89R2692 JCG-F By: West S.B. No. 1081 A BILL TO BE ENTITLED AN ACT relating to the regulation of art therapy, including the establishment of the Texas Art Therapy Board and the duties of the Texas Behavioral Health Executive Council; requiring an occupational license; creating a criminal offense; imposing a fee. BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: ARTICLE 1. TEXAS BEHAVIORAL HEALTH EXECUTIVE COUNCIL SECTION 1.01. Section 507.001, Occupations Code, is amended by amending Subdivision (1) and adding Subdivision (1-a) to read as follows: (1) "Art therapy board" means the Texas Art Therapy Board established under Chapter 508. (1-a) "Executive council" means the Texas Behavioral Health Executive Council. SECTION 1.02. Section 507.051(a), Occupations Code, is amended to read as follows: (a) The Texas Behavioral Health Executive Council consists of eleven [nine] members as follows: (1) one marriage and family therapist member and one public member of the marriage and family therapy board, each appointed by that board; (2) one licensed professional counselor member and one public member of the professional counseling board, each appointed by that board; (3) one psychologist member and one public member of the psychology board, each appointed by that board; (4) one social worker member and one public member of the social work board, each appointed by that board; [and] (5) one professional art therapist member and the public member of the art therapy board, each appointed by that board; and (6) one public member appointed by the governor. SECTION 1.03. Section 507.052, Occupations Code, is amended to read as follows: Sec. 507.052. ELIGIBILITY OF PUBLIC MEMBER APPOINTED BY GOVERNOR. A person is not eligible for appointment by the governor as a public member of the executive council if the person or the person's spouse: (1) is registered, certified, or licensed by an occupational regulatory agency in the field of health care; (2) is employed by or participates in the management of a business entity or other organization regulated by or receiving money from the executive council, the marriage and family therapy board, the professional counseling board, the psychology board, [or] the social work board, or the art therapy board; (3) owns or controls, directly or indirectly, more than a 10 percent interest in a business entity or other organization regulated by or receiving money from the executive council, the marriage and family therapy board, the professional counseling board, the psychology board, [or] the social work board, or the art therapy board; or (4) uses or receives a substantial amount of tangible goods, services, or money from the executive council, the marriage and family therapy board, the professional counseling board, the psychology board, [or] the social work board, or the art therapy board, other than compensation or reimbursement authorized by law for executive council, marriage and family therapy board, professional counseling board, psychology board, [or] social work board, or art therapy board membership, attendance, or expenses. SECTION 1.04. Section 507.053(c), Occupations Code, is amended to read as follows: (c) A person may not be a member of the executive council or act as the general counsel to the executive council if the person is required to register as a lobbyist under Chapter 305, Government Code, because of the person's activities for compensation on behalf of a profession related to the operation of the executive council, the marriage and family therapy board, the professional counseling board, the psychology board, [or] the social work board, or the art therapy board. SECTION 1.05. Section 507.151(a), Occupations Code, is amended to read as follows: (a) The executive council shall administer and enforce this chapter and Chapters 501, 502, 503, [and] 505, and 508. SECTION 1.06. Section 507.153(a), Occupations Code, is amended to read as follows: (a) Unless the rule has been proposed by the applicable board for the profession, the executive council may not adopt under this chapter or Chapter 501, 502, 503, [or] 505, or 508: (1) a rule regarding: (A) the qualifications necessary to obtain a license, including limiting an applicant's eligibility for a license based on the applicant's criminal history; (B) the scope of practice of and standards of care and ethical practice for the profession; or (C) continuing education requirements for license holders; or (2) a schedule of sanctions for violations of the laws and rules applicable to the profession. SECTION 1.07. Section 507.154, Occupations Code, is amended to read as follows: Sec. 507.154. FEES. The executive council shall set fees in amounts reasonable and necessary to cover the costs of administering this chapter and Chapters 501, 502, 503, [and] 505, and 508, including fees for: (1) licenses issued by the executive council; (2) license renewals and late renewals; (3) examinations; and (4) any other program or activity administered by the executive council for which a fee is authorized. ARTICLE 2. ART THERAPISTS SECTION 2.01. Subtitle I, Title 3, Occupations Code, is amended by adding Chapter 508 to read as follows: CHAPTER 508. ART THERAPISTS SUBCHAPTER A. GENERAL PROVISIONS Sec. 508.001. SHORT TITLE. This chapter may be cited as the "Art Therapy