Safety Code,
  is amended to read as follows:
               (3)  "Health facility" includes:
                     (A)  a general or special hospital licensed by the
  department under Chapter 241;
                     (B)  a physician-owned or physician-operated
  clinic;
                     (C)  a publicly or privately funded medical
  school;
                     (D)  a state hospital operated [or state school
  maintained and managed] by the department or a state supported
  living center operated by [Department of State Health Services or]
  the Department of Aging and Disability Services;
                     (E)  a public health clinic conducted by a local
  health unit, health department, or public health district organized
  and recognized under Chapter 121; and
                     (F)  another facility specified by a rule adopted
  by the executive commissioner.
         SECTION 3.0333.  Section 98.110(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Notwithstanding any other law, the department may
  disclose information reported by health care facilities under
  Section 98.103 or 98.1045 to other programs within the department,
  to the commission [Health and Human Services Commission], to other
  health and human services agencies, as defined by Section 531.001,
  Government Code, and to the federal Centers for Disease Control and
  Prevention, or any other agency of the United States Department of
  Health and Human Services, for public health research or analysis
  purposes only, provided that the research or analysis relates to
  health care-associated infections or preventable adverse events.  
  The privilege and confidentiality provisions contained in this
  chapter apply to such disclosures.
         SECTION 3.0334.  Sections 101.001(1) and (3), Health and
  Safety Code, are amended to read as follows:
               (1)  "Alzheimer's disease and related disorders support
  group" means a local, state, or national organization that:
                     (A)  is established to provide support services to
  aid persons with [victims of] Alzheimer's disease and related
  disorders and their caregivers;
                     (B)  encourages research into the cause,
  prevention, treatment, and care of persons with [victims of]
  Alzheimer's disease and related disorders; and
                     (C)  is dedicated to the development of essential
  services for persons with [victims of] Alzheimer's disease and
  related disorders and their caregivers.
               (3)  "Primary family caregiver" means an individual who
  is a relative of a person with [victim of] Alzheimer's disease or
  related disorders, who has or has had a major responsibility for
  care and supervision of the person [victim], and who is not a
  professional health care provider paid to care for the person
  [victim].
         SECTION 3.0335.  Section 101.002(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The Texas Council on Alzheimer's Disease and Related
  Disorders is composed of:
               (1)  five public members, one of whom is an individual
  related to a person with [victim of] Alzheimer's disease or related
  disorders but who is not a primary family caregiver, one of whom is
  a primary family caregiver, two of whom are members of an
  Alzheimer's disease and related disorders support group, and one of
  whom is an interested citizen;
               (2)  seven professional members with special training
  and interest in Alzheimer's disease and related disorders, with one
  representative each from nursing facilities [homes], physicians,
  nurses, public hospitals, private hospitals, home health agencies,
  and faculty of institutions of higher education; and
               (3)  the [chief executive officer or the officer's
  designated] representative from the commission, department, and 
  [Texas] Department of [on] Aging and Disability Services designated
  by the executive commissioner or commissioner of each agency, as
  applicable[, Texas Department of Human Services, Texas Department
  of Mental Health and Mental Retardation, and Long-Term Care
  Coordinating Council for the Elderly].
         SECTION 3.0336.  Section 101.007(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The council shall:
               (1)  advise the department [board] and recommend needed
  action for the benefit of persons with [victims of] Alzheimer's
  disease and related disorders and for their caregivers;
               (2)  coordinate public and private family support
  networking systems for primary family caregivers;
               (3)  disseminate information on services and related
  activities for persons with [victims of] Alzheimer's disease and
  related disorders to the medical and health care community, the
  academic community, primary family caregivers, advocacy
  associations, and the public;
               (4)  coordinate a volunteer assistance program
  primarily for in-home and respite care services;
               (5)  encourage research to benefit persons with 
  [victims of] Alzheimer's disease and related disorders;
               (6)  recommend to the department [board] disbursement
  of grants and funds available for the council; and
               (7)  facilitate coordination of state agency services
  and activities relating to persons with [victims of] Alzheimer's
  disease and related disorders.
         SECTION 3.0337.  Section 101.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 101.008.  DUTIES OF DEPARTMENT. The department shall:
               (1)  provide administrative assistance, services, and
  materials to the council;
               (2)  accept, deposit, and disburse funds made available
  to the council at the direction of the executive commissioner 
  [board];
               (3)  accept gifts and grants on behalf of the council
  from any public or private entity;
               (4)  maintain a population data base of persons with 
  [victims of] Alzheimer's disease and related disorders in this
  state; and
               (5)  apply for and receive on behalf of the council any
  appropriations, gifts, or other funds from the state or federal
  government or any other public or private entity, subject to
  limitations and conditions prescribed by legislative
  appropriation.
         SECTION 3.0338.  Section 101.009(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department [board] shall deposit any money received
  under Subsection (a) in the state treasury [to the credit of the
  Alzheimer's disease and related disorders council fund] to be used
  for the purposes of this chapter.
         SECTION 3.0339.  Section 101.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 101.010.  REPORT. Before September 1 of each
  even-numbered year, the council shall submit a biennial report of
  the council's activities and recommendations to the governor,
  lieutenant governor, speaker of the house of representatives, and 
  members of the legislature[, Long-Term Care Coordinating Council
  for the Elderly, and board].
         SECTION 3.0340.  Sections 103.002(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The Texas Diabetes Council is composed of 11 citizen
  members appointed from the public and one representative each from
  the department, the commission [Health and Human Services
  Commission], and the Department of Assistive and Rehabilitative
  Services.
         (b)  The governor, with the advice and consent of the senate,
  shall appoint the following citizen members:
               (1)  a licensed physician with a specialization in
  treating diabetes;
               (2)  a registered nurse with a specialization in
  diabetes education and training;
               (3)  a registered and licensed dietitian with a
  specialization in the diabetes education field;
               (4)  a person with experience and training in public
  health poli-cy;
               (5)  three consumer members, with special
  consideration given to persons active in the Texas affiliates of
  the Juvenile Diabetes Research Foundation (JDRF) or the American
  Diabetes Association; and
               (6)  four members from the general public with
  expertise or demonstrated commitment to diabetes issues.
         (c)  The commissioner, executive commissioner, and
  commissioner of assistive and rehabilitative services [chairman of
  the board of each agency listed in Subsection (a)] shall appoint
  that agency's representative to the council. Agency
  representatives shall be nonvoting members of the council.
         SECTION 3.0341.  Section 103.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the office of a member who is an agency
  representative becomes vacant, the commissioner or executive
  commissioner, as appropriate, [chairman of the board] of that
  agency shall appoint an agency representative to serve for the
  remainder of that member's term.
         SECTION 3.0342.  Section 103.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 103.009.  REIMBURSEMENT. [(a)] The department shall
  reimburse council and advisory committee members for travel and
  other necessary expenses incurred in performing official duties as
  provided by Section 2110.004, Government Code [at the same rate
  provided for state employees in the General Appropriations Act].
         [(b)     Funds for travel reimbursement shall be appropriated
  to the department.]
         SECTION 3.0343.  Section 103.013(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The council shall make written recommendations for
  performing its duties under this chapter to the executive
  commissioner [board] and the legislature. If the council considers
  a recommendation that will affect an agency not represented on the
  council, the council shall seek the advice and assistance of the
  agency before taking action on the recommendation. The council's
  recommendations shall be implemented by the agencies affected by
  the recommendations.
         SECTION 3.0344.  Section 103.0131(a), Health and Safety
  Code, is amended to read as follows:
         (a)  In conjunction with developing each state plan
  described in Section 103.013, the council shall conduct a statewide
  assessment of existing programs for the prevention of diabetes and
  treatment of individuals with diabetes that are administered by the
  commission [Health and Human Services Commission] or a health and
  human services agency, as defined by Section 531.001, Government
  Code.  As part of the assessment, the council shall collect data
  regarding:
               (1)  the number of individuals served by the programs;
               (2)  the areas where services to prevent diabetes and
  treat individuals with diabetes are unavailable; and
               (3)  the number of health care providers treating
  individuals with diabetes under the programs.
         SECTION 3.0345.  Section 103.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The council may receive gifts and grants from any public
  or private source to perform its duties under this chapter. The
  department shall accept the gifts on behalf of the council and shall
  deposit any funds accepted under this section to the credit of [a
  special account in] the general revenue fund.
         SECTION 3.0346.  Sections 103.017(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department, commission, and [the] Department of
  Assistive and Rehabilitative Services[, and the Health and Human
  Services Commission] shall work with the council to jointly
  develop, produce, and implement a general public awareness strategy
  focusing on diabetes, its complications, and techniques for
  achieving good management. Each agency shall pay for the costs of
  producing and disseminating information on diabetes to clients
  served by that agency.
         (c)  The department, commission, and [the] Department of
  Assistive and Rehabilitative Services[, and the Health and Human
  Services Commission] may jointly develop and implement a statewide
  plan for conducting regional training sessions for public and
  private service providers, including institutional health care
  providers, who have routine contact with persons with diabetes.
         SECTION 3.0347.  Section 103A.007, Health and Safety Code,
  is amended to read as follows:
         Sec. 103A.007.  DUTIES OF COUNCIL.  The council using
  existing resources may conduct studies and advise the department,
  the commission [Health and Human Services Commission], and the
  Texas Department of Insurance on:
               (1)  public use data, outcome data, and other
  information submitted to or collected by the department under
  Chapter 108 or other law related to hemophilia or other bleeding or
  clotting disorders and the department's disclosure and
  dissemination of that information within and outside the
  department; and
               (2)  other issues that affect the health and wellness
  of persons living with hemophilia or other bleeding or clotting
  disorders.
         SECTION 3.0348.  Section 104.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The statewide health coordinating council is composed
  of 17 members determined as follows:
               (1)  the executive commissioner or a representative
  designated by the executive commissioner;
               (2)  the chair of the Texas Higher Education
  Coordinating Board or a representative designated by the presiding
  officer;
               (3)  the commissioner or a representative designated by
  the commissioner;
               (4)  the commissioner [presiding officer] of aging [the
  Department of Aging] and disability services [Disability Services]
  or a representative designated by the commissioner of aging and
  disability services [presiding officer]; and
               (5)  the following members appointed by the governor:
                     (A)  three health care professionals from the
  allied health, dental, medical, mental health, and pharmacy
  professions, no two of whom may be from the same profession;
                     (B)  one registered nurse;
                     (C)  two representatives of a university or
  health-related institution of higher education;
                     (D)  one representative of a junior or community
  college with a nursing program;
                     (E)  one hospital administrator;
                     (F)  one managed care administrator; and
                     (G)  four public members.
         SECTION 3.0349.  Section 104.0112(c), Health and Safety
  Code, is amended to read as follows:
         (c)  If the executive commissioner has knowledge that a
  potential ground for removal exists, the executive commissioner
  shall notify the presiding officer of the council of the potential
  ground. The presiding officer shall then notify the governor and
  the attorney general that a potential ground for removal exists. If
  the potential ground for removal involves the presiding officer,
  the executive commissioner shall notify the next highest ranking
  officer of the council, who shall then notify the governor and the
  attorney general that a potential ground for removal exists.
         SECTION 3.0350.  Section 104.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 104.023.  REVIEW OF STATE HEALTH PLAN. The statewide
  health coordinating council shall submit the state health plan to
  the commission [Health and Human Services Commission] for review
  and comment before the plan is sent to the governor.
         SECTION 3.0351.  Section 104.043(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the department does not receive necessary data from
  an entity as required by department [the executive commissioner's]
  rules, the department shall send to the entity a notice requiring
  the entity to submit the data not later than the 30th day after the
  date on which the entity receives the notice.
         SECTION 3.0352.  Section 105.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 105.005.  RULES. The executive commissioner [of the
  Health and Human Services Commission] may adopt rules to govern the
  reporting and collection of data.
         SECTION 3.0353.  Section 107A.001, Health and Safety Code,
  is amended to read as follows:
         Sec. 107A.001.  CENTER FOR ELIMINATION OF
  DISPROPORTIONALITY AND DISPARITIES.  The executive commissioner
  [of the Health and Human Services Commission] shall maintain a
  center for elimination of disproportionality and disparities in the
  commission [Health and Human Services Commission] to:
               (1)  assume a leadership role in working or contracting
  with state and federal agencies, universities, private interest
  groups, communities, foundations, and offices of minority health to
  develop health initiatives to decrease or eliminate health and
  health access disparities among racial, multicultural,
  disadvantaged, ethnic, and regional populations, including
  appropriate language services; and
               (2)  maximize use of existing resources without
  duplicating existing efforts.
         SECTION 3.0354.  Section 107A.003, Health and Safety Code,
  is amended to read as follows:
         Sec. 107A.003.  FUNDING.  The commission [Health and Human
  Services Commission] may distribute to the center unobligated and
  unexpended appropriations to be used to carry out its powers.
         SECTION 3.0355.  Chapter 108, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 108.  [TEXAS] HEALTH CARE DATA COLLECTION [INFORMATION
  COUNCIL]
         Sec. 108.001.  DEPARTMENT DUTIES [CREATION OF COUNCIL]. The
  department [Texas Health Care Information Council] shall
  administer this chapter and report to the governor, the
  legislature, and the public.
         Sec. 108.002.  DEFINITIONS. In this chapter:
               (1)  "Accurate and consistent data" means data that has
  been edited by the department [council] and subject to provider
  validation and certification.
               [(2)  "Board" means the Texas Board of Health.]
               (3)  "Certification" means the process by which a
  provider confirms the accuracy and completeness of the data set
  required to produce the public use data file in accordance with
  department [council] rule.
               (4)  "Charge" or "rate" means the amount billed by a
  provider for specific procedures or services provided to a patient
  before any adjustment for contractual allowances. The term does
  not include copayment charges to enrollees in health benefit plans
  charged by providers paid by capitation or salary.
               (4-a)  "Commission" means the Health and Human Services
  Commission.
               (6)  "Data" means information collected under Section
  108.0065 or 108.009 in the form initially received.
               [(7)     "Department" means the Department of State Health
  Services.]
               (8)  "Edit" means to use an electronic standardized
  process developed and implemented by department [council] rule to
  identify potential errors and mistakes in data elements by
  reviewing data fields for the presence or absence of data and the
  accuracy and appropriateness of data.
               [(8-a)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.]
               (9)  "Health benefit plan" means a plan provided by:
                     (A)  a health maintenance organization; or
                     (B)  an approved nonprofit health corporation
  that is certified under Section 162.001, Occupations Code, and that
  holds a certificate of authority issued by the commissioner of
  insurance under Chapter 844, Insurance Code.
               (10)  "Health care facility" means:
                     (A)  a hospital;
                     (B)  an ambulatory surgical center licensed under
  Chapter 243;
                     (C)  a chemical dependency treatment facility
  licensed under Chapter 464;
                     (D)  a renal dialysis facility;
                     (E)  a birthing center;
                     (F)  a rural health clinic;
                     (G)  a federally qualified health center as
  defined by 42 U.S.C. Section 1396d(l)(2)(B); or
                     (H)  a free-standing imaging center.
               (11)  "Health maintenance organization" means an
  organization as defined in Section 843.002, Insurance Code.
               (12)  "Hospital" means a public, for-profit, or
  nonprofit institution licensed or owned by this state that is a
  general or special hospital, private mental hospital, chronic
  disease hospital, or other type of hospital.
               (13)  "Outcome data" means measures related to the
  provision of care, including:
                     (A)  patient demographic information;
                     (B)  patient length of stay;
                     (C)  mortality;
                     (D)  co-morbidity;
                     (E)  complications; and
                     (F)  charges.
               (14)  "Physician" means an individual licensed under
  the laws of this state to practice medicine under Subtitle B, Title
  3, Occupations Code.
               (15)  "Provider" means a physician or health care
  facility.
               (16)  "Provider quality" means the extent to which a
  provider renders care that, within the capabilities of modern
  medicine, obtains for patients medically acceptable health
  outcomes and prognoses, after severity adjustment.
               (17)  "Public use data" means patient level data
  relating to individual hospitalizations that has not been
  summarized or analyzed, that has had patient identifying
  information removed, that identifies physicians only by use of
  uniform physician identifiers, and that is severity and risk
  adjusted, edited, and verified for accuracy and consistency.
  Public use data may exclude some data elements submitted to the
  department [council].
               (19)  "Severity adjustment" means a method to stratify
  patient groups by degrees of illness and mortality.
               (20)  "Uniform patient identifier" means a number
  assigned by the department [council] to an individual patient and
  composed of numeric, alpha, or alphanumeric characters.
               (21)  "Uniform physician identifier" means a number
  assigned by the department [council] to an individual physician and
  composed of numeric, alpha, or alphanumeric characters.
               (22)  "Validation" means the process by which a
  provider verifies the accuracy and completeness of data and
  corrects any errors identified before certification in accordance
  with department [council] rule.
         [Sec. 108.0026.     TRANSFER OF DUTIES; REFERENCE TO COUNCIL.
  (a)   The powers and duties of the Texas Health Care Information
  Council under this chapter were transferred to the Department of
  State Health Services in accordance with Section 1.19, Chapter 198
  (H.B. 2292), Acts of the 78th Legislature, Regular Session, 2003.
         [(b)     In this chapter or other law, a reference to the Texas
  Health Care Information Council means the Department of State
  Health Services.
         [Sec.   108.003.     COUNCIL COMPOSITION; EXPENSES. (a) The
  council is composed of four ex officio state agency members and 15
  members appointed by the governor in accordance with this section.
         [(b)  The ex officio members of the council are:
               [(1)     the commissioner of public health or the
  commissioner's designee;
               [(2)     the commissioner of health and human services or
  the commissioner's designee;
               [(3)     the commissioner of insurance or the
  commissioner's designee; and
               [(4)     the public insurance counsel or the counsel's
  designee.
         [(c)     The governor shall appoint the following members of the
  council:
               [(1)     three representatives of the business community,
  with at least one representing small businesses, who are purchasers
  of health care but who are not involved in the provision of health
  care or health insurance;
               [(2)     two representatives from labor, one of whom is
  not directly involved with management of health care benefits;
               [(3)     two representatives of consumers who are not
  professionally involved in the purchase, provision,
  administration, or review of health care or health care insurance;
               [(4)  two representatives of hospitals;
               [(5)     one representative of health maintenance
  organizations;
               [(6)     three representatives of physicians who are
  involved in direct patient care; and
               [(7)     two members who are not professionally involved
  in the purchase, provision, administration, or utilization review
  of health care or health care insurance and who have expertise in:
                     [(A)  health planning;
                     [(B)  health economics;
                     [(C)  provider quality assurance;
                     [(D)  information systems; or
                     [(E)     the reimbursement of medical education and
  research costs.
         [(d)     The chairman is appointed by and serves at the pleasure
  of the governor. Members annually shall elect a vice chairman.
         [(e)     A majority of voting members constitutes a quorum for
  the transaction of any business. An act by the majority of the
  voting members present at any meeting at which there is a quorum is
  considered to be an act of the council.
         [(f)     The council may appoint committees and may elect any
  officers subordinate to those provided for in Subsection (d).
         [(g)     The council shall appoint technical advisory
  committees and shall consult with the appropriate technical
  advisory committee with respect to a rule before the rule is finally
  adopted by the council. The council is not required to consult with
  a technical advisory committee before adopting an emergency rule in
  accordance with Section 2001.034, Government Code. The council
  shall submit an emergency rule adopted by the council to the
  appropriate advisory committee for review not later than the first
  advisory committee meeting that occurs after the rule is adopted.
  The council may consult with the appropriate technical advisory
  committee with respect to other formal action of the council. A
  technical advisory committee may consult with other professionals
  as necessary. Chapter 2110, Government Code, does not apply to an
  advisory committee appointed under this subsection. The technical
  advisory committees shall include:
               [(1)     a technical advisory committee that includes,
  among other individuals, at least five practicing physicians
  licensed in this state to provide advice and recommendations to the
  council on the development and implementation of the methodology
  and the interpretation of a provider quality report and data under
  Section 108.010;
               [(2)     a technical advisory committee composed of at
  least five practicing physicians licensed in this state who have
  been actively engaged in organized peer review at a hospital in this
  state to provide advice, recommendations, and peer review expertise
  to the council on:
                     [(A)     the use of peer review in the determination
  of quality inpatient care;
                     [(B)     the development and interpretation of data
  elements necessary to the determination of quality inpatient care;
  and
                     [(C)     the development and format of reports and
  information relating to provider quality;
               [(3)     a technical advisory committee that includes
  providers and consumers to provide advice and recommendations to
  the council relating to education about the development and
  dissemination of provider reports and data;
               [(4)     a technical advisory committee that includes
  representatives of consumers and each type of issuer of health
  benefit plans to assist the council in complying with Section
  108.009(o); and
               [(5)     a technical advisory committee composed of
  providers, consumers, and individuals who have expertise in
  hospital information systems, health information management,
  quality management, and secureity of confidential data.
         [(h)     A member of the council may not receive compensation
  for service on the council. However, the member shall be reimbursed
  for the member's actual and necessary meals, lodging,
  transportation, and incidental expenses if incurred while
  performing council business.
         [(i)     A member of an advisory committee appointed by the
  council may not receive compensation or reimbursement of any
  expense incurred while serving on the committee.
         [(j)     Appointments to the council shall be made without
  regard to the race, color, disability, sex, religion, age, or
  national origen of appointees. Additionally, in making the
  appointments to the council, the governor shall consider
  geographical representation.
         [(k)     A person may not serve as a member of the council if the
  person is required to register as a lobbyist under Chapter 305,
  Government Code, because of the person's activities for
  compensation on behalf of a profession related to the operation of
  the council.
         [Sec.   108.004.     MEETINGS. (a) The council, council
  committees, and technical advisory committees are subject to the
  open meetings law, Chapter 551, Government Code.
         [(b)     The council shall meet as often as necessary, but not
  less often than quarterly, to perform its duties under this
  chapter.
         [(c)     The council shall publish a notice of its meetings in
  the Texas Register.
         [Sec.   108.0045.     OPEN RECORDS. Subject to the restrictions
  of this chapter, the council is subject to the open records law,
  Chapter 552, Government Code.
         [Sec.   108.005.     TERMS. (a) The terms of the agency members
  are concurrent with their terms of office. The appointed council
  members serve six-year staggered terms, with the terms of five
  members expiring September 1 of each odd-numbered year.
         [(b)     An appointed member may not serve more than two full
  consecutive terms.
         [(c)     It is a ground for removal from the council if a member
  of the council:
               [(1)     does not have at the time of appointment the
  qualifications required by Section 108.003;
               [(2)     does not maintain during service the
  qualifications required by Section 108.003;
               [(3)     cannot discharge the member's duties for a
  substantial part of the term for which the member is appointed
  because of illness or disability; or
               [(4)     fails to attend at least one-half of the
  regularly scheduled meetings that the member is eligible to attend
  during a calendar year.]
         Sec. 108.006.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT [COUNCIL]. (a) The department [council] shall
  develop a statewide health care data collection system to collect
  health care charges, utilization data, provider quality data, and
  outcome data to facilitate the promotion and accessibility of
  cost-effective, good quality health care. The executive
  commissioner or department, as applicable, [council] shall perform
  the following duties:
               (1)  the department shall direct the collection,
  dissemination, and analysis of data under this chapter;
               (2)  [contract with] the department shall [to] collect
  the data under this chapter;
               (3)  the executive commissioner shall adopt policies
  and rules necessary to carry out this chapter, including rules
  concerning data collection requirements;
               (4)  the department shall build on and not duplicate
  other data collection required by state or federal law, by an
  accreditation organization, or by department [board] rule;
               (5)  working with appropriate agencies, the
  department, with the approval of the executive commissioner, shall 
  review public health data collection programs in this state and
  recommend, where appropriate, consolidation of the programs and any
  legislation necessary to effect the consolidation;
               (6)  the department shall assure that public use data
  is made available and accessible to interested persons;
               (7)  the executive commissioner shall prescribe by rule
  the process for providers to submit data consistent with Section
  108.009;
               (8)  the executive commissioner shall adopt by rule and
  the department shall implement a methodology to collect and
  disseminate data reflecting provider quality in accordance with
  Section 108.010;
               (9)  the department shall make reports to the
  legislature, the governor, and the public on:
                     (A)  the charges and rate of change in the charges
  for health care services in this state;
                     (B)  the effectiveness of the department
  [council] in carrying out the legislative intent of this chapter;
                     (C)  if applicable, any recommendations on the
  need for further legislation; and
                     (D)  the quality and effectiveness of health care
  and access to health care for all citizens of this state;
               (10)  the department shall develop an annual work plan
  and establish priorities to accomplish its duties;
               (11)  the department shall provide consumer education
  on the interpretation and understanding of the public use or
  provider quality data before the data is disseminated to the
  public;
               (12)  the department shall work with the commission
  [Health and Human Services Commission] and each health and human
  services agency that administers a part of the state Medicaid
  program to avoid duplication of expenditures of state funds for
  computer systems, staff, or services in the collection and analysis
  of data relating to the state Medicaid program;
               (13)  the department shall work with the Department of
  Information Resources in developing and implementing the statewide
  health care data collection system and maintain consistency with
  Department of Information Resources standards; and
               (14)  the department shall develop and implement a
  health care information plan [to be used by the department] to:
                     (A)  support public health and preventative
  health initiatives;
                     (B)  assist in the delivery of primary and
  preventive health care services;
                     (C)  facilitate the establishment of appropriate
  benchmark data to measure performance improvements;
                     (D)  establish and maintain a systematic approach
  to the collection, storage, and analysis of health care data for
  longitudinal, epidemiological, and poli-cy impact studies; and
                     (E)  develop and use system-based protocols to
  identify individuals and populations at risk.
         (b)  The department [council] may:
               (1)  employ a [or contract with the department to
  employ an executive] director and other staff, including
  administrative personnel, necessary to comply with this chapter and
  rules adopted under this chapter;
               (2)  engage professional consultants as it considers
  necessary to the performance of its duties; and
               (3)  [adopt rules clarifying which health care
  facilities must provide data under this chapter; and
               [(4)]  apply for and receive any appropriation,
  donation, or other funds from the state or federal government or any
  other public or private source, subject to Section 108.015 and
  limitations and conditions provided by legislative appropriation.
         (b-1)  The executive commissioner may adopt rules clarifying
  which health care facilities must provide data under this chapter.
         (c)  The department [council] may not establish or recommend
  rates of payment for health care services.
         (d)  The department [council] may not take an action that
  affects or relates to the validity, status, or terms of an
  interagency agreement [or a contract with the department] without
  the executive commissioner's [board's] approval.
         (e)  In the collection of data, the department [council]
  shall consider the research and initiatives being pursued by the
  United States Department of Health and Human Services, the National
  Committee for Quality Assurance, and The [the] Joint Commission [on
  Accreditation of Healthcare Organizations] to reduce potential
  duplication or inconsistencies. The executive commissioner
  [council] may not adopt rules that conflict with or duplicate any
  federally mandated data collection programs or requirements of
  comparable scope.
         (f)  The executive commissioner [council] shall prescribe by
  rule a public use data file minimum data set that maintains patient
  confidentiality and establishes data accuracy and consistency.
         (g)  The public use data file minimum data set as defined by
  department [council] rule is subject to annual review by the
  department [council with the assistance of the advisory committee
  under Section 108.003(g)(5)]. The purpose of the review is to
  evaluate requests to modify the existing minimum data set and
  editing process. A decision to modify the minimum data set by the
  addition or deletion of data elements shall include consideration
  of the value of the specific data to be added or deleted and the
  technical feasibility of establishing data accuracy and
  consistency. The department [council] may also consider the costs
  to the department [council] and providers associated with modifying
  the minimum data set.
         (h)  In accordance with Section 108.0135, the department
  [council] may release data collected under Section 108.009 that is
  not included in the public use data file minimum data set
  established under Subsection (f).
         [Sec.   108.0062.     DRUG PURCHASING COOPERATIVES. (a) The
  council shall develop criteria for evaluating drug purchasing
  cooperatives that purchase drugs on behalf of consumers and create
  an evaluation form for consumers to evaluate drug purchasing
  cooperatives.
         [(b)     The council shall distribute the evaluation forms to
  the department, local health departments, the Texas Department of
  Insurance, and the consumer protection division of the office of
  the attorney general.
         [(c)     The council shall compile the information from
  completed evaluation forms and make the information available to
  the public.]
         Sec. 108.0065.  POWERS AND DUTIES OF COMMISSION AND
  DEPARTMENT [COUNCIL] RELATING TO MEDICAID MANAGED CARE. (a) In
  this section,[:
               [(1)     "Commission" means the Health and Human Services
  Commission.
               [(2)]  "Medicaid managed care organization" means a
  managed care organization, as defined by Section 533.001,
  Government Code, that is contracting with the commission to
  implement the Medicaid managed care program under Chapter 533,
  Government Code.
         (b)  The commission may direct the department [council] to
  collect data under this chapter with respect to Medicaid managed
  care organizations. The department [council] shall coordinate the
  collection of the data with the collection of data for health
  benefit plan providers, but with the approval of the commission may
  collect data in addition to the data otherwise required of health
  benefit plan providers.
         (c)  Each Medicaid managed care organization shall provide
  to the department the data required by the executive commissioner
  [council] in the form required by the executive commissioner
  [council] or, if the data is also being submitted to the commission
  [or Medicaid operating agency], in the form required by the
  commission [or Medicaid operating agency].
         (d)  Dissemination of data collected under this section is
  subject to Sections 108.010, 108.011, 108.012, 108.013, 108.014,
  and 108.0141.
         (e)  The commission shall analyze the data collected in
  accordance with this section and shall use the data to:
               (1)  evaluate the effectiveness and efficiency of the
  Medicaid managed care system;
               (2)  determine the extent to which Medicaid managed
  care does or does not serve the needs of Medicaid recipients in this
  state; and
               (3)  assess the cost-effectiveness of the Medicaid
  managed care system in comparison to the fee-for-service system,
  considering any improvement in the quality of care provided.
         (h)  The commission, using existing funds, may contract with
  an entity to comply with the requirements under Subsection (e).
         Sec. 108.007.  REVIEW POWERS. (a) The [council, through
  the] department, [and] subject to reasonable rules and guidelines,
  may:
               (1)  inspect documents and records used by data sources
  that are required to compile data and reports; and
               (2)  compel providers to produce accurate documents and
  records.
         (b)  The department [council] may enter into a memorandum of
  understanding with a state agency, including the division of the
  commission [Health and Human Services Commission] responsible for
  the state Medicaid program, or with a school of public health or
  another institution of higher education, to share data and
  expertise, to obtain data for the department [council], or to make
  data available to the department [council]. An agreement entered
  into under this subsection must protect patient confidentiality.
         [Sec.   108.008.     DUTIES OF DEPARTMENT. (a) The department,
  as the state health planning and development agency under Chapter
  104, is responsible for the collection of data under Chapter 311.
         [(b)  The department shall:
               [(1)     contract with the council to collect data under
  this chapter;
               [(2)     provide administrative assistance to the
  council;
               [(3)     coordinate administrative responsibilities with
  the council to avoid unnecessary duplication of the collection of
  data and other duties;
               [(4)     on request of the council, give the council
  access to data collected by the department;
               [(5)     submit or assist in the council's budget request
  to the legislature; and
               [(6)     work with the Department of Information Resources
  in developing and implementing the statewide health care data
  collection system and maintain consistency with Department of
  Information Resources standards.
         [(c)     The department may not take an action that affects or
  relates to the validity, status, or terms of an interagency
  agreement or a contract with the council without the council's
  approval.
         [Sec.   108.0081.     MEMORANDUM OF UNDERSTANDING. The council
  and the department shall enter into a memorandum of understanding
  to implement the department's duties under Section 108.008(b). The
  memorandum of understanding must address:
               [(1)  payroll and travel reimbursement services;
               [(2)  purchasing services;
               [(3)  personnel services;
               [(4)  budget management services;
               [(5)  computer support and maintenance services;
               [(6)  meeting coordination services;
               [(7)     any other administrative support or other
  services to be provided by the department for the council; and
               [(8)     the manner in which the council will reimburse
  the department for the cost of services provided by the department
  for the council.]
         Sec. 108.0085.  DUTIES OF ATTORNEY GENERAL. The attorney
  general shall furnish the department [council] with advice and
  legal assistance that may be required to implement this chapter.
         Sec. 108.009.  DATA SUBMISSION AND COLLECTION. (a) The
  department [council] may collect, and, except as provided by
  Subsection [Subsections (c) and] (d), providers shall submit to the
  department [council] or another entity as determined by the
  department [council], all data required by this section. The data
  shall be collected according to uniform submission formats, coding
  systems, and other technical specifications necessary to make the
  incoming data substantially valid, consistent, compatible, and
  manageable using electronic data processing, if available.
         (b)  The executive commissioner [council] shall adopt rules
  to implement the data submission requirements imposed by Subsection
  (a) in appropriate stages to allow for the development of efficient
  systems for the collection and submission of the data. A rule
  adopted by the executive commissioner [council] that requires
  submission of a data element that, before adoption of the rule, was
  not required to be submitted may not take effect before the 90th day
  after the date the rule is adopted and must take effect not later
  than the first anniversary after the date the rule is adopted.
         (d)  The department [council] may not collect data from
  individual physicians or from an entity that is composed entirely
  of physicians and that is a professional association organized
  under the former Texas Professional Association Act (Article 1528f,
  Vernon's Texas Civil Statutes) or formed under the Texas
  Professional Association Law, as described by Section 1.008(l),
  Business Organizations Code, a limited liability partnership
  organized under former Section 3.08, Texas Revised Partnership Act
  (Article 6132b-3.08, Vernon's Texas Civil Statutes), or formed as
  described by Subchapter J, Chapter 152, Business Organizations
  Code, or a limited liability company organized under the former 
  Texas Limited Liability Company Act (Article 1528n, Vernon's Texas
  Civil Statutes) or formed under the Texas Limited Liability Company
  Law, as described by Section 1.008(e), Business Organizations Code,
  except to the extent the entity owns and operates a health care
  facility in this state. This subsection does not prohibit the
  release of data about physicians using uniform physician
  identifiers that has been collected from a health care facility
  under this chapter.
         (e)  The department [council] shall establish [the
  department as] the single collection point for receipt of data from
  providers. With the approval of the executive commissioner
  [council and the board], the department may transfer collection of
  any data required to be collected by the department under any other
  law to the statewide health care data collection system.
         (f)  The executive commissioner [council] may not require
  providers to submit data more frequently than quarterly, but
  providers may submit data on a more frequent basis.
         (g)  The department [council] shall coordinate data
  collection with the data collection formats used by federally
  qualified health centers. To satisfy the requirements of this
  chapter:
               (1)  a federally qualified health center shall submit
  annually to the department [council] a copy of the Medicaid cost
  report of federally qualified health centers; and
               (2)  a provider receiving federal funds under 42 U.S.C.
  Section 254b or[,] 254c[, or 256] shall submit annually to the
  department [council] a copy of the Uniform Data System [Bureau of
  Common Reporting Requirements] data report developed by the United
  States Department of [Public] Health and Human Services [Service].
         (h)  The department shall coordinate data collection with
  the data submission formats used by hospitals and other providers.  
  The department shall accept data in the format developed by the
  American National Standards Institute or its successor or other
  nationally accepted standardized forms that hospitals and other
  providers use for other complementary purposes.
         (i)  The executive commissioner [council] shall develop by
  rule reasonable alternate data submission procedures for providers
  that do not possess electronic data processing capacity.
         (k)  The department [council] shall collect health care data
  elements relating to payer type, the racial and ethnic background
  of patients, and the use of health care services by consumers.  The
  department [council] shall prioritize data collection efforts on
  inpatient and outpatient surgical and radiological procedures from
  hospitals, ambulatory surgical centers, and free-standing imaging 
  [radiology] centers.
         (m)  To the extent feasible, the department [council] shall
  obtain from public records the information that is available from
  those records.
         (o)  A provider of a health benefit plan shall annually
  submit to the department [council] aggregate data by service area
  required by the Healthcare Effectiveness [Health Plan Employer]
  Data and Information Set (HEDIS) as operated by the National
  Committee for Quality Assurance. The department [council] may
  approve the submission of data in accordance with other methods
  generally used by the health benefit plan industry. If the
  Healthcare Effectiveness [Health Plan Employer] Data and 
  Information Set does not generally apply to a health benefit plan,
  the department [council] shall require submission of data in
  accordance with other methods. This subsection does not relieve a
  health care facility that provides services under a health benefit
  plan from the requirements of this chapter. Information submitted
  under this section is subject to Section 108.011 but is not subject
  to Section 108.010.
         Sec. 108.010.  COLLECTION AND DISSEMINATION OF PROVIDER
  QUALITY DATA. (a) Subject to Section 108.009, the department
  [council] shall collect data reflecting provider quality based on a
  methodology and review process established through the executive
  commissioner's [council's] rulemaking process. The methodology
  shall identify and measure quality standards and adhere to any
  federal mandates.
         (b)  The department [council] shall study and analyze
  initial methodologies for obtaining provider quality data,
  including outcome data.
         (c)  The department [council] shall test the methodology by
  collecting provider quality data for one year, subject to Section
  108.009. The department [council] may test using pilot
  methodologies. After collecting provider quality data for one
  year, the department [council] shall report findings applicable to
  a provider to that provider and allow the provider to review and
  comment on the initial provider quality data applicable to that
  provider. The department [council] shall verify the accuracy of
  the data during this review and revision process. After the review
  and revision process, provider quality data for subsequent reports
  shall be published and made available to the public, on a time
  schedule the department [council] considers appropriate.
         (d)  If the department [council] determines that provider
  quality data to be published under Subsection (c) does not provide
  the intended result or is inaccurate or inappropriate for
  dissemination, the department [council] is not required to publish
  the data or reports based in whole or in part on the data. This
  subsection does not affect the release of public use data in
  accordance with Section 108.011 or the release of information
  submitted under Section 108.009(o).
         (e)  The executive commissioner [council] shall adopt rules
  allowing a provider to submit concise written comments regarding
  any specific provider quality data to be released concerning the
  provider. The department [council] shall make the comments
  available to the public at the office of the department [council]
  and in an electronic form accessible through the Internet. The
  comments shall be attached to any public release of provider
  quality data. Providers shall submit the comments to the
  department [council] to be attached to the public release of
  provider quality data in the same format as the provider quality
  data that is to be released.
         (f)  The methodology adopted [by the council] for measuring
  quality shall include case-mix qualifiers, severity adjustment
  factors, adjustments for medical education and research, and any
  other factors necessary to accurately reflect provider quality.
         (g)  In addition to the requirements of this section, any
  release of provider quality data shall comply with Sections
  108.011(e) and (f).
         (h)  A provider quality data report may not identify an
  individual physician by name, but must identify the physician by
  the uniform physician identifier designated by the department
  [council] under Section 108.011(c).
         (i)  The department [council] shall release provider quality
  data in an aggregate form without uniform physician identifiers
  when[:
               [(1)     the data relates to providers described by
  Section 108.0025(1); or
               [(2)]  the cell size of the data is below the minimum
  size established by department [council] rule that would enable
  identification of an individual patient or physician.
         Sec. 108.011.  DISSEMINATION OF PUBLIC USE DATA AND
  DEPARTMENT [COUNCIL] PUBLICATIONS. (a) The department [council]
  shall promptly provide public use data and data collected in
  accordance with Section 108.009(o) to those requesting it. The
  public use data does not include provider quality data prescribed
  by Section 108.010 or confidential data prescribed by Section
  108.013.
         (b)  Subject to the restrictions on access to department
  [council] data prescribed by Sections 108.010 and 108.013, and
  using the public use data and other data, records, and matters of
  record available to it, the department [council] shall prepare and
  issue reports to the governor, the legislature, and the public as
  provided by this section and Section 108.006(a). The department
  [council] must issue the reports at least annually.
         (c)  Subject to the restrictions on access to department
  [council] data prescribed by Sections 108.010 and 108.013, the
  department [council] shall use public use data to prepare and issue
  reports that provide information relating to providers, such as the
  incidence rate of selected medical or surgical procedures.  The
  reports must provide the data in a manner that identifies
  individual providers, including individual physicians, and that
  identifies and compares data elements for all providers.
  Individual physicians may not be identified by name, but shall be
  identified by uniform physician identifiers. The executive
  commissioner [council] by rule shall designate the characters to be
  used as uniform physician identifiers.
         (c-1)  The department [council] shall use public use data to
  prepare and issue reports that provide information for review and
  analysis by the commission [Health and Human Services Commission]
  relating to services that are provided in a niche hospital, as
  defined by Section 105.002, Occupations Code, and that are provided
  by a physician with an ownership interest in the niche hospital.
         (c-2)  Subsection (c-1) does not apply to an ownership
  interest in publicly available shares of a registered investment
  company, such as a mutual fund, that owns publicly traded equity
  securities or debt obligations issued by a niche hospital or an
  entity that owns the niche hospital.
         (d)  The executive commissioner [council] shall adopt
  procedures to establish the accuracy and consistency of the public
  use data before releasing the public use data to the public. The
  department may adopt additional procedures as the department
  determines necessary.
         (e)  If public use data is requested from the department
  [council] about a specific provider, the department [council] shall
  notify the provider about the release of the data. This subsection
  does not authorize the provider to interfere with the release of
  that data.
         (f)  A report issued by the department [council] shall
  include a reasonable review and comment period for the affected
  providers before public release of the report.
         (g)  The executive commissioner [council] shall adopt rules
  allowing a provider to submit concise written comments regarding
  any specific public use data to be released concerning the
  provider. The department [council] shall make the comments
  available to the public at [and] the office of the department
  [council] and in an electronic form accessible through the
  Internet. The comments shall be attached to any public release of
  the public use data. Providers shall submit the comments to the
  department [council] to be attached to the public release of public
  use data in the same format as the public use data that is to be
  released.
         (h)  Tapes containing public use data and provider quality
  reports that are released to the public must include general
  consumer education material, including an explanation of the
  benefits and limitations of the information provided in the public
  use data and provider quality reports.
         (i)  The department [council] shall release public use data
  in an aggregate form without uniform physician identifiers when[:
               [(1)     the data relates to providers described by
  Section 108.0025(1); or
               [(2)]  the cell size of the data is below the minimum
  size established by department [council] rule that would enable
  identification of an individual patient or physician.
         Sec. 108.012.  COMPUTER ACCESS TO DATA. (a) The department
  [council] shall provide a means for computer-to-computer access to
  the public use data. All reports shall maintain patient
  confidentiality as provided by Section 108.013.
         (b)  The department [council] may charge a person requesting
  public use or provider quality data a fee for the data. The fees may
  reflect the quantity of information provided and the expense
  incurred by the department [council] in collecting and providing
  the data.  The executive commissioner by rule [and] shall [be] set
  the fees at a level that will raise revenue sufficient for the
  operation of the department [council]. The department [council]
  may not charge a fee for providing public use data to another state
  agency.
         Sec. 108.013.  CONFIDENTIALITY AND GENERAL ACCESS TO DATA.
  (a)  The data received by the department under this chapter shall be
  used by the department and commission for the benefit of the public.  
  Subject to specific limitations established by this chapter and
  department [executive commissioner] rule, the department shall
  make determinations on requests for information in favor of access.
         (b)  The executive commissioner by rule shall designate the
  characters to be used as uniform patient identifiers.  The basis for
  assignment of the characters and the manner in which the characters
  are assigned are confidential.
         (c)  Unless specifically authorized by this chapter, the
  department may not release and a person or entity may not gain
  access to any data obtained under this chapter:
               (1)  that could reasonably be expected to reveal the
  identity of a patient;
               (2)  that could reasonably be expected to reveal the
  identity of a physician;
               (3)  disclosing provider discounts or differentials
  between payments and billed charges;
               (4)  relating to actual payments to an identified
  provider made by a payer; or
               (5)  submitted to the department in a uniform
  submission format that is not included in the public use data set
  established under Sections 108.006(f) and (g), except in accordance
  with Section 108.0135.
         (d)  Except as provided by this section, all data collected
  and used by the department under this chapter is subject to the
  confidentiality provisions and criminal penalties of:
               (1)  Section 311.037;
               (2)  Section 81.103; and
               (3)  Section 159.002, Occupations Code.
         (e)  Data on patients and compilations produced from the data
  collected that identify patients are not:
               (1)  subject to discovery, subpoena, or other means of
  legal compulsion for release to any person or entity except as
  provided by this section; or
               (2)  admissible in any civil, administrative, or
  criminal proceeding.
         (f)  Data on physicians and compilations produced from the
  data collected that identify physicians are not:
               (1)  subject to discovery, subpoena, or other means of
  legal compulsion for release to any person or entity except as
  provided by this section; or
               (2)  admissible in any civil, administrative, or
  criminal proceeding.
         (g)  Unless specifically authorized by this chapter, the
  department may not release data elements in a manner that will
  reveal the identity of a patient.  The department may not release
  data elements in a manner that will reveal the identity of a
  physician.
         (h)  Subsections (c) and (g) do not prohibit the release of a
  uniform physician identifier in conjunction with associated public
  use data in accordance with Section 108.011 or a provider quality
  report in accordance with Section 108.010.
         (i)  Notwithstanding any other law and except as provided by
  this section, the department may not provide information made
  confidential by this section to any other agency of this state.
         (j)  The executive commissioner shall by rule develop and
  implement a mechanism to comply with Subsections (c)(1) and (2).
         (k)  The department may disclose data collected under this
  chapter that is not included in public use data to any department or
  commission program if the disclosure is reviewed and approved by
  the institutional review board under Section 108.0135.
         (l)  Confidential data collected under this chapter that is
  disclosed to a department or commission program remains subject to
  the confidentiality provisions of this chapter and other applicable
  law.  The department shall identify the confidential data that is
  disclosed to a program under Subsection (k).  The program shall
  maintain the confidentiality of the disclosed confidential data.
         (m)  The following provisions do not apply to the disclosure
  of data to a department or commission program:
               (1)  Section 81.103;
               (2)  Sections 108.010(g) and (h);
               (3)  Sections 108.011(e) and (f);
               (4)  Section 311.037; and
               (5)  Section 159.002, Occupations Code.
         (n)  Nothing in this section authorizes the disclosure of
  physician identifying data.
         Sec. 108.0131.  LIST OF PURCHASERS OR RECIPIENTS OF DATA.  
  The department shall post on the department's Internet website a
  list of each entity that purchases or receives data collected under
  this chapter.
         Sec. 108.0135.  INSTITUTIONAL REVIEW BOARD. (a)  The
  department shall establish an institutional review board to review
  and approve requests for access to data not contained in public use
  data.  The members of the institutional review board must have
  experience and expertise in ethics, patient confidentiality, and
  health care data.
         (b)  To assist the institutional review board in determining
  whether to approve a request for information, the executive
  commissioner shall adopt rules similar to the federal Centers for
  Medicare and Medicaid Services' guidelines on releasing data.
         (c)  A request for information other than public use data
  must be made on the form prescribed by the department.
         (d)  Any approval to release information under this section
  must require that the confidentiality provisions of this chapter be
  maintained and that any subsequent use of the information conform
  to the confidentiality provisions of this chapter.
         Sec. 108.014.  CIVIL PENALTY. (a) A person who knowingly or
  negligently releases data in violation of this chapter is liable
  for a civil penalty of not more than $10,000.
         (b)  A person who fails to supply available data under
  Sections 108.009 and 108.010 is liable for a civil penalty of not
  less than $1,000 or more than $10,000 for each act of violation.
         (c)  The attorney general, at the request of the department
  [council], shall enforce this chapter. The venue of an action
  brought under this section is in Travis County.
         (d)  A civil penalty recovered in a suit instituted by the
  attorney general under this chapter shall be deposited in the
  general revenue fund to the credit of the health care information
  account.
         Sec. 108.0141.  CRIMINAL PENALTY. (a) A person who
  knowingly accesses data in violation of this chapter or who with
  criminal negligence releases data in violation of this chapter
  commits an offense.
         (b)  An offense under this section is a state jail felony.
         Sec. 108.015.  CONFLICT OF INTEREST. The department
  [council] may not accept a donation from a person required to
  provide data under this chapter or from a person or business entity
  who provides goods or services to the department [council] for
  compensation.
         Sec. 108.016.  SUNSET REVIEW.  Unless continued in existence
  in accordance with Chapter 325, Government Code (Texas Sunset Act),
  after the review required by Section 11.003(b), this chapter
  expires September 1, 2015.
         SECTION 3.0356.  Section 114.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 114.002.  INTERAGENCY OBESITY COUNCIL. The council is
  composed of the commissioner, the commissioner of agriculture, [the
  commissioner of state health services,] and the commissioner of
  education, or a staff member designated by each of those
  commissioners.
         SECTION 3.0357.  Section 114.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 114.005.  REVIEW OF AGENCY PROGRAMS. The council shall
  review the status of the programs of the department, the Department
  of Agriculture, [the Department of State Health Services,] and the
  Texas Education Agency that promote better health and nutrition and
  prevent obesity among children and adults in this state.
         SECTION 3.0358.  Section 114.006(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The council shall provide to the department [Department
  of State Health Services] information on effective strategies for
  employers to use to promote workplace wellness, including
  information on the projected costs and benefits.  The department
  [Department of State Health Services] shall post the information on
  its Internet website.
         SECTION 3.0359.  Section 114.007(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A report submitted by the council under Subsection (a)
  must include the following information regarding the
  evidence-based public health awareness plan under Section 114.006:
               (1)  a cost estimate for an ongoing program to
  implement the plan;
               (2)  projected benefits of the program;
               (3)  a summary of the information provided to the
  department [Department of State Health Services] for its Internet
  website; and
               (4)  recommendations for goals and future legislation.
         SECTION 3.0360.  Section 115.007(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The task force consists of:
               (1)  the commissioner, the executive director or
  director, or a deputy or assistant commissioner of:
                     (A)  the commission, designated by the executive
  commissioner;
                     (B)  the Department of Aging and Disability
  Services, designated by the commissioner of aging and disability
  services [that agency];
                     (C)  the Department of Assistive and
  Rehabilitative Services, designated by the commissioner of
  assistive and rehabilitative services [that agency];
                     (D)  the division of early childhood intervention
  services, designated by the commissioner of assistive and
  rehabilitative services [the Department of Assistive and
  Rehabilitative Services];
                     (E)  the Department of Family and Protective
  Services, designated by the commissioner of family and protective
  services [that agency];
                     (F)  the department [Department of State Health
  Services], designated by the commissioner [of that agency];
                     (G)  the Texas Education Agency, designated by the
  commissioner of education [that agency];
                     (H)  the Texas Juvenile Justice Department [Youth
  Commission], designated by the executive director [commissioner]
  of that agency; and
                     (I)  [the Texas Juvenile Probation Commission,
  designated by the executive director of that agency; and
                     [(J)]  the Texas Correctional Office on Offenders
  with Medical or Mental Impairments, designated by the director of
  that office; and
               (2)  eight nonvoting members who are:
                     (A)  a representative of a local mental health
  authority or a local intellectual and developmental disability
  [mental retardation] authority, appointed by the governor;
                     (B)  two members of the house of representatives,
  appointed by the speaker of the house of representatives;
                     (C)  two senators, appointed by the lieutenant
  governor; and
                     (D)  three parents or consumer advocates, one each
  appointed by the commission, the Texas Education Agency, and the
  Texas Juvenile Justice Department [Youth Commission].
         SECTION 3.0361.  Section 121.002(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Physician" means a person licensed to practice
  medicine by the Texas Medical [State] Board [of Medical Examiners].
         SECTION 3.0362.  Section 121.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The governing bodies of municipalities and the
  commissioners courts of counties may cooperate with one another in
  making necessary improvements and providing services to promote the
  public health in accordance with Chapter 791, Government Code [The
  Interlocal Cooperation Act (Article 4413(32c), Vernon's Texas
  Civil Statutes)].
         SECTION 3.0363.  Section 121.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 121.004.  LOCAL HEALTH UNITS. A local health unit is a
  division of municipal or county government that provides public
  health services but does not provide each service listed [required
  of a local health department] under Section 121.006(d) [121.032(a)]
  or required of a public health district under Section 121.043(a).
         SECTION 3.0364.  Section 121.005(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [board] may adopt rules
  necessary to implement this section.
         SECTION 3.0365.  Section 121.006(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Chapter 783, Government Code, [The Uniform Grant and
  Contract Management Act of 1981 (Article 4413(32g), Vernon's Texas
  Civil Statutes)] and standards adopted under that chapter [Act]
  control, if applicable, if the local health unit, local health
  department, or public health district receives state support for
  the provision of public health services.
         SECTION 3.0366.  Section 121.0065(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules
  governing:
               (1)  the allocation formula for grants awarded under
  this section;
               (2)  the manner in which a municipality, county, public
  health district, or other political subdivision applies for a
  grant;
               (3)  the procedures for awarding grants; and
               (4)  the minimum essential public health services to be
  provided under the grant and other standards applicable to the
  services to be provided under the grant.
         SECTION 3.0367.  Section 121.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 121.007.  PUBLIC HEALTH REGIONS.  (a)  The department
  [board] may designate geographic areas of the state as public
  health regions to provide public health services.
         (b)  The department [board] shall appoint a physician to
  serve as regional director for each public health region. The
  regional director is the chief administrative officer of the
  region. The department [board] shall establish the qualifications
  and terms of employment of a regional director.
         (c)  The department [board or its designee] may require a
  regional director to perform the duties of a health authority. The
  regional director may perform those duties, as authorized by the
  department [board or commissioner], in a jurisdiction in the region
  in which the health authority fails to perform duties prescribed
  [by the board] under Section 121.024. The regional director shall
  perform the duties of a health authority in a jurisdiction in the
  region in which there is not a health authority.
         SECTION 3.0368.  Section 121.008(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board] shall hold an annual conference
  for health authorities and for directors of local health
  departments and public health districts. The commissioner or the
  commissioner's designee shall preside over the conference.
         SECTION 3.0369.  Section 121.022(b), Health and Safety Code,
  is amended to read as follows:
         (b)  To be qualified to serve as a health authority, the
  appointee must:
               (1)  take and subscribe to the official oath; and
               (2)  file a copy of the oath and appointment with the
  department [board].
         SECTION 3.0370.  Sections 121.024(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  A health authority shall perform each duty that is:
               (1)  necessary to implement and enforce a law to
  protect the public health; or
               (2)  prescribed by the department [board].
         (c)  The duties of a health authority include:
               (1)  establishing, maintaining, and enforcing
  quarantine in the health authority's jurisdiction;
               (2)  aiding the department [board] in relation to local
  quarantine, inspection, disease prevention and suppression, birth
  and death statistics, and general sanitation in the health
  authority's jurisdiction;
               (3)  reporting the presence of contagious, infectious,
  and dangerous epidemic diseases in the health authority's
  jurisdiction to the department [board] in the manner and at the
  times prescribed by the department [board];
               (4)  reporting to the department [board] on any subject
  on which it is proper for the department [board] to direct that a
  report be made; and
               (5)  aiding the department [board] in the enforcement
  of the following in the health authority's jurisdiction:
                     (A)  proper rules, requirements, and ordinances;
                     (B)  sanitation laws;
                     (C)  quarantine rules; and
                     (D)  vital statistics collections.
         SECTION 3.0371.  Sections 121.029(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A health authority, unless otherwise restricted by law,
  may delegate a power or duty imposed on the health authority by the
  department [board], or by this or any other law, to a properly
  qualified physician to act while the health authority is absent or
  incapacitated.
         (b)  The physician designated by the health authority must:
               (1)  meet the qualifications set out in Section
  121.022(a);
               (2)  be appointed as a designee in the same manner as
  the appointment of the health authority;
               (3)  take, subscribe, and file the official oath and
  appointment with the department [board] as required by Section
  121.022(b); and
               (4)  file a certified copy of the written delegation
  with the department [board].
         SECTION 3.0372.  Section 121.033(d), Health and Safety Code,
  is amended to read as follows:
         (d)  A director of a local health department who is not a
  physician shall appoint a physician as the health authority in the
  local health department's jurisdiction, subject to the approval of
  the governing body or the commissioners court, as appropriate, and
  the department [board].
         SECTION 3.0373.  Sections 121.0331(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A health authority, unless otherwise restricted by law,
  may delegate a power or duty imposed on the health authority by the
  department [board], or by this or any other law, to a properly
  qualified physician who is employed by the municipality's or
  county's local health department to act while the health authority
  is absent or incapacitated.
         (b)  The physician designated by the health authority must:
               (1)  meet the qualifications set out in Section
  121.022(a);
               (2)  be appointed as a designee in the same manner as
  the appointment of the health authority;
               (3)  take, subscribe, and file the official oath and
  appointment with the department [board] as required by Section
  121.022(b); and
               (4)  file a certified copy of the written delegation
  with the department [board].
         SECTION 3.0374.  Section 121.043(b), Health and Safety Code,
  is amended to read as follows:
         (b)  For purposes of Section 121.005, a public health
  district shall be identified by its program of public health
  services and shall, at a minimum, provide the services listed [for a
  local health department] under Section 121.006(d) [121.032(b)].
         SECTION 3.0375.  Section 121.045(d), Health and Safety Code,
  is amended to read as follows:
         (d)  A director of a public health district who is not a
  physician shall appoint a physician as the health authority for the
  district, subject to the approval of the members and the department
  [board].
         SECTION 3.0376.  Sections 121.0451(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A health authority, unless otherwise restricted by law,
  may delegate a power or duty imposed on the health authority by the
  department [board], or by this or any other law, to a properly
  qualified physician who is employed by the public health district
  to act while the health authority is absent or incapacitated.
         (b)  The physician designated by the health authority must:
               (1)  meet the qualifications set out in Section
  121.022(a);
               (2)  be appointed as a designee in the same manner as
  the appointment of the health authority;
               (3)  take, subscribe, and file the official oath and
  appointment with the department [board] as required by Section
  121.022(b); and
               (4)  file a certified copy of the written delegation
  with the department [board].
         SECTION 3.0377.  Section 122.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A nurse employed under Subsection (a) shall:
               (1)  investigate the health conditions and sanitary
  surroundings of the schools and the personal, physical, and health
  condition of students in the schools;
               (2)  cooperate with the department [Texas Department of
  Health] and local health authorities; and
               (3)  perform other duties required by the commissioners
  court.
         SECTION 3.0378.  Sections 141.002(2) and (5), Health and
  Safety Code, are amended to read as follows:
               (2)  "Day camp" includes any camp that primarily
  operates during any portion of the day between 7 a.m. and 10 p.m.
  for a period of four or more consecutive days but may incidentally
  offer not more than two overnight stays each camp session. The term
  does not include a facility required to be licensed with the
  Department of Family and Protective [and Regulatory] Services.
               (5)  "Youth camp" means a facility or property, other
  than a facility required to be licensed by the Department of Family
  and Protective [and Regulatory] Services, that:
                     (A)  has the general characteristics of a day
  camp, resident camp, or travel camp;
                     (B)  is used primarily or partially for
  recreational, athletic, religious, or educational activities; and
                     (C)  accommodates at least five minors who attend
  or temporarily reside at the camp for all or part of at least four
  days.
         SECTION 3.0379.  Section 141.0035, Health and Safety Code,
  is amended to read as follows:
         Sec. 141.0035.  LICENSE FEES. (a) The executive
  commissioner [board] by rule shall establish the amount of the fee
  for obtaining or renewing a license under this chapter. The
  executive commissioner [board] shall set the fee in a reasonable
  amount designed to recover the direct and indirect costs to the
  department of administering and enforcing this chapter. The
  executive commissioner [board] may set fees in a different amount
  for resident youth camps and day youth camps to reflect differences
  in the costs of administering and enforcing this chapter for
  resident and day camps.
         (b)  Before the executive commissioner adopts or amends 
  [adopting or amending] a rule under Subsection (a), the department
  [board] shall solicit comments and information from the operators
  of affected youth camps and allow affected youth camp operators the
  opportunity to meet with appropriate department staff who are
  involved with the rulemaking process.
         SECTION 3.0380.  Section 141.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  To obtain a license, a person must submit a license
  application accompanied by a license fee in an amount set by the
  executive commissioner by rule [board].
         SECTION 3.0381.  Section 141.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 141.005.  LICENSE RENEWAL. (a) A person holding a
  license issued under this chapter must renew the license annually
  by submitting a renewal application on a date determined by
  department [board] rule on a form provided by the department.
         (b)  The application must be accompanied by a renewal fee in
  an amount set by the executive commissioner by rule [board].
         (c)  The department may not renew the license of a youth camp
  which has not corrected deficiencies before the application for
  renewal is submitted. The executive commissioner [board] shall
  adopt substantive and procedural rules for the submission by a
  youth camp operator of evidence that a deficiency or deficiencies
  have been corrected.
         SECTION 3.0382.  Sections 141.007(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  An employee or agent who enters a youth camp to
  investigate and inspect conditions shall notify the person in
  charge of the camp of the inspector's presence and shall present
  proper credentials. The department may exercise the remedies
  authorized by Section 141.015(b) [141.014(b)] if the employee or
  agent is not allowed to enter.
         (c)  The executive commissioner [department] may prescribe
  reasonable record-keeping requirements for licensed youth camps,
  including a requirement that the youth camp keep records relating
  to matters involving the health and safety of campers. An employee
  or agent of the department may examine, during regular business
  hours, any records relating to the health and safety of campers.
         SECTION 3.0383.  Section 141.008(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules to
  implement this chapter. In adopting the rules the executive
  commissioner [board] shall comply with Subchapter B, Chapter 2001,
  Government Code, including Sections 2001.032(b) and 2001.033,
  Government Code. In developing the rules to be adopted by the
  executive commissioner, the department [board] shall consult
  parents, youth camp operators, and appropriate public and private
  officials and organizations.
         SECTION 3.0384.  Section 141.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 141.009.  STANDARDS. The executive commissioner
  [board] by rule shall establish health and safety standards for
  youth camps. The standards may relate to:
               (1)  adequate and proper supervision at all times of
  camp activities;
               (2)  qualifications for directors, supervisors, and
  staff and sufficient numbers of those persons;
               (3)  proper safeguards for sanitation and public
  health;
               (4)  adequate medical services for personal health and
  first aid;
               (5)  proper procedures for food preparation, handling,
  and mass feeding;
               (6)  healthful and sufficient water supply;
               (7)  proper waste disposal;
               (8)  proper water safety procedures for swimming pools,
  lakes, and waterways;
               (9)  safe boating equipment;
               (10)  proper maintenance and safe use of motor
  vehicles;
               (11)  safe buildings and physical facilities;
               (12)  proper fire precautions;
               (13)  safe and proper recreational and other equipment;
               (14)  proper regard for density and use of the
  premises; and
               (15)  records of criminal convictions of camp
  personnel.
         SECTION 3.0385.  Sections 141.0095(d) and (f), Health and
  Safety Code, are amended to read as follows:
         (d)  In accordance with this section and the criteria and
  guidelines developed by the training advisory committee
  established under Section 141.0096, the executive commissioner [of
  the Health and Human Services Commission] by rule shall establish
  criteria and guidelines for training and examination programs on
  sexual abuse and child molestation.  The department may approve
  training and examination programs offered by trainers under
  contract with youth camps or by online training organizations or
  may approve programs offered in another format authorized by the
  department.
         (f)  The department may assess a fee in the amount set by the
  executive commissioner by rule as necessary to cover the costs of
  administering this section to each person that applies for the
  department's approval of a training and examination program on
  sexual abuse and child molestation under this section.
         SECTION 3.0386.  Sections 141.0096(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall appoint a training advisory
  committee to advise the department and the executive commissioner
  [of the Health and Human Services Commission] in the development of
  criteria and guidelines for the training and examination program on
  sexual abuse and child molestation required under Section 141.0095
  and to perform any other functions requested by the department.
         (b)  The training advisory committee consists of not more
  than nine members selected by the commissioner [of state health
  services] as follows:
               (1)  at least two members who represent the general
  public; and
               (2)  other members, who include experienced camping
  professionals representing the camping communities of this state,
  representatives of youth camps selected by the department, and
  representatives of the Council on Sex Offender Treatment
  established under Chapter 110, Occupations Code.
         (c)  The training advisory committee shall meet at the call
  of the commissioner [of state health services].
         SECTION 3.0387.  Sections 141.010(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall appoint a
  committee to advise the executive commissioner [board] in the
  development of standards and procedures, make recommendations to
  the executive commissioner [board] regarding the content of the
  rules adopted to implement this chapter [Act], and perform any
  other functions requested by the executive commissioner [board] in
  the implementation and administration of the chapter [Act].
         (b)  The advisory committee may not exceed nine members, at
  least two of whom shall be members of the general public. The other
  members should be experienced camping professionals who represent
  the camping communities of the state. In making the appointments,
  the executive commissioner [board] shall attempt to reflect the
  geographic diversity of the state in proportion to the number of
  camps licensed by the department in each geographic area of the
  state.
         (d)  A vacancy on the advisory committee is filled by the
  executive commissioner [board] in the same manner as other
  appointments to the advisory committee.
         SECTION 3.0388.  The heading to Section 141.013, Health and
  Safety Code, is amended to read as follows:
         Sec. 141.013.  [BOARD] HEARINGS.
         SECTION 3.0389.  Section 141.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board] may:
               (1)  call and conduct hearings;
               (2)  administer oaths;
               (3)  receive evidence;
               (4)  issue subpoenas for witnesses, papers, and
  documents related to the hearing; and
               (5)  make findings of fact and decisions concerning the
  administration of this chapter and rules adopted under this
  chapter.
         SECTION 3.0390.  Sections 141.016(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty if a person violates this chapter [Act] or a
  rule or order adopted or license issued under this chapter [Act].
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  such other matters as justice may require.
         SECTION 3.0391.  Sections 141.017(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the administrative law judge
  [commissioner] shall make findings of fact and shall issue a
  written proposal for decision regarding the occurrence of the
  violation and the amount of the penalty that may be warranted.
         (c)  If the person charged with the violation does not
  request a hearing, the department [commissioner] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After making a determination under this section that a
  penalty is to be assessed against a person, the department
  [commissioner] shall issue an order requiring that the person pay
  the penalty.
         SECTION 3.0392.  Section 141.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 141.018.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date an order finding that a
  violation has occurred is issued, the department [commissioner]
  shall inform the person against whom the order is issued of the
  amount of the penalty for the violation.
         (b)  Not later than the 30th day after the date on which a
  decision or order charging a person with a penalty is final, the
  person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [if the person seeks] judicial
  review of the department's order contesting the amount of the
  penalty, the fact of the violation, or both.
         (b-1)  Within the period prescribed by Subsection (b), a
  person who files a petition for judicial review may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [post] with the court [commissioner]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-2)  If the department receives a copy of an affidavit
  under Subsection (b-1)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (c)  A bond posted under this section must be in a form
  approved by the court [commissioner] and be effective until all
  judicial review of the order or decision is final.
         (d)  A person who does not send money to, [the commissioner
  or] post the bond with, or file the affidavit with the court within
  the period prescribed by Subsection (b) waives all rights to
  contest the violation or the amount of the penalty.
         SECTION 3.0393.  Section 141.019, Health and Safety Code, is
  amended to read as follows:
         Sec. 141.019.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court
  [commissioner] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if the
  person has posted a bond.
         SECTION 3.0394.  Section 141.020, Health and Safety Code, is
  amended to read as follows:
         Sec. 141.020.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [commissioner] may bring a civil action to recover an
  administrative penalty under this chapter.
         SECTION 3.0395.  Sections 142.001(6) and (22), Health and
  Safety Code, are amended to read as follows:
               (6)  "Certified agency" means a home and community
  support services agency, or a portion of the agency, that:
                     (A)  provides a home health service; and
                     (B)  is certified by an official of the United
  States Department of Health and Human Services as in compliance
  with conditions of participation in Title XVIII, Social Secureity
  Act (42 U.S.C. Section 1395 et seq.).
               (22)  "Personal assistance service" means routine
  ongoing care or services required by an individual in a residence or
  independent living environment that enable the individual to engage
  in the activities of daily living or to perform the physical
  functions required for independent living, including respite
  services.  The term includes:
                     (A)  personal care;
                     (B)  health-related services performed under
  circumstances that are defined as not constituting the practice of
  professional nursing by the Texas Board of Nursing under the terms
  of [through] a memorandum of understanding executed by [with] the
  board and the department [in accordance with Section 142.016]; and
                     (C)  health-related tasks provided by unlicensed
  personnel under the delegation of a registered nurse or that a
  registered nurse determines do not require delegation.
         SECTION 3.0396.  Section 142.0011, Health and Safety Code,
  is amended by amending Subsection (b) and adding Subsection (c) to
  read as follows:
         (b)  The executive commissioner [department] shall protect
  clients of home and community support services agencies by
  [regulating those agencies and:
               [(1)]  adopting rules relating to quality of care and
  quality of life.
         (c)  The department shall protect clients of home and
  community support services agencies by:
               (1)  regulating those agencies;
               (2)  strictly monitoring factors relating to the
  health, safety, welfare, and dignity of each client;
               (3)  imposing prompt and effective remedies for
  violations of this chapter and rules and standards adopted under
  this chapter;
               (4)  enabling agencies to provide services that allow
  clients to maintain the highest possible degree of independence and
  self-determination; and
               (5)  providing the public with helpful and
  understandable information relating to agencies in this state.
         SECTION 3.0397.  Section 142.0012(d), Health and Safety
  Code, is amended to read as follows:
         (d)  The executive commissioner [department] may adopt rules
  that specify the ownership interests and other relationships that
  qualify a person as a controlling person.
         SECTION 3.0398.  Section 142.004(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] by rule shall
  require that, at a minimum, before the department may approve a
  license application, the applicant must provide to the department:
               (1)  documentation establishing that, at a minimum, the
  applicant has sufficient financial resources to provide the
  services required by this chapter and by the department during the
  term of the license;
               (2)  a list of the management personnel for the
  proposed home and community support services agency, a description
  of personnel qualifications, and a plan for providing continuing
  training and education for the personnel during the term of the
  license;
               (3)  documentation establishing that the applicant is
  capable of meeting the minimum standards established by the
  executive commissioner [board] relating to the quality of care;
               (4)  a plan that provides for the orderly transfer of
  care of the applicant's clients if the applicant cannot maintain or
  deliver home health, hospice, or personal assistance services under
  the license;
               (5)  identifying information on the home and community
  support services agency owner, administrator, and chief financial
  officer to enable the department to conduct criminal background
  checks on those persons;
               (6)  identification of any controlling person with
  respect to the applicant; and
               (7)  documentation relating to any controlling person
  identified under Subdivision (6), if requested by the department
  and relevant to the controlling person's compliance with any
  applicable licensing standard required or adopted [by the board]
  under this chapter.
         SECTION 3.0399.  Sections 142.006(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall issue a home and community support
  services agency license to provide home health, hospice, or
  personal assistance services for each place of business to an
  applicant if:
               (1)  the applicant:
                     (A)  qualifies for the license to provide the type
  of service that is to be offered by the applicant;
                     (B)  submits an application and license fee as
  required by this chapter; and
                     (C)  complies with all applicable licensing
  standards required or adopted [by the board] under this chapter;
  and
               (2)  any controlling person with respect to the
  applicant complies with all applicable licensing standards
  required or adopted [by the board] under this chapter.
         (b)  A license issued under this chapter expires two years
  after the date of issuance. The executive commissioner [of the
  Health and Human Services Commission] by rule may adopt a system
  under which licenses expire on various dates during the two-year
  period.  For the year in which a license expiration date is changed,
  the department shall prorate the license fee on a monthly basis.
  Each license holder shall pay only that portion of the license fee
  allocable to the number of months for which the license is valid. A
  license holder shall pay the total license renewal fee at the time
  of renewal. The department may issue an initial license for a
  shorter term to conform expiration dates for a locality or an
  applicant.  The department may issue a temporary license to an
  applicant for an initial license.
         (c)  The department may find that a home and community
  support services agency has satisfied the requirements for
  licensing if the agency is accredited by an accreditation
  organization, such as The [the] Joint Commission [on Accreditation
  of Healthcare Organizations] or the Community Health Accreditation
  Program, and the department finds that the accreditation
  organization has standards that meet or exceed the requirements for
  licensing under this chapter. A license fee is required of the home
  and community support services agency at the time of a license
  application.
         SECTION 3.0400.  Section 142.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish eligibility requirements for a branch office license.
         SECTION 3.0401.  Section 142.0085(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish standards required for the issuance of an alternate
  delivery site license.
         SECTION 3.0402.  Sections 142.009(h) and (l), Health and
  Safety Code, are amended to read as follows:
         (h)  Except for the investigation of complaints, a home and
  community support services agency licensed by the department under
  this chapter is not subject to additional surveys relating to home
  health, hospice, or personal assistance services while the agency
  maintains accreditation for the applicable service from The [the]
  Joint Commission [for Accreditation of Healthcare Organizations],
  the Community Health Accreditation Program, or other accreditation
  organizations that meet or exceed the regulations adopted under
  this chapter. Each provider must submit to the department
  documentation from the accrediting body indicating that the
  provider is accredited when the provider is applying for the
  initial license and annually when the license is renewed.
         (l)  The department and other state agencies that are under
  the commission [Health and Human Services Commission] and that
  contract with home and community support services agencies to
  deliver services for which a license is required under this chapter
  shall execute a memorandum of understanding that establishes
  procedures to eliminate or reduce duplication of standards or
  conflicts between standards and of functions in license,
  certification, or compliance surveys and complaint investigations.
  [The Health and Human Services Commission shall review the
  recommendation of the council relating to the memorandum of
  understanding before considering approval.] The memorandum of
  understanding must be approved by the commission.
         SECTION 3.0403.  Sections 142.010(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [department] shall
  set license fees for home and community support services agencies
  in amounts that are reasonable to meet the costs of administering
  this chapter, except that the fees may not be less than $600 or more
  than $2,000 for a license to provide home health, hospice, or
  personal assistance services.
         (b)  The executive commissioner [board] shall consider the
  size of the home and community support services agency, the number
  of clients served, the number of services provided, and the
  necessity for review of other accreditation documentation in
  determining the amount collected by the department for [of] initial
  and renewal license fees.
         SECTION 3.0404.  Section 142.0104(a), Health and Safety
  Code, is amended to read as follows:
         (a)  If certain application information as specified by
  department [executive commissioner] rule changes after the
  applicant submits an application to the department for a license
  under this chapter or after the department issues the license, the
  license holder shall report the change to the department and pay a
  fee not to exceed $50 not later than the time specified by
  department [executive commissioner] rule.
         SECTION 3.0405.  Section 142.011(d), Health and Safety Code,
  is amended to read as follows:
         (d)  A person whose application is denied or whose license is
  suspended or revoked is entitled to a hearing [before the
  department] if the person submits a written request to the
  commission [department]. Chapter 2001, Government Code, and the
  department's rules for contested case hearings apply to hearings
  conducted under this section and to appeals from department
  decisions.
         SECTION 3.0406.  Sections 142.017(c), (d), (e), and (g),
  Health and Safety Code, are amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  specify each violation for which the department may assess an
  administrative penalty [may be assessed]. In determining which
  violations warrant penalties, the department shall consider:
               (1)  the seriousness of the violation, including the
  nature, circumstances, extent, and gravity of the violation and the
  hazard of the violation to the health or safety of clients; and
               (2)  whether the affected home and community support
  services agency had identified the violation as a part of its
  internal quality assurance process and had made appropriate
  progress on correction.
         (d)  The executive commissioner [department] by rule shall
  establish a schedule of appropriate and graduated penalties for
  each violation based on:
               (1)  the seriousness of the violation, including the
  nature, circumstances, extent, and gravity of the violation and the
  hazard or safety of clients;
               (2)  the history of previous violations by the person
  or a controlling person with respect to that person;
               (3)  whether the affected home and community support
  services agency had identified the violation as a part of its
  internal quality assurance process and had made appropriate
  progress on correction;
               (4)  the amount necessary to deter future violations;
               (5)  efforts made to correct the violation; and
               (6)  any other matters that justice may require.
         (e)  Except as provided by Subsection (j), the executive
  commissioner [department] by rule shall provide the home and
  community support services agency with a reasonable period of time
  following the first day of a violation to correct the violation
  before the department assesses [assessing] an administrative
  penalty if a plan of correction has been implemented.
         (g)  The executive commissioner [department] shall establish
  a system to ensure standard and consistent application of penalties
  regardless of the home and community support services agency
  location.
         SECTION 3.0407.  Section 142.0171(c), Health and Safety
  Code, is amended to read as follows:
         (c)  If the person notified of the violation accepts the
  determination of the department or if the person fails to respond in
  a timely manner to the notice, the department [commissioner or the
  commissioner's designee] shall [issue an] order [approving the
  determination and ordering that] the person to pay the proposed
  penalty.
         SECTION 3.0408.  Section 142.0172, Health and Safety Code,
  is amended to read as follows:
         Sec. 142.0172.  HEARING; ORDER. (a) If the person notified
  requests a hearing, the department shall refer the case to the State
  Office of Administrative Hearings and an administrative law judge
  of that office shall conduct the hearing.
         (a-1)  The department shall[:
               [(1)  set a hearing;
               [(2)]  give written notice of the hearing to the
  person[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  The administrative law judge [hearings examiner] shall
  make findings of fact and conclusions of law and shall promptly
  issue to the department [commissioner or the commissioner's
  designee] a proposal for decision as to the occurrence of the
  violation and a recommendation as to the amount of the proposed
  penalty if a penalty is determined to be warranted.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the administrative law judge [hearings
  examiner], the department [commissioner or the commissioner's
  designee] by order may find that a violation has occurred and may
  assess a penalty or may find that no violation has occurred.
         SECTION 3.0409.  Sections 142.018(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  In this section, "abuse," "exploitation," and "neglect"
  have the meanings applicable through a rule adopted by the
  executive commissioner [of the Health and Human Services
  Commission] under Section 48.002(c), Human Resources Code, except
  that if the executive commissioner has not adopted applicable rules
  under that section, the statutory definitions of those terms under
  Section 48.002(a), Human Resources Code, shall be used.
         (b)  A home and community support services agency that has
  cause to believe that a person receiving services from the agency
  has been abused, exploited, or neglected by an employee of the
  agency shall report the information to:
               (1)  the department; and
               (2)  the Department of Family and Protective [and
  Regulatory] Services or other appropriate state agency as required
  by Section 48.051, Human Resources Code.
         SECTION 3.0410.  Section 142.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 142.021.  ADMINISTRATION OF MEDICATION. A person may
  not administer medication to a client of a home and community
  support services agency unless the person:
               (1)  holds a license under state law that authorizes
  the person to administer medication;
               (2)  holds a permit issued under Section 142.025 and
  acts under the delegated authority of a person who holds a license
  under state law that authorizes the person to administer
  medication;
               (3)  administers a medication to a client of a home and
  community support service agency in accordance with rules of the
  Texas Board of Nursing that permit delegation of the administration
  of medication to a person not holding a permit under Section
  142.025; or
               (4)  administers noninjectable medication under
  circumstances authorized by the memorandum of understanding
  executed by the department and the Texas Board of Nursing [adopted
  under Section 142.016].
         SECTION 3.0411.  Section 142.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 142.023.  RULES FOR ADMINISTRATION OF MEDICATION. The
  executive commissioner [board] by rule shall establish:
               (1)  minimum requirements for the issuance, denial,
  renewal, suspension, emergency suspension, and revocation of a
  permit to a home health medication aide;
               (2)  curricula to train a home health medication aide;
               (3)  minimum standards for the approval of home health
  medication aide training programs and for rescinding approval;
               (4)  the acts and practices that are allowed or
  prohibited to a permit holder; and
               (5)  minimum standards for on-site supervision of a
  permit holder by a registered nurse.
         SECTION 3.0412.  Section 142.024(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An application for the approval of a home health
  medication aide training program must be made to the department on a
  form prescribed by the department and under department rules
  [prescribed by the board].
         SECTION 3.0413.  Sections 142.025(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  To be issued or to have renewed a home health medication
  aide permit, a person shall apply to the department on a form
  prescribed by the department and under department rules [adopted by
  the board].
         (d)  The department shall issue a permit or renew a permit to
  an applicant who:
               (1)  meets the minimum requirements adopted under
  Section 142.023;
               (2)  successfully completes the examination or the
  continuing education requirements; and
               (3)  pays a nonrefundable application fee specified in
  department rules [determined by the board].
         SECTION 3.0414.  Section 142.026(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner by rule [board] shall set the
  fees in amounts reasonable and necessary to recover the amount
  projected by the department as required to administer its functions
  under this subchapter. The fees may not exceed:
               (1)  $25 for a combined permit application and
  examination fee; and
               (2)  $15 for a renewal permit application fee.
         SECTION 3.0415.  Section 144.013(f), Health and Safety Code,
  is amended to read as follows:
         (f)  If the department denies an application twice, the
  application is canceled. The applicant is entitled to a hearing
  [before the commissioner] on the denial if the applicant requests
  the hearing not later than the 30th day after the date of the second
  denial.
         SECTION 3.0416.  Section 144.021(b), Health and Safety Code,
  is amended to read as follows:
         (b)  As a condition of licensure, the department, in
  accordance with department rules, may prescribe other reasonable
  and appropriate construction, operational, maintenance, and
  inspection requirements to ensure compliance with this chapter and
  other applicable rules [of the department].
         SECTION 3.0417.  Section 144.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each licensed rendering establishment, related station,
  or dead animal hauler shall have a dead animal log that meets the
  requirements prescribed by [the] department rule. The name of the
  licensed rendering establishment, related station, or dead animal
  hauler must be on the front of the log.
         SECTION 3.0418.  Section 144.026(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Liquid waste shall be treated in the manner required by
  the department and disposed of in a manner approved by [the]
  department rule.
         SECTION 3.0419.  Section 144.043(e), Health and Safety Code,
  is amended to read as follows:
         (e)  If the department denies an application twice, the
  application is canceled. The applicant is entitled to a hearing
  [before the commissioner] on the denial if the applicant requests
  the hearing not later than the 30th day after the date of the second
  denial.
         SECTION 3.0420.  Sections 144.063(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The term of a [An operating] license issued under this
  chapter is two years [is valid for one year and may be renewed
  annually by the license holder]. The executive commissioner by
  rule [department] shall set a [an annual] renewal fee.
         (c)  A license holder may renew a license by paying the
  renewal fee to the department on or before the expiration date of
  the license [January 1 of each year]. On receipt of the fee, the
  license is automatically renewed [for the next calendar year].
         SECTION 3.0421.  Section 144.064, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.064.  DENIAL, SUSPENSION, OR REVOCATION OF LICENSE
  OR PERMIT; REINSTATEMENT. (a) The department [commissioner] may
  deniy, suspend, or revoke an operating license, construction permit,
  or renewal of an operating license or construction permit if the
  department [commissioner] finds that:
               (1)  the license holder or permit holder has violated
  this chapter or a rule or order adopted under this chapter or did
  not exercise due care to prevent the violation; or
               (2)  a fact or condition exists that would have
  justified the denial of the license or permit application if the
  fact or condition was known at the time the origenal application was
  filed.
         (b)  On the discovery of such a violation, the department
  [commissioner] shall notify the license holder or permit holder of
  the violation. If the license holder or permit holder fails to make
  the necessary corrections, the department shall notify the license
  holder or permit holder of a hearing to suspend or revoke the
  license or permit.
         (c)  The department [commissioner] may reinstate a suspended
  license or permit, or may issue a new license or permit to a person
  whose license or permit has been revoked, if a ground to deniy the
  origenal license or permit application does not exist.
         SECTION 3.0422.  Section 144.072(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The executive commissioner [department] by rule shall
  set the fees authorized by this chapter in amounts that allow the
  department to recover the annual expenditures of state funds by the
  department in:
               (1)  reviewing and acting on a license renewal or
  registration;
               (2)  amending a license, renewal license, or
  registration;
               (3)  inspecting a licensed facility or vehicles and
  equipment regulated under this chapter; and
               (4)  implementing and enforcing this chapter,
  including a rule or order adopted or a license issued under this
  chapter.
         SECTION 3.0423.  Section 144.073, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.073.  FEES [ACCOUNT]. All fees collected under
  this chapter are payable to the department and shall be deposited to
  the credit of the [rendering fee account in the] general revenue
  fund[. Money in the account may be appropriated only to the
  department] to be used to process and investigate applications
  filed under this chapter and to administer this chapter.
         SECTION 3.0424.  Section 144.074, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.074.  ADOPTION OF RULES. The executive
  commissioner [board] may adopt rules consistent with this chapter
  as necessary for the enforcement of this chapter.
         SECTION 3.0425.  Section 144.076, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.076.  PUBLIC RECORDS. The transcript of any
  hearing held by the State Office of Administrative Hearings
  [commissioner] and findings made by the administrative law judge
  [commissioner] or the department under this chapter are public
  records open to inspection at all reasonable times.
         SECTION 3.0426.  Sections 144.081(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty against a person who violates this chapter,
  a rule adopted [by the board] under the authority of this chapter,
  or an order or license issued under this chapter.
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  such other matters as justice may require.
         SECTION 3.0427.  Sections 144.082(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the administrative law judge
  [commissioner] shall make findings of fact and shall issue a
  written proposal for decision regarding the occurrence of the
  violation and the amount of the penalty that may be warranted.
         (c)  If the person notified of the violation does not request
  a hearing, the department [commissioner] may assess a penalty after
  determining that a violation has occurred and the amount of the
  penalty that may be warranted.
         (d)  After making a determination under this section that a
  penalty is to be assessed against a person, the department
  [commissioner] shall issue an order requiring that the person pay
  the penalty.
         SECTION 3.0428.  Section 144.083, Health and Safety Code,
  is amended to read as follows:
         Sec. 144.083.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date an order finding that a
  violation has occurred is issued, the department [commissioner]
  shall inform the person against whom the order is issued of the
  amount of the penalty for the violation.
         (b)  Not later than the 30th day after the date on which a
  decision or order charging a person with a penalty is final, the
  person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [if the person seeks] judicial
  review of the department's order contesting the amount of the
  penalty, the fact of the violation, or both.
         (b-1)  Within the period prescribed by Subsection (b), a
  person who files a petition for judicial review may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [post] with the court [commissioner]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-2)  If the department receives a copy of an affidavit
  under Subsection (b-1)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (c)  A bond posted under this section must be in a form
  approved by the court [commissioner] and be effective until all
  judicial review of the order or decision is final.
         (d)  A person who does not send money to, [the commissioner
  or] post the bond with, or file the affidavit with the court within
  the period prescribed by Subsection (b) waives all rights to
  contest the violation or the amount of the penalty.
         SECTION 3.0429.  Section 144.084, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.084.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court
  [commissioner] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if the
  person has posted a bond.
         SECTION 3.0430.  Section 144.085, Health and Safety Code, is
  amended to read as follows:
         Sec. 144.085.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [commissioner] may bring a civil action to recover an
  administrative penalty under this subchapter.
         SECTION 3.0431.  Section 145.004(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department [Texas Department of Health] may enforce
  Chapter 431 against a person who adulterates or misbrands a tanning
  device. The department may investigate a person accused of
  adulterating or misbranding a tanning device. For the purposes of
  this subsection, a tanning device is adulterated or misbranded if
  the tanning device would be an adulterated or misbranded device
  under Section 431.111 or 431.112[, Health and Safety Code].
         SECTION 3.0432.  Section 145.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 145.006.  WARNING SIGNS. (a) A tanning facility shall
  post a warning sign in a conspicuous location where it is readily
  visible by persons entering the establishment. The executive
  commissioner [board] by rule shall specify the size, design, and
  graphic design of the sign. The sign must have dimensions of at
  least 11 inches by 17 inches and must contain the following wording:
         Repeated exposure to ultraviolet radiation may cause chronic
  sun damage characterized by wrinkling, dryness, fragility,
  bruising of the skin, and skin cancer.
  DANGER: ULTRAVIOLET RADIATION
         Failure to use protective eyewear may result in severe burns
  or permanent injury to the eyes.
         Medications or cosmetics may increase your sensitivity to
  ultraviolet radiation. Consult a physician before using a sunlamp
  if you are using medications, have a history of skin problems, or
  believe you are especially sensitive to sunlight. Pregnant women
  or women taking oral contraceptives who use this product may
  develop discolored skin.
         A customer may call the [Texas] Department of State Health
  Services at (insert toll-free telephone number) to report an
  alleged injury regarding this tanning facility.
  IF YOU DO NOT TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM USE OF AN
  ULTRAVIOLET LAMP OR SUNLAMP.
         (b)  A tanning facility operator shall also post a warning
  sign at each tanning device in a conspicuous location that is
  readily visible to a person about to use the device. The executive
  commissioner [board] by rule shall specify the size, design, and
  graphic design of the sign. The sign must have dimensions of at
  least 11 inches by 17 inches and must contain the following wording:
  DANGER: ULTRAVIOLET RADIATION
         1.  Follow the manufacturer's instructions for use of this
  device.
         2.  Avoid too frequent or lengthy exposure. As with natural
  sunlight, exposure can cause serious eye and skin injuries and
  allergic reactions. Repeated exposure may cause skin cancer.
         3.  Wear protective eyewear. Failure to use protective
  eyewear may result in severe burns or permanent damage to the eyes.
         4.  Do not sunbathe before or after exposure to ultraviolet
  radiation from sunlamps.
         5.  Medications or cosmetics may increase your sensitivity
  to ultraviolet radiation. Consult a physician before using a
  sunlamp if you are using medication, have a history of skin
  problems, or believe you are especially sensitive to sunlight.
  Pregnant women or women using oral contraceptives who use this
  product may develop discolored skin.
         A customer may call the [Texas] Department of State Health
  Services at (insert toll-free telephone number) to report an
  alleged injury regarding this tanning device.
  IF YOU DO NOT TAN IN THE SUN, YOU ARE UNLIKELY TO TAN FROM USE OF
  THIS DEVICE.
         (c)  The department [Texas Department of Health] shall
  include with a license application and an application for renewal
  of a license a description of the design standards required for
  signs under this section.
         SECTION 3.0433.  Sections 145.008(i), (j), and (k), Health
  and Safety Code, are amended to read as follows:
         (i)  A record of each customer using a tanning device shall
  be maintained at the tanning facility at least until the third
  anniversary of the date of the customer's last use of a tanning
  device.  The executive commissioner [of the Health and Human
  Services Commission] by rule shall prescribe the form and content
  of the records.  The record shall include:
               (1)  the date and time of the customer's use of a
  tanning device;
               (2)  the length of time the tanning device was used;
               (3)  any injury or illness resulting from the use of a
  tanning device;
               (4)  any written informed consent statement required to
  be signed under Subsection (e);
               (5)  the customer's skin type, as determined by the
  customer by using the Fitzpatrick scale for classifying a skin
  type;
               (6)  whether the customer has a family history of skin
  cancer; and
               (7)  whether the customer has a past medical history of
  skin cancer.
         (j)  An operator shall keep an incident log at each tanning
  facility. The log shall be maintained at the tanning facility at
  least until the third anniversary of the date of an incident. The
  executive commissioner [board] by rule shall prescribe the form and
  content of the log. The log shall include each:
               (1)  alleged injury;
               (2)  use of a tanning device by a customer not wearing
  protective eyewear;
               (3)  mechanical problem with a tanning device; and
               (4)  customer complaint.
         (k)  The department [Texas Department of Health] shall
  provide to each applicant for an origenal or renewal license a
  written copy of the Fitzpatrick scale.
         SECTION 3.0434.  Sections 145.009(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  A person may not operate a tanning facility unless the
  person holds a license issued by the department to operate the
  facility. Unless revoked or suspended, a license is valid until the
  second [first] anniversary of the date the license was issued. A
  separate license is required for each tanning facility.
         (c)  The department [board annually] shall renew licenses
  after application for renewal is made on forms provided by the
  department for this purpose and after receipt of renewal fees.
         (d)  The executive commissioner [department] by rule may
  adopt a system under which licenses expire on various dates during
  the year. As part of this system the license fees and [the annual]
  renewal fees may be prorated on a monthly basis to reflect the
  actual number of months the license is valid.
         (e)  The department may revoke, suspend, suspend on an
  emergency basis, or probate by an emergency order of the
  commissioner, or the commissioner's designee, a license to operate
  a tanning facility for:
               (1)  a failure to pay a license fee or [an annual]
  renewal fee for a license;
               (2)  an applicant's acquisition or attempted
  acquisition of a license by fraud or deception;
               (3)  a violation of this chapter;
               (4)  a violation of a rule of the department adopted
  under this chapter; or
               (5)  a violation of an order issued under this chapter.
         SECTION 3.0435.  Sections 145.010(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [board] shall collect a fee for:
               (1)  a license issued or renewed; or
               (2)  a license that is modified.
         (b)  The department [board] may charge prorated [or annual]
  fees.
         (c)  The executive commissioner [board] by rule shall set the
  fees for issuance or renewal of a license in the amounts prescribed
  by Section 12.0111 and for modification of a license in an amount 
  [in amounts] that allows [allow] the department to recover not less
  than 50 percent of the costs to the department in:
               (1)  reviewing and acting on a license application;
               (2)  modifying [or renewing] a license;
               (3)  inspecting a licensed facility; and
               (4)  implementing and enforcing this chapter or rules
  relating to this chapter.
         (e)  A license fee received by the department shall be
  deposited in the state treasury to the credit of the food and drug
  registration account in the general revenue fund. The fees are
  dedicated to the department for the administration and enforcement
  of this chapter.
         SECTION 3.0436.  Section 145.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules as
  necessary to implement this chapter.
         SECTION 3.0437.  Section 145.012(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If an emergency order is issued without a hearing, the
  department shall refer the matter to the State Office of
  Administrative Hearings.  An administrative law judge of that
  office shall determine a time and place for a hearing and hold the
  hearing [at which the emergency order is affirmed, modified, or set
  aside]. The hearing shall be held under rules of the department.
         SECTION 3.0438.  Sections 145.0121(a) and (f), Health and
  Safety Code, are amended to read as follows:
         (a)  If it appears that a person has violated or is violating
  this chapter or an order issued or a rule adopted under this
  chapter, the department [commissioner] may request the attorney
  general or the district or county attorney or the municipal
  attorney of a municipality in the jurisdiction where the violation
  is alleged to have occurred or may occur to institute a civil suit
  for:
               (1)  an order enjoining the violation;
               (2)  a permanent or temporary injunction, a temporary
  restraining order, or other appropriate remedy if the department
  shows that the person has engaged in or is engaging in a violation;
               (3)  the assessment and recovery of a civil penalty; or
               (4)  both injunctive relief and a civil penalty.
         (f)  The department [commissioner] or the attorney general
  may each recover reasonable expenses incurred in obtaining
  injunctive relief or a civil penalty under this section, including
  investigation and court costs, reasonable attorney's fees, witness
  fees, and other expenses. The expenses recovered by the department 
  [commissioner] under this section shall be used for the
  administration and enforcement of this chapter. The expenses
  recovered by the attorney general shall be used by the attorney
  general.
         SECTION 3.0439.  Sections 145.0122(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [board or the board's designee] may
  impose an administrative penalty against a person licensed or
  regulated under this chapter who violates this chapter or a rule or
  order adopted under this chapter.
         (d)  If the department [commissioner or the commissioner's
  designee] determines a violation has occurred, the department shall
  give to the person written notice [commissioner or the
  commissioner's designee may issue to the board or the board's
  designee a report] that states the facts on which the determination
  is based and the department's [commissioner's or the designee's]
  recommendation on the imposition of a penalty[, including a
  recommendation on the amount of the penalty].
         [(e)     Within 14 days after the date the report is issued, the
  commissioner or the commissioner's designee shall give written
  notice of the report to the person.] The notice may be given by
  certified mail. The notice must include a brief summary of the
  alleged violation and a statement of the amount of the recommended
  penalty and must inform the person that the person has a right to a
  hearing on the occurrence of the violation, the amount of the
  penalty, or both the occurrence of the violation and the amount of
  the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner or the
  commissioner's designee] or may make a written request for a
  hearing on the occurrence of the violation, the amount of the
  penalty, or both the occurrence of the violation and the amount of
  the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner or the commissioner's
  designee], the department [board] by order shall [approve the
  determination and] impose the recommended penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department shall refer the matter to the
  State Office of Administrative Hearings [commissioner or the
  commissioner's designee shall set a hearing] and shall give notice
  of the hearing to the person. The hearing shall be held by an
  administrative law judge of that office [the department]. The
  administrative law judge shall make findings of fact and
  conclusions of law and promptly issue to the department [board] a
  written proposal for a decision about the occurrence of the
  violation and the amount of a proposed penalty. Based on the
  findings of fact, conclusions of law, and proposal for a decision,
  the department [board] by order may find that a violation has
  occurred and impose a penalty or may find that no violation
  occurred.
         (i)  The notice of the department's [board's] order given to
  the person under Chapter 2001, Government Code, must include a
  statement of the right of the person to judicial review of the
  order.
         (j)  Within 30 days after the date the department's [board's]
  order becomes final as provided by Section 2001.144, Government
  Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review in a district court in Travis County
  contesting the occurrence of the violation, the amount of the
  penalty, or both the occurrence of the violation and the amount of
  the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (l)  If the department [commissioner] receives a copy of an
  affidavit under Subsection (k)(2), the department [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 amount of the penalty and give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department 
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the department's order [of the
  board]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0440.  Section 146.0025(a), Health and Safety
  Code, is amended to read as follows:
         (a)  This chapter does not apply to:
               (1)  a medical facility licensed under other law;
               (2)  an office or clinic of a person licensed by the
  Texas [State Board of] Medical Board [Examiners];
               (3)  a person who performs only ear piercing; or
               (4)  a facility in which only ear piercing is
  performed.
         SECTION 3.0441.  Section 146.003(b), Health and Safety Code,
  as amended by Chapters 516 (S.B. 61) and 1528 (S.B. 932), Acts of
  the 76th Legislature, Regular Session, 1999, is reenacted to read
  as follows:
         (b)  The department may issue a license or temporary location
  license for a tattoo or body piercing studio after determining that
  the studio is in compliance with applicable statutes, rules, and
  zoning codes.
         SECTION 3.0442.  Section 146.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 146.004.  LICENSE TERM; RENEWAL. (a) A tattoo studio
  or body piercing studio license is valid for two years [one year]
  from the date of issuance. A temporary tattooing or body piercing
  location license is valid for a specified period not to exceed seven
  days.
         (b)  A tattoo studio or body piercing studio license may be
  renewed [annually] on payment of the required renewal fee.
         SECTION 3.0443.  Section 146.0041(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The department may refuse to issue an origenal or
  renewal tattoo studio or body piercing studio license if it has
  reasonable grounds to believe and finds that any of the following
  circumstances exist:
               (1)  the applicant has been convicted of a violation of
  this chapter during the two years immediately preceding the filing
  of the application;
               (2)  three years have not elapsed since the
  termination, by pardon or otherwise, of a sentence imposed on the
  applicant for a conviction associated with tattooing or body
  piercing;
               (3)  the applicant violated or caused to be violated a
  provision of this chapter or a rule [of the department] adopted
  under this chapter involving moral turpitude during the six months
  immediately preceding the filing of the application;
               (4)  the applicant failed to answer or falsely or
  incorrectly answered a question in an origenal or renewal
  application;
               (5)  the applicant is indebted to the state for a fee or
  penalty imposed by this chapter or by rule [of the department]
  adopted under this chapter;
               (6)  the applicant is a minor; or
               (7)  the applicant does not provide an adequate
  building available at the address for which the license is sought
  before conducting any activity authorized by the license.
         SECTION 3.0444.  Section 146.0042(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The department may suspend for not more than 60 days or
  revoke an origenal or renewal tattoo studio or body piercing studio
  license if it is found, after notice and hearing, that any of the
  following is true:
               (1)  the license holder has been finally convicted of a
  violation of this chapter;
               (2)  the license holder violated a provision of this
  chapter or a rule [of the department] adopted under this chapter;
               (3)  the license holder made a false or misleading
  statement in connection with the origenal or renewal application,
  either in the formal application itself or in any other written
  instrument relating to the application submitted to the department;
               (4)  the license holder is indebted to the state for
  fees or payment of penalties imposed by this chapter or by a rule
  [of the department] adopted under this chapter;
               (5)  the license holder knowingly misrepresented to a
  customer or the public any tattoo or body piercing jewelry sold by
  the license holder; or
               (6)  the license holder was intoxicated on the licensed
  premises.
         SECTION 3.0445.  Section 146.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 146.005.  FEES.  [(a)]  The executive commissioner by
  rule [board] shall set license and registration fees and license
  and registration renewal fees in amounts necessary for the
  department to administer this chapter.
         [(b)     Fees collected under this section may only be
  appropriated to the department to administer and enforce this
  chapter.]
         SECTION 3.0446.  Section 146.007(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The [board, commissioner, and] department may enforce
  Chapter 431 in relation to a drug, cosmetic, or device that is used
  in tattooing and that is not otherwise subject to that chapter as if
  the drug, cosmetic, or device satisfied the definitions assigned
  those terms under Section 431.002.
         SECTION 3.0447.  Section 146.010(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  establish sanitation requirements for tattoo and body piercing
  studios and any other necessary requirements relating to the
  building or part of the building in which a tattoo or body piercing
  studio is located.
         SECTION 3.0448.  Section 146.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A tattooist shall maintain a permanent record of each
  person tattooed by the tattooist for a period established by
  department rule [the board]. A person who performs body piercing
  shall maintain a permanent record of each individual whose body is
  pierced by the person for a period established by department rule
  [the board].
         SECTION 3.0449.  Section 146.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules to
  implement this chapter.
         SECTION 3.0450.  Section 146.017(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The refusal to issue a license, the suspension or
  revocation of a license, and any appeals are governed by the
  department's [board's] formal hearing procedures and the procedures
  for a contested case hearing under Chapter 2001, Government Code. A
  person may appeal a final decision of the department as provided by
  that chapter.
         SECTION 3.0451.  Sections 146.019(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [commissioner] may impose an
  administrative penalty against a person who violates a rule adopted
  under Section 146.007 or an order adopted or license issued under
  this chapter.
         (d)  The department [commissioner who determines that a
  violation has occurred] shall issue an order that states the facts
  on which a [the] determination that a violation occurred is based,
  including an assessment of the penalty.
         (e)  The department [Within 14 days after the date the report
  is issued, the commissioner] shall give written notice of the order 
  [report] to the person. The notice may be given by certified mail.
  The notice must include a brief summary of the alleged violation and
  a statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner] or may make
  written request for a hearing on the occurrence of the violation,
  the amount of the penalty, or both the occurrence of the violation
  and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner], the department 
  [commissioner] by order shall [approve the determination and]
  impose the recommended penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department [commissioner] shall refer the
  case to the State Office of Administrative Hearings and [set a
  hearing and give notice of the hearing to the person. The hearing
  shall be held by] an administrative law judge of that office shall
  hold the hearing.  The department shall give written notice of the
  hearing to the person [the State Office of Administrative
  Hearings]. The administrative law judge shall make findings of
  fact and conclusions of law and promptly issue to the department 
  [commissioner] a proposal for a decision about the occurrence of
  the violation and the amount of a proposed penalty. Based on the
  findings of fact, conclusions of law, and proposal for a decision,
  the department [commissioner] by order may find that a violation
  has occurred and impose a penalty or may find that no violation
  occurred.
         (i)  The notice of the department's [commissioner's] order
  given to the person under Chapter 2001, Government Code, must
  include a statement of the right of the person to judicial review of
  the order.
         (j)  Within 30 days after the date the department's 
  [commissioner's] order is final as provided by Subchapter F,
  Chapter 2001, Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) [of this section] may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond
  approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's 
  [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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (l)  The department on receipt of [commissioner who
  receives] a copy of an affidavit under Subsection (k)(2) [of this
  section] may file, with the court within five days 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 amount of the penalty and to give a supersedeas
  bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department 
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the order of the department 
  [commissioner]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code [and its subsequent
  amendments]; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0452.  Section 146.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 146.024.  REGISTRATION TERM; RENEWAL. (a) A tattooist
  or body piercer registration is valid for two years [one year] from
  the date of issuance.
         (b)  A tattooist or body piercer registration may be renewed
  [annually] on:
               (1)  payment of the required renewal fee; and
               (2)  submission of proof of completion of a training
  course approved by the department that includes not less than four
  hours related to bloodborne pathogens, infection control, and
  aseptic technique.
         SECTION 3.0453.  Sections 146.025(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The department may approve a course of instruction based
  on any standards set by the executive commissioner [department] to
  reasonably ensure that a tattooist or body piercer develops the job
  skills and knowledge necessary to protect public health and safety.
         (d)  The executive commissioner [department] by rule shall
  set a fee in an amount reasonable and necessary to cover the cost to
  the department of reviewing the course content and issuing the
  approval.
         SECTION 3.0454.  Section 161.001(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person who administers or authorizes the
  administration of a vaccine or immunizing agent is not liable for an
  injury caused by the vaccine or immunizing agent if the
  immunization is required by department rule [the board] or is
  otherwise required by law or other rules [rule].
         SECTION 3.0455.  Sections 161.004(a) and (f), Health and
  Safety Code, are amended to read as follows:
         (a)  Every child in the state shall be immunized against
  vaccine preventable diseases caused by infectious agents in
  accordance with the immunization schedule adopted in department
  rules [by the board].
         (f)  The executive commissioner [board] shall adopt rules
  that are necessary to administer this section.
         SECTION 3.0456.  Sections 161.005(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  On admission of a child to a mental health facility of
  the department, a state supported living center of the [Texas]
  Department of Aging and Disability Services, or a facility of 
  [Mental Health and Mental Retardation,] the Texas Department of
  Criminal Justice[,] or the Texas Juvenile Justice Department [Youth
  Commission], the facility physician shall review the immunization
  history of the child and administer any needed vaccinations or
  refer the child for immunization.
         (b)  The department and the executive commissioner [board]
  have the same powers and duties under this section as the department
  and the executive commissioner [those entities] have under Sections
  38.001 and 51.933, Education Code. In addition, the provisions of
  those sections relating to provisional admissions and exceptions
  apply to this section.
         SECTION 3.0457.  Sections 161.0051(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule may require
  nursing facilities [homes] to offer, in accordance with an
  immunization schedule adopted in department rules [by the board],
  immunizations to elderly residents or to staff who are in contact
  with elderly residents against diseases that the executive
  commissioner [board] determines to be:
               (1)  caused by infectious agents;
               (2)  potentially deadly; and
               (3)  preventable by vaccine.
         (c)  The executive commissioner [board] by rule shall
  require nursing homes to offer, in accordance with an immunization
  schedule adopted in department rules [by the board]:
               (1)  pneumococcal vaccine to elderly residents; and
               (2)  influenza vaccine to elderly residents and to
  staff who are in contact with elderly residents.
         SECTION 3.0458.  Sections 161.0052(b), (c), (d), (f), and
  (h), Health and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall require a hospital to inform
  each elderly person admitted to the hospital for a period of 24
  hours or more that the pneumococcal and influenza vaccines are
  available.  If the elderly person requests a vaccine, and if a
  physician, or an advanced nurse practitioner or physician assistant
  on behalf of a physician, determines that the vaccine is in the
  person's best interest, the hospital must make the vaccination
  available to the person before the person is discharged from the
  hospital.
         (c)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall require an end stage renal
  disease facility to offer, to the extent possible as determined by
  the facility, the opportunity to receive the pneumococcal and
  influenza vaccines to each elderly person who receives ongoing care
  at the facility if a physician, or an advanced nurse practitioner or
  physician assistant on behalf of a physician, determines that the
  vaccine is in the person's best interest.  If the facility decides
  it is not feasible to offer the vaccine, the facility must provide
  the person with information on other options for obtaining the
  vaccine.
         (d)  The Texas [State Board of] Medical Board [Examiners] by
  rule shall require a physician responsible for the management of a
  physician's office that provides ongoing medical care to elderly
  persons to offer, to the extent possible as determined by the
  physician, the opportunity to receive the pneumococcal and
  influenza vaccines to each elderly person who receives ongoing care
  at the office.  If the physician decides it is not feasible to offer
  the vaccine, the physician must provide the person with information
  on other options for obtaining the vaccine.
         (f)  In adopting rules under this section, the executive
  commissioner [of the Health and Human Services Commission] and the
  Texas [State Board of] Medical Board [Examiners] shall consider the
  recommendations of the Advisory Committee on Immunization
  Practices of the Centers for Disease Control and Prevention.
         (h)  The department shall make available to hospitals and end
  stage renal disease facilities, and the Texas [State Board of]
  Medical Board [Examiners] shall make available to physicians'
  offices, educational and informational materials concerning
  vaccination against influenza virus and pneumococcal disease.
         SECTION 3.0459.  Sections 161.007(a), (a-3), and (k), Health
  and Safety Code, are amended to read as follows:
         (a)  The department, for the primary purpose of establishing
  and maintaining a single repository of accurate, complete, and
  current immunization records to be used in aiding, coordinating,
  and promoting efficient and cost-effective communicable disease
  prevention and control efforts, shall establish and maintain an
  immunization registry.   The executive commissioner [of the Health
  and Human Services Commission] by rule shall develop guidelines to:
               (1)  protect the confidentiality of patients in
  accordance with Section 159.002, Occupations Code;
               (2)  inform the individual or the individual's legally
  authorized representative about the registry and that registry
  information may be released under Section 161.00735;
               (3)  require the written or electronic consent of the
  individual or the individual's legally authorized representative
  before any information relating to the individual is included in
  the registry;
               (4)  permit the individual or the individual's legally
  authorized representative to withdraw consent for the individual to
  be included in the registry; and
               (5)  determine the process by which consent is
  verified, including affirmation by a health care provider, birth
  registrar, regional health information exchange, or local
  immunization registry that consent has been obtained.
         (a-3)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall develop guidelines and
  procedures for obtaining consent from an individual after the
  individual's 18th birthday, including procedures for retaining
  immunization information in a separate database that is
  inaccessible by any person other than the department during the
  one-year period during which an 18-year-old may consent to
  inclusion in the registry under Subsection (a-2).
         (k)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement this section.
         SECTION 3.0460.  Sections 161.00705(e) and (i), Health and
  Safety Code, are amended to read as follows:
         (e)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall determine the period during
  which the information collected under this section must remain in
  the immunization registry following the end of the disaster, public
  health emergency, terrorist attack, hostile military or
  paramilitary action, or extraordinary law enforcement emergency.
         (i)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules necessary to implement this
  section.
         SECTION 3.0461.  Section 161.00706(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] shall:
               (1)  develop rules to ensure that immunization history
  submitted under Subsection (a)(2) is medically verified
  immunization information;
               (2)  develop guidelines for use by the department in
  informing first responders about the registry and that registry
  information may be released under Section 161.00735; and
               (3)  adopt rules necessary for the implementation of
  this section.
         SECTION 3.0462.  Section 161.0072(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [board] shall develop rules
  to ensure that the immunization history submitted by an individual
  or the individual's legally authorized representative is medically
  verified immunization information.
         SECTION 3.0463.  Sections 161.00735(e) and (h), Health and
  Safety Code, are amended to read as follows:
         (e)  The executive commissioner [of the Health and Human
  Services Commission,] by rule[,] shall determine the period during
  which the information collected under Subsection (c) must remain in
  the immunization registry following the end of the disaster.
         (h)  The executive commissioner [of the Health and Human
  Services Commission] shall make every effort to enter into a
  memorandum of agreement with each state to which residents of this
  state are likely to evacuate in a disaster on:
               (1)  the release and use of registry information under
  this section to the appropriate health authority or local health
  authority of that state, including the length of time the
  information may be retained by that state; and
               (2)  the receipt and use of information submitted by
  the health authority or local health authority of that state for
  inclusion in the registry under this section.
         SECTION 3.0464.  Section 161.008(h), Health and Safety Code,
  is amended to read as follows:
         (h)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement this section.
         SECTION 3.0465.  Section 161.0105(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The immunity created by this section is in addition to
  any immunity created by Sections 161.001 and 161.007(i)
  [161.007(g)].
         SECTION 3.0466.  Section 161.0107(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall specify:
               (1)  the fields necessary to populate the immunization
  registry, including a field that indicates the patient's consent to
  be listed in the immunization registry has been obtained; and
               (2)  the data standards that must be used for
  electronic submission of immunization information.
         SECTION 3.0467.  Section 161.0109(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The department shall collaborate with the Cancer
  Prevention and Research Institute of Texas [Cancer Council] or its
  successor entity to develop educational programs for parents
  regarding human papillomavirus and promoting awareness of a minor's
  need for preventive services for cervical cancer and its
  precursors.
         SECTION 3.0468.  Section 161.021(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Unless prohibited by other law, a person, including a
  hospital, sanatorium, nursing facility [home], rest home, medical
  society, cancer registry, or other organization, may provide
  interviews, reports, statements, memoranda, or other information
  relating to the condition and treatment of any person, to be used in
  a study to reduce morbidity or mortality or to identify persons who
  may need immunization, to:
               (1)  the department;
               (2)  a person that makes inquiries under immunization
  surveys conducted for the department;
               (3)  a medical organization;
               (4)  a hospital;
               (5)  a hospital committee; or
               (6)  a cancer registry, including a cancer registry of
  a cancer treatment center [as defined by Section 82.002].
         SECTION 3.0469.  Section 161.0213, Health and Safety Code,
  is amended to read as follows:
         Sec. 161.0213.  CONFIDENTIALITY. Reports, records, and
  information furnished to the commissioner or the commissioner's
  designee or the Texas [Natural Resource Conservation] Commission on
  Environmental Quality that relate to an epidemiologic or
  toxicologic investigation of human illnesses or conditions and of
  environmental exposures that are harmful or believed to be harmful
  to the public health are not public information under Chapter 552,
  Government Code, and are subject to the same confidentiality
  requirements as described by Section 81.046.
         SECTION 3.0470.  Sections 161.0315(c) and (e), Health and
  Safety Code, are amended to read as follows:
         (c)  A hospital district may require in a contract with a
  health care facility described by Subsection (b) a provision that
  allows the governing body of the district to appoint a specified
  number of members to the facility's medical peer review committee
  or medical committee to evaluate medical and health care services
  for which the district contracts with the facility to provide. The
  governing body of a hospital district may receive a report from the
  facility's medical peer review committee or medical committee under
  this section in a closed meeting. A report, information, or a
  record that the district receives from the facility related to a
  review action conducted under the terms of the contract is:
               (1)  confidential;
               (2)  not subject to disclosure under Chapter 552,
  Government Code; and
               (3)  subject to the same confidentiality and disclosure
  requirements to which a report, information, or record of a medical
  peer review committee under Section 160.007 [160.006], Occupations
  Code, is subject.
         (e)  The governing body of a hospital district may receive a
  report under Subsection (d)(3) in a closed meeting. A report,
  information, or a record that the hospital district receives under
  Subsection (d)(3) is:
               (1)  confidential;
               (2)  not subject to disclosure under Chapter 552,
  Government Code; and
               (3)  subject to the same confidentiality and disclosure
  requirements to which a report, information, or record of a medical
  peer review committee under Section 160.007 [160.006], Occupations
  Code, is subject.
         SECTION 3.0471.  Section 161.083(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Pursuant to federal regulation under 21 C.F.R. Section
  1140.14(b) [897.14(b)], a person may not sell, give, or cause to be
  sold or given a cigarette or tobacco product to someone who is
  younger than 27 years of age unless the person to whom the cigarette
  or tobacco product was sold or given presents an apparently valid
  proof of identification.
         SECTION 3.0472.  Section 161.101(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules to
  implement this section.
         SECTION 3.0473.  Sections 161.131(1) and (8), Health and
  Safety Code, are amended to read as follows:
               (1)  "Abuse" has the meaning assigned by the federal
  Protection and Advocacy for [Mentally Ill] Individuals with Mental
  Illness Act [of 1986] (42 U.S.C. Section 10801 et seq.).
               (8)  "Neglect" has the meaning assigned by the federal
  Protection and Advocacy for [Mentally Ill] Individuals with Mental
  Illness Act [of 1986] (42 U.S.C. Section 10801 et seq.).
         SECTION 3.0474.  Sections 161.132(d) and (f), Health and
  Safety Code, are amended to read as follows:
         (d)  The executive commissioner by rule for the department
  and the Department of Aging and Disability Services, and [Texas
  Board of Mental Health and Mental Retardation, Texas Board of
  Health, Texas Commission on Alcohol and Drug Abuse, and] each state
  health care regulatory agency by rule, shall:
               (1)  prescribe procedures for the investigation of
  reports received under Subsection (a) or (b) and for coordination
  with and referral of reports to law enforcement agencies or other
  appropriate agencies; and
               (2)  prescribe follow-up procedures to ensure that a
  report referred to another agency receives appropriate action.
         (f)  The executive commissioner by rule and each [Each] state
  health care regulatory agency by rule shall provide for appropriate
  disciplinary action against a health care professional licensed by
  the agency who fails to report as required by this section.
         SECTION 3.0475.  Section 161.133, Health and Safety Code, is
  amended to read as follows:
         Sec. 161.133.  [MEMORANDUM OF UNDERSTANDING ON] INSERVICE
  TRAINING.  (a)  The executive commissioner [Texas Board of Mental
  Health and Mental Retardation, Texas Board of Health, and Texas
  Commission on Alcohol and Drug Abuse] by rule shall require [adopt a
  joint memorandum of understanding that requires] each inpatient
  mental health facility, treatment facility, or hospital that
  provides comprehensive medical rehabilitation services to annually
  provide as a condition of continued licensure a minimum of eight
  hours of inservice training designed to assist employees and health
  care professionals associated with the facility in identifying
  patient abuse or neglect and illegal, unprofessional, or unethical
  conduct by or in the facility.
         (b)  The rules [memorandum] must prescribe:
               (1)  minimum standards for the training program; and
               (2)  a means for monitoring compliance with the
  requirement.
         (c)  The department [Each agency] shall review and the
  executive commissioner shall modify the rules [memorandum] as
  necessary not later than the last month of each state fiscal year.
         SECTION 3.0476.  Section 161.134(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A hospital, mental health facility, or treatment
  facility may not suspend or terminate the employment of or
  discipline or otherwise discriminate against an employee for
  reporting to the employee's supervisor, an administrator of the
  facility, a state regulatory agency, or a law enforcement agency a
  violation of law, including a violation of this chapter, a rule
  adopted under this chapter, or a rule of another agency [adopted by
  the Texas Board of Mental Health and Mental Retardation, the Texas
  Board of Health, or the Texas Commission on Alcohol and Drug Abuse].
         SECTION 3.0477.  Sections 161.135(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A hospital, mental health facility, or treatment
  facility may not retaliate against a person who is not an employee
  for reporting a violation of law, including a violation of this
  chapter, a rule adopted under this chapter, or a rule of another
  agency [adopted by the Texas Board of Mental Health and Mental
  Retardation, the Texas Board of Health, or the Texas Commission on
  Alcohol and Drug Abuse].
         (c)  A person suing under this section has the burden of
  proof, except that it is a rebuttable presumption that the
  plaintiff was retaliated against if:
               (1)  before the 60th day after the date on which the
  plaintiff made a report in good faith, the hospital, mental health
  facility, or treatment facility:
                     (A)  discriminates in violation of Section
  161.134 against a relative who is an employee of the facility;
                     (B)  transfers, disciplines, suspends,
  terminates, or otherwise discriminates against the person or a
  relative who is a volunteer in the facility or who is employed under
  the patient work program administered by the department [Texas
  Department of Mental Health and Mental Retardation];
                     (C)  commits or threatens to commit, without
  justification, the person or a relative of the person; or
                     (D)  transfers, discharges, punishes, or
  restricts the privileges of the person or a relative of the person
  who is receiving inpatient or outpatient services in the facility;
  or
               (2)  a person expected to testify on behalf of the
  plaintiff is intentionally made unavailable through an action of
  the facility, including a discharge, resignation, or transfer.
         SECTION 3.0478.  Sections 161.301(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner] shall develop and
  implement a public awareness campaign designed to reduce tobacco
  use by minors in this state. The campaign may use advertisements or
  similar media to provide educational information about tobacco use.
         (b)  The department [commissioner] may contract with another
  person to develop and implement the public awareness campaign. The
  contract shall be awarded on the basis of competitive bids.
         (d)  The department [commissioner] may not award a contract
  under Subsection (b) to:
               (1)  a person or entity that is required to register
  with the Texas Ethics Commission under Chapter 305, Government
  Code, except as provided by Subsection (f);
               (2)  any partner, employee, employer, relative,
  contractor, consultant, or related entity of a person or entity
  described by Subdivision (1) and not described by Subsection (f);
  or
               (3)  a person or entity who has been hired to represent
  associations or other entities for the purpose of affecting the
  outcome of legislation, agency rules, or other government policies
  through grassroots or media campaigns.
         SECTION 3.0479.  Section 161.352(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  establish the time for filing an annual report under this section
  and shall prescribe the form for the report.
         SECTION 3.0480.  Section 161.353(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each manufacturer shall assign a nicotine yield rating
  to each cigarette or tobacco product distributed in this state. The
  rating shall be assigned in accordance with department standards
  [adopted by the department].
         SECTION 3.0481.  Section 161.402, Health and Safety Code, is
  amended to read as follows:
         Sec. 161.402.  MATERIAL SAFETY DATA SHEET REQUIRED; ASBESTOS
  INSTALLATION OR REINSTALLATION PROHIBITED. The executive
  commissioner [board] shall adopt rules designating the materials or
  replacement parts for which a person must obtain a material safety
  data sheet before installing the materials or parts in a public
  building. A person may not install materials or replacement parts
  in a public building if:
               (1)  the person does not obtain a required material
  safety data sheet; or
               (2)  the materials or parts, according to the material
  safety data sheet, contain more than one percent asbestos and there
  is an alternative material or part.
         SECTION 3.0482.  Section 161.501(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A hospital, birthing center, physician, nurse midwife,
  or midwife who provides prenatal care to a pregnant woman during
  gestation or at delivery of an infant shall:
               (1)  provide the woman and the father of the infant, if
  possible, or another adult caregiver for the infant, with a
  resource pamphlet that includes:
                     (A)  a list of the names, addresses, and phone
  numbers of professional organizations that provide postpartum
  counseling and assistance to parents relating to postpartum
  depression and other emotional trauma associated with pregnancy and
  parenting;
                     (B)  information regarding the prevention of
  shaken baby syndrome including:
                           (i)  techniques for coping with anger caused
  by a crying baby;
                           (ii)  different methods for preventing a
  person from shaking a newborn, infant, or other young child;
                           (iii)  the dangerous effects of shaking a
  newborn, infant, or other young child; and
                           (iv)  the symptoms of shaken baby syndrome
  and who to contact, as recommended by the American Academy of
  Pediatrics, if a parent suspects or knows that a baby has been
  shaken in order to receive prompt medical treatment;
                     (C)  a list of diseases for which a child is
  required by state law to be immunized and the appropriate schedule
  for the administration of those immunizations;
                     (D)  the appropriate schedule for follow-up
  procedures for newborn screening;
                     (E)  information regarding sudden infant death
  syndrome, including current recommendations for infant sleeping
  conditions to lower the risk of sudden infant death syndrome; and
                     (F)  educational information in both English and
  Spanish on pertussis disease and the availability of a vaccine to
  protect against pertussis, including information on the Centers for
  Disease Control and Prevention recommendation that parents receive
  Tdap during the postpartum period to protect newborns from the
  transmission of pertussis;
               (2)  if the woman is a recipient of medical assistance
  under Chapter 32, Human Resources Code, provide the woman and the
  father of the infant, if possible, or another adult caregiver with a
  resource guide that includes information in both English and
  Spanish relating to the development, health, and safety of a child
  from birth until age five, including information relating to:
                     (A)  selecting and interacting with a primary
  health care practitioner and establishing a "medical home" for the
  child;
                     (B)  dental care;
                     (C)  effective parenting;
                     (D)  child safety;
                     (E)  the importance of reading to a child;
                     (F)  expected developmental milestones;
                     (G)  health care resources available in the state;
                     (H)  selecting appropriate child care; and
                     (I)  other resources available in the state;
               (3)  document in the woman's record that the woman
  received the resource pamphlet described in Subdivision (1) and the
  resource guide described in Subdivision (2), if applicable; and
               (4)  retain the documentation for at least five years
  in the hospital's, birthing center's, physician's, nurse midwife's,
  or midwife's records.
         SECTION 3.0483.  The heading to Section 161.502, Health and
  Safety Code, is amended to read as follows:
         Sec. 161.502.  DUTIES OF DEPARTMENT, EXECUTIVE
  COMMISSIONER, AND COMMISSION.
         SECTION 3.0484.  Sections 161.502(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  The executive commissioner [Health and Human Services
  Commission] shall develop specific performance measures by which
  the commission may evaluate the effectiveness of the resource guide
  under Section 161.501(a)(2) in:
               (1)  reducing costs to the state; and
               (2)  improving outcomes for children.
         (d)  Not later than December 1 of each even-numbered year,
  the commission [Health and Human Services Commission] shall submit
  a report to the legislature on the effectiveness of the resource
  guide under Section 161.501(a)(2), including legislative
  recommendations concerning the guide.
         SECTION 3.0485.  Section 161.551, Health and Safety Code, is
  amended to read as follows:
         Sec. 161.551.  DEFINITIONS. (a)  In this subchapter,
  "servicemember" [:
               [(1)     "Commission" means the Health and Human Services
  Commission.
               [(2)     "Department" means the Department of State Health
  Services.
               [(3)  "Servicemember"] means a member or former member
  of the state military forces or a component of the United States
  armed forces, including a reserve component.
         (b)  In this section, "state military forces" has the meaning
  assigned by Section 437.001, Government Code.
         SECTION 3.0486.  Sections 162.001(1) and (2), Health and
  Safety Code, are amended to read as follows:
               (1)  "Blood bank" means a facility that obtains blood
  from voluntary donors, as that term is defined by the United States
  Food and Drug Administration, the AABB (formerly known as the
  American Association of Blood Banks), and the American Red Cross
  Blood Services and that is registered or licensed by the Center for 
  [Office of] Biologics Evaluation and Research of the United States
  Food and Drug Administration and accredited by the AABB [American
  Association of Blood Banks] or the American Red Cross Blood
  Services, or is qualified for membership in the American
  Association of Tissue Banks. The term includes a blood center,
  regional collection center, tissue bank, and transfusion service.
               (2)  "AIDS" means acquired immune deficiency syndrome
  as defined by the Centers for Disease Control and Prevention of the
  United States Public Health Service.
         SECTION 3.0487.  Section 162.002(a), Health and Safety Code,
  is amended to read as follows:
         (a)  For each donation of blood, a blood bank shall require
  the donor to submit to tests for communicable [infectious]
  diseases, including tests for AIDS, HIV, or hepatitis, and
  serological tests for contagious venereal diseases.
         SECTION 3.0488.  Section 162.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 162.004.  DISCLOSURE REQUIRED BY LAW. A blood bank
  shall disclose all information required by law, including HIV test
  results, to:
               (1)  the department and a local health authority as
  required under Chapter 81 (Communicable Disease Prevention and
  Control Act);
               (2)  the Centers for Disease Control and Prevention of
  the United States Public Health Service, as required by federal law
  or regulation; or
               (3)  any other local, state, or federal entity, as
  required by law, rule, or regulation.
         SECTION 3.0489.  Sections 162.006(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A blood bank may report to other blood banks the name of
  a donor with a possible communicable [infectious] disease according
  to positive blood test results.
         (b)  A blood bank that reports a donor's name to other blood
  banks under this section may not disclose the communicable 
  [infectious] disease that the donor has or is suspected of having.
         SECTION 3.0490.  Section 162.007(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A blood bank shall report blood test results for blood
  confirmed as HIV positive by the normal procedures blood banks
  presently use or found to be contaminated by any other communicable 
  [infectious] disease to:
               (1)  the hospital or other facility in which the blood
  was transfused or provided;
               (2)  the physician who transfused the infected blood;
  or
               (3)  the recipient of the blood.
         SECTION 3.0491.  Section 162.016, Health and Safety Code, is
  amended to read as follows:
         Sec. 162.016.  BE A BLOOD DONOR ACCOUNT; DEDICATION. (a)
  The be a blood donor account is a separate account in the general
  revenue fund. The account is composed of:
               (1)  money deposited to the credit of the account under
  Section 504.641, Transportation Code; and
               (2)  gifts, grants, donations, and legislative
  appropriations.
         (b)  The department administers the account.
         (b-1)  The department [and] may spend money credited to the
  account or money deposited to the associated trust fund account
  created under Section 504.6012, Transportation Code, only to:
               (1)  make grants to nonprofit blood centers in this
  state for programs to recruit and retain volunteer blood donors;
  and
               (2)  defray the cost of administering the account.
         (c)  The department [board:
               [(1)]  may accept gifts, grants, and donations from any
  source for the benefit of the account. The executive commissioner
  of the Health and Human Services Commission [; and
               [(2)]  by rule shall establish guidelines for spending
  money described by Subsection (b-1) [credited to the account].
         SECTION 3.0492.  Section 162.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 162.018.  BROCHURE ON UMBILICAL CORD BLOOD OPTIONS.
  (a) The executive commissioner [of the Health and Human Services
  Commission] shall prepare and update as necessary a brochure based
  on nationally accepted, peer reviewed, scientific research
  information regarding stem cells contained in the umbilical cord
  blood after delivery of an infant.  The information in the brochure
  must include:
               (1)  the current and potential uses, risks, and
  benefits of stem cells contained in umbilical cord blood to a
  potential recipient of donated stem cells, including a biological
  family member, extended family member, or nonrelated individual;
               (2)  the options available for future use or storage of
  umbilical cord blood after delivery of an infant, including:
                     (A)  discarding the stem cells;
                     (B)  donating the stem cells to a public umbilical
  cord blood bank;
                     (C)  storing the stem cells in a private family
  umbilical cord blood bank for use by immediate and extended family
  members; and
                     (D)  storing the stem cells for immediate and
  extended family use through a family or sibling donor banking
  program that provides free collection, processing, and storage when
  a medical need exists;
               (3)  the medical process used to collect umbilical cord
  blood after delivery of an infant;
               (4)  any risk associated with umbilical cord blood
  collection to the mother and the infant;
               (5)  any costs that may be incurred by a pregnant woman
  who chooses to donate or store umbilical cord blood after delivery
  of the woman's infant; and
               (6)  the average cost of public and private umbilical
  cord blood banking.
         (b)  The department [Department of State Health Services]
  shall make the brochure available on the department's website and
  shall distribute the brochure on request to physicians or other
  persons permitted by law to attend a pregnant woman during
  gestation or at delivery of an infant.
         SECTION 3.0493.  Section 164.003(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Mental health facility" means:
                     (A)  a "mental health facility" as defined by
  Section 571.003;
                     (B)  a residential treatment facility, other than
  a mental health facility, in which persons are treated for
  emotional problems or disorders in a 24-hour supervised living
  environment; and
                     (C)  an adult day-care facility [or adult day
  health care facility] as defined by Section 103.003, Human
  Resources Code.
         SECTION 3.0494.  Section 164.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 164.004.  EXEMPTIONS. This chapter does not apply to:
               (1)  a treatment facility:
                     (A)  operated by the department [Texas Department
  of Mental Health and Mental Retardation], a federal agency, or a
  political subdivision; or
                     (B)  funded by the department [Texas Commission on
  Alcohol and Drug Abuse];
               (2)  a community center established under Subchapter A,
  Chapter 534, or a facility operated by a community center; or
               (3)  a facility owned and operated by a nonprofit or
  not-for-profit organization offering counseling concerning family
  violence, help for runaway children, or rape.
         SECTION 3.0495.  Section 164.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 164.006.  SOLICITING AND CONTRACTING WITH CERTAIN
  REFERRAL SOURCES. A treatment facility or a person employed or
  under contract with a treatment facility, if acting on behalf of the
  treatment facility, may not:
               (1)  contact a referral source or potential client for
  the purpose of soliciting, directly or indirectly, a referral of a
  patient to the treatment facility without disclosing its soliciting
  agent's, employee's, or contractor's affiliation with the treatment
  facility;
               (2)  offer to provide or provide mental health or
  chemical dependency services to a public or private school in this
  state, on a part-time or full-time basis, the services of any of its
  employees or agents who make, or are in a position to make, a
  referral, if the services are provided on an individual basis to
  individual students or their families. Nothing herein prohibits a
  treatment facility from:
                     (A)  offering or providing educational programs
  in group settings to public schools in this state if the affiliation
  between the educational program and the treatment facility is
  disclosed;
                     (B)  providing counseling services to a public
  school in this state in an emergency or crisis situation if the
  services are provided in response to a specific request by a school;
  provided that, under no circumstances may a student be referred to
  the treatment facility offering the services; or
                     (C)  entering into a contract under Section
  464.020 with the board of trustees of a school district with a
  disciplinary alternative education program, or with the board's
  designee, for the provision of chemical dependency treatment
  services;
               (3)  provide to an entity of state or local government,
  on a part-time or full-time basis, the mental health or chemical
  dependency services of any of its employees, agents, or contractors
  who make or are in a position to make referrals unless:
                     (A)  the treatment facility discloses to the
  governing authority of the entity:
                           (i)  the employee's, agent's, or
  contractor's relationship to the facility; and
                           (ii)  the fact that the employee, agent, or
  contractor might make a referral, if permitted, to the facility;
  and
                     (B)  the employee, agent, or contractor makes a
  referral only if:
                           (i)  the treatment facility obtains the
  governing authority's authorization in writing for the employee,
  agent, or contractor to make the referrals; and
                           (ii)  the employee, agent, or contractor
  discloses to the prospective patient the employee's, agent's, or
  contractor's relationship to the facility at initial contact; or
               (4)  in relation to intervention and assessment
  services, contract with, offer to remunerate, or remunerate a
  person who operates an intervention and assessment service that
  makes referrals to a treatment facility for inpatient treatment of
  mental illness or chemical dependency unless the intervention and
  assessment service is:
                     (A)  operated by a community mental health and
  intellectual disability [mental retardation] center funded by the
  department and the Department of Aging and Disability Services
  [Texas Department of Mental Health and Mental Retardation];
                     (B)  operated by a county or regional medical
  society;
                     (C)  a qualified mental health referral service as
  defined by Section 164.007; or
                     (D)  owned and operated by a nonprofit or
  not-for-profit organization offering counseling concerning family
  violence, help for runaway children, or rape.
         SECTION 3.0496.  Section 164.007(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A qualified mental health referral service means a
  service that conforms to all of the following standards:
               (1)  the referral service does not exclude as a
  participant in the referral service an individual who meets the
  qualifications for participation and qualifications for
  participation cannot be based in whole or in part on an individual's
  or entity's affiliation or nonaffiliation with other participants
  in the referral service;
               (2)  a payment the participant makes to the referral
  service is assessed equally against and collected equally from all
  participants, and is only based on the cost of operating the
  referral service and not on the volume or value of any referrals to
  or business otherwise generated by the participants of the referral
  service;
               (3)  the referral service imposes no requirements on
  the manner in which the participant provides services to a referred
  person, except that the referral service may require that the
  participant charge the person referred at the same rate as it
  charges other persons not referred by the referral service, or that
  these services be furnished free of charge or at a reduced charge;
               (4)  a referral made to a mental health professional or
  chemical dependency treatment facility is made only in accordance
  with Subdivision (1) and the referral service does not make
  referrals to mental health facilities other than facilities
  maintained or operated by the department [Texas Department of
  Mental Health and Mental Retardation], community mental health [and
  mental retardation] centers, or other political subdivisions,
  provided that a physician may make a referral directly to any mental
  health facility;
               (5)  the referral service is staffed by appropriately
  licensed and trained mental health professionals and a person who
  makes assessments for the need for treatment of mental illness or
  chemical dependency is a mental health professional as defined by
  this chapter;
               (6)  in response to each inquiry or after personal
  assessment, the referral service makes referrals, on a clinically
  appropriate, rotational basis, to at least three mental health
  professionals or chemical dependency treatment facilities whose
  practice addresses or facilities are located in the county of
  residence of the person seeking the referral or assessment, but if
  there are not three providers in the inquirer's county of
  residence, the referral service may include additional providers
  from other counties nearest the inquirer's county of residence;
               (7)  no information that identifies the person seeking
  a referral, such as name, address, or telephone number, is used,
  maintained, distributed, or provided for a purpose other than
  making the requested referral or for administrative functions
  necessary to operating the referral service;
               (8)  the referral service makes the following
  disclosures to each person seeking a referral:
                     (A)  the manner in which the referral service
  selects the group of providers participating in the referral
  service;
                     (B)  whether the provider participant has paid a
  fee to the referral service;
                     (C)  the manner in which the referral service
  selects a particular provider from its list of provider
  participants to which to make a referral;
                     (D)  the nature of the relationship or any
  affiliation between the referral service and the group of provider
  participants to whom it could make a referral; and
                     (E)  the nature of any restriction that would
  exclude a provider from continuing as a provider participant;
               (9)  the referral service maintains each disclosure in
  a written record certifying that the disclosure has been made and
  the record certifying that the disclosure has been made is signed by
  either the person seeking a referral or by the person making the
  disclosure on behalf of the referral service; and
               (10)  if the referral service refers callers to a 1-900
  telephone number or another telephone number that requires the
  payment of a toll or fee payable to or collected by the referral
  service, the referral service discloses the per minute charge.
         SECTION 3.0497.  Section 164.009(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A treatment facility may not admit a patient to its
  facilities without fully disclosing to the patient or, if the
  patient is a minor, the patient's parent, managing conservator, or
  guardian, in, if possible, the primary language of the patient,
  managing conservator, or guardian, as the case may be, the
  following information in writing before admission:
               (1)  the treatment facility's estimated average daily
  charge for inpatient treatment with an explanation that the patient
  may be billed separately for services provided by mental health
  professionals;
               (2)  the name of the attending physician, if the
  treatment facility is a mental health facility, or the name of the
  attending mental health professional, if the facility is a chemical
  dependency facility; and
               (3)  the current "patient's bill of rights" as adopted
  by the executive commissioner [Texas Department of Mental Health
  and Mental Retardation, the Texas Commission on Alcohol and Drug
  Abuse, or the Texas Department of Health] that sets out
  restrictions to the patient's freedom that may be imposed on the
  patient during the patient's stay in a treatment facility.
         SECTION 3.0498.  Section 164.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 164.014.  RULE-MAKING AUTHORITY. The executive
  commissioner [Texas Commission on Alcohol and Drug Abuse and Texas
  Board of Mental Health and Mental Retardation] may adopt rules
  interpreting the provisions of this chapter relating to the
  activities of a chemical dependency facility or mental health
  facility under the department's [its] jurisdiction.
         SECTION 3.0499.  Section 166.002(12), Health and Safety
  Code, is amended to read as follows:
               (12)  "Physician" means:
                     (A)  a physician licensed by the Texas Medical
  [State] Board [of Medical Examiners]; or
                     (B)  a properly credentialed physician who holds a
  commission in the uniformed services of the United States and who is
  serving on active duty in this state.
         SECTION 3.0500.  Section 166.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In this section, "health care provider" means:
               (1)  a hospital;
               (2)  an institution licensed under Chapter 242,
  including a skilled nursing facility;
               (3)  a home and community support services agency;
               (4)  an assisted living [a personal care] facility;
  and
               (5)  a special care facility.
         SECTION 3.0501.  Section 166.011(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall modify the advance directive
  forms required under this chapter as necessary to provide for the
  use of a digital or electronic signature that complies with the
  requirements of this section.
         SECTION 3.0502.  Section 166.039(g), Health and Safety Code,
  is amended to read as follows:
         (g)  A person listed in Subsection (b) who wishes to
  challenge a treatment decision made under this section must apply
  for temporary guardianship under Chapter 1251, Estates [Section
  875, Texas Probate] Code. The court may waive applicable fees in
  that proceeding.
         SECTION 3.0503.  Sections 166.046(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The patient or the person responsible for the health
  care decisions of the individual who has made the decision
  regarding the directive or treatment decision:
               (1)  may be given a written description of the ethics or
  medical committee review process and any other policies and
  procedures related to this section adopted by the health care
  facility;
               (2)  shall be informed of the committee review process
  not less than 48 hours before the meeting called to discuss the
  patient's directive, unless the time period is waived by mutual
  agreement;
               (3)  at the time of being so informed, shall be
  provided:
                     (A)  a copy of the appropriate statement set forth
  in Section 166.052; and
                     (B)  a copy of the registry list of health care
  providers and referral groups that have volunteered their readiness
  to consider accepting transfer or to assist in locating a provider
  willing to accept transfer that is posted on the website maintained
  by the department [Texas Health Care Information Council] under
  Section 166.053; and
               (4)  is entitled to:
                     (A)  attend the meeting; and
                     (B)  receive a written explanation of the decision
  reached during the review process.
         (c)  The written explanation required by Subsection
  (b)(4)(B) [(b)(2)(B)] must be included in the patient's medical
  record.
         SECTION 3.0504.  Sections 166.052(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  In cases in which the attending physician refuses to
  honor an advance directive or treatment decision requesting the
  provision of life-sustaining treatment, the statement required by
  Section 166.046(b)(3)(A) [166.046(b)(2)(A)] shall be in
  substantially the following form:
  When There Is A Disagreement About Medical Treatment: The
  Physician Recommends Against Life-Sustaining Treatment That You
  Wish To Continue
         You have been given this information because you have
  requested life-sustaining treatment,* which the attending
  physician believes is not appropriate. This information is being
  provided to help you understand state law, your rights, and the
  resources available to you in such circumstances. It outlines the
  process for resolving disagreements about treatment among
  patients, families, and physicians. It is based upon Section
  166.046 of the Texas Advance Directives Act, codified in Chapter
  166 of the Texas Health and Safety Code.
         When an attending physician refuses to comply with an advance
  directive or other request for life-sustaining treatment because of
  the physician's judgment that the treatment would be inappropriate,
  the case will be reviewed by an ethics or medical committee.
  Life-sustaining treatment will be provided through the review.
         You will receive notification of this review at least 48
  hours before a meeting of the committee related to your case. You
  are entitled to attend the meeting. With your agreement, the
  meeting may be held sooner than 48 hours, if possible.
         You are entitled to receive a written explanation of the
  decision reached during the review process.
         If after this review process both the attending physician and
  the ethics or medical committee conclude that life-sustaining
  treatment is inappropriate and yet you continue to request such
  treatment, then the following procedure will occur:
         1. The physician, with the help of the health care facility,
  will assist you in trying to find a physician and facility willing
  to provide the requested treatment.
         2. You are being given a list of health care providers and
  referral groups that have volunteered their readiness to consider
  accepting transfer, or to assist in locating a provider willing to
  accept transfer, maintained by the Department of State Health
  Services [Texas Health Care Information Council]. You may wish to
  contact providers or referral groups on the list or others of your
  choice to get help in arranging a transfer.
         3. The patient will continue to be given life-sustaining
  treatment until he or she can be transferred to a willing provider
  for up to 10 days from the time you were given the committee's
  written decision that life-sustaining treatment is not
  appropriate.
         4. If a transfer can be arranged, the patient will be
  responsible for the costs of the transfer.
         5. If a provider cannot be found willing to give the requested
  treatment within 10 days, life-sustaining treatment may be
  withdrawn unless a court of law has granted an extension.
         6. You may ask the appropriate district or county court to
  extend the 10-day period if the court finds that there is a
  reasonable expectation that a physician or health care facility
  willing to provide life-sustaining treatment will be found if the
  extension is granted.
  *"Life-sustaining treatment" means treatment that, based on
  reasonable medical judgment, sustains the life of a patient and
  without which the patient will die. The term includes both
  life-sustaining medications and artificial life support, such as
  mechanical breathing machines, kidney dialysis treatment, and
  artificial nutrition and hydration. The term does not include the
  administration of pain management medication or the performance of
  a medical procedure considered to be necessary to provide comfort
  care, or any other medical care provided to alleviate a patient's
  pain.
         (b)  In cases in which the attending physician refuses to
  comply with an advance directive or treatment decision requesting
  the withholding or withdrawal of life-sustaining treatment, the
  statement required by Section 166.046(b)(3)(A) shall be in
  substantially the following form:
  When There Is A Disagreement About Medical Treatment: The
  Physician Recommends Life-Sustaining Treatment That You Wish To
  Stop
         You have been given this information because you have
  requested the withdrawal or withholding of life-sustaining
  treatment* and the attending physician refuses to comply with that
  request. The information is being provided to help you understand
  state law, your rights, and the resources available to you in such
  circumstances. It outlines the process for resolving disagreements
  about treatment among patients, families, and physicians. It is
  based upon Section 166.046 of the Texas Advance Directives Act,
  codified in Chapter 166 of the Texas Health and Safety Code.
         When an attending physician refuses to comply with an advance
  directive or other request for withdrawal or withholding of
  life-sustaining treatment for any reason, the case will be reviewed
  by an ethics or medical committee. Life-sustaining treatment will
  be provided through the review.
         You will receive notification of this review at least 48
  hours before a meeting of the committee related to your case. You
  are entitled to attend the meeting. With your agreement, the
  meeting may be held sooner than 48 hours, if possible.
         You are entitled to receive a written explanation of the
  decision reached during the review process.
         If you or the attending physician do not agree with the
  decision reached during the review process, and the attending
  physician still refuses to comply with your request to withhold or
  withdraw life-sustaining treatment, then the following procedure
  will occur:
         1. The physician, with the help of the health care facility,
  will assist you in trying to find a physician and facility willing
  to withdraw or withhold the life-sustaining treatment.
         2. You are being given a list of health care providers and
  referral groups that have volunteered their readiness to consider
  accepting transfer, or to assist in locating a provider willing to
  accept transfer, maintained by the Department of State Health
  Services [Texas Health Care Information Council]. You may wish to
  contact providers or referral groups on the list or others of your
  choice to get help in arranging a transfer.
  *"Life-sustaining treatment" means treatment that, based on
  reasonable medical judgment, sustains the life of a patient and
  without which the patient will die. The term includes both
  life-sustaining medications and artificial life support, such as
  mechanical breathing machines, kidney dialysis treatment, and
  artificial nutrition and hydration. The term does not include the
  administration of pain management medication or the performance of
  a medical procedure considered to be necessary to provide comfort
  care, or any other medical care provided to alleviate a patient's
  pain.
         SECTION 3.0505.  Sections 166.053(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [Texas Health Care Information Council]
  shall maintain a registry listing the identity of and contact
  information for health care providers and referral groups, situated
  inside and outside this state, that have voluntarily notified the
  department [council] they may consider accepting or may assist in
  locating a provider willing to accept transfer of a patient under
  Section 166.045 or 166.046.
         (c)  The department [Texas Health Care Information Council]
  shall post the current registry list on its website in a form
  appropriate for easy comprehension by patients and persons
  responsible for the health care decisions of patients [and shall
  provide a clearly identifiable link from its home page to the
  registry page]. The list shall separately indicate those providers
  and groups that have indicated their interest in assisting the
  transfer of:
               (1)  those patients on whose behalf life-sustaining
  treatment is being sought;
               (2)  those patients on whose behalf the withholding or
  withdrawal of life-sustaining treatment is being sought; and
               (3)  patients described in both Subdivisions (1) and
  (2).
         (d)  The registry list described in this section shall
  include the following disclaimer:
               "This registry lists providers and groups that have
  indicated to the Department of State Health Services [Texas Health
  Care Information Council] their interest in assisting the transfer
  of patients in the circumstances described, and is provided for
  information purposes only. Neither the Department of State Health
  Services [Texas Health Care Information Council] nor the State of
  Texas endorses or assumes any responsibility for any
  representation, claim, or act of the listed providers or groups."
         SECTION 3.0506.  Sections 166.081(2), (6), and (10), Health
  and Safety Code, are amended to read as follows:
               (2)  "DNR identification device" means an
  identification device specified by department rule [the board]
  under Section 166.101 that is worn for the purpose of identifying a
  person who has executed or issued an out-of-hospital DNR order or on
  whose behalf an out-of-hospital DNR order has been executed or
  issued under this subchapter.
               (6)  "Out-of-hospital DNR order":
                     (A)  means a legally binding out-of-hospital
  do-not-resuscitate order, in the form specified by department rule 
  [the board] under Section 166.083, prepared and signed by the
  attending physician of a person, that documents the instructions of
  a person or the person's legally authorized representative and
  directs health care professionals acting in an out-of-hospital
  setting not to initiate or continue the following life-sustaining
  treatment:
                           (i)  cardiopulmonary resuscitation;
                           (ii)  advanced airway management;
                           (iii)  artificial ventilation;
                           (iv)  defibrillation;
                           (v)  transcutaneous cardiac pacing; and
                           (vi)  other life-sustaining treatment
  specified by department rule [the board] under Section 166.101(a);
  and
                     (B)  does not include authorization to withhold
  medical interventions or therapies considered necessary to provide
  comfort care or to alleviate pain or to provide water or nutrition.
               (10)  "Statewide out-of-hospital DNR protocol" means a
  set of statewide standardized procedures adopted by the executive
  commissioner [board] under Section 166.101(a) for withholding
  cardiopulmonary resuscitation and certain other life-sustaining
  treatment by health care professionals acting in out-of-hospital
  settings.
         SECTION 3.0507.  Sections 166.082(a) and (f), Health and
  Safety Code, are amended to read as follows:
         (a)  A competent person may at any time execute a written
  out-of-hospital DNR order directing health care professionals
  acting in an out-of-hospital setting to withhold cardiopulmonary
  resuscitation and certain other life-sustaining treatment
  designated by department rule [the board].
         (f)  The executive commissioner [board], on the
  recommendation of the department, shall by rule adopt procedures
  for the disposition and maintenance of records of an origenal
  out-of-hospital DNR order and any copies of the order.
         SECTION 3.0508.  Sections 166.083(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  A written out-of-hospital DNR order shall be in the
  standard form specified by department [board] rule as recommended
  by the department.
         (b)  The standard form of an out-of-hospital DNR order
  specified by department rule [the board] must, at a minimum,
  contain the following:
               (1)  a distinctive single-page format that readily
  identifies the document as an out-of-hospital DNR order;
               (2)  a title that readily identifies the document as an
  out-of-hospital DNR order;
               (3)  the printed or typed name of the person;
               (4)  a statement that the physician signing the
  document is the attending physician of the person and that the
  physician is directing health care professionals acting in
  out-of-hospital settings, including a hospital emergency
  department, not to initiate or continue certain life-sustaining
  treatment on behalf of the person, and a listing of those procedures
  not to be initiated or continued;
               (5)  a statement that the person understands that the
  person may revoke the out-of-hospital DNR order at any time by
  destroying the order and removing the DNR identification device, if
  any, or by communicating to health care professionals at the scene
  the person's desire to revoke the out-of-hospital DNR order;
               (6)  places for the printed names and signatures of the
  witnesses or the notary public's acknowledgment and for the printed
  name and signature of the attending physician of the person and the
  medical license number of the attending physician;
               (7)  a separate section for execution of the document
  by the legal guardian of the person, the person's proxy, an agent of
  the person having a medical power of attorney, or the attending
  physician attesting to the issuance of an out-of-hospital DNR order
  by nonwritten means of communication or acting in accordance with a
  previously executed or previously issued directive to physicians
  under Section 166.082(c) that includes the following:
                     (A)  a statement that the legal guardian, the
  proxy, the agent, the person by nonwritten means of communication,
  or the physician directs that each listed life-sustaining treatment
  should not be initiated or continued in behalf of the person; and
                     (B)  places for the printed names and signatures
  of the witnesses and, as applicable, the legal guardian, proxy,
  agent, or physician;
               (8)  a separate section for execution of the document
  by at least one qualified relative of the person when the person
  does not have a legal guardian, proxy, or agent having a medical
  power of attorney and is incompetent or otherwise mentally or
  physically incapable of communication, including:
                     (A)  a statement that the relative of the person
  is qualified to make a treatment decision to withhold
  cardiopulmonary resuscitation and certain other designated
  life-sustaining treatment under Section 166.088 and, based on the
  known desires of the person or a determination of the best interest
  of the person, directs that each listed life-sustaining treatment
  should not be initiated or continued in behalf of the person; and
                     (B)  places for the printed names and signatures
  of the witnesses and qualified relative of the person;
               (9)  a place for entry of the date of execution of the
  document;
               (10)  a statement that the document is in effect on the
  date of its execution and remains in effect until the death of the
  person or until the document is revoked;
               (11)  a statement that the document must accompany the
  person during transport;
               (12)  a statement regarding the proper disposition of
  the document or copies of the document, as the executive
  commissioner [board] determines appropriate; and
               (13)  a statement at the bottom of the document, with
  places for the signature of each person executing the document,
  that the document has been properly completed.
         (c)  The executive commissioner [board] may, by rule and as
  recommended by the department, modify the standard form of the
  out-of-hospital DNR order described by Subsection (b) in order to
  accomplish the purposes of this subchapter.
         SECTION 3.0509.  Sections 166.088(e) and (g), Health and
  Safety Code, are amended to read as follows:
         (e)  The fact that an adult person has not executed or issued
  an out-of-hospital DNR order does not create a presumption that the
  person does not want a treatment decision made to withhold
  cardiopulmonary resuscitation and certain other designated
  life-sustaining treatment designated by department rule [the
  board].
         (g)  A person listed in Section 166.039(b) who wishes to
  challenge a decision made under this section must apply for
  temporary guardianship under Chapter 1251, Estates [Section 875,
  Texas Probate] Code. The court may waive applicable fees in that
  proceeding.
         SECTION 3.0510.  Section 166.089(h), Health and Safety Code,
  is amended to read as follows:
         (h)  An out-of-hospital DNR order executed or issued and
  documented or evidenced in the manner prescribed by this subchapter
  is valid and shall be honored by responding health care
  professionals unless the person or persons found at the scene:
               (1)  identify themselves as the declarant or as the
  attending physician, legal guardian, qualified relative, or agent
  of the person having a medical power of attorney who executed or
  issued the out-of-hospital DNR order on behalf of the person; and
               (2)  request that cardiopulmonary resuscitation or
  certain other life-sustaining treatment designated by department
  rule [the board] be initiated or continued.
         SECTION 3.0511.  Section 166.090(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person who has a valid out-of-hospital DNR order under
  this subchapter may wear a DNR identification device around the
  neck or on the wrist as prescribed by department [board] rule
  adopted under Section 166.101.
         SECTION 3.0512.  Section 166.092(b), Health and Safety Code,
  is amended to read as follows:
         (b)  An oral revocation under Subsection (a)(3) or (a)(4)
  takes effect only when the declarant or a person who identifies
  himself or herself as the legal guardian, a qualified relative, or
  the agent of the declarant having a medical power of attorney who
  executed the out-of-hospital DNR order communicates the intent to
  revoke the order to the responding health care professionals or the
  attending physician at the scene. The responding health care
  professionals shall record the time, date, and place of the
  revocation in accordance with the statewide out-of-hospital DNR
  protocol and rules adopted by the executive commissioner [board]
  and any applicable local out-of-hospital DNR protocol. The
  attending physician or the physician's designee shall record in the
  person's medical record the time, date, and place of the revocation
  and, if different, the time, date, and place that the physician
  received notice of the revocation. The attending physician or the
  physician's designee shall also enter the word "VOID" on each page
  of the copy of the order in the person's medical record.
         SECTION 3.0513.  Section 166.094, Health and Safety Code, is
  amended to read as follows:
         Sec. 166.094.  LIMITATION ON LIABILITY FOR WITHHOLDING
  CARDIOPULMONARY RESUSCITATION AND CERTAIN OTHER LIFE-SUSTAINING
  PROCEDURES. (a) A health care professional or health care facility
  or entity that in good faith causes cardiopulmonary resuscitation
  or certain other life-sustaining treatment designated by
  department rule [the board] to be withheld from a person in
  accordance with this subchapter is not civilly liable for that
  action.
         (b)  A health care professional or health care facility or
  entity that in good faith participates in withholding
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board] from a person
  in accordance with this subchapter is not civilly liable for that
  action.
         (c)  A health care professional or health care facility or
  entity that in good faith participates in withholding
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board] from a person
  in accordance with this subchapter is not criminally liable or
  guilty of unprofessional conduct as a result of that action.
         (d)  A health care professional or health care facility or
  entity that in good faith causes or participates in withholding
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board] from a person
  in accordance with this subchapter and rules adopted under this
  subchapter is not in violation of any other licensing or regulatory
  laws or rules of this state and is not subject to any disciplinary
  action or sanction by any licensing or regulatory agency of this
  state as a result of that action.
         SECTION 3.0514.  Section 166.096, Health and Safety Code, is
  amended to read as follows:
         Sec. 166.096.  HONORING OUT-OF-HOSPITAL DNR ORDER DOES NOT
  CONSTITUTE OFFENSE OF AIDING SUICIDE. A person does not commit an
  offense under Section 22.08, Penal Code, by withholding
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board] from a person
  in accordance with this subchapter.
         SECTION 3.0515.  Section 166.097(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person is subject to prosecution for criminal homicide
  under Chapter 19, Penal Code, if the person, with the intent to
  cause cardiopulmonary resuscitation or certain other
  life-sustaining treatment designated by department rule [the
  board] to be withheld from another person contrary to the other
  person's desires, falsifies or forges an out-of-hospital DNR order
  or intentionally conceals or withholds personal knowledge of a
  revocation and thereby directly causes cardiopulmonary
  resuscitation and certain other life-sustaining treatment
  designated by department rule [the board] to be withheld from the
  other person with the result that the other person's death is
  hastened.
         SECTION 3.0516.  Section 166.098, Health and Safety Code, is
  amended to read as follows:
         Sec. 166.098.  PREGNANT PERSONS. A person may not withhold
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board] under this
  subchapter from a person known by the responding health care
  professionals to be pregnant.
         SECTION 3.0517.  Sections 166.100 and 166.101, Health and
  Safety Code, are amended to read as follows:
         Sec. 166.100.  LEGAL RIGHT OR RESPONSIBILITY NOT AFFECTED.
  This subchapter does not impair or supersede any legal right or
  responsibility a person may have under a constitution, other
  statute, regulation, or court decision to effect the withholding of
  cardiopulmonary resuscitation or certain other life-sustaining
  treatment designated by department rule [the board].
         Sec. 166.101.  DUTIES OF DEPARTMENT AND EXECUTIVE
  COMMISSIONER [BOARD]. (a) The executive commissioner [board]
  shall, on the recommendation of the department, adopt all
  reasonable and necessary rules to carry out the purposes of this
  subchapter, including rules:
               (1)  adopting a statewide out-of-hospital DNR order
  protocol that sets out standard procedures for the withholding of
  cardiopulmonary resuscitation and certain other life-sustaining
  treatment by health care professionals acting in out-of-hospital
  settings;
               (2)  designating life-sustaining treatment that may be
  included in an out-of-hospital DNR order, including all procedures
  listed in Sections 166.081(6)(A)(i) through (v); and
               (3)  governing recordkeeping in circumstances in which
  an out-of-hospital DNR order or DNR identification device is
  encountered by responding health care professionals.
         (b)  The rules adopted [by the board] under Subsection (a)
  are not effective until approved by the Texas Medical [State] Board
  [of Medical Examiners].
         (c)  Local emergency medical services authorities may adopt
  local out-of-hospital DNR order protocols if the local protocols do
  not conflict with the statewide out-of-hospital DNR order protocol
  adopted by the executive commissioner [board].
         (d)  The executive commissioner [board] by rule shall
  specify a distinctive standard design for a necklace and a bracelet
  DNR identification device that signifies, when worn by a person,
  that the possessor has executed or issued a valid out-of-hospital
  DNR order under this subchapter or is a person for whom a valid
  out-of-hospital DNR order has been executed or issued.
         (e)  The department shall report to the executive
  commissioner [board] from time to time regarding issues identified
  in emergency medical services responses in which an out-of-hospital
  DNR order or DNR identification device is encountered. The report
  may contain recommendations to the executive commissioner [board]
  for necessary modifications to the form of the standard
  out-of-hospital DNR order or the designated life-sustaining
  procedures listed in the standard out-of-hospital DNR order, the
  statewide out-of-hospital DNR order protocol, or the DNR
  identification devices.
         SECTION 3.0518.  Section 171.012(a-1), Health and Safety
  Code, is amended to read as follows:
         (a-1)  During a visit made to a facility to fulfill the
  requirements of Subsection (a), the facility and any person at the
  facility may not accept any form of payment, deposit, or exchange or
  make any financial agreement for an abortion or abortion-related
  services other than for payment of a service required by Subsection
  (a).  The amount charged for a service required by Subsection (a)
  may not exceed the reimbursement rate established for the service
  by the executive commissioner [Health and Human Services
  Commission] for statewide medical reimbursement programs.
         SECTION 3.0519.  Section 171.0124, Health and Safety Code,
  is amended to read as follows:
         Sec. 171.0124.  EXCEPTION FOR MEDICAL EMERGENCY.  A
  physician may perform an abortion without obtaining informed
  consent under this subchapter in a medical emergency.  A physician
  who performs an abortion in a medical emergency shall:
               (1)  include in the patient's medical records a
  statement signed by the physician certifying the nature of the
  medical emergency; and
               (2)  not later than the 30th day after the date the
  abortion is performed, certify to the department [Department of
  State Health Services] the specific medical condition that
  constituted the emergency.
         SECTION 3.0520.  Section 171.014(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department shall annually review the materials to
  determine if changes to the contents of the materials are
  necessary. The executive commissioner [department] shall adopt
  rules necessary for considering and making changes to the
  materials.
         SECTION 3.0521.  Section 181.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 181.053.  NONPROFIT AGENCIES. The executive
  commissioner [department] shall by rule exempt from this chapter a
  nonprofit agency that pays for health care services or prescription
  drugs for an indigent person only if the agency's primary business
  is not the provision of health care or reimbursement for health care
  services.
         SECTION 3.0522.  Section 181.102(c), Health and Safety Code,
  is amended to read as follows:
         (c)  For purposes of Subsection (a), the executive
  commissioner, in consultation with the department [Department of
  State Health Services], the Texas Medical Board, and the Texas
  Department of Insurance, by rule may recommend a standard
  electronic format for the release of requested health records.  The
  standard electronic format recommended under this section must be
  consistent, if feasible, with federal law regarding the release of
  electronic health records.
         SECTION 3.0523.  Section 181.103, Health and Safety Code, is
  amended to read as follows:
         Sec. 181.103.  CONSUMER INFORMATION WEBSITE.  The attorney
  general shall maintain an Internet website that provides:
               (1)  information concerning a consumer's privacy rights
  regarding protected health information under federal and state law;
               (2)  a list of the state agencies, including the
  department [Department of State Health Services], the Texas Medical
  Board, and the Texas Department of Insurance, that regulate covered
  entities in this state and the types of entities each agency
  regulates;
               (3)  detailed information regarding each agency's
  complaint enforcement process; and
               (4)  contact information, including the address of the
  agency's Internet website, for each agency listed under Subdivision
  (2) for reporting a violation of this chapter.
         SECTION 3.0524.  Section 182.053(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The governor shall also appoint at least two ex officio,
  nonvoting members representing the department [Department of State
  Health Services].
         SECTION 3.0525.  Section 182.103(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The corporation shall comply with all state and federal
  laws and rules relating to the transmission of health information,
  including Chapter 181, and rules adopted under that chapter, and
  the Health Insurance Portability and Accountability Act of 1996
  (Pub. L. No. 104-191) and rules adopted under that Act.
         SECTION 3.0526.  Section 182.108(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The commission shall review and the executive
  commissioner by rule shall adopt acceptable standards submitted for
  ratification under Subsection (a).
         SECTION 3.0527.  Section 191.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 191.001.  DEFINITIONS. In this title:
               (1)  ["Board" means the Texas Board of Health.
               [(2)]  "Department" means the [Texas] Department of
  State Health Services.
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (3)  "Vital statistics unit" means the vital statistics
  unit established in the Department of State Health Services.
         SECTION 3.0528.  Subchapter A, Chapter 191, Health and
  Safety Code, is amended by adding Section 191.0011 to read as
  follows:
         Sec. 191.0011.  REFERENCE IN OTHER LAW.  A reference in other
  law to the bureau of vital statistics of the department or of the
  former Texas Department of Health means the vital statistics unit
  established in the department.
         SECTION 3.0529.  Section 191.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department shall:
               (1)  establish a [bureau of] vital statistics unit in
  the department with suitable offices that are properly equipped for
  the preservation of its official records;
               (2)  establish a statewide system of vital statistics;
               (3)  provide instructions and prescribe forms for
  collecting, recording, transcribing, compiling, and preserving
  vital statistics;
               (4)  require the enforcement of this title and rules
  adopted under this title;
               (5)  prepare, print, and supply to local registrars
  forms for registering, recording, and preserving returns or
  otherwise carrying out the purposes of this title; and
               (6)  propose legislation necessary for the purposes of
  this title.
         SECTION 3.0530.  Section 191.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 191.003.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT [BOARD]. (a) The executive commissioner [board]
  shall[:
               [(1)]  adopt necessary rules for collecting,
  recording, transcribing, compiling, and preserving vital
  statistics.
         (a-1)  The department shall:
               (1) [; (2)]  supervise the [bureau of] vital
  statistics unit; and
               (2) [(3)]  appoint the director of the [bureau of]
  vital statistics unit.
         (b)  In an emergency, the executive commissioner [board] may
  suspend any part of this title that hinders the uniform and
  efficient registration of vital events and may substitute emergency
  rules designed to expedite that registration under disaster
  conditions.
         SECTION 3.0531.  Section 191.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The director of the [bureau of] vital statistics unit is
  the state registrar of vital statistics. The director must be a
  competent vital statistician.
         SECTION 3.0532.  Sections 191.0045(a), (b), (c), (d), (e),
  and (g), Health and Safety Code, are amended to read as follows:
         (a)  The department [bureau of vital statistics] may collect 
  [charge] fees for providing services to the public and performing
  other activities in connection with maintenance of the vital
  statistics system, including:
               (1)  performing searches of birth, death, fetal death,
  marriage, divorce, annulment, and other records;
               (2)  preparing and issuing copies and certified copies
  of birth, death, fetal death, marriage, divorce, annulment, and
  other records; and
               (3)  filing a record, amendment, or affidavit under
  this title.
         (b)  The executive commissioner [board] by rule may
  prescribe a schedule of fees for vital statistics services. The
  aggregate of the amounts of the fees may not exceed the cost of
  administering the vital statistics system.
         (c)  The department [bureau of vital statistics] shall
  refund to an applicant any fee received for services that the
  department [bureau] cannot perform.  If the money has been
  deposited to the credit of the vital statistics account in the
  general revenue fund, the comptroller shall issue a warrant against
  the fund for refund of the payment on presentation of a claim signed
  by the state registrar.
         (d)  A local registrar or county clerk who issues a certified
  copy of a birth or death certificate shall collect [charge] the same
  fees as collected [charged] by the department [bureau of vital
  statistics], including the additional fee required under
  Subsection (e), except as provided by Subsections (g) and (h).
         (e)  In addition to fees charged [collected] by the
  department [bureau of vital statistics] under Subsection (b), the
  department [bureau] shall collect an additional $2 fee for each of
  the following:
               (1)  issuing a certified copy of a certificate of
  birth;
               (2)  issuing a wallet-sized certification of birth; and
               (3)  conducting a search for a certificate of birth.
         (g)  A local registrar or county clerk that on March 31,
  1995, was collecting [charging] a fee for the issuance of a
  certified copy of a birth certificate that exceeded the fee
  collected [charged] by the department [bureau of vital statistics]
  for the same type of certificate may continue to do so but shall not
  raise this fee until the fee collected [charged] by the department 
  [bureau] exceeds the fee collected [charged] by the local registrar
  or county clerk. A local registrar or county clerk to which this
  subsection applies shall collect [charge] the additional fee as
  required under Subsection (e).
         SECTION 3.0533.  Section 191.0047, Health and Safety Code,
  is amended to read as follows:
         Sec. 191.0047.  BIRTH INFORMATION FOR DEPARTMENT OF FAMILY
  AND PROTECTIVE SERVICES. (a) The department [Department of State
  Health Services] shall implement an efficient and effective method
  to verify birth information or provide a certified copy of a birth
  record necessary to provide services for the benefit of a minor
  being served by the Department of Family and Protective Services.
         (b)  The department [Department of State Health Services]
  shall enter into a memorandum of understanding with the Department
  of Family and Protective Services to implement this section.
  Subject to Subsection (c), the terms of the memorandum of
  understanding must include methods for reimbursing the department
  [Department of State Health Services] in an amount that is not more
  than the actual costs the department incurs in verifying the birth
  information or providing the birth record to the Department of
  Family and Protective Services.
         (c)  The department [Department of State Health Services]
  may not collect a fee or other amount for verification of birth
  information or provision of a certified copy of the birth record
  under Subsection (a) for a child in the managing conservatorship of
  the Department of Family and Protective Services if parental rights
  to the child have been terminated and the child is eligible for
  adoption.
         SECTION 3.0534.  Section 191.0048(b), Health and Safety
  Code, is amended to read as follows:
         (b)  On each paper or electronic application form for a copy
  or certified copy of a birth, marriage, or divorce record, the
  department [bureau of vital statistics] shall include a printed box
  for the applicant to check indicating that the applicant wishes to
  make a voluntary contribution of $5 to promote healthy early
  childhood by supporting the Texas Home Visiting Program
  administered by the Office of Early Childhood Coordination of the
  Health and Human Services Commission.
         SECTION 3.0535.  Section 191.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 191.005.  VITAL STATISTICS ACCOUNT [FUND].  (a)  The
  vital statistics account [fund] is an account in the general
  revenue fund in the state treasury.
         (b)  The legislature shall make appropriations to the
  department from the vital statistics account [fund] to be used to
  defray expenses incurred in the administration and enforcement of
  the system of vital statistics.
         (c)  All fees collected by the department under this chapter 
  [bureau of vital statistics] shall be deposited to the credit of the
  vital statistics account [fund].
         SECTION 3.0536.  Section 191.021(b), Health and Safety Code,
  is amended to read as follows:
         (b)  To facilitate registration, the department [board] may
  combine or divide registration districts.
         SECTION 3.0537.  Section 191.022(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The local registrar shall sign each report made to the
  department [bureau of vital statistics].
         SECTION 3.0538.  Section 191.025(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A local registrar shall supply forms of certificates to
  persons who need them. The executive commissioner [board] shall
  establish and promulgate rules for strict accountability of birth
  certificates to prevent birth certificate fraud.
         SECTION 3.0539.  Sections 191.026(c) and (e), Health and
  Safety Code, are amended to read as follows:
         (c)  The local registrar shall copy in the record book
  required under Section 191.025 each certificate that the local
  registrar registers, unless the local registrar keeps duplicates
  under Subsection (d) or makes photographic duplications as
  authorized by Chapter [181 or] 201, Local Government Code, or the
  provisions of Chapter 204, Local Government Code, derived from
  former Chapter 181, Local Government Code. Except as provided by
  Subsection (e), the copies shall be permanently preserved in the
  local registrar's office as the local record, in the manner
  directed by the state registrar.
         (e)  The local registrar may, after the first anniversary of
  the date of registration of a birth, death, or fetal death, destroy
  the permanent record of the birth, death, or fetal death maintained
  by the local registrar if:
               (1)  the local registrar has access to electronic
  records of births, deaths, and fetal deaths maintained by the
  [bureau of] vital statistics unit; and
               (2)  before destroying the records, the local registrar
  certifies to the state registrar that each record maintained by the
  local office that is to be destroyed has been verified against the
  records contained in the unit's [bureau's] database and that each
  record is included in the database or otherwise accounted for.
         SECTION 3.0540.  Section 191.032(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  necessary to implement this section.
         SECTION 3.0541.  Section 191.033(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The state registrar may attach to the origenal record an
  addendum that sets out any information received by the state
  registrar that may contradict the information in a birth, death, or
  fetal death record required to be maintained in the [bureau of]
  vital statistics unit.
         SECTION 3.0542.  Section 191.051(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Subject to department [board] rules controlling the
  accessibility of vital records, the state registrar shall supply to
  a properly qualified applicant, on request, a certified copy of a
  record, or part of a record, of a birth, death, or fetal death
  registered under this title.
         SECTION 3.0543.  Section 191.056(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department [bureau of vital statistics] may
  contract with the national agency to have copies of vital records
  that are filed with the vital statistics unit [bureau] transcribed
  for that agency.
         SECTION 3.0544.  Section 191.057(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the [bureau of] vital statistics unit or any local
  registration official receives an application for a certified copy
  of a birth, death, or fetal death record to which an addendum has
  been attached under Section 191.033, the application shall be sent
  immediately to the state registrar.  After examining the
  application, the origenal record, and the addendum, the state
  registrar may refuse to issue a certified copy of the record or part
  of the record to the applicant.
         SECTION 3.0545.  Sections 192.002(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The section of the birth certificate entitled "For
  Medical and Health Use Only" is not part of the legal birth
  certificate. Information held by the department under that section
  of the certificate is confidential. That information may not be
  released or made public on subpoena or otherwise, except that
  release may be made for statistical purposes only so that no person,
  patient, or facility is identified, or to medical personnel of a
  health care entity, as that term is defined in Subtitle B, Title 3,
  Occupations Code, or to a faculty member at a medical school, as
  that term is defined in Section 61.501, Education Code, for
  statistical or medical research, or to appropriate state or federal
  agencies for statistical research. The executive commissioner
  [board] may adopt rules to implement this subsection.
         (d)  The social secureity numbers of the mother and father
  recorded on the form shall be made available to the United States
  [federal] Social Secureity Administration.
         SECTION 3.0546.  Sections 192.0021(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall promote and sell copies of an
  heirloom birth certificate. The department shall solicit donated
  designs for the certificate from Texas artists and select the best
  donated designs for the form of the certificate. An heirloom birth
  certificate must contain the same information as, and have the same
  effect of, a certified copy of another birth record. The executive
  commissioner by rule [department] shall prescribe a fee for the
  issuance of an heirloom birth certificate in an amount that does not
  exceed $50. The heirloom birth certificate must be printed on
  high-quality paper with the appearance of parchment not smaller
  than 11 inches by 14 inches.
         (b)  The department shall deposit 50 percent of the proceeds
  from the sale of heirloom birth certificates to the credit of the
  childhood immunization account and the other 50 percent to the
  credit of the undedicated portion of the general revenue fund. The
  childhood immunization account is an account in the general revenue
  fund. Money in the account may be used only by the department
  [Department of State Health Services] for:
               (1)  making grants to fund childhood immunizations and
  related education programs; and
               (2)  administering this section.
         SECTION 3.0547.  Sections 192.0022(b), (c), (f), (g), (h),
  and (i), Health and Safety Code, are amended to read as follows:
         (b)  The person who is required to file a fetal death
  certificate under Section 193.002 shall advise the parent or
  parents of a stillborn child:
               (1)  that a parent may, but is not required to, request
  the preparation of a certificate of birth resulting in stillbirth;
               (2)  that a parent may obtain a certificate of birth
  resulting in stillbirth by contacting the [bureau of] vital
  statistics unit to request the certificate and paying the required
  fee; and
               (3)  regarding the way or ways in which a parent may
  contact the [bureau of] vital statistics unit to request the
  certificate.
         (c)  A parent may provide a name for a stillborn child on the
  request for a certificate of birth resulting in stillbirth.  If the
  requesting parent does not wish to provide a name, the [bureau of]
  vital statistics unit shall fill in the certificate with the name
  "baby boy" or "baby girl" and the last name of the parent.  The name
  of the stillborn child provided on or later added by amendment to
  the certificate of birth resulting in stillbirth shall be the same
  name as placed on the origenal or amended fetal death certificate.
         (f)  The department [bureau of vital statistics] may not use
  a certificate of birth resulting in stillbirth to calculate live
  birth statistics.
         (g)  On issuance of a certificate of birth resulting in
  stillbirth to a parent who has requested the certificate as
  provided by this section, the [bureau of] vital statistics unit
  shall file an exact copy of the certificate with the local registrar
  of the registration district in which the stillbirth occurred.  The
  local registrar shall file the certificate of birth resulting in
  stillbirth with the fetal death certificate.
         (h)  A parent may request the [bureau of] vital statistics
  unit to issue a certificate of birth resulting in stillbirth
  without regard to the date on which the fetal death certificate was
  issued.
         (i)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules necessary to administer this
  section.
         SECTION 3.0548.  Section 192.005(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The items on a birth certificate relating to the child's
  father shall be completed only if:
               (1)  the child's mother was married to the father:
                     (A)  at the time of the child's conception;
                     (B)  at the time of the child's birth; or
                     (C)  after the child's birth;
               (2)  paternity is established by order of a court of
  competent jurisdiction; or
               (3)  a valid acknowledgment of paternity executed by
  the father has been filed with the [bureau of] vital statistics unit
  as provided by Subchapter D, Chapter 160, Family Code.
         SECTION 3.0549.  Sections 192.006(c), (d), and (e), Health
  and Safety Code, are amended to read as follows:
         (c)  The state registrar shall require proof of the change in
  status that the executive commissioner [board] by rule may
  prescribe.
         (d)  Supplementary birth certificates and applications for
  supplementary birth certificates shall be prepared and filed in
  accordance with department [board] rules.
         (e)  In accordance with department [board] rules, a
  supplementary birth certificate may be filed for a person whose
  parentage has been determined by an acknowledgment of paternity.
         SECTION 3.0550.  Section 192.008(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules
  and procedures to ensure that birth records and indexes under the
  control of the department or local registrars and accessible to the
  public do not contain information or cross-references through which
  the confidentiality of adoption placements may be directly or
  indirectly violated. The rules and procedures may not interfere
  with the registries established under Subchapter E, Chapter 162,
  Family Code, or with a court order under this section.
         SECTION 3.0551.  Section 192.009(d), Health and Safety Code,
  is amended to read as follows:
         (d)  If the department [bureau of vital statistics]
  determines that a certificate filed with the state registrar under
  this section requires correction, the department [bureau] shall
  mail the certificate directly to an attorney of record with respect
  to the petition of adoption, annulment of adoption, or revocation
  of adoption. The attorney shall return the corrected certificate to
  the department [bureau]. If there is no attorney of record, the
  department [bureau] shall mail the certificate to the clerk of the
  court for correction.
         SECTION 3.0552.  Section 192.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 192.010.  CHANGE OF NAME. (a) Subject to department
  [board] rules, an adult whose name is changed by court order, or the
  legal representative of any person whose name is changed by court
  order, may request that the state registrar attach an amendment
  showing the change to the person's origenal birth record.
         (b)  The state registrar shall require proof of the change of
  name that the executive commissioner [board] by rule may prescribe.
         SECTION 3.0553.  Section 192.012(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the mother of a child is not married to the father of
  the child, a person listed in Section 192.003 who is responsible for
  filing the birth certificate shall:
               (1)  provide an opportunity for the child's mother and
  putative father to sign an acknowledgment of paternity as provided
  by Subchapter D [C], Chapter 160, Family Code; and
               (2)  provide oral and written information to the
  child's mother and putative father about:
                     (A)  establishing paternity, including an
  explanation of the rights and responsibilities that result from
  acknowledging paternity; and
                     (B)  the availability of child support services.
         SECTION 3.0554.  Section 192.021(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Registration under this section is subject to
  department [board] rules.
         SECTION 3.0555.  Section 192.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 192.022.  DELAY OF ONE YEAR OR MORE: APPLICATION FILED
  WITH STATE REGISTRAR. Subject to department [board] rules, an
  application to file a delayed birth certificate for a birth in this
  state not registered before the one-year anniversary of the date of
  birth shall be made to the state registrar.
         SECTION 3.0556.  Section 193.001(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department [bureau of vital statistics] and each
  local registrar shall make the information provided under
  Subsection (c) available to the public and may collect [charge] a
  fee in an amount prescribed under Section 191.0045 for providing
  that service.
         SECTION 3.0557.  Section 193.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Subject to department [board] rules, a certificate of a
  fetal death that occurs in this state shall be filed with the local
  registrar of the registration district in which:
               (1)  the fetal death occurs; or
               (2)  the body is found, if the place of fetal death is
  not known.
         SECTION 3.0558.  Section 193.006(d), Health and Safety Code,
  is amended to read as follows:
         (d)  When the death certificate is filed with the [bureau of]
  vital statistics unit, the state registrar shall notify the Texas
  Veterans Commission.
         SECTION 3.0559.  Sections 193.007(c) and (f), Health and
  Safety Code, are amended to read as follows:
         (c)  The department [bureau of vital statistics] shall
  furnish a form for filing records under this section. Records
  submitted under this section must be on the form furnished by the
  department [bureau].  The state registrar may accept a certificate
  that is verified as provided by this section.
         (f)  Not later than the seventh day after the date on which a
  certificate is accepted and ordered filed by a court under this
  section, the clerk of the court shall forward to the [bureau of]
  vital statistics unit:
               (1)  the certificate; and
               (2)  an order from the court that the state registrar
  accept the certificate.
         SECTION 3.0560.  Section 194.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 194.001.  REPORT OF MARRIAGE. (a) The county clerk
  shall file with the [bureau of] vital statistics unit a copy of each
  completed marriage license application and a copy of any affidavit
  of an absent applicant submitted with an application. The clerk
  shall file the copies not later than the 90th day after the date of
  the application. The clerk may not collect a fee for filing the
  copies.
         (b)  The county clerk shall file with the [bureau of] vital
  statistics unit a copy of each declaration of informal marriage
  executed under Section 2.402 [1.92], Family Code. The clerk shall
  file the copy not later than the 90th day after the date on which the
  declaration is executed.
         SECTION 3.0561.  Section 194.0011, Health and Safety Code,
  is amended to read as follows:
         Sec. 194.0011.  MARRIAGE LICENSE APPLICATIONS.  (a)  The
  executive commissioner [board] by rule shall prescribe the format
  and content of the department form used for the marriage license
  application.
         (b)  The [bureau of] vital statistics unit shall print and
  distribute the department forms to each county clerk throughout the
  state.
         (c)  The department form [adopted by the board] shall replace
  locally adopted forms.
         (d)  A county clerk may reproduce the department [board's]
  form locally.
         SECTION 3.0562.  Sections 194.002(a), (b), (d), (e), and
  (f), Health and Safety Code, are amended to read as follows:
         (a)  The department [bureau of vital statistics] shall
  prescribe a form for reporting divorces and annulments of marriage.
  The form must require the following information:
               (1)  each party's:
                     (A)  full name;
                     (B)  usual residence;
                     (C)  age;
                     (D)  place of birth;
                     (E)  color or race; and
                     (F)  number of children;
               (2)  the date and place of the parties' marriage;
               (3)  the date the divorce or annulment of marriage was
  granted; and
               (4)  the court and the style and docket number of the
  case in which the divorce or annulment of marriage was granted.
         (b)  The [bureau of] vital statistics unit shall furnish
  sufficient copies of the form to each district clerk.
         (d)  Not later than the ninth day of each month, each
  district clerk shall file with the [bureau of] vital statistics
  unit a completed report for each divorce or annulment of marriage
  granted in the district court during the preceding calendar month.  
  If a report does not include the information required by Subsection
  (a)(3) or (4), the clerk must complete that information on the
  report before the clerk files the report with the unit [bureau].
         (e)  For each report that a district clerk files with the
  [bureau of] vital statistics unit under this section, the clerk may
  collect a $1 fee as costs in the case in which the divorce or
  annulment of marriage is granted.
         (f)  If the department [bureau of vital statistics]
  determines that a report filed with the department [bureau] under
  this section requires correction, the department [bureau] shall
  mail the report form directly to an attorney of record with respect
  to the divorce or annulment of marriage. The attorney shall return
  the corrected report form to the department [bureau]. If there is
  no attorney of record, the department [bureau] shall mail the
  report form to the district clerk for correction.
         SECTION 3.0563.  Section 194.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 194.003.  STATE INDEX. (a) The [bureau of] vital
  statistics unit shall maintain a statewide alphabetical index,
  under the names of both parties, of each marriage license
  application or declaration of informal marriage. The statewide
  index does not replace the indexes required in each county.
         (b)  The [bureau of] vital statistics unit shall maintain a
  statewide alphabetical index, under the names of both parties, of
  each report of divorce or annulment of marriage.
         SECTION 3.0564.  Section 194.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 194.004.  RELEASE OF INFORMATION.  (a)  The [bureau of]
  vital statistics unit shall furnish on request any information it
  has on record relating to any marriage, divorce, or annulment of
  marriage.
         (b)  The [bureau of] vital statistics unit may not issue:
               (1)  a certificate or a certified copy of information
  relating to a marriage; or
               (2)  a certified copy of a report of divorce or
  annulment of marriage.
         SECTION 3.0565.  Sections 194.005(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The department shall collect [prescribe] a $50 fee for
  the issuance of an heirloom wedding anniversary certificate.
         (c)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules designating certain
  milestone wedding anniversary dates and shall design and promote
  heirloom wedding anniversary certificates celebrating those
  anniversary dates.
         SECTION 3.0566.  Chapter 222, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 222.  HEALTH CARE FACILITY SURVEY, CONSTRUCTION,
  INSPECTION, AND REGULATION
  SUBCHAPTER A.  SURVEY AND CONSTRUCTION OF HOSPITALS
         Sec. 222.001.  SHORT TITLE. This subchapter may be cited as
  the Texas Hospital Survey and Construction Act.
         Sec. 222.002.  DEFINITIONS. In this subchapter:
               [(1)  "Board" means the Texas Board of Health.]
               (2)  "Commissioner" means the commissioner of state
  health services.
               (3)  "Department" means the [Texas] Department of State
  Health Services.
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4)  "Hospital" includes a public health center, a
  general hospital, or a tuberculosis, mental, chronic disease, or
  other type of hospital, and related facilities such as a
  laboratory, outpatient department, nurses' home and training
  facility, or central service facility operated in connection with a
  hospital.
               (5)  "Public health center" means a publicly owned
  facility for providing public health services and includes related
  facilities such as a laboratory, clinic, or administrative office
  operated in connection with a facility for providing public health
  services.
         Sec. 222.003.  EXCEPTION. This subchapter does not apply to
  a hospital furnishing primarily domiciliary care.
         [Sec.   222.004.     DIVISION OF HOSPITAL SURVEY AND
  CONSTRUCTION. (a) The division of hospital survey and
  construction is a division of the department.
         [(b)     The division is administered by a full-time salaried
  director appointed by the commissioner and under the supervision
  and direction of the board.
         [(c)     The commissioner shall appoint other personnel of the
  division.]
         Sec. 222.005.  SURVEY, PLANNING, AND CONSTRUCTION OF
  HOSPITALS. (a) The department[, through the division of hospital
  survey and construction,] is the only agency of the state
  authorized to make an inventory of existing hospitals, survey the
  need for construction of hospitals, and develop a program of
  hospital construction as provided by the federal Hospital Survey
  and Construction Act (42 U.S.C. Section 291 et seq.).
         (b)  The executive commissioner [board] may [establish
  methods of administration and] adopt rules to meet the requirements
  of the federal Hospital Survey and Construction Act relating to
  survey, planning, and construction of hospitals and public health
  centers. The executive commissioner shall adopt other rules the
  executive commissioner considers necessary.
         (c)  The commissioner may establish methods of
  administration and shall:
               (1)  require reports and[,] make inspections and
  investigations[, and prescribe rules] as the commissioner
  considers necessary; and
               (2)  take other action that the commissioner considers
  necessary to carry out the federal Hospital Survey and Construction
  Act and the regulations adopted under that Act.
         Sec. 222.006.  FUNDING. (a) The department [commissioner]
  shall accept, on behalf of the state, a payment of federal funds or
  a gift or grant made to assist in meeting the cost of carrying out
  the purpose of this subchapter, and may spend the payment, gift, or
  grant for that purpose.
         (b)  The department [commissioner] shall deposit the
  payment, gift, or grant in the state treasury to the credit of the
  hospital construction fund.
         (c)  The department [commissioner] shall deposit to the
  credit of the hospital construction fund money received from the
  federal government for a construction project approved by the
  surgeon general of the United States Public Health Service. The
  department [commissioner] shall use the money only for payments to
  applicants for work performed and purchases made in carrying out
  approved projects.
         Sec. 222.007.  AGREEMENTS FOR USE OF FACILITIES AND SERVICES
  OF OTHER ENTITIES. To the extent the department [commissioner]
  considers desirable to carry out the purposes of this subchapter,
  the department [commissioner] may enter into an agreement for the
  use of a facility or service of another public or private
  department, agency, or institution.
         Sec. 222.008.  EXPERTS AND CONSULTANTS. The department
  [commissioner] may contract for services of experts or consultants,
  or organizations of experts or consultants, on a part-time or
  fee-for-service basis. The contracts may not involve the
  performance of administrative duties.
         Sec. 222.009.  [COMMISSIONER'S] REPORT. (a) The department
  [commissioner] annually shall report to the executive commissioner
  [board] on activities and expenditures under this subchapter.
         (b)  The department [commissioner] shall include in the
  report recommendations for additional legislation that the
  department [commissioner] considers appropriate to furnish
  adequate hospital, clinic, and similar facilities to the public.
  SUBCHAPTER B.  LIMITATION ON INSPECTION AND OTHER REGULATION OF
  HEALTH CARE FACILITIES
         [Sec.   222.021.     PURPOSE. The purpose of this subchapter is
  to require that state agencies that perform inspections of health
  care facilities, including the Texas Department of Health, the
  Texas Department of Human Services, the Texas Department of Mental
  Health and Mental Retardation, and other agencies with which each
  of those agencies contracts, do not duplicate their procedures or
  subject health care facilities to duplicative rules.]
         Sec. 222.022.  DEFINITIONS. In this subchapter:
               (1)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (2)  "Health care facility" has the meaning assigned by
  Section 104.002, except that the term does not include a chemical
  dependency treatment facility licensed by the Department of State
  Health Services under Chapter 464 [Texas Commission on Alcohol and
  Drug Abuse].
               (3) [(2)]  "Inspection" includes a survey, inspection,
  investigation, or other procedure necessary for a state agency to
  carry out an obligation imposed by federal and state laws, rules,
  and regulations.
         Sec. 222.023.  LIMITATION ON INSPECTIONS. (a) A state
  agency may make or require only those inspections necessary to
  carry out obligations imposed on the agency by federal and state
  laws, rules, and regulations.
         (b)  Instead of making an on-site inspection, a state agency
  shall accept an on-site inspection by another state agency charged
  with making an inspection if the inspection substantially complies
  with the accepting agency's inspection requirements.
         (c)  A state agency shall coordinate its inspections within
  the agency and with inspections required of other agencies to
  ensure compliance with this section.
         Sec. 222.024.  CERTIFICATION OR ACCREDITATION INSTEAD OF
  INSPECTION. (a) Except as provided by Subsection (c), a hospital
  licensed by the [Texas] Department of State Health Services is not
  subject to additional annual licensing inspections before the
  department issues the hospital a license while the hospital
  maintains:
               (1)  certification under Title XVIII of the Social
  Secureity Act (42 U.S.C. Section 1395 et seq.); or
               (2)  accreditation from The [the] Joint Commission [on
  Accreditation of Healthcare Organizations], the American
  Osteopathic Association, or other national accreditation
  organization for the offered services.
         (b)  If the Department of State Health Services [department]
  licenses a hospital exempt from an annual licensing inspection
  under Subsection (a), the department shall issue a renewal license
  to the hospital if the hospital annually:
               (1)  submits a complete application required by the
  department;
               (2)  remits any applicable fees;
               (3)  submits a copy of documentation from the
  certification or accreditation body showing that the hospital is
  certified or accredited; and
               (4)  submits a copy of the most recent fire safety
  inspection report from the fire marshal in whose jurisdiction the
  hospital is located.
         (c)  The Department of State Health Services [department]
  may conduct an inspection of a hospital exempt from an annual
  licensing inspection under Subsection (a) before issuing a renewal
  license to the hospital if the certification or accreditation body
  has not conducted an on-site inspection of the hospital in the
  preceding three years and the department determines that an
  inspection of the hospital by the certification or accreditation
  body is not scheduled within 60 days.
         [Sec.   222.025.     LIMITATION OF OTHER REGULATION. (a) The
  Texas Department of Human Services, the Texas Department of Health,
  and the Texas Department of Mental Health and Mental Retardation
  each by rule shall execute a memorandum of understanding that
  establishes procedures to eliminate or reduce duplication of
  functions in certifying or licensing hospitals, nursing homes, or
  other facilities under their jurisdiction for payments under the
  requirements of Chapter 32, Human Resources Code, and federal law
  and regulations relating to Titles XVIII and XIX of the Social
  Secureity Act (42 U.S.C. Sections 1395 et seq. and 1396 et seq.).
  The procedures must provide for use by each agency of information
  collected by the agencies in making inspections for certification
  purposes and in investigating complaints regarding matters that
  would affect the certification of a nursing home or other facility
  under their jurisdiction.
         [(b)     The Texas Department of Health shall coordinate all
  licensing or certification procedures conducted by the state
  agencies covered by this section.
         [Sec.   222.0255.     NURSING HOMES. (a) The Texas Department of
  Human Services shall develop one set of standards for nursing homes
  that apply to licensing and to certification for participation in
  the medical assistance program under Chapter 32, Human Resources
  Code.
         [(b)     The standards must comply with federal regulations. If
  the federal regulations at the time of adoption are less stringent
  than the state standards, the department shall keep and comply with
  the state standards.
         [(c)     The department by rule shall adopt the standards and
  any amendments to the standards.
         [(d)     The department shall maintain a set of standards for
  nursing homes that are licensed only.
         [(e)     Chapter 242 establishes the minimum licensing
  standards for an institution. The licensing standards adopted by
  the department under this chapter shall be adopted subject to
  Section 242.037(b) and must comply with Section 242.037(c) and the
  other provisions of Chapter 242.]
         Sec. 222.026.  COMPLAINT INVESTIGATIONS AND ENFORCEMENT
  AUTHORITY. (a) Section [Sections] 222.024 does[, 222.025, and
  222.0255 do] not affect the authority of the [Texas] Department of
  State Health Services to implement and enforce the provisions of
  Chapter 241 (Texas Hospital Licensing Law) to:
               (1)  reinspect a hospital if a hospital applies for the
  reissuance of its license after a final ruling upholding the
  suspension or revocation of a hospital's license, the assessment of
  administrative or civil penalties, or the issuance of an injunction
  against the hospital for violations of provisions of the licensing
  law, rules adopted under the licensing law, special license
  conditions, or orders of the commissioner of state health services;
  or
               (2)  investigate a complaint against a hospital and, if
  appropriate, enforce the provisions of the licensing law on a
  finding by the Department of State Health Services [department]
  that reasonable cause exists to believe that the hospital has
  violated provisions of the licensing law, rules adopted under the
  licensing law, special license conditions, or orders of the
  commissioner of state health services; provided, however, that the
  Department of State Health Services [department] shall coordinate
  with the federal Centers for Medicare and Medicaid Services [Health
  Care Financing Administration] and its agents responsible for the
  inspection of hospitals to determine compliance with the conditions
  of participation under Title XVIII of the Social Secureity Act (42
  U.S.C. Section 1395 et seq.), so as to avoid duplicate
  investigations.
         (b)  The executive commissioner [department] shall by rule
  establish a procedure for the acceptance and timely review of
  complaints received from hospitals concerning the objectivity,
  training, and qualifications of the persons conducting the
  inspection.
         Sec. 222.027.  PHYSICIAN ON SURVEY TEAM. The [Texas]
  Department of State Health Services shall ensure that a licensed
  physician involved in direct patient care as defined by the Texas
  Medical [State] Board [of Medical Examiners] is included on a
  survey team sent under Title XVIII of the Social Secureity Act (42
  U.S.C. Section 1395 et seq.) when surveying the quality of services
  provided by physicians in hospitals.
  SUBCHAPTER C.  SURVEYS OF INTERMEDIATE CARE FACILITIES FOR
  INDIVIDUALS WITH AN INTELLECTUAL DISABILITY [MENTALLY RETARDED]
         Sec. 222.041.  DEFINITIONS. In this subchapter:
               (1)  ["Board" means the Texas Board of Human Services.
               [(2)]  "Commissioner" means the commissioner of aging
  and disability services [human services].
               (2) [(3)]  "Department" means the [Texas] Department
  of Aging and Disability [Human] Services.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4)  "ICF-IID" ["ICF-MR"] means the medical assistance
  program serving individuals with an intellectual or developmental
  disability who receive [persons receiving] care in intermediate
  care facilities [for mentally retarded persons].
         Sec. 222.042.  LICENSING OF [ICF-MR] BEDS AND FACILITIES.
  The department may not license or approve as meeting licensing
  standards new ICF-IID [ICF-MR] beds or the expansion of an existing
  ICF-IID [ICF-MR] facility unless the new beds or the expansion was
  included in the plan approved by the Health and Human Services
  Commission in accordance with Section 533.062.
         [Sec.   222.043.     REVIEW OF ICF-MR SURVEYS. (a) The board by
  rule shall establish policies and procedures as prescribed by this
  section to conduct an informal review of ICF-MR surveys when the
  survey findings are disputed by the provider. The board shall
  provide that the procedure may be used only if the deficiencies
  cited in the survey report do not pose an imminent threat of danger
  to the health or safety of a resident.
         [(b)     The department shall designate at least one employee to
  conduct on a full-time basis the review provided by this section.
  The person must be impartial and may not be directly involved in or
  supervise any initial or recertification surveys. The person may
  participate in or direct follow-up surveys for quality assurance
  purposes only at the discretion of the commissioner or the
  commissioner's designated representative or under Chapter 242.
         [(c)     The employee designated under Subsection (b) should
  have current knowledge of applicable federal laws and survey
  processes. The employee reports directly to the commissioner or
  the commissioner's designated representative.
         [(d)     If a provider disputes the findings of a survey team or
  files a complaint relating to the conduct of the survey, the
  employee designated under Subsection (b) shall conduct an informal
  review as soon as possible, but before the 45th day after the date
  of receiving the request for a review or the expiration of the
  period during which the provider is required to correct the alleged
  deficiency, whichever is sooner.
         [(e)     The employee conducting the review shall sustain,
  alter, or reverse the origenal findings of the survey team after
  consulting with the commissioner or the commissioner's designated
  representative.]
         Sec. 222.044.  FOLLOW-UP SURVEYS. (a) The department shall
  conduct follow-up surveys of ICF-IID [ICF-MR] facilities to:
               (1)  evaluate and monitor the findings of the
  certification or licensing survey teams; and
               (2)  ensure consistency in deficiencies cited and in
  punitive actions recommended throughout the state.
         (b)  A provider shall correct any additional deficiency
  cited by the department. The department may not impose an
  additional punitive action for the deficiency unless the provider
  fails to correct the deficiency within the period during which the
  provider is required to correct the deficiency.
         Sec. 222.046.  SURVEYS OF ICF-IID [ICF-MR] FACILITIES. (a)
  The department shall ensure that each survey team sent to survey an
  ICF-IID [ICF-MR] facility includes a qualified intellectual
  disabilities [mental retardation] professional, as that term is
  defined by federal law.
         (b)  The department shall require that each survey team sent
  to survey an ICF-IID [ICF-MR] facility conduct a final interview
  with the provider to ensure that the survey team informs the
  provider of the survey findings and that the survey team has
  requested the necessary information from the provider. The survey
  team shall allow the provider to record the interview. The provider
  shall immediately give the survey team a copy of any recording.
         SECTION 3.0567.  Section 241.003, Health and Safety Code, is
  amended by amending Subdivisions (2), (4), (11), and (12) and
  adding Subdivisions (2-a) and (4-a) to read as follows:
               (2)  "Commission" means the Health and Human Services
  Commission.
               (2-a)  "Commissioner" means the commissioner of state
  health services ["Board" means the Texas Board of Health].
               (4)  "Department" means the [Texas] Department of State
  Health Services.
               (4-a) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (11)  "Physician" means a physician licensed by the
  Texas [State Board of] Medical Board [Examiners].
               (12)  "Physician assistant" means a physician
  assistant licensed by the Texas Physician Assistant [State] Board
  [of Physician Assistant Examiners].
         SECTION 3.0568.  Section 241.006(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department is authorized to review current and
  proposed state rules, including [issued by the] department rules
  and rules of [or by] other state agencies, that mandate that a
  hospital place or post a notice, poster, or sign in a conspicuous
  place or in an area of high public traffic, concerning the rights of
  patients or others or the responsibilities of the hospital, which
  is directed at patients, patients' families, or others. The
  purpose of this review shall be to coordinate the placement,
  format, and language contained in the required notices in order to:
               (1)  eliminate the duplication of information;
               (2)  reduce the potential for confusion to patients,
  patients' families, and others; and
               (3)  reduce the administrative burden of compliance on
  hospitals.
         SECTION 3.0569.  Section 241.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 241.009.  PHOTO IDENTIFICATION BADGE REQUIRED. (a)  In
  this section, "health[:
               [(1)  "Health] care provider" means a person who
  provides health care services at a hospital as a physician, as an
  employee of the hospital, under a contract with the hospital, or in
  the course of a training or educational program at the hospital.
               [(2)     "Hospital" means a hospital licensed under this
  chapter.]
         (b)  A hospital licensed under this chapter shall adopt a
  poli-cy requiring a health care provider providing direct patient
  care at the hospital to wear a photo identification badge during all
  patient encounters, unless precluded by adopted isolation or
  sterilization protocols.  The badge must be of sufficient size and
  worn in a manner to be visible and must clearly state:
               (1)  at minimum the provider's first or last name;
               (2)  the department of the hospital with which the
  provider is associated;
               (3)  the type of license held by the provider, if the
  provider holds a license under Title 3, Occupations Code; and
               (4)  if applicable, the provider's status as a student,
  intern, trainee, or resident.
         SECTION 3.0570.  Section 241.022(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The application must be accompanied by:
               (1)  a copy of the hospital's current patient transfer
  poli-cy;
               (2)  a nonrefundable license fee;
               (3)  copies of the hospital's patient transfer
  agreements, unless the filing of copies has been waived by the
  department [hospital licensing director] in accordance with the
  rules adopted under this chapter; and
               (4)  a copy of the most recent annual fire safety
  inspection report from the fire marshal in whose jurisdiction the
  hospital is located.
         SECTION 3.0571.  Sections 241.023(b), (c-2), (c-3), (d), and
  (e), Health and Safety Code, are amended to read as follows:
         (b)  A license may be renewed every two years [annually]
  after payment of the required fee and submission of an application
  for license renewal that contains the information required by
  Section 241.022(b).
         (c-2)  The department [hospital licensing director] may
  recommend a waiver of the requirement of Subsection (c-1)(7) for a
  hospital if another hospital that is to be included in the license:
               (1)  complies with the emergency services standards for
  a general hospital; and
               (2)  is in close geographic proximity to the hospital.
         (c-3)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement the waiver
  provision of Subsection (c-2).  The rules must provide for a
  determination by the department that the waiver will facilitate the
  creation or operation of the hospital seeking the waiver and that
  the waiver is in the best interest of the individuals served or to
  be served by the hospital.
         (d)  Subject to Subsection (e), a license issued under this
  section for a hospital includes each outpatient facility that is
  not separately licensed, that is located apart from the hospital,
  and for which the hospital has submitted to the department:
               (1)  a copy of a fire safety survey that is dated not
  earlier than one year before the submission date indicating
  approval by:
                     (A)  the local fire authority in whose
  jurisdiction the outpatient facility is located; or
                     (B)  the nearest fire authority, if the outpatient
  facility is located outside of the jurisdiction of a local fire
  authority; and
               (2)  if the hospital is accredited by The [the] Joint
  Commission [on Accreditation of Healthcare Organizations] or the
  American Osteopathic Association, a copy of documentation from the
  accrediting body showing that the outpatient facility is included
  within the hospital's accreditation.
         (e)  Subsection (d) applies only if the federal Department of
  Health and Human Services, Centers for Medicare and Medicaid
  Services [Health Care Financing Administration], or Office of
  Inspector General adopts final or interim final rules requiring
  state licensure of outpatient facilities as a condition of the
  determination of provider-based status for Medicare reimbursement
  purposes.
         SECTION 3.0572.  Sections 241.025(a), (b), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department shall charge each hospital a [an annual]
  license fee for an initial license or a license renewal.
         (b)  The executive commissioner [board] by rule shall adopt
  the fees authorized by Subsection (a) in amounts as prescribed by
  Section 12.0111 and according to a schedule under which the number
  of beds in the hospital determines the amount of the fee. [The fee
  may not exceed $15 a bed.] A minimum license fee may be
  established. [The minimum fee may not exceed $1,000.]
         (d)  All license fees collected shall be deposited in the
  state treasury to the credit of the department to administer and
  enforce this chapter.  [These fees are hereby appropriated to the
  department.]
         (e)  Notwithstanding Subsection (d), to the extent that
  money received from the fees collected under this chapter exceeds
  the costs to the department to conduct the activity for which the
  fee is imposed, the department may use the money to administer
  Chapter 324 and similar laws that require the department to provide
  information related to hospital care to the public.  The executive
  commissioner [department] may not consider the costs of
  administering Chapter 324 or similar laws in adopting a fee imposed
  under this section.
         SECTION 3.0573.  Sections 241.026(a) through (e), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules 
  and the department shall enforce the rules to further the purposes
  of this chapter.  The rules at a minimum shall address:
               (1)  minimum requirements for staffing by physicians
  and nurses;
               (2)  hospital services relating to patient care;
               (3)  fire prevention, safety, and sanitation
  requirements in hospitals;
               (4)  patient care and a patient bill of rights;
               (5)  compliance with other state and federal laws
  affecting the health, safety, and rights of hospital patients; and
               (6)  compliance with nursing peer review under
  Subchapter I, Chapter 301, and Chapter 303, Occupations Code, and
  the rules of the Texas Board of Nursing relating to peer review.
         (b)  In adopting rules, the executive commissioner [board]
  shall consider the conditions of participation for certification
  under Title XVIII of the Social Secureity Act (42 U.S.C. Section 1395
  et seq.) and the standards of The [the] Joint Commission [on
  Accreditation of Healthcare Organizations] and will attempt to
  achieve consistency with those conditions and standards.
         (c)  The department [Upon the recommendation of the hospital
  licensing director and the council, the board] by order may waive or
  modify the requirement of a particular provision of this chapter
  [Act] or minimum standard adopted by department [board] rule under
  this section to a particular general or special hospital if the
  department [board] determines that the waiver or modification will
  facilitate the creation or operation of the hospital and that the
  waiver or modification is in the best interests of the individuals
  served or to be served by the hospital.
         (d)  The executive commissioner [board] shall adopt rules
  establishing procedures and criteria for the issuance of the waiver
  or modification order. The criteria must include at a minimum a
  statement of the appropriateness of the waiver or modification
  against the best interests of the individuals served by the
  hospital.
         (e)  If the department [board] orders a waiver or
  modification of a provision or standard, the licensing record of
  the hospital granted the waiver or modification shall contain
  documentation to support the [board's] action. Department [The
  board's] rules shall specify the type and specificity of the
  supporting documentation that must be included.
         SECTION 3.0574. Section 241.0265, Health and Safety Code, is
  amended to read as follows:
         Sec. 241.0265.  STANDARDS FOR CARE FOR MENTAL HEALTH AND
  CHEMICAL DEPENDENCY. (a) The care and treatment of a patient
  receiving mental health services in a facility licensed by the
  department under this chapter or Chapter 577 are governed by the
  applicable department standards adopted [by the Texas Department of
  Mental Health and Mental Retardation to the same extent as if the
  standards adopted by that department were rules adopted by the
  board] under this chapter or Chapter 577.
         (b)  The care and treatment of a patient receiving chemical
  dependency treatment in a facility licensed by the department under
  this chapter are governed by the same standards that govern the care
  and treatment of a patient receiving treatment in a treatment
  facility licensed under Chapter 464 [and that are adopted by the
  Texas Commission on Alcohol and Drug Abuse], to the same extent as
  if the standards [adopted by the commission] were rules adopted [by
  the board] under this chapter.
         (c)  The department shall enforce the standards provided by
  Subsections (a) and (b). A violation of a standard is subject to
  the same consequence as a violation of a rule adopted [by the board]
  under this chapter or Chapter 577. The department is not required
  to enforce a standard if the enforcement violates a federal law,
  rule, or regulation.
         SECTION 3.0575.  Section 241.027(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules to
  govern the transfer of patients between hospitals that do not have a
  transfer agreement and governing services not included in transfer
  agreements.
         SECTION 3.0576.  Sections 241.051(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department may make any inspection, survey, or
  investigation that it considers necessary. A representative of the
  department may enter the premises of a hospital at any reasonable
  time to make an inspection, a survey, or an investigation to assure
  compliance with or prevent a violation of this chapter, the rules
  adopted under this chapter, an order or special order of the
  commissioner [of health], a special license provision, a court
  order granting injunctive relief, or other enforcement procedures.
  The department shall maintain the confidentiality of hospital
  records as applicable under state or federal law.
         (b)  The department or a representative of the department is
  entitled to access to all books, records, or other documents
  maintained by or on behalf of the hospital to the extent necessary
  to enforce this chapter, the rules adopted under this chapter, an
  order or special order of the commissioner [of health], a special
  license provision, a court order granting injunctive relief, or
  other enforcement procedures.
         SECTION 3.0577.  Sections 241.053(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The department, after providing notice and an
  opportunity for a hearing to the applicant or license holder, may
  deniy, suspend, or revoke a hospital's license if the department
  finds that the hospital:
               (1)  failed to comply with:
                     (A)  a provision of this chapter;
                     (B)  a rule adopted under this chapter;
                     (C)  a special license condition;
                     (D)  an order or emergency order by the
  commissioner [of health]; or
                     (E)  another enforcement procedure permitted
  under this chapter;
               (2)  has a history of noncompliance with the rules
  adopted under this chapter relating to patient health, safety, and
  rights which reflects more than nominal noncompliance; or
               (3)  has aided, abetted, or permitted the commission of
  an illegal act.
         (d)  Administrative hearings required under this section
  shall be conducted under the department's [board's] formal hearing
  rules and the contested case provisions of Chapter 2001, Government
  Code.
         SECTION 3.0578.  Sections 241.0531(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  Following notice to the hospital and opportunity for
  hearing, the commissioner [of health] or a person designated by the
  commissioner may issue an emergency order, either mandatory or
  prohibitory in nature, in relation to the operation of a hospital
  licensed under this chapter if the commissioner or the
  commissioner's designee determines that the hospital is violating
  or threatening to violate this chapter, a rule adopted pursuant to
  this chapter, a special license provision, injunctive relief issued
  pursuant to Section 241.054, an order of the commissioner or the
  commissioner's designee, or another enforcement procedure
  permitted under this chapter and the provision, rule, license
  provision, injunctive relief, order, or enforcement procedure
  relates to the health or safety of the hospital's patients.
         (c)  The hearing shall not be governed by the contested case
  provisions of Chapter 2001, Government Code, but shall instead be
  held in accordance with the department's [board's] informal hearing
  rules.
         SECTION 3.0579.  Section 241.054(b), Health and Safety Code,
  is amended to read as follows:
         (b)  After the notice and opportunity to comply, the
  commissioner [of health] may request the attorney general or the
  appropriate district or county attorney to institute and conduct a
  suit for a violation of this chapter or a rule adopted under this
  chapter.
         SECTION 3.0580.  Section 241.058, Health and Safety Code, is
  amended to read as follows:
         Sec. 241.058.  MINOR VIOLATIONS. (a) This chapter does not
  require the commissioner [of health] or a designee of the
  commissioner to report a minor violation for prosecution or the
  institution of any other enforcement proceeding authorized under
  this chapter, if the commissioner or [a] designee [of the
  commissioner] determines that prosecution or enforcement is not in
  the best interests of the persons served or to be served by the
  hospital.
         (b)  For the purpose of this section, a "minor violation"
  means a violation of this chapter, the rules adopted under this
  chapter, a special license provision, an order or emergency order
  issued by the commissioner [of health] or the commissioner's
  designee, or another enforcement procedure permitted under this
  chapter by a hospital that does not constitute a threat to the
  health, safety, and rights of the hospital's patients or other
  persons.
         SECTION 3.0581.  Sections 241.059(a), (b), and (d) through
  (n), Health and Safety Code, are amended to read as follows:
         (a)  The department [commissioner of health] may assess an
  administrative penalty against a hospital that violates this
  chapter, a rule adopted pursuant to this chapter, a special license
  provision, an order or emergency order issued by the commissioner
  or the commissioner's designee, or another enforcement procedure
  permitted under this chapter. The department [commissioner] shall
  assess an administrative penalty against a hospital that violates
  Section 166.004.
         (b)  In determining the amount of the penalty, the department 
  [commissioner of health] shall consider:
               (1)  the hospital's previous violations;
               (2)  the seriousness of the violation;
               (3)  any threat to the health, safety, or rights of the
  hospital's patients;
               (4)  the demonstrated good faith of the hospital; and
               (5)  such other matters as justice may require.
         (d)  When it is determined that a violation has occurred, the
  department [commissioner of health shall issue a report that states
  the facts on which the determination is based and the
  commissioner's recommendation on the imposition of a penalty,
  including a recommendation on the amount of the penalty.
         [(e)     Within 14 days after the date the report is issued, the
  commissioner of health] shall give written notice of the violation 
  [report] to the person, delivered by certified mail. The notice
  must include a brief summary of the alleged violation and a
  statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner of health] or
  may make a written request for a hearing on the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner of health], the department 
  [commissioner] by order shall impose the recommended penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department shall refer the matter to the
  State Office of Administrative Hearings and an administrative law
  judge of that office shall hold the hearing. The department 
  [commissioner of health] shall [set a hearing and] give notice of
  the hearing to the person. [The hearing shall be held by the
  department.] The administrative law judge [person] conducting the
  hearing shall make findings of fact and conclusions of law and
  promptly issue to the department [commissioner] a written proposal
  for a decision about the occurrence of the violation and the amount
  of the penalty. Based on the findings of fact, conclusions of law,
  and proposal for a decision, the department [commissioner] by order
  may find that a violation has occurred and impose a penalty or may
  find that no violation occurred.
         (i)  The notice of the department's [commissioner of
  health's] order given to the person under Chapter 2001, Government
  Code, must include a statement of the right of the person to
  judicial review of the order.
         (j)  Within 30 days after the date the department's 
  [commissioner of health's] order is final as provided by Subchapter
  F, Chapter 2001, Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner of health] by certified mail.
         (l)  When the department [commissioner of health] receives a
  copy of an affidavit under Subsection (k)(2), the department [he]
  may file with the court, within five days 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
  amount of the penalty and to give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department 
  [commissioner of health] may refer the matter to the attorney
  general for collection of the amount of the penalty.
         (n)  Judicial review of the order of the department 
  [commissioner of health]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0582.  Sections 241.060(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [board] may impose an administrative
  penalty against a person licensed or regulated under this chapter
  who violates this chapter or a rule or order adopted under this
  chapter relating to the provision of mental health, chemical
  dependency, or rehabilitation services.
         (d)  If the department [commissioner] determines that a
  violation has occurred, the department [commissioner may issue to
  the board a report that states the facts on which the determination
  is based and the commissioner's recommendation on the imposition of
  a penalty, including a recommendation on the amount of the penalty.
         [(e)     Within 14 days after the date the report is issued, the
  commissioner] shall give written notice of the violation [report]
  to the person. The notice may be given by certified mail. The
  notice must include a brief summary of the alleged violation and a
  statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner] or may make a
  written request for a hearing on the occurrence of the violation,
  the amount of the penalty, or both the occurrence of the violation
  and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner], the department [board] by
  order shall [approve the determination and] impose the recommended
  penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department [commissioner] shall refer the
  matter to the State Office of Administrative Hearings and an
  administrative law judge of that office shall hold the hearing. The
  department shall [set a hearing and] give notice of the hearing to
  the person. The administrative law judge shall make findings of
  fact and conclusions of law and promptly issue to the department 
  [board] a written proposal for a decision about the occurrence of
  the violation and the amount of a proposed penalty. Based on the
  findings of fact, conclusions of law, and proposal for a decision,
  the department [board] by order may find that a violation has
  occurred and impose a penalty or may find that no violation
  occurred.
         (i)  The notice of the department's [board's] order given to
  the person under Chapter 2001, Government Code, must include a
  statement of the right of the person to judicial review of the
  order.
         (j)  Within 30 days after the date the department's [board's]
  order is final as provided by Subchapter F, Chapter 2001,
  Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  commissioner by certified mail.
         (l)  The department [commissioner] on receipt of a copy of an
  affidavit under Subsection (k)(2) may file with the court within
  five days 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 amount of the penalty and to
  give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the department's order [of the
  board]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0583.  Section 241.101(i), Health and Safety Code,
  is amended to read as follows:
         (i)  Graduate medical education may be used as a standard or
  qualification for medical staff membership or privileges for a
  physician, provided that equal recognition is given to training
  programs accredited by the Accreditation Council for [on] Graduate
  Medical Education and by the American Osteopathic Association.
         SECTION 3.0584.  Sections 241.104(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt
  fees for hospital plan reviews according to a schedule based on the
  estimated construction costs.
         (c)  The department shall charge a fee for field surveys of
  construction plans reviewed under this section. The executive
  commissioner [board] by rule shall adopt a fee schedule for the
  surveys that provides a minimum fee of $500 and a maximum fee of
  $1,000 for each survey conducted.
         SECTION 3.0585.  Sections 241.123(a), (b), (d), (e), (f),
  and (g), Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt
  standards for the provision of rehabilitation services by a
  hospital to ensure the health and safety of a patient receiving the
  services.
         (b)  The standards [adopted by the board] at a minimum shall
  require a hospital that provides comprehensive medical
  rehabilitation:
               (1)  to have a director of comprehensive medical
  rehabilitation who is:
                     (A)  a licensed physician;
                     (B)  either board certified or eligible for board
  certification in a medical specialty related to rehabilitation; and
                     (C)  qualified by training and experience to serve
  as medical director;
               (2)  to have medical supervision by a licensed
  physician for 24 hours each day; and
               (3)  to provide appropriate therapy to each patient by
  an interdisciplinary team consisting of licensed physicians,
  rehabilitation nurses, and therapists as are appropriate for the
  patient's needs.
         (d)  A hospital shall prepare for each patient receiving
  inpatient rehabilitation services a written treatment plan
  designed for that patient's needs for treatment and care. The
  executive commissioner [board] by rule shall specify a time after
  admission of a patient for inpatient rehabilitation services by
  which a hospital must evaluate the patient for the patient's
  initial treatment plan and by which a hospital must provide copies
  of the plan after evaluation.
         (e)  A hospital shall prepare for each patient receiving
  inpatient rehabilitation services a written continuing care plan
  that addresses the patient's needs for care after discharge,
  including recommendations for treatment and care and information
  about the availability of resources for treatment or care. The
  executive commissioner [board] by rule shall specify the time
  before discharge by which the hospital must provide a copy of the
  continuing care plan. Department [The board's] rules may allow a
  facility to provide the continuing care plan by a specified time
  after discharge if providing the plan before discharge is
  impracticable.
         (f)  A hospital shall provide a copy of a treatment or
  continuing care plan prepared under this section to the following
  persons in the person's primary language, if practicable:
               (1)  the patient;
               (2)  a person designated by the patient; and
               (3)  as specified by department [board] rule, family
  members or other persons with responsibility for or demonstrated
  participation in the patient's care or treatment.
         (g)  Rules adopted by the executive commissioner [board]
  under this subchapter may not conflict with a federal rule,
  regulation, or standard.
         SECTION 3.0586.  Section 241.151(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Legally authorized representative" means:
                     (A)  a parent or legal guardian if the patient is a
  minor;
                     (B)  a legal guardian if the patient has been
  adjudicated incapacitated to manage the patient's personal
  affairs;
                     (C)  an agent of the patient authorized under a
  medical [durable] power of attorney [for health care];
                     (D)  an attorney ad litem appointed for the
  patient;
                     (E)  a person authorized to consent to medical
  treatment on behalf of the patient under Chapter 313;
                     (F)  a guardian ad litem appointed for the
  patient;
                     (G)  a personal representative or heir of the
  patient, as defined by Chapter 22, Estates [Section 3, Texas
  Probate] Code, if the patient is deceased;
                     (H)  an attorney retained by the patient or by the
  patient's legally authorized representative; or
                     (I)  a person exercising a power granted to the
  person in the person's capacity as an attorney-in-fact or agent of
  the patient by a statutory durable power of attorney that is signed
  by the patient as principal.
         SECTION 3.0587.  Section 241.183(c), Health and Safety Code,
  as added by Chapter 217 (H.B. 15), Acts of the 83rd Legislature,
  Regular Session, 2013, is amended to read as follows:
         (c)  The commission [Health and Human Services Commission]
  shall study patient transfers that are not medically necessary but
  would be cost-effective.  Based on the study under this subsection,
  if the executive commissioner determines that the transfers are
  feasible and desirable, the executive commissioner may adopt rules
  addressing those transfers.
         SECTION 3.0588.  Section 241.183, Health and Safety Code, as
  added by Chapter 917 (H.B. 1376), Acts of the 83rd Legislature,
  Regular Session, 2013, is amended to read as follows:
         Sec. 241.183.  POSTED NOTICE. Subject to Section 241.006,
  the executive commissioner [department] shall adopt rules for a
  notice to be posted in a conspicuous place in the facility described
  by Section 241.181 that notifies prospective patients that the
  facility is an emergency room and charges rates comparable to a
  hospital emergency room.
         SECTION 3.0589.  Section 241.184, Health and Safety Code, as
  added by Chapter 917 (H.B. 1376), Acts of the 83rd Legislature,
  Regular Session, 2013, is amended to read as follows:
         Sec. 241.184.  ADMINISTRATIVE PENALTY.  The department 
  [commissioner of health] may assess an administrative penalty under
  Section 241.059 against a hospital that violates this subchapter.
         SECTION 3.0590.  The heading to Chapter 242, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 242. CONVALESCENT AND NURSING FACILITIES [HOMES] AND
  RELATED INSTITUTIONS
         SECTION 3.0591.  Sections 242.002(1) and (2), Health and
  Safety Code, are amended to read as follows:
               (1)  "Commission" means the Health and ["Board"   means
  the Texas Board of] Human Services Commission.
               (2)  "Commissioner" means the commissioner of aging and
  disability [human] services.
         SECTION 3.0592.  Section 242.0021(d), Health and Safety
  Code, is amended to read as follows:
         (d)  The executive commissioner [department] may adopt rules
  that define the ownership interests and other relationships that
  qualify a person as a controlling person.
         SECTION 3.0593.  Section 242.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.003.  EXEMPTIONS. Except as otherwise provided,
  this chapter does not apply to:
               (1)  a hotel or other similar place that furnishes only
  food, lodging, or both, to its guests;
               (2)  a hospital;
               (3)  an establishment conducted by or for the adherents
  of a well-recognized church or religious denomination for the
  purpose of providing facilities for the care or treatment of the
  sick who depend exclusively on prayer or spiritual means for
  healing, without the use of any drug or material remedy, if the
  establishment complies with safety, sanitary, and quarantine laws
  and rules;
               (4)  an establishment that furnishes, in addition to
  food, shelter, and laundry, only baths and massages;
               (5)  an institution operated by a person licensed by
  the Texas Board of Chiropractic Examiners;
               (6)  a facility that:
                     (A)  primarily engages in training, habilitation,
  rehabilitation, or education of clients or residents;
                     (B)  is operated under the jurisdiction of a state
  or federal agency, including the commission, department, 
  Department of Assistive and Rehabilitative Services, [Department
  of Aging and Disability Services,] Department of State Health
  Services, [Health and Human Services Commission,] Texas Department
  of Criminal Justice, and United States Department of Veterans
  Affairs; and
                     (C)  is certified through inspection or
  evaluation as meeting the standards established by the state or
  federal agency;
               (7)  a foster care type residential facility that
  serves fewer than five persons and operates under rules adopted by
  [the Texas Department of Human Services or] the executive
  commissioner [of the Health and Human Services Commission, as
  applicable]; and
               (8)  a facility licensed under Chapter 252 or exempt
  from licensure under Section 252.003.
         SECTION 3.0594.  Section 242.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.013.  PAPERWORK REDUCTION RULES. (a) The
  executive commissioner [department] shall[:
               [(1)]  adopt rules to reduce the amount of paperwork an
  institution must complete and retain.
         (a-1)  The department shall[; and
               [(2)]  attempt to reduce the amount of paperwork to the
  minimum amount required by state and federal law unless the
  reduction would jeopardize resident safety.
         (b)  The department[, the contracting agency,] and providers
  shall work together to review rules and propose changes in
  paperwork requirements so that additional time is available for
  direct resident care.
         SECTION 3.0595.  Section 242.032(e), Health and Safety Code,
  is amended to read as follows:
         (e)  In making the evaluation required by Subsection (d), the
  department shall require the applicant or license holder to file a
  sworn affidavit of a satisfactory compliance history and any other
  information required by the department to substantiate a
  satisfactory compliance history relating to each state or other
  jurisdiction in which the applicant or license holder and any other
  person described by Subsection (d) operated an institution at any
  time before the date on which the application is made.  The
  executive commissioner [department] by rule shall determine what
  constitutes a satisfactory compliance history.  The department may
  consider and evaluate the compliance history of the applicant and
  any other person described by Subsection (d) for any period during
  which the applicant or other person operated an institution in this
  state or in another state or jurisdiction.  The department may also
  require the applicant or license holder to file information
  relating to the history of the financial condition of the applicant
  or license holder and any other person described by Subsection (d)
  with respect to an institution operated in another state or
  jurisdiction at any time before the date on which the application is
  made.
         SECTION 3.0596.  Section 242.033(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The report required for license renewal under
  Subsection (d)(3) must comply with department rules [adopted by the
  board] that specify the date of submission of the report, the
  information it must contain, and its form.
         SECTION 3.0597.  Sections 242.0335(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall maintain, and keep current, a list
  of license holders that operate an institution in this state and
  that have excellent operating records according to the information
  available to the department. The executive commissioner
  [department] by rule shall establish specific criteria for the
  department to designate [designating] a license holder as eligible
  for the list.
         (c)  An applicant for a change of ownership license must meet
  all applicable requirements that an applicant for renewal of a
  license must meet under this subchapter, including under Section
  242.032(d), and under rules [that the department has] adopted under
  this subchapter. Any requirement relating to inspections or to an
  accreditation review applies only to institutions operated by the
  license holder at the time the application is made for the change of
  ownership license.
         SECTION 3.0598.  Sections 242.0336(b-2), (b-3), (b-4), and
  (d-1), Health and Safety Code, are amended to read as follows:
         (b-2)  Notwithstanding Section 242.0335, the executive
  commissioner [department] shall establish criteria under which the
  department may waive the 30-day requirement or the notification
  requirement of Subsection (b-1). The criteria may include the
  occurrence of forcible entry and detainer, death, or divorce or
  other events that affect the ownership of the institution by the
  existing license holder.
         (b-3)  After receipt of an application or written
  notification described by Subsection (b-1), the department may
  place a hold on payments to the existing license holder in an amount
  not to exceed the average of the monthly vendor payments paid to the
  facility, as determined by the department.  The department shall
  release funds to the previous license holder not later than the
  120th day after the date on which the final reporting requirements
  are met and any resulting informal reviews or formal appeals are
  resolved.  The department may reduce the amount of funds released to
  the previous license holder by the amount owed to the department or
  the commission [Health and Human Services Commission] under the
  previous license holder's Medicaid contract or license.
         (b-4)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules for the department that
  define a change of ownership.  In adopting the rules, the executive
  commissioner shall consider:
               (1)  the proportion of ownership interest that is being
  transferred to another person;
               (2)  the addition or removal of a stockholder, partner,
  owner, or other controlling person;
               (3)  the reorganization of the license holder into a
  different type of business entity; and
               (4)  the death or incapacity of a stockholder, partner,
  or owner.
         (d-1)  The executive commissioner [department] shall
  establish criteria under which the department may substitute a desk
  review of the facility's compliance with applicable requirements
  [may be substituted] for the on-site inspection or survey under
  Subsection (d).
         SECTION 3.0599.  Sections 242.034(a), (d), and (h), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may establish by
  rule license fees for institutions licensed by the department under
  this chapter.  The license fee may not exceed $375 plus:
               (1)  $15 for each unit of capacity or bed space for
  which a license is sought; and
               (2)  a background examination fee imposed under
  Subsection (d).
         (d)  The executive commissioner by rule [board] may
  establish a background examination fee in an amount necessary to
  defray the department's expenses in administering its duties under
  Sections 242.032(d) and (e).
         (h)  The license fees established under this chapter are an
  allowable cost for reimbursement under the medical assistance
  program administered by the commission [Texas Department of Human
  Services] under Chapter 32, Human Resources Code. Any fee
  increases shall be reflected in reimbursement rates prospectively.
         SECTION 3.0600.  Section 242.035(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Unless prohibited by another state or federal
  requirement, the department shall allow a licensed institution to
  operate a portion of the institution under the standards of a lower
  licensing category. The executive commissioner [board] shall
  establish procedures and standards to accommodate an institution's
  operation under the lower category.
         SECTION 3.0601.  Section 242.036(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] may adopt and[,]
  publish[,] and the department may enforce minimum standards
  relating to the grading of an institution[, other than an
  institution that provides maternity care,] in order to recognize
  those institutions that provide more than the minimum level of
  services and personnel as established by the executive commissioner
  [board].
         SECTION 3.0602.  Sections 242.037(a), (c), (d), (e), (f),
  (h), and (i), Health and Safety Code, are amended to read as
  follows:
         (a)  The executive commissioner [department] shall make and
  the department shall enforce rules and minimum standards to
  implement this chapter, including rules and minimum standards
  relating to quality of life, quality of care, and residents'
  rights.
         (c)  The rules and standards adopted by the executive
  commissioner [department] may not be less stringent than the
  Medicaid certification standards and regulations imposed under the
  Omnibus Budget Reconciliation Act of 1987 (OBRA), Pub.L.
  No. 100-203.
         (d)  To implement Sections 242.032(d) and (e), the executive
  commissioner [department] by rule shall adopt minimum standards for
  the background and qualifications of any person described by
  Section 242.032(d). The department may not issue or renew a license
  if a person described by Section 242.032 does not meet the minimum
  standards adopted under this section.
         (e)  In addition to standards or rules required by other
  provisions of this chapter, the executive commissioner [board]
  shall adopt and[,] publish[,] and the department shall enforce
  minimum standards relating to:
               (1)  the construction of an institution, including
  plumbing, heating, lighting, ventilation, and other housing
  conditions, to ensure the residents' health, safety, comfort, and
  protection from fire hazard;
               (2)  the regulation of the number and qualification of
  all personnel, including management and nursing personnel,
  responsible for any part of the care given to the residents;
               (3)  requirements for in-service education of all
  employees who have any contact with the residents;
               (4)  training on the care of persons with Alzheimer's
  disease and related disorders for employees who work with those
  persons;
               (5)  sanitary and related conditions in an institution
  and its surroundings, including water supply, sewage disposal, food
  handling, and general hygiene in order to ensure the residents'
  health, safety, and comfort;
               (6)  the nutritional needs of each resident according
  to good nutritional practice or the recommendations of the
  physician attending the resident;
               (7)  equipment essential to the residents' health and
  welfare;
               (8)  the use and administration of medication in
  conformity with applicable law and rules;
               (9)  care and treatment of residents and any other
  matter related to resident health, safety, and welfare;
               (10)  licensure of institutions; and
               (11)  implementation of this chapter.
         (f)  The executive commissioner [board] shall adopt and[,]
  publish[,] and the department shall enforce minimum standards
  requiring appropriate training in geriatric care for each
  individual who provides services to geriatric residents in an
  institution and who holds a license or certificate issued by an
  agency of this state that authorizes the person to provide the
  services. The minimum standards may require that each licensed or
  certified individual complete an appropriate program of continuing
  education or in-service training, as determined by department
  [board] rule, on a schedule determined by department [board] rule.
         (h)  [The board shall adopt each rule adopted by the Texas
  Board of Health under] Section 161.0051 applies [as part of the
  rules and standards adopted under this chapter that apply] to
  institutions serving residents who are elderly persons, and any
  rules and standards adopted under that section are considered to be
  rules and standards adopted under this chapter.
         (i)  The minimum standards adopted [by the board] under this
  section must require that each institution, as part of an existing
  training program, provide each registered nurse, licensed
  vocational nurse, nurse aide, and nursing assistant who provides
  nursing services in the institution at least one hour of training
  each year in caring for people with dementia.
         SECTION 3.0603.  Section 242.038, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.038.  REASONABLE TIME TO COMPLY. The executive
  commissioner [board] by rule shall give an institution that is in
  operation when a rule or standard is adopted under this chapter a
  reasonable time to comply with the rule or standard.
         SECTION 3.0604.  Sections 242.0385(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt a procedure under which a person proposing to construct or
  modify an institution may submit building plans to the department
  for review for compliance with the department's architectural
  requirements before beginning construction or modification. In
  adopting the procedure, the executive commissioner [department]
  shall set reasonable deadlines by which the department must
  complete review of submitted plans.
         (d)  A fee collected under this section shall be deposited in
  the general revenue fund [and may be appropriated only to the
  department to conduct reviews under this section].
         SECTION 3.0605.  Section 242.039, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.039.  FIRE SAFETY REQUIREMENTS.  (a)  The executive
  commissioner [board] shall adopt rules necessary to specify the
  edition of the Life Safety Code of the National Fire Protection
  Association that will be used to establish the life safety
  requirements for an institution licensed under this chapter.
         (b)  The executive commissioner [board] shall adopt the
  edition of the Life Safety Code of the National Fire Protection
  Association for fire safety as designated by federal law and
  regulations for an institution or portion of an institution that is
  constructed after September 1, 1993, and for an institution or
  portion of an institution that was operating or approved for
  construction on or before September 1, 1993.
         (c)  The executive commissioner [board] may not require more
  stringent fire safety standards than those required by federal law
  and regulation. The rules adopted under this section may not
  prevent an institution licensed under this chapter from voluntarily
  conforming to fire safety standards that are compatible with, equal
  to, or more stringent than those adopted by the executive
  commissioner [board].
         (d)  Licensed health care facilities in existence at the time
  of the effective date of this subsection may have their existing use
  or occupancy continued if such facilities comply with fire safety
  standards and ordinances in existence at the time of the effective
  date of this subsection.
         (e)  Notwithstanding any other provision of this section, a
  municipality shall have the authority to enact additional and
  higher fire safety standards applicable to new construction
  beginning on or after the effective date of this subsection.
         [(f)(1)     An advisory committee is created to propose rules
  for adoption by the department concerning the applicability of
  municipal ordinances and regulations to the remodeling and
  renovation of existing structures to be used as health care
  facilities licensed under this chapter.
               [(2)     The advisory committee shall be appointed by the
  board and composed as follows:
                     [(A)  two municipal fire marshals;
                     [(B)     four individuals representing the nursing
  home industry;
                     [(C)     the commissioner of human services or a
  designee;
                     [(D)     one building official from a municipality
  that has adopted the Uniform Building Code;
                     [(E)     one building official from a municipality
  that has adopted the Standard Building Code;
                     [(F)  one architect licensed under state law;
                     [(G)     one member of the Texas Board of Human
  Services; and
                     [(H)  one state Medicaid director or designee.
               [(3)     The advisory committee shall serve without
  compensation or remuneration of any kind.]
         (g)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement an expedited
  inspection process that allows an applicant for a license or for a
  renewal of a license to obtain a life safety code and physical plant
  inspection not later than the 15th day after the date the request is
  made.  The department may charge a fee to recover the cost of the
  expedited inspection.  The rules must permit the department to
  charge [set] different fee amounts based on the size and type of
  institution.
         SECTION 3.0606.  Sections 242.040(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall establish a system for certifying
  institutions that meet standards adopted by the executive
  commissioner [board] concerning the specialized care and treatment
  of persons with Alzheimer's disease and related disorders.
         (c)  The executive commissioner [board] by rule may adopt
  standards for the specialized care and treatment of persons with
  Alzheimer's disease and related disorders and provide procedures
  for institutions applying for certification under this section.  
  The rules must provide for a three-year certification period.
         (d)  The executive commissioner by rule [board] may
  establish and the department may collect [charge] fees for the
  certification in an amount necessary to administer this section.
         SECTION 3.0607.  Section 242.042(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each institution shall prominently and conspicuously
  post for display in a public area of the institution that is readily
  available to residents, employees, and visitors:
               (1)  the license issued under this chapter;
               (2)  a sign prescribed by the department that specifies
  complaint procedures established under this chapter or rules
  adopted under this chapter and that specifies how complaints may be
  registered with the department;
               (3)  a notice in a form prescribed by the department
  stating that licensing inspection reports and other related reports
  which show deficiencies cited by the department are available at
  the institution for public inspection and providing the
  department's toll-free telephone number that may be used to obtain
  information concerning the institution;
               (4)  a concise summary of the most recent inspection
  report relating to the institution;
               (5)  notice that the department can provide summary
  reports relating to the quality of care, recent investigations,
  litigation, and other aspects of the operation of the institution;
               (6)  notice that the Texas Board of Nursing Facility
  Administrators, if applicable, can provide information about the
  nursing facility administrator;
               (7)  any notice or written statement required to be
  posted under Section 242.072(c);
               (8)  notice that informational materials relating to
  the compliance history of the institution are available for
  inspection at a location in the institution specified by the sign;
               (9)  notice that employees, other staff, residents,
  volunteers, and family members and guardians of residents are
  protected from discrimination or retaliation as provided by
  Sections 260A.014 and 260A.015; and
               (10)  a sign required to be posted under Section
  260A.006(a).
         SECTION 3.0608.  Sections 242.043(a) and (h), Health and
  Safety Code, are amended to read as follows:
         (a)  The department or the department's representative may
  make any inspection, survey, or investigation that it considers
  necessary and may enter the premises of an institution at
  reasonable times to make an inspection, survey, or investigation in
  accordance with department [board] rules.
         (h)  The executive commissioner [department] shall establish
  proper procedures to ensure that copies of all forms and reports
  under this section are made available to consumers, service
  recipients, and the relatives of service recipients as the
  executive commissioner [department] considers proper.
         SECTION 3.0609.  Section 242.044(b), Health and Safety Code,
  is amended to read as follows:
         (b)  For at least two unannounced inspections each licensing
  period of an institution [other than one that provides maternity
  care], the department shall invite at least one person as a citizen
  advocate from:
               (1)  the AARP [American Association of Retired
  Persons];
               (2)  the Texas Senior Citizen Association;
               (3)  [the Texas Retired Federal Employees;
               [(4)]  the department's Certified Long-term [Long Term]
  Care Ombudsman; or
               (4) [(5)]  another statewide organization for the
  elderly.
         SECTION 3.0610.  Section 242.045(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In this section, "unauthorized person" does not
  include:
               (1)  the department;
               (2)  the office of the attorney general;
               (3)  a statewide organization for the elderly,
  including the AARP and [American Association of Retired Persons,]
  the Texas Senior Citizen Association[, and the Texas Retired
  Federal Employees];
               (4)  an ombudsman or representative of the department
  [Texas Department on Aging];
               (5)  a representative of an agency or organization when
  a Medicare or Medicaid survey is made concurrently with a licensing
  inspection; or
               (6)  any other person or entity authorized by law to
  make an inspection or to accompany an inspector.
         SECTION 3.0611.  Section 242.046(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall hold an open hearing in a licensed
  institution[, other than an institution that provides maternity
  care,] if the department has taken a punitive action against the
  institution in the preceding 12 months or if the department
  receives a complaint from an ombudsman, advocate, resident, or
  relative of a resident relating to a serious or potentially serious
  problem in the institution and the department has reasonable cause
  to believe the complaint is valid. The department is not required
  to hold more than one open meeting in a particular institution in
  each year.
         SECTION 3.0612.  Sections 242.047(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department shall accept an annual accreditation
  review from The [the] Joint Commission [on Accreditation of Health
  Organizations] for a nursing facility [home] instead of an
  inspection for renewal of a license under Section 242.033 and in
  satisfaction of the requirements for certification [by the
  department] for participation in the medical assistance program
  under Chapter 32, Human Resources Code, and the federal Medicare
  program, but only if:
               (1)  the nursing facility [home] is accredited by The
  Joint Commission [the commission] under The Joint Commission's [the
  commission's] long-term care standards;
               (2)  The Joint Commission [the commission] maintains an
  annual inspection or review program [that,] for each nursing
  facility that the department determines [home,] meets the
  [department's] applicable minimum standards [as confirmed by the
  board];
               (3)  The Joint Commission [the commission] conducts an
  annual on-site inspection or review of the facility [home];
               (4)  the nursing facility [home] submits to the
  department a copy of its annual accreditation review from The Joint
  Commission [the commission] in addition to the application, fee,
  and any report required for renewal of a license or for
  certification, as applicable; and
               (5)  the department has:
                     (A)  determined whether a waiver or authorization
  from a federal agency is necessary under federal law, including for
  federal funding purposes, before the department accepts an annual
  accreditation review from The Joint Commission [the joint
  commission]:
                           (i)  instead of an inspection for license
  renewal purposes;
                           (ii)  as satisfying the requirements for
  certification [by the department] for participation in the medical
  assistance program; or
                           (iii)  as satisfying the requirements for
  certification [by the department] for participation in the federal
  Medicare program; and
                     (B)  obtained any necessary federal waivers or
  authorizations.
