ER, Hospitalization and Urgent Care Entry Form

***FORM UPDATE FY 25***

Some fields have been removed to shorten the form and streamline data collection.

If there are any questions, please let your IT dept. know. 

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K. Type of Report
N. Person Recommending the Visit
O. Was 911 used?
Q. When was the guardian notified?
R. Is there an Unusual Incident Report associated with this visit?
Z. Disposition from ER/Hospital
Please provide the following information in question "ZE":

1. What led up to the event described above?

2. What was the exact issue that caused the event?

3. What was staff's immediate response to the event?

4a. What testing was done?

4b. What was the results of the testing?

5. What treatment was ordered as a result of the testing?

6. Is there any follow-up needed related to this event?

Please give a brief, specific description that includes all requested information (see instruction above).

Qualified Mental Health Professional FCC 4324N (Homewood, IL)

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Position: Therapist

Location: Homewood, IL

Salary: $50,000- $54,000

Shift: Varied, 2 evening nights per week required

POSITION OVERVIEW:

Under the direction and immediate supervision of the Program Director, the Therapist/Qualified Mental Health Practitioner (QMHP) performs clinical duties, such as delivery of therapeutic assessments and services, clinical supervision of therapists, data collection, policy and protocol development and implementation, training and workshop facilitation, and cultivation of partnerships with key stakeholders.

ESSENTIAL FUNCTIONS:

  • Facilitates individual therapy sessions and/or family therapy sessions.
  • Administers and interprets assessment instruments.
  • Develops treatment plan for individuals/ families engaged in treatment.
  • Participates in regular multidisciplinary team meetings
  • Makes appropriate referrals for individuals and families psychological and psychosocial needs and follows-up to identify if services were accessed.
  • Maintains service records, database, and statistics.
  • Submits documentation for services in a timely fashion
  • Demonstrated knowledge of correct procedures for Medicaid billing
  • Participates in clinical supervision weekly
  • Completes intakes, verifies insurance, and manages billing.
  • Monitor programmatic goals and outcomes continually adapting to meet or exceed them.
  • May have some intern supervision, on-call and crisis response responsibilities depending on the site.

SKILLS AND ABILITIES:

  • Knowledge of the techniques and principles of child and family development, family systems theory, individual, family, behavioral therapy (ACT, DBT), and crisis focused interventions
  • Strong communication, leadership, and counseling skills
  • Ability to independently diagnose using the DSM 5
  • Strong command of treating people with chronic mental illness

QUALIFICATIONS:

  • Completion of Master’s Degree in psychology, counseling, social work or related field. Clinical License (LCPC, LCSW, LMFT) preferred
  • Bilingual preferred

Contact: Contact: if you are interested in this position you may submit your resume to Justina Nava at jobs@trinityservices.org

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