(a) The departments have the authority to license services and facilities operated for the provision of mental health services, alcohol and drug abuse prevention or treatment, for the provision of services for intellectual and developmental disabilities, and for personal support services. The department of mental health and substance abuse services shall license services and facilities operated for persons with mental illness or serious emotional disturbance or in need of alcohol and drug abuse prevention or treatment services. Subject to subsection (c), the department of mental health and substance abuse services shall also license personal support services for the aged as well as persons with mental illness. Subject to subsection (c), services and facilities operated for persons with intellectual or developmental disabilities and personal support services for persons with intellectual or developmental disabilities shall be licensed by the department of intellectual and developmental disabilities. A personal support services agency licensed by either department may also serve individuals with physical or other disabilities. Notwithstanding any references in this part to the licensing of “facilities” or “services,” only persons, proprietorships, partnerships, associations, governmental agencies, or corporations may be listed on license applications or licenses as the licensed entity.
Terms Used In Tennessee Code 33-2-403
Abuse: means the knowing infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain, or mental anguish. See Tennessee Code 33-2-402
Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
Commissioner: means the commissioner of mental health and substance abuse services, or, when applicable, the commissioner of intellectual and developmental disabilities, the commissioner's authorized representative, or in the event of the commissioner's absence or a vacancy in the office of commissioner, the deputy commissioner of mental health and substance abuse services, or, when applicable, the deputy commissioner of intellectual and developmental disabilities. See Tennessee Code 33-2-402
Consumer direction: means a model of service delivery for certain medicaid home and community-based services in which the person receiving the services, family member, or other representative employs and supervises the individual who provides the services. See Tennessee Code 33-2-402
Department: means the department of mental health and substance abuse services, or, when applicable, the department of intellectual and developmental disabilities. See Tennessee Code 33-2-402
Drug abuse: means a condition characterized by the continuous or episodic use of a drug or drugs resulting in social impairment, vocational impairment, psychological dependence or pathological patterns of use. See Tennessee Code 33-1-101
Facility: means a developmental center, treatment resource, group residence, boarding home, sheltered workshop, activity center, rehabilitation center, hospital, community mental health center, counseling center, clinic, group home, halfway house or any other entity that provides a mental health, intellectual or developmental disability service or an alcohol and drug abuse prevention and/or treatment facility. See Tennessee Code 33-2-402
Hospital: means a public or private hospital or facility or part of a hospital or facility equipped to provide inpatient care and treatment for persons with mental illness or serious emotional disturbance. See Tennessee Code 33-1-101
Intellectual disability: means , for the purposes of the general functions of the department as set forth in §. See Tennessee Code 33-1-101
Mental illness: means a psychiatric disorder, alcohol dependence, or drug dependence, but does not include intellectual disability or other developmental disabilities. See Tennessee Code 33-1-101
Nonresidential office-based opiate treatment facility: includes , but is not limited to, stand-alone clinics, treatment resources, individual physical locations occupied as the professional practice of a prescriber or prescribers licensed pursuant to title 63, or other entities prescribing products containing buprenorphine, or products containing any other controlled substance designed to treat opiate addiction by preventing symptoms of withdrawal to twenty-five percent (25%) or more of its patients or to one hundred fifty (150) or more patients. See Tennessee Code 33-2-402
Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
Personal support services: means nursing consultation, education services, and other personal assistance services as defined by rule, which are provided to individuals with substantial limitation in two (2) or more major life activities in either their regular or temporary residences, but does not mean direct nursing services provided in connection with an acute episode of illness or injury. See Tennessee Code 33-2-402
Reporter: Makes a record of court proceedings and prepares a transcript, and also publishes the court's opinions or decisions (in the courts of appeals).
Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
Serious emotional disturbance: means a condition in a child who currently or at any time during the past year has had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet psychiatric diagnostic criteria that results in functional impairment that substantially interferes with or limits the child's role or functioning in family, school, or community activities and includes any mental disorder, regardless of whether it is of biological etiology. See Tennessee Code 33-1-101
Service: includes any activity to prevent, treat, or ameliorate mental illness, serious emotional disturbance, alcohol and drug use, intellectual or developmental disabilities, which includes diagnosis, evaluation, residential assistance, training, habilitation, rehabilitation, prevention, treatment, counseling, case coordination, or supervision of persons with mental illness, alcohol and drug abuse issues, serious emotional disturbances, and intellectual or developmental disabilities. See Tennessee Code 33-2-402
Service recipient: means a person who is receiving service, has applied for service, or for whom someone has applied for or proposed service because the person has mental illness, serious emotional disturbance, or a developmental disability. See Tennessee Code 33-1-101
State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
Support: means any activity or resource that enables a service recipient to participate in a service for mental illness, serious emotional disturbance, or developmental disabilities or in community life. See Tennessee Code 33-1-101
(b) The following are exempt from licensing under this part:
(1) Private practitioners who are authorized to practice by the boards of healing arts and only in private practice in that capacity. This subdivision (b)(1) shall not apply to a private practitioner, prescriber, or prescribers operating a nonresidential office-based opiate treatment facility, as defined in § 33-2-402;(2) A person providing personal care solely to one (1) person with mental illness, serious emotional disturbance or developmental disability, or other service recipient receiving personal support services and not in a business arrangement with any other service recipient. This exception shall not apply to an individual who holds out to the public as being in the business of personal support services for compensation;(3) An individual providing service or support only to members of the person’s own family or relatives;(4) An individual providing service or support that is not subject to licensing under any other title of the code and doing so only on a part-time basis as defined in department rules;(5) Foster homes that accept placements only from agencies of state government or licensed child-placing agencies;(6) Services or facilities providing employee assistance programs;(7) Services or facilities providing only employment placement;(8) Facilities that are appropriately licensed by the health facilities commission as a:
(A)Hospital whose primary purpose is not the provision of mental health or developmental disabilities services; or(B) Satellite hospital, as defined by rules of the health facilities commission, whose primary purpose is the provision of mental health or developmental disabilities services, and that the department verifies to the health facilities commission as satisfying standards under this chapter;(9) Facilities that are operated by state, county, or municipal departments of education, the department of correction, the department of human services, or the department of children’s services and that affirmatively state that the primary purpose of the facility is other than the provision of mental health, alcohol and drug abuse prevention and/or treatment services or intellectual or developmental disabilities services; and(10) A person providing direct care services to no more than three (3) people receiving services through consumer direction in a medicaid home- and community-based services program. This subdivision (b)(10) does not apply to an individual who holds out to the public as being in the business of providing personal support services for compensation.(c)(1) A service or facility that can demonstrate compliance with rules and standards by a current personal support services license from another state agency is considered in compliance with rules and standards under this part so that duplicate licensing is not necessary. Personal support services agencies that provide services for the aged or persons with mental illness and persons with intellectual or developmental disabilities shall not be required to obtain a license from both departments. The departments shall work together to ensure that licensure standards for personal support services agencies are appropriate across all of the populations that may be served and are consistently applied.(2) The licensing entity shall be determined based on the larger population served by the agency as of April 10, 2015, or in the case of new applicants for licensure, the larger population anticipated to be served by the agency at the time of licensure application.(d)(1) The department shall appoint a review panel to review periodically all exclusions and waivers granted under the licensure law and perform other duties under this part. The department’s legal counsel shall advise the panel.(2) The panel’s membership shall be:
(A) The commissioner or the commissioner’s designee;(B) For the mental health panel, a representative of licensed community mental health services and a representative of licensed alcohol and drug abuse prevention and/or treatment services;(C) For the intellectual and developmental disabilities panel, a representative of licensed intellectual disability community services and a representative of licensed developmental disability community services;(D) For the mental health panel, a representative of a licensed residential facility for persons with mental illness or serious emotional disturbance and a representative of a licensed residential facility for alcohol and drug abuse prevention and/or treatment services;(E) For the intellectual and developmental disabilities panel, a representative of a licensed residential facility for persons with intellectual and developmental disabilities;(F) For the mental health panel, a representative of a licensed residential mental health facility for children and youth;(G) Five (5) service recipient representatives; and(H) A representative of a personal support services agency.(3) The panel shall elect a chair and vice chair and shall report any findings directly to the commissioner.(4) The vote of a majority binds the panel.(5) Travel expenses for panel members shall be reimbursed. All reimbursement for travel expenses shall be in conformity with the comprehensive state travel regulations as promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.(e) The license holder of a nonresidential office-based opiate treatment facility shall ensure that adequate billing records are maintained, in any format, onsite at the nonresidential office-based opiate treatment facility and shall ensure that adequate billing records are maintained for all patients and for all patient visits. Billing records shall be maintained for a period of three (3) years from the date of the patient’s last treatment at the nonresidential office-based opiate treatment facility. Billing records shall be made for all methods of payment. Billing records shall be made available to the department upon request. Billing records shall include, but not be limited to, the following:
(1) The amount paid for services;(2) Method of payment;(3) Date of the delivery of services;(4) Date of payment; and(5) Description of services.(f) The license holder of a nonresidential office-based opiate treatment facility shall ensure that records of all bank deposits of cash payments for services provided at the nonresidential office-based opiate treatment facility are maintained, in any format, at the nonresidential office-based opiate treatment facility for a period of three (3) years.(g) The license holder of a nonresidential office-based opiate treatment facility shall ensure that patient medical records are maintained, in any format, for a period of ten (10) years from the date of the patient’s last treatment at the facility.(h) By January 1, 2019, the commissioner of mental health and substance abuse services shall revise rules for nonresidential office-based opiate treatment facilities to be consistent with state and federal law and to establish:
(1) Standards for determining what constitutes a high dose of the opioid employed in treatment at a nonresidential office-based opiate treatment facility;(2) Protocols for initiating or switching a patient at a nonresidential office-based treatment facility to a high dose of the opioids employed in treatment; and(3) Protocols for initiating periodic prescriber-initiated-and-led discussions with patients regarding patient readiness to taper down or taper off the opioids employed in treatment.(i) The commissioner is authorized to use emergency rulemaking under § 4-5-208 to promulgate the rules pursuant to subsection (h). The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.(j)(1) Beginning in 2020, the commissioner of mental health and substance abuse services shall review the rules for nonresidential office-based opiate treatment facilities by September 30 of each even-numbered year.(2) The commissioner of mental health and substance abuse services shall submit the rules for nonresidential office-based opiate treatment facilities to each health-related board that licenses any practitioner authorized by the state to prescribe the products for the treatment of an opioid use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders and to the board of pharmacy.(3)(A) Each board shall review the rules and enforce the rules with respect to that board’s licensees.(B) When a board’s licensees are subject to the rules for nonresidential office-based opiate treatment facilities, the definition of “enforce” for purposes of this subdivision (j)(3) means referring any complaints or information regarding those licensees to the department.(4) Each board shall post the rules on the licensing board’s website.(k)(1) The commissioner of mental health and substance abuse services shall provide a copy of any emergency rule developed pursuant to subsection (h) or (i) and any revision to a rule developed pursuant to subsection (j) to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate at the same time the rules are submitted to the licensing boards pursuant to subdivision (j)(2).(2) The commissioner of mental health and substance abuse services shall provide a copy of any rule developed pursuant to subsection (h) or (j) and any revision to a rule developed pursuant to subsection (j) to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.(l) A violation of a rule described in subsections (h) and (j) is grounds for disciplinary action against a practitioner licensed under title 63 by the board that licensed that practitioner.