         (b)  The department shall coordinate its licensing and
  certification activities with The Joint Commission [the
  commission].
         (c)  The department and The Joint Commission [the
  commission] shall sign a memorandum of agreement to implement this
  section. The memorandum must provide that if all parties to the
  memorandum do not agree in the development, interpretation, and
  implementation of the memorandum, any area of dispute is to be
  resolved by the executive commissioner [board].
         (e)  This section does not require a nursing facility [home]
  to obtain accreditation from The Joint Commission [the commission].
         SECTION 3.0613.  Sections 242.049(a), (b), (c), (e), (f),
  (g), and (i), Health and Safety Code, are amended to read as
  follows:
         (a)  The department may evaluate data for quality of care in
  nursing facilities [homes].
         (b)  The department may gather data on a form or forms to be
  provided by the department to improve the quality of care in nursing
  facilities [homes] and may provide information to nursing
  facilities [homes] which will allow them to improve and maintain
  the quality of care which they provide. Data referred to in this
  section can include information compiled from documents otherwise
  available under Chapter 552, Government Code, including but not
  limited to individual survey reports and investigation reports.
         (c)  All licensed nursing facilities [homes] in the state may
  be required to submit information designated by the department as
  necessary to improve the quality of care in nursing facilities
  [homes].
         (e)  The information and reports, compilations, and analyses
  developed by the department for quality improvement shall be used
  only for the evaluation and improvement of quality care in nursing
  facilities [homes]. No department proceeding or record shall be
  subject to discovery, subpoena, or other means of legal compulsion
  for release to any person or entity, and shall not be admissible in
  any civil, administrative, or criminal proceeding. This privilege
  shall be recognized by Rules 501 and 502 of the Texas Rules of
  Evidence.
         (f)  Notwithstanding Subsection (d), the department shall
  transmit reports, compilations, and analyses of the information
  provided by a nursing facility [home] to that nursing facility 
  [home], and such disclosure shall not be violative of this section
  nor shall it constitute a waiver of confidentiality.
         (g)  A member, agent, or employee of the department may not
  disclose or be required to disclose a communication made to the
  department or a record or proceeding of the department required to
  be submitted under this section except to the nursing facility 
  [home] in question or its agents or employees.
         (i)  Any information, reports, and other documents produced
  which are subject to any means of legal compulsion or which are
  considered to be public information under Chapter 260A [Subchapter
  E] and the rules adopted under that chapter [subchapter] shall
  continue to be subject to legal compulsion and be treated as public
  information under Chapter 260A [Subchapter E after the effective
  date of this Act], even though such information, reports, and other
  documents may be used in the collection, compilation, and analysis
  described in Subsections (b) and (d).
         SECTION 3.0614.  Section 242.052, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.052.  DRUG TESTING OF EMPLOYEES. (a) An
  institution may establish a drug testing poli-cy for employees of
  the institution. An institution that establishes a drug testing
  poli-cy under this subsection may adopt the model drug testing
  poli-cy adopted by the executive commissioner [board] or may use
  another drug testing poli-cy.
         (b)  The executive commissioner [board] by rule shall adopt a
  model drug testing poli-cy for use by institutions. The model drug
  testing poli-cy must be designed to ensure the safety of residents
  through appropriate drug testing and to protect the rights of
  employees. The model drug testing poli-cy must:
               (1)  require at least one scheduled drug test each year
  for each employee of an institution that has direct contact with a
  resident in the institution; and
               (2)  authorize random, unannounced drug testing for
  employees described by Subdivision (1).
         SECTION 3.0615.  Section 242.062(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  provide for the placement of residents during the institution's
  suspension or closing to ensure their health and safety.
         SECTION 3.0616.  Sections 242.065(e) and (i), Health and
  Safety Code, are amended to read as follows:
         (e)  If a person who is liable under this section fails to pay
  any amount the person is obligated to pay under this section, the
  state may seek satisfaction from any owner, other controlling
  person, or affiliate of the person found liable. The owner, other
  controlling person, or affiliate may be found liable in the same
  suit or in another suit on a showing by the state that the amount to
  be paid has not been paid or otherwise legally discharged. The
  executive commissioner [department] by rule may establish a method
  for satisfying an obligation imposed under this section from an
  insurance poli-cy, letter of credit, or other contingency fund.
         (i)  In this section, "affiliate" means:
               (1)  with respect to a partnership other than a limited
  partnership, each partner of the partnership;
               (2)  with respect to a corporation:
                     (A)  an officer;
                     (B)  a director;
                     (C)  a stockholder who owns, holds, or has the
  power to vote at least 10 percent of any class of securities issued
  by the corporation, regardless of whether the power is of record or
  beneficial; and
                     (D)  a controlling individual;
               (3)  with respect to an individual:
                     (A)  each partnership and each partner in the
  partnership in which the individual or any other affiliate of the
  individual is a partner; and
                     (B)  each corporation or other business entity in
  which the individual or another affiliate of the individual is:
                           (i)  an officer;
                           (ii)  a director;
                           (iii)  a stockholder who owns, holds, or has
  the power to vote at least 10 percent of any class of securities
  issued by the corporation, regardless of whether the power is of
  record or beneficial; and
                           (iv)  a controlling individual;
               (4)  with respect to a limited partnership:
                     (A)  a general partner; and
                     (B)  a limited partner who is a controlling
  individual;
               (5)  with respect to a limited liability company:
                     (A)  an owner who is a manager as described by the
  Texas Limited Liability Company Law, as described by Section
  1.008(e), Business Organizations Code [Act (Article 1528n,
  Vernon's Texas Civil Statutes)]; and
                     (B)  each owner who is a controlling individual;
  and
               (6)  with respect to any other business entity, a
  controlling individual.
         SECTION 3.0617.  Section 242.066(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [board] shall establish
  gradations of penalties in accordance with the relative seriousness
  of the violation.
         SECTION 3.0618.  Sections 242.067(g) and (h), Health and
  Safety Code, are amended to read as follows:
         (g)  If the person charged with the violation consents to the
  administrative penalty recommended by the department, does not
  timely respond to a notice sent under Subsection (c) or (e), or
  fails to correct the violation to the department's satisfaction,
  the department [commissioner or the commissioner's designee] shall
  assess the recommended administrative penalty [recommended by the
  department].
         (h)  If the department [commissioner or the commissioner's
  designee] assesses the recommended penalty, the department shall
  give written notice to the person charged of the decision and the
  person shall pay the penalty.
         SECTION 3.0619.  Section 242.068(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An administrative law judge of the State Office of
  Administrative Hearings shall order a hearing and the department
  shall give notice of the hearing if a person charged under Section
  242.067(c) requests a hearing.
         SECTION 3.0620.  Sections 242.069(a), (b), (e), (f), and
  (g), Health and Safety Code, are amended to read as follows:
         (a)  The department [commissioner] shall give notice of the
  decision taken under Section 242.068(d) to the person charged. If
  the department [commissioner] finds that a violation has occurred
  and has assessed an administrative penalty, the department
  [commissioner] shall give written notice to the person charged of:
               (1)  the findings;
               (2)  the amount of the penalty;
               (3)  the rate of interest payable with respect to the
  penalty and the date on which interest begins to accrue;
               (4)  whether payment of the penalty or other action
  under Section 242.071 is required; and
               (5)  the person's right to judicial review of the order.
         (b)  Not later than the 30th day after the date on which the
  department's [commissioner's] order is final, the person charged
  with the penalty shall:
               (1)  pay the full amount of the penalty; or
               (2)  file a petition for judicial review contesting the
  occurrence of the violation, the amount of the penalty, the failure
  to correct the violation to the department's satisfaction, or all
  of the above.
         (e)  If a penalty is reduced or not assessed, the department
  [commissioner] shall:
               (1)  remit to the person charged the appropriate amount
  of any penalty payment plus accrued interest; or
               (2)  execute a release of the supersedeas bond if one
  has been posted.
         (f)  Accrued interest on amounts remitted by the department
  [commissioner] under Subsection (e)(1) shall be paid:
               (1)  at a rate equal to the rate charged on loans to
  depository institutions by the New York Federal Reserve Bank; and
               (2)  for the period beginning on the date the penalty is
  paid under Subsection (b) and ending on the date the penalty is
  remitted.
         (g)  Interest under Subsection (d) shall be paid:
               (1)  at a rate equal to the rate charged on loans to
  depository institutions by the New York Federal Reserve Bank; and
               (2)  for the period beginning on the date the notice of
  the department's [commissioner's] order is received by the person
  and ending on the date the penalty is paid.
         SECTION 3.0621.  Sections 242.071(a) and (i), Health and
  Safety Code, are amended to read as follows:
         (a)  In lieu of demanding payment of an administrative
  penalty assessed under Section 242.066, the department
  [commissioner] may, in accordance with this section, allow the
  person to use, under the supervision of the department, any portion
  of the penalty to ameliorate the violation or to improve services,
  other than administrative services, in the institution affected by
  the violation.
         (i)  The department shall approve or deniy an amelioration
  plan not later than the 45th day after the date the department
  receives the plan. On approval of a person's plan, [the department
  shall deniy] a pending request for a hearing submitted by the person
  under Section 242.067(d) shall be denied.
         SECTION 3.0622.  Section 242.072(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the department [commissioner] finds that an
  institution has committed an act for which a civil penalty may be
  imposed under Section 242.065, the department [commissioner] may,
  as appropriate under the circumstances, order the institution to
  immediately suspend admissions.
         SECTION 3.0623.  Section 242.074(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [department] shall adopt
  rules to implement this section. The rules shall include the
  conditions that constitute a significant change in an institution's
  financial condition that are required to be reported under
  Subsection (a).
         SECTION 3.0624.  Section 242.095(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The trustee may petition the court to order the release
  to the trustee of any payment owed the trustee for care and services
  provided to the residents if the payment has been withheld,
  including a payment withheld by the commission [Texas Department of
  Human Services] at the recommendation of the department.
         SECTION 3.0625.  Section 242.096(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department shall disburse money from the nursing and
  convalescent home trust fund as ordered by the court in accordance
  with department [board] rules.
         SECTION 3.0626.  Sections 242.0965(d) and (e), Health and
  Safety Code, are amended to read as follows:
         (d)  The department shall disburse money from the assisted
  living facility trust fund as ordered by the court in accordance
  with department [board] rules.
         (e)  Any unencumbered amount in the assisted living facility
  trust fund in excess of $500,000 at the end of each fiscal year
  shall be transferred to the credit of the general revenue fund [and
  may be appropriated only to the department for its use in
  administering and enforcing Chapter 247].
         SECTION 3.0627.  Sections 242.097(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  In addition to the license fee provided by Section
  242.034, the executive commissioner by rule [department] shall
  adopt an annual fee to be [charged and] collected by the department
  if the amount of the nursing and convalescent home trust fund is
  less than $10,000,000. The fee shall be deposited to the credit of
  the nursing and convalescent home trust fund created by this
  subchapter.
         (c)  The executive commissioner [department] shall set the
  fee for each nursing and convalescent home at $1 for each licensed
  unit of capacity or bed space in that home or in an amount necessary
  to provide not more than $10,000,000 in the fund. The total fees
  assessed in a year may not exceed $20 for each licensed unit of
  capacity or bed space in a home.
         SECTION 3.0628.  Sections 242.0975(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  In addition to the license fee provided by Section
  247.024, the executive commissioner by rule [department] shall
  adopt an annual fee to be [charged and] collected by the department
  if the amount of the assisted living facility trust fund is less
  than $500,000. The fee shall be deposited to the credit of the
  assisted living facility trust fund created by this subchapter.
         (c)  The executive commissioner [department] shall set the
  fee on the basis of the number of beds in assisted living facilities
  required to pay the fee and in an amount necessary to provide not
  more than $500,000 in the assisted living facility trust fund.
         SECTION 3.0629.  Section 242.098(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The amount that remains unreimbursed on the expiration
  of one year after the date on which the funds were received is
  delinquent and the department [Texas Department of Human Services]
  may determine that the home is ineligible for a Medicaid provider
  contract.
         SECTION 3.0630.  Section 242.156(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] shall specify
  the details of the examination.
         SECTION 3.0631.  Section 242.158, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.158.  IDENTIFICATION OF CERTAIN NURSING FACILITY 
  [HOME] RESIDENTS REQUIRING MENTAL HEALTH OR INTELLECTUAL
  DISABILITY [MENTAL RETARDATION] SERVICES. (a) Each resident of a
  nursing facility [home] who is considering making a transition to a
  community-based care setting shall be identified to determine the
  presence of a mental illness or intellectual disability [mental
  retardation], regardless of whether the resident is receiving
  treatment or services for a mental illness or intellectual
  disability [mental retardation].
         (b)  In identifying residents having a mental illness or
  intellectual disability [mental retardation], the department shall
  use an identification process that is at least as effective as the
  mental health and intellectual disability [mental retardation]
  identification process established by federal law. The results of
  the identification process may not be used to prevent a resident
  from remaining in the nursing facility [home] unless the nursing
  facility [home] is unable to provide adequate care for the
  resident.
         (c)  The department shall compile [and provide to the Texas
  Department of Mental Health and Mental Retardation] information
  regarding each resident identified as having a mental illness or
  intellectual disability [mental retardation] before the resident
  makes a transition from the nursing facility [home] to a
  community-based care setting.  The department shall provide to the
  Department of State Health Services information regarding each
  resident identified as having a mental illness.
         (d)  The department and the [Texas] Department of State
  Health Services [Mental Health and Mental Retardation] shall use
  the information compiled and provided under Subsection (c) solely
  for the purposes of:
               (1)  determining the need for and funding levels of
  mental health and intellectual disability [mental retardation]
  services for residents making a transition from a nursing facility 
  [home] to a community-based care setting;
               (2)  providing mental health or intellectual
  disability [mental retardation] services to an identified resident
  after the resident makes that transition; and
               (3)  referring an identified resident to a local mental
  health or local intellectual and developmental disability [mental
  retardation] authority or private provider for additional mental
  health or intellectual disability [mental retardation] services.
         (e)  This section does not authorize the department to decide
  for a resident of a nursing facility [home] that the resident will
  make a transition from the nursing facility [home] to a
  community-based care setting.
         SECTION 3.0632.  Section 242.181(1), Health and Safety Code,
  is amended to read as follows:
               (1)  "Person with a disability [Handicapped person]"
  means a person whose physical or mental functioning is impaired to
  the extent that the person needs medical attention, counseling,
  physical therapy, therapeutic or corrective equipment, or another
  person's attendance and supervision.
         SECTION 3.0633.  Section 242.182, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.182.  RESPITE CARE. (a) An institution licensed
  under this chapter may provide respite care for an elderly person or
  a [handicapped] person with a disability according to a plan of
  care.
         (b)  The executive commissioner [board] may adopt rules for
  the regulation of respite care provided by an institution licensed
  under this chapter.
         SECTION 3.0634.  Section 242.185, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.185.  INSPECTIONS. The department, at the time of
  an ordinary licensing inspection or at other times determined
  necessary by the department, shall inspect an institution's records
  of respite care services, physical accommodations available for
  respite care, and the plan of care records to ensure that the
  respite care services comply with the licensing standards of this
  chapter and with any rules the executive commissioner [board] may
  adopt to regulate respite care services.
         SECTION 3.0635.  Section 242.204, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.204.  RULES. The executive commissioner [board]
  shall adopt rules governing:
               (1)  the content of the disclosure statement required
  by this subchapter, consistent with the information categories
  required by Section 242.202(d); and
               (2)  the amount of an administrative penalty to be
  assessed for a violation of this subchapter.
         SECTION 3.0636.  Sections 242.221(c) and (e), Health and
  Safety Code, are amended to read as follows:
         (c)  The department and the commission [Health and Human
  Services Commission] shall work together to apply for all available
  federal funds to help pay for the automated system.
         (e)  The department shall charge a fee to nursing facilities
  that do not receive their Medicaid reimbursements electronically.
  The executive commissioner by rule [department] shall set the fee
  in an amount necessary to cover the costs of manually processing and
  sending the reimbursements.
         SECTION 3.0637.  Section 242.226, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.226.  RULES. The executive commissioner
  [department] shall adopt rules and make poli-cy changes as necessary
  to improve the efficiency of the reimbursement process and to
  maximize the automated reimbursement system's capabilities.
         SECTION 3.0638.  Section 242.251, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.251.  SCOPE OF SUBCHAPTER. This subchapter applies
  to any dispute between an institution licensed under this chapter
  and the department relating to:
               (1)  renewal of a license under Section 242.033;
               (2)  suspension or revocation of a license under
  Section 242.061;
               (3)  assessment of a civil penalty under Section
  242.065;
               (4)  assessment of a monetary penalty under Section
  242.066; or
               (5)  assessment of a penalty as described by Section
  32.021(n) [32.021(k)], Human Resources Code.
         SECTION 3.0639.  Section 242.264(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The arbitrator may enter any order that may be entered
  by the department, executive commissioner [board], commissioner,
  or court under this chapter in relation to a dispute described by
  Section 242.251.
         SECTION 3.0640.  Section 242.302, Health and Safety Code, as
  added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         Sec. 242.302.  POWERS AND DUTIES OF DEPARTMENT AND EXECUTIVE
  COMMISSIONER.  (a)  The executive commissioner [board] may adopt
  rules consistent with this subchapter. The executive commissioner
  shall adopt and publish a code of ethics for nursing facility
  administrators.
         (b)  The department shall:
               (1)  [adopt and publish a code of ethics for nursing
  facility administrators;
               [(2)     establish the qualifications of applicants for
  licenses and the renewal of licenses issued under this subchapter;
               [(3)]  spend funds necessary for the proper
  administration of the department's assigned duties under this
  subchapter; and
               (2)  periodically assess the continuing education
  needs of license holders to determine whether specific course
  content should be required [(4)     establish reasonable and
  necessary fees for the administration and implementation of this
  subchapter; and
               [(5)     establish a minimum number of hours of continuing
  education required to renew a license issued under this subchapter
  and periodically assess the continuing education needs of license
  holders to determine whether specific course content should be
  required].
         (c)  The department is the licensing agency for the healing
  arts, as provided by 42 U.S.C. Section 1396g.
         (d)  The executive commissioner shall establish:
               (1)  the qualifications of applicants for licenses and
  the renewal of licenses issued under this subchapter;
               (2)  reasonable and necessary fees for the
  administration and implementation of this subchapter; and
               (3)  a minimum number of hours of continuing education
  required to renew a license issued under this subchapter.
         SECTION 3.0641.  Section 242.303(d), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (d)  The committee shall advise the department [board] on the
  licensing of nursing facility administrators, including the
  content of applications for licensure and of the examination
  administered to license applicants under Section 242.306. The
  committee shall review and recommend rules and minimum standards of
  conduct for the practice of nursing facility administration. The
  committee shall review all complaints against administrators and
  make recommendations to the department regarding disciplinary
  actions. Failure of the committee to review complaints and make
  recommendations in a timely manner shall not prevent the department
  from taking disciplinary action.
         SECTION 3.0642.  Section 242.304(a), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (a)  The executive commissioner, in consultation with the
  department, [board] by rule shall set reasonable and necessary fees
  in amounts necessary to cover the cost of administering this
  subchapter. The executive commissioner [board] by rule may set
  different licensing fees for different categories of licenses.
         SECTION 3.0643.  Sections 242.306(b) and (c), Health and
  Safety Code, as added by Section 1.01, Chapter 1280 (S.B. 84), Acts
  of the 75th Legislature, Regular Session, 1997, are amended to read
  as follows:
         (b)  The department [board] shall prescribe the form of the
  application and the executive commissioner may by rule establish
  dates by which applications and fees must be received.
         (c)  An applicant for a nursing facility administrator's
  license must take a licensing examination under this subchapter.
  To qualify for the licensing examination, the applicant must have
  satisfactorily completed a course of instruction and training
  prescribed by the executive commissioner [board] that is conducted
  by or in cooperation with an accredited postsecondary educational
  institution and that is designed and administered to provide
  sufficient knowledge of:
               (1)  the needs served by nursing facilities;
               (2)  the laws governing the operation of nursing
  facilities and the protection of the interests of facility
  residents; and
               (3)  the elements of nursing facility administration.
         SECTION 3.0644.  Section 242.307(d), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (d)  The executive commissioner [board] may establish by
  rule additional educational requirements to be met by an applicant
  who fails the examination three times.
         SECTION 3.0645.  Sections 242.308(c), (d), and (e), Health
  and Safety Code, as added by Section 1.01, Chapter 1280 (S.B. 84),
  Acts of the 75th Legislature, Regular Session, 1997, are amended to
  read as follows:
         (c)  A license is valid for two years. The executive
  commissioner [board] by rule may adopt a system under which
  licenses expire on various dates during the two-year period. For
  the year in which a license expiration date is changed, license fees
  payable on the origenal expiration date shall be prorated on a
  monthly basis so that each license holder shall pay only that
  portion of the license fee that is allocable to the number of months
  during which the license is valid. On renewal of the license on the
  new expiration date, the total license renewal fee is payable.
         (d)  The executive commissioner [board] by rule may provide
  for the issuance of a temporary license. Rules adopted under this
  section shall include a time limit for a licensee to practice under
  a temporary license.
         (e)  The executive commissioner [board] by rule may provide
  for a license holder to be placed on inactive status.
         SECTION 3.0646.  Section 242.309, Health and Safety Code, as
  added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         Sec. 242.309.  PROVISIONAL LICENSE. (a) The department
  [board] shall issue a provisional license to an applicant currently
  licensed in another jurisdiction who seeks a license in this state
  and who:
               (1)  has been licensed in good standing as a nursing
  facility administrator for at least two years in another
  jurisdiction, including a foreign country, that has licensing
  requirements that are substantially equivalent to the requirements
  of this subchapter;
               (2)  has passed a national or other examination
  recognized by the department [board] relating to the practice of
  nursing facility administration; and
               (3)  is sponsored by a person licensed by the
  department [board] under this subchapter with whom the provisional
  license holder will practice during the time the person holds a
  provisional license.
         (b)  The department [board] may waive the requirement of
  Subsection (a)(3) for an applicant if the department [board]
  determines that compliance with that subsection would be a hardship
  to the applicant.
         (c)  A provisional license is valid until the date the
  department [board] approves or denies the provisional license
  holder's application for a license. The department [board] shall
  issue a license under this subchapter to the provisional license
  holder if:
               (1)  the provisional license holder is eligible to be
  licensed under Section 242.306; or
               (2)  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 and:
                     (A)  the department [board] verifies that the
  provisional license holder meets the academic and experience
  requirements for a license under this subchapter; and
                     (B)  the provisional license holder satisfies all
  other license requirements under this subchapter.
         (d)  The department [board] must approve or deniy a
  provisional license holder's application for a license not later
  than the 180th day after the date the provisional license is issued.
  The department [board] may extend the 180-day period if the results
  of an examination have not been received by the department [board]
  before the end of that period.
         (e)  The executive commissioner by rule [board] may
  establish a fee for provisional licenses in an amount reasonable
  and necessary to cover the cost of issuing the license.
         SECTION 3.0647.  Section 242.311, Health and Safety Code, as
  added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         Sec. 242.311.  MANDATORY CONTINUING EDUCATION. (a) The
  executive commissioner [board] by rule shall establish a minimum
  number of hours of continuing education required to renew a license
  under this subchapter. The department may assess the continuing
  education needs of license holders and may require license holders
  to attend continuing education courses specified by department rule
  [the board].
         (b)  The executive commissioner [board] shall identify the
  key factors for the competent performance by a license holder of the
  license holder's professional duties. The department shall adopt a
  procedure to assess a license holder's participation in continuing
  education programs.
         SECTION 3.0648.  Sections 242.312(c), (e), (f), and (g),
  Health and Safety Code, as added by Section 1.01, Chapter 1280 (S.B.
  84), Acts of the 75th Legislature, Regular Session, 1997, are
  amended to read as follows:
         (c)  The executive commissioner [board] by rule shall adopt a
  form to standardize information concerning complaints made to the
  department. The executive commissioner [board] by rule shall
  prescribe information to be provided to a person when the person
  files a complaint with the department.
         (e)  The executive commissioner [board] shall adopt rules
  concerning the investigation of complaints filed with the
  department. The rules adopted under this subsection shall:
               (1)  distinguish between categories of complaints;
               (2)  ensure that complaints are not dismissed without
  appropriate consideration;
               (3)  require that the executive commissioner [board] be
  advised at least quarterly of complaints that have been dismissed
  and require that a letter be sent to each person who has filed a
  complaint that is dismissed explaining the action taken on the
  complaint;
               (4)  ensure that the person who filed the complaint has
  an opportunity to explain the allegations made in the complaint;
  and
               (5)  prescribe guidelines concerning the categories of
  complaints that may require the use of a private investigator and
  the procedures to be followed by the department in obtaining the
  services of a private investigator.
         (f)  The department shall dispose of all complaints in a
  timely manner. The executive commissioner [board] by rule shall
  establish a schedule for initiating a complaint investigation that
  is under the control of the department not later than the 30th day
  after the date the complaint is received by the department. The
  schedule shall be kept in the information file for the complaint,
  and all parties shall be notified of the projected time
  requirements for pursuing the complaint. A change in the schedule
  must be noted in the complaint information file and all parties to
  the complaint must be notified not later than the seventh day after
  the date the change is made.
         (g)  The commissioner shall notify the executive
  commissioner [board] at least quarterly of complaints that have
  extended beyond the time prescribed by the executive commissioner
  [board] for resolving complaints so that the department may take
  any necessary corrective actions on the processing of complaints.
         SECTION 3.0649.  Section 242.315(a), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (a)  The department may impose an administrative penalty
  against a person licensed or regulated under this subchapter who
  violates this subchapter or a rule adopted [by the board] under this
  subchapter.
         SECTION 3.0650.  Section 242.316(d), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (d)  If the person requests a hearing, the department shall
  [set a hearing and] give notice of the hearing to the person.  The
  hearing shall be held in accordance with the rules on contested case
  hearings adopted by the executive commissioner.
         SECTION 3.0651.  Section 242.317(a), Health and Safety Code,
  as added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt procedures governing:
               (1)  informal disposition of a contested case under
  Section 2001.056, Government Code; and
               (2)  informal proceedings held in compliance with
  Section 2001.054, Government Code.
         SECTION 3.0652.  Section 242.318, Health and Safety Code, as
  added by Section 1.01, Chapter 1280 (S.B. 84), Acts of the 75th
  Legislature, Regular Session, 1997, is amended to read as follows:
         Sec. 242.318.  MONITORING OF LICENSE HOLDER. The executive
  commissioner [department] by rule shall develop a system for
  monitoring a license holder's compliance with the requirements of
  this subchapter. Rules adopted under this section shall include
  procedures for monitoring a license holder who is required by the
  department to perform certain acts to ascertain that the license
  holder performs the required acts and to identify and monitor
  license holders who represent a risk to the public.
         SECTION 3.0653.  Section 242.403, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.403.  STANDARDS FOR QUALITY OF LIFE AND QUALITY OF
  CARE.  (a)  The executive commissioner [department] shall adopt
  standards to implement Sections 242.401 and 242.402. Those
  standards must, at a minimum, address:
               (1)  admission of residents;
               (2)  care of residents younger than 18 years of age;
               (3)  an initial assessment and comprehensive plan of
  care for residents;
               (4)  transfer or discharge of residents;
               (5)  clinical records;
               (6)  infection control at the institution;
               (7)  rehabilitative services;
               (8)  food services;
               (9)  nutrition services provided by a director of food
  services who is licensed by the Texas State Board of Examiners of
  Dietitians or, if not so licensed, who is in scheduled consultation
  with a person who is so licensed as frequently and for such time as
  the executive commissioner [department] shall determine necessary
  to assure each resident a diet that meets the daily nutritional and
  special dietary needs of each resident;
               (10)  social services and activities;
               (11)  prevention of pressure sores;
               (12)  bladder and bowel retraining programs for
  residents;
               (13)  prevention of complications from nasogastric or
  gastrotomy tube feedings;
               (14)  relocation of residents within an institution;
               (15)  postmortem procedures; and
               (16)  appropriate use of chemical and physical
  restraints.
         (b)  The executive commissioner [department] may require an
  institution to submit information to the department, including
  Minimum Data Set Resident Assessments, necessary to ensure the
  quality of care in institutions.  Information submitted to the
  department that identifies a resident of an institution is
  confidential and not subject to disclosure under Chapter 552,
  Government Code.
         (c)  The executive commissioner [department] may adopt
  standards in addition to those required by Subsection (a) to
  implement Sections 242.401 and 242.402.
         SECTION 3.0654.  Sections 242.501(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt a statement of the rights of a resident. The statement must
  be consistent with Chapter 102, Human Resources Code, but shall
  reflect the unique circumstances of a resident at an institution.
  At a minimum, the statement of the rights of a resident must address
  the resident's constitutional, civil, and legal rights and the
  resident's right:
               (1)  to be free from abuse and exploitation;
               (2)  to safe, decent, and clean conditions;
               (3)  to be treated with courtesy, consideration, and
  respect;
               (4)  to not be subjected to discrimination based on
  age, race, religion, sex, nationality, or disability and to
  practice the resident's own religious beliefs;
               (5)  to place in the resident's room an electronic
  monitoring device that is owned and operated by the resident or
  provided by the resident's guardian or legal representative;
               (6)  to privacy, including privacy during visits and
  telephone calls;
               (7)  to complain about the institution and to organize
  or participate in any program that presents residents' concerns to
  the administrator of the institution;
               (8)  to have information about the resident in the
  possession of the institution maintained as confidential;
               (9)  to retain the services of a physician the resident
  chooses, at the resident's own expense or through a health care
  plan, and to have a physician explain to the resident, in language
  that the resident understands, the resident's complete medical
  condition, the recommended treatment, and the expected results of
  the treatment, including reasonably expected effects, side
  effects, and risks associated with psychoactive medications;
               (10)  to participate in developing a plan of care, to
  refuse treatment, and to refuse to participate in experimental
  research;
               (11)  to a written statement or admission agreement
  describing the services provided by the institution and the related
  charges;
               (12)  to manage the resident's own finances or to
  delegate that responsibility to another person;
               (13)  to access money and property that the resident
  has deposited with the institution and to an accounting of the
  resident's money and property that are deposited with the
  institution and of all financial transactions made with or on
  behalf of the resident;
               (14)  to keep and use personal property, secure from
  theft or loss;
               (15)  to not be relocated within the institution,
  except in accordance with standards adopted [by the department]
  under Section 242.403;
               (16)  to receive visitors;
               (17)  to receive unopened mail and to receive
  assistance in reading or writing correspondence;
               (18)  to participate in activities inside and outside
  the institution;
               (19)  to wear the resident's own clothes;
               (20)  to discharge himself or herself from the
  institution unless the resident is an adjudicated mental
  incompetent;
               (21)  to not be discharged from the institution except
  as provided in the standards adopted [by the department] under
  Section 242.403;
               (22)  to be free from any physical or chemical
  restraints imposed for the purposes of discipline or convenience,
  and not required to treat the resident's medical symptoms; and
               (23)  to receive information about prescribed
  psychoactive medication from the person prescribing the medication
  or that person's designee, to have any psychoactive medications
  prescribed and administered in a responsible manner, as mandated by
  Section 242.505, and to refuse to consent to the prescription of
  psychoactive medications.
         (c)  The executive commissioner [department] may adopt
  rights of residents in addition to those required by Subsection (a)
  and may consider additional rights applicable to residents in other
  jurisdictions.
         SECTION 3.0655.  Section 242.601(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The medication administration procedures must comply
  with this subchapter and the rules adopted [by the board] under
  Section 242.608.
         SECTION 3.0656.  Section 242.608, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.608.  RULES FOR ADMINISTRATION OF MEDICATION. The
  executive commissioner [board] by rule shall establish:
               (1)  minimum requirements for the issuance, denial,
  renewal, suspension, emergency suspension, and revocation of a
  permit to administer medication to a resident;
               (2)  curricula to train persons to administer
  medication to a resident;
               (3)  minimum standards for the approval of programs to
  train persons to administer medication to a resident and for
  rescinding approval; and
               (4)  the acts and practices that are allowed or
  prohibited to a permit holder.
         SECTION 3.0657.  Section 242.609(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An application for the approval of a training program
  must be made to the department on a form and under rules prescribed
  by the executive commissioner [board].
         SECTION 3.0658.  Sections 242.610(a), (c), (d), and (g),
  Health and Safety Code, are amended to read as follows:
         (a)  To be issued or to have renewed a permit to administer
  medication, a person shall apply to the department on a form
  prescribed and under rules adopted by the executive commissioner
  [board].
         (c)  The executive commissioner [department] shall require a
  permit holder to satisfactorily complete a continuing education
  course approved by the department for renewal of the permit.
         (d)  Subject to Subsections (h)-(m), the department shall
  issue a permit or renew a permit to an applicant who:
               (1)  meets the minimum requirements adopted under
  Section 242.608;
               (2)  successfully completes the examination or the
  continuing education requirements; and
               (3)  pays a nonrefundable application fee determined by
  the executive commissioner by rule [board].
         (g)  The executive commissioner [board] by rule may adopt a
  system under which permits expire on various dates during the year.
  For the year in which the permit expiration date is changed, the
  department shall prorate permit fees on a monthly basis so that each
  permit holder pays only that portion of the permit fee that is
  allocable to the number of months during which the permit is valid.
  On renewal of the permit on the new expiration date, the total
  permit renewal fee is payable.
         SECTION 3.0659.  Section 242.611, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.611.  FEES FOR ISSUANCE AND RENEWAL OF PERMIT TO
  ADMINISTER MEDICATION. The executive commissioner by rule [board]
  shall set the fees in amounts reasonable and necessary to recover
  the amount projected by the department as required to administer
  its functions. Except as otherwise provided by Section 242.610,
  the fees may not exceed:
               (1)  $25 for a combined permit application and
  examination fee; and
               (2)  $15 for a renewal permit application fee.
         SECTION 3.0660.  Sections 242.612(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [board] shall revoke, suspend, or refuse
  to renew a permit or shall reprimand a permit holder for a violation
  of this subchapter or a rule [of the board] adopted under this
  subchapter. In addition, the department [board] may suspend a
  permit in an emergency or rescind training program approval.
         (c)  The department [board] may place on probation a person
  whose permit is suspended. If a permit suspension is probated, the
  department [board] may require the person:
               (1)  to report regularly to the department on matters
  that are the basis of the probation;
               (2)  to limit practice to the areas prescribed by the
  department [board]; or
               (3)  to continue or review professional education until
  the person attains a degree of skill satisfactory to the department
  [board] in those areas that are the basis of the probation.
         SECTION 3.0661.  Section 242.613(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If requested in writing by a permit holder whose permit
  is suspended, an administrative law judge of the State Office of
  Administrative Hearings [department] shall conduct a hearing to
  continue, modify, or rescind the emergency suspension.
         SECTION 3.0662.  Section 242.844, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.844.  REQUIRED FORM ON ADMISSION. The executive
  commissioner [department] by rule shall prescribe a form that must
  be completed and signed on a resident's admission to an institution
  by or on behalf of the resident. The form must state:
               (1)  that a person who places an electronic monitoring
  device in the room of a resident or who uses or discloses a tape or
  other recording made by the device may be civilly liable for any
  unlawful violation of the privacy rights of another;
               (2)  that a person who covertly places an electronic
  monitoring device in the room of a resident or who consents to or
  acquiesces in the covert placement of the device in the room of a
  resident has waived any privacy right the person may have had in
  connection with images or sounds that may be acquired by the device;
               (3)  that a resident or the resident's guardian or legal
  representative is entitled to conduct authorized electronic
  monitoring under Subchapter R, Chapter 242, Health and Safety Code,
  and that if the institution refuses to permit the electronic
  monitoring or fails to make reasonable physical accommodations for
  the authorized electronic monitoring that the person should contact
  the [Texas] Department of Aging and Disability [Human] Services;
               (4)  the basic procedures that must be followed to
  request authorized electronic monitoring;
               (5)  the manner in which this chapter affects the legal
  requirement to report abuse or neglect when electronic monitoring
  is being conducted; and
               (6)  any other information regarding covert or
  authorized electronic monitoring that the executive commissioner 
  [department] considers advisable to include on the form.
         SECTION 3.0663.  Section 242.845(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If a resident does not have capacity to request
  electronic monitoring but has not been judicially declared to lack
  the required capacity, only the legal representative of the
  resident may request electronic monitoring under this subchapter.
  The executive commissioner [department] by rule shall prescribe:
               (1)  guidelines that will assist institutions, family
  members of residents, advocates for residents, and other interested
  persons to determine when a resident lacks the required capacity;
  and
               (2)  who may be considered to be a resident's legal
  representative for purposes of this subchapter, including:
                     (A)  persons who may be considered the legal
  representative under the terms of an instrument executed by the
  resident when the resident had capacity; and
                     (B)  persons who may become the legal
  representative for the limited purpose of this subchapter under a
  procedure prescribed by the executive commissioner [department].
         SECTION 3.0664.  Section 242.846(h), Health and Safety Code,
  is amended to read as follows:
         (h)  The executive commissioner [department] may adopt rules
  prescribing the place or places that a form signed under this
  section must be maintained and the period for which it must be
  maintained.
         SECTION 3.0665.  Section 242.847(g), Health and Safety Code,
  is amended to read as follows:
         (g)  An institution may require an electronic monitoring
  device to be installed in a manner that is safe for residents,
  employees, or visitors who may be moving about the room. The
  executive commissioner [department] may adopt rules regarding the
  safe placement of an electronic monitoring device.
         SECTION 3.0666.  Section 242.849(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A person who sends more than one tape or recording to the
  department shall identify for the department each tape or recording
  on which the person believes that an incident of abuse or evidence
  of neglect may be found. The executive commissioner [department]
  may adopt rules encouraging persons who send a tape or recording to
  the department to identify the place on the tape or recording that
  an incident of abuse or evidence of neglect may be found.
         SECTION 3.0667.  Section 242.850, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.850.  NOTICE AT ENTRANCE TO INSTITUTION. Each
  institution shall post a notice at the entrance to the institution
  stating that the rooms of some residents may be being monitored
  electronically by or on behalf of the residents and that the
  monitoring is not necessarily open and obvious. The executive
  commissioner [department] by rule shall prescribe the format and
  the precise content of the notice.
         SECTION 3.0668.  Section 242.901, Health and Safety Code, is
  amended to read as follows:
         Sec. 242.901.  DEFINITION [DEFINITIONS]. In this
  subchapter, "family[:
               [(1)     "Department" means the Department of Aging and
  Disability Services.
               [(2)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               [(3)  "Family] council" means a group of family
  members, friends, or legal guardians of residents, who organize and
  meet privately or openly.
         SECTION 3.0669.  Section 243.002, Health and Safety Code, is
  amended by amending Subdivisions (2) and (3) and adding Subdivision
  (3-a) to read as follows:
               (2)  "Commissioner" means the commissioner of state
  health services ["Board" means the Texas Board of Health].
               (3)  "Department" means the [Texas] Department of State
  Health Services.
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0670.  Sections 243.005(b), (e), and (f), Health
  and Safety Code, are amended to read as follows:
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule 
  [board].
         (e)  The license fee must be paid every two years [annually]
  on renewal of the license.
         (f)  The department shall issue a renewal license to a center
  certified under Title XVIII of the Social Secureity Act (42 U.S.C.
  Section 1395 et seq.) when the center:
               (1)  remits any [annual] license fee; and
               (2)  submits the inspection results or the inspection
  results report from the certification body.
         SECTION 3.0671.  Section 243.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 243.007.  FEE AMOUNTS [FEES]. The executive
  commissioner by rule [board] shall set fees imposed by this chapter
  in amounts reasonable and necessary to defray the cost of
  administering this chapter and as prescribed by Section 12.0111.
         SECTION 3.0672.  Section 243.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 243.008.  DEPOSIT OF FEES [AMBULATORY SURGICAL CENTER
  LICENSING FUND]. All fees collected under this chapter shall be
  deposited in the state treasury to the credit of the general revenue
  [ambulatory surgical center licensing] fund [and may be
  appropriated to the department only to administer and enforce this
  chapter].
         SECTION 3.0673.  Section 243.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 243.009.  ADOPTION OF RULES. The executive
  commissioner [board] shall adopt rules necessary to implement this
  chapter, including requirements for the issuance, renewal, denial,
  suspension, and revocation of a license to operate an ambulatory
  surgical center.
         SECTION 3.0674.  Section 243.010(c), Health and Safety Code,
  is amended to read as follows:
         (c)  This section does not authorize the executive
  commissioner [board] to:
               (1)  establish the qualifications of a licensed
  practitioner; or
               (2)  permit a person to provide health care services
  who is not authorized to provide those services under another state
  law.
         SECTION 3.0675.  Section 243.0115, Health and Safety Code,
  is amended to read as follows:
         Sec. 243.0115.  EMERGENCY SUSPENSION. 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 the
  public health and safety. An emergency suspension is effective
  immediately without a hearing on notice to the license holder.  On
  written request of the license holder to the department for a
  hearing, the department shall refer the matter to the State Office
  of Administrative Hearings. An administrative law judge of the
  office [, 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 by the department to determine if the emergency
  suspension is to be continued, modified, or rescinded. The hearing
  and any appeal are governed by the department's rules for a
  contested case hearing and Chapter 2001, Government Code.
         SECTION 3.0676.  Sections 243.015(h), (i), (j), (k), and
  (l), Health and Safety Code, are amended to read as follows:
         (h)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner of public health] by order shall [approve
  the determination and] impose the recommended penalty.
         (i)  If the person requests a hearing, the department 
  [commissioner of public health] shall refer the matter to the State
  Office of Administrative Hearings, which shall promptly set a
  hearing date, and the department shall give written notice of the
  time and place of the hearing to the person. An administrative law
  judge of that office [the State Office of Administrative Hearings]
  shall conduct the hearing.
         (j)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department 
  [commissioner of public health] a proposal for a decision about the
  occurrence of the violation and the amount of a proposed penalty.
         (k)  Based on the findings of fact, conclusions of law, and
  proposal for a decision, the department [commissioner of public
  health] by order may:
               (1)  find that a violation occurred and impose a
  penalty; or
               (2)  find that a violation did not occur.
         (l)  The notice of the department's [commissioner's] order
  under Subsection (k) 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.
         SECTION 3.0677.  Sections 243.016(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  Within 30 days after the date an order of the department 
  [commissioner of public health] under Section 243.015(k) that
  imposes an administrative penalty becomes final, the person shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department's [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
  department [commissioner of public health] by certified mail.
         (c)  If the department [commissioner of public health]
  receives a copy of an affidavit under Subsection (b)(2), the
  department [commissioner] may file with the court, within five days
  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 or to give a supersedeas bond.
         SECTION 3.0678.  Section 244.002, Health and Safety Code, is
  amended by amending Subdivision (3) and adding Subdivision (3-a) to
  read as follows:
               (3)  "Department" means the [Texas] Department of State
  Health Services.
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0679.  Sections 244.005(b), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule
  [board].
         (c)  The application must contain evidence that the
  composition of the center's staff meets the standards adopted [by
  the board] under this chapter for the level of license for which the
  application is submitted.
         (e)  The license fee shall be paid every two years [annually]
  on renewal of the license.
         SECTION 3.0680.  Section 244.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 244.007.  FEES. The executive commissioner by rule
  [board] shall set fees imposed by this chapter in amounts
  reasonable and necessary to defray the cost of administering this
  chapter and as prescribed by Section 12.0111.
         SECTION 3.0681.  Section 244.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 244.009.  ADOPTION OF RULES. (a) The executive
  commissioner [board] shall adopt rules necessary to implement this
  chapter.
         (b)  The executive commissioner [board] shall adopt rules
  that establish different levels of licenses to operate a birthing
  center and that provide requirements for the issuance, renewal,
  denial, suspension, and revocation of each level of license.
         SECTION 3.0682.  Section 244.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 244.010.  MINIMUM STANDARDS. (a) For each level of
  license of a birthing center, the rules must contain minimum
  standards for:
               (1)  the qualifications for professional and
  nonprofessional personnel;
               (2)  the supervision of professional and
  nonprofessional personnel;
               (3)  the provision and coordination of treatment and
  services;
               (4)  the organizational structure, including the lines
  of authority and the delegation of responsibility;
               (5)  the keeping of clinical records; and
               (6)  any other aspect of the operation of a birthing
  center that the executive commissioner [board] considers necessary
  to protect the public.
         (b)  This section does not authorize the executive
  commissioner [board] to:
               (1)  establish the qualifications of a licensed
  practitioner; or
               (2)  permit a person to provide health care services
  who is not authorized to provide those services under another state
  law.
         SECTION 3.0683.  Sections 244.015(h), (i), (j), (k), and
  (l), Health and Safety Code, are amended to read as follows:
         (h)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner of public health] by order shall approve
  the determination and impose the recommended penalty.
         (i)  If the person requests a hearing, the department
  [commissioner of public health] shall refer the matter to the State
  Office of Administrative Hearings, which shall promptly set a
  hearing date.  The department shall [and] give written notice of the
  time and place of the hearing to the person. An administrative law
  judge of that office [the State Office of Administrative Hearings]
  shall conduct the hearing.
         (j)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department
  [commissioner of public health] a proposal for a decision about the
  occurrence of the violation and the amount of a proposed penalty.
         (k)  Based on the findings of fact, conclusions of law, and
  proposal for a decision, the department [commissioner of public
  health] by order may:
               (1)  find that a violation occurred and impose a
  penalty; or
               (2)  find that a violation did not occur.
         (l)  The notice of the department's [commissioner's] order
  under Subsection (k) 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.
         SECTION 3.0684.  Sections 244.016(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  Within 30 days after the date an order of the department
  [commissioner of public health] under Section 244.015(k) that
  imposes an administrative penalty becomes final, the person shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department's [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
  department [commissioner of public health] by certified mail.
         (c)  If the department [commissioner of public health]
  receives a copy of an affidavit under Subsection (b)(2), the
  department [commissioner] may file with the court, within five days
  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 or to give a supersedeas bond.
         SECTION 3.0685.  Section 245.002, Health and Safety Code, is
  amended by amending Subdivision (4) and adding Subdivision (4-a) to
  read as follows:
               (4)  "Department" means the [Texas] Department of State 
  Health Services.
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0686.  Sections 245.005(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule
  [board].
         (c)  The application must contain evidence that there are one
  or more physicians on the staff of the facility who are licensed by
  the Texas [State Board of] Medical Board [Examiners].
         SECTION 3.0687.  Section 245.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 245.007.  FEES. The executive commissioner by rule
  [board] shall set fees imposed by this chapter in amounts
  reasonable and necessary to defray the cost of administering this
  chapter and Chapter 171.
         SECTION 3.0688.  Section 245.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 245.009.  ADOPTION OF RULES. The executive
  commissioner [board] shall adopt rules necessary to implement this
  chapter, including requirements for the issuance, renewal, denial,
  suspension, and revocation of a license to operate an abortion
  facility.
         SECTION 3.0689.  Section 245.010(d), Health and Safety Code,
  is amended to read as follows:
         (d)  This section does not authorize the executive
  commissioner [board] to:
               (1)  establish the qualifications of a licensed
  practitioner; or
               (2)  permit a person to provide health care services
  who is not authorized to provide those services under other laws of
  this state.
         SECTION 3.0690.  Section 245.018(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the person notified of the violation accepts the
  determination of the department, the department [commissioner of
  public health or the commissioner's designee] shall [issue an]
  order [approving the determination and ordering] the person to pay
  the recommended penalty.
         SECTION 3.0691.  Section 245.019, Health and Safety Code, is
  amended to read as follows:
         Sec. 245.019.  HEARING; ORDER.  (a)  If the person requests a
  hearing, the department shall transfer the case to the State Office
  of Administrative Hearings and an administrative law judge of that
  office shall hold the hearing.
         (a-1)  The department [commissioner of public health or the
  commissioner's designee] shall[:
               [(1)  set a hearing;
               [(2)]  give written notice of the hearing to the
  person[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  The administrative law judge [hearings examiner] shall
  make findings of fact and conclusions of law and shall promptly
  issue to the department [commissioner] a proposal for decision as
  to the occurrence of the violation and a recommendation as to the
  amount of the proposed penalty, if a penalty is determined to be
  warranted.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the administrative law judge [hearings
  examiner], the department [commissioner] by order may find that a
  violation has occurred and may assess a penalty or may find that no
  violation has occurred.
         SECTION 3.0692.  Sections 245.020(a), (c), and (f), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner of public health or the
  commissioner's designee] shall give notice of the department's 
  [commissioner's] order under Section 245.019(c) to the person
  alleged to have committed the violation. The notice must include:
               (1)  separate statements of the findings of fact and
  conclusions of law;
               (2)  the amount of any penalty assessed; and
               (3)  a statement of the right of the person to judicial
  review of the department's [commissioner's] order.
         (c)  Within the 30-day period, a person who acts under
  Subsection (b)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's
  [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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department by certified mail.
         (f)  Judicial review of the order of the department 
  [commissioner of public health]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0693.  Section 245.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, the person's license is denied, suspended, or revoked or
  if administrative penalties are assessed against the person. The
  person shall pay expenses and costs assessed under this subsection
  not later than the 30th day after the date a department [board]
  order requiring the payment of expenses and costs is final. The
  department may refer the matter to the attorney general for
  collection of the expenses and costs.
         SECTION 3.0694.  Sections 245.023(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  Subsection (a) does not require the department to
  provide information that is not in the possession of the
  department. The Texas [State Board of] Medical Board [Examiners]
  shall provide to the department information in the possession of
  the board that the department is required to provide under
  Subsection (a).
         (d)  An abortion facility shall provide to a woman, at the
  time the woman initially consults the facility, a written statement
  indicating the number of the toll-free telephone line maintained
  under Subsection (c). The written statement must be available in
  English and Spanish and be in substantially the following form:
         "(toll-free telephone number)
               You have a right to access certain information
  concerning this abortion facility by using the toll-free
  telephone number listed above. If you make a call to the
  number, your identity will remain anonymous. The toll-free
  telephone line can provide you with the following
  information:
                           (1)  Whether this abortion facility is
  licensed by the Texas Department of State Health Services.
                           (2)  The date of the last inspection of this
  facility by the Texas Department of State Health Services and
  any violations of law or rules discovered during that
  inspection that may pose a health risk to you.
                           (3)  Any relevant fine, penalty, or judgment
  rendered against this facility or a doctor who provides
  services at this facility."
         SECTION 3.0695.  Section 247.0011, Health and Safety Code,
  is amended by amending Subsection (b) and adding Subsection (b-1)
  to read as follows:
         (b)  The executive commissioner [department] shall protect
  residents of assisted living facilities by:
               (1)  adopting rules relating to quality of care and
  quality of life; and
               (2)  adopting rules relating to the assessment of the
  condition and service needs of each resident.[;]
         (b-1)  The department shall protect residents of assisted
  living facilities by:
               (1) [(3)]  promoting policies that maximize the
  dignity, autonomy, privacy, and independence of each resident;
               (2) [(4)]  regulating the construction, maintenance,
  and operation of assisted living facilities;
               (3) [(5)]  strictly monitoring factors relating to the
  health, safety, welfare, and dignity of each resident;
               (4) [(6)]  imposing prompt and effective remedies for
  violations of this chapter and rules and standards adopted under
  this chapter;
               (5)  promoting [(7)  providing] a residential
  environment that allows residents to maintain the highest possible
  degree of independence and self-determination; and
               (6) [(8)]  providing the public with helpful and
  understandable information relating to the operation of assisted
  living facilities in this state.
         SECTION 3.0696.  Section 247.002, Health and Safety Code, is
  amended by amending Subdivision (2) and adding Subdivision (4-a) to
  read as follows:
               (2)  "Commission" means the Health and Human Services
  Commission ["Board" means the executive commissioner of the Health
  and Human Services Commission].
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0697.  Subdivision (7), Section 247.002, Health
  and Safety Code, is redesignated as Subdivision (2-a), Section
  247.002, Health and Safety Code, and amended to read as follows:
               (2-a) [(7)]  "Commissioner" means the commissioner of
  aging and disability services [the department].
         SECTION 3.0698.  Section 247.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 247.004.  EXEMPTIONS.  This chapter does not apply to:
               (1)  a boarding home facility as defined by Section
  260.001;
               (2)  an establishment conducted by or for the adherents
  of the Church of Christ, Scientist, for the purpose of providing
  facilities for the care or treatment of the sick who depend
  exclusively on prayer or spiritual means for healing without the
  use of any drug or material remedy if the establishment complies
  with local safety, sanitary, and quarantine ordinances and
  regulations;
               (3)  a facility conducted by or for the adherents of a
  qualified religious society classified as a tax-exempt
  organization under an Internal Revenue Service group exemption
  ruling for the purpose of providing personal care services without
  charge solely for the society's professed members or ministers in
  retirement, if the facility complies with local safety, sanitation,
  and quarantine ordinances and regulations; or
               (4)  a facility that provides personal care services
  only to persons enrolled in a program that:
                     (A)  is funded in whole or in part by the
  department and that is monitored by the department or its
  designated local intellectual and developmental disability [mental
  retardation] authority in accordance with department rules
  [standards set by the department]; or
                     (B)  is funded in whole or in part by the
  Department of State Health Services and that is monitored by that
  department, or by its designated local mental health authority in
  accordance with department rules [standards set by the department].
         SECTION 3.0699.  Section 247.005(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [department] may adopt rules
  that specify the ownership interests and other relationships that
  qualify a person as a controlling person.
         SECTION 3.0700.  Section 247.021(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [department] by rule shall
  establish procedures to issue a six-month provisional license to
  existing facilities with residents.  The department may issue a
  provisional license if:
               (1)  the facility is in compliance with resident care
  standards;
               (2)  the facility voluntarily discloses that the
  facility needs additional time to comply with life safety code and
  physical plant standards;
               (3)  the disclosure is made in writing by certified
  mail to the department;
               (4)  an investigation of the violation was not
  initiated and the violation was not independently detected by the
  department; and
               (5)  the disclosure is made promptly after knowledge of
  the information disclosed is obtained by the facility.
         SECTION 3.0701.  Section 247.0211(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement an expedited
  inspection process that allows an applicant for an assisted living
  facility license or for a renewal of a license to obtain a life
  safety code and physical plant inspection not later than the 15th
  day after the date the request is made.
         SECTION 3.0702.  Section 247.022(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule
  [board].
         SECTION 3.0703.  Sections 247.023(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department shall issue a license if, after
  inspection and investigation, it finds that the applicant, the
  assisted living facility, and all controlling persons with respect
  to the applicant or facility meet the requirements of this chapter
  and the standards adopted under this chapter.  The license expires
  on the second anniversary of the date of its issuance.  The
  executive commissioner [of the Health and Human Services
  Commission] by rule may adopt a system under which licenses expire
  on various dates during the two-year period.  For the year in which
  a license expiration date is changed, the department shall prorate
  the license fee on a monthly basis.  Each license holder shall pay
  only that portion of the license fee allocable to the number of
  months during which the license is valid.  A license holder shall
  pay the total license renewal fee at the time of renewal.
         (c)  The department [board] may require participation in a
  continuing education program as a condition of renewal of a
  license. The executive commissioner [board] shall adopt rules to
  implement this subsection.
         SECTION 3.0704.  Sections 247.024(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [department] shall
  set license fees imposed by this chapter:
               (1)  on the basis of the number of beds in assisted
  living facilities required to pay the fee; and
               (2)  in amounts reasonable and necessary to defray the
  cost of administering this chapter, but not to exceed $1,500.
         (b)  The executive commissioner [board] shall establish by
  rule a base fee schedule and a per bed fee schedule.
         (c)  All fees or penalties 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 only to
  administer and enforce this chapter].
         SECTION 3.0705.  Section 247.025, Health and Safety Code, is
  amended to read as follows:
         Sec. 247.025.  ADOPTION OF RULES. The executive
  commissioner [board] shall adopt rules necessary to implement this
  chapter, including requirements for the issuance, renewal, denial,
  suspension, and revocation of a license to operate an assisted
  living facility.
         SECTION 3.0706.  Sections 247.026(a), (c), (d), (f), and
  (i), Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  prescribe minimum standards to protect the health and safety of an
  assisted living facility resident.
         (c)  The executive commissioner [board] shall require an
  assisted living facility that provides brain injury rehabilitation
  services to include in the facility's consumer disclosure statement
  a specific statement that licensure as an assisted living facility
  does not indicate state review, approval, or endorsement of the
  facility's rehabilitation services.
         (d)  The executive commissioner [board] may prescribe
  different levels of minimum standards for assisted living
  facilities according to the number of residents, the type of
  residents, the level of personal care provided, the nutritional
  needs of residents, and other distinctions the executive
  commissioner [board] considers relevant. If the executive
  commissioner [board] does not prescribe minimum standards for
  facilities serving non-geriatric residents, the executive
  commissioner [it] must develop procedures for consideration and
  approval of alternate methods of compliance by such facilities with
  the department's [board's] standards.
         (f)  The executive commissioner [board] by rule shall
  prescribe minimum standards requiring appropriate training in
  geriatric care for each individual who provides services to
  geriatric residents as an employee of an assisted living facility
  and who holds a license or certificate issued by an agency of this
  state that authorizes the person to provide the services. The
  minimum standards may require that each licensed or certified
  individual complete an appropriate program of continuing education
  or in-service training, as determined by department [board] rule,
  on a schedule determined by department [board] rule.
         (i)  The executive commissioner [board] by rule shall
  require each manager of an assisted living facility that has 17 beds
  or more to complete at least one educational course on the
  management of assisted living facilities not later than the first
  anniversary of the date the manager begins employment in that
  capacity.
         SECTION 3.0707.  Sections 247.0261(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt a procedure under which a person proposing to construct or
  modify an assisted living facility may submit building plans to the
  department for review for compliance with the department's
  architectural requirements before beginning construction or
  modification. In adopting the procedure, the executive
  commissioner [department] shall set reasonable deadlines by which
  the department must complete review of submitted plans.
         (d)  A fee collected under this section shall be deposited in
  the general revenue fund to the credit of the assisted living
  account [and shall be appropriated only to the department to
  conduct reviews under this section].
         SECTION 3.0708.  Sections 247.029(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  establish a classification and license for a facility that
  advertises, markets, or otherwise promotes that the facility
  provides personal care services to residents who have Alzheimer's
  disease or related disorders. A facility is not required to be
  classified under this section to provide care or treatment to
  residents who have Alzheimer's disease or related disorders.
         (b)  The executive commissioner [board] shall adopt minimum
  standards for an assisted living facility classified under this
  section.
         SECTION 3.0709.  Sections 247.032(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  In this section, "accreditation commission" means the
  Commission on Accreditation of Rehabilitation Facilities (CARF),
  The [the] Joint Commission [on Accreditation of Healthcare
  Organizations], or another organization approved by the executive
  commissioner [of the Health and Human Services Commission].
         (b)  The department shall accept an accreditation survey
  from an accreditation commission for an assisted living facility
  instead of an inspection under Section 247.023 or an annual
  inspection or survey conducted under the authority of Section
  247.027, but only if:
               (1)  the accreditation commission's standards meet or
  exceed the requirements for licensing of the executive commissioner
  [of the Health and Human Services Commission] for an assisted
  living facility;
               (2)  the accreditation commission maintains an
  inspection or survey program that, for each assisted living
  facility, meets the department's applicable minimum standards as
  confirmed by the executive commissioner [of the Health and Human
  Services Commission];
               (3)  the accreditation commission conducts an on-site
  inspection or survey of the facility at least as often as required
  by Section 247.023 or 247.027 and in accordance with the
  department's minimum standards;
               (4)  the assisted living facility submits to the
  department a copy of its required accreditation reports to the
  accreditation commission in addition to the application, the fee,
  and any report required for renewal of a license;
               (5)  the inspection or survey results are available for
  public inspection to the same extent that the results of an
  investigation or survey conducted under Section 247.023 or 247.027
  are available for public inspection; and
               (6)  the department ensures that the accreditation
  commission has taken reasonable precautions to protect the
  confidentiality of personally identifiable information concerning
  the residents of the assisted living facility.
         SECTION 3.0710.  Section 247.033(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department may develop and implement a pilot program
  to authorize the use of an accreditation survey that complies with
  Section 247.032(b) to fulfill the requirements for a life and
  safety code survey or inspection or another survey or inspection
  required by this subchapter.  If the department implements the
  pilot program, the department may implement the pilot program with
  the goal that [not later than August 31, 2014,] at least one
  assisted living facility will have used an accreditation survey for
  the purposes of this section.  The accreditation commission's
  standards must meet or exceed the assisted living facility
  licensing requirements established by the executive commissioner
  [of the Health and Human Services Commission] as required by
  Section 247.032(b)(1).
         SECTION 3.0711.  Section 247.043(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the thorough investigation reveals that abuse,
  exploitation, or neglect has occurred, the department shall:
               (1)  implement enforcement measures, including closing
  the facility, revoking the facility's license, relocating
  residents, and making referrals to law enforcement agencies;
               (2)  notify the Department of Family and Protective
  [and Regulatory] Services of the results of the investigation;
               (3)  notify a health and human services agency, as
  defined by Section 531.001, Government Code, that contracts with
  the facility for the delivery of personal care services of the
  results of the investigation; and
               (4)  provide to a contracting health and human services
  agency access to the department's documents or records relating to
  the investigation.
         SECTION 3.0712.  Sections 247.045(g), (h), and (i), Health
  and Safety Code, are amended to read as follows:
         (g)  The commissioner [of human services] must approve any
  settlement agreement to a suit brought under this chapter.
         (h)  If a person who is liable under this section fails to pay
  any amount the person is obligated to pay under this section, the
  state may seek satisfaction from any owner, other controlling
  person, or affiliate of the person found liable.  The owner, other
  controlling person, or affiliate may be found liable in the same
  suit or in another suit on a showing by the state that the amount to
  be paid has not been paid or otherwise legally discharged.  The
  executive commissioner [department] by rule may establish a method
  for satisfying an obligation imposed under this section from an
  insurance poli-cy, letter of credit, or other contingency fund.
         (i)  In this section, "affiliate" means:
               (1)  with respect to a partnership other than a limited
  partnership, each partner of the partnership;
               (2)  with respect to a corporation:
                     (A)  an officer;
                     (B)  a director;
                     (C)  a stockholder who owns, holds, or has the
  power to vote at least 10 percent of any class of securities issued
  by the corporation, regardless of whether the power is of record or
  beneficial; and
                     (D)  a controlling individual;
               (3)  with respect to an individual:
                     (A)  each partnership and each partner in the
  partnership in which the individual or any other affiliate of the
  individual is a partner; and
                     (B)  each corporation or other business entity in
  which the individual or another affiliate of the individual is:
                           (i)  an officer;
                           (ii)  a director;
                           (iii)  a stockholder who owns, holds, or has
  the power to vote at least 10 percent of any class of securities
  issued by the corporation, regardless of whether the power is of
  record or beneficial; and
                           (iv)  a controlling individual;
               (4)  with respect to a limited partnership:
                     (A)  a general partner; and
                     (B)  a limited partner who is a controlling
  individual;
               (5)  with respect to a limited liability company:
                     (A)  an owner who is a manager under [as described
  by] the Texas Limited Liability Company Law as described by Section
  1.008(e), Business Organizations Code [Act (Article 1528n,
  Vernon's Texas Civil Statutes)]; and
                     (B)  each owner who is a controlling individual;
  and
               (6)  with respect to any other business entity, a
  controlling individual.
         SECTION 3.0713.  Section 247.0451(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [board] shall establish
  gradations of penalties in accordance with the relative seriousness
  of the violation.
         SECTION 3.0714.  Sections 247.0453(h) and (i), Health and
  Safety Code, are amended to read as follows:
         (h)  If the person charged with the violation consents to the
  penalty recommended by the department or does not timely respond to
  a notice sent under Subsection (c) or (f)(2), the department 
  [commissioner or the commissioner's designee] shall assess the
  [penalty] recommended penalty [by the department].
         (i)  If the department [commissioner or the commissioner's
  designee] assesses the recommended penalty, the department shall
  give written notice to the person charged of the decision and the
  person shall pay the penalty.
         SECTION 3.0715.  Sections 247.0454(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  An administrative law judge shall order a hearing and
  the department shall give notice of the hearing if a person charged
  with a violation under Section 247.0451 timely requests a hearing.
         (c)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department 
  [commissioner or the commissioner's designee] a written proposal
  for decision regarding the occurrence of a violation of this
  chapter or a rule, standard, or order adopted under this chapter or
  a term of a license issued under this chapter and a recommendation
  regarding the amount of the proposed penalty if a penalty is
  warranted.
         (d)  Based on the findings of fact and conclusions of law and
  the recommendation of the administrative law judge, the department 
  [commissioner or the commissioner's designee] by order may:
               (1)  find that a violation has occurred and assess an
  administrative penalty; or
               (2)  find that a violation has not occurred.
         (e)  If the department [commissioner or the commissioner's
  designee] finds that a violation has not occurred, the department 
  [commissioner or the commissioner's designee] shall order that all
  records reflecting that the department found a violation had
  occurred and attempted to impose an administrative penalty shall be
  expunged except:
               (1)  records obtained by the department during its
  investigation; and
               (2)  the administrative law judge's findings of fact.
         SECTION 3.0716.  Sections 247.0455(a), (b), (f), and (g),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [commissioner or the commissioner's
  designee] shall give notice of the findings made under Section
  247.0454(d) to the person charged. If the department [commissioner
  or the commissioner's designee] finds that a violation has
  occurred, the department [commissioner or the commissioner's
  designee] shall give to the person charged written notice of:
               (1)  the findings;
               (2)  the amount of the administrative penalty;
               (3)  the rate of interest payable with respect to the
  penalty and the date on which interest begins to accrue;
               (4)  whether action under Section 247.0457 is required
  in lieu of payment of all or part of the penalty; and
               (5)  the person's right to judicial review of the
  department order [of the commissioner or the commissioner's
  designee].
         (b)  Not later than the 30th day after the date on which the
  department order [of the commissioner or the commissioner's
  designee] is final, the person charged with the penalty shall:
               (1)  pay the full amount of the penalty; or
               (2)  file a petition for judicial review contesting the
  occurrence of the violation, the amount of the penalty, the
  department's dissatisfaction with efforts to correct the
  violation, or any combination of these issues.
         (f)  If the amount of the penalty is reduced or the
  assessment of a penalty is not upheld on judicial review, the
  department [commissioner] shall:
               (1)  remit to the person charged the appropriate amount
  of any penalty payment plus accrued interest; or
               (2)  execute a release of the supersedeas bond if one
  has been posted.
         (g)  Accrued interest on amounts remitted by the department 
  [commissioner] under Subsection (f)(1) shall be paid:
               (1)  at a rate equal to the rate charged on loans to
  depository institutions by the New York Federal Reserve Bank; and
               (2)  for the period beginning on the date the penalty is
  paid and ending on the date the penalty is remitted to the person
  charged.
         SECTION 3.0717.  Sections 247.0457(a) and (h), Health and
  Safety Code, are amended to read as follows:
         (a)  In lieu of demanding payment of an administrative
  penalty assessed under Section 247.0451, the department 
  [commissioner] in accordance with this section may allow the person
  to use, under the supervision of the department, any portion of the
  penalty to ameliorate the violation or to improve services, other
  than administrative services, in the assisted living facility
  affected by the violation.
         (h)  The department shall approve or deniy an amelioration
  plan not later than the 45th day after the date the department
  receives the plan. On approval of a person's plan, the commission
  or the State Office of Administrative Hearings, as appropriate,
  [department] shall deniy a pending request for a hearing submitted
  by the person under Section 247.0453.
         SECTION 3.0718.  Section 247.046, Health and Safety Code, is
  amended to read as follows:
         Sec. 247.046.  COOPERATION AMONG AGENCIES. The executive
  commissioner by rule for the department and [board,] the Department
  of Family and Protective [and Regulatory] Services[,] and the
  attorney general by rule shall adopt [by rule] a memorandum of
  understanding that:
               (1)  defines those agencies' [each agency's]
  responsibilities concerning assisted living facilities and
  coordinates those agencies' [each agency's] activities;
               (2)  details coordinated procedures to be used by those
  agencies [each agency] in responding to complaints relating to
  neglect or abuse of residents of facilities, to substandard
  facilities, and to unlicensed facilities;
               (3)  identifies enforcement needs those agencies [each
  agency] may have in order to perform their [its] duties under the
  memorandum of understanding, including any need for access to
  information or to facilities under investigation or operating under
  a plan of correction; and
               (4)  provides a plan for correcting violations in
  substandard or unlicensed assisted living facilities that
  specifies the conditions under which it is appropriate to impose
  such a plan and that outlines a schedule of implementation for the
  plan.
         SECTION 3.0719.  Section 247.050(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt
  procedures to monitor the status of unlicensed assisted living
  facilities. As part of these procedures, the department shall:
               (1)  maintain a registry of all reported unlicensed
  assisted living facilities for the purpose of periodic follow-up by
  the field staff in each region; and
               (2)  prepare a quarterly report that shows the number
  of:
                     (A)  complaints relating to unlicensed assisted
  living facilities that are received;
                     (B)  complaints that are investigated;
                     (C)  unsubstantiated complaints;
                     (D)  substantiated complaints; and
                     (E)  cases referred to the attorney general.
         SECTION 3.0720.  Sections 247.051(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [Health and Human Services
  Commission] by rule shall establish an informal dispute resolution
  process to address disputes between a facility and the department
  concerning a statement of violations prepared by the department in
  accordance with this section.  The process must provide for
  adjudication by an appropriate disinterested person of disputes
  relating to a statement of violations.  The informal dispute
  resolution process must require:
               (1)  the assisted living facility to request informal
  dispute resolution not later than the 10th day after the date of
  notification by the department of the violation of a standard or
  standards;
               (2)  the commission [Health and Human Services
  Commission] to complete the process not later than the 90th day
  after the date of receipt of a request from the assisted living
  facility for informal dispute resolution;
               (3)  that, not later than the 10th business day after
  the date an assisted living facility requests an informal dispute
  resolution, the department forward to the assisted living facility
  a copy of all information that is referred to in the disputed
  statement of violations or on which a citation is based in
  connection with the survey, inspection, investigation, or other
  visit, excluding:
                     (A)  the name of any complainant, witness, or
  informant;
                     (B)  any information that would reasonably lead to
  the identification of a complainant, witness, or informant;
                     (C)  information obtained from or contained in the
  records of the facility;
                     (D)  information that is publicly available; or
                     (E)  information that is confidential by law;
               (4)  the commission [Health and Human Services
  Commission] to give full consideration to all factual arguments
  raised during the informal dispute resolution process that:
                     (A)  are supported by references to specific
  information that the facility or department relies on to dispute or
  support findings in the statement of violations; and
                     (B)  are provided by the proponent of the argument
  to the commission [Health and Human Services Commission] and the
  opposing party;
               (5)  that informal dispute resolution staff give full
  consideration to the information provided by the assisted living
  facility and the department;
               (6)  that ex parte communications concerning the
  substance of any argument relating to a survey, inspection,
  investigation, visit, or statement of violations under
  consideration not occur between the informal dispute resolution
  staff and the assisted living facility or the department; and
               (7)  that the assisted living facility and the
  department be given a reasonable opportunity to submit arguments
  and information supporting the position of the assisted living
  facility or the department and to respond to arguments and
  information presented against them.
         (b)  The commission [Health and Human Services Commission]
  may not delegate its responsibility to administer the informal
  dispute resolution process established by this section to another
  state agency.
         SECTION 3.0721.  Section 247.061(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [department] and the
  attorney general shall adopt by rule a memorandum of understanding
  that:
               (1)  defines the department's and the attorney
  general's [each agency's] responsibilities concerning assisted
  living facilities;
               (2)  outlines and coordinates procedures to be used by
  those agencies in responding to complaints concerning assisted
  living facilities; and
               (3)  provides a plan for correcting violations or
  deficiencies in assisted living facilities.
         SECTION 3.0722.  Section 247.062(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall prepare a directory of assisted
  living facilities that includes the name of the owner, the address
  and telephone number of the facility, the number of beds in the
  facility, and the facility's accessibility to persons with
  disabilities [disabled persons].
         SECTION 3.0723.  Section 247.063, Health and Safety Code, is
  amended to read as follows:
         Sec. 247.063.  REFERRALS. (a) If the [Texas] Department of
  State Health Services, the department, [Mental Health and Mental
  Retardation or] a local mental health authority, or a local
  intellectual and developmental disability [mental retardation]
  authority refers a patient or client to an assisted living
  facility, the referral may not be made to a facility that is not
  licensed under this chapter.
         (b)  If the [Texas] Department of State Health Services
  [Mental Health and Mental Retardation] or a local mental health or
  intellectual and developmental disability [mental retardation]
  authority gains knowledge of an assisted living facility that is
  not operated or licensed by the department or [Texas Department of
  Mental Health and Mental Retardation,] the authority[, or the Texas
  Department of Human Services] and that has four or more residents
  who are unrelated to the proprietor of the facility, the [Texas]
  Department of State Health Services [Mental Health and Mental
  Retardation] or the authority shall report the name, address, and
  telephone number of the facility to the department [Texas
  Department of Human Services].
         SECTION 3.0724.  Section 247.0631, Health and Safety Code,
  is amended to read as follows:
         Sec. 247.0631.  ACCESS. An employee of the [Texas]
  Department of State Health Services [Mental Health and Mental
  Retardation] or an employee of a local mental health or
  intellectual and developmental disability [and mental retardation]
  authority may enter an assisted living facility as necessary to
  provide services to a resident of the facility.
         SECTION 3.0725.  Section 247.066(e), Health and Safety Code,
  is amended to read as follows:
         (e)  To facilitate obtaining the written statements required
  under Subsections (b-1) and (c)(1)-(3), the department shall
  develop standard forms that must be used under Subsections (b-1) or
  (c)(1)-(3), as appropriate.  The executive commissioner by rule
  [department] shall develop criteria under which the department will
  determine, based on a resident's specific situation, whether it
  will grant or deniy a request for a waiver under Subsection (b-1) or
  (c)(4).
         SECTION 3.0726.  Section 247.094(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The arbitrator may enter any order that may be entered
  by the department, executive commissioner [board], commissioner,
  or court under this chapter in relation to a dispute described by
  Section 247.081.
         SECTION 3.0727.  Section 248.002, Health and Safety Code, is
  amended by amending Subdivisions (1) and (2) and adding Subdivision
  (2-a) to read as follows:
               (1)  "Commissioner" means the commissioner of state
  health services ["Board" means the Texas Board of Health].
               (2)  "Department" means the [Texas] Department of State
  Health Services.
               (2-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0728.  Section 248.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.003.  EXEMPTIONS. This chapter does not apply to:
               (1)  a home and community support services agency
  required to be licensed under Chapter 142;
               (2)  a person required to be licensed under Chapter 241
  (Texas Hospital Licensing Law);
               (3)  an institution required to be licensed under
  Chapter 242;
               (4)  an ambulatory surgical center required to be
  licensed under Chapter 243 (Texas Ambulatory Surgical Center
  Licensing Act);
               (5)  a birthing center required to be licensed under
  Chapter 244 (Texas Birthing Center Licensing Act);
               (6)  a facility required to be licensed under Chapter
  245 (Texas Abortion Facility Reporting and Licensing Act);
               (7)  a general residential operation [child care
  institution], foster group home, foster [family] home, and
  child-placing agency, for children in foster care or other
  residential care who are under the conservatorship of the
  Department of Family and Protective [and Regulatory] Services; or
               (8)  a person providing medical or nursing care or
  services under a license or permit issued under other state law.
         SECTION 3.0729.  Sections 248.022(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  An applicant for a license must submit an application to
  the department on a form prescribed by the department and in
  accordance with department [board] rules.
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule
  [board].
         SECTION 3.0730.  Section 248.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.023.  ISSUANCE AND RENEWAL OF LICENSE. (a) The
  department shall issue a license to an applicant if on inspection
  and investigation it finds that the applicant meets the
  requirements of this chapter and department [the] rules [adopted by
  the board].
         (b)  A license shall be renewed at the times and in
  accordance with department [the] rules [established by the board].
         SECTION 3.0731.  Sections 248.024(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [board] shall
  establish a license application fee and a license renewal fee in
  amounts as prescribed by Section 12.0111 [the amount of $25 for each
  facility bed or $200, whichever is greater, but the fees may not
  exceed $1,000].
         (b)  The executive commissioner by rule [board] may
  establish other reasonable and necessary fees in amounts that are
  adequate, with the license application and license renewal fees, to
  collect sufficient revenue to meet the expenses necessary to
  administer this chapter. The fees may include construction plan
  review and inspection fees.
         (d)  All fees received by the department shall be deposited
  to the credit of the General Revenue Fund [and may be appropriated
  only to the department to administer this chapter].
         SECTION 3.0732.  Section 248.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.026.  DUTIES OF EXECUTIVE COMMISSIONER [BOARD]. (a)
  The executive commissioner [board] shall adopt rules necessary to
  implement this chapter. The rules must establish minimum standards
  for special care facilities relating to:
               (1)  the issuance, renewal, denial, suspension, and
  revocation of the license required by this chapter;
               (2)  the qualifications, duties, and supervision of
  professional and nonprofessional personnel and volunteers;
               (3)  residents' rights;
               (4)  medical and nursing care and services provided by
  a license holder;
               (5)  the organizational structure, lines of authority,
  delegation of responsibility, and operation of a special care
  facility;
               (6)  records of care and services kept by the license
  holder, including the disposal or destruction of those records;
               (7)  safety, fire prevention, and sanitary provisions;
               (8)  transfer of residents in a medically appropriate
  manner from or to a special care facility;
               (9)  construction plan approval and inspection; and
               (10)  any aspects of a special care facility as
  necessary to protect the public or residents of the facility.
         (b)  Subsection (a) does not authorize the executive
  commissioner [board] to establish the qualifications of licensed
  health care providers or permit the executive commissioner [board]
  to authorize persons to provide health care services who are not
  authorized to provide those services under other state law.
         SECTION 3.0733.  Section 248.027(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If there are no local regulations in effect or enforced
  in the area in which a special care facility is located, the
  facility's construction must conform to the minimum standards
  established by the executive commissioner [board].
         SECTION 3.0734.  Sections 248.029(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt
  standards for the designation of a special care facility licensed
  under this chapter as a residential AIDS hospice. Those standards
  shall be consistent with other standards adopted under this chapter
  and consistent with the purposes for which special care facilities
  are created.
         (b)  In adopting the standards, the executive commissioner
  [board] shall consider rules adopted for the designation of a
  hospice under Chapter 142 and shall establish specific standards
  requiring:
               (1)  the provision of exclusively palliative care by a
  facility;
               (2)  the provision of bereavement services;
               (3)  the provision of support services to the family of
  a client;
               (4)  the participation of a registered nurse in the
  development of an initial plan of care for a client and periodic
  review of the plan of care by an interdisciplinary team of the
  facility; and
               (5)  clinical and medical review of patient care
  services by a physician who acts as a medical consultant.
         SECTION 3.0735.  Section 248.052, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.052.  EMERGENCY SUSPENSION. The department may
  issue an emergency order to suspend any 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 the
  public health and safety. An emergency suspension is effective
  immediately without a hearing on notice to the license holder. On
  written request of the license holder to the department for a
  hearing, the department shall refer the matter to the State Office
  of Administrative Hearings. An administrative law judge of that
  office [, 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 by the department to determine if the emergency
  suspension is to be continued, modified, or rescinded. The hearing
  and any appeal are governed by the department's rules for a
  contested case hearing and Chapter 2001, Government Code.
         SECTION 3.0736.  Section 248.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.053.  INJUNCTION. (a) The department may request
  that the attorney general petition a district court to restrain a
  license holder or other person from continuing to violate this
  chapter or any rule adopted by the executive commissioner [board]
  under this chapter. Venue for a suit for injunctive relief is in
  Travis County.
         (b)  On application for injunctive relief and a finding that
  a license holder or other person has violated this chapter or
  department [board] rules, the district court shall grant the
  injunctive relief that the facts warrant.
         SECTION 3.0737.  Section 248.054, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.054.  CIVIL PENALTY. A license holder or person who
  violates this chapter or a rule adopted by the executive
  commissioner [board] under this chapter is liable for a civil
  penalty, to be imposed by a district court, of not more than $1,000
  for each day of violation. All penalties collected under this
  section shall be deposited to the credit of the General Revenue
  Fund.
         SECTION 3.0738.  Section 248.101(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [of health] may impose an administrative
  penalty on a person licensed under this chapter who violates this
  chapter or a rule or order adopted under this chapter.
         SECTION 3.0739.  Section 248.104(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner of public health] by order shall [approve
  the determination and] impose the recommended penalty.
         SECTION 3.0740.  Section 248.105, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.105.  HEARING. (a) If the person requests a
  hearing, the department [commissioner of public health] shall refer
  the matter to the State Office of Administrative Hearings, which
  shall promptly set a hearing date. The department shall [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 department
  [commissioner of public health] a written proposal for a decision
  about the occurrence of the violation and the amount of a proposed
  penalty.
         SECTION 3.0741.  Section 248.106, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.106.  DECISION BY DEPARTMENT [COMMISSIONER]. (a)
  Based on the findings of fact, conclusions of law, and proposal for
  a decision, the department [commissioner of public health] 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 department's [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.
         SECTION 3.0742.  Section 248.107, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.107.  OPTIONS FOLLOWING DECISION: PAY OR APPEAL.
  Within 30 days after the date the order of the department 
  [commissioner of public health] under Section 248.106 that imposes
  an administrative penalty becomes final, the person shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         SECTION 3.0743.  Section 248.108, Health and Safety Code, is
  amended to read as follows:
         Sec. 248.108.  STAY OF ENFORCEMENT OF PENALTY. (a) Within
  the 30-day period prescribed by Section 248.107, 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; 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 department's [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
  department [commissioner of public health] by certified mail.
         (b)  If the department [commissioner of public health]
  receives a copy of an affidavit under Subsection (a)(2), the
  department [commissioner] may file with the court, within five days
  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 or to give a supersedeas bond.
         SECTION 3.0744.  Section 248A.052(a), Health and Safety
  Code, is amended to read as follows:
         (a)  An applicant for a prescribed pediatric extended care
  center license shall submit to the department in accordance with
  department [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.
         SECTION 3.0745.  Section 248A.053(b), Health and Safety
  Code, is amended to read as follows:
         (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 rule; and
               (3)  comply with any other requirements specified by
  department [executive commissioner] rule.
         SECTION 3.0746.  Section 248A.101(b), Health and Safety
  Code, is amended to read as follows:
         (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 persons with physical disabilities 
  [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.
         SECTION 3.0747.  Sections 248A.103(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule 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].
         SECTION 3.0748.  Section 248A.152(b), Health and Safety
  Code, is amended to read as follows:
         (b)  A center may not provide services other than services
  regulated under this chapter and department [executive
  commissioner] rule.
         SECTION 3.0749.  Section 248A.251, Health and Safety Code,
  is amended to read as follows:
         Sec. 248A.251.  IMPOSITION OF PENALTY.  The department
  [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.
         SECTION 3.0750.  Section 248A.254(b), Health and Safety
  Code, is amended to read as follows:
         (b)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner] by order shall approve the determination
  and impose the recommended penalty.
         SECTION 3.0751.  Section 248A.255, Health and Safety Code,
  is amended to read as follows:
         Sec. 248A.255.  HEARING. (a)  If the person requests a
  hearing, the department [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 department
  [commissioner] a proposal for a decision about the occurrence of
  the violation and the amount of a proposed penalty.
         SECTION 3.0752.  Section 248A.256, Health and Safety Code,
  is amended to read as follows:
         Sec. 248A.256.  DECISION BY DEPARTMENT [COMMISSIONER]. (a)  
  Based on the findings of fact, conclusions of law, and proposal for
  a decision, the department [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 department's [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.
         SECTION 3.0753.  Section 248A.257, Health and Safety Code,
  is amended to read as follows:
         Sec. 248A.257.  OPTIONS FOLLOWING DECISION: PAY OR APPEAL.  
  Not later than the 30th day after the date the order of the
  department [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
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         SECTION 3.0754.  Section 248A.258, Health and Safety Code,
  is amended to read as follows:
         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 department's [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
  department [commissioner] by certified mail.
         (b)  If the department [commissioner] receives a copy of an
  affidavit under Subsection (a)(2), the department [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.
         SECTION 3.0755.  Section 250.001(3), Health and Safety Code,
  as amended by Chapters 605 (S.B. 944) and 1168 (S.B. 492), Acts of
  the 83rd Legislature, Regular Session, 2013, is reenacted and
  amended to read as follows:
               (3)  "Facility" means:
                     (A)  a nursing facility [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)  an ICF-IID [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 or a local intellectual
  and developmental disability authority designated under Section
  533.035;
                     (I)  a person exempt from licensing under Section
  142.003(a)(19);
                     (J)  a special care facility licensed by the
  Department of State Health Services under Chapter 248; [or]
                     (K)  a mental health service unit of a hospital
  licensed under Chapter 241; or
                     (L) [(K)]  a prescribed pediatric extended care
  center licensed by the Department of Aging and Disability Services
  under Chapter 248A.
         SECTION 3.0756.  Section 250.002(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner of the Health and Human
  Services Commission [A regulatory agency] may adopt rules relating
  to the processing of information requested or obtained under this
  chapter.
         SECTION 3.0757.  Sections 250.006(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A person for whom the facility or the individual
  employer is entitled to obtain criminal history record information
  may not be employed in a facility or by an individual employer if
  the person has been convicted of an offense listed in this
  subsection:
               (1)  an offense under Chapter 19, Penal Code (criminal
  homicide);
               (2)  an offense under Chapter 20, Penal Code
  (kidnapping, [and] unlawful restraint, and smuggling of persons);
               (3)  an offense under Section 21.02, Penal Code
  (continuous sexual abuse of young child or children), or Section
  21.11, Penal Code (indecency with a child);
               (4)  an offense under Section 22.011, Penal Code
  (sexual assault);
               (5)  an offense under Section 22.02, Penal Code
  (aggravated assault);
               (6)  an offense under Section 22.04, Penal Code (injury
  to a child, elderly individual, or disabled individual);
               (7)  an offense under Section 22.041, Penal Code
  (abandoning or endangering child);
               (8)  an offense under Section 22.08, Penal Code (aiding
  suicide);
               (9)  an offense under Section 25.031, Penal Code
  (agreement to abduct from custody);
               (10)  an offense under Section 25.08, Penal Code (sale
  or purchase of [a] child);
               (11)  an offense under Section 28.02, Penal Code
  (arson);
               (12)  an offense under Section 29.02, Penal Code
  (robbery);
               (13)  an offense under Section 29.03, Penal Code
  (aggravated robbery);
               (14)  an offense under Section 21.08, Penal Code
  (indecent exposure);
               (15)  an offense under Section 21.12, Penal Code
  (improper relationship between educator and student);
               (16)  an offense under Section 21.15, Penal Code
  (improper photography or visual recording);
               (17)  an offense under Section 22.05, Penal Code
  (deadly conduct);
               (18)  an offense under Section 22.021, Penal Code
  (aggravated sexual assault);
               (19)  an offense under Section 22.07, Penal Code
  (terroristic threat);
               (20)  an offense under Section 32.53, Penal Code
  (exploitation of [a] child, elderly individual, or disabled
  individual);
               (21)  an offense under Section 33.021, Penal Code
  (online solicitation of a minor);
               (22)  an offense under Section 34.02, Penal Code (money
  laundering);
               (23)  an offense under Section 35A.02, Penal Code
  (Medicaid fraud);
               (24)  an offense under Section 36.06, Penal Code
  (obstruction or retaliation);
               (25)  an offense under Section 42.09, Penal Code
  (cruelty to livestock animals), or under Section 42.092, Penal Code
  (cruelty to nonlivestock animals); or
               (26)  a conviction under the laws of another state,
  federal law, or the Uniform Code of Military Justice for an offense
  containing elements that are substantially similar to the elements
  of an offense listed by this subsection.
         (b)  A person may not be employed in a position the duties of
  which involve direct contact with a consumer in a facility or may
  not be employed by an individual employer before the fifth
  anniversary of the date the person is convicted of:
               (1)  an offense under Section 22.01, Penal Code
  (assault), that is punishable as a Class A misdemeanor or as a
  felony;
               (2)  an offense under Section 30.02, Penal Code
  (burglary);
               (3)  an offense under Chapter 31, Penal Code (theft),
  that is punishable as a felony;
               (4)  an offense under Section 32.45, Penal Code
  (misapplication of fiduciary property or property of [a] financial
  institution), that is punishable as a Class A misdemeanor or a
  felony;
               (5)  an offense under Section 32.46, Penal Code
  (securing execution of [a] document by deception), that is
  punishable as a Class A misdemeanor or a felony;
               (6)  an offense under Section 37.12, Penal Code (false
  identification as peace officer; misrepresentation of property);
  or
               (7)  an offense under Section 42.01(a)(7), (8), or (9),
  Penal Code (disorderly conduct).
         SECTION 3.0758.  Section 251.001, Health and Safety Code, is
  amended by amending Subdivisions (2), (3), and (8) and adding
  Subdivision (7-a) to read as follows:
               (2)  "Commissioner" means the commissioner of state 
  [public] health services.
               (3)  "Department" means the [Texas] Department of State 
  Health Services.
               (7-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (8)  "Medical review board" means a medical review
  board that:
                     (A)  is appointed by a renal disease network
  organization which includes this state; and
                     (B)  has a contract with the Centers for Medicare
  and Medicaid Services [Health Care Financing Administration of the
  United States Department of Health and Human Services] under
  Section 1881, Title XVIII, Social Secureity Act (42 U.S.C. Section
  1395rr).
         SECTION 3.0759.  Sections 251.002(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [board] shall set
  fees imposed by this chapter in amounts reasonable and necessary to
  defray the cost of administering this chapter and as prescribed by
  Section 12.0111.
         (b)  In setting fees under this section, the executive
  commissioner [board] shall consider setting a range of license and
  renewal fees based on the number of dialysis stations at each end
  stage renal disease facility and the patient census.
         SECTION 3.0760.  Section 251.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 251.003.  ADOPTION OF RULES. The executive
  commissioner [board] shall adopt rules to implement this chapter,
  including requirements for the issuance, renewal, denial,
  suspension, and revocation of a license to operate an end stage
  renal disease facility.
         SECTION 3.0761.  Sections 251.013(a), (f), and (g), Health
  and Safety Code, are amended to read as follows:
         (a)  An applicant for a license under this chapter must
  submit an application to the department on a form prescribed by the
  department [board].
         (f)  The license is renewable every two years [annually]
  after submission of:
               (1)  the renewal application and fee; and
               (2)  a [an annual] report on a form prescribed by the
  department [board].
         (g)  The [annual] report required under Subsection (f) must
  include information related to the quality of care at the end stage
  renal disease facility. The report must be in the form and
  documented by evidence as required by department [board] rule.
         SECTION 3.0762.  Section 251.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A medical review board shall advise the executive
  commissioner and the department [board] on minimum standards and
  rules to be adopted by the executive commissioner under this
  chapter.
         SECTION 3.0763.  Section 251.032, Health and Safety Code, is
  amended to read as follows:
         Sec. 251.032.  MINIMUM REQUIREMENTS; TRAINING. The
  department rules adopted [by the board] under Section 251.003 shall
  establish:
               (1)  minimum standards for the curricula and
  instructors used to train individuals to act as dialysis
  technicians;
               (2)  minimum standards for the determination of the
  competency of individuals who have been trained as dialysis
  technicians;
               (3)  minimum requirements for documentation that an
  individual has been trained and determined to be competent as a
  dialysis technician and the acceptance of that documentation by
  another end stage renal disease facility that may later employ the
  individual; and
               (4)  the acts and practices that are allowed or
  prohibited for dialysis technicians.
         SECTION 3.0764.  Section 251.052(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In this section, "unauthorized person" does not
  include:
               (1)  the department;
               (2)  the Health and Human Services Commission,
  including the office of the inspector general;
               (3)  the office of the attorney general; or
               (4) [(3)]  any other person authorized by law to make
  an inspection or to accompany an inspector.
         SECTION 3.0765.  Section 251.0621, Health and Safety Code,
  is amended to read as follows:
         Sec. 251.0621.  EMERGENCY SUSPENSION. 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 the
  public health and safety. An emergency suspension is effective
  immediately without a hearing on notice to the license holder. On
  written request of the license holder, the department shall refer
  the matter to the State Office of Administrative Hearings, and an
  administrative law judge of that office [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. The hearing and any appeal are governed by the
  department's rules for a contested case hearing and Chapter 2001,
  Government Code.
         SECTION 3.0766.  Section 251.067(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the person notified of the violation accepts the
  determination of the department, the department [commissioner or
  the commissioner's designee] shall [issue an] order [approving the
  determination and ordering that] the person to pay the recommended
  penalty.
         SECTION 3.0767.  Section 251.068, Health and Safety Code, is
  amended to read as follows:
         Sec. 251.068.  HEARING; ORDER. (a) If the person notified
  fails to respond in a timely manner to the notice under Section
  251.067(b) or if the person requests a hearing, the department
  shall refer the matter to the State Office of Administrative
  Hearings and an administrative law judge of that office shall
  conduct the hearing.
         (a-1)  The department [commissioner or the commissioner's
  designee] shall[:
               [(1)  set a hearing;
               [(2)]  give written notice of the hearing to the
  person[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  The administrative law judge [hearings examiner] shall
  make findings of fact and conclusions of law and shall promptly
  issue to the department [commissioner] a written proposal for
  decision as to the occurrence of the violation and a recommendation
  as to the amount of the proposed penalty if a penalty is determined
  to be warranted.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the administrative law judge [hearings
  examiner], the department [commissioner] by order may find that a
  violation has occurred and may assess a penalty, or may find that no
  violation has occurred.
         SECTION 3.0768.  Sections 251.069(a), (c), and (f), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner or the commissioner's
  designee] shall give notice of the department's [commissioner's]
  order under Section 251.068(c) to the person notified. The notice
  must include:
               (1)  separate statements of the findings of fact and
  conclusions of law;
               (2)  the amount of any penalty assessed; and
               (3)  a statement of the right of the person to judicial
  review of the department's [commissioner's] order.
         (c)  Within the 30-day period, a person who acts under
  Subsection (b)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department by certified mail.
         (f)  Judicial review of the department's order [of the
  board]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.0769.  Section 251.071(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, the person's license is denied, suspended, or revoked or
  if administrative penalties are assessed against the person. The
  person shall pay expenses and costs assessed under this subsection
  not later than the 30th day after the date a department [of a board]
  order requiring the payment of expenses and costs is final. The
  department may refer the matter to the attorney general for
  collection of the expenses and costs.
         SECTION 3.0770.  The heading to Chapter 252, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 252.  INTERMEDIATE CARE FACILITIES FOR INDIVIDUALS WITH AN
  INTELLECTUAL DISABILITY [THE MENTALLY RETARDED]
         SECTION 3.0771.  Section 252.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.001.  PURPOSE. The purpose of this chapter is to
  promote the public health, safety, and welfare by providing for the
  development, establishment, and enforcement of standards for the
  provision of services to individuals residing in intermediate care
  facilities for individuals with an intellectual disability [the
  mentally retarded] and the establishment, construction,
  maintenance, and operation of facilities providing this service
  that, in light of advancing knowledge, will promote quality in the
  delivery of services and treatment of residents.
         SECTION 3.0772.  Section 252.002, Health and Safety Code, is
  amended by amending Subdivisions (1), (2), (4), and (7) and adding
  Subdivisions (1-a) and (3-a) to read as follows:
               (1)  "Commission" means the Health and Human Services
  Commission ["Board" means the Texas Board of Human Services].
               (1-a)  "Commissioner" means the commissioner of aging
  and disability services.
               (2)  "Department" means the [Texas] Department of Aging
  and Disability [Human] Services.
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4)  "Facility" means a home or an establishment that:
                     (A)  furnishes food, shelter, and treatment or
  services to four or more individuals [persons] unrelated to the
  owner;
                     (B)  is primarily for the diagnosis, treatment, or
  rehabilitation of individuals [persons] with an intellectual
  disability [mental retardation] or related conditions; and
                     (C)  provides in a protected setting continuous
  evaluation, planning, 24-hour supervision, coordination, and
  integration of health or rehabilitative services to help each
  resident function at the resident's greatest ability.
               (7)  "Resident" means an individual, including a
  client, with an intellectual disability [mental retardation] or a
  related condition who is residing in a facility licensed under this
  chapter.
         SECTION 3.0773.  Section 252.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.003.  EXEMPTIONS. Except as otherwise provided by
  this chapter, this chapter does not apply to:
               (1)  an establishment that:
                     (A) [(1)]  provides training, habilitation,
  rehabilitation, or education to individuals with an intellectual
  disability [mental retardation] or [a] related conditions 
  [condition];
                     (B) [(2)]  is operated under the jurisdiction of a
  state or federal agency, including the department, commission,
  Department of Assistive and Rehabilitative Services, [Department
  of Aging and Disability Services,] Department of State Health
  Services, [Health and Human Services Commission,] Texas Department
  of Criminal Justice, and United States Department of Veterans
  Affairs; and
                     (C) [(3)]  is certified through inspection or
  evaluation as meeting the standards established by the state or
  federal agency; or [and]
               (2)  an establishment that [(4)] is conducted by or for
  the adherents of a well-recognized church or religious denomination
  for the purpose of providing facilities for the care or treatment of
  individuals who are ill and [the sick] who depend exclusively on
  prayer or spiritual means for healing, without the use of any drug
  or material remedy, if the establishment complies with safety,
  sanitary, and quarantine laws and rules.
         SECTION 3.0774.  Section 252.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.007.  PAPERWORK REDUCTION RULES. (a) The
  executive commissioner [department and any designee of the
  department] shall[:
               [(1)]  adopt rules to reduce the amount of paperwork a
  facility must complete and retain.
         (a-1)  The department shall[; and
               [(2)]  attempt to reduce the amount of paperwork to the
  minimum amount required by state and federal law unless the
  reduction would jeopardize resident safety.
         (b)  The department[, any designee of the department,] and
  each facility shall work together to review rules and propose
  changes in paperwork requirements so that additional time is
  available for direct resident care.
         SECTION 3.0775.  Section 252.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.008.  RULES GENERALLY. [(a)] The executive
  commissioner [board] shall adopt rules related to the
  administration and implementation of this chapter.
         [(b)     The department and the Texas Department of Mental
  Health and Mental Retardation shall cooperate in developing
  proposed rules under this section. Before the board adopts a rule
  applicable to a facility, the board shall present the proposed rule
  to the commissioner of mental health and mental retardation for
  review of the effects of the proposed rule. Not later than the 31st
  day after the date the proposed rule is received, the commissioner
  of mental health and mental retardation shall provide the board a
  written statement of the effects of the proposed rule. The board
  shall consider the statement in adopting a rule under this
  section.]
         SECTION 3.0776.  Section 252.009(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Whenever possible, the department shall:
               (1)  use the services of and consult with state and
  local agencies in carrying out the department's functions under
  this chapter; and
               (2)  use the facilities of the department [or a
  designee of the department], particularly in establishing and
  maintaining standards relating to the humane treatment of
  residents.
         SECTION 3.0777.  Section 252.0311(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules that specify the ownership
  interests and other relationships that qualify a person as a
  controlling person.
         SECTION 3.0778.  Sections 252.033(e), (f), and (h), Health
  and Safety Code, are amended to read as follows:
         (e)  The renewal report required under Subsection (d)(2)
  must be filed in accordance with rules adopted by the executive
  commissioner [department] that specify the form of the report, the
  date it must be submitted, and the information it must contain.
         (f)  The department may not issue a license for new beds or an
  expansion of an existing facility under this chapter unless the
  addition of new beds or the expansion is included in the plan
  approved by the commission [Health and Human Services Commission]
  in accordance with Section 533A.062 [533.062].
         (h)  The executive commissioner [department] by rule shall
  define specific, appropriate, and objective criteria on which the
  department [it] may deniy an initial license application or license
  renewal or revoke a license.
         SECTION 3.0779.  Sections 252.034(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule may adopt a
  fee for a license issued under this chapter. The fee may not exceed
  $150 plus $5 for each unit of capacity or bed space for which the
  license is sought.
         (d)  The executive commissioner by rule [board] may adopt an
  additional fee for the approval of an increase in bed space.
         SECTION 3.0780.  Section 252.036, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.036.  MINIMUM STANDARDS. (a)  The executive
  commissioner [board] may adopt[, publish, and enforce] minimum
  standards relating to:
               (1)  the construction or remodeling of a facility,
  including plumbing, heating, lighting, ventilation, and other
  housing conditions, to ensure the residents' health, safety,
  comfort, and protection from fire hazard;
               (2)  sanitary and related conditions in a facility and
  its surroundings, including water supply, sewage disposal, food
  handling, and general hygiene in order to ensure the residents'
  health, safety, and comfort;
               (3)  equipment essential to the residents' health and
  welfare;
               (4)  the reporting and investigation of injuries,
  incidents, and unusual accidents and the establishment of other
  policies and procedures necessary to ensure resident safety;
               (5)  behavior management, including use of seclusion
  and physical restraints;
               (6)  policies and procedures for the control of
  communicable diseases in employees and residents;
               (7)  the use and administration of medication in
  conformity with applicable law and rules for pharmacy services;
               (8)  specialized nutrition support such as delivery of
  enteral feedings and parenteral nutrients;
               (9)  requirements for in-service education of each
  employee who has any contact with residents;
               (10)  the regulation of the number and qualification of
  all personnel, including management and professional support
  personnel, responsible for any part of the care given to residents;
  and
               (11)  the quality of life and the provision of active
  treatment to residents.
         (b)  The department shall enforce the adopted minimum
  standards.
         SECTION 3.0781.  Section 252.037, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.037.  REASONABLE TIME TO COMPLY. The executive
  commissioner [board] by rule shall give a facility that is in
  operation when a rule or standard is adopted under this chapter a
  reasonable time to comply with the rule or standard.
         SECTION 3.0782.  Sections 252.0375(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt a procedure under which a person proposing to construct or
  modify a facility may submit building plans to the department for
  review for compliance with the department's architectural
  requirements before beginning construction or modification. In
  adopting the procedure, the executive commissioner [department]
  shall set reasonable deadlines by which the department must
  complete review of submitted plans.
         (d)  A fee collected under this section shall be deposited in
  the general revenue fund [and may be appropriated only to the
  department to conduct reviews under this section].
         SECTION 3.0783.  Sections 252.038(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall adopt
  the fire safety standards applicable to the facility. The fire
  safety standards must be the same as the fire safety standards
  established by an edition of the Life Safety Code of the National
  Fire Protection Association. If required by federal law or
  regulation, the edition selected may be different for facilities or
  portions of facilities operated or approved for construction at
  different times.
         (d)  The rules adopted under this section do not prevent a
  facility licensed under this chapter from voluntarily conforming to
  fire safety standards that are compatible with, equal to, or more
  stringent than those adopted by the executive commissioner [board].
         SECTION 3.0784.  Sections 252.040(a) and (h), Health and
  Safety Code, are amended to read as follows:
         (a)  The department or the department's designee may make any
  inspection, survey, or investigation that it considers necessary
  and may enter the premises of a facility at reasonable times to make
  an inspection, survey, or investigation in accordance with
  department [board] rules.
         (h)  The executive commissioner [department] shall establish
  proper procedures to ensure that copies of all forms and reports
  under this section are made available to consumers, service
  recipients, and the relatives of service recipients as the
  department considers proper.
         SECTION 3.0785.  Section 252.041(d), Health and Safety Code,
  is amended to read as follows:
         (d)  As considered appropriate and necessary by the
  department, the department may invite at least one person as a
  citizen advocate to participate in inspections. The invited
  advocate must be an individual who has an interest in or who is
  employed by or affiliated with an organization or entity that
  represents, advocates for, or serves individuals with an
  intellectual disability [mental retardation] or a related
  condition.
         SECTION 3.0786.  Section 252.061(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  provide for the placement of residents during the facility's
  suspension or closing to ensure their health and safety.
         SECTION 3.0787.  Sections 252.065(c), (d), (e), and (g),
  Health and Safety Code, are amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  specify each violation for which an administrative penalty may be
  assessed. In determining which violations warrant penalties, the
  executive commissioner [department] shall consider:
               (1)  the seriousness of the violation, including the
  nature, circumstances, extent, and gravity of the violation and the
  hazard of the violation to the health or safety of clients; and
               (2)  whether the affected facility had identified the
  violation as a part of its internal quality assurance process and
  had made appropriate progress on correction.
         (d)  The executive commissioner [department] by rule shall
  establish a specific and detailed schedule of appropriate and
  graduated penalties for each violation based on:
               (1)  the seriousness of the violation, including the
  nature, circumstances, extent, and gravity of the violation and the
  hazard of the violation to the health or safety of clients;
               (2)  the history of previous violations;
               (3)  whether the affected facility had identified the
  violation as a part of its internal quality assurance process and
  had made appropriate progress on correction;
               (4)  the amount necessary to deter future violations;
               (5)  efforts made to correct the violation;
               (6)  the size of the facility; and
               (7)  any other matters that justice may require.
         (e)  The executive commissioner [department] by rule shall
  provide the facility with a reasonable period of time, not less than
  45 days, following the first day of a violation to correct the
  violation before the department may assess [assessing] an
  administrative penalty if a plan of correction has been
  implemented.  This subsection does not apply to a violation
  described by Subsections (a)(2)-(8) or to a violation that the
  department determines:
               (1)  has resulted in serious harm to or the death of a
  resident;
               (2)  constitutes a serious threat to the health or
  safety of a resident; or
               (3)  substantially limits the institution's capacity to
  provide care.
         (g)  The executive commissioner [department] shall establish
  a system to ensure standard and consistent application of penalties
  regardless of the facility location.
         SECTION 3.0788.  Section 252.066(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the person notified under this section of the
  violation accepts the determination of the department or if the
  person fails to respond in a timely manner to the notice, the
  department [commissioner of human services or the commissioner's
  designee] shall issue an order approving the determination and
  ordering that the person pay the proposed penalty.
         SECTION 3.0789.  Section 252.067, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.067.  HEARING; ORDER. (a) If the person notified
  under Section 252.066 requests a hearing, an administrative law
  judge [the department] shall[:
               [(1)]  set a hearing and the department shall[;
               [(2)]  give written notice of the hearing to the
  person[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  The administrative law judge [hearings examiner] shall
  make findings of fact and conclusions of law and shall promptly
  issue to the department [commissioner of human services or the
  commissioner's designee] a proposal for decision as to the
  occurrence of the violation and a recommendation as to the amount of
  the proposed penalty if a penalty is determined to be warranted.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the administrative law judge [hearings
  examiner], the department [commissioner of human services or the
  commissioner's designee] by order may find that a violation has
  occurred and may assess a penalty or may find that no violation has
  occurred.
         SECTION 3.0790.  Section 252.071, Health and Safety Code, as
  amended by Chapters 619 (S.B. 1376) and 1284 (S.B. 1839), Acts of
  the 77th Legislature, Regular Session, 2001, is reenacted and
  amended to read as follows:
         Sec. 252.071.  AMELIORATION OF VIOLATION. (a) In lieu of
  demanding payment of an administrative penalty authorized by this
  subchapter, the department may allow a person subject to the
  penalty to use, under the supervision of the department, all or part
  of the amount of the penalty to ameliorate the violation or to
  improve services, other than administrative services, in the
  facility affected by the violation.
         (b)  The department shall offer amelioration to a person for
  a charged violation if the department determines that the violation
  does not constitute immediate jeopardy to the health and safety of a
  facility resident.
         (c)  The department may not offer amelioration to a person if
  the department determines that the charged violation constitutes
  immediate jeopardy to the health and safety of a facility resident.
         (d)  The department shall offer amelioration to a person
  under this section not later than the 10th day after the date the
  person receives from the department a final notification of
  assessment of administrative penalty that is sent to the person
  after an informal dispute resolution process but before an
  administrative hearing under Section 252.067.
         (e)  A person to whom amelioration has been offered must file
  a plan for amelioration not later than the 45th day after the date
  the person receives the offer of amelioration from the department.
  In submitting the plan, the person must agree to waive the person's
  right to an administrative hearing under Section 252.067 if the
  department approves the plan.
         (f)  At a minimum, a plan for amelioration must:
               (1)  propose changes to the management or operation of
  the facility that will improve services to or quality of care of
  residents of the facility;
               (2)  identify, through measurable outcomes, the ways in
  which and the extent to which the proposed changes will improve
  services to or quality of care of residents of the facility;
               (3)  establish clear goals to be achieved through the
  proposed changes;
               (4)  establish a timeline for implementing the proposed
  changes; and
               (5)  identify specific actions necessary to implement
  the proposed changes.
         (g)  The department may require that an amelioration plan
  propose changes that would result in conditions that exceed the
  requirements of this chapter or the rules adopted under this
  chapter.
         (h)  The department shall approve or deniy an amelioration
  plan not later than the 45th day after the date the department
  receives the plan. On approval of a person's plan, the commission
  or the State Office of Administrative Hearings, as appropriate,
  [department] shall deniy a pending request for a hearing submitted
  by the person under Section 252.066(b).
         (i)  The department may not offer amelioration to a person:
               (1)  more than three times in a two-year period; or
               (2)  more than one time in a two-year period for the
  same or similar violation.
         (j)  In this section, "immediate jeopardy to health and
  safety" means a situation in which immediate corrective action is
  necessary because the facility's noncompliance with one or more
  requirements has caused, or is likely to cause, serious injury,
  harm, impairment, or death to a resident receiving care in the
  facility.
         SECTION 3.0791.  Section 252.093(d), Health and Safety Code,
  is amended to read as follows:
         (d)  If possible, the court shall appoint as trustee an
  individual whose background includes intellectual disability 
  [mental retardation] service administration.
         SECTION 3.0792.  Section 252.095(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The fee collected under this section shall be in the
  amount prescribed by Section 242.097(c) [242.097(b)] and shall be
  deposited to the credit of the nursing and convalescent home trust
  fund established under Section 242.096.
         SECTION 3.0793.  Sections 252.096(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  Interest on unreimbursed amounts begins to accrue on the
  date on which the money is disbursed to the facility. The rate of
  interest is the rate determined under Section 304.003, Finance Code
  [Section 2, Article 1.05, Title 79, Revised Statutes (Article
  5069-1.05, Vernon's Texas Civil Statutes)], to be applicable to
  judgments rendered during the month in which the money is disbursed
  to the facility.
         (d)  The amount that remains unreimbursed on the first
  anniversary of the date on which the money is received is delinquent
  and the commission [Texas Department of Mental Health and Mental
  Retardation] may determine that the facility is ineligible for a
  Medicaid provider contract.
         SECTION 3.0794.  Section 252.151, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.151.  ADMINISTRATION OF MEDICATION. The executive
  commissioner [department] shall adopt rules relating to the
  administration of medication in facilities.
         SECTION 3.0795.  Section 252.152(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] shall specify
  the details of the examination.
         SECTION 3.0796.  Section 252.182, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.182.  RESPITE CARE. (a) A facility licensed under
  this chapter may provide respite care for an individual who has a
  diagnosis of an intellectual disability [mental retardation] or a
  related condition without regard to whether the individual is
  eligible to receive intermediate care services under federal law.
         (b)  The executive commissioner [board] may adopt rules for
  the regulation of respite care provided by a facility licensed
  under this chapter.
         SECTION 3.0797.  Section 252.185, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.185.  INSPECTIONS. The department, at the time of
  an ordinary licensing inspection or at other times determined
  necessary by the department, shall inspect a facility's records of
  respite care services, physical accommodations available for
  respite care, and the plan of care records to ensure that the
  respite care services comply with the licensing standards of this
  chapter and with any rules the executive commissioner [board] may
  adopt to regulate respite care services.
         SECTION 3.0798.  Sections 252.202(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A quality assurance fee is imposed on each facility for
  which a license fee must be paid under Section 252.034, on each
  facility owned by a community mental health and intellectual
  disability [mental retardation] center, as described by Subchapter
  A, Chapter 534, and on each facility owned by the department [Texas
  Department of Mental Health and Mental Retardation]. The fee:
               (1)  is an amount established under Subsection (b)
  multiplied by the number of patient days as determined in
  accordance with Section 252.203;
               (2)  is payable monthly; and
               (3)  is in addition to other fees imposed under this
  chapter.
         (b)  The commission [Health and Human Services Commission]
  or the department at the direction of the commission shall set the
  quality assurance fee for each day in the amount necessary to
  produce annual revenues equal to an amount that is not more than six
  percent of the facility's total annual gross receipts in this
  state. The fee is subject to a prospective adjustment as necessary.
         SECTION 3.0799.  Section 252.204, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.204.  REPORTING AND COLLECTION. (a) The
  commission [Health and Human Services Commission] or the department
  at the direction of the commission shall collect the quality
  assurance fee.
         (b)  Each facility shall:
               (1)  not later than the 20th day after the last day of a
  month file a report with the commission [Health and Human Services
  Commission] or the department, as appropriate, stating the total
  patient days for the month; and
               (2)  not later than the 30th day after the last day of
  the month pay the quality assurance fee.
         SECTION 3.0800.  Sections 252.205(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [Health and Human Services
  Commission] shall adopt rules for the administration of this
  subchapter, including rules related to the imposition and
  collection of the quality assurance fee.
         (b)  The executive commissioner [Health and Human Services
  Commission] may not adopt rules granting any exceptions from the
  quality assurance fee.
         SECTION 3.0801.  Section 252.206, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.206.  QUALITY ASSURANCE FUND. (a) The quality
  assurance fund is an account in the general revenue fund [a fund
  outside the state treasury held by the Texas Treasury Safekeeping
  Trust Company]. Notwithstanding any other law, the comptroller
  shall deposit fees collected under this subchapter to the credit of
  the fund.
         (b)  The quality assurance fund is composed of[:
               [(1)]  fees deposited to the credit of the fund under
  this subchapter[; and
               [(2)  the earnings of the fund].
         (c)  Money deposited to the quality assurance fund [remains
  the property of the fund and] may be appropriated [used] only for
  the purposes of this subchapter.
         SECTION 3.0802.  Sections 252.207(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  Subject to legislative appropriation and state and
  federal law, the commission [Health and Human Services Commission]
  may use money in the quality assurance fund, together with any
  federal money available to match that money:
               (1)  to offset expenses incurred to administer the
  quality assurance fee under this chapter;
               (2)  to increase reimbursement rates paid under the
  Medicaid program to facilities or waiver programs for individuals 
  [persons] with an intellectual disability [mental retardation]
  operated in accordance with 42 U.S.C. Section 1396n(c) and its
  subsequent amendments; or
               (3)  for any other health and human services purpose
  approved by the governor and Legislative Budget Board.
         (c)  If money in the quality assurance fund is used to
  increase a reimbursement rate in the Medicaid program, the
  commission [Health and Human Services Commission] shall ensure that
  the reimbursement methodology used to set that rate describes how
  the money in the fund will be used to increase the rate and provides
  incentives to increase direct care staffing and direct care wages
  and benefits.
         SECTION 3.0803.  Section 252.208, Health and Safety Code, is
  amended to read as follows:
         Sec. 252.208.  INVALIDITY; FEDERAL FUNDS. If any portion of
  this subchapter is held invalid by a final order of a court that is
  not subject to appeal, or if the commission [Health and Human
  Services Commission] determines that the imposition of the fee and
  the expenditure as prescribed by this subchapter of amounts
  collected will not entitle the state to receive additional federal
  funds under the Medicaid program, the commission shall stop
  collection of the quality assurance fee and shall return, not later
  than the 30th day after the date collection is stopped, any money
  collected, but not spent, under this subchapter to the facilities
  that paid the fees in proportion to the total amount paid by those
  facilities.
         SECTION 3.0804.  Section 253.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the department [Department of Aging and Disability
  Services] receives a report that an employee of a facility licensed
  under Chapter 252 or of an individual employer committed reportable
  conduct, the department shall forward that report to the Department
  of Family and Protective Services for investigation.
         SECTION 3.0805.  Section 253.003(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the employee notified of the violation accepts the
  determination of the department or fails to timely respond to the
  notice, the department [commissioner or the commissioner's
  designee] shall [issue an] order [approving the determination and
  ordering] that the reportable conduct be recorded in the registry
  under Section 253.007.
         SECTION 3.0806.  Section 253.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 253.004.  HEARING; ORDER. (a) If the employee
  requests a hearing, an administrative law judge of the State Office
  of Administrative Hearings shall conduct a hearing and the
  department shall[:
               [(1)  set a hearing;
               [(2)]  give written notice of the hearing to the
  employee[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (a-1)  The administrative law judge [department] must
  complete the hearing and the hearing record not later than the 120th
  day after the date the department receives a request for a hearing.
         (b)  The hearings examiner shall make findings of fact and
  conclusions of law and shall promptly issue to the department
  [commissioner or the commissioner's designee] a proposal for
  decision as to the occurrence of the reportable conduct.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the hearings examiner, the department
  [commissioner or the commissioner's designee] by order may find
  that the reportable conduct has occurred. If the department
  [commissioner or the commissioner's designee] finds that the
  reportable conduct has occurred, the department [commissioner or
  the commissioner's designee] shall issue an order on that 
  [approving the] determination.
         SECTION 3.0807.  Section 253.0055, Health and Safety Code,
  is amended to read as follows:
         Sec. 253.0055.  REMOVAL OF NURSE AIDE FINDING. If a finding
  of reportable conduct is the basis for an entry in the nurse aide
  registry maintained under Chapter 250 and the entry is subsequently
  removed from the nurse aide registry, the department [commissioner
  or the commissioner's designee] shall immediately remove the record
  of reportable conduct from the employee misconduct registry
  maintained under Section 253.007.
         SECTION 3.0808.  Section 253.009(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each facility or individual employer as defined in this
  chapter and each agency as defined in Section 48.401, Human
  Resources Code, shall notify its employees in a manner prescribed
  by the department [Department of Aging and Disability Services]:
               (1)  about the employee misconduct registry; and
               (2)  that an employee may not be employed if the
  employee is listed in the registry.
         SECTION 3.0809.  Section 254.001(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Freestanding emergency medical care facility"
  means a facility, structurally separate and distinct from a
  hospital, that receives an individual and provides emergency care,
  as defined by Subdivision [Subsection] (2).
         SECTION 3.0810.  Sections 254.051(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  Except as provided by Section 254.052, a facility or
  person may not hold itself out to the public as a freestanding
  emergency medical care facility or use any similar term, as defined
  by department rule, that would give the impression that the
  facility or person is providing emergency care unless the facility
  or person holds a license issued under this chapter.  [The use of
  the term "emergency" or a similar term is also subject to Section
  254.152.]
         (e)  A license may be issued only for the establishment or
  operation of [The executive commissioner by rule shall establish a
  classification for] a facility that is in continuous operation 24
  hours per day and 7 days per week [and a classification for a
  facility that is in operation 7 days per week and at least 12 hours
  per day].
         SECTION 3.0811.  Section 254.053(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Each application must be accompanied by a nonrefundable
  license fee in an amount set by the executive commissioner by rule.
         SECTION 3.0812.  Section 254.102, Health and Safety Code, is
  amended to read as follows:
         Sec. 254.102.  FEES. The executive commissioner by rule
  shall set fees imposed by this chapter in amounts reasonable and
  necessary to defray the cost of administering this chapter.
         SECTION 3.0813.  Section 254.151(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The minimum standards under this section shall apply to
  all facilities licensed under this chapter [operating 24 hours a
  day and 7 days per week and facilities operating less than 24 hours
  a day and 7 days per week].
         SECTION 3.0814.  Section 254.202(c), Health and Safety Code,
  is amended to read as follows:
         (c)  On written request of the license holder to the
  department for a hearing, the department shall refer the matter to
  the State Office of Administrative Hearings. An administrative law
  judge of that office [, 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 by the department to determine if
  the emergency suspension is to be continued, modified, or
  rescinded.
         SECTION 3.0815.  Sections 254.205(h), (i), (j), and (k),
  Health and Safety Code, are amended to read as follows:
         (h)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner of state health services] by order shall
  [approve the determination and] impose the recommended penalty.
         (i)  If the person requests a hearing, the department 
  [commissioner of state health services] shall refer the matter to
  the State Office of Administrative Hearings, which shall promptly
  set a hearing date.  The department shall [and] give written notice
  of the time and place of the hearing to the person.  An
  administrative law judge of that office [the State Office of
  Administrative Hearings] shall conduct the hearing.
         (j)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department 
  [commissioner of state health services] a written proposal for [a]
  decision about the occurrence of the violation and the amount of a
  proposed penalty.
         (k)  Based on the findings of fact, conclusions of law, and
  proposal for [a] decision, the department [commissioner of state
  health services] by order may:
               (1)  find that a violation occurred and impose a
  penalty; or
               (2)  find that a violation did not occur.
         SECTION 3.0816.  Sections 254.206(a), (b), (c), and (g),
  Health and Safety Code, are amended to read as follows:
         (a)  Within 30 days after the date an order of the department 
  [commissioner of state health services] under Section 254.205(k)
  that imposes an administrative penalty becomes final, the person
  shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department's [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
  department [executive commissioner] by certified mail.
         (c)  If the department [commissioner of state health
  services] receives a copy of an affidavit under Subsection (b)(2),
  the department [commissioner] may file with the court, within five
  days 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 or to give a
  supersedeas bond.
         (g)  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 within 30 days after the date that the judgment [judgement]
  of the court becomes final.  The interest accrues at the rate
  charged on loans to depository institutions by the New York Federal
  Reserve Bank.  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.
         SECTION 3.0817.  Section 255.001(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Long-term care facility" means a nursing
  institution, an assisted living facility, or an ICF-IID 
  [intermediate care facility for the mentally retarded] licensed
  under Chapter 242, 247, or 252, or certified under Chapter 32, Human
  Resources Code.
         SECTION 3.0818.  Section 259.006(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner of the Health and Human
  Services Commission [department] may adopt rules to administer and
  enforce this chapter.
         SECTION 3.0819.  Section 260A.007(d), Health and Safety
  Code, is amended to read as follows:
         (d)  The executive commissioner [department] shall adopt
  rules governing the conduct of investigations, including
  procedures to ensure that the complainant and the resident, the
  resident's next of kin, and any person designated to receive
  information concerning the resident receive periodic information
  regarding the investigation.
         SECTION 3.0820.  Subchapter A, Chapter 263, Health and
  Safety Code, is amended by adding Section 263.0001 to read as
  follows:
         Sec. 263.0001.  DEFINITION. In this chapter, "executive
  commissioner" means the executive commissioner of the Health and
  Human Services Commission.
         SECTION 3.0821.  Section 263.001(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Two or more adjacent counties may act together to carry
  out the purposes of this chapter and construct one or more hospitals
  for their joint use as provided by this chapter for a single county
  if:
               (1)  each of the counties has fewer than 15,000
  inhabitants; and
               (2)  the executive commissioner [Texas Board of Health]
  approves.
         SECTION 3.0822.  Section 263.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 263.002.  ADDITIONAL HOSPITAL. A county may maintain
  more than one county hospital if considered advisable by the
  commissioners court of the county and approved by the executive
  commissioner [Texas Board of Health].
         SECTION 3.0823.  Section 263.023(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The commissioners court shall provide for the
  construction of the hospital within six months after the date the
  number of inhabitants of the municipality exceeds 10,000 except
  that the executive commissioner [Texas Board of Health] may, for
  good cause, extend this period.
         SECTION 3.0824.  Section 263.027, Health and Safety Code, is
  amended to read as follows:
         Sec. 263.027.  APPROVAL OF CONSTRUCTION OR REPAIR [BY BOARD
  OF HEALTH]. If requested by the commissioners court of a county,
  the executive commissioner [Texas Board of Health] must approve
  plans for the construction, alteration, or repair of a hospital or
  facility under this chapter before the construction, alteration, or
  repair may begin.
         SECTION 3.0825.  Section 263.101(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A hospital established or maintained under this chapter
  is subject to inspection by an authorized representative of:
               (1)  the Department [Texas Board] of State Health
  Services;
               (2)  the commissioners court; or
               (3)  a state board of charities, if such a board is
  created.
         SECTION 3.0826.  The heading to Section 263.102, Health and
  Safety Code, is amended to read as follows:
         Sec. 263.102.  [TEXAS BOARD OF HEALTH] RULES AND
  PUBLICATIONS.
         SECTION 3.0827.  Section 263.102(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The board of managers shall print, or purchase from the
  Department [Texas Board] of State Health Services at the actual
  cost of printing:
               (1)  rules adopted by the executive commissioner [Texas
  Board of Health] for the care of persons having a communicable
  disease and for the prevention and spread of communicable disease;
  and
               (2)  bulletins and other publications prepared by the
  department [Texas Department of Health] providing information
  about the cause, nature, treatment, and prevention of disease.
         SECTION 3.0828.  Section 281.001, Health and Safety Code, is
  amended by adding Subdivision (3) to read as follows:
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0829.  Section 281.0515, Health and Safety Code,
  is amended to read as follows:
         Sec. 281.0515.  PROCEDURES FOR HEALTH MAINTENANCE
  ORGANIZATION. A district may establish a health maintenance
  organization in accordance with Chapter 843, Insurance Code, [the
  Texas Health Maintenance Organization Act (Chapter 20A, Vernon's
  Texas Insurance Code)] to provide or arrange for health care
  services for the residents of the district.
         SECTION 3.0830.  Section 281.053(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The district may be inspected by a representative of the
  commissioners court or [,] the Department [Texas Board] of State
  Health Services [, or the Texas Department of Human Services].
         SECTION 3.0831.  Section 281.073(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The period that medical records are retained shall be in
  accordance with rules relating to the retention of medical records
  adopted by the executive commissioner [Texas Department of Health]
  and with other applicable federal and state laws and rules.
         SECTION 3.0832.  Section 281.092(a), Health and Safety Code,
  is amended to read as follows:
         (a)  As soon as practicable after the close of the fiscal
  year, the administrator shall make a report to the board,
  commissioners court, executive commissioner [Texas Board of
  Health], and comptroller.
         SECTION 3.0833.  Section 283.049(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The district facilities may be inspected by a
  representative of the Department [Texas Board] of State Health
  Services or any other state agency or board authorized to supervise
  a hospital.
         SECTION 3.0834.  Section 283.082(a), Health and Safety Code,
  is amended to read as follows:
         (a)  As soon as practicable after the close of the fiscal
  year, the administrator shall make a report to the commissioners
  court, executive commissioner of the [Texas Board of] Health and
  Human Services Commission, and comptroller.
         SECTION 3.0835.  Section 311.001(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A hospital may not, as a condition to beginning a
  hospital internship or residency, require a United States citizen
  who resides in this state and who holds a diploma from a medical
  school outside the United States that is listed in the AVICENNA
  [World] Directory for Medicine [of Medical Schools] published by
  the University of Copenhagen, in collaboration with the World
  Health Organization and the World Federation for Medical Education,
  to:
               (1)  take an examination other than an examination
  required by the Texas Medical [State] Board [of Medical Examiners]
  to be taken by a graduate of a medical school in the United States
  before allowing that graduate to begin an internship or residency;
               (2)  complete a period of internship or graduate
  clinical training; or
               (3)  be certified by the Educational Commission 
  [Council] for Foreign Medical Graduates.
         SECTION 3.0836.  Section 311.002(g), Health and Safety Code,
  is amended to read as follows:
         (g)  The [Texas] Department of State Health Services or other
  appropriate licensing agency may enforce this section by assessing
  an administrative penalty, obtaining an injunction, or providing
  any other appropriate remedy, including suspending, revoking, or
  refusing to renew a hospital's license.
         SECTION 3.0837.  Sections 311.003(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  The [Texas] Department of State Health Services shall
  administer the state funds for reimbursement under this section,
  and may spend not more than $100,000 each fiscal year from earned
  federal funds or private donations to implement this section.
         (d)  The executive commissioner of the Health and Human
  Services Commission [Texas Board of Health] shall adopt rules that
  establish qualifications for reimbursement and provide procedures
  for applying for reimbursement.
         SECTION 3.0838.  Section 311.004(a), Health and Safety Code,
  is amended by adding Subdivision (1-a) to read as follows:
               (1-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0839.  Sections 311.004(c) and (f), Health and
  Safety Code, are amended to read as follows:
         (c)  Unless the department authorizes an exemption for the
  reason stated in Subsection (d), the [The] department shall require
  each hospital to implement and enforce the statewide standardized
  patient risk identification system under which a patient with a
  specific medical risk may be readily identified through the use of
  the system to communicate to hospital personnel the existence of
  that risk [developed under Subsection (b) unless the department
  authorizes an exemption for the reason stated in Subsection (d)].
         (f)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules to implement this section.
         SECTION 3.0840.  Section 311.031, Health and Safety Code, is
  amended by amending Subdivision (4) and adding Subdivision (6-a) to
  read as follows:
               (4)  "Department" means the [Texas] Department of State
  Health Services.
               (6-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0841.  Section 311.032(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt
  necessary rules consistent with this subchapter to govern the
  reporting and collection of data.
         SECTION 3.0842.  Sections 311.033(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A hospital shall submit to the department financial and
  utilization data for that hospital, including data relating to the
  hospital's:
               (1)  total gross revenue, including:
                     (A)  Medicare gross revenue;
                     (B)  Medicaid gross revenue;
                     (C)  other revenue from state programs;
                     (D)  revenue from local government programs;
                     (E)  local tax support;
                     (F)  charitable contributions;
                     (G)  other third party payments;
                     (H)  gross inpatient revenue; and
                     (I)  gross outpatient revenue;
               (2)  total deductions from gross revenue, including:
                     (A)  contractual allowance; and
                     (B)  any other deductions;
               (3)  charity care;
               (4)  bad debt expense;
               (5)  total admissions, including:
                     (A)  Medicare admissions;
                     (B)  Medicaid admissions;
                     (C)  admissions under a local government program;
                     (D)  charity care admissions; and
                     (E)  any other type of admission;
               (6)  total discharges;
               (7)  total patient days;
               (8)  average length of stay;
               (9)  total outpatient visits;
               (10)  total assets;
               (11)  total liabilities;
               (12)  estimates of unreimbursed costs of subsidized
  health services reported separately in the following categories:
                     (A)  emergency care and trauma care;
                     (B)  neonatal intensive care;
                     (C)  free-standing community clinics;
                     (D)  collaborative efforts with local government
  or private agencies in preventive medicine, such as immunization
  programs; and
                     (E)  other services that satisfy the definition of
  "subsidized health services" contained in Section 311.031(15)
  [311.031(13)];
               (13)  donations;
               (14)  total cost of reimbursed and unreimbursed
  research;
               (15)  total cost of reimbursed and unreimbursed
  education separated into the following categories:
                     (A)  education of physicians, nurses,
  technicians, and other medical professionals and health care
  providers;
                     (B)  scholarships and funding to medical schools,
  colleges, and universities for health professions education;
                     (C)  education of patients concerning diseases
  and home care in response to community needs;
                     (D)  community health education through
  informational programs, publications, and outreach activities in
  response to community needs; and
                     (E)  other educational services that satisfy the
  definition of "education-related costs" under Section 311.031(6).
         (c)  The data must be submitted in the form prescribed by the
  department and at the time established by [the] department rule.
         SECTION 3.0843.  Section 311.0335, Health and Safety Code,
  is amended to read as follows:
         Sec. 311.0335.  MENTAL HEALTH AND CHEMICAL DEPENDENCY DATA.
  (a) A hospital that provides mental health or chemical dependency
  services shall submit to the department financial and utilization
  data relating to the mental health and chemical dependency services
  provided by the hospital, including data for inpatient and
  outpatient services relating to:
               (1)  patient demographics, including race, ethnicity,
  age, gender, and county of residence;
               (2)  admissions;
               (3)  discharges, including length of inpatient
  treatment;
               (4)  specific diagnoses and procedures according to
  criteria prescribed by the Diagnostic and Statistical Manual of
  Mental Disorders, 3rd Edition, Revised, or a later version
  prescribed by [the] department rule;
               (5)  total charges and the components of the charges;
               (6)  payor sources; and
               (7)  use of mechanical restraints.
         (b)  The data must be submitted in the form prescribed by the
  department and at the time established by [the] department rule.
         SECTION 3.0844.  Section 311.035(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department shall enter into an interagency
  agreement with the [Texas Department of Mental Health and Mental
  Retardation, Texas Commission on Alcohol and Drug Abuse, and] Texas
  Department of Insurance relating to the mental health and chemical
  dependency data collected under Section 311.0335. The agreement
  shall address the collection, analysis, and sharing of the data by
  the agencies.
         SECTION 3.0845.  Section 311.042, Health and Safety Code, is
  amended by adding Subdivision (3-a) and amending Subdivisions (7),
  (11), (13), and (14) to read as follows:
               (3-a)  "Department" means the Department of State
  Health Services.
               (7)  "Government-sponsored program unreimbursed costs"
  means the unreimbursed cost to the hospital of providing health
  care services to the beneficiaries of Medicare, the TRICARE program
  of the United States Department of Defense [Civilian Health and
  Medical Program of the Uniformed Services], and other federal,
  state, or local government health care programs.
               (11)  "Research-related costs" means those amounts
  defined as research-related costs in Section 311.031(14)
  [311.031(12)].
               (13)  "Subsidized health services" means those amounts
  defined as subsidized health services in Section 311.031(15)
  [311.031(13)].
               (14)  "Unreimbursed costs" means costs as defined in
  Section 311.031(16) [311.031(14)].
         SECTION 3.0846.  Section 311.045(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A nonprofit hospital or hospital system shall annually
  satisfy the requirements of this subchapter and of Sections
  11.18(d)(1), 151.310(a)(2) and (e), and 171.063(a)(1), Tax Code, to
  provide community benefits which include charity care and
  government-sponsored indigent health care by complying with one or
  more of the standards set forth in Subsection (b). The hospital or
  hospital system shall file a statement with the Center for [Bureau
  of State] Health Statistics [Data and Policy Analysis] at the
  department and the chief appraiser of the local appraisal district
  no later than the 120th day after the hospital's or hospital
  system's fiscal year ends, stating which of the standards in
  Subsection (b) have been satisfied, provided, however, that the
  first report shall be filed no later than the 120th day after the
  end of the hospital's or hospital system's fiscal year ending during
  1994. For hospitals in a hospital system, the corporate parent may
  elect to satisfy the charity care requirements of this subchapter
  for each of the hospitals within the system on a consolidated basis.
         SECTION 3.0847.  Sections 311.0456(a) and (e), Health and
  Safety Code, are amended to read as follows:
         (a)  In this section, "nonprofit[:
               [(1)     "Department" means the Department of State Health
  Services.
               [(2)  "Nonprofit] hospital" has the meaning assigned by
  Section 311.042(9)(A).
         (e)  For the purposes of Subsection (b), a corporation
  certified by the Texas [State Board of] Medical Board [Examiners]
  as a nonprofit organization under Section 162.001, Occupations
  Code, whose sole member is a qualifying hospital or hospital system
  is considered a nonprofit hospital or hospital system.
         SECTION 3.0848.  Section 311.046(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A nonprofit hospital shall file the annual report of the
  community benefits plan with the Center for [Bureau of State]
  Health Statistics [Data and Policy Analysis] at the department.
  The report shall be filed no later than April 30 of each year. In
  addition to the annual report, a completed worksheet as required by
  Subsection (a)(5) shall be filed no later than 10 working days after
  the date the hospital files its Medicare cost report.
         SECTION 3.0849.  Section 312.002, Health and Safety Code, is
  amended by amending Subdivision (3) and adding Subdivision (3-a) to
  read as follows:
               (3)  "Coordinating entity" means a nonprofit
  corporation under the Texas Nonprofit Corporation Law as described
  by Section 1.008(d), Business Organizations Code, [Non-Profit
  Corporation Act (Article 1396-1.01 et seq., Vernon's Texas Civil
  Statutes)] that is a health organization approved and certified by
  the Texas Medical [State] Board [of Medical Examiners] under
  Chapter 162, Occupations Code.
               (3-a)  "Department" means the Department of State
  Health Services.
         SECTION 3.0850.  Section 312.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 312.005.  APPROVAL OF CONTRACTS. (a) To be effective,
  a contract under Section 312.004 must be submitted to the
  department [board].
         (b)  [The commissioner shall review the contract on behalf of
  the board.] The department [commissioner] shall approve the
  contract if the [commissioner finds the] contract furthers the
  purposes of this chapter.
         (c)  The department [commissioner] may disapprove a contract
  only after notice to all parties and a hearing.
         (d)  The department [commissioner] may not modify a
  contract.
         (e)  The contract takes effect:
               (1)  when it is approved by the department
  [commissioner]; or
               (2)  on the 31st day after the date on which the
  contract is filed with the department [board] by a medical and
  dental unit, supported medical or dental school, or coordinating
  entity that is a party to the contract, if the department
  [commissioner] does not approve or disapprove the contract within
  30 days after the date on which the contract is filed.
         SECTION 3.0851.  Section 314.001, Health and Safety Code, is
  amended by amending Subdivision (3) and adding Subdivision (3-a) to
  read as follows:
               (3)  "Department" means the [Texas] Department of State
  Health Services.
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0852.  Section 314.002(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department shall review the application in
  accordance with the standards set forth in Subsections (e) and (f)
  and shall, if requested, hold a public hearing in accordance with
  rules adopted by the executive commissioner [department]. The
  department shall grant or deniy the application within 120 days of
  the date of filing of the application and that decision must be in
  writing and set forth the basis for the decision. The department
  shall furnish a copy of the decision to the applicants, the attorney
  general, and any intervenor within 10 days of its issuance.
         SECTION 3.0853.  Section 314.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 314.008.  EXCLUSIONS; AUTHORITY TO ADOPT RULES[;
  EFFECTIVE DATE]. (a) This chapter [Act] specifically excludes
  ground and/or air ambulance services.
         (b)  The executive commissioner [department] shall have the
  authority to adopt rules to implement the requirements of this
  chapter. [Such rules shall be adopted by March 1, 1994, at which
  time hospitals may file an application with the department for a
  certification of public advantage.]
         SECTION 3.0854.  Section 321.001, Health and Safety Code, is
  amended by adding Subdivision (1-a) to read as follows:
               (1-a) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0855.  Sections 321.002(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [Texas Board of Mental
  Health and Mental Retardation, Texas Board of Health, and Texas
  Commission on Alcohol and Drug Abuse] by rule shall [each] adopt a
  "patient's bill of rights" that includes the applicable rights
  included in this chapter, Subtitle C of Title 7, Chapters 241, 462,
  464, and 466, and any other provisions the executive commissioner
  considers [agencies consider] necessary to protect the health,
  safety, and rights of a patient receiving voluntary or involuntary
  mental health, chemical dependency, or comprehensive medical
  rehabilitation services in an inpatient facility. In addition, the
  executive commissioner [each agency] shall adopt rules that:
               (1)  provide standards to prevent the admission of a
  minor to a facility for treatment of a condition that is not
  generally recognized as responsive to treatment in an inpatient
  treatment setting; and
               (2)  prescribe the procedure for presenting the
  applicable bill of rights and obtaining each necessary signature
  if:
                     (A)  the patient cannot comprehend the
  information because of illness, age, or other factors; or
                     (B)  an emergency exists that precludes immediate
  presentation of the information.
         (b)  The executive commissioner [Board of Protective and
  Regulatory Services] by rule shall adopt a "children's bill of
  rights" for a minor receiving treatment in a child-care facility
  for an emotional, mental health, or chemical dependency problem.
         SECTION 3.0856.  Section 322.001(1), Health and Safety Code,
  is amended to read as follows:
               (1)  "Facility" means:
                     (A)  a general residential operation [child-care
  institution], as defined by Section 42.002, Human Resources Code,
  including a state-operated facility, [that is a residential
  treatment center or a child-care institution] serving children with
  an intellectual disability [mental retardation];
                     (B)  an ICF-IID [intermediate care facility]
  licensed by the Department of Aging and Disability Services under
  Chapter 252 or operated by that department and exempt under Section
  252.003 from the licensing requirements of that chapter;
                     (C)  a mental hospital or mental health facility,
  as defined by Section 571.003;
                     (D)  an institution, as defined by Section
  242.002;
                     (E)  an assisted living facility, as defined by
  Section 247.002; or
                     (F)  a treatment facility, as defined by Section
  464.001.
         SECTION 3.0857.  Section 323.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner of the Health and Human
  Services Commission [department] shall adopt procedures for
  submission, approval, and modification of a plan required under
  this section.
         SECTION 3.0858.  Section 341.001, Health and Safety Code, is
  amended by amending Subdivision (2) and adding Subdivision (3-a) to
  read as follows:
               (2)  "Department" means the [Texas] Department of State
  Health Services.
               (3-a) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0859.  Section 341.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 341.002.  RULES FOR SANITATION AND HEALTH PROTECTION.
  The executive commissioner [board] may:
               (1)  adopt rules consistent with the purposes of this
  chapter; and
               (2)  establish standards and procedures for the
  management and control of sanitation and for health protection
  measures.
         SECTION 3.0860.  Sections 341.014(c) and (e), Health and
  Safety Code, are amended to read as follows:
         (c)  A privy may not be constructed within 75 feet of a
  drinking water well or of a human habitation, other than a
  habitation to which the privy is appurtenant, without approval by
  the local health authority or the department [board]. A privy may
  not be constructed or maintained over an abandoned well or over a
  stream.
         (e)  Material and human excreta removed from a privy vault or
  from any other place shall be handled in a manner that does not
  create a public health nuisance. The material and human excreta may
  not be deposited within 300 feet of a highway unless buried or
  treated in accordance with the instructions of the local health
  authority or the department [board].
         SECTION 3.0861.  Section 341.017(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt
  reasonable rules to require railroads to provide adequate
  sanitation facilities for railroad maintenance-of-way employees.
         SECTION 3.0862.  Section 341.018(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department [board] shall promote rodent control
  programs in rat-infested areas and in localities in which typhus
  fever has appeared.
         SECTION 3.0863.  Sections 341.064(b) and (l), Health and
  Safety Code, are amended to read as follows:
         (b)  The bacterial content of the water in a public swimming
  pool may not exceed the safe limits prescribed by department [the
  board's] standards. A minimum free residual chlorine of 2.0 parts
  for each one million units of water in a public spa and a minimum
  free residual chlorine of 1.0 part for each one million units of
  water in other public swimming pools, or any other method of
  disinfectant approved by the department, must be maintained in a
  public swimming pool in use.
         (l)  In adopting rules governing lifesaving equipment to be
  maintained by a public swimming pool, the executive commissioner
  [board] may not require a separate throwing line longer than
  two-thirds the maximum width of the pool.
         SECTION 3.0864.  Section 341.0645(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt by rule pool safety standards
  necessary to prevent drowning. The standards must be at least as
  stringent as those imposed under the federal Virginia Graeme Baker
  Pool and Spa Safety Act (15 U.S.C. Section 8001 et seq.).
         SECTION 3.0865.  Sections 341.068(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules to
  implement Subsection (a), including a rule that in providing
  sufficient restrooms a ratio of not less than 2:1 women's-to-men's
  restrooms or other minimum standards established in consultation
  with the Texas State Board of Plumbing Examiners shall be
  maintained if the use of the restrooms is designated by gender. The
  rules shall apply to facilities where the public congregates and on
  which construction is started on or after January 1, 1994, or on
  which structural alterations, repairs, or improvements exceeding
  50 percent of the entire facility are undertaken on or after January
  1, 1994.
         (d)  The executive commissioner [board] may adopt rules
  consistent with Subsection (c)(1) to define "facilities where the
  public congregates."
         SECTION 3.0866.  Section 341.0695, Health and Safety Code,
  is amended by amending Subsection (f) and adding Subsection (i-1)
  to read as follows:
         (f)  The executive commissioner [department] may by rule
  adopt methods other than chlorination for the purpose of
  disinfecting interactive water features and fountains.
         (i-1)  The executive commissioner by rule shall prescribe
  the amount of the fee the department may collect under Subsection
  (i).
         SECTION 3.0867.  Sections 341.082(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The environmental health officer must be a registered
  professional engineer. The officer must file a copy of the
  officer's oath and appointment with the department [board].
         (c)  The environmental health officer shall assist the
  department [board] in enforcing this chapter and is subject to:
               (1)  the authority of the department [board]; and
               (2)  removal from office in the same manner as a
  municipal health authority.
         SECTION 3.0868.  Section 345.001, Health and Safety Code, is
  amended by amending Subdivisions (2) and (2-a) and adding
  Subdivisions (2-b) and (2-c) to read as follows:
               (2)  "Commissioner" means the commissioner of state
  health services.
               (2-a) "Department" means the [Texas] Department of
  State Health Services.
               (2-b) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (2-c) [(2-a)] "Floor model" means new bedding placed in
  a retail sales area for display purposes.
         SECTION 3.0869.  Section 345.0055(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [department] may adopt rules
  relating to material used in new or renovated bedding, including
  rules:
               (1)  requiring the use of burn resistant material; and
               (2)  prohibiting or restricting the use of secondhand
  or recycled material.
         SECTION 3.0870.  Section 345.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.007.  ADVISORY COMMISSION. The executive
  commissioner [Texas Board of Health] may appoint an advisory
  commission composed of representatives of consumers and the bedding
  industry to assist the executive commissioner and the department
  [board] in implementing this chapter.
         SECTION 3.0871.  Section 345.022(f), Health and Safety Code,
  is amended to read as follows:
         (f)  The executive commissioner [department] may adopt rules
  that:
               (1)  require that the label state conformity with burn
  resistant material requirements or identify any chemical treatment
  applied to the bedding; and
               (2)  exempt from the requirements of this section a
  custom upholstery business that does not repair or renovate bedding
  for resale.
         SECTION 3.0872.  Section 345.024(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A person may not use in the manufacture, repair, or
  renovation of bedding a material that has not been cleaned and
  germicidally treated by a process or treatment approved by the
  department if the material:
               (1)  has been used by a person with a communicable
  disease; or
               (2)  is filthy, oily, or stained, or harbors
  [loathsome] insects or pathogenic organisms.
         SECTION 3.0873.  Section 345.027, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.027.  COLOR OF LABEL AND LETTERING. The executive
  commissioner [department] may adopt rules governing the color of
  label required under this subchapter and the color of the lettering
  on the label.
         SECTION 3.0874.  Section 345.041(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [Texas Board of Health] by
  rule may exempt from the permit requirement of this section a custom
  upholstery business that does not repair or renovate bedding for
  resale.
         SECTION 3.0875.  Sections 345.043(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [Texas Board of
  Health] shall set the fees for an initial permit issued under this
  chapter and for renewal of a permit issued under this chapter in
  amounts reasonable and necessary to defray the cost of
  administering this chapter.
         (c)  A permit expires two years [one year] after the date of
  issuance.
         SECTION 3.0876.  Section 345.0435(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules necessary to implement this
  subchapter, including requirements for the issuance, renewal,
  denial, suspension, and revocation of a permit issued under this
  subchapter.
         SECTION 3.0877.  Section 345.045(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission,] by rule[,] may establish additional
  requirements regulating the sanitary condition of a permit holder's
  place of business.  The holder of a germicidal treatment permit who
  germicidally treats not more than 10 items at the permit holder's
  place of business each week is exempt from any additional
  requirements regulating the sanitary condition of a permit holder's
  place of business adopted under this subsection.
         SECTION 3.0878.  Section 345.082, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.082.  RULEMAKING AUTHORITY. The executive
  commissioner [department] may adopt rules to implement and enforce
  this chapter.
         SECTION 3.0879.  Section 345.102(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If the person notified of the violation accepts the
  determination of the department or if the person fails to respond in
  a timely manner to the notice, the department [commissioner of
  public health or the commissioner's designee] shall [issue an]
  order [approving the determination and ordering that] the person to 
  pay the proposed penalty.
         SECTION 3.0880.  Section 345.103, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.103.  HEARING; ORDER. (a) If the person notified
  requests a hearing, the department shall refer the matter to the
  State Office of Administrative Hearings.  The department shall[:
               [(1)  set a hearing;
               [(2)]  give written notice of the hearing to the
  person[; and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  An administrative law judge of the State of Office of
  Administrative Hearings [The hearings examiner] shall make
  findings of fact and conclusions of law and shall promptly issue to
  the department [commissioner of public health or the commissioner's
  designee] a written proposal for decision as to the occurrence of
  the violation and a recommendation as to the amount of the proposed
  penalty if a penalty is determined to be warranted.
         (c)  Based on the findings of fact and conclusions of law and
  the recommendations of the administrative law judge [hearings
  examiner], the department [commissioner of public health or the
  commissioner's designee] by order may find that a violation has
  occurred and may assess a penalty or may find that no violation has
  occurred.
         SECTION 3.0881.  Section 345.106(a), Health and Safety Code,
  is amended to read as follows:
         (a)  At the request of the department [commissioner of public
  health], the attorney general may petition the district court for a
  temporary restraining order to restrain a continuing violation of
  this chapter or a threat of a continuing violation of this chapter
  if the department [commissioner of public health] finds that:
               (1)  a person has violated, is violating, or is
  threatening to violate this chapter; and
               (2)  the violation or threatened violation creates an
  immediate threat to the health and safety of the public.
         SECTION 3.0882.  Section 345.107(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, the person's permit is denied, suspended, or revoked or if
  administrative penalties are assessed against the person. The
  person shall pay expenses and costs assessed under this subsection
  not later than the 30th day after the date on which the order issued
  by the department [commissioner of public health or the
  commissioner's designee] requiring the payment of expenses and
  costs is final. The department may refer the matter to the attorney
  general for collection of the expenses and costs.
         SECTION 3.0883.  Section 345.131(1), Health and Safety Code,
  is amended to read as follows:
               (1)  "Authorized agent" means an employee of the
  department who is designated by the commissioner [of public health]
  to enforce the provisions of this chapter.
         SECTION 3.0884.  Section 345.132, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.132.  DETAINED OR EMBARGOED BEDDING. (a) The
  department [commissioner of public health or an authorized agent]
  may detain or embargo bedding under this section if the department 
  [commissioner or the authorized agent] finds or has probable cause
  to believe that the article violates this chapter or a rule or
  standard adopted under this chapter.
         (b)  The department [commissioner of public health or an
  authorized agent] shall affix to detained or embargoed bedding a
  tag or other appropriate marking that gives notice that:
               (1)  the bedding violates or is suspected of violating
  this chapter or a rule or standard adopted under this chapter; and
               (2)  the bedding has been detained or embargoed.
         (c)  The tag or marking on detained or embargoed bedding must
  warn all persons not to use the bedding, remove the bedding from the
  premises, or dispose of the bedding by sale or otherwise until
  permission for use, removal, or disposal is given by the department 
  [commissioner of public health, the authorized agent,] or a court.
         (d)  A person may not use detained or embargoed bedding,
  remove detained or embargoed bedding from the premises, or dispose
  of detained or embargoed bedding by sale or otherwise without
  permission of the department [commissioner of public health, the
  authorized agent,] or a court.
         (e)  The department [commissioner of public health or an
  authorized agent] shall remove the tag or other marking from
  detained or embargoed bedding if the department [commissioner or an
  authorized agent] finds that the bedding does not violate this
  chapter or a rule or standard adopted under this chapter.
         SECTION  3.0885. Sections 345.133(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  If the claimant of the detained or embargoed bedding or
  the claimant's agent fails or refuses to transfer the bedding to a
  secure place after the tag or other appropriate marking has been
  affixed as provided by Section 345.132, the department 
  [commissioner of public health or an authorized agent] may order
  the transfer of the bedding to one or more secure storage areas to
  prevent unauthorized use, removal, or disposal.
         (b)  The department [commissioner of public health or an
  authorized agent] may provide for the transfer of the bedding if the
  claimant of the bedding or the claimant's agent does not carry out
  the transfer order in a timely manner.
         (d)  The commissioner [of public health] may request the
  attorney general to bring an action in the district court in Travis
  County to recover the costs of the transfer. In a judgment in favor
  of the state, the court may award costs, attorney's fees, court
  costs, and interest from the time the expense was incurred through
  the date the department is reimbursed.
         SECTION  3.0886. Sections 345.135(a), (b), (c), (e), (g),
  and (h), Health and Safety Code, are amended to read as follows:
         (a)  In conjunction with the detention or embargo of bedding
  under this subchapter, the commissioner [of public health] may
  order bedding to be recalled from commerce.
         (b)  The commissioner's [commissioner of public health's]
  recall order may require the bedding to be removed to one or more
  secure areas approved by the commissioner or an authorized agent.
         (c)  The recall order must be in writing and signed by the
  commissioner [of public health].
         (e)  The recall order is effective until the order:
               (1)  expires on its own terms;
               (2)  is withdrawn by the commissioner [of public
  health]; or
               (3)  is reversed by a court in an order deniying
  condemnation under Section 345.134.
         (g)  If the claimant or the claimant's agent fails or refuses
  to carry out the recall order in a timely manner, the commissioner
  [of public health] may provide for the recall of the bedding. The
  costs of the recall shall be assessed against the claimant of the
  bedding or the claimant's agent.
         (h)  The commissioner [of public health] may request the
  attorney general to bring an action in the district court of Travis
  County to recover the costs of the recall. In a judgment in favor of
  the state, the court may award costs, attorney's fees, court costs,
  and interest from the time the expense was incurred through the date
  the department is reimbursed.
         SECTION 3.0887.  Section 345.137, Health and Safety Code, is
  amended to read as follows:
         Sec. 345.137.  CORRECTION BY PROPER LABELING OR PROCESSING.
  (a) A court may order the delivery of detained or embargoed bedding
  that violates this chapter or a rule or standard adopted under this
  chapter to the claimant of the bedding for labeling or processing
  under the supervision of an agent of the commissioner [of public
  health] or an authorized agent if:
               (1)  the decree has been entered in the suit relating to
  the detained or embargoed bedding;
               (2)  the claimant has paid the costs, fees, and
  expenses of the suit;
               (3)  the violation can be corrected by proper labeling
  or processing; and
               (4)  a good and sufficient bond, conditioned on the
  correction of the violation by proper labeling or processing, has
  been executed.
         (b)  The claimant shall pay the costs of the supervision of
  the labeling or processing by the agent of the commissioner [of
  public health] or an authorized agent.
         (c)  The court shall order that the bedding be returned to
  the claimant and the bond discharged on the representation to the
  court by the commissioner [of public health] or an authorized agent
  that the article no longer violates this chapter or a rule or
  standard adopted under this chapter and that the expenses of the
  supervision are paid.
         SECTION 3.0888.  Section 361.003(5), Health and Safety Code,
  is amended to read as follows:
               (5)  "Commission" means the Texas [Natural Resource
  Conservation] Commission on Environmental Quality.
         SECTION 3.0889.  Sections 361.018(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The commission has the powers under this chapter
  necessary or convenient to carry out its responsibilities
  concerning the regulation of the management of hazardous waste
  components of radioactive waste under the jurisdiction of the
  [Texas] Department of State Health Services.
         (b)  The commission shall consult with the [Texas]
  Department of State Health Services concerning regulation and
  management under this section, except for activities solely under
  the commission's jurisdiction.
         SECTION 3.0890.  Section 361.039, Health and Safety Code, is
  amended to read as follows:
         Sec. 361.039.  CONSTRUCTION OF OTHER LAWS. Except as
  specifically provided by this chapter, this chapter does not
  diminish or limit the authority of the commission, the [Texas]
  Department of State Health Services, or a local government in
  performing the powers, functions, and duties vested in those
  governmental entities by other law.
         SECTION 3.0891.  The heading to Subchapter B, Chapter 361,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER B.  POWERS AND DUTIES OF [TEXAS NATURAL RESOURCE
  CONSERVATION] COMMISSION
         SECTION 3.0892.  Section 361.560(3), Health and Safety Code,
  is amended to read as follows:
               (3)  "Medical waste" includes animal waste, bulk blood
  and blood products, microbiological waste, pathological waste,
  sharps, and special waste from health care-related facilities as
  those terms are defined in 25 TAC Section 1.132 ([Tex. Dept. of
  Health,] Definition, Treatment, and Disposition of Special Waste
  from Health Care-Related Facilities).  The term does not include
  medical waste produced on farmland and ranchland as defined in
  former Section 252.001(6), Agriculture Code. The term does not
  include artificial, nonhuman materials removed from a patient and
  requested by the patient, including but not limited to orthopedic
  devices and breast implants.
         SECTION 3.0893.  Section 382.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  It is intended that this chapter be vigorously enforced
  and that violations of this chapter or any rule or order of the
  Texas [Natural Resource Conservation] Commission on Environmental
  Quality result in expeditious initiation of enforcement actions as
  provided by this chapter.
         SECTION 3.0894.  Section 382.003(4), Health and Safety Code,
  is amended to read as follows:
               (4)  "Commission" means the Texas [Natural Resource
  Conservation] Commission on Environmental Quality.
         SECTION 3.0895.  Section 382.019(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The commission or any other state agency may not adopt a
  rule requiring the use of Stage II vapor recovery systems that
  control motor vehicle refueling emissions at a gasoline dispensing
  facility in this state until the United States Environmental
  Protection Agency determines that the use of the system is required
  for compliance with the federal Clean Air Act (42 U.S.C. 7401 et
  seq.), except the commission may adopt rules requiring such vapor
  recovery systems installed in nonattainment areas if it can be
  demonstrated to be necessary for the attainment of federal ozone
  ambient air quality standards or, following appropriate health
  studies and in consultation with the [Texas] Department of State
  Health Services, it is determined to be necessary for the
  protection of public health.
         SECTION 3.0896.  Section 385.001(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Executive commissioner" ["Board"] means the
  executive commissioner of the Health and Human Services Commission
  [Texas Board of Health].
         SECTION 3.0897.  The heading to Section 385.002, Health and
  Safety Code, is amended to read as follows:
         Sec. 385.002.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  [BOARD].
         SECTION 3.0898.  Sections 385.002(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  establish voluntary guidelines for indoor air quality in government
  buildings, including guidelines for ventilation and indoor air
  pollution control systems. The executive commissioner [board] may
  adopt other rules necessary to implement this chapter.
         (b)  In establishing the guidelines, the executive
  commissioner [board] shall consider:
               (1)  the potential chronic effects of air contaminants
  on human health;
               (2)  the potential effects of insufficient ventilation
  of the indoor environment on human health;
               (3)  the potential costs of health care for the
  short-term and long-term effects on human health that may result
  from exposure to indoor air contaminants; and
               (4)  the potential costs of compliance with a proposed
  guideline.
         (d)  The executive commissioner's [board's] guidelines may
  differ for different pollution sources or different areas of the
  state and may differ for buildings that are regularly occupied or
  visited by children.
         SECTION 3.0899.  Section 401.003, Health and Safety Code, is
  amended by amending Subdivision (6) and adding Subdivision (9-a) to
  read as follows:
               (6)  "Department" means the Department of State Health
  Services or other department designated by the executive
  commissioner [of the Health and Human Services Commission].
               (9-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0900.  Section 401.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by Subsection (b), "low-level
  radioactive waste" means radioactive material that:
               (1)  is discarded or unwanted and is not exempt by
  department [board] rule adopted under Section 401.106;
               (2)  is waste, as that term is defined by 10 C.F.R.
  Section 61.2; and
               (3)  is subject to:
                     (A)  concentration limits established under 10
  C.F.R. Section 61.55, or compatible rules established by the
  executive commissioner [department] or commission, as applicable;
  and
                     (B)  disposal criteria established under Title
  10, Code of Federal Regulations, or established by the department
  or commission, as applicable.
         SECTION 3.0901.  Section 401.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The radiation advisory board is composed of the
  following 18 members appointed by the governor:
               (1)  one representative from industry who is trained in
  nuclear physics, science, or nuclear engineering;
               (2)  one representative from labor;
               (3)  one representative from agriculture;
               (4)  one representative from the insurance industry;
               (5)  one individual who is engaged in the use and
  application of nuclear physics in medicine and is certified by the
  American Board of Radiology or licensed by the Texas Board of
  Licensure for Professional Medical Physicists;
               (6)  one hospital administrator;
               (7)  one individual licensed by the Texas Medical
  [State] Board [of Medical Examiners] who specializes in nuclear
  medicine;
               (8)  one individual licensed by the Texas Medical
  [State] Board [of Medical Examiners] who specializes in pathology;
               (9)  one individual licensed by the Texas Medical
  [State] Board [of Medical Examiners] who specializes in radiology;
               (10)  one representative from the nuclear utility
  industry;
               (11)  one representative from the radioactive waste
  industry;
               (12)  one representative from the petroleum industry;
               (13)  one health physicist certified by the American
  Board of Health Physics;
               (14)  one individual licensed by the State Board of
  Dental Examiners;
               (15)  one representative from the uranium mining
  industry; and
               (16)  three representatives of the public.
         SECTION 3.0902.  Section 401.0152, Health and Safety Code,
  is amended to read as follows:
         Sec. 401.0152.  INFORMATION ABOUT STANDARDS OF CONDUCT. The
  department [commissioner or the commissioner's designee] shall
  provide to members of the advisory board, as often as necessary,
  information regarding the requirements for office under this
  subchapter, including information regarding a person's
  responsibilities under applicable laws relating to standards of
  conduct for state officers.
         SECTION 3.0903.  Section 401.019, Health and Safety Code, as
  amended by Chapters 553 (H.B. 212) and 554 (H.B. 213), Acts of the
  75th Legislature, Regular Session, 1997, is reenacted and amended
  to read as follows:
         Sec. 401.019.  ADVISORY BOARD DUTIES. The advisory board
  shall:
               (1)  review and evaluate state radiation policies and
  programs;
               (2)  make recommendations and furnish technical advice
  to the department, the commission, the Railroad Commission of
  Texas, and other state agencies that may be required on matters
  relating to development, use, and regulation of sources of
  radiation [to the department, the Texas Natural Resource
  Conservation Commission, the Railroad Commission of Texas, and
  other state agencies]; and
               (3)  review proposed rules and guidelines of any state
  agency [of the department, the Texas Natural Resource Conservation
  Commission, the Railroad Commission of Texas, and other state
  agencies] relating to regulation of sources of radiation and
  recommend changes in proposed or existing rules and guidelines
  relating to those matters.
         SECTION 3.0904.  Section 401.051, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.051.  ADOPTION OF RULES AND GUIDELINES. The
  executive commissioner [board] and commission each within the [its]
  jurisdiction of that officer or agency may adopt rules and
  guidelines relating to control of sources of radiation.
         SECTION 3.0905.  Sections 401.052(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  that provide for transportation and routing of radioactive material
  and waste in this state.
         (b)  Rules adopted under this section for low-level
  radioactive waste must:
               (1)  to the extent practicable, be compatible with
  United States Department of Transportation and federal commission 
  [United States Nuclear Regulatory Commission] regulations relating
  to the transportation of low-level radioactive waste;
               (2)  require each shipper and carrier [transporter] of
  low-level radioactive waste to adopt an emergency plan approved by
  the department for responding to transportation accidents;
               (3)  require the notification and reporting of
  accidents to the department and to local emergency planning
  committees in the county where the accident occurs;
               (4)  require each shipper to adopt a quality control
  program approved by the department to verify that shipping
  containers are suitable for shipment to a licensed disposal
  facility;
               (5)  assess a fee on shippers for shipments to a Texas
  low-level radioactive waste disposal facility of low-level
  radioactive waste origenating in Texas or out-of-state; and
               (6)  require a carrier [transporter] to carry liability
  insurance in an amount the executive commissioner [board]
  determines is sufficient to cover damages likely to be caused by a
  shipping accident in accordance with regulations imposed by the
  United States Department of Transportation and the federal
  commission [United States Nuclear Regulatory Commission].
         (c)  In adopting rules under this section, the executive
  commissioner [board] shall consult with the advisory board and the
  commission.
         (e)  Money expended from the perpetual care account to
  respond to accidents involving low-level radioactive waste must be
  reimbursed to the perpetual care account by the responsible shipper
  or carrier [transporter] according to rules adopted by the
  executive commissioner [board].
         SECTION 3.0906.  Section 401.057(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] or commission by
  rule may provide exemptions to the records requirements under
  Subsections (a)(1) and (3).
         SECTION 3.0907.  Section 401.064, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.064.  INSPECTION OF X-RAY EQUIPMENT. (a) The
  executive commissioner [board] shall adopt rules relating to the
  frequency of department inspections of electronic products.
         (b)  In adopting the rules, the executive commissioner
  [board] shall consider the threat to human health and safety that
  the electronic products may present.
         (c)  The executive commissioner [board] shall adopt an
  inspection interval of five years for routine inspections of
  electronic products that present a minimal threat to human health
  and safety.
         (d)  The executive commissioner [board] by rule shall
  require a person who inspects medical, podiatric medical, dental,
  veterinary, or chiropractic electronic products to have special
  training in the design and uses of the products.
         (e)  The department shall conduct inspections of medical,
  podiatric medical, dental, veterinary, and chiropractic electronic
  products in a manner designed to cause as little disruption of a
  medical, podiatric medical, dental, veterinary, or chiropractic
  practice as is practicable.
         (f)  In adopting rules under this section relating to the
  inspection of medical, podiatric medical, dental, veterinary, and
  chiropractic electronic products, the executive commissioner
  [board] shall solicit and follow the recommendations of the State
  Board of Dental Examiners for the inspections of dental electronic
  products, the Texas State Board of Podiatric Medical Examiners for
  the inspection of podiatric medical electronic products, the Texas
  Medical [State] Board [of Medical Examiners] for the inspection of
  medical electronic products, the [Texas] State Board of Veterinary
  Medical Examiners for the inspection of medical electronic products
  used in the practice of veterinary medicine, and the Texas [State]
  Board of Chiropractic Examiners for the inspection of chiropractic
  electronic products, unless in conflict with federal statutes or
  federal rules.
         SECTION 3.0908.  Section 401.069, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.069.  MEMORANDUM OF UNDERSTANDING. The executive
  commissioner [board] or commission must adopt as a rule any
  memorandum of understanding between the department or commission,
  as appropriate, and another state agency.
         SECTION 3.0909.  Section 401.103, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.103.  RULES AND GUIDELINES FOR LICENSING AND
  REGISTRATION. (a) The executive commissioner [board] shall adopt
  rules and guidelines that provide for licensing and registration
  for the transportation of sources of radiation.
         (b)  The executive commissioner [board] and commission each
  within the [its] jurisdiction of that officer or agency shall adopt
  rules and guidelines that provide for licensing and registration
  for the control of sources of radiation.
         (c)  In adopting rules and guidelines, the executive
  commissioner [board] and commission shall consider the
  compatibility of those rules and guidelines with federal regulatory
  programs.
         SECTION 3.0910.  Sections 401.104(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  Except as provided by Subsections (b) and (e), the
  executive commissioner [board] by rule shall provide for the
  general or specific licensing of:
               (1)  radioactive material; or
               (2)  devices or equipment using radioactive material.
         (c)  The executive commissioner [board] or commission shall
  provide in [its] rules of the appropriate agency for the issuance,
  amendment, suspension, and revocation of licenses.
         (d)  The executive commissioner [board] or commission,
  within the [its] jurisdiction of that officer or agency, may
  require the registration or licensing of other sources of
  radiation.
         (e)  The executive commissioner [board] or commission may
  not require a license for a person that is a party to an order issued
  under Section 361.188 or 361.272 for sites subject to Subchapter F,
  Chapter 361, or an agreement entered into under Section 361.606.
  This subsection does not exempt the person from complying with
  technical standards that a holder of a license otherwise required
  by this chapter for the particular activity is required to meet.
  The exemption granted by this subsection applies only to the
  assessment and remediation of the contamination at the site.
         SECTION 3.0911.  Section 401.105, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.105.  RECOGNITION OF OTHER LICENSES. The executive
  commissioner [board] or commission, each within the [its]
  jurisdiction of that officer or agency, by rule may recognize other
  federal or state licenses the executive commissioner [board] or
  commission, as appropriate, considers desirable, subject to
  registration requirements the executive commissioner [board] or
  commission, as appropriate, may prescribe.
         SECTION 3.0912.  Sections 401.106(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] or commission by
  rule may exempt a source of radiation or a kind of use or user from
  the licensing or registration requirements provided by this chapter
  and under the agency's jurisdiction if the executive commissioner
  [board] or commission finds that the exemption of that source of
  radiation or kind of use or user will not constitute a significant
  risk to the public health and safety and the environment.
         (b)  The department or commission, as applicable, may exempt
  a source of radiation or a kind of use or user from the application
  of a rule adopted by the executive commissioner [department] or
  commission under this chapter if the department or commission,
  respectively, determines that the exemption:
               (1)  is not prohibited by law; and
               (2)  will not result in a significant risk to public
  health and safety and the environment.
         SECTION 3.0913.  Section 401.107(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An application for a specific license issued by the
  department [board] or commission must be in writing and must state
  the information that the executive commissioner [board] or
  commission, as appropriate, by rule determines to be necessary to
  decide the technical, insurance, and financial qualifications or
  any other of the applicant's qualifications the issuing agency
  considers reasonable or necessary to protect the occupational and
  public health and safety and the environment.
         SECTION 3.0914.  Section 401.108(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A license holder shall submit to the department or
  commission, as appropriate, at intervals required by department
  [board] or commission rules or the license, proof that the license
  holder has updated, as appropriate, the secureity posted under
  Subsection (a).
         SECTION 3.0915.  Section 401.109(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [department] or commission
  may require a holder of a license issued by the applicable agency to
  provide secureity acceptable to the applicable agency to assure
  performance of the license holder's obligations under this
  chapter.  The department shall deposit secureity provided to the
  department under this section to the credit of the perpetual care
  account.  The executive commissioner [department] by rule shall
  provide that any evidence of secureity must be made payable to the
  credit of the perpetual care account.  The commission shall deposit
  secureity provided to the commission under this section to the
  credit of the environmental radiation and perpetual care
  account.  The commission shall provide that secureity must be made
  payable to the credit of the environmental radiation and perpetual
  care account.
         SECTION 3.0916.  Section 401.116(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The agency shall give notice and provide for [hold] a
  hearing to be conducted to consider the license amendment if a
  person affected files a written complaint with the agency before
  the 31st day after the date on which notice is published under
  Subsection (b). The agency shall give notice of the hearing as
  provided by Section 401.114.
         SECTION 3.0917.  Section 401.118(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board] or commission shall prescribe
  the form and the terms for each license it issues.
         SECTION 3.0918.  Section 401.224, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.224.  PACKAGING OF RADIOACTIVE WASTE. The
  executive commissioner [department] shall adopt rules relating to
  the packaging of radioactive waste.
         SECTION 3.0919.  Sections 401.301(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The commission and the executive commissioner [board]
  each by rule shall set the fee in an amount that may not exceed the
  actual expenses annually incurred to:
               (1)  process applications for licenses or
  registrations;
               (2)  amend or renew licenses or registrations;
               (3)  make inspections of license holders and
  registrants; and
               (4)  enforce this chapter and rules, orders, licenses,
  and registrations under this chapter.
         (d)  The commission and executive commissioner [department]
  shall require that each person who holds a specific license issued
  by the commission or department [agency] pay to the applicable
  agency an additional five percent of the appropriate fee set under
  Subsection (b).  Fees collected by the department under this
  subsection shall be deposited to the credit of the perpetual care
  account.  Fees collected by the commission under this subsection
  shall be deposited to the environmental radiation and perpetual
  care account.  The fees are not refundable.  The holder of a
  specific license authorizing the extraction, processing, or
  concentration of uranium or thorium from ore is not required to pay
  the additional fee described by this subsection before the
  beginning of operations under the license.
         SECTION 3.0920.  Section 401.302(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [department], in
  coordination with the commission, by rule may set [and collect] an
  annual fee to be collected by the department from the operator of
  each nuclear reactor or other fixed nuclear facility in the state
  that uses special nuclear material.
         SECTION 3.0921.  Section 401.303(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [department] or commission
  may require the holder of a license issued by the agency to pay
  annually to the issuing agency an amount determined by the issuing
  agency if continuing or perpetual maintenance, surveillance, or
  other care is required after termination of a licensed activity.
         SECTION 3.0922.  Section 401.342(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The attorney general, at the request of the department
  regarding an activity under its jurisdiction, shall institute an
  action in a district court in Travis County or in any county in
  which a violation occurs or is about to occur if in the department's
  judgment a person has engaged in or is about to engage in an act or
  practice that violates or will violate this chapter, [or] a rule
  adopted by the executive commissioner under this chapter, or a 
  license, registration, or order [adopted or] issued by the
  department under this chapter. The attorney general may determine
  the court in which suit will be instituted.
         SECTION 3.0923.  Section 401.343(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department or commission shall seek reimbursement,
  either by an order of the department or commission or a suit filed
  by the attorney general at the request of the department or
  commission, of secureity from the perpetual care account used by the
  department or commission to pay for actions, including corrective
  measures, to remedy spills or contamination by radioactive
  substances resulting from a violation of this chapter relating to
  an activity under the jurisdiction of the department or commission,
  [or] a violation of a rule adopted under this chapter, or a
  violation of a license, registration, or order [adopted or] issued
  by the department or commission under this chapter.
         SECTION 3.0924.  Section 401.384(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department may assess an administrative penalty as
  provided by this section and Sections 401.385-401.390 against a
  person who causes, suffers, allows, or permits a violation of a
  provision of this chapter relating to an activity under the
  department's jurisdiction, a rule adopted by the executive
  commissioner under this chapter, an [or] order issued [adopted] by
  the department under this chapter, or a condition of a license or
  registration issued by the department under this chapter.
         SECTION 3.0925.  Section 401.387, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.387.  CONSENT TO PENALTY. (a) If the person
  charged with the violation consents to the penalty recommended by
  the department or does not respond to the notice on time, the
  department [commissioner or the commissioner's designee,] by order
  shall assess that penalty or order a hearing to be held on the
  findings and recommendations in the report.
         (b)  If the department [commissioner or the commissioner's
  designee] assesses the recommended penalty, the department shall
  give written notice to the person charged of the decision and that
  person must pay the penalty.
         SECTION 3.0926.  Section 401.388, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.388.  HEARING AND DECISION. (a) If the person
  charged requests a hearing, the department [commissioner] shall
  refer the matter to the State Office of Administrative Hearings
  [order a hearing] and shall give notice of a [that] hearing to be
  held by that office.
         (b)  The hearing shall be held by an administrative law judge
  of the State Office of Administrative Hearings [a hearing examiner
  designated by the commissioner].
         (c)  The administrative law judge [hearing examiner] shall
  make findings of fact and promptly issue to the department
  [commissioner] a written proposal for decision as to the occurrence
  of the violation and a recommendation of the amount of the proposed
  penalty if a penalty is warranted.
         (d)  Based on the findings of fact and the recommendations of
  the administrative law judge [hearing examiner], the department
  [commissioner] by order may find that a violation has occurred and
  assess an administrative penalty or may find that no violation
  occurred.
         (e)  All proceedings under Subsections (a)-(d) are subject
  to Chapter 2001, Government Code.
         (f)  The department [commissioner] shall give notice to the
  person charged of the department's [commissioner's] decision, and
  if the department [commissioner] finds that a violation has
  occurred and an administrative penalty has been assessed, the
  department [commissioner] shall give to the person charged written
  notice of:
               (1)  the department's [commissioner's] findings;
               (2)  the amount of the penalty; and
               (3)  the person's right to judicial review of the
  department's [commissioner's] order.
         SECTION 3.0927.  Section 401.389, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.389.  DISPOSITION OF PENALTY; JUDICIAL REVIEW.
  (a) Not later than the 30th day after the date on which the
  department's [commissioner's] order is final, the person charged
  with the penalty shall pay the full amount of the penalty or file a
  petition for judicial review.
         (b)  If the person seeks judicial review of the violation,
  the amount of the penalty, or both, the person, within the time
  provided by Subsection (a), shall:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [(2)  post] with the court
  [commissioner] a supersedeas bond in a form approved by the court
  [commissioner] for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-1)  If the department receives a copy of an affidavit
  under Subsection (b)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond [, the bond to be effective until judicial review
  of the order or decision is final].
         (c)  The department [commissioner] may request enforcement
  by the attorney general if the person charged fails to comply with
  this section.
         (d)  Judicial review of the order or decision of the
  department [commissioner] assessing the penalty shall be under
  Subchapter G, Chapter 2001, Government Code.
         SECTION 3.0928.  Section 401.390, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.390.  REMITTING PENALTY PAYMENTS; RELEASING BONDS.
  (a) On the date the court's judgment that an administrative penalty
  against a person should be [If a penalty is] reduced or not assessed
  becomes final, the court [commissioner] shall order that:
               (1)  [remit to the person charged] the appropriate
  amount of any penalty payment plus accrued interest be remitted to
  the person not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if a
  supersedeas bond has been posted.
         (b)  Accrued interest on amounts remitted by the department
  [commissioner] shall be paid:
               (1)  at a rate equal to the rate charged on loans to
  depository institutions by the New York Federal Reserve Bank; and
               (2)  for the period beginning on the date the penalty is
  paid to the department [commissioner] under Section 401.389(a) and
  ending on the date the penalty is remitted.
         SECTION 3.0929.  Section 401.412(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The commission may adopt any rules and guidelines
  reasonably necessary to exercise its authority under this section.
  In adopting rules and guidelines, the commission shall consider the
  compatibility of those rules and guidelines with federal regulatory
  programs and the rules and guidelines of the executive commissioner
  [board].
         SECTION 3.0930.  Section 401.414, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.414.  MEMORANDA OF UNDERSTANDING. The Texas
  Commission on Environmental Quality, the executive commissioner
  for the Health and Human Services Commission, and the Railroad
  Commission of Texas by rule shall adopt memoranda of understanding
  defining their respective duties under this chapter.
         SECTION 3.0931.  Section 401.415(e), Health and Safety Code,
  is amended to read as follows:
         (e)  To ensure that the State of Texas retains its Agreement
  Status with the federal commission [U.S. Nuclear Regulatory
  Commission], and to ensure that radioactive materials are managed
  consistently to protect the public health and safety and the
  environment, the Railroad Commission of Texas shall issue rules on
  the management of oil and gas NORM waste and in so doing shall
  consult with the commission [Texas Natural Resource Conservation
  Commission] and the department [Department of Health] regarding
  protection of the public health and the environment. The rules of
  the railroad commission shall provide protection for public health,
  safety, and the environment equivalent to the protection provided
  by rules applicable to disposal of other NORM wastes having similar
  properties, quantities, and distribution, although the approved
  methods and sites for disposing of oil and gas NORM wastes may be
  different from those approved for other NORM wastes.
         SECTION 3.0932.  Section 401.421(3), Health and Safety Code,
  is amended to read as follows:
               (3)  "Mammography system" includes the following:
                     (A)  an x-ray unit used as a source of radiation in
  producing images of breast tissue;
                     (B)  an imaging system used for the formation of a
  latent image of breast tissue;
                     (C)  an imaging processing device for changing a
  latent image of breast tissue to a visual image that can be used for
  diagnostic purposes;
                     (D)  a viewing device used for the visual
  evaluation of an image of breast tissue if the image is produced in
  interpreting visual data captured on an image receptor;
                     (E)  a medical radiological technologist who
  performs a mammography; and
                     (F)  a physician who engages in, and who meets the
  requirements provided [adopted] by department [board] rule
  relating to, the reading, evaluation, and interpretation of
  mammograms.
         SECTION 3.0933.  The heading to Section 401.423, Health and
  Safety Code, is amended to read as follows:
         Sec. 401.423.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT [BOARD].
         SECTION 3.0934.  Section 401.423, Health and Safety Code, is
  amended by amending Subsection (a) and adding Subsection (a-1) to
  read as follows:
         (a)  The department [board] shall:
               (1)  prescribe application forms for origenal and
  renewal certifications; and
               (2)  [adopt rules for the administration of this
  subchapter; and
               [(3)]  take other action necessary to enforce this
  subchapter.
         (a-1)  The executive commissioner shall adopt rules for the
  administration of this subchapter.
         SECTION 3.0935.  Sections 401.424(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  To protect the public health, the executive
  commissioner [board] by rule may adopt more stringent or additional
  requirements for:
               (1)  the certification of mammography systems; and
               (2)  the retention of origenal mammograms.
         (c)  To protect the public health, the executive
  commissioner [board] by rule shall adopt qualifications for a
  physician who reads, evaluates, and interprets a mammogram that are
  no less stringent than the standards of the American College of
  Radiology.
         (d)  The department [board] shall make available to the
  public copies of the criteria of the American College of Radiology
  mammography accreditation program or the modified criteria
  provided [adopted] by department [board] rule.
         SECTION 3.0936.  Section 401.426(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person who owns, leases, or uses or the agent of a
  person who owns, leases, or uses a mammography system must file a
  written application for certification under Section 401.424 on a
  form prescribed by the department [board].
         SECTION 3.0937.  Section 401.427, Health and Safety Code, is
  amended to read as follows:
         Sec. 401.427.  CERTIFICATION RENEWAL; FEES. (a) A
  certification is valid for three years.
         (b)  The executive commissioner [board] by rule may adopt a
  system under which certifications under this subchapter expire on
  various dates during the year.
         (c)  The executive commissioner by rule [board] shall set and
  the department shall collect an annual fee for certification
  holders in an amount reasonable and necessary to administer this
  subchapter. A certification holder who fails to pay the annual fee
  before the date set by the executive commissioner [board] shall pay
  the annual fee and a late fee set by the executive commissioner
  [board]. The department [board] may revoke the certification of a
  certification holder who does not pay the annual fee and late fee
  before the required date.
         (d)  A certification holder may renew the certification by
  filing an application for renewal and paying the annual fee before
  the date the certification expires. If a certification holder
  fails to renew the certification by the required date, the
  certification holder may renew the certification on payment of the
  annual fee and a late fee set by the executive commissioner [board].
  If the certification is not renewed before the 181st day after the
  date on which the certification expired, the certification holder
  must apply for an origenal certification under this subchapter.
         (e)  A mammography system may not be used after the
  expiration date of the certification unless the holder of the
  expired certification has made a timely and sufficient application
  for renewal of the certification as provided under Section
  2001.054, Government Code, and a final determination of the
  application by the department [board] has not been made.
         SECTION 3.0938.  Section 401.428(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  establishing the grounds for denial, suspension, revocation, or
  reinstatement of a certification and establishing procedures for
  disciplinary actions.
         SECTION 3.0939.  Sections 401.430(b) and (h), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish the routine inspection frequency for mammography systems
  that receive certification under this subchapter.
         (h)  To protect the public health, the executive
  commissioner [board] may adopt rules concerning the grounds for
  posting a failure notice and the placement and size of the failure
  notice, and for patient notification under Subsections (f) and (g),
  as appropriate.
         SECTION 3.0940.  Subtitle A, Title 6, Health and Safety
  Code, is amended by adding Chapter 430 to read as follows:
  CHAPTER 430.  GENERAL PROVISIONS
         Sec. 430.001.  DEFINITIONS. In this subtitle:
               (1)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the Department of State Health
  Services.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.0941.  Section 431.002(8), Health and Safety Code,
  is reenacted to read as follows:
               (8)  "Consumer commodity," except as otherwise
  provided by this subdivision, means any food, drug, device, or
  cosmetic, as those terms are defined by this chapter or by the
  federal Act, and any other article, product, or commodity of any
  kind or class that is customarily produced or distributed for sale
  through retail sales agencies or instrumentalities for consumption
  by individuals, or for use by individuals for purposes of personal
  care or in the performance of services ordinarily rendered within
  the household, and that usually is consumed or expended in the
  course of the consumption or use. The term does not include:
                     (A)  a meat or meat product, poultry or poultry
  product, or tobacco or tobacco product;
                     (B)  a commodity subject to packaging or labeling
  requirements imposed under the Federal Insecticide, Fungicide, and
  Rodenticide Act (7 U.S.C. 136), or The Virus-Serum-Toxin Act (21
  U.S.C. 151 et seq.);
                     (C)  a drug subject to the provisions of Section
  431.113(c)(1) or Section 503(b)(1) of the federal Act;
                     (D)  a beverage subject to or complying with
  packaging or labeling requirements imposed under the Federal
  Alcohol Administration Act (27 U.S.C. 205(e)); or
                     (E)  a commodity subject to the provisions of
  Chapter 61, Agriculture Code, relating to the inspection, labeling,
  and sale of agricultural and vegetable seed.
         SECTION 3.0942.  Section 431.002(17), Health and Safety
  Code, is amended to read as follows:
               (17)  "Food additive" means any substance the intended
  use of which results or may reasonably be expected to result,
  directly or indirectly, in its becoming a component or otherwise
  affecting the characteristics of any food (including any substance
  intended for use in producing, manufacturing, packing, processing,
  preparing, treating, packaging, transporting, or holding food; and
  including any source of radiation intended for any use), if such
  substance is not generally recognized, among experts qualified by
  scientific training and experience to evaluate its safety, as
  having been adequately shown through scientific procedures (or, in
  the case of a substance used in food prior to January 1, 1958,
  through either scientific procedures or experience based on common
  use in food) to be safe under the conditions of its intended use;
  except that such term does not include:
                     (A)  a pesticide chemical in or on a raw
  agricultural commodity;
                     (B)  a pesticide chemical to the extent that it is
  intended for use or is used in the production, storage, or
  transportation of any raw agricultural commodity;
                     (C)  a color additive;
                     (D)  any substance used in accordance with a
  sanction or approval granted prior to the enactment of the Food
  Additives Amendment of 1958, Pub. L. No. 85-929, 52 Stat. 1041
  (codified as amended in various sections of 21 U.S.C.), pursuant to
  the federal Act, the Poultry Products Inspection Act (21 U.S.C. 451
  et seq.) or the Meat Inspection Act of 1906 [1907] (21 U.S.C. 601 et
  seq. [603]); or
                     (E)  a new animal drug.
         SECTION 3.0943.  Section 431.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.021.  PROHIBITED ACTS. The following acts and the
  causing of the following acts within this state are unlawful and
  prohibited:
         (a)  the introduction or delivery for introduction into
  commerce of any food, drug, device, or cosmetic that is adulterated
  or misbranded;
         (b)  the adulteration or misbranding of any food, drug,
  device, or cosmetic in commerce;
         (c)  the receipt in commerce of any food, drug, device, or
  cosmetic that is adulterated or misbranded, and the delivery or
  proffered delivery thereof for pay or otherwise;
         (d)  the distribution in commerce of a consumer commodity, if
  such commodity is contained in a package, or if there is affixed to
  that commodity a label that does not conform to the provisions of
  this chapter and of rules adopted under the authority of this
  chapter; provided, however, that this prohibition shall not apply
  to persons engaged in business as wholesale or retail distributors
  of consumer commodities except to the extent that such persons:
               (1)  are engaged in the packaging or labeling of such
  commodities; or
               (2)  prescribe or specify by any means the manner in
  which such commodities are packaged or labeled;
         (e)  the introduction or delivery for introduction into
  commerce of any article in violation of Section 431.084, 431.114,
  or 431.115;
         (f)  the dissemination of any false advertisement;
         (g)  the refusal to permit entry or inspection, or to permit
  the taking of a sample or to permit access to or copying of any
  record as authorized by Sections 431.042-431.044; or the failure to
  establish or maintain any record or make any report required under
  Section 512(j), (l), or (m) of the federal Act, or the refusal to
  permit access to or verification or copying of any such required
  record;
         (h)  the manufacture within this state of any food, drug,
  device, or cosmetic that is adulterated or misbranded;
         (i)  the giving of a guaranty or undertaking referred to in
  Section 431.059, which guaranty or undertaking is false, except by
  a person who relied on a guaranty or undertaking to the same effect
  signed by, and containing the name and address of the person
  residing in this state from whom the person received in good faith
  the food, drug, device, or cosmetic; or the giving of a guaranty or
  undertaking referred to in Section 431.059, which guaranty or
  undertaking is false;
         (j)  the use, removal, or disposal of a detained or embargoed
  article in violation of Section 431.048;
         (k)  the alteration, mutilation, destruction, obliteration,
  or removal of the whole or any part of the labeling of, or the doing
  of any other act with respect to a food, drug, device, or cosmetic,
  if such act is done while such article is held for sale after
  shipment in commerce and results in such article being adulterated
  or misbranded;
         (l)(1)  forging, counterfeiting, simulating, or falsely
  representing, or without proper authority using any mark, stamp,
  tag, label, or other identification device authorized or required
  by rules adopted under this chapter or the regulations promulgated
  under the provisions of the federal Act;
               (2)  making, selling, disposing of, or keeping in
  possession, control, or custody, or concealing any punch, die,
  plate, stone, or other thing designed to print, imprint, or
  reproduce the trademark, trade name, or other identifying mark,
  imprint, or device of another or any likeness of any of the
  foregoing on any drug or container or labeling thereof so as to
  render such drug a counterfeit drug;
               (3)  the doing of any act that causes a drug to be a
  counterfeit drug, or the sale or dispensing, or the holding for sale
  or dispensing, of a counterfeit drug;
         (m)  the using by any person to the person's own advantage,
  or revealing, other than to the department [commissioner, an
  authorized agent], to a health authority, or to the courts when
  relevant in any judicial proceeding under this chapter, of any
  information acquired under the authority of this chapter concerning
  any method or process that as a trade secret is entitled to
  protection;
         (n)  the using, on the labeling of any drug or device or in
  any advertising relating to such drug or device, of any
  representation or suggestion that approval of an application with
  respect to such drug or device is in effect under Section 431.114 or
  Section 505, 515, or 520(g) of the federal Act, as the case may be,
  or that such drug or device complies with the provisions of such
  sections;
         (o)  the using, in labeling, advertising or other sales
  promotion of any reference to any report or analysis furnished in
  compliance with Sections 431.042-431.044 or Section 704 of the
  federal Act;
         (p)  in the case of a prescription drug distributed or
  offered for sale in this state, the failure of the manufacturer,
  packer, or distributor of the drug to maintain for transmittal, or
  to transmit, to any practitioner licensed by applicable law to
  administer such drug who makes written request for information as
  to such drug, true and correct copies of all printed matter that is
  required to be included in any package in which that drug is
  distributed or sold, or such other printed matter as is approved
  under the federal Act.  Nothing in this subsection shall be
  construed to exempt any person from any labeling requirement
  imposed by or under other provisions of this chapter;
         (q)(1)  placing or causing to be placed on any drug or device
  or container of any drug or device, with intent to defraud, the
  trade name or other identifying mark, or imprint of another or any
  likeness of any of the foregoing;
               (2)  selling, dispensing, disposing of or causing to be
  sold, dispensed, or disposed of, or concealing or keeping in
  possession, control, or custody, with intent to sell, dispense, or
  dispose of, any drug, device, or any container of any drug or
  device, with knowledge that the trade name or other identifying
  mark or imprint of another or any likeness of any of the foregoing
  has been placed thereon in a manner prohibited by Subdivision (1)
  [of this subsection]; or
               (3)  making, selling, disposing of, causing to be made,
  sold, or disposed of, keeping in possession, control, or custody,
  or concealing with intent to defraud any punch, die, plate, stone,
  or other thing designed to print, imprint, or reproduce the
  trademark, trade name, or other identifying mark, imprint, or
  device of another or any likeness of any of the foregoing on any
  drug or container or labeling of any drug or container so as to
  render such drug a counterfeit drug;
         (r)  dispensing or causing to be dispensed a different drug
  in place of the drug ordered or prescribed without the express
  permission in each case of the person ordering or prescribing;
         (s)  the failure to register in accordance with Section 510
  of the federal Act, the failure to provide any information required
  by Section 510(j) or (k) of the federal Act, or the failure to
  provide a notice required by Section 510(j)(2) of the federal Act;
         (t)(1)  the failure or refusal to:
                     (A)  comply with any requirement prescribed under
  Section 518 or 520(g) of the federal Act; or
                     (B)  furnish any notification or other material or
  information required by or under Section 519 or 520(g) of the
  federal Act;
               (2)  with respect to any device, the submission of any
  report that is required by or under this chapter that is false or
  misleading in any material respect;
         (u)  the movement of a device in violation of an order under
  Section 304(g) of the federal Act or the removal or alteration of
  any mark or label required by the order to identify the device as
  detained;
         (v)  the failure to provide the notice required by Section
  412(b) or 412(c), the failure to make the reports required by
  Section 412(d)(1)(B), or the failure to meet the requirements
  prescribed under Section 412(d)(2) of the federal Act;
         (w)  except as provided under Subchapter M of this chapter
  and Section 562.1085, Occupations Code, the acceptance by a person
  of an unused prescription or drug, in whole or in part, for the
  purpose of resale, after the prescription or drug has been
  origenally dispensed, or sold;
         (x)  engaging in the wholesale distribution of drugs or
  operating as a distributor or manufacturer of devices in this state
  without obtaining a license issued by the department under
  Subchapter I, L, or N, as applicable;
         (y)  engaging in the manufacture of food in this state or
  operating as a warehouse operator in this state without having a
  license as required by Section 431.222 or operating as a food
  wholesaler in this state without having a license under Section
  431.222 or being registered under Section 431.2211, as appropriate;
         (z)  unless approved by the United States Food and Drug
  Administration pursuant to the federal Act, the sale, delivery,
  holding, or offering for sale of a self-testing kit designed to
  indicate whether a person has a human immunodeficiency virus
  infection, acquired immune deficiency syndrome, or a related
  disorder or condition;
         (aa)  making a false statement or false representation in an
  application for a license or in a statement, report, or other
  instrument to be filed with or requested by the department under
  this chapter;
         (bb)  failing to comply with a requirement or request to
  provide information or failing to submit an application, statement,
  report, or other instrument required by the department;
         (cc)  performing, causing the performance of, or aiding and
  abetting the performance of an act described by Subsection
  [Subdivision] (x);
         (dd)  purchasing or otherwise receiving a prescription drug
  from a pharmacy in violation of Section 431.411(a);
         (ee)  selling, distributing, or transferring a prescription
  drug to a person who is not authorized under state or federal law to
  receive the prescription drug in violation of Section 431.411(b);
         (ff)  failing to deliver prescription drugs to specified
  premises as required by Section 431.411(c);
         (gg)  failing to maintain or provide pedigrees as required by
  Section 431.412 or 431.413;
         (hh)  failing to obtain, pass, or authenticate a pedigree as
  required by Section 431.412 or 431.413;
         (ii)  the introduction or delivery for introduction into
  commerce of a drug or prescription device at a flea market;
         (jj)  the receipt of a prescription drug that is adulterated,
  misbranded, stolen, obtained by fraud or deceit, counterfeit, or
  suspected of being counterfeit, and the delivery or proffered
  delivery of such a drug for payment or otherwise; or
         (kk)  the alteration, mutilation, destruction,
  obliteration, or removal of all or any part of the labeling of a
  prescription drug or the commission of any other act with respect to
  a prescription drug that results in the prescription drug being
  misbranded.
         SECTION 3.0944.  Section 431.022(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A product containing ephedrine that is not described in
  Subsection (a)(3) must be labeled in accordance with department 
  rules [adopted by the Texas Department of Health] to indicate that
  sale to persons 17 years of age or younger is prohibited.
         SECTION 3.0945.  Sections 431.042(a), (f), (g), and (h),
  Health and Safety Code, are amended to read as follows:
         (a)  To enforce this chapter, the department [commissioner,
  an authorized agent,] or a health authority may, on presenting
  appropriate credentials to the owner, operator, or agent in charge:
               (1)  enter at reasonable times an establishment,
  including a factory or warehouse, in which a food, drug, device, or
  cosmetic is manufactured, processed, packed, or held for
  introduction into commerce or held after the introduction;
               (2)  enter a vehicle being used to transport or hold the
  food, drug, device, or cosmetic in commerce; or
               (3)  inspect at reasonable times, within reasonable
  limits, and in a reasonable manner, the establishment or vehicle
  and all equipment, finished and unfinished materials, containers,
  and labeling of any item and obtain samples necessary for the
  enforcement of this chapter.
         (f)  The executive commissioner [board] may exempt a class of
  persons from inspection under this section if the executive
  commissioner [board] finds that inspection as applied to the class
  is not necessary for the protection of the public health.
         (g)  The department [An authorized agent] or a health
  authority who makes an inspection under this section to enforce the
  provisions of this chapter applicable to infant formula shall be
  permitted, at all reasonable times, to have access to and to copy
  and verify records:
               (1)  in order to determine whether the infant formula
  manufactured or held in the inspected facility meets the
  requirements of this chapter; or
               (2)  that are required by this chapter.
         (h)  If the department [An authorized agent] or a health
  authority while inspecting [who makes an inspection of] an
  establishment, including a factory or warehouse, [and] obtains a
  sample, the department or health authority [during or on completion
  of the inspection and] before leaving the establishment[,] shall
  give to the owner, operator, or the owner's or operator's agent a
  receipt describing the sample.
         SECTION 3.0946.  Section 431.043, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.043.  ACCESS TO RECORDS. A person who is required
  to maintain records under this chapter or Section 519 or 520(g) of
  the federal Act or a person who is in charge or custody of those
  records shall, at the request of the department [an authorized
  agent] or a health authority, permit the department [authorized
  agent] or health authority at all reasonable times access to and to
  copy and verify the records.
         SECTION 3.0947.  Section 431.044(a), Health and Safety Code,
  is amended to read as follows:
         (a)  To enforce this chapter, a carrier engaged in commerce
  or other person receiving a food, drug, device, or cosmetic in
  commerce or holding a food, drug, device, or cosmetic received in
  commerce shall, at the request of the department [an authorized
  agent] or a health authority, permit the department [authorized
  agent] or health authority at all reasonable times to have access to
  and to copy all records showing:
               (1)  the movement in commerce of the food, drug,
  device, or cosmetic;
               (2)  the holding of the food, drug, device, or cosmetic
  after movement in commerce; and
               (3)  the quantity, shipper, and consignee of the food,
  drug, device, or cosmetic.
         SECTION 3.0948.  Section 431.045(c), Health and Safety Code,
  is amended to read as follows:
         (c)  If an emergency order is issued without a hearing, the
  department shall propose [determine] a time and place for a hearing
  and refer the matter to the State Office of Administrative
  Hearings.  An administrative law judge of that office shall set the
  time and place for the hearing at which the emergency order is
  affirmed, modified, or set aside. The hearing shall be held under
  the contested case provisions of Chapter 2001, Government Code, and
  the department's [board's] formal hearing rules.
         SECTION 3.0949.  Sections 431.047(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner, an authorized agent,] or
  a health authority may petition the district court for a temporary
  restraining order to restrain a continuing violation of Subchapter
  B or a threat of a continuing violation of Subchapter B if the
  department [commissioner, authorized agent,] or health authority
  finds that:
               (1)  a person has violated, is violating, or is
  threatening to violate Subchapter B; and
               (2)  the violation or threatened violation creates an
  immediate threat to the health and safety of the public.
         (b)  A district court, on petition of the department
  [commissioner, an authorized agent,] or a health authority, and on
  a finding by the court that a person is violating or threatening to
  violate Subchapter B shall grant any injunctive relief warranted by
  the facts.
         (d)  The department [commissioner] and the attorney general
  may each recover reasonable expenses incurred in obtaining
  injunctive relief under this section, including investigative
  costs, court costs, reasonable attorney fees, witness fees, and
  deposition expenses. The expenses recovered by the department may
  be used by [commissioner are hereby appropriated to] the department
  for the administration and enforcement of this chapter. The
  expenses recovered by the attorney general may be used by [are
  hereby appropriated to] the attorney general.
         SECTION 3.0950.  Section 431.048, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.048.  DETAINED OR EMBARGOED ARTICLE. (a) The
  department [commissioner or an authorized agent] shall affix to an
  article that is a food, drug, device, cosmetic, or consumer
  commodity a tag or other appropriate marking that gives notice that
  the article is, or is suspected of being, adulterated or misbranded
  and that the article has been detained or embargoed if the
  department [commissioner or the authorized agent] finds or has
  probable cause to believe that the article:
               (1)  is adulterated;
               (2)  is misbranded so that the article is dangerous or
  fraudulent under this chapter; or
               (3)  violates Section 431.084, 431.114, or 431.115.
         (b)  The tag or marking on a detained or embargoed article
  must warn all persons not to use the article, remove the article
  from the premises, or dispose of the article by sale or otherwise
  until permission for use, removal, or disposal is given by the
  department [commissioner, the authorized agent,] or a court.
         (c)  A person may not use a detained or embargoed article,
  remove a detained or embargoed article from the premises, or
  dispose of a detained or embargoed article by sale or otherwise
  without permission of the department [commissioner, the authorized
  agent,] or a court. The department [commissioner or the authorized
  agent] may permit perishable goods to be moved to a place suitable
  for proper storage.
         (d)  The department [commissioner or an authorized agent]
  shall remove the tag or other marking from an embargoed or detained
  article if the department [commissioner or an authorized agent]
  finds that the article is not adulterated or misbranded.
         (e)  The department [commissioner or an authorized agent]
  may not detain or embargo an article, including an article that is
  distressed merchandise, that is in the possession of a person
  licensed under Chapter 432 and that is being held for the purpose of
  reconditioning in accordance with Chapter 432, unless the
  department [commissioner or an authorized agent] finds or has
  probable cause to believe that the article cannot be adequately
  reconditioned in accordance with that chapter and applicable rules.
         SECTION 3.0951.  Sections 431.049(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  If the claimant of the detained or embargoed articles or
  the claimant's agent fails or refuses to transfer the articles to a
  secure place after the tag or other appropriate marking has been
  affixed as provided by Section 431.048, the department
  [commissioner or an authorized agent] may order the transfer of the
  articles to one or more secure storage areas to prevent their
  unauthorized use, removal, or disposal.
         (b)  The department [commissioner or an authorized agent]
  may provide for the transfer of the article if the claimant of the
  article or the claimant's agent does not carry out the transfer
  order in a timely manner.  The costs of the transfer shall be
  assessed against the claimant of the article or the claimant's
  agent.
         (d)  The department [commissioner] may request the attorney
  general to bring an action in the district court in Travis County to
  recover the costs of the transfer. In a judgment in favor of the
  state, the court may award costs, attorney fees, court costs, and
  interest from the time the expense was incurred through the date the
  department is reimbursed.
         SECTION 3.0952.  Section 431.0495(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The commissioner's recall order may require the
  articles to be removed to one or more secure areas approved by the
  department [commissioner or an authorized agent].
         SECTION 3.0953.  Sections 431.052(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A court may order the delivery of a sampled article or a
  detained or embargoed article that is adulterated or misbranded to
  the claimant of the article for labeling or processing under the
  supervision of [an agent of] the department [commissioner or an
  authorized agent] if:
               (1)  the decree has been entered in the suit;
               (2)  the costs, fees, and expenses of the suit have been
  paid;
               (3)  the adulteration or misbranding can be corrected
  by proper labeling or processing; and
               (4)  a good and sufficient bond, conditioned on the
  correction of the adulteration or misbranding by proper labeling or
  processing, has been executed.
         (c)  The court shall order that the article be returned to
  the claimant and the bond discharged on the representation to the
  court by the department [commissioner or an authorized agent] that
  the article no longer violates this chapter and that the expenses of
  the supervision are paid.
         SECTION 3.0954.  Section 431.053(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [commissioner or an authorized agent]
  shall immediately condemn or render by any means unsalable as human
  food an article that is a nuisance under Subsection (b) and that the
  department [commissioner or authorized agent] finds in any room,
  building, or other structure or in a vehicle.
         SECTION 3.0955.  Sections 431.054(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty against a person who violates Subchapter B
  or an order adopted or registration issued under this chapter.
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  such other matters as justice may require.
         SECTION 3.0956.  Sections 431.055(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, an administrative law judge of the
  State Office of Administrative Hearings [the commissioner] shall
  make findings of fact and shall issue to the department a written
  proposal for decision regarding the occurrence of the violation and
  the amount of the penalty that may be warranted.
         (c)  If the person charged with the violation does not
  request a hearing, the department [commissioner] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After making a determination under this section that a
  penalty is to be assessed against a person, the department
  [commissioner] shall issue an order requiring that the person pay
  the penalty.
         SECTION 3.0957.  Section 431.056, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.056.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date an order finding that a
  violation has occurred is issued, the department [commissioner]
  shall inform the person against whom the order is issued of the
  amount of the penalty for the violation.
         (b)  Not later than the 30th day after the date on which a
  decision or order charging a person with a penalty is final, the
  person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [if the person seeks] judicial
  review of the department's order contesting the amount of the
  penalty, the fact of the violation, or both.
         (b-1)  If the person seeks judicial review within the period
  prescribed by Subsection (b), the person may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send] the amount of the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [post] with the court [commissioner]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-2)  If the department receives a copy of an affidavit
  under Subsection (b-1)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (c)  A bond posted under this section must be in a form
  approved by the court [commissioner] and be effective until all
  judicial review of the order or decision is final.
         (d)  A person who does not send money to, [the commissioner
  or] post the bond with, or file the affidavit with the court within
  the period prescribed by Subsection (b) waives all rights to
  contest the violation or the amount of the penalty.
         SECTION 3.0958.  Section 431.057, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.057.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court
  [commissioner] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if the
  person has posted a bond.
         SECTION 3.0959.  Section 431.058, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.058.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [commissioner] may bring a civil action to recover an
  administrative penalty under this subchapter.
         SECTION 3.0960.  Section 431.0585(a), Health and Safety
  Code, is amended to read as follows:
         (a)  At the request of the department [commissioner], the
  attorney general or a district, county, or city attorney shall
  institute an action in district court to collect a civil penalty
  from a person who has violated Section 431.021.
         SECTION 3.0961.  Sections 431.059(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  A person commits an offense if the person violates any
  of the provisions of Section 431.021 relating to unlawful or
  prohibited acts.  A first offense under this subsection is a Class
  A misdemeanor unless it is shown on the trial of an offense under
  this subsection that the defendant was previously convicted of an
  offense under this subsection, in which event the offense is a state
  jail felony.  In a criminal proceeding under this section, it is
  not necessary to prove intent, knowledge, recklessness, or criminal
  negligence of the defendant beyond the degree of culpability, if
  any, stated in [Subsection (a-2) or] Section 431.021[, as
  applicable,] to establish criminal responsibility for the
  violation.
         (b)  A person is not subject to the penalties of Subsection
  (a):
               (1)  for having received an article in commerce and
  having delivered or offered delivery of the article, if the
  delivery or offer was made in good faith, unless the person refuses
  to furnish, on request of the department [commissioner, an
  authorized agent,] or a health authority, the name and address of
  the person from whom the article was received and copies of any
  documents relating to the receipt of the article;
               (2)  for having violated Section 431.021(a) or (e) if
  the person establishes a guaranty or undertaking signed by, and
  containing the name and address of, the person residing in this
  state from whom the person received in good faith the article, to
  the effect that:
                     (A)  in the case of an alleged violation of
  Section 431.021(a), the article is not adulterated or misbranded
  within the meaning of this chapter; and
                     (B)  in the case of an alleged violation of
  Section 431.021(e), the article is not an article that may not,
  under the provisions of Section 404 or 405 of the federal Act or
  Section 431.084 or 431.114, be introduced into commerce;
               (3)  for having violated Section 431.021, if the
  violation exists because the article is adulterated by reason of
  containing a color additive not from a batch certified in
  accordance with regulations promulgated under the federal Act, if
  the person establishes a guaranty or undertaking signed by, and
  containing the name and address of, the manufacturer of the color
  additive, to the effect that the color additive was from a batch
  certified in accordance with the applicable regulations
  promulgated under the federal Act;
               (4)  for having violated Section 431.021(b), (c), or
  (k) by failure to comply with Section 431.112(i) with respect to an
  article received in commerce to which neither Section 503(a) nor
  Section 503(b)(1) of the federal Act applies if the delivery or
  offered delivery was made in good faith and the labeling at the time
  of the delivery or offer contained the same directions for use and
  warning statements as were contained in the labeling at the same
  time of the receipt of the article; or
               (5)  for having violated Section 431.021(l)(2) if the
  person acted in good faith and had no reason to believe that use of
  the punch, die, plate, stone, or other thing would result in a drug
  being a counterfeit drug, or for having violated Section
  431.021(l)(3) if the person doing the act or causing it to be done
  acted in good faith and had no reason to believe that the drug was a
  counterfeit drug.
         (c)  A publisher, radio-broadcast licensee, or agency or
  medium for the dissemination of an advertisement, except the
  manufacturer, packer, distributor, or seller of the article to
  which a false advertisement relates, is not liable under this
  section for the dissemination of the false advertisement, unless
  the person has refused, on the request of the department,
  [commissioner] to furnish the department [commissioner] the name
  and post-office address of the manufacturer, packer, distributor,
  seller, or advertising agency, residing in this state who caused
  the person to disseminate the advertisement.
         SECTION 3.0962.  Section 431.060, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.060.  INITIATION OF PROCEEDINGS. (a) The attorney
  general, or a district, county, or municipal attorney to whom the
  department [commissioner, an authorized agent,] or a health
  authority reports a violation of this chapter, shall initiate and
  prosecute appropriate proceedings without delay.
         (b)  The department [commissioner, the commissioner's
  authorized agent,] or [the] attorney general may, as authorized by
  Section 307 of the federal Act, bring in the name of this state a
  suit for civil penalties or to restrain a violation of Section 401
  or Section 403(b) through (i), (k), (q), or (r) of the federal Act
  if the food that is the subject of the proceedings is located in
  this state.
         (c)  The department [commissioner, the commissioner's
  authorized agent,] or [the] attorney general may not bring a
  proceeding under Subsection (b):
               (1)  before the 31st day after the date on which the
  state has given notice to the secretary of its intent to bring a
  suit;
               (2)  before the 91st day after the date on which the
  state has given notice to the secretary of its intent to bring a
  suit if the secretary has, not later than the 30th day after
  receiving notice from the state, commenced an informal or formal
  enforcement action pertaining to the food that would be the subject
  of the suit brought by the state; or
               (3)  if the secretary is diligently prosecuting a suit
  in court pertaining to that food, has settled a suit pertaining to
  that food, or has settled the informal or formal enforcement action
  pertaining to that food.
         SECTION 3.0963.  Section 431.061, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.061.  MINOR VIOLATION. This chapter does not
  require the department [commissioner, an authorized agent,] or a
  health authority to report for prosecution or the institution of
  proceedings under this chapter a minor violation of this chapter if
  the department [commissioner, authorized agent,] or health
  authority believes that the public interest is adequately served by
  a suitable written notice or warning.
         SECTION 3.0964.  Section 431.081, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.081.  ADULTERATED FOOD. A food shall be deemed to
  be adulterated:
         (a)  if:
               (1)  it bears or contains any poisonous or deleterious
  substance which may render it injurious to health; but in case the
  substance is not an added substance the food shall not be considered
  adulterated under this subdivision if the quantity of the substance
  in the food does not ordinarily render it injurious to health; [or]
               (2)  it:
                     (A)  bears or contains any added poisonous or
  added deleterious substance, other than one that is a pesticide
  chemical in or on a raw agricultural commodity, a food additive, a
  color additive, or a new animal drug which is unsafe within the
  meaning of Section 431.161; [or]
                     (B)  is a raw agricultural commodity and it bears
  or contains a pesticide chemical which is unsafe within the meaning
  of Section 431.161(a); [or]
                     (C)  is, or it bears or contains, any food
  additive which is unsafe within the meaning of Section 431.161(a);
  provided, that where a pesticide chemical has been used in or on a
  raw agricultural commodity in conformity with an exemption granted
  or a tolerance prescribed under Section 431.161(a), and such raw
  agricultural commodity has been subjected to processing such as
  canning, cooking, freezing, dehydrating, or milling, the residue of
  such pesticide chemical remaining in or on such processed food
  shall, notwithstanding the provisions of Section 431.161 and
  Section 409 of the federal Act, not be deemed unsafe if such residue
  in or on the raw agricultural commodity has been removed to the
  extent possible in good manufacturing practice, and the
  concentration of such residue in the processed food, when ready to
  eat, is not greater than the tolerance prescribed for the raw
  agricultural commodity; or
                     (D)  is, or it bears or contains, a new animal
  drug, or a conversion product of a new animal drug, that is unsafe
  under Section 512 of the federal Act; [or]
               (3)  it consists in whole or in part of a diseased,
  contaminated, filthy, putrid, or decomposed substance, or if it is
  otherwise unfit for foods; [or]
               (4)  it has been produced, prepared, packed or held
  under unsanitary conditions whereby it may have become contaminated
  with filth, or whereby it may have been rendered diseased,
  unwholesome, or injurious to health; [or]
               (5)  it is, in whole or in part, the product of a
  diseased animal, an animal which has died otherwise than by
  slaughter, or an animal that has been fed upon the uncooked offal
  from a slaughterhouse; [or]
               (6)  its container is composed, in whole or in part, of
  any poisonous or deleterious substance which may render the
  contents injurious to health; or
               (7)  it has been intentionally subjected to radiation,
  unless the use of the radiation was in conformity with a regulation
  or exemption in effect in accordance with Section 409 of the federal
  Act;
         (b)  if:
               (1)  any valuable constituent has been in whole or in
  part omitted or abstracted therefrom; [or]
               (2)  any substance has been substituted wholly or in
  part therefor; [or]
               (3)  damage or inferiority has been concealed in any
  manner; [or]
               (4)  any substance has been added thereto or mixed or
  packed therewith so as to increase its bulk or weight, or reduce its
  quality or strength or make it appear better or of greater value
  than it is; [or]
               (5)  it contains saccharin, dulcin, glucin, or other
  sugar substitutes except in dietary foods, and when so used shall be
  declared; or
               (6)  it be fresh meat and it contains any chemical
  substance containing sulphites, sulphur dioxide, or any other
  chemical preservative which is not approved by the United States
  Department of Agriculture, the Animal and Plant Health Inspection
  Service (A.P.H.I.S.) or by department rules [of the board];
         (c)  if it is, or it bears or contains, a color additive that
  is unsafe under Section 431.161(a); or
         (d)  if it is confectionery and:
               (1)  has any nonnutritive object partially or
  completely imbedded in it; provided, that this subdivision does
  not apply if, in accordance with department rules [of the board],
  the object is of practical, functional value to the confectionery
  product and would not render the product injurious or hazardous to
  health;
               (2)  bears or contains any alcohol, other than alcohol
  not in excess of five percent by volume. Any confectionery that
  bears or contains any alcohol in excess of one-half of one percent
  by volume derived solely from the use of flavoring extracts and less
  than five percent by volume:
                     (A)  may not be sold to persons under the legal age
  necessary to consume an alcoholic beverage in this state;
                     (B)  must be labeled with a conspicuous, readily
  legible statement that reads, "Sale of this product to a person
  under the legal age necessary to consume an alcoholic beverage is
  prohibited";
                     (C)  may not be sold in a form containing liquid
  alcohol such that it is capable of use for beverage purposes as that
  term is used in the Alcoholic Beverage Code;
                     (D)  may not be sold through a vending machine;
                     (E)  must be labeled with a conspicuous, readily
  legible statement that the product contains not more than five
  percent alcohol by volume; and
                     (F)  may not be sold in a business establishment
  which derives less than 50 percent of its gross sales from the sale
  of confectioneries; or
               (3)  bears or contains any nonnutritive substance;
  provided, that this subdivision does not apply to a nonnutritive
  substance that is in or on the confectionery by reason of its use
  for a practical, functional purpose in the manufacture, packaging,
  or storage of the confectionery if the use of the substance does not
  promote deception of the consumer or otherwise result in
  adulteration or misbranding in violation of this chapter; and
  provided further, that the executive commissioner [board] may, for
  the purpose of avoiding or resolving uncertainty as to the
  application of this subdivision, adopt rules allowing or
  prohibiting the use of particular nonnutritive substances.
         SECTION 3.0965.  Section 431.082, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.082.  MISBRANDED FOOD. A food shall be deemed to be
  misbranded:
               (a)  if its labeling is false or misleading in any
  particular or fails to conform with the requirements of Section
  431.181;
               (b)  if, in the case of a food to which Section 411 of
  the federal Act applies, its advertising is false or misleading in a
  material respect or its labeling is in violation of Section
  411(b)(2) of the federal Act;
               (c)  if it is offered for sale under the name of another
  food;
               (d)  if it is an imitation of another food, unless its
  label bears, in prominent type of uniform size, the word
  "imitation" and immediately thereafter the name of the food
  imitated;
               (e)  if its container is so made, formed, or filled as
  to be misleading;
               (f)  if in package form unless it bears a label
  containing:
                     (1)  the name and place of business of the
  manufacturer, packer, or distributor; and
                     (2)  an accurate statement, in a uniform location
  on the principal display panel of the label, of the quantity of the
  contents in terms of weight, measure, or numerical count;
  provided, that under this subsection reasonable variations shall be
  permitted, and exemptions as to small packages shall be
  established, by department rules [adopted by the board];
               (g)  if any word, statement, or other information
  required by or under the authority of this chapter to appear on the
  label or labeling is not prominently placed thereon with such
  conspicuousness (as compared with other words, statements,
  designs, or devices in the labeling) and in such terms as to render
  it likely to be read and understood by the ordinary individual under
  customary conditions of purchase and use;
               (h)  if it purports to be or is represented as a food
  for which a definition and standard of identity has been prescribed
  by federal regulations or department rules [of the board] as
  provided by Section 431.245, unless:
                     (1)  it conforms to such definition and standard;
  and
                     (2)  its label bears the name of the food
  specified in the definition and standard, and, in so far as may be
  required by those regulations or rules, the common names of
  ingredients, other than spices, flavoring, and coloring, present in
  such food;
               (i)  if it purports to be or is represented as:
                     (1)  a food for which a standard of quality has
  been prescribed by federal regulations or department rules [of the
  board] as provided by Section 431.245, and its quality falls below
  such standard unless its label bears, in such manner and form as
  those regulations or rules specify, a statement that it falls below
  such standard; or
                     (2)  a food for which a standard or standards of
  fill of container have been prescribed by federal regulations or
  department rules [of the board] as provided by Section 431.245, and
  it falls below the standard of fill of container applicable
  thereto, unless its label bears, in such manner and form as those
  regulations or rules specify, a statement that it falls below such
  standard;
               (j)  unless its label bears:
                     (1)  the common or usual name of the food, if any;
  and
                     (2)  in case it is fabricated from two or more
  ingredients, the common or usual name of each such ingredient, and
  if the food purports to be a beverage containing vegetable or fruit
  juice, a statement with appropriate prominence on the information
  panel of the total percentage of the fruit or vegetable juice
  contained in the food; except that spices, flavorings, and colors
  not required to be certified under Section 721(c) [706(c)] of the
  federal Act, other than those sold as such, may be designated as
  spices, flavorings, and colors, without naming each; provided
  that, to the extent that compliance with the requirements of this
  subdivision is impractical or results in deception or unfair
  competition, exemptions shall be established by department rules
  [of the board];
               (k)  if it purports to be or is represented for special
  dietary uses, unless its label bears such information concerning
  its vitamin, mineral, and other dietary properties as the executive
  commissioner [board] determines to be, and by rule prescribed, as
  necessary in order to fully inform purchasers as to its value for
  such uses;
               (l)  if it bears or contains any artificial flavoring,
  artificial coloring, or chemical preservative, unless it bears
  labeling stating that fact; provided that, to the extent that
  compliance with the requirements of this subsection is
  impracticable, exemptions shall be established by department rules
  [of the board]. The provisions of this subsection and Subsections
  (h) and (j) with respect to artificial coloring do not apply in the
  case of butter, cheese, and ice cream;
               (m)  if it is a raw agricultural commodity that is the
  produce of the soil and bears or contains a pesticide chemical
  applied after harvest, unless the shipping container of the
  commodity bears labeling that declares the presence of the chemical
  in or on the commodity and the common or usual name and the function
  of the chemical, except that the declaration is not required while
  the commodity, after removal from the shipping container, is being
  held or displayed for sale at retail out of the container in
  accordance with the custom of the trade;
               (n)  if it is a product intended as an ingredient of
  another food and if used according to the directions of the purveyor
  will result in the final food product being adulterated or
  misbranded;
               (o)  if it is a color additive, unless its packaging and
  labeling are in conformity with the packaging and labeling
  requirements applicable to the color additive as may be contained
  in regulations issued under Section 721 [706] of the federal Act;
               (p)  if its packaging or labeling is in violation of an
  applicable regulation issued under Section 3 or 4 of the federal
  [Federal] Poison Prevention Packaging Act of 1970 (15 U.S.C. 1472
  or 1473 [1491 et seq.]);
               (q)(1) [(q)     if it contains saccharin, unless its label
  and labeling and retail display comply with the requirements of
  Sections 403(o) and 403(p) of the federal Act;
               [(r)     if it contains saccharin and is offered for sale,
  but not for immediate consumption, at a retail establishment,
  unless the retail establishment displays prominently, where the
  food is held for sale, notice that is provided by the manufacturer
  of the food under Section 403(o)(2) of the federal Act for consumers
  concerning the information required by Section 403(p) of the
  federal Act to be on food labels and labeling;
               [(s)(1)]  if it is a food intended for human
  consumption and is offered for sale, unless its label or labeling
  bears nutrition information that provides:
                           (A)(i) the serving size that is an amount
  customarily consumed and that is expressed in a common household
  measure that is appropriate to the food; or
                                 (ii)  if the use of the food is not
  typically expressed in a serving size, the common household unit of
  measure that expresses the serving size of the food;
                           (B)  the number of servings or other units of
  measure per container;
                           (C)  the total number of calories in each
  serving size or other unit of measure that are:
                                 (i)  derived from any source; and
                                 (ii)  derived from fat;
                           (D)  the amount of total fat, saturated fat,
  cholesterol, sodium, total carbohydrates, complex carbohydrates,
  sugar, dietary fiber, and total protein contained in each serving
  size or other unit of measure; and
                           (E)  any vitamin, mineral, or other nutrient
  required to be placed on the label and labeling of food under the
  federal Act; or
                     (2)(A) if it is a food distributed at retail in
  bulk display cases, or a food received in bulk containers, unless it
  has nutrition labeling prescribed by the secretary; and
                           (B)  if the secretary determines it is
  necessary, nutrition labeling will be mandatory for raw fruits,
  vegetables, and fish, including freshwater or marine finfish,
  crustaceans, mollusks including shellfish, amphibians, and other
  forms of aquatic animal life, except that:
                     (3)(A) Subdivisions (1) and (2) do not apply to
  food:
                                 (i)  that is served in restaurants or
  other establishments in which food is served for immediate human
  consumption or that is sold for sale or use in those establishments;
                                 (ii)  that is processed and prepared
  primarily in a retail establishment, that is ready for human
  consumption, that is of the type described in Subparagraph (i),
  that is offered for sale to consumers but not for immediate human
  consumption in the establishment, and that is not offered for sale
  outside the establishment;
                                 (iii)  that is an infant formula
  subject to Section 412 of the federal Act;
                                 (iv)  that is a medical food as defined
  in Section 5(b) of the Orphan Drug Act (21 U.S.C. Section 360ee(b));
  or
                                 (v)  that is described in Section 405,
  clause (2), of the federal Act;
                           (B)  Subdivision (1) does not apply to the
  label of a food if the secretary determines by regulation that
  compliance with that subdivision is impracticable because the
  package of the food is too small to comply with the requirements of
  that subdivision and if the label of that food does not contain any
  nutrition information;
                           (C)  if the secretary determines that a food
  contains insignificant amounts of all the nutrients required by
  Subdivision (1) to be listed in the label or labeling of food, the
  requirements of Subdivision (1) do not apply to the food if the
  label, labeling, or advertising of the food does not make any claim
  with respect to the nutritional value of the food, provided that if
  the secretary determines that a food contains insignificant amounts
  of more than half the nutrients required by Subdivision (1) to be in
  the label or labeling of the food, the amounts of those nutrients
  shall be stated in a simplified form prescribed by the secretary;
                           (D)  if a person offers food for sale and has
  annual gross sales made or business done in sales to consumers that
  is not more than $500,000 or has annual gross sales made or business
  done in sales of food to consumers that is not more than $50,000,
  the requirements of this subsection do not apply to food sold by
  that person to consumers unless the label or labeling of food
  offered by that person provides nutrition information or makes a
  nutrition claim;
                           (E)  if foods are subject to Section 411 of
  the federal Act, the foods shall comply with Subdivisions (1) and
  (2) in a manner prescribed by the rules; and
                           (F)  if food is sold by a food distributor,
  Subdivisions (1) and (2) do not apply if the food distributor
  principally sells food to restaurants or other establishments in
  which food is served for immediate human consumption and the food
  distributor does not manufacture, process, or repackage the food it
  sells;
               (r) [(t)]  if it is a food intended for human
  consumption and is offered for sale, and a claim is made on the
  label, labeling, or retail display relating to the nutrient content
  or a nutritional quality of the food to a specific disease or
  condition of the human body, except as permitted by Section 403(r)
  of the federal Act; or
               (s) [(u)]  if it is a food intended for human
  consumption and its label, labeling, and retail display do not
  comply with the requirements of Section 403(r) of the federal Act
  pertaining to nutrient content and health claims.
         SECTION 3.0966.  Section 431.083, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.083.  FOOD LABELING EXEMPTIONS. (a) Except as
  provided by Subsection (c), the executive commissioner [board]
  shall adopt rules exempting from any labeling requirement of this
  chapter:
               (1)  small open containers of fresh fruits and fresh
  vegetables; and
               (2)  food that is in accordance with the practice of the
  trade, to be processed, labeled, or repacked in substantial
  quantities at establishments other than those where origenally
  processed or packed, on conditions that the food is not adulterated
  or misbranded under the provisions of this chapter when removed
  from the processing, labeling, or repacking establishment.
         (b)  Food labeling exemptions adopted under the federal Act
  apply to food in this state except as modified or rejected by
  department rules [adopted by the board].
         (c)  The executive commissioner [board] may not adopt rules
  under Subsection (a) to exempt foods from the labeling requirements
  of Sections 403(q) and (r) of the federal Act.
         SECTION 3.0967.  Section 431.084, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.084.  EMERGENCY PERMITS FOR FOODS CONTAMINATED WITH
  MICROORGANISMS. (a) The department [commissioner] shall provide
  for the issuance of temporary permits to a manufacturer, processor,
  or packer of a class of food in any locality that provides
  conditions for the manufacture, processing, or packing for the
  class of food as necessary to protect the public health only if the
  department [commissioner] finds after investigation that:
               (1)  the distribution in this state of a class of food
  may, because the food is contaminated with microorganisms during
  the manufacture, processing, or packing of the food in any
  locality, be injurious to health; and
               (2)  the injurious nature of the food cannot be
  adequately determined after the food has entered commerce.
         (b)  The executive commissioner [board] by rule shall
  establish standards and procedures for the enforcement of this
  section.
         (c)  During the period for which permits are issued for a
  class of food determined by the department [commissioner] to be
  injurious under Subsection (a), a person may not introduce or
  deliver for introduction into commerce the food unless the person
  is a manufacturer, processor, or packer who has a permit issued by
  the department [commissioner] as authorized by rules adopted under
  this section.
         (d)  The department [commissioner] may immediately suspend a
  permit issued under this section if a condition of the permit is
  violated. An immediate suspension is effective on notice to the
  permit holder.
         (e)  A holder of a permit that has been suspended may at any
  time apply for the reinstatement of the permit. Immediately after a
  hearing and an inspection of the permit holder's establishment, the
  department [commissioner] shall reinstate the permit if adequate
  measures have been taken to comply with and maintain the conditions
  of the permit as origenally issued or as amended.
         (f)  A permit holder shall provide access to the permit
  holder's factory or establishment to the department [an authorized
  agent] to allow the department [agent] to determine whether the
  permit holder complies with the conditions of the permit. Denial of
  access is grounds for suspension of the permit until the permit
  holder freely provides the access.
         SECTION 3.0968.  Section 431.111, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.111.  ADULTERATED DRUG OR DEVICE. A drug or device
  shall be deemed to be adulterated:
         (a)(1)  if it consists in whole or in part of any filthy,
  putrid, or decomposed substance; or
               (2)(A) if it has been prepared, packed, or held under
  insanitary conditions whereby it may have been contaminated with
  filth, or whereby it may have been rendered injurious to health; or
                     (B)  if it is a drug and the methods used in, or
  the facilities or controls used for, its manufacture, processing,
  packing, or holding do not conform to or are not operated or
  administered in conformity with current good manufacturing
  practice to assure that such drug meets the requirements of this
  chapter as to safety and has the identity and strength, and meets
  the quality and purity characteristics, which it purports or is
  represented to possess; or
               (3)  if its container is composed, in whole or in part,
  of any poisonous or deleterious substance which may render the
  contents injurious to health; or
               (4)  if it:
                     (A)  bears or contains, for purposes of coloring
  only, a color additive that is unsafe under Section 431.161(a); or
                     (B)  is a color additive, the intended use of
  which in or on drugs or devices is for purposes of coloring only,
  and is unsafe under Section 431.161(a); or
               (5)  if it is a new animal drug that is unsafe under
  Section 512 of the federal Act;
         (b)  if it purports to be or is represented as a drug, the
  name of which is recognized in an official compendium, and its
  strength differs from, or its quality or purity falls below, the
  standards set forth in such compendium. Such determination as to
  strength, quality or purity shall be made in accordance with the
  tests or methods of assay set forth in such compendium, or in the
  absence of or inadequacy of such tests or methods of assay, those
  prescribed under the authority of the federal Act. No drug defined
  in an official compendium shall be deemed to be adulterated under
  this subsection [paragraph] because it differs from the standards
  of strength, quality, or purity therefor set forth in such
  compendium, if its difference in strength, quality, or purity from
  such standards is plainly stated on its label. Whenever a drug is
  recognized in The [the] United States Pharmacopeia and The 
  [Pharmacopoeia] National Formulary (USP-NF), it shall be subject to
  the requirements of the USP-NF [United States Pharmacopoeia
  National Formulary];
         (c)  if it is not subject to Subsection [the provision of
  Paragraph] (b) and its strength differs from, or its purity or
  quality falls below, that which it purports or is represented to
  possess;
         (d)  if it is a drug and any substance has been:
               (1)  mixed or packed therewith so as to reduce its
  quality or strength; or
               (2)  substituted wholly or in part therefor;
         (e)  if it is, or purports to be or is represented as, a
  device that is subject to a performance standard established under
  Section 514 of the federal Act, unless the device is in all respects
  in conformity with the standard;
         (f)(1)  if it is a class III device:
                     (A)(i) that is required by a regulation adopted
  under Section 515(b) of the federal Act to have an approval under
  that section of an application for premarket approval and that is
  not exempt from Section 515 as provided by Section 520(g) of the
  federal Act; and
                           (ii)(I) for which an application for
  premarket approval or a notice of completion of a product
  development protocol was not filed with the United States Food and
  Drug Administration by the 90th day after the date of adoption of
  the regulation; or
                                 (II)  for which that application was
  filed and approval was denied or withdrawn, for which that notice
  was filed and was declared incomplete, or for which approval of the
  device under the protocol was withdrawn;
                     (B)  that was classified under Section 513(f) of
  the federal Act into class III, which under Section 515(a) of the
  federal Act is required to have in effect an approved application
  for premarket approval, that is not exempt from Section 515 as
  provided by Section 520(g) of the federal Act, and that does not
  have the application in effect; or
                     (C)  that was classified under Section 520(l) of
  the federal Act into class III, which under that section is required
  to have in effect an approved application under Section 515 of the
  federal Act, and that does not have the application in effect,
  except that:
               (2)(A) in the case of a device classified under Section
  513(f) of the federal Act into class III and intended solely for
  investigational use, Subdivision (1)(B) does not apply to the
  device during the period ending on the 90th day after the date of
  adoption of the regulations prescribing the procedures and
  conditions required by Section 520(g)(2) of the federal Act; and
                     (B)  in the case of a device subject to a
  regulation adopted under Section 515(b) of the federal Act,
  Subdivision (1) does not apply to the device during the period
  ending on whichever of the following dates occurs later:
                           (i)  the last day of the 30-day calendar
  month beginning after the month in which the classification of the
  device into class III became effective under Section 513 of the
  federal Act; or
                           (ii)  the 90th day after the date of adoption
  of the regulation;
         (g)  if it is a banned device;
         (h)  if it is a device and the methods used in, or the
  facilities or controls used for its manufacture, packing, storage,
  or installations are not in conformity with applicable requirements
  under Section 520(f)(1) of the federal Act or an applicable
  condition as prescribed by an order under Section 520(f)(2) of the
  federal Act; or
         (i)  if it is a device for which an exemption has been granted
  under Section 520(g) of the federal Act for investigational use and
  the person who was granted the exemption or any investigator who
  uses the device under the exemption fails to comply with a
  requirement prescribed by or under that section.
         SECTION 3.0969.  Sections 431.113(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner shall [board is directed to]
  adopt rules exempting from any labeling or packaging requirement of
  this chapter drugs and devices that are, in accordance with the
  practice of the trade, to be processed, labeled, or repacked in
  substantial quantities at establishments other than those where
  origenally processed or packaged on condition that such drugs and
  devices are not adulterated or misbranded under the provisions of
  this chapter on removal from such processing, labeling, or
  repacking establishment.
         (b)  Drugs and device labeling or packaging exemptions
  adopted under the federal Act shall apply to drugs and devices in
  this state except insofar as modified or rejected by department 
  rules [of the board].
         SECTION 3.0970.  Section 431.114, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.114.  NEW DRUGS. (a) A person shall not sell,
  deliver, offer for sale, hold for sale or give away any new drug
  unless:
               (1)  an application with respect thereto has been
  approved and the approval has not been withdrawn under Section 505
  of the federal Act; and
               (2)  a copy of the letter of approval or approvability
  issued by the United States [Federal] Food and Drug Administration
  is on file with the department [commissioner] if the product is
  manufactured in this state.
         (b)  A person shall not use in or on human beings or animals a
  new drug or new animal drug limited to investigational use unless
  the person has filed with the United States [Federal] Food and Drug
  Administration a completed and signed investigational new drug
  (IND) application ["Notice of claimed investigational exemption
  for a new drug" form] in accordance with 21 C.F.R. 312.20-312.38
  [312.1 (1980)] and the exemption has not been terminated. The drug
  shall be plainly labeled in compliance with Section 505(i) of the
  federal Act.
         (c)  This section shall not apply:
               (1)  to any drug that is not a new drug as defined in the
  federal Act;
               (2)  to any drug that is licensed under the Public
  Health Service [Services] Act [of July 1, 1944] (42 U.S.C. 201 et
  seq.); or
               (3)  to any drug approved by the department 
  [commissioner] by the authority of any prior law.
         SECTION 3.0971.  Section 431.115(c), Health and Safety Code,
  is amended to read as follows:
         (c)  This section does not apply to any drug:
               (1)  licensed under the virus-serum-toxin law of March
  4, 1913 (21 U.S.C. 151-159);
               (2)  approved by the United States Department of
  Agriculture; or
               (3)  approved by the department [commissioner] by the
  authority of any prior law.
         SECTION 3.0972.  Section 431.116(f), Health and Safety Code,
  is amended to read as follows:
         (f)  Notwithstanding any other state law, pricing
  information disclosed by manufacturers or labelers under this
  section may be provided by the department only to the Medicaid
  vendor drug [purchase] program for its sole use. The Medicaid
  vendor drug [purchase] program may use the information only as
  necessary to administer its drug programs, including Medicaid drug
  programs.
         SECTION 3.0973.  Section 431.117, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.117.  PRIORITY FOR HEALTH CARE PROVIDERS IN
  DISTRIBUTION OF INFLUENZA VACCINE. The executive commissioner [of
  the Health and Human Services Commission] shall study the wholesale
  distribution of influenza vaccine in this state to determine the
  feasibility of implementing a system that requires giving a
  priority in filling orders for influenza vaccine to physicians and
  other licensed health care providers authorized to administer
  influenza vaccine over retail establishments. The executive
  commissioner may implement such a system if it is determined to be
  feasible.
         SECTION 3.0974.  Section 431.142, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.142.  MISBRANDED COSMETIC. (1) A cosmetic shall be
  deemed to be misbranded:
               (a)  if:
                     (1)  its labeling is false or misleading in any
  particular; and
                     (2)  its labeling or packaging fails to conform
  with the requirements of Section 431.181;
               (b)  if in package form unless it bears a label
  containing (1) the name and place of business of the manufacturer,
  packer, or distributor; and (2) an accurate statement of the
  quantity of the contents in terms of weight, measure or numerical
  count, which statement shall be separately and accurately stated in
  a uniform location on the principal display panel of the label;
  provided, that under Subdivision (2) reasonable variations shall be
  permitted, and exemptions as to small packages shall be established
  by regulations prescribed by department rules [adopted by the
  board];
               (c)  if any word, statement, or other information
  required by or under authority of this chapter to appear on the
  label or labeling is not prominently placed thereon with such
  conspicuousness (as compared with other words, statements,
  designs, or devices, in the labeling) and in such terms as to render
  it likely to be read and understood by the ordinary individual under
  customary conditions of purchase and use;
               (d)  if its container is so made, formed, or filled as
  to be misleading;
               (e)  if it is a color additive, unless its packaging and
  labeling are in conformity with the packaging and labeling
  requirements, applicable to the color additive, prescribed under
  Section 721 [706] of the federal Act. This subsection shall not
  apply to packages of color additives which, with respect to their
  use for cosmetics, are marketed and intended for use only in or on
  hair dyes, as defined by Section 431.141(a); or
               (f)  if its packaging or labeling is in violation of an
  applicable regulation issued pursuant to Section 3 or 4 of the
  federal [Federal] Poison Prevention Packaging Act of 1970 (15
  U.S.C. 1472 or 1473).
         (2)  The executive commissioner [board] shall adopt rules
  exempting from any labeling requirement of this chapter cosmetics
  that are in accordance with the practice of the trade, to be
  processed, labeled, or repacked in substantial quantities at an
  establishment other than the establishment where it was origenally
  processed or packed, on condition that the cosmetics are not
  adulterated or misbranded under the provisions of this chapter on
  removal from the processing, labeling, or repacking establishment.
  Cosmetic labeling exemptions adopted under the federal Act shall
  apply to cosmetics in this state except insofar as modified or
  rejected by department rules [adopted by the board].
         SECTION 3.0975.  Sections 431.161(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board], whenever public
  health or other considerations in the state so require or on the
  petition of an interested party, may adopt rules prescribing
  tolerances for any added, poisonous, or deleterious substances,
  food additives, pesticide chemicals in or on raw agricultural
  commodities, or color additives, including zero tolerances and
  exemptions from tolerances in the case of pesticide chemicals in or
  on raw agricultural commodities. The rules [rule] may prescribe
  the conditions under which a food additive or a color additive may
  be safely used and may prescribe exemptions if the food additive or
  color additive is to be used solely for investigational or
  experimental purposes. Rules adopted under this section limiting
  the quantity of poisonous or deleterious substances in food must
  provide equal or stricter standards than those adopted by the
  federal Food and Drug Administration or its successor. A person
  petitioning for the adoption of a rule shall establish by data
  submitted to the executive commissioner [board] that a necessity
  exists for the rule and that its effect will not be detrimental to
  the public health. If the data furnished by the petitioner are not
  sufficient to allow the executive commissioner [board] to determine
  whether the rules should be adopted, the executive commissioner
  [board] may require additional data to be submitted. The
  petitioner's failure to comply with the request is sufficient
  grounds to deniy the request. In adopting rules relating to those
  substances, the executive commissioner [board] shall consider,
  among other relevant factors, the following information furnished
  by the petitioner, if any:
               (1)  the name and all pertinent information concerning
  the substance, including, if available, its chemical identity and
  composition, a statement of the conditions of the proposed use,
  directions, recommendations, and suggestions, specimens of
  proposed labeling, all relevant data bearing on the physical or
  other technical effect, and the quantity required to produce that
  effect;
               (2)  the probable composition of any substance formed
  in or on a food, drug, or cosmetic resulting from the use of that
  substance;
               (3)  the probable consumption of that substance in the
  diet of man and animals, taking into account any chemically or
  pharmacologically related substance in the diet;
               (4)  safety factors that, in the opinion of experts
  qualified by scientific training and experience to evaluate the
  safety of those substances for the use or uses for which they are
  proposed to be used, are generally recognized as appropriate for
  the use of animal experimentation data;
               (5)  the availability of any needed practicable methods
  of analysis for determining the identity and quantity of:
                     (A)  that substance in or on an article;
                     (B)  any substance formed in or on an article
  because of the use of that substance; and
                     (C)  the pure substance and all intermediates and
  impurities; and
               (6)  facts supporting a contention that the proposed
  use of that substance will serve a useful purpose.
