| (a) Competency of staff members, including volunteers.
The LMHA, MCO, and provider must implement a process to ensure the
competency of staff members prior to providing services that, at a
minimum:
(1) ensures services are provided by staff members
who are operating within the scope of their license, job description,
or contract specification;
(2) ensures that the mental health community services
provided by peer providers are limited to mental health rehabilitative,
supported employment, supported housing, parent support group, and
family partner services; and
(3) defines competency-based expectations for each
position as follows:
(A) required competencies must be included for all
staff members, including adequate, accurate knowledge of:
(i) the nature of severe and persistent mental illness
and serious emotional disturbances;
(ii) the recovery and resiliency model of mental illness
and serious emotional disturbance;
(iii) the dignity and rights of an individual, as described
in Chapter 404, Subchapter E of this title (relating to Rights of
Persons Receiving Mental Health Services);
(iv) identifying, preventing, and reporting abuse,
neglect, and exploitation, in accordance with Chapter 414, Subchapter
L of this title (relating to Abuse, Neglect, and Exploitation in Local
Authorities and Community Centers);
(v) individual confidentiality, as described in Chapter
414, Subchapter A of this title (relating to Protected Health Information)
and other relevant state and federal laws affecting confidentiality
of medical records, including Title 42 CFR Part 2;
(vi) interacting with an individual who has a physical
disability such as a hearing or visual impairment;
(vii) responding to an individual's language and cultural
needs through knowledge of customs, beliefs, and values of various,
racial, ethnic, religious, and social groups;
(viii) exposure control of blood borne pathogens;
(ix) identification of an individual as being in a
crisis and accessing emergency or urgent care services;
(x) proper documentation of services provided; and
(xi) planning and training for responding to severe
weather, disasters, and bioterrorism;
(B) critical competencies must be included for positions
in which a staff member's primary job duties are related to individual
service contacts and interactions and include, but are not limited
to, adequate and accurate knowledge of:
(i) cardio pulmonary resuscitation (CPR);
(ii) first aid;
(iii) safe management of verbally and physically aggressive
behavior;
(iv) utilization of assistive technology such as communication
devices with individuals who are deaf or hard of hearing; and
(v) seizure response and assessment;
(C) specialty competencies must be included for positions
in which a staff member performs specialized services and tasks and
include adequate and accurate knowledge of specialized services and
tasks, such as:
(i) the requirements of this subchapter;
(ii) age appropriate clinical assessment including
the uniform assessment;
(iii) age appropriate engagement techniques (e.g.,
motivational interviewing);
(iv) use of telemedicine equipment;
(v) the utilization management guidelines;
(vi) developing and implementing an individualized
treatment plan;
(vii) appropriate actions to take in a crisis (e.g.,
screening, intervention, management and if applicable, suicide/homicide
precautions);
(viii) services for co-occurring psychiatric and substance
use disorders described in Chapter 411, Subchapter N of this title
(relating to Standards for Services to Individuals with Co-Occurring
Psychiatric and Substance Use Disorders (COPSD));
(ix) accessing resources within the local community;
(x) strategies for effective advocacy and referral
for an individual;
(xi) infection control;
(xii) recognition, reporting, and recording of side
effects, contraindications, and drug interactions of psychoactive
medication;
(xiii) age appropriate rehabilitative approaches;
(xiv) proficiency in specimen collection;
(xv) the peer-provider or consumer-operated service
model;
(xvi) assessment and intervention with children, adolescents,
and families; and
(xvii) clinical specialties directly related to the
services to be performed.
(D) crisis hotline competencies must be included for
positions in which a staff member routinely answers the crisis hotline
and include adequate and accurate knowledge of:
(i) the nature of severe and persistent mental illness
and serious emotional disturbances and COPSD;
(ii) behavioral health crisis situations;
(iii) operating a telephone system to access behavioral
health crisis screening and response;
(iv) age appropriate crisis intervention and response;
(v) utilization of assistive technology such as communication
devices with individuals who are deaf or hard of hearing;
(vi) advocacy for treatment in the most clinically
appropriate, available environment; and
(vii) applicable privacy laws, rules, and regulations
including those described in Chapter 414, Subchapter A of this title
(relating to Protected Health Information) and in Title 42 CFR Part
2.
(E) telemedicine competencies must be included for
positions in which a staff member's job duties are related to assisting
with telemedicine services and include adequate and accurate knowledge
of:
(i) operation of the telemedicine equipment; and
(ii) how to use the equipment to adequately present
the individual.
