By Coleman                                            H.B. No. 3302
         76R2706 SMJ-D                           
                                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.
1-14                 (3)  "Department" means the Texas Department of Health.
1-15           Sec. 253.002.  APPLICABILITY.  This chapter does not apply
1-16     to:
1-17                 (1)  a community center established under Subchapter A,
1-18     Chapter 534;
1-19                 (2)  a mental health facility operated by the Texas
1-20     Department of Mental Health and Mental Retardation or a federal
1-21     agency; or
1-22                 (3)  an individual provider of behavioral or mental
1-23     health care services, including a mental health professional as
1-24     defined by Section 164.003.
 2-1           Sec. 253.003.  APPLICABILITY OF OTHER LAW.  Subchapter A,
 2-2     Chapter 534, does not apply to a center licensed under this
 2-3     chapter.
 2-4           Sec. 253.004.  RULES.  (a)  The board shall adopt rules
 2-5     necessary to implement this chapter, including requirements for the
 2-6     issuance, renewal, denial, suspension, and revocation of a license
 2-7     to operate a center.
 2-8           (b)  The board may adopt rules for the issuance of a
 2-9     temporary or probationary license to operate a center.
2-10              (Sections 253.005-253.010 reserved for expansion
2-11               SUBCHAPTER B.  LICENSING, FEES, AND INSPECTION
2-12           Sec. 253.011.  LICENSE REQUIRED.  A person may not operate a
2-13     facility that provides a service described by Subchapter D unless
2-14     the person holds a license issued under this chapter.
2-15           Sec. 253.012.  LICENSE APPLICATION.  (a)  An applicant for a
2-16     license under this chapter must submit an application to the
2-17     department in accordance with board rules.
2-18           (b)  Each application must be accompanied by a nonrefundable
2-19     license fee in an amount set by the board.
2-20           Sec. 253.013.  ISSUANCE OF LICENSE.  (a)  The department
2-21     shall issue a license to an applicant if, after inspection and
2-22     investigation, it finds that the applicant and the center meet the
2-23     requirements of this chapter and rules adopted under this chapter.
2-24           (b)  A license issued under this chapter is not transferable
2-25     or assignable and is valid only for operation of the center for
2-26     which it is issued.  If the holder of a license transfers a
2-27     majority of the ownership interest in the center for which it is
 3-1     issued or transfers responsibility for its operation to another
 3-2     person, the license is void.
 3-3           Sec. 253.014.  LICENSE POSTING.  A person who holds a license
 3-4     issued under this chapter shall post the license in a conspicuous
 3-5     place at the center for which it is issued.
 3-6           Sec. 253.015.  LICENSE FEES.  The board shall impose fees for
 3-7     licensure under this chapter in amounts reasonable and necessary to
 3-8     defray the cost of administering this chapter.
 3-9           Sec. 253.016.  INSPECTIONS.  The department may inspect a
3-10     center and its records at reasonable times as necessary to ensure
3-11     compliance with this chapter and rules adopted under this chapter.
3-12           Sec. 253.017.  STANDARDS.  (a)  The board by rule shall adopt
3-13     standards applicable to a center regarding:
3-14                 (1)  the number, qualifications, and duties of the
3-15     professional staff and other personnel;
3-16                 (2)  the organizational structure, including lines of
3-17     authority and delegation of responsibility;
3-18                 (3)  the rights of clients;
3-19                 (4)  client accommodations and sanitary and hygienic
3-20     conditions of the center and its surroundings;
3-21                 (5)  the reporting and investigation of injuries,
3-22     incidents, and accidents;
3-23                 (6)  the maintenance, disposal, and destruction of
3-24     records of care and services provided at the center; and
3-25                 (7)  any other aspect of center facilities, staff, or
3-26     services necessary to protect the center's clients or the public.
3-27           (b)  This section does not authorize the board to:
 4-1                 (1)  establish the qualifications of a licensed
 4-2     practitioner; or
 4-3                 (2)  permit a person to provide behavioral or mental
 4-4     health services if the person is not authorized to provide those
 4-5     services in this state.
