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Office of Mental Health

Home and Community Based Services Waiver
Guidance Document
Division of Children and Families

300.5 Roles, Qualifications, Training Requirements for Crisis Response, Intensive In-Home, Skill Building, Respite and Family Support Services Workers

Policy

The five Waiver services other than Individualized Care Coordination are Crisis Response, Intensive In-Home, Skill Building, Family Support and Respite. Workers who deliver these services may be employed by the Individualized Care Coordinator (ICC) agency or work for a subcontracted provider. Prior to delivering services, each worker must provide professional and/or personal references and a personal history of his/her experience and appropriateness to provide the service, be cleared by the State Child Abuse Register, complete fingerprinting clearance (if hired after April 1, 2005), demonstrate that qualifications are met for the service being provided and complete training requirements. Note that any worker without appropriate documentation of fingerprinting and State Child Abuse Register clearance must not be alone with and must be directly supervised in all contacts with Waiver clients until appropriate documentation is received by the ICC agency. Each worker must be familiar with the service plan and the safety plan for the child with whom they are working and must sign a statement to that effect. The following describes the role and primary responsibilities as well as the required qualifications and training, pertaining to workers in each of the five services. For a complete listing of competencies for workers in each of the five services, see the website link following each description.

Crisis Response Services Workers

Job Description:
Crisis Response Services Workers perform interventions designed to assist children and families when they are in crisis. These workers provide immediate, short-term interventions until linkages are made with other appropriate services. This may include assessment, consultation, facilitating the safety plan's interventions and referral wherever and whenever necessary on a 24 hour/7 day a week basis. For a listing of Crisis worker competencies, see Crisis Response Services CRS Competencies.

Qualifications:

Crisis Response workers must:

  • have a Master's degree in one of the following fields: audiology, child and family studies, communication disorders, community mental health, counseling, education, nursing, occupational therapy, physical therapy, psychology, recreation, recreation therapy, rehabilitation, social work, sociology, or speech and language pathology, human services, human development, criminal justice or other related degrees, or a NYS Teacher's Certificate, and two years experience providing direct services for children with one or more of the following primary diagnoses: mental illness, mental retardation, alcoholism, chemical dependency or substance abuse
    or
    a Bachelor's degree in one of the above fields, or a NYS Teacher's Certificate, and four years experience providing direct services, or providing linkage to services, for children with one or more of the following primary diagnoses: mental illness, mental retardation, alcoholism, chemical dependency or substance abuse. Qualifying experience may be pre- or post- degree. Candidates may qualify by meeting the qualifications for the NYS Intensive Case Manager position.
  • be affiliated with an OMH-certified provider;
  • be cleared by the State Child Abuse Registry; and
  • complete fingerprinting clearance (if hired after April 1, 2005).

Training:

Crisis Response workers must:

  • Complete training in Partnering for Safety (PFS);
  • have training in mental health diagnosis Diagnostic and Statistical Manual (DSM-IV), suicide assessment, psychopharmacology, crisis intervention techniques, and available community resources;
  • complete Mandated Reporting self-direct online training* (effective May 2015); and
  • complete OMH online Foundations training when other service specific required trainings are either not offered or scheduled within the first 30 days of employment (effective May 2015).

Intensive In-Home Services Workers

Job Description:
The Intensive In-Home (IIH) provides services that help to facilitate the child's emotional and social development and learning. The IIH worker receives direction from the Individual Care Coordinator who assures the initial and on-going flow of clinical information between the ICC, the treatment provider and the IIH worker. The IIH worker supports the child and family in implementing both their Treatment Plan (from the clinical provider) and the Waiver Service Plan (established by the Waiver program) by engaging the child and family in ways that support the everyday application of treatment methods as described in the child's Treatment Plan and Waiver Service Plan. Specifically, the IIH worker reinforces desired cognitive and behavioral changes to prevent crises and to support the emotional well–being of the child and family. As each family is unique, strategies are designed to be sensitive to the family's culture and values and may include: anger management, socialization (issues/dynamics as opposed to functional social skills), psycho–education, post crisis de–briefing, re–enforcing the integration of safety plans in the home, parent–child relationship building, teaching parenting skills, providing support in emotional self-regulation in situational contexts, encouraging supportive sibling relationships with the Waiver child, developing healthy coping mechanisms, making healthy choices, inter–personal communication, building self-esteem, clarifying identity issues, etc. IIH Services may be provided in the home or in the community for an individual child and their family. IIH can be billed at the individual rate only, not the group rate. For more details, see IIH Competencies.

