No. 29383 (Amendment): R523-1-23. Case Manager Certification

DAR File No.: 29383
Filed: 01/02/2007, 02:04
Received by: NL

RULE ANALYSIS

Purpose of the rule or reason for the change:

This rule is being established to legitimize actions taken by the Division of Substance Abuse and Mental Health to meet billing requirements issued by Medicaid. The Division entered into an informal agreement with Medicaid to create a training and licensing process for mental health case managers to ensure competent and qualified workers are providing case management services. The curriculum, training, and certification of case managers has already been a practice throughout the State of Utah, so this rule does not create or mandate a new system or process, but merely institutionalizes a practice that has been going on for several years.

Summary of the rule or change:

This rule provides for the certification of case managers who work in the State of Utah for local mental health and/or substance abuse authorities. Minimum standards for qualification to seek certification are outlined; testing and experience standards are set; a request for a waiver of the minimum standards is provided; a process for application is identified; continuation of licensing requirements are established; and a recertification process is provided along with a revocation process and appeals.

State statutory or constitutional authorization for this rule:

Subsection 62A-15-105(5)

Anticipated cost or savings to:

the state budget:

Implementation of this rule will not require the Division to provide additional outlays of capital beyond that which has already been budgeted currently and in past years. A database for tracking certified case managers and recertification time lines already exists and is being maintained. Other costs currently tied to this rule are: support staff time used for printing and sending certificates; support staff time used for maintaining the database; the cost of buying certificates; the cost of printing names on certificates; staff time for administering and scoring tests, and staff time for maintaining and updating test standards.

local governments:

Local governments have no cost associated with this rule because they do not certify or train persons seeking case management certification.

other persons:

Costs to others could include travel expenses to take the test and possible updated training costs for continuing education hours to maintain certification. Eight hours of continuing education are required per year and recertification is due every three years. Continuing education hours may be obtained through in-house agency trainings or purchased through conferences and seminars so actual costs would be difficult to anticipate.

Compliance costs for affected persons:

Costs associated with this rule are limited to those persons who are seeking case management certification and include travel expenses to take the test and updated training costs for continuing education hours to maintain certification. Continuing education hours may be obtained through in-house agency trainings or purchase through conferences and seminars so actual costs would be difficult to anticipate.

Comments by the department head on the fiscal impact the rule may have on businesses:

After careful review, the Department of Human Services has determined that this rule will have no financial impact on businesses in the State of Utah. Lisa-Michele Church, Executive Director

The full text of this rule may be inspected, during regular business hours, at the Division of Administrative Rules, or at:

Human Services
Substance Abuse and Mental Health
120 N 200 W
SALT LAKE CITY UT 84103-1500

Direct questions regarding this rule to:

Thom Dunford at the above address, by phone at 801-538-4519, by FAX at 801-538-9892, or by Internet E-mail at [e-mail]

Interested persons may present their views on this rule by submitting written comments to the address above no later than 5:00 p.m. on:

02/14/2007

This rule may become effective on:

02/22/2007

Authorized by:

Mark I Payne, Director

RULE TEXT

R523. Human Services, Substance Abuse and Mental Health.

R523-1. Procedures.

R523-1-23. Case Manager Certification.

(1) Definitions.

(a) "Mental Health and Substance Abuse Case Manager" means an individual under the supervision of a qualified provider employed by the local mental health authority or contracted by a local substance abuse authority, who is responsible for coordinating, advocating, linking and monitoring activities that assist individuals with serious and often persistent mental illness and serious emotional disorder in children and individuals with substance abuse disorders to access prescribed medical and related therapeutic services. Also, to promote the individual's general health and their ability to function independently and successfully in the community.

(b) "Qualified providers" include any individual who is a licensed physician, a licensed psychologist, a licensed clinical social worker, a licensed certified social worker, a licensed social service worker, a licensed advanced practice registered nurse, a licensed registered nurse, a licensed practical nurse, a licensed professional counselor, licensed marriage and family counselor, or a licensed. substance abuse counselor, and employed by a local mental health authority or contracted by a local mental health authority.

(2) A certified case manager must meet the following minimum standards:

(a) be an individual who is not a licensed mental health professional, who is supervised by one of the qualified providers listed in Subsection R523-1-23(1)(b);

(b) be at least 18 years of age;

(c) have at least a high school degree or a GED;

(d) have at least two years experience in the support of individuals with mental illness or substance abuse;

(e) be employed by the local mental health authority or contracted by a local substance abuse authority;

(f) pass a Division exam which tests basic knowledge, ethics, attitudes and case management skills with a score of 70 percent or above; and

(g) completes an approved case management practicum.

(3) An individual applying to become a certified case manager may request a waiver of the minimum standards in Subsection R523-1-23(2) based on their prior experience and training. The individual shall submit the request in writing to the Division. The Division shall review the documentation and issues a written decision regarding the request for waiver.

(4) Applications and instructions to apply for certification to become a case manager can be obtained from the Division of Substance Abuse and Mental Health. Only complete applications supported by all necessary documents shall be considered.

(a) Individuals will be notified in writing of disposition and determination to grant or deny the application within 60 days of completion of case management requirements. The Division shall issue a certificate for three years.

(b) If the application is denied the individual may file a written appeal within 30 days to the Division Director.

(5) Each certified case manager is required to complete and document eight hours of continuing education (CEU) credits each calendar year related to mental health or substance abuse topics.

(a) A certified case manager shall submit CEU documentation to the Division when they apply for recertification.

(b) Documents to verify CEU credits include:

(i) a certificate of completion documenting continuing education validation furnished by the presenter:

(ii) a letter of certificate from the sponsoring agency verifying the name of the program, presenter, and number of hours attended and participants; or

(iii) an official grade transcript verifying completion of an undergraduate or graduate course(s) of study.

(6) Certified case managers shall submit the Request for Re-certification and documentation of 24 hours of CEU's 30 days prior to the date of expiration on the initial certificate or re-certification. Failure to submit the Request for Re-certification will result in automatic revocation of the certificate.

(7) Certified case managers shall abide by the Rules of Professional Code of Conduct pursuant to Subsection R495-876(a), the Department of Human Services Provider Code of Conduct Policy.

(a) Each employer shall notify the Division within 30 days, if a certified case manager engages in unprofessional or unlawful conduct.

(b) The Division shall revoke, refuse to certify or renew a certification to an individual who is substantiated to have engaged in unprofessional or unlawful conduct.

(c) An individual who has been served a Notice of Agency Action that the certification has been revoked or will not be renewed may request a Request for Review to the Division Director or designee within 30 days of receipt of notice.

(d) The Division Director or designee will review the findings of the Notice of Agency Action and shall determine to uphold, amend or revise the action of denial or revocation of the certification.

(8) If a certified case manager fails to complete the requirements for CEU's, their certificate will be revoked or allowed to expire and will not be renewed.

(9) If an individual fails the Division examination they must wait 30 days before taking the examination again. The individual may only attempt to pass the examination two times with a twelve-month period.

(10) The case managers certification must be posted and available upon request.

 

KEY: bed allocations, due process, prohibited items and devices, fees

Date of Enactment or Last Substantive Amendment: [March 7, 2005]2007

Notice of Continuation: December 11, 2002

Authorizing, and Implemented or Interpreted Law: 62A-12-102; 62A-12-104; 62A-12-209.6(2); 62A-12-283.1(3)(a)(i); 62A-12-283.1(3)(a)(ii); 62A-15-612(2); 62A-15-105(5)