CREDENTIALING USER MANUAL EFFECTIVE JANUARY 1, 2014 Please note that this user manual is for your information only. ALL APPLICATIONS AND REFERENCES MUST BE COMPLETED ONLINE THROUGH THE CREDENTIALING DATABASE AT: https://arizonans4prevention.org/credential NO HARD COPIES WILL BE ACCEPTED. Applications are reviewed on the first Tuesday of every month. Applications must be submitted a minimum of two full business days in advance of each monthly meeting— i.e., by close of business the preceding Thursday — in order to be included on the review agenda. Applications received less than two full business days before the meeting will be reviewed the following month. A united vision and voice for prevention in the state of Arizona. Preface The Arizonans for Prevention (AzFP) Credentialing Committee works to advance prevention science as an effective and recognized field of human services by establishing and promoting professional standards through the credentialing process. Table of Contents Introduction……………………..…….……... 2 Purpose ……………….………………..….....2 Submission Checklist ………………………..2 In order to obtain a prevention credential in the State of Arizona, you must: 1. Possess minimum education and training requirements; 2. Possess minimum work and experience requirements; 3. Meet specific competency and ethical conduct requirements; and 4. Submit a completed credentialing application to the AzFP Credentialing Committee for approval. Audit Process All information included in this application is subject to random audit and verification by the AzFP Credentialing Committee. Property of the Board Materials submitted to the AzFP for credentialing are considered property of the AzFP Board. Materials include but are not limited to application, evaluations, transcripts and certificates. Applicants are encouraged to maintain copies of all materials and paperwork as submitted for credentialing. All credentials and credentialing cards are property of the AzFP Board and must be surrendered upon Board request. Board Policy and Procedures Applicants and credentialed professionals are individually responsible for ensuring they are following current AzFP credentialing policies and procedures. Credentialing Standards ………………..…..3 Application General Application and Fees..........4 Education…………………………….5 Work Experience……...…..….…...6-7 Professional Credentials …….……..8 Training Verification……………..9-11 Supervision…………….....………...12 Code of Ethics Acknowledgement…………….…...13 Statement of Understanding and Release of Information………….…14 Attachments Professional Reference Form...16-18 SAMHSA Code of Ethics….…..19-20 Grievance and Appeals…………...21 Re-credentialing Fees ……...…… 22 Re-credentialing Standards………23 1 Introduction Prevention professionals empower individuals, families and communities to be healthy – an essential role in health and human services. They represent diverse educational and experiential backgrounds. In addition, they work in a wide variety of settings to address a broad range of issues including, but not limited to, alcohol, tobacco, and other drug use, violence, child and domestic abuse, crime and delinquency, school dropout, teenage pregnancy, suicide and sexually transmitted diseases. In recognition of the eclectic nature of prevention, the AzFP Credentialing Committee has identified and defined the core competencies required for Prevention Professionals regardless of work setting or focus area. Arizonans for Prevention recognizes four levels of Prevention Professionals. The AzFP Credentialing Committee will evaluate each applicant’s competency as a Prevention Professional and grant recognition to those professionals who meet the identified standards of their designated level. Purpose The purpose of the AzFP credentialing process is to: 1. Assure Arizonans quality prevention services by endorsing an identified standard of competency. 2. Provide professional recognition to qualified Prevention Professionals through a process that examines demonstrated skills and abilities. 3. Encourage and provide opportunities for ongoing professional development Prevention Professionals. 4. Promote professional and ethical practice in prevention. 5. Assist employers in identifying qualified Prevention Professionals. Submission Checklist Application Sections to Complete (in the order listed in the online application): General Application (name, contact info, level at which you are applying) Education (including copy of transcript/diploma) Work Experience (specific to prevention) Professional Credentials (existing licenses or certifications, including TOTs) Training Verification (domains 1-5) Supervision Professional References* (to be completed by one current supervisor or three peers/colleagues) Upload Resume Code of Ethics Payment** (fees are listed on page 4 of this manual) Statement of Understanding & Release of Information form Review / Submit Application*** Please note that you will not be able to submit your application for review until your payment has been received and all of your required professional references are complete. You can check the current status of these components on the View Application page of your online application (this is easily