Licensing and Practice Act." Sec. 508.002. DEFINITIONS. In this chapter: (1) "Accredited educational institution" means: (A) a university or college accredited by the Commission on Accreditation of Allied Health Education Programs or another nationally recognized accrediting agency of institutions of higher education approved by the executive council; or (B) an institution and clinical program approved by the American Art Therapy Association, or a successor organization approved by the executive council. (2) "Board" means the Texas Art Therapy Board. (3) "Executive council" means the Texas Behavioral Health Executive Council. (4) "Face-to-face meeting" means: (A) an in-person meeting between two or more persons; or (B) a video meeting between two or more persons, if the meeting is synchronous and involves verbal and visual interaction. (5) "Licensed associate art therapist" means a person who holds an associate art therapist license issued under this chapter. (6) "Licensed professional art therapist" means a person who holds a professional art therapist license issued under this chapter. (7) "Qualified art therapy supervisor" means any person who: (A) is a licensed professional art therapist; or (B) both: (i) is a licensed professional counselor, licensed clinical social worker, licensed psychologist, licensed marriage and family therapist, or licensed physician; and (ii) holds a credential as a Registered Art Therapist with Board Certification (ATR-BC) or Art Therapy Credentialed Supervisor (ATCS) issued by the Art Therapy Credentials Board, Inc. (8) "Supervised educational experience" means the regular oversight of the functions and activities of a graduate art therapy student by a qualified art therapy supervisor as part of either: (A) an internship or practicum experience; or (B) the practice of art therapy to fulfill the requirements to be licensed under this chapter. (9) "Supervision" means a formalized professional relationship between a qualified art therapy supervisor and a supervised person in which the qualified art therapy supervisor directs, monitors, and evaluates the supervised person's professional art therapy practice while promoting the development of the supervised person's knowledge, skills, and abilities to provide professional art therapy services in an ethical and competent manner. Sec. 508.003. PRACTICE OF ART THERAPY. A person practices art therapy if the person provides, for compensation, a specialized form of psychotherapy that involves expressive arts media and the creative process to address and alleviate mental and emotional disorders or psychopathologies, improve cognitive function or sensory-motor functions, or support wellness, through diagnosis, assessment, testing, treatment, evaluation, or rehabilitation. The practice of art therapy includes: (1) an evidence-based clinical practice of art therapy within a professional relationship conducted by a professionally trained art therapist who is licensed under this chapter; (2) the integration of psychological theories, art therapy theory, art-based assessment models, traditional verbal counseling techniques, and the creative process into the provision of psychotherapy; (3) the provision of services to accomplish art therapy goals, including using expressive arts media, creative techniques, nonverbal communication, psychotherapy, art-based assessment models, and the creative process in a therapeutic relationship between a client and a licensed professional art therapist or a licensed art therapy associate; (4) evaluation, assessment, and diagnosis to define and implement individualized treatment plans to address developmental, rehabilitative, habilitative, medical, mental health, preventive, wellness care, or educational needs of clients; (5) systematically evaluating and comparing a client's response to an individualized art therapy treatment plan and suggesting modifications, as appropriate; (6) therapeutic interventions to facilitate alternative modes of receptive and expressive communication that can circumvent the limitations of verbal articulation; (7) the use of treatment interventions that include psychotherapy or counseling integrated with art therapy theory, the creative process, or art media to facilitate human development and to identify and remediate mental, emotional, or behavioral disorders and associated distresses that interfere with daily functioning; and (8) the use of appropriate knowledge and specialized training in art therapy theory, art media, the creative process, the neurobiological implications of art-making, psychotherapy and counseling principles and theory, and clinical decision-making skills to inform practice and determine the appropriate course of action, tailored to the context of each specific clinical setting. Sec. 508.004. APPLICABILITY. (a) This chapter does not apply to: (1) a student or intern who: (A) practices under the supervision of a qualified art therapy supervisor in an educational institution or agency as part of the institution's or agency's graduate degree program in art therapy or a related field; and (B) is designated by a title such as "student," "trainee," "intern," or another title clearly indicating the person's training status; or (2) an activity conducted or a service performed by a person who is