(4) requires staff members to demonstrate competencies
in the following manner:
(A) all staff members must demonstrate required competencies
before contact with individuals, confidential information, or protected
health information and periodically throughout the staff member's
tenure of employment or association with the LMHA, MCO, or provider;
(B) all staff members in positions that require critical
competencies must demonstrate the critical competencies before contact
with individuals and periodically throughout the staff member's or
volunteer's tenure of employment or association with the LMHA, MCO,
or provider;
(C) all staff members in positions that require specialty
competencies must demonstrate the specialty competencies before providing
the specialized service(s) or performing the specialized task(s) and
periodically throughout the staff member's or volunteer's tenure of
employment or association with the LMHA, MCO, or provider; and
(D) all staff members in positions that require crisis
hotline competencies must demonstrate those competencies before providing
crisis hotline services and at least annually throughout the staff
member's or volunteer's tenure of employment or association with the
LMHA, MCO, or provider.
(b) Competency of crisis services providers. The LMHA
and MCO must develop and implement policies and procedures governing
the provision of crisis services to ensure that providers with which
they contract or employ for the provision of crisis services are trained
in:
(1) crisis access and age appropriate assessment and
intervention services;
(2) advocacy for the most clinically appropriate, available
environment; and
(3) community referral resources.
(c) Credentialing and appeals. Before providing services,
the LMHA and MCO must:
(1) implement a timely credentialing and re-credentialing
process for all its licensed staff members, peer providers, family
partners, and every QMHP-CS and CSSP;
(2) ensure that documentation verifying a staff member's
credentialing and re-credentialing is maintained in the staff member's
personnel records;
(3) have a process for staff members to appeal credentialing
and re-credentialing decisions; and
(4) require providers to:
(A) use the LMHA's or MCO's credentialing and re-credentialing
and appeals processes for all of the provider's licensed staff, QMHP-CSs,
CSSPs, peer providers, family partners, and utilization management
job functions; or
(B) implement a credentialing and re-credentialing
process for all of the provider's licensed staff, QMHP-CSs, CSSPs,
peer providers, family partners, and utilization management job functions
that meets the LMHA's or MCO's credentialing and re-credentialing
criteria and have a process for those staff members to appeal credentialing
and re-credentialing decisions.
(d) Additional requirements for credentialing a QMHP-CS.
For credentialing as a QMHP-CS who is not a registered nurse, the
credentialing and re-credentialing process described in subsection
(c) of this section must include:
(1) determining the minimum number of coursework hours
that is equivalent to a major and whether a combination of coursework
hours in the specified areas is acceptable;
(2) reviewing the individual's coursework; and
(3) justifying and documenting the credentialing decisions;
or
(4) completing an alternative credentialing process
identified by the department.
(e) Additional requirements for credentialing as a
CSSP. For credentialing as a CSSP, the credentialing and re-credentialing
process described in subsection (c) of this section must include:
(1) verifying a high school diploma or high school
equivalent certificate issued in accordance with the law of the issuing
state;
(2) verifying three continuous years of documented
full-time experience in the provision of mental health case management
or rehabilitative services prior to August 31, 2004;
(3) reviewing the staff member's provision and documentation
of mental health case management or rehabilitative services; and
(4) certifying, justifying, and documenting the credentialing
decisions.
(f) Additional requirements for credentialing as a
peer provider. For credentialing as a peer provider, the credentialing
and re-credentialing process described in subsection (c) of this section
or the alternative credentialing by an organization recognized by
the department must, at minimum, include:
(1) verifying a high school diploma or high school
equivalent certificate issued in accordance with the law of the issuing
state;
(2) verifying at least one cumulative year of receiving
mental health community services for a disorder that is treated in
the target population for Texas;
(3) demonstration of competency in the provision and
documentation of mental health rehabilitative services, supported
employment, or supported housing; and
(4) justifying and documenting the credentialing decisions.
(g) Additional requirements for utilization management
job functions. For credentialing as a staff member who performs utilization
management job functions, the credentialing and re-credentialing process
described in subsection (c) of this section must include:
(1) the staff member's job description indicating
the performance of utilization management functions;
(2) if the staff member is not the utilization management
physician, the staff member's job description indicating they neither
provide services nor supervise service providers;
(3) documenting licenses;
(4) documenting training and supervision received;
and
(5) justifying and documenting credentialing decisions.
(h) Maintaining documented personnel information. The
LMHA, MCO, and provider must maintain personnel files for each staff
member that include:
(1) a current, signed job description for each staff
member;
(2) documented, periodic performance reviews;
(3) copies of current credentials and training; and
(4) criminal background checks.
|
