88R2527 JCG-D

By: A. Johnson of Harris H.B. No. 667

A BILL TO BE ENTITLED

AN ACT

relating to the licensing and regulation of music therapists; requiring an occupational license; authorizing fees.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 51.2031(a), Occupations Code, is amended to read as follows:

(a) This section applies only to the regulation of the following professions by the department:

(1) athletic trainers;

(2) behavior analysts;

(3) dietitians;

(4) hearing instrument fitters and dispensers;

(5) midwives;

(6) music therapists;

(7) orthotists and prosthetists; and

(8) [(7)] speech-language pathologists and audiologists.

SECTION 2. Section 51.254(b), Occupations Code, is amended to read as follows:

(b) This section applies to health-related professions regulated by this state the administration of which is assigned to the department by law, including the following professions:

(1) athletic trainers regulated under Chapter 451;

(2) behavior analysts regulated under Chapter 506;

(3) dietitians regulated under Chapter 701;

(4) dyslexia practitioners and dyslexia therapists regulated under Chapter 403;

(5) hearing instrument fitters and dispensers regulated under Chapter 402;

(6) massage therapists regulated under Chapter 455;

(7) midwives regulated under Chapter 203;

(8) music therapists regulated under Chapter 456;

(9) orthotists and prosthetists regulated under Chapter 605;

(10) [(9)] podiatrists regulated under Chapter 202; and

(11) [(10)] speech-language pathologists and audiologists regulated under Chapter 401.

SECTION 3. Subtitle H, Title 3, Occupations Code, is amended by adding Chapter 456 to read as follows:

CHAPTER 456. MUSIC THERAPISTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 456.001. SHORT TITLE. This chapter may be cited as the Music Therapist Licensing Act.

Sec. 456.002. DEFINITIONS. In this chapter:

(1) "Advisory board" means the Music Therapist Advisory Board created under Subchapter B.

(2) "Certifying entity" means the nationally accredited Certification Board for Music Therapists or another entity that is accredited by the National Commission for Certifying Agencies or the American National Standards Institute to issue credentials in the professional practice of music therapy and approved by the department.

(3) "Commission" means the Texas Commission of Licensing and Regulation.

(4) "Department" means the Texas Department of Licensing and Regulation.

(5) "Executive director" means the executive director of the department.

(6) "Music therapist" means a person who holds a music therapist license issued by the department under this chapter.

(7) "Music therapy" means the clinical and evidence-based use of music interventions by a person for a client who is in a therapeutic relationship with the person to assist the client in accomplishing particular goals. The music interventions may include music improvisation, receptive music listening, songwriting, lyric discussion, music and imagery, singing, music performance, learning through music, music combined with other arts, music-assisted relaxation, music-based patient education, electronic music technology, adapted music intervention, and movement to music. The practice of music therapy does not include the diagnosis or assessment of or screening for any physical, mental, or communication disorder. The term includes:

(A) accepting referrals for music therapy services from medical, developmental, mental health, or education professionals, family members, clients, caregivers, or any other person involved with the provision of music therapy services;

(B) conducting an assessment of a client to determine whether music therapy is recommended or necessary for the client, including the collection of information to determine the recommended or necessary manner of music therapy services;

(C) developing an individualized music therapy treatment plan based on an assessment described by Paragraph (B), including specific goals for the client, specific methods to be used to achieve the goals, and a plan to ensure that the client receives music therapy in the least restrictive environment;

(D) implementing an individualized music therapy treatment plan that is consistent with any other medical, developmental, mental health, educational, preventative, or wellness services being provided to a client;

(E) evaluating a client's response to a music therapy treatment plan, documenting progress, and recommending changes, including terminating treatment, as appropriate;

(F) collaborating with any appropriate person with regard to a client receiving music therapy services, including the client's caretakers or family, to ensure that the music therapy services are appropriate; and

(G) researching and applying best practices as applicable to each clinical setting.

Sec. 456.003. APPLICABILITY. (a) This chapter does not apply to:

(1) a person certified, or otherwise accredited, to practice an occupation and who uses music within the scope of that accreditation and within the scope of the person's training, education, and competence, including a licensed health care worker or other professional acting within the scope of the person's license;

(2) a student who is performing activities under the supervision of a license holder as part of a degree program described by Section 456.153(2);

(3) a person employed:

(A) in the service of the federal government while performing duties related to that employment; or

(B) by a music therapist and who provides music therapy services under the direct supervision of the music therapist;

(4) a family member or guardian of a recipient of music therapy services who is implementing a treatment plan for the recipient under the extended authority and direction of a licensed music therapist; or

(5) a music therapist licensed in another jurisdiction or certified by the certifying entity if the activities and services conducted in this state:

(A) are within the music therapist's customary area of practice;

(B) are conducted not more than 20 days in a calendar year; and

(C) are not otherwise in violation of this chapter.

(b) A person described by Subsection (a)(3)(B) may not represent that the person is a music therapist.

(c) A music therapist described by Subsection (a)(5) shall inform the recipient of music therapy services, or a parent or guardian of the recipient if the recipient is under 18 years of age, that:

(1) the music therapist is not licensed in this state; and

(2) the activities and services provided by the music therapist are time-limited.

SUBCHAPTER B. MUSIC THERAPIST ADVISORY BOARD

Sec. 456.051. ADVISORY BOARD MEMBERSHIP. (a) The advisory board is composed of seven members appointed by the presiding officer of the commission with the approval of the commission as follows:

(1) four licensed music therapists;

(2) one physician or other health professional who is authorized to refer patients or clients to receive music therapy services; and

(3) two members who represent the public and who are either former recipients of music therapy services or the parent or guardian of a current or former recipient of music therapy services.

(b) To be qualified for appointment under Subsection (a)(1), a person must have at least three years of experience as a licensed music therapist.

(b-1) Notwithstanding Subsections (a)(1) and (b), a person is eligible for appointment to the advisory board as a licensed music therapist member if the person has practiced music therapy for the period required under Subsection (b), regardless of whether the person has held a license under this chapter continuously during that period. This subsection expires January 31, 2027.

(c) Appointments to the advisory board shall be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointee.

Sec. 456.052. DUTIES OF ADVISORY BOARD. The advisory board shall provide advice and recommendations to the department on technical matters relevant to the administration of this chapter.

Sec. 456.053. TERMS; VACANCY. (a) Members of the advisory board serve staggered six-year terms, with the terms of two or three members expiring February 1 of each odd-numbered year.

(b) A member may not serve more than two consecutive terms.

(c) If a vacancy occurs during a member's term, the presiding officer of the commission, with the commission's approval, shall appoint a replacement who meets the qualifications for the vacant position to serve for the remainder of the term.

Sec. 456.054. PRESIDING OFFICER. The presiding officer of the commission shall designate a member of the advisory board to serve as the presiding officer of the advisory board for a term of one year. The presiding officer of the advisory board may vote on any matter before the advisory board.

Sec. 456.055. MEETINGS. The advisory board shall meet at least twice each year and at the call of the presiding officer of the commission or the executive director.

Sec. 456.056. GROUNDS FOR REMOVAL. A member of the advisory board may be removed as provided by Section 51.209.

Sec. 456.057. COMPENSATION; REIMBURSEMENT. (a) A member of the advisory board may not receive compensation for service on the advisory board.

(b) A member of the advisory board is entitled to reimbursement for actual and necessary expenses incurred in performing functions as a member of the advisory board, subject to any applicable limitation on reimbursement provided by the General Appropriations Act.

SUBCHAPTER C. POWERS AND DUTIES

Sec. 456.101. GENERAL POWERS AND DUTIES. (a) The commission shall:

(1) adopt rules consistent with this chapter for the administration and enforcement of this chapter; and

(2) establish standards of ethical practice and adopt and publish a code of ethics.

(b) The department shall:

(1) administer and enforce this chapter;

(2) evaluate the qualifications of license applicants;

(3) provide for the examination of license applicants;

(4) issue licenses;

(5) in connection with a hearing under this chapter, issue subpoenas, examine witnesses, and administer oaths under the laws of this state; and

(6) investigate persons engaging in practices that violate this chapter.

(c) The commission or executive director may deny, revoke, or suspend a license or may otherwise discipline a license holder in accordance with Section 51.353.

Sec. 456.102. FEES. The commission, in consultation with the advisory board, shall set fees in amounts that are reasonable and necessary to cover the costs of administering and enforcing this chapter.

SUBCHAPTER D. LICENSE REQUIREMENTS

Sec. 456.151. LICENSE REQUIRED. (a) Except as provided by Section 456.003, a person may not practice music therapy unless the person holds a license issued under this chapter.

(b) Unless the person holds a license issued under this chapter, a person may not use in connection with the person's name, including in advertisements:

(1) the title "licensed professional music therapist"; or

(2) any other designation that would imply that the person is a music therapist.

Sec. 456.152. LICENSE APPLICATION. Each applicant for a license under this chapter must submit an application and the required fees to the department. The application must include sufficient evidence, as defined by commission rules, that the applicant has successfully completed a state-approved criminal background check.

Sec. 456.153. LICENSE ELIGIBILITY. To be eligible for a license, a person must:

(1) be at least 18 years of age;

(2) hold a bachelor's or graduate degree in music therapy, or an equivalent field of study, from a program approved by the American Music Therapy Association, or a successor organization, within an accredited public or private institution of higher education and that is approved by the department;

(3) successfully complete any clinical training hours required as part of a degree program described by Subdivision (2);

(4) if applicable, be in good standing with any other jurisdiction from which the applicant holds a music therapy license;

(5) pass the examination for board certification offered by the certifying entity or provide proof of being transitioned into board certification by the certifying entity;

(6) be certified as a music therapist by the certifying entity;

(7) be in compliance with all professional, ethical, and disciplinary standards established by the certifying entity; and

(8) not be subject to any disciplinary action by the certifying entity.

