By: Hinojosa, et al.  S.B. No. 204
         (In the Senate - Filed March 5, 2015; March 9, 2015, read
  first time and referred to Committee on Health and Human Services;
  April 7, 2015, reported adversely, with favorable Committee
  Substitute by the following vote:  Yeas 9, Nays 0; April 7, 2015,
  sent to printer.)
Click here to see the committee vote
 
  COMMITTEE SUBSTITUTE FOR S.B. No. 204 By:  Schwertner
 
 
A BILL TO BE ENTITLED
 
AN ACT
 
  relating to the functions and operations of the Department of Aging
  and Disability Services; increasing penalties.
         BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
         SECTION 1.  Subchapter A, Chapter 142, Health and Safety
  Code, is amended by adding Section 142.0125 to read as follows:
         Sec. 142.0125.  PROGRESSIVE SANCTIONS.  (a)  The executive
  commissioner by rule shall create a matrix of progressive sanctions
  that the department must use to assess penalty amounts and impose
  disciplinary actions under this chapter appropriately and fairly
  for a violation of a law, rule, standard, or order adopted or
  license issued under this chapter or for a violation of other law
  for which this chapter provides a sanction.
         (b)  The matrix of progressive sanctions adopted under this
  section must provide for increases in amounts of administrative
  penalties based on type, frequency, and seriousness of violations
  and must provide guidance for determining appropriate and graduated
  administrative penalties to assess under this chapter to deter
  future violations, including guidance on considering the factors
  listed in this chapter for determining the amount of a penalty.
         (c)  The matrix of progressive sanctions adopted under this
  section must provide for imposing stronger sanctions, including
  license suspension or revocation, for more serious violations or
  for repeated violations as appropriate to deter future serious or
  repeated violations. The matrix of progressive sanctions must
  describe appropriate time frames to be used in determining whether
  a home and community support services agency has committed repeated
  violations or has engaged in a pattern of repeated violations, such
  as repeated violations found in consecutive regular inspections.
         SECTION 2.  Sections 142.017(b) and (j), Health and Safety
  Code, are amended to read as follows:
         (b)  The penalty shall be not less than $100 or more than
  $5,000 [$1,000] for each violation. Each day of a violation that
  occurs before the day on which the person receives written notice of
  the violation from the department does not constitute a separate
  violation and shall be considered to be one violation. Each day of
  a continuing violation that occurs after the day on which the person
  receives written notice of the violation from the department
  constitutes a separate violation.
         (j)  The executive commissioner by rule shall define the
  types of minor violations an agency may correct under Subsection
  (e) before the department may assess an administrative penalty.
  The executive commissioner shall ensure that all other violations
  are not subject to a right to correct [The department may assess an
  administrative penalty without providing a reasonable period of
  time to the agency to correct the violation if the violation:
               [(1)  results in serious harm or death;
               [(2)  constitutes a serious threat to health or safety;
               [(3)     substantially limits the agency's capacity to
  provide care;
               [(4)  is a violation in which a person:
                     [(A)     makes a false statement, that the person
  knows or should know is false, of a material fact:
                           [(i)     on an application for issuance or
  renewal of a license or in an attachment to the application; or
                           [(ii)     with respect to a matter under
  investigation by the department;
                     [(B)     refuses to allow a representative of the
  department to inspect a book, record, or file required to be
  maintained by an agency;
                     [(C)     wilfully interferes with the work of a
  representative of the department or the enforcement of this
  chapter;
                     [(D)     wilfully interferes with a representative
  of the department preserving evidence of a violation of this
  chapter or a rule, standard, or order adopted or license issued
  under this chapter;
                     [(E)     fails to pay a penalty assessed by the
  department under this chapter not later than the 10th day after the
  date the assessment of the penalty becomes final; or
                     [(F)  fails to submit:
                           [(i)     a plan of correction not later than the
  10th day after the date the person receives a statement of licensing
  violations; or
                           [(ii)     an acceptable plan of correction not
  later than the 30th day after the date the person receives
  notification from the department that the previously submitted plan
  of correction is not acceptable;
               [(5)  is a violation of Section 142.0145; or
               [(6)     involves the rights of the elderly under Chapter
  102, Human Resources Code].
         SECTION 3.  Section 242.061, Health and Safety Code, is
  amended by adding Subsections (c-1), (c-2), and (e) to read as
  follows:
         (c-1)  The department shall revoke the license of an
  institution that violates this chapter or a rule, standard, or
  order adopted or license issued under this chapter in a manner that
  causes immediate jeopardy to health and safety on three separate
  days within a 24-month period.