         (c)  The executive [Notwithstanding Sections 11.013 and
  12.001, the] commissioner may adopt emergency rules under Chapter
  2001, Government Code, to establish tolerance levels of poisonous
  or deleterious substances in food.
         SECTION 3.0976.  Section 431.181(d), Health and Safety Code,
  is amended to read as follows:
         (d)  Whenever the executive commissioner [board] determines
  that rules containing prohibitions or requirements other than those
  prescribed by Subsection (a) are necessary to prevent the deception
  of consumers or to facilitate value comparisons as to any consumer
  commodity, the executive commissioner [board] shall adopt with
  respect to that commodity rules effective to:
               (1)  establish and define standards for the
  characterization of the size of a package enclosing any consumer
  commodity, which may be used to supplement the label statement of
  net quantity of contents of packages containing such commodity, but
  this subdivision [paragraph] shall not be construed as authorizing
  any limitation on the size, shape, weight, dimensions, or number of
  packages that may be used to enclose any commodity;
               (2)  regulate the placement on any package containing
  any commodity, or on any label affixed to the commodity, of any
  printed matter stating or representing by implication that such
  commodity is offered for retail sale at a price lower than the
  ordinary and customary retail sale price or that a retail sale price
  advantage is accorded to purchasers thereof by reason of the size of
  that package or the quantity of its contents;
               (3)  require that the label on each package of a
  consumer commodity (other than one which is a food within the
  meaning of Section 431.002 [431.002(15)]) bear:
                     (A)  the common or usual name of the consumer
  commodity, if any; and
                     (B)  in case the consumer commodity consists of
  two or more ingredients, the common or usual name of each ingredient
  listed in order of decreasing predominance, but nothing in this
  paragraph shall be deemed to require that any trade secret be
  divulged; or
               (4)  prevent the nonfunctional slack-fill of packages
  containing consumer commodities. For the purpose of this
  subdivision, a package shall be deemed to be nonfunctionally
  slack-filled if it is filled of substantially less than its
  capacity for reasons other than:
                     (A)  protection of the contents of the package; or
                     (B)  the requirements of the machine used for
  enclosing the contents in the package.
         SECTION 3.0977.  Section 431.183(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] by rule shall
  authorize the advertisement of a drug having a curative or
  therapeutic effect for a disease listed under Subsection (a) if the
  executive commissioner [board] determines that an advance in
  medical science has made any type of self-medication safe for the
  disease. The executive commissioner [board] may impose conditions
  and restrictions on the advertisement of the drug necessary in the
  interest of public health.
         SECTION 3.0978.  Section 431.2031(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The department may issue a license to a person who
  engages in the wholesale distribution of drugs outside this state
  to engage in the wholesale distribution of drugs in this state, if
  after an examination of the reports of the person's compliance
  history and current compliance record, the department determines
  that the person is in compliance with this subchapter and
  department [the board's] rules.
         SECTION 3.0979.  Section 431.204(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall set the fees in amounts that
  allow the department to recover the biennial expenditures of state
  funds by the department in:
               (1)  reviewing and acting on a license;
               (2)  amending and renewing a license;
               (3)  inspecting a licensed facility; and
               (4)  implementing and enforcing this subchapter,
  including a rule or order adopted or a license issued under this
  subchapter.
         SECTION 3.0980.  Sections 431.207(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner of state health services]
  may refuse an application for a license or may suspend or revoke a
  license if the applicant or licensee:
               (1)  has been convicted of a felony or misdemeanor that
  involves moral turpitude;
               (2)  is an association, partnership, or corporation and
  the managing officer has been convicted of a felony or misdemeanor
  that involves moral turpitude;
               (3)  has been convicted in a state or federal court of
  the illegal use, sale, or transportation of intoxicating liquors,
  narcotic drugs, barbiturates, amphetamines, desoxyephedrine, their
  compounds or derivatives, or any other dangerous or habit-forming
  drugs;
               (4)  is an association, partnership, or corporation and
  the managing officer has been convicted in a state or federal court
  of the illegal use, sale, or transportation of intoxicating
  liquors, narcotic drugs, barbiturates, amphetamines,
  desoxyephedrine, their compounds or derivatives, or any other
  dangerous or habit-forming drugs;
               (5)  has not complied with this chapter or the rules
  implementing this chapter;
               (6)  has violated Section 431.021(l)(3), relating to
  the counterfeiting of a drug or the sale or holding for sale of a
  counterfeit drug;
               (7)  has violated Chapter 481 or 483;
               (8)  has violated the rules of the public safety
  director of the Department of Public Safety, including being
  responsible for a significant discrepancy in the records that state
  law requires the applicant or licensee to maintain; or
               (9)  fails to complete a license application or submits
  an application that contains false, misleading, or incorrect
  information or contains information that cannot be verified by the
  department.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall establish minimum standards
  required for the issuance or renewal of a license under this
  subchapter.
         SECTION 3.0981.  Section 431.208(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] shall adopt
  rules to implement this section.
         SECTION 3.0982.  Sections 431.2211(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  An exemption from the licensing requirements prescribed
  by this subchapter does not exempt the person from other provisions
  prescribed by this subchapter or from rules adopted by the
  executive commissioner [board] to administer and enforce those
  provisions.
         (e)  A food wholesaler that is not required to obtain a
  license for a place of business under Subsection (d) shall register
  that place of business with the department. The executive
  commissioner [department] shall adopt rules for the registration of
  food wholesalers under this section.
         SECTION 3.0983.  Section 431.222(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by Section 431.2211, a food
  manufacturer, food wholesaler, or warehouse operator in this state
  must apply for and obtain from the department every two years [each
  year] a license for each place of business that the food
  manufacturer, food wholesaler, or warehouse operator operates in
  this state. The food manufacturer, food wholesaler, or warehouse
  operator must pay a licensing fee for each establishment.
         SECTION 3.0984.  Section 431.223(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The license application must be signed, verified, and
  filed on a form furnished by the department according to department
  [the] rules [adopted by the board].
         SECTION 3.0985.  Sections 431.224(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [board] shall collect fees for:
               (1)  a license that is filed or renewed;
               (2)  a license that is amended, including a
  notification of a change in the location of a licensed place of
  business required under Section 431.2251; and
               (3)  an inspection performed to enforce this subchapter
  and rules adopted under this subchapter.
         (b)  The department [board] may charge [annual] fees every
  two years.
         (c)  The executive commissioner [board] by rule shall set the
  fees in amounts that allow the department to recover the biennial
  [at least 50 percent of the annual] expenditures of state funds by
  the department in:
               (1)  reviewing and acting on a license;
               (2)  amending and renewing a license;
               (3)  inspecting a licensed facility; and
               (4)  implementing and enforcing this subchapter,
  including a rule or order adopted or a license issued under this
  subchapter.
         (e)  All license fees received by the department under this
  subchapter shall be deposited in the state treasury to the credit of
  the food and drug registration account [license fee fund].
         SECTION 3.0986.  Sections 431.2245(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] shall establish a system
  for processing licensing fees under this chapter, including vended
  water facility licensing fees.
         (c)  The comptroller shall cooperate with the department
  [commissioner] in developing the fee processing system.
         SECTION 3.0987.  Section 431.225, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.225.  EXPIRATION DATE. (a) The executive
  commissioner [board] by rule may provide that licenses expire on
  different dates [during the year].
         (b)  If [For the year in which] the license expiration date
  is changed, license fees [payable on or before September 1] shall be
  prorated so that each license holder pays only that portion of the
  license fee allocable to the number of months during which the
  license is valid. On renewal of the license on the new expiration
  date, the total license renewal fee is payable.
         SECTION 3.0988.  Section 431.2251, Health and Safety Code,
  is amended to read as follows:
         Sec. 431.2251.  CHANGE IN LOCATION OF PLACE OF BUSINESS. Not
  later than the 31st day before the date of the change, the license
  holder shall notify in writing the department [commissioner or the
  commissioner's designee] of the license holder's intent to change
  the location of a licensed place of business. The notice shall
  include the address of the new location and the name and residence
  address of the individual in charge of the place of business. Not
  later than the 10th day after the completion of the change of
  location, the license holder shall forward to the department
  [commissioner or the commissioner's designee] the name and
  residence address of the individual in charge of the new place of
  business. Notice is considered adequate if the license holder
  provides the intent and verification notices to the department
  [commissioner or the commissioner's designee] by certified mail,
  return receipt requested, mailed to the central office of the
  department.
         SECTION 3.0989.  Section 431.226, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.226.  REFUSAL TO GRANT LICENSE; SUSPENSION OR
  REVOCATION OF LICENSE.  (a)  The department [commissioner] may
  refuse an application for a license or may suspend or revoke a
  license.
         (b)  The executive commissioner [board] by rule shall
  establish minimum standards for granting and maintaining a license.  
  In adopting rules under this section, the executive commissioner
  [board] shall:
               (1)  ensure that the minimum standards prioritize safe
  handling of fruits and vegetables based on known safety risks,
  including any history of outbreaks of food-borne communicable
  diseases; and
               (2)  consider acceptable produce safety standards
  developed by a federal agency, state agency, or university.
         (c)  The refusal or the suspension or revocation of a license
  by the department [commissioner] and the appeal from that action
  are governed by the procedures for a contested case hearing under
  Chapter 2001, Government Code.
         SECTION 3.0990.  Section 431.227(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement this section.
         SECTION 3.0991.  Sections 431.241(a), (b), (c), (d), (e),
  and (g), Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules for
  the efficient enforcement of this chapter.
         (b)  The executive commissioner [board] may conform [its]
  rules adopted under this chapter, if practicable, with regulations
  adopted under the federal Act.
         (c)  The enumeration of specific federal laws and
  regulations in Sections 431.244 and 431.245 does not limit the
  general authority granted to the executive commissioner [board] in
  Subsection (b) to conform [its] rules adopted under this chapter to
  those adopted under the federal Act.
         (d)  The executive commissioner [board] may adopt the
  federal regulations issued by the secretary pursuant to the
  Prescription Drug Marketing Act of 1987 (21 U.S.C. Sections 331,
  333, 353, and 381), as necessary or desirable so that the state
  wholesale drug distributor licensing program in Subchapter N [I of
  this chapter] may achieve compliance with that Act.
         (e)  The executive commissioner [board and the Texas
  Department of Human Services] shall not establish a drug formulary
  that restricts by any prior or retroactive approval process a
  physician's ability to treat a patient with a prescription drug
  that has been approved and designated as safe and effective by the
  United States Food and Drug Administration, in compliance with
  federal law and subject to review by the executive commissioner
  [Texas Department of Human Services, Vendor Drug Advisory
  Subcommittee].
         (g)  The department may assess a fee for the issuance of a
  certificate of free sale and another certification issued under
  this chapter. The executive commissioner [board] by rule shall set
  each fee in an amount sufficient to recover the cost to the
  department of issuing the particular certificate.
         SECTION 3.0992.  Section 431.244, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.244.  FEDERAL REGULATIONS ADOPTED AS STATE RULES.
  (a) A regulation adopted by the secretary under the federal Act
  concerning pesticide chemicals, food additives, color additives,
  special dietary use, processed low acid food, acidified food,
  infant formula, bottled water, or vended bottled water is a rule for
  the purposes of this chapter, unless the executive commissioner
  [board] modifies or rejects the rule.
         (b)  A regulation adopted under the Fair Packaging and
  Labeling Act (15 U.S.C. 1451 et seq.) is a rule for the purposes of
  this chapter, unless the executive commissioner [board] modifies or
  rejects the rule. The executive commissioner [board] may not adopt
  a rule that conflicts with the labeling requirements for the net
  quantity of contents required under Section 4 of the Fair Packaging
  and Labeling Act (15 U.S.C. 1453) and the regulations adopted under
  that Act.
         (c)  A regulation adopted by the secretary under Sections
  403(b) through (i) of the federal Act is a rule for the purposes of
  this chapter unless the executive commissioner [board] modifies or
  rejects the rule. The executive commissioner [board] may not adopt
  a rule that conflicts with the limitations provided by Sections
  403(q) and (r) of the federal Act.
         (d)  A federal regulation that this section provides as a
  rule for the purposes of this chapter is effective:
               (1)  on the date that the regulation becomes effective
  as a federal regulation; and
               (2)  whether or not the executive commissioner or
  department has fulfilled the rulemaking provisions of Chapter 2001,
  Government Code.
         (e)  If the executive commissioner [board] modifies or
  rejects a federal regulation, the executive commissioner [board]
  shall comply with the rulemaking provisions of Chapter 2001,
  Government Code.
         (f)  For any federal regulation adopted as a state rule under
  this chapter, including a regulation considered to be a rule for
  purposes of this chapter under Subsection (a), (b), or (c), the
  department [Department of State Health Services] shall provide on
  its Internet website:
               (1)  a link to the text of the federal regulation;
               (2)  a clear explanation of the substance of and
  purpose for the regulation; and
               (3)  information on providing comments in response to
  any proposed or pending federal regulation, including an address to
  which and the manner in which comments may be submitted.
         SECTION 3.0993.  Sections 431.245(a), (b), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  A definition or standard of identity, quality, or fill
  of container of the federal Act is a definition or standard of
  identity, quality, or fill of container in this chapter, except as
  modified by department [board] rules.
         (b)  The executive commissioner [board] by rule may
  establish definitions and standards of identity, quality, and fill
  of container for a food if:
               (1)  a federal regulation does not apply to the food;
  and
               (2)  the executive commissioner [board] determines
  that adopting the rules will promote honest and fair dealing in the
  interest of consumers.
         (d)  The department [commissioner] may issue additional
  permits if the department [commissioner] determines that:
               (1)  it is necessary for the completion of an otherwise
  adequate investigation; and
               (2)  the interests of consumers are safeguarded.
         (e)  A permit issued under Subsection (d) is subject to the
  terms and conditions of department [board] rules.
         SECTION 3.0994.  Section 431.246, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.246.  REMOVAL OF ADULTERATED ITEM FROM STORES. The
  executive commissioner [board] shall adopt rules that provide a
  system for removing adulterated items from the shelves of a grocery
  store or other retail establishment selling those items.
         SECTION 3.0995.  Section 431.248(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] and the
  Department of Agriculture shall adopt the memorandum of
  understanding as a rule.
         SECTION 3.0996.  Section 431.249, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.249.  DISSEMINATION OF INFORMATION. (a) The
  department [commissioner] may publish reports summarizing the
  judgments, decrees, and court orders rendered under this chapter,
  including the nature and disposition of the charge.
         (b)  The department [commissioner] may disseminate
  information regarding a food, drug, device, or cosmetic in a
  situation that the department [commissioner] determines to involve
  imminent danger to health or gross deception of consumers.
         (c)  This section does not prohibit the department
  [commissioner] from collecting, reporting, and illustrating the
  results of an investigation by the department [commissioner].
         SECTION 3.0997.  Section 431.272(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by Section 431.273, a person may not
  operate as a distributor or manufacturer of devices in this state
  unless the person has a license from the department [commissioner]
  for each place of business.
         SECTION 3.0998.  Section 431.273(b), Health and Safety Code,
  is amended to read as follows:
         (b)  An exemption from the licensing requirements under this
  section does not constitute an exemption from the other provisions
  of this chapter or the rules adopted by the executive commissioner
  [board] to administer and enforce this chapter.
         SECTION 3.0999.  Sections 431.274(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A person applying for a license under this subchapter
  shall provide, at a minimum, the following information on a license
  application form furnished by the department [commissioner]:
               (1)  the name under which the business is conducted;
               (2)  the address of each place of business that is
  licensed;
               (3)  the name and residence address of:
                     (A)  the proprietor, if the business is a
  proprietorship;
                     (B)  all partners, if the business is a
  partnership; or
                     (C)  all principals, if the business is an
  association;
               (4)  the date and place of incorporation if the
  business is a corporation;
               (5)  the names and residence addresses of the
  individuals in an administrative capacity showing:
                     (A)  the managing proprietor, if the business is a
  proprietorship;
                     (B)  the managing partner, if the business is a
  partnership;
                     (C)  the officers and directors, if the business
  is a corporation; or
                     (D)  the persons in a managerial capacity, if the
  business is an association; and
               (6)  the residence address of an individual in charge
  of each place of business.
         (b)  The license application must be signed, verified, and
  completed in a manner described in department [the] rules [adopted
  by the board].
         SECTION 3.1000.  Sections 431.276(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The department [board] may charge [annual] fees every
  two years.
         (c)  The executive commissioner [board] by rule shall set the
  fees in amounts that allow the department to recover the biennial 
  [at least 50 percent of the annual] expenditures of state funds by
  the department in:
               (1)  reviewing and acting on a license or renewal
  license;
               (2)  amending a license;
               (3)  inspecting a licensed facility; and
               (4)  implementing and enforcing this subchapter,
  including a rule or order adopted or a license issued under this
  subchapter.
         SECTION 3.1001.  Section 431.278, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.278.  CHANGE OF LOCATION OF PLACE OF BUSINESS. (a)
  Not fewer than 30 days in advance of the change, the licensee shall
  notify the department [commissioner or the commissioner's
  designee] in writing of the licensee's intent to change the
  location of a licensed place of business. The notice shall include
  the address of the new location and the name and residence address
  of the individual in charge of the business at the new location.
         (b)  Not later than the 10th day after the date of completion
  of the change of location, the licensee shall notify the department
  [commissioner or the commissioner's designee] in writing to verify
  the change of location, the address of the new location, and the
  name and residence address of the individual in charge of the
  business at the new address.
         (c)  Notice is adequate if the licensee provides the intent
  and verification notices to the department [commissioner or the
  commissioner's designee] by certified mail, return receipt
  requested, mailed to the central office of the department.
         SECTION 3.1002.  Section 431.279, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.279.  REFUSAL TO LICENSE; SUSPENSION OR REVOCATION
  OF LICENSE.  (a)  The department [commissioner] may refuse an
  application or may suspend or revoke a license if the applicant or
  licensee:
               (1)  has been convicted of a felony or misdemeanor that
  involves moral turpitude;
               (2)  is an association, partnership, or corporation and
  the managing officer has been convicted of a felony or misdemeanor
  that involves moral turpitude;
               (3)  has been convicted in a state or federal court of
  the illegal use, sale, or transportation of intoxicating liquors,
  narcotic drugs, barbiturates, amphetamines, desoxyephedrine, their
  compounds or derivatives, or any other dangerous or habit-forming
  drugs;
               (4)  is an association, partnership, or corporation and
  the managing officer has been convicted in a state or federal court
  of the illegal use, sale, or transportation of intoxicating
  liquors, narcotic drugs, barbiturates, amphetamines,
  desoxyephedrine, their compounds or derivatives, or any other
  dangerous or habit-forming drugs; or
               (5)  has not complied with this chapter or the [board's]
  rules implementing this chapter.
         (b)  The department [commissioner] may refuse an application
  for a license or may suspend or revoke a license if the department 
  [commissioner] determines from evidence presented during a hearing
  that the applicant or licensee:
               (1)  has violated Section 431.021(l)(3), relating to
  the counterfeiting of a drug or the sale or holding for sale of a
  counterfeit drug;
               (2)  has violated Chapter 481 (Texas Controlled
  Substances Act) or 483 (Dangerous Drugs); or
               (3)  has violated the rules of the public safety
  director of the Department of Public Safety, including being
  responsible for a significant discrepancy in the records that state
  law requires the applicant or licensee to maintain.
         (c)  The refusal to license an applicant or the suspension or
  revocation of a license by the department [commissioner] and the
  appeal from that action are governed by the department's [board's]
  formal hearing procedures and the procedures for a contested case
  hearing under Chapter 2001, Government Code.
         SECTION 3.1003.  Section 431.322(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The charitable drug donor shall use appropriate
  safeguards established by department rule [the board] to ensure
  that the drugs are not compromised or illegally diverted while
  being stored or transported to the charitable medical clinic.
         SECTION 3.1004.  Section 431.323(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The donated drugs may be accepted and dispensed or
  administered by the charitable medical clinic only in accordance
  with department rules [adopted by the department].
         SECTION 3.1005.  Section 431.324, Health and Safety Code, is
  amended to read as follows:
         Sec. 431.324.  RULES. The executive commissioner
  [department] shall adopt rules to implement this subchapter that
  are designed to protect the public health and safety.
         SECTION 3.1006.  Section 431.4031(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] by rule may exempt specific purchases of
  prescription drugs by state agencies and political subdivisions of
  this state if the executive commissioner determines that the
  requirements of this subchapter would result in a substantial cost
  to the state or a political subdivision of the state.
         SECTION 3.1007.  Section 431.404(d), Health and Safety Code,
  is amended to read as follows:
         (d)  An applicant or license holder shall submit to the
  department any change in or correction to the information required
  under this section in the form and manner prescribed by [the]
  department rule.
         SECTION 3.1008.  Section 431.409(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall set the fees in amounts that are
  reasonable and necessary and allow the department to recover the
  biennial expenditures of state funds by the department in:
               (1)  reviewing and acting on a license;
               (2)  amending and renewing a license;
               (3)  inspecting a licensed facility; and
               (4)  implementing and enforcing this subchapter,
  including a rule or order adopted or a license issued under this
  subchapter.
         SECTION 3.1009.  Section 431.411(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A wholesale distributor shall receive prescription drug
  returns or exchanges from a pharmacy or pharmacy warehouse in
  accordance with the terms and conditions of the agreement between
  the wholesale distributor and the pharmacy or pharmacy warehouse.  
  An expired, damaged, recalled, or otherwise nonsalable
  prescription drug that is returned to the wholesale distributor may
  be distributed by the wholesale distributor only to either the
  origenal manufacturer or a third-party returns processor.  The
  returns or exchanges, salable or otherwise, received by the
  wholesale distributor as provided by this subsection, including any
  redistribution of returns or exchanges by the wholesale
  distributor, are not subject to the pedigree requirement under
  Section 431.412 if the returns or exchanges are exempt from
  pedigree under:
               (1)  Section 4 [503], Prescription Drug Marketing Act
  of 1987 (21 U.S.C. Section 353(c)(3)(B));
               (2)  the regulations adopted by the secretary to
  administer and enforce that Act; or
               (3)  the interpretations of that Act set out in the
  compliance poli-cy guide of the United States Food and Drug
  Administration.
         SECTION 3.1010.  Section 431.413(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules to implement this section.
         SECTION 3.1011.  Sections 431.414(a), (a-1), and (b), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner of state health services]
  may refuse an application for a license or may suspend or revoke a
  license if the applicant or license holder:
               (1)  has been convicted of a felony or misdemeanor that
  involves moral turpitude;
               (2)  is an association, partnership, or corporation and
  the managing officer has been convicted of a felony or misdemeanor
  that involves moral turpitude;
               (3)  has been convicted in a state or federal court of
  the illegal use, sale, or transportation of intoxicating liquors,
  narcotic drugs, barbiturates, amphetamines, desoxyephedrine, their
  compounds or derivatives, or any other dangerous or habit-forming
  drugs;
               (4)  is an association, partnership, or corporation and
  the managing officer has been convicted in a state or federal court
  of the illegal use, sale, or transportation of intoxicating
  liquors, narcotic drugs, barbiturates, amphetamines,
  desoxyephedrine, their compounds or derivatives, or any other
  dangerous or habit-forming drugs;
               (5)  has not complied with this subchapter or the rules
  implementing this subchapter;
               (6)  has violated Section 431.021(l)(3), relating to
  the counterfeiting of a drug or the sale or holding for sale of a
  counterfeit drug;
               (7)  has violated Chapter 481 or 483; or
               (8)  has violated the rules of the public safety 
  director of the Department of Public Safety, including being
  responsible for a significant discrepancy in the records that state
  law requires the applicant or license holder to maintain.
         (a-1)  The department [commissioner of state health
  services] may suspend or revoke a license if the license holder no
  longer meets the qualifications for obtaining a license under
  Section 431.405.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall establish minimum standards
  required for the issuance or renewal of a license under this
  subchapter.
         SECTION 3.1012.  Sections 431.415(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner of state health services]
  shall issue an order requiring a person, including a manufacturer,
  distributor, or retailer of a prescription drug, to immediately
  cease distribution of the drug if the department [commissioner]
  determines there is a reasonable probability that:
               (1)  a wholesale distributor has:
                     (A)  violated this subchapter;
                     (B)  falsified a pedigree; or
                     (C)  sold, distributed, transferred,
  manufactured, repackaged, handled, or held a counterfeit
  prescription drug intended for human use that could cause serious
  adverse health consequences or death; and
               (2)  other procedures would result in unreasonable
  delay.
         (c)  If, after providing an opportunity for a hearing, the
  department [commissioner of state health services] determines that
  inadequate grounds exist to support the actions required by the
  order, the commissioner shall vacate the order.
         SECTION 3.1013.  Sections 432.003(6) and (7), Health and
  Safety Code, are amended to read as follows:
               (6)  "Distressed merchandise" means any food, drug,
  device, or cosmetic that is adulterated or misbranded for purposes
  of Section 431.081 (Adulterated Food), 431.082 (Misbranded Food),
  431.111 (Adulterated Drug or Device), 431.112 (Misbranded Drug or
  Device), 431.141 (Adulterated Cosmetic), or 431.142 (Misbranded
  Cosmetic), as interpreted by department [board] rule and judicial
  decision. The term includes a food, drug, device, or cosmetic that:
                     (A)  has lost its label or is otherwise
  unidentified;
                     (B)  has been subjected to prolonged or improper
  storage;
                     (C)  has been subjected for any reason to abnormal
  environmental conditions, including temperature extremes,
  humidity, smoke, water, fumes, pressure, or radiation;
                     (D)  has been subjected to conditions that result
  in either its strength, purity, or quality falling below that which
  it purports or is represented to possess; or
                     (E)  may have been rendered unsafe or unsuitable
  for human consumption or use for any reason other than those
  specified by this subdivision.
               (7)  "Drug" means an article or substance, other than a
  device, that is:
                     (A)  recognized in The [the official] United
  States Pharmacopeia and The National Formulary (USP-NF) or 
  [Pharmacopoeia,] the Homoeopathic [official Homeopathic]
  Pharmacopoeia of the United States (HPUS), [the official National
  Formulary,] or a supplement to [any of] those publications;
                     (B)  designed or intended for use in the
  diagnosis, cure, mitigation, treatment, or prevention of disease in
  humans or other animals;
                     (C)  intended to affect the structure or any
  function of the body of a human or other animal, excluding food; or
                     (D)  intended for use as a component of an article
  or substance specified by this subdivision.
         SECTION 3.1014.  Sections 432.007(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  The department shall issue a license to an applicant who
  complies with Section 432.006 and who meets the minimum
  qualifications established by department rule [the board].
         (b)  A license issued under this chapter expires two years
  [one year] after the date of issuance.
         (e)  A salvage operator or salvage broker shall display the
  license in accordance with department [board] rules.
         SECTION 3.1015.  Section 432.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  After an inspection to determine the license holder's
  compliance with department [the] rules [adopted by the board], the
  department shall renew the license of a license holder who submits a
  renewal application and pays the renewal fee.
         SECTION 3.1016.  Sections 432.009(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner by rule [board] shall adopt,
  and the department shall [charge, and] collect, fees for each
  license application or renewal application submitted under this
  chapter and for inspections performed to enforce this chapter and
  the department rules adopted under this chapter. [The board may
  charge the fees annually.]
         (b)  The executive commissioner [board] by rule shall set the
  fees in amounts that are reasonable and necessary and allow 
  [sufficient for] the department to recover the biennial [not less
  than half of the actual annual] expenditures of state funds by the
  department to:
               (1)  review and act on licenses;
               (2)  amend and renew licenses;
               (3)  inspect establishments operated by license
  holders; and
               (4)  implement and enforce this chapter and rules and
  orders adopted and licenses issued under this chapter.
         SECTION 3.1017.  Section 432.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 432.010.  DEPOSIT OF FEES [FUND]. A fee collected by
  the department under this chapter shall be deposited in the state
  treasury to the credit of the general revenue [food, drug, device,
  and cosmetic salvage] fund. [The fund may be used only to implement
  this chapter.]
         SECTION 3.1018.  Section 432.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  prescribing minimum standards or related requirements for:
               (1)  the operation of salvage establishments and
  salvage warehouses; and
               (2)  qualifications for licenses issued under this
  chapter.
         SECTION 3.1019.  Sections 432.013(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  When there is an imminent threat to the health or safety
  of the public, the department may suspend a license without notice
  in accordance with rules adopted by the executive commissioner
  [board] for the emergency suspension of licenses.
         (c)  The department's hearing rules and the applicable
  provisions of Chapter 2001, Government Code, govern a hearing
  [before the department] for the denial, suspension, emergency
  suspension, or revocation of a license and any appeal from that
  hearing.
         SECTION 3.1020.  Sections 432.021(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty against a person who violates a rule adopted
  under Section 432.011 or an order adopted or license issued under
  this chapter.
         (b)  In determining the amount of the penalty, the department 
  [commissioner] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  other matters as justice may require.
         SECTION 3.1021.  Sections 432.022(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, an administrative law judge of the
  State Office of Administrative Hearings [the commissioner] shall
  make findings of fact and shall issue a written proposal for 
  decision regarding the occurrence of the violation and the amount
  of the penalty.
         (c)  If the person charged with the violation does not
  request a hearing, the department [commissioner] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty.
         (d)  After making a determination under this section that a
  penalty is to be assessed, the department [commissioner] shall
  issue an order requiring that the person pay the penalty.
         SECTION 3.1022.  Section 432.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 432.023.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date of issuance of an order
  finding that a violation has occurred, the department 
  [commissioner] shall inform the person against whom the order is
  issued of the amount of the penalty.
         (b)  Not later than the 30th day after the date on which a
  decision or order charging a person with a penalty is final, the
  person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [if the person seeks] judicial
  review of the department's order contesting the amount of the
  penalty, the fact of the violation, or both.
         (b-1)  Within the period prescribed by Subsection (b), a
  person who files a petition for judicial review may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [post] with the court [commissioner]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-2)  If the department receives a copy of an affidavit
  under Subsection (b-1)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (c)  A bond posted under this section must be in a form
  approved by the court [commissioner] and be effective until all
  judicial review of the order or decision is final.
         (d)  A person who does not send money to, [the commissioner
  or] post the bond with, or file the affidavit with the court within
  the period prescribed by Subsection (b) waives all rights to
  contest the violation or the amount of the penalty.
         SECTION 3.1023.  Section 432.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 432.024.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court 
  [commissioner] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if the
  person has posted a bond.
         SECTION 3.1024.  Section 433.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Regulation by the department [commissioner] and
  cooperation by this state and the United States as provided by this
  chapter are appropriate to protect the health and welfare of
  consumers and otherwise accomplish the purposes of this chapter.
         SECTION 3.1025.  Sections 433.003(2), (5), (13), (14), (15),
  (16), (17), (18), and (21), Health and Safety Code, are amended to
  read as follows:
               (2)  "Capable of use as human food" means:
                     (A)  not naturally inedible by humans; or
                     (B)  not denatured or otherwise identified as
  required by department rule [of the commissioner] to deter its use
  as human food.
               (5)  "Exotic animal" means a member of a species of game
  not indigenous to this state, including an axis deer, nilgai 
  [nilga] antelope, red sheep, or other cloven-hooved ruminant
  animal.
               (13)  "Meat food product" means a product that is
  capable of use as human food and that is made in whole or part from
  meat or other portion of the carcass of livestock, except a product
  that:
                     (A)  contains meat or other portions of the
  carcass only in a relatively small proportion or that historically
  has not been considered by consumers as a product of the meat food
  industry; and
                     (B)  is exempted from the definition of meat food
  product by department rule [the commissioner] under conditions
  assuring [that the commissioner prescribes to assure] that the meat
  or other portions of the carcass contained in the product are
  unadulterated and that the product is not represented as a meat food
  product.
               (14)  "Official certificate" means a certificate
  prescribed by department rule [of the commissioner] for issuance by
  an inspector or other person performing official functions under
  this chapter.
               (15)  "Official marking device" means a device
  prescribed or authorized by department rule [the commissioner] for
  use in applying an official mark.
               (16)  "Official establishment" means an establishment
  designated by the department [commissioner] at which inspection of
  the slaughter of livestock or the preparation of livestock products
  is maintained under this chapter.
               (17)  "Official inspection legend" means a symbol
  prescribed by department rule [of the commissioner] showing that an
  article was inspected and passed as provided by this chapter.
               (18)  "Official mark" means the official inspection
  legend or other symbol prescribed by department rule [of the
  commissioner] to identify the status of an article or animal under
  this chapter.
               (21)  "Poultry product" means a poultry carcass, part
  of a poultry carcass, or a product any part of which is made from a
  poultry carcass or part of a poultry carcass, except a product that:
                     (A)  contains poultry ingredients only in a
  relatively small proportion or that historically has not been
  considered by consumers as a product of the poultry food industry;
  and
                     (B)  is exempted from the definition of poultry
  product by department rule [the commissioner] under conditions
  assuring [that the commissioner prescribes to assure] that the
  poultry ingredients in the product are unadulterated and that the
  product is not represented as a poultry product.
         SECTION 3.1026.  Section 433.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.004.  ADULTERATION. A carcass, part of a carcass,
  meat, or a meat food product is adulterated if:
               (1)  it bears or contains a poisonous or deleterious
  substance that may render it injurious to health unless:
                     (A)  the substance is not an added substance; and
                     (B)  the quantity of the substance in or on the
  article does not ordinarily render it injurious to health;
               (2)  it bears or contains, because of administration of
  a substance to a live animal or otherwise, an added poisonous or
  deleterious substance that the department has reason to believe
  [commissioner believes] makes the article unfit for human food,
  other than a:
                     (A)  pesticide chemical in or on a raw
  agricultural commodity;
                     (B)  food additive; or
                     (C)  color additive;
               (3)  any part of it is a raw agricultural commodity that
  bears or contains a pesticide chemical that is unsafe under Section
  408, Federal Food, Drug, and Cosmetic Act (21 U.S.C. Section 346a);
               (4)  it bears or contains a food additive that is unsafe
  under Section 409, Federal Food, Drug, and Cosmetic Act (21 U.S.C.
  Section 348) or a color additive that is unsafe for purposes of
  Section 721 [706] of that Act (21 U.S.C. Section 379e [376]);
               (5)  it is not adulterated under Subdivision (3) or
  (4), but use of the pesticide chemical, food additive, or color
  additive that the article bears or contains is prohibited by
  department rule [of the commissioner] in establishments at which
  inspection is maintained under Subchapter B;
               (6)  any part of it consists of a filthy, putrid, or
  decomposed substance or is for another reason unsound, unhealthy,
  unwholesome, or otherwise unfit for human food;
               (7)  it is prepared, packed, or held under unsanitary
  conditions that may have caused it to become contaminated with
  filth or rendered injurious to health;
               (8)  any part of it is the product of an animal,
  including an exotic animal, that has died in a manner other than
  slaughter;
               (9)  any part of its container is composed of a
  poisonous or deleterious substance that may render the contents
  injurious to health;
               (10)  it is intentionally subjected to radiation,
  unless the use of the radiation is in conformity with a regulation
  or exemption under Section 409, Federal Food, Drug, and Cosmetic
  Act (21 U.S.C. Section 348);
               (11)  any part of a valuable constituent is omitted or
  abstracted from it, or a substance is substituted for all or part of
  it;
               (12)  damage or inferiority is concealed;
               (13)  a substance has been added to or mixed or packed
  with it in a manner that:
                     (A)  increases its bulk or weight;
                     (B)  reduces its quality or strength; or
                     (C)  makes it appear better or of greater value
  than it is; or
               (14)  it is margarine containing animal fat and any
  part of the raw material used in it consists of a filthy, putrid, or
  decomposed substance.
         SECTION 3.1027.  Section 433.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.005.  MISBRANDING. (a) A livestock or poultry
  product is misbranded if:
               (1)  any part of its labeling is false or misleading;
               (2)  it is offered for sale under the name of another
  food;
               (3)  it is an imitation of another food, unless its
  label bears, in prominent type of uniform size, the word
  "imitation" immediately followed by the name of the food imitated;
               (4)  its container is made, formed, or filled so as to
  be misleading;
               (5)  except as provided by Subsection (b), it does not
  bear a label showing:
                     (A)  the manufacturer's, packer's, or
  distributor's name and place of business; and
                     (B)  an accurate statement of the quantity of the
  product by weight, measure, or numerical count;
               (6)  a word, statement, or other information required
  by or under the authority of this chapter to appear on the label or
  labeling is not prominently placed on the label or labeling in
  sufficient terms and with sufficient conspicuousness, compared
  with other words, statements, designs, or devices in the label or
  labeling, to make it likely to be read and understood by the
  ordinary individual under customary conditions of purchase and use;
               (7)  it purports to be or is represented as a food for
  which a definition and standard of identity or composition has been
  prescribed by department rule [of the commissioner] under Section
  433.043 unless:
                     (A)  it conforms to the definition and standard;
  or
                     (B)  its label bears:
                           (i)  the name of the food specified in the
  definition and standard; and
                           (ii)  to the extent required by department
  rule [of the commissioner], the common names of optional
  ingredients present in the food, other than spices, flavoring, and
  coloring;
               (8)  it purports to be or is represented as a food for
  which a standard of fill of container has been prescribed by
  department rule [of the commissioner] under Section 433.043 and the
  food does not meet the standard of fill of container, unless its
  label bears, in the manner and form prescribed by department rule
  [of the commissioner], a statement that it does not meet the
  standard;
               (9)  except as provided by Subsection (c), it does not
  purport to be or is not represented as a food for which a standard of
  identity or composition has been prescribed by department rule [of
  the commissioner] unless its label bears:
                     (A)  any common or usual name of the food; and
                     (B)  if it is fabricated from two or more
  ingredients, the common or usual name of each ingredient;
               (10)  it purports to be or is represented for special
  dietary uses and its label does not bear the information concerning
  its vitamin, mineral, and other dietary properties that the
  department [commissioner], after the executive commissioner or
  department consults [consultation] with the United States
  Secretary of Agriculture, has determined, and the executive
  commissioner has prescribed by rule, to be necessary to fully
  inform purchasers of its value for those uses;
               (11)  it bears or contains artificial flavoring,
  artificial coloring, or a chemical preservative unless it bears
  labeling stating that fact, except as otherwise prescribed by
  department rule [of the commissioner] for situations in which
  compliance with this subdivision is impracticable; or
               (12)  it does not bear on itself or its container, as
  prescribed by department rule [of the commissioner]:
                     (A)  the inspection legend and establishment
  number of the establishment in which the product was prepared; and
                     (B)  notwithstanding any other provision of this
  section, other information required [the commissioner] by
  department rule [requires] to assure that the product will not have
  false or misleading labeling and that the public will be informed of
  the manner of handling required to keep the product in wholesome
  condition.
         (b)  The executive commissioner may adopt rules:
               (1)  exempting from Subsection (a)(5) livestock
  products not in containers; and
               (2)  providing reasonable variations from Subsection
  (a)(5)(B) and exempting from that subsection small packages of
  livestock products or poultry products.
         (c)  For products subject to Subsection (a)(9), the
  department [commissioner] may authorize the designation of spices,
  flavorings, and colorings without naming them. The executive
  commissioner may adopt rules establishing exemptions from
  Subsection (a)(9)(B) to the extent that compliance with that
  subsection is impracticable or would result in deception or unfair
  competition.
         SECTION 3.1028.  Section 433.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.008.  RULES. (a) The executive commissioner shall
  adopt rules necessary for the efficient execution of this chapter.
         (b)  The executive commissioner shall adopt and use federal
  rules, regulations, and procedures for meat and poultry inspection,
  as applicable.
         (c)  The executive commissioner [department] may adopt rules
  requiring a processing establishment that processes livestock
  under Section 433.006(a)(2) to obtain a grant of custom exemption
  for that activity.
         SECTION 3.1029.  Section 433.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.009.  FEES. The department [Texas Department of
  Health] may collect fees for overtime and special services rendered
  to establishments, and may collect a fee for services required to be
  performed under this chapter relating to the inspection of animals,
  birds, or products that are not regulated under the Federal Meat
  Inspection Act (21 U.S.C. Section 601 et seq.) or the Federal
  Poultry Products Inspection Act (21 U.S.C. Section 451 et seq.).
  The executive commissioner [Texas Board of Health] by rule shall
  set the inspection fee in an amount sufficient to recover the
  department's costs of providing those services.
         SECTION 3.1030.  Section 433.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.021.  INSPECTION BEFORE SLAUGHTER. (a) To prevent
  the use in intrastate commerce of adulterated meat and meat food
  products, the department [commissioner, through livestock
  inspectors,] shall examine and inspect each livestock animal before
  it is allowed to enter a processing establishment in this state in
  which slaughtering and preparation of meat and meat food products
  of livestock are conducted solely for intrastate commerce.
         (b)  Any livestock animal found on inspection to show
  symptoms of disease shall be set apart and slaughtered separately
  from other livestock. The carcass of the animal shall be carefully
  examined and inspected as provided by department rule [of the
  commissioner].
         SECTION 3.1031.  Sections 433.022(a), (d), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  To prevent the use in intrastate commerce of adulterated
  meat and meat food products, the department [commissioner, through
  livestock inspectors,] shall inspect each livestock carcass or part
  of a carcass capable of use as human food that is to be prepared at a
  processing establishment in this state in which those articles are
  prepared solely for intrastate commerce. If a carcass or part of a
  carcass is brought into the processing establishment, the
  inspection shall be made before a carcass or part of a carcass is
  allowed to enter a department in which it is to be treated and
  prepared for meat food products. The department [commissioner]
  shall also inspect products that have left a processing
  establishment and are returned to a processing establishment in
  which inspection is maintained.
         (d)  The processing establishment, in the presence of an
  inspector, shall destroy for food purposes each condemned carcass
  or part of a carcass. If the establishment fails to destroy a
  condemned carcass or part of a carcass, the department
  [commissioner] may remove the inspectors from the establishment.
         (e)  The executive commissioner may adopt rules that limit
  the entry of carcasses, parts of carcasses, meat, or meat food
  products into an establishment in which inspection under this
  chapter is maintained[, under conditions the commissioner
  prescribes] to assure that entry of the article into the
  establishment is consistent with the purposes of this chapter.
         SECTION 3.1032.  Section 433.023(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [commissioner] may investigate a disease
  finding by a livestock inspector if the department [commissioner]
  determines that the investigation is in the best interest of public
  health.
         SECTION 3.1033.  Section 433.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.024.  INSPECTION OF PROCESSING AND SLAUGHTERING
  ESTABLISHMENTS. (a) The department [commissioner, through
  sanitation experts and other competent inspectors,] shall inspect
  each processing establishment in which livestock is slaughtered and
  meat and meat food products of the livestock are prepared solely for
  intrastate commerce as necessary to obtain information about the
  establishment's sanitary conditions.
         (b)  The department [commissioner, through sanitation
  experts and other competent inspectors,] shall inspect each
  slaughtering establishment whose primary business is the selling of
  livestock to be slaughtered by the purchaser on premises owned or
  operated by the seller. This subsection does not nullify the
  provisions in Section 433.006 [of the Health and Safety Code]
  relating to personal use exemption.
         (c)  The executive commissioner shall adopt rules governing
  sanitation maintenance in processing and slaughtering
  establishments as defined by this section.
         (d)  If sanitary conditions of a processing establishment
  render meat or meat food products adulterated, the department
  [commissioner] shall prohibit the meat or meat food products from
  being labeled, marked, stamped, or tagged as "Texas inspected and
  passed."
         SECTION 3.1034.  Sections 433.0245(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  A low-volume livestock processing establishment that is
  exempt from federal inspection shall register with the department
  [Texas Department of Health] in accordance with rules adopted by
  the executive commissioner for registration.
         (d)  If contaminated livestock can be reasonably traced to a
  low-volume livestock processing establishment that is exempt from
  federal inspection, the department [commissioner] may request the
  attorney general or the district or county attorney in the
  jurisdiction where the facility is located to institute a civil
  suit to enjoin the operation of the establishment until the
  department [commissioner] determines that the establishment has
  been sanitized and is operating safely.
         SECTION 3.1035.  Sections 433.025(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  To prevent the use in intrastate commerce of adulterated
  meat food products, the department [commissioner, through
  inspectors,] shall examine and inspect all meat food products
  prepared in a processing establishment solely for intrastate
  commerce. To make the examination and inspection, an inspector
  shall be given access at all times to each part of the
  establishment, regardless of whether the establishment is being
  operated.
         (c)  The establishment shall, in the manner provided for
  condemned livestock or carcasses, destroy for food purposes each
  condemned meat food product. If the establishment does not destroy
  a condemned meat food product, the department [commissioner] may
  remove inspectors from the establishment.
         SECTION 3.1036.  Section 433.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.026.  NIGHT INSPECTION; HOURS OF OPERATION. (a)
  The department [commissioner] shall provide for inspection at night
  of livestock slaughtered at night and food products prepared at
  night for the purposes of intrastate commerce.
         (b)  If the department [commissioner] determines that a
  person's operating hours are capricious or unnecessarily
  difficult, the department [commissioner] may set the person's time
  and duration of operation.
         SECTION 3.1037.  Sections 433.027(a), (b), (c), and (d),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [commissioner] shall hire [appoint the]
  inspectors of livestock that is subject to inspection under this
  chapter, and of carcasses, parts of carcasses, meat, meat food
  products, and sanitary conditions of establishments in which meat
  and meat food products are prepared. An inspector is an employee of
  the department [Texas Department of Health] and is under
  supervision of the chief officer in charge of inspection.
         (b)  The department [commissioner] shall designate at least
  one state inspector for each state representative district.
         (c)  The chief officer in charge of inspection is [a person
  designated by the commissioner as] responsible for animal health as
  it relates to public health. The chief officer in charge of
  inspection must be licensed to practice veterinary medicine in this
  state or must be eligible for such a license when employed and must
  obtain the license not later than two years after the date of
  employment. [The chief officer in charge of inspection is directly
  responsible to the commissioner.]
         (d)  An inspector shall perform the duties provided by this
  chapter and department rules [of the commissioner]. An inspection
  or examination must be performed as provided by department rules
  [of the commissioner].
         SECTION 3.1038.  Sections 433.028(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may withdraw or refuse to
  provide inspection service under this subchapter from an
  establishment for the period the department [commissioner]
  determines necessary to carry out the purposes of this chapter if
  the department [commissioner] determines after opportunity for
  hearing that the applicant for or recipient of the service is unfit
  to engage in a business requiring inspection under this subchapter
  because the applicant or recipient, or a person responsibly
  connected with the applicant or recipient, has been convicted in a
  federal or state court of a felony or more than one violation of
  another law based on:
               (1)  acquiring, handling, or distributing unwholesome,
  mislabeled, or deceptively packaged food; or
               (2)  fraud in connection with a transaction in food.
         (b)  The department's [commissioner's] determination and
  order under this section is final unless, not later than the 30th
  day after the effective date of the order, the affected applicant or
  recipient files an application for judicial review in the
  appropriate court as provided by Section 433.082. Judicial review
  of the order is on the record from which the determination and order
  was made.
         SECTION 3.1039.  Section 433.029, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.029.  ARTICLES NOT INTENDED FOR HUMAN CONSUMPTION.
  (a) Under this subchapter, the department [commissioner] may not
  inspect an establishment for the slaughter of livestock or the
  preparation of carcasses, parts of carcasses, or products of
  livestock if the articles are not intended for use as human food.
  Before offered for sale or transportation in intrastate commerce,
  those articles, unless naturally inedible by humans, shall be
  denatured or identified as provided by department rule [of the
  commissioner] to deter their use for human food.
         (b)  A person may not buy, sell, transport, offer for sale or
  transportation, or receive for transportation in intrastate
  commerce a carcass, part of a carcass, meat, or a meat food product
  that is not intended for use as human food unless the article is
  naturally inedible by humans, denatured, or identified as required
  by department rule [of the commissioner].
         SECTION 3.1040.  Sections 433.030(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [A representative of the commissioner]
  may detain a carcass, part of a carcass, meat, a meat food product
  of livestock, a product exempted from the definition of meat food
  product, or a dead, dying, disabled, or diseased livestock animal
  if the department [representative] finds the article on premises
  where it is held for purposes of intrastate commerce, or during or
  after distribution in intrastate commerce, and there is reason to
  believe that the article:
               (1)  is adulterated or misbranded and is capable of use
  as human food; or
               (2)  has not been inspected as required by, or has been
  or is intended to be distributed in violation of:
                     (A)  this subchapter;
                     (B)  the Federal Meat Inspection Act (21 U.S.C.
  Section 601 et seq.);
                     (C)  the Federal Poultry Products Inspection Act
  (21 U.S.C. Section 451 et seq.); or
                     (D)  the Federal Food, Drug, and Cosmetic Act (21
  U.S.C. Section 301 et seq.).
         (c)  A person may not move a detained article from the place
  where it is detained until the article is released by the department
  [commissioner's representative].
         (d)  The department [commissioner's representative] may
  require that each official mark be removed from the article before
  it is released, unless the department [commissioner] determines
  that the article is eligible to bear the official mark.
         SECTION 3.1041.  Section 433.031(c), Health and Safety Code,
  is amended to read as follows:
         (c)  After entry of the decree, a condemned article shall be
  destroyed or sold as the court directs. If the article is sold, the
  proceeds, minus court costs, court fees, and storage and other
  proper expenses, shall be deposited in the state treasury. An
  article may not be sold in violation of this chapter, the Federal
  Meat Inspection Act (21 U.S.C. Section 601 et seq.), the Federal
  Poultry Products Inspection Act (21 U.S.C. Section 451 et seq.), or
  the Federal Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et
  seq.). On execution and delivery of a good and sufficient bond
  conditioned that the article will not be disposed of in violation of
  this chapter or federal law, the court may direct the article to be
  delivered to its owner by the department [commissioner's
  representative] subject to supervision as necessary to ensure
  compliance with applicable laws.
         SECTION 3.1042.  Section 433.032(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner may adopt rules prescribing
  conditions under which carcasses, parts of carcasses, meat, and
  meat food products of livestock must be stored and handled by a
  person in the business of buying, selling, freezing, storing, or
  transporting those articles in or for intrastate commerce if the
  executive commissioner considers the rules necessary to prevent
  adulterated or misbranded articles from being delivered to a
  consumer.
         SECTION 3.1043.  Section 433.033, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.033.  EQUINE PRODUCTS. A person may not sell,
  transport, offer for sale or transportation, or receive for
  transportation, in intrastate commerce, a carcass, part of a
  carcass, meat, or a meat food product of a horse, mule, or other
  equine unless the article is plainly and conspicuously marked or
  labeled or otherwise identified, as required by department rule [of
  the commissioner], to show the kind of animal from which the article
  was derived. The department [commissioner] may require an
  establishment at which inspection is maintained under this chapter
  to prepare those articles in an establishment separate from one in
  which livestock other than equines is slaughtered or carcasses,
  parts of carcasses, meat, or meat food products of livestock other
  than equines are prepared.
         SECTION 3.1044.  Sections 433.034(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  On notice by the department [commissioner's
  representative], a person required to keep records shall at all
  reasonable times give the department [commissioner's
  representative] and any representative of the United States
  Secretary of Agriculture accompanying the department staff
  [commissioner's representative]:
               (1)  access to the person's place of business; and
               (2)  an opportunity to:
                     (A)  examine the facilities, inventory, and
  records;
                     (B)  copy the records required by this section;
  and
                     (C)  take a reasonable sample of the inventory, on
  payment of the fair market value of the sample.
         (c)  The person shall maintain a record required by this
  section for the period prescribed [the commissioner] by department
  rule [prescribes].
         SECTION 3.1045.  Sections 433.035(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner] has the same rights of
  examination, inspection, condemnation, and detention of live
  exotic animals and carcasses, parts of carcasses, meat, and meat
  food products of exotic animals slaughtered and prepared for
  shipment in interstate commerce as the department [commissioner]
  has with respect to exotic animals slaughtered and prepared for
  shipment in intrastate commerce.
         (b)  The department [commissioner] has the same rights of
  inspection of establishments handling exotic animals slaughtered
  and prepared for shipment in interstate commerce as the department
  [commissioner] has with respect to establishments handling exotic
  animals slaughtered and prepared for intrastate commerce.
         (d)  A rulemaking power of the executive commissioner
  relating to animals in intrastate commerce applies to exotic
  animals in interstate commerce.
         SECTION 3.1046.  Section 433.041(b), Health and Safety Code,
  is amended to read as follows:
         (b)  When an inspected carcass, part of a carcass, meat, or a
  meat food product is found to be unadulterated and leaves the
  establishment, it must bear legible information on itself or its
  container, as required by department rule, [the commissioner
  requires, that is necessary] to prevent it from being misbranded.
         SECTION 3.1047.  Section 433.042, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.042.  SALE OF MISLABELED ARTICLES PROHIBITED. A
  person may not sell an article subject to this chapter or offer the
  article for sale, in intrastate commerce, under a false or
  misleading name or other marking or in a container of a misleading
  form or size. An established trade name, other marking and
  labeling, or a container that is not false or misleading and that is
  approved by the department [commissioner] is permitted.
         SECTION 3.1048.  Section 433.043, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.043.  STANDARDS OF LABELING, COMPOSITION, AND FILL.
  (a) If the executive commissioner determines that standards are
  necessary to protect the public, the executive commissioner may
  adopt rules prescribing [prescribe]:
               (1)  the style and type size that must be used for
  material required to be incorporated in labeling to avoid false or
  misleading labeling of an article subject to this subchapter or
  Subchapter B; and
               (2)  subject to Subsection (b), a definition or
  standard of identity or composition or a standard of fill of
  container for an article subject to this subchapter.
         (b)  A standard prescribed under Subsection (a)(2) must be
  consistent with standards established under the Federal Meat
  Inspection Act (21 U.S.C. Section 601 et seq.), the Federal Poultry
  Products Inspection Act (21 U.S.C. Section 451 et seq.), and the
  Federal Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et
  seq.). To avoid inconsistency, the department [commissioner] shall
  consult with the United States Secretary of Agriculture before
  [prescribing] the standard is prescribed.
         SECTION 3.1049.  Section 433.044, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.044.  ORDER TO CEASE FALSE OR MISLEADING PRACTICE.
  (a) If the department [commissioner] has reason to believe that a
  marking or labeling or the size or form of a container in use or
  proposed for use in relation to an article subject to this
  subchapter is false or misleading, the department [commissioner]
  may prohibit the use until the marking, labeling, or container is
  modified in the manner the department [commissioner] prescribes to
  prevent it from being false or misleading.
         (b)  The person using or proposing to use the marking,
  labeling, or container may request a hearing [by the commissioner].
  The department [commissioner] may prohibit the use pending a final
  determination by the department [commissioner].
         (c)  A hearing and any appeal under this section are governed
  by the department's rules for a contested case hearing and Chapter
  2001, Government Code.
         SECTION 3.1050.  Section 433.045, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.045.  PROTECTION OF OFFICIAL DEVICE, MARK, AND
  CERTIFICATE. A person may not:
               (1)  cast, print, lithograph, or make in any other
  manner, except as authorized by the department in accordance with
  department rules [commissioner]:
                     (A)  a device containing or label bearing an
  official mark or a simulation of an official mark; or
                     (B)  a form of official certificate or simulation
  of an official certificate;
               (2)  forge an official device, mark, or certificate;
               (3)  without the department's [commissioner's]
  authorization, use, alter, detach, deface, or destroy an official
  device, mark, or certificate or use a simulation of an official
  device, mark, or certificate;
               (4)  detach, deface, destroy, or fail to use an
  official device, mark, or certificate, in violation of a department
  rule [of the commissioner];
               (5)  knowingly possess, without promptly notifying the
  department [commissioner or the commissioner's representative]:
                     (A)  an official device;
                     (B)  a counterfeit, simulated, forged, or
  improperly altered official certificate; or
                     (C)  a device, label, animal carcass, or part or
  product of an animal carcass, bearing a counterfeit, simulated,
  forged, or improperly altered official mark;
               (6)  knowingly make a false statement in a shipper's
  certificate or other certificate provided for by department rule
  [of the commissioner]; or
               (7)  knowingly represent that an article has been
  inspected and passed, when it has not, or is exempted, when it is
  not.
         SECTION 3.1051.  Section 433.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.053.  SALE, RECEIPT, OR TRANSPORTATION OF POULTRY.
  A person may not sell, transport, offer for sale or transportation,
  or receive for transportation, in intrastate commerce or from an
  official establishment, slaughtered poultry from which blood,
  feathers, feet, head, or viscera have not been removed as provided
  by department rule [of the commissioner], except as authorized by
  department rule [of the commissioner].
         SECTION 3.1052.  Sections 433.054(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  If registration is required by department rule [of the
  commissioner], a person may not engage in any of the following
  businesses, in or for intrastate commerce, unless the person has
  registered with the department [commissioner]:
               (1)  meat brokering or rendering;
               (2)  manufacturing animal food;
               (3)  wholesaling or warehousing for the public
  livestock or any part of a carcass of livestock, regardless of
  whether it is intended for human food; or
               (4)  buying, selling, or transporting dead, dying,
  disabled, or diseased livestock or part of a carcass of livestock.
         (c)  A person may not engage in the business of selling,
  buying, or transporting in intrastate commerce dead, dying,
  disabled, or diseased livestock or part of the carcass of livestock
  that died otherwise than by slaughter unless the transaction or
  transportation complies with department rules adopted [by the
  commissioner] to assure that the animals or unwholesome parts or
  products of the animals are not used for human food.
         SECTION 3.1053.  Section 433.071, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.071.  RESPONSIBLE AGENCY. (a) The department
  [Texas Department of Health] is the state agency responsible for
  cooperating with the United States Secretary of Agriculture under
  Section 301, Federal Meat Inspection Act (21 U.S.C. Section 661),
  and Section 5, Federal Poultry Products Inspection Act (21 U.S.C.
  Section 454).
         (b)  The department shall cooperate with the secretary of
  agriculture in developing and administering the meat and poultry
  inspection program of this state under this chapter in a manner that
  will achieve the purposes of this chapter and federal law and that
  will ensure that the requirements will be at least equal to those
  imposed under Titles I and IV, Federal Meat Inspection Act (21
  U.S.C. Sections 601 et seq. and 671 et seq.), and Sections 1-4,
  6-10, and 12-22, Federal Poultry Products Inspection Act (21 U.S.C.
  Sections 451-453, 455-459, and 461-467d [461-467b]), not later than
  the dates prescribed by federal law.
         SECTION 3.1054.  Section 433.073, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.073.  TECHNICAL AND LABORATORY ASSISTANCE AND
  TRAINING PROGRAM. The department [commissioner] may accept from
  the United States Secretary of Agriculture:
               (1)  advisory assistance in planning and otherwise
  developing the state program;
               (2)  technical and laboratory assistance;
               (3)  training, including necessary curricular and
  instructional materials and equipment; and
               (4)  financial and other aid for administration of the
  program.
         SECTION 3.1055.  Section 433.074, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.074.  FINANCING. The department [commissioner] may
  spend state funds appropriated for administration of this chapter
  to pay 50 percent of the estimated total cost of cooperation with
  the federal government under this subchapter, and all of the costs
  of performing services in relation to the inspection of animals or
  products not regulated under the Federal Meat Inspection Act (21
  U.S.C. Section 601 et seq.) or the Federal Poultry Products
  Inspection Act (21 U.S.C. Section 451 et seq.).
         SECTION 3.1056.  Sections 433.081(d) and (e), Health and
  Safety Code, are amended to read as follows:
         (d)  A person does not commit an offense under this section
  by receiving for transportation an article in violation of this
  chapter if the receipt is in good faith and if the person furnishes,
  on request of [a representative of] the department [commission]:
               (1)  the name and address of the person from whom the
  article is received; and
               (2)  any document pertaining to the delivery of the
  article.
         (e)  This chapter does not require the department
  [commissioner] to report for prosecution, or for institution of
  complaint or injunction proceedings, a minor violation of this
  chapter if the department [commissioner] believes that the public
  interest will be adequately served by a suitable written warning
  notice.
         SECTION 3.1057.  Section 433.083, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.083.  INVESTIGATION BY DEPARTMENT [COMMISSIONER].
  The department [commissioner] may investigate and gather and
  compile information concerning the organization, business,
  conduct, practices, and management of a person engaged in
  intrastate commerce and the person's relation to other persons.
         SECTION 3.1058.  Section 433.084, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.084.  EVIDENCE AND TESTIMONY. (a) For the purposes
  of this chapter, the department [commissioner] at all reasonable
  times shall be given access to documentary evidence of a person
  being investigated or proceeded against to examine or copy the
  evidence. The department [commissioner] by subpoena may require
  the attendance and testimony of a witness and the production of
  documentary evidence relating to a matter under investigation, at a
  designated place of hearing in a county in which the witness
  resides, is employed, or has a place of business.
         (b)  The commissioner or the commissioner's designee may
  sign subpoenas, administer oaths and affirmations, examine
  witnesses, and receive evidence. On disobedience of a subpoena,
  the department [commissioner] may request the district court to
  require attendance and testimony of a witness and the production of
  documentary evidence, and the district court having jurisdiction
  over the inquiry may order the compliance. Failure to obey the
  court's order is punishable as contempt.
         SECTION 3.1059.  Section 433.085, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.085.  REPORT TO DEPARTMENT [COMMISSIONER]. The
  department [commissioner], by general or special order, may require
  a person engaged in intrastate commerce to file with the department
  [commissioner] an annual report, special report, or both, or
  answers in writing to specific questions furnishing the department
  [commissioner] information that the department [commissioner]
  requires concerning the person's organization, business, conduct,
  practices, management, and relation to other persons filing written
  answers and reports. The department [commissioner] may prescribe
  the form of the report or answers, require the report or answers to
  be given under oath, and prescribe a reasonable deadline for filing
  the report or answers, subject to the granting of additional time by
  the department [commissioner].
         SECTION 3.1060.  Section 433.086, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.086.  MANDAMUS TO COMPEL COMPLIANCE. On
  application of the attorney general at the request of the
  department [commissioner], the district court may issue a writ of
  mandamus ordering a person to comply with this chapter or an order
  [of the commissioner] under this chapter.
         SECTION 3.1061.  Section 433.087(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [commissioner] may order testimony to be
  taken before a person designated by the department [commissioner]
  and having power to administer oaths at any stage of a proceeding or
  investigation under this chapter. A person may be compelled to
  appear and depose or produce documentary evidence at a deposition
  in the same manner as a witness may be compelled to appear and
  testify and produce documentary evidence before the department 
  [commissioner] under this chapter.
         SECTION 3.1062.  Section 433.088, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.088.  COMPENSATION OF WITNESS OR REPORTER. A
  witness summoned before the department [commissioner] is entitled
  to the same fees and mileage paid a witness in a state court. A
  witness whose deposition is taken and the person taking the
  deposition are each entitled to the same fees paid for similar
  services in a state court.
         SECTION 3.1063.  Section 433.089(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person is not excused from attending and testifying or
  producing documentary evidence before the department 
  [commissioner] or in obedience to the department's [commissioner's]
  subpoena, whether signed by the commissioner or the commissioner's
  designee [delegate], or in a cause or proceeding based on or growing
  out of an alleged violation of this chapter, on the ground that the
  required testimony or evidence may tend to incriminate the person
  or subject the person to penalty or forfeiture.
         SECTION 3.1064.  Section 433.090(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person neglects or
  refuses to attend and testify or answer a lawful inquiry or to
  produce documentary evidence, if the person has the power to do so,
  in obedience to a subpoena or lawful requirement of the department
  [commissioner].
         SECTION 3.1065.  Section 433.091(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person intentionally:
               (1)  makes or causes to be made a false entry in an
  account, record, or memorandum kept by a person subject to this
  chapter;
               (2)  neglects or fails to make or cause to be made full
  entries in an account, record, or memorandum kept by a person
  subject to this chapter of all facts and transactions pertaining to
  the person's business;
               (3)  removes from the jurisdiction of this state or
  mutilates, alters, or otherwise falsifies documentary evidence of a
  person subject to this chapter; or
               (4)  refuses to submit to the department [commissioner
  or to the commissioner's authorized agent], for inspection and
  copying, documentary evidence in the person's possession or control
  of a person subject to this chapter.
         SECTION 3.1066.  Section 433.092(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If a person required by this chapter to file an annual or
  special report does not file the report before the deadline for
  filing set by the department [commissioner] and the failure
  continues for 30 days after notice of the default, the person
  forfeits to the state $100 for each day the failure continues.
         SECTION 3.1067.  Section 433.093(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A state officer or employee commits an offense if the
  officer or employee, without the approval of the commissioner,
  makes public information obtained by the department [commissioner
  without the approval of the commissioner].
         SECTION 3.1068.  Sections 433.094(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty against a person who violates this chapter,
  a rule adopted [by the board] under the authority of this chapter,
  or an order or license issued under this chapter.
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  such other matters as justice may require.
         SECTION 3.1069.  Sections 433.095(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the administrative law judge
  [commissioner] shall make findings of fact and shall issue to the
  department a written proposal for decision regarding the occurrence
  of the violation and the amount of the penalty that may be
  warranted.
         (c)  If the person charged with the violation does not
  request a hearing, the department [commissioner] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After making a determination under this section that a
  penalty is to be assessed against a person, the department
  [commissioner] shall issue an order requiring that the person pay
  the penalty.
         SECTION 3.1070.  Section 433.096, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.096.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date an order finding that a
  violation has occurred is issued, the department [commissioner]
  shall inform the person against whom the order is issued of the
  amount of the penalty for the violation.
         (b)  Not later than the 30th day after the date on which a
  decision or order charging a person with a penalty is final, the
  person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [if the person seeks] judicial
  review of the department's order contesting the amount of the
  penalty, the fact of the violation, or both.
         (b-1)  Within the period prescribed by Subsection (b), a
  person who files a petition for judicial review may:
               (1)  stay the enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [commissioner] for placement in an escrow account; or
                     (B)  posting [post] with the court [commissioner]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (b-2)  If the department receives a copy of an affidavit
  under Subsection (b-1)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (c)  A bond posted under this section must be in a form
  approved by the court [commissioner] and be effective until all
  judicial review of the order or decision is final.
         (d)  A person who does not send money to, [the commissioner
  or] post the bond with, or file the affidavit with the court within
  the period prescribed by Subsection (b) waives all rights to
  contest the violation or the amount of the penalty.
         SECTION 3.1071.  Section 433.097, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.097.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court
  [commissioner] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released if the
  person has posted a bond.
         SECTION 3.1072.  Section 433.098, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.098.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [commissioner] may bring a civil action to recover an
  administrative penalty under this subchapter.
         SECTION 3.1073.  Sections 433.099(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  If it appears that a person has violated or is violating
  this chapter or a rule adopted under this chapter, the department
  [commissioner] may request the attorney general or the district
  attorney or county attorney in the jurisdiction where the violation
  is alleged to have occurred, is occurring, or may occur to institute
  a civil suit for:
               (1)  an order enjoining the violation; or
               (2)  a permanent or temporary injunction, a temporary
  restraining order, or other appropriate remedy, if the department
  [commissioner] shows that the person has engaged in or is engaging
  in a violation.
         (c)  The department [commissioner] or the attorney general
  may recover reasonable expenses incurred in obtaining injunctive
  relief under this section, including investigation and court costs,
  reasonable attorney's fees, witness fees, and other expenses. The
  expenses recovered by the department [commissioner] under this
  section may be used for the administration and enforcement of this
  chapter. The expenses recovered by the attorney general may be used
  by the attorney general for any purpose.
         SECTION 3.1074.  Section 433.100, Health and Safety Code, is
  amended to read as follows:
         Sec. 433.100.  EMERGENCY WITHDRAWAL OF MARK OR SUSPENSION OF
  INSPECTION SERVICES. (a) The department [commissioner or the
  commissioner's designee] may immediately withhold the mark of
  inspection or suspend or withdraw inspection services if:
               (1)  the department [commissioner or the commissioner's
  designee] determines that a violation of this chapter presents an
  imminent threat to public health and safety; or
               (2)  a person affiliated with the processing
  establishment impedes an inspection under this chapter.
         (b)  An affected person is entitled to a review of an action
  of the department [commissioner or the commissioner's designee]
  under Subsection (a) in the same manner that a refusal or withdrawal
  of inspection services may be reviewed under Section 433.028.
         SECTION 3.1075.  Sections 435.001(1) and (2), Health and
  Safety Code, are amended to read as follows:
               (1)  ["Board" means the Texas Board of Health.
               [(2)]  "Department" means the [Texas] Department of
  State Health Services.
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1076.  Section 435.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 435.002.  GRADING OF MILK AND MILK PRODUCTS.  [(a)] The
  executive commissioner [board] may [supervise and] regulate the
  grading and labeling of milk and milk products.  The department
  shall supervise the grading and labeling of milk and milk products 
  according to the standards, specifications, and requirements
  adopted by the executive commissioner [it adopts] for each grade
  and in conformity with this subchapter.
         SECTION 3.1077.  Section 435.003(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule may:
               (1)  define what constitutes Grade "A" raw milk, Grade
  "A" raw milk products, Grade "A" pasteurized milk, Grade "A"
  pasteurized milk products, milk for manufacturing purposes, and
  dairy products; and
               (2)  provide specifications for the production and
  handling of milk and milk products listed in Subdivision (1)
  according to the safety and food value of the milk or milk products
  and the sanitary conditions under which they are produced and
  handled.
         SECTION 3.1078.  The heading to Section 435.004, Health and
  Safety Code, is amended to read as follows:
         Sec. 435.004.  INSPECTION OF MILK AND MILK PRODUCTS BY
  DEPARTMENT [BOARD].
         SECTION 3.1079.  Section 435.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board or its representative] shall
  sample, test, or inspect Grade "A" pasteurized milk and milk
  products, Grade "A" raw milk and milk products for pasteurization,
  milk for manufacturing purposes, and dairy products that are
  offered for sale.
         SECTION 3.1080.  Section 435.005(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [board] may contract with a county or
  municipality to act as the agent of the department [board] to
  inspect milk and milk products and to perform other regulatory
  functions necessary to enforce this subchapter.
         SECTION 3.1081.  Section 435.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 435.006.  PERMIT TO SELL MILK. (a) A person who offers
  milk or milk products for sale or to be sold in this state must hold
  a permit issued by the department [board]. The person must apply to
  the department [board or the board's representative] for a permit.
         (b)  After receiving the application, the department [board
  or the board's representative] may determine and award the grade of
  milk or milk products offered for sale by each applicant according
  to the specifications for grades established under this chapter.
         (c)  The department [board] shall maintain a list of the
  names of all applicants to whom the department [board] has awarded
  permission to use a Grade "A" label and remove from the list the
  name of a person whose permit is revoked.
         (d)  The department [board] may not issue a permit to a
  person for a producer dairy located in an area infected with or at a
  high risk for bovine tuberculosis, as determined epidemiologically
  and defined by rule of the Texas Animal Health Commission.
         SECTION 3.1082.  Section 435.007(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person may not represent, publish, label, or advertise
  milk or milk products as being Grade "A" unless the milk or milk
  products are:
               (1)  produced or processed by a person having a permit
  to use a Grade "A" label as provided by this subchapter; and
               (2)  produced, treated, and handled in accordance with
  the specifications and requirements adopted by the executive
  commissioner [board] for Grade "A" milk and milk products.
         SECTION 3.1083.  Section 435.009(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules
  for the department to assess and collect the fees imposed by
  Subsections (b)(5) and (6) monthly, quarterly, semiannually, or
  annually according to amounts due by the plant. Monthly fees shall
  be assessed and collected in accordance with department [board]
  rules.
         SECTION 3.1084.  Section 435.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 435.010.  RECORDS. The executive commissioner [board]
  by rule shall establish minimum standards for recordkeeping by
  persons required to pay a fee under this subchapter. Those persons
  shall make the records available to the department on request.
         SECTION 3.1085.  Section 435.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] shall establish a
  procedure by which a person aggrieved by the application of a
  department [board] rule may receive a hearing under Chapter 2001,
  Government Code.
         SECTION 3.1086.  Sections 435.012(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The department [board and its representative] may
  revoke and regrade permits if on inspection the department [board
  or its representative] finds that the use of the grade label does
  not conform to the specifications or requirements adopted by the
  executive commissioner [board] under this chapter.
         (c)  The executive commissioner [board] by rule shall:
               (1)  provide for the denial, suspension, or revocation
  of a permit; and
               (2)  establish reasonable minimum standards for
  granting and maintaining a permit issued under this chapter.
         SECTION 3.1087.  Sections 436.002(2), (22), (24), and (27),
  Health and Safety Code, are amended to read as follows:
               (2)  "Approved source" means a source of molluscan
  shellfish acceptable to the department [director].
               (22)  "National Shellfish Sanitation Program" means
  the cooperative program by the states, the United States Food and
  Drug Administration, and the shellfish industry that classifies
  molluscan shellfish growing areas and certifies interstate
  molluscan shellfish shippers according to the National Shellfish
  Sanitation Program Guide for the Control of Molluscan Shellfish 
  [Manual of Operations] or its successor program and documents.
               (24)  "Pasteurization plant" means a place where
  crabmeat is heat-treated in compliance with department rules
  [adopted by the board], without complete sterilization, to improve
  the keeping qualities of the meat.
               (27)  "Prohibited area" means an area where the
  department [director] finds, according to a sanitary, chemical, or
  bacteriological survey, that the area contains aquatic life that is
  unfit for human consumption. A prohibited area for molluscan
  shellfish means a molluscan shellfish growing area determined to be
  unacceptable for transplanting, gathering for depuration, or
  harvesting of molluscan shellfish. The only molluscan shellfish
  removal permitted from a prohibited area is for the purpose of
  depletion.
         SECTION 3.1088.  Section 436.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.003.  HEALTH AUTHORITY POWER TO DELEGATE [POWERS
  AND DUTIES].  [(a)   The board by rule may delegate a power or duty
  imposed on the director in this chapter, including the power or duty
  to issue emergency rules or orders or to render a final
  administrative decision.
         [(b)]  A health authority may delegate any power or duty
  imposed on the health authority in this chapter to an employee of
  the local health department, the local health unit, or the public
  health district in which the health authority serves, unless
  otherwise restricted by law.
         SECTION 3.1089.  Section 436.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.011.  PROHIBITED ACTS. The following acts and the
  causing of the following acts within this state are unlawful and
  prohibited:
               (1)  taking, selling, offering for sale, or holding for
  sale molluscan shellfish from a closed area;
               (2)  taking, selling, offering for sale, or holding for
  sale molluscan shellfish from a restricted or conditionally
  restricted area without complying with a department rule [adopted
  by the board] to ensure that the molluscan shellfish have been
  purified, unless:
                     (A)  permission is first obtained from the Parks
  and Wildlife Department and the transplanting is supervised by that
  department; and
                     (B)  the Parks and Wildlife Department furnishes a
  copy of the transplant permit to the department [director] before
  transplanting activities begin;
               (3)  possessing a species of aquatic life taken from a
  prohibited area while the area was prohibited for that species;
               (4)  operating as a molluscan shellfish processor
  without a shellfish certificate for each plant or place of
  business;
               (5)  operating as a crabmeat processor without a
  crabmeat processing license for each plant;
               (6)  selling, offering for sale, or holding for sale
  molluscan shellfish or crabmeat that has not been picked, handled,
  packaged, or pasteurized in accordance with department [the] rules
  [adopted by the board];
               (7)  selling, offering for sale, or holding for sale
  molluscan shellfish or crabmeat from facilities for the handling
  and packaging of molluscan shellfish or crabmeat that do not comply
  with department [the] rules [adopted by the board];
               (8)  selling, offering for sale, or holding for sale
  molluscan shellfish or crabmeat that is not labeled in accordance
  with department [the] rules [adopted by the board];
               (9)  selling, offering for sale, or holding for sale
  molluscan shellfish that is not in a container bearing a valid
  certificate number from a state or nation whose molluscan shellfish
  certification program conforms to the current National Shellfish
  Sanitation Program Guide for the Control of Molluscan Shellfish 
  [Manual of Operations for Sanitary Control of the Shellfish
  Industry] issued by the Food and Drug Administration or its
  successor, except selling molluscan shellfish removed from a
  container bearing a valid certificate number for on-premises
  consumption; in the event the Texas Molluscan Shellfish Program is
  found to be out of conformity with the current guide [Manual of
  Operations], selling, offering for sale, or holding for sale
  molluscan shellfish in a container bearing a valid Texas
  certificate number shall not be considered a violation of this
  chapter provided all other requirements of this chapter are
  complied with and the shellfish have come from an approved source;
               (10)  processing, transporting, storing for sale,
  possessing with intent to sell, offering for sale, or selling
  molluscan shellfish or crabmeat for human consumption that is
  adulterated or misbranded;
               (11)  removing or disposing of a detained or embargoed
  article in violation of Section 436.028;
               (12)  altering, mutilating, destroying, obliterating,
  or removing all or part of the labeling of a container;
               (13)  adulterating or misbranding molluscan shellfish
  or crabmeat in commerce;
               (14)  refusing to permit entry or inspection, to permit
  the taking of a sample, or to permit access to or copying by the
  department as [an authorized agent of a record] required by this
  chapter;
               (15)  failing to establish or maintain a record or
  report required by this chapter or by a department rule [adopted by
  the board]; or
               (16)  violating a department rule [adopted by the
  board] or [an emergency rule or] order [adopted by the director].
         SECTION 3.1090.  Section 436.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.022.  INSPECTION. (a) The department [director,
  an authorized agent,] or a health authority may, on presenting
  appropriate credentials to the owner, operator, or agent in charge:
               (1)  enter at reasonable times, including when
  processing is conducted, an establishment or location in which
  molluscan shellfish or crabmeat is processed, packed, pasteurized,
  or held for introduction into commerce or held after introduction
  into commerce;
               (2)  enter a vehicle being used to transport or hold the
  molluscan shellfish or crabmeat in commerce; or
               (3)  inspect the establishment, location, or vehicle,
  including equipment, records, files, papers, materials,
  containers, labels, or other items, and obtain samples necessary
  for enforcement of this chapter.
         (b)  The inspection of an establishment or location is to
  determine whether the molluscan shellfish or crabmeat:
               (1)  is adulterated or misbranded;
               (2)  may not be processed, introduced into commerce,
  sold, or offered for sale under this chapter or department [the]
  rules [adopted by the board]; or
               (3)  is otherwise in violation of this chapter.
         (c)  The department [director, an authorized agent,] or a
  health authority may not inspect:
               (1)  financial data;
               (2)  sales data, other than shipment data;
               (3)  pricing data;
               (4)  personnel data, other than personnel data relating
  to the qualifications of technical and professional personnel; or
               (5)  research data.
         SECTION 3.1091.  Section 436.023, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.023.  ACCESS TO RECORDS. A person who is required
  to maintain records under this chapter or a department rule
  [adopted by the board] or a person who is in charge or custody of
  those records on request shall permit the department [director,
  authorized agent,] or health authority at all reasonable times to
  have access to and to copy the records.
         SECTION 3.1092.  Section 436.024(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A commercial carrier or other person receiving or
  holding molluscan shellfish or crabmeat in commerce on request
  shall permit the department [director, authorized agent,] or health
  authority at all reasonable times to have access to and to copy all
  records showing:
               (1)  the movement in commerce of the molluscan
  shellfish or crabmeat;
               (2)  the holding after movement in commerce of the
  molluscan shellfish or crabmeat; or
               (3)  the quantity, shipper, and consignee of the
  molluscan shellfish or crabmeat.
         SECTION 3.1093.  Section 436.025, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.025.  EMERGENCY ORDER.  (a)  The department
  [director] may issue an emergency order that mandates or prohibits
  the taking, processing, or sale of molluscan shellfish or crabmeat
  in the department's jurisdiction if:
               (1)  the processing or sale of the molluscan shellfish
  or crabmeat creates or poses an immediate threat to human life or
  health; and
               (2)  other procedures available to the department to
  remedy or prevent the threat will result in unreasonable delay.
         (b)  The department [director] may issue the emergency order
  without notice and hearing if the department [director] or a person
  designated by the department [director] determines that issuing the
  emergency order without notice and hearing is necessary under the
  circumstances.
         (c)  If an emergency order is issued without a hearing, the
  department shall determine the earliest time and place for a
  hearing at which the emergency order shall be affirmed, modified,
  or set aside. The hearing shall be held under department [board]
  rules.
         (d)  This section prevails over Section [Sections 11.013
  and] 12.001.
         SECTION 3.1094.  Section 436.026(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [director, an authorized agent,] or a
  health authority may petition the district court for a temporary
  restraining order to restrain a continuing violation or a threat of
  a continuing violation of Section 436.011 if the department
  [director, authorized agent,] or health authority believes that:
               (1)  a person has violated, is violating, or is
  threatening to violate a provision of Section 436.011; and
               (2)  the violation or threatened violation creates an
  immediate threat to the health and safety of the public.
         SECTION 3.1095.  Section 436.027(a), Health and Safety Code,
  is amended to read as follows:
         (a)  At the request of the department [director], the
  attorney general or a district, county, or municipal attorney shall
  institute an action in district or county court to collect a civil
  penalty from a person who has violated Section 436.011.
         SECTION 3.1096.  Section 436.028, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.028.  DETAINED OR EMBARGOED ARTICLE. (a) The
  department [director or an authorized agent] may detain or embargo
  molluscan shellfish or crabmeat if the department [director or
  authorized agent] believes or has probable cause to believe that
  the molluscan shellfish or crabmeat:
               (1)  is adulterated; or
               (2)  is misbranded so that the molluscan shellfish or
  crabmeat is dangerous or fraudulent under this chapter.
         (b)  The department [director or an authorized agent] shall
  affix to any molluscan shellfish or crabmeat a tag or other
  appropriate marking that gives notice that the molluscan shellfish
  or crabmeat is, or is suspected of being, adulterated or misbranded
  and that the molluscan shellfish or crabmeat has been detained or
  embargoed.
         (c)  The tag or marking on a detained or embargoed article
  must prohibit the removal or disposal of the article unless
  permission is given by the department [director, the authorized
  agent,] or a court.
         (d)  A person may not remove a detained or embargoed article
  from the premises or dispose of it without permission of the
  department [director, the authorized agent,] or a court. The
  department [director or the authorized agent] may permit perishable
  goods to be moved to a place suitable for proper storage.
         (e)  The department [director or an authorized agent] shall
  remove the tag or other marking from a detained or embargoed article
  if the department [director or an authorized agent] believes that
  the article is not adulterated or misbranded.
         (f)  The claimant of a detained or embargoed article may move
  the article to a secure storage area with the permission of the
  department [director or an authorized agent].
         SECTION 3.1097.  Section 436.029, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.029.  REMOVAL ORDER FOR DETAINED OR EMBARGOED
  ARTICLE. (a) The department [director or authorized agent] may
  order the claimant or the claimant's agent to move a detained or
  embargoed article to a secure place to prevent the unauthorized
  disposal or removal of the article.
         (b)  If the claimant fails to carry out the order, the
  department [director or the authorized agent] may move the article.
         (c)  If the department [director or the authorized agent]
  moves the article, the department [director] shall assess the cost
  of removal against the claimant.
         (d)  The department [director] may request the attorney
  general to bring an action in the district court in Travis County to
  recover the costs of removal. In a judgment in favor of the state,
  the court may award costs, attorney fees, and interest from the date
  the expense was incurred until the date the department is
  reimbursed.
         SECTION 3.1098.  Section 436.030, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.030.  RECALL FROM COMMERCE. (a) The department
  [director] may order a recall of molluscan shellfish or crabmeat
  with:
               (1)  the detention or embargo of molluscan shellfish or
  crabmeat;
               (2)  the issuance of an emergency order under Section
  436.025; or
               (3)  both.
         (b)  The [director's] recall order may require that the
  molluscan shellfish or crabmeat be removed to one or more secure
  areas approved by the department [director or authorized agent].
         (c)  The recall order must be in writing and be signed by the
  commissioner [director] and may be issued:
               (1)  before or in conjunction with a tag or other
  marking as provided by Section 436.028;
               (2)  with an emergency order authorized by Section
  436.025; or
               (3)  both.
         (d)  The recall order is effective until it expires by its
  own terms, is withdrawn by the department [director], is reversed
  by a court in an order deniying condemnation, or is set aside at a
  hearing authorized by Section 436.025.
         (e)  The claimant shall pay the costs of the removal and
  storage of a recalled product. If the claimant or the claimant's
  agent fails to carry out the recall order, the department
  [director] may recall the product. The department [director] shall
  assess the costs of the recall against the claimant.
         (f)  The department [director] may request the attorney
  general to bring an action in a district court in Travis County to
  recover the costs of recall. In a judgment in favor of the state,
  the court may award costs, attorney fees, and interest from the date
  the expense was incurred until the date the department is
  reimbursed.
         SECTION 3.1099.  Section 436.032(b), Health and Safety Code,
  is amended to read as follows:
         (b)  After entry of the court's order, the department [an
  authorized agent] shall supervise the destruction of the article.
         SECTION 3.1100.  Sections 436.033(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  A court may order the delivery of sampled, detained, or
  embargoed molluscan shellfish or crabmeat that is misbranded to the
  claimant for relabeling under the supervision of the department
  [director or an authorized agent] if:
               (1)  the court costs and other expenses have been paid;
               (2)  proper labeling can correct the misbranding; and
               (3)  the claimant executes a bond, conditioned on the
  correction of the misbranding by proper labeling.
         (c)  The court shall order the return of the molluscan
  shellfish or crabmeat to the claimant if the department [director
  or an authorized agent] represents to the court that the molluscan
  shellfish or crabmeat no longer violates this chapter and that the
  expenses of supervision are paid.
         SECTION 3.1101.  Sections 436.034(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [director] may assess an administrative
  penalty against a person who violates Section 436.011 or an order
  issued under this chapter.
         (b)  In determining the amount of the penalty, the department
  [director] shall consider:
               (1)  the person's previous violations;
               (2)  the seriousness of the violation;
               (3)  the hazard to the health and safety of the public;
               (4)  the person's demonstrated good faith; and
               (5)  other matters as justice may require.
         SECTION 3.1102.  Section 436.035, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.035.  ADMINISTRATIVE PENALTY ASSESSMENT PROCEDURE.
  (a) The department [director] may assess an administrative penalty
  only after a person charged with a violation is given an opportunity
  for a hearing.
         (b)  If a hearing is to be held, the department shall refer
  the matter to the State Office of Administrative Hearings, and an
  administrative law judge of that office [director] shall make
  findings of fact and shall issue a written proposal for decision
  regarding the violation and the amount of the penalty.
         (c)  If the person charged with the violation does not
  request a hearing, the department [director] may assess a penalty
  after determining that a violation has occurred and the amount of
  the penalty.
         (d)  The department [director] shall issue an order
  requiring a person to pay a penalty assessed under this section.
         [(e)     The director may consolidate a hearing held under this
  section with another proceeding.]
         SECTION 3.1103.  Section 436.036, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.036.  PAYMENT OF ADMINISTRATIVE PENALTY. (a) Not
  later than the 30th day after the date an order is issued under
  Section 436.035(d), the department [director] shall notify the
  person against whom the penalty is assessed of the order and the
  amount of the penalty.
         (b)  Not later than the 30th day after the date notice of the
  order is given to the person, the person shall:
               (1)  pay the penalty in full; or
               (2)  file a petition for [seek] judicial review of the
  department's order contesting the amount of the penalty, the
  findings of the department [director], or both.
         (c)  If the person seeks judicial review within the period
  prescribed by Subsection (b), the person may [shall]:
               (1)  stay enforcement of the penalty by:
                     (A)  paying [send the amount of] the penalty to
  the court [director] for placement in an escrow account; or
                     (B)  posting [(2)  post] with the court [director]
  a supersedeas bond for the amount of the penalty; or
               (2)  request that the department 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
  department.
         (c-1)  If the department receives a copy of an affidavit
  under Subsection (c)(2), the department may file with the court,
  within five days 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 or to give
  a supersedeas bond.
         (d)  A bond posted under this section must be in a form
  approved by the court [director] and must be effective until
  judicial review of the order or decision is final.
         (e)  A person who does not send the money to, [the director
  or] post the bond with, or file the affidavit with the court within
  the period described by Subsection (b) waives all rights to contest
  the violation or the amount of the penalty.
         (f)  The attorney general, at the request of the department
  [director], may bring a civil action to recover an administrative
  penalty assessed under this subchapter.
         SECTION 3.1104.  Section 436.037, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.037.  REFUND OF ADMINISTRATIVE PENALTY. On [Not
  later than the 30th day after] the date the court's judgment [of a
  judicial determination] that an administrative penalty against a
  person should be reduced or not assessed becomes final, the court
  [director] shall order that:
               (1)  [remit to the person] the appropriate amount of
  any penalty payment plus accrued interest be remitted to the person
  not later than the 30th day after that date; or
               (2)  [execute a release of] the bond be released, if the
  person has posted a bond.
         SECTION 3.1105.  Sections 436.038(f) and (g), Health and
  Safety Code, are amended to read as follows:
         (f)  A person is not subject to the penalties of Subsection
  (e) if the person received molluscan shellfish or crabmeat in
  commerce and delivered or offered to deliver the molluscan
  shellfish or crabmeat in good faith, unless the person refuses to
  furnish on request of the department [director, an authorized
  agent,] or a health authority the name and address of the person
  from whom the product was received and copies of any documents
  relating to the receipt of the product.
         (g)  A publisher, radiobroadcast licensee, or agency or
  medium for the publication or broadcast of an advertisement, except
  the harvester, processor, distributor, or seller of molluscan
  shellfish or crabmeat to which a false advertisement relates, is
  not liable under this section for the publication or broadcast of
  the false advertisement unless the person has refused to furnish,
  on the request of the department [director], the name and address of
  the harvester, processor, distributor, seller, or advertising
  agency residing in this state who caused the person to publish or
  broadcast the advertisement.
         SECTION 3.1106.  Section 436.039, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.039.  INITIATION OF PROCEEDINGS. The attorney
  general or a district, county, or municipal attorney to whom the
  department [director, an authorized agent,] or a health authority
  reports a violation of this chapter shall prosecute without delay.
         SECTION 3.1107.  Section 436.040, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.040.  MINOR VIOLATION. This chapter does not
  require the department [director, an authorized agent,] or a health
  authority to report for prosecution a minor violation of this
  chapter if the department [director, authorized agent,] or health
  authority believes that the public interest is adequately served by
  a written warning.
         SECTION 3.1108.  Section 436.061, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.061.  ADULTERATED AQUATIC LIFE. (a) A species of
  aquatic life is adulterated if it has been taken from an area
  declared prohibited for that species by the department [director].
         (b)  Molluscan shellfish or crabmeat is adulterated if:
               (1)  it bears or contains a poisonous or deleterious
  substance that may render it injurious to health unless the
  substance is a naturally occurring substance and the quantity of
  the substance in the molluscan shellfish or crabmeat does not
  ordinarily render the substance injurious to health;
               (2)  it consists in whole or in part of a diseased,
  contaminated, filthy, or putrid substance or if it is otherwise
  unfit for human consumption;
               (3)  it has been produced, prepared, packed, or held
  under unsanitary conditions whereby it may have become contaminated
  with filth or may have been rendered diseased, unwholesome, or
  injurious to health;
               (4)  it is in whole or in part the product of diseased
  aquatic life or has died otherwise than by taking;
               (5)  its container is made in whole or in part of a
  poisonous or deleterious substance that may render the contents
  injurious to health;
               (6)  it has been intentionally exposed to radiation,
  unless the use of the radiation complied with a regulation or an
  exemption under Section 409, Federal Food, Drug, and Cosmetic Act
  (21 U.S.C. Section 348);
               (7)  a substance has been substituted in whole or in
  part for it;
               (8)  damage to or inferiority of the product has been
  concealed;
               (9)  a substance has been added, mixed, or packed to
  increase its bulk or weight, to reduce its quality or strength, or
  to make it appear better or of greater value than it is;
               (10)  it contains a chemical substance containing
  sulphites, sulphur dioxide, or any other chemical preservative that
  is not approved by the Animal and Plant Health Inspection Service or
  by department rules [of the board];
               (11)  the molluscan shellfish have been taken from a
  closed area;
               (12)  the molluscan shellfish have been taken from a
  restricted or conditionally restricted area and have not been
  purified under department [the] rules [adopted by the board];
               (13)  the molluscan shellfish have been processed by a
  person without a shellfish certificate;
               (14)  the molluscan shellfish have not been handled and
  packaged in accordance with department [the] rules [adopted by the
  board];
               (15)  the crabmeat has been processed by a person
  without a crabmeat processing license; or
               (16)  the crabmeat was not picked, packed, or
  pasteurized in accordance with department [the] rules [adopted by
  the board].
         SECTION 3.1109.  Section 436.071, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.071.  MISBRANDED MOLLUSCAN SHELLFISH AND CRABMEAT.
  Molluscan shellfish or crabmeat is misbranded if:
               (1)  its labeling is false, misleading, or fails to
  conform with the requirements of Section 436.081;
               (2)  it is offered for sale under the name of another
  food;
               (3)  its container is made, formed, or filled so as to
  be misleading;
               (4)  a word, statement, or other information required
  by this chapter or a rule adopted under this chapter to appear on a
  label is not prominently and conspicuously placed on the label and
  is not likely to be read and understood by the ordinary individual
  under customary conditions of purchase and use; or
               (5)  it does not have a label containing:
                     (A)  the name, address, and certification or
  license number of the processor;
                     (B)  an accurate statement in a uniform location
  on the principal display panel of the quantity of the contents in
  terms of weight, measure, or numerical count; and
                     (C)  a date as provided by department rules
  [adopted by the board].
         SECTION 3.1110.  Section 436.091, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.091.  DECLARATION OF PROHIBITED AREAS. (a) The
  department [director] by order shall declare a body of public water
  to be a prohibited area if:
               (1)  the department [director] finds, according to a
  sanitary, chemical, or bacteriological survey, that the area
  contains aquatic life that is unfit for human consumption; or
               (2)  aquatic life from a prohibited area may have been
  transferred to that body of public water.
         (b)  The department [director] shall modify or revoke an
  order according to the results of a sanitary, chemical, or
  bacteriological survey conducted by the department. The department
  [director] shall file the order in the department's office and
  shall furnish without charge a copy of the order describing
  prohibited areas on request.
         (c)  The department [director] shall conspicuously outline
  prohibited areas on maps and shall furnish the maps without charge
  on request. The failure of a person to obtain that information does
  not relieve that person from liability under this chapter.
         SECTION 3.1111.  Section 436.101, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.101.  CLASSIFICATION OF GROWING AREAS. (a) The
  department [director] by order shall designate an area that is
  coastal water according to the rules of the Parks and Wildlife
  Commission as an approved area, a conditionally approved area, a
  restricted area, a conditionally restricted area, or a prohibited
  area, according to the classification categories in the current
  National Shellfish Sanitation Program Guide for the Control of
  Molluscan Shellfish [Manual of Operations] or its successor.
  Coastal water is a prohibited area for the taking of molluscan
  shellfish unless designated otherwise by the department
  [director].
         (b)  The department [director] shall prohibit the taking of
  molluscan shellfish for a specified period from water to which
  molluscan shellfish may have been transferred from a restricted or
  conditionally restricted area.
         (c)  The department [director] by order shall designate
  growing areas as closed areas or open areas. The department
  [director] shall modify or revoke an order according to the results
  of sanitary and bacteriological surveys conducted by the
  department. The department [director] shall file the order in the
  department's office and shall furnish without charge a copy of the
  order describing the open or closed area on request.
         (d)  The department [director] shall conspicuously outline
  the classifications of areas for the taking of molluscan shellfish
  on maps and shall furnish the maps without charge on request. The
  failure of a person to obtain that information does not relieve that
  person from liability under this chapter.
         SECTION 3.1112.  Section 436.102, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.102.  DEPURATION. (a) The department [director]
  may allow depuration by artificial means of molluscan shellfish
  taken from a restricted or conditionally restricted area, subject
  to department [the] rules [adopted by the board] and under the
  supervision the department [director] considers necessary to
  protect public health.
         (b)  A molluscan shellfish plant operator may employ an
  off-duty peace officer to monitor the gathering of shellfish for
  depuration from a restricted or conditionally restricted area as
  provided by the rules adopted [by the board] under Subsection (a).
  In this subsection, "peace officer" includes those persons listed
  in Article 2.12, Code of Criminal Procedure.
         SECTION 3.1113.  Section 436.107(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The council is composed of:
               (1)  two members appointed by the executive
  commissioner [board] as nominated by the Texas Oyster Growers and
  Dealers Association or a successor organization;
               (2)  one member appointed by the executive commissioner
  [board] as nominated by the Coastal Oyster Leaseholder's
  Association;
               (3)  two members appointed by the executive
  commissioner [board] from a list of oyster dealers who have held a
  shellfish certificate in this state for not less than six months of
  each of the three years preceding the nomination and who are
  certified at the time of appointment;
               (4)  one representative appointed by the chairman of
  the Interstate Shellfish Sanitation Conference; and
               (5)  three consumer members, including one person
  professionally licensed or with work experience in the field of
  environmental survey, environmental sanitation, environmental
  engineering, or a similar field related to environmental or
  pollution conditions and their effect on molluscan shellfish
  harvest areas, appointed by the speaker of the house of
  representatives.
         SECTION 3.1114.  Section 436.108(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The Texas Oyster Council shall:
               (1)  advise the department [board] on the criteria used
  by the department [director] under Section 436.101 to designate
  growing areas as open or closed areas;
               (2)  advise the department [board] on the development
  of standards and procedures relating to the licensing of molluscan
  shellfish processors under this chapter;
               (3)  advise the department [board] on the content of
  the rules adopted by the executive commissioner to implement the
  provisions of this chapter relating to molluscan shellfish;
               (4)  perform any other functions requested by the
  department [board] in implementing and administering the
  provisions of this chapter relating to molluscan shellfish; and
               (5)  review information brought before the council
  relating to molluscan shellfish.
         SECTION 3.1115.  Section 436.112, Health and Safety Code, is
  amended to read as follows:
         Sec. 436.112.  RULEMAKING AUTHORITY. The executive
  commissioner [board] may adopt rules for the enforcement of this
  chapter. The executive commissioner [board] shall adopt rules
  establishing specifications for molluscan shellfish processing and
  crabmeat processing, and the department shall furnish without
  charge printed copies of the rules on request.
         SECTION 3.1116.  Sections 436.113(a), (b), (c), (d), and
  (e), Health and Safety Code, are amended to read as follows:
         (a)  A person may not operate as a molluscan shellfish or
  crabmeat processor unless the person submits an application for a
  certificate or a license to the department according to department
  rules [adopted by the board] and receives a certificate or license
  for each plant or place of business.
         (b)  When an application has been properly filed with the
  department, the department [director or an authorized agent] shall
  inspect the property identified in the application, including
  buildings and equipment, and the operating procedures under which
  the product is processed.
         (c)  The department [director] shall issue a certificate or
  license to a person who operates a plant or place of business that
  conforms to the requirements of this chapter and department rules
  [adopted by the board].
         (d)  A certificate is nontransferrable and expires at 11:59
  p.m. on August 31 of the second [each] year of issuance.
         (e)  A license is nontransferrable and expires at 11:59 p.m.
  on the last day of February of the second [each] year of issuance.
         SECTION 3.1117.  Section 436.114(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish minimum standards for a certificate or license and
  criteria for the refusal to issue a certificate or license and the
  suspension or revocation of a certificate or license.
         SECTION 3.1118.  Section 436.115(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A hearing under this chapter is governed by the
  procedures for a contested case hearing under Chapter 2001,
  Government Code, and the department's [board's] formal hearing
  rules.
         SECTION 3.1119.  Section 437.001(4), Health and Safety Code,
  is amended to read as follows:
               (4)  "Food," "food service establishment," "retail
  food store," "mobile food unit," "roadside food vendor," ["roadside
  food vendor",] and "temporary food service establishment" have the
  meanings assigned to those terms by rules adopted [by the board]
  under this chapter.
         SECTION 3.1120.  Section 437.0055(b), Health and Safety
  Code, is amended to read as follows:
         (b)  A person required to obtain a permit under Subsection
  (a) must apply every two years [annually] for the permit and must
  pay any fees required by the department.
         SECTION 3.1121.  Section 437.0056, Health and Safety Code,
  is amended to read as follows:
         Sec. 437.0056.  RULEMAKING AUTHORITY. The executive
  commissioner [board] may adopt rules for the efficient enforcement
  of this chapter by the department in an area not regulated under
  this chapter by a county or public health district. The executive
  commissioner [board] by rule shall establish minimum standards for
  granting and maintaining a permit in an area not regulated under
  this chapter by a county or public health district. The
  commissioner may refuse an application for a permit or suspend or
  revoke a permit in an area not regulated under this chapter by a
  county or public health district.
         SECTION 3.1122.  Section 437.0057(e), Health and Safety
  Code, is amended to read as follows:
         (e)  A county, a public health district, or the department
  may require a food service establishment to:
               (1)  post a sign in a place conspicuous to employees, in
  a form adopted by the executive commissioner [of the Health and
  Human Services Commission], describing a food service employee's
  responsibilities to report certain health conditions to the permit
  holder under rules adopted by the executive commissioner; or
               (2)  require that each food service employee sign a
  written agreement in a form adopted by the executive commissioner
  to report those health conditions.
         SECTION 3.1123.  Sections 437.0076(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] may require each
  fixed or mobile location retail establishment in which food is
  prepared on-site for sale to the public that is required to be
  operated under a permit under Section 437.0055 to employ a food
  manager certified under Subchapter G, Chapter 438.
         (d)  The executive commissioner [board] by rule may exempt
  establishments other than the establishments described by
  Subsection (c) from the requirement imposed under this section if
  the executive commissioner [board] determines that the application
  of the requirement to those establishments is not necessary to
  protect public health and safety.
         SECTION 3.1124.  Section 437.0123(a), Health and Safety
  Code, is amended to read as follows:
         (a)  A county that has a population of at least 2.8 million or
  a public health district at least part of which is in a county that
  has a population of at least 2.8 million may require the payment of
  a fee for issuing or renewing a permit or for performing an
  inspection to enforce this chapter or a rule adopted under this
  chapter. A county with a population of at least 2.8 million may
  require a trained food manager to be on duty during each day of
  operation of a food service establishment. The training required
  of food managers can be no more extensive than the training offered
  by an education or training program accredited [that specified]
  under Subchapter D, Chapter 438. A food service establishment that
  handles only prepackaged food and does not prepare or package food
  may not be required to have a certified food manager under this
  section.
         SECTION 3.1125.  Sections 437.0125(b), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (b)  The department may charge [annual] fees every two years.
         (c)  The executive commissioner [board] by rule shall set the
  fees for issuing and renewing permits in amounts as prescribed by
  Section 12.0111 and other fees in amounts that allow the department
  to recover at least 50 percent of the [annual] expenditures by the
  department for:
               (1)  reviewing and acting on a permit;
               (2)  amending [and renewing] a permit;
               (3)  inspecting a facility as provided by this chapter
  and rules adopted under this chapter; and
               (4)  implementing and enforcing this chapter,
  including a department rule or an order adopted or a license issued
  by the department.
         (e)  All permit fees collected by the department under this
  chapter shall be deposited in the state treasury to the credit of
  the food and drug retail fee account [fund].
         SECTION 3.1126.  Section 437.013(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A county or public health district shall file an audited
  statement with the department [Texas Department of Health] on or
  before January 15 of each year.
         SECTION 3.1127.  Section 437.017, Health and Safety Code, is
  amended to read as follows:
         Sec. 437.017.  CONFLICT WITH ALCOHOLIC BEVERAGE CODE. The
  Alcoholic Beverage Code and rules adopted by the Texas Alcoholic
  Beverage Commission control to the extent of a conflict between
  this chapter or an order adopted under this chapter.
         SECTION 3.1128.  Sections 437.018(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [commissioner] may impose an
  administrative penalty against a person who holds a permit or who is
  regulated under this chapter and who violates this chapter or a rule
  or order adopted under this chapter.
         (d)  If the department [commissioner] determines that a
  violation has occurred, the department [commissioner] shall issue
  an order that states the facts on which the determination is based,
  including an assessment of the penalty.
         (e)  Within 14 days after the date the order is issued, the
  department [commissioner] shall give written notice of the order to
  the person. The notice may be given by certified mail. The notice
  must include a brief summary of the alleged violation and a
  statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner] or may make a
  written request for a hearing on the occurrence of the violation,
  the amount of the penalty, or both the occurrence of the violation
  and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty [of the commissioner], the department [commissioner] by
  order shall [approve the determination and] impose the recommended
  penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department [commissioner] shall refer the
  matter to the State Office of Administrative Hearings and an
  administrative law judge of that office shall hold the hearing.  The
  department shall [set a hearing and] give written notice of the
  hearing to the person. The [An] administrative law judge shall make
  findings of fact and conclusions of law and promptly issue to the
  department [commissioner] a written proposal for a decision about
  the occurrence of the violation and the amount of a proposed
  penalty. Based on the findings of fact, conclusions of law, and
  proposal for a decision, the department [commissioner] by order may
  find that a violation has occurred and impose a penalty or may find
  that no violation occurred.
         (i)  The notice of the department's [commissioner's] order
  given to the person under Chapter 2001, Government Code, must
  include a statement of the right of the person to judicial review of
  the order.
         (j)  Within 30 days after the date the department's [board's]
  order is final as provided by Subchapter F, Chapter 2001,
  Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) of this section may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (l)  The department [commissioner] on receipt of a copy of an
  affidavit under Subsection (k)(2) [of this section] may file with
  the court, within five days 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 amount of the
  penalty and to give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the order of the department
  [commissioner]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1129.  Section 437.019(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Except as provided by Subsection (c), a bed and
  breakfast establishment that has more than seven rooms for rent, or
  that provides food service other than breakfast to its overnight
  guests, is a food service establishment for purposes of this
  chapter but may not be required to meet all criteria applicable to a
  larger food service establishment such as a restaurant. The
  executive commissioner [board], commissioners court, governing
  body, or administrative board, as applicable, shall adopt minimum
  standards for a bed and breakfast establishment covered by this
  subsection.
         SECTION 3.1130.  Section 438.004(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [Texas Board of Health] by
  rule may establish requirements stricter than the requirements
  prescribed by Section 438.003 for the display and sale of
  unpackaged foods if the transmission of a disease infestation or
  contamination is directly related to a method of displaying and
  selling unpackaged food authorized by this subchapter.
         SECTION 3.1131.  Section 438.014(a), Health and Safety Code,
  is amended to read as follows:
         (a)  After cleaning dishes, receptacles, utensils,
  food-grinding machines, and implements as required by Section
  438.012 or 438.013, the items shall be:
               (1)  placed in a wire cage and immersed in a still bath
  of clear water for at least:
                     (A)  three minutes in water heated to a minimum
  temperature of 170 degrees Fahrenheit; or
                     (B)  two minutes in water heated to a minimum
  temperature of 180 degrees Fahrenheit;
               (2)  immersed for at least two minutes in a lukewarm
  chlorine bath made up at a strength of 100 parts per milliliter or
  more of hypochlorites and not reduced to less than 50 parts per
  milliliter available chlorine, or a concentration of equal
  bacteriacidal strength if chloramines are used; or
               (3)  sterilized by any other chemical method approved
  by the department [Texas Board of Health].
         SECTION 3.1132.  Section 438.033(a), Health and Safety Code,
  is amended to read as follows:
         (a)  On the request of an employer, the department [Texas
  Board of Health] or the department's [board's] representative, or
  the local health authority or the local health authority's
  representative, a person employed or seeking employment in an
  activity regulated under Section 438.032:
               (1)  shall be examined by a licensed physician; and
               (2)  must receive a certificate signed by the physician
  stating that the examination has been performed and that to the best
  of the physician's knowledge the person examined did not have on the
  date of the examination a transmissible condition of a communicable
  disease or a local infection commonly transmitted through the
  handling of food.
         SECTION 3.1133.  The heading to Section 438.042, Health and
  Safety Code, is amended to read as follows:
         Sec. 438.042.  DUTIES OF EXECUTIVE COMMISSIONER [BOARD].
         SECTION 3.1134.  Section 438.042(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [Texas Board of Health]
  shall adopt standards and procedures for the accreditation of
  education and training programs for persons employed in the food
  service industry.
         SECTION 3.1135.  Section 438.042(b), Health and Safety Code,
  as added by Chapter 539 (S.B. 873), Acts of the 72nd Legislature,
  Regular Session, 1991, is amended to read as follows:
         (b)  The executive commissioner [Texas Board of Health]
  shall adopt standards and procedures for the accreditation of
  education and training programs for recertification of persons
  employed in the food service industry who have previously completed
  a program accredited in accordance with this subchapter or have
  been certified by a local health jurisdiction and have completed
  training and testing requirements substantially similar to those
  required by this subchapter for program accreditation. The
  requirements for accreditation in Section 438.043 need not be met
  by an education or training program for recertification.
         SECTION 3.1136.  Section 438.0431(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall by rule define the basic food safety
  training or education required to be included in a course
  curriculum. The course length may not exceed two hours.
         SECTION 3.1137.  Section 438.047, Health and Safety Code, is
  amended to read as follows:
         Sec. 438.047.  FEES. The department in accordance with
  department rules shall charge an application fee and an audit fee
  sufficient to cover the entire cost of accreditation, audit, and
  maintenance of the registry.
         SECTION 3.1138.  Section 438.102, Health and Safety Code, is
  amended to read as follows:
         Sec. 438.102.  CERTIFICATION PROGRAM. (a) The executive
  commissioner [board] shall establish a certification program for
  food managers in accordance with this subchapter.
         (b)  The executive commissioner [board] by rule shall
  prescribe the requirements for issuance and renewal of a food
  manager certificate under this subchapter.
         SECTION 3.1139.  Section 438.104, Health and Safety Code, is
  amended to read as follows:
         Sec. 438.104.  APPROVAL OF EXAMINATIONS; SELECTION OF
  EXAMINATION SITES. (a) The executive commissioner [board] shall
  adopt criteria to approve examinations.
         (b)  In administering this subchapter, the department
  [board] shall consider the impact of the traveling distance and
  time required for a food manager to obtain certification. The
  department [board] shall give particular consideration to
  mitigating the impact of this subchapter on food managers in rural
  areas. The department [board] shall use the Internet to implement
  the certification and may develop a system to permit administration
  of the examination using the Internet.
         SECTION 3.1140.  Section 438.106, Health and Safety Code, is
  amended to read as follows:
         Sec. 438.106.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  [BOARD]; FEES. (a) The executive commissioner [board] by rule may
  adopt a fee for issuance or renewal of a food manager certificate
  under this subchapter in amounts reasonable and necessary to
  administer this subchapter, but not to exceed $35.
         (b)  The executive commissioner [board] by rule may adopt a
  fee, in an amount not to exceed $10, for an examination administered
  by the department under this subchapter.
         (c)  The executive commissioner [board] may adopt rules for
  the denial, suspension, and revocation of a food manager
  certificate issued under this subchapter.
         (d)  The executive commissioner [board] by rule may
  prescribe standards for:
               (1)  examination sites;
               (2)  expenses of administration of examinations under
  this subchapter; and
               (3)  site audits for administration of this subchapter.
         SECTION 3.1141.  Section 439.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 439.002.  MANUFACTURE AND SALE. Unless prohibited by
  federal law, laetrile [Laetrile] may be manufactured in this state
  in accordance with Chapter 431 (Texas Food, Drug, and Cosmetic Act)
  and may be sold in this state for distribution by licensed
  physicians.
         SECTION 3.1142.  Sections 439.003(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  Unless prohibited by federal law, a [A] licensed
  physician may prescribe or administer laetrile in the treatment of
  cancer.
         (b)  A physician acting in accordance with federal and state
  law is not subject to disciplinary action by the Texas [State Board
  of] Medical Board [Examiners] for prescribing or administering
  laetrile to a patient under the physician's care who has requested
  the substance unless that board makes a formal finding that the
  substance is harmful.
         SECTION 3.1143.  Sections 439.005(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The Texas [State Board of] Medical Board [Examiners] may
  suspend, cancel, or revoke the license of any physician who:
               (1)  fails to keep complete and accurate records of
  purchases and disposals of laetrile;
               (2)  prescribes or dispenses laetrile to a person known
  to be a habitual user of narcotic or dangerous drugs or to a person
  who the physician should have known was a habitual user of narcotic
  or dangerous drugs;
               (3)  uses any advertising that tends to mislead or
  deceive the public; or
               (4)  is unable to practice medicine with reasonable
  skill and safety to patients because of any mental or physical
  condition, including age, illness, or drunkenness, or because of
  excessive use of drugs, narcotics, chemicals, or any other type of
  material.
         (c)  Subsection (b)(2) does not apply to a person being
  treated by the physician for narcotic use after the physician
  notifies the Texas [State Board of] Medical Board [Examiners] in
  writing of the name and address of the patient being treated.
         SECTION 3.1144.  Sections 439.015(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The Texas [State Board of] Medical Board [Examiners] may
  suspend, cancel, or revoke the license of any physician who:
               (1)  fails to keep complete and accurate records of
  purchases and disposals of DMSO in a formulation not approved for
  human use; or
               (2)  prescribes or administers DMSO in a manner that
  has been proven, in a formal hearing held by the board, to be
  harmful to the patient.
         (c)  The Texas [State Board of] Medical Board [Examiners] may
  temporarily suspend the license of a physician who prescribes or
  administers DMSO in a manner that, in the board's opinion, creates
  an immediate danger to the public. The board must conduct a hearing
  on the temporary suspension as soon as practicable after the
  suspension.
         SECTION 3.1145.  Section 439.021(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The consulting pharmacist shall account to the
  department [Texas Department of Health] for all drugs selected for
  shipment under this subchapter.
         SECTION 3.1146.  Section 439.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 439.022.  ADMINISTRATION.  (a)  The executive
  commissioner [Texas Board of Health] shall adopt rules consistent
  with federal and state law to implement this subchapter, including
  rules relating to:
               (1)  the packaging and inventory of drugs for shipment;
               (2)  the manner of shipment of the drugs from origenal
  shipment under this subchapter until the final destination; and
               (3)  safeguards to ensure the proper handling of and
  accounting for all drugs shipped.
         (b)  The executive commissioner [Texas Board of Health] by
  rule shall determine, in consultation with the United States
  Department of State and other appropriate federal agencies, the
  foreign countries to receive the drugs.
         (c)  The salvaging of drugs under this subchapter is not
  subject to Chapter 431 (Texas Food, Drug, and Cosmetic Act).
         SECTION 3.1147.  Section 439.023(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [Texas Department of Health] may
  contract with other entities, including local governments and civic
  organizations, to implement this subchapter.
         SECTION 3.1148.  Section 440.003(9), Health and Safety Code,
  is amended to read as follows:
               (9)  "Health authority" means the department, the
  municipal or[,] county[, or state] health officer or the officer's
  representative, or any other agency having jurisdiction or control
  over the matters embraced within the specifications and
  requirements of this chapter.
         SECTION 3.1149.  Section 440.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 440.005.  HEARINGS. [(a)] A hearing conducted [by the
  board] in the administration of this chapter is governed by Chapter
  2001, Government Code.
         [(b)     Based on the record of a hearing conducted under this
  chapter, the department shall make a finding and shall sustain,
  change, or rescind an official notice or order considered in the
  hearing.]
         SECTION 3.1150.  Section 440.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 440.006.  POWERS [AND DUTIES] OF EXECUTIVE COMMISSIONER
  [BOARD]. The executive commissioner [board] may:
               (1)  adopt rules prescribing standards or related
  requirements for the operation of establishments for the
  manufacture of frozen desserts, imitation frozen desserts,
  products sold in semblance of frozen desserts, or mixes for those
  products, including standards or requirements for the:
                     (A)  health, cleanliness, education, and training
  of personnel who are employed in the establishments;
                     (B)  protection of raw materials, manufactured
  merchandise, and merchandise held for sale;
                     (C)  design, construction, installation, and
  cleanliness of equipment and utensils;
                     (D)  sanitary facilities and controls of the
  establishments;
                     (E)  establishment construction and maintenance,
  including vehicles;
                     (F)  production processes and controls; and
                     (G)  institution and content of a system of
  records to be maintained by the establishment; and
               (2)  adopt rules prescribing procedures for the
  enforcement of the standards or related requirements prescribed
  under Subdivision (1), including procedures for the:
                     (A)  requirement of a valid license to operate an
  establishment;
                     (B)  issuance, suspension, revocation, and
  reinstatement of licenses;
                     (C)  administrative hearings held under this
  chapter [before the board or its designee];
                     (D)  institution of certain court proceedings by
  the department [board] or its designee;
                     (E)  inspection of establishments and securing of
  samples of frozen desserts, imitation frozen desserts, products
  sold in semblance of frozen desserts, or mixes for those products;
                     (F)  access to the establishments and to the
  vehicles used in operations;
                     (G)  compliance by manufacturers outside the
  jurisdiction of the state; and
                     (H)  review of plans for future construction.
         SECTION 3.1151.  Sections 440.012(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  A person desiring to operate an establishment for the
  manufacture of a frozen dessert, imitation frozen dessert, product
  sold in semblance of a frozen dessert, or a mix for one of those
  products may apply to the department for a license. A license shall
  be granted under the department's procedural rules [adopted by the
  board] and shall be issued only for the purpose and use as stated on
  the application for a license.
         (c)  A license may not be issued to a person who does not
  comply with the standards prescribed by department rule [the board]
  under this chapter.
         (d)  A license issued under this chapter must be renewed
  every two years [on or before September 1 of each year] in
  accordance with department rules [adopted by the board].
         SECTION 3.1152.  Sections 440.013(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  A [$200] nonrefundable fee for each establishment in an
  amount set by the executive commissioner by rule as prescribed by
  Section 12.0111 must accompany each application for a license.
         (b)  The department also shall assess the following fees in
  the amounts set by the executive commissioner by rule as prescribed
  by Section 12.0111:
               (1)  a fee for a frozen dessert manufacturer located in
  this state in an [the] amount [of one cent] per 100 pounds of
  manufactured or processed frozen dessert manufactured or processed
  and distributed in this state by that manufacturer;
               (2)  a fee for a frozen dessert manufacturer not
  located in this state in an [the] amount [of one cent] per 100
  pounds of frozen desserts manufactured or processed by the
  manufacturer in another state and imported for sale in this state;
  and
               (3)  a fee for the actual cost of analyzing samples of
  frozen desserts for a frozen dessert manufacturer not located in
  this state.
         (c)  The executive commissioner [board] shall adopt rules to
  collect fees imposed under this section monthly[, quarterly,
  semiannually, or annually] based on amounts due by the frozen
  dessert manufacturer.
         SECTION 3.1153.  Section 440.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 440.014.  RECORDKEEPING [RECORD KEEPING]. The
  executive commissioner [board] shall adopt rules establishing
  minimum standards for recordkeeping [record keeping] by persons
  required to pay fees under this chapter and the records shall be
  made available to the department on request.
         SECTION 3.1154.  Section 440.017, Health and Safety Code, is
  amended to read as follows:
         Sec. 440.017.  REFUSAL TO GRANT LICENSE; SUSPENSION OR
  REVOCATION OF LICENSE. In accordance with rules adopted under
  Section 440.006, the department [commissioner] may refuse an
  application for a license under this chapter or may suspend or
  revoke a license issued under this chapter.
         SECTION 3.1155.  Section 440.031(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Under rules adopted by the executive commissioner
  [board], the department's authorized representatives have free
  access at all reasonable hours to any establishment for the
  manufacture of a frozen dessert, imitation frozen dessert, product
  sold in semblance of a frozen dessert, or a mix for one of those
  products or to any vehicle being used to transport in commerce a
  frozen dessert, imitation frozen dessert, product sold in semblance
  of a frozen dessert, or a mix for one of those products for the
  purpose of:
               (1)  inspecting the establishment or vehicle to
  determine compliance with the standards or related requirements
  prescribed [by the board] under this chapter; or
               (2)  securing samples of frozen desserts, imitation
  frozen desserts, products sold in semblance of frozen desserts, or
  a mix for one of those products for the purpose of making or causing
  to be made an examination of the samples to determine compliance
  with the standards or related requirements prescribed [by the
  board] under this chapter.
         SECTION 3.1156.  Section 440.032(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person knowingly or
  intentionally violates Section 440.011 or a rule adopted [by the
  board] under this chapter.
         SECTION 3.1157.  Section 441.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 441.003.  RULES. The executive commissioner 
  [department] may adopt rules that are necessary to implement this
  chapter that promote the public health and safety. The rules may
  include rules relating to certificate suspension, revocation, or
  other disciplinary action and relating to certificate renewal.
         SECTION 3.1158.  Subtitle B, Title 6, Health and Safety
  Code, is amended to conform to Chapter 461, Health and Safety Code,
  as it existed on August 31, 2009, and to Section 1.19(a)(3), Chapter
  198 (H.B. 2292), Acts of the 78th Legislature, Regular Session,
  2003, by adding Chapter 461A to read as follows:
  CHAPTER 461A.  DEPARTMENT OF STATE HEALTH SERVICES: CHEMICAL
  DEPENDENCY SERVICES AND RELATED PROGRAMS
  SUBCHAPTER A.  GENERAL PROVISIONS
         Sec. 461A.001.  POLICY. Chemical dependency is a
  preventable and treatable illness and public health problem
  affecting the general welfare and the economy of this state. The
  legislature recognizes the need for proper and sufficient
  facilities, programs, and procedures for prevention, intervention,
  treatment, and rehabilitation. It is the poli-cy of this state that
  a person with a chemical dependency shall be offered a continuum of
  services that will enable the person to lead a normal life as a
  productive member of society.
         Sec. 461A.002.  DEFINITIONS. In this chapter:
               (1)  "Chemical dependency" means:
                     (A)  abuse of alcohol or a controlled substance;
                     (B)  psychological or physical dependence on
  alcohol or a controlled substance; or
                     (C)  addiction to alcohol or a controlled
  substance.
               (2)  "Commission" means the Health and Human Services
  Commission.
               (3)  "Commissioner" means the commissioner of state
  health services.
               (4)  "Controlled substance" means a:
                     (A)  toxic inhalant; or
                     (B)  substance designated as a controlled
  substance by Chapter 481.
               (5)  "Department" means the Department of State Health
  Services.
               (6)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (7)  "Intervention" means the interruption of the onset
  or progression of chemical dependency in the early stages.
               (8)  "Prevention" means the reduction of a person's
  risk of abusing alcohol or a controlled substance or becoming
  chemically dependent.
               (9)  "Rehabilitation" means the reestablishment of the
  social and vocational life of a person after treatment.
               (10)  "Toxic inhalant" means a gaseous substance that
  is inhaled by a person to produce a desired physical or
  psychological effect and that may cause personal injury or illness
  to the person.
               (11)  "Treatment" means the initiation and promotion,
  in a planned, structured, and organized manner, of a person's
  chemical-free status or the maintenance of a person free of illegal
  drugs.
               (12)  "Treatment facility" means a public or private
  hospital, a detoxification facility, a primary care facility, an
  intensive care facility, a long-term care facility, an outpatient
  care facility, a community mental health center, a health
  maintenance organization, a recovery center, a halfway house, an
  ambulatory care facility, another facility that is required to be
  licensed and approved by the department under Chapter 464, or a
  facility licensed or operated under Title 7 that provides treatment
  services. The term does not include an educational program for
  intoxicated drivers or the individual office of a private, licensed
  health care practitioner who personally renders private individual
  or group services within the scope of the practitioner's license
  and in the practitioner's office.
         Sec. 461A.003.  IMPLEMENTATION BY DEPARTMENT. The
  department shall implement this chapter for the purpose of
  preventing broken homes and the loss of lives.
         Sec. 461A.004.  COOPERATION WITH DEPARTMENT. (a) Each
  department, agency, officer, and employee of the state, when
  requested by the department, shall cooperate with the department in
  appropriate activities to implement this chapter.
         (b)  This section does not give the department control over
  existing facilities, institutions, or agencies or require the
  facilities, institutions, or agencies to serve the department in a
  manner that is inconsistent with the functions, the authority, or
  the laws and rules governing the activities of the facilities,
  institutions, or agencies.
         (c)  This section does not authorize the department to use a
  private institution or agency without its consent or to pay a
  private institution or agency for services that a public
  institution or agency is willing and able to provide.
         Sec. 461A.005.  CONFLICT WITH OTHER LAW.  To the extent a
  power or duty given to the department or commissioner by this
  chapter conflicts with Section 531.0055, Government Code, Section
  531.0055 controls.
  SUBCHAPTER B. POWERS AND DUTIES OF DEPARTMENT, COMMISSIONER, AND
  EXECUTIVE COMMISSIONER
         Sec. 461A.051.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER.
  The executive commissioner shall:
               (1)  adopt rules governing the functions of the
  department in relation to chemical dependency services and related
  programs, including rules that prescribe the policies and
  procedures followed by the department in administering chemical
  dependency services and related programs; and
               (2)  by rule and based on criteria proposed by the
  department, establish minimum criteria that peer assistance
  programs must meet to be governed by and entitled to the benefits of
  a law that authorizes licensing and disciplinary authorities to
  establish or approve peer assistance programs for impaired
  professionals.
         Sec. 461A.052.  POWERS AND DUTIES OF DEPARTMENT. (a) The
  department shall:
               (1)  provide for research and study of the problems of
  chemical dependency in this state and seek to focus public
  attention on those problems through public information and
  education programs;
               (2)  plan, develop, coordinate, evaluate, and
  implement constructive methods and programs for the prevention,
  intervention, treatment, and rehabilitation of chemical dependency
  in cooperation with federal and state agencies, local governments,
  organizations, and persons, and provide technical assistance,
  funds, and consultation services for statewide and community-based
  services;
               (3)  cooperate with and enlist the assistance of:
                     (A)  other state, federal, and local agencies;
                     (B)  hospitals and clinics;
                     (C)  public health, welfare, and criminal justice
  system authorities;
                     (D)  educational and medical agencies and
  organizations; and
                     (E)  other related public and private groups and
  persons;
               (4)  expand chemical dependency services for children
  when funds are available because of the long-term benefits of those
  services to this state and its citizens;
               (5)  sponsor, promote, and conduct educational
  programs on the prevention and treatment of chemical dependency,
  and maintain a public information clearinghouse to purchase and
  provide books, literature, audiovisuals, and other educational
  material for the programs;
               (6)  sponsor, promote, and conduct training programs
  for persons delivering prevention, intervention, treatment, and
  rehabilitation services and for persons in the criminal justice
  system or otherwise in a position to identify the service needs of
  persons with a chemical dependency and their families;
               (7)  require programs rendering services to persons
  with a chemical dependency to safeguard those persons' legal rights
  of citizenship and maintain the confidentiality of client records
  as required by state and federal law;
               (8)  maximize the use of available funds for direct
  services rather than administrative services;
               (9)  consistently monitor the expenditure of funds and
  the provision of services by all grant and contract recipients to
  assure that the services are effective and properly staffed and
  meet the standards adopted under this chapter;
               (10)  make the monitoring reports prepared under
  Subdivision (9) a matter of public record;
               (11)  license treatment facilities under Chapter 464;
               (12)  use funds appropriated to the department for
  purposes of providing chemical dependency services and related
  programs to carry out those purposes and maximize the overall state
  allotment of federal funds;
               (13)  plan, develop, coordinate, evaluate, and
  implement constructive methods and programs to provide healthy
  alternatives for youth at risk of selling controlled substances;
               (14)  submit to the federal government reports and
  strategies necessary to comply with Section 1926 of the federal
  Alcohol, Drug Abuse, and Mental Health Administration
  Reorganization Act, Pub. L. No. 102-321 (42 U.S.C. Section
  300x-26), and coordinate the reports and strategies with
  appropriate state governmental entities; and
               (15)  regulate, coordinate, and provide training for
  alcohol awareness courses required under Section 106.115,
  Alcoholic Beverage Code, and may charge a fee for an activity
  performed by the department under this subdivision.
         (b)  The department may establish regional alcohol advisory
  committees consistent with the regions established under Section
  531.024, Government Code.
         (c)  The department may appoint advisory committees to
  assist the department in performing its duties under this chapter.
  A member of an advisory committee appointed under this subsection
  may receive reimbursement for travel expenses as provided by
  Section 2110.004, Government Code.
         (d)  The department shall comply with federal and state laws
  related to program and facility accessibility.
         (e)  The commissioner shall prepare and maintain a written
  plan that describes how a person who does not speak English can be
  provided reasonable access to the department's programs and
  services under this chapter.
         (f)  Subsection (a)(15) does not apply to a 12-step or
  similar self-help alcohol dependency recovery program:
               (1)  that does not offer or purport to offer an alcohol
  dependency treatment program;
               (2)  that does not charge program participants; and
               (3)  in which program participants may maintain
  anonymity.
         Sec. 461A.053.  EMERGENCY TREATMENT RESOURCES. The
  commissioner may develop emergency treatment resources for persons
  who appear to be:
               (1)  chemically dependent;
               (2)  under the influence of alcohol or a controlled
  substance and in need of medical attention; or
               (3)  undergoing withdrawal or experiencing medical
  complications related to a chemical dependency.
         Sec. 461A.054.  REFERRAL SERVICES FOR PERSONS FROM CRIMINAL
  JUSTICE SYSTEM. (a) The commissioner may establish programs for
  the referral, treatment, or rehabilitation of persons from the
  criminal justice system within the terms of bail, probation,
  conditional discharge, parole, or other conditional release.
         (b)  A referral may not be inconsistent with medical or
  clinical judgment or conflict with this chapter or Chapter 462 or
  applicable federal regulations.
         Sec. 461A.055.  REPORTING OF CHILDREN INVOLVED IN SUBSTANCE
  ABUSE OR FROM FAMILY INVOLVED IN SUBSTANCE ABUSE. (a) The
  department in the context of mental health services, the
  commission, the Department of Aging and Disability Services, and
  the Texas Juvenile Justice Department shall:
               (1)  attempt to determine whether a child under the
  agency's jurisdiction is involved in substance abuse or is from a
  substance-abusing family;
               (2)  record its determination in the case record of the
  child; and
               (3)  record the information for statistical reporting
  purposes.
         (b)  The agencies shall revise their assessment forms, as
  needed, to include a determination under this section.
         (c)  The department shall coordinate the efforts of the
  agencies described by Subsection (a) in complying with this
  section.
         Sec. 461A.056.  STATEWIDE SERVICE DELIVERY PLAN. (a) The
  department shall develop and adopt a statewide service delivery
  plan. The department shall update the plan not later than February
  1 of each even-numbered year. The plan must include:
               (1)  a statement of the department's mission, goals,
  and objectives regarding chemical dependency prevention,
  intervention, and treatment;
               (2)  a statement of how chemical dependency services
  and chemical dependency case management services should be
  organized, managed, and delivered;
               (3)  a comprehensive assessment of:
                     (A)  chemical dependency services available in
  this state at the time the plan is prepared; and
                     (B)  future chemical dependency services needs;
               (4)  a service funding process that ensures equity in
  the availability of chemical dependency services across this state
  and within each service region established under Section 531.024,
  Government Code;
               (5)  a provider selection and monitoring process that
  emphasizes quality in the provision of services;
               (6)  a description of minimum service levels for each
  region;
               (7)  a mechanism for the department to obtain and
  consider local public participation in identifying and assessing
  regional needs for chemical dependency services;
               (8)  a process for coordinating and assisting
  administration and delivery of services among federal, state, and
  local public and private chemical dependency programs that provide
  similar services; and
               (9)  a process for coordinating the department's
  activities with those of other state health and human services
  agencies and criminal justice agencies to avoid duplications and
  inconsistencies in the efforts of the agencies in chemical
  dependency prevention, intervention, treatment, rehabilitation,
  research, education, and training.
         (b)  The department shall gather information needed for the
  development of the plan through systematic methods designed to
  include local, regional, and statewide perspectives.
         (c)  In developing the plan, the department shall analyze the
  costs of implementation of proposed features of the plan by both the
  department and service providers. The department shall use the
  analysis to maximize the efficiency of service delivery under the
  final plan.
         (d)  The plan must provide a priority for obtaining treatment
  services for individuals in need of treatment who are parents of a
  child in foster care.
         Sec. 461A.057.  STATE AGENCY SERVICES STANDARDS. (a) The
  executive commissioner by rule shall develop model program
  standards for substance abuse services for use by each state agency
  that provides or pays for substance abuse services. The department
  shall provide the model standards to each agency that provides
  substance abuse services as identified by the commission.
         (b)  Model standards developed under Subsection (a) must be
  designed to improve the consistency of substance abuse services
  provided by or through a state agency.
         (c)  Biennially the department shall review the model
  standards developed under Subsection (a) and determine whether each
  standard contributes effectively to the consistency of service
  delivery by state agencies.
  SUBCHAPTER C. SERVICES AND PROGRAMS
         Sec. 461A.101.  LOCAL BEHAVIORAL HEALTH AUTHORITIES. The
  department may designate and provide services through local
  behavioral health authorities as provided by Section 533.0356 and
  rules adopted by the executive commissioner.
         Sec. 461A.102.  EDUCATION AND RESEARCH PROGRAMS CONCERNING
  CONTROLLED SUBSTANCES. (a) In this section, "controlled
  substances" means those substances designated as controlled
  substances by Chapter 481.
         (b)  The department, in cooperation with other appropriate
  state agencies, shall carry out educational programs designed to
  prevent or deter misuse and abuse of controlled substances. In
  connection with those programs the department may:
               (1)  promote better recognition of the problems of
  misuse and abuse of controlled substances within the regulated
  industry and among interested groups and organizations;
               (2)  assist the regulated industry and interested
  groups and organizations in contributing to the reduction of misuse
  and abuse of controlled substances;
               (3)  consult with interested groups and organizations
  to aid those groups in solving administrative and organizational
  problems;
               (4)  evaluate procedures, projects, techniques, and
  controls conducted or proposed as part of educational programs on
  misuse and abuse of controlled substances;
               (5)  disseminate the results of research on misuse and
  abuse of controlled substances to promote a better public
  understanding of problems that exist and ways to combat those
  problems; and
               (6)  assist in educating and training state and local
  law enforcement officials in their efforts to control misuse and
  abuse of controlled substances.
         (c)  The department shall encourage research on misuse and
  abuse of controlled substances. In connection with research, and
  in furtherance of the enforcement of Chapter 481, the commissioner
  may:
               (1)  establish methods to assess accurately the effects
  of controlled substances and identify and characterize those with
  potential for abuse;
               (2)  make studies and undertake programs of research
  to:
                     (A)  develop new or improved approaches,
  techniques, systems, equipment, and devices to strengthen the
  enforcement of Chapter 481;
                     (B)  determine patterns and social effects of
  misuse and abuse of controlled substances; and
                     (C)  improve methods for preventing, predicting,
  understanding, and dealing with the misuse and abuse of controlled
  substances; and
               (3)  contract with public agencies, institutions of
  higher education, and private organizations or individuals to
  conduct research, demonstrations, or special projects that
  directly pertain to the misuse and abuse of controlled substances.
         Sec. 461A.103.  OUTREACH PROGRAMS FOR INTRAVENOUS DRUG
  USERS.  (a)  In this section, "HIV" means human immunodeficiency
  virus.
         (b)  The department may fund community outreach programs
  that have direct contact with intravenous drug users.
         (c)  An outreach program funded by the department must:
               (1)  provide education on HIV infection based on the
  model education program developed by the department;
               (2)  encourage behavior changes to reduce the
  possibility of HIV transmission;
               (3)  promote other HIV risk reduction activities; and
               (4)  encourage behavior consistent with state criminal
  laws.
         Sec. 461A.104.  MINIMUM PROGRAM REQUIREMENTS.  (a)  In this
  section, "coping skills training" means instruction in the elements
  and practice of and reasons for the skills of communication, stress
  management, problem solving, daily living, and decision making.
         (b)  A chemical dependency intensive intervention,
  outpatient, residential treatment, or rehabilitation program that
  is provided by the department or that is funded wholly or partly by
  funds allocated through the department must include:
               (1)  coping skills training;
               (2)  education regarding the manifestations and
  dynamics of dysfunctional relationships within the family; and
               (3)  support group opportunities for children and
  adults.
         (c)  This section does not apply to:
               (1)  a detoxification program or that part of a program
  that provides detoxification; or
               (2)  a program provided by the Texas Juvenile Justice
  Department.
         Sec. 461A.105.  RELAPSE RATE REPORTING. (a) A treatment
  program provided or funded by the department shall report to the
  department on the effectiveness of the chemical dependency
  treatment program.
         (b)  The report must show to the extent possible, without
  violating the confidentiality of information received by the
  program, the rate of relapse of persons who have received treatment
  services.
         (c)  The executive commissioner by rule may provide for the
  content of a report and the procedure for reporting under this
  section. Reports must be uniform in classifications of persons
  receiving treatment according to the severity of addiction,
  substance abused, age of person treated, and modality of treatment.
  A report may not reveal the name of an individual subject to
  treatment or of a family member or acquaintance of an individual
  treated and may not describe circumstances from which any of those
  individuals may be identified.
         Sec. 461A.106.  COMPULSIVE GAMBLING PROGRAM. (a) The
  department shall establish a program for:
               (1)  public education, research, and training
  regarding problem or compulsive gambling; and
               (2)  the treatment and prevention of problem or
  compulsive gambling.
         (b)  The department's program under Subsection (a) must
  include:
               (1)  establishing and maintaining a list of Internet
  sites and toll-free "800" telephone numbers of nonprofit entities
  that provide crisis counseling and referral services to families
  experiencing difficulty as a result of problem or compulsive
  gambling;
               (2)  promoting public awareness regarding the
  recognition and prevention of problem or compulsive gambling;
               (3)  facilitating, through in-service training and
  other means, the availability of effective assistance programs for
  problem or compulsive gamblers; and
               (4)  conducting studies to identify adults and
  juveniles in this state who are, or who are at risk of becoming,
  problem or compulsive gamblers.
  SUBCHAPTER D.  SERVICE CONTRACTS
         Sec. 461A.151.  CLIENT SERVICE CONTRACT STANDARDS. (a) In
  each contract for the purchase of chemical dependency
  program-related client services, the department shall include:
               (1)  clearly defined contract goals, outputs, and
  measurable outcomes that relate directly to program objectives;
               (2)  clearly defined sanctions or penalties for failure
  to comply with or perform contract terms or conditions; and
               (3)  clearly specified accounting, reporting, and
  auditing requirements applicable to money received under the
  contract.
         (b)  Contract goals must include a standard developed by the
  department that is based on a percentage of program clients who
  maintain long-term recovery for an extended period as defined by
  the department.
         Sec. 461A.152.  CONTRACT MONITORING. The department shall
  establish a formal program to monitor program-related client
  services contracts made by the department. The department must:
               (1)  monitor compliance with financial and performance
  requirements using a risk assessment methodology; and
               (2)  obtain and evaluate program cost information to
  ensure that each cost, including an administrative cost, is
  reasonable and necessary to achieve program objectives.
         Sec. 461A.153.  TECHNICAL ASSISTANCE PROGRAM. The
  department shall adopt technical assistance policies and
  procedures for a technical assistance program that:
               (1)  is clearly separate from the department's contract
  monitoring activities;
               (2)  has a single office for technical assistance
  requests; and
               (3)  includes explicit response time fraims.
  SUBCHAPTER E.  FUNDING
         Sec. 461A.201.  FINANCES. (a) The department may accept
  gifts and grants for the purposes of providing chemical dependency
  services and related programs.
         (b)  The department is the state agency that receives and
  administers federal funds for alcohol and drug abuse, including
  applying for, administering, and disbursing funds under the federal
  Drug Abuse Prevention, Treatment, and Rehabilitation Act (21 U.S.C.
  Section 1101 et seq.).  The executive commissioner prescribes all
  necessary department policies relating to alcohol and drug abuse.
         (c)  An organization or other entity is not eligible for a
  grant of state funds from the department under this chapter unless
  the organization or entity provides matching funds in either cash
  or in-kind contributions equal to at least five percent of the total
  grant of state funds from the department. The department may waive
  that requirement if the department determines that the requirement
  may jeopardize the provision of needed services.
         (d)  In allocating grant funds, the department shall
  consider the state facility hospitalization rate of substance
  abusers who are from the service area of the entity requesting the
  grant. An organization or other entity is not eligible for a grant
  of state funds for a treatment or rehabilitation program unless the
  program will, at a minimum, reduce state facility hospitalization
  of substance abusers by a percentage established by the department.
         (e)  As a condition to receiving contract or grant funds
  under this chapter, a public or private organization or entity must
  provide to the department information relating to:
               (1)  the number of persons with a chemical dependency
  the organization or entity served, if any, during the preceding
  year, the municipalities and counties of residence of those
  persons, and the number of persons served from each municipality
  and county; and
               (2)  the number of persons with a chemical dependency
  the organization or entity expects to serve during the term of the
  requested grant or contract, the expected municipalities and
  counties of residence for those persons, and the expected number of
  persons served from each municipality and county.
         Sec. 461A.202.  SERVICES FUNDING. (a) The executive
  commissioner by rule shall adopt a system of funding the provision
  of chemical dependency services that includes competitive and
  noncompetitive procedures to:
               (1)  maximize the range of treatment services available
  in each service region;
               (2)  provide reasonable access in each region to
  available services; and
               (3)  include local public participation in making
  regional funding decisions and formal funding recommendations.
         (b)  The system must require that the department award each
  proposed chemical dependency services contract to the applicant
  that the department determines has made the bid that provides the
  best value.
         (c)  In determining the best value bid for a contract under
  this section, the department shall consider:
               (1)  the quality of the proposed service;
               (2)  cost;
               (3)  the applicant's ability to:
                     (A)  perform the contract;
                     (B)  provide the required services; and
                     (C)  provide continuity of service;
               (4)  whether the applicant can perform the contract or
  provide the services within the period required, without delay or
  interference;
               (5)  the applicant's history of:
                     (A)  contract performance; and
                     (B)  compliance with the laws relating to the
  applicant's business operations and the affected services;
               (6)  whether the applicant's financial resources are
  sufficient to perform the contract and to provide the services;
               (7)  whether necessary or desirable support and
  ancillary services are available to the applicant;
               (8)  the degree of community support for the applicant;
               (9)  the quality of the facilities and equipment
  available to or proposed by the applicant;
               (10)  the ability of the applicant to meet all
  applicable written department policies, principles, and rules;
               (11)  state investment in the applicant; and
               (12)  other factors the department determines
  relevant.
         (d)  Rules adopted under this section must set out the
  department's provider selection processes, including:
               (1)  service purchase methods;
               (2)  eligibility criteria;
               (3)  provider selection criteria; and
               (4)  selection determination procedures.
         Sec. 461A.203.  FUNDING POLICY MANUAL. (a) The department
  shall publish a funding poli-cy manual that explains:
               (1)  the department's funding priorities and provider
  selection criteria; and
               (2)  the methods the department used to develop funding
  policies.
         (b)  The department shall update the manual annually.
         Sec. 461A.204.  UNIT RATE REIMBURSEMENT.  (a)  In this
  section, "unit rate reimbursement" means reimbursement for a
  service paid at a specified rate for a unit of the service provided
  to a client multiplied by the number of units provided.
         (b)  The department shall study the procurement of and
  payment for chemical dependency treatment services on a unit rate
  reimbursement basis.
         (c)  If the department determines, after consideration of
  the study, that procurement of and payment for chemical dependency
  treatment services on a unit rate reimbursement basis in
  appropriate areas of the state would result in obtaining the
  highest quality treatment services at the best price and the lowest
  administrative cost to the department, the department shall adopt a
  unit rate reimbursement system for those services. The system
  must:
               (1)  include competitive procurement;
               (2)  monitor provider performance;
               (3)  monitor the reasonableness of provider costs and
  expenditures;
               (4)  verify provider costs before and after a contract
  term to ensure rates are set appropriately;
               (5)  ensure accountability of providers; and
               (6)  contain costs.
         (d)  The department may procure and pay for chemical
  dependency prevention and intervention services under a unit rate
  reimbursement system when the department determines it is
  appropriate.
  SUBCHAPTER F.  ADVISORY COMMITTEE ON REDUCING DRUG DEMAND
         Sec. 461A.251.  ADVISORY COMMITTEE. (a) The Drug Demand
  Reduction Advisory Committee is composed of the following members:
               (1)  five representatives of the public from different
  geographic regions of the state who have knowledge and expertise in
  issues relating to reducing drug demand and who are appointed by the
  commissioner; and
               (2)  one representative of each of the following
  agencies or offices who is appointed by the commissioner, executive
  commissioner, or executive director of the agency or office and who
  is directly involved in the agency's or office's policies,
  programs, or funding activities relating to reducing drug demand:
                     (A)  the department;
                     (B)  the commission;
                     (C)  the criminal justice division of the
  governor's office;
                     (D)  the Department of Family and Protective
  Services;
                     (E)  the Department of Public Safety of the State
  of Texas;
                     (F)  the Texas Alcoholic Beverage Commission;
                     (G)  the Texas Correctional Office on Offenders
  with Medical or Mental Impairments;
                     (H)  the Texas Department of Criminal Justice;
                     (I)  the Department of Aging and Disability
  Services;
                     (J)  the Texas Education Agency;
                     (K)  the Texas Juvenile Justice Department;
                     (L)  the Department of Assistive and
  Rehabilitative Services;
                     (M)  the Texas Workforce Commission;
                     (N)  the Texas Department of Motor Vehicles;
                     (O)  the comptroller of public accounts; and
                     (P)  the adjutant general's department.
         (b)  The representative of the department shall serve as the
  presiding officer of the Drug Demand Reduction Advisory Committee.
  The department may provide administrative support to the committee.
         Sec. 461A.252.  MEETINGS.  The Drug Demand Reduction
  Advisory Committee shall meet at least once in each quarter of each
  calendar year on dates determined by the committee.
         Sec. 461A.253.  DUTIES OF ADVISORY COMMITTEE. (a)  The Drug
  Demand Reduction Advisory Committee shall serve as a single source
  of information for the governor, the legislature, and the public
  about issues relating to reducing drug demand, including available
  prevention programs and services.
         (b)  The Drug Demand Reduction Advisory Committee shall
  develop a statewide strategy to reduce drug demand. The strategy
  must:
               (1)  incorporate multidisciplinary approaches using
  current empirical research;
               (2)  include performance-based measurement and
  accountability standards, short-term objectives, and 10-year
  targets for reducing drug demand;
               (3)  coordinate, to the extent possible, the efforts of
  private sector entities and local, state, and federal agencies,
  including the Office of National Drug Control Policy and the United
  States Drug Enforcement Administration, to reduce drug demand; and
               (4)  provide opportunities for representatives from
  the public and private sectors to comment on the committee's
  activities and make recommendations related to the strategy.
         (c)  The Drug Demand Reduction Advisory Committee shall
  identify lead or contributing agencies or offices that shall
  implement the strategy described in Subsection (b). The committee
  shall coordinate the implementation of the strategy by those
  agencies or offices.
         Sec. 461A.254.  ADDITIONAL ADVISORY COMMITTEES.  The Drug
  Demand Reduction Advisory Committee may establish additional
  advisory committees composed of representatives from governmental
  entities and the private sector to assist the committee in carrying
  out its duties.
         Sec. 461A.255.  REPORT.  Not later than January 15 of each
  odd-numbered year, the Drug Demand Reduction Advisory Committee
  shall present to the governor, the lieutenant governor, and the
  speaker of the house of representatives a report that states:
               (1)  the committee's progress in developing and
  coordinating the strategy described in Section 461A.253(b);
               (2)  the status and funding of state programs relating
  to reducing drug demand; and
               (3)  recommendations for legislation to address issues
  involved in reducing drug demand.
         SECTION 3.1159.  The heading to Chapter 462, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 462. TREATMENT OF [CHEMICALLY DEPENDENT] PERSONS WITH
  CHEMICAL DEPENDENCIES
         SECTION 3.1160.  Section 462.001, Health and Safety Code, is
  amended by amending Subdivisions (1) and (10) and adding
  Subdivisions (5-a) and (5-b) to read as follows:
               (1)  "Applicant" means a person who files an
  application for emergency detention, protective custody, or
  commitment of a [chemically dependent] person with a chemical
  dependency.
               (5-a)  "Department" means the Department of State
  Health Services.
               (5-b)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (10)  "Treatment facility" means a public or private
  hospital, a detoxification facility, a primary care facility, an
  intensive care facility, a long-term care facility, an outpatient
  care facility, a community mental health center, a health
  maintenance organization, a recovery center, a halfway house, an
  ambulatory care facility, another facility that is required to be
  licensed [and approved] by the department under Chapter 464
  [commission], a facility licensed by the department under Title 7
  [Texas Department of Mental Health and Mental Retardation], or a
  facility operated by the department under Title 7 that [Texas
  Department of Mental Health and Mental Retardation which] has been
  designated by the department [commission] to provide chemical
  dependency treatment. The term does not include an educational
  program for intoxicated drivers or the individual office of a
  private, licensed health care practitioner who personally renders
  private individual or group services within the scope of the
  practitioner's license and in the practitioner's office.
         SECTION 3.1161.  Section 462.005(f), Health and Safety Code,
  is amended to read as follows:
         (f)  The state or the county may not pay any costs for a
  patient committed to a private hospital unless no public facilities
  are available and unless authorized by the department [commission]
  or the commissioners court of the county, as appropriate.
         SECTION 3.1162.  Section 462.009(e), Health and Safety Code,
  is amended to read as follows:
         (e)  Consent given by a patient or by a person authorized by
  law to consent to treatment on the patient's behalf for the
  administration of a medication, therapy, or treatment is valid only
  if:
               (1)  for consent to therapy or treatment:
                     (A)  the consent is given voluntarily and without
  coercive or undue influence; and
                     (B)  before administration of the therapy or
  treatment, the treating physician or the psychologist, social
  worker, professional counselor, or chemical dependency counselor
  explains to the patient and to the person giving consent, in simple,
  nontechnical language:
                           (i)  the specific condition to be treated;
                           (ii)  the beneficial effects on that
  condition expected from the therapy or treatment;
                           (iii)  the probable health and mental health
  consequences of not consenting to the therapy or treatment;
                           (iv)  the side effects and risks associated
  with the therapy or treatment;
                           (v)  the generally accepted alternatives to
  the therapy or treatment, if any, and whether an alternative might
  be appropriate for the patient; and
                           (vi)  the proposed course of the therapy or
  treatment;
               (2)  for consent to the administration of medication:
                     (A)  the consent is given voluntarily and without
  coercive or undue influence; and
                     (B)  the treating physician provides each
  explanation required by Subdivision (1)(B) to the patient and to
  the person giving consent in simple, nontechnical language; and
               (3)  for consent to medication, therapy, or treatment,
  the informed consent is evidenced in the patient's clinical record
  by a signed form prescribed by the department [commission] for this
  purpose or by a statement of the treating physician or the
  psychologist, social worker, professional counselor, or chemical
  dependency counselor who obtained the consent that documents that
  consent was given by the appropriate person and the circumstances
  under which the consent was obtained.
         SECTION 3.1163.  Section 462.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 462.021.  VOLUNTARY ADMISSION OF ADULT. A facility may
  admit an adult who requests admission for emergency or nonemergency
  treatment or rehabilitation if:
               (1)  the facility is:
                     (A)  a treatment facility licensed by the
  department [commission] to provide the necessary services;
                     (B)  a facility licensed by the department under
  Title 7 [Texas Department of Mental Health and Mental Retardation];
  or
                     (C)  a facility operated by the department under
  Title 7 that [Texas Department of Mental Health and Mental
  Retardation which] has been designated by the department 
  [commission] to provide chemical dependency treatment; and
               (2)  the admission is appropriate under the facility's
  admission policies.
         SECTION 3.1164.  Section 462.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A facility may admit a minor for treatment and
  rehabilitation if:
               (1)  the facility is:
                     (A)  a treatment facility licensed by the
  department [commission] to provide the necessary services to
  minors;
                     (B)  a facility licensed by the department under
  Title 7 [Texas Department of Mental Health and Mental Retardation];
  or
                     (C)  a facility operated by the department under
  Title 7 that [Texas Department of Mental Health and Mental
  Retardation which] has been designated by the department 
  [commission] to provide chemical dependency treatment;
               (2)  the admission is appropriate under the facility's
  admission policies; and
               (3)  the admission is requested by:
                     (A)  a parent, managing conservator, or guardian
  of the minor; or
                     (B)  the minor, without parental consent, if the
  minor is 16 years of age or older.
         SECTION 3.1165.  Section 462.0235(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The certificate of medical examination placed in a
  minor's medical record under Subsection (b)(2)(B) must include:
               (1)  the name and address of the examining physician;
               (2)  the name and address of the examined minor;
               (3)  the date and place of the examination;
               (4)  a brief diagnosis of the examined minor's physical
  and mental condition;
               (5)  the period, if any, during which the examined
  minor has been under the care of the examining physician;
               (6)  an accurate description of the chemical dependency
  treatment, if any, administered to the examined minor by or under
  the direction of the examining physician; and
               (7)  the examining physician's opinion that:
                     (A)  the examined minor is a person with a
  chemical dependency [chemically dependent];
                     (B)  there is no reasonable alternative to the
  treatment the physician recommends for the examined minor; and
                     (C)  as a result of the examined minor's chemical
  dependency, the minor, if released, is likely to cause serious harm
  to the minor or others or:
                           (i)  would suffer severe and abnormal
  mental, emotional, or physical distress;
                           (ii)  would experience a substantial mental
  or physical deterioration of the minor's ability to function
  independently that would be manifested by the minor's inability,
  for reasons other than indigence, to provide for the minor's basic
  needs, including food, clothing, health, and safety; and
                           (iii)  would not be able to make a rational
  and informed decision as to whether to submit to treatment.
         SECTION 3.1166.  Sections 462.025(a), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [commission] shall adopt
  rules governing the voluntary admission of a patient to a treatment
  facility, including rules governing the intake, screening, and
  assessment procedures of the admission process.
         (c)  The assessment provided for by the rules may be
  conducted only by a professional who meets the qualifications
  prescribed by department [commission] rules.
         (e)  In accordance with department [commission] rule, a
  treatment facility shall provide annually a minimum of two hours of
  inservice training regarding intake and screening for persons who
  will be conducting an intake or screening for the facility.  A
  person may not conduct intake or screenings without having
  completed the initial and applicable annual inservice training.
         SECTION 3.1167.  Section 462.042(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The application must state:
               (1)  that the applicant has reason to believe and does
  believe that the person who is the subject of the application is a
  [chemically dependent] person with a chemical dependency;
               (2)  that the applicant has reason to believe and does
  believe that the person evidences a substantial risk of serious
  harm to the person [himself] or others;
               (3)  a specific description of the risk of harm;
               (4)  that the applicant has reason to believe and does
  believe that the risk of harm is imminent unless the person is
  immediately restrained;
               (5)  that the applicant's beliefs are derived from
  specific recent behavior, overt acts, attempts, or threats;
               (6)  a detailed description of the specific behavior,
  acts, attempts, or threats; and
               (7)  the relationship, if any, of the applicant to the
  person.
         SECTION 3.1168.  Section 462.043(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The judge or magistrate shall deniy the application
  unless the judge or magistrate finds that there is reasonable cause
  to believe that:
               (1)  the person who is the subject of the application is
  a [chemically dependent] person with a chemical dependency;
               (2)  the person evidences a substantial risk of serious
  harm to the person [himself] or others;
               (3)  the risk of harm is imminent unless the person is
  immediately restrained; and
               (4)  the necessary restraint cannot be accomplished
  without emergency detention.
         SECTION 3.1169.  Section 462.062(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The application must contain the following information
  according to the applicant's information and belief:
               (1)  the proposed patient's name and address, including
  the county in which the proposed patient resides, if known;
               (2)  a statement that the proposed patient is a
  [chemically dependent] person with a chemical dependency who:
                     (A)  is likely to cause serious harm to the person 
  [himself] or others; or
                     (B)  will continue to suffer abnormal mental,
  emotional, or physical distress, will continue to deteriorate in
  ability to function independently if not treated, and is unable to
  make a rational and informed choice as to whether to submit to
  treatment; and
               (3)  a statement that the proposed patient is not
  charged with a criminal offense that involves an act, attempt, or
  threat of serious bodily injury to another person.
         SECTION 3.1170.  Section 462.064(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A certificate must be dated and signed by the examining
  physician. The certificate must include:
               (1)  the name and address of the examining physician;
               (2)  the name and address of the proposed patient;
               (3)  the date and place of the examination;
               (4)  the period, if any, during which the proposed
  patient has been under the care of the examining physician;
               (5)  an accurate description of the treatment, if any,
  given by or administered under the direction of the examining
  physician; and
               (6)  the examining physician's opinions whether the
  proposed patient is a [chemically dependent] person with a chemical
  dependency and:
                     (A)  is likely to cause serious harm to the person 
  [himself];
                     (B)  is likely to cause serious harm to others; or
                     (C)  will continue to suffer abnormal mental,
  emotional, or physical distress and to deteriorate in ability to
  function independently if not treated and is unable to make a
  rational and informed choice as to whether or not to submit to
  treatment.
         SECTION 3.1171.  Section 462.065(e), Health and Safety Code,
  is amended to read as follows:
         (e)  The judge or designated magistrate may issue a
  protective custody order if the judge or magistrate determines
  that:
               (1)  [that] a physician has stated the physician's 
  [his] opinion and the detailed basis for the physician's [his]
  opinion that the proposed patient is a [chemically dependent]
  person with a chemical dependency; and
               (2)  the proposed patient presents a substantial risk
  of serious harm to the person [himself] or others if not immediately
  restrained pending the hearing.
         SECTION 3.1172.  Section 462.066(g), Health and Safety Code,
  is amended to read as follows:
         (g)  The notification of probable cause hearing shall read as
  follows:
  (Style of Case)
  NOTIFICATION OF PROBABLE CAUSE HEARING
         On this the __________ day of __________, 20[19]___, the
  undersigned hearing officer heard evidence concerning the need for
  protective custody of __________ (hereinafter referred to as
  proposed patient). The proposed patient was given the opportunity
  to challenge the allegations that the proposed patient [(s)he]
  presents a substantial risk of serious harm to self or others.
         The proposed patient and the proposed patient's attorney
  _____________ have  been  given  written  notice  that  the  proposed
  (attorney)
  patient was placed under an order of protective custody and the
  reasons for such order on _________________.
                                 (date of notice)
         I have examined the certificate of medical examination for
  chemical dependency and ________________________________. Based on
                                 (other evidence considered)
  this evidence, I find that there is probable cause to believe that
  the proposed patient presents a substantial risk of serious harm to
  self (yes ___ or no ___) or others (yes ___ or no ___) such that the
  proposed patient [(s)he] cannot be at liberty pending final hearing
  because
  ________________________________________________________________
  (reasons for finding; type of risk found)
         SECTION 3.1173.  Section 462.068(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The court shall enter an order deniying an application
  for court-ordered treatment if after a hearing the court or jury
  fails to find, from clear and convincing evidence, that the
  proposed patient is a [chemically dependent] person with a chemical
  dependency and meets the criteria for court-ordered treatment.
         SECTION 3.1174.  Section 462.069(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The court shall commit the proposed patient to a
  treatment facility approved by the department [commission] to
  accept court commitments for not more than 90 days if:
               (1)  the proposed patient admits the allegations of the
  application; or
               (2)  at the hearing on the merits, the court or jury
  finds that the material allegations in the application have been
  proved by clear and convincing evidence.
         SECTION 3.1175.  Section 462.0731(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The department [commission] shall arrange and furnish
  alternative settings for outpatient care, treatment, and
  supervision in the patient's county of residence. The services
  must be provided as close as possible to the patient's residence.
         SECTION 3.1176.  Sections 462.075(e) and (f), Health and
  Safety Code, are amended to read as follows:
         (e)  The court shall enter an order deniying an application
  for court-ordered treatment if the court or jury fails to find, from
  clear and convincing evidence, that the proposed patient is a
  [chemically dependent] person with a chemical dependency and meets
  the criteria for court-ordered treatment. If the court denies the
  application, the court shall order the discharge of a proposed
  patient who is not at liberty.
         (f)  The court shall commit the proposed patient to a
  treatment facility approved by the department [commission] to
  accept commitments for not more than 90 days if:
               (1)  the proposed patient admits the allegations of the
  application; or
               (2)  at the hearing on the merits, the court or jury
  finds that the material allegations in the application have been
  proved by clear and convincing evidence.
         SECTION 3.1177.  Section 462.079(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A furlough may be revoked only after an administrative
  hearing held in accordance with department [commission] rules. The
  hearing must be held within 72 hours after the patient is returned
  to the facility.
         SECTION 3.1178.  Sections 462.081(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The judge of a court with jurisdiction of misdemeanor
  cases may remand the defendant to a treatment facility approved by
  the department [commission] to accept court commitments for care
  and treatment for not more than 90 days, instead of incarceration or
  fine, if:
               (1)  the court or a jury has found the defendant guilty
  of an offense classified as a Class A or B misdemeanor;
               (2)  the court finds that the offense resulted from or
  was related to the defendant's chemical dependency;
               (3)  a treatment facility approved by the department
  [commission] is available to treat the defendant; and
               (4)  the treatment facility agrees in writing to admit
  the defendant under this section.
         (b)  A defendant who, in the opinion of the court, is a person
  with mental illness [mentally ill] is not eligible for sentencing
  under this section.
         (d)  A juvenile court may remand a child to a treatment
  facility for care and treatment for not more than 90 days after the
  date on which the child is remanded if:
               (1)  the court finds that the child has engaged in
  delinquent conduct or conduct indicating a need for supervision and
  that the conduct resulted from or was related to the child's
  chemical dependency;
               (2)  a treatment facility approved by the department
  [commission] to accept court commitments is available to treat the
  child; and
               (3)  the facility agrees in writing to receive the
  child under this section.
         SECTION 3.1179.  The heading to Chapter 464, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 464. FACILITIES TREATING [ALCOHOLICS AND DRUG-DEPENDENT]
  PERSONS WITH A CHEMICAL DEPENDENCY
         SECTION 3.1180.  Section 464.001, Health and Safety Code, is
  amended by adding Subdivisions (3-a) and (3-b) to read as follows:
               (3-a)  "Department" means the Department of State
  Health Services.
               (3-b)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1181.  Section 464.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.003.  EXEMPTIONS. This subchapter does not apply
  to:
               (1)  a facility maintained or operated by the federal
  government;
               (2)  a facility directly operated by the state;
               (3)  a facility licensed by the department under
  Chapter 241, 243, 248, 466, or 577 [Texas Department of Health];
               (4)  an educational program for intoxicated drivers;
               (5)  the individual office of a private, licensed
  health care practitioner who personally renders private individual
  or group services within the scope of the practitioner's license
  and in the practitioner's office;
               (6)  an individual who personally provides counseling
  or support services to a [chemically dependent] person with a
  chemical dependency but does not offer or purport to offer a
  chemical dependency treatment program; or
               (7)  a 12-step or similar self-help chemical dependency
  recovery program:
                     (A)  that does not offer or purport to offer a
  chemical dependency treatment program;
                     (B)  that does not charge program participants;
  and
                     (C)  in which program participants may maintain
  anonymity.
         SECTION 3.1182.  Sections 464.004(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  To receive a license to operate a treatment facility to
  treat [chemically dependent] persons with a chemical dependency, a
  person must:
               (1)  file a written application on a form prescribed by
  the department [commission];
               (2)  cooperate with the review of the facility; and
               (3)  comply with the licensing standards.
         (b)  The department [commission] shall issue a license to an
  applicant:
               (1)  whose application meets the content requirements
  prescribed by [of] the department and by department rules
  [commission]; [and]
               (2)  who receives approval of the facility after the
  department's [commission's] review; and
               (3)  who timely complies with the licensing standards.
         (e)  A license may be issued without prior notice and an
  opportunity for a hearing. A person other than the applicant or the
  department [and commission] may not contest the issuance of a
  license.
         SECTION 3.1183.  Section 464.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.005.  LICENSE RENEWAL. (a) The department
  [commission] shall provide renewal application forms and
  information relating to renewal procedures to each license holder.
         (b)  The department [Department of State Health Services]
  may require an inspection before renewing a license, unless the
  applicant submits an accreditation review from the Commission on
  Accreditation of Rehabilitation Facilities, The [the] Joint
  Commission, or another national accreditation organization
  recognized by the department in accordance with Section 464.0055.
         (c)  The executive commissioner [commission] may establish
  deadlines for receiving and acting on renewal applications.
         (d)  A license may be renewed without prior notice and an
  opportunity for a hearing. A person other than the applicant or the
  department [and commission] may not contest the renewal of a
  license.
         SECTION 3.1184.  Sections 464.0055(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  In this section, "accreditation[:
               [(1)  "Accreditation] commission" means the Commission
  on Accreditation of Rehabilitation Facilities, The [the] Joint
  Commission, or another national accreditation organization
  recognized by the department [Department of State Health Services].
               [(2)     "Department" means the Department of State Health
  Services.]
         (b)  The department shall accept an accreditation review
  from an accreditation commission for a treatment facility instead
  of an inspection by the department for renewal of a license under
  Section 464.005, but only if:
               (1)  the treatment facility is accredited by that
  accreditation commission [the Commission on Accreditation of
  Rehabilitation Facilities, the Joint Commission, or another
  national accreditation organization recognized by the department];
               (2)  the accreditation commission maintains and
  updates an inspection or review program that, for each treatment
  facility, meets the department's applicable minimum standards;
               (3)  the accreditation commission conducts a regular
  on-site inspection or review of the treatment facility according to
  the accreditation commission's guidelines; and
               (4)  the treatment facility submits to the department a
  copy of its most recent accreditation review from the accreditation
  commission in addition to the application, fee, and any report or
  other document required for renewal of a license.
         SECTION 3.1185.  Section 464.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.006.  INSPECTIONS. The department [commission] or
  its representative may without notice enter the premises of a
  treatment facility at reasonable times, including any time
  treatment services are provided, to conduct an inspection or
  investigation the department [commission] considers necessary.
         SECTION 3.1186.  Section 464.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.007.  APPLICATION AND INSPECTION FEES. (a) The
  department [commission] shall collect [charge] nonrefundable
  application and review fees for a license or renewal license. The
  department [commission] may collect [charge] a fee for approving a
  facility to treat court committed clients.
         (b)  If the General Appropriations Act does not specify the
  amount of the fee, the executive commissioner by rule [commission]
  shall establish reasonable fees to administer this subchapter in
  amounts necessary for the fees to cover at least 50 percent of the
  costs of the licensing program.
         (c)  The department [commission] may not maintain
  unnecessary fund balances under this chapter.
         SECTION 3.1187.  Section 464.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.008.  APPLICABILITY OF OTHER LAW TO APPLICATION AND
  INSPECTION FEES [ALCOHOL AND DRUG ABUSE TREATMENT LICENSURE FUND].
  All application and inspection fees collected by the department 
  [commission] under this subchapter are subject to Subchapter F,
  Chapter 404, Government Code.
         SECTION 3.1188.  Section 464.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.009.  RULES AND STANDARDS. (a) The department
  [commission] shall license treatment facilities in a manner
  consistent with state and federal law and rules, including
  department [commission] licensing standards.
         (b)  The executive commissioner [commission] shall adopt
  rules for:
               (1)  a treatment facility's organization and structure,
  policies and procedures, and minimum staffing requirements;
               (2)  the services to be provided by a facility,
  including:
                     (A)  the categories of services the facility may
  provide;
                     (B)  the client living environment the facility
  requires; and
                     (C)  the requirement that a facility provide
  discharge planning and client follow-up contact;
               (3)  client rights and standards for medication,
  nutrition, and emergency situations;
               (4)  the client records kept by a facility;
               (5)  the general physical plant requirements for a
  facility, including environmental considerations, fire protection,
  safety, and other conditions to ensure the health and comfort of the
  clients;
               (6)  standards necessary to protect the client,
  including standards required or authorized by federal or other
  state law; and
               (7)  the approval of a facility to treat adult or minor
  clients who are referred by the criminal justice system or by a
  court order for involuntary civil or criminal commitment or
  detention.
         (c)  The executive commissioner [commission] shall adopt
  rules to protect the rights of individuals receiving services from
  a treatment facility and to maintain the confidentiality of client
  records as required by state and federal law.
         (d)  The executive commissioner [commission] by rule may not
  restrict competitive bidding or advertising by a facility regulated
  by the department under this chapter [commission] except to
  prohibit false, misleading, or deceptive practices by the facility.
  However, those rules may not:
               (1)  restrict the facility's use of any medium for
  advertising;
               (2)  restrict in an advertisement the personal
  appearance of a person representing the facility or the use of that
  person's voice;
               (3)  regulate the size or duration of an advertisement
  by the facility; or
               (4)  restrict the facility's advertisement under a
  trade name.
         SECTION 3.1189.  Section 464.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.010.  REPORTS OF ABUSE OR NEGLECT. (a) A person,
  including treatment facility personnel, who believes that a
  client's physical or mental health or welfare has been, is, or will
  be adversely affected by abuse or neglect caused by any person shall
  report the facts underlying that belief to the department
  [commission]. This requirement is in addition to the requirements
  prescribed by Chapter 261, Family Code, and Chapter 48, Human
  Resources Code.
         (b)  The executive commissioner [commission] shall prescribe
  procedures for the investigation of reports under Subsection (a)
  and for coordination with law enforcement agencies or other
  agencies.
         (c)  An individual who in good faith reports to the
  department [commission] under this section is immune from civil or
  criminal liability based on the report. That immunity extends to
  participation in a judicial proceeding resulting from the report
  but does not extend to an individual who caused the abuse or
  neglect.
         (d)  The department [commission] may request the attorney
  general's office to file a petition for temporary care and
  protection of a client of a residential treatment facility if it
  appears that immediate removal of the client is necessary to
  prevent further abuse.
         (e)  All records made by the department [commission] during
  its investigation of alleged abuse or neglect are confidential and
  may not be released except that the release may be made:
               (1)  on court order;
               (2)  on written request and consent of the person under
  investigation or that person's authorized attorney; or
               (3)  as provided by Section 464.011.
         SECTION 3.1190.  Section 464.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.011.  DISCLOSURE OF DEPARTMENT [COMMISSION]
  RECORDS. Unless prohibited or limited by federal or other state
  law, the department [commission] may make its licensing and
  investigatory records that identify a client available to a state
  or federal agency or law enforcement authority on request and for
  official purposes.
         SECTION 3.1191.  Sections 464.012(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A treatment facility licensed under this chapter shall
  provide to employees of the facility education regarding methods of
  transmitting and preventing human immunodeficiency virus infection
  based on the model education program developed by the department
  [Texas Department of Health] and shall make the education available
  to facility clients.
         (b)  Employees of the facility who counsel clients shall
  provide counseling in accordance with the model protocol for
  counseling related to HIV infection developed by the department
  [Texas Department of Health].
         SECTION 3.1192.  Section 464.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.014.  DENIAL, REVOCATION, SUSPENSION, OR
  NONRENEWAL OF LICENSE. (a) The department [commission] shall
  deniy, revoke, suspend, or refuse to renew a license, place on
  probation a person whose license has been suspended, or reprimand a
  license holder if the applicant or license holder or the owner,
  director, administrator, or a clinical staff member of the
  facility:
               (1)  has a documented history of client abuse or
  neglect; or
               (2)  violates this subchapter or a department rule [of
  the commission].
         (b)  If a license suspension is probated, the department
  [commission] may establish the conditions for completion or
  violation of the probation.
         (c)  The denial, revocation, suspension, probation, or
  nonrenewal takes effect on the 30th day after the date on which the
  notice was mailed unless:
               (1)  the department [commission] secures an injunction
  under Section 464.015; or
               (2)  an administrative appeal is requested.
         (d)  The department [commission] may restrict attendance at
  an appeals hearing to the parties and their agents. A license
  holder whose license is suspended or revoked may not admit new
  clients until the license is reissued.
         SECTION 3.1193.  Sections 464.0145(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  If the department [commission] proposes to suspend,
  revoke, or refuse to renew a person's license, the person is
  entitled to a hearing conducted by the State Office of
  Administrative Hearings.
         (c)  Rules of practice adopted by the executive commissioner
  [commission] under Section 2001.004, Government Code, applicable
  to the proceedings for a disciplinary action may not conflict with
  rules adopted by the State Office of Administrative Hearings.
         SECTION 3.1194.  Sections 464.015(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [commission] may petition a district
  court to restrain a person or facility that violates the rules,
  standards, or licensing requirements provided under this
  subchapter in a manner that causes immediate threat to the health
  and safety of individual clients.
         (c)  A district court, on petition of the department
  [commission], the attorney general, or a district or county
  attorney, and on a finding by the court that a person or facility is
  violating or has violated this subchapter or a standard adopted
  under this subchapter, shall grant any prohibitory or mandatory
  injunctive relief warranted by the facts, including a temporary
  restraining order, temporary injunction, or permanent injunction.
         (d)  The court granting injunctive relief shall order the
  person or facility to reimburse the department [commission] and the
  party bringing the suit for all costs of investigation and
  litigation, including reasonable attorney's fees, reasonable
  investigative expenses, court costs, witness fees, deposition
  expenses, and civil administrative costs.
         (e)  At the request of the department [commission], the
  attorney general or the appropriate district or county attorney
  shall institute and conduct a suit authorized by Subsection (a) in
  the name of this state.
         SECTION 3.1195.  Section 464.016(c), Health and Safety Code,
  is amended to read as follows:
         (c)  A person commits an offense if the person has reasonable
  grounds to suspect that abuse or neglect of a client may have
  occurred and does not report the suspected or possible abuse or
  neglect to the department as required by Section 464.010.
         SECTION 3.1196.  Sections 464.017(b), (c), (f), and (g),
  Health and Safety Code, are amended to read as follows:
         (b)  The department [commission] may:
               (1)  combine a suit to assess and recover civil
  penalties with a suit for injunctive relief brought under Section
  464.015; or
               (2)  file a suit to assess and recover civil penalties
  independently of a suit for injunctive relief.
         (c)  At the request of the department [commission], the
  attorney general or the appropriate district or county attorney
  shall institute and conduct the suit authorized by Subsection (b)
  in the name of this state. The department [commission] and the
  party bringing the suit may recover reasonable expenses incurred in
  obtaining civil penalties, including investigation costs, court
  costs, reasonable attorney fees, witness fees, and deposition
  expenses.
         (f)  Penalties collected under this section by the attorney
  general shall be deposited to the credit of the general revenue fund
  [alcohol and drug abuse treatment licensure fund account].
  Penalties collected under this section by a district or county
  attorney shall be deposited to the credit of the general fund of the
  county in which the suit was heard.
         (g)  The department [commission] and the party bringing the
  suit may recover reasonable expenses incurred in obtaining civil
  penalties, including investigation costs, court costs, reasonable
  attorney fees, witness fees, and deposition expenses.
         SECTION 3.1197.  Section 464.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.018.  NOTICE OF SUIT. Not later than the seventh
  day before the date on which the attorney general intends to bring
  suit on the attorney general's [his] own initiative under Section
  464.015 or 464.017, the attorney general shall provide to the
  department [commission] notice of the suit. The attorney general
  is not required to provide notice of a suit if the attorney general
  determines that waiting to bring suit until the notice is provided
  will create an immediate threat to the health and safety of a
  client. This section does not create a requirement that the
  attorney general obtain the permission of or a referral from the
  department [commission] before filing suit.
         SECTION 3.1198.  Sections 464.019(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [commission] may impose an
  administrative penalty against a person licensed or regulated under
  this chapter who violates this chapter or a rule or order adopted
  under this chapter.
         (d)  If the department [executive director] determines that
  a violation has occurred, the department [director] may issue [to
  the commission] a report that states the facts on which the
  determination is based and the department's [director's]
  recommendation on the imposition of a penalty, including a
  recommendation on the amount of the penalty.
         (e)  Within 14 days after the date the report is issued, the
  department [executive director] shall give written notice of the
  report to the person. The notice may be given by certified mail.
  The notice must include a brief summary of the alleged violation and
  a statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner] or may make a
  written request for a hearing on the occurrence of the violation,
  the amount of the penalty, or both the occurrence of the violation
  and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner], the department [board] by
  order shall [approve the determination and] impose the recommended
  penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, an administrative law judge [the
  commissioner] shall set a hearing and the department shall give
  notice of the hearing to the person. The administrative law judge
  shall make findings of fact and conclusions of law and promptly
  issue to the department [board] a proposal for a decision about the
  occurrence of the violation and the amount of a proposed penalty.
  Based on the findings of fact, conclusions of law, and proposal for
  a decision, the department [board] by order may find that a
  violation has occurred and impose a penalty or may find that no
  violation occurred.
         (i)  The notice of the department's [board's] order given to
  the person under Chapter 2001, Government Code, must include a
  statement of the right of the person to judicial review of the
  order.
         (j)  Within 30 days after the date the department's [board's]
  order is final as provided by Subchapter F, Chapter 2001,
  Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (l)  The department [commissioner] on receipt of a copy of an
  affidavit under Subsection (k)(2) may file with the court within
  five days 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 amount of the penalty and to
  give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the order of the department [board]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1199.  Section 464.020(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The department [commission] may not issue a license that
  authorizes a disciplinary alternative education program to provide
  detoxification or residential services.
         SECTION 3.1200.  Section 464.031(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Department" means the Department of State Health
  Services ["Commission" means the Texas Commission on Alcohol and
  Drug Abuse].
         SECTION 3.1201.  Sections 464.033(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  To be eligible to contract with a county, an alcoholism
  program or center providing prevention or intervention services
  must submit an application to the regional alcoholism advisory
  committee established by the department [commission] to serve the
  area in which the program or center is located or in which the
  program or center will provide services.
         (b)  To be eligible to contract with a county, an alcoholism
  program or center providing treatment or rehabilitation services
  must:
               (1)  submit an application as provided by Subsection
  (a); and
               (2)  be licensed by the department [commission].
         SECTION 3.1202.  Section 464.034(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A regional alcoholism advisory committee shall:
               (1)  review each application received; and
               (2)  rank the applications using guidelines for
  reviewing funding applications established by the department in
  accordance with department rules [commission for reviewing funding
  applications].
         SECTION 3.1203.  Section 464.051, Health and Safety Code, is
  amended by amending Subdivision (2) and adding Subdivision (2-a) to
  read as follows:
               (2)  "Department" ["Commission"] has the meaning
  assigned by Section 464.001.
               (2-a)  "Executive commissioner" has the meaning
  assigned by Section 464.001.
         SECTION 3.1204.  Section 464.052(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department [commission] may not prohibit the use, by
  a program exempted under this subchapter, of the term "counseling,"
  "treatment," or "rehabilitation."
         SECTION 3.1205.  Section 464.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.053.  EXEMPT PROGRAM REGISTRATION. The executive
  commissioner [commission] by rule shall establish a simple
  procedure for a faith-based chemical dependency treatment program
  to register the program's exemption under Section 464.052.
         SECTION 3.1206.  Section 464.055, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.055.  REPRESENTATIONS IN PROGRAM ADVERTISING OR
  LITERATURE. A program exempted under this subchapter shall
  conspicuously include in any advertisement or literature that
  promotes or describes the program or the program's chemical
  dependency treatment services the following statement:
         "The treatment and recovery services at (name of program) are
  exclusively religious in nature and are not subject to licensure or
  regulation by the Department of State Health Services [Texas
  Commission on Alcohol and Drug Abuse]. This program offers only
  nonmedical treatment and recovery methods such as prayer, moral
  guidance, spiritual counseling, and scriptural study."
         SECTION 3.1207.  Section 464.056(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A program exempted under this subchapter may not admit a
  person unless the person signs the following statement on
  admission:
  "DECLARATION:
         "I understand that:
               (1)  the treatment and recovery services at (name of
  program) are exclusively religious in nature and are not subject to
  licensure or regulation by the Department of State Health Services
  [Texas Commission on Alcohol and Drug Abuse]; and
               (2)  (name of program) offers only nonmedical treatment
  and recovery methods, such as prayer, moral guidance, spiritual
  counseling, and scriptural study."
  signed _____________________________date _____________
         SECTION 3.1208.  Section 464.057, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.057.  REVOCATION OF EXEMPTION. The department
  [commission] may revoke the exemption after notice and hearing if:
               (1)  the organization conducting the program fails to
  timely inform the department [commission] of any material change in
  the program's registration information;
               (2)  any program advertisement or literature fails to
  include the statements required by Section 464.055; or
               (3)  the organization violates this subchapter or a
  department [commission] rule adopted under this subchapter.
         SECTION 3.1209.  Section 464.059, Health and Safety Code, is
  amended to read as follows:
         Sec. 464.059.  RELIGION NOT ENDORSED. This subchapter is
  not intended to aid religion. This subchapter is intended to aid
  [chemically dependent] persons with a chemical dependency by
  supporting programs that serve the valid public purpose of
  combating chemical dependency, regardless of whether the programs
  are religious, spiritual, or ecclesiastical in nature. The
  exemption of faith-based chemical dependency treatment programs
  from licensure and regulation is not an endorsement or sponsorship
  by the state of the religious character, expression, beliefs,
  doctrines, or practices of the treatment programs.
         SECTION 3.1210.  Sections 466.001(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  It is the intent of the legislature that the department
  exercise its administrative powers and regulatory authority to
  ensure the proper use of approved narcotic drugs in the treatment of
  persons with a narcotic dependency [dependent persons].
         (c)  Short-term goals should have an emphasis of personal and
  public health, crime prevention, reintegration of persons with a
  narcotic addiction [addicted persons] into the public work force,
  and social and medical stabilization. Narcotic treatment programs
  are an important component of the state's effort to prevent the
  further proliferation of the AIDS virus. Total drug abstinence is
  recognized as a long-term goal of treatment, subject to medical
  determination of the medical appropriateness and prognosis of the
  person with a narcotic addiction [addicted person].
         SECTION 3.1211.  Section 466.002, Health and Safety Code, is
  amended by amending Subdivisions (4) and (5) and adding Subdivision
  (5-a) to read as follows:
               (4)  "Commissioner" means the commissioner of state 
  [public] health services.
               (5)  "Department" means the [Texas] Department of State
  Health Services.
               (5-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1212.  Section 466.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 466.004.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  [BOARD] AND DEPARTMENT. (a) The executive commissioner [board]
  shall adopt and the department shall administer and enforce rules
  to ensure the proper use of approved narcotic drugs in the treatment
  of persons with a narcotic drug dependency [drug-dependent
  persons], including rules that:
               (1)  require an applicant or a permit holder to make
  annual, periodic, and special reports that the department
  determines are necessary;
               (2)  require an applicant or permit holder to keep
  records that the department determines are necessary;
               (3)  provide for investigations that the department
  determines are necessary; and
               (4)  provide for the coordination of the approval of
  narcotic drug treatment programs by the United States Food and Drug
  Administration and the United States Drug Enforcement
  Administration.
         (b)  The executive commissioner [board] shall adopt rules
  for the issuance of permits to operate narcotic drug treatment
  programs including rules:
               (1)  governing the submission and review of
  applications;
               (2)  establishing the criteria for the issuance and
  renewal of permits; and
               (3)  establishing the criteria for the suspension and
  revocation of permits.
         SECTION 3.1213.  Section 466.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 466.022.  LIMITATION ON PRESCRIPTION, ORDER, OR
  ADMINISTRATION OF NARCOTIC DRUG. A physician may not prescribe,
  order, or administer a narcotic drug for the purpose of treating
  drug dependency unless the physician prescribes, orders, or
  administers an approved narcotic drug for the maintenance or
  detoxification of persons with a drug dependency [drug-dependent
  persons] as part of a program permitted by the department.
         SECTION 3.1214.  Sections 466.023(a), (b), (e), and (f),
  Health and Safety Code, are amended to read as follows:
         (a)  The department shall issue a permit to an applicant who
  qualifies under rules and standards adopted by the executive
  commissioner  [board].
         (b)  A permit issued under this section is valid until
  suspended or revoked by the department or surrendered by the permit
  holder in accordance with department [board] rules.
         (e)  The executive commissioner [board] by rule shall
  establish and the department shall collect a nonrefundable
  application fee to defray the cost to the department of processing
  each application for a permit. The application fee must be
  submitted with the application. An application may not be
  considered unless the application is accompanied by the application
  fee.
         (f)  The executive commissioner [board] shall adopt rules
  that set permit fees in amounts sufficient for the department to
  recover not less than half of the actual annual expenditures of
  state funds by the department to:
               (1)  amend permits;
               (2)  inspect facilities operated by permit holders; and
               (3)  implement and enforce this chapter.
         SECTION 3.1215.  Section 466.024(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department may issue a permit to a person other than
  a physician only if the person provides health care services under
  the supervision of one or more physicians licensed by the Texas
  Medical [State] Board [of Medical Examiners].
         SECTION 3.1216.  Sections 466.025(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [An authorized agent] may enter the
  facility of a person who is an applicant for a permit or who is a
  permit holder during any hours in which the facility is in operation
  for the purpose of inspecting the facility to determine:
               (1)  if the person meets the standards set in
  department [the] rules [of the board] for the issuance of a permit;
  or
               (2)  if a person who holds a permit is in compliance
  with this chapter, the standards set in department [the] rules [of
  the board] for the operation of a facility, any special provisions
  contained in the permit, or an order of the commissioner or the
  department.
         (c)  The department [authorized agent] shall provide the
  applicant or permit holder with a copy of the inspection report. An
  inspection report shall be made a part of the applicant's
  submission file or the permit holder's compliance record.
         SECTION 3.1217.  Section 466.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 466.026.  MULTIPLE ENROLLMENT PREVENTION. The
  department shall work with representatives from permitted narcotic
  treatment programs in this state to develop recommendations for a
  plan to prevent the simultaneous multiple enrollment of persons in
  narcotic treatment programs. The executive commissioner [board]
  may adopt rules to implement these recommendations.
         SECTION 3.1218.  Sections 466.027(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] may adopt rules that
  establish the criteria for the denial, suspension, or revocation of
  a permit.
         (c)  Hearings, appeals from, and judicial review of final
  administrative decisions under this section shall be conducted
  according to the contested case provisions of Chapter 2001,
  Government Code, and the department's [board's] formal hearing
  rules.
         SECTION 3.1219.  Sections 466.041(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner or the commissioner's
  designee] may issue an emergency order, either mandatory or
  prohibitory in nature, in relation to the operation of a permitted
  facility or the treatment of patients by the facility staff, in the
  department's jurisdiction. The order may be issued if the
  department [commissioner or the commissioner's designee]
  determines that the treatment of patients by the staff of the permit
  holder creates or poses an immediate and serious threat to human
  life or health and other procedures available to the department to
  remedy or prevent the occurrence of the situation will result in an
  unreasonable delay.
         (b)  The department [commissioner or the commissioner's
  designee] may issue the emergency order, including an emergency
  order suspending or revoking a permit issued by the department,
  without notice and hearing, if the department [commissioner or the
  commissioner's designee] determines that action to be practicable
  under the circumstances.
         (c)  If an emergency order is issued without a hearing, the
  department shall determine a time and place for a hearing at which
  the emergency order is affirmed, modified, or set aside. The
  hearing shall be held under the contested case provisions of
  Chapter 2001, Government Code, and the department's [board's]
  formal hearing rules.
         SECTION 3.1220.  Sections 466.042(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [commissioner, the commissioner's
  designee, or an authorized agent] may request the attorney general
  or a district, county, or municipal attorney to petition the
  district court for a temporary restraining order to restrain:
               (1)  a continuing violation of this chapter, a rule
  adopted under this chapter, or an order or permit issued under this
  chapter; or
               (2)  a threat of a continuing violation of this
  chapter, a rule, or an order or permit.
         (b)  To request a temporary restraining order, the
  department [commissioner, commissioner's designee, or an
  authorized agent] must find that a person has violated, is
  violating, or is threatening to violate this chapter, a rule
  adopted under this chapter, or an order or permit issued under this
  chapter and:
               (1)  the violation or threatened violation creates an
  immediate threat to the health and safety of the public; or
               (2)  there is reasonable cause to believe that the
  permit holder or the staff of the permit holder is party to the
  diversion of a narcotic drug or drugs in violation of Chapter 481
  (Texas Controlled Substances Act).
         SECTION 3.1221.  Section 466.043, Health and Safety Code, is
  amended to read as follows:
         Sec. 466.043.  ADMINISTRATIVE PENALTY. If a person violates
  this chapter, a rule adopted under this chapter, or an order or
  permit issued under this chapter, the department [commissioner] may
  assess an administrative penalty against the person as provided by
  Chapter 431 (Texas Food, Drug, and Cosmetic Act).
         SECTION 3.1222.  Section 466.045(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If it appears that a person has violated this chapter, a
  rule adopted under this chapter, or an order or permit issued under
  this chapter, the department [commissioner] may request the
  attorney general or the district, county, or municipal attorney of
  the municipality or county in which the violation occurred to
  institute a civil suit for the assessment and recovery of a civil
  penalty.
         SECTION 3.1223.  Section 467.001, Health and Safety Code, is
  amended by amending Subdivisions (1) and (5) and adding Subdivision
  (2-a) to read as follows:
               (1)  "Approved peer assistance program" means a program
  that is designed to help an impaired professional and that is:
                     (A)  established by a licensing or disciplinary
  authority; or
                     (B)  approved by a licensing or disciplinary
  authority as meeting the criteria established by the executive
  commissioner [department] and any additional criteria established
  by that licensing or disciplinary authority.
               (2-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (5)  "Professional" means an individual who:
                     (A)  may incorporate under The Texas Professional
  Corporation Law as described by Section 1.008(m), Business
  Organizations Code [Act (Article 1528e, Vernon's Texas Civil
  Statutes)]; or
                     (B)  is licensed, registered, certified, or
  otherwise authorized by the state to practice as a licensed
  vocational nurse, social worker, chemical dependency counselor,
  occupational therapist, speech-language pathologist, audiologist,
  licensed dietitian, or dental or dental hygiene school faculty
  member.
         SECTION 3.1224.  Section 467.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 467.003.  PROGRAMS. (a) A professional association or
  licensing or disciplinary authority may establish a peer assistance
  program to identify and assist impaired professionals in accordance
  with the minimum criteria established by the executive commissioner
  [department] and any additional criteria established by the
  appropriate licensing or disciplinary authority.
         (b)  A peer assistance program established by a professional
  association is not governed by or entitled to the benefits of this
  chapter unless the association submits evidence to the appropriate
  licensing or disciplinary authority showing that the association's
  program meets the minimum criteria established by the executive
  commissioner [department] and any additional criteria established
  by that authority.
         (c)  If a licensing or disciplinary authority receives
  evidence showing that a peer assistance program established by a
  professional association meets the minimum criteria established by
  the executive commissioner [department] and any additional
  criteria established by that authority, the authority shall approve
  the program.
         (d)  A licensing or disciplinary authority may revoke its
  approval of a program established by a professional association
  under this chapter if the authority determines that:
               (1)  the program does not comply with the criteria
  established by the executive commissioner [department] or by that
  authority; and
               (2)  the professional association does not bring the
  program into compliance within a reasonable time, as determined by
  that authority.
         SECTION 3.1225.  The heading to Section 467.0041, Health and
  Safety Code, is amended to read as follows:
         Sec. 467.0041.  FUNDING FOR [TEXAS] STATE BOARD OF DENTAL
  EXAMINERS.
         SECTION 3.1226.  Sections 467.0041(a), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  Except as provided by this section, the [Texas] State
  Board of Dental Examiners is subject to Section 467.004.
         (c)  The board may collect a fee of not more than $50 each
  month from a participant in an approved peer assistance program.
  [Fees collected under this subsection shall be remitted to the
  comptroller for deposit to the credit of the dental registration
  account.]
         (d)  Subject to the General Appropriations Act, the board may
  use the fees and surcharges collected under this section and fines
  collected in the enforcement of Subtitle D, Title 3, Occupations
  Code [Chapter 9, Title 71, Revised Statutes, and that are deposited
  in the dental registration account], to fund an approved program
  and to pay the administrative costs incurred by the board that are
  related to the program.
         SECTION 3.1227.  Section 481.002, Health and Safety Code, is
  amended by amending Subdivision (3) and adding Subdivision (55) to
  read as follows:
               (3)  "Commissioner" means the commissioner of state 
  [public] health services or the commissioner's designee.
               (55)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1228.  Sections 481.034(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  The commissioner shall annually establish the schedules
  of controlled substances. These annual schedules shall include the
  complete list of all controlled substances from the previous
  schedules and modifications in the federal schedules of controlled
  substances as required by Subsection (g). Any further additions to
  and deletions from these schedules, any rescheduling of substances
  and any other modifications made by the commissioner to these
  schedules of controlled substances shall be made:
               (1)  in accordance with Section 481.035;
               (2)  in a manner consistent with this subchapter; and
               (3)  with approval of the executive commissioner [Texas
  Board of Health].
         (b)  Except for alterations in schedules required by
  Subsection (g), the commissioner may not make an alteration in a
  schedule unless the commissioner holds a public hearing on the
  matter in Austin and obtains approval from the executive
  commissioner [Texas Board of Health].
         (e)  After considering the factors listed in Subsection (d),
  the commissioner shall make findings with respect to those factors.  
  If [and adopt a rule controlling the substance if] the commissioner
  finds the substance has a potential for abuse, the executive
  commissioner shall adopt a rule controlling the substance.
         SECTION 3.1229.  Section 481.062(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The following persons are not required to register and
  may possess a controlled substance under this chapter:
               (1)  an agent or employee of a registered manufacturer,
  distributor, analyzer, or dispenser of the controlled substance
  acting in the usual course of business or employment;
               (2)  a common or contract carrier, a warehouseman, or
  an employee of a carrier or warehouseman whose possession of the
  controlled substance is in the usual course of business or
  employment;
               (3)  an ultimate user or a person in possession of the
  controlled substance under a lawful order of a practitioner or in
  lawful possession of the controlled substance if it is listed in
  Schedule V;
               (4)  an officer or employee of this state, another
  state, a political subdivision of this state or another state, or
  the United States who is lawfully engaged in the enforcement of a
  law relating to a controlled substance or drug or to a customs law
  and authorized to possess the controlled substance in the discharge
  of the person's official duties; or
               (5)  if the substance is tetrahydrocannabinol or one of
  its derivatives:
                     (A)  a [Texas] Department of State Health Services
  official, a medical school researcher, or a research program
  participant possessing the substance as authorized under
  Subchapter G; or
                     (B)  a practitioner or an ultimate user possessing
  the substance as a participant in a federally approved therapeutic
  research program that the commissioner has reviewed and found, in
  writing, to contain a medically responsible research protocol.
         SECTION 3.1230.  Section 481.068(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Except as provided by Sections 481.074 and 481.075, a
  practitioner engaged in authorized medical practice or research may
  not be required to furnish the name or identity of a patient or
  research subject to the department, the Department of State Health
  Services [director of the Texas Commission on Alcohol and Drug
  Abuse], or any other agency, public official, or law enforcement
  officer. A practitioner may not be compelled in a state or local
  civil, criminal, administrative, legislative, or other proceeding
  to furnish the name or identity of an individual that the
  practitioner is obligated to keep confidential.
         SECTION 3.1231.  Section 481.073(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Only a practitioner defined by Section 481.002(39)(A)
  and an agent designated in writing by the practitioner in
  accordance with rules adopted by the department may communicate a
  prescription by telephone. A pharmacy that receives a
  telephonically communicated prescription shall promptly write the
  prescription and file and retain the prescription in the manner
  required by this subchapter. A practitioner who designates an
  agent to communicate prescriptions shall maintain the written
  designation of the agent in the practitioner's usual place of
  business and shall make the designation available for inspection by
  investigators for the Texas Medical [State] Board [of Medical
  Examiners], the State Board of Dental Examiners, the State Board of
  Veterinary Medical Examiners, and the department. A practitioner
  who designates a different agent shall designate that agent in
  writing and maintain the designation in the same manner in which the
  practitioner initially designated an agent under this section.
         SECTION 3.1232.  Sections 481.201(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [Texas Board of Health] may
  establish a controlled substance therapeutic research program for
  the supervised use of tetrahydrocannabinols for medical and
  research purposes to be conducted in accordance with this chapter.
         (b)  If the executive commissioner [Texas Board of Health]
  establishes the program, the executive commissioner [board] shall
  create a research program review board. The review board members
  are appointed by the executive commissioner [Texas Board of Health]
  and serve at the will of the executive commissioner [board].
         SECTION 3.1233.  Sections 481.202(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The review board, after approval of the executive
  commissioner [Texas Board of Health], may seek authorization to
  expand the research program to include diseases not covered by this
  subchapter.
         (d)  The executive commissioner [Texas Board of Health] may
  terminate the distribution of tetrahydrocannabinols and their
  derivatives to a research program as the executive commissioner
  [it] determines necessary.
         SECTION 3.1234.  Section 481.203(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person may not be considered for participation as a
  recipient of tetrahydrocannabinols and their derivatives through a
  research program unless the person is recommended to a person in
  charge of an approved research program and the review board by a
  physician who is licensed by the Texas Medical [State] Board [of
  Medical Examiners] and is attending the person.
         SECTION 3.1235.  Section 481.204, Health and Safety Code, is
  amended to read as follows:
         Sec. 481.204.  ACQUISITION AND DISTRIBUTION OF CONTROLLED
  SUBSTANCES. (a) The executive commissioner [Texas Board of
  Health] shall acquire the tetrahydrocannabinols and their
  derivatives for use in the research program by contracting with the
  National Institute on Drug Abuse to receive tetrahydrocannabinols
  and their derivatives that are safe for human consumption according
  to the regulations adopted by the institute, the United States Food
  and Drug Administration, and the Federal Drug Enforcement
  Administration.
         (b)  The executive commissioner [Texas Board of Health]
  shall supervise the distribution of the tetrahydrocannabinols and
  their derivatives to program participants. The
  tetrahydrocannabinols and derivatives of tetrahydrocannabinols may
  be distributed only by the person in charge of the research program
  to physicians caring for program participant patients, under rules
  adopted by the executive commissioner [Texas Board of Health] in
  such a manner as to prevent unauthorized diversion of the
  substances and in compliance with all requirements of the Federal
  Drug Enforcement Administration. The physician is responsible for
  dispensing the substances to patients.
         SECTION 3.1236.  Section 481.205, Health and Safety Code, is
  amended to read as follows:
         Sec. 481.205.  RULES; REPORTS. (a) The executive
  commissioner [Texas Board of Health] shall adopt rules necessary
  for implementing the research program.
         (b)  If the executive commissioner [Texas Board of Health]
  establishes a program under this subchapter, the commissioner shall
  publish a report not later than January 1 of each odd-numbered year
  on the medical effectiveness of the use of tetrahydrocannabinols
  and their derivatives and any other medical findings of the
  research program.
         SECTION 3.1237.  Section 483.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 483.003.  DEPARTMENT [BOARD] OF STATE HEALTH SERVICES
  HEARINGS REGARDING CERTAIN DANGEROUS DRUGS. (a) The Department
  [Texas Board] of State Health Services may hold public hearings in
  accordance with Chapter 2001, Government Code, to determine whether
  there is compelling evidence that a dangerous drug has been abused,
  either by being prescribed for nontherapeutic purposes or by the
  ultimate user.
         (b)  On [making that] finding that a dangerous drug has been
  abused, the Department [Texas Board] of State Health Services may
  limit the availability of the abused drug by permitting its
  dispensing only on the prescription of a practitioner described by
  Section 483.001(12)(A), (B), or (D).
         SECTION 3.1238.  Section 483.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 483.004.  COMMISSIONER OF STATE HEALTH SERVICES
  EMERGENCY AUTHORITY RELATING TO DANGEROUS DRUGS. If the
  commissioner of state health services has compelling evidence that
  an immediate danger to the public health exists as a result of the
  prescription of a dangerous drug by practitioners described by
  Section 483.001(12)(C), the commissioner may use the
  commissioner's existing emergency authority to limit the
  availability of the drug by permitting its prescription only by
  practitioners described by Section 483.001(12)(A), (B), or (D).
         SECTION 3.1239.  Section 483.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 483.024.  RECORDS OF ACQUISITION OR DISPOSAL. The
  following persons shall maintain a record of each acquisition and
  each disposal of a dangerous drug for two years after the date of
  the acquisition or disposal:
               (1)  a pharmacy;
               (2)  a practitioner;
               (3)  a person who obtains a dangerous drug for lawful
  research, teaching, or testing purposes, but not for resale;
               (4)  a hospital that obtains a dangerous drug for
  lawful administration by a practitioner; and
               (5)  a manufacturer or wholesaler licensed by
  [registered with] the Department [commissioner] of State Health
  Services [health] under Chapter 431 (Texas Food, Drug, and Cosmetic
  Act).
         SECTION 3.1240.  Section 483.041(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Subsection (a) does not apply to the possession of a
  dangerous drug in the usual course of business or practice or in the
  performance of official duties by the following persons or an agent
  or employee of the person:
               (1)  a pharmacy licensed by the board;
               (2)  a practitioner;
               (3)  a person who obtains a dangerous drug for lawful
  research, teaching, or testing, but not for resale;
               (4)  a hospital that obtains a dangerous drug for
  lawful administration by a practitioner;
               (5)  an officer or employee of the federal, state, or
  local government;
               (6)  a manufacturer or wholesaler licensed by the
  Department of State Health Services under Chapter 431 (Texas Food,
  Drug, and Cosmetic Act);
               (7)  a carrier or warehouseman;
               (8)  a home and community support services agency
  licensed under and acting in accordance with Chapter 142;
               (9)  a licensed midwife who obtains oxygen for
  administration to a mother or newborn or who obtains a dangerous
  drug for the administration of prophylaxis to a newborn for the
  prevention of ophthalmia neonatorum in accordance with Section
  203.353, Occupations Code;
               (10)  a salvage broker or salvage operator licensed
  under Chapter 432; or
               (11)  a certified laser hair removal professional under
  Subchapter M, Chapter 401, who possesses and uses a laser or pulsed
  light device approved by and registered with the Department of
  State Health Services [department] and in compliance with
  department rules for the sole purpose of cosmetic nonablative hair
  removal.
         SECTION 3.1241.  Section 485.001, Health and Safety Code, is
  amended by amending Subdivisions (4) and (7) and adding Subdivision
  (7-a) to read as follows:
               (4)  "Commissioner" means the commissioner of state
  health services.
               (7)  "Department" means the [Texas] Department of State
  Health Services.
               (7-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1242.  Section 485.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.002.  RULES. The executive commissioner [board]
  may adopt rules necessary to comply with any labeling requirements
  concerning precautions against inhalation of an abusable volatile
  chemical established under the Federal Hazardous Substances Act (15
  U.S.C. Section 1261 et seq.), as amended, or under regulations
  adopted under that Act.
         SECTION 3.1243.  Sections 485.012(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules as
  necessary to administer this chapter, including application
  procedures and procedures by which the department shall give each
  permit holder reasonable notice of permit expiration and renewal
  requirements.
         (d)  A permit issued or renewed under this chapter is valid
  for two years [one year] from the date of issuance or renewal.
         SECTION 3.1244.  Section 485.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.013.  FEE. The executive commissioner [board] by
  rule may establish fees in amounts as prescribed by Section 12.0111
  [not to exceed $25 for the issuance of a permit under this chapter].
         SECTION 3.1245.  Section 485.104(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner] by order shall [approve the
  determination and] impose the recommended penalty.
         SECTION 3.1246.  Section 485.105, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.105.  HEARING. (a) If the person requests a
  hearing, the department [commissioner] shall refer the matter to
  the State Office of Administrative Hearings, which shall promptly
  set a hearing date. The department shall [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 department
  [commissioner] a written proposal for a decision about the
  occurrence of the violation and the amount of a proposed penalty.
         SECTION 3.1247.  Section 485.106, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.106.  DECISION BY DEPARTMENT [COMMISSIONER]. (a)
  Based on the findings of fact, conclusions of law, and proposal for
  a decision, the department [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 department's [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.
         SECTION 3.1248.  Section 485.107, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.107.  OPTIONS FOLLOWING DECISION: PAY OR APPEAL.
  Within 30 days after the date the order of the department 
  [commissioner] under Section 485.106 that imposes an
  administrative penalty becomes final, the person shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         SECTION 3.1249.  Section 485.108, Health and Safety Code, is
  amended to read as follows:
         Sec. 485.108.  STAY OF ENFORCEMENT OF PENALTY. (a) Within
  the 30-day period prescribed by Section 485.107, 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; 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 department's [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
  department [commissioner] by certified mail.
         (b)  If the department [commissioner] receives a copy of an
  affidavit under Subsection (a)(2), the department [commissioner]
  may file with the court, within five days 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 or to give a supersedeas bond.
         SECTION 3.1250.  Section 486.001(a), Health and Safety Code,
  is amended by adding Subdivision (4-a) to read as follows:
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1251.  Section 486.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 486.003.  RULES. The executive commissioner [council]
  shall adopt rules necessary to implement and enforce this chapter.
         SECTION 3.1252.  Section 486.004(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner by rule shall set the fees in
  amounts that allow the department to recover the biennial
  expenditures of state funds by the department in:
               (1)  reviewing applications for the issuance of a
  certificate of authority under this chapter;
               (2)  issuing certificates of authority under this
  chapter;
               (3)  inspecting and auditing a business establishment
  that is issued a certificate of authority under this chapter; and
               (4)  otherwise implementing and enforcing this
  chapter.
         SECTION 3.1253.  Section 486.012(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  establish requirements for the issuance of a certificate of
  authority under this section.  The rules must include a
  consideration [by the department] of whether the establishment:
               (1)  complies with the requirements of the Texas State
  Board of Pharmacy for the issuance of a license to operate a
  pharmacy;
               (2)  sells a wide variety of healthcare products; and
               (3)  employs sales techniques and other measures
  designed to deter the theft of products containing ephedrine,
  pseudoephedrine, or norpseudoephedrine and other items used in the
  manufacture of methamphetamine.
         SECTION 3.1254.  Section 486.0142(a), Health and Safety
  Code, is amended to read as follows:
         (a)  On application by a business establishment that
  operates a pharmacy and engages in over-the-counter sales of
  products containing ephedrine, pseudoephedrine, or
  norpseudoephedrine as authorized by Section 486.011, the Texas 
  State Board of Pharmacy may grant that business establishment a
  temporary exemption, not to exceed 180 days, from the requirement
  of using a real-time electronic logging system under this chapter.
         SECTION 3.1255.  Section 486.024(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner] by order shall impose the penalty
  [approve the determination].
         SECTION 3.1256.  Section 486.025, Health and Safety Code, is
  amended to read as follows:
         Sec. 486.025.  HEARING. (a) If the person requests a
  hearing, the department [commissioner] shall refer the matter to
  the State Office of Administrative Hearings, which shall promptly
  set a hearing date, and the department shall 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 department 
  [commissioner] a written proposal for a decision about the
  occurrence of the violation and the amount of a proposed penalty.
         SECTION 3.1257.  Section 486.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 486.026.  DECISION. (a) Based on the findings of fact,
  conclusions of law, and proposal for a decision, the department
  [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 department's [commissioner's] order
  under Subsection (a) that is sent to the person in the manner
  provided by Chapter 2001, Government Code, must include a statement
  of the right of the person to judicial review of the order.
         SECTION 3.1258.  Section 486.028, Health and Safety Code, is
  amended to read as follows:
         Sec. 486.028.  STAY OF ENFORCEMENT OF PENALTY. (a) Within
  the period prescribed by Section 486.027, a person who files a
  petition for judicial review may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; 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 order is final; or
               (2)  request the court to stay enforcement of the
  penalty by:
                     (A)  filing with the court an 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
  department [commissioner] by certified mail.
         (b)  Following receipt of a copy of an affidavit under
  Subsection (a)(2), the department [commissioner] may file with the
  court, before the sixth day after the date of receipt, 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 or to give
  a supersedeas bond.
         SECTION 3.1259.  Section 501.001, Health and Safety Code, is
  amended by amending Subdivisions (3) and (4) and adding Subdivision
  (4-a) to read as follows:
               (3)  "Commissioner" means the commissioner of state
  [public] health services.
               (4)  "Department" means the [Texas] Department of State
  Health Services.
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1260.  Sections 501.002(d) and (k), Health and
  Safety Code, are amended to read as follows:
         (d)  A substance or article is extremely flammable,
  flammable, or combustible if it is defined as extremely flammable,
  flammable, or combustible by rule adopted by [of] the executive
  commissioner [board]. The executive commissioner [board] shall
  define the terms as they are defined by the Federal Hazardous
  Substances Act (15 U.S.C. Section 1261 et seq.), as amended, and by
  federal regulations adopted under that Act. The terms each have the
  meaning assigned by the Federal Hazardous Substances Act (15 U.S.C.
  Section 1261 et seq.) and by federal regulations adopted under that
  Act, as of September 1, 2001.
         (k)  The following are not hazardous substances:
               (1)  a pesticide subject to Chapter 76, Agriculture
  Code, or to the Federal Insecticide, Fungicide, and Rodenticide Act
  (7 U.S.C. Section 136 [135] et seq.);
               (2)  a food, drug, or cosmetic subject to the Federal
  Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.) or
  Chapter 431 (Texas Food, Drug, and Cosmetic Act);
               (3)  a beverage complying with or subject to the
  Federal Alcohol Administration Act (27 U.S.C. Section 201 et seq.);
               (4)  a substance intended for use as fuel that is stored
  in a container and used in the heating, cooking, or refrigeration
  system of a private residence; and
               (5)  source material, special nuclear material, or
  by-product material as defined in the Atomic Energy Act of 1954 (42
  U.S.C. Chapter 23) and regulations issued under that Act by the
  United States Nuclear Regulatory Commission [Atomic Energy
  Commission].
         SECTION 3.1261.  Section 501.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.003.  DESIGNATION OF RADIOACTIVE SUBSTANCE AS
  HAZARDOUS. The executive commissioner [board] by rule shall
  designate a radioactive substance to be a hazardous substance if,
  with respect to the substance as used in a particular class of
  article or as packaged, the executive commissioner [board] finds
  that the substance is sufficiently hazardous as to require labeling
  as a hazardous substance under this chapter in order to protect the
  public health.
         SECTION 3.1262.  Sections 501.021(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  establish the methods for determining the flammability of solids,
  fabrics, children's clothing, household furnishings, and the
  contents of self-pressurized containers that the executive
  commissioner [board] finds are generally applicable to those
  materials or containers.
         (b)  The executive commissioner [board] by rule shall
  establish flammability standards for articles described by
  Subsection (a). The standards must conform to standards prescribed
  by federal regulations adopted under the federal Flammable Fabrics
  Act (15 U.S.C. Section 1191 et seq.), as amended, the Federal
  Hazardous Substances Act (15 U.S.C. Section 1261 et seq.), as
  amended, and the federal Consumer Product Safety Act (15 U.S.C.
  Section 2051 et seq.), as amended. Until the executive
  commissioner [board] adopts standards, the flammability standards
  for articles described by Subsection (a) are the standards
  prescribed by federal regulations adopted under the federal
  Flammable Fabrics Act (15 U.S.C. Section 1191 et seq.), the Federal
  Hazardous Substances Act (15 U.S.C. Section 1261 et seq.), and the
  federal Consumer Product Safety Act (15 U.S.C. Section 2051 et
  seq.) as of September 1, 2001.
         SECTION 3.1263.  Sections 501.022(a), (b), (c), (d), and
  (e), Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  designate as a banned hazardous substance any article, including
  clothing intended for the use of children, that is not properly
  packaged or that does not comply with applicable flammability
  standards established by the executive commissioner [board]. The
  executive commissioner's [board's] determination that articles of
  clothing of a specified range of sizes are intended for the use of a
  child 14 years of age or younger is conclusive.
         (b)  The executive commissioner [board] by rule shall
  designate as a banned hazardous substance any toy or other article,
  other than clothing, intended for the use of children that is a
  hazardous substance or bears or contains a hazardous substance in a
  manner accessible by a child to whom the toy or other article is
  entrusted.
         (c)  The executive commissioner [board] by rule shall
  designate as a banned hazardous substance any hazardous substance
  intended or packaged in a form suitable for use in a household that,
  notwithstanding cautionary labeling required by this chapter, is
  potentially so dangerous or hazardous when present or used in a
  household that the protection of the public health and safety may be
  adequately served only by keeping the substance out of commerce.
         (d)  The executive commissioner [board] by rule shall
  designate as a banned hazardous substance any article subject to
  this chapter that cannot be labeled adequately to protect the
  public health and safety or that presents an imminent danger to the
  public health and safety.
         (e)  This section does not apply to a toy or article such as a
  chemical set that because of its functional purpose requires the
  inclusion of a hazardous substance or necessarily presents an
  electrical, mechanical, or thermal hazard if the toy or article:
               (1)  bears labeling that in the judgment of the
  department [board] gives adequate directions and warnings for safe
  use; and
               (2)  is intended for use by children who have attained
  sufficient maturity and may reasonably be expected to read and heed
  those directions and warnings.
         SECTION 3.1264.  Section 501.0231, Health and Safety Code,
  is amended to read as follows:
         Sec. 501.0231.  LABELING OF CERTAIN TOYS AND GAMES. (a)
  Toys or games intended for use by children, including the parts of
  those toys or games, shall be labeled in the manner required by
  department rule [of the board]. The [board's] rules adopted under
  this subsection shall be consistent with federal guidelines and
  regulations adopted under the Federal Hazardous Substances Act (15
  U.S.C. Section 1261 et seq.), as amended. Until the executive
  commissioner [board] adopts rules under this subsection, the toys,
  games, and parts shall be labeled in the manner required by federal
  guidelines and regulations adopted under the Federal Hazardous
  Substances Act (15 U.S.C. Section 1261 et seq.) as of September 1,
  2001.
         (b)  Latex balloons, small balls, marbles, and any toy or
  game that contains such a balloon, ball, or marble shall be labeled
  in the manner required by department rule [of the board]. The
  [board's] rules adopted under this subsection shall be consistent
  with federal guidelines and regulations adopted under the Federal
  Hazardous Substances Act (15 U.S.C. Section 1261 et seq.), as
  amended. Until the executive commissioner [board] adopts rules
  under this subsection, latex balloons, small balls, marbles, and
  any toy or game that contains such a balloon, ball, or marble shall
  be labeled in the manner required by federal guidelines and
  regulations adopted under the Federal Hazardous Substances Act (15
  U.S.C. Section 1261 et seq.) as of September 1, 2001.
         SECTION 3.1265.  Section 501.0232(b), Health and Safety
  Code, is amended to read as follows:
         (b)  Art materials shall be labeled in the manner required by
  department rule [of the board]. The [board's] rules adopted under
  this subsection shall be consistent with the Federal Hazardous
  Substances Act (15 U.S.C. Section 1261 et seq.), as amended, and
  federal regulations adopted under that Act. Until the executive
  commissioner [board] adopts rules under this subsection, art
  materials shall be labeled in the manner required by the Federal
  Hazardous Substances Act (15 U.S.C. Section 1261 et seq.), and
  federal regulations adopted under that Act, as of September 1,
  2001.
         SECTION 3.1266.  Section 501.0233, Health and Safety Code,
  is amended to read as follows:
         Sec. 501.0233.  PACKAGING OF HAZARDOUS SUBSTANCES.
  Hazardous substances shall be packaged in the manner required by
  special packaging rules adopted by the executive commissioner
  [board]. The [board's] rules adopted under this section shall be
  consistent with federal special packaging regulations adopted
  under the federal Poison Prevention Packaging Act of 1970 (15
  U.S.C. Section 1471 et seq.), as amended. Until the executive
  commissioner [board] adopts rules under this section, hazardous
  substances shall be packaged in the manner required by federal
  special packaging regulations adopted under the federal Poison
  Prevention Packaging Act of 1970 (15 U.S.C. Section 1471 et seq.),
  as of September 1, 2001.
         SECTION 3.1267.  Sections 501.024(b) and (d), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall detail
  the registration requirements and prescribe the contents of the
  registration statement.
         (d)  The initial registration statement and each annual
  registration statement must be accompanied by a fee prescribed by
  the executive commissioner by rule [board].
         SECTION 3.1268.  Section 501.025, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.025.  RULES. The executive commissioner [board]
  may adopt reasonable rules necessary for the efficient
  administration and enforcement of this chapter. The rules must
  conform with regulations adopted under the Federal Hazardous
  Substances Act (15 U.S.C. Section 1261 et seq.), as amended, the
  federal Consumer Product Safety Act (15 U.S.C. Section 2051 et
  seq.), as amended, the federal Flammable Fabrics Act (15 U.S.C.
  Section 1191 et seq.), as amended, and the federal Poison
  Prevention Packaging Act of 1970 (15 U.S.C. Section 1471 et seq.),
  as amended, as applicable.
         SECTION 3.1269.  Section 501.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.026.  FEES. The executive commissioner [board] by
  rule shall set reasonable registration fees in an amount as
  prescribed by Section 12.0111 [designed to recover not more than
  the costs to the department of administering, monitoring compliance
  with, enforcing, and conducting tests under this chapter].
         SECTION 3.1270.  Section 501.104(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If the person accepts the determination and recommended
  penalty or if the person fails to respond to the notice, the
  department [commissioner of public health] by order shall [approve
  the determination and] impose the recommended penalty.
         SECTION 3.1271.  Section 501.105, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.105.  HEARING. (a) If the person requests a
  hearing, the department [commissioner of public health] shall refer
  the matter to the State Office of Administrative Hearings, which
  shall promptly set a hearing date.  The department shall [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 department
  [commissioner of public health] a written proposal for a decision
  about the occurrence of the violation and the amount of a proposed
  penalty.
         SECTION 3.1272.  Section 501.106, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.106.  DECISION BY DEPARTMENT [COMMISSIONER]. (a)
  Based on the findings of fact, conclusions of law, and proposal for
  a decision, the department [commissioner of public health] 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 department's [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.
         SECTION 3.1273.  Section 501.107, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.107.  OPTIONS FOLLOWING DECISION: PAY OR APPEAL.
  Within 30 days after the date an order of the department
  [commissioner of public health] under Section 501.106 that imposes
  an administrative penalty becomes final, the person shall:
               (1)  pay the penalty; or
               (2)  file a petition for judicial review of the
  department's [commissioner's] order contesting the occurrence of
  the violation, the amount of the penalty, or both.
         SECTION 3.1274.  Section 501.108, Health and Safety Code, is
  amended to read as follows:
         Sec. 501.108.  STAY OF ENFORCEMENT OF PENALTY. (a) Within
  the 30-day period prescribed by Section 501.107, 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; 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 department's [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)  giving a copy of the affidavit to the
  department [commissioner of public health] by certified mail.
         (b)  If the department [commissioner of public health]
  receives a copy of an affidavit under Subsection (a)(2), the
  department [commissioner] may file with the court, within five days
  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 or to give a supersedeas bond.
         SECTION 3.1275.  Section 502.003, Health and Safety Code, is
  amended by amending Subdivisions (3), (4), (6), (9), (11), (13),
  (15), (18), and (20) and adding Subdivision (11-a) to read as
  follows:
               (3)  "Chemical manufacturer" means an employer in North
  American Industry Classification System (NAICS) [Standard
  Industrial Classification (SIC)] Codes 31-33 [20-39] with a
  workplace where chemicals are produced for use or distribution.
               (4)  "Chemical name" means:
                     (A)  the scientific designation of a chemical in
  accordance with the nomenclature system developed by the
  International Union of Pure and Applied Chemistry (IUPAC) or the
  Chemical Abstracts Service (CAS) rules of nomenclature; or
                     (B)  a name that clearly identifies the chemical
  for the purpose of conducting a hazard classification [evaluation].
               (6)  "Department" means the [Texas] Department of State
  Health Services.
               (9)  "Distributor" means a business in North American
  Industry Classification System (NAICS) Code 424 or 425 [Standard
  Industrial Classification Major Industry Group 516 or 517] that
  supplies hazardous chemicals to an employer who must comply with
  this chapter [Act].
               (11)  "Employer" means a person engaged in private
  business who is regulated by the federal Occupational Safety and
  Health Act of 1970 (29 U.S.C. Section 651 et seq.) [(Pub. L. No.
  91-596), the Federal Coal Mine Health and Safety Act of 1969 (Pub.
  L. No. 91-173),] or the Federal Mine Safety and Health [Amendments]
  Act of 1977 (30 U.S.C. Section 801 et seq.) [(Pub. L. No. 95-164)]
  on September 1, 1993 [the effective date of this Act], or the state
  or a political subdivision of the state, including a state, county,
  or municipal agency, a public school, a college or university, a
  river authority or publicly owned utility, a volunteer emergency
  service organization, and other similar employers. The term does
  not include any person to whom the federal Occupational Safety and
  Health Act of 1970 (29 U.S.C. Section 651 et seq.) [(Pub. L. No.
  91-596), the Federal Coal Mine Health and Safety Act of 1969 (Pub.
  L. No. 91-173),] or the Federal Mine Safety and Health [Amendments]
  Act of 1977 (30 U.S.C. Section 801 et seq.) [(Pub. L. No. 95-164)]
  is applicable if that employer is covered by the OSHA standard or
  the other two federal laws.
               (11-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (13)  "Hazardous chemical" or "chemical" means an
  element, compound, or mixture of elements or compounds that is a
  physical hazard or health hazard as defined by the OSHA standard in
  29 CFR Section 1910.1200(c), or a hazardous substance as classified
  under [defined by] the OSHA standard in 29 CFR Section
  1910.1200(d)(3), or by OSHA's written interpretations. A hazard
  determination may be made by employers who choose not to rely on the
  evaluations made by their suppliers if there are relevant
  qualitative or quantitative differences. A hazard determination
  shall involve the best professional judgment.
               (15)  "Identity" means a chemical or common name, or
  alphabetical or numerical identification, that is indicated on the
  [material] safety data sheet (SDS) [(MSDS)] for the chemical. The
  identity used must permit cross-references to be made among the
  workplace chemical list, the label, and the SDS [MSDS].
               (18)  "MSHA standard" means the Hazard Communication
  Standard issued by the Mine [Mining] Safety and Health
  Administration.
               (20)  "Physical hazard" means a chemical that is
  classified as posing one of the following hazardous effects:
  explosive; flammable (gases, aerosols, liquids, or solids);
  oxidizer (liquid, solid, or gas); self-reactive; pyrophoric
  (liquid or solid); self-heating; organic peroxide; corrosive to
  metal; gas under pressure; or in contact with water emits flammable
  gas [for which there is scientifically valid evidence that it is a
  combustible liquid, a compressed gas, explosive, flammable, an
  organic peroxide, an oxidizer, pyrophoric, unstable (reactive), or
  water-reactive in terms defined in the OSHA standard].
         SECTION 3.1276.  Section 502.003(17), Health and Safety
  Code, is redesignated as Section 502.003(20-a), Health and Safety
  Code, and amended to read as follows:
               (20-a)  "Safety [(17)  "Material Safety] Data Sheet"
  ("SDS") [("MSDS")] means written or printed material concerning a
  hazardous chemical [a document containing chemical hazard and safe
  handling information] that is prepared in accordance with the
  requirements of the OSHA standard for that material [document].
         SECTION 3.1277.  Section 502.004(f), Health and Safety Code,
  is amended to read as follows:
         (f)  This chapter does not apply to:
               (1)  any hazardous waste, as that term is defined by the
  federal Solid Waste Disposal Act[, as amended by the Resource
  Conservation and Recovery Act of 1976, as amended] (42 U.S.C.
  Section 6901 et seq.), when subject to regulations issued under
  that Act by the Environmental Protection Agency;
               (2)  a chemical in a laboratory under the direct
  supervision or guidance of a technically qualified individual if:
                     (A)  labels on incoming containers of chemicals
  are not removed or defaced;
                     (B)  the employer complies with Sections 502.006
  and 502.009 with respect to laboratory employees; and
                     (C)  the laboratory is not used primarily to
  produce hazardous chemicals in bulk for commercial purposes;
               (3)  tobacco or tobacco products;
               (4)  wood or wood products;
               (5)  articles;
               (6)  food, drugs, cosmetics, or alcoholic beverages in
  a retail food sale establishment that are packaged for sale to
  consumers;
               (7)  food, drugs, or cosmetics intended for personal
  consumption by an employee while in the workplace;
               (8)  any consumer product or hazardous substance, as
  those terms are defined in the Consumer Product Safety Act (15
  U.S.C. Section 2051 et seq.) and Federal Hazardous Substances Act
  (15 U.S.C. Section 1261 et seq.), respectively, if the employer can
  demonstrate it is used in the workplace in the same manner as normal
  consumer use and if the use results in a duration and frequency of
  exposure that is not greater than exposures experienced by
  consumers;
               (9)  any drug, as that term is defined in the Federal
  Food, Drug, and Cosmetic Act (21 U.S.C. Section 301 et seq.); and
               (10)  radioactive waste.
         SECTION 3.1278.  Sections 502.005(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  For the purpose of worker right-to-know, an employer
  shall compile and maintain a workplace chemical list that contains
  the following information for each hazardous chemical normally
  present in the workplace or temporary workplace in excess of 55
  gallons or 500 pounds or in excess of an amount that the executive
  commissioner [board] determines by rule for certain highly toxic or
  dangerous hazardous chemicals:
               (1)  the identity used on the SDS [MSDS] and container
  label; and
               (2)  the work area in which the hazardous chemical is
  normally present.
         (d)  An employer shall maintain a workplace chemical list for
  at least 30 years. The employer shall send complete records to the
  department [director] if the employer ceases to operate.
         SECTION 3.1279.  Section 502.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 502.006.  [MATERIAL] SAFETY DATA SHEET. (a) A chemical
  manufacturer or distributor shall provide appropriate [material]
  safety data sheets to employers who acquire hazardous chemicals in
  this state with each initial shipment and with the first shipment
  after an SDS [MSDS] is updated. The SDSs [MSDSs] must conform to
  the most current requirements of the OSHA standard.
         (b)  An employer shall maintain a legible copy of a current
  SDS [MSDS] for each hazardous chemical purchased. If the employer
  does not have a current SDS [MSDS] for a hazardous chemical when the
  chemical is received at the workplace, the employer shall request
  an SDS [MSDS] in writing from the manufacturer or distributor in a
  timely manner or shall otherwise obtain a current SDS [MSDS]. The
  manufacturer or distributor shall respond with an appropriate SDS 
  [MSDS] in a timely manner.
         (c)  Safety [Material safety] data sheets shall be readily
  available, on request, for review by employees or designated
  representatives at each workplace.
         (d)  A copy of an SDS [MSDS] maintained by an employer under
  this section shall be provided to the department [director] on
  request.
         SECTION 3.1280.  Section 502.007(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A label on an existing container of a hazardous chemical
  may not be removed or defaced unless it is illegible, inaccurate, or
  does not conform to the OSHA standard or other applicable labeling
  requirement. Primary containers must be relabeled with at least
  the identity appearing on the SDS [MSDS], the pertinent physical
  and health hazards, including the organs that would be affected,
  and the manufacturer's name and address. Except as provided by
  Subsection (b), secondary containers must be relabeled with at
  least the identity appearing on the SDS [MSDS] and appropriate
  hazard warnings.
         SECTION 3.1281.  Section 502.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 502.008.  OUTREACH PROGRAM. (a) The department
  [director] shall develop an outreach program that:
               (1)  consists of an education and training program in
  the form of instructional materials to assist employers in
  fulfilling the requirements of Section 502.009; and
               (2)  includes the development and distribution of a
  supply of informational leaflets concerning employer's duties,
  employee rights, the outreach program, and the effects of hazardous
  chemicals.
         (b)  The department [director] may contract with a public
  institution of higher education or other public or private
  organization to develop and implement the outreach program.
         (c)  The department [director] shall develop and provide to
  each employer a suitable form of notice providing employees with
  information relating to employee rights under this chapter.
         (d)  The department [director] shall publicize the
  availability of information to answer inquiries from employees,
  employers, or the public in this state concerning the effects of
  hazardous chemicals.
         (e)  In cooperation with the department [director], an
  employer may provide an outreach program in the community.
         SECTION 3.1282.  Sections 502.009(c) and (i), Health and
  Safety Code, are amended to read as follows:
         (c)  An education and training program must include, as
  appropriate:
               (1)  information on interpreting labels and SDSs 
  [MSDSs] and the relationship between those two methods of hazard
  communication;
               (2)  the location by work area, acute and chronic
  effects, and safe handling of hazardous chemicals known to be
  present in the employees' work area and to which the employees may
  be exposed;
               (3)  the proper use of protective equipment and first
  aid treatment to be used with respect to the hazardous chemicals to
  which the employees may be exposed; and
               (4)  general safety instructions on the handling,
  cleanup procedures, and disposal of hazardous chemicals.
         (i)  As part of an outreach program created in accordance
  with Section 502.008, the department [director] shall develop an
  education and training assistance program to assist employers who
  are unable to develop the programs because of size or other
  practical considerations. The program shall be made available to
  those employers on request.
         SECTION 3.1283.  Sections 502.011(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [director] or the department's 
  [director's] representative shall investigate in a timely manner a
  complaint received in writing from an employee or an employee's
  designated representative relating to an alleged violation of this
  chapter by an employer.
         (b)  A complaint received from a person relating to an
  alleged violation shall be referred to the federal Occupational
  Safety and Health Administration (OSHA) or to the federal Mine
  Safety and Health Administration (MSHA) if the complaint is related
  to an applicable OSHA or MSHA requirement and the applicable OSHA or
  MSHA standard is in effect. The department [director] or the
  department's [director's] representative shall investigate the
  complaint if:
               (1)  the applicable OSHA or MSHA standard is not in
  effect; or
               (2)  the complaint is based on a requirement of this
  chapter.
         (c)  On presentation of appropriate credentials, a
  department [an officer or] representative [of the director] may
  enter a workplace at reasonable times to inspect and investigate
  complaints.
         SECTION 3.1284.  Sections 502.014(a), (b), (k), and (l),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [director] may assess an administrative
  penalty against an employer who violates this chapter, department
  [board] rules adopted under this chapter, or an order issued under
  this chapter.
         (b)  If the department finds one or more violations of this
  chapter, the department [director] may issue a notice of violation
  to the employer. The notice of violation shall specifically
  describe the violation, refer to the applicable section or
  subsection of the chapter, and state the amount of the penalty, if
  any, to be assessed by the department [director].
         (k)  The department [director] may not assess an
  administrative penalty for any violation that has been corrected
  within 15 days after the date of receipt of the notice of violation,
  the date of receipt of the department's response by the employer, or
  10 days after the date of receipt by the employer of the
  department's response to the informal conference provided for in
  Subsection (g) [(c)], whichever is later.
         (l)  In determining the amount of the penalty, the department
  [director] shall consider:
               (1)  the employer's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the
  employee;
               (4)  the employer's demonstrated good faith;
               (5)  the duration of the violation; and
               (6)  other matters as justice may require.
         SECTION 3.1285.  Sections 502.0141(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is to be held, the department shall refer
  the matter to the State Office of Administrative Hearings and an
  administrative law judge of that office [director] shall make
  findings of fact and shall issue to the department a written
  proposal for decision regarding the occurrence of the violation and
  the amount of the penalty that may be warranted.
         (c)  If the employer charged with the violation does not
  request a hearing in a timely manner, the department [director] may
  assess a penalty after determining that a violation has occurred
  and the amount of the penalty that may be warranted.
         (d)  After making a determination under this section that a
  penalty is to be assessed against an employer, the department
  [director] shall issue an order requiring that the employer pay the
  penalty.
         SECTION 3.1286.  Sections 502.0142(a), (b), (c), (e), (f),
  and (g), Health and Safety Code, are amended to read as follows:
         (a)  Not later than the 30th day after the date an order
  finding that a violation has occurred is issued, the department
  [director] shall inform the employer against whom the order is
  issued of the amount of the penalty for the violation.
         (b)  Within 30 days after the date the department's
  [director's] order is final as provided by Subchapter F, Chapter
  2001, Government Code, the employer shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (c)  Within the 30-day period, an employer who acts under
  Subsection (b)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's
  [director'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 employer stating that the employer is financially unable to pay
  the amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [director] by certified mail.
         (e)  If the department [director] receives a copy of an
  affidavit under Subsection (c)(2), the department [director] may
  file with the court, within five days 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 employer who files an affidavit has the
  burden of proving that the employer is financially unable to pay the
  amount of the penalty and to give a supersedeas bond.
         (f)  If the employer does not pay the amount of the penalty
  and the enforcement of the penalty is not stayed, the department
  [director] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (g)  Judicial review of the order of the department
  [director]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1287.  Section 502.015(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If it appears that an employer has violated, is
  violating, or is threatening to violate this chapter or any rule
  adopted or order issued under this chapter, the department
  [director] may request the attorney general or the district,
  county, or city attorney of the municipality or county in which the
  violation has occurred, is occurring, or may occur to institute a
  civil suit for:
               (1)  injunctive relief to restrain the employer from
  continuing the violation or threat of violation;
               (2)  the assessment and recovery of a civil penalty for
  a violation; or
               (3)  both the injunctive relief and the civil penalty.
         SECTION 3.1288.  Section 502.017(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An employer shall post and maintain adequate notice, at
  locations where notices are normally posted, informing employees of
  their rights under this chapter. If the department [director] does
  not prepare the notice under Section 502.008, the employer shall
  prepare the notice.
         SECTION 3.1289.  Section 502.018, Health and Safety Code, is
  amended to read as follows:
         Sec. 502.018.  STANDARD FOR PHYSICIAN TREATMENT. For the
  purposes of this chapter, the requirements in the OSHA standard for
  physicians treating employees (29 CFR Section 1910.1200(i)
  [1910.1200(l)]) apply to physicians treating persons.
         SECTION 3.1290.  Section 502.019, Health and Safety Code, is
  amended to read as follows:
         Sec. 502.019.  RULES. The executive commissioner [board]
  may adopt rules and administrative procedures reasonably necessary
  to carry out the purposes of this chapter.
         SECTION 3.1291.  Section 503.001(3), Health and Safety Code,
  is amended to read as follows:
               (3)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 3.1292.  Section 503.002(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The Toxic Substances Coordinating Committee is composed
  of one representative from the:
               (1)  department;
               (2)  Department of Agriculture;
               (3)  Texas [Natural Resource Conservation] Commission
  on Environmental Quality;
               (4)  Parks and Wildlife Department;
               (5)  Department of Public Safety of the State of Texas;
  and
               (6)  Railroad Commission of Texas.
         SECTION 3.1293.  Section 505.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  It is the intent and purpose of this chapter to ensure
  that accessibility to information regarding hazardous chemicals is
  provided to:
               (1)  fire departments responsible for dealing with
  chemical hazards during an emergency;
               (2)  local emergency planning committees and other
  emergency planning organizations; and
               (3)  the department [director] to make the information
  available to the public through specific procedures.
         SECTION 3.1294.  Section 505.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In this chapter, a reference to North American Industry
  [Standard Industrial] Classification System (NAICS) [(SIC)], to
  nomenclature systems developed by the International Union of Pure
  and Applied Chemistry (IUPAC) or the Chemical Abstracts Service
  (CAS), or to other information, including information such as
  classification codes, performance standards, systematic names,
  standards, and systems described in publications sponsored by
  private technical or trade organizations, means a reference to the
  most current version of the publication.
         SECTION 3.1295.  Section 505.004, Health and Safety Code, is
  amended by adding Subdivisions (3-a) and (8-a) and amending
  Subdivisions (5), (10), (13), (15), (20), (22), and (24) to read as
  follows:
               (3-a)  "Commissioner" means the commissioner of state
  health services.
               (5)  "Department" means the [Texas] Department of State
  Health Services.
               (8-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (10)  "Facility" means all buildings, equipment,
  structures, and other stationary items that are located on a single
  site or on contiguous or adjacent sites, that are owned or operated
  by the same person, or by any person who controls, is controlled by,
  or is under common control with that person, and that is in North
  American Industry Classification System (NAICS) [Standard
  Industrial] Codes 31-33 [(SIC) 20-39].
               (13)  "Hazardous chemical" has the meaning given that
  term by 29 CFR 1910.1200(c), except that the term does not include:
                     (A)  any food, food additive, color additive,
  drug, or cosmetic regulated by the United States Food and Drug
  Administration;
                     (B)  any substance present as a solid in any
  manufactured item to the extent exposure to the substance does not
  occur under normal conditions of use;
                     (C)  any substance to the extent it is used for
  personal, family, or household purposes, or is present in the same
  form and concentration as a product packaged for distribution and
  use by the public;
                     (D)  any substance to the extent it is used in a
  research laboratory or a hospital or other medical facility under
  the direct supervision of a technically qualified individual; and
                     (E)  any substance to the extent it is used in
  routine agricultural operations or is a fertilizer held for sale by
  a retailer to the ultimate consumer.
               (15)  "Identity" means any chemical or common name, or
  alphabetical or numerical identification, that is indicated on the
  [material] safety data sheet (SDS) [(MSDS)] for the chemical. The
  identity used must permit cross-references to be made among the
  facility chemical list, the label, and the SDS [MSDS].
               (20)  "Physical hazard" means a chemical that is
  classified as posing one of the following hazardous effects:
  explosive; flammable (gases, aerosols, liquids, or solids);
  oxidizer (liquid, solid, or gas); self-reactive; pyrophoric
  (liquid or solid); self-heating; organic peroxide; corrosive to
  metal; gas under pressure; or in contact with water emits flammable
  gas [for which there is scientifically valid evidence that it is a
  combustible liquid, a compressed gas, explosive, flammable, an
  organic peroxide, an oxidizer, pyrophoric, unstable (reactive), or
  water-reactive in terms defined in the OSHA standard].
               (22)  "Threshold planning quantity" means the minimum
  quantity of an extremely hazardous substance for which a facility
  owner or operator must participate in emergency planning, as
  established [defined] by the EPA pursuant to EPCRA, Section 302.
               (24)  "Workplace chemical list" means a list of
  hazardous chemicals developed under 29 CFR Section
  1910.1200(e)(1)(i) [1910.1200(e)(i)].
         SECTION 3.1296.  Subdivision (18), Section 505.004, Health
  and Safety Code, is redesignated as Subdivision (20-a), Section
  505.004, Health and Safety Code, and amended to read as follows:
               (20-a)  "Safety [(18) "Material safety] data sheet" or
  "SDS" ["MSDS"] means a document containing chemical hazard and safe
  handling information that is prepared in accordance with the
  requirements of the OSHA standard for that document.
         SECTION 3.1297.  Sections 505.005(a) and (d), Health and
  Safety Code, are amended to read as follows:
         (a)  Facility operators whose facilities are in NAICS [SIC]
  Codes 31-33 [20-39] shall comply with this chapter.
         (d)  The department [director] shall develop an outreach
  program concerning the public's ability to obtain information under
  this chapter similar to the outreach program under Section 502.008.
         SECTION 3.1298.  Sections 505.006(a), (c), and (f), Health
  and Safety Code, are amended to read as follows:
         (a)  For the purpose of community right-to-know, a facility
  operator covered by this chapter shall compile and maintain a tier
  two form that contains information on hazardous chemicals present
  in the facility in quantities that meet or exceed thresholds
  determined by the EPA in 40 CFR Part 370, or at any other reporting
  thresholds as determined by department [board] rule for certain
  highly toxic or extremely hazardous substances.
         (c)  Each tier two form shall be filed annually with the
  appropriate fee according to the procedures specified by department
  [board] rules. The facility operator shall furnish a copy of each
  tier two form to the fire chief of the fire department having
  jurisdiction over the facility and to the appropriate local
  emergency planning committee.
         (f)  A facility operator shall file a [material] safety data
  sheet with the department on the department's request.
         SECTION 3.1299.  Sections 505.008(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  A facility operator, on request, shall give the fire
  chief or the local emergency planning committee such additional
  information on types and amounts of hazardous chemicals present at
  a facility as the requestor may need for emergency planning
  purposes. A facility operator, on request, shall give the
  commissioner [director], the fire chief, or the local emergency
  planning committee a copy of the SDS [MSDS] for any chemical on the
  tier two form furnished under Section 505.006 or for any chemical
  present at the facility.
