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.