BEFORE THE DEPARTMENT OF PUBLIC
HEALTH AND HUMAN SERVICES OF THE
STATE OF MONTANA
TO: All Concerned Persons
1. On December 26, 2013, the Department of Public Health and Human Services published MAR Notice No. 37-662 pertaining to the public hearing on the proposed amendment of the above-stated rules at page 2397 of the 2013 Montana Administrative Register, Issue Number 24.
2. The department has amended ARM 37.91.102, 37.91.201, 37.91.205, 37.91.210, 37.91.220, 37.91.401, 37.91.402, 37.91.407, and 37.91.601 as proposed.
3. The department has amended the following rule as proposed, but with the following changes from the original proposal, new matter underlined, deleted matter interlined:
37.91.106 DEFINITIONS (1) through (9) remain as proposed.
(10) "Mental Health Professional Person" means a type of professional person who is certified by the department under 53-21-106, MCA, to perform the privileges granted under ARM 37.91.402.
(10) (11) "Professional person" means a mental health professional person as defined in 53-21-102 (10)(b)(16), MCA.
AUTH: 53-21-106, MCA
IMP: 53-21-106, MCA
4. The department has thoroughly considered the comments and testimony received. A summary of the comments received and the department's responses are as follows:
COMMENT #1: A commenter expressed concern with the proposed requirement found in ARM 37.91.106 to have a standardized "approved facility training program" as it would place a burden on agencies. The commenter also expressed concern on the deletion of the rule allowing the order of restraint and seclusion by facility professional persons.
RESPONSE #1: In the existing administrative rule there are two types of professional person certifications. They are described in ARM 37.91.106 as full mental health certification and facility mental health certification. A facility professional person is certified to act as a mental health professional person only in the facility for which the person is certified and only with those privileges described in ARM 37.91.407. At the present time, facility professional person status is confined to the Montana State Hospital, where they have their own internal six-month training program and examination tailored to their stated privileges and duties. There was a time when at least one community hospital also used the facility type of certification. Regarding facility professional person restraint and seclusion, state hospital policy has never permitted restraint and/or seclusion of patients except on the order of a medical doctor. The department does permit restraint/seclusion by full mental health professional persons when necessary as per 53-21-146, MCA.
COMMENT #2: A commenter expressed concern that the removal of language pertaining to college transcripts in ARM 37.91.201 would remove an important safeguard, especially with respect to persons coming from out-of-state to provide mental health services to Montana consumers.
RESPONSE #2: The rule change in ARM 37.91.201 proposes that in order to qualify as a professional person an applicant must be licensed as a mental health professional. If the license is from outside of Montana, then the licensee must demonstrate that the license was obtained under standards equal to or superior to those of Montana. The professional person applicant must demonstrate having met education standards of the National Council on Social Work Education, a Licensed Clinical Professional Counselor (LCPC) exam, and 3,000 supervised hours of clinical practice as described in ARM 24.219.504, 24.219.604; and 37-22-301, 37-23-202, MCA.
COMMENT #3: A commenter testified at the public hearing that the proposed language found in ARM 37.91.106(5), requiring training with mental health consumers over the age of 18, should be amended to also allow training applicable to consumers under the age of 18.
RESPONSE #3: The proposed rule amendment states that "clinical mental health experience" means work experience evaluating persons for mental illness and providing direct mental health treatment to a caseload which includes persons 18 years and older who are seriously impaired due to mental illness. The proposed change does not preclude also having experience treating persons under age 18. The proposed rule is targeting adults because persons under age 18 are not committed to the state hospital.
COMMENT #4: A commenter raised a concern that in ARM 37.91.201 the department requiring professional persons to be licensed could make it very difficult for employers to hire a new graduate or an out-of-state clinician.
RESPONSE #4: This proposed rule amendment is designed to protect the public by requiring that clinicians participating in involuntary commitments achieve at least a mental health professional license, thus establishing a level of integrity of the mental health commitment process and raising the standard of qualification to a more professional level.
COMMENT #5: A commenter was concerned that the proposed amendment to ARM 37.91.210 would allow the certification committee to revoke an individual's certification for failing to meet ongoing educational requirements.
RESPONSE #5: The department may revoke an individual's certification for failing to meet ongoing educational requirements when it threatens to or causes the individual's mental health professional license to be revoked due to failure to meet ongoing educational requirements. These continuing educational units are the same as those referred to by licensure requirements.
COMMENT #6: A commenter requested clarification on the difference between a "mental health professional person" and a "professional person."
RESPONSE #6: The department has added a definition for "mental health professional person" in order to distinguish the difference between that and a "professional person." The department also corrected a citation to the Montana Code Annotated under the definition for "professional person."
/s/ John C. Koch /s/ Richard H. Opper
John C. Koch Richard H. Opper, Director
Rule Reviewer Public Health and Human Services
Certified to the Secretary of State March 3, 2014