Office of Academic Affiliations Update on Psychology Education Robert Zeiss, Ph.D. Associate Director, Associated Health

1. Office of Academic Affiliations Update on Psychology Education Robert Zeiss, Ph.D. Associate Director, Associated Health Education Office of Academic Affiliations VA Central Office, Washington, DC VA Psychology Leadership Conference May 2007 Dallas, TX

2. VA Training Impact on Psychology • Reallocation of Temporary Training Positions • Associated Health Supervision Handbook • Affiliation Agreements

3. VA’s Impact on National Psychology About 35.5% of licensed psychologists have had some VA training. In FY06, 1116 received some VA training In 2006, 4494 took EPPP, of which about 75% passed. 1116/3146 = 35.5% -Data from Professional Examination Services

4. Trainee AllocationsFY 2008/ Academic Year 2007-2008 • Interns • 396 positions at 86 facilities • Includes 31 temporary positions • Postdoctoral Fellows • 114 positions at 27 facilities • Includes 21 temporary positions • Totals: 510 positions (13 more than current yr)

5. Reallocation of Training Positions Temporary positions for this year and next will be pulled back for reallocation in a more planned manner RFP to be out around June 1

6. Reallocation of Training Positions Very interested in supporting new initiatives, especially postdoctoral All proposals will be considered

7. Reallocation of Training Positions • Emphasis on Evidence Based Practices and Mental Health Strategic Plan, with focus on • Geriatrics • Home Based Primary Care • Interprofessional Care • Mental Health in Primary Care • Recovery • Suicide Prevention • TBI

8. Associated Health Supervision Handbook • All trainees must have an identified supervisor for each patient • Supervisor has clinical and legal responsibility • Supervisor is the Primary Provider (VHA Directive 2006-026, Patient Care Data Capture) • Level & type of supervision must be consistent with assigned level of responsibility

9. Graduated Levels of Responsibility • Trainees earn progressive responsibilities • Levels of responsibility must be formally assigned and documented • At all levels of responsibility, the minimal standard is that supervisor must be in the facility, immediately available, and able to be physically present as needed.

10. 3 Types of Supervision • Physically present in the same room • In the same physical area and immediately available • Supervisor not in the immediate area, but in facility and able to be present if needed

11. 3 Types of Documentation • Separate progress note • Addendum • Co-signature implies full concurrence with the trainee note

12. Billing Concerns • VA follows CMS rules • CMS rules do not allow billing for any student-provided services • Only services provided by a credentialed provider may be billed • Only documentation by the credentialed provider may be used for billing purposes

13. Future Plans • Expand Graduate Medical Education Program based on recommendations of Federally Chartered Advisory Committee • 4 New Sites for Interprofessional Fellowship Program for the Care of Veterans with Serious Mental Illness • Affiliation Agreements

14. Thank You Questions?