TITLE 25.HEALTH SERVICES

Part 1. DEPARTMENT OF STATE HEALTH SERVICES

Chapter 448. STANDARD OF CARE

Subchapter E. FACILITY REQUIREMENTS

25 TAC §448.505

The Executive Commissioner of the Health and Human Services Commission, on behalf of the Department of State Health Services (department), proposes an amendment to §448.505 concerning the general environment in chemical dependency treatment facilities.

BACKGROUND AND PURPOSE

The proposed amendment to §448.505 makes available to all chemical dependency treatment facilities by rule a limited exception to the prohibition against alcohol on the program site, which had been previously granted by variance to a facility requesting it. The proposed amendment provides for a narrow exception, with safeguards, for presiding clergy members' possession and consumption on the program site of a limited amount of alcohol as a standard part of a sacramental rite in order to avoid undue governmental interference with the free exercise of religion.

SECTION-BY-SECTION SUMMARY

The amendment to §448.505 allows four ounces of alcohol to be brought onto the program site by a clergy member, and while on site to remain in the sole possession, custody, and control of the clergy member. The alcohol is permitted to be brought onto the program site and used solely for the purpose of enabling a clergy member to preside over a sacramental rite. The chemical dependency treatment facility is not permitted to allow any person other than the clergy member to be in possession, custody, or control of, or to consume any portion of the alcohol brought to the program site. The facility is required to maintain and make available to the department upon request documentation of the clergy member's identification, and each date and time when alcohol is permitted to be brought onto the program site.

FISCAL NOTE

Kathy Perkins, Director, Healthcare Quality Section, Regulatory Division, has determined that for each year of the first five-year period that the section will be in effect, there will be no fiscal implications to state or local governments as a result of enforcing and administering the section as proposed in that costs and workload resulting from the rule amendment will be absorbed within the existing budget.

SMALL AND MICRO-BUSINESS IMPACT ANALYSIS

Ms. Perkins has also determined that there will be no effect on small businesses or micro-businesses required to comply with the section as proposed. This was determined by interpretation of the rule that small businesses and micro-businesses that operate chemical dependency treatment facilities will not be required to significantly alter their business practices in order to comply with the section. There are no anticipated economic costs to persons who are required to comply with the section as proposed because the alcohol would be brought onto the program site by a clergy member and additional documentation requirements are minimal and can be absorbed within facilities' existing costs. There is no anticipated negative impact on local employment.

PUBLIC BENEFIT

In addition, Ms. Perkins has also determined that for each year of the first five years the section is in effect, the public will benefit from adoption of the section. The public benefit anticipated as a result of enforcing or administering the section is the prevention of state interference with the free exercise of religion by chemical dependency treatment facility clients by permitting, with safeguards, a clergy member's use of alcohol during a sacramental rite at a facility.

REGULATORY ANALYSIS

The department has determined that this proposal is not a "major environmental rule" as defined by Government Code, §2001.0225. "Major environmental rule" is defined to mean a rule the specific intent of which is to protect the environment or reduce risk to human health from environmental exposure and that may adversely affect, in a material way, the economy, a sector of the economy, productivity, competition, jobs, the environment or the pubic health and safety of a state or a sector of the state. This proposal is not specially intended to protect the environment or reduce risks to human health from environmental exposure.

TAKINGS IMPACT ASSESSMENT

The department has determined that the proposed amendment does not restrict or limit an owner's right to his or her property that would otherwise exist in the absence of government action and, therefore, do not constitute a taking under Government Code, §2007.043.

PUBLIC COMMENT

Comments on the proposal may be submitted to Jane Guerrero, Facility Licensing Group, Regulatory Licensing Unit, Department of State Health Services, 1100 West 49th Street, Mail Code 1980, Austin, Texas 78756, (512) 834-6639 or by email to jane.guerrero@dshs.state.tx.us. Comments will be accepted for 30 days following publication of the proposal in the Texas Register .

LEGAL CERTIFICATION

The Department of State Health Services General Counsel, Cathy Campbell, certifies that the proposed rule has been reviewed by legal counsel and found to be within the state agencies' authority to adopt.

STATUTORY AUTHORITY

The proposed amendment is authorized by Health and Safety Code, §464.009, which authorizes the Executive Commissioner of the Health and Human Services Commission (Executive Commissioner) to adopt rules governing chemical dependency treatment facilities, including their policies and procedures, client living environment, protection of client rights, and standards to ensure client safety, protection, health and comfort; and Government Code, §531.0055, and Health and Safety Code, §1001.075, which authorize the Executive Commissioner to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Health and Safety Code, Chapter 1001.

The proposed amendment affects the Health and Safety Code, Chapters 464 and 1001, and Government Code, Chapter 531.

§448.505.General Environment.

(a) The facility shall comply with applicable requirements of the Americans with Disabilities Act (ADA). The facility shall maintain documentation that it has conducted a self-inspection to evaluate compliance and implemented a corrective action plan, as necessary, with reasonable time frames to address identified deficiencies.

(b) The facility shall have a certificate of occupancy from the local authority that reflects the current use by the occupant or documentation that the locality does not issue occupancy certificates.

(c) The site, including grounds, buildings, electrical and mechanical systems, appliances, equipment, and furniture shall be structurally sound, in good repair, clean, and free from health and safety hazards.

(d) The facility shall provide a safe, clean, well-lighted and well-maintained environment.

(e) The facility shall have adequate space, furniture, and supplies.

(f) The facility shall have private space for confidential interactions, including all group counseling sessions.

(g) The facility shall prohibit smoking inside facility buildings and vehicles and during structured program activities. If smoking areas are permitted, they shall be clearly marked as designated smoking areas and shall not be less than 15 feet from any entrance to any building(s) and comply with local codes and ordinances. Staff shall not provide or facilitate client access to tobacco products.

(h) The facility shall prohibit firearms and other weapons, alcohol, illegal drugs, illegal activities, and violence on the program site or at or during the course of any program activity, except as provided for in paragraphs (1) and (2) of this subsection. The facility shall be responsible for any noncompliance with this subsection .

(1) The facility may allow a clergy member to bring four ounces or less of alcohol on site or to a program activity for purposes of presiding over a religious or spiritual rite, as long as the alcohol remains in the possession, custody, or control of the presiding clergy member at all times while on the program site or at the program activity, is not distributed, and is consumed only by the presiding clergy member, if at all.

(2) The facility shall inform any clergy member bringing alcohol on site or to a program activity under paragraph (1) of this subsection. The facility shall create and maintain documentation, which shall be available to staff of the Department of State Health Services upon request, reflecting each date and time when alcohol is permitted to be brought onto the program site or to a program activity pursuant to this subsection. The documentation shall include the name, address, and title of the clergy member, and shall document staff verification that the clergy member was self-identified as such, that alcohol was brought on site or to a program activity and that it was thereafter either removed from the site or program activity, or represented by the presiding clergy member to have been personally consumed.

(i) Animals shall be properly vaccinated and supervised.

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.

Filed with the Office of the Secretary of State on June 19, 2006.

TRD-200603359

Cathy Campbell

General Counsel

Department of State Health Services

Earliest possible date of adoption: July 30, 2006

For further information, please call: (512) 458-7111 x6972