Diana Martinez Texas Assisted Living Association April 3 2019 Out and About with TALA TALA is committed to raising awareness of assisted living issues especially at the Texas Capitol and at the Health and Human Services Commission ID: 815894
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Advocacy UpdateJaime Capelo, Capelo Law FirmDiana Martinez, Texas Assisted Living Association
April 3, 2019
Slide2Out and About with TALA
TALA is committed to raising awareness of assisted living issues, especially at the Texas Capitol and at the Health and Human Services Commission.
Slide3TALA Advocacy Day 2019
T
ALA Advocacy Day was March 5
th
at the Texas Capitol
“TALA always has a great showing at the Capitol. I thoroughly enjoyed spending part of your advocacy day with you. Keep up the good work.”
Representative Richard Pena Raymond
Slide4TALA Advocacy Day at the Texas Capitol
“Our United strength thru TALA was pivotal to this year’s success at Advocacy Day 2019!”
Michelle Neumann
Administrator
Silverado Onion Creek
Slide5TALA Advocacy Day at the Texas Capitol
During the TALA Advocacy Day, we got to share with legislators what we do and our legislative agenda (which everyone we spoke with seemed to think made common sense, once they learned what we actually do!). It was a productive, informative, and fun experience! Thank you Diana, Jamie, and TALA for helping us give a voice to the residents we serve every day.
Helen Hunsinger
Manager, Strategic Relations
Belmont Village
Slide6TALA Advocacy Day at the Texas Capitol
“Advocacy Day at the Capital was a great experience to learn about the various types of legislation that impact senior living operations and the residents we serve. I’m grateful to TALA for the leadership they provide and for the opportunity to open channels of communication with our legislators.”
Anthony Ormsbee-Hale
VP, People Operations
Civitas Senior Living
Slide7TALA Advocacy Day at the Texas Capitol
A special thanks to
Civitas Senior Living for showing up in force!
Slide8Community Tours
A special thanks to
Arbor House Assisted Living, a Veritas community, in Wichita Falls for hosting Rep. James Frank
!
October 22, 2018
Slide9Community Tours
A special thanks to
Atria Westchase in Houston who hosted Representative Gene Wu for a tour
!
October 30, 2018
Slide1086
th
Legislative Session
Key Leaders and the Legislative Process
Slide11The Trifecta
Governor Greg Abbott
Lt. Governor Dan Patrick
Speaker Dennis Bonnen
Slide1286th Texas Legislature
Texas Senate – 31 Members
19 Republicans – 12 Democrats
Health and Human Services Committee Chair Lois Kolkhorst
Texas House of Representatives – 150 Members
83 Republicans – 67 Democrats
Human Services Committee Chair James Frank
Slide13The Legislative Process Simplified
Process Starts Over in Opposite Chamber
Governor can sign, do nothing, or veto
Slide14How busy is the 86th Legislative Session?
Began January 8
th
//
Lasts 140 days
83rd Legislative Session5868 bills were filed1457 passed outright (24.8%)84
th Legislative Session6,276 bills were filed1282 passed outright (20.4%) 85th Legislative Session
6,631 bills filed
1,211 passed outright / Governor vetoed 50 (17.5%)
86
th
Legislative Session
7,105 bills filed
Slide1586th Legislative SessionTALA’s Legislative Agenda
Slide16Safer Assisted Living Communities Through Heightened Background Checks
SB 898 by Senator Charles Perry HB 2392 by Representative Stephanie Klick
Issue
The current background checks process for potential employees does a great job of screening for people who have resided in Texas.
However, the workforce is becoming increasing mobile. Texas’ great economy draws hundreds of new people to the state every day.
The current required background check system required by HHSC does not require employers to do an out of state screen on applicants who have moved to Texas.
Slide17Safer Assisted Living Communities Through Heightened Background Checks
SB 898 // HB 2392
For all perspective applicants who have moved to Texas within 5 years of the date employment application, require assisted living communities conduct a name-based criminal background check in each state that the applicant resided.
