By: Toth H.B. No. 5244

A BILL TO BE ENTITLED

AN ACT

relating to certain hospitals and their treatment of mental health.

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

SECTION 1. Section 448.901, Administrative code, is amended by amending Subsections(c), (o), and (p) to read as follows:

(c) Chemical dependency or Mental Health education and life skills training shall follow a written curriculum. All educational sessions shall include client participation and discussion of the material presented.

(o) Individuals responsible for planning, directing, or supervising treatment programs shall be QCCs. The clinical program director must have at least two years of post-licensure experience providing chemical dependency treatment. Clinical Directors of a Mental Health primary residential program must be a Psychiatrist or a Licensed Medical Doctor, or PA with a minimum of 2 years experience with mental health medicine maintenance protocol.

(p) Chemical dependency counseling must be provided by a qualified credentialed counselor (QCC), graduate, or counselor intern. Mental health and trauma counseling must be provided by a qualified credentialed counselor, graduate, or counselor intern. Chemical dependency and mental health education and life skills training shall be provided by counselors or individuals who have the specialized education and expertise.

SECTION 2. Section 448.903, Administrative Code, is amended to read as follows:

(a) Residential treatment provides 24-hour per day, 7 days per week multidisciplinary professional clinical support to facilitate recovery from addiction or other mental health conditions. Clients are housed in a residential site. Comprehensive chemical dependency treatment services or mental health care treatment services offer a structured therapeutic environment.

(b) The facility shall ensure access to the full continuum of treatment services and will ensure sufficient treatment intensity to achieve treatment plan goals. Intensity and content of treatment shall be appropriate to the client's needs and consistent with generally accepted placement guidelines and standards of care.

(c) Each individual admitted to intensive residential services shall be appropriate for this treatment setting, with written justification to support the admission.

(d) Intensive residential shall provide an average of at least 30 hours of services per week for each client, comprised of at least:

(1) ten hours of chemical dependency or mental health counseling, (one hour of which shall be individual counseling);

(2) ten hours of additional counseling, chemical dependency or mental health education, life skills training, relapse prevention education, if appropriate; and

(3) ten hours of planned, structured activities monitored by staff. Five hours of these services shall occur on weekends and evenings.

(e) In adult intensive residential programs, the direct care staff-to-client ratio shall be at least 1:16 when clients are awake and 1:32 during sleeping hours.

(f) In intensive residential programs counselor caseloads shall not exceed ten clients for each counselor.

(g) Supportive residential shall provide at least six hours of treatment services per week for each client, comprised of at least :

(1) three hours of chemical dependency and mental health counseling (one hour per month of which shall be individual counseling); and

(2) three hours of additional counseling, chemical dependency education, life skills training, and relapse prevention education or mental health counselling based on individual's treatment plan.

(h) In adult supportive residential programs, the direct care staff-to-client ratio shall be at least 1:20 when clients are awake and 1:50 during sleeping hours.

(i) Each supportive residential program shall set limits on caseload size that ensure effective, individualized treatment. The program shall justify the caseload size in writing based on the program design, characteristics and needs of the population served, and any other relevant factors.

SECTION 3. Section 448.912, Administrative Code, is amended to read as follows:

A licensed chemical dependency treatment facility shall not discriminate based on a client's disability and shall comply with Texas Health and Safety Code Chapter 161, Subchapter S (relating to Allocation of Kidneys and Other Organs Available for Transplant).

SECTION 4. This Act takes effect September 1, 2023.