BEHAVIORAL HEALTH STAFF COVERAGE PROTOCOL Scial Service Prvider Cverage Plan. 2 Psychiatrist and Psychlgist Cverage Plan.....4 Telemedicine.7 1
SOCIAL SERVICE PROVIDER COVERAGE PLAN In situatins where there is an SSP vacancy/extended medical leave/training perid beynd ne (1) week/annual leave where service t yuth will be interrupted, the Reginal Behaviral Health Services Administratr (RBHSA) will cnsult with the facility directr n whether they are in need f and will supprt the use f a cntingency plan. Three ptins exist fr cnsideratin and implementatin f a Cntingency Plan, which are: 1. Facility Requests - Use f existing staff (PSSW, existing facility MH staff) by increasing hurs t cver. RBHSA will wrk with Facility Directr and RA and apprve the use f existing facility resurces lcally (i.e., increase hurs f n staff PSSW r Psychlgist; hire substitute PSSW; etc). The facility AOC will submit request fr use f facility resurces by submitting OPB request t budget ffice as directed by Office f Budget Services. 2. Reginal Resurce Requests - Use f ther facility staff within regin t cver duties temprarily. RBHSA will wrk with Facility Directr and RA and seek apprval t use ther facility resurces within r utside f the facility s regin. RBHSA will crdinate with ther facilities regarding days staff will cver at the facility with a vacancy. RBHSA will submit a Cntingency Plan t the Office f Behaviral Health (OBHS) fr apprval. OBHS Directr, Assistant Deputy Cmmissiner f the Divisin f Prgrams and Services, Budget Services and RA will be cpied n the facility s request t use a substitute clinician submitted by the facility persnnel/aoc. 3. OBHS - Scial Services Clinician Requests -If existing facility r reginal resurces are nt available RBHSA may request the use f utside Scial Services Clinicians. RBHSA will submit a Cntingency Plan t the Office f Behaviral Health (OBHS) fr apprval. At the same time, the facility Directr will be asked t frward an e-mail t OBHS administratin stating their financial ability t supprt the request fr utside persnnel frm their budget and their supprt fr the cntingency plan. Once the plan is apprved by OBHS the plan will be frwarded t Divisin f Prgrams and Services fr their apprval. If the plan is apprved based n the fact that the facility has the budget t supprt the request, the plan will be taken t Budget Services fr apprval. 2
If the facility des nt have the funds t cver the psitin a request will be submitted t Budget Services requesting fr them t apprve the plan with deficit spending. If the plan is apprved, OBHS will ntify the Directr and ther pertinent staff f the plan apprval. GENERAL NOTES: All plans shuld be submitted tw weeks frm the date f need r plan extensin date. Plans will nly be apprved fr up t 45 days. When a plan is expiring, a new plan will need t be submitted fr cnsideratin f an extensin. The extensin will need t be apprved in the same way as a new Cntingency Plan. Apprval by the Office f Budget Services will be psted in the persnnel services lgs. 3
PSYCHIATRIST & PSYCHOLOGIST COVERAGE PLAN PURPOSE This prtcl prvides a systematic plan fr arranging cverage whenever a facility has a psychiatrist r psychlgist vacancy r absence. Fr purpses f this prtcl, an absence f 10 days r less frm date f last n-site wrk will be cnsidered a brief absence. Any absence that is lnger than 10 days frm date f last n-site wrk will be cnsidered an extended absence. The Reginal Behaviral Health Services Administratr and facility Directr will jintly develp a plan f cverage. COVERAGE OPTIONS 1. Phne cverage by clinician; 2. On-site cverage by a substitute; 3. Phne cnsultatin by a substitute; 4. Off-site electrnic review/ cnsultatin fr Assessments, SMPs & Treatment Plans; and 5. Telemedicine by substitute. 4
COVERAGE PLAN FOR BRIEF ABSENCES (10 days r less frm date f last n-site wrk) Psychiatry Psychiatrist absences fr 10 days r less frm date f last visit shuld be crdinated lcally if pssible. Psychdiagnstic Evaluatins (PDEs) may be cmpleted when the psychiatrist returns as lng as the PDE des nt ccur utside the ten-day plicy threshld. PDEs that wuld typically be assigned t the psychiatrist may als be perfrmed by the psychlgist in the psychiatrist s absence. Medicatin rders can be cntinued by the primary care physician in cnsultatin with the DJJ Chief f Psychiatry Services r Cnsulting Psychiatrist. Medicatin rders can als be btained by the DJJ Cnsulting Psychiatrist, Chief f Psychiatric Services r n-call psychiatrist. Arrangement fr phne cverage shuld be made prir t the facility psychiatrist s absence. Reviews and signatures f ITPs, Treatment plans and Special Management Plans may be cmpleted upn return with the fllwing ntatin pst hc review due t absence. Clinician Respnsibilities: Ntify the facility Supervisr and Reginal Behaviral Health Administratr f any planned r unplanned brief absence as sn as pssible. Indicate whether willing and able t prvide phne cnsultatin. Psychlgy Psychlgist absences fr 10 days r less frm date f last n-site wrk shuld be crdinated lcally if pssible. MHA Reviews may be perfrmed remtely by the absent psychlgist r the facility psychiatrist can perfrm this functin in the psychlgist s absence. Psychdiagnstic Evaluatins (PDEs) may be cmpleted when the psychlgist returns as lng as the PDE des nt ccur utside the ten-day plicy threshld. PDEs that wuld typically be assigned t the psychlgist may als be perfrmed by the psychiatrist in the psychlgist s absence. Phne cnsultatin (fr level changes, emergencies, etc.) may be perfrmed remtely by the psychlgist r the facility psychiatrist can perfrm this functin in the psychlgist s absence. Reviews and signatures f ITPs, Treatment plans and Special Management Plans may be cmpleted upn return with the fllwing ntatin pst hc review due t absence. 5