Require all applicants deny in a statement that no disqualifying crimes have occurred.
A facility may employ a person pending an out-of-state criminal history check; however, the facility shall ensure that the person has no direct care contact with a resident until the facility obtains the person's criminal history record information and verifies the person's employability.
Slide18Clarify the Types of Services Permitted in Assisted Living Communities
SB 1406 by Senator Dawn BuckinghamHB 3329 by Representative James Frank
Issue
Communities around the state have been cited for performing task that are routine maintenance health task. Examples: minor wound dressing changes; changing catheter bags; and Bolus tube feedings.
Current statute is ambiguous on some of the types of services permitted in communities.
This creates inconsistency in interpretation by both providers and the Health and Human Services Commission.
Slide19Clarify the Types of Services Permitted in Assisted Living Communities
SB 1406 // HB 3329The legislation defines an assisted living community as an establishment that may
provide Health Maintenance Activities as defined by the Texas Board of Nursing.
HMAs are tasks that
may
be exempt from RN delegation based on a RN assessment that enables a resident to remain in an independent living environment and go beyond ADLs because of the higher skill level required to perform.
Slide20Budget
Advocate for additional HHSC funding for licensing specialist.
HHSC is asking for 17 new FTEs in Licensing / 12 Specialist.
Advocate that the Assisted Living Ombudsman’s maintain funding
ALF ombudsman funds were impacted by general appropriation reductions to HHSC – loss of $90,000/year.
As a result of the loss in funding, facility visits will be reduced. In previous years, ombudsmen were required to visit between 4-10 times a year, depending on the facility type and size. Ombudsman are now required to visit anywhere between 4-7 times a year. This results in approximately 1,600 fewer visits.
Slide2186th Legislative SessionLegislation Impacting Assisted Living
Slide22Legislation Impacting Assisted Living
HB 284
by Rep. Mary Ann Perez
Relating to disclosure requirements of certain facilities that provide care for persons with Alzheimer's disease and related disorders.
An AL must disclosure whether a community is Alz. Certified or is notMust provide disclosure to residents, those applying for services, and those requesting
Must keep a record of all provided disclosure toMust post disclosure regardless if certified
Slide23Legislation Impacting Assisted Living
HB 823
by Yvonne Davis
Relating to an expedited on-site health inspection process for assisted living facility license applicants.
Allows for an expedited life safety inspection or an expedited health inspection
Slide24Legislation Impacting Assisted Living
HB 1423
by Bobby Guerra and HB 1361 by Wu
Relating to an immunization rate tracking system for employees and residents of certain long-term care facilities.
Requires a community to track the immunization rates of the facility’s employees and residents. Must include: (1) aggregate immunization rates of the facility ’ s employees and residents; and (2) changes to the aggregate immunization ratesRequires that the rate data be provided on request.
Data provided may not in any manner identify an employee or resident.
Slide25Legislation Impacting Assisted Living
HB 1715
by Yvonne Davis
Relating to registration of certain establishments providing assisted living services.
Requires registration of “Similar Assisted Living Services Establishments”.Establishments serving 1 to 3 people not related to the owner and provides personal care services or medication administration.Uses the same definition as an assisted living facilitiy
.Subject to enforcement action.
Slide26Legislation Impacting Assisted Living
HB 1848
by Stephanie Klick and HB 1360 by Wu
Relating to prevention of communicable diseases in certain long-term care facilities
Each facility’s infection prevention and control program must include:monitoring of key infectious agents, including multidrug-resistant organismsprocedures for communicating the presence of multidrug-resistant organism infections when admitting a resident to or transferring a resident from the facility
procedures for making rapid influenza diagnostic tests available to facility residents.
Slide27Legislation Impacting Assisted Living
HB 1848
by Stephanie Klick and HB 1360 by Wu
Requires each facility’s infection prevention and control program have a provision for reporting to the health authority or the department when two or more confirmed cases of influenza occur among facility residents within a 72-hour period.