licensed, certified, or registered in a profession other than art therapy, if: (A) the activity or service is conducted or performed within the scope of the person's license, certificate, or registration; and (B) the person does not represent the person to the public by any title, initials, or description of services as being a licensed professional art therapist or a licensed associate art therapist. (b) The executive council may adopt rules governing the supervision required to qualify for the exemption under Subsection (a). SUBCHAPTER B. TEXAS ART THERAPY BOARD Sec. 508.051. BOARD; MEMBERSHIP. (a) The Texas Art Therapy Board consists of five members appointed by the governor with the advice and consent of the senate as follows: (1) three licensed professional art therapists who have been actively engaged in the practice of art therapy in this state for at least the three years preceding the member's appointment; (2) one health care professional who is not a licensed professional art therapist; and (3) one member who represents the public. (b) Appointments to the board shall be made without regard to the race, color, disability, sex, religion, age, or national origin of the appointee. (c) Notwithstanding Subsection (a)(1), a person practicing as a professional art therapist is eligible for appointment as an initial member of the board regardless of whether the person holds a professional art therapy license issued under this chapter. This subsection expires September 1, 2026. Sec. 508.052. PUBLIC MEMBERSHIP ELIGIBILITY. (a) The public member of the board may not: (1) be licensed under this chapter; or (2) have an interest in the practice of art therapy other than as a consumer. (b) A person is not eligible for appointment as the public member of the board if: (1) the person is registered, certified, or licensed by an occupational regulatory agency in the field of health care; (2) the person's spouse is registered, certified, or licensed by an occupational regulatory agency in the field of mental health; or (3) the person or the person's spouse: (A) is employed by or participates in the management of a business entity or other organization regulated by or receiving funds from the board or executive council; (B) owns or controls, directly or indirectly, more than a 10 percent interest in a business entity or other organization regulated by or receiving funds from the board or executive council; or (C) uses or receives a substantial amount of tangible goods, services, or funds from the board or executive council, other than compensation or reimbursement authorized by law for board membership, attendance, or expenses. Sec. 508.053. MEMBERSHIP RESTRICTIONS. (a) In this section, "Texas trade association" means a cooperative and voluntarily joined statewide association of business or professional competitors in this state designed to assist its members and its industry or profession in dealing with mutual business or professional problems and in promoting their common interest. (b) A person may not be a member of the board if: (1) the person is an officer, employee, or paid consultant of a Texas trade association in the field of health care; or (2) the person's spouse is an officer, manager, or paid consultant of a Texas trade association in the field of mental health. (c) A person may not be a member of the board if the person is required to register as a lobbyist under Chapter 305, Government Code, because of the person's activities for compensation on behalf of a profession related to the operation of the board. Sec. 508.054. TERMS. Members of the board serve staggered six-year terms with the terms of one or two members expiring on February 1 of each odd-numbered year. Sec. 508.055. GROUNDS FOR REMOVAL. (a) It is a ground for removal from the board that a member: (1) does not have at the time of taking office the qualifications required by Section 508.051(a); (2) does not maintain during service on the board the qualifications required by Section 508.051(a); (3) is ineligible for membership under Section 508.052 or 508.053; (4) cannot, because of illness or disability, discharge the member's duties for a substantial part of the member's term; or (5) is absent from more than half of the regularly scheduled board meetings that the member is eligible to attend during a calendar year without an excuse approved by a majority vote of the board. (b) The validity of an action of the board is not affected by the fact that it is taken when a ground for removal of a board member exists. (c) If the executive director of the executive council has knowledge that a potential ground for removal exists, the executive director shall notify the presiding officer of the board of the potential ground. The presiding officer shall then notify the governor and the attorney general that a potential ground for removal exists. If the potential ground for removal involves the presiding officer, the executive director shall notify the next highest ranking officer of the board, who shall then notify the governor and attorney general that a potential ground for removal exists. Sec. 508.056. EXPENSE REIMBURSEMENT. Each board member is entitled to reimbursement for expenses incurred in traveling to and from the business of the board at the rates provided in the General Appropriations