Under direction of the Clinic Operations Manager and within federal, state and local guidelines performs complex (journey-level) human services support work and eligibility determination for prescription assistance programs (PAP). Work involves reviewing clients' records, interviewing clients, documenting client information, determining client eligibility for different PAP programs, verifying case data, explaining PAP benefits and requirements and providing information to clients or assisting staff in the delivery of social services. May train others.

This position adheres to all applicable laws, regulations, policies and procedures of DSHS, DADS, and DCMHMR. In addition, this position assists consumers who are indigent and without Medicaid or other prescription coverage to procure their medications from numerous pharmaceutical companies at no cost or low cost for psychiatric medications prescribed by DCMHMR physicians or Nurse Practitioner. Works under moderate supervision, with limited latitude for the use of initiative and independent judgment.

Education, Training, and Experience

• High School Diploma or General Education Degree required.
• Prefer one to two years of college or work experience.
• Good communication and organizational skills a plus.
• Prefer knowledge of psychotropic medications.

Registration, Certification, Licensure, and Other Qualifications

• 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.

• 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 the needs, problems, and community environments of persons with disabilities; of community and government service delivery systems; of case management systems; and of community welfare resources.
• Skill in the operation of computers, applicable computer software, and office equipment.
• Ability to negotiate services, to communicate effectively, to evaluate information, to perform basic arithmetic and data analysis, and to train others
• 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. Identifies potentially eligible clients to participate in Prescription Assistance Program (PAP) from schedule and by referrals from PCAs, nurses & other clinic staff.
2. Obtains, verifies, and calculates income and resources to determine eligibility for PAP.
   • Prints and reviews Planned Events for PAP report at least once per week.
3. Enters new PAP eligible clients in Med Data Services within 2 business days of receiving client's information.
4. Updates existing PAP eligible clients' information in Med Data Services when notified of a change within 2 business days.
5. Refers to individual PAP guidelines to determine client eligibility.
6. Generates, assists clients in completing and submits PAP applications for each client identified for psychiatric medications only. Works with Psychiatric Clinic Assistants, Nurses, and prescribers to secure needed scripts, signatures, and other information needed to complete application.
   • When notified by PCA or other clinic staff, generates applications and obtains signatures while client is still at center.
7. Generates applications for PAP renewals for upcoming appointments and distributes to the PCAs and Med Room Assistants by the morning of the appointment.
8. Highlights areas on applications that need to be completed or communicates instructions to the appropriate staff. Educates staff and clients on PAP application processes and requirements.
9. Maintains an accurate, up to date data base tracking system.
10. Monitors, reviews, and communicates client eligibility or enrollment status changes to the clients, authorized representatives, and appropriate staff as needed.
    • Documents in Med Data Services each time an application is sent to the prescriber or client; an application is received back from the prescriber or client; an application is sent to the PAP company; PAP meds are received; or refills are ordered.
11. Documents any status updates in Med Data Services, such as requesting documents from client, temporary approval, client missed appointment, more information needed from client, etc.
12. Provider's information about clients' PAP status when requested in a timely manner.
13. Works closely with clinic staff and management to ensure continuity of services.
14. May consult with program staff on policies & procedures, work practices, records, budgets, and community resources as needed.
    • Attends regularly scheduled PAP meetings. Provides updates on PAP reports requested by clinic management.
15. Communicates any emergent issues or questions that arise related to PAP with the Clinic Operations Manager and/or AON in a timely manner.
16. Informs clinic management and clinic staff of any changes to PAP programs promptly.
17. Acts as the point of contact for pharmaceutical representatives and communicates with them to identify new PAP needs.
    • Contacts pharmaceutical representatives to request samples, vouchers, or information when needed.
18. Works with PCAs to coordinate meetings between pharmaceutical representatives and prescribers.
19. Ensures all samples received are documented on sample sign in log.
20. Works with Consumer Benefits Staff to obtain needed documentation and verify information.
    • Files copies of income documentation and sends to PAP companies as appropriate received from Consumer Benefits department.
21. Contacts Consumer Benefits Supervisor to request assistance in obtaining any additional income documents needed, or to assist client in obtaining additional assistance.
22. Follows the PAP and medication procedures for all PAP interactions.
23. Follows all clinic and medication room procedures.
24. Logs in all PAP forms received.
25. Mails all forms as required.
    • Checks in all PAP medications with a second staff member. Handles and stores all PAP meds according to center policies & procedures.
26. Logs all PAP forms received in Med Data Services.
27. Counts and co-signs for any PAP meds being sent to contract pharmacy.

Performs additional duties as deemed necessary by department supervisor within designated timeframes, which may include:

1. Assists with medication room duties.
2. Monitoring sample medication inventory.
3. Participating in eval phone rotation.
4. Observing self-administration of med boxes by clients.
5. Escorting clients to and from lobby.
6. Documenting messages from nurse line and returns calls to clients as appropriate, referring calls to nursing staff as needed.
   • Follows all center policies & procedures and clinic work practices related to additional duties assigned.
7. Checks nurse line and accurately documents messages in a timely manner, at least once hourly, when assigned. Takes each call to NIC and follows instructions given. Legibly documents any actions taken in client's record.
8. Schedules evals following clinic protocol. Informs front desk of evals in a timely manner.
9. Counts and verifies medication amounts stored at clinic match records, along with a second staff member. Reviews inventory for expired meds and sets aside for disposal for nursing staff.
10. 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.