Texas 2025 - 89th Regular

Texas House Bill HB5030 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1	89R8734 AB-F
2	2	By: Johnson H.B. No. 5030
3	3
4	4
5	5
6	6
7	7	A BILL TO BE ENTITLED
8	8	AN ACT
9	9	relating to the provision of certain mental and behavioral health
10	10	services under Medicaid, Medicaid coverage and reimbursement for
11	11	those services, and the regulation of psychiatric residential
12	12	treatment facilities; requiring an occupational license.
13	13	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
14	14	SECTION 1. Section 540.0703(a), Government Code, as
15	15	effective April 1, 2025, is amended to read as follows:
16	16	(a) In this section:
17	17	(1) "Behavioral [, "behavioral] health services"
18	18	means mental health and substance use disorder services. The term
19	19	includes crisis services, intensive outpatient services, and
20	20	partial hospitalization services.
21	21	(2) "Crisis services" means mental health community
22	22	services or other necessary interventions provided to an individual
23	23	in crisis. The term includes:
24	24	(A) crisis respite services, including mobile
25	25	and facility-based services;
26	26	(B) crisis stabilization services, including
27	27	mobile crisis stabilization services and services provided in an
28	28	extended observation unit or crisis stabilization unit; and
29	29	(C) other crisis services as the commission
30	30	determines.
31	31	(3) "Intensive outpatient services" means outpatient
32	32	treatment services, including treatment services for substance use
33	33	disorders, depression, eating disorders, and other mental health
34	34	conditions that do not require detoxification or 24-hour
35	35	supervision, provided to patients who require a time-limited,
36	36	multifaceted array of services, structures, and supports by a team
37	37	of clinical staff capable of providing, at a minimum, the following
38	38	services:
39	39	(A) individual counseling;
40	40	(B) group counseling;
41	41	(C) family counseling;
42	42	(D) motivational enhancement training; and
43	43	(E) relapse prevention, drug refusal, and coping
44	44	skills training.
45	45	(4) "Partial hospitalization services" means distinct
46	46	and organized intensive ambulatory treatment services provided for
47	47	periods of not more than 24 hours at a location other than a
48	48	patient's home or in an inpatient or a residential care setting.
49	49	The term includes the services described by 42 C.F.R. Section
50	50	410.43(a)(4).
51	51	SECTION 2. The heading to Chapter 577A, Health and Safety
52	52	Code, is amended to read as follows:
53	53	CHAPTER 577A. PSYCHIATRIC RESIDENTIAL [YOUTH] TREATMENT
54	54	FACILITIES
55	55	SECTION 3. Section 577A.001(3), Health and Safety Code, is
56	56	amended to read as follows:
57	57	(3) "Psychiatric residential [youth] treatment
58	58	facility" means a private facility that provides psychiatric health
59	59	treatments and services in a residential, nonhospital setting
60	60	exclusively to individuals who are 21 years of age or younger [and
61	61	is licensed as a general residential operation under Chapter 42,
62	62	Human Resources Code]. The term includes a facility that provides
63	63	room and board.
64	64	SECTION 4. The heading to Subchapter B, Chapter 577A,
65	65	Health and Safety Code, is amended to read as follows:
66	66	SUBCHAPTER B. LICENSURE [CERTIFICATION], FEES, AND INSPECTIONS
67	67	SECTION 5. Section 577A.051, Health and Safety Code, is
68	68	amended to read as follows:
69	69	Sec. 577A.051. LICENSE REQUIRED [VOLUNTARY QUALITY
70	70	STANDARDS CERTIFICATION]. A person may not operate a psychiatric
71	71	residential treatment facility unless the person holds a license
72	72	issued by the commission [The commission shall, using existing
73	73	resources to the extent feasible, develop and implement a voluntary
74	74	quality standards certification process to certify a psychiatric
75	75	residential youth treatment facility that meets standards for
76	76	certification] under this chapter.
77	77	SECTION 6. The heading to Section 577A.052, Health and
78	78	Safety Code, is amended to read as follows:
79	79	Sec. 577A.052. LICENSE [CERTIFICATE] APPLICATION.
