Amends TCA Title 2; Title 4; Title 8; Title 12; Title 13; Title 33; Title 34; Title 37; Title 40; Title 41; Title 45; Title 49; Title 52; Title 55; Title 56; Title 63; Title 67; Title 68; Title 71 and Chapter 1100 of the Public Acts of 2010.
This bill reconstitutes the department of intellectual and developmental disabilities into a newly created department of disability and aging. The general functions of the newly created department are to coordinate, set standards for, plan for, monitor, and promote the development and provision of services and supports to meet the needs of persons with disabilities and persons who are 60 or older ("older persons") through the public and private sectors in this state. This bill transfers such duties of the department of intellectual and developmental disabilities relative to those functions to the newly created department. Additionally, this bill moves some of those duties relative to those functions from the existing commission on aging and disability to the department of disability and aging and attaches that commission to the department of disability and aging. POWERS AND DUTIES This bill transfers from the department of intellectual and developmental disabilities and commission on aging and disability various powers and duties, including managing services for individuals with intellectual or developmental disabilities and facilities, enforcing rules applicable to persons supported, upholding rights of residential persons supported, operating secure units and forensic services, managing services for children who have an intellectual or developmental disability, and providing administrative support to various boards, commissions, and councils as detailed in the bill. Generally, the powers and duties described in present law with regard to these listed powers and duties are otherwise unchanged. As used in this bill, a "person supported" means a person who is (i) receiving service, has applied for services, or for whom someone has applied for or proposed services because the person has an intellectual or developmental disability; (ii) receiving service, has applied for services, or for whom someone has applied for or proposed services because the person is an older person or otherwise eligible for the state-funded long-term care home and community services program or public guardianship program for the elderly; or (iii) receiving early intervention services, has applied for early intervention services, or for whom someone has applied for or proposed early intervention services. REGULATION OF FACILITIES This bill provides that the department of disability and aging has jurisdiction over the intellectual and developmental disabilities facilities of the state, regardless of the names by which the facilities are known. The department, through its appropriate officials, has the power and duty to provide the best possible care for persons with intellectual and developmental disabilities in the state by improving existing facilities, by developing future facilities and programs, and by adopting a preventive program for intellectual and developmental disabilities, with control over those services and supports. Licensing of these facilities is the responsibility of the department of disability and aging. SERVICE PLAN DEVELOPMENT Present law provides that if upon completion of an evaluation of a person under involuntary commitment, judicial commitment, or transfer, the department of intellectual and developmental disabilities determines that the person meets the standards relative to certain criminal defendants, then the department must attempt to develop a service plan for the person for the purpose stated. The plan must be for a maximum of two years, and a person must not participate in the plan for more than two years. This bill places the above responsibility upon the department of disability and aging and adds to the present law by also qualifying the attempt to develop such a service plan on whether the department certifies to the court that there are funds available within the limits of the department's line-item appropriation for services. OTHER PROGRAMS, OFFICES, AND DUTIES ALZHEIMER'S AND DEMENTIA RESPITE CARE PILOT PROGRAM. Through December 31, 2025, present law creates the Alzheimer's and dementia respite care pilot program to provide home- and community-based services through grants provided to each of the nine area agencies on aging and disability in this state. This bill transfers this program from the commission on aging and disability to the department of disability and aging. OFFICE OF LONG-TERM CARE OMBUDSMAN. Present law establishes within the commission on aging and disability an office of the state long-term care ombudsman, which carries out those functions delineated in the Older Americans Act. The office must designate and contract with, either directly or through the area agency on aging, a local grantee to establish and operate a local ombudsman program in each of the designated planning and service areas. This bill transfers this office from the commission on aging and disability to the department of disability and aging. CONGREGATE AND HOME-DELIVERED MEALS. Present law requires the standards and procedures developed by the commission on aging and disability relative to the nutrition program for older persons operated in accordance with the Older Americans Act to establish a threshold of an annual