accessed via the Application tab at the top of the page). *Clicking the “Email Reminder” button on the Prevention Professional References page of your online application will generate an automatic reminder email to any reference that shows as “pending” or “not complete”. **If you need to receive an invoice in order to complete your payment or if you need to pay by check, please email credentialing@arizonans4prevention.org to let us know. ***Once on the Review/Submit Application page, you must scroll to the bottom and click “Submit Application” to send it off for review. A message should appear at the top of the screen to confirm that it has been submitted. You can also confirm submission on the View Application page. Your status will say “in-process” or “not yet submitted” if it is still in edit mode and has not been submitted to reviewers; it will say “submitted” when it has officially been submitted for review. Once submitted, you should check the View Application page frequently to see if any reviewer notes have been added to your account and/or to see if your application status has been changed (i.e., approved or declined). 2 Initial Credentialing Standards Level 1 Option 1 Option 1 Option 2 Level 2 GED/High School Diploma with 2,000 hours (1 year) of cumulative professional experience 48 documented hours of training (cumulative) 40 hours within past 2 years, including a minimum of 5 hours in each domain AND 64 documented hours of supervision (cumulative) 40 within past year AND 48 documented hours of training (cumulative) 40 hours within past 2 years, including a minimum of 5 hours in each domain GED/High School Diploma with 8,000 hours (4 years) of cumulative professional experience AA with 6,000 hours (3 years) of cumulative professional experience AND BA Option 3 with 4,000 hours (2 years) of cumulative professional experience 64 documented hours of supervision (cumulative) 40 within past year AND Option 1 BA with 8,000 hours (4 years) of cumulative professional experience AND Level 3 Option 2 MA with 6,000 hours (3 years) of cumulative professional experience 48 documented hours of training (cumulative) 40 hours within past 2 years, including a minimum of 5 hours in each domain AND 64 documented hours of supervision (cumulative) 12 within past year Ph.D. Option 3 with 2,000 hours (1 year) of cumulative professional experience AND Option 1 Level 4 Option 2 Option 3 BA with 10,000 hours (5 years) of cumulative professional experience AND MA with 8,000 hours (4 years) of cumulative professional experience AND Ph.D. with 6,000 hours (3 years) of cumulative professional experience AND 48 documented hours of training (cumulative) 40 hours within past 2 years, including a minimum of 5 hours in each domain 64 documented hours of supervision (cumulative) 12 within past year 3 General Application Applicant Information Gender: Male Last Name, First Name, MI Female Year of Birth (yyyy) Mailing Address City Preferred Phone Number State Zip Code Email Credentialing Information What level of credentialing are you requesting? See page 3 for description of credentialing standards. Level I (GED/High School Diploma) Level II (GED/HS Diploma, AA, BA) Level III (BA/MA/Ph.D.) Level IV (BA/MA/Ph.D.) Fees Initial Application Fees: $100: AzFP Members, including the three designated representatives of AzFP Member Agencies (membership must be on file with AzFP) $140: Additional staff of AzFP Member Agencies ($10 discount from the non-member rate) $150: Non-members* *Note: If you are not currently an AzFP member but would like to become one and apply for credentialing at the member rate ($100), you may do so during the credentialing process for a total of $140. Instructions are available on the Payment page of your online application. Re-credentialing Fees: (more details on page 22) $75: AzFP Members $100: Non-members Resubmission Fee: If an applicant submits an incomplete application or the review committee requests supplemental documentation, the applicant will have 10 business days to supply the requested information. If he/she does not submit the requested information prior to the given deadline, the application will be closed and the applicant will be charged a $25 resubmission fee to have the application re-opened for review. This policy applies to both initial credentialing applications and re-credentialing applications. ***All fees are non-refundable*** 4 Education Please complete the chart below for all academic institutions attended. Order chronologically, beginning with the most recent and ending with high school/GED. Include copies of all diplomas and/or transcripts necessary to verify your highest level of education when you submit your online application. If a transcript validates completion of a previous institution no prior transcripts are required. For example, if an applicant earned a Master’s degree, no transcripts that validate a Bachelor’s degree are needed. Name of School Attended Location Dates attended (mm/yy – mm/yy) Major Degree Earned 5 _______ Total hours Cumulative Work Experience A. Please provide contact information for your current employer, your length of employment with your current employer, your current position