TITLE 26. HEALTH AND HUMAN SERVICES

PART 1. HEALTH AND HUMAN SERVICES COMMISSION

CHAPTER 307. BEHAVIORAL HEALTH PROGRAMS

SUBCHAPTER F. BEHAVIORAL HEALTH PARTNERSHIP PROGRAM

26 TAC §§307.251, 307.253, 307.255, 307.257, 307.259, 307.261, 307.263, 307.265, 307.267

The Texas Health and Human Services Commission (HHSC) adopts new Subchapter F, Behavioral Health Partnership Program, in Texas Administrative Code, Chapter 307. New Subchapter F comprises §307.251, concerning Purpose; §307.253, concerning Application; §307.255, concerning Definitions; §307.257, concerning Behavioral Health Partnership Program Liaison Qualifications; §307.259, concerning Local Mental Health Authority or Local Behavioral Health Authority Responsibilities; §307.261, concerning Determining which Local Mental Health Authority or Local Behavioral Health Authority Employs a Behavioral Health Partnership Program Liaison; §307.263, concerning Responsibilities of a Behavioral Health Partnership Program Liaison; §307.265, concerning Texas Health and Human Services Commission Waiver Process; and §307.267, concerning Texas Health and Human Services Commission Notification.

Sections 307.259, 307.261, 307.263, and 307.265 are adopted with changes to the proposed text as published in the February 16, 2024, issue of the Texas Register (49 TexReg 840). These rules will be republished.

Sections 307.251, 307.253, 307.255, 307.257, and 307.267 are adopted without changes to the proposed text as published in the February 16, 2024, issue of the Texas Register (49 TexReg 840). These rules will not be republished.

BACKGROUND AND JUSTIFICATION

The rules comply with Texas Education Code §8.151 and §8.152, as amended by Senate Bill 26, 88th Legislature, Regular Session, 2023, which establishes a process for local mental health authorities (LMHAs) to submit a waiver request to the HHSC Executive Commissioner to hire a licensed master social worker or licensed professional counselor associate in lieu of a non-physician mental health professional (NPMHP) if the LMHA is unable to hire a NPMHP in its designated regional education service center (ESC). This adoption also includes application to Local Behavioral Health Authorities (LBHA). The adoption establishes the behavioral health partnership program (BHPP) as the program name and "behavioral health partnership program liaison" as the position title that includes an NPMHP or a person hired under the waiver process.

COMMENTS

The 31-day comment period ended on March 18, 2024.

During this period, HHSC received comments regarding the proposed rules from one commenter, the Texas Council of Community Centers. A summary of comments relating to the rules and HHSC's responses follows.

Comment: One commenter suggested the cross reference in §307.259(a)(7) addressing the annual activity and evaluation report, be amended to Texas Education Code §8.155 to refer to BHPP liaison duties, not Texas Education Code §8.153, which addresses the required Memorandum of Understanding with a regional educational service center.

Response: HHSC agrees with the comment and made a revision to correct the cross reference to Texas Education Code §8.155 in §307.259(a)(7).

Comment: One commenter stated the rules in §307.259(a)(6) and (7) do not identify specific metrics and do not require a certain mechanism to track outcomes of services provided. The commenter recommended revising language related to metrics and reporting practices in this section.

Response: HHSC declines to revise the rule. HHSC requires a quarterly report to monitor outcomes under §307.259(a)(6), although it is not required by statute. HHSC does not require specific metrics or a specific tracking mechanism as they vary widely by district and students. Additionally, LMHAs and LBHAs are already required to report on outcomes for school districts and students, and HHSC submits an annual report to the Legislature as required by Texas Education Code §8.158.

Comment: One commenter suggested that in compliance with Texas Education Code §8.152(b), the language in §307.261 be amended to reference all the requirements in Texas Education Code §8.152(b) rather than reference the general obligation to employ the BHPP liaison.

Response: HHSC agrees and revised language in §307.261 to add the requirement for the LMHA or LBHA to consult with other LMHAs or LBHAs in the service area and the ESC when making a hiring decision, as is consistent with Texas Education Code §8.152(b).

HHSC made minor editorial changes to §307.263(b), §307.263(b)(3)(C), §307.265(b)(2), and §307.265(b)(5) for clarity. HHSC also updated the agency's contact method in §307.259(a)(8) and §307.265(b).

STATUTORY AUTHORITY

The new sections are adopted under 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 Education Code §8.152(c) which provides the Executive Commissioner of HHSC with authority to approve waiver requests for an LMHA to hire a licensed master social worker or licenses professional counselor associate if an NPMHP cannot be hired.

§307.259.Local Mental Health Authority or Local Behavioral Health Authority Responsibilities.