80	80	SECTION 7. Section 577A.052(a), Health and Safety Code, is
81	81	amended to read as follows:
82	82	(a) To obtain a license [certificate] under this chapter, an
83	83	applicant must submit to the commission an application in the form
84	84	and manner prescribed by the commission.
85	85	SECTION 8. Section 577A.053, Health and Safety Code, is
86	86	amended to read as follows:
87	87	Sec. 577A.053. FEES. The executive commissioner by rule
88	88	shall establish a nonrefundable license [certificate] application
89	89	fee and a nonrefundable license [certificate] renewal fee in
90	90	amounts necessary to cover the costs of administering this chapter.
91	91	SECTION 9. Section 577A.054, Health and Safety Code, is
92	92	amended to read as follows:
93	93	Sec. 577A.054. ISSUANCE AND RENEWAL OF LICENSE
94	94	[CERTIFICATE]. (a) The commission shall issue a license
95	95	[certificate] to an applicant if on inspection and investigation
96	96	the commission determines the applicant meets the requirements of
97	97	this chapter and commission rules. [The commission may not issue to
98	98	an applicant a certificate under this chapter unless the applicant
99	99	is licensed as a general residential operation under Chapter 42,
100	100	Human Resources Code.]
101	101	(b) A license [certificate] issued under this chapter
102	102	expires on the second anniversary of the date the license
103	103	[certificate] is issued or renewed.
104	104	(c) The commission shall renew a license [certificate] if:
105	105	(1) the license [certificate] holder submits to the
106	106	commission a fee established by the executive commissioner under
107	107	Section 577A.053; and
108	108	(2) on inspection and investigation the commission
109	109	determines the license [certificate] holder meets the requirements
110	110	of this chapter and commission rules.
111	111	SECTION 10. Section 577A.055, Health and Safety Code, is
112	112	amended to read as follows:
113	113	Sec. 577A.055. INSPECTIONS. In addition to the inspections
114	114	required under Section 577A.054, the commission shall conduct an
115	115	inspection not later than the first anniversary of the date a
116	116	license [certificate] is issued or renewed to ensure the license
117	117	[certificate] holder remains in compliance with the requirements of
118	118	this chapter and commission rules.
119	119	SECTION 11. The heading to Subchapter C, Chapter 577A,
120	120	Health and Safety Code, is amended to read as follows:
121	121	SUBCHAPTER C. REGULATION OF LICENSED [CERTIFIED] PSYCHIATRIC
122	122	RESIDENTIAL [YOUTH] TREATMENT FACILITIES
123	123	SECTION 12. Section 577A.101, Health and Safety Code, is
124	124	amended to read as follows:
125	125	Sec. 577A.101. MINIMUM STANDARDS. The executive
126	126	commissioner by rule shall establish minimum standards for the
127	127	licensing [certification] of psychiatric residential [youth]
128	128	treatment facilities under this chapter. The minimum standards
129	129	must require a facility to:
130	130	(1) obtain accreditation by The Joint Commission, the
131	131	Commission on Accreditation of Rehabilitation Facilities, the
132	132	Council on Accreditation, or another accrediting organization
133	133	approved by the commission; [and]
134	134	(2) provide and prescribe guidelines for the provision
135	135	of the following activities, treatments, and services:
136	136	(A) development and implementation of individual
137	137	plans of care, including the provision of services provided by a
138	138	licensed psychiatrist or physician to develop individual plans of
139	139	care;
140	140	(B) individual therapy;
141	141	(C) family engagement activities;
142	142	(D) consultation services with qualified
143	143	professionals, including case managers, primary care
144	144	professionals, community-based mental health providers, school
145	145	staff, and other support planners;
146	146	(E) 24-hour nursing services; and
147	147	(F) direct care and supervision services,
148	148	supportive services for daily living and safety, and positive
149	149	behavior management services;
150	150	(3) satisfy federal requirements for a psychiatric
151	151	residential treatment facility under 42 C.F.R. Section 441.151 et
152	152	seq. and 42 C.F.R. Section 483.350 et seq.; and
153	153	(4) satisfy all requirements for licensure as a
154	154	general residential operation under Chapter 42, Human Resources
155	155	Code, and comply with rules adopted under that chapter.
