Texas Behavioral Health Executive Council Discipline

Who BHEC Regulates

Section summaryBHEC oversees four behavioral health professions through four member boards. Each profession has its own substantive rules but shares a unified enforcement track.

The Behavioral Health Executive Council was created by the Texas Legislature to consolidate enforcement for four formerly independent behavioral health licensing boards. BHEC now provides intake, investigation, prosecution, ALJ referral, and final order entry for:

• Texas State Board of Examiners of Psychologists — psychologists (PhD/PsyD), psychological associates, and provisionally licensed psychologists, under Occupations Code Chapter 501.
• Texas State Board of Examiners of Marriage and Family Therapists — LMFTs and LMFT Associates, under Chapter 502.
• Texas State Board of Examiners of Professional Counselors — LPCs and LPC Associates, under Chapter 503.
• Texas State Board of Social Worker Examiners — LCSWs, LMSWs, and LBSWs, under Chapter 505.

BHEC itself is governed by Occupations Code Chapter 507. Each member board retains rulemaking authority over substantive practice standards in its profession; BHEC handles the unified enforcement function.

BHEC Structure and Member Boards

Section summaryInvestigation and prosecution flow through BHEC, but the member board decides on substantive sanctions. Understanding the division of authority is important to navigating a case.

The division of authority between BHEC and the member boards is unusual among Texas regulatory structures. BHEC employs the investigators, attorneys, and administrative staff who handle complaints. The member boards adopt the substantive rules each profession follows and decide on final disciplinary action within the unified framework.

Practically, a licensee facing a BHEC complaint will:

Receive notice from BHEC

BHEC handles the intake and sends the notice of complaint, request for response, and any subsequent investigation correspondence.

Respond to BHEC investigators

The written response and any document production goes to BHEC's investigation unit, not directly to the member board.

Attend a BHEC-conducted informal conference

The informal conference is staffed by BHEC, with member-board representatives participating to evaluate proposed agreed orders.

Have any agreed order adopted by the member board

The member board ratifies the agreed order. The order is then a final order of the member board, not of BHEC.

This structure means counsel must understand both the BHEC procedural framework and the specific substantive rules of the licensee's profession. A complaint that involves both substantive practice issues and procedural defenses requires familiarity with both layers.

Common Complaint Categories

Section summaryComplaint categories cluster around confidentiality, dual relationships, billing, mandatory reporting, and supervision. Categories overlap across the four professions with profession-specific variations.

The four professions share many complaint categories, though the underlying rules differ:

• Confidentiality. Improper disclosure of patient or client information, release without authorization, or inadvertent disclosure through electronic communication or social media.
• Dual relationships and boundary violations. Personal, business, or sexual relationships with current or former clients; in psychology, sexual relationships with former clients are restricted for a defined period.
• Mandatory reporting. Failure to report suspected child abuse or neglect under the Family Code, failure to report elder abuse, or failure to make required mental health reports.
• Billing. Insurance fraud, double billing, billing for services not rendered, or improper coding of services.
• Supervision violations. For supervisors of associates, failure to provide the required supervision hours, improper documentation, or improper expansion of an associate's scope.
• Practice outside scope. Performing services beyond the licensee's training or credentialing.
• Advertising and credentialing. Misrepresentation of credentials, training, or specialty areas.
• Criminal convictions. Convictions touching on fitness to practice, particularly those involving dishonesty, violence, or substance abuse.

Confidentiality and Boundary Violations

Section summaryConfidentiality and boundary violations are the two highest-volume complaint categories. Both have evolved with technology and changing professional norms.

Confidentiality complaints have grown more complex with electronic health records, telemental health, and social media. The rule structure varies across the four professions but the principles converge. Common confidentiality issues include:

• Disclosure to family members or third parties without proper authorization.
• Improper electronic communication, including email containing protected information, unencrypted file sharing, or text messages.
• Social media interactions with clients or former clients.
• Telemental health practice that did not satisfy applicable security or jurisdictional requirements.
• Improper response to subpoenas or court orders without consulting client or counsel.

Dual relationship complaints are similarly recurring. The rules vary in detail across the four professions but share a core principle that the licensee must avoid personal, business, or sexual relationships that could impair professional judgment or exploit the client. Sexual relationships during the professional relationship are prohibited across all four professions; post-termination restrictions vary by profession and member board rule. Bartering, social-media connections, and dual professional relationships (such as the licensee also serving as a forensic evaluator) each have their own rule sets.

Defense of a confidentiality or boundary complaint turns on documentation: the client's written consent or authorization, the licensee's contemporaneous notes, and the policies the licensee follows. Documentation gaps that may have seemed minor at the time can be the dispositive issue at the informal conference.

Investigation and Resolution

Section summaryBHEC investigates, requests a written response, may convene an informal conference, and refers unresolved matters to SOAH.

The BHEC process tracks the unified enforcement framework adopted at consolidation. The sequence runs:

1. BHEC receives the complaint and screens for jurisdiction and statement of a possible violation.
2. BHEC sends notice and requests written response from the licensee.
3. Investigators gather records, may interview witnesses, and may consult subject-matter experts.
4. BHEC and the member board representative evaluate the investigation findings.
5. If informal resolution is appropriate, an informal conference is convened.
6. If no agreement, the matter is referred to SOAH for contested case proceedings under the Texas APA.
7. Final orders are entered by the member board on recommendation from BHEC.

Written responses to BHEC investigators are particularly important because the BHEC investigation file follows the matter through informal conference and any SOAH proceeding. Inconsistencies between the written response and later testimony become evidence against the licensee. Counsel should help the licensee construct a response that is accurate, complete, and consistent with the documentary record.

Informal conferences with BHEC are an opportunity to present mitigation, demonstrate insight where appropriate, and explore an agreed order. Preparation should include consideration of the member board's typical sanction range for the category at issue and the licensee's specific aggravating or mitigating factors.

Sanctions and Collateral Effects

Section summarySanctions range from administrative penalty through revocation. Collateral effects include reciprocal action, payor de-credentialing, and supervision-eligibility loss.

Each member board has authority to impose the full range of sanctions: administrative penalty, reprimand, probation with conditions, supervision requirements, continuing education, restriction of practice areas, suspension, and revocation. Voluntary surrender during an investigation is reported as disciplinary action.

Collateral effects of a BHEC member-board sanction include:

• Reciprocal-discipline exposure in other states where the licensee holds licensure.
• Payor network re-credentialing reviews and possible termination from insurance panels, particularly Medicaid managed care organizations.
• Loss of supervision eligibility for licensees who supervise associates; this affects revenue and training-program participation.
• Malpractice insurance underwriting consequences.
• Notice to the National Practitioner Data Bank for certain action types.
• For some categories, mandatory reporting on hospital credentialing or employer compliance forms.

Evaluating an agreed order against the collateral-consequences map is a central part of the strategic decision. A condition that requires ongoing reporting to the Board over a five-year period may carry meaningful operational burden even if the initial sanction looks modest.

Frequently Asked Questions

Next Steps

If you are facing a situation described here, consult counsel promptly. Many issues in this area run on strict deadlines.

• Call (972) 370-5060
• Email info@landllawgroup.com