This recruitment is for level I/II/II.
The Butte County Behavioral Health Psychiatric Health Facility (PHF) is seeking nurses (LVN, LPT) to provide direct client care to patients receiving inpatient psychiatric treatment in our facility treating our community members in psychiatric crisis. Care includes, but is not limited to, consultation with providers, participating in multidisciplinary team meetings, medication administration, managing admissions and discharges, oversight of facility functioning and providing quality documentation. 
FLSA: Non-Exempt
DEFINITION
Under close supervision (Behavioral Health Emergency & Forensic Psychiatric Technician I), general supervision (Behavioral Health Emergency & Forensic Psychiatric Technician II) or supervision (Behavioral Health Emergency & Forensic Psychiatric Technician III), provides medication management support to clients; collaborates with other medical staff and interdisciplinary health treatment teams to implement treatment plans and reports on impact of medications; and may serve as first point of contact for clients discharged from psychiatric facilities to orient them to County behavioral health services. Non-traditional working hours/shifts (weekend, nights and holidays) may be required depending on specific assignment; performs related duties as assigned.
 
SUPERVISION RECEIVED AND EXERCISED
Receives supervision from assigned supervisory or management personnel. Exercises no direct supervision over staff.
 
CLASS CHARACTERISTICS
Behavioral Health Emergency & Forensic Psychiatric Technician I: This is an entry-level classification in the Behavioral Health Emergency & Forensic Psychiatric Technician series. Positions at this level learn duties as assigned, working under close supervision. This class is distinguished from the Behavioral Health Emergency & Forensic Psychiatric Technician II in that the latter performs the full range of work assigned to the series. 
 
Behavioral Health Emergency & Forensic Psychiatric Technician II: This is the journey-level classification in the Behavioral Health Emergency & Forensic Psychiatric Technician series. Positions at this level perform the full range of duties assigned, working independently and exercising judgment and initiative. Positions at this level receive only occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies of the work unit. This class is distinguished from the Behavioral Health Emergency & Forensic Psychiatric Technician III in that the latter performs the more complex work assigned to the series.
 
Behavioral Health Emergency & Forensic Psychiatric Technician III: This is the advanced journey-level classification in the Behavioral Health Emergency & Forensic Psychiatric Technician series responsible for performing the most complex work related to providing medication management and nursing services to behavioral health clients. Incumbents regularly work on tasks which are varied and complex, requiring considerable discretion and independent judgement. Positions in the classification rely on experience and judgement to perform assigned duties. Assignments are given with general guidelines and incumbents are responsible for establishing objectives, timelines, and methods to deliver services. Work is typically reviewed upon completion for soundness, appropriateness, and conformity to policy and requirements.
 
Positions in the Behavioral Health Emergency & Forensic Psychiatric Technician class series are flexibly staffed; positions at the II- and III-levels may be filled by advancement from the I- and II-levels, respectively; progression to the II-level is dependent on (i) management affirmation that the position is performing the full range of duties assigned to the classification; (ii) satisfactory work performance; (iii) the incumbent meeting the minimum qualifications for the classification including any licenses and certifications; and (iv) management approval for progression to the II-level.
 EXAMPLES OF TYPICAL JOB FUNCTIONS
Typical functions may include any of the following tasks, knowledge, abilities, and other characteristics. The list that follows is not intended as a comprehensive list; it is intended to provide a representative summary of the major duties and responsibilities. Incumbent(s) may not be required to perform all duties listed, and may be required to perform additional, position-specific tasks.
Some duties, knowledge, skills, and abilities may be performed in a learning capacity for entry-level (I Level) positions.
 