         (c-2)  In the case of revocation of a license under
  Subsection (c-1), to ensure the health and safety of residents of
  the institution, the department may:
               (1)  request the appointment of a trustee to operate
  the institution under Subchapter D;
               (2)  obtain a new operator for the institution; or
               (3)  assist with the relocation of residents to another
  institution.
         (e)  In this section, "immediate jeopardy to health and
  safety" means a situation in which immediate corrective action is
  necessary because the institution'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
  institution.
         SECTION 4.  Subchapter C, Chapter 242, Health and Safety
  Code, is amended by adding Section 242.0613 to read as follows:
         Sec. 242.0613.  PROGRESSIVE SANCTIONS. (a)  The executive
  commissioner by rule shall create a matrix of progressive sanctions
  that the department must use to assess penalty amounts and impose
  disciplinary actions under this chapter appropriately and fairly
  for a violation of a law, rule, standard, or order adopted or
  license issued under this chapter or for a violation of other law
  for which this chapter provides a sanction.
         (b)  The matrix of progressive sanctions adopted under this
  section must provide for increases in amounts of administrative
  penalties based on type, frequency, and seriousness of violations
  and must provide guidance for determining appropriate and graduated
  administrative penalties to assess under this chapter to deter
  future violations, including guidance on considering the factors
  listed in this chapter for determining the amount of a penalty.
         (c)  The matrix of progressive sanctions adopted under this
  section must provide for imposing stronger sanctions, including
  license suspension or revocation, for more serious violations or
  for repeated violations as appropriate to deter future serious or
  repeated violations. The matrix of progressive sanctions must
  describe appropriate time frames to be used in determining whether
  a facility has committed repeated violations or has engaged in a
  pattern of repeated violations, such as repeated violations found
  in consecutive regular inspections.
         SECTION 5.  Section 242.0665(b), Health and Safety Code, is
  amended to read as follows:
         (b)  The executive commissioner by rule shall define types of
  minor violations a facility may correct under Subsection (a) before
  the department may assess an administrative penalty. The executive
  commissioner shall ensure that all other violations are not subject
  to a right to correct [Subsection (a) does not apply:
               [(1)  to a violation that the department determines:
                     [(A)     results in serious harm to or death of a
  resident;
                     [(B)     constitutes a serious threat to the health
  or safety of a resident; or
                     [(C)     substantially limits the institution's
  capacity to provide care;
               [(2)     to a violation described by Sections
  242.066(a)(2)-(7);
               [(3)     to a violation of Section 260A.014 or 260A.015;
  or
               [(4)     to a violation of a right of a resident adopted
  under Subchapter L].
         SECTION 6.  Subchapter C, Chapter 247, Health and Safety
  Code, is amended by adding Section 247.0415 to read as follows:
         Sec. 247.0415.  PROGRESSIVE SANCTIONS. (a)  The executive
  commissioner by rule shall create a matrix of progressive sanctions
  that the department must use to assess penalty amounts and impose
  disciplinary actions under this chapter appropriately and fairly
  for a violation of a law, rule, standard, or order adopted or
  license issued under this chapter or for a violation of other law
  for which this chapter provides a sanction.
         (b)  The matrix of progressive sanctions adopted under this
  section must provide for increases in amounts of administrative
  penalties based on type, frequency, and seriousness of violations
  and must provide guidance for determining appropriate and graduated
  administrative penalties to assess under this chapter to deter
  future violations, including guidance on considering the factors
  listed in this chapter for determining the amount of a penalty.
         (c)  The matrix of progressive sanctions adopted under this
  section must provide for imposing stronger sanctions, including
  license suspension or revocation, for more serious violations or
  for repeated violations as appropriate to deter future serious or
  repeated violations. The matrix of progressive sanctions must
  describe appropriate time frames to be used in determining whether
  an assisted living facility has committed repeated violations or
  has engaged in a pattern of repeated violations, such as repeated
  violations found in consecutive regular inspections.
         SECTION 7.  Section 247.0451(b), Health and Safety Code, is
  amended to read as follows:
         (b)  Except as provided by Section 247.0452(c), the penalty
  may not exceed $5,000 [$1,000] for each violation.  Each day a
  violation occurs or continues is a separate violation for purposes
  of imposing a penalty.