and the number of hours you have spent in that position. B. List all previous professional experience related to prevention (pg. 9). Make sure all columns are completed. C. Calculate total cumulative hours of experience and enter in box at top right corner of this page (). Please note that a 1.0 FTE works 40 hours per week, totaling 2,080 hours per year. For a breakdown in hours worked for a 1.0 FTE, please see the table below. Years Worked 1 2 3 4 5 6 7 Number of Hours 2,080 4,160 6,240 8,320 10,400 12,480 14,560 If you have worked over 7 years in the prevention field please multiply the number of years worked by 2,080. For example if you worked 7 years multiply 7 X 2,080 = 14,560. If you are not a full time employee in prevention, you will need to calculate the total hours on an hour-for-hour basis. Current Experience Current Employer: _________________________________________________________________________ Position: ________________________________________________________________________________ Title: __________________________________________________________________________________ Business Address: ________________________________________________________________________ City:_____________________________________ State: __________ Zip: _________________________ Business Phone: ____________________________ Fax: ________________________________________ Dates of employment: From: ___/___/___ To: ___/___/___ Hours worked per week: ____________ Average # of hours per week spent on prevention-related activities: _____________________________ Total hours of experience in prevention with this position: ____________________________________ Note: Total hours of experience = #FTE x years and months of employment 6 Past Experience Please provide information about each of your previous employers. List only work experiences relevant to prevention. Position Title Employer Dates of employment (mm/yy – mm/yy) Length of employment (years and months) # of full time equivalents (FTEs) in prevention Total hours of prevention experience in this position 7 Professional Credentials Please list all licensures, certifications or registrations relevant to this application, including Trainer of Trainers (TOT) certifications. Title of Credential State or Issuing Agency Date Issued Expiration Date 8 Training Verification ________ ________ Total hours Cumulative Total hours Past 2 Years Instructions Please list training hours below by domain, according to minimum hour requirements, and provide a detailed description explaining how that training relates to prevention and to the specific domain under which it is listed. The description should also include the sponsor of the training and an explanation of the training format (e.g., webinar, two-day conference, etc.). If you attended multiple workshops at a conference (e.g. CADCA), list them separately by corresponding domain. If you participated in a training series (e.g., Skills for Effective Prevention, SPF process), please list each module individually under the appropriate domain as well. Place the sum of your hours (cumulative and past 2 calendar years) in the top right hand corner of this page (). Certification, description or other proof of training completion is not required unless selected by random audit. Keep all supporting documentation, in case of audit. Please note: You may not use the same training for multiple domains; each entry must be unique in order to count toward your overall hours. Seminars, webinars, professional trainings, workshops, etc. are accrued on an hour-per-hour basis. One college semester hour in a course specific to prevention or public health is equal to 15 training hours (if completed within the last two years). A three-credit semester-long course equals 45 training credit hours. If you are using one course to fulfill requirements in multiple domains, please upload a course syllabus. If you have completed a nonstandard course or training related to prevention or public health (e.g., a course from a non-accredited education or web-based organization), please upload supplemental documentation to support the number of training hours listed. Domain 1: Planning and Evaluation *5 minimum required hours E.g. Needs assessment, program planning, data collection methods, prevention research, evaluation theory, practice and procedure, evaluation, grant and proposal writing, outcomes, etc. Training Title Training/Course Sponsor Example: CADCA Training Type (webinar, conference session, college course, workshop, nonstandard course) Conference session Detailed Description of Content How does it relate to this domain? How to find data Covers data Using and use it to plan collection Data to programs to and program Design address planning Programs community needs Date 07/25/2012 Hours 1.5 9 Domain 2: Education & Skill Development *5 minimum required hours E.g. substance abuse, risk and protective factors, safety, human development, sexuality, brain development, program facilitation, public speaking, etc. Training Title Training/Course Sponsor Example: Arizona The Training Type (webinar, conference session, college course, workshop, nonstandard course) Webinar Detailed Description of