Prescribing Practitioner

Felton Institute•Oakland, CA

1d•Hybrid

About The Position

The Triage, Consultation, and Wellness Response Team (TCWRT) is a specialized program operated by Felton Institute and funded by the Alameda County Probation Department (ACPD) and the Alameda County Behavioral Health Department (ACBHD) under the AB 109 Mental Health and Wellness (MHW) initiative. The TCWRT serves as the primary referral point for ACPD staff seeking mental health, substance use, and co-occurring disorder services for AB 109 Clients. Program responsibilities include clinical consultation and triage, peer and supportive services, wellness response, outreach and mental health promotion, and connection to the Specialty Provider Pool (SPP). Services are delivered across CORE Oakland, CORE Hayward, Santa Rita Jail, AB 109 Housing Programs, ACPD offices, client homes, and other community settings throughout Alameda County. The Prescribing Practitioner is the licensed psychiatric prescriber on the TCWRT, working under the administrative direction of the Program Manager. This position may be filled by a licensed Psychiatrist (MD/DO), Psychiatric Mental Health Nurse Practitioner (PMHNP), or Physician Assistant with psychiatric experience and prescribing authority in the State of California. The Prescribing Practitioner provides psychiatric evaluation, medication management, prescribing, and bridge psychiatric services for AB 109 Clients during the period between initial referral and sustained connection to a community psychiatric provider, serving a population that includes individuals on Post-Release Community Supervision, Penal Code 1170(h)-eligible clients, formal probationers, pre-trial participants, and specialty court participants—many of whom present with serious mental illness (SMI), co-occurring substance use disorders, complex trauma histories, and significant barriers to traditional outpatient psychiatric care. The role emphasizes harm reduction, trauma-informed care, motivational interviewing, and active coordination with the broader TCWRT, Deputy Probation Officers (DPOs), in-custody providers, and community psychiatric providers to support sustainable connection to long-term psychiatric care.

Requirements

Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) with completion of an ACGME-accredited residency in Psychiatry, and current Board Certification or Board Eligibility by the American Board of Psychiatry and Neurology (ABPN); OR a Master's or Doctoral degree as a Psychiatric Mental Health Nurse Practitioner (PMHNP) from an accredited program, with current national certification (e.g., ANCC PMHNP-BC); OR a Master's or Doctoral degree as a Physician Assistant (PA) from an accredited program, with current NCCPA certification and substantive psychiatric experience and training.
Current, active, and unrestricted California professional license in good standing (Medical Board of California for MD/DO; California Board of Registered Nursing with Furnishing Number for PMHNP; Physician Assistant Board of California for PA).
Current, active, and unrestricted DEA registration authorizing prescribing of controlled substances (Schedules II–V) and ability to prescribe via electronic prescribing of controlled substances (EPCS).
Active and compliant registration with California CURES (Controlled Substance Utilization Review and Evaluation System) prescription drug monitoring program.
For PMHNPs: current California Furnishing Number and Standardized Procedure or Supervising Physician arrangement consistent with California law. For PAs: a current Practice Agreement consistent with California law.
Minimum of two (2) years of post-licensure psychiatric prescribing experience providing direct psychiatric care.
Demonstrated experience providing psychiatric care to adults with serious mental illness (SMI), co-occurring substance use disorders, complex trauma histories, and/or experiences of housing instability.
Expert clinical knowledge of psychiatric diagnosis and evidence-based psychopharmacology, including treatment of mood, anxiety, trauma-related, psychotic, and co-occurring substance use disorders.
Working knowledge of Alameda County mental health, substance use, and crisis service systems, including ACCESS, ACBHD networks, John George Psychiatric Hospital, CRT programs, and community psychiatric providers.
Demonstrated competency in trauma-informed care, harm reduction, motivational interviewing, shared decision-making, and culturally responsive practice.
Knowledge of California prescribing law, controlled substance regulations, CURES requirements, EPCS requirements, and applicable practice agreement requirements for the practitioner's licensure type.
Strong knowledge of HIPAA, 42 CFR Part 2 (substance use confidentiality), Tarasoff duty to warn/protect, and mandated reporting obligations.
Skilled in psychiatric crisis assessment, de-escalation, and appropriate use of 5150 procedures.
Proficiency with electronic health records, electronic prescribing platforms, provider portals (e.g., the ACPD “Enterprise Supervision” Provider Portal), telehealth platforms, and standard office software.
Strong interpersonal and consultation skills with ability to work collaboratively with Clinical Case Managers, Peer Support Specialists, DPOs, in-custody providers, and community psychiatric providers.
Ability to pass a Live Scan background check and any clearances required for entry to Santa Rita Jail, ACPD facilities, and other applicable sites.
Valid California driver's license, reliable transportation, and proof of insurance; ability to travel within Alameda County to perform on-site work at multiple service locations.

Nice To Haves

Experience serving justice-involved adults—including individuals on Post-Release Community Supervision, Penal Code 1170(h)-eligible populations, formal probation, pre-trial supervision, or specialty courts—is strongly preferred.
Experience providing psychiatric services in community-based, outpatient, FQHC, county behavioral health, in-custody, crisis, or other safety-net settings is strongly preferred.