Establishes Antimicrobial Stewardship Regional Advisory Committees.
Slide28Legislation Impacting Assisted Living
HB 1915
by John Zerwas
Relating to a state plan for education on and treatment of Alzheimer's disease and related disorders.HHSC shall develop and implement a state plan for education on and treatment of Alzheimer ’ s disease and related disorders. The plan must include strategies for:improving early detection of, reducing disease onset risks for, and improving treatment of Alzheimer ’ s disease and related disorders for specific demographic groups;
educating health care professionals, caregivers, and the public to increase awareness;providing caregiver support;advancing basic science and applied research; andcollecting and evaluating information on efforts to prevent and treat Alzheimer ’ s disease and related disorders.
Slide29Legislation Impacting Assisted Living
HB 1878
by Sarah Davis
Relating to a report on the quality of care provided to and quality of life of assisted living facility residents
HHSC shall conduct a study of not less than 30% ALs, to assess the quality of care provided to and quality of life of residents. In conducting the study, HHSC shall:(1) conduct on-site case reviews of the care provided to residents (2) review the disclosure statements and policies, including policies related to residents’ rights, and
(3) conduct interviews with residents, representatives of residents, personnel; and any ombudsman that investigates and reviews the facility.
Slide30Legislation Impacting Assisted Living
HB 1922
by Shawn Thierry
Relating to emergency power sources in nursing facilities and assisted living facilities
Requires each assisted living facility to ensure the facility is equipped with an emergency power source.2059 by Cesar Blanco Relating to required human trafficking prevention training for health care practitioners and certain employees of health care facilities.
Requires ALs to require each health care practitioner who is employed by the facility to successfully complete a training course on identifying and assisting victims of human trafficking
Slide31Legislation Impacting Assisted Living
HB 1952
by John Zerwas
Relating to community homes for persons with disabilities; creating a criminal offense.
A HOA may not “effectively prohibit” a Chapter 123 home.Can’t have more cars than bedrooms in the home. Creates a criminal offense if exceed car allotment.
A HOA or property owner can file a complaint with HHSC.A HOA can enforce a restrictive covenant against an AL to the same extent as any other property owner.
Slide32Legislation Impacting Assisted Living
HB 2067
by Bobby Guerra
Relating to influenza information for residents of assisted living facilities.
Requires ALs to provide educational information regarding influenza to each resident not later than September 1st of each year.Material must include:(1) the risks associated with influenza;(2) the latest influenza vaccination recommendations from the CDC;
(3) the availability, effectiveness, and known contraindications of the flu vaccine;(4) the causes and symptoms; and(5) the means by which the flu is spread.HHSC can’t require AL to provide or pay for vaccine.
Slide33Legislation Impacting Assisted Living
HB 2205
by Travis Clardy
Relating to the informal dispute resolution process for certain disputes between the Health and Human Services Commission and long-term care facilities.
The IDR process for the statement of violations must require:(1) the surveyor who conducted the survey to be available to testify or be examined during any proceeding of the IDR process; and(2) the commission’s review of the institution’s or facility’s informal dispute resolution request to be conducted by a registered nurse with long-term care experience for a standard of care violation.
Slide34Legislation Impacting Assisted Living
HB 2873 by Yvonne Davis
Relating to the room placement of individuals with Alzheimer's disease or dementia in health care facilities and correctional facilities.
Prohibits a health care facility from requiring a resident with Alzheimer’s disease or dementia to reside in the same room as a resident with mental illness and a history of violence.
Slide35Legislation Impacting Assisted Living
HB 3170
by Jeff Leach
Relating to the establishment of an interim registry for certain persons who have been accused of employee misconduct who are employed by a facility that provides care to individuals with an intellectual disability.
Creates an interim registry for employees who have requested a hearing on a finding or determination.Name, address, SSN, name and address of the facility or individual employer of the employee, date on which the reportable conduct occurred, and description of the conduct.