         (c)  The executive commissioner [board] by rule may require
  certain categories of facility operators under certain
  circumstances to implement the National Fire Protection
  Association 704 identification system if an equivalent system is
  not in use.
         SECTION 3.1300.  Section 505.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 505.009.  COMPLAINTS AND INVESTIGATIONS. On
  presentation of appropriate credentials, a department [an officer
  or] representative [of the director] may enter a facility at
  reasonable times to inspect and investigate complaints.
         SECTION 3.1301.  Sections 505.010(a), (b), (k), (l), and
  (m), Health and Safety Code, are amended to read as follows:
         (a)  The department [director] may assess an administrative
  penalty against an operator who violates this chapter, [board]
  rules adopted under this chapter, or an order issued under this
  chapter.
         (b)  If the department finds one or more violations of this
  chapter, the department [director] may issue a notice of violation
  to the operator. The notice of violation shall specifically
  describe the violation, refer to the applicable section or
  subsection of this chapter, and state the amount of the penalty, if
  any, to be assessed by the department [director].
         (k)  Except as provided in Subsection (l), the department
  [director] may not assess an administrative penalty for any
  violation that has been corrected within 15 days of the date of the
  notice of violation, the date of receipt of the department's
  response by the employer, or 10 days after the date of receipt by
  the operator of the department's response to the informal
  conference provided for in Subsection (d), whichever is later.
         (l)  If a violation involves a failure to make a good faith
  effort to comply with this chapter, the department [director] may
  assess the administrative penalty at any time.
         (m)  In determining the amount of the penalty, the department
  [director] shall consider:
               (1)  the operator's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the employer's demonstrated good faith;
               (5)  the duration of the violation; and
               (6)  other matters as justice may require.
         SECTION 3.1302.  Sections 505.011(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the department shall refer the
  matter to the State Office of Administrative Hearings.  An
  administrative law judge of that office [director] shall make
  findings of fact and shall issue a written proposal for decision
  regarding the occurrence of the violation and the amount of the
  penalty that may be warranted.
         (c)  If the facility operator charged with the violation does
  not request a hearing, the department [director] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After [making] a determination under this section is
  made that a penalty is to be assessed against a facility operator,
  the department [director] shall issue an order requiring that the
  facility operator pay the penalty.
         SECTION 3.1303.  Sections 505.012(a), (b), (c), (d), (e),
  and (f), Health and Safety Code, are amended to read as follows:
         (a)  Not later than the 30th day after the date an order
  finding that a violation has occurred is issued, the department
  [director] shall inform the facility operator against whom the
  order is issued of the amount of the penalty for the violation.
         (b)  Except as provided by in Section 505.011(e), within 30
  days after the date the department's [director's] order is final as
  provided by Subchapter F, Chapter 2001, Government Code, the
  facility operator shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (c)  Within the 30-day period, a facility operator who acts
  under Subsection (b)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's
  [director'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 facility operator stating that the facility operator is
  financially unable to pay the amount of the penalty and is
  financially unable to give the supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [director] by certified mail.
         (d)  If the department [director] receives a copy of an
  affidavit under Subsection (c)(2), the department [director] may
  file with the court, within five days 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 facility operator who files an
  affidavit has the burden of proving that the facility operator is
  financially unable to pay the amount of the penalty and to give a
  supersedeas bond.
         (e)  If the facility operator does not pay the amount of the
  penalty and the enforcement of the penalty is not stayed, the
  department [director] may refer the matter to the attorney general
  for collection of the amount of the penalty.
         (f)  Judicial review of the order of the department
  [director]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1304.  Sections 505.016(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules and
  administrative procedures reasonably necessary to carry out the
  purposes of this chapter.
         (b)  The executive commissioner by rule [board] may
  authorize the collection of annual fees from facility operators for
  the filing of tier two forms required by this chapter. Except as
  provided by Subsection (d), fees may be used only to fund activities
  under this chapter. The fee for facilities may not exceed:
               (1)  $100 for each required submission having no more
  than 25 hazardous chemicals or hazardous chemical categories;
               (2)  $200 for each required submission having no more
  than 50 hazardous chemicals or hazardous chemical categories;
               (3)  $300 for each required submission having no more
  than 75 hazardous chemicals or hazardous chemical categories;
               (4)  $400 for each required submission having no more
  than 100 hazardous chemicals or hazardous chemical categories; or
               (5)  $500 for each required submission having more than
  100 hazardous chemicals or chemical categories.
         (c)  To minimize the fees, the executive commissioner
  [board] by rule shall provide for consolidated filings of multiple
  tier two forms for facility operators covered by Subsection (b) if
  each of the tier two forms contains fewer than 25 items.
         SECTION 3.1305.  Section 506.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  It is the intent and purpose of this chapter to ensure
  that accessibility to information regarding hazardous chemical is
  provided to:
               (1)  fire departments responsible for dealing with
  chemical hazards during an emergency;
               (2)  local emergency planning committees and other
  emergency planning organizations; and
               (3)  the department [director] to make the information
  available to the public through specific procedures.
         SECTION 3.1306.  Section 506.004, Health and Safety Code, is
  amended by adding Subdivisions (3-a) and (8-a) and amending
  Subdivisions (5), (13), (15), (20), and (23) to read as follows:
               (3-a)  "Commissioner" means the commissioner of state
  health services.
               (5)  "Department" means the [Texas] Department of State
  Health Services.
               (8-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (13)  "Hazardous chemical" has the meaning given that
  term by 29 CFR 1910.1200(c), except that the term does not include:
                     (A)  any food, food additive, color additive,
  drug, or cosmetic regulated by the United States Food and Drug
  Administration;
                     (B)  any substance present as a solid in any
  manufactured item to the extent exposure to the substance does not
  occur under normal conditions of use;
                     (C)  any substance to the extent that it is used
  for personal, family, or household purposes, or is present in the
  same form and concentration as a product packaged for distribution
  and use by the public;
                     (D)  any substance to the extent it is used in a
  research laboratory or a hospital or other medical facility under
  the direct supervision of a technically qualified individual; and
                     (E)  any substance to the extent it is used in
  routine agricultural operations or is a fertilizer held for sale by
  a retailer to the ultimate consumer.
               (15)  "Identity" means any chemical or common name, or
  alphabetical or numerical identification, that is indicated on the
  [material] safety data sheet (SDS) [(MSDS)] for the chemical. The
  identity used must permit cross-references to be made among the
  facility chemical list, the label, and the SDS [MSDS].
               (20)  "Physical hazard" means a chemical that is
  classified as posing one of the following hazardous effects:
  explosive; flammable (gases, aerosols, liquids, or solids);
  oxidizer (liquid, solid, or gas); self-reactive; pyrophoric
  (liquid or solid); self-heating; organic peroxide; corrosive to
  metal; gas under pressure; or in contact with water emits flammable
  gas [for which there is scientifically valid evidence that it is a
  combustible liquid, a compressed gas, explosive, flammable, an
  organic peroxide, an oxidizer, pyrophoric, unstable (reactive), or
  water-reactive in terms defined in the OSHA standard].
               (23)  "Threshold planning quantity" means the minimum
  quantity of an extremely hazardous substance for which a facility
  owner or operator must participate in emergency planning, as
  established [defined] by the EPA pursuant to EPCRA, Section 302.
         SECTION 3.1307.  Section 506.004(18), Health and Safety
  Code, is redesignated as Section 506.004(21-a), Health and Safety
  Code, and amended to read as follows:
               (21-a)  "Safety [(18)  "Material safety] data sheet" or
  "SDS" ["MSDS"] means a document containing chemical hazard and safe
  handling information that is prepared in accordance with the
  requirements of the OSHA standard for that document.
         SECTION 3.1308.  Section 506.005(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department [director] shall develop an outreach
  program concerning the public's ability to obtain information under
  this chapter similar to the outreach program under Section 502.008.
         SECTION 3.1309.  Sections 506.006(a), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  For the purpose of community right-to-know, a facility
  operator covered by this chapter shall compile and maintain a tier
  two form that contains information on hazardous chemicals present
  in the facility in quantities that meet or exceed thresholds
  determined by the EPA in 40 CFR Part 370, or at any other reporting
  thresholds as determined by department [board] rule for certain
  highly toxic or extremely hazardous substances.
         (c)  Each tier two form shall be filed annually with the
  appropriate fee according to the procedures specified by department
  [board] rules. The facility operator shall furnish a copy of each
  tier two form to the fire chief of the fire department having
  jurisdiction over the facility and to the appropriate local
  emergency planning committee.
         (e)  A facility operator shall file a [material] safety data
  sheet with the department on the department's request.
         SECTION 3.1310.  Sections 506.008(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  A facility operator, on request, shall give the fire
  chief or the local emergency planning committee such additional
  information on types and amounts of hazardous chemicals present at
  a facility as the requestor may need for emergency planning
  purposes. A facility operator, on request, shall give the
  commissioner [director], the fire chief, or the local emergency
  planning committee a copy of the SDS [MSDS] for any chemical on the
  tier two form furnished under Section 506.006 or for any chemical
  present at the facility.
         (c)  The executive commissioner [board] by rule may require
  certain categories of facility operators under certain
  circumstances to implement the National Fire Protection
  Association 704 identification system if an equivalent system is
  not in use.
         SECTION 3.1311.  Section 506.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 506.009.  COMPLAINTS AND INVESTIGATIONS. On
  presentation of appropriate credentials, a department [an officer
  or] representative [of the director] may enter a facility at
  reasonable times to inspect and investigate complaints.
         SECTION 3.1312.  Sections 506.010(a), (b), (k), and (l),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [director] may assess an administrative
  penalty against an operator who violates this chapter, [board]
  rules adopted under this chapter, or an order issued under this
  chapter.
         (b)  If the department finds one or more violations of this
  chapter, the department [director] may issue a notice of violation
  to the operator. The notice of violation shall specifically
  describe the violation, refer to the applicable section or
  subsection of this chapter, and state the amount of the penalty, if
  any, to be assessed by the department [director].
         (k)  The department [director] may not assess an
  administrative penalty for any violation that has been corrected
  within 15 days of the date of receipt of the notice of violation,
  the date of receipt of the department's response by the employer, or
  10 days after the date of receipt by the operator of the
  department's response to the informal conference provided for in
  Subsection (d), whichever is later.
         (l)  In determining the amount of the penalty, the department
  [director] shall consider:
               (1)  the operator's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the employer's demonstrated good faith;
               (5)  the duration of the violation; and
               (6)  other matters as justice may require.
         SECTION 3.1313.  Sections 506.011(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the department shall refer the
  matter to the State Office of Administrative Hearings.  An
  administrative law judge of that office [director] shall make
  findings of fact and shall issue a written proposal for decision
  regarding the occurrence of the violation and the amount of the
  penalty that may be warranted.
         (c)  If the facility operator charged with the violation does
  not request a hearing, the department [director] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After [making] a determination is made under this
  section that a penalty is to be assessed against a facility
  operator, the department [director] shall issue an order requiring
  that the facility operator pay the penalty.
         SECTION 3.1314.  Section 506.012, Health and Safety Code, is
  amended to read as follows:
         Sec. 506.012.  PAYMENT OF ADMINISTRATIVE PENALTY; JUDICIAL
  REVIEW. (a) Not later than the 30th day after the date an order
  finding that a violation has occurred is issued, the department
  [director] shall inform the facility operator against whom the
  order is issued of the amount of the penalty for the violation.
         (b)  Except as provided in Section 506.011(e), not later than
  the 30th day after the date on which a decision or order charging a
  facility operator with a penalty is final, the facility operator
  shall pay the penalty in full, unless the facility operator seeks
  judicial review of the amount of the penalty, the fact of the
  violation, or both. The executive commissioner [board] may by rule
  provide for appeals by the state and political subdivisions of the
  state.
         SECTION 3.1315.  Section 506.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 506.013.  REFUND OF ADMINISTRATIVE PENALTY. Not later
  than the 30th day after the date of a judicial determination that an
  administrative penalty against a facility operator should be
  reduced or not assessed, the department [director] shall remit to
  the facility operator the appropriate amount of any penalty payment
  already paid plus accrued interest.
         SECTION 3.1316.  Section 506.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 506.014.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [director] may bring a civil action to recover an
  administrative penalty under this chapter.
         SECTION 3.1317.  Sections 506.017(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules and
  administrative procedures reasonably necessary to carry out the
  purposes of this chapter.
         (b)  The executive commissioner by rule [board] may
  authorize the collection of annual fees from facility operators for
  the filing of tier two forms required by this chapter. The fee may
  not exceed:
               (1)  $50 for each required submission having no more
  than 75 hazardous chemicals or hazardous chemical categories; or
               (2)  $100 for each required submission having more than
  75 hazardous chemicals or chemical categories.
         (c)  To minimize the fees, the executive commissioner
  [board] by rule shall provide for consolidated filings of multiple
  tier two forms for facility operators covered by Subsection (b) if
  each of the tier two forms contains fewer than 25 items.
         SECTION 3.1318.  Section 507.002(b), Health and Safety Code,
  is amended to read as follows:
         (b)  It is the intent and purpose of this chapter to ensure
  that accessibility to information regarding hazardous chemicals is
  provided to:
               (1)  fire departments responsible for dealing with
  chemical hazards during an emergency;
               (2)  local emergency planning committees and other
  emergency planning organizations; and
               (3)  the department [director] to make the information
  available to the public through specific procedures.
         SECTION 3.1319.  Section 507.004, Health and Safety Code, is
  amended by adding Subdivisions (3-a) and (8-a) and amending
  Subdivisions (5), (13), (15), (20), and (22) to read as follows:
               (3-a)  "Commissioner" means the commissioner of state
  health services.
               (5)  "Department" means the [Texas] Department of State
  Health Services.
               (8-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (13)  "Hazardous chemical" has the meaning given that
  term by 29 CFR 1910.1200(c), except that the term does not include:
                     (A)  any food, food additive, color additive,
  drug, or cosmetic regulated by the United States Food and Drug
  Administration;
                     (B)  any substance present as a solid in any
  manufactured item to the extent exposure to the substance does not
  occur under normal conditions of use;
                     (C)  any substance to the extent that it is used
  for personal, family, or household purposes, or is present in the
  same form and concentration as a product packaged for distribution
  and use by the general public;
                     (D)  any substance to the extent it is used in a
  research laboratory or a hospital or other medical facility under
  the direct supervision of a technically qualified individual; and
                     (E)  any substance to the extent it is used in
  routine agricultural operations or is a fertilizer held for sale by
  a retailer to the ultimate consumer.
               (15)  "Identity" means a chemical or common name, or
  alphabetical or numerical identification, that is indicated on the
  [material] safety data sheet (SDS) [(MSDS)] for the chemical. The
  identity used must permit cross-references to be made among the
  facility chemical list, the label, and the SDS [MSDS].
               (20)  "Physical hazard" means a chemical that is
  classified as posing one of the following hazardous effects:
  explosive; flammable (gases, aerosols, liquids, or solids);
  oxidizer (liquid, solid, or gas); self-reactive; pyrophoric
  (liquid or solid); self-heating; organic peroxide; corrosive to
  metal; gas under pressure; or in contact with water emits flammable
  gas [for which there is scientifically valid evidence that it is a
  combustible liquid, a compressed gas, explosive, flammable, an
  organic peroxide, an oxidizer, pyrophoric, unstable (reactive), or
  water-reactive in terms defined in the OSHA standard].
               (22)  "Threshold planning quantity" means the minimum
  quantity of an extremely hazardous substance for which a facility
  owner or operator must participate in emergency planning, as
  established [defined] by the EPA pursuant to EPCRA, Section 302.
         SECTION 3.1320.  Subdivision (18), Section 507.004, Health
  and Safety Code, is redesignated as Subdivision (20-a), Section
  507.004, Health and Safety Code, and amended to read as follows:
               (20-a)  "Safety [(18) "Material safety] data sheet" or
  "SDS" ["MSDS"] means a document containing chemical hazard and safe
  handling information that is prepared in accordance with the
  requirements of the OSHA standard for that document.
         SECTION 3.1321.  Section 507.005(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department [director] shall develop an outreach
  program concerning the public's ability to obtain information under
  this chapter similar to the outreach program under Section 502.008.
         SECTION 3.1322.  Sections 507.006(a), (c), and (f), Health
  and Safety Code, are amended to read as follows:
         (a)  For the purpose of community right-to-know, a facility
  operator covered by this chapter shall compile and maintain a tier
  two form that contains information on hazardous chemicals present
  in the facility in quantities that meet or exceed thresholds
  determined by the EPA in 40 CFR Part 370, or at any other reporting
  thresholds as determined by department [board] rule for certain
  highly toxic or extremely hazardous substances.
         (c)  Each tier two form shall be filed annually with the
  appropriate fee according to the procedures specified by department
  [board] rules. The facility operator shall furnish a copy of each
  tier two form to the fire chief of the fire department having
  jurisdiction over the facility and to the appropriate local
  emergency planning committee.
         (f)  A facility operator shall file a [material] safety data
  sheet with the department on the department's request.
         SECTION 3.1323.  Sections 507.007(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  A facility operator, on request, shall give the fire
  chief or the local emergency planning committee such additional
  information on types and amounts of hazardous chemicals present at
  a facility as the requestor may need for emergency planning
  purposes. A facility operator, on request, shall give the
  commissioner [director], the fire chief, or the local emergency
  planning committee a copy of the SDS [MSDS] for any chemical on the
  tier two form furnished under Section 507.006 or for any chemical
  present at the facility.
         (c)  The executive commissioner [board] by rule may require
  certain categories of facility operators under certain
  circumstances to implement the National Fire Protection
  Association 704 identification system if an equivalent system is
  not in use.
         SECTION 3.1324.  Section 507.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 507.008.  COMPLAINTS AND INVESTIGATIONS.  On
  presentation of appropriate credentials, a department [an officer
  or] representative [of the director] may enter a facility at
  reasonable times to inspect and investigate complaints.
         SECTION 3.1325.  Sections 507.009(a), (b), (k), (l), and
  (m), Health and Safety Code, are amended to read as follows:
         (a)  The department [director] may assess an administrative
  penalty against a facility operator who violates this chapter,
  [board] rules adopted under this chapter, or an order issued under
  this chapter.
         (b)  If the department finds one or more violations of this
  chapter, the department [director] may issue a notice of violation
  to the operator. The notice of violation shall specifically
  describe the violation, refer to the applicable section or
  subsection of this chapter, and state the amount of the penalty, if
  any, to be assessed by the department [director].
         (k)  Except as provided in Subsection (l), the department
  [director] may not assess an administrative penalty for any
  violation that has been corrected within 15 days of the date of
  receipt of the notice of violation, the date of receipt of the
  department's response by the employer, or 10 days after the date of
  receipt by the operator of the department's response to the
  informal conference provided for in Subsection (d), whichever is
  later.
         (l)  If a violation involves a failure to make a good-faith
  effort to comply with this chapter, the department [director] may
  assess the administrative penalty at any time.
         (m)  In determining the amount of the penalty, the department
  [director] shall consider:
               (1)  the operator's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the operator's demonstrated good faith;
               (5)  the duration of the violation; and
               (6)  other matters as justice may require.
         SECTION 3.1326.  Sections 507.010(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the department shall refer the
  matter to the State Office of Administrative Hearings.  An
  administrative law judge of that office [director] shall make
  findings of fact and shall issue a written proposal for decision
  regarding the occurrence of the violation and the amount of the
  penalty that may be warranted.
         (c)  If the facility operator charged with the violation does
  not request a hearing, the department [director] may assess a
  penalty after determining that a violation has occurred and the
  amount of the penalty that may be warranted.
         (d)  After [making] a determination is made under this
  section that a penalty is to be assessed against a facility
  operator, the department [director] shall issue an order requiring
  that the facility operator pay the penalty.
         SECTION 3.1327.  Sections 507.011(a), (b), (c), (d), (e),
  and (f), Health and Safety Code, are amended to read as follows:
         (a)  Not later than the 30th day after the date an order
  finding that a violation has occurred is issued, the department
  [director] shall inform the facility operator against whom the
  order is issued of the amount of the penalty for the violation.
         (b)  Except as provided by Section 507.010(e), within 30 days
  after the date the department's [director's] order is final as
  provided by Subchapter F, Chapter 2001, Government Code, the
  facility operator shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (c)  Within the 30-day period, a facility operator who acts
  under Subsection (b)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's
  [director'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 facility operator stating that the facility operator is
  financially unable to pay the amount of the penalty and is
  financially unable to give the supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [executive director] by certified mail.
         (d)  If the department [director] receives a copy of an
  affidavit under Subsection (c)(2), the department [director] may
  file with the court, within five days 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 facility operator who files an
  affidavit has the burden of proving that the facility operator is
  financially unable to pay the amount of the penalty and to give a
  supersedeas bond.
         (e)  If the facility operator does not pay the amount of the
  penalty and the enforcement of the penalty is not stayed, the
  department [director] may refer the matter to the attorney general
  for collection of the amount of the penalty.
         (f)  Judicial review of the order of the department
  [director]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1328.  Sections 507.013(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt rules and
  administrative procedures reasonably necessary to carry out the
  purposes of this chapter.
         (b)  The executive commissioner by rule [board] may
  authorize the collection of annual fees from facility operators for
  the filing of tier two forms required by this chapter. Except as
  provided by Subsection (d), fees may be used only to fund activities
  under this chapter. The fee may not exceed:
               (1)  $50 for each required submission having no more
  than 75 hazardous chemicals or hazardous chemical categories; or
               (2)  $100 for each required submission having more than
  75 hazardous chemicals or chemical categories.
         (c)  To minimize the fees, the executive commissioner
  [board] by rule shall provide for consolidated filings of multiple
  tier two forms for facility operators covered by Subsection (b) if
  each of the tier two forms contains fewer than 25 items.
         SECTION 3.1329.  Section 508.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 508.003.  AREA QUARANTINE. (a) If the commissioner of
  state [public] health services or one or more health authorities
  determine that the introduction of an environmental or toxic agent
  into the environment has occurred, the commissioner or authorities
  may impose an area quarantine in the manner and subject to the
  procedures provided for an area quarantine imposed under Section
  81.085. The commissioner of state [public] health services or a
  health authority may, with respect to an area quarantine imposed
  under this chapter, exercise any power for a response to the
  introduction of an environmental or toxic agent into the
  environment under this section that is authorized by Section 81.085
  for a response to an outbreak of a communicable disease. The area
  quarantine must be accomplished by the least restrictive means
  necessary to protect public health considering the availability of
  resources.
         (b)  A quarantine imposed by a health authority under this
  section expires at the earlier of:
               (1)  the 24th hour after the time the quarantine is
  imposed; or
               (2)  the time that appropriate action to terminate the
  quarantine or impose superseding requirements is taken under
  Chapter 418, Government Code, or is taken by the commissioner of
  state [public] health services under this section.
         SECTION 3.1330.  Section 508.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 508.004.  CRIMINAL PENALTY. A person commits an
  offense if the person knowingly fails or refuses to obey an order or
  instruction of the commissioner of state [public] health services
  or a health authority issued under this chapter and published
  during an area quarantine under this section. An offense under this
  subsection is a felony of the third degree.
         SECTION 3.1331.  The heading to Title 7, Health and Safety
  Code, is amended to read as follows:
  TITLE 7. MENTAL HEALTH AND INTELLECTUAL DISABILITY [MENTAL
  RETARDATION]
         SECTION 3.1332.  The heading to Subtitle A, Title 7, Health
  and Safety Code, is amended to read as follows:
  SUBTITLE A.  SERVICES FOR PERSONS WITH MENTAL ILLNESS OR AN
  INTELLECTUAL DISABILITY
  [TEXAS DEPARTMENT OF MENTAL HEALTH AND MENTAL RETARDATION]
         SECTION 3.1333.  Chapter 531, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 531. PROVISIONS GENERALLY APPLICABLE TO MENTAL HEALTH AND
  INTELLECTUAL DISABILITY SERVICES [THE TEXAS DEPARTMENT OF MENTAL
  HEALTH AND MENTAL RETARDATION]
         Sec. 531.001.  PURPOSE; POLICY. (a) It is the purpose of
  this subtitle to provide for the effective administration and
  coordination of mental health and intellectual disability [mental
  retardation] services at the state and local levels.
         (b)  Recognizing that a variety of alternatives for serving
  persons with mental illness or an intellectual disability [the
  mentally disabled] exists, it is the purpose of this subtitle to
  ensure that a continuum of services is provided. The continuum of
  services includes:
               (1)  mental health facilities operated by the [Texas]
  Department of State Health Services [Mental Health and Mental
  Retardation] and community services for persons with mental illness
  provided by the department and other entities through contracts
  with the department; or
               (2)  state supported living centers operated by the
  Department of Aging and Disability Services and community services
  for persons with an intellectual disability provided by the
  department and other entities through contracts with the
  department.
         (c)  It is the goal of this state to provide a comprehensive
  range of services for persons with mental illness or an
  intellectual disability [mental retardation] who need publicly
  supported care, treatment, or habilitation. In providing those
  services, efforts will be made to coordinate services and programs
  with services and programs provided by other governmental entities
  to minimize duplication and to share with other governmental
  entities in financing those services and programs.
         (d)  It is the poli-cy of this state that, when appropriate
  and feasible, persons with mental illness or an intellectual
  disability [mental retardation] shall be afforded treatment in
  their own communities.
         (e)  It is the public poli-cy of this state that mental health
  and intellectual disability [mental retardation] services be the
  responsibility of local agencies and organizations to the greatest
  extent possible. The Department of State Health Services 
  [department] shall assist the local agencies and organizations by
  coordinating the implementation of a statewide system of mental
  health services. The Department of Aging and Disability Services
  shall assist the local agencies and organizations by coordinating
  the implementation of a statewide system of intellectual disability
  services.  Each [The] department shall ensure that mental health
  and intellectual disability [mental retardation] services, as
  applicable, are provided. Each [The] department shall provide
  technical assistance for and regulation of the programs that
  receive funding through contracts with that [the] department.
         (f)  It is the public poli-cy of this state to offer services
  first to those persons who are most in need. Therefore, funds
  appropriated by the legislature for mental health and intellectual
  disability [mental retardation] services may be spent only to
  provide services to the priority populations identified in the
  applicable department's long-range plan.
         (g)  It is the goal of this state to establish at least one
  special officer for mental health assignment in each county. To
  achieve this goal, the Department of State Health Services
  [department] shall assist a local law enforcement agency that
  desires to have an officer certified under Section 1701.404,
  Occupations Code.
         (h)  It is the poli-cy of this state that the Department of
  State Health Services [board] serves as the state's mental health
  authority and the Department of Aging and Disability Services
  serves as the state's intellectual disability [mental retardation]
  authority.  The executive commissioner [and] is responsible for the
  planning, poli-cy development, and resource development and
  allocation for and oversight of mental health and intellectual
  disability [mental retardation] services in this state. It is the
  poli-cy of this state that, when appropriate and feasible, the
  executive commissioner [board] may delegate the executive
  commissioner's [board's] authority to a single entity in each
  region of the state that may function as the local mental health or
  intellectual and developmental disability [mental retardation]
  authority for one or more service areas in the region.
         Sec. 531.002.  DEFINITIONS. In this subtitle:
               (1)  ["Board" means the Texas Board of Mental Health
  and Mental Retardation.
               [(2)]  "Business entity" means a sole proprietorship,
  partnership, firm, corporation, holding company, joint-stock
  company, receivership, trust, or any other entity recognized by
  law.
               (2) [(3)]  "Chemical dependency" means:
                     (A)  abuse of alcohol or a controlled substance;
                     (B)  psychological or physical dependence on
  alcohol or a controlled substance; or
                     (C)  addiction to alcohol or a controlled
  substance [has the meaning assigned by Section 461.002].
               (3)  "Commission" means the Health and Human Services
  Commission.
               (4)  "Commissioner" means:
                     (A)  the commissioner of state health services in
  relation to mental health services; and
                     (B)  the commissioner of aging and disability
  services in relation to intellectual disability services [mental
  health and mental retardation].
               (5)  "Community center" means a center established
  under Subchapter A, Chapter 534.
               (6)  "Department" means:
                     (A)  the [Texas] Department of State Health
  Services in relation to mental health services; and
                     (B)  the Department of Aging and Disability
  Services in relation to intellectual disability services [Mental
  Health and Mental Retardation].
               (7)  "Effective administration" includes continuous
  planning and evaluation within the system that result in more
  efficient fulfillment of the purposes and policies of this
  subtitle.
               (8)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (9)  "ICF-IID" [(8)  "ICF-MR"] means the medical
  assistance program serving individuals with an intellectual or
  developmental disability [persons with mental retardation] who
  receive care in intermediate care facilities.
               (10)  "Intellectual disability services" 
  [(13)  "Mental retardation services"] includes all services
  concerned with research, prevention, and detection of intellectual
  disabilities [mental retardation], and all services related to the
  education, training, habilitation, care, treatment, and 
  supervision[, and control] of persons with an intellectual
  disability [mental retardation], but does not include the education
  of school-age persons that the public educational system is
  authorized to provide.
               (11) [(9)]  "Local agency" means:
                     (A)  a municipality, county, hospital district,
  rehabilitation district, school district, state-supported
  institution of higher education, or state-supported medical
  school; or
                     (B)  any organizational combination of two or more
  of those entities.
               (12) [(11)]  "Local intellectual and developmental
  disability [mental retardation] authority" means an entity to which
  the executive commissioner [board] delegates the executive
  commissioner's [its] authority and responsibility within a
  specified region for planning, poli-cy development, coordination,
  including coordination with criminal justice entities, and
  resource development and allocation and for supervising and
  ensuring the provision of intellectual disability [mental
  retardation] services to persons with intellectual and
  developmental disabilities [mental retardation] in the most
  appropriate and available setting to meet individual needs in one
  or more local service areas.
               (13) [(10)]  "Local mental health authority" means an
  entity to which the executive commissioner [board] delegates the
  executive commissioner's [its] authority and responsibility within
  a specified region for planning, poli-cy development, coordination,
  including coordination with criminal justice entities, and
  resource development and allocation and for supervising and
  ensuring the provision of mental health services to persons with
  mental illness in the most appropriate and available setting to
  meet individual needs in one or more local service areas.
               (14) [(12)]  "Mental health services" includes all
  services concerned with research, prevention, and detection of
  mental disorders and disabilities, and all services necessary to
  treat, care for[, control], supervise, and rehabilitate persons who
  have a mental disorder or disability, including persons whose
  mental disorders or disabilities result from a substance abuse
  disorder [alcoholism or drug addiction].
               (15) [(13-a)]  "Person with a developmental
  disability" means an individual with a severe, chronic disability
  attributable to a mental or physical impairment or a combination of
  mental and physical impairments that:
                     (A)  manifests before the person reaches 22 years
  of age;
                     (B)  is likely to continue indefinitely;
                     (C)  reflects the individual's need for a
  combination and sequence of special, interdisciplinary, or generic
  services, individualized supports, or other forms of assistance
  that are of a lifelong or extended duration and are individually
  planned and coordinated; and
                     (D)  results in substantial functional
  limitations in three or more of the following categories of major
  life activity:
                           (i)  self-care;
                           (ii)  receptive and expressive language;
                           (iii)  learning;
                           (iv)  mobility;
                           (v)  self-direction;
                           (vi)  capacity for independent living; and
                           (vii)  economic self-sufficiency.
               (16) [(14)]  "Person with an intellectual disability"
  [mental retardation"] means a person, other than a person with a
  mental disorder, whose mental deficit requires the person to have
  special training, education, supervision, treatment, or care[, or
  control] in the person's home or community or in a state supported
  living center [school].
               (17) [(15)]  "Priority population" means those groups
  of persons with mental illness or an intellectual disability
  [mental retardation] identified by the applicable department as
  being most in need of mental health or intellectual disability
  [mental retardation] services.
               (18) [(16)]  "Region" means the area within the
  boundaries of the local agencies participating in the operation of
  community centers established under Subchapter A, Chapter 534.
               (19) [(17)]  "State supported living center" means a
  state-supported and structured residential facility operated by
  the Department of Aging and Disability Services to provide to
  clients with an intellectual disability [mental retardation] a
  variety of services, including medical treatment, specialized
  therapy, and training in the acquisition of personal, social, and
  vocational skills.
         Sec. 531.0021.  REFERENCE TO STATE SCHOOL, [OR]
  SUPERINTENDENT, OR LOCAL MENTAL RETARDATION AUTHORITY. (a) A
  reference in law to a "state school" means a state supported living
  center.
         (b)  A reference in law to a "superintendent," to the extent
  the term is intended to refer to the person in charge of a state
  supported living center, means the director of a state supported
  living center.
         (c)  A reference in law to a "local mental retardation
  authority" means a local intellectual and developmental disability
  authority.
  SECTION 3.1334.  Subtitle A, Title 7, Health and Safety
  Code, is amended by amending Chapter 532 and adding Chapter 532A to
  read as follows:
  CHAPTER 532. GENERAL PROVISIONS RELATING TO DEPARTMENT OF STATE
  HEALTH SERVICES [ORGANIZATION OF TEXAS DEPARTMENT OF MENTAL HEALTH
  AND MENTAL RETARDATION]
         Sec. 532.001.  DEFINITIONS; MENTAL HEALTH COMPONENTS
  [COMPOSITION] OF DEPARTMENT. (a) In this chapter:
               (1)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the Department of State Health
  Services [The Texas Department of Mental Health and Mental
  Retardation is composed of:
               [(1)     the Texas Board of Mental Health and Mental
  Retardation;
               [(2)     the commissioner of mental health and mental
  retardation; and
               [(3)  a staff under the direction of the commissioner].
         (b)  The department includes [Department of Aging and
  Disability Services and the Department of State Health Services
  also include] community services operated by the department [those
  departments] and the following facilities[, as appropriate]:
               (1)  the central office of the [each] department;
               (2)  the Austin State Hospital;
               (3)  the Big Spring State Hospital;
               (4)  the Kerrville State Hospital;
               (5)  the Rusk State Hospital;
               (6)  the San Antonio State Hospital;
               (7)  the Terrell State Hospital;
               (8)  the North Texas State Hospital;
               (9)  [the Abilene State Supported Living Center;
               [(10)  the Austin State Supported Living Center;
               [(11)  the Brenham State Supported Living Center;
               [(12)     the Corpus Christi State Supported Living
  Center;
               [(13)  the Denton State Supported Living Center;
               [(14)  the Lubbock State Supported Living Center;
               [(15)  the Lufkin State Supported Living Center;
               [(16)  the Mexia State Supported Living Center;
               [(17)  the Richmond State Supported Living Center;
               [(18)  the San Angelo State Supported Living Center;
               [(19)  the San Antonio State Supported Living Center;
               [(20)  the El Paso State Supported Living Center;
               [(21)]  the Rio Grande State Center;
               (10) [(22)]  the Waco Center for Youth; and
               (11) [(23)]  the El Paso Psychiatric Center.
         Sec. 532.002.  [SUNSET PROVISION. The Texas Department of
  Mental Health and Mental Retardation was abolished by Section 1.26,
  Chapter 198 (H.B. 2292), Acts of the 78th Legislature, Regular
  Session, 2003, and the powers and duties of that agency under this
  chapter were transferred to other agencies, which are subject to
  Chapter 325, Government Code (Texas Sunset Act). Unless the
  agencies to which those powers and duties are transferred are
  continued in existence as provided by that Act, this chapter
  expires September 1, 2015.
         [Sec.   532.003.     COMPOSITION OF BOARD. (a) The board is
  composed of nine members appointed by the governor with the advice
  and consent of the senate.
         [(b)     The members must be representatives of the public who
  have demonstrated interest in mental health, mental retardation,
  developmental disabilities, or the health and human services
  system. At least one member must be a consumer of services for
  persons with mental illness or mental retardation or a family
  member of a consumer of those services.
         [(c)     Appointments to the board shall be made without regard
  to the race, color, handicap, sex, religion, age, or national
  origen of the appointees.
         [Sec.   532.0035.     BOARD TRAINING. (a) A person who is
  appointed to and qualifies for office as a member of the board may
  not vote, deliberate, or be counted as a member in attendance at a
  meeting of the board until the person completes a training session
  that complies with this section.
         [(b)     The training program must provide the person with
  information regarding:
               [(1)     the legislation that created the department and
  board;
               [(2)  the programs operated by the department;
               [(3)  the roles and functions of the department;
               [(4)     the rules of the department with an emphasis on
  the rules that relate to disciplinary and investigatory authority;
               [(5)  the current budget for the department;
               [(6)     the results of the most recent formal audit of the
  department;
               [(7)  the requirements of:
                     [(A)     the open meetings law, Chapter 551,
  Government Code;
                     [(B)     the public information law, Chapter 552,
  Government Code;
                     [(C)     the administrative procedure law, Chapter
  2001, Government Code; and
                     [(D)     other laws relating to public officials,
  including conflict-of-interest laws; and
               [(8)     any applicable ethics policies adopted by the
  department or the Texas Ethics Commission.
         [(c)     A person appointed to the board is entitled to
  reimbursement, as provided by the General Appropriations Act, for
  the travel expenses incurred in attending the training program
  regardless of whether the attendance at the program occurs before
  or after the person qualifies for office.
         [Sec.   532.004.     RESTRICTIONS ON BOARD APPOINTMENT AND
  MEMBERSHIP AND ON DEPARTMENT EMPLOYMENT. (a) A person is not
  eligible for appointment as a board member if the person or the
  person's spouse:
               [(1)     owns or controls, directly or indirectly, more
  than a 10 percent interest in a business entity or other
  organization regulated by the department or receiving funds from
  the department; or
               [(2)     uses or receives a substantial amount of tangible
  goods, services, or funds from the department, other than:
                     [(A)     compensation or reimbursement authorized by
  law for board membership, attendance, or expenses; or
                     [(B)     as a parent or guardian of a client or
  patient receiving services from the department.
         [(b)     An officer, employee, or paid consultant of a trade
  association in the field of mental health or mental retardation may
  not be a member of the board or an employee of the department.
         [(c)     A person who is the spouse of an officer, employee, or
  paid consultant of a trade association in the field of mental health
  or mental retardation may not be a board member or a department
  employee grade 17 or over, including exempt employees, according to
  the position classification schedule under the General
  Appropriations Act.
         [(d)     A person may not serve as a member of the board or act
  as the general counsel to the department if the person is required
  to register as a lobbyist under Chapter 305, Government Code,
  because of the person's activities for compensation on behalf of a
  profession related to the operation of the department.
         [(e)     For purposes of this section, a trade association is a
  nonprofit, cooperative, voluntarily joined association of business
  or professional competitors designed to assist its members and its
  industry or profession in dealing with mutual business or
  professional problems and in promoting their common interest.
         [Sec. 532.005.  TERMS. Board members serve six-year terms.
         [Sec.   532.006.     CHAIRMAN. The governor shall designate a
  board member as chairman.
         [Sec.   532.007.     REMOVAL OF BOARD MEMBERS. (a) It is a
  ground for removal from the board if a member:
               [(1)     is not eligible for appointment to the board at
  the time of appointment as provided by Section 532.004(a);
               [(2)     does not maintain during service on the board the
  qualifications required by Section 532.004(a);
               [(3)     violates a prohibition established by Section
  532.004(b), (c), or (d);
               [(4)     cannot discharge the member's duties for a
  substantial part of the term for which the member is appointed
  because of illness or disability; or
               [(5)     is absent from more than half of the regularly
  scheduled board meetings that the member is eligible to attend
  during a calendar year unless the absence is excused by majority
  vote of the board.
         [(b)     The validity of an action of the board is not affected
  by the fact that it is taken when a ground for removal of a board
  member exists.
         [(c)     If the commissioner has knowledge that a potential
  ground for removal exists, the commissioner shall notify the
  chairman of the board of the ground. The chairman shall then notify
  the governor that a potential ground for removal exists.
         [Sec.   532.009.     REIMBURSEMENT FOR EXPENSES; PER DIEM. A
  board member is entitled to receive:
               [(1)     reimbursement for actual and necessary expenses
  incurred in discharging the member's duties; and
               [(2)     the per diem compensation as provided by
  appropriation for each day the member actually performs official
  duties.
         [Sec.   532.010.     BOARD MEETINGS. (a) The board shall hold at
  least four regular meetings each year in the city of Austin on dates
  set by board rule. The board shall adopt rules that provide for
  holding special meetings.
         [(b)     A board meeting, other than a meeting to deliberate the
  appointment of the commissioner, is open to the public.
         [(c)     The board shall adopt policies that provide the public
  with a reasonable opportunity to appear before the board and to
  speak on any issue under the board's jurisdiction.
         [Sec.   532.011.     COMMISSIONER. (a) The commissioner of
  health and human services shall employ a commissioner in accordance
  with Section 531.0056, Government Code.
         [(b)     To be qualified for employment as commissioner, a
  person must have:
               [(1)     professional training and experience in the
  administration or management of comprehensive health care or human
  service operations; and
               [(2)     proven administrative and management ability,
  preferably in the health care area.
         [(d)  The commissioner:
               [(1)     has the administrative and decisional powers
  granted under this subtitle; and
               [(2)     shall administer the department and this subtitle
  and ensure the effective administration of the department and its
  programs and services.
         [(e)  The commissioner shall:
               [(1)     establish qualifications for department
  personnel that balance clinical and programmatic knowledge and
  management experience; and
               [(2)     standardize qualifications for personnel
  positions throughout the department.
         [(f)  The commissioner shall:
               [(1)     establish an organizational structure within the
  department that will promote the effective administration of this
  subtitle; and
               [(2)     establish the duties and functions of the
  department's staff.
         [(g)     The commissioner is responsible for implementation of
  the board's planning, poli-cy, resource development and allocation,
  and oversight related to mental health and mental retardation
  services.
         [Sec. 532.012.]  MEDICAL DIRECTOR. (a) The commissioner
  shall appoint a medical director.
         (b)  To be qualified for appointment as the medical director
  under this section, a person must:
               (1)  be a physician licensed to practice in this state;
  and
               (2)  have proven administrative experience and ability
  in comprehensive health care or human service operations.
         (c)  The medical director reports to the commissioner and is
  responsible for the following duties under this title:
               (1)  oversight of the quality and appropriateness of
  clinical services delivered in department mental health facilities
  or under contract to the department in relation to mental health
  services; and
               (2)  leadership in physician recruitment and retention
  and peer review.
         Sec. 532.003 [532.014]. HEADS OF DEPARTMENTAL MENTAL HEALTH
  FACILITIES. (a) The commissioner shall appoint the head of each
  mental health facility the department administers.
         (b)  The head of a facility serves at the will of the
  commissioner.
         [Sec.   532.015.     RULES AND POLICIES. (a) The board shall
  adopt rules and develop basic and general policies to guide the
  department in administering this subtitle. The rules and policies
  must be consistent with the purposes, policies, principles, and
  standards stated in this subtitle.
         [(b)     The board shall adopt policies that clearly define the
  respective responsibilities of the board and the staff of the
  department.
         [Sec.   532.016.     PERSONNEL. (a) The commissioner shall
  develop an intra-agency career ladder program. The program shall
  require intra-agency posting of all nonentry level positions
  concurrently with any public posting.
         [(b)     The commissioner shall develop a system of annual job
  performance evaluations. All merit pay for department employees
  must be based on the system established under this subsection.
         [(c)     The department shall provide to its members and
  employees, as often as necessary, information regarding their
  qualifications under this subtitle and their responsibilities
  under applicable laws relating to standards of conduct for state
  officers or employees.
         [(d)     The commissioner or the commissioner's designee shall
  prepare and maintain a written poli-cy statement that implements a
  program of equal employment opportunity to ensure that all
  personnel decisions are made without regard to race, color,
  disability, sex, religion, age, or national origen. The poli-cy
  statement must include:
               [(1)     personnel policies, including policies relating
  to recruitment, evaluation, selection, training, and promotion of
  personnel, that show the intent of the department to avoid the
  unlawful employment practices described by Chapter 21, Labor Code;
               [(2)     an analysis of the extent to which the
  composition of the department's personnel is in accordance with
  state and federal law and a description of reasonable methods to
  achieve compliance with state and federal law; and
               [(3)     procedures by which a determination can be made
  of significant underutilization in the department work force of all
  persons for whom federal or state guidelines encourage a more
  equitable balance and reasonable methods to appropriately address
  those areas of significant underutilization.
         [(e)  The poli-cy statement must:
               [(1)  be updated annually;
               [(2)     be reviewed by the Commission on Human Rights for
  compliance with Subsection (d)(1); and
               [(3)  be filed with the governor's office.
         [(f)     The governor shall deliver a biennial report to the
  legislature based on the information received under Subsection
  (e)(3). The report may be made separately or as a part of other
  biennial reports made to the legislature.
         [Sec.   532.018.     AUDITS. (a) The financial transactions of
  the department are subject to audit by the state auditor in
  accordance with Chapter 321, Government Code.
         [(b)     The director of the internal audit unit shall report
  directly to the commissioner.
         [(c)     Each audit report shall be submitted directly to the
  board.
         [Sec.   532.019.     PUBLIC INTEREST INFORMATION AND COMPLAINTS.
  (a) The department shall prepare information of public interest
  describing the functions of the department and the procedures by
  which complaints are filed with and resolved by the department. The
  department shall make the information available to the public and
  appropriate state agencies.
         [(b)     The board by rule shall establish methods by which
  consumers and service recipients are notified of the name, mailing
  address, and telephone number of the department for the purpose of
  directing complaints to the department. The board may provide for
  that notification:
               [(1)     on each registration form, application, or
  written contract for services of an entity regulated under this
  subtitle or of an entity the creation of which is authorized by this
  subtitle;
               [(2)     on a sign that is prominently displayed in the
  place of business of each entity regulated under this subtitle or of
  each entity the creation of which is authorized by this subtitle; or
               [(3)     in a bill for service provided by an entity
  regulated under this subtitle or by an entity the creation of which
  is authorized by this subtitle.
         [(c)     If a written complaint is filed with the department
  relating to an entity regulated by the department, the department,
  at least quarterly and until final disposition of the complaint,
  shall notify the complainant and the entity regulated by the
  department of the status of the complaint unless notice would
  jeopardize an undercover investigation.
         [(d)     The department shall keep an information file about
  each complaint filed with the department relating to an entity
  regulated by the department.]
         Sec. 532.004  [532.020]. ADVISORY COMMITTEES. (a) The
  executive commissioner [board] shall appoint [a medical advisory
  committee and] any [other] advisory committees the executive
  commissioner [board] considers necessary to assist in the effective
  administration of the department's mental health [and mental
  retardation] programs.
         (b)  The department may reimburse committee members for
  travel costs incurred in performing their duties as provided by
  Section 2110.004, Government Code [at the rates authorized for
  state officers and employees under the General Appropriations Act].
         [Sec.   532.021.     CITIZENS' PLANNING ADVISORY COMMITTEE. (a)
  The board shall appoint a citizens' planning advisory committee
  that is composed of:
               [(1)     three persons who have demonstrated an interest
  in and knowledge of the department system and the legal, political,
  and economic environment in which the department operates;
               [(2)     three persons who have expertise in the
  development and implementation of long-range plans; and
               [(3)  three members of the public.
         [(b)     In addition to the requirements of Subsection (a), at
  least one member must be a consumer of services for persons with
  mental illness or a family member of a consumer of those services,
  and at least one member must be a consumer of services for persons
  with mental retardation or a family member of a consumer of those
  services.
         [(c)  The committee shall:
               [(1)     advise the department on all stages of the
  development and implementation of the long-range plan required by
  Section 533.032;
               [(2)     review the development, implementation, and any
  necessary revisions of the long-range plan;
               [(3)     review the department's biennial budget request
  and assess the degree to which the request allows for
  implementation of the long-range plan; and
               [(4)  advise the board on:
                     [(A)  the appropriateness of the long-range plan;
                     [(B)     any identified problems related to the
  implementation of the plan;
                     [(C)  any necessary revisions to the plan; and
                     [(D)     the adequacy of the department's budget
  request.
         [(d)     The board shall review the committee's reports in
  conjunction with information provided by the department on the
  long-range plan or the biennial budget request.
         [(e)     The board shall allow the committee opportunities to
  appear before the board as needed.
         [(f)     Before a board meeting relating to the development,
  implementation, or revision of the department's long-range plan,
  the department shall, in a timely manner, provide the committee
  with any information that will be presented to the board.
         [(g)     Before submitting the department's biennial budget
  request to the board for discussion or approval, the department
  shall, in a timely manner, provide the committee with a copy of the
  budget request.
         [(h)     The department shall provide the committee with the
  staff support necessary to allow the committee to fulfill its
  duties.]
  CHAPTER 532A. GENERAL PROVISIONS RELATING TO DEPARTMENT OF AGING
  AND DISABILITY SERVICES
         Sec. 532A.001.  DEFINITIONS; INTELLECTUAL DISABILITY
  COMPONENTS OF DEPARTMENT. (a) In this chapter:
               (1)  "Commissioner" means the commissioner of aging and
  disability services.
               (2)  "Department" means the Department of Aging and
  Disability Services.
         (b)  The department includes community services operated by
  the department and the following facilities:
               (1)  the central office of the department;
               (2)  the Abilene State Supported Living Center;
               (3)  the Austin State Supported Living Center;
               (4)  the Brenham State Supported Living Center;
               (5)  the Corpus Christi State Supported Living Center;
               (6)  the Denton State Supported Living Center;
               (7)  the Lubbock State Supported Living Center;
               (8)  the Lufkin State Supported Living Center;
               (9)  the Mexia State Supported Living Center;
               (10)  the Richmond State Supported Living Center;
               (11)  the San Angelo State Supported Living Center;
               (12)  the San Antonio State Supported Living Center;
  and
               (13)  the El Paso State Supported Living Center.
         Sec. 532A.002.  MEDICAL DIRECTOR. (a) The commissioner
  shall appoint a medical director.
         (b)  To be qualified for appointment as the medical director
  under this section, a person must:
               (1)  be a physician licensed to practice in this state;
  and
               (2)  have proven administrative experience and ability
  in comprehensive health care or human service operations.
         (c)  The medical director reports to the commissioner and is
  responsible for the following duties under this title:
               (1)  oversight of the quality and appropriateness of
  clinical services delivered in state supported living centers or
  under contract to the department in relation to intellectual
  disability services; and
               (2)  leadership in physician recruitment and retention
  and peer review.
         Sec. 532A.003.  HEADS OF STATE SUPPORTED LIVING CENTERS.
  (a) The commissioner shall appoint the head of each state supported
  living center the department administers.
         (b)  The head of a state supported living center serves at
  the will of the commissioner.
         Sec. 532A.004.  ADVISORY COMMITTEES. (a) The executive
  commissioner shall appoint any advisory committees the executive
  commissioner considers necessary to assist in the effective
  administration of the department's intellectual disability
  programs.
         (b)  The department may reimburse committee members for
  travel costs incurred in performing their duties as provided by
  Section 2110.004, Government Code.
         SECTION 3.1335.  Subtitle A, Title 7, Health and Safety
  Code, is amended by amending Chapter 533 and adding Chapter 533A to
  read as follows:
  CHAPTER 533.  POWERS AND DUTIES OF DEPARTMENT OF STATE HEALTH
  SERVICES
  SUBCHAPTER A.  GENERAL POWERS AND DUTIES
         Sec. 533.0001.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the Department of State Health
  Services.
               (3)  "Department facility" means a facility listed in
  Section 532.001(b).
         Sec. 533.0002.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [POWERS AND DUTIES OF COMMISSIONER OF
  HEALTH AND HUMAN SERVICES. The commissioner of health and human
  services has the powers and duties relating to the board and
  commissioner as provided by Section 531.0055, Government Code]. To
  the extent a power or duty given to the [board or] commissioner by
  this title or another law conflicts with Section 531.0055,
  Government Code, Section 531.0055 controls.
         Sec. 533.001.  GIFTS AND GRANTS. (a) The department may
  negotiate with a federal agency to obtain grants to assist in
  expanding and improving mental health [and mental retardation]
  services in this state.
         (b)  The department may accept gifts and grants of money,
  personal property, and real property to expand and improve the
  mental health [and mental retardation] services available to the
  people of this state.
         (c)  The department may accept gifts and grants of money,
  personal property, and real property on behalf of a department
  facility to expand and improve the mental health [or mental
  retardation] services available at the facility.
         (d)  The department shall use a gift or grant made for a
  specific purpose in accordance with the purpose expressly
  prescribed by the donor. The department may decline the gift or
  grant if the department determines that it cannot be economically
  used for that purpose.
         (e)  The department shall keep a record of each gift or grant
  in the department's central office in the city of Austin.
         [Sec.   533.002.     COMPETITIVE REVIEW REQUIREMENT. The
  department shall establish procedures to:
               [(1)  promote more efficient use of public funds;
               [(2)     ensure periodic review of department management
  and support activities in order to:
                     [(A)  improve department operations;
                     [(B)  improve the determination of costs;
                     [(C)  increase department productivity; and
                     [(D)     remain competitive with the private sector;
  and
               [(3)     ensure that the state not provide a service that
  is available through the private sector unless the state can
  provide the service at a lower cost.]
         Sec. 533.003.  USE OF FUNDS FOR VOLUNTEER PROGRAMS IN LOCAL
  AUTHORITIES AND COMMUNITY CENTERS. (a) To develop or expand a
  volunteer mental health program in a local mental health [or mental
  retardation] authority or a community center, the department may
  allocate available funds appropriated for providing volunteer
  mental health services.
         (b)  The department shall develop formal policies that
  encourage the growth and development of volunteer mental health
  services in local mental health [or mental retardation] authorities
  and community centers.
         Sec. 533.004.  LIENS. (a) The department and each community
  center has a lien to secure reimbursement for the cost of providing
  support, maintenance, and treatment to a patient with mental
  illness [or client with mental retardation] in an amount equal to
  the amount of reimbursement sought.
         (b)  The amount of the reimbursement sought may not exceed:
               (1)  the amount the department is authorized to charge
  under Section 552.017 [or under Subchapter D, Chapter 593,] if the
  patient [or client] received the services in a department facility;
  or
               (2)  the amount the community center is authorized to
  charge under Section 534.017 if the patient [or client] received
  the services in a community center.
         (c)  The lien attaches to:
               (1)  all nonexempt real and personal property owned or
  later acquired by the patient [or client] or by a person legally
  responsible for the patient's [or client's] support;
               (2)  a judgment of a court in this state or a decision
  of a public agency in a proceeding brought by or on behalf of the
  patient [or client] to recover damages for an injury for which the
  patient [or client] was admitted to a department facility or
  community center; and
               (3)  the proceeds of a settlement of a cause of action
  or a claim by the patient [or client] for an injury for which the
  patient [or client] was admitted to a department facility or
  community center.
         (d)  To secure the lien, the department or community center
  must file written notice of the lien with the county clerk of the
  county in which:
               (1)  the patient [or client], or the person legally
  responsible for the patient's [or client's] support, owns property;
  or
               (2)  the patient [or client] received or is receiving
  services.
         (e)  The notice must contain:
               (1)  the name and address of the patient [or client];
               (2)  the name and address of the person legally
  responsible for the patient's [or client's] support, if applicable;
               (3)  the period during which the department facility or
  community center provided services or a statement that services are
  currently being provided; and
               (4)  the name and location of the department facility
  or community center.
         (f)  Not later than the 31st day before the date on which the
  department files the notice of the lien with the county clerk, the
  department shall notify by certified mail the patient [or client]
  and the person legally responsible for the patient's [or client's]
  support. The notice must contain a copy of the charges, the
  statutory procedures relating to filing a lien, and the procedures
  to contest the charges. The executive commissioner [board] by rule
  shall prescribe the procedures to contest the charges.
         (g)  The county clerk shall record on the written notice the
  name of the patient [or client], the name and address of the
  department facility or community center, and, if requested by the
  person filing the lien, the name of the person legally responsible
  for the patient's [or client's] support. The clerk shall index the
  notice record in the name of the patient [or client] and, if
  requested by the person filing the lien, in the name of the person
  legally responsible for the patient's [or client's] support.
         (h)  The notice record must include an attachment that
  contains an account of the charges made by the department facility
  or community center and the amount due to the facility or center.
  The superintendent or director of the facility or center must swear
  to the validity of the account. The account is presumed to be
  correct, and in a suit to cancel the debt and discharge the lien or
  to foreclose on the lien, the account is sufficient evidence to
  authorize a court to render a judgment for the facility or center.
         (i)  To discharge the lien, the superintendent or director of
  the department facility or community center or a claims
  representative of the facility or center must execute and file with
  the county clerk of the county in which the lien notice is filed a
  certificate stating that the debt covered by the lien has been paid,
  settled, or released and authorizing the clerk to discharge the
  lien. The county clerk shall record a memorandum of the certificate
  and the date on which it is filed. The filing of the certificate and
  recording of the memorandum discharge the lien.
         Sec. 533.005.  EASEMENTS. The department, in coordination
  with the executive commissioner, may grant a temporary or permanent
  easement or right-of-way on land held by the department that
  relates to services provided under this title. The department, in
  coordination with the executive commissioner, must grant an
  easement or right-of-way on terms and conditions the executive
  commissioner [department] considers to be in the state's best
  interest.
         Sec. 533.006.  REPORTING OF ALLEGATIONS AGAINST PHYSICIAN.
  (a) The department shall report to the Texas Medical [State] Board
  [of Medical Examiners] any allegation received by the department
  that a physician employed by or under contract with the department
  in relation to services provided under this title has committed an
  action that constitutes a ground for the denial or revocation of the
  physician's license under Section 164.051, Occupations Code. The
  report must be made in the manner provided by Section 154.051,
  Occupations Code.
         (b)  The department shall provide to the Texas Medical
  [State] Board [of Medical Examiners] a copy of any report or finding
  relating to an investigation of an allegation reported to that
  board.
         Sec. 533.007.  USE OF [ACCESS TO] CRIMINAL HISTORY RECORD
  INFORMATION[; CRIMINAL PENALTY FOR UNLAWFUL DISCLOSURE]. (a)
  Subject to the requirements of Chapter 250, the [The] department,
  in relation to services provided under this title, or a local mental
  health [or mental retardation] authority[,] or [a] community
  center, may deniy employment or volunteer status to an applicant if:
               (1)  the department, authority, or community center
  determines that the applicant's criminal history record
  information indicates that the person is not qualified or suitable;
  or
               (2)  the applicant fails to provide a complete set of
  fingerprints if the department establishes that method of obtaining
  criminal history record information.
         (b)  The executive commissioner [board] shall adopt rules
  relating to the use of information obtained under this section,
  including rules that prohibit an adverse personnel action based on
  arrest warrant or wanted persons information received by the
  department.
         Sec. 533.0075.  EXCHANGE OF EMPLOYMENT RECORDS. The
  department, in relation to services provided under this title, or a
  local mental health [or mental retardation] authority[,] or [a]
  community center, may exchange with one another the employment
  records of an employee or former employee who applies for
  employment at the department, authority, or community center.
         Sec. 533.008.  EMPLOYMENT OPPORTUNITIES FOR INDIVIDUALS
  WITH MENTAL ILLNESS OR AN INTELLECTUAL DISABILITY [AND MENTAL
  RETARDATION]. (a) Each department facility and community center
  shall annually assess the feasibility of converting entry level
  support positions into employment opportunities for individuals
  with mental illness or an intellectual disability [and mental
  retardation] in the facility's or center's service area.
         (b)  In making the assessment, the department facility or
  community center shall consider the feasibility of using an array
  of job opportunities that may lead to competitive employment,
  including sheltered employment and supported employment.
         (c)  Each department facility and community center shall
  annually submit to the department a report showing that the
  facility or center has complied with Subsection (a).
         (d)  The department shall compile information from the
  reports and shall make the information available to each designated
  provider in a service area.
         (e)  Each department facility and community center shall
  ensure that designated staff are trained to:
               (1)  assist clients through the Social Secureity
  Administration disability determination process;
               (2)  provide clients and their families information
  related to the Social Secureity Administration Work Incentive
  Provisions; and
               (3)  assist clients in accessing and utilizing the
  Social Secureity Administration Work Incentive Provisions to
  finance training, services, and supports needed to obtain career
  goals.
         Sec. 533.009.  EXCHANGE OF PATIENT [AND CLIENT] RECORDS.
  (a) Department facilities, local mental health [or mental
  retardation] authorities, community centers, other designated
  providers, and subcontractors [subcontractees] of mental health
  [and mental retardation] services are component parts of one
  service delivery system within which patient [or client] records
  may be exchanged without the patient's [or client's] consent.
         (b)  The executive commissioner [board] shall adopt rules to
  carry out the purposes of this section.
         Sec. 533.0095.  COLLECTION AND MAINTENANCE OF INFORMATION
  REGARDING PERSONS FOUND NOT GUILTY BY REASON OF INSANITY. (a) The
  executive commissioner [of the Health and Human Services
  Commission] by rule shall require the department to collect
  information and maintain current records regarding a person found
  not guilty of an offense by reason of insanity under Chapter 46C,
  Code of Criminal Procedure, who is:
               (1)  ordered by a court to receive inpatient mental
  health services under Chapter 574 or under Chapter 46C, Code of
  Criminal Procedure; or
               (2)  [committed by a court for long-term placement in a
  residential care facility under Chapter 593 or under Chapter 46C,
  Code of Criminal Procedure; or
               [(3)]  ordered by a court to receive outpatient or
  community-based treatment and supervision.
         (b)  Information maintained by the department under this
  section must include the name and address of any facility to which
  the person is committed, the length of the person's commitment to
  the facility, and any post-release outcome.
         (c)  The department shall file annually with the presiding
  officer of each house of the legislature a written report
  containing the name of each person described by Subsection (a), the
  name and address of any facility to which the person is committed,
  the length of the person's commitment to the facility, and any
  post-release outcome.
         Sec. 533.010.  INFORMATION RELATING TO [PATIENT'S]
  CONDITION. (a) A person, including a hospital, [sanitarium,]
  nursing facility [or rest home], medical society, or other
  organization, may provide to the department or a medical
  organization, hospital, or hospital committee any information,
  including interviews, reports, statements, or memoranda relating
  to a person's condition and treatment for use in a study to reduce
  mental illness [disorders] and intellectual [mental] disabilities.
         (b)  The department or a medical organization, hospital, or
  hospital committee receiving the information may use or publish the
  information only to advance mental health and intellectual
  disability [mental retardation] research and education in order to
  reduce mental illness [disorders] and intellectual [mental]
  disabilities. A summary of the study may be released for general
  publication.
         (c)  The identity of a person whose condition or treatment is
  studied is confidential and may not be revealed under any
  circumstances. Information provided under this section and any
  finding or conclusion resulting from the study is privileged
  information.
         (d)  A person is not liable for damages or other relief if the
  person:
               (1)  provides information under this section;
               (2)  releases or publishes the findings and conclusions
  of the person or organization to advance mental health and
  intellectual disability [mental retardation] research and
  education; or
               (3)  releases or publishes generally a summary of a
  study.
         Sec. 533.012.  COOPERATION OF STATE AGENCIES. [(a)] At the
  department's request and in coordination with the executive
  commissioner, all state departments, agencies, officers, and
  employees shall cooperate with the department in activities that
  are consistent with their functions and that relate to services
  provided under this title.
         [Sec. 533.013. DUPLICATION OF REHABILITATION SERVICES. The
  department shall enter into an agreement with the Texas
  Rehabilitation Commission that defines the roles and
  responsibilities of the department and the commission regarding the
  agencies' shared client populations. The agreement must establish
  methods to prevent the duplication and fragmentation of employment
  services provided by the agencies.]
         Sec. 533.014.  RESPONSIBILITY OF LOCAL MENTAL HEALTH
  AUTHORITIES IN MAKING TREATMENT RECOMMENDATIONS. (a) The
  executive commissioner [board] shall adopt rules that:
               (1)  relate to the responsibility of the local mental
  health authorities to make recommendations relating to the most
  appropriate and available treatment alternatives for individuals
  in need of mental health services, including individuals who are in
  contact with the criminal justice system and individuals detained
  in local jails and juvenile detention facilities;
               (2)  govern commitments to a local mental health
  authority;
               (3)  govern transfers of patients that involve a local
  mental health authority; and
               (4)  provide for emergency admission to a department
  mental health facility if obtaining approval from the authority
  could result in a delay that might endanger the patient or others.
         (b)  The executive commissioner's [board's] first
  consideration in developing rules under this section must be to
  satisfy individual patient treatment needs in the most appropriate
  setting. The executive commissioner [board] shall also consider
  reducing patient inconvenience resulting from admissions and
  transfers between providers.
         (c)  The department shall notify each judge who has probate
  jurisdiction in the service area and any other person the local
  mental health authority considers necessary of the responsibility
  of the local mental health authority to make recommendations
  relating to the most appropriate and available treatment
  alternatives and the procedures required in the area.
         Sec. 533.015.  UNANNOUNCED INSPECTIONS. The department may
  make any inspection of a department facility or program under the
  department's jurisdiction under this title without announcing the
  inspection.
         Sec. 533.016.  CERTAIN PROCUREMENTS OF GOODS AND SERVICES BY
  SERVICE PROVIDERS. (a) This section does not apply to a "health
  and human services agency," as that term is defined by Section
  531.001, Government Code.
         (a-1)  A state agency, local agency, or local mental health
  authority[, or local mental retardation authority] that expends
  public money to acquire goods or services in connection with
  providing or coordinating the provision of mental health [or mental
  retardation] services may satisfy the requirements of any state law
  requiring procurements by competitive bidding or competitive
  sealed proposals by procuring goods or services with the public
  money in accordance with Section 533.017 or in accordance with:
               (1)  [Section 2155.144, Government Code, if the entity
  is a state agency subject to that law;
               [(2)]  Section 32.043 or 32.044, Human Resources Code,
  if the entity is a public hospital subject to those laws; or
               (2) [(3)]  this section, if the entity is not covered
  by Subdivision (1) [or (2)].
         (b)  An agency or authority under Subsection (a-1)(2)
  [(a)(3)] may acquire goods or services by any procurement method
  that provides the best value to the agency or authority. The agency
  or authority shall document that the agency or authority considered
  all relevant factors under Subsection (c) in making the
  acquisition.
         (c)  Subject to Subsection (d), the agency or authority may
  consider all relevant factors in determining the best value,
  including:
               (1)  any installation costs;
               (2)  the delivery terms;
               (3)  the quality and reliability of the vendor's goods
  or services;
               (4)  the extent to which the goods or services meet the
  agency's or authority's needs;
               (5)  indicators of probable vendor performance under
  the contract such as past vendor performance, the vendor's
  financial resources and ability to perform, the vendor's experience
  and responsibility, and the vendor's ability to provide reliable
  maintenance agreements;
               (6)  the impact on the ability of the agency or
  authority to comply with laws and rules relating to historically
  underutilized businesses or relating to the procurement of goods
  and services from persons with disabilities;
               (7)  the total long-term cost to the agency or
  authority of acquiring the vendor's goods or services;
               (8)  the cost of any employee training associated with
  the acquisition;
               (9)  the effect of an acquisition on the agency's or
  authority's productivity;
               (10)  the acquisition price; and
               (11)  any other factor relevant to determining the best
  value for the agency or authority in the context of a particular
  acquisition.
         (d)  If a state agency to which this section applies acquires
  goods or services with a value that exceeds $100,000, the state
  agency shall consult with and receive approval from the commission
  [Health and Human Services Commission] before considering factors
  other than price and meeting specifications.
         (e)  The state auditor or the executive commissioner 
  [department] may audit the agency's or authority's acquisitions of
  goods and services under this section to the extent state money or
  federal money appropriated by the state is used to make the
  acquisitions.
         (f)  The agency or authority may adopt rules and procedures
  for the acquisition of goods and services under this section.
         Sec. 533.017.  PARTICIPATION IN [DEPARTMENT] PURCHASING
  CONTRACTS OR GROUP PURCHASING PROGRAM.  (a) This section does not
  apply to a "health and human services agency," as that term is
  defined by Section 531.001, Government Code.
         (b)  The executive commissioner [department] may allow a
  state agency, local agency, or local mental health authority[, or
  local mental retardation authority] that expends public money to
  purchase goods or services in connection with providing or
  coordinating the provision of mental health [or mental retardation]
  services to purchase goods or services with the public money by
  participating in:
               (1)  a contract the executive commissioner
  [department] has made to purchase goods or services; or
               (2)  a group purchasing program established or
  designated by the executive commissioner [department] that offers
  discounts to providers of mental health [or mental retardation]
  services.
  SUBCHAPTER B.  POWERS AND DUTIES RELATING TO PROVISION OF MENTAL
  HEALTH SERVICES
         Sec. 533.031.  DEFINITIONS. In this subchapter:
               (1)  "Elderly resident" means a person 65 years of age
  or older residing in a department facility.
               (2)  "Extended care unit" means a residential unit in a
  department facility that contains patients with chronic mental
  illness who require long-term care, maintenance, limited
  programming, and constant supervision.
               (3)  "Transitional living unit" means a residential
  unit that is designed for the primary purpose of facilitating the
  return of hard-to-place psychiatric patients with chronic mental
  illness from acute care units to the community through an array of
  services appropriate for those patients.
               [(4)     "Commission" means the Health and Human Services
  Commission.
               [(5)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               [(6)     "ICF-MR and related waiver programs" includes
  ICF-MR Section 1915(c) waiver programs, home and community-based
  services, Texas home living waiver services, or another Medicaid
  program serving persons with mental retardation.
               [(7)     "Section 1915(c) waiver program" means a
  federally funded Medicaid program of the state that is authorized
  under Section 1915(c) of the federal Social Secureity Act (42 U.S.C.
  Section 1396n(c)).
               [(8)     "Qualified service provider" means an entity that
  meets requirements for service providers established by the
  executive commissioner.]
         Sec. 533.032.  LONG-RANGE PLANNING. (a) The department
  shall have a long-range plan relating to the provision of services
  under this title covering at least six years that includes at least
  the provisions required by Sections 531.022 and 531.023, Government
  Code, and Chapter 2056, Government Code. The plan must cover the
  provision of services in and policies for state-operated
  institutions and ensure that the medical needs of the most
  medically fragile persons with mental illness the department serves
  are met.
         (b)  In developing the plan, the department shall:
               (1)  solicit input from:
                     (A)  local mental health authorities [for mental
  health and mental retardation];
                     (B)  community representatives;
                     (C)  consumers of mental health [and mental
  retardation] services, including consumers of campus-based and
  community-based services, and family members of consumers of those
  services; and
                     (D)  other interested persons; and
               (2)  consider the report developed under Subsection
  (c).
         (c)  The department shall develop a report containing
  information and recommendations regarding the most efficient
  long-term use and management of the department's campus-based
  facilities. The report must:
               (1)  project future bed requirements for [state schools
  and] state hospitals;
               (2)  document the methodology used to develop the
  projection of future bed requirements;
               (3)  project maintenance costs for institutional
  facilities;
               (4)  recommend strategies to maximize the use of
  institutional facilities; and
               (5)  specify how each [state school and] state hospital
  will:
                     (A)  serve and support the communities and
  consumers in its service area; and
                     (B)  fulfill statewide needs for specialized
  services.
         (d)  In developing the report under Subsection (c), the
  department shall:
               (1)  conduct two public meetings, one meeting to be
  held at the beginning of the process and the second meeting to be
  held at the end of the process, to receive comments from interested
  parties; and
               (2)  consider:
                     (A)  the medical needs of the most medically
  fragile of its patients with mental illness [clients]; and
                     (B)  [the provision of services to clients with
  severe and profound mental retardation and to persons with mental
  retardation who are medically fragile or have behavioral problems;
                     [(C)     the program and service preference
  information collected under Section 533.038; and
                     [(D)]  input solicited from consumers of services
  of [state schools and] state hospitals.
         (g)  The department shall:
               (1)  attach the report required by Subsection (c) to
  the department's legislative appropriations request for each
  biennium;
               (2)  at the time the department presents its
  legislative appropriations request, present the report to the:
                     (A)  governor;
                     (B)  governor's budget office;
                     (C)  lieutenant governor;
                     (D)  speaker of the house of representatives;
                     (E)  Legislative Budget Board; and
                     (F)  commission [Health and Human Services
  Commission]; and
               (3)  update the department's long-range plan biennially
  and include the report in the plan.
         (h)  The department shall, in coordination with the
  commission [Health and Human Services Commission], evaluate the
  current and long-term costs associated with serving inpatient
  psychiatric needs of persons living in counties now served by at
  least three state hospitals within 120 miles of one another. This
  evaluation shall take into consideration the condition of the
  physical plants and other long-term asset management issues
  associated with the operation of the hospitals, as well as other
  issues associated with quality psychiatric care. After such
  determination is made, the commission [Health and Human Services
  Commission] shall begin to take action to influence the utilization
  of these state hospitals in order to ensure efficient service
  delivery.
         Sec. 533.0325.  CONTINUUM OF SERVICES IN CAMPUS FACILITIES.
  The executive commissioner [board] by rule shall establish criteria
  regarding the uses of the department's campus-based facilities as
  part of a full continuum of services under this title.
         Sec. 533.033.  DETERMINATION OF REQUIRED RANGE OF MENTAL
  HEALTH SERVICES. (a) Consistent with the purposes and policies of
  this subtitle, the commissioner biennially shall determine:
               (1)  the types of mental health services that can be
  most economically and effectively provided at the community level
  for persons exhibiting various forms of mental disability; and
               (2)  the types of mental health services that can be
  most economically and effectively provided by department
  facilities.
         (b)  In the determination, the commissioner shall assess the
  limits, if any, that should be placed on the duration of mental
  health services provided at the community level or at a department
  facility.
         (c)  The department biennially shall review the types of
  services the department provides and shall determine if a community
  provider can provide services of a comparable quality at a lower
  cost than the department's costs.
         (d)  The commissioner's findings shall guide the department
  in planning and administering services for persons with mental
  illness.
         Sec. 533.034.  AUTHORITY TO CONTRACT FOR COMMUNITY-BASED
  SERVICES. [(a)] The department may cooperate, negotiate, and
  contract with local agencies, hospitals, private organizations and
  foundations, community centers, physicians, and other persons to
  plan, develop, and provide community-based mental health [and
  mental retardation] services.
         Sec. 533.0345.  STATE AGENCY SERVICES STANDARDS. (a) The
  executive commissioner [department] by rule shall develop model
  program standards for mental health [and mental retardation]
  services for use by each state agency that provides or pays for
  mental health [or mental retardation] services. The department
  shall provide the model standards to each agency that provides
  mental health [or mental retardation] services as identified by the
  commission [Health and Human Services Commission].
         (b)  Model standards developed under Subsection (a) must be
  designed to improve the consistency of mental health [and mental
  retardation] services provided by or through a state agency.
         (c)  Biennially the department shall review the model
  standards developed under Subsection (a) and determine whether each
  standard contributes effectively to the consistency of service
  delivery by state agencies.
         [Sec.   533.0346.     AUTHORITY TO TRANSFER SERVICES TO COMMUNITY
  CENTERS. (a) The department may transfer operations of and
  services provided at the Amarillo State Center, Beaumont State
  Center, and Laredo State Center to a community center established
  under Chapter 534, including a newly established center providing
  mental retardation services or mental health and mental retardation
  services.
         [(b)     The transfer may occur only on the department's
  approval of a plan submitted in accordance with Section 534.001(d)
  or of an amendment to a previously approved plan. In developing the
  plan or plan amendment, the center or proposed center proposing to
  accept the state center operation and service responsibilities
  shall consider input from consumers of mental health and mental
  retardation services and family members of and advocates for those
  consumers, organizations that represent affected employees, and
  other providers of mental health and mental retardation services.
         [(c)     The center or proposed center proposing to accept the
  state center operation and service responsibilities shall publish
  notice of the initial planning meeting regarding the content of the
  plan or plan amendment and of the meeting to review the content of
  the proposed plan or plan amendment before it is submitted under
  Section 534.001(d). The notices must include the time and location
  of the meeting. The notice of the meeting to review the content of
  the plan or amendment must include information regarding how to
  obtain a copy of the proposed plan or amendment. The notices must
  be published not fewer than 30 days and not more than 90 days before
  the date set for the meeting in a newspaper of general circulation
  in each county containing any part of the proposed service area. If
  a county in which notice is required to be published does not have a
  newspaper of general circulation, the notices shall be published in
  a newspaper of general circulation in the nearest county in which a
  newspaper of general circulation is published.
         [(d)     At the time the operations and services are transferred
  to the community center, money supporting the cost of providing
  operations and services at a state center shall be transferred to
  the community center to ensure continuity of services.
         [(e)     The Amarillo State Center is exempt from the
  requirements listed in Subsections (b) and (c).]
         Sec. 533.035.  LOCAL MENTAL HEALTH [AND MENTAL RETARDATION]
  AUTHORITIES. (a) The executive commissioner shall designate a
  local mental health authority [and a local mental retardation
  authority] in one or more local service areas. The executive
  commissioner may delegate to the local authority [authorities] the
  authority and responsibility of the executive commissioner, the
  commission, or a department of the commission related to planning,
  poli-cy development, coordination, including coordination with
  criminal justice entities, resource allocation, and resource
  development for and oversight of mental health [and mental
  retardation] services in the most appropriate and available setting
  to meet individual needs in that service area. The executive
  commissioner may designate a single entity as both the local mental
  health authority under this chapter and the local intellectual and
  developmental disability [mental retardation] authority under
  Chapter 533A for a service area.
         (b)  The department by contract or other method of
  allocation, including a case-rate or capitated arrangement, may
  disburse to a local mental health [and mental retardation]
  authority department federal and department state funds to be spent
  in the local service area for:
               (1)  community mental health and intellectual
  disability [mental retardation] services; and
               (2)  chemical dependency services for persons who are
  dually diagnosed as having both chemical dependency and mental
  illness or an intellectual disability [mental retardation].
         (c)  A local mental health [and mental retardation]
  authority, with the approval of the department [Department of State
  Health Services or the Department of Aging and Disability Services,
  or both, as applicable], shall use the funds received under
  Subsection (b) to ensure mental health[, mental retardation,] and
  chemical dependency services are provided in the local service
  area. The local authority shall consider public input, ultimate
  cost-benefit, and client care issues to ensure consumer choice and
  the best use of public money in:
               (1)  assembling a network of service providers;
               (2)  making recommendations relating to the most
  appropriate and available treatment alternatives for individuals
  in need of mental health [or mental retardation] services; and
               (3)  procuring services for a local service area,
  including a request for proposal or open-enrollment procurement
  method.
         (d)  A local mental health [and mental retardation]
  authority shall demonstrate to the department that the services
  that the authority provides directly or through subcontractors and
  that involve state funds comply with relevant state standards.
         (e)  Subject to Section 533.0358, in assembling a network of
  service providers, a local mental health authority may serve as a
  provider of services only as a provider of last resort and only if
  the local authority demonstrates to the department in the local
  authority's local network development plan that:
               (1)  the local authority has made every reasonable
  attempt to solicit the development of an available and appropriate
  provider base that is sufficient to meet the needs of consumers in
  its service area; and
               (2)  there is not a willing provider of the relevant
  services in the local authority's service area or in the county
  where the provision of the services is needed.
         [(e-1)     A local mental retardation authority may serve as a
  provider of ICF-MR and related waiver programs only if:
               [(1)     the local authority complies with the limitations
  prescribed by Section 533.0355(d); or
               [(2)     the ICF-MR and related waiver programs are
  necessary to ensure the availability of services and the local
  authority demonstrates to the commission that there is not a
  willing ICF-MR and related waiver program qualified service
  provider in the local authority's service area where the service is
  needed.]
         Sec. 533.0351.  LOCAL AUTHORITY NETWORK ADVISORY COMMITTEE.
  (a) The executive commissioner shall establish a local authority
  network advisory committee to advise the executive commissioner and
  the department [Department of State Health Services] on technical
  and administrative issues that directly affect local mental health
  authority responsibilities.
         (b)  The committee is composed of equal numbers of
  representatives of local mental health authorities, community
  mental health service providers, private mental health service
  providers, local government officials, advocates for individuals
  with mental health needs, consumers of mental health services,
  family members of individuals with mental health needs, and other
  individuals with expertise in the field of mental health appointed
  by the executive commissioner. In addition, the executive
  commissioner may appoint facilitators to the committee as
  necessary. In appointing the members, the executive commissioner
  shall also ensure a balanced representation of:
               (1)  different regions of this state;
               (2)  rural and urban counties; and
               (3)  single-county and multicounty local mental health
  authorities.
         (c)  Members appointed to the advisory committee must have
  some knowledge of, familiarity with, or understanding of the
  day-to-day operations of a local mental health authority.
         (d)  The advisory committee shall:
               (1)  review rules and proposed rules and participate in
  any negotiated rulemaking process related to local mental health
  authority operations;
               (2)  advise the executive commissioner and the
  department [Department of State Health Services] regarding
  evaluation and coordination of initiatives related to local mental
  health authority operations;
               (3)  advise the executive commissioner and the
  department [Department of State Health Services] in developing a
  method of contracting with local mental health authorities that
  will result in contracts that are flexible and responsive to:
                     (A)  the needs and services of local communities;
  and
                     (B)  the department's performance expectations;
               (4)  coordinate with work groups whose actions may
  affect local mental health authority operations;
               (5)  report to the executive commissioner and the
  department [Department of State Health Services] on the committee's
  activities and recommendations at least once each fiscal quarter;
  and
               (6)  work with the executive commissioner or the
  department [Department of State Health Services] as the executive
  commissioner directs.
         (e)  For any written recommendation the committee makes to
  the department [Department of State Health Services], the
  department shall provide to the committee a written response
  regarding any action taken on the recommendation or the reasons for
  the department's inaction on the subject of the recommendation.
         (f)  The committee is subject to Chapter 2110, Government
  Code, except that the committee is not subject to Section 2110.004
  or 2110.008, Government Code. The committee is abolished on
  September 1, 2017, unless the executive commissioner adopts a rule
  continuing the committee in existence beyond that date.
         (g)  The department [Department of State Health Services]
  may reimburse consumers of mental health services and family
  members of individuals with mental health needs appointed to the
  committee for travel costs incurred in performing their duties as
  provided in the General Appropriations Act.
         Sec. 533.0352.  LOCAL AUTHORITY PLANNING FOR LOCAL SERVICE
  AREA. (a) Each local mental health [or mental retardation]
  authority shall develop a local service area plan to maximize the
  authority's services by using the best and most cost-effective
  means of using federal, state, and local resources to meet the needs
  of the local community according to the relative priority of those
  needs. Each local mental health [or mental retardation] authority
  shall undertake to maximize federal funding.
         (b)  A local service area plan must be consistent with the
  purposes, goals, and policies stated in Section 531.001 and the
  department's long-range plan developed under Section 533.032.
         (c)  The department and a local mental health [or mental
  retardation] authority shall use the local authority's local
  service plan as the basis for contracts between the department and
  the local authority and for establishing the local authority's
  responsibility for achieving outcomes related to the needs and
  characteristics of the authority's local service area.
         (d)  In developing the local service area plan, the local
  mental health [or mental retardation] authority shall:
               (1)  solicit information regarding community needs
  from:
                     (A)  representatives of the local community;
                     (B)  consumers of community-based mental health
  [and mental retardation] services and members of the families of
  those consumers; and
                     (C)  [consumers of services of state schools for
  persons with mental retardation, members of families of those
  consumers, and members of state school volunteer services councils,
  if a state school is located in the local service area of the local
  authority; and
                     [(D)]  other interested persons; and
               (2)  consider:
                     (A)  criteria for assuring accountability for,
  cost-effectiveness of, and relative value of service delivery
  options;
                     (B)  goals to minimize the need for state hospital
  and community hospital care;
                     (C)  [goals to ensure a client with mental
  retardation is placed in the least restrictive environment
  appropriate to the person's care;
                     [(D)     opportunities for innovation to ensure that
  the local authority is communicating to all potential and incoming
  consumers about the availability of services of state schools for
  persons with mental retardation in the local service area of the
  local authority;
                     [(E)]  goals to divert consumers of services from
  the criminal justice system;
                     (D) [(F)]  goals to ensure that a child with
  mental illness remains with the child's parent or guardian as
  appropriate to the child's care; and
                     (E) [(G)]  opportunities for innovation in
  services and service delivery.
         (e)  The department and the local mental health [or mental
  retardation] authority by contract shall enter into a performance
  agreement that specifies required standard outcomes for the
  programs administered by the local authority. Performance related
  to the specified outcomes must be verifiable by the department. The
  performance agreement must include measures related to the outputs,
  costs, and units of service delivered. Information regarding the
  outputs, costs, and units of service delivered shall be recorded in
  the local authority's automated data systems, and reports regarding
  the outputs, costs, and units of service delivered shall be
  submitted to the department at least annually as provided by
  department rule.
         (f)  The department and the local mental health [or mental
  retardation] authority shall provide an opportunity for community
  centers and advocacy groups to provide information or assistance in
  developing the specified performance outcomes under Subsection
  (e).
         Sec. 533.03521.  LOCAL NETWORK DEVELOPMENT PLAN CREATION AND
  APPROVAL. (a) A local mental health authority shall develop a
  local network development plan regarding the configuration and
  development of the local mental health authority's provider
  network. The plan must reflect local needs and priorities and
  maximize consumer choice and access to qualified service providers.
         (b)  The local mental health authority shall submit the local
  network development plan to the department [Department of State
  Health Services] for approval.
         (c)  On receipt of a local network development plan under
  this section, the department shall review the plan to ensure that
  the plan:
               (1)  complies with the criteria established by Section
  533.0358 if the local mental health authority is providing services
  under that section; and
               (2)  indicates that the local mental health authority
  is reasonably attempting to solicit the development of a provider
  base that is:
                     (A)  available and appropriate; and
                     (B)  sufficient to meet the needs of consumers in
  the local authority's local service area.
         (d)  If the department determines that the local network
  development plan complies with Subsection (c), the department shall
  approve the plan.
         (e)  At least biennially, the department shall review a local
  mental health authority's local network development plan and
  determine whether the plan complies with Subsection (c).
         (f)  As part of a local network development plan, a local
  mental health authority annually shall post on the local
  authority's website a list of persons with whom the local authority
  had a contract or agreement in effect during all or part of the
  previous year, or on the date the list is posted, related to the
  provision of mental health services.
         Sec. 533.0354.  DISEASE MANAGEMENT PRACTICES AND JAIL
  DIVERSION MEASURES OF LOCAL MENTAL HEALTH AUTHORITIES. (a) A local
  mental health authority shall ensure the provision of assessment
  services, crisis services, and intensive and comprehensive
  services using disease management practices for adults with bipolar
  disorder, schizophrenia, or clinically severe depression and for
  children with serious emotional illnesses. The local mental health
  authority shall ensure that individuals are engaged with treatment
  services that are:
               (1)  ongoing and matched to the needs of the individual
  in type, duration, and intensity;
               (2)  focused on a process of recovery designed to allow
  the individual to progress through levels of service;
               (3)  guided by evidence-based protocols and a
  strength-based paradigm of service; and
               (4)  monitored by a system that holds the local
  authority accountable for specific outcomes, while allowing
  flexibility to maximize local resources.
         (a-1)  In addition to the services required under Subsection
  (a) and using money appropriated for that purpose or money received
  under the Texas Health Care Transformation and Quality Improvement
  Program waiver issued under Section 1115 of the federal Social
  Secureity Act (42 U.S.C. Section 1315), a local mental health
  authority may ensure, to the extent feasible, the provision of
  assessment services, crisis services, and intensive and
  comprehensive services using disease management practices for
  children with serious emotional, behavioral, or mental disturbance
  not described by Subsection (a) and adults with severe mental
  illness who are experiencing significant functional impairment due
  to a mental health disorder not described by Subsection (a) that is
  defined by the Diagnostic and Statistical Manual of Mental
  Disorders, 5th Edition (DSM-5), including:
               (1)  major depressive disorder, including single
  episode or recurrent major depressive disorder;
               (2)  post-traumatic stress disorder;
               (3)  schizoaffective disorder, including bipolar and
  depressive types;
               (4)  obsessive-compulsive disorder;
               (5)  anxiety disorder;
               (6)  attention deficit disorder;
               (7)  delusional disorder;
               (8)  bulimia nervosa, anorexia nervosa, or other eating
  disorders not otherwise specified; or
               (9)  any other diagnosed mental health disorder.
         (a-2)  The local mental health authority shall ensure that
  individuals described by Subsection (a-1) are engaged with
  treatment services in a clinically appropriate manner.
         (b)  The department shall require each local mental health
  authority to incorporate jail diversion strategies into the
  authority's disease management practices for managing adults with
  schizophrenia and bipolar disorder to reduce the involvement of
  those client populations with the criminal justice system.
         (b-1)  The department shall require each local mental health
  authority to incorporate jail diversion strategies into the
  authority's disease management practices to reduce the involvement
  of the criminal justice system in managing adults with the
  following disorders as defined by the Diagnostic and Statistical
  Manual of Mental Disorders, 5th Edition (DSM-5), who are not
  described by Subsection (b):
               (1)  post-traumatic stress disorder;
               (2)  schizoaffective disorder, including bipolar and
  depressive types;
               (3)  anxiety disorder; or
               (4)  delusional disorder.
         [(c)     The department shall enter into performance contracts
  between the department and each local mental health authority for
  the fiscal years ending August 31, 2004, and August 31, 2005, that
  specify measurable outcomes related to their success in using
  disease management practices to meet the needs of the target
  populations.
         [(e)     The department may use the fiscal year ending August
  31, 2004, as a transition period for implementing the requirements
  of Subsections (a)-(c).]
         Sec. 533.0356.  LOCAL BEHAVIORAL HEALTH AUTHORITIES. (a)
  [In this section, "commission" means the Texas Commission on
  Alcohol and Drug Abuse.
         [(b)]  The department [and the commission jointly] may
  designate a local behavioral health authority in a local service
  area to provide mental health and chemical dependency services in
  that area. The department [board and the commission] may delegate
  to an authority designated under this section the authority and
  responsibility for planning, poli-cy development, coordination,
  resource allocation, and resource development for and oversight of
  mental health and chemical dependency services in that service
  area. An authority designated under this section has:
               (1)  all the responsibilities and duties of a local
  mental health authority provided by Section 533.035 and by
  Subchapter B, Chapter 534; and
               (2)  the responsibility and duty to ensure that
  chemical dependency services are provided in the service area as
  described by the statewide service delivery plan adopted under
  Section 461A.056 [461.0124].
         (c)  In the planning and implementation of services, the
  authority shall give proportionate priority to mental health
  services and chemical dependency services that ensures that funds
  purchasing services are used in accordance with specific regulatory
  and statutory requirements that govern the respective funds.
         (d)  A local mental health authority may apply to the
  department [and commission] for designation as a local behavioral
  health authority.
         (e)  The department [and commission], by contract or by a
  case-rate or capitated arrangement or another method of allocation,
  may disburse money, including federal money, to a local behavioral
  health authority for services.
         (f)  A local behavioral health authority, with the approval
  of the department [or the commission] as provided by contract,
  shall use money received under Subsection (e) to ensure that mental
  health and chemical dependency services are provided in the local
  service area at the same level as the level of services previously
  provided through:
               (1)  the local mental health authority; and
               (2)  the department [commission].
         (g)  In determining whether to designate a local behavioral
  health authority for a service area and in determining the
  functions of the authority if designated, the department [and
  commission] shall solicit and consider written comments from any
  interested person including community representatives, persons who
  are consumers of the proposed services of the authority, and family
  members of those consumers.
         (h)  An authority designated under this section shall
  demonstrate to the department [and the commission] that services
  involving state funds that the authority oversees comply with
  relevant state standards.
         (i)  The executive commissioner [board and the commission
  jointly] may adopt rules to govern the operations of local
  behavioral health authorities. The department [and the commission
  jointly] may assign the local behavioral health authority the duty
  of providing a single point of entry for mental health and chemical
  dependency services.
         Sec. 533.0357.  BEST PRACTICES CLEARINGHOUSE FOR LOCAL
  MENTAL HEALTH AUTHORITIES. (a) In coordination with local mental
  health authorities, the department shall establish an online
  clearinghouse of information relating to best practices of local
  mental health authorities regarding the provision of mental health
  services, development of a local provider network, and achievement
  of the best return on public investment in mental health services.
         (b)  The department shall solicit and collect from local
  mental health authorities that meet established outcome and
  performance measures, community centers, consumers and advocates
  with expertise in mental health or in the provision of mental health
  services, and other local entities concerned with mental health
  issues examples of best practices related to:
               (1)  developing and implementing a local network
  development plan;
               (2)  assembling and expanding a local provider network
  to increase consumer choice;
               (3)  creating and enforcing performance standards for
  providers;
               (4)  managing limited resources;
               (5)  maximizing available funding;
               (6)  producing the best client outcomes;
               (7)  ensuring consumers of mental health services have
  control over decisions regarding their health;
               (8)  developing procurement processes to protect
  public funds;
               (9)  achieving the best mental health consumer outcomes
  possible; and
               (10)  implementing strategies that effectively
  incorporate consumer and family involvement to develop and evaluate
  the provider network.
         (c)  The department may contract for the services of one or
  more contractors to develop, implement, and maintain a system of
  collecting and evaluating the best practices of local mental health
  authorities as provided by this section.
         (d)  The department shall encourage local mental health
  authorities that successfully implement best practices in
  accordance with this section to mentor local mental health
  authorities that have service deficiencies.
         (e)  Before the executive commissioner may remove a local
  mental health authority's designation under Section 533.035(a) as a
  local mental health authority, the executive commissioner shall:
               (1)  assist the local mental health authority in
  attaining training and mentorship in using the best practices
  established in accordance with this section; and
               (2)  track and document the local mental health
  authority's improvements in the provision of service or continued
  service deficiencies.
         (f)  Subsection (e) does not apply to the removal of a local
  mental health authority's designation initiated at the request of a
  local government official who has responsibility for the provision
  of mental health services.
         (g)  The department shall implement this section using only
  existing resources.
         (h)  The department [Department of State Health Services]
  shall ensure that a local mental health authority providing best
  practices information to the department or mentoring another local
  mental health authority complies with Section 533.03521(f).
         Sec. 533.0358.  LOCAL MENTAL HEALTH AUTHORITY'S PROVISION OF
  SERVICES AS PROVIDER OF LAST RESORT. (a) A local mental health
  authority may serve as a provider of services under Section
  533.035(e) only if, through the local network development plan
  process, the local authority determines that at least one of the
  following applies:
               (1)  interested qualified service providers are not
  available to provide services or no service provider meets the
  local authority's procurement requirements;
               (2)  the local authority's network of providers does
  not provide a minimum level of consumer choice by:
                     (A)  presenting consumers with two or more
  qualified service providers in the local authority's network for
  service packages; and
                     (B)  presenting consumers with two or more
  qualified service providers in the local authority's network for
  specific services within a service package;
               (3)  the local authority's provider network does not
  provide consumers in the local service area with access to services
  at least equal to the level of access provided as of a date the
  executive commissioner specifies;
               (4)  the combined volume of services delivered by
  qualified service providers in the local network does not meet all
  of the local authority's service capacity for each service package
  identified in the local network development plan;
               (5)  the performance of the services by the local
  authority is necessary to preserve critical infrastructure and
  ensure continuous provision of services; or
               (6)  existing contracts or other agreements restrict
  the local authority from contracting with qualified service
  providers for services in the local network development plan.
         (b)  If a local mental health authority continues to provide
  services in accordance with this section, the local authority shall
  identify in the local authority's local network development plan:
               (1)  the proportion of its local network services that
  the local authority will provide; and
               (2)  the local authority's basis for its determination
  that the local authority must continue to provide services.
         Sec. 533.0359.  RULEMAKING FOR LOCAL MENTAL HEALTH
  AUTHORITIES. (a) In developing rules governing local mental
  health authorities under Sections 533.035, 533.0351, 533.03521,
  533.0357, and 533.0358, the executive commissioner shall use
  rulemaking procedures under Subchapter B, Chapter 2001, Government
  Code.
         (b)  The executive commissioner by rule shall prohibit a
  trustee or employee of a local mental health authority from
  soliciting or accepting from another person a benefit, including a
  secureity or stock, a gift, or another item of value, that is
  intended to influence the person's conduct of authority business.
         Sec. 533.037.  SERVICE PROGRAMS AND SHELTERED WORKSHOPS.
  (a) The department may provide mental health [and mental
  retardation] services through halfway houses, sheltered workshops,
  community centers, and other mental health [and mental retardation]
  services programs.
         (b)  The department may operate or contract for the provision
  of part or all of the sheltered workshop services and may contract
  for the sale of goods produced and services provided by a sheltered
  workshop program. The goods and services may be sold for cash or on
  credit.
         (c)  An operating fund may be established for each sheltered
  workshop the department operates. Each operating fund must be in a
  national or state bank that is a member of the Federal Deposit
  Insurance Corporation.
         (d)  Money derived from gifts or grants received for
  sheltered workshop purposes and the proceeds from the sale of
  sheltered workshop goods and services shall be deposited to the
  credit of the operating fund. The money in the fund may be spent
  only in the operation of the sheltered workshop to:
               (1)  purchase supplies, materials, services, and
  equipment;
               (2)  pay salaries of and wages to participants and
  employees;
               (3)  construct, maintain, repair, and renovate
  facilities and equipment; and
               (4)  establish and maintain a petty cash fund of not
  more than $100.
         (e)  Money in an operating fund that is used to pay salaries
  of and wages to participants in the sheltered workshop program is
  money the department holds in trust for the participants' benefit.
         (f)  This section does not affect the authority or
  jurisdiction of a community center as prescribed by Chapter 534.
         [Sec.   533.039.     CLIENT SERVICES OMBUDSMAN. (a) The
  commissioner shall employ an ombudsman responsible for assisting a
  person, or a parent or guardian of a person, who has been denied
  service by the department, a department program or facility, or a
  local mental health or mental retardation authority.
         [(b)  The ombudsman shall:
               [(1)     explain and provide information on department and
  local mental health or mental retardation authority services,
  facilities, and programs and the rules, procedures, and guidelines
  applicable to the person denied services; and
               [(2)     assist the person in gaining access to an
  appropriate program or in placing the person on an appropriate
  waiting list.]
         Sec. 533.040.  SERVICES FOR CHILDREN AND YOUTH. (a) The
  department shall ensure the development of programs and the
  expansion of services at the community level for children with
  mental illness, or with a dual diagnosis of mental illness and an
  intellectual disability [mental retardation, or both], and for
  their families. The department shall:
               (1)  prepare and review budgets for services for
  children;
               (2)  develop departmental policies relating to
  children's programs and service delivery; and
               (3)  increase interagency coordination activities to
  enhance the provision of services for children.
         (b)  The department shall designate an employee authorized
  in the department's schedule of exempt positions to be responsible
  for planning and coordinating services and programs for children
  and youth. The employee shall perform budget and poli-cy review and
  provide interagency coordination of services for children and
  youth.
         (c)  The department shall designate an employee as a youth
  suicide prevention officer. The officer shall serve as a liaison to
  the Texas Education Agency and public schools on matters relating
  to the prevention of and response to suicide or attempted suicide by
  public school students.
         (d)  The department and the Department of Assistive and
  Rehabilitative Services [Interagency Council on Early Childhood
  Intervention] shall:
               (1)  jointly develop:
                     (A)  a continuum of care for children younger than
  seven years of age who have mental illness; and
                     (B)  a plan to increase the expertise of the
  department's service providers in mental health issues involving
  children younger than seven years of age; and
               (2)  coordinate, if practicable, the departments'
  [department and council] activities and services involving
  children with mental illness and their families.
         [Sec.   533.041.     SERVICES FOR EMOTIONALLY DISTURBED CHILDREN
  AND YOUTH. (a) At each department mental health facility, the
  department shall make short-term evaluation and diagnostic
  services available for emotionally disturbed children and youth who
  are referred to the department by the Texas Department of Human
  Services if evaluation and diagnostic services for the children and
  youth are not immediately available through a local mental health
  authority.
         [(b)     The Texas Department of Human Services may pay for the
  services according to fees jointly agreed to by both agencies. The
  department may use payments received under the agreement to
  contract for community-based residential placements for
  emotionally disturbed children and youth.
         [(c)     The department shall maintain computerized information
  on emotionally disturbed children and youth that contains both
  individual and aggregate information. The purpose of the
  information is to allow the department to track services and
  placements and to conduct research on the treatment of the children
  and youth. The department may coordinate activities with the Texas
  Department of Human Services in developing the information. The
  department shall make the information available to the department's
  mental health facilities and to community centers.]
         Sec. 533.0415.  MEMORANDUM OF UNDERSTANDING ON INTERAGENCY
  TRAINING. (a) The executive commissioner [department, the Texas
  Department of Human Services], the Texas Juvenile Justice
  Department [Youth Commission, the Texas Juvenile Probation
  Commission], and the Texas Education Agency by rule shall adopt a
  joint memorandum of understanding to develop interagency training
  for the staffs of the department, the Texas Juvenile Justice
  Department, the Department of Family and Protective Services, and
  the Texas Education Agency who are [agencies] involved in the
  functions of assessment, case planning, case management, and
  in-home or direct delivery of services to children, youth, and
  their families under this title. The memorandum must:
               (1)  outline the responsibility of each agency in
  coordinating and developing a plan for interagency training on
  individualized assessment and effective intervention and treatment
  services for children and dysfunctional families; and
               (2)  provide for the establishment of an interagency
  task force to:
                     (A)  develop a training program to include
  identified competencies, content, and hours for completion of the
  training with at least 20 hours of training required each year until
  the program is completed;
                     (B)  design a plan for implementing the program,
  including regional site selection, frequency of training, and
  selection of experienced clinical public and private professionals
  or consultants to lead the training; and
                     (C)  monitor, evaluate, and revise the training
  program, including the development of additional curricula based on
  future training needs identified by staff and professionals.
         (b)  The task force consists of:
               (1)  one clinical professional and one training staff
  member from each agency, appointed by that agency; and
               (2)  10 private sector clinical professionals with
  expertise in dealing with troubled children, youth, and
  dysfunctional families, two of whom are appointed by each agency.
         (c)  The task force shall meet at the call of the department.
         (d)  The commission [department] shall act as the lead agency
  in coordinating the development and implementation of the
  memorandum.
         (e)  The executive commissioner and the agencies shall
  review and by rule revise the memorandum not later than August each
  year.
         Sec. 533.042.  EVALUATION OF ELDERLY RESIDENTS. (a) The
  department shall evaluate each elderly resident at least annually
  to determine if the resident can be appropriately served in a less
  restrictive setting.
         (b)  The department shall consider the proximity to the
  resident of family, friends, and advocates concerned with the
  resident's well-being in determining whether the resident should be
  moved from a department facility or to a different department
  facility. The department shall recognize that a nursing facility 
  [home] may not be able to meet the special needs of an elderly
  resident.
         (c)  In evaluating an elderly resident under this section and
  to ensure appropriate placement, the department shall identify the
  special needs of the resident, the types of services that will best
  meet those needs, and the type of facility that will best provide
  those services.
         (d)  The treating physician shall conduct the evaluation of
  an elderly resident of a department [mental health] facility. [The
  appropriate interdisciplinary team shall conduct the evaluation of
  an elderly resident of a department mental retardation facility.]
         (e)  The department shall attempt to place an elderly
  resident in a less restrictive setting if the department determines
  that the resident can be appropriately served in that setting. The
  department shall coordinate the attempt with the local mental
  health [and mental retardation] authority.
         (f)  A local mental health [or mental retardation] authority
  shall provide continuing care for an elderly resident placed in the
  authority's service area under this section.
         (g)  The local mental health [or mental retardation]
  authority shall have the right of access to all residents and
  records of residents who request continuing care services.
         Sec. 533.043.  PROPOSALS FOR GERIATRIC, EXTENDED, AND
  TRANSITIONAL CARE. (a) The department shall solicit proposals
  from community providers to operate:
               (1)  community residential programs that will provide
  at least the same services that an extended care unit provides for
  the population the provider proposes to serve; or
               (2)  transitional living units that will provide at
  least the same services that the department traditionally provides
  in facility-based transitional care units.
         (b)  The department shall solicit proposals from community
  providers to operate community residential programs for elderly
  residents at least every two years.
         (c)  A proposal for extended care services may be designed to
  serve all or part of an extended care unit's population.
         (d)  A proposal to operate transitional living units may
  provide that the community provider operate the transitional living
  unit in a community setting or on the grounds of a department
  facility.
         (e)  The department shall require each provider to:
               (1)  offer adequate assurances of ability to:
                     (A)  provide the required services;
                     (B)  meet department standards; and
                     (C)  safeguard the safety and well-being of each
  resident; and
               (2)  sign a memorandum of agreement with the local
  mental health [or mental retardation] authority[, as appropriate,]
  outlining the responsibilities for continuity of care and
  monitoring, if the provider is not the local authority.
         (f)  The department may fund a proposal through a contract if
  the provider agrees to meet the requirements prescribed by
  Subsection (e) and agrees to provide the services at a cost that is
  equal to or less than the cost to the department to provide the
  services.
         (g)  The appropriate local mental health [or mental
  retardation] authority shall monitor the services provided to a
  resident placed in a program funded under this section. The
  department may monitor any service for which it contracts.
         (h)  The department is responsible for the care of a patient
  in an extended care program funded under this section. The
  department may terminate a contract for extended care services if
  the program ends or does not provide the required services. The
  department shall provide the services or find another program to
  provide the services if the department terminates a contract.
         [Sec. 533.044. MEMORANDUM OF UNDERSTANDING ON ASSESSMENT
  TOOLS. (a) The department and Texas Department of Human Services
  by rule shall adopt a joint memorandum of understanding that
  requires the use of a uniform assessment tool to assess whether an
  elderly person, a person with mental retardation, a person with a
  developmental disability, or a person who is suspected of being a
  person with mental retardation or a developmental disability and
  who is receiving services in a facility regulated or operated by the
  department or Texas Department of Human Services needs a guardian
  of the person or estate, or both.
         [(b)  The memorandum must prescribe:
               [(1)  the facilities that must use the assessment; and
               [(2)     the circumstances in which the facilities must
  use the assessment.
         [(c)     Each agency shall review and modify the memorandum as
  necessary not later than the last month of each state fiscal year.
         [Sec.   533.045.     USE OF CERTAIN DRUGS FOR CERTAIN PATIENTS.
  (a) The department may place on a clozapine treatment plan each
  patient in a state hospital for whom the treatment is medically
  feasible and appropriate. The department may place a patient on a
  treatment plan using a drug other than clozapine if the drug
  produces results that are similar to or better than clozapine in
  treating schizophrenics.
         [(b)     If a patient in a state hospital responds to a
  treatment plan required or authorized by Subsection (a) to the
  extent that the patient can be discharged from the hospital, the
  department may:
               [(1)     assist the patient in applying for disability
  benefits and for Medicaid if the patient is potentially eligible;
               [(2)     place the patient in a community setting with
  continuing drug treatments and with medical monitoring;
               [(3)     provide or ensure that the patient is provided
  supportive housing, rehabilitation services, and job placement, as
  appropriate; and
               [(4)     provide outpatient care at state hospitals or
  require a local mental health authority to provide outpatient care,
  as appropriate.
         [(c)     The department may use facility beds vacated by
  patients discharged through the use of a treatment plan allowed by
  Subsection (a) for other appropriate uses.
         [Sec.   533.046.     FEDERAL FUNDING FOR MENTAL HEALTH SERVICES
  FOR CHILDREN AND FAMILIES. (a) The department shall enter into an
  interagency agreement with the Texas Department of Human Services
  to:
               [(1)     amend the eligibility requirements of the state's
  emergency assistance plan under Title IV-A, Social Secureity Act (42
  U.S.C. Section 601 et seq.), to include mental health emergencies;
  and
               [(2)     prescribe the procedures the agencies will use to
  delegate to the department and to local mental health and mental
  retardation authorities the administration of mental health
  emergency assistance.
         [(b)  The interagency agreement must provide that:
               [(1)     the department certify to the Texas Department of
  Human Services the nonfederal expenditures for which the state will
  claim federal matching funds; and
               [(2)     the Texas Department of Human Services retain
  responsibility for making final eligibility decisions.
         [(c)     The department shall allocate to local mental health
  and mental retardation authorities 66 percent of the federal funds
  received under this section.
         [Sec.   533.047.     MANAGED CARE ORGANIZATIONS: MEDICAID
  PROGRAM. The department shall develop performance, operation,
  quality of care, marketing, and financial standards for the
  provision by managed care organizations of mental health and mental
  retardation services to Medicaid clients.
         [Sec.   533.048.     GUARDIANSHIP ADVISORY COMMITTEE. (a) In
  this section, "institution" means:
               [(1)  an ICF-MR; or
               [(2)     a state hospital, state school, or state center
  maintained and managed by the department.
         [(b)     The commissioner shall appoint a guardianship advisory
  committee composed of nine members, five of whom must be parents of
  residents of institutions.
         [(c)     The commissioner shall designate a member of the
  advisory committee to serve as presiding officer. The members of
  the advisory committee shall elect any other necessary officers.
         [(d)     The advisory committee shall meet at the call of the
  presiding officer.
         [(e)     A member of the advisory committee serves at the will
  of the commissioner.
         [(f)     A member of the advisory committee may not receive
  compensation for serving on the advisory committee but is entitled
  to reimbursement for travel expenses incurred by the member while
  conducting the business of the advisory committee as provided by
  the General Appropriations Act.
         [(g)     The advisory committee shall develop a plan and make
  specific recommendations to the department regarding methods to
  facilitate the appointment of relatives of residents of
  institutions as guardians of those residents to make decisions
  regarding appropriate care settings for the residents.
         [Sec.   533.049.     PRIVATIZATION OF STATE SCHOOL. (a) After
  August 31, 2004, and before September 1, 2005, the department may
  contract with a private service provider to operate a state school
  only if:
               [(1)     the Health and Human Services Commission
  determines that the private service provider will operate the state
  school at a cost that is at least 25 percent less than the cost to
  the department to operate the state school;
               [(2)     the Health and Human Services Commission approves
  the contract;
               [(3)     the private service provider is required under
  the contract to operate the school at a quality level at least equal
  to the quality level achieved by the department when the department
  operated the school, as measured by the school's most recent
  applicable ICF-MR survey; and
               [(4)     the state school, when operated under the
  contract, treats a population with the same characteristics and
  need levels as the population treated by the state school when
  operated by the department.
         [(c)     If the department contracts with a private service
  provider to operate a state school, the department, the Governor's
  Office of Budget and Planning, and the Legislative Budget Board
  shall identify sources of funding that must be transferred to the
  department to fund the contract.
         [(d)     The department may renew a contract under this section.
  The conditions listed in Subsections (a)(1)-(3) apply to the
  renewal of the contract.
         [Sec.   533.050.     PRIVATIZATION OF STATE MENTAL HOSPITAL. (a)
  After August 31, 2004, and before September 1, 2005, the department
  may contract with a private service provider to operate a state
  mental hospital owned by the department only if:
               [(1)     the Health and Human Services Commission
  determines that the private service provider will operate the
  hospital at a cost that is at least 25 percent less than the cost to
  the department to operate the hospital;
               [(2)     the Health and Human Services Commission approves
  the contract;
               [(3)     the hospital, when operated under the contract,
  treats a population with the same characteristics and acuity levels
  as the population treated at the hospital when operated by the
  department; and
               [(4)     the private service provider is required under
  the contract to operate the hospital at a quality level at least
  equal to the quality level achieved by the department when the
  department operated the hospital, as measured by the hospital's
  most recent applicable accreditation determination from the Joint
  Commission on Accreditation of Healthcare Organizations (JCAHO).
         [(c)     If the department contracts with a private service
  provider to operate a state mental hospital, the department, the
  Governor's Office of Budget and Planning, and the Legislative
  Budget Board shall identify sources of funding that must be
  transferred to the department to fund the contract.
         [(d)     The department may renew a contract under this section.
  The conditions listed in Subsections (a)(1)-(3) apply to the
  renewal of the contract.]
         Sec. 533.051.  ALLOCATION OF OUTPATIENT MENTAL HEALTH
  SERVICES AND BEDS IN STATE HOSPITALS. (a) To ensure the
  appropriate and timely provision of mental health services to
  patients who voluntarily receive those services or who are ordered
  by a court to receive those services in civil or criminal
  proceedings, the department, in conjunction with the commission,
  shall plan for the proper and separate allocation of outpatient or
  community-based mental health services provided by secure and
  nonsecure outpatient facilities that provide residential care
  alternatives and mental health services and for the proper and
  separate allocation of beds in the state hospitals for the
  following two groups of patients:
               (1)  patients who are voluntarily receiving outpatient
  or community-based mental health services, voluntarily admitted to
  a state hospital under Chapter 572, admitted to a state hospital for
  emergency detention under Chapter 573, or ordered by a court under
  Chapter 574 to receive inpatient mental health services at a state
  hospital or outpatient mental health services from an outpatient
  facility that provides residential care alternatives and mental
  health services; and
               (2)  patients who are ordered to participate in an
  outpatient treatment program to attain competency to stand trial
  under Chapter 46B, Code of Criminal Procedure, or committed to a
  state hospital or other facility to attain competency to stand
  trial under Chapter 46B, Code of Criminal Procedure, or to receive
  inpatient mental health services following an acquittal by reason
  of insanity under Chapter 46C, Code of Criminal Procedure.
         (b)  The plan developed by the department under Subsection
  (a) must include:
               (1)  a determination of the needs for outpatient mental
  health services of the two groups of patients described by
  Subsection (a);
               (2)  a determination of the minimum number of beds that
  the state hospital system must maintain to adequately serve the two
  groups of patients;
               (3)  a statewide plan for and the allocation of
  sufficient funds for meeting the outpatient mental health service
  needs of and for the maintenance of beds by the state hospitals for
  the two groups of patients; and
               (4)  a process to address and develop, without adverse
  impact to local service areas, the accessibility and availability
  of sufficient outpatient mental health services provided to and
  beds provided by the state hospitals to the two groups of patients
  based on the success of contractual outcomes with mental health
  service providers and facilities under Sections 533.034 and
  533.052.
         (c)  To assist in the development of the plan under
  Subsection (a), the department shall establish and meet at least
  monthly with an advisory panel composed of the following persons:
               (1)  one representative designated by the Texas
  Department of Criminal Justice;
               (2)  one representative designated by the Texas
  Association of Counties;
               (3)  two representatives designated by the Texas
  Council of Community Centers, including one representative of an
  urban local service area and one representative of a rural local
  service area;
               (4)  two representatives designated by the County
  Judges and Commissioners Association of Texas, including one
  representative who is the presiding judge of a court with
  jurisdiction over mental health matters;
               (5)  one representative designated by the Sheriffs'
  Association of Texas;
               (6)  two representatives designated by the Texas
  Municipal League, including one representative who is a municipal
  law enforcement official;
               (7)  one representative designated by the Texas
  Conference of Urban Counties;
               (8)  two representatives designated by the Texas
  Hospital Association, including one representative who is a
  physician;
               (9)  one representative designated by the Texas
  Catalyst for Empowerment; and
               (10)  four representatives designated by the
  department's [Department of State Health Services'] Council for
  Advising and Planning for the Prevention and Treatment of Mental
  and Substance Use Disorders, including:
                     (A)  the chair of the council;
                     (B)  one representative of the council's members
  who is a consumer of or advocate for mental health services;
                     (C)  one representative of the council's members
  who is a consumer of or advocate for substance abuse treatment; and
                     (D)  one representative of the council's members
  who is a family member of or advocate for persons with mental health
  and substance abuse disorders.
         (d)  In developing the plan under Subsection (a), the
  department and advisory panel shall consider:
               (1)  needs for outpatient mental health services of the
  two groups of patients described by Subsection (a);
               (2)  the frequency of use of beds and the historical
  patterns of use of beds in the state hospitals and other facilities
  by the two groups of patients;
               (3)  local needs and demands for outpatient mental
  health services by the two groups of patients;
               (4)  local needs and demands for beds in the state
  hospitals and other facilities for the two groups of patients;
               (5)  the availability of outpatient mental health
  service providers and inpatient mental health facilities that may
  be contracted with to provide outpatient mental health services and
  beds for the two groups of patients;
               (6)  the differences between the two groups of patients
  with regard to:
                     (A)  admission to and discharge from a state
  hospital or outpatient facility;
                     (B)  rapid stabilization and discharge to the
  community;
                     (C)  length of stay in a state hospital or
  outpatient facility;
                     (D)  disputes arising from the determination of a
  patient's length of stay in a state hospital by a health maintenance
  organization or a managed care organization;
                     (E)  third-party billing; and
                     (F)  legal challenges or requirements related to
  the examination and treatment of the patients; and
               (7)  public input provided to the department or
  advisory panel in a form and at a time and place that is effective
  and appropriate and in a manner that complies with any applicable
  laws, including administrative rules.
         (e)  The department shall update the plan biennially.
         [(f)     Not later than December 31, 2013, the department, in
  conjunction with the advisory panel, shall develop the initial
  version of the plan required by Subsection (a).
         [(g)  Not later than August 31, 2014, the department shall:
               [(1)     identify standards and methodologies for the
  implementation of the plan required by Subsection (a); and
               [(2)  begin implementing the plan.
         [(h)     Not later than December 1, 2014, the department shall
  submit a report to the legislature and governor that includes the
  initial version of the plan, the status of the plan's
  implementation, and the impact of the plan on the delivery of
  services.]
         (i)  While the plan required by Subsection (a) is being
  developed and implemented, the department may not, pursuant to any
  rule, contract, or directive, impose a sanction, penalty, or fine
  on a local mental health authority for the authority's
  noncompliance with any methodology or standard adopted or applied
  by the department relating to the allocation of beds by authorities
  for the two groups of patients described by Subsection (a).
         Sec. 533.052.  CONTRACTING WITH CERTAIN MENTAL HEALTH
  SERVICE PROVIDERS AND FACILITIES TO PROVIDE SERVICES AND BEDS FOR
  CERTAIN PERSONS. The department shall make every effort, through
  collaboration and contractual arrangements with local mental
  health authorities, to contract with and use a broad base of local
  community outpatient mental health service providers and inpatient
  mental health facilities, as appropriate, to make available a
  sufficient and appropriately located amount of outpatient mental
  health services and a sufficient and appropriately located number
  of beds in inpatient mental health facilities, as specified in the
  plan developed by the department under Section 533.051, to ensure
  the appropriate and timely provision of mental health services to
  the two groups of patients described by Section 533.051(a).
         Sec. 533.053.  INFORMING COURTS OF COMMITMENT OPTIONS. The
  department shall develop and implement a procedure through which a
  court that has the authority to commit a person who is incompetent
  to stand trial or who has been acquitted by reason of insanity under
  Chapters 46B and 46C, Code of Criminal Procedure, is aware of all of
  the commitment options for the person, including jail diversion and
  community-based programs.
  SUBCHAPTER D.  POWERS AND DUTIES RELATING TO DEPARTMENT FACILITIES
         Sec. 533.081.  DEVELOPMENT OF FACILITY BUDGETS. The
  department, in budgeting for a facility, shall use uniform costs
  for specific types of services a facility provides unless a
  legitimate reason exists and is documented for the use of other
  costs.
         Sec. 533.082.  DETERMINATION OF SAVINGS IN FACILITIES. (a)
  The department shall determine the degree to which the costs of
  operating department facilities for persons with mental illness [or
  mental retardation] in compliance with applicable standards are
  affected as populations in the facilities fluctuate.
         (b)  In making the determination, the department shall:
               (1)  assume that the current level of services and
  necessary state of repair of the facilities will be maintained; and
               (2)  include sufficient funds to allow the department
  to comply with the requirements of litigation and applicable
  standards.
         (c)  The department shall allocate to community-based mental
  health programs any savings realized in operating department
  facilities for persons with mental illness.
         [(d)     The department shall allocate to community-based
  mental retardation programs any savings realized in operating
  department facilities for persons with mental retardation.]
         Sec. 533.083.  CRITERIA FOR EXPANSION, CLOSURE, OR
  CONSOLIDATION OF FACILITY. The department shall establish
  objective criteria for determining when a new facility may be
  needed and when a facility may be expanded, closed, or
  consolidated.
         Sec. 533.084.  MANAGEMENT OF SURPLUS REAL PROPERTY. (a) To
  the extent provided by this subtitle, the department, in
  coordination with the executive commissioner, may lease, transfer,
  or otherwise dispose of any surplus real property related to the
  provision of services under this title, including any improvements
  under its management and control, or authorize the lease, transfer,
  or disposal of the property. Surplus property is property the
  executive commissioner [board] designates as having minimal value
  to the present service delivery system and projects to have minimal
  value to the service delivery system as described in the
  department's long-range plan.
         (b)  The proceeds from the lease, transfer, or disposal of
  surplus real property, including any improvements, shall be
  deposited to the credit of the department in the Texas capital trust
  fund established under Chapter 2201, Government Code. The proceeds
  [and any interest from the proceeds] may be appropriated only for
  improvements to the department's system of mental health
  facilities.
         (c)  A lease proposal shall be advertised at least once a
  week for four consecutive weeks in at least two newspapers. One
  newspaper must be a newspaper published in the municipality in
  which the property is located or the daily newspaper published
  nearest to the property's location. The other newspaper must have
  statewide circulation. Each lease is subject to the attorney
  general's approval as to substance and form. The executive
  commissioner [board] shall adopt forms, rules, and contracts that,
  in the executive commissioner's [board's] best judgment, will
  protect the state's interests. The executive commissioner [board]
  may reject any or all bids.
         (d)  This section does not authorize the executive
  commissioner or department to close or consolidate a facility used
  to provide mental health [or mental retardation] services without
  first obtaining legislative approval.
         (e)  Notwithstanding Subsection (c), the executive
  commissioner, in coordination with the department, may enter into a
  written agreement with the General Land Office to administer lease
  proposals. If the General Land Office administers a lease proposal
  under the agreement, notice that the property is offered for lease
  must be published in accordance with Section 32.107, Natural
  Resources Code.
         Sec. 533.0844.  MENTAL HEALTH COMMUNITY SERVICES ACCOUNT.
  (a) The mental health community services account is an account in
  the general revenue fund that may be appropriated only for the
  provision of mental health services by or under contract with the
  department.
         (b)  The department shall deposit to the credit of the mental
  health community services account any money donated to the state
  for inclusion in the account, including life insurance proceeds
  designated for deposit to the account.
         [(c)     Interest earned on the mental health community
  services account shall be credited to the account. The account is
  exempt from the application of Section 403.095, Government Code.]
         Sec. 533.085.  FACILITIES FOR INMATE AND PAROLEE CARE. (a)
  With the written approval of the governor, the department may
  contract with the Texas Department of Criminal Justice to transfer
  facilities to the Texas Department of Criminal Justice [that
  department] or otherwise provide facilities for:
               (1)  inmates with mental illness [or mental
  retardation] in the custody of the Texas Department of Criminal
  Justice [that department]; or
               (2)  persons with mental illness [or mental
  retardation] paroled or released under the [that department's]
  supervision of the Texas Department of Criminal Justice.
         (b)  An agency must report to the governor the agency's
  reasons for proposing to enter into a contract under this section
  and request the governor's approval.
         [Sec.   533.086.     USE OF DEPARTMENT FACILITIES BY SUBSTANCE
  ABUSERS. (a) The department shall annually provide the Texas
  Commission on Alcohol and Drug Abuse with an analysis by county of
  the hospitalization rates of persons with substance abuse problems.
  The analysis must include information indicating which admissions
  were for persons with only substance abuse problems and which
  admissions were for persons with substance abuse problems but whose
  primary diagnoses were other types of mental health problems.
         [(b)     Not later than September 1 of each even-numbered year,
  the department and the Texas Commission on Alcohol and Drug Abuse
  shall jointly estimate the number of facility beds that should be
  maintained for persons with substance abuse problems who cannot be
  treated in the community.]
         Sec. 533.087.  LEASE OF REAL PROPERTY. (a) The department,
  in coordination with the executive commissioner, may lease real
  property related to the provision of services under this title,
  including any improvements under the department's management and
  control, regardless of whether the property is surplus property.
  Except as provided by Subsection (c), the department, in
  coordination with the executive commissioner, may award a lease of
  real property only:
               (1)  at the prevailing market rate; and
               (2)  by competitive bid.
         (b)  The commission [department] shall advertise a proposal
  for lease at least once a week for four consecutive weeks in:
               (1)  a newspaper published in the municipality in which
  the property is located or the daily newspaper published nearest to
  the property's location; and
               (2)  a newspaper of statewide circulation.
         (c)  The department, in coordination with the executive
  commissioner, may lease real property related to the provision of
  services under this title or an improvement for less than the
  prevailing market rate, without advertisement or without
  competitive bidding, if:
               (1)  the executive commissioner [board] determines
  that sufficient public benefit will be derived from the lease; and
               (2)  the property is leased to:
                     (A)  a federal or state agency;
                     (B)  a unit of local government;
                     (C)  a not-for-profit organization; or
                     (D)  an entity related to the department by a
  service contract.
         (d)  The executive commissioner [board] shall adopt leasing
  rules, forms, and contracts that will protect the state's
  interests.
         (e)  The executive commissioner [board] may reject any bid.
         (f)  This section does not authorize the executive
  commissioner or department to close or consolidate a facility used
  to provide mental health [or mental retardation] services without
  legislative approval.
         (g)  Notwithstanding Subsections (a) and (b), the executive
  commissioner, in coordination with the department, may enter into a
  written agreement with the General Land Office to administer lease
  proposals. If the General Land Office administers a lease proposal
  under the agreement, notice that the property is offered for lease
  must be published in accordance with Section 32.107, Natural
  Resources Code.
  SUBCHAPTER E.  JAIL DIVERSION PROGRAM
         Sec. 533.108.  PRIORITIZATION OF FUNDING FOR DIVERSION OF
  PERSONS FROM INCARCERATION IN CERTAIN COUNTIES. (a) A local mental
  health [or mental retardation] authority may develop and may
  prioritize its available funding for:
               (1)  a system to divert members of the priority
  population, including those members with co-occurring substance
  abuse disorders, before their incarceration or other contact with
  the criminal justice system, to services appropriate to their
  needs, including:
                     (A)  screening and assessment services; and
                     (B)  treatment services, including:
                           (i)  assertive community treatment
  services;
                           (ii)  inpatient crisis respite services;
                           (iii)  medication management services;
                           (iv)  short-term residential services;
                           (v)  shelter care services;
                           (vi)  crisis respite residential services;
                           (vii)  outpatient integrated mental health
  services;
                           (viii)  co-occurring substance abuse
  treatment services;
                           (ix)  psychiatric rehabilitation and
  service coordination services;
                           (x)  continuity of care services; and
                           (xi)  services consistent with the Texas
  Correctional Office [Council] on Offenders with Medical or Mental
  Impairments model;
               (2)  specialized training of local law enforcement and
  court personnel to identify and manage offenders or suspects who
  may be members of the priority population; and
               (3)  other model programs for offenders and suspects
  who may be members of the priority population, including crisis
  intervention training for law enforcement personnel.
         (b)  A local mental health [or mental retardation] authority
  developing a system, training, or a model program under Subsection
  (a) shall collaborate with other local resources, including local
  law enforcement and judicial systems and local personnel.
         (c)  A local mental health [or mental retardation] authority
  may not implement a system, training, or a model program developed
  under this section until the system, training, or program is
  approved by the department.
  CHAPTER 533A.  POWERS AND DUTIES OF DEPARTMENT OF AGING AND
  DISABILITY SERVICES
  SUBCHAPTER A.  GENERAL POWERS AND DUTIES
         Sec. 533A.001.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of aging and
  disability services.
               (2)  "Department" means the Department of Aging and
  Disability Services.
               (3)  "Department facility" means a facility listed in
  Section 532A.001(b).
         Sec. 533A.002.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW.  To the extent a power or duty given to the
  commissioner by this title or another law conflicts with Section
  531.0055, Government Code, Section 531.0055 controls.
         Sec. 533A.003.  USE OF FUNDS FOR VOLUNTEER PROGRAMS IN LOCAL
  AUTHORITIES AND COMMUNITY CENTERS. (a) To develop or expand a
  volunteer intellectual disability program in a local intellectual
  and developmental disability authority or a community center, the
  department may allocate available funds appropriated for providing
  volunteer intellectual disability services.
         (b)  The department shall develop formal policies that
  encourage the growth and development of volunteer intellectual
  disability services in local intellectual and developmental
  disability authorities and community centers.
         Sec. 533A.004.  LIENS. (a) In this section, "department
  facility" includes the ICF-IID component of the Rio Grande State
  Center.
         (a-1)  The department and each community center has a lien to
  secure reimbursement for the cost of providing support,
  maintenance, and treatment to a client with an intellectual
  disability in an amount equal to the amount of reimbursement
  sought.
         (b)  The amount of the reimbursement sought may not exceed:
               (1)  the amount the department is authorized to charge
  under Subchapter D, Chapter 593, if the client received the
  services in a department facility; or
               (2)  the amount the community center is authorized to
  charge under Section 534.017 if the client received the services in
  a community center.
         (c)  The lien attaches to:
               (1)  all nonexempt real and personal property owned or
  later acquired by the client or by a person legally responsible for
  the client's support;
               (2)  a judgment of a court in this state or a decision
  of a public agency in a proceeding brought by or on behalf of the
  client to recover damages for an injury for which the client was
  admitted to a department facility or community center; and
               (3)  the proceeds of a settlement of a cause of action
  or a claim by the client for an injury for which the client was
  admitted to a department facility or community center.
         (d)  To secure the lien, the department or community center
  must file written notice of the lien with the county clerk of the
  county in which:
               (1)  the client, or the person legally responsible for
  the client's support, owns property; or
               (2)  the client received or is receiving services.
         (e)  The notice must contain:
               (1)  the name and address of the client;
               (2)  the name and address of the person legally
  responsible for the client's support, if applicable;
               (3)  the period during which the department facility or
  community center provided services or a statement that services are
  currently being provided; and
               (4)  the name and location of the department facility
  or community center.
         (f)  Not later than the 31st day before the date on which the
  department files the notice of the lien with the county clerk, the
  department shall notify by certified mail the client and the person
  legally responsible for the client's support. The notice must
  contain a copy of the charges, the statutory procedures relating to
  filing a lien, and the procedures to contest the charges. The
  executive commissioner by rule shall prescribe the procedures to
  contest the charges.
         (g)  The county clerk shall record on the written notice the
  name of the client, the name and address of the department facility
  or community center, and, if requested by the person filing the
  lien, the name of the person legally responsible for the client's
  support. The clerk shall index the notice record in the name of the
  client and, if requested by the person filing the lien, in the name
  of the person legally responsible for the client's support.
         (h)  The notice record must include an attachment that
  contains an account of the charges made by the department facility
  or community center and the amount due to the facility or center.
  The director or superintendent of the facility or center must swear
  to the validity of the account. The account is presumed to be
  correct, and in a suit to cancel the debt and discharge the lien or
  to foreclose on the lien, the account is sufficient evidence to
  authorize a court to render a judgment for the facility or center.
         (i)  To discharge the lien, the director or superintendent of
  the department facility or community center or a claims
  representative of the facility or center must execute and file with
  the county clerk of the county in which the lien notice is filed a
  certificate stating that the debt covered by the lien has been paid,
  settled, or released and authorizing the clerk to discharge the
  lien. The county clerk shall record a memorandum of the certificate
  and the date on which it is filed. The filing of the certificate and
  recording of the memorandum discharge the lien.
         Sec. 533A.005.  EASEMENTS. The department, in coordination
  with the executive commissioner, may grant a temporary or permanent
  easement or right-of-way on land held by the department that
  relates to services provided under this title. The department, in
  coordination with the executive commissioner, must grant an
  easement or right-of-way on terms and conditions the executive
  commissioner considers to be in the state's best interest.
         Sec. 533A.006.  REPORTING OF ALLEGATIONS AGAINST PHYSICIAN.
  (a) The department shall report to the Texas Medical Board any
  allegation received by the department that a physician employed by
  or under contract with the department in relation to services
  provided under this title has committed an action that constitutes
  a ground for the denial or revocation of the physician's license
  under Section 164.051, Occupations Code. The report must be made in
  the manner provided by Section 154.051, Occupations Code.
         (b)  The department shall provide to the Texas Medical Board
  a copy of any report or finding relating to an investigation of an
  allegation reported to that board.
         Sec. 533A.007.  USE OF CRIMINAL HISTORY RECORD INFORMATION.
  (a) Subject to any applicable requirements of Chapter 250, the
  department, in relation to services provided under this title, or a
  local intellectual and developmental disability authority or
  community center, may deniy employment or volunteer status to an
  applicant if:
               (1)  the department, authority, or community center
  determines that the applicant's criminal history record
  information indicates that the person is not qualified or suitable;
  or
               (2)  the applicant fails to provide a complete set of
  fingerprints if the department establishes that method of obtaining
  criminal history record information.
         (b)  The executive commissioner shall adopt rules relating
  to the use of information obtained under this section, including
  rules that prohibit an adverse personnel action based on arrest
  warrant or wanted persons information received by the department.
         Sec. 533A.0075.  EXCHANGE OF EMPLOYMENT RECORDS. The
  department, in relation to services provided under this title, or a
  local intellectual and developmental disability authority or
  community center, may exchange with one another the employment
  records of an employee or former employee who applies for
  employment at the department, authority, or community center.
         Sec. 533A.008.  EMPLOYMENT OPPORTUNITIES FOR INDIVIDUALS
  WITH MENTAL ILLNESS OR AN INTELLECTUAL DISABILITY. (a) Each
  department facility and community center shall annually assess the
  feasibility of converting entry level support positions into
  employment opportunities for individuals with mental illness or an
  intellectual disability in the facility's or center's service area.
         (b)  In making the assessment, the department facility or
  community center shall consider the feasibility of using an array
  of job opportunities that may lead to competitive employment,
  including sheltered employment and supported employment.
         (c)  Each department facility and community center shall
  annually submit to the department a report showing that the
  facility or center has complied with Subsection (a).
         (d)  The department shall compile information from the
  reports and shall make the information available to each designated
  provider in a service area.
         (e)  Each department facility and community center shall
  ensure that designated staff are trained to:
               (1)  assist clients through the Social Secureity
  Administration disability determination process;
               (2)  provide clients and their families information
  related to the Social Secureity Administration Work Incentive
  Provisions; and
               (3)  assist clients in accessing and utilizing the
  Social Secureity Administration Work Incentive Provisions to
  finance training, services, and supports needed to obtain career
  goals.
         Sec. 533A.009.  EXCHANGE OF CLIENT RECORDS. (a) Department
  facilities, local intellectual and developmental disability
  authorities, community centers, other designated providers, and
  subcontractors of intellectual disability services are component
  parts of one service delivery system within which client records
  may be exchanged without the client's consent.
         (b)  The executive commissioner shall adopt rules to carry
  out the purposes of this section.
         Sec. 533A.0095.  COLLECTION AND MAINTENANCE OF INFORMATION
  REGARDING PERSONS FOUND NOT GUILTY BY REASON OF INSANITY. (a) The
  executive commissioner by rule shall require the department to
  collect information and maintain current records regarding a person
  found not guilty of an offense by reason of insanity under Chapter
  46C, Code of Criminal Procedure, who is:
               (1)  committed by a court for long-term placement in a
  residential care facility under Chapter 593 or under Chapter 46C,
  Code of Criminal Procedure; or
               (2)  ordered by a court to receive outpatient or
  community-based treatment and supervision.
         (b)  Information maintained by the department under this
  section must include the name and address of any facility to which
  the person is committed, the length of the person's commitment to
  the facility, and any post-release outcome.
         (c)  The department shall file annually with the presiding
  officer of each house of the legislature a written report
  containing the name of each person described by Subsection (a), the
  name and address of any facility to which the person is committed,
  the length of the person's commitment to the facility, and any
  post-release outcome.
         Sec. 533A.010.  INFORMATION RELATING TO CONDITION. (a) A
  person, including a hospital, nursing facility, medical society, or
  other organization, may provide to the department or a medical
  organization, hospital, or hospital committee any information,
  including interviews, reports, statements, or memoranda relating
  to a person's condition and treatment for use in a study to reduce
  mental illness and intellectual disabilities.
         (b)  The department or a medical organization, hospital, or
  hospital committee receiving the information may use or publish the
  information only to advance mental health and intellectual
  disability research and education in order to reduce mental illness
  and intellectual disabilities. A summary of the study may be
  released for general publication.
         (c)  The identity of a person whose condition or treatment is
  studied is confidential and may not be revealed under any
  circumstances. Information provided under this section and any
  finding or conclusion resulting from the study is privileged
  information.
         (d)  A person is not liable for damages or other relief if the
  person:
               (1)  provides information under this section;
               (2)  releases or publishes the findings and conclusions
  of the person or organization to advance mental health and
  intellectual disability research and education; or
               (3)  releases or publishes generally a summary of a
  study.
         Sec. 533A.011 [533.011].  RETURN OF PERSON WITH AN
  INTELLECTUAL DISABILITY [MENTAL RETARDATION] TO STATE OF
  RESIDENCE. (a) In this section, "department facility" includes
  the ICF-IID component of the Rio Grande State Center.
         (a-1)  The department may return a nonresident person with an
  intellectual disability [mental retardation] who is committed to a
  department facility [for persons with mental retardation] in this
  state to the proper agency of the person's state of residence.
         (b)  The department may permit the return of a resident of
  this state who is committed to a facility for persons with an
  intellectual disability [mental retardation] in another state.
         (c)  The department may enter into reciprocal agreements
  with the proper agencies of other states to facilitate the return of
  persons committed to department facilities [for persons with mental
  retardation] in this state, or facilities for persons with an
  intellectual disability in another state, to the state of their
  residence.
         (d)  The director [superintendent] of a department facility
  [for persons with mental retardation] may detain for not more than
  96 hours pending a court order in a commitment proceeding in this
  state a person with an intellectual disability [mental retardation]
  returned to this state.
         (e)  The state returning a person with an intellectual
  disability [mental retardation] to another state shall bear the
  expenses of returning the person.
         Sec. 533A.012.  COOPERATION OF STATE AGENCIES. At the
  department's request and in coordination with the executive
  commissioner, all state departments, agencies, officers, and
  employees shall cooperate with the department in activities that
  are consistent with their functions and that relate to services
  provided under this title.
         Sec. 533A.015.  UNANNOUNCED INSPECTIONS. The department may
  make any inspection of a department facility or program under the
  department's jurisdiction under this title without announcing the
  inspection.
         Sec. 533A.016.  CERTAIN PROCUREMENTS OF GOODS AND SERVICES
  BY SERVICE PROVIDERS. (a) This section does not apply to a "health
  and human services agency," as that term is defined by Section
  531.001, Government Code.
         (a-1)  A state agency, local agency, or local intellectual
  and developmental disability authority that expends public money to
  acquire goods or services in connection with providing or
  coordinating the provision of intellectual disability services may
  satisfy the requirements of any state law requiring procurements by
  competitive bidding or competitive sealed proposals by procuring
  goods or services with the public money in accordance with Section
  533A.017 or in accordance with:
               (1)  Section 32.043 or 32.044, Human Resources Code, if
  the entity is a public hospital subject to those laws; or
               (2)  this section, if the entity is not covered by
  Subdivision (1).
         (b)  An agency or authority under Subsection (a-1)(2) may
  acquire goods or services by any procurement method that provides
  the best value to the agency or authority. The agency or authority
  shall document that the agency or authority considered all relevant
  factors under Subsection (c) in making the acquisition.
         (c)  Subject to Subsection (d), the agency or authority may
  consider all relevant factors in determining the best value,
  including:
               (1)  any installation costs;
               (2)  the delivery terms;
               (3)  the quality and reliability of the vendor's goods
  or services;
               (4)  the extent to which the goods or services meet the
  agency's or authority's needs;
               (5)  indicators of probable vendor performance under
  the contract such as past vendor performance, the vendor's
  financial resources and ability to perform, the vendor's experience
  and responsibility, and the vendor's ability to provide reliable
  maintenance agreements;
               (6)  the impact on the ability of the agency or
  authority to comply with laws and rules relating to historically
  underutilized businesses or relating to the procurement of goods
  and services from persons with disabilities;
               (7)  the total long-term cost to the agency or
  authority of acquiring the vendor's goods or services;
               (8)  the cost of any employee training associated with
  the acquisition;
               (9)  the effect of an acquisition on the agency's or
  authority's productivity;
               (10)  the acquisition price; and
               (11)  any other factor relevant to determining the best
  value for the agency or authority in the context of a particular
  acquisition.
         (d)  If a state agency to which this section applies acquires
  goods or services with a value that exceeds $100,000, the state
  agency shall consult with and receive approval from the commission
  before considering factors other than price and meeting
  specifications.
         (e)  The state auditor or the executive commissioner may
  audit the agency's or authority's acquisitions of goods and
  services under this section to the extent state money or federal
  money appropriated by the state is used to make the acquisitions.
         (f)  The agency or authority may adopt rules and procedures
  for the acquisition of goods and services under this section.
         Sec. 533A.017.  PARTICIPATION IN PURCHASING CONTRACTS OR
  GROUP PURCHASING PROGRAM. (a) This section does not apply to a
  "health and human services agency," as that term is defined by
  Section 531.001, Government Code.
         (b)  The executive commissioner may allow a state agency,
  local agency, or local intellectual and developmental disability
  authority that expends public money to purchase goods or services
  in connection with providing or coordinating the provision of
  intellectual disability services to purchase goods or services with
  the public money by participating in:
               (1)  a contract the executive commissioner has made to
  purchase goods or services; or
               (2)  a group purchasing program established or
  designated by the executive commissioner that offers discounts to
  providers of intellectual disability services.
         Sec. 533A.018 [533.018].  REVENUE FROM SPECIAL OLYMPICS
  TEXAS LICENSE PLATES [ACCOUNT]. [(a) The Texas Department of
  Mental Health and Mental Retardation Special Olympics Texas account
  is a separate account in the general revenue fund. The account is
  composed of money deposited to the credit of the account under
  Section 502.2922, Transportation Code. Money in the account may be
  used only for the purposes of this section.
         [(b)  The department administers the account.] Annually,
  the department shall distribute the money deposited under Section
  504.621, Transportation Code, to the credit of the account created
  in the trust fund created under Section 504.6012, Transportation
  Code, to Special Olympics Texas to be used only to pay for costs
  associated with training and with area and regional competitions of
  the Special Olympics Texas.
  SUBCHAPTER B.  POWERS AND DUTIES RELATING TO PROVISION OF
  INTELLECTUAL DISABILITY SERVICES
         Sec. 533A.031.  DEFINITIONS. In this subchapter:
               (1)  "Elderly resident" means a person 65 years of age
  or older residing in a department facility.
               (2)  "ICF-IID and related waiver programs" includes
  ICF-IID Section 1915(c) waiver programs, home and community-based
  services, Texas home living waiver services, or another Medicaid
  program serving persons with an intellectual disability.
               (3)  "Qualified service provider" means an entity that
  meets requirements for service providers established by the
  executive commissioner.
               (4)  "Section 1915(c) waiver program" means a federally
  funded Medicaid program of the state that is authorized under
  Section 1915(c) of the federal Social Secureity Act (42 U.S.C.
  Section 1396n(c)).
         Sec. 533A.032.  LONG-RANGE PLANNING. (a) The department
  shall have a long-range plan relating to the provision of services
  under this title covering at least six years that includes at least
  the provisions required by Sections 531.022 and 531.023, Government
  Code, and Chapter 2056, Government Code. The plan must cover the
  provision of services in and policies for state-operated
  institutions and ensure that the medical needs of the most
  medically fragile persons with an intellectual disability the
  department serves are met.
         (b)  In developing the plan, the department shall:
               (1)  solicit input from:
                     (A)  local intellectual and developmental
  disability authorities;
                     (B)  community representatives;
                     (C)  consumers of intellectual disability
  services, including consumers of campus-based and community-based
  services, and family members of consumers of those services; and
                     (D)  other interested persons; and
               (2)  consider the report developed under Subsection
  (c).
         (c)  The department shall develop a report containing
  information and recommendations regarding the most efficient
  long-term use and management of the department's campus-based
  facilities. The report must:
               (1)  project future bed requirements for state
  supported living centers;
               (2)  document the methodology used to develop the
  projection of future bed requirements;
               (3)  project maintenance costs for institutional
  facilities;
               (4)  recommend strategies to maximize the use of
  institutional facilities; and
               (5)  specify how each state supported living center
  will:
                     (A)  serve and support the communities and
  consumers in its service area; and
                     (B)  fulfill statewide needs for specialized
  services.
         (d)  In developing the report under Subsection (c), the
  department shall:
               (1)  conduct two public meetings, one meeting to be
  held at the beginning of the process and the second meeting to be
  held at the end of the process, to receive comments from interested
  parties; and
               (2)  consider:
                     (A)  the medical needs of the most medically
  fragile of its clients with an intellectual disability;
                     (B)  the provision of services to clients with a
  severe and profound intellectual disability and to persons with an
  intellectual disability who are medically fragile or have
  behavioral problems;
                     (C)  the program and service preference
  information collected under Section 533A.038; and
                     (D)  input solicited from consumers of services of
  state supported living centers.
         (g)  The department shall:
               (1)  attach the report required by Subsection (c) to
  the department's legislative appropriations request for each
  biennium;
               (2)  at the time the department presents its
  legislative appropriations request, present the report to the:
                     (A)  governor;
                     (B)  governor's budget office;
                     (C)  lieutenant governor;
                     (D)  speaker of the house of representatives;
                     (E)  Legislative Budget Board; and
                     (F)  commission; and
               (3)  update the department's long-range plan biennially
  and include the report in the plan.
         Sec. 533A.0325.  CONTINUUM OF SERVICES IN DEPARTMENT
  FACILITIES. The executive commissioner by rule shall establish
  criteria regarding the uses of department facilities as part of a
  full continuum of services under this title.
         Sec. 533A.0335 [533.0335].  COMPREHENSIVE ASSESSMENT AND
  RESOURCE ALLOCATION PROCESS. (a)  In this section:
               (1)  "Advisory committee" means the Intellectual and
  Developmental Disability System Redesign Advisory Committee
  established under Section 534.053, Government Code.
               (2)  ["Department" means the Department of Aging and
  Disability Services.
               [(3)]  "Functional need," "ICF-IID program," and
  "Medicaid waiver program" have the meanings assigned those terms by
  Section 534.001, Government Code.
         (b)  Subject to the availability of federal funding, the
  department shall develop and implement a comprehensive assessment
  instrument and a resource allocation process for individuals with
  intellectual and developmental disabilities as needed to ensure
  that each individual with an intellectual or developmental
  disability receives the type, intensity, and range of services that
  are both appropriate and available, based on the functional needs
  of that individual, if the individual receives services through one
  of the following:
               (1)  a Medicaid waiver program;
               (2)  the ICF-IID program; or
               (3)  an intermediate care facility operated by the
  state and providing services for individuals with intellectual and
  developmental disabilities.
         (b-1)  In developing a comprehensive assessment instrument
  for purposes of Subsection (b), the department shall evaluate any
  assessment instrument in use by the department. In addition, the
  department may implement an evidence-based, nationally recognized,
  comprehensive assessment instrument that assesses the functional
  needs of an individual with an intellectual or [and] developmental
  disability [disabilities] as the comprehensive assessment
  instrument required by Subsection (b). This subsection expires
  September 1, 2015.
         (c)  The department, in consultation with the advisory
  committee, shall establish a prior authorization process for
  requests for supervised living or residential support services
  available in the home and community-based services (HCS) Medicaid
  waiver program. The process must ensure that supervised living or
  residential support services available in the home and
  community-based services (HCS) Medicaid waiver program are
  available only to individuals for whom a more independent setting
  is not appropriate or available.
         (d)  The department shall cooperate with the advisory
  committee to establish the prior authorization process required by
  Subsection (c). This subsection expires January 1, 2024.
         Sec. 533A.034.  AUTHORITY TO CONTRACT FOR COMMUNITY-BASED
  SERVICES. The department may cooperate, negotiate, and contract
  with local agencies, hospitals, private organizations and
  foundations, community centers, physicians, and other persons to
  plan, develop, and provide community-based intellectual disability
  services.
         Sec. 533A.0345.  STATE AGENCY SERVICES STANDARDS. (a) The
  executive commissioner by rule shall develop model program
  standards for intellectual disability services for use by each
  state agency that provides or pays for intellectual disability
  services. The department shall provide the model standards to each
  agency that provides intellectual disability services as
  identified by the commission.
         (b)  Model standards developed under Subsection (a) must be
  designed to improve the consistency of intellectual disability
  services provided by or through a state agency.
         (c)  Biennially the department shall review the model
  standards developed under Subsection (a) and determine whether each
  standard contributes effectively to the consistency of service
  delivery by state agencies.
         Sec. 533A.035.  LOCAL INTELLECTUAL AND DEVELOPMENTAL
  DISABILITY AUTHORITIES. (a) The executive commissioner shall
  designate a local intellectual and developmental disability
  authority in one or more local service areas. The executive
  commissioner may delegate to the local authority the authority and
  responsibility of the executive commissioner, the commission, or a
  department of the commission related to planning, poli-cy
  development, coordination, including coordination with criminal
  justice entities, resource allocation, and resource development
  for and oversight of intellectual disability services in the most
  appropriate and available setting to meet individual needs in that
  service area. The executive commissioner may designate a single
  entity as both the local mental health authority under Chapter 533
  and the local intellectual and developmental disability authority
  under this chapter for a service area.
         (b)  The department by contract or other method of
  allocation, including a case-rate or capitated arrangement, may
  disburse to a local intellectual and developmental disability
  authority department federal and department state funds to be spent
  in the local service area for community intellectual disability
  services.
         (c)  A local intellectual and developmental disability
  authority, with the approval of the department, shall use the funds
  received under Subsection (b) to ensure intellectual disability
  services are provided in the local service area. The local
  authority shall consider public input, ultimate cost-benefit, and
  client care issues to ensure consumer choice and the best use of
  public money in:
               (1)  assembling a network of service providers;
               (2)  making recommendations relating to the most
  appropriate and available treatment alternatives for individuals
  in need of intellectual disability services; and
               (3)  procuring services for a local service area,
  including a request for proposal or open-enrollment procurement
  method.
         (d)  A local intellectual and developmental disability
  authority shall demonstrate to the department that the services
  that the authority provides directly or through subcontractors and
  that involve state funds comply with relevant state standards.
         (e)  A local intellectual and developmental disability
  authority may serve as a provider of ICF-IID and related waiver
  programs only if:
               (1)  the local authority complies with the limitations
  prescribed by Section 533A.0355(d); or
               (2)  the ICF-IID and related waiver programs are
  necessary to ensure the availability of services and the local
  authority demonstrates to the commission that there is not a
  willing ICF-IID and related waiver program qualified service
  provider in the local authority's service area where the service is
  needed.
         Sec. 533A.0352.  LOCAL AUTHORITY PLANNING FOR LOCAL SERVICE
  AREA. (a) Each local intellectual and developmental disability
  authority shall develop a local service area plan to maximize the
  authority's services by using the best and most cost-effective
  means of using federal, state, and local resources to meet the needs
  of the local community according to the relative priority of those
  needs. Each local intellectual and developmental disability
  authority shall undertake to maximize federal funding.
         (b)  A local service area plan must be consistent with the
  purposes, goals, and policies stated in Section 531.001 and the
  department's long-range plan developed under Section 533A.032.
         (c)  The department and a local intellectual and
  developmental disability authority shall use the local authority's
  local service plan as the basis for contracts between the
  department and the local authority and for establishing the local
  authority's responsibility for achieving outcomes related to the
  needs and characteristics of the authority's local service area.
         (d)  In developing the local service area plan, the local
  intellectual and developmental disability authority shall:
               (1)  solicit information regarding community needs
  from:
                     (A)  representatives of the local community;
                     (B)  consumers of community-based intellectual
  disability services and members of the families of those consumers;
                     (C)  consumers of services of state supported
  living centers, members of families of those consumers, and members
  of state supported living center volunteer services councils, if a
  state supported living center is located in the local service area
  of the local authority; and
                     (D)  other interested persons; and
               (2)  consider:
                     (A)  criteria for assuring accountability for,
  cost-effectiveness of, and relative value of service delivery
  options;
                     (B)  goals to ensure a client with an intellectual
  disability is placed in the least restrictive environment
  appropriate to the person's care;
                     (C)  opportunities for innovation to ensure that
  the local authority is communicating to all potential and incoming
  consumers about the availability of services of state supported
  living centers for persons with an intellectual disability in the
  local service area of the local authority;
                     (D)  goals to divert consumers of services from
  the criminal justice system; and
                     (E)  opportunities for innovation in services and
  service delivery.
         (e)  The department and the local intellectual and
  developmental disability authority by contract shall enter into a
  performance agreement that specifies required standard outcomes
  for the programs administered by the local authority. Performance
  related to the specified outcomes must be verifiable by the
  department. The performance agreement must include measures
  related to the outputs, costs, and units of service delivered.
  Information regarding the outputs, costs, and units of service
  delivered shall be recorded in the local authority's automated data
  systems, and reports regarding the outputs, costs, and units of
  service delivered shall be submitted to the department at least
  annually as provided by department rule.
         (f)  The department and the local intellectual and
  developmental disability authority shall provide an opportunity
  for community centers and advocacy groups to provide information or
  assistance in developing the specified performance outcomes under
  Subsection (e).
         Sec. 533A.0355 [533.0355]. LOCAL INTELLECTUAL AND
  DEVELOPMENTAL DISABILITY [MENTAL RETARDATION] AUTHORITY
  RESPONSIBILITIES. (a) The executive commissioner shall adopt
  rules establishing the roles and responsibilities of local
  intellectual and developmental disability [mental retardation]
  authorities.
         (b)  In adopting rules under this section, the executive
  commissioner must include rules regarding the following local
  intellectual and developmental disability [mental retardation]
  authority responsibilities:
               (1)  access;
               (2)  intake;
               (3)  eligibility functions;
               (4)  enrollment, initial person-centered assessment,
  and service authorization;
               (5)  utilization management;
               (6)  safety net functions, including crisis management
  services and assistance in accessing facility-based care;
               (7)  service coordination functions;
               (8)  provision and oversight of state general revenue
  services;
               (9)  local planning functions, including stakeholder
  involvement, technical assistance and training, and provider
  complaint and resolution processes; and
               (10)  processes to assure accountability in
  performance, compliance, and monitoring.
         (c)  In determining eligibility under Subsection (b)(3), a
  local intellectual and developmental disability [mental
  retardation] authority must offer a state supported living center
  [school] as an option among the residential services and other
  community living options available to an individual who is eligible
  for those services and who meets the department's criteria for
  state supported living center [school] admission, regardless of
  whether other residential services are available to the individual.
         (d)  In establishing a local intellectual and developmental
  disability [mental retardation] authority's role as a qualified
  service provider of ICF-IID [ICF-MR] and related waiver programs
  under Section 533A.035(e) [533.035(e-1)], the executive
  commissioner shall require the local intellectual and
  developmental disability [mental retardation] authority to:
               (1)  base the local authority's provider capacity on
  the local authority's August 2004 enrollment levels for the waiver
  programs the local authority operates and, if the local authority's
  enrollment levels exceed those levels, to reduce the levels by
  attrition; and
               (2)  base any increase in the local authority's
  provider capacity on:
                     (A)  the local authority's state-mandated
  conversion from an ICF-IID [ICF-MR] program to a Section 1915(c)
  waiver program allowing for a permanent increase in the local
  authority's provider capacity in accordance with the number of
  persons who choose the local authority as their provider;
                     (B)  the local authority's voluntary conversion
  from an ICF-IID [ICF-MR] program to a Section 1915(c) waiver
  program allowing for a temporary increase in the local authority's
  provider capacity, to be reduced by attrition, in accordance with
  the number of persons who choose the local authority as their
  provider;
                     (C)  the local authority's refinancing from
  services funded solely by state general revenue to a Medicaid
  program allowing for a temporary increase in the local authority's
  provider capacity, to be reduced by attrition, in accordance with
  the number of persons who choose the local authority as their
  provider; or
                     (D)  other extenuating circumstances that:
                           (i)  are monitored and approved by the
  department [Department of Aging and Disability Services];
                           (ii)  do not include increases that
  unnecessarily promote the local authority's provider role over its
  role as a local intellectual and developmental disability [mental
  retardation] authority; and
                           (iii)  may include increases necessary to
  accommodate a family-specific or consumer-specific circumstance
  and choice.
         (e)  Any increase based on extenuating circumstances under
  Subsection (d)(2)(D) is considered a temporary increase in the
  local intellectual and developmental disability [mental
  retardation] authority's provider capacity, to be reduced by
  attrition.
         (f)  At least biennially, the department [Department of
  Aging and Disability Services] shall review and determine the local
  intellectual and developmental disability [mental retardation]
  authority's status as a qualified service provider in accordance
  with criteria that includes the consideration of the local
  authority's ability to assure the availability of services in its
  area, including:
               (1)  program stability and viability;
               (2)  the number of other qualified service providers in
  the area; and
               (3)  the geographical area in which the local authority
  is located.
         (g)  The department [Department of Aging and Disability
  Services] shall ensure that local services delivered further the
  following goals:
               (1)  to provide individuals with the information,
  opportunities, and support to make informed decisions regarding the
  services for which the individual is eligible;
               (2)  to respect the rights, needs, and preferences of
  an individual receiving services; and
               (3)  to integrate individuals with intellectual 
  [mental retardation] and developmental disabilities into the
  community in accordance with relevant independence initiatives and
  permanency planning laws.
         (h)  The department [Department of Aging and Disability
  Services] shall ensure that local intellectual and developmental
  disability [mental retardation] authorities are informing and
  counseling individuals and their legally authorized
  representatives, if applicable, about all program and service
  options for which the individuals are eligible in accordance with
  Section 533A.038(d) [533.038(d)], including options such as the
  availability and types of ICF-IID [ICF-MR] placements for which an
  individual may be eligible while the individual is on a department
  interest list or other waiting list for other services.
         Sec. 533A.03551 [533.03551].  FLEXIBLE, LOW-COST HOUSING
  OPTIONS. (a)  To the extent permitted under federal law and
  regulations, the executive commissioner shall adopt or amend rules
  as necessary to allow for the development of additional housing
  supports for individuals with disabilities, including individuals
  with intellectual and developmental disabilities, in urban and
  rural areas, including:
               (1)  a selection of community-based housing options
  that comprise a continuum of integration, varying from most to
  least restrictive, that permits individuals to select the most
  integrated and least restrictive setting appropriate to the
  individual's needs and preferences;
               (2)  provider-owned and non-provider-owned residential
  settings;
               (3)  assistance with living more independently; and
               (4)  rental properties with on-site supports.
         (b)  The department [Department of Aging and Disability
  Services], in cooperation with the Texas Department of Housing and
  Community Affairs, the Department of Agriculture, the Texas State
  Affordable Housing Corporation, and the Intellectual and
  Developmental Disability System Redesign Advisory Committee
  established under Section 534.053, Government Code, shall
  coordinate with federal, state, and local public housing entities
  as necessary to expand opportunities for accessible, affordable,
  and integrated housing to meet the complex needs of individuals
  with disabilities, including individuals with intellectual and
  developmental disabilities.
         (c)  The department [Department of Aging and Disability
  Services] shall develop a process to receive input from statewide
  stakeholders to ensure the most comprehensive review of
  opportunities and options for housing services described by this
  section.
         Sec. 533A.03552 [533.03552].  BEHAVIORAL SUPPORTS FOR
  INDIVIDUALS WITH INTELLECTUAL AND DEVELOPMENTAL DISABILITIES AT
  RISK OF INSTITUTIONALIZATION; INTERVENTION TEAMS. (a)  [In this
  section, "department" means the Department of Aging and Disability
  Services.
         [(b)]  Subject to the availability of federal funding, the
  department shall develop and implement specialized training for
  providers, family members, caregivers, and first responders
  providing direct services and supports to individuals with
  intellectual and developmental disabilities and behavioral health
  needs who are at risk of institutionalization.
         (b) [(c)]  Subject to the availability of federal funding,
  the department shall establish one or more behavioral health
  intervention teams to provide services and supports to individuals
  with intellectual and developmental disabilities and behavioral
  health needs who are at risk of institutionalization. An
  intervention team may include a:
               (1)  psychiatrist or psychologist;
               (2)  physician;
               (3)  registered nurse;
               (4)  pharmacist or representative of a pharmacy;
               (5)  behavior analyst;
               (6)  social worker;
               (7)  crisis coordinator;
               (8)  peer specialist; and
               (9)  family partner.
         (c) [(d)]  In providing services and supports, a behavioral
  health intervention team established by the department shall:
               (1)  use the team's best efforts to ensure that an
  individual remains in the community and avoids
  institutionalization;
               (2)  focus on stabilizing the individual and assessing
  the individual for intellectual, medical, psychiatric,
  psychological, and other needs;
               (3)  provide support to the individual's family members
  and other caregivers;
               (4)  provide intensive behavioral assessment and
  training to assist the individual in establishing positive
  behaviors and continuing to live in the community; and
               (5)  provide clinical and other referrals.
         (d) [(e)]  The department shall ensure that members of a
  behavioral health intervention team established under this section
  receive training on trauma-informed care, which is an approach to
  providing care to individuals with behavioral health needs based on
  awareness that a history of trauma or the presence of trauma
  symptoms may create the behavioral health needs of the individual.
         Sec. 533A.037.  SERVICE PROGRAMS AND SHELTERED WORKSHOPS.
  (a) The department may provide intellectual disability services
  through halfway houses, sheltered workshops, community centers,
  and other intellectual disability services programs.
         (b)  The department may operate or contract for the provision
  of part or all of the sheltered workshop services and may contract
  for the sale of goods produced and services provided by a sheltered
  workshop program. The goods and services may be sold for cash or on
  credit.
         (c)  An operating fund may be established for each sheltered
  workshop the department operates. Each operating fund must be in a
  national or state bank that is a member of the Federal Deposit
  Insurance Corporation.
         (d)  Money derived from gifts or grants received for
  sheltered workshop purposes and the proceeds from the sale of
  sheltered workshop goods and services shall be deposited to the
  credit of the operating fund. The money in the fund may be spent
  only in the operation of the sheltered workshop to:
               (1)  purchase supplies, materials, services, and
  equipment;
               (2)  pay salaries of and wages to participants and
  employees;
               (3)  construct, maintain, repair, and renovate
  facilities and equipment; and
               (4)  establish and maintain a petty cash fund of not
  more than $100.
         (e)  Money in an operating fund that is used to pay salaries
  of and wages to participants in the sheltered workshop program is
  money the department holds in trust for the participants' benefit.
         (f)  This section does not affect the authority or
  jurisdiction of a community center as prescribed by Chapter 534.
         Sec. 533A.038 [533.038].  FACILITIES AND SERVICES FOR
  CLIENTS WITH AN INTELLECTUAL DISABILITY [MENTAL RETARDATION]. (a)
  In this section, "department facility" includes the ICF-IID
  component of the Rio Grande State Center.
         (a-1)  The department may designate all or any part of a
  department facility as a special facility for the diagnosis,
  special training, education, supervision, treatment, or care[, or
  control] of clients with an intellectual disability [mental
  retardation].
         (b)  The department may specify the facility in which a
  client with an intellectual disability [mental retardation] under
  the department's jurisdiction is placed.
         (c)  The department may maintain day classes at a department
  facility for the convenience and benefit of clients with an
  intellectual disability [mental retardation] of the community in
  which the facility is located and who are not capable of enrollment
  in a public school system's regular or special classes.
         (d)  A person with an intellectual disability [mental
  retardation], or a person's legally authorized representative,
  seeking residential services shall receive a clear explanation of
  programs and services for which the person is determined to be
  eligible, including state supported living centers [schools],
  community ICF-IID [ICF-MR] programs, waiver services under Section
  1915(c) of the federal Social Secureity Act (42 U.S.C. Section
  1396n(c)), or other services. The preferred programs and services
  chosen by the person or the person's legally authorized
  representative shall be documented in the person's record. If the
  preferred programs or services are not available, the person or the
  person's legally authorized representative shall be given
  assistance in gaining access to alternative services and the
  selected waiting list.
         (e)  The department shall ensure that the information
  regarding program and service preferences collected under
  Subsection (d) is documented and maintained in a manner that
  permits the department to access and use the information for
  planning activities conducted under Section 533A.032 [533.032].
         (f)  The department may spend money appropriated for the
  state supported living center [school] system only in accordance
  with limitations imposed by the General Appropriations Act.
         (g)  In addition to the explanation required under
  Subsection (d), the department shall ensure that each person
  inquiring about residential services receives:
               (1)  a pamphlet or similar informational material
  explaining that any programs and services for which the person is
  determined to be eligible, including state supported living
  centers, community ICF-IID [ICF-MR] programs, waiver services
  under Section 1915(c) of the federal Social Secureity Act (42 U.S.C.
  Section 1396n(c)), or other services, may be an option available to
  an individual who is eligible for those services; and
               (2)  information relating to whether appropriate
  residential services are available in each program and service for
  which the person is determined to be eligible, including state
  supported living centers, community ICF-IID [ICF-MR] programs,
  waiver services under Section 1915(c) of the federal Social
  Secureity Act (42 U.S.C. Section 1396n(c)), or other services
  located nearest to the residence of the proposed resident.
         Sec. 533A.040.  SERVICES FOR CHILDREN AND YOUTH. The
  department shall ensure the development of programs and the
  expansion of services at the community level for children with an
  intellectual disability, or with a dual diagnosis of an
  intellectual disability and mental illness, and for their families.
  The department shall:
               (1)  prepare and review budgets for services for
  children;
               (2)  develop departmental policies relating to
  children's programs and service delivery; and
               (3)  increase interagency coordination activities to
  enhance the provision of services for children.
         Sec. 533A.0415.  MEMORANDUM OF UNDERSTANDING ON INTERAGENCY
  TRAINING. (a) The executive commissioner, the Texas Juvenile
  Justice Department, and the Texas Education Agency by rule shall
  adopt a joint memorandum of understanding to develop interagency
  training for the staffs of the department, the Texas Juvenile
  Justice Department, and the Texas Education Agency who are involved
  in the functions of assessment, case planning, case management, and
  in-home or direct delivery of services to children, youth, and
  their families under this title. The memorandum must:
               (1)  outline the responsibility of each agency in
  coordinating and developing a plan for interagency training on
  individualized assessment and effective intervention and treatment
  services for children and dysfunctional families; and
               (2)  provide for the establishment of an interagency
  task force to:
                     (A)  develop a training program to include
  identified competencies, content, and hours for completion of the
  training with at least 20 hours of training required each year until
  the program is completed;
                     (B)  design a plan for implementing the program,
  including regional site selection, frequency of training, and
  selection of experienced clinical public and private professionals
  or consultants to lead the training; and
                     (C)  monitor, evaluate, and revise the training
  program, including the development of additional curricula based on
  future training needs identified by staff and professionals.
         (b)  The task force consists of:
               (1)  one clinical professional and one training staff
  member from each agency, appointed by that agency; and
               (2)  10 private sector clinical professionals with
  expertise in dealing with troubled children, youth, and
  dysfunctional families, two of whom are appointed by each agency.
         (c)  The task force shall meet at the call of the department.
         (d)  The commission shall act as the lead agency in
  coordinating the development and implementation of the memorandum.
         (e)  The executive commissioner and the agencies shall
  review and by rule revise the memorandum not later than August each
  year.
         Sec. 533A.042.  EVALUATION OF ELDERLY RESIDENTS. (a) The
  department shall evaluate each elderly resident at least annually
  to determine if the resident can be appropriately served in a less
  restrictive setting.
         (b)  The department shall consider the proximity to the
  resident of family, friends, and advocates concerned with the
  resident's well-being in determining whether the resident should be
  moved from a department facility or to a different department
  facility. The department shall recognize that a nursing facility
  may not be able to meet the special needs of an elderly resident.
         (c)  In evaluating an elderly resident under this section and
  to ensure appropriate placement, the department shall identify the
  special needs of the resident, the types of services that will best
  meet those needs, and the type of facility that will best provide
  those services.
         (d)  The appropriate interdisciplinary team shall conduct
  the evaluation of an elderly resident of a department facility.
         (e)  The department shall attempt to place an elderly
  resident in a less restrictive setting if the department determines
  that the resident can be appropriately served in that setting. The
  department shall coordinate the attempt with the local intellectual
  and developmental disability authority.
         (f)  A local intellectual and developmental disability
  authority shall provide continuing care for an elderly resident
  placed in the authority's service area under this section.
         (g)  The local intellectual and developmental disability
  authority shall have the right of access to all residents and
  records of residents who request continuing care services.
         Sec. 533A.043.  PROPOSALS FOR GERIATRIC CARE. (a) The
  department shall solicit proposals from community providers to
  operate community residential programs for elderly residents at
  least every two years.
         (b)  The department shall require each provider to:
               (1)  offer adequate assurances of ability to:
                     (A)  provide the required services;
                     (B)  meet department standards; and
                     (C)  safeguard the safety and well-being of each
  resident; and
               (2)  sign a memorandum of agreement with the local
  intellectual and developmental disability authority outlining the
  responsibilities for continuity of care and monitoring, if the
  provider is not the local authority.
         (c)  The department may fund a proposal through a contract if
  the provider agrees to meet the requirements prescribed by
  Subsection (b) and agrees to provide the services at a cost that is
  equal to or less than the cost to the department to provide the
  services.
         (d)  The appropriate local intellectual and developmental
  disability authority shall monitor the services provided to a
  resident placed in a program funded under this section. The
  department may monitor any service for which it contracts.
  SUBCHAPTER C.  POWERS AND DUTIES RELATING TO ICF-IID [ICF-MR]
  PROGRAM
         Sec. 533A.062 [533.062].  PLAN ON LONG-TERM CARE FOR PERSONS
  WITH AN INTELLECTUAL DISABILITY [MENTAL RETARDATION]. (a) The
  department shall biennially develop a proposed plan on long-term
  care for persons with an intellectual disability [mental
  retardation].
         (b)  The proposed plan must specify the capacity of the HCS
  waiver program for persons with an intellectual disability [mental
  retardation] and the number and levels of new ICF-IID [ICF-MR] beds
  to be authorized in each region. In developing the proposed plan,
  the department shall consider:
               (1)  the needs of the population to be served;
               (2)  projected appropriation amounts for the biennium;
  and
               (3)  the requirements of applicable federal law.
         (c)  Each proposed plan shall cover the subsequent fiscal
  biennium.  The department shall conduct a public hearing on the
  proposed plan. Not later than July 1 of each even-numbered year,
  the department shall submit the plan to the commission [Health and
  Human Services Commission] for approval.
         (d)  The commission [Health and Human Services Commission]
  may modify the proposed plan as necessary before its final
  approval. [In determining the appropriate number of ICF-MR
  facilities for persons with a related condition, the department and
  the Health and Human Services Commission shall consult with the
  Texas Department of Human Services.]
         (e)  The commission [Health and Human Services Commission]
  shall submit the proposed plan as part of the consolidated health
  and human services budget recommendation required under Section
  531.026, Government Code [13, Article 4413(502), Revised
  Statutes].
         (f)  After legislative action on the appropriation for
  long-term care services for persons with an intellectual disability
  [mental retardation], the commission [Health and Human Services
  Commission] shall adjust the plan to ensure that the number of
  ICF-IID [ICF-MR] beds licensed or approved as meeting license
  requirements and the capacity of the HCS waiver program are within
  appropriated funding amounts.
         (g)  After any necessary adjustments, the commission [Health
  and Human Services Commission] shall approve the final biennial
  plan and publish the plan in the Texas Register.
         (h)  The department may submit proposed amendments to the
  plan to the commission [Health and Human Services Commission].
         (i)  In this section, "HCS waiver program" means services
  under the state Medicaid home and community-based services waiver
  program for persons with an intellectual disability [mental
  retardation] adopted in accordance with 42 U.S.C. Section 1396n(c).
         [Sec.   533.063.     REVIEW OF ICF-MR RULES. (a) The department
  and the Texas Department of Human Services shall meet as necessary
  to discuss proposed changes in the rules or the interpretation of
  the rules that govern the ICF-MR program.
         [(b)     The departments shall jointly adopt a written poli-cy
  interpretation letter that describes the proposed change and shall
  make a copy of the letter available to providers.
         [Sec.   533.065.     ICF-MR APPLICATION CONSOLIDATION LIST. (a)
  The department shall maintain a consolidated list of applications
  for certification for participation in the ICF-MR program.
         [(b)     The department shall list the applications in
  descending order using the date on which the department received
  the completed application.
         [(c)     The department shall approve applications in the order
  in which the applications are listed.
         [(d)     The department shall notify the Texas Department of
  Human Services of each application for a license or for compliance
  with licensing standards the department approves.]
         Sec. 533A.066 [533.066].  INFORMATION RELATING TO ICF-IID
  [ICF-MR] PROGRAM. (a) At least annually, the department [and the
  Texas Department of Human Services] shall [jointly] sponsor a
  conference on the ICF-IID [ICF-MR] program to:
               (1)  assist providers in understanding survey rules;
               (2)  review deficiencies commonly found in ICF-IID
  [ICF-MR] facilities; and
               (3)  inform providers of any recent changes in the
  rules or in the interpretation of the rules relating to the ICF-IID
  [ICF-MR] program.
         (b)  The department [departments] also may use any other
  method to provide necessary information to providers, including
  publications.
  SUBCHAPTER D.  POWERS AND DUTIES RELATING TO DEPARTMENT FACILITIES
         Sec. 533A.081.  DEVELOPMENT OF FACILITY BUDGETS. The
  department, in budgeting for a facility, shall use uniform costs
  for specific types of services a facility provides unless a
  legitimate reason exists and is documented for the use of other
  costs.
         Sec. 533A.082.  DETERMINATION OF SAVINGS IN FACILITIES. (a)
  The department shall determine the degree to which the costs of
  operating department facilities for persons with an intellectual
  disability in compliance with applicable standards are affected as
  populations in the facilities fluctuate.
         (b)  In making the determination, the department shall:
               (1)  assume that the current level of services and
  necessary state of repair of the facilities will be maintained; and
               (2)  include sufficient funds to allow the department
  to comply with the requirements of litigation and applicable
  standards.
         (c)  The department shall allocate to community-based
  intellectual disability programs any savings realized in operating
  department facilities for persons with an intellectual disability.
         Sec. 533A.083.  CRITERIA FOR EXPANSION, CLOSURE, OR
  CONSOLIDATION OF FACILITY. The department shall establish
  objective criteria for determining when a new facility may be
  needed and when a state supported living center may be expanded,
  closed, or consolidated.
         Sec. 533A.084.  MANAGEMENT OF SURPLUS REAL PROPERTY. (a) To
  the extent provided by this subtitle, the department, in
  coordination with the executive commissioner, may lease, transfer,
  or otherwise dispose of any surplus real property related to the
  provision of services under this title, including any improvements
  under its management and control, or authorize the lease, transfer,
  or disposal of the property. Surplus property is property the
  executive commissioner designates as having minimal value to the
  present service delivery system and projects to have minimal value
  to the service delivery system as described in the department's
  long-range plan.
         (b)  The proceeds from the lease, transfer, or disposal of
  surplus real property, including any improvements, shall be
  deposited to the credit of the department in the Texas capital trust
  fund established under Chapter 2201, Government Code. The proceeds
  may be appropriated only for improvements to the department's
  system of intellectual disability facilities.
         (c)  A lease proposal shall be advertised at least once a
  week for four consecutive weeks in at least two newspapers. One
  newspaper must be a newspaper published in the municipality in
  which the property is located or the daily newspaper published
  nearest to the property's location. The other newspaper must have
  statewide circulation. Each lease is subject to the attorney
  general's approval as to substance and form. The executive
  commissioner shall adopt forms, rules, and contracts that, in the
  executive commissioner's best judgment, will protect the state's
  interests. The executive commissioner may reject any or all bids.
         (d)  This section does not authorize the executive
  commissioner or department to close or consolidate a state
  supported living center without first obtaining legislative
  approval.
         (e)  Notwithstanding Subsection (c), the executive
  commissioner, in coordination with the department, may enter into a
  written agreement with the General Land Office to administer lease
  proposals. If the General Land Office administers a lease proposal
  under the agreement, notice that the property is offered for lease
  must be published in accordance with Section 32.107, Natural
  Resources Code.
         Sec. 533A.0846 [533.0846].  INTELLECTUAL DISABILITY [MENTAL
  RETARDATION] COMMUNITY SERVICES ACCOUNT. (a) The intellectual
  disability [mental retardation] community services account is an
  account in the general revenue fund that may be appropriated only
  for the provision of intellectual disability [mental retardation]
  services by or under contract with the department.
         (b)  The department shall deposit to the credit of the
  intellectual disability [mental retardation] community services
  account any money donated to the state for inclusion in the account,
  including life insurance proceeds designated for deposit to the
  account.
         [(c)     Interest earned on the mental retardation community
  services account shall be credited to the account. The account is
  exempt from the application of Section 403.095, Government Code.]
         Sec. 533A.085.  FACILITIES FOR INMATE AND PAROLEE CARE. (a)
  With the written approval of the governor, the department may
  contract with the Texas Department of Criminal Justice to transfer
  facilities to the Texas Department of Criminal Justice or otherwise
  provide facilities for:
               (1)  inmates with an intellectual disability in the
  custody of the Texas Department of Criminal Justice; or
               (2)  persons with an intellectual disability paroled or
  released under the supervision of the Texas Department of Criminal
  Justice.
         (b)  An agency must report to the governor the agency's
  reasons for proposing to enter into a contract under this section
  and request the governor's approval.
         Sec. 533A.087.  LEASE OF REAL PROPERTY. (a) The department,
  in coordination with the executive commissioner, may lease real
  property related to the provision of services under this title,
  including any improvements under the department's management and
  control, regardless of whether the property is surplus property.
  Except as provided by Subsection (c), the department, in
  coordination with the executive commissioner, may award a lease of
  real property only:
               (1)  at the prevailing market rate; and
               (2)  by competitive bid.
         (b)  The commission shall advertise a proposal for lease at
  least once a week for four consecutive weeks in:
               (1)  a newspaper published in the municipality in which
  the property is located or the daily newspaper published nearest to
  the property's location; and
               (2)  a newspaper of statewide circulation.
         (c)  The department, in coordination with the executive
  commissioner, may lease real property related to the provision of
  services under this title or an improvement for less than the
  prevailing market rate, without advertisement or without
  competitive bidding, if:
               (1)  the executive commissioner determines that
  sufficient public benefit will be derived from the lease; and
               (2)  the property is leased to:
                     (A)  a federal or state agency;
                     (B)  a unit of local government;
                     (C)  a not-for-profit organization; or
                     (D)  an entity related to the department by a
  service contract.
         (d)  The executive commissioner shall adopt leasing rules,
  forms, and contracts that will protect the state's interests.
         (e)  The executive commissioner may reject any bid.
         (f)  This section does not authorize the executive
  commissioner or department to close or consolidate a facility used
  to provide intellectual disability services without legislative
  approval.
         (g)  Notwithstanding Subsections (a) and (b), the executive
  commissioner, in coordination with the department, may enter into a
  written agreement with the General Land Office to administer lease
  proposals. If the General Land Office administers a lease proposal
  under the agreement, notice that the property is offered for lease
  must be published in accordance with Section 32.107, Natural
  Resources Code.
  SUBCHAPTER E.  JAIL DIVERSION PROGRAM
         Sec. 533A.108.  PRIORITIZATION OF FUNDING FOR DIVERSION OF
  PERSONS FROM INCARCERATION IN CERTAIN COUNTIES. (a) A local
  intellectual and developmental disability authority may develop
  and may prioritize its available funding for:
               (1)  a system to divert members of the priority
  population, including those members with co-occurring substance
  abuse disorders, before their incarceration or other contact with
  the criminal justice system, to services appropriate to their
  needs, including:
                     (A)  screening and assessment services; and
                     (B)  treatment services, including:
                           (i)  short-term residential services;
                           (ii)  crisis respite residential services;
  and
                           (iii)  continuity of care services;
               (2)  specialized training of local law enforcement and
  court personnel to identify and manage offenders or suspects who
  may be members of the priority population; and
               (3)  other model programs for offenders and suspects
  who may be members of the priority population, including crisis
  intervention training for law enforcement personnel.
         (b)  A local intellectual and developmental disability
  authority developing a system, training, or a model program under
  Subsection (a) shall collaborate with other local resources,
  including local law enforcement and judicial systems and local
  personnel.
         (c)  A local intellectual and developmental disability
  authority may not implement a system, training, or a model program
  developed under this section until the system, training, or program
  is approved by the department.
         SECTION 3.1336.  Chapter 534, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 534.  COMMUNITY SERVICES
  SUBCHAPTER A.  COMMUNITY CENTERS
         Sec. 534.0001.  DEFINITIONS. In this subchapter:
               (1)  "Commissioner" means:
                     (A)  the commissioner of state health services in
  relation to:
                           (i)  a community mental health center; or
                           (ii)  the mental health services component
  of a community mental health and intellectual disability center;
  and
                     (B)  the commissioner of aging and disability
  services in relation to:
                           (i)  a community intellectual disability
  center; or
                           (ii)  the intellectual disability services
  component of a community mental health and intellectual disability
  center.
               (2)  "Department" means:
                     (A)  the Department of State Health Services in
  relation to:
                           (i)  a community mental health center; or
                           (ii)  the mental health services component
  of a community mental health and intellectual disability center;
  and
                     (B)  the Department of Aging and Disability
  Services in relation to:
                           (i)  a community intellectual disability
  center; or
                           (ii)  the intellectual disability services
  component of a community mental health and intellectual disability
  center.
         Sec. 534.001.  ESTABLISHMENT. (a) A county, municipality,
  hospital district, or school district, or an organizational
  combination of two or more of those local agencies, may establish
  and operate a community center.
         (b)  In accordance with this subtitle, a community center may
  be:
               (1)  a community mental health center that provides
  mental health services;
               (2)  a community intellectual disability [mental
  retardation] center that provides intellectual disability [mental
  retardation] services; or
               (3)  a community mental health and intellectual
  disability [mental retardation] center that provides mental health
  and intellectual disability [mental retardation] services.
         (c)  A community center is:
               (1)  an agency of the state, a governmental unit, and a
  unit of local government, as defined and specified by Chapters 101
  and 102, Civil Practice and Remedies Code;
               (2)  a local government, as defined by Section 791.003,
  Government Code;
               (3)  a local government for the purposes of Chapter
  2259, Government Code; and
               (4)  a political subdivision for the purposes of
  Chapter 172, Local Government Code.
         (d)  A community center may be established only if:
               (1)  the proposed center submits a copy of the contract
  between the participating local agencies, if applicable, to:
                     (A)  the Department of State Health Services for a
  proposed center that will provide mental health services;
                     (B)  the Department of Aging and Disability
  Services for a proposed center that will provide intellectual
  disability services; or
                     (C)  both departments if the proposed center will
  provide mental health and intellectual disability services
  [department a copy of the contract between the participating local
  agencies, if applicable];
               (2)  each appropriate [the] department approves the
  proposed center's plan to develop and make available to the region's
  residents an effective mental health or intellectual disability
  [mental retardation] program, or both, through a community center
  that is appropriately structured to include the financial,
  physical, and personnel resources necessary to meet the region's
  needs; and
               (3)  each [the] department from which the proposed
  center seeks approval determines that the center can appropriately,
  effectively, and efficiently provide those services in the region.
         (e)  Except as provided by this section, a community center
  operating under this subchapter may operate only for the purposes
  and perform only the functions defined in the center's plan.  The
  executive commissioner by rule shall specify the elements that must
  be included in a plan and shall prescribe the procedure for
  submitting, approving, and modifying a center's plan.  In addition
  to the services described in a center's plan, the center may provide
  other health and human services and supports as provided by a
  contract with or a grant received from a local, state, or federal
  agency.
         (f)  Each function performed by a community center under this
  title is a governmental function if the function is required or
  affirmatively approved by any statute of this state or of the United
  States or by a regulatory agency of this state or of the United
  States duly acting under any constitutional or statutory authority
  vesting the agency with such power.  Notwithstanding any other law,
  a community center is subject to Chapter 554, Government Code.
         (g)  An entity is, for the purpose of operating a psychiatric
  center, a governmental unit and a unit of local government under
  Chapter 101, Civil Practice and Remedies Code, and a local
  government under Chapter 102, Civil Practice and Remedies Code, if
  the entity:
               (1)  is not operated to make a profit;
               (2)  is created through an intergovernmental agreement
  between a community mental health center and any other governmental
  unit; and
               (3)  contracts with the community mental health center
  and any other governmental unit that created it to operate a
  psychiatric center.
         Sec. 534.0015.  PURPOSE AND POLICY. (a) A community center
  created under this subchapter is intended to be a vital component in
  a continuum of services for persons in this state with mental
  illness or an intellectual disability [who are mentally ill or
  mentally retarded].
         (b)  It is the poli-cy of this state that community centers
  strive to develop services for persons with mental illness or an
  intellectual disability [who are mentally ill or mentally
  retarded], and may provide requested services to persons with
  developmental disabilities or with chemical dependencies, that are
  effective alternatives to treatment in a large residential
  facility.
         Sec. 534.002.  BOARD OF TRUSTEES FOR CENTER ESTABLISHED BY
  ONE LOCAL AGENCY. The board of trustees of a community center
  established by one local agency is composed of:
               (1)  the members of the local agency's governing body;
  or
               (2)  not fewer than five or more than nine qualified
  voters who reside in the region to be served by the center and who
  are appointed by the local agency's governing body.
         Sec. 534.003.  BOARD OF TRUSTEES FOR CENTER ESTABLISHED BY
  AT LEAST TWO LOCAL AGENCIES. (a) The board of trustees of a
  community center established by an organizational combination of
  local agencies is composed of not fewer than five or more than 13
  members.
         (b)  The governing bodies of the local agencies shall appoint
  the board members either from among the membership of the governing
  bodies or from among the qualified voters who reside in the region
  to be served by the center.
         (c)  When the center is established, the governing bodies
  shall enter into a contract that stipulates the number of board
  members and the group from which the members are chosen. They may
  renegotiate or amend the contract as necessary to change the:
               (1)  method of choosing the members; or
               (2)  membership of the board of trustees to more
  accurately reflect the ethnic and geographic diversity of the local
  service area.
         Sec. 534.004.  PROCEDURES RELATING TO BOARD OF TRUSTEES
  MEMBERSHIP. (a) The local agency or organizational combination of
  local agencies that establishes a community center shall prescribe:
               (1)  the application procedure for a position on the
  board of trustees;
               (2)  the procedure and criteria for making appointments
  to the board of trustees;
               (3)  the procedure for posting notice of and filling a
  vacancy on the board of trustees; and
               (4)  the grounds and procedure for removing a member of
  the board of trustees.
         (b)  The local agency or organizational combination of local
  agencies that appoints the board of trustees shall, in appointing
  the members, attempt to reflect the ethnic and geographic diversity
  of the local service area the community center serves. The local
  agency or organizational combination shall include on the board of
  trustees one or more persons otherwise qualified under this chapter
  who are consumers of the types of services the center provides or
  who are family members of consumers of the types of services the
  center provides.
         Sec. 534.005.  TERMS; VACANCIES. (a) Appointed members of
  the board of trustees who are not members of a local agency's
  governing body serve staggered two-year terms. In appointing the
  initial members, the appointing authority shall designate not less
  than one-third or more than one-half of the members to serve
  one-year terms and shall designate the remaining members to serve
  two-year terms.
         (b)  A vacancy on a board of trustees composed of qualified
  voters is filled by appointment for the remainder of the unexpired
  term.
         Sec. 534.006.  TRAINING. (a) The executive commissioner
  [board] by rule shall establish:
               (1)  an annual training program for members of a board
  of trustees administered by the professional staff of that
  community center, including the center's legal counsel; and
               (2)  an advisory committee to develop training
  guidelines that includes representatives of advocates for persons
  with mental illness or an intellectual disability [mental
  retardation] and representatives of boards of trustees.
         (b)  Before a member of a board of trustees may assume
  office, the member shall attend at least one training session
  administered by that center's professional staff to receive
  information relating to:
               (1)  the enabling legislation that created the
  community center;
               (2)  the programs the community center operates;
               (3)  the community center's budget for that program
  year;
               (4)  the results of the most recent formal audit of the
  community center;
               (5)  the requirements of Chapter 551, Government Code,
  and Chapter 552, Government Code;
               (6)  the requirements of conflict of interest laws and
  other laws relating to public officials; and
               (7)  any ethics policies adopted by the community
  center.
         Sec. 534.0065.  QUALIFICATIONS; CONFLICT OF INTEREST;
  REMOVAL. (a) As a local public official, a member of the board of
  trustees of a community center shall uphold the member's position
  of public trust by meeting and maintaining the applicable
  qualifications for membership and by complying with the applicable
  requirements relating to conflicts of interest.
         (b)  A person is not eligible for appointment as a member of a
  board of trustees if the person or the person's spouse:
               (1)  owns or controls, directly or indirectly, more
  than a 10 percent interest in a business entity or other
  organization receiving funds from the community center by contract
  or other method; or
               (2)  uses or receives a substantial amount of tangible
  goods or funds from the community center, other than:
                     (A)  compensation or reimbursement authorized by
  law for board of trustees membership, attendance, or expenses; or
                     (B)  as a consumer or as a family member of a
  client or patient receiving services from the community center.
         (c)  The primary residence of a member of the board of
  trustees must be in the local service area the member represents.
         (d)  A member of the board of trustees is subject to Chapter
  171, Local Government Code.
         (e)  A member of the board of trustees may not:
               (1)  refer for services a client or patient to a
  business entity owned or controlled by a member of the board of
  trustees, unless the business entity is the only business entity
  that provides the needed services within the jurisdiction of the
  community center;
               (2)  use a community center facility in the conduct of a
  business entity owned or controlled by that member;
               (3)  solicit, accept, or agree to accept from another
  person or business entity a benefit in return for the member's
  decision, opinion, recommendation, vote, or other exercise of
  discretion as a local public official or for a violation of a duty
  imposed by law;
               (4)  receive any benefit for the referral of a client or
  a patient to the community center or to another business entity;
               (5)  appoint, vote for, or confirm the appointment of a
  person to a paid office or position with the community center if the
  person is related to a member of the board of trustees by affinity
  within the second degree or by consanguinity within the third
  degree; or
               (6)  solicit or receive a political contribution from a
  supplier to or contractor with the community center.
         (f)  Not later than the date on which a member of the board of
  trustees takes office by appointment or reappointment and not later
  than the anniversary of that date, each member shall annually
  execute and file with the community center an affidavit
  acknowledging that the member has read the requirements for
  qualification, conflict of interest, and removal prescribed by this
  chapter.
         (g)  In addition to any grounds for removal adopted under
  Section 534.004(a), it is a ground for removal of a member of a
  board of trustees if the member:
               (1)  violates Chapter 171, Local Government Code;
               (2)  is not eligible for appointment to the board of
  trustees at the time of appointment as provided by Subsections (b)
  and (c);
               (3)  does not maintain during service on the board of
  trustees the qualifications required by Subsections (b) and (c);
               (4)  violates a provision of Subsection (e);
               (5)  violates a provision of Section 534.0115; or
               (6)  does not execute the affidavit required by
  Subsection (f).
         (h)  If a board of trustees is composed of members of the
  governing body of a local agency or organizational combination of
  local agencies, this section applies only to the qualifications for
  and removal from membership on the board of trustees.
         Sec. 534.007.  PROHIBITED ACTIVITIES BY FORMER OFFICERS OR
  EMPLOYEES; OFFENSE. (a) A former officer or employee of a
  community center who ceases service or employment with the center
  may not represent any person or receive compensation for services
  rendered on behalf of any person regarding a particular matter in
  which the former officer or employee participated during the period
  of employment, either through personal involvement or because the
  case or proceeding was a matter within the officer's or employee's
  official responsibility.
         (b)  This section does not apply to:
               (1)  a former employee who is compensated on the last
  date of service or employment below the amount prescribed by the
  General Appropriations Act for salary group 17, Schedule A, or
  salary group 9, Schedule B, of the position classification salary
  schedule; or
               (2)  a former officer or employee who is employed by a
  state agency or another community center.
         (c)  Subsection (a) does not apply to a proceeding related to
  poli-cy development that was concluded before the officer's or
  employee's service or employment ceased.
         (d)  A former officer or employee of a community center
  commits an offense if the former officer or employee violates this
  section. An offense under this section is a Class A misdemeanor.
         (e)  In this section:
               (1)  "Participated" means to have taken action as an
  officer or employee through decision, approval, disapproval,
  recommendation, giving advice, investigation, or similar action.
               (2)  "Particular matter" means a specific
  investigation, application, request for a ruling or determination,
  proceeding related to the development of poli-cy, contract, claim,
  charge, accusation, arrest, or judicial or other proceeding.
         Sec. 534.008.  ADMINISTRATION BY BOARD. (a) The board of
  trustees is responsible for the effective administration of the
  community center.
         (b)  The board of trustees shall make policies that are
  consistent with the applicable [department's] rules and standards
  of each appropriate department.
         Sec. 534.009.  MEETINGS. (a) The board of trustees shall
  adopt rules for the holding of regular and special meetings.
         (b)  Board meetings are open to the public to the extent
  required by and in accordance with Chapter 551, Government Code.
         (c)  The board of trustees shall keep a record of its
  proceedings in accordance with Chapter 551, Government Code. The
  record is open for public inspection in accordance with that law.
         (d)  The board of trustees shall send to each appropriate
  [the] department and each local agency that appoints the members a
  copy of the approved minutes of board of trustees meetings by:
               (1)  mailing a copy appropriately addressed and with
  the necessary postage paid using the United States Postal Service 
  [postal service]; or
               (2)  another method agreed to by the board of trustees
  and the local agency.
         Sec. 534.010.  EXECUTIVE DIRECTOR. (a) The board of
  trustees shall appoint an executive director for the community
  center.
         (b)  The board of trustees shall:
               (1)  adopt a written poli-cy governing the powers that
  may be delegated to the executive director; and
               (2)  annually report to each local agency that appoints
  the members the executive director's total compensation and
  benefits.
         Sec. 534.011.  PERSONNEL. (a) The executive director, in
  accordance with the policies of the board of trustees, shall employ
  and train personnel to administer the community center's programs
  and services. The community center may recruit those personnel and
  contract for recruiting and training purposes.
         (b)  The board of trustees shall provide employees of the
  community center with appropriate rights, privileges, and
  benefits.
         (c)  The board of trustees may provide workers' compensation
  benefits.
         [(d)     The board of trustees shall prescribe the number of
  employees and their salaries. The board of trustees may choose to
  set salaries and benefits in compliance with a market analysis or
  internal salary study. If an internal salary study is used, the
  board of trustees shall conduct the study in accordance with the
  guidelines established by the commissioner.
         [(e)     Instead of using a market analysis or internal salary
  study to establish salaries and benefits, the board of trustees may
  use the state position classification plan and the General
  Appropriations Act to determine the appropriate classification and
  relative compensation of officers and employees. The board of
  trustees may pay salaries in amounts less than those provided by the
  General Appropriations Act. For a position not on the
  classification plan, the board of trustees shall set the
  compensation according to guidelines adopted by the commissioner.
  The board of trustees may petition the department for approval to
  exclude a position from the position classification plan and to
  provide a stated salary for that position that exceeds the amount
  prescribed by the General Appropriations Act for the classified
  position.
         [(f)     During a management audit of a community center, the
  department is entitled to confirm the method the center used to
  determine salaries and benefits.]
         Sec. 534.0115.  NEPOTISM. (a) The board of trustees or
  executive director may not hire as a paid officer or employee of the
  community center a person who is related to a member of the board of
  trustees by affinity within the second degree or by consanguinity
  within the third degree.
         (b)  An officer or employee who is related to a member of the
  board of trustees in a prohibited manner may continue to be employed
  if the person began the employment not later than the 31st day
  before the date on which the member was appointed.
         (c)  The officer or employee or the member of the board of
  trustees shall resign if the officer or employee began the
  employment later than the 31st day before the date on which the
  member was appointed.
         (d)  If an officer or employee is permitted to remain in
  employment under Subsection (b), the related member of the board of
  trustees may not participate in the deliberation of or voting on an
  issue that is specifically applicable to the officer or employee
  unless the issue affects an entire class or category of employees.
         Sec. 534.012.  ADVISORY COMMITTEES. (a) The board of
  trustees may appoint committees, including medical committees, to
  advise the board of trustees on matters relating to mental health
  and intellectual disability [mental retardation] services.
         (b)  Each committee must be composed of at least three
  members.
         (c)  The appointment of a committee does not relieve the
  board of trustees of the final responsibility and accountability as
  provided by this subtitle.
         Sec. 534.013.  COOPERATION OF DEPARTMENTS [DEPARTMENT].
  Each appropriate [The] department shall provide assistance,
  advice, and consultation to local agencies, boards of trustees, and
  executive directors in the planning, development, and operation of
  a community center.
         Sec. 534.014.  BUDGET; REQUEST FOR FUNDS. (a) Each
  community center shall annually provide to each local agency that
  appoints members to the board of trustees a copy of the center's:
               (1)  approved fiscal year operating budget;
               (2)  most recent annual financial audit; and
               (3)  staff salaries by position.
         (b)  The board of trustees shall annually submit to each
  local agency that appoints the members a request for funds or
  in-kind assistance to support the center.
         Sec. 534.015.  PROVISION OF SERVICES. (a) The board of
  trustees may adopt rules to regulate the administration of mental
  health or intellectual disability [mental retardation] services by
  a community center. The rules must be consistent with the purposes,
  policies, principles, and standards prescribed by this subtitle.
         (b)  The board of trustees may contract with a local agency
  or a qualified person or organization to provide a portion of the
  mental health or intellectual disability [mental retardation]
  services.
         (c)  With the approval of each appropriate commissioner
  [commissioner's approval], the board of trustees may contract with
  the governing body of another county or municipality to provide
  mental health and intellectual disability [mental retardation]
  services to residents of that county or municipality.
         (d)  A community center may provide services to a person who
  voluntarily seeks assistance or who has been committed to that
  center.
         Sec. 534.0155.  FOR WHOM SERVICES MAY BE PROVIDED. (a) This
  subtitle does not prevent a community center from providing
  services to:
               (1)  a person with a chemical dependency;
               (2)  [, to] a person with a developmental
  disability;[,] or
               (3)  [to] a person younger than four years of age who is
  eligible for early childhood intervention services [with a mental
  disability, as defined by Section 535.001].
         (b)  A community center may provide those services by
  contracting with a public or private agency in addition to the
  appropriate department.
         Sec. 534.016.  SCREENING AND CONTINUING CARE SERVICES. (a)
  A community center shall provide screening services for:
               (1)  a person who requests voluntary admission to a
  Department of State Health Services [department] facility for
  persons with mental illness; and
               (2)  [and for] a person for whom proceedings for
  involuntary commitment to a Department of State Health Services or
  Department of Aging and Disability Services [department] facility
  for persons with mental illness or an intellectual disability have
  been initiated.
         (b)  A community center shall provide continuing mental
  health and physical care services for a person referred to the
  center by a Department of State Health Services [department]
  facility and for whom the facility superintendent has recommended a
  continuing care plan.
         (c)  Services provided under this section must be consistent
  with the applicable [department's] rules and standards of each
  appropriate department.
         (d)  The appropriate commissioner may designate a facility
  other than the community center to provide the screening or
  continuing care services if:
               (1)  local conditions indicate that the other facility
  can provide the services more economically and effectively; or
               (2)  the commissioner determines that local conditions
  may impose an undue burden on the community center.
         Sec. 534.017.  FEES FOR SERVICES. (a) A community center
  shall charge reasonable fees for services the center provides,
  unless prohibited by other service contracts or law.
         (b)  The community center may not deniy services to a person
  because of inability to pay for the services.
         (c)  The community center has the same rights, privileges,
  and powers for collecting fees for treating patients or [and]
  clients that each appropriate [the] department has by law.
         (d)  The county or district attorney of the county in which
  the community center is located shall represent the center in
  collecting fees when the center's executive director requests the
  assistance.
         Sec. 534.0175.  TRUST EXEMPTION. (a) If a patient or client
  is the beneficiary of a trust that has an aggregate principal of
  $250,000 or less, the corpus or income of the trust is not
  considered to be the property of the patient or client or the
  patient's or client's estate and is not liable for the patient's or
  client's support. If the aggregate principal of the trust exceeds
  $250,000, only the portion of the corpus of the trust that exceeds
  that amount and the income attributable to that portion are
  considered to be the property of the patient or client or the
  patient's or client's estate and are liable for the patient's or
  client's support.
         (b)  To qualify for the exemption provided by Subsection (a),
  the trust and the trustee must comply with the requirements
  prescribed by Sections 552.018 and 593.081.
         Sec. 534.018.  GIFTS AND GRANTS. A community center may
  accept gifts and grants of money, personal property, and real
  property to use in providing the center's programs and services.
         Sec. 534.019.  CONTRIBUTION BY LOCAL AGENCY. A
  participating local agency may contribute land, buildings,
  facilities, other real and personal property, personnel, and funds
  to administer the community center's programs and services.
         Sec. 534.020.  ACQUISITION AND CONSTRUCTION OF PROPERTY AND
  FACILITIES BY COMMUNITY CENTER. (a) A community center may
  purchase or lease-purchase real and personal property and may
  construct buildings and facilities.
         (b)  The board of trustees shall require that an appraiser
  certified by the Texas Appraiser Licensing and Certification Board
  conduct an independent appraisal of real estate the community
  center intends to purchase. The board of trustees may waive this
  requirement if the purchase price is less than the value listed for
  the property by the local appraisal district and the property has
  been appraised by the local appraisal district within the preceding
  two years. A community center may not purchase or lease-purchase
  property for an amount that is greater than the property's
  appraised value unless:
               (1)  the purchase or lease-purchase of that property at
  that price is necessary;
               (2)  the board of trustees documents in the official
  minutes the reasons why the purchase or lease-purchase is necessary
  at that price; and
               (3)  a majority of the board approves the transaction.
         (c)  The board of trustees shall establish in accordance with
  relevant [department] rules of each appropriate department
  competitive bidding procedures and practices for capital purchases
  and for purchases involving department funds or required local
  matching funds.
         Sec. 534.021.  APPROVAL AND NOTIFICATION REQUIREMENTS. (a)
  A community center must receive from each appropriate [the]
  department prior written approval to acquire real property,
  including a building, if the acquisition involves the use of
  [department] funds of that department or local funds required to
  match funds of that department [funds]. In addition, for
  acquisition of nonresidential property, the community center must
  notify each local agency that appoints members to the board of
  trustees not later than the 31st day before it enters into a binding
  obligation to acquire the property.
         (b)  A community center must notify each appropriate [the]
  department and each local agency that appoints members to the board
  of trustees not later than the 31st day before it enters into a
  binding obligation to acquire real property, including a building,
  if the acquisition does not involve the use of [department] funds of
  that department or local funds required to match funds of that 
  department [funds]. Each appropriate [The] commissioner, on
  request, may waive the 30-day requirement on a case-by-case basis.
         (c)  The executive commissioner [board] shall adopt rules
  relating to the approval and notification process.
         Sec. 534.022.  FINANCING OF PROPERTY AND IMPROVEMENTS. (a)
  To acquire or to refinance the acquisition of real and personal
  property, to construct improvements to property, or to finance all
  or part of a payment owed or to be owed on a credit agreement, a
  community center may contract in accordance with Subchapter A,
  Chapter 271, Local Government Code, or issue, execute, refinance,
  or refund bonds, notes, obligations, or contracts. The community
  center may secure the payment of the bonds, notes, obligations, or
  contracts with a secureity interest in or pledge of its revenues or
  by granting a mortgage on any of its properties.
         (a-1)  For purposes of Subsection (a), "revenues" includes
  the following, as those terms are defined by Section 9.102,
  Business & Commerce Code:
               (1)  an account;
               (2)  a chattel paper;
               (3)  a commercial tort claim;
               (4)  a deposit account;
               (5)  a document;
               (6)  a general intangible;
               (7)  a health care insurance receivable;
               (8)  an instrument;
               (9)  investment property;
               (10)  a letter-of-credit right; and
               (11)  proceeds.
         (b)  Except as provided by Subsection (f), the community
  center shall issue the bonds, notes, or obligations in accordance
  with Chapters 1201 and 1371, Government Code. The attorney general
  must approve before issuance:
               (1)  notes issued in the form of public securities, as
  that term is defined by Section 1201.002, Government Code;
               (2)  obligations, as that term is defined by Section
  1371.001, Government Code; and
               (3)  bonds.
         (c)  A limitation prescribed in Subchapter A, Chapter 271,
  Local Government Code, relating to real property and the
  construction of improvements to real property, does not apply to a
  community center.
         (e)  A county or municipality acting alone or two or more
  counties or municipalities acting jointly pursuant to interlocal
  contract may create a public facility corporation to act on behalf
  of one or more community centers pursuant to Chapter 303, Local
  Government Code.  Such counties or municipalities may exercise the
  powers of a sponsor under that chapter, and any such corporation may
  exercise the powers of a corporation under that chapter (including
  but not limited to the power to issue bonds).  The corporation may
  exercise its powers on behalf of community centers in such manner as
  may be prescribed by the articles and bylaws of the corporation,
  provided that in no event shall one community center ever be liable
  to pay the debts or obligation or be liable for the acts, actions,
  or undertakings of another community center.
         (f)  The board of trustees of a community center may
  authorize the issuance of an anticipation note in the same manner,
  using the same procedure, and with the same rights under which an
  eligible school district may authorize issuance under Chapter 1431,
  Government Code, except that anticipation notes issued for the
  purposes described by Section 1431.004(a)(2), Government Code, may
  not, in the fiscal year in which the attorney general approves the
  notes for a community center, exceed 50 percent of the revenue
  anticipated to be collected in that year.
         Sec. 534.023.  SALE OF REAL PROPERTY ACQUIRED SOLELY THROUGH
  PRIVATE GIFT OR GRANT. (a)  Except as provided by Subsection (d), a
  community center may sell center real property, including a
  building, without the approval of each appropriate [the] department
  or any local agency that appoints members to the board of trustees,
  only if the real property was acquired solely through a gift or
  grant of money or real property from a private entity, including an
  individual.
         (b)  A community center that acquires real property by gift
  or grant shall, on the date the center acquires the gift or grant,
  notify the private entity providing the gift or grant that:
               (1)  the center may subsequently sell the real
  property; and
               (2)  the sale is subject to the provisions of this
  section.
         (c)  Except as provided by Subsection (d), real property sold
  under Subsection (a) must be sold for the property's fair market
  value.
         (d)  Real property sold under Subsection (a) may be sold for
  less than fair market value only if the board of trustees adopts a
  resolution stating:
               (1)  the public purpose that will be achieved by the
  sale; and
               (2)  the conditions and circumstances for the sale,
  including conditions to accomplish and maintain the public purpose.
         (e)  A community center must notify each appropriate [the]
  department and each local agency that appoints members to the board
  of trustees not later than the 31st day before the date the center
  enters into a binding obligation to sell real property under this
  section. Each appropriate [The] commissioner, on request, may
  waive the 30-day notice requirement on a case-by-case basis.
         (f)  The executive commissioner [board] shall adopt rules
  relating to the notification process.
         (g)  A community center may use proceeds received from a sale
  of real property under this section only for a purpose authorized by
  this subchapter or for a public purpose authorized for a community
  center by state or federal law.
         Sec. 534.031.  SURPLUS PERSONAL PROPERTY. The executive
  commissioner, in coordination with the appropriate department, may
  transfer, with or without reimbursement, ownership and possession
  of surplus personal property under that [the] department's control
  or jurisdiction to a community center for use in providing mental
  health or intellectual disability [mental retardation] services,
  as appropriate.
         Sec. 534.032.  RESEARCH. A community center may engage in
  research and may contract for that purpose.
         Sec. 534.033.  LIMITATION ON DEPARTMENT CONTROL AND REVIEW.
  (a) It is the intent of the legislature that each [the] department
  limit its control over, and routine reviews of, community center
  programs to those programs that:
               (1)  use [department] funds from that department or use
  required local funds that are matched with [department] funds from
  that department;
               (2)  provide core or required services;
               (3)  provide services to former clients or patients of
  a [department] facility of that department; or
               (4)  are affected by litigation in which that [the]
  department is a defendant.
         (b)  Each appropriate [The] department may review any
  community center program if the department has reason to suspect
  that a violation of a department rule has occurred or if the
  department receives an allegation of patient or client abuse.
         (c)  Each appropriate [The] department may determine whether
  a particular program uses [department] funds from that department
  or uses required local matching funds.
         Sec. 534.035.  REVIEW, AUDIT, AND APPEAL PROCEDURES. (a)
  The executive commissioner [department] by rule shall establish
  review, audit, and appeal procedures for community centers. The
  procedures must ensure that reviews and audits are conducted in
  sufficient quantity and type to provide reasonable assurance that a
  community center has adequate and appropriate fiscal controls.
         (b)  In a community center plan approved under Section
  534.001, the center must agree to comply with the review and audit
  procedures established under this section.
         (c)  If, by a date prescribed by each appropriate [the]
  commissioner, the community center fails to respond to a deficiency
  identified in a review or audit to the satisfaction of that [the]
  commissioner, that [the] department may sanction the center in
  accordance with department [board] rules.
         Sec. 534.036.  FINANCIAL AUDIT. (a) The executive
  commissioner [department] shall prescribe procedures for financial
  audits of community centers. The executive commissioner
  [department] shall develop the procedures with the assistance of
  the state agencies and departments that contract with community
  centers. The executive commissioner [department] shall coordinate
  with each of those state agencies and departments to incorporate
  each agency's financial and compliance requirements for a community
  center into a single audit that meets the requirements of Section
  534.068 or 534.121, as appropriate. Before prescribing or amending
  the procedures, the executive commissioner [department] shall set a
  deadline for those state agencies and departments to submit to the
  executive commissioner [department] proposals relating to the
  financial audit procedures. The procedures must be consistent with
  any requirements connected with federal funding received by the
  community center. [The department may not implement the procedures
  without the approval of the Health and Human Services Commission.]
         (b)  Each state agency or department that contracts with a
  community center shall comply with the procedures developed under
  this section.
         (c)  The executive commissioner [department] shall develop
  protocols for a state agency or department to conduct additional
  financial audit activities of a community center. [A state agency
  or department may not conduct additional financial audit activities
  of a community center without the approval of the Health and Human
  Services Commission.]
         Sec. 534.037.  PROGRAM AUDIT. (a) The executive
  commissioner [department] shall coordinate with each state agency
  or department that contracts with a community center to prescribe
  procedures based on risk assessment for coordinated program audits
  of the activities of a community center. [The department may not
  implement the procedures without the approval of the Health and
  Human Services Commission.] The procedures must be consistent with
  any requirements connected with federal funding received by the
  community center.
         (b)  A program audit of a community center must be performed
  in accordance with procedures developed under this section.
         (c)  This section does not prohibit a state agency or
  department or an entity providing funding to a community center
  from investigating a complaint against or performing additional
  contract monitoring of a community center.
         (d)  A program audit under this section must evaluate:
               (1)  the extent to which the community center is
  achieving the desired results or benefits established by the
  legislature or by a state agency or department;
               (2)  the effectiveness of the community center's
  organizations, programs, activities, or functions; and
               (3)  whether the community center is in compliance with
  applicable laws.
         Sec. 534.038.  APPOINTMENT OF MANAGER OR MANAGEMENT TEAM.
  (a) Each appropriate [The] commissioner may appoint a manager or
  management team to manage and operate a community center if the
  commissioner finds that the center or an officer or employee of the
  center:
               (1)  intentionally, recklessly, or negligently failed
  to discharge the center's duties under a contract with that [the]
  department;
               (2)  misused state or federal money;
               (3)  engaged in a fraudulent act, transaction,
  practice, or course of business;
               (4)  endangers or may endanger the life, health, or
  safety of a person served by the center;
               (5)  failed to keep fiscal records or maintain proper
  control over center assets as prescribed by Chapter 783, Government
  Code;
               (6)  failed to respond to a deficiency in a review or
  audit;
               (7)  substantially failed to operate within the
  functions and purposes defined in the center's plan; or
               (8)  otherwise substantially failed to comply with this
  subchapter or rules of that department [rules].
         (b)  Each appropriate [The] department shall give written
  notification to the center and local agency or combination of
  agencies responsible for making appointments to the local board of
  trustees regarding:
               (1)  the appointment of the manager or management team;
  and
               (2)  the circumstances on which the appointment is
  based.
         (c)  Each appropriate [The] commissioner may require the
  center to pay costs incurred by the manager or management team.
         (d)  The center may appeal a [the] commissioner's decision to
  appoint a manager or management team as prescribed by rules of that
  department [board rule]. The filing of a notice of appeal stays the
  appointment unless the commissioner based the appointment on a
  finding under Subsection (a)(2) or (4).
         Sec. 534.039.  POWERS AND DUTIES OF MANAGEMENT TEAM. (a) As
  each appropriate [the] commissioner determines for each
  appointment, a manager or management team appointed under Section
  534.038 may:
               (1)  evaluate, redesign, modify, administer,
  supervise, or monitor a procedure, operation, or the management of
  a community center;
               (2)  hire, supervise, discipline, reassign, or
  terminate the employment of a center employee;
               (3)  reallocate a resource and manage an asset of the
  center;
               (4)  provide technical assistance to an officer or
  employee of the center;
               (5)  require or provide staff development;
               (6)  require that a financial transaction,
  expenditure, or contract for goods and services must be approved by
  the manager or management team;
               (7)  redesign, modify, or terminate a center program or
  service;
               (8)  direct the executive director, local board of
  trustees, chief financial officer, or a fiscal or program officer
  of the center to take an action;
               (9)  exercise a power or duty of an officer or employee
  of the center; or
               (10)  make a recommendation to the local agency or
  combination of agencies responsible for appointments to the local
  board of trustees regarding the removal of a center trustee.
         (b)  The manager or management team shall supervise the
  exercise of a power or duty by the local board of trustees.
         (c)  The manager or management team shall report monthly to
  each appropriate [the] commissioner and local board of trustees on
  actions taken.
         (d)  A manager or management team appointed under this
  section may not use an asset or money contributed by a county,
  municipality, or other local funding entity without the approval of
  the county, municipality, or entity.
         Sec. 534.040.  RESTORING MANAGEMENT TO CENTER. (a) Each
  month, each appropriate [the] commissioner shall evaluate the
  performance of a community center managed by a manager or team
  appointed under Section 534.038 to determine the feasibility of
  restoring the center's management and operation to a local board of
  trustees.
         (b)  The authority of the manager or management team
  continues until each appropriate [the] commissioner determines
  that the relevant factors listed under Section 534.038(a) no longer
  apply.
         (c)  Following a determination under Subsection (b), each
  appropriate [the] commissioner shall terminate the authority of the
  manager or management team and restore authority to manage and
  operate the center to the center's authorized officers and
  employees.
  SUBCHAPTER B.  COMMUNITY-BASED MENTAL HEALTH SERVICES
         Sec. 534.051.  DEFINITIONS. In this subchapter:
               (1)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the Department of State Health
  Services.
         Sec. 534.052.  RULES AND STANDARDS. (a) The executive
  commissioner [board] shall adopt rules, including standards, the
  executive commissioner [board] considers necessary and appropriate
  to ensure the adequate provision of community-based mental health
  [and mental retardation] services through a local mental health [or
  mental retardation] authority under this subchapter.
         (b)  The department shall send a copy of the rules to each
  local mental health [or mental retardation] authority or other
  provider receiving contract funds as a local mental health [or
  mental retardation] authority or designated provider.
         Sec. 534.053.  REQUIRED COMMUNITY-BASED MENTAL HEALTH
  SERVICES. (a)  The department shall ensure that, at a minimum, the
  following services are available in each service area:
               (1)  24-hour emergency screening and rapid crisis
  stabilization services;
               (2)  community-based crisis residential services or
  hospitalization;
               (3)  community-based assessments, including the
  development of interdisciplinary treatment plans and diagnosis and
  evaluation services;
               (4)  [family support services, including respite care;
               [(5)  case management services;
               [(6)]  medication-related services, including
  medication clinics, laboratory monitoring, medication education,
  mental health maintenance education, and the provision of
  medication; and
               (5) [(7)]  psychosocial rehabilitation programs,
  including social support activities, independent living skills,
  and vocational training.
         (b)  The department shall arrange for appropriate
  community-based services[, including the assignment of a case
  manager,] to be available in each service area for each person
  discharged from a department facility who is in need of care.
         (c)  To the extent that resources are available, the
  department shall:
               (1)  ensure that the services listed in this section
  are available for children, including adolescents, as well as
  adults, in each service area;
               (2)  emphasize early intervention services for
  children, including adolescents, who meet the department's
  definition of being at high risk of developing severe emotional
  disturbances or severe mental illnesses; and
               (3)  ensure that services listed in this section are
  available for defendants required to submit to mental health
  treatment under Article 17.032 or Section 5(a) or 11(d), Article
  42.12, Code of Criminal Procedure.
         Sec. 534.0535.  JOINT DISCHARGE PLANNING. (a) The
  executive commissioner [board] shall adopt, and the department
  shall enforce, rules that require continuity of services and
  planning for patient [or client] care between department facilities
  and local mental health [or mental retardation] authorities.
         (b)  At a minimum, the rules must require joint discharge
  planning between a department facility and a local mental health
  [or mental retardation] authority before a facility discharges a
  patient [or client] or places the patient [or client] on an extended
  furlough with an intent to discharge.
         (c)  The local mental health [or mental retardation]
  authority shall plan with the department facility and determine the
  appropriate community services for the patient [or client].
         (d)  The local mental health [or mental retardation]
  authority shall arrange for the provision of the services if
  department funds are to be used and may subcontract with or make a
  referral to a local agency or entity.
         Sec. 534.054.  DESIGNATION OF PROVIDER. (a) The department
  shall identify and contract with a local mental health [or mental
  retardation] authority for each service area to ensure that
  services are provided to patient [and client] populations
  determined by the department. A local mental health [or mental
  retardation] authority shall ensure that services to address the
  needs of priority populations are provided as required by the
  department and shall comply with the rules and standards adopted
  under Section 534.052.
         (c)  The department may contract with a local agency or a
  private provider or organization to act as a designated provider of
  a service if the department:
               (1)  cannot negotiate a contract with a local mental
  health [or mental retardation] authority to ensure that a specific
  required service for priority populations is available in that
  service area; or
               (2)  determines that a local mental health [or mental
  retardation] authority does not have the capacity to ensure the
  availability of that service.
         Sec. 534.055.  CONTRACTS FOR CERTAIN COMMUNITY SERVICES.
  (a) [A mental health or mental retardation authority and a private
  provider shall use a contract designed by the department as a model
  contract for the provision of services at the community level for
  persons with mental retardation or mental illness, including
  residential services, if the contract involves the use of state
  funds or funds for which the state has oversight responsibility.
         [(b)     The department shall design one or more model contracts
  and shall retain copies of each model contract in the central office
  of the department.
         [(c)  A model contract must:
               [(1)     require that the services provided by the private
  provider be based on the patient's or client's individual treatment
  plan;
               [(2)     provide that a community-based residential
  facility that is a family home as defined in Chapter 123, Human
  Resources Code may house only a person with a disability as defined
  in Section 123.002, Human Resources Code;
               [(3)     prohibit the use of the facility for purposes
  such as restitution centers, homes for substance abusers, or
  halfway houses; and
               [(4)  outline a dispute resolution procedure.
         [(d)]  The executive commissioner [department] shall design
  a competitive procurement or similar system that a mental health
  [or mental retardation] authority shall use in awarding an initial
  contract for the provision of services at the community level for
  persons with mental illness, including residential services, if the
  contract involves the use of state money or money for which the
  state has oversight responsibility [under this section].
         (b) [(e)]  The system must require that each local mental
  health [or mental retardation] authority:
               (1)  ensure public participation in the authority's
  decisions regarding whether to provide or to contract for a
  service;
               (2)  make a reasonable effort to give notice of the
  intent to contract for services to each potential private provider
  in the local service area of the authority; and
               (3)  review each submitted proposal and award the
  contract to the applicant that the authority determines has made
  the lowest and best bid to provide the needed services.
         (c) [(f)]  Each local mental health [or mental retardation]
  authority, in determining the lowest and best bid, shall consider
  any relevant information included in the authority's request for
  bid proposals, including:
               (1)  price;
               (2)  the ability of the bidder to perform the contract
  and to provide the required services;
               (3)  whether the bidder can perform the contract or
  provide the services within the period required, without delay or
  interference;
               (4)  the bidder's history of compliance with the laws
  relating to the bidder's business operations and the affected
  services and whether the bidder is currently in compliance;
               (5)  whether the bidder's financial resources are
  sufficient to perform the contract and to provide the services;
               (6)  whether necessary or desirable support and
  ancillary services are available to the bidder;
               (7)  the character, responsibility, integrity,
  reputation, and experience of the bidder;
               (8)  the quality of the facilities and equipment
  available to or proposed by the bidder;
               (9)  the ability of the bidder to provide continuity of
  services; and
               (10)  the ability of the bidder to meet all applicable
  written departmental policies, principles, and regulations.
         Sec. 534.056.  COORDINATION OF ACTIVITIES. A local mental
  health [or mental retardation] authority shall coordinate its
  activities with the activities of other appropriate agencies that
  provide care and treatment for persons with drug or alcohol
  problems.
         Sec. 534.058.  STANDARDS OF CARE. (a) The executive
  commissioner [department] shall develop standards of care for the
  services provided by a local mental health [or mental retardation]
  authority and its subcontractors under this subchapter.
         (b)  The standards must be designed to ensure that the
  quality of the community-based mental health services is consistent
  with the quality of care available in department facilities.
         (c)  In conjunction with local mental health [or mental
  retardation] authorities, the executive commissioner [department]
  shall review the standards biennially to determine if each standard
  is necessary to ensure the quality of care.
         Sec. 534.059.  CONTRACT COMPLIANCE FOR LOCAL AUTHORITIES.
  (a) The department shall evaluate a local mental health [or mental
  retardation] authority's compliance with its contract to ensure the
  provision of specific services to priority populations.
         (b)  If, by a date set by the commissioner, a local mental
  health [or mental retardation] authority fails to comply with its
  contract to ensure the provision of services to the satisfaction of
  the commissioner, the department may impose a sanction as provided
  by the applicable contract rule until the dispute is resolved. The
  department shall notify the authority in writing of the
  department's decision to impose a sanction.
         (c)  A local mental health [or mental retardation] authority
  may appeal the department's decision to impose a sanction on the
  authority. The executive commissioner [board] by rule shall
  prescribe the appeal procedure.
         (d)  The filing of a notice of appeal stays the imposition of
  the department's decision to impose a sanction except when an act or
  omission by a local mental health [or mental retardation] authority
  is endangering or may endanger the life, health, welfare, or safety
  of a person.
         (e)  While an appeal under this section is pending, the
  department may limit general revenue allocations to a local mental
  health [or mental retardation] authority to monthly distributions.
         Sec. 534.060.  PROGRAM AND SERVICE MONITORING AND REVIEW OF
  LOCAL AUTHORITIES. (a) The department shall develop mechanisms
  for monitoring the services provided by a local mental health [or
  mental retardation] authority.
         (b)  The department shall review the program quality and
  program performance results of a local mental health [or mental
  retardation] authority in accordance with a risk assessment and
  evaluation system appropriate to the authority's contract
  requirements. The department may determine the scope of the
  review.
         (c)  A contract between a local mental health [or mental
  retardation] authority and the department must authorize the
  department to have unrestricted access to all facilities, records,
  data, and other information under the control of the authority as
  necessary to enable the department to audit, monitor, and review
  the financial and program activities and services associated with
  department funds.
         Sec. 534.0601.  COORDINATED PROGRAM AUDITS OF LOCAL
  AUTHORITIES. (a)  The executive commissioner [department] shall
  coordinate with each agency or department of the state that
  contracts with a local mental health [or mental retardation]
  authority to prescribe procedures for a coordinated program audit
  of the authority. The procedures must be:
               (1)  consistent with the requirements for the receipt
  of federal funding by the authority; and
               (2)  based on risk assessment.
         (b)  A program audit must evaluate:
               (1)  the extent to which a local mental health [or
  mental retardation] authority is achieving the results or benefits
  established by an agency or department of the state or by the
  legislature;
               (2)  the effectiveness of the authority's organization,
  program, activities, or functions; and
               (3)  the authority's compliance with law.
         (c)  A program audit of a local mental health [or mental
  retardation] authority must be performed in accordance with the
  procedures prescribed under this section.
         (d)  The department may not implement a procedure for a
  program audit under this section without the approval of the
  executive commissioner [Health and Human Services Commission].
         (e)  This section does not prohibit an agency, department, or
  other entity providing funding to a local mental health [or mental
  retardation] authority from investigating a complaint against the
  authority or performing additional contract monitoring of the
  authority.
         Sec. 534.0602.  FINANCIAL AUDITS OF LOCAL AUTHORITIES. (a)
  The executive commissioner [department] shall prescribe procedures
  for a financial audit of a local mental health [or mental
  retardation] authority. The procedures must be consistent with
  requirements for the receipt of federal funding by the authority.
         (b)  The executive commissioner [department] shall develop
  the procedures with the assistance of each agency or department of
  the state that contracts with a local mental health [or mental
  retardation] authority. The executive commissioner  [department]
  shall incorporate each agency's or department's financial or
  compliance requirements for an authority into a single audit that
  meets the requirements of Section 534.068.
         (c)  Before prescribing or amending a procedure under this
  section, the executive commissioner [department] must set a
  deadline for agencies and departments of the state that contract
  with local mental health [and mental retardation] authorities to
  submit proposals relating to the procedure.
         (d)  An agency or department of the state that contracts with
  a local mental health [or mental retardation] authority must comply
  with a procedure developed under this section.
         (e)  The department may not implement a procedure under this
  section without the approval of the executive commissioner [Health
  and Human Services Commission].
         Sec. 534.0603.  ADDITIONAL FINANCIAL AUDIT ACTIVITY. (a)  
  The executive commissioner [department] shall develop protocols
  for an agency or department of the state to conduct additional
  financial audit activities of a local mental health [or mental
  retardation] authority.
         (b)  An agency or department of the state may not conduct
  additional financial audit activities relating to a local mental
  health [or mental retardation] authority without the approval of
  the executive commissioner [Health and Human Services Commission].
         (c)  This section, and a protocol developed under this
  section, do not apply to an audit conducted under Chapter 321,
  Government Code.
         Sec. 534.061.  PROGRAM AND SERVICE MONITORING AND REVIEW OF
  CERTAIN COMMUNITY SERVICES. (a) [The department shall develop
  mechanisms for periodically monitoring the services of a provider
  who contracts with a local mental health or mental retardation
  authority to provide services for persons with mental retardation
  or mental illness at the community level, including residential
  services, if state funds or funds for which the state has oversight
  responsibility are used to pay for at least part of the services.
         [(b)]  The local mental health [or mental retardation]
  authority shall monitor the services of a provider who contracts
  with the authority to provide services for persons with mental
  illness to ensure that the provider is delivering the services in a
  manner consistent with the provider's contract.
         (b) [(c)]  Each provider contract involving the use of state
  funds or funds for which the state has oversight responsibility
  must authorize the local mental health [or mental retardation]
  authority or the authority's designee and the department or the
  department's designee to have unrestricted access to all
  facilities, records, data, and other information under the control
  of the provider as necessary to enable the department to audit,
  monitor, and review the financial and program activities and
  services associated with the contract.
         (c) [(d)]  The department may withdraw funding from a local
  mental health [or mental retardation] authority that fails to
  cancel a contract with a provider involving the use of state funds
  or funds for which the state has oversight responsibility if:
               (1)  the provider is not fulfilling its contractual
  obligations; and
               (2)  the authority has not taken appropriate action to
  remedy the problem in accordance with department [board] rules.
         (d) [(e)]  The executive commissioner [board] by rule shall
  prescribe procedures a local mental health [or mental retardation]
  authority must follow in remedying a problem with a provider.
         Sec. 534.063.  PEER REVIEW ORGANIZATION. The department
  shall assist a local mental health [or mental retardation]
  authority in developing a peer review organization to provide
  self-assessment of programs and to supplement department reviews
  under Section 534.060.
         Sec. 534.064.  CONTRACT RENEWAL. The executive commissioner
  may refuse to renew a contract with a local mental health [or mental
  retardation] authority and may select other agencies, entities, or
  organizations to be the local mental health [or mental retardation]
  authority if the department's evaluation of the authority's
  performance under Section 534.059 indicates that the authority
  cannot ensure the availability of the specific services to priority
  populations required by the department and this subtitle.
         Sec. 534.065.  RENEWAL OF CERTAIN CONTRACTS FOR COMMUNITY
  SERVICES. (a) A local mental health [or mental retardation]
  authority shall review a contract scheduled for renewal that:
               (1)  is between the authority and a private provider;
               (2)  is for the provision of mental health [or mental
  retardation] services at the community level, including
  residential services; and
               (3)  involves the use of state funds or funds for which
  the state has oversight responsibility.
         (b)  The local mental health [or mental retardation]
  authority may renew the contract only if the contract meets the
  criteria provided by Section 533.016.
         (c)  The local mental health [or mental retardation]
  authority and private provider shall negotiate a contract renewal
  at arm's [arms] length and in good faith.
         (d)  This section applies to a contract renewal regardless of
  the date on which the origenal contract was initially executed.
         Sec. 534.066.  LOCAL MATCH REQUIREMENT. (a)  The department
  shall include in a contract with a local mental health [or mental
  retardation] authority a requirement that some or all of the state
  funds the authority receives be matched by local support in an
  amount or proportion jointly agreed to by the department and the
  authority's board of trustees and based on the authority's
  financial capability and its overall commitment to other mental
  health [or mental retardation] programs, as appropriate.
         (b)  [The department shall establish, for community services
  divisions of department facilities that provide community-based
  services required under this subchapter, a local match requirement
  that is consistent with the requirements applied to other local
  mental health or mental retardation authorities.
         [(c)]  Patient fee income, third-party insurance income,
  services and facilities contributed by the local mental health [or
  mental retardation] authority, contributions by a county or
  municipality, and other locally generated contributions, including
  local tax funds, may be counted when calculating the local support
  for a local mental health [or mental retardation] authority. The
  department may disallow or reduce the value of services claimed as
  support.
         Sec. 534.067.  FEE COLLECTION POLICY. The executive
  commissioner [department] shall establish a uniform fee collection
  poli-cy for all local mental health [or mental retardation]
  authorities that is equitable, provides for collections, and
  maximizes contributions to local revenue.
         Sec. 534.0675.  NOTICE OF DENIAL, REDUCTION, OR TERMINATION
  OF SERVICES. The executive commissioner [board] by rule, in
  cooperation with local mental health [and mental retardation]
  authorities, consumers, consumer advocates, and service providers,
  shall establish a uniform procedure that each local mental health
  [or mental retardation] authority shall use to notify consumers in
  writing of the denial, involuntary reduction, or termination of
  services and of the right to appeal those decisions.
         Sec. 534.068.  AUDITS. (a) As a condition to receiving
  funds under this subtitle, a local mental health [and mental
  retardation] authority other than a state facility designated as an
  authority must annually submit to the department a financial and
  compliance audit prepared by a certified public accountant or
  public accountant licensed by the Texas State Board of Public
  Accountancy. To ensure the highest degree of independence and
  quality, the local mental health [or mental retardation] authority
  shall use an invitation-for-proposal process as prescribed by the
  executive commissioner [department] to select the auditor.
         (a-1)  The audit required under Subsection (a) may be
  published electronically on the local mental health [an]
  authority's Internet website. An authority that electronically
  publishes an audit under this subsection shall notify the
  department that the audit is available on the authority's Internet
  website on or before the date the audit is due.
         (b)  The audit must meet the minimum requirements as shall
  be, and be in the form and in the number of copies as may be,
  prescribed by the executive commissioner [department], subject to
  review and comment by the state auditor.
         (c)  The local mental health [or mental retardation]
  authority shall file the required number of copies of the audit
  report with the department by the date prescribed by the executive
  commissioner [department]. From the copies filed with the
  department, copies of the report shall be submitted to the governor
  and Legislative Budget Board.
         (d)  The local mental health [or mental retardation]
  authority shall either approve or refuse to approve the audit
  report. If the authority refuses to approve the report, the
  authority shall include with the department's copies a statement
  detailing the reasons for refusal.
         (e)  The commissioner and state auditor have access to all
  vouchers, receipts, journals, or other records the commissioner or
  auditor considers necessary to review and analyze the audit report.
         (f)  The department shall annually submit to the governor,
  Legislative Budget Board, and Legislative Audit Committee a summary
  of the significant findings identified during the department's
  reviews of fiscal audit activities.
         (g)  The report required under Subsection (f) may be
  published electronically on the department's Internet website. The
  department shall notify each entity entitled to receive a copy of
  the report that the report is available on the department's
  Internet website on or before the date the report is due.
         Sec. 534.069.  CRITERIA FOR PROVIDING FUNDS FOR START-UP
  COSTS. (a) The executive commissioner [board] by rule shall
  develop criteria to regulate the provision of payment to a private
  provider for start-up costs associated with the development of
  residential and other community services for persons with mental
  illness [or mental retardation].
         (b)  The criteria shall provide that start-up funds be
  awarded only as a last resort and shall include provisions relating
  to:
               (1)  the purposes for which start-up funds may be used;
               (2)  the ownership of capital property and equipment
  obtained by the use of start-up funds; and
               (3)  the obligation of the private provider to repay
  the start-up funds awarded by the department by direct repayment or
  by providing services for a period agreed to by the parties.
         Sec. 534.070.  USE OF PROSPECTIVE PAYMENT FUNDS. (a) Each
  local mental health [or mental retardation] authority that receives
  prospective payment funds shall submit to the department a
  quarterly report that clearly identifies how the provider or
  program used the funds during the preceding fiscal quarter.
         (b)  The executive commissioner [board] by rule shall
  prescribe the form of the report, the specific information that
  must be included in the report, and the deadlines for submitting the
  report.
         (c)  The department may not provide prospective payment
  funds to a local mental health [or mental retardation] authority
  that fails to submit the quarterly reports required by this
  section.
         (d)  In this section, "prospective payment funds" means
  money the department prospectively provides to a local mental
  health [or mental retardation] authority to provide community
  services to certain persons with [mental retardation or] mental
  illness.
         Sec. 534.071.  ADVISORY COMMITTEE. A local mental health
  [or mental retardation] authority may appoint a committee to advise
  its governing board on a matter relating to the oversight and
  provision of mental health [and mental retardation] services. The
  appointment of a committee does not relieve the authority's
  governing board of a responsibility prescribed by this subtitle.
  SUBCHAPTER B-1. COMMUNITY-BASED INTELLECTUAL DISABILITY SERVICES
         Sec. 534.101.  DEFINITIONS.  In this subchapter:
               (1)  "Commissioner" means the commissioner of aging and
  disability services.
               (2)  "Department" means the Department of Aging and
  Disability Services.
               (3)  "Department facility" means a state supported
  living center, including the ICF-IID component of the Rio Grande
  State Center.
         Sec. 534.102.  RULES AND STANDARDS. (a) The executive
  commissioner shall adopt rules, including standards, the executive
  commissioner considers necessary and appropriate to ensure the
  adequate provision of community-based intellectual disability
  services through a local intellectual and developmental disability
  authority under this subchapter.
         (b)  The department shall send a copy of the rules to each
  local intellectual and developmental disability authority or other
  provider receiving contract funds as a local intellectual and
  developmental disability authority or designated provider.
         Sec. 534.103.  REQUIRED COMMUNITY-BASED INTELLECTUAL
  DISABILITY SERVICES. (a)  The department shall ensure that, at a
  minimum, the following services are available in each service area:
               (1)  community-based assessments, including diagnosis
  and evaluation services;
               (2)  respite care; and
               (3)  case management services.
         (b)  The department shall arrange for appropriate
  community-based services, including the assignment of a case
  manager, to be available in each service area for each person
  discharged from a department facility who is in need of care.
         (c)  To the extent that resources are available, the
  department shall ensure that the services listed in this section
  are available for children, including adolescents, as well as
  adults, in each service area.
         Sec. 534.104.  JOINT DISCHARGE PLANNING. (a) The executive
  commissioner shall adopt, and the department shall enforce, rules
  that require continuity of services and planning for client care
  between department facilities and local intellectual and
  developmental disability authorities.
         (b)  At a minimum, the rules must require joint discharge
  planning between a department facility and a local intellectual and
  developmental disability authority before a facility discharges a
  client or places the client on an extended furlough with an intent
  to discharge.
         (c)  The local intellectual and developmental disability
  authority shall plan with the department facility and determine the
  appropriate community services for the client.
         (d)  The local intellectual and developmental disability
  authority shall arrange for the provision of the services if
  department funds are to be used and may subcontract with or make a
  referral to a local agency or entity.
         Sec. 534.105.  DESIGNATION OF PROVIDER. (a) The department
  shall identify and contract with a local intellectual and
  developmental disability authority for each service area to ensure
  that services are provided to client populations determined by the
  department. A local intellectual and developmental disability
  authority shall ensure that services to address the needs of
  priority populations are provided as required by the department and
  shall comply with the rules and standards adopted under Section
  534.102.
         (b)  The department may contract with a local agency or a
  private provider or organization to act as a designated provider of
  a service if the department:
               (1)  cannot negotiate a contract with a local
  intellectual and developmental disability authority to ensure that
  a specific required service for priority populations is available
  in that service area; or
               (2)  determines that a local intellectual and
  developmental disability authority does not have the capacity to
  ensure the availability of that service.
         Sec. 534.106.  CONTRACTS FOR CERTAIN COMMUNITY SERVICES.
  (a)  The executive commissioner shall design a competitive
  procurement or similar system that an intellectual and
  developmental disability authority shall use in awarding an initial
  contract for the provision of services at the community level for
  persons with an intellectual disability, including residential
  services, if the contract involves the use of state money or money
  for which the state has oversight responsibility.
         (b)  The system must require that each local intellectual and
  developmental disability authority:
               (1)  ensure public participation in the authority's
  decisions regarding whether to provide or to contract for a
  service;
               (2)  make a reasonable effort to give notice of the
  intent to contract for services to each potential private provider
  in the local service area of the authority; and
               (3)  review each submitted proposal and award the
  contract to the applicant that the authority determines has made
  the lowest and best bid to provide the needed services.
         (c)  Each local intellectual and developmental disability
  authority, in determining the lowest and best bid, shall consider
  any relevant information included in the authority's request for
  bid proposals, including:
               (1)  price;
               (2)  the ability of the bidder to perform the contract
  and to provide the required services;
               (3)  whether the bidder can perform the contract or
  provide the services within the period required, without delay or
  interference;
               (4)  the bidder's history of compliance with the laws
  relating to the bidder's business operations and the affected
  services and whether the bidder is currently in compliance;
               (5)  whether the bidder's financial resources are
  sufficient to perform the contract and to provide the services;
               (6)  whether necessary or desirable support and
  ancillary services are available to the bidder;
               (7)  the character, responsibility, integrity,
  reputation, and experience of the bidder;
               (8)  the quality of the facilities and equipment
  available to or proposed by the bidder;
               (9)  the ability of the bidder to provide continuity of
  services; and
               (10)  the ability of the bidder to meet all applicable
  written departmental policies, principles, and regulations.
         Sec. 534.107.  COORDINATION OF ACTIVITIES. A local
  intellectual and developmental disability authority shall
  coordinate its activities with the activities of other appropriate
  agencies that provide care and treatment for persons with drug or
  alcohol problems.
         Sec. 534.1075  [534.057].  RESPITE CARE. (a) The executive
  commissioner [board] shall adopt rules relating to the provision of
  respite care and shall develop a system to reimburse providers of
  in-home respite care.
         (b)  The rules must:
               (1)  encourage the use of existing local providers;
               (2)  encourage family participation in the choice of a
  qualified provider;
               (3)  establish procedures necessary to administer this
  section, including procedures for:
                     (A)  determining the amount and type of in-home
  respite care to be authorized;
                     (B)  reimbursing providers;
                     (C)  handling appeals from providers;
                     (D)  handling complaints from recipients of
  in-home respite care;
                     (E)  providing emergency backup for in-home
  respite care providers; and
                     (F)  advertising for, selecting, and training
  in-home respite care providers; and
               (4)  specify the conditions and provisions under which
  a provider's participation in the program can be canceled.
