26 Tex. Admin. Code § 301.331 - Competency and Credentialing
(a) Competency
of staff members, including volunteers. The LMHA, MCO, and provider must
implement a process to ensure the competency of staff members prior to
providing services that, at a minimum:
(1)
ensures services are provided by staff members who are operating within the
scope of their license, job description, or contract specification;
(2) ensures that the mental health community
services provided by peer providers are limited to mental health
rehabilitative, supported employment, supported housing, parent support group,
and family partner services; and
(3) defines competency-based expectations for
each position as follows:
(A) required
competencies must be included for all staff members, including adequate,
accurate knowledge of:
(i) the nature of
severe and persistent mental illness and serious emotional
disturbances;
(ii) the recovery and
resiliency model of mental illness and serious emotional disturbance;
(iii) the dignity and rights of an
individual, as described in Chapter 404, Subchapter E of Title 25 (relating to
Rights of Persons Receiving Mental Health Services);
(iv) identifying, preventing, and reporting
abuse, neglect, and exploitation, in accordance with Chapter 414, Subchapter L
of Title 25 (relating to Abuse, Neglect, and Exploitation in Local Authorities
and Community Centers);
(v)
individual confidentiality, as described in Chapter 414, Subchapter A of Title
25 (relating to Protected Health Information) and other relevant state and
federal laws affecting confidentiality of medical records, including Title 42
CFR Part 2;
(vi) interacting with
an individual who has a physical disability such as a hearing or visual
impairment;
(vii) responding to an
individual's language and cultural needs through knowledge of customs, beliefs,
and values of various, racial, ethnic, religious, and social groups;
(viii) exposure control of blood borne
pathogens;
(ix) identification of
an individual as being in a crisis and accessing emergency or urgent care
services;
(x) proper documentation
of services provided; and
(xi)
planning and training for responding to severe weather, disasters, and
bioterrorism;
(B)
critical competencies must be included for positions in which a staff member's
primary job duties are related to individual service contacts and interactions
and include, but are not limited to, adequate and accurate knowledge of:
(i) cardio pulmonary resuscitation
(CPR);
(ii) first aid;
(iii) safe management of verbally and
physically aggressive behavior;
(iv) utilization of assistive technology such
as communication devices with individuals who are deaf or hard of hearing;
and
(v) seizure response and
assessment;
(C)
specialty competencies must be included for positions in which a staff member
performs specialized services and tasks and include adequate and accurate
knowledge of specialized services and tasks, such as:
(i) the requirements of this
subchapter;
(ii) age appropriate
clinical assessment including the uniform assessment;
(iii) age appropriate engagement techniques
(e.g., motivational interviewing);
(iv) use of telemedicine equipment;
(v) the utilization management
guidelines;
(vi) developing and
implementing an individualized treatment plan;
(vii) appropriate actions to take in a crisis
(e.g., screening, intervention, management and if applicable, suicide/homicide
precautions);
(viii) services for
co-occurring psychiatric and substance use disorders described in Chapter 411,
Subchapter N of Title 25 (relating to Standards for Services to Individuals
with Co-Occurring Psychiatric and Substance Use Disorders (COPSD));
(ix) accessing resources within the local
community;
(x) strategies for
effective advocacy and referral for an individual;
(xi) infection control;
(xii) recognition, reporting, and recording
of side effects, contraindications, and drug interactions of psychoactive
medication;
(xiii) age appropriate
rehabilitative approaches;
(xiv)
proficiency in specimen collection;
(xv) the peer-provider or consumer-operated
service model;
(xvi) assessment and
intervention with children, adolescents, and families; and
(xvii) clinical specialties directly related
to the services to be performed.
(D) crisis hotline competencies must be
included for positions in which a staff member routinely answers the crisis
hotline and include adequate and accurate knowledge of:
(i) the nature of severe and persistent
mental illness and serious emotional disturbances and COPSD;
(ii) behavioral health crisis
situations;
(iii) operating a
telephone system to access behavioral health crisis screening and
response;
(iv) age appropriate
crisis intervention and response;
(v) utilization of assistive technology such
as communication devices with individuals who are deaf or hard of
hearing;
(vi) advocacy for
treatment in the most clinically appropriate, available environment;
and
(vii) applicable privacy laws,
rules, and regulations including those described in Chapter 414, Subchapter A
of Title 25 (relating to Protected Health Information) and in Title 42 CFR Part
2.
(E) telemedicine
competencies must be included for positions in which a staff member's job
duties are related to assisting with telemedicine services and include adequate
and accurate knowledge of:
(i) operation of
the telemedicine equipment; and
(ii) how to use the equipment to adequately
present the individual.
(4) requires staff members to demonstrate
competencies in the following manner:
(A) all
staff members must demonstrate required competencies before contact with
individuals, confidential information, or protected health information and
periodically throughout the staff member's tenure of employment or association
with the LMHA, MCO, or provider;
(B) all staff members in positions that
require critical competencies must demonstrate the critical competencies before
contact with individuals and periodically throughout the staff member's or
volunteer's tenure of employment or association with the LMHA, MCO, or
provider;
(C) all staff members in
positions that require specialty competencies must demonstrate the specialty
competencies before providing the specialized service(s) or performing the
specialized task(s) and periodically throughout the staff member's or
volunteer's tenure of employment or association with the LMHA, MCO, or
provider; and
(D) all staff members
in positions that require crisis hotline competencies must demonstrate those
competencies before providing crisis hotline services and at least annually
throughout the staff member's or volunteer's tenure of employment or
association with the LMHA, MCO, or provider.
(b) Competency of crisis services providers.
The LMHA and MCO must develop and implement policies and procedures governing
the provision of crisis services to ensure that providers with which they
contract or employ for the provision of crisis services are trained in:
(1) crisis access and age appropriate
assessment and intervention services;
(2) advocacy for the most clinically
appropriate, available environment; and
(3) community referral resources.
(c) Credentialing and appeals.
Before providing services, the LMHA and MCO must:
(1) implement a timely credentialing and
re-credentialing process for all its licensed staff members, peer providers,
family partners, and every QMHP-CS and CSSP;
(2) ensure that documentation verifying a
staff member's credentialing and re-credentialing is maintained in the staff
member's personnel records;
(3)
have a process for staff members to appeal credentialing and re-credentialing
decisions; and
(4) require
providers to:
(A) use the LMHA's or MCO's
credentialing and re-credentialing and appeals processes for all of the
provider's licensed staff, QMHP-CSs, CSSPs, peer providers, family partners,
and utilization management job functions; or
(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.
Notes
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