The PA is responsible for the care and administrative needs of mental health patients in both the inpatient and outpatient settings. This PA will be fully qualified and certified to function in both a clinical and administrative role and accordance with the guidelines and policies of the Durham Veterans Affairs Health Care System. The PA functions as a coordinator between the attending physician and other members of the patients' care team. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Graduate of a training program which is accredited by the Accreditation Review Commission on Education of PA (ARC-PA) or one of its predecessor organizations. Additionally, candidates must meet one of the following: (1) Master's degree in any discipline; OR (2) Bachelor's degree in any discipline with one year of experience as a PA. Must have successfully passed the PA National Certifying Exam (PANCE). PAs must possess an active, current, full, and unrestricted license to practice in a State, Territory, or Commonwealth of the United States, or in the District of Columbia. PAs must maintain current registration in the State of licensure if this is a requirement for continuing active and current licensure in that State. - Exceptions for Graduate PAs. (a) PAs who otherwise meet the basic requirements, but do not possess the required licensure, may be appointed, pending licensure, as a graduate PA on a temporary full-time appointment not-to-exceed two years under the authority of 38 U.S.C. § 7405(c)(2)(B). (b) Graduate PAs may only be appointed at the entry grade level and may not be promoted/converted until certification is obtained. (c) Temporary graduate PA appointments may not be extended beyond two years or converted to a new temporary appointment. NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. § 7402(f)). This requirement does not apply to licensed PAs currently employed by VA as of November 30, 1999, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification The full performance level of this vacancy is VN-0603-III. The actual grade at which an applicant may be selected for this vacancy is in the range of VN-0603-I to VN-0603-III. Preferred Experience: 1 year of experience as a licensed independent practitioner in acute care mental health. (This does not include time spent on clinical rotations during training.) Grade Determinations: In addition to the basic requirements stated above, the following qualification criteria must be met in determining the appropriate grade assignment of candidates: Physician Assistant-I (PA-I) (a) Experience and Education. None beyond the basic requirements. This is the entry level for PAs.(b) Demonstrated Knowledge, Skills, and Abilities. The following list of knowledge, skills, and abilities (KSA) present the minimum skill set expected of an Entry Level PA. This practice may include but is not limited to: i. Ability to utilize the principles of PA practice in the care of assigned patients to provide appropriate care. ii. Ability to perform patient history and physical. iii. Ability to formulate a plan and provide treatment to the patient. iv. Ability to provide patient care that is abreast of changing concepts and advancements in the profession. (2) Physician Assistant-II (PA-II) (a) Experience and Education. The PA at this grade is at the intermediate grade level and has had progressively increasing responsibility and experiences as indicated in the KSAs listed below. Individuals will have demonstrated the ability to analyze and solve more complex medical problems than at the entry level grade and can utilize their training in the successful practice of patient care and participate in team problem solving. Individuals demonstrate the KSAs of PA-II intermediate level by i. Two years of successful practice as a PA OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education. (b) Demonstrated Knowledge, Skills, and Abilities (KSAs). PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-II: i. Skills to analyze and solve complex medical problems. ii. Ability to function autonomously and make independent medical decisions. iii. Skill to incorporate training and experience into the successful practice of patient care including telehealth medical care. iv. Ability to work effectively in an interdisciplinary environment for improvement of services for patient care. v. Ability to practice with colleagues and peers collaboratively. (3) Physician Assistant-III (PA-III) (a) Experience and Education. PAs at the PA-III grade are at the full performance level and lead and organize patient care independently, practice within multidisciplinary teams, and coordinate all aspects of patient care across the health care system. They utilize advanced clinical knowledge and judgment in decision-making and evaluating outcomes. They function as experts in clinical practice and/or in areas related to the assigned roles and responsibilities, may serve as mentors for transitioning PAs, and may provide training for health care students. Individuals can demonstrate the KSAs for the full performance level by: i. Three years of successful practice as a PA OR ii. Successful completion of a PA post-graduate residency program sponsored by VHA Office of Academic Affiliations or other postgraduate residency programs accredited by VA, ARC-PA, U.S. Armed Forces, or another accrediting agency and one year of professional practice as a PA. OR iii. A doctoral degree in a health-related field from an accredited college or university recognized by the U.S. Department of Education and one year of professional practice as a PA. (b) Demonstrated Knowledge, Skills, and Abilities. PAs at this level are not required to meet each individual KSA listed below to qualify, but should be able to demonstrate, develop, or acquire those not met upon appointment for PA-III: i. Ability to clinically evaluate facility patient care delivery systems and validate or