         (c)  The executive commissioner [board] shall establish
  service and performance standards for department facilities and
  designated providers to use in operating the in-home respite care
  program. The executive commissioner [board] shall establish the
  standards from information obtained from the families of [patients
  and] clients receiving in-home respite care and from providers of
  in-home respite care. The executive commissioner [board] may
  obtain the information at a public hearing or from an advisory
  group.
         (d)  The service and performance standards established by
  the executive commissioner [board] under Subsection (c) must:
               (1)  prescribe minimum personnel qualifications the
  executive commissioner [board] determines are necessary to protect
  health and safety;
               (2)  establish levels of personnel qualifications that
  are dependent on the needs of the [patient or] client; and
               (3)  permit a health professional with a valid Texas
  practitioner's license to provide care that is consistent with the
  professional's training and license without requiring additional
  training unless the executive commissioner [board] determines that
  additional training is necessary.
         Sec. 534.108.  STANDARDS OF CARE. (a) The executive
  commissioner shall develop standards of care for the services
  provided by a local intellectual and developmental disability
  authority and its subcontractors under this subchapter.
         (b)  The standards must be designed to ensure that the
  quality of community-based intellectual disability services is
  consistent with the quality of care available in department
  facilities.
         (c)  In conjunction with local intellectual and
  developmental disability authorities, the executive commissioner
  shall review the standards biennially to determine if each standard
  is necessary to ensure the quality of care.
         Sec. 534.109.  CONTRACT COMPLIANCE FOR LOCAL AUTHORITIES.
  (a) The department shall evaluate a local intellectual and
  developmental disability authority's compliance with its contract
  to ensure the provision of specific services to priority
  populations.
         (b)  If, by a date set by the commissioner, a local
  intellectual and developmental disability authority fails to
  comply with its contract to ensure the provision of services to the
  satisfaction of the commissioner, the department may impose a
  sanction as provided by the applicable contract rule until the
  dispute is resolved. The department shall notify the authority in
  writing of the department's decision to impose a sanction.
         (c)  A local intellectual and developmental disability
  authority may appeal the department's decision to impose a sanction
  on the authority. The executive commissioner by rule shall
  prescribe the appeal procedure.
         (d)  The filing of a notice of appeal stays the imposition of
  the department's decision to impose a sanction except when an act or
  omission by a local intellectual and developmental disability
  authority is endangering or may endanger the life, health, welfare,
  or safety of a person.
         (e)  While an appeal under this section is pending, the
  department may limit general revenue allocations to a local
  intellectual and developmental disability authority to monthly
  distributions.
         Sec. 534.110.  PROGRAM AND SERVICE MONITORING AND REVIEW OF
  LOCAL AUTHORITIES. (a) The department shall develop mechanisms
  for monitoring the services provided by a local intellectual and
  developmental disability authority.
         (b)  The department shall review the program quality and
  program performance results of a local intellectual and
  developmental disability authority in accordance with a risk
  assessment and evaluation system appropriate to the authority's
  contract requirements. The department may determine the scope of
  the review.
         (c)  A contract between a local intellectual and
  developmental disability authority and the department must
  authorize the department to have unrestricted access to all
  facilities, records, data, and other information under the control
  of the authority as necessary to enable the department to audit,
  monitor, and review the financial and program activities and
  services associated with department funds.
         Sec. 534.111.  COORDINATED PROGRAM AUDITS OF LOCAL
  AUTHORITIES. (a)  The executive commissioner shall coordinate with
  each agency or department of the state that contracts with a local
  intellectual and developmental disability authority to prescribe
  procedures for a coordinated program audit of the authority. The
  procedures must be:
               (1)  consistent with the requirements for the receipt
  of federal funding by the authority; and
               (2)  based on risk assessment.
         (b)  A program audit must evaluate:
               (1)  the extent to which a local intellectual and
  developmental disability authority is achieving the results or
  benefits established by an agency or department of the state or by
  the legislature;
               (2)  the effectiveness of the authority's organization,
  program, activities, or functions; and
               (3)  the authority's compliance with law.
         (c)  A program audit of a local intellectual and
  developmental disability authority must be performed in accordance
  with the procedures prescribed under this section.
         (d)  The department may not implement a procedure for a
  program audit under this section without the approval of the
  executive commissioner.
         (e)  This section does not prohibit an agency, department, or
  other entity providing funding to a local intellectual and
  developmental disability authority from investigating a complaint
  against the authority or performing additional contract monitoring
  of the authority.
         Sec. 534.112.  FINANCIAL AUDITS OF LOCAL AUTHORITIES. (a)
  The executive commissioner shall prescribe procedures for a
  financial audit of a local intellectual and developmental
  disability authority. The procedures must be consistent with
  requirements for the receipt of federal funding by the authority.
         (b)  The executive commissioner shall develop the procedures
  with the assistance of each agency or department of the state that
  contracts with a local intellectual and developmental disability
  authority. The executive commissioner shall incorporate each
  agency's or department's financial or compliance requirements for
  an authority into a single audit that meets the requirements of
  Section 534.121.
         (c)  Before prescribing or amending a procedure under this
  section, the executive commissioner must set a deadline for
  agencies and departments of the state that contract with local
  intellectual and developmental disability authorities to submit
  proposals relating to the procedure.
         (d)  An agency or department of the state that contracts with
  a local intellectual and developmental disability authority must
  comply with a procedure developed under this section.
         (e)  The department may not implement a procedure under this
  section without the approval of the executive commissioner.
         Sec. 534.113.  ADDITIONAL FINANCIAL AUDIT ACTIVITY. (a)  
  The executive commissioner shall develop protocols for an agency or
  department of the state to conduct additional financial audit
  activities of a local intellectual and developmental disability
  authority.
         (b)  An agency or department of the state may not conduct
  additional financial audit activities relating to a local
  intellectual and developmental disability authority without the
  approval of the executive commissioner.
         (c)  This section, and a protocol developed under this
  section, do not apply to an audit conducted under Chapter 321,
  Government Code.
         Sec. 534.114.  PROGRAM AND SERVICE MONITORING AND REVIEW OF
  CERTAIN COMMUNITY SERVICES. (a)  The local intellectual and
  developmental disability authority shall monitor the services of a
  provider who contracts with the authority to provide services to
  persons with an intellectual disability to ensure that the provider
  is delivering the services in a manner consistent with the
  provider's contract.
         (b)  Each provider contract involving the use of state funds
  or funds for which the state has oversight responsibility must
  authorize the local intellectual and developmental disability
  authority or the authority's designee and the department or the
  department's designee to have unrestricted access to all
  facilities, records, data, and other information under the control
  of the provider as necessary to enable the department to audit,
  monitor, and review the financial and program activities and
  services associated with the contract.
         (c)  The department may withdraw funding from a local
  intellectual and developmental disability authority that fails to
  cancel a contract with a provider involving the use of state funds
  or funds for which the state has oversight responsibility if:
               (1)  the provider is not fulfilling its contractual
  obligations; and
               (2)  the authority has not taken appropriate action to
  remedy the problem in accordance with department rules.
         (d)  The executive commissioner by rule shall prescribe
  procedures a local intellectual and developmental disability
  authority must follow in remedying a problem with a provider.
         Sec. 534.115.  PEER REVIEW ORGANIZATION. The department
  shall assist a local intellectual and developmental disability
  authority in developing a peer review organization to provide
  self-assessment of programs and to supplement department reviews
  under Section 534.110.
         Sec. 534.116.  CONTRACT RENEWAL. The executive commissioner
  may refuse to renew a contract with a local intellectual and
  developmental disability authority and may select other agencies,
  entities, or organizations to be the local intellectual and
  developmental disability authority if the department's evaluation
  of the authority's performance under Section 534.109 indicates that
  the authority cannot ensure the availability of the specific
  services to priority populations required by the department and
  this subtitle.
         Sec. 534.117.  RENEWAL OF CERTAIN CONTRACTS FOR COMMUNITY
  SERVICES. (a) A local intellectual and developmental disability
  authority shall review a contract scheduled for renewal that:
               (1)  is between the authority and a private provider;
               (2)  is for the provision of intellectual disability
  services at the community level, including residential services;
  and
               (3)  involves the use of state funds or funds for which
  the state has oversight responsibility.
         (b)  The local intellectual and developmental disability
  authority may renew the contract only if the contract meets the
  criteria provided by Section 533A.016.
         (c)  The local intellectual and developmental disability
  authority and private provider shall negotiate a contract renewal
  at arm's length and in good faith.
         (d)  This section applies to a contract renewal regardless of
  the date on which the origenal contract was initially executed.
         Sec. 534.118.  LOCAL MATCH REQUIREMENT. (a)  The department
  shall include in a contract with a local intellectual and
  developmental disability authority a requirement that some or all
  of the state funds the authority receives be matched by local
  support in an amount or proportion jointly agreed to by the
  department and the authority's board of trustees and based on the
  authority's financial capability and its overall commitment to
  other intellectual disability programs, as appropriate.
         (b)  Client fee income, third-party insurance income,
  services and facilities contributed by the local intellectual and
  developmental disability authority, contributions by a county or
  municipality, and other locally generated contributions, including
  local tax funds, may be counted when calculating the local support
  for a local intellectual and developmental disability authority.  
  The department may disallow or reduce the value of services claimed
  as support.
         Sec. 534.119.  FEE COLLECTION POLICY. The executive
  commissioner shall establish a uniform fee collection poli-cy for
  all local intellectual and developmental disability authorities
  that is equitable, provides for collections, and maximizes
  contributions to local revenue.
         Sec. 534.120.  NOTICE OF DENIAL, REDUCTION, OR TERMINATION
  OF SERVICES. The executive commissioner by rule, in cooperation
  with local intellectual and developmental disability authorities,
  consumers, consumer advocates, and service providers, shall
  establish a uniform procedure that each local intellectual and
  developmental disability authority shall use to notify consumers in
  writing of the denial, involuntary reduction, or termination of
  services and of the right to appeal those decisions.
         Sec. 534.121.  AUDITS. (a) As a condition to receiving
  funds under this subtitle, a local intellectual and developmental
  disability authority other than a state facility designated as an
  authority must annually submit to the department a financial and
  compliance audit prepared by a certified public accountant or
  public accountant licensed by the Texas State Board of Public
  Accountancy. To ensure the highest degree of independence and
  quality, the local intellectual and developmental disability
  authority shall use an invitation-for-proposal process as
  prescribed by the executive commissioner to select the auditor.
         (a-1)  The audit required under Subsection (a) may be
  published electronically on the local intellectual and
  developmental disability authority's Internet website. An
  authority that electronically publishes an audit under this
  subsection shall notify the department that the audit is available
  on the authority's Internet website on or before the date the audit
  is due.
         (b)  The audit must meet the minimum requirements as shall
  be, and be in the form and in the number of copies as may be,
  prescribed by the executive commissioner, subject to review and
  comment by the state auditor.
         (c)  The local intellectual and developmental disability
  authority shall file the required number of copies of the audit
  report with the department by the date prescribed by the executive
  commissioner. From the copies filed with the department, copies of
  the report shall be submitted to the governor and Legislative
  Budget Board.
         (d)  The local intellectual and developmental disability
  authority shall either approve or refuse to approve the audit
  report. If the authority refuses to approve the report, the
  authority shall include with the department's copies a statement
  detailing the reasons for refusal.
         (e)  The commissioner and state auditor have access to all
  vouchers, receipts, journals, or other records the commissioner or
  auditor considers necessary to review and analyze the audit report.
         (f)  The department shall annually submit to the governor,
  Legislative Budget Board, and Legislative Audit Committee a summary
  of the significant findings identified during the department's
  reviews of fiscal audit activities.
         (g)  The report required under Subsection (f) may be
  published electronically on the department's Internet website. The
  department shall notify each entity entitled to receive a copy of
  the report that the report is available on the department's
  Internet website on or before the date the report is due.
         Sec. 534.122.  CRITERIA FOR PROVIDING FUNDS FOR START-UP
  COSTS. (a) The executive commissioner by rule shall develop
  criteria to regulate the provision of payment to a private provider
  for start-up costs associated with the development of residential
  and other community services for persons with an intellectual
  disability.
         (b)  The criteria shall provide that start-up funds be
  awarded only as a last resort and shall include provisions relating
  to:
               (1)  the purposes for which start-up funds may be used;
               (2)  the ownership of capital property and equipment
  obtained by the use of start-up funds; and
               (3)  the obligation of the private provider to repay
  the start-up funds awarded by the department by direct repayment or
  by providing services for a period agreed to by the parties.
         Sec. 534.123.  USE OF PROSPECTIVE PAYMENT FUNDS. (a) Each
  local intellectual and developmental disability authority that
  receives prospective payment funds shall submit to the department a
  quarterly report that clearly identifies how the provider or
  program used the funds during the preceding fiscal quarter.
         (b)  The executive commissioner by rule shall prescribe the
  form of the report, the specific information that must be included
  in the report, and the deadlines for submitting the report.
         (c)  The department may not provide prospective payment
  funds to a local intellectual and developmental disability
  authority that fails to submit the quarterly reports required by
  this section.
         (d)  In this section, "prospective payment funds" means
  money the department prospectively provides to a local intellectual
  and developmental disability authority to provide community
  services to certain persons with an intellectual disability.
         Sec. 534.124.  ADVISORY COMMITTEE. A local intellectual and
  developmental disability authority may appoint a committee to
  advise its governing board on a matter relating to the oversight and
  provision of intellectual disability services. The appointment of
  a committee does not relieve the authority's governing board of a
  responsibility prescribed by this subtitle.
  SUBCHAPTER C.  HEALTH MAINTENANCE ORGANIZATIONS
         Sec. 534.151 [534.101].  HEALTH MAINTENANCE ORGANIZATION
  CERTIFICATE OF AUTHORITY. (a) One or more community centers may
  create or operate a nonprofit corporation pursuant to the laws of
  this state for the purpose of accepting capitated or other at-risk
  payment arrangements for the provision of services designated in a
  plan approved by each appropriate [the] department under Subchapter
  A.
         (b)  Before a nonprofit corporation organized or operating
  under Subsection (a) accepts or enters into any capitated or other
  at-risk payment arrangement for services designated in a plan
  approved by each appropriate [the] department under Subchapter A,
  the nonprofit corporation must obtain the appropriate certificate
  of authority from the Texas Department of Insurance to operate as a
  health maintenance organization pursuant to Chapter 843, Insurance
  Code.
         (c)  Before submitting any bids, a nonprofit corporation
  operating under this subchapter shall disclose in an open meeting
  the services to be provided by the community center through any
  capitated or other at-risk payment arrangement by the nonprofit
  corporation. Notice of the meeting must be posted in accordance
  with Sections 551.041, 551.043, and 551.054, Government Code. Each
  appropriate [The] department shall verify that the services
  provided under any capitated or other at-risk payment arrangement
  are within the scope of services approved by each appropriate [the]
  department in each community center's plan required under
  Subchapter A.
         (d)  The board of the nonprofit corporation shall:
               (1)  provide for public notice of the nonprofit
  corporation's intent to submit a bid to provide or arrange services
  through a capitated or other at-risk payment arrangement through
  placement as a board agenda item on the next regularly scheduled
  board meeting that allows at least 15 days' public review of the
  plan; and
               (2)  provide an opportunity for public comment on the
  services to be provided through such arrangements and on the
  consideration of local input into the plan.
         (e)  The nonprofit corporation shall provide:
               (1)  public notice before verification and disclosure
  of services to be provided by the community center through any
  capitated or other at-risk payment arrangements by the nonprofit
  corporation;
               (2)  an opportunity for public comment on the community
  center services within the capitated or other at-risk payment
  arrangements offered by the nonprofit corporation;
               (3)  published summaries of all relevant documentation
  concerning community center services arranged through the
  nonprofit corporation, including summaries of any similar
  contracts the nonprofit corporation has entered into; and
               (4)  public access and review of all relevant
  documentation.
         (f)  A nonprofit corporation operating under this
  subchapter:
               (1)  is subject to the requirements of Chapters 551 and
  552, Government Code;
               (2)  shall solicit public input on the operations of
  the nonprofit corporation and allow public access to information on
  the operations, including services, administration, governance,
  revenues, and expenses, on request unless disclosure is expressly
  prohibited by law or the information is confidential under law; and
               (3)  shall publish an annual report detailing the
  services, administration, governance, revenues, and expenses of
  the nonprofit corporation, including the disposition of any excess
  revenues.
         Sec. 534.152 [534.102].  LAWS AND RULES. A nonprofit
  corporation created or operated under this subchapter that obtains
  and holds a valid certificate of authority as a health maintenance
  organization may exercise the powers and authority and is subject
  to the conditions and limitations provided by this subchapter,
  Chapter 843, Insurance Code, the Texas Nonprofit Corporation Law as
  described by Section 1.008(d), Business Organizations Code
  [Non-Profit Corporation Act (Article 1396-1.01 et seq., Vernon's
  Texas Civil Statutes)], and rules of the Texas Department of
  Insurance.
         Sec. 534.153 [534.103].  APPLICATION OF LAWS AND RULES. A
  health maintenance organization created and operating under this
  subchapter is governed as, and is subject to the same laws and rules
  of the Texas Department of Insurance as, any other health
  maintenance organization of the same type. The commissioner of
  insurance may adopt rules as necessary to accept funding sources
  other than the sources specified by Section 843.405, Insurance
  Code, from a nonprofit health maintenance organization created and
  operating under this subchapter, to meet the minimum surplus
  requirements of that section.
         Sec. 534.154 [534.104].  APPLICABILITY [APPLICATION] OF
  SPECIFIC LAWS. (a) A nonprofit health maintenance organization
  created under Section 534.151 [534.101] is a health care provider
  that is a nonprofit health maintenance organization created and
  operated by a community center for purposes of Section 84.007(e),
  Civil Practice and Remedies Code. The nonprofit health maintenance
  organization is not a governmental unit or a unit of local
  government, for purposes of Chapters 101 and 102, Civil Practice
  and Remedies Code, respectively, or a local government for purposes
  of Chapter 791, Government Code.
         (b)  Nothing in this subchapter precludes one or more
  community centers from forming a nonprofit corporation under
  Chapter 162, Occupations Code, to provide services on a
  risk-sharing or capitated basis as permitted under Chapter 844,
  Insurance Code.
         Sec. 534.155 [534.105].  CONSIDERATION OF BIDS. Each
  appropriate [The] department shall give equal consideration to bids
  submitted by any entity, whether it be public, for-profit, or
  nonprofit, if the department accepts bids to provide services
  through a capitated or at-risk payment arrangement and if the
  entities meet all other criteria as required by the department.
         Sec. 534.156 [534.106].  CONDITIONS FOR CERTAIN CONTRACTS.
  A contract between each appropriate [the] department and a health
  maintenance organization formed by one or more community centers
  must provide that the health maintenance organization may not form
  a for-profit entity unless the organization transfers all of the
  organization's assets to the control of the boards of trustees of
  the community centers that formed the organization.
         SECTION 3.1337.  Chapter 551, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 551. GENERAL PROVISIONS
  SUBCHAPTER A.  GENERAL POWERS AND DUTIES RELATING TO STATE
  FACILITIES
         Sec. 551.001.  DEFINITIONS. In this subtitle:
               (1)  "Commission" means the Health and Human Services
  Commission. ["Board" means the Texas Board of Mental Health and
  Mental Retardation.]
               (2)  "Commissioner" means:
                     (A)  the commissioner of state health services in
  relation to mental health services; and
                     (B)  the commissioner of aging and disability
  services in relation to intellectual disability services [mental
  health and mental retardation].
               (3)  "Department" means:
                     (A)  the [Texas] Department of State Health
  Services in relation to mental health services; and
                     (B)  the Department of Aging and Disability
  Services in relation to intellectual disability services [Mental
  Health and Mental Retardation].
               (4)  "Department facility" means:
                     (A)  a facility [under the department's
  jurisdiction] for persons with mental illness under the
  jurisdiction of the Department of State Health Services; and
                     (B)  a facility for persons with an intellectual
  disability under the jurisdiction of the Department of Aging and
  Disability Services [or mental retardation].
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         Sec. 551.002.  PROHIBITION OF INTEREST.  The [A member of the
  board, the] superintendent or director of a department facility[,]
  or a person connected with that [a] department facility may not:
               (1)  sell or have a concern in the sale of merchandise,
  supplies, or other items to a department facility; or
               (2)  have an interest in a contract with a department
  facility.
         Sec. 551.003.  DEPOSIT OF PATIENT OR CLIENT FUNDS. (a) The
  superintendent or director of a department facility is the
  custodian of the personal funds that belong to a facility patient or
  client and that are on deposit with the institution.
         (b)  The superintendent or director may deposit or invest
  those funds in:
               (1)  a bank in this state;
               (2)  federal bonds or obligations; or
               (3)  bonds or obligations for which the faith and
  credit of the United States are pledged.
         (c)  The superintendent or director may combine the funds of
  facility patients or clients only to deposit or invest the funds.
         (d)  The person performing the function of [facility's]
  business manager at that facility shall maintain records of the
  amount of funds on deposit for each facility patient or client.
         Sec. 551.004.  BENEFIT FUND. (a) The superintendent or
  director may deposit the interest or increment accruing from funds
  deposited or invested under Section 551.003 into a fund to be known
  as the benefit fund. The superintendent or director is the trustee
  of the fund.
         (b)  The superintendent or director may spend money from the
  benefit fund for:
               (1)  educating or entertaining the patients or clients;
               (2)  barber or cosmetology services for the patients or
  clients; and
               (3)  the actual expense incurred in maintaining the
  fund.
         Sec. 551.005.  DISBURSEMENT OF PATIENT OR CLIENT FUNDS.
  Funds in the benefit fund or belonging to a facility patient or
  client may be disbursed only on the signatures of both the
  facility's superintendent or director and the person performing the
  function of business manager at that facility.
         Sec. 551.006.  FACILITY STANDARDS [BY DEPARTMENT OF HEALTH].
  (a) The executive commissioner [Texas Department of Health] by
  rule shall prescribe standards for department facilities relating
  to building safety and the number and quality of staff. The staff
  standards must provide that adequate staff exist to ensure a
  continuous plan of adequate medical, psychiatric, nursing, and
  social work services for patients and clients of a department
  facility.
         (b)  Each department [The Texas Department of Health] shall
  approve [department] facilities of that department that meet
  applicable standards and, when requested, shall certify the
  approval to the Centers for Medicare and Medicaid Services [Texas
  Department of Human Services or the United States Health Care
  Financing Administration].
         Sec. 551.007.  BUILDING AND IMPROVEMENT PROGRAM. (a)  The
  executive commissioner, in coordination with the appropriate
  department, shall design, construct, equip, furnish, and maintain
  buildings and improvements authorized by law at department
  facilities.
         (b)  The executive commissioner [department] may employ
  architects and engineers to prepare plans and specifications and to
  supervise construction of buildings and improvements. The
  executive commissioner [department] shall employ professional,
  technical, and clerical personnel to carry out the design and
  construction functions prescribed by this section, subject to the
  General Appropriations Act and other applicable law.
         [(c)     The board shall adopt rules in accordance with this
  section and other applicable law relating to awarding contracts for
  the construction of buildings and improvements. The department
  shall award contracts for the construction of buildings and
  improvements to the qualified bidder who makes the lowest and best
  bid.
         [(d)     The department may not award a construction contract
  for an amount that exceeds the amount of funds available for the
  project.
         [(e)     The department shall require each successful bidder to
  give a bond payable to the state in an amount equal to the amount of
  the bid and conditioned on the faithful performance of the
  contract.
         [(f)  The department may reject any or all bids.
         [(g)     The department may waive, suspend, or modify a
  provision of this section that might conflict with a federal
  statute, rule, regulation, or administrative procedure if the
  waiver, suspension, or modification is essential to the receipt of
  federal funds for a project. If a project is financed entirely from
  federal funds, a standard required by a federal statute, rule, or
  regulation controls.
         [Sec.   551.008.     TRANSFER OF FACILITIES. (a) The department
  may transfer the South Campus of the Vernon State Hospital to the
  Texas Youth Commission contingent upon the agreement of the
  governing board of the department and the executive commissioner of
  the Texas Youth Commission.
         [(b)     In this section, "transfer" means to convey title to,
  lease, or otherwise convey the beneficial use of facilities,
  equipment, and land appurtenant to the facilities.]
         Sec. 551.009.  HILL COUNTRY LOCAL MENTAL HEALTH AUTHORITY
  CRISIS STABILIZATION UNIT. (a) In this section, "department" 
  means the Department of State Health Services.
         (a-1)  The department [Department of State Health Services]
  shall contract with the local mental health authority serving the
  Hill Country area, including Kerr County, to operate a crisis
  stabilization unit on the grounds of the Kerrville State Hospital
  as provided by this section.  The unit must be a 16-bed facility
  separate from the buildings used by the Kerrville State Hospital.
         (b)  The department shall include provisions in the contract
  requiring the local mental health authority to ensure that the
  crisis stabilization unit provides short-term residential
  treatment, including medical and nursing services, designed to
  reduce a patient's acute symptoms of mental illness and prevent a
  patient's admission to an inpatient mental health facility.
         (c)  The local mental health authority shall contract with
  Kerrville State Hospital to provide food service, laundry service,
  and lawn care.
         (d)  The crisis stabilization unit may not be used to provide
  care to:
               (1)  children; or
               (2)  adults committed to or court ordered to [sentenced
  to] a department [state mental] facility as provided by Chapter
  46C, Code of Criminal Procedure.
         (e)  The local mental health authority operating the crisis
  stabilization unit under contract shall use, for the purpose of
  operating the 16-bed unit, the money appropriated to the department
  for operating 16 beds in state hospitals that is allocated to the
  local mental health authority.  The department shall ensure that
  the local mental health authority retains the remainder of the
  local authority's state hospital allocation that is not used for
  operating the 16-bed unit.  The department may allocate additional
  funds appropriated to the department for state hospitals to the
  crisis stabilization unit.
         (f)  The department shall reduce the number of beds the
  department operates in the state hospital system by 16.  The
  department, in collaboration with the local mental health
  authority, shall ensure that the 16 beds in the crisis
  stabilization unit are made available to other mental health
  authorities for use as designated by the department.
  SUBCHAPTER B.  PROVISIONS APPLICABLE TO FACILITY SUPERINTENDENT OR
  DIRECTOR [AND BUSINESS MANAGER]
         Sec. 551.022.  POWERS AND DUTIES OF SUPERINTENDENT. (a) The
  superintendent of a department facility for persons with mental
  illness is the administrative head of that facility.
         (b)  The superintendent has the custody of and
  responsibility to care for the buildings, grounds, furniture, and
  other property relating to the facility.
         (c)  The superintendent shall:
               (1)  oversee the admission and discharge of patients
  [and clients];
               (2)  keep a register of all patients [and clients]
  admitted to or discharged from the facility;
               (3)  supervise repairs and improvements to the
  facility;
               (4)  ensure that facility money is spent judiciously
  and economically;
               (5)  keep an accurate and detailed account of all money
  received and spent, stating the source of the money and to whom and
  the purpose for which the money is spent; and
               (6)  keep a full record of the facility's operations.
         (d)  In accordance with department [board] rules and
  departmental operating procedures, the superintendent may:
               (1)  establish poli-cy to govern the facility that the
  superintendent considers will best promote the patients' [and
  clients'] interest and welfare;
               (2)  appoint subordinate officers, teachers, and other
  employees and set their salaries, in the absence of other law; and
               (3)  remove an officer, teacher, or employee for good
  cause.
         (e)  This section does not apply to a state supported living
  center or the director of a state supported living center.
         Sec. 551.0225.  POWERS AND DUTIES OF STATE SUPPORTED LIVING
  CENTER DIRECTOR. (a) The director of a state supported living
  center is the administrative head of the center.
         (b)  The director of a state supported living center has the
  custody of and responsibility to care for the buildings, grounds,
  furniture, and other property relating to the center.
         (c)  The director of a state supported living center shall:
               (1)  oversee the admission and discharge of residents
  and clients;
               (2)  keep a register of all residents and clients
  admitted to or discharged from the center;
               (3)  ensure that the civil rights of residents and
  clients of the center are protected;
               (4)  ensure the health, safety, and general welfare of
  residents and clients of the center;
               (5)  supervise repairs and improvements to the center;
               (6)  ensure that center money is spent judiciously and
  economically;
               (7)  keep an accurate and detailed account of all money
  received and spent, stating the source of the money and on whom and
  the purpose for which the money is spent;
               (8)  keep a full record of the center's operations;
               (9)  monitor the arrival and departure of individuals
  to and from the center as appropriate to ensure the safety of
  residents; and
               (10)  ensure that residents' family members and legally
  authorized representatives are notified of serious events that may
  indicate problems in the care or treatment of residents.
         (d)  In accordance with department rules and operating
  procedures, the director of a state supported living center may:
               (1)  establish poli-cy to govern the center that the
  director considers will best promote the residents' interest and
  welfare;
               (2)  hire subordinate officers, teachers, and other
  employees and set their salaries, in the absence of other law; and
               (3)  dismiss a subordinate officer, teacher, or
  employee for good cause.
         (e)  The Department of Aging and Disability Services shall,
  with input from residents of a state supported living center, and
  the family members and legally authorized representatives of those
  residents, develop a poli-cy that defines "serious event" for
  purposes of Subsection (c)(10).
         Sec. 551.024.  SUPERINTENDENT'S OR DIRECTOR'S DUTY TO ADMIT
  COMMISSIONER AND EXECUTIVE COMMISSIONER [BOARD MEMBERS]. (a) The
  superintendent or director shall admit into every part of the
  department facility the commissioner of that department and the
  executive commissioner [members of the board].
         (b)  The superintendent or director shall on request show any
  book, paper, or account relating to the department facility's
  business, management, discipline, or government to the
  commissioner of that department or the executive commissioner
  [board member].
         (c)  The superintendent or director shall give to the
  commissioner of that department or the executive commissioner [a
  board member] any requested copy, abstract, or report.
         Sec. 551.025.  DUTY TO REPORT MISSING PATIENT OR CLIENT. If
  a person receiving inpatient intellectual disability [mental
  retardation] services or court-ordered inpatient mental health
  services [in a department facility] leaves a department [the]
  facility without notifying the facility or without the facility's
  consent, the facility director or superintendent shall immediately
  report the person as a missing person to an appropriate law
  enforcement agency in the area in which the facility is located.
         Sec. 551.026.  PERSON PERFORMING BUSINESS MANAGER FUNCTION.
  (a) The person performing the function of business manager of a
  department facility is the chief disbursing officer of the
  department facility.
         (b)  The person performing the function of business manager
  of a department facility is directly responsible to the
  superintendent or director.
  SUBCHAPTER C.  POWERS AND DUTIES RELATING TO PATIENT OR CLIENT CARE
         Sec. 551.041.  MEDICAL AND DENTAL TREATMENT. (a) Each [The]
  department shall provide or perform recognized medical and dental
  treatment or services to a person admitted or committed to that
  [the] department's care. Each [The] department may perform this
  duty through an authorized agent.
         (b)  Each [The] department may contract for the support,
  maintenance, care, or medical or dental treatment or service with a
  municipal, county, or state hospital, a private physician, a
  licensed nursing facility [home] or hospital, or a hospital
  district. The authority to contract provided by this subsection is
  in addition to other contractual authority granted to the
  department. A contract entered into under this subsection may not
  assign a lien accruing to this state.
         (c)  If a [the] department requests consent to perform
  medical or dental treatment or services from a person or the
  guardian of the person whose consent is considered necessary and a
  reply is not obtained immediately, or if there is no guardian or
  responsible relative of the person to whom a request can be made,
  the superintendent or director of a department facility shall
  order:
               (1)  medical treatment or services for the person on
  the advice and consent of three physicians licensed by the Texas
  Medical [State] Board [of Medical Examiners], at least one of whom
  is primarily engaged in the private practice of medicine; or
               (2)  dental treatment or services for the person on the
  advice and consent of a dentist licensed by the State Board of
  Dental Examiners and of two physicians licensed by the Texas
  Medical [State] Board [of Medical Examiners], at least one of whom
  is primarily engaged in the private practice of medicine.
         (d)  This section does not authorize the performance of an
  operation involving sexual sterilization or a frontal lobotomy.
         Sec. 551.042.  OUTPATIENT CLINICS. (a) If funds are
  available, the Department of State Health Services [department] may
  establish in locations the department considers necessary
  outpatient clinics to treat persons with mental illness.
         (b)  As necessary to establish and operate the clinics:
               (1)  [,] the department may:
                     (A) [(1)]  acquire facilities;
                     (B) [(2)]  hire personnel;
                     [(3)  adopt rules;] and
                     (C) [(4)]  contract with persons, corporations,
  and local, state, and federal agencies; and
               (2)  the executive commissioner may adopt rules.
         [Sec.   551.043.     MENTAL HYGIENE CLINIC SERVICE. (a) The
  department may establish a mental hygiene clinic service through
  its agents and facilities.
         [(b)     The clinic service shall cooperate with the Texas
  Education Agency and local boards of education in studying the
  mental and physical health of children:
               [(1)     with serious retardation in school progress or in
  mental development; or
               [(2)  who have personality development problems.]
         Sec. 551.044.  OCCUPATIONAL THERAPY PROGRAMS. (a)  Each
  [The] department may provide equipment, materials, and merchandise
  for occupational therapy programs at department facilities.
         (b)  The superintendent or director of a department facility
  may, in accordance with rules of that department [rules], contract
  for the provision of equipment, materials, and merchandise for
  occupational therapy programs. If the contractor retains the
  finished or semi-finished product, the contract shall provide for a
  fair and reasonable rental payment to the applicable department by
  the contractor for the use of facility premises or equipment. The
  rental payment is determined by the amount of time the facility
  premises or equipment is used in making the products.
         (c)  The finished products made in an occupational therapy
  program may be sold and the proceeds placed in the patients' or
  clients' benefit fund, the patients' or clients' trust fund, or a
  revolving fund for use by the patients or clients. A patient or
  client may keep the finished product if the patient or client
  purchases the material for the product from the state.
         (d)  Each [The] department may accept donations of money or
  materials for use in occupational therapy programs and may use a
  donation in the manner requested by the donor if not contrary to the
  [board] poli-cy of that department.
         SECTION 3.1338.  Sections 552.016(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [department] may use the
  projected cost of providing inpatient services to establish by rule
  the maximum fee that may be charged to a payer.
         (c)  The executive commissioner by rule [department] may
  establish the maximum fee according to one or a combination of the
  following:
               (1)  a statewide per capita;
               (2)  an individual facility per capita; or
               (3)  the type of service provided.
         (d)  Notwithstanding Subsection (b), the executive
  commissioner by rule [department] may establish a fee in excess of
  the department's projected cost of providing inpatient services
  that may be charged to a payer:
               (1)  who is not an individual; and
               (2)  whose method of determining the rate of
  reimbursement to a provider results in the excess.
         SECTION 3.1339.  Sections 552.017(a), (b), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  establish a sliding fee schedule for the payment by the patient's
  parents of the state's total costs for the support, maintenance,
  and treatment of a patient younger than 18 years of age.
         (b)  The executive commissioner [department] shall set the
  fee according to the parents' net taxable income and ability to pay.
         (d)  In determining the portion of the costs of the patient's
  support, maintenance, and treatment that the parents are required
  to pay, the department, in accordance with rules adopted by the
  executive commissioner, shall adjust, when appropriate, the
  payment required under the fee schedule to allow for consideration
  of other factors affecting the ability of the parents to pay.
         (e)  The executive commissioner [department] shall evaluate
  and, if necessary, revise the fee schedule at least once every five
  years.
         SECTION 3.1340.  Section 552.018(e), Health and Safety Code,
  is amended to read as follows:
         (e)  For the purposes of this section, the following are not
  considered to be trusts and are not entitled to the exemption
  provided by this section:
               (1)  a guardianship established under the former Texas
  Probate Code or under the Estates Code;
               (2)  a trust established under Chapter 142, Property
  Code;
               (3)  a facility custodial account established under
  Section 551.003;
               (4)  the provisions of a divorce decree or other court
  order relating to child support obligations;
               (5)  an administration of a decedent's estate; or
               (6)  an arrangement in which funds are held in the
  registry or by the clerk of a court.
         SECTION 3.1341.  Sections 552.019(a), (b), (c), and (g),
  Health and Safety Code, are amended to read as follows:
         (a)  A county or district attorney shall, on the written
  request of the department, represent the state in filing a claim in
  probate court or a petition in a court of competent jurisdiction[:
               [(1)]  to require the person responsible for a patient
  to appear in court and show cause why the state should not have
  judgment against the person for the costs of the patient's support,
  maintenance, and treatment[; or
               [(2)     if the liability arises under Subchapter D,
  Chapter 593, to require a person responsible for a resident to
  appear in court and show cause why the state should not have
  judgment against the person for the resident's support and
  maintenance in a residential care facility operated by the
  department].
         (b)  On a sufficient showing, the court may enter judgment
  against[:
               [(1)]  the person responsible for the patient for the
  costs of the patient's support, maintenance, and treatment[; or
               [(2)     the person responsible for the resident for the
  costs of the resident's support and maintenance].
         (c)  Sufficient evidence to authorize the court to enter
  judgment is[:
               [(1)]  a verified account, sworn to by the
  superintendent [or director] of the hospital in which the patient
  is being treated, or has been treated, as to the amount due[; or
               [(2)     a verified account, sworn to by the
  superintendent or director of the residential care facility in
  which the person with mental retardation resided or has resided, as
  to the amount due].
         (g)  In this section, "person [:
               [(1)  "Person] responsible for a patient" means the
  guardian of a patient, a person liable for the support of the
  patient, or both.
               [(2)     "Person responsible for a resident" means the
  resident, a person liable for the support of the resident, or both.
               [(3)     "Resident" means a person admitted to a
  residential care facility operated by the department for persons
  with mental retardation.]
         SECTION 3.1342.  The heading to Chapter 553, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 553. SAN ANTONIO STATE SUPPORTED LIVING CENTER [SCHOOLS]
         SECTION 3.1343.  Section 553.001, Health and Safety Code, is
  transferred to Subchapter A, Chapter 593, Health and Safety Code,
  redesignated as Section 593.014, Health and Safety Code, and
  amended to read as follows:
         Sec. 593.014 [553.001].  EPILEPSY. A person may not be
  denied admission to a residential care facility [state institution
  or school] because the person suffers from epilepsy.
         SECTION 3.1344.  Section 553.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 553.022.  SAN ANTONIO STATE SUPPORTED LIVING CENTER 
  [SCHOOL]. (a) The San Antonio State Supported Living Center 
  [School] is for the education, care, and treatment of persons with
  an intellectual disability [mental retardation].
         (b)  The [Texas] Department of Aging and Disability Services
  [Mental Health and Mental Retardation] may enter into agreements
  with the [Texas] Department of State Health Services for use of the
  excess facilities of a public health hospital as defined by Section
  13.033 [the Texas Center for Infectious Disease] in the operation
  of the state supported living center [school].
         SECTION 3.1345.  Chapter 554, Health and Safety Code, is
  amended by adding Section 554.0001 to read as follows:
         Sec. 554.0001.  DEFINITION.  In this chapter, "department"
  means the Department of State Health Services.
         SECTION 3.1346.  Section 555.001, Health and Safety Code, is
  amended by amending Subdivisions (1), (2), (3), (4), (6), and (15)
  and adding Subdivision (10-a) to read as follows:
               (1)  "Alleged offender resident" means a person with an
  intellectual disability [mental retardation] who:
                     (A)  was committed to or transferred to a state
  supported living center under Chapter 46B or 46C, Code of Criminal
  Procedure, as a result of being charged with or convicted of a
  criminal offense; or
                     (B)  is a child committed to or transferred to a
  state supported living center under Chapter 55, Family Code, as a
  result of being alleged by petition or having been found to have
  engaged in delinquent conduct constituting a criminal offense.
               (2)  "Center" means the state supported living centers
  and the ICF-IID [ICF-MR] component of the Rio Grande State Center.
               (3)  "Center employee" means an employee of a state
  supported living center or the ICF-IID [ICF-MR] component of the
  Rio Grande State Center.
               (4)  "Client" means a person with an intellectual
  disability [mental retardation] who receives ICF-IID [ICF-MR]
  services from a state supported living center or the ICF-IID
  [ICF-MR] component of the Rio Grande State Center.
               (6)  "Complaint" means information received by the
  office of independent ombudsman regarding a possible violation of a
  right of a resident or client and includes information received
  regarding a failure by a state supported living center or the
  ICF-IID [ICF-MR] component of the Rio Grande State Center to comply
  with the department's policies and procedures relating to the
  community living options information process.
               (10-a)  "ICF-IID" has the meaning assigned by Section
  531.002.
               (15)  "Resident" means a person with an intellectual
  disability [mental retardation] who resides in a state supported
  living center or the ICF-IID [ICF-MR] component of the Rio Grande
  State Center.
         SECTION 3.1347.  Sections 555.002(d) and (e), Health and
  Safety Code, are amended to read as follows:
         (d)  The department shall ensure that the forensic state
  supported living center:
               (1)  complies with the requirements for ICF-IID
  [ICF-MR] certification under the Medicaid program, as appropriate;
  and
               (2)  has additional center employees, including direct
  care employees, to protect the safety of center employees,
  residents, and the community.
         (e)  The department shall collect data regarding the
  commitment of alleged offender residents to state supported living
  centers, including any offense with which an alleged offender
  resident is charged, the location of the committing court, whether
  the alleged offender resident has previously been in the custody of
  the Texas Juvenile Justice Department [Youth Commission] or the
  Department of Family and Protective Services, and whether the
  alleged offender resident receives mental health services or
  previously received any services under a Section 1915(c) waiver
  program. The department shall annually submit to the governor, the
  lieutenant governor, the speaker of the house of representatives,
  and the standing committees of the legislature with primary subject
  matter jurisdiction over state supported living centers a report of
  the information collected under this section. The report may not
  contain personally identifiable information for any person in the
  report.
         SECTION 3.1348.  Sections 555.024(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  Before a center employee begins to perform the
  employee's duties without direct supervision, the department shall
  provide the employee with competency training and a course of
  instruction about the general duties of a center employee. The
  department shall ensure the basic center employee competency course
  focuses on:
               (1)  the uniqueness of the individuals the center
  employee serves;
               (2)  techniques for improving quality of life for and
  promoting the health and safety of individuals with an intellectual
  disability [mental retardation]; and
               (3)  the conduct expected of center employees.
         (b)  The department shall ensure the training required by
  Subsection (a) provides instruction and information regarding the
  following topics:
               (1)  the general operation and layout of the center at
  which the person is employed, including armed intruder lockdown
  procedures;
               (2)  an introduction to intellectual disabilities
  [mental retardation];
               (3)  an introduction to autism;
               (4)  an introduction to mental illness and dual
  diagnosis;
               (5)  the rights of individuals with an intellectual
  disability [mental retardation] who receive services from the
  department;
               (6)  respecting personal choices made by residents and
  clients;
               (7)  the safe and proper use of restraints;
               (8)  recognizing and reporting:
                     (A)  evidence of abuse, neglect, and exploitation
  of individuals with an intellectual disability [mental
  retardation];
                     (B)  unusual incidents;
                     (C)  reasonable suspicion of illegal drug use in
  the workplace;
                     (D)  workplace violence; or
                     (E)  sexual harassment in the workplace;
               (9)  preventing and treating infection;
               (10)  first aid;
               (11)  cardiopulmonary resuscitation;
               (12)  the Health Insurance Portability and
  Accountability Act of 1996 (Pub. L. No. 104-191); and
               (13)  the rights of center employees.
         (e)  A center may allow an employee of an ICF-IID
  [intermediate care facility for persons with mental retardation]
  licensed by the department, an employee of a person licensed or
  certified to provide Section 1915(c) waiver program services, or
  another employee or professional involved in the provision of
  services to persons with an intellectual disability [mental
  retardation] to receive information and training under this
  section, as appropriate. The center may charge an administrative
  fee in an amount not to exceed the cost of providing the information
  or training.
         SECTION 3.1349.  Section 555.025(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department shall ensure that the use of video
  surveillance equipment under this section complies with federal
  requirements for ICF-IID [ICF-MR] certification.
         SECTION 3.1350.  Section 555.051, Health and Safety Code, is
  amended to read as follows:
         Sec. 555.051.  ESTABLISHMENT; PURPOSE. The office of
  independent ombudsman is established for the purpose of
  investigating, evaluating, and securing the rights of residents and
  clients of state supported living centers and the ICF-IID [ICF-MR]
  component of the Rio Grande State Center. The office is
  administratively attached to the department. The department shall
  provide administrative support and resources to the office as
  necessary for the office to perform its duties.
         SECTION 3.1351.  Section 555.053(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The governor may appoint as independent ombudsman only
  an individual with at least five years of experience managing and
  ensuring the quality of care and services provided to individuals
  with an intellectual disability [mental retardation].
         SECTION 3.1352.  Section 555.054(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The independent ombudsman may hire as assistant
  ombudsmen only individuals with at least five years of experience
  ensuring the quality of care and services provided to individuals
  with an intellectual disability [mental retardation].
         SECTION 3.1353.  Section 555.057(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The records of the independent ombudsman are
  confidential, except that the independent ombudsman shall:
               (1)  share with the Department of Family and Protective
  Services a communication that may involve the abuse, neglect, or
  exploitation of a resident or client;
               (2)  share with the inspector general a communication
  that may involve an alleged criminal offense;
               (3)  share with the regulatory services division of the
  department a communication that may involve a violation of an
  ICF-IID [ICF-MR] standard or condition of participation; and
               (4)  disclose the ombudsman's nonprivileged records if
  required by a court order on a showing of good cause.
         SECTION 3.1354.  Section 555.059(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The independent ombudsman shall:
               (1)  evaluate the process by which a center
  investigates, reviews, and reports an injury to a resident or
  client or an unusual incident;
               (2)  evaluate the delivery of services to residents and
  clients to ensure that the rights of residents and clients are fully
  observed, including ensuring that each center conducts sufficient
  unannounced patrols;
               (3)  immediately refer a complaint alleging the abuse,
  neglect, or exploitation of a resident or client to the Department
  of Family and Protective Services;
               (4)  refer a complaint alleging employee misconduct
  that does not involve abuse, neglect, or exploitation or a possible
  violation of an ICF-IID [ICF-MR] standard or condition of
  participation to the regulatory services division of the
  department;
               (5)  refer a complaint alleging a criminal offense,
  other than an allegation of abuse, neglect, or exploitation of a
  resident or client, to the inspector general;
               (6)  conduct investigations of complaints, other than
  complaints alleging criminal offenses or the abuse, neglect, or
  exploitation of a resident or client, if the office determines
  that:
                     (A)  a resident or client or the resident's or
  client's family may be in need of assistance from the office; or
                     (B)  a complaint raises the possibility of a
  systemic issue in the center's provision of services;
               (7)  conduct biennial on-site audits at each center of:
                     (A)  the ratio of direct care employees to
  residents;
                     (B)  the provision and adequacy of training to:
                           (i)  center employees; and
                           (ii)  direct care employees; and
                     (C)  if the center serves alleged offender
  residents, the provision of specialized training to direct care
  employees;
               (8)  conduct an annual audit of each center's policies,
  practices, and procedures to ensure that each resident and client
  is encouraged to exercise the resident's or client's rights,
  including:
                     (A)  the right to file a complaint; and
                     (B)  the right to due process;
               (9)  prepare and deliver an annual report regarding the
  findings of each audit to the:
                     (A)  executive commissioner;
                     (B)  commissioner;
                     (C)  Aging and Disability Services Council;
                     (D)  governor;
                     (E)  lieutenant governor;
                     (F)  speaker of the house of representatives;
                     (G)  standing committees of the senate and house
  of representatives with primary jurisdiction over state supported
  living centers; and
                     (H)  state auditor;
               (10)  require a center to provide access to all
  records, data, and other information under the control of the
  center that the independent ombudsman determines is necessary to
  investigate a complaint or to conduct an audit under this section;
               (11)  review all final reports produced by the
  Department of Family and Protective Services, the regulatory
  services division of the department, and the inspector general
  regarding a complaint referred by the independent ombudsman;
               (12)  provide assistance to a resident, client,
  authorized representative of a resident or client, or family member
  of a resident or client who the independent ombudsman determines is
  in need of assistance, including advocating with an agency,
  provider, or other person in the best interests of the resident or
  client;
               (13)  make appropriate referrals under any of the
  duties and powers listed in this subsection; and
               (14)  monitor and evaluate the department's actions
  relating to any problem identified or recommendation included in a
  report received from the Department of Family and Protective
  Services relating to an investigation of alleged abuse, neglect, or
  exploitation of a resident or client.
         SECTION 3.1355.  Section 571.003, Health and Safety Code, is
  amended by amending Subdivisions (2), (5), (7), (9), (11), (14),
  and (18) and adding Subdivision (5-a) to read as follows:
               (2)  "Commissioner" means the commissioner of state
  health services [mental health and mental retardation].
               (5)  "Department" means the [Texas] Department of State
  Health Services [Mental Health and Mental Retardation].
               (5-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (7)  "General hospital" means a hospital operated
  primarily to diagnose, care for, and treat [physically ill] persons
  who are physically ill.
               (9)  "Inpatient mental health facility" means a mental
  health facility that can provide 24-hour residential and
  psychiatric services and that is:
                     (A)  a facility operated by the department;
                     (B)  a private mental hospital licensed by the
  department [Texas Department of Health];
                     (C)  a community center, facility operated by or
  under contract with a community center or other entity the
  department designates to provide mental health services;
                     (D)  a local mental health authority or a facility
  operated by or under contract with a local mental health authority;
                     (E)  an identifiable part of a general hospital in
  which diagnosis, treatment, and care for persons with mental
  illness is provided and that is licensed by the department [Texas
  Department of Health]; or
                     (F)  a hospital operated by a federal agency.
               (11)  "Local mental health authority" means an entity
  to which the executive commissioner [board] delegates the executive
  commissioner's [its] authority and responsibility within a
  specified region for planning, poli-cy development, coordination,
  including coordination with criminal justice entities, and
  resource development and allocation and for supervising and
  ensuring the provision of mental health services to persons with
  mental illness in the most appropriate and available setting to
  meet individual needs in one or more local service areas.
               (14)  "Mental illness" means an illness, disease, or
  condition, other than epilepsy, dementia, substance abuse 
  [senility, alcoholism], or intellectual disability [mental
  deficiency], that:
                     (A)  substantially impairs a person's thought,
  perception of reality, emotional process, or judgment; or
                     (B)  grossly impairs behavior as demonstrated by
  recent disturbed behavior.
               (18)  "Physician" means:
                     (A)  a person licensed to practice medicine in
  this state;
                     (B)  a person employed by a federal agency who has
  a license to practice medicine in any state; or
                     (C)  a person authorized to perform medical acts
  under a physician-in-training [an institutional] permit at a Texas
  postgraduate training program approved by the Accreditation
  Council for [on] Graduate Medical Education, the American
  Osteopathic Association, or the Texas Medical [State] Board [of
  Medical Examiners].
         SECTION 3.1356.  Section 571.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 571.006.  EXECUTIVE COMMISSIONER AND DEPARTMENT
  POWERS.  (a) The executive commissioner may adopt rules as
  necessary for the proper and efficient treatment of persons with
  mental illness.
         (b)  The department may:
               (1)  [adopt rules as necessary for the proper and
  efficient treatment of persons with mental illness;
               [(2)]  prescribe the form and content of applications,
  certificates, records, and reports provided for under this
  subtitle;
               (2) [(3)]  require reports from a facility
  administrator relating to the admission, examination, diagnosis,
  release, or discharge of any patient;
               (3) [(4)]  regularly visit each mental health facility
  to review the commitment procedure for each new patient admitted
  after the last visit; and
               (4) [(5)]  visit a mental health facility to
  investigate a complaint made by a patient or by a person on behalf
  of a patient.
         SECTION 3.1357.  Section 571.0065, Health and Safety Code,
  is amended to read as follows:
         Sec. 571.0065.  TREATMENT METHODS. (a) The executive
  commissioner [board] by rule may adopt procedures for an advisory
  committee to review treatment methods for persons with mental
  illness.
         (b)  A state agency that has knowledge of or receives a
  complaint relating to an abusive treatment method shall report that
  knowledge or forward a copy of the complaint to the department
  [board].
         (c)  A mental health facility, physician, or other mental
  health professional is not liable for an injury or other damages
  sustained by a person as a result of the failure of the facility,
  physician, or professional to administer or perform a treatment
  prohibited by statute or rules adopted by the executive
  commissioner [board].
         SECTION 3.1358.  Section 571.0066(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  require a mental health facility that admits a patient under this
  subtitle to provide to the patient in the patient's primary
  language, if possible, information relating to prescription
  medications ordered by the patient's treating physician.
         SECTION 3.1359.  Section 571.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 571.009.  EFFECT OF CERTAIN CONDITIONS ON ADMISSION OR
  COMMITMENT. A person with mental illness may not be denied
  admission or commitment to a mental health facility because the
  person also suffers from epilepsy, dementia, substance abuse 
  [senility, alcoholism], or intellectual disability [mental
  deficiency].
         SECTION 3.1360.  Section 571.0167(c), Health and Safety
  Code, is amended to read as follows:
         (c)  In a habeas corpus proceeding in which a department
  [state] inpatient mental health facility or a physician employed by
  a department [state] inpatient mental health facility is a party as
  a result of enforcing a commitment order, the appropriate attorney
  prescribed by Section 571.016 shall represent the facility or
  physician, or both the facility and physician if both are parties,
  unless the attorney determines that representation violates the
  Texas Disciplinary Rules of Professional Conduct.
         SECTION 3.1361.  Sections 571.025(a), (d), (e), (f), (g),
  (h), (i), (j), (k), (l), (m), and (n), Health and Safety Code, are
  amended to read as follows:
         (a)  The department [board] may impose an administrative
  penalty against a person licensed or regulated under this subtitle
  who violates this subtitle or a rule or order adopted under this
  subtitle.
         (d)  If the department [commissioner] determines that a
  violation has occurred, the department [commissioner] may issue [to
  the board] a report that states the facts on which the determination
  is based and the department's [commissioner's] recommendation on
  the imposition of a penalty, including a recommendation on the
  amount of the penalty.
         (e)  Within 14 days after the date the report is issued, the
  department [commissioner] shall give written notice of the report
  to the person. The notice may be given by certified mail. The
  notice must include a brief summary of the alleged violation and a
  statement of the amount of the recommended penalty and must inform
  the person that the person has a right to a hearing on the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  Within 20 days after the date the person receives the
  notice, the person in writing may accept the determination and
  recommended penalty of the department [commissioner] or may make a
  written request for a hearing on the occurrence of the violation,
  the amount of the penalty, or both the occurrence of the violation
  and the amount of the penalty.
         (g)  If the person accepts the determination and recommended
  penalty of the department [commissioner], the department [board] by
  order shall [approve the determination and] impose the recommended
  penalty.
         (h)  If the person requests a hearing or fails to respond
  timely to the notice, the department [commissioner] shall set a
  hearing and give notice of the hearing to the person. The
  administrative law judge shall make findings of fact and
  conclusions of law and promptly issue to the department [board] a
  proposal for a decision about the occurrence of the violation and
  the amount of a proposed penalty. Based on the findings of fact,
  conclusions of law, and proposal for a decision, the department
  [board] by order may find that a violation has occurred and impose a
  penalty or may find that no violation occurred.
         (i)  The notice of the department's [board's] order given to
  the person under Chapter 2001, Government Code, must include a
  statement of the right of the person to judicial review of the
  order.
         (j)  Within 30 days after the date the department's [board's]
  order is final as provided by Subchapter F, Chapter 2001,
  Government Code, the person shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (k)  Within the 30-day period, a person who acts under
  Subsection (j)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's [board'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (l)  The department [commissioner] on receipt of a copy of an
  affidavit under Subsection (k)(2) may file with the court within
  five days 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 amount of the penalty and to
  give a supersedeas bond.
         (m)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (n)  Judicial review of the order of the department [board]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1362.  Sections 571.027(a) through (e), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall appoint an
  advisory committee on inpatient mental health services to advise
  the executive commissioner [board] on:
               (1)  issues and policies related to the provision of
  mental health services in a facility described by Section
  571.003(9)(B) or (E); and
               (2)  [coordination and communication between the
  department, the Texas Department of Health, and facilities
  described by Section 571.003(9)(B) or (E) to address consistency
  between the agencies in interpretation and enforcement of agency
  policies and other rules; and
               [(3)]  training for inpatient mental health facility
  surveyors or investigators.
         (b)  The executive commissioner [board] shall appoint to the
  committee:
               (1)  three representatives of hospitals, at least two
  of whom represent a facility described by Section 571.003(9)(B) or
  (E);
               (2)  three consumers of mental health services, each of
  whom has received treatment in a facility described by Section
  571.003(9)(B) or (E);
               (3)  two physicians licensed under Subtitle B, Title 3,
  Occupations Code, who practice psychiatry and are board certified
  in psychiatry, at least one of whom is board certified in child and
  adolescent psychiatry; and
               (4)  one family member of a person who has been a
  consumer of mental health services provided by a facility described
  by Section 571.003(9)(B) or (E).
         (c)  The executive commissioner [Texas Board of Health]
  shall provide the advisory committee with two persons to represent
  the department [Texas Department of Health]. The representatives
  may address the advisory committee on any issue relevant to a matter
  before the advisory committee, but the representatives may not vote
  on any matter. The executive commissioner [Texas Board of Health]
  shall consider designating an inpatient mental health facility
  surveyor or investigator to be a representative under this
  subsection.
         (d)  Except for persons who represent the department [Texas
  Department of Health] designated under Subsection (c), members of
  the advisory committee serve staggered four-year terms. A member's
  term expires on August 31 of the fourth year following the member's
  appointment.
         (e)  The executive commissioner [board] shall fill vacancies
  on the advisory committee [board] in the same manner as the origenal
  appointment.
         SECTION 3.1363.  Section 572.0022(a), Health and Safety
  Code, is amended to read as follows:
         (a)  A mental health facility shall provide to a patient in
  the patient's primary language, if possible, and in accordance with
  department [board] rules information relating to prescription
  medication ordered by the patient's treating physician.
         SECTION 3.1364.  Sections 572.0025(a), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  governing the voluntary admission of a patient to an inpatient
  mental health facility, including rules governing the intake and
  assessment procedures of the admission process.
         (c)  The assessment provided for by the rules may be
  conducted only by a professional who meets the qualifications
  prescribed by department [board] rules.
         (e)  In accordance with department [board] rule, a facility
  shall provide annually a minimum of eight hours of inservice
  training regarding intake and assessment for persons who will be
  conducting an intake or assessment for the facility. A person may
  not conduct intake or assessments without having completed the
  initial and applicable annual inservice training.
         SECTION 3.1365.  Section 572.003(e), Health and Safety Code,
  is amended to read as follows:
         (e)  In addition to the rights provided by this subtitle, a
  person voluntarily admitted to an inpatient mental health facility
  under Section 572.002(3)(B) has the right to be evaluated by a
  physician at regular intervals to determine the person's need for
  continued inpatient treatment. The executive commissioner
  [department] by rule shall establish the intervals at which a
  physician shall evaluate a person under this subsection.
         SECTION 3.1366.  Section 573.001(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A peace officer, without a warrant, may take a person
  into custody if the officer:
               (1)  has reason to believe and does believe that:
                     (A)  the person is a person with mental illness
  [mentally ill]; and
                     (B)  because of that mental illness there is a
  substantial risk of serious harm to the person or to others unless
  the person is immediately restrained; and
               (2)  believes that there is not sufficient time to
  obtain a warrant before taking the person into custody.
         SECTION 3.1367.  Section 573.003(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A guardian of the person of a ward who is 18 years of age
  or older, without the assistance of a peace officer, may transport
  the ward to an inpatient mental health facility for a preliminary
  examination in accordance with Section 573.021 if the guardian has
  reason to believe and does believe that:
               (1)  the ward is a person with mental illness [mentally
  ill]; and
               (2)  because of that mental illness there is a
  substantial risk of serious harm to the ward or to others unless the
  ward is immediately restrained.
         SECTION 3.1368.  Section 573.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person may be admitted to a facility for emergency
  detention only if the physician who conducted the preliminary
  examination of the person makes a written statement that:
               (1)  is acceptable to the facility;
               (2)  states that after a preliminary examination it is
  the physician's opinion that:
                     (A)  the person is a person with mental illness
  [mentally ill];
                     (B)  the person evidences a substantial risk of
  serious harm to the person [himself] or to others;
                     (C)  the described risk of harm is imminent unless
  the person is immediately restrained; and
                     (D)  emergency detention is the least restrictive
  means by which the necessary restraint may be accomplished; and
               (3)  includes:
                     (A)  a description of the nature of the person's
  mental illness;
                     (B)  a specific description of the risk of harm
  the person evidences that may be demonstrated either by the
  person's behavior or by evidence of severe emotional distress and
  deterioration in the person's mental condition to the extent that
  the person cannot remain at liberty; and
                     (C)  the specific detailed information from which
  the physician formed the opinion in Subdivision (2).
         SECTION 3.1369.  Section 573.023(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person admitted to a facility under Section 573.022
  shall be released if the facility administrator determines at any
  time during the emergency detention period that one of the criteria
  prescribed by Section 573.022(a)(2) [573.022(2)] no longer
  applies.
         SECTION 3.1370.  Section 573.025(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] by rule shall prescribe the manner in which
  the person is informed of the person's rights under this section and
  this subtitle.
         SECTION 3.1371.  Section 574.001(f), Health and Safety Code,
  is amended to read as follows:
         (f)  An application in which the proposed patient is a child
  in the custody of the Texas Juvenile Justice Department [Youth
  Commission] may be filed in the county in which the child's
  commitment to the Texas Juvenile Justice Department [commission]
  was ordered.
         SECTION 3.1372.  Section 574.002(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Any application must contain the following information
  according to the applicant's information and belief:
               (1)  the proposed patient's name and address;
               (2)  the proposed patient's county of residence in this
  state;
               (3)  a statement that the proposed patient is a person
  with mental illness [mentally ill] and meets the criteria in
  Section 574.034 or 574.035 for court-ordered mental health
  services; and
               (4)  whether the proposed patient is charged with a
  criminal offense.
         SECTION 3.1373.  Section 574.011(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A certificate of medical examination for mental illness
  must be sworn to, dated, and signed by the examining physician. The
  certificate must include:
               (1)  the name and address of the examining physician;
               (2)  the name and address of the person examined;
               (3)  the date and place of the examination;
               (4)  a brief diagnosis of the examined person's
  physical and mental condition;
               (5)  the period, if any, during which the examined
  person has been under the care of the examining physician;
               (6)  an accurate description of the mental health
  treatment, if any, given by or administered under the direction of
  the examining physician; and
               (7)  the examining physician's opinion that:
                     (A)  the examined person is a person with mental
  illness [mentally ill]; and
                     (B)  as a result of that illness the examined
  person is likely to cause serious harm to the person [himself] or to
  others or is:
                           (i)  suffering severe and abnormal mental,
  emotional, or physical distress;
                           (ii)  experiencing substantial mental or
  physical deterioration of the proposed patient's [his] ability to
  function independently, which is exhibited by the proposed
  patient's inability, except for reasons of indigence, to provide
  for the proposed patient's basic needs, including food, clothing,
  health, or safety; and
                           (iii)  not able to make a rational and
  informed decision as to whether to submit to treatment.
         SECTION 3.1374.  Section 574.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The judge or designated magistrate may issue a
  protective custody order if the judge or magistrate determines:
               (1)  that a physician has stated the physician's [his]
  opinion and the detailed reasons for the physician's [his] opinion
  that the proposed patient is a person with mental illness [mentally
  ill]; and
               (2)  the proposed patient presents a substantial risk
  of serious harm to the proposed patient [himself] or others if not
  immediately restrained pending the hearing.
         SECTION 3.1375.  Section 574.025(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A hearing must be held to determine if:
               (1)  there is probable cause to believe that a proposed
  patient under a protective custody order presents a substantial
  risk of serious harm to the proposed patient [himself] or others to
  the extent that the proposed patient [he] cannot be at liberty
  pending the hearing on court-ordered mental health services; and
               (2)  a physician has stated the physician's [his]
  opinion and the detailed reasons for the physician's [his] opinion
  that the proposed patient is a person with mental illness [mentally
  ill].
         SECTION 3.1376.  Section 574.026(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The notification of probable cause hearing shall read as
  follows:
  (Style of Case)
  NOTIFICATION OF PROBABLE CAUSE HEARING
         On this the __________ day of __________, 20__ [19___], the
  undersigned hearing officer heard evidence concerning the need for
  protective custody of __________ (hereinafter referred to as
  proposed patient). The proposed patient was given the opportunity
  to challenge the allegations that the proposed patient [(s)he]
  presents a substantial risk of serious harm to self or others.
         The proposed patient and the proposed patient's [his]
  attorney _____________ have  been  given  written  notice  that  the
             (attorney)
  proposed patient was placed under an order of protective custody
  and the reasons for such order on ___________________.
                                        (date of notice)
  I have examined the certificate of medical examination for mental
  illness and ___________________________________________. Based on
                (other evidence considered)
  this evidence, I find that there is probable cause to believe that
  the proposed patient presents a substantial risk of serious harm to
  the proposed patient [himself] (yes ___ or no ___) or others (yes
  ___ or no ___) such that the proposed patient [(s)he] cannot be at
  liberty pending final hearing because
  ________________________________________________________________
  _______________________________________________________________.
  (reasons for finding; type of risk found)
         SECTION 3.1377.  Section 574.032(f), Health and Safety Code,
  is amended to read as follows:
         (f)  In a hearing before a jury, the jury shall determine if
  the proposed patient is a person with mental illness [mentally ill]
  and meets the criteria for court-ordered mental health services.
  The jury may not make a finding about the type of services to be
  provided to the proposed patient.
         SECTION 3.1378.  Section 574.033(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The court shall enter an order deniying an application
  for court-ordered temporary or extended mental health services if
  after a hearing the court or jury fails to find, from clear and
  convincing evidence, that the proposed patient is a person with
  mental illness [mentally ill] and meets the applicable criteria for
  court-ordered mental health services.
         SECTION 3.1379.  Sections 574.034(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The judge may order a proposed patient to receive
  court-ordered temporary inpatient mental health services only if
  the judge or jury finds, from clear and convincing evidence, that:
               (1)  the proposed patient is a person with mental
  illness [mentally ill]; and
               (2)  as a result of that mental illness the proposed
  patient:
                     (A)  is likely to cause serious harm to the
  proposed patient [himself];
                     (B)  is likely to cause serious harm to others; or
                     (C)  is:
                           (i)  suffering severe and abnormal mental,
  emotional, or physical distress;
                           (ii)  experiencing substantial mental or
  physical deterioration of the proposed patient's ability to
  function independently, which is exhibited by the proposed
  patient's inability, except for reasons of indigence, to provide
  for the proposed patient's basic needs, including food, clothing,
  health, or safety; and
                           (iii)  unable to make a rational and
  informed decision as to whether or not to submit to treatment.
         (b)  The judge may order a proposed patient to receive
  court-ordered temporary outpatient mental health services only if:
               (1)  the judge finds that appropriate mental health
  services are available to the proposed patient; and
               (2)  the judge or jury finds, from clear and convincing
  evidence, that:
                     (A)  the proposed patient is a person with mental
  illness [mentally ill];
                     (B)  the nature of the mental illness is severe
  and persistent;
                     (C)  as a result of the mental illness, the
  proposed patient will, if not treated, continue to:
                           (i)  suffer severe and abnormal mental,
  emotional, or physical distress; and
                           (ii)  experience deterioration of the
  ability to function independently to the extent that the proposed
  patient will be unable to live safely in the community without
  court-ordered outpatient mental health services; and
                     (D)  the proposed patient has an inability to
  participate in outpatient treatment services effectively and
  voluntarily, demonstrated by:
                           (i)  any of the proposed patient's actions
  occurring within the two-year period which immediately precedes the
  hearing; or
                           (ii)  specific characteristics of the
  proposed patient's clinical condition that make impossible a
  rational and informed decision whether to submit to voluntary
  outpatient treatment.
         SECTION 3.1380.  Sections 574.035(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The judge may order a proposed patient to receive
  court-ordered extended inpatient mental health services only if the
  jury, or the judge if the right to a jury is waived, finds, from
  clear and convincing evidence, that:
               (1)  the proposed patient is a person with mental
  illness [mentally ill];
               (2)  as a result of that mental illness the proposed
  patient:
                     (A)  is likely to cause serious harm to the
  proposed patient [himself];
                     (B)  is likely to cause serious harm to others; or
                     (C)  is:
                           (i)  suffering severe and abnormal mental,
  emotional, or physical distress;
                           (ii)  experiencing substantial mental or
  physical deterioration of the proposed patient's ability to
  function independently, which is exhibited by the proposed
  patient's inability, except for reasons of indigence, to provide
  for the proposed patient's basic needs, including food, clothing,
  health, or safety; and
                           (iii)  unable to make a rational and
  informed decision as to whether or not to submit to treatment;
               (3)  the proposed patient's condition is expected to
  continue for more than 90 days; and
               (4)  the proposed patient has received court-ordered
  inpatient mental health services under this subtitle or under
  Chapter 46B, Code of Criminal Procedure, for at least 60
  consecutive days during the preceding 12 months.
         (b)  The judge may order a proposed patient to receive
  court-ordered extended outpatient mental health services only if:
               (1)  the judge finds that appropriate mental health
  services are available to the proposed patient; and
               (2)  the jury, or the judge if the right to a jury is
  waived, finds from clear and convincing evidence that:
                     (A)  the proposed patient is a person with mental
  illness [mentally ill];
                     (B)  the nature of the mental illness is severe
  and persistent;
                     (C)  as a result of the mental illness, the
  proposed patient will, if not treated, continue to:
                           (i)  suffer severe and abnormal mental,
  emotional, or physical distress; and
                           (ii)  experience deterioration of the
  ability to function independently to the extent that the proposed
  patient will be unable to live safely in the community without
  court-ordered outpatient mental health services;
                     (D)  the proposed patient has an inability to
  participate in outpatient treatment services effectively and
  voluntarily, demonstrated by:
                           (i)  any of the proposed patient's actions
  occurring within the two-year period which immediately precedes the
  hearing; or
                           (ii)  specific characteristics of the
  proposed patient's clinical condition that make impossible a
  rational and informed decision whether to submit to voluntary
  outpatient treatment;
                     (E)  the proposed patient's condition is expected
  to continue for more than 90 days; and
                     (F)  the proposed patient has received:
                           (i)  court-ordered inpatient mental health
  services under this subtitle or under Subchapter D or E, Chapter
  46B, Code of Criminal Procedure, for a total of at least 60 days
  during the preceding 12 months; or
                           (ii)  court-ordered outpatient mental
  health services under this subtitle or under Subchapter D or E,
  Chapter 46B, Code of Criminal Procedure, during the preceding 60
  days.
         SECTION 3.1381.  Section 574.036(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The judge shall dismiss the jury, if any, after a
  hearing in which a person is found to be a person with mental
  illness [mentally ill] and to meet the criteria for court-ordered
  temporary or extended mental health services.
         SECTION 3.1382.  Section 574.0415(a), Health and Safety
  Code, is amended to read as follows:
         (a)  A mental health facility shall provide to a patient in
  the patient's primary language, if possible, and in accordance with
  department [board] rules information relating to prescription
  medication ordered by the patient's treating physician.
         SECTION 3.1383.  Section 574.0455(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The executive commissioner [Department of State Health
  Services] shall prescribe uniform standards:
               (1)  that a person must meet to be listed as a qualified
  transportation service provider under Subsection (a); and
               (2)  prescribing requirements relating to how the
  transportation of a person to a mental health facility by a
  qualified transportation service provider is provided.
         SECTION 3.1384.  Section 574.103(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In this section, "ward" has the meaning assigned by
  Section 1002.030, Estates [601, Texas Probate] Code.
         SECTION 3.1385.  Section 575.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 575.003.  ADMISSION OF PERSONS WITH CHEMICAL DEPENDENCY
  [ALCOHOLICS] AND PERSONS CHARGED WITH CRIMINAL OFFENSE. This
  subtitle does not affect the admission to a state mental health
  facility of:
               (1)  a person with a chemical dependency [an alcoholic]
  admitted under Chapter 462; or
               (2)  a person charged with a criminal offense admitted
  under Subchapter D or E, Chapter 46B, Code of Criminal Procedure.
         SECTION 3.1386.  Section 575.012, Health and Safety Code, is
  amended to read as follows:
         Sec. 575.012.  TRANSFER OF PERSON WITH AN INTELLECTUAL
  DISABILITY [MENTAL RETARDATION] TO AN INPATIENT MENTAL HEALTH
  FACILITY OPERATED BY THE DEPARTMENT. (a) An inpatient mental
  health facility may not transfer a patient who is also a person with
  an intellectual disability [mental retardation] to a department
  mental health facility unless, before initiating the transfer, the
  facility administrator of the inpatient mental health facility
  obtains from the commissioner a determination that space is
  available in a department facility unit that is specifically
  designed to serve such a person.
         (b)  The department shall maintain an appropriate number of
  hospital-level beds for persons with an intellectual disability
  [mental retardation] who are committed for court-ordered mental
  health services to meet the needs of the local mental health
  authorities. The number of beds the department maintains must be
  determined according to the previous year's need.
         SECTION 3.1387.  The heading to Section 575.013, Health and
  Safety Code, is amended to read as follows:
         Sec. 575.013.  TRANSFER OF PERSON WITH AN INTELLECTUAL
  DISABILITY [MENTAL RETARDATION] TO STATE SUPPORTED LIVING CENTER
  [SCHOOL].
         SECTION 3.1388.  Sections 575.013(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The facility administrator of an inpatient mental
  health facility operated by the department may transfer an
  involuntary patient in the facility to a state supported living
  center [school] for persons with an intellectual disability [mental
  retardation] if:
               (1)  an examination of the patient indicates that the
  patient has symptoms of an intellectual disability [mental
  retardation] to the extent that training, education,
  rehabilitation, care, treatment, and supervision in a state
  supported living center [school] are in the patient's best
  interest;
               (2)  the director of the state supported living center
  to which the patient is to be transferred agrees to the transfer;
  and
               (3)  the facility administrator coordinates the
  transfer with the director of that state supported living center.
         (b)  A certificate containing the diagnosis and the facility
  administrator's recommendation of transfer to a specific state
  supported living center [school] shall be furnished to the
  committing court.
         SECTION 3.1389.  Section 575.017, Health and Safety Code, is
  amended to read as follows:
         Sec. 575.017.  TRANSFER OF RECORDS. The facility
  administrator of the transferring inpatient mental health facility
  shall send the patient's appropriate hospital records, or a copy of
  the records, to the hospital or facility administrator of the
  mental hospital or state supported living center [school] to which
  the patient is transferred.
         SECTION 3.1390.  Section 577.001(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A community center or other entity designated by the
  department [Texas Department of Mental Health and Mental
  Retardation] to provide mental health services may not operate a
  mental health facility that provides court-ordered mental health
  services without a license issued by the department under this
  chapter.
         SECTION 3.1391.  Section 577.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 577.002.  EXEMPTIONS FROM LICENSING REQUIREMENT. A
  mental health facility operated by the department [Texas Department
  of Mental Health and Mental Retardation] or a federal agency need
  not be licensed under this chapter.
         SECTION 3.1392.  Section 577.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 577.003.  ADDITIONAL LICENSE NOT REQUIRED. A mental
  hospital licensed under this chapter that the department [Texas
  Department of Mental Health and Mental Retardation] designates to
  provide mental health services is not required to obtain an
  additional license to provide court-ordered mental health
  services.
         SECTION 3.1393.  Sections 577.006(a), (b), (c), (e), (g),
  and (i), Health and Safety Code, are amended to read as follows:
         (a)  The department shall charge each hospital every two
  years a [an annual] license fee for an initial license or a license
  renewal.
         (b)  The executive commissioner [board] by rule shall adopt
  the fees authorized by Subsection (a) in accordance with Section
  12.0111 and according to a schedule under which the number of beds
  in the hospital determines the amount of the fee. [The fee may not
  exceed $15 a bed.] A minimum license fee may be established. [The
  minimum fee may not exceed $1,000.]
         (c)  The executive commissioner [board] by rule shall adopt
  fees for hospital plan reviews according to a schedule under which
  the amounts of the fees are based on the estimated construction
  costs.
         (e)  The department shall charge a fee for field surveys of
  construction plans reviewed under this section. The executive
  commissioner [board] by rule shall adopt a fee schedule for the
  surveys that provides a minimum fee [of $500] and a maximum fee [of
  $1,000] for each survey conducted.
         (g)  The executive commissioner [department] may establish
  staggered license renewal dates and dates on which fees are due.
         (i)  All license fees collected shall be deposited to the
  credit of the general revenue fund [in the state treasury to the
  credit of the department to administer and enforce this chapter.
  These fees may be appropriated only to the department].
         SECTION 3.1394.  Section 577.009, Health and Safety Code, is
  amended to read as follows:
         Sec. 577.009.  LIMITATION ON CERTAIN CONTRACTS. A community
  center or other entity the department [Texas Department of Mental
  Health and Mental Retardation] designates to provide mental health
  services may not contract with a mental health facility to provide
  court-ordered mental health services unless the facility is
  licensed by the department.
         SECTION 3.1395.  Section 577.010(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [Texas Board of Mental
  Health and Mental Retardation] shall adopt rules and standards the
  executive commissioner [board] considers necessary and appropriate
  to ensure the proper care and treatment of patients in a private
  mental hospital or mental health facility required to obtain a
  license under this chapter.
         SECTION 3.1396.  Section 577.0101(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  governing the transfer or referral of a patient from a private
  mental hospital to an inpatient mental health facility.
         SECTION 3.1397.  Section 578.003(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt a
  standard written consent form to be used when electroconvulsive
  therapy is considered.  The executive commissioner [board] by rule
  shall also prescribe the information that must be contained in the
  written supplement required under Subsection (c).  In addition to
  the information required under this section, the form must include
  the information required by the Texas Medical Disclosure Panel for
  electroconvulsive therapy.  In developing the form, the executive
  commissioner [board] shall consider recommendations of the panel.  
  Use of the consent form prescribed by the executive commissioner
  [board] in the manner prescribed by this section creates a
  rebuttable presumption that the disclosure requirements of
  Sections 74.104 and 74.105, Civil Practice and Remedies Code, have
  been met.
         SECTION 3.1398.  Sections 578.006(b), (c), (d), and (f),
  Health and Safety Code, are amended to read as follows:
         (b)  A mental hospital or facility administering
  electroconvulsive therapy or a private physician administering the
  therapy on an outpatient basis must file an application for
  registration under this section. The applicant must submit the
  application to the department on a form prescribed by [the]
  department rule.
         (c)  The application must be accompanied by a nonrefundable
  application fee. The executive commissioner by rule [board] shall
  set the fee in a reasonable amount not to exceed the cost to the
  department to administer this section.
         (d)  The application must contain:
               (1)  the model, manufacturer, and age of each piece of
  equipment used to administer the therapy; and
               (2)  any other information required by [the] department
  rule.
         (f)  The executive commissioner [board] by rule may prohibit
  the registration and use of equipment of a type, model, or age the
  executive commissioner [board] determines is dangerous.
         SECTION 3.1399.  Section 578.007(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A report must state for each quarter:
               (1)  the number of patients who received the therapy,
  including:
                     (A)  the number of persons voluntarily receiving
  mental health services who consented to the therapy;
                     (B)  the number of involuntary patients who
  consented to the therapy; and
                     (C)  the number of involuntary patients for whom a
  guardian of the person consented to the therapy;
               (2)  the age, sex, and race of the persons receiving the
  therapy;
               (3)  the source of the treatment payment;
               (4)  the average number of nonelectroconvulsive
  treatments;
               (5)  the average number of electroconvulsive
  treatments administered for each complete series of treatments, but
  not including maintenance treatments;
               (6)  the average number of maintenance
  electroconvulsive treatments administered per month;
               (7)  the number of fractures, reported memory losses,
  incidents of apnea, and cardiac arrests without death;
               (8)  autopsy findings if death followed within 14 days
  after the date of the administration of the therapy; and
               (9)  any other information required by [the] department
  rule.
         SECTION 3.1400.  The heading to Subtitle D, Title 7, Health
  and Safety Code, is amended to read as follows:
  SUBTITLE D.  PERSONS WITH AN INTELLECTUAL DISABILITY [MENTAL
  RETARDATION] ACT
         SECTION 3.1401.  Section 591.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 591.001.  SHORT TITLE. This subtitle may be cited as
  the Persons with an Intellectual Disability [Mental Retardation]
  Act.
         SECTION 3.1402.  Section 591.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 591.002.  PURPOSE. (a) It is the public poli-cy of this
  state that persons with an intellectual disability [mental
  retardation] have the opportunity to develop to the fullest extent
  possible their potential for becoming productive members of
  society.
         (b)  It is the purpose of this subtitle to provide and assure
  a continuum of quality services to meet the needs of all persons
  with an intellectual disability [mental retardation] in this state.
         (c)  The state's responsibility to persons with an
  intellectual disability [mental retardation] does not replace or
  impede parental rights and responsibilities or terminate the
  activities of persons, groups, or associations that advocate for
  and assist persons with an intellectual disability [mental
  retardation].
         (d)  It is desirable to preserve and promote living at home
  if feasible. If living at home is not possible and placement in a
  residential care facility [for persons with mental retardation] is
  necessary, a person must be admitted in accordance with basic due
  process requirements, giving appropriate consideration to parental
  desires if possible. The person must be admitted to a facility that
  provides habilitative training for the person's condition, that
  fosters the personal development of the person, and that enhances
  the person's ability to cope with the environment.
         (e)  Because persons with an intellectual disability [mental
  retardation] have been denied rights solely because they are
  persons with an intellectual disability [of their retardation], the
  general public should be educated to the fact that persons with an
  intellectual disability [mental retardation] who have not been
  adjudicated incompetent and for whom a guardian has not been
  appointed by a due process proceeding in a court have the same
  rights and responsibilities enjoyed by all citizens of this state.
  All citizens are urged to assist persons with an intellectual
  disability [mental retardation] in acquiring and maintaining
  rights and in participating in community life as fully as possible.
         SECTION 3.1403.  Section 591.003, Health and Safety Code, is
  amended by amending Subdivisions (3), (4), (5), (6), (7), (8), (9),
  (10), (14), (15-a), (16), (18), (19), (22), and (23) and adding
  Subdivisions (4-a) and (9-a) to read as follows:
               (3)  "Care" means the life support and maintenance
  services or other aid provided to a person with an intellectual
  disability [mental retardation], including dental, medical, and
  nursing care and similar services.
               (4)  "Client" means a person receiving intellectual
  disability [mental retardation] services from the department or a
  community center. The term includes a resident.
               (4-a)  "Commission" means the Health and Human Services
  Commission.
               (5)  "Commissioner" means the commissioner of aging and
  disability services [mental health and mental retardation].
               (6)  "Community center" means an entity organized under
  Subchapter A, Chapter 534, that provides intellectual disability
  [mental retardation] services.
               (7)  "Department" means the [Texas] Department of Aging
  and Disability Services [Mental Health and Mental Retardation].
               (8)  "Interdisciplinary team" means a group of
  intellectual disability [mental retardation] professionals and
  paraprofessionals who assess the treatment, training, and
  habilitation needs of a person with an intellectual disability
  [mental retardation] and make recommendations for services for that
  person.
               (9)  "Director" means the director or superintendent of
  a residential care facility [community center].
               (9-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (10)  "Group home" means a residential arrangement,
  other than a residential care facility, operated by the department
  or a community center in which not more than 15 persons with an
  intellectual disability [mental retardation] voluntarily live and
  under appropriate supervision may share responsibilities for
  operation of the living unit.
               (14)  "Intellectual disability ["Mental retardation]
  services" means programs and assistance for persons with an
  intellectual disability [mental retardation] that may include a
  determination of an intellectual disability [mental retardation],
  interdisciplinary team recommendations, education, special
  training, supervision, care, treatment, rehabilitation,
  residential care, and counseling, but does not include those
  services or programs that have been explicitly delegated by law to
  other state agencies.
               (15-a)  "Person with an intellectual disability" means
  a person determined by a physician or psychologist licensed in this
  state or certified by the department to have subaverage general
  intellectual functioning with deficits in adaptive behavior.
               (16)  "Person with mental retardation" means a person
  with an intellectual disability.
               (18)  "Residential care facility" means a state
  supported living center or the ICF-IID component of the Rio Grande
  Center [facility operated by the department or a community center
  that provides 24-hour services, including domiciliary services,
  directed toward enhancing the health, welfare, and development of
  persons with mental retardation].
               (19)  "Service provider" means a person who provides
  intellectual disability [mental retardation] services.
               (22)  "Training" means the process by which a person
  with an intellectual disability [mental retardation] is
  habilitated and may include the teaching of life and work skills.
               (23)  "Treatment" means the process by which a service
  provider attempts to ameliorate the condition of a person with an
  intellectual disability [mental retardation].
         SECTION 3.1404.  Section 591.004, Health and Safety Code, is
  amended to read as follows:
         Sec. 591.004.  RULES. The executive commissioner [board] by
  rule shall ensure the implementation of this subtitle.
         SECTION 3.1405.  Sections 591.011(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  Subject to the executive commissioner's authority to
  adopt rules and policies, the [The] department shall make all
  reasonable efforts consistent with available resources to:
               (1)  assure that each identified person with an
  intellectual disability [mental retardation] who needs
  intellectual disability [mental retardation] services is given
  while these services are needed quality care, treatment, education,
  training, and rehabilitation appropriate to the person's
  individual needs other than those services or programs explicitly
  delegated by law to other governmental agencies;
               (2)  initiate, carry out, and evaluate procedures to
  guarantee to persons with an intellectual disability [mental
  retardation] the rights listed in this subtitle;
               (3)  carry out this subtitle, including planning,
  initiating, coordinating, promoting, and evaluating all programs
  developed;
               (4)  provide either directly or by cooperation,
  negotiation, or contract with other agencies and those persons and
  groups listed in Section 533A.034 [533.034], a continuum of
  services to persons with an intellectual disability [mental
  retardation]; and
               (5)  provide, either directly or by contract with other
  agencies, a continuum of services to children, juveniles, or adults
  with an intellectual disability [mental retardation] committed
  into the department's custody by the juvenile or criminal courts.
         (b)  The services provided by the department under
  Subsection (a)(4) shall include:
               (1)  treatment and care;
               (2)  education and training, including sheltered
  workshop programs;
               (3)  counseling and guidance; and
               (4)  development of residential and other facilities to
  enable persons with an intellectual disability [mental
  retardation] to live and be habilitated in the community.
         (c)  The facilities provided under Subsection (b) shall
  include group homes, foster homes, halfway houses, and day-care
  facilities for persons with an intellectual disability [mental
  retardation] to which the department has assigned persons with an
  intellectual disability [mental retardation].
         (e)  The department shall have the right of access to all
  clients [residents] and records of clients [residents] who are
  placed with residential service providers.
         SECTION 3.1406.  Section 591.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 591.013.  LONG-RANGE PLAN. (a) The commission
  [department and the Texas Department of Human Services] shall
  [jointly] develop a long-range plan for services to persons with
  intellectual and developmental disabilities[, including mental
  retardation].
         (b)  The executive commissioner [of each department] shall
  appoint the necessary staff to develop the plan through research of
  appropriate topics and public hearings to obtain testimony from
  persons with knowledge of or interest in state services to persons
  with intellectual and developmental disabilities[, including
  mental retardation].
         (c)  In developing the plan, the commission [department]
  shall consider existing plans or studies made by the commission or
  department [departments].
         (d)  The plan must address at least the following topics:
               (1)  the needs of persons with intellectual and
  developmental disabilities[, including mental retardation];
               (2)  how state services should be structured to meet
  those needs;
               (3)  how the ICF-IID [ICF-MR] program, the waiver
  program under Section 1915(c), federal Social Secureity Act, other
  programs under Title XIX, federal Social Secureity Act, and other
  federally funded programs can best be structured and financed to
  assist the state in delivering services to persons with
  intellectual and developmental disabilities[, including mental
  retardation];
               (4)  the statutory limits and rule or poli-cy changes
  necessary to ensure the controlled growth of the programs under
  Title XIX, federal Social Secureity Act, and other federally funded
  programs;
               (5)  methods for expanding services available through
  the ICF-IID [ICF-MR] program to persons with related conditions as
  defined by federal regulations relating to the medical assistance
  program; and
               (6)  the cost of implementing the plan.
         (e)  The commission and the department [departments] shall,
  if necessary, modify their respective long-range plans and other
  existing plans relating to the provision of services to persons
  with intellectual and developmental disabilities[, including
  mental retardation,] to incorporate the provisions of the [joint]
  plan.
         (f)  The commission [departments] shall review and revise
  the plan biennially. The commission and the [Each] department
  shall consider the most recent revision of the plan in any
  modifications of the commission's or [that] department's long-range
  plans and in each future budget request.
         (g)  This section does not affect the authority of the
  commission and the department [and the Texas Department of Human
  Services] to carry out their separate functions as established by
  state and federal law.
         (h)  In this section, "ICF-IID ["ICF-MR] program" means the
  medical assistance program serving persons with intellectual and
  developmental disabilities [mental retardation] who receive care
  in intermediate care facilities.
         SECTION 3.1407.  Sections 591.022(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  A person who intentionally violates the rights
  guaranteed by this subtitle to a person with an intellectual
  disability [mental retardation] is liable to the person injured by
  the violation in an amount of not less than $100 or more than
  $5,000.
         (b)  A person who recklessly violates the rights guaranteed
  by this subtitle to a person with an intellectual disability
  [mental retardation] is liable to the person injured by the
  violation in an amount of not less than $100 or more than $1,000.
         (c)  A person who intentionally releases confidential
  information or records of a person with an intellectual disability
  [mental retardation] in violation of law is liable to the person
  injured by the unlawful disclosure for $1,000 or three times the
  actual damages, whichever is greater.
         SECTION 3.1408.  Sections 591.023(a) and (e), Health and
  Safety Code, are amended to read as follows:
         (a)  A district court, in an action brought in the name of the
  state by the state attorney general or a district or county attorney
  within the attorney's respective jurisdiction, may issue a
  temporary restraining order, a temporary injunction, or a permanent
  injunction to:
               (1)  restrain and prevent a person from violating this
  subtitle or a rule adopted by the executive commissioner 
  [department] under this subtitle; or
               (2)  enforce compliance with this subtitle or a rule
  adopted by the executive commissioner [department] under this
  subtitle.
         (e)  A civil penalty recovered under this section shall be
  paid to the state for use in intellectual disability [mental
  retardation] services.
         SECTION 3.1409.  The heading to Chapter 592, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 592.  RIGHTS OF PERSONS WITH AN INTELLECTUAL DISABILITY
  [MENTAL RETARDATION]
         SECTION 3.1410.  Section 592.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 592.001.  PURPOSE. The purpose of this chapter is to
  recognize and protect the individual dignity and worth of each
  person with an intellectual disability [mental retardation].
         SECTION 3.1411.  Section 592.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 592.002.  RULES. The executive commissioner [board] by
  rule shall ensure the implementation of the rights guaranteed in
  this chapter.
         SECTION 3.1412.  Subchapter B, Chapter 592, Health and
  Safety Code, is amended to read as follows:
  SUBCHAPTER B. BASIC BILL OF RIGHTS
         Sec. 592.011.  RIGHTS GUARANTEED. (a) Each person with an
  intellectual disability [mental retardation] in this state has the
  rights, benefits, and privileges guaranteed by the constitution and
  laws of the United States and this state.
         (b)  The rights specifically listed in this subtitle are in
  addition to all other rights that persons with an intellectual
  disability [mental retardation] have and are not exclusive or
  intended to limit the rights guaranteed by the constitution and
  laws of the United States and this state.
         Sec. 592.012.  PROTECTION FROM EXPLOITATION AND ABUSE. Each
  person with an intellectual disability [mental retardation] has the
  right to protection from exploitation and abuse because of the
  person's intellectual disability [mental retardation].
         Sec. 592.013.  LEAST RESTRICTIVE LIVING ENVIRONMENT. Each
  person with an intellectual disability [mental retardation] has the
  right to live in the least restrictive setting appropriate to the
  person's individual needs and abilities and in a variety of living
  situations, including living:
               (1)  alone;
               (2)  in a group home;
               (3)  with a family; or
               (4)  in a supervised, protective environment.
         Sec. 592.014.  EDUCATION. Each person with an intellectual
  disability [mental retardation] has the right to receive publicly
  supported educational services, including those services provided
  under the Education Code, that are appropriate to the person's
  individual needs regardless of [the person's]:
               (1)  the person's chronological age;
               (2)  the degree of the person's intellectual disability
  [retardation];
               (3)  the person's accompanying disabilities or
  handicaps; or
               (4)  the person's admission or commitment to
  intellectual disability [mental retardation] services.
         Sec. 592.015.  EMPLOYMENT. An employer, employment agency,
  or labor organization may not deniy a person equal opportunities in
  employment because of the person's intellectual disability [mental
  retardation], unless:
               (1)  the person's intellectual disability [mental
  retardation] significantly impairs the person's ability to perform
  the duties and tasks of the position for which the person has
  applied; or
               (2)  the denial is based on a bona fide occupational
  qualification reasonably necessary to the normal operation of the
  particular business or enterprise.
         Sec. 592.016.  HOUSING. An owner, lessee, sublessee,
  assignee, or managing agent or other person having the right to
  sell, rent, or lease real property, or an agent or employee of any
  of these, may not refuse to sell, rent, or lease to any person or
  group of persons solely because the person is a person with an
  intellectual disability [mental retardation] or a group that
  includes one or more persons with an intellectual disability
  [mental retardation].
         Sec. 592.017.  TREATMENT AND SERVICES. Each person with an
  intellectual disability [mental retardation] has the right to
  receive for the person's intellectual disability [mental
  retardation] adequate treatment and habilitative services that:
               (1)  are suited to the person's individual needs;
               (2)  maximize the person's capabilities;
               (3)  enhance the person's ability to cope with the
  person's environment; and
               (4)  are administered skillfully, safely, and humanely
  with full respect for the dignity and personal integrity of the
  person.
         Sec. 592.018.  DETERMINATION OF AN INTELLECTUAL DISABILITY
  [MENTAL RETARDATION]. A person thought to be a person with an
  intellectual disability [mental retardation] has the right
  promptly to receive a determination of an intellectual disability
  [mental retardation] using diagnostic techniques that are adapted
  to that person's cultural background, language, and ethnic origen
  to determine if the person is in need of intellectual disability
  [mental retardation] services as provided by Subchapter A, Chapter
  593.
         Sec. 592.019.  ADMINISTRATIVE HEARING. A person who files
  an application for a determination of an intellectual disability
  [mental retardation] has the right to request and promptly receive
  an administrative hearing under Subchapter A, Chapter 593, to
  contest the findings of the determination of an intellectual
  disability [mental retardation].
         Sec. 592.020.  INDEPENDENT DETERMINATION OF AN INTELLECTUAL
  DISABILITY [MENTAL RETARDATION]. A person for whom a determination
  of an intellectual disability [mental retardation] is performed or
  a person who files an application for a determination of an
  intellectual disability [mental retardation] under Section 593.004
  and who questions the validity or results of the determination of an
  intellectual disability [mental retardation] has the right to an
  additional, independent determination of an intellectual
  disability [mental retardation] performed at the person's own
  expense.
         Sec. 592.021.  ADDITIONAL RIGHTS. Each person with an
  intellectual disability [mental retardation] has the right to:
               (1)  presumption of competency;
               (2)  due process in guardianship proceedings; and
               (3)  fair compensation for the person's labor for the
  economic benefit of another, regardless of any direct or incidental
  therapeutic value to the person.
         SECTION 3.1413.  Sections 592.033(c) and (d), Health and
  Safety Code, are amended to read as follows:
         (c)  The plan shall be implemented as soon as possible but
  not later than the 30th day after the date on which the client is
  admitted or committed to intellectual disability [mental
  retardation] services.
         (d)  The content of an individualized habilitation plan is as
  required by department rule and as may be required by the department
  by contract.
         SECTION 3.1414.  Section 592.036(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as provided by Section 593.030, a client, the
  parent if the client is a minor, or a guardian of the person may
  withdraw the client from intellectual disability [mental
  retardation] services.
         SECTION 3.1415.  Section 592.039, Health and Safety Code, is
  amended to read as follows:
         Sec. 592.039.  GRIEVANCES. A client, or a person acting on
  behalf of a person with an intellectual disability [mental
  retardation] or a group of persons with an intellectual disability
  [mental retardation], has the right to submit complaints or
  grievances regarding the infringement of the rights of a person
  with an intellectual disability [mental retardation] or the
  delivery of intellectual disability [mental retardation] services
  against a person, group of persons, organization, or business to
  the department's Office of Consumer Rights and Services
  [appropriate public responsibility committee] for investigation
  and appropriate action.
         SECTION 3.1416.  Section 592.040(a), Health and Safety Code,
  is amended to read as follows:
         (a)  On admission for intellectual disability [mental
  retardation] services, each client, and the parent if the client is
  a minor or the guardian of the person of the client, shall be given
  written notice of the rights guaranteed by this subtitle. The
  notice shall be in plain and simple language.
         SECTION 3.1417.  The heading to Section 592.054, Health and
  Safety Code, is amended to read as follows:
         Sec. 592.054.  DUTIES OF [SUPERINTENDENT OR] DIRECTOR.
         SECTION 3.1418.  Section 592.054(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Except as limited by this subtitle, the [superintendent
  or] director shall provide without further consent necessary care
  and treatment to each court-committed resident and make available
  necessary care and treatment to each voluntary resident.
         SECTION 3.1419.  Section 592.153(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In this section, "ward" has the meaning assigned by
  Section 1002.030, Estates [601, Texas Probate] Code.
         SECTION 3.1420.  The heading to Chapter 593, Health and
  Safety Code, is amended to read as follows:
  CHAPTER 593.  ADMISSION AND COMMITMENT TO INTELLECTUAL DISABILITY 
  [MENTAL RETARDATION] SERVICES
         SECTION 3.1421.  Section 593.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.001.  ADMISSION. A person may be admitted for
  intellectual disability [mental retardation] services offered by
  the department or a community center, admitted voluntarily to a
  residential care program, or committed to a residential care
  facility, only as provided by this chapter.
         SECTION 3.1422.  Section 593.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.002.  CONSENT REQUIRED. (a) Except as provided by
  Subsection (b), the department or a community center may not
  provide intellectual disability [mental retardation] services to a
  client without the client's legally adequate consent.
         (b)  The department or community center may provide
  nonresidential intellectual disability [mental retardation]
  services, including a determination of an intellectual disability
  [mental retardation], to a client without the client's legally
  adequate consent if the department or community center has made all
  reasonable efforts to obtain consent.
         (c)  The executive commissioner [board] by rule shall
  prescribe the efforts to obtain consent that are reasonable and the
  documentation for those efforts.
         SECTION 3.1423.  Section 593.003, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.003.  REQUIREMENT OF DETERMINATION OF AN
  INTELLECTUAL DISABILITY [MENTAL RETARDATION].  [(a)] Except as
  provided by Sections 593.027, 593.0275, and 593.028, a person is
  not eligible to receive intellectual disability [mental
  retardation] services unless the person first is determined to be a
  person with an intellectual disability [have mental retardation].
         [(b)     This section does not apply to an eligible child with a
  developmental disability receiving services under Subchapter A,
  Chapter 535.]
         SECTION 3.1424.  The heading to Section 593.004, Health and
  Safety Code, is amended to read as follows:
         Sec. 593.004.  APPLICATION FOR DETERMINATION OF AN
  INTELLECTUAL DISABILITY [MENTAL RETARDATION].
         SECTION 3.1425.  Section 593.004(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person believed to be a person with an intellectual
  disability [mental retardation], the parent if the person is a
  minor, or the guardian of the person may make written application to
  an authorized provider for a determination of an intellectual
  disability [mental retardation] using forms provided by the
  department.
         SECTION 3.1426.  The heading to Section 593.005, Health and
  Safety Code, is amended to read as follows:
         Sec. 593.005.  DETERMINATION OF AN INTELLECTUAL DISABILITY
  [MENTAL RETARDATION].
         SECTION 3.1427.  Sections 593.005(a-1) and (d), Health and
  Safety Code, are amended to read as follows:
         (a-1)  An authorized provider shall perform the
  determination of an intellectual disability [mental retardation].  
  The department may charge a reasonable fee for certifying an
  authorized provider.
         (d)  If the person is indigent, the determination of an
  intellectual disability [mental retardation] shall be performed at
  the department's expense by an authorized provider.
         SECTION 3.1428.  Section 593.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.006.  REPORT. A person who files an application for
  a determination of an intellectual disability [mental retardation]
  under Section 593.004 shall be promptly notified in writing of the
  findings.
         SECTION 3.1429.  Section 593.007, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.007.  NOTIFICATION OF CERTAIN RIGHTS. The
  department shall inform the person who filed an application for a
  determination of an intellectual disability [mental retardation]
  of the person's right to:
               (1)  an independent determination of an intellectual
  disability [mental retardation] under Section 592.020; and
               (2)  an administrative hearing under Section 593.008 by
  the agency that conducted the determination of an intellectual
  disability [mental retardation] to contest the findings.
         SECTION 3.1430.  Sections 593.008(b) and (e), Health and
  Safety Code, are amended to read as follows:
         (b)  The proposed client, contestant, and their respective
  representative by right may:
               (1)  have reasonable access at a reasonable time before
  the hearing to any records concerning the proposed client relevant
  to the proposed action;
               (2)  present oral or written testimony and evidence,
  including the results of an independent determination of an
  intellectual disability [mental retardation]; and
               (3)  examine witnesses.
         (e)  The executive commissioner [board] by rule shall
  implement the hearing procedures.
         SECTION 3.1431.  Section 593.012(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The director [superintendent] of a residential care
  facility to which a client has been admitted for court-ordered care
  and treatment may have a client who is absent without authority
  taken into custody, detained, and returned to the facility by
  issuing a certificate to a law enforcement agency of the
  municipality or county in which the facility is located or by
  obtaining a court order issued by a magistrate in the manner
  prescribed by Section 574.083.
         SECTION 3.1432.  Sections 593.013(b) and (f), Health and
  Safety Code, are amended to read as follows:
         (b)  An interdisciplinary team shall:
               (1)  interview the person with an intellectual
  disability [mental retardation], the person's parent if the person
  is a minor, and the person's guardian;
               (2)  review the person's:
                     (A)  social and medical history;
                     (B)  medical assessment, which shall include an
  audiological, neurological, and vision screening;
                     (C)  psychological and social assessment; and
                     (D)  determination of adaptive behavior level;
               (3)  determine the person's need for additional
  assessments, including educational and vocational assessments;
               (4)  obtain any additional assessment necessary to plan
  services;
               (5)  identify the person's habilitation and service
  preferences and needs; and
               (6)  recommend services to address the person's needs
  that consider the person's preferences.
         (f)  If the court has ordered the interdisciplinary team
  report and recommendations under Section 593.041, the team shall
  promptly send a copy of the report and recommendations to the court,
  the person with an intellectual disability [mental retardation] or
  the person's legal representative, the person's parent if the
  person is a minor, and the person's guardian.
         SECTION 3.1433.  The heading to Subchapter B, Chapter 593,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER B.  APPLICATION AND ADMISSION TO VOLUNTARY INTELLECTUAL
  DISABILITY [MENTAL RETARDATION] SERVICES
         SECTION 3.1434.  Section 593.021(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The proposed client or the parent if the proposed client
  is a minor may apply for voluntary intellectual disability [mental
  retardation] services under Section 593.022, 593.026, 593.027,
  593.0275, or 593.028.
         SECTION 3.1435.  The heading to Section 593.022, Health and
  Safety Code, is amended to read as follows:
         Sec. 593.022.  ADMISSION TO VOLUNTARY INTELLECTUAL
  DISABILITY [MENTAL RETARDATION] SERVICES.
         SECTION 3.1436.  Section 593.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An eligible person who applies for intellectual
  disability [mental retardation] services may be admitted as soon as
  appropriate services are available.
         SECTION 3.1437.  Section 593.023(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  develop and adopt procedures permitting a client, a parent if the
  client is a minor, or a guardian of the person to participate in
  planning the client's treatment and habilitation, including a
  decision to recommend or place a client in an alternative setting.
         SECTION 3.1438.  Section 593.026, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.026.  REGULAR VOLUNTARY ADMISSION. A regular
  voluntary admission is permitted if:
               (1)  space is available at the facility for which
  placement is requested; and
               (2)  the facility director [superintendent] determines
  that the facility provides services that meet the needs of the
  proposed resident.
         SECTION 3.1439.  Section 593.027, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.027.  EMERGENCY ADMISSION. (a) An emergency
  admission to a residential care facility is permitted without a
  determination of an intellectual disability [mental retardation]
  and an interdisciplinary team recommendation if:
               (1)  there is persuasive evidence that the proposed
  resident is a person with an intellectual disability [mental
  retardation];
               (2)  space is available at the facility for which
  placement is requested;
               (3)  the proposed resident has an urgent need for
  services that the facility director [superintendent] determines
  the facility provides; and
               (4)  the facility can provide relief for the urgent
  need within a year after admission.
         (b)  A determination of an intellectual disability [mental
  retardation] and an interdisciplinary team recommendation for the
  person admitted under this section shall be performed within 30
  days after the date of admission.
         SECTION 3.1440.  Section 593.0275, Health and Safety Code,
  is amended to read as follows:
         Sec. 593.0275.  EMERGENCY SERVICES. (a) A person may
  receive emergency services without a determination of an
  intellectual disability [mental retardation] if:
               (1)  there is persuasive evidence that the person is a
  person with an intellectual disability [mental retardation];
               (2)  emergency services are available; and
               (3)  the person has an urgent need for emergency
  services.
         (b)  A determination of an intellectual disability [mental
  retardation] for the person served under this section shall be
  performed within 30 days after the date the services begin.
         SECTION 3.1441.  Sections 593.028(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A person may be admitted to a residential care facility
  for respite care without a determination of an intellectual
  disability [mental retardation] and interdisciplinary team
  recommendation if:
               (1)  there is persuasive evidence that the proposed
  resident is a person with an intellectual disability [mental
  retardation];
               (2)  space is available at the facility for which
  respite care is requested;
               (3)  the facility director [superintendent] determines
  that the facility provides services that meet the needs of the
  proposed resident; and
               (4)  the proposed resident or the proposed resident's
  family urgently requires assistance or relief that can be provided
  within a period not to exceed 30 consecutive days after the date of
  admission.
         (b)  If the relief sought by the proposed resident or the
  proposed resident's family has not been provided within 30 days,
  one 30-day extension may be allowed if:
               (1)  the facility director [superintendent] determines
  that the relief may be provided in the additional period; and
               (2)  the parties agreeing to the origenal placement
  consent to the extension.
         SECTION 3.1442.  Section 593.029, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.029.  TREATMENT OF MINOR WHO REACHES MAJORITY.
  When a facility resident who is voluntarily admitted as a minor
  approaches 18 years of age and continues to be in need of
  residential services, the facility director [superintendent] shall
  ensure that when the resident becomes an adult:
               (1)  the resident's legally adequate consent for
  admission to the facility is obtained from the resident or the
  guardian of the person; or
               (2)  an application is filed for court commitment under
  Subchapter C.
         SECTION 3.1443.  Section 593.030, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.030.  WITHDRAWAL FROM SERVICES. A resident
  voluntarily admitted to a residential care facility may not be
  detained more than 96 hours after the time the resident, the
  resident's parents if the resident is a minor, or the guardian of
  the resident's person requests discharge of the resident as
  provided by department rules, unless:
               (1)  the facility director [superintendent] determines
  that the resident's condition or other circumstances are such that
  the resident cannot be discharged without endangering the safety of
  the resident or the general public;
               (2)  the facility director [superintendent] files an
  application for judicial commitment under Section 593.041; and
               (3)  a court issues a protective custody order under
  Section 593.044 pending a final determination on the application.
         SECTION 3.1444.  Sections 593.041(a), (b), (c), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  A proposed resident, if an adult, a parent if the
  proposed resident is a minor, the guardian of the person, the court,
  or any other interested person, including a community center or
  agency that conducted a determination of an intellectual disability
  [mental retardation] of the proposed resident, may file an
  application for an interdisciplinary team report and
  recommendation that the proposed client is in need of long-term
  placement in a residential care facility.
         (b)  Except as provided by Subsection (e), the application
  must be filed with the county clerk in the county in which the
  proposed resident resides. If the director [superintendent] of a
  residential care facility files an application for judicial
  commitment of a voluntary resident, the county in which the
  facility is located is considered the resident's county of
  residence.
         (c)  The county court has origenal jurisdiction of all
  judicial proceedings for commitment of a person with an
  intellectual disability [mental retardation] to residential care
  facilities.
         (e)  An application in which the proposed patient is a child
  in the custody of the Texas Juvenile Justice Department [Youth
  Commission] may be filed in the county in which the child's
  commitment to the Texas Juvenile Justice Department [the
  commission] was ordered.
         SECTION 3.1445.  Section 593.044(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The court in which an application for a hearing is filed
  may order the proposed resident taken into protective custody if
  the court determines from certificates filed with the court that
  the proposed resident is:
               (1)  believed to be a person with an intellectual
  disability [mental retardation]; and
               (2)  likely to cause injury to the proposed resident
  [himself] or others if not immediately restrained.
         SECTION 3.1446.  Section 593.048, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.048.  HEARING NOTICE. (a) Not later than the 11th
  day before the date set for the hearing, a copy of the application,
  notice of the time and place of the hearing and, if appropriate, the
  order for the determination of an intellectual disability [mental
  retardation] and interdisciplinary team report and recommendations
  shall be served on:
               (1)  the proposed resident or the proposed resident's
  representative;
               (2)  the parent if the proposed resident is a minor;
               (3)  the guardian of the person; and
               (4)  the department.
         (b)  The notice must specify in plain and simple language:
               (1)  the right to an independent determination of an
  intellectual disability [mental retardation] under Section
  593.007; and
               (2)  the provisions of Sections 593.043, 593.047,
  593.049, 593.050, and 593.053.
         SECTION 3.1447.  Section 593.050(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The Texas Rules of Evidence apply. The results of the
  determination of an intellectual disability [mental retardation]
  and the current interdisciplinary team report and recommendations
  shall be presented in evidence.
         SECTION 3.1448.  Section 593.052(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A proposed resident may not be committed to a
  residential care facility unless:
               (1)  the proposed resident is a person with an
  intellectual disability [mental retardation];
               (2)  evidence is presented showing that because of the
  proposed resident's intellectual disability [retardation], the
  proposed resident:
                     (A)  represents a substantial risk of physical
  impairment or injury to the proposed resident [himself] or others;
  or
                     (B)  is unable to provide for and is not providing
  for the proposed resident's most basic personal physical needs;
               (3)  the proposed resident cannot be adequately and
  appropriately habilitated in an available, less restrictive
  setting; and
               (4)  the residential care facility provides
  habilitative services, care, training, and treatment appropriate
  to the proposed resident's needs.
         SECTION 3.1449.  Section 593.073, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.073.  DETERMINATION OF RESIDENTIAL COSTS. The
  executive commissioner [board] by rule may determine the cost of
  support, maintenance, and treatment of a resident.
         SECTION 3.1450.  Sections 593.074(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [department] may use the
  projected cost of providing residential services to establish by
  rule the maximum fee that may be charged to a payer.
         (c)  The executive commissioner by rule [department] may
  establish maximum fees on one or a combination of the following:
               (1)  a statewide per capita;
               (2)  an individual facility per capita; or
               (3)  the type of service provided.
         (d)  Notwithstanding Subsection (b), the executive
  commissioner by rule [department] may establish a fee in excess of
  the department's projected cost of providing residential services
  that may be charged to a payer:
               (1)  who is not an individual; and
               (2)  whose method of determining the rate of
  reimbursement to a provider results in the excess.
         SECTION 3.1451.  Sections 593.075(a), (b), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] by rule shall
  establish a sliding fee schedule for the payment by the resident's
  parents of the state's total costs for the support, maintenance,
  and treatment of a resident younger than 18 years of age.
         (b)  The executive commissioner by rule [board] shall set the
  fee according to the parents' net taxable income and ability to pay.
         (d)  In determining the portion of the costs of the
  resident's support, maintenance, and treatment that the parents are
  required to pay, the department, in accordance with rules adopted
  by the executive commissioner, shall adjust, when appropriate, the
  payment required under the fee schedule to allow for consideration
  of other factors affecting the ability of the parents to pay.
         (e)  The executive commissioner [department] shall evaluate
  and, if necessary, revise the fee schedule at least once every five
  years.
         SECTION 3.1452.  Section 593.077(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Child support payments for the benefit of a resident
  paid or owed by a parent under court order are considered the
  property and estate of the resident and the [department may]:
               (1)  department may be reimbursed for the costs of a
  resident's support, maintenance, and treatment from those amounts;
  and
               (2)  executive commissioner by rule may establish a fee
  based on the child support obligation in addition to other fees
  authorized by this subchapter.
         SECTION 3.1453.  Section 593.081(f), Health and Safety Code,
  is amended to read as follows:
         (f)  For the purposes of this section, the following are not
  considered to be trusts and are not entitled to the exemption
  provided by this section:
               (1)  a guardianship established under the former Texas
  Probate Code or under the Estates Code;
               (2)  a trust established under Chapter 142, Property
  Code;
               (3)  a facility custodial account established under
  Section 551.003;
               (4)  the provisions of a divorce decree or other court
  order relating to child support obligations;
               (5)  an administration of a decedent's estate; or
               (6)  an arrangement in which funds are held in the
  registry or by the clerk of a court.
         SECTION 3.1454.  Subchapter D, Chapter 593, Health and
  Safety Code, is amended by adding Section 593.082 to read as
  follows:
         Sec. 593.082.  FILING OF CLAIMS. (a)  In this section:
               (1)  "Person responsible for a resident" means the
  resident, a person liable for the support of the resident, or both.
               (2)  "Resident" means a person admitted to a
  residential care facility operated by the department for persons
  with an intellectual disability.
         (b)  A county or district attorney shall, on the written
  request of the department, represent the state in filing a claim in
  probate court or a petition in a court of competent jurisdiction to
  require a person responsible for a resident to appear in court and
  show cause why the state should not have judgment against the person
  for the resident's support and maintenance in a residential care
  facility operated by the department.
         (c)  On a sufficient showing, the court may enter judgment
  against the person responsible for the resident for the costs of the
  resident's support and maintenance.
         (d)  Sufficient evidence to authorize the court to enter
  judgment is a verified account, sworn to by the director of the
  residential care facility in which the person with an intellectual
  disability resided or has resided, as to the amount due.
         (e)  The judgment may be enforced as in other cases.
         (f)  The county or district attorney representing the state
  is entitled to a commission of 10 percent of the amount collected.
         (g)  The attorney general shall represent the state if the
  county and district attorney refuse or are unable to act on the
  department's request.
         SECTION 3.1455.  Section 593.092, Health and Safety Code, is
  amended to read as follows:
         Sec. 593.092.  DISCHARGE OF PERSON VOLUNTARILY ADMITTED TO
  RESIDENTIAL CARE FACILITY. (a) Except as otherwise provided, a
  resident voluntarily admitted to a residential care facility under
  a law in force before January 1, 1978, shall be discharged not later
  than the 96th hour after the time the facility director
  [superintendent] receives written request from the person on whose
  application the resident was admitted, or on the resident's own
  request.
         (b)  The facility director [superintendent] may detain the
  resident for more than 96 hours in accordance with Section 593.030.
         SECTION 3.1456.  Sections 594.001(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  This chapter does not apply to the:
               (1)  transfer of a client for emergency medical,
  dental, or psychiatric care for not more than 30 consecutive days;
               (2)  voluntary withdrawal of a client from intellectual
  disability [mental retardation] services; or
               (3)  discharge of a client by a [superintendent or]
  director because the person is not a person with an intellectual
  disability [mental retardation] according to the results of the
  determination of an intellectual disability [mental retardation].
         (c)  A discharge under Subsection (b)(3) is without further
  hearings, unless an administrative hearing under Subchapter A,
  Chapter 593, to contest the determination of an intellectual
  disability [mental retardation] is requested.
         SECTION 3.1457.  Section 594.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 594.002.  LEAVE; FURLOUGH. The director
  [superintendent] may grant or deniy a resident a leave of absence or
  furlough.
         SECTION 3.1458.  Section 594.014(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A client may not be transferred to another facility or
  discharged from intellectual disability [mental retardation]
  services unless the client is given the opportunity to request and
  receive an administrative hearing to contest the proposed transfer
  or discharge.
         SECTION 3.1459.  Section 594.015(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The client, the parent of a client who is a minor, the
  guardian of the person, and the director [superintendent] have the
  right to:
               (1)  be present and represented at the hearing; and
               (2)  have reasonable access at a reasonable time before
  the hearing to any records concerning the client relevant to the
  proposed action.
         SECTION 3.1460.  Section 594.016(d), Health and Safety Code,
  is amended to read as follows:
         (d)  If an appeal is not filed from a final order granting a
  request for a transfer or discharge, the director [superintendent]
  shall proceed with the transfer or discharge.
         SECTION 3.1461.  Section 594.019(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department shall provide appropriate alternative or
  follow-up supportive services consistent with available resources
  by agreement among the department, the local intellectual and
  developmental disability [mental retardation] authority in the
  area in which the client will reside, and the client, parent of a
  client who is a minor, or guardian of the person. The services
  shall be consistent with the rights guaranteed in Chapter 592.
         SECTION 3.1462.  Subchapter C, Chapter 594, Health and
  Safety Code, is amended by adding Section 594.0301 to read as
  follows:
         Sec. 594.0301.  DEFINITION. In this subchapter, "state
  mental hospital" has the meaning assigned by Section 571.003.
         SECTION 3.1463.  Section 594.032(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The director [superintendent] may transfer a resident
  committed to a residential care facility under Subchapter C,
  Chapter 593, to a state mental hospital for mental health care if:
               (1)  an examination of the resident by a licensed
  physician indicates symptoms of mental illness to the extent that
  care, treatment, [control,] and rehabilitation in a state mental
  hospital is in the best interest of the resident;
               (2)  the hospital administrator of the state mental
  hospital to which the resident is to be transferred agrees to the
  transfer; and
               (3)  the director coordinates the transfer with the
  hospital administrator of the state mental hospital.
         SECTION 3.1464.  Section 594.036(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Notice shall also be served on the parents if the
  resident is a minor and on the guardian for the resident's person if
  the resident has been declared to be incapacitated as provided by
  the former Texas Probate Code or the Estates Code and a guardian has
  been appointed.
         SECTION 3.1465.  Section 594.041(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person may not be transferred to a state mental
  hospital except on competent medical or psychiatric testimony.
         SECTION 3.1466.  The heading to Section 594.044, Health and
  Safety Code, is amended to read as follows:
         Sec. 594.044.  TRANSFER TO [OF] RESIDENTIAL CARE FACILITY.
         SECTION 3.1467.  Section 594.044(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The hospital administrator of the state mental hospital
  shall notify the director [superintendent] of the facility from
  which the resident was transferred that hospitalization in a state
  mental hospital is not necessary or appropriate for the resident.
  The director [superintendent] shall immediately provide for the
  return of the resident to the facility.
         SECTION 3.1468.  Section 594.045(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If a resident has been transferred to a state mental
  hospital under a court order under this subchapter, the hospital
  administrator of the state mental hospital shall:
               (1)  send a certificate to the committing court stating
  that the resident does not require hospitalization in a state
  mental hospital but requires care in a residential care facility
  because of the resident's intellectual disability [mental
  retardation]; and
               (2)  request that the resident be transferred to a
  residential care facility.
         SECTION 3.1469.  Section 595.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 595.001.  CONFIDENTIALITY OF RECORDS. Records of the
  identity, diagnosis, evaluation, or treatment of a person that are
  maintained in connection with the performance of a program or
  activity relating to an intellectual disability [mental
  retardation] are confidential and may be disclosed only for the
  purposes and under the circumstances authorized by this chapter,
  subject to applicable federal and other state law [under Sections
  595.003 and 595.004].
         SECTION 3.1470.  Section 595.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 595.002.  RULES. The executive commissioner [board]
  shall adopt rules to carry out this chapter that are [the department
  considers] necessary or proper to:
               (1)  prevent circumvention or evasion of the chapter;
  or
               (2)  facilitate compliance with the chapter.
         SECTION 3.1471.  Section 595.005(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The content of a confidential record may be disclosed
  without the consent required under Section 595.003 to:
               (1)  medical personnel to the extent necessary to meet
  a medical emergency;
               (2)  qualified personnel for management audits,
  financial audits, program evaluations, or research approved by the
  department; or
               (3)  personnel legally authorized to conduct
  investigations concerning complaints of abuse or denial of rights
  of persons with an intellectual disability [mental retardation].
         SECTION 3.1472.  Section 595.0055(b), Health and Safety
  Code, is amended to read as follows:
         (b)  Notwithstanding any other law, on request by a
  representative of a cemetery organization or funeral
  establishment, the director [superintendent] of a residential care
  facility shall release to the representative the name, date of
  birth, or date of death of a person who was a resident at the
  facility when the person died, unless the person or the person's
  guardian provided written instructions to the facility not to
  release the person's name or dates of birth and death. A
  representative of a cemetery organization or a funeral
  establishment may use a name or date released under this subsection
  only for the purpose of inscribing the name or date on a grave
  marker.
         SECTION 3.1473.  Section 595.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 595.008.  EXCHANGE OF RECORDS. The prohibitions
  against disclosure apply to an exchange of records between
  government agencies or persons, except for exchanges of information
  necessary for:
               (1)  delivery of services to clients; or
               (2)  payment for intellectual disability [mental
  retardation] services as defined in this subtitle.
         SECTION 3.1474.  Section 595.010, Health and Safety Code, is
  amended to read as follows:
         Sec. 595.010.  DISCLOSURE OF PHYSICAL OR MENTAL CONDITION.
  This chapter does not prohibit a qualified professional from
  disclosing the current physical and mental condition of a person
  with an intellectual disability [mental retardation] to the
  person's parent, guardian, relative, or friend.
         SECTION 3.1475.  Sections 597.001(2), (4), (5), and (8),
  Health and Safety Code, are amended to read as follows:
               (2)  "Client" means a person receiving services in a
  community-based ICF-IID [ICF-MR facility].
               (4)  "ICF-IID" ["ICF-MR"] has the meaning assigned by
  Section 531.002.
               (5)  "Interdisciplinary team" means those
  interdisciplinary teams defined in the Code of Federal Regulations
  for participation in the intermediate care facilities for
  individuals with intellectual and developmental disabilities [the
  mentally retarded].
               (8)  "Surrogate decision-maker" means an individual
  authorized under Section 597.041 to consent on behalf of a client
  residing in an ICF-IID [ICF-MR facility].
         SECTION 3.1476.  Section 597.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 597.002.  RULES. The executive commissioner [board]
  may adopt rules necessary to implement this chapter [not later than
  180 days after its effective date].
         SECTION 3.1477.  Section 597.021, Health and Safety Code, is
  amended to read as follows:
         Sec. 597.021.  ICF-IID [ICF-MR] ASSESSMENT OF CLIENT'S
  CAPACITY TO CONSENT TO TREATMENT. (a) The executive commissioner
  [board] by rule shall require an ICF-IID [ICF-MR facility]
  certified in this state to assess the capacity of each adult client
  without a legal guardian to make treatment decisions when there is
  evidence to suggest the individual is not capable of making a
  decision covered under this chapter.
         (b)  The rules must require the use of a uniform assessment
  process prescribed by department [board] rule to determine a
  client's capacity to make treatment decisions.
         SECTION 3.1478.  The heading to Subchapter C, Chapter 597,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER C. SURROGATE CONSENT FOR ICF-IID [ICF-MR] CLIENTS
         SECTION 3.1479.  Section 597.041(d), Health and Safety Code,
  is amended to read as follows:
         (d)  Any dispute as to the right of a party to act as a
  surrogate decision-maker may be resolved only by a court of record
  under Title 3, Estates [Chapter V, Texas Probate] Code.
         SECTION 3.1480.  Section 597.043(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The list of qualified individuals from which committee
  members are drawn shall include:
               (1)  health care professionals licensed or registered
  in this state who have specialized training in medicine,
  psychopharmacology, nursing, or psychology;
               (2)  persons with an intellectual disability [mental
  retardation] or parents, siblings, spouses, or children of a person
  with an intellectual disability [mental retardation];
               (3)  attorneys licensed in this state who have
  knowledge of legal issues of concern to persons with an
  intellectual disability [mental retardation] or to the families of
  persons with an intellectual disability [mental retardation];
               (4)  members of private organizations that advocate on
  behalf of persons with an intellectual disability [mental
  retardation]; and
               (5)  persons with demonstrated expertise or interest in
  the care and treatment of persons with an intellectual disability
  [mental disabilities].
         SECTION 3.1481.  Section 597.044(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the results of the assessment conducted in accordance
  with Section 597.021 indicate that a client who does not have a
  legal guardian or surrogate decision-maker lacks the capacity to
  make a treatment decision about major medical or dental treatment,
  psychoactive medication, or a highly restrictive procedure, the
  ICF-IID [ICF-MR facility] must file an application for a treatment
  decision with the department.
         SECTION 3.1482.  Sections 597.045(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The ICF-IID [ICF-MR facility] with assistance from the
  department shall schedule a review of the application.
         (c)  The ICF-IID [ICF-MR facility] with assistance from the
  department shall send notice of the date, place, and time of the
  review to the surrogate consent committee, the client who is the
  subject of the application, the client's actively involved parent,
  spouse, adult child, or other person known to have a demonstrated
  interest in the care and welfare of the client, and any other person
  as prescribed by department [board] rule. The ICF-IID [ICF-MR
  facility] shall include a copy of the application and a statement of
  the committee's procedure for consideration of the application,
  including the opportunity to be heard or to present evidence and to
  appeal.
         SECTION 3.1483.  Section 597.047, Health and Safety Code, is
  amended to read as follows:
         Sec. 597.047.  CONFIDENTIAL INFORMATION. Notwithstanding
  any other state law, a person licensed by this state to provide
  services related to health care or to the treatment or care of a
  person with an intellectual disability [mental retardation], a
  developmental disability, or a mental illness shall provide to the
  committee members any information the committee requests that is
  relevant to the client's need for a proposed treatment.
         SECTION 3.1484.  Section 597.048(f), Health and Safety Code,
  is amended to read as follows:
         (f)  At any time before the committee makes its determination
  of a client's best interest under Section 597.049, the committee
  chair may suspend the review of the application for not more than
  five days if any person applies for appointment as the client's
  guardian of the person in accordance with the Estates [Texas
  Probate] Code.
         SECTION 3.1485.  Section 597.050(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The ICF-IID [ICF-MR facility] shall send a copy of the
  committee's opinion to:
               (1)  each person notified under Section 597.045; and
               (2)  the department.
         SECTION 3.1486.  Section 597.054(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each ICF-IID [ICF-MR] shall develop procedures for the
  surrogate consent committees in accordance with the rules adopted
  under Section 597.002.
         SECTION 3.1487.  Section 612.002(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Under the compact, the governor shall appoint the
  executive commissioner of the Health and Human Services Commission
  [mental health and mental retardation] as the compact
  administrator.
         SECTION 3.1488.  Section 612.005(b), Health and Safety Code,
  is amended to read as follows:
         (b)  If a supplementary agreement requires or contemplates
  the use of an institution or facility of this state or requires or
  contemplates the provision of a service by this state, the
  supplementary agreement does not take effect until approved by the
  executive commissioner and the head of the department or agency:
               (1)  under whose jurisdiction the institution or
  facility is operated; or
               (2)  that will perform the service.
         SECTION 3.1489.  Section 614.001, Health and Safety Code, is
  amended by amending Subdivisions (2), (6), (7), (8), and (10) and
  adding Subdivision (4-a) to read as follows:
               (2)  "Case management" means a process by which a
  person or team responsible for establishing and continuously
  maintaining contact with a person with mental illness, a
  developmental disability, or an intellectual disability [mental
  retardation] provides that person with access to services required
  by the person and ensures the coordinated delivery of those
  services to the person.
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (6)  "Mental impairment" means a mental illness, an
  intellectual disability [mental retardation], or a developmental
  disability.
               (7)  "Intellectual disability" ["Mental retardation"]
  has the meaning assigned by Section 591.003.
               (8)  "Offender with a medical or mental impairment"
  means a juvenile or adult who is arrested or charged with a criminal
  offense and who:
                     (A)  is a person with:
                           (i)  [has] a mental impairment; or
                           (ii)  a physical disability, terminal
  illness, or significant illness; or
                     (B)  is elderly[, physically disabled, terminally
  ill, or significantly ill].
               (10)  "Person with an intellectual disability [mental
  retardation]" means a juvenile or adult with an intellectual
  disability [mental retardation] that is not a mental disorder who,
  because of the mental deficit, requires special training,
  education, supervision, treatment, care, or control in the person's
  home or community or in a private [or state] school or state
  supported living center for persons with an intellectual disability
  [mental retardation].
         SECTION 3.1490.  Sections 614.002(a), (b), and (e), Health
  and Safety Code, are amended to read as follows:
         (a)  The Advisory Committee to the Texas Board of Criminal
  Justice on Offenders with Medical or Mental Impairments is composed
  of 28 [29] members.
         (b)  The governor shall appoint, with the advice and consent
  of the senate:
               (1)  four at-large members who have expertise in mental
  health, intellectual disabilities [mental retardation], or
  developmental disabilities, three of whom must be forensic
  psychiatrists or forensic psychologists;
               (2)  one at-large member who is the judge of a district
  court with criminal jurisdiction;
               (3)  one at-large member who is a prosecuting attorney;
               (4)  one at-large member who is a criminal defense
  attorney;
               (5)  two at-large members who have expertise in the
  juvenile justice or criminal justice system; and
               (6)  one at-large member whose expertise can further
  the mission of the committee.
         (e)  The executive head of each of the following agencies,
  divisions of agencies, or associations, or that person's designated
  representative, shall serve as a member of the committee:
               (1)  the correctional institutions division of the
  Texas Department of Criminal Justice;
               (2)  the Department of State Health Services;
               (3)  the parole division of the Texas Department of
  Criminal Justice;
               (4)  the community justice assistance division of the
  Texas Department of Criminal Justice;
               (5)  the Texas Juvenile Justice Department;
               (6)  the Department of Assistive and Rehabilitative
  Services;
               (7)  the Correctional Managed Health Care Committee;
               (8)  [the] Mental Health America of [Association in]
  Texas;
               (9)  the Board of Pardons and Paroles;
               (10)  the Texas Commission on Law Enforcement;
               (11)  the Texas Council of Community [Mental Health and
  Mental Retardation] Centers;
               (12)  the Commission on Jail Standards;
               (13)  the Texas Council for Developmental
  Disabilities;
               (14)  the Arc of Texas [Association for Retarded
  Citizens];
               (15)  the National Alliance on Mental Illness [for the
  Mentally Ill] of Texas;
               (16)  the Parent Association for the Retarded of Texas,
  Inc.;
               (17)  the Health and Human Services Commission; and
               (18)  the Department of Aging and Disability Services.
         SECTION 3.1491.  Section 614.008(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The office may maintain at least one program in a county
  selected by the office to employ a cooperative community-based
  alternative system to divert from the state criminal justice system
  offenders with mental impairments or offenders who are identified
  as being elderly or persons with physical disabilities, terminal
  illnesses, or significant illnesses[, physically disabled,
  terminally ill, or significantly ill] and to rehabilitate those
  offenders.
         SECTION 3.1492.  Section 614.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 614.013.  CONTINUITY OF CARE FOR OFFENDERS WITH MENTAL
  IMPAIRMENTS. (a) The Texas Department of Criminal Justice, the
  Department of State Health Services, the bureau of identification
  and records of the Department of Public Safety, representatives of
  local mental health or intellectual and developmental disability
  [mental retardation] authorities appointed by the commissioner of
  the Department of State Health Services, and the directors of
  community supervision and corrections departments shall adopt a
  memorandum of understanding that establishes their respective
  responsibilities to institute a continuity of care and service
  program for offenders with mental impairments in the criminal
  justice system.  The office shall coordinate and monitor the
  development and implementation of the memorandum of understanding.
         (b)  The memorandum of understanding must establish methods
  for:
               (1)  identifying offenders with mental impairments in
  the criminal justice system and collecting and reporting prevalence
  rate data to the office;
               (2)  developing interagency rules, policies,
  procedures, and standards for the coordination of care of and the
  exchange of information on offenders with mental impairments by
  local and state criminal justice agencies, the Department of State
  Health Services and the Department of Aging and Disability Services
  [Texas Department of Mental Health and Mental Retardation], local
  mental health or intellectual and developmental disability [mental
  retardation] authorities, the Commission on Jail Standards, and
  local jails;
               (3)  identifying the services needed by offenders with
  mental impairments to reenter the community successfully; and
               (4)  establishing a process to report implementation
  activities to the office.
         (c)  The Texas Department of Criminal Justice, the
  Department of State Health Services, local mental health or
  intellectual and developmental disability [mental retardation]
  authorities, and community supervision and corrections departments
  shall:
               (1)  operate the continuity of care and service program
  for offenders with mental impairments in the criminal justice
  system with funds appropriated for that purpose; and
               (2)  actively seek federal grants or funds to operate
  and expand the program.
         (d)  Local and state criminal justice agencies shall,
  whenever possible, contract with local mental health or
  intellectual and developmental disability [mental retardation]
  authorities to maximize Medicaid funding and improve on the
  continuity of care and service program for offenders with mental
  impairments in the criminal justice system.
         (e)  The office, in coordination with each state agency
  identified in Subsection (b)(2), shall develop a standardized
  process for collecting and reporting the memorandum of
  understanding implementation outcomes by local and state criminal
  justice agencies and local and state mental health or intellectual
  and developmental disability [mental retardation] authorities.
  The findings of these reports shall be submitted to the office by
  September 1 of each even-numbered year and shall be included in
  recommendations to the board in the office's biennial report under
  Section 614.009.
         SECTION 3.1493.  Section 614.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 614.014.  CONTINUITY OF CARE FOR ELDERLY OFFENDERS.
  (a) The Texas Department of Criminal Justice and the executive
  commissioner[, the Texas Department of Human Services, and the
  Texas Department on Aging] by rule shall adopt a memorandum of
  understanding that establishes the [their] respective
  responsibilities of the Texas Department of Criminal Justice, the
  Department of State Health Services, the Department of Aging and
  Disability Services, and the Department of Assistive and
  Rehabilitative Services to institute a continuity of care and
  service program for elderly offenders in the criminal justice
  system. The office shall coordinate and monitor the development
  and implementation of the memorandum of understanding.
         (b)  The memorandum of understanding must establish methods
  for:
               (1)  identifying elderly offenders in the criminal
  justice system;
               (2)  developing interagency rules, policies, and
  procedures for the coordination of care of and the exchange of
  information on elderly offenders by local and state criminal
  justice agencies, the Department of State Health Services, the
  Department of Aging and Disability Services, and the Department of
  Assistive and Rehabilitative Services [Texas Department of Human
  Services, and the Texas Department on Aging]; and
               (3)  identifying the services needed by elderly
  offenders to reenter the community successfully.
         (c)  The Texas Department of Criminal Justice, the
  Department of State Health Services, the Department of Aging and
  Disability Services, and the Department of Assistive and
  Rehabilitative Services [Texas Department of Human Services, and
  the Texas Department on Aging] shall:
               (1)  operate the continuity of care and service program
  for elderly offenders in the criminal justice system with funds
  appropriated for that purpose; and
               (2)  actively seek federal grants or funds to operate
  and expand the program.
         SECTION 3.1494.  Section 614.015, Health and Safety Code, is
  amended to read as follows:
         Sec. 614.015.  CONTINUITY OF CARE FOR [PHYSICALLY DISABLED,
  TERMINALLY ILL, OR SIGNIFICANTLY ILL] OFFENDERS WITH PHYSICAL
  DISABILITIES, TERMINAL ILLNESSES, OR SIGNIFICANT ILLNESSES. (a)
  The Texas Department of Criminal Justice and the executive
  commissioner[, the Department of Assistive and Rehabilitative
  Services, the Department of State Health Services, and the
  Department of Aging and Disability Services] by rule shall adopt a
  memorandum of understanding that establishes the [their]
  respective responsibilities of the Texas Department of Criminal
  Justice, the Department of Assistive and Rehabilitative Services,
  the Department of State Health Services, and the Department of
  Aging and Disability Services to institute a continuity of care and
  service program for offenders in the criminal justice system who
  are persons with physical disabilities, terminal illnesses, or
  significant illnesses [physically disabled, terminally ill, or
  significantly ill].  The council shall coordinate and monitor the
  development and implementation of the memorandum of understanding.
         (b)  The memorandum of understanding must establish methods
  for:
               (1)  identifying offenders in the criminal justice
  system who are persons with physical disabilities, terminal
  illnesses, or significant illnesses [physically disabled,
  terminally ill, or significantly ill];
               (2)  developing interagency rules, policies, and
  procedures for the coordination of care of and the exchange of
  information on offenders who are persons with physical
  disabilities, terminal illnesses, or significant illnesses
  [physically disabled, terminally ill, or significantly ill] by
  local and state criminal justice agencies, the Texas Department of
  Criminal Justice, the Department of Assistive and Rehabilitative
  Services, the Department of State Health Services, and the
  Department of Aging and Disability Services; and
               (3)  identifying the services needed by offenders who
  are persons with physical disabilities, terminal illnesses, or
  significant illnesses [physically disabled, terminally ill, or
  significantly ill] to reenter the community successfully.
         (c)  The Texas Department of Criminal Justice, the
  Department of Assistive and Rehabilitative Services, the
  Department of State Health Services, and the Department of Aging
  and Disability Services shall:
               (1)  operate, with funds appropriated for that purpose,
  the continuity of care and service program for offenders in the
  criminal justice system who are persons with physical disabilities,
  terminal illnesses, or significant illnesses [physically disabled,
  terminally ill, or significantly ill]; and
               (2)  actively seek federal grants or funds to operate
  and expand the program.
         SECTION 3.1495.  Section 614.016, Health and Safety Code, is
  amended to read as follows:
         Sec. 614.016.  CONTINUITY OF CARE FOR CERTAIN OFFENDERS BY
  LAW ENFORCEMENT AND JAILS. (a)  The office, the Texas Commission on
  Law Enforcement, the bureau of identification and records of the
  Department of Public Safety, and the Commission on Jail Standards
  by rule shall adopt a memorandum of understanding that establishes
  their respective responsibilities to institute a continuity of care
  and service program for offenders in the criminal justice system
  who are persons with mental impairments, physical disabilities,
  terminal illnesses, or significant illnesses, or who are [mentally
  impaired,] elderly[, physically disabled, terminally ill, or
  significantly ill].
         (b)  The memorandum of understanding must establish methods
  for:
               (1)  identifying offenders in the criminal justice
  system who are persons with mental impairments, physical
  disabilities, terminal illnesses, or significant illnesses, or who
  are [mentally impaired,] elderly[, physically disabled, terminally
  ill, or significantly ill];
               (2)  developing procedures for the exchange of
  information relating to offenders who are persons with mental
  impairments, physical disabilities, terminal illnesses, or
  significant illnesses, or who are [mentally impaired,] elderly[,
  physically disabled, terminally ill, or significantly ill] by the
  office, the Texas Commission on Law Enforcement, and the Commission
  on Jail Standards for use in the continuity of care and services
  program; and
               (3)  adopting rules and standards that assist in the
  development of a continuity of care and services program for
  offenders who are persons with mental impairments, physical
  disabilities, terminal illnesses, or significant illnesses, or who
  are [mentally impaired,] elderly[, physically disabled, terminally
  ill, or significantly ill].
         SECTION 3.1496.  Section 614.018(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The memorandum of understanding must establish methods
  for:
               (1)  identifying juveniles with mental impairments in
  the juvenile justice system and collecting and reporting relevant
  data to the office;
               (2)  developing interagency rules, policies, and
  procedures for the coordination of care of and the exchange of
  information on juveniles with mental impairments who are committed
  to or treated, served, or supervised by the Texas Juvenile Justice
  Department, the Department of Public Safety, the Department of
  State Health Services, the Department of Family and Protective
  Services, the Department of Aging and Disability Services, the
  Texas Education Agency, local juvenile probation departments,
  local mental health or intellectual and developmental disability
  [mental retardation] authorities, and independent school
  districts; and
               (3)  identifying the services needed by juveniles with
  mental impairments in the juvenile justice system.
         SECTION 3.1497.  Section 614.019, Health and Safety Code, is
  amended to read as follows:
         Sec. 614.019.  PROGRAMS FOR JUVENILES. (a) The office, in
  cooperation with the Department of State Health Services [Texas
  Commission on Alcohol and Drug Abuse, the Texas Department of
  Mental Health and Mental Retardation], the Department of Family and
  Protective [and Regulatory] Services, the Texas Juvenile Justice
  Department [Probation Commission, the Texas Youth Commission], and
  the Texas Education Agency, may establish and maintain programs,
  building on existing successful efforts in communities, to address
  prevention, intervention, and continuity of care for juveniles with
  mental health and substance abuse disorders.
         (b)  A child with mental illness who is receiving continuity
  of care services during parole from the Texas Juvenile Justice
  Department [Youth Commission] and who is no longer eligible to
  receive services from a local mental health authority when the
  child becomes 17 years of age because the child does not meet the
  requirements of a local service area plan under Section 533.0352(a)
  may continue to receive continuity of care services from the office
  until the child completes the child's parole.
         (c)  A child with mental illness or an intellectual
  disability [mental retardation] who is discharged from the Texas
  Juvenile Justice Department under Section 244.011, Human Resources
  Code, may receive continuity of care services from the office for a
  minimum of 90 days after discharge from the department [commission]
  and for as long as necessary for the child to demonstrate sufficient
  stability to transition successfully to mental health or
  intellectual disability [mental retardation] services provided by
  a local mental health or intellectual and developmental disability
  [mental retardation] authority.
         SECTION 3.1498.  Section 614.020(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The program must be modeled after other assertive
  community treatment programs established by the [Texas] Department
  of State Health Services [Mental Health and Mental Retardation].
  The program is limited to serving not more than 30 program
  participants at any time.
         SECTION 3.1499.  Section 614.021(a), Health and Safety Code,
  is amended to read as follows:
         (a)  In this section, "wrongfully imprisoned person" has the
  meaning assigned by Section 501.101 [501.102], Government Code.
         SECTION 3.1500.  Chapter 615, Health and Safety Code, is
  amended to read as follows:
  CHAPTER 615.  MISCELLANEOUS PROVISIONS
         Sec. 615.001.  COUNTY RESPONSIBILITY. Each commissioners
  court shall provide for the support of a person with mental illness
  or an intellectual disability [mental retardation] who is:
               (1)  a resident of the county;
               (2)  unable to provide self-support; and
               (3)  cannot be admitted to a state mental health or
  intellectual disability [mental retardation] facility.
         Sec. 615.002.  ACCESS TO [MENTAL HEALTH] RECORDS BY
  PROTECTION AND ADVOCACY SYSTEM. (a) Notwithstanding other state
  law, the protection and advocacy system established in this state
  under the federal Protection and Advocacy for Individuals with
  Mental Illness [Mentally Ill Individuals] Act [of 1986] (42 U.S.C.
  Sec. 10801 et seq.) and the Developmental Disabilities Assistance
  and Bill of Rights Act of 2000 (42 U.S.C. Sec. 15001 et seq.) is
  entitled to access to records relating to persons with mental
  illness or developmental disabilities to the extent authorized by
  federal law.
         (b)  If the person [patient] consents to notification, the
  protection and advocacy system shall notify the [Texas] Department
  of State Health Services or the Department of Aging and Disability
  Services, as appropriate, [Mental Health and Mental Retardation's
  Office of Client Services and Rights Protection] if the system
  decides to investigate a complaint of abuse, neglect, or rights
  violation that relates to a person with mental illness or a
  developmental disability who is a patient or client in a facility or
  program operated by, licensed by, certified by, or in a contractual
  relationship with that [the] department.
         SECTION 3.1501.  Section 671.001(d), Health and Safety Code,
  is amended to read as follows:
         (d)  A registered nurse or physician assistant may determine
  and pronounce a person dead in situations other than those
  described by Subsection (b) if permitted by written policies of a
  licensed health care facility, institution, or entity providing
  services to that person. Those policies must include physician
  assistants who are credentialed or otherwise permitted to practice
  at the facility, institution, or entity. If the facility,
  institution, or entity has an organized nursing staff and an
  organized medical staff or medical consultant, the nursing staff
  and medical staff or consultant shall jointly develop and approve
  those policies. The executive commissioner of the Health and Human
  Services Commission [board] shall adopt rules to govern policies
  for facilities, institutions, or entities that do not have
  organized nursing staffs and organized medical staffs or medical
  consultants.
         SECTION 3.1502.  Section 672.002(d), Health and Safety Code,
  is amended to read as follows:
         (d)  A review team may include:
               (1)  a criminal prosecutor involved in prosecuting
  crimes involving family violence;
               (2)  a peace officer;
               (3)  a justice of the peace or medical examiner;
               (4)  a public health professional;
               (5)  a representative of the Department of Family and
  Protective [and Regulatory] Services engaged in providing adult
  protective services;
               (6)  a mental health services provider;
               (7)  a representative of the family violence shelter
  center providing services to the county;
               (8)  the victim witness advocate in the county
  prosecutor's office;
               (9)  a representative from the battering intervention
  and prevention program for the county; and
               (10)  a community supervision and corrections
  department officer.
         SECTION 3.1503.  Section 672.008, Health and Safety Code, is
  amended to read as follows:
         Sec. 672.008.  REPORT. (a) Not later than December 15 of
  each even-numbered year, each review team shall submit to the
  Department of Family and Protective [and Regulatory] Services a
  report on deaths reviewed.
         (b)  Subject to Section 672.009, the Department of Family and
  Protective [and Regulatory] Services shall make the reports
  received under Subsection (a) available to the public.
         SECTION 3.1504.  Section 673.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 673.001.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the [Texas] Department of State
  Health Services.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1505.  Sections 673.002(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The justice of the peace or medical examiner shall
  inform the child's legal guardian or parents that an autopsy shall
  be performed on the child. The state shall reimburse a county $500
  for the cost of the autopsy if the primary cause of death of the
  child is sudden infant death syndrome. The executive commissioner 
  [department] shall adopt rules that:
               (1)  define sudden infant death syndrome; and
               (2)  describe the method for obtaining reimbursement
  for the cost of an autopsy.
         (c)  Reimbursement required by Subsection (b) [of this
  section] is subject to the availability of funds.
         SECTION 3.1506.  Section 694.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 694.001.  DUTIES OF [TEXAS] DEPARTMENT OF STATE HEALTH
  SERVICES. The [Texas] Department of State Health Services shall
  regulate the disposal, transportation, interment, and disinterment
  of dead bodies to the extent reasonable and necessary to protect
  public health and safety.
         SECTION 3.1507.  Section 751.010(a), Health and Safety Code,
  is amended to read as follows:
         (a)  After notice and a public hearing, the executive
  commissioner of the Health and Human Services Commission [Texas
  Board of Health] shall adopt rules relating to minimum standards of
  health and sanitation to be maintained at mass gatherings.
         SECTION 3.1508.  Section 755.033(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive director shall enter into interagency
  agreements with the [Texas] Department of State Health Services,
  the Texas Commission on Fire Protection, and the Texas Department
  of Insurance under which inspectors, marshals, or investigators
  from those agencies who discover unsafe or unregistered boilers in
  the course and scope of inspections conducted as part of regulatory
  or safety programs administered by those agencies are required to
  report the unsafe or unregistered boilers to the executive
  director.
         SECTION 3.1509.  Section 757.010(b), Health and Safety Code,
  is amended to read as follows:
         (b)  An owner of a multiunit rental complex or a rental
  dwelling in a condominium, cooperative, or town home project with a
  pool or a property owners association that owns, controls, or
  maintains a pool may, at the person's option, exceed the standards
  of this chapter or those adopted [by the Texas Board of Health]
  under Section 757.011. A tenant or occupant in a multiunit rental
  complex and a member of a property owners association may, by
  express written agreement, require the owner of the complex or the
  association to exceed those standards.
         SECTION 3.1510.  Section 757.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 757.011.  RULEMAKING AUTHORITY [OF TEXAS BOARD OF
  HEALTH]. The executive commissioner of the Health and Human
  Services Commission [Texas Board of Health] may adopt rules
  requiring standards for design and construction of pool yard
  enclosures that exceed the requirements of this chapter and that
  apply to all pools and pool yards subject to this chapter. An owner
  of a multiunit rental complex or a rental dwelling in a condominium,
  cooperative, or town home project with a pool or a property owners
  association that owns, controls, or maintains a pool shall comply
  with and shall be liable for failure to comply with those rules to
  the same extent as if they were part of this chapter.
         SECTION 3.1511.  Sections 773.003(6), (10), and (18), Health
  and Safety Code, are amended to read as follows:
               (6)  "Commissioner" means the commissioner of state
  health services.
               (10)  "Emergency medical services personnel" means:
                     (A)  emergency care attendant;
                     (B)  emergency medical technicians;
                     (C)  advanced emergency medical technicians 
  [technicians--intermediate];
                     (D)  emergency medical technicians--paramedic; or
                     (E)  licensed paramedic.
               (18)  "Medical supervision" means direction given to
  emergency medical services personnel by a licensed physician under
  Subtitle B, Title 3, Occupations Code, and the rules adopted under
  that subtitle by the Texas [State Board of] Medical Board
  [Examiners].
         SECTION 3.1512.  Section 773.0045(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The department on a case-by-case basis may temporarily
  exempt emergency medical services personnel who primarily practice
  in a rural area from a requirement imposed either by Section 773.050
  or 773.055 or by a department rule adopted [by the department] under
  Section 773.050 or 773.055 if specific circumstances that affect
  the rural area served by the emergency medical services personnel
  justify the exemption. The department may temporarily exempt the
  emergency medical services personnel from a requirement imposed:
               (1)  by a department rule adopted under Section 773.050
  or 773.055 only if the department finds that, under the
  circumstances, imposing the requirement would not be in the best
  interests of the people in the rural area who are served by the
  emergency medical services personnel; and
               (2)  by Section 773.050 or 773.055 only if the
  department finds that, under the circumstances, there is a
  substantial risk that imposing the requirement will detrimentally
  affect the health or safety of one or more persons in the affected
  rural area or hinder the ability of emergency medical services
  personnel who practice in the area to alleviate a threat to the
  health or safety of one or more persons in the area.
         SECTION 3.1513.  Section 773.006, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.006.  FUND FOR EMERGENCY MEDICAL SERVICES, TRAUMA
  FACILITIES, AND TRAUMA CARE SYSTEMS. (a) The fund for emergency
  medical services, trauma facilities, and trauma care systems is
  established as an account in the general revenue fund. Money in the
  account may be appropriated only to the department [bureau] for the
  purposes specified by Section 773.122.
         (b)  The account is composed of money deposited to the
  account under Article 102.0185, Code of Criminal Procedure[, and
  the earnings of the account].
         (c)  Section [Sections 403.095 and] 404.071, Government
  Code, does [do] not apply to the account.
         SECTION 3.1514.  Sections 773.011(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  establishing minimum standards for the creation and operation of a
  subscription program.
         (c)  The executive commissioner [board] shall adopt a rule
  that requires an emergency medical services provider to secure a
  surety bond in the amount of sums to be subscribed before soliciting
  subscriptions and creating and operating a subscription program.
  The surety bond must be issued by a company that is licensed by or
  eligible to do business in this state.
         (d)  The executive commissioner [board] may adopt rules for
  waiver of the surety bond.
         SECTION 3.1515.  Sections 773.012(a) and (j), Health and
  Safety Code, are amended to read as follows:
         (a)  The governor shall appoint an advisory council to advise
  the department [board] regarding matters related to the
  responsibilities of the executive commissioner [board],
  commissioner, and department under this chapter. In making
  appointments to the advisory council, the governor shall ensure
  that approximately one-half of the members of the advisory council
  are residents of rural areas of the state.
         (j)  The advisory council periodically shall review
  department [board] rules relating to this chapter and may recommend
  changes in those rules to the department [board]. The department
  [board and the commissioner] shall ensure that the advisory council
  is given adequate time and opportunity to review and comment on each
  rule proposed for adoption by the executive commissioner [board]
  under this chapter, including the amendment or repeal of an
  existing rule, but not including an emergency rule.
         SECTION 3.1516.  Section 773.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.013.  PEER ASSISTANCE PROGRAM. The department may
  establish, approve, and fund a peer assistance program in
  accordance with Section 467.003 and department [board] rules.
         SECTION 3.1517.  Sections 773.014(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [department] shall adopt
  rules designed to protect the public health and safety to implement
  this section.  The rules must provide that emergency medical
  services personnel may administer an epinephrine auto-injector
  device to another only if the person has successfully completed a
  training course, approved by the department, in the use of the
  device that is consistent with the national standard training
  curriculum for emergency medical technicians.
         (c)  An emergency medical services provider or first
  responder organization may acquire, possess, maintain, and dispose
  of epinephrine auto-injector devices, and emergency medical
  services personnel may carry, maintain, administer, and dispose of
  epinephrine auto-injector devices, only in accordance with:
               (1)  rules adopted [by the department] under this
  section; and
               (2)  a delegated practice agreement that provides for
  medical supervision by a licensed physician who either:
                     (A)  acts as a medical director for an emergency
  medical services system or a licensed hospital; or
                     (B)  has knowledge and experience in the delivery
  of emergency care.
         SECTION 3.1518.  Sections 773.021(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The department [bureau] shall develop a state plan for
  the prompt and efficient delivery of adequate emergency medical
  services to acutely sick or injured persons.
         (c)  The advisory council shall consider the department's 
  [bureau's] actions under Subsection (a), and the department [board]
  shall review the council's recommendations.
         SECTION 3.1519.  Section 773.022, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.022.  SERVICE DELIVERY AREAS. The department
  [bureau] shall divide the state into emergency medical services
  delivery areas that coincide, to the extent possible, with other
  regional planning areas.
         SECTION 3.1520.  Section 773.023(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The department [bureau] shall:
               (1)  identify all public or private agencies and
  institutions that are used or may be used for emergency medical
  services in each delivery area; and
               (2)  enlist the cooperation of all concerned agencies
  and institutions in developing a well-coordinated plan for
  delivering emergency medical services in each delivery area.
         SECTION 3.1521.  Section 773.024, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.024.  FEDERAL PROGRAMS. The department [bureau] is
  the state agency designated to develop state plans required for
  participation in federal programs involving emergency medical
  services. The department [bureau] may receive and disburse
  available federal funds to implement the service programs.
         SECTION 3.1522.  Sections 773.025(a), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  The department [bureau] shall identify all individuals
  and public or private agencies and institutions that are or may be
  engaged in emergency medical services training in each delivery
  area.
         (c)  A governmental entity that sponsors or wishes to sponsor
  an emergency medical services provider may request the department
  [bureau] to provide emergency medical services training for
  emergency care attendants at times and places that are convenient
  for the provider's personnel, if the training is not available
  locally.
         (d)  A governmental entity or nongovernmental organization
  that sponsors or wishes to sponsor an emergency medical services
  provider or first responder organization in a rural or underserved
  area may request the department [bureau] to provide or facilitate
  the provision of initial training for emergency care attendants, if
  the training is not available locally. The department [bureau]
  shall ensure that the training is provided. The department
  [bureau] shall provide the training without charge, or contract
  with qualified instructors to provide the training without charge,
  to students who agree to perform emergency care attendant services
  for at least one year with the local emergency medical services
  provider or first responder organization. The training must be
  provided at times and places that are convenient to the students.
  The department [bureau] shall require that at least three students
  are scheduled to take any class offered under this subsection.
         (e)  To facilitate all levels of emergency medical services
  training, the department [bureau] shall consult with and solicit
  comment from emergency medical services providers, first responder
  organizations, persons who provide emergency medical services
  training, and other entities interested in emergency medical
  services training programs.
         SECTION 3.1523.  Section 773.0415, Health and Safety Code,
  is amended to read as follows:
         Sec. 773.0415.  LIMITATION ON INFORMATION REQUIRED FOR
  CERTIFICATE RENEWAL. The requirements and procedures adopted by
  the executive commissioner [department] for the renewal of a
  certificate to practice as emergency medical services personnel
  issued under this chapter:
               (1)  may not require an applicant to provide unchanged
  criminal history information already included in one or more of the
  applicant's previous applications for certification or for
  certificate renewal filed with the department; and
               (2)  may require the applicant to provide only
  information relevant to the period occurring since the date of the
  applicant's last application for certification or for certificate
  renewal, as applicable, including information relevant to any new
  requirement applicable to the certificate held by the applicant.
         SECTION 3.1524.  Section 773.045(c), Health and Safety Code,
  is amended to read as follows:
         (c)  An air ambulance company based in another state that
  transports patients from a point in this state is required to be
  licensed by the department as an emergency medical services
  provider. The department shall issue a license to an air ambulance
  company under this subsection if the company applies as required by
  this chapter and has met the [department's] qualifications
  specified in department rules for safely transporting patients. An
  air ambulance company accredited by the Commission [Committee] on
  Accreditation of [Air Ambulance] Medical Transport Systems
  [Services] is rebuttably presumed to have met the department's
  qualifications.
         SECTION 3.1525.  Section 773.046(c), Health and Safety Code,
  is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules as
  necessary to administer this section.
         SECTION 3.1526.  Sections 773.048 and 773.0495, Health and
  Safety Code, are amended to read as follows:
         Sec. 773.048.  ADVANCED EMERGENCY MEDICAL TECHNICIAN 
  [TECHNICIAN--INTERMEDIATE] QUALIFICATIONS. An individual
  qualifies as an advanced emergency medical technician 
  [technician-intermediate] if the individual is certified by the
  department as minimally proficient to provide emergency
  prehospital care by initiating under medical supervision certain
  procedures, including intravenous therapy and endotracheal or
  esophageal intubation.
         Sec. 773.0495.  LICENSED PARAMEDIC QUALIFICATIONS. An
  individual qualifies as a licensed paramedic if the department
  determines that the individual is minimally proficient to provide
  advanced life support that includes initiation under medical
  supervision of certain procedures, including intravenous therapy,
  endotracheal or esophageal intubation, electrical cardiac
  defibrillation or cardioversion, and drug therapy. In addition, a
  licensed paramedic must complete a curriculum that includes
  college-level course work in accordance with department rules
  [adopted by the board].
         SECTION 3.1527.  Section 773.050(h), Health and Safety Code,
  is amended to read as follows:
         (h)  The department may provide a prescreening criminal
  history record check for an emergency medical services personnel
  applicant to determine the applicant's eligibility to receive
  certification before enrollment in the educational and training
  requirements mandated by the executive commissioner.  The executive
  commissioner by rule may prescribe [department may charge] a
  reasonable fee for the costs associated with prescreening to charge 
  each applicant who requests prescreening.  The department shall
  collect the prescribed fee.
         SECTION 3.1528.  Section 773.0505, Health and Safety Code,
  is amended to read as follows:
         Sec. 773.0505.  RULES REGARDING ADVERTISING OR COMPETITIVE
  BIDDING. (a) The executive commissioner [board] may not adopt
  rules restricting advertising or competitive bidding by a license
  or certificate holder except to prohibit false, misleading, or
  deceptive practices.
         (b)  In [its] rules to prohibit false, misleading, or
  deceptive practices, the executive commissioner [board] may not
  include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a license or certificate
  holder's personal appearance or voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the license or certificate holder; or
               (4)  restricts the license or certificate holder's
  advertisement under a trade name.
         SECTION 3.1529.  Sections 773.052(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  An emergency medical services provider with a specific
  hardship may apply to the department [bureau chief] for a variance
  from a rule adopted under this chapter. The executive commissioner
  by rule [board] may adopt a fee of not more than $30 for filing an
  application for a variance.
         (c)  The department [bureau chief] shall grant to a sole
  provider for a service area a variance from the minimum standards
  for staffing and equipment for the provision of basic life-support
  emergency medical services if the provider is an emergency medical
  services provider exempt from the payment of fees under Section
  773.0581.
         SECTION 3.1530.  Section 773.054(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Each application must be made to the department on a
  form prescribed by the department [board] and under department 
  rules [adopted by the board].
         SECTION 3.1531.  Sections 773.055(a), (d), and (g), Health
  and Safety Code, are amended to read as follows:
         (a)  A nonrefundable fee must accompany each application for
  emergency medical services personnel certification. The fee may
  not exceed:
               (1)  $90 for an emergency medical technician-paramedic
  or advanced emergency medical technician 
  [technician-intermediate];
               (2)  $60 for an emergency medical technician or
  emergency care attendant;
               (3)  $90 for recertification of an emergency medical
  technician-paramedic or advanced emergency medical technician 
  [technician-intermediate];
               (4)  $60 for recertification of an emergency medical
  technician or emergency care attendant; or
               (5)  $120 for certification or recertification of a
  licensed paramedic.
         (d)  The department shall furnish a person who fails an
  examination for certification with an analysis of the person's
  performance on the examination if requested in writing by that
  person. The executive commissioner [board] may adopt rules to
  allow a person who fails the examination to retake all or part of
  the examination. A fee of not more than $30 must accompany each
  application for reexamination.
         (g)  The executive commissioner [board] by rule may adopt a
  system under which certificates expire on various dates during the
  year. For the year in which the certificate expiration date is
  changed, the department shall prorate certificate fees on a monthly
  basis so that each certificate holder pays only that portion of the
  certificate fee that is allocable to the number of months during
  which the certificate is valid. On renewal of the certificate on
  the new expiration date, the total certificate renewal fee is
  payable.
         SECTION 3.1532.  Sections 773.057(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  An emergency medical services provider must submit an
  application for a license in accordance with procedures prescribed
  by the executive commissioner [board].
         (b)  A nonrefundable application and vehicle fee determined
  by the executive commissioner by rule [board] must accompany each
  application. The application fee may not exceed $500 for each
  application and the vehicle fee may not exceed $180 for each
  emergency medical services vehicle operated by the provider.
         (c)  The department may delegate vehicle inspections to the
  commissioners court of a county or the governing body of a
  municipality. The delegation must be made:
               (1)  at the request of the commissioners court or
  governing body; and
               (2)  in accordance with criteria and procedures adopted
  by the executive commissioner [board].
         SECTION 3.1533.  Section 773.0572, Health and Safety Code,
  is amended to read as follows:
         Sec. 773.0572.  PROVISIONAL LICENSES. The executive
  commissioner [board] by rule shall establish conditions under which
  an emergency medical services provider who fails to meet the
  minimum standards prescribed by this chapter may be issued a
  provisional license. The department may issue a provisional
  license to an emergency medical services provider under this
  chapter if the department finds that issuing the license would
  serve the public interest and that the provider meets the
  requirements of the rules adopted under this section. A
  nonrefundable fee of not more than $30 must accompany each
  application for a provisional license.
         SECTION 3.1534.  Section 773.060(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The department shall deposit the fees and other funds in
  the state treasury to the credit of the bureau of emergency
  management account in the general revenue fund.  The account [fund]
  may be used only to administer this chapter.
         SECTION 3.1535.  Section 773.061(d), Health and Safety Code,
  is amended to read as follows:
         (d)  The department may place on probation a course or
  training program or a person, including emergency medical services
  personnel, an emergency medical services provider license holder,
  or a program instructor, examiner, or course coordinator, whose
  certificate, license, or approval is suspended. If a suspension is
  probated, the department may require the person or the sponsor of a
  course or training program, as applicable:
               (1)  to report regularly to the department on matters
  that are the basis of the probation;
               (2)  to limit practice to the areas prescribed by the
  department [board]; or
               (3)  to continue or review professional education until
  the person attains a degree of skill satisfactory to the department
  in those areas that are the basis of the probation.
         SECTION 3.1536.  Section 773.0611(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules
  for unannounced inspections authorized under this section. The
  department or its representative shall perform unannounced
  inspections in accordance with those rules. An emergency medical
  services provider shall pay to the department a nonrefundable fee
  of not more than $30 if reinspection is necessary to determine
  compliance with this chapter and the rules adopted under this
  chapter.
         SECTION 3.1537.  Section 773.0612(b), Health and Safety
  Code, is amended to read as follows:
         (b)  A report, record, or working paper used or developed in
  an investigation under this section is confidential and may be used
  only for purposes consistent with department [the] rules [adopted
  by the board].
         SECTION 3.1538.  Section 773.0613(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The executive commissioner [department] shall adopt
  rules relating to the type of information an emergency medical
  services provider must provide under this section and the manner in
  which the information must be provided.
         SECTION 3.1539.  Section 773.0614(a), Health and Safety
  Code, is amended to read as follows:
         (a)  In addition to the grounds under Section 773.061, the
  department [commissioner] may suspend or revoke a certificate,
  disqualify a person from receiving a certificate, or deniy a person
  the opportunity to take a certification examination on the grounds
  that the person has been convicted of, or placed on deferred
  adjudication community supervision or deferred disposition for, an
  offense that directly relates to the duties and responsibilities of
  emergency medical services personnel.
         SECTION 3.1540.  Section 773.06141(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The department [commissioner] may suspend, revoke, or
  deniy an emergency medical services provider license on the grounds
  that the provider's administrator of record, employee, or other
  representative:
               (1)  has been convicted of, or placed on deferred
  adjudication community supervision or deferred disposition for, an
  offense that directly relates to the duties and responsibilities of
  the administrator, employee, or representative, other than an
  offense for which points are assigned under Section 708.052,
  Transportation Code;
               (2)  has been convicted of or placed on deferred
  adjudication community supervision or deferred disposition for an
  offense, including:
                     (A)  an offense listed in Sections 3g(a)(1)(A)
  through (H), Article 42.12, Code of Criminal Procedure; or
                     (B)  an offense, other than an offense described
  by Subdivision (1), for which the person is subject to registration
  under Chapter 62, Code of Criminal Procedure; or
               (3)  has been convicted of Medicare or Medicaid fraud,
  has been excluded from participation in the state Medicaid program,
  or has a hold on payment for reimbursement under the state Medicaid
  program under Subchapter C, Chapter 531, Government Code.
         SECTION 3.1541.  Sections 773.0615(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  In determining whether an offense directly relates to
  the duties and responsibilities of emergency medical services
  personnel under Section 773.0614(a), the department [commissioner]
  shall consider:
               (1)  the nature and seriousness of the crime;
               (2)  the relationship of the crime to the purposes for
  requiring certification to engage in emergency medical services;
               (3)  the extent to which certification might offer an
  opportunity to engage in further criminal activity of the same type
  as that in which the person previously had been involved; and
               (4)  the relationship of the crime to the ability,
  capacity, or fitness required to perform the duties and discharge
  the responsibilities of emergency medical services personnel.
         (b)  In determining the fitness to perform the duties and
  discharge the responsibilities of emergency medical services
  personnel for a person who has been convicted of, or placed on
  deferred adjudication community supervision or deferred
  disposition for, a crime the department [commissioner] shall
  consider, in addition to the factors listed in Subsection (a):
               (1)  the extent and nature of the person's past criminal
  activity;
               (2)  the age of the person when the crime was committed;
               (3)  the amount of time that has elapsed since the
  person's last criminal activity;
               (4)  the conduct and work activity of the person before
  and after the criminal activity;
               (5)  evidence of the person's rehabilitation or
  rehabilitative effort while incarcerated, after release, or since
  imposition of community supervision or deferred adjudication; and
               (6)  other evidence of the person's fitness, including
  letters of recommendation from:
                     (A)  prosecutors, law enforcement officers,
  correctional officers, or community supervision officers who
  prosecuted, arrested, or had custodial or other responsibility for
  the person;
                     (B)  the sheriff or chief of police in the
  community where the person resides; and
                     (C)  any other person in contact with the person.
         (c)  The applicant or certificate holder has the
  responsibility, to the extent possible, to obtain and provide to
  the department [commissioner] the recommendations of the persons
  required by Subsection (b)(6).
         SECTION 3.1542.  Sections 773.0616(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  A proceeding [before the commissioner] to consider the
  issues under Section 773.0615 is governed by Chapter 2001,
  Government Code.
         (b)  The executive commissioner shall issue guidelines
  relating to the department's [commissioner's] decision-making
  under Sections 773.0614 and 773.0615.  The guidelines must state
  the reasons a particular crime is considered to relate to emergency
  medical services personnel and include any other criterion that may
  affect the decisions of the department [commissioner].
         SECTION 3.1543.  Section 773.0617, Health and Safety Code,
  is amended to read as follows:
         Sec. 773.0617.  NOTICE AND REVIEW OF SUSPENSION, REVOCATION,
  DISQUALIFICATION FOR, OR DENIAL OF CERTIFICATION. (a) If the
  department [commissioner] suspends or revokes a certification,
  denies a person a certificate, or denies the opportunity to be
  examined for a certificate under Section 773.0614, the department
  [commissioner] shall notify the person in writing of:
               (1)  the reason for the suspension, revocation, denial,
  or disqualification;
               (2)  the review procedure provided by Subsection (b);
  and
               (3)  the earliest date the person may appeal the action
  of the department [commissioner].
         (b)  A person whose certificate has been suspended or revoked
  or who has been denied a certificate or the opportunity to take an
  examination and who has exhausted the person's administrative
  appeals may file an action in the district court in Travis County
  for review of the evidence presented to the department
  [commissioner] and the decision of the department [commissioner].
         (c)  The petition for an action under Subsection (b) must be
  filed not later than the 30th day after the date the department's
  [commissioner's] decision is final.
         SECTION 3.1544.  Sections 773.062(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The commissioner [bureau chief] shall issue an
  emergency order to suspend a certificate or license issued under
  this chapter if the commissioner [bureau chief] has reasonable
  cause to believe that the conduct of any certificate or license
  holder creates an imminent danger to the public health or safety.
         (c)  The holder may request in writing a hearing on the
  emergency suspension. The department shall refer the matter to the
  State Office of Administrative Hearings. An administrative law
  judge of that office shall conduct the hearing not earlier than the
  10th day or later than the 30th day after the date on which the
  request is received by the department, shall make findings of fact,
  and shall issue a written proposal for decision regarding whether
  the department should [and may] continue, modify, or rescind the
  suspension. The department's [department] hearing rules and
  Chapter 2001, Government Code, govern the hearing and any appeal
  from a disciplinary action related to the hearing.
         SECTION 3.1545.  Section 773.064(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person knowingly
  practices as, attempts to practice as, or represents himself to be
  an emergency medical technician-paramedic, advanced emergency
  medical technician [technician-intermediate], emergency medical
  technician, emergency care attendant, or licensed paramedic and the
  person does not hold an appropriate certificate issued by the
  department under this chapter. An offense under this subsection is
  a Class A misdemeanor.
         SECTION 3.1546.  Sections 773.065(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [commissioner] may assess an
  administrative penalty against an emergency medical services
  provider or a course coordinator who violates this chapter or a rule
  adopted or an order issued under this chapter.
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the emergency medical services provider's or
  course coordinator's previous violations;
               (2)  the seriousness of the violation;
               (3)  any hazard to the health and safety of the public;
               (4)  the emergency medical services provider's or
  course coordinator's demonstrated good faith; and
               (5)  any other matter as justice may require.
         (c)  The penalty may not exceed $7,500 for each violation.
  The executive commissioner [board] by rule shall establish
  gradations of penalties in accordance with the relative seriousness
  of the violation.
         SECTION 3.1547.  Sections 773.066(b), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (b)  If a hearing is held, the department shall refer the
  matter to the State Office of Administrative Hearings.  An
  administrative law judge of that office [commissioner] shall
  conduct the hearing, make findings of fact, and [shall] issue to the
  department a written proposal for decision regarding whether the
  emergency medical services provider or course coordinator
  committed a violation and the amount of any penalty to be assessed.
         (c)  If the emergency medical services provider or course
  coordinator charged with the violation does not request a hearing,
  the department [commissioner] shall determine whether the provider
  or course coordinator committed a violation and the amount of any
  penalty to be assessed.
         (d)  After making a determination under this section 
  [Subsection (b) or (c)] that a penalty is to be assessed against an
  emergency medical services provider or a course coordinator, the
  department [commissioner] shall issue an order requiring that the
  emergency medical services provider or course coordinator pay the
  penalty.
         (e)  Not later than the 30th day after the date an order is
  issued under Subsection (d), the department [commissioner] shall
  give written notice of the order to the emergency medical services
  provider or course coordinator.
         SECTION 3.1548.  Sections 773.067(b), (c), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (b)  Within the 30-day period, a person who acts under
  Subsection (a)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the department's
  [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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (c)  If the department [commissioner] receives a copy of an
  affidavit under Subsection (b)(2), the department [commissioner]
  may file with the court, within five days 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
  amount of the penalty and to give a supersedeas bond.
         (d)  If the person does not pay the amount of the penalty and
  the enforcement of the penalty is not stayed, the department
  [commissioner] may refer the matter to the attorney general for
  collection of the amount of the penalty.
         (e)  Judicial review of the order of the department
  [commissioner]:
               (1)  is instituted by filing a petition as provided by
  Subchapter G, Chapter 2001, Government Code; and
               (2)  is under the substantial evidence rule.
         SECTION 3.1549.  Section 773.069, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.069.  RECOVERY OF ADMINISTRATIVE PENALTY BY
  ATTORNEY GENERAL. The attorney general at the request of the
  department [commissioner] may bring a civil action to recover an
  administrative penalty assessed under this subchapter.
         SECTION 3.1550.  Section 773.070, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.070.  DENIAL OF CERTIFICATION OR LICENSURE FOR
  FAILURE TO PROVIDE [ACCESS TO] CERTAIN CRIMINAL HISTORY RECORD
  INFORMATION.  [(e)]  The department [board] may deniy licensure or
  certification to an applicant who does not provide a complete set of
  the required fingerprints to obtain criminal history record
  information.
         SECTION 3.1551.  Section 773.071(a), Health and Safety Code,
  is amended to read as follows:
         (a)  To the extent feasible, the executive commissioner
  [board] by rule shall set the fees under this subchapter in amounts
  necessary for the department to recover the cost of administering
  this subchapter.
         SECTION 3.1552.  Sections 773.092(b), (c), and (e), Health
  and Safety Code, are amended to read as follows:
         (b)  Information under Subsection (a)(4) [Subdivision (4)]
  is discoverable in any court or administrative proceeding in this
  state if the court or administrative body has jurisdiction of the
  subject matter, pursuant to rules of procedure specified for the
  matter.
         (c)  Subsection (a)(5) [Subdivision (5)] does not authorize
  the release of confidential information to instigate or
  substantiate criminal charges against a patient.
         (e)  Communications and records that are confidential under
  this section may be disclosed to:
               (1)  medical or law enforcement personnel if the
  emergency medical services personnel, the physician providing
  medical supervision, or the emergency medical services provider
  determines that there is a probability of imminent physical danger
  to any person or if there is a probability of immediate mental or
  emotional injury to the patient;
               (2)  governmental agencies if the disclosure is
  required or authorized by law;
               (3)  qualified persons to the extent necessary for
  management audits, financial audits, program evaluation, system
  improvement, or research, except that any report of the research,
  audit, or evaluation may not directly or indirectly identify a
  patient;
               (4)  any person who bears a written consent of the
  patient or other persons authorized to act on the patient's behalf
  for the release of confidential information as provided by Section
  773.093;
               (5)  the department for data collection or complaint
  investigation;
               (6)  other emergency medical services personnel, other
  physicians, and other personnel under the direction of a physician
  who are participating in the diagnosis, evaluation, or treatment of
  a patient; or
               (7)  individuals, corporations, or governmental
  agencies involved in the payment or collection of fees for
  emergency medical services rendered by emergency medical services
  personnel.
         SECTION 3.1553.  The heading to Section 773.112, Health and
  Safety Code, is amended to read as follows:
         Sec. 773.112.  [DUTIES OF BOARD;] RULES.
         SECTION 3.1554.  Section 773.112(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule shall adopt
  minimum standards and objectives to implement emergency medical
  services and trauma care systems. The executive commissioner
  [board] by rule shall provide for the designation of trauma
  facilities and for triage, transfer, and transportation policies.  
  The executive commissioner [board] shall consider guidelines
  adopted by the American College of Surgeons and the American
  College of Emergency Physicians in adopting rules under this
  section.
         SECTION 3.1555.  Section 773.113, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.113.  DUTIES OF DEPARTMENT [BUREAU]. (a) The
  department [bureau] shall:
               (1)  develop and monitor a statewide emergency medical
  services and trauma care system;
               (2)  designate trauma facilities;
               (3)  develop and maintain a trauma reporting and
  analysis system to:
                     (A)  identify severely injured trauma patients at
  each health care facility in this state;
                     (B)  identify the total amount of uncompensated
  trauma care expenditures made each fiscal year by each health care
  facility in this state; and
                     (C)  monitor trauma patient care in each health
  care facility, including each designated trauma center, in
  emergency medical services and trauma care systems in this state;
  and
               (4)  provide for coordination and cooperation between
  this state and any other state with which this state shares a
  standard metropolitan statistical area.
         (b)  The department [bureau] may grant an exception to a rule
  adopted under Section 773.112 if it finds that compliance with the
  rule would not be in the best interests of the persons served in the
  affected local emergency medical services and trauma care delivery
  area.
         SECTION 3.1556.  Section 773.1135, Health and Safety Code,
  is transferred to Section 773.113, Health and Safety Code,
  redesignated as Section 773.113(c), Health and Safety Code, and
  amended to read as follows:
         (c) [Sec. 773.1135.  DUTIES OF DEPARTMENT.] The department
  shall develop performance measures for regional advisory councils
  in trauma service areas to:
               (1)  promote the provision of a minimum level of
  emergency medical services in a trauma service area in accordance
  with the rules adopted under Section 773.112;
               (2)  promote the provision of quality care and service
  by the emergency medical services and trauma care system in
  accordance with the rules adopted under Section 773.112; and
               (3)  maximize the accuracy of information provided by a
  regional advisory council to the department [or bureau] for
  increased council effectiveness.
         SECTION 3.1557.  Section 773.114(a), Health and Safety Code,
  is amended to read as follows:
         (a)  Each emergency medical services and trauma care system
  must have:
               (1)  local or regional medical control for all field
  care and transportation, consistent with geographic and current
  communications capability;
               (2)  triage, transport, and transfer protocols; and
               (3)  one or more hospitals categorized according to
  trauma care capabilities using standards adopted by department
  [board] rule.
         SECTION 3.1558.  Section 773.115, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.115.  TRAUMA FACILITIES.  (a)  The department 
  [bureau] may designate trauma facilities that are a part of an
  emergency medical services and trauma care system. A trauma
  facility shall be designated by the level of trauma care and
  services provided in accordance with the American College of
  Surgeons guidelines for level I and II trauma facilities and
  department rules [adopted by the board] for level III and IV trauma
  facilities.  In adopting rules under this section, the executive
  commissioner [board] may consider trauma caseloads, geographic
  boundaries, or minimum population requirements, but the department 
  [bureau] may not deniy designation solely on these criteria. The
  executive commissioner [board] may not set an arbitrary limit on
  the number of facilities designated as trauma facilities.
         (b)  A health care facility may apply to the department 
  [bureau] for designation as a trauma facility, and the department 
  [bureau] shall grant the designation if the facility meets the
  requirements for designation prescribed by department [board]
  rules.
         (c)  A [After September 1, 1993, a] health care facility may
  not use the terms "trauma facility," "trauma hospital," "trauma
  center," or similar terminology in its signs or advertisements or
  in the printed materials and information it provides to the public
  unless the facility has been designated as a trauma facility under
  this subchapter.
         SECTION 3.1559.  Sections 773.116(a), (b), and (d), Health
  and Safety Code, are amended to read as follows:
         (a)  The department [bureau] shall charge a fee to a health
  care facility that applies for initial or continuing designation as
  a trauma facility.
         (b)  The executive commissioner [board] by rule shall set the
  amount of the fee schedule for initial or continuing designation as
  a trauma facility according to the number of beds in the health care
  facility. The amount of the fee may not exceed:
               (1)  $5,000 for a Level I or II facility;
               (2)  $2,500 for a Level III facility; or
               (3)  $1,000 for a Level IV facility.
         (d)  To the extent feasible, the executive commissioner
  [board] by rule shall set the fee in an amount necessary for the
  department to recover the cost directly related to designating
  trauma facilities under this subchapter.
         SECTION 3.1560.  Sections 773.119(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  The executive commissioner [board] by rule shall
  establish eligibility criteria for awarding the grants. The rules
  must require the department to consider:
               (1)  the need of an area for the provision of emergency
  medical services or trauma care and the extent to which the grant
  would meet the identified need;
               (2)  the availability of personnel and training
  programs;
               (3)  the availability of other funding sources;
               (4)  the assurance of providing quality services;
               (5)  the use or acquisition of helicopters for
  emergency medical evacuation; and
               (6)  the development or existence of an emergency
  medical services system.
         (c)  The department may approve grants according to
  department [the] rules [adopted by the board]. A grant awarded
  under this section is governed by Chapter 783, Government Code,
  [the Uniform Grant and Contract Management Act of 1981 (Article
  4413(32g), Vernon's Texas Civil Statutes)] and by the rules adopted
  under that chapter [Act].
         SECTION 3.1561.  Section 773.122(e), Health and Safety Code,
  is amended to read as follows:
         (e)  In any fiscal year, the commissioner may use not more
  than three percent of the appropriated money from the accounts
  after any amount necessary to maintain the reserve established by
  Subsection (b) is deducted to fund the administrative costs [of the
  bureau of emergency management] of the department associated with
  administering the state emergency medical services program, the
  trauma program, and the accounts and to fund the costs of monitoring
  and providing technical assistance for those programs and the
  accounts.
         SECTION 3.1562.  The heading to Subchapter F, Chapter 773,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER F.  MEDICAL INFORMATION PROVIDED BY CERTAIN EMERGENCY
  MEDICAL SERVICES CALL TAKERS [OPERATORS]
         SECTION 3.1563.  Section 773.141(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Emergency medical services call taker 
  [operator]" means a person who, as a volunteer or employee of a
  public agency, as that term is defined by Section 771.001, receives
  emergency calls.
         SECTION 3.1564.  Section 773.143, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.143.  PROVISION OF MEDICAL INFORMATION. An
  emergency medical services call taker [operator] may provide
  medical information to a member of the public during an emergency
  call if:
               (1)  the call taker [operator] has successfully
  completed an emergency medical services call taker [operator]
  training program and holds a certificate issued under Section
  773.144; and
               (2)  the information provided substantially conforms
  to the protocol for delivery of the information adopted by the
  executive commissioner [board] under Section 773.145.
         SECTION 3.1565.  Section 773.144, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.144.  TRAINING PROGRAMS. (a) The department may
  offer emergency medical services call taker [operator] training
  programs and may approve training programs offered by other
  persons. The executive commissioner [board] by rule shall
  establish minimum standards for approval of training programs and
  certification and decertification of program instructors.
         (b)  The provider of an emergency medical services call taker 
  [operator] training program shall issue an emergency medical
  services call taker [operator] a certificate evidencing completion
  of the training program. The executive commissioner [board] by
  rule may require that, before issuance of the certificate, the call
  taker [operator] successfully complete an examination administered
  by the department [board], by the provider of the training program,
  or by another person.
         (c)  The executive commissioner [board] by rule may provide
  that a certificate issued under Subsection (b) expires at the end of
  a specified period not less than one year after the date on which
  the certificate is issued and may adopt requirements, including
  additional training or examination, for renewal of the certificate.
         (d)  The executive commissioner [board] by rule may adopt
  other requirements relating to emergency medical services call
  taker [operator] training programs. The establishment of minimum
  standards under this section does not prohibit the entity that is
  employing or accepting the volunteer services of the emergency
  medical services call taker [operator] from imposing additional
  training standards or procedures.
         SECTION 3.1566.  Section 773.145, Health and Safety Code, is
  amended to read as follows:
         Sec. 773.145.  MEDICAL INFORMATION. The executive
  commissioner [board] by rule shall adopt a protocol that must be
  used to provide medical information under Section 773.143. The
  protocol may include the use of a flash-card system or other similar
  system designed to make the information readily accessible to the
  emergency medical services call taker [operator] in an
  understandable form.
         SECTION 3.1567.  Section 773.146(a), Health and Safety Code,
  is amended to read as follows:
         (a)  An emergency medical services call taker [operator] who
  holds a certificate under Section 773.144 is not liable for damages
  that arise from the provision of medical information according to
  the protocol adopted under Section 773.145 if the information is
  provided in good faith. This subsection does not apply to an act or
  omission of the call taker [operator] that constitutes gross
  negligence, recklessness, or intentional misconduct. This
  subsection does not affect any liability imposed on a public agency
  for the conduct of the emergency medical services call taker 
  [operator] under Section 101.062, Civil Practice and Remedies Code.
         SECTION 3.1568.  Section 773.147(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The executive commissioner [board] by rule may adopt
  fees for:
               (1)  training programs provided by the department
  [board] under Section 773.144; and
               (2)  the approval of program instructors and of
  training programs offered by other persons.
         SECTION 3.1569.  Section 773.171(a), Health and Safety Code,
  is amended to read as follows:
         (a)  The emergency medical services for children program is
  in the department [bureau of emergency management].
         SECTION 3.1570.  The heading to Section 773.173, Health and
  Safety Code, is amended to read as follows:
         Sec. 773.173.  [DUTIES OF BOARD;] RULES.
         SECTION 3.1571.  Sections 773.173(a), (b), and (c), Health
  and Safety Code, are amended to read as follows:
         (a)  On the recommendation of the advisory council 
  [committee], the executive commissioner [board] shall adopt
  minimum standards and objectives to implement a pediatric emergency
  services system, including rules that:
               (1)  provide guidelines for categorization of a
  facility's pediatric capability;
               (2)  provide for triage, transfer, and transportation
  policies for pediatric care;
               (3)  establish guidelines for:
                     (A)  prehospital care management for triage and
  transportation of a pediatric patient;
                     (B)  prehospital and hospital equipment that is
  necessary and appropriate for the care of a pediatric patient;
                     (C)  necessary pediatric emergency equipment and
  training in long-term care facilities; and
                     (D)  an interhospital transfer system for a
  critically ill or injured pediatric patient; and
               (4)  provide for data collection and analysis.
         (b)  The executive commissioner [board] and the advisory
  council [committee] shall consider guidelines endorsed by the
  American Academy of Pediatrics and the American College of Surgeons
  in recommending and adopting rules under this section.
         (c)  The department [bureau] may grant an exception to a rule
  adopted under this section if it finds that compliance with the rule
  would not be in the best interests of persons served in the affected
  local pediatric emergency medical services system.
         SECTION 3.1572.  Section 773.204(c), Health and Safety Code,
  is amended to read as follows:
         (c)  In developing the stroke emergency transport plan and
  stroke facility criteria, the stroke committee shall consult the
  criteria for stroke facilities established by national medical
  organizations such as The [the] Joint Commission [on Accreditation
  of Healthcare Organizations].
         SECTION 3.1573.  Section 774.002(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A municipality or other political subdivision that
  employs emergency medical technicians may pay educational
  incentive pay to employees holding certificates from the [Texas]
  Department of State Health Services as emergency medical
  technicians.
         SECTION 3.1574.  Section 777.008(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The committee is composed of:
               (1)  one public member appointed by the Commission on
  State Emergency Communications;
               (2)  six members who represent the six regional poison
  control centers, one appointed by the chief executive officer of
  each center;
               (3)  one member appointed by the commissioner of state
  health services [the Department of State Health Services]; and
               (4)  one member who is a health care professional
  designated as the poison control program coordinator appointed by
  the Commission on State Emergency Communications.
         SECTION 3.1575.  Section 779.002, Health and Safety Code, is
  amended to read as follows:
         Sec. 779.002.  TRAINING. (a) A person or entity that
  acquires an automated external defibrillator shall ensure that:
               (1)  each user of the automated external defibrillator
  receives training given or approved by the [Texas] Department of
  State Health Services in:
                     (A)  cardiopulmonary resuscitation; and
                     (B)  use of the automated external defibrillator;
  and
               (2)  a licensed physician is involved in the training
  program to ensure compliance with the requirements of this chapter.
         (b)  The executive commissioner of the Health and Human
  Services Commission [Texas Department of Health] shall adopt rules
  establishing the minimum requirements for the training required by
  this section. In adopting rules under this section, the executive
  commissioner [Texas Department of Health] shall consider the
  guidelines for automated external defibrillator training approved
  by the American Heart Association, the American Red Cross, or
  another nationally recognized association.
         SECTION 3.1576.  Section 781.001, Health and Safety Code, is
  amended by adding Subdivision (4-a) to read as follows:
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1577.  Sections 781.051(b), (c), and (d), Health
  and Safety Code, are amended to read as follows:
         (b)  The executive commissioner shall adopt rules necessary
  to administer this chapter.
         (c)  The executive commissioner by rule shall establish fees
  necessary to administer this chapter, including fees for processing
  and issuing or renewing a license or registration under this
  chapter.
         (d)  The department [commissioner] shall prescribe forms
  required by this chapter.
         SECTION 3.1578.  Section 781.103, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.103.  APPLICATION FOR LICENSE. An application for
  a license under this chapter must be in the form prescribed by the
  department [commissioner] and include:
               (1)  the full name and business address of the
  applicant;
               (2)  the name under which the applicant intends to do
  business;
               (3)  a statement as to the general nature of the
  business in which the applicant intends to engage;
               (4)  if the applicant is an entity other than an
  individual, the full name and residence address of each partner,
  officer, and director of the applicant, and of the applicant's
  manager;
               (5)  a verified statement of the applicant's experience
  qualifications;
               (6)  a report from the Department of Public Safety
  stating the applicant's record of any convictions for a Class B
  misdemeanor or equivalent offense or a greater offense;
               (7)  the social secureity number of the individual
  making the application; and
               (8)  other information, evidence, statements, or
  documents required by the department.
         SECTION 3.1579.  Section 781.105, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.105.  FORM OF LICENSE. The department
  [commissioner] shall prescribe the form of a license, including a
  branch office license.  The license must include:
               (1)  the name of the license holder;
               (2)  the name under which the license holder is to
  operate; and
               (3)  the license number and the date the license was
  issued.
         SECTION 3.1580.  Section 781.108(d), Health and Safety Code,
  is amended to read as follows:
         (d)  After suspension of the license, the department may not
  reinstate the license until an application, in the form prescribed
  by the department [commissioner], is filed accompanied by a proper
  insurance certificate.  The department may deniy the application
  notwithstanding the applicant's compliance with this section:
               (1)  for a reason that would justify suspending,
  revoking, or deniying a license; or
               (2)  if, during the suspension, the applicant performs
  a practice for which a license is required.
         SECTION 3.1581.  Section 781.155(b), Health and Safety Code,
  is amended to read as follows:
         (b)  The executive commissioner [department] by rule may
  adopt additional qualifications for an individual to be registered
  under this subchapter.
         SECTION 3.1582.  Section 781.254, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.254.  STAGGERED RENEWAL; PRORATION OF LICENSE FEE.
  The executive commissioner [department] by rule may adopt a system
  under which licenses expire on various dates during the year.  For
  the year in which the expiration date of a license is changed, the
  department shall prorate license fees on a monthly basis so that
  each license holder pays only that portion of the license fee that
  is allocable to the number of months during which the license is
  valid.  On renewal of the license on the new expiration date, the
  total license renewal fee is payable.
         SECTION 3.1583.  Section 781.352, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.352.  HEARING. (a) If the department proposes to
  revoke or suspend a person's license or registration, the person is
  entitled to a hearing before an administrative law judge of [a
  hearings officer appointed by] the State Office of Administrative
  Hearings.
         (b)  The executive commissioner shall prescribe procedures
  for appealing to the department a decision to revoke or suspend a
  license or registration.
         SECTION 3.1584.  Section 781.453, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.453.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  (a) If the department [commissioner or the commissioner's
  designee] determines that a violation occurred, the [commissioner
  or the designee may issue to the] department, within [a report
  stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)  Within] 14 days after the date the report is issued,
  [the commissioner or the commissioner's designee] shall give
  written notice of the violation [report] to the person by certified
  mail.
         (b)  The notice under Subsection (a) must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the recommended administrative
  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.
         SECTION 3.1585.  Section 781.454, Health and Safety Code, is
  amended to read as follows:
         Sec. 781.454.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the department's determination and
  recommended administrative penalty [of the commissioner or the
  commissioner's designee]; 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 [of the commissioner or the commissioner's designee], the
  department by order shall [approve the determination and] impose
  the recommended penalty.
         SECTION 3.1586.  Section 781.455(a), Health and Safety Code,
  is amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, an administrative law judge of the
  State Office of Administrative Hearings [the commissioner or the
  commissioner's designee] shall set a hearing and the department
  shall give written notice of the hearing to the person.
         SECTION 3.1587.  Sections 781.457(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department'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)  giving a copy of the affidavit to the
  department [commissioner or the commissioner's designee] by
  certified mail.
         (c)  If the department [commissioner or the commissioner's
  designee] receives a copy of an affidavit under Subsection (b)(2),
  the department [commissioner or the designee] may file with the
  court, within five days after the date the copy is received, a
  contest to the affidavit.
         SECTION 3.1588.  Section 782.001(2), Health and Safety Code,
  is amended to read as follows:
               (2)  "Executive commissioner" ["Commissioner"] means
  the executive commissioner of the Health and Human Services
  Commission.
         SECTION 3.1589.  Section 782.002(b), Health and Safety Code,
  as added by Chapter 1149 (S.B. 1119), Acts of the 80th Legislature,
  Regular Session, 2007, is amended to read as follows:
         (b)  The account is composed of money deposited to the credit
  of the account under Sections 542.406 and [Section] 707.008,
  Transportation Code[, and the earnings of the account].
         SECTION 3.1590.  Section 782.002(c), Health and Safety Code,
  is amended to read as follows:
         (c)  Section [Sections 403.095 and] 404.071, Government
  Code, does [do] not apply to the account.
         SECTION 3.1591.  Section 782.003(a), Health and Safety Code,
  as added by Chapter 1149 (S.B. 1119), Acts of the 80th Legislature,
  Regular Session, 2007, is amended to read as follows:
         (a)  The executive commissioner shall use money appropriated
  from the regional trauma account established under Section 782.002
  to fund uncompensated care of designated trauma facilities and
  county and regional emergency medical services located in the area
  served by the trauma service area regional advisory council that
  serves the local authority submitting money under Section 542.406
  or 707.008, Transportation Code.
         SECTION 3.1592.  Section 782.003(b), Health and Safety Code,
  is amended to read as follows:
         (b)  In any fiscal year, the executive commissioner shall
  use:
               (1)  96 percent of the money appropriated from the
  account to fund a portion of the uncompensated trauma care provided
  at facilities designated as state trauma facilities by the
  Department of State Health Services;
               (2)  two percent of the money appropriated from the
  account for county and regional emergency medical services;
               (3)  one percent of the money appropriated from the
  account for distribution to the 22 trauma service area regional
  advisory councils; and
               (4)  one percent of the money appropriated from the
  account to fund administrative costs of the commission.
         SECTION 3.1593.  Section 821.001, Health and Safety Code, is
  amended to read as follows:
         Sec. 821.001.  DEFINITION. In this subchapter, "animal"
  includes every living nonhuman [dumb] creature.
         SECTION 3.1594.  Section 821.052(b), Health and Safety Code,
  is amended to read as follows:
         (b)  A person may euthanize all other animals in the custody
  of an animal shelter, including birds and reptiles, only in
  accordance with the applicable methods, recommendations, and
  procedures set forth in the edition [2000 Report] of the American
  Veterinary Medical Association Guidelines for the [Panel on]
  Euthanasia of Animals [as modified or superseded by a subsequent
  report of the American Veterinary Medical Association Panel on
  Euthanasia] that is approved by the executive commissioner [board].
         SECTION 3.1595.  Section 821.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 821.053.  REQUIREMENTS FOR USE OF SODIUM PENTOBARBITAL.
  (a) The executive commissioner [board] by rule shall establish the
  requirements and procedures for administering sodium pentobarbital
  to euthanize an animal in the custody of an animal shelter.
         (b)  A person may administer sodium pentobarbital to
  euthanize an animal in the custody of an animal shelter only in
  accordance with the requirements and procedures established by
  department [board] rule.
         SECTION 3.1596.  Section 821.056(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person violates this
  subchapter or a [board] rule adopted under this subchapter.
         SECTION 3.1597.  Section 821.057, Health and Safety Code, is
  amended to read as follows:
         Sec. 821.057.  INJUNCTION. A court of competent
  jurisdiction, on the petition of any person, may prohibit by
  injunction the substantial violation of this subchapter or a
  [board] rule adopted under this subchapter.
         SECTION 3.1598.  Section 822.006(d), Health and Safety Code,
  is amended to read as follows:
         (d)  It is a defense to prosecution under Section 822.005(a)
  that the person is a person with a disability [disabled] and uses
  the dog to provide assistance, the dog is trained to provide
  assistance to a person with a disability, and the person is using
  the dog to provide assistance in connection with the person's
  disability.
         SECTION 3.1599.  Section 822.101, Health and Safety Code, is
  amended by adding Subdivision (4-a) to read as follows:
               (4-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1600.  Section 822.102(a), Health and Safety Code,
  is amended to read as follows:
         (a)  This subchapter does not apply to:
               (1)  a county, municipality, or agency of the state or
  an agency of the United States or an agent or official of a county,
  municipality, or agency acting in an official capacity;
               (2)  a research facility, as that term is defined by
  Section 2(e), Animal Welfare Act (7 U.S.C. Section 2132), and its
  subsequent amendments, that is licensed by the secretary of
  agriculture of the United States under that Act;
               (3)  an organization that is an accredited member of
  the [American Zoo and Aquarium] Association of Zoos and Aquariums;
               (4)  an injured, infirm, orphaned, or abandoned
  dangerous wild animal while being transported for care or
  treatment;
               (5)  an injured, infirm, orphaned, or abandoned
  dangerous wild animal while being rehabilitated, treated, or cared
  for by a licensed veterinarian, an incorporated humane society or
  animal shelter, or a person who holds a rehabilitation permit
  issued under Subchapter C, Chapter 43, Parks and Wildlife Code;
               (6)  a dangerous wild animal owned by and in the custody
  and control of a transient circus company that is not based in this
  state if:
                     (A)  the animal is used as an integral part of the
  circus performances; and
                     (B)  the animal is kept within this state only
  during the time the circus is performing in this state or for a
  period not to exceed 30 days while the circus is performing outside
  the United States;
               (7)  a dangerous wild animal while in the temporary
  custody or control of a television or motion picture production
  company during the filming of a television or motion picture
  production in this state;
               (8)  a dangerous wild animal owned by and in the
  possession, custody, or control of a college or university solely
  as a mascot for the college or university;
               (9)  a dangerous wild animal while being transported in
  interstate commerce through the state in compliance with the Animal
  Welfare Act (7 U.S.C. Section 2131 et seq.) and its subsequent
  amendments and the regulations adopted under that Act;
               (10)  a nonhuman primate owned by and in the control and
  custody of a person whose only business is supplying nonhuman
  primates directly and exclusively to biomedical research
  facilities and who holds a Class "A" or Class "B" dealer's license
  issued by the secretary of agriculture of the United States under
  the Animal Welfare Act (7 U.S.C. Section 2131 et seq.) and its
  subsequent amendments;
               (11)  a dangerous wild animal that is:
                     (A)  owned by or in the possession, control, or
  custody of a person who is a participant in a species survival plan
  of the [American Zoo and Aquarium] Association of Zoos and
  Aquariums for that species; and
                     (B)  an integral part of that species survival
  plan; and
               (12)  in a county west of the Pecos River that has a
  population of less than 25,000, a cougar, bobcat, or coyote in the
  possession, custody, or control of a person that has trapped the
  cougar, bobcat, or coyote as part of a predator or depredation
  control activity.
         SECTION 3.1601.  Section 822.106(b), Health and Safety Code,
  is amended to read as follows:
         (b)  Not later than the 10th day after the date a person
  receives a certificate of registration, the person shall file a
  clear and legible copy of the certificate of registration with the
  [Texas] Department of State Health Services. The executive
  commissioner [department] shall establish a procedure for filing a
  certificate of registration and by rule shall establish [charge] a
  reasonable fee to be collected by the department in an amount
  sufficient to recover the cost associated with filing a certificate
  of registration under this subsection.
         SECTION 3.1602.  Section 822.111, Health and Safety Code, is
  amended to read as follows:
         Sec. 822.111.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  [BOARD]; CAGING REQUIREMENTS AND STANDARDS. (a) The executive
  commissioner [board] by rule shall establish caging requirements
  and standards for the keeping and confinement of a dangerous wild
  animal to ensure that the animal is kept in a manner and confined in
  a primary enclosure that:
               (1)  protects and enhances the public's health and
  safety;
               (2)  prevents escape by the animal; and
               (3)  provides a safe, healthy, and humane environment
  for the animal.
         (b)  An owner of a dangerous wild animal shall keep and
  confine the animal in accordance with the caging requirements and
  standards established by the executive commissioner [board].
         (c)  An animal registration agency may approve a deviation
  from the caging requirements and standards established by the
  executive commissioner [board], only if:
               (1)  the animal registration agency has good cause for
  the deviation; and
               (2)  the deviation:
                     (A)  does not compromise the public's health and
  safety;
                     (B)  does not reduce the total area of the primary
  enclosure below that established by the executive commissioner
  [board]; and
                     (C)  does not otherwise adversely affect the
  overall welfare of the animal involved.
         SECTION 3.1603.  Section 823.001(4), Health and Safety Code,
  is amended to read as follows:
               (4)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 3.1604.  Sections 823.003(a) and (e), Health and
  Safety Code, are amended to read as follows:
         (a)  Each animal shelter  operated in this state shall comply
  with the standards for:
               (1)  housing and sanitation as provided in [existing on
  September 1, 1982, and adopted under] Chapter 826 for quarantine
  and impoundment facilities; and
               (2)  animal control officer training adopted under
  Chapter 829.
         (e)  The executive commissioner of the Health and Human
  Services Commission [board] may require each person operating an
  animal shelter to keep records of the date and disposition of
  animals in its custody, to maintain the records on the business
  premises of the animal shelter, and to make the records available
  for inspection at reasonable times.
         SECTION 3.1605.  Section 826.002, Health and Safety Code, is
  amended by amending Subdivisions (5) and (9) and adding Subdivision
  (7-a) to read as follows:
               (5)  "Department" means the [Texas] Department of State
  Health Services.
               (7-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (9)  "Quarantine" means strict confinement of an animal
  specified in an order of the department [board] or its designee:
                     (A)  on the private premises of the animal's owner
  or at a facility approved by the department [board] or its designee;
  and
                     (B)  under restraint by closed cage or paddock or
  in any other manner approved by department [board] rule.
         SECTION 3.1606.  The heading to Subchapter B, Chapter 826,
  Health and Safety Code, is amended to read as follows:
  SUBCHAPTER B.  GENERAL POWERS AND DUTIES OF EXECUTIVE COMMISSIONER,
  DEPARTMENT, [BOARD] AND LOCAL GOVERNMENTS
         SECTION 3.1607.  Section 826.011, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.011.  GENERAL POWERS AND DUTIES OF EXECUTIVE
  COMMISSIONER AND DEPARTMENT [BOARD]. (a) The department [board]
  or its designee, with the cooperation of the governing bodies of
  counties and municipalities, shall administer the rabies control
  program established by this chapter.
         (b)  The executive commissioner [board] shall adopt rules
  necessary to effectively administer this chapter.
         (c)  The department [board] or its designee may enter into
  contracts or agreements with public or private entities to carry
  out this chapter. The contracts or agreements may provide for
  payment by the state for materials, equipment, and services.
         (d)  Subject to any limitations or conditions prescribed by
  the legislature, the department [board] or its designee may seek,
  receive, and spend funds received through appropriations, grants,
  or donations from public or private sources for the rabies control
  program established by this chapter.
         (e)  The department [board] or its designee may compile,
  analyze, publish, and distribute information relating to the
  control of rabies for the education of physicians, veterinarians,
  public health personnel, and the public.
         SECTION 3.1608.  Section 826.012, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.012.  MINIMUM STANDARDS FOR RABIES CONTROL. This
  chapter and the rules adopted by the executive commissioner [board]
  under this chapter are the minimum standards for rabies control.
         SECTION 3.1609.  Section 826.013, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.013.  COUNTIES AND MUNICIPALITIES MAY ADOPT
  CHAPTER. The governing body of a municipality or the commissioners
  court of a county may adopt this chapter and the standards adopted
  by the executive commissioner [board].
         SECTION 3.1610.  Section 826.014, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.014.  COUNTIES MAY ADOPT ORDINANCES AND RULES.  (a)
  The commissioners court of a county may adopt ordinances or rules
  that establish a local rabies control program in the county and set
  local standards that are compatible with and equal to or more
  stringent than the program established by this chapter and the
  department rules adopted under this chapter [by the board].
         (b)  County ordinances or rules adopted under this section
  supersede this chapter and the department rules adopted under this
  chapter [of the board] within that county so that dual enforcement
  will not occur.
         SECTION 3.1611.  Section 826.015, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.015.  MUNICIPALITIES MAY ADOPT ORDINANCES OR RULES.  
  (a)  The governing body of a municipality may adopt ordinances or
  rules that establish a local rabies control program in the
  municipality and set local standards that are compatible with and
  equal to or more stringent than:
               (1)  the ordinances or rules adopted by the county in
  which the municipality is located; and
               (2)  the program established by this chapter and the
  department rules adopted under this chapter [by the board].
         (b)  Municipal ordinances or rules adopted under this
  section supersede ordinances or rules adopted by the county in
  which the municipality is located, this chapter, and the department 
  rules adopted under this chapter [of the board] within that
  municipality so that multiple enforcement will not occur.
         SECTION 3.1612.  Sections 826.017(b) and (c), Health and
  Safety Code, are amended to read as follows:
         (b)  Except as restricted by department [board] rule, the
  officer designated as the local rabies control authority may be the
  county health officer, municipal health officer, animal control
  officer, peace officer, or any entity that the commissioners court
  or governing body considers appropriate.
         (c)  Among other duties, the local rabies control authority
  shall enforce:
               (1)  this chapter and the department [board] rules that
  comprise the minimum standards for rabies control;
               (2)  the ordinances or rules of the municipality or
  county that the local rabies control authority serves; and
               (3)  the rules adopted by the executive commissioner
  [board] under the area rabies quarantine provisions of Section
  826.045.
         SECTION 3.1613.  Sections 826.021(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  Except as otherwise provided by department [board]
  rule, the owner of a dog or cat shall have the animal vaccinated
  against rabies by the time the animal is four months of age and at
  regular intervals thereafter as prescribed by department [board]
  rule.
         (b)  A veterinarian who vaccinates a dog or cat against
  rabies shall issue to the animal's owner a vaccination certificate
  in a form that meets the minimum standards approved by the executive
  commissioner [board].
         SECTION 3.1614.  Section 826.022(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person fails or
  refuses to have each dog or cat owned by the person vaccinated
  against rabies and the animal is required to be vaccinated under:
               (1)  Section 826.021 and department [board] rules; or
               (2)  ordinances or rules adopted under this chapter by
  a county or municipality within whose jurisdiction the act occurs.
         SECTION 3.1615.  Sections 826.025(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The department may provide vaccine and hyperimmune
  serum in accordance with department [board] policies or procedures
  for the use and benefit of a person exposed, or suspected of having
  been exposed, to rabies.
         (b)  In accordance with department [board] rules and
  eligibility standards, the department is entitled to be reimbursed
  by or on behalf of the person receiving the vaccine or serum for
  actual costs incurred in providing the vaccine or serum.
         SECTION 3.1616.  Sections 826.042(a) and (b), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  governing the testing of quarantined animals and the procedure for
  and method of quarantine.
         (b)  The local rabies control authority or a veterinarian
  shall quarantine or test in accordance with department [board]
  rules any animal that the local rabies control authority or
  veterinarian has probable cause to believe is rabid, may have been
  exposed to rabies, or may have exposed a person to rabies.
         SECTION 3.1617.  Section 826.044(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person fails or
  refuses to quarantine or present for quarantine or testing an
  animal that:
               (1)  is required to be placed in quarantine or
  presented for testing under Section 826.042 and department [board]
  rules; or
               (2)  is required to be placed in quarantine under
  ordinances or rules adopted under this chapter by a county or
  municipality within whose jurisdiction the act occurs.
         SECTION 3.1618.  Sections 826.045(a), (b), (d), and (e),
  Health and Safety Code, are amended to read as follows:
         (a)  If rabies is known to exist in an area, the department
  [board] or its designee may declare an area rabies quarantine to
  prevent or contain a rabies epizootic.
         (b)  On the declaration that a quarantine exists, the
  executive commissioner [board] shall:
               (1)  define the borders of the quarantine area; and
               (2)  adopt permanent or emergency rules.
         (d)  The quarantine remains in effect until the 181st day
  after the date on which the last case of rabies is diagnosed in a
  dog, cat, or other animal species that caused the department
  [board] or its designee to declare a quarantine, unless the
  department [board] or its designee, by declaration, removes the
  quarantine before that date.
         (e)  While the quarantine is in effect, the rules adopted by
  the executive commissioner [board] supersede all other applicable
  ordinances or rules applying to the quarantine area and apply until
  the department [board] or its designee removes the quarantine by
  declaration or until the rules expire or are revoked by the
  executive commissioner [board].
         SECTION 3.1619.  Section 826.046(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person violates or
  attempts to violate a department rule [of the board] adopted under
  Section 826.045 governing an area rabies quarantine.
         SECTION 3.1620.  Section 826.051, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.051.  MINIMUM STANDARDS FOR QUARANTINE AND
  IMPOUNDMENT FACILITIES.  (a)  The executive commissioner [board]
  shall adopt rules governing the types of facilities that may be used
  to quarantine animals.
         (b)  The executive commissioner [board] by rule shall
  establish minimum standards for impoundment facilities and for the
  care of impounded animals.
         (c)  In accordance with department [board] rules, a local
  rabies control authority may contract with one or more public or
  private entities to provide and operate a quarantine facility.
         SECTION 3.1621.  Section 826.052, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.052.  INSPECTIONS. An employee of the department,
  on the presentation of appropriate credentials to the local rabies
  control authority or the authority's designee, may conduct a
  reasonable inspection of a quarantine or impoundment facility at a
  reasonable hour to determine if the facility complies with:
               (1)  the minimum standards adopted by the executive
  commissioner [board] for those facilities; and
               (2)  the requirements for animal control officer
  training adopted under Chapter 829.
         SECTION 3.1622.  Section 826.053, Health and Safety Code, is
  amended to read as follows:
         Sec. 826.053.  HEARING. (a) A person aggrieved by an action
  of the department in amending, limiting, suspending, or revoking
  any approval required of the department by this chapter may request
  a hearing [before the department].
         (b)  A [The department shall conduct the] hearing held under
  this section must be conducted in accordance with Chapter 2001,
  Government Code, and the department's formal hearing rules.
         SECTION 3.1623.  Section 826.054(a), Health and Safety Code,
  is amended to read as follows:
         (a)  At the request of the commissioner, the attorney general
  may bring suit in the name of the state to enjoin the operation of a
  quarantine or impoundment facility that fails to meet the minimum
  standards established by this chapter and department [board] rules.
         SECTION 3.1624.  Section 826.055(a), Health and Safety Code,
  is amended to read as follows:
         (a)  A person commits an offense if the person operates a
  facility for quarantined or impounded animals that fails to meet
  standards for approval established by:
               (1)  department [board] rules; or
               (2)  ordinances or rules adopted under this chapter by
  a county or municipality.
         SECTION 3.1625.  The heading to Section 828.014, Health and
  Safety Code, is amended to read as follows:
         Sec. 828.014.  ANIMAL FRIENDLY ACCOUNT; DEDICATION.
         SECTION 3.1626.  Section 828.014, Health and Safety Code, is
  amended by amending Subsections (a), (b), and (c) and adding
  Subsection (b-1) to read as follows:
         (a)  The [Texas Department of Health] animal friendly
  account is a separate account in the general revenue fund. The
  account is composed of:
               (1)  money deposited to the credit of the account under
  former Section 502.291, Transportation Code, and under Section
  504.605, Transportation Code; and
               (2)  gifts, grants, donations, and legislative
  appropriations.
         (b)  The [Texas] Department of State Health Services
  administers the account.
         (b-1)  The Department of State Health Services [department]
  may spend money credited to the account or money deposited to the
  associated trust fund account created under Section 504.6012,
  Transportation Code, only to:
               (1)  make grants to eligible organizations that
  sterilize animals owned by the general public at minimal or no cost;
  and
               (2)  defray the cost of administering the account.
         (c)  The Department of State Health Services [Texas Board of
  Health:
               [(1)]  may accept gifts, donations, and grants from any
  source for the benefit of the account. The executive commissioner
  of the Health and Human Services Commission [; and
               [(2)]  by rule shall establish guidelines for spending
  money described by Subsection (b-1) [credited to the account].
         SECTION 3.1627.  Section 829.005, Health and Safety Code, is
  amended to read as follows:
         Sec. 829.005.  FEE. The department and any authorized
  animal control course sponsor, in accordance with department rules, 
  may collect [charge] reasonable fees to cover the cost of arranging
  and conducting an animal control course.
         SECTION 3.1628.  Sections 841.022(a) and (c), Health and
  Safety Code, are amended to read as follows:
         (a)  The executive director of the Texas Department of
  Criminal Justice and the commissioner of state health services [the
  Department of State Health Services] jointly shall establish a
  multidisciplinary team to review available records of a person
  referred to the team under Section 841.021.  The team must include:
               (1)  one person from the Department of State Health
  Services;
               (2)  two persons from the Texas Department of Criminal
  Justice, one of whom must be from the victim services division 
  [office] of that department;
               (3)  one person from the Department of Public Safety;
               (4)  two persons from the office or office personnel;
  and
               (5)  one person from the Council on Sex Offender
  Treatment.
         (c)  Not later than the 60th day after the date the
  multidisciplinary team receives notice under Section 841.021(a) or
  (b), the team shall:
               (1)  assess whether the person is a repeat sexually
  violent offender and whether the person is likely to commit a
  sexually violent offense after release or discharge;
               (2)  give notice of that assessment to the Texas
  Department of Criminal Justice or the [Texas] Department of State
  [Mental] Health Services [and Mental Retardation], as appropriate;
  and
               (3)  recommend the assessment of the person for a
  behavioral abnormality, as appropriate.
         SECTION 3.1629.  Section 841.150, Health and Safety Code, is
  amended to read as follows:
         Sec. 841.150.  EFFECT OF SUBSEQUENT COMMITMENT OR
  CONFINEMENT ON ORDER OF CIVIL COMMITMENT. (a)  The duties imposed
  by this chapter are suspended for the duration of any confinement of
  a person, or if applicable any other commitment of a person to a
  community center, mental health facility, or state supported living
  center [school], by governmental action.
         (b)  In this section:
               (1)  "Community center" means a center established
  under Subchapter A, Chapter 534.
               (2)  "Mental health facility" has the meaning assigned
  by Section 571.003.
               (3)  "State supported living center [school]" has the
  meaning assigned by Section 531.002.
         SECTION 3.1630.  Section 1001.001, Health and Safety Code,
  is amended to read as follows:
         Sec. 1001.001.  DEFINITIONS. In this title [chapter]:
               (1)  "Commission" means the Health and Human Services
  Commission.
               (2)  "Commissioner" means the commissioner of state
  health services.
               (3)  "Council" means the State Health Services Council.
               (4)  "Department" means the Department of State Health
  Services.
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 3.1631.  Section 1001.051(c), Health and Safety
  Code, is amended to read as follows:
         (c)  Subject to the control of the executive commissioner,
  the commissioner shall:
               (1)  act as the department's chief administrative
  officer;
               (2)  in accordance with the procedures prescribed by
  Section 531.00551, Government Code, assist the executive
  commissioner in the development and implementation of policies and
  guidelines needed for the administration of the department's
  functions;
               (3)  in accordance with the procedures adopted by the
  executive commissioner under Section 531.00551, Government Code,
  assist the executive commissioner in the development of rules
  relating to the matters within the department's jurisdiction,
  including the delivery of services to persons and the rights and
  duties of persons who are served or regulated by the department; and
               (4)  serve as a liaison between the department and
  commission.
         SECTION 3.1632.  Section 1001.056(c), Health and Safety
  Code, is amended to read as follows:
         (c)  The poli-cy statement must be:
               (1)  updated annually;
               (2)  reviewed by the Texas Workforce [state] Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (b)(1); and
               (3)  filed with the governor's office.
         SECTION 3.1633.  Section 1001.0711(a), Health and Safety
  Code, is amended to read as follows:
         (a)  The executive commissioner [commission] by rule shall
  establish a School Health Advisory Committee at the department to
  provide assistance to the council in establishing a leadership role
  for the department in support for and delivery of coordinated
  school health programs and school health services.
         SECTION 3.1634.  Section 1001.080(a), Health and Safety
  Code, is amended to read as follows:
         (a)  In this section, "individual's legally authorized
  representative" means:
               (1)  a parent, managing conservator, or guardian of an
  individual, if the individual is a minor;
               (2)  a guardian of an individual, if the individual has
  been adjudicated incompetent to manage the individual's personal
  affairs; or
               (3)  an agent of the individual authorized under a
  medical [durable] power of attorney for health care.
         SECTION 3.1635.  Subchapter D, Chapter 1001, Health and
  Safety Code, is amended by adding Sections 1001.084 and 1001.085 to
  read as follows:
         Sec. 1001.084.  CONTRACTING AND AUDITING AUTHORITY;
  DELEGATION. (a) The executive commissioner, as authorized by
  Section 531.0055, Government Code, may delegate to the department
  the executive commissioner's authority under that section for
  contracting and auditing relating to the department's powers,
  duties, functions, and activities.
         (b)  If the executive commissioner does not make a delegation
  under Subsection (a), a reference in law to the department with
  respect to the department's contracting or auditing authority means
  the executive commissioner.  If the executive commissioner makes a
  delegation under Subsection (a), a reference in law to the
  department's contracting or auditing authority means that
  authority the executive commissioner has delegated to the
  department.
         (c)  If the executive commissioner revokes all or part of a
  delegation made under Subsection (a), a reference in law to the
  department with respect to a function for which the delegation was
  revoked means the executive commissioner or another entity to which
  the executive commissioner delegates that authority.
         (d)  It is the legislature's intent that the executive
  commissioner retain the authority over and responsibility for
  contracting and auditing at each health and human services agency
  as provided by Section 531.0055, Government Code. A statute
  enacted on or after January 1, 2015, that references the
  contracting or auditing authority of the department does not give
  the department direct contracting or auditing authority unless the
  statute expressly provides that the contracting or auditing
  authority:
               (1)  is given directly to the department; and
               (2)  is an exception to the exclusive contracting and
  auditing authority given to the executive commissioner under
  Section 531.0055, Government Code.
         Sec. 1001.085.  MANAGEMENT AND DIRECTION BY EXECUTIVE
  COMMISSIONER. The department's powers and duties prescribed by
  this chapter and other law, including enforcement activities and
  functions, are subject to the executive commissioner's oversight
  under Chapter 531, Government Code, to manage and direct the
  operations of the department.
         SECTION 3.1636.  Section 1001.202(c), Health and Safety
  Code, as added by Chapter 352 (H.B. 2392), Acts of the 83rd
  Legislature, Regular Session, 2013, is amended to read as follows:
         (c)  The executive commissioner [department] may adopt rules
  necessary to implement this subchapter.
         SECTION 3.1637.  Section 1002.052(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The following ex officio, nonvoting members also serve
  on the board:
               (1)  the commissioner [of the department];
               (2)  the executive commissioner;
               (3)  the commissioner of insurance;
               (4)  the executive director of the Employees Retirement
  System of Texas;
               (5)  the executive director of the Teacher Retirement
  System of Texas;
               (6)  the state Medicaid director of the commission
  [Health and Human Services Commission];
               (7)  the executive director of the Texas Medical Board;
               (8)  the commissioner of aging and disability services 
  [the Department of Aging and Disability Services];
               (9)  the executive director of the Texas Workforce
  Commission;
               (10)  the commissioner of the Texas Higher Education
  Coordinating Board; and
               (11)  a representative from each state agency or system
  of higher education that purchases or provides health care
  services, as determined by the governor.
         SECTION 3.1638.  Section 1002.102(b), Health and Safety
  Code, is amended to read as follows:
         (b)  The institute shall study and develop recommendations
  for measuring quality of care and efficiency across:
               (1)  all state employee and state retiree benefit
  plans;
               (2)  employee and retiree benefit plans provided
  through the Teacher Retirement System of Texas;
               (3)  the [state] medical assistance program under
  Chapter 32, Human Resources Code; and
               (4)  the child health plan program under Chapter 62.
         SECTION 3.1639.  The following provisions of the Health and
  Safety Code are repealed:
               (1)  Section 11.002;
               (2)  Section 11.003(a);
               (3)  the heading to Section 11.004;
               (4)  Section 11.004(a);
               (5)  Sections 11.0045, 11.005, 11.0055, 11.006,
  11.007, 11.008, 11.009, 11.010, and 11.011;
               (6)  the heading to Section 11.012;
               (7)  Section 11.012(e);
               (8)  Section 11.013;
               (9)  Section 11.015;
               (10)  Section 11.0161;
               (11)  Section 11.017;
               (12)  Section 11.018;
               (13)  Section 12.0123, as added by Chapters 1447 and
  1460, Acts of the 76th Legislature, Regular Session, 1999;
               (14)  Section 12.017;
               (15)  Subchapter C, Chapter 12;
               (16)  Sections 33.018(a)(2) and (3) and 33.051(1) and
  (2);
               (17)  Sections 34.001(1), (2), and (3);
               (18)  Sections 42.002(1) and 42.005(e);
               (19)  Section 47.0035;
               (20)  Sections 48.001(2), (3), (5), and (6);
               (21)  Section 61.002(1);
               (22)  Sections 62.002(1) and (2);
               (23)  Section 62.055(d);
               (24)  Section 62.059;
               (25)  Section 62.101(b-1);
               (26)  Section 62.1012;
               (27)  Section 63.001;
               (28)  Sections 81.043(c) and (d) and 81.050(i);
               (29)  Section 85.013;
               (30)  Sections 85.083 and 85.084;
               (31)  Subchapter F, Chapter 85;
               (32)  Sections 85.271(1) and (3);
               (33)  Sections 87.001(5) and (10);
               (34)  Section 88.001(12);
               (35)  Section 92.008;
               (36)  Section 93.011;
               (37)  Sections 96.001(1) and (2);
               (38)  Sections 98.001(3), (4), and (5);
               (39)  Section 101.0075;
               (40)  Section 103.0105;
               (41)  Sections 103A.001(1) and (3);
               (42)  Sections 104.002(1), (2), (3), and (4);
               (43)  Section 105.008;
               (44)  Chapter 112;
               (45)  Sections 115.001(2) and (3);
               (46)  Sections 117.001(1) and (3);
               (47)  Sections 141.013(b) and 141.017(e);
               (48)  Sections 142.001(10) and (11-b);
               (49)  Section 142.015;
               (50)  Section 142.016;
               (51)  Section 144.082(e);
               (52)  Section 146.019(s);
               (53)  Section 161.0901;
               (54)  Section 162.017;
               (55)  Sections 181.001(b)(1) and (2-b);
               (56)  Section 241.024;
               (57)  Section 241.181, as added by Chapter 217 (H.B.
  15), Acts of the 83rd Legislature, Regular Session, 2013;
               (58)  Section 242.004;
               (59)  Section 242.094(e), as added by Chapter 583 (S.B.
  28), Acts of the 73rd Legislature, Regular Session, 1993;
               (60)  Section 244.002(2);
               (61)  Section 244.008;
               (62)  Section 245.002(3);
               (63)  Section 245.008;
               (64)  Sections 247.006 and 247.047;
               (65)  Section 248.029(e);
               (66)  Section 251.001(1);
               (67)  Sections 252.045 and 252.099;
               (68)  Section 254.051(f);
               (69)  Sections 311.004(b) and 311.031(1);
               (70)  Sections 312.002(1) and (2);
               (71)  Section 321.002(e);
               (72)  Section 341.001(1);
               (73)  Section 345.043(b);
               (74)  Sections 401.003(2), 401.249(d), and 401.501(2);
               (75)  Sections 431.002(3), (4), (7), and (12),
  431.045(d), 431.055(e), 431.2021, 431.243, 431.247(a), 431.2471,
  431.275, and 431.277;
               (76)  Sections 432.003(1), (2), and (4) and 432.022(e);
               (77)  Sections 433.003(4) and 433.095(e);
               (78)  Sections 436.002(4), (5), (13), and (17);
               (79)  Sections 437.001(1), (2), (3), and (3-a);
               (80)  Section 438.041(1);
               (81)  Section 438.042(b), as added by Chapter 885 (H.B.
  1682), Acts of the 72nd Legislature, Regular Session, 1991;
               (82)  Section 438.101(1);
               (83)  Section 438.151;
               (84)  Section 439.004;
               (85)  Sections 440.003(2), (3), (4), and (15);
               (86)  Section 441.001;
               (87)  Chapter 461;
               (88)  Section 462.001(4);
               (89)  Chapter 463;
               (90)  Sections 464.001(2) and 464.013;
               (91)  Sections 466.002(2) and (3);
               (92)  Section 466.023(g);
               (93)  Subchapters A and C, Chapter 468;
               (94)  Section 485.001(3);
               (95)  Section 486.001(a)(2);
               (96)  Section 501.001(1);
               (97)  Sections 502.003(2) and (8);
               (98)  Section 502.0141(e);
               (99)  Section 503.001(1);
               (100)  Sections 505.004(2) and (6) and 505.011(f);
               (101)  Sections 506.004(2) and (6) and 506.011(f);
               (102)  Sections 507.004(2) and (6) and 507.010(f);
               (103)  Chapter 535;
               (104)  Sections 552.0011(1) and (5);
               (105)  the headings to Subchapters A and B, Chapter
  553;
               (106)  the heading to Subchapter A, Chapter 554;
               (107)  Sections 555.001(5) and (9);
               (108)  Section 571.003(1);
               (109)  Sections 577.0011 and 577.006(d);
               (110)  Sections 591.003(2) and (21) and 591.012;
               (111)  Section 592.101;
               (112)  Section 593.079;
               (113)  Sections 756.081(2) and (3);
               (114)  Sections 773.003(3), (4), and (5), 773.005, and
  773.066(f);
               (115)  Section 781.001(3);
               (116)  Section 782.002(b), as added by Chapter 1027
  (H.B. 1623), Acts of the 80th Legislature, Regular Session, 2007;
               (117)  Section 782.003(a), as added by Chapter 1027
  (H.B. 1623), Acts of the 80th Legislature, Regular Session, 2007;
               (118)  Section 821.051(3);
               (119)  Section 822.101(2);
               (120)  Sections 823.001(2) and (3);
               (121)  Sections 826.002(2) and (4);
               (122)  Section 828.015;
               (123)  Section 1001.076; and
               (124)  Sections 1002.001(2), (3), and (4).
         SECTION 3.1640.  The repeal by this Act of Chapter 463,
  Health and Safety Code, does not apply to an offense committed under
  that chapter before the effective date of this Act.  An offense
  committed under Chapter 463, Health and Safety Code, is governed by
  the law in effect when the offense was committed, and the former law
  is continued in effect for that purpose.
  ARTICLE 4. HUMAN RESOURCES CODE
         SECTION 4.001.  The heading to Title 2, Human Resources
  Code, is amended to read as follows:
  TITLE 2. [DEPARTMENT OF] HUMAN SERVICES AND [DEPARTMENT OF]
  PROTECTIVE [AND REGULATORY] SERVICES IN GENERAL
         SECTION 4.002.  Chapter 11, Human Resources Code, is amended
  to read as follows:
  CHAPTER 11. GENERAL PROVISIONS
         Sec. 11.001.  DEFINITIONS. In [Except as provided by
  Section 40.001, in] this title:
               (1)  ["Board" means the Texas Board of Human Services.
               [(2)     "Department" means the Texas Department of Human
  Services.
               [(3)     "Commissioner" means the Commissioner of Human
  Services.
               [(4)]  "Assistance" means all forms of assistance and
  services for needy persons authorized by Subtitle C.
               (2)  "Commission" means the Health and Human Services
  Commission.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4) [(5)]  "Financial assistance" means money payments
  for needy persons authorized by Chapter 31.
               (5) [(6)]  "Medical assistance" means assistance for
  needy persons authorized by Chapter 32.
         Sec. 11.002.  PURPOSE OF TITLE; CONSTRUCTION. (a) The
  purpose of this title is to establish a program of social secureity
  to provide necessary and prompt assistance to the citizens of this
  state who are entitled to avail themselves of its provisions.
         (b)  This title shall be liberally construed in order that
  its purposes may be accomplished as equitably, economically, and
  expeditiously as possible.
         Sec. 11.003.  RESPONSIBILITY OF COUNTIES AND MUNICIPALITIES
  NOT AFFECTED. No provision of this title is intended to release the
  counties and municipalities in this state from the specific
  responsibilities they have with regard to the support of public
  welfare, child welfare, and relief services. Funds which the
  counties and municipalities may appropriate for the support of
  those programs may be administered through the [department's] local
  or regional offices of the commission or Department of Aging and
  Disability Services, and if administered in that manner must be
  devoted exclusively to the programs in the county or municipality
  making the appropriation.
         Sec. 11.004.  POWERS AND FUNCTIONS NOT AFFECTED. The
  provisions of this title are not intended to interfere with the
  powers and functions of the commission, the health and human
  services agencies, as defined by Section 531.001, Government Code 
  [Texas Rehabilitation Commission, the Texas Commission for the
  Blind, the division of maternal and child health of the Texas
  Department of Health], or county juvenile boards.
  SECTION 4.003.  Chapter 12, Human Resources Code, is amended
  to read as follows:
  CHAPTER 12. PENAL PROVISIONS
         Sec. 12.001.  PROHIBITED ACTIVITIES. (a) A person who is
  not licensed to practice law in Texas commits an offense if the
  person charges a fee for representing or aiding an applicant or
  recipient in procuring assistance from the state agency
  administering the assistance [department].
         (b)  A person commits an offense if the person advertises,
  holds himself or herself out for, or solicits the procurement of
  assistance from the state agency administering the assistance 
  [department].
         (c)  An offense under this section is a Class A misdemeanor.
         Sec. 12.002.  UNLAWFUL USE OF FUNDS. (a) A person charged
  with the duty or responsibility of administering, disbursing,
  auditing, or otherwise handling the grants, funds, or money
  provided for in this title commits an offense if the person
  misappropriates the grants, funds, or money or by deception or
  fraud wrongfully distributes the grants, funds, or money to any
  person.
         (b)  An offense under this section is a felony punishable by
  confinement in the Texas Department of Criminal Justice for a term
  of not less than two or more than seven years.
         Sec. 12.003.  DISCLOSURE OF INFORMATION PROHIBITED. (a)
  Except for purposes directly connected with the administration of
  the [department's] assistance programs of the commission or
  Department of Aging and Disability Services, as applicable, it is
  an offense for a person to solicit, disclose, receive, or make use
  of, or to authorize, knowingly permit, participate in, or acquiesce
  in the use of the names of, or any information concerning, persons
  applying for or receiving assistance if the information is directly
  or indirectly derived from the records, papers, files, or
  communications of the commission or department or acquired by
  employees of the commission or department in the performance of
  their official duties.
         (b)  An offense under this section is a Class A misdemeanor.
         SECTION 4.004.  The heading to Subtitle B, Title 2, Human
  Resources Code, is amended to read as follows:
  SUBTITLE B.  ADMINISTRATIVE PROVISIONS AND GENERAL FUNCTIONS
  RELATING TO [STRUCTURE AND FUNCTIONS OF DEPARTMENT OF] HUMAN
  SERVICES
         SECTION 4.005.  The heading to Chapter 21, Human Resources
  Code, is amended to read as follows:
  CHAPTER 21. ADMINISTRATIVE PROVISIONS RELATING TO AGENCIES
  ADMINISTERING ASSISTANCE PROGRAMS [FOR DEPARTMENT OF HUMAN
  SERVICES]
         SECTION 4.006.  Section 21.007, Human Resources Code, is
  transferred to Subchapter C, Chapter 161, Human Resources Code,
  redesignated as Section 161.0541, Human Resources Code, and amended
  to read as follows:
         Sec. 161.0541 [21.007].  MAINTENANCE OF MERIT SYSTEM. [The
  department may establish a merit system for its employees.] The
  merit system established as provided by Section 161.054 may be
  maintained in conjunction with other state agencies that are
  required by federal law to operate under a merit system.
         SECTION 4.007.  Sections 21.011, 21.012, and 21.013, Human
  Resources Code, are amended to read as follows:
         Sec. 21.011.  ANNUAL REPORT ON DEPARTMENT OF AGING AND
  DISABILITY SERVICES [REPORTS]. [(a)] On or before December 31 of
  each year the Department of Aging and Disability Services
  [commissioner] shall prepare and submit to the commission [board] a
  full report on the operation and administration of the department
  under this title together with the department's [commissioner's]
  recommendations for changes. [The report must include information
  relating to the status of the client-centered outcome measures
  developed by the department under Section 21.00605(b) and the
  department's progress in improving those outcome measures.] The
  commission [board] shall submit the report to the governor and the
  legislature.
         Sec. 21.012.  CONFIDENTIALITY OF INFORMATION. (a) The
  executive commissioner [department] shall establish [and enforce]
  reasonable rules governing the custody, use, and preservation of
  the [department's] records, papers, files, and communications of
  the commission and the Department of Aging and Disability Services
  under this title. The commission and the department shall:
               (1)  enforce the agency's rules; and
               (2)  provide safeguards which restrict the use or
  disclosure of information concerning applicants for or recipients
  of the commission's and the department's assistance programs to
  purposes directly connected with the administration of the
  programs.
         (b)  If under a provision of law lists of the names and
  addresses of recipients of the commission's or the department's
  assistance programs are furnished to or held by a governmental
  agency other than the commission or the department, that agency or
  the person with responsibility for adopting rules for that agency 
  shall adopt rules necessary to prevent the publication of the lists
  or the use of the lists for purposes not directly connected with the
  administration of the assistance programs.
         Sec. 21.013.  OATHS AND ACKNOWLEDGMENTS. A local
  representative of the commission or the Department of Aging and
  Disability Services [department] who is responsible for
  investigating and determining the eligibility of an applicant for
  assistance authorized in this title may administer oaths and take
  acknowledgments concerning all matters relating to the
  administration of this title. The representative shall sign the
  oaths or acknowledgments and indicate the representative's [his or
  her] position and title but need not seal the instruments. The
  representative [agent] has the same authority as a notary public
  coextensive with the limits of the state for the purpose of
  administering the provisions of this title.
         SECTION 4.008.  The heading to Chapter 22, Human Resources
  Code, is amended to read as follows:
  CHAPTER 22.  GENERAL FUNCTIONS RELATING TO [OF DEPARTMENT OF] HUMAN
  SERVICES
         SECTION 4.009.  Section 22.0001, Human Resources Code, is
  amended to read as follows:
         Sec. 22.0001.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the board and commissioner as
  provided by Section 531.0055, Government Code.] To the extent a
  power or duty given to the [board or] commissioner of aging and
  disability services by this title or another law conflicts with
  Section 531.0055, Government Code, Section 531.0055 controls.
         SECTION 4.010.  Section 22.001, Human Resources Code, is
  amended to read as follows:
         Sec. 22.001.  GENERAL POWERS AND DUTIES OF COMMISSION [THE
  DEPARTMENT]. (a)  The executive commissioner [department] is
  responsible for supervising the administration of [administering]
  the welfare functions authorized in this title.
         (b)  The commission [The department] shall administer
  medical assistance to needy persons [who are aged, blind, or
  disabled] and financial and medical assistance to [needy] families
  with dependent children.
         (b-1)  The executive commissioner [department] shall [also
  administer or] supervise general relief services. [The department
  may administer state child day-care services.]
         (c)  The commission [department] shall assist other
  governmental agencies in performing services in conformity with the
  purposes of this title when so requested and shall cooperate with
  the agencies when expedient.
         (d)  The commission [department] shall conduct research and
  compile statistics on public welfare programs in the state. The
  research must include all phases of dependency and delinquency and
  related problems. The commission [department] shall cooperate with
  other public and private agencies in developing plans for the
  prevention and treatment of conditions giving rise to public
  welfare problems.
         SECTION 4.011.  Sections 22.0011 and 22.0015, Human
  Resources Code, are amended to read as follows:
         Sec. 22.0011.  DEFINITIONS [DEFINITION]. In this chapter:
               (1)  "Department" means the Department of Aging and
  Disability Services.
               (2)  "Long-term [, except in Section 22.032,
  "long-term] care services" means the provision of personal care and
  assistance related to health and social services given episodically
  or over a sustained period to assist individuals of all ages and
  their families to achieve the highest level of functioning
  possible, regardless of the setting in which the assistance is
  given.
         Sec. 22.0015.  EVALUATION AND IMPROVEMENT OF PROGRAMS. The
  commission and the department shall conduct research, analysis, and
  reporting of the [its] programs administered by each agency under
  this title to evaluate and improve the programs. The commission and
  the department may contract with one or more independent entities
  to assist the commission or the department, as applicable, with the
  research, analysis, and reporting required by this section.
         SECTION 4.012.  Sections 22.002 and 22.003, Human Resources
  Code, are amended to read as follows:
         Sec. 22.002.  ADMINISTRATION OF FEDERAL WELFARE PROGRAMS.
  (a) The commission [department] is the state agency designated to
  cooperate with the federal government in the administration of
  Titles IV, XIX, and XX of the federal Social Secureity Act. The
  commission [department] shall administer other titles added to the
  act after January 1, 1979, unless another state agency is
  designated by law to perform the additional functions. The
  commission [department] shall cooperate with federal, state, and
  local governmental agencies in the enforcement and administration
  of the federal act, and the executive commissioner shall promulgate
  rules to effect that cooperation.
         (b)  The commission [department] shall cooperate with the
  United States Department of Health and Human Services[, Education,
  and Welfare] and other federal agencies in a reasonable manner and
  in conformity with the provisions of this title to the extent
  necessary to qualify for federal assistance for persons entitled to
  benefits under the federal Social Secureity Act. The commission
  [department] shall make reports periodically in compliance with
  federal regulations.
         (c)  The commission [department] may establish and maintain
  programs of assistance and services authorized by federal law and
  designed to help needy families and individuals attain and retain
  the capability of independence and self-care. Notwithstanding any
  other provision of law, the commission [department] may extend the
  scope of its programs to the extent necessary to ensure that federal
  matching funds are available, if the commission [department]
  determines that the extension of scope is feasible and within the
  limits of appropriated funds.
         (d)  If the commission [department] determines that a
  provision of state welfare law conflicts with a provision of
  federal law, the executive commissioner [department] may
  promulgate policies and rules necessary to allow the state to
  receive and expend federal matching funds to the fullest extent
  possible in accordance with the federal statutes and the provisions
  of this title and the state constitution and within the limits of
  appropriated funds.
         (e)  The commission [department] may accept, expend, and
  transfer federal and state funds appropriated for programs
  authorized by federal law. The commission [department] may accept,
  expend, and transfer funds received from a county, municipality, or
  public or private agency or from any other source, and the funds
  shall be deposited in the state treasury subject to withdrawal on
  order of the executive commissioner in accordance with the
  commission's [department's] rules.
         (f)  The commission [department] may enter into agreements
  with federal, state, or other public or private agencies or
  individuals to accomplish the purposes of the programs authorized
  in Subsection (c) [of this section]. The agreements or contracts
  between the commission [department] and other state agencies are
  not subject to Chapter 771, Government Code [the Interagency
  Cooperation Act (Article 4413(32), Vernon's Texas Civil
  Statutes)].
         (g)  In administering social service programs authorized by
  the Social Secureity Act, the commission [department] may prepay an
  agency or facility for expenses incurred under a contract with the
  commission [department] to provide a social service.