Act for state employees. A member may not receive actual or necessary expenses except for travel to and from meetings. Sec. 508.057. OFFICERS. (a) The governor shall designate a member of the board as presiding officer. The presiding officer serves in that capacity at the will of the governor. (b) The board shall elect an assistant presiding officer to serve as provided by board rule. Sec. 508.058. MEETINGS. (a) The board shall meet at least three times each year. (b) The board may hold other regular meetings as provided by board rule and special meetings as determined by the board. Sec. 508.059. TRAINING. (a) A person who is appointed to and qualifies for office as a member of the board may not vote, deliberate, or be counted as a member in attendance at a meeting of the board until the person completes a training program that complies with this section. (b) The training program must provide the person with information regarding: (1) the law governing board operations; (2) the programs, functions, rules, and budget of the board; (3) the scope of and limitations on the rulemaking authority of the board; (4) the types of board rules, interpretations, and enforcement actions that may implicate federal antitrust law by limiting competition or impacting prices charged by persons engaged in a profession or business the board regulates, including any rule, interpretation, or enforcement action that: (A) regulates the scope of practice of persons in a profession or business the board regulates; (B) restricts advertising by persons in a profession or business the board regulates; (C) affects the price of goods or services provided by persons in a profession or business the board regulates; or (D) restricts participation in a profession or business the board regulates; (5) the results of the most recent formal audit of the board; (6) the requirements of: (A) laws relating to open meetings, public information, administrative procedure, and disclosure of conflicts of interest; and (B) other laws applicable to members of the board in performing their duties; and (7) any applicable ethics policies adopted by the board or the Texas Ethics Commission. (c) A person appointed to the board is entitled to reimbursement, as provided by the General Appropriations Act, for the travel expenses incurred in attending the training program regardless of whether the attendance at the program occurs before or after the person qualifies for office. (d) The executive director of the executive council shall create a training manual that includes the information required by Subsection (b). The executive director shall distribute a copy of the training manual annually to each board member. Each member of the board shall sign and submit to the executive director a statement acknowledging that the member received and has reviewed the training manual. SUBCHAPTER C. GENERAL POWERS AND DUTIES Sec. 508.101. GENERAL POWERS AND DUTIES OF EXECUTIVE COUNCIL. (a) The executive council shall administer and enforce this chapter. (b) The executive council may: (1) adopt and enforce rules necessary to perform the executive council's duties under this chapter; (2) ensure strict compliance with and enforcement of this chapter, including by recommending violations of this chapter to the appropriate district, criminal district, or county attorney for prosecution; and (3) enter into contracts as necessary to administer and enforce this chapter. (c) The executive council shall adopt a code of ethics for license holders. Sec. 508.102. BOARD DUTIES. The board shall propose to the executive council: (1) rules regarding: (A) the qualifications necessary to obtain a license, including rules limiting an applicant's eligibility for a license based on the applicant's criminal history; (B) the scope of practice of and standards of care and ethical practice for the practice of art therapy; and (C) continuing education requirements for license holders; and (2) a schedule of sanctions for violations of this chapter or rules adopted under this chapter. Sec. 508.103. ROSTER OF PERSONS LICENSED UNDER THIS CHAPTER. The executive council shall compile and publish annually a roster of names, license numbers, and addresses of each person licensed under this chapter. Sec. 508.104. FEES. (a) Subject to Subsection (b), the executive council shall establish reasonable and necessary fees for the administration of this chapter, including fees for license applications and license renewals and any penalty fee for late renewals. (b) The fee to apply for a professional art therapist license must be at least $183. SUBCHAPTER D. LICENSE REQUIREMENTS Sec. 508.151. LICENSE REQUIRED TO PRACTICE ART THERAPY; TITLE RESTRICTIONS. (a) A person may not engage in the practice of art therapy unless the person is licensed under this chapter. (b) Unless the person holds the appropriate license under this chapter, a person may not use or cause to be used: (1) the titles "licensed professional art therapist" or "licensed associate art therapist"; (2) the abbreviations "LPAT" or "LAAT"; or (3) any other title, designation, word, letter, abbreviation, or insignia indicating the practice of art therapy. Sec. 508.152. APPLICATION; ISSUANCE. (a) A person may apply for a license under this chapter by submitting an application to the executive