Fillable Printable Bhs Policy 403

Bhs Policy 403

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

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1. PURPOSE:

In order to effectively meet the requirements of the Arizona Department of Health

Services/Division of Behavioral Health Services (ADHS/DBHS) the Tribal/Regional

Behavioral Health Authorities (T/RBHAs) must participate in development, implementation

and support of trainings for behavioral health contractors and subcontractors to ensure

appropriate training, education, technical assistance and workforce development

opportunities. Specifically to:

a. Promote a consistent practice philosophy; provide voice and empowerment to staff and

behavioral health recipients;

b. Ensure a qualified, knowledgeable and culturally competent workforce;

c. Provide timely information regarding initiatives and best practices; and

d. Ensure that services are delivered in a manner that results in achievement of the

Arizona System Principles, which include the

9 Guiding Principles for Recovery Oriented

Adult Behavioral Health Services and Systems and Arizona Children’s Vision and

Principles.

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.

2. PROCEDURES:

a. Required training for behavioral health providers

i. Each T/RBHA must monitor and implement training activities and requirements

outlined in Section 9.1.6 A - H. In addition, T/RBHAs will annually evaluate the

impact of the training requirements and activities in order to develop a qualified,

knowledgeable and culturally competent workforce.

ii. T/RBHAs and their providers must ensure the following within 90 days of the staff

person’s hire date, as relevant to each staff person’s job duties and responsibilities

and annually as applicable (see subsection 2.d. for tr aining requir ements applicable

to Home Care Training to Home Care Client (HCTC) providers and subsection 2.e.

for training requirements applicable to Community Service Agencies):

(1) Section 1

(a) Fraud and program abuse recognition and reporting requirements and

protocols;

(b) Managed care concepts, including information on the T/RBHA and the public

behavioral health system;

(when eligible), and referral when indicated;

(d) Overview of Ar izona behavioral health system policies and procedures in the

Arizona Vision and 12 Principles

in the children’s system,

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 2 of 8

(e) Overview of Arizona’s behavioral health system policies and procedures in

the

9 Guiding Principles for Recovery Oriented Adult Behavioral Health

Services and Systems in the adult system,

(f) Overview of partnership with Department of Economic Services/Rehabilitative

Services Ad minist r at ion (DES/RSA);

(g) Cultural competency; including Cultural Competency 101: Embracing

Diversity ( ADHS/DBHS c u rriculu m) ;

(h) Interpretation and translation services;

(i) ADHS/DBHS Demographic Data Set, including required timeframes for data

submission and valid values; and

(j) Identification and reporting of quality of care concerns and the quality of care

concerns investigation process.

(2) Section 2

(a) Use of assessment and other screening tools (e.g., substance-related,

crisis/risk, developmental, Early and Periodic Screening, Diagnosis and

Treatmen t ( EPSDT) Pr og ram etc.), including the Birth-to-Five Assessment

depending upon population(s) served;

(b) Use of effective interview and observational techniques that support

engagement and are strengths-based, recovery-oriented, and culturally

sensitive;

population(s) served;

(d) Best practices in the treatment and prevention of behavioral health disorders;

(e) Behavioral health service planning and implementation which includes family

vision and voice, developed in collaborations with the individual/f amily needs

as identified through initial and ongoing assessment practices;

(f) 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);

(g) Overview of Substance Abuse Prevention and Treatment Block Grant

(SAPT): pr ior it y placement criteria, interim service provision, consumer wait

list reporting, and expenditure restrictions of the SAPT Block Grant in

accordance with requirements in Policy 110, Special Populations;

Policy 102

Appointment Standards and Timeliness of Service and; 45 CFR Part 96;

(h) Behavioral health providers should receive training on the ADHS/DBHS

National Practice Guidelines and Clinical Guidance Documents with required

elements before providing services, but must receive training within si x

months of the staff person’s hire date. (Protocol training is only required if

pertinent to populations served).

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 3 of 8

(i) Clinical training as it relates to specialty populations including but limited to

conditions based on identified need;

(j) Informatio n r egarding the appropriate clinical approaches when delivering

services to children in the care and custody of the Arizona Department of

Economic Security/Division of Children Youth and Families (ADES/DCY F);

and

(k) Understanding behavioral and environmental risk factors, nonphysical

interventions, the safe use of seclusion or restraint and responding to

emergency situations in accordance with

Policy 702 Report ing and

Monitoring the Use of Seclusion and Restraint.

