ORGANIZATIONAL PROVIDER AUDIT TOOL

The following is part of the intake paperwork filled out and signed by each new incoming member:

Member Rights and Responsibilities

Welcome to our facility.

As a participant receiving mental health services, you have certain rights, some defined by law, others by professional ethical codes, and others by the policies of this agency. You have the right to be fully informed of your rights and to have any questions answered about things you do nor understand.

YOUR RIGHTS INCLUDE:

• The right to decide on the provider you want to obtain services. It is our policy to provide services requested and to assist participant in finding another agency if they so desire.
• The right to be treated with dignity and respect.
• The right to a safe environment during behavioral health services, free from physical, sexual, or emotional abuse and from discrimination on the basis of race, gender, age, religion, national origin, or sexual orientation.
• The right to be informed about the professional qualifications of the providers involved in your treatment, and to be treated only by persons who are trained and qualified to provide treatment.
• The right to be informed about you or your child's mental health services, including potential benefits, the scientific basis for treatment recommendations, any risks that treatment might involve, and what alternatives there might be.  This includes the right to be informed of the potential benefits and prospects of success of any treatment, the possible side effects of any medication and of the risks of any counseling procedure.
• The right to participate in planning and making decisions about you or your child's treatment.
• The right to refuse any particular medication or treatment technique or to withdraw from treatment at any time.  If you request referral to another behavioral health worker, we will provide you with a list of qualified professionals.
• The right to be informed in writing about fees, payment methods, co-payments, and frequency and duration of sessions and treatments.
• The right to have access to your treatment plan, mental health assessment, and to be informed of your diagnosis, prognosis, and progress in treatment.
• The right to privacy and confidentiality in your treatment, including the right to know if your behavioral health worker will discuss your case with supervisors or colleagues.
• The right to have your clinical information released to any person or agency of your choice.
• The right to register a complaint if you are dissatisfied with your treatment, without fear of retaliation. You have the right to be assisted in filing a grievance if your need assistance.

Scientific research show that behavioral health services have helped many people, and that most people who engage in behavioral health services are helped by it, but success is never guaranteed.  There are some risks as well as benefits.  It is important that you know that, as problems are faced, they may seem to get worse before they get better.  As you learn new ways of thinking and acting, you may make choices which may lead to conflict with others in your life.  We will try hard to limit these risks, and to help you cope with any distress you encounter, but even positive change can be difficult and sometimes painful.

As a participant, you also have responsibilities.  For behavioral health services  to be successful, you must be an active participant.  This means maintaining a consistent schedule with your behavioral health worker, talking openly to your therapist and/or other behavioral health worker about your concerns, and sometimes practicing new skills between sessions.  It is your responsibility to call 24 hours in advance if you must cancel an appointment.  It is also your responsibility to let us know of any changes in insurance companies or benefits, or of other factors that might affect your ability to pay for treatment.

Member and Family Education and Involvement

Our facility will involve the member and their family when applicable and appropriate at the time of assessment in the treatment provided. This will be true of all treatment modalities provided by our facility.

The staff assigned to provide treatment will educate the member and family members about the modalities of services, benefits and risks of treatment, and provide for education about medications by appropriate professionals.

INFORMED CONSENT TO MENTAL HEALTH TREATMENT

Welcome to our facility. 

As a participant receiving mental health services, you have certain rights, some defined by law, others by professional ethical codes, and others by the policies of this agency. You have the right to be fully informed of your rights and to have any questions answered about things you do not understand.

YOUR RIGHTS INCLUDE:

The right to decide on the provider you want to obtain services. It is our policy to provide services requested and to assist participant in finding another agency if they so desire. 

The right to be treated with dignity and respect.

The right to a safe environment during services, free from physical, sexual, or emotional abuse and from discrimination on the basis of race, gender, age, religion, national origin, or sexual orientation. 

The right to be informed about the professional qualifications of the providers involved in your treatment, and to be treated only by persons who are trained and qualified to provide treatment. 

The right to be informed about you or your child’s behavioral health services, including potential benefits, the scientific basis for treatment recommendations, any risks that treatment might involve, and what alternatives there might be. This includes the right to be informed of the potential benefits and prospects of success of any treatment, the possible side effects of any medication and of the risks of any counseling procedure.

The right to participate in planning and making decisions about you or your child’s treatment. 

The right to refuse any particular medication or treatment technique or to withdraw from treatment at any time. If you request referral to another provider, we will provide you with a list of qualified professionals. 

The right to be informed in writing about fees, payment methods, co-payments, and frequency and duration of sessions and treatments. 

The right to have access to your records, and to be informed of your diagnoses, prognosis, and progress in treatment.

The right to privacy and confidentiality in your treatment, including the right to know if your provider will discuss your case with supervisors or colleagues. 

The right to have your clinical information released to any person or agency of your choice. 

The right to register a complaint if you are dissatisfied with your treatment, without fear of retaliation. You have the right to be assisted in filing a grievance if you need assistance. 

Scientific research shows that behavior health services have helped many people, and that most people who engage in services are helped by it, but success is never guaranteed. There are some risks as well as benefits. It is important that you know that, as problems are faced, they may seem to get worse before they get better. As you learn new ways of thinking and acting, you may make choices which may lead to conflict with others in your life. We will try hard to limit these risks, and to help you cope with any distress you encounter, but even positive change can be difficult and sometimes painful. 

As a participant, you also have responsibilities. If behavioral health services are to be successful, you must be an active participant. This means maintaining a consistent schedule with your service provider, talking openly to your provider about your concerns, and sometimes practicing new skills between sessions. It is your responsibility to call 24 hours in advance if you must cancel an appointment. It is also your responsibility to let us know of any changes in insurance companies or benefits, or of other factors that might affect your ability to pay for treatment. 

Member and Family Education and Involvement

Our facility will involve the member and their family when applicable and appropriate at the time of assessment in the treatment provided. This will be true of all treatment modalities provided by our facility.

The staff assigned to provide treatment will educate the member and family members about the modalities of services, benefits and risks of treatment, and provide for education about medications by appropriate professionals.

Confidentiality and Disclosure
All worksite associates with access to confidential information may not use that information for personal gain. Once an associate becomes separated from our facility he or she is not allowed to divulge or use any of the our facility worksites’ confidential information or trade secrets directly, or indirectly, personally, or on behalf of any other person, business, or corporation or entity. Such confidential information includes, but is not limited to, the following examples:

• Patient Information
• Customer Lists
• Corporate Strategies
• Financial/Accounting Information
• Manual of Operations
• Marketing Strategies
• Personnel Data
• Pending Projects
• Research & Development Information and Strategies

Worksite Associate Information

Inappropriate disclosure of proprietary and/or confidential information of inappropriate removal of records may result in disciplinary action up to and including termination and legal action for damages.