council and paying any required fee. The application must: (1) be on a form and submitted in a manner prescribed by the executive council; (2) include evidence satisfactory to the executive council that the applicant meets the eligibility requirements for the license for which the applicant is applying; and (3) contain any other information required by executive council rule. (b) The executive council shall review applications submitted under Subsection (a) and issue the appropriate license to a person who meets the eligibility requirements of this chapter for the license for which the person applied. Sec. 508.153. ELIGIBILITY FOR PROFESSIONAL ART THERAPIST LICENSE. (a) To be eligible for a professional art therapist license, an applicant must: (1) be at least 21 years of age; (2) be licensed as an associate art therapist; (3) subject to Subsection (b), have completed the minimum number of hours practicing art therapy as a licensed associate art therapist as required by executive council rule in a period of not less than two years, which may not be less than 3,000 hours; and (4) satisfactorily complete the Art Therapy Credentials Board Examination (ATC-BE) or a substantially similar examination approved by the executive council. (b) With respect to the hours required under Subsection (a)(3): (1) at least 1,500 of those hours must have been spent practicing art therapy with clients in face-to-face meetings for the purpose of diagnosing or treating mental, emotional, behavioral, or addiction disorders; (2) for every 10 hours the licensed associate art therapist practices art therapy with clients in face-to-face meetings, the qualified art therapy supervisor must provide to the licensed associate art therapist at least one hour of direct supervision by face-to-face meeting; and (3) notwithstanding Subdivision (2), the qualified art therapy supervisor must provide at least two hours of supervision each month to the associate art therapist through group or individual supervision, which shall be credited toward meeting the hours of supervision required by Subdivision (2). Sec. 508.154. ELIGIBILITY FOR ASSOCIATE ART THERAPIST LICENSE. To be eligible for an associate art therapist license, an applicant must: (1) be at least 21 years of age; (2) either: (A) have completed a master's or doctoral degree program in art therapy with an accredited educational institution that included at least 700 hours of supervised educational experience through an internship; or (B) have completed each of the following: (i) a master's or doctoral degree program in a field related to art therapy with an accredited educational institution; (ii) as part of the degree program described by Subparagraph (i), at least 30 graduate credit hours in any combination of the following subjects: (a) theory and practice of art therapy, including applicable standards for the practice of art therapy; (b) art therapy media and techniques; (c) history of art therapy; (d) human growth and developmental dynamics in art; (e) application of art therapy with persons in different treatment settings; (f) art therapy appraisal; (g) diagnosis and assessment; (h) group art therapy; (i) ethical and legal issues of art therapy practice; and (j) matters of cultural and social diversity bearing on the practice of art therapy; and (iii) at least 700 hours of supervised educational experience through an internship; (3) submit at least one letter of recommendation attesting to the applicant's integrity and competence from a qualified art therapy supervisor who has provided direct clinical supervision of the applicant's graduate program clinical training, practicum, or internship; and (4) have secured employment as an associate art therapist and completed a postgraduate supervised training plan on forms prescribed by the executive council describing the services to be provided, place of employment, and individuals responsible for supervision and in a statement acknowledging the rules and requirements for practice as an associate art therapist. Sec. 508.155. EXAMINATIONS. The executive council shall adopt or develop, and administer as necessary, examinations for licensure as a professional art therapist and associate art therapist. Sec. 508.156. ISSUANCE OF LICENSE TO APPLICANTS LICENSED IN OTHER JURISDICTIONS. The executive council may issue a professional art therapist license or associate art therapist license to an applicant for a license under this chapter who is licensed, registered, certified, or otherwise credentialed in another jurisdiction to engage in the practice of art therapy if: (1) the executive council determines that the standards for issuance of the credential issued in the other jurisdiction are substantially equivalent to the requirements for a license under this chapter; (2) the applicant demonstrates in the manner prescribed by the executive council that the applicant: (A) will comply with the laws and rules governing the practice of art therapy in this state and practice art therapy within the scope authorized by law; (B) has not been subject to any disciplinary action of a serious nature by the licensing authority in the other jurisdiction; and (C) has completed a master's or doctoral degree program in art therapy or a related field with an accredited educational institution; and (3) the applicant pays any required application fee. Sec. 508.157. ISSUANCE OF LICENSE FOR CERTAIN PERSONS PRACTICING ART THERAPY BEFORE ENACTMENT OF CHAPTER; EXPIRATION. (a) The executive council may waive the requirements of this chapter for licensure as a professional art therapist for an applicant who, not later than March 1, 2027, pays any required application fee and demonstrates to the executive council in a manner prescribed by the executive council that the applicant: (1) has completed a master's or doctoral degree program in art therapy or a related field; (2) holds a credential in good standing with the Art Therapy Credentials Board, Inc., or an equivalent credential as determined by the executive council; and (3) has engaged in the practice of art therapy for at least five years preceding September 1, 2025. (b) This section expires September 1, 2027. SUBCHAPTER E. LICENSE RENEWAL AND CONTINUING EDUCATION Sec. 508.201. PROFESSIONAL ART THERAPIST LICENSE TERM; RENEWAL. (a) A professional art therapist license is valid for a term of two years. (b) The executive council by rule shall adopt a system under which professional art therapist licenses expire on various dates during the year. (c) To renew a professional art therapist license, the license holder must apply on a form and in a manner prescribed by the executive council, pay any required fee, and demonstrate to the satisfaction of the executive council that the license holder has completed any required continuing education. (d) On application by a license holder, the executive council shall renew the license if the license holder meets all the renewal requirements of this chapter, including any rule adopted under this chapter. Sec. 508.202. ASSOCIATE ART THERAPIST LICENSE TERM; EXTENSION OF TERM. (a) An associate art therapist license is valid for a term of three years and may not be renewed. (b) A licensed associate art therapist who has not met the requirement for licensure as a professional art therapist before the expiration of the person's license may apply for a one-time extension of the license for an additional two years. An application for extension under this subsection must include: (1) a plan for completing the requirements to obtain a professional art therapist license; (2) documented evidence of compliance with any required continuing education; (3) documented evidence that the license holder is receiving appropriate supervision from a qualified art therapy supervisor; and (4) at least one letter of recommendation from a qualified art therapy supervisor who is providing supervision to the license holder. Sec. 508.203. CONTINUING EDUCATION. (a) The executive council shall: (1) require each person licensed under this chapter to complete a minimum number of continuing education courses or programs once every 24 months; (2) recognize the American Art Therapy Association and other persons as providers of continuing education for any continuing education required under Chapter 507, this chapter, or a rule adopted under either of those chapters; (3) subject to Subsection (b), accredit educational courses or programs related to art therapy as qualifying continuing education, including: (A) attending meetings of constituents and components of art therapy associations recognized by the executive council; (B) preparing or participating in examinations; (C) preparing papers; (D) publications; (E) presentations; and (F) obtaining teaching and research appointments; and (4) establish procedures for the issuance of continuing education credit on receiving satisfactory evidence of completion of the courses or programs described by Subdivision (3). (b) The executive council may approve courses or programs described by Subsection (a)(3) only if the programs are open to all art therapists in this state on a reasonably nondiscriminatory basis. (c) For an education course or program that qualifies as continuing education, each hour of instruction is equivalent to one credit. (d) As part of the continuing education hours required under Subsection (a)(1), each person licensed under this chapter must complete at least three hours of courses or programs on the ethical practice of art therapy. Sec. 508.204. EXTENSION TO COMPLETE CONTINUING EDUCATION REQUIREMENTS. The executive council shall adopt rules to provide for a professional art therapy license holder who is unable to complete the required continuing education hours for renewal before the expiration of the license holder's license to apply for an extension of the term of the license for a time considered adequate by the executive council for the license holder to complete any remaining required continuing education hours. Sec. 508.205. REQUIRED NOTICE OF RENEWAL; INACTIVE STATUS. (a) Not later than the 30th day before the date a person's professional art therapy license expires, the executive council shall provide notice to the license holder of the renewal fees under Section 507.255 and that the license holder may request that the executive council place the license on inactive status. (b) On request of a professional art therapy license holder, the executive council shall place the person's license on inactive status. (c) A person whose license is inactive: (1) may not practice art therapy under this chapter; and (2) is not