Texas State Laws and Regulations - Summary

Frequently Asked Questions

Addiction Treatment Centers

Overview
  1. What does it mean to be "licensed," "certified," "registered," or "accredited" in this industry?
  2. A license means that a facility or professional may operate or may deliver services with the advance and continuous authorization of a designated government agency, which is done to ensure protection of public health, safety, and welfare. Read More


  3. Which addiction treatment facilities are required to be licensed and what kind of services can they provide?
  4. In Texas, as in most states, any substance abuse facility that offers treatment services for chemical dependency requires a license, unless an exception applies. Read More


  5. Which addiction treatment facilities are exempt from licensure requirements?
  6. Type of Provider Reason
    Faith-Based Chemical Dependency Programs

    These programs are conducted by religious organizations and offer only nonmedical treatment and recovery methods such as prayer, moral guidance, spiritual counseling, and scriptural study. Read More


    Licensing
  7. Which body licenses drug rehabilitation facilities in the State of Texas?
  8. As of September 1, 2017, regulatory authority over licensed substance abuse treatment facilities was transferred from the DSHS to HHSC. Read More


  9. What information must be provided in an initial application for licensure?
  10. A written application must be submitted to HHSC on form available Read More


  11. How long does a licensing application usually take?
  12. HHSC will notify the applicant that the application is materially complete or specify the additional information required within 45 days of receipt of the application. Read More


  13. Does a license have to be renewed?
  14. The license must be renewed using forms provided by HHSC every two years from the date on which it was issued. Read More


  15. What kinds of onsite audits or inspections will there be for licensure determination and how can a facility prepare?
  16. HHSC may conduct a scheduled or unannounced inspection or request materials for review at reasonable times, including any time treatment services are provided. Read More


  17. What kinds of things could affect a license once granted?
  18. As explained below, issues that could affect an existing license include client abuse, neglect, or regulatory violations, license expiration, changes in status, inactivation, or closure.Read More


    Certification
  19. Does a facility have to be certified?
  20. Certification for residential and outpatient programs is voluntary, but it demonstrates that a higher level of quality has been attained than might be illustrated by licensing alone. Read More


  21. What are the practical benefits of certifying a facility?
  22. Certification is a signal to potential clients, insurance companies, regulators and the public that a program aims to offer a responsible, safe, supportive and high-quality service. Read More


  23. How does a facility apply for certification?
  24. Certification depends on the type of facility and the certifying body. For sober home certification, an online application is made to the TROHN. The cost of certification is $200 + $10 per bed capacity, + $50 for an onsite inspection. Read More


    Zoning and Land Use
  25. What are the protections afforded to small group homes used for the purpose of residential drug rehabilitation?
  26. The regulation of land use and zoning is traditionally reserved to state and local governments, except to the extent that it conflicts with requirements imposed by the Fair Housing Act, the protections of the ADA, or other federal laws. Read More


  27. Are there any proximity restrictions regulating how close treatment centers may be to each other? Can a residential treatment center be opened right next to one that is already there?
  28. There is no regulation preventing multiple facilities from operating in close proximity. However, many residential treatment facilities have faced objections and difficulties in various locations across the state. Read More


  29. What kind of spaces can be used as treatment facilities?
  30. In the case of residential programs, the provider must provide an appropriate, safe, clean, and well-maintained environment.Read More


    Care, Treatment, and Services
  31. How does a program decide if a client is suitable for the services they can provide?
  32. Facilities have an obligation to provide adequate and appropriate services to their clients that must be delivered with objectivity, respect and integrity. Read More


  33. What kind of health examinations are needed prior to admitting a client?
  34. All clients referred to the program must receive a comprehensive psychosocial assessment by a licensed substance use disorder counselor. Read More


  35. What documentation should be collected from the client during intake?
  36. Before any treatment takes place, written authorization must be obtained from the client, or the person responsible for the client and the staff person providing the information that they have received and understood the information given to them. Read More


  37. What should a facility put in its admissions agreement?
  38. The admissions agreement should include the following information: Read More


  39. What should go in a treatment plan?
  40. In collaboration with the client, and the client’s family where appropriate, a treatment plan should be developed that proposes services and support which meet the client’s needs identified at the admission assessment stage. Read More


  41. What services is a facility required to provide to a client?
  42. The services required vary by facility type, as follows: Read More


  43. Are facilities permitted to physically restrain an aggressive client?
  44. Facilities have a responsibility not to admit a client who is beyond their ability to help, or whose behavior or symptoms exceed their ability to manage. Read More


  45. How should staff manage client medication?
  46. The facility must develop written procedures for managing clients’ medication, which must include storage, administration, documentation, inventory, and disposal. Read More


  47. What rights are guaranteed to clients?
  48. Clients’ rights must be respected and protected. Clients must be made aware of their rights upon admission, and sign to confirm they have received a copy of the Client Bill of Rights that contains the following: Read More


  49. What are the circumstanced under which a client should be discharged from a treatment program?
  50. There are two types of discharge: mandatory discharge when the law mandates a client leave a program and permissible discharge when a program has the discretion to make a discharge decision. Read More


  51. If a facility needs to discharge a client that relapsed, will the facility be at risk if he or she overdoses tonight and, if so, how can the facility protect itself?
  52. The discharge of a client must be handled carefully given the potential risks if a client suffers negative health consequences following discharge. Read More