The following is included in our intake paperwork and is to be signed by each incoming prospective member.

Mental Health Clinic Services: HIPAA & Confidentiality (Medicaid Provider Agreement Page 1 of 3.1. Compliance):

• Our facility will ensure accurate documentation regarding HIPAA Privacy Statement
• Our facility will define what a participant’s right entails in their medical record
• Our facility will ensure the clinic observes confidentiality practices
• Our facility will ensure standard employee confidentiality agreement
• Our facility will ensure that clinical medical record information is available to employees on a need-to-know basis
• Our facility will ensure the definition and documentation for violations of confidentiality
• Our facility will ensure accuracy in reporting HIPAA violations.  This policy should include internal investigations and resolution and also show ability for anyone in the clinic, participant or employee to report to the Federal Government
• Our facility will ensure the clinic’s security (e.g., double-locked clinical files)
• Our facility will ensure a safe electronic exchange of Protected Health Information
• Our facilitywill ensure a contingency plan for responding to emergency or disaster that damages systems that contain Protected Health Information.

The privacy of your treatment is protected by federal and state laws, as described in the Notice of Privacy Practices statement you have received. Because we are obligated by law and professional ethics to protect you and other members of society from harm, there are circumstances under which your right to confidentiality may be limited:

If we learn of an imminent danger to someone’s life or health (such as threat of suicide or homicide);

If we learn that a child or other vulnerable person is being abused or neglected;

If we learn that a communicable disease (such as HIV) may be transmitted and the person at risk has not been informed;

If we are ordered by a court to divulge information about you;

If a medical emergency occurs while you are at the clinic, we will share just enough information with medical personnel to ensure that you receive needed treatment.

STATEMENT OF INFORMED CONSENT

I have carefully read or had read to me the above statement of my rights and responsibilities as a participant in mental health treatment. I have also had a chance to ask questions and obtain additional information needed to make a decision about entering mental health treatment. By my signature, I certify that my options for mental health services have been explained to me including a choice of who provides these services. I freely give my informed consent to receive mental health treatment from our facility and acknowledge that I have been given a copy of this statement.

Computers and Related Equipment
In order to use company computers, telephones, and mail systems worksite associates must agree to abide by the company electronic, telephone and mail systems following policies. Any employee found acting in a manner inconsistent with this policy may be subject to discipline up to and including termination.

Computer Use
Worksite associates agree to use the computers for business purposes only and will not use them for personal use. Furthermore, associates are forbidden to use the computer for improper, derogatory, defamatory, obscene, or other inappropriate purposes. In addition, Our facility reserves the right to monitor use of its computers at any time. Inappropriate use of the computers may result in disciplinary action up to and including termination. Instant messaging must be used for business purposes only and is strictly prohibited in the workplace unless your job duties permit otherwise.

Telephone Use
Our facility understands that employees may have a need for personal phone calls during working hours. As a public service business we must ensure that associate personal phone calls do not interfere with customer care or work processes.

Employees will limit the number of personal phone calls made and received from business phones during work hours.

Personal calls will be made only during breaks and not during work hours except in emergencies. If an associate is found to be deviating from this policy, he/she will be subject to disciplinary action, up to and including termination.

Cellular Phone Use
Cellular phones may be provided to associates to improve customer service and to enhance business efficiencies. Cellular phones are not a personal benefit and shall not be a primary mode of communication, unless they are the most cost-effective means of conducting business.

Associates are responsible for operating client-owned vehicles and potentially hazardous equipment in a safe and prudent manner, and therefore, associates should refrain from using cellular phones while operating such vehicles and equipment.

Possessing a cellular phone is a privilege and all associates are expected to use them responsibly. Our facility may seek reimbursement for any additional charges resulting from personal calls. Cellular phones with photographic capabilities are to be used for business purposes only. Misuse of a client cellular phone may result in its revocation and possible disciplinary action up to and including termination.

Mail Systems
The mail system is reserved for business purposes only. Associates should refrain from sending or receiving personal mail at the workplace.

Personal Cellular Phones and other Electronic Devices
Personal cellular phones and other personal electronic devices are common items in the work environment and have significantly enhanced the way individuals communicate, gather information, and access entertainment. These items may include but are not limited to: Cellular Phones, Digital Cameras, Blackberries, Personal Digital Assistants (PDA’s), Bluetooth Devices, MP3 devices such as iPods, or any electronic device which can perform any and/or all of these functions. Use of these devices shall be subject to the following policies:

All ringers, personal alerts, tones, and/or other notification settings shall be set to vibrate or silent. No exceptions.

No such personal device will access or be given permission has been granted by the appropriate supervisor.

No such personal device will be installed on any computer system, workstation, or server owned and operated by our facility, unless permission has been granted by the appropriate supervisor.

Internet browsing, excessive text messaging, or any activity that disrupts workplace continuity or employee production will be subject to discipline up to and including termination.

Any employee who brings an electronic device which is found to have improper, derogatory, defamatory, obscene, or other inappropriate material or media open to the public or an employee will be subject to discipline up to and including termination.

The unapproved use of any digital imaging device such as digital cameras, camera phones, or digital recorders is prohibited. Those found to have violated this policy will be subject to discipline up to and including termination.

There is signage by the road and also at our entrance.

Security: All individuals entering our facility must first check in with the administrative/office staff located in the reception area. Suspicious behaviors or concerns are to be brought to the attention of our facility's staff to assess potential risks. If a consensus of danger/risk is determined, immediate alerts will be placed to local law enforcement and our facility executive management.

Toxic Substances:  Our facility will ensure hazards or toxic substances are properly labeled and stored under lock and key. 

Procedure for cleaning up blood or bodily fluids on hard surfaces:

Blood, vomit and feces may contain germs that can cause serious infections. People who clean blood and other bodily fluids should reduce the risk of infection to themselves and others by following these procedures: 

Procedure for Blood Spills/Vomit/Feces

1. Wear appropriate personal protective equipment, such as disposable gloves when cleaning up a spill. If the possibility of splashing exists, protective eyewear and a gown should be worn. Eye glasses are not considered to be protective eyewear. 

2. Dispose with care, any broken glass or sharps into a puncture-proof container. If available, disposal of sharps into an approved sharps container for biomedical waste is preferred. 