156	156	SECTION 13. Section 577A.102, Health and Safety Code, is
157	157	amended to read as follows:
158	158	Sec. 577A.102. ADMISSION CRITERIA. A facility licensed
159	159	[certified] under this chapter may not admit or provide treatments
160	160	or services to an individual unless the individual:
161	161	(1) is 21 years of age or younger;
162	162	(2) has been diagnosed with a severe emotional
163	163	disturbance by a licensed mental health professional;
164	164	(3) requires residential psychiatric treatment under
165	165	the direction of a licensed physician to improve the individual's
166	166	condition; and
167	167	(4) was referred for treatments or services in a
168	168	psychiatric residential [youth] treatment facility by a licensed
169	169	mental health professional.
170	170	SECTION 14. Section 577A.151, Health and Safety Code, is
171	171	amended to read as follows:
172	172	Sec. 577A.151. PENALTIES. A facility licensed [certified]
173	173	under this chapter is subject to a civil penalty under Section
174	174	571.023 or an administrative penalty under Section 571.025, as
175	175	applicable, for a violation of this chapter or a rule adopted under
176	176	this chapter.
177	177	SECTION 15. Section 32.024, Human Resources Code, is
178	178	amended by adding Subsections (oo-1) and (ss) to read as follows:
179	179	(oo-1) The commission shall provide medical assistance
180	180	reimbursement to a health care provider who delivers to a recipient
181	181	under the medical assistance program services classified as
182	182	multisystemic therapy by the Healthcare Common Procedure Coding
183	183	System (HCPCS) code. The executive commissioner shall establish a
184	184	separate provider type for multisystemic therapy providers for
185	185	purposes of enrollment as a provider for and reimbursement under
186	186	the medical assistance program.
187	187	(ss) The commission in the commission's rules and standards
188	188	governing the scope of services provided under the medical
189	189	assistance program shall include psychiatric treatment and related
190	190	services provided by a psychiatric residential treatment facility
191	191	licensed under Chapter 577A, Health and Safety Code, to the extent
192	192	permitted by federal law.
193	193	SECTION 16. Section 32.027, Human Resources Code, is
194	194	amended by amending Subsection (l) and adding Subsection (m) to
195	195	read as follows:
196	196	(l) Subject to appropriations, the commission shall assure
197	197	that a recipient of medical assistance under this chapter may
198	198	select a licensed psychologist, a licensed marriage and family
199	199	therapist, as defined by Section 502.002, Occupations Code, a
200	200	licensed professional counselor, as defined by Section 503.002,
201	201	Occupations Code, or a licensed clinical [master] social worker, as
202	202	defined by Section 505.002, Occupations Code, to perform any health
203	203	care service or procedure covered under the medical assistance
204	204	program if the selected person is authorized by law to perform the
205	205	service or procedure. This subsection shall be liberally
206	206	construed.
207	207	(m) The commission shall assure that a recipient of medical
208	208	assistance under this chapter may select the following to perform
209	209	any health care service or procedure covered under the medical
210	210	assistance program if the selected person is licensed and
211	211	authorized by law to perform the service or procedure:
212	212	(1) a licensed marriage and family therapist
213	213	associate, as defined by Section 502.002, Occupations Code, who is
214	214	working toward fulfilling the supervised practice requirements to
215	215	be licensed as a licensed marriage and family therapist, as defined
216	216	by that section;
217	217	(2) a licensed master social worker, as defined by
218	218	Section 505.002, Occupations Code, who is actively pursuing the
219	219	education and training required to be licensed as a licensed
220	220	clinical social worker, as defined by that section; or
221	221	(3) a licensed professional counselor associate, as
222	222	described by 22 T.A.C. Chapter 681, who is working toward
223	223	fulfilling the supervised practice requirements to be licensed as a
224	224	licensed professional counselor, as defined by Section 503.002,
225	225	Occupations Code.
226	226	SECTION 17. Subchapter B, Chapter 32, Human Resources Code,
227	227	is amended by adding Section 32.04261 to read as follows:
228	228	Sec. 32.04261. REIMBURSEMENT FOR FUNCTIONAL FAMILY THERAPY
229	229	SERVICES. (a) In this section:
230	230	(1) "At-risk youth" means children who are at risk of
231	231	involvement with the child welfare system, the criminal justice
232	232	system, or the juvenile justice system.
