HB5030 - Relating to the provision of certain mental and behavioral health services under Medicaid, Medicaid coverage and reimbursement for those services, and the regulation of psychiatric residential treatment facilities; requiring an occupational license.

  89R8734 AB-F     By: Johnson H.B. No. 5030       A BILL TO BE ENTITLED   AN ACT   relating to the provision of certain mental and behavioral health   services under Medicaid, Medicaid coverage and reimbursement for   those services, and the regulation of psychiatric residential   treatment facilities; requiring an occupational license.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 540.0703(a), Government Code, as   effective April 1, 2025, is amended to read as follows:          (a)  In this section :                 (1)  "Behavioral [ , "behavioral ] health services"   means mental health and substance use disorder services.   The term   includes crisis services, intensive outpatient services, and   partial hospitalization services.                 (2)     "Crisis services"   means mental health community   services or other necessary interventions provided to an individual   in crisis.   The term includes:                       (A)     crisis respite services, including mobile   and facility-based services;                       (B)     crisis stabilization services, including   mobile crisis stabilization services and services provided in an   extended observation unit or crisis stabilization unit; and                       (C)     other crisis services as the commission   determines.                 (3)     "Intensive outpatient services" means outpatient   treatment services, including treatment services for substance use   disorders, depression, eating disorders, and other mental health   conditions that do not require detoxification or 24-hour   supervision, provided to patients who require a time-limited,   multifaceted array of services, structures, and supports by a team   of clinical staff capable of providing, at a minimum, the following   services:                       (A)  individual counseling;                       (B)  group counseling;                       (C)  family counseling;                       (D)  motivational enhancement training; and                       (E)     relapse prevention, drug refusal, and coping   skills training.                 (4)     "Partial hospitalization services" means distinct   and organized intensive ambulatory treatment services provided for   periods of not more than 24 hours at a location other than a   patient's home or in an inpatient or a residential care setting.   The term includes the services described by 42 C.F.R. Section   410.43(a)(4).          SECTION 2.  The heading to Chapter 577A, Health and Safety   Code, is amended to read as follows:   CHAPTER 577A. PSYCHIATRIC RESIDENTIAL [ YOUTH ] TREATMENT   FACILITIES          SECTION 3.  Section 577A.001(3), Health and Safety Code, is   amended to read as follows:                (3)  "Psychiatric residential [ youth ] treatment   facility" means a private facility that provides psychiatric health   treatments and services in a residential, nonhospital setting   exclusively to individuals who are 21 years of age or younger [ and   is licensed as a general residential operation under Chapter 42,   Human Resources Code ]. The term includes a facility that provides   room and board.          SECTION 4.  The heading to Subchapter B, Chapter 577A,   Health and Safety Code, is amended to read as follows:   SUBCHAPTER B. LICENSURE [ CERTIFICATION ], FEES, AND INSPECTIONS          SECTION 5.  Section 577A.051, Health and Safety Code, is   amended to read as follows:          Sec. 577A.051.   LICENSE REQUIRED [ VOLUNTARY QUALITY   STANDARDS CERTIFICATION ]. A person may not operate a psychiatric   residential treatment facility unless the person holds a license   issued by the commission [ The commission shall, using existing   resources to the extent feasible, develop and implement a voluntary   quality standards certification process to certify a psychiatric   residential youth treatment facility that meets standards for   certification ] under this chapter.          SECTION 6.  The heading to Section 577A.052, Health and   Safety Code, is amended to read as follows:          Sec. 577A.052.   LICENSE [ CERTIFICATE ] APPLICATION.          SECTION 7.  Section 577A.052(a), Health and Safety Code, is   amended to read as follows:          (a)  To obtain a license [ certificate ] under this chapter, an   applicant must submit to the commission an application in the form   and manner prescribed by the commission.          SECTION 8.  Section 577A.053, Health and Safety Code, is   amended to read as follows:          Sec. 577A.053.  FEES. The executive commissioner by rule   shall establish a nonrefundable license [ certificate ] application   fee and a nonrefundable license [ certificate ] renewal fee in   amounts necessary to cover the costs of administering this chapter.          SECTION 9.  Section 577A.054, Health and Safety Code, is   amended to read as follows:          Sec. 577A.054.  