3. Clean the spill area with paper towel to remove most of the spill. Disinfectants cannot work properly if the surface has blood or other bodily fluids on it. Cloth towels should not be used unless they are to be thrown out. 

4. Discard the paper towel soaked with the blood, vomit, feces or fluid in a plastic-lined garbage bin. 

5. Care must be taken to avoid splashing or spraying during the clean up  process. 

6. Clean the affected area with soap and water then disinfect with a 1:10 bleach solution for 10 minutes or an appropriate disinfectant with proven effectiveness against non-enveloped viruses (eg. Poliovirus, Norovirus, Rotavirus, Feline Calicivirus). Refer to the manufacturer’s label to ensure the disinfectant is left on the contaminated surface for the correct contact time. With bleach, this would mean the surface stays wet for at least 10 minutes. 

7. Ventilate the room well when using a bleach solution. Make sure it is not mixed with other cleaning agents. 

8. Wipe the treated area with paper towels soaked in tap water. Allow the area to dry. 

9. Discard contaminated paper towels, gloves and other disposable equipment in a plastic lined garbage bin. Immediately tie and place with regular trash. Take care not to contaminate other surfaces during this process. Change gloves if needed. 

10. Practice hand hygiene, either with soap and water or an alcohol-based hand rub of at least 60% concentration, for 15 seconds after gloves are removed. If the hands are visibly soiled, then soap and water should be used over a hand rub. 

11. If an injury occurs during the cleaning process, such as a skin puncture with a blood-contaminated sharp object, seek medical attention immediately. Any occurrence that takes place in a workplace should be reported to the occupational health and safety representative. 

Mixing a 1:10 Bleach Solution 

(1 cup of bleach: 9 cups of water). 

Contact time on surface is 10 minutes 

HIV and HIPAA

Idaho law does not provide increased protection of records of HIV test results.

Idaho law does not prohibit the individual testing of a person without their informed consent.

It permits adolescents to be tested for HIV without the consent of a parent.

Exception: Anonymous testing sites are exempt from the requirement that the informed consent be in writing.

The diagnosis of AIDS is PHI that can be disclosed (or must be protected) using the same standards for disclosure of all other PHI.

A signed consent is not required when HIV test results are disclosed to the following:

To the patient

To the healthcare provider designated by the patient

To a person or persons to whom the test subject has authorized disclosure in a writing

Anonymous testing sites

Court ordered disclosure

According to HIPAA, “it is not necessary to separate contents related toHIV matters in the patients medical records.

All information, e.g. test results, treatment records for AIDS, patient concerns related to HIV, psychiatric conditions related to or resulting from AIDS, may be integrated into the body of the chart.”

Remember: If a patient has not signed an authorization to disclose HIV test information contained in their medical records, it is the responsibility of the provider to remove that information before responding to a request for medical records.

In the event of an unexpected closure of our facility that would require members to seek other services, our facility administrative staff will be required to call all members.

If members cannot be reached by phone, a letter from the CEO will be mailed to the participant’s last known address advising them on options available.

Fire Extinguishers:  Our facility will ensure the presence of fire extinguishers installed throughout the facility.  Each fire extinguisher will be inspected to ensure the charge is current, have the number, type and location correct as directed by fire authority.

Fire Inspection:  Our facility will ensure clinic facilities meet all local and state codes concerning fire and life safety.  The facility will be inspected by local fire authority and pass inspection.  In absence of local fire authority inspections must be obtained by Idaho State Fire Marshall’s Office.  A copy of the inspection must be made available upon request and must include documentation of any necessary corrective action taken on violations cited.

Fire Drills:Our facility will ensure all employees engage in periodic fire drills.  At least one of these fire drills must include evacuation of the building.

Summary of Fire Drills:  Our facility will ensure the accurate documentation of a brief summary of the fire drill and the response of the employees and participants.  This must be written and maintained on file.  The summary must indicate the date and time the drill occurred, problems encountered and corrective action taken.

Electrical Installations:   Our facility will ensure all applicable local or state electrical requirements on installations.  Extensions cords and multiple electrical outlet adapters must not be utilized unless U.L. approved and the numbers, locations, and use of them are approved, in writing, by the local fire or building authority.

Portable Heating Devices:  Our facility will ensure portable heating devices are prohibited except units that have heating elements that are limited to not more than two hundred twelve (212°) degrees Fahrenheit.  The use of unvented, fuel-fire heating devices of any kind is prohibited.  All portable space heaters must be U.L. approved as well as approved by the local fire or building authority.

Exits:  Our facility will ensure all furnishings, decorations, or other objects do not obstruct exits or access to exits.

Evacuation Plans:  Our facility will ensure evacuation plans are posted in every occupied room.  The plans must include the point of orientation, location of fire extinguishers, location of fire exits and designated meeting area outside of building.

In the event an evacuation is necessary, employees performing services with a participant shall be responsible for safely evacuating that individual according to the evacuation plan.

The Administration Team Leader/ designee is charged with ensuring all individuals working and/or participating in services at the time of an emergency evacuation are present and accounted for at the designated staging area.

Members Rights are posted in waiting and care areas.

Fire Inspection: Our facility will ensure clinic facilities meet all local and state codes concerning fire and life safety. The facility will be inspected at least annually by local fire authority and pass inspection. In absence of local fire authority inspections must be obtained by Idaho State Fire Marshall’s Office. A copy of the inspection must be made available upon request and must include documentation of any necessary corrective action taken on violations cited.

Fire Extinguishers: Our facility will ensure the presence of fire extinguishers installed throughout the facility. Each fire extinguisher will be inspected to ensure the charge is current, have the number, type and location correct as directed by fire authority.

Exits: Our facility will ensure all furnishings, decorations, or other objects do not obstruct exits or access to exits.

Evacuation Plans: Our facility will ensure evacuation plans are posted in every occupied room. The plans must include the point of orientation, location of fire extinguishers, location of fire exits and designated meeting area outside of building.

Our facility is cleaned daily and deep cleaned each weekend

We have a patient waiting area that is sizable and we utilize waiting area music to help ensure audible privacy in rooms during sessions.

Our furnishings are up-to-date and professional, we used an outside decorator to establish a professional office environment. We clean the furnishings on a weekly basis.

We are very mindful of diversity and do our best to ensure our patrons feel safe and respected.

Crisis in our facility Building: In the event a crisis occurs in the our facility building, the following procedures are to be followed immediately.  Our facility administrative staff will call 911 and request for the Crisis Intervention Team (CIT) to respond if an emergency exists with a participant with mental illness or any unidentified individual.  If additional facility staff is requested for accountability/reliability purposes, a coded call to the administrative office requesting for “Johnny” is to be placed immediately.