average of 10 congregate and home-delivered meals a day for any nutrition sites. This bill transfers this program from the commission on aging and disability to the department of disability and aging. WORKING GROUP. Present law requires the executive director of the commission on aging and disability to establish a working group to draft and develop a field guide to provide law enforcement in this state with the specific statutes and other resources related to assisting in the prevention, investigation, and prosecution of abuse of adults. This bill transfers this working group from the commission on aging and disability to the department of disability and aging. MULTIDISCIPLINARY COLLABORATIVE COALITION. Present law requires the executive director of the commission on aging and disability to establish and lead a multidisciplinary collaborative coalition of state agencies and departments involved in the prevention, investigation, and prosecution of elder and vulnerable adult abuse, neglect, and exploitation in order to develop and undertake strategies to increase communication with the public and state agencies, propose educational outreach, and promote the sharing of existing resources and information. This bill transfers this coalition from the commission on aging and disability to the department of disability and aging. TENNESSEE VULNERABLE ADULT COALITION. Present law establishes the Tennessee vulnerable adult coalition (TVAC) as an advisory entity, which is administratively attached to the commission on aging and disability, to bring public and private entities in this state together to promote the collaboration necessary to prevent the abuse, neglect, and financial exploitation of elderly and vulnerable adults. This bill transfers this coalition from the commission on aging and disability to the department of disability and aging. RESOURCE MAPPING FOR FUNDING FOR SUPPORT OF OLDER ADULTS. Present law requires the commission on aging and disability to oversee a resource mapping of all federal-and state-funding sources and funding streams as well as resources for nonprofit and other nongovernmental entities that support the health, safety, and welfare of older adults in this state. This bill transfers this duty from the commission on aging and disability to the department of disability and aging. UNLICENSED FACILITIES REGISTRY. Present law requires the commission on aging and disability to maintain a registry containing the names and addresses of unlicensed facilities that have been determined by a state agency to be providing care to elderly or vulnerable persons without maintaining the appropriate licensure and to publish the registry on its website. This bill transfers this duty from the commission on aging and disability to the department of disability and aging. CONFIDENTIALITY OF RECORDS GENERALLY. This bill applies the same confidentiality law found in present law to all applications, certificates, records, reports, legal documents, and pleadings made and all information provided or received in connection with services applied for, provided under, or regulated under this bill and directly or indirectly identifying a person supported or former person supported. However, this bill adds to present law that such confidentiality protections remain in effect until 50 years after the death of the individual who is the subject of the confidential information. AUTHORIZED TO DISCLOSE WITH CONSENT. This bill authorizes information about a person supported that is confidential to be disclosed with the consent of (i) the person supported who is 16 or older; (ii) the conservator of the person supported or a conservator whom the court has granted the authority to make such disclosures; (iii) the attorney in fact under a power of attorney who has the right to make disclosures under the power; (iv) the parent, legal guardian, or legal custodian of a person supported who is a child; (v) the person supported's guardian ad litem for the purposes of the litigation in which the guardian ad litem serves; (vi) the executor or administrator of the estate of a deceased adult person supported, or the parent or legal guardian of a deceased person supported who was a minor at the time of death; (vii) the caregiver under a power of attorney for care of a minor child; or (viii) an individual acting as an agent, or a person's surrogate as designated, under the Tennessee Health Care Decisions Act. AUTHORIZED TO DISCLOSE WITHOUT CONSENT. This bill authorizes the information that is confidential to be disclosed without consent of the person supported if the following criteria is met: (1) Disclosure is necessary to carry out duties under this bill; (2) Disclosure is for the purposes of treatment, payment for treatment, or health care operations; (3) Disclosure may be necessary to assure service or care to the person supported by the least drastic means that are suitable to the person supported's liberty and interests; (4) The disclosure is for a judicial or administrative proceeding and the confidential information is disclosed in compliance with federal law; (5) If not contrary to other law or court order, it is solely information as to a residential person supported's overall medical condition without clinical details and is sought by the person supported's family members, relatives, conservator, legal guardian, legal custodian, guardian ad litem, foster parents, or friends; (6) A