         SECTION 8.  Section 247.0452(b), Health and Safety Code, is
  amended to read as follows:
         (b)  The executive commissioner by rule shall define the
  types of minor violations an assisted living facility may correct
  under Subsection (a) before the department may assess an
  administrative penalty. The executive commissioner shall ensure
  that all other violations are not subject to a right to
  correct [Subsection (a) does not apply:
               [(1)     to a violation that the department determines
  results in serious harm to or death of a resident;
               [(2)     to a violation described by Sections
  247.0451(a)(2)-(7) or a violation of Section 260A.014 or 260A.015;
               [(3)  to a second or subsequent violation of:
                     [(A)     a right of the same resident under Section
  247.064; or
                     [(B)     the same right of all residents under
  Section 247.064; or
               [(4)     to a violation described by Section 247.066,
  which contains its own right to correct provisions].
         SECTION 9.  Subchapter C, Chapter 252, Health and Safety
  Code, is amended by adding Section 252.0615 to read as follows:
         Sec. 252.0615.  PROGRESSIVE SANCTIONS. (a)  The executive
  commissioner by rule shall create a matrix of progressive sanctions
  that the department must use to assess penalty amounts and impose
  disciplinary actions under this chapter appropriately and fairly
  for a violation of a law, rule, standard, or order adopted or
  license issued under this chapter or for a violation of other law
  for which this chapter provides a sanction.
         (b)  The matrix of progressive sanctions adopted under this
  section must provide for increases in amounts of administrative
  penalties based on type, frequency, and seriousness of violations
  and must provide guidance for determining appropriate and graduated
  administrative penalties to assess under this chapter to deter
  future violations, including guidance on considering the factors
  listed in this chapter for determining the amount of a penalty.
         (c)  The matrix of progressive sanctions adopted under this
  section must provide for imposing stronger sanctions, including
  license suspension or revocation, for more serious violations or
  for repeated violations as appropriate to deter future serious or
  repeated violations. The matrix of progressive sanctions must
  describe appropriate time frames to be used in determining whether
  a facility has committed repeated violations or has engaged in a
  pattern of repeated violations, such as repeated violations found
  in consecutive regular inspections.
         SECTION 10.  Section 252.065, Health and Safety Code, is
  amended by amending Subsection (b) and Subsection (e), as amended
  by S.B. 219, Acts of the 84th Legislature, Regular Session, 2015, to
  read as follows:
         (b)  The penalty for a facility with fewer than 60 beds shall
  be not less than $100 or more than $1,000 for each violation. The
  penalty for a facility with 60 beds or more shall be not less than
  $100 or more than $5,000 for each violation. [The total amount of
  the penalty assessed for a violation continuing or occurring on
  separate days under this subsection may not exceed $5,000 for a
  facility with fewer than 60 beds or $25,000 for a facility with 60
  beds or more.] Each day a violation occurs or continues is a
  separate violation for purposes of imposing a penalty.
         (e)  The executive commissioner 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 an administrative penalty if a
  plan of correction has been implemented. The executive
  commissioner by rule shall define the types of minor violations a
  facility may correct before the department may assess an
  administrative penalty. The executive commissioner shall ensure
  that all other violations are not subject to a right to correct
  [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].
         SECTION 11.  Subchapter B, Chapter 533A, Health and Safety
  Code, as added by S.B. 219, Acts of the 84th Legislature, Regular
  Session, 2015, is amended by adding Section 533A.044 to read as
  follows:
         Sec. 533A.044.  CRISIS INTERVENTION TEAMS. (a)  In this
  section, "crisis intervention team" means a team of individuals
  specially trained to provide services and support to persons with
  an intellectual or developmental disability who have behavioral
  health needs and who are at risk of institutionalization.
         (b)  The department shall evaluate the effectiveness of
  various models of crisis intervention teams that are funded under a
  waiver under Section 1115 of the federal Social Security Act (42
  U.S.C. Section 1315) and operated by a local intellectual and
  developmental disability authority.
         (c)  Not later than March 1, 2016, the department shall
  select for implementation one or more models for crisis
  intervention teams the department determines best provide
  comprehensive, cost-effective support.
         (d)  The department shall determine the areas in this state
  in which local intellectual and developmental disability
  authorities do not operate crisis intervention teams and, subject
  to available funding, shall implement in each area a team that
  operates in accordance with a model selected for implementation
  under this section.
         SECTION 12.  Chapter 555, Health and Safety Code, is amended
  by adding Subchapter F to read as follows:
  SUBCHAPTER F.  STATE SUPPORTED LIVING CENTER RESTRUCTURING AND
  CLOSURES
         Sec. 555.201.  STATE SUPPORTED LIVING CENTER RESTRUCTURING
  COMMISSION. (a)  In this subchapter, "restructuring commission"
  means the state supported living center restructuring commission.
