Credentials All counselors, licensed practitioners, and psychiatrists providing behavioral health overlay services in child welfare settings must meet the specific education and training requirements described in this chapter.
Counselor
Staffing Ratio The ratio of counselors to youth must not exceed one counselor to 20 youths.
Clinical Staff Qualifications and Responsibilities
Counselor
Qualifications To provide behavioral health overlay services in child welfare settings, a counselor must meet one of the following qualifications:
1. Hold a master’s degree from an accredited university or college in the field of counseling, social work, psychology, rehabilitation, special education, or in a related human services field (Effective October 1, 2014, graduate level coursework must have included at least four (4) of the following 13 content areas: human growth and development; diagnosis and treatment of psychopathology; human sexuality; counseling theories and techniques;
group theories and practice; dynamics of marriage and family systems;
individual evaluation and assessment; career and lifestyle assessment;
research and program evaluation; personality theories; social and cultural foundations; counseling in community settings; and substance abuse); or Or
2. Hold a bachelor’s degree from an accredited university or college in the field of counseling, social work, psychology, rehabilitation, special education, health education or in a human services field and have two years experience in working with children with serious emotional disturbances or substance abuse problems.
Counselors with bachelor’s degrees are restricted to providing face-to-face behavioral support services and group therapy. They may not provide individual or family therapy. Only counselors with a minimum of a master’s degree may provide individual and family therapy.
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Clinical Staff Qualifications and Responsibilities,
continuedCounselor Job
Responsibilities Counselors must be supervised by a licensed practitioner of the healing arts, as defined in this handbook.
Counselors are responsible for:
• Completing or requesting required assessments;
• Providing therapeutic support services and interventions;
• Providing individual, group and family therapy when indicated and in accordance with qualificationssupportive counseling;
• However, whenever a child or his family is assessed as needing more intensive therapy than supportive counseling, a master’s level practitioner, as defined in Chapter 1 of this handbook, must provide these individual or family services.
• Overseeing behavioral health treatment services associated with the treatment plan and with the recipient’s permanency plan;
• Training direct care staff in the implementation of the individualized treatment plan for behavioral health overlay services child welfare, including any behavioral management components;
Counselor Job
Responsibilities, continued
• Monitoring the overall course of treatment services and observing and documenting direct care staff’s implementation of the recipients individualized treatment plan.
• Participating in and Cconvening and participating in treatment team meetings as scheduled or as needed to discuss behavioral health overlay services child welfare;
• Developing the recipient’s behavioral health discharge plan and aftercare plan; and
• Providing Serving as a liaison with between the BHOS provider and the Substance Abuse and Mental Health Program OfficeDepartment of Children and Families, the Department of Juvenile Justice, other involved agencies, and the Child Welfare and Community- Based Care
organization’s case managerslead agency, and other involved agencies, if indicated, to address continuity of care issues..
Licensed
Practitioner Qualifications
Licensed practitioners must be licensed by the State of Florida under Chapters 458, 459, 490, 491, 464, F.S., providing for licensure of psychiatrists, physician assistants, psychiatric nurses or ARNP’s, clinical social workers, mental health counselors, psychologists, and marriage and family therapists. In addition, for recipients with a primary substance abuse diagnosis, licensed practitioners include masters prepared certified addictions professionals with a master’s degree.
To provide behavioral health overlay services child welfare, the licensed practitioner must meet the specific qualifications described in Chapter 1 and Chapter 2, Section 2 of this handbook.
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Clinical Staff Qualifications and Responsibilities,
continuedLicensed Practitioner Responsibilities
The licensed practitioner’s responsibilities include:
• Conducting interviews with recipients to develop individualized behavioral health treatment plans which must be in accordance with the policies in this handbook;
• Reviewing and signing the recipient’s:
Certification for Eligibility for Behavioral Health Overlay Services Child Welfare.
Psychosocial assessment if it is prepared by an unlicensed counselor.
Individualized behavioral health treatment plan. If the Licensed practitioner is enrolled in Medicaid as a treating provider, this signature may serve to authorize the treatment plan, without additional sign off by the psychiatrist,
• Providing documented weekly clinical supervision to the counselors.
Licensed practitioners may provide assessments, and individual or family therapy if a child or family is assessed as needing specialized or more intensive treatment services than can be provided by a bachelor’s level staff.
Behavior Analyst If behavior therapy is utilized by a provider, consultation with a certified behavior analyst or person with specialized training in behavior therapy is encouraged to:
• Review the behavior modification components of the treatment plan;
• Consult with staff implementing behavior management plans; and
• Provide training to direct care staff, counselors and administrators on behavior management principles and application.
Psychiatrist
Qualifications The psychiatrist must be a medical doctor or doctor of osteopathy, licensed pursuant to Chapter 458 or 459, F.S., and board eligible or certified in psychiatry.
Psychiatrist
Responsibilities The psychiatrist’s responsibilities include:
• Managing the delivery of psychiatric services to recipients;
• Supervising the treatment for recipients who are on psychotropic medications, in coordination with the primary health caregiver, when indicated by a recipient’s medical condition; and
• Authorizing the delivery of services to recipients that are not authorized by a licensed practitioner of the healing arts.
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Clinical Staff Qualifications and Responsibilities,
continuedClinical
Supervision A licensed practitioner must provide and document at least four hours of clinical supervision per month for each unlicensed counselor. The documentation should include the name of the participants, length of the meeting, and a list of the topics discussed. Licensed staff must be available by phone to provide emergency consultation services. through a posted on-call schedule. The supervision may be individual or group supervision. Treatment team meetings and treatment plan reviews may not be substituted for
supervision.
Recipient Eligibility for Behavioral Health Overlay Services
Who May Receive
Services To receive behavioral health overlay services, a recipient must be placed in a Medicaid-enrolled residential program that has been self-certified or self-certified to provide behavioral health overlay services in child welfare settings and must be certified as meeting the clinical criteria listed below.
Recipient Eligibility for Behavioral Health Overlay Services
Who May Receive
Services To receive behavioral health overlay services, a recipient must:
• be a child or adolescent under 18 years of age;
• be placed in a Medicaid-enrolled residential program that has been self-certified or certified to provide behavioral health overlay services in child welfare settings; and
• be certified as meeting the clinical criteria listed below.
Eligibility Criteria The recipient must meet both diagnostic eligibility criteria described in Section A and one of the eight risk factors in Section B.
Section A: Diagnostic Criteria
1. Has an ICD-9-CM diagnosis of 294.8, 294.9, 295.0 through 298.9; 300 through 301.9, 307.1, 307.23, 307.5 through 307.7, 308.0 through 312.4, 312.81 through 314.9; and 303.0 through 305.9; and
2. The child or adolescent demonstrates significant impairment of age-appropriate, developmental progression and psychosocial functioning as a result of the ICD-9-CM diagnosis, in one or more of the following areas:
family, social and peer relationships, educational or vocational.