required to pay a license renewal fee or any penalty fee. (d) A person whose license is inactive may apply to reactivate the license. The executive council shall reactivate the license if the applicant: (1) pays a license fee; (2) is not in violation of this chapter when the applicant applies to reactivate the license; and (3) fulfills the requirements provided by executive council rule for the holder of an inactive license. SUBCHAPTER F. PRACTICE BY LICENSE HOLDER Sec. 508.251. INDEPENDENT PRACTICE BY LICENSED PROFESSIONAL ART THERAPIST. (a) In this section, the "independent practice of art therapy" means to diagnose and treat mental health disorders specified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders designated by the executive council for use by licensed professional art therapists. (b) Notwithstanding any other law, a licensed professional art therapist may engage in the independent practice of art therapy. (c) If a client has symptoms of a mental disorder, a licensed professional art therapist shall request a consultation from and consult with the client's primary care physician or psychiatrist, as applicable, to determine whether a medical condition or medication is causing or contributing to the client's symptoms of the mental disorder. (d) A licensed professional art therapist is not required to consult a client's primary care physician or psychiatrist under Subsection (c) if the client waives that requirement in writing. The licensed professional art therapist shall maintain any written waiver under this subsection with the client's records. (e) Regardless of when the consultation required by Subsection (c) is obtained, the licensed professional art therapist may continue, after the consultation is requested under Subsection (c) or waived under Subsection (d), to evaluate and treat the client. (f) The executive council may adopt rules governing the independent practice of art therapy by a licensed professional art therapist. Sec. 508.252. SUPERVISED PRACTICE OF ART THERAPY BY LICENSED ASSOCIATE ART THERAPIST. (a) A licensed associate art therapist may not: (1) practice art therapy unless: (A) the licensed associate art therapist is practicing under the supervision of a qualified art therapy supervisor; (B) the licensed associate art therapist and each of the therapist's qualified art therapy supervisors have entered into a postgraduate supervised training plan on forms prescribed by the executive council describing the services to be provided, place of employment, and individuals responsible for supervision and in a statement acknowledging the rules and requirements for practice as a licensed associate art therapist; and (C) the training plan described by Paragraph (B) has been approved by the executive council; and (2) represent that the licensed associate art therapist is a licensed professional art therapist or that the licensed associate art therapist may engage in the independent practice of art therapy. (b) The supervision of a licensed associate art therapist by a qualified art therapy supervisor must comply with the following requirements: (1) the practice of art therapy is under the order, control, and full professional responsibility of the supervisor who reviews aspects of the practice and case management in a face-to-face meeting with the therapist; and (2) the supervisor: (A) accepts direct responsibility for the client services provided by the licensed associate art therapist and conducts regular face-to-face meetings with the therapist; (B) ensures that the extent, kind, and quality of art therapy services provided by the therapist are consistent with the education, training, and experience of the therapist; (C) reviews client or patient records of the clients or patients for whom the therapist provided art therapy services; (D) monitors the therapist's practice of art therapy; (E) evaluates any assessment administered, diagnosis made, or treatment decision made by the therapist; and (F) ensures compliance with laws and rules governing the practice of art therapy, including as practiced by a licensed associate art therapist. Sec. 508.253. CONFIDENTIALITY OF COMMUNICATIONS MADE DURING ART THERAPY SERVICES. (a) Any communication made between a licensed professional art therapist or a licensed associate art therapist and the therapist's client while the therapist is practicing art therapy is confidential. (b) A communication that is confidential under this section may not be disclosed by the therapist unless: (1) the client receiving the art therapy service authorizes the disclosure in writing; (2) the therapist is the defendant in a civil, criminal, or administrative action arising from the art therapy service during which the communication was made; or (3) the disclosure is authorized by other law. (c) A disclosure authorized by Subsection (b) does not waive the right to assert in the future that the communication is confidential. SUBCHAPTER G. DISCIPLINARY ACTIONS Sec. 508.301. DISCIPLINARY ACTIONS. A person is subject to disciplinary action as provided by Subchapter G or H, Chapter 507, if the person: (1) violates this chapter or a rule or code of ethics adopted under this chapter; or (2) commits an act for which liability exists under Chapter 81, Civil Practice and Remedies Code. Sec. 508.302. REFUND. (a) Subject