General Description

Works under the direction of the Program Manager of Mobile Crisis Outreach Team (MCOT) Services and within federal, state and local guidelines performs risk of harm (ROH) assessments, moderately complex case management work, and counseling intervention. Work involves developing and maintaining relationships with individuals served, their families, and service providers for medical, social, educational, and related service needs.

The MCOT Licensed Practitioner of the Healing Arts (LPHA) is responsible for providing crisis services to residents of Denton County. Job duties include face to face ROH assessments within the county at a secure location and responding to needed telephone interventions. Additionally, this position provides brief intervention therapy aimed at resolving the crisis situation. This position requires weekly psychotherapy sessions, performing risk of harm assessments, and conducting hospital aftercare assessments. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.

Education, Training, and Experience

•   Graduation from an accredited four-year college or university and a master's degree in behavioral sciences, social sciences, and/or humanities.
•  Licensure to qualify as a Licensed Practitioner of the Healing Arts (LPHA) required
•   One year prior experience in a mental health field required.

Registration, Certification, Licensure, and Other Qualifications

• Active license through the state of Texas as a: Licensed Professional Counselor, Licensed Marriage and Family Therapist, or Licensed Clinical Social Worker is required.
•   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

•   Must demonstrate regular and dependable in-person attendance.
•   Knowledge of causes and treatment of mental illness and related conditions.

• Skill in interviewing, listening, providing case management/brief intervention therapy services to individuals served, and in the operation of computers and applicable computer software.
•   Ability to screen for suicide risk and complete comprehensive risk of harm assessments to determine appropriate treatment recommendations, referrals and resources, and provide clinically appropriate documentation in a timely manner (must be able to type clinical documentation as the assessment is taking place).
• Ability to convey instructions and explanations to individuals served and interested parties, to negotiate/facilitate available services, and to train others.
• Highly effective in working objectively with a diverse group of people and able to demonstrate communication, organizational, administrative and office managerial skills.
• Computer skills required for both clinical and clerical programs.
• Ability to travel, during working hours, throughout Denton County to meet with individuals at locations that could include jail settings, medical and psychiatric hospital settings, other community settings, and individual residence settings.
• Ability to make decisions based on education and/or clinical experience, which reflect consistency with Center's Guiding Principles, Policies and Procedures, and Standards of Care.
•   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. Attends and participates in all scheduled meetings.
1. Attends all Crisis team meetings as scheduled and signs in for meetings to acknowledge presence and understanding of the topics discussed.
2. Attends all other pertinent meetings as scheduled and communicate with supervisor when unavailable.
2. Provides courteous, professional services at all times.
1. Maintain professional boundaries.
2. Maintains professionalism when interacting with center staff, individuals served, and community members.
3. Enter time worked accurately each day and submits time sheet by deadline given.
1. Utilize timeclock system
2. Audit punches up to a week at a time to ensure accuracy.
4. Provides Brief Intervention Therapy (BIT) and/or Cognitive Behavioral Therapy (CBT) for individuals in level of care 5 services.
1. Maintains and updates counseling schedule.
2. Complete counseling documentation within 2 business days and documents Suicidal/Homicidal Ideations utilizing since last visit Columbia Suicide Severity Rating Scale (C-SSRS) and next appointment date and time.
3. Contact clients the same day of missed counseling appointment for follow [DH1] .
4. Documents all services provided and interactions with individuals served or collateral within Center and program guidelines.
5. Counseling caseload may fluctuate based on staffing and number of individuals active LOC5 services. There are other licensed staff, counseling associates, and interns on MCOT who also provide counseling services to individuals served in LOC5 services.

  i.  Individuals served in LOC5 services will be assigned to a counselor based on their preference of date, time, availability, clinical discretion, and supervisor discretion.

1. The Crisis Counselor will be assigned other MCOT tasks such as conducting risk of harm assessments, triages, aftercares, and other duties as deemed necessary by crisis leadership, when they are not scheduled to meet with individuals served for counseling.
2. Number of counseling days in a week is determined by the MCOT Program Manager and the needs of individuals served in LOC5 services.

5.  Provides emergency/crisis intervention when necessary, according to Texas Health and Human Services Commission (HHSC), Information Item V, trauma informed care principles, and center policies and procedures.

1. Respond to all calls assigned within a maximum of ten minutes.
1. Collaborates with MCOT team members to determine least restrictive treatment through screening form and other assessment methods.
1. Discuss treatment recommendations at the end of every ROH Assessment.
2. Ensure all appropriate documentation is complete within the timeframes allotted.
2. Collaborates on an individual level and with community agencies to carry out least restrictive environment.
1. Arrange or provide transportation as needed.
2. Facilitate ensure safety as needed.
3. Coordinate/confirm admission to inpatient facility as needed.
4. Complete triages as assigned. Notifies and staffs with appropriate manager if needed.
3. Respond to all ROH Assessments within one hour of receiving the call if in the community and 10 minutes of receiving the call if at the office or virtual.
1. Community assessments may be completed at secure locations within Denton County limits such as any of our DCMHMR locations, City Jails, Denton County Jail, medical hospitals, behavioral health hospitals, and schools.
2. MCOT also assesses individuals at unsecure locations such as private residences or facilities that do not have law enforcement or SRO's present. If assessments are completed at unsecure locations, local law enforcement is called to accompany MCOT on scene.
4. Ensures follow-up on 100% of individuals screened within 24 hours.
1. Complete and/or ensures screening email is sent to all necessary parties, with all necessary information to complete 24-hour follow up.
2. Follow up appointment is documented in appropriate schedule.
3. Like ROH assessments, follow ups are completed at unsecure and secure locations without law enforcement present.
5. MCOT team members will be asked to complete a variety of crisis related tasks at secure and unsecure locations.
1. If at any time staff feel unsafe during a crisis related task, it is the staff's responsibility to voice their concerns to their next level supervisor. The staff and next level supervisor will collaborate to determine the next steps.
6. Completes Adult Needs and Strength Assessment (ANSA)/Child and Adolescent Needs and Strengths (CANS) Assessment at time of Risk of Harm assessment to determine whether the individual qualifies for crisis level of care.
1. Document reasons for clinical decision if deviating into level of [DH2] .
2. Document the individuals determined level of care in crisis assessment and screening email.
7. Works collaboratively with MCOT to ensure all necessary level of care 9,0, and 5 services are provided.
1. Complete follow ups, LOC5 appointments, and case management appointments as assigned within deadline given.
2. Communicate recommendations to necessary staff (i.e. Counselor, Supervisors, Psychiatrist, Case Manager, etc.?)
8. Develops Crisis/Recovery plans collaboratively with each individual.
1. Crisis plans are completed at time of risk of harm assessment/recover plans are completed during LOC5 appointment, case management appointment, aftercare appointment or at time of modified intake into Mental Health services.
2. All persons with a substance abuse diagnosis, have a Recovery Plan goal which addresses substance abuse needs.
3. All Recovery Plan objectives are individualized and measurable.
4. The Recovery Plan is reviewed as needed and updated when the individual served  identifies new goals or completes goals.
9. Completes aftercare appointments with individuals released from the contract hospitals or state hospital the same business day and link those individuals to appropriate center/community resources.
1. Complete aftercares as assigned including all necessary paperwork.
2. Assign case manager and communicate via email information regarding individual served, along with any treatment recommendations. Copies new case manager's supervisor on emails.
3. Collaboratively facilitate completion of satisfaction survey and turns into appropriate person by end of business day.
4. Ensure individual served gains access to medications by completing necessary paperwork and faxing to pharmacy when applicable.
5. Provides referrals as needed.
10. Completes LPHA assessments for Crisis Residential Unit (CRU) admission as assigned.
1. When applicable collaboratively completes LPHA CRU assessments and all necessary paperwork.
2. Staff as needed with program manager, director, or administrator.
11. Documents all services provided to an individual served or on behalf of an individual served according to center guidelines.
1. Documentation is completed within 2 business days and uploaded into Smart Care if applicable.
2. Complete ROH Assessment documentation within one hour of interview.
3. Corrections are completed within 2 business days of being notified.
4. 24 hour follow ups are documented by the end of each shift.
5. Respond to emails within a timely manner.
12. Contact supervisor or designated backup for clarifications of procedures or clinical assistance as needed.
1. Communicate urgent clinical and logistical needs with appropriate manager.
2. Contact Team Lead or Program Manager for clarification of protocols or needed direction or assistance.
13. Shares knowledge and resources by collaborating with teammates and sharing community resources when beneficial to an individual's treatment.
14. Is familiar with all applicable Texas Administrative Code (TAC), fidelity tools and HHSC contract information and Center policies and procedures.
1. All documentation is completed within two business days.
2. Skill training notes include fidelity words.
3. All documentation is complete, accurate, and compliant with Center and HHSC guidelines.
4. Sign company cars out prior to use and in after use, complete travel log in each car, complete maintenance request upon identifying problems, fills cars up with gas using center gas card when cars reach ? tank, and  follow center policy regarding accidents in center vehicles or on center time.
15. Completes tasks in a manner that fosters principle of creating a safe place for both staff and individuals served.
1. Identify and report safety hazards to the appropriate manager.
2. Complete Incident Reports according to Denton County MHMR Policies and Procedures.
16. Ensures charts are in compliance with HHSC contract requirements and standards.
1. Respond to all chart audits by assigned deadline.
2. All paperwork will be signed in black ink with credentials and date.
17. Works in a team setting and provides support and assistance to other MCOT members as needed.
18. All assignments given are completed in a timely manner.
19. Has the ability to work independently and make decisions but seeks guidance when needed.
1. Attempt to contact all collaterals to gather or collaborate information provided during ROH Assessment, prior to staffing with management.
2. Staff as needed with appropriate manager.

25.  Participates in the Center's Zero Suicide Initiative.

a.  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.

b.  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.

c.  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.