RLV H.B. 3410 75(R)BILL ANALYSIS PUBLIC HEALTH H.B. 3410 By: Hirschi 5-2-97 Committee Report (Unamended) BACKGROUND Licensed Psychological Associates (LPAs) or master level psychologists offer affordable, professional services to patients across Texas. Their services are utilized by many state and private agencies including public schools, hospitals, and various mental health delivery systems. Last legislative session, a bill that would have allowed LPAs to practice their profession independently was amended to require these mental health professionals to provide services with minimal supervision by a licensed psychologist (a person holding a doctorate degree in psychology) or a psychiatrist. Medicaid and Medicare do not reimburse for the services of any practitioner who is not licensed to practice independently. The Texas Department of Mental Health and Mental Retardation (MHMR) community centers have traditionally provided services under the Medicaid Rehabilitative Services for Persons with Mental Illness, and the LPAs are eligible for reimbursement for these services. As the MHMR community centers begin to participate in the Medicaid managed care pilots, they are increasingly providing services within the Acute Care Service array, under which the LPAs are not eligible for reimbursement. Any Medicaid reimbursement for psychological services is optional. The state currently reimburses licensed professional counselors, licensed psychologists, and licensed masters of social work for acute care services. Therefore, the LPAs are beginning to lose positions to these other mental health professionals who are eligible for acute care service reimbursements. To preserve their profession, the LPAs are pursuing this legislation to authorize independent practice authority. Allowing independent practice authority will qualify these providers as eligible for Medicaid reimbursement. However, the LPAs would still have to pursue a change to the state Medicaid plan to become authorized by the state as providers. PURPOSE HB 3410 will make licensed psychological associates eligible for independent practitioner status. RULEMAKING AUTHORITY It is the committee's opinion that this bill grants additional rulemaking authority to the Texas State Board of Examiners of Psychologists (board) in SECTION 6(b). SECTION BY SECTION ANALYSIS SECTION 1. Amends Sections 11(b) and (c), Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes) by adding master's degree in psychology to all requirements established in these subsections. SECTION 2. Amends Section 19, Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes) by establishing that a licensed psychological associate who is in good standing with the Board may practice independently, notwithstanding any other provisions of this Act. SECTION 3. Amends Section 19A(1), Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes) as follows: Subdivision(1)(2) changes the supervision requirements for psychological associates from less than five years of practice to less than two years. Subdivision(1)(7) makes conforming changes. SECTION 4. Amends Section 21(a)(2), Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes) by adding master's program and master's degree as criteria for any person licensed as a psychologist and who receives compensation for services. SECTION 5. Establishes that the effective date of this Act is September 1, 1997. SECTION 6. Subsection (a) establishes that a person may be licensed as a psychological associate without an examination if the person applies by September 1, 1998 and fulfills the requirements as defined in this subsection. Subsection (b) allows the board to create rules to waive the educational and experience requirements of Subsection (a) of this section and allow a person to receive a license as a psychological associate without an examination if the person is (1) a school psychologist certified by a national organization recognized by the board, or (2) a licensed specialist in school psychology under Section 26, Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes). Subsection (c) allows a person licensed under this section to practice psychology independently without complying with any other requirements of the Psychologists' Certification and Licensing Act (Article 4512c, Vernon's Texas Civil Statutes). SECTION 7. Emergency Clause.