 4-6              (Sections 253.018-253.030 reserved for expansion
 4-7                         SUBCHAPTER C.  ENFORCEMENT
 4-8           Sec. 253.031.  DENIAL, SUSPENSION, OR REVOCATION OF LICENSE.
 4-9     (a)  The department may deny, suspend, or revoke a license for a
4-10     violation of this chapter or a rule adopted under this chapter.
4-11           (b)  Except as provided by Section 253.032, the denial,
4-12     suspension, or revocation of a license by the department and an
4-13     appeal from that action are governed by the procedures for a
4-14     contested case hearing under Chapter 2001, Government Code.
4-15           Sec. 253.032.  EMERGENCY SUSPENSION ORDER.  (a)  The
4-16     department, without a hearing, may issue an emergency order to
4-17     suspend a license issued under this chapter if the department has
4-18     reasonable cause to believe that the conduct of a license holder
4-19     creates an immediate danger to the health and safety of a client or
4-20     the public.
4-21           (b)  An emergency suspension is effective immediately on
4-22     notice to the license holder.
4-23           (c)  On written request of the holder of a license suspended
4-24     under this section, the department shall conduct a hearing to
4-25     determine whether there is cause to continue the suspension.  The
4-26     hearing must be held not earlier than the 10th day and not later
4-27     than the 30th day after the date the request is received.
 5-1           Sec. 253.033.  INJUNCTION.  (a)  The department may petition
 5-2     a district court for a temporary restraining order to restrain a
 5-3     continuing violation of the standards or licensing requirements
 5-4     provided under this chapter if the department finds that the
 5-5     violation creates an immediate threat to the health and safety of
 5-6     the public or of a client of a center.
 5-7           (b)  A district court, on petition of the department and on a
 5-8     finding by the court that a person is violating the standards or
 5-9     licensing requirements provided under this chapter, may by
5-10     injunction:
5-11                 (1)  prohibit a person from continuing a violation of
5-12     the standards or licensing requirements provided under this
5-13     chapter;
5-14                 (2)  restrain or prevent the establishment or operation
5-15     of a center without a license issued under this chapter; or
5-16                 (3)  grant any other injunctive relief warranted by the
5-17     facts.
5-18           (c)  The attorney general shall institute and conduct a suit
5-19     authorized by this section at the request of the department.
5-20           (d)  Venue for a suit brought under this section is in the
5-21     county in which the center is located or in Travis County.
5-22           Sec. 253.034.  CIVIL PENALTY.  (a)  A person who violates
5-23     this chapter or a rule adopted under this chapter is liable for a
5-24     civil penalty of not less than $100 or more than $500 for each
5-25     violation if the department determines the violation threatens the
5-26     health and safety of a client or the public.
5-27           (b)  Each day of a continuing violation constitutes a
 6-1     separate ground for recovery.
 6-2           (c)  The attorney general may sue to collect the penalty.
 6-3           Sec. 253.035.  CRIMINAL PENALTY.  (a)  A person commits an
 6-4     offense if the person operates a facility that provides a service
 6-5     described by Subchapter D without a license.
 6-6           (b)  An offense under this section is a Class C misdemeanor.
 6-7           (c)  Each day of a continuing violation constitutes a
 6-8     separate offense.
 6-9           Sec. 253.036.  ADMINISTRATIVE PENALTY.  (a)  The board may
6-10     impose an administrative penalty against a person who violates this
6-11     chapter or a rule adopted under this chapter.
6-12           (b)  The amount of the penalty may not exceed $5,000.  Each
6-13     day a violation continues or occurs is a separate violation for the
6-14     purpose of imposing a penalty.
6-15           (c)  Subject to the limitation provided by Subsection (b),
6-16     the board shall impose a penalty in accordance with the procedures
6-17     provided by Section 241.060 as if the person had violated Chapter
6-18     241 or a rule adopted under that chapter.
6-19              (Sections 253.037-253.050 reserved for expansion
6-20                           SUBCHAPTER D.  SERVICES
6-21           Sec. 253.051.  PARTIAL HOSPITALIZATION SERVICES.  (a)  A
6-22     center for which a license is issued under this chapter may provide
6-23     partial hospitalization services to a client who exhibits a severe
6-24     or disabling condition related to:
6-25                 (1)  an acute psychiatric or psychological condition;
6-26     or
6-27                 (2)  an acute exacerbation of a severe and persistent
 7-1     mental disorder.