Content How does it relate to this domain? Explained how Provided Department of the brain general Adolescent Health Services, develops and prevention Brain Division of how brain education Behavioral development related to Health affects future brain behavior functioning Date 1/13/2013 Hours 2 Domain 3: Community Organization *5 minimum required hours E.g. Teams and coalition development, community mobilization, capacity building, networking, working with volunteers, outreach, marketing, recruitment and retention, etc. Training Title Training/Course Sponsor Example: Arizona Nonprofit Recruitment Professionals Strategies Training Type (webinar, conference session, college course, workshop, nonstandard course) Workshop Detailed Description of Content How does it relate to this domain? How to identify and Covers engage community volunteers/community outreach members in and prevention efforts mobilization Date 05/18/2013 Hours 3.5 10 Domain 4: Public and Environmental Policy *5 minimum required hours E.g. Advocacy methods, environmental strategies, communicating with policymakers, public policy initiatives and analysis, etc. Training Title Training/Course Sponsor Example: AzFP Training Type (webinar, conference session, college course, workshop, nonstandard course) Conference session Detailed Description of Content How does it relate to this domain? How to participate Covers Advocacy in the policy advocacy Shortcuts process and methods and communicate with communicating policymakers with Date 08/09/2013 Hours 1.5 policymakers Domain 5: Professional Growth & Responsibility *5 minimum required hours E.g. Cultural competency, ethics, conflict resolution, leadership, management, rules and regulations, self care, etc. Training Type (webinar, conference session, college course, workshop, nonstandard course) Nonstandard, online Information and Covered course strategies related cultural (4 hours in the to working with competency per week workplace people/clients which over 4 from different enhances weeks) backgrounds overall Training Title Training/Course Sponsor Example: Coursera Diversity Detailed Description of Content How does it relate to this domain? Date 11/08/2012 Hours 16 professional growth 11 ______________ Total hours Cumulative ______________ Total hours Past Year Supervision Please complete the table below to demonstrate that you meet the minimum requirements listed below. Supervision requirements: All applicants – 64 hours cumulative AND Levels 1 & 2 – 40 hours within the past 12 months Levels 3 & 4 – 12 hours within the past 12 months Supervision may be defined as any time you formally meet with your supervisor, whether it is to address an issue, receive feedback on program implementation or when in need of guidance. Supervision can take place in individual or group sessions and may include direct observation or consulting. For individuals in administrative positions, supervision sessions may also include meetings with CEOs, monthly meetings with Boards of Directors, etc. Sessions may be face-to-face or via distance technologies (telephone, web-based, etc.). Supervisor (Name & Organization) Supervisor Contact Information (Phone & Email) Period of time over which supervision took place Total supervision hours related to prevention TOTAL HOURS ATTAINED (CUMULATIVE): Also enter total in box at top right corner of this page TOTAL HOURS ATTAINED (PAST 12 MONTHS): Also enter total in box at top right corner of this page 12 Code of Ethics Acknowledgement The AzFP Credentialing Board upholds the Code of Ethics set forth by the Substance Abuse and Mental Health Services Administration (SAMHSA). By initialing and signing below, you indicate that you have read the SAMHSA Code of Ethics and agree to adhere to its professional standards of conduct. Find the Code of Ethics on pages 19-20 Initials _____ Initials _____ I certify that I have read the SAMHSA Code of Ethics and acknowledge my obligation to uphold and fulfill the duties and responsibilities set forth therein. I commit to comply with the terms of the SAMHSA Code of Ethics as long as I am granted the AzFP credential. I understand that violations of the Code of Ethics may lead to disciplinary action, including revocation of the credential. ____________________________________ Signature ____________________________________ Date 13 Statement of Understanding and Release of Information Each application is subject to audit at the discretion of the AzFP Credentialing Board. It is the responsibility of the applicant to keep all related documentation for a minimum of two (2) years in case of an audit. If audited, the applicant must provide supporting documentation to verify training, employment history, etc. AzFP reserves the right to request further information from all employers and other persons listed on the application form. This information is used for purposes of credentialing, kept confidential by the AzFP Credentialing Committee, and can only be released with written consent of the applicant. By initialing and signing below, you indicate that you have read the statements related to your application and personal responsibilities. Your initials and signature are required. Initials ______ Initials ______ Initials ______ Initials ______ Initials ______ “I confirm that all information in the application is true and qualifies me, to the best of my knowledge, for the level of credentialing for which I am applying.” “I grant permission for the AzFP Credentialing Board to audit statements contained in this application. I understand that intentionally false or misleading statements or intentional omissions shall result in the denial or revocation of my credential.” “I consent to the release of information contained in my application, credentialing file or other pertinent data submitted to or collected by the AzFP Credentialing Board for purposes of credentialing. I understand that upon submission of this application the following information will be made public and will be posted on the AzFP website: name, application date, level of credential applied for, application status (pending, approved, denied), reason for denial (if applicable), application approval date, level approved, and expiration date of credential.” “I agree to maintain AzFP officers, Board members, examiners free from any civil liability for damages or complaints by reason of any action that is within the scope of the performance of their duties which they may take in connection with this application and subsequent examinations and/or failure of the AzFP to issue a credential.” “I acknowledge that it is my sole responsibility to keep the AzFP Credentialing Board appraised of my current contact information. I agree to immediately notify the AzFP Credentialing Board of any arrest(s), convictions, indictments, suspensions, or revocations while my credential certification is pending or while credentialed, if granted.” _____________________________________________________________ Signature _____________________________________________________________ Date 14 Attachments Prevention Professional Reference Form……..…………………………………….………16-18 SAMHSA Code of Ethics………………..…………….………………………………………...19-20 Grievance and Appeals Process……………………………………………………………….…21 Re-credentialing Fees and Requirements……………….………………………………….22-23 15 Prevention Professional Reference Form To be completed by a Supervisor, Colleague, Mentor or Peer in the Prevention Field* This applicant is applying to be credentialed as an Arizona Prevention Professional with the Credentialing Committee of Arizonans for Prevention (AzFP). If you agree to serve as a reference for this applicant, please complete and submit all information contained in the next three pages of this Professional Reference Form. _____________________________________________________ Applicant’s Name _____________________________________________________ Your Name _____________________________________________________ Title _____________________________________________________ Agency Name _____________________________________________________ Address _____________________________________________________ Telephone _____________________________________________________ Email Professional license(s), certificate(s) or degree(s) you hold (list): ________________________________________________________________________________________ ________________________________________________________________________________________ How long have you known the applicant? ____________________________________________________ In what capacity (circle)? Recommendations from family members will not be accepted. Current Supervisor Former Supervisor Colleague Peer If you are the applicant’s current or former supervisor, please complete the following information: (Otherwise, continue to next page.) During what time period did you provide supervision for the applicant? (mm/yy-mm/yy) __________________________ Did the applicant work full-time or part-time: Full Time Part Time If part time, how many hours per week?: ______________ How many total hours did you supervise the applicant (including in-person, telephone, email, etc.)? _____________ hours How many hours of supervision were in the past 12 months? _____________ hours * A peer or colleague can include but is not limited to a co-worker, coalition leader, coalition member, other community partner (Weed and Seed, etc.) or any other peer/colleague that has observed your work in the prevention field. 16 Prevention Professional Reference Form Supervisor, Colleague, Mentor or Peer in Prevention Field INSTRUCTIONS: The table below presents the Five Performance Domains and Core Function requirements for all Arizona Prevention Professionals. Please indicate, based on your first hand knowledge of the applicant, if he/she satisfied each requirement. “Yes” indicates that you observed the applicant and endorse his/her ability to perform the skill. If you did not observe the applicant perform the skill or cannot endorse his/her ability to do so, please mark “no.” If you have no basis for evaluating the applicant regarding a particular skill or professional activity, please select “not applicable” (N/A). Yes No N/A Planning and Evaluation Used needs assessment strategies to gather relevant data for prevention planning. Identified gaps and prioritized needs based on the assessment of community conditions. Selected prevention