Dual Diagnosis Counselor

POSITION SUMMARY

The role of the Dual Diagnosis Counselor includes service delivery for adult patients in the Fora Health program to which the position is assigned. The Dual Diagnosis Counselor works under the direction of the assigned program manager and collaborates with a multidisciplinary team. The Dual Diagnosis Counselor has the skills to complete mental health and ASAM assessments, collaborative treatment plans, individual therapy, and group therapy, and to support patients’ ' referral to and transition between levels of care, in recovering from the effects of substance use and mental health disorders, consistent with the mission and philosophy of Fora Health. Program-specific duties are listed under Program Assignment Duties and are performed within the scope of this classification and assigned Program.

Work Schedule: Monday through Friday from 8:30am-5pm (with some evenings required)

ESSENTIAL JOB FUNCTIONS

Clinical Evaluation, Treatment Planning, and Documentation

• Inform patients of confidentiality rights, program procedures that safeguard them, and the exceptions imposed by regulations. Protect patient rights to privacy and confidentially in the communications of patient information. 
• Gather data systematically from the patient and other available collateral sources. Obtain and interpret all relevant assessment information and utilize the ASAM and DSM-5 to justify medical necessity of the ASAM level of care and overall risk, to include co-occurring disorder treatment needs
• Determine the patient's appropriate ASAM level of care and stage of change. Ability to utilize the DSM-5 to assess and diagnose substance use and mental health disorder at time of enrollment. 
• Formulate with the patient mutually agreed upon and measurable treatment outcome statements for each need. Identify appropriate strategies for each outcome.
• Assess treatment and recovery progress and, in consultation with the patient and internal integrated care team, and when indicated legal guardian, referent, or other external care team members, make appropriate changes to the treatment plan to ensure progress toward treatment goals at regular intervals and/or when indicated by changing circumstances.
• Utilize the electronic medical record and additional technology tools made available by Fora to document all patient encounters, to include progress and outcomes in relation to the treatment goals in progress notes, Mental Health and ASAM assessments and updates, (such as for re-authorizations or referral to a different level of care), screenings related to enrollment in specific services, progress notes, and transfer summary.
•  Apply placement, continued stay, and completion/transition criteria based on medical necessity and patient preferences. 
• Work collaboratively with all service areas within the agency to provide appropriate patient referrals and communicate relevant patient information as needed.  
• Communicate and collaborate with referral agencies regarding scheduled screenings, status of client, and treatment and discharge planning.
• Complete clinical documentation, including individual and group progress notes, referent contacts, treatment plan reviews, discharge plans, and discharge summaries within 24 hours from date of service provided, 
• Contact referents within 24 hours of admit, at least once per month during the patient’s treatment, and before and during the patient’s discharge. Document these contacts as case management progress notes.
• · ASAM and mental health treatment plan reviews and authorization summaries are completed and reviewed within 30 days of admit and on a regular cadence as required per insurance payer and program specific standards (at a frequency ranging from every 7 days, 30 days or every 90 days at a maximum thereafter). Submit treatment plans as required and post in a timely fashion in order to obtain continuing authorization for pa-tients
• · A Discharge/Continuity of Care Plan is developed with the client 30 days prior to a planned discharge, and continuing care plan is completed with patient in final session. 
• · A Discharge Summary is completed and the patient chart is closed within 5 days fol-lowing discharge. When required, insurance is notified within 24 hours of discharge.

Counseling and Education

• Establish a helping relationship with the patient characterized by professionalism, warmth, respect, genuineness, concreteness, and empathy.  
• Facilitate the patient’s engagement in the treatment and recovery process. 
• Be an active member of an integrated care team model, to include coordination of care with the peer mentors, psychiatric providers, medical providers, and other team members involved in the care team. Provide evidence-based models in individual and group counseling as a part of the therapeutic process to achieve treatment goals.  
• Meet individually with patients with the frequency determined by the treatment plan or program assignment.
• Demonstrate the skillset of cultural humility and remain aware of patient’s individualized needs in relation to cultural identity and values, ethnic background, age, and gender in treatment and recovery   
• Describe the health and behavior problems related to substance use, including transmission and prevention of HIV/AIDS, TB, STDs, and other infectious diseases.
• Be able to teach life skills, including but not limited to, stress management, relaxation, communication, and refusal skills.
• Provide therapeutic interventions to address treatment-interfering behaviors as needed. 
• Complete continuing education classes and maintain required credentials for position.  