person supported moves from one service provider to another and exchange of information is necessary for continuity of service; (7) A custodial agent for another state agency that has legal custody of the person supported cannot perform the agent's duties properly without the information; (8) Necessary for the preparation of a post-mortem examination report and authorized to be obtained pursuant to state law; or (9) The disclosure is one permitted under, and the disclosure complies with federal law. ADDITIONAL PERMITTED DISCLOSURES. This bill does not preclude making reports of harm or granting access to records if making such reports or granting such access is (i) expressly required by law relative to mandatory child abuse reporting, child sexual abuse, adult protection, and other family and sexual abuse; or (ii) requested by a state or federal entity investigating reports of abuse, neglect, or exploitation under the respective authority of that state or federal entity. PERSON SUPPORTED'S ACCESS TO OWN RECORDS. Upon request by a person supported 18 or older, or the person supported's conservator, if applicable, this bill requires a service provider to disclose to the person supported or their conservator what records the provider maintains on the person supported and how the person supported or conservator can obtain access to them. Upon written request by a person supported or their conservator, a service provider must permit the person supported or conservator, within a reasonable time, to review the person supported's record, or the part of the record that the person supported or conservator requests, or a copy of the record, or a copy of the part of the record that the person supported or conservator requests, except to the extent that (i) the person supported's or conservator's access to the record is expressly restricted or prohibited by another statute or court order; or (ii) the provider is authorized to deny access. If a person's qualified mental health professional determines that giving the person supported, or a person acting for the person supported, access to part of the person supported's record poses a substantial risk of serious harm to the health or safety of the person supported or another person, then the qualified mental health professional may refuse access to that part of the record. STATE PALLIATIVE CARE AND QUALITY OF LIFE ADVISORY COUNCIL Present law provides that the state palliative care and quality of life council is administratively attached to the commission on aging and disability, wherein the executive director of the commission on aging and disability makes appointments to the council. This bill revises the present law by administratively attaching the council to the department of health and substituting the executive director for the commissioner of health for the appointments. ALZHEIMER'S DISEASE AND RELATED DEMENTIA ADVISORY COUNCIL Present law provides that the state Alzheimer's disease and related dementia advisory council is administratively attached to the commission on aging and disability, wherein one of the members is the commissioner of health and several members are appointed to the council by the executive director of the commission on aging and disability. This bill revises the present law by administratively attaching the council to the department of health, substituting the commissioner of health as one of the members for the commission of disability and aging, and substituting the executive director for the commissioner of health for the applicable appointments. CURRENT MEMBERS OF AFFECTED BOARDS, COMMISSIONS, OR COUNCILS This bill provides that each member serving, as of June 30, 2024, on a board, commission, or council affected by this bill continues to serve as a member on July 1, 2024, through to the end of the member's existing term. RULEMAKING This bill requires the commissioner of disability and aging to promulgate, amend, revise, and rescind rules as are necessary and appropriate to carry out this bill. ON MARCH 18, 2024, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2098, AS AMENDED. AMENDMENT #1 makes the following changes: (1) Changes the definition of "person supported" to mean a person who is an individual who qualifies or may qualify for programs or supports through the department of disability and aging ("department"); (2) Changes the definition of "support" to mean any activity or resource that enables a person supported to participate in a service or program through the department; DEPARTMENT POWERS AND DUTIES (3) Requires the department to serve as an advocate within the government and the community for older persons and persons with disabilities in this state; (4) Authorizes the department to establish or review pilot projects relating to intellectual or developmental disabilities, including projects to provide, develop, or plan service and support for its persons supported or their families through direct administration or through contracting with service providers, as well as research, pilot projects, and programs designed to promote and encourage healthy aging. Pilot projects are subject to other state and federal laws; (5) Authorizes the department to, independently or in coordination with other agencies, conduct, develop, and implement research, pilot projects, and programs designed to promote and encourage healthy aging; POWER AND DUTIES OF COMMISSIONER OF DISABILITY AND