Juvenile Justice Facilities require Psychiatrists to have a minimum of twelve (12) continuous months of experience within the last three (3) years performing services similar in scope to those defined herein, in a public or private institution. Internship does not count towards the required experience.
Patient-inmate/ward health care is of paramount importance. Accuracy in communications is critical to ensure timely, correct care is provided. Therefore, any licensed Psychiatrists providing services through this Agreement must be proficient in the English language and be able to communicate effectively with CDCR/CCHCS. All Psychiatrists must be able to speak, understand oral and written communication and write effectively in the English language. Any Psychiatrist who fails to meet the minimum qualifications shall not be permitted to perform service.
The CEO/CMH, Chief Psychiatrist, Senior Psychiatrist or designee or shall state in writing the reason(s) the Psychiatrist does not meet minimum qualifications and submit to the Vendor Manager and the CCHCS, Direct Medical Contracts, Contracts Management Team. After notification of failure to meet minimum requirements has been provided, CDCR/CCHCS shall not pay the Vendor Worker for an additional hours identified as not meeting the minimum
Service Delivery Requirements Under the clinical direction of the Chief Psychiatrist/Senior Psychiatrist or designee, and the administrative direction of the Chief of Mental Health, Psychiatrists provide extensive psychiatric services or work in a review, evaluation, or consultative capacity. Psychiatrists may work in any of the State correctional institutions/facilities and provide direct patient psychiatric services to mentally ill inmates/wards. Psychiatrists may also be used in headquarters or field offices in a review and/or consultative capacity.
Meet with mentally ill patient-inmates/youths for crisis interventions, face-to-face interviews, etc. Must be able to provide clinical face-to-face interviews at cell fronts in inmate housing units. In some institutions, multi-tiered housing units may require the ability to climb stairs and walk long distances
Conduct initial mental health evaluations including criminal, psychiatric, and substance abuse case history to assess inmate’s/ward’s current needs and make treatment recommendations in the initial evaluation.
Conduct clinically sound suicide risk evaluations including clinical reviews, applying suicide risk assessment protocols, pertinent data/chart reviews, proper documentation and consultations as needed
Participate in Interdisciplinary Treatment Team (IDTT) meetings
Document all care provided to the patient-inmate/ward, including face-to-face contacts and IDTT meetings
Monitor inmate/ward progress using Subjective, Objective, Assessment, Plan and Education (SOAPE) formatted progress notes;
Effectively applies community standard of practice for psychiatric treatment modalities and ethical standards.
Perform mental status exam (MSE) in face-to-face clinical interviews.
Identify the relevant signs and symptoms of medical/psychological disorders in order to comprehensively diagnose, assess and manage the presenting symptomatology
Examine prior mental health records, institutional chromos, probation reports, court records and other available documents to assist in the formulation of patient’s diagnosis and aid in the development of the inmate’s/ward’s treatment plans.
Review, examine and diagnose psychiatric patients of all ages and patient records and files in mental health program to determine progress, effectiveness and/or appropriateness of treatment services; Consult, as necessary, with supervising psychiatrist on unusual, complex, or serious cases, or present such cases to a clinical conference for advice or decision
Provide clinical consultation to psychiatric staff on unusual, complex or serious problems and cases where technical expertise is needed.
Prescribe medication as deemed appropriate for treatment and utilize the CDCR Correctional Formulary or obtain non-formulary approval; Interpret laboratory results and make clinically appropriate referrals to medical services, as appropriate
Determine type of psychiatric and general medical treatment needed
Prescribe changes in treatment when indicated
When conditions are suspected, adhere to mandated reporting requirements regarding California Psychiatrists, including, but not limited to, reported child and elder abuse, danger to self or others, duty to warn (Tarasoff) reporting and other confidentiality mandates
Develop a therapeutic relationship with the patient-inmate’s/ward’s families and caretakers to enhance effective treatment delivery
Work in consult with primary care medicine in identifying and managing co-occurring, co-morbid and treatment related medical conditions
Make clinical rounds and review progress of patients, including assessments in inmate/ward housing units; Serve periodically as psychiatrist-of-the-day for on-call/call back during weekend and off-hours for patient emergencies, Mental Health Crisis Beds follow up, and 5-day follow ups
Administer psychiatric treatment with assistance, as necessary, from other health care providers.
Maintain order and supervise conduct of persons committed to the correctional facility in order to prevent escapes or injury by these persons to themselves or others;
Wear personal protective equipment, clothing and breathing apparatus to prevent injuries and exposures to blood/air borne pathogens
Participate in committees and Quality Improvement Teams
Compile and analyze data from audits pertaining to the mental health program requirements
Provide information (i.e. appointment documentation, no-shows, etc.) to support staff for data entry
Protect and maintain safety and security of property, including documentation of unusual occurrence and inventory control of psychological testing material, reference material, computers, and other equipment
Give input and help to implement new programs for the treatment, training or rehabilitation of patient-inmates/youths as directed by the CEO/CMH, Chief Psychiatrist, Senior Psychiatrist or designee
Instruct health care providers, and staff assigned for special training on the principles and practices of psychiatry.
Telemedicine Psychiatry Services
Under the direction of the Statewide Chief of Psychiatry support and coordination of the Office of Telemedicine Services (OTS), all telemedicine visits/clinics will adhere to patient-inmate confidentiality and privacy policies, Health Insurance Portability and Accountability Act (HIPAA), and Health Information Technology for Economic and Clinical Health (HITECH) and Confidentiality of Medical Information Act (CMIA) requirements.
The Telemedicine Psychiatrist must be available for the clinical schedule specific to the institution and they shall ensure that all scheduled services are delivered at the time scheduled, unless unavoidable circumstances occur. The Telemedicine Psychiatrist shall also refer to and utilize the CDCR Correctional Formulary or obtain or obtain nonformulary approval for medications not listed via the CDCR Request for Non-Formulary Medication, form 7374, and they must receive official program guide training before initiating Telemedicine Psychiatry Services as well as attend in-service training when requested by the institutional leadership or OTS. L On-site medical record information on each patient-inmate seen via telemedicine must be maintained by the Telemedicine Psychiatrist and comply with the requirements of CDCR, HIPAA, HITECH, and CMIA. In addition, all equipment and connectivity to perform telemedicine must meet the CDCR established and approved methods and specifications, and it shall meet or exceed the Information Technology (IT) security standards established by CCHCS based upon Internal Standards Organization (ISO) 27002 standard and the National Institute of Standards and Technology (NIST) 800 series. Telephonic Psychiatry On-call/Standby Services Services are defined as the express requirement that a psychiatrist be available by telephone during off-duty hours to receive communication regarding a mental health need. On-call services will be provided on an as-needed basis. Services will be utilized to temporarily fill telephone on-call functions due to staff vacancies and/or sick leave replacement of CDCR psychiatrists. The telephone on-call assignment will be mutually agreed upon between Vendor and Institution through the Vendor Manager. In the event the Psychiatrist is unable to maintain on-call status, Vendor shall provide twenty-four (24) hours’ prior notification to the Vendor Manager of the Psychiatrist’s absence. Vendor shall provide, to the institution’s representative, the next available Psychiatrist listed on Vendor’s registry. For the duration of the on-call Psychiatrist’s absence, Vendor shall maintain an updated listing of available Psychiatrists, and shall provide this information in writing, to the institution’s representative.