233	233	(2) "Functional family therapy" means an intensive,
234	234	short-term, family-based therapeutic treatment program for at-risk
235	235	youth designed to improve family dynamics, communication, and
236	236	support by:
237	237	(A) addressing core causes of dysfunctional
238	238	behavior patterns;
239	239	(B) decreasing negativity in the household; and
240	240	(C) providing tools to improve parental skills
241	241	and relationships.
242	242	(b) The commission shall ensure that medical assistance
243	243	reimbursement is provided to a provider who provides functional
244	244	family therapy services to a recipient under the medical assistance
245	245	program.
246	246	SECTION 18. Subchapter B, Chapter 32, Human Resources Code,
247	247	is amended by adding Section 32.079 to read as follows:
248	248	Sec. 32.079. REIMBURSEMENT FOR CERTAIN COUNSELING
249	249	SERVICES. (a) The commission shall provide reimbursement under
250	250	the medical assistance program to a provider described by Section
251	251	32.027(l) who is a licensed marriage and family therapist, licensed
252	252	professional counselor, or licensed clinical social worker, is
253	253	selected by a recipient of medical assistance, and provides
254	254	counseling services covered under the medical assistance program
255	255	that the provider is authorized by law to perform. The commission
256	256	shall ensure that the provider is reimbursed at a rate equal to the
257	257	reimbursement rate established for a licensed psychiatrist or
258	258	licensed psychologist for providing similar services.
259	259	(b) The commission shall provide reimbursement under the
260	260	medical assistance program to a provider described by Section
261	261	32.027(m) who is selected by a recipient of medical assistance and
262	262	who provides counseling services covered under the medical
263	263	assistance program that the provider is authorized by law to
264	264	perform. The commission shall ensure that the provider is
265	265	reimbursed at a rate equal to 70 percent of the reimbursement rate
266	266	established for a licensed psychiatrist or licensed psychologist
267	267	for providing similar services.
268	268	(c) This section shall be liberally construed.
269	269	SECTION 19. Section 42.041(b), Human Resources Code, is
270	270	amended to read as follows:
271	271	(b) This section does not apply to:
272	272	(1) a state-operated facility;
273	273	(2) an agency foster home;
274	274	(3) a facility that is operated in connection with a
275	275	shopping center, business, religious organization, or
276	276	establishment where children are cared for during short periods
277	277	while parents or persons responsible for the children are attending
278	278	religious services, shopping, or engaging in other activities,
279	279	including retreats or classes for religious instruction, on or near
280	280	the premises, that does not advertise as a child-care facility or
281	281	day-care center, and that informs parents that it is not licensed by
282	282	the state;
283	283	(4) a school or class for religious instruction that
284	284	does not last longer than two weeks and is conducted by a religious
285	285	organization during the summer months;
286	286	(5) a youth camp licensed by the Department of State
287	287	Health Services;
288	288	(6) a facility licensed, operated, certified, or
289	289	registered by another state agency;
290	290	(7) an educational facility that is accredited by the
291	291	Texas Education Agency, the Southern Association of Colleges and
292	292	Schools, or an accreditation body that is a member of the Texas
293	293	Private School Accreditation Commission and that operates
294	294	primarily for educational purposes for prekindergarten and above, a
295	295	before-school or after-school program operated directly by an
296	296	accredited educational facility, or a before-school or
297	297	after-school program operated by another entity under contract with
298	298	the educational facility, if the Texas Education Agency, the
299	299	Southern Association of Colleges and Schools, or the other
300	300	accreditation body, as applicable, has approved the curriculum
301	301	content of the before-school or after-school program operated under
302	302	the contract;
303	303	(8) an educational facility that operates solely for
304	304	educational purposes for prekindergarten through at least grade
305	305	two, that does not provide custodial care for more than one hour
306	306	during the hours before or after the customary school day, and that
307	307	is a member of an organization that promulgates, publishes, and
308	308	requires compliance with health, safety, fire, and sanitation
309	309	standards equal to standards required by state, municipal, and
310	310	county codes;
311	311	(9) a kindergarten or preschool educational program
312	312	that is operated as part of a public school or a private school
313	313	accredited by the Texas Education Agency, that offers educational