Provider participating in the HCS or TxHmL waiver programs may have to take actions regarding an employee who is on the interim registry based on seriousness of conduct. Actions could include: additional monitoring; reassignment; or suspension.
Slide36Legislation Impacting Assisted Living
HB 3400
by Bill
Zedler
Relating to required criminal history checks for nurse aides; authorizing a fee. A health care facility may not employ a nurse aide or contract for nurse aide services with a nurse aide unless the facility or practitioner obtains the HHSC ’s verification of employability for the nurse aide.
Nurse aide means an individual who provides nursing or nursing-related services under the delegated authority of a nurse. To determine employability HHSC shall consider info from DPS or the FBIHHSC may charge a fee to verify employability.
Slide37Legislation Impacting Assisted Living
HB 3428
by Giovanni Capriglione
Relating to training on Alzheimer's disease and dementia for certain Department of Family and Protective Services employees and area agencies on aging employees and volunteers.
HHSC shall develop training for Adult Protective Services employees on identifying and interacting with individuals who have Alzheimer ’ s disease or dementia. The APS training must include an initial four-hour training requirement and an annual two hour continuing education requirementAn area agency on aging must ensure that the agency’s employees or volunteers who provide services directly to an elderly individual or the individual ’ s family members or caregivers receive training on Alzheimer’s disease and dementia.
Slide38Legislation Impacting Assisted Living
HB 3611
by Yvonne Davis
Relating to the number of persons authorized to reside in certain homes and facilities for persons with disabilities.
This legislation specifies that the limitation on the number of persons who may residein a Chapter 123 community home at the same time does not apply to an assisted living facility licensed under Chapter 247, Health and Safety Code, unless the assisted living facility qualifies as a community home in accordance with Section 123.004
Slide39Legislation Impacting Assisted Living
HB 3774
by Yvonne Davis
Relating to investigations of abuse or exploitation of an elderly person or person with a disability.
Removes the requirement that an individual, other than a family member or caretaker, have an ongoing relationship with the individual in order for there to be abuse or exploitation. B 3857 by Tony Tinderholt
Relating to discrimination by a health care provider based on immunization status.Prohibits a health care provider from refusing to provide health care services to a patient solely because a patient has or has not received immunization for a particular communicable disease.
Slide40Legislation Impacting Assisted Living
HB 4057
by Yvonne Davis
Relating to the amount of an administrative penalty that may be assessed against an assisted living facility.
This legislation changes the maximum administrative penalty for communities with 16 or fewer beds from $5,000 to $1,000.The violation must represents a pattern of violation that results in actual harm or is widespread in scope and results in actual harm; or constitutes an immediate threat to the health or safety of a resident;
Slide41Legislation Impacting Assisted Living
HB 4224
by Ron Reynolds
Relating to a study to evaluate state and local regulation of group homes.
Requires HHSC to conduct a study on state and local regulation of group homes. The study must:identify and evaluate state laws relating to the regulation of group homes, including: assisted living facilities; boarding home facilities; and Chapter 123 community homes analyze the procedures for filing complaints against group homes and make recommendations to expedite complaint processesanalyze complaints filed against group homes after 2009analyze the enforcement authority over group homes granted to state and local governmental agencies, including the authority of counties and municipalities to enforce boarding home regulations
Slide42Legislation Impacting Assisted Living
HB 4476
by Yvonne Davis
Relating to civil liability for abuse or exploitation of an elderly person or person with a disability.
The legislation creates a civil cause of action for abuse or exploitation of an elderly person or person with a disability.A claimant who prevails in a suit under this section may recover actual damages, including damages for mental anguish even if an injury other than mental anguish is not shown. a claimant who prevails in a suit may recover exemplary damages and reasonable attorney fees.
Slide43Legislation Impacting Assisted Living
SB 763
by Jose Menendez
Relating to a creditor's remedies with respect to certain delinquent payments owed by an elderly person who has an agent appointed under a durable power of attorney.