  53. How can a facility prepare clients for discharge?
  54. In order to ensure a safe discharge and continuity of services, the client, or the person responsible for the client, and the counselor should develop an individualized written discharge plan, which must be updated as the client makes progress through treatment. Read More


  55. How should clients’ privacy be protected?
  56. Client confidentiality is an important issue covered by both federal and state laws. These laws set forth specific requirements... Read More


    Governance and Staffing
  57. What kind of governance structure should a substance abuse facility have?
  58. If the facility is incorporated, then it needs a governing body with legal authority to operate in the State of Texas. Read More


  59. What are the staffing requirements for different types of services?
  60. Staffing requirements vary, in part, based on facility type. However, there are certain requirements that apply to all treatment services. Read More


  61. Can a program employ its own clients?
  62. Clients may not be hired or utilized to fill staff positions until at least two years after their documented discharge from the facility. Read More


    Payment
  63. How should a facility respond to clients who are unable to pay the required deductibles? Can a facility waive a program participant’s financial responsibility?
  64. Clients seeking drug and alcohol rehabilitative services often face financial difficulties, whether as a result of the consequences of their addiction or as a result of the expense of multiple, prior failed treatment programs. Read More


  65. What are the key issues insurers raise to demand recoupment of fees from substance abuse treatment programs?
  66. Insurers may demand recoupment of fees based on any defect in the billing claim or supporting documentation and/or based on any noncompliance with federal or state laws. Read More


    Marketing
  67. What marketing practices are prohibited?
  68. The most widespread prohibited marketing practices in addiction treatment appear to revolve around inappropriate inducements and inaccurate marketing claims. Read More


  69. What are the limits of gift giving to potential referral sources?
  70. State and federal laws and regulations prohibit the exchange of items of value to induce referrals so the exchange of any item of value, whether it is cash or in kind, must be carefully monitored. Read More


  71. What kind of benefits can a facility offer existing or new clients?
  72. Facilities should avoid giving gifts to clients or referral sources based on anti-kickback statutes that prohibit inducements and patient brokering.Read More


    Sober Living Environments

    Overview

  73. What is a sober home?
  74. A sober home is an alcohol and drug-free environment inhabited by individuals who are attempting to maintain their recovery from substance abuse disorders. Read More


    Licensing
  75. Is a license required to open a sober home?
  76. Licenses are not required to operate sober-living homes, so long as they provide... Read More


  77. Are there any consequences to being unlicensed?
  78. Because there is no regulatory oversight, some have complained that many sober living homes are maintained in poor,... Read More


  79. What kinds of services can a sober home offer?
  80. Sober homes typically provide an alcohol and drug-free living environment to enable residents to organize activities... Read More


    Certification
  81. How can a sober home demonstrate to clients that it is offering a high-quality living environment?
  82. A sober home can elect to demonstrate voluntarily that it meets minimum quality standards. Several states (including Texas) have formally adopted an optional certification process for sober living facilities. Read More


  83. Does a sober home have to obtain certification in order to operate?
  84. The law protects small groups of individuals who choose to live together in peer-supportive environments... Read More


  85. How does a sober home apply for certification, and what is the process?
  86. An online application for certification must be completed and submitted to the TROHN. Read More


  87. What should a sober home do in preparation for the onsite compliance review?
  88. Prior to the onsite visit, TROHN will supply an inspection packet, which should be reviewed along with the certification standards. Read More


  89. How often must a sober home renew certification?
  90. TROHN certification is for one year, at which point it terminates automatically if it has not been renewed. Read More


    Zoning and Land Use
  91. What are the protections afforded by federal law to small group homes used for sober living residences?
  92. A recovery house with six or fewer people is generally exempt from zoning and land use regulations based on federal and state law,... Read More


  93. Can local governments put special restrictions on sober living residences?
  94. This area of law is complex and evolving. It is well settled that state and federal law prohibit local governments from discriminating against or treating the residents of sober living homes differently from that of traditional families. Read More


  95. What other aspects should an operator consider before choosing a location for its sober home?
  96. In siting a recovery house, attention should be paid to potential hostility from neighbors. Read More


    Residents’ Rights and Responsibilities
  97. What are sober homes’ obligations to residents?
  98. In general, recovery houses should agree to the following: Read More


  99. What kind of agreement should sober homes ask residents to sign?
  100. The agreement should include: (1) a pledge from the client to live by the house rules... Read More


  101. Can a sober home insist on drug tests and searches?
  102. Sober homes do not have the right to impose testing... Read More


  103. Can a sober home bill insurance for required and/or random drug testing?
  104. Sober homes sometimes rely on the drug screening that takes place... Read More


  105. Can a sober home make residents’ obligations contractually enforceable?
  106. If the rules are contained in the sober home agreement as conditions of residence, and the resident agrees to them upon accepting the housing, then the rules generally should be enforceable. Read More


    Governance and Staffing
  107. What ownership and staffing structures are common with these types of residential arrangements?
  108. A sober housing facility may be structured as a nonprofit corporation, a for-profit corporation, a limited liability company, a partnership, or a sole-owner arrangement. Read More


  109. Are there any other organizations that could help us?
  110. Substance Abuse and Mental Health Services Administration

    http://www.samhsa.gov/ Read More


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