to Subsection (b), the executive council may order a license holder to pay a refund to a consumer as provided in an agreement resulting from an informal settlement conference instead of or in addition to imposing an administrative penalty under Subchapter H, Chapter 507. (b) The amount of a refund ordered as provided in an agreement resulting from an informal settlement conference may not exceed the amount the consumer paid to the license holder for a service regulated by this chapter. The executive council may not require payment of other damages or estimate harm in a refund order. SUBCHAPTER H. CRIMINAL PENALTY Sec. 508.351. OFFENSE. (a) A person commits an offense if the person: (1) violates Section 508.151; or (2) engages in the independent practice of art therapy without holding a professional art therapist license. (b) An offense under this section is a Class B misdemeanor. SECTION 2.02. Section 81.001(2), Civil Practice and Remedies Code, is amended to read as follows: (2) "Mental health services provider" means an individual, licensed or unlicensed, who performs or purports to perform mental health services, including a: (A) licensed social worker as defined by Section 505.002, Occupations Code; (B) chemical dependency counselor as defined by Section 504.001, Occupations Code; (C) licensed professional counselor as defined by Section 503.002, Occupations Code; (D) licensed marriage and family therapist as defined by Section 502.002, Occupations Code; (E) member of the clergy; (F) physician who is practicing medicine as defined by Section 151.002, Occupations Code; (G) psychologist offering psychological services as defined by Section 501.003, Occupations Code; [or] (H) special officer for mental health assignment certified under Section 1701.404, Occupations Code; or (I) professional art therapist or associate art therapist licensed under Chapter 508, Occupations Code. SECTION 2.03. As soon as practicable after the effective date of this Act, the governor shall appoint the members of the Texas Art Therapy Board in accordance with Chapter 508, Occupations Code, as added by this Act. In making the initial appointments, the governor shall designate two members for terms expiring February 1, 2027, two members for terms expiring February 1, 2029, and one member for a term expiring February 1, 2031. SECTION 2.04. Not later than January 1, 2026, the Texas Behavioral Health Executive Council shall adopt the rules, procedures, and fees necessary to administer Chapter 508, Occupations Code, as added by this Act. SECTION 2.05. Notwithstanding Chapter 508, Occupations Code, as added by this Act, an art therapist is not required to hold a license under that chapter to practice as a licensed professional art therapist or licensed associate art therapist in this state before September 1, 2026. ARTICLE 3. CONFORMING AMENDMENTS SECTION 3.01. Sections 503.310(a) and (b), Occupations Code, are amended to read as follows: (a) On application and payment of applicable fees, the executive council may issue a provisional license to a person who holds a license as a counselor [or art therapist] issued by another state or by a jurisdiction acceptable to the executive council. (b) An applicant for a provisional license must: (1) be licensed in good standing as a counselor [or art therapist] in another state, territory, or jurisdiction that has licensing requirements substantially equivalent to the requirements of this chapter; (2) have passed the required license examination; and (3) be sponsored by a person licensed under this chapter with whom the applicant may practice under a provisional license. SECTION 3.02. Section 503.452(a), Occupations Code, is amended to read as follows: (a) A person commits an offense if the person knowingly: (1) engages in the practice of professional counseling without holding a license under this chapter; (2) represents the person by the title "Licensed Professional Counselor" or "Licensed Counselor" without holding a license under this chapter; [(3) represents the person by the title "Licensed Professional Counselor -- Art Therapist," "Art Therapist," or by the initials "L.P.C. -- A.T." or "A.T." without: [(A) holding a license with a specialization in art therapy under Section 503.303; or [(B) holding a license under Section 503.309;] or (3) [(4)] uses any title, words, letters, or abbreviations that imply that the person is licensed under this chapter if the person is not licensed under this chapter. SECTION 3.03. Section 503.303, Occupations Code, is repealed. SECTION 3.04. Section 503.452(a), Occupations Code, as amended by this Act, applies only to an offense committed on or after the effective date of this Act. An offense committed before the effective date of this Act is governed by the law in effect on the date the offense was committed, and the former law is continued in effect for that purpose. For purposes of this section, an offense was committed before the effective date of this Act if any element of the offense occurred before that date. ARTICLE 4. EFFECTIVE DATE SECTION 4.01. (a) Except as provided by Subsection (b) of this section, this Act takes effect September 1, 2025. (b) Section 508.151 and Subchapters G and H, Chapter 508, Occupations Code, as added by this Act, take effect September 1, 2026.