314	314	programs through grade six, and that does not provide custodial
315	315	care during the hours before or after the customary school day;
316	316	(10) a family home, whether registered or listed;
317	317	(11) an educational facility that is integral to and
318	318	inseparable from its sponsoring religious organization or an
319	319	educational facility both of which do not provide custodial care
320	320	for more than two hours maximum per day, and that offers an
321	321	educational program in one or more of the
322	322	following: prekindergarten through at least grade three,
323	323	elementary grades, or secondary grades;
324	324	(12) an emergency shelter facility, other than a
325	325	facility that would otherwise require a license as a child-care
326	326	facility under this section, that provides shelter or care to a
327	327	minor and the minor's child or children, if any, under Section
328	328	32.201, Family Code, if the facility:
329	329	(A) is currently under a contract with a state or
330	330	federal agency; or
331	331	(B) meets the requirements listed under Section
332	332	51.005(b)(3);
333	333	(13) a juvenile detention facility certified under
334	334	Section 51.12, Family Code, a juvenile correctional facility
335	335	certified under Section 51.125, Family Code, a juvenile facility
336	336	providing services solely for the Texas Juvenile Justice
337	337	Department, or any other correctional facility for children
338	338	operated or regulated by another state agency or by a political
339	339	subdivision of the state;
340	340	(14) an elementary-age (ages 5-13) recreation program
341	341	operated by a municipality provided the governing body of the
342	342	municipality annually adopts standards of care by ordinance after a
343	343	public hearing for such programs, that such standards are provided
344	344	to the parents of each program participant, and that the ordinances
345	345	shall include, at a minimum, staffing ratios, minimum staff
346	346	qualifications, minimum facility, health, and safety standards,
347	347	and mechanisms for monitoring and enforcing the adopted local
348	348	standards; and further provided that parents be informed that the
349	349	program is not licensed by the state and the program may not be
350	350	advertised as a child-care facility;
351	351	(15) an annual youth camp held in a municipality with a
352	352	population of more than 1.5 million that operates for not more than
353	353	three months and that has been operated for at least 10 years by a
354	354	nonprofit organization that provides care for the homeless;
355	355	(16) a food distribution program that:
356	356	(A) serves an evening meal to children two years
357	357	of age or older; and
358	358	(B) is operated by a nonprofit food bank in a
359	359	nonprofit, religious, or educational facility for not more than two
360	360	hours a day on regular business days;
361	361	(17) a child-care facility that operates for less than
362	362	three consecutive weeks and less than 40 days in a period of 12
363	363	months;
364	364	(18) a program:
365	365	(A) in which a child receives direct instruction
366	366	in a single skill, talent, ability, expertise, or proficiency;
367	367	(B) that does not provide services or offerings
368	368	that are not directly related to the single talent, ability,
369	369	expertise, or proficiency;
370	370	(C) that does not advertise or otherwise
371	371	represent that the program is a child-care facility, day-care
372	372	center, or licensed before-school or after-school program or that
373	373	the program offers child-care services;
374	374	(D) that informs the parent or guardian:
375	375	(i) that the program is not licensed by the
376	376	state; and
377	377	(ii) about the physical risks a child may
378	378	face while participating in the program; and
379	379	(E) that conducts background checks for all
380	380	program employees and volunteers who work with children in the
381	381	program using information that is obtained from the Department of
382	382	Public Safety;
383	383	(19) an elementary-age (ages 5-13) recreation program
384	384	that:
385	385	(A) adopts standards of care, including
386	386	standards relating to staff ratios, staff training, health, and
387	387	safety;
388	388	(B) provides a mechanism for monitoring and
389	389	enforcing the standards and receiving complaints from parents of
390	390	enrolled children;
391	391	(C) does not advertise as or otherwise represent
392	392	the program as a child-care facility, day-care center, or licensed
393	393	before-school or after-school program or that the program offers
394	394	child-care services;
395	395	(D) informs parents that the program is not
396	396	licensed by the state;
397	397	(E) is organized as a nonprofit organization or
398	398	is located on the premises of a participant's residence;
399	399	(F) does not accept any remuneration other than a
