General Description
Under direction of the Chief Medical Officer ( CMO ) and within federal, state, and local guidelines performs quality psychiatric clinical work. This position reports to the CMO except for scheduling time off, training, and general program related matters which is coordinated by the Clinic Operations Director in collaboration with the center CMO. Work involves assessing, planning, and providing comprehensive patient care independently or in collaboration with other health care professionals. Part of the position may be grant funded.
Provide Psychiatric services in the Denton County MHMR Center outpatient clinics 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 a degree as a medical doctor with psychiatric specialty required.
• Board Certification in Psychiatry, prior experience with the MHMR priority population, prior experience with dual diagnosis (developmental disabilities, substance abuse and mental illness) and prior experience working with children and adolescents preferred.
Registration, Certification, Licensure, and Other Qualifications
• Medical licensure must be current and without restriction
• Must have prescriptive authority
• Must maintain current licensure including DEA licensure
• 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
• Willingness to provide clinical supervision and delegation of prescriptive authority to Psychiatric Nurse Practitioners.
• Excellent written and verbal communication skills.
• Must be able to document and be proficient in using an Electronic health record.
• Unrestricted eligibility to participate in provider network for Medicare/Medicaid/other third-party payers
• Strong organizational skills.
• Ability to work with and treat individuals with sever 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; of methods and procedures in general medicine; and of the principles and practices in the development, implementation, and documentation of individualized care and treatment plans.
• 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.
• Skill in the care and treatment of patients, in the use of medical and psychiatric diagnostic and treatment tools and equipment,
• Ability to apply commonsense understanding to carry out complex instructions
• Ability to deal with situations that may involve a high degree of variables.
• Ability and skills in operating computers, printers, and applicable computer software.
• Ability to use and document in center’s Electronic Health Record System. Computer skills, typing skills and proficiency necessary to use and document in electronic medical record, Microsoft Office programs, and email.
• 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 according to applicable Texas Administrative Code, as outlined in the DCMHMR policies and procedures.
• Conducts a psychiatric evaluation. Explores and takes in to account all relevant data sources in conduction and formulating diagnosis.
• 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.
• Conducts medication management and monitoring
• Completes documentation on the same day.
• CPT coding sheet is completed on the same day of the service.
• Diagnosis updates are done at least annually and additionally as necessary.
2. Orders lab studies as recommended by prescribing guidelines and according to the DCMHMR Standing Lab Orders.
• Appropriate labs are ordered, available labs are reviewed appropriately when prescribing psychotropic medications.
• Reviews and signs off lab results in timely manner.
• 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 doctor’s caseloads.
• Medications will be prescribed appropriate to the diagnosis and according to the appropriate DSHS approved medication treatment guidelines and documented on the DCMHMR Clinical Record Form.
• Psychotropic consent is obtained and AIMS done appropriately.
• Work cooperatively with the client using recovery-based language and incorporate the client’s preferences for treatment when clinically appropriate.
• Patient and family education will be completed at each visit according to the Patient and Family Education (PFEP) program requirements and documented on the Denton County MHMR Clinical Record Form. This education will include information regarding diagnosis, treatment options, prescribed treatment, and recovery through self-monitoring and self-management.
• Will monitor and make recommendations regarding lab studies, according to the Denton County MHMR Standing Lab Orders and Abnormal Lab Value procedure.
• Avoid the use of polypharmacy and document clinical justification if required, following the DCMHMR Policies and Procedures regarding polypharmacy.
• Documents appropriately rational for prescribing and changes in the medication.
4. Serve as a member of the treatment team and make recommendations for plans of care.
• Seek consultation from the CMO and Psychiatric Peer Team on difficult cases and document this consultation.
• Refers clients to appropriate medical and community resources documenting this in the plan of care, eliciting assistance from case management, rehabilitation and nursing staff.
• Provides consultation and orders regarding treatment, to the RNs and LVNs, regarding clients on each center prescriber’s individual caseload or as the clinic doctor when a client’s treating physician or APRN is not available for consult. Sign verbal orders in a timely manner at the next available opportunity.
• Reviews each RN assessment at the client’s next appointment when the RN is working under Standing Orders and provide suggestions or corrections as needed.
• Participates in Peer Review when applicable.
• 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.
• Provides Certificate of Medical Examinations when applicable and as soon as possible considering existing clinic schedules.
• 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.
• 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, and TAC.
• Each note must contain the required elements for Medicaid or other third-party billing and must be completed at the time of service.
• Daily completion of Service Activity Logs is required along with accurate CPT coding.
• The attending psychiatrist will help facilitate filling out applications for disability benefits and prescription assistance programs when requested.
• The psychiatrist is to maintain consumer confidentiality and ethical standards.
7. Practices workplace safety procedures.
• Adheres to the use of Universal Precautions.
• Adheres to the Center Infection Control Plan.
• Informs appropriate staff of any safety hazard or issue promptly.
8. Attend regularly scheduled meetings.
• Attends regularly scheduled staff meetings.
• Attends regularly scheduled staff trainings.
• Attends regularly scheduled committee meetings.
• Attends regularly scheduled clinical team meetings.
9. Provides emergency intervention when necessary according to Department of Human Services (DHS) and Center rules and procedures.
• Provides verbal and physical Prevention Management of Aggressive Behavior (PMAB) intervention correctly when necessary.
• Provides Cardiopulmonary Resuscitation (CPR) in an emergency until other medical aid arrives.
• Provides emergency and non-emergency first aid until professional medical aid arrives or as directed by licensed medical professional.
• Maintains all emergency intervention training according to Denton County MHMR (DCMHMR) policies and procedures.
10. Provides courteous, professional services at all times.
• Provides appropriate customer service and demonstrates cultural sensitivity
• Supervise and delegate prescriptive authority to APRN
• Performs additional duties as assigned by CMO within designated timeframes.
• Demonstrates leadership, teamwork, dependability and customer service.
• Is available and approachable for consultation to nursing staff.
• Demonstrates willingness to work in walk- in clients and crisis clients.
• Works collaboratively with case managers and other treatment team members.
• Demonstrates cultural sensitivity and cultural awareness.
• Demonstrates ability to work with others to identify opportunities and resolve issues to achieve group goal.
• Willing to supervise and delegate prescriptive authority to APRN and provide appropriate supervision as required by law and governing Boards.
• Takes initiative and provides input towards the solutions
11. 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.