Part I.
Texas Department of Health
Chapter 133.
Hospital Licensing
Subchapter D. Special Service Requirements
25 TAC §133.52
(Editor's note: The Texas Department of Health proposes for permanent
adoption the amended section it adopts on an emergency basis in this issue.
The text of the amended section is in the Emergency Rules section of this
issue.)
The Texas Department of Health (TDH) proposes an
amendment to §133.52 concerning standards for the provision of mental
health services in an identifiable part of a hospital. The amendment requires
hospitals providing mental health services to comply with specific rules
adopted by the Texas Board of Mental Health and Mental Retardation board
(TXMHMR) which are set out in subsection (b)(1)-(5).
The Texas Hospital Licensing Law, Health and Safety Code, §241.0265
states that the care and treatment of a patient receiving mental health services
in a hospital is governed by the standards adopted by TXMHMR to the same
extent as if the TXMHMR standards were rules adopted by the Board of Health.
TDH is required to enforce the TXMHMR standards.
TXMHMR contemporaneously repealed and adopted new rules as follows: Chapter
401, Subchapter J (relating to Standards of Care and Treatment in Psychiatric
Hospitals), as referenced in §133.52(b)(1), was adopted effective September
13, 1996; Chapter 405, Subchapter FF (relating to Consent to Treatment with
Psychoactive Medication), as referenced in §133.52(b)(4), was adopted
effective October 1, 1996; and Chapter 405, Subchapter F (relating to Voluntary
and Involuntary Behavioral Interventions in Mental Health Programs (formerly
titled Restraint and Seclusion in Mental Health Facilities), as referenced
in §133.52(b)(5), was amended effective October 1, 1996. TXMHMR amended
Chapter 404, Subchapter E (relating to Rights of Persons Receiving Mental
Health Services), as referenced in §133.52(b)(2), effective October
1, 1996. TXMHMR made no changes to Chapter 405, Subchapter E (relating to
Electroconvulsive Therapy) as referenced in §133.52(b)(3).
The amendments to subsection (b)(1)-(5) delete the effective dates of the
TXMHMR rules so that the TXMHMR rules are accurately described and so that
TDH will not have to amend its rules next time TXMHMR revises its rules;
correct an incomplete sentence in subsection (b)(2); delete a provision in
subsection (b)(4) which no longer applies due to TXMHMR's deletion of the
funding provision from the TXMHMR rule; and reflect the new title of the
TXMHMR rule referenced in subsection (b)(5). The amendment is necessary in
order to meet the requirements of the Texas Hospital Licensing Law to enforce
the revisions made by TXMHMR effective September 13, 1996 and October 1,
1996, and to prevent confusion among hospitals as to which rules are in effect.
Contemporaneous with this proposal, TDH is adopting this amendment on an
emergency basis.
Bernie Underwood, Chief of Staff Services, Health Care Quality and Standards,
has determined that for each of the first five years the section is in effect,
there will be no additional fiscal costs to state or local governments as
a result of enforcing or administering the sections as proposed. TXMHMR stated
in the preamble to the new section relating to consent to treatment with
psychoactive medication there may be some additional cost to local government
or small businesses as a result of administering the new section as proposed;
however, TXMHMR indicated the impact could not be calculated at the time
the rule was proposed. When contacted by TDH, a TXMHMR official stated there
had been no comment on the fiscal note during or following the public comment
period. TDH has not identified any additional fiscal impact.
Ms. Underwood also has determined that for each year of the first five
years the section as proposed will be in effect, the public benefits for
those persons who utilize the mental health services provided by hospitals
are assurances that rules for compliance with State of Texas rules are clearly
and consistently stated. There will be no costs to small businesses. There
is no anticipated cost to individuals required to comply with the sections
as proposed. There will be no significant local employment impact.
Comments on the proposed rules may be submitted to John M. Evans, Jr.,
Hospital Licensing Director, Health Facility Licensing Division, Texas Department
of Health, 1100 West 49th Street, Austin, Texas 78756-3199. Comments will
be accepted for a period of 30 days after publication of the proposed amendments
in the
Texas Register
.
The amendment is proposed under the Health and Safety Code, Chapter
241, which provides the Texas Board of Health (board) with authority to adopt
rules to establish and enforce minimum standards for the licensing of hospitals;
Chapter 321 which provides the board with the authority to adopt a patient
bill of rights; and §12.001 which provides the board with the authority
to adopt rules for the performance of every duty imposed by law upon the
board, TDH and the commissioner of health.
This agency hereby certifies that the proposal has been reviewed
by legal counsel and found to be within the agency's legal authority to adopt.
Issued in Austin, Texas, on January 21, 1997.
TRD-9700875
Susan K. Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: March 3, 1997
For further information, please call: (512) 458-7236
Subchapter C. Operational Requirements
Chapter 134.
Private Psychiatric Hospitals and Crisis Stabilization Units