WEST VIRGINIA LEGISLATURE
2024 REGULAR SESSION
ENGROSSED
Committee Substitute for House Bill 5248
By Delegates Summers and Tully [Originating in the Committee on Health and Human Resources; Reported on February 1, 2024]
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1 A BILL to amend the Code of West Virginia, 1931, by adding thereto a new article, designated
2 §16B-22-1, §16B-22-2, §16B-22-3, §16B-22-4, §16B-22-5, §16B-22-6, §16B-22-7, §16B-
3 22-8, §16B-22-9, §16B-22-10 and §16B-22-11; and to repeal §27-9-1 and §27-9-2 of said
4 code; and to repeal §27-17-1, §27-17-2, §27-17-3, and §27-17-4 of said code, all relating
5 to the regulation of behavioral health centers; providing definitions; creating licenses for
6 residential behavioral health centers and non-residential behavioral health centers; setting
7 license fees for residential behavioral health centers and non-residential behavioral health
8 centers; providing for the regulation and oversight of all behavioral health centers by the
9 Office of Health Facility Licensure and Certification; designating the necessity for a
10 governing body and administrator and prescribing duties and responsibilities; setting
11 certain minimum standards in any behavioral health center; setting certain minimum
12 standards for behavioral health centers; restricting the location of specific treatment
13 settings for behavioral health centers; allowing for variances or waivers from licensure
14 standards; providing for inspections and inspection warrants; designating license
15 limitations; providing a procedure for denial, suspension, or revocation of a license;
16 allowing civil money penalties; providing for administrative review and appeal rights; and
17 permitting the Inspector General to promulgate rules, including emergency rules.
Be it enacted by the Legislature of West Virginia:
CHAPTER 16B. INSPECTOR GENERAL.
ARTICLE 22. BEHAVIORAL HEALTH CENTER LICENSURE ACT.
§16B-22-1. Definitions.
1 "Abuse" means the willful infliction of injury, unreasonable confinement, intimidation, or
2 punishment with resulting physical harm, pain, or mental anguish. Abuse also includes the
3 deprivation by an individual, including a caretaker, of goods and services that are necessary to
4 attain or maintain physical, mental, and psychosocial well-being. Instances of abuse of all
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5 residents, irrespective of any mental or physical condition, cause physical harm, pain, or mental
6 anguish. It includes verbal abuse, sexual abuse, physical abuse, and mental abuse, including
7 abuse facilitated or enabled through the use of technology. Willful, as used in this definition of
8 abuse, means the individual must have acted deliberately, not that the individual must have
9 intended to inflict injury or harm.
10 "Addiction" means a disease characterized by the individual's pursuing reward, relief, or
11 both, by substance use or other behaviors. Addiction is characterized by impairment in behavioral
12 control, craving, inability to consistently abstain, and diminished recognition of significant
13 problems with one's behaviors and interpersonal relationships; likely to involve cycles of relapse
14 and remission.
15 "Advocate" means a person or agency that acts on behalf of a client to establish, expand,
16 protect, and enforce his or her human, legal, and civil rights in a client's best interest.
17 "Behavioral disability" means a disability of a person which: (1) is attributable to severe or
18 persistent mental illness, emotional disorder, or chemical dependency; and (2) results in
19 substantial functional limitations in self-direction, capacity for independent living, or economic self-
20 sufficiency.
21 "Behavioral health center" means a provider, entity, or facility that provides behavioral
22 health services, supports, or both. As used in this article and any rules promulgated pursuant to
23 this article, behavioral health center means both residential behavioral health centers and non-
24 residential behavioral health centers.
25 "Behavioral health service" means a direct service provided as an inpatient, residential, or
26 outpatient service to an individual with mental health, addictive, behavioral, or adaptive challenges
27 that is intended to improve or maintain functioning in the community. The service is designed to
28 provide treatment, habilitation, or rehabilitation.
29 "Chief executive officer" means the individual designated by the governing body to be
30 responsible for the provider's daily operations. The chief executive officer may also be referred to
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31 as the provider's president, executive director, or chief administrative officer. The chief executive
32 officer may delegate requirements within this rule but will retain responsibility that the delegated
33 requirements are met.
34 "Client" means an individual who receives services, supports, or both, from a behavioral
35 health center licensed under this rule.
