-
To promote a consistent practice philosophy;
-
To assist behavioral health providers in developing a qualified,
knowledgeable and culturally competent workforce;
-
To provide timely information regarding new initiatives and
best practices that impact the delivery of behavioral health
services; and
-
The intent
of this section is to provide information to behavioral health
providers regarding the scope of required training topics, how
training needs are identified for behavioral health providers
and how behavioral health providers may request specific technical
assistance from contracted T/RBHAs.
Go
to top
9.1.2
References
The following citations can serve as additional resources for this
content area:
9.1.3
Scope
To Whom Does this Apply?
This section
applies to all behavioral health providers delivering services within
the ADHS/DBHS public behavioral health system.
Go
to top
9.1.4
Did you know...?
- ADHS/DBHS
monitors the T/RBHAs to ensure that behavioral health providers
receive all required training.
- ADHS/DBHS
requires T/RBHAs to consult with providers regarding what training
topics are necessary, how training curricula are developed and
how training content is presented.
-
Information concerning the qualifications required of T/RBHA and
provider trainers is determined by each T/RBHA. Please contact the Gila River
BHS Training Coordinator to learn more about specific training
information at 602-528-7100.
- In addition
to the required training content areas, T/RBHAs must ensure that
appropriate training/technical assistance is available to behavioral health providers
when deficiencies are identified.
- Providers involved in
ordering, providing, monitoring or evaluating seclusion or restraint must
complete and document education and training. Education and training must
include the following: understanding behavioral and environmental risk factors,
nonphysical interventions, the safe use of seclusion or restraint and
responding to emergency situations in accordance with
R9-20-602(Q).
- Family members, peer-run,
family-run, and parent-support organizations must be utilized to provide
technical assistance, training, coaching and support to peers, family members
and youth who assume leadership roles within the behavioral health system (i.e.,
roles or membership on Boards of Directors and advisory groups which develop
and implement programs, policies, and quality management activities).
9.1.5
Objectives
To ensure that behavioral health providers have the necessary knowledge
and skills to successfully provide high quality services to persons receiving
services in the public behavioral health system.
Go
to top
9.1.6
Procedures
9.1.6-A
Required training for behavioral health providers
(This section does not apply to Home Care Training to
Home Care Client (HCTC) providers [see subsection 9.1.6-C] and
Community Service Agency providers [see subsection 9.1.6-D].)
The following is required training content that behavioral
health providers should receive before providing services, but
must receive within 90 days of the staff person's hire date, as
relevant to each staff person's job duties and responsibilities:
- Screening for eligibility, enrollment for covered behavioral health services (when eligible), and referral when indicated;
-
Use of assessment and other screening tools (e.g., substance-related, crisis/risk, developmental, etc.), including the Birth-to-Five Assessment depending upon population(s) served;
-
Application of diagnostic classification systems and methods depending upon population(s) served;
-
Use of effective interview and observational techniques that support engagement and are strengths-based, recovery-oriented, and culturally sensitive;
-
Behavioral health service planning that addresses the client’s/family’s needs as identified through initial and ongoing assessment practices;
-
Behavioral health record documentation requirements;
-
Confidentiality/HIPAA;
-
Coordination of care requirements with Primary Care Providers (PCPs) (see
PM Section 4.3, Coordination of Care with AHCCCS Health Plans, Primary Care Providers and Medicare Providers) and other involved agencies and government entities (see
PM Section 4.4, Coordination of Care with other Governmental Entities);
-
Sharing of treatment/medical information;
-
Management of difficult cases, including high-risk persons and persons that are court ordered for treatment;
-
Covered behavioral health services (including information on how to assist persons in accessing all medically necessary covered behavioral health services regardless of a person’s behavioral health category assignment or involvement with any one type of service provider);/li>
-
Overview of Substance Abuse Prevention and Treatment Block Grant: Priority placement criteria, interim service provision, consumer wait list reporting, and expenditure restrictions of the Substance Abuse Prevention and Treatment Block Grant in accordance with requirements in
PM Section 3.19, Special Populations;
PM Section 3.2 Appointment Standards and Timeliness of Service;
PM Section 3.21 Service Prioritization for Non-Title XIX/XXI Funding, and 45 CFR Part 96);
-
Early, Periodic, Screening, Diagnosis and Treatment (
-