 7-2           (b)  The services provided must be:
 7-3                 (1)  reasonable and necessary for the diagnosis or
 7-4     active treatment of the client's condition; and
 7-5                 (2)  reasonably expected to improve or maintain the
 7-6     client's condition and functional level to prevent relapse or
 7-7     hospitalization.
 7-8           (c)  The services may include:
 7-9                 (1)  diagnostic services;
7-10                 (2)  individual, group, occupational, or family
7-11     therapy;
7-12                 (3)  the administration of drugs or biologicals;
7-13                 (4)  activity therapy that is not primarily
7-14     recreational or diversionary; or
7-15                 (5)  education or training.
7-16           (d)  A client may be admitted for partial hospitalization
7-17     services only by a physician's order following the physician's
7-18     evaluation of the client in person.  Partial hospitalization
7-19     services must be furnished under the supervision of a physician.
7-20           Sec. 253.052.  OTHER SERVICES.  A center may provide:
7-21                 (1)  outpatient services for a client, including
7-22     specialized services for:
7-23                       (A)  a child;
7-24                       (B)  an elderly person;
7-25                       (C)  a person with a chronic mental illness; or
7-26                       (D)  a person who has been discharged from
7-27     inpatient treatment at a Texas Department of Mental Health and
 8-1     Mental Retardation facility;
 8-2                 (2)  psychosocial rehabilitation services;
 8-3                 (3)  emergency mental health services available 24
 8-4     hours a day; or
 8-5                 (4)  screening services for a person being considered
 8-6     for admission to a Texas Department of Mental Health and Mental
 8-7     Retardation facility for persons with mental illness.
 8-8           SECTION 2.  Section 250.001(3), Health and Safety Code, is
 8-9     amended to read as follows:
8-10                 (3)  "Facility" means:
8-11                       (A)  a nursing home, custodial care home, or
8-12     other institution licensed by the Texas Department of Human
8-13     Services under Chapter 242;
8-14                       (B)  a personal care facility licensed by the
8-15     Texas Department of Human Services under Chapter 247;
8-16                       (C)  a home health agency licensed by the Texas
8-17     Department of Health under Chapter 142;
8-18                       (D)  an adult day care facility or adult day
8-19     health care facility licensed by the Texas Department of Human
8-20     Services under Chapter 103, Human Resources Code;
8-21                       (E)  a facility for persons with mental
8-22     retardation licensed or certified by the Texas Department of Human
8-23     Services;
8-24                       (F)  an unlicensed attendant care agency that
8-25     contracts with the Texas Department of Human Services;
8-26                       (G)  an intermediate care facility for persons
8-27     with mental retardation that is certified by the Texas Department
 9-1     of Human Services to participate in the Medicaid program under
 9-2     Title XIX of the Social Security Act (42 U.S.C. Section 1396 et
 9-3     seq.);
 9-4                       (H)  an adult foster care provider that contracts
 9-5     with the Texas Department of Human Services; [or]
 9-6                       (I)  a facility that provides mental health
 9-7     services and that is operated by or contracts with the Texas
 9-8     Department of Mental Health and Mental Retardation; or
 9-9                       (J)  a center that provides behavioral or mental
9-10     health care services and is licensed under Chapter 253 by the Texas
9-11     Department of Health.
9-12           SECTION 3.  (a)  A private behavioral or mental health care
9-13     center is not required to be licensed under Chapter 253, Health and
9-14     Safety Code, as added by this Act, before January 1, 2000.
9-15           (b)  The Texas Board of Health shall adopt rules as necessary
9-16     to implement Chapter 253, Health and Safety Code, as added by this
9-17     Act, so that the Texas Department of Health may issue licenses
9-18     under and enforce that chapter on or before January 1, 2000.
9-19           SECTION 4.  This Act takes effect September 1, 1999.
9-20           SECTION 5.  The importance of this legislation and the
9-21     crowded condition of the calendars in both houses create an
9-22     emergency and an imperative public necessity that the
9-23     constitutional rule requiring bills to be read on three several
9-24     days in each house be suspended, and this rule is hereby suspended.