Qualifications:

Intensive In-Home workers must:

have a Master's degree in one of the following fields: audiology, child and family studies, communication disorders, community mental health, counseling, education, nursing, occupational therapy, physical therapy, psychology, recreation, recreation therapy, rehabilitation, social work, sociology, or speech and language pathology, human services, human development, criminal justice or other related degrees, or a NYS Teacher's Certificate, and two years experience providing direct services for children with one or more of the following primary diagnoses: mental illness, mental retardation, alcoholism, chemical dependency or substance abuse
or
a Bachelor's degree in one of the above fields, or a NYS Teacher's Certificate, and four years experience providing direct services, or providing linkage to services, for children with one or more of the following primary diagnoses: mental illness, mental retardation, alcoholism, chemical dependency or substance abuse. Qualifying experience may be pre- or post- degree. Candidates may qualify by meeting the qualifications for the NYS Intensive Case Manager position.

  • be cleared by the State Child Abuse Registry; and
  • complete fingerprinting for a criminal history background clearance (if hired after April 1, 2005).

Training:

IIH workers must complete:

  • 14 Collaborative Action, Research and Training C.A.R.A.T. curriculum (If the worker has a Master's degree, IIH services may be provided prior to completion of the 14 C.A.R.A.T. training but the worker must complete the training when next offered in the agency's region or as reasonable in other regions);
  • Partnering for Safety (previously ‘Safety in the Community’);
  • complete Mandated Reporting self-direct online training*(effective May 2015);
  • complete OMH online Foundations training when other service specific required trainings are either not offered or scheduled within the first 30 days of employment (effective May 2015).

Training is strongly recommended in areas such as working with specific child diagnostic populations, overviews of evidence based practices, child and adolescent developmental stages, substance abuse, trauma, suicide prevention, teaching parenting skills, and stress management techniques.

Skill Builder

Job Description:

Skill Builders focus on the developmental stage of the child and work with the child towards achieving age appropriate developmental tasks. In collaboration with the Individual Care Coordinator, they design and provide activities that assist children in developing skills for performing age appropriate tasks needed to live successfully in their homes and communities. Skill Builders help the child to identify current assets and strategies for acquiring desired ones. Skill Builders may work with an individual Waiver child or groups of Waiver children on developing specific social skills necessary for acceptable social interactions such as how to give and receive a compliment, how to start a conversation, how to ask for something, the etiquette of common courtesy, etc. Activities may support areas such as completing schoolwork, being part of a team, handling money and activities of daily living. Skill Builders may also work with youth in developing skills for independent living and in accessing vocational skills training. They may also work with the Waiver child’s family, including siblings, in teaching them how to best support the child in maintaining the skill sets. For a description of Skill Building Service worker competencies, see SKB Competencies.

Qualifications:

Skill Building Service workers must:

  • be at least 18 years of age;
  • have experience working with children (preference given to those with experience working with children with special needs);
  • have some high school education (a high school diploma or G.E.D. preferred)
  • be supervised by an individual who meets the criteria for a "qualified mental health staff person" found in 14 NYCRR 594 or 14 NYCRR 595;
  • be cleared by the State Child Abuse Registry; and
  • complete fingerprinting for a criminal history background clearance (if hired after April 1, 2005).