         (b)  The restructuring commission consists of five members
  appointed by the governor and the following three nonvoting ex
  officio members:
               (1)  the executive commissioner or the executive
  commissioner's designee;
               (2)  the executive director of the Texas Facilities
  Commission or the executive director's designee; and
               (3)  the commissioner of the General Land Office or the
  commissioner's designee.
         (c)  The restructuring commission is established to evaluate
  each state supported living center in the state to determine
  whether closure of the center is recommended to maintain only the
  number of centers necessary to meet the level of need in the state.
  In evaluating each state supported living center, the restructuring
  commission shall consider:
               (1)  the quality of services provided by the center,
  including the center's most recent certification inspections and
  the center's ability to meet the minimum ICF-IID standards;
               (2)  the costs of operating the center;
               (3)  the center's compliance with the 2009 settlement
  agreement between the department and the United States Department
  of Justice regarding services provided to individuals with an
  intellectual or developmental disability in state-operated
  facilities;
               (4)  the availability of community service providers in
  the area served by the center;
               (5)  the specialty services provided at the center,
  including the ability of the center to serve alleged offenders or
  high-risk residents;
               (6)  the availability of employment opportunities for
  center employees if the center closes;
               (7)  any infrastructure deficiency costs relating to
  the center;
               (8)  the property value of, the market demand for, and
  any deed restrictions applicable to property and facilities of the
  center;
               (9)  whether closure of the center would adversely
  affect the geographic distribution of centers in the state; 
               (10)  the availability and capacity of service
  providers and resources in the community capable of delivering the
  quality and level of care each resident of the center would require
  following the center's closure; and
               (11)  any other criteria the restructuring commission
  considers appropriate.
         (d)  Not later than December 1, 2016, the restructuring
  commission shall submit to the governor, the lieutenant governor,
  the speaker of the house of representatives, and the presiding
  officers of the standing committees of the senate and house of
  representatives having primary jurisdiction over intellectual and
  developmental disability issues a report detailing the
  restructuring commission's evaluation of each state supported
  living center and, if applicable, proposing the closure of certain
  centers.
         (e)  The restructuring commission is abolished and this
  section expires January 1, 2017.
         Sec. 555.202.  RECOMMENDED CLOSURES OF STATE SUPPORTED
  LIVING CENTERS. (a)  If the restructuring commission proposes the
  closure of one or more state supported living centers, the 85th
  Legislature shall consider legislation proposing the closure of the
  centers recommended for closure. In considering the proposed
  legislation described by this subsection, members of the
  legislature may not propose amendments to the legislation.
         (b)  If the legislation described by Subsection (a) is
  enacted and becomes law, the department shall ensure that each
  state supported living center approved by the legislature for
  closure under Subsection (a) is closed not later than August 31,
  2025.
         (c)  This subchapter expires September 1, 2025.
         Sec. 555.203.  CLOSURE OF AUSTIN STATE SUPPORTED LIVING
  CENTER. (a)  The department shall establish a closure plan for the
  Austin State Supported Living Center. The plan must provide for
  closure of the facility and operations of the Austin State
  Supported Living Center not later than August 31, 2017.
         (b)  The closure plan must provide procedures to transition
  to the community each resident for whom transition to the community
  is practicable while maintaining respect for resident choice.
         (c)  The department may award one-time retention bonuses to
  each direct support professional, qualified intellectual
  disability professional, social worker, and case manager who agrees
  to continue to provide services at the Austin State Supported
  Living Center until the center is closed.
         (d)  The proceeds from the closure, including from the sale
  or lease of facilities or other property, may be appropriated only
  for services for persons with an intellectual or developmental
  disability, including persons with a dual diagnosis of an
  intellectual or developmental disability and mental illness.
         (e)  Not later than August 31, 2018, the department shall
  evaluate the closure process, including how well the closure plan
  worked, and, if appropriate, establish policies for improving the
  closure process for future closures of other state supported living
  centers.
         (f)  This section expires September 1, 2018.