identify barriers to safe and effective patient care. ii. Skill to consistently demonstrate an elevated level of expertise and autonomy in diagnosing and treating seriously ill, multi-symptomatic patients through facility Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). iii. Ability to present clinical findings and recommendations to appropriate management officials. iv. Ability to clinically facilitate the delivery of patient care in collaboration with health professionals, health managers, and other health care personnel. v. Ability to implement and initiate clinical changes to established treatment protocols based upon new medical literature research findings to enhance patient delivery care for improved patient outcomes.vi. Ability to participate clinically in the development of the PA patient care audit processes involving in-depth review and analysis of medical records. Reference: VA Handbook 5005/134-September 27, 2020, PART II APPENDIX G8. This can be found in the local Human Resources Office. Physical Requirements: See VA Directives and Handbook 5019, Employee Occupational Health Service. ["The Physician Assistant (PA) works within an interdisciplinary team to provide care to mentally ill patients within acute care settings including the inpatient Psychiatry service, the Emergency Department and those admitted to medical, surgical and critical care units needing psychiatric care. The PA is responsible for the care and administrative needs of mental health patients in both the inpatient and outpatient settings. This PA will be fully qualified and certified to function in both a clinical and administrative role and accordance with the guidelines and policies of the Durham Veterans Affairs Health Care System. This individual is delegated the authority and responsibility to assume clinical, consultative, educational, research, and administrative duties and assignments related to the care of in-hospital and outpatients. The PA functions as a coordinator between the attending physician and other members of the patients' care team. GENERAL DESCRIPTION OF DUTIES The primary focus of practice in assessing, diagnosing, and treating mental health problems, including initiation and adjustment of therapeutic regimens, ordering diagnostics and tests/studies, initiating consults and referrals, and prescribing medications and supplies according to VA policy VA formulary and State Regulations. Maintain effective relationships with other team members to determine and meet the social, environmental, economic, and psychological needs of the patient. Utilizes and promotes approved standards of care, procedures, methods, techniques, safety precautions, and protocols in their application to treatment and management of acute and chronic mental illnesses. Provides medication management and individual and group psychotherapy as clinically indicated. The primary treatment modality will be medication management. Collaborates with other medical center health care resources to ensure continuity of care. Evaluation and management of patients admitted to psychiatric inpatient services as needed Responding to psychiatric crisis calls on behavioral health units, the emergency department, and medical/surgical units Facilitates the care of patients and their entry and exit from various health care systems by establishing and maintaining liaison with a variety of medical specialists and associated staff. Recording pertinent findings, impressions, and plan of care in the patient's medical record for all patient encounters. This will generally be in diagnostic interviews for new patients and progress notes for existing patients. Record/document health appraisal information, clinical assessments, treatment decision, plan of care, ongoing management and therapeutic outcomes, order medications, diagnostic test and referral consultations where needed for every patient encounter; recording will be accomplished using the electronic comprehensive patient record system (CPRS), be completed on the day of the encounter. Respond to computerized \"alerts\" indicating diagnostic test abnormalities and to health line request from Veterans/family members within recommended time periods as per policy. Follow Performance Measure guidelines, including completion of clinical reminders in CPRS; access and timeliness standards; prescription order entry, National VA formulary requirements, and customer service standards. Other clinical duties as assigned by the supervisor include coverage for other psychiatric advanced practice provider's clinical staff on leave. Administrative/Education/Research: Promotes and participates in the delivery of patient and family health care education. Attends conferences and committee meetings as assigned by the supervising physician. Participates, directs, and provides opportunities for staff development through in-service education. Facilitates responses/actions to patient inquiries regarding care and treatment received. Assures self-development responsibilities and maintains current knowledge of trends in the management of in-patients. Participates in clinical research programs when appropriate. Supervision and training of residents and health care trainees from a variety of disciplines. Other administrative &/or educational/research duties as assigned by the supervising physician Supervisory Controls:\nThe incumbent is directly responsible to the Acute Care Chief. In the clinic, assignments evolve from the flow of work and the PA provides care without detailed instructions. Work Schedule: TBD; includes weekend and weekday time not to exceed 80 hours in a 2 week period (average of 40 hours per week)\nTelework: Not Available\nVirtual: This is not a virtual position.\nRelocation Incentives: Not Authorized\nPermanent Change of Station (PCS): Not Authorized\nFinancial Disclosure Report: Not required"]
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.