strategies, programs, and best practices to meet the identified needs of the community. Developed prevention plan(s) based on research and theory that addressed community needs and desired outcomes. Identified resources to sustain prevention activities. Identified appropriate prevention program evaluation strategies. Conducted evaluation activities to document program implementation and effectiveness. Used evaluation findings to determine whether and how to adapt prevention strategies. Education and Skill Development Developed prevention education and skill development activities based on target audience analysis. Connected prevention theory and practice to implement effective prevention education and skill development activities. Maintained program fidelity when implementing evidence-based programs. Assured that education and skill activities were appropriate to the culture of the community being served. Used appropriate instructional strategies to meet the needs of the target audience. Ensured all prevention education and skill development programs provided accurate, relevant, timely, and appropriate content information. Identified, adapted, or developed instructor and participant materials for use when implementing prevention activities. Provided professionals in related fields with accurate, relevant, timely, and appropriate prevention information. Provided technical assistance to community members and organizations regarding prevention strategies and best practices. Community Organization Identified the community’s demographic characteristics and core values. Identified key community leaders to ensure diverse representation in prevention programming activities. Built community ownership of prevention programs by collaborating with key community leaders/members when planning, implementing, and evaluating prevention activities. Provided technical assistance to community members/leaders in implementing prevention activities. Developed capacity within the community by recruiting, training, and mentoring prevention-focused volunteers. Assisted in creating and sustaining community-based coalition. 17 Prevention Professional Reference Form Continued Yes No N/A Public Policy & Environmental Change Examined the community’s public policies and norms to determine environmental change needs. Made recommendations to policy makers/stakeholders that would positively influence the community’s public policies and norms. Provided technical assistance, training, and consultation that promoted environmental change. Participated in public policy development and enforcement initiatives to affect environmental changes. Used media strategies to enhance prevention efforts in the community. Professional Growth and Responsibility Maintained personal knowledge, skills, and abilities related to current prevention theory and practice. Networked with others to develop personal and professional relationships. Adhered to all legal, professional, and ethical standards. Built skills necessary for effectively working within the cultural context of the community. Demonstrated self-care consistent with prevention messages. I certify that I have directly supervised or been in a position to observe ____________________________________________________________________________ (Name of Applicant) By my signature, I affirm that, to the best of my knowledge, the above evaluation is true. ___________________________________ Signature ___________________________________ Date THIS FORM IS FOR YOUR INFORMATION ONLY. ALL PROFESSIONAL REFERENCES MUST BE COMPLETED ONLINE THROUGH THE CREDENTIALING DATABASE. HARD COPIES WILL NOT BE ACCEPTED. THANK YOU. 18 Code of Ethical Conduct for Prevention Professionals SAMHSA All developing fields need an ethical code to guide behavior. The field of substance abuse prevention needs to develop a code of ethics to serve as a guide for professional conduct. Circumstances and situations often arise in the helping professions that are both complex and difficult to handle. A code of ethics can help us make good decisions when faced with problematic situations. The following is a set of ethics for prevention professionals to consider. The National Association of Prevention Professionals and Advocates (NAPPA) originally developed these ethical codes. However, this organization is no longer in existence. As an emerging discipline, ethical codes of conduct need to be developed and advanced for the field of prevention to act as a benchmark for positive professional behavior. Preamble The Principles of Ethics are a model of standards of exemplary professional conduct. These Principles of the Code of Ethical Conduct for Prevention Professionals express the professional's recognition of his/her responsibilities to the public, to service recipients and to colleagues. They guide members in the performance of their professional responsibilities and express the basic tenets of ethical and professional conduct. The principles call for commitment to honorable behavior, even at the sacrifice of personal advantage. These Principles should not be regarded as limitations or restrictions, but as goals for which prevention professionals should constantly strive. They are guided by core values and competencies that have emerged in the development of the field. Principles 1. Nondiscrimination A prevention professional shall not discriminate against recipients or colleagues based on race, religion, national origin, sex, age, sexual orientation, economic condition, or physical or mental disability, including persons testing positive for HIV. A prevention professional shall broaden his or her understanding and acceptance of cultural and individual differences, and in so doing render services and provide information sensitive to those differences. 