(3) Section 3

(a) Behavioral health record documentation requirements (see Policy 802,

Behavioral Health Medical Record Standards);

(b) Confidentiality/Health Information Portability and Accountability Act (HIPAA);

(d) Coordination of service delivery for persons with complex needs (e.g.

persons at risk of harm to self and others, court ordered to receive treatment);

(e) Rights and responsibilities of eligible and enrolled behavioral health

recipients, including rights for persons determined to have Serious Mental

Illness (SMI);

(f) Appeals, grievances and requests for investigations;

(g) Complaint process (see Policy 1802, Complaint Resolution

);

(h) Customer service;

(i) Coordination of care requirements with Primary Care Providers (PCPs) (see

Policy 902, Coordination of Care with AHCCCS Health Plans, Primary Care

Providers and Medicare Providers);

(j) Third pa rt y liability and coordination of benefits (see Policy 701, Third Party

Liability and Coordination of Benefits);

(k) Other involved agencies and government entities (see Policy 903,

Coordination of Care with other Governmental Entities);

(l) Claims/encounters submission process (see Policy 501, Submitting Claims

and Encounters);

(m) Advance Directives (see Policy 801, Advance Directives);

(n) 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 (see

Policy 113, Special Assistance for Persons Determined to Have a Serious

Mental Illness);

(o) Providers delivering services through distinct programs (e.g., Assertive

Community Treatment teams, Dialectical Behavioral Therapy, Multi-Systemic

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 4 of 8

Therapy, developmental disabilities, trauma, substance abuse, children age

birth to five, and Level I facilities );

(p) Behavioral health recipient benefit options trainings: such as Medicare

Modernization Act (MMA) Department of Economic Security/Rehabilitation

Services Administration (DES/RSA) Substance Abuse Prevention Treatment

(SAPT) grant.

iii. Specific s it uat ions may necessitate the need for additional trainings. For example,

quality improvement initiatives that may require focused training efforts and/or new

regulations that impact the public behavioral health system (e.g., the Balanced

Budget Act (BBA), Medicaid Modernization Act (MMA), the Affordable Care Act

(ACA) a nd Def ic it Reductio n Ac t (DRA)). Additional trainings may be required, as

determined by geographic service area identified needs.

iv. T/RBHAs must develop and make available to providers any policies and procedures

regarding additional training information.

b. Annual and Ongoing Training Requirements

i. In addition to training required within the first 90 days of hire, all T/RBHA

subcontracted providers are required to undergo and provide ongoing training for the

following content areas:

(1) ADHS/DBHS Demographic Data Set, including required timeframes for data

submission, valid values and as changes occur;

(2) Monthly training s concerning procedures for submissions of encounters as

determined by ADHS/DBHS;

(3) Annual cultural competency and linguistically appropriate training updates for

staff at all levels and across all disciplines respective to

underrepresented/underserved populations;

(4) Identification and reporting of Quality of Care Concerns and the Quality of Care

Concerns investigations process;

(5) Inter-rater reliability;

(6) American Society of Addition Medicine Patient Placement Criteria (ASAM PPC-

2R);

(7) Child and Adolescent Service Intensity Instrument (CASII);

(8) Ticket to Work/Disability Benefits 101;

(9) Peer, family member, peer-run, family-run and parent-support training and

coaching,

(10) 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 (see

Policy

113, Special Assistance for Persons Determined to Have a Serious Mental

Illness) and;

(11) Workforce Development trainings specific to hiring, support, continuing

education and professional development.

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 5 of 8

ii. Specific situations may necessitate the need for additional trainings. For example,

quality improvement initiatives that may require focused training efforts and/or new

regulations that impact the public behavioral health system (e.g., the Balanced

Budget Act (BBA), Medicaid Modernization Act (MMA), the Affordable Care Act

(ACA) a nd Def ic it Reductio n Ac t (DRA)). Addit ional tr ainings may be required, as

determined by geographic service area identified needs.

iii. T/RBHAs must develop and make available to providers any policies and procedures

regarding specific ongoing training requirements.

c. Office of Behavioral Health Licensing (OBHL) required training

i. Training must be completed and documented in accordance with OBHL

requirements (see R9-20-204(F) and R9-20-206 and the

ADHS Division of Public

Health Services, Licensing Services website

d. Required training specific to Professional Foster Homes Providing HCTC Services

i. Children

(1) Medicaid reimburs able Home Care Training to Home Car e Client (HCTC)

services for children are provided in professional foster homes licensed by the

Arizona Department of Economic Security/Office of Licensing, Certification and

Regulation which must comply with training requirements as listed in R6-5-

5850. All agencies that recruit and license professional fost er home providers

must provide and credibly document the following training to each contracted

provider:

(2) CPR and First Aid Training;

(3) 18 hours of pre-service training utilizing the Arizona Home Care Training to

Client Service Curriculum ;

ii. The provider delivering HCTC services must complete the above training prior to

delivering 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.

iii. Adults

(1) Medicaid reimburs able HCTC services for adults are provided in Adult

Therapeutic Foster Homes licensed by ADHS/OBHL, and must comply with

training requirements as listed in

R9-20-1502:

(a) Protecting the person’s rights;

(b) Providing behavioral health services that the adult therapeutic foster home is

authorized to provide and the provider delivering HCTC services is qualified

to provide;

(d) Recognizing and respecting cultural differences;

(e) Recognizing, preventing or responding to a situation in which a person:

(i) May be a danger to self or a danger to others;

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 6 of 8

(ii) Behaves in an aggressive or destructive manner;

(iii) May be experiencing a crisis situation; or

(iv) May be experiencing a medical emergency;

(f) Reading and implementing a person’s treatment plan; and

(g) 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

e. Required training specific to Community Service Agencies

i. 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 406, Comm unity Service Agencies-Title XIX Certification

f. Tr ain ing Expec tations fo r ADHS/DBHS Clinical and Recovery Practice Protocols

i. Under the direction of the ADHS/DBHS Chief Medical Off icer, the Department

publishes national practice guidelines and clinical guidance documents to assist

behavioral health providers. These documents, some with required elements can be

accessed at http://azdhs.gov/bhs/guidance/index.htm

ii. Behavioral health providers providing services to children and families involved with

Child Protective Services (CPS) will be required to attend “Unique Needs of Children

Involved with CPS” training that is offered by each T/RBHA on a regular basis. (See

ADHS/DBHS Pr ac tice Protocol,

The Unique Behavioral Health Service Needs of

Children, Youth and Families Involved with Child Protective Services).

iii. T r aining on Child and Family Team (CFT) practice, depending on the population(s)

served; (See ADHS/DBHS Pr ac tice Protoc o l Child and Family Team Practice

)

Training curriculums can be differentiated based on the role (BHMP, BHT, Coaches,

Family Support Partners, Supervisors, etc.) of the training participation provides in

CFT Practice. Curriculums and certification processes shall be approved by

T/RBHAs a nd ADHS/DBHS.

g. Training Requests

i. For additional training requests and/or technical assistance specific to the trainings

listed above and /or identified are of need, contact the T/RBHA.

ii. T/RBHAs must develop and make available to providers any policies and procedures

that identify how providers can access these types or trainings including specific

T/RBHA contact information.

h. W orkforce Development

i. Training Expert:

(1) T/RBHAs must employ a training expert/contact as key personnel and point of

contact to implement and oversee compliance with the training requirements,

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 7 of 8

training plan, Policy 403, Training Requirements and participate in the Training

Coordinators committees.

ii. Training Development Plan:

(1) Each T/RBHA must develop, implement and submit an Annual Training Plan

that provides information and documentation of all trainings. The training plan

and training curriculums will be submitted annually, forty-five days after fiscal

year end.

iii. Training Quarterly Updates:

(1) Each T/RBHA must submit a Workforce Development Quarterly Update which

includes information specific to initiatives and activities specif ic to training.

Quarterly updates are to be submitted 30 days after quarter end.

iv. ADHS/DBHS O wner ship of any intellectual property:

(1) This policy will serve as disclosure of ownership of any intellectual property

created or disclosed during the course of the service contract such as

educational materials created for classroom training and/or learning programs.

v. Exceptions:

(1) Those cases in which the production of such materials is part of sponsored

programs;

(2) those cases in which substantial University resources were used in creating

educational materials; and

(3) those cases which are specifically commissioned by contacted vendors or done

as part of an explicitly designated assignment other than normal contactor

educational pursuits.

vi. T/RBHAs must develop and make available to providers any additional policies and

procedures regarding specific workforce development requirements.

3. REFERENCES:

A.A.C. R6 -5-5850

A.A.C. R9-20-203

A.A.C. R9-20-204(F)

A.A.C. R9-20-206

A.A.C. R9-20-602(Q)

A.A.C. R9-20-1502

A.A.C. R9 -21-101

A.A.C. R9 -21-301 through 314

AHCCCS/ADHS Contrac t

ADHS/RBHA Contrac ts

ADHS/TRBHA IG As

Policy 113, Special Assistance for Persons Determined to Have a Serious Mental Illness

Policy 404, Peer Support/Recovery Support Training, Certification and Supervision

Requirements

Policy 405, Credentialing and Recredentialing

Policy 406, Communit y Service Agencies-Tit le XIX Certifica tion

Arizona Departm ent of Health Services Current Effective Date: 3/1/2013

Division of Behavioral Health Services Last Review Date: 1/24/2013

Policy and Procedures Manual

SECTION: 1 CHAPTER: 400

POLICY: 403 , Training Requirements

____________________________________________________________________________

XX.X Sect ion Name

Page 8 of 8

Policy 407, Cultural Competence

Policy 902, Coordination of Care with AHCCCS Health Plans, Primary Care Providers and

Medicare Providers

Policy 903, Coordination of Care with other Governmental Entities

Policy 1002, Perform ance Improvement Projects

Policy 1702, Reporting and Monitoring the Use of Seclusion and Restraint

Arizona Vision and 12 Principles

9 Guiding Principles for Recovery Oriented Adult Behavioral Health Services and Systems

Principles for Persons Determined to have a Serious Mental Illness (SMI).

ADHS/DBHS Of fice of I ndividu a l an d F a m ily Af fairs W eb Pag e