The Texas Department of Mental Health and Mental Retardation (TDMHMR) proposes new §§412.301-412.322 of Chapter 412, Subchapter G, governing mental health community services standards. The repeals of §§408.21-408.25 of Chapter 408, Subchapter B, governing the same, and the repeals of §§409.401-409.406 of Chapter 409, Subchapter K, governing standards for behavioral health services by Medicaid managed care organizations, both of which the new sections will replace, are contemporaneously proposed in this issue of the Texas Register .

The proposed new rules would establish uniform standards for mental health community services delivered by local mental health authorities, Medicaid managed care organizations, and providers of rehabilitative services and service coordination reimbursed by Medicaid. Currently, local mental health authorities of TDMHMR and providers of rehabilitative services and service coordination reimbursed by Medicaid are required to comply with TDMHMR rules governing mental health community services standards (25 TAC Chapter 408, Subchapter B) and Medicaid managed care organizations are required to comply with TDMHMR rules governing standards for behavioral health services by Medicaid managed care organizations (25 TAC Chapter 409, Subchapter K). The proposed new rules would create one set of standards for the delivery of mental health community services funded by or through TDMHMR or funded by Medicaid managed care.

Bill Campbell, chief financial officer, has determined that for each year of the first five years the proposed new rules are in effect enforcing or administering the rules does not have foreseeable implications relating to cost or revenues of the state or local governments.

Sue Dillard, director, Quality Management, has determined that for each year of the first five years the proposed new rules are in effect the public benefit expected as a result of the adoption of the rules is the promulgation of uniform performance requirements for local mental health authorities, Medicaid managed care organizations, and providers of rehabilitative services and service coordination reimbursed by Medicaid regarding the provision of mental health community services funded by or through TDMHMR or funded by Medicaid managed care. Uniform standards ensure mental health community services are delivered to consumers in a consistent manner regardless of where consumers receive those services. It is anticipated that there would be no economic cost to persons required to comply with the rules.

It is not anticipated that the rules will affect a local economy.

It is anticipated that the rules will not have an adverse economic effect on small businesses because the revised standards do not significantly alter requirements that providers contracting with local mental health authorities or Medicaid managed care organizations are already required to comply with under the rules proposed for repeal or under an MMCO's contract with the Texas Department of Health.

Written comments on the proposal may be sent to Linda Logan, director, Policy Development, Texas Department of Mental Health and Mental Retardation, P.O. Box 12668, Austin, Texas 78711-2668, within 30 days of publication.

A public hearing will be held at 9:00 a.m. on Tuesday, June 22, 1999, in the auditorium of the main TDMHMR Central Office building (Building 2) at TDMHMR Central Office, 909 West 45th Street, Austin, Texas, to accept oral and written testimony concerning this proposal. Persons requiring an interpreter for the deaf or hearing impaired should contact the TDMHMR Central Office operator at least 72 hours prior to the hearing at TDD (512) 206-5330. Persons requiring any other accommodation for a disability should notify Sheila Wilkins, Office of Policy Development, at least 72 hours prior to the hearing by calling (512) 206-4516 or the TDY phone number of Texas Relay, 1-800-735-2988.

1. General Provisions

25 TAC §§412.301-412.306

These rules are proposed under the Texas Health and Safety Code, §532.015(a), which provides the Texas Board of Mental Health and Mental Retardation with broad rulemaking authority; the Texas Government Code, §531.021(a), and the Texas Human Resources Code, §32.021(a), which provide HHSC with the authority to administer the federal medical assistance (Medicaid) program in Texas; Acts 1995, 74th Legislature, Chapter 6, §1, (Senate Bill 509), which clarifies the authority of HHSC to delegate the operation of all or part of a Medicaid program to a health and human services agency; the Human Resources Code, §32.021(c), which provides an agency operating part of the Medicaid program with the authority to adopt necessary rules for the proper and efficient operation of the program; the Texas Health and Safety Code, §534.052, which requires the Texas Board of Mental Health and Mental Retardation to adopt rules, including standards, that it considers necessary and appropriate to ensure the adequate provision of community-based mental health services through a local mental health authority; and the Texas Health and Safety Code, §533.047, which requires the Texas Board of Mental Health and Mental Retardation to develop performance, operation, quality of care, marketing, and financial standards for the provision by managed care organizations of mental health and mental retardation services to Medicaid clients. HHSC has delegated to TDMHMR the authority to operate the Medicaid programs for rehabilitative services and service coordination.

These rules would affect the Texas Health and Safety Code, §533.047 and §534.052, and the Human Resources Code, §32.021(c).

§412.301.Purpose.

The purpose of this subchapter is to describe performance requirements for the provision of mental health community services for:

(1)

local mental health authorities, Medicaid managed care organizations, and providers as authorized by the Texas Health and Safety Code, §533.047 and §534.052; and

(2)

providers of rehabilitative services and service coordination that are reimbursed by Medicaid.

§412.302.Application.

(a)