Clinician Respnsibilities: Ntify the facility Supervisr and Reginal Behaviral Health Administratr f any planned r unplanned brief absence as sn as pssible. Indicate whether willing and able t prvide phne cnsultatin. Indicate whether willing and able t perfrm Mental Health Assessment Reviews remtely during absence. COORDINATION OF COVERAGE FOR VACANCY OR EXTENDED ABSENCE Clinician Respnsibilities: Ntify the facility Supervisr, RBHSA and apprpriate clinical authrity at least 30 days befre any planned absence. Ntificatin f an unplanned absence shuld be made as sn as the clinician is aware f the absence. Indicate whether they are willing t prvide phne cverage fr n-call needs. Psychlgists shuld als indicate whether they are able t perfrm any wrk functins that can be cmpleted ff-site (e.g., review JTS mental health assessments, treatment plans, special management plans, etc.). Reginal Behaviral Health Services Administratr Respnsibilities: Make sure that the clinical authrity (Chief f Psychiatric Services r Chief f Psychlgical Services) is ntified f the resignatin and planned r unplanned absence. Manages, develps and crdinates cntingency plan fr facility cverage. First ptin is t pull frm their wn reginal pl; Secnd ptin is t pull frm ther regins; Third ptin is t request assistance frm Chief f Psychiatric Services r Chief f Psychlgical Services if ptins 1 and 2 are nt viable. Cnsult with the apprpriate clinical authrity as needed. Develps a cntingency plan and submits t the Directr f OBHS and the apprpriate OBHS clinical authrity (Chief f Psychiatric Services r Chief f Psychlgical Services). 6
Telemedicine Prcess Telemedicine can be utilized fr psychiatry cverage when psychiatrists are ut n extended vacatins, extended illnesses r as cverage fr lw ppulatin RYDCs. The telemedicine prcess will fllw the utline as listed belw: 1. The time fr the telemedicine sessins shuld be scheduled at least 48 hurs prir t the sessin when pssible t ensure rm availability. Psychiatrist, nursing staff, lead SSPII, SSC, r ther designated staff is respnsible fr ensuring that the apprpriate rms are reserved. 2. Sessins require a staff with the yuth wh is able t be present when mental health issues are discussed. The lead SSPII, SSC, r nursing staff is respnsible fr ensuring that apprpriate staff is present during the sessins with the yuths. 3. Security r ther designated staff will prvide transprtatin f the yuths t the lcatin f the telemedicine sessins. 4. When rders are written by nursing, a cpy f the rder will be sent t the psychiatrist (fax, email r shared flder). The psychiatrist will sign and send a cpy f the rder back t the facility. 5. When rders are written by the psychiatrist a signed cpy will be sent t the facility. This can be dne initially by fax, email, r by saving in a shared HIPPA cmpliant flder. The riginal frms shuld als be sent t the facility via mail weekly. The tp cpy f the rder may be sent directly t the pharmacy at the psychiatrist s discretin. 7. Cnsents shuld be initiated by the psychiatrist. A cpy f the cnsent may be sent initially by fax, email, r by saving in a shared HIPPA cmpliant flder. The riginal cnsent frms shuld als be sent t the facility via mail weekly. 6. When Treatment Team Ntes, Initial Treatment Plans, r Cmprehensive Treatment Plans need t be reviewed by the psychiatrist, a list f items needing review, r a cpy f the frms shuld be sent t the psychiatrist by Behaviral Health Staff via fax, email, r by saving in a shared HIPPA cmpliant flder. A JTS Treatment Team Prgress Nte may be dne and signed by the psychiatrist. Dcumentatin shuld include the date f the treatment plan reviewed and if there are any changes r mdificatins that need t be made t the plan based n the review cntact with the SSC r designee shuld be made by e-mail r at the next treatment team meeting. An alternative is t have the psychiatrist sign a cpy f the signature page f the Treatment Plan r Treatment Team Nte. The signed dcuments shuld be sent t the facility. This can be dne initially by fax, email, r by saving in a shared HIPPA cmpliant flder. The riginal frms shuld als be sent t the facility via mail weekly.
7. When Medical Mental Health Treatment Plans r Medical Clinic Visit Sheets require a review by the psychiatrist, a list f items needing review, cpies f the items that need review, r a cpy f the frms shuld be sent t the psychiatrist by Medical staff. A JTS Prgress Nte may be dne and signed by the psychiatrist. An alternative is t have the psychiatrist sign a cpy f the signature page f the dcument. The signed dcuments shuld be sent t the facility. This can be dne initially by fax, email, r by saving in a shared HIPPA cmpliant flder. The riginal frms shuld als be sent t the facility via mail weekly.