Training:

  • Complete training in Partnering for Safety (PFS);
  • successfully complete OMH’s Online Foundations training (effective May 2015);
  • complete Skill Building Fundamentals training (worker must complete the training when next offered in the agency's region or as reasonable in other regions); and
  • complete Mandated Reporting self-direct online training*(effective May 2015).
  • must receive training in Partnering for Safety (previously ‘Safety in the Community’) or equivalent provided through their agency or ICC agency.

Respite Care Services Workers

Job Description:
Respite Workers temporarily care for the Waiver child, on an emergency or planned basis, providing relief from care-giving responsibilities for the family. This eases the on-going stress often experienced by families of children with serious emotional disturbances. Respite Workers supervise the child and engage the child in recreational activities that support his/her constructive interests and abilities. Respite may occur in the child’s home, the respite worker’s home or in the community with one child or a group, as defined in Waiver Billing Rules, of Waiver children. For a description of Respite worker competencies, see RS Competencies.

Qualifications:

Respite workers must:

  • be staff of an OMH-certified Community Residence, including Crisis Residence, which has an OMH Operating Certificate demonstrating compliance with 14 NYCRR 594;

or

  • be a respite worker who:
    • is at least 18 years of age for daytime and 21 for overnight services;
    • has experience working with children (preference given to those with experience working with children with special needs);
    • has some high school education (a high school diploma or G.E.D. is preferred) and
    • is supervised by an individual who meets the criteria for a "qualified mental health staff person"1 found in 14 NYCRR 594 or 14 NYCRR 595; and
    • is cleared by the State Child Abuse Registry; and
    • has completed fingerprinting for a criminal history background clearance (if hired after April 1, 2005).

Training:

  • Respite workers who have completed one of the following OMH-approved training curriculum: Rest A Bit, Parenting Skills Training, Model Approach to Partnerships and Parenting (MAAP), Therapeutic Crisis Intervention or alternative OMH approved curriculum and the Individualized Care Model prior to January 2008 are not required to complete the OMH Respite Curriculum;
  • Respite workers must receive training in Partnering for Safety (previously ‘Safety in the Community’) provided through their agency or ICC agency;
  • complete Mandated Reporting self-direct online training*(effective May 2015);
  • successfully complete OMH’s Online Foundations training (effective May 2015);
  • complete Respite Fundamentals training (worker must complete the training when next offered in the agency's region or as reasonable in other regions).

Note: Staff working in an OMH certified community residence, crisis residence or family based treatment program who have met the training requirements for that program are exempt from completing the OMH Respite curriculum. "OCFS licensed/certified Therapeutic Foster Homes" can provide Respite to Home and Community Based Services (HCBS) Waiver children. The training requirements of their certified program will meet the training requirement for Waiver Respite.

Respite and Skill Builders Training Addendum

It is the responsibility of the ICC agency to approve the qualifications for each sub-contractor staff. For Skill Builders and Respite Workers with degrees including advanced degrees (Master's degree and PhD) in the human services field (defined in 300.4) that may wish to provide Respite or a limited skill set training for a limited number of HCBS Waiver children and youth, the ICC agency may individualize the Respite and the Skill Builders curriculum training and allow individuals with advanced human services degrees, for example, to read all or portions of the curriculum and discuss the material with the approved trainer or review materials learned from training they have completed to meet the competencies of the Respite or Skill Builder position. See Respite Worker and Skill Builder and Respite competencies above.

The ICC agency will need to document any individualized Respite or Skill Builders training other than the approved OMH Foundations and Fundamentals curriculum training with their rationale for approval to be reviewed during annual site visits. Field Coordinators are available for consultation and to ensure that there is consistency across regions in determining any alternate individualized training but the responsibility remains with the HCBS Waiver provider about determining and approving alternate individualized training requirements for Respite Workers and Skill Builders with advanced degree credentials.