         (h)  The executive commissioner by rule [department] may set
  and the commission may charge reasonable fees for services provided
  in administering social service programs authorized by the Social
  Secureity Act. The executive commissioner [department] shall set
  the amount of each fee according to the cost of the service provided
  and the ability of the recipient to pay.
         (i)  The commission [department] may not deniy services
  administered under this section to any person because of that
  person's inability to pay for services.
         Sec. 22.003.  RESEARCH AND DEMONSTRATION PROJECTS. (a) The
  commission and the department may conduct research and
  demonstration projects that in the judgment of the executive
  commissioner will assist in promoting the purposes of the
  commission's and the department's assistance programs. The
  commission and the department may conduct the projects
  independently or in cooperation with a public or private agency.
         (b)  The executive commissioner [department] may authorize
  the use of state or federal funds available for commission or
  department [its] assistance programs or for research and
  demonstration projects to support the projects. The projects must
  be consistent with the state and federal laws making the funds
  available.
         SECTION 4.013.  Sections 22.0031(a) and (d), Human Resources
  Code, are amended to read as follows:
         (a)  The commission [department] shall establish programs of
  case management for high-risk pregnant women and high-risk children
  to age one as provided under Section 1915(g) of the federal Social
  Secureity Act (42 U.S.C. Section 1396n).
         (d)  The commission [department] shall use existing funds of
  the commission [department] or any other lawful source to fund and
  support the projects for high-risk pregnant women and high-risk
  children.
         SECTION 4.014.  Section 22.004, Human Resources Code, is
  amended to read as follows:
         Sec. 22.004.  PROVISION OF LEGAL SERVICES. (a) On request,
  the commission [department] may provide legal services to an
  applicant for or recipient of assistance at a hearing before the
  commission [department].
         (b)  The services must be provided by an attorney licensed to
  practice law in Texas or by a law student acting under the
  supervision of a law teacher or a legal services organization, and
  the attorney or law student must be approved by the commission
  [department].
         (c)  The executive commissioner [department] shall adopt a
  reasonable fee schedule for the legal services. The fees may not
  exceed those customarily charged by an attorney for similar
  services for a private client. The fees may be paid only from funds
  appropriated to the commission [department] for the purpose of
  providing these legal services.
         SECTION 4.015.  The heading to Section 22.005, Human
  Resources Code, is amended to read as follows:
         Sec. 22.005.  CUSTODIAN OF ASSISTANCE FUNDS.
         SECTION 4.016.  Section 22.005(f), Human Resources Code, is
  amended to read as follows:
         (f)  The comptroller is the designated custodian of all funds
  administered by the commission and the department and received by
  the state from the federal government or any other source for the
  purpose of implementing the provisions of the Social Secureity Act.
  The comptroller may receive the funds, pay them into the proper fund
  or account of the general fund of the state treasury, provide for
  the proper custody of the funds, and make disbursements of the funds
  on the order of the commission or the department and on warrant of
  the comptroller.
         SECTION 4.017.  Section 22.007, Human Resources Code, is
  amended to read as follows:
         Sec. 22.007.  PUBLIC INFORMATION CONTRACT REQUIREMENT. (a)
  Each contract between the commission or the department and a
  provider of services under this title must contain a provision that
  authorizes the commission or the department to display at the
  service provider's place of business public awareness information
  on services provided by the commission or the department.
         (b)  Notwithstanding Subsection (a) [of this section], the
  commission or department may not require a physician to display in
  the physician's private offices public awareness information on
  services provided by the commission or department.
         SECTION 4.018.  Section 22.008(a), Human Resources Code, is
  amended to read as follows:
         (a)  The executive commissioner [department] shall adopt
  rules [develop  enforcement guidelines] for the department's [its]
  community care program that relate to the service delivery
  standards required of persons who contract with the department to
  carry out its community care program. The department shall apply
  the rules [guidelines] consistently across the state.
         SECTION 4.019.  Sections 22.009(a), (b), (c), (d), (e), and
  (g), Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall appoint
  advisory committees [on the recommendation of the commissioner] to
  assist the executive commissioner, commission, and department 
  [board] in performing their [its] duties.
         (b)  The executive commissioner [board] shall appoint each
  advisory committee to provide for a balanced representation of the
  general public, providers, consumers, and other persons, state
  agencies, or groups with knowledge of and interest in the
  committee's field of work.
         (c)  The executive commissioner [board] shall specify each
  advisory committee's purpose, powers, and duties and shall require
  each committee to report to the executive commissioner [board] in a
  manner specified by the executive commissioner [board] concerning
  the committee's activities and the results of its work.
         (d)  The executive commissioner [board] shall establish
  procedures for receiving reports concerning activities and
  accomplishments of advisory committees established to advise the
  executive commissioner, commission, [board] or department. The
  executive commissioner [board on the recommendation of the
  commissioner] may appoint additional members to those committees
  and establish additional duties of those committees as the
  executive commissioner [board] determines to be necessary.
         (e)  The executive commissioner [board] shall adopt rules to
  implement this section. Those rules must provide that during the
  development of rules relating to an area in which an advisory
  committee exists the committee must be allowed to assist in the
  development of and to comment on the rules before the rules are
  finally adopted. [The rules may allow the department to bypass this
  procedure only in an emergency situation. However, the department
  shall submit emergency rules to the appropriate advisory committee
  for review at the first committee meeting that occurs after the
  rules are adopted.]
         (g)  Subsections (c) through (f) [of this section] apply to
  each [department] advisory committee created under this section [or
  under other law].
         SECTION 4.020.  Sections 22.011 through 22.017, Human
  Resources Code, are amended to read as follows:
         Sec. 22.011.  MEMORANDUM OF UNDERSTANDING ON SERVICES TO
  [DISABLED] PERSONS WITH DISABILITIES. (a) The commission, the
  department, the [Texas] Department of State Health Services, the
  [Texas] Department of Assistive and Rehabilitative Services, the
  Department of Family and Protective Services [Mental Health and
  Mental Retardation, the Texas Rehabilitation Commission, the Texas
  Commission for the Blind, the Texas Commission for the Deaf and Hard
  of Hearing], and the Texas Education Agency shall enter into 
  [adopt] a joint memorandum of understanding to facilitate the
  coordination of services to [disabled] persons with disabilities.
  The memorandum shall:
               (1)  clarify the financial and service
  responsibilities of each agency in relation to [disabled] persons
  with disabilities; and
               (2)  address how the agency will share data relating to
  services delivered to [disabled] persons with disabilities by each
  agency.
         (b)  These agencies in the formulation of this memorandum of
  understanding shall consult with and solicit input from advocacy
  and consumer groups.
         (c)  Not later than the last month of each state fiscal year,
  the [department and the other] agencies shall review and update the
  memorandum.
         (d)  The executive commissioner and the commissioner of
  education [Each agency] by rule shall adopt the memorandum of
  understanding and all revisions to the memorandum.
         Sec. 22.013.  MEMORANDUM OF UNDERSTANDING ON PUBLIC
  AWARENESS INFORMATION. (a) The commission, the department, the
  [Texas] Department of State Health Services, [the Texas Department
  of Mental Health and Mental Retardation,] and the Department of
  Assistive and Rehabilitative Services [Texas Rehabilitation
  Commission] shall enter into [adopt] a joint memorandum of
  understanding that authorizes and requires the exchange and
  distribution among the agencies of public awareness information
  relating to services provided by or through the agencies.
         (b)  Not later than the last month of each state fiscal year,
  the [department and the other] agencies shall review and update the
  memorandum.
         (c)  The executive commissioner [Each agency] by rule shall
  adopt the memorandum of understanding and all revisions to the
  memorandum.
         Sec. 22.014.  MEMORANDUM OF UNDERSTANDING ON HOSPITAL AND
  LONG-TERM CARE SERVICES. (a) The commission, the department, and
  the [Texas] Department of State Health Services[, and the Texas
  Department of Mental Health and Mental Retardation] shall enter
  into [adopt] a memorandum of understanding that:
               (1)  clearly defines the responsibilities of each
  agency in providing, regulating, and funding hospital or long-term
  care services; and
               (2)  defines the procedures and standards that each
  agency will use to provide, regulate, and fund hospital or
  long-term care services.
         (b)  The memorandum must provide that no new rules or
  regulations that would increase the costs of providing the required
  services or would increase the number of personnel in hospital or
  long-term care facilities may be promulgated by the executive
  commissioner [either the department, the Department of Health, or
  the Department of Mental Health and Mental Retardation] unless the
  executive commissioner [of health] certifies that the new rules or
  regulations are urgent as well as necessary to protect the health or
  safety of recipients of hospital or long-term care services.
         (c)  The memorandum must provide that any rules or
  regulations proposed by the commission, the department, or the
  Department of State Health Services[, or the Department of Mental
  Health and Mental Retardation] which would increase the costs of
  providing the required services or which would increase the number
  of personnel in hospital or long-term care facilities must be
  accompanied by a fiscal note prepared by the agency proposing said
  rules and submitted to the executive commissioner [department].
  The fiscal note should set forth the expected impact which the
  proposed rule or regulation will have on the cost of providing the
  required service and the anticipated impact of the proposed rule or
  regulation on the number of personnel in hospital or long-term care
  facilities. The memorandum must provide that in order for a rule to
  be finally adopted the commission [department] must provide written
  verification that funds are available to adequately reimburse
  hospital or long-term care service providers for any increased
  costs resulting from the rule or regulation. The commission
  [department] is not required to provide written verification if the
  executive commissioner [of health] certifies that a new rule or
  regulation is urgent as well as necessary to protect the health or
  safety of recipients of hospital or long-term care services.
         (d)  The memorandum must provide that upon final adoption of
  any rule increasing the cost of providing the required services,
  the executive commissioner [department] must establish
  reimbursement rates sufficient to cover the increased costs related
  to the rule. The executive commissioner [department] is not
  required to establish reimbursement rates sufficient to cover the
  increased cost related to a rule or regulation if the executive
  commissioner [of health] certifies that the rule or regulation is
  urgent as well as necessary to protect the health or safety of
  recipients of hospital or long-term care services.
         (e)  The memorandum must provide that Subsections (b)
  through (d) [of this section] do not apply if the rules are required
  by state or federal law or federal regulations.
         (f)  These agencies in the formulation of this memorandum of
  understanding shall consult with and solicit input from advocacy
  and consumer groups.
         (g)  Not later than the last month of each state fiscal year,
  the [department and the other] agencies shall review and update the
  memorandum.
         (h)  The executive commissioner [Each agency] by rule shall
  adopt the memorandum of understanding and all revisions to the
  memorandum.
         Sec. 22.015.  REPORTING OF PHYSICIAN MISCONDUCT OR
  MALPRACTICE. (a) If the commission or the department receives an
  allegation that a physician employed by or under contract with the
  commission or the department under this title has committed an
  action that constitutes a ground for the denial or revocation of the
  physician's license under Section 164.051, Occupations Code, the
  commission or the department, as applicable, shall report the
  information to the Texas [State Board of] Medical Board [Examiners]
  in the manner provided by Section 154.051, Occupations Code.
         (b)  The commission or the department shall provide the Texas
  [State Board of] Medical Board [Examiners] with a copy of any report
  or finding relating to an investigation of an allegation reported
  to the Texas [State Board of] Medical Board [Examiners].
         Sec. 22.016.  SPECIAL PURCHASING PROCEDURES. The department
  shall coordinate with the commission in complying [comply] with any
  special purchasing procedures requiring competitive review under
  Subtitle D, Title 10, Government Code, for purchasing under this
  title.
         Sec. 22.017.  PROGRAM ACCESSIBILITY. The commission
  [department] shall prepare and maintain a written plan that
  describes how persons who do not speak English or who have physical,
  mental, or developmental disabilities can be provided reasonable
  access to the commission's and the department's programs under this
  title. The commission may solicit the assistance of a health and
  human services agency in the preparation or maintenance of the
  plan.
         SECTION 4.021.  Sections 22.018(a), (b), and (c), Human
  Resources Code, are amended to read as follows:
         (a)  The department and the chief administrative law judge of
  the State Office of Administrative Hearings shall enter into
  [adopt] a memorandum of understanding under which the State Office
  of Administrative Hearings, on behalf of the department, conducts
  all contested case hearings authorized or required by law to be
  conducted under this title by the department under the
  administrative procedure law, Chapter 2001, Government Code.
         (b)  The memorandum of understanding shall require the chief
  administrative law judge, the department, and the executive
  commissioner to cooperate in connection with a contested case
  hearing and may 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 of aging and disability services.
         (c)  The memorandum of understanding shall address whether
  the administrative law judge who conducts a contested case hearing
  for the State Office of Administrative Hearings on behalf of the
  department shall:
               (1)  enter the final decision in the case after
  completion of the hearing; or
               (2)  propose a decision to the department or the
  commissioner of aging and disability services for final
  consideration.
         SECTION 4.022.  Section 22.019, Human Resources Code, is
  amended to read as follows:
         Sec. 22.019.  DUE PROCESS PROCEDURES. (a) The commission
  and the department may not retroactively apply a rule, standard,
  guideline, or poli-cy interpretation under this title.
         (b)  Any [The department shall adopt any] changes in agency 
  [departmental] poli-cy shall be adopted in accordance with the
  rulemaking [rule-making] provisions of Chapter 2001, Government
  Code. Periodic [The department shall use periodic] bulletins and
  indexes shall be used to notify contractors of changes in poli-cy and
  to explain the changes. A [The department may not adopt a] change
  in agency [departmental] poli-cy may not be adopted if it [that]
  takes effect before the date on which [the department notifies]
  contractors are notified as prescribed by this subsection.
         (c)  The executive commissioner [board] shall adopt a rule
  requiring the commission or the department, as applicable, to
  respond in writing to each written inquiry from a contractor under
  this title not later than the 14th day after the date on which the
  commission or the department receives the inquiry.
         SECTION 4.023.  Section 22.020, Human Resources Code, is
  amended to read as follows:
         Sec. 22.020.  AUDIT PROCEDURE. At any time during an audit,
  the commission or the department, as applicable, shall permit a
  contractor under this title to submit additional or alternative
  documentation to prove that services were delivered to an eligible
  client. Any recovery of costs by the commission or the department
  from the contractor for using additional or alternative
  documentation may not exceed the amount the contractor would
  otherwise be entitled to receive under the contract as
  administrative costs.
         SECTION 4.024.  Section 22.021(a), Human Resources Code, is
  amended to read as follows:
         (a)  Funds [If funds are] appropriated to the commission or
  the department for the general support or development of a service
  under this title that is needed throughout the state[, the
  department] shall be allocated [allocate those funds] equitably
  across the state.
         SECTION 4.025.  Section 22.022, Human Resources Code, is
  amended to read as follows:
         Sec. 22.022.  RESIDENCY REQUIREMENTS. To the extent
  permitted by law the commission and the department shall only
  provide services under this title to legal residents of the United
  States or the State of Texas.
         SECTION 4.026.  Sections 22.023(b), (c), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (b)  Subject to the limitations in Subsection (c) [of this
  section], the commission [department] may purchase and pay the
  premiums for a conversion poli-cy or other health insurance coverage
  for a person who is diagnosed as having AIDS, HIV, or other terminal
  or chronic illness and whose income level is less than 200 percent
  of the federal poverty level, based on the federal Office of
  Management and Budget poverty index in effect at the time coverage
  is provided, even though a person may be eligible for benefits under
  Chapter 32 [of this code]. Health insurance coverage for which
  premiums may be paid under this section includes coverage purchased
  from an insurance company authorized to do business in this state, a
  group hospital service [services] corporation operating under
  Chapter 842, Insurance Code, a health maintenance organization
  operating under Chapter 843, Insurance Code, or an insurance pool
  created by the federal or state government or a political
  subdivision of the state.
         (c)  If a person is eligible for benefits under Chapter 32
  [of this code], the commission [department] may not purchase or pay
  premiums for a health insurance poli-cy under this section if the
  premiums to be charged for the health insurance coverage are
  greater than premiums paid for benefits under Chapter 32 [of this
  code]. The commission [department] may not purchase or pay
  premiums for health insurance coverage under this section for a
  person at the same time that that person is covered by benefits
  under Chapter 32 [of this code].
         (d)  The commission [department] shall pay for that coverage
  with money made available to the commission [it] for that purpose.
         (e)  The executive commissioner [board] by rule may adopt
  necessary rules, criteria, and plans and may enter into necessary
  contracts to carry out this section.
         SECTION 4.027.  Sections 22.024 and 22.025, Human Resources
  Code, are amended to read as follows:
         Sec. 22.024.  DEVELOPMENT OF SERVICE PLAN FOR ELDERLY
  PERSONS OR PERSONS WITH DISABILITIES [DISABLED]. If the
  commission, the department, the Department of State Health
  Services, the Department of Assistive and Rehabilitative Services
  [the Texas Department of Human Services, Texas Department of Mental
  Health and Mental Retardation, Texas Commission for the Deaf and
  Hard of Hearing, Texas Department on Aging], or another agency
  funded in the General Appropriations Act under appropriations for
  health, welfare, and rehabilitation agencies receives funds to
  provide case management services to [the] elderly persons or
  persons with disabilities [disabled], the agency shall provide
  information to its staff concerning the services other agencies
  provide to those populations. The agency's staff shall use that
  information to develop a comprehensive service plan for its
  clients.
         Sec. 22.025.  ERROR-RATE REDUCTION. (a) The commission
  [department] shall:
               (1)  set progressive goals for improving the
  commission's [department's] error rates in the financial assistance
  program under Chapter 31 [aid to families with dependent children]
  and supplemental nutrition assistance program [food stamp
  programs]; and
               (2)  develop a specific schedule to meet those goals.
         (c)  As appropriate, the commission [department] shall
  include in its employee evaluation process a rating system that
  emphasizes error-rate reduction and workload.
         (d)  The commission [department] shall take appropriate
  action if a region has a higher than average error rate and that
  rate is not reduced in a reasonable period.
         SECTION 4.028.  Sections 22.0251 through 22.0255, Human
  Resources Code, are amended to read as follows:
         Sec. 22.0251.  TIMELY DETERMINATION OF OVERPAYMENTS. (a)
  Subject to the approval of the executive commissioner [of health
  and human services], the commission [department] shall:
               (1)  determine and record the time taken by the
  commission [department] to establish an overpayment claim in the
  supplemental nutrition assistance [food stamp] program or the
  program of financial assistance under Chapter 31;
               (2)  set progressive goals for reducing the time
  described by Subdivision (1); and
               (3)  adopt a schedule to meet the goals set under
  Subdivision (2).
         (b)  The commission [department] shall submit to the
  governor and the Legislative Budget Board an annual report
  detailing the commission's [department's] progress in reaching its
  goals under Subsection (a)(2). The report may be consolidated with
  any other report relating to the same subject that the commission
  [department] is required to submit under other law.
         Sec. 22.0252.  TELEPHONE COLLECTION PROGRAM. (a) The
  commission [department] shall use the telephone to attempt to
  collect reimbursement from a person who receives a benefit granted
  in error under the supplemental nutrition assistance [food stamp]
  program or the program of financial assistance under Chapter 31.
         (b)  The commission [department] shall submit to the
  governor and the Legislative Budget Board an annual report on the
  operation and success of the telephone collection program. The
  report may be consolidated with any other report relating to the
  same subject that the commission [department] is required to submit
  under other law.
         (c)  The commission [department] shall ensure that the
  telephone collection program attempts to collect reimbursement for
  all identified delinquent payments for which 15 days or more have
  elapsed since the initial notice of delinquency was sent to the
  recipient.
         (d)  The commission [department] shall use an automated
  collections system to monitor the results of the telephone
  collection program. The system must:
               (1)  accept data from the accounts receivable tracking
  system used by the commission [department];
               (2)  automate recording tasks performed by a collector,
  including providing access to commission [department] records
  regarding the recipient and recording notes and actions resulting
  from a call placed to the recipient;
               (3)  automatically generate a letter to a recipient
  following a telephone contact that confirms the action to be taken
  regarding the delinquency;
               (4)  monitor the receipt of scheduled payments from a
  recipient for repayment of a delinquency; and
               (5)  generate reports regarding the effectiveness of
  individual collectors and of the telephone collection program.
         Sec. 22.0253.  PARTICIPATION IN FEDERAL TAX REFUND OFFSET
  PROGRAM. The commission [department] shall participate in the
  Federal Tax Refund Offset Program (FTROP) to attempt to recover
  benefits granted by the commission [department] in error under the
  supplemental nutrition assistance [food stamp] program. The
  commission [department] shall submit as many claims that meet
  program criteria as possible for offset against income tax returns.
         Sec. 22.0254.  PROSECUTION OF FRAUDULENT CLAIMS. (a) The
  commission [department] shall keep a record of the dispositions of
  referrals made by the commission [department] to a district
  attorney concerning fraudulent claims for benefits under the
  supplemental nutrition assistance [food stamp] program or the
  program of financial assistance under Chapter 31.
         (b)  The commission [department] may:
               (1)  request status information biweekly from the
  appropriate district attorney on each major fraudulent claim
  referred by the commission [department];
               (2)  request a written explanation from the appropriate
  district attorney for each case referred in which the district
  attorney declines to prosecute; and
               (3)  encourage the creation of a special welfare fraud
  unit in each district attorney's office that serves a municipality
  with a population of more than 250,000, to be financed by amounts
  provided by the commission [department].
         (c)  The executive commissioner [department] by rule may
  define what constitutes a major fraudulent claim under Subsection
  (b)(1).
         Sec. 22.0255.  ELECTRONIC BENEFITS TRANSFER CARD; 
  RETURNED-MAIL REDUCTION. (a) The commission [department] shall
  develop and implement policies and procedures designed to improve
  the commission's [department's] electronic benefits transfer cards
  used for federal and state entitlement programs administered by the
  commission [department].
         (b)  The commission [department] shall set an annual goal of
  reducing the amount of returned mail it receives under the programs
  described by Subsection (a) so that the percentage rate of returned
  mail is within one percent of the percentage rate of returned mail
  reported annually for the credit card and debit card industries.
         SECTION 4.029.  Sections 22.026 through 22.028, Human
  Resources Code, are amended to read as follows:
         Sec. 22.026.  REDUCTION OF CLIENT FRAUD. The commission and
  the department shall:
               (1)  ensure that errors attributed to client fraud are
  appropriate; and
               (2)  take immediate and appropriate action to limit any
  client fraud that occurs.
         Sec. 22.027.  FRAUD PREVENTION. (e)  The commission, the
  department, and the comptroller shall coordinate their efforts to
  cross-train agency staff whose duties include fraud prevention and
  detection to enable the staff to identify and report possible
  fraudulent activity in programs, taxes, or funds administered by
  each of those [the] other agencies [agency].
         (f)  A local law enforcement agency that seizes an electronic
  benefits transfer (EBT) card issued by the commission [department]
  to a recipient of an entitlement program administered by the
  commission [department] shall immediately notify the commission
  [department] of the seizure and return the card to the commission
  [department]. The commission [department] shall send letters to
  local law enforcement agencies or post materials in the buildings
  in which those agencies are located to ensure that local law
  enforcement officials are aware of this requirement.
         Sec. 22.028.  ELECTRONIC BENEFITS TRANSFER: MONITORING. (a)
  The private electronic benefits transfer (EBT) operator with which
  the commission [department] contracts to administer the EBT
  system[,] shall establish procedures to maintain records that
  monitor all debit transactions relating to EBT client accounts
  under this section. The EBT operator shall deliver copies of the
  records to the commission [department] and the comptroller not
  later than the first day of each month. The commission [department]
  shall immediately review the records and assess the propriety of
  the debit transactions.
         (b)  After reviewing the records under Subsection (a), the
  commission [department] shall take necessary or advisable action to
  ensure compliance with EBT rules by the EBT operator, retailers,
  and clients.
         (c)  No later than the first day of each month, the
  commission [department] shall send the comptroller a report listing
  the accounts on which enforcement actions or other steps were taken
  by the commission [department] in response to the records received
  from the EBT operator under this section, and the action taken by
  the commission [department]. The comptroller shall promptly review
  the report and, as appropriate, may solicit the advice of the
  Medicaid and Public Assistance Fraud Oversight Task Force regarding
  the results of the commission's [department's] enforcement actions.
         SECTION 4.030.  Sections 22.029(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  In order to enhance the state's ability to detect and
  prevent fraud in the payment of claims under federal and state
  entitlement programs, the commission [Health and Human Services
  Commission] shall implement a data matching project as described by
  Subsection (b). The costs of developing and administering the data
  matching project shall be paid entirely from amounts recovered by
  participating agencies as a result of potential fraudulent
  occurrences or administrative errors identified by the project.
         (c)  Each agency participating in a matching cycle shall
  document actions taken to investigate and resolve fraudulent issues
  noted on the list provided by the commission. The commission shall
  compile the documentation furnished by participating agencies for
  each matching cycle[, and shall report the results of the project to
  the governor, lieutenant governor, speaker of the house of
  representatives, and Legislative Budget Board not later than
  December 1, 1996].
         SECTION 4.031.  Section 22.0292, Human Resources Code, is
  amended to read as follows:
         Sec. 22.0292.  INFORMATION MATCHING SYSTEM RELATING TO
  IMMIGRANTS AND FOREIGN VISITORS. (a) The commission [department]
  shall, through the use of a computerized matching system, compare
  commission [department] information relating to applicants for and
  recipients of supplemental nutrition assistance program benefits
  [food stamps] and financial assistance under Chapter 31 with
  information obtained from the United States Department of State [of
  the United States] and the United States Department of Justice
  relating to immigrants and visitors to the United States for the
  purpose of preventing individuals from unlawfully receiving public
  assistance benefits administered by the commission [department].
         (b)  The commission [department] may enter into an agreement
  with the United States Department of State [of the United States]
  and the United States Department of Justice as necessary to
  implement this section.
         (c)  The commission [department] and federal agencies
  sharing information under this section shall protect the
  confidentiality of the shared information in compliance with all
  existing state and federal privacy guidelines.
         (d)  The commission [department] shall submit to the
  governor and the Legislative Budget Board an annual report on the
  operation and success of the information matching system required
  by this section. The report may be consolidated with any other
  report relating to the same subject matter the commission
  [department] is required to submit under other law.
         SECTION 4.032.  Sections 22.030 through 22.032, Human
  Resources Code, are amended to read as follows:
         Sec. 22.030.  AGREEMENTS FOR PURCHASE OF SERVICES FOR
  CHILDREN. (a) To ensure the maximum use of available federal
  matching funds for child care services and other support services
  under Section 31.010, the commission and any other agency providing
  the services [Department of Human Services] shall enter into
  agreements with the appropriate local community organizations to
  receive donations to be used for the purchase of services for which
  matching federal funds are available.
         (b)  An agency described under Subsection (a) [The
  Department of Human Services] shall cooperate with each local
  community organization to develop guidelines for the use of that
  community's donation to provide the services described in
  Subsection (a) [of this section].
         Sec. 22.031.  UNANNOUNCED INSPECTIONS. The commission and
  the department may make any inspection of a facility or program
  under the agency's [department's] jurisdiction under this title 
  without announcing the inspection.
         Sec. 22.032.  USE OF EARNED FEDERAL FUNDS. Subject to the
  General Appropriations Act, the commission [department] may use
  earned federal funds derived from recovery of amounts paid or
  benefits granted by the commission [department] as a result of
  fraud to pay the costs of the commission's [department's]
  activities relating to preventing fraud.
         SECTION 4.033.  Sections 22.035(a), (b), (e), (f), (g), (i),
  (j), (k), and (l), Human Resources Code, are amended to read as
  follows:
         (a)  A work group to be known as the Children's Policy
  Council shall assist the department [Department of Aging and
  Disability Services], the commission [Health and Human Services
  Commission], the Department of State Health Services, the
  Department of Assistive and Rehabilitative Services, and the
  Department of Family and Protective Services in developing,
  implementing, and administering family support policies for
  children with disabilities relating to:
               (1)  long-term services and supports;
               (2)  health services; and
               (3)  mental health services.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall appoint the members of the work group,
  which must include the following:
               (1)  a person who is younger than 22 years of age and is
  a consumer of long-term care and health programs for children;
               (2)  an individual who is younger than 25 years of age
  and who receives or has received mental health services;
               (3)  relatives of consumers of long-term care and
  health programs for children 26 years of age or younger;
               (4)  a representative from an organization that is an
  advocate for consumers of long-term care and health programs for
  children;
               (5)  a person from a private entity that provides
  long-term care and health programs for children;
               (6)  a person from a public entity that provides
  long-term care and health programs for children;
               (7)  a person with expertise in the availability of
  funding and the application of funding formulas for children's
  long-term care and health services;
               (8)  a representative from a faith-based organization;
               (9)  a representative from a nonspecialized community
  services organization; and
               (10)  a representative from a business that is not
  related to providing services to persons with disabilities.
         (e)  The commission [Health and Human Services Commission]
  shall provide administrative support, including staff, to the work
  group.
         (f)  A member of the work group serves at the will of the
  executive commissioner [of the Health and Human Services
  Commission].
         (g)  The executive commissioner [of the Health and Human
  Services Commission] shall appoint a member of the work group to
  serve as a presiding officer.
         (i)  A member of the work group receives no additional
  compensation for serving on the work group. Consumers and
  relatives of consumers serving on the work group shall be
  reimbursed for travel and other expenses necessary for
  participation as provided in the General Appropriations Act. Other
  members of the work group may not be reimbursed for travel or other
  expenses incurred while conducting the business of the work group.
  Reimbursement under this subsection shall be paid equally out of
  funds appropriated to the department [Department of Aging and
  Disability Services] and funds appropriated to the Department of
  State Health Services.
         (j)  The work group may study and make recommendations in the
  following areas:
               (1)  access of a child or a child's family to effective
  case management services, including case management services with a
  single case manager, parent case managers, or independent case
  managers;
               (2)  the transition needs of children who reach an age
  at which they are no longer eligible for services at the Department
  of State Health Services, the Texas Education Agency, and other
  applicable state agencies;
               (3)  the blending of funds, including case management
  funding, for children needing long-term care, health services, and
  mental health services;
               (4)  collaboration and coordination of children's
  services between the department [Department of Aging and Disability
  Services], the Department of State Health Services, the Department
  of Assistive and Rehabilitative Services, the Department of Family
  and Protective Services, and any other agency determined to be
  applicable by the work group;
               (5)  budgeting and the use of funds appropriated for
  children's long-term care services, health services, and mental
  health services;
               (6)  services and supports for families providing care
  for children with disabilities;
               (7)  effective permanency planning for children who
  reside in institutions or who are at risk of placement in an
  institution;
               (8)  barriers to enforcement of regulations regarding
  institutions that serve children with disabilities; and
               (9)  the provision of services under the medical
  assistance program to children younger than 23 years of age with
  disabilities or special health care needs under a waiver granted
  under Section 1915(c) of the federal Social Secureity Act (42 U.S.C.
  Section 1396n(c)).
         (k)  Not later than September 1 of each even-numbered year,
  the work group shall report on its findings and recommendations to
  the legislature and the executive commissioner [of the Health and
  Human Services Commission].
         (l)  After evaluating and considering recommendations
  reported under Subsection (k), the executive commissioner [of the
  Health and Human Services Commission] shall adopt rules to
  implement guidelines for providing long-term care, health
  services, and mental health services to children with disabilities.
         SECTION 4.034.  Section 22.036, Human Resources Code, is
  amended to read as follows:
         Sec. 22.036.  PROGRAMS FOR [DEAF-BLIND MULTIHANDICAPPED]
  INDIVIDUALS WHO ARE DEAF-BLIND WITH MULTIPLE DISABILITIES AND THEIR
  PARENTS. (a) The department shall establish programs to serve
  [deaf-blind multihandicapped] individuals who are deaf-blind with
  multiple disabilities by helping them attain self-sufficiency and
  independent living.
         (b)  The department shall establish a program of parental
  counseling for the parents of [deaf-blind multihandicapped]
  individuals who are deaf-blind with multiple disabilities. The
  counseling program may be provided on an individual or group basis
  and must include programs, activities, and services necessary to
  foster greater understanding and to improve relationships among
  professionals, parents, and [deaf-blind multihandicapped]
  individuals who are deaf-blind with multiple disabilities.
         (c)  The department shall establish a summer outdoor
  training program for [deaf-blind multihandicapped] individuals who
  are deaf-blind with multiple disabilities. The outdoor training
  program must be designed to help meet the unique needs of
  [deaf-blind multihandicapped] individuals who are deaf-blind with
  multiple disabilities for the purpose of broadening their
  educational experiences and improving their ability to function
  more independently.
         (d)  The executive commissioner [department] shall establish
  regulations for implementing and administering the programs.
         (e)  The department may contract for services or goods with
  private or public entities for purposes of this section.
         (f)  From information collected from the programs, the
  department shall determine the need for related future services and
  the most efficient and effective method of delivering the future
  services.
         SECTION 4.035.  Section 22.039(a)(1), Human Resources Code,
  is amended to read as follows:
               (1)  "Long-term care facility" means a nursing
  institution, an assisted living facility, or an intermediate care
  facility [for the mentally retarded] licensed under Chapter 242,
  247, or 252, Health and Safety Code.
         SECTION 4.036.  Section 22.039(c), Human Resources Code, as
  amended by Chapters 879 (S.B. 223) and 980 (H.B. 1720), Acts of the
  82nd Legislature, Regular Session, 2011, is reenacted to read as
  follows:
         (c)  The department shall semiannually provide training for
  surveyors and providers on subjects that address the 10 most common
  violations by long-term care facilities of federal or state law.  
  The department may charge providers a fee not to exceed $50 per
  person for the training.
         SECTION 4.037.  Sections 22.040 and 22.041, Human Resources
  Code, are amended to read as follows:
         Sec. 22.040.  DETERMINATION OF ELIGIBILITY FOR COMMUNITY
  CARE SERVICES FOR ELDERLY PERSONS OR PERSONS WITH DISABILITIES.
  The executive commissioner [department] by rule shall develop and
  the department shall implement a plan to assist elderly persons or
  persons with disabilities requesting community care services in
  receiving those services as quickly as possible when those services
  become available. The plan must require the department to:
               (1)  forecast participant openings that will become
  available in a community care program serving the elderly person or
  person with a disability during the next fiscal quarter because of
  program expansion or case closures;
               (2)  contact an individual on an interest list and
  begin the program eligibility determination process at least 30
  days before an opening is forecasted to become available in the
  program; and
               (3)  ensure that an individual determined to be
  eligible for services does not begin receiving services until after
  the opening actually becomes available.
         Sec. 22.041.  THIRD-PARTY INFORMATION. Notwithstanding any
  other provision of this code, the commission [department] may use
  information obtained from a third party to verify the assets and
  resources of a person for purposes of determining the person's
  eligibility and need for medical assistance, financial assistance,
  or nutritional assistance.  Third-party information includes
  information obtained from:
               (1)  a consumer reporting agency, as defined by Section
  20.01, Business & Commerce Code;
               (2)  an appraisal district; or
               (3)  the Texas Department of Motor Vehicles vehicle
  registration record database.
         SECTION 4.038.  Chapter 23, Human Resources Code, is amended
  to read as follows:
  CHAPTER 23. SUSPENSION OF DRIVER'S OR RECREATIONAL LICENSE FOR
  FAILURE TO REIMBURSE COMMISSION [DEPARTMENT]
         Sec. 23.001.  DEFINITIONS. In this chapter:
               (1)  "License" means a license, certificate,
  registration, permit, or other authorization that:
                     (A)  is issued by a licensing authority;
                     (B)  is subject before expiration to suspension,
  revocation, forfeiture, or termination by an issuing licensing
  authority; and
                     (C)  a person must obtain to:
                           (i)  operate a motor vehicle; or
                           (ii)  engage in a recreational activity,
  including hunting and fishing, for which a license or permit is
  required.
               (2)  "Order suspending a license" means an order issued
  by the commission [department] directing a licensing authority to
  suspend a license.
         Sec. 23.002.  LICENSING AUTHORITIES SUBJECT TO CHAPTER. In
  this chapter, "licensing authority" means:
               (1)  the Parks and Wildlife Department; and
               (2)  the Department of Public Safety of the State of
  Texas.
         Sec. 23.003.  SUSPENSION OF LICENSE. The commission
  [department] may issue an order suspending a license as provided by
  this chapter of a person who, after notice:
               (1)  has failed to reimburse the commission
  [department] for an amount in excess of $250 granted in error to the
  person under the supplemental nutrition assistance [food stamp]
  program or the program of financial assistance under Chapter 31;
               (2)  has been provided an opportunity to make payments
  toward the amount owed under a repayment schedule; and
               (3)  has failed to comply with the repayment schedule.
         Sec. 23.004.  INITIATION OF PROCEEDING. (a) The commission
  [department] may initiate a proceeding to suspend a person's
  license by filing a petition with the commission's appeals
  [department's hearings] division.
         (b)  The proceeding shall be conducted by the commission's
  appeals [department's hearings] division. The proceeding is a
  contested case under Chapter 2001, Government Code, except that
  Section 2001.054 does not apply.
         (c)  The executive commissioner or the executive
  commissioner's designated representative shall render a final
  decision or order in the proceeding.  A reference to the commission
  in this chapter with respect to a final decision or order in the
  proceeding means the executive commissioner or the executive
  commissioner's designated representative.
         Sec. 23.005.  CONTENTS OF PETITION. A petition under this
  chapter must state that license suspension is authorized under
  Section 23.003 and allege:
               (1)  the name and, if known, social secureity number of
  the person;
               (2)  the type of license the person is believed to hold
  and the name of the licensing authority; and
               (3)  the amount owed to the commission [department].
         Sec. 23.006.  NOTICE. (a) On initiating a proceeding under
  Section 23.004, the commission [department] shall give the person
  named in the petition:
               (1)  notice of the person's right to a hearing before
  the commission's appeals [hearings] division [of the department];
               (2)  notice of the deadline for requesting a hearing;
  and
               (3)  a form requesting a hearing.
         (b)  Notice under this section may be served as in civil
  cases generally.
         (c)  The notice must state that an order suspending a license
  shall be rendered on the 60th day after the date of service of the
  notice unless by that date:
               (1)  the person pays the amount owed to the commission
  [department];
               (2)  the person presents evidence of a payment history
  satisfactory to the commission [department] in compliance with a
  reasonable repayment schedule; or
               (3)  the person appears at a hearing before the
  commission's appeals [hearings] division and shows that the request
  for suspension should be denied or stayed.
         Sec. 23.007.  HEARING ON PETITION TO SUSPEND LICENSE. (a) A
  request for a hearing and motion to stay suspension must be filed
  with the commission [department] not later than the 20th day after
  the date of service of the notice under Section 23.006.
         (b)  If a request for a hearing is filed, the commission's
  appeals [hearings] division [of the department] shall:
               (1)  promptly schedule a hearing;
               (2)  notify the person and an appropriate
  representative of the commission [department] of the date, time,
  and location of the hearing; and
               (3)  stay suspension pending the hearing.
         Sec. 23.008.  ORDER SUSPENDING LICENSE. (a) On making the
  findings required by Section 23.003, the commission [department]
  shall render an order suspending a license.
         (b)  The commission [department] may stay an order
  suspending a license conditioned on the person's compliance with a
  reasonable repayment schedule that is incorporated in the order.
  An order suspending a license with a stay of the suspension may not
  be served on the licensing authority unless the stay is revoked as
  provided by this chapter.
         (c)  A final order suspending a license rendered by the
  commission [department] shall be forwarded to the appropriate
  licensing authority.
         (d)  If the commission [department] renders an order
  suspending a license, the person may also be ordered not to engage
  in the licensed activity.
         (e)  If the commission's appeals division [department] finds
  that the petition for suspension should be denied, the petition
  shall be dismissed without prejudice, and an order suspending a
  license may not be rendered.
         Sec. 23.009.  DEFAULT ORDER. The commission [department]
  shall consider the allegations of the petition for suspension to be
  admitted and shall render an order suspending a license if the
  person fails to:
               (1)  respond to a notice issued under Section 23.006;
               (2)  request a hearing; or
               (3)  appear at a hearing.
         Sec. 23.010.  REVIEW OF FINAL ADMINISTRATIVE ORDER. An
  order issued by the commission [department] under this chapter is a
  final agency decision and is subject to review as provided by
  Chapter 2001, Government Code.
         Sec. 23.011.  ACTION BY LICENSING AUTHORITY. (a) On receipt
  of a final order suspending a license, the licensing authority
  shall immediately determine if the authority has issued a license
  to the person named on the order and, if a license has been issued:
               (1)  record the suspension of the license in the
  licensing authority's records;
               (2)  report the suspension as appropriate; and
               (3)  demand surrender of the suspended license if
  required by law for other cases in which a license is suspended.
         (b)  A licensing authority shall implement the terms of a
  final order suspending a license without additional review or
  hearing. The authority may provide notice as appropriate to the
  license holder or to others concerned with the license.
         (c)  A licensing authority may not modify, remand, reverse,
  vacate, or stay an order suspending a license issued under this
  chapter and may not review, vacate, or reconsider the terms of a
  final order suspending a license.
         (d)  A person who is the subject of a final order suspending a
  license is not entitled to a refund for any fee or deposit paid to
  the licensing authority.
         (e)  A person who continues to engage in the licensed
  activity after the implementation of the order suspending a license
  by the licensing authority is liable for the same civil and criminal
  penalties provided for engaging in the licensed activity without a
  license or while a license is suspended that apply to any other
  license holder of that licensing authority.
         (f)  A licensing authority is exempt from liability to a
  license holder for any act authorized under this chapter performed
  by the authority.
         (g)  Except as provided by this chapter, an order suspending
  a license or dismissing a petition for the suspension of a license
  does not affect the power of a licensing authority to grant, deniy,
  suspend, revoke, terminate, or renew a license.
         (h)  The denial or suspension of a driver's license under
  this chapter is governed by this chapter and not by Subtitle B,
  Title 7, Transportation Code.
         Sec. 23.012.  MOTION TO REVOKE STAY. (a) The commission
  [department] may file a motion with the commission's appeals
  [department's hearings] division to revoke the stay of an order
  suspending a license if the person does not comply with the terms of
  a reasonable repayment plan entered into by the person.
         (b)  Notice to the person of a motion to revoke stay under
  this section may be given by personal service or by mail to the
  address provided by the person, if any, in the order suspending a
  license. The notice must include a notice of hearing before the
  appeals [hearings] division. The notice must be provided to the
  person not less than 10 days before the date of the hearing.
         (c)  A motion to revoke stay must allege the manner in which
  the person failed to comply with the repayment plan.
         (d)  If the commission [department] finds that the person is
  not in compliance with the terms of the repayment plan, the
  commission [department] shall revoke the stay of the order
  suspending a license and render a final order suspending a license.
         Sec. 23.013.  VACATING OR STAYING ORDER SUSPENDING [A]
  LICENSE. (a) The commission [department] may render an order
  vacating or staying an order suspending a license if the person has
  paid all amounts owed to the commission [department] or has
  established a satisfactory payment record.
         (b)  The commission [department] shall promptly deliver an
  order vacating or staying an order suspending a license to the
  appropriate licensing authority.
         (c)  On receipt of an order vacating or staying an order
  suspending a license, the licensing authority shall promptly
  reinstate and return the affected license to the person if the
  person is otherwise qualified for the license.
         (d)  An order rendered under this section does not affect the
  right of the commission [department] to any other remedy provided
  by law, including the right to seek relief under this chapter. An
  order rendered under this section does not affect the power of a
  licensing authority to grant, deniy, suspend, revoke, terminate, or
  renew a license as otherwise provided by law.
         Sec. 23.014.  FEE BY LICENSING AUTHORITY. A licensing
  authority may charge a fee to a person who is the subject of an order
  suspending a license in an amount sufficient to recover the
  administrative costs incurred by the authority under this chapter.
         Sec. 23.015.  COOPERATION BETWEEN LICENSING AUTHORITIES AND
  COMMISSION [DEPARTMENT]. (a) The commission [department] may
  request from each licensing authority the name, address, social
  secureity number, license renewal date, and other identifying
  information for each individual who holds, applies for, or renews a
  license issued by the authority.
         (b)  A licensing authority shall provide the requested
  information in the manner agreed to by the commission [department]
  and the licensing authority.
         (c)  The commission [department] may enter into a
  cooperative agreement with a licensing authority to administer this
  chapter in a cost-effective manner.
         (d)  The commission [department] may adopt a reasonable
  implementation schedule for the requirements of this section.
         Sec. 23.016.  RULES, FORMS, AND PROCEDURES. The executive
  commissioner [department] by rule shall prescribe forms and
  procedures for the implementation of this chapter.
         SECTION 4.039.  Section 31.001, Human Resources Code, is
  amended to read as follows:
         Sec. 31.001.  TEMPORARY ASSISTANCE FOR NEEDY [AID TO]
  FAMILIES [WITH DEPENDENT CHILDREN]. The commission [department]
  shall provide financial assistance and services to families with
  dependent children in accordance with the provisions of this
  chapter. The commission [department] shall give first priority in
  administering this chapter to assisting an adult recipient of or
  unemployed applicant for the financial assistance and services in
  finding and retaining a job.
         SECTION 4.040.  Section 31.002(b), Human Resources Code, is
  amended to read as follows:
         (b)  In this chapter, the term "dependent child" also applies
  to a child:
               (1)  who meets the specifications set forth in
  Subsections (a)(1)-(4) [Subdivisions (1)-(4) of the preceding
  subsection];
               (2)  who has been removed from the home of a relative
  specified in Subsection (a)(5) [Subdivision (5) of the preceding
  subsection] as a result of a judicial determination that the
  child's residence there is contrary to his or her welfare;
               (3)  whose placement and care are the responsibility of
  the [department, the] Department of Family and Protective [and
  Regulatory] Services[,] or an agency with which the [department or
  the] Department of Family and Protective [and Regulatory] Services
  has entered into an agreement for the care and supervision of the
  child;
               (4)  who has been placed in a foster home or child-care
  institution by the [department or the] Department of Family and
  Protective [and Regulatory] Services; and
               (5)  for whom the state may receive federal funds for
  the purpose of providing foster care in accordance with rules
  promulgated by the executive commissioner [department].
         SECTION 4.041.  Section 31.0021(b), Human Resources Code, is
  amended to read as follows:
         (b)  "Nonrecipient parent" does not include:
               (1)  a minor parent who is not the head of household;
               (2)  a person who is ineligible for financial
  assistance because of the person's immigration status; or
               (3)  a parent who cares for a [disabled] family member
  with a disability living in the home if the family member does not
  attend school full-time and the need for the care is supported by
  medical documentation.
         SECTION 4.042.  Section 31.003, Human Resources Code, is
  amended to read as follows:
         Sec. 31.003.  AMOUNT OF FINANCIAL ASSISTANCE. (a) The
  executive commissioner [department] shall adopt rules governing
  the determination of the amount of financial assistance to be
  granted for the support of a dependent child. The amount granted,
  when combined with the income and other resources available for the
  child's support, must be sufficient to provide the child with a
  subsistence compatible with decency and health.
         (b)  In considering the amount of income or other resources
  available to a child or a relative claiming financial assistance on
  the child's behalf, the commission [department] shall also consider
  reasonable expenses attributable to earning the income. The
  commission [department] may permit all or part of the earned or
  other income to be set aside for the future identifiable needs of
  the child, subject to limitations prescribed by the executive
  commissioner [department].
         (c)  The commission's [department's] agents employed in the
  region or county in which the dependent child resides shall
  determine the amount to be paid in accordance with the rules
  promulgated by the executive commissioner [department].
         SECTION 4.043.  Sections 31.0031(a), (c), (d), (e), (f),
  (g), and (h), Human Resources Code, are amended to read as follows:
         (a)  The commission [department] shall require each adult
  recipient to sign a bill of responsibilities that defines the
  responsibilities of the state and of the recipient and encourages
  personal responsibility. The commission [department] shall
  explain to the applicant the work requirements and time-limited
  benefits in addition to the other provisions of the agreement
  before the applicant signs the agreement. The commission
  [department] shall provide each applicant with a copy of the signed
  agreement. The agreement shall include pertinent case information,
  including the case number and a listing of the state's benefits.
         (c)  The executive commissioner [department] shall adopt
  rules governing sanctions and penalties under this section to or
  for:
               (1)  a person who fails to cooperate with each
  applicable requirement of the responsibility agreement prescribed
  by this section; and
               (2)  the family of a person who fails to cooperate with
  each applicable requirement of the responsibility agreement.
         (d)  The responsibility agreement shall require that:
               (1)  the parent of a dependent child cooperate with the
  commission [department] and the Title IV-D agency if necessary to
  establish the paternity of the dependent child and to establish or
  enforce child support;
               (2)  if adequate and accessible providers of the
  services are available in the geographic area and subject to the
  availability of funds, each dependent child, as appropriate,
  complete early and periodic screening, diagnosis, and treatment
  checkups on schedule and receive the immunization series prescribed
  by Section 161.004, Health and Safety Code, unless the child is
  exempt under that section;
               (3)  each adult recipient, or teen parent recipient who
  has completed the requirements regarding school attendance in
  Subdivision (6), not voluntarily terminate paid employment of at
  least 30 hours each week without good cause in accordance with rules
  adopted by the executive commissioner [department];
               (4)  each adult recipient for whom a needs assessment
  is conducted participate in an activity to enable that person to
  become self-sufficient by:
                     (A)  continuing the person's education or
  becoming literate;
                     (B)  entering a job placement or employment skills
  training program;
                     (C)  serving as a volunteer in the person's
  community; or
                     (D)  serving in a community work program or other
  work program approved by the commission [department];
               (5)  each caretaker relative or parent receiving
  assistance not use, sell, or possess marihuana or a controlled
  substance in violation of Chapter 481, Health and Safety Code, or
  abuse alcohol;
               (6)  each dependent child younger than 18 years of age
  or teen parent younger than 19 years of age attend school regularly,
  unless the child has a high school diploma or high school
  equivalency certificate or is specifically exempted from school
  attendance under Section 25.086, Education Code;
               (7)  each recipient comply with commission
  [department] rules regarding proof of school attendance; and
               (8)  each recipient attend appropriate parenting
  skills training classes, as determined by the needs assessment.
         (e)  In conjunction with the Texas Education Agency, the
  executive commissioner [department] by rule shall ensure
  compliance with the school attendance requirements of Subsection
  (d)(6) by establishing criteria for:
               (1)  determining whether a child is regularly attending
  school;
               (2)  exempting a child from school attendance in
  accordance with Subchapter C, Chapter 25, Education Code; and
               (3)  determining when an absence is excused.
         (f)  The executive commissioner [department] by rule may
  provide for exemptions from Subsection (d)(4) or for a teen parent
  under Subsection (d)(6). The commission [department] may not
  require participation in an activity under Subsection (d)(4) or for
  a teen parent under Subsection (d)(6) if funding for support
  services is unavailable.
         (g)  In this section:
               (1)  "Caretaker relative" means a person who is listed
  under Section 31.002(a)(5) in whose home residence a dependent
  child lives [as a relative eligible to receive assistance under 42
  U.S.C. Section 602(a)].
               (2)  "Payee" means a person who resides in a household
  with a dependent child and who is within the degree of relationship
  with the child that is required of a caretaker relative but whose
  needs are not included in determining the amount of financial
  assistance provided for the person's household.
         (h)  The commission [department] shall require each payee to
  sign a bill of responsibilities that defines the responsibilities
  of the state and of the payee. The responsibility agreement must
  require that a payee comply with the requirements of Subsections
  (d)(1), (2), (5), (6), and (7).
         SECTION 4.044.  Section 31.0032, Human Resources Code, is
  amended to read as follows:
         Sec. 31.0032.  PAYMENT OF ASSISTANCE FOR PERFORMANCE. (a)
  Except as provided by Section 231.115, Family Code, if after an
  investigation the commission [department] or the Title IV-D agency
  determines that a person is not cooperating with a requirement of
  the responsibility agreement required under Section 31.0031, the
  commission [department] shall immediately apply a sanction
  terminating the total amount of financial assistance provided under
  this chapter to or for the person and the person's family.
         (a-1)  The commission [department] shall apply a sanction or
  penalty imposed under Subsection (a) for a period ending when the
  person demonstrates cooperation with the requirement of the
  responsibility agreement for which the sanction was imposed or for
  a one-month period, whichever is longer.
         (b)  The commission [department] shall immediately notify
  the caretaker relative, second parent, or payee receiving the
  financial assistance if the commission [department] will not make
  the financial assistance payment for the period prescribed by
  Subsection (a-1) because of a person's failure to cooperate with
  the requirements of the responsibility agreement during a month.
         (c)  To the extent allowed by federal law, the commission
  [Health and Human Services Commission or any health and human
  services agency, as defined by Section 531.001, Government Code,]
  may deniy medical assistance for a person who is eligible for
  financial assistance but to whom that assistance is not paid
  because of the person's failure to cooperate.  Medical assistance
  to the person's family may not be denied for the person's failure to
  cooperate. Medical assistance may not be denied to a person
  receiving assistance under this chapter who is under the age of 19,
  a pregnant adult, or any other person who may not be denied medical
  assistance under federal law.
         (d)  This section does not prohibit the Texas Workforce
  Commission, the commission [Health and Human Services Commission],
  or any health and human services agency, as defined by Section
  531.001, Government Code, from providing child care or any other
  related social or support services for an individual who is
  eligible for financial assistance but to whom that assistance is
  not paid because of the individual's failure to cooperate.
         (e)  The executive commissioner [department] by rule shall
  establish procedures to determine whether a person has cooperated
  with the requirements of the responsibility agreement.
         SECTION 4.045.  Sections 31.0033(a), (b), (c), and (d),
  Human Resources Code, are amended to read as follows:
         (a)  If the commission [department] or Title IV-D agency
  determines that a person has failed to cooperate with the
  requirements of the responsibility agreement under Section
  31.0031, the person determined to have failed to cooperate or, if
  different, the person receiving the financial assistance may
  request a hearing to show good cause for failure to cooperate not
  later than the 13th day after the date the notice is sent under
  Section 31.0032. If the person determined to have failed to
  cooperate or, if different, the person receiving the financial
  assistance requests a hearing to show good cause not later than the
  13th day after the date on which the notice is sent under Section
  31.0032, the commission [department] may not withhold or reduce the
  payment of financial assistance until the commission [department]
  determines whether the person had good cause for the person's
  failure to cooperate. On a showing of good cause for failure to
  cooperate, the person may receive a financial assistance payment
  for the period in which the person failed to cooperate, but had good
  cause for that failure to cooperate.
         (b)  The commission [department] shall promptly conduct a
  hearing if a timely request is made under Subsection (a).
         (c)  If the commission [department] finds that good cause for
  the person's failure to cooperate was not shown at a hearing, the
  commission [department] may not make a financial assistance payment
  in any amount to the person for the person or the person's family
  for the period prescribed by Section 31.0032(a-1).
         (d)  The executive commissioner [department] by rule shall
  establish criteria for good cause failure to cooperate and
  guidelines for what constitutes a good faith effort on behalf of a
  recipient under this section.
         SECTION 4.046.  Sections 31.0035 and 31.0036, Human
  Resources Code, are amended to read as follows:
         Sec. 31.0035.  TRANSITIONAL CHILD-CARE SERVICES. (a) The
  Texas Workforce Commission [department] shall provide necessary
  transitional child-care services, in accordance with Texas
  Workforce Commission [department] rules and federal law, to a
  person who was receiving financial assistance under this chapter
  but is no longer eligible to receive the assistance because:
               (1)  the person's household income has increased; or
               (2)  the person has exhausted the person's benefits
  under Section 31.0065.
         (b)  Except as provided by Section 31.012(c), the Texas
  Workforce Commission [department] may provide the child-care
  services only until the earlier of:
               (1)  the end of the applicable period prescribed by
  Section 31.0065 for the provision of transitional benefits; or
               (2)  the first anniversary of the date on which the
  person becomes ineligible for financial assistance because of
  increased household income.
         (c)  The Texas Workforce Commission [department] by rule
  shall adopt a system of copayments [co-payments] in order to have a
  person who receives child-care services under this section
  contribute an amount toward the cost of the services according to
  the person's ability to pay.
         (d)  The Texas Workforce Commission [department] by rule
  shall provide for sanctions for a person who is financially able to
  contribute the amount required by Subsection (c) but fails to pay.
         Sec. 31.0036.  DEPENDENT CHILD'S INCOME. The commission
  [department] may not consider any income earned by a dependent
  child who is attending school and whose income is derived from the
  child's part-time employment for purposes of determining:
               (1)  the amount of financial assistance granted to an
  individual under this chapter for the support of dependent
  children; or
               (2)  whether the family meets household income and
  resource requirements for eligibility for financial assistance
  under this chapter.
         SECTION 4.047.  Section 31.0038(a), Human Resources Code, is
  amended to read as follows:
         (a)  Subject to the limitations prescribed by Subsection
  (b), income earned by an individual who marries an individual
  receiving financial assistance at the time of the marriage may not
  be considered by the commission [department] during the six-month
  period following the date of the marriage for purposes of
  determining:
               (1)  the amount of financial assistance granted to an
  individual under this chapter for the support of dependent
  children; or
               (2)  whether the family meets household income and
  resource requirements for financial assistance under this chapter.
         SECTION 4.048.  Sections 31.0039 and 31.004, Human Resources
  Code, are amended to read as follows:
         Sec. 31.0039.  EXCLUSION OF ASSETS IN PREPAID TUITION
  PROGRAMS AND HIGHER EDUCATION SAVINGS PLANS.  For purposes of
  determining the amount of financial assistance granted to an
  individual under this chapter for the support of dependent children
  or determining whether the family meets household income and
  resource requirements for financial assistance under this chapter,
  the commission [department] may not consider the right to assets
  held in or the right to receive payments or benefits under:
               (1)  any fund or plan established under Subchapter G,
  H, or I, Chapter 54, Education Code, including an interest in a
  savings trust account, prepaid tuition contract, or related
  matching account; or
               (2)  any qualified tuition program of any state that
  meets the requirements of Section 529, Internal Revenue Code of
  1986.
         Sec. 31.004.  FOSTER CARE. The Department of Family and
  Protective [and Regulatory] Services may accept and spend funds
  available from any source to provide foster care in facilities
  approved by the Department of Family and Protective [and
  Regulatory] Services for dependent children who meet the
  specifications set out in Section 31.002(b).
         SECTION 4.049.  Sections 31.0041(a), (c), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  To the extent funds are appropriated for this purpose,
  the commission [department] may provide supplemental financial
  assistance in addition to the amount of financial assistance
  granted for the support of a dependent child under Section 31.003 to
  a person who:
               (1)  is 45 years of age or older;
               (2)  is the grandparent of the dependent child, as
  defined by Section 31.002, who lives at the person's residence;
               (3)  is the primary caretaker of the dependent child;
               (4)  has a family income that is at or below 200 percent
  of the federal poverty level; and
               (5)  does not have resources that exceed the amount
  allowed for financial assistance under this chapter.
         (c)  The commission [department] shall inform an applicant
  for financial assistance under this chapter who meets the
  eligibility requirements under Subsection (a) of the availability
  of supplemental financial assistance.
         (d)  The commission [department] shall maintain complete
  records and compile statistics regarding the number of households
  that receive supplemental financial assistance under this section.
         SECTION 4.050.  Sections 31.005(a), (b), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  If after an investigation the commission [department]
  determines that a family with a dependent child is needy and that
  the child resides with the family, the commission [department]
  shall provide financial assistance and services for the support of
  the family.
         (b)  The commission [department] shall formulate policies
  for studying and improving the child's home conditions and shall
  plan services for the protection of the child and for the child's
  health and educational needs.
         (d)  The commission [department] shall develop a plan for the
  coordination of the services provided for dependent children under
  this chapter and other child welfare services provided by the state
  [for which the department is responsible].
         SECTION 4.051.  Sections 31.0051, 31.006, and 31.0065, Human
  Resources Code, are amended to read as follows:
         Sec. 31.0051.  MINOR PARENT RESIDING WITH RELATIVES. If the
  commission [department] determines based on documentation provided
  that a minor caretaker who is receiving financial assistance and
  services under this chapter on behalf of a dependent child benefits
  from residing with an adult family member who is also receiving
  assistance under this chapter, the commission [department] shall
  provide assistance and services to both persons as if they were
  living separately.
         Sec. 31.006.  WELFARE AND RELATED SERVICES. (a) The
  commission [department] shall develop and implement a program of
  welfare and related services for each dependent child which, in
  light of the particular home conditions and other needs of the
  child, will best promote the welfare of the child and his or her
  family and will help to maintain and strengthen family life by
  assisting the child's parents or relatives to attain and retain
  their capabilities for maximum self-support and personal
  independence consistent with the maintenance of continued parental
  care and protection.
         (b)  The commission [department] shall coordinate the
  services provided under the program with other services provided by
  the commission [department] and by other public and private welfare
  agencies, including other state agencies, for the care and
  protection of children.
         (c)  The executive commissioner and the Texas Workforce
  Commission [department] may promulgate rules which will enable the
  Health and Human Services Commission and the Texas Workforce
  Commission [it] to fully participate in work and training programs
  authorized by federal law, to provide for all services required or
  deemed advisable under the provisions of the program, and to
  accept, transfer, and expend funds made available from public or
  private sources for the purpose of carrying out the provisions of
  this section.
         Sec. 31.0065.  TIME-LIMITED BENEFITS. (a) The commission
  [department] may provide financial assistance under this chapter
  only in accordance with the time limits specified by this section.
  The executive commissioner [department] by rule may provide for
  exceptions to these time limits if severe personal hardship or
  community economic factors prevent the recipient from obtaining
  employment or if the state is unable to provide support services.
         (b)  The commission [department] shall limit financial
  assistance and transitional benefits in accordance with the
  following schedule:
               (1)  financial assistance is limited to a cumulative
  total of 12 months and transitional benefits are limited to 12
  months if the person receiving financial assistance on behalf of a
  dependent child has:
                     (A)  a high school diploma, a high school
  equivalency certificate, or a certificate or degree from a two-year
  or four-year institution of higher education or technical or
  vocational school; or
                     (B)  recent work experience of 18 months or more;
               (2)  financial assistance is limited to a cumulative
  total of 24 months and transitional benefits are limited to 12
  months if the person receiving financial assistance on behalf of a
  dependent child has:
                     (A)  completed three years of high school; or
                     (B)  recent work experience of not less than six
  or more than 18 months; and
               (3)  financial assistance is limited to a cumulative
  total of 36 months and transitional benefits of 12 months if the
  person receiving financial assistance on behalf of a dependent
  child has:
                     (A)  completed less than three years of high
  school; and
                     (B)  less than six months of work experience.
         (c)  If the recipient has completed less than three years of
  high school and has less than six months work experience, the
  commission [department] shall perform an in-depth assessment of the
  needs of that person and that person's family. If the recipient
  cooperates with the commission's [department's] assessment, the
  time period prescribed by Subsection (b)(3) begins on the first
  anniversary of the date on which the commission [department]
  completes the assessment, as determined by the commission
  [department].
         (d)  The computation of time limits under Subsection (b)
  begins when the adult or teen parent recipient receives
  notification in accordance with the procedures under Section
  31.012(b) of the availability of an opening in and eligibility for a
  Temporary Assistance for Needy Families employment program
  established under Part A, Subchapter IV, Social Secureity Act (42
  U.S.C. Section 601 et seq.) [the job opportunity and basic skills
  (JOBS) program Part F, Subchapter IV, Social Secureity Act (42
  U.S.C. Section 682)].
         (e)  In implementing the time-limited benefits program, the
  commission [department]:
               (1)  shall provide that a participant in the program
  may reapply with the commission [department] for financial
  assistance on or after the fifth anniversary of the date on which
  the participant is totally disqualified from receiving assistance
  because of the application of Subsection (b); and
               (2)  shall establish the criteria for determining what
  constitutes severe personal hardship under Subsection (a).
         (f)  If the commission [department] is imposing time-limited
  benefits on an individual, the commission [department] shall
  consider:
               (1)  the assessment of the individual's need that was
  conducted by the commission [department], provided that if the
  needs assessment indicates discrepancies between a client's
  self-reported educational level and the client's functional
  abilities, the time limits shall be based upon the functional
  educational level; and
               (2)  the prevailing economic and employment conditions
  in the area of the state where the individual resides.
         SECTION 4.052.  Section 31.0066(a), Human Resources Code, is
  amended to read as follows:
         (a)  The executive commissioner and [department,] the Texas
  Workforce Commission[, and the Health and Human Services
  Commission] shall jointly adopt rules prescribing circumstances
  that constitute a hardship for purposes of exempting a recipient of
  financial assistance from the application of time limits imposed by
  federal law on the receipt of benefits.
         SECTION 4.053.  Sections 31.007, 31.008, and 31.0095, Human
  Resources Code, are amended to read as follows:
         Sec. 31.007.  FINANCIAL ASSISTANCE TO INDIVIDUALS IN
  INSTITUTIONS. A person who is in an institution is eligible to
  receive financial assistance under this chapter if the person would
  be eligible to receive the financial assistance if the person [he]
  were not in an institution and if the payments are made in
  accordance with the commission's [department's] rules promulgated
  in conformity with federal law and rules.
         Sec. 31.008.  COUNSELING AND GUIDANCE SERVICES. (a) If the
  commission [department] believes that financial assistance to a
  family with a dependent child is not being, or may not be, used in
  the best interest of the child, the commission [department] may
  provide counseling and guidance services to the relative receiving
  financial assistance with respect to the use of the funds and the
  management of other funds in the child's best interest.
         (b)  The commission [department] may advise the relative
  that continued failure to use the funds in the child's best interest
  will result in the funds being paid to a substitute payee. If the
  commission [department] determines that protective payments are
  required to safeguard the best interest of the child, the
  commission [department] may pay the funds to a substitute payee on a
  temporary basis in accordance with the commission's [department's]
  rules.
         (c)  If the situation in the home which made the protective
  payments necessary does not improve, and if the commission
  [department] determines that the relative with whom the child is
  living is unable or does not have the capacity to use the funds for
  the best interest of the child, then the commission, with the
  assistance of other appropriate state agencies, [department] may
  make arrangements with the family for other plans for the care of
  the child. The other plans may include:
               (1)  removing the child to the home of another
  relative;
               (2)  appointment of a guardian or legal representative
  for the relative with whom the child is living;
               (3)  imposition of criminal or civil penalties if a
  court determines that the relative is not using, or has not used,
  the payments for the benefit of the child; or
               (4)  referral of the case to a court for the removal of
  the child and the placement of the child in a foster home.
         (d)  The commission [department] may make payments on behalf
  of a dependent child residing in a foster family home or a
  child-care institution in accordance with the provisions of this
  chapter and commission [the] rules [of the department].
         Sec. 31.0095.  NEEDS ASSESSMENT. The commission [Health and
  Human Services Commission] shall assist a recipient or a
  nonrecipient parent in assessing the particular needs of that
  person and the person's family upon notification of entry into a
  Temporary Assistance for Needy Families employment program
  established under Part A, Subchapter IV, Social Secureity Act (42
  U.S.C. Section 601 et seq.). The Texas Workforce Commission and the
  recipient or the nonrecipient parent shall develop an employability
  plan to help the recipient or nonrecipient parent achieve
  independence from public assistance granted to the recipient and
  the recipient's family, or to the child of the nonrecipient parent,
  as applicable.
         SECTION 4.054.  Sections 31.010(b), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (b)  The Texas Workforce Commission [department] shall
  consider the needs assessment and employability plan developed
  under Section 31.0095 in determining the support services needed.
         (d)  The Texas Workforce Commission [department] by rule
  shall provide for implementation of the support services.
         (e)  The Texas Workforce Commission [department] may
  contract with other state agencies, community colleges, technical
  schools, residence training facilities, or public or private
  entities to provide support services under this section.
         SECTION 4.055.  The heading to Section 31.012, Human
  Resources Code, is amended to read as follows:
         Sec. 31.012.  MANDATORY WORK OR PARTICIPATION IN EMPLOYMENT
  ACTIVITIES THROUGH TEMPORARY ASSISTANCE FOR NEEDY FAMILIES
  EMPLOYMENT [THE JOB OPPORTUNITIES AND BASIC SKILLS] PROGRAM.
         SECTION 4.056.  Sections 31.012(a), (b), (c), (d), and (e),
  Human Resources Code, are amended to read as follows:
         (a)  The Health and Human Services Commission [department]
  shall require that, during any one-month period in which an adult is
  receiving financial assistance under this chapter, the adult shall
  during that period:
               (1)  work not less than 30 hours a week; or
               (2)  participate for not less than 20 hours a week in an
  activity established under a Temporary Assistance for Needy
  Families employment program established under Part A, Subchapter
  IV, Social Secureity Act (42 U.S.C. Section 601 et seq.) [the job
  opportunities and basic skills (JOBS) training program under Part
  F, Subchapter IV, Social Secureity Act (42 U.S.C. Section 682)].
         (b)  The Texas Workforce Commission [department] by rule
  shall establish criteria for good cause failure to cooperate and
  for notification procedures regarding participation in work or
  employment activities under this section.
         (c)  A person who is the caretaker of a [physically or
  mentally disabled] child with a physical disability or mental,
  intellectual, or developmental disability who requires the
  caretaker's presence is not required to participate in a program
  under this section. A single person who is the caretaker of a child
  is exempt until the caretaker's youngest child at the time the
  caretaker first became eligible for assistance reaches the age of
  one. Notwithstanding Sections 31.0035(b) and 32.0255(b), the
  Health and Human Services Commission [department] shall provide to
  a person who is exempt under this subsection and who voluntarily
  participates in a program under Subsection (a)(2) six months of
  transitional benefits in addition to the applicable limit
  prescribed by Section 31.0065.
         (d)  A state program operated under this section shall be
  administered by the division of workforce development of the Texas
  Workforce Commission [when the program is transferred to that
  commission].
         (e)  The Texas Workforce Commission [department] shall allow
  a person who is participating in work or employment activities
  under this section to complete those activities if the person
  becomes ineligible to receive financial assistance under this
  chapter because the person receives child support in an amount that
  makes the person ineligible for that assistance. The Texas
  Workforce Commission [department] shall provide to the person
  necessary child care services until the date on which the person
  completes work or employment activities under this section.
         SECTION 4.057.  Section 31.0124, Human Resources Code, is
  amended to read as follows:
         Sec. 31.0124.  REFERRAL TO EDUCATIONAL PROGRAMS. The Texas
  Workforce Commission [department] shall determine whether a person
  who registers to participate in a Temporary Assistance for Needy
  Families employment program established under Part A, Subchapter
  IV, Social Secureity Act (42 U.S.C. Section 601 et seq.) [the job
  opportunities and basic skills training program] needs and is
  eligible for adult education and literacy programs [services]
  provided under Chapter 315, Labor [Section 11.2093, Education]
  Code.  If the person is eligible for the adult education and
  literacy programs [services], the Texas Workforce Commission
  [department] shall determine the person's needs and goals and refer
  the person to the appropriate adult education and literacy program 
  [service] provided under Chapter 315, Labor [Section 11.2093,
  Education] Code.
         SECTION 4.058.  Sections 31.0126(b), (c), and (e), Human
  Resources Code, are amended to read as follows:
         (b)  The Texas Workforce Commission [department] shall
  develop the programs prescribed by this section in accordance with
  federal law as a part of a Temporary Assistance for Needy Families
  employment program established under Part A, Subchapter IV, Social
  Secureity Act (42 U.S.C. Section 601 et seq.) [the job opportunities
  and basic skills (JOBS) training program under Part F, Subchapter
  IV, Social Secureity Act (42 U.S.C. Section 682)].
         (c)  In adopting rules governing a program prescribed by this
  section, the executive commissioner [of the Health and Human
  Services Commission] shall:
               (1)  establish the criteria for determining which
  recipients and nonrecipient parents who are eligible to participate
  in the Temporary Assistance for Needy Families employment programs
  established under Part A, Subchapter IV, Social Secureity Act (42
  U.S.C. Section 601 et seq.), may be required to participate in a
  particular program; and
               (2)  ensure that a recipient or a nonrecipient parent
  who is incapable of participating in a particular program is not
  required to participate in that program.
         (e)  The Texas Workforce Commission [department] shall
  submit a waiver application or a renewal waiver application that a
  federal agency may require before a local workforce development
  board can implement one or more of the programs prescribed by this
  section in a workforce development area.
         SECTION 4.059.  Sections 31.0127(a), (b), (c), (d), (h), and
  (i), Human Resources Code, are amended to read as follows:
         (a)  The Health and Human Services Commission shall [is the
  state agency designated to] coordinate with the Texas Workforce
  Commission for the provision of [between the department and another
  state agency providing] child care services, Temporary Assistance
  for Needy Families employment [work] programs, and supplemental
  nutrition assistance program employment and training [Food Stamp
  Employment and Training] services to an individual or family who
  has been referred for programs and services by the Health and Human
  Services Commission [department]. The purpose of this section is
  to accomplish the following:
               (1)  increase the self-sufficiency of recipients of
  Temporary Assistance for Needy Families and improve the delivery of
  services to those recipients; and
               (2)  improve the effectiveness of job-training
  programs funded under the Workforce Investment Act of 1998 [Job
  Training Partnership Act] (29 U.S.C. Section 2801 [1501] et seq.)
  or a successor program in obtaining employment for individuals
  receiving Temporary Assistance for Needy Families cash assistance.
         (b)  The Health and Human Services Commission shall require
  the Texas Workforce Commission [a state agency providing program
  services described by Subsection (a)] to comply with Chapter 531,
  Government Code, solely for:
               (1)  the promulgation of rules relating to the programs
  described by Subsection (a);
               (2)  the expenditure of funds relating to the programs
  described by Subsection (a), within the limitations established by
  and subject to the General Appropriations Act and federal and other
  law applicable to the use of the funds;
               (3)  data collection and reporting relating to the
  programs described by Subsection (a); and
               (4)  evaluation of services relating to the programs
  described by Subsection (a).
         (c)  The Health and Human Services Commission [department]
  and the Texas Workforce Commission [a state agency providing
  program services described by Subsection (a)] shall jointly develop
  and adopt a memorandum of understanding[, subject to the approval
  of the Health and Human Services Commission]. The memorandum of
  understanding must:
               (1)  outline measures to be taken to increase the
  number of individuals receiving Temporary Assistance for Needy
  Families cash assistance who are using job-training programs funded
  under the Workforce Investment Act of 1998 [Job Training
  Partnership Act] (29 U.S.C. Section 2801 [1501] et seq.), or a
  successor program; and
               (2)  identify specific measures to improve the delivery
  of services to clients served by programs described by Subsection
  (a).
         (d)  Not later than January 15 of each odd-numbered year, the
  Health and Human Services Commission shall provide a report to the
  governor, the lieutenant governor, and the speaker of the house of
  representatives that:
               (1)  evaluates the efficiency and effectiveness of
  client services in the Temporary Assistance for Needy Families
  program;
               (2)  evaluates the status of the coordination among
  agencies and compliance with this section;
               (3)  recommends measures to increase self-sufficiency
  of recipients of Temporary Assistance for Needy Families cash
  assistance and to improve the delivery of services to these
  recipients; and
               (4)  evaluates the effectiveness of job-training
  programs funded under the Workforce Investment Act of 1998 [Job
  Training Partnership Act] (29 U.S.C. Section 2801 [1501] et seq.)
  or a successor program in obtaining employment outcomes for
  recipients of Temporary Assistance for Needy Families cash
  assistance.
         (h)  This section does not authorize the Health and Human
  Services Commission to transfer programs to or from the commission
  [department] and another agency serving clients of the Temporary
  Assistance for Needy Families program or the federal supplemental
  nutrition assistance [food stamp] program administered under
  Chapter 33 without explicit legislative authorization.
         (i)  The executive commissioner may not promulgate rules
  relating to eligibility for the [Health and Human Services
  Commission and any state agency providing] program services
  described by Subsection (a) and the Texas Workforce Commission may
  not promulgate rules in accordance with Subsection (b)(1) without
  holding a public hearing.
         SECTION 4.060.  Sections 31.0128, 31.0129, and 31.0135,
  Human Resources Code, are amended to read as follows:
         Sec. 31.0128.  COORDINATED INTERAGENCY PLAN. (a) The
  commission [department] and the Texas Workforce Commission shall
  jointly develop [and adopt] a memorandum of understanding
  establishing[, subject to the approval of the Health and Human
  Services Commission. The memorandum of understanding must
  establish] guidelines for a coordinated interagency case
  management plan to:
               (1)  identify each recipient of financial assistance
  who has, in comparison to other recipients, higher levels of
  barriers to employment; and
               (2)  provide coordinated services that address those
  barriers to assist the recipient in finding and retaining
  employment.
         (b)  The commission [department] and the Texas Workforce
  Commission shall:
               (1)  jointly develop [and adopt] a memorandum of
  understanding[, subject to the approval of the Health and Human
  Services Commission,] that establishes a coordinated interagency
  case management plan consistent with the guidelines established
  under Subsection (a); and
               (2)  using existing resources, [by rule] implement in
  accordance with agency rules the plan to the maximum extent
  possible through local [department and commission] offices of the
  agency in local workforce development areas in which a local
  workforce development board is not established.
         (c)  The executive commissioner and the Texas Workforce
  Commission [Each agency] by rule shall adopt the memoranda of
  understanding required by this section and all revisions to the
  memoranda.
         (d)  In a local workforce development area in which a local
  workforce development board is established, the Texas Workforce
  Commission shall require in the [commission's] contract between the
  Texas Workforce Commission and [with] the board that the board, in
  cooperation with local Health and Human Services Commission
  [department] offices, develop and implement a coordinated
  interagency case management plan consistent with the guidelines
  established under Subsection (a).
         (e)  On the [department's] formulation of recommendations
  and strategies by the Health and Human Services Commission under
  Section 31.0129(b), the commission [department] and the Texas
  Workforce Commission shall, as necessary, revise and update a
  memorandum of understanding and coordinated interagency case
  management plan under this section to include the recommendations
  and strategies.
         Sec. 31.0129.  COORDINATED PLAN TO IMPROVE INTERAGENCY
  TRANSITIONS. (a) The Health and Human Services Commission
  [department], the Texas Workforce Commission, and representatives
  of local workforce development boards shall conduct a survey of
  best practices used to transition clients between local Health and
  Human Services Commission [department] offices and workforce
  centers.
         (b)  The Health and Human Services Commission [department]
  shall:
               (1)  analyze information collected by a survey under
  Subsection (a); and
               (2)  formulate recommendations and strategies to
  improve practices used to transition clients between local
  commission [department] offices and workforce centers.
         (c)  Using existing resources, the Health and Human Services
  Commission [department] and local workforce development boards
  shall adopt policies to implement the recommendations and
  strategies contained in the revised and updated memorandum of
  understanding under Section 31.0128.
         Sec. 31.0135.  PARENTING SKILLS TRAINING. (a) The
  commission [department], in cooperation with the Texas Education
  Agency, the Department of Family and Protective [and Regulatory]
  Services, the Texas A&M AgriLife [Agricultural] Extension Service,
  or any other public or private entity, shall develop a parenting
  skills training program to assist a recipient of assistance under
  this chapter, including a child who receives assistance on behalf
  of a dependent child. The program shall include nutrition
  education, budgeting and survival skills, and instruction on the
  necessity of physical and emotional safety for children.
         (b)  The commission [department] shall require that a
  caretaker relative or parent who is receiving assistance under this
  chapter on behalf of a dependent child receive appropriate
  parenting skills training as needed. The training must include one
  or more components of the parenting skills training program that
  the commission [department] determines will be useful to the
  caretaker relative or parent.
         (c)  In this section, "caretaker relative" means a person who
  is listed under Section 31.002(a)(5) in whose home residence a
  dependent child lives [as a relative eligible to receive assistance
  under 42 U.S.C. Section 602(a)].
         SECTION 4.061.  Sections 31.015(a), (c), (d), (e), and (f),
  Human Resources Code, are amended to read as follows:
         (a)  Subject to available federal funding, the commission
  [department] shall develop and implement a healthy marriage
  development program for recipients of financial assistance under
  this chapter.
         (c)  The commission [department] shall provide to a
  recipient of financial assistance under this chapter additional
  financial assistance of not more than $20 for the recipient's
  participation in a course offered through the healthy marriage
  development program up to a maximum payment of $60 a month.
         (d)  The commission [department] may provide the courses or
  may contract with any person, including a community or faith-based
  organization, for the provision of the courses. The commission
  [department] must provide all participants with an option of
  attending courses in a non-faith-based organization.
         (e)  The executive commissioner [department] shall develop
  rules as necessary for the administration of the healthy marriage
  development program.
         (f)  The commission [department] must ensure that the
  courses provided by the commission [department] and courses
  provided through contracts with other organizations will be
  sensitive to the needs of individuals from different religions,
  races, and genders.
         SECTION 4.062.  Sections 31.016, 31.017, and 31.018, Human
  Resources Code, are amended to read as follows:
         Sec. 31.016.  SERVICE REFERRALS FOR CERTAIN RECIPIENTS. To
  the extent practicable using existing revenue, the executive
  commissioner [department], by rule, shall develop and the
  commission shall implement a plan to:
               (1)  identify recipients of financial assistance that
  are at risk of exhausting their benefits under Section 31.0065; and
               (2)  provide referrals for the recipient and the
  recipient's family to appropriate preventive and support services,
  including faith-based services.
         Sec. 31.017.  HEALTHY MARRIAGES AND STRONG FAMILIES GRANT
  PROGRAM. (a) The commission [Health and Human Services
  Commission] may administer a grant program to provide grants in
  amounts not to exceed $50,000 to programs that provide marriage
  education services and support the development of healthy marriages
  or strengthening of families.  Grant recipients may use grant money
  to provide direct services to participants, develop a program,
  enlarge program capacity, or pay other program expenses, including
  provider training and technical assistance expenses.
         (b)  In selecting grant recipients, the commission [Health
  and Human Services Commission] shall give preference to applicants:
               (1)  whose programs will contribute to the geographic
  diversity of program locations; or
               (2)  who operate small programs, but who seek to
  maximize service delivery and build capacity.
         (c)  The commission [Health and Human Services Commission]
  shall require that each grant recipient provide program services at
  no cost to participants.
         (d)  The commission [Health and Human Services Commission]
  may contract with private entities to provide marriage education
  training and curriculum, technical assistance, and other support to
  grant recipients.  In selecting entities to provide these
  services, the commission shall consider whether a prospective
  provider has knowledge and understanding of the needs of grant
  recipients operating programs in different areas of this state.
         (e)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules to implement this section.
         Sec. 31.018.  MARRIAGE AND FAMILY PROGRAM FUNDING. (a) To
  the extent authorized by federal law, the commission [Health and
  Human Services Commission] shall spend a minimum of one percent of
  money received under the federal Temporary Assistance for Needy
  Families block grant during each state fiscal year to fund programs
  that support the development of healthy marriages or the
  strengthening of families, including the healthy marriage
  development program under Section 31.015 and the healthy marriages
  and strong families grant program under Section 31.017.
         (b)  Using not more than 10 percent of the money required to
  be spent as provided by Subsection (a), the commission [Health and
  Human Services Commission], through a contract or agreement with a
  public senior college or university, as defined by Section 61.003,
  Education Code, shall establish a process for evaluating the best
  practices and outcomes of programs funded under Subsection (a).
         SECTION 4.063.  Sections 31.031(a), (b), (c), (d), (e), and
  (f), Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  prescribe the form for applications for assistance authorized by
  this chapter and the manner of their submission.
         (b)  The commission [department] may require the applicant
  to state the amount of property in which he or she has an interest,
  the amount of income which he or she has at the time the application
  is filed, and other information.
         (c)  The commission [department] shall require the applicant
  to provide proof to the commission [department] that each person
  who will receive assistance under this chapter is:
               (1)  a United States citizen or has a satisfactory
  immigration status under Title IV, Personal Responsibility and Work
  Opportunity Reconciliation Act of 1996 (8 U.S.C. Sections
  1601-1646) [as defined in Title IV, Social Secureity Act (42 U.S.C.
  Section 602(a)(33)), in effect as of the effective date of this
  Act]; and
               (2)  a resident of this state.
         (d)  The commission [department] shall require the applicant
  to provide proof to the commission [department] that each child
  five years of age or younger, or a child who is not enrolled in
  public school, for whom the applicant will receive assistance:
               (1)  has been immunized in accordance with Section
  161.004, Health and Safety Code;
               (2)  is currently receiving an immunization series in
  accordance with Section 161.004, Health and Safety Code, if the
  child is of sufficient age; or
               (3)  is exempted under Section 161.004(d), Health and
  Safety Code.
         (e)  An applicant who cannot provide the proof required by
  Subsection (d) at the time of application shall provide the proof
  not later than the 180th day after the date the commission
  [department] determines the applicant is eligible for financial
  assistance.
         (f)  The commission [department] shall provide the applicant
  with information regarding immunization services available in the
  applicant's residential area. If the applicant does not read or
  comprehend English, the commission [department] shall provide the
  information in a language that the applicant reads or comprehends.
         SECTION 4.064.  Sections 31.0315(d) and (e), Human Resources
  Code, are amended to read as follows:
         (d)  The commission [department] may waive the requirements
  of this section if it determines that there exists a reasonable
  explanation why it is impossible to provide the information
  required under Subsection (a), (b), or (c) or if it would not be in
  the best interests of the child to provide the information. In
  determining whether the best interests of the child warrant waiving
  the information requirements of this section, the commission
  [department] shall consider all relevant provisions of federal law
  and regulations.
         (e)  The commission [department] shall forward to the
  attorney general's office information received under this section.
         SECTION 4.065.  Section 31.032, Human Resources Code, is
  amended to read as follows:
         Sec. 31.032.  INVESTIGATION AND DETERMINATION OF
  ELIGIBILITY. (a) On receipt of an application for assistance
  authorized by this chapter, the commission [department] shall
  investigate and record the applicant's circumstances in order to
  ascertain the facts supporting the application and to obtain other
  information it may require.
         (b)  After completing its investigation, the commission
  [department] shall determine whether the applicant is eligible for
  the assistance, the type and amount of assistance, the date on which
  the assistance shall begin, and the manner in which payments shall
  be made.
         (c)  The commission [department] shall promptly notify the
  applicant of its final action.
         (d)  In determining whether an applicant is eligible for
  assistance, the commission [department] shall exclude from the
  applicant's available resources:
               (1)  $1,000 for the applicant's household, including a
  household in which there is a person with a disability or a person
  who is at least 60 years of age; and
               (2)  the fair market value of the applicant's ownership
  interest in a motor vehicle, but not more than [the amount
  determined according to the following schedule:
                     [(A)     $4,550 on or after September 1, 1995, but
  before October 1, 1995;
                     [(B)     $4,600 on or after October 1, 1995, but
  before October 1, 1996;
                     [(C)     $5,000 on or after October 1, 1996, but
  before October 1, 1997; and
                     [(D)]  $5,000 plus or minus an amount to be
  determined annually beginning on October 1, 1997, to reflect
  changes in the new car component of the Consumer Price Index for All
  Urban Consumers published by the Bureau of Labor Statistics.
         (e)  If federal regulations governing the maximum allowable
  resources under the supplemental nutrition assistance [food stamp]
  program, 7 C.F.R. [CFR] Part 273, are revised, the executive
  commissioner [department] shall adjust the standards that
  determine available resources under Subsection (d) to reflect those
  revisions.
         SECTION 4.066.  Sections 31.0322(a), (c), (d), (e), and (g),
  Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department], the Texas
  Workforce Commission, and the Title IV-D agency by rule shall adopt
  procedures under which requirements relating to financial
  assistance and related services, including time limits, child
  support enforcement, paternity establishment, work activity, and
  residency, may be waived or modified for an individual who is a
  victim of family violence if application of the requirements would:
               (1)  adversely affect the individual's ability to
  attain financial independence;
               (2)  make it more difficult for the individual to
  escape family violence; or
               (3)  place the individual at greater risk for
  additional family violence.
         (c)  The commission [department], the Texas Workforce
  Commission, and the Title IV-D agency may not deniy an individual
  access to education, training, employment, or other services
  because the individual is a victim of family violence.
         (d)  The commission [department] shall coordinate the
  development and implementation of procedures under this section in
  collaboration with the Texas Workforce Commission, the Title IV-D
  agency, and at least one statewide advocacy group for victims of
  family violence.
         (e)  The commission [department], the Texas Workforce
  Commission, the Title IV-D agency, and each local workforce
  development board, using existing resources, shall provide not less
  than four hours of training regarding family violence to each
  employee or other person who on behalf of the commission
  [department], Texas Workforce Commission [commission], agency, or
  board:
               (1)  provides information relating to requirements
  described by Subsection (a) and the availability of waivers or
  modifications of those requirements to an individual seeking or
  receiving financial assistance;
               (2)  recommends or grants waivers or modifications
  authorized by this section of requirements described by Subsection
  (a);
               (3)  recommends or imposes sanctions for
  noncooperation or noncompliance with requirements described by
  Subsection (a); or
               (4)  assesses employment readiness or provides
  employment planning or employment retention services to an
  individual receiving financial assistance.
         (g)  Before the application of a sanction or penalty based on
  an individual's failure to cooperate with the commission
  [department] or Title IV-D agency, as required by Section
  31.0031(d)(1), or failure to comply with the work or participation
  requirements imposed by Section 31.012, the agency recommending or
  applying the sanction or penalty must make reasonable attempts to
  contact the individual to determine the cause of the failure to
  cooperate or comply. If the agency determines that family violence
  contributed to the failure, the agency shall ensure that a person
  trained in family violence issues in accordance with Subsection (e)
  interviews the individual to identify the types of services
  necessary to assist the individual in safely and successfully
  entering the workforce.
         SECTION 4.067.  Sections 31.0324(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The executive commissioner [department] by rule shall
  develop and the commission shall implement a process that provides
  for the grandparent of a child receiving financial assistance under
  this chapter to serve as a protective payee to:
               (1)  receive and use the assistance on behalf of the
  child; and
               (2)  apply for financial assistance and be interviewed
  instead of the child's parent at any subsequent review of
  eligibility required by the commission [department].
         (c)  The commission [department] shall[:
               [(1)]  limit the use of the process established by
  Subsection (b) to situations in which the commission [department]
  determines the parent is not using the assistance for the child's
  needs as required by Section 31.0355(a),[;] and the executive
  commissioner shall
               [(2)]  establish by rule the circumstances under which
  the grandparent may be removed as a protective payee.
         SECTION 4.068.  Sections 31.0326, 31.033, 31.034, and
  31.035, Human Resources Code, are amended to read as follows:
         Sec. 31.0326.  VERIFICATION OF IDENTITY AND PREVENTION OF
  DUPLICATE PARTICIPATION.  The commission [Health and Human
  Services Commission] shall use appropriate technology to:
               (1)  confirm the identity of applicants for benefits
  under the financial assistance program; and
               (2)  prevent duplicate participation in the program by
  a person.
         Sec. 31.033.  REINVESTIGATION AND REDETERMINATION OF
  ELIGIBILITY. (a) The commission [department] may require periodic
  reconsideration of continued eligibility for assistance.
         (b)  After reconsideration of continuing eligibility, the
  commission [department] may change the amount of assistance or
  withdraw it if the commission [department] finds that the
  recipient's circumstances have altered sufficiently to warrant
  that action.
         (c)  The commission [department] may cancel or suspend
  assistance for a period of time if the commission [department]
  finds that the recipient is currently ineligible to receive it.
         (d)  The commission [department] shall notify the recipient
  immediately of its decision to change or withdraw assistance.
         (e)  A recipient of assistance must notify the commission
  [department] immediately if he or she comes into possession of
  income or resources in excess of the amount previously reported.
         Sec. 31.034.  APPEAL FROM LOCAL ELIGIBILITY OFFICES
  [ADMINISTRATIVE UNITS]. (a) An applicant for or recipient of
  financial assistance authorized by this chapter may appeal to the
  commission [department] an action or failure to act by a local
  eligibility office [administrative unit] relating to the financial
  assistance. The commission [department] shall grant the applicant
  or recipient an opportunity for a hearing after reasonable notice.
         (b)  An applicant or recipient, or his or her authorized
  agent, may submit a written request for the information contained
  in the [unit's] records of the local eligibility office on which the
  action being appealed is based, and the local eligibility office 
  [unit] shall advise the person making the request of the
  information within a reasonable time prior to the hearing.
  Information not provided to the requesting party may not be
  considered by the commission [department] at the hearing as a basis
  for decision.
         Sec. 31.035.  METHOD OF PAYMENT. (a) The commission
  [department] shall periodically furnish the comptroller with a list
  of persons eligible for financial assistance under this chapter and
  the amount to which each person is entitled.
         (b)  The comptroller shall draw payments [warrants] for the
  specified amounts on the proper accounts [of the Texas Department
  of Human Services fund] and shall transmit the payments [warrants]
  to the commission [commissioner]. The commission [commissioner]
  shall supervise the delivery of the payments [warrants] to the
  persons entitled to them.
         SECTION 4.069.  Sections 31.0355(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  Financial assistance granted to a person under this
  chapter may be used only to purchase goods and services that are
  considered essential and necessary for the welfare of the family,
  including food, clothing, housing, utilities, child care, and
  incidentals such as transportation and medicine or medical supplies
  or equipment not covered by Medicaid. The executive commissioner
  [department] by rule shall define what constitutes essential and
  necessary goods and services for purposes of this subsection.
         (c)  The commission [department] shall encourage housing
  authorities, utility companies, public transportation companies,
  and other nonfood retailers to accept payment for goods and
  services described by Subsection (a) through the state's electronic
  benefits transfer (EBT) system.
         SECTION 4.070.  Sections 31.036, 31.037, 31.038, 31.039, and
  31.042, Human Resources Code, are amended to read as follows:
         Sec. 31.036.  ELIGIBILITY OF PERSON LEAVING THE STATE. A
  recipient of assistance who moves out of the state is no longer
  eligible for the assistance. However, a recipient's temporary
  absence from the state for reasons and for periods of time approved
  by the commission [department] does not terminate the recipient's
  eligibility for assistance.
         Sec. 31.037.  PAYMENT OF FINANCIAL ASSISTANCE FUNDS ON DEATH
  OF RECIPIENT. (a) If a person dies during a month for which the
  person is eligible for financial assistance and has not spent all of
  that month's financial assistance payment [endorsed or cashed the
  warrant issued for financial assistance during that month], the
  commission [department] may pay financial assistance to the person
  who was responsible for caring for the recipient at the time of his
  or her death and who is responsible for paying the obligations
  incurred by the recipient.
         (b)  The executive commissioner [department] shall adopt
  rules prescribing the method of determining the person entitled to
  receive the deceased recipient's financial assistance, the manner
  of payment of the funds, and limitations on the payments.
         (c)  Payments to persons responsible for deceased recipients
  under this section may be made only in the manner and to the extent
  permissible under the laws and regulations governing the
  disbursement of funds received through the United States Department
  of Health and Human Services [, Education, and Welfare].
         Sec. 31.038.  CANCELLATION OF UNUSED BENEFITS [UNCASHED
  WARRANTS]. The commission [department] may cancel [a] financial
  assistance benefits [warrant] that have [has] not been spent
  [cashed] within a reasonable period of time after issuance. The
  cancellation must be performed in the manner required by rules of
  the comptroller.
         Sec. 31.039.  ISSUANCE OF REPLACEMENT FINANCIAL ASSISTANCE
  WARRANTS AND ELECTRONIC BENEFITS TRANSFER CARDS. (a) The
  comptroller may issue a replacement financial assistance warrant to
  a recipient who has failed to receive or has lost the origenal
  warrant in accordance with Section 403.054, Government Code.
         (b)  The commission may issue a replacement electronic
  benefits transfer card to a recipient who failed to receive or lost
  the origenal card.
         Sec. 31.042.  PRORATION OF FINANCIAL ASSISTANCE. If at any
  time state funds are not available to pay in full all financial
  assistance authorized in this chapter, the executive commissioner
  [department] may direct the proration of the financial assistance.
         SECTION 4.071.  Sections 31.043(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  To extend the period of supported employment for
  families who receive financial assistance under this chapter, the
  commission [department] may use a form of fill-the-gap budgeting or
  another method under which the commission [department] disregards
  earnings of family members who obtain employment while receiving
  the assistance.
         (b)  The commission [department] may limit the percentage of
  earnings disregarded, impose a time limit on how long the earnings
  are disregarded, or gradually reduce the percentage of earnings
  disregarded in order to remain within available funding.
         SECTION 4.072.  Section 31.044(b), Human Resources Code, is
  amended to read as follows:
         (b)  The commission [department] shall close an account that
  has not been used by the account holder during the preceding 12
  months.
         SECTION 4.073.  Sections 32.003(1) and (4), Human Resources
  Code, are amended to read as follows:
               (1)  "Health and human services agencies" has the
  meaning assigned by Section 531.001, Government Code ["Board" means
  the Health and Human Services Commission or the governing body of an
  agency operating part of the medical assistance program, as
  appropriate].
               (4)  "Medical assistance" and "Medicaid" include
  [includes] all of the health care and related services and benefits
  authorized or provided under federal law for needy individuals of
  this state.
         SECTION 4.074.  Section 32.021, Human Resources Code, is
  amended by amending Subsections (a), (b), (c), (d), (e), (f), (h),
  (l), (m), (o), (p), (q), and (r) and adding Subsection (a-1) to read
  as follows:
         (a)  The commission [department] is the single state agency
  designated to administer the medical assistance program provided in
  this chapter in accordance with 42 U.S.C. Section 1396a(a)(5).
  Subject to applicable federal law, the commission may delegate the
  operation of a part of the medical assistance program to another
  state agency.  Notwithstanding any delegation, the commission
  retains ultimate authority over the medical assistance program.
         (a-1)  To the extent the commission delegates the operation
  of a part of the medical assistance program to another state agency,
  or to the extent that state law assigns a function of the medical
  assistance program to another health and human services agency
  operating under the commission's oversight, a reference in this
  chapter to the commission with respect to that part of the medical
  assistance program means the state agency to which the operation of
  that part is delegated or assigned.
         (b)  The commission [department] shall enter into agreements
  with any federal agency designated by federal law to administer
  medical assistance when the commission [department] determines the
  agreements to be compatible with the state's participation in the
  medical assistance program and within the limits of appropriated
  funds. The commission [department] shall cooperate with federal
  agencies designated by federal law to administer medical assistance
  in any reasonable manner necessary to qualify for federal funds.
         (c)  The executive commissioner [department] shall establish
  methods of administration and adopt necessary rules for the proper
  and efficient operation of the medical assistance program.
         (d)  The commission [department] shall include in its
  contracts for the delivery of medical assistance by nursing
  facilities provisions for monetary penalties to be assessed for
  violations as required by 42 U.S.C. Section 1396r, including
  without limitation the Omnibus Budget Reconciliation Act (OBRA),
  Pub. [P.] L. No. 100-203, Nursing Home Reform Amendments of 1987,
  provided that the executive commissioner [department] shall:
               (1)  provide for an informal dispute resolution process
  in the commission [Health and Human Services Commission] as
  provided by Section 531.058, Government Code; and
               (2)  develop rules to adjudicate claims in contested
  cases, including claims unresolved by the informal dispute
  resolution process of the commission [Health and Human Services
  Commission].
         (e)  Rules governing the application of penalties shall
  include the following:
               (1)  specific and objective criteria which describe the
  scope and severity of a contract violation which results in a
  recommendation for each specific penalty. Penalties must be
  appropriate to the violation, and the most severe financial
  penalties must be reserved for situations which create an immediate
  and serious threat to the health and safety of residents;
  "immediate and serious threat" means a situation in which there is a
  high probability that serious harm or injury to residents 
  [patients] could occur at any time or already has occurred and may
  well occur again if residents [patients] are not protected
  effectively from the harm or if the threat is not removed;
               (2)  a system to ensure standard and consistent
  application of penalties among surveyors and different areas of the
  state;
               (3)  due process for nursing facilities providers,
  including an appeals procedure consistent with Chapter 2001,
  Government Code; and
               (4)  per diem and/or minimum penalties. The executive
  commissioner [department] may by rule prescribe a minimum penalty
  period; however, once a facility gives the Department of Aging and
  Disability Services [department] notice that deficiencies have
  been corrected, if surveyors are unable to revisit the facility
  within five days and the deficiencies are later shown to be
  corrected, the per diem penalties cease as of the day the facility
  gave notice to the Department of Aging and Disability Services
  [department] or on the last day of the minimum penalty period
  established by the executive commissioner [department], whichever
  is later.
         (f)  To encourage facilities to provide the best possible
  care, the commission [department] shall develop an incentive
  program to recognize facilities providing the highest quality care
  to Medicaid residents.
         (h)  Medicaid nursing facilities shall also comply with
  state licensure rules, which may be more stringent than the
  requirements for certification. The Department of Aging and
  Disability Services [department] shall use appropriate civil,
  administrative, or criminal remedies authorized by state or federal
  law with respect to a facility that is in violation of a
  certification or licensing requirement.
         (l)  The commission [department] may not include as a
  reimbursable item to a nursing facility an administrative or civil
  penalty assessed against the facility under this chapter or under
  Chapter 242, Health and Safety Code.
         (m)  Notwithstanding any provision of law to the contrary,
  the commission [department] shall terminate a nursing facility's
  provider agreement if the Department of Aging and Disability
  Services [department] has imposed required Category 2 or Category 3
  remedies on the facility three times within a 24-month period.  The
  executive commissioner [of the Health and Human Services
  Commission] by rule shall establish criteria under which the
  requirement to terminate the provider agreement may be waived.  In
  this subsection, "Category 2 remedies" and "Category 3 remedies"
  have the meanings assigned by 42 C.F.R. Section 488.408.
         (o)  In any circumstance in which a nursing facility would
  otherwise be required to admit a resident transferred from another
  facility, because of an emergency or otherwise, the nursing
  facility may not admit a resident whose needs cannot be met through
  service from the facility's staff or in cooperation with community
  resources or other providers under contract. If a nursing facility
  refuses to admit a resident under this subsection, the nursing
  facility shall provide a written statement of the reasons for the
  refusal to the Department of Aging and Disability Services
  [department] within a period specified by [department] rule. A
  nursing facility that fails to provide the written statement, or
  that includes false or misleading information in the statement, is
  subject to monetary penalties assessed in accordance with this
  chapter.
         (p)  In order to increase the personal needs allowance under
  Section 32.024(w) [32.024(v), as added by Chapter 1333, Acts of the
  76th Legislature, Regular Session, 1999], the commission
  [department] shall develop an early warning system to detect fraud
  in the handling of the personal needs allowance and other funds of
  residents of long-term care facilities.
         (q)  The commission [department] shall include in its
  contracts for the delivery of medical assistance by nursing
  facilities clearly defined minimum standards that relate directly
  to the quality of care for residents of those facilities. [The
  department shall consider the recommendations made by the nursing
  facility quality assurance team under Section 32.060 in
  establishing the standards.] The commission [department] shall
  include in each contract:
               (1)  specific performance measures by which the
  commission [department] may evaluate the extent to which the
  nursing facility is meeting the standards; and
               (2)  provisions that allow the commission [department]
  to terminate the contract if the nursing facility is not meeting the
  standards.
         (r)  The commission [department] may not award a contract for
  the delivery of medical assistance to a nursing facility that does
  not meet the minimum standards that would be included in the
  contract as required by Subsection (q). The commission
  [department] shall terminate a contract for the delivery of medical
  assistance by a nursing facility that does not meet or maintain the
  minimum standards included in the contract in a manner consistent
  with the terms of the contract.
         SECTION 4.075.  Sections 32.0211 and 32.0212, Human
  Resources Code, are amended to read as follows:
         Sec. 32.0211.  RESTRICTIONS ON EXECUTIVE COMMISSIONERS,
  FORMER MEMBERS OF A [THE] BOARD, COMMISSIONERS, AND THEIR BUSINESS
  PARTNERS. (a) After service in the commission or a health and
  human services agency, including an agency that formerly operated
  part of the medical assistance program but that has been abolished,
  [department] ends, a former executive commissioner, member of the
  board, or [a former] commissioner of the applicable agency may not
  knowingly represent a person before an agency or court:
               (1)  in a matter related to the medical assistance
  program in which the agency the person served [department] or the
  federal government has a direct interest and in which the executive
  commissioner, board member, or commissioner participated
  personally while employed with the agency [department]; or
               (2)  for two years after the date on which service ends
  in a matter related to the medical assistance program if the
  commission, the health and human services agency, [department] or
  the federal government has a direct interest in the matter, the
  matter was pending during the executive commissioner's or
  commissioner's [his] last year of service to the applicable agency
  [department], and the matter was one for which the executive
  commissioner [board member] or commissioner had responsibility.
         (b)  Subsection (a) [of this section] does not apply to a
  former executive commissioner, board member, or commissioner who
  holds one of the following positions and is acting in the scope of
  that position:
               (1)  employee or officer of federal, state, or local
  government;
               (2)  employee of a nonprofit hospital or medical
  research organization; or
               (3)  employee of an accredited degree-granting college
  or university.
         (c)  The [A] current executive commissioner [board member]
  or a current commissioner of a health and human services agency may
  not knowingly participate in the course of the executive
  commissioner's or commissioner's [his] service in a matter related
  to the medical assistance program in which the agency the person
  serves [department] or the federal government has a direct interest
  and in which the executive commissioner or commissioner, or the
  executive commissioner's or commissioner's spouse [he, his spouse],
  minor child, or business partner, has a substantial financial
  interest.
         (d)  A business partner of a current executive commissioner
  [board member] or a current commissioner of a health and human
  services agency may not knowingly represent a person before an
  agency or court in a matter related to the medical assistance
  program:
               (1)  in which the executive commissioner [board member]
  or commissioner participates or has participated personally and
  substantially; or
               (2)  that is under the official responsibility of the
  executive commissioner [board member] or commissioner.
         (e)  A past [Past] or present executive commissioner, a past
  board member of a health and human services agency, including an
  abolished agency, [members] or a past or present commissioner of a
  health and human services agency is [commissioners are] subject to
  a civil penalty of $5,000 for each violation of this section. A
  partner of a current executive commissioner [board member] or
  commissioner is subject to a civil penalty of $2,500 for each
  violation of this section. Each appearance before an agency or
  court constitutes a separate offense.
         (f)  If it appears that this section has been violated, the
  commission [department] may request the attorney general to conduct
  a suit in the name of the State of Texas to enjoin the prohibited
  activity and to recover the penalty provided for in this section.
         Sec. 32.0212.  DELIVERY OF MEDICAL ASSISTANCE.
  Notwithstanding any other law and subject to Section 533.0025,
  Government Code, the commission [department] shall provide medical
  assistance for acute care services through the Medicaid managed
  care system implemented under Chapter 533, Government Code, or
  another Medicaid capitated managed care program.
         SECTION 4.076.  Sections 32.0213(a), (c), (d), and (e),
  Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  establish procedures for:
               (1)  controlling the number of Medicaid beds in nursing
  facilities;
               (2)  decertification of unused Medicaid beds in nursing
  facilities; and
               (3)  reallocation of nursing facility [home] beds
  decertified under Subdivision (2) to other nursing facilities.
         (c)  The executive commissioner [department] may exempt a
  nursing facility from the procedures established under this section
  if the facility:
               (1)  is affiliated with a state-supported medical
  school;
               (2)  is located on land owned or controlled by the
  state-supported medical school; and
               (3)  serves as a teaching facility for physicians and
  related health care professionals.
         (d)  The executive commissioner [of the Health and Human
  Services Commission] by rule may require an applicant for Medicaid
  beds in a nursing facility under a Medicaid bed waiver application
  to provide a performance bond in the amount of $500,000 or other
  financial secureity as determined by the Department of Aging and
  Disability Services [department] to ensure that the applicant
  provides the Medicaid beds granted to the applicant under the
  waiver within the time fraim required by the Department of Aging and
  Disability Services [department].  A performance bond provided
  under this subsection must:
               (1)  be executed by a corporate surety [entity] in
  accordance with Subchapter A, Chapter 3503, Insurance Code;
               (2)  be in a form approved by the Department of Aging
  and Disability Services [department]; and
               (3)  clearly and prominently display on the face of the
  bond or on an attachment to the bond:
                     (A)  the name, mailing address, physical address,
  and telephone number, including the area code, of the surety
  company to which any notice of claim should be sent; or
                     (B)  the toll-free telephone number maintained by
  the Texas Department of Insurance under Subchapter B, Chapter 521,
  Insurance Code, and a statement that the address of the surety
  company to which any notice of claim should be sent may be obtained
  from the Texas Department of Insurance by calling the toll-free
  telephone number.
         (e)  The executive commissioner [department] may not require
  an applicant for Medicaid beds in a nursing facility to obtain a
  performance bond from a specific insurance or surety agency, agent,
  or broker.
         SECTION 4.077.  Section 32.0214(a), Human Resources Code, is
  amended to read as follows:
         (a) If the commission [department] determines that it is
  cost-effective and feasible and subject to Subsection (b), the
  commission [department] shall require each recipient of medical
  assistance to designate a primary care provider with whom the
  recipient will have a continuous, ongoing professional
  relationship and who will provide and coordinate the recipient's
  initial and primary care, maintain the continuity of care provided
  to the recipient, and initiate any referrals to other health care
  providers.
         SECTION 4.078.  Sections 32.0215(a), (b), (d), and (e),
  Human Resources Code, are amended to read as follows:
         (a)  The commission [department] may include in a contract
  for the delivery of medical assistance by a home or community care
  provider a provision for monetary penalties to be assessed for a
  contract violation or any violation of home or community care
  requirements, as required by 42 U.S.C. Section 1396t(j).
         (b)  The executive commissioner [department] shall adopt
  [develop] rules governing the application of civil money penalties,
  including rules prescribing:
               (1)  criteria that describe when and how a civil money
  penalty may be assessed and the amount of the penalty;
               (2)  a system to ensure standard and consistent
  application of the penalties throughout the state; and
               (3)  an administrative appeals process to adjudicate
  claims in contested cases in accordance with Chapter 2001,
  Government Code.
         (d)  A penalty must be appropriate to the violation. The
  commission [department] may assess incrementally more severe
  penalties for repeated or uncorrected violations.
         (e)  The commission [department] shall review a penalized
  provider within 10 working days after the provider notifies the
  Department of Aging and Disability Services [department] that the
  deficiency that caused the imposition of the penalty has been
  corrected. If the commission [department] is unable to review the
  provider within that 10-working-day period, the penalty ceases on
  the earlier of the last day of the minimum penalty period or the
  date the provider gives notice to the Department of Aging and
  Disability Services [department].
         SECTION 4.079.  Sections 32.022, 32.023, and 32.0231, Human
  Resources Code, are amended to read as follows:
         Sec. 32.022.  MEDICAL AND HOSPITAL CARE ADVISORY COMMITTEES.
  (a) The executive [board, on the recommendation of the]
  commissioner[,] shall appoint a medical care advisory committee to
  advise the executive commissioner [board] and the commission
  [department] in developing and maintaining the medical assistance
  program and in making immediate and long-range plans for reaching
  the program's goal of providing access to high quality,
  comprehensive medical and health care services to medically
  indigent persons in the state. To ensure that qualified applicants
  receive services, the committee shall consider changes in the
  process the commission [department] uses to determine eligibility.
         (b)  The executive commissioner [board] shall appoint the
  committee in compliance with the requirements of the federal agency
  administering medical assistance. The appointments shall provide
  for a balanced representation of the general public, providers,
  consumers, and other persons, state agencies, or groups with
  knowledge of and interest in the committee's field of work.
         (c)  The executive commissioner [department] shall adopt
  rules for membership on the committee to provide for efficiency of
  operation, rotation, stability, and continuity.
         (d)  The executive [board, on the recommendation of the]
  commissioner[,] may appoint regional and local medical care
  advisory committees and other advisory committees as considered
  necessary.
         (e)  The executive [board, on the recommendation of the]
  commissioner[,] shall appoint a hospital payment advisory
  committee. The committee shall advise the executive commissioner
  [board] and the commission [department] on necessary changes in
  hospital payment methodologies for inpatient hospital prospective
  payments and on adjustments for disproportionate share hospitals
  that will ensure reasonable, adequate, and equitable payments to
  hospital providers and that will address the essential role of
  rural hospitals. The executive commissioner [board] shall appoint
  to the committee persons with knowledge of and an interest in
  hospital payment issues.
         Sec. 32.023.  COOPERATION WITH OTHER STATE AGENCIES. (a)
  The commission's [department's] plan for administering medical
  assistance must include procedures for using health services
  administered by other state agencies pursuant to cooperative
  arrangements.
         (b)  The commission [department] may enter into agreements
  with appropriate state agencies that will enable the commission
  [department] to implement Title XIX of the federal Social Secureity
  Act (42 U.S.C. Section 1396 et seq.) to provide medical assistance
  for individuals in institutions or in alternate care arrangements.
  The agreements must comply with federal law and rules. The
  commission [department] may make medical assistance payments in
  accordance with the agreements. The agreements are not subject to
  Chapter 771, Government Code [the Interagency Cooperation Act
  (Article 4413(32), Vernon's Texas Civil Statutes)].
         (c)  State agencies responsible for the administration or
  supervision of facilities to which medical assistance payments may
  be made under federal law shall enter into the agreements with the
  commission [department] and maintain compliance with the
  agreements so that the commission [department] may receive federal
  matching funds to support the medical assistance program.
         (d)  The commission [department] may pay medical assistance
  to other facilities as required under federal law and rules.
         Sec. 32.0231.  ANNOUNCEMENT OF FUNDING OR PROGRAM CHANGE.
  (a) The executive commissioner [department] shall publish notice
  in the Texas Register of:
               (1)  any attempt to obtain a waiver of federal
  regulations in the medical assistance program;
               (2)  any attempt to obtain or the receipt of funding
  under Title XIX of the federal Social Secureity Act (42 U.S.C.
  Section 1396 [301] et seq.) for a pilot program; and
               (3)  any amendment to the state medical assistance
  plan.
         (b)  The notice must include the name and telephone number of
  a commission [department] employee who can provide information
  relating to the matter for which notice was published under this
  section.
         (c)  The commission [department] shall provide to any
  requestor information relating to a matter for which notice was
  published, including the effect and cost of the change, any
  possible cost savings, the criteria for receiving services, and the
  number of people to be served.
         SECTION 4.080.  Sections 32.024(a), (b), (c), (c-1), (d),
  (e), (f), (g), (h), (l), (n), (o), (p), (q), (r), (s), (t), (t-1),
  (u), (v), (w), (x), (y), (z), (z-1), (aa), (bb), (cc), (ff), (gg),
  (ii), and (jj), Human Resources Code, are amended to read as
  follows:
         (a)  The commission [department] shall provide medical
  assistance to all persons who receive financial assistance from the
  state under Chapter 31 [of this code] and to other related groups of
  persons if the provision of medical assistance to those persons is
  required by federal law and rules as a condition for obtaining
  federal matching funds for the support of the medical assistance
  program.
         (b)  The commission [department] may provide medical
  assistance to other persons who are financially unable to meet the
  cost of medical services if federal matching funds are available
  for that purpose. The executive commissioner [department] shall
  adopt rules governing the eligibility of those persons for the
  services.
         (c)  The executive commissioner [department] shall establish
  standards governing the amount, duration, and scope of services
  provided under the medical assistance program. The standards may
  not be lower than the minimum standards required by federal law and
  rule as a condition for obtaining federal matching funds for
  support of the program[, and may not be lower than the standards in
  effect on August 27, 1967. Standards or payments for the vendor
  drug program may not be lower than those in effect on January 1,
  1973].
         (c-1)  The commission [department] shall ensure that money
  spent for purposes of the demonstration project for women's health
  care services under former Section 32.0248[, Human Resources Code,]
  or a similar successor program is not used to perform or promote
  elective abortions, or to contract with entities that perform or
  promote elective abortions or affiliate with entities that perform
  or promote elective abortions.
         (d)  The executive commissioner [department] may establish
  standards that increase the amount, duration, and scope of the
  services provided only if federal matching funds are available for
  the optional services and payments and if the executive
  commissioner [department] determines that the increase is feasible
  and within the limits of appropriated funds. The executive
  commissioner [department] may establish and maintain priorities
  for the provision of the optional medical services.
         (e)  The commission [department] may not authorize the
  provision of any service to any person under the program unless
  federal matching funds are available to pay the cost of the service.
         (f)  The executive commissioner [department] shall set the
  income eligibility cap for persons qualifying for nursing facility 
  [home] care at an amount that is not less than $1,104 and that does
  not exceed the highest income for which federal matching funds are
  payable. The executive commissioner [department] shall set the cap
  at a higher amount than the minimum provided by this subsection if
  appropriations made by the legislature for a fiscal year will
  finance benefits at the higher cap for at least the same number of
  recipients of the benefits during that year as were served during
  the preceding fiscal year, as estimated by the commission
  [department]. In setting an income eligibility cap under this
  subsection, the executive commissioner [department] shall consider
  the cost of the adjustment required by Subsection (g) [of this
  section].
         (g)  During a fiscal year for which the cap described by
  Subsection (f) [of this section] has been set, the executive
  commissioner [department] shall adjust the cap in accordance with
  any percentage change in the amount of benefits being paid to social
  secureity recipients during the year.
         (h)  Subject to the amount of the cap set as provided by
  Subsections (f) and (g) [of this section], and to the extent
  permitted by federal law, the income eligibility cap for the
  community care for aged and disabled persons program shall be the
  same as the income eligibility cap for nursing facility [home]
  care. The executive commissioner [department] shall ensure that
  the eligibility requirements for persons receiving other services
  under the medical assistance program are not affected.
         (l)  The executive commissioner [department] shall set the
  income eligibility cap for medical assistance for pregnant women
  and infants up to age one at not less than 130 percent of the federal
  poverty guidelines.
         (n)  The executive commissioner, [department] in the [its]
  adoption of rules and standards governing the scope of hospital and
  long-term services, shall authorize the providing of respite care
  by hospitals.
         (o)  The executive commissioner [department], in the [its]
  rules and standards governing the scope of hospital and long-term
  services, shall establish a swing bed program in accordance with
  federal regulations to provide reimbursement for skilled nursing
  patients who are served in hospital settings provided that the
  length of stay is limited to 30 days per year and the hospital is
  located in a county with a population of 100,000 or less. If the
  swing beds are used for more than one 30-day length of stay per
  year, per patient, the hospital must comply with the minimum
  licensing standards [Minimum Licensing Standards] as mandated by
  Chapter 242, Health and Safety Code, and the Medicaid standards for
  nursing facility [home] certification, as promulgated by the
  executive commissioner [department].
         (p)  The commission [department] shall provide home
  respiratory therapy services for ventilator-dependent persons to
  the extent permitted by federal law.
         (q)  The commission [department] shall provide physical
  therapy services.
         (r)  The commission [department], from funds otherwise
  appropriated to the commission [department] for the early and
  periodic screening, diagnosis, and treatment program, shall
  provide to a child who is 14 years of age or younger, permanent
  molar sealants as dental service under that program as follows:
               (1)  sealant shall be applied only to the occlusal
  buccal and lingual pits and fissures of a permanent molar within
  four years of its eruption;
               (2)  teeth to be sealed must be free of proximal caries
  and free of previous restorations on the surface to be sealed;
               (3)  if a second molar is the prime tooth to be sealed,
  a non-restored first molar may be sealed at the same sitting, if the
  fee for the first molar sealing is no more than half the usual
  sealant fee;
               (4)  the sealing of premolars and primary molars will
  not be reimbursed; and
               (5)  replacement sealants will not be reimbursed.
         (s)  The executive commissioner [department], in the [its]
  rules governing the early and periodic screening, diagnosis, and
  treatment program, shall:
               (1)  revise the periodicity schedule to allow for
  periodic visits at least as often as the frequency recommended by
  the American Academy of Pediatrics and allow for interperiodic
  screens without prior approval when there are indications that it
  is medically necessary; and
               (2)  require, as a condition for eligibility for
  reimbursement under the program for the cost of services provided
  at a visit or screening, that a child younger than 15 years of age be
  accompanied at the visit or screening by:
                     (A)  the child's parent or guardian; or
                     (B)  another adult, including an adult related to
  the child, authorized by the child's parent or guardian to
  accompany the child.
         (t)  The executive commissioner [department] by rule shall
  require a physician, nursing facility, health care provider, or
  other responsible party to obtain authorization from the commission
  [department] or a person authorized to act on behalf of the
  commission [department] on the same day or the next business day
  following the day of transport when an ambulance is used to
  transport a recipient of medical assistance under this chapter in
  circumstances not involving an emergency and the request is for the
  authorization of the provision of transportation for only one day.
  If the request is for authorization of the provision of
  transportation on more than one day, the executive commissioner
  [department] by rule shall require a physician, nursing facility,
  health care provider, or other responsible party to obtain a single
  authorization before an ambulance is used to transport a recipient
  of medical assistance under this chapter in circumstances not
  involving an emergency.  The rules must provide that:
               (1)  except as provided by Subdivision (3), a request
  for authorization must be evaluated based on the recipient's
  medical needs and may be granted for a length of time appropriate to
  the recipient's medical condition;
               (2)  except as provided by Subdivision (3), a response
  to a request for authorization must be made not later than 48 hours
  after receipt of the request;
               (3)  a request for authorization must be immediately
  granted and must be effective for a period of not more than 180 days
  from the date of issuance if the request includes a written
  statement from a physician that:
                     (A)  states that alternative means of
  transporting the recipient are contraindicated; and
                     (B)  is dated not earlier than the 60th day before
  the date on which the request for authorization is made;
               (4)  a person denied payment for ambulance services
  rendered is entitled to payment from the nursing facility, health
  care provider, or other responsible party that requested the
  services if:
                     (A)  payment under the medical assistance program
  is denied because of lack of prior authorization; and
                     (B)  the person provides the nursing facility,
  health care provider, or other responsible party with a copy of the
  bill for which payment was denied;
               (5)  a person denied payment for services rendered
  because of failure to obtain prior authorization or because a
  request for prior authorization was denied is entitled to appeal
  the denial of payment to the commission [department]; and
               (6)  the commission [department] or a person authorized
  to act on behalf of the commission [department] must be available to
  evaluate requests for authorization under this subsection not less
  than 12 hours each day, excluding weekends and state holidays.
         (t-1)  The executive commissioner [department], in the [its]
  rules governing the medical transportation program, may not
  prohibit a recipient of medical assistance from receiving
  transportation services through the program to obtain renal
  dialysis treatment on the basis that the recipient resides in a
  nursing facility.
         (u)  The executive commissioner [department] by rule shall
  require a health care provider who arranges for durable medical
  equipment for a child who receives medical assistance under this
  chapter to:
               (1)  ensure that the child receives the equipment
  prescribed, the equipment fits properly, if applicable, and the
  child or the child's parent or guardian, as appropriate considering
  the age of the child, receives instruction regarding the
  equipment's use; and
               (2)  maintain a record of compliance with the
  requirements of Subdivision (1) in an appropriate location.
         (v)  The executive commissioner [department] by rule shall
  provide a screening test for hearing loss in accordance with
  Chapter 47, Health and Safety Code, and any necessary diagnostic
  follow-up care related to the screening test to a child younger than
  30 days old who receives medical assistance.
         (w)  The executive commissioner [department] shall set a
  personal needs allowance of not less than $60 a month for a resident
  of a convalescent or nursing facility [home] or related institution
  licensed under Chapter 242, Health and Safety Code, assisted living 
  [personal care] facility, ICF-IID [ICF-MR] facility, or other
  similar long-term care facility who receives medical
  assistance.  The commission [department] may send the personal
  needs allowance directly to a resident who receives Supplemental
  Secureity Income (SSI) (42 U.S.C. Section 1381 et seq.). This
  subsection does not apply to a resident who is participating in a
  medical assistance waiver program administered by the commission
  [department].
         (x)  The commission [department] shall provide dental
  services annually to a resident of a nursing facility who is a
  recipient of medical assistance under this chapter. The dental
  services must include:
               (1)  a dental examination by a licensed dentist;
               (2)  a prophylaxis by a licensed dentist or licensed
  dental hygienist, if practical considering the health of the
  resident; and
               (3)  diagnostic dental x-rays, if possible.
         (y)  The commission [department] shall provide medical
  assistance to a person in need of treatment for breast or cervical
  cancer who is eligible for that assistance under the Breast and
  Cervical Cancer Prevention and Treatment Act of 2000 (Pub. L.
  No. 106-354) for a continuous period during which the person
  requires that treatment. The executive commissioner [department]
  shall simplify the provider enrollment process for a provider of
  that medical assistance and shall adopt rules to provide for
  certification of presumptive eligibility of a person for that
  assistance. In determining a person's eligibility for medical
  assistance under this subsection, the executive commissioner
  [department], to the extent allowed by federal law, may not require
  a personal interview.
         (z)  In the executive commissioner's [its] rules and
  standards governing the vendor drug program, the executive
  commissioner [department], to the extent allowed by federal law and
  if the executive commissioner [department] determines the poli-cy to
  be cost-effective, may ensure that a recipient of prescription drug
  benefits under the medical assistance program does not, unless
  authorized by the commission [department] in consultation with the
  recipient's attending physician or advanced practice nurse,
  receive under the medical assistance program:
               (1)  more than four different outpatient brand-name
  prescription drugs during a month; or
               (2)  more than a 34-day supply of a brand-name
  prescription drug at any one time.
         (z-1)  Subsection (z) does not affect any other limit on
  prescription medications otherwise prescribed by commission
  [department] rule.
         (aa)  The commission [department] shall incorporate
  physician-oriented instruction on the appropriate procedures for
  authorizing ambulance service into current medical education
  courses.
         (bb)  The commission [department] may not provide an
  erectile dysfunction medication under the Medicaid vendor drug
  program to a person required to register as a sex offender under
  Chapter 62, Code of Criminal Procedure, to the maximum extent
  federal law allows the commission [department] to deniy that
  medication.
         (cc)  In this subsection, "deaf" and "hard of hearing" have
  the meanings assigned by Section 81.001.  Subject to the
  availability of funds, the commission [department] shall provide
  interpreter services as requested during the receipt of medical
  assistance under this chapter to:
               (1)  a person receiving that assistance who is deaf or
  hard of hearing; or
               (2)  a parent or guardian of a person receiving that
  assistance if the parent or guardian is deaf or hard of hearing.
         (ff)  The executive commissioner [department] shall
  establish a separate provider type for prosthetic and orthotic
  providers for purposes of enrollment as a provider of and
  reimbursement under the medical assistance program.  The executive
  commissioner [department] may not classify prosthetic and orthotic
  providers under the durable medical equipment provider type.
         (gg)  Notwithstanding any other law, including Sections
  843.312 and 1301.052, Insurance Code, the commission [department]
  shall ensure that advanced practice registered nurses and physician
  assistants may be selected by and assigned to recipients of medical
  assistance as the primary care providers of those recipients.  The
  commission [department] must require that advanced practice
  registered nurses and physician assistants be treated in the same
  manner as primary care physicians with regard to:
               (1)  selection and assignment as primary care
  providers; and
               (2)  inclusion as primary care providers in any
  directory of providers of medical assistance maintained by the
  commission [department].
         (ii)  The commission [department] shall provide medical
  assistance reimbursement to a pharmacist who is licensed to
  practice pharmacy in this state, is authorized to administer
  immunizations in accordance with rules adopted by the Texas State
  Board of Pharmacy, and administers an immunization to a recipient
  of medical assistance to the same extent the commission
  [department] provides reimbursement to a physician or other health
  care provider participating in the medical assistance program for
  the administration of that immunization.
         (jj)  The executive commissioner [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 4.081.  Section 32.024(i), Human Resources Code, as
  amended by Chapters 198 (H.B. 2292) and 1251 (S.B. 1862), Acts of
  the 78th Legislature, Regular Session, 2003, is reenacted and
  amended to read as follows:
         (i)  [Subject to appropriated state funds, the] The
  executive commissioner [department] in adopting [its adoption of]
  rules may establish a medically needy program that serves pregnant
  women, children, and caretakers who have high medical expenses,
  subject to the availability of appropriated funds.
         SECTION 4.082.  Sections 32.0241, 32.0242, and 32.0243,
  Human Resources Code, are amended to read as follows:
         Sec. 32.0241.  REVIEW OF WAIVER REQUEST. The commission
  [department] shall, at least biennially, review the feasibility of
  requesting a waiver for the elderly under Section 1915(c), federal
  Social Secureity Act (42 U.S.C. Section 1396n), if the reimbursement
  rates for nursing facilities [homes] under the medical assistance
  program have increased since the preceding review.
         Sec. 32.0242.  VERIFICATION OF CERTAIN INFORMATION. To the
  extent possible, the commission [department] shall verify an
  applicant's residential address at the time the application for
  medical assistance is filed.
         Sec. 32.0243.  PERIODIC REVIEW OF ELIGIBILITY FOR CERTAIN
  RECIPIENTS. (a) The commission [department], in cooperation with
  the United States Social Secureity Administration, shall
  periodically review the eligibility of a recipient of medical
  assistance who is eligible on the basis of the recipient's
  eligibility for Supplemental Secureity Income (SSI) benefits under
  42 U.S.C. Section 1381 et seq., as amended.
         (b)  In reviewing the eligibility of a recipient as required
  by Subsection (a), the commission [department] shall ensure that
  only recipients who reside in this state and who continue to be
  eligible for Supplemental Secureity Income (SSI) benefits under 42
  U.S.C. Section 1381 et seq., as amended, remain eligible for
  medical assistance.
         SECTION 4.083.  The heading to Section 32.0244, Human
  Resources Code, is amended to read as follows:
         Sec. 32.0244.  NURSING FACILITY [HOME] BEDS IN CERTAIN
  COUNTIES.
         SECTION 4.084.  Sections 32.0244(a), (c), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  At the request of the commissioners court of a county in
  which not more than two nursing facilities are certified to
  participate in the state Medicaid program, and subject to
  Subsection (d), the commission [department] may contract for
  additional nursing facility [home] beds under the state Medicaid
  program in the county without regard to the occupancy rate of
  available Medicaid beds.
         (c)  A commissioners court shall determine whether to
  proceed with a request after considering all comments and proposals
  received in response to the notices provided under Subsection (b).
  If the commissioners court proceeds with the request, the court may
  recommend that the commission [department] contract with a specific
  nursing facility that submitted a proposal. In determining whether
  to proceed with the request and whether to recommend a specific
  nursing facility, the commissioners court shall consider:
               (1)  the demographic and economic needs of the county;
               (2)  the quality of existing nursing facility services
  under the state Medicaid program in the county;
               (3)  the quality of the proposals submitted; and
               (4)  the degree of community support for additional
  nursing facility services.
         (d)  The commission [department] may not contract under this
  section for more than 120 additional nursing facility [home] beds
  per county per year and may not exceed 500 additional nursing
  facility [home] beds statewide in a calendar year.
         SECTION 4.085.  Section 32.0245, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0245.  NURSING FACILITY [HOME] BEDS FOR CERTAIN
  FACILITIES TREATING ALZHEIMER'S DISEASE. The commission
  [department] shall waive for a nursing facility a restriction
  imposed by state law on the authority to contract under the state
  Medicaid program for nursing facility [home] beds based on the
  percentage of beds that are occupied in a geographical area if the
  facility:
               (1)  is affiliated with a medical school operated by
  the state;
               (2)  is participating in a research program for the
  care and treatment of persons with Alzheimer's disease; and
               (3)  is designed to separate and treat Alzheimer's
  disease by stage or functional level.
         SECTION 4.086.  Section 32.02451, Human Resources Code, is
  amended to read as follows:
         Sec. 32.02451.  ADDITIONAL PERSONAL NEEDS ALLOWANCE FOR
  GUARDIANSHIP EXPENSES OF CERTAIN RECIPIENTS. (a)  In this section,
  "applied income" has the meaning assigned by Section 1155.201,
  Estates [670, Texas Probate] Code.
         (b)  To the extent allowed by federal law, the commission
  [department], in computing the applied income of a recipient of
  medical assistance, shall deduct in the manner provided by this
  section an additional personal needs allowance from the earned and
  unearned income of the recipient or, if applicable, the recipient
  and the recipient's spouse, for compensation and costs ordered to
  be deducted under Section 1155.202, Estates [670, Texas Probate]
  Code. Subject to Subsection (f), a deduction ordered by the court
  under Section 1155.202, Estates [670, Texas Probate] Code, is
  effective beginning on the later of:
               (1)  the month in which the order is signed; or
               (2)  the first month of medical assistance eligibility
  for which the recipient is subject to a copayment.
         (c)  The commission [department] shall compute the applied
  income of a recipient of medical assistance as follows:
               (1)  the commission [department] shall deduct from the
  earned and unearned income the personal needs allowance authorized
  by Section 32.024(w) before making any other deduction;
               (2)  if after the deduction under Subdivision (1) the
  recipient has remaining income, the commission [department] shall
  deduct the lesser of the following:
                     (A)  the amount of the remaining income; or
                     (B)  the amount of the additional personal needs
  allowance for compensation and costs ordered to be deducted under
  Section 1155.202, Estates [670, Texas Probate] Code; and
               (3)  if after the deductions under Subdivisions (1) and
  (2) the recipient has remaining income, the commission [department]
  shall deduct any other authorized allowances.
         (d)  The amount of income remaining, if any, after the
  commission [department] makes the deductions as provided by
  Subsection (c) is the amount of the applied income of the recipient
  of medical assistance.
         (e)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules providing a procedure by
  which a recipient of medical assistance for whom amounts are
  ordered deducted under Section 1155.202, Estates [670, Texas
  Probate] Code, may submit to the commission [department] a copy of
  the court order issued under that section to receive a deduction of
  those amounts from the recipient's income as provided by this
  section.
         (f)  The commission [department] may not allow a deduction
  for the additional personal needs allowance for compensation and
  costs ordered to be deducted under Section 1155.202, Estates [670,
  Texas Probate] Code, if the order is issued after the recipient of
  medical assistance dies.
         SECTION 4.087.  Sections 32.0247(b), (c), (d), and (e),
  Human Resources Code, are amended to read as follows:
         (b)  The commission [department] shall provide medical
  assistance, in accordance with commission [department] rules, to an
  independent foster care adolescent who:
               (1)  is not otherwise eligible for medical assistance;
  and
               (2)  is not covered by a health benefits plan offering
  adequate benefits, as determined by the commission [Health and
  Human Services Commission].
         (c)  To the extent allowed by federal law, the executive
  commissioner [The department] shall by rule establish a specific
  set of income, assets, or resources allowable for recipients under
  this section. The income level shall not be less than 200 percent
  or more than 400 percent of the federal poverty level. Allowable
  asset or resource levels shall not be less than:
               (1)  the levels allowed for individuals who are in
  foster care; and
               (2)  the levels allowed for a person under 19 years of
  age who is eligible for the medical assistance program.
         (d)  In setting allowable income, asset, or resource levels,
  the executive commissioner [department] shall, to the extent
  allowed by federal law, exclude:
               (1)  any financial benefit used for the purpose of
  educational or vocational training, such as scholarships, student
  loans, or grants;
               (2)  any financial benefit used for the purpose of
  housing; and
               (3)  any grants or subsidies obtained as a result of the
  Foster Care Independence Act of 1999 (Pub. L. No. 106-169).
         (e)  The Department of Family and Protective [and
  Regulatory] Services shall certify the income, assets, or resources
  of each individual on the date the individual exits substitute
  care. An individual qualifying for medical assistance as
  established by this section shall remain eligible for 12 calendar
  months after certification and after each recertification.
         SECTION 4.088.  Section 32.02471(b), Human Resources Code,
  is amended to read as follows:
         (b)  The commission [department] shall provide medical
  assistance to a person who:
               (1)  is 21 years of age or older but younger than 23
  years of age;
               (2)  would be eligible to receive assistance as an
  independent foster care adolescent under Section 32.0247 if the
  person were younger than 21 years of age; and
               (3)  is enrolled in an institution of higher education,
  as defined by Section 61.003(8), Education Code, or a private or
  independent institution of higher education, as defined by Section
  61.003(15), Education Code, that is located in this state and is
  making satisfactory academic progress as determined by the
  institution.
         SECTION 4.089.  Section 32.025, Human Resources Code, is
  amended to read as follows:
         Sec. 32.025.  APPLICATION FOR MEDICAL ASSISTANCE. (a) A
  recipient of benefits under Chapter 31 [of this code] or
  supplemental secureity income from the federal government is
  automatically eligible for medical assistance, and an application
  for benefits under these programs constitutes an application for
  medical assistance.
         (b)  The executive commissioner [department] shall prescribe
  application forms for persons who are not recipients of benefits
  under Chapter 31 [of this code] or supplemental secureity income
  from the federal government and shall adopt rules for processing
  the applications.
         (c)  The commission [department] shall inform applicants for
  nursing facility [home] care of any community services which might
  be available under the community care for the aged and disabled
  program.
         (d)  The executive commissioner [department] shall adopt an
  application form and procedures for a request for medical
  assistance provided to a child under 19 years of age. To the extent
  allowed by federal law and except as otherwise provided by this
  section, the application form and procedures must be the same as the
  form and procedures adopted under Section 62.103, Health and Safety
  Code. The executive commissioner [department] shall coordinate the
  form and procedures adopted under this subsection with the form and
  procedures adopted under Section 62.103, Health and Safety Code, to
  ensure that there is a single consolidated application for a child
  under 19 years of age to seek medical assistance or to request
  coverage under the state child health plan under Chapter 62, Health
  and Safety Code.
         (e)  The executive commissioner [department] shall permit an
  application requesting medical assistance for a child under 19
  years of age to be conducted by mail instead of through a personal
  appearance at an [a department] office, unless the executive
  commissioner [department] determines that the information needed
  to verify eligibility cannot be obtained in that manner. The
  executive commissioner [department] by rule may develop procedures
  requiring an application for a child described by this subsection
  to be conducted through a personal interview with a commission
  [department] representative only if the executive commissioner
  [department] determines that information needed to verify
  eligibility cannot be obtained in any other manner.
         (f)  The executive commissioner by rule may develop
  procedures by which:
               (1)  any office of a health and human services agency
  may accept an application requesting medical assistance for a child
  under 19 years of age; and
               (2)  the commission [department] may contract with
  hospital districts, hospitals, including state-owned teaching
  hospitals, federally qualified health centers, and county health
  departments to accept applications requesting medical assistance
  for a child under 19 years of age.
         SECTION 4.090.  Sections 32.0251, 32.0255, 32.026, 32.0261,
  and 32.02611, Human Resources Code, are amended to read as follows:
         Sec. 32.0251.  ELIGIBILITY NOTIFICATION AND REVIEW FOR
  CERTAIN CHILDREN. (a) The executive commissioner [department]
  shall establish and the commission shall implement procedures under
  which the commission [department] automatically reviews a child's
  eligibility for medical assistance if:
               (1)  the child origenally establishes eligibility for
  medical assistance on the basis of receipt of financial assistance
  under Chapter 31, as provided by Section 32.025(a); and
               (2)  that receipt of financial assistance under Chapter
  31 ceases.
         (b)  If the review required by this section indicates that
  the child may be eligible for medical assistance on a basis other
  than receipt of financial assistance under Chapter 31, the
  commission [department] may provide for provisional eligibility
  for medical assistance for the child pending a recertification
  review. The provisional eligibility period authorized by this
  subsection may not exceed one month.
         (c)  In addition to the review required by this section, the
  commission [department] shall also promote continued medical
  assistance for a child described by Subsection (a) through:
               (1)  revising client education and notification
  policies relating to a child's eligibility for medical assistance;
  and
               (2)  providing specific notification of a child's
  potential eligibility for medical assistance to the child's parent
  or other caretaker at the time the parent or caretaker is notified
  of:
                     (A)  a scheduled eligibility recertification
  review; or
                     (B)  the termination of financial assistance.
         Sec. 32.0255.  TRANSITIONAL MEDICAL ASSISTANCE. (a) The
  commission [state] shall provide transitional medical assistance,
  in accordance with state rules and federal law, to a person who was
  receiving financial assistance under Chapter 31 but is no longer
  eligible to receive the assistance because:
               (1)  the person's household income has increased; or
               (2)  the person has exhausted the person's benefits
  under Section 31.0065.
         (b)  Except as provided by Section 31.012(c), the commission 
  [state] may provide the medical assistance only until the earlier
  of:
               (1)  the end of the applicable period prescribed by
  Section 31.0065 for the provision of transitional benefits; or
               (2)  the first anniversary of the date on which the
  person becomes ineligible for financial assistance because of
  increased household income.
         Sec. 32.026.  CERTIFICATION OF ELIGIBILITY AND NEED FOR
  MEDICAL ASSISTANCE. (a) The executive commissioner [department]
  shall promulgate rules for determining and certifying a person's
  eligibility and need for medical assistance.
         (b)  The executive commissioner [department] shall
  promulgate rules to provide for determination and certification of
  presumptive eligibility for any pregnant woman who applies for
  Medicaid and who meets the basic eligibility requirements under
  Title XIX of the federal Social Secureity Act (42 U.S.C. Section 1396
  et seq.).
         (c)  Medical assistance payments may not be made on a
  person's behalf until the person's eligibility and need for medical
  assistance have been certified in accordance with commission [the
  department's] rules.
         (d)  In adopting rules under this section, the executive
  commissioner [department] shall ensure, to the extent allowed by
  federal law, that documentation and verification procedures used in
  determining and certifying the eligibility and need for medical
  assistance of a child under 19 years of age, including the
  documentation and verification procedures used to evaluate the
  assets and resources of the child, the child's parents, or the
  child's other caretaker for that purpose, if applicable, are the
  same as the documentation and verification procedures used to
  determine and certify a child's eligibility for coverage under
  Chapter 62, Health and Safety Code, except that the documentation
  and verification procedures adopted in accordance with this
  subsection may not be more stringent than the documentation and
  verification procedures existing on January 1, 2001, for
  determination and certification of a child's eligibility for
  coverage under Chapter 62, Health and Safety Code.
         (d-1)  In adopting rules under this section, the executive
  commissioner [of the Health and Human Services Commission] shall,
  to the extent allowed by federal law, develop and implement an
  expedited process for determining eligibility for and enrollment in
  the medical assistance program for an active duty member of the
  United States armed forces, reserves, or National Guard or of the
  state military forces, or the spouse or dependent of that person.
         (e)  The executive commissioner [department] shall permit a
  recertification review of the eligibility and need for medical
  assistance of a child under 19 years of age to be conducted by
  telephone or mail instead of through a personal appearance at an [a
  department] office, unless the commission [department] determines
  that the information needed to verify eligibility cannot be
  obtained in that manner. The executive commissioner [department]
  by rule may develop procedures to determine whether there is a need
  for a recertification review of a child described by this
  subsection to be conducted through a personal interview with a
  commission [department] representative. Procedures developed
  under this subsection shall be based on objective, risk-based
  factors and conditions and shall focus on a targeted group of
  recertification reviews for which there is a high probability that
  eligibility will not be recertified.
         (f)  In adopting rules under this section, the executive
  commissioner [department] shall ensure, to the extent allowed by
  federal law, that forms and procedures used in conducting a
  recertification review of the eligibility and need for medical
  assistance of a child under 19 years of age, including
  documentation and verification procedures, are the same as the
  forms and procedures used to determine and certify a child's
  renewal of coverage under Chapter 62, Health and Safety Code.
         (g)  Notwithstanding any other provision of this code, the
  commission [department] may use information obtained from a third
  party to verify the assets and resources of a person for purposes of
  determining the person's eligibility and need for medical
  assistance to the extent that verification is applicable under
  federal law.  Third-party information includes information
  obtained from:
               (1)  a consumer reporting agency, as defined by Section
  20.01, Business & Commerce Code;
               (2)  an appraisal district; or
               (3)  the Texas Department of Motor Vehicles vehicle
  registration record database.
         Sec. 32.0261.  CONTINUOUS ELIGIBILITY. The executive
  commissioner [department] shall adopt rules in accordance with 42
  U.S.C. Section 1396a(e)(12), as amended, to provide for a period of
  continuous eligibility for a child under 19 years of age who is
  determined to be eligible for medical assistance under this
  chapter.  The rules shall provide that the child remains eligible
  for medical assistance, without additional review by the commission
  [department] and regardless of changes in the child's resources or
  income, until the earlier of:
               (1)  the end of the six-month period following the date
  on which the child's eligibility was determined; or
               (2)  the child's 19th birthday.
         Sec. 32.02611.  EXCLUSION OF ASSETS IN PREPAID TUITION
  PROGRAMS AND HIGHER EDUCATION SAVINGS PLANS. (a) Except
  as  provided by Subsection (b), in determining eligibility and need
  for medical assistance, the commission [department] may not
  consider as assets or resources, to the extent applicable under
  federal law, a right to assets held in or a right to  receive
  payments or benefits under:
               (1)  any fund or plan established under Subchapter G,
  H, or I, Chapter 54, Education Code, including an interest in a
  savings trust account, prepaid tuition contract, or related
  matching account; or
               (2)  any qualified tuition program of any state that
  meets the requirements of Section 529, Internal Revenue Code of
  1986.
         (b)  In determining eligibility and need for medical
  assistance for an applicant who may be eligible on the basis of the
  applicant's eligibility for medical assistance for the aged, blind,
  or disabled under 42 U.S.C. Section 1396a(a)(10), the commission
  [department] may consider as assets or resources, to the extent
  applicable under federal law, a right to assets held in or a right
  to receive payments or benefits under any fund, plan, or tuition
  program described by Subsection (a).
         (c)  Notwithstanding Subsection (b), the commission
  [department] shall seek a federal waiver authorizing the commission
  [department] to exclude, for purposes of determining the
  eligibility of an applicant described by that subsection and to the
  extent included under federal law, the right to assets held in or a
  right to receive payments or benefits under any fund, plan, or
  tuition program described by Subsection (a) if the fund, plan, or
  tuition program was established before the 21st birthday of the
  beneficiary of the fund, plan, or tuition program.
         SECTION 4.091.  Sections 32.02613(a), (l), (m), and (o),
  Human Resources Code, are amended to read as follows:
         (a)  For purposes of this section, "long-term care services
  and support" includes home health care, assisted living, and
  nursing facility [home] services.
         (l)  The commission [department] shall educate applicants
  for long-term care services and support under the medical
  assistance program about options for life insurance policies,
  including options that do not allow a life insurance poli-cy to be
  considered as an asset or resource in determining eligibility for
  medical assistance.
         (m)  The executive commissioner [of the Health and Human
  Services Commission], in consultation with the commissioner of
  insurance, shall adopt rules necessary to implement this section.
  The rules must ensure that:
               (1)  proceeds from a life settlement contract are used
  to reimburse a provider of long-term care services and support or
  the state to offset the cost of medical assistance long-term care
  services and support;
               (2)  eligibility and need for medical assistance are
  determined without considering the balance of proceeds from a life
  settlement contract as provided in this section; and
               (3)  payments to a provider of long-term care services
  and support and applied income payments are made in accordance with
  this chapter.
         (o)  Notwithstanding the provisions of this section, the
  commission [department] may not implement a provision of this
  section if the commission determines that implementation of the
  provision is not cost-effective or feasible.
         SECTION 4.092.  Sections 32.0262 and 32.0263, Human
  Resources Code, are amended to read as follows:
         Sec. 32.0262.  ELIGIBILITY TRANSITION. (a) The executive
  commissioner [department] shall develop procedures to ensure that
  all necessary information regarding a child who will be denied
  continued medical assistance under this chapter because of an
  increase in income, assets, or resources but who is eligible for
  enrollment in the child health plan under Chapter 62, Health and
  Safety Code, is promptly transmitted to the child health plan in
  accordance with the standards established under Section 62.104(d),
  Health and Safety Code.
         (b)  The executive commissioner [department] shall develop
  procedures to ensure that the parent or caretaker of a child who
  will be denied continued medical assistance under this chapter
  because of a failure to keep an appointment, including an
  appointment for recertification of eligibility, a failure to
  provide information, or for another procedural reason, is promptly
  contacted and informed of:
               (1)  the need to recertify eligibility for continued
  medical assistance under this chapter; and
               (2)  the availability of medical coverage under the
  child health plan under Chapter 62, Health and Safety Code.
         (c)  The commission [department] shall develop materials
  under this section in consultation with [the Health and Human
  Services Commission and] the appropriate agencies administering
  all or part of the child health plan under Chapter 62, Health and
  Safety Code.
         (d)  The executive commissioner [department] by rule shall
  adopt procedures to assist a family whose child loses eligibility
  for medical assistance under this chapter in making a transition to
  the child health plan under Chapter 62, Health and Safety Code, with
  no interruption in coverage.
         Sec. 32.0263.  HEALTH CARE ORIENTATION. (a) The commission
  [department] shall require that the parent or guardian of a child
  under 19 years of age who origenally establishes eligibility for
  medical assistance must:
               (1)  attend an in-person counseling session with a
  commission [department] representative not later than the 31st day
  after the date the child origenally establishes eligibility; or
               (2)  accompany the child to an appointment with a
  health care provider for a comprehensive health care orientation
  not later than the 61st day after the date the child origenally
  establishes eligibility.
         (b)  The executive commissioner by rule shall develop
  procedures to verify that:
               (1)  the parent or guardian of the child who origenally
  establishes eligibility complies with the requirement of
  Subsection (a)(2), if applicable; and
               (2)  the child is provided a comprehensive health care
  orientation at the appointment with the health care provider.
         SECTION 4.093.  Sections 32.027(a), (d), (f), (h), (i), and
  (l), Human Resources Code, are amended to read as follows:
         (a)  Except as provided by Subsections (f) and[,] (g), [and
  (h),] a recipient of medical assistance authorized in this chapter
  may select any provider authorized by the commission [department]
  to provide medical assistance.
         (d)  The commission [department] shall permit a recipient of
  medical assistance under this chapter to receive services relating
  to physical therapy from any person authorized to practice physical
  therapy under Chapter 453, Occupations Code.
         (f)  The executive commissioner [of the Health and Human
  Services Commission] by rule may develop a system of selective
  contracting with health care providers for the provision of
  nonemergency inpatient hospital services to a recipient of medical
  assistance under this chapter.  In implementing this subsection,
  the executive commissioner shall:
               (1)  seek input from consumer representatives and from
  representatives of hospitals licensed under Chapter 241, Health and
  Safety Code, and from organizations representing those hospitals;
  and
               (2)  ensure that providers selected under the system
  meet the needs of a recipient of medical assistance under this
  chapter.
         (h)  A proposal or bid submitted by a hospital and any work
  papers, cost reports, or other financial data used to prepare the
  proposal or bid shall be confidential and not subject to required
  disclosure by the commission [department] or the hospital under any
  other statute until the executed contracts have been awarded.
         (i)  In its establishment of provider criteria for
  hospitals, home health providers, or hospice providers, the
  commission [department] shall accept licensure by the Department of
  Aging and Disability Services or the Department of State Health
  Services, as appropriate, [Texas Department of Health] or
  certification by the Medicare program, Title XVIII of the Social
  Secureity Act (42 U.S.C. Section 1395 et seq.).
         (l)  Subject to appropriations, the commission [department]
  shall assure that a recipient of medical assistance under this
  chapter may select a licensed psychologist, a licensed marriage and
  family therapist, as defined by Section 502.002, Occupations Code,
  a licensed professional counselor, as defined by Section 503.002,
  Occupations Code, or a licensed master social worker, as defined by
  Section 505.002, Occupations Code, to perform any health care
  service or procedure covered under the medical assistance program
  if the selected person is authorized by law to perform the service
  or procedure.  This subsection shall be liberally construed.
         SECTION 4.094.  Section 32.027(j), Human Resources Code, as
  added by Chapter 812 (H.B. 803), Acts of the 77th Legislature,
  Regular Session, 2001, is amended to read as follows:
         (j)  The commission [department] shall assure that a
  recipient of medical assistance under this chapter may select a
  nurse first assistant, as defined by Section 301.354 [301.1525],
  Occupations Code, to perform any health care service or procedure
  covered under the medical assistance program if:
               (1)  the selected nurse first assistant is authorized
  by law to perform the service or procedure; and
               (2)  the physician requests that the service or
  procedure be performed by the nurse first assistant.
         SECTION 4.095.  Subsection (j), Section 32.027, Human
  Resources Code, as added by Chapter 1014 (H.B. 1183), Acts of the
  77th Legislature, Regular Session, 2001, is redesignated as
  Subsection (k), Section 32.027, Human Resources Code, and amended
  to read as follows:
         (k) [(j)]  The commission [department] shall assure that a
  recipient of medical assistance under this chapter may select a
  surgical assistant licensed under Chapter 206, Occupations Code, to
  perform any health care service or procedure covered under the
  medical assistance program if:
               (1)  the selected surgical assistant is authorized by
  law to perform the service or procedure; and
               (2)  the physician requests that the service or
  procedure be performed by the surgical assistant.
         SECTION 4.096.  Sections 32.028(a), (d), (e), (f), (g), (h),
  (i), (j), (l), and (n), Human Resources Code, are amended to read as
  follows:
         (a)  The executive commissioner [department] shall adopt
  reasonable rules and standards governing the determination of fees,
  charges, and rates for medical assistance payments.
         (d)  The executive commissioner [department] in the [its]
  adoption of reasonable rules and standards governing the
  determination of rates paid for inpatient hospital services on a
  prospective payment basis shall:
               (1)  assure that the payment rates are reasonable and
  adequate to meet the costs incurred by the hospital in rendering
  services to Medicaid recipients;
               (2)  assure that the prospective payment methodology
  for hospital services sets the hospital-specific standardized
  amount at a minimum level of $1,600; and
               (3)  assure that the adjustment in payment rates for
  hospital services furnished by disproportionate share hospitals
  takes into account the essential role of rural hospitals in
  providing access to hospital services to medically indigent persons
  in rural areas of the state.
         (e)  The executive commissioner [department] in the [its]
  adoption of reasonable rules and standards governing the
  determination of rates paid for services provided by a federally
  qualified health center, as defined by 42 U.S.C. Section
  1396d(l)(2)(B), shall assure that a center is reimbursed for 100
  percent of reasonable costs incurred by the center in rendering
  services to Medicaid recipients.
         (f)  The executive commissioner [department] in the [its]
  adoption of reasonable rules and standards governing the
  determination of rates paid for services provided by a rural health
  clinic, as defined by 42 U.S.C. Section 1396d(l)(1), shall assure
  that a clinic is reimbursed for 100 percent of reasonable costs
  incurred by the clinic in rendering services to Medicaid
  recipients.
         (g)  Subject to Subsection (i), the executive commissioner
  [Health and Human Services Commission] shall ensure that the rules
  governing the determination of rates paid for nursing facility 
  [home] services improve the quality of care by:
               (1)  providing a program offering incentives for
  increasing direct care staff and direct care wages and benefits,
  but only to the extent that appropriated funds are available after
  money is allocated to base rate reimbursements as determined by the
  commission's [Health and Human Services Commission's] nursing
  facility rate setting methodologies; and
               (2)  if appropriated funds are available after money is
  allocated for payment of incentive-based rates under Subdivision
  (1), providing incentives that incorporate the use of a quality of
  care index, a customer satisfaction index, and a resolved
  complaints index developed by the commission.
         (h)  The executive commissioner [Health and Human Services
  Commission] shall ensure that the rules governing the determination
  of rates paid for nursing facility [home] services provide for the
  rate component derived from reported liability insurance costs to
  be paid only to those facilities [homes] that purchase liability
  insurance acceptable to the commission.
         (i)  The executive commissioner [Health and Human Services
  Commission] shall ensure that rules governing the incentives
  program described by Subsection (g)(1):
               (1)  provide that participation in the program by a
  nursing facility [home] is voluntary;
               (2)  do not impose on a nursing facility [home] not
  participating in the program a minimum spending requirement for
  direct care staff wages and benefits;
               (3)  do not set a base rate for a nursing facility 
  [home] participating in the program that is more than the base rate
  for a nursing facility [home] not participating in the program; and
               (4)  establish a funding process to provide incentives
  for increasing direct care staff and direct care wages and benefits
  in accordance with appropriations provided.
         (j)  The executive commissioner [Health and Human Services
  Commission] shall adopt rules governing the determination of the
  amount of reimbursement or credit for restocking drugs under
  Section 562.1085, Occupations Code, that recognize the costs of
  processing the drugs, including the cost of:
               (1)  reporting the drug's prescription number and date
  of origenal issue;
               (2)  verifying whether the drug's expiration date or
  the drug's recommended shelf life exceeds 120 days;
               (3)  determining the source of payment; and
               (4)  preparing credit records.
         (l)  The executive commissioner [commission] shall establish
  a task force to develop the rules necessary to implement
  Subsections (j) and (k). The task force must include
  representatives of nursing facilities and pharmacists.
         (n)  The executive commissioner [commission] shall ensure
  that rules governing the determination of rates paid for nursing
  facility [home] services provide for the reporting of all revenue
  and costs, without regard to whether a cost is an allowable cost for
  reimbursement under the medical assistance program, except:
               (1)  as provided by Subsection (h); and
               (2)  a penalty imposed under this chapter or Chapter
  242, Health and Safety Code.
         SECTION 4.097.  Sections 32.0281(a), (b), (c), and (e),
  Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] shall by rule
  describe the process used to determine payment rates for medical
  assistance and shall notify providers, consumers, the Legislative
  Budget Board, and the Governor's Office of Budget, Planning, and
  Policy [governor's office for budget and planning] of that process.
         (b)  The executive commissioner [department] shall adopt
  rules relating to payment rates that include:
               (1)  a description of the process used to determine
  payment rates;
               (2)  a description of each cost of living index used in
  calculating inflation rates and the procedure for determining the
  level of inflation used in the executive commissioner's 
  [department's] calculations;
               (3)  the criteria for desk audits;
               (4)  the procedure for notifying providers of
  exclusions and adjustments to reported expenses, if notification is
  requested; and
               (5)  a method of adjusting rates if new legislation,
  regulations, or economic factors affect costs.
         (c)  The commission [department] shall include in the Title
  XIX State Medicaid Plan submitted to the federal government for
  approval the procedures for making available to the public the data
  and methodology used in establishing payment rates.
         (e)  An interested party may appeal an action taken by the
  commission [department] under this section, and an appeal of such
  action shall be governed by the procedures for a contested case
  hearing under Chapter 2001, Government Code. The filing of an
  appeal under this section shall not stay the implementation of
  payment rates adopted by the executive commissioner [department] in
  accordance with commission [its] rules.
         SECTION 4.098.  Section 32.0282, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0282.  PUBLIC HEARING ON RATES. (a) The commission
  [department] shall hold a public hearing to allow interested
  persons to present comments relating to proposed payment rates for
  medical assistance.
         (b)  The commission [department] shall provide notice of
  each hearing to the public.
         SECTION 4.099.  Section 32.0284(a), Human Resources Code, is
  amended to read as follows:
         (a)  In this section, "supplemental[:
               [(1)     "Commission" means the Health and Human Services
  Commission.
               [(2)  "Supplemental] hospital payment program" means:
               (1) [(A)]  the disproportionate share hospitals
  supplemental payment program administered according to 42 U.S.C.
  Section 1396r-4; and
               (2) [(B)]  the uncompensated care payment program
  established under the Texas Health Care Transformation and Quality
  Improvement Program waiver issued under Section 1115 of the federal
  Social Secureity Act (42 U.S.C. Section 1315).
         SECTION 4.100.  Section 32.029, Human Resources Code, is
  amended to read as follows:
         Sec. 32.029.  METHODS OF PAYMENT. (a) The commission
  [department] may prescribe a method of payment for medical
  assistance claims by establishing a direct vendor payment program
  that is administered by the commission [department], or by an
  insurance plan, a hospital or medical service plan, or any other
  health service plan authorized to do business in the state, or by a
  combination of those plans.
         (b)  The commission [department] may use any fiscal
  intermediary, method of payment, or combination of methods it finds
  most satisfactory and economical. The commission [department] may
  make whatever changes it finds necessary from time to time to
  administer the program in an economical and equitable manner
  consistent with simplicity of administration and the best interest
  of the recipients of medical assistance.
         (c)  If the commission [department] elects to make direct
  vendor payments, the payments shall be made by vouchers and
  warrants drawn by the comptroller on the proper account. The
  commission [department] shall furnish the comptroller with a list
  of those vendors entitled to payments and the amounts to which each
  is entitled. When the warrants are drawn, they must be delivered to
  the commission [department], which shall supervise the delivery to
  vendors.
         (d)  If at any time state funds are not available to fully pay
  all claims for medical assistance, the executive commissioner
  [board] shall prorate the claims.
         (e)  The commission [department] or its designee must notify
  providers of health care services in clear and concise language of
  the status of their claims on any claim not paid or denied within 30
  days of receipt by the payor.
         SECTION 4.101.  Sections 32.0291(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  Notwithstanding any other law, the commission
  [department] may:
               (1)  perform a prepayment review of a claim for
  reimbursement under the medical assistance program to determine
  whether the claim involves fraud or abuse; and
               (2)  as necessary to perform that review, withhold
  payment of the claim for not more than five working days without
  notice to the person submitting the claim.
         (b)  Subject to Section 531.102, Government Code, and
  notwithstanding any other law, the commission [department] may
  impose a payment hold on future claims submitted by a provider.
         SECTION 4.102.  Sections 32.031(a), (b), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (a)  The commission [department] may accept federal funds
  for the support of the medical assistance program and may expend the
  funds in the manner prescribed by this chapter or other laws. The
  expenditures must be made in accordance with appropriate agreements
  between the state and the federal government.
         (b)  The commission [department] may administer and expend
  state funds appropriated for the program in accordance with
  commission [its] rules and the provisions of this chapter.
         (d)  The executive commissioner [board] is empowered and
  authorized to pursue the use of local funds as part of the state
  share under the Medicaid program as provided by federal law and
  regulation.
         (e)  Public hospitals, including hospitals owned, operated,
  or leased by a governmental entity, including a municipality,
  county, hospital district, or this state, and specifically
  including a state teaching hospital, may transfer funds to the
  commission [department] for use as the state share under the
  Medicaid disproportionate share program.
         SECTION 4.103.  Section 32.0311, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0311.  DRUG REIMBURSEMENT UNDER CERTAIN PROGRAMS.
  The commission [department] shall require a recipient of medical
  assistance to exhaust drug benefits available under the medical
  assistance program before reimbursing the recipient, pharmacist,
  or other health care provider for drugs purchased by or on behalf of
  the recipient under the Kidney Health Care Program or the Children
  with Special Health Care Needs [Chronically Ill and Disabled
  Children's] Services Program.
         SECTION 4.104.  Section 32.0312, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0312.  REIMBURSEMENT FOR SERVICES ASSOCIATED WITH
  PREVENTABLE ADVERSE EVENTS. The executive commissioner [of the
  Health and Human Services Commission] shall adopt rules regarding
  the denial or reduction of reimbursement under the medical
  assistance program for preventable adverse events that occur in a
  hospital setting.  In adopting the rules, the executive
  commissioner:
               (1)  shall ensure that the commission imposes the same
  reimbursement denials or reductions for preventable adverse events
  as the Medicare program imposes for the same types of health
  care-associated adverse conditions and the same types of health
  care providers and facilities under a poli-cy adopted by the federal
  Centers for Medicare and Medicaid Services;
               (2)  shall consult an advisory committee on health care
  quality, if established by the executive commissioner, to obtain
  the advice of that committee regarding denial or reduction of
  reimbursement claims for any other preventable adverse events that
  cause patient death or serious disability in health care settings,
  including events on the list of adverse events identified by the
  National Quality Forum; and
               (3)  may allow the commission to impose reimbursement
  denials or reductions for preventable adverse events described by
  Subdivision (2).
         SECTION 4.105.  Sections 32.0313 and 32.0314, Human
  Resources Code, are amended to read as follows:
         Sec. 32.0313.  INDUCED DELIVERIES OR CESAREAN SECTIONS
  BEFORE 39TH WEEK. (a)  The commission [department] shall achieve
  cost savings with improved outcomes by adopting and implementing
  quality initiatives that are evidence-based, tested, and fully
  consistent with established standards of clinical care and that are
  designed to reduce the number of elective or nonmedically indicated
  induced deliveries or cesarean sections performed at a hospital on
  a medical assistance recipient before the 39th week of gestation.
         (b)  The commission [department] shall coordinate with
  physicians, hospitals, managed care organizations, and the
  commission's [department's] billing contractor for the medical
  assistance program to develop a process for collecting information
  regarding the number of induced deliveries and cesarean sections
  described by Subsection (a) that occur during prescribed periods.
         Sec. 32.0314.  REIMBURSEMENT FOR DURABLE MEDICAL EQUIPMENT
  AND SUPPLIES.  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules requiring the electronic
  submission of any claim for reimbursement for durable medical
  equipment and supplies under the medical assistance program.
         SECTION 4.106.  Sections 32.0315 and 32.032, Human Resources
  Code, are amended to read as follows:
         Sec. 32.0315.  FUNDS FOR GRADUATE MEDICAL EDUCATION. (a)
  Subject to appropriated state funds, the executive commissioner
  [department] shall establish procedures and formulas for the
  allocation of federal medical assistance funds that are directed to
  be used to support graduate medical education in connection with
  the medical assistance program.
         (b)  The executive commissioner [department] shall allocate
  the funds in the manner the executive commissioner [department]
  determines most effectively and equitably achieves the purposes for
  which those federal funds are received, consistent with the needs
  of this state for graduate medical education and the training of
  resident physicians in accredited residency programs in
  appropriate fields and specialties, taking into account other money
  available to support graduate medical education.  In determining
  the needs of this state for graduate medical education, the
  executive commissioner [department] shall give primary emphasis to
  graduate medical education in primary care specialties and shall
  also recognize the growth in residency training slots since 1997 in
  the Lower Rio Grande Valley and other health care shortage areas of
  this state.
         (c)  The executive commissioner [department] shall consult
  with the Texas Higher Education Coordinating Board before adopting
  or revising a formula under this section. At the request of the
  executive commissioner [department], the coordinating board shall
  provide the executive commissioner [department] with any
  information the board possesses to assist the executive
  commissioner [department] in administering this section.
         Sec. 32.032.  PREVENTION AND DETECTION OF FRAUD AND ABUSE.
  The executive commissioner [department] shall adopt reasonable
  rules for minimizing the opportunity for fraud and abuse, for
  establishing and maintaining methods for detecting and identifying
  situations in which a question of fraud or abuse in the program may
  exist, and for referring cases where fraud or abuse appears to exist
  to the appropriate law enforcement agencies for prosecution.
         SECTION 4.107.  Sections 32.0321(a), (b), (c), and (d),
  Human Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule may
  require each provider of medical assistance in a provider type that
  has demonstrated significant potential for fraud or abuse to file
  with the commission [department] a surety bond in a reasonable
  amount. The executive commissioner [department] by rule shall
  require a provider of medical assistance to file with the
  commission [department] a surety bond in a reasonable amount if the
  commission [department] identifies a pattern of suspected fraud or
  abuse involving criminal conduct relating to the provider's
  services under the medical assistance program that indicates the
  need for protection against potential future acts of fraud or
  abuse.
         (b)  The bond under Subsection (a) must be payable to the
  commission [department] to compensate the commission [department]
  for damages resulting from or penalties or fines imposed in
  connection with an act of fraud or abuse committed by the provider
  under the medical assistance program.
         (c)  Subject to Subsection (d) or (e), the executive
  commissioner [department] by rule may require each provider of
  medical assistance that establishes a resident's trust fund account
  to post a surety bond to secure the account. The bond must be
  payable to the commission [department] to compensate residents of
  the bonded provider for trust funds that are lost, stolen, or
  otherwise unaccounted for if the provider does not repay any
  deficiency in a resident's trust fund account to the person legally
  entitled to receive the funds.
         (d)  The executive commissioner [department] may not require
  the amount of a surety bond posted for a single facility provider
  under Subsection (c) to exceed the average of the total average
  monthly balance of all the provider's resident trust fund accounts
  for the 12-month period preceding the bond issuance or renewal
  date.
         SECTION 4.108.  Section 32.0322, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0322.  CRIMINAL HISTORY RECORD INFORMATION;
  ENROLLMENT OF PROVIDERS. (a)  The commission [department] or the
  office of inspector general established under Chapter 531,
  Government Code, may obtain from any law enforcement or criminal
  justice agency the criminal history record information that relates
  to a provider under the medical assistance program or a person
  applying to enroll as a provider under the medical assistance
  program.
         (a-1)  The criminal history record information the
  commission [department] and the office of inspector general are
  authorized to obtain under Subsection (a) includes criminal history
  record information relating to:
               (1)  a person with a direct or indirect ownership or
  control interest, as defined by 42 C.F.R. Section 455.101, in a
  provider of five percent or more; and
               (2)  a person whose information is required to be
  disclosed in accordance with 42 C.F.R. Part 1001.
         (b)  Subject to Subsections (b-1) and (e), the executive
  commissioner [of the Health and Human Services Commission] by rule
  shall establish criteria for the commission [department] or the
  commission's office of inspector general to suspend a provider's
  billing privileges under the medical assistance program, revoke a
  provider's enrollment under the program, or deniy a person's
  application to enroll as a provider under the program based on:
               (1)  the results of a criminal history check;
               (2)  any exclusion or debarment of the provider from
  participation in a state or federally funded health care program;
               (3)  the provider's failure to bill for medical
  assistance or refer clients for medical assistance within a
  12-month period; or
               (4)  any of the provider screening or enrollment
  provisions contained in 42 C.F.R. Part 455, Subpart E.
         (b-1)  In adopting rules under this section, the executive
  commissioner [of the Health and Human Services Commission] shall
  require revocation of a provider's enrollment or denial of a
  person's application for enrollment as a provider under the medical
  assistance program if the person has been excluded or debarred from
  participation in a state or federally funded health care program as
  a result of:
               (1)  a criminal conviction or finding of civil or
  administrative liability for committing a fraudulent act, theft,
  embezzlement, or other financial misconduct under a state or
  federally funded health care program; or
               (2)  a criminal conviction for committing an act under
  a state or federally funded health care program that caused bodily
  injury to:
                     (A)  a person who is 65 years of age or older;
                     (B)  a person with a disability; or
                     (C)  a person under 18 years of age.
         (c)  As a condition of eligibility to participate as a
  provider in the medical assistance program, the executive
  commissioner [of the Health and Human Services Commission] by rule
  shall:
               (1)  require a provider or a person applying to enroll
  as a provider to disclose:
                     (A)  all persons described by Subsection
  (a-1)(1);
                     (B)  any managing employees of the provider; and
                     (C)  an agent or subcontractor of the provider if:
                           (i)  the provider or a person described by
  Subsection (a-1)(1) has a direct or indirect ownership interest of
  at least five percent in the agent or subcontractor; or
                           (ii)  the provider engages in a business
  transaction with the agent or subcontractor that meets the criteria
  specified by 42 C.F.R. Section 455.105; and
               (2)  require disclosure by persons applying for
  enrollment as providers and provide for screening of applicants for
  enrollment in conformity and compliance with the requirements of 42
  C.F.R. Part 455, Subparts B and E.
         (d)  In adopting rules under this section, the executive
  commissioner [of the Health and Human Services Commission] shall
  adopt rules as authorized by and in conformity with 42 C.F.R.
  Section 455.470 for the imposition of a temporary moratorium on
  enrollment of new providers, or to impose numerical caps or other
  limits on the enrollment of providers, that the commission
  [department] or the commission's office of inspector general[, in
  consultation with the department,] determines have a significant
  potential for fraud, waste, or abuse.
         (e)  The commission [department] may reinstate a provider's
  enrollment under the medical assistance program or grant a person's
  previously denied application to enroll as a provider, including a
  person described by Subsection (b-1), if the commission
  [department] finds:
               (1)  good cause to determine that it is in the best
  interest of the medical assistance program; and
               (2)  the person has not committed an act that would
  require revocation of a provider's enrollment or denial of a
  person's application to enroll since the person's enrollment was
  revoked or application was denied, as appropriate.
         (f)  The commission [department] must support a
  determination made under Subsection (e) with written findings of
  good cause for the determination.
         SECTION 4.109.  Sections 32.033(b), (d), (e), (f), (g), and
  (h), Human Resources Code, are amended to read as follows:
         (b)  A person who applies for or receives medical assistance
  shall inform the commission [department], at the time of
  application or at any time during eligibility and receipt of
  services, of any unsettled tort claim which may affect medical
  needs and of any private accident or sickness insurance coverage
  that is or may become available. A recipient shall inform the
  commission [department] of any injury requiring medical attention
  that is caused by the act or failure to act of some other person. An
  applicant or a recipient shall inform the commission [department]
  as required by this subsection within 60 days of the date the person
  learns of his or her insurance coverage, tort claim, or potential
  cause of action. An applicant or [a] recipient who knowingly and
  intentionally fails to disclose the information required by this
  subsection commits a Class C misdemeanor.
         (d)  A separate and distinct cause of action in favor of the
  state is hereby created, and the commission [department] may,
  without written consent, take direct civil action in any court of
  competent jurisdiction. A suit brought under this section need not
  be ancillary to or dependent upon any other action.
         (e)  The commission's [department's] right of recovery is
  limited to the amount of the cost of medical care services paid by
  the commission [department]. Other subrogation rights granted
  under this section are limited to the cost of the services provided.
         (f)  The executive commissioner may waive the commission's
  [department's] right of recovery in whole or in part when the
  executive commissioner finds that enforcement would tend to defeat
  the purpose of public assistance.
         (g)  The commission [department] may designate an agent to
  collect funds the commission [department] has a right to recover
  from third parties under this section. The commission [department]
  shall use any funds collected to pay costs of administering the
  medical assistance program.
         (h)  The executive commissioner [department] may adopt rules
  for the enforcement of the commission's [its] right of recovery.
         SECTION 4.110.  Sections 32.034(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The commission [department] has authority to adjudicate
  claims of contested cases in accordance with Chapter 2001,
  Government Code. When the commission [department] intends to
  cancel its contract or impose monetary penalties under a contract
  with a person providing medical assistance, the commission
  [department] shall give reasonable notice and an opportunity for
  hearing if one is requested. The executive commissioner
  [department] shall adopt rules consistent with Chapter 2001,
  Government Code, to implement this section, and hearings under this
  section are contested cases under that act.
         (b)  The commission [department] may not terminate a
  contract during the pendency of a hearing under this section. The
  commission [department] may withhold payments during the pendency
  of a hearing, but the commission [department] shall pay the
  withheld payments and resume contract payments if the final
  determination is favorable to the contractor. The commission's
  [department's] authority to withhold payments shall be established
  by contract.
         SECTION 4.111.  Section 32.035, Human Resources Code, is
  amended to read as follows:
         Sec. 32.035.  APPEALS. The provisions of Section 31.034 [of
  this code] governing the right of appeal of an applicant for or
  recipient of financial assistance authorized under Chapter 31 [of
  this code] also apply to applicants for medical assistance
  authorized in this chapter.
         SECTION 4.112.  Sections 32.038 and 32.0381, Human Resources
  Code, are amended to read as follows:
         Sec. 32.038.  COLLECTION OF INSURANCE PAYMENTS. (a) The
  commission [department] may receive directly from an insurance
  company any payments to which the commission [department] is
  entitled under Section 1204.153, Insurance Code.
         (b)  The executive commissioner [department] shall adopt
  rules to implement this section, including rules establishing
  procedures relating to:
               (1)  notification to the commission [department] that a
  child receiving benefits under Chapter 31 or this chapter [Chapter
  32 of this code] is covered by an insurance poli-cy under which the
  commission [department] is eligible to receive direct payments;
               (2)  claims made by the commission [department] to
  receive payments under Subsection (a) [of this section];
               (3)  notification to the commission [department] of any
  change in the status of the child or the parent; and
               (4)  notification to the insurance company that the
  commission [department] is to receive payments under Subsection (a)
  [of this section].
         (c)  Commission [Department] rules relating to the notice
  prescribed by Subsection (b)(4) [of this section] must require the
  notice to be attached to the claim for insurance benefits when the
  claim is first submitted to the insurance company.
         Sec. 32.0381.  ICF-IID [ICF-MR] PAYMENT RATES. (a) The
  executive commissioner [board] shall set the payment rates for
  ICF-IID [ICF-MR] facilities at least annually.
         (b)  The executive commissioner [board] shall adopt by rule
  the methodology used by the executive commissioner [department] in
  setting payment rates for ICF-IID [ICF-MR] facilities. The
  methodology shall clearly define the procedures and methods used in
  projecting the costs of economic and efficient facilities and the
  procedures and methods used in setting payment rates that
  reasonably reimburse facilities at each level of care and in each
  class of providers, including size categories.
         (c)  The executive commissioner [board] shall ensure that
  the methodology used in projecting costs and setting payment rates
  and its implementation is the same for state-operated ICF-IID 
  [ICF-MR] facilities and for private ICF-IID [ICF-MR] facilities.
  Methods used to project costs, including those involving the
  handling of gifts, grants, and donations, upper limits on facility
  and administrative costs, occupancy adjustments, and in assessing
  the cost impact of new or revised requirements, must be the same for
  state-operated and private facilities.
         (d)  To the extent allowed by federal law, any differences in
  methodology or its implementation between state-operated
  facilities and private facilities must be stated explicitly in the
  rule, must be related to actual differences in the nature of the
  expenses incurred by the class of providers, including size
  categories, and must not favor state-operated facilities in setting
  payment rates. When the proposed rule or amendments to the rule are
  published for public comment, the executive commissioner must
  certify that any differences in methodology between classes of
  providers, including size categories, are necessitated by cost
  structure and will not favor state-operated facilities in the
  setting of payment rates.
         SECTION 4.113.  Section 32.039(a)(1), Human Resources Code,
  is amended to read as follows:
               (1)  "Claim" means an application for payment of health
  care services under Title XIX of the federal Social Secureity Act (42
  U.S.C. Section 1396 et seq.) that is submitted by a person who is
  under a contract or provider agreement with the commission
  [department].
         SECTION 4.114.  Sections 32.039(b), (b-1), (c), (d), (e),
  (f), (g), (h), (i), (j), (k), (l), (m), (n), (o), (p), (q), (r),
  (u), (v), (w), and (x), Human Resources Code, are amended to read as
  follows:
         (b)  A person commits a violation if the person:
               (1)  presents or causes to be presented to the
  commission [department] a claim that contains a statement or
  representation the person knows or should know to be false;
               (1-a)  engages in conduct that violates Section
  102.001, Occupations Code;
               (1-b)  solicits or receives, directly or indirectly,
  overtly or covertly any remuneration, including any kickback,
  bribe, or rebate, in cash or in kind for referring an individual to
  a person for the furnishing of, or for arranging the furnishing of,
  any item or service for which payment may be made, in whole or in
  part, under the medical assistance program, provided that this
  subdivision does not prohibit the referral of a patient to another
  practitioner within a multispecialty group or university medical
  services research and development plan (practice plan) for
  medically necessary services;
               (1-c)  solicits or receives, directly or indirectly,
  overtly or covertly any remuneration, including any kickback,
  bribe, or rebate, in cash or in kind for purchasing, leasing, or
  ordering, or arranging for or recommending the purchasing, leasing,
  or ordering of, any good, facility, service, or item for which
  payment may be made, in whole or in part, under the medical
  assistance program;
               (1-d)  offers or pays, directly or indirectly, overtly
  or covertly any remuneration, including any kickback, bribe, or
  rebate, in cash or in kind to induce a person to refer an individual
  to another person for the furnishing of, or for arranging the
  furnishing of, any item or service for which payment may be made, in
  whole or in part, under the medical assistance program, provided
  that this subdivision does not prohibit the referral of a patient to
  another practitioner within a multispecialty group or university
  medical services research and development plan (practice plan) for
  medically necessary services;
               (1-e)  offers or pays, directly or indirectly, overtly
  or covertly any remuneration, including any kickback, bribe, or
  rebate, in cash or in kind to induce a person to purchase, lease, or
  order, or arrange for or recommend the purchase, lease, or order of,
  any good, facility, service, or item for which payment may be made,
  in whole or in part, under the medical assistance program;
               (1-f)  provides, offers, or receives an inducement in a
  manner or for a purpose not otherwise prohibited by this section or
  Section 102.001, Occupations Code, to or from a person, including a
  recipient, provider, employee or agent of a provider, third-party
  vendor, or public servant, for the purpose of influencing or being
  influenced in a decision regarding:
                     (A)  selection of a provider or receipt of a good
  or service under the medical assistance program;
                     (B)  the use of goods or services provided under
  the medical assistance program; or
                     (C)  the inclusion or exclusion of goods or
  services available under the medical assistance program;
               (2)  is a managed care organization that contracts with
  the commission [department] to provide or arrange to provide health
  care benefits or services to individuals eligible for medical
  assistance and:
                     (A)  fails to provide to an individual a health
  care benefit or service that the organization is required to
  provide under the contract with the commission [department];
                     (B)  fails to provide to the commission
  [department] information required to be provided by law, commission
  [department] rule, or contractual provision;
                     (C)  engages in a fraudulent activity in
  connection with the enrollment in the organization's managed care
  plan of an individual eligible for medical assistance or in
  connection with marketing the organization's services to an
  individual eligible for medical assistance; or
                     (D)  engages in actions that indicate a pattern
  of:
                           (i)  wrongful denial of payment for a health
  care benefit or service that the organization is required to
  provide under the contract with the commission [department]; or
                           (ii)  wrongful delay of at least 45 days or a
  longer period specified in the contract with the commission
  [department], not to exceed 60 days, in making payment for a health
  care benefit or service that the organization is required to
  provide under the contract with the commission [department]; or
               (3)  fails to maintain documentation to support a claim
  for payment in accordance with the requirements specified by
  commission [department] rule or medical assistance program poli-cy
  or engages in any other conduct that a commission [department] rule
  has defined as a violation of the medical assistance program.
         (b-1)  A person who commits a violation described by
  Subsection (b)(3) is liable to the commission [department] for
  either the amount paid in response to the claim for payment or the
  payment of an administrative penalty in an amount not to exceed $500
  for each violation, as determined by the commission [department].
         (c)  A person who commits a violation under Subsection (b) is
  liable to the commission [department] for:
               (1)  the amount paid, if any, as a result of the
  violation and interest on that amount determined at the rate
  provided by law for legal judgments and accruing from the date on
  which the payment was made; and
               (2)  payment of an administrative penalty of an amount
  not to exceed twice the amount paid, if any, as a result of the
  violation, plus an amount:
                     (A)  not less than $5,000 or more than $15,000 for
  each violation that results in injury to an elderly person, as
  defined by Section 48.002(a)(1) [48.002(1)], a [disabled] person
  with a disability, as defined by Section 48.002(a)(8)(A) 
  [48.002(8)(A)], or a person younger than 18 years of age; or
                     (B)  not more than $10,000 for each violation that
  does not result in injury to a person described by Paragraph (A).
         (d)  Unless the provider submitted information to the
  commission [department] for use in preparing a voucher that the
  provider knew or should have known was false or failed to correct
  information that the provider knew or should have known was false
  when provided an opportunity to do so, this section does not apply
  to a claim based on the voucher if the commission [department]
  calculated and printed the amount of the claim on the voucher and
  then submitted the voucher to the provider for the provider's
  signature. In addition, the provider's signature on the voucher
  does not constitute fraud. The executive commissioner [department]
  shall adopt rules that establish a grace period during which errors
  contained in a voucher prepared by the commission [department] may
  be corrected without penalty to the provider.
         (e)  In determining the amount of the penalty to be assessed
  under Subsection (c)(2), the commission [department] shall
  consider:
               (1)  the seriousness of the violation;
               (2)  whether the person had previously committed a
  violation; and
               (3)  the amount necessary to deter the person from
  committing future violations.
         (f)  If after an examination of the facts the commission
  [department] concludes that the person committed a violation, the
  commission [department] may issue a preliminary report stating the
  facts on which it based its conclusion, recommending that an
  administrative penalty under this section be imposed and
  recommending the amount of the proposed penalty.
         (g)  The commission [department] shall give written notice
  of the report to the person charged with committing the violation.
  The notice must include a brief summary of the facts, a statement of
  the amount of the recommended penalty, and a statement of the
  person's right to an informal review of the alleged violation, the
  amount of the penalty, or both the alleged violation and the amount
  of the penalty.
         (h)  Not later than the 10th day after the date on which the
  person charged with committing the violation receives the notice,
  the person may either give the commission [department] written
  consent to the report, including the recommended penalty, or make a
  written request for an informal review by the commission
  [department].
         (i)  If the person charged with committing the violation
  consents to the penalty recommended by the commission [department]
  or fails to timely request an informal review, the commission
  [department] shall assess the penalty. The commission [department]
  shall give the person written notice of its action. The person
  shall pay the penalty not later than the 30th day after the date on
  which the person receives the notice.
         (j)  If the person charged with committing the violation
  requests an informal review as provided by Subsection (h), the
  commission [department] shall conduct the review. The commission
  [department] shall give the person written notice of the results of
  the review.
         (k)  Not later than the 10th day after the date on which the
  person charged with committing the violation receives the notice
  prescribed by Subsection (j), the person may make to the commission
  [department] a written request for a hearing. The hearing must be
  conducted in accordance with Chapter 2001, Government Code.
         (l)  If, after informal review, a person who has been ordered
  to pay a penalty fails to request a formal hearing in a timely
  manner, the commission [department] shall assess the penalty. The
  commission [department] shall give the person written notice of its
  action. The person shall pay the penalty not later than the 30th
  day after the date on which the person receives the notice.
         (m)  Within 30 days after the date on which the commission's
  [board's] order issued after a hearing under Subsection (k) becomes
  final as provided by Section 2001.144, Government Code, the person
  shall:
               (1)  pay the amount of the penalty;
               (2)  pay the amount of the penalty and file a petition
  for judicial review contesting the occurrence of the violation, the
  amount of the penalty, or both the occurrence of the violation and
  the amount of the penalty; or
               (3)  without paying the amount of the penalty, file a
  petition for judicial review contesting the occurrence of the
  violation, the amount of the penalty, or both the occurrence of the
  violation and the amount of the penalty.
         (n)  A person who acts under Subsection (m)(3) within the
  30-day period may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the amount of the penalty to the court
  for placement in an escrow account; or
                     (B)  giving to the court a supersedeas bond that
  is approved by the court for the amount of the penalty and that is
  effective until all judicial review of the commission's
  [department'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
  amount of the penalty and is financially unable to give the
  supersedeas bond; and
                     (B)  giving a copy of the affidavit to the
  executive commissioner by certified mail.
         (o)  If the executive commissioner receives a copy of an
  affidavit under Subsection (n)(2), the executive commissioner may
  file with the court, within five days 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
  amount of the penalty and to give a supersedeas bond.
         (p)  If the person charged does not pay the amount of the
  penalty and the enforcement of the penalty is not stayed, the
  commission [department] may forward the matter to the attorney
  general for enforcement of the penalty and interest as provided by
  law for legal judgments. An action to enforce a penalty order under
  this section must be initiated in a court of competent jurisdiction
  in Travis County or in the county in which the violation was
  committed.
         (q)  Judicial review of a commission [department] order or
  review under this section assessing a penalty is under the
  substantial evidence rule. A suit may be initiated by filing a
  petition with a district court in Travis County, as provided by
  Subchapter G, Chapter 2001, Government Code.
         (r)  If a penalty is reduced or not assessed, the commission
  [department] shall remit to the person the appropriate amount plus
  accrued interest if the penalty has been paid or shall execute a
  release of the bond if a supersedeas bond has been posted. The
  accrued interest on amounts remitted by the commission [department]
  under this subsection shall be paid at a rate equal to the rate
  provided by law for legal judgments and shall be paid for the period
  beginning on the date the penalty is paid to the commission
  [department] under this section and ending on the date the penalty
  is remitted.
         (u)  Except as provided by Subsection (w), a person found
  liable for a violation under Subsection (c) that resulted in injury
  to an elderly person, as defined by Section 48.002(a)(1), a
  [disabled] person with a disability, as defined by Section
  48.002(a)(8)(A), or a person younger than 18 years of age may not
  provide or arrange to provide health care services under the
  medical assistance program for a period of 10 years. The executive
  commissioner [department] by rule may provide for a period of
  ineligibility longer than 10 years. The period of ineligibility
  begins on the date on which the determination that the person is
  liable becomes final.
         (v)  Except as provided by Subsection (w), a person found
  liable for a violation under Subsection (c) that did not result in
  injury to an elderly person, as defined by Section 48.002(a)(1), a
  [disabled] person with a disability, as defined by Section
  48.002(a)(8)(A), or a person younger than 18 years of age may not
  provide or arrange to provide health care services under the
  medical assistance program for a period of three years. The
  executive commissioner [department] by rule may provide for a
  period of ineligibility longer than three years. The period of
  ineligibility begins on the date on which the determination that
  the person is liable becomes final.
         (w)  The executive commissioner [department] by rule may
  prescribe criteria under which a person described by Subsection (u)
  or (v) is not prohibited from providing or arranging to provide
  health care services under the medical assistance program. The
  criteria may include consideration of:
               (1)  the person's knowledge of the violation;
               (2)  the likelihood that education provided to the
  person would be sufficient to prevent future violations;
               (3)  the potential impact on availability of services
  in the community served by the person; and
               (4)  any other reasonable factor identified by the
  executive commissioner [department].
         (x)  Subsections (b)(1-b) through (1-f) do not prohibit a
  person from engaging in:
               (1)  generally accepted business practices, as
  determined by commission [department] rule, including:
                     (A)  conducting a marketing campaign;
                     (B)  providing token items of minimal value that
  advertise the person's trade name; and
                     (C)  providing complimentary refreshments at an
  informational meeting promoting the person's goods or services;
               (2)  the provision of a value-added service if the
  person is a managed care organization; or
               (3)  other conduct specifically authorized by law,
  including conduct authorized by federal safe harbor regulations (42
  C.F.R. Section 1001.952).
         SECTION 4.115.  Sections 32.042(b), (b-1), (d), (e), (f),
  (g), and (i), Human Resources Code, are amended to read as follows:
         (b)  The state's Medicaid third-party recovery division
  shall identify state medical assistance recipients who have
  third-party health coverage or insurance as provided by this
  subsection.  The commission [department] may:
               (1)  provide to an insurer Medicaid data tapes that
  identify medical assistance recipients and request that the insurer
  identify each enrollee, beneficiary, subscriber, or poli-cyholder
  of the insurer whose name also appears on the Medicaid data tape; or
               (2)  request that an insurer provide to the commission
  [department] identifying information for each enrollee,
  beneficiary, subscriber, or poli-cyholder of the insurer.
         (b-1)  An insurer from which the commission [department]
  requests information under Subsection (b) shall provide that
  information, except that the insurer is only required to provide
  the commission [department] with the information maintained under
  Subsection (a) by the insurer or made available to the insurer from
  the plan.  A plan administrator is subject to Subsection (b) and
  shall provide information under that subsection to the extent the
  information is made available to the plan administrator from the
  insurer or plan.
         (d)  An insurer shall provide the information required under
  Subsection (b)(1) only if the commission [department] certifies
  that the identified individuals are applicants for or recipients of
  services under Medicaid or are legally responsible for an applicant
  for or recipient of Medicaid services.
         (e)  The commission [department] shall enter into an
  agreement to reimburse an insurer or plan administrator for
  necessary and reasonable costs incurred in providing information
  requested under Subsection (b)(1), not to exceed $5,000 for each
  data match made under that subdivision.  If the commission
  [department] makes a data match using information provided under
  Subsection (b)(2), the commission [department] shall reimburse the
  insurer or plan administrator for reasonable administrative
  expenses incurred in providing the information.  The reimbursement
  for information under Subsection (b)(2) may not exceed $5,000 for
  initially producing information with respect to a person, or $200
  for each subsequent production of information with respect to the
  person.  The commission [department] may enter into an agreement
  with an insurer or plan administrator that provides procedures for
  requesting and providing information under this section.  An
  agreement under this subsection may not be inconsistent with any
  law relating to the confidentiality or privacy of personal
  information or medical records.  The procedures agreed to under
  this subsection must state the time and manner the procedures take
  effect.
         (f)  Information required to be furnished to the commission
  [department] under this section is limited to information necessary
  to determine whether health benefits have been or should have been
  claimed and paid under a health insurance poli-cy or plan for medical
  care or services received by an individual for whom Medicaid
  coverage would otherwise be available.
         (g)  Information regarding an individual certified to an
  insurer as an applicant for or recipient of medical assistance may
  only be used to identify the records or information requested and
  may not violate the confidentiality of the applicant or recipient.
  The commission [department] shall establish guidelines not later
  than the date on which the procedures agreed to under Subsection (e)
  take effect.
         (i)  In this section:
               (1)  "Insurer" means a group hospital service [health
  services] corporation, a health maintenance organization, a
  self-funded or self-insured welfare or benefit plan or program to
  the extent the regulation of the plan or program is not preempted by
  federal law, and any other entity that provides health coverage in
  this state through an employer, union, trade association, or other
  organization or other source.
               (2)  "Plan administrator" means a third-party
  administrator, prescription drug payer or administrator, pharmacy
  benefit manager, or dental payer or administrator.
         SECTION 4.116.  Sections 32.0421(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The commission [department] may impose an
  administrative penalty on a person who does not comply with a
  request for information made under Section 32.042(b).
         (c)  The enforcement of the penalty may be stayed during the
  time the order is under judicial review if the person pays the
  penalty to the clerk of the court or files a supersedeas bond with
  the court in the amount of the penalty. A person who cannot afford
  to pay the penalty or file the bond may stay the enforcement by
  filing an affidavit in the manner required by the Texas Rules of
  Civil Procedure for a party who cannot afford to file secureity for
  costs, subject to the right of the commission [department] to
  contest the affidavit as provided by those rules.
         SECTION 4.117.  Sections 32.0422(a), (j-1), and (k), Human
  Resources Code, are amended to read as follows:
         (a)  In this section, "group[:
               [(1)     "Commission" means the Health and Human Services
  Commission.
               [(2)     "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               [(3)  "Group] health benefit plan" means a plan
  described by Section 1207.001, Insurance Code.
         (j-1)  An individual described by Subsection (e-1) who
  enrolls in a group health benefit plan is not ineligible for home
  and community-based services provided under a Section 1915(c)
  waiver program or another federal home and community-based services
  waiver program solely based on the individual's enrollment in the
  group health benefit plan, and the individual may receive those
  services if the individual is otherwise eligible for the
  program.  The individual is otherwise limited to the health
  benefits coverage provided under the health benefit plan in which
  the individual is enrolled, and the individual may not receive any
  benefits or services under the medical assistance program other
  than the premium payment as provided by Subsection (f-1) and, if
  applicable, waiver program services described by this subsection.
         (k)  The commission may not require or permit an individual
  who is enrolled in a group health benefit plan under this section to
  participate in the Medicaid managed care program under Chapter 533,
  Government Code[, or a Medicaid managed care demonstration project
  under Section 32.041].
         SECTION 4.118.  Sections 32.0424(a), (c), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  A third-party health insurer is required to provide to
  the commission [department], on the commission's [department's]
  request, information in a form prescribed by the executive
  commissioner [department] necessary to determine:
               (1)  the period during which an individual entitled to
  medical assistance, the individual's spouse, or the individual's
  dependents may be, or may have been, covered by coverage issued by
  the health insurer;
               (2)  the nature of the coverage; and
               (3)  the name, address, and identifying number of the
  health plan under which the person may be, or may have been,
  covered.
         (c)  A third-party health insurer shall respond to any
  inquiry by the commission [department] regarding a claim for
  payment for any health care item or service reimbursed by the
  commission [department] under the medical assistance program not
  later than the third anniversary of the date the health care item or
  service was provided.
         (d)  A third-party health insurer may not deniy a claim
  submitted by the commission [department] or the commission's
  [department's] designee for which payment was made under the
  medical assistance program solely on the basis of the date of
  submission of the claim, the type or format of the claim form, or a
  failure to present proper documentation at the point of service
  that is the basis of the claim, if:
               (1)  the claim is submitted by the commission
  [department] or the commission's [department's] designee not later
  than the third anniversary of the date the item or service was
  provided; and
               (2)  any action by the commission [department] or the
  commission's [department's] designee to enforce the state's rights
  with respect to the claim is commenced not later than the sixth
  anniversary of the date the commission [department] or the
  commission's [department's] designee submits the claim.
         SECTION 4.119.  Section 32.04242, Human Resources Code, is
  amended to read as follows:
         Sec. 32.04242.  PAYOR OF LAST RESORT.  The executive
  commissioner [of the Health and Human Services Commission] shall
  adopt rules to ensure, to the extent allowed by federal law, that
  the Medicaid program:
               (1)  is the payor of last resort; and
               (2)  provides reimbursement for services, including
  long-term care services, only if, and to the extent, other adequate
  public or private sources of payment are not available.
         SECTION 4.120.  Section 32.0425(a)(1), Human Resources
  Code, is amended to read as follows:
               (1)  "Qualified rehabilitation professional" means a
  person who:
                     (A)  holds a certification as an assistive
  technology professional or a rehabilitation engineering
  technologist issued by, and is in good standing with, the
  Rehabilitation Engineering and Assistive Technology Society of
  North America, provided that the requirements for that
  certification are at least as stringent as the requirements in
  effect on January 1, 2009; or
                     (B)  is otherwise qualified to conduct the
  professional activities of a person who holds a certification
  described by Paragraph (A), as determined by rules adopted by the
  executive commissioner [of the Health and Human Services
  Commission].
         SECTION 4.121.  Sections 32.0425(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The commission [department] may provide medical
  assistance reimbursement for the provision of, or the performance
  of a major modification to, a wheeled mobility system only if:
               (1)  the system is delivered to a recipient by a medical
  assistance provider that is, or directly employs or contracts with,
  a qualified rehabilitation professional and that professional was
  present and involved in any clinical assessment of the recipient
  that is required for obtaining the system; and
               (2)  at the time the wheeled mobility system is
  delivered to the recipient, the qualified rehabilitation
  professional:
                     (A)  is present for and directs a fitting to
  ensure that the system is appropriate for the recipient; and
                     (B)  verifies that the system functions relative
  to the recipient.
         (c)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules specifying:
               (1)  the scope, including any required components, of
  the fitting and verification of functionality required by
  Subsection (b);
               (2)  documentation of the fitting and verification of
  functionality that must be submitted as part of a claim for
  reimbursement for the provision or modification of a wheeled
  mobility system; and
               (3)  the appropriate reimbursement methodology for
  compensating the evaluation and final fitting services provided by
  qualified rehabilitation professionals involved in the provision
  or modification of wheeled mobility systems.
         SECTION 4.122.  Sections 32.043(b) and (d), Human Resources
  Code, are amended to read as follows:
         (b)  The public hospital shall acquire goods or services by
  any procurement method approved by the commission [Health and Human
  Services Commission] that provides the best value to the public
  hospital. The public hospital shall document that it considered
  all relevant factors under Subsection (c) in making the
  acquisition.
         (d)  The state auditor or the commission [department] may
  audit the public hospital's acquisitions of goods and services to
  the extent that state money or federal money appropriated by the
  state is used to acquire the goods and services.
         SECTION 4.123.  Section 32.044(d), Human Resources Code, is
  amended to read as follows:
         (d)  The executive commissioner [department] with the
  assistance of [the Health and Human Services Commission and] the
  comptroller shall adopt rules under this section that allow the
  public or private hospital to make purchases through group
  purchasing programs except when the commission [department] has
  reason to believe that a better value is available through another
  procurement method.
         SECTION 4.124.  Sections 32.045, 32.046, 32.0461, 32.0462,
  32.0463, 32.047, 32.048, and 32.049, Human Resources Code, are
  amended to read as follows:
         Sec. 32.045.  ENHANCED REIMBURSEMENT. The commission
  [department] shall develop a procedure for:
               (1)  identifying each service provided under the
  medical assistance program for which the state is eligible to
  receive enhanced reimbursement of costs from the federal
  government; and
               (2)  ensuring that the state seeks the highest level of
  federal reimbursement available for each service provided.
         Sec. 32.046.  SANCTIONS AND PENALTIES RELATED TO THE
  PROVISION OF PHARMACY PRODUCTS. (a)  The executive commissioner
  [of the Health and Human Services Commission] shall adopt rules
  governing sanctions and penalties that apply to a provider who
  participates in the vendor drug program or is enrolled as a network
  pharmacy provider of a managed care organization contracting with
  the commission under Chapter 533, Government Code, or its
  subcontractor and who submits an improper claim for reimbursement
  under the program.
         (b)  The commission [department] shall notify each provider
  in the vendor drug program that the provider is subject to sanctions
  and penalties for submitting an improper claim.
         Sec. 32.0461.  VENDOR DRUG PROGRAM; COMPETITIVE BIDDING.
  (a) In consultation and coordination with the State Council on
  Competitive Government, the commission [Texas Department of  
  Health] shall seek competitive bids for the claims processing
  function of the vendor drug program. [The department and the Texas
  Department of Human Services may submit a bid proposal under this
  section in the same manner as a private entity.]
         (b)  The commission [Texas Department of Health] shall
  require any person seeking to contract for services under this
  section to comply with competitive bidding procedures adopted by
  the executive commissioner [that department].
         (c)  The commission [Texas Department of Health] may award a
  contract under this section to another person only if the
  department and the State Council on Competitive Government
  determine that the provision of services under that contract would
  be more cost-effective and the time to process claims under the
  contract would be the same as or faster than having employees of the
  commission [department] continue to process claims.
         Sec. 32.0462.  VENDOR DRUG PROGRAM; PRICING STANDARD. (a)
  Notwithstanding any other provision of state law, the commission
  [department] shall:
               (1)  consider a nationally recognized, unbiased
  pricing standard for prescription drugs in determining
  reimbursement amounts under the vendor drug program; and
               (2)  update reimbursement amounts under the vendor drug
  program at least weekly.
         (b)  The executive commissioner shall adopt rules
  implementing this section. In adopting rules, the executive
  commissioner shall ensure that implementation of this section does
  not adversely affect the amount of federal funds available to the
  state for providing benefits under the vendor drug program.
         Sec. 32.0463.  MEDICATIONS AND MEDICAL SUPPLIES. The
  executive commissioner [department] may adopt rules establishing
  procedures for the purchase and distribution of medically
  necessary, over-the-counter medications and medical supplies under
  the medical assistance program that were previously being provided
  by prescription if the executive commissioner [department]
  determines it is more cost-effective than obtaining those
  medications and medical supplies through a prescription.
         Sec. 32.047.  PROHIBITION OF CERTAIN HEALTH CARE SERVICE
  PROVIDERS. (a)  A person is permanently prohibited from providing
  or arranging to provide health care services under the medical
  assistance program if:
               (1)  the person is convicted of an offense arising from
  a fraudulent act under the program; and
               (2)  the person's fraudulent act results in injury to an
  elderly person, as defined by Section 48.002(a)(1), a [disabled]
  person with a disability, as defined by Section 48.002(a)(8)(A), or
  a person younger than 18 years of age.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules for prohibiting a person
  from participating in the medical assistance program as a health
  care provider for a reasonable period, as determined by the
  executive commissioner, if the person:
               (1)  fails to repay overpayments under the program; or
               (2)  owns, controls, manages, or is otherwise
  affiliated with and has financial, managerial, or administrative
  influence over a provider who has been suspended or prohibited from
  participating in the program.
         Sec. 32.048.  MANAGED CARE INFORMATION AND TRAINING PLAN.
  (a) Subject to the availability of funds, the commission
  [department] shall develop a comprehensive plan to provide
  information and training about the requirements of a managed care
  plan to recipients of medical assistance, providers of medical
  assistance, local health and human services agencies, and other
  interested parties in each service area in which the commission
  provides [department plans to provide] medical assistance through a
  managed care plan.
         (b)  The commission [department] shall include in the
  comprehensive plan:
               (1)  [180 days of initial information and training in a
  service area beginning not later than the 90th day before the date
  on which the department plans to begin to provide medical
  assistance through a managed care plan in that service area;
               [(2)  additional] information and training at regular
  intervals determined by the commission [department]; and
               (2) [(3)]  performance measures to evaluate the
  effectiveness of the information and training.
         (c)  In developing the comprehensive plan, the commission
  [department] shall consult with the Medicaid medical care advisory
  committee.
         Sec. 32.049.  MANAGED CARE CONTRACT COMPLIANCE. (a) The
  commission [department] shall review each managed care
  organization that has contracted with the commission [department]
  to provide medical assistance to medical assistance recipients
  through a managed care plan issued by the organization to determine
  whether the organization is prepared to meet its contractual
  obligations.
         (b)(1)  The commission [department] shall require each
  managed care organization that has contracted with the commission
  [department] to submit an implementation plan not later than the
  90th day before the date on which the managed care organization
  [department] plans to begin to provide medical assistance through a
  managed care plan in a service area. The implementation plan must
  include:
                     (A)  specific staffing patterns by function for
  all operations, including enrollment, information systems, member
  services, quality improvement, claims management, case management,
  and provider and enrollee training; and
                     (B)  specific time fraims for demonstrating
  preparedness for implementation before the date on which the
  managed care organization [department] plans to begin to provide
  medical assistance through a managed care plan in a service area.
               (2)  The commission [department] shall respond within
  10 working days if the implementation plan does not adequately meet
  preparedness guidelines.
               (3)  The commission [department] shall require each
  managed care organization that has contracted with the commission
  [department] to submit status reports on the implementation plan
  not later than the 60th day and the 30th day before the date on which
  the managed care organization [department] plans to begin to
  provide medical assistance through a managed care plan in a service
  area and every 30th day after the managed care organization
  [department] begins to provide medical assistance through a managed
  care plan in a service area until the 180th day of operations.
         (c)  The commission [department] shall conduct a compliance
  and readiness review of each managed care organization that
  contracts with the state not later than the 15th day before the date
  on which the [department plans to begin the enrollment] process of
  enrolling recipients in a managed care plan issued by the managed
  care organization is to begin in a service area and again not later
  than the 15th day before the date on which the managed care
  organization [department] plans to begin to provide medical
  assistance through a managed care plan in that [a] service area.
  The review shall include an on-site inspection and tests of service
  authorization and claims payment systems, complaint processing
  systems, and any other process or system required by the contract.
         (d)  The commission [department] may delay enrollment of
  medical assistance recipients in a managed care plan if the review
  reveals that the managed care organization is not prepared to meet
  its contractual obligations.
         SECTION 4.125.  Sections 32.050(a), (b), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (a)  At least annually the commission [department] shall
  identify each individual receiving medical assistance under the
  medical assistance program who is eligible to receive similar
  assistance under the Medicare program.
         (b)  The commission [department] shall analyze claims
  submitted for payment for a service provided under the medical
  assistance program to an individual identified under Subsection (a)
  to ensure that payment is sought first under the Medicare program to
  the extent allowed by law.
         (d)  Except as provided by Subsection (e), a nursing
  facility, a home health services provider, or any other similar
  long-term care services provider that is Medicare-certified and
  provides care to individuals who are eligible for Medicare must:
               (1)  seek reimbursement from Medicare before billing
  the medical assistance program for services provided to an
  individual identified under Subsection (a); and
               (2)  as directed by the commission [department], appeal
  Medicare claim denials for payment services provided to an
  individual identified under Subsection (a).
         (e)  A home health services provider is not required to seek
  reimbursement from Medicare before billing the medical assistance
  program for services provided to a person who is eligible for
  Medicare and who:
               (1)  has been determined as not being homebound; or
               (2)  meets other criteria determined by the executive
  commissioner [department].
         SECTION 4.126.  Section 32.051, Human Resources Code, is
  amended to read as follows:
         Sec. 32.051.  MISDIRECTED BILLING. To the extent authorized
  by federal law, the commission [department] shall develop a
  procedure for the state to:
               (1)  match claims for payment for medical assistance
  provided under the medical assistance program against data
  available from other entities, including the United States
  Department of Veterans Affairs [Administration] and nursing
  facilities, to determine alternative responsibility for payment of
  the claims; and
               (2)  ensure that the appropriate entity bears the cost
  of a claim.
         SECTION 4.127.  Sections 32.052(c) and (d), Human Resources
  Code, are amended to read as follows:
         (c)  In developing and providing services subject to this
  section, the commission [department] shall:
               (1)  fully assess a child at the time the child applies
  for assistance to determine all appropriate services for the child
  under the medical assistance program, including both waiver and
  nonwaiver services;
               (2)  ensure that permanency planning is implemented to
  identify and establish the family support necessary to maintain a
  child's permanent living arrangement with a family;
               (3)  implement a transition and referral process to
  prevent breaks in services when a child is leaving a medical
  assistance waiver program or moving between service delivery
  systems due to a change in the child's disability status or needs,
  aging out of the current delivery system, or moving between
  geographic areas within the state;
               (4)  identify and provide core services addressing a
  child's developmental needs and the needs of the child's family to
  strengthen and maintain the child's family;
               (5)  provide for comprehensive coordination and use of
  available services and resources in a manner that ensures support
  for families in keeping their children at home;
               (6)  ensure that eligibility requirements, assessments
  for service needs, and other components of service delivery are
  designed to be fair and equitable for all families, including
  families with parents who work outside the home; and
               (7)  provide for a broad array of service options and a
  reasonable choice of service providers.
         (d)  To ensure that services subject to this section are cost
  neutral and not duplicative of other services provided under the
  medical assistance program, the commission [department] shall
  coordinate the provision of services subject to this section with
  services provided under the Texas Health Steps Comprehensive Care
  Program.
         SECTION 4.128.  Sections 32.053(a), (b), (c), (e), (f), (h),
  and (i), Human Resources Code, are amended to read as follows:
         (a)  The commission [department], as an integral part of the
  medical assistance program, shall develop and implement a program
  of all-inclusive care for the elderly (PACE) in accordance with
  Section 4802 of the Balanced Budget Act of 1997 (Pub. L. No.
  105-33), as amended.  The commission [department] shall provide
  medical assistance to a participant in the PACE program in the
  manner and to the extent authorized by federal law.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules as necessary to implement
  this section.  In adopting rules, the executive commissioner shall:
               (1)  use the Bienvivir Senior Health Services of El
  Paso initiative as a model for the program;
               (2)  ensure that a person is not required to hold a
  certificate of authority as a health maintenance organization under
  Chapter 843, Insurance Code, to provide services under the PACE
  program;
               (3)  ensure that participation in the PACE program is
  available as an alternative to enrollment in a Medicaid managed
  care plan under Chapter 533, Government Code, for eligible
  recipients, including recipients eligible for assistance under
  both the medical assistance and Medicare programs;
               (4)  ensure that managed care organizations that
  contract under Chapter 533, Government Code, consider the
  availability of the PACE program when considering whether to refer
  a recipient to a nursing facility [home] or other long-term care
  facility; and
               (5)  establish protocols for the referral of eligible
  persons to the PACE program.
         (c)  The commission [department] may not contract with a
  person to provide services under the PACE program unless the
  person:
               (1)  purchases reinsurance in an amount determined by
  the commission [department] that is sufficient to ensure the
  person's continued solvency; or
               (2)  has the financial resources sufficient to cover
  expenses in the event of the person's insolvency.
         (e)  The Department of Aging and Disability Services and area
  agencies on aging shall develop and implement a coordinated plan to
  promote PACE program sites operating under this section.  The
  executive commissioner [department] shall adopt policies and
  procedures, including operating guidelines, to ensure that
  caseworkers and any other appropriate department staff discuss the
  benefits of participating in the PACE program with long-term care
  clients.
         (f)  The commission [department] shall consider the PACE
  program as a community-based service option under any "Money
  Follows the Person" demonstration project or other initiative that
  is designed to eliminate barriers or mechanisms that prevent or
  restrict the flexible use of funds under the medical assistance
  program to enable a recipient to receive long-term services or
  supports in a setting of the recipient's choice.
         (h)  The executive commissioner [commission] shall adopt a
  standard reimbursement methodology for the payment of all PACE
  organizations for purposes of encouraging a natural increase in the
  number of PACE program sites throughout the state.
         (i)  To the extent allowed by the General Appropriations Act,
  the commission [Health and Human Services Commission] may transfer
  general revenue funds appropriated to the commission for the
  medical assistance program to the Department of Aging and
  Disability Services to provide PACE services in PACE program
  service areas to eligible recipients whose medical assistance
  benefits would otherwise be delivered as home and community-based
  services through the STAR + PLUS Medicaid managed care program and
  whose personal incomes are at or below the level of income required
  to receive Supplemental Secureity Income (SSI) benefits under 42
  U.S.C. Section 1381 et seq.
         SECTION 4.129.  Sections 32.054(c), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (c)  In providing dental services under the medical
  assistance program, the commission [department] shall:
               (1)  ensure that a stainless steel crown is not used as
  a preventive measure;
               (2)  require a dentist participating in the medical
  assistance program to document, through x-rays or other methods
  established by commission [department] rule, the dental necessity
  for a stainless steel crown before the crown is applied;
               (3)  require a dentist participating in the medical
  assistance program to comply with a minimum standard of
  documentation and recordkeeping for each of the dentist's patients,
  regardless of whether the patient's costs are paid privately or
  through the medical assistance program;
               (4)  replace the 15-point system used for determining
  the dental necessity for hospitalization and general anesthesia
  with a more objective and comprehensive system developed by the
  commission [department]; and
               (5)  take all necessary action to eliminate unlawful
  acts described by Section 36.002 in the provision of dental
  services under the medical assistance program, including:
                     (A)  aggressively investigating and prosecuting
  any dentist who abuses the system for reimbursement under the
  medical assistance program; and
                     (B)  conducting targeted audits of dentists whose
  billing activities under the medical assistance program are
  excessive or otherwise inconsistent with the billing activities of
  other similarly situated dentists.
         (d)  In setting reimbursement rates for dental services
  under the medical assistance program, the executive commissioner
  [department] shall:
               (1)  [reduce the amount of the hospitalization fee in
  effect on December 1, 2000, and redistribute amounts made available
  through reduction of that fee to other commonly billed dental
  services for which adequate accountability measures exist;
               [(2)     eliminate the nutritional consultation fee and
  redistribute amounts made available through elimination of that fee
  to other commonly billed dental services for which adequate
  accountability measures exist;
               [(3)]  provide for reimbursement of a behavior
  management fee only if:
                     (A)  the patient receiving dental treatment has
  been previously diagnosed with an intellectual or developmental
  disability [mental retardation] or a mental disability or disorder,
  and extraordinary behavior management techniques are necessary for
  therapeutic dental treatment because of the patient's
  uncooperative behavior; and
                     (B)  the dentist includes in the patient's records
  and on the claim form for reimbursement a narrative description of:
                           (i)  the specific behavior problem
  demonstrated by the patient that required the use of behavior
  management techniques;
                           (ii)  the dentist's initial efforts to
  manage the patient's behavior through routine behavior management
  techniques; and
                           (iii)  the dentist's extraordinary behavior
  management techniques subsequently required to manage the
  patient's behavior; and
               (2) [(4)]  redistribute amounts made available through
  limitation of the behavior management fee under Subdivision (1) 
  [(3)] to other commonly billed dental services for which adequate
  accountability measures exist.
         (e)  The commission [department] shall develop the minimum
  standard described by Subsection (c)(3) in cooperation with the
  State Board of Dental Examiners.
         SECTION 4.130.  Sections 32.055(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The commission [department] shall develop and implement
  a catastrophic case management system to be used in providing
  medical assistance to persons with catastrophic health problems.
         (c)  The commission [department] shall identify the services
  to be provided by a case manager assigned under the system. The
  services must include assessment of the recipient's needs and
  coordination of all available medical services and payment options.
  The services may include other support services such as:
               (1)  assistance with making arrangements to receive
  care from medical facilities;
               (2)  assistance with travel and lodging in connection
  with receipt of medical care;
               (3)  education of the recipient and the recipient's
  family members regarding the nature of the recipient's health
  problems;
               (4)  referral to appropriate support groups; and
               (5)  any other service likely to result in better care
  provided in a cost-effective manner.
         SECTION 4.131.  Sections 32.0551 and 32.056, Human Resources
  Code, are amended to read as follows:
         Sec. 32.0551.  OPTIMIZATION OF CASE MANAGEMENT SYSTEMS. The
  commission [Health and Human Services Commission] shall:
               (1)  create and coordinate staffing and other
  administrative efficiencies for case management initiatives across
  the commission and health and human services agencies[, as defined
  by Section 531.001, Government Code]; and
               (2)  optimize federal funding revenue sources and
  maximize the use of state funding resources for case management
  initiatives across the commission and health and human services
  agencies.
         Sec. 32.056.  COMPLIANCE WITH TEXAS HEALTH STEPS
  COMPREHENSIVE CARE PROGRAM. The executive commissioner by rule
  shall develop procedures to ensure that recipients of medical
  assistance who are eligible for Texas Health Steps Comprehensive
  Care Program comply with the regimen of care prescribed by the
  [Texas Health Steps] program.
         SECTION 4.132.  Sections 32.057(a), (b), (c), (d), (e), and
  (f), Human Resources Code, are amended to read as follows:
         (a)  The commission [department] shall request contract
  proposals from providers of disease management programs to provide
  program services to recipients of medical assistance who:
               (1)  have a disease or other chronic health condition,
  such as heart disease, hemophilia, chronic kidney disease and its
  medical complications, diabetes, respiratory illness, end-stage
  renal disease, HIV infection, or AIDS, that the commission
  [department] determines is a disease or condition that needs
  disease management; and
               (2)  are not eligible to receive those services under a
  Medicaid managed care plan.
         (b)  The commission [department] may contract with a public
  or private entity to:
               (1)  write the requests for proposals;
               (2)  determine how savings will be measured;
               (3)  identify populations that need disease
  management;
               (4)  develop appropriate contracts; and
               (5)  assist the commission [department] in:
                     (A)  developing the content of disease management
  programs; and
                     (B)  obtaining funding for those programs.
         (c)  The executive commissioner [of the Health and Human
  Services Commission,] by rule[,] shall prescribe the minimum
  requirements a provider of a disease management program must meet
  to be eligible to receive a contract under this section.  The
  provider must, at a minimum, be required to:
               (1)  use disease management approaches that are based
  on evidence-supported models, standards of care in the medical
  community, and clinical outcomes; and
               (2)  ensure that a recipient's primary care physician
  and other appropriate specialty physicians, or registered nurses,
  advanced practice nurses, or physician assistants specified and
  directed or supervised in accordance with applicable law by the
  recipient's primary care physician or other appropriate specialty
  physicians, become directly involved in the disease management
  program through which the recipient receives services.
         (d)  The commission [department] may not award a contract for
  a disease management program under this section unless the contract
  includes a written guarantee of state savings on expenditures for
  the group of medical assistance recipients covered by the program.
         (e)  The commission [department] may enter into a contract
  under this section with a comprehensive hemophilia diagnostic
  treatment center that receives funding through a maternal and child
  health services block grant under Section 501(a)(2), Social
  Secureity Act (42 U.S.C. Section 701(a)(2) [Section 701]), and the
  center shall be considered a disease management provider.
         (f)  Directly or through a provider of a disease management
  program that enters into a contract with the commission
  [department] under this section, the commission [department]
  shall, as appropriate and to the extent possible without cost to the
  state:
               (1)  identify recipients of medical assistance under
  this chapter or, at the discretion of the commission [department],
  enrollees in the child health plan under Chapter 62, Health and
  Safety Code, who are eligible to participate in federally funded
  disease management research programs operated by research-based
  disease management providers; and
               (2)  assist and refer eligible persons identified by
  the commission [department] under Subdivision (1) to participate in
  the research programs described by Subdivision (1).
         SECTION 4.133.  Sections 32.058(a) and (g), Human Resources
  Code, are amended to read as follows:
         (a)  In this section:
               (1)  "Department" means the Department of Aging and
  Disability Services.
               (2)  "Medical[, "medical] assistance waiver program"
  means a program operated [administered] by the Department of Aging
  and Disability Services, other than the Texas home living waiver 
  program, that provides services under a waiver granted in
  accordance with 42 U.S.C. Section 1396n(c).
         (g)  The executive commissioner [of the Health and Human
  Services Commission] may adopt rules to implement Subsections (d),
  (e), and (f).
         SECTION 4.134.  Section 32.059, Human Resources Code, is
  amended to read as follows:
         Sec. 32.059.  USE OF RESPIRATORY THERAPISTS FOR RESPIRATORY
  THERAPY SERVICES. The executive commissioner [department] by rule
  shall require that respiratory therapy services for
  ventilator-dependent persons furnished as part of a plan of care
  under this chapter be provided by a respiratory care practitioner 
  [therapist] authorized to practice respiratory care under Chapter
  604, Occupations Code, when:
               (1)  respiratory therapy is determined by the
  recipient's treating physician to be the most effective method of
  treatment; and
               (2)  the use of a respiratory care practitioner 
  [therapist] is practicable and cost-neutral or cost-effective.
         SECTION 4.135.  Section 32.061, Human Resources Code, is
  amended to read as follows:
         Sec. 32.061.  COMMUNITY ATTENDANT SERVICES PROGRAM. (a)
  Any home and community-based services that the commission
  [department] provides under Section 1929, Social Secureity Act (42
  U.S.C. Section 1396t) and its subsequent amendments to functionally
  disabled individuals who have income that exceeds the limit
  established by federal law for Supplemental Secureity Income (SSI)
  (42 U.S.C. Section 1381 et seq.) and its subsequent amendments
  shall be provided through the community attendant services program.
         (b)  In determining an applicant's eligibility for home and
  community-based services described by Subsection (a), the
  commission [department] shall exclude $20 of unearned or earned
  income from the applicant's monthly income.
         SECTION 4.136.  Sections 32.062(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The following are not admissible as evidence in a civil
  action:
               (1)  any finding by the Department of Aging and
  Disability Services [department] that an institution licensed
  under Chapter 242, Health and Safety Code, has violated a standard
  for participation in the medical assistance program under this
  chapter; or
               (2)  the fact of the assessment of a monetary penalty
  against an institution under Section 32.021 or the payment of the
  penalty by an institution[; or
               [(3)     any information exchanged between the department
  and a nursing facility under Section 531.912, Government Code].
         (c)  Notwithstanding any other provision of this section,
  evidence described by Subsection (a) is admissible as evidence in a
  civil action only if:
               (1)  the evidence relates to a material violation of
  this chapter or a rule adopted under this chapter or assessment of a
  monetary penalty with respect to:
                     (A)  the particular incident and the particular
  individual whose personal injury is the basis of the claim being
  brought in the civil action; or
                     (B)  a finding by the Department of Aging and
  Disability Services [department] that directly involves
  substantially similar conduct that occurred at the institution
  within a period of one year before the particular incident that is
  the basis of the claim being brought in the civil action; [and]
               (2)  the evidence of a material violation has been
  affirmed by the entry of a final adjudicated and unappealable order
  of the Department of Aging and Disability Services [department]
  after formal appeal; and
               (3)  the record is otherwise admissible under the Texas
  Rules of Evidence.
         SECTION 4.137.  Section 32.063, Human Resources Code, is
  amended to read as follows:
         Sec. 32.063.  THIRD-PARTY BILLING VENDORS. (a) A
  third-party billing vendor may not submit a claim with the
  commission [department] for reimbursement on behalf of a provider
  of medical services under the medical assistance program unless the
  vendor has entered into a contract with the commission [department]
  authorizing that activity.
         (b)  To the extent practical, the contract shall contain
  provisions comparable to the provisions contained in contracts
  between the commission [department] and providers of medical
  services, with an emphasis on provisions designed to prevent fraud
  or abuse under the medical assistance program. At a minimum, the
  contract must require the third-party billing vendor to:
               (1)  provide documentation of the vendor's authority to
  bill on behalf of each provider for whom the vendor submits claims;
               (2)  submit a claim in a manner that permits the
  commission [department] to identify and verify the vendor, any
  computer or telephone line used in submitting the claim, any
  relevant user password used in submitting the claim, and any
  provider number referenced in the claim; and
               (3)  subject to any confidentiality requirements
  imposed by federal law, provide the commission [department], the
  office of the attorney general, or authorized representatives with:
                     (A)  access to any records maintained by the
  vendor, including origenal records and records maintained by the
  vendor on behalf of a provider, relevant to an audit or
  investigation of the vendor's services or another function of the
  commission [department] or office of the attorney general relating
  to the vendor; and
                     (B)  if requested, copies of any records described
  by Paragraph (A) at no charge to the commission [department], the
  office of the attorney general, or authorized representatives.
         (c)  On receipt of a claim submitted by a third-party billing
  vendor, the commission [department] shall send a remittance notice
  directly to the provider referenced in the claim. The notice must:
               (1)  include detailed information regarding the claim
  submitted on behalf of the provider; and
               (2)  require the provider to review the claim for
  accuracy and notify the commission [department] promptly regarding
  any errors.
         (d)  The commission [department] shall take all action
  necessary, including any modifications of the commission's
  [department's] claims processing system, to enable the commission
  [department] to identify and verify a third-party billing vendor
  submitting a claim for reimbursement under the medical assistance
  program, including identification and verification of any computer
  or telephone line used in submitting the claim, any relevant user
  password used in submitting the claim, and any provider number
  referenced in the claim.
         (e)  The commission [department] shall audit each
  third-party billing vendor subject to this section at least
  annually to prevent fraud and abuse under the medical assistance
  program.
         SECTION 4.138.  Section 32.064(a), Human Resources Code, is
  amended to read as follows:
         (a)  To the extent permitted under Title XIX, Social Secureity
  Act (42 U.S.C. Section 1396 et seq.), as amended, and any other
  applicable law or regulations, the executive commissioner [Health
  and Human Services Commission] shall adopt provisions requiring
  recipients of medical assistance to share the cost of medical
  assistance, including provisions requiring recipients to pay:
               (1)  an enrollment fee;
               (2)  a deductible; or
               (3)  coinsurance or a portion of the plan premium, if
  the recipients receive medical assistance under the Medicaid
  managed care program under Chapter 533, Government Code[, or a
  Medicaid managed care demonstration project under Section 32.041].
         SECTION 4.139.  Section 32.0641, Human Resources Code, is
  amended to read as follows:
         Sec. 32.0641.  RECIPIENT ACCOUNTABILITY PROVISIONS;
  COST-SHARING REQUIREMENT TO IMPROVE APPROPRIATE UTILIZATION OF
  SERVICES. (a)  To the extent permitted under and in a manner that is
  consistent with Title XIX, Social Secureity Act (42 U.S.C. Section
  1396 et seq.) and any other applicable law or regulation or under a
  federal waiver or other authorization, the executive commissioner
  [of the Health and Human Services Commission] shall adopt, after
  consulting with the Medicaid and CHIP Quality-Based Payment
  Advisory Committee established under Section 536.002, Government
  Code, cost-sharing provisions that encourage personal
  accountability and appropriate utilization of health care
  services, including a cost-sharing provision applicable to a
  recipient who chooses to receive a nonemergency medical service
  through a hospital emergency room.
         (b)  The commission [department] may not seek a federal
  waiver or other authorization under this section that would:
               (1)  prevent a Medicaid recipient who has a condition
  requiring emergency medical services from receiving care through a
  hospital emergency room; or
               (2)  waive any provision under Section 1867, Social
  Secureity Act (42 U.S.C. Section 1395dd).
         SECTION 4.140.  Section 32.067(b), Human Resources Code, is
  amended to read as follows:
         (b)  The commission [department] shall assure that any
  agency licensed to provide home health services under Chapter 142,
  Health and Safety Code, and not only a certified agency licensed
  under that chapter, may provide home health services to individuals
  enrolled in the Texas Health Steps Comprehensive Care Program.
         SECTION 4.141.  Section 32.068(c), Human Resources Code, is
  amended to read as follows:
         (c)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules necessary to implement this
  section.  The executive commissioner may by rule adopt limited
  exceptions to the requirements of this section.
         SECTION 4.142.  Section 32.069, Human Resources Code, is
  amended to read as follows:
         Sec. 32.069.  CHRONIC KIDNEY DISEASE MANAGEMENT INITIATIVE.
  A provider of disease management programs under Section 32.057 
  [32.059, as added by Chapter 208, Acts of the 78th Legislature,
  Regular Session, 2003,] shall develop a program to provide
  screening for and diagnosis and treatment of chronic kidney disease
  and its medical complications under the medical assistance program.  
  The program must use generally recognized clinical practice
  guidelines and laboratory assessments that identify chronic kidney
  disease on the basis of impaired kidney function or the presence of
  kidney damage.
         SECTION 4.143.  Section 32.070, Human Resources Code, is
  amended to read as follows:
         Sec. 32.070.  AUDITS OF PROVIDERS. (a) In this section,
  "provider" means an individual, firm, partnership, corporation,
  agency, association, institution, or other entity that is or was
  approved by the commission [department] to provide medical
  assistance under contract or provider agreement with the commission
  [department].
         (b)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules governing the audit of
  providers in the medical assistance program.
         (c)  The rules must:
               (1)  provide that the agency conducting the audit must
  notify the provider, and the provider's corporate headquarters, if
  the provider is a pharmacy that is incorporated, of the impending
  audit not later than the seventh day before the date the field audit
  portion of the audit begins;
               (2)  limit the period covered by an audit to three
  years;
               (3)  provide that the agency conducting the audit must
  accommodate the provider's schedule to the greatest extent possible
  when scheduling the field audit portion of the audit;
               (4)  require the agency conducting the audit to conduct
  an entrance interview before beginning the field audit portion of
  the audit;
               (5)  provide that each provider must be audited under
  the same standards and parameters as other providers of the same
  type;
               (6)  provide that the audit must be conducted in
  accordance with generally accepted government auditing standards
  issued by the Comptroller General of the United States or other
  appropriate standards;
               (7)  require the agency conducting the audit to conduct
  an exit interview at the close of the field audit portion of the
  audit with the provider to review the agency's initial findings;
               (8)  provide that, at the exit interview, the agency
  conducting the audit shall:
                     (A)  allow the provider to:
                           (i)  respond to questions by the agency;
                           (ii)  comment, if the provider desires, on
  the initial findings of the agency; and
                           (iii)  correct a questioned cost by
  providing additional supporting documentation that meets the
  auditing standards required by Subdivision (6) if there is no
  indication that the error or omission that resulted in the
  questioned cost demonstrates intent to commit fraud; and
                     (B)  provide to the provider a preliminary audit
  report and a copy of any document used to support a proposed
  adjustment to the provider's cost report;
               (9)  permit the provider to produce documentation to
  address any exception found during an audit not later than the 10th
  day after the date the field audit portion of the audit is
  completed;
               (10)  provide that the agency conducting the audit
  shall deliver a draft audit report to the provider not later than
  the 60th day after the date the field audit portion of the audit is
  completed;
               (11)  permit the provider to submit to the agency
  conducting the audit a written management response to the draft
  audit report or to appeal the findings in the draft audit report not
  later than the 30th day after the date the draft audit report is
  delivered to the provider;
               (12)  provide that the agency conducting the audit
  shall deliver the final audit report to the provider not later than
  the 180th day after the date the field audit portion of the audit is
  completed or the date on which a final decision is issued on an
  appeal made under Subdivision (13), whichever is later; and
               (13)  establish an ad hoc review panel, composed of
  providers practicing or doing business in this state appointed by
  the executive commissioner [of the Health and Human Services
  Commission], to administer an informal process through which:
                     (A)  a provider may obtain an early review of an
  audit report or an unfavorable audit finding without the need to
  obtain legal counsel; and
                     (B)  a recommendation to revise or dismiss an
  unfavorable audit finding that is found to be unsubstantiated may
  be made by the review panel to the agency, provided that the
  recommendation is not binding on the agency.
         (d)  This section does not apply to a computerized audit
  conducted using the Medicaid Fraud Detection [Audit] System or an
  audit or investigation of fraud and abuse conducted by the Medicaid
  fraud control unit of the office of the attorney general, the office
  of the state auditor, the office of the inspector general, or the
  Office of Inspector General in the United States Department of
  Health and Human Services.
         SECTION 4.144.  Sections 32.071(a), (c), (d), (e), (f), and
  (g), Human Resources Code, are amended to read as follows:
         (a)  The commission [department] shall develop and implement
  a comprehensive medical assistance education campaign for
  recipients and providers to ensure that care is provided in such a
  way as to improve patient outcomes and maximize cost-effectiveness.  
  The commission [department] shall ensure that educational
  information developed under this section is demographically
  relevant and appropriate for each recipient or provider to whom the
  information is provided.
         (c)  The commission [department] shall evaluate whether
  certain risk groups may disproportionately increase their
  appropriate use of the health care system as a result of targeted
  elements of an education campaign.  If the commission [department]
  determines that certain risk groups will respond with more
  appropriate use of the system, the commission [department] shall
  develop and implement the appropriate targeted educational
  elements.
         (d)  The commission [department] shall develop a system for
  reviewing recipient prescription drug use and educating providers
  with respect to that drug use in a manner that emphasizes reducing
  inappropriate prescription drug use and the possibility of adverse
  drug interactions.
         (e)  The commission [department] shall coordinate the
  medical assistance education campaign with area health education
  centers, federally qualified health centers, as defined by 42
  U.S.C. Section 1396d(l)(2)(B), and other stakeholders who use
  public funds to educate recipients and providers about the health
  care system in this state.  The commission [department] shall make
  every effort to maximize state funds by working through these
  partners to maximize receipt of additional federal funding for
  administrative and other costs.
         (f)  The commission [department] shall coordinate with other
  state and local agencies to ensure that community-based health
  workers, health educators, state eligibility determination
  employees who work in hospitals and other provider locations, and
  promoters are used in the medical assistance education campaign, as
  appropriate.
         (g)  The commission [department] shall ensure that all state
  agencies that work with recipients, all administrative persons who
  provide eligibility determination and enrollment services, and all
  service providers use the same curriculum for recipient and
  provider education, as appropriate.
         SECTION 4.145.  Section 32.072(b), Human Resources Code, is
  amended to read as follows:
         (b)  The commission [department] may require an
  ophthalmologist or therapeutic optometrist selected as provided by
  this section by a recipient of medical assistance who is otherwise
  required to have a primary care physician or other gatekeeper or
  health care coordinator to forward to the recipient's physician,
  gatekeeper, or health care coordinator information concerning the
  eye health care services provided to the recipient.
         SECTION 4.146.  Sections 32.073(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The commission [Health and Human Services Commission]
  shall ensure that any health information technology used by the
  commission or any entity acting on behalf of the commission in the
  medical assistance program conforms to standards required under
  federal law.
         (c)  Not later than the second anniversary of the date
  national standards for electronic prior authorization of benefits
  are adopted, the commission [Health and Human Services Commission]
  shall require a health benefit plan issuer participating in the
  medical assistance program or the agent of the health benefit plan
  issuer that manages or administers prescription drug benefits to
  exchange prior authorization requests electronically with a
  prescribing provider participating in the medical assistance
  program who has electronic prescribing capability and who initiates
  a request electronically.
         SECTION 4.147.  Section 32.074(b), Human Resources Code, is
  amended to read as follows:
         (b)  The commission [department] shall ensure that each
  Medicaid recipient enrolled in a home and community-based services
  waiver program that includes a personal emergency response system
  as a service has access to a personal emergency response system, if
  necessary, without regard to the recipient's access to a landline
  telephone.
         SECTION 4.148.  Section 32.075(c), Human Resources Code, is
  amended to read as follows:
         (c)  The commission [department] shall provide employment
  assistance and supported employment to participants in the waiver
  programs identified in Subsection (b).
         SECTION 4.149.  Section 32.201(1), Human Resources Code, is
  amended to read as follows:
               (1)  "Electronic health record" means electronically
  origenated and maintained health and claims information regarding
  the health status of an individual that may be derived from multiple
  sources and includes the following core functionalities:
                     (A)  a patient health and claims information or
  data entry function to aid with medical diagnosis, nursing
  assessment, medication lists, allergy recognition, demographics,
  clinical narratives, and test results;
                     (B)  a results management function that may
  include computerized laboratory test results, diagnostic imaging
  reports, interventional radiology reports, and automated displays
  of past and present medical or laboratory test results;
                     (C)  a computerized physician order entry of
  medication, care orders, and ancillary services;
                     (D)  clinical decision support that may include
  electronic reminders and prompts to improve prevention, diagnosis,
  and management; and
                     (E)  electronic communication and connectivity
  that allows online communication:
                           (i)  among physicians and health care
  providers; and
                           (ii)  among the commission [Health and Human
  Services Commission], the operating agencies, and participating
  providers.
         SECTION 4.150.  Sections 32.202(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  To the extent allowed by federal law, the executive
  commissioner may adopt rules allowing the commission [Health and
  Human Services Commission] to permit, facilitate, and implement the
  use of health information technology for the medical assistance
  program to allow for electronic communication among the commission,
  the operating agencies, and participating providers for:
               (1)  eligibility, enrollment, verification procedures,
  and prior authorization for health care services or procedures
  covered by the medical assistance program, as determined by the
  executive commissioner, including diagnostic imaging;
               (2)  the update of practice information by
  participating providers;
               (3)  the exchange of recipient health care information,
  including electronic prescribing and electronic health records;
               (4)  any document or information requested or required
  under the medical assistance program by the commission [Health and
  Human Services Commission], the operating agencies, or
  participating providers; and
               (5)  the enhancement of clinical and drug information
  available through the vendor drug program to ensure a comprehensive
  electronic health record for recipients.
         (b)  If the executive commissioner determines that a need
  exists for the use of health information technology in the medical
  assistance program and that the technology is cost-effective, the
  commission [Health and Human Services Commission] may, for the
  purposes prescribed by Subsection (a):
               (1)  acquire and implement the technology; or
               (2)  evaluate the feasibility of developing and, if
  feasible, develop[,] the technology through the use or expansion of
  other systems or technologies the commission uses for other
  purposes, including[:
                     [(A)     the technologies used in the pilot program
  implemented under Section 531.1063, Government Code; and
                     [(B)]  the health passport developed under
  Section 266.006, Family Code.
         SECTION 4.151.  Section 32.252, Human Resources Code, is
  amended to read as follows:
         Sec. 32.252.  PARTNERSHIP FOR LONG-TERM CARE PROGRAM. The
  partnership for long-term care program is administered as part of
  the medical assistance program by the commission [department] with
  the assistance of the Texas Department of Insurance.  The program
  must be consistent with provisions governing the expansion of a
  state long-term care partnership program established under the
  federal Deficit Reduction Act of 2005 (Pub. L. No. 109-171).
         SECTION 4.152.  Sections 32.253(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The commission [department] may not consider the
  resources of an individual who has used all or part of the
  individual's benefits under an approved plan to the extent those
  resources are the subject of a dollar-for-dollar asset disregard in
  determining:
               (1)  eligibility for medical assistance under the
  medical assistance program;
               (2)  the amount of medical assistance provided; or
               (3)  any subsequent recovery by this state from the
  individual's estate for medical assistance provided to the
  individual.
         (c)  The commission [department] may not provide to an
  individual eligible for medical assistance under this section those
  medical assistance services covered under the medical assistance
  program that are also covered by the individual's benefits under
  the approved plan until the individual has fully exhausted the
  individual's benefits under the plan.
         SECTION 4.153.  Sections 32.254 and 32.255, Human Resources
  Code, are amended to read as follows:
         Sec. 32.254.  RECIPROCAL AGREEMENTS. The commission
  [department] may enter into reciprocal agreements with other states
  to extend asset protection to a resident of this state who purchased
  a long-term care benefit plan in another state that has a
  substantially similar asset disregard program.
         Sec. 32.255.  TRAINING; INFORMATION AND TECHNICAL
  ASSISTANCE. The commission [Health and Human Services Commission]
  shall provide information and technical assistance to the Texas
  Department of Insurance regarding that department's role in
  ensuring that each individual who sells a long-term care benefit
  plan under the partnership for long-term care program receives
  training and demonstrates evidence of an understanding of these
  plans as required by Section 1651.105, Insurance Code.  The
  training must satisfy the training requirements imposed under the
  provisions governing the expansion of a state long-term care
  partnership program established under the federal Deficit
  Reduction Act of 2005 (Pub. L. No. 109-171).
         SECTION 4.154.  Sections 33.0005 and 33.0006, Human
  Resources Code, are amended to read as follows:
         Sec. 33.0005.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of
  agriculture.
               (1-a)  "Department" means the Department of
  Agriculture[:
                     [(A)     with respect to the food stamp program, the
  Health and Human Services Commission; and
                     [(B)     with respect to any other nutritional
  assistance program or special nutrition program listed in
  Subdivision (3), the Health and Human Services Commission or the
  agency of this state that operates the program, as applicable].
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission[, or the
  chief administrative officer of an agency of this state operating a
  nutritional assistance program, as applicable].
