The psychiatrist works under the leadership of the Medical Director and Chief Executive Officer, and within federal, state, and local guidelines performs quality psychiatric clinical work. This position reports to the Medical Director except for scheduling time off, training, and general program related matters which is coordinated by the Clinic operations Director manager of the program in collaboration with the center Medical Director. Work involves assessing, planning, and providing comprehensive patient care independently or in collaboration with other health care professionals.

Provides Psychiatric services in the Denton County MHMR Center outpatient clinics, Crisis services and various center sponsored programs. Provide evaluations, medication management, diagnostics, and plan of care recommendations to clients with acute and persistent mental illness. Provides both crisis and regular services. Services may be provided face-to-face, by telephone, or by telemedicine. The psychiatrist will serve as a member of the treatment team and works collaboratively with nursing, case management, and Crisis Staff. Works under minimal supervision, with extensive latitude for the use of initiative and independent judgment. 

Education, Training, and Experience

·        Graduation from an accredited college of medicine, with MD/DO degree with psychiatric specialty required

·        Board Certification or Board eligible in Child and Adolescent Psychiatry preferred

·        Prior experience with the MHMR priority population, with dual diagnosis (developmental disabilities, substance abuse, and mental illness) preferred 

Registration, Certification, Licensure, and Other Qualifications 

• Medical licensure must be current and without restriction
• Must have prescriptive authority, with willingness to provide clinical supervision and delegation of prescriptive authority to Psychiatric Nurse Practitioners
• Must maintain current TX licensure including DEA
• All job specific training must be completed within 30 days of hire
• Must maintain a valid Texas driver's license, auto liability insurance, and a driving record acceptable to the Centers insurance requirements
• Maintain current CPR certification
• Excellent written and verbal communication, and organizational skills
• Ability to work with and treat individuals with severe and persistent mental illness
• Must have and maintain a background and criminal history free from any disqualifying offenses as outlined by the Texas Administrative Code (TAC) and the Health and Human Services Commission (HHSC).
• Must possess and maintain a valid driver’s license and automobile insurance.

o   Individuals with an out-of-state driver’s license must be able to obtain a driver’s license in the state of Texas within thirty (30) days.

·        Successful completion of all position-specific training within thirty (30) days of employment is required. 

Knowledge, Skills, and Abilities

·        Knowledge of psychiatric principles and methods; in general, and psychiatric medicine; and of the principles and practices in the development, implementation, and documentation of individualized care and treatment plans

·        Skill in the care and treatment of patients, in the use of medical and psychiatric diagnostic and treatment tools and equipment, in conducting psychiatric research, and in the operation of computers and applicable computer software

·        Ability to examine, diagnose, and treat mental disorders; to interpret psychological diagnoses and analyses; to communicate effectively; and to assign and/or supervise the work of others.

·        Working knowledge of computers, proficiency in typing to be able to document in a timely and efficient manner, ability to use and document in center’s Electronic Health Record System.

·        Ability to do parallel documentation.

·        Ability and skills needed to provide services using Telepsych modality.

·        Ability and skills to use instant messaging system.

·        Ability to display regular and reliable (in-person, if required) attendance.

·        Understanding and practice of Trauma Informed Care principles.

Essential Duties

The following list outlines key responsibilities for the position; however, it is not exhaustive and does not encompass all responsibilities. Additional duties may be assigned as needed.

1.      Provides evaluation, diagnostic, and medication management services to child and adolescent and adult clients according to applicable Texas Administrative Code, as outlined in the DCMHMR policies and procedures.

o   Conducts psychiatric evaluation and medication management services. Explores and takes into account all relevant data sources in conduction and formulating diagnosis. Service notes include appropriate clinical and other details to substantiate diagnosis and treatment decision making.

o   Record the results of a primary evaluation and diagnosis in the clinical record and on the approved diagnostic tool using guidelines from current contract approved Diagnostic and Statistical Manual of Mental Disorders.

o   Completes documentation as per center documentation guidelines and preferably on the same day for continuity of care and communication of care provided. All required elements in the service note are filled out.

o   Service note reflects appropriate details for CPT billing code selected.

o   Diagnosis updates are done at least annually and additionally as necessary.

o   Monitors vitals as appropriate.

2.      Orders lab studies as recommended by prescribing guidelines and according to the DCMHMR Standing Lab Orders.

o   Appropriate labs are ordered, available labs are reviewed appropriately when prescribing psychotropic medications.

o   Reviews and signs off lab results in timely manner.

o   Addresses abnormal lab values appropriately and in a timely manner.