Family Support Service Workers

Family Support Worker Job Description:

FSW’s are parents who are raising or have raised a child with mental health concerns and are personally familiar with the associated challenges. FSW’s offer the integrity of their experience to the families they serve and are often able to connect with waiver families based on a unique understanding of their circumstances.FSW’s have first hand knowledge of the services and supports available in the community. FSW’s offer waiver families’ activities designed to enhance the family unit, ultimately developing safe, stable, and supportive families who are connected to their communities.

FSW’s offer resources, including, but not limited to: education, advocacy and support. FSW’s offer information to families on community resources, assist families in connecting to community resources and natural supports, and advocate with the family to access supports, services and activities. FSW’s introduce and connect families to community activities which foster family cohesion. These activities, which may be cultural, educational or recreational, are individualized for each family based on their culture, needs, values and preferences and are consistent with the family’s income to assure the possibility of continuing the activities post-Waiver.FSW’s are also expected to facilitate family/parent support groups. Family support group activities for parents (i.e.., monthly meetings, game nights, annual picnics) are provided as a venue for engaging parents with similar experience as a way of assisting in building natural support systems in their communities.

The role of the Family Support Worker is to:

  • Strengthen and support the care-giving efforts of families with special emphasis on needs such as: emotional, physical health, parenting, and family interaction.
  • Empower families to make informed choices regarding the nature of supports for themselves and their child by providing an understanding of what resources, services and supports are available and how to access them in their communities.
  • Develop a family's capacity to actively participate in all decisions about services and supports for themselves and their child.
  • Develop a family's capacity to enhance and improve the overall health and well-being of their child and family.
  • Work with the family and their provider team to promote effective collaboration and communication.
  • Strengthen and develop a family's skill and feeling of self-efficacy so they can effectively advocate for their child, work collaboratively with service providers and do so with increasing independence over time.

FSW’s may work with an individual parent/guardian or a group of Waiver parents/guardians. Workers must be supervised by an individual who meets the criteria for a "qualified mental health staff person" * found in 14 NYCRR 594 or 14 NYCRR 595 and described below. For a complete description of Family Support Service worker competencies, see FSS Competencies.

Qualifications:

Family Support Services workers must:

  • have some high school education (a high school diploma or G.E.D. is preferred);
  • be at least 18 years of age;
  • have experience working with children (preference given to those with experience working with children with special needs);
  • be a parent or caregiver of a child with a history of emotional or behavioral problems (parent or caregiver is defined as a parent, foster parent or other family member with direct responsibility for the care of a child with a diagnosis of emotional disturbance). OMH Parent/Family Advisors at the OMH Regional Offices assist in recruitment of qualified family support workers);
  • be cleared by the State Child Abuse Registry; and
  • obtain the Family Peer Advocate Credential within two years of employment (for new hires on/after November 1st, 2013); and
  • complete fingerprinting for a criminal history background clearance (if hired after April 1, 2005).

Training:

Family Support Services workers must:

  • complete Parent Empowerment Program (PEP) training the earliest of the next offered training in the agency's region (for new hires on/after November 1st, 2013);
  • complete Partnering for Safety (previously ‘Safety in the Community’) training as supplied by the ICC agency and
  • be supervised by a *qualified Mental Health staff person. This is defined as a licensed physician, a licensed psychologist, an MSW or CSW, R.N. other professional disciplines which receive the written approval of the Office of Mental Health, or any individual having education, experience and demonstrated competence (this is defined as Master’s or Bachelor’s degree in a human services related field, or Associate’s degree in a human services related field and three years experience in human services, or a high school diploma and 5 years experience in human services);
  • complete Mandated Reporting self-direct online training*(effective May 2015);
  • complete OMH online Foundations training when other service specific required trainings are either not offered or scheduled within the first 30 days of employment (effective May 2015).

* Self –Directed Mandated Reporting online training Leaving OMH site

Training is strongly recommended in First Aid/CPR.

Comments or questions about the information on this page can be directed to the Home and Community Based Waiver Program.