H.B. No. 4696

	AN ACT
	relating to the reporting and investigation of certain allegations
	of abuse, neglect, and exploitation, the making and investigation
	of complaints alleging violations of certain health facility
	licensing requirements, and the content of the employee misconduct
	registry.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  Section 261.005, Family Code, is amended to read
	as follows:
	Sec. 261.005.  REFERENCE TO EXECUTIVE COMMISSIONER OR
	COMMISSION.  Unless otherwise provided by a provision of this
	chapter, in [In] this chapter:
	(1)  a reference to the executive commissioner or the
	executive commissioner of the Health and Human Services Commission
	means the commissioner of the department; and
	(2)  a reference to the Health and Human Services
	Commission means the department.
	SECTION 2.  Section 261.105(c-1), Family Code, is amended to
	read as follows:
	(c-1)  Notwithstanding Subsections (b) and (c), if a report
	under this section relates to a child with an intellectual
	disability receiving services in a state supported living center as
	defined by Section 531.002, Health and Safety Code, or the ICF-IID
	component of the Rio Grande State Center, the department shall
	immediately notify the commission and the commission shall proceed
	with the investigation of the report as provided by Section
	261.404. Notwithstanding Section 261.005, in this subsection,
	"commission" means the Health and Human Services Commission.
	SECTION 3.  Section 261.404, Family Code, is amended by
	amending Subsections (a), (a-1), (a-2), (a-3), (b), (c), and (d)
	and adding Subsection (a-4) to read as follows:
	(a)  Notwithstanding Section 261.005, in this section:
	(1)  "Commission" means the Health and Human Services
	Commission.
	(2)  "Executive commissioner" means the executive
	commissioner of the Health and Human Services Commission.
	(a-1)  The commission [department] shall investigate a
	report of abuse, neglect, or exploitation of a child receiving
	services from a provider, as those terms are defined by Section
	48.251, Human Resources Code, or as otherwise defined by rule.  The
	commission [department] shall also investigate, under Subchapter
	F, Chapter 48, Human Resources Code, a report of abuse, neglect, or
	exploitation of a child receiving services from an officer,
	employee, agent, contractor, or subcontractor of a home and
	community support services agency licensed under Chapter 142,
	Health and Safety Code, if the officer, employee, agent,
	contractor, or subcontractor is or may be the person alleged to have
	committed the abuse, neglect, or exploitation.
	(a-2) [(a-1)]  For an investigation of a child living in a
	residence owned, operated, or controlled by a provider of services
	under the home and community-based services waiver program
	described by Section 534.001(11)(B), Government Code, the
	department, in accordance with Subchapter E, Chapter 48, Human
	Resources Code, may provide emergency protective services
	necessary to immediately protect the child from serious physical
	harm or death and, if necessary, obtain an emergency order for
	protective services under Section 48.208, Human Resources Code.
	(a-3) [(a-2)]  For an investigation of a child living in a
	residence owned, operated, or controlled by a provider of services
	under the home and community-based services waiver program
	described by Section 534.001(11)(B), Government Code, regardless
	of whether the child is receiving services under that waiver
	program from the provider, the department shall provide protective
	services to the child in accordance with Subchapter E, Chapter 48,
	Human Resources Code.
	(a-4) [(a-3)]  For purposes of this section, Subchapters E
	and F, Chapter 48, Human Resources Code, apply to an investigation
	of a child and to the provision of protective services to that child
	in the same manner those subchapters apply to an investigation of an
	elderly person or person with a disability and the provision of
	protective services to that person.
	(b)  The commission [department] shall investigate a [the]
	report under this section under rules developed by the executive
	commissioner.
	(c)  If a report under this section relates to a child with an
	intellectual disability receiving services in a state supported
	living center or the ICF-IID component of the Rio Grande State
	Center, the commission [department] shall, within 24 hours [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 commission's [department's]
	investigation of reported abuse, neglect, or exploitation, a
	caseworker of the commission [department] or the caseworker's
	supervisor has cause to believe that a child with an intellectual
	disability 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 commission's
	[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 commission's [department's]
	investigation report.
	SECTION 4.  Section 142.009(j), Health and Safety Code, is
	amended to read as follows:
	(j)  Except as provided by Subsections (h) and (l), a [an
	on-site] survey may [must] be conducted within 18 months after a
	survey for an initial license. After that time, an on-site survey
	must be conducted at least every 36 months.
