PART 1. DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 412. LOCAL MENTAL HEALTH AUTHORITY RESPONSIBILITIES
SUBCHAPTER G. MENTAL HEALTH COMMUNITY SERVICES STANDARDS
The Executive Commissioner of the Health and Human Services Commission (commission) on behalf of the Department of State Health Services (department) adopts the repeal of §§412.301 - 412.322, and new §§412.301, 412.303, 412.304, 412.311 - 412.318, and 412.321 - 412.327, concerning mental health community services standards, without changes to the proposed text as published in the February 6, 2009, issue of the Texas Register (34 TexReg 785) and, therefore, the sections will not be republished.
BACKGROUND AND PURPOSE
The purpose of this subchapter is to describe requirements for ensuring the adequate provision and appropriate delivery of mental health community services. Repeal of the existing rules is necessary due to substantial changes being made to the rules to align them with existing service delivery requirements. Beginning with fiscal year 2005, the department began incorporating principles of Resiliency and Disease Management (RDM) into its overall approach to regulating the delivery of community mental health services. The core services affected by RDM include mental health rehabilitative and mental health case management services. However, key components of RDM are reflected throughout the adopted new rules.
Although the repealed rules applied to all Medicaid managed care organizations, the new adopted rules will only apply to local mental health authorities, managed care organizations, and other providers that contract directly with the department. Under the Texas Health and Safety Code, §533.047, Managed Care Organizations: Medicaid Program, the former Texas Department of Mental Health and Mental Retardation was charged with developing performance and quality of care standards for the provision of mental health and mental retardation services to Medicaid clients by managed care organizations involved in the Medicaid Program. As a result of the passage of House Bill 2292 (78th Texas Legislature, Regular Session, 2003), effective September 1, 2004, the responsibility to implement the Texas Health and Safety Code, §533.047, was transferred to the commission. Therefore, the department is only responsible for developing standards for community mental health services by those providers with which the department contracts directly.
Texas Government Code, §2001.039, requires that each state agency review and consider for readoption each rule adopted by that agency pursuant to the Texas Government Code, Chapter 2001 (Administrative Procedure Act). Sections 412.301 - 412.322 have been reviewed and the department has determined that reasons for adopting the sections continue to exist because rules on this subject are needed.
SECTION-BY-SECTION SUMMARY
In the new adopted rules, certain terms have been changed, such as using "consumer" instead of "individual," to reflect current usage of terminology within the mental health care delivery system. Other changes made to the new rules include various grammatical, punctuation, and formatting changes. In addition, more specific changes reflected in the new rules are described as follows.
Division 1. General Provisions.
Adopted §412.301 states the purpose of the subchapter and its application to providers with which the department contracts.
Adopted §412.303 sets forth a number of definitions of terms used throughout the subchapter.
Adopted §412.304 specifically identifies which of the divisions in the subchapter apply to which types of providers, and sets forth the responsibilities of local mental health authorities (LMHAs), and managed care organizations (MCOs).
Division 2. Organizational Standards.
Adopted §412.311 sets forth primary leadership responsibilities of the LMHA and MCO.
Adopted §412.312 sets forth requirements to ensure a proper environment of care and safety at service delivery sites.
Adopted §412.313 sets forth the rights and protections that must be afforded by providers to all individuals who are seeking or receiving mental health services.
Adopted §412.314 sets forth provider requirements relating to the provision of adequate access to mental health community services.
Adopted §412.315 sets forth the requirements relating to maintenance of medical records.
Adopted §412.316 sets forth requirements for certain competencies of staff members.
Adopted §412.317 requires that community mental health services be provided under a detailed quality management plan.
Adopted §412.318 requires providers to develop and implement a utilization management program, timely prior authorization system, and appeal and fair hearing procedures.
Division 3. Standards of Care.
Adopted §412.321 identifies specific requirements relating to the provision of crisis services.
Adopted §412.322 identifies various aspects of providers' responsibilities relating to service authorization; assessment, diagnosis and provision of services and related documentation; implementation and use of the department's utilization management guidelines and uniform assessment tools; and integrated treatment planning.
Adopted §412.323 sets forth requirements concerning medication services, including delegation of services, handling of medications, supervision of self-administration of medication, and medication errors.
Adopted §412.324 sets forth additional standards of care relating to the administration of the uniform assessment and the provision of mental health community services to children and adolescents.
Adopted §412.325 sets forth requirements for the provision of telemedicine and/or telepsychiatry.
Adopted §412.326 sets forth specific documentation requirements relating to service provision, including a requirement that such documentation be made within two business days after each service encounter occurs, with the exceptions of crisis services, day programs for acute needs, and case management services.
Adopted §412.327 sets forth requirements for supervision of various staff members, and for implementation of a peer review process for licensed staff members.
COMMENTS
The department, on behalf of the commission, did not receive any comments regarding the proposed rules during the comment period.
LEGAL CERTIFICATION
The Department of State Health Services General Counsel, Lisa Hernandez, certifies that the rules, as adopted, have been reviewed by legal counsel and found to be a valid exercise of the agencies' legal authority.
DIVISION 1. GENERAL PROVISIONS
STATUTORY AUTHORITY
The adopted repeals are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901383
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted repeals are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901385
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted repeals are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901387
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted repeals are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901389
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted repeals are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901390
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
25 TAC §§412.301, 412.303, 412.304
STATUTORY AUTHORITY
The adopted new rules are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901384
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted new rules are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901386
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972
STATUTORY AUTHORITY
The adopted new rules are authorized by Texas Health and Safety Code, §534.053, which requires the department to ensure that certain community-based services are available in each service area; Texas Health and Safety Code, §534.058, which requires the department to develop standards of care for the services provided by local mental health authorities and their subcontractors; and Texas Government Code, §531.0055, and Texas Health and Safety Code, §1001.075, which authorize the Executive Commissioner of the Health and Human Services Commission to adopt rules and policies necessary for the operation and provision of health and human services by the department and for the administration of Texas Health and Safety Code, Chapter 1001. Review of the sections implements Texas Government Code, §2001.039.
This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency's legal authority.
Filed with the Office of the Secretary of State on April 9, 2009.
TRD-200901388
Lisa Hernandez
General Counsel
Department of State Health Services
Effective date: April 29, 2009
Proposal publication date: February 6, 2009
For further information, please call: (512) 458-7111 x6972