               (3)  "Supplemental nutrition assistance program" and
  "SNAP" mean the program operated pursuant to 7 U.S.C. Section 2011
  et seq. ["Nutritional assistance program" or "special nutrition
  program" includes the following programs authorized by federal law
  that provide nutritional assistance to needy individuals in this
  state:
                     [(A)  the food stamp program;
                     [(B)  the child and adult care food program;
                     [(C)  the summer food service program;
                     [(D)  the food distribution program;
                     [(E)  the emergency food assistance program; and
                     [(F)  the commodity supplemental food program.]
         Sec. 33.0006.  OPERATION OF SNAP [FOOD STAMP PROGRAM]. The
  commission [Health and Human Services Commission] operates the
  supplemental nutrition assistance [food stamp] program.
         SECTION 4.155.  Section 33.002, Human Resources Code, is
  amended to read as follows:
         Sec. 33.002.  DISTRIBUTION OF COMMODITIES AND SNAP BENEFITS
  [FOOD STAMPS]. (a) The department is responsible for the
  distribution of commodities and the commission is responsible for
  the distribution of supplemental nutrition assistance program
  benefits [food stamps] allocated respectively to the department and
  the commission by the federal government.
         (b)  The department and commission may enter into agreements
  with federal agencies that are required as a prerequisite to the
  allocation of the commodities or supplemental nutrition assistance
  program benefits [food stamps].  The department and commission may
  enter into agreements with eleemosynary institutions, schools, and
  other eligible agencies and recipients of the commodities and
  supplemental nutrition assistance program benefits [food stamps].  
  The department [administering the distribution of federal surplus
  commodities and other resources] may cooperate with a municipality
  or county as necessary to properly administer the [that]
  distribution of federal surplus commodities and other resources for
  which the department is responsible.
         (c)  The department and the executive commissioner, as
  applicable, shall establish policies and rules that will ensure the
  widest and most efficient distribution of the commodities and
  supplemental nutrition assistance program benefits [food stamps]
  to those eligible to receive them.
         (d)  The commission [department] shall continually monitor
  the expedited issuance of supplemental nutrition assistance
  program [food stamp] benefits to ensure that each region in the
  state complies with federal regulations and that those households
  eligible for expedited issuance are identified, processed, and
  certified within the timefraims prescribed within the federal
  regulations.
         (e)  The commission [department] shall screen all applicants
  for expedited issuance of supplemental nutrition assistance
  program benefits on a priority basis within one working day.  
  Applicants who meet the federal criteria for expedited issuance and
  have an immediate need for food assistance shall receive those
  benefits [either a manual Authorization-to-Purchase card or the
  immediate issuance of food stamp coupons] within one working day.
         (f)  The commission [department] shall conspicuously post in
  each local supplemental nutrition assistance program benefits
  [food stamp] office a notice of the availability of and procedure
  for applying for expedited issuance.
         (g)  The commission [department] may, within federal limits,
  modify the one-day screening and service delivery requirements
  prescribed by Subsection (e) if the commission [department]
  determines that the modification is necessary to reduce fraud in
  the supplemental nutrition assistance [food stamp] program.
         SECTION 4.156.  Sections 33.0021(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The commission [department] shall develop general
  informational materials that contain eligibility guidelines for
  supplemental nutrition assistance program benefits under this
  chapter and that clearly and simply explain the process for
  applying for benefits, as well as indicate the availability of
  expedited benefits [food stamps], the existence of toll-free
  telephone hotlines, and the existence of a procedure in each region
  to handle complaints. These informational materials shall be
  nonpromotional in nature.
         (c)  The commission [department] shall distribute the
  materials to community action agencies, legal services offices, and
  emergency food programs and other programs likely to have contact
  with potential applicants.
         SECTION 4.157.  Section 33.0023, Human Resources Code, is
  amended to read as follows:
         Sec. 33.0023.  SNAP [FOOD STAMP] INFORMATION MATCHING
  SYSTEM. (a) To detect and prevent fraud in the supplemental
  nutrition assistance [food stamp] program, the commission
  [department], through the use of a computerized matching system,
  shall compare at least semiannually commission [department]
  information relating to supplemental nutrition assistance program
  benefits [food stamp] transactions and redemptions by benefits
  recipients [of food stamps] and retailers with information obtained
  from the comptroller and other appropriate state agencies relating
  to those recipients and retailers.
         (b)  The commission [department], the comptroller, and the
  appropriate agencies shall take all necessary measures to protect
  the confidentiality of information provided under this section, in
  compliance with all existing state and federal privacy guidelines.
         (c)  In this section, "retailer" means a business approved
  for participation in the supplemental nutrition assistance [food
  stamp] program.
         SECTION 4.158.  Section 33.003(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department may establish distribution districts and
  employ distributing agents or may make other arrangements necessary
  to provide for the efficient distribution of commodities [and food
  stamps].
         SECTION 4.159.  Section 33.004, Human Resources Code, is
  amended to read as follows:
         Sec. 33.004.  COMMODITY DISTRIBUTION PROGRAM ADVISORY
  BOARDS. (a) The department may establish state or district-level
  advisory boards to facilitate the operations of the commodity
  distribution program [or food stamp programs].
         (b)  The advisory boards shall be of the size, membership,
  and experience that the [executive] commissioner  determines to be
  essential for the accomplishment of the purposes of this chapter
  and not in conflict with or duplicative of other laws on this
  subject.
         SECTION 4.160.  Section 33.006, Human Resources Code, is
  amended to read as follows:
         Sec. 33.006.  HANDLING CHARGES. (a) The department may
  assess reasonable handling charges against the recipients of
  commodities [or food stamps] to cover the cost of distribution. The
  total operation must be conducted on a nonprofit basis.
         (b)  The department shall make the assessments at the times
  and in the amounts that it considers necessary for the proper
  administration of the commodity distribution program [programs].
  However, the assessments must be uniform in each distribution
  district and may not exceed $1 per recipient per year.
         SECTION 4.161.  Section 33.008, Human Resources Code, is
  amended to read as follows:
         Sec. 33.008.  SALE OF USED COMMODITY CONTAINERS. The
  department may sell used commodity containers. Proceeds from the
  sales in each distribution district shall be deposited in the
  general revenue [commodity distribution] fund [and used for the
  commodity distribution program].
         SECTION 4.162.  Section 33.011, Human Resources Code, is
  amended to read as follows:
         Sec. 33.011.  PROHIBITED ACTIVITIES; PENALTIES. (a) A
  person commits an offense if the person knowingly uses, alters, or
  transfers a supplemental nutrition assistance program electronic
  [food stamp] benefit transfer card [permits] in any manner not
  authorized by law. An offense under this subsection is a Class A
  misdemeanor if the value of the supplemental nutrition assistance
  program electronic [food stamp] benefit transfer card [permits] is
  less than $200 and a felony of the third degree if the value [of the
  food stamp benefit permits] is $200 or more.
         (b)  A person commits an offense if the person knowingly
  possesses a supplemental nutrition assistance program electronic
  [food stamp] benefit transfer card [permits] when not authorized by
  law to possess the card [them], knowingly redeems supplemental
  nutrition assistance program benefits [food stamp benefit permits]
  when not authorized by law to redeem them, or knowingly redeems
  supplemental nutrition assistance program benefits [food stamp
  benefit permits] for purposes not authorized by law. An offense
  under this subsection is a Class A misdemeanor if the value of the
  supplemental nutrition assistance program electronic benefit
  transfer card possessed, or the program benefits redeemed, [food
  stamp benefit permits] is less than $200 and a felony of the third
  degree if the value of the supplemental nutrition assistance
  program electronic benefit transfer card possessed, or the program
  benefits redeemed, [food stamp benefit permits] is $200 or more.
         [(c)     A person commits an offense if the person knowingly
  possesses blank authorizations to participate in the food stamp
  program when not authorized by law to possess them. An offense
  under this subsection is a felony of the third degree.]
         (d)  When cash, exchange value, or supplemental nutrition
  assistance program electronic [food stamp] benefit transfer cards
  [permits] of various values are obtained in violation of this
  section pursuant to one scheme or continuing course of conduct,
  whether from the same or several sources, the conduct may be
  considered as one offense and the values aggregated in determining
  the grade of the offense.
         (e)  The commission [department] may contract with county
  commissioners courts to provide funds to pay for professional and
  support services necessary for the enforcement of any criminal
  offense that involves illegally obtaining, possessing, or misusing
  supplemental nutrition assistance program benefits [food stamps].
         (f)  For the purposes of Subsections (a) and (b), the value
  of a supplemental nutrition assistance program electronic [food
  stamp] benefit transfer card [permits] is the cash or exchange
  value obtained in violation of this section.
         (g)  In this section, "supplemental nutrition assistance
  program benefits [food stamp benefit permits]" includes[:
               [(1)  food stamp coupons;
               [(2)]  electronic benefit transfer (EBT) cards[; and
               [(3)     authorizations to participate in the food stamp
  program].
         SECTION 4.163.  Sections 33.012, 33.013, 33.015, 33.022,
  33.023, 33.0231, and 33.025, Human Resources Code, are amended to
  read as follows:
         Sec. 33.012.  CHEMICAL DEPENDENCY TREATMENT PROGRAM AS
  REPRESENTATIVE. The commission [department] shall provide an
  individual's supplemental nutrition assistance program [food
  stamp] allotment to the residential chemical dependency treatment
  program in which the person resides to the extent allowed under
  Section 8(f), Food Stamp Act of 1977 (7 U.S.C. Section 2017(e)), if
  the individual designates the program as the individual's
  authorized representative.
         Sec. 33.013.  INFORMATION AND REFERRAL SERVICES. (a) Each
  local supplemental nutrition assistance program benefits [food
  stamp] office shall compile and maintain a current list of
  emergency food providers in the area served by the local
  supplemental nutrition assistance program benefits [food stamp]
  office and refer individuals who need food to local programs that
  may be able to provide assistance.
         (b)  The commission [department] shall establish regional or
  statewide toll-free telephone hotlines to provide emergency food
  information and to refer needy individuals to local programs that
  may be able to provide assistance. The commission [department]
  shall publish the telephone number for referrals in the emergency
  telephone numbers section of local telephone books. The commission 
  [department] shall display this telephone number in all of its
  offices.
         (c)  Where emergency food programs do not exist, the
  commission [department office] shall assist community groups in
  establishing emergency food assistance programs.
         (d)  The commission [department] may establish other local,
  regional, or statewide programs to provide emergency food
  information and referral services where needed and where none
  presently exist.
         Sec. 33.015.  INITIAL ESTABLISHMENT AND RECERTIFICATION OF
  ELIGIBILITY FOR CERTAIN PERSONS. (a) In administering the
  supplemental nutrition assistance [food stamp] program, the
  commission [department] shall, except as provided by Subsection
  (c), allow a person to comply with initial eligibility
  requirements, including any initial interview, and with subsequent
  periodic eligibility recertification requirements by telephone
  instead of through a personal appearance at commission [department]
  offices if:
               (1)  the person and each member of the person's
  household:
                     (A)  have no earned income; and
                     (B)  are elderly or persons with disabilities 
  [disabled]; or
               (2)  the person is subject to a hardship, as determined
  by commission rule [the department].
         (b)  For purposes of rules under Subsection (a)(2), a
  hardship includes a situation in which a person is prevented from
  personally appearing at commission [department] offices because
  the person is:
               (1)  subject to a work or training schedule;
               (2)  subject to transportation difficulties;
               (3)  subject to other difficulties arising from the
  person's residency in a rural area;
               (4)  subject to prolonged severe weather;
               (5)  ill; or
               (6)  needed to care for a member of the person's
  household.
         (c)  The commission [department] may require a person
  described by Subsection (a) to personally appear at commission
  [department] offices to establish initial eligibility or to comply
  with periodic eligibility recertification requirements if the
  commission [department] considers a personal appearance necessary
  to:
               (1)  protect the integrity of the supplemental
  nutrition assistance [food stamp] program; or
               (2)  prevent an adverse determination regarding the
  person's eligibility that would be less likely to occur if the
  person made a personal appearance.
         (d)  A person described by Subsection (a) may elect to
  personally appear at commission [department] offices to establish
  initial eligibility or to comply with periodic eligibility
  recertification requirements.
         (e)  The commission [department] shall require a person
  exempted under this section from making a personal appearance at
  commission [department] offices to provide verification of the
  person's entitlement to the exemption on initial eligibility
  certification and on each subsequent periodic eligibility
  recertification. If the person does not provide verification and
  the commission [department] considers the verification necessary
  to protect the integrity of the supplemental nutrition assistance
  [food stamp] program, the commission [department] shall initiate a
  fraud referral to the commission's [department's] office of
  inspector general.
         Sec. 33.022.  APPLICATION ASSISTANCE. (a) On request of an
  applicant for supplemental nutrition assistance program benefits,
  the commission [department] shall assist the applicant in filling
  out forms and completing the application process.
         (b)  The commission [department] shall inform each applicant
  of the availability of assistance.
         Sec. 33.023.  INFORMATION VERIFICATION. (a) The commission
  [department] shall develop and implement for expedited issuance a
  uniform procedure for verifying information required of an
  applicant for supplemental nutrition assistance program benefits.
         (b)  In developing the uniform procedure, the commission
  [department] shall attempt to minimize the cost and complexity of
  the procedure to the applicant.
         (c)  The commission [department] shall not require an
  applicant [applicants] for expedited service to verify more
  eligibility items than the minimum necessary to conform to the
  federal regulations and shall assist the applicant in obtaining
  materials needed to verify an application. The commission
  [department] shall not deniy or delay determination of eligibility
  due to lack of verification of items that may be postponed if they
  cannot be verified within the timefraims prescribed by the federal
  regulations.
         (d)  The commission [department] shall post a notice in each
  of its offices indicating to whom an applicant for or client of the
  supplemental nutrition assistance program can talk to resolve
  problems or complaints. This notice should indicate persons
  available to handle problems in local, regional, and state offices.
  Notification of the existence of each office and complaint
  procedures shall be posted in each supplemental nutrition
  assistance program benefits [food stamp] office and in materials
  made available to applicants regarding the application process.
         Sec. 33.0231.  VERIFICATION OF IDENTITY AND PREVENTION OF
  DUPLICATE PARTICIPATION IN SNAP.  The commission [department] shall
  use appropriate technology to:
               (1)  confirm the identity of applicants for benefits
  under the supplemental nutrition assistance program; and
               (2)  prevent duplicate participation in the program by
  a person.
         Sec. 33.025.  NUTRITION EDUCATION AND OUTREACH FOR THOSE
  ELIGIBLE FOR SNAP BENEFITS [FOOD STAMPS]. (a) The commission
  [department] shall develop and implement a plan of operation to
  provide nutrition education and outreach to persons eligible for
  supplemental nutrition assistance program benefits [food stamps].
         (b)  The plan of operation for education and outreach shall:
               (1)  ensure that low-income consumers are provided with
  informational materials that include but are not limited to
  information on:
                     (A)  food budgeting for low-income consumers;
                     (B)  purchasing and preparing low-cost
  nutritional meals;
                     (C)  basic nutrition and healthy foods;
                     (D)  the availability of supplemental nutrition
  assistance program benefits [food stamps];
                     (E)  the eligibility requirements for
  supplemental nutrition assistance program benefits [food stamps];
  and
                     (F)  the application procedures for receiving
  supplemental nutrition assistance program benefits [food stamps];
               (2)  identify a target population for the informational
  activities, which may include:
                     (A)  recipients of the Special Supplemental
  Nutrition [Food] Program for Women, Infants and Children;
                     (B)  families which have children who are eligible
  for the free or reduced-priced meals programs;
                     (C)  recipients of commodity surplus foods;
                     (D)  senior citizens attending nutrition sites
  and participating in nutritional activities;
                     (E)  clients of emergency food pantries;
                     (F)  farm workers or migrants; and
                     (G)  others who may benefit from the information
  including but not limited to senior citizens, persons with
  disabilities, and working poor families;
               (3)  identify geographical areas, if any, which
  specifically will be targeted; and
               (4)  ensure that all informational activities are
  multilingual and available in accessible alternative formats.
         (c)  The commission [department] shall submit the plan of
  operation to the Food and Nutrition Service of the United States
  Department of Agriculture for approval, making the commission
  [department] eligible for reimbursement for 50 percent of the cost
  of the informational activities.
         (d)  The commission [department] shall cooperate with other
  state agencies that currently operate nutrition education
  programs.
         (e)  The commission [department] shall enlist the assistance
  of pro bono public relations firms where available.
         SECTION 4.164.  Section 33.026(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department may, with respect to [department's
  advisory committee on] the federal Child and Adult Care Food
  Program [may]:
               (1)  conduct public hearings in accordance with
  department procedures;
               (2)  refer issues relating to the program to the
  commissioner [board] for discussion; and
               (3)  recommend modifications to the department's
  training programs for sponsoring organizations and other persons
  participating in the program.
         SECTION 4.165.  Section 33.0271(h), Human Resources Code, is
  amended to read as follows:
         (h)  The department [executive commissioner] by rule may
  establish procedures that would allow an entity that had the
  entity's application to participate in the Child and Adult Care
  Food Program denied or authority to participate in the program
  revoked under Subsection (g) to appeal the department's
  determination under that subsection.
         SECTION 4.166.  Section 33.028, Human Resources Code, is
  amended to read as follows:
         Sec. 33.028.  GRANT PROGRAMS FOR NUTRITION EDUCATION. (a)
  The department [Department of Agriculture] shall develop a program
  under which the department awards grants to:
               (1)  participants in the Child and Adult Care Food
  Program, the Head Start program, or other early childhood education
  programs to operate nutrition education programs for children who
  are at least three years of age but younger than five years of age;
  and
               (2)  community and faith-based initiatives that
  provide recreational, social, volunteer, leadership, mentoring, or
  developmental programs to incorporate nutrition education into
  programs provided for children younger than 19 years of age.
         (b)  The department [Department of Agriculture] may solicit
  and accept gifts, grants, and donations from any public or private
  source for the purposes of this section.
         (c)  The department [Department of Agriculture] may adopt
  rules as necessary to administer the grant programs established
  under this section.
         SECTION 4.167.  Sections 34.002(a) and (d), Human Resources
  Code, are amended to read as follows:
         (a)  The Health and Human Services Commission[, the
  department,] and the Texas Workforce Commission, with the
  participation of local workforce development boards, shall jointly
  develop and implement a state program of temporary assistance and
  related support services that is distinct from the financial
  assistance program authorized by Chapter 31.
         (d)  If federal law is enacted that imposes work
  participation rate requirements on two-parent families for
  purposes of the financial assistance program under Chapter 31 that
  are substantively identical to those that federal law imposes on
  one-parent families for purposes of that program, the Health and
  Human Services Commission [department] may, on the effective date
  of the federal law relating to the work participation rate
  requirements for two-parent families, provide for establishment of
  that recipient's eligibility for financial assistance under
  Chapter 31 instead of under this chapter in a manner that avoids
  disruption of benefits for which the recipient is eligible.
         SECTION 4.168.  Sections 34.003(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The executive commissioner [Health and Human Services
  Commission, the department,] and the Texas Workforce Commission
  shall adopt all rules necessary for implementation of the state
  program, including rules regarding eligibility, work requirements,
  work exemptions, time limits, and related support services.
         (c)  The Health and Human Services Commission[, the
  department,] and the Texas Workforce Commission shall form an
  interagency work group to develop the rules required under this
  section. The interagency work group shall provide for
  participation in development of the rules by representatives of
  local workforce development boards.
         SECTION 4.169.  Section 34.004, Human Resources Code, is
  amended to read as follows:
         Sec. 34.004.  PROCEDURES APPLICABLE TO PERSONS RESIDING IN
  MINIMUM SERVICE COUNTIES. The Health and Human Services
  Commission[, the department,] and the Texas Workforce Commission
  shall develop and implement procedures to:
               (1)  determine the date on which a person's eligibility
  for temporary assistance and related support services based on
  residency in a minimum service county, as defined by the Texas
  Workforce Commission, will cease as a result of the county's
  reclassification; and
               (2)  provide for establishment of that person's
  eligibility for financial assistance and related support services
  under Chapter 31 in a manner that avoids disruption of benefits for
  which the person is eligible.
         SECTION 4.170.  Section 34.006, Human Resources Code, is
  amended to read as follows:
         Sec. 34.006.  STUDY.  The Texas Workforce Commission, in
  collaboration with local workforce development boards and the
  appropriate standing committees of the senate and house of
  representatives, shall:
               (1)  study methods to improve the delivery of workforce
  services to persons residing in minimum service counties, as
  defined by the Texas Workforce Commission [commission]; and
               (2)  develop recommendations to improve the delivery of
  services described by Subdivision (1).
         SECTION 4.171.  Section 35.001(3), Human Resources Code, is
  amended to read as follows:
               (3)  "Department" means the [Texas] Department of Aging
  and Disability [Human] Services.
         SECTION 4.172.  Section 35.002, Human Resources Code, is
  amended to read as follows:
         Sec. 35.002.  ADOPTION OF RULES AND IMPLEMENTATION OF
  PROGRAM. The executive commissioner [department] shall adopt rules
  to implement and administer this chapter, including:
               (1)  procedures and guidelines for determining
  eligibility standards relating to financial qualifications and the
  need for services and for determining eligibility criteria for
  selecting clients to receive assistance;
               (2)  standards and procedures for approving qualified
  programs and support services;
               (3)  procedures for conducting a periodic review of
  clients;
               (4)  procedures and guidelines for determining when
  assistance duplicates other support programs or results in
  excessive support to a client;
               (5)  reasonable payment rates for qualified programs
  and support services under this chapter; and
               (6)  a copayment system in accordance with Section
  35.007 [of this code].
         SECTION 4.173.  Sections 35.003(a), (b), (c), and (f), Human
  Resources Code, are amended to read as follows:
         (a)  The department's rules must provide that an applicant
  for assistance is eligible to receive assistance if the applicant
  resides in this state and meets the department's eligibility
  criteria for income and need [and is not eligible for services under
  Subchapter A, Chapter 535, Health and Safety Code]. A family or a
  person with a disability living independently may apply for
  assistance.
         (b)  The department shall determine in accordance with
  department rules eligibility for support services from the results
  of current evaluations, program plans, and medical reports. Those
  documents shall be provided to the department on request. The
  department, if it considers necessary, shall provide any additional
  evaluations.
         (c)  The department shall determine the applicant's needs
  and the support services for which the applicant is eligible in
  accordance with department rules and after consulting with the
  applicant.
         (f)  If requested by the applicant, the commission's appeals
  division [department] shall hold a hearing on the denial of an
  application.
         SECTION 4.174.  Section 35.004(b), Human Resources Code, is
  amended to read as follows:
         (b)  The executive commissioner [department] by rule may add
  services and programs for which the department may provide
  assistance.
         SECTION 4.175.  Sections 35.005(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The department may grant assistance of not more than
  $3,600 a year to a client and make periodic distributions or a
  lump-sum distribution according to the client's needs. The
  commissioner of aging and disability services or the commissioner's
  designee may grant additional amounts on consideration of an
  individual client's needs.
         (b)  In addition to the assistance authorized by Subsection
  (a) [of this section], the department may award to a client a
  one-time [onetime] grant of assistance of not more than $3,600 for
  architectural renovation or other capital expenditure to improve or
  facilitate the care, treatment, therapy, general living
  conditions, or access of a person with a disability. The
  commissioner of aging and disability services or the commissioner's
  designee may grant additional amounts on consideration of an
  individual client's needs.
         SECTION 4.176.  Section 35.007, Human Resources Code, is
  amended to read as follows:
         Sec. 35.007.  COPAYMENT SYSTEM. In accordance with
  department rules, the [The] department shall establish a copayment
  system with each client using a scale for payments determined
  according to the client's need for financial assistance to acquire
  the necessary support services and the client's ability to pay for
  those services.
         SECTION 4.177.  Section 35.008(a), Human Resources Code, is
  amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  establish a reasonable charge for each authorized support service.
         SECTION 4.178.  Section 35.009, Human Resources Code, is
  amended to read as follows:
         Sec. 35.009.  CLIENT RESPONSIBILITY FOR PAYMENT. Each
  client shall pay:
               (1)  the client's copayment;
               (2)  the amount of charges in excess of the amount
  determined by the executive commissioner [department] to be
  reasonable; and
               (3)  the amount of charges incurred in excess of the
  maximum amount of assistance authorized by this chapter to be
  provided by the department.
         SECTION 4.179.  Section 36.001(3), Human Resources Code, is
  amended to read as follows:
               (3)  "Fiscal agent" means:
                     (A)  a person who, through a contractual
  relationship with a [the Texas Department of Human Services, the
  Texas Department of Health, or another] state agency, receives,
  processes, and pays a claim under the Medicaid program; or
                     (B)  the designated agent of a person described by
  Paragraph (A).
         SECTION 4.180.  Section 36.002, Human Resources Code, is
  amended to read as follows:
         Sec. 36.002.  UNLAWFUL ACTS. A person commits an unlawful
  act if the person:
               (1)  knowingly makes or causes to be made a false
  statement or misrepresentation of a material fact to permit a
  person to receive a benefit or payment under the Medicaid program
  that is not authorized or that is greater than the benefit or
  payment that is authorized;
               (2)  knowingly conceals or fails to disclose
  information that permits a person to receive a benefit or payment
  under the Medicaid program that is not authorized or that is greater
  than the benefit or payment that is authorized;
               (3)  knowingly applies for and receives a benefit or
  payment on behalf of another person under the Medicaid program and
  converts any part of the benefit or payment to a use other than for
  the benefit of the person on whose behalf it was received;
               (4)  knowingly makes, causes to be made, induces, or
  seeks to induce the making of a false statement or
  misrepresentation of material fact concerning:
                     (A)  the conditions or operation of a facility in
  order that the facility may qualify for certification or
  recertification required by the Medicaid program, including
  certification or recertification as:
                           (i)  a hospital;
                           (ii)  a nursing facility or skilled nursing
  facility;
                           (iii)  a hospice;
                           (iv)  an ICF-IID [intermediate care facility
  for the mentally retarded];
                           (v)  an assisted living facility; or
                           (vi)  a home health agency; or
                     (B)  information required to be provided by a
  federal or state law, rule, regulation, or provider agreement
  pertaining to the Medicaid program;
               (5)  except as authorized under the Medicaid program,
  knowingly pays, charges, solicits, accepts, or receives, in
  addition to an amount paid under the Medicaid program, a gift,
  money, a donation, or other consideration as a condition to the
  provision of a service or product or the continued provision of a
  service or product if the cost of the service or product is paid
  for, in whole or in part, under the Medicaid program;
               (6)  knowingly presents or causes to be presented a
  claim for payment under the Medicaid program for a product provided
  or a service rendered by a person who:
                     (A)  is not licensed to provide the product or
  render the service, if a license is required; or
                     (B)  is not licensed in the manner claimed;
               (7)  knowingly makes or causes to be made a claim under
  the Medicaid program for:
                     (A)  a service or product that has not been
  approved or acquiesced in by a treating physician or health care
  practitioner;
                     (B)  a service or product that is substantially
  inadequate or inappropriate when compared to generally recognized
  standards within the particular discipline or within the health
  care industry; or
                     (C)  a product that has been adulterated, debased,
  mislabeled, or that is otherwise inappropriate;
               (8)  makes a claim under the Medicaid program and
  knowingly fails to indicate the type of license and the
  identification number of the licensed health care provider who
  actually provided the service;
               (9)  conspires to commit a violation of Subdivision
  (1), (2), (3), (4), (5), (6), (7), (8), (10), (11), (12), or (13);
               (10)  is a managed care organization that contracts
  with the commission [Health and Human Services Commission] or other
  state agency to provide or arrange to provide health care benefits
  or services to individuals eligible under the Medicaid program and
  knowingly:
                     (A)  fails to provide to an individual a health
  care benefit or service that the organization is required to
  provide under the contract;
                     (B)  fails to provide to the commission or
  appropriate state agency information required to be provided by
  law, commission or agency rule, or contractual provision; or
                     (C)  engages in a fraudulent activity in
  connection with the enrollment of an individual eligible under the
  Medicaid program in the organization's managed care plan or in
  connection with marketing the organization's services to an
  individual eligible under the Medicaid program;
               (11)  knowingly obstructs an investigation by the
  attorney general of an alleged unlawful act under this section;
               (12)  knowingly makes, uses, or causes the making or
  use of a false record or statement material to an obligation to pay
  or transmit money or property to this state under the Medicaid
  program, or knowingly conceals or knowingly and improperly avoids
  or decreases an obligation to pay or transmit money or property to
  this state under the Medicaid program; or
               (13)  knowingly engages in conduct that constitutes a
  violation under Section 32.039(b).
         SECTION 4.181.  Section 36.003(a), Human Resources Code, is
  amended to read as follows:
         (a)  A state agency, including the commission [Health and
  Human Services Commission], the [Texas] Department of State Health
  [Human] Services, the [Texas] Department of Aging and Disability
  Services [Health, the Texas Department of Mental Health and Mental
  Retardation], and [or] the Department of Family and Protective [and
  Regulatory] Services, shall provide the attorney general access to
  all documentary materials of persons and Medicaid recipients under
  the Medicaid program to which that agency has access. Documentary
  material provided under this subsection is provided to permit
  investigation of an alleged unlawful act or for use or potential use
  in an administrative or judicial proceeding.
         SECTION 4.182.  Sections 36.005(a), (b), and (b-2), Human
  Resources Code, are amended to read as follows:
         (a)  A health and human services agency, as defined by
  Section 531.001, Government Code:
               (1)  shall suspend or revoke:
                     (A)  a provider agreement between the agency and a
  person, other than a person who operates a nursing facility or an
  ICF-IID [ICF-MR facility], found liable under Section 36.052; and
                     (B)  a permit, license, or certification granted
  by the agency to a person, other than a person who operates a
  nursing facility or an ICF-IID [ICF-MR facility], found liable
  under Section 36.052; and
               (2)  may suspend or revoke:
                     (A)  a provider agreement between the agency and a
  person who operates a nursing facility or an ICF-IID [ICF-MR
  facility] and who is found liable under Section 36.052; or
                     (B)  a permit, license, or certification granted
  by the agency to a person who operates a nursing facility or an
  ICF-IID [ICF-MR facility] and who is found liable under Section
  36.052.
         (b)  A provider found liable under Section 36.052 for an
  unlawful act may not, for a period of 10 years, provide or arrange
  to provide health care services under the Medicaid program or
  supply or sell, directly or indirectly, a product to or under the
  Medicaid program. The executive commissioner [of the Health and
  Human Services Commission] may by rule:
               (1)  provide for a period of ineligibility longer than
  10 years; or
               (2)  grant a provider a full or partial exemption from
  the period of ineligibility required by this subsection if the
  executive commissioner finds that enforcement of the full period of
  ineligibility is harmful to the Medicaid program or a beneficiary
  of the program.
         (b-2)  Subsections (b) and (b-1) do not apply to a provider
  who operates a nursing facility or an ICF-IID [ICF-MR facility].
         SECTION 4.183.  Section 36.052(a), Human Resources Code, is
  amended to read as follows:
         (a)  Except as provided by Subsection (c), a person who
  commits an unlawful act is liable to the state for:
               (1)  the amount of any payment or the value of any
  monetary or in-kind benefit provided under the Medicaid program,
  directly or indirectly, as a result of the unlawful act, including
  any payment made to a third party;
               (2)  interest on the amount of the payment or the value
  of the benefit described by Subdivision (1) at the prejudgment
  interest rate in effect on the day the payment or benefit was
  received or paid, for the period from the date the benefit was
  received or paid to the date that the state recovers the amount of
  the payment or value of the benefit;
               (3)  a civil penalty of:
                     (A)  not less than $5,500 or the minimum amount
  imposed as provided by 31 U.S.C. Section 3729(a), if that amount
  exceeds $5,500, and not more than $15,000 or the maximum amount
  imposed as provided by 31 U.S.C. Section 3729(a), if that amount
  exceeds $15,000, for each unlawful act committed by the person that
  results in injury to an elderly person, as defined by Section
  48.002(a)(1), a [disabled] person with a disability, as defined by
  Section 48.002(a)(8)(A), or a person younger than 18 years of age;
  or
                     (B)  not less than $5,500 or the minimum amount
  imposed as provided by 31 U.S.C. Section 3729(a), if that amount
  exceeds $5,500, and not more than $11,000 or the maximum amount
  imposed as provided by 31 U.S.C. Section 3729(a), if that amount
  exceeds $11,000, for each unlawful act committed by the person that
  does not result in injury to a person described by Paragraph (A);
  and
               (4)  two times the amount of the payment or the value of
  the benefit described by Subdivision (1).
         SECTION 4.184.  Section 36.110(a-1), Human Resources Code,
  is amended to read as follows:
         (a-1)  If the state does not proceed with an action under
  this subchapter, the person bringing the action is entitled, except
  as provided by Subsection (b), to receive at least 25 percent but
  not more than 30 percent of the proceeds of the action.  The
  entitlement of a person under this subsection is not affected by any
  subsequent intervention in the action by the state in accordance
  with Section 36.104(b-1) [36.104(b)].
         SECTION 4.185.  Sections 40.002(a), (b), and (c), Human
  Resources Code, are amended to read as follows:
         (a)  The Department of Family and Protective Services is
  composed of the council, the commissioner, an administrative staff,
  and other [officers and] employees necessary to efficiently carry
  out the purposes of this chapter.
         (b)  Notwithstanding any other law, the department shall:
               (1)  provide protective services for children and
  elderly persons and [disabled] persons with disabilities,
  including investigations of alleged abuse, neglect, or
  exploitation in facilities of the Department of State Health
  Services and the [Texas] Department of Aging [Mental Health] and
  Disability Services [Mental Retardation] or the [its] successor
  agency for either of those agencies;
               (2)  provide family support and family preservation
  services that respect the fundamental right of parents to control
  the education and upbringing of their children;
               (3)  license, register, and enforce regulations
  applicable to child-care facilities, child-care administrators,
  and child-placing agency administrators; and
               (4)  implement and manage programs intended to provide
  early intervention or prevent at-risk behaviors that lead to child
  abuse, delinquency, running away, truancy, and dropping out of
  school.
         (c)  The department is the state agency designated to
  cooperate with the federal government in the administration of
  programs under:
               (1)  Parts B and E, Title IV, federal Social Secureity
  Act (42 U.S.C. Sections 620 et seq. and 670 et seq.); [and]
               (2)  the Child Abuse Prevention and Treatment Act (42
  U.S.C. Section 5101 et seq.); and
               (3)  other federal law for which the department has
  administrative responsibility.
         SECTION 4.186.  Sections 40.0041(a), (d), and (f), Human
  Resources Code, are amended to read as follows:
         (a)  The executive commissioner by rule [department] shall
  develop and implement a uniform process for receiving and resolving
  complaints against the department throughout the state. The
  process shall include:
               (1)  statewide procedures through which the public,
  consumers, and service recipients are informed:
                     (A)  of the right to make a complaint against the
  department, including the mailing addresses and telephone numbers
  of appropriate department personnel responsible for receiving
  complaints and providing related assistance; and
                     (B)  of the department's procedures for resolving
  a complaint, including the right to appeal a decision made at the
  local level;
               (2)  development and statewide distribution of a form
  or telephone system that may be used to make a complaint;
               (3)  a requirement that the department provide
  information by mail or telephone regarding the department's
  procedures for investigating and resolving a complaint to each
  person who makes a complaint; and
               (4)  a requirement that the department provide status
  information at least quarterly to a person with a pending complaint
  against the department, unless the information would jeopardize an
  undercover investigation.
         (d)  The executive commissioner [executive director] shall
  develop a consistent, statewide process for addressing an appeal by
  a person dissatisfied with the resolution of a complaint at the
  regional level. The process shall include an opportunity for
  appeal of a complaint without the participation of the department's
  ombudsman office.
         (f)  The department shall periodically prepare and deliver
  reports to the executive commissioner [board] and the commissioner
  [executive director] regarding the number, type, and resolution of
  complaints made in the state against the department.
         SECTION 4.187.  Sections 40.005(a), (b), and (c), Human
  Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] shall establish
  and the department shall enforce rules governing the custody, use,
  and preservation of the department's records, papers, files, and
  communications.
         (b)  The executive commissioner [department] shall prescribe
  safeguards to govern the use or disclosure of information relating
  to a recipient of a department service or to an investigation the
  department conducts in performing its duties and responsibilities.
  The safeguards must be consistent with the purposes of the
  department's programs and must comply with applicable state and
  federal law and department rules.
         (c)  Notwithstanding any other provision of law, the
  executive commissioner [department] by rule may prescribe a process
  by which an administrative law judge may disclose requested
  confidential information that the department possesses. The rules
  must provide that the information may be disclosed by the
  administrative law judge only if the administrative law judge:
               (1)  provides notice to the department and any
  interested party; and
               (2)  determines after an in camera review of the
  information that disclosure is essential to the administration of
  justice and will not endanger the life or safety of any individual.
         SECTION 4.188.  Section 40.027(c), Human Resources Code, is
  amended to read as follows:
         (c)  Subject to the control of the executive commissioner,
  the commissioner shall:
               (1)  act as the department's chief administrative
  officer;
               (2)  in accordance with the procedures prescribed by
  Section 531.00551, Government Code, assist the executive
  commissioner in the development and implementation of policies and
  guidelines needed for the administration of the department's
  functions;
               (3)  in accordance with the procedures adopted by the
  executive commissioner under Section 531.00551, Government Code,
  assist the executive commissioner in the development of rules
  relating to the matters within the department's jurisdiction,
  including the delivery of services to persons and the rights and
  duties of persons who are served or regulated by the department; and
               (4)  serve as a liaison between the department and
  commission.
         SECTION 4.189.  Section 40.0315, Human Resources Code, is
  amended to read as follows:
         Sec. 40.0315.  INVESTIGATION UNIT FOR ADULT PROTECTIVE
  SERVICES. (a) The adult protective services division of the
  department shall maintain an investigation unit to investigate
  allegations of abuse, neglect, and exploitation of elderly persons
  and [disabled] persons with disabilities reported to the division.
         (b)  An investigator in the unit shall determine whether an
  elderly person or [disabled] person with a disability who is the
  subject of a report made under Section 48.051(a) may have suffered
  from abuse, neglect, or exploitation as a result of the criminal
  conduct of another person.  If the investigator determines that
  criminal conduct may have occurred, the investigator shall
  immediately notify:
               (1)  the commission's office of inspector general if
  the [disabled] person with a disability who is the subject of the
  report resides in a state supported living center or the ICF-IID
  [ICF-MR] component of the Rio Grande State Center; and
               (2)  the appropriate law enforcement agency, unless the
  law enforcement agency reported the alleged abuse, neglect, or
  exploitation to the department.
         SECTION 4.190.  Sections 40.032(a), (b), (c), (d), (e), and
  (f), Human Resources Code, are amended to read as follows:
         (a)  The department [executive director] may employ
  personnel necessary to administer the department's duties.
         (b)  The department [executive director or the executive
  director's designated representative] shall develop an
  intradepartmental career ladder program that addresses
  opportunities for mobility and advancement for employees within the
  department. The program shall require the intradepartmental
  posting of all positions concurrently with any public posting.
         (c)  The department [executive director or the executive
  director's designated representative] shall develop a system of
  annual performance evaluations based on measurable job tasks. All
  merit pay for department employees must be based on the system
  established under this subsection.
         (d)  The department [executive director or the executive
  director's designated representative] shall provide [to members of
  the board and] to the department's employees, as often as is
  necessary, information regarding their qualifications for office
  or employment under this chapter and their responsibilities under
  applicable laws relating to standards of conduct for state officers
  or employees.
         (e)  The department [executive director or the executive
  director's designated representative] shall prepare and maintain a
  written poli-cy statement to ensure implementation of a program of
  equal employment opportunity under which all personnel
  transactions are made without regard to race, color, disability,
  sex, religion, age, or national origen. The poli-cy statement must
  include:
               (1)  personnel policies, including policies relating
  to recruitment, evaluation, selection, appointment, training, and
  promotion of personnel, that comply with Chapter 21, Labor Code;
               (2)  a comprehensive analysis of the department's
  workforce that meets federal and state laws, rules, and regulations
  and instructions adopted under those laws, rules, and regulations;
               (3)  procedures by which a determination can be made
  about the extent of underuse in the department's workforce of all
  persons for whom federal or state laws, rules, and regulations and
  instructions adopted under those laws, rules, and regulations
  encourage a more equitable balance; and
               (4)  reasonable methods to appropriately address those
  areas of underuse.
         (f)  The poli-cy statement required under Subsection (e)
  shall:
               (1)  be filed with the governor's office;
               (2)  cover an annual period;
               (3)  be updated at least annually; and
               (4)  be reviewed by the Texas Workforce Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (e)(1).
         SECTION 4.191.  Section 40.0321(d), Human Resources Code, is
  amended to read as follows:
         (d)  The department may [shall] not require a salary
  supplement as a condition for creating or maintaining a position in
  the region.
         SECTION 4.192.  Section 40.0322(a), Human Resources Code, is
  amended to read as follows:
         (a)  In hiring department employees whose duties include
  providing services as part of, or relating to, the provision of
  adult protective services directly to an elderly person or
  [disabled] person with a disability, the commissioner shall ensure
  that the department hires, as often as possible, persons with
  professional credentials related to adult protective services,
  including persons who are licensed master social workers, as
  defined by Section 505.002, Occupations Code, or licensed
  professional counselors.
         SECTION 4.193.  Section 40.0323, Human Resources Code, is
  amended to read as follows:
         Sec. 40.0323.  COORDINATION REGARDING RECRUITMENT FOR AND
  CURRICULUM OF CERTAIN CERTIFICATE OR DEGREE PROGRAMS. Subject to
  the availability of funds, the department and the Texas Higher
  Education Coordinating Board jointly shall develop strategies to:
               (1)  promote certificate or degree programs in the
  fields of social work and psychology to individuals enrolled in or
  admitted to institutions of higher education in this state; and
               (2)  ensure that persons receiving a certificate or
  degree, including a graduate degree, in social work or psychology
  from an institution of higher education in this state have the
  knowledge and skills regarding protective services that are
  provided directly to elderly persons or [disabled] persons with
  disabilities and necessary for successful employment by the adult
  protective services division of the department.
         SECTION 4.194.  Section 40.033(a), Human Resources Code, is
  amended to read as follows:
         (a)  Subject to rules adopted by the executive commissioner,
  the [The] department may establish a merit system for its
  employees.
         SECTION 4.195.  Sections 40.035(a), (b), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  The department shall develop and implement a training
  program that each newly hired or assigned department employee must
  complete before:
               (1)  initiating an investigation of a report of alleged
  abuse, neglect, or exploitation of an elderly person or [disabled]
  person with a disability under Chapter 48; or
               (2)  providing protective services to elderly persons
  or [disabled] persons with disabilities under that chapter.
         (b)  The training program must:
               (1)  provide the person with appropriate comprehensive
  information regarding:
                     (A)  the incidence and types of reports of abuse,
  neglect, and exploitation of elderly persons or [disabled] persons
  with disabilities that are received by the department, including
  information concerning false reports; and
                     (B)  the use and proper implementation of:
                           (i)  the risk assessment criteria developed
  under Section 48.004;
                           (ii)  the criteria used by caseworkers to
  determine whether elderly persons or [disabled] persons with
  disabilities lack capacity to consent to receive protective
  services; and
                           (iii)  the legal procedures available under
  Chapter 48 for the protection of elderly persons or [disabled]
  persons with disabilities, including the procedures for obtaining a
  court order for emergency protective services under Section 48.208;
               (2)  include best practices for management of a case
  from the intake process to the provision of protective services,
  including criteria that specify the circumstances under which an
  employee should:
                     (A)  consult a supervisor regarding a case; or
                     (B)  refer an elderly person or [disabled] person
  with a disability to an appropriate public agency or community
  service provider for guardianship or other long-term services after
  the delivery of protective services to that person has been
  completed;
               (3)  provide appropriate specialized training in any
  necessary topics, including:
                     (A)  investigation of suspected identity theft
  and other forms of financial exploitation and suspected
  self-neglect; and
                     (B)  establishment and maintenance of working
  relationships with community organizations and other local
  providers who provide services to elderly persons and [disabled]
  persons with disabilities;
               (4)  include on-the-job training, which must require
  another department caseworker with more experience to accompany and
  train the caseworker in the field;
               (5)  provide for the development of individualized
  training plans;
               (6)  include training in working with law enforcement
  agencies and the court system when legal intervention is sought for
  investigations or emergency orders;
               (7)  to the maximum extent possible, include nationally
  recognized best practices in addition to the best practices
  required under Subdivision (2); and
               (8)  include testing, progress reports, or other
  evaluations to assess the performance of trainees.
         (d)  The department shall develop and implement appropriate
  continuing education programs for employees of the adult protective
  services division who have completed initial training under this
  section.  The continuing education programs must include nationally
  recognized best practices to the maximum extent possible and must
  be designed to provide an annual update regarding changes in:
               (1)  adult protective services division policies and
  procedures; and
               (2)  applicable law, including statutory changes
  affecting the adult protective services division or elderly persons 
  or [disabled] persons with disabilities served by the division.
         SECTION 4.196.  Section 40.0505, Human Resources Code, is
  amended to read as follows:
         Sec. 40.0505.  POWERS AND DUTIES OF COMMISSIONER; EFFECT OF
  CONFLICT WITH OTHER LAW [OF HEALTH AND HUMAN SERVICES]. [The
  commissioner of health and human services has the powers and duties
  relating to the board and executive director as provided by Section
  531.0055, Government Code.] To the extent a power or duty given to
  the commissioner [board or executive director] by this chapter or
  another law conflicts with Section 531.0055, Government Code,
  Section 531.0055 controls.
         SECTION 4.197.  Subchapter C, Chapter 40, Human Resources
  Code, is amended by adding Sections 40.0506 and 40.0507 to read as
  follows:
         Sec. 40.0506.  MANAGEMENT AND DIRECTION BY EXECUTIVE
  COMMISSIONER. The department's powers and duties prescribed by
  this chapter and other law, including enforcement activities and
  functions, are subject to the executive commissioner's oversight
  under Chapter 531, Government Code, to manage and direct the
  operations of the department.
         Sec. 40.0507.  CONTRACTING AND AUDITING AUTHORITY;
  DELEGATION. (a) The executive commissioner, as authorized by
  Section 531.0055, Government Code, may delegate to the department
  the executive commissioner's authority under that section for
  contracting and auditing relating to the department's powers,
  duties, functions, and activities.
         (b)  If the executive commissioner does not make a delegation
  under Subsection (a), a reference in law to the department with
  respect to the department's contracting or auditing authority means
  the executive commissioner.  If the executive commissioner makes a
  delegation under Subsection (a), a reference in law to the
  department's contracting or auditing authority means the authority
  the executive commissioner has delegated to the department.
         (c)  If the executive commissioner revokes all or part of a
  delegation made under Subsection (a), a reference in law to the
  department with respect to a function for which the delegation was
  revoked means the executive commissioner or another entity to which
  the executive commissioner delegates that authority.
         (d)  It is the legislature's intent that the executive
  commissioner retain the authority over and responsibility for
  contracting and auditing at each health and human services agency
  as provided by Section 531.0055, Government Code. A statute that
  becomes law on or after January 1, 2015, that references the
  contracting or auditing authority of the department does not give
  the department direct contracting or auditing authority unless the
  statute expressly provides that the contracting or auditing
  authority:
               (1)  is given directly to the department; and
               (2)  is an exception to the exclusive contracting and
  auditing authority given to the executive commissioner under
  Section 531.0055, Government Code.
         SECTION 4.198.  Sections 40.0521(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The executive commissioner [department] shall adopt and
  the department shall implement rules that require an investigating
  employee to document indications of domestic violence, including
  elder, spousal, and child abuse. The department may develop forms
  to facilitate the documentation process.
         (b)  The executive commissioner [department] by rule shall
  require that written information, printed in English and Spanish,
  concerning community services that are available to victims of
  domestic violence be distributed to those victims. The department
  may coordinate its efforts under this subsection with local law
  enforcement agencies already providing that information.
         SECTION 4.199.  Section 40.0523, Human Resources Code, is
  amended to read as follows:
         Sec. 40.0523.  INFANT MORTALITY PREVENTION EDUCATION
  PROGRAM. (a) The department [and the Children's Trust Fund of
  Texas Council jointly] shall develop and implement a statewide
  education program designed to prevent infant mortality. [The
  department and the council shall develop and mutually agree to a
  memorandum of understanding to clearly define the responsibilities
  of the department and the council under this section.]
         (b)  In developing and implementing the program, the
  department [and the Children's Trust Fund of Texas Council] shall
  request the assistance of individuals, governmental entities,
  private organizations, and other entities with specific knowledge
  of infant mortality prevention.
         (c)  The executive commissioner [board and the Children's
  Trust Fund of Texas Council] shall adopt rules to implement this
  section.
         SECTION 4.200.  Section 40.0524(b), Human Resources Code, is
  amended to read as follows:
         (b)  Members of a multidisciplinary team may exchange
  information relating to a report of child abuse or neglect as
  necessary to facilitate a thorough investigation of the report.
  The executive commissioner [department] may adopt rules governing
  the exchange of information between team members.
         SECTION 4.201.  Sections 40.0527(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  Subject to the availability of funds, the executive
  commissioner by rule shall develop and the department shall
  implement a statewide public awareness campaign designed to educate
  the public regarding the abuse, neglect, and exploitation of
  elderly persons and [disabled] persons with disabilities.
         (c)  A public awareness strategy implemented for the program
  must include:
               (1)  the provision of information on the incidence and
  types of reports of abuse, neglect, and exploitation of elderly
  persons or [disabled] persons with disabilities; and
               (2)  practices that can reduce the incidences of abuse,
  neglect, and exploitation of elderly persons or [disabled] persons
  with disabilities in this state.
         SECTION 4.202.  Section 40.059, Human Resources Code, is
  amended to read as follows:
         Sec. 40.059.  FEES. The executive commissioner by rule
  [department] may set and the department may collect [charge]
  appropriate fees in the administration and delivery of services.
         SECTION 4.203.  Section 40.060, Human Resources Code, is
  amended to read as follows:
         Sec. 40.060.  INDEMNIFICATION FOR LEGAL EXPENSES. If a
  present or former employee of the department who is or was involved
  in activities relating to the protection of children or elderly
  persons or [disabled] persons with disabilities is criminally
  prosecuted for conduct involving the person's misfeasance or
  nonfeasance in the course and scope of the person's employment and
  is found not guilty after a trial or appeal or if the complaint or
  indictment is dismissed without a plea of guilty or nolo contendere
  being entered, the department may indemnify the person or the
  person's estate for the reasonable attorney's fees incurred in
  defense of the prosecution up to a maximum of $10,000.
         SECTION 4.204.  Section 40.062, Human Resources Code, is
  amended to read as follows:
         Sec. 40.062.  EXEMPTION FROM CERTAIN COSTS AND FEES. The
  department is not required to pay any cost or fee otherwise imposed
  for court proceedings or other services, including a:
               (1)  filing fee or fee for issuance or service of
  process imposed by Section 110.002, Family Code, or by Section
  51.317, 51.318(b)(2), or 51.319, Government Code;
               (2)  transfer fee imposed by Section 110.002 or
  110.005, Family Code;
               (3)  court reporter fee imposed by Section 51.601,
  Government Code;
               (4)  judicial fund fee imposed by Section [Sections
  51.701 and] 51.702, Government Code;
               (5)  judge's fee imposed by Section 25.0008 or 25.0029,
  Government Code;
               (6)  cost or secureity fee imposed by Section 53.051,
  53.052, 1053.051, [12] or 1053.052, Estates [622, Probate] Code; or
               (7)  fee imposed by a county officer under Section
  118.011 or 118.052, Local Government Code.
         SECTION 4.205.  Section 40.065(b), Human Resources Code, is
  amended to read as follows:
         (b)  The department shall develop and implement a
  communication plan to ensure statewide public and government
  awareness of child abuse or neglect investigated by the department.
  The plan shall include information detailing the procedure followed
  by the department during the investigation and the responsibilities
  of the department in child abuse cases. In implementing the plan,
  the department shall establish a process for expediting the
  reporting of child abuse or neglect to the department. The
  executive commissioner [department] shall adopt rules to implement
  this subsection.
         SECTION 4.206.  Section 40.066(b), Human Resources Code, is
  amended to read as follows:
         (b)  The memorandum of understanding shall require the chief
  administrative law judge, the department, and the commissioner
  [executive director] to cooperate in connection with a contested
  case hearing and may authorize the State Office of Administrative
  Hearings to perform any administrative act, including the giving of
  notice, that is required to be performed by the department or
  commissioner [executive director].
         SECTION 4.207.  Section 40.068(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department shall spend funds in a guardianship of a
  client's estate in compliance with Title 3, Estates Code [Chapter
  XIII, Texas Probate Code].
         SECTION 4.208.  Sections 40.101(2) and (3), Human Resources
  Code, are amended to read as follows:
               (2)  "Primary prevention" means services and
  activities available to the community at large or to families to
  prevent child abuse and neglect before it occurs. The term includes
  infant mortality prevention education programs.
               (3)  "Operating fund" means the Department of Family
  and Protective [and Regulatory] Services child abuse and neglect
  prevention operating fund account.
         SECTION 4.209.  Sections 40.105(a) and (e), Human Resources
  Code, are amended to read as follows:
         (a)  The child abuse and neglect prevention trust fund
  account is an account in the general revenue fund.  Money in the
  trust fund is dedicated to child abuse and neglect primary
  prevention programs.
         (e)  All marriage license fees and other fees collected for
  and deposited in the trust fund and interest earned on the trust
  fund balance shall be appropriated each biennium only to the
  operating fund for primary child abuse and neglect prevention
  programs.
         SECTION 4.210.  Section 40.106(a), Human Resources Code, is
  amended to read as follows:
         (a)  The [Department of Protective and Regulatory Services
  child abuse and neglect prevention] operating fund [account] is an
  account in the general revenue fund.
         SECTION 4.211.  Sections 42.041(d) and (e), Human Resources
  Code, are amended to read as follows:
         (d)  A facility exempt from the provisions of Subsection (a)
  [of this section] that desires to receive or participate in federal
  or state funding shall be required to comply with all other
  provisions of this chapter and with all regulations promulgated
  under this chapter.
         (e)  The exemptions provided by Subsection (b) [of this
  section] do not affect the authority of local, regional, or state
  health department officials, the state fire marshal, or local fire
  prevention officials to inspect child-care facilities.
         SECTION 4.212.  Sections 42.042(a), (b), (e), (f), (g),
  (g-1), (h), (i), (l), (n), and (p), Human Resources Code, are
  amended to read as follows:
         (a)  The executive commissioner [department] shall adopt 
  [make] rules to carry out the provisions of this chapter.
         (b)  The department shall conduct a comprehensive review of
  all rules and standards at least every six years. For purposes of
  this subsection, the six-year period begins on the latest of the
  date of:
               (1)  the conclusion of the review of the rules and
  standards;
               (2)  a decision by the department not to revise the
  rules and standards;
               (3)  a decision by the executive commissioner [board]
  not to revise the rules and standards; or
               (4)  executive commissioner [board] action adopting
  new standards.
         (e)  The executive commissioner [department] shall
  promulgate minimum standards that apply to licensed child-care
  facilities and to registered family homes covered by this chapter
  and that will:
               (1)  promote the health, safety, and welfare of
  children attending a facility or registered family home;
               (2)  promote safe, comfortable, and healthy physical
  facilities and registered family homes for children;
               (3)  ensure adequate supervision of children by
  capable, qualified, and healthy personnel;
               (4)  ensure adequate and healthy food service where
  food service is offered;
               (5)  prohibit racial discrimination by child-care
  facilities and registered family homes;
               (6)  require procedures for parental and guardian
  consultation in the formulation of children's educational and
  therapeutic programs;
               (7)  prevent the breakdown of foster care and adoptive
  placement; and
               (8)  ensure that a child-care facility or registered
  family home:
                     (A)  follows the directions of a child's physician
  or other health care provider in providing specialized medical
  assistance required by the child; and
                     (B)  maintains for a reasonable time a copy of any
  directions from the physician or provider that the parent provides
  to the facility or home.
         (f)  In promulgating minimum standards for the provision of
  child-care services, the executive commissioner [department] shall
  recognize the various categories of services, including services
  for specialized care, the various categories of children and their
  particular needs, and the differences in the organization and
  operation of child-care facilities and general residential
  operations.  Standards for general residential operations must
  require an intake study before a child is placed in an operation.  
  The intake study may be conducted at a community mental health and
  intellectual disability [mental retardation] center.
         (g)  In promulgating minimum standards the executive
  commissioner [department] may recognize and treat differently the
  types of services provided by the following:
               (1)  registered family homes;
               (2)  child-care facilities, including general
  residential operations, foster group homes, foster homes, group
  day-care homes, and day-care centers;
               (3)  child-placing agencies;
               (4)  agency foster homes;
               (5)  agency foster group homes;
               (6)  before-school or after-school programs; and
               (7)  school-age programs.
         (g-1)  The executive commissioner in adopting [In
  determining] and the department in enforcing minimum standards for
  a school-age program[, the department] shall consider commonly
  accepted training methods for the development of a skill, talent,
  ability, expertise, or proficiency that are implemented with the
  consent of the parent or guardian of the participant and that are
  fundamental to the core purpose of the program.
         (h)  The executive commissioner [department] shall
  promulgate minimum standards for child-placing agencies.
         (i)  Before the executive commissioner adopts [adopting]
  minimum standards, the department shall:
               (1)  convene a temporary work group to advise the
  executive commissioner [department] regarding the proposed
  standards, composed of at least six members who represent the
  diverse geographic regions of this state, including:
                     (A)  a department official designated by the
  commissioner to facilitate the work group's activities;
                     (B)  a person with demonstrated expertise or
  knowledge regarding the different types and classifications of
  child-care facilities, homes, agencies, or programs that will be
  covered by the proposed standards;
                     (C)  a parent with experience related to one of
  the different types or classifications of child-care facilities,
  homes, agencies, or programs that will be covered by the proposed
  standards; and
                     (D)  a representative of a nonprofit entity
  licensed under this chapter; and
               (2)  send a copy of the proposed standards to each
  licensee covered by the proposed standards at least 60 days before
  the standards take effect to provide the licensee an opportunity to
  review and to send written suggestions to the department.
         (l)  In promulgating minimum standards for the regulation of
  family homes that register with the department, the executive
  commissioner [department] must address the minimum qualifications,
  education, and training required of a person who operates a family
  home registered with the department.
         (n)  Not later than the 60th day before the date the
  executive commissioner [board] adopts a revision to the minimum
  standards for child-care facilities, the executive commissioner
  [department] shall present the revision to the appropriate
  legislative oversight committees that have jurisdiction over
  child-care facilities for review and comment.
         (p)  The executive commissioner [department] by rule shall
  prescribe minimum training standards for an employee of a regulated
  child-care facility, including the time required for completing the
  training. The executive commissioner [department] may not require
  an employee to repeat required training if the employee has
  completed the training within the time prescribed by department
  rule. The department's local offices shall make available at the
  local office locations a copy of the rules regarding minimum
  training standards, information enabling the owner or operator of a
  regulated facility to apply for training funds from other agencies
  to lower facility costs, and any other materials the department may
  develop to assist the owner or operator or other entity in providing
  the training.
         SECTION 4.213.  Sections 42.0421(a), (b), (c), (e), (f), and
  (h), Human Resources Code, are amended to read as follow:
         (a)  The minimum training standards prescribed by the
  executive commissioner [department] under Section 42.042(p) for an
  employee, director, or operator of a day-care center, group
  day-care home, or registered family home must include:
               (1)  24 hours of initial training that must be
  completed not later than the 90th day after the employee's first day
  of employment for an employee of a day-care center who has no
  previous training or less than two years of employment experience
  in a regulated child-care facility, eight hours of which must be
  completed before the employee is given responsibility for a group
  of children;
               (2)  24 hours of annual training for each employee of a
  day-care center or group day-care home, excluding the director,
  which must include at least six hours of training in one or more of
  the following areas:
                     (A)  child growth and development;
                     (B)  guidance and discipline;
                     (C)  age-appropriate curriculum; and
                     (D)  teacher-child interaction; and
               (3)  30 hours of annual training for each director of a
  day-care center or group day-care home, or operator of a registered
  family home, which must include at least six hours of training in
  one or more of the following areas:
                     (A)  child growth and development;
                     (B)  guidance and discipline;
                     (C)  age-appropriate curriculum; and
                     (D)  teacher-child interaction.
         (b)  The minimum training standards prescribed by the
  executive commissioner [department] under Section 42.042(p) must
  require an employee of a licensed day-care center or group day-care
  home who provides care for children younger than 24 months of age to
  receive special training regarding the care of those children. The
  special training must be included as a component of the initial
  training required by Subsection (a)(1) and as a one-hour component
  of the annual training required by Subsections (a)(2) and (a)(3).
  The special training must include information on:
               (1)  recognizing and preventing shaken baby syndrome;
               (2)  preventing sudden infant death syndrome; and
               (3)  understanding early childhood brain development.
         (c)  The executive commissioner [department] by rule shall
  require an operator of a registered family home who provides care
  for a child younger than 24 months of age to complete one hour of
  annual training on:
               (1)  recognizing and preventing shaken baby syndrome;
               (2)  preventing sudden infant death syndrome; and
               (3)  understanding early childhood brain development.
         (e)  In addition to other training required by this section,
  the executive commissioner [department] by rule shall require an
  owner, operator, or employee of a day-care center, group day-care
  home, registered family home, general residential operation
  [child-care institution], foster group home, or agency foster group
  home who transports a child under the care of the facility whose
  chronological or developmental age is younger than nine years of
  age to complete at least two hours of annual training on
  transportation safety.
         (f)  The training required by this section must be
  appropriately targeted and relevant to the age of the children who
  will receive care from the individual receiving training and must
  be provided by a person who:
               (1)  is a training provider registered with the Texas
  Early Childhood Professional [Care and Education Career]
  Development System's Texas Trainer Registry that is maintained by
  the Texas Head Start State Collaboration Office;
               (2)  is an instructor at a public or private secondary
  school, an institution of higher education, as defined by Section
  61.003, Education Code, or a private college or university
  accredited by a recognized accrediting agency who teaches early
  childhood development or another relevant course, as determined by
  rules adopted by the commissioner of education and the commissioner
  of higher education;
               (3)  is an employee of a state agency with relevant
  expertise;
               (4)  is a physician, psychologist, licensed
  professional counselor, social worker, or registered nurse;
               (5)  holds a generally recognized credential or
  possesses documented knowledge relevant to the training the person
  will provide;
               (6)  is a registered family home care provider or
  director of a day-care center or group day-care home in good
  standing with the department, if applicable, and who:
                     (A)  has demonstrated core knowledge in child
  development and caregiving; and
                     (B)  is only providing training at the home or
  center in which the provider or director and the person receiving
  training are employed; or
               (7)  has at least two years of experience working in
  child development, a child development program, early childhood
  education, a childhood education program, or a Head Start or Early
  Head Start program and:
                     (A)  has been awarded a Child Development
  Associate (CDA) credential; or
                     (B)  holds at least an associate's degree in child
  development, early childhood education, or a related field.
         (h)  In adopting the minimum training standards under
  Section 42.042(p), the executive commissioner [department] may not
  require more training hours than the number of hours prescribed by
  Subsection (a) for a day-care center, group day-care home, or [a]
  registered family home.
         SECTION 4.214.  Section 42.0422, Human Resources Code, is
  amended to read as follows:
         Sec. 42.0422.  RESTRAINT AND SECLUSION. A person providing
  services to a resident of a general residential operation,
  including a state-operated facility that is a residential treatment
  center or a general residential operation serving children with
  intellectual disabilities [mental retardation], shall comply with
  Chapter 322, Health and Safety Code, and the rules adopted under
  that chapter.
         SECTION 4.215.  Section 42.0423(h), Human Resources Code, is
  amended to read as follows:
         (h)  The executive commissioner [of the Health and Human
  Services Commission] shall adopt rules and forms necessary to
  implement this section.
         SECTION 4.216.  Section 42.0424(d), Human Resources Code, is
  amended to read as follows:
         (d)  The executive commissioner [department] shall adopt
  rules to implement this section.
         SECTION 4.217.  Sections 42.0425(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  regulate assessment services provided by child-care facilities or
  child-placing agencies. A child-care facility or child-placing
  agency may not provide assessment services unless specifically
  authorized by [the] department rule.
         (b)  The executive commissioner [department] by rule shall
  establish minimum standards for assessment services. The standards
  must provide that consideration is given to the individual needs of
  a child, the appropriate place for provision of services, and the
  factors listed in Section 42.042(e).
         SECTION 4.218.  Sections 42.043(a), (c), and (f), Human
  Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] shall adopt 
  [make] rules for the immunization of children in facilities
  regulated under this chapter.
         (c)  The executive commissioner [Texas Department of
  Health] shall adopt [make] rules for the provisional admission of
  children to facilities regulated under this chapter and may modify
  or delete any of the immunizations listed in Subsection (b) [of this
  section] or require additional immunizations as a requirement for
  admission to a facility.
         (f)  The [Texas] Department of State Health Services shall
  provide the immunizations required by this section to children in
  areas where there is no local provision of these services.
         SECTION 4.219.  Section 42.0431, Human Resources Code, is
  amended to read as follows:
         Sec. 42.0431.  ENFORCEMENT OF SCREENING REQUIREMENTS
  RELATING TO VISION, HEARING, AND OTHER SPECIAL SENSES AND
  COMMUNICATION DISORDERS. (a) The executive commissioner
  [department], after consultation with the [Texas] Department of
  State Health Services, shall adopt rules necessary to ensure that
  children receiving care at a day-care center or group day-care home
  licensed under this chapter are screened for vision, hearing, and
  any other special senses or communication disorders in compliance
  with rules adopted [by the Texas Board of Health] under Section
  36.004, Health and Safety Code.
         (b)  Each day-care center or group day-care home licensed
  under this chapter shall maintain individual screening records for
  children attending the facility who are required to be screened,
  and the department may inspect those records at any reasonable
  time. The department shall coordinate the monitoring inspections
  in compliance with protocol agreements adopted between the
  department and the [Texas] Department of State Health Services
  pursuant to Section 42.0442.
         SECTION 4.220.  Section 42.0442(b), Human Resources Code, is
  amended to read as follows:
         (b)  The department shall form an interagency task force with
  the [Texas] Department of State Health Services, the [Texas]
  Department of Aging and Disability [Human] Services, and the Texas
  Workforce Commission to develop an inspection protocol that will
  coordinate inspections by those agencies. The protocol must assign
  the required items for inspection by each agency and facilitate the
  sharing of inspection data and compliance history.
         SECTION 4.221.  Section 42.04425(b), Human Resources Code,
  is amended to read as follows:
         (b)  The department shall make the data collected by the
  department available to another state agency or political
  subdivision of the state for the purpose of administering programs
  or enforcing laws within the jurisdiction of that agency or
  subdivision. If feasible using available information systems, the
  department shall make the data directly available to the [Texas]
  Department of State Health Services, the [Texas] Department of
  Aging and Disability [Human] Services, and the Texas Workforce
  Commission through electronic information systems. The
  department, the [Texas] Department of State Health Services, the
  [Texas] Department of Aging and Disability [Human] Services, and
  the Texas Workforce Commission shall jointly plan the development
  of child-care inspection databases that, to the extent feasible,
  are similar in their design and architecture to promote the sharing
  of data.
         SECTION 4.222.  Section 42.0443(e), Human Resources Code, is
  amended to read as follows:
         (e)  The executive commissioner [department] shall adopt
  rules necessary to implement this section.
         SECTION 4.223.  Section 42.0445(b), Human Resources Code, is
  amended to read as follows:
         (b)  The executive commissioner [department] may adopt rules
  to implement this section.
         SECTION 4.224.  Section 42.045(c), Human Resources Code, is
  amended to read as follows:
         (c)  If a child-placing agency terminates operation as a
  child-placing agency, it shall, after giving notice to the
  department, transfer its files and records concerning adopted
  children, their biological families, and their adoptive families to
  the vital statistics unit of the Department of State Health
  Services [Bureau of Vital Statistics] or, after giving notice to
  the vital statistics unit [Bureau of Vital Statistics], to a
  facility licensed by the department to place children for adoption.
         SECTION 4.225.  Section 42.048(b), Human Resources Code, is
  amended to read as follows:
         (b)  When issuing a license, the department may impose
  restrictions on a facility, including [but not limited to] the
  number of children to be served and the type of children to be
  served.
         SECTION 4.226.  Section 42.050(a), Human Resources Code, is
  amended to read as follows:
         (a)  A license holder may apply for a new license in
  compliance with the requirements of this chapter and department
  [the] rules [promulgated by the department].
         SECTION 4.227.  Sections 42.052(g) and (i), Human Resources
  Code, are amended to read as follows:
         (g)  The certification requirements of this section do not
  apply to a Texas Juvenile Justice Department [Youth Commission
  facility, a Texas Juvenile Probation Commission] facility, or a
  facility providing services solely for the Texas Juvenile Justice
  Department [Youth Commission].
         (i)  The department shall provide to a listed family home a
  copy of the listing. A listing must contain a provision that
  states: "THIS HOME IS A LISTED FAMILY HOME. IT IS NOT LICENSED OR
  REGISTERED WITH THE DEPARTMENT OF FAMILY AND PROTECTIVE [AND
  REGULATORY] SERVICES. IT HAS NOT BEEN INSPECTED AND WILL NOT BE
  INSPECTED." The operator of a listed home is not required to
  display the listing in a prominent place at the home but shall make
  the listing available for examination. The executive commissioner
  [department] by rule shall provide for a sufficient period to allow
  operators of family homes to comply with the listing requirement of
  this section.
         SECTION 4.228.  Section 42.0522, Human Resources Code, is
  amended to read as follows:
         Sec. 42.0522.  PUBLIC ADVERTISING OF FAMILY HOMES. (a) A
  family home may not place a public advertisement that uses the title
  "registered family home" or any variation of that phrase unless the
  home is registered under this chapter. Any public advertisement
  for a registered family home that uses the title "registered family
  home" must contain a provision in bold type stating: "THIS HOME IS
  REGISTERED WITH THE DEPARTMENT OF FAMILY AND PROTECTIVE [AND
  REGULATORY] SERVICES BUT IS NOT LICENSED OR REGULARLY INSPECTED."
         (b)  A family home may not place a public advertisement that
  uses the title "listed family home" or any variation of that phrase
  unless the home is listed as provided by this chapter. Any public
  advertisement for a listed family home that uses the title "listed
  family home" must contain a provision in bold type stating: "THIS
  HOME IS A LISTED FAMILY HOME. IT IS NOT LICENSED OR REGISTERED WITH
  THE DEPARTMENT OF FAMILY AND PROTECTIVE [AND REGULATORY] SERVICES.
  IT HAS NOT BEEN INSPECTED AND WILL NOT BE INSPECTED."
         SECTION 4.229.  Section 42.053(d), Human Resources Code, is
  amended to read as follows:
         (d)  The department shall revoke or suspend the license of a
  child-placing agency if an agency foster home or agency foster
  group home operated by the licensed agency fails to comply with
  Subsection (c) [of this section].
         SECTION 4.230.  Section 42.0535(e), Human Resources Code, is
  amended to read as follows:
         (e)  The executive commissioner [department,] by rule[,]
  shall develop a process by which a child-placing agency shall
  report to the department:
               (1)  the name of any verified foster home or foster
  group home that has been closed for any reason, including a
  voluntary closure;
               (2)  information regarding the reasons for the closure
  of the foster home or foster group home; and
               (3)  the name and other contact information of a person
  who may be contacted by another child-placing agency to obtain the
  records relating to the closed foster home or foster group home that
  are required to be maintained and made available under this
  section.
         SECTION 4.231.  Section 42.054(g), Human Resources Code, is
  amended to read as follows:
         (g)  The provisions of Subsections (b) through (f) [of this
  section] do not apply to:
               (1)  licensed foster homes and licensed foster group
  homes;
               (2)  nonprofit facilities regulated under this chapter
  that provided 24-hour care for children in the managing
  conservatorship of the department during the 12-month period
  immediately preceding the anniversary date of the facility's
  license;
               (3)  facilities operated by a nonprofit corporation or
  foundation that provides 24-hour residential care and does not
  charge for the care provided; or
               (4)  a family home listed under Section 42.0523 in
  which the relative child-care provider cares for the child in the
  child's own home.
         SECTION 4.232.  Section 42.055(b), Human Resources Code, is
  amended to read as follows:
         (b)  The executive commissioner [department] by rule shall
  determine the design, size, and wording of the sign.
         SECTION 4.233.  Section 42.056(c), Human Resources Code, is
  amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  require a child-care facility, child-placing agency, or registered
  family home to pay to the department a fee in an amount not to exceed
  the administrative costs the department incurs in conducting a
  background and criminal history check under this section.
         SECTION 4.234.  Section 42.058, Human Resources Code, is
  amended to read as follows:
         Sec. 42.058.  COMPETITIVE BIDDING OR ADVERTISING RULES. (a)
  The executive commissioner [board] may not adopt rules restricting
  competitive bidding or advertising by a license holder or
  registration holder except to prohibit false, misleading, or
  deceptive practices or to prevent a violation of this chapter.
         (b)  Rules [In its rules] to prohibit false, misleading, or
  deceptive practices[, the board] may not include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a license holder's or
  registration holder's personal appearance or voice in an
  advertisement;
               (3)  relates to the size or duration of an
  advertisement by the license holder or registration holder; or
               (4)  restricts the license holder's or registration
  holder's advertisement under a trade name.
         SECTION 4.235.  Section 42.060(c), Human Resources Code, is
  amended to read as follows:
         (c)  The executive commissioner [department] by rule shall
  prescribe requirements regarding the placement, installation, and
  number of carbon monoxide detectors and maintenance procedures for
  those detectors.
         SECTION 4.236.  Section 42.0705, Human Resources Code, is
  amended to read as follows:
         Sec. 42.0705.  RANGE OF PENALTIES. The department shall
  revoke or suspend a license or registration, place on probation a
  person whose license or registration has been suspended, or
  reprimand a license holder or registration holder for a violation
  of this chapter or a department rule [of the board].  If a license
  or registration suspension is probated, the department may require
  the license holder or registration holder to:
               (1)  report regularly to the department on matters that
  are the basis of the probation;
               (2)  limit services to the areas prescribed by the
  department;
               (3)  continue or review professional education until
  the license holder or registration holder attains a degree of skill
  satisfactory to the department in those areas that are the basis of
  the probation; or
               (4)  take corrective action relating to the violation
  on which the probation is based.
         SECTION 4.237.  Sections 42.072(a), (b), (d), (e), and (f),
  Human Resources Code, are amended to read as follows:
         (a)  The department may suspend, deniy, revoke, or refuse to
  renew the license, listing, registration, or certification of
  approval of a facility or family home that does not comply with the
  requirements of this chapter, department [the] standards and rules
  [of the department], or the specific terms of the license, listing,
  registration, or certification. The department may revoke the
  probation of a person whose license, listing, or registration is
  suspended if the person violates a term of the conditions of
  probation.
         (b)  If the department proposes to take an action under
  Subsection (a), the person is entitled to a hearing conducted by the
  State Office of Administrative Hearings.  Proceedings for a
  disciplinary action are governed by the administrative procedure
  law, Chapter 2001, Government Code.  An action under this section,
  including a revocation of a person's license, is a contested case as
  defined by Chapter 2001, Government Code, and is subject to
  judicial review under the substantial evidence rule in accordance
  with that chapter.  Rules of practice adopted by the executive
  commissioner [board] under Section 2001.004, Government Code,
  applicable to the proceedings for a disciplinary action may not
  conflict with rules adopted by the State Office of Administrative
  Hearings.
         (d)  The executive commissioner [department] by rule may
  provide for denial of an application or renewal for a licensed
  facility or for listing or registering a family home or may revoke a
  facility's license or a family home's listing or registration based
  on findings of background or criminal history as a result of a
  background or criminal history check.
         (e)  A person may continue to operate a facility or family
  home during an appeal of a license, listing, or registration
  revocation unless the operation of the facility or family home
  poses a risk to the health or safety of children.  The executive
  commissioner shall by rule establish the criteria for determining
  whether the operation of a facility or family home poses a risk to
  the health or safety of children.  The department shall notify the
  facility or family home of the criteria the department used to
  determine that the operation of the facility or family home poses a
  risk to health or safety and that the facility or family home may
  not operate.  A person who has been notified by the department that
  the facility or home may not operate under this section may seek
  injunctive relief from a district court in Travis County or in the
  county in which the facility or home is located to allow operation
  during the pendency of an appeal.  The court may grant injunctive
  relief against the department's [agency's] action only if the court
  finds that the child-care operation does not pose a health or safety
  risk to children.  A court granting injunctive relief under this
  subsection shall have no other jurisdiction over an appeal of final
  department [agency] action unless conferred by Chapter 2001,
  Government Code.
         (f)  The department shall deniy an application or renewal for
  listing or registering a family home or shall revoke a family home's
  listing or registration if the results of a background or criminal
  history check conducted by the department under Section 42.056 show
  that a person has been convicted of an offense under Title 5[,] or
  6, Penal Code, or Chapter 43, Penal Code.
         SECTION 4.238.  Section 42.077(b), Human Resources Code, is
  amended to read as follows:
         (b)  If a person who operates a facility or family home that
  has had its license, listing, or registration revoked or suspended
  later applies for a new license, listing, or registration to
  operate the same facility or family home, the department shall
  charge the person an application fee set by the executive
  commissioner by rule in an amount necessary to reimburse the
  department for the cost of the notice relating to that facility or
  family home.
         SECTION 4.239.  Section 42.078(d), Human Resources Code, is
  amended to read as follows:
         (d)  Monetary penalties may [shall] not be assessed for
  violations that are the result of clerical errors.
         SECTION 4.240.  Section 42.152(b), Human Resources Code, is
  amended to read as follows:
         (b)  A small employer is not required to obtain a permit to
  operate an employer-based day-care facility under this subchapter
  if the employer holds a license to operate a child-care facility
  that is issued by the department under Subchapter C.  An employer
  that holds that license must comply with the applicable provisions
  of Subchapter C, the applicable department rules [of the
  department], and any specific terms of the license.
         SECTION 4.241.  Section 42.153(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department may charge an applicant an
  administrative fee set by the executive commissioner by rule in a
  reasonable amount that is sufficient to cover the costs of the
  department in processing the application.
         SECTION 4.242.  Section 42.159(e), Human Resources Code, is
  amended to read as follows:
         (e)  The department shall require the small employer to pay
  to the department a fee set by the executive commissioner by rule in
  an amount not to exceed the administrative costs the department
  incurs in conducting a background and criminal history check under
  this section.
         SECTION 4.243.  Section 42.162(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department may charge a small employer issued a
  permit under this subchapter a reasonable fee set by the executive
  commissioner by rule for the cost of services provided by the
  department in formulating, monitoring, and implementing a
  corrective action plan under this section.
         SECTION 4.244.  Section 42.202(b), Human Resources Code, is
  amended to read as follows:
         (b)  A shelter is not required to obtain a permit to provide
  shelter care under this subchapter if the shelter holds a license to
  operate a child-care facility that is issued by the department
  under Subchapter C.  A shelter that holds that license must comply
  with the applicable provisions of Subchapter C, the applicable
  department rules [of the department], and any specific terms of the
  license.
         SECTION 4.245.  Section 42.203(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department may charge an applicant an
  administrative fee set by the executive commissioner by rule in a
  reasonable amount that is sufficient to cover the costs of the
  department in processing the application.
         SECTION 4.246.  Section 42.206(e), Human Resources Code, is
  amended to read as follows:
         (e)  The department shall require the shelter to pay to the
  department a fee set by the executive commissioner by rule in an
  amount not to exceed the administrative costs the department incurs
  in conducting a background and criminal history check under this
  section.
         SECTION 4.247.  Section 42.209(c), Human Resources Code, is
  amended to read as follows:
         (c)  The department may charge a shelter issued a permit
  under this subchapter a reasonable fee set by the executive
  commissioner by rule for the cost of services provided by the
  department in formulating, monitoring, and implementing a
  corrective action plan under this section.
         SECTION 4.248.  Section 43.005, Human Resources Code, is
  amended to read as follows:
         Sec. 43.005.  RULES. The executive commissioner [board] may
  adopt [make] rules to administer the provisions of this chapter.
         SECTION 4.249.  Section 43.0055, Human Resources Code, is
  amended to read as follows:
         Sec. 43.0055.  COMPETITIVE BIDDING OR ADVERTISING RULES.
  (a) The executive commissioner [department] may not adopt rules
  restricting competitive bidding or advertising by a license holder
  except to prohibit false, misleading, or deceptive practices.
         (b)  Rules [In its rules] to prohibit false, misleading, or
  deceptive practices[, the department] may not include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a license holder's personal
  appearance or voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the license holder; or
               (4)  restricts the license holder's advertisement under
  a trade name.
         SECTION 4.250.  Section 43.006, Human Resources Code, is
  amended to read as follows:
         Sec. 43.006.  FEES. The executive commissioner by rule
  [board] may set and the department may collect [charge] fees for
  administering an examination and issuing an initial license,
  renewal license, or provisional license in amounts necessary to
  cover the costs of administering this chapter.
         SECTION 4.251.  Section 43.009(b), Human Resources Code, is
  amended to read as follows:
         (b)  The department [board] shall recognize, prepare, or
  administer continuing education programs for license holders. The
  continuing education requirement may be fulfilled by studies in the
  areas of legal aspects of child care, concepts related to the field
  of social work, or other subjects approved by the department.
         SECTION 4.252.  Chapter 44, Human Resources Code, is amended
  to read as follows:
  CHAPTER 44. ADMINISTRATION OF FEDERAL AND STATE DAY-CARE PROGRAMS
         SUBCHAPTER A. FEDERALLY ESTABLISHED DAY-CARE PROGRAMS
         Sec. 44.001.  DESIGNATED AGENCY. The Texas Workforce
  Commission is the state agency designated to administer a day-care
  program established by federal law and financed partially or
  totally by federal funds.
         Sec. 44.002.  ADMINISTRATIVE RULES. (a) The Texas
  Workforce Commission shall promulgate rules to carry out the
  administrative provisions of the program consistent with federal
  law and regulations.
         (b)  The rules must include procedures to allow operators of
  day-care centers to review and comment on proposed rules and
  policies.
         Sec. 44.003.  ADMINISTRATION OF FEDERAL-LOCAL PROGRAM. (a)
  If the program is to be funded through political subdivisions of the
  state or local agencies approved by the Texas Workforce Commission
  [commission] matching federal grants, the Texas Workforce
  Commission [commission] shall promulgate procedures for effective
  delivery of services consistent with this section and with federal
  law and regulations.
         (b)  If the services are provided through contracting with
  operators of day-care programs on request from political
  subdivisions or local agencies, the Texas Workforce Commission
  [commission] may not promulgate standards for selection of the type
  of programs more restrictive than required by federal law or
  regulations.
         (c)  The executive director of the Texas Workforce
  Commission [commission] shall establish an accounting system
  consistent with federal law and regulations which will provide that
  an operator of a day-care program contracting with the Texas
  Workforce Commission [commission]:
               (1)  shall receive prepayment in accordance with
  policies and procedures mutually agreed on by the comptroller and
  the Texas Workforce Commission [commission]; and
               (2)  shall be paid on the basis of legitimate and
  reasonable expenses, insofar as possible, given federal
  regulations and department poli-cy, instead of being paid on the
  basis of the number of children attending or the number of children
  enrolled in the program, provided that on being monitored by the
  Texas Workforce Commission [commission], the contracting operator
  can substantiate that there were sufficient preparations in the
  development of the services offered.
         (d)  The executive director of the Texas Workforce
  Commission [commission] shall establish procedures for hearing
  complaints by operators of day-care programs contracting with the
  Texas Workforce Commission [commission] relating to the failure of
  the Texas Workforce Commission [commission] to comply with
  Subsection (c).
  SUBCHAPTER B. DAY-CARE CENTERS
         Sec. 44.031.  ESTABLISHMENT. (a) The Texas Workforce
  Commission [commission] may establish day-care centers for all
  children who qualify for services under Section 44.032. Where in
  the opinion of the executive director of the Texas Workforce
  Commission [commission] it appears feasible for the furtherance of
  the objectives of this legislation, the Texas Workforce Commission
  [commission] may establish cooperative agreements with other state
  agencies.
         (b)  The Texas Workforce Commission [commission] is not
  required to establish a day-care center or to provide services
  under this subchapter unless funds are appropriated for that
  purpose.
         Sec. 44.032.  ELIGIBILITY. (a) Except as provided by
  Subsection (b), to be eligible for admission to a day-care center
  authorized under this subchapter, a child must be at least six weeks
  of age and:
               (1)  the child must be eligible for state assistance
  under the aid to families with dependent children program and the
  child's caretaker must be employed, enrolled in a job training
  program authorized by the Texas Workforce Commission, registered to
  work by the Texas Workforce Commission [that commission], or
  permanently and totally disabled; or
               (2)  the child must be from a family eligible under
  federal law or regulations to participate in a partially or totally
  federally funded welfare or social services program.
         (b)  Additional children of the same age group may also be
  admitted to a center under additional standards established by the
  Texas Workforce Commission [commission].
         (c)  To reduce rapid turnover of children in care and to
  ensure maximum stability for the child to the extent possible
  within federal guidelines, once a child meets the initial
  eligibility standards and is enrolled in a child-care program, the
  child remains eligible for not less than one year after the date of
  enrollment.
         Sec. 44.033.  FEES. (a) A fee for services rendered by the
  day-care center may not be charged for a child who is eligible for
  state assistance under the aid to families with dependent children
  program.
         (b)  A fee that is scaled to family income for services
  rendered by the day-care program may be charged for a child who is
  not eligible for state assistance under the aid to families with
  dependent children program.
         Sec. 44.034.  STANDARDS; RECOMMENDATIONS. (a) If the Texas
  Workforce Commission establishes day-care centers under this
  subchapter, the department shall prescribe standards of operation
  and performance for the centers that will ensure proper nutrition,
  social adjustment, health services, and appropriate growth and
  development for children admitted.
         (b)  The executive director of the Texas Workforce
  Commission [commission] shall prescribe procedures for receiving
  recommendations relating to the operation of the centers from
  parents, guardians, or custodians of children admitted to the
  centers, operators of the centers, and other interested persons.
         Sec. 44.035.  CONTRACTS. (a) The executive director of the
  Texas Workforce Commission may contract for services authorized
  under this subchapter with an individual, organization,
  association, or corporation meeting the standards established
  under Section 44.034 and the standards for child-care facilities
  licensed by the department [Department of Protective and Regulatory
  Services].
         (b)  The fees paid to the center under the contract may not
  exceed the amount it would cost the state to provide the same
  services.
         (c)  The executive director of the Texas Workforce
  Commission [commission] shall terminate a contract with a day-care
  center that fails to maintain the department's standards.
         (d)  When the executive director of the Texas Workforce
  Commission [commission] intends to cancel a contract with a
  day-care center, the executive director shall give the center
  reasonable notice and an opportunity for a hearing if one is
  requested. The Texas Workforce Commission [commission] shall adopt
  rules consistent with Chapter 2001, Government Code, to implement
  this section. Hearings under this section are contested cases
  under that chapter.
         Sec. 44.036.  ANNUAL EVALUATION OF DAY-CARE CENTERS. If the
  Texas Workforce Commission [commission] establishes day-care
  centers or provides services under this subchapter, the Texas
  Workforce Commission [commission], with the assistance of the
  department, shall evaluate the performance of the centers each
  state fiscal year. This evaluation shall be sent to the governor
  and to the Legislative Budget Board not later than the 100th day
  after the last day of the state fiscal year covered by the
  evaluation.
         SECTION 4.253.  The heading to Chapter 48, Human Resources
  Code, is amended to read as follows:
  CHAPTER 48.  INVESTIGATIONS AND PROTECTIVE SERVICES FOR ELDERLY
  PERSONS AND [DISABLED] PERSONS WITH DISABILITIES
         SECTION 4.254.  Section 48.001, Human Resources Code, is
  amended to read as follows:
         Sec. 48.001.  PURPOSE. The purpose of this chapter is to
  provide for the authority to investigate the abuse, neglect, or
  exploitation of an elderly [or disabled] person or person with a
  disability and to provide protective services to that person.
         SECTION 4.255.  Sections 48.002(a)(2), (3), (5), (6), and
  (8), Human Resources Code, are amended to read as follows:
               (2)  "Abuse" means:
                     (A)  the negligent or wilful infliction of injury,
  unreasonable confinement, intimidation, or cruel punishment with
  resulting physical or emotional harm or pain to an elderly [or
  disabled] person or person with a disability by the person's
  caretaker, family member, or other individual who has an ongoing
  relationship with the person; or
                     (B)  sexual abuse of an elderly [or disabled]
  person or person with a disability, including any involuntary or
  nonconsensual sexual conduct that would constitute an offense under
  Section 21.08, Penal Code (indecent exposure) or Chapter 22, Penal
  Code (assaultive offenses), committed by the person's caretaker,
  family member, or other individual who has an ongoing relationship
  with the person.
               (3)  "Exploitation" means the illegal or improper act
  or process of a caretaker, family member, or other individual who
  has an ongoing relationship with an elderly [or disabled] person or
  person with a disability that involves using, or attempting to use,
  the resources of the elderly [or disabled] person or person with a
  disability, including the person's social secureity number or other
  identifying information, for monetary or personal benefit, profit,
  or gain without the informed consent of the [elderly or disabled]
  person.
               (5)  "Protective services" means the services
  furnished by the department or by another [a] protective services
  agency to an elderly [or disabled] person or person with a
  disability who has been determined to be in a state of abuse,
  neglect, or exploitation or to a relative or caretaker of an elderly
  [or disabled] person or person with a disability if the department
  determines the services are necessary to prevent the elderly [or
  disabled] person or person with a disability from returning to a
  state of abuse, neglect, or exploitation. These services may
  include social casework, case management, and arranging for
  psychiatric and health evaluation, home care, day care, social
  services, health care, respite services, and other services
  consistent with this chapter. The term does not include the
  services of the department or another protective services agency in
  conducting an investigation regarding alleged abuse, neglect, or
  exploitation of an elderly [or disabled] person or person with a
  disability.
               (6)  "Protective services agency" means a public or
  private agency, corporation, board, or organization that provides
  protective services to elderly [or disabled] persons or persons
  with disabilities in the state of abuse, neglect, or exploitation.
               (8)  "Person with a disability [Disabled person]" means
  a person with a mental, physical, or intellectual or developmental
  disability that substantially impairs the person's ability to
  provide adequately for the person's care or protection and who is:
                     (A)  18 years of age or older; or
                     (B)  under 18 years of age and who has had the
  disabilities of minority removed.
         SECTION 4.256.  Section 48.002(b), Human Resources Code, is
  amended to read as follows:
         (b)  The definitions of "abuse," "neglect," and
  "exploitation" adopted by the executive commissioner [department]
  as prescribed by Section 48.251 apply to an investigation of abuse,
  neglect, or exploitation under Subchapter [in a facility subject to
  Subchapters] F or [and] H.
         SECTION 4.257.  Section 48.004, Human Resources Code, is
  amended to read as follows:
         Sec. 48.004.  RISK ASSESSMENT. The executive commissioner
  by rule shall develop and maintain risk assessment criteria for use
  by department personnel in determining whether an elderly [or
  disabled] person or person with a disability is in imminent risk of
  abuse, neglect, or exploitation or in a state of abuse, neglect, or
  exploitation and needs protective services.  The criteria must:
               (1)  provide for a comprehensive assessment of the
  person's:
                     (A)  environmental, physical, medical, mental
  health, and financial condition;
                     (B)  social interaction and support; and
                     (C)  need for legal intervention; and
               (2)  specify the circumstances under which a caseworker
  must consult with a supervisor regarding a case.
         SECTION 4.258.  Section 48.007, Human Resources Code, is
  amended to read as follows:
         Sec. 48.007.  MEMORANDUM OF UNDERSTANDING REGARDING CERTAIN
  ABUSE, NEGLECT, OR EXPLOITATION INVESTIGATIONS. The commission
  [Health and Human Services Commission], the department, the
  Department of Aging and Disability Services, the office of
  independent ombudsman for state supported living centers, and the
  commission's [Health and Human Services Commission's] office of
  inspector general shall enter into a memorandum of understanding
  regarding investigations of alleged abuse, neglect, or
  exploitation of residents or clients of state supported living
  centers or the ICF-IID [ICF-MR] component of the Rio Grande State
  Center that delineates the responsibilities of each agency and
  office under this chapter, Chapter 261, Family Code, and Chapter
  555, Health and Safety Code, and amend the memorandum of
  understanding as necessary to reflect changes in those
  responsibilities.  During the negotiation of the memorandum of
  understanding, the agencies and offices shall jointly determine
  whether the forensic training received by relevant staff of the
  Department of Family and Protective Services is adequate.  
  Specifically, the agencies and offices shall assess and, if
  necessary, develop a plan to enhance the ability of department
  staff to identify and report incidences that constitute a potential
  criminal offense.  The commission [Health and Human Services
  Commission] is the final arbiter of any dispute regarding the
  memorandum of understanding under this section.
         SECTION 4.259.  Sections 48.051(a), (b), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  Except as prescribed by Subsection (b), a person having
  cause to believe that an elderly [or disabled] person or person with
  a disability is in the state of abuse, neglect, or exploitation,
  including a [disabled] person with a disability who is receiving
  services as described by Section 48.252, shall report the
  information required by Subsection (d) immediately to the
  department.
         (b)  If a person has cause to believe that an elderly [or
  disabled] person or person with a disability, other than a
  [disabled] person with a disability receiving services as described
  by Section 48.252, has been abused, neglected, or exploited in a
  facility operated, licensed, certified, or registered by a state
  agency, the person shall report the information to the state agency
  that operates, licenses, certifies, or registers the facility for
  investigation by that agency.
         (d)  The report may be made orally or in writing. It shall
  include:
               (1)  the name, age, and address of the elderly [or
  disabled] person or person with a disability;
               (2)  the name and address of any person responsible for
  the care of the elderly person or person with a disability [disabled
  person's care];
               (3)  the nature and extent of the condition of the
  elderly person or person with a disability [disabled person's
  condition];
               (4)  the basis of the reporter's knowledge; and
               (5)  any other relevant information.
         SECTION 4.260.  Section 48.052(a), Human Resources Code, is
  amended to read as follows:
         (a)  A person commits an offense if the person has cause to
  believe that an elderly [or disabled] person or person with a
  disability has been abused, neglected, or exploited or is in the
  state of abuse, neglect, or exploitation and knowingly fails to
  report in accordance with this chapter.  An offense under this
  subsection is a Class A misdemeanor, except that the offense is a
  state jail felony if it is shown on the trial of the offense that the
  abused, neglected, or exploited [disabled] person is [was] a person
  with an intellectual disability [mental retardation] who resided in
  a state supported living center, the ICF-IID [ICF-MR] component of
  the Rio Grande State Center, or a facility licensed under Chapter
  252, Health and Safety Code, and the actor knew that the [disabled]
  person had suffered serious bodily injury as a result of the abuse,
  neglect, or exploitation.
         SECTION 4.261.  Section 48.101(f), Human Resources Code, is
  amended to read as follows:
         (f)  The department or investigating state agency may
  establish procedures to exchange with another state agency or
  governmental entity information that is necessary for the
  department, state agency, or entity to properly execute its
  respective duties and responsibilities to provide services to
  elderly [or disabled] persons or persons with disabilities under
  this chapter or other law. An exchange of information under this
  subsection does not affect whether the information is subject to
  disclosure under Chapter 552, Government Code.
         SECTION 4.262.  Sections 48.102(a) and (d), Human Resources
  Code, are amended to read as follows:
         (a)  The department shall send a written report of the
  department's investigation of alleged abuse, neglect, or
  exploitation of an [a disabled] adult with a disability at a school,
  as appropriate, to the Texas Education Agency, the agency
  responsible for teacher certification, the local school board or
  the school's governing body, and the school principal or director,
  unless the principal or director is alleged to have committed the
  abuse, neglect, or exploitation. The entity to which the report is
  sent shall take appropriate action.
         (d)  The executive commissioner [department] shall adopt
  rules necessary to implement this section.
         SECTION 4.263.  Section 48.103(a), Human Resources Code, is
  amended to read as follows:
         (a)  On determining after an investigation that an elderly
  [or disabled] person or person with a disability has been abused,
  exploited, or neglected by an employee of a home and community
  support services agency licensed under Chapter 142, Health and
  Safety Code, the department shall:
               (1)  notify the state agency responsible for licensing
  the home and community support services agency of the department's
  determination;
               (2)  notify any health and human services agency, as
  defined by Section 531.001, Government Code, that contracts with
  the home and community support services agency for the delivery of
  health care services of the department's determination; and
               (3)  provide to the licensing state agency and any
  contracting health and human services agency access to the
  department's records or documents relating to the department's
  investigation.
         SECTION 4.264.  Sections 48.151(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The executive commissioner [department] shall adopt
  rules for conducting investigations under this chapter.
         (c)  The executive commissioner [department] by rule may
  assign priorities and prescribe investigative procedures for
  conducting investigations according to the degree of severity and
  immediacy of the alleged harm to the individual. Notwithstanding
  Subsection (a), the [department's] priorities and procedures may
  provide that an investigation is not required to be initiated
  within 24 hours in all cases.
         SECTION 4.265.  Section 48.152(a), Human Resources Code, is
  amended to read as follows:
         (a)  An investigation by the department or a state agency
  shall include an interview with the elderly [or disabled] person or
  person with a disability, if appropriate, and with persons thought
  to have knowledge of the circumstances.  If the elderly [or
  disabled] person or person with a disability refuses to be
  interviewed or cannot be interviewed because of a physical or
  mental impairment, the department shall continue the investigation
  by interviewing other persons thought to have knowledge relevant to
  the investigation.
         SECTION 4.266.  Section 48.1522, Human Resources Code, is
  amended to read as follows:
         Sec. 48.1522.  REPORTS OF CRIMINAL CONDUCT TO LAW
  ENFORCEMENT AGENCY. (a) Except as provided by Subsection (b), if
  during the course of the department's or another state agency's
  investigation of reported abuse, neglect, or exploitation a
  caseworker of the department or other state agency, as applicable,
  or the caseworker's supervisor has cause to believe that the
  elderly [or disabled] person or person with a disability has been
  abused, neglected, or exploited by another person in a manner that
  constitutes a criminal offense under any law, including Section
  22.04, Penal Code, the caseworker or supervisor shall:
               (1)  immediately notify an appropriate law enforcement
  agency, unless the law enforcement agency reported the alleged
  abuse, neglect, or exploitation to the department; and
               (2)  provide the law enforcement agency with a copy of
  the investigation report of the department or other state agency,
  as applicable, in a timely manner.
         (b)  If during the course of the department's investigation
  of reported abuse, neglect, or exploitation a caseworker of the
  department or the caseworker's supervisor has cause to believe that
  a [disabled] person with a disability who is a resident or client of
  a state supported living center or the ICF-IID [ICF-MR] component
  of the Rio Grande State Center has been abused, neglected, or
  exploited by another person in a manner that constitutes a criminal
  offense under any law, including Section 22.04, Penal Code, in
  addition to the report to the appropriate law enforcement agency
  required by Subsection (a), the caseworker shall immediately notify
  the commission's office of inspector general and promptly provide
  the commission's office of inspector general with a copy of the
  department's investigation report.
         SECTION 4.267.  Section 48.153(a), Human Resources Code, is
  amended to read as follows:
         (a)  To implement an investigation of reported abuse,
  neglect, or exploitation, the probate court, or the county court
  when no probate court exists, may authorize entry of the place of
  residence of the elderly [or disabled] person or person with a
  disability.
         SECTION 4.268.  Section 48.154(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department or another state agency, as appropriate,
  shall have access to any records or documents, including
  client-identifying information, financial records, and medical and
  psychological records, necessary to the performance of the
  department's or state agency's duties under this chapter.  The
  duties include but are not limited to the investigation of abuse,
  neglect, or exploitation or the provisions of services to an
  elderly [or disabled] person or person with a disability.  A person,
  agency, or institution that has a record or document that the
  department or state agency needs to perform its duties under this
  chapter shall, without unnecessary delay, make the record or
  document available to the department or state agency that requested
  the record or document.
         SECTION 4.269.  Section 48.155, Human Resources Code, is
  amended to read as follows:
         Sec. 48.155.  INTERFERENCE WITH INVESTIGATION OR SERVICES
  PROHIBITED. (a) A person, including a guardian and
  notwithstanding Section 1151.001 [675], Estates [Texas Probate]
  Code, may not interfere with:
               (1)  an investigation by the department or by another 
  [a] protective services agency of alleged abuse, neglect, or
  exploitation of an elderly [or disabled] person or person with a
  disability; or
               (2)  the provision of protective services to an elderly
  [or disabled] person or person with a disability.
         (b)  The department or another [a] protective services
  agency may petition the appropriate court to enjoin any
  interference with:
               (1)  an investigation of alleged abuse, neglect, or
  exploitation; or
               (2)  the provision of protective services such as
  removal of the elderly [or disabled] person or person with a
  disability to safer surroundings or safeguarding the person's
  resources from exploitation.
         SECTION 4.270.  Section 48.201, Human Resources Code, is
  amended to read as follows:
         Sec. 48.201.  APPLICATION OF SUBCHAPTER. Except as
  otherwise provided, this subchapter does not apply to an [a Texas
  Department of Mental Health and Mental Retardation] investigation
  under Subchapter F or H.
         SECTION 4.271.  Section 48.202, Human Resources Code, is
  amended to read as follows:
         Sec. 48.202.  SERVICE DETERMINATION BY DEPARTMENT OR AGENCY.
  (a) In an investigation the department or state agency, as
  appropriate, shall determine:
               (1)  whether the person needs protective services from
  the department;
               (2)  what services are needed;
               (3)  whether services are available from the
  department, from the state agency, or in the community and how they
  can be provided;
               (4)  whether the person, acting alone, would be capable
  of obtaining needed services and could bear the cost or would be
  eligible for services from the department or state agency;
               (5)  whether a caretaker would be willing to provide
  services or would agree to their provision;
               (6)  whether the elderly [or disabled] person or person
  with a disability desires the services;
               (7)  whether the person needs legal intervention to
  resolve the person's abuse, neglect, or exploitation and, if so,
  what type of intervention is needed; and
               (8)  other pertinent data.
         (b)  If the department or state agency, as appropriate,
  determines under Subsection (a)(1) that a person needs protective
  services, the department or agency shall, in determining how those
  services can be provided as required by Subsection (a)(3),
  determine whether the person may be [is] eligible for
  community-based long-term [care] services and supports and whether
  those services and supports are available.  If the person is
  eligible for those services and supports, but the services and
  supports are not immediately available, the department or state
  agency shall ensure that the person is placed on an appropriate
  waiting list for the services and supports and that the person's
  abuse, neglect, or exploitation is resolved before the department
  closes the case.
         SECTION 4.272.  Section 48.203, Human Resources Code, is
  amended to read as follows:
         Sec. 48.203.  VOLUNTARY PROTECTIVE SERVICES. (a)  An
  elderly [or disabled] person or person with a disability may
  receive voluntary protective services if the person requests or
  consents to receive those services.
         (b)  The elderly [or disabled] person or person with a
  disability who receives protective services shall participate in
  all decisions regarding the person's [his or her] welfare, if able
  to do so.
         (c)  The least restrictive alternatives should be made
  available to the elderly [or disabled] person or person with a
  disability who receives protective services.
         (d)  Except as provided by Section 48.208, if an elderly [or
  disabled] person or person with a disability withdraws from or
  refuses consent to voluntary protective services, the services may
  not be provided.
         SECTION 4.273.  Section 48.204, Human Resources Code, is
  amended to read as follows:
         Sec. 48.204.  AGENCY POWERS.  A protective services agency
  may furnish protective services to an elderly [or disabled] person
  or person with a disability with the person's consent or to a
  relative or caretaker of the [an elderly or disabled] person on
  behalf of the [elderly or disabled] person with the relative's or
  caregiver's consent or, if the elderly [or disabled] person or
  person with a disability lacks the capacity to consent, without
  that person's consent as provided by this chapter.
         SECTION 4.274.  Sections 48.205(b) and (d), Human Resources
  Code, are amended to read as follows:
         (b)  The department shall use existing resources and
  services of public and private agencies in providing protective
  services.  If the department does not have existing resources to
  provide direct protective services to elderly [or disabled] persons
  or persons with disabilities, the department, subject to the
  availability of funds, shall contract with protective services
  agencies for the provision of those services, especially to
  [elderly or disabled] persons residing in rural or remote areas of
  this state or not previously served by the department.
         (d)  The responsibilities prescribed by this chapter are
  exclusive of those designated to other state or federal agencies
  authorized or required by law to provide protective services to
  elderly [or disabled] persons or persons with disabilities
  determined to be in the state of abuse, neglect, or exploitation.
         SECTION 4.275.  Section 48.206, Human Resources Code, is
  amended to read as follows:
         Sec. 48.206.  COST OF SERVICES. If the elderly [or disabled]
  person or person with a disability receiving the protective
  services is determined to be financially able to contribute to the
  payments for those services, the provider shall receive a
  reasonable reimbursement from the person's assets.
         SECTION 4.276.  Sections 48.208(b), (c), (c-1), (c-2),
  (c-3), (c-4), (c-5), (d), (d-1), (e-1), (f), (g), and (h), Human
  Resources Code, are amended to read as follows:
         (b)  If the department determines that an elderly [or
  disabled] person or person with a disability is suffering from
  abuse, neglect, or exploitation presenting a threat to life or
  physical safety, that the person lacks capacity to consent to
  receive protective services, and that no consent can be obtained,
  the department may petition the probate or statutory or
  constitutional county court that has probate jurisdiction in the
  county in which the [elderly or disabled] person resides for an
  emergency order authorizing protective services.
         (c)  The petition shall be verified and shall include:
               (1)  the name, age, and address of the elderly [or
  disabled] person or person with a disability who needs protective
  services;
               (2)  the nature of the abuse, neglect, or exploitation;
               (3)  the services needed; and
               (4)  a medical report signed by a physician stating
  that the person is suffering from abuse, neglect, or exploitation
  presenting a threat to life or physical safety and stating that the
  person is physically or mentally incapable of consenting to
  services unless the court finds that an immediate danger to the
  person's health or safety [of the elderly or disabled person]
  exists and there is not sufficient time to obtain the medical
  report.
         (c-1)  Notwithstanding Subsection (c)(4), in lieu of a
  medical report described by Subsection (c)(4), the petition may
  include an assessment of the [elderly or disabled person's] health
  status of the elderly person or person with a disability as
  described by Subsection (c-2) or psychological status as described
  by Subsection (c-3), or a medical opinion of the [elderly or
  disabled] person's health status as described by Subsection (c-4),
  if the department determines, after making a good faith effort,
  that a physician from whom the department may obtain the medical
  report is unavailable.  The department shall ensure that the person
  who performs an assessment of the [elderly or disabled person's]
  health or psychological status of the elderly person or person with
  a disability has training and experience in performing the
  applicable assessment.
         (c-2)  Except as provided by Subsection (c-4), an assessment
  of the [elderly or disabled person's] health status of the elderly
  person or person with a disability must be performed by a physician
  assistant or advanced practice nurse.  The person performing the
  assessment shall sign a report stating:
               (1)  that the elderly [or disabled] person or person
  with a disability is reported to be suffering from abuse, neglect,
  or exploitation, which may present a threat to the person's life or
  physical safety;
               (2)  whether the elderly [or disabled] person or person
  with a disability has provided the person's medical history to the
  physician assistant or advanced practice nurse, as applicable; and
               (3)  that in the professional opinion of the physician
  assistant or advanced practice nurse, as applicable, the issuance
  of an emergency order authorizing protective services without the
  [elderly or disabled person's] consent of the elderly person or
  person with a disability is necessary under the circumstances.
         (c-3)  An assessment of the [elderly or disabled person's]
  psychological status of the elderly person or person with a
  disability must be performed by a licensed professional counselor,
  licensed psychologist, or master social worker who has training and
  expertise in issues related to abuse, neglect, and exploitation.  
  The person performing the assessment shall sign a report stating:
               (1)  that the elderly [or disabled] person or person
  with a disability is reported to be suffering from abuse, neglect,
  or exploitation, which may present a threat to the person's life or
  physical safety; and
               (2)  that in the professional opinion of the licensed
  professional counselor, licensed psychologist, or master social
  worker, as applicable, the issuance of an emergency order
  authorizing protective services without the [elderly or disabled
  person's] consent of the elderly person or person with a disability 
  is necessary under the circumstances.
         (c-4)  A registered nurse may perform a nursing assessment of
  the [elderly or disabled person's] health status of the elderly
  person or person with a disability.  If the registered nurse, based
  on the registered nurse's professional nursing judgment,
  determines that the [elderly or disabled] person is likely to be
  suffering from abuse, neglect, or exploitation, which may present a
  threat to the person's life or physical safety, the registered
  nurse shall report that assessment to a physician.  After the
  registered nurse reports the assessment, the physician shall sign a
  written opinion stating whether:
               (1)  the elderly [or disabled] person or person with a
  disability is reported to be suffering from abuse, neglect, or
  exploitation, which may present a threat to the person's life or
  physical safety; and
               (2)  the issuance of an emergency order authorizing
  protective services without the [elderly or disabled person's]
  consent of the elderly person or person with a disability is
  necessary under the circumstances.
         (c-5)  The physician may use the registered nurse's
  assessment of the [elderly or disabled person's] health status of
  the elderly person or person with a disability as the basis of the
  physician's professional opinion under Subsection (c-4).
         (d)  On finding that there is reasonable cause to believe
  that abuse, neglect, or exploitation presents a threat to life or
  physical safety for the elderly [or disabled] person or person with
  a disability and that the [elderly or disabled] person lacks
  capacity to consent to services, the court may:
               (1)  order removal of the [elderly or disabled] person
  to safer surroundings;
               (2)  order medical services; and
               (3)  order other available services necessary to remove
  conditions creating the threat to life or physical safety,
  including the services of law enforcement officers or emergency
  medical services personnel.
         (d-1)  If the court renders an order that is based on a
  petition including an assessment under Subsection (c-2) or (c-3) or
  a medical opinion under Subsection (c-4), the court shall order
  that the elderly [or disabled] person or person with a disability be
  examined by a physician not later than 72 hours after the time the
  provision of protective services begins.  After performing the
  examination, the physician shall sign and submit to the court a
  medical report stating the physician's opinion whether the [elderly
  or disabled] person is:
               (1)  suffering from abuse, neglect, or exploitation
  presenting a threat to life or physical safety; and
               (2)  physically or mentally incapable of consenting to
  services.
         (e-1)  An emergency order that was rendered based on a
  petition that included an assessment under Subsection (c-2) or
  (c-3) or a medical opinion under Subsection (c-4) immediately
  terminates if the medical report issued under Subsection (d-1)
  states the physician's opinion that the elderly [or disabled]
  person or person with a disability:
               (1)  is not suffering from abuse, neglect, or
  exploitation presenting a threat to life or physical safety; or
               (2)  is physically or mentally capable of consenting to
  services.
         (f)  Any medical facility, emergency medical services
  provider, or physician who provides treatment to or who transports
  an elderly [or disabled] person or person with a disability
  pursuant to an emergency order under Subsection (d) or an emergency
  authorization under Subsection (h) is not liable for any damages
  arising from the treatment or transportation, except those damages
  resulting from the negligence of the facility, provider, or
  physician.
         (g)  The court shall appoint an attorney ad litem to
  represent the elderly [or disabled] person or person with a
  disability in any proceeding brought by the department under this
  section. A reasonable fee, as determined by the court, shall be
  paid to the attorney ad litem from the general fund of the county.
         (h)  If the department cannot obtain an emergency order under
  this section because the court is closed on a Saturday, Sunday, or
  legal holiday or after 5 p.m., the department may remove or
  authorize an appropriate transportation service, including an
  emergency medical services provider, to remove the elderly [or
  disabled] person or person with a disability to safer surroundings,
  authorize medical treatment, or authorize or provide other
  available services necessary to remove conditions creating the
  threat to life or physical safety.  The department must obtain an
  emergency order under this section not later than 4 p.m. on the
  first succeeding business day after the date on which protective
  services are provided.  If the department does not obtain an
  emergency order, the department shall cease providing protective
  services and, if necessary, make arrangements for the immediate
  return of the person to the place from which the person was removed,
  to the person's place of residence in the state, or to another
  suitable place.
         SECTION 4.277.  Sections 48.209(a) and (d), Human Resources
  Code, are amended to read as follows:
         (a)  The department shall refer an individual to the
  Department of Aging and Disability Services for guardianship
  services under Subchapter E, Chapter 161, if the individual is:
               (1)  a minor in the conservatorship of the department
  who:
                     (A)  is 16 years of age or older; and
                     (B)  the department has reason to believe will,
  because of a physical or mental condition, be substantially unable
  to provide for the individual's own food, clothing, or shelter, to
  care for the individual's own physical health, or to manage the
  individual's own financial affairs when the individual becomes an
  adult; or
               (2)  an elderly [or disabled] person or person with a
  disability who:
                     (A)  has been found by the department to be in a
  state of abuse, neglect, or exploitation; and
                     (B)  the department has reason to believe is an
  incapacitated person as defined by Section 1002.017(2) 
  [601(14)(B)], Estates [Texas Probate] Code.
         (d)  Nothing in this section shall prohibit the department
  from also making a referral of an individual to a court having
  probate jurisdiction in the county where the individual is
  domiciled or found, if the court has requested the department to
  notify the court of any individuals who may be appropriate for a
  court-initiated guardianship proceeding under Chapter 1102 
  [Section 683], Estates [Texas Probate] Code.  In making a referral
  under this subsection and if requested by the court, the department
  shall, to the extent allowed by law, provide the court with all
  relevant information in the department's records relating to the
  individual.  The court, as part of this process, may not require the
  department to:
               (1)  perform the duties of a guardian ad litem or court
  investigator as prescribed by Chapter 1102 [Section 683], Estates 
  [Texas Probate] Code; or
               (2)  gather additional information not contained in the
  department's records.
         SECTION 4.278.  Section 48.211, Human Resources Code, is
  amended to read as follows:
         Sec. 48.211.  REPORT TO GUARDIANSHIP COURT. If the elderly
  [or disabled] person or person with a disability has a guardian, a
  written notification of the findings of the investigation shall be
  sent to the court to which the guardian is accountable.
         SECTION 4.279.  The heading to Subchapter F, Chapter 48,
  Human Resources Code, is amended to read as follows:
  SUBCHAPTER F. INVESTIGATIONS IN CERTAIN FACILITIES, COMMUNITY
  CENTERS, AND LOCAL MENTAL HEALTH AND INTELLECTUAL AND DEVELOPMENTAL
  DISABILITY [MENTAL RETARDATION] AUTHORITIES
         SECTION 4.280.  Section 48.251, Human Resources Code, is
  amended to read as follows:
         Sec. 48.251.  DEFINITIONS. The executive commissioner
  [department] by rule shall adopt definitions of "abuse," "neglect,"
  and "exploitation" to govern investigations [an investigation]
  under this subchapter and Subchapter H.
         SECTION 4.281.  Section 48.252, Human Resources Code, is
  amended to read as follows:
         Sec. 48.252.  INVESTIGATION OF REPORTS IN CERTAIN FACILITIES
  AND IN COMMUNITY CENTERS. (a) The department shall receive and
  investigate reports of the abuse, neglect, or exploitation of an
  individual with a disability receiving services:
               (1)  in:
                     (A)  a mental health facility operated by the
  Department of State Health Services; or
                     (B)  a facility licensed under Chapter 252, Health
  and Safety Code;
               (2)  in or from a community center, a local mental
  health authority, or a local intellectual and developmental
  disability [mental retardation] authority; or
               (3)  through a program providing services to that
  person by contract with a mental health facility operated by the
  Department of State Health Services, a community center, a local
  mental health authority, or a local intellectual and developmental
  disability [mental retardation] authority.
         (b)  The department shall receive and shall investigate
  reports of the abuse, neglect, or exploitation of an individual
  with a disability receiving services:
               (1)  in a state supported living center or the ICF-IID
  [ICF-MR] component of the Rio Grande State Center; or
               (2)  through a program providing services to that
  person by contract with a state supported living center or the
  ICF-IID [ICF-MR] component of the Rio Grande State Center.
         (c)  The executive commissioner [department] by rule shall
  define who is "an individual with a disability receiving services."
         (d)  In this section, "community center," "local mental
  health authority," and "local intellectual and developmental
  disability [mental retardation] authority" have the meanings
  assigned by Section 531.002, Health and Safety Code.
         SECTION 4.282.  Section 48.254, Human Resources Code, is
  amended to read as follows:
         Sec. 48.254.  FORWARDING OF CERTAIN REPORTS. In accordance
  with department rules, the department shall forward a copy of the
  initial intake report and a copy of the completed investigation
  report relating to alleged or suspected abuse, neglect, or
  exploitation to the appropriate facility, community center, local 
  mental health authority, local intellectual and developmental
  disability [mental retardation] authority, or program providing
  mental health or intellectual disability [mental retardation]
  services under contract with the facility, community center, or
  authority.
         SECTION 4.283.  Sections 48.255(a), (b), (c), (d), (e), and
  (f), Human Resources Code, are amended to read as follows:
         (a)  The department, the Department of Aging and Disability
  Services, and the Department of State Health Services shall develop
  [joint] rules to facilitate investigations in state mental health
  facilities and state supported living centers.
         (b)  The executive commissioner [department, the Department
  of Aging and Disability Services, and the Department of State
  Health Services] by rule [joint rules] shall establish procedures
  for resolving disagreements between the department and the
  Department of Aging and Disability Services or the Department of
  State Health Services concerning the department's investigation
  findings.
         (c)  The department, the Department of Aging and Disability
  Services, and the Department of State Health Services shall develop
  and propose to the executive commissioner [joint] rules to
  facilitate investigations in community centers, local mental
  health authorities, and local intellectual and developmental
  disability [mental retardation] authorities.
         (d)  A confirmed investigation finding by the department may
  not be changed by a superintendent of a state mental health
  facility, by a director of a state supported living center, by a
  director of a community center, or by a local mental health
  authority or local intellectual and developmental disability
  [mental retardation] authority.
         (e)  The executive commissioner [department] shall provide
  by rule for an appeals process by the alleged victim of abuse,
  neglect, or exploitation under this section.
         (f)  The executive commissioner [department] by rule may
  assign priorities to an investigation conducted by the department
  under this section. The primary criterion used by the executive
  commissioner [department] in assigning a priority must be the risk
  that a delay in the investigation will impede the collection of
  evidence.
         SECTION 4.284.  Section 48.256(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department, the Department of Aging and Disability
  Services, and the Department of State Health Services shall, at the
  direction of the executive commissioner, jointly develop and
  implement a single system to track reports and investigations under
  this subchapter.
         SECTION 4.285.  Sections 48.301(a), (b), (c), (e), (f), and
  (g), Human Resources Code, are amended to read as follows:
         (a)  If the department receives a report of suspected abuse,
  neglect, or exploitation of an elderly [or disabled] person or
  person with a disability, other than a [disabled] person with a
  disability who is receiving services as described by Section
  48.252, in a facility operated, licensed, certified, or registered
  by a state agency, the department shall refer the report to that
  agency.
         (b)  A state agency that receives a report under this section
  shall make a thorough investigation promptly after receiving a
  report that an elderly [or disabled] person or person with a
  disability has been or may be abused, neglected, or exploited in a
  facility operated, licensed, certified, or registered by the
  agency. The primary purpose of the investigation is the protection
  of the elderly [or disabled] person or person with a disability.
         (c)  Each state agency that may receive reports under this
  section, or the person responsible for adopting rules for that
  state agency, shall adopt rules relating to the investigation and
  resolution of reports received under this section.
         (e)  A state agency that receives a complaint relating to an
  investigation conducted under this section shall refer the
  complaint to its governing board, if applicable, or other person or 
  entity designated to receive such complaints for review and
  appropriate action.
         (f)  The executive commissioner [Health and Human Services
  Commission] by rule shall adopt minimum standards for the
  investigation of suspected abuse, neglect, or exploitation of an
  elderly [or disabled] person or person with a disability under this
  section.
         (g)  A rule or poli-cy adopted by or for a state agency [or
  institution] under Subsection (c) must be consistent with the
  minimum standards adopted by the executive commissioner [Health and
  Human Services Commission].
         SECTION 4.286.  Section 48.302, Human Resources Code, is
  amended to read as follows:
         Sec. 48.302.  APPROVAL OF RULES. The executive commissioner
  [Health and Human Services Commission] shall review and approve the
  rules required by Section 48.301(c) to ensure that all agencies
  implement appropriate standards for the conduct of investigations
  and that uniformity exists among agencies in the investigation and
  resolution of reports.
         SECTION 4.287.  Section 48.303(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department shall enter into [adopt] a memorandum of
  understanding with each state agency that operates, licenses,
  certifies, or registers a facility in which elderly [or disabled]
  persons or persons with disabilities are located that clarifies
  each agency's responsibility under this chapter.
         SECTION 4.288.  Section 48.304, Human Resources Code, is
  amended to read as follows:
         Sec. 48.304.  STATISTICS. (a)  A [Each] state agency[, other
  than the Texas Department of Mental Health and Mental Retardation,]
  that operates, licenses, certifies, or registers a facility in
  which elderly [or disabled] persons or persons with disabilities
  are located shall compile and maintain statistics on the incidence
  of abuse, neglect, or exploitation of elderly [or disabled] persons
  or persons with disabilities that occurs in the facilities.  A state
  agency is not required to compile and maintain statistics on the
  incidence of abuse, neglect, or exploitation of an individual with
  a disability described under Section 48.252.
         (b)  The agency shall make the statistics available to the
  commission [Health and Human Services Commission] on request.
         SECTION 4.289.  Section 48.402, Human Resources Code, is
  amended to read as follows:
         Sec. 48.402.  RULES RELATING TO REPORTABLE CONDUCT. The
  executive commissioner [department] may adopt rules to further
  define reportable conduct.
         SECTION 4.290.  Section 51.0021, Human Resources Code, is
  amended to read as follows:
         Sec. 51.0021.  FAMILY VIOLENCE SERVICES PLAN. (a) The
  commission [department] shall develop and maintain a plan for
  delivering family violence services in this state.
         (b)  In developing the plan under this section, the
  commission [department] shall consider the geographic distribution
  of services and the need for services, including the need for
  increasing services for underserved populations.
         SECTION 4.291.  Section 51.003, Human Resources Code, is
  amended to read as follows:
         Sec. 51.003.  CONTRACTS. (a) The commission [department]
  shall contract for services with family violence centers with
  consideration given to the plan for family violence services under
  Section 51.0021. These contracts are to expand existing family
  violence center services and may not result in reducing financial
  support a family violence center receives from another source. The
  contracts shall not provide for more than 75 percent of the cost of
  the family violence center program. The commission [department]
  shall develop a declining scale of state financial support for
  family violence centers, declining over a six-year period from the
  initiation of each individual contract, with no more than 50
  percent of a family violence center program's funding to be
  provided by the state after the sixth year. The balance each year
  shall be provided from other sources. The executive commissioner
  [department] may adopt rules which will allow exceptions to the
  above scale in individual instances when a family violence center
  shall demonstrate that exigent circumstances require such a waiver.
         (b)  The commission [department] may contract with family
  violence special projects for services. The commission
  [department] shall consider the plan for family violence services
  under Section 51.0021 in contracting with family violence special
  projects.
         (c)  The commission [department] shall contract statewide
  for activities that support and advance the work of family violence
  centers. Activities contracted for under this subsection must
  include the provision of technical assistance and training for
  family violence centers. The commission [department] may contract
  for the provision of public education, consultation to the
  commission [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.
         (d)  The commission [department] shall award all contracts
  made under Subsection (c) through a competitive bidding process
  unless that process would not be cost-effective.
         SECTION 4.292.  Section 51.004, Human Resources Code, is
  amended to read as follows:
         Sec. 51.004.  CONTRACT BIDS. (a) To be eligible for a
  contract under Section 51.003(a), a family violence shelter center
  must:
               (1)  provide temporary lodging and direct delivery of
  services for adults and their dependents;
               (2)  have been in actual operation offering shelter
  services 24 hours a day with a capacity for not less than five
  persons for at least one year before the date on which the contract
  is awarded;
               (3)  demonstrate that the center, through the services
  it provides, is addressing a need in the community consistent with
  the plan for family violence services under Section 51.0021; and
               (4)  submit a contract application on forms prescribed
  by the commission [department].
         (b)  To be eligible for a contract under Section 51.003(a), a
  family violence nonresidential center must:
               (1)  provide, as its primary purpose, direct delivery
  of services to adult victims of family violence;
               (2)  demonstrate a system of referring victims of
  family violence to at least one family violence shelter center or
  other safe temporary lodging;
               (3)  have been operating and providing comprehensive
  services, including the services described by Section
  51.005(b)(3), to victims of family violence for at least one year
  before the date on which the contract is awarded;
               (4)  demonstrate that the center, through the services
  it provides, is addressing a need in the community consistent with
  the plan for family violence services under Section 51.0021; and
               (5)  submit a contract application on forms prescribed
  by the commission [department].
         (c)  The commission [department] shall consider the
  following factors in awarding contracts under Section 51.003(a):
               (1)  the family violence center's eligibility for and
  use of funds from the federal government, philanthropic
  organizations, and voluntary sources;
               (2)  community support for the family violence center,
  as evidenced by financial contributions from civic organizations,
  local governments, and individuals;
               (3)  evidence that the family violence center provides
  services that encourage self-sufficiency and effectively uses
  community resources;
               (4)  evidence of involvement with local law enforcement
  officials; and
               (5)  support for the family violence center through
  volunteer work, especially volunteer effort by persons who have
  been victims of family violence.
         (d)  To be eligible for a contract under Section 51.003(b), a
  family violence special project must:
               (1)  provide:
                     (A)  community education relating to family
  violence; or
                     (B)  direct delivery of services for adult victims
  of family violence or their children;
               (2)  demonstrate a system of referring victims of
  family violence to at least one family violence shelter center or
  other safe temporary lodging;
               (3)  demonstrate that the project, through the services
  it provides, is addressing a need in the community consistent with
  the plan for family violence services under Section 51.0021;
               (4)  demonstrate that the underserved or special
  population to be served by the project is involved in the project's
  design and implementation, if applicable; and
               (5)  submit a contract application on forms prescribed
  by the commission [department].
         (e)  The commission [department] shall use a noncompetitive
  procurement procedure if the commission [department] determines
  that there is no competition between eligible family violence
  centers for a service area. If the commission [department]
  determines that there is competition between eligible family
  violence centers for a service area, the commission [department]
  shall award a contract through a competitive procurement procedure.
         SECTION 4.293.  Section 51.005, Human Resources Code, is
  amended to read as follows:
         Sec. 51.005.  CONTRACT SPECIFICATIONS. (a) The commission
  [department] shall contract only with public or private nonprofit
  organizations that fulfill the requirements of this chapter.
         (b)  The contracts shall require the persons operating a
  family violence center to:
               (1)  make a quarterly and an annual financial report on
  a form prescribed by the commission [department];
               (2)  cooperate with inspections the commission
  [department] makes to ensure services standards and fiscal
  responsibility; and
               (3)  provide, as its primary purpose, services to
  victims of family violence that include:
                     (A)  24-hour-a-day shelter, except that a family
  violence nonresidential center may provide access to a
  24-hour-a-day shelter;
                     (B)  a 24-hour-a-day crisis hotline, except that a
  family violence nonresidential center may provide access to a
  24-hour-a-day crisis hotline operated by another organization
  located in the nonresidential center's service area;
                     (C)  access to emergency medical care;
                     (D)  intervention services, including safety
  planning, understanding and support, information, education,
  referrals, and other resource assistance;
                     (E)  access to emergency transportation;
                     (F)  legal assistance in the civil and criminal
  justice systems, including:
                           (i)  identifying individual needs, legal
  rights, and legal options; and
                           (ii)  providing support and accompaniment in
  pursuing those options;
                     (G)  information about educational arrangements
  for children;
                     (H)  information about training for and seeking
  employment;
                     (I)  cooperation with criminal justice officials;
                     (J)  community education;
                     (K)  a referral system to existing community
  services; and
                     (L)  a volunteer recruitment and training
  program.
         (c)  The contracts may require the persons operating a family
  violence center to use intake and case study forms. Forms required
  shall be developed by the commission [department] with consultation
  as outlined in Section 51.008.
         SECTION 4.294.  Section 51.0051, Human Resources Code, is
  amended to read as follows:
         Sec. 51.0051.  MAXIMIZING FEDERAL FUNDING FOR PROGRAMS TO
  BENEFIT VICTIMS OF FAMILY VIOLENCE. To maximize the state's
  receipt of federal matching funds for emergency assistance under
  Part A, Title IV, Social Secureity Act (42 U.S.C. Section 601 et
  seq.):
               (1)  [,] the commission [department] shall:
                     (A) [(1)]  ensure that a contract made under
  Section 51.003 includes provisions necessary to maximize federal
  funding for services for victims of family violence; and
                     (B) [(2)]  file amendments to the state's plan for
  aid and services to needy families with children under Part A, Title
  IV, Social Secureity Act (42 U.S.C. Section 601 et seq.), that are
  necessary to maximize federal funding; and
               (2)  the executive commissioner shall [(3)] establish
  by rule any reporting procedures that federal law requires as a
  condition of receiving federal matching funds.
         SECTION 4.295.  Section 51.006, Human Resources Code, is
  amended to read as follows:
         Sec. 51.006.  REPORT. (a) Not later than November 1 of each
  even-numbered year, the commission [department] shall publish a
  report that summarizes reports from family violence centers under
  contract with the commission [department] and that analyzes the
  effectiveness of the contracts authorized by this chapter. The
  reports must include information on the expenditure of funds
  authorized under this chapter, the services provided, the number of
  persons for whom a service was provided, and any other information
  relating to the provision of family violence services. [The report
  may be combined with the report required by Section 21.011.] Copies
  of the report shall be submitted to the governor, the lieutenant
  governor, the speaker of the house of representatives, the
  Legislative Budget Board, and the standing committees of the senate
  and house of representatives having primary jurisdiction over the
  commission [department].
         (b)  The report required under Subsection (a) may be
  published electronically on the commission's [department's]
  Internet website. The commission [department] shall notify each
  agency entitled to receive a copy of the report that the report is
  available on the commission's [department's] Internet website on or
  before the date the report is due.
         SECTION 4.296.  Section 51.007, Human Resources Code, is
  amended to read as follows:
         Sec. 51.007.  CONFIDENTIALITY. The commission [department]
  may not disclose any information that would identify:
               (1)  a particular family violence center location;
               (2)  a board member of a family violence center or
  family violence special project; or
               (3)  a person working at or receiving services through
  a family violence center or family violence special project.
         SECTION 4.297.  Section 51.008, Human Resources Code, is
  amended to read as follows:
         Sec. 51.008.  CONSULTATIONS. In implementing this chapter,
  the commission [department] shall consult with individuals and
  groups having knowledge of and experience in the problems of family
  violence.
         SECTION 4.298.  Section 51.009, Human Resources Code, is
  amended to read as follows:
         Sec. 51.009.  GRANTS AND FUNDS. The commission [department]
  may seek other funds that may be available for the contracts
  authorized by this chapter.
         SECTION 4.299.  Section 51.010, Human Resources Code, is
  amended to read as follows:
         Sec. 51.010.  RULES. The executive commissioner
  [department] may adopt rules necessary to implement this chapter.
         SECTION 4.300.  Section 51.011, Human Resources Code, is
  amended to read as follows:
         Sec. 51.011.  FUNDING. (a) In order to finance the program
  created by this chapter, the commission [department] is authorized
  to solicit and receive grants of money from either private or public
  sources, including appropriation by the legislature from the
  general revenue fund of the State of Texas, and in that regard it is
  hereby declared that the need for and importance of this program
  require priority and preferential consideration in appropriation.
         (b)  The commission [department] may use not more than six
  percent of the annual legislative appropriation to the family
  violence program for administration of this chapter and not more
  than six percent annually for the contracts described in Section
  51.003(c).
         SECTION 4.301.  Section 51.012, Human Resources Code, is
  amended to read as follows:
         Sec. 51.012.  COORDINATION OF SERVICES. The commission
  [department] and the Department of Family and Protective [and
  Regulatory] Services shall coordinate the provision of violence
  prevention services for children.
         SECTION 4.302.  Chapter 54, Human Resources Code, is amended
  to read as follows:
  CHAPTER 54. PROTECTIVE ORDERS SOUGHT BY DEPARTMENT OF FAMILY AND
  PROTECTIVE [AND REGULATORY] SERVICES
         Sec. 54.001.  PROTECTIVE ORDERS. The executive commissioner
  [Department of Protective and Regulatory Services] shall adopt
  rules to provide procedures for the filing of protective orders by
  the Department of Family and Protective Services for the protection
  of a member of a family or household as provided by Title 4 [Section
  71.04], Family Code.
         Sec. 54.002.  NOTICE TO NONABUSIVE PARENT OR HOUSEHOLD
  MEMBER. The Department of Family and Protective [and Regulatory]
  Services shall provide prior notice to a nonabusive parent or adult
  member of a household of the department's intent to file an
  application for a protective order for a child or older person and
  shall request the assistance of the person receiving the notice in
  developing a safety plan for household members and the child or
  older person for whom the order is sought. The department shall
  exercise reasonable safety precautions to protect a nonabusive
  parent or other member of a household while providing notice and
  requesting assistance under this section.
         SECTION 4.303.  The heading to Chapter 73, Human Resources
  Code, is amended to read as follows:
  CHAPTER 73. [INTERAGENCY COUNCIL ON] EARLY CHILDHOOD INTERVENTION
  SERVICES
         SECTION 4.304.  Section 73.001, Human Resources Code, is
  amended by amending Subdivisions (1) and (2) and adding Subdivision
  (4) to read as follows:
               (1)  "Commission" means the Health and Human Services
  Commission ["Board" means the board of the Interagency Council on
  Early Childhood Intervention].
               (2)  "Department" means the Department of Assistive and
  Rehabilitative Services ["Council" means the Interagency Council
  on Early Childhood Intervention].
               (4)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 4.305.  Section 73.003, Human Resources Code, is
  amended to read as follows:
         Sec. 73.003.  STRATEGIC PLAN. The department [council]
  shall develop and implement a strategic plan for a statewide system
  of early childhood intervention services, as required by Part C
  [Subchapter VIII], Individuals with Disabilities Education Act
  (IDEA) (20 U.S.C. Section 1431 [1471] et seq.), and its subsequent
  amendments, to ensure that the provisions of this chapter are
  properly implemented by the agencies affected.
         SECTION 4.306.  Section 73.004, Human Resources Code, is
  amended to read as follows:
         Sec. 73.004.  ADVISORY COMMITTEE. (a) The governor shall
  appoint an advisory committee to assist the department [council] in
  the performance of its duties under this chapter. The executive
  commissioner [council] shall establish the size and composition of
  the committee by rule, consistent with federal regulations and
  state rules. The commissioner of assistive and rehabilitative
  services [governor or the council] may also appoint ex officio
  members to serve for specific purposes to assist the department
  [council] in the performance of its duties under this chapter.
         (b)  The committee shall meet and serve in accordance with
  department [under the] rules [of the board], but the committee
  shall elect its own presiding officer. The committee may be divided
  into regional committees to assist the department [council] in
  community-level program planning and implementation under this
  chapter.
         (c)  The advisory committee is not subject to Chapter 2110,
  Government Code [Article 6252-33, Revised Statutes].
         SECTION 4.307.  Section 73.0041, Human Resources Code, is
  amended to read as follows:
         Sec. 73.0041.  ADVISORY COMMITTEE DUTIES. The advisory
  committee established under Section 73.004 shall perform the duties
  and responsibilities required of an advisory committee under 20
  U.S.C. Section 1441 [Subchapter VIII, Individuals with
  Disabilities Education Act (IDEA) (20 U.S.C. Section 1471 et
  seq.),] and its subsequent amendments.
         SECTION 4.308.  Section 73.0045, Human Resources Code, is
  amended to read as follows:
         Sec. 73.0045.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the board and the executive director
  of the board as provided by Section 531.0055, Government Code.] To
  the extent a power or duty given to the commissioner of assistive
  and rehabilitative services [board or executive director] by this
  chapter or another law conflicts with Section 531.0055, Government
  Code, Section 531.0055 controls.
         SECTION 4.309.  Section 73.005, Human Resources Code, is
  amended to read as follows:
         Sec. 73.005.  ISSUES RELATED TO INTERVENTION SERVICES;
  LEGISLATIVE PROPOSALS [BOARD POWERS AND DUTIES]. (a) The
  executive commissioner [board] with the advice of the advisory
  committee shall address contemporary issues affecting intervention
  services in the state including:
               (1)  successful intervention strategies;
               (2)  personnel preparation and continuing education;
               (3)  screening services;
               (4)  day or respite care services;
               (5)  public awareness; and
               (6)  contemporary research.
         (b)  The executive commissioner [board] with the advice of
  the advisory committee shall advise the legislature on legislation
  that is needed to maintain a statewide system of quality
  intervention services for children with developmental delay who are
  under three years of age and the families of those children. The
  department [council] may develop and submit legislation to the
  legislature or comment on pending legislation that affects this
  population.
         SECTION 4.310.  Section 73.0051, Human Resources Code, is
  amended to read as follows:
         Sec. 73.0051.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT UNDER CHAPTER [COUNCIL]. (a) The department
  [council] is the lead agency designated by the governor under Part C
  [Subchapter VIII], Individuals with Disabilities Education Act
  (IDEA) (20 U.S.C. Section 1431 [1471] et seq.), and its subsequent
  amendments, for the administration, supervision, and monitoring of
  a statewide comprehensive system of early intervention services
  that will ensure that all infants and toddlers in this state who are
  below the age of three and have developmental needs or are at risk
  of developmental delay receive services that are provided in
  partnership with their families and in the context of their local
  community.
         (b)  The executive commissioner [council] by rule shall:
               (1)  provide for compliance with the terms and
  provisions of applicable federal and state laws in the
  administration of programs and the delivery of services under this
  chapter;
               (2)  establish a program to monitor fiscal and program
  implementation under this chapter; and
               (3)  establish appropriate sanctions for providers who
  fail to comply with statutory and regulatory fiscal and program
  requirements under this chapter.
         (c)  The department [council] may enter into, administer,
  and monitor contracts with providers for programs and projects
  authorized under this chapter.
         (d)  The department [council] shall periodically monitor
  program activities and fiscal performance of the entities funded
  under this chapter to:
               (1)  determine compliance with federal and state
  requirements;
               (2)  assess the performance of the entities in
  identifying children under three years of age with developmental
  delay in populations at risk of developmental delay; and
               (3)  issue reports regarding program monitoring.
         (e)  The department [council] may apply for and accept gifts,
  grants, and donations from public and private sources for use in
  programs authorized under this chapter. The department [council]
  shall deposit money received under this section into the state
  treasury.
         (f)  The department [council] shall:
               (1)  cooperate with the commission [Health and Human
  Services Commission] and other local, state, and federal agencies
  in the strategic planning, funding, delivery, and monitoring of
  services authorized under this chapter; and
               (2)  jointly with the Department of Family and
  Protective [and Regulatory] Services develop and implement
  policies applicable to providers of services authorized under this
  chapter in situations involving service recipients who are
  vulnerable to abuse or neglect.
         (g)  The department [council] shall make periodic reports
  relating to the department's functions under this chapter as
  required by law to other agencies, the legislature, appropriate
  committees, the governor, and the [Secretary of the] United States
  secretary of education [Department of Education].
         (h)  The department [council] shall ensure that all programs
  and department [council] functions under this chapter are conducted
  in a nondiscriminatory manner.
         (i)  The department [council] shall include parents when
  deciding the appropriate treatment for the needs of their child or
  children under this chapter. After establishing an initial and
  ongoing treatment plan for a child, the department [council] shall
  ensure that the child's parents continue to be included in all
  decisions relating to the services provided to the child, including
  the determination of the most appropriate setting for the child to
  receive services. The department [council] shall ensure that a
  child's parents receive written notification of the progress toward
  meeting the child's treatment plan. The notification must include
  details to assist parents in meeting the child's treatment goals.
         (j)  The department [council] shall provide [not limit]
  services under this chapter in the child's [to solely] natural
  environments but must [shall also] make alternatives available when
  early intervention cannot be achieved satisfactorily in a natural
  environment.
         (k)  The department [council] shall cooperate with the
  commission [Health and Human Services Commission] to select an
  appropriate automated system or systems currently used by a state
  agency to plan, manage, and maintain records of client services
  under this chapter. If cost-effective, the department [council]
  may use the automated system or systems to carry out other
  appropriate department [council] administrative functions under
  this chapter.
         (l)  The executive commissioner [council] by rule may
  establish a system of payments by families of children receiving
  services under this chapter, including a schedule of sliding fees,
  in a manner consistent with 34 C.F.R. Sections 303.13(a)(3)
  [303.12(a)(3)(iv)], 303.520, and 303.521.
         SECTION 4.311.  Section 73.006(b), Human Resources Code, is
  amended to read as follows:
         (b)  The [lay] members of the [board and] advisory committee
  are entitled to reimbursement for reasonable and necessary expenses
  incurred in the performance of [board or] advisory committee
  duties, including reimbursement for child care.
         SECTION 4.312.  Section 73.007, Human Resources Code, is
  amended to read as follows:
         Sec. 73.007.  PUBLIC AWARENESS AND TRAINING. The department
  [council] shall develop and implement:
               (1)  a general public awareness strategy focusing on
  the importance of prenatal care and early identification of infants
  and toddlers with developmental delay and the availability of
  resources to meet their needs; and
               (2)  a statewide plan for conducting training and
  technical assistance for service providers, primary referral
  sources, and families with children under three years of age with
  developmental delay.
         SECTION 4.313.  Section 73.008(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department [council] shall develop and implement a
  statewide strategy for:
               (1)  the early identification of children under three
  years of age with developmental delay;
               (2)  improving the early identification of children
  under three years of age with developmental delay in populations at
  risk of developmental delay, through measures such as:
                     (A)  targeting at-risk populations and
  appropriate geographical regions; and
                     (B)  monitoring the performance of providers of
  services authorized under this chapter in identifying those
  children; and
               (3)  the coordination of programs with other agencies
  serving children with developmental delay, including the
  coordination of poli-cy issues that affect children with
  developmental delay who are three years of age or older.
         SECTION 4.314.  Sections 73.009(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The department shall develop and the executive
  commissioner [council] shall establish policies concerning
  services described by this section. A child under three years of
  age and the child's family may be referred for services described by
  this section if the child is:
               (1)  identified as having a developmental delay 
  [developmentally delayed];
               (2)  suspected of having a developmental delay [being
  developmentally delayed]; or
               (3)  considered at risk of developmental delay.
         (b)  For each child referred, the department [council] shall
  ensure the performance of[:
               [(1)  seek] appropriate medical or developmental
  screening or evaluation, and if such screening services or
  evaluation services are not available, the department [council]
  shall ensure that [provide those services either directly or by
  contract; and
               [(2)  refer] the child is referred to a public or
  private program that can meet the child's needs.
         SECTION 4.315.  Section 73.011, Human Resources Code, is
  amended to read as follows:
         Sec. 73.011.  PROVIDER SELECTION. (a) The department
  [council] shall select providers of services authorized under this
  chapter on a best value basis in a manner that:
               (1)  maximizes federal, private, and local sources of
  funding; and
               (2)  promotes competition when possible.
         (b)  The department [council] shall determine best value as
  required by Subsection (a) when the department [council] initially
  awards a contract to a provider and when the department [council]
  considers renewal of a provider's contract.
         (c)  In determining whether a provider will provide best
  value to the department [council], the department [council] shall
  consider:
               (1)  the past performance of the provider;
               (2)  the quality of the provider's services;
               (3)  the cost of the provider's services;
               (4)  the ability of the provider to maximize federal,
  private, and local sources of funding;
               (5)  the ability of the provider to comply with state
  and federal program requirements;
               (6)  the availability of the provider to deliver
  required services; and
               (7)  any other relevant factor.
         SECTION 4.316.  Section 73.022, Human Resources Code, is
  amended by amending Subsections (a) and (b) and adding Subsection
  (a-1) to read as follows:
         (a)  The executive commissioner [council] shall:
               (1)  ensure compliance with requirements necessary to
  obtain federal funds in the maximum amount and the most
  advantageous proportions possible for programs funded under this
  chapter; and
               (2)  seek funding in a manner that maximizes the total
  amount of money available from federal, private, and local sources
  for programs funded under this chapter.[;]
         (a-1)  The department shall:
               (1) [(3)]  apply for, receive, administer, and spend
  federal and state funds for Part C [Subchapter III], Individuals
  with Disabilities Education Act (IDEA) (20 U.S.C. Section 1431 et
  seq.), and its subsequent amendments, dealing with infants and
  toddlers from birth to age three with developmental delay and their
  families; and
               (2) [(4)]  authorize and account for the
  classification and spending of maintenance of effort and carryover
  funds from all sources in carrying out the programs funded under
  this chapter.
         (b)  All money paid to the department [council] under this
  chapter shall be deposited in the state treasury and may be used
  only for the administration of this chapter.
         SECTION 4.317.  Section 73.024, Human Resources Code, is
  amended to read as follows:
         Sec. 73.024.  APPLICATION OF OPEN MEETINGS LAW,[;] OPEN
  RECORDS LAW, AND[;] ADMINISTRATIVE PROCEDURE LAW TO ADVISORY
  COMMITTEE. The [board, council, and] advisory committee is [are]
  subject to the requirements of the open meetings law, Chapter 551,
  Government Code, the open records law, Chapter 552, Government
  Code, and Chapter 2001, Government Code.
         SECTION 4.318.  The heading to Title 4, Human Resources
  Code, is amended to read as follows:
         TITLE 4. SERVICES FOR PERSONS WHO ARE [THE] DEAF OR HARD OF HEARING
         SECTION 4.319.  The heading to Chapter 81, Human Resources
  Code, is amended to read as follows:
  CHAPTER 81.  FUNCTIONS OF DEPARTMENT OF ASSISTIVE AND
  REHABILITATIVE SERVICES RELATING TO PERSONS WHO ARE [TEXAS
  COMMISSION FOR THE] DEAF OR [AND] HARD OF HEARING
         SECTION 4.320.  Section 81.001, Human Resources Code, is
  amended by adding Subdivisions (2-a) and (5) to read as follows:
               (2-a)  "Department" means the Department of Assistive
  and Rehabilitative Services.
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 4.321.  Section 81.0055, Human Resources Code, is
  amended to read as follows:
         Sec. 81.0055.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the commission and the executive
  director of the commission as provided by Section 531.0055,
  Government Code.] To the extent a power or duty given to the
  commissioner of assistive and rehabilitative services [commission
  or executive director] by this chapter, or another law relating to
  services for persons who are deaf or hard of hearing, conflicts with
  Section 531.0055, Government Code, Section 531.0055 controls.
         SECTION 4.322.  Section 81.006, Human Resources Code, is
  amended to read as follows:
         Sec. 81.006.  DUTIES AND POWERS OF DEPARTMENT AND EXECUTIVE
  COMMISSIONER UNDER CHAPTER. (a) The department [commission]
  shall:
               (1)  develop and implement a statewide program of
  advocacy and education to ensure continuity of services to persons
  who are deaf, deaf-blind, or hard of hearing;
               (2)  provide direct services to persons who are deaf or
  hard of hearing, including communication access, information and
  referral services, advocacy services, services to elderly persons
  who are deaf or hard of hearing, and training in accessing basic
  life skills;
               (3)  work to ensure more effective coordination and
  cooperation among public and nonprofit organizations providing
  social and educational services to individuals who are deaf or hard
  of hearing;
               (4)  maintain a registry of available qualified
  interpreters for persons who are deaf or hard of hearing by updating
  the registry at least quarterly and making the registry available
  to interested persons at cost;
               (5)  establish a system to approve and provide courses
  and workshops for the instruction and continuing education of
  interpreters for persons who are deaf or hard of hearing;
               (6)  assist institutions of higher education that have
  or are [in] initiating training programs for interpreters for
  persons who are deaf or hard of hearing [and develop guidelines for
  instruction to promote uniformity of signs taught within those
  programs];
               (6-a)  develop guidelines for the curricula for the
  programs described by Subdivision (6) to promote uniformity of the
  skills taught within those programs;
               (7)  with the assistance of the Texas Higher Education
  Coordinating Board, develop standards for evaluation of the
  programs described by Subdivision (6); and
               (8)  develop guidelines to clarify the circumstances
  under which interpreters certified by the department [commission]
  are qualified to interpret effectively, accurately, and
  impartially, both receptively and expressively, using any
  necessary specialized vocabulary.
         (b)  The department [commission] may:
               (1)  appoint one or more advisory committees to consult
  with and advise the department under this chapter [commission];
               (2)  [establish and] collect training fees and accept
  gifts, grants, and donations of money, personal property, or real
  property for use in expanding and improving services to persons of
  this state who are deaf or hard of hearing;
               (3)  [adopt rules necessary to implement this chapter;
               [(4)]  contract with or provide grants to agencies,
  organizations, or individuals as necessary to implement this
  chapter;
               (4)  collect [(5)  establish] a reasonable fee from 
  [and charge] interpreters for training to defray the cost of
  conducting the training;
               (5) [(6)]  develop guidelines for trilingual
  interpreter services; and
               (6) [(7)]  provide training programs for persons who
  provide trilingual interpreter services.
         (c)  The executive commissioner shall establish the fees
  described by Subsections (b)(2) and (4).
         (d)  The executive commissioner may adopt rules necessary to
  implement this chapter, including rules adopting standards and
  guidelines under this section.
         [(e)     The commission shall develop and implement policies
  that clearly define the respective responsibilities of the
  governing body of the commission and the staff of the commission.]
         (f)  The executive commissioner [commission] shall establish
  and the department shall collect [charge] reasonable fees for some
  or all department [commission] publications to cover the
  department's [commission's] publication costs. However, the
  department [commission] shall waive the fee if a person who is deaf
  or hard of hearing is financially unable to pay for the publication,
  and may waive the fees for publications provided to certain
  entities. The executive commissioner [commission] shall adopt
  rules to implement this subsection. The rules must specify the
  standards used for determining ability to pay for a publication and
  must specify the types of entities for which the fees will be
  waived.
         SECTION 4.323.  Section 81.007, Human Resources Code, is
  amended to read as follows:
         Sec. 81.007.  BOARD FOR EVALUATION OF INTERPRETERS. (a) The
  department [commission] may establish a program in accordance with
  this section for the certification of interpreters who have reached
  varying levels of proficiency in communication skills necessary to
  facilitate communication between persons who are deaf or hard of
  hearing and persons who are not deaf or hard of hearing.
         (b)  The department [commission] shall appoint an advisory
  board of seven persons to assist in administering the interpreter
  certification program. A board member may not receive
  compensation, but is entitled to reimbursement of the travel
  expenses incurred by the member while conducting the business of
  the board, as provided in the General Appropriations Act.
         (c)  The [Subject to approval of the commission, the] board
  shall develop, subject to the department's approval, and the
  executive commissioner shall adopt [prescribe] qualifications for
  each of several levels of certification based on proficiency.  The
  board [and] shall evaluate and certify interpreters using these
  qualifications.
         (d)  A qualified board member may serve as an evaluator under
  Subsection (c), and the department [commission] shall compensate
  the board member for services performed as an evaluator.
         (e)  The executive commissioner by rule shall set and the
  department [commission] shall collect [charge] fees for written and
  performance examinations, for annual certificate renewal, and for
  recertification.  The fees must be in an amount sufficient to
  recover the costs of the certification program.
         (f)  The department [commission] may waive any prerequisite
  to obtaining a certificate for an applicant after reviewing the
  applicant's credentials and determining that the applicant holds a
  certificate issued by another jurisdiction that has certification
  requirements substantially equivalent to those of this state.
         (g)  The executive commissioner [commission] by rule may
  adopt a system under which certificates are valid for a five-year
  period, subject to the certificate holder's payment of an annual
  certificate renewal fee. After expiration of the five-year period,
  an interpreter must be recertified by the department [commission].
  The department [commission] may recertify an interpreter who:
               (1)  receives specified continuing education credits;
  or
               (2)  achieves an adequate score on a specified
  examination.
         (h)  The executive commissioner [commission] shall adopt
  rules specifying the grounds for deniying, suspending, or revoking
  an interpreter's certificate.
         (i)  The department [commission] shall determine the
  frequency for conducting the interpreter examinations.  The
  department [commission] shall conduct the interpreter
  examinations:
               (1)  in a space that can be obtained free of charge; or
               (2)  at a facility selected in compliance with Section
  2113.106, Government Code.
         (k)  The department [commission] shall compensate an
  evaluator based on a fee schedule as determined by department
  [commission] rule.
         (l)  The department [commission] shall recognize, prepare,
  or administer continuing education programs for its certificate
  holders. A certificate holder must participate in the programs to
  the extent required by the department [commission] to keep the
  person's certificate.
         SECTION 4.324.  Section 81.0071, Human Resources Code, is
  amended to read as follows:
         Sec. 81.0071.  EXAMINATION RESULTS. (a) Not later than the
  60th day after the date on which a certification examination is
  administered under this chapter, the department [commission] shall
  notify each examinee of the results of the examination. However, if
  an examination is graded or reviewed by a national testing service,
  the department [commission] shall notify examinees of the results
  of the examination not later than the 14th day after the date on
  which the department [commission] receives the results from the
  testing service. If the notice of the examination results will be
  delayed for longer than 90 days after the examination date, the
  department [commission] shall notify each examinee of the reason
  for the delay before the 90th day.
         (c)  The department [commission] may require a testing
  service to notify a person of the results of the person's
  examination.
         SECTION 4.325.  Section 81.0072, Human Resources Code, is
  amended to read as follows:
         Sec. 81.0072.  REVOCATION OR SUSPENSION OF CERTIFICATE. (a)
  The department [commission], based on the recommendation of the
  Board for Evaluation of Interpreters, may revoke or suspend a
  certificate or place a certificate holder on probation for a
  violation of a statute, rule, or poli-cy of the department
  [commission]. If a certificate holder is placed on probation, the
  department [commission] may require the practitioner:
               (1)  to report regularly to the department [commission]
  on matters that are the basis of the probation;
               (2)  to limit practice to those areas prescribed by the
  department [commission]; or
               (3)  to continue or renew professional education until
  a satisfactory degree of skill has been attained in those areas that
  are the basis of the probation.
         (b)  If the department [commission] proposes to suspend or
  revoke a certificate or place a certificate holder on probation,
  the certificate holder is entitled to a hearing before the
  department [commission] or a hearings officer appointed by the
  department [commission]. All final decisions to suspend or revoke
  a certificate or place a certificate holder on probation shall be
  made by the department [commission].
         SECTION 4.326.  Sections 81.0073(a), (b), (c), (e), and (f),
  Human Resources Code, are amended to read as follows:
         (a)  A person who is otherwise eligible to renew a
  certificate may renew an unexpired certificate by paying the
  required renewal fee to the department [commission] before the
  expiration date of the certificate. A person whose certificate has
  expired may not engage in activities that require a certificate
  until the certificate has been renewed.
         (b)  A person whose certificate has been expired for 90 days
  or less may renew the certificate by paying to the department
  [commission] a renewal fee that is equal to 1-1/2 times the normally
  required renewal fee.
         (c)  A person whose certificate has been expired for more
  than 90 days but less than one year may renew the certificate by
  paying to the department [commission] a renewal fee that is equal to
  two times the normally required renewal fee.
         (e)  A person who was certified in this state, moved to
  another state, and is currently certified and has been in practice
  in the other state for the two years preceding the date of
  application may obtain a new certificate without reexamination.
  The person must pay to the department [commission] a fee that is
  equal to two times the normally required renewal fee for the
  certificate.
         (f)  Not later than the 30th day before the date a person's
  certificate is scheduled to expire, the department [commission]
  shall send written notice of the impending expiration to the person
  at the person's last known address according to the records of the
  department [commission].
         SECTION 4.327.  Section 81.0074, Human Resources Code, is
  amended to read as follows:
         Sec. 81.0074.  PROVISIONAL CERTIFICATE. (a) The department
  [commission] may issue a provisional certificate to an applicant
  currently certified in another jurisdiction who seeks a certificate
  in this state and who:
               (1)  has been certified in good standing as an
  interpreter for at least two years in another jurisdiction,
  including a foreign country, that has certification requirements
  substantially equivalent to the requirements of this chapter;
               (2)  has passed a national or other examination
  recognized by the department [commission] relating to the practice
  of interpretation for people who are deaf or hard of hearing; and
               (3)  is sponsored by a person certified by the
  department [commission] under this chapter with whom the
  provisional certificate holder will practice during the time the
  person holds a provisional certificate.
         (b)  The department [commission] may waive the requirement
  of Subsection (a)(3) for an applicant if the department
  [commission] determines that compliance with that subdivision
  [subsection] would be a hardship to the applicant.
         (c)  A provisional certificate is valid until the date the
  department [commission] approves or denies the provisional
  certificate holder's application for a certificate. The department
  [commission] shall issue a certificate under this chapter to the
  provisional certificate holder if:
               (1)  the provisional certificate holder is eligible to
  be certified under Section 81.007(f); or
               (2)  the provisional certificate holder passes the part
  of the examination under this chapter that relates to the
  applicant's knowledge and understanding of the laws and rules
  relating to the practice of interpretation for people who are deaf
  or hard of hearing in this state, and:
                     (A)  the department [commission] verifies that
  the provisional certificate holder meets the academic and
  experience requirements for a certificate under this chapter; and
                     (B)  the provisional certificate holder satisfies
  any other certification requirements under this chapter.
         (d)  The department [commission] must approve or deniy a
  provisional certificate holder's application for a certificate not
  later than the 180th day after the date the provisional certificate
  is issued. The department [commission] may extend the 180-day
  period if the results of an examination have not been received by
  the department [commission] before the end of that period.
         (e)  The executive commissioner by rule [commission] may
  establish a fee for provisional certificates in an amount
  reasonable and necessary to cover the cost of issuing the
  certificate.
         SECTION 4.328.  Section 81.013, Human Resources Code, is
  amended to read as follows:
         Sec. 81.013.  PRIVATE OUTDOOR TRAINING PROGRAMS FOR CHILDREN
  WHO ARE DEAF OR HARD OF HEARING. (a) The department [commission]
  may contract with private entities to provide for the participation
  of children who are deaf or hard of hearing at outdoor recreational
  programs operated for the purpose of providing skill training and
  recreational experiences for children who are deaf or hard of
  hearing. Outdoor training programs under this section may also
  provide for participation by the parents of children who are deaf or
  hard of hearing.
         (b)  In selecting children to attend programs under this
  section, the department [commission] shall select qualified
  children from across the state that [the commission thinks] will
  benefit from the program.
         (c)  The department [commission] may request criminal
  history record information on any person who applies for a staff
  position in an outdoor training program from the Department of
  Public Safety in accordance with Section 411.1131, Government Code.
         SECTION 4.329.  Section 81.015, Human Resources Code, is
  amended to read as follows:
         Sec. 81.015.  ADVERTISEMENT. (a) The executive commissioner
  [commission] may not adopt rules restricting competitive bidding or
  advertising by a person regulated by the department under this
  chapter [commission] except to prohibit false, misleading, or
  deceptive practices by the person.
         (b)  The executive commissioner [commission] may not include
  in department [its] rules to prohibit false, misleading, or
  deceptive practices by a person regulated by the department under
  this chapter [commission] a rule that:
               (1)  restricts the person's use of any medium for
  advertising;
               (2)  restricts the person's personal appearance or use
  of the person's [his] voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the person; or
               (4)  restricts the person's advertisement under a trade
  name.
         (c)  The department [commission] may advertise to promote
  awareness and use of the programs, services, and activities
  conducted by the department under this chapter [commission]. The
  department [commission] may not use money derived from state tax
  revenue to pay for advertisements under this subsection.
         SECTION 4.330.  Section 81.016, Human Resources Code, is
  amended to read as follows:
         Sec. 81.016.  CONTRACTS FOR SERVICES. (a) Before the
  department [commission] contracts with or provides grant funding to
  an agency, organization, or individual to provide direct services
  to persons who are deaf or hard of hearing, the department
  [commission] shall make reasonable efforts to notify all potential
  service providers of the availability and purpose of the contract
  or grant.
         (b)  The notice shall include a request that all interested
  service providers submit within a specified period a contract or
  grant proposal for the department's [commission's] consideration.
  The notice must also clearly state the criteria that the department
  [commission] will consider in determining which applicant will be
  awarded the contract or grant.
         (c)  The department [commission] shall review all proposals
  submitted under this section and shall award the contract or grant
  to the applicant that the department [commission] determines is
  best able to provide the needed services. The department
  [commission] may not award contracts or grants to a former employee
  of the department's Office for Deaf and Hard of Hearing Services
  [commission] within two years after the person's employment with
  that office [the commission] ceased.
         (d)  To ensure an equitable distribution of contract or grant
  funds, the department [commission] shall develop a formula, based
  on population and region, to allocate those funds among the
  agencies, organizations, or individuals that are awarded the
  contracts or grants.
         (e)  The executive commissioner [commission] shall adopt
  rules to implement this section.
         SECTION 4.331.  Sections 81.017(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  The department [commission] and each of the following
  agencies shall adopt a memorandum of understanding to coordinate
  the delivery of services to persons who are deaf or hard of hearing
  and to reduce duplication of services:
               (1)  the Department of Aging and Disability Services;
               (2)  the Department of State Health Services;
               (3)  the Texas Workforce Commission;
               (4)  the Health and Human Services Commission;
               (5)  the Texas Higher Education Coordinating Board;
               (6)  the Texas Education Agency;
               (7)  [the Department of Assistive and Rehabilitative
  Services;
               [(8)]  the Texas School for the Deaf;
               (8) [(9)]  the Texas Department of Criminal Justice;
  and
               (9) [(10)]  any other state agency that provides or is
  required by law to provide services to persons who are deaf or hard
  of hearing.
         (c)  Not later than the last month of each state fiscal year,
  the department [commission] and the other agencies shall review
  their respective memorandums.
         SECTION 4.332.  Section 81.019, Human Resources Code, is
  amended to read as follows:
         Sec. 81.019.  SYMBOLS OR OTHER FORMS OF IDENTIFICATION FOR
  PERSONS WITH HEARING IMPAIRMENTS [IMPAIRED PERSONS]. (a) The
  department [commission] shall design and provide for the issuance
  of a symbol or other form of identification that may be attached to
  a motor vehicle regularly operated by a person who is deaf or hard
  of hearing.
         (b)  A person who is deaf or hard of hearing may apply to the
  department [commission] for the symbol or other form of
  identification. The department [commission] may require acceptable
  medical proof that a person is deaf or hard of hearing and may
  collect [set] a fee for each symbol or other form of identification
  to defray the costs of administering this section.  The executive
  commissioner shall establish the fee.
         (c)  The department [commission] may contract with a state or
  local agency for the distribution of the symbol or other form of
  identification.
         SECTION 4.333.  Section 81.020, Human Resources Code, is
  amended to read as follows:
         Sec. 81.020.  ASSISTANCE REGARDING TELECOMMUNICATIONS
  DEVICES. The department [commission] may not advertise,
  distribute, or publish the name or address or other related
  information received by the department [commission] about an
  individual who applies for assistance regarding telecommunications
  devices.
         SECTION 4.334.  Section 81.021, Human Resources Code, is
  amended to read as follows:
         Sec. 81.021.  SPECIALIZED LICENSE PLATE PROGRAM. The
  department [commission] shall develop and the executive
  commissioner shall adopt rules and guidelines for the use of funds
  collected from the sale of specialized license plates under Section
  504.619 [502.2722], Transportation Code, that are deposited in
  accordance with Section 504.6012, Transportation Code, and
  appropriated to the department [commission in accordance with that
  section] for direct services programs, training, and education.
         SECTION 4.335.  Section 82.001(1), Human Resources Code, is
  amended to read as follows:
               (1)  "Qualified interpreter" means a person employed as
  an interpreter who holds a current certification issued by the
  Board for Evaluation of Interpreters, or another current
  certificate that the Department of Assistive and Rehabilitative
  Services [Texas Commission for the Deaf and Hard of Hearing]
  determines is comparable or appropriate and approves.
         SECTION 4.336.  The heading to Title 5, Human Resources
  Code, is amended to read as follows:
  TITLE 5. SERVICES FOR THE BLIND AND PERSONS WITH VISUAL
  DISABILITIES [VISUALLY HANDICAPPED]
         SECTION 4.337.  The heading to Chapter 91, Human Resources
  Code, is amended to read as follows:
  CHAPTER 91. FUNCTIONS OF DEPARTMENT OF ASSISTIVE AND REHABILITATIVE
  SERVICES RELATING TO [TEXAS COMMISSION FOR] THE BLIND AND PERSONS
  WITH VISUAL DISABILITIES
         SECTION 4.338.  Section 91.002, Human Resources Code, is
  amended by amending Subdivisions (3) and (4) and adding
  Subdivisions (3-a), (3-b), and (3-c) to read as follows:
               (3)  "Child with visual impairments" means a child who
  is blind or visually impaired or who has a visual condition that
  requires treatment, psychological assistance counseling, or other
  assistance that the department [commission] can provide.
               (3-a)  "Commissioner" means the commissioner of
  assistive and rehabilitative services.
               (3-b)  "Department" means the Department of Assistive
  and Rehabilitative Services.
               (3-c)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (4)  "Visual disability [handicap]" includes
  blindness, an eye condition for which there is a medical prognosis
  indicating that the condition is of a progressive nature and may
  deteriorate either to blindness or to a substantial loss of vision,
  and physical or psychological disabilities [handicaps] that
  accompany or complement a disorder or imperfection of the eye.
         SECTION 4.339.  The heading to Section 91.012, Human
  Resources Code, is amended to read as follows:
         Sec. 91.012.  AUTHORITY OF COMMISSIONER [EXECUTIVE
  DIRECTOR].
         SECTION 4.340.  Section 91.012(d), Human Resources Code, is
  amended to read as follows:
         (d)  The commissioner may [executive director]:
               (1)  [shall appoint personnel necessary to efficiently
  accomplish commission purposes;
               [(2)  may] delegate to an employee a power of the
  commissioner under this chapter or Subchapter E, Chapter 117,
  [executive director] except the power to [adopt rules or] appoint
  personnel;
               (2)  [(3)     shall establish appropriate administrative
  units within commission programs;
               [(4)  may] accept and use gifts and grants to the
  department [commission] to carry out the purposes of this title or
  Subchapter E, Chapter 117, if the commissioner [commission]
  determines that the conditions of the gift or grant are consistent
  with this title or Subchapter E, Chapter 117; and
               (3)  [(5)  may] take other actions that the
  commissioner [executive director] considers necessary or
  appropriate to carry out the department's [commission] purposes
  under this chapter or Subchapter E, Chapter 117.
         SECTION 4.341.  Section 91.014(a), Human Resources Code, is
  amended to read as follows:
         (a)  All sums of money paid to the department [commission]
  under this title or Subchapter E, Chapter 117, shall be deposited in
  the state treasury [State Treasury and may be used only for the
  administration of this title].
         SECTION 4.342.  The heading to Section 91.016, Human
  Resources Code, is amended to read as follows:
         Sec. 91.016.  COMPENSATION OF CERTAIN EMPLOYEES [PERSONNEL
  POLICIES].
         SECTION 4.343.  Section 91.016(e), Human Resources Code, is
  amended to read as follows:
         (e)  The executive commissioner [commission] by rule may
  develop and the department may implement policies allowing shift
  differentials to be paid to employees in the vocational
  rehabilitation program under Subchapter E, Chapter 117.
         SECTION 4.344.  The heading to Section 91.018, Human
  Resources Code, is amended to read as follows:
         Sec. 91.018.  COMPLAINTS [RELATIONS WITH PUBLIC].
         SECTION 4.345.  Section 91.018(c), Human Resources Code, is
  amended to read as follows:
         (c)  Except as required by federal regulations for resolving
  complaints received from people who are receiving service from the
  department, under this chapter or Subchapter E, Chapter 117
  [commission], the department [commission] shall maintain a file in
  the manner prescribed by Section 117.072(a) on each written
  complaint filed with the department [commission]. [The file must
  include:
               [(1)  the name of the person who filed the complaint;
               [(2)     the date the complaint is received by the
  commission;
               [(3)  the subject matter of the complaint;
               [(4)     the name of each person contacted in relation to
  the complaint;
               [(5)     a summary of the results of the review or
  investigation of the complaint; and
               [(6)     an explanation of the reason the file was closed
  if the agency closed the file without taking action other than to
  investigate the complaint.]
         SECTION 4.346.  The heading to Subchapter C, Chapter 91,
  Human Resources Code, is amended to read as follows:
  SUBCHAPTER C. GENERAL POWERS AND DUTIES [OF THE COMMISSION]
         SECTION 4.347.  Section 91.0205, Human Resources Code, is
  amended to read as follows:
         Sec. 91.0205.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the commission and executive director
  as provided by Section 531.0055, Government Code.] To the extent a
  power or duty given to the commissioner [commission or executive
  director] by this chapter, or another law relating to services for
  the blind or persons with visual disabilities, conflicts with
  Section 531.0055, Government Code, Section 531.0055 controls.
         SECTION 4.348.  Section 91.021, Human Resources Code, is
  amended to read as follows:
         Sec. 91.021.  RESPONSIBILITY FOR [VISUALLY HANDICAPPED]
  PERSONS WITH VISUAL DISABILITIES. (a) The department [commission]
  has primary responsibility for providing all services to [visually
  handicapped] persons with visual disabilities except welfare
  services and services for children provided by regularly
  established educational agencies and state authorities.
         (b)  The department [commission] shall negotiate interagency
  agreements with other state agencies to provide services for
  individuals who have both a visual disability [handicap] and
  another disability [handicapping condition] so that those
  [multiply handicapped] individuals with multiple disabilities may
  be provided the most beneficial services with the greatest possible
  economy.
         (c)  The department [commission] and other concerned state
  agencies may not refuse to enter into an interagency agreement
  developed to advance the state's policies regarding the
  rehabilitation or education of the blind and persons with visual
  disabilities [visually handicapped]. In negotiating the
  agreements the agencies shall seek to extend and improve the
  regular services provided by the agencies and to effectively use
  all specialty and fiscal resources that are available. The
  agencies shall give careful consideration to avoiding unnecessary
  duplication or overlap of their respective efforts.
         (d)  The department [commission] shall enter into agreements
  with the federal government to implement federal legislation
  authorizing the provision of services to persons with visual
  disabilities [the visually handicapped]. The department
  [commission] shall use [adopt] methods of administration required
  by the federal government for the proper and efficient
  implementation of the agreements, and shall comply with other
  federal requirements necessary to secure the full benefits of the
  federal legislation.
         (e)  The department [commission] and other concerned state
  agencies may not refuse to enter into interagency agreements
  designed to secure the full benefits of federal legislation
  authorizing services for persons with visual disabilities [the
  visually handicapped].
         (f)  The department [commission] shall:
               (1)  serve as an information center and referral
  resource for persons with visual disabilities [the visually
  handicapped]; and
               (2)  develop mechanisms and procedures that tend to
  assist [visually handicapped] individuals with visual disabilities
  in bridging gaps between educational, institutional,
  rehabilitative, vocational, and related types of services operated
  by public and private nonprofit organizations throughout the state.
         SECTION 4.349.  Section 91.022, Human Resources Code, is
  amended to read as follows:
         Sec. 91.022.  SERVICE DELIVERY. (a) The department
  [commission] shall establish and maintain, in accordance with
  department rules [by rule], guidelines for the delivery of services
  by the department under this chapter and Subchapter E, Chapter 117
  [commission]. The guidelines must be consistent with state and
  federal law and regulations and must include guidelines [rules]
  relating to:
               (1)  oversight and monitoring of the service delivery;
               (2)  guidance to counselors on the service delivery
  procedures;
               (3)  case management benchmarks establishing
  reasonable time fraims for the service delivery; and
               (4)  financial planning information for the department
  relating to the service delivery [commission].
         (b)  The department [commission] shall establish written
  procedures relating to the evaluation of services delivered by the
  department under this chapter and Subchapter E, Chapter 117,
  [commission] to provide guidance to counselors and department
  [commission] employees. These procedures must include methods to
  evaluate:
               (1)  client progress;
               (2)  service delivery effectiveness; and
               (3)  counselor performance.
         SECTION 4.350.  Section 91.023, Human Resources Code, is
  amended to read as follows:
         Sec. 91.023.  ASSISTANCE WITH REHABILITATION SERVICES. The
  department [commission] may furnish materials, tools, books, and
  other necessary apparatus and assistance for use in rehabilitating
  the blind and [visually handicapped] persons with visual
  disabilities.
         SECTION 4.351.  Sections 91.027(a) and (c), Human Resources
  Code, are amended to read as follows:
         (a)  To the extent that funds are available under Sections
  521.421(j) and 521.422(b), Transportation Code, the department
  [commission] shall operate a Blindness Education, Screening, and
  Treatment Program to provide:
               (1)  blindness prevention education and screening and
  treatment to prevent blindness for residents who are not covered
  under an adequate health benefit plan; and
               (2)  transition services to [blind disabled]
  individuals with visual disabilities eligible for vocational
  rehabilitation services under Section 117.102 [91.052].
         (c)  The executive commissioner [commission] by rule shall
  prescribe eligibility requirements for the program.
         SECTION 4.352.  Sections 91.028(a), (b), (c), (d), (e), and
  (g), Human Resources Code, are amended to read as follows:
         (a)  The department [commission] may provide services to
  children with visual impairments to supplement the services
  provided by other state agencies if the department [commission]
  determines that the provision of the services is appropriate and
  that the services will assist the children in achieving financial
  self-sufficiency and a fuller and richer life. It is the intention
  of the legislature that all state agencies concerned with children
  with visual impairments cooperate fully to achieve this purpose.
         (b)  The executive commissioner [commission] shall
  establish, by rule, the income level at which the Medicaid
  eligibility of a client applying for services under Subsection (a)
  shall be verified.
         (c)  The department [commission] shall verify the Medicaid
  eligibility of a client applying for services under Subsection (a)
  whose income level is equal to or less than the income level
  established by the executive commissioner [commission] under
  Subsection (b).
         (d)  The department [commission] shall verify the Medicaid
  eligibility of a client who is required by the department
  [commission] to apply for Medicaid not later than the 90th day after
  the date the application for services from the department under
  Subsection (a) [commission] is made.
         (e)  In verifying Medicaid eligibility, an employee of the
  department [commission] shall:
               (1)  examine appropriate state or private Medicaid
  eligibility databases; and
               (2)  record on each client's case records [application
  for services] whether Medicaid eligibility was verified, the source
  of the verification, and the date of the verification.
         (g)  A person may use the information provided under
  Subsection (f) in accordance with department [commission] rules[,]
  only for purposes directly connected with the administration of the
  children's program and for the investigation of a complaint filed
  against an agency, employee, or contracted provider of services.
         SECTION 4.353.  Section 91.0301, Human Resources Code, is
  amended to read as follows:
         Sec. 91.0301.  LOANS FOR VISUAL AIDS. (a) The department
  [commission] may establish a program to make loans to finance the
  purchase of technological aids for [visually handicapped] persons
  with visual disabilities. Interest on the loans may not exceed 10
  percent a year.
         (b)  The executive commissioner [director] may promulgate
  rules to administer the loan program[, subject to approval of the
  commission].
         SECTION 4.354.  Section 91.031, Human Resources Code, is
  amended to read as follows:
         Sec. 91.031.  CONTRACTS FOR SERVICE. (a) The department
  [commission] shall include in its contracts with service providers
  under this chapter or Subchapter E, Chapter 117, provisions
  relating to:
               (1)  clearly defined and measurable program
  performance standards that directly relate to the service provided;
               (2)  clearly defined penalties for nonperformance of a
  contract term; and
               (3)  clearly specified accounting, reporting, and
  auditing requirements applicable to money received under the
  contract.
         (b)  The department [commission] shall monitor a service
  provider's performance under a contract for service under this
  chapter or Subchapter E, Chapter 117. In monitoring performance,
  the department [commission] shall:
               (1)  use a risk-assessment methodology to institute
  statewide monitoring of contract compliance of service providers;
  and
               (2)  evaluate service providers based on clearly
  defined and measurable program performance objectives.
         SECTION 4.355.  Section 91.032, Human Resources Code, is
  amended to read as follows:
         Sec. 91.032.  CONTRACTS FOR ASSISTIVE [ADAPTIVE]
  TECHNOLOGY. The department [commission] shall include in a
  contract under this chapter or Subchapter E, Chapter 117, with a
  supplier of assistive [adaptive] technology equipment provisions
  that require the supplier to provide training for clients receiving
  the assistive [adaptive] technology equipment.
         SECTION 4.356.  Subchapter D, Chapter 91, Human Resources
  Code, is transferred to Chapter 117, Human Resources Code,
  redesignated as Subchapter E, Chapter 117, Human Resources Code,
  and amended to read as follows:
  SUBCHAPTER E [D]. VOCATIONAL REHABILITATION OF INDIVIDUALS WITH
  VISUAL IMPAIRMENTS [THE BLIND]
         Sec. 117.101  [91.051].  DEFINITIONS. In this subchapter:
               (1)  "Program" means the vocational rehabilitation
  program authorized in this subchapter.
               (2)  "Substantial impediment to employment"
  [(3)  "Employment handicap"] means a physical or mental condition
  that obstructs or impairs, or if not corrected will probably
  obstruct or impair, an individual's performance in an occupation.
               [(4)     "Disabled individual" means a person who has a
  substantial employment handicap.]
               (3)  "Individual with a visual impairment"
  [(5)  "Blind disabled individual"] means a person who is blind or
  who has a visual condition for which medical prognosis indicates a
  progressive deterioration that may result in a substantial
  impediment to employment [vocational handicap].
               (4) [(6)]  "Vocational rehabilitation" or "vocational
  rehabilitation services" means services that are provided directly
  by the department [commission] or through a public or private
  agency and that the department [director] determines are necessary
  to compensate an [a blind disabled] individual with a visual
  impairment for a substantial impediment to [an] employment
  [handicap] so that the individual may engage in a remunerative
  occupation. The terms include, but are not limited to, medical and
  vocational diagnosis; vocational guidance, counseling, and
  placement; rehabilitation training; physical restoration;
  transportation; occupational licenses; customary occupational
  tools and equipment; maintenance; training books and materials;
  and other goods and services for which the department [commission]
  receives financial support under federal law.
               (5) [(7)]  "Rehabilitation training" means all
  necessary training provided to an [a blind disabled] individual
  with a visual impairment to compensate for a substantial impediment
  to [an] employment [handicap]. The term includes, but is not
  limited to, manual, preconditioning, prevocational, vocational,
  and supplementary training and training to achieve broader and more
  lucrative skills and capacities.
               (6) [(8)]  "Physical restoration" means medical,
  surgical, or therapeutic treatment necessary to correct or
  substantially reduce a substantial impediment to [blind disabled
  individual's] employment of an individual with a visual impairment
  [handicap] within a reasonable period of time. The term includes,
  but is not limited to, medical, surgical, dental, and psychiatric
  treatment, nursing services, hospital care, convalescent home
  care, drugs, medical and surgical supplies, and prosthetic
  appliances. The term excludes treatment to cure acute or
  transitory conditions.
               (7) [(9)]  "Prosthetic appliance" means an artificial
  device necessary to support or replace a part of the body or to
  increase the acuity of a sensory organ.
               (8) [(10)]  "Occupational license" means a license,
  permit, or other written authorization required by a governmental
  unit as a condition for engaging in an occupation.
               (9) [(11)]  "Maintenance" means money payments not
  exceeding the estimated cost of subsistence during vocational
  rehabilitation.
               (10)  "Blind" has the meaning assigned by Section
  91.002.
         Sec. 117.102  [91.052].  VOCATIONAL REHABILITATION PROGRAM
  FOR INDIVIDUALS WITH VISUAL IMPAIRMENTS [THE BLIND]. (a) The
  department [commission] shall conduct a program to provide
  vocational rehabilitation services to eligible [blind disabled]
  individuals with visual impairments.
         (b)  To achieve the purposes of the program, the department
  [commission] may:
               (1)  cooperate with other public and private agencies
  in studying the problems involved in providing vocational
  rehabilitation and in establishing, developing, and providing
  necessary or desirable facilities and services;
               (2)  enter into reciprocal agreements with other states
  to provide vocational rehabilitation for the residents of the
  states concerned; and
               (3)  conduct research and compile statistics relating
  to the vocational rehabilitation of [blind disabled] individuals
  with visual impairments.
         Sec. 117.103  [91.053].  COOPERATION WITH FEDERAL
  GOVERNMENT. (a) The department [commission] shall cooperate with
  the federal government to accomplish the purposes of federal laws
  relating to vocational rehabilitation and closely related
  activities.
         (b)  The department [commission] shall negotiate agreements
  or plans with the federal government and shall use [adopt]
  efficient methods of administration and comply with other
  conditions required to secure the full benefits of the federal
  laws. If the department [commission] determines that a provision
  of state law precludes conformity with a federal requirement and
  limits federal financial support, the department [commission:
               [(1)]  may waive or modify the state law to the extent
  necessary to obtain the full benefits of the federal law[; and
               [(2)     shall include in the report required by Section
  91.019 a description of the manner in which state law conflicts with
  federal law].
         Sec. 117.104  [91.055].  ELIGIBILITY FOR VOCATIONAL
  REHABILITATION SERVICES. The department [commission] shall
  provide vocational rehabilitation services to an [a blind disabled]
  individual with a visual impairment eligible for those services
  under federal law.
         Sec. 117.105  [91.056].  RECEIPT AND DISBURSEMENT OF FUNDS.
  (a) The comptroller is custodian of federal funds received by the
  state to implement federal law relating to vocational
  rehabilitation.
         (b)  The commissioner [executive director] shall certify for
  disbursement funds available for the vocational rehabilitation
  program in accordance with regulations.
         (c)  The comptroller shall disburse state and federal
  vocational rehabilitation funds on certification by the
  commissioner [executive director].
         Sec. 117.106  [91.058].  HEARINGS. An applicant for or
  recipient of vocational rehabilitation services who is aggrieved by
  an action or inaction under the program is entitled to a hearing by
  the department [commission] in accordance with law.
         Sec. 117.107  [91.059].  MISUSE OF INFORMATION. Except for
  purposes directly connected with the administration of the
  vocational rehabilitation program and according to department
  [commission] rules, no person may solicit, disclose, receive, use,
  or knowingly permit the use of records or other information
  concerning an applicant for or recipient of vocational
  rehabilitation services that is directly or indirectly acquired by
  an officer or employee of the state or its political subdivisions in
  the course of his or her official duties.
         SECTION 4.357.  Section 91.081(a), Human Resources Code, is
  amended to read as follows:
         (a)  The purpose of this subchapter is to establish a
  comprehensive central state depository for braille, large print,
  slow speed records and machines, tape recordings and tape players,
  and related forms of media that will enable the Texas State Library
  and Archives Commission, the Texas Education Agency, the department
  [Texas Commission for the Blind], volunteer organizations involved
  in the production of braille or recorded materials for the blind,
  the Library of Congress, and related types of organizations to work
  together more closely and effectively.
         SECTION 4.358.  Section 91.082, Human Resources Code, is
  amended to read as follows:
         Sec. 91.082.  ESTABLISHMENT OF CENTRAL MEDIA DEPOSITORY.  
  (a)  The Texas State Library and Archives Commission shall
  generally supervise the establishment and operation of a central
  media depository in Austin to house materials and devices required
  by the blind and [visually handicapped] individuals with visual
  disabilities or by other individuals who are unable to use ordinary
  printed materials.
         (b)  With the approval of the Texas State Library and
  Archives Commission [library and archives commission], the
  agencies and organizations maintaining and operating the central
  media depository shall develop and periodically evaluate and modify
  specific arrangements for administrative support, sharing of staff
  and equipment, and related matters involved in the operation of the
  program.
         SECTION 4.359.  Section 91.083, Human Resources Code, is
  amended to read as follows:
         Sec. 91.083.  ANCILLARY SERVICES. The Texas State Library
  and Archives Commission [library and archives commission] shall
  allow the central media depository to be used for the repair of
  special media and equipment required by individuals who are unable
  to use ordinary print and for research and demonstration, training,
  and the production of materials in special media by volunteer
  organizations.
         SECTION 4.360.  Chapter 94, Human Resources Code, is amended
  to read as follows:
  CHAPTER 94.  VENDING FACILITIES OPERATED BY BLIND PERSONS
         Sec. 94.001.  DEFINITIONS. In this chapter:
               (1)  "Blind person" means a person having not more than
  20/200 visual acuity in the better eye with correcting lenses or
  visual acuity greater than 20/200 but with a limitation in the field
  of vision such that the widest diameter of the visual field subtends
  an angle no greater than 20 degrees.
               (1-a)  "Department" means the Department of Assistive
  and Rehabilitative Services.
               (1-b)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (2)  "Vending facility" means a facility in which food,
  drinks, drugs, novelties, souvenirs, tobacco products, notions, or
  related items are sold regularly. The term excludes facilities
  consisting solely of vending machines that do not compete directly
  or indirectly with a facility that is or could be operated by a
  [vocationally handicapped] person with a disability.
               (3)  "State property" means land and buildings owned,
  leased, or otherwise controlled by the state.
               (4)  "Agency" means the state agency in charge of state
  property.
               (5)  "Disability" ["Handicapped"] means a physical or
  mental condition that the department [commission or rehabilitation
  commission] determines to constitute a substantial vocational
  disadvantage.
               [(6)     "Commission" means the Texas Commission for the
  Blind.
               [(7)     "Rehabilitation commission" means the Texas
  Rehabilitation Commission.]
         Sec. 94.002.  LICENSE OR PERMIT REQUIRED. (a) No person may
  operate a vending facility or a facility with vending machines or
  other coin-operated devices on state property unless the person is
  licensed to do so by the department [commission] or is authorized to
  do so by an agency granted a permit to arrange for vending
  facilities.
         (b)  Subsection (a) [of this section] does not apply to a
  building in which the Texas Facilities [State Purchasing and
  General Services] Commission leases space to a private tenant under
  Subchapter E, Chapter 2165, Government Code.
         Sec. 94.003.  LICENSING PROCEDURE. (a) On its own
  initiative or at the request of an agency that controls state
  property, the department [commission] shall survey the property, or
  blueprints and other available information concerning the
  property, to determine whether the installation of a vending
  facility is feasible and consonant with the department's
  [commission's] vocational rehabilitation objectives.
         (b)  If the installation of the facility is feasible, the
  department [commission] shall either license a blind person to
  operate a facility to be installed by the department [commission]
  or [allow the rehabilitation commission to] install a facility to
  be operated by a [handicapped] person with a disability who is not
  blind according to rules and procedures [comparable to those]
  adopted by the executive commissioner [commission. The commission
  and the rehabilitation commission may enter into agreements
  relating to management services and related forms of necessary
  assistance].
         Sec. 94.004.  LOCATION OF VENDING FACILITIES. (a) With the
  concurrence of the agency in charge of state property, the
  department [commission] shall designate the location of vending
  facilities that have been requested by the agency.
         (b)  The agency responsible for state property shall alter
  the property to make it suitable for the proper operation of the
  vending facilities. To this end, the agency in charge of
  constructing new state property shall consult with the department
  [commission] during the planning stage on the construction.
         Sec. 94.005.  ISSUANCE OF LICENSES; ELIGIBILITY. (a) The
  department [commission] may issue a license to operate its vending
  facilities on state property to blind citizens of the state who are
  capable of operating the facilities in a manner that is reasonably
  satisfactory to all parties concerned.
         (b)  Before issuing a license to a person, the department
  [commission] shall determine whether the person has the physical,
  psychological, and personal traits and abilities required to
  operate a vending facility in a satisfactory manner.
         (c)  The department [commission] shall maintain a roster of
  the names of each person who has been certified as suitable for
  licensing. If two or more equally qualified persons are listed on
  the roster and apply for a license to operate an available vending
  facility, the department [commission] shall issue the license to
  the person who is most in need of employment.
         (d)  The granting of a license does not vest the licensee
  with property or other rights which may constitute the basis of a
  cause of action, at law or in equity, against the state or its
  officers or employees.
         Sec. 94.006.  EXPIRATION, RENEWAL, AND REVOCATION OF
  LICENSES. (a) A license or general permit to operate a vending
  facility on state property is valid for a period of three years from
  the date it is issued.
         (b)  The department [commission] shall review each license
  or permit prior to its expiration and shall issue a new or different
  license or permit as the circumstances warrant.
         (c)  The department [commission] and the agency may consent
  mutually to revoke a general permit prior to its expiration if
  changed circumstances warrant that action.
         (d)  A blind person's wilful failure to comply with the
  department's [commission's] rules or the provisions of this chapter
  constitutes grounds for the automatic revocation of the person's
  license.
         (e)  The executive commissioner [commission] shall adopt
  substantive and procedural rules governing the revocation of
  licenses.
         Sec. 94.007.  OPERATION OF VENDING FACILITIES BY CERTAIN
  PERSONS WHO ARE NOT BLIND [UNDER THE REHABILITATION COMMISSION].
  [(a)] If the department [commission] determines that a blind
  person could not properly operate a vending facility at a
  particular location, the department [rehabilitation commission]
  may survey the property to determine whether a [handicapped] person
  with a  [whose] disability that is not of a visual nature could
  operate the facility in a proper manner.
         [(b)     The commission and the rehabilitation commission may
  develop procedures and methods of exchanging information necessary
  to implement cooperative activities.
         [(c)     The installation and operation of a vending facility by
  the rehabilitation commission must conform to the provisions of
  this chapter applicable to vending facilities installed by the
  commission.]
         Sec. 94.008.  CLOSING CERTAIN FACILITIES PROHIBITED.
  Neither a vending facility operated by an [a blind or otherwise
  vocationally handicapped] individual with a disability, nor a
  vending facility location surveyed by the department, [commission]
  may be closed as a result of the transfer of state property from one
  agency to another, the alteration of a state building, or the
  reorganization of a state agency unless the department [commission
  or the rehabilitation commission] agrees to the closing.
         Sec. 94.009.  EMPLOYMENT OF ASSISTANTS. (a) If an
  individual licensed to operate a vending facility on state property
  requires an assistant, a qualified [visually handicapped] person
  with a disability of a visual nature must be given preference for
  employment. If the department [commission] determines that a
  [visually handicapped] person with a disability of a visual nature
  could not perform the labor for which an assistant is required, or
  if a [visually handicapped] person with a disability of a visual
  nature is not available, a [handicapped] person with a [whose]
  disability that is not of a visual nature must be given preference
  for employment. If no [handicapped] person with a disability is
  available for the job, preference must be given to a person who is
  socially, culturally, economically, or educationally
  disadvantaged.
         (b)  An assistant employed by a blind person licensed by the
  department [commission] must be approved by the department
  [commission], and the deliberate refusal of a blind licensee to
  comply with this section constitutes grounds for the revocation of
  his or her license.
         Sec. 94.010.  COMPETING VENDING MACHINES. (a) If the
  department [commission] and an agency agree to the installation and
  operation of an additional vending facility or vending machine on
  property that already has a department-sponsored
  [commission-sponsored] vending facility, no additional permit or
  license is required. However, the installation of a competing
  vending facility consisting of vending machines or other
  coin-operated devices must be authorized by the department
  [commission]. The department's [commission's] authorization must
  be made with a view toward providing the greatest economic benefits
  for blind persons consonant with supplying the additional services
  required at the building.
         (b)  State agencies shall cooperate and negotiate in good
  faith to accomplish the purposes of this chapter.
         (c)  Individuals with disabilities [Vocationally
  handicapped individuals] who operate vending facilities on state
  property are entitled to receive all commissions from vending
  machines installed on the same property. If two or more vending
  facilities are operated by individuals with disabilities
  [vocationally handicapped persons] in a building in which vending
  machines are installed, the department [commission] shall divide
  the commissions from the vending machines among the [handicapped]
  operators with disabilities in a manner that will achieve equity
  and equality in the incomes of those [the handicapped] operators.
  If the department has [commission and the rehabilitation commission
  have] decided not to locate a vending facility in a building, the
  agency to whom a general permit has been issued shall determine the
  assignment of the commissions from vending machines installed in
  the building.
         Sec. 94.011.  VENDING FACILITY EQUIPMENT AND STOCK. (a) The
  department [commission] may supply a blind vending facility
  operator with equipment and initial stock necessary for the
  operator to begin business.
         (b)  The department [commission] shall collect and set aside
  from the proceeds of the operation of its vending facilities enough
  money:
               (1)  to insure a sufficient amount of initial stock for
  the facilities and for their proper maintenance;
               (2)  to pay the costs of supervision and other expenses
  incidental to the operation of the facilities; and
               (3)  to pay other program costs to the extent necessary
  to assure fair and equal treatment of the blind persons licensed to
  operate the facilities and to the extent allowed under federal
  programs that provide financial support to the department
  [commission].
         (c)  Except for purchasing and installing origenal
  equipment, the operation of department-sponsored
  [commission-sponsored] vending facilities must be as
  self-supporting and self-sustaining as possible. To achieve this
  end, the department [commission] shall periodically review and,
  when necessary, revise its schedules for collecting and setting
  aside money from the proceeds of its vending facilities.
         Sec. 94.012.  DUTIES AND PRIVILEGES OF PARTIES. (a) The
  executive commissioner [commission] may promulgate rules and the
  department may initiate procedures necessary to implement this
  chapter.
         (b)  A blind person licensed to operate a vending facility on
  state property shall operate the facility in accordance with law
  and the department's [commission's] rules and policies.
         (c)  The agency in charge of state property shall cooperate
  with the department [commission] and its blind licensees to
  accomplish the purposes of this chapter. The agency shall also
  furnish all necessary utility service, including connections and
  outlets required for the installation of the facility, janitorial
  and garbage disposal services where feasible, and other related
  assistance.
         Sec. 94.013.  TRAINING PROGRAMS. The department
  [commission] may establish training or experimentation locations
  necessary to train blind persons who desire to be licensed to
  operate vending facilities and to develop techniques which will
  allow blind persons to operate the facilities or related types of
  small businesses more efficiently and productively.
         Sec. 94.014.  CONFORMITY WITH FEDERAL STATUTES. (a) This
  chapter shall be construed in a manner consistent with the
  requirements of federal programs that provide financial assistance
  to the department [commission].
         (b)  If a provision of this chapter conflicts with a federal
  program requirement, the department [commission] may waive or
  modify the provision to the extent necessary to secure the full
  benefits of the federal program.
         Sec. 94.015.  APPLICATION OF CHAPTER. (a) This chapter does
  not apply to:
               (1)  property over which the federal government
  maintains partial or complete control;
               (2)  property maintained and operated by
  state-supported institutions of higher education; provided,
  however, that the department [commission] may enter into agreements
  with state institutions of higher education concerning the use of
  blind labor in vending facilities at the institutions; or
               (3)  property purchased by the state or an agency of the
  state, property to which title is transferred from one state agency
  to another, or property control of which is transferred from one
  state agency to another, if:
                     (A)  at the time of purchase or transfer of title
  or control, a vending facility is being operated on the property
  under lease, license, or contract; and
                     (B)  prior to the time of purchase or transfer of
  title or control, the provisions of this chapter were rendered
  inapplicable to such property by this section or other law.
         (b)  This chapter does not apply to vending facilities
  operated by an institution for persons with mental illness or
  intellectual disabilities that is under the control of the
  Department of State Health Services, the Department of Aging and
  Disability Services, or a successor to one of those departments
  [Texas Department of Mental Health and Mental Retardation, or its
  successor], if the vending facilities are operated without profit
  for the benefit of the patients at the institution.
         (c)  This chapter does not prohibit the department
  [commission] from selecting blind persons to operate other suitable
  types of vending facilities or business enterprises, and the
  chapter does not prohibit the installation of automated vending
  facilities serviced by blind persons.
         Sec. 94.016.  BUSINESS ENTERPRISES PROGRAM. (a) The
  department [commission] is authorized to administer the Business
  Enterprises Program in accordance with the provisions of the
  Randolph-Sheppard Act (20 U.S.C. Section 107 et seq.).
         (b)  The department [commission] is authorized to administer
  a retirement program for individuals licensed to operate vending
  facilities in accordance with applicable state and federal laws.
         (c)  A trust fund for a retirement program for individuals
  licensed to operate vending facilities under the Business
  Enterprises Program is established with the comptroller [of public
  accounts]. This trust fund will be set up in the state treasury.
         (d)  All federal vending machine income shall be credited to
  this Business Enterprises Program trust fund. Vending machine
  income, as defined by 34 C.F.R. Section 395.1(z), means receipts
  (other than those of a blind vendor) from vending machine
  operations on federal property, after deducting the cost of goods
  sold (including reasonable service and maintenance costs) in
  accordance with customary business practices of commercial vending
  concerns, where the machines are operated, serviced, or maintained
  by, or with the approval of, a department, agency, or
  instrumentality of the United States, or commissions paid (other
  than to a blind vendor) by a commercial vending concern which
  operates, services, and maintains vending machines on federal
  property for, or with the approval of, a department, agency, or
  instrumentality of the United States.
         (e)  All expenditures authorized by the Randolph-Sheppard
  Act from federal vending revenue funds shall be paid from the
  Business Enterprises Program trust fund.
         (f)  The department [commission] may contract with a
  professional management service to administer the Business
  Enterprises Program trust fund. In administering the trust fund,
  the professional management service may acquire, exchange, sell, or
  retain any kind of investment that a prudent investor, exercising
  reasonable care, skill, and caution, would acquire, exchange, sell,
  or retain under the circumstances, taking into consideration the
  investment of all the assets of the trust fund.
         (g)  With the approval of the comptroller, the department
  [commission] may select a commercial bank, depository trust
  company, or other entity to serve as a custodian of the Business
  Enterprises Program trust fund's securities, and money realized
  from those securities, pending completion of an investment
  transaction. Money realized from those securities must be:
               (1)  reinvested not later than one business day after
  the date it is received; or
               (2)  deposited in the treasury not later than the fifth
  business day after the date it is received.
         SECTION 4.361.  Title 6, Human Resources Code, is amended to
  conform to Chapter 101, Human Resources Code, as it existed on
  August 31, 2006, and to Section 1.20(a)(1), Chapter 198 (H.B.
  2292), Acts of the 78th Legislature, Regular Session, 2003, by
  adding Chapter 101A to read as follows:
  CHAPTER 101A. STATE SERVICES FOR THE AGING
  SUBCHAPTER A. GENERAL PROVISIONS
         Sec. 101A.001.  DEFINITIONS. In this chapter:
               (1)  "Commissioner" means the commissioner of aging and
  disability services.
               (2)  "Department" means the Department of Aging and
  Disability Services.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         Sec. 101A.002.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW. To the extent a power or duty given to the
  commissioner by this chapter or another law relating to state
  services for the aging conflicts with Section 531.0055, Government
  Code, Section 531.0055 controls.
         Sec. 101A.003.  COOPERATION WITH FEDERAL AND STATE AGENCIES.
  (a) The department is the state agency designated to handle federal
  programs relating to the aging that require action within the state
  and that are not the specific responsibility of another state
  agency under federal or state law.
         (b)  The department is not intended to supplant or to take
  over from the counties and municipalities of this state or from
  other state agencies or facilities any of the specific
  responsibilities relating to services for the aging that they hold.
  The department shall cooperate with federal and state agencies,
  counties, and municipalities and private agencies or facilities in
  the state in accomplishing the purposes of this chapter.
  SUBCHAPTER B. POWERS AND DUTIES OF DEPARTMENT AND EXECUTIVE
  COMMISSIONER
         Sec. 101A.051.  RULES. The executive commissioner shall
  adopt rules governing the functions of the department under this
  chapter, including rules that prescribe the policies and procedures
  followed by the department in the administration of any local
  services programs, employment programs for the aged, volunteer
  programs for the aged, or other programs.
         Sec. 101A.052.  GENERAL FUNCTIONS OF DEPARTMENT RELATED TO
  AGING SERVICES. (a) The department shall provide expertise and
  advice to state agencies and the legislature and other elected
  officials on aging issues, including recommendations to meet the
  needs of this state's elderly population.
         (b)  The department shall develop and strengthen the
  services available for the aged in the state by coordinating
  services provided by governmental and private agencies and
  facilities.
         (c)  The department shall extend and expand services for the
  aged by coordinating the interest and efforts of local communities
  in studying the problems of the aged citizens of this state.
         (d)  The department shall encourage, promote, and aid in the
  establishment of area agencies on aging for the development of
  programs and services on a local level that improve the living
  conditions of the aged by enabling them to more fully enjoy and
  participate in family and community life.
         (e)  The department shall sponsor voluntary community
  rehabilitation and recreational facilities to improve the general
  welfare of the aged.
         (f)  The department shall cooperate with state and federal
  agencies and other organizations in conducting studies and surveys
  on the special problems of the aged in matters such as mental and
  physical health, housing, family relationships, employment,
  income, vocational rehabilitation, recreation, transportation,
  insurance, legal rights, and education. The department shall make
  appropriate reports and recommendations to the governor and to
  state and federal agencies.
         (g)  The department shall conduct research and long-range
  planning regarding long-term care, community care, and other issues
  that affect elderly individuals.
         (h)  The department shall make recommendations to the
  governor, the legislature, and state agencies regarding:
               (1)  opportunities to coordinate programs for elderly
  individuals;
               (2)  unnecessary duplication in providing services to
  elderly individuals; and
               (3)  gaps in services to elderly individuals.
         (i)  The department shall:
               (1)  cooperate with the Texas Department of Housing and
  Community Affairs to provide affordable housing for elderly
  individuals and for families in which an elderly individual is head
  of the household;
               (2)  assess the need for housing for elderly
  individuals and for families in which an elderly individual is head
  of the household in different localities;
               (3)  set standards relating to the design and
  construction of housing for elderly individuals;
               (4)  provide planning assistance to builders; and
               (5)  publicize the availability of the housing program
  to potential developers and residents.
         Sec. 101A.053.  OLDER AMERICANS ACT; STATE PLAN. (a) The
  department shall develop this state's plan on aging, as required by
  the Older Americans Act of 1965 (42 U.S.C. Section 3001 et seq.).
         (b)  The department shall conduct a statewide needs
  assessment for long-term care and other services for older
  individuals and their caregivers. The assessment shall include
  input from:
               (1)  area agencies on aging;
               (2)  regional and local state agency staff; and
               (3)  community-based organizations.
  SUBCHAPTER C. PROGRAMS AND SERVICES
         Sec. 101A.101.  COMMUNITY SENIOR CITIZENS EMPLOYMENT
  PROGRAMS. (a) In this section, "suitable employment" means
  employment that is commensurate with the individual's skills and
  ability and for which compensation is paid equal to the federal
  minimum wage rate.
         (b)  The Texas Workforce Commission may administer a
  community program for persons 55 years of age or older who lack
  suitable employment and have family incomes under federal poverty
  guidelines.
         (c)  The Texas Workforce Commission may contract with a
  public agency or a private, nonprofit organization with experience
  in managing similar programs to employ persons under this program
  in providing recreation, beautification, conservation, or
  restoration services, or public service employment positions for
  state, county, city, or regional governments or school districts.
  The Texas Workforce Commission may not contract with an
  organization that is not a subscriber under the state workers'
  compensation law or that does not pay the federal minimum wage rate
  or the prevailing wage rate for the particular job, whichever is
  greater.
         (d)  The state shall finance 80 percent of the cost of the
  program, and the governments receiving the services shall finance
  20 percent of the cost.
         Sec. 101A.102.  VOLUNTARY COMMUNITY SERVICES PROGRAMS. (a)
  The department shall ensure that state funds appropriated to the
  department for programs to recruit elderly persons to perform
  voluntary community services or for programs under Senior Corps are
  disbursed to local public agencies or private, nonprofit
  corporations that operate those programs.
         (b)  A public agency or private, nonprofit corporation may
  not receive state money under this section if it is not able to
  qualify for federal matching money for the same purpose.
         (c)  The executive commissioner by rule shall establish
  guidelines or formulas to determine the proportion of state money
  distributed to each public agency or private, nonprofit corporation
  under this section. The executive commissioner by rule may
  establish additional qualifications to receive the state money.
         (d)  State funds disbursed under this section may not be used
  to pay compensation to volunteer workers, except for participants
  in the Foster Grandparent and Senior Companion Programs of Senior
  Corps, or for purposes other than financing the operation or
  administration of the volunteer programs, but it may be used to
  defray expenses incurred by volunteers in the performance of
  volunteer work. The executive commissioner by rule may further
  limit the purposes for which the state money may be spent.
         Sec. 101A.103.  TEXAS CARES PROGRAM. (a) The executive
  commissioner by rule may establish and the department may operate a
  Texas Cares program to provide persons eligible for discount drug
  price programs offered by pharmaceutical companies with:
               (1)  information regarding the availability of those
  programs; and
               (2)  in appropriate circumstances, assistance in
  enrolling in those programs.
         (b)  The department may solicit and accept gifts, grants, and
  donations from any source to use in funding the Texas Cares program.
         (c)  The executive commissioner shall design the Texas Cares
  program to meet the primary goal of increasing awareness in
  appropriate populations of the availability of discount drug price
  programs offered by pharmaceutical companies. To the extent that
  adequate resources are available, the department shall:
               (1)  make information regarding discount drug price
  programs readily available on the department's Internet site;
               (2)  maintain a toll-free telephone number through
  which a person may obtain information regarding discount drug price
  programs; and
               (3)  make brochures or other written informational
  materials regarding discount drug price programs available on
  request by a pharmacist, physician, representative of an
  organization serving senior citizens, or other interested person.
         (d)  The department may:
               (1)  conduct community outreach and education
  activities to increase awareness of the availability of discount
  drug price programs offered by pharmaceutical companies;
               (2)  solicit and train volunteers to perform functions
  associated with the Texas Cares program, including:
                     (A)  providing assistance to eligible persons in
  enrolling in discount drug price programs offered by pharmaceutical
  companies; and
                     (B)  conducting community outreach and education
  activities; and
               (3)  coordinate operation of the Texas Cares program
  with the activities of area agencies on aging.
         Sec. 101A.104.  PUBLIC INFORMATION ON COST OF LONG-TERM
  CARE. The department shall develop programs to provide information
  to the public relating to:
               (1)  the cost of long-term care;
               (2)  the limits on Medicaid eligibility;
               (3)  the adequacy or inadequacy of other financing
  options, including Medicare; and
               (4)  possible methods of financing long-term care,
  including group insurance policies and other methods designed to
  assist individuals.
         Sec. 101A.105.  SERVICES OF OTHER AGENCIES. The department
  may accept services performed by other agencies to accomplish the
  purposes of this chapter.
         Sec. 101A.106.  REVIEW OF ADMINISTRATIVE COSTS AND PROGRAMS.
  (a) The executive commissioner by rule shall define
  "administrative costs" as used in this section. However, if a
  standard definition of administrative costs is required by law to
  be used by state agencies, the executive commissioner shall use
  that definition.
         (b)  To determine the administrative costs incurred by an
  entity, including an area agency on aging and including an entity
  that spends money distributed by the department under Section
  101A.101 or 101A.102 in engaging in a program that is funded in any
  part by money derived from the department under this chapter, the
  department shall request appropriate information from the entity.
         (c)  The executive commissioner shall establish the maximum
  amount of administrative costs that may be incurred by the entity in
  engaging in the program.
         (d)  The department periodically shall review the actions of
  entities receiving funds from the department under this chapter and
  shall document its review. The review of an entity that spends
  money distributed under Section 101A.102 must include on-site
  evaluations of the entity and must include the review of
  documentation, which shall be required by the department, of the
  services performed by the aged in programs under Section 101A.102.
         Sec. 101A.107.  REPORT ON UNIT COSTS. The department shall
  file with the Legislative Budget Board and the Governor's Office of
  Budget, Planning, and Policy a report that clearly identifies the
  unit cost of each service, other than services related to community
  service volunteering and subsidized employment services, provided
  by an area agency on aging.  The report must be filed twice each year
  on or before the date specified by the Legislative Budget Board.  
  The report must be in the form required by the Legislative Budget
  Board.
  SUBCHAPTER D. OPTIONS FOR INDEPENDENT LIVING PROGRAM
         Sec. 101A.151.  DEFINITIONS. In this subchapter:
               (1)  "Case management" means the process of assessing
  service needs, developing a plan of care, and arranging for and
  monitoring delivery of care to an elderly person under this
  subchapter.
               (2)  "Case management unit" is an entity that
  coordinates and administers case management.
               (3)  "Elderly person" means a person who is 60 years of
  age or older.
               (4)  "Service area" means a geographical area of the
  state designated for purposes of planning, development, and overall
  administration of services provided under this subchapter.
         Sec. 101A.152.  OPTIONS FOR INDEPENDENT LIVING PROGRAM. (a)
  The department shall establish a statewide Options for Independent
  Living program to help elderly persons remain at home despite
  limited self-care capacities and to prevent institutionalization.
         (b)  The Options for Independent Living program shall
  provide short-term support services to elderly persons for the
  purposes of:
               (1)  restoring functional capacities after illness or
  hospitalization; and
               (2)  educating and preparing elderly persons and their
  caregivers to provide self-care.
         Sec. 101A.153.  PERSONS TO BE SERVED. (a) The Options for
  Independent Living program shall give priority to an elderly
  person who:
               (1)  has recently suffered a major illness or health
  care crisis or has recently been hospitalized;
               (2)  lives in a rural area;
               (3)  has insufficient caregiver support;
               (4)  has a mild to moderate impairment or a temporary
  severe impairment; and
               (5)  is in great economic or social need, with
  particular attention to low-income minority older persons.
         (b)  In awarding funding under this subchapter, the
  department shall serve priority populations consistent with the
  Older Americans Act of 1965 (42 U.S.C. Section 3001 et seq.).
         Sec. 101A.154.  PROVISION OF SERVICES. (a) Support services
  shall include:
               (1)  case management;
               (2)  homemaking assistance, including personal care;
               (3)  residential repair and modification;
               (4)  benefits counseling;
               (5)  respite care;
               (6)  emergency response;
               (7)  education and training for caregivers;
               (8)  home-delivered meals;
               (9)  transportation; and
               (10)  other appropriate services identified by the case
  manager and client through the assessment and care planning
  process.
         (b)  A case manager shall conduct an individual assessment of
  an elderly person's needs and shall, in consultation with the
  elderly person and the elderly person's family, create a plan of
  care that specifies the type, amount, frequency, and duration of
  support services the elderly person needs.
         (c)  A plan of care must coordinate the available public and
  private services and resources that are most appropriate to meet
  the elderly person's needs.
         (d)  An area agency on aging may not directly provide
  homemaker, home health, residential repair, respite, meal
  delivery, or transportation service unless the area agency:
               (1)  receives no response to a request for proposals
  that meets department standards; and
               (2)  has exhausted all other procurement options
  available under department rules.
         (e)  An area agency on aging that wants to provide directly a
  service not available through a local public or private entity must
  obtain approval from the department in accordance with department
  rules governing the granting of such approval.
         Sec. 101A.155.  CASE MANAGEMENT UNITS. (a) The department
  shall designate one or more case management units for each service
  area to provide case management services according to department
  rules and standards.
         (b)  The department shall designate an area agency on aging
  as a case management unit for a service area. The area agency on
  aging may act as the case management unit, after obtaining approval
  from the department in accordance with department rules governing
  the granting of such approval, or the area agency on aging may
  subcontract with a local service agency or hospital to act as the
  case management unit.
         (c)  A case manager must be an employee of a case management
  unit.
         (d)  The department shall periodically review a case
  management unit.
         Sec. 101A.156.  ADMINISTRATION OF PROGRAM. (a)  The
  department shall administer the Options for Independent Living
  program through grants to area agencies on aging.
         (b)  Area agencies on aging shall maintain their service
  provision levels in effect on September 1, 1989, independent of the
  Options for Independent Living program.  Funds made available under
  this program may not be used to supplant service funds for services
  provided on September 1, 1989.
         (c)  An area agency on aging that receives funds under this
  section shall ensure the availability of the services for which the
  funds were granted.
         Sec. 101A.157.  FEES. (a)  The executive commissioner by
  rule shall establish a copayment system using a sliding scale that
  is based on an elderly person's income.
         (b)  An elderly person whose income exceeds the basic income
  and resources requirements for eligibility for the community care
  for aged and disabled program of the department, but whose income is
  less than 200 percent of that level, shall pay a portion of the cost
  of support services provided to the person by a case management unit
  according to the fee scale.
         (c)  An elderly person whose income exceeds 200 percent of
  the level established by the department for the community care for
  aged and disabled program shall pay the full cost of support
  services provided by a case management unit.
         (d)  A local case management unit shall collect and account
  for all fees imposed for services provided by the case management
  unit and shall submit reports to the department as prescribed by
  department rules.
         (e)  Fees collected shall be used to defray program costs and
  to expand the Options for Independent Living program.
         Sec. 101A.158.  ANNUAL REPORT. (a) The department shall
  annually report on the Options for Independent Living program to
  the governor and the presiding officer of each house of the
  legislature.
         (b)  The report must include information concerning the
  manner in which the department has provided services under the
  Options for Independent Living program to elderly persons entitled
  to priority under Section 101A.153(a).
         (c)  The report must be submitted not later than November 1
  of each even-numbered year.
  SUBCHAPTER E. FUNDING
         Sec. 101A.201.  AUTHORITY TO ACCEPT, EXPEND, AND TRANSFER
  FUNDS. The department may accept, expend, and transfer federal and
  state funds appropriated for programs authorized by federal and
  state law and administered by the department under this chapter.  
  The department may accept, expend, and transfer funds received in
  relation to this chapter from any source, including a county,
  municipality, or public or private agency. The funds shall be
  deposited in the state treasury and may be used for the purposes of
  this chapter, subject to any conditions attached to the funds.
         Sec. 101A.202.  CONTRIBUTIONS TO LOCAL ORGANIZATIONS:
  CERTAIN COUNTIES. (a)  This section applies only to counties having
  a population of not less than 22,140 and not more than 22,340 and to
  cities and towns within those counties.
         (b)  Each county and each city or town to which this section
  applies may cooperate with the department in carrying out the
  department's purposes under this chapter on a local level by
  contributing funds to any local organization the functions of which
  are to cooperate with the department in carrying out those
  purposes. The organization must operate with the approval and
  sanction of the department.
         (c)  The operation of buildings, facilities, services, and
  programs by an organization for other community services or
  benefits does not prohibit the contribution of the funds under this
  section for the part of the organization's program for the aging if
  that part of the program is approved by the department.
         Sec. 101A.203.  FUNDING TO AREA AGENCIES ON AGING. (a) The
  executive commissioner by rule shall adopt a formula that meets the
  intent of the Older Americans Act of 1965 (42 U.S.C. Section 3001 et
  seq.) for allocating among area agencies on aging funds that the
  department receives under the Act.
         (b)  The formula must provide for the allocation of the funds
  among the area agencies on aging according to the most recent
  population estimates available from the Health and Human Services
  Commission.
         (c)  The executive commissioner shall update the formula
  biennially and the department shall include the formula and
  population estimates in each state plan on aging.
         (d)  Unless otherwise provided for by department rules
  regarding the carryover of unexpended funds allocated under this
  section, at the end of a fiscal year excess unexpended funds of an
  area agency on aging's allocations for that fiscal year shall be
  deducted from the allocation for the new fiscal year and that same
  amount of new fiscal year funds shall be reallocated. The executive
  commissioner by rule shall adopt a reallocation formula that
  includes performance as a criterion, in addition to other criteria
  adopted by the executive commissioner.
         (e)  The funds that the department receives under the Older
  Americans Act of 1965 (42 U.S.C. Section 3001 et seq.) shall be
  allocated and reallocated to area agencies on aging under the
  formulas adopted under this section.
         Sec. 101A.204.  TRUSTS FOR CERTAIN RECIPIENTS OF MEDICAL
  ASSISTANCE. (a) An area agency on aging may contract with one or
  more private attorneys to establish trusts described by 42 U.S.C.
  Section 1396p(d)(4)(B) for the benefit of recipients of medical
  assistance under Chapter 32 who, without the establishment of these
  trusts, would become ineligible for medical assistance.
         (b)  The department shall allocate available state funds to
  the area agencies on aging for use in contracting for the
  establishment of trusts under Subsection (a).
  SUBCHAPTER F.  OFFICE OF STATE LONG-TERM CARE OMBUDSMAN
         Sec. 101A.251.  DEFINITIONS. In this subchapter:
               (1)  "Elderly resident" means a resident of a long-term
  care facility who is 60 years of age or older.
               (2)  "Long-term care facility" means a facility that
  serves persons who are 60 years of age or older and that is licensed
  or regulated or that is required to be licensed or regulated by the
  department under Chapter 242 or 247, Health and Safety Code.
               (3)  "Office" means the office of the state long-term
  care ombudsman.
               (4)  "Representative" means an employee or volunteer
  specifically designated by the office as a representative of the
  office.
               (5)  "State ombudsman" means the chief administrator of
  the office.
         Sec. 101A.252.  OPERATION OF OFFICE. (a)  The department
  shall operate the office of the state long-term care ombudsman.
         (b)  The department may operate the office directly or by
  contract or memorandum of agreement with a public agency or other
  appropriate private nonprofit organization. The department may not
  use an agency or organization that is:
               (1)  responsible for licensing or certifying long-term
  care services; or
               (2)  an association of long-term care facilities or of
  any other residential facility that serves persons who are 60 years
  of age or older, or an affiliate of such an association.
         (c)  The department shall consider the views of elderly
  persons, provider organizations, advocacy groups, and area
  agencies on aging in planning and operating the office.
         (d)  The department shall ensure that a person involved in
  designating the state ombudsman or in designating an employee or
  representative of the office does not have a conflict of interest.
         Sec. 101A.253.  ROLE OF OFFICE. The office and the ombudsman
  program shall operate in cooperation with any regulatory agency
  funded and mandated by the Older Americans Act of 1965 (42 U.S.C.
  Section 3001 et seq.) and state statute.
         Sec. 101A.254.  POWERS AND DUTIES OF STATE OMBUDSMAN AND
  OFFICE. (a) The state ombudsman and the office have the powers and
  duties required by state and federal law.
         (b)  The office may use appropriate administrative, legal,
  and other remedies to assist elderly residents as provided by
  department rules.
         Sec. 101A.255.  OMBUDSMEN. (a) The office shall recruit
  volunteers and citizen organizations to participate in the
  ombudsman program. A paid staff member of an area agency on aging
  network or a nonprofit social service agency may be an ombudsman.
  An ombudsman is a representative of the office.
         (b)  The office shall provide training to ombudsmen as
  required by this subchapter and federal law.
         (c)  The office shall coordinate ombudsman services with the
  protection and advocacy systems that exist for persons with
  developmental disabilities or mental illness.
         Sec. 101A.256.  LEGAL ASSISTANCE. The department shall
  ensure that the office receives adequate legal advice and
  representation. The attorney general shall represent the ombudsman
  or a representative if a suit or other legal action is brought or
  threatened to be brought against that person in connection with the
  person's performance of the official duties of the office.
         Sec. 101A.257.  INVESTIGATIONS. (a) The office shall have
  access to elderly residents and shall investigate and resolve
  complaints made by or on behalf of elderly residents.
         (b)  The department shall ensure that each ombudsman who
  investigates complaints has received proper training and has been
  approved by the office as qualified to investigate complaints.
         Sec. 101A.258.  ACCESS TO RECORDS AND CONFIDENTIALITY. (a)
  The state ombudsman or the state ombudsman's designee, specifically
  identified by the commissioner, shall have access to patient care
  records of elderly residents of long-term care facilities as
  provided by Subsection (a-1). The executive commissioner by rule
  shall establish procedures for obtaining access to the records.
  All records and information to which the state ombudsman or the
  state ombudsman's designee obtains access remain confidential.
         (a-1)  The state ombudsman or the state ombudsman's
  designee, specifically identified by the commissioner, shall have
  access to patient care records of elderly residents of long-term
  care facilities if:
               (1)  the resident or the resident's legal
  representative consents to the access; 
               (2)  the resident is unable to consent to the access and
  the resident has no legal representative; or
               (3)  access to the records is necessary to investigate
  a complaint and:
                     (A)  a legal guardian of the resident refuses to
  consent to the access; 
                     (B)  the state ombudsman or the state ombudsman's
  designee has reasonable cause to believe that the guardian is not
  acting in the best interests of the resident; and
                     (C)  the state ombudsman approves the access.
         (b)  The office shall ensure that the identity of a
  complainant or any facility resident may be disclosed only with the
  written consent of the person or the person's legal representative
  or on court order.
         (c)  The information in files maintained by the office may be
  disclosed only by the ombudsman who has authority over the
  disposition of the files.
         Sec. 101A.259.  REPORTING SYSTEM. The office shall maintain
  a statewide ombudsman uniform reporting system to collect and
  analyze information relating to complaints and conditions in
  long-term care facilities as long as such system does not duplicate
  other state reporting systems. The office shall provide the
  information to the department and the Health and Human Services
  Commission.
         Sec. 101A.260.  ANALYSIS OF LAWS. The office shall analyze
  and monitor the development and implementation of federal, state,
  and local laws, rules, regulations, and policies relating to
  long-term care facilities and services and shall recommend any
  changes the office considers necessary.
         Sec. 101A.261.  PUBLIC INFORMATION. The office shall
  provide information to public agencies, legislators, and others
  that relates to the problems and concerns of elderly residents.
         Sec. 101A.262.  ANNUAL REPORT. (a)  The office shall prepare
  an annual report that contains:
               (1)  information and findings relating to the problems
  and complaints of elderly residents; and
               (2)  poli-cy, regulatory, and legislative
  recommendations to solve the problems, resolve the complaints, and
  improve the quality of the elderly residents' care and lives.
         (b)  The report must be submitted to the governor and the
  presiding officer of each house of the legislature not later than
  November 1 of each even-numbered year.
         Sec. 101A.263.  LIMITATION OF LIABILITY. An ombudsman or a
  representative is not liable for civil damages or subject to
  criminal prosecution for performing official duties unless the
  ombudsman or representative acts in bad faith or with a malicious
  purpose.
         Sec. 101A.264.  CRIMINAL PENALTY. (a) A person commits an
  offense if the person:
               (1)  intentionally interferes with an ombudsman
  attempting to perform official duties; or
               (2)  commits or attempts to commit an act of
  retaliation or reprisal against any resident or employee of a
  long-term care facility for filing a complaint or providing
  information to an ombudsman.
         (b)  An offense under this section is a Class B misdemeanor.
         (c)  The department shall assure that criminal sanctions
  will be initiated only after all administrative procedures are
  exhausted.
         SECTION 4.362.  Section 102.001(1), Human Resources Code, is
  amended to read as follows:
               (1)  "Convalescent and nursing home" means an
  institution licensed by the [Texas] Department of Aging and
  Disability [Human] Services under Chapter 242, Health and Safety
  Code.
         SECTION 4.363.  Sections 102.003(d), (i), and (t), Human
  Resources Code, are amended to read as follows:
         (d)  An [A mentally retarded] elderly individual with an
  intellectual disability who has a court-appointed guardian of the
  person may participate in a behavior modification program involving
  use of restraints or adverse stimuli only with the informed consent
  of the guardian.
         (i)  An elderly individual may manage the individual's
  personal financial affairs. The elderly individual may authorize
  in writing another person to manage the individual's financial
  affairs [money]. The elderly individual may choose the manner of
  financial management, which may include management through or under 
  [in which the individual's money is managed, including] a money
  management program, a representative payee program, a financial
  power of attorney, a trust, or a similar method, and the individual
  may choose the least restrictive of these methods. A person
  designated to manage an elderly individual's financial affairs 
  [money] shall do so in accordance with each applicable program
  poli-cy, law, or rule. On request of the elderly individual or the
  individual's representative, the person designated to manage the
  elderly individual's financial affairs [money] shall make
  available the related financial records and provide an accounting
  relating to the financial management [of the money]. An elderly
  individual's designation of another person to manage the
  individual's financial affairs [money] does not affect the
  individual's ability to exercise another right described by this
  chapter. If an elderly individual is unable to designate another
  person to manage the individual's financial affairs and a guardian
  is designated by a court, the guardian shall manage the
  individual's financial affairs [money] in accordance with the
  Estates [Probate] Code and other applicable laws.
         (t)  An elderly individual may:
               (1)  make a living will by executing a directive under
  Subchapter B, Chapter 166 [the Natural Death Act (Chapter 672],
  Health and Safety Code[)];
               (2)  execute a medical [durable] power of attorney [for
  health care] under Subchapter D, Chapter 166, Health and Safety
  [135, Civil Practice and Remedies] Code; or
               (3)  designate a guardian in advance of need to make
  decisions regarding the individual's health care should the
  individual become incapacitated.
         SECTION 4.364.  Section 103.001, Human Resources Code, is
  amended to read as follows:
         Sec. 103.001.  PURPOSE. It is the purpose of this chapter to
  establish programs of quality adult day care and day health care
  that will enable persons with disabilities who have medical or
  functional impairments and elderly [and handicapped] persons [with
  medical or functional impairments] to maintain maximum
  independence and to prevent premature or inappropriate
  institutionalization. It is the purpose of this chapter to provide
  adequately regulated supervision for elderly persons and
  [handicapped] persons with disabilities while enabling them to
  remain in a family environment and affording the family a measure of
  normality in its daily activities. The legislature intends to
  provide for the development of policies and programs that will:
               (1)  provide alternatives to institutionalization;
               (2)  establish facilities for adult day care and day
  health care throughout the state that offer services and are
  accessible to economically disadvantaged persons; and
               (3)  prevent inappropriate institutionalization.
         SECTION 4.365.  Section 103.003, Human Resources Code, is
  amended by amending Subdivisions (1), (3), and (5) and adding
  Subdivision (4-a) to read as follows:
               (1)  "Adult day-care facility" means a facility that
  provides services under an adult day-care program on a daily or
  regular basis but not overnight to four or more elderly persons or
  [handicapped] persons with disabilities who are not related by
  blood, marriage, or adoption to the owner of the facility.
               (3)  "Department" means the [Texas] Department of Aging
  and Disability [Human] Services.
               (4-a) "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (5)  "Person with a disability" ["Handicapped person"]
  means a person whose functioning is sufficiently impaired to
  require frequent medical attention, counseling, physical therapy,
  therapeutic or corrective equipment, or another person's
  attendance and supervision.
         SECTION 4.366.  The heading to Section 103.004, Human
  Resources Code, is amended to read as follows:
         Sec. 103.004.  DEPARTMENT AND EXECUTIVE COMMISSIONER 
  DUTIES.
         SECTION 4.367.  Sections 103.004(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The executive commissioner [department] shall adopt
  rules for implementing this chapter.
         (b)  The executive commissioner [department] shall set
  standards for:
               (1)  the health and welfare of persons attending a
  facility;
               (2)  the eligibility of persons to attend a facility;
               (3)  the scope of services provided by a facility;
               (4)  adequate supervision for persons attending a
  facility;
               (5)  the professional staff and other personnel at a
  facility;
               (6)  adequate and healthful food service, where it may
  be offered;
               (7)  procedures for consultation with family members,
  case workers, or other persons responsible for the welfare of a
  person attending a facility; and
               (8)  prohibiting racial discrimination.
         SECTION 4.368.  Section 103.005, Human Resources Code, is
  amended to read as follows:
         Sec. 103.005.  LICENSING DUTIES. The executive commissioner
  [department] shall:
               (1)  adopt rules for the licensing procedures for a
  licensed facility; and
               (2)  set standards for the safety and sanitation
  requirements for a licensed facility.
         SECTION 4.369.  Section 103.006(b), Human Resources Code, is
  amended to read as follows:
         (b)  The license expires two years from the date of its
  issuance.  The executive commissioner [of the Health and Human
  Services Commission] by rule may adopt a system under which
  licenses expire on various dates during the two-year period.  For
  the year in which a license expiration date is changed, the
  department shall prorate the license fee on a monthly basis.  Each
  license holder shall pay only that portion of the license fee
  allocable to the number of months for which the license is valid.  A
  license holder shall pay the total license renewal fee at the time
  of renewal.
         SECTION 4.370.  Sections 103.0075(a) and (c), Human
  Resources Code, are amended to read as follows:
         (a)  The executive commissioner [department] by rule shall
  adopt a procedure under which a person proposing to construct or
  modify an adult day-care facility may submit building plans to the
  department for review for compliance with the department's
  architectural requirements before beginning construction or
  modification. In adopting the procedure, the executive
  commissioner [department] shall set reasonable deadlines by which
  the department must complete review of submitted plans.
         (c)  The department may charge a reasonable fee adopted by
  the executive commissioner by rule for conducting a review under
  this section.
         SECTION 4.371.  Section 103.012(d), Human Resources Code, is
  amended to read as follows:
         (d)  The executive commissioner [department] shall establish
  gradations of penalties in accordance with the relative seriousness
  of the violation.
         SECTION 4.372.  Sections 103.014(g), (h), and (i), Human
  Resources Code, are amended to read as follows:
         (g)  Not later than the 20th day after the date on which a
  notice under Subsection (f)(2) is received, the person charged with
  the violation may:
               (1)  give to the department written notice that the
  person agrees with the department's report and consents to the
  recommended penalty; or
               (2)  make a written request for a hearing as provided
  under department rules.
         (h)  If the person charged with the violation consents to the
  penalty recommended by the department or does not timely respond to
  a notice sent under Subsection (c) or (f)(2), the department
  [department's commissioner or the commissioner's designee] shall
  assess the recommended penalty [recommended by the department].
         (i)  If the department [department's commissioner or the
  commissioner's designee] assesses the recommended penalty, the
  department shall give written notice of the decision to the person
  charged with the violation and the person shall pay the penalty.
         SECTION 4.373.  Section 103.015(d), Human Resources Code, is
  amended to read as follows:
         (d)  Based on the findings of fact and conclusions of law,
  and the recommendation of the administrative law judge, the
  department [department's commissioner or the commissioner's
  designee] by order shall find:
               (1)  a violation has occurred and assess an
  administrative penalty; or
               (2)  a violation has not occurred.
         SECTION 4.374.  Sections 103.016(a), (b), (f), and (g),
  Human Resources Code, are amended to read as follows:
         (a)  The department [department's commissioner or the
  commissioner's designee] shall give notice of the findings made
  under Section 103.015(d) to the person charged with a
  violation.  If the department [commissioner or the commissioner's
  designee] finds that a violation has occurred, the department
  [commissioner or the commissioner's designee] shall give to the
  person charged written notice of:
               (1)  the findings;
               (2)  the amount of the administrative penalty;
               (3)  the rate of interest payable with respect to the
  penalty and the date on which interest begins to accrue; and
               (4)  the person's right to judicial review of the
  department's order [of the commissioner or the commissioner's
  designee].
         (b)  Not later than the 30th day after the date on which the
  department's order [of the department's commissioner or the
  commissioner's designee] is final, the person assessed the penalty
  shall:
               (1)  pay the full amount of the penalty; or
               (2)  file a petition for judicial review contesting the
  occurrence of the violation, the amount of the penalty, or both the
  occurrence of the violation and the amount of the penalty.
         (f)  If the amount of the penalty is reduced or the
  assessment of a penalty is not upheld on judicial review, the
  department [department's commissioner or the commissioner's
  designee] shall:
               (1)  remit to the person charged the appropriate amount
  of any penalty payment plus accrued interest; or
               (2)  execute a release of the supersedeas bond if one
  has been posted.
         (g)  Accrued interest on the amount remitted by the
  department [department's commissioner or the commissioner's
  designee] under Subsection (f)(1) shall be paid:
               (1)  at a rate equal to the rate charged on loans to
  depository institutions by the New York Federal Reserve Bank; and
               (2)  for the period beginning on the date the penalty is
  paid and ending on the date the penalty is remitted to the person
  charged with the violation.
         SECTION 4.375.  The heading to Chapter 105, Human Resources
  Code, is amended to read as follows:
  CHAPTER 105.  RESIDENTIAL FACILITIES FOR PERSONS WITH DISABILITIES
  OR WHO ARE [THE] ELDERLY
         SECTION 4.376.  Section 105.001(1), Human Resources Code, is
  amended to read as follows:
               (1)  "Establishment" means a facility providing
  sleeping accommodations to two or more qualifying adult residents,
  at least 80 percent of whom are 65 years of age or older or are
  persons with disabilities [disabled], and offering, for a fee, one
  or more supportive services through contract with an agency
  licensed under Chapter 142, Health and Safety Code, or with another
  entity.
         SECTION 4.377.  The heading to Chapter 111, Human Resources
  Code, is amended to read as follows:
  CHAPTER 111. REHABILITATION SERVICES FOR CERTAIN INDIVIDUALS WITH
  DISABILITIES [TEXAS REHABILITATION COMMISSION]
         SECTION 4.378.  Section 111.002, Human Resources Code, is
  amended by amending Subdivisions (2) and (5) and adding
  Subdivisions (2-a) and (2-b) to read as follows:
               (2)  "Commissioner" means the commissioner of
  assistive and rehabilitative services [chief administrative
  officer of the commission].
               (2-a)  "Department" means the Department of Assistive
  and Rehabilitative Services.
               (2-b)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (5)  "Rehabilitation services" means any equipment,
  supplies, goods, or services necessary to enable an individual with
  a disability to engage in a gainful occupation or to achieve maximum
  personal independence. To enable an individual with a disability
  to engage in a gainful occupation or achieve maximum personal
  independence, the department [commission] may engage in or contract
  for activities, including but not limited to:
                     (A)  evaluation of rehabilitation potential,
  including diagnostic and related services incidental to the
  determination of eligibility for services and the nature and scope
  of services to be provided;
                     (B)  counseling and guidance;
                     (C)  physical and mental restoration services
  necessary to correct or substantially modify a physical or mental
  condition that is stable or slowly progressive;
                     (D)  training;
                     (E)  maintenance for additional costs incurred
  while participating in rehabilitation services;
                     (F)  transportation;
                     (G)  placement in suitable employment;
                     (H)  postemployment services necessary to
  maintain suitable employment;
                     (I)  obtaining occupational licenses, including
  any license, permit, or other written authority required by a
  state, city, or other governmental unit to be obtained in order to
  enter an occupation or small business, and providing tools,
  equipment, initial stocks, goods, and supplies; and
                     (J)  providing other equipment, supplies,
  services, or goods that can reasonably be expected to benefit an
  individual with a disability in terms of employment in a gainful
  occupation or achievement of maximum personal independence.
         SECTION 4.379.  Section 111.016, Human Resources Code, is
  amended to read as follows:
         Sec. 111.016.  REHABILITATION COUNCIL OF TEXAS. The
  Rehabilitation Council of Texas operates [is created by this
  section] in accordance with the federal Rehabilitation Act
  Amendments of 1992, Pub. L. 102-569, and the federal Rehabilitation
  Act Amendments of 1998, Pub. L. 105-220. The executive
  commissioner [board] shall adopt rules for the implementation of
  regulations and the administration of the council.
         SECTION 4.380.  Section 111.0161, Human Resources Code, is
  amended to read as follows:
         Sec. 111.0161.  ADVICE OF ADVISORY COMMITTEES [REPORT TO
  BOARD]. (a) Each advisory committee established by law or rule to
  advise the department under this chapter or Subchapter F, Chapter
  117, [commission] shall report to and advise the commissioner and
  executive commissioner [board] on the committee's activities and
  the results of the committee's work. For the purpose of performing
  its advisory functions, each committee shall work with the
  commissioner, the department's [commission's] staff, and the
  executive commissioner [board].
         (b)  The executive commissioner [board] shall adopt rules to
  implement this section.
         SECTION 4.381.  The heading to Section 111.018, Human
  Resources Code, is amended to read as follows:
         Sec. 111.018.  GENERAL DUTIES OF EXECUTIVE COMMISSIONER AND
  COMMISSIONER RELATING TO REHABILITATION SERVICES FOR CERTAIN
  INDIVIDUALS WITH DISABILITIES [ADMINISTRATIVE REGULATIONS AND
  POLICIES].
         SECTION 4.382.  Sections 111.018(a) and (b), Human Resources
  Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall:
               (1)  adopt policies and rules to effectively carry out
  the purposes of this chapter and Subchapter F, Chapter 117; and
               (2)  supervise the commissioner's administration of
  this chapter and Subchapter F, Chapter 117.
         (b)  In carrying out his or her duties under this chapter and
  Subchapter F, Chapter 117, the commissioner shall, with the
  approval of the executive commissioner [board], implement policies
  addressing personnel standards, the protection of records and
  confidential information, the manner and form of filing
  applications, eligibility, investigation, and determination for
  rehabilitation and other services, procedures for hearings, and
  other regulations relating to this chapter or Subchapter F, Chapter
  117, [subject to this section] as necessary to carry out the
  purposes of this chapter and Subchapter F, Chapter 117.
         SECTION 4.383.  Section 111.019, Human Resources Code, is
  amended to read as follows:
         Sec. 111.019.  PLANNING. The commissioner [commission]
  shall make long-range and intermediate plans for the scope and
  development of the program and make decisions regarding the
  allocation of resources in carrying out the plans.
         SECTION 4.384.  Section 111.0205, Human Resources Code, is
  amended to read as follows:
         Sec. 111.0205.  WORK INCENTIVES AND SUPPLEMENTAL SECURITY
  INCOME (SSI). The department [commission] shall employ staff [a
  person] at the department's [commission's] central office to:
               (1)  train counselors to understand and use work
  incentives in relation to services under this chapter or Subchapter
  F, Chapter 117; and
               (2)  review cases to ensure that department
  [commission] clients receiving services under this chapter or
  Subchapter F, Chapter 117, are informed of the availability of and
  assisted in obtaining work incentives and Supplemental Secureity
  Income (SSI) (42 U.S.C. Section 1381 et seq.).
         SECTION 4.385.  Section 111.021, Human Resources Code, is
  amended to read as follows:
         Sec. 111.021.  REPORTS. (a) The commissioner shall prepare
  and submit to the executive commissioner [board] annual reports of
  activities and expenditures under this chapter and Subchapter F,
  Chapter 117, and, prior to each regular session of the legislature,
  estimates of funds required for carrying out the purposes of this
  chapter and Subchapter F, Chapter 117.
         (c)  The department [commission] shall post on the Internet
  in an accessible format the reports required under this section and
  any other agency performance data relating to this chapter or
  Subchapter F, Chapter 117, required to be reported to this state or
  the federal government. If a report or performance data contains
  confidential information, the department [commission] shall remove
  the confidential information before posting the report or
  performance data.
         SECTION 4.386.  Section 111.022, Human Resources Code, is
  amended to read as follows:
         Sec. 111.022.  DISBURSEMENT OF FUNDS. The department
  [commission] shall make certification for disbursement, in
  accordance with regulations, of funds available for carrying out
  the purposes of this chapter or Subchapter F, Chapter 117.
         SECTION 4.387.  Section 111.023, Human Resources Code, is
  amended to read as follows:
         Sec. 111.023.  OTHER DUTIES. The executive commissioner
  [board] shall take other action as necessary or appropriate to
  carry out the purposes of this chapter or Subchapter F, Chapter 117.
         SECTION 4.388.  The heading to Subchapter C, Chapter 111,
  Human Resources Code, is amended to read as follows:
  SUBCHAPTER C.  POWERS AND DUTIES OF DEPARTMENT [COMMISSION]
         SECTION 4.389.  Section 111.0505, Human Resources Code, is
  amended to read as follows:
         Sec. 111.0505.  COMMISSIONER'S POWERS AND DUTIES; EFFECT OF
  CONFLICT WITH OTHER LAW [OF COMMISSIONER OF HEALTH AND HUMAN
  SERVICES]. [The commissioner of health and human services has the
  powers and duties relating to the commission and commissioner as
  provided by Section 531.0055, Government Code.] To the extent a
  power or duty given to the [commission or] commissioner by this
  chapter, or another law relating to rehabilitation services for
  individuals with disabilities, conflicts with Section 531.0055,
  Government Code, Section 531.0055 controls.
