BHEC Systems and Processes vs Smoky Backroom Deals
Systems and processes vs smoky backroom deals. That's the current chatter, primarily in the self-educating Facebook counseling groups, about why the professional board members don't have the same sway in complaint decisions in the BHEC era as they did during the DSHS days. Several of our members have asked recently about my thoughts and the following was my reply to them and I thought I'd share my fact-based perspective with you. The background is most important.
WHY We Left DSHS
In 2017 the Texas Sunset Commission (TSC) determined and publicly declared that DSHS was an administrative nightmare and excoriated all four DSHS boards for "not doing anything right". There was not one thing they did well, not one. I have over four years of direct and personal experience with them to attest to that.
TSC actually contemplated the dissolution of each board for a number of reasons. These included, but was not limited to, their lack of consistent protocols in the primary duty areas of 1) public protection 2) licensing and 3) complaint resolution. Licensing was taking many, many months and many cases were measured in years. Complaint resolution was even worse.
All four boards demonstrated a lack of consistent penalties for licensee offenses. Two licensees with the same infraction received different outcomes. One received a slap on the hand, the other lost her license, all depending on who you knew at DSHS and whether or not you could afford to hire an attorney who might know someone on the board. You could negotiate your way out of a penalty at the expense of public safety because there was no standard in place, no consistency of process other than a consistent back-room protocol.
TSC's guiding narrative here was that a failure to perform their primary functions was a massive failure to protect Joe Citizen which was, and remains, the primary directive. We needed to clean house.
TSC Did Two Things
TSC demanded that DSHS clean up its house to stop the immediate bleeding, and recommended that a new governing infrastructure (a new agency; BHEC) be put into place.
A 13-point checklist and a deadline were decreed under the threat of punitive action that would see the dissolution of mental health licenses. One of those demands was to set up a "penalty matrix" which would largely eliminate the subjective aspects of warranted punitive complaint outcomes, and inject much needed consistency in the process. All four boards completed all items on the triage checklist including the penalty matrix's development requirement.
Why the Penalty Matrix is So Important
The penalty matrixes were deliberately designed to reduce complaint processing times, to offer fair and just consistency to the complaint process, and not bother the board members during every single informal conference (IC).
This is the primary point over which the FB dialogue is raging; the penalty matrix has removed the good ol' boy, backroom dealing aspects of the punishment phase of the complaint process. Those who used to enjoy and exercise this opportunity to subjectively influence outcomes don't like that one bit.
HOW We Got to BHEC
TSC then determined that a new governing house needed to be set up. We would either be governed by TDLR, which was my preference, or a new governing agency (BHEC) would be created.
I testified at meetings, against the formation of BHEC for several reasons, one of which was that entities and individuals which had enjoyed proxy control of hearing outcomes wanted a big say in how things would be set up and run in the new governing body. I didn't want that. It did not make sense to me why self-governance was even on the table if all four boards got an "F" in all categories at DSHS! We needed established, proven systems and leadership that could be had overnight through TDLR.
Nevertheless, TSC established BHEC through legislative action and the new agency opened in Sept of 2019. In hindsight, I was wrong and here's why. BHEC was designed with system, process, and checks & balances in place, infrastructure and process which greatly alleviated my concerns about 3rd-party influence in the development and on-going operation of the new agency. TSC and the legislature did that.
The parties complaining online in the FB Groups still have the same opportunity to express themselves at public meetings and through written submissions like everyone else. It's not a perfect system but it's light-years ahead of what we had at DSHS.
On Board Involvement and the FB Kerfluffle
I think counselors are waking up and learning that if the BHEC complaint process determines there was a legitimate violation, and there is a penalty for that in the matrix, it will be enforced. BHEC will not deviate or renegotiate. They are following Texas Sunset Commission requirements so they don't run into trouble with TSC at renewal time. The system is working thanks in large part to the agency's Executive Director Darrel Spinks and his staff.
There has always been board involvement during the initial complaint when BHEC needs a consult, and at the informal conference level as needed, and that will continue. The revised rule in question, the catalyst for the online dialogue, still allows for board member input. Again, BHEC does include a professional board member as needed but the Board member cannot override or veto the Penalty.
Here's the Bottom-Line
Under the DSHS umbrella our four boards were wild-west, runaway back-room deal operations that didn't have public safety as their main focus. Those parties both internally and externally who enjoyed proxy control had it taken away from them with the creation of BHEC and its well-run, legislatively mandated systems, and they don't like that.
Counselors, you may still hire an attorney to plead your case before your licensing board but please be aware their subjective powers of persuasion have been cobbled, superseded by the Penalty Matrix, put in place for this very reason. The era of rogue agency operation is over.
Make sense?
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