Rights and responsibilities of eligible and enrolled behavioral health recipients, including rights for persons determined to have Serious Mental Illness;
-
Appeals, grievances and requests for investigations;/li>
-
Complaint Process;
-
Customer service;
-
Fraud and abuse requirements and protocols;
-
Managed care concepts, including information on the T/RBHA and the public behavioral health system;
-
Overview of Arizona behavioral health system policies and procedures, including the ADHS/DBHS system principles:
-
Best practices in the treatment and prevention of behavioral health disorders;
-
Clinical training as it relates to specialty populations and/or conditions;
- Information
regarding the appropriate clinical approaches when delivering
services to children in the care and custody of ADES/DCYF;
-
Cultural competency;
- Overview of partnership with Department of Economic
Services/Rehabilitative Services Administration (DES/RSA);
-
Child and Family Team
(CFT) practice depending on the population(s)
served;
-
Third party liability and coordination of benefits;
- Claims/encounters submission process;
- Advance
Directives;
- Interpretation and translation services;
-
Identification and reporting of persons in need of Special
Assistance for individuals who have been determined to have a
Serious Mental Illness (SMI) and ensuring involvement of persons
providing Special Assistance;
-
ADHS/DBHS Demographic Data Set, including required timeframes
for data submission and valid values; and
-
Medicare Prescription Drug Modernization and Improvement Act of
2003 (MMA), including the following (as required by the Balanced
Budget Amendment):
-
Assisting persons in choosing a Medicare Part D plan;
-
Accessing relevant resources (e.g., plan formularies); and
-
Answering questions and obtaining informational materials.
Continuing Training Requirements
In addition to training required within the first 90 days of hire, all providers are required to undergo ongoing training for the following content areas:
- Each RBHA must provide evidence to the Office of Program Support (OPS) Encounter Unit, on a monthly basis, of ongoing provider training concerning procedures for submission of encounters. In addition, the RBHA must provide training to any provider with a data validation review rate greater than ten percent;
- ADHS/DBHS Demographic Data Set, including required timeframes for data submission and valid values; and
- Providers must ensure that staff at all levels and across all disciplines receives ongoing education and training in culturally and linguistically appropriate service delivery.
ADHS/DBHS also
recognizes that there may be ongoing training requirements, specific
to each T/RBHA. Please contact the Gila River BHS Training
Coordinator to learn more about specific training information at 602-528-7100.
Go
to top
9.1.6-B. Office of Behavioral Health Licensure (OBHL)
required training
(This section does not apply to Home Care Training to Home Care Client (HCTC) providers [see subsection 9.1.6-C] and Community Service Agency providers [see subsection 9.1.6-D].)
The following is required training content where a licensee shall ensure that a behavioral health technician or behavioral health paraprofessional has the skills and knowledge necessary to perform the duties consistent with the job description of the behavioral health technician or behavioral health paraprofessional and the services the agency is authorized to provide including, if applicable, the skills and knowledge necessary to:
- Protect client rights in
R9-20-203;
- Provide treatment that promotes client dignity, independence, individuality, strengths, privacy and choice;
- Recognize obvious symptoms of a mental disorder, personality disorder, or substance abuse;
- Provide the behavioral health services that the agency is authorized to provide and that the staff member is qualified to provide;
- Meet the unique needs of the client populations served by the agency or the staff member, such as children, adults age 65 or older, individuals who have substance abuse problems, individuals who are seriously mentally ill, or individuals who have co-occurring disorders;
- Protect and maintain the confidentiality of client records and information;
- Recognize and respect cultural differences;
- Recognize, prevent, and respond to a situation in which a client:
- May be a danger to self or a danger to others,
- Behaves in an aggressive or destructive manner,
- May be experiencing a crisis situation, or
- May be experiencing a medical emergency;
- Read and implement a client's treatment plan;
- Assist a client in accessing community services and resources;
- Record and document client information;
- Demonstrate ethical behavior, such as by respecting staff member and client boundaries and recognizing the inappropriateness of receiving gratuities from a client;
- Identify types of medications commonly prescribed for mental disorders, personality disorders, and substance abuse and the common side effects and adverse reactions of the medications;
- Recognize and respond to a fire, disaster, hazard, and medical emergency; and
- Provide the activities or behavioral health services identified in the staff member's job description or the agency's policy and procedure.