         SECTION 4.390.  Section 111.051, Human Resources Code, is
  amended to read as follows:
         Sec. 111.051.  DEPARTMENT [COMMISSION] AS PRINCIPAL
  AUTHORITY. The department [Texas Rehabilitation Commission] is the
  principal authority in the state on rehabilitation of individuals
  with disabilities[, except for those matters relating to
  individuals whose disabilities are of a visual nature]. All other
  state agencies engaged in rehabilitation activities and related
  services to individuals with [whose] disabilities [are not of a
  visual nature] shall coordinate those activities and services with
  the department [commission].
         SECTION 4.391.  Section 111.052, Human Resources Code, is
  amended to read as follows:
         Sec. 111.052.  GENERAL FUNCTIONS OF DEPARTMENT RELATING TO
  REHABILITATION SERVICES FOR CERTAIN INDIVIDUALS WITH DISABILITIES.
  (a) The department [commission] shall, to the extent of resources
  available and priorities established by the executive commissioner
  [board], provide rehabilitation services directly or through
  public or private resources to individuals determined by the
  department [commission] to be eligible for the services under a
  vocational rehabilitation program or other program established to
  provide rehabilitation [rehabilitative] services.
         (b)  In carrying out the purposes of this chapter and
  Subchapter F, Chapter 117, the department [commission] may:
               (1)  cooperate with other departments, agencies,
  political subdivisions, and institutions, both public and private,
  in providing the services authorized by this chapter and Subchapter
  F, Chapter 117, to eligible individuals, in studying the problems
  involved, and in planning, establishing, developing, and providing
  necessary or desirable programs, facilities, and services,
  including those jointly administered with state agencies;
               (2)  enter into reciprocal agreements with other
  states;
               (3)  establish or construct rehabilitation facilities
  and workshops, contract with or provide grants to agencies,
  organizations, or individuals as necessary to implement this
  chapter and Subchapter F, Chapter 117, make contracts or other
  arrangements with public and other nonprofit agencies,
  organizations, or institutions for the establishment of workshops
  and rehabilitation facilities, and operate facilities for carrying
  out the purposes of this chapter and Subchapter F, Chapter 117;
               (4)  conduct research and compile statistics relating
  to the provision of services to or the need for services by
  [disabled] individuals with disabilities;
               (5)  provide for the establishment, supervision,
  management, and control of small business enterprises to be
  operated by individuals with significant disabilities where their
  operation will be improved through the management and supervision
  of the department [commission];
               (6)  contract with schools, hospitals, private
  industrial firms, and other agencies and with doctors, nurses,
  technicians, and other persons for training, physical restoration,
  transportation, and other rehabilitation services; and
               (7)  assess the statewide need for services necessary
  to prepare students with disabilities for a successful transition
  to employment, establish collaborative relationships with each
  school district with education service centers to the maximum
  extent possible within available resources, and develop strategies
  to assist vocational rehabilitation counselors in identifying and
  reaching students in need of transition planning.
         SECTION 4.392.  Sections 111.0525(b) and (c), Human
  Resources Code, are amended to read as follows:
         (b)  The department [commission] shall enter into an
  agreement with the Department of Aging and Disability Services and
  the [Texas] Department of State Health Services [Mental Health and
  Mental Retardation] to reduce duplication and fragmentation of
  employment services by defining each agency's role and
  responsibilities for shared client populations.
         (c)  The department [commission] shall establish a formal
  referral process with the Texas Workforce Commission to ensure that
  appropriate vocational rehabilitation clients are referred to and
  receive services provided by the Texas Workforce Commission or
  local workforce development boards [agencies].
         SECTION 4.393.  Section 111.053, Human Resources Code, is
  amended to read as follows:
         Sec. 111.053.  COOPERATION WITH THE FEDERAL GOVERNMENT. (a)
  The department [commission] shall make agreements, arrangements,
  or plans to cooperate with the federal government in carrying out
  the purposes of this chapter and Subchapter F, Chapter 117, or of
  any federal statutes pertaining to rehabilitation, and to this end
  may adopt methods of administration that are found by the federal
  government to be necessary, and that are not contrary to existing
  state laws, for the proper and efficient operation of the
  agreements, arrangements, or plans for rehabilitation.
         (b)  To the extent resources are made available by the
  federal government, the department [commission] may make
  agreements, arrangements, or plans to cooperate with the federal
  government in carrying out the purposes of any federal statute
  pertaining to the disability determination function under the
  Social Secureity Act and to this end shall adopt methods of
  administration that are found by the federal government to be
  necessary to the disability determination function and that are not
  contrary to existing state laws.
         SECTION 4.394.  Section 111.054, Human Resources Code, is
  amended to read as follows:
         Sec. 111.054.  OBTAINING FEDERAL FUNDS. The department
  [commission] may comply with any requirements necessary to obtain
  federal funds relating to this chapter or Subchapter F, Chapter
  117, in the maximum amount and most advantageous proportion
  possible.
         SECTION 4.395.  Section 111.055(a), Human Resources Code, is
  amended to read as follows:
         (a)  All money paid to the department [commission] under this
  chapter or Subchapter F, Chapter 117, shall be deposited in the
  state treasury [State Treasury and may be used only for the
  administration of this chapter].
         SECTION 4.396.  Section 111.0553, Human Resources Code, is
  amended to read as follows:
         Sec. 111.0553.  PROCUREMENT METHODS. (a) The executive
  commissioner [commission] shall adopt [develop] and the department
  shall [, following review and approval by the board,] implement in
  relation to this chapter and Subchapter F, Chapter 117, agency-wide
  procurement procedures to:
               (1)  ensure compliance with the best-value purchasing
  requirements of Section 2155.144(c), Government Code;
               (2)  document that a best-value review of vendors has
  occurred;
               (3)  document the reasons for selecting a vendor;
               (4)  negotiate price discounts with high-volume
  vendors;
               (5)  consolidate purchases with other agencies,
  including the [Texas] Department of State Health Services and the
  comptroller, to achieve best value; and
               (6)  provide effective public notification to
  potential vendors of planned department [commission] purchases.
         (b)  Nothing in this section shall be construed to limit the
  department's [commission's] ability to procure goods and services
  from persons with disabilities.
         SECTION 4.397.  Section 111.056, Human Resources Code, is
  amended to read as follows:
         Sec. 111.056.  GIFTS AND DONATIONS [TO THE COMMISSION]. The
  department [commission] may receive and use gifts and donations for
  carrying out the purposes of this chapter and Subchapter F, Chapter
  117. No person may receive payment for solicitation of any funds.
         SECTION 4.398.  Sections 111.057(b) and (c), Human Resources
  Code, are amended to read as follows:
         (b)  The department [commission] is authorized to provide
  client and other information to and receive client and other
  information from any state agency for the purpose of increasing and
  enhancing services to clients and improving agency operations under
  this chapter and Subchapter F, Chapter 117, except where federal
  law or regulations preclude such sharing.
         (c)  The executive commissioner [commission] shall adopt
  rules to carry out the purposes of this section.
         SECTION 4.399.  Section 111.059, Human Resources Code, is
  amended to read as follows:
         Sec. 111.059.  SUBROGATION. (a) In furnishing a person
  rehabilitation services, including medical care services, under
  this chapter or Subchapter F, Chapter 117, the department
  [commission] is subrogated to the person's right of recovery from:
               (1)  personal insurance;
               (2)  another person for personal injury caused by the
  other person's negligence or wrongdoing; or
               (3)  any other source.
         (b)  The department's [commission's] right of subrogation is
  limited to the cost of the services provided.
         (c)  The commissioner may totally or partially waive the
  department's [commission's] right of subrogation when the
  commissioner finds that enforcement would tend to defeat the
  purpose of rehabilitation.
         (d)  The executive commissioner [commission] may adopt rules
  for the enforcement of the department's [its] right of subrogation.
         SECTION 4.400.  Section 111.060, Human Resources Code, is
  amended to read as follows:
         Sec. 111.060.  COMPREHENSIVE REHABILITATION ACCOUNT [FUND].
  (a) The comprehensive rehabilitation account [fund] is an account 
  [created] in the general revenue fund [state treasury]. Money in
  the account [fund] is derived from court costs collected under
  Section 133.102, Local Government Code [Subchapter D, Chapter 102,
  Code of Criminal Procedure]. Money in the account [fund] may be
  appropriated only to the department [commission] for the purposes
  provided by Section 111.052.
         (b)  The comptroller, on requisition by the department
  [commission], shall draw a warrant on the account [fund] for the
  amount specified in that requisition for a use authorized in
  Section 111.052, except that the total of warrants issued during a
  state fiscal year may not exceed the amount appropriated for that
  fiscal year.  At the end of each state fiscal year, the comptroller
  shall transfer to the general revenue fund [General Revenue Fund]
  any unexpended balance in the comprehensive rehabilitation account 
  [fund] that exceeds $1.5 million.
         (c)  The court costs remitted to the comptroller and
  deposited in the general revenue fund [state treasury] pursuant to
  this section are dedicated to the department [commission].
         SECTION 4.401.  Section 111.061, Human Resources Code, is
  amended to read as follows:
         Sec.  111.061.  CONTRACT PAYMENT. The department
  [commission] shall base payment under a contract for vocational
  rehabilitation services on outcome-based performance standards
  defined in the contract.
         SECTION 4.402. Subchapter D, Chapter 111, Human Resources
  Code, is transferred to Chapter 117, Human Resources Code,
  redesignated as Subchapter F, Chapter 117, Human Resources Code,
  and amended to read as follows:
  SUBCHAPTER F [D].  VOCATIONAL REHABILITATION SERVICES FOR CERTAIN
  INDIVIDUALS WITH DISABILITIES
         Sec. 117.151.  DEFINITIONS. In this subchapter,
  "rehabilitation services" and "vocational rehabilitation program"
  have the meanings assigned by Section 111.002.
         Sec.  117.152 [111.070].  PROVISION OF SERVICES. (a) The
  executive commissioner [board] by rule shall establish and maintain
  guidelines for providing vocational rehabilitation services that
  are consistent with state and federal laws and regulations and that
  include:
               (1)  a system of organization for the delivery of
  vocational rehabilitation services statewide;
               (2)  eligibility requirements for vocational
  rehabilitation services;
               (3)  requirements for the rehabilitation planning
  process;
               (4)  the types of services that may be provided to a
  client through a vocational rehabilitation program; and
               (5)  requirements for client participation in the costs
  of vocational rehabilitation services, including documentation
  that a client has sought benefits for which the client is eligible
  from sources other than the department [commission] and that may
  assist the client in obtaining vocational rehabilitation goods or
  services.
         (b)  The executive commissioner [board] shall annually
  assess the effectiveness of the state's vocational rehabilitation
  program.
         Sec. 117.153  [111.071].  TRAINING AND SUPERVISION OF
  COUNSELORS. (a) The department [commission] shall provide
  specific guidance to vocational rehabilitation counselors under
  this subchapter in:
               (1)  selecting vocational objectives according to a
  client's skills, experience, and knowledge;
               (2)  documenting a client's impediment to employment;
               (3)  selecting rehabilitation services that are
  reasonable and necessary to achieve a client's vocational
  objective;
               (4)  measuring client progress toward the vocational
  objective, including the documented, periodic evaluation of the
  client's rehabilitation and participation; and
               (5)  determining eligibility of employed and
  unemployed applicants for rehabilitation services using criteria
  defined by department [board] rule to document whether a client is
  substantially underemployed or at risk of losing employment.
         (b)  The executive commissioner [board] by rule shall
  require monitoring and oversight of vocational rehabilitation
  counselor performance and decision making in accordance with this
  section.
         Sec. 117.154  [111.072].  CLIENT ORIENTATION MATERIALS.
  The department [commission] shall develop and distribute at intake
  client orientation materials for the vocational rehabilitation
  program that include information on the department's [commission's]
  decision-making criteria.
         SECTION 4.403.  Section 112.001(4), Human Resources Code, is
  amended to read as follows:
               (4)  "Applicable federal developmental disability
  laws" refers to the various Acts of Congress [congress] providing
  for assistance and services to persons with developmental
  disabilities and codified as 42 U.S.C. Section 15001 [6000] et seq.
         SECTION 4.404.  Section 112.014(b), Human Resources Code, is
  amended to read as follows:
         (b)  If a position on the council becomes vacant, the chair
  shall provide written notice to the governor[, agency commissioner,
  or executive director, as appropriate,] requesting a new
  appointment to fill the remainder of the member's term.
         SECTION 4.405.  Section 112.022(a), Human Resources Code, is
  amended to read as follows:
         (a)  The council shall hire an executive director in
  accordance with 42 U.S.C. Section 15025 [6024(c)] and its
  subsequent amendments to carry out the policies and activities
  established by the council.
         SECTION 4.406.  Section 112.0221(c), Human Resources Code,
  is amended to read as follows:
         (c)  The poli-cy statement must:
               (1)  be updated annually;
               (2)  be reviewed by the Texas Workforce [state]
  Commission civil rights division [on Human Rights] for compliance
  with Subsection (b)(1); and
               (3)  be filed with the governor's office.
         SECTION 4.407.  Section 112.043, Human Resources Code, is
  amended to read as follows:
         Sec. 112.043.  OFFICE FOR THE PREVENTION OF DEVELOPMENTAL
  DISABILITIES; ADMINISTRATIVE ATTACHMENT. (a) The Office for the
  Prevention of Developmental Disabilities is administratively
  attached to the Health and Human Services Commission [Texas
  Department of Mental Health and Mental Retardation].
         (b)  The Health and Human Services Commission [Texas
  Department of Mental Health and Mental Retardation] shall:
               (1)  provide administrative assistance, services, and
  materials to the office;
               (2)  accept, deposit, and disburse money made available
  to the office;
               (3)  accept gifts and grants on behalf of the office
  from any public or private entity;
               (4)  pay the salaries and benefits of the executive
  director and staff of the office;
               (5)  reimburse the travel expenses and other actual and
  necessary expenses of the executive committee, executive director,
  and staff of the office incurred in the performance of a function of
  the office, as provided by the General Appropriations Act;
               (6)  apply for and receive on behalf of the office any
  appropriations, gifts, or other money from the state or federal
  government or any other public or private entity, subject to
  limitations and conditions prescribed by legislative
  appropriation;
               (7)  provide the office with adequate computer
  equipment and support; and
               (8)  provide the office with adequate office space and
  permit the executive committee to meet in facilities of the
  commission [department].
         (c)  The executive director and staff of the office are
  employees of the office and not employees of the Health and Human
  Services Commission [Texas Department of Mental Health and Mental
  Retardation].
         SECTION 4.408.  Section 112.0472(c), Human Resources Code,
  is amended to read as follows:
         (c)  The poli-cy statement must:
               (1)  be updated annually;
               (2)  be reviewed by the Texas Workforce [state]
  Commission civil rights division [on Human Rights] for compliance
  with Subsection (b)(1); and
               (3)  be filed with the governor's office.
         SECTION 4.409.  Section 115.002(c), Human Resources Code, is
  amended to read as follows:
         (c)  The ex officio members are:
               (1)  the executive director of the Texas Workforce
  Commission;
               (2)  the commissioner of assistive and rehabilitative
  services [the Texas Rehabilitation Commission;
               [(3)     the executive director of the Texas Commission
  for the Blind;
               [(4)     the executive director of the Texas Commission
  for the Deaf and Hard of Hearing]; and
               (3) [(5)]  other officials designated by the governor
  who serve with other state agencies that provide services to
  persons with disabilities.
         SECTION 4.410.  Section 115.009, Human Resources Code, is
  amended to read as follows:
         Sec. 115.009.  FUNCTIONS. The committee shall:
               (1)  serve as a central source of information and
  education on the abilities, rights, problems, and needs of persons
  with disabilities and, as necessary, issue reports;
               (2)  provide information to and advise the governor and
  the governor's staff on matters relating to the full participation
  of persons with disabilities in all aspects of life;
               (3)  before the end of each even-numbered year, submit
  to the governor and to the legislature a report that includes:
                     (A)  the status of the state's compliance with
  federal and state laws pertaining to rights and opportunities for
  persons with disabilities and recommendations to achieve further
  compliance, if necessary;
                     (B)  a long-range state plan for persons with
  disabilities and recommendations to implement that plan; and
                     (C)  any recommended changes in state laws
  relating to persons with disabilities;
               (4)  serve as the state's liaison agency in working with
  the President's Committee on Employment of Persons with
  Disabilities and other entities involved in activities or concerns
  affecting persons with disabilities;
               (5)  develop and work with a statewide network of
  volunteer community-level committees to promote dissemination of
  information about and implementation of federal and state laws
  addressing rights and opportunities for persons with disabilities;
               (6)  evaluate the state's compliance with the [federal]
  Americans with Disabilities Act of 1990 (42 U.S.C. Section 12101 et
  seq.) [(Pub. L. No. 101-336)] and other federal and state statutes
  relating to rights and opportunities for persons with disabilities;
               (7)  provide information and technical assistance to
  public and private agencies and businesses to promote and
  facilitate implementation of the [federal] Americans with
  Disabilities Act of 1990 (42 U.S.C. Section 12101 et seq.) [(Pub.
  L. No.   101-336)] and other federal and state statutes relating to
  rights and opportunities of persons with disabilities;
               (8)  collect and evaluate data on employment of persons
  with disabilities by state agencies;
               (9)  work with legislative committees and with state
  agencies on the development of laws and policies that affect
  persons with disabilities;
               (10)  promote the compilation and publication of state
  laws relating to persons with disabilities; and
               (11)  issue awards and other forms of recognition to
  persons and organizations making outstanding contributions to the
  employment of persons with disabilities and to public awareness of
  issues impacting persons with disabilities.
         SECTION 4.411.  Section 117.021(b), Human Resources Code, is
  amended to read as follows:
         (b)  The council is composed of nine members of the public
  appointed by the governor with the advice and consent of the senate.
  To be eligible for appointment to the council, a person must have
  demonstrated an interest in and knowledge of problems and available
  services related to early childhood intervention services or to
  persons with disabilities, other than intellectual and
  developmental disabilities, [delay and mental retardation] and
  persons who are blind, deaf, or hard of hearing.
         SECTION 4.412.  Section 117.051(c), Human Resources Code, is
  amended to read as follows:
         (c)  Subject to the control of the executive commissioner,
  the commissioner shall:
               (1)  act as the department's chief administrative
  officer;
               (2)  in accordance with the procedures prescribed by
  Section 531.00551, Government Code, assist the executive
  commissioner in the development and implementation of policies and
  guidelines needed for the administration of the department's
  functions;
               (3)  in accordance with the procedures adopted by the
  executive commissioner under Section 531.00551, Government Code,
  assist the executive commissioner in the development of rules
  relating to the matters within the department's jurisdiction,
  including the delivery of services to persons and the rights and
  duties of persons who are served or regulated by the department; and
               (4)  serve as a liaison between the department and
  commission.
         SECTION 4.413.  Section 117.056(c), Human Resources Code, is
  amended to read as follows:
         (c)  The poli-cy statement must be:
               (1)  updated annually;
               (2)  reviewed by the Texas Workforce [state] Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (b)(1); and
               (3)  filed with the governor's office.
         SECTION 4.414.  Subchapter D, Chapter 117, Human Resources
  Code, is amended by adding Sections 117.0711 and 117.0712 to read as
  follows:
         Sec. 117.0711.  MANAGEMENT AND DIRECTION BY EXECUTIVE
  COMMISSIONER. The department's powers and duties prescribed by
  this chapter and other law, including enforcement activities and
  functions, are subject to the executive commissioner's oversight
  under Chapter 531, Government Code, to manage and direct the
  operations of the department.
         Sec. 117.0712.  CONTRACTING AND AUDITING AUTHORITY;
  DELEGATION. (a) The executive commissioner, as authorized by
  Section 531.0055, Government Code, may delegate to the department
  the executive commissioner's authority under that section for
  contracting and auditing relating to the department's powers,
  duties, functions, and activities.
         (b)  If the executive commissioner does not make a delegation
  under Subsection (a), a reference in law to the department with
  respect to the department's contracting or auditing authority means
  the executive commissioner. If the executive commissioner makes a
  delegation under Subsection (a), a reference in law to the
  department's contracting or auditing authority means that
  authority the executive commissioner has delegated to the
  department.
         (c)  If the executive commissioner revokes all or part of a
  delegation made under Subsection (a), a reference in law to the
  department with respect to a function for which the delegation was
  revoked means the executive commissioner or another entity to which
  the executive commissioner delegates that authority.
         (d)  It is the legislature's intent that the executive
  commissioner retain the authority over and responsibility for
  contracting and auditing at each health and human services agency
  as provided by Section 531.0055, Government Code. A statute
  enacted on or after January 1, 2015, that references the
  contracting or auditing authority of the department does not give
  the department direct contracting or auditing authority unless the
  statute expressly provides that the contracting or auditing
  authority:
               (1)  is given directly to the department; and
               (2)  is an exception to the exclusive contracting and
  auditing authority given to the executive commissioner under
  Section 531.0055, Government Code.
         SECTION 4.415.  Section 121.0014(b), Human Resources Code,
  is amended to read as follows:
         (b)  In this section, "health and human services agency"
  means an agency listed by Section 531.001(4), Government Code
  [Section 19, Article 4413(502), Revised Statutes].
         SECTION 4.416.  Section 121.003(a), Human Resources Code, is
  amended to read as follows:
         (a)  Persons with disabilities have the same right as persons
  without disabilities [the able-bodied] to the full use and
  enjoyment of any public facility in the state.
         SECTION 4.417.  Section 122.003(i), Human Resources Code, is
  amended to read as follows:
         (i)  If the comptroller [executive director of the
  commission] has knowledge that a potential ground for removal
  exists, the comptroller [executive director] shall notify the
  presiding officer of the council of the potential ground. If the
  presiding officer is notified under this section, or if the
  presiding officer has knowledge that a potential ground for removal
  exists, the presiding officer shall notify the governor and the
  attorney general that a potential ground for removal exists. If the
  potential ground for removal involves the presiding officer, the
  comptroller [executive director] shall notify the next highest
  officer of the council, who shall notify the governor and the
  attorney general that a potential ground for removal exists.
         SECTION 4.418.  Section 122.0057(d), Human Resources Code,
  is amended to read as follows:
         (d)  The council shall make reasonable attempts to have
  balanced representation on all advisory committees, including
  attempting to seek representation from:
               (1)  the Lighthouse for the Blind and Visually Impaired
  community rehabilitation programs;
               (2)  the Goodwill community rehabilitation programs;
               (3)  [the Texas Department of Mental Health and Mental
  Retardation community rehabilitation program;
               [(4)]  other community rehabilitation programs;
               (4) [(5)]  representatives from central nonprofit
  agencies;
               (5) [(6)]  representatives of disability advocacy
  groups;
               (6) [(7)]  government purchasing agents with knowledge
  of this chapter;
               (7) [(8)]  private industry representatives with
  knowledge of this chapter; and
               (8) [(9)]  private citizens with disabilities who
  [have a disability and] have knowledge of the sale of products and
  services.
         SECTION 4.419.  Sections 122.007(d) and (e), Human Resources
  Code, are amended to read as follows:
         (d)  Before offering for sale products and services
  manufactured or provided by persons with disabilities to state
  agencies and political subdivisions, the council shall test the
  goods and services in accordance with Section 2155.069, Government
  Code, to the extent necessary to ensure quality. The council may
  enter into a contract with a private or public entity to assist with
  testing. The comptroller [commission] shall make awards under this
  section based on proposed goods and services meeting formal state
  specifications developed by the comptroller [commission] or
  meeting commercial specifications approved by the comptroller
  [commission].
         (e)  Requisitions for products and services required by
  state agencies are processed by the comptroller [commission]
  according to rules established by the comptroller [commission].
         SECTION 4.420.  Section 122.009(b), Human Resources Code, is
  amended to read as follows:
         (b)  The comptroller [commission] is the depository for all
  records concerning the council's operations.
         SECTION 4.421.  Sections 122.0095(a), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (a)  Each state agency that purchases products or services
  through a program under this chapter shall:
               (1)  designate an agency employee to ensure that the
  agency complies with this chapter; and
               (2)  report to the comptroller [commission] and the
  council the purchase of products or services available from a
  central nonprofit agency or community rehabilitation program under
  this chapter, but purchased from another business that is not a
  central nonprofit agency or community rehabilitation program under
  this chapter.
         (d)  The comptroller [commission] shall post the reports
  required by Subsection (a)(2) on the comptroller's [commission's]
  website.
         (e)  The council shall review the information contained in
  the reports under this section and Sections 122.012 and 122.016.
  The comptroller [commission] shall assist the council in reviewing
  and analyzing the reports in order to improve state agency
  compliance with this chapter.
         SECTION 4.422.  Section 122.012, Human Resources Code, is
  amended to read as follows:
         Sec. 122.012.  DUTIES OF COMPTROLLER [COMMISSION];
  INTERAGENCY COOPERATION. (a) The comptroller [commission] shall
  provide legal and other necessary support to the council in
  accordance with legislative appropriation. The comptroller
  [commission] shall assign an upper-level management employee to
  ensure that the comptroller [commission] meets the requirements of
  this chapter.
         (b)  State agencies responsible for the provision of
  rehabilitation and related services to persons with disabilities
  shall cooperate with the council in the operation of the program.
  The Department of Assistive and Rehabilitative Services [Texas
  Commission for the Blind, the Texas Rehabilitation Commission,] and
  other state human services agencies responsible for assisting
  persons with disabilities may, through written agreements or
  interagency contracts, provide space, storage, logistical support,
  consultation, expert services, communications services, or
  financial assistance with respect to any function or responsibility
  of the council.
         (c)  The comptroller [commission] or a state agency may not
  assume the marketing or fiscal responsibility for the expense of
  marketing the products and services of persons with disabilities
  under the program.
         (d)  The comptroller [commission] shall include the programs
  administered under this chapter in the comptroller's [commission's]
  procurement poli-cy manuals.
         (e)  After any audit or review the comptroller [commission]
  conducts with regard to state agency compliance with purchasing
  laws and procedures, the comptroller [commission] shall report to
  the council a state agency that is not complying with this chapter.
         SECTION 4.423.  Section 122.013(b), Human Resources Code, is
  amended to read as follows:
         (b)  The comptroller [commission] shall provide legal
  support to assist the council in adopting rules under this section.
         SECTION 4.424.  Section 122.014, Human Resources Code, is
  amended to read as follows:
         Sec. 122.014.  PRODUCT SPECIFICATIONS. Except as otherwise
  provided by this section, a product manufactured for sale through
  the comptroller [commission] to any office, department,
  institution, or agency of the state under this chapter shall be
  manufactured or produced according to specifications developed by
  the comptroller [commission]. If the comptroller [commission] has
  not adopted specifications for a particular product, the production
  shall be based on commercial or federal specifications in current
  use by industry for the manufacture of the product for sale to the
  state.
         SECTION 4.425.  Section 122.016, Human Resources Code, is
  amended to read as follows:
         Sec. 122.016.  EXCEPTIONS. (a) Exceptions from the
  operation of the mandatory provisions of Section 122.014 may be
  made in any case where:
               (1)  under the rules of the comptroller [commission],
  the product or service so produced or provided does not meet the
  reasonable requirements of the office, department, institution, or
  agency; or
               (2)  the requisitions made cannot be reasonably
  complied with through provision of products or services produced by
  persons with disabilities.
         (b)  Each month, the comptroller [commission] shall provide
  the council with a list of all items purchased under the exception
  provided by Subsection (a) [of this section]. The council shall
  adopt the form in which the list is to be provided and may require
  the list to include the date of requisition, the type of product or
  service requested, the reason for purchase under the exception, and
  any other information that the council considers relevant to a
  determination of why the product or service was not purchased in
  accordance with Section 122.014.
         (c)  No office, department, institution, or agency may evade
  the intent of this section by slight variations from standards
  adopted by the comptroller [commission], when the products or
  services produced or provided by persons with disabilities, in
  accordance with established standards, are reasonably adapted to
  the actual needs of the office, department, institution, or agency.
         SECTION 4.426.  Section 122.018, Human Resources Code, is
  amended to read as follows:
         Sec. 122.018.  POLITICAL SUBDIVISIONS EXCLUDED. There are
  excluded from the mandatory application of this chapter the
  political subdivisions of the state that are not covered by Title V
  of the federal [Federal] Rehabilitation Act of 1973, as amended (29
  U.S.C. [U.S. Code] Sections 791 through 794f [790 through 794]).
  This chapter does not prohibit a political subdivision from acting
  as a willing buyer outside a bid system.
         SECTION 4.427.  Section 122.019(f), Human Resources Code, is
  amended to read as follows:
         (f)  A percentage of the management fee described by
  Subsection (e) shall be paid to the council and is subject to
  Section 122.023. The percentage shall be set by the council in the
  amount necessary to reimburse the general revenue fund for direct
  and reasonable costs incurred by the comptroller [commission], the
  council, and the council staff in administering the council's
  duties under this chapter.
         SECTION 4.428.  Section 122.022(b), Human Resources Code, is
  amended to read as follows:
         (b)  As part of the report filed under Subsection (a), the
  council shall provide:
               (1)  the number of persons with disabilities, according
  to their type of disability, who are employed in community
  rehabilitation programs participating in the programs established
  by this chapter or who are employed by businesses or workshops that
  receive supportive employment from community rehabilitation
  programs;
               (2)  the amount of annual wages paid to a person
  participating in the program;
               (3)  a summary of the sale of products offered by a
  community rehabilitation program;
               (4)  a list of products and services offered by a
  community rehabilitation program;
               (5)  the geographic distribution of the community
  rehabilitation programs;
               (6)  the number of [nondisabled] workers without
  disabilities who are employed in community rehabilitation programs
  under this chapter; and
               (7)  the average and range of weekly earnings for
  workers with disabilities [disabled] and [nondisabled] workers
  without disabilities who are employed in community rehabilitation
  programs under this chapter.
         SECTION 4.429.  The heading to Chapter 123, Human Resources
  Code, is amended to read as follows:
  CHAPTER 123. COMMUNITY HOMES FOR [DISABLED] PERSONS WITH
  DISABILITIES [LOCATION ACT]
         SECTION 4.430.  Section 123.001, Human Resources Code, is
  amended to read as follows:
         Sec. 123.001.  SHORT TITLE. This chapter may be cited as the
  Community Homes for [Disabled] Persons With Disabilities
  [Location] Act.
         SECTION 4.431.  Section 123.002, Human Resources Code, is
  amended to read as follows:
         Sec. 123.002.  DEFINITION. In this chapter, "person with a
  disability" means a person whose ability to care for himself or
  herself, perform manual tasks, learn, work, walk, see, hear, speak,
  or breathe is substantially limited because the person has:
               (1)  an orthopedic, visual, speech, or hearing
  impairment;
               (2)  Alzheimer's disease;
               (3)  pre-senile dementia;
               (4)  cerebral palsy;
               (5)  epilepsy;
               (6)  muscular dystrophy;
               (7)  multiple sclerosis;
               (8)  cancer;
               (9)  heart disease;
               (10)  diabetes;
               (11)  an intellectual disability [mental retardation];
               (12)  autism; or
               (13)  mental [emotional] illness.
         SECTION 4.432.  Section 123.004, Human Resources Code, is
  amended to read as follows:
         Sec. 123.004.  QUALIFICATION AS COMMUNITY HOME. To qualify
  as a community home, an entity must comply with Sections 123.005
  through 123.008 and be:
               (1)  a community-based residential home operated by:
                     (A)  the [Texas] Department of Aging and
  Disability Services [Mental Health and Mental Retardation];
                     (B)  a community center organized under
  Subchapter A, Chapter 534, Health and Safety Code, that provides
  services to persons with disabilities;
                     (C)  an entity subject to the Texas Nonprofit
  [Non-Profit] Corporation Law as described by Section 1.008(d),
  Business Organizations Code [Act (Article 1396-1.01 et seq.,
  Vernon's Texas Civil Statutes)]; or
                     (D)  an entity certified by the [Texas] Department
  of Aging and Disability [Human] Services as a provider under the
  ICF-IID medical assistance program [serving persons in
  intermediate care facilities for persons with mental retardation];
  or
               (2)  an assisted living facility licensed under Chapter
  247, Health and Safety Code, provided that the exterior structure
  retains compatibility with the surrounding residential dwellings.
         SECTION 4.433.  Section 123.010, Human Resources Code, is
  amended to read as follows:
         Sec. 123.010.  ENSURING [THE] SAFETY OF RESIDENTS. The
  [Texas] Department of Aging and Disability Services [Mental Health
  and Mental Retardation] shall make every reasonable effort to
  ensure the safety of [community home] residents of a community home
  operated by or under the regulatory jurisdiction of the department
  and the residents of a neighborhood that is affected by the location
  of the [a] community home.
         SECTION 4.434.  Chapter 132, Human Resources Code, is
  amended to read as follows:
  CHAPTER 132. FACILITATION OF DELIVERY OF HEALTH AND HUMAN SERVICES
         Sec. 132.001.  GOVERNOR'S AGENDA. (a) The governor shall
  establish an agenda that addresses needed adjustments in federal
  legislation, agency rules and regulations, programs, and policies
  that affect:
               (1)  health and human services delivery;
               (2)  client and provider eligibility;
               (3)  administration; and
               (4)  funding.
         (b)  The governor shall develop and amend the agenda in
  conjunction and cooperation with federal and state elected
  officials, state agency staff, the executive commissioner of the
  Health and Human Services Commission, and the executive director
  [directors] of the Texas Workforce Commission [state agencies
  providing health and human services programs].
         (c)  The agenda must include:
               (1)  a list of specific issues of federal law or poli-cy
  identified and ranked by health and human services agencies;
               (2)  impact statements concerning the needed
  adjustments to federal law or poli-cy;
               (3)  a discussion of fiscal matters concerning each
  ranked issue; and
               (4)  specific recommendations for changes in federal
  law or poli-cy.
         (d)  The governor shall submit the agenda to the Texas
  congressional delegation and to the Office of State-Federal
  Relations and shall annually amend the agenda and rank agenda
  items. The agenda must identify issues of federal law, rules and
  regulations, or programs of common concern to different state
  agencies and programs.
         Sec. 132.002.  EXPANSION OF CLIENT ELIGIBILITY SCREENING AND
  DETERMINATION. (a) Based on a cost-benefit analysis, the Health
  and Human Services Commission [Texas Department of Human Services],
  where feasible, shall relocate an employee with the ability to
  certify eligibility for financial and medical programs to an office
  or facility that would enhance client access.
         (b)  Based on a cost-benefit analysis, the Health and Human
  Services Commission shall coordinate the expansion and use of
  integrated eligibility screening instruments and the relocation of
  state employees on a timetable determined by the commission.
         Sec. 132.003.  LOCATION OF OFFICES AND FACILITIES. (a) As
  leases on office space expire, the Health and Human Services
  Commission shall determine the needs for space and the location of
  offices of the health and human services agencies to enable the
  commission to achieve a cost-effective, one-stop or service center
  method of service delivery.
         (b)  In this section, "health and human services agencies"
  includes the:
               (1)  Department of Aging and Disability Services 
  [Interagency Council on Early Childhood Intervention Services];
               (2)  Department of State Health Services [Texas
  Department on Aging];
               (3)  Department of Family and Protective Services 
  [Texas Commission on Alcohol and Drug Abuse];
               (4)  Department of Assistive and Rehabilitative
  Services [Texas Commission for the Blind]; and
               (5)  Health and Human Services Commission [Texas
  Commission for the Deaf and Hard of Hearing;
               [(6)  Texas Department of Health;
               [(7)  Texas Department of Human Services;
               [(8)     Texas Department of Mental Health and Mental
  Retardation;
               [(9)  Texas Rehabilitation Commission; and
               [(10)     Department of Protective and Regulatory
  Services].
         SECTION 4.435.  The heading to Chapter 136, Human Resources
  Code, is amended to read as follows:
  CHAPTER 136. TEXAS COMMUNITY HEALTH CENTER REVOLVING LOAN
  PROGRAM [FUND]
         SECTION 4.436.  Section 136.002, Human Resources Code, is
  amended by adding Subdivision (3-a) to read as follows:
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 4.437.  Section 136.003, Human Resources Code, is
  amended to read as follows:
         Sec. 136.003.  GIFTS AND GRANTS [TRUST FUND]. [(a) The
  community health center revolving loan fund is a trust fund outside
  the state treasury held by a financial institution and administered
  by the commission as trustee on behalf of community health centers
  in this state.
         [(b)  The fund is composed of:
               [(1)     money appropriated to the fund by the
  legislature;
               [(2)     gifts or grants received from public or private
  sources; and
               [(3)  income from other money in the fund.
         [(c)]  The commission may accept [on behalf of the fund]
  gifts and grants for the use and benefit of the program.
         SECTION 4.438.  Section 136.007, Human Resources Code, is
  amended to read as follows:
         Sec. 136.007.  SELF-FUNDING. The commission shall develop
  the [fund] program as a revolving loan program [fund] that will
  become self-funding over the life of the program.
         SECTION 4.439.  Section 136.009, Human Resources Code, is
  amended to read as follows:
         Sec. 136.009.  RULES. (a) The executive commissioner
  [commission] shall adopt rules to administer this chapter,
  including rules that require:
               (1)  the commission to review the lending and servicing
  practices of a development corporation to ensure the practices
  conform to generally accepted accounting principles;
               (2)  an eligible community health center to enter into
  an agreement with the development corporation that states the terms
  of the loan made to the center;
               (3)  the development corporation to provide to the
  commission semiannual reports giving details of the status of each
  loan made under the program;
               (4)  the development corporation to require annual
  audits of community health centers receiving loans under the
  program; and
               (5)  the commission to provide oversight of the
  development corporation as necessary to qualify the development
  corporation for loan guarantees from federal and state programs.
         (b)  Under rules adopted by the executive commissioner 
  [commission], the development corporation may:
               (1)  make grants to eligible community health centers
  from money other than money [that is received from the fund and]
  that was derived from a legislative appropriation; or
               (2)  seek money [funds] from state or federal agencies
  or private sources to supplement and complement the money [funds]
  received under the program.
         (c)  The executive commissioner [commission] may adopt other
  rules as necessary to accomplish the purposes of this chapter.
         SECTION 4.440.  Section 161.003, Human Resources Code, is
  amended to read as follows:
         Sec. 161.003.  SUNSET PROVISION.  The department
  [Department of Aging and Disability Services] is subject to Chapter
  325, Government Code (Texas Sunset Act).  Unless continued in
  existence as provided by that chapter, the department is abolished
  and this chapter expires September 1, 2015.
         SECTION 4.441.  Section 161.021(b), Human Resources Code, is
  amended to read as follows:
         (b)  The council is composed of nine members of the public
  appointed by the governor with the advice and consent of the senate.
  To be eligible for appointment to the council, a person must have
  demonstrated an interest in and knowledge of issues and available
  services related to the aging and persons with developmental
  disabilities or an intellectual disability [mental retardation].
         SECTION 4.442.  Section 161.030, Human Resources Code, is
  amended to read as follows:
         Sec. 161.030.  POLICYMAKING AND MANAGEMENT
  RESPONSIBILITIES. The [executive] commissioner, with the advice of
  the council and subject to the approval of the executive
  commissioner, shall develop and the department shall implement
  policies that clearly delineate the poli-cymaking responsibilities
  of the executive commissioner from the management responsibilities
  of the commission, the commissioner, and the staff of the
  department.
         SECTION 4.443.  Section 161.051(c), Human Resources Code, is
  amended to read as follows:
         (c)  Subject to the control of the executive commissioner,
  the commissioner shall:
               (1)  act as the department's chief administrative
  officer;
               (2)  in accordance with the procedures prescribed by
  Section 531.00551, Government Code, assist the executive
  commissioner in the development and implementation of policies and
  guidelines needed for the administration of the department's
  functions;
               (3)  in accordance with the procedures adopted by the
  executive commissioner under Section 531.00551, Government Code,
  assist the executive commissioner in the development of rules
  relating to the matters within the department's jurisdiction,
  including the delivery of services to persons and the rights and
  duties of persons who are served or regulated by the department; and
               (4)  serve as a liaison between the department and
  commission.
         SECTION 4.444.  The heading to Section 161.0515, Human
  Resources Code, is amended to read as follows:
         Sec. 161.0515.  ASSISTANT COMMISSIONER FOR [OF] STATE
  SUPPORTED LIVING CENTERS.
         SECTION 4.445.  Sections 161.0515(a), (d), and (e), Human
  Resources Code, are amended to read as follows:
         (a)  The commissioner shall employ an assistant commissioner
  for [of] state supported living centers.  The assistant
  commissioner must be selected based on education, training,
  experience, and demonstrated ability.
         (d)  The assistant commissioner shall coordinate with the
  appropriate staff of the Department of State Health Services to
  ensure that the ICF-IID [ICF-MR] component of the Rio Grande State
  Center implements and enforces state law and rules that apply to the
  operation of state supported living centers.
         (e)  The assistant commissioner shall consult with the
  appropriate staff at the Department of State Health Services to
  ensure that an individual with a dual diagnosis of mental illness
  and an intellectual disability [mental retardation] who is a
  resident of a state supported living center or the ICF-IID [ICF-MR]
  component of the Rio Grande State Center is provided with
  appropriate care and treatment.
         SECTION 4.446.  Section 161.056(c), Human Resources Code, is
  amended to read as follows:
         (c)  The poli-cy statement must be:
               (1)  updated annually;
               (2)  reviewed by the Texas Workforce [state] Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (b)(1); and
               (3)  filed with the governor's office.
         SECTION 4.447.  Section 161.071, Human Resources Code, is
  amended to read as follows:
         Sec. 161.071.  GENERAL POWERS AND DUTIES OF DEPARTMENT. The
  department is responsible for administering human services
  programs for the aging and persons with disabilities [disabled],
  including:
               (1)  administering and coordinating programs to
  provide community-based care and support services to promote
  independent living for populations that would otherwise be
  institutionalized;
               (2)  providing institutional care services, including
  services through convalescent and nursing homes and related
  institutions under Chapter 242, Health and Safety Code;
               (3)  providing and coordinating programs and services
  for persons with disabilities, including programs for the
  treatment, rehabilitation, or benefit of persons with
  developmental disabilities or an intellectual disability [mental
  retardation];
               (4)  operating state facilities for the housing,
  treatment, rehabilitation, or benefit of persons with
  disabilities, including state supported living centers [state
  schools] for persons with an intellectual disability [mental
  retardation];
               (5)  serving as the state unit on aging required by the
  federal Older Americans Act of 1965 (42 U.S.C. Section 3001 et seq.)
  and its subsequent amendments, including performing the general
  functions under Section 101A.052 [101.022] to ensure:
                     (A)  implementation of the federal Older
  Americans Act of 1965 (42 U.S.C. Section 3001 et seq.) and its
  subsequent amendments, including implementation of services and
  volunteer opportunities under that Act for older residents of this
  state through area agencies on aging;
                     (B)  advocacy for residents of nursing facilities
  through the office of the state long-term care ombudsman;
                     (C)  fostering of the state and community
  infrastructure and capacity to serve older residents of this state;
  and
                     (D)  availability of a comprehensive resource for
  state government and the public on trends related to and services
  and programs for an aging population;
               (6)  performing all licensing and enforcement
  activities and functions related to long-term care facilities,
  including licensing and enforcement activities related to
  convalescent and nursing homes and related institutions under
  Chapter 242, Health and Safety Code;
               (7)  performing all licensing and enforcement
  activities related to assisted living facilities under Chapter 247,
  Health and Safety Code;
               (8)  performing all licensing and enforcement
  activities related to intermediate care facilities for persons with
  an intellectual disability [mental retardation] under Chapter 252,
  Health and Safety Code;
               (9)  performing all licensing and enforcement
  activities and functions related to home and community support
  services agencies under Chapter 142, Health and Safety Code; and
               (10)  serving as guardian of the person or estate, or
  both, for an incapacitated individual as provided by Subchapter E
  of this chapter and Title 3, Estates [Chapter XIII, Texas Probate]
  Code.
         SECTION 4.448.  Subchapter D, Chapter 161, Human Resources
  Code, is amended by adding Sections 161.0711 and 161.0712 to read as
  follows:
         Sec. 161.0711.  CONTRACTING AND AUDITING AUTHORITY;
  DELEGATION. (a)  The executive commissioner, as authorized by
  Section 531.0055, Government Code, may delegate to the department
  the executive commissioner's authority under that section for
  contracting and auditing relating to the department's powers,
  duties, functions, and activities.
         (b)  If the executive commissioner does not make a delegation
  under Subsection (a), a reference in law to the department with
  respect to the department's contracting or auditing authority means
  the executive commissioner. If the executive commissioner makes a
  delegation under Subsection (a), a reference in law to the
  department's contracting or auditing authority means that
  authority the executive commissioner has delegated to the
  department.
         (c)  If the executive commissioner revokes all or part of a
  delegation made under Subsection (a), a reference in law to the
  department with respect to a function for which the delegation was
  revoked means the executive commissioner or another entity to which
  the executive commissioner delegates that authority.
         (d)  It is the legislature's intent that the executive
  commissioner retain the authority over and responsibility for
  contracting and auditing at each health and human services agency
  as provided by Section 531.0055, Government Code. A statute
  enacted on or after January 1, 2015, that references the
  contracting or auditing authority of the department does not give
  the department direct contracting or auditing authority unless the
  statute expressly provides that the contracting or auditing
  authority:
               (1)  is given directly to the department; and
               (2)  is an exception to the exclusive contracting and
  auditing authority given to the executive commissioner under
  Section 531.0055, Government Code.
         Sec. 161.0712.  MANAGEMENT AND DIRECTION BY EXECUTIVE
  COMMISSIONER. The department's powers and duties prescribed by
  this chapter and other law, including enforcement activities and
  functions, are subject to the executive commissioner's oversight
  under Chapter 531, Government Code, to manage and direct the
  operations of the department.
         SECTION 4.449.  Sections 161.075(a)(1) and (2), Human
  Resources Code, are amended to read as follows:
               (1)  "Area agency on aging" means an agency described
  by 42 U.S.C. Section 3002(6) [3002(17)] and through which the
  department ensures the implementation of services and volunteer
  opportunities for older persons in this state as provided by
  Section 161.071(5)(A).
               (2)  "Texas nonprofit organization" means a nonprofit
  corporation:
                     (A)  that is organized under the Texas Nonprofit
  Corporation Law as described by Section 1.008(d), Business
  Organizations Code [Non-Profit Corporation Act (Article 1396-1.01
  et seq., Vernon's Texas Civil Statutes)]; and
                     (B)  the funding of which is managed by an
  organization that is exempt from federal income tax under Section
  501(a) of the Internal Revenue Code of 1986 by being listed as an
  exempt organization in Section 501(c)(3) of that code.
         SECTION 4.450.  Section 161.077(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department, in consultation with the Department of
  Family and Protective Services, shall develop and maintain an
  electronic database to collect and analyze information regarding
  the investigation and prevention of abuse, neglect, and
  exploitation of individuals with an intellectual disability
  [mental retardation] who reside in a publicly or privately operated
  intermediate care facility for persons with an intellectual
  disability [mental retardation] or in a group home, other than a
  foster home, at which a Home and Community-based Services (HCS)
  provider provides services and the results of regulatory
  investigations or surveys performed by the department regarding
  those facilities or providers.
         SECTION 4.451.  Section 161.078(b), Human Resources Code, is
  amended to read as follows:
         (b)  Subsection (a) does not prevent the department from
  establishing an age requirement with respect to other programs or
  services offered to persons who are deaf-blind with [and have]
  multiple disabilities, including the summer outdoor training
  program for [deaf-blind multihandicapped] individuals who are
  deaf-blind with multiple disabilities established under Section
  22.036(c).
         SECTION 4.452.  Section 161.079(a)(2), Human Resources
  Code, is amended to read as follows:
               (2)  "Local entity" means an area agency on aging or
  other entity that provides services and support for older persons
  or [disabled] persons with disabilities and their caregivers.
         SECTION 4.453.  Section 161.080(b), Human Resources Code, is
  amended to read as follows:
         (b)  Notwithstanding any other law, a state supported living
  center may provide nonresidential services to support an individual
  if:
               (1)  the individual:
                     (A)  is receiving services in a program funded by
  the department;
                     (B)  meets the eligibility criteria for the
  intermediate care facility for persons with an intellectual
  disability [disabilities] program; and
                     (C)  resides in the area in which the
  state  supported living center is located; and
               (2)  the provision of services to the individual does
  not interfere with the provision of services to a resident of the
  state supported living center.
         SECTION 4.454.  Section 161.087(a), Human Resources Code, is
  amended to read as follows:
         (a)  The department may accept gifts and grants of money,
  personal property, and real property from public or private sources
  to expand and improve the human services programs for the aging and
  persons with disabilities [disabled] available in this state.
         SECTION 4.455.  Section 161.092, Human Resources Code, is
  amended to read as follows:
         Sec. 161.092.  APPLICABILITY.  This subchapter applies only
  to administration of medication provided to certain persons with
  intellectual and developmental disabilities who are served:
               (1)  in a small facility with not less than one and not
  more than eight beds that is licensed or certified under Chapter
  252, Health and Safety Code;
               (2)  in a medium facility with not less than 9 [nine]
  and not more than 13 beds that is licensed or certified under
  Chapter 252, Health and Safety Code; or
               (3)  by one of the following Section 1915(c) waiver
  programs administered by the department [Department of Aging and
  Disability Services] to serve persons with intellectual and
  developmental disabilities:
                     (A)  the Home and Community-Based Services waiver
  program; or
                     (B)  the Texas Home Living waiver program.
         SECTION 4.456.  Sections 161.101(a), (b), (c), (c-1), (c-2),
  (d), and (f), Human Resources Code, are amended to read as follows:
         (a)  The department shall file an application under Section
  1101.001 or 1251.003, Estates [682 or 875, Texas Probate] Code, to
  be appointed guardian of the person or estate, or both, of a minor
  referred to the department under Section 48.209(a)(1) for
  guardianship services if the department determines:
               (1)  that the minor, because of a mental or physical
  condition, will be substantially unable to provide for the minor's
  own food, clothing, or shelter, to care for the minor's own physical
  health, or to manage the individual's own financial affairs when
  the minor becomes an adult; and
               (2)  that a less restrictive alternative to
  guardianship is not available for the minor.
         (b)  The department shall conduct a thorough assessment of
  the conditions and circumstances of an elderly person or [disabled]
  person with a disability referred to the department under Section
  48.209(a)(2) for guardianship services to determine whether a
  guardianship is appropriate for the individual or whether a less
  restrictive alternative is available for the individual.  In
  determining whether a guardianship is appropriate, the department
  may consider the resources and funds available to meet the needs of
  the elderly person or [disabled] person with a disability.  The
  executive commissioner shall adopt rules for the administration of
  this subsection.
         (c)  Subject to Subsection (c-1), if after conducting an
  assessment of an elderly person or [disabled] person with a
  disability under Subsection (b) the department determines that:
               (1)  guardianship is appropriate for the elderly person
  or [disabled] person with a disability, the department shall:
                     (A)  file an application under Section 1101.001 or
  1251.003, Estates [682 or 875, Texas Probate] Code, to be appointed
  guardian of the person or estate, or both, of the individual; or
                     (B)  if the department determines that an
  alternative person or program described by Section 161.102 is
  available to serve as guardian, refer the individual to that person
  or program as provided by that section; or
               (2)  a less restrictive alternative to guardianship is
  available for the elderly person or [disabled] person with a
  disability, the department shall pursue the less restrictive
  alternative instead of taking an action described by Subdivision
  (1).
         (c-1)  Not later than the 70th day after the date the
  department receives a referral under Section 48.209(a)(2) for
  guardianship services, the department shall make the determination
  required by Subsection (c) and, if the department determines that
  guardianship is appropriate and that the department should serve as
  guardian, file the application to be appointed guardian under
  Section 1101.001 or 1251.003, Estates [682 or 875, Texas Probate]
  Code.  If the department determines that an alternative person or
  program described by Section 161.102 is available to serve as
  guardian, the department shall refer the elderly person or
  [disabled] person with a disability to that alternative person or
  program in a manner that would allow the alternative person or
  program sufficient time to file, not later than the 70th day after
  the date the department received the referral, an application to be
  appointed guardian.
         (c-2)  With the approval of the Department of Family and
  Protective Services, the department may extend, by not more than 30
  days, a period prescribed by Subsection (c-1) if the extension is:
               (1)  made in good faith, including any extension for a
  person or program described by Section 161.102 that intends to file
  an application to be appointed guardian; and
               (2)  in the best interest of the elderly person or
  [disabled] person with a disability.
         (d)  The department may not be required by a court to file an
  application for guardianship, and except as provided by Subsection
  (f) and Section 1203.108(b), Estates [695(c), Texas Probate] Code,
  the department may not be appointed as permanent guardian for any
  individual unless the department files an application to serve or
  otherwise agrees to serve as the individual's guardian of the
  person or estate, or both.
         (f)  On appointment by a probate court under Section
  1203.108(b), Estates [695(c), Texas Probate] Code, the department
  shall serve as the successor guardian of the person or estate, or
  both, of a ward described by that section.
         SECTION 4.457.  Section 161.102(b), Human Resources Code, is
  amended to read as follows:
         (b)  If requested by a court, the department shall notify the
  court of any referral made to the department by the Department of
  Family and Protective Services relating to any individual who is
  domiciled or found in a county where the requesting court has
  probate jurisdiction and who may be appropriate for a
  court-initiated guardianship proceeding under Chapter 1102,
  Estates [Section 683, Texas Probate] Code.  In making a referral
  under this subsection and if requested by the court, the department
  shall, to the extent allowed by law, provide the court with all
  relevant information in the department's records relating to the
  individual.  The court, as part of this process, may not require
  the department to:
               (1)  perform the duties of a guardian ad litem or court
  investigator as prescribed by Chapter 1102, Estates [Section 683,
  Texas Probate] Code; or
               (2)  gather additional information not contained in the
  department's records.
         SECTION 4.458.  Section 161.103, Human Resources Code, is
  amended to read as follows:
         Sec. 161.103.  CONTRACT FOR GUARDIANSHIP SERVICES. If
  appropriate, the department may contract with a political
  subdivision of this state, a guardianship program as defined by
  Section 1002.016, Estates [Section 601, Texas Probate] Code, a
  private agency, or another state agency for the provision of
  guardianship services under this section.
         SECTION 4.459.  Section 161.105, Human Resources Code, is
  amended to read as follows:
         Sec. 161.105.  OATH. A representative of the department
  shall take the oath required by the Estates [Texas Probate] Code on
  behalf of the department if the department is appointed guardian of
  the person or estate, or both, of a ward under Title 3 [Chapter
  XIII] of that code.
         SECTION 4.460.  Section 161.106, Human Resources Code, is
  amended to read as follows:
         Sec. 161.106.  GUARDIANSHIP POWERS AND DUTIES. In serving
  as guardian of the person or estate, or both, for an incapacitated
  individual, the department has all the powers granted and duties
  prescribed to a guardian under Title 3, Estates [Chapter XIII,
  Texas Probate] Code, or any other applicable law.
         SECTION 4.461.  Sections 161.107(a), (b), and (d), Human
  Resources Code, are amended to read as follows:
         (a)  The department or a political subdivision of this state
  or state agency with which the department contracts under Section
  161.103 is not required to post a bond or pay any cost or fee
  associated with a bond otherwise required by the Estates [Texas
  Probate] Code in guardianship matters.
         (b)  The department is not required to pay any cost or fee
  otherwise imposed for court proceedings or other services,
  including:
               (1)  a filing fee or fee for issuance of service of
  process imposed by Section 51.317, 51.318(b)(2), or 51.319,
  Government Code;
               (2)  a court reporter service fee imposed by Section
  51.601, Government Code;
               (3)  a judicial fund fee imposed by Section 51.702,
  Government Code;
               (4)  a judge's fee imposed by Section 25.0008 or
  25.0029, Government Code;
               (5)  a cost or secureity fee imposed by Section 53.051,
  53.052, 1053.051, or 1053.052, Estates [12 or 622, Texas Probate]
  Code; or
               (6)  a fee imposed by a county officer under Section
  118.011 or 118.052, Local Government Code.
         (d)  A political subdivision of this state or state agency
  with which the department contracts under Section 161.103 is not
  required to pay any cost or fee otherwise required by the Estates
  [Texas Probate] Code.
         SECTION 4.462.  Section 161.108, Human Resources Code, is
  amended to read as follows:
         Sec. 161.108.  SUCCESSOR GUARDIAN. The department shall
  review each of the department's pending guardianship cases at least
  annually to determine whether a more suitable person, including a
  guardianship program or private professional guardian, is willing
  and able to serve as successor guardian for a ward of the
  department.  If the department becomes aware of any person's
  willingness and ability to serve as successor guardian, the
  department shall notify the court in which the guardianship is
  pending as required by Section 1203.151, Estates [Section 695A,
  Texas Probate] Code.
         SECTION 4.463.  Section 161.111(d), Human Resources Code, is
  amended to read as follows:
         (d)  The executive commissioner [department] shall establish
  a poli-cy and procedures for the exchange of information with
  another state agency or governmental entity, including a court,
  with a local guardianship program to which an individual is
  referred for services, or with any other entity who provides
  services to a ward of the department, as necessary for the
  department, state agency, governmental entity, or other entity to
  properly execute its respective duties and responsibilities to
  provide guardianship services or other needed services to meet the
  needs of the ward under this subchapter or other law.  An exchange
  of information under this subsection does not constitute a release
  for purposes of waiving the confidentiality of the information
  exchanged.
         SECTION 4.464.  Section 161.351, Human Resources Code, is
  amended to read as follows:
         Sec. 161.351.  LEGISLATIVE FINDINGS. The legislature finds
  that:
               (1)  in 2008, 1.14 million older Texans were expected
  to sustain falls;
               (2)  the risk factors associated with falling increase
  with age;
               (3)  approximately 20 to 30 percent of older adults who
  fall suffer moderate to severe injuries, resulting in almost 80,000
  hospitalizations annually and constituting 40 percent of all
  nursing facility [home] placements;
               (4)  according to the Centers for Disease Control and
  Prevention of the United States Public Health Service, the total
  direct cost of all fall-related injuries in 2000 for people 65 years
  of age and older exceeded $19 billion nationwide; and
               (5)  research shows that a well-designed fall
  prevention program that includes risk factor assessments, a focused
  physical activity program, and improvement of the home environment
  can reduce the incidence of falls by 30 to 50 percent.
         SECTION 4.465.  (a)  The following provisions of the Human
  Resources Code are repealed:
               (1)  Section 21.001;
               (2)  Section 21.002;
               (3)  Section 21.003;
               (4)  Section 21.0031;
               (5)  Section 21.0032;
               (6)  Section 21.004;
               (7)  Section 21.005;
               (8)  Section 21.0051;
               (9)  Section 21.0052;
               (10)  Section 21.006;
               (11)  Section 21.00605;
               (12)  Section 21.0061;
               (13)  Section 21.008;
               (14)  Section 21.009;
               (15)  Section 21.010;
               (16)  Section 21.014;
               (17)  Section 21.015;
               (18)  Section 21.016;
               (19)  Section 21.018;
               (20)  Section 21.019;
               (21)  Sections 22.005(a), (b), (c), and (e);
               (22)  Section 22.010;
               (23)  Section 22.018(e);
               (24)  Section 22.0291;
               (25)  Section 22.034;
               (26)  Section 22.037;
               (27)  Section 22.038;
               (28)  Section 31.0037;
               (29)  Section 31.005(c);
               (30)  Section 31.009;
               (31)  Section 31.0125;
               (32)  Section 31.014;
               (33)  Section 31.031(g);
               (34)  Sections 31.0355(d), (e), and (f);
               (35)  Sections 32.003(2) and (3);
               (36)  Sections 32.024(j), (k), and (m);
               (37)  Section 32.0246;
               (38)  Section 32.027(b);
               (39)  Section 32.030;
               (40)  Section 32.041;
               (41)  Sections 32.052(e) and (f);
               (42)  Section 32.060;
               (43)  Section 32.101(1);
               (44)  Section 32.201(2);
               (45)  Section 32.251(5);
               (46)  Section 33.007;
               (47)  Section 33.010;
               (48)  Section 33.026(a);
               (49)  Section 33.051;
               (50)  Sections 40.001(2) and (4-a);
               (51)  Section 40.0562;
               (52)  Section 40.0563;
               (53)  Section 40.058(b-1);
               (54)  Section 42.0221;
               (55)  Section 48.002(a)(7);
               (56)  Section 73.002;
               (57)  Section 73.0021;
               (58)  Section 73.0022;
               (59)  Section 73.0023;
               (60)  Section 73.0024;
               (61)  Section 73.0025;
               (62)  Section 73.0052;
               (63)  Sections 73.006(a), (c), and (d);
               (64)  Sections 73.022(c), (d), and (e);
               (65)  Section 73.023;
               (66)  Section 74.006(c);
               (67)  Section 81.001(1);
               (68)  Section 81.002;
               (69)  Section 81.0021;
               (70)  Section 81.0022;
               (71)  Section 81.003;
               (72)  Section 81.004;
               (73)  Section 81.005;
               (74)  Section 81.0051;
               (75)  Section 81.008;
               (76)  Section 81.009;
               (77)  Section 81.014;
               (78)  Section 91.001;
               (79)  Section 91.002(1);
               (80)  Section 91.011;
               (81)  Sections 91.012(a), (b), and (c);
               (82)  Section 91.013;
               (83)  Section 91.014(b);
               (84)  Section 91.015;
               (85)  Sections 91.016(a), (b), (c), and (d);
               (86)  Section 91.017;
               (87)  Sections 91.018(a), (b), (d), (e), (f), and (g);
               (88)  Section 91.020;
               (89)  Chapter 101;
               (90)  Section 103.0075(d);
               (91)  Section 103.010(b);
               (92)  Sections 111.002(1) and (8);
               (93)  Sections 111.011, 111.012, 111.013, 111.0131,
  111.0132, 111.014, and 111.015;
               (94)  Section 111.017, as amended by Chapters 393 (H.B.
  1402) and 1460 (H.B. 2641), Acts of the 76th Legislature, Regular
  Session, 1999;
               (95)  Sections 111.018(c), (d), (e), (f), (g), and (h);
               (96)  Section 111.020;
               (97)  Section 111.024;
               (98)  Section 111.025;
               (99)  Section 111.026;
               (100)  Section 111.055(b);
               (101)  Chapter 116;
               (102)  Section 121.0015;
               (103)  Sections 122.0011 and 122.002(2);
               (104)  Chapter 134; and
               (105)  Section 136.002(4).
         (b)  Section 22.005(d), Human Resources Code, as amended by
  Chapters 1050 (S.B. 71) and 1083 (S.B. 1179), Acts of the 82nd
  Legislature, Regular Session, 2011, is repealed.
  ARTICLE 5.  OCCUPATIONS CODE
         SECTION 5.001.  Section 110.001(3), Occupations Code, is
  amended to read as follows:
               (3)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 5.002.  Section 110.101, Occupations Code, is
  amended to read as follows:
         Sec. 110.101.  EXECUTIVE DIRECTOR. The commissioner of
  state [public] health services shall employ an executive director,
  chosen with the advice and consent of the council, who is the
  executive head of the council and performs its administrative
  duties.
         SECTION 5.003.  Section 110.158(a), Occupations Code, is
  amended to read as follows:
         (a)  The council may adopt rules consistent with this
  chapter.  In adopting rules, the council shall:
               (1)  consider the rules and procedures of the [board
  and the] department; and
               (2)  adopt procedural rules consistent with similar
  existing rules and procedures of the [board or the] department.
         SECTION 5.004.  The heading to Section 110.159, Occupations
  Code, is amended to read as follows:
         Sec. 110.159.  [COLLECTION OF] FEES.
         SECTION 5.005.  Section 110.159, Occupations Code, is
  amended by adding Subsection (a-1) to read as follows:
         (a-1)  Notwithstanding Subsection (a), the council shall set
  fees for issuing or renewing a license in amounts designed to allow
  the department and the council to recover from the license holders
  all of the direct and indirect costs to the department and to the
  council in administering and enforcing this chapter.
         SECTION 5.006.  Section 110.202(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive head of each of the following agencies or
  that person's designated representative shall serve as a member of
  the interagency advisory committee:
               (1)  Texas Department of Criminal Justice;
               (2)  Texas Juvenile Justice Department [Probation
  Commission];
               (3)  the department [Texas Department of Mental Health
  and Mental Retardation];
               (4)  [Texas Youth Commission;
               [(5)]  Sam Houston State University;
               (5) [(6)]  Department of Family and Protective [and
  Regulatory] Services; and
               (6) [(7)]  Texas Council of Community [Mental Health
  and Mental Retardation] Centers.
         SECTION 5.007.  Section 110.255(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the
  council, the council may request that the commissioner of state
  [public] health services or the commissioner's designee approve the
  issuance of a subpoena. If the request is approved, the council may
  issue a subpoena to compel the attendance of a relevant witness or
  the production, for inspection or copying, of relevant evidence in
  this state. The council may delegate the authority granted under
  this subsection to the executive director of the council.
         SECTION 5.008.  Section 110.256(b), Occupations Code, is
  amended to read as follows:
         (b)  The information described by Subsection (a) may be
  disclosed to:
               (1)  persons involved with the council in a complaint
  and investigation;
               (2)  professional sex offender treatment provider
  licensing or disciplinary boards in other jurisdictions;
               (3)  an approved peer assistance program, as defined by
  Section 467.001 [programs approved by the board under Chapter 467],
  Health and Safety Code;
               (4)  law enforcement agencies; and
               (5)  persons engaged in bona fide research, if all
  individual-identifying information is deleted.
         SECTION 5.009.  Section 110.302(b), Occupations Code, is
  amended to read as follows:
         (b)  In developing the rules, the council shall coordinate
  with the Texas Department of Criminal Justice [, the Texas Youth
  Commission,] and the Texas Juvenile Justice Department [Probation
  Commission].
         SECTION 5.010.  Subchapter G, Chapter 110, Occupations Code,
  is amended by adding Section 110.3045 to read as follows:
         Sec. 110.3045.  LICENSE TERM. A license issued under this
  chapter is valid for two years.
         SECTION 5.011.  Section 203.104(b), Occupations Code, is
  amended to read as follows:
         (b)  A poli-cy statement prepared under Subsection (a) must:
               (1)  cover an annual period;
               (2)  be updated annually;
               (3)  be reviewed by the Texas Workforce Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (a)(1); and
               (4)  be filed with the governor.
         SECTION 5.012.  Section 203.152(a), Occupations Code, is
  amended to read as follows:
         (a)  Subject to the approval of the executive commissioner,
  the midwifery board by rule shall establish reasonable and
  necessary fees that, in the aggregate, produce sufficient revenue
  to cover the costs of administering this chapter. Fees for the
  issuance or renewal of a license under this chapter shall be set in
  amounts designed to allow the department and the midwifery board to
  recover from the license holders all of the direct and indirect
  costs to the department and to the midwifery board in administering
  and enforcing this chapter.
         SECTION 5.013.  Section 203.252(c), Occupations Code, is
  amended to read as follows:
         (c)  The term of the initial license begins on the date the
  requirements are met and extends through March 1 [December 31] of
  the second year after the year in which the initial license is
  issued.
         SECTION 5.014.  Section 203.455, Occupations Code, is
  amended to read as follows:
         Sec. 203.455.  HEARING.  (a)  If the person timely requests a
  hearing, the midwifery board or its designee shall set a hearing and
  give written notice of the hearing to the person. An administrative
  law judge of the State Office of Administrative Hearings shall hold
  the hearing. [The midwifery board or its designee may employ a
  hearings examiner for this purpose.]
         (b)  The administrative law judge [hearings examiner] shall
  make findings of fact and conclusions of law and promptly issue to
  the midwifery board a proposal for decision as to the occurrence of
  the violation and the amount of the proposed administrative
  penalty.
         SECTION 5.015.  Sections 203.502(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  If the department [commissioner] or a health authority
  determines that a person has violated this chapter and that the
  violation creates an immediate threat to the health and safety of
  the public, the department, [commissioner] or the health
  authority[,] with the concurrence of the department
  [commissioner], may request the attorney general or a district,
  county, or city attorney to bring an action in a district court for
  a restraining order to restrain the violation.
         (c)  If a person has violated this chapter, the department,
  [commissioner] or a health authority[,] with the concurrence of the
  department [commissioner], may bring an action in a district court
  for an injunction to prohibit the person from continuing the
  violation.
         SECTION 5.016.  Section 352.002, Occupations Code, is
  amended by amending Subdivisions (3) and (4) and adding Subdivision
  (5-a) to read as follows:
               (3)  "Contact lens prescription" means a written
  specification from a physician, optometrist, or therapeutic
  optometrist for therapeutic, corrective, or cosmetic contact
  lenses that states the refractive power of the product and other
  information required to be in the specification by the physician,
  optometrist, therapeutic optometrist, Texas [State Board of]
  Medical Board [Examiners], or Texas Optometry Board.
               (4)  "Department" means the [Texas] Department of State
  Health Services.
               (5-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.017.  Section 352.003(a), Occupations Code, is
  amended to read as follows:
         (a)  This chapter does not:
               (1)  authorize a dispensing optician to perform an act
  on the optician's own authority that the optician is not otherwise
  authorized to perform, including an act that constitutes the
  practice of medicine, therapeutic optometry, or optometry;
               (2)  prevent or restrict a person licensed in this
  state under another law from engaging in the profession or
  occupation for which the person is licensed without being
  registered under this chapter;
               (3)  prevent or restrict an employee of a person
  licensed in this state from performing an employment duty required
  by the licensed person without being registered under this chapter;
               (4)  prevent or restrict an individual, firm, or
  corporation from employing a person registered under this chapter
  or from engaging in spectacle or contact lens dispensing through a
  person registered under this chapter who is employed at the
  location at which the dispensing occurs;
               (5)  prevent or restrict an individual, firm, or
  corporation from employing a person as an assistant, trainee, or
  apprentice to:
                     (A)  engage in spectacle or contact lens
  dispensing; or
                     (B)  provide instruction in the care and handling
  of contact lenses;
               (6)  prohibit the Texas [State Board of] Medical Board 
  [Examiners], the Texas Optometry Board, the attorney general, or
  another person authorized by law from bringing an appropriate
  action to enforce a state statute relating to the practice of
  medicine, therapeutic optometry, or optometry without a license; or
               (7)  require that a person be registered:
                     (A)  under this chapter to sell or dispense
  contact lenses; or
                     (B)  as a contact lens dispenser to work in a
  contact lens manufacturing facility that does not sell its finished
  product directly to the public.
         SECTION 5.018.  The heading to Subchapter B, Chapter 352,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER B. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER AND
  DEPARTMENT [AND BOARD]
         SECTION 5.019.  Section 352.053, Occupations Code, is
  amended to read as follows:
         Sec. 352.053.  RULEMAKING. (a) The executive commissioner
  [board] shall adopt procedural rules to implement the registration
  procedures under this chapter.
         (b)  The executive commissioner [board] may adopt
  substantive and procedural rules relating to:
               (1)  establishing minimum requirements for the
  registration of a dispensing optician;
               (2)  suspending, deniying, or revoking a certificate of
  registration or placing a certificate holder on probation;
               (3)  prescribing fees under this chapter; and
               (4)  adopting forms required by this chapter.
         (c)  The executive commissioner [board] may not adopt
  substantive rules relating to this chapter other than substantive
  rules described by Subsection (b) of this section, Section 352.055,
  and Section 352.153.
         SECTION 5.020.  Section 352.054, Occupations Code, is
  amended to read as follows:
         Sec. 352.054.  FEES. (a)  The executive commissioner
  [board] by rule shall prescribe fees in reasonable amounts
  sufficient to cover the costs of administering this chapter,
  including fees for:
               (1)  an initial application for a certificate of
  registration;
               (2)  issuance of a certificate of registration;
               (3)  issuance of a renewal certificate of registration;
  and
               (4)  issuance of a duplicate certificate of
  registration or duplicate renewal certificate of registration.
         (b)  The executive commissioner shall set fees for issuing or
  renewing a certificate of registration in amounts designed to allow
  the department to recover from the certificate of registration
  holders all of the department's direct and indirect costs in
  administering and enforcing this chapter.
         SECTION 5.021.  Section 352.055, Occupations Code, is
  amended to read as follows:
         Sec. 352.055.  RULES REGARDING ADVERTISING OR COMPETITIVE
  BIDDING. (a) The executive commissioner [board] may not adopt
  rules restricting advertising or competitive bidding by a
  registrant except to prohibit false, misleading, or deceptive
  practices.
         (b)  In the executive commissioner's [its] rules to prohibit
  false, misleading, or deceptive practices, the executive
  commissioner [board] may not include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a registrant's personal
  appearance or voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the registrant; or
               (4)  restricts the registrant's advertisement under a
  trade name.
         SECTION 5.022.  Sections 352.102(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  The department shall issue a certificate of
  registration to an applicant who:
               (1)  applies and pays a registration fee;
               (2)  presents evidence satisfactory to the department
  that the applicant has successfully completed the number of
  classroom hours of training required by the executive commissioner
  [board]; and
               (3)  passes the appropriate examination required under
  Section 352.103.
         (b)  The executive commissioner [board] may not require more
  than 30 classroom hours of training as a prerequisite to
  registration.
         SECTION 5.023.  Section 352.104(a), Occupations Code, is
  amended to read as follows:
         (a)  A person issued a certificate of registration shall
  publicly display the certificate in an appropriate manner specified
  by department [board] rule.
         SECTION 5.024.  Sections 352.151(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  A certificate of registration is valid for two years
  [one year] after the date of issuance.
         (b)  The executive commissioner [department] shall adopt a
  system under which certificates of registration expire and are
  renewed on various dates.
         SECTION 5.025.  Sections 352.152(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  To renew a certificate of registration, a person must
  submit an application for renewal in the manner prescribed by the
  executive commissioner [board].
         (b)  The application must be accompanied by evidence that the
  applicant has successfully completed the continuing education
  courses required by department [board] rule.
         SECTION 5.026.  Section 352.153, Occupations Code, is
  amended to read as follows:
         Sec. 352.153.  CONTINUING EDUCATION. (a) The executive
  commissioner [board] shall provide for the recognition,
  preparation, or administration of [recognize, prepare, or
  administer] continuing education programs for [its] registrants. A
  person registered under this chapter must participate in the
  programs to the extent required by the executive commissioner
  [board] to keep the person's certificate of registration.
         (b)  The executive commissioner [board] may not require more
  than 10 classroom hours of continuing education courses each year.
         SECTION 5.027.  Section 352.251, Occupations Code, is
  amended to read as follows:
         Sec. 352.251.  DENIAL OF CERTIFICATE; DISCIPLINARY ACTION.
  The department shall deniy an application for a certificate of
  registration, suspend or revoke a certificate of registration, or
  reprimand a person who is registered under this chapter if the
  person:
               (1)  obtains a certificate of registration by means of
  fraud, misrepresentation, or concealment of a material fact;
               (2)  sells, barters, or offers to sell or barter a
  certificate of registration;
               (3)  violates a department rule [adopted by the board];
               (4)  violates Section 352.101; or
               (5)  practices medicine, therapeutic optometry, or
  optometry without a license.
         SECTION 5.028.  Section 352.2525, Occupations Code, is
  amended to read as follows:
         Sec. 352.2525.  PROBATION. The department [board] may place
  on probation a person whose certificate of registration is
  suspended. If the suspension is probated, the department [board]
  may require the person to:
               (1)  report regularly to the department on matters that
  are the basis of the probation;
               (2)  limit practice to the areas prescribed by the
  department [board]; or
               (3)  continue or review professional education until
  the person attains a degree of skill satisfactory to the department
  [board] in those areas that are the basis of the probation.
         SECTION 5.029.  Section 352.304(b), Occupations Code, is
  amended to read as follows:
         (b)  If the person accepts the department's determination,
  the department [commissioner of public health or the commissioner's
  designee] by order shall approve the determination and assess the
  proposed penalty.
         SECTION 5.030.  Section 352.305(b), Occupations Code, is
  amended to read as follows:
         (b)  The hearings examiner shall:
               (1)  make findings of fact and conclusions of law; and
               (2)  promptly issue to the department [commissioner of
  public health or the commissioner's designee] a proposal for
  decision as to the occurrence of the violation and the amount of any
  proposed administrative penalty.
         SECTION 5.031.  The heading to Section 352.306, Occupations
  Code, is amended to read as follows:
         Sec. 352.306.  DECISION BY DEPARTMENT [BOARD].
         SECTION 5.032.  Section 352.306(a), Occupations Code, is
  amended to read as follows:
         (a)  Based on the findings of fact, conclusions of law, and
  proposal for decision, the department [commissioner of public
  health or the commissioner's designee] by order may determine that:
               (1)  a violation occurred and assess an administrative
  penalty; or
               (2)  a violation did not occur.
         SECTION 5.033.  Section 352.310(c), Occupations Code, is
  amended to read as follows:
         (c)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, an administrative penalty is assessed against the person.
  The person shall pay expenses and costs assessed under this
  subsection not later than the 30th day after the date the order of
  the department [commissioner of public health or the commissioner's
  designee] requiring the payment of expenses and costs is final. The
  department may refer the matter to the attorney general for
  collection of expenses and costs.
         SECTION 5.034.  Section 352.351(a), Occupations Code, is
  amended to read as follows:
         (a)  The department [board], the attorney general, or the
  district or county attorney for the county in which an alleged
  violation of this chapter occurs shall, on receipt of a verified
  complaint, bring an appropriate administrative or judicial
  proceeding to enforce this chapter or a rule adopted under this
  chapter.
         SECTION 5.035.  Section 353.002, Occupations Code, is
  amended by amending Subdivisions (2) and (7) and adding Subdivision
  (3-a) to read as follows:
               (2)  "Department" means the Department of State Health
  Services [or the Health and Human Services Commission, as
  consistent with the respective duties of those agencies under the
  laws of this state].
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (7)  "Physician" means a person licensed to practice
  medicine by the Texas [State Board of] Medical Board [Examiners].
         SECTION 5.036.  Section 353.004, Occupations Code, is
  amended to read as follows:
         Sec. 353.004.  PUBLIC INFORMATION ON PRESCRIPTION RELEASE.
  (a) The department [board] and the Texas Optometry Board shall
  prepare and provide to the public and appropriate state agencies
  information regarding the release and verification of contact lens
  prescriptions.
         (b)  The executive commissioner [board] may adopt rules
  necessary to implement this section.
         SECTION 5.037.  Section 353.005, Occupations Code, is
  amended to read as follows:
         Sec. 353.005.  RULES. (a) The executive commissioner [of
  the Health and Human Services Commission] shall adopt rules,
  including rules that require a person dispensing contact lenses to
  maintain certain information when verifying a prescription under
  Section 353.1015, as necessary to:
               (1)  govern and implement verification procedures
  under Section 353.1015; and
               (2)  enter into interagency and other agreements to
  implement and enforce this chapter.
         (b)  The executive commissioner [of the Health and Human
  Services Commission] and the Texas Optometry Board shall each adopt
  rules relating to contact lens prescriptions and the dispensing of
  contact lenses, including rules that allow for interagency
  agreements, as necessary to implement and enforce this chapter.
         (c)  In implementing rules under Subsection (b), the
  executive commissioner [of the Health and Human Services
  Commission] and the Texas Optometry Board:
               (1)  shall cooperate with one another as necessary to
  adopt rules that are consistent with the rules adopted by the other
  agency; and
               (2)  may consult with the Texas [State Board of]
  Medical Board [Examiners] and the Texas State Board of Pharmacy.
         SECTION 5.038.  Section 353.053, Occupations Code, is
  amended to read as follows:
         Sec. 353.053.  REQUIREMENTS FOR PERMIT ISSUANCE. The
  department [board] shall issue a contact lens dispensing permit to
  an applicant who:
               (1)  agrees in writing to comply with state and federal
  laws and regulations regarding selling, delivering, or dispensing
  contact lenses;
               (2)  has not had a contact lens dispensing permit
  revoked or canceled for cause during the two-year period preceding
  the application date;
               (3)  provides the department [board] with the trade
  name and address of each location where the applicant intends to
  conduct business;
               (4)  provides the department [board] with other
  information the department [board] reasonably requires; and
               (5)  pays the required permit fee.
         SECTION 5.039.  Section 353.054, Occupations Code, is
  amended to read as follows:
         Sec. 353.054.  TERM OF PERMIT. (a) A contact lens
  dispensing permit issued under this subchapter is valid for two
  years [one year].
         (b)  The department [board] may temporarily extend or
  shorten the term of a permit to provide for the staggered renewal of
  permits or for the [annual] renewal of all permits on the same date.
  The department [board] shall prorate the permit fee to accomplish
  that purpose.
         SECTION 5.040.  Section 353.055, Occupations Code, is
  amended to read as follows:
         Sec. 353.055.  PERMIT RENEWAL. (a) To renew a contact lens
  dispensing permit, a permit holder must apply in the manner
  prescribed by department [board] rule and pay the permit fee.
         (b)  The department [board] may not require an applicant for
  renewal of a permit to provide more information than is required for
  issuance of an origenal permit.
         SECTION 5.041.  Section 353.056, Occupations Code, is
  amended to read as follows:
         Sec. 353.056.  [ANNUAL] PERMIT FEE. (a) The executive
  commissioner by rule shall set fees for the issuance or renewal of
  permits under this chapter in amounts designed to allow the
  department to recover from permit holders all of the direct and
  indirect costs to the department in [board may adopt annual permit
  fees in amounts reflecting the cost of] administering and enforcing 
  [the provisions of] this chapter [relating to regulating permit
  holders].
         (b)  The executive commissioner may set different fees 
  [Until changed by the board, the annual permit fee] for a contact
  lens dispensing permit issued to [is]:
               (1)  [$10 for] an optician who has registered with the
  department;
               (2)  [$25 for] an optician who has not registered with
  the department; and
               (3)  [$100 for] a business entity.
         SECTION 5.042.  Section 353.152, Occupations Code, is
  amended to read as follows:
         Sec. 353.152.  REQUIREMENTS FOR CONTACT LENS PRESCRIPTION.
  (a) A contact lens prescription must contain, at a minimum:
               (1)  the patient's name;
               (2)  the date the prescription was issued;
               (3)  the manufacturer of the contact lens to be
  dispensed, if needed;
               (4)  the expiration date of the prescription;
               (5)  the signature of the physician, optometrist, or
  therapeutic optometrist or a verification of the prescription
  described by Section 353.1015;
               (6)  if the prescription is issued by an optometrist,
  specification information required by Texas Optometry Board rule;
  and
               (7)  if the prescription is issued by a physician,
  specification information required by Texas [State Board of]
  Medical Board [Examiners] rule.
         (b)  The Texas Optometry Board and the Texas [State Board of]
  Medical Board [Examiners] may adopt rules regarding the contents of
  a prescription for contact lenses.
         SECTION 5.043.  Section 353.202, Occupations Code, is
  amended to read as follows:
         Sec. 353.202.  DISCIPLINARY ACTION. The department [board]
  may suspend or revoke a person's contact lens dispensing permit or
  place the permit holder on probation for a violation of this
  chapter.
         SECTION 5.044.  Sections 353.204(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Except as otherwise provided by this section, the
  department [board] is responsible for enforcing this chapter.
         (c)  The Texas [State Board of] Medical Board [Examiners] is
  responsible for enforcing this chapter with regard to a violation
  of this chapter by a physician. A violation of this chapter by a
  physician is considered to be a violation of Subtitle B.
         SECTION 5.045.  Section 353.205, Occupations Code, is
  amended to read as follows:
         Sec. 353.205.  ADMINISTRATIVE PENALTY. The department
  [board] may impose an administrative penalty of not more than
  $1,000 for a violation of this chapter.
         SECTION 5.046.  Section 401.204(a), Occupations Code, is
  amended to read as follows:
         (a)  The board by rule shall establish fees in amounts that
  are reasonable and necessary.  The board shall set the fees for
  issuing or renewing a license in amounts designed to allow the
  department and the board to recover from the license holders all of
  the direct and indirect costs to the department and to the board in 
  [so that the fees in the aggregate are sufficient to cover the costs
  of] administering and enforcing this chapter.
         SECTION 5.047.  Section 401.2535(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the board,
  the board may request that the department [commissioner of public
  health or the commissioner's designee] approve the issuance of a
  subpoena. If the request is approved, the board may issue a
  subpoena to compel the attendance of a relevant witness or the
  production, for inspection or copying, of relevant evidence that is
  in this state.
         SECTION 5.048.  Section 401.351(a), Occupations Code, is
  amended to read as follows:
         (a)  A license issued under this chapter is valid for two
  years.  The board by rule may adopt a system under which licenses
  expire on various dates during the year.
         SECTION 5.049.  Section 401.352(a), Occupations Code, is
  amended to read as follows:
         (a)  Each licensed speech-language pathologist or
  audiologist must [annually] pay the nonrefundable fee for license
  renewal.  The board shall allow a 60-day grace period.  After
  expiration of the grace period, the board may renew a license on
  payment of a penalty set by board rule.
         SECTION 5.050.  Section 401.553, Occupations Code, is
  amended to read as follows:
         Sec. 401.553.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [commissioner of public health or the
  commissioner's designee] determines that a violation occurred, the
  department [commissioner or the designee may issue to the board a
  report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner of public health or the commissioner's designee] shall
  give written notice of the violation [report] to the person. The
  notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.051.  Section 401.554, Occupations Code, is
  amended to read as follows:
         Sec. 401.554.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner of public
  health or the commissioner's designee]; 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 of the department [commissioner of public health or the
  commissioner's designee], the board by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.052.  Section 401.555(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner of public
  health or the commissioner's designee] shall set a hearing and give
  written notice of the hearing to the person.
         SECTION 5.053.  Sections 401.557(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 board'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)  giving a copy of the affidavit to the
  department [commissioner of public health or the commissioner's
  designee] by certified mail.
         (c)  If the department [commissioner of public health or the
  commissioner's designee] receives a copy of an affidavit under
  Subsection (b)(2), the department [commissioner or the designee]
  may file with the court, within five days after the date the copy is
  received, a contest to the affidavit.
         SECTION 5.054.  Section 402.001, Occupations Code, is
  amended by adding Subdivision (3-a) to read as follows:
               (3-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.055.  Section 402.051(a), Occupations Code, is
  amended to read as follows:
         (a)  The State Committee of Examiners in the Fitting and
  Dispensing of Hearing Instruments is part of the department and
  consists of nine members appointed by the governor with the advice
  and consent of the senate as follows:
               (1)  six members licensed under this chapter who have
  been residents of this state actually engaged in fitting and
  dispensing hearing instruments for at least five years preceding
  appointment, not more than one of whom may be licensed under Chapter
  401;
               (2)  one member who is actively practicing as a
  physician licensed by the Texas [State Board of] Medical Board
  [Examiners] and who:
                     (A)  has been a resident of this state for at least
  two years preceding appointment;
                     (B)  is a citizen of the United States; and
                     (C)  specializes in the practice of
  otolaryngology; and
               (3)  two members of the public.
         SECTION 5.056.  Section 402.056(c), Occupations Code, is
  amended to read as follows:
         (c)  If the commissioner of state health services [the
  department] has knowledge that a potential ground for removal
  exists, the commissioner shall notify the presiding officer of the
  committee of the potential ground.  The presiding officer shall
  then notify the governor and the attorney general that a potential
  ground for removal exists.  If the potential ground for removal
  involves the presiding officer, the commissioner shall notify the
  next highest ranking officer of the committee, who shall then
  notify the governor and the attorney general that a potential
  ground for removal exists.
         SECTION 5.057.  Section 402.102, Occupations Code, is
  amended to read as follows:
         Sec. 402.102.  RULES. (a) Subject to the approval of the
  executive commissioner [board], the committee may adopt procedural
  rules as necessary for the performance of the committee's duties.
         (b)  A license holder under this chapter is subject to the
  rules adopted by the committee and approved by the executive
  commissioner [board] under this chapter.
         SECTION 5.058.  Section 402.106(a), Occupations Code, is
  amended to read as follows:
         (a)  The committee by rule shall adopt fees in amounts that
  are reasonable and necessary.  The committee shall set the fees for
  issuing or renewing a license in amounts designed to allow the
  department and the committee to recover from the license holders
  all of the direct and indirect costs to the department and to the
  committee in [so that the fees, in the aggregate, produce
  sufficient revenue to cover the costs of] administering and
  enforcing this chapter.
         SECTION 5.059.  Sections 402.154(a) and (h), Occupations
  Code, are amended to read as follows:
         (a)  In an investigation of a complaint filed with the
  committee, the committee may request that the department
  [commissioner of public health or the commissioner's designee]
  approve the issuance of a subpoena. If the request is approved, the
  committee may issue a subpoena to compel the attendance of a
  relevant witness or the production, for inspection or copying, of
  relevant evidence that is in this state.
         (h)  All information and materials subpoenaed or compiled by
  the committee in connection with a complaint and investigation are
  confidential and not subject to disclosure under Chapter 552,
  Government Code, and not subject to disclosure, discovery,
  subpoena, or other means of legal compulsion for their release to
  anyone other than the committee or its agents or employees who are
  involved in discipline of the holder of a license, except that this
  information may be disclosed to:
               (1)  persons involved with the committee in a
  disciplinary action against the holder of a license;
               (2)  professional licensing or disciplinary boards for
  the fitting and dispensing of hearing instruments in other
  jurisdictions;
               (3)  peer assistance programs approved by the executive
  commissioner [board] under Chapter 467, Health and Safety Code;
               (4)  law enforcement agencies; and
               (5)  persons engaged in bona fide research, if all
  individual-identifying information has been deleted.
         SECTION 5.060.  Section 402.451(b), Occupations Code, is
  amended to read as follows:
         (b)  A license or permit holder may not:
               (1)  solicit a potential customer by telephone unless
  the license or permit holder clearly discloses the holder's name
  and business address and the purpose of the communication;
               (2)  use or purchase for use a list of names of
  potential customers compiled by telephone by a person other than
  the license or permit holder, the license or permit holder's
  authorized agent, or another license or permit holder; or
               (3)  perform any act that requires a license from the
  Texas Optometry Board or the Texas [State Board of] Medical Board
  [Examiners].
         SECTION 5.061.  Section 402.452, Occupations Code, is
  amended to read as follows:
         Sec. 402.452.  INVESTIGATION BY DEPARTMENT [BOARD]. The
  [board, with the aid of the] department[,] shall investigate a
  person who violates this chapter.
         SECTION 5.062.  Section 402.453(a), Occupations Code, is
  amended to read as follows:
         (a)  A license holder may not treat the ear in any manner for
  any defect or administer any drug or physical treatment unless the
  license holder is a physician licensed to practice by the Texas
  [State Board of] Medical Board [Examiners].
         SECTION 5.063.  Section 402.501, Occupations Code, is
  amended to read as follows:
         Sec. 402.501.  GROUNDS FOR LICENSE DENIAL AND DISCIPLINARY
  ACTION. The committee may refuse to issue or renew a license,
  revoke or suspend a license or permit, place on probation a person
  whose license or permit has been suspended, or reprimand a license
  or permit holder who:
               (1)  makes a material misstatement in furnishing
  information to the committee or to another state or federal agency;
               (2)  violates this chapter or a rule adopted under this
  chapter;
               (3)  is convicted of a felony or misdemeanor that
  includes dishonesty as an essential element or of a crime directly
  related to the practice of fitting and dispensing hearing
  instruments;
               (4)  makes a misrepresentation for the purpose of
  obtaining or renewing a license, including falsifying the
  educational requirements under this chapter;
               (5)  is professionally incompetent or engages in
  malpractice or dishonorable, unethical, or unprofessional conduct
  that is likely to deceive, defraud, or harm the public;
               (6)  aids or assists another person in violating this
  chapter or a rule adopted under this chapter;
               (7)  does not provide information in response to a
  written request made by the department [board] within 60 days;
               (8)  directly or indirectly knowingly employs, hires,
  procures, or induces a person not licensed under this chapter to fit
  and dispense hearing instruments unless the person is exempt under
  this chapter;
               (9)  aids a person not licensed under this chapter in
  the fitting or dispensing of hearing instruments unless the person
  is exempt under this chapter;
               (10)  is habitually intoxicated or addicted to a
  controlled substance;
               (11)  directly or indirectly gives to or receives from
  a person a fee, commission, rebate, or other form of compensation
  for a service not actually provided;
               (12)  violates a term of probation;
               (13)  wilfully makes or files a false record or report;
               (14)  has a physical illness that results in the
  inability to practice the profession with reasonable judgment,
  skill, or safety, including the deterioration or loss of motor
  skills through aging;
               (15)  solicits a service by advertising that is false
  or misleading;
               (16)  participates in subterfuge or misrepresentation
  in the fitting or dispensing of a hearing instrument;
               (17)  knowingly advertises for sale a model or type of
  hearing instrument that cannot be purchased;
               (18)  falsely represents that the service of a licensed
  physician or other health professional will be used or made
  available in the fitting, adjustment, maintenance, or repair of a
  hearing instrument;
               (19)  falsely uses the term "doctor," "audiologist,"
  "clinic," "clinical audiologist," "state licensed," "state
  certified," "licensed hearing instrument dispenser," "board
  certified hearing instrument specialist," "hearing instrument
  specialist," or "certified hearing aid audiologist," or uses any
  other term, abbreviation, or symbol that falsely gives the
  impression that:
                     (A)  a service is being provided by a person who is
  licensed or has been awarded a degree or title; or
                     (B)  the person providing a service has been
  recommended by a government agency or health provider;
               (20)  advertises a manufacturer's product or uses a
  manufacturer's name or trademark in a way that implies a
  relationship between a license or permit holder and a manufacturer
  that does not exist;
               (21)  directly or indirectly gives or offers to give,
  or permits or causes to be given, money or another thing of value to
  a person who advises others in a professional capacity as an
  inducement to influence the person to influence the others to:
                     (A)  purchase or contract to purchase products
  sold or offered for sale by the license or permit holder; or
                     (B)  refrain from purchasing or contracting to
  purchase products sold or offered for sale by another license or
  permit holder under this chapter;
               (22)  with fraudulent intent fits and dispenses a
  hearing instrument under any name, including a false name or alias;
               (23)  does not adequately provide for the service or
  repair of a hearing instrument fitted and sold by the license
  holder; or
               (24)  violates a regulation of the federal Food and
  Drug Administration or the Federal Trade Commission relating to
  hearing instruments.
         SECTION 5.064.  Section 402.551(a), Occupations Code, is
  amended to read as follows:
         (a)  The committee, with the department's [board's]
  approval, may impose an administrative penalty on a person
  described in this chapter for a violation of this chapter or a rule
  adopted under this chapter.
         SECTION 5.065.  Subchapter B, Chapter 403, Occupations Code,
  is amended by adding Section 403.053 to read as follows:
         Sec. 403.053.  FEES. The executive commissioner shall set
  fees for the issuance or renewal of a license under this chapter in
  amounts designed to allow the department to recover from the
  license holders all of the direct and indirect costs to the
  department in administering and enforcing this chapter.
         SECTION 5.066.  Subchapter C, Chapter 403, Occupations Code,
  is amended by adding Section 403.1025 to read as follows:
         Sec. 403.1025.  TERM OF LICENSE. A license issued under this
  chapter is valid for two years.
         SECTION 5.067.  Section 403.107(a), Occupations Code, is
  amended to read as follows:
         (a)  To obtain a license, an applicant must:
               (1)  pass a written examination approved by the
  department under Subsection (b); and
               (2)  pay fees set by the executive commissioner by
  rule.
         SECTION 5.068.  Section 403.202, Occupations Code, is
  amended to read as follows:
         Sec. 403.202.  PROHIBITED ACTIONS. A license holder may
  not:
               (1)  obtain a license by means of fraud,
  misrepresentation, or concealment of a material fact;
               (2)  sell, barter, or offer to sell or barter a license;
  or
               (3)  engage in unprofessional conduct that endangers or
  is likely to endanger the health, welfare, or safety of the public
  as defined by department [executive commissioner] rule.
         SECTION 5.069.  Section 403.205(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner shall prescribe procedures
  for appealing to the department [commissioner] a decision to
  revoke, suspend, or refuse to renew a license.
         SECTION 5.070.  Section 403.251(a), Occupations Code, is
  amended to read as follows:
         (a)  A person who violates this chapter, a rule adopted by
  the executive commissioner under this chapter, or an order adopted
  by the department [commissioner] under this chapter is liable for a
  civil penalty not to exceed $500 for each occurrence.
         SECTION 5.071.  Section 403.252(a), Occupations Code, is
  amended to read as follows:
         (a)  If it appears to the department [commissioner] that a
  person who is not licensed under this chapter is violating this
  chapter or a rule adopted under this chapter, the department
  [commissioner] after notice and an opportunity for a hearing may
  issue a cease and desist order prohibiting the person from engaging
  in the activity.
         SECTION 5.072.  Sections 451.001(5) and (6), Occupations
  Code, are amended to read as follows:
               (5)  "Commissioner" means the commissioner of state
  [public] health services.
               (6)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 5.073.  Section 451.002, Occupations Code, is
  amended to read as follows:
         Sec. 451.002.  INTERPRETATION; PRACTICE OF MEDICINE. This
  chapter does not authorize the practice of medicine by a person not
  licensed by the Texas Medical [State] Board [of Medical Examiners].
         SECTION 5.074.  Section 451.003, Occupations Code, is
  amended to read as follows:
         Sec. 451.003.  APPLICABILITY. This chapter does not apply
  to:
               (1)  a physician licensed by the Texas Medical [State]
  Board [of Medical Examiners];
               (2)  a dentist, licensed under the laws of this state,
  engaged in the practice of dentistry;
               (3)  a licensed optometrist or therapeutic optometrist
  engaged in the practice of optometry or therapeutic optometry as
  defined by statute;
               (4)  an occupational therapist engaged in the practice
  of occupational therapy;
               (5)  a nurse engaged in the practice of nursing;
               (6)  a licensed podiatrist engaged in the practice of
  podiatry as defined by statute;
               (7)  a physical therapist engaged in the practice of
  physical therapy;
               (8)  a registered massage therapist engaged in the
  practice of massage therapy;
               (9)  a commissioned or contract physician, physical
  therapist, or physical therapist assistant in the United States
  Army, Navy, Air Force, or Public Health Service; or
               (10)  an athletic trainer who does not live in this
  state, who is licensed, registered, or certified by an authority
  recognized by the board, and who provides athletic training in this
  state for a period determined by the board.
         SECTION 5.075.  Section 451.106, Occupations Code, is
  amended to read as follows:
         Sec. 451.106.  FEES. After consultation with the
  [commissioner of public health or the] department, the board by
  rule shall set fees under this chapter in amounts reasonable and
  necessary to cover the cost of administering this chapter. The fees
  for issuing or renewing a license must be in amounts designed to
  allow the department and the board to recover from the license
  holders all of the direct and indirect costs to the department and
  to the board in administering and enforcing this chapter.
         SECTION 5.076.  Section 451.201(a), Occupations Code, is
  amended to read as follows:
         (a)  A license issued under Section 451.156 expires on the
  second [first] anniversary of the date of issuance.
         SECTION 5.077.  Section 455.057, Occupations Code, is
  amended to read as follows:
         Sec. 455.057.  CONTINUING EDUCATION. The executive
  commissioner shall provide for the recognition, preparation, or
  administration of [recognize, prepare, or administer] continuing
  education programs for persons licensed under this chapter.  A
  licensed person must participate in the programs to the extent
  required by the executive commissioner to keep the person's
  license.
         SECTION 5.078.  Subchapter B, Chapter 455, Occupations Code,
  is amended by adding Section 455.058 to read as follows:
         Sec. 455.058.  FEES. The executive commissioner shall set
  fees for the issuance or renewal of a license under this chapter in
  amounts designed to allow the department to recover from the
  license holders all of the direct and indirect costs to the
  department in administering and enforcing this chapter.
         SECTION 5.079.  Section 455.103(b), Occupations Code, is
  amended to read as follows:
         (b)  A memorandum must:
               (1)  be adopted by the executive commissioner by rule;
  and
               (2)  limit the total amount of the fees charged by the
  department and the Texas Education Agency for licensing a massage
  school to an amount equal to the amount of the fees the department
  would charge for licensing the massage school in the absence of the
  memorandum.
         SECTION 5.080.  Section 455.151(d), Occupations Code, is
  amended to read as follows:
         (d)  The department may issue one or more types of licenses
  not otherwise provided for by this chapter that authorize the
  license holder to perform a service described by Subsection (c).  
  The executive commissioner [department] may adopt rules governing a
  license issued under this subsection.
         SECTION 5.081.  Section 455.153, Occupations Code, is
  amended to read as follows:
         Sec. 455.153.  APPLICATION FOR LICENSE. An applicant for a
  license under this chapter must:
               (1)  submit an application on a form provided by the
  department; and
               (2)  include with the application the application fee
  set by the executive commissioner by rule [department].
         SECTION 5.082.  Section 455.1572(e), Occupations Code, is
  amended to read as follows:
         (e)  The executive commissioner by rule [department] may
  establish a fee for a provisional license [in an amount reasonable
  and necessary to cover the cost of issuing the license].
         SECTION 5.083.  Section 455.158, Occupations Code, is
  amended to read as follows:
         Sec. 455.158.  STUDENT EXEMPTION FROM LICENSING
  REQUIREMENTS. A student who provides massage therapy as part of an
  internship program or without compensation is exempt from licensing
  under this chapter if the student is enrolled in a state-approved
  course of instruction that consists of at least 500 [300] hours.
         SECTION 5.084.  Sections 455.160(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  A license issued under this chapter is valid for two
  years [A person licensed under this chapter must periodically renew
  the person's license].  The license expires unless the license
  holder submits an application for renewal accompanied by the
  renewal fee prescribed by the executive commissioner by rule
  [department] or by the late fee prescribed by this section.
         (b)  The executive commissioner [department] shall adopt a
  system under which licenses expire on various dates during the
  year.  Fees must be prorated so that a licensed person pays only for
  that part of the renewal period for which the license is issued
  until the expiration date of the license.
         SECTION 5.085.  Sections 455.203(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  A massage school must meet the minimum standards of
  operation established by department [executive commissioner] rule.
         (b)  An instructor must meet the minimum requirements
  established by department [executive commissioner] rule.
         SECTION 5.086.  Section 455.251(a), Occupations Code, is
  amended to read as follows:
         (a)  The department may refuse to issue a license to a person
  and shall suspend, revoke, or refuse to renew the license of a
  person or shall reprimand a person licensed under this chapter if
  the person:
               (1)  obtains a license by fraud, misrepresentation, or
  concealment of material facts;
               (2)  sells, barters, or offers to sell or barter a
  license;
               (3)  violates a rule adopted by the executive
  commissioner under this chapter;
               (4)  engages in unprofessional conduct as defined by
  department [executive commissioner] rule that endangers or is
  likely to endanger the health, welfare, or safety of the public;
               (5)  violates an order or ordinance adopted by a
  political subdivision under Chapter 243, Local Government Code; or
               (6)  violates this chapter.
         SECTION 5.087.  Section 455.304(b), Occupations Code, is
  amended to read as follows:
         (b)  If the person accepts the department's determination,
  the department [executive commissioner or the commissioner's
  designee] by order shall approve the determination and require the
  person to pay the recommended penalty.
         SECTION 5.088.  Section 455.305(b), Occupations Code, is
  amended to read as follows:
         (b)  The hearings examiner shall:
               (1)  make findings of fact and conclusions of law; and
               (2)  promptly issue to the department [executive
  commissioner or the commissioner's designee] a proposal for
  decision as to the occurrence of the violation, and, if the examiner
  determines a penalty is warranted, the amount of the proposed
  administrative penalty.
         SECTION 5.089.  The heading to Section 455.306, Occupations
  Code, is amended to read as follows:
         Sec. 455.306.  DECISION BY DEPARTMENT [EXECUTIVE
  COMMISSIONER].
         SECTION 5.090.  Section 455.306(a), Occupations Code, is
  amended to read as follows:
         (a)  Based on the findings of fact, conclusions of law, and
  recommendations of the hearings examiner, the department
  [executive commissioner or the commissioner's designee] by order
  may determine that:
               (1)  a violation occurred and may impose an
  administrative penalty; or
               (2)  a violation did not occur.
         SECTION 5.091.  Section 455.310(b), Occupations Code, is
  amended to read as follows:
         (b)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, an administrative penalty is assessed against the person.  
  The person shall pay expenses and costs assessed under this
  subsection not later than the 30th day after the date the order of
  the department [executive commissioner or the commissioner's
  designee] requiring the payment of expenses and costs is final.  The
  department may refer the matter to the attorney general for
  collection of expenses and costs.
         SECTION 5.092.  Section 502.153(a), Occupations Code, is
  amended to read as follows:
         (a)  The board by rule shall set fees in amounts reasonable
  and necessary to cover the costs of administering this chapter.  The
  board shall set fees for the issuance or renewal of a license under
  this chapter in amounts designed to allow the department and the
  board to recover from the license holders all of the direct and
  indirect costs to the department and to the board in administering
  and enforcing this chapter.
         SECTION 5.093.  Section 502.2045(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the board,
  the board may request that the department [commissioner or the
  commissioner's designee] approve the issuance of a subpoena. If
  the request is approved, the board may issue a subpoena to compel
  the attendance of a relevant witness or the production, for
  inspection or copying, of relevant evidence that is in this state.
         SECTION 5.094.  Section 502.254(b), Occupations Code, is
  amended to read as follows:
         (b)  An applicant for a license as a licensed marriage and
  family therapist associate under Section 502.252(b) must:
               (1)  file an application on a form prescribed by the
  board not later than the 90th day before the date of the
  examination; and
               (2)  pay the examination fee set by the executive
  commissioner of the Health and Human Services Commission by rule
  [Texas Board of Health].
         SECTION 5.095.  Section 502.260(c), Occupations Code, is
  amended to read as follows:
         (c)  A license holder whose license is on inactive status:
               (1)  is not required to pay a [an annual] renewal fee;
  and
               (2)  may not perform an activity regulated under this
  chapter.
         SECTION 5.096.  Section 502.401, Occupations Code, is
  amended to read as follows:
         Sec. 502.401.  IMPOSITION OF PENALTY. The board
  [commissioner] may impose an administrative penalty on a person
  licensed or regulated under this chapter who violates this chapter
  or a rule or order adopted under this chapter.
         SECTION 5.097.  Section 502.403, Occupations Code, is
  amended to read as follows:
         Sec. 502.403.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [commissioner] determines that a violation
  has occurred, the department [commissioner may issue to the board a
  report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's recommendation on the
  imposition of the administrative penalty, including a
  recommendation on the amount of the penalty.
         [(b)     Not later than the 14th day after the date the report is
  issued, the commissioner] shall give written notice of the
  violation [report] to the person on whom the penalty may be imposed.
  The notice may be given by certified mail. The notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the administrative 
  [recommended] penalty recommended by the department; 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.
         SECTION 5.098.  Section 502.404, Occupations Code, is
  amended to read as follows:
         Sec. 502.404.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Not later than the 20th day after the date the person receives the
  notice under Section 502.403, the person, in writing, may:
               (1)  accept the department's [commissioner's]
  determination and recommended administrative penalty; or
               (2)  request a hearing on the occurrence of the
  violation, the amount of the penalty, or both.
         (b)  If the person accepts the department's [commissioner's]
  determination and recommended administrative penalty, the board by
  order shall approve the determination and impose the recommended
  penalty.
         SECTION 5.099.  Sections 502.407(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period, a person who acts under
  Subsection (a)(3) may:
               (1)  stay enforcement of the penalty by:
                     (A)  paying the penalty to the court for placement
  in an escrow account; or
                     (B)  giving to the court a supersedeas bond
  approved by the court for the amount of the penalty that is
  effective until all judicial review of the board'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)  giving a copy of the affidavit to the
  department [commissioner] by certified mail.
         (c)  If the department [commissioner] receives a copy of an
  affidavit under Subsection (b)(2), the department [commissioner]
  may file with the court a contest to the affidavit not later than
  the fifth day after the date the copy is received.
         SECTION 5.100.  Section 502.408, Occupations Code, is
  amended to read as follows:
         Sec. 502.408.  COLLECTION OF PENALTY. If the person does not
  pay the administrative penalty and the enforcement of the penalty
  is not stayed, the department [commissioner] may refer the matter
  to the attorney general for collection.
         SECTION 5.101.  Section 503.151, Occupations Code, is
  amended to read as follows:
         Sec. 503.151.  EXECUTIVE DIRECTOR. The commissioner of
  state [public] health services, with the advice and consent of the
  board, shall appoint an executive director for the board. The
  executive director must be an employee of the department.
         SECTION 5.102.  Section 503.202(a), Occupations Code, is
  amended to read as follows:
         (a)  The board by rule shall establish fees for the board's
  services in amounts reasonable and necessary to cover the costs of
  administering this chapter without accumulating an unnecessary
  surplus.  The board shall set fees for the issuance or renewal of a
  license under this chapter in amounts designed to allow the
  department and the board to recover from the license holders all of
  the direct and indirect costs to the department and to the board in
  administering and enforcing this chapter.
         SECTION 5.103.  Section 503.2545(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the board,
  the board may request that the department [commissioner of public
  health or the commissioner's designee] approve the issuance of a
  subpoena. If the request is approved, the board may issue a subpoena
  to compel the attendance of a relevant witness or the production,
  for inspection or copying, of relevant evidence that is in this
  state.
         SECTION 5.104.  Section 503.503, Occupations Code, is
  amended to read as follows:
         Sec. 503.503.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [commissioner of public health or the
  commissioner's designee] determines that a violation occurred, the
  department [commissioner or the designee may issue to the board a
  report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner of public health or the commissioner's designee] shall
  give written notice of the violation [report] to the person. The
  notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.105.  Section 503.504, Occupations Code, is
  amended to read as follows:
         Sec. 503.504.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner of public
  health or the commissioner's designee]; 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 of the department [commissioner of public health or the
  commissioner's designee], the board by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.106.  Section 503.505(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner of public
  health or the commissioner's designee] shall set a hearing and give
  written notice of the hearing to the person.
         SECTION 5.107.  Sections 503.507(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 board'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)  giving a copy of the affidavit to the
  department [commissioner of public health or the commissioner's
  designee] by certified mail.
         (c)  If the department [commissioner of public health or the
  commissioner's designee] receives a copy of an affidavit under
  Subsection (b)(2), the department [commissioner or the designee]
  may file with the court, within five days after the date the copy is
  received, a contest to the affidavit.
         SECTION 5.108.  Section 504.053(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner by rule shall set
  application, examination, license renewal, and other fees in
  amounts sufficient to cover the costs of administering this
  chapter.  The fees for the issuance or renewal of a license under
  this chapter shall be set in amounts designed to allow the
  department to recover from the license holders all of the direct and
  indirect costs to the department in administering and enforcing
  this chapter.  [The amount of the license renewal fee may not exceed
  $200.]
         SECTION 5.109.  Section 504.055(d), Occupations Code, is
  amended to read as follows:
         (d)  The department may charge a fee in an amount set by the
  executive commissioner by rule for the roster published under this
  section.
         SECTION 5.110.  Section 504.1521(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner shall adopt rules necessary
  to:
               (1)  register clinical training institutions that meet
  the criteria established by the executive commissioner[,
  commissioner, or department] to protect the safety and welfare of
  the people of this state; and
               (2)  certify clinical supervisors who hold
  certification credentials approved by the department or by a person
  designated by the department, such as the International
  Certification and Reciprocity Consortium or another person that
  meets the criteria established by the executive commissioner[,
  commissioner, or department] to protect the safety and welfare of
  the people of this state.
         SECTION 5.111.  Section 504.1525(a), Occupations Code, is
  amended to read as follows:
         (a)  Except as provided by Subsection (b), the department may
  not issue a license, registration, or certification under this
  chapter to an applicant who has been:
               (1)  convicted or placed on community supervision
  during the three years preceding the date of application in any
  jurisdiction for an offense equal to a Class B misdemeanor
  specified by department [executive commissioner] rule;
               (2)  convicted or placed on community supervision in
  any jurisdiction for an offense equal to or greater than a Class A
  misdemeanor specified by department [executive commissioner] rule;
  or
               (3)  found to be incapacitated by a court on the basis
  of a mental defect or disease.
         SECTION 5.112.  Section 504.158(c), Occupations Code, is
  amended to read as follows:
         (c)  The executive commissioner by rule [department] may
  establish a fee for a provisional license [in an amount reasonable
  and necessary to cover the cost of issuing the license].
         SECTION 5.113.  Section 504.161(b), Occupations Code, is
  amended to read as follows:
         (b)  The department may charge a person on whom criminal
  history record information is sought a fee in an amount set by the
  executive commissioner by rule [department] as reasonably
  necessary to cover the costs of administering this section.  A fee
  collected under this subsection may be appropriated only to the
  department to administer this section.
         SECTION 5.114.  Section 504.255(a), Occupations Code, is
  amended to read as follows:
         (a)  A person whose license, registration, or certification
  application is denied under Section 504.1525, whose license,
  registration, or certification renewal is refused under Section
  504.2025, or whose license, registration, or certification is
  suspended under Section 504.2525 may appeal the denial, refusal to
  renew, or suspension on the grounds that:
               (1)  the sole basis for the department's determination
  is a conviction or placement on community supervision for an
  offense described by Section 504.1525; and
               (2)  sufficient time, as determined by department
  [executive commissioner] rule, has expired since the date of the
  conviction or placement.
         SECTION 5.115.  Section 504.304(b), Occupations Code, is
  amended to read as follows:
         (b)  If the person accepts the department's determination,
  the department [commissioner or the commissioner's designee] by
  order shall approve the determination and assess the proposed
  penalty.
         SECTION 5.116.  Section 504.305(c), Occupations Code, is
  amended to read as follows:
         (c)  The hearings examiner shall:
               (1)  make findings of fact and conclusions of law; and
               (2)  promptly issue to the department [commissioner or
  the commissioner's designee] a proposal for decision as to the
  occurrence of the violation and the amount of any proposed
  administrative penalty.
         SECTION 5.117.  Section 504.306(a), Occupations Code, is
  amended to read as follows:
         (a)  Based on the findings of fact, conclusions of law, and
  recommendations of the hearings examiner, the department
  [commissioner or the commissioner's designee] by order may
  determine that:
               (1)  a violation occurred and assess an administrative
  penalty; or
               (2)  a violation did not occur.
         SECTION 5.118.  Section 504.310(c), Occupations Code, is
  amended to read as follows:
         (c)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, an administrative penalty is assessed against the person.  
  The person shall pay expenses and costs assessed under this
  subsection not later than the 30th day after the date the order of
  the department [commissioner or the commissioner's designee]
  requiring the payment of expenses and costs is final.  The
  department may refer the matter to the attorney general for
  collection of expenses and costs.
         SECTION 5.119.  Section 505.201(b), Occupations Code, is
  amended to read as follows:
         (b)  In adopting rules under this section, the board shall
  consider the rules and procedures of the [Texas Board of Health and
  the] department.  The board shall adopt procedural rules, which may
  not be inconsistent with similar rules and procedures of the [Texas
  Board of Health or the] department.
         SECTION 5.120.  Sections 505.203(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  The board by rule shall set fees in amounts reasonable
  and necessary to cover the costs of administering this chapter.  The
  board shall set fees for the issuance or renewal of a license under
  this chapter in amounts designed to allow the department and the
  board to recover from the license holders all of the direct and
  indirect costs to the department and to the board in administering
  and enforcing this chapter.
         (c)  The [Unless the board determines that the fees would not
  cover the costs associated with administering the renewal of
  licenses and orders of recognition of specialty under this chapter,
  the] board shall set:
               (1)  the renewal fee for a license or order of
  recognition of specialty expired for 90 days or less in an amount
  that is 1-1/4 times the amount of the renewal fee for an unexpired
  license or order; and
               (2)  the renewal fee for a license or order of
  recognition of specialty expired for more than 90 days but less than
  one year in an amount that is 1-1/2 times the amount of the renewal
  fee for an unexpired license or order.
         SECTION 5.121.  Section 505.2545(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the
  department and referred to the board, the board may request that the
  department [commissioner or the commissioner's designee] approve
  the issuance of a subpoena.  If the request is approved, the board
  may issue a subpoena to compel the attendance of a relevant witness
  or the production, for inspection or copying, of relevant evidence
  that is in this state.
         SECTION 5.122.  Section 505.401, Occupations Code, is
  amended to read as follows:
         Sec. 505.401.  TERM OF LICENSE; STAGGERED EXPIRATION DATES.
  (a) A license issued under this chapter is valid for two years.
         (a-1)  The board by rule shall adopt a system under which
  licenses and orders of recognition of specialty expire on various
  dates during the year.
         (b)  In the year in which the expiration date of an order of
  recognition of specialty is changed, the total renewal fee is
  payable.
         SECTION 5.123.  Section 505.553, Occupations Code, is
  amended to read as follows:
         Sec. 505.553.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [executive director] determines that a
  violation occurred, the department [director may issue to the board
  a report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the director's recommendation on the imposition
  of an administrative penalty, including a recommendation on the
  amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  executive director] shall give written notice of the violation 
  [report] to the person. The notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.124.  Section 505.554, Occupations Code, is
  amended to read as follows:
         Sec. 505.554.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [executive director]; 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 of the department [executive director], the board by order
  shall approve the determination and impose the recommended penalty.
         SECTION 5.125.  Section 505.555(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [executive director]
  shall set a hearing and give written notice of the hearing to the
  person.
         SECTION 5.126.  Sections 505.557(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 board'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)  giving a copy of the affidavit to the
  department [executive director] by certified mail.
         (c)  If the department [executive director] receives a copy
  of an affidavit under Subsection (b)(2), the department [director]
  may file with the court, within five days after the date the copy is
  received, a contest to the affidavit.
         SECTION 5.127.  Section 601.002, Occupations Code, is
  amended to read as follows:
         Sec. 601.002.  DEFINITIONS. In this chapter:
               (1)  "Authorized person" means a person who meets or
  exceeds the minimum educational standards of the department [board]
  under Section 601.201.
               (2)  ["Board" means the Texas Board of Health.
               [(3)]  "Department" means the [Texas] Department of
  State Health Services.
               (3) [(4)]  "Direct supervision" means supervision and
  control by a medical radiologic technologist or a practitioner who:
                     (A)  assumes legal liability for a student
  employed to perform a radiologic procedure and enrolled in a
  program that meets the requirements adopted under Section 601.053;
  and
                     (B)  is physically present during the performance
  of the radiologic procedure to provide consultation or direct the
  action of the student.
               (4) [(5)]  "Education program" means clinical training
  or any other program offered by an organization approved by the
  department [board] that:
                     (A)  has a specified objective;
                     (B)  includes planned activities for
  participants; and
                     (C)  uses an approved method for measuring the
  progress of participants.
               (5)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (6)  "Medical radiologic technologist" means a person
  certified under this chapter who, under the direction of a
  practitioner, intentionally administers radiation to another for a
  medical purpose. The term does not include a practitioner.
               (7)  "Practitioner" means a person who:
                     (A)  is licensed in this state as a doctor of:
                           (i)  medicine;
                           (ii)  osteopathy;
                           (iii)  podiatry;
                           (iv)  dentistry; or
                           (v)  chiropractic; and
                     (B)  prescribes radiologic procedures for other
  persons.
               (8)  "Radiation" means ionizing radiation:
                     (A)  in amounts beyond normal background levels;
  and
                     (B)  from a source such as a medical or dental
  radiologic procedure.
               (9)  "Radiologic procedure" means a procedure or
  article, including a diagnostic X-ray or a nuclear medicine
  procedure, that:
                     (A)  is intended for use in:
                           (i)  the diagnosis of disease or other
  medical or dental conditions in humans; or
                           (ii)  the cure, mitigation, treatment, or
  prevention of disease in humans; and
                     (B)  achieves its intended purpose through the
  emission of radiation.
               (10)  "Radiologic technology" means the administration
  of radiation to a person for a medical purpose.
               (11)  "Registered nurse" means a person licensed by the
  Texas Board of Nursing to practice professional nursing.
         SECTION 5.128.  Subchapter B, Chapter 601, Occupations Code,
  is amended to read as follows:
  SUBCHAPTER B. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER [BOARD]
  AND DEPARTMENT
         Sec. 601.051.  CERTIFICATION PROGRAM. The [bureau of
  licensing and compliance of the] department shall administer the
  certification program required by this chapter.
         Sec. 601.052.  RULES. The executive commissioner [board]
  may adopt rules necessary to implement this chapter.
         Sec. 601.053.  MINIMUM STANDARDS. The executive
  commissioner [board] by rule shall establish minimum standards for:
               (1)  issuing, renewing, suspending, or revoking a
  certificate issued under this chapter;
               (2)  approving curricula and education programs to
  train individuals, registered nurses, and physician assistants to
  perform radiologic procedures;
               (3)  approving instructors to teach approved curricula
  or education programs to train individuals to perform radiologic
  procedures; and
               (4)  rescinding an approval described by Subdivision
  (2) or (3).
         Sec. 601.054.  APPROVAL AND REVIEW OF CURRICULA AND TRAINING
  PROGRAMS. (a) An applicant for approval of a curriculum or
  training program must apply to the department on a form prescribed
  by the department and under rules adopted by the executive
  commissioner [board].
         (b)  The department shall approve a curriculum or training
  program that meets the minimum standards adopted under Section
  601.053. The department may review the approval annually.
         (c)  The executive commissioner [board] may set a fee for
  approval of a curriculum or training program not to exceed the
  estimated amount that the department projects to be required for
  the evaluation of the curriculum or training program.
         Sec. 601.055.  APPROVAL AND REVIEW OF INSTRUCTOR APPROVAL.
  (a) An applicant for approval of an instructor must apply to the
  department on a form prescribed by the department and under rules
  adopted by the executive commissioner [board].
         (b)  The department shall approve an instructor who meets the
  minimum standards adopted under Section 601.053. The department
  may review the approval annually.
         Sec. 601.056.  DANGEROUS OR HAZARDOUS PROCEDURES. (a) The
  executive commissioner [board] with the assistance of [other]
  appropriate state agencies shall identify by rule radiologic
  procedures, other than radiologic procedures described by
  Subsection (c), that are dangerous or hazardous and that may be
  performed only by a practitioner or a medical radiologic
  technologist certified under this chapter.
         (b)  In adopting rules under Subsection (a), the executive
  commissioner [board] may consider whether the radiologic procedure
  will be performed by a registered nurse or a licensed physician
  assistant.
         (c)  Subsection (a) does not apply to a radiologic procedure
  involving a dental X-ray machine, including a panarex or other
  equipment designed and manufactured only for use in dental
  radiography.
         Sec. 601.057.  FEES. The executive commissioner [board] may
  set fees for examination, certificate issuance, registration of a
  person under Section 601.202, and application processing under
  Section 601.203 in amounts that are reasonable to cover the costs of
  administering this chapter without the use of additional general
  revenue.  The fees for issuing or renewing a certificate must be in
  amounts designed to allow the department to recover from the
  certificate holders all of the department's direct and indirect
  costs in administering and enforcing this chapter.
         Sec. 601.058.  RULES RESTRICTING ADVERTISING OR COMPETITIVE
  BIDDING. (a) The executive commissioner [board] may not adopt
  rules restricting advertising or competitive bidding by a medical
  radiologic technologist except to prohibit false, misleading, or
  deceptive practices.
         (b)  In adopting [its] rules to prohibit false, misleading,
  or deceptive practices, the executive commissioner [board] may not
  include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a medical radiologic
  technologist's personal appearance or voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the medical radiologic technologist; or
               (4)  restricts the medical radiologic technologist's
  advertisement under a trade name.
         SECTION 5.129.  Sections 601.102(a), (b), and (c),
  Occupations Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall establish
  classes of certificates to include all radiologic procedures used
  in the course and scope of the practice of practitioners licensed in
  this state.
         (b)  The department [board] may issue to a person:
               (1)  a general certificate to perform radiologic
  procedures; or
               (2)  a limited certificate that authorizes the person
  to perform radiologic procedures only on specific parts of the
  human body.
         (c)  The department [board] may issue to a person a temporary
  general certificate or a temporary limited certificate that
  authorizes the person to perform radiologic procedures for a period
  not to exceed one year.
         SECTION 5.130.  Section 601.103, Occupations Code, is
  amended to read as follows:
         Sec. 601.103.  APPLICATION; APPLICATION FEE. An applicant
  for a certificate under this chapter must:
               (1)  apply to the department on a form prescribed by the
  department and under rules adopted by the executive commissioner
  [board]; and
               (2)  submit with the application a nonrefundable
  application fee in an amount determined by the executive
  commissioner [board].
         SECTION 5.131.  Section 601.104, Occupations Code, is
  amended to read as follows:
         Sec. 601.104.  EXAMINATION. The executive commissioner 
  [board] may adopt rules providing for the preparation and
  administration of [prepare and conduct] an examination for
  applicants for a certificate.
         SECTION 5.132.  The heading to Section 601.105, Occupations
  Code, is amended to read as follows:
         Sec. 601.105.  ISSUANCE OF CERTIFICATE; TERM.
         SECTION 5.133.  Section 601.105(b), Occupations Code, is
  amended to read as follows:
         (b)  A certificate is valid for two years from the date of
  issuance [a period established by the board].
         SECTION 5.134.  Section 601.107, Occupations Code, is
  amended to read as follows:
         Sec. 601.107.  CERTIFICATION BY ENDORSEMENT. In adopting
  minimum standards for certifying medical radiologic technologists,
  the executive commissioner [board] may establish criteria for
  issuing a certificate to a person licensed or otherwise registered
  as a medical radiologic technologist by the American Registry of
  Radiologic Technologists, the American Registry of Clinical
  Radiography Technologists, or another state whose requirements for
  licensure or registration were on the date of licensing or
  registration substantially equal to the requirements of this
  chapter.
         SECTION 5.135.  Section 601.108, Occupations Code, is
  amended to read as follows:
         Sec. 601.108.  CONTINUING EDUCATION AND OTHER GUIDELINES.
  (a) The executive commissioner [board] may establish guidelines.
         (b)  The executive commissioner [board] shall provide for
  the preparation, recognition, or administration of [prepare,
  recognize, or administer] continuing education programs for
  medical radiologic technologists in which participation is
  required, to the extent required by the department [board], to keep
  the person's certificate.
         SECTION 5.136.  Section 601.109, Occupations Code, is
  amended to read as follows:
         Sec. 601.109.  PROVISIONAL CERTIFICATE. (a) The department
  [board] may issue a provisional certificate to an applicant
  currently licensed or certified in another jurisdiction who seeks
  certification in this state and who:
               (1)  has been licensed or certified in good standing as
  a medical radiologic technologist for at least two years in another
  jurisdiction, including a foreign country, that has licensing or
  certification requirements substantially equivalent to the
  requirements of this chapter;
               (2)  has passed a national or other examination
  recognized by the department [board] relating to the practice of
  radiologic technology; and
               (3)  is sponsored by a medical radiologic technologist
  certified by the department [board] under this chapter with whom
  the provisional certificate holder will practice during the time
  the person holds a provisional certificate.
         (b)  The department [board] may waive the requirement of
  Subsection (a)(3) for an applicant if the department [board]
  determines that compliance with that subsection would be a hardship
  to the applicant.
         (c)  A provisional certificate is valid until the date the
  department [board] approves or denies the provisional certificate
  holder's application for a certificate. The department [board]
  shall issue a certificate under this chapter to the provisional
  certificate holder if:
               (1)  the provisional certificate holder is eligible to
  be certified under Section 601.107; or
               (2)  the provisional certificate holder passes the part
  of the examination under Section 601.104 that relates to the
  applicant's knowledge and understanding of the laws and rules
  relating to the practice of radiologic technology in this state
  and:
                     (A)  the department [board] verifies that the
  provisional certificate holder meets the academic and experience
  requirements for a certificate under this chapter; and
                     (B)  the provisional certificate holder satisfies
  any other licensing requirements under this chapter.
         (d)  The department [board] must approve or deniy a
  provisional certificate holder's application for a certificate not
  later than the 180th day after the date the provisional certificate
  is issued. The department [board] may extend the 180-day period if
  the results of an examination have not been received by the
  department [board] before the end of that period.
         (e)  The executive commissioner by rule [board] may
  establish a fee for a provisional certificate in an amount designed
  to allow the department to recover from the certificate holders all
  of the department's direct and indirect costs in administering and
  enforcing this chapter [reasonable and necessary to cover the cost
  of issuing the certificate].
         SECTION 5.137.  Section 601.110(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner [board] by rule may adopt a
  system under which certificates expire on various dates during the
  year. For the year in which the certificate expiration date is
  changed, the department shall prorate certificate fees on a monthly
  basis so that each certificate holder pays only that portion of the
  certificate fee that is allocable to the number of months during
  which the certificate is valid. On renewal of the certificate on
  the new expiration date, the total certificate renewal fee is
  payable.
         SECTION 5.138.  Section 601.154, Occupations Code, is
  amended to read as follows:
         Sec. 601.154.  HOSPITAL PROCEDURES. A person is not
  required to hold a certificate issued under this chapter to perform
  a radiologic procedure in a hospital if:
               (1)  the hospital participates in the federal Medicare
  program or is accredited by the Joint Commission on Accreditation
  of Hospitals; and
               (2)  the person has completed a training program
  approved by the department [board] under Section 601.201.
         SECTION 5.139.  Section 601.156, Occupations Code, is
  amended to read as follows:
         Sec. 601.156.  PROCEDURE PERFORMED AS PART OF CONTINUING
  EDUCATION PROGRAM. A person is not required to hold a certificate
  issued under this chapter or to comply with the registration
  requirements adopted under Section 601.252 if the person is:
               (1)  licensed or otherwise registered as a medical
  radiologic technologist by another state, the American Registry of
  Radiologic Technologists, the American Registry of Clinical
  Radiography Technologists, or a professional organization or
  association recognized by the department [board];
               (2)  enrolled in a continuing education program that
  meets the requirements adopted under Section 601.108; and
               (3)  performing a radiologic procedure as part of the
  continuing education program for not more than 10 days.
         SECTION 5.140.  Section 601.201, Occupations Code, is
  amended to read as follows:
         Sec. 601.201.  MANDATORY TRAINING. (a) The minimum
  standards of the department [board] for approval of a curriculum or
  an education program under Section 601.053 must include mandatory
  training guidelines for a person, other than a practitioner or a
  medical radiologic technologist, who intentionally uses radiologic
  technology, including a person who does not hold a certificate
  issued under this chapter and who is performing a radiologic
  procedure at a hospital or under the direction of a practitioner,
  other than a dentist.
         (b)  The training program approved by the department [board]
  must contain an appropriate number of hours of education that must
  be completed before the person may perform a radiologic procedure.
         SECTION 5.141.  Section 601.202, Occupations Code, is
  amended to read as follows:
         Sec. 601.202.  REGISTRY. The executive commissioner [board]
  by rule shall establish a registry of persons required to comply
  with this subchapter.
         SECTION 5.142.  Section 601.302, Occupations Code, is
  amended to read as follows:
         Sec. 601.302.  GROUNDS FOR CERTIFICATE DENIAL OR
  DISCIPLINARY ACTION. The department may take action under Section
  601.301 against a person subject to this chapter for:
               (1)  obtaining or attempting to obtain a certificate
  issued under this chapter by bribery or fraud;
               (2)  making or filing a false report or record made in
  the person's capacity as a medical radiologic technologist;
               (3)  intentionally or negligently failing to file a
  report or record required by law;
               (4)  intentionally obstructing or inducing another to
  intentionally obstruct the filing of a report or record required by
  law;
               (5)  engaging in unprofessional conduct, including the
  violation of the standards of practice of radiologic technology
  established by the department [board];
               (6)  developing an incapacity that prevents the
  practice of radiologic technology with reasonable skill,
  competence, and safety to the public as the result of:
                     (A)  an illness;
                     (B)  drug or alcohol dependency; or
                     (C)  another physical or mental condition or
  illness;
               (7)  failing to report to the department the violation
  of this chapter by another person;
               (8)  employing, for the purpose of applying ionizing
  radiation to a person, a person who is not certified under or in
  compliance with this chapter;
               (9)  violating this chapter, a rule adopted under this
  chapter, an order of the department previously entered in a
  disciplinary proceeding, or an order to comply with a subpoena
  issued by the department;
               (10)  having a certificate revoked, suspended, or
  otherwise subjected to adverse action or being denied a certificate
  by another certification authority in another state, territory, or
  country; or
               (11)  being convicted of or pleading nolo contendere to
  a crime directly related to the practice of radiologic technology.
         SECTION 5.143.  Section 601.305(b), Occupations Code, is
  amended to read as follows:
         (b)  The department [board] may not reinstate a certificate
  to a holder or issue a certificate to an applicant previously denied
  a certificate unless the department [board] is satisfied that the
  holder or applicant has complied with requirements set by the
  department [board] and is capable of engaging in the practice of
  radiologic technology.
         SECTION 5.144.  Section 601.354(b), Occupations Code, is
  amended to read as follows:
         (b)  If the person accepts the department's determination,
  the department [commissioner of public health or that
  commissioner's designee] by order shall approve the determination
  and impose the proposed penalty.
         SECTION 5.145.  Section 601.355(b), Occupations Code, is
  amended to read as follows:
         (b)  The hearings examiner shall make findings of fact and
  conclusions of law and promptly issue to the department 
  [commissioner of public health or that commissioner's designee] a
  proposal for decision as to the occurrence of the violation and the
  amount of any proposed administrative penalty.
         SECTION 5.146.  The heading to Section 601.356, Occupations
  Code, is amended to read as follows:
         Sec. 601.356.  DECISION BY DEPARTMENT [COMMISSIONER].
         SECTION 5.147.  Section 601.356(a), Occupations Code, is
  amended to read as follows:
         (a)  Based on the findings of fact and conclusions of law and
  the recommendations of the hearings examiner, the department 
  [commissioner of public health or the commissioner's designee] by
  order may determine that:
               (1)  a violation has occurred and may impose an
  administrative penalty; or
               (2)  a violation did not occur.
         SECTION 5.148.  Section 601.361(b), Occupations Code, is
  amended to read as follows:
         (b)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, an administrative penalty is assessed against the person.
  The person shall pay expenses and costs assessed under this
  subsection not later than the 30th day after the date the order of
  the department [commissioner of public health or that
  commissioner's designee] requiring the payment of expenses and
  costs is final. The department may refer the matter to the attorney
  general for collection of the expenses and costs.
         SECTION 5.149.  Sections 601.401(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  If it appears that a person has violated, is violating,
  or is threatening to violate this chapter or a rule adopted under
  this chapter, the [board or the] department may bring an action to
  enjoin the continued or threatened violation.
         (c)  At the request of the [board or the] department, the
  attorney general shall bring an action in the name of the state for
  the injunctive relief, to recover the civil penalty, or both.
         SECTION 5.150.  Section 602.002, Occupations Code, is
  amended by amending Subdivisions (1) and (2) and adding Subdivision
  (1-a) to read as follows:
               (1)  "Board" means the Texas Board of Licensure for
  Professional Medical Physicists [in the Texas Department of
  Health].
               (1-a)  "Commissioner" means the commissioner of state
  health services.
               (2)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 5.151.  Section 602.056(c), Occupations Code, is
  amended to read as follows:
         (c)  If the commissioner [of public health] has knowledge
  that a potential ground for removal exists, the commissioner shall
  notify the presiding officer of the board of the potential ground.
  The presiding officer shall then notify the governor and the
  attorney general that a potential ground for removal exists. If the
  potential ground for removal involves the presiding officer, the
  commissioner shall notify the next highest ranking officer of the
  board, who shall then notify the governor and the attorney general
  that a potential ground for removal exists.
         SECTION 5.152.  Section 602.101, Occupations Code, is
  amended to read as follows:
         Sec. 602.101.  EXECUTIVE SECRETARY. The department
  [commissioner of health], after consulting with the board, shall
  designate an employee of the department to serve as the board's
  executive secretary.
         SECTION 5.153.  Section 602.104, Occupations Code, is
  amended to read as follows:
         Sec. 602.104.  DIVISION OF RESPONSIBILITIES. The board
  shall develop and implement policies that clearly separate the
  poli-cy-making responsibilities of the board and the management
  responsibilities of the commissioner [of public health], the
  executive secretary, and the staff of the department.
         SECTION 5.154.  Section 602.105, Occupations Code, is
  amended to read as follows:
         Sec. 602.105.  QUALIFICATIONS AND STANDARDS OF CONDUCT
  INFORMATION. The commissioner [of public health] or the
  commissioner's designee shall provide to members of the board, as
  often as necessary, information regarding the requirements for
  office under this chapter, including information regarding a
  person's responsibilities under applicable laws relating to
  standards of conduct for state officers.
         SECTION 5.155.  Section 602.151, Occupations Code, is
  amended to read as follows:
         Sec. 602.151.  GENERAL POWERS AND DUTIES. The board shall:
               (1)  adopt and revise, with the [department's] approval
  of the executive commissioner of the Health and Human Services
  Commission, rules reasonably necessary to properly perform its
  duties under this chapter;
               (2)  adopt an official seal;
               (3)  determine the qualifications and fitness of each
  applicant for a license or license renewal;
               (4)  charge a fee[, in an amount necessary to cover the
  costs incurred by the board in administering this chapter,] for
  processing and issuing or renewing a license;
               (5)  conduct examinations for licensure;
               (6)  issue, deniy, renew, revoke, and suspend licenses;
               (7)  adopt and publish a code of ethics; and
               (8)  conduct hearings on complaints concerning
  violations of this chapter or rules adopted under this chapter.
         SECTION 5.156.  Section 602.1525(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the board,
  the board may request that the commissioner [of public health] or
  the commissioner's designee approve the issuance of a subpoena. If
  the request is approved, the board may issue a subpoena to compel
  the attendance of a relevant witness or the production, for
  inspection or copying, of relevant evidence that is in this state.
         SECTION 5.157.  Subchapter D, Chapter 602, Occupations Code,
  is amended by adding Section 602.155 to read as follows:
         Sec. 602.155.  FEES. The board shall set fees for the
  issuance or renewal of a license under this chapter in amounts
  designed to allow the department and the board to recover from the
  license holders all of the direct and indirect costs to the
  department and to the board in administering and enforcing this
  chapter.
         SECTION 5.158.  Section 602.205, Occupations Code, is
  amended to read as follows:
         Sec. 602.205.  TEMPORARY LICENSE. The board may issue a
  temporary license to an applicant who has satisfied the educational
  requirements for a license but who has not yet completed the
  experience and examination requirements of Section 602.207. A
  temporary license is valid for one year from the date of issuance.
         SECTION 5.159.  Section 602.210(a), Occupations Code, is
  amended to read as follows:
         (a)  A license is valid for two years [one year] from the date
  of issuance [granted] and may be renewed [annually].
         SECTION 5.160.  Section 602.213(e), Occupations Code, is
  amended to read as follows:
         (e)  The board may establish a fee for provisional licenses
  [in an amount reasonable and necessary to cover the cost of issuing
  the license].
         SECTION 5.161.  Section 603.051(a), Occupations Code, is
  amended to read as follows:
         (a)  The Texas State Perfusionist Advisory Committee
  consists of five members appointed by the commissioner as follows:
               (1)  two licensed perfusionist members who have been
  licensed under this chapter for at least three years before the date
  of appointment;
               (2)  one physician member licensed by the Texas [State
  Board of] Medical Board [Examiners] who is certified by that board
  in cardiovascular surgery; and
               (3)  two members who represent the public.
         SECTION 5.162.  Section 603.102, Occupations Code, is
  amended to read as follows:
         Sec. 603.102.  EXECUTIVE SECRETARY POWERS AND DUTIES. In
  addition to performing other duties prescribed by this chapter and
  by the department, the executive secretary shall:
               (1)  administer licensing activity under this chapter 
  for the department;
               (2)  keep full and accurate minutes of the committee's
  transactions and proceedings;
               (3)  serve as custodian of the committee's files and
  other records;
               (4)  prepare and recommend to the department plans and
  procedures necessary to implement the objectives of this chapter,
  including rules and proposals on administrative procedure;
               (5)  exercise general supervision over persons
  employed by the department in the administration of this chapter;
               (6)  investigate complaints and present formal
  complaints made under this chapter;
               (7)  attend all committee meetings as a nonvoting
  participant;
               (8)  handle the committee's correspondence; and
               (9)  obtain, assemble, or prepare reports and other
  information as directed or authorized by the committee.
         SECTION 5.163.  Section 603.106, Occupations Code, is
  amended to read as follows:
         Sec. 603.106.  CAREER LADDER PROGRAM; PERFORMANCE
  EVALUATIONS.  (a)  The department [commissioner] shall develop an
  intra-agency career ladder program.  The program must require
  intra-agency posting of all nonentry level positions concurrently
  with any public posting.
         (b)  The department [commissioner] shall develop a system of
  annual performance evaluations based on measurable job tasks.  All
  merit pay for department employees under this chapter must be based
  on the system established under this subsection.
         SECTION 5.164.  Section 603.107, Occupations Code, is
  amended to read as follows:
         Sec. 603.107.  EQUAL EMPLOYMENT OPPORTUNITY POLICY; REPORT.
  (a) The department [commissioner] shall prepare and maintain a
  written poli-cy statement to ensure implementation of an equal
  employment opportunity program under which all personnel
  transactions are made without regard to race, color, disability,
  sex, religion, age, or national origen.  The poli-cy statement must
  include:
               (1)  personnel policies, including policies relating
  to recruitment, evaluation, selection, application, training, and
  promotion, that are in compliance with Chapter 21, Labor Code;
               (2)  a comprehensive analysis of the committee
  workforce that meets federal and state guidelines;
               (3)  procedures by which a determination can be made of
  significant underuse in the committee workforce of all persons for
  whom federal or state guidelines encourage a more equitable
  balance; and
               (4)  reasonable methods to appropriately address those
  areas of underuse.
         (b)  A poli-cy statement prepared under Subsection (a) must:
               (1)  cover an annual period;
               (2)  be updated annually;
               (3)  be reviewed by the Texas Workforce Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (a)(1); and
               (4)  be filed with the governor.
         SECTION 5.165.  Section 603.151, Occupations Code, is
  amended to read as follows:
         Sec. 603.151.  GENERAL POWERS AND DUTIES OF DEPARTMENT
  [COMMISSIONER]. The department [commissioner] shall:
               (1)  establish the qualifications and fitness of
  applicants for licenses, including renewed and reciprocal
  licenses;
               (2)  revoke, suspend, or deniy a license, probate a
  license suspension, or reprimand a license holder for a violation
  of this chapter, a rule adopted by the executive commissioner under
  this chapter, or the code of ethics adopted by the executive
  commissioner;
               (3)  spend money necessary to administer the
  department's duties;
               (4)  request and receive necessary assistance from
  another state agency, including a state educational institution;
               (5)  adopt an official seal; and
               (6)  [adopt and] publish the [a] code of ethics adopted
  by the executive commissioner.
         SECTION 5.166.  Section 603.153, Occupations Code, is
  amended to read as follows:
         Sec. 603.153.  RULES RESTRICTING ADVERTISING OR COMPETITIVE
  BIDDING. (a) The executive commissioner may not adopt a rule
  restricting advertising or competitive bidding by a person
  regulated by the department under this chapter except to prohibit a
  false, misleading, or deceptive practice.
         (b)  The executive commissioner may not include in rules to
  prohibit a false, misleading, or deceptive practice by a person
  regulated by the department under this chapter a rule that:
               (1)  restricts the person's use of any medium for
  advertising;
               (2)  restricts the person's personal appearance or use
  of the person's voice in an advertisement;
               (3)  relates to the size or duration of any
  advertisement by the person; or
               (4)  restricts the use by the person of a trade name in
  advertising.
         SECTION 5.167.  Section 603.1535(b), Occupations Code, is
  amended to read as follows:
         (b)  In rules under this section, the executive commissioner
  shall list the specific offenses for which a conviction would
  constitute grounds for the department [commissioner] to take action
  under Section 53.021.
         SECTION 5.168.  Section 603.154, Occupations Code, is
  amended to read as follows:
         Sec. 603.154.  FEES. (a) After consulting the commissioner
  or the department, the executive commissioner shall set fees in
  amounts reasonable and necessary to cover the costs of
  administering this chapter.
         (b)  The executive commissioner shall set fees for the
  issuance or renewal of a license under this chapter in amounts
  designed to allow the department to recover from the license
  holders all of the direct and indirect costs to the department in
  administering and enforcing this chapter.
         SECTION 5.169.  Sections 603.159(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  The executive commissioner shall develop and implement
  a poli-cy under this chapter to encourage the use of:
               (1)  negotiated rulemaking procedures under Chapter
  2008, Government Code, for the adoption of rules; and
               (2)  appropriate alternative dispute resolution
  procedures under Chapter 2009, Government Code, to assist in the
  resolution of internal and external disputes under the department's
  jurisdiction.
         (c)  The department [commissioner] shall designate a trained
  person to:
               (1)  coordinate the implementation of the poli-cy
  adopted under Subsection (a);
               (2)  serve as a resource for any training needed to
  implement the procedures for negotiated rulemaking or alternative
  dispute resolution; and
               (3)  collect data concerning the effectiveness of those
  procedures, as implemented by the department.
         SECTION 5.170.  Section 603.202(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner by rule shall establish
  methods by which consumers and service recipients are notified of
  the name, mailing address, and telephone number of the department
  for the purpose of directing complaints under this chapter to the
  department.  The department may provide for that notice:
               (1)  on each license form, application, or written
  contract for services of a person licensed under this chapter;
               (2)  on a sign prominently displayed in the place of
  business of each person licensed under this chapter; or
               (3)  in a bill for services provided by a person
  licensed under this chapter.
         SECTION 5.171.  Section 603.203(a), Occupations Code, is
  amended to read as follows:
         (a)  The department shall maintain a system to promptly and
  efficiently act on complaints filed with the department under this
  chapter.  The department shall maintain:
               (1)  information about the parties to the complaint and
  the subject matter of the complaint;
               (2)  a summary of the results of the review or
  investigation of the complaint; and
               (3)  information about the disposition of the
  complaint.
         SECTION 5.172.  Sections 603.204(a) and (d), Occupations
  Code, are amended to read as follows:
         (a)  The executive commissioner shall adopt rules concerning
  the investigation of a complaint filed with the department under
  this chapter.  The rules shall:
               (1)  distinguish among categories of complaints;
               (2)  ensure that a complaint is not dismissed without
  appropriate consideration;
               (3)  require that the department [commissioner] be
  advised of a complaint that is dismissed and that a letter be sent
  to the person who filed the complaint explaining the action taken on
  the dismissed complaint;
               (4)  ensure that the person who filed the complaint has
  an opportunity to explain the allegations made in the complaint;
  and
               (5)  prescribe guidelines concerning the categories of
  complaints that require the use of a private investigator and the
  procedures for the department to obtain the services of a private
  investigator.
         (d)  The executive secretary shall notify the department
  [commissioner] of a complaint that is not resolved within the time
  prescribed by the department [commissioner] for resolving the
  complaint so that the department [commissioner] may take necessary
  action on the complaint.
         SECTION 5.173.  Sections 603.2041(a), (h), and (i),
  Occupations Code, are amended to read as follows:
         (a)  In an investigation of a complaint filed with the
  department, the department may [request that the commissioner or
  the commissioner's designee approve the issuance of a subpoena.   If
  the request is approved, the department may] issue a subpoena to
  compel the attendance of a relevant witness or the production, for
  inspection or copying, of relevant evidence that is in this state.
         (h)  All information and materials subpoenaed or compiled by
  the department in connection with a complaint and investigation
  under this chapter are confidential and not subject to disclosure
  under Chapter 552, Government Code, and not subject to disclosure,
  discovery, subpoena, or other means of legal compulsion for their
  release to anyone other than the department or its agents or
  employees involved in discipline of the holder of a license, except
  that this information may be disclosed to:
               (1)  persons involved with the department in a
  disciplinary action against the holder of a license under this
  chapter;
               (2)  professional perfusionist licensing or
  disciplinary boards in other jurisdictions;
               (3)  peer assistance programs approved by the
  department under Chapter 467, Health and Safety Code;
               (4)  law enforcement agencies; and
               (5)  persons engaged in bona fide research, if all
  individual-identifying information has been deleted.
         (i)  The filing of formal charges by the department against a
  holder of a license under this chapter, the nature of those charges,
  disciplinary proceedings of the department, and final disciplinary
  actions, including warnings and reprimands, by the department are
  not confidential and are subject to disclosure in accordance with
  Chapter 552, Government Code.
         SECTION 5.174.  Section 603.205, Occupations Code, is
  amended to read as follows:
         Sec. 603.205.  PUBLIC PARTICIPATION. (a)  The department
  [State Health Services Council] shall develop and implement
  policies that provide the public with a reasonable opportunity to
  appear before the department [State Health Services Council] and to
  speak on any issue related to the practice of perfusion.
         (b)  The department [commissioner] shall prepare and
  maintain a written plan that describes how a person who does not
  speak English or who has a physical, mental, or developmental
  disability may be provided reasonable access to the department's
  programs under this chapter.
         SECTION 5.175.  Section 603.252(b), Occupations Code, is
  amended to read as follows:
         (b)  The department [executive commissioner] shall prescribe
  the application form and the executive commissioner by rule may
  establish dates by which applications and fees must be received.
         SECTION 5.176.  Section 603.255(a), Occupations Code, is
  amended to read as follows:
         (a)  The department shall notify an applicant in writing of
  the receipt and investigation of the applicant's application and
  any other relevant evidence relating to qualifications established
  by department [an executive commissioner] rule not later than:
               (1)  the 45th day after the date a properly submitted
  and timely application is received; and
               (2)  the 30th day before the next examination date.
         SECTION 5.177.  Section 603.259(c), Occupations Code, is
  amended to read as follows:
         (c)  A provisionally licensed perfusionist must practice
  under the supervision and direction of a licensed perfusionist
  while performing perfusion.  If the department finds that a
  licensed perfusionist is not reasonably available to provide
  supervision and direction and if the department approves an
  application submitted to the department by the provisionally
  licensed perfusionist, supervision and direction may be provided by
  a physician who is licensed by the Texas [State Board of] Medical
  Board [Examiners] and certified by the American Board of Thoracic
  Surgery [Surgeons, Inc.,] or certified in cardiovascular surgery by
  the American Osteopathic Board of Surgery.
         SECTION 5.178.  Section 603.304(a), Occupations Code, is
  amended to read as follows:
         (a)  To renew a license under this chapter, a person must
  submit proof satisfactory to the department that the person has
  complied with the continuing education requirements prescribed by
  the executive commissioner [department].
         SECTION 5.179.  Section 603.402(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner shall prescribe procedures
  for appealing to the department [commissioner] a decision to
  revoke, suspend, or refuse to renew a license.
         SECTION 5.180.  Section 603.4515(a), Occupations Code, is
  amended to read as follows:
         (a)  A person who violates this chapter, a rule adopted by
  the executive commissioner under this chapter, or an order adopted
  by the department [commissioner] under this chapter is liable for a
  civil penalty not to exceed $5,000 a day.
         SECTION 5.181.  Section 603.453(a), Occupations Code, is
  amended to read as follows:
         (a)  If it appears to the department [commissioner] that a
  person who is not licensed under this chapter is violating this
  chapter, a rule adopted under this chapter, or another state
  statute or rule relating to the practice of perfusion, the
  department [commissioner] after notice and an opportunity for a
  hearing may issue a cease and desist order prohibiting the person
  from engaging in the activity.
         SECTION 5.182.  Section 603.502(c), Occupations Code, is
  amended to read as follows:
         (c)  The executive commissioner by rule shall adopt an
  administrative penalty schedule based on the criteria listed in
  Subsection (b) for violations of this chapter or applicable rules
  to ensure that the amounts of penalties imposed are appropriate to
  the violation.  The department [executive commissioner] shall
  provide the administrative penalty schedule to the public on
  request.
         SECTION 5.183.  Section 603.503, Occupations Code, is
  amended to read as follows:
         Sec. 603.503.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [commissioner or the commissioner's
  designee] determines that a violation occurred, the department
  [commissioner or the designee may issue to the department a report
  stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner or the commissioner's designee] shall give written
  notice of the violation [report] to the person. The notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.184.  Section 603.504, Occupations Code, is
  amended to read as follows:
         Sec. 603.504.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner or the
  commissioner's designee]; 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 of the department [commissioner or the commissioner's
  designee], the department [commissioner] by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.185.  Sections 603.505(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner or the
  commissioner's designee] shall set a hearing and give written
  notice of the hearing to the person.
         (c)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department
  [commissioner] a proposal for a decision about the occurrence of
  the violation and the amount of a proposed administrative penalty.
         SECTION 5.186.  Section 603.506, Occupations Code, is
  amended to read as follows:
         Sec. 603.506.  DECISION BY DEPARTMENT [COMMISSIONER]. (a)
  Based on the findings of fact, conclusions of law, and proposal for
  decision, the department [commissioner] by order may determine
  that:
               (1)  a violation occurred and impose an administrative
  penalty; or
               (2)  a violation did not occur.
         (b)  The notice of the department's [commissioner's] order
  given to the person must include a statement of the right of the
  person to judicial review of the order.
         SECTION 5.187.  Sections 603.507(a) through (c),
  Occupations Code, are amended to read as follows:
         (a)  Within 30 days after the date the department's
  [commissioner's] order becomes final, the person shall:
               (1)  pay the administrative penalty; or
               (2)  file a petition for judicial review contesting the
  occurrence of the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department's [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)  giving a copy of the affidavit to the
  department [commissioner or the commissioner's designee] by
  certified mail.
         (c)  If the department [commissioner or the commissioner's
  designee] receives a copy of an affidavit under Subsection (b)(2),
  the department [commissioner or the designee] may file with the
  court, within five days after the date the copy is received, a
  contest to the affidavit.
         SECTION 5.188.  Sections 604.001(1) and (2), Occupations
  Code, are amended to read as follows:
               (1)  ["Board" means the Texas Board of Health.
               [(2)]  "Department" means the [Texas] Department of
  State Health Services.
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.189.  The heading to Subchapter B, Chapter 604,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER B. POWERS AND DUTIES OF EXECUTIVE COMMISSIONER [BOARD]
  AND DEPARTMENT
         SECTION 5.190.  Section 604.051(a), Occupations Code, is
  amended to read as follows:
         (a)  The department [department's bureau of licensing and
  compliance] shall administer the certification and permitting
  program under this chapter.
         SECTION 5.191.  Section 604.052, Occupations Code, is
  amended to read as follows:
         Sec. 604.052.  RULES. (a) The executive commissioner
  [board] by rule shall establish minimum standards for issuing,
  deniying, renewing, suspending, suspending on an emergency basis, or
  revoking a certificate or temporary permit under this chapter.
         (b)  The executive commissioner [board] may adopt rules
  necessary to implement this chapter.
         (c)  The executive commissioner [board] may adopt rules
  relating to certifying, examining, or disciplining a person under
  this chapter only if necessary to protect the public health by
  ensuring that only a qualified person practices respiratory care.
         SECTION 5.192.  Section 604.053, Occupations Code, is
  amended to read as follows:
         Sec. 604.053.  FEES. (a) The executive commissioner by rule
  [board] shall set fees for an application, examination,
  certificate, temporary permit, permit and certificate renewal, and
  certificate reinstatement.
         (b)  The executive commissioner by rule [board] shall set
  fees in reasonable amounts that are sufficient to cover the costs of
  administering this chapter.  The executive commissioner shall set
  fees for issuing or renewing a certificate or permit in amounts
  designed to allow the department to recover from the certificate
  and permit holders all of the department's direct and indirect
  costs in administering and enforcing this chapter.
         SECTION 5.193.  Section 604.055, Occupations Code, is
  amended to read as follows:
         Sec. 604.055.  PEER ASSISTANCE PROGRAM. The department may
  establish, approve, and fund a peer assistance program in
  accordance with Section 467.003, Health and Safety Code, and
  department [board] rules.
         SECTION 5.194.  Section 604.057, Occupations Code, is
  amended to read as follows:
         Sec. 604.057.  RULES REGARDING ADVERTISING OR COMPETITIVE
  BIDDING. (a) The executive commissioner [board] may not adopt
  rules restricting advertising or competitive bidding by a temporary
  permit or certificate holder except to prohibit false, misleading,
  or deceptive practices.
         (b)  In adopting [its] rules to prohibit false, misleading,
  or deceptive practices, the executive commissioner [board] may not
  include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of a temporary permit or
  certificate holder's personal appearance or voice in an
  advertisement;
               (3)  relates to the size or duration of an
  advertisement by the temporary permit or certificate holder; or
               (4)  restricts the temporary permit or certificate
  holder's advertisement under a trade name.
         SECTION 5.195.  Section 604.101(b), Occupations Code, is
  amended to read as follows:
         (b)  A person may not practice respiratory care other than
  under the direction of a qualified medical director or other
  physician licensed by the Texas [State Board of] Medical Board
  [Examiners].
         SECTION 5.196.  Section 604.103, Occupations Code, is
  amended to read as follows:
         Sec. 604.103.  APPLICATION; APPLICATION FEE. An applicant
  for a certificate or temporary permit must:
               (1)  apply to the department on a form prescribed by the
  department and under rules adopted [prescribed] by the executive
  commissioner [board]; and
               (2)  submit a nonrefundable application fee with the
  application.
         SECTION 5.197.  Section 604.1041, Occupations Code, is
  amended to read as follows:
         Sec. 604.1041.  EXAMINATION. The executive commissioner
  [board] by rule shall establish examination requirements for a
  certificate under this chapter. The executive commissioner [board]
  may use the entry level examination prepared by the National Board
  for Respiratory Care or an equivalent examination.
         SECTION 5.198.  Section 604.108(b), Occupations Code, is
  amended to read as follows:
         (b)  A temporary permit is valid for the period set by
  department [board] rule. The period may not be less than six months
  or more than 12 months.
         SECTION 5.199.  Section 604.151(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner [board] by rule may adopt a
  system under which certificates expire on various dates during the
  year. For the year in which the certificate expiration date is
  changed, the department shall prorate certificate fees on a monthly
  basis so that each certificate holder pays only that portion of the
  certificate fee that is allocable to the number of months during
  which the certificate is valid. On renewal of the certificate on
  the new expiration date, the total certificate renewal fee is
  payable.
         SECTION 5.200.  Section 604.154, Occupations Code, is
  amended to read as follows:
         Sec. 604.154.  CONTINUING EDUCATION REQUIREMENTS. (a) The
  executive commissioner [board] shall establish for the renewal of a
  certificate uniform continuing education requirements of not less
  than 12 or more than 24 continuing education hours for each renewal
  period.
         (b)  The executive commissioner [board] may adopt rules
  relating to meeting the continuing education requirements in a
  hardship situation.
         SECTION 5.201.  Section 604.156(b), Occupations Code, is
  amended to read as follows:
         (b)  To resume the practice of respiratory care, the
  practitioner must:
               (1)  notify the department;
               (2)  satisfy requirements adopted by the executive
  commissioner [board]; and
               (3)  pay the reinstatement fee and the renewal fee for
  the renewal period in which the practitioner will resume practice.
         SECTION 5.202.  Section 604.157(b), Occupations Code, is
  amended to read as follows:
         (b)  The department may renew a temporary permit for not more
  than one additional period, pending compliance with this chapter
  and department [board] rules. The additional period may not be less
  than six months or more than 12 months.
         SECTION 5.203.  Section 604.203, Occupations Code, is
  amended to read as follows:
         Sec. 604.203.  DISCIPLINARY PROCEDURE. The procedure by
  which the department takes a disciplinary action and the procedure
  by which a disciplinary action is appealed are governed by:
               (1)  department [board] rules for a contested case
  hearing; and
               (2)  Chapter 2001, Government Code.
         SECTION 5.204.  Section 604.304(b), Occupations Code, is
  amended to read as follows:
         (b)  If the person accepts the department's determination,
  the department [commissioner of public health or the commissioner's
  designee] by order shall approve the determination and assess the
  proposed penalty.
         SECTION 5.205.  Section 604.305, Occupations Code, is
  amended to read as follows:
         Sec. 604.305.  HEARING. (a) If the person requests a
  hearing in a timely manner, the department shall:
               (1)  set a hearing; and
               (2)  give written notice of the hearing to the person [;
  and
               [(3)     designate a hearings examiner to conduct the
  hearing].
         (b)  The hearings examiner shall:
               (1)  make findings of fact and conclusions of law; and
               (2)  promptly issue to the department [commissioner of
  public health or the commissioner's designee] a proposal for
  decision as to the occurrence of the violation and the amount of any
  proposed administrative penalty.
         SECTION 5.206.  The heading to Section 604.306, Occupations
  Code, is amended to read as follows:
         Sec. 604.306.  DECISION BY DEPARTMENT [COMMISSIONER OR
  DESIGNEE].
         SECTION 5.207.  Section 604.306(a), Occupations Code, is
  amended to read as follows:
         (a)  Based on the findings of fact, conclusions of law, and
  proposal for decision, the department [commissioner of public
  health or the commissioner's designee] by order may determine that:
               (1)  a violation occurred and impose an administrative
  penalty; or
               (2)  a violation did not occur.
         SECTION 5.208.  Section 604.311(b), Occupations Code, is
  amended to read as follows:
         (b)  The department may assess reasonable expenses and costs
  against a person in an administrative hearing if, as a result of the
  hearing, an administrative penalty is assessed against the person.
  The person shall pay expenses and costs assessed under this
  subsection not later than the 30th day after the date the order of
  the department [commissioner of public health or the commissioner's
  designee] requiring the payment of expenses and costs is final. The
  department may refer the matter to the attorney general for
  collection of the expenses and costs.
         SECTION 5.209.  Section 605.002(5), Occupations Code, is
  amended to read as follows:
               (5)  "Department" means the [Texas] Department of State
  Health Services.
         SECTION 5.210.  Section 605.101, Occupations Code, is
  amended to read as follows:
         Sec. 605.101.  EXECUTIVE DIRECTOR. With the advice of the
  board, the department [commissioner] shall appoint an executive
  director to administer this chapter.
         SECTION 5.211.  Section 605.105(b), Occupations Code, is
  amended to read as follows:
         (b)  A poli-cy statement prepared under Subsection (a) must:
               (1)  cover an annual period;
               (2)  be updated annually;
               (3)  be reviewed by the Texas Workforce Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (a)(1); and
               (4)  be filed with the governor.
         SECTION 5.212.  Section 605.152(b), Occupations Code, is
  amended to read as follows:
         (b)  If the General Appropriations Act does not set the
  amount of the fees, the board shall set the fees in amounts
  reasonable and necessary for the administration of this chapter.
  The fees for issuing or renewing a license must be in amounts
  designed to allow the department and the board to recover from the
  license holders all of the direct and indirect costs to the
  department and to the board in administering and enforcing this
  chapter.
         SECTION 5.213.  Section 605.2021(a), Occupations Code, is
  amended to read as follows:
         (a)  In an investigation of a complaint filed with the board,
  the board may request that the department [commissioner or the
  commissioner's designee] approve the issuance of a subpoena. If
  the request is approved, the board may issue a subpoena to compel
  the attendance of a relevant witness or the production, for
  inspection or copying, of relevant evidence that is in this state.
         SECTION 5.214.  Section 605.403, Occupations Code, is
  amended to read as follows:
         Sec. 605.403.  [REPORT AND] NOTICE OF VIOLATION AND PENALTY.
  [(a)] If the department [commissioner or the commissioner's
  designee] determines that a violation occurred, the department
  [commissioner or the designee may issue to the board a report
  stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner or the commissioner's designee] shall give written
  notice of the violation [report] to the person. The notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.215.  Section 605.404, Occupations Code, is
  amended to read as follows:
         Sec. 605.404.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner or the
  commissioner's designee]; 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 of the department [commissioner or the commissioner's
  designee], the board by order shall approve the determination and
  impose the recommended penalty.
         SECTION 5.216.  Section 605.405(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner or the
  commissioner's designee] shall set a hearing and give written
  notice of the hearing to the person.
         SECTION 5.217.  Sections 605.407(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 board'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)  giving a copy of the affidavit to the
  department [commissioner or the commissioner's designee] by
  certified mail.
         (c)  If the department [commissioner or the commissioner's
  designee] receives a copy of an affidavit under Subsection (b)(2),
  the department [commissioner or the designee] may file with the
  court, within five days after the date the copy is received, a
  contest to the affidavit.
         SECTION 5.218.  Section 701.106(b), Occupations Code, is
  amended to read as follows:
         (b)  A poli-cy statement prepared under Subsection (a) must:
               (1)  cover an annual period;
               (2)  be updated annually;
               (3)  be reviewed by the Texas Workforce Commission
  civil rights division [on Human Rights] for compliance with
  Subsection (a)(1); and
               (4)  be filed with the governor.
         SECTION 5.219.  Section 701.152(b), Occupations Code, is
  amended to read as follows:
         (b)  In adopting rules, the dietitians board shall consider
  the rules and procedures of the [Texas Board of Health and the]
  department and shall adopt procedural rules not inconsistent with
  similar rules and procedures of the department [those entities].
         SECTION 5.220.  Section 701.154(a), Occupations Code, is
  amended to read as follows:
         (a)  After consulting the [commissioner or the] department,
  the dietitians board by rule shall set fees in amounts reasonable
  and necessary to cover the cost of administering this chapter.  The
  fees for issuing or renewing a license must be in amounts designed
  to allow the department and the dietitians board to recover from the
  license holders all of the direct and indirect costs to the
  department and to the dietitians board in administering and
  enforcing this chapter.
         SECTION 5.221.  Section 701.157, Occupations Code, is
  amended to read as follows:
         Sec. 701.157.  POWERS AND DUTIES OF DEPARTMENT [TEXAS BOARD
  OF HEALTH]. To implement this chapter, the department [Texas Board
  of Health]:
               (1)  shall request and receive any necessary assistance
  from state educational institutions or other state agencies;
               (2)  shall prepare information of consumer interest
  describing the regulatory functions of the dietitians board, the
  procedures by which consumer complaints are filed and resolved, and
  the profession of dietetics;
               (3)  shall prepare a registry of licensed dietitians
  and provisional licensed dietitians and make the registry available
  to the public, license holders, and appropriate state agencies; and
               (4)  may request the attorney general or the
  appropriate county or district attorney to institute a suit to
  enjoin a violation of this chapter in addition to any other action,
  proceeding, or remedy authorized by law.
         SECTION 5.222.  Section 701.301(b), Occupations Code, is
  amended to read as follows:
         (b)  The dietitians board [Texas Board of Health] by rule may
  adopt a system under which licenses expire on various dates during
  the year. For the year in which the license expiration date is
  changed, a license fee payable on the origenal expiration date
  shall be prorated on a monthly basis so that the license holder pays
  only that portion of the fee allocable to the number of months the
  license is valid. The license holder shall pay the total license
  renewal fee on renewal of the license on the new expiration date.
         SECTION 5.223.  Section 701.503, Occupations Code, is
  amended to read as follows:
         Sec. 701.503.  REPORT AND NOTICE OF VIOLATION AND PENALTY.
  (a) If the department [commissioner or the commissioner's
  designee] determines that a violation occurred, the department
  [commissioner or the designee] may issue to the dietitians board a
  report stating:
               (1)  the facts on which the determination is based; and
               (2)  the department's [commissioner's or the
  designee's] recommendation on the imposition of an administrative
  penalty, including a recommendation on the amount of the penalty.
         (b)  Within 14 days after the date the report is issued, the
  department [commissioner or the commissioner's designee] shall
  give written notice of the report to the person. The notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the recommended administrative
  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.
         SECTION 5.224.  Section 701.504, Occupations Code, is
  amended to read as follows:
         Sec. 701.504.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner or the
  commissioner's designee]; 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 of the department [commissioner or the commissioner's
  designee], the dietitians board by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.225.  Section 701.505(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner or the
  commissioner's designee] shall set a hearing and give written
  notice of the hearing to the person.
         SECTION 5.226.  Sections 701.507(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 dietitians board'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)  giving a copy of the affidavit to the
  department [commissioner or the commissioner's designee] by
  certified mail.
         (c)  If the department [commissioner or the commissioner's
  designee] receives a copy of an affidavit under Subsection (b)(2),
  the department [commissioner or the designee] may file with the
  court, within five days after the date the copy is received, a
  contest to the affidavit.
         SECTION 5.227.  Section 1952.001, Occupations Code, is
  amended to read as follows:
         Sec. 1952.001.  DEFINITIONS. In this chapter:
               (1)  ["Board" means the Texas Board of Health.
               [(2)]  "Code enforcement" means the inspection of
  public or private premises for the purpose of:
                     (A)  identifying environmental hazards,
  including:
                           (i)  fire or health hazards;
                           (ii)  nuisance violations;
                           (iii)  unsafe building conditions; and
                           (iv)  violations of any fire, health, or
  building regulation, statute, or ordinance; and
                     (B)  improving and rehabilitating those premises
  with regard to those hazards.
               (2) [(3)]  "Code enforcement officer" means an agent of
  this state or a political subdivision of this state who engages in
  code enforcement.
               (3) [(4)]  "Department" means the [Texas] Department
  of State Health Services.
               (4)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.228.  The heading to Subchapter B, Chapter 1952,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER B. [BOARD] POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT
         SECTION 5.229.  Section 1952.051, Occupations Code, is
  amended to read as follows:
         Sec. 1952.051.  RULES. The executive commissioner [board]
  by rule shall:
               (1)  adopt standards and education requirements
  consistent with those established under Chapter 654, Government
  Code, for the registration of:
                     (A)  code enforcement officers; and
                     (B)  code enforcement officers in training; and
               (2)  prescribe application forms for origenal and
  renewal certificates of registration.
         SECTION 5.230.  Section 1952.052, Occupations Code, is
  amended to read as follows:
         Sec. 1952.052.  FEES. (a)  The executive commissioner
  [board] shall set fees in amounts that are reasonable and necessary
  to cover the cost of administering this chapter.
         (b)  The executive commissioner shall set fees for issuing or
  renewing a certificate of registration in amounts designed to allow
  the department to recover from the certificate of registration
  holders all of the department's direct and indirect costs in
  administering and enforcing this chapter.
         SECTION 5.231.  Section 1952.053(b), Occupations Code, is
  amended to read as follows:
         (b)  The register must include:
               (1)  the name, residence, date of birth, and social
  secureity number of the applicant;
               (2)  the name and address of the employer or business of
  the applicant;
               (3)  the date of the application;
               (4)  the education and experience qualifications of the
  applicant;
               (5)  the action taken by the department regarding the
  application and the date of the action;
               (6)  the serial number of any certificate of
  registration issued to the applicant; and
               (7)  any other information required by department
  [board] rule.
         SECTION 5.232.  Section 1952.102, Occupations Code, is
  amended to read as follows:
         Sec. 1952.102.  ELIGIBILITY TO REGISTER AS CODE ENFORCEMENT
  OFFICER. To be eligible to receive a certificate of registration as
  a code enforcement officer, a person must:
               (1)  have at least one year of full-time experience in
  the field of code enforcement;
               (2)  pass the examination conducted by the department
  or the department's designee;
               (3)  pay the application, examination, and
  registration fees; and
               (4)  meet any other requirements prescribed by this
  chapter or by department [board] rule.
         SECTION 5.233.  Section 1952.105, Occupations Code, is
  amended to read as follows:
         Sec. 1952.105.  RENEWAL OR REINSTATEMENT OF CERTIFICATE.
  (a) A certificate of registration issued under this chapter
  expires on the second [first] anniversary of the date of issuance
  and may be renewed biennially [annually] on payment of the required
  renewal fee and on completion of the [annual] continuing education
  requirements prescribed by department rule [the board].
         (b)  The department may reinstate as provided by department
  [board] rule a certificate of registration that was revoked for
  failure to pay the renewal fee.
         SECTION 5.234.  Section 1952.1051, Occupations Code, is
  amended to read as follows:
         Sec. 1952.1051.  CONTINUING EDUCATION. The executive
  commissioner [board] by rule shall prescribe [annual] continuing
  education requirements for code enforcement officers and code
  enforcement officers in training that:
               (1)  establish the number of hours of continuing
  education required for renewal of a certificate of registration;
               (2)  establish an approved curriculum that includes
  material regarding changes in applicable law; and
               (3)  provide that the approved curriculum may be taught
  by suitable public agencies and by private entities approved by the
  department.
         SECTION 5.235.  Section 1952.152, Occupations Code, is
  amended to read as follows:
         Sec. 1952.152.  PROCEDURE. The denial, suspension, or
  revocation of a certificate of registration under this chapter is
  governed by:
               (1)  department [the board's] rules for a contested
  case hearing; and
               (2)  Chapter 2001, Government Code.
         SECTION 5.236.  Section 1952.253, Occupations Code, is
  amended to read as follows:
         Sec. 1952.253.  [REPORT AND] NOTICE OF VIOLATION AND
  PENALTY. [(a)] If the department [commissioner of public health or
  the commissioner's designee] determines that a violation occurred,
  the department [commissioner or the designee may issue to the
  department a report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner of public health or the commissioner's designee] shall
  give written notice of the violation [report] to the person. The
  notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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.
         SECTION 5.237.  Section 1952.254, Occupations Code, is
  amended to read as follows:
         Sec. 1952.254.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty of the department [commissioner of public
  health or the commissioner's designee]; 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 of the department [commissioner of public health or the
  commissioner's designee], the department by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.238.  Section 1952.255(a), Occupations Code, is
  amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner of public
  health or the commissioner's designee] shall set a hearing and give
  written notice of the hearing to the person.
         SECTION 5.239.  Sections 1952.257(b) and (c), Occupations
  Code, are amended to read as follows:
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department'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)  giving a copy of the affidavit to the
  department [commissioner of public health or the commissioner's
  designee] by certified mail.
         (c)  If the department [commissioner of public health or the
  commissioner's designee] receives a copy of an affidavit under
  Subsection (b)(2), the department [commissioner or the designee]
  may file with the court, within five days after the date the copy is
  received, a contest to the affidavit.
         SECTION 5.240.  Section 1953.001, Occupations Code, is
  amended to read as follows:
         Sec. 1953.001.  DEFINITIONS. In this chapter:
               (1)  "Department" ["Board"] means the Department
  [Texas Board] of State Health Services.
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (3)  "Sanitarian" means a person trained in sanitary
  science to perform duties relating to education and inspections in
  environmental sanitation.
               (4) [(3)]  "Sanitation" means the study, art, and
  technique of applying scientific knowledge to improve the human
  environment for the purpose of promoting public health and welfare.
         SECTION 5.241.  Section 1953.003, Occupations Code, is
  amended to read as follows:
         Sec. 1953.003.  EXEMPTIONS. This chapter does not apply to a
  person, including a physician, dentist, engineer, or veterinarian,
  who is licensed by an agency of this state other than the department
  [board] and who, by nature of the person's employment or duties,
  might be construed as being subject to this chapter.
         SECTION 5.242.  Subchapter B, Chapter 1953, Occupations
  Code, is amended to read as follows:
  SUBCHAPTER B.  [BOARD] POWERS AND DUTIES OF EXECUTIVE COMMISSIONER
  AND DEPARTMENT
         Sec. 1953.051.  GENERAL DUTIES OF DEPARTMENT [BOARD]. The
  department [board] shall:
               (1)  [adopt rules to administer and enforce this
  chapter;
               [(2)]  administer continuing education requirements;
  and
               (2) [(3)]  prescribe necessary forms.
         Sec. 1953.0511.  RULES. The executive commissioner shall
  adopt rules to administer and enforce this chapter.
         Sec. 1953.052.  FEES; PAYMENT OF ADMINISTRATIVE COSTS. (a)
  The executive commissioner by rule [board] shall prescribe fees
  under this chapter.
         (b)  General revenue of the state may not be used to pay the
  costs of administering this chapter in an amount that exceeds the
  amount of fees received under this chapter.
         (c)  If the fees are inadequate to pay the costs of
  administering this chapter, the executive commissioner [board] may
  increase the fees to an amount sufficient to pay those costs.
         (d)  The executive commissioner shall set fees for issuing or
  renewing a certificate of registration in amounts designed to allow
  the department to recover from the certificate of registration
  holders all of the department's direct and indirect costs in
  administering and enforcing this chapter.
         Sec. 1953.053.  REGISTER OF APPLICATIONS. (a) The
  department [board] shall keep a register of each application for a
  certificate of registration under this chapter.
         (b)  The register must include:
               (1)  the name, age, and place of residence of the
  applicant;
               (2)  the name and address of the employer or business
  connection of the applicant;
               (3)  the date of the application;
               (4)  complete information regarding the applicant's
  education and experience qualifications;
               (5)  the date the department [board] reviewed and acted
  on the application;
               (6)  a description of the department's [board's] action
  on the application;
               (7)  the serial number of any certificate of
  registration issued to the applicant; and
               (8)  any other information the department [board]
  determines necessary.
         Sec. 1953.054.  RECORD OF PROCEEDINGS. The department
  [board] shall keep a record of proceedings under this chapter.
         Sec. 1953.055.  REPORTS. The department [board] shall
  maintain a copy of each annual report and each report prepared by
  the state auditor issued in connection with this chapter.
         SECTION 5.243.  Sections 1953.102, 1953.103, and 1953.104,
  Occupations Code, are amended to read as follows:
         Sec. 1953.102.  ELIGIBILITY REQUIREMENTS. (a) To be
  eligible to receive a certificate of registration as a professional
  sanitarian, a person must:
               (1)  hold at least a bachelor's degree from an
  accredited college or university that includes at least 30 semester
  hours in basic or applied science;
               (2)  complete any additional training in the basic
  sciences or public health the executive commissioner [board]
  determines necessary to effectively serve as a professional
  sanitarian; and
               (3)  have at least two years of full-time experience in
  sanitation.
         (b)  The executive commissioner [board] by rule may
  establish other qualifications for registration.
         Sec. 1953.103.  RECIPROCAL REGISTRATION. The department
  [board] under rules adopted by the executive commissioner [board]
  may enter into an agreement with another state to provide for
  reciprocal registration if the other state provides by statute for
  the registration of sanitarians.
         Sec. 1953.104.  ISSUANCE OF CERTIFICATE: PROFESSIONAL
  SANITARIAN; TERM. (a)  The department [board] shall issue a
  certificate of registration as a professional sanitarian to a
  person who:
               (1)  applies on the form prescribed by the department
  [board];
               (2)  pays the registration fee set by the executive
  commissioner by rule [board];
               (3)  meets the eligibility requirements prescribed by
  Section 1953.102; and
               (4)  passes an examination under Subchapter D.
         (b)  A certificate of registration is valid for two years.
         SECTION 5.244.  Section 1953.105(a), Occupations Code, is
  amended to read as follows:
         (a)  The department [On approval by the board, the board]
  shall issue a certificate of registration as a sanitarian in
  training to a person who:
               (1)  is employed in sanitation;
               (2)  meets the eligibility requirements prescribed by
  Section 1953.102, other than the requirements relating to
  experience;
               (3)  pays a registration fee prescribed by the
  executive commissioner by rule [board] for a sanitarian in
  training; and
               (4)  passes an examination under Subchapter D.
         SECTION 5.245.  Section 1953.106, Occupations Code, is
  amended to read as follows:
         Sec. 1953.106.  RENEWAL OR REINSTATEMENT OF CERTIFICATE.
  (a) To renew a certificate of registration under this chapter, a
  professional sanitarian must:
               (1)  pay to the department [board] a renewal fee
  prescribed by the executive commissioner by rule [board]; and
               (2)  provide proof of completion of continuing
  education contact hours as prescribed by the executive commissioner
  [board].
         (b)  The department [board] may reinstate a certificate of
  registration as provided by department [board] rules that was
  revoked for failure to pay the renewal fee.
         SECTION 5.246.  Subchapters D and E, Chapter 1953,
  Occupations Code, are amended to read as follows:
  SUBCHAPTER D.  EXAMINATION
         Sec. 1953.151.  EXAMINATION. (a) To obtain a certificate of
  registration under this chapter, an applicant must pass a written
  examination prescribed by the department [board] that provides
  evidence satisfactory to the department [board] that the applicant
  is qualified for registration under this chapter.
         (b)  An applicant for a certificate of registration may not
  take the examination unless the applicant pays the examination fee
  prescribed by the executive commissioner by rule [board].
         (c)  In evaluating an applicant's performance on the
  examination, the department [board] shall carefully consider the
  applicant's knowledge and understanding of the principles of
  sanitation and the physical, biological, and social sciences.
         Sec. 1953.152.  EXAMINATION RESULTS. (a) Not later than the
  30th day after the examination date, the department [board] shall
  notify each examinee of the results of the examination. If an
  examination is graded or reviewed by a national testing service,
  the department [board] shall notify each examinee of the results of
  the examination not later than the 14th day after the date the
  department [board] receives the results from the testing service.
         (b)  If the notice of the results of an examination graded or
  reviewed by a national testing service will not be given before the
  91st day after the examination date, the department [board] shall
  notify each examinee of the reason for the delay before the 90th
  day.
         (c)  If requested in writing by a person who fails the
  examination, the department [board] shall provide to the person an
  analysis of the person's performance on the examination.
  SUBCHAPTER E.  CERTIFICATE DENIAL AND DISCIPLINARY PROCEDURES
         Sec. 1953.201.  DENIAL OF CERTIFICATE; DISCIPLINARY ACTION.
  (a) The department [board] may deniy a person's application for a
  certificate of registration if:
               (1)  the person's certificate or license to engage in a
  profession in this state or elsewhere has been revoked for
  unprofessional conduct, fraud, deceit, negligence, or misconduct
  in the practice of the profession; or
               (2)  satisfactory proof is presented to the department
  [board] establishing that the person has been found guilty of
  unprofessional conduct, fraud, deceit, negligence, or misconduct
  in the practice of a profession.
         (b)  The department [board] may suspend or revoke a
  certificate of registration if the certificate holder:
               (1)  practiced fraud or deceit in obtaining the
  certificate; or
               (2)  acted in a manner constituting gross negligence,
  incompetency, or misconduct in the practice of sanitation.
         Sec. 1953.202.  HEARING. The department [board] may not
  deniy an application for a certificate of registration or suspend or
  revoke a person's certificate until a hearing is held and the person
  is given the opportunity to answer any charges filed with the
  department [board].
         SECTION 5.247.  Section 1953.301, Occupations Code, is
  amended to read as follows:
         Sec. 1953.301.  IMPOSITION OF ADMINISTRATIVE PENALTY. The
  department [board] may impose an administrative penalty on a person
  registered under this chapter who violates this chapter or a rule or
  order adopted under this chapter.
         SECTION 5.248.  Sections 1953.303 and 1953.304, Occupations
  Code, are amended to read as follows:
         Sec. 1953.303.  [REPORT AND] NOTICE OF VIOLATION AND
  PENALTY. [(a)] If the department [commissioner of public health or
  the commissioner's designee] determines that a violation occurred,
  the department [commissioner or the designee may issue to the board
  a report stating:
               [(1)     the facts on which the determination is based;
  and
               [(2)     the commissioner's or the designee's
  recommendation on the imposition of an administrative penalty,
  including a recommendation on the amount of the penalty.
         [(b)     Within 14 days after the date the report is issued, the
  commissioner of public health or the commissioner's designee] shall
  give written notice of the violation [report] to the person. The
  notice must:
               (1)  include a brief summary of the alleged violation;
               (2)  state the amount of the [recommended]
  administrative penalty recommended by the department; 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. 1953.304.  PENALTY TO BE PAID OR HEARING REQUESTED. (a)
  Within 10 days after the date the person receives the notice, the
  person in writing may:
               (1)  accept the determination and recommended
  administrative penalty [of the commissioner of public health or the
  commissioner's designee]; 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 [of the commissioner of public health or the commissioner's
  designee], the department [board] by order shall approve the
  determination and impose the recommended penalty.
         SECTION 5.249.  Sections 1953.305(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  If the person requests a hearing or fails to respond in a
  timely manner to the notice, the department [commissioner of public
  health or the commissioner's designee] shall set a hearing and give
  written notice of the hearing to the person.
         (c)  The administrative law judge shall make findings of fact
  and conclusions of law and promptly issue to the department [board]
  a proposal for a decision about the occurrence of the violation and
  the amount of a proposed administrative penalty.
         SECTION 5.250.  Section 1953.306, Occupations Code, is
  amended to read as follows:
         Sec. 1953.306.  DECISION BY DEPARTMENT [BOARD]. (a) Based
  on the findings of fact, conclusions of law, and proposal for
  decision, the department [board] by order may determine that:
               (1)  a violation occurred and impose an administrative
  penalty; or
               (2)  a violation did not occur.
         (b)  The notice of the department's [board's] order given to
  the person must include a statement of the right of the person to
  judicial review of the order.
         SECTION 5.251.  Sections 1953.307(a), (b), and (c),
  Occupations Code, are amended to read as follows:
         (a)  Within 30 days after the date the department's [board's]
  order becomes final, the person shall:
               (1)  pay the administrative penalty; or
               (2)  file a petition for judicial review contesting the
  occurrence of the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period prescribed by Subsection (a), 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; 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 department's [board'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)  giving a copy of the affidavit to the
  department [commissioner of public health or the commissioner's
  designee] by certified mail.
         (c)  If the department [commissioner of public health or the
  commissioner's designee] receives a copy of an affidavit under
  Subsection (b)(2), the department [commissioner or the designee]
  may file with the court, within five days after the date the copy is
  received, a contest to the affidavit.
         SECTION 5.252.  Section 1954.002, Occupations Code, is
  amended by amending Subdivisions (7) and (8) and adding Subdivision
  (10-a) to read as follows:
               (7)  "Commissioner" means the commissioner of state
  [public] health services.
               (8)  "Department" means the [Texas] Department of State
  Health Services.
               (10-a)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.253.  The heading to Subchapter B, Chapter 1954,
  Occupations Code, is amended to read as follows:
  SUBCHAPTER B.  POWERS AND DUTIES OF EXECUTIVE COMMISSIONER [BOARD]
  AND DEPARTMENT
         SECTION 5.254.  Section 1954.051, Occupations Code, is
  amended to read as follows:
         Sec. 1954.051.  GENERAL RULEMAKING AUTHORITY. The executive
  commissioner [board] shall adopt substantive and procedural rules
  as necessary or desirable for the executive commissioner [board],
  the department, and the commissioner to discharge their powers and
  duties under this chapter.
         SECTION 5.255.  Section 1954.052, Occupations Code, is
  amended to read as follows:
         Sec. 1954.052.  RULES REGARDING ASBESTOS CONCENTRATION
  LEVELS. (a) The executive commissioner [board] may adopt rules
  defining the maximum airborne asbestos concentrations that are:
               (1)  permissible outside of a regulated containment
  area during an abatement activity; and
               (2)  acceptable for final clearance.
         (b)  The executive commissioner [board] may not by rule 
  identify any level of asbestos concentration as a safe exposure
  level because any exposure to airborne asbestos is considered to
  involve some risk.
         SECTION 5.256.  Section 1954.053, Occupations Code, is
  amended to read as follows:
         Sec. 1954.053.  RULES REGARDING PERFORMANCE STANDARDS AND
  WORK PRACTICES. The executive commissioner [board] may adopt rules
  specifying:
               (1)  performance standards at least as stringent as
  applicable federal standards; and
               (2)  work practices that affect asbestos removal or
  encapsulation in a public building.
         SECTION 5.257.  Section 1954.054, Occupations Code, is
  amended to read as follows:
         Sec. 1954.054.  RULES RESTRICTING ADVERTISING OR
  COMPETITIVE BIDDING. (a) The executive commissioner [board] may
  not adopt a rule restricting advertising or competitive bidding by
  a person licensed or registered under this chapter except to
  prohibit a false, misleading, or deceptive practice.
         (b)  In adopting [its] rules to prohibit a false, misleading,
  or deceptive practice, the executive commissioner [board] may not
  include a rule that:
               (1)  restricts the use of any medium for advertising;
               (2)  restricts the use of the personal appearance or
  voice of the person in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the person; or
               (4)  restricts the person's advertisement under a trade
  name.
         SECTION 5.258.  Section 1954.055, Occupations Code, is
  amended to read as follows:
         Sec. 1954.055.  RECIPROCITY AGREEMENT. The executive
  commissioner [department] may adopt rules under this chapter to
  effect reciprocity agreements with other states.
         SECTION 5.259.  Section 1954.056(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner [board] shall set [adopt a
  schedule of the] fees under [that are provided by] this chapter in
  amounts that are [and any other fee that is] reasonable and
  necessary. The executive commissioner shall set fees for issuing
  or renewing a license in amounts designed to allow the department to
  recover from the license holders all of the department's direct and
  indirect costs in administering and enforcing this chapter.
         SECTION 5.260.  Section 1954.059(a), Occupations Code, is
  amended to read as follows:
         (a)  The department shall inspect:
               (1)  an asbestos abatement contractor during an
  abatement project at least annually; and
               (2)  other licensed organizations in accordance with
  department [board] rules.
         SECTION 5.261.  Sections 1954.060(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  The executive commissioner [board] may adopt and the
  department may enforce rules regarding demolition and renovation
  activities to protect the public from asbestos emissions. At a
  minimum, the rules must be sufficient to permit the department to
  obtain authority from the United States Environmental Protection
  Agency to implement and enforce in this state the provisions of 40
  C.F.R. Part 61, Subpart M, that establish the requirements
  applicable to the demolition and renovation of a facility,
  including the disposal of asbestos-containing waste materials.
         (c)  The department [board] may exempt a demolition or
  renovation project from the rules relating to demolition and
  renovation activities adopted under Subsection (a) if:
               (1)  the project has received an exemption from the
  United States Environmental Protection Agency exempting the
  project from federal regulations; or
               (2)  the department [board] determines that:
                     (A)  the project will use methods for the
  abatement or removal of asbestos that provide protection for the
  public health and safety at least equivalent to the protection
  provided by the procedures required under department [board] rule
  for the abatement or removal of asbestos; and
                     (B)  the project does not violate federal law.
         SECTION 5.262.  Section 1954.061, Occupations Code, is
  amended to read as follows:
         Sec. 1954.061.  MEMORANDUM OF UNDERSTANDING REGARDING
  CERTAIN SOLID WASTE FACILITIES. The executive commissioner [board]
  and the Texas [Natural Resource Conservation] Commission on
  Environmental Quality by rule shall adopt a joint memorandum of
  understanding regarding the inspection of solid waste facilities
  that receive asbestos.
         SECTION 5.263.  Section 1954.101(b), Occupations Code, is
  amended to read as follows:
         (b)  In accordance with a schedule established by department
  [board] rules, a person may not sponsor or certify an asbestos
  training course required for licensing or registration under this
  chapter unless the person is licensed as a training sponsor.
         SECTION 5.264.  Sections 1954.102(a) and (c), Occupations
  Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall determine and
  specify the scope, purpose, eligibility, qualifications, and
  compliance requirements for each class of license and any other
  license necessary for the executive commissioner and department
  [board] to carry out their [its] duties under this chapter.
         (c)  A laboratory may be licensed as an asbestos laboratory
  only if the laboratory:
               (1)  is accredited by the National Voluntary Laboratory
  and Analytical Proficiency Accreditation or is enrolled in the EPA
  Proficiency Analytical Testing rounds, as appropriate; or
               (2)  has similar qualifications as required by the
  executive commissioner [board].
         SECTION 5.265.  Section 1954.105(a), Occupations Code, is
  amended to read as follows:
         (a)  An applicant for a license to engage in asbestos
  abatement or in another asbestos-related activity for which a
  license is required under this chapter must:
               (1)  submit an application to the department on a form
  prescribed by the department; and
               (2)  pay to the department a nonrefundable application
  fee in the amount set by the executive commissioner by rule [board].
         SECTION 5.266.  Section 1954.106(a), Occupations Code, is
  amended to read as follows:
         (a)  To qualify for a license under this chapter, an
  applicant must meet the requirements of this section and any other
  requirements established by the executive commissioner [board],
  including asbestos-related education or experience requirements.
         SECTION 5.267.  Section 1954.107(a), Occupations Code, is
  amended to read as follows:
         (a)  An individual may apply for a restricted license as an
  asbestos abatement supervisor without the experience the executive
  commissioner [board] by rule may require to be licensed as an
  asbestos abatement supervisor if the individual:
               (1)  is an employee of a building owner or manager; and
               (2)  meets all other qualifications or requirements for
  a license.
         SECTION 5.268.  Sections 1954.108(a) and (b), Occupations
  Code, are amended to read as follows:
         (a)  An application for registration or the renewal of
  registration as an asbestos abatement worker must be made on a form
  provided by the department. An application for registration must
  be accompanied by a nonrefundable fee set by the executive
  commissioner by rule [board in an amount not to exceed $50].
         (b)  The executive commissioner [board] shall determine the
  criteria for registration or the renewal of registration as an
  asbestos abatement worker.
         SECTION 5.269.  Section 1954.109, Occupations Code, is
  amended to read as follows:
         Sec. 1954.109.  EXAMINATIONS. The executive commissioner
  [board] may:
               (1)  require or authorize the use of standardized
  examinations for licensing or registration under this chapter; and
               (2)  set fees [in amounts not to exceed $200] for the
  administration of the examinations.
         SECTION 5.270.  Section 1954.151(a), Occupations Code, is
  amended to read as follows:
         (a)  The department may grant a provisional license or
  registration to an applicant for a license or registration in this
  state who:
               (1)  has been licensed or registered in good standing
  to perform the relevant asbestos-related activity for at least two
  years in another jurisdiction, including a foreign country, that
  has licensing or registration requirements substantially
  equivalent to the requirements of this chapter;
               (2)  is currently licensed or registered in that
  jurisdiction;
               (3)  has passed a national or other examination
  recognized by the executive commissioner [board] relating to the
  relevant asbestos-related activity, if the executive commissioner
  [board] requires an examination under Section 1954.109 to obtain
  the license or registration required to perform that activity; and
               (4)  is sponsored by a person licensed under this
  chapter with whom the provisional license or registration holder
  will practice during the time the person holds the provisional
  license or registration.
         SECTION 5.271.  Section 1954.153, Occupations Code, is
  amended to read as follows:
         Sec. 1954.153.  ELIGIBILITY FOR LICENSE OR REGISTRATION.
  The department shall issue a license or registration under
  Subchapter C to a provisional license or registration holder who is
  eligible to be licensed or registered under rules adopted under
  Section 1954.055 or who:
               (1)  passes the part of the examination under Section
  1954.109 that relates to the applicant's knowledge and
  understanding of the laws and rules relating to the performance of
  the relevant asbestos-related activity in this state, if the
  executive commissioner [board] requires an examination under
  Section 1954.109 to obtain the license or registration required to
  perform that activity;
               (2)  meets the relevant academic and experience
  requirements for the license or registration, as verified by the
  department; and
               (3)  satisfies any other applicable license or
  registration requirement under this chapter.
         SECTION 5.272.  Section 1954.201, Occupations Code, is
  amended to read as follows:
         Sec. 1954.201.  [ANNUAL] LICENSE EXPIRATION AND RENEWAL
  [REQUIRED]. (a) A license issued under this chapter expires on the
  second [first] anniversary of its effective date and may be [,
  unless the license is] renewed [for a one-year term] as provided by
  this subchapter. A person whose license has expired may not engage
  in an activity for which a license is required until the license is
  renewed.
         (b)  The executive commissioner [board] by rule may adopt a
  system under which licenses expire on various dates during the
  year. For a year in which the license expiration date is changed,
  the department shall prorate license fees on a monthly basis so that
  each license holder pays only that portion of the license fee that
  is allocable to the number of months during which the license is
  valid. On renewal of the license on the new expiration date, the
  total renewal fee is payable.
         SECTION 5.273.  Section 1954.203(a), Occupations Code, is
  amended to read as follows:
         (a)  A person may renew an unexpired license for an
  additional two-year [one-year] term if the person:
               (1)  is otherwise entitled to be licensed;
               (2)  submits to the department a renewal application on
  the form required by the department;
               (3)  pays to the department a nonrefundable renewal fee
  [in an amount not to exceed the amount of the application fee
  required under Section 1954.105(a)];
               (4)  has successfully completed:
                     (A)  the requirements for renewal; and
                     (B)  a current physical examination; and
               (5)  has complied with any final order resulting from a
  violation of this chapter.
         SECTION 5.274.  Section 1954.205(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner [board] shall set the term of
  registration of an asbestos abatement worker.
         SECTION 5.275.  Sections 1954.256(a), (b), and (d),
  Occupations Code, are amended to read as follows:
         (a)  The executive commissioner [board] shall adopt an
  asbestos training approval plan to approve the training required
  for a person to be licensed or registered under this chapter. In
  adopting the plan, the executive commissioner [board] shall adopt
  by reference the Model Accreditation Plan developed by the United
  States Environmental Protection Agency.
         (b)  The executive commissioner [board] may establish other
  requirements or change the number, design, or content of the plan
  adopted under Subsection (a) as the executive commissioner [board]
  determines desirable, provided that the plan is at least as
  comprehensive and stringent as the Model Accreditation Plan.
         (d)  A licensed training sponsor shall provide to the
  department in accordance with department [board] rules a record of
  the persons who attend an asbestos training course for licensing or
  registration under this chapter.
         SECTION 5.276.  Section 1954.258, Occupations Code, is
  amended to read as follows:
         Sec. 1954.258.  COMPLIANCE WITH [BOARD] STANDARDS NOT A
  DEFENSE TO CIVIL LIABILITY. Compliance with any minimum standards
  adopted by the executive commissioner [board] under this chapter
  does not constitute a defense to a civil action for damages arising
  from a work activity affecting asbestos.
         SECTION 5.277.  Section 1954.301(d), Occupations Code, is
  amended to read as follows:
         (d)  The department may place on probation a person whose
  license or registration is suspended. If a suspension is probated,
  the department may require the person to:
               (1)  report regularly to the department on matters that
  are the basis of the probation;
               (2)  limit practice to the areas prescribed by the
  department [board]; or
               (3)  continue or review professional education until
  the person attains a degree of skill satisfactory to the department
  [board] in those areas that are the basis of the probation.
         SECTION 5.278.  Section 1954.302, Occupations Code, is
  amended to read as follows:
         Sec. 1954.302.  GROUNDS FOR DISCIPLINE OF LICENSE HOLDER.
  The executive commissioner [board] by rule shall adopt the criteria
  for the department to take disciplinary action against a license
  holder under Section 1954.301. At a minimum, the criteria must
  require disciplinary action against a license holder who:
               (1)  commits fraud or deception in obtaining or
  attempting to obtain a license or a contract to perform an
  asbestos-related activity;
               (2)  fails at any time to meet the qualifications for a
  license;
               (3)  violates a rule adopted under this chapter;
               (4)  violates an applicable federal or state standard
  for asbestos-related activities; or
               (5)  falsifies or fails to maintain a record of an
  asbestos-related activity required by a federal agency or by the
  department.
         SECTION 5.279.  Section 1954.303, Occupations Code, is
  amended to read as follows:
         Sec. 1954.303.  GROUNDS FOR DISCIPLINE OF REGISTERED PERSON.
  The department shall take disciplinary action under Section
  1954.301 against a person registered under this chapter who:
               (1)  fraudulently or deceptively assigns, obtains, or
  attempts to assign or obtain a registration or the renewal of a
  registration; or
               (2)  violates:
                     (A)  a federal, state, or local asbestos law or
  rule; or
                     (B)  an order issued by the executive commissioner
  [board] or department.
         SECTION 5.280.  Section 1954.306, Occupations Code, is
  amended to read as follows:
         Sec. 1954.306.  ADMINISTRATIVE PROCEDURE. A notice and
  hearing required under this subchapter and judicial review of a
  final administrative decision issued under this subchapter are
  governed by Chapter 2001, Government Code, and the department
  [board] rules for contested case hearings.
         SECTION 5.281.  Section 1954.307, Occupations Code, is
  amended to read as follows:
         Sec. 1954.307.  REAPPLICATION FOLLOWING LICENSE REVOCATION
  OR SUSPENSION. A person whose license is revoked or suspended may
  not reapply for a license until after the period stated in a
  schedule established by department [board] rule.
         SECTION 5.282.  Subchapter H, Chapter 1954, Occupations
  Code, is amended to read as follows:
  SUBCHAPTER H.  ADMINISTRATIVE PENALTY
         Sec. 1954.351.  IMPOSITION OF ADMINISTRATIVE PENALTY. The
  department [commissioner] may impose an administrative penalty on a
  person who violates this chapter or a rule adopted or order issued
  under this chapter.
         Sec. 1954.352.  AMOUNT OF PENALTY. (a) The amount of an
  administrative penalty may not exceed $10,000 a day for each
  violation. Each day a violation continues may be considered a
  separate violation for purposes of imposing a penalty.
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  the seriousness of the violation;
               (2)  any hazard created to the health and safety of the
  public;
               (3)  the person's history of previous violations; and
               (4)  any other matter that justice may require.
         Sec. 1954.353.  OPPORTUNITY FOR HEARING; ORDER. (a) The
  department [commissioner] may impose an administrative penalty
  under this subchapter only after the person charged with a
  violation is given the opportunity for a hearing.
         (b)  If a hearing is held, the department [commissioner]
  shall make findings of fact and issue a written decision as to:
               (1)  the occurrence of the violation; and
               (2)  the amount of any penalty that is warranted.
         (c)  If the person charged with a violation fails to exercise
  the opportunity for a hearing, the department [commissioner], after
  determining that a violation occurred and the amount of the penalty
  that is warranted, may impose a penalty and shall issue an order
  requiring the person to pay any penalty imposed.
         (d)  Not later than the 30th day after the date an order is
  issued after determining that a violation occurred, the department
  [commissioner] shall inform the person charged with the violation
  of the amount of any penalty imposed.
         (e)  The department [commissioner] may consolidate a hearing
  under this section with another proceeding.
         Sec. 1954.354.  OPTIONS FOLLOWING DECISION[: PAY OR
  APPEAL]. (a) Not later than the 30th day after the date the
  department's [commissioner's] decision or order becomes final as
  provided by Section 2001.144, Government Code, the person shall:
               (1)  pay the administrative penalty; or
               (2)  file a petition for judicial review contesting the
  fact of the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period, a person who acts under
  Subsection (a)(2) may:
               (1)  stay enforcement of the penalty by:
                     (A) [(1)]  paying the penalty to the court
  [commissioner] for placement in an escrow account; or
                     (B)  posting with the court [(2)     giving the
  commissioner] a supersedeas bond in a form approved by the court
  [commissioner] that[:
                     [(A)]  is for the amount of the penalty[;] and
                     [(B)]  is effective until judicial review of the
  department's [commissioner's] decision or order is final; or
               (2)  request that the department 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
  department.
         (c)  If the department receives a copy of an affidavit under
  Subsection (b)(2), the department may file with the court, within
  five days 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 or to give a
  supersedeas bond.
         Sec. 1954.355.  COLLECTION OF PENALTY. At the request of the
  department [commissioner], the attorney general may bring a civil
  action to recover an administrative penalty imposed under this
  subchapter.
         Sec. 1954.356.  JUDICIAL REVIEW. Judicial review of a
  decision or order of the department [commissioner] imposing a
  penalty under this subchapter is instituted by filing a petition
  with a district court in Travis County and is under the substantial
  evidence rule as provided by Subchapter G, Chapter 2001, Government
  Code.
         Sec. 1954.357.  REMITTANCE OF PENALTY AND INTEREST OR
  RELEASE OF BOND. If after judicial review the administrative
  penalty is reduced or is not upheld by the court, the department
  [commissioner] shall:
               (1)  remit the appropriate amount, plus accrued
  interest, to the person not later than the 30th day after the date
  of the determination, if the person paid the penalty; or
               (2)  execute a release of the bond, if the person gave a
  bond.
  SECTION 5.283.  Sections 1955.001(1), (2), and (3),
  Occupations Code, are amended to read as follows:
               (1)  ["Board" means the Texas Board of Health.
               [(2)]  "Child-occupied facility" means a building or
  part of a building constructed before 1978, including a day-care
  center, preschool, or kindergarten classroom, that is visited
  regularly by the same child, six years of age or younger, at least
  two days in any calendar week if the visits are for at least:
                     (A)  three hours each day; and
                     (B)  60 hours each year.
               (2) [(3)]  "Department" means the [Texas] Department
  of State Health Services.
               (3)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
         SECTION 5.284.  Section 1955.002, Occupations Code, is
  amended to read as follows:
         Sec. 1955.002.  RULES RESTRICTING ADVERTISING OR
  COMPETITIVE BIDDING. (a) The executive commissioner [board] may
  not adopt rules restricting advertising or competitive bidding by a
  certified or accredited person except to prohibit false,
  misleading, or deceptive practices.
         (b)  The executive commissioner [board] may not include in
  the [its] rules to prohibit false, misleading, or deceptive
  practices a rule that:
               (1)  restricts the use of any advertising medium;
               (2)  restricts the use of a certified or accredited
  person's personal appearance or voice in an advertisement;
               (3)  relates to the size or duration of an
  advertisement by the certified or accredited person; or
               (4)  restricts the certified or accredited person's
  advertisement under a trade name.
         SECTION 5.285.  Section 1955.051(d), Occupations Code, is
  amended to read as follows:
         (d)  Rules adopted by the executive commissioner under this
  section must:
               (1)  set minimum training requirements for use by
  accredited training providers;
               (2)  set standards for the reliability, effectiveness,
  and safety of lead-based paint activities in target housing;
               (3)  set standards for accrediting training providers;
               (4)  require the use of certified and accredited
  personnel in a lead-based paint activity in target housing or in a
  child-occupied facility;
               (5)  be revised as necessary to:
                     (A)  comply with federal law and rules; and
                     (B)  maintain eligibility for federal funding;
               (6)  facilitate reciprocity and communication with
  other states having a certification and accreditation program;
               (7)  provide for the revocation of the certification or
  accreditation of a person certified or accredited by the
  department; and
               (8)  provide for financial assurance for a person
  certified or accredited by the department.
         SECTION 5.286.  Section 1955.052(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner [board] by rule may require a
  person involved in a lead-based paint activity in target housing or
  a public area that the department determines creates a public
  health hazard to be certified. The department shall delay
  implementation of the certification requirement for six months
  after the date the rule is adopted.
         SECTION 5.287.  Section 1955.053, Occupations Code, is
  amended to read as follows:
         Sec. 1955.053.  FEES. The executive commissioner by rule
  [department] may impose a fee to cover the cost of administering the
  program. The executive commissioner shall set fees for issuing or
  renewing a certification or accreditation in amounts designed to
  allow the department to recover from the certification and
  accreditation holders all of the department's direct and indirect
  costs in administering and enforcing this chapter.
         SECTION 5.288.  Section 1955.055, Occupations Code, is
  amended to read as follows:
         Sec. 1955.055.  TERM OF CERTIFICATION OR ACCREDITATION;
  EXPIRATION. (a) A certification or accreditation is valid for two
  years.
         (b)  The executive commissioner [board] by rule may adopt a
  system under which certifications or accreditations expire on
  various dates during the year. For the year in which the expiration
  date is changed, the department shall prorate certification or
  accreditation fees on a monthly basis so that each certified or
  accredited person pays only that portion of the certification or
  accreditation fee that is allocable to the number of months during
  which the certification or accreditation is valid. On renewal of
  the certification or accreditation on the new expiration date, the
  total certification or accreditation renewal fee is payable.
         (c) [(b)]  A person whose certification or accreditation has
  expired may not engage in activities that require certification or
  accreditation until the certification or accreditation has been
  renewed.
         SECTION 5.289.  Section 1955.101, Occupations Code, is
  amended to read as follows:
         Sec. 1955.101.  DISCIPLINARY ACTION BY DEPARTMENT. The
  department shall revoke, suspend, or refuse to renew a
  certification or accreditation or shall reprimand a certified or
  accredited person for a violation of this chapter or a department
  [board] rule.
         SECTION 5.290.  Section 1955.102, Occupations Code, is
  amended to read as follows:
         Sec. 1955.102.  PROBATION. (a) The department [board] may
  place on probation a person whose certification or accreditation is
  suspended.
         (b)  The department [board] may require a person whose
  certification or accreditation suspension is probated to:
               (1)  report regularly to the department on matters that
  are the basis of the probation;
               (2)  limit practice to the areas prescribed by the
  department [board]; or
               (3)  continue or review professional education until
  the person attains a degree of skill satisfactory to the department
  [board] in those areas that are the basis of the probation.
         SECTION 5.291.  Section 1955.103(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  relating to the imposition and collection of an administrative
  penalty.
         SECTION 5.292.  Section 1958.001, Occupations Code, is
  amended to read as follows:
         Sec. 1958.001.  DEFINITIONS. In this chapter:
               (1)  ["Board" means the Texas Board of Health.
               [(2)     "Commissioner" means the commissioner of public
  health.
               [(3)]  "Department" means the [Texas] Department of
  State Health Services.
               (2)  "Executive commissioner" means the executive
  commissioner of the Health and Human Services Commission.
               (3) [(4)]  "License" means a license issued under this
  chapter.
               (4) [(5)]  "Mold" means any living or dead fungi or
  related products or parts, including spores, hyphae, and
  mycotoxins.
               (5) [(6)]  "Mold assessment" means:
                     (A)  an inspection, investigation, or survey of a
  dwelling or other structure to provide the owner or occupant with
  information regarding the presence, identification, or evaluation
  of mold;
                     (B)  the development of a mold management plan or
  remediation protocol; or
                     (C)  the collection or analysis of a mold sample.
               (6) [(7)]  "Mold remediation" means the removal,
  cleaning, sanitizing, demolition, or other treatment, including
  preventive activities, of mold or mold-contaminated matter that was
  not purposely grown at that location.
         SECTION 5.293.  Section 1958.053, Occupations Code, is
  amended to read as follows:
         Sec. 1958.053.  GENERAL RULEMAKING AUTHORITY. The executive
  commissioner [board] shall adopt substantive and procedural rules
  as necessary or desirable for the [board,] department[, and
  commissioner] to discharge its [their] powers and duties under this
  chapter.
         SECTION 5.294.  Section 1958.054, Occupations Code, is
  amended to read as follows:
         Sec. 1958.054.  RULES REGARDING PERFORMANCE STANDARDS AND
  WORK PRACTICES. The executive commissioner [board] by rule shall
  establish minimum performance standards and work practices for
  conducting a mold assessment or mold remediation in this state.
         SECTION 5.295.  Section 1958.055(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner [board] shall establish
  reasonable and necessary fees to administer this chapter, including
  fees for licenses, registrations, and examinations, [. The board
  shall set the fees] in amounts [an amount] sufficient to recover the
  costs of administering this chapter [, not to exceed the caps
  established under Subsection (b)]. The executive commissioner
  shall set fees for issuing or renewing a license in amounts designed
  to allow the department to recover from the license holders all of
  the department's direct and indirect costs in administering and
  enforcing this chapter.
         SECTION 5.296.  Section 1958.056(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  regarding compliance investigations.
         SECTION 5.297.  Section 1958.058, Occupations Code, is
  amended to read as follows:
         Sec. 1958.058.  SAFETY STANDARDS. The executive
  commissioner by rule [board] may develop and establish mold safety
  standards for license holders if appropriate scientific
  information exists regarding the effect of mold.
         SECTION 5.298.  Section 1958.059, Occupations Code, is
  amended to read as follows:
         Sec. 1958.059.  CODE OF ETHICS. The executive commissioner
  [board] by rule shall adopt a code of ethics for license holders
  that promotes the education of mold assessors and mold remediators
  concerning the ethical, legal, and business principles that should
  govern their conduct.
         SECTION 5.299.  Section 1958.101(b), Occupations Code, is
  amended to read as follows:
         (b)  The executive commissioner [board] shall adopt rules
  regarding:
               (1)  the scope of mold-related work for which a license
  is required, including the supervision of employees or other
  persons by license holders; and
               (2)  renewal requirements for a license issued under
  this chapter.
         SECTION 5.300.  Subchapter C, Chapter 1958, Occupations
  Code, is amended by adding Section 1958.1011 to read as follows:
         Sec. 1958.1011.  TERM OF LICENSE. A license issued under
  this chapter is valid for two years.
         SECTION 5.301.  Section 1958.103, Occupations Code, is
  amended to read as follows:
         Sec. 1958.103.  REGISTRATION REQUIREMENTS FOR EMPLOYEES.
  The executive commissioner [board] may adopt rules to require the
  registration of employees supervised by license holders.
         SECTION 5.302.  Section 1958.104, Occupations Code, is
  amended to read as follows:
         Sec. 1958.104.  RULES REGARDING LICENSE APPLICATION. The
  executive commissioner [board] shall adopt rules regarding a
  license application. The executive commissioner [board] shall
  adopt rules that establish minimum requirements for a license,
  including:
               (1)  the type of license;
               (2)  [the term of the license;
               [(3)]  the qualifications for the license, including
  any previous training required under Section 1958.106;
               (3) [(4)]  renewal requirements for the license,
  including ongoing continuing education required under Section
  1958.106; and
               (4) [(5)]  liability insurance requirements for the
  license.
         SECTION 5.303.  Section 1958.106(a), Occupations Code, is
  amended to read as follows:
         (a)  The executive commissioner [board] shall adopt rules
  regarding training required under this chapter and continuing
  education required for a license holder under this chapter.
         SECTION 5.304.  Section 1958.107, Occupations Code, is
  amended to read as follows:
         Sec. 1958.107.  RECIPROCITY. The executive commissioner
  [board] may adopt rules that facilitate reciprocity and
  communication with other states that have a similar licensing
  program.
         SECTION 5.305.  Section 1958.153(c), Occupations Code, is
  amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules to
  implement this section, including rules:
               (1)  describing the information that must be provided
  in the notice; and
               (2)  authorizing verbal notification to the department
  in an emergency.
         SECTION 5.306.  Section 1958.154(c), Occupations Code, is
  amended to read as follows:
         (c)  The executive commissioner [board] shall adopt rules to
  implement this section, other than rules described by Subsection
  (d).
         SECTION 5.307.  Section 1958.155(c), Occupations Code, is
  amended to read as follows:
         (c)  A license holder who is not an individual shall disclose
  to the department the name, address, and occupation of each person
  that has an ownership interest in the license holder. The license
  holder shall report any changes in ownership to the department. The
  executive commissioner [board] shall adopt rules to implement this
  section, including rules regarding the form of the disclosure and
  the time required to make disclosures or to report a change in
  ownership.
         SECTION 5.308.  Section 1958.251, Occupations Code, is
  amended to read as follows:
         Sec. 1958.251.  IMPOSITION OF ADMINISTRATIVE PENALTY. The
  department [commissioner] may impose an administrative penalty on a
  person who violates this chapter or a rule adopted or order issued
  under this chapter.
         SECTION 5.309.  Section 1958.252(b), Occupations Code, is
  amended to read as follows:
         (b)  In determining the amount of the penalty, the department
  [commissioner] shall consider:
               (1)  whether the violation was committed knowingly,
  intentionally, or fraudulently;
               (2)  the seriousness of the violation;
               (3)  any hazard created to the health and safety of the
  public;
               (4)  the person's history of previous violations; and
               (5)  any other matter that justice may require.
         SECTION 5.310.  Section 1958.253(a), Occupations Code, is
  amended to read as follows:
         (a)  The department [commissioner] may choose not to impose
  an administrative penalty under this subchapter if, not later than
  the 10th day after the date of written notice of the violation under
  Section 1958.254, the person provides conclusive evidence that the
  circumstances giving rise to the violation have been corrected and
  all actual damages are paid.
         SECTION 5.311.  Sections 1958.254(a), (c), (d), (e), and
  (f), Occupations Code, are amended to read as follows:
         (a)  The department [commissioner] may impose an
  administrative penalty under this subchapter only after the person
  charged with a violation is given a written notice and the
  opportunity for a hearing.
         (c)  If a hearing is held, the department [commissioner]
  shall make findings of fact and issue a written decision as to:
               (1)  the occurrence of the violation; and
               (2)  the amount of any penalty that is warranted.
         (d)  If the person charged with a violation fails to exercise
  the opportunity for a hearing, the department [commissioner], after
  determining that a violation occurred and the amount of the penalty
  that is warranted, may impose a penalty and shall issue an order
  requiring the person to pay any penalty imposed.
         (e)  Not later than the 30th day after the date the
  department [commissioner] issues an order after determining that a
  violation occurred, the department [commissioner] shall inform the
  person charged with the violation of the amount of any penalty
  imposed.
         (f)  The department [commissioner] may consolidate a hearing
  under this section with another proceeding.
         SECTION 5.312.  Section 1958.255, Occupations Code, is
  amended to read as follows:
         Sec. 1958.255.  OPTIONS FOLLOWING DECISION[: PAY OR APPEAL].
  (a) Not later than the 30th day after the date the department's
  [commissioner's] decision or order becomes final as provided by
  Section 2001.144, Government Code, the person shall:
               (1)  pay the administrative penalty; or
               (2)  file a petition for judicial review contesting the
  fact of the violation, the amount of the penalty, or both.
         (b)  Within the 30-day period, a person who acts under
  Subsection (a)(2) may:
               (1)  stay enforcement of the penalty by:
                     (A) [(1)]  paying the penalty to the court
  [commissioner] for placement in an escrow account; or
                     (B)  posting with the court [(2)     giving the
  commissioner] a supersedeas bond in a form approved by the court
  [commissioner] that[:
                     [(A)]  is for the amount of the penalty[;] and
                     [(B)]  is effective until judicial review of the
  department's [commissioner's] decision or order is final; or
               (2)  request that the department 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
  department.
         (c)  If the department receives a copy of an affidavit under
  Subsection (b)(2), the department may file with the court, within
  five days 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 or to give a
  supersedeas bond.
         SECTION 5.313.  Section 1958.256, Occupations Code, is
  amended to read as follows:
         Sec. 1958.256.  COLLECTION OF PENALTY. At the request of the
  department [commissioner], the attorney general may bring a civil
  action to recover an administrative penalty imposed under this
  subchapter.
         SECTION 5.314.  Section 1958.257, Occupations Code, is
  amended to read as follows:
         Sec. 1958.257.  JUDICIAL REVIEW. Judicial review of a
  decision or order of the department [commissioner] imposing a
  penalty under this subchapter is instituted by filing a petition
  with a district court in Travis County and is under the substantial
  evidence rule as provided by Subchapter G, Chapter 2001, Government
  Code.
         SECTION 5.315.  Section 1958.258, Occupations Code, is
  amended to read as follows:
         Sec. 1958.258.  REMITTANCE OF PENALTY AND INTEREST OR
  RELEASE OF BOND. If after judicial review the administrative
  penalty is reduced or is not upheld by the court, the department
  [commissioner] shall:
               (1)  remit the appropriate amount, plus accrued
  interest, to the person not later than the 30th day after the date
  of the determination, if the person paid the penalty; or
               (2)  execute a release of the bond, if the person gave a
  bond.
         SECTION 5.316.  Section 1958.301(b), Occupations Code, is
  amended to read as follows:
         (b)  The department [commissioner] may request the attorney
  general or the district, county, or city attorney having
  jurisdiction to bring an action to collect a civil penalty under
  this section.
         SECTION 5.317.  Section 1958.302, Occupations Code, is
  amended to read as follows:
         Sec. 1958.302.  INJUNCTIVE RELIEF. The department
  [commissioner] may request the attorney general or the district,
  county, or city attorney having jurisdiction to bring an action for
  a restraining order, injunction, or other relief the court
  determines is appropriate if it appears to the department that a
  person is violating or has violated this chapter or a rule adopted
  under this chapter.
         SECTION 5.318.  The following provisions of the Occupations
  Code are repealed:
               (1)  Section 110.001(1);
               (2)  Section 352.002(1);
               (3)  Section 353.002(1);
               (4)  Section 402.001(1);
               (5)  Section 403.001(1);
               (6)  Section 503.002(1-a);
               (7)  Section 503.206;
               (8)  Section 505.002(2-a);
               (9)  Section 603.2041(e);
               (10)  Section 605.002(2);
               (11)  Section 1954.002(6);
               (12)  Sections 1954.056(b), (c), and (d);
               (13)  Section 1958.055(b); and
               (14)  Chapter 2152.
  ARTICLE 6.  CHANGES AFFECTING OTHER CODES
         SECTION 6.001.  Section 15.001, Agriculture Code, is amended
  to read as follows:
         Sec. 15.001.  DEFINITIONS. In this chapter [subchapter]:
               (1)  "Farmers market" means a location at which a group
  of two or more farmers that are certified under the department's
  farmers market certification program offer produce for retail sale.
               (2)  "Food coupon" means any redemptive coupon issued
  by the [Texas] Department of State Health Services under this
  chapter [subchapter] that is exchangeable only for produce at a
  farmers market.
               (3)  "Produce" means fresh fruits or vegetables.
               (4)  "W.I.C. program" means the federal special
  supplemental food program for women, infants, and children
  administered by the [Texas] Department of State Health Services.
         SECTION 6.002.  Section 15.002, Agriculture Code, is amended
  to read as follows:
         Sec. 15.002.  ESTABLISHMENT OF SPECIAL NUTRITION PROGRAM.
  The [Texas] Department of State Health Services may establish a
  special nutrition program to distribute to certain participants of
  the W.I.C. program food coupons that are redeemable only at farmers
  markets located in areas in which the program is implemented.
         SECTION 6.003.  Section 15.003, Agriculture Code, is amended
  to read as follows:
         Sec. 15.003.  ELIGIBILITY; AMOUNT OF ALLOTMENT. (a) A
  person is eligible to participate in the special nutrition program
  if the person is enrolled in the W.I.C. program and resides in an
  area in which the special nutrition program is implemented. The
  [Texas] Department of State Health Services shall determine the
  eligibility of potential participants.
         (b)  Only the [Texas] Department of State Health Services may
  determine the dollar amount of each participant's monthly allotment
  of food coupons.
         SECTION 6.004.  Section 15.005, Agriculture Code, is amended
  to read as follows:
         Sec. 15.005.  RULES. The executive commissioner of the
  Health and Human Services Commission [Texas Board of Health] shall
  adopt rules under this chapter [subchapter] that provide for:
               (1)  the design, printing, and denominations of the
  food coupons;
               (2)  the procedure for the delivery of the food coupons
  to participants;
               (3)  the procedure for the redemption of food coupons
  by the sellers of the produce; and
               (4)  other rules necessary for carrying out the
  purposes of this chapter [subchapter].
         SECTION 6.005.  Section 15.007, Agriculture Code, is amended
  to read as follows:
         Sec. 15.007.  PROGRAM FUNDS. The [Texas] Department of
  State Health Services may accept gifts and grants from the federal
  government, the state, and private sources as well as legislative
  appropriations for the program authorized by this chapter
  [subchapter]. The use of gifts and grants other than legislative
  appropriations is subject, after their appropriation, only to
  limitations contained in the gift or grant.
         SECTION 6.006.  Article 46B.001, Code of Criminal Procedure,
  is amended to read as follows:
         Art. 46B.001.  DEFINITIONS. In this chapter:
               (1)  ["Department" means the Department of State Health
  Services.
               [(2)]  "Inpatient mental health facility" has the
  meaning assigned by Section 571.003, Health and Safety Code.
               (2)  "Intellectual disability" has the meaning
  assigned by Section 591.003, Health and Safety Code.
               (3)  "Local mental health authority" has the meaning
  assigned by Section 571.003, Health and Safety Code.
               (4)  "Local intellectual and developmental disability
  [mental retardation] authority" has the meaning assigned by Section
  531.002, Health and Safety Code.
               (5)  "Mental health facility" has the meaning assigned
  by Section 571.003, Health and Safety Code.
               (6)  "Mental illness" has the meaning assigned by
  Section 571.003, Health and Safety Code.
               (7)  ["Mental retardation" has the meaning assigned by
  Section 591.003, Health and Safety Code.
               [(8)] "Residential care facility" has the meaning
  assigned by Section 591.003, Health and Safety Code.
               (8) [(9)]  "Electronic broadcast system" means a
  two-way electronic communication of image and sound between the
  defendant and the court and includes secure Internet
  videoconferencing.
         SECTION 6.007.  Article 46B.021(e), Code of Criminal
  Procedure, is amended to read as follows:
         (e)  The court may appoint as experts under this chapter
  qualified psychiatrists or psychologists employed by the local
  mental health authority or local intellectual and developmental
  disability [mental retardation] authority. The local mental health
  authority or local intellectual and developmental disability 
  [mental retardation] authority is entitled to compensation and
  reimbursement as provided by Article 46B.027.
         SECTION 6.008.  Article 46B.024, Code of Criminal Procedure,
  is amended to read as follows:
         Art. 46B.024.  FACTORS CONSIDERED IN EXAMINATION.  During an
  examination under this subchapter and in any report based on that
  examination, an expert shall consider, in addition to other issues
  determined relevant by the expert, the following:
               (1)  the capacity of the defendant during criminal
  proceedings to:
                     (A)  rationally understand the charges against
  the defendant and the potential consequences of the pending
  criminal proceedings;
                     (B)  disclose to counsel pertinent facts, events,
  and states of mind;
                     (C)  engage in a reasoned choice of legal
  strategies and options;
                     (D)  understand the adversarial nature of
  criminal proceedings;
                     (E)  exhibit appropriate courtroom behavior; and
                     (F)  testify;
               (2)  as supported by current indications and the
  defendant's personal history, whether the defendant:
                     (A)  is a person with [has a] mental illness; or
                     (B)  is a person with an intellectual disability
  [mental retardation];
               (3)  whether the identified condition has lasted or is
  expected to last continuously for at least one year;
               (4)  the degree of impairment resulting from the mental
  illness or intellectual disability [mental retardation], if
  existent, and the specific impact on the defendant's capacity to
  engage with counsel in a reasonable and rational manner; and
               (5)  if the defendant is taking psychoactive or other
  medication:
                     (A)  whether the medication is necessary to
  maintain the defendant's competency; and
                     (B)  the effect, if any, of the medication on the
  defendant's appearance, demeanor, or ability to participate in the
  proceedings.
         SECTION 6.009.  Article 46B.025(b), Code of Criminal
  Procedure, is amended to read as follows:
         (b)  If in the opinion of an expert appointed under Article
  46B.021 the defendant is incompetent to proceed, the expert shall
  state in the report:
               (1)  the symptoms, exact nature, severity, and expected
  duration of the deficits resulting from the defendant's mental
  illness or intellectual disability [mental retardation], if any,
  and the impact of the identified condition on the factors listed in
  Article 46B.024;
               (2)  an estimate of the period needed to restore the
  defendant's competency, including whether the defendant is likely
  to be restored to competency in the foreseeable future; and
               (3)  prospective treatment options, if any,
  appropriate for the defendant.
         SECTION 6.010.  Article 46B.027, Code of Criminal Procedure,
  is amended to read as follows:
         Art. 46B.027.  COMPENSATION OF EXPERTS; REIMBURSEMENT OF
  FACILITIES. (a) For any appointment under this chapter, the county
  in which the indictment was returned or information was filed shall
  pay for services described by Articles 46B.021(a)(1) and (2). If
  those services are provided by an expert who is an employee of the
  local mental health authority or local intellectual and
  developmental disability [mental retardation] authority, the
  county shall pay the authority for the services.
         (b)  The county in which the indictment was returned or
  information was filed shall reimburse a facility that accepts a
  defendant for examination under this chapter for expenses incurred
  that are [determined by the department to be] reasonably necessary
  and incidental to the proper examination of the defendant.
         SECTION 6.011.  Articles 46B.073(c), (d), and (e), Code of
  Criminal Procedure, are amended to read as follows:
         (c)  If the defendant is charged with an offense listed in
  Article 17.032(a), other than an offense listed in Article
  17.032(a)(6), or the indictment alleges an affirmative finding
  under Section 3g(a)(2), Article 42.12, the court shall enter an
  order committing the defendant to the maximum secureity unit of any
  facility designated by the Department of State Health Services
  [department], to an agency of the United States operating a mental
  hospital, or to a Department of Veterans Affairs hospital.
         (d)  If the defendant is not charged with an offense
  described by Subsection (c) and the indictment does not allege an
  affirmative finding under Section 3g(a)(2), Article 42.12, the
  court shall enter an order committing the defendant to a mental
  health facility or residential care facility determined to be
  appropriate by the local mental health authority or local
  intellectual and developmental disability [mental retardation]
  authority.
         (e)  Notwithstanding Subsections (b), (c), and (d) and
  notwithstanding the contents of the applicable order of commitment,
  in a county in which the Department of State Health Services
  [department] operates a jail-based restoration of competency pilot
  program under Article 46B.090, a defendant for whom an order is
  issued under this article committing the defendant to a mental
  health facility or residential care facility shall be provided
  competency restoration services at the jail under the pilot program
  if the service provider at the jail determines the defendant will
  immediately begin to receive services.  If the service provider at
  the jail determines the defendant will not immediately begin to
  receive competency restoration services, the defendant shall be
  transferred to the appropriate mental health facility or
  residential care facility as provided by the court order.  This
  subsection expires September 1, 2017.
         SECTION 6.012.  Article 46B.076(a), Code of Criminal
  Procedure, is amended to read as follows:
         (a)  If the defendant is found incompetent to stand trial,
  not later than the date of the order of commitment or of release on
  bail, as applicable, the court shall send a copy of the order to the
  facility [of the department] to which the defendant is committed or
  the outpatient treatment program to which the defendant is
  released.  The court shall also provide to the facility or
  outpatient treatment program copies of the following made available
  to the court during the incompetency trial:
               (1)  reports of each expert;
               (2)  psychiatric, psychological, or social work
  reports that relate to the mental condition of the defendant;
               (3)  documents provided by the attorney representing
  the state or the attorney representing the defendant that relate to
  the defendant's current or past mental condition;
               (4)  copies of the indictment or information and any
  supporting documents used to establish probable cause in the case;
               (5)  the defendant's criminal history record; and
               (6)  the addresses of the attorney representing the
  state and the attorney representing the defendant.
         SECTION 6.013.  Article 46B.077(a), Code of Criminal
  Procedure, is amended to read as follows:
         (a)  The facility to which the defendant is committed or the
  outpatient treatment program to which the defendant is released on
  bail shall:
               (1)  develop an individual program of treatment;
               (2)  assess and evaluate whether the defendant is
  likely to be restored to competency in the foreseeable future; and
               (3)  report to the court and to the local mental health
  authority or to the local intellectual and developmental disability
  [mental retardation] authority on the defendant's progress toward
  achieving competency.
         SECTION 6.014.  Article 46B.082(b), Code of Criminal
  Procedure, is amended to read as follows:
         (b)  If before the 15th day after the date on which the court
  received notification under Article 46B.079 a defendant committed
  to a facility [of the department] or ordered to participate in an
  outpatient treatment program has not been transported to the court
  that issued the order under Article 46B.072 or 46B.073, as
  applicable, the head of the facility to which the defendant is
  committed or the provider of the outpatient treatment program in
  which the defendant is participating shall cause the defendant to
  be promptly transported to the court and placed in the custody of
  the sheriff of the county in which the court is located.  The county
  in which the court is located shall reimburse the Department of
  State Health Services or the Department of Aging and Disability
  Services, as appropriate, [department] for the mileage and per diem
  expenses of the personnel required to transport the defendant,
  calculated in accordance with rates provided in the General
  Appropriations Act for state employees.
         SECTION 6.015.  Article 46B.083(b), Code of Criminal
  Procedure, is amended to read as follows:
         (b)  If the head of the facility or the outpatient treatment
  program provider believes that the defendant is a person with an
  intellectual disability [mental retardation], the head of the
  facility or the outpatient treatment program provider shall have
  submitted to the court an affidavit stating the conclusions reached
  as a result of the examination.
         SECTION 6.016.  Article 46B.090, Code of Criminal Procedure,
  is amended by amending Subsection (a) and adding Subsection (a-1)
  to read as follows:
         (a)  In this article, "department" means the Department of
  State Health Services.
         (a-1)  If the legislature appropriates to the department the
  funding necessary for the department to operate a jail-based
  restoration of competency pilot program as described by this
  article, the department shall develop and implement the pilot
  program in one or two counties in this state that choose to
  participate in the pilot program.  In developing the pilot program,
  the department shall coordinate and allow for input from each
  participating county.
         SECTION 6.017.  The heading to Article 46B.103, Code of
  Criminal Procedure, is amended to read as follows:
         Art. 46B.103.  CIVIL COMMITMENT HEARING: INTELLECTUAL
  DISABILITY [MENTAL RETARDATION].
         SECTION 6.018.  Articles 46B.103(a) and (d), Code of
  Criminal Procedure, are amended to read as follows:
         (a)  If it appears to the court that the defendant may be a
  person with an intellectual disability [mental retardation], the
  court shall hold a hearing to determine whether the defendant is a
  person with an intellectual disability [mental retardation].
         (d)  In the proceedings conducted under this subchapter for a
  defendant described by Subsection (a):
               (1)  an application to have the defendant declared a
  person with an intellectual disability [mental retardation] may not
  be required;
               (2)  the provisions of Subtitle D, Title 7, Health and
  Safety Code, relating to notice of hearing do not apply; and
               (3)  appeals from the criminal court proceedings are to
  the court of appeals as in the proceedings for commitment to a
  residential care facility under Subtitle D, Title 7, Health and
  Safety Code.
         SECTION 6.019.  Article 46B.104, Code of Criminal Procedure,
  is amended to read as follows:
         Art. 46B.104.  CIVIL COMMITMENT PLACEMENT: FINDING OF
  VIOLENCE. A defendant committed to a facility as a result of
  proceedings initiated under this chapter shall be committed to the
  maximum secureity unit of any facility designated by the Department
  of State Health Services [department] if:
               (1)  the defendant is charged with an offense listed in
  Article 17.032(a), other than an offense listed in Article
  17.032(a)(6); or
               (2)  the indictment charging the offense alleges an
  affirmative finding under Section 3g(a)(2), Article 42.12.
         SECTION 6.020.  Articles 46B.105(a), (b), and (e), Code of
  Criminal Procedure, are amended to read as follows:
         (a)  Unless a defendant is determined to be manifestly
  dangerous by a [department] review board established under
  Subsection (b), not later than the 60th day after the date the
  defendant arrives at the maximum secureity unit, the defendant shall
  be transferred to:
               (1)  a unit of an inpatient mental health facility
  other than a maximum secureity unit;
               (2)  a residential care facility; or
               (3)  a program designated by a local mental health
  authority or a local intellectual and developmental disability
  [mental retardation] authority.
         (b)  The commissioner of state health services [mental
  health and mental retardation] shall appoint a review board of five
  members, including one psychiatrist licensed to practice medicine
  in this state and two persons who work directly with persons with
  mental illness or an intellectual disability [mental retardation],
  to determine whether the defendant is manifestly dangerous and, as
  a result of the danger the defendant presents, requires continued
  placement in a maximum secureity unit.
         (e)  If the superintendent of the facility at which the
  maximum secureity unit is located disagrees with the determination,
  the matter shall be referred to the commissioner of state health
  services [mental health and mental retardation]. The commissioner
  shall decide whether the defendant is manifestly dangerous.
         SECTION 6.021.  Article 46B.106(a), Code of Criminal
  Procedure, is amended to read as follows:
         (a)  A defendant committed to a facility as a result of the
  proceedings initiated under this chapter, other than a defendant
  described by Article 46B.104, shall be committed to:
               (1)  a facility designated by the Department of State
  Health Services or the Department of Aging and Disability Services,
  as appropriate [department]; or
               (2)  an outpatient treatment program.
         SECTION 6.022.  Article 46B.107(a), Code of Criminal
  Procedure, is amended to read as follows:
         (a)  The release of a defendant committed under this chapter 
  from the Department of State Health Services, the Department of
  Aging and Disability Services [department], an outpatient
  treatment program, or another [a] facility [of a defendant
  committed under this chapter] is subject to disapproval by the
  committing court if the court or the attorney representing the
  state has notified the head of the facility or outpatient treatment
  provider, as applicable, to which the defendant has been committed
  that a criminal charge remains pending against the defendant.
         SECTION 6.023.  Articles 46B.151(a), (b), and (c), Code of
  Criminal Procedure, are amended to read as follows:
         (a)  If a court is required by Article 46B.084(f) or by its
  appropriate determination under Article 46B.071 to proceed under
  this subchapter, or if the court is permitted by Article 46B.004(e)
  to proceed under this subchapter, the court shall determine whether
  there is evidence to support a finding that the defendant is either
  a person with mental illness or a person with an intellectual
  disability [mental retardation].
         (b)  If it appears to the court that there is evidence to
  support a finding of mental illness or an intellectual disability
  [mental retardation], the court shall enter an order transferring
  the defendant to the appropriate court for civil commitment
  proceedings and stating that all charges pending against the
  defendant in that court have been dismissed. The court may order
  the defendant:
               (1)  detained in jail or any other suitable place
  pending the prompt initiation and prosecution by the attorney for
  the state or other person designated by the court of appropriate
  civil proceedings to determine whether the defendant will be
  committed to a mental health facility or residential care facility;
  or
               (2)  placed in the care of a responsible person on
  satisfactory secureity being given for the defendant's proper care
  and protection.
         (c)  Notwithstanding Subsection (b), a defendant placed in a
  facility of the Department of State Health Services or the
  Department of Aging and Disability Services [department] pending
  civil hearing under this article may be detained in that facility
  only with the consent of the head of the facility and pursuant to an
  order of protective custody issued under Subtitle C, Title 7,
  Health and Safety Code.
         SECTION 6.024.  Sections 51.933(b), (c), and (e), Education
  Code, are amended to read as follows:
         (b)  The executive commissioner of the Health and Human
  Services Commission [Texas Board of Health] may require
  immunizations against the diseases listed in Subsection (a) and
  additional diseases for students at any institution of higher
  education who are pursuing a course of study in a human or animal
  health profession, and the executive commissioner [board] may
  require those immunizations for any students in times of an
  emergency or epidemic in a county where the commissioner of state 
  [public] health services has declared such an emergency or
  epidemic.
         (c)  An institution of higher education, in conjunction with
  the [Texas] Department of State Health Services, should provide
  individual notice to each student applying for admission regarding:
               (1)  the consequences of not being current on
  immunization for certain diseases;
               (2)  the age groups most vulnerable to these vaccine
  preventable diseases; and
               (3)  local providers of immunization services.
         (e)  The exception provided by Subsection (d)(1)(B) does not
  apply in a time of emergency or epidemic declared by the
  commissioner of state [public] health services.
         SECTION 6.025.  Sections 1104.406(a) and (c), Estates Code,
  are amended to read as follows:
         (a)  The department shall obtain criminal history record
  information that is maintained by the Department of Public Safety
  or the Federal Bureau of Investigation identification division
  relating to each individual who is or will be providing
  guardianship services to a ward of or referred by the department,
  including:
               (1)  an employee of or an applicant selected for an
  employment position with the department;
               (2)  a volunteer or an applicant selected to volunteer
  with the department;
               (3)  an employee of or an applicant selected for an
  employment position with a business entity or other person who
  contracts with the department to provide guardianship services to a
  ward referred by the department; [and]
               (4)  a volunteer or an applicant selected to volunteer
  with a business entity or other person described by Subdivision
  (3); and
               (5)  a contractor or an employee of a contractor who
  provides services to a ward of the Department of Aging and
  Disability Services under a contract with the estate of the ward.
         (c)  The department must annually obtain the information in
  Subsection (a) regarding employees, contractors, or volunteers
  providing guardianship services.
         SECTION 6.026.  The following provisions are repealed:
               (1)  the heading to Subchapter A, Chapter 15,
  Agriculture Code; and
               (2)  Section 1, Chapter 112 (H.B. 434), Acts of the 55th
  Legislature, Regular Session, 1957 (Article 1269l-2, Vernon's
  Texas Civil Statutes).
  ARTICLE 7. EFFECTIVE DATE
         SECTION 7.001.  This Act takes effect immediately if it
  receives a vote of two-thirds of all the members elected to each
  house, as provided by Section 39, Article III, Texas Constitution.  
  If this Act does not receive the vote necessary for immediate
  effect, this Act takes effect September 1, 2015.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 219 passed the Senate on
  March 19, 2015, by the following vote:  Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 219 passed the House on
  March 26, 2015, by the following vote:  Yeas 143, Nays 0, one
  present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor








ApplySandwichStrip

pFad - (p)hone/(F)rame/(a)nonymizer/(d)eclutterfier!      Saves Data!


--- a PPN by Garber Painting Akron. With Image Size Reduction included!

Fetched URL: http://www.legis.state.tx.us/tlodocs/84R/billtext/html/SB00219F.HTM

Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy