BG C.S.H.B. 2481 75(R) BILL ANALYSIS PUBLIC HEALTH C.S.H.B. 2481 By: Swinford 5-1-97 Committee Report (Substituted) BACKGROUND Current Texas law prohibits anyone from offering or purporting to offer chemical dependency treatment without a license. "Treatment" is defined broadly to encompass virtually all organized efforts to promote a person's "chemical-free status or the maintenance of a person free of illegal drugs." To acquire a license, Texas law mandates compliance with licensing standards issued by the Texas Commission on Alcohol and Drug Abuse (TCADA). These detailed standards embrace a strict "medical" model of addiction treatment and regulate every aspect of a treatment facility, including organization, structure, policies and procedures, staffing requirements, services, and other requirements. The TCADA definition of what constitutes bona fide treatment, however, rejects the unique nature and philosophy of "faith-based" treatment programs. Yet independent research verifies that many of these faith-based programs help thousands of addicts and alcoholics find sobriety. Understanding that no single appropriate treatment exists for chemically dependent persons, and that it is important to match individuals with the treatment methods that serve them best, other states have recognized the unique status of faith-based treatment programs. Florida and Tennessee for example permit these facilities and their counselors to operate free of the state licensing standards which threaten their religious integrity and autonomy. Some faith-based programs in Texas have been threatened with fines and closure because they fail to embrace the medical model. These programs, which utilize former abusers as counselors instead of credentialed professionals, treat addiction as the result of underlying spiritual trouble that are curable through non-medical means such as prayer, spiritual counseling, and moral teaching. PURPOSE CSHB 2481 exempts faith-based chemical dependency treatment programs that utilize nonmedical methods of treatment that are exclusively religious in nature from state licensure and regulation. RULEMAKING AUTHORITY It is the committee's opinion that this bill expressly grants additional rulemaking authority to TCADA in SECTION 1 (Sec. 464.053, Health and Safety Code). SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 464, Health and Safety Code, by adding Subchapter C, entitled "Faith-based Chemical Dependency Treatment Programs," as follows: Sec. 464.051. DEFINITIONS. defines "chemical dependency," "commission," "religious organization," "treatment," and "treatment facility." Sec. 464.052. EXEMPTION FOR FAITH-BASED CHEMICAL DEPENDENCY TREATMENT PROGRAM. Exempts a chemical dependency treatment program that is conducted by a religious organization, exclusively religious, spiritual, or ecclesiastical nature, which does not treat minors, and is registered as specified, from licensure and regulation. Forbids TCADA from prohibiting an exempted program from using the terms "counseling," "treatment," or "rehabilitation." Sec. 464.053. EXEMPT PROGRAM REGISTRATION. Requires TCADA to establish by rule a procedure by which a qualifying faith-based program registers its exemption. Sec. 464.054. MEDICAL SERVICES PROHIBITED. Prohibits exempted programs from providing medical care, medical detoxification, or medical withdrawal services. Sec. 464.055. REPRESENTATIONS IN PROGRAM ADVERTISING OR LITERATURE. Requires exempted programs to conspicuously note in any advertisements or literature a statement regarding their status as a faith-based treatment program as specified. Sec. 464.056. DECLARATION ON ADMISSION. Prohibits an exempted program from admitting a person without the person's signed declaration, as specified. Requires the program to keep the statement on file and also provide a copy to the person admitted. Sec. 464.057. REVOCATION OF EXEMPTION. Allows revocation of the exemption after notice and hearing in certain circumstances. Sec. 464.058. GENERAL DIRECTIVE TO STATE AGENCIES. Prohibits a state agency from denying social service benefits, as specified, on the basis of participation in a faith- based residential chemical dependency treatment program. Sec. 464.059. RELIGION NOT ENDORSED. Establishes that this subchapter is not intended to aid, endorse or sponsor religion but to help addicted persons by permitting the operation of treatment programs as specified. Sec. 464.060. DIRECT PUBLIC FUNDING PROHIBITED. Establishes that an exempted program is not eligible to compete for direct federal or state treatment funding. Sec. 464.061. EFFECT ON HEALTH AND SAFETY DUTIES OR POWERS. Establishes that this subchapter does not affect the authority of a local, regional, or state official to inspect a facility as specified. SECTION 2. Amends Chapter 33, Human Resources Code, by adding Section 33.012, entitled "Chemical Dependency Treatment Program as Representative," to require the Department of Human Services to provide an individual's food stamp allotment to the individual's designated residential treatment program as specified. SECTION 3. Amends Section 464.002, Health and Safety Code, to add language to clarify that a person working for or providing counseling with an exempted program is not subject to license requirements. SECTION 4. Amends Section 3(b), Chapter 635, Acts of the 72nd Legislature, Regular Session, 1991 (Article 4512o, Vernon's Texas Civil Statutes) to make conforming changes. SECTION 5. Effective date: September 1, 1997. SECTION 6. Emergency clause. COMPARISON OF ORIGINAL TO SUBSTITUTE All of the changes made by the substitute bill are in SECTION 1. CSHB 2481 revises the original bill's Sec. 464.055 by providing a specific statement for an exempt program's advertisement or literature. A new Sec. 464.056 is added to require a signed acknowledgment of the nature of the treatment offered and the unlicensed status of the facility from participants. Subsequent sections of SECTION 1 in the substitute bill are renumbered as appropriate, so that it is Sec. 464.056 of the bill-as-filed (now Sec. 464.057) that inserts the words "after notice and hearing" to ensure that providers have an opportunity to contest revocation. Two additional sections added into CSHB 2481 are Sec. 464.060 and 464.061 prohibiting competition for direct federal and state treatment funds and ensuring that the facilities are given no special exemptions from site safety inspections.