	SECTION 5.  Section 142.018(b), Health and Safety Code, is
	amended to read as follows:
	(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 commission [department; and
	[(2)  the Department of Family and Protective Services
	or other appropriate state agency as required by Section 48.051,
	Human Resources Code].
	SECTION 6.  Section 252.039, Health and Safety Code, is
	amended to read as follows:
	Sec. 252.039.  POSTING. Each facility shall prominently and
	conspicuously post for display in a public area of the facility that
	is readily available to residents, employees, and visitors:
	(1)  the license issued under this chapter;
	(2)  a sign prescribed by the commission [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 commission [department];
	(3)  a notice in a form prescribed by the commission
	[department] stating that inspection and related reports are
	available at the facility for public inspection and providing the
	commission's [department's] toll-free telephone number that may be
	used to obtain information concerning the facility;
	(4)  a concise summary of the most recent inspection
	report relating to the facility;
	(5)  a notice providing instructions for reporting an
	allegation of abuse, neglect, or exploitation to the commission
	[Department of Family and Protective Services]; and
	(6)  a notice that employees, other staff, residents,
	volunteers, and family members and guardians of residents are
	protected from discrimination or retaliation as provided by
	Sections 252.132 and 252.133.
	SECTION 7.  Section 252.121(a), Health and Safety Code, is
	amended to read as follows:
	(a)  A person, including an owner or employee of a facility,
	who has cause to believe that a resident is being or has been
	subjected to abuse, neglect, or exploitation shall report the
	suspected abuse, neglect, or exploitation to the commission
	[Department of Family and Protective Services, as required by
	Chapter 48, Human Resources Code, or Chapter 261, Family Code, as
	appropriate].  The commission [Department of Family and Protective
	Services] shall investigate the allegation of abuse, neglect, or
	exploitation in the manner prescribed by the commission [provided
	by Chapter 48, Human Resources Code, or Section 261.404, Family
	Code, as applicable].
	SECTION 8.  Section 252.125, Health and Safety Code, is
	amended to read as follows:
	Sec. 252.125.  IMMEDIATE REMOVAL TO PROTECT RESIDENT.
	Before the completion of the investigation by the commission
	[Department of Family and Protective Services], the commission
	[department] shall file a petition for temporary care and
	protection of a resident if the commission [department]
	determines[, based on information provided to the department by the
	Department of Family and Protective Services,] that immediate
	removal is necessary to protect the resident from further abuse,
	neglect, or exploitation.
	SECTION 9.  Sections 253.001(1) and (4), Health and Safety
	Code, are amended to read as follows:
	(1)  "Commission" means the Health and Human Services
	Commission ["Commissioner" means the commissioner of aging and
	disability services].
	(4)  "Facility" means:
	(A)  a nursing facility[:
	[(i)]  licensed by the commission under
	Chapter 242 [department]; [or]
	(B)  an intermediate care facility for
	individuals with an intellectual disability [(ii)] licensed by the
	commission under Chapter 252;
	(C) [(B)]  an adult foster care provider that
	contracts with the commission [department];
	(D) [(C)]  a home and community support services
	agency licensed by the commission [department] under Chapter 142;
	[or]
	(E) [(D)]  a prescribed pediatric extended care
	center licensed by the commission under Chapter 248A;
	(F)  an assisted living facility licensed by the
	commission under Chapter 247;
	(G)  a day activity and health services facility
	licensed by the commission under Chapter 103, Human Resources Code;
	(H)  a residential child-care facility as defined
	by Section 42.002, Human Resources Code, at which an elderly person
	or an adult with a disability resides or is in the facility's care;
	(I)  a provider who provides home and
	community-based services under the home and community-based
	services (HCS) waiver program or the Texas home living (TxHmL)
	waiver program; or
	(J)  a facility that is exempt from licensure
	under Section 252.003.
	SECTION 10.  Section 260A.001, Health and Safety Code, is
	amended by adding Subdivision (1-a) to read as follows:
	(1-a)  "Commission" means the Health and Human Services
	Commission.
	SECTION 11.  Section 260A.002, Health and Safety Code, is
	amended by amending Subsections (a-1) and (c) and adding Subsection
	(d) to read as follows:
	(a-1)  Notwithstanding any other provision of this chapter,
	a report made under this section that a provider is or may be
	alleged to have committed abuse, neglect, or exploitation of a
	resident of a facility other than a prescribed pediatric extended
	care center shall be investigated by the commission [Department of
	Family and Protective Services] in accordance with Subchapter F,
	Chapter 48, Human Resources Code, and this chapter does not apply to
	that investigation. In this subsection, "facility" and "provider"
	have the meanings assigned by Section 48.251, Human Resources Code.