AGING ("COMMISSIONER") (6) Authorizes the commissioner to select and recommend to the appropriate state officials the employment of all personnel required for the operation of the department; (7) Removes the authorization for the commissioner to publish a report on the operation of the department and the facilities and programs under its supervision; furnish the report to the governor and members of the general assembly; and upon approval of the governor, further distribute copies of the report as considered proper by the commissioner; INTERAGENCY AGREEMENTS (8) Authorizes the commissioner to develop and enter into interagency agreements on services and supports for individuals with a disability or for older persons, instead of individuals with an intellectual or developmental disability; (9) Authorizes the commissioner to develop and enter into interagency agreements on services and supports for individuals with a disability or for older persons to promote inclusion of disability and aging issues in crisis and disaster planning; DEVELOPMENTAL DISABILITIES PLANNING AND POLICY AND REGIONAL CITIZEN-BASED PLANNING AND POLICY COUNCILS (10) Requires the department to establish a state developmental disabilities planning and policy council and a regional citizen-based planning and policy council, each composed of persons supported, family members of persons supported, advocates for persons supported, and other affected persons and organizations for each of the three grand divisions of the state. For purposes of the state developmental disabilities planning and policy council, "persons supported" means an individual with a developmental disability. For purposes of the regional citizen-based planning and policy councils, ''persons supported'' means an individual with an intellectual or developmental disability; (11) Removes the requirement for the regional citizen-based planning and policy councils established by the department to strive to ensure that at least a majority of each council's membership consists of current or former persons supported and family members of persons supported; DISABILITY SERVICES AND PERSONAL SUPPORT SERVICES LICENSURE LAW (12) Establishes that an area agency on aging and disability is exempt from licensing under this heading; (13) Requires that the membership of the review panel appointed to review periodically all exclusions and waivers granted under the licensure law include a representative of a licensed residential facility for persons with intellectual or developmental disabilities, instead of a licensed residential facility for persons with disability and aging services; (14) Authorizes the sue to enjoin any person, partnership, association, or corporation from establishing, conducting, managing, or operating any service or facility providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services within the meaning of the bill without having obtained a license as required or while its license has been suspended or revoked. Suit may be brought in the name of the state, either by the attorney general or by the legal counsel for the department, in the chancery court of Davidson County or in the chancery court of the county in which all or part of the violations occurred; (15) If the commissioner finds that a service or facility is providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services without a license as required under the bill, authorizes the commissioner to, without prior notice, order the service or facility immediately to cease and desist from providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services. Before issuing a cease and desist order, the commissioner must find that issuing the order is in the public interest; necessary for the protection of the health, safety, or welfare of the persons supported of the service or facility; and consistent with the purposes fairly intended by the bill; TRANSPORTATION (16) Requires the department to, at least annually, convene a meeting on transportation services for persons with an intellectual or developmental disability and for older persons; COSTS IN STATE FACILITIES (17) Authorizes the commissioner, in consultation with, instead of with the approval of, the comptroller of the treasury and with the approval of the commissioner of finance and administration, to establish by rule a method for determination at least annually of charges for services and supports provided to persons supported in programs operated by the department, including the charges for all institutional or professional services; (18) Authorizes the commissioner, in consultation with, instead of with the approval of, the comptroller of the treasury and with the approval of the commissioner of finance and administration, to establish rules for determining indigence and payments to be made periodically by nonindigent persons supported or their responsible relatives; (19) Adds that for purposes of a person supported who obtains services and supports under a court order from a program operated by the department, "person supported" does not include persons receiving services under the public guardianship program for the elderly authorized by state law; (20) Adds that if the state has a continuing claim against a person supported by a program operated by the department. "person supported" does not include persons receiving services under the public guardianship program for the elderly authorized by state law; (21) Clarifies that a person whose service is