36 "Developmental disability" means a chronic disability of a person which: (1) is attributable
37 to a mental or physical impairment or combination of mental and physical impairments; (2) is likely
38 to continue indefinitely; (3) results in substantial functional limitations in self-direction, capacity for
39 independent living, or economic self-sufficiency; and (4) reflects the person's need for a
40 combination and sequence of special, interdisciplinary or generic care, treatment, or other
41 services which are of lifelong or extended duration and are individually planned and coordinated.
42 "Director" means the director of the Office of Health Facility Licensure and Certification, or
43 his or her designee.
44 "Forensic group home" means a facility which is owned, leased, or operated by a
45 behavioral health center and which provides behavioral health services or supportive services and
46 supervision to criminal offenders who have been adjudicated as incompetent to stand trial, in need
47 of restoration, incompetent to stand trial, unable to be restored, or not guilty by reason of mental
48 illness.
49 "Governing body" means a clearly identified group of persons or partnership, when
50 applicable, which ensures accountability, exercises authority over, and has responsibility for the
51 provider's operation and approval and review of policies and practices. The provider shall
52 designate the governing body at the time of licensure. If an entity is a corporation with an out-of-
53 state ownership or management structure, the provider shall identify the governing body in
54 conjunction with the Inspector General.
55 "Group residential facility" means a facility which is owned, leased, or operated by a
56 behavioral health center and which provides residential services and supervision for individuals
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57 who are developmentally disabled or behaviorally disabled and is occupied as a residence by
58 individuals who are developmentally disabled.
59 "Group residential home" means a residence owned or leased by a developmentally
60 disabled or behaviorally disabled persons for the purpose of establishing a personal residence. A
61 behavioral health center shall not lease a residence to such persons if the behavioral health center
62 is providing behavioral health services to those persons. A behavioral health center providing
63 behavioral health services in a group residential home must be licensed, but the individuals with a
64 developmental or behavioral disability that own or lease the residence do not need to be licensed.
65 "Inspector General" means the Inspector General of the Office of the Inspector General as
66 described in §16-1-22 of this code, or his or her designee.
67 "Intermediate care facility" means a facility, or distinct part of a facility that is primarily for
68 the diagnosis, treatment, or rehabilitation of the intellectually disabled or persons with related
69 conditions; and provides, in a protected residential setting, ongoing evaluation, planning, 24-hour
70 supervision, coordination, and integration of health or rehabilitative services to help each
71 individual function at his or her greatest ability.
72 "Neglect" means the failure of the behavioral health center, its employees, or service
73 providers to provide goods and services to a resident that are necessary to avoid physical harm,
74 pain, mental anguish, or emotional distress.
75 "Non-residential behavioral health center" means a behavioral health center that does not
76 provide behavioral health services in a residential treatment model, including, but not limited to,
77 outpatient behavioral health centers.
78 "Office of Health Facility Licensure and Certification" means the West Virginia Office of
79 Health Facility Licensure and Certification within the Office of the Inspector General.
80 "Owner" means any person, partnership, association, or corporation listed as the owner of
81 a behavioral health center on the application and licensing forms required by this article.
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82 "Residential behavioral health center" means a behavioral health center that provides
83 behavioral health services in a residential treatment model, including, but not limited to, forensic
84 group home, group residential facility, group residential home, intermediate care facility, crisis
85 residential unit, detox services, or a combination thereof.
86 "Substantial compliance" means a level of compliance with the minimum standards set
87 forth in this article and any applicable rules promulgated pursuant to this article so as not to impose
88 a risk to the rights, health, and safety of a client.
89 "Supportive service" means a service provided exclusively to individuals with intellectual
90 disabilities, developmental disabilities, ongoing mental health, or addictive challenged, or
91 traumatic brain injury. This service is designed to assist the individual to live in the community in a
92 manner that is socially inclusive, optimally independent, and self-directed while preserving his or
93 her health, safety, and quality of life. These services are not designed to change behavior or
94 emotional functioning to support the individual in his or her community-based settings. Supportive
95 services may include coaching or prompting of age-appropriate living skills.
96 "Telehealth" means the mode of delivering health care services and public health via
97 information and communication technologies to facilitate the diagnosis, consultation, treatment,
98 education, care management, and self-management of a patient's health care while the patient is
99 at the originating site and the health care provider is at a distant sight.
100 "Variance" means written permission granted by the Inspector General to a behavioral
101 health center that a requirement of this article or rules promulgated pursuant to this article may be
102 accomplished in a manner different from the manner set forth in this article or associated rules.
