Texas Behavioral Health Services Policy Manual

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The Texas Behavioral Health Services Policy Manual provides a comprehensive framework for delivering high-quality mental health and substance use disorder (SUD) services to individuals across Texas. This manual aligns with federal and state regulations, including the Texas Administrative Code (§306.152), the Health and Safety Code (Chapter 611), Medicaid and CHIP managed care contracts, and guidelines from the Texas Health and Human Services Commission (HHSC). It ensures compliance with legal mandates to support equitable access to behavioral health care while promoting patient rights, safety, and quality assurance.
The manual outlines policies and procedures for the prevention, diagnosis, treatment, and recovery of mental health conditions and substance use disorders. It incorporates evidence-based practices, clinical screening criteria, workforce requirements, and service delivery standards to ensure effective care.
Key areas covered in the manual include:
Eligibility and Access: Guidelines for determining eligibility for behavioral health services under Medicaid, CHIP, or other funding sources, ensuring coverage for outpatient, intensive outpatient, residential treatment, and crisis services.
Service Delivery Standards: Policies for providing a continuum of care that includes outpatient therapy, inpatient psychiatric care, substance use treatment programs, and community-based wraparound services.
Provider Requirements: Standards for licensed providers, including training in culturally informed practices, compliance with licensure rules, and maintaining adequate staffing levels to meet client needs.
Patient Rights and Safety: Provisions to protect patient rights such as humane treatment in the least restrictive setting, freedom from unnecessary restraints or seclusion, and access to grievance procedures.
Coordination of Care: Procedures to ensure continuity of care between behavioral health providers, medical professionals, managed care organizations (MCOs), and local mental health authorities (LMHAs).
Clinical Documentation and Prior Authorization: Requirements for maintaining accurate clinical records and obtaining prior authorization for intensive services to verify medical necessity.
Quality Assurance: Policies for monitoring service outcomes through data collection, reporting systems, and adherence to best practices.
The Texas Behavioral Health Services Policy Manual serves as a vital resource for agencies and providers to deliver person-centered behavioral health care while adhering to state regulations. It supports improved mental health outcomes by addressing gaps in care, enhancing workforce capacity, and ensuring equitable access to services across diverse communities.