This bill reconstitutes the department of intellectual and developmental disabilities into a newly created department of disability and aging. The general functions of the newly created department are to coordinate, set standards for, plan for, monitor, and promote the development and provision of services and supports to meet the needs of persons with disabilities and persons who are 60 or older ("older persons") through the public and private sectors in this state. This bill transfers such duties of the department of intellectual and developmental disabilities relative to those functions to the newly created department. Additionally, this bill moves some of those duties relative to those functions from the existing commission on aging and disability to the department of disability and aging and attaches that commission to the department of disability and aging. POWERS AND DUTIES This bill transfers from the department of intellectual and developmental disabilities and commission on aging and disability various powers and duties, including managing services for individuals with intellectual or developmental disabilities and facilities, enforcing rules applicable to persons supported, upholding rights of residential persons supported, operating secure units and forensic services, managing services for children who have an intellectual or developmental disability, and providing administrative support to various boards, commissions, and councils as detailed in the bill. Generally, the powers and duties described in present law with regard to these listed powers and duties are otherwise unchanged. As used in this bill, a "person supported" means a person who is (i) receiving service, has applied for services, or for whom someone has applied for or proposed services because the person has an intellectual or developmental disability; (ii) receiving service, has applied for services, or for whom someone has applied for or proposed services because the person is an older person or otherwise eligible for the state-funded long-term care home and community services program or public guardianship program for the elderly; or (iii) receiving early intervention services, has applied for early intervention services, or for whom someone has applied for or proposed early intervention services. REGULATION OF FACILITIES This bill provides that the department of disability and aging has jurisdiction over the intellectual and developmental disabilities facilities of the state, regardless of the names by which the facilities are known. The department, through its appropriate officials, has the power and duty to provide the best possible care for persons with intellectual and developmental disabilities in the state by improving existing facilities, by developing future facilities and programs, and by adopting a preventive program for intellectual and developmental disabilities, with control over those services and supports. Licensing of these facilities is the responsibility of the department of disability and aging. SERVICE PLAN DEVELOPMENT Present law provides that if upon completion of an evaluation of a person under involuntary commitment, judicial commitment, or transfer, the department of intellectual and developmental disabilities determines that the person meets the standards relative to certain criminal defendants, then the department must attempt to develop a service plan for the person for the purpose stated. The plan must be for a maximum of two years, and a person must not participate in the plan for more than two years. This bill places the above responsibility upon the department of disability and aging and adds to the present law by also qualifying the attempt to develop such a service plan on whether the department certifies to the court that there are funds available within the limits of the department's line-item appropriation for services. OTHER PROGRAMS, OFFICES, AND DUTIES ALZHEIMER'S AND DEMENTIA RESPITE CARE PILOT PROGRAM. Through December 31, 2025, present law creates the Alzheimer's and dementia respite care pilot program to provide home- and community-based services through grants provided to each of the nine area agencies on aging and disability in this state. This bill transfers this program from the commission on aging and disability to the department of disability and aging. OFFICE OF LONG-TERM CARE OMBUDSMAN. Present law establishes within the commission on aging and disability an office of the state long-term care ombudsman, which carries out those functions delineated in the Older Americans Act. The office must designate and contract with, either directly or through the area agency on aging, a local grantee to establish and operate a local ombudsman program in each of the designated planning and service areas. This bill transfers this office from the commission on aging and disability to the department of disability and aging. CONGREGATE AND HOME-DELIVERED MEALS. Present law requires the standards and procedures developed by the commission on aging and disability relative to the nutrition program for older persons operated in accordance with the Older Americans Act to establish a threshold of an annual average of 10 congregate and home-delivered meals a day for any nutrition sites. This bill transfers this program from the commission on aging and disability to the department of disability