76R14573 SMJ-D
By Coleman H.B. No. 3302
Substitute the following for H.B. No. 3302:
By Hilderbran C.S.H.B. No. 3302
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to certain private facilities that provide behavioral or
1-3 mental health care services; imposing civil, criminal, and
1-4 administrative penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subtitle B, Title 4, Health and Safety Code, is
1-7 amended by adding Chapter 253 to read as follows:
1-8 CHAPTER 253. BEHAVIORAL HEALTH CARE CENTERS
1-9 SUBCHAPTER A. GENERAL PROVISIONS
1-10 Sec. 253.001. DEFINITIONS. In this chapter:
1-11 (1) "Board" means the Texas Board of Health.
1-12 (2) "Center" means a private behavioral or mental
1-13 health care center that provides partial hospitalization services.
1-14 (3) "Department" means the Texas Department of Health.
1-15 (4) "Partial hospitalization services" means distinct
1-16 and organized outpatient psychiatric treatment that is:
1-17 (A) comprehensive, intensive, individualized,
1-18 and multidisciplinary;
1-19 (B) administered daily for less than 24 hours;
1-20 (C) not available in a regular outpatient
1-21 setting; and
1-22 (D) provided to clients with profound or
1-23 disabling mental health conditions who would otherwise require
1-24 inpatient care.
2-1 Sec. 253.002. APPLICABILITY. This chapter does not apply
2-2 to:
2-3 (1) a community center established under Subchapter A,
2-4 Chapter 534;
2-5 (2) a state mental health facility or other program
2-6 operated by the Texas Department of Mental Health and Mental
2-7 Retardation or a federal agency;
2-8 (3) a private mental health facility licensed under
2-9 Chapter 577 or a hospital licensed under Chapter 241; or
2-10 (4) an individual provider of behavioral or mental
2-11 health care services, including a mental health professional as
2-12 defined by Section 164.003.
2-13 Sec. 253.003. APPLICABILITY OF OTHER LAW. Subchapter A,
2-14 Chapter 534, does not apply to a center licensed under this
2-15 chapter.
2-16 Sec. 253.004. RULES. (a) The board shall adopt rules
2-17 necessary to implement this chapter, including requirements for the
2-18 issuance, renewal, denial, suspension, and revocation of a license
2-19 to operate a center.
2-20 (b) The board may adopt rules for the issuance of a
2-21 temporary or probationary license to operate a center.
2-22 (Sections 253.005-253.010 reserved for expansion
2-23 SUBCHAPTER B. LICENSING, FEES, AND INSPECTION
2-24 Sec. 253.011. LICENSE REQUIRED. A person may not operate a
2-25 center unless the person holds a license issued under this chapter.
2-26 Sec. 253.012. LICENSE APPLICATION. (a) An applicant for a
2-27 license under this chapter must submit an application to the
3-1 department in accordance with board rules.
3-2 (b) Each application must be accompanied by a nonrefundable
3-3 license fee in an amount set by the board.
3-4 Sec. 253.013. ISSUANCE OF LICENSE. (a) The department
3-5 shall issue a license to an applicant if it finds that the
3-6 applicant and the center meet the requirements of this chapter and
3-7 rules adopted under this chapter.
3-8 (b) A license issued under this chapter may be transferred
3-9 or assigned only if the department approves the transfer or
3-10 assignment in writing.
3-11 Sec. 253.014. LICENSE POSTING. A person who holds a license
3-12 issued under this chapter shall post the license in a conspicuous
3-13 place at the center for which it is issued.
3-14 Sec. 253.015. LICENSE FEES. The board shall impose fees for
3-15 licensure under this chapter in amounts reasonable and necessary to
3-16 defray the cost of administering this chapter.
3-17 Sec. 253.016. INSPECTIONS. The department may inspect a
3-18 center and its records at reasonable times as necessary to ensure
3-19 compliance with this chapter and rules adopted under this chapter.
3-20 Sec. 253.017. GENERAL STANDARDS. (a) The board by rule
3-21 shall adopt minimum standards applicable to a center regarding:
3-22 (1) the number, qualifications, and duties of the
3-23 professional staff, including physicians and nurses, and other
3-24 personnel;
3-25 (2) the organizational structure, including lines of
3-26 authority and delegation of responsibility;
3-27 (3) the rights of clients;
4-1 (4) a quality assurance program for the care of
4-2 clients;
4-3 (5) client accommodations, fire prevention, and safety
4-4 and sanitary conditions of the center and its surroundings;
4-5 (6) the reporting and investigation of injuries,
4-6 incidents, and accidents;
4-7 (7) the maintenance, disposal, and destruction of
4-8 records of care and services provided at the center; and
4-9 (8) any other aspect of center facilities, staff, or
4-10 services necessary to protect the center's clients or the public.