         SECTION 13.  Section 531.0318, Government Code, is amended
  by adding Subsections (b-1), (d), and (e) to read as follows:
         (b-1)  The information for consumers required by this
  section must include for each provider of long-term care services:
               (1)  a rating assigned by the Department of Aging and
  Disability Services indicating the quality of the care provided or,
  alternatively, a link to a rating assigned a provider on an Internet
  website maintained by the federal government;
               (2)  information concerning quality of care, as that
  information becomes available;
               (3)  staffing information, if available, including for
  each year the number of staff members who began employment with the
  provider during that year and the number of staff members who ceased
  employment with the provider during that year;
               (4)  the ratio of staff members to residents; and
               (5)  the provider's regulatory performance, as
  available.
         (d)  The Department of Aging and Disability Services shall
  immediately post notice on the department's Internet website when a
  provider of long-term care services loses its Medicaid
  certification.
         (e)  The Department of Aging and Disability Services shall
  periodically solicit input regarding the content of the information
  required under this section and the usability and accessibility of
  the website on which the information is located from consumers,
  consumer advocates, long-term care services providers, and the
  general public.
         SECTION 14.  Subchapter D, Chapter 48, Human Resources Code,
  is amended by adding Section 48.15221 to read as follows:
         Sec. 48.15221.  REPORTS CONCERNING DAY HABILITATION
  SERVICES PROVIDERS. (a)  In this section, "day habilitation
  services" and "day habilitation services provider" have the
  meanings assigned by Section 161.401.
         (b)  The department shall prepare and submit to the
  Department of Aging and Disability Services an annual report of the
  number of investigations arising from a report of abuse, neglect,
  or exploitation of a person with an intellectual or developmental
  disability that was allegedly committed by or on the premises of a
  day habilitation services provider, and whether the investigation
  concluded that the report of alleged abuse, neglect, or
  exploitation was confirmed, unconfirmed, inconclusive, or
  unfounded.
         (c)  The duty to prepare and submit a report under Subsection
  (b) does not affect the duty of the department to investigate and
  hold accountable a community-based intellectual and developmental
  disabilities services provider or intermediate care facility for
  any abuse, neglect, or exploitation of a person who receives day
  habilitation services from the provider. 
         SECTION 15.  Chapter 103, Human Resources Code, is amended
  by adding Section 103.0085 to read as follows:
         Sec. 103.0085.  PROGRESSIVE SANCTIONS. (a)  The executive
  commissioner by rule shall create a matrix of progressive sanctions
  that the department must use to assess penalty amounts and impose
  disciplinary actions under this chapter appropriately and fairly
  for a violation of a law, rule, standard, or order adopted or
  license issued under this chapter or for a violation of other law
  for which this chapter provides a sanction.
         (b)  The matrix of progressive sanctions adopted under this
  section must provide for increases in amounts of administrative
  penalties based on type, frequency, and seriousness of violations
  and must provide guidance for determining appropriate and graduated
  administrative penalties to assess under this chapter to deter
  future violations, including guidance on considering the factors
  listed in this chapter for determining the amount of a penalty.
         (c)  The matrix of progressive sanctions adopted under this
  section must provide for imposing stronger sanctions, including
  license suspension or revocation, for more serious violations or
  for repeated violations as appropriate to deter future serious or
  repeated violations. The matrix of progressive sanctions must
  describe appropriate time frames to be used in determining whether
  an adult day-care facility has committed repeated violations or has
  engaged in a pattern of repeated violations, such as repeated
  violations found in consecutive regular inspections.
         SECTION 16.  Section 103.013(b), Human Resources Code, is
  amended to read as follows:
         (b)  The executive commissioner by rule shall define the
  types of minor violations an adult day-care facility may correct
  under Subsection (a) before the department may assess an
  administrative penalty. The executive commissioner shall ensure
  that all other violations are not subject to a right to correct
  [Subsection (a) does not apply to:
               [(1)  a violation that the department determines:
                     [(A)     results in serious harm to or death of a
  person attending the facility;
                     [(B)     constitutes a serious threat to the health
  and safety of a person attending the facility; or
                     [(C)     substantially limits the facility's
  capacity to provide care;
               [(2)     a violation described by Sections
  103.012(a)(2)-(7); or
               [(3)  a violation of Section 103.011].
         SECTION 17.  Section 161.080, Human Resources Code, is
  amended by adding Subsection (c) to read as follows:
         (c)  The executive commissioner by rule shall establish a
  list of services a state supported living center may provide under a
  contract described by Subsection (a) and a schedule of fees the
  state supported living center may charge for those services. In
  establishing the schedule of fees for services, the executive
  commissioner shall use the reimbursement rate for the applicable
  service under the Medicaid program or modify that rate with a
  written justification for the modification.