	(c)  A person shall make an oral or electronic report
	immediately on learning of the abuse, neglect, or exploitation [and
	shall make a written report to the department not later than the
	fifth day after the oral report is made].
	(d)  A facility or provider shall submit a provider
	investigation report to the commission not later than the fifth day
	after the date the facility or provider makes the oral or electronic
	report under Subsection (c).
	SECTION 12.  Section 260A.007, Health and Safety Code, is
	amended by amending Subsection (e) and adding Subsection (e-1) to
	read as follows:
	(e)  In investigating the report of abuse, neglect,
	exploitation, or other complaint, the investigator for the
	commission [department] shall:
	(1)  conduct [make] an unannounced investigation
	[visit to the facility] to determine the nature and cause of the
	alleged abuse, neglect, or exploitation of the resident;
	(2)  interview each available witness, including the
	resident who suffered the alleged abuse, neglect, or exploitation
	if the resident is able to communicate or another resident or other
	witness identified by any source as having personal knowledge
	relevant to the report of abuse, neglect, exploitation, or other
	complaint;
	(3)  [personally] inspect any physical circumstance
	that is relevant and material to the report of abuse, neglect,
	exploitation, or other complaint and that may be objectively
	observed;
	(4)  if an on-site investigation is conducted, make a
	photographic record of any injury to a resident, subject to
	Subsection (n);
	(5)  write an investigation report that includes:
	(A)  the investigator's personal observations;
	(B)  a review of relevant documents and records;
	(C)  a summary of each witness statement,
	including the statement of the resident that suffered the alleged
	abuse, neglect, or exploitation and any other resident interviewed
	in the investigation; and
	(D)  a statement of the factual basis for the
	findings for each incident or problem alleged in the report or other
	allegation; and
	(6)  for a resident of an institution or assisted
	living facility, inspect any court order appointing a guardian of
	the resident who was the subject of the alleged abuse, neglect, or
	exploitation that is maintained in the resident's medical records
	under Section 242.019 or 247.070.
	(e-1)  In addition to the requirements under Subsection (e),
	the commission shall make an unannounced visit to a facility to
	conduct an investigation of abuse or neglect.
	SECTION 13.  Section 48.0021, Human Resources Code, is
	amended to read as follows:
	Sec. 48.0021.  REFERENCE TO COMMISSION OR EXECUTIVE
	COMMISSIONER.  Unless otherwise provided by a provision of this
	chapter, in [In] this chapter:
	(1)  a reference to the Health and Human Services
	Commission means the Department of Family and Protective Services;
	and
	(2)  a reference to the executive commissioner means
	the commissioner of the Department of Family and Protective
	Services.
	SECTION 14.  Section 48.051, Human Resources Code, is
	amended by adding Subsection (b-1) and amending Subsection (c) to
	read as follows:
	(b-1)  This subsection applies only to a provider under the
	home and community-based services (HCS) waiver program or the Texas
	home living (TxHmL) waiver program, an intermediate care facility
	licensed under Chapter 252, Health and Safety Code, a state
	supported living center as defined by Section 531.002, Health and
	Safety Code, or a home and community support services agency
	licensed under Chapter 142, Health and Safety Code. Except as
	provided by Subsections (a) and (b), a person, including an
	officer, employee, agent, contractor, or subcontractor of a
	facility or provider subject to this subsection, having cause to
	believe that an individual receiving services from the facility or
	provider is in the state of abuse, neglect, or exploitation shall
	immediately report to the commission the information required by
	Subsection (d). Notwithstanding Section 48.0021, in this
	subsection "commission" means the Health and Human Services
	Commission.
	(c)  The duty imposed by Subsections (a), (b), and (b-1)
	[(b)] applies without exception to a person whose knowledge
	concerning possible abuse, neglect, or exploitation is obtained
	during the scope of the person's employment or whose professional
	communications are generally confidential, including an attorney,
	clergy member, medical practitioner, social worker, employee or
	member of a board that licenses or certifies a professional, and
	mental health professional.
	SECTION 15.  Section 48.251(a), Human Resources Code, is
	amended by adding Subdivisions (1-a) and (2-a) and amending
	Subdivision (3) to read as follows:
	(1-a)  "Commission" means the Health and Human Services
	Commission, notwithstanding Section 48.0021.