4-11 (b) This chapter does not authorize the board to:
4-12 (1) establish the qualifications of a licensed
4-13 practitioner; or
4-14 (2) permit a person to provide behavioral or mental
4-15 health services if the person is not authorized to provide those
4-16 services in this state.
4-17 Sec. 253.018. MENTAL HEALTH CARE STANDARDS. (a) The care
4-18 and treatment of a client receiving mental health services,
4-19 including partial hospitalization, in a center licensed under this
4-20 chapter are governed by standards adopted by the Texas Department
4-21 of Mental Health and Mental Retardation to the same extent as if
4-22 the standards adopted by that department were rules adopted by the
4-23 board under this chapter.
4-24 (b) The department shall enforce the standards provided by
4-25 Subsection (a). A violation of a standard is subject to the same
4-26 consequence as a violation of a rule adopted by the board under
4-27 this chapter. The department is not required to enforce a standard
5-1 if the enforcement violates a federal law, rule, or regulation.
5-2 Sec. 253.019. NOTICE IN ADVERTISING AND CONTRACTS FOR
5-3 SERVICES. (a) This section applies only to a center licensed
5-4 under this chapter that does not have a contract with:
5-5 (1) the Texas Department of Mental Health and Mental
5-6 Retardation as a service provider;
5-7 (2) a local mental health authority designated under
5-8 Section 533.035; or
5-9 (3) a community center established under Chapter 534.
5-10 (b) A center shall include in its advertising or written
5-11 contracts for services a notice containing the following words:
5-12 "This facility is a private behavioral health care center licensed
5-13 by the state. This facility is not affiliated with the state
5-14 mental health and mental retardation system."
5-15 (Sections 253.020-253.030 reserved for expansion
5-16 SUBCHAPTER C. ENFORCEMENT
5-17 Sec. 253.031. DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
5-18 (a) The department may deny, suspend, or revoke a license for a
5-19 violation of this chapter or a rule adopted under this chapter.
5-20 (b) Except as provided by Section 253.032, the denial,
5-21 suspension, or revocation of a license by the department and an
5-22 appeal from that action are governed by the procedures for a
5-23 contested case hearing under Chapter 2001, Government Code.
5-24 Sec. 253.032. EMERGENCY SUSPENSION ORDER. (a) The
5-25 department, without a hearing, may issue an emergency order to
5-26 suspend a license issued under this chapter if the department has
5-27 reasonable cause to believe that the conduct of a license holder
6-1 creates an immediate danger to the health and safety of a client or
6-2 the public.
6-3 (b) An emergency suspension is effective immediately on
6-4 notice to the license holder.
6-5 (c) On written request of the holder of a license suspended
6-6 under this section, the department shall conduct a hearing to
6-7 determine whether there is cause to continue the suspension. The
6-8 hearing must be held not earlier than the 10th day and not later
6-9 than the 30th day after the date the request is received.
6-10 Sec. 253.033. INJUNCTION. (a) The department may petition
6-11 a district court for a temporary restraining order to restrain a
6-12 continuing violation of the standards or licensing requirements
6-13 provided under this chapter if the department finds that the
6-14 violation creates an immediate threat to the health and safety of
6-15 the public or of a client of a center.
6-16 (b) A district court, on petition of the department and on a
6-17 finding by the court that a person is violating the standards or
6-18 licensing requirements provided under this chapter, may by
6-19 injunction:
6-20 (1) prohibit a person from continuing a violation of
6-21 the standards or licensing requirements provided under this
6-22 chapter;
6-23 (2) restrain or prevent the establishment or operation
6-24 of a center without a license issued under this chapter; or
6-25 (3) grant any other injunctive relief warranted by the
6-26 facts.
6-27 (c) The attorney general shall institute and conduct a suit
7-1 authorized by this section at the request of the department.
7-2 (d) Venue for a suit brought under this section is in the
7-3 county in which the center is located or in Travis County.
7-4 Sec. 253.034. CIVIL PENALTY. (a) A person who violates
7-5 this chapter or a rule adopted under this chapter is liable for a
7-6 civil penalty of not less than $100 or more than $500 for each
7-7 violation if the department determines the violation threatens the
7-8 health and safety of a client or the public.
7-9 (b) Each day of a continuing violation constitutes a
7-10 separate ground for recovery.
7-11 (c) The attorney general may sue to collect the penalty.