(a) The LMHA or LBHA must:

(1) enter into a memorandum of understanding with the ESC to collaborate regarding the administration of this subchapter;

(2) employ a BHPP liaison to serve as a mental health and substance use resource for school districts located in the region served by an ESC and in which the LMHA or LBHA delivers services;

(3) pay the ESC a reasonable and negotiated cost-recovery fee, not to exceed $15,000 per year unless the LMHA or LBHA and the ESC agree to a higher amount, for providing the space and administrative support necessary for the BHPP liaison to carry out the professional duties outlined in Texas Education Code §8.155;

(4) supervise the BHPP liaison;

(5) consult with any other LMHA or LBHA in the region and the regional ESC for input on supervising the BHPP liaison and coordinating services provided by the BHPP liaison;

(6) submit a written quarterly activity and evaluation report to the HHSC contract manager regarding the outcomes for school districts and students resulting from services delivered by a BHPP liaison in accordance with §307.263 of this subchapter (relating to Responsibilities of a Behavioral Health Partnership Program Liaison);

(7) submit a written annual activity and evaluation report to the HHSC contract manager regarding the outcomes for school districts and students resulting from services delivered by a BHPP liaison in accordance with Texas Education Code§8.155;

(8) submit a written waiver request to BHPP@hhs.texas.gov if required under Texas Education Code §8.152(c);

(9) ensure an LMSW or an LPC associate is eligible for an HHSC waiver request as outlined in this subchapter and the LMSW or LPC associate has the ability to fulfill the duties outlined in this subchapter if a waiver is requested;

(10) retain documentation in accordance with the LMHA's and LBHA's policies and procedures on efforts made to hire an NPMHP before submitting a waiver request; and

(11) submit a new waiver request, as needed, if the HHSC BHPP liaison vacates the position.

(b) If a BHPP liaison vacates the position within one year of approval of the waiver under subsection (a)(11) of this section, a new waiver request is not required.

(c) If a BHPP liaison vacates the position more than a year after approval of the waiver under subsection (a)(11) of this section, the LMHA or LBHA must attempt to hire a professional pursuant to Texas Education Code §8.152 before requesting a waiver under subsection (a)(11) of this section.

§307.261.Determining which Local Mental Health Authority or Local Behavioral Health Authority Employs a Behavioral Health Partnership Program Liaison.

If two or more LMHAs or LBHAs provide services in a region served by a regional ESC, the LMHA or LBHA that primarily operates in the county in which the center is located shall:

(1) in making a hiring decision about a BHPP liaison, consult with the other LMHAs or LBHAs providing services in that region;

(2) consult with the ESC before making the final hiring decision; and

(3) employ the BHPP liaison.

§307.263.Responsibilities of a Behavioral Health Partnership Program Liaison.

(a) A BHPP liaison must:

(1) serve as a mental health and substance use resource for school districts located in the region served by a regional ESC in which the LMHA or LBHA provides services; and

(2) operate within the scope of their professional state license.

(b) A BHPP liaison is responsible for carrying out the following functions and duties required of an NPMHP in accordance with Texas Education Code §8.155, including:

(1) helping school district personnel gain awareness and a better understanding of mental health and co-occurring mental health and substance use disorders;

(2) assisting school district personnel to implement initiatives related to mental health or substance use under state law or agency rules, interagency memorandums of understanding, and related programs; and

(3) ensuring school district personnel are aware of:

(A) the list of recommended best practice-based programs and research-based practices developed under Texas Education Code §38.351;

(B) other public and private mental health and substance use prevention, treatment, and recovery programs available in the school district, including evidence-based programs delivered by an LMHA or LBHA and other public and private mental health resources, such as the Texas School Mental Health Resources database as required by Texas Education Code §38.253; and

(C) other available public and private mental health and substance use prevention, treatment, and recovery program resources administered by the LMHA or LBHA or HHSC to support school districts, students, and families;

(4) on a monthly basis, facilitating mental health first aid training;

(5) on a monthly basis, facilitating training on the effects of grief and trauma and providing support to children with intellectual or developmental disabilities who suffer from grief or trauma; and

(6) on a monthly basis, facilitating training on prevention and intervention programs that have been shown to be effective in helping students cope with pressures to:

(A) use alcohol, cigarettes, or illegal drugs; or

(B) misuse prescription drugs.

(c) A BHPP liaison employed under this subchapter must not treat or provide counseling to a student or provide advice to school district personnel regarding a specific student.

§307.265.Texas Health and Human Services Commission Waiver Process.

(a) If an LMHA or LBHA is unable to employ a person who qualifies as an NPMHP for the BHPP liaison position in its designated ESC, the LMHA or LBHA may request a waiver from the HHSC Executive Commissioner, or designee, to employ an LMSW or LPC associate to serve as the BHPP liaison, pursuant to Texas Education Code §8.152(c).

(b) To apply for a waiver, the LMHA or LBHA must complete and submit the written HHSC Local Mental and Behavioral Health Authority Waiver Request Form to BHPP@hhs.texas.gov addressing the following information:

(1) the name of the LMHA or LBHA requesting the waiver;

(2) the LMHA or LBHA's staff member's name and contact information;

(3) the LMHA or LBHA's recruitment efforts to hire an NPMHP;

(4) the duration of time the LMHA or LBHA was unable to hire for this position before requesting a waiver; and

(5) that the BHPP liaison waiver candidate is licensed as an LMSW or LPC associate.

The agency certifies that legal counsel has reviewed the adoption and found it to be a valid exercise of the agency's legal authority.

Filed with the Office of the Secretary of State on May 22, 2024.

TRD-202402279

Karen Ray

Chief Counsel

Health and Human Services Commission

Effective date: June 11, 2024

Proposal publication date: February 16, 2024

For further information, please call: (512) 243-4241