By Nelson S.B. No. 1811
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.