• Perform Behavioral Health Emergency and Forensic Psychiatric Technician work in a locked facility with constant and direct patient interaction.
• Daily and ongoing exposure to volatile, acting out, verbally aggressive and physically violent clients, including clients who may be under the influence of drugs or alcohol or with a history of criminal violence.
• Primarily evaluates patients in a variety of in- and out-patient settings, such as Juvenile Hall, County Jail, County Behavioral Health offices, hospital emergency, Crisis Responses, and other settings; obtains patient history and conducts behavioral status exam.
• Primarily responds to community-based environments (upon referral and acute need), with less access to other in-person behavioral health resources, including but not limited to: homeless encampments, homeless shelters, personal homes, and sober living environments.
• Required to physically intervene and/or restrain clients.
• Required to assist with client’s personal care needs (toileting, showering etc.). 
• Required to give emergency medications (against client’s will, resisting person).
• Provide regular/ongoing redirection of inappropriate behaviors. 
• Ongoing management of minor/chronic medical needs (wound care, diabetes management etc.)
• Transport and monitor involuntary clients within community. 
• Management of medication room (ordering, stocking, destruction, etc.,). 
• Performs complex forensic, mental health, or substance use related evaluations. 
• Attends court proceedings and is expected to interact with Judges, District Attorneys, Probation, Public Defenders, County Counsel, and other agency officials.
• Respond as needed to cover shifts to meet mandatory staffing requirements (weekends, holidays, and afterhours included).
• Facilitate and participate in Lanterman-Petris-Short Act (LPS) related certification hearings, LPS conservatorship hearings, Mental Health Diversion proceedings, and other court procedures as required. 
• Provide regular/ongoing redirection of inappropriate behaviors.
• Under the direction of clinical staff, provides medication management services to behavioral health clients; ensures the proper acquisition and administration of medication; may travel to outpatient clinics, residences, transitional housing, inmate facilities, or other locations to work with clients.
• Serves as initial point of contact for clients who have been discharged from a psychiatric health facility; orients clients to the County’s behavioral health services; verifies client information, including medical history and medication needs; responds to client questions and concerns.
• Performs nursing procedures such as administering medications and treatments, including oral medications, hypodermic injections, and charting temperature, pulse and respiration; observes patients’ conditions and behavior; reports significant changes to unit supervisor or physician and records nursing notes on patients; gives first aid as needed.
• Collaborates with clinical staff to process new prescriptions and refills; works with insurance companies to obtain approvals; writes medical justifications to have prescriptions approved, as necessary; works with clinical staff and insurance companies to determine options when prescriptions are denied.
• Collects, organizes, and delivers medications to clients; provides education and training to clients, their families, and/or staff on the proper care and use of medications, including symptoms of, reaction to, or side effects of, specific medications; informs clients of the impact of abuse and/or misuse of medications.
• Conducts medication checks on clients to assess their overall medication management capabilities; takes appropriate action if client poses danger with respect to the use or abuse of medication; orders laboratory tests needed to assess efficacy of medication and client vital signs as needed.
• Serves as part of a full-service treatment team comprised of clinicians and other team members; updates team on medication changes, concerns, side effects, and other important client information; keeps clients stable and medication compliant with the treatment goal of improving overall life functionality.
• Performs crisis intervention for walk-in clients or non-clients; evaluates individuals to identify level of stable behavior; provides support and assistance in problem resolution; coordinates or arranges for the provision of appropriate care services.
• Serves as an advocate for clients with internal and external medical professionals; accompanies clients to medical and clinician appointments and provides support/information as needed and appropriate.
• Collaborates with clinicians and medical professionals from the Alcohol and Drug Program (ADP) to ensure their clients are medication compliant; updates ADP staff on medication changes and violations and works with them to formulate a strategy for client progress toward goal completion.
• Maintains accurate records and files; documents client progress and procedures performed.
• Adheres to the confidentiality standards of the Privacy Act of 1974 (U.S.C. § 552a), as amended.
• Performs related duties as assigned.

Knowledge of:

• Understanding of Lanterman-Petris-Short Act (LPS) requirements and ability to manage conservatorship referrals and treatment recommendations.
• Understanding of criminogenic thinking and behavior and ability to therapeutically intervene with these populations and characteristics.
• Operations, services, and activities of a comprehensive behavioral health program with respect to the intervention and treatment of clients.
• Principles and practices of case management for behavioral health clients, including client charting and process documentation.
• Pharmacological understanding of the proper use and effectiveness of medications, including contra-indications, side effects, and probability of addiction or dependency.
• Methods and techniques of observing clients for negative reactions to medications, or addictive/dependency outcomes, and courses of action to treat same.
• Medical and psychiatric terminology.
• Methods and techniques of performing crisis intervention assessments, and identification of options for mitigation/management.
• Insurance and pharmacy processes for ordering and procuring needed medications for clients.
• Methods and techniques of conducting client interviews and eliciting needed information.
• Evolving trends and strategies in medication management.
• Applicable federal, state and local laws, regulatory codes, ordinances and procedures relevant to assigned areas of responsibility including confidentiality laws and the permitted use of medical records.
• Methods and techniques of conducting research.
• Principles and practices of complex documentation preparation and recordkeeping.
• Techniques for providing a high level of customer service by effectively dealing with the public, vendors, contractors, and County staff.
• Techniques for working with individuals with significant behavioral health challenges.
• The structure and content of the English language, including the meaning and spelling of words, rules of composition, and grammar.
• Modern equipment and communication tools used for business functions and program, project, and task coordination, including computers and software programs relevant to work performed.

