GEC/HBPC Amarillo VA Healthcare System

DEPARTMENT OF VETERANS AFFAIRS

 AMARILLO  HEALTH CARE SYSTEM

(HBPC Medical Director Home Based Primary Care) SCOPE OF PRACTICE

GEC/HBPC Service

SCOPE OF PRACTICE:

All providers who are granted privileges in VA Amarillo Health Care System are allowed to provide, deliver and/or interpret professional services (within the scope of their license) in all care settings. It is understood that the requested privileges (as marked below) represent only the requested privileges in the areas in which the applicant believes he/she meets the applicable standards of education, training, Board Certification and demonstrated proficiency.

CORE PRIVILEGES:

All (HBPC Medical Director Home Based Primary Care) who are granted privileges to provide, deliver and/or interpret are hereby granted the following core privileges:

 Home Base Primary Care (HBPC) Medical Director within the Geriatric and Extended Care (GEC) Service at the Thomas E. Creek VA Health Care System is responsible for clinical over site of all HBPC services in Amarillo and satellite programs. Will work in collaboration with the HBPC Program Director, (50% FTE) . The HBPC Medical Director will also provide clinical care (up to the 50% FTE) in other departments within the GEC service line (Geri PACT Care Clinic, CLC and Hospice & Palliative Care Clinic, etc) The HBPC Medical Director will report to the Chief of GEC. The Home Based Primary Care (HBPC) Program targets frail, chronically ill veterans who require care by interdisciplinary health care teams, continuity, coordination of care, and the integration of diverse services to cover complex medical, social, rehabilitative, and behavioral care needs. These veterans need comprehensive, longitudinal home care services, as they age, to maximize function, minimize institutionalization, and maintain quality of life. The Physician is academically and clinically prepared to perform a broad spectrum of patient care services at the expert level. In addition to providing primary health care, the MD serves as a consultant to nursing and medical staff for patients with interdisciplinary team members in providing quality care and patient education and assisting patients in acute and chronic rehabilitation techniques. The MD serves on medical center, VISN and/ or national committees and assists in the development, evaluation, and communication of policies and standards to all healthcare disciplines.

1. Collaborating with the HBPC Program Director. a. Provide leadership to the HBPC Program. b. Determine appropriateness and eligibility for veterans referred to HBPC program. c. Plan and direct the educational and clinical experience of medical students, residents and fellows assigned to the HBPC Program. d. Assume a leadership role in the development and implementation of the HBPC performance improvement plan. e. Advocate for HBPC with VHA leadership and the medical community. f. Jointly select HBPC Team members. 2. Providing clinical input and oversight for all patient treatment plans. 3. Being readily available to the team members for collaboration when medical or other problems arise. 4. Participating in HBPC team meetings. 5. Keeping the HBPC team apprised of medical care advances and practice standards. 6. Arranging physician coverage and communicating the plan of coverage to the HBPC team. 7. Collaborating with other HBPC Medical Directors, VISN leadership, and VA Central Office staff on program development issue. 8. Work to ensure alignment of the program with VACO, JC, VISN guidelines. 9. Promptly addressing noteworthy findings from internal& external audits, and review JC, LTCI, OIG, OMI, and others.

The HBPC Medical Director, in collaboration with the HBPC interdisciplinary team, is responsible for:

1. Assuming primary medical responsibility for HBPC patients. 2. Identifying the patients' medical problems. 3. Defining the medical management of these problems. 4. Determining the need for consultation from medical, surgical, and/or psychiatric sub-specialty clinics as well as community care. 5. Determining the need for, and facilitating, admission to the hospital.3

6.Visiting the HBPC patients at home, when appropriate.7.Serving as collaborator for advanced practice nurses and/or physician assistants.8.Providing medical administrative support such as signing forms requiring physician signature forthe HBPC patients.

1.Collaborating with community home health and hospice agencies as needed for HBPC patients.2.Following HBPC Staff Safety procedures.3.Complying with Medical Center and VHA regulations regarding the use of government vehicles.4.Demonstrating work practices that include adherence to Infection Control standards and the safe use and operation of equipment.5.The incumbent will also be responsible for informing the HBPC team of advancements in medical care and practice standards.6.The position requires travel and incumbent must maintain a valid state driver’s license.7.The clinical and administrative duties listed above are not comprehensive and may include other duties as determined by the program needs and assigned by the GEC Chief.8.Additional duties may require coverage of clinics, Community Living Center, Hospice & Palliative care, Contract Nursing Home, etc. as directed by Chief of GEC.