400	400	nominal annual membership fee;
401	401	(G) does not solicit donations as compensation or
402	402	payment for any good or service provided as part of the program; and
403	403	(H) conducts background checks for all program
404	404	employees and volunteers who work with children in the program
405	405	using information that is obtained from the Department of Public
406	406	Safety;
407	407	(20) a living arrangement in a caretaker's home
408	408	involving one or more children or a sibling group, excluding
409	409	children who are related to the caretaker, in which the caretaker:
410	410	(A) had a prior relationship with the child or
411	411	sibling group or other family members of the child or sibling group;
412	412	(B) does not care for more than one unrelated
413	413	child or sibling group;
414	414	(C) does not receive compensation or solicit
415	415	donations for the care of the child or sibling group; and
416	416	(D) has a written agreement with the parent to
417	417	care for the child or sibling group;
418	418	(21) a living arrangement in a caretaker's home
419	419	involving one or more children or a sibling group, excluding
420	420	children who are related to the caretaker, in which:
421	421	(A) the department is the managing conservator of
422	422	the child or sibling group;
423	423	(B) the department placed the child or sibling
424	424	group in the caretaker's home; and
425	425	(C) the caretaker had a long-standing and
426	426	significant relationship with the child or sibling group, or the
427	427	family of the child or sibling group, before the child or sibling
428	428	group was placed with the caretaker;
429	429	(22) a living arrangement in a caretaker's home
430	430	involving one or more children or a sibling group, excluding
431	431	children who are related to the caretaker, in which the child is in
432	432	the United States on a time-limited visa under the sponsorship of
433	433	the caretaker or of a sponsoring organization;
434	434	(23) a facility operated by a nonprofit organization
435	435	that:
436	436	(A) does not otherwise operate as a child-care
437	437	facility that is required to be licensed under this section;
438	438	(B) provides emergency shelter and care for not
439	439	more than 15 days to children 13 years of age or older but younger
440	440	than 18 years of age who are victims of human trafficking alleged
441	441	under Section 20A.02, Penal Code;
442	442	(C) is located in a municipality with a
443	443	population of at least 600,000 that is in a county on an
444	444	international border; and
445	445	(D) meets one of the following criteria:
446	446	(i) is licensed by, or operates under an
447	447	agreement with, a state or federal agency to provide shelter and
448	448	care to children; or
449	449	(ii) meets the eligibility requirements for
450	450	a contract under Section 51.005(b)(3);
451	451	(24) a facility that provides respite care exclusively
452	452	for a local mental health authority under a contract with the local
453	453	mental health authority; [or]
454	454	(25) a living arrangement in a caretaker's home
455	455	involving one or more children or a sibling group in which the
456	456	caretaker:
457	457	(A) has a written authorization agreement under
458	458	Chapter 34, Family Code, with the parent of each child or sibling
459	459	group to care for each child or sibling group;
460	460	(B) does not care for more than six children,
461	461	excluding children who are related to the caretaker; and
462	462	(C) does not receive compensation for caring for
463	463	any child or sibling group; or
464	464	(26) a psychiatric residential treatment facility
465	465	licensed under Chapter 577A, Health and Safety Code.
466	466	SECTION 20. Section 577A.003, Health and Safety Code, is
467	467	repealed.
468	468	SECTION 21. As soon as practicable after the effective date
469	469	of this Act, the executive commissioner of the Health and Human
470	470	Services Commission shall adopt rules as necessary to implement the
471	471	changes in law made by this Act.
472	472	SECTION 22. If before implementing any provision of this
473	473	Act a state agency determines that a waiver or authorization from a
474	474	federal agency is necessary for implementation of that provision,
475	475	the agency affected by the provision shall request the waiver or
476	476	authorization and may delay implementing that provision until the
477	477	waiver or authorization is granted.
478	478	SECTION 23. Notwithstanding the changes in law made by this
479	479	Act to Chapter 577A, Health and Safety Code, a psychiatric
480	480	residential treatment facility that is licensed under Chapter 42,
481	481	Human Resources Code, on the effective date of this Act is not
482	482	required to be licensed under Chapter 577A, Health and Safety Code,
483	483	until the expiration of the facility's license under Chapter 42,
484	484	Human Resources Code.
485	485	SECTION 24. This Act takes effect September 1, 2025.