2. Competence A prevention professional shall observe the profession's technical and ethical standards, strive continually to improve personal competence and quality of service delivery, and discharge professional responsibility to the best of his or her ability. Competence is derived from a synthesis of education and experience. It begins with the mastery of a body of knowledge and skill competencies. The maintenance of competence requires a commitment to learning and professional improvement that must continue throughout the professional's life. A. Professionals should be diligent in discharging responsibilities. Diligence imposes the responsibility to render services carefully and promptly, to be thorough, and to observe applicable technical and ethical standards. B. Due care requires a professional to plan and supervise adequately any professional activity for which she or he is responsible. C. A prevention professional should recognize limitations and boundaries of competencies and not use techniques or offer services outside his or her competencies. Each professional is responsible for assessing the adequacy of his or her own competence for the responsibility to be assumed. D. When a prevention professional is aware of unethical conduct or practice on the part of an agency or prevention professional, he or she has an ethical responsibility to report the conduct or practices to appropriate authorities or to the public. 19 3. Integrity To maintain and broaden public confidence, prevention professionals should perform all professional responsibilities with the highest sense of integrity. Integrity can accommodate the inadvertent error and the honest difference of opinion. It cannot accommodate deceit or subordination of principle. A. Personal gain and advantage should not subordinate service and the public trust. All information should be presented fairly and accurately. Each professional should document and assign credit to all contributing sources used in published material or public statements. B. Prevention professionals should not misrepresent either directly or by implication professional qualifications or affiliations. C. A prevention professional should not be associated directly or indirectly with any services or products in a way that is misleading or incorrect. 4. Nature of Services Above all, prevention professionals should do no harm to service recipients. Practices shall be respectful and non-exploitative. Services should protect the recipient from harm and the professional and the profession from censure. A. Where there is evidence of child or other abuse, the prevention professional shall report the evidence to the appropriate agency and follow up to ensure that appropriate action has been taken. B. Where there is evidence of impairment in a colleague or a service recipient, a prevention professional should be supportive of assistance or treatment. C. A prevention professional should recognize the effect of impairment on professional performance and should be willing to seek appropriate treatment for himself/ or herself. 5. Confidentiality Confidential information acquired during service delivery shall be safeguarded from disclosure, including— but not limited to—verbal disclosure, unsecured maintenance of records, or recording of an activity or presentation without appropriate releases. 6. Ethical Obligations to Community and Society According to their consciences, prevention professionals should be proactive on public policy and legislative issues. The public welfare and the individual's right to services and personal wellness should guide the efforts of prevention professionals who must adopt a personal and professional stance that promotes the well-being of all humankind. 20 Grievance & Appeals Process When an applicant is denied his/her Arizona Prevention Professional Credential or questions the decision of the credentialing review committee, the applicants has the right to an inquiry and appeal. An inquiry is when an applicant requests a written summary from the AzFP Credentialing Review Committee that explains the reason for the action in question. If the applicant does not agree with the decision of the review committee, she/he may appeal the decision. The applicant may appeal the decision of the Credentialing Review Committee within 30 days of receipt of the summary notice or any other action deemed unjustified, by sending a written appeal in a certified letter to the President of the AzFP Board of Directors (P.O. Box 26525, Tucson, AZ 85726). The Appeal Process 1. Members of the credentialing committee will review appeal from