and aging. WORKING GROUP. Present law requires the executive director of the commission on aging and disability to establish a working group to draft and develop a field guide to provide law enforcement in this state with the specific statutes and other resources related to assisting in the prevention, investigation, and prosecution of abuse of adults. This bill transfers this working group from the commission on aging and disability to the department of disability and aging. MULTIDISCIPLINARY COLLABORATIVE COALITION. Present law requires the executive director of the commission on aging and disability to establish and lead a multidisciplinary collaborative coalition of state agencies and departments involved in the prevention, investigation, and prosecution of elder and vulnerable adult abuse, neglect, and exploitation in order to develop and undertake strategies to increase communication with the public and state agencies, propose educational outreach, and promote the sharing of existing resources and information. This bill transfers this coalition from the commission on aging and disability to the department of disability and aging. TENNESSEE VULNERABLE ADULT COALITION. Present law establishes the Tennessee vulnerable adult coalition (TVAC) as an advisory entity, which is administratively attached to the commission on aging and disability, to bring public and private entities in this state together to promote the collaboration necessary to prevent the abuse, neglect, and financial exploitation of elderly and vulnerable adults. This bill transfers this coalition from the commission on aging and disability to the department of disability and aging. RESOURCE MAPPING FOR FUNDING FOR SUPPORT OF OLDER ADULTS. Present law requires the commission on aging and disability to oversee a resource mapping of all federal-and state-funding sources and funding streams as well as resources for nonprofit and other nongovernmental entities that support the health, safety, and welfare of older adults in this state. This bill transfers this duty from the commission on aging and disability to the department of disability and aging. UNLICENSED FACILITIES REGISTRY. Present law requires the commission on aging and disability to maintain a registry containing the names and addresses of unlicensed facilities that have been determined by a state agency to be providing care to elderly or vulnerable persons without maintaining the appropriate licensure and to publish the registry on its website. This bill transfers this duty from the commission on aging and disability to the department of disability and aging. CONFIDENTIALITY OF RECORDS GENERALLY. This bill applies the same confidentiality law found in present law to all applications, certificates, records, reports, legal documents, and pleadings made and all information provided or received in connection with services applied for, provided under, or regulated under this bill and directly or indirectly identifying a person supported or former person supported. However, this bill adds to present law that such confidentiality protections remain in effect until 50 years after the death of the individual who is the subject of the confidential information. AUTHORIZED TO DISCLOSE WITH CONSENT. This bill authorizes information about a person supported that is confidential to be disclosed with the consent of (i) the person supported who is 16 or older; (ii) the conservator of the person supported or a conservator whom the court has granted the authority to make such disclosures; (iii) the attorney in fact under a power of attorney who has the right to make disclosures under the power; (iv) the parent, legal guardian, or legal custodian of a person supported who is a child; (v) the person supported's guardian ad litem for the purposes of the litigation in which the guardian ad litem serves; (vi) the executor or administrator of the estate of a deceased adult person supported, or the parent or legal guardian of a deceased person supported who was a minor at the time of death; (vii) the caregiver under a power of attorney for care of a minor child; or (viii) an individual acting as an agent, or a person's surrogate as designated, under the Tennessee Health Care Decisions Act. AUTHORIZED TO DISCLOSE WITHOUT CONSENT. This bill authorizes the information that is confidential to be disclosed without consent of the person supported if the following criteria is met: (1) Disclosure is necessary to carry out duties under this bill; (2) Disclosure is for the purposes of treatment, payment for treatment, or health care operations; (3) Disclosure may be necessary to assure service or care to the person supported by the least drastic means that are suitable to the person supported's liberty and interests; (4) The disclosure is for a judicial or administrative proceeding and the confidential information is disclosed in compliance with federal law; (5) If not contrary to other law or court order, it is solely information as to a residential person supported's overall medical condition without clinical details and is sought by the person supported's family members, relatives, conservator, legal guardian, legal custodian, guardian ad litem, foster parents, or friends; (6) A person supported moves from one service provider to another and exchange of information is necessary for continuity of service; (7) A custodial agent for another state agency that has legal