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LATINO COUNSELING CENTER, INC.

CBHI THERAPEUTIC TRAINING & SUPPORT (TT&S) SPECIALIST

Department

Children's Behavioral Health Initiative (CBHI) – In-Home Therapy (IHT)

Position

Therapeutic Training & Support (TT&S) Specialist

Classification

Paraprofessional / Bachelor's-Level Eligible Role

Reports To

Assigned IHT Clinician / Clinical Supervisor / Program Director

Work Setting

Home, school, community, and other natural environments as clinically appropriate

Schedule

Flexible based on family need; evening/community availability may be required

On-Call

Participation as assigned under LCC's IHT on-call structure

1. ORGANIZATIONAL OVERVIEW

Latino Counseling Center, Inc. (LCC) is a bilingual and culturally responsive behavioral-health organization serving children, youth, adults, and families. LCC is committed to safe, confidential, family-centered, clinically appropriate, and compliant services.

2. POSITION PURPOSE

The Therapeutic Training & Support (TT&S) Specialist is a qualified paraprofessional member of the In-Home Therapy (IHT) team. TT&S works under the supervision and clinical direction of the assigned IHT Clinician and supports implementation of the clinician's treatment plan.

TT&S does not independently diagnose, determine medical necessity, establish the treatment plan, provide independent psychotherapy, or function as the clinical decision-maker. The role is to help the youth and family practice and generalize the therapeutic skills, routines, coping strategies, communication methods, behavioral supports, and family interventions identified by the IHT Clinician.

CORE CBHI ROLE: TT&S SUPPORTS THE IHT CLINICIAN'S TREATMENT PLAN. THE TT&S SPECIALIST TEACHES, MODELS, PRACTICES, REINFORCES, AND REPORTS ON SKILL DEVELOPMENT WITH THE YOUTH AND FAMILY; THE TT&S SPECIALIST DOES NOT REPLACE THE IHT CLINICIAN.

3. CBHI PRACTICE EXPECTATIONS

• Provide strength-based, youth- and family-centered services in natural environments.
• Work as part of the IHT team and maintain frequent communication with the assigned IHT Clinician.
• Implement only interventions and objectives that are consistent with the current treatment plan and clinical direction.
• Teach youth to identify, understand, manage, and regulate feelings and emotional responses.
• Coach parents/caregivers in supporting the youth's emotional, behavioral, and mental-health needs.
• Model and rehearse coping skills, problem-solving, communication, limit-setting, routines, emotional-regulation skills, and other treatment-plan interventions.
• Support use of natural and community supports and help the family generalize gains outside formal sessions.
• Participate in care coordination and team collaboration within the scope assigned by the IHT Clinician.
• Recognize and promptly escalate safety concerns, clinical changes, barriers to treatment, and concerns requiring clinician review.
• Practice culturally and linguistically responsive care and offer services in the family's preferred language when qualified/assigned.

4. TEN CORE PRACTICE ELEMENTS – EXPECTED FAMILIARITY

TT&S staff are expected to understand and apply the core elements of LCC's IHT practice model and the MassHealth-CBHI IHT Practice Profile as trained by LCC. These concepts should be observable in the employee's work, supervision, and documentation.

Practice Element

TT& S Expectation

Engagement

Build respectful, collaborative relationships with youth and caregivers.

Youth/Family Voice & Choice

Use family priorities, strengths, culture, language, and preferences in service delivery.

Assessment-Informed Practice

Understand the clinician's assessment, treatment targets, risks, strengths, and functional needs relevant to TT&S work.

Collaborative Treatment Planning

Know the current treatment-plan goals and implement only the TT&S objectives assigned within that plan.

Skill Building

Teach, model, practice, reinforce, and measure functional coping, communication, emotional-regulation, family, and behavioral skills.

Caregiver Capacity

Coach caregivers to use strategies independently and strengthen their ability to support the youth.

Risk Management / Safety

Recognize risk changes, follow the Safety Plan, and escalate urgent concerns immediately.

Team Collaboration / Care Coordination

Communicate with the IHT Clinician and authorized team members; avoid working in isolation.

Natural Supports / Sustainability

Help the family identify and strengthen supports that can continue after treatment.

Progress Monitoring & Transition

Track response to interventions, report progress/barriers to the clinician, and support planned transition/discharge.