the applicants within 20 business days of receipt of the certified letter. Members must come to 2/3rd agreement regarding the applicant’s status. If (1) agreement is not met or (2)applicant is unsatisfied with the outcome, then: 2. Applicant may send a (1) Written Appeal or (2) Second Appeal within 7 business days of notification by certified letter. (1)Written appeal or (2) Second Appeal will be reviewed by the AzFP CEO. AzFP CEO will have 7 business days to review appeal and make a decision. If applicant is unsatisfied with the outcome, then: 3. Applicant may appeal AzFP’s CEO decision within 5 business days of notification by sending a final appeal in a certified letter. Final Appeal will be reviewed by the AzFP Board of Directors within 10 business days. The Board must come to a 2/3rd agreement regarding the status of the application. Board decision is final and cannot be appealed. 21 Re-Credentialing Fees Re-credentialing is to be completed every 2 years. The fee schedule for the re-credentialing process is as follows: Credential Re-Credential Resubmission* Member $100 $75 $25 Non-Member $150 $100 $25 Each Arizona Credentialed Prevention Professional (ACPP) is personally responsible for all payments associated with the initial credentialing and the re-credentialing processes. This includes coordinating with their agency, as appropriate, to ensure that all payments are made by stated deadlines. Notification will be sent to all ACPPs 60 days prior to expiration of their current credentials. Applicants will be provided an additional 30-day grace period following their current expiration dates to pay their re-credentialing fees and submit their re-credentialing applications. This provides a total of 90 days for ACPPs to complete their re-credentialing processes in a timely manner. If these 90 days are lapsed, applicants will be charged an initial $25 flat fee as well as an additional $10 for every 30 days thereafter until the re-credential is completed. These fees are incurred in addition to the $75/$100 re-credentialing fee listed in the table above. ACPPs whose credentials are not renewed within 3 months (90 days) following their expiration date will be considered ineligible for re-credentialing and must reapply for credentials using the initial credentialing application. Example Fee Calculation: A credential expires June 30. Notification will be sent to the ACPP by April 1. The ACPP will have until July 31 to complete their re-credential at a price of $75 if they are an AzFP member. If this ACPP does not complete their re-credential until September, his/her total cost will be: $75 (re-credentialing fee) + $25 (flat rate lapse fee) + $10 (additional month lapse) = $110 *If an applicant submits an incomplete application or the review committee requests supplemental documentation, the applicant will have 10 business days to supply the requested information. If he/she does not submit the requested information prior to the given deadline, the application will be closed and the applicant will be charged a $25 resubmission fee to have the application re-opened for review. 22 Re-credentialing Standards* Level 1 Option 1 Current Level I Credential AND 40 hours of training within past 2 years, including a minimum of 5 hours in each domain 40 hours of supervision within past year Option 1 OR Option 2 Level 2 Current Level II Credential AND Current Level I Credential and GED/High School Diploma with 8,000 hours (4 years) of cumulative professional experience AND Option 3 AA with 6,000 hours (3 years) of cumulative professional experience AND Option 4 BA with 4,000 hours (2 years) of cumulative professional experience AND Option 1 Current Level III Credential OR Current Level I or II Credential Option 2 Option 3 MA With 6,000 hours (3 years) of cumulative professional experience AND Option 4 Ph.D. with 2,000 hours (1 year) of cumulative professional experience AND Option 1 Current Level IV Credential OR Option 2 Level 4 40 hours of training within past 2 years, including a minimum of 5 hours in each domain 12 hours of supervision within past year AND Current Level I, II or III Credential and BA with 10,000 hours (5 years) of cumulative professional experience AND MA With 8,000 hours (4 years) of cumulative professional experience AND Option 3 40 hours of supervision within past year AND and BA with 8,000 hours (4 years) of cumulative professional experience AND Level 3 40 hours of training within past 2 years, including a minimum of 5 hours in each domain 40 hours of training within past 2 years, including a minimum of 5 hours in each domain 12 hours of supervision within past year Ph.D. with 6,000 hours (3 years) of cumulative professional experience AND * Individuals applying for re-credentialing may request to be re-credentialed at a higher level than the one at which they were originally credentialed at no additional charge. In addition to meeting the above requirements, applicants seeking a higher level of credentialing will need to submit either one professional reference form from a current supervisor or three professional reference forms from peers or colleagues in prevention. 23
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