Ability To:

• Provide medication management services to a diverse range of clients with behavioral health disorders.
• Administer medications and observe, record, and report their effects.
• Effectively contribute to assigned team discussions on client treatment and progress.
• Work collaboratively with medical professionals, pharmacies, and insurance companies to obtain needed client medications.
• Observe client behavior to determine whether intervention is needed, or to identify negative reactions to medications.
• Respond to crisis intervention situations and client emergencies in a calm and effective manner.
• Understand, interpret, and apply all pertinent laws, codes, regulations, policies and procedures, and standards relevant to work performed.
• Prepare clear and concise client progress reports and other written material. 
• Document and maintain complex client records and files, including client medical histories.
• Independently organize work, set priorities, meet critical deadlines, and follow-up on assignments.
• Effectively use computer systems, software applications, and modern business equipment to perform a variety of work tasks.
• Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax.
• Use tact, initiative, prudence, and independent judgment within general policy, procedural, and legal guidelines.
• Effectively use computer systems, software applications relevant to work performed and modern business equipment to perform a variety of work tasks.
• Communicate clearly and concisely, both orally and in writing, using appropriate English grammar and syntax.
• Establish, maintain, and foster positive and effective working relationships with those contacted in the course of work.

 
Education and Experience:
Any combination of training and experience that would provide the required knowledge, skills, and abilities is qualifying. A typical way to obtain the required qualifications would be:

Equivalent to a an Associate’s degree from an accredited educational institution with major coursework in nursing, psychology, or a related field and
 
Behavioral Health Emergency & Forensic Psychiatric Technician I: One (1) year of experience performing medication management duties.
 
Behavioral Health Emergency & Forensic Psychiatric Technician II: Two (2) years of medication program support for behavioral health clients at a level equivalent to the County’s class of Behavioral Health Emergency & Forensic Psychiatric Technician.
 
Behavioral Health Emergency & Forensic Psychiatric Technician III: Two (2) years of medication program support for behavioral health clients at a level equivalent to the County’s class of Behavioral Health Emergency & Forensic Psychiatric Technician II.
 
Certifications and Licenses:

• Must possess a valid US driver’s license upon date of application. Must obtain California driver’s license following hire date per California DMV regulations.
• Possession of license as a Psychiatric Technician or Licensed Vocational Nurse in the State of California

PHYSICAL DEMANDS

• Mobility to work in out-patient, clinics, jails or juvenile facilities and standard office settings; use standard office equipment, including a computer, and to operate a motor vehicle to visit various County and meeting sites; standing in and walking between work areas is frequently required; frequently bend, stoop, kneel, and reach to perform assigned duties, as well as push and pull drawers open and closed to retrieve and file information; ability to lift, carry, push, and pull materials and objects up to 25 pounds.
• Vision to observe client behavior read printed materials and a computer screen.
• Hearing and speech to communicate in person and over the telephone.
• Finger dexterity is needed to access, enter, and retrieve data using a computer keyboard or calculator and to operate standard office equipment.

WORKING CONDITIONS

• Employees work in an office, out-patient, clinic, jail, juvenile facility or locked psychiatric facility environment with moderate noise levels, controlled temperature conditions, and no direct exposure to hazardous physical substances.
• Employees may work outdoors and are occasionally exposed to loud noise levels and cold and/or hot temperatures.
• Employees provide services in controlled environment, including a jail-based setting with long wait times, non-traditional service locations and lack of access to internet or computer materials.
• Employees interact with clients with behavioral disorders/erratic and assaultive behavior, including those which require emergency crisis intervention.
• Incumbents may be exposed to blood and body fluids in performing their assigned duties.
• Employees may be exposed to communicable diseases and blood borne pathogens.
• Employees may interact with upset staff and/or public and private representatives in interpreting and enforcing departmental policies and procedures.
• Must be willing to work afterhours, weekends, and holidays as needed.
• Employees may be at risk for secondary trauma and long hours and schedules.

 
EQUIPMENT AND TOOLS UTILIZED

• Equipment utilized includes a motor vehicle, medical equipment utilized in the course of work (ex. stethoscope, blood pressure monitoring equipment, injection supplies), personal protective clothing, personal computer, fax machine, and standard office equipment.

Disaster Service Worker
All Butte County employees are designated Disaster Service Workers through state and local law (California Government Code Section 3100-3109). Employment with the County requires the affirmation of a loyalty oath to this effect. Employees are required to complete all Disaster Service Worker related training as assigned, and to return to work as ordered in the event of an emergency.