Training must be completed and documented in accordance with OBHL requirements (see R9-20-204(F) and R9-20-206).
9.1.6-C.
Required training specific to Professional Foster Home Providing
HCTC Services
Children
Medicaid reimbursable
Home Care Training to Home Care Client (HCTC) services for children
are provided in Professional Foster Homes licensed by the Arizona
Department of Economic Security, which must comply with
training requirements as listed in
R6-5-5850. All agencies that
recruit and license Professional Foster Home providers must provide
and credibly document the following training to each provider:
-
CPR and First Aid Training;
-
30 hours of pre-service training utilizing Partnering for Safety and Permanence:
the Model Approach to Partnerships in Parenting (PS-MAPP);
-
18 hours of pre-service training utilizing the Arizona Home Care Training to
Client Service Curriculum.
-
Behavioral health management of crisis situations including:
-
Prevention of violent behaviors,
-
Behavior management skills, and
-
De-escalation techniques
-
Medical/health care issues, procedures, and
techniques, including the purpose/use/administration of medications,
medication interactions, and potential medication reactions.
The provider delivering HCTC services must complete the above training prior to providing
services. In addition, the provider delivering HCTC services for children must complete and
credibly document annual training as outlined in
R6-5-5850, Special Provisions for a Professional Foster Home.
Adults
Medicaid reimbursable
HCTC services for adults are provided in Adult Therapeutic Foster
Homes
licensed by the
Arizona Department of Health, which must comply with training requirements as listed in
R9-20-1502:
-
Protecting the person’s rights;
-
Providing behavioral health services that the
adult therapeutic foster home is authorized to provide and the
provider delivering HCTC services is qualified to provide;
-
Protecting and maintaining the confidentiality of clinical records;
-
Recognizing and respecting cultural differences;
-
Recognizing, preventing or responding to a situation in which a
person:
-
May be a danger to self or a danger to others
-
Behaves in an
aggressive or destructive manner;
-
May be experiencing a
crisis situation; or
-
May be experiencing a medical
emergency;
-
Reading and implementing a person’s treatment plan; and
-
Recognizing and responding to a fire, disaster, hazard or medical
emergency.
In addition, providers delivering
HCTC services to adults must complete and credibly document annual
training as required by
R9-20-1502.
Go
to top
9.1.6-D.
Required training specific to community service agencies
Community
Service Agencies (CSAs) must
submit documentation as part of the initial and annual CSA
application indicating that all direct service staff and volunteers have completed training
specific to CSAs prior to providing services to behavioral health
recipients. For a complete description of all required training
specific to CSAs, see
Policy and Procedure Manual MI 5.2, Community Service Agencies –
Title XIX Certification.
9.1.6-E.
Other situations that may prompt additional behavioral health provider training
Additional training
is necessary for behavioral health providers serving in specific
roles and functions including:
In addition, specific
situations may necessitate the need for additional training. For
example, quality improvement initiatives may require focused training
efforts. New regulations that impact the public behavioral health
system may also require concerted training strategies (e.g., the
Balanced Budget Act (BBA), Medicaid
Modernization Act (MMA) and Deficit Reduction Act (DRA)).
9.1.6-F.
Training Expectations for ADHS/DBHS Clinical and Recovery Practice
Protocols
Under the direction
of the ADHS/DBHS Chief Medical Officer,
the Department publishes ADHS/DBHS
Practice Protocols and identifies national clinical best practices to assist behavioral health providers.
National guidelines and
Practice Protocols without required elements can be accessed at
http://www.azdhs.gov/bhs/guidance/guidance.htm.
Select Practice Protocols have required elements.
Behavioral health
providers should receive training on Practice Protocols with
required elements before providing services, but must receive
training within six months of the staff person’s hire date. (Protocol training is only required if pertinent to populations served). As Practice Protocols with required elements are revised or added, training expectations will be identified. Practice Protocols with required elements can be accessed at
http://www.azdhs.gov/bhs/guidance/guidance.htm.
9.1.6-G.
Training Requests
Please contact the Gila River BHS Training coordinator at
602-528-7100 to find out where and when training is
available or to request technical assistance or trainings that are
mentioned in this section.
Go
to top
9.1
Training Requirements
Last Revised: 06/01/2010
Effective Date: 07/15/2010
|
