HANDBOOK - Northwell Health · Psychology Internship Handbook: 2019-20 Page 7. The . Clinical Child...

Handbook

for the

Doctoral Internship in Clinical Psychology

2019 – 2020

Division of Psychological Services

Director of Psychological Services Stewart Lipner, Ph.D. Director of Psychology Training and Adult Internship Track Elihu Turkel, Psy.D. Associate Director of Training, Clinical Child Psychology Stephanie Solow, Psy.D. Associate Director of Training, Clinical Neuropsychology Paul Mattis, Ph.D., ABPP

Clinical Psychology Internship Handbook 2019-2020

OVERVIEW ............................................................................................................................................... 3

EDUCATIONAL GOALS, THEIR ASSESSMENT, AND ASSESSMENT OF THE INTERNSHIP PROGRAM ............. 6

PROGRAM MODEL, GOAL, AND COMPETENCIES .................................................................................................... 6 DIVERSITY EDUCATION AND TRAINING ................................................................................................................. 7 COMMUNICATION WITH DOCTORAL PROGRAMS ................................................................................................... 7 TRAINEE SELF-DISCLOSURE ............................................................................................................................... 8 SUPERVISION .................................................................................................................................................. 9 ORIENTATION PERIOD ...................................................................................................................................... 9 PLACEMENTS AND SCHEDULE .......................................................................................................................... 10 WEEKLY ACTIVITY LOG ................................................................................................................................... 10 ASSESSING YOUR PROGRESS ............................................................................................................................ 11 DUE PROCESS ............................................................................................................................................... 12 WORK LOAD ................................................................................................................................................ 12 RECORD KEEPING .......................................................................................................................................... 13 GRIEVANCE PROCEDURE ................................................................................................................................. 13 TRAINEE CONDUCT ........................................................................................................................................ 13 CRITERIA FOR SUCCESSFUL COMPLETION OF THE INTERNSHIP ................................................................................. 14 EXTENDED TRAINING POLICY ........................................................................................................................... 14 CERTIFICATE OF COMPLETION .......................................................................................................................... 15 FEEDBACK ABOUT THE INTERNSHIP FROM INTERNS ............................................................................................... 15 RECORD KEEPING .......................................................................................................................................... 16

GENERAL ISSUES .................................................................................................................................... 16

PAID TIME OFF ............................................................................................................................................. 16 TIMEKEEPING ............................................................................................................................................... 17 SICK TIME .................................................................................................................................................... 18 CONFERENCE TIME ........................................................................................................................................ 19 BENEFITS ..................................................................................................................................................... 19 MEDICAL AND PSYCHIATRIC EMERGENCIES ......................................................................................................... 19 TELEPHONES ................................................................................................................................................ 20 VIRTUAL (PHONE LINE) VOICEMAIL: ................................................................................................................. 22 LONG DISTANCE PHONE CALLS ........................................................................................................................ 22 PAGERS ....................................................................................................................................................... 23 COMPUTERS AND PRINTERS ............................................................................................................................ 23

ADMINISTRATIVE ISSUES ....................................................................................................................... 25

PSYCHOLOGICAL SERVICES SECRETARIAL STAFF ................................................................................................... 25 PARKING (ZHH) ........................................................................................................................................... 26 TEXT ALERTS ................................................................................................................................................ 26 MAILBOXES .................................................................................................................................................. 27 FOOD ......................................................................................................................................................... 27 PAY ............................................................................................................................................................ 27 KEEPING TRACK OF WHERE YOU ARE ................................................................................................................ 28 FIRE ALARMS - ZHH ...................................................................................................................................... 28 KEYS ........................................................................................................................................................... 28 ACCESS TO INPATIENT UNITS AT ZHH ............................................................................................................... 28 CREDIT UNION ............................................................................................................................................. 29

APPENDIX LIST ....................................................................................................................................... 30

Psychology Internship Handbook: 2019-20 Page 3

Overview

The Doctoral Internship in Clinical Psychology at Long Island Jewish Medical Center, The

Zucker Hillside Hospital (ZHH) affords an opportunity for training in diverse clinical settings located

at Zucker Hillside Hospital, The Cohen Children’s Medical Center (CCMC), Long Island Jewish

Hospital (LIJH) and North Shore University Hospital (NSUH). All these settings are part of Northwell

Health. The internship program has been accredited by the American Psychological Association (APA)

since 1979 and is accredited through 2020. (Our most recent site visit occurred in October 2013.)

Questions related to the program’s accredited status should be directed to the Commission on

Accreditation:

Office of Program Consultation and Accreditation American Psychological Association

750 1st Street, NE, Washington, DC 20002 Phone: (202) 336-5979 / E-mail: [email protected]

Web: www.apa.org/ed/accreditation

Hillside Hospital was initially founded in 1927 in Hastings-on-Hudson as “Hastings Hillside

Hospital.” Looking to expand its facility, the Hospital moved to Queens in 1942 and opened on the

Glen Oaks campus where it resides today. In 1972, Hillside merged with Long Island Jewish Hospital

to form “Long Island Jewish-Hillside Medical Center.” In 1983 Schneider Children’s Hospital was

established as another division of Long Island Jewish Medical Center along with the existing Hillside

Hospital and Long Island Jewish Hospital divisions. North Shore University Hospital (NSUH) and Long

Island Jewish Medical Center merged in 1997 to form the North Shore - LIJ Health System. In 2002

Hillside Hospital was renamed “Zucker Hillside Hospital” (ZHH) in recognition of the generosity of

the Zucker family’s support and their sponsorship of the Zucker Hillside Ambulatory Care Pavilion

(ACP). In 2010 Schneider Children’s Hospital was renamed the Steven and Alexandra Cohen

Children's Medical Center (CCMC) of New York