If a concern for a potential emergency presents itself, facility staff is to contact the Police Department.  

Reporting:  All crisis situations will be reported verbally and a written incident will be completed and submitted immediately to facility's owner.

Crisis Intervention Service

Agencies are required to provide Crisis Intervention Services 24 hours a day, 7 days a week. Crisis may be precipitated by loss of housing, employment or reduction of income, risk of incarnation, risk of physical harm, family altercation or other emergencies. Staff may deliver direct services within the scope of IDAPA rules or link the participant to community resources to resolve the crisis or both.

Our program provides a 24 hour crisis phone service.

Specialists working part-time (less than 32 hours but more than 10 hours per week) and full-time (32 or more hours per week) shall take a rotation handling our facilities crisis calls.

Crisis documentation has been developed which contains information on how to handle a crisis. 

Specialists scheduled for a particular period may swap with another Specialist for that same period notifying their supervisor.

In the event the on-call Specialist encounters a situation they believe they need assistance in handling they are directed to call the provider assigned to that particular participant; second – their Team Leader; third – Program Director. In the unlikely event none of the individuals listed can be reached, the on-call Specialist is free to call any experienced provider on the company phone list.

We offer non-life threatening emergent care within 6 hours to our members. In many instances this is provided on-site or at the members location. Our electronic scheduling system provides / allows non-life threatening appointments within a 6 hour period.

We offer urgent mental health care within 48 hours to our members. In many instances this is provided on-site or at the members location. Our electronic scheduling system provides / allows urgent care appointments to be scheduled within a 48 hour period.

We offer routine office visits within 10 working days to our members. Our electronic scheduling system provides / allows routine office visit appointments within 10 working days.

We offer 24/7 emergency response services to our members. In many instances this is provided via phone / on-site or at the members location. Our automated phone system provides our members with a crisis member 24/7. See crisis line information above (20).

Treatment Modality Criteria (Transitions & Exclusions)

1 - An Initial client intake is completed

2 - The client will be assigned modalities for which they qualify, that best treat their issues

For Clinical Therapy:

• Client has a mental health diagnosis and a GAF score that indicates a need for therapy
• Comprehensive Diagnostic Assessment is also completed

For Case Management:

• Client scores on the CAFAS or PECFAS when applicable indicate they will need multiple levels of care; and
• Client has mental illness that pervades three or more functional areas of their lives; and
• Problems include those that are beyond the scope and limitations of the expectations of clinical therapy alone.
• Parent/guardian requests these services after being explained the risks/benefits of this modality
• Client meets eligibility requirements for this modality of treatment based on appropriate IDAPA regulations IDAPA 16.03.10 as well as Optum Guidelines established in the Provider Manual
•  Clinical therapist may recommend case management for the member and parent/guardian or member accepts this recommendation after therapy has begun due to need.
• Comprehensive Diagnostic Assessment states or is amended to state that these services are necessary for the member's current needs.
•  When a client achieves the goals outlined for this service modality.  A discharge summary is completed with appropriate referrals outlining the continuing care needs of the member.

For CBRS:

• Parent/guardian requests these services after being explained the risks/benefits of this modality
• Client scores an 80 or above on the CAFAS or PECFAS which then states that they will need multiple levels of functioning; and
• Client has mental illness that pervades three or more functional areas of their lives; and
• Problems include those that are beyond the scope and limitations of the expectations of clinical therapy alone.
• Client meets eligibility requirements for this modality of treatment based on appropriate IDAPA regulations IDAPA 16.03.10 as well as Optum Guidelines established in the Provider Manual
• Clinical therapist may recommend CBRS services for the member and parent/guardian or member accepts this recommendation after therapy has begun due to need.
• Comprehensive Diagnostic Assessment states, or is amended to state that these services are necessary for the member's current needs.
• When a client achieves the goals outlined for this service modality.  A discharge summary is completed with appropriate referrals outlining the continuing care needs of the member.

Our facility will adhere to IDAPA rules as well as Optum guidelines pertaining to the requirements and exclusionary criteria for these service modalities. All clients or designated caregivers will be notified of their eligibility for these services as well as reasons or regulations that may exclude them from obtaining these services.

Members will be notified of their eligibility for these services as well as the expectations of these services.

Members may stop services at any time for any reason and may attempt to start these services once again at any time. Our staff will assist members in accessing the services required to meet the needs of the individual and family (when applicable). Services rendered or recommended will be the least restrictive to meet the needs of the member and also may be deemed medically necessary for the member.

Members may be excluded from services due to not meeting the requirements established for these services. These exclusions may be due to - not meeting medical necessity, possible duplication of services, or not being the least restrictive level of care required. Refference - • For all levels of care, services must be for the purpose of diagnostic study or reasonably be expected to improve the patient’s condition. The treatment must, at a minimum, be designed to reduce or control the patient’s psychiatric symptoms so as to prevent relapse or hospitalization, and improve or maintain the patient’s level of functioning.
o It is not necessary that a course of therapy have as its goal restoration of the patient to the level of functioning exhibited prior to the onset of the illness, although this may be appropriate for some patient. For many other psychiatric patients, particularly those with long-term chronic conditions, control of symptoms and maintenance of a functional level to avoid further deterioration or hospitalization is an acceptable expectation of improvement. “Improvement” in this context is measured by comparing the effect of continuing treatment versus discontinuing it. Where there is a reasonable expectation that if treatment were withdrawn the patient’s condition would deteriorate, relapse further, or require hospitalization, this criterion is met.

In addition to the above, for outpatient services, some patients may undergo a course of treatment that increases their level of functioning but then reach a point where further significant increase is not expected. Such claims are not automatically considered non-covered because conditions have stabilized, or because treatment is now primarily for the purpose of maintaining a present level of functioning. Rather, coverage depends on whether the criteria discussed above are met; for example, that stability can be maintained without further treatment or with less intensive treatment.

Our facility will review member progress as required by IDAPTA rules and any and all requirements of member insurance carrier. At any time, member may terminate services or no longer meet requirements by these services. At this time the assigned worker will complete a transition of care summary for the member to include any outpatient or additional services member may continue to need. Staff will ensure continuing care needs are addressed through the completion of the transition of care summary .

Continuation of Services:

Our facility will ensure intermittent individualized treatment plan reviews are conducted when medically necessary.