custody of the person supported cannot perform the agent's duties properly without the information; (8) Necessary for the preparation of a post-mortem examination report and authorized to be obtained pursuant to state law; or (9) The disclosure is one permitted under, and the disclosure complies with federal law. ADDITIONAL PERMITTED DISCLOSURES. This bill does not preclude making reports of harm or granting access to records if making such reports or granting such access is (i) expressly required by law relative to mandatory child abuse reporting, child sexual abuse, adult protection, and other family and sexual abuse; or (ii) requested by a state or federal entity investigating reports of abuse, neglect, or exploitation under the respective authority of that state or federal entity. PERSON SUPPORTED'S ACCESS TO OWN RECORDS. Upon request by a person supported 18 or older, or the person supported's conservator, if applicable, this bill requires a service provider to disclose to the person supported or their conservator what records the provider maintains on the person supported and how the person supported or conservator can obtain access to them. Upon written request by a person supported or their conservator, a service provider must permit the person supported or conservator, within a reasonable time, to review the person supported's record, or the part of the record that the person supported or conservator requests, or a copy of the record, or a copy of the part of the record that the person supported or conservator requests, except to the extent that (i) the person supported's or conservator's access to the record is expressly restricted or prohibited by another statute or court order; or (ii) the provider is authorized to deny access. If a person's qualified mental health professional determines that giving the person supported, or a person acting for the person supported, access to part of the person supported's record poses a substantial risk of serious harm to the health or safety of the person supported or another person, then the qualified mental health professional may refuse access to that part of the record. STATE PALLIATIVE CARE AND QUALITY OF LIFE ADVISORY COUNCIL Present law provides that the state palliative care and quality of life council is administratively attached to the commission on aging and disability, wherein the executive director of the commission on aging and disability makes appointments to the council. This bill revises the present law by administratively attaching the council to the department of health and substituting the executive director for the commissioner of health for the appointments. ALZHEIMER'S DISEASE AND RELATED DEMENTIA ADVISORY COUNCIL Present law provides that the state Alzheimer's disease and related dementia advisory council is administratively attached to the commission on aging and disability, wherein one of the members is the commissioner of health and several members are appointed to the council by the executive director of the commission on aging and disability. This bill revises the present law by administratively attaching the council to the department of health, substituting the commissioner of health as one of the members for the commission of disability and aging, and substituting the executive director for the commissioner of health for the applicable appointments. CURRENT MEMBERS OF AFFECTED BOARDS, COMMISSIONS, OR COUNCILS This bill provides that each member serving, as of June 30, 2024, on a board, commission, or council affected by this bill continues to serve as a member on July 1, 2024, through to the end of the member's existing term. RULEMAKING This bill requires the commissioner of disability and aging to promulgate, amend, revise, and rescind rules as are necessary and appropriate to carry out this bill. ON MARCH 18, 2024, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2098, AS AMENDED. AMENDMENT #1 makes the following changes: (1) Changes the definition of "person supported" to mean a person who is an individual who qualifies or may qualify for programs or supports through the department of disability and aging ("department"); (2) Changes the definition of "support" to mean any activity or resource that enables a person supported to participate in a service or program through the department; DEPARTMENT POWERS AND DUTIES (3) Requires the department to serve as an advocate within the government and the community for older persons and persons with disabilities in this state; (4) Authorizes the department to establish or review pilot projects relating to intellectual or developmental disabilities, including projects to provide, develop, or plan service and support for its persons supported or their families through direct administration or through contracting with service providers, as well as research, pilot projects, and programs designed to promote and encourage healthy aging. Pilot projects are subject to other state and federal laws; (5) Authorizes the department to, independently or in coordination with other agencies, conduct, develop, and implement research, pilot projects, and programs designed to promote and encourage healthy aging; POWER AND DUTIES OF COMMISSIONER OF DISABILITY AND AGING ("COMMISSIONER") (6) Authorizes the commissioner to select and recommend to the appropriate state officials the employment of all personnel required for the operation of the