Proposed Changes to MRSS Rules – 5122-29-14

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) has proposed changes to its Mobile Response and Stabilization Service (MRSS) rule, O.A.C. 5122-29-14.

A summary of the proposed changes includes:

  • Requirements that a qualified behavioral health specialist (QBHS) or certified peer supporter who participates on an MRSS team receive MRSS training from a training program identified by OhioMHAS before the provision of MRSS. Also specifies that QBHSs and certified peer supporters are to receive at least one hour of supervision each week from a clinician identified in current O.A.C. 5122-29-30 regardless of whether the QBHS or certified peer supporter is working in an individual or group setting.
  • Requirements that an MRSS provider achieve a passing benchmark score (specified on https://mrssohio.org) on each annual fidelity review and that an individual or organization conducting a fidelity review utilize the MRSS individual provider fidelity rating tool, available at https://mrssohio.org/.
  • Requirements that an MRSS provider to participate in ongoing MRSS quality improvement activities that include the provider collecting required data and submitting all of that data to OhioMHAS through the MRSS data management system.
  • For three years after the effective date of the amendment to the rule, requires that an MRSS provider provide MRSS, at a minimum, between the hours of 8 am and 8 pm, Monday through Friday, including holidays. Also requires that a caller that contacts the MRSS provider outside of the provider’s operational hours be provided with after-hours telephonic crisis de-escalation support and be scheduled for a mobile response the next business day. After three years, then requires the provider to provide MRSS 24 hours a day, seven days a week, including holidays.
  • Requires that an initial response be conducted by at least one of the following:
    1. A clinician identified in O.A.C. 5122-29-30 who holds a valid and unrestricted license issued by any Ohio professional licensing board that includes a scope of practice for behavioral health conditions. (This clinician may be an independently licensed supervising practitioner, but that is not mandatory.)
    2. A clinician described in (a), above, and either (i) a QBHS, (ii) a certified family peer supporter, or (iii) a certified youth peer supporter.
    3. A combination of at least one QBHS and either (i) another QBHS or (ii) another certified peer supporter.

Also generally requires that if a clinician described in (a), above, is not part of the initial response, there is to be immediate access to one by telehealth and a clinician must provide follow-up consultation within 72 hours of the initial response.

  • Regarding de-escalation services, requires that administration of the Ohio Children’s Initiative Brief Child and Adolescent Needs and Strengths (CANS) assessment be performed by a provider who is a certified CANS assessor if at least one of three criteria is present.
  • Requires an MRSS provider to attempt to contact the parent, guardian, or custodian of a minor to which the provider intends to provide MRSS for the purpose of obtaining that individual’s consent for all three activities of MRSS. Specifies that it is only mandatory, however, for a provider to obtain the consent of the minor’s parent, guardian, or custodian for the activity of stabilization.
  • Clarifies that MRSS may be delivered using a telehealth modality when clinically appropriate.

Comments on the proposed rule were due to OhioMHAS by October 18th. The Ohio Council submitted comments and feedback on the new MRSS Rules to both The Ohio Department of Medicaid (ODM) regarding proposed changes to MRSS Rules found in OAC Rules 5160-27-13 and 5160-27-03, as well as to The Ohio Department of Mental Health & Addiction Services regarding the proposed changes to the MRSS Rules found in OAC 5122-29-14.

As OhioMHAS and ODM review stakeholder feedback, we will continue to monitor any updates to the proposed MRSS rules and will keep Ohio Council members informed of any modifications or future opportunities to provide input.