Gila River Health Care Corporation
Gila River Health Care Corporation
PROVIDER MANUAL
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Arizona Department of Health Services

Division of Behavioral Health Services
PROVIDER MANUAL
Gila River Regional Behavioral Health Authority Edition


Section 9.1 Training Requirements


9.1.1 Introduction
9.1.2 References
9.1.3 Scope
9.1.4 Did you know…?
9.1.5 Objectives
9.1.6 Procedures
9.1.6-A. Required training for behavioral health providers
9.1.6-B Annual and Ongoing Training Requirements
9.1.6-C. Office of Behavioral Licensure (OBHL) required training
9.1.6-D. Required training specific to Professional Foster Homes Providing HCTC Services
9.1.6-E. Required training specific to Community Service Agencies
9.1.6-F. Training Expectations for ADHS/DBHS Clinical Recovery Practice Protocols
9.1.6-G. Training Requests
9.1.6-H. Workforce Development


9.1.1 Introduction
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:

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.

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9.1.2 References
The following citations can serve as additional resources for this content area:

9.1.3 Scope
To Whom Does this Apply?

This section applies to all T/RBHAs and contracted behavioral health providers delivering covered services within the ADHS/DBHS public health and behavioral health systems.

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9.1.4 Did you know...?

  • ADHS/DBHS monitors the T/RBHAs to ensure behavioral health providers receive all required training.
  • ADHS/DBHS requires T/RBHAs to consult with providers regarding what training topics are necessary, how training curricula are developed and how training content is presented.
     
  • Information concerning the qualifications required of T/RBHA and provider trainers is determined by each T/RBHA. Please contact the Gila River BHS Training Coordinator to learn more about specific training information at 602-528-7100.
  • In addition to the required training content areas, T/RBHAs must ensure that appropriate training/technical assistance is available to behavioral health providers when deficiencies are identified.
     
  • Providers involved in ordering, providing, monitoring or evaluating seclusion or restraint must complete and document education and training. Education and training must include the following: understanding behavioral and environmental risk factors, nonphysical interventions, the safe use of seclusion or restraint and responding to emergency situations (see PM 7.3, Seclusion and Restraint Reporting).
  • Family members, peer-run, family-run, and parent-support organizations must be utilized to provide technical assistance, training, coaching and support to peers, family members and youth who assume leadership roles within the behavioral health system (i.e., roles or membership on Boards of Directors and advisory groups which develop and implement programs, policies, and quality management activities). For more information, see the ADHS/DBHS Office of Individual and Family Affairs web page.

9.1.5 Objectives
To ensure T/RBHAs and their contracted providers have the necessary knowledge, education and skills to increase and successfully provide high quality services for all individuals accessing and receiving services in the public behavioral health system.

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9.1.6 Procedures
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.

9.1.6-A Required training for behavioral health providers
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 responsibilities and annually as applicable (see subsection 9.1.6-D for training requirements applicable to Home Care Training to Home Care Client (HCTC) providers and subsection 9.1.6-E for training requirements applicable to Community Service Agencies):

Section 1

  • Fraud and program abuse recognition and reporting requirements and protocols;
  • Managed care concepts, including information on the T/RBHA and the public behavioral health system;
  • Screening for eligibility, enrollment for covered behavioral health services (when eligible), and referral when indicated;
  • Overview of Arizona behavioral health system policies and procedures in the Arizona Vision and 12 Principles in the children’s system,
  • 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,
  • Overview of partnership with Department of Economic Services/Rehabilitative Services Administration (DES/RSA);
  • Cultural competency; including Cultural Competency 101: Embracing Diversity (ADHS/DBHS curriculum); • Interpretation and translation services;
  • ADHS/DBHS Demographic Data Set, including required timeframes for data submission and valid values; and
  • Identification and reporting of quality of care concerns and the quality of care concerns investigation process.

Section 2

  • Use of assessment and other screening tools (e.g., substance-related, crisis/risk, developmental, Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program etc.), including the Birth-to-Five Assessment depending upon population(s) served;
  • Use of effective interview and observational techniques that support engagement and are strengths-based, recovery-oriented, and culturally sensitive;
  • Application of diagnostic classification systems and methods depending upon population(s) served;
  • Best practices in the treatment and prevention of behavioral health disorders;
  • Behavioral health service planning and implementation which includes family vision and voice, developed in collaborations with the individual/family needs as identified through initial and ongoing assessment practices;
  • 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);
  • Overview of Substance Abuse Prevention and Treatment Block Grant (SAPT): priority placement criteria, interim service provision, consumer wait list reporting, and expenditure restrictions of the SAPT Block Grant in accordance with requirements in PM Section 3.19, Special Populations; PM 3.2 Appointment Standards and Timeliness of Service and; 45 CFR Part 96;
  • 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 six months of the staff person’s hire date. (Protocol training is only required if pertinent to populations served).
  • Clinical training as it relates to specialty populations including but limited to conditions based on identified need;
  • Information regarding 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/DCYF); and
  • Understanding behavioral and environmental risk factors, nonphysical interventions, the safe use of seclusion or restraint and responding to emergency situations in accordance with PM 7.3, Seclusion and Restraint Reporting.