	(2-a)  "Executive commissioner" means the executive
	commissioner of the Health and Human Services Commission,
	notwithstanding Section 48.0021.
	(3)  "Facility" means:
	(A)  a facility listed in Section 532.001(b) or
	532A.001(b), Health and Safety Code, [including community services
	operated by the Department of State Health Services or Department
	of Aging and Disability Services,] as described by those sections,
	or a person contracting with a health and human services agency to
	provide inpatient mental health services; [and]
	(B)  a facility licensed under Chapter 252, Health
	and Safety Code;
	(C)  a residential child-care facility as defined
	by Section 42.002 at which an elderly person or an adult with a
	disability resides or is in the facility's care; and
	(D)  a home and community support services agency
	licensed under Chapter 142, Health and Safety Code.
	SECTION 16.  Sections 48.252(b) and (c), Human Resources
	Code, are amended to read as follows:
	(b)  The department may not investigate under this
	subchapter reports of abuse, neglect, or exploitation alleged or
	suspected to have been committed by a provider that is operated,
	licensed, certified, or registered by a state agency that has
	authority under this chapter or other law to investigate reports of
	abuse, neglect, or exploitation of an individual by the provider.
	The department shall forward any report of abuse, neglect, or
	exploitation alleged or suspected to have been committed by a
	provider described by this subsection to the commission
	[appropriate state agency] for investigation.
	(c)  The commission [department] shall receive and
	investigate under this subchapter reports of abuse, neglect, or
	exploitation of:
	(1)  an individual who lives in a residence that is
	owned, operated, or controlled by a provider who provides home and
	community-based services under the home and community-based
	services waiver program described by Section 534.001(11)(B),
	Government Code, regardless of whether the individual is receiving
	services under that waiver program from the provider; and
	(2)  an elderly person or an adult with a disability who
	lives in or is in the care of a residential child-care facility as
	defined by Section 42.002.
	SECTION 17.  Sections 48.253(a), (b), and (c), Human
	Resources Code, are amended to read as follows:
	(a)  On receipt by the commission [department] of a report of
	alleged abuse, neglect, or exploitation under this subchapter, the
	commission [department] shall initiate a prompt and thorough
	investigation as needed to evaluate the accuracy of the report and
	to assess the need for emergency protective services, unless the
	commission [department], in accordance with rules adopted under
	this subchapter, determines that the report:
	(1)  is frivolous or patently without a factual basis;
	or
	(2)  does not concern abuse, neglect, or exploitation.
	(b)  After receiving a report that alleges that a provider is
	or may be the person who committed the alleged abuse, neglect, or
	exploitation, the commission [department] shall notify the
	provider [and the appropriate health and human services agency] in
	accordance with rules adopted by the executive commissioner.
	(c)  The provider identified under Subsection (b) shall:
	(1)  cooperate completely with an investigation
	conducted under this subchapter; and
	(2)  provide the commission [department] complete
	access during an investigation to:
	(A)  all sites owned, operated, or controlled by
	the provider; and
	(B)  clients and client records.
	SECTION 18.  Sections 48.254(a) and (c), Human Resources
	Code, are amended to read as follows:
	(a)  The executive commissioner by rule shall establish
	procedures for the commission [department] to use to forward a copy
	of the initial intake report and a copy of the completed provider
	investigation report relating to alleged or suspected abuse,
	neglect, or exploitation to the appropriate provider [and health
	and human services agency].
	(c)  A provider that receives the findings of an [a
	completed] investigation from the commission report under
	Subsection (a) shall forward the findings [report] to the managed
	care organization with which the provider contracts for services
	for the alleged victim.
	SECTION 19.  Sections 48.255(a) and (b), Human Resources
	Code, are amended to read as follows:
	(a)  The executive commissioner shall adopt rules to:
	(1)  prioritize investigations conducted under this
	subchapter with the primary criterion being whether there is a risk
	that a delay in the investigation will impede the collection of
	evidence in that investigation; and
	(2)  [establish procedures for resolving disagreements
	between the department and health and human services agencies
	concerning the department's investigation findings; and
	[(3)]  provide for an appeals process by the commission
	[department] for the alleged victim of abuse, neglect, or
	exploitation.
	(b)  A confirmed investigation finding by the commission
	[department] may not be changed by the administrator of a facility,
	a community center, a local mental health authority, or a local
	intellectual and developmental disability authority.