Referral

• Arrange or assist patients in following through with referrals to other professionals, agencies, community programs, or other appropriate resources to meet patient needs. This includes referrals to longer-term external mental health treatment as part of the discharge plan when indicated. 
• Explain in clear language to the patient the necessity for and process of referral.
• Obtain written client consent that meets 42 CFR Part 2 and HIPAA requirements before disclosing patient information to outside providers, hospitals, referral agencies, or other third parties, except where a regulatory exception applies
• Exchange relevant information with the agency or professional to whom the referral is being made. Facilitate the patient’s transition to continuing care resources prior to their discharge from treatment. Document all referral/case management services provided. 
• Develop effective collaborative relationships with mental health practitioners, prescribers, PO’s, ADSS/ADES’S, EAP, DHS etc., or insurance authorization representatives, and/or any other agency with whom the patient is engaged.

Professional and Ethical Responsibilities

• Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the patient 
• Adhere to Federal and State laws and agency policies and procedures regarding the treatment of substance use disorders.
• Recognize the importance of individual differences that influence patient behavior and apply this understanding to clinical practice.
• Participate in ongoing supervision and consultation.
• Maintain (or complete) current addiction counselor certification and QMHP privileging or mental health licensure.
• Maintains healthy boundaries with patients and their families.  

Functions as an Active Member of the Program Clinical Team

• Contribute to a high quality patient experience by remaining a flexible and positive team member at all levels of care. This includes supporting overage needs within all departments as assigned by direct supervisor; which includes assessments, group, individual sessions, and case management with little to no advance notice to ensure patient needs are met during last minute schedule changes. This includes cross department coverage at all levels of care.
• Attend and participate in all treatment team meetings as assigned.
• Attend all clinical supervision meetings as assigned. 
• Maintain and strengthen good working relationships with team members.
• Communicate and coordinate with staff from other departments effectively. 
• Maintain cleanliness and safety of work environment. 
• Attend all meetings as assigned. 
• Perform related tasks as assigned.

ADDITIONAL JOB RESPONSIBILITIES

• Additional trainings to be completed as assigned in a timely manner
• Special projects and other duties as assigned

SUPERVISORY FUNCTIONS

• This position has no supervisory duties.

QUALIFICATIONS

EDUCATION AND EXPERIENCE REQUIRED

• Graduate degree in psychology, social work, or other behavioral health field.
• Per OARs, QMHP credential or master’s level licensure (LPC, LCSW, LMFT)

A QMHP must demonstrate the ability to conduct an assessment, including identifying precipitating events, gathering histories of mental and physical health, substance use, past mental health services and criminal justice contacts, assessing family, cultural, social and work relationships, and conducting a mental status examination, complete a DSM diagnosis, write and supervise the implementation of a Service Plan and provide individual, family or group therapy within the scope of their training. 

• CADC I or ability to qualify for CADC I credential within 6 months. CADC II or III preferred

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

• Has basic knowledge of substance use disorders and the impact SUDS has on managing mental health symptoms. 
• Has basic understanding of mental health diagnoses and symptomology 
• Understands basic psychopharmacology 
• Can describe warning signs, symptoms, and the course of substance use disorders.
• Can describe how substance use disorders affect families and concerned others.
• Can describe principles and philosophy of prevention, treatment, and recovery
• Incorporates foundational models (e.g., MI, DBT, ACT, CBT, IFS)
• Skillfully addresses issues related to self-awareness, diversity, and ethics
• Effectively communicates and establishes rapport
• Can facilitate clinical evaluation covering the scope of both ASAM and DSM 5 dimensions
• Demonstrates knowledge of and ability to maintain clinical documentation, including treatment plans, consistent with agency standard
• Demonstrates ability to facilitate groups
• Able to effectively engage in problem solving and independent decision making. 
• Understands emergency situations and protocols to maintain a safe milieu. Ability to use de-escalation skills in crisis situations. 

OTHER REQUIREMENTS

• For employees with a history of substance use disorder, Fora Health’s policy requires certification of a minimum of two years of sobriety for this position.
• Ability to pass a pre-employment or for cause drug tests.
• Ability to pass DHS criminal background.
• Completed registration with Oregon Health Authority (DMAP) and National Plan and Provider Identifier (NPI).

WORKING CONDITIONS

• This position generally works in an indoor office or clinical environment, with travel between Fora Health sites, to special events, 
• Position requires some evening and weekend work based on patient need Adjustment of work schedule may be required to avoid overtime
• Possible exposure to communicable diseases which can encompass a variety of illnesses and infections, including tuberculosis, Hepatitis A, B, and C, and HIV.
• Possible exposure to upset, angry, severely traumatized, disabled, or emotionally disturbed adults and families.
• Shift work may include weekday, weekend, and holiday hours.
• Exposure to potentially hazardous cleaning chemicals, personal protective equipment provided.