3.      Prescribes medications and maintenance treatment to clients assigned to the individual doctor’s and APRN’s caseload and in emergency situations to those on other Denton County MHMR prescriber’s  caseloads.

o   Medications will be prescribed appropriate to the diagnosis and according to the appropriate HHSC approved medication treatment guidelines and documented on the DCMHMR Clinical Record Form.

o   Informed psychotropic medication consent is obtained from Clients or LAR (Legally Authorized Representative) and documented. AIMS done appropriately and as per TAC guidelines.

o   Will monitor and make recommendations regarding lab studies, according to the Denton County MHMR Standing Lab Orders and Abnormal Lab Value procedure.

o   Avoid the use of polypharmacy and document clinical justification if required, following the DCMHMR Policies and Procedures regarding polypharmacy.

o   Documents appropriately rational for prescribing and changes in the medication.

o   Work cooperatively with the client using recovery-based language and incorporate the client’s preferences for treatment when clinically appropriate.

o   Patient and family education will be completed at each visit according to the Patient and Family Education (PFEP) program requirements and documented in the service note. This education will include information regarding diagnosis, treatment options, prescribed treatment, and recovery through self-monitoring and self-management.

o   Will monitor and make recommendations regarding lab studies, according to the Denton County MHMR Standing Lab Orders and additionally as clinically indicated and, as per abnormal Lab Value procedure.

4.      Serves as a member of the treatment team and makes recommendations for plans of care.

o   Seek consultation from the Assistant Medical Director and Psychiatric Peer Team on difficult cases and document this consultation.

o   Refers clients to appropriate medical and community resources documenting this in the plan of care, eliciting assistance from case management, care coordination team, and nursing staff.

o   Provides consultation and orders regarding treatment, to the RNs and LVNs, regarding clients on other center prescriber’s individual caseload or when a client’s treating physician or APRN is not available for consult. Sign verbal orders/ GMO in a timely manner at the next available opportunity.

o   Reviews each RN assessment at the client’s next appointment when the RN is working under Standing Orders and provides suggestions or corrections as needed.

o   Participates in Peer Review when applicable.

o   Completes client care related paperwork appropriately and in timely manner.

5.      Provides crisis care to new adult or C & A clients referred by crisis teams as well as crisis services to existing adult or C & A clients.

o   Provides Certificate of Medical Examinations when applicable and as soon as possible considering existing clinic schedules.

o   Participates in telephonic on call rotation. Provides consultation to RNs and Crisis Residential Unit nursing as well as QMHP staff for medication treatment and other recommendations for existing as well as new clients being served by the crisis teams and Crisis Residential Unit clients. LPHA’s serving the crisis teams may also access the doctor on call for non-medication recommendations.

o   Provides crisis services during regularly scheduled hours.

6.      Provides and documents each service according to rules and regulations outlined by the Medical Board, DCMHMR, the State Pharmacy Board, HHSC, DADS, and TAC.

o   Each note must contain the required elements for Medicaid or other third-party billing and must be completed at the time of service.

o   The attending psychiatrist will help facilitate filling out documents for disability benefits, prescription assistance programs, prior authorization approval, FMLA and other necessary documents when requested.

o   The psychiatrist is to maintain consumer confidentiality and ethical standards at all times.

7.      Practices workplace safety procedures.

o   Adheres to the use of Universal Precautions.

o   Adheres to the Center Infection Control Plan.

o   Informs appropriate staff of any safety hazard or issue promptly.

8.      Provides emergency intervention when necessary, according to Department of Human Services (DHS) and Center rules and procedures.

9.      Maintains productivity as per center requirements.

10.   Willing to collaborate with educational institutes and supervise/precept medical students, residents, and psychiatric nurse practitioner students.

11.   Provides courteous, professional services at all times.

o   Provides appropriate customer service and demonstrates cultural sensitivity and cultural awareness.

o   Performs additional duties as assigned by Assistant Medical Director or CMO (Chief Medical Officer) within designated timeframes.

o   Demonstrates leadership, teamwork, dependability, and customer service.

o   Is available and approachable for consultation to nursing staff.

o   Demonstrates willingness to work in walk- in clients and crisis clients.

o   Works collaboratively with case managers and other treatment team members.

o   Demonstrates ability to work with others to identify opportunities and resolve issues to achieve common goal.

o   Willing to supervise and delegate prescriptive authority to APRN and provide appropriate supervision as required by law and governing Boards.

o   Takes initiative and provides input towards the solutions.

12.   Participates in the Center’s Zero Suicide Initiative.

o   Supports individuals experiencing a crisis by promptly connecting them with appropriate Center programs, such as the Mobile Crisis Outreach Team (MCOT), Psychiatric Triage, Crisis Prevention services, and/or other applicable resources. Ensure seamless coordination to facilitate timely intervention.

o   Remains with individuals, when deemed safe, to provide support and maintain a calm environment until specialized crisis staff or emergency personnel arrive to take over intervention efforts. Adheres to safety protocols to prevent escalation of the crisis situation.

o   Participates in debriefing sessions with the immediate supervisor or designated staff following a crisis event. Collaborate with the team to review the incident, identify lessons learned, and ensure all HHSC guidelines and Center policies are followed.

13.  Additional duties may be assigned as needed.