PART 15. TEXAS HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 353. MEDICAID MANAGED CARE

SUBCHAPTER P. MENTAL HEALTH TARGETED CASE MANAGEMENT AND MENTAL HEALTH REHABILITATION

1 TAC §353.1415

The Executive Commissioner of the Texas Health and Human Services Commission (HHSC) proposes an amendment to §353.1415, concerning Staff Member Credentialing.

BACKGROUND AND PURPOSE

Texas Government Code §533.00255(d)(2) requires HHSC to ensure that providers in the Behavioral Health and Physical Services Network in §533.00255 are well-qualified and able to provide an appropriate array of services.

The proposed amendment expands the minimum qualifications for a Qualified Mental Health Professional-Community Services (QMHP-CS) credential to help address mental health workforce shortages.

Currently, the qualifications for a QMHP-CS credential include an option for individuals with a bachelor's degree in a human services discipline to meet the criteria. The proposed amendment expands the list of acceptable human services degrees to include a bachelor's degree in human development and family sciences, public health or child and family welfare.

In addition, the proposed amendment includes a new option for individuals with a non-human services bachelor's degree to meet the criteria for a QMHP-CS credential if the individual has at least one year of documented experience as an intern or employee in a program that provides mental health or substance use services.

The proposed amendment to §353.1415 also updates rule formatting; updates a rule reference; and removes ambiguous language to align more closely with updates to the Texas Medicaid medical policies and state plan for Mental Health Targeted Case Management and Mental Health Rehabilitation Services.

FISCAL NOTE

Trey Wood, HHSC Chief Financial Officer, has determined that for each year of the first five years that the rule will be in effect, enforcing or administering the rule does not have foreseeable implications relating to costs or revenues of state or local governments.

GOVERNMENT GROWTH IMPACT STATEMENT

HHSC has determined that during the first five years that the rule will be in effect:

(1) the proposed rule will not create or eliminate a government program;

(2) implementation of the proposed rule will not affect the number of HHSC employee positions;

(3) implementation of the proposed rule will result in no assumed change in future legislative appropriations;

(4) the proposed rule will not affect fees paid to HHSC;

(5) the proposed rule will not create new regulations;

(6) the proposed rule will expand an existing regulation;

(7) the proposed rule will increase the number of individuals subject to the rule; and

(8) HHSC has insufficient information to determine the proposed rule's effect on the state's economy.

SMALL BUSINESS, MICRO-BUSINESS, AND RURAL COMMUNITY IMPACT ANALYSIS

Trey Wood has also determined that there will be no adverse economic effect on small businesses, micro-businesses, or rural communities. The rule does not impose any additional costs on small businesses, micro-businesses, or rural communities that are required to comply with the rules.

LOCAL EMPLOYMENT IMPACT

The proposed rule will not affect a local economy.

COSTS TO REGULATED PERSONS

Texas Government Code §2001.0045 does not apply to this rule because the rule is necessary to protect the health, safety, and welfare of the residents of Texas; and does not impose a cost on regulated persons.

PUBLIC BENEFIT AND COSTS

Emily Zalkovsky, State Medicaid Director, has determined that for each year of the first five years the rule is in effect, the public benefit will be increased access to Texas Medicaid Mental Health Targeted Case Management and Mental Health Rehabilitative services by expanding the applicant pool of individuals who meet the qualifications of a QMHP-CS who primarily delivers these services.

Trey Wood has also determined that for the first five years the rule is in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rule because there are no costs associated with expanding the qualifications of a QMHP-CS.

TAKINGS IMPACT ASSESSMENT

HHSC has determined that the proposal does not restrict or limit an owner's right to the owner's property that would otherwise exist in the absence of government action and, therefore, does not constitute a taking under Texas Government Code §2007.043.

PUBLIC COMMENT

Written comments on the proposal may be submitted to Rules Coordination Office, P.O. Box 13247, Mail Code 4102, Austin, Texas 78711-3247, or street address 4601 West Guadalupe Street, Austin, Texas 78751; or emailed to HHSRulesCoordinationOffice@hhs.texas.gov.