A creditor to whom an elderly person owes a payment that is delinquent and arose out of a purchase or lease agreement or other contractual arrangement that secures the elderly person’s living quarters must comply with these requirements before taking an adverse action against the elderly person, including commencing an eviction proceeding, if the creditor knows or has reason to know that the elderly principal executed a durable power of attorney that grants authority to an agent that would allow the agent to make the payment that is delinquent.
Slide44Legislation Impacting Assisted Living
SB 763
by Jose Menendez
The creditor must:
1) submit a written request to the agent by certified mail, return receipt requested, that the delinquent payment be made on or before the 30th day after the date the agent receives the request; and2) if the creditor does not receive payment on or before the 30th day after the date the agent received the written request, bring an action requesting a court to review the agent ’ s conduct and grant appropriate relief.A creditor who files an action with a court may not take an adverse action against the elderly person until the court enters an order on the action.
Slide45Legislation Impacting Assisted Living
SB 1519
by Lois Kolkhorst
Relating to a council on long-term care facilities.
Requires the executive commissioner to establish a Long-Term Care Facilities Council as a permanent advisory committee to the commission. The council shall study and make recommendations regarding best practices and protocols to make survey, inspection, and informal dispute resolution processes more efficient and less burdensome on long-term care facilities; recommend uniform standards for those processes; and study and make recommendations regarding Medicaid quality-based payment systems for long-term care facilities.
Slide46Legislation Impacting Assisted Living
SB 1897
by Judith Zaffirini
Relating to a bill of rights for home health care attendants employed at certain long-term care facilities.HHSC, in collaboration with the Texas Workforce Commission, shall prepare and publish on the HHSC’s Internet website a bill of rights for home health care attendants employed by a long-term care facility licensed under Chapter 103, Human Resources Code, or Chapter 242, 247, 248A, or 252, Health and Safety Code.
Slide47Legislation Impacting Assisted Living
SB 2279
by Royce West
Relating to creating the criminal offense of financial abuse of an elderly individual.Creates a criminal offense if a person knowingly engages in the financial abuse of an elderly individual"Financial abuse" means the wrongful taking, appropriation, obtaining, retention, or use of, or assisting in the wrongful taking, appropriation, obtaining, retention, or use of, money or other property of another person by any means, including by exerting undue influence. The term includes financial exploitation.
"Financial exploitation" includes: breach of a fiduciary relationship, including the misuse of a durable power of attorney or the abuse of guardianship powers, that results in the unauthorized appropriation, sale, or transfer of another person’s property; knowing or intentional failure to effectively use another person’s income and assets for the necessities required for the person’s support and maintenance.
Slide48Life after SessionDealing with the Aftermath
Slide49When do the laws of the 86th take effect?
Almost all laws passed during the 86th
will take effect on 9/1/2019.
However, most of the laws that impact ALFs have to have changes made to the Texas Administration Code.
That process takes time. First, the agency has to develop the new regulations and present them to the HHSC Executive Council. Then the suggested change is posted to the Texas Registry for public comment. The change is finally signed off on by the HHSC commissioner.
Expect regulation changes to start happening in early spring of 2020.
TALA will monitor implementation of significant legislation from the 86th – We will participate in various work groups to provide input, submit testimony, and testify as needed.
Slide50Grass Roots AdvocacyHelp others see the future!
After the legislative session is over TALA will be working to get members of the legislature and key staff out to assisted living communities.
Having people at the Capitol informed about assisted living issues gives us an edge during the legislative session.
If you are interested in inviting a legislator to your community please contact Diana Martinez.
Slide51Contact Information
Diana MartinezVP of Public PolicyTexas Assisted Living Association
4505 Spicewood Springs Rd, Suite 250
Austin, TX 78759
512-914-3908
diana.martinez@tala.orgTwitter tag: @TALAPOLICY