| (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.
|
| Source Note: The provisions of this §301.331 adopted to be effective April 29, 2009, 34 TexReg 2603; transferred effective March 15, 2020, as published in the February 21, 2020 issue of the Texas Register, 45 TexReg 1237 |