ISSUANCE AND RENEWAL OF LICENSE   [ CERTIFICATE ]. (a) The commission shall issue a license   [ certificate ] to an applicant if on inspection and investigation   the commission determines the applicant meets the requirements of   this chapter and commission rules. [ The commission may not issue to   an applicant a certificate under this chapter unless the applicant   is licensed as a general residential operation under Chapter 42,   Human Resources Code. ]          (b)  A license [ certificate ] issued under this chapter   expires on the second anniversary of the date the license   [ certificate ] is issued or renewed.          (c)  The commission shall renew a license [ certificate ] if:                (1)  the license [ certificate ] holder submits to the   commission a fee established by the executive commissioner under   Section 577A.053; and                (2)  on inspection and investigation the commission   determines the license [ certificate ] holder meets the requirements   of this chapter and commission rules.          SECTION 10.  Section 577A.055, Health and Safety Code, is   amended to read as follows:          Sec. 577A.055.  INSPECTIONS. In addition to the inspections   required under Section 577A.054, the commission shall conduct an   inspection not later than the first anniversary of the date a   license [ certificate ] is issued or renewed to ensure the license   [ certificate ] holder remains in compliance with the requirements of   this chapter and commission rules.          SECTION 11.  The heading to Subchapter C, Chapter 577A,   Health and Safety Code, is amended to read as follows:   SUBCHAPTER C. REGULATION OF LICENSED [ CERTIFIED ] PSYCHIATRIC   RESIDENTIAL [ YOUTH ] TREATMENT FACILITIES          SECTION 12.  Section 577A.101, Health and Safety Code, is   amended to read as follows:          Sec. 577A.101.  MINIMUM STANDARDS. The executive   commissioner by rule shall establish minimum standards for the   licensing [ certification ] of psychiatric residential [ youth ]   treatment facilities under this chapter. The minimum standards   must require a facility to:                (1)  obtain accreditation by The Joint Commission, the   Commission on Accreditation of Rehabilitation Facilities, the   Council on Accreditation, or another accrediting organization   approved by the commission; [ and ]                (2)  provide and prescribe guidelines for the provision   of the following activities, treatments, and services:                      (A)  development and implementation of individual   plans of care, including the provision of services provided by a   licensed psychiatrist or physician to develop individual plans of   care;                      (B)  individual therapy;                      (C)  family engagement activities;                      (D)  consultation services with qualified   professionals, including case managers, primary care   professionals, community-based mental health providers, school   staff, and other support planners;                      (E)  24-hour nursing services; and                      (F)  direct care and supervision services,   supportive services for daily living and safety, and positive   behavior management services ;                 (3)     satisfy federal requirements for a psychiatric   residential treatment facility under 42 C.F.R. Section 441.151 et   seq. and 42 C.F.R. Section 483.350 et seq.; and                 (4)     satisfy all requirements for licensure as a   general residential operation under Chapter 42, Human Resources   Code, and comply with rules adopted under that chapter .          SECTION 13.  Section 577A.102, Health and Safety Code, is   amended to read as follows:          Sec. 577A.102.  ADMISSION CRITERIA. A facility licensed   [ certified ] under this chapter may not admit or provide treatments   or services to an individual unless the individual:                (1)  is 21 years of age or younger;                (2)  has been diagnosed with a severe emotional   disturbance by a licensed mental health professional;                (3)  requires residential psychiatric treatment under   the direction of a licensed physician to improve the individual's   condition; and                (4)  was referred for treatments or services in a   psychiatric residential [ youth ] treatment facility by a licensed   mental health professional.          SECTION 14.  Section 577A.151, Health and Safety Code, is   amended to read as follows:          Sec. 577A.151.  PENALTIES. A facility licensed [ certified ]   under this chapter is subject to a civil penalty under Section   571.023 or an administrative penalty under Section 571.025, as   applicable, for a violation of this chapter or a rule adopted under   this chapter.          SECTION 15.  Section 32.024, Human Resources Code, is   amended by adding Subsections (oo-1) and (ss) to read as follows:           (oo-1)     The commission shall provide medical assistance   reimbursement to a health care provider who delivers to a recipient   under the medical assistance program services classified as   multisystem [Text truncated for display. Full text available on Congress.gov.]