Responsibilities

Conduct comprehensive psychiatric evaluations of AB 109 Clients referred by the TCWRT, including assessment of mental status, psychiatric diagnosis, risk (suicide, violence, self-neglect), substance use, medical comorbidities, and psychosocial context.
Prescribe, monitor, adjust, and discontinue psychiatric medications consistent with current standards of care, applicable California prescribing regulations, and the client's clinical presentation, preferences, and goals.
Provide bridge psychiatric medication management for AB 109 Clients who are between psychiatric providers, recently released from custody or psychiatric hospitalization, or otherwise without immediate access to a community prescriber—with the goal of maintaining stability until a sustainable connection is established (typically up to approximately two months of dual or transitional services, in alignment with ACCESS handoff timelines).
Apply harm-reduction principles, trauma-informed care, motivational interviewing, and shared decision-making in all prescribing decisions.
Order, interpret, and document laboratory studies, screenings, and other diagnostic information necessary for safe prescribing, including baseline and ongoing monitoring labs.
Review and reconcile medication histories using available records including the SHIE Community Health Record, the MHS 140 Intake Form/Face Page, CURES as required by California law, and records from in-custody providers, psychiatric hospitals, and prior community providers.
Provide clinical psychiatric consultation to Clinical Case Managers, Peer Support Specialists, the Program Manager, and—where appropriate within the scope of program-level consultation—DPOs on psychiatric considerations, including working with clients with SMI, co-occurring disorders, and complex medication regimens.
Support TCWRT triage decision-making for clients with complex psychiatric presentations, including those appropriate for ACCESS referral, Crisis Residential Treatment (CRT), Full Service Partnership (FSP) referral, conservatorship evaluation, or specialty psychiatric services.
Participate in case planning, care coordination, and discharge planning meetings with ACPD, in-custody providers, psychiatric hospitals (including John George Psychiatric Hospital), crisis residential programs, ACBHD, CRSP, and community mental health and substance use providers.
Contribute psychiatric input to TCWRT clinical pictures and Provider Service Plans (PSPs), recognizing that PSPs are plain-language documents shared with ACPD and are not clinical treatment plans.
Provide consultation to the TCWRT during Wellness Response situations involving AB 109 Clients experiencing acute mental health incidents at ACPD offices, CORE locations, and AB 109 Housing Programs.
Support de-escalation, 5150 evaluation determinations, and clinical handoffs to County crisis teams and local law enforcement when other County crisis teams are not appropriate or available.
Coordinate with crisis services, emergency departments, and psychiatric inpatient and crisis residential providers to facilitate appropriate level-of-care decisions and continuity of psychiatric care.
Following Wellness Response events involving psychiatric medication concerns, support medication reconciliation, follow-up evaluation, and bridge prescribing as clinically indicated.
Assist AB 109 Clients in obtaining psychiatric medications, including coordination with pharmacies, manufacturer patient assistance programs, Medi-Cal pharmacy benefits, managed care plans, and free or low-cost community pharmacy resources; support prior authorization and appeals following medication denials.
Collaborate with Clinical Case Managers and Peer Support Specialists on medication adherence support, addressing practical barriers (transportation, refill timing, side-effect management) and psychological barriers (stigma, ambivalence, prior negative experiences).
Coordinate with MAT providers, primary care providers, and substance use providers to support integrated care for AB 109 Clients with co-occurring substance use disorders, within the Prescribing Practitioner's scope of practice and Felton Institute policy.
Coordinate psychiatric handoff to community psychiatric providers—including County Contracted Providers, FSP teams, Medi-Cal psychiatric providers, primary care behavioral health, and telepsychiatry platforms—ensuring continuity of medication regimens and minimizing gaps in care.
For clients transitioning out of Santa Rita Jail, CDCR facilities, John George Psychiatric Hospital, or other facilities, coordinate with in-custody or in-facility prescribers prior to release to ensure continuity of psychiatric medications during the high-risk reentry window.
Maintain timely, accurate, and complete psychiatric documentation in Felton Institute's electronic health record and in the ACPD Provider Portal (where appropriate and consistent with confidentiality requirements), within 72 business hours of service delivery.
Comply with all applicable California prescribing regulations, including controlled substance prescribing standards, CURES reporting and review requirements, and electronic prescribing of controlled substances (EPCS) requirements.
Maintain compliance with HIPAA, 42 CFR Part 2, mandated reporting obligations (child, elder, and dependent adult abuse; Tarasoff duty to warn/protect), and Felton Institute clinical policies.
Report any adverse client events—including emergencies, psychiatric hospitalizations, medication-related adverse events, suicide attempts, or unexpected program exits—immediately to the Program Manager, supporting ACPD's 24-hour reporting requirement.
Contribute to monthly, quarterly, annual, and final program reports as requested; participate in Felton Institute quality assurance, peer review, utilization management, and continuous quality improvement activities, supporting the program's target of at least 25% of services utilizing evidence-based practices.
Provide psychoeducation to AB 109 Clients, family members, peer staff, Clinical Case Managers, and—where appropriate within the scope of program-level consultation—DPOs and ACPD staff on psychiatric medications, mental illness, co-occurring disorders, and harm reduction.
Contribute to resource sharing activities, workshops, and Community Resource Forums at CORE, supporting the program target of at least 10 resource sharing activities annually; participate in psychoeducation opportunities for AB 109 Contracted Providers and CORE staff.
Complete trainings as required or requested by the County, Felton Institute, and applicable licensing boards; support the team in implementing evidence-based practices including Motivational Interviewing, Contingency Management, and trauma-informed care.