COVID-19 Related Changes to Fellowship - Captain James A. Lovell Federal Health Care Center
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Captain James A. Lovell Federal Health Care Center

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COVID-19 Related Changes to Fellowship

The COVID-19 pandemic has created numerous personal and professional challenges for us all.  One of these challenges is uncertanity about what will happen next week, next month, and especially one year from now. 

The Captain James A. Lovell Federal Health Care Center psychology training program has prided itself on its transparency, providing detailed and accurate information about our program and training opportunities.  With COVID, transparency means we cannot definitively predict how specific rotations or adjunctive training oppoortunities may evolve for the 2021/2022 training year. 

With confidence, we can say that there will likely be more utilization of telehealth and technology-based delivery platforms.  We do not expect there to be any significant changes to the base clinical services or populations served and adjunctive experiences described in our materials.  With that being said, we have detailed some of the changes that have occurred below.  However, due to the fluid nature of the situation, these changes may or may not continue into the next training year or into 2021/2022 training year. 

Although a lot has happened this spring and summer with our trainees and with many staff/trainees  abruptly shifting to providing clinical services and training remotely, our dedication to high-quality clinical care and psychology training and our dedication to the trainees themselves has never been stronger. 

We will continue to update our public materials as we know more about what will be in store for the 2021/2022 training year.  Please feel free to reach out to us if you have any questions. 

Changes to Benefits

Until December 31st, 2020 (unless extended), the fellow may be eligible for up to 80 hours of COVID-19 related leave.  Please see Families First Coronavirus Response Act (https://www.opm.gov/policy-data-oversight/covid-19/opm-fact-sheet-federal-employee-coverage-under-the-leave-provisions-of-the-families-first-coronavirus-response-act-ffcra.pdf) for more information.  Please note, it is incumbent upon the fellow to determine whether taking this leave would impact their ability to meet licensure requirements in their desired state of licensure.  

Changes to On-Boarding

We do anticipate starting fellowship on-time and will still require all the normal on-boarding requirements including being up-to-date on immunizations and fingerprinting.  The CDC has stated that keeping up to date on immunizations is important during this time to protect against any other illnesses that may compromise the immune system.  Thus, we view this as an additional public health safety precaution.  Our facility has ruled that finger-printing is an essential function and necessary to protect the interests of our patients.  Thus, finger-printing is also still a requirement and needs to be completed 30 days before the start of fellowship.  The finger-printing department at Lovell Federal Health Care Center has enacted extra safety measures including all staff wearing masks, extra sanitization, and 30-60 minutes in between appointments.  If the finger-printing office is closed at your nearest VA, please let me know so we can coordinate with our Human Resources as to what the next steps would be. 

Telework from Home Arrangements

Captain James A. Lovell Federal Health Care Center views all employees, including trainees, as essential healthcare workers, and are not bound by state shelter-in-place orders.  With that being said and with much consultation from local and national leadership, we may offer telework at home options depending on local conditions.  However, we will not be able to offer telework from home arrangements for our fellows immediately upon entry into the program.  Teleworking holds significant challenges even for seasoned clinicians and makes it harder to access needed support in standard and emergency situations.  We will need time to assess your competency level and to document this appropriately.  Additionally, some emphasis areas/aspects of your fellowship do not allow for telework.  After the training department has signed-off on your competency checks, if there is still a need for more stringent shelter-in-place orders and we still have emergency tele-supervision allowances from our national and local leadership and you are engaged in training activities that allows for telework, you will be allowed to telework at that time.  As of right now, all post-doctoral emphasis areas require at least some on-site work and so you would likely only be able to telework part-time.    

Facility Safety Procedures

Our facility has enacted a large number of safety measures to allow for as much social distancing as possible.  Facility-wide safety measures include the following: staff must wear masks at all times when on campus unless they are alone in their office; staff must have their temperatures taken; all cars entering campus are stopped and asked screening questions; all staff must stay home if they are not feeling well and cleared by Occupational Health before returning to work if experiencing any COVID symptoms (extra days of leave are allowed under certain circumstances to encourage this); all staff and trainees can present to Occupational Health for treatment and screening if they develop any COVID symptoms at work; trainees will have access to standard surgical masks, hand sanitizer, and CAVI wipes; interns will have their own office.

For the Outpatient Mental Health Clinic and PTSD Outpatient Clinic: Until further notice, all therapy will be conducted via virtual video conferencing or phone.  Group and individual supervision will be conducted via Skype until further notice.  We do not have an anticipated date for return to face-to-face appointments at the moment. 

For the residential programs: Due to the nature of treatment, the trainee will be engaging in face-to-face appointments. New patients are quarantined for 14 days and will not have any interaction with trainees during this period; positive or presumed positive COVID cases are removed from the building and sent to quarantine in another building, which the trainees will not be permitted to access; all patients and staff wear masks; all patients and staff have their temperatures checked daily (patients 2x a day) and asked screening questions; patients are not allowed to go on pass or leave campus for the duration of their admission (although if Veterans in the Homeless Program have employment, they are permitted to leave in order to work); volunteer/outside services are temporarily stopped; social distancing is enforced: groups are kept small and individuals are assigned to private rooms; trainees will have a private space to complete charting.  The supervisor will be on-site to assist with emergencies and on-the-fly supervision.

Changes to Emphasis Areas as of Summer 2020

*VVC: Telehealth System

Addiction Treatment Program (ATP): The training program does not have any major changes.  There is a possible involvement in outpatient VVC work but residential work is done in person.  There is no option to telework. 

Stress Disorder Treatment Unit (SDTU): The patient census has been limited during the COVID pandemic.  There is opportunity to treat both patients in the Addiction Treatment Program who present with PTSD and SDTU patients.  There is also an opportunity to provide programming to the Veterans who are quarantined via VVC.  The rotation offers part-time telework but it is limited to screenings or individual appointments who have recently discharged.

Neuropsychology Testing Lab: Reduced face to face hands-on testing. We are exploring use of protective measures to get back to testing (i.e., sneeze guards, clear masks for providers, primary use of verbal tasks). Telehealth for interviews and feedbacks at this point. Things that will/have remained the same but are done with social distancing in mind, include: supervision, scoring, report writing, and learning of test administration. Didactics could be completed in my office with masks and social distancing given the space.  We are providing telehealth services for interviews and feedbacks currently so part time telework is an option. Face to face testing via VVC is not an option at this time. We may consider continuing doing this to reduce face-to-face time when we are given a thumbs up to do testing in person.

Gero-psychology (CLC): Socially distant with PPE, students can provide face-to-face brief intervention. Trying to reduce need for physical presence on households.  Trainees will not interact with any positive COVID cases. Our CLC residents now have access to iPads on the household to participate in VVC psychotherapy remotely. We are also attending all IDT meetings through a VANTS line remotely. Roundings on households are done virtually through phone calls. Anything that needs real hands-on attention is provided on the household in proper PPE. COVID testing and fit testing is being provided to our CLC providers.  At this time, no work is being done on the short-term rehabilitation floor and not treatment is being conducted with Active Duty Service Members.  Option to telework part-time. 

Homeless Veterans Rehabilitation Unit: As of now, there is less opportunity for exposure to therapeutic milieu and groups are being run at limited capacity. Aside from those two COVID-related changes, everything in our materials should be consistent.  There are opportunities for telework and those would be dependent upon the trainees training goals and needs.

Trauma Recovery Program: All patient appointments are currently being run in a virtual or phone format. Telework may be available.