Sec. 456.154. ISSUANCE OF LICENSE. The department shall issue a music therapist license to a person who meets the requirements of this chapter and rules adopted under this chapter.

Sec. 456.155. LICENSE RENEWAL. A music therapist license expires on the second anniversary of the date of issuance. The commission by rule shall provide requirements and procedures for the renewal of a music therapist license, including requiring a license holder to provide proof of the license holder's continuing certification in music therapy by the certifying entity.

Sec. 456.156. LICENSE HOLDER INFORMATION. A license holder shall:

(1) notify the department of a change of the license holder's residence or business address; and

(2) provide the department with the license holder's new address not later than the 30th day after the date the address change occurs.

SUBCHAPTER E. PRACTICE BY LICENSE HOLDER

Sec. 456.201. REFERRALS REQUIRED FOR CERTAIN SERVICES. (a) A music therapist may provide the following music therapy services without a referral from a health professional:

(1) consultation and evaluation;

(2) preventative care;

(3) wellness care;

(4) education; and

(5) specialized support.

(b) Providing music therapy services for a specific health condition, other than consultation and evaluation, requires a referral from a physician or other health professional acting within the scope of the professional's license.

Sec. 456.202. REQUIREMENTS FOR CERTAIN CLIENTS. (a) Before providing music therapy services to a client for a clinical, developmental, or other health-related need diagnosed or otherwise identified by a health care provider, the music therapist must review with the appropriate health care provider involved in providing care for that identified need the client's diagnosis, treatment needs, and treatment plan.

(b) During the provision of music therapy services to a client described by Subsection (a), the music therapist shall collaborate with any licensed professional providing care for the identified need, including collaborating with, as applicable, the client's physician, psychologist, social worker, or other mental health professional.

(c) Before providing music therapy services to a client for an educational need, the music therapist must, if applicable, review with the individuals who are implementing the client's individualized family service plan or individualized education program the client's diagnosis, treatment needs, and treatment plan.

(d) A music therapist providing music therapy services to a client with a communication disorder who is also receiving services from an audiologist or speech-language pathologist:

(1) shall collaborate with and disclose the music therapy treatment plan with the client's audiologist or speech-language pathologist, as applicable; and

(2) may not provide music therapy services in a manner that replaces the services provided by the audiologist or speech-language pathologist.

SUBCHAPTER F. DISCIPLINARY GROUNDS

Sec. 456.251. GROUNDS FOR LICENSE DENIAL AND DISCIPLINARY ACTION. After a hearing, the commission or executive director may deny a license to an applicant, suspend or revoke a music therapist's license, or place on probation a music therapist if the applicant or music therapist:

(1) violates this chapter, a commission rule, or an order of the commission or the executive director;

(2) obtains a license by means of fraud, misrepresentation, or concealment of a material fact;

(3) sells, barters, or offers to sell or barter a license;

(4) engages in unprofessional conduct that:

(A) endangers or is likely to endanger the health, welfare, or safety of the public as defined by commission rule; or

(B) violates the code of ethics adopted and published by the commission;

(5) treats or attempts to treat a client's specific health condition by means other than music therapy;

(6) fails to refer a client to a health care provider for treatment if a music therapist recognizes symptoms for which treatment by music therapy is inadvisable or which warrant treatment that is outside the scope of music therapy;

(7) is unable to practice music therapy with reasonable skill and safety because of excessive use of alcohol, drugs, narcotics, chemicals, or another substance;

(8) is convicted of a felony that directly relates to the duties and responsibilities of a music therapist or that indicates that the person poses a continued threat to public safety;

(9) practices music therapy in a grossly negligent manner;

(10) is adjudicated as an incapacitated person by a court;

(11) is convicted of an offense indicating that the music therapist's continued practice of music therapy is detrimental to the best interests of the public or profession, including an offense that constitutes a violation of any applicable ethical rule of the profession; or

(12) has had a music therapy license suspended or revoked by another jurisdiction.

SECTION 4. As soon as practicable after the effective date of this Act, the presiding officer of the Texas Commission of Licensing and Regulation shall appoint seven members to the Music Therapist Advisory Board in accordance with Chapter 456, Occupations Code, as added by this Act. In making the initial appointments, the presiding officer of the commission shall designate two members for terms expiring February 1, 2025, two members for terms expiring February 1, 2027, and three members for terms expiring February 1, 2029.

SECTION 5. Not later than April 1, 2024, the Texas Commission of Licensing and Regulation shall adopt the rules, procedures, and fees necessary to administer Chapter 456, Occupations Code, as added by this Act.

SECTION 6. Notwithstanding Chapter 456, Occupations Code, as added by this Act, a music therapist is not required to hold a license under that chapter to practice as a licensed music therapist in this state before September 1, 2024.

SECTION 7. (a) Except as provided by Subsection (b) of this section, this Act takes effect September 1, 2023.

(b) Section 456.151 and Subchapter F, Chapter 456, Occupations Code, as added by this Act, take effect September 1, 2024.