Paid Time Off:

• 26 Days paid annual (vacation/personal) leave
• 13 Days paid sick leave each year with no limit on accumulation
• 11 Federal holidays with pay annually
• 5 Days paid absence to attend approved CME courses

Insurance:

• Health Insurance: VA employees have an outstanding number of health insurance plans from which to choose (premiums are partially paid by VA) Lifetime Healthcare Insurance options available
• Dental & Vision: Our insurance options also include exceptional vision and dental plans (premiums are partially paid by VA)
• VA employees have the option to use Flexible Spending Accounts, which allow you to use tax-free dollars to pay for medical, dental, and vision care expenses that are not reimbursed by your health insurance plan
• Term life insurance, family, and additional coverage options are available with the cost shared by the Federal Government
• Long-term care insurance is available as an option

Federal Retirement Plan:

• VA employees are covered by the Federal Employees Retirement System (FERS). FERS is a three-tiered retirement plan composed of 1) Social Security benefits, 2) FERS-RAE basic benefits (pension), and 3) Thrift Savings Plan (TSP) which is a 401K-type plan
• How is the pension funded? VA employees automatically contribute 4.4% of their salary each pay period and the VA contributes 12.2% of the employee’s salary each pay period for a total annual contribution percentage equal to 16.6% of the employee’s salary
• Similar to the 401(k) savings plans widely available in the private sector, the TSP allows employees to tax defer a portion of their income each year, subject to the requirements of the Internal Revenue Service. For calendar year 2020, employees under the age of 50 may contribute up to $19,500, while those over age 50 are eligible to make catch-up contributions that allow them to defer up to $25,500.
• The Federal Government also provides an automatic basic contribution (1% of salary) and up to 4% of salary in matching contributions, depending on the amount of the employee contribution
• For retired military personnel, these benefits are in addition to full monthly retirement pay or pension
• In addition to FERS, VA provides health care insurance coverage for retired personnel
• Disability Retirement
• Employees are vested in a federal pension after only 5 years service

DEPARTMENT OF VETERANS AFFAIRS

 VA AMARILLO HEALTH CARE SYSTEM

Lubbock, TX

(PULMONOLOGIST) SCOPE OF PRACTICE

SPECIALTY SERVICE

SCOPE OF PRACTICE:

All providers who are granted privileges in VA Amarillo Health Care System are allowed to provide, deliver and/or interpret professional services (within the scope of their license) in all care settings. It is understood that the requested privileges (as marked below) represent only the requested privileges in the areas in which the applicant believes he/she meets the applicable standards of education, training, Board Certification and demonstrated proficiency.

CORE PRIVILEGES:

All (Pulmonologist) who are granted privileges to provide, deliver and/or interpret are hereby granted the following core privileges:

• The Pulmonologist is responsible for patient care, patient/family education and participation in any indicated clinical research in pulmonary medicine. The pulmonologist provides comprehensive care for patients who have illnesses within the scope of pulmonary medicine/sleep spectrum as noted in privileges granted. The Scope of these activities covers all phases of ambulatory care. Other responsibilities may include education of medical students and residents and/or supervision of other providers. Most of the pulmonologist’s time is devoted to patient care and education, with the remaining time set aside for performance improvement activities, creative research to improve patient care, activities sufficient to maintain proficiency in state-of-the-art pulmonary care. Care will be provided to the Amarillo VA Healthcare System, physical duty location is the Amarillo, TX.

• 2. Documents care provided in the computerized Patient Record System (CPRS) in accordance with Amarillo VA Health Care System requirement.
• Documents the detailed, targeted, initial history and physical examination required for evaluation in the electronic tools(s) required by VA.
• Obtains consent and documents procedures performed for which the pulmonary specialist is responsible. Provides education and counseling of patients and families in preventative care, medical conditions, and the use of prescribed treatments and drugs.
• Review and revise policies and scope of practice/standards of operation to meet the needs of the National VA and Amarillo VA Health Care System mandates.

• Review and guide protocols in chronic patient managements including coordinating efforts with prosthetics department to meet patient’s needs and maintain fiscal responsibility.

3. Writes medical orders and prescriptions for non-controlled and controlled substances, as necessary, for the care of the patient in accordance with Federal and State law.

Responds to and completes consults received for the evaluation of pulmonary and sleep, including Performing comprehensive, detailed, targeted, initial history and physical examinations in compliance with national guidelines.

Orders diagnostic studies such as laboratory tests, X-rays, PFTs, electrocardiograms (EKG’s) and other tests.