Our facility will ensure intermittent individualized treatment plan reviews be conducted at least every 90 days with the participant or their legal guardian

Our facility will ensure the staff providing the services, the member, and any other members of the participant’s interdisciplinary team as identified by the participant or by their parent/legal guardian will review the progress the member has made on objectives. They will also identify objectives that may be added, amended, or deleted from the individualized treatment plan. The attendees of the treatment plan review are determined by the member or their legal guardian and agency staff providing the services. They may also identify at this time, that the member has met the discharge criteria. If no other functional impairment is identified, or if identified, does not significantly impact daily functioning, Our facility staff and member and their parent or legal guardian may establish time-line for discontinuation of services.

Our facility will ensure continuation of services after the first (1^st) year based on documentation of the following:

Description of the ways the participant has specifically benefited from mental health services

Why the participant continues to need additional services

The participant’s progress toward the achievement of therapeutic goals that would eliminate the need for the service to continue.

Continuing Stay Criteria
The admission criteria continue to be met and active treatment is being provided. For treatment to be considered “active”, service(s) must be as follows: o Supervised and evaluated by the admitting provider; Provided under an individualized treatment plan consistent with Common Clinical Best Practices; Reasonably expected to improve the member’s presenting problems. AND
The factors leading to admission have been identified and are integrated into the treatment and discharge plans. AND
Clinical best practices are being provided with sufficient intensity to address the member’s treatment needs. AND
The member’s family and other natural resources are engaged to participate in the member’s treatment as clinically indicated and feasible.

Discharge Criteria
The continued stay criteria are no longer met. Examples include:

The member’s condition no longer requires care.
The member’s condition has changed to the extent that the condition now meets admission criteria for another level of care.
Treatment is primarily for the purpose of providing social, custodial, recreational, or respite care.
The member requires medical/surgical treatment. After an initial assessment the member is unwilling or unable to participate in treatment despite motivational support or intervention to engage in treatment, and involuntary treatment or guardianship is not being pursued.

Our facility will ensure each individualized treatment plan is reviewed, updated and signed by a physician at least annually.

Assessments

Our facility will comply with all Assessment criteria for Services as documented in Idaho Code and Optum Provider manual. Appropriate staff will complete the Assessment as required and described below if one has not already been completed. If an assessment was completed at another agency, our facility will obtain a copy of the assessment through use of appropriate releases and requests for information. The assessment will be reviewed to ensure it meets the criteria. If the assessment does not meet the criteria a clinician at the our facility will be assigned to obtain the information required to obtain the missing information.

The assessment will be used as a tool in identifying areas of need for the member and developing treatment plan of services for the member's needs.

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

29. Current behavioral/emotional functioning of the member including history of emotional, behavioral and substance abuse problems or treatment, use of alcohol or other drugs by member or the member's family, and the member's maladaptive or problem behaviors.

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

30. Presenting problems, relevant psychological and social conditions affecting the member's psychiatric and medical status

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

31. Reasons for treatment or admission into a treatment program

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

32. Psychiatric and medical history including previous treatment dates, identify the treating clinician data, relevant family information, results of any laboratory tests and consultation reports.

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

33. Learning needs or barriers to learning, level of functioning and/or functional impairment

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

34. Mental status exam to include affect, mood thought content, judgment, insight, attention, concentration, memory and impulse control.

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

35. Risk assessments

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

36. Community resources used by the member and/or family

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

37. Extent of family's participation in treatments

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

38. Vocational, spiritual, cultural, educational and legal history, issues and influences on the member

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

39. Medical history. When the assessment is completed by our facility staff and appropriate release will be given to obtain consent to obtain necessary medical records and share information from the primary care physician. The assessor will remind member or caregiver to meet with their Primary Care Physician yearly for the Annual History and Physical exam as needed. Our facility will request via fax any information required from the member's PCP with appropriate releases signed by member or guardian.

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

40. Identify and list prominently relevant medical conditions

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

41. Identify any known or reported infectious diseases

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

42. Allergies to medications and other substances(if any)

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

43. Identification of specific services to be provided to children and adolescent members when applicable

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

44. Identification and treatment of chemical dependence when applicable

The CDA included in the Simply Clinical EMR includes all of the points discussed in items 29-38, 40-45. Our facility will ensure that clinicians who perform the CDA will complete the form adequately through a review process performed by a member of the staff as well as requirements included in the form itself.

The Assessment will be completed prior to services being rendered and include the following criteria:

Type of care to be provided and the need for further assessments, ie. Psychological assessments and evaluations as well as yearly updates.

45. The CDA will be used to directly determine the treatment plan and what if any additional services will be recommended for the member

Level of Care Determination

The outcomes for progress identified on each participant's treatment plan for the service are achieved or are modified due to changes in circumstances, abilities, or a reassessment to ensure that the scope, amount and duration of services provided are no more than is medically necessary.  This will be determined during weekly supervision between our CBRS worker and/or Case manager and Clinician.  Reviews for each member's treatment plan will be conducted every 90 days by the appropriate staff.

Medications

Our facility will document in member's chart current medication the member is prescribed as well as the prescribing physician as part of the CDA.

Our facility will document name, dosage, and refills of all medications the members are prescribed as well as the pharmacy where these prescriptions are refilled as part of the CDA.

Case manager will make contact with prescribing physician and pharmacy at the time of initiation of services and at each time of refill to ensure medications are being taken as prescribed and to be aware of any medication recalls or side-effects that may impact the member.

The Consent to Treatment for our facility states:

I, the member or guardian of the member on this treatment plan, have participated in the development of this plan and I agree that it reflects my goals for change through mental health treatment. The procedures to be used have been explained, with their potential risks and benefits including the risks of refusing treatment. I have been offered education relating to care options, participating in care and prognosis and outcomes of that care. I have had the opportunity to ask questions about anything that may be unclear to me. I understand that I will be consulted and participate in any changes to this treatment plan, as well as in periodic reviews of my progress toward the stated goals. I understand that I may terminate treatment at any time and be referred to another provider. I consent to receive mental health treatment under this plan at Our facility.

This information is on all of our treatment plans and is acknowledged by signature by all members or guardians.

Quality Management

Supervising therapists and Management meet regularly

Ensure quality services are provided based on weekly supervision of staff

Identify problems with staff and/or clients in treatment.

