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.