5. ESSENTIAL JOB RESPONSIBILITIES

• Provide scheduled TT&S services to assigned youth and families in the home and community according to the current IHT treatment plan.
• Review treatment goals, TT&S objectives, Safety Plan, relevant clinical risks, and assigned interventions with the IHT Clinician before independently carrying out assigned TT&S activities.
• Use structured skill-building, coaching, modeling, rehearsal, role play, psychoeducation, and reinforcement consistent with the clinician's plan.
• Observe and report changes in youth/family functioning, barriers, strengths, new risks, progress, and response to interventions.
• Participate in case consultation, team meetings, clinical supervision, training, and case reviews.
• Maintain professional boundaries and remain within TT&S paraprofessional scope.
• Coordinate with the IHT Clinician before materially changing intervention focus or addressing a new clinical issue.
• Follow crisis/safety protocols and immediately notify the IHT Clinician/supervisor of urgent or significant concerns.
• Maintain required productivity while preserving documentation quality, medical necessity, authorization compliance, and client safety.
• Maintain confidentiality, HIPAA compliance, secure communication, and minimum-necessary access to PHI.
• Participate in QA, audits, corrective-action plans, retraining, competency validation, and re-audits when required.

6. DOCUMENTATION – REQUIRED LCC TIMELINES

Documentation is an essential job function. The following are LCC operational performance standards. If a payer, MassHealth/MCE requirement, contract, law, or approved program policy establishes a shorter deadline, the shorter controlling deadline applies.

Documentation / Action

LCC Deadline

Required Content / Standard

Escalation Rule

TT&S Progress / Service Note

Within 24 hours of the service; same day whenever feasible

Accurate date, start/end time or units, location, participants, treatment-plan objective, intervention/skill practiced, youth/family response, progress/barrier, safety concerns, plan/next step, and required signature.

If unable to complete within 24 hours, notify supervisor/clinician before the deadline when possible.

Care Coordination / Collateral Contact

Within 24 hours

Document clinically relevant authorized communication and its connection to the treatment plan.

Escalate clinically significant information to the IHT Clinician promptly.

Safety / Risk Concern

Immediately; documentation as soon as safely possible the same day

Follow current Safety Plan and LCC crisis protocol. Document facts, action taken, persons notified, and disposition.

Urgent risk is reported immediately to the IHT Clinician/supervisor; do not wait for the next supervision.

Incident / Mandated Reporting Concern

Immediate verbal escalation; written documentation per LCC policy

Document objective facts and actions; do not investigate beyond role or alter the clinical record.

Notify designated supervisor/clinical leadership immediately.

Treatment Plan Review

Before providing services and whenever updated

TT&S must know the active TT&S objectives and assigned strategies.

If plan is missing, expired, unclear, or inconsistent with proposed service, contact the IHT Clinician before proceeding except for immediate safety needs.

Authorization / Eligibility Concern

Before service whenever known

Verify/confirm assigned case and report discrepancies; TT&S does not independently authorize services.

Notify clinician/supervisor/authorization staff promptly; do not create or alter documentation to make a service billable.

Late Entry / Addendum

Only when necessary and in accordance with EHR/LCC policy

Clearly identify the entry as late/addendum; use current actual date; preserve the original record.

Never backdate or overwrite a signed historical note.

QA / Audit Correction

By the deadline assigned by supervisor/QA/Compliance

Correct only factual/documentation deficiencies through the approved EHR correction/addendum process.

If you disagree or cannot complete by deadline, escalate before due date.

7. DOCUMENTATION QUALITY STANDARDS

• Every note must show why the TT&S contact occurred and how it relates to an active treatment-plan objective.
• Document what was actually done—not generic statements such as 'provided support' without identifying the skill/intervention.
• Document the youth/family response and observable progress, difficulty, or barrier.
• Document only the actual service time and participants present.
• Travel, preparation, administrative work, supervision, and other non-billable activities must never be documented as direct client service unless the controlling payer expressly permits billing for that activity.
• Do not copy forward inaccurate information or duplicate another staff member's note.
• Do not document services not personally rendered.
• Do not change service dates, times, units, participants, or content to support payment.
• Do not sign another provider's documentation or allow another person to use your credentials.
• Notify the clinician/supervisor when the family's needs, risks, or treatment response suggest that the treatment plan may require clinical reassessment.

BILLING-INTEGRITY RULE: TT&S STAFF MAY BILL/DOCUMENT ONLY SERVICES ACTUALLY RENDERED AND ALLOWABLE UNDER THE CURRENT PLAN, AUTHORIZATION, PAYER RULES, AND ASSIGNED SCOPE. BACKDATING, FABRICATION, DUPLICATE/OVERLAPPING TIME, UNSUPPORTED UNITS, OR ALTERING DOCUMENTATION TO MAKE A CLAIM PAYABLE IS PROHIBITED.

8. SUPERVISION & CLINICAL DIRECTION

TT&S works under clinician supervision and must use supervision proactively. The employee is expected to attend all required individual/group supervision and case consultation.

• Bring treatment-plan questions, documentation concerns, barriers, family engagement concerns, and progress to supervision.
• Immediately seek clinician/supervisor consultation for safety concerns, significant clinical deterioration, abuse/neglect concerns, high-risk behavior, or a situation outside TT&S scope.
• Follow the clinician's direction regarding treatment objectives and clinical priorities.
• Complete required supervision documentation/acknowledgment when applicable.
• Repeated failure to attend supervision or follow lawful clinical direction may result in corrective action.

9. TRAINING & COMPETENCY

• Complete LCC orientation and required CBHI/IHT training.
• Maintain familiarity with the IHT Practice Profile and LCC's ten core practice elements.
• Complete HIPAA/privacy/security, Fraud/Waste/Abuse, documentation, mandated reporting, safety/crisis, cultural responsiveness, and payer/program training as assigned.
• Demonstrate competency in treatment-plan implementation, family engagement, skill coaching, documentation, safety escalation, and professional boundaries.
• Participate in remedial training when QA, audit, supervision, or performance review identifies a gap.

10. QUALIFICATIONS

• Bachelor's degree in Psychology, Social Work, Human Services, Counseling, Child/Family Studies, or another field accepted by the applicable CBHI/MassHealth/MCE staffing requirement; or another qualification pathway approved by LCC and the controlling payer/program.
• Experience working with children, adolescents, and families with behavioral-health, emotional, developmental, or family-system needs.
• Ability to work effectively in homes, schools, and community settings.
• Ability to write clear, accurate, professional documentation.
• Strong communication, organization, time-management, and teamwork skills.
• Bilingual Spanish/English preferred for positions serving bilingual families.
• Valid driver's license/reliable transportation when required for community-based assignments.
• Ability to meet background, credentialing, training, and payer/program requirements.

11. PRODUCTIVITY, SCHEDULING & ATTENDANCE

TT&S is a community-based position. Scheduling must reflect family availability and clinical need. Employees are expected to maintain the productivity standard assigned by LCC while also completing documentation, supervision, meetings, training, care coordination, and other required duties.

Productivity does not override quality, safety, scope, documentation, authorization, or medical-necessity requirements. No employee should extend, duplicate, or create services solely to meet a productivity target.

12. ON-CALL / URGENT RESPONSE EXPECTATIONS

TT&S employees participate in the IHT program's rotating on-call or urgent-response structure when assigned. The specific schedule, coverage period, escalation pathway, and clinician backup are determined by LCC program policy. TT&S staff must not independently manage a clinical emergency beyond their training and role; urgent situations must be escalated to the appropriate clinician/supervisor and emergency/crisis resource.

13. PERFORMANCE ACCOUNTABILITY

Performance is evaluated based on quality of services, adherence to the treatment plan, documentation timeliness and accuracy, attendance/reliability, supervision participation, family engagement, professional boundaries, teamwork, productivity, compliance, responsiveness to corrective feedback, and audit/QA performance.

Failure to meet required documentation or role expectations may result in coaching, retraining, increased supervision, corrective action, performance improvement planning, restriction of duties, or other action consistent with LCC policy and applicable law.

14. EMPLOYEE ACKNOWLEDGMENT

By signing below, I acknowledge that I received and reviewed this TT&S Job Description. I understand that TT&S is a paraprofessional role performed under IHT clinician supervision, that documentation deadlines are essential job expectations, and that I am responsible for asking for clarification before acting outside my scope or missing a known requirement.

Employee Name

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Supervisor / Program Director

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Latino Counseling Center, Inc. • CBHI In-Home Therapy Program