• provide solutions to these problems
• Redirect staff as needed to ensure quality services
• Contact clients/parent or guardian to review changes to services
• Risk management for clients with issues that are potentially dangerous to self and/or others as well as develop appropriate plan of intervention for each as they occur.
• Assign clients to staff based on client needs and staff strengths
• Review Adverse problems and situations that have occurred throughout the week.
• Supervising Therapist reviews all Incident reports weekly to ensure staff follows through with protocols put forth by our facility.
• All therapists meet weekly to discuss problems and successes and provide feedback to each other on their cases.
• CBRS staff attend staff meetings with clinical supervisor and director to ensure treatment plans, policies and procedures and rules and regulations are followed.

Clinical supervision meetings status check:

For review purposes to determine if services are still wanted, needed and appropriate.

To receive feedback on the satisfaction of services

To make any changes needed on service plans and update assessments

Review progress (or lack thereof) with the client/parent or guardianship

Discharge planning

Owners review all grievances as they are submitted and determine any action needed to take.

Critical Incidents

Methodology:

To improve the overall quality of care provided to our members, Optum Idaho employs peer reviews for occurrences related to members that have been identified as potential critical incidents.

Our facility will report potential Critical Incidents to Optum Idaho within 24 hours of being made aware of the occurrence. A Critical Incident is a serious, unexpected occurrence involving a member that is believed to represent a possible Quality of Care Concern on the part of the provider or agency providing services, which has, or may have, detrimental effects on the member, including death or serious disability, that occurs during the course of a member receiving behavioral health treatment. Optum Idaho classifies a Critical Incident as being any of the following events:

• A completed suicide by a member who was engaged in treatment at any level of care at the time of the death, or within the previous 60 calendar days.
• A serious suicide attempt by a member, requiring an overnight admission to a hospital medical unit that occurred while the member was receiving treatment services.
• An unexpected death of a member that occurred while the member was receiving agency based treatment or within 12 months of a member having received MH/SA treatment.
• A serious injury requiring an overnight admission to a hospital medical unit of a member occurring on an agency ’s premises while the member was receiving agency- based treatment.
• A report of a serious physical assault of a member occurring on an agency’s premises while in agency-based treatment.
• A report of a sexual assault of a member occurring on an agency ’s premises while in agency-based treatment.
• A report of a serious physical assault by a member occurring on an agency’s premises while the member was receiving agency-based treatment.
• A report of sexual assault by a member occurring on an agency ’s premises while the member was receiving agency-based treatment.
• A homicide that is attributed to a member who was engaged in treatment at any level of care at the time of the homicide, or within the previous 60 calendar days.
• A report of an abduction of a member occurring on an agency’s premises while the member was receiving agency-based treatment.
• An instance of care ordered or provided for a member by someone impersonating a physician, nurse or other health care professional.

High profile incidents identified by the IDHW as warranting investigation.

Risk Management, Critical Incidents

A. Risk Management

Client risk factors will be determined during the initial intake and information gathering session.

These factors will be reviewed with clinical therapist, CBRS workers and Case Managers (when applicable) prior to the client starting treatment services.

B. Critical Incidents:

• Our facility staff that are the direct service providers will complete incident reports as needed.
• Reportable Incidents will include but may not be limited to:
• a child being injured while services are provided
• a child making threats to themselves or others
• any activity that may be deemed of an inappropriate sexual nature such as exposure, contact verbalizations, or attempts to make contact or expose themselves
• client becomes a danger to themselves, others, or property
• Reports will contain:
• Date
• Time
• Precipitating factors
• Staff attempts to de-escalate
• Staff responses including what consequences were used
• Contact made with parent
• Feedback given to the client and family members
• Clinical feedback made to the provider as well as the person who reviewed this incident's signature ensuring that the incident was reviewed and feedback given. As well as any corrective measures or opportunities of improvement suggested to or given to the provider of services.
• A copy of the report will be kept in the client's file.

If the incident results in the member requiring incarceration or inpatient treatment documentation of the incident will be sent to Optum Idaho through the provider portal.

Records from the Simply Clinical EMR can be saved as a .pdf and faxed to an outside prescriber/clinician if correct releases are in place. Any in house provider has access to their clients file via a secure and unique login.

Simply Clinical EMR organizes the member record in a filing system similar to, but much more complete than a paper file.

Mental Health Clinic Services:  HIPAA & Confidentiality

(Medicaid Provider Agreement Page 1 of 3.1.  Compliance):

• Our facility will ensure accurate documentation regarding HIPAA Privacy Statement
• Our facility will define what a participant’s right entails in their medical record
• Our facility will ensure the clinic observes confidentiality practices
• Our facility will ensure standard employee confidentiality agreement
• Our facility will ensure that clinical medical record information is available to employees on a need-to-know basis
• Our facility will ensure the definition and documentation for violations of confidentiality
• Our facility will ensure accuracy in reporting HIPAA violations.  This policy should include internal investigations and resolution and also show ability for anyone in the clinic, participant or employee to report to the Federal Government
• Our facility will ensure the clinic’s security (e.g., double-locked clinical files)
• Our facility will ensure a safe electronic exchange of Protected Health Information
• Our facility will ensure a contingency plan for responding to emergency or disaster that damages systems that contain Protected Health Information.

EMR is backed up daily on-site as well as on Simply Clinical servers around the world.

Electronic Medical Records are secured using unique user names and passwords that allow access only to areas within the EMR necessary to complete stated job responsibilities.

Transporting Patient Records

All patient records and documents containing patient protected health information (“PHI”) must be adequately secured to help ensure our patients’ information is not exposed to unauthorized individuals. 

All staff and associates should follow these standards when transporting medical records, documents and portable media devices (such as laptops or flash drives) containing PHI:

Transporting Client Files

Ensure the necessary authorizations given and/or obtained for sharing PHI.

Only transport PHI off-site after obtaining your supervisor’s approval. 

Transport the minimum amount of PHI necessary. Never leave PHI (including portable media devices) unattended, including in your vehicle.

Transport PHI information in a SEALED folder available at the front desk.

Regular performance and training meetings are held for CEU's and other needed trainings and evaluations

This is all included

Criminal background checks are completed for all needed personnel

TB testing included as required

Case Management

Case Managers  Are assigned to clients who are in need of medical health, mental health, geriatric care, substance abuse, and / or welfare related services. Case Managers may be assigned some or all of the following duties:

Duties and Responsibilities

Help clients assess their requirements, and find social services programs that would best assist them.

Review behavioral, educational, and medical needs.

Coordinate the integration of case management and / or other social services into the clients care, home planning, and discharge processes.

Act as patient advocate, investigating, and reporting adverse occurrences.

Evaluate quality of healthcare provided and patient satisfaction level.

Skills and Specifications

Ability to maintain and respect confidentiality.