	SECTION 20.  Sections 48.256(a), (b), and (c), Human
	Resources Code, are amended to read as follows:
	(a)  The executive commissioner shall adopt rules that
	prescribe the appropriate manner in which [health and human
	services agencies and] managed care organizations provide the
	commission [department] with information necessary to facilitate
	the:
	(1)  identification of individuals receiving services
	from providers; and
	(2)  [to facilitate] notification of providers by the
	commission [department].
	(b)  The executive commissioner shall adopt rules requiring
	a provider to provide information [to the administering health and
	human services agency] necessary to facilitate the:
	(1)  identification by the commission [department] of
	individuals receiving services from providers; and
	(2)  [to facilitate] notification of providers by the
	commission [department].
	(c)  A provider of home and community-based services under
	the home and community-based services waiver program described by
	Section 534.001(11)(B), Government Code, shall post in a
	conspicuous location inside any residence owned, operated, or
	controlled by the provider in which home and community-based waiver
	services are provided, a sign that states:
	(1)  the name, address, and telephone number of the
	provider;
	(2)  the effective date of the provider's contract with
	the commission [applicable health and human services agency] to
	provide home and community-based services; and
	(3)  the name of the legal entity that contracted with
	the commission [applicable health and human services agency] to
	provide those services.
	SECTION 21.  Sections 48.258(a) and (b), Human Resources
	Code, are amended to read as follows:
	(a)  The commission [health and human services agencies]
	shall[, at the direction of the executive commissioner, jointly]
	develop and implement a system to track reports and investigations
	under this subchapter.
	(b)  To facilitate implementation of the system, the
	commission [health and human services agencies] shall use
	appropriate methods of measuring the number and outcome of reports
	and investigations under this subchapter.
	SECTION 22.  Section 103.008(b), Human Resources Code, is
	amended to read as follows:
	(b)  Any person may request an inspection of a facility by
	notifying the commission in writing of an alleged violation of a
	licensing requirement.  The complaint shall be as detailed as
	possible and signed by the complainant.  The commission shall:
	(1)  if the complaint alleges abuse, neglect, or
	exploitation, perform an [on-site] inspection as soon as feasible
	but not [no] later than the 14th day [30 days] after the date the
	commission receives [receiving] the complaint, unless after an
	investigation the complaint is found to be frivolous;[.  The
	commission shall respond to a complainant in writing.]
	(2)  if the complaint does not allege abuse, neglect,
	or exploitation, investigate the complaint not later than the 45th
	day after the date the commission receives the complaint;
	(3)  respond to a complainant in writing; and
	(4)  [The commission shall also] receive and
	investigate anonymous complaints.
	SECTION 23.  The following provisions are repealed:
	(1)  Section 252.121(b), Health and Safety Code;
	(2)  Section 252.126(b), Health and Safety Code;
	(3)  Section 48.252(a), Human Resources Code; and
	(4)  Section 48.254(b), Human Resources Code.
	SECTION 24.  (a)  As soon as practicable after the effective
	date of this Act, but not later than December 1, 2024, the
	commissioner of the Department of Family and Protective Services
	shall transfer any department funds and resources, including
	information technology, documents, and personnel allocated for the
	investigation of reports under Subchapter F, Chapter 48, Human
	Resources Code, to the Health and Human Services Commission to
	allow the commission to perform the functions described under
	Subchapter F, Chapter 48, Human Resources Code, as amended by this
	Act.
	(b)  Notwithstanding the effective date of this Act, the
	Health and Human Services Commission is not required to comply with
	changes in law made by this Act until the transfer required by
	Subsection (a) of this section is completed.
	SECTION 25.  If before implementing any provision of this
	Act a state agency determines that a waiver or authorization from a
	federal agency is necessary for implementation of that provision,
	the agency affected by the provision shall request the waiver or
	authorization and may delay implementing that provision until the
	waiver or authorization is granted.
	SECTION 26.  This Act takes effect September 1, 2023.
	______________________________	______________________________
	President of the Senate	Speaker of the House
	I certify that H.B. No. 4696 was passed by the House on May 2,
	2023, by the following vote:  Yeas 139, Nays 1, 1 present, not
	voting; and that the House concurred in Senate amendments to H.B.
	No. 4696 on May 26, 2023, by the following vote:  Yeas 138, Nays 0,
	1 present, not voting.
	______________________________
	Chief Clerk of the House
	I certify that H.B. No. 4696 was passed by the Senate, with
	amendments, on May 24, 2023, by the following vote:  Yeas 30, Nays
	0.
	______________________________
	Secretary of the Senate
	APPROVED: __________________
	Date
	__________________
	Governor