         SECTION 18.  Chapter 161, Human Resources Code, is amended
  by adding Subchapter J to read as follows:
  SUBCHAPTER J. POWERS AND DUTIES RELATING TO DAY HABILITATION
  SERVICES PROVIDERS
         Sec. 161.401.  DEFINITIONS. In this subchapter:
               (1)  "Day habilitation services" means services to
  assist persons with an intellectual or developmental disability in
  acquiring, retaining, and improving the self-help, socialization,
  and adaptive skills necessary to reside successfully in the
  community, including prevocational, educational, and supported
  employment services.
               (2)  "Day habilitation services provider" means a
  person who contracts with a community-based intellectual and
  developmental disabilities services provider or intermediate care
  facility to provide federally funded Medicaid day habilitation
  services authorized under Section 1915(c) of the federal Social
  Security Act (42 U.S.C. Section 1396n(c)).
         Sec. 161.402.  DAY HABILITATION SERVICES PROVIDER
  INFORMATION TRACKING. (a)  Each community-based intellectual and
  developmental disabilities services provider and intermediate care
  facility shall annually submit to the department a report
  providing:
               (1)  an estimate of the number of clients receiving day
  habilitation services for each month of that year;
               (2)  the physical address of each day habilitation
  services provider that provided those services;
               (3)  the services provided to those clients; and
               (4)  an estimate of monthly expenditures for the
  provision of those services to those clients.
         (b)  The department shall maintain information obtained
  during a department inspection of a day habilitation services
  provider concerning conduct or conditions that would constitute a
  violation of federal or state law or of department rules applicable
  to the community-based intellectual and developmental disabilities
  services provider or intermediate care facility with which the day
  habilitation services provider contracts.
         (c)  The department shall maintain information concerning an
  investigation of abuse, neglect, or exploitation concerning a day
  habilitation services provider that the department receives from
  the Department of Family and Protective Services under Section
  48.15221.
         Sec. 161.403.  DAY HABILITATION PROGRAM ADVISORY COMMITTEE.
  (a)  Not later than September 1, 2015, the department shall
  establish a day habilitation program advisory committee composed of
  members that represent community-based waiver providers, owners of
  day habilitation services providers, and advocates for persons with
  an intellectual or developmental disability. 
         (b)  The day habilitation program advisory committee shall
  consider and make recommendations concerning whether the provision
  of day habilitation services in this state should be redesigned and
  whether day habilitation services providers should be subject to
  regulation, including by licensure or certification.
         (c)  In considering the redesign of the provision of day
  habilitation services in this state, the day habilitation program
  advisory committee shall examine whether day habilitation service
  providers currently comply with the requirements of 42 C.F.R.
  Section 441.301.
         (d)  The day habilitation program advisory committee shall
  also consider and make recommendations concerning issues relevant
  to the provision of day habilitation services, including the
  appropriate funding for services, reimbursable settings and
  services, staff-to-client ratio requirements, safety requirements,
  and other required or applicable standards.
         (e)  Not later than September 1, 2016, the day habilitation
  program advisory committee shall submit to the governor, the
  lieutenant governor, the speaker of the house of representatives,
  and the presiding officers of the standing committees of the senate
  and house of representatives having primary jurisdiction over
  intellectual and developmental disability issues a report
  containing the committee's recommendations concerning the redesign
  of the provision of day habilitation services in this state and the
  necessity for regulation, licensure, or certification of day
  habilitation services providers.
         (f)  The day habilitation program advisory committee is
  abolished and this section expires December 31, 2016.
         SECTION 19.  Section 101A.158, Human Resources Code, as
  added by S.B. 219, Acts of the 84th Legislature, Regular Session,
  2015, is repealed.
         SECTION 20.  (a)  Not later than September 1, 2016, the
  executive commissioner of the Health and Human Services Commission
  shall adopt by rule the matrices of progressive sanctions required
  by Sections 142.0125, 242.0613, 247.0415, and 252.0615, Health and
  Safety Code, and Section 103.0085, Human Resources Code, as added
  by this Act.
         (b)  Not later than September 1, 2015, the governor shall
  appoint five members of the state supported living center
  restructuring commission, as required by Section 555.201, Health
  and Safety Code, as added by this Act.
         (c)  Not later than September 1, 2016, the executive
  commissioner of the Health and Human Services Commission shall
  adopt the rule listing services a state supported living center may
  provide under a contract and the schedule of fees for those services
  as required by Section 161.080, Human Resources Code, as amended by
  this Act.
         SECTION 21.  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.
 
  * * * * *