7-12 Sec. 253.035. CRIMINAL PENALTY. (a) A person commits an
7-13 offense if the person operates a center without a license.
7-14 (b) An offense under this section is a Class C misdemeanor.
7-15 (c) Each day of a continuing violation constitutes a
7-16 separate offense.
7-17 Sec. 253.036. ADMINISTRATIVE PENALTY. (a) The board may
7-18 impose an administrative penalty against a person who violates this
7-19 chapter or a rule adopted under this chapter.
7-20 (b) The amount of the penalty may not exceed $5,000. Each
7-21 day a violation continues or occurs is a separate violation for the
7-22 purpose of imposing a penalty.
7-23 (c) Subject to the limitation provided by Subsection (b),
7-24 the board shall impose a penalty in accordance with the procedures
7-25 provided by Section 241.060 as if the person had violated Chapter
7-26 241 or a rule adopted under that chapter.
7-27 (Sections 253.037-253.050 reserved for expansion
8-1 SUBCHAPTER D. SERVICES
8-2 Sec. 253.051. PARTIAL HOSPITALIZATION SERVICES. (a) A
8-3 center licensed under this chapter may provide partial
8-4 hospitalization services to a client who exhibits a severe or
8-5 disabling condition related to:
8-6 (1) an acute psychiatric or psychological condition;
8-7 or
8-8 (2) an acute exacerbation of a severe and persistent
8-9 mental disorder.
8-10 (b) The partial hospitalization services provided must be:
8-11 (1) reasonable and necessary for the diagnosis or
8-12 active treatment of the client's condition; and
8-13 (2) reasonably expected to improve or maintain the
8-14 client's condition and functional level to prevent relapse or
8-15 hospitalization.
8-16 (c) The partial hospitalization services may include:
8-17 (1) diagnostic services;
8-18 (2) individual, group, occupational, or family
8-19 therapy;
8-20 (3) activity therapy that is not primarily
8-21 recreational or diversionary; or
8-22 (4) education or training.
8-23 (d) A client may be admitted for partial hospitalization
8-24 services only by the order of a physician trained in the diagnosis
8-25 and treatment of psychiatric illness following the physician's
8-26 evaluation of the client in person. Partial hospitalization
8-27 services must be furnished under the supervision of a physician.
9-1 SECTION 2. Section 250.001(3), Health and Safety Code, is
9-2 amended to read as follows:
9-3 (3) "Facility" means:
9-4 (A) a nursing home, custodial care home, or
9-5 other institution licensed by the Texas Department of Human
9-6 Services under Chapter 242;
9-7 (B) a personal care facility licensed by the
9-8 Texas Department of Human Services under Chapter 247;
9-9 (C) a home health agency licensed by the Texas
9-10 Department of Health under Chapter 142;
9-11 (D) an adult day care facility or adult day
9-12 health care facility licensed by the Texas Department of Human
9-13 Services under Chapter 103, Human Resources Code;
9-14 (E) a facility for persons with mental
9-15 retardation licensed or certified by the Texas Department of Human
9-16 Services;
9-17 (F) an unlicensed attendant care agency that
9-18 contracts with the Texas Department of Human Services;
9-19 (G) an intermediate care facility for persons
9-20 with mental retardation that is certified by the Texas Department
9-21 of Human Services to participate in the Medicaid program under
9-22 Title XIX of the Social Security Act (42 U.S.C. Section 1396 et
9-23 seq.);
9-24 (H) an adult foster care provider that contracts
9-25 with the Texas Department of Human Services; [or]
9-26 (I) a facility that provides mental health
9-27 services and that is operated by or contracts with the Texas
10-1 Department of Mental Health and Mental Retardation; or
10-2 (J) a center that provides behavioral or mental
10-3 health care services and is licensed under Chapter 253 by the Texas
10-4 Department of Health.
10-5 SECTION 3. (a) A private behavioral or mental health care
10-6 center is not required to be licensed under Chapter 253, Health and
10-7 Safety Code, as added by this Act, before January 1, 2000.
10-8 (b) The Texas Board of Health shall adopt rules as necessary
10-9 to implement Chapter 253, Health and Safety Code, as added by this
10-10 Act, so that the Texas Department of Health may issue licenses
10-11 under and enforce that chapter on or before January 1, 2000.
10-12 SECTION 4. This Act takes effect September 1, 1999.
10-13 SECTION 5. The importance of this legislation and the
10-14 crowded condition of the calendars in both houses create an
10-15 emergency and an imperative public necessity that the
10-16 constitutional rule requiring bills to be read on three several
10-17 days in each house be suspended, and this rule is hereby suspended.