Ability to self-direct the assigned work.

Effective stress coping skills

Ability to be patient with clients and their circumstances.

Ability to respect cultural, social and racial differences.

Education and Qualifications

Bachelor’s degree in psychology, social work, sociology, child development or related field from an accredited institution.

Master’s degree in social work, sociology or psychology.

Community Based Rehabilitation Specialist (CBRS)

CBRS providers assist clients in gaining and utilizing skills necessary to participate successfully in life by teaching skills such as behavior control, social skills, communication skills, appropriate interpersonal behaviors, symptom management strategies, and coping skills.

Duties and Responsibilities

Provide quality, personalized treatment sessions that teach, encourage and challenge our clients to reach the goals outlined in the clients treatment plan.

Provide interventions and needed services that promote the highest possible level of success by encouraging rehabilitation and the teaching skills that enable the client to maintain their health.

Assist clients with issues related to their Mental Wellness by obtaining skills to live independently.

Assist clients in gaining and / or improving their interpersonal skills.

Participate in developing interventions with other professionals that are engaged in the clients treatment and wellbeing.

Provide social skill training to improve communication skills and facilitate appropriate interpersonal behaviors.

Problem solving, training, support and supervision of the client.

Assist clients in gaining and utilizing coping skills.

Teach and model positive social skills.

Skills and Specifications

Ability to maintain and respect confidentiality.

Ability to self-direct work.

Effective stress coping skills

Should be patient with client and circumstances.

Should respect cultural, social and racial differences.

Education and Qualifications

Bachelor’s degree in psychology, social work, sociology, child development or related field from an accredited institution.

Master’s degree in social work, sociology or psychology.

Clinical Counselors

Advocate for the mental wellbeing of our clients.  Provide appropriate assessment and treatment of clients from diverse social economic backgrounds.  Help clients through challenging life transitions, hardships, and mentally-difficult times. 

Duties and Responsibilities

Identify the needs of clients

Help clients of all life stages cope with and solve everyday problems

Advocate for and develop plans to improve the clients well-being

Research and refer clients to community resources

Work with individuals, families or groups

Respond to clients in crisis situations

Work with a variety of public and private organizations

Observe client behavior, assess needs and develop treatment strategies.

Diagnose psychological, behavioral and emotional disorders.

Develop and implement treatment plans.

Consult with doctors, therapists and medical professionals.

Administer social service programs.

Instruct clients' families during treatment.

Skills and Specifications

Ability to maintain and respect confidentiality.

Ability to self-direct the work.

Effective stress-coping skills

Should be patient with client and circumstances.

Should respect cultural, social and racial differences.

Licensed Social Worker (LSW) / Master Social Worker (MSW)

Education and Qualifications

Bachelor’s degree in psychology, social work, or sociology

Master’s degree in social work, sociology or psychology.

Licensed Clinical Social Worker (LCSW) / Licensed Clinical Professional Counselor (LCPC)

Education and Qualifications

Master’s degree in social work, sociology or psychology.

3,000 Hours of Supervised Clinical Work

Certified Peer Specialist is an individual in recovery from mental illness or mental illness with a co-occurring substance use disorder who uses his/her lived experience and specialized training to assist other individuals in their own recovery.   

Duties and Responsibilities

Engages, educates, guides and supports recovering individuals to create new ways of seeing, thinking and doing in order to have healthy relationships and live successfully in the community.  These new ways are determined by the client being served.

Is non-clinical and does not diagnose or offer primary treatment for mental health issues.

Models recovery principles to show that recovery is possible and attainable. 

Shares recovery story as appropriate and walk the road of recovery alongside the client.

Increases level of cultural sensitivity, awareness and competency regarding person centered and peer delivered services.

Educates and advocates for the values and principles of the recovery model.

Conducts education and support groups using approved curriculum.

Collects information regarding client's history through a combination of methods.

Participates in the development of the recovery plan with the client and WRAP if desired by client.

Collaborates with psychiatrists, therapists, treatment counselors, case-workers and other involved providers and the client’s natural support network.

Skills and Specifications

Ability to maintain and respect confidentiality.

Ability to self-direct the work.

Effective stress coping skills

Should be patient with client and circumstances.

Should respect cultural, social and racial differences.

Education and Qualifications

Certified Peer Specialist (CPS) has a mental illness or a mental illness and co-occurring substance use disorder diagnosis and at least one year of lived experience receiving behavioral health services from a behavioral health service system.

CPS must be at least 18 years old.

CPS maintains a working knowledge of current trends and developments in the fields of mental health, substance use disorders, brain research as it relates to behavioral health, wellness and recovery, ethical practices and peer support services by reading current journals, books, etc., attending webinars, workshops and conferences as they relate to these fields, and sharing with other CPSs.  

CPS completes the forty-hour Appalachian Group/DBSA (Depression and Bipolar Support Alliance) training.

CPS passes the Appalachian Group/DBSA certification exam with a score of 80% or higher.

CPS understands and lives by Idaho’s Certified Peer Specialist Code of Ethics.

If the CPS candidate holds a bachelor’s degree in human services (i.e. social work, psychology, education, sociology, social sciences), he/she documents 100 hours of work experience in the human services field within a year from completing the training.  If the 100 hours of work experience are not completed within a year, a review is required by the certifying body.

If the CPS candidate does not hold a bachelor’s degree in human services, he/she must have a high school diploma or GED and documents 200 hours of work experience in the

human services field within a year from completing training.  If the 200 hours of work experience are not completed within a year, a review is required by the certifying body.

CPS candidate completes 20 supervision hours with a designated Idaho CPS supervisor within a year from completing the training.

CPS maintains certification and renews it yearly.

CPS completes at least 10 hours of approved continuing education approved by the certifying body of Idaho’s CPS and documents said education.  

Must possess a current driver's license, access to a vehicle, and car insurance.

Have strong reading and writing skills.

Be able to use a computer email and basic software.

Have experience in consumer advocacy or leadership.

Receptionist  Ensure that everyone that contacts our office either by phone or in person has an outstanding experience.  Help all people to feel better about themselves, and our business as they interact with our company via phone, social media or the front desk.  Complete administrative tasks daily or as assigned.

Duties and Responsibilities

Answer phones within first 3 rings and direct calls or take messages.

