QMHP- QUALIFIED MENTAL HEALTH PROFESSIONAL ????

QMHP- ????

QMHP is a designation that was initially created by the Department of Behavioral Health and Developmental Services (DBHDS).  The Virginia Department of Medical Assistance Services (DMAS-also known as Medicaid) defined services delivered by a QMHP as reimbursable.  The licensing part of the DBHDS required contractors to maintain documentation in the personal files of each QMPH that documented the employee met the requirements.  DMAS conducted an audit and found that such documentation was lacking in many situations.  This led to a collaborative effort by DMAS, DBHDS and the Department of Health Professions (DHP) to have legislation passed that required all persons with the designation of QMHP to be registered with the Board of Counseling (one of 23 health regulatory boards in the DHP). The Board of Counseling (BOC) drafted proposed regulations.  As part of that process, they filed an Agency Background Statement that stated the purpose of the regulations (See below).

This regulation is the result of collaborative efforts by DHP, DBHDS, DMAS, private providers, and other licensing boards to address concerns about the use of unlicensed and unregistered persons in the provision of services to clients and the lack of accountability for those services.

DBHDS has been working with DHP to make titles and definitions for mental health professionals more consistent with licensure and certification under health regulatory boards, but there remained a large group of "qualified" mental health professionals who have no such oversight. The intent of the regulation was to establish a registry of QMHPs, so there is some accountability for their practice and a listing of qualified persons for the purpose of reimbursement by DMAS.

 

The purpose of the registration is to address concerns jointly expressed by DHP, DBHDS, and DMAS about the lack of oversight and accountability for persons who are providing mental health, but who are not responsible to a health regulatory board with authority to take disciplinary action. By requiring a person who works as a QMHP in a program approved by DBHDS, to be registered by the Board of Counseling, persons who have been disciplined and removed from the registry would no longer be able to be employed in that capacity. The purpose is greater protection for the public and a reduction in the incidents of abuse and fraud in Medicaid-funded programs.

(Agency Background Statement, submitted June 14, 2019.)

 

The key word is “accountability.”  In the legislation the definitions for QMHP- Adult and QMHP-Child are clearly defined with the requirement for this designation to only be available to the following: 

“...A qualified mental health professional-adult shall provide such services as an employee or independent contractor of the Department of Behavioral Health and Developmental Services or the Department of Corrections, or as a provider licensed by the Department of Behavioral Health and Developmental Services…”

There was a “grandfathering in” process:

The General Assembly authorized the Board of Counseling in 2017 to register Qualified Mental Health Professionals (QMHPs). Effective January 3, 2018, individuals are able to apply for QMHP registration by submitting an online application, fee paid online and supplemental documentation with the Board of Counseling. DMAS and DBHDS require all QMHP-A, QMHP-C and QMHP-Trainee staff to be registered with the Board of Counseling in order to provide services and to be reimbursement for such services. (Please note that QMHP credential is a registration and not a license.) Grandfather Provision within the Regulations expired on 12/31/2018.

https://www.dhp.virginia.gov/Boards/Counseling/ApplicantResources/QMHPInformation/

 The Quarterly Report for the 2^nd quarter of FY 2019 (October 2018 to December 31, 2018) listed the number of QMHPs as 11, 205 that were “Grandfathered in” as QMHPs. The Quarterly report ending on March 31, 2023, shows that in just 6 years the QMHP has become the largest group regulated by the Board of Counseling (20,302). All the other groups regulated by the Bboard of Counseling combined (18,489) equal less than the number of QHMP’s. The QMHPs are now 37% of the discipline cases for the BOC.

There are groups advocating for less stringent regulations for the QMHPs and other groups advocating for the Board of Counseling to hold firm to the accountability goal that was the purpose of the regulations.

DMAS policy is to reimburse QMHP’s for provides collaborative mental health services.”  The regulations for the QMHP defines “Collaborative Mental Health Services:

“… means those rehabilitative supportive services that are provided by a qualified mental health professional, as set forth in a service plan under the direction of and in collaboration with either a mental health professional licensed in Virginia or a person under supervision that has been approved by the Board of Counseling, Board of Psychology, or Board of Social Work as a prerequisite for licensure. 

I have not found a definition in the Code of Virginia or in the QMHP regulations for “rehabilitative supportive services”.  Usually when a term is not defined then it is assumed to mean what the term means in everyday language.  I think the regulations purposely left the wording to be broad.  The more key part of the definition is “…, as set forth in a service plan under the direction of and in collaboration with…”  The QMHP is to be held accountable to provide services in collaboration with a licensed mental health professional.  The QMHP designation only can be used in settings that provide this oversight.