To be considered, comments must be submitted no later than 31 days after the date of this issue of the Texas Register. Comments must be (1) postmarked or shipped before the last day of the comment period; (2) hand-delivered before 5:00 p.m. on the last working day of the comment period; or (3) emailed before midnight on the last day of the comment period. If the last day to submit comments falls on a holiday, comments must be postmarked, shipped, or emailed before midnight on the following business day to be accepted. When emailing comments, please indicate "Comments on Proposed Rule 24R081" in the subject line.

STATUTORY AUTHORITY

The amendment is authorized by Texas Government Code §531.0055, which provides that the Executive Commissioner of HHSC shall adopt rules for the operation and provision of services by the health and human services agencies; and Texas Government Code §531.033, which provides the Executive Commissioner of HHSC with broad rulemaking authority; Texas Human Resources Code §32.021, which provides HHSC with the authority to administer the federal medical assistance program in Texas and to adopt rules and standards for program administration; and Texas Government Code §533.00255(i) which requires the Commissioner to adopt rules necessary to implement Texas Government Code §533.00255, concerning the behavioral health and physical health services network.

The amendment implements Texas Government Code §531.0055 and §533.00255(d)(2).

§353.1415.Staff Member Credentialing.

(a) QMHP-CS [Qualified Mental Health Professional-Community Services (QMHP-CS)]. A [staff member must meet at least one of three minimum requirements to be credentialed as a] QMHP-CS must have the following minimum requirements:

(1) completed a standardized training curriculum;

(2) demonstrated competency in the work to be performed; and

(3) obtained one of the following:

(A) [(1)] a [The staff member has at least a] bachelor's degree in one of the following disciplines from an accredited college or university [and a minimum number of hours that is equivalent to a major in]:

(i) psychology;[,]

(ii) social work;[,]

(iii) medicine;[,]

(iv) nursing;[,]

(v) rehabilitation;[,]

(vi) counseling;[,]

(vii) sociology;[,]

(viii) human growth and development;[,]

(ix) physician assistant;[,]

(x) gerontology;[,]

(xi) special education;[,]

(xii) educational psychology;[,]

(xiii) early childhood education;[, or]

(xiv) early childhood intervention;[.]

(xv) human development and family sciences;

(xvi) public health; or

(xvii) child and family welfare;

(B) a bachelor's degree in a discipline other than those listed under subparagraph (A) of this paragraph from an accredited college or university with at least one year of documented experience as an intern or employee in a program that provides mental health or substance use services;

(C) [(2)] a license as [ The staff member is] a registered nurse; or[.]

(D) [(3)] a license as [ The staff member is] a Licensed Practitioner of the Healing Arts (LPHA).

(b) CSSP [Community Services Specialist (CSSP)]. A CSSP must, [staff member who,] as of August 31, 2004, have met the criteria set forth in 26 TAC §301.303 [25 TAC §412.303] (relating to Definitions).

(c) Peer Provider. A peer provider must have the following [The] minimum requirements [to credential a staff member as a peer provider are that the staff member has]:

(1) a high school diploma or high school equivalency certificate issued in accordance with the law of the issuing state;

(2) at least one cumulative year of receiving mental health services; and

(3) demonstrated competency in the provision and documentation of mental health rehabilitative services, supported employment, or supported housing.

(d) CFP [Certified Family Partners (CFPs)]. A CFP must have the following [The] minimum requirements [to credential a staff member as a CFP include verifying that the staff member]:

(1) be [is] 18 years of age or older;

(2) have [has] a high school diploma or high school equivalency certificate issued in accordance with the law of the issuing state;

(3) have [has] at least one year of personal experience as a parent or LAR raising a child or youth with serious emotional disturbance or mental illness;

(4) have [has] at least one year of personal experience as a parent or LAR navigating a child-service system (e.g., mental health, juvenile justice, social security, or special education); and

(5) have [has] successfully completed and passed the HHSC-approved certification process.

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on January 24, 2025.

TRD-202500223

Karen Ray

Chief Counsel

Texas Health and Human Services Commission

Earliest possible date of adoption: March 9, 2025

For further information, please call: (512) 438-2910