103 "Waiver" means a formal, time-limited agreement between a designated oversight agency
104 and the behavioral health center that suspends a rule, policy, or standard for a specific situation so
105 long as the health, safety, welfare, and clinical treatment of the client is better served in the
106 situation by suspension of the rule, policy, and standard than by enforcement.
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§16B-22-2. Residential behavioral health centers to obtain license; applications; fees and inspections.
2 (a) The Inspector General designates the director of the Office of Health Facility Licensure
3 and Certification to enforce the provisions of this article for residential behavioral health centers,
4 except where otherwise stated.
5 (b) No person, partnership, association, or corporation may operate a residential
6 behavioral health center without first obtaining a license from the director in accordance with the
7 provisions of this article and the rules lawfully promulgated pursuant to this article.
8 (c) Any person, partnership, association, or corporation desiring a license to operate a
9 residential behavioral health center in this state shall file with the Office of Health Facility Licensure
10 and Certification an application in such form and with such information as the director shall
11 prescribe and furnish accompanied by an application fee.
12 (d) The Office of Health Facility Licensure and Certification shall inspect each residential
13 behavioral health center and review all documentation submitted with the application. The Office
14 of Health Facility Licensure and Certification shall issue a license if the residential behavioral
15 health center is in substantial compliance with the provisions of this article and with the rules
16 lawfully promulgated pursuant to this article.
17 (e) A license shall be issued in one of three categories:
18 (1) An initial 12-month license shall be issued to a residential behavioral health center
19 establishing a new residential behavioral health center for which there is insufficient client
20 participation to demonstrate substantial compliance with this article and with all rules promulgated
21 pursuant to this article;
22 (2) A provisional license shall be issued when a residential behavioral health center seeks
23 a renewal license and the residential behavioral health center is not in substantial compliance with
24 this article and with all rules promulgated pursuant to this article, but does not pose a significant
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25 risk to the health, safety, welfare, or clinical treatment of a client. It shall expire not more than six
26 months from the date of issuance, and may not be consecutively reissued; or
27 (3) A renewal license shall be issued when a residential behavioral health center is in
28 substantial compliance with this article and with all rules promulgated pursuant to this article. A
29 renewal license shall expire not more than two years from the date of issuance.
30 (f) At least 60 days prior to the license expiration date, an application for renewal shall be
31 submitted by the residential behavioral health center to the director on forms furnished by the
32 director. A license shall be renewed if the director determines that the applicant is in substantial
33 compliance with this article and with all rules promulgated pursuant to this article.
34 (g) Any behavioral health center licensed prior to the effective date of this article which is a
35 residential behavioral health center, as defined herein, shall submit a renewal application as a
36 residential behavioral health center at least 60 days prior to the license expiration date to the
37 director on forms furnished by the director. A license shall be renewed if the director determines
38 that the applicant is in substantial compliance with this article and with all rules promulgated
39 pursuant to this article.
40 (h) A license issued to one residential behavioral health center pursuant to this article is
41 not transferrable or assignable. Each residential behavioral health center license may encompass
42 multiple locations within the residential behavioral health center's designated service area.
43 (i) Any change of ownership of a licensed residential behavioral health center requires
44 submission of a new application. The residential behavioral health center shall notify the director
45 of any change in ownership within 10 days of the change of ownership and must submit a new
46 application within the time frame prescribed by the director.
47 (j) Any person, partnership, association, or corporation that seeks to obtain or renew a
48 license for a residential behavioral health center in this state must submit to the director the
49 following information and documentation:
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50 (1) Full operating name of the residential behavioral health center as advertised, as well as
51 the full operating name of each location within the designated service area of the residential
52 behavioral health center;
53 (2) Legal name of the residential behavioral health center as registered with the West
54 Virginia Secretary of State;
55 (3) Physical address of the residential behavioral health center for the administrative
56 office;
57 (4) Mailing address for the residential behavioral health center for the administrative office;
58 (5) Email address to be used as the primary contact for the residential behavioral health
59 center;
60 (6) Federal Employer Identification Number assigned to the residential behavioral health
61 center;
62 (7) All business licenses issued to the residential behavioral health center by this state, the
63 state Tax Department, the Secretary of State, and all other applicable business entities;
64 (8) Brief description of all services provided by the residential behavioral health center;
65 (9) Description of designated service area which shall not encompass the entire state in
66 one license;
67 (10) For each residential behavioral health center location:
68 (A) Name of location or building;
69 (B) Physical address;
70 (C) Telephone number;
71 (D) Ownership of the building;
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