Greet clients with excellent customer service

Notify providers when clients arrive

Update EMR with check-in/check-out

Collect monies owed and past due amounts

Print receipts for monies collected

Assure clients complete all necessary paperwork

Scan cards

Schedule Comprehensive Assessments after the initial intake

Take care of all tasks/alerts for clients as they come in

Make reminder calls daily

Any and all other tasks as assigned

Be flexible and willing to adjust as unforeseen situations arise

Skills and Specifications

Ability to maintain and respect confidentiality

Ability to self-direct the assigned work Effective stress coping skills Ability to be patient with clients and their circumstances Ability to respect cultural, social and racial differences

Patients Education and Qualifications High School Graduate or equivalent

Superior communication skills

Multi-line phone operation

Attention to detail

Computer skills (word processing, spreadsheet, EMR, electronic filing, scanning)

Add paragraph text here.

Our behavioral health facility policy is to hold a supervision meeting on a regular basis as outlined in the Optum BH supervisory protocol for each CBRS, CM, Therapist, and Peer Specialist to be able to voice instances from their working with members that they would like extra insight on from colleges and the Clinician. This is in accordance with Optum Idaho and IDAPA guidelines. These meetings are to be clinical and consulted nature learning for all staff to build toward their repertoire of knowledge. The Supervision meeting will be documented (Appendix Document 1 – Supervision Log Note) on a regular basis (most often weekly) with Attendance, Clinician’s signature, Date, Place, and brief summaries of each member staffed – Question from staff and answers from staff and clinician. Additionally, each staff member will have a written log (Appendix Document 2 – Associate Staffing Log Sheet) of an issue with a member and write it on their log sheet to review by clinician regardless if staff member had a chance to verbally staff the member in the meeting. The supervision meeting will not exceed 6 associates. Clinician will be available for 30 minutes following Supervision meeting once a month for one-on-one session with any non-independently licensed or unlicensed associates.

Supervising Clinician will quarterly evaluate (Appendix Document 3 – Associate Performance Review) each associates ability to render services within the scope of their practice.

Supervising Clinician will annually evaluate (Appendix Document 3 – Associate Performance Review) each LSW and MSW’s performance for rendering services within the scope of their practice.

The Supervision meeting will be documented (Appendix Document 1 – Supervision Log Note) each week or as required by rule - with Attendance, Clinician’s signature, Date, Place, and brief summaries of each member staffed – Question from staff and answers from staff and clinician. Additionally, each staff member will have a written log (Appendix Document 2 – Associate Staffing Log Sheet) of an issue with a member and write it on their log sheet to review by clinician regardless if staff member had a chance to verbally staff the member in the meeting. The documentation of these meetings are integrated into our EMR system.

Our behavioral health facility policy is to hold a supervision meeting weekly for each CBRS, CM, Therapist, and Peer Specialist to be able to voice instances from their working with members that they would like extra insight on from colleges and the Clinician. This is in accordance with Optum Idaho and IDAPA guidelines. Reference - Supervising Practitioner is required to have regular one-to-one (1:1) supervision with the Non- credentialed Practitioner(s) to review treatment provided to Members on an ongoing basis. The frequency of the 1:1 supervision is guided by the needs and experiences of the Non-credentialed Practitioner(s) but should occur at least once a month.

The supervision meeting will not exceed 6 associates. Reference - Group supervision may be used in addition to 1:1 supervision. Group supervision should not include more than six (6) Non- credentialed Practitioners. Supervision is clinical and consultative in nature and focuses on specific cases the Non-credentialed Practitioner is assigned to. Supervision is to be documented and kept on file.

These meetings are clinical and consultive in nature. Allowing all staff members to increase their knowledge. The Supervision meeting will be documented (Appendix Document 1 – Supervision Weekly Log Note) each week with Attendance, Clinician’s signature, Date, Place, and brief summaries of each member staffed. Reference - Supervision must be consultative teaching supervision which is directed toward enhancement and improvement of the Non-credentialed Practitioner’s social work values, knowledge, methods and techniques. Supervision may occur in a group setting for up to 50% of the supervision. The group should not include more than six (6) Non-credentialed Practitioners identified as LMSW’s

This requirement is met - Reference - Supervising LMSW’s – Supervising Practitioners for LMSW’s providing psychotherapy services must be registered as a supervisor by the Idaho Bureau of Occupational Licensing as LCSW, psychiatrist or psychologist, LCPC or LMFT registered as a supervisor by the Idaho Licensing Board of Professional Counselors as outlined in Idaho Administrative Code.

CBRS Providers are sent to training per requirement - Reference - The Non-credentialed Practitioner(s) will have, at a minimum, a Bachelor’s degree or the minimum relevant licensure or certification available for the service they are providing (e.g., CADC). Community Based Rehabilitation Specialists (CBRS) must either have a relevant license (e.g., LSW, RN) or certification through Psychiatric Rehabilitation Association.

This information is documented and included in the employment file.

Supervising Clinician will quarterly evaluate (Appendix Document 3 – Associate Performance Review) each associates ability to render services within the scope of their practice. - Reference - Group Based Provider, who is credentialed or formally rostered by UBH/Optum Idaho and in good standing in the UBH network, will provide supervision of Non-credentialed Practitioner(s). Supervising Practitioners are responsible for ensuring each Non-credentialed Practitioner renders services within their scope of practice

N/A

N/A

Credentialing

Our facility will adopt and apply the guidelines set forth in the United Behavioral Health (UBH) guidelines for credentialing the facility and any treatment modalities as well as the credentialing of clinicians employed at the facility.

Check

In the event that staff is exposed to infectious material they will notify District 7 Health Department (208) 522-0310 and follow their guidelines and recommendations

Infectious Diseases

Member is identified in the Assessment process to have an infectious disease

Pertinent Staff informed of the disease based on HIPPA guidelines for disclosure and treatment

In the event that staff is exposed to infectious material they will notify District 7 Health Department (208) 522-0310 and follow their guidelines and recommendations

Staff will notify supervisor of the incident.

Staff will complete an incident report

Yes

Yes

Yes

Yes

We can serve this population

Complaint Policy

Any member can submit a complaint either verbally or in writing to any of the clinical therapists, managers or owners of the agency. If a complaint comes to an employee they will share the complaint with ownership.  Ownership will then investigate the complaint and the necessary or proper action will be taken based on the complaint.  The complaint will be addressed by ownership with the member within 48 hours of receipt.  Any action needed will take place within an appropriate time allotment, based on the complaint.  Notes from that meeting will be signed by the owner and member and entered into their file.

(As taken from the intake paperwork, signed by member or parent/guardian)

The right to register a complaint if you are dissatisfied with your treatment, without fear of retaliation. You have the right to be assisted in filing a grievance if you need assistance.

N/A

N/A