department; (7) Removes the authorization for the commissioner to publish a report on the operation of the department and the facilities and programs under its supervision; furnish the report to the governor and members of the general assembly; and upon approval of the governor, further distribute copies of the report as considered proper by the commissioner; INTERAGENCY AGREEMENTS (8) Authorizes the commissioner to develop and enter into interagency agreements on services and supports for individuals with a disability or for older persons, instead of individuals with an intellectual or developmental disability; (9) Authorizes the commissioner to develop and enter into interagency agreements on services and supports for individuals with a disability or for older persons to promote inclusion of disability and aging issues in crisis and disaster planning; DEVELOPMENTAL DISABILITIES PLANNING AND POLICY AND REGIONAL CITIZEN-BASED PLANNING AND POLICY COUNCILS (10) Requires the department to establish a state developmental disabilities planning and policy council and a regional citizen-based planning and policy council, each composed of persons supported, family members of persons supported, advocates for persons supported, and other affected persons and organizations for each of the three grand divisions of the state. For purposes of the state developmental disabilities planning and policy council, "persons supported" means an individual with a developmental disability. For purposes of the regional citizen-based planning and policy councils, ''persons supported'' means an individual with an intellectual or developmental disability; (11) Removes the requirement for the regional citizen-based planning and policy councils established by the department to strive to ensure that at least a majority of each council's membership consists of current or former persons supported and family members of persons supported; DISABILITY SERVICES AND PERSONAL SUPPORT SERVICES LICENSURE LAW (12) Establishes that an area agency on aging and disability is exempt from licensing under this heading; (13) Requires that the membership of the review panel appointed to review periodically all exclusions and waivers granted under the licensure law include a representative of a licensed residential facility for persons with intellectual or developmental disabilities, instead of a licensed residential facility for persons with disability and aging services; (14) Authorizes the sue to enjoin any person, partnership, association, or corporation from establishing, conducting, managing, or operating any service or facility providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services within the meaning of the bill without having obtained a license as required or while its license has been suspended or revoked. Suit may be brought in the name of the state, either by the attorney general or by the legal counsel for the department, in the chancery court of Davidson County or in the chancery court of the county in which all or part of the violations occurred; (15) If the commissioner finds that a service or facility is providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services without a license as required under the bill, authorizes the commissioner to, without prior notice, order the service or facility immediately to cease and desist from providing intellectual or developmental disability services, services to older persons and adults with disabilities, or personal support services. Before issuing a cease and desist order, the commissioner must find that issuing the order is in the public interest; necessary for the protection of the health, safety, or welfare of the persons supported of the service or facility; and consistent with the purposes fairly intended by the bill; TRANSPORTATION (16) Requires the department to, at least annually, convene a meeting on transportation services for persons with an intellectual or developmental disability and for older persons; COSTS IN STATE FACILITIES (17) Authorizes the commissioner, in consultation with, instead of with the approval of, the comptroller of the treasury and with the approval of the commissioner of finance and administration, to establish by rule a method for determination at least annually of charges for services and supports provided to persons supported in programs operated by the department, including the charges for all institutional or professional services; (18) Authorizes the commissioner, in consultation with, instead of with the approval of, the comptroller of the treasury and with the approval of the commissioner of finance and administration, to establish rules for determining indigence and payments to be made periodically by nonindigent persons supported or their responsible relatives; (19) Adds that for purposes of a person supported who obtains services and supports under a court order from a program operated by the department, "person supported" does not include persons receiving services under the public guardianship program for the elderly authorized by state law; (20) Adds that if the state has a continuing claim against a person supported by a program operated by the department. "person supported" does not include persons receiving services under the public guardianship program for the elderly authorized by state law; (21) Clarifies that a person whose service is
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