Section 3

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) and Deficit Reduction Act (DRA)). Additional trainings may be required, as determined by geographic service area identified needs.

ADHS/DBHS also recognizes that there may be ongoing training requirements, specific to each T/RBHA. Please contact the Gila River BHS Training Coordinator to learn more about specific training information at 602-528-7100.

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9.1.6-B. Annual and Ongoing Training Requirements

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:

  • ADHS/DBHS Demographic Data Set, including required timeframes for data submission, valid values and as changes occur;
  • Monthly trainings concerning procedures for submissions of encounters as determined by ADHS/DBHS;
  • Annual cultural competency and linguistically appropriate training updates for staff at all levels and across all disciplines respective to underrepresented/underserved populations;
  • Identification and reporting of Quality of Care Concerns and the Quality of Care Concerns investigations process;
  • Inter-rater reliability;
  • American Society of Addition Medicine Patient Placement Criteria (ASAM PPC-2R);
  • Child and Adolescent Service Intensity Instrument (CASII);
  • Ticket to Work/Disability Benefits 101;
  • Peer, family member, peer-run, family-run and parent-support training and coaching,
  • 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 PM 5.4, Special Assistance for Persons Determined to Have a Serious Mental Illness) and;
  • Workforce Development trainings specific to hiring, support, continuing education and professional development.

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) and Deficit Reduction Act (DRA)). Additional trainings may be required, as determined by geographic service area identified needs.

ADHS/DBHS also recognizes that there may be ongoing training requirements, specific to each T/RBHA. Please contact the Gila River BHS Training Coordinator to learn more about specific training information at 602-528-7100.

9.1.6-C. Office of Behavioral Health Licensure (OBHL) required training

Training must be completed and documented in accordance with OBHL requirements (see R9-20-204(F) and R9-20-206 and http://www.azdhs.gov/als/behavior/training.htm).

9.1.6-D. Required training specific to Professional Foster Home Providing HCTC Services

Children
Medicaid reimbursable Home Care Training to Home Care Client (HCTC) services for children are provided in Professional Foster Homes licensed by the Arizona Department of Economic Security, which must comply with training requirements as listed in R6-5-5850. All agencies that recruit and license Professional Foster Home providers must provide and credibly document the following training to each contracted provider:

  • CPR and First Aid Training;
  • 18 hours of pre-service training utilizing the Arizona Home Care Training to Client Service Curriculum..

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.

Adults
Medicaid reimbursable HCTC services for adults are provided in Adult Therapeutic Foster Homes licensed by the ADHS/OBHL, and must comply with training requirements as listed in R9-20-1502:

  • Protecting the person’s rights;
  • Providing behavioral health services that the adult therapeutic foster home is authorized to provide and the provider delivering HCTC services is qualified to provide;
  • Protecting and maintaining the confidentiality of clinical records;
  • Recognizing and respecting cultural differences;
  • Recognizing, preventing or responding to a situation in which a person:
    • May be a danger to self or a danger to others
    • Behaves in an aggressive or destructive manner;
    • May be experiencing a crisis situation; or
    • May be experiencing a medical emergency;
  • Reading and implementing a person’s treatment plan; and

  • 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 R9-20-15022.

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9.1.6-E. Required training specific to community service agencies
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 and Procedure Manual MI 5.2, Community Service Agencies – Title XIX Certification.

9.1.6-F. Training Expectations for ADHS/DBHS Clinical and Recovery Practice Protocols
Under the direction of the ADHS/DBHS Chief Medical Officer, 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://www.azdhs.gov/bhs/guidance/guidance.htm.

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 Practice Protocol, Unique Needs of Children, Youth and Families Involved with Child Protective Services).

Training on Child and Family Team (CFT) practice, depending on the population(s) served; (See ADHS/DBHS Practice Protocol Child and Family Team Practice) Training curriculums can be differentiated based on the role (BHMP, BHT, Coaches, Family Support Partners, Supervisors, etc.) of training participation provided in CFT Practice. Curriculums and certification processes shall be approved by T/RBHAs and ADHS/DBHS.

9.1.6-G. Training Requests
For additional training requests and/or technical assistance specific to the trainings listed above and /or identified area of need, please contact the Gila River BHS Training coordinator at 602-528-7100.

9.1.6-H. Workforce Development
Training Expert:
T/RBHAs must employ a training expert/contact as key personnel and point of contact to implement and oversee compliance with the training requirements, training plan, PM 9.1, Training Requirements and participate in the Training Coordinators committees.

Training Development Plan:
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.

Training Quarterly Updates:
Each T/RBHA must submit a Workforce Development Quarterly Update which includes information specific to initiatives and activities specific to training. Quarterly updates are to be submitted 30 days after quarter end.

ADHS/DBHS Ownership of any intellectual property:
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.

Exceptions:

  • Those cases in which the production of such materials is part of sponsored programs;
  • those cases in which substantial University resources were used in creating educational materials; and
  • those cases which are specifically commissioned by contacted vendors or done as part of an explicitly designated assignment other than normal contactor educational pursuits.

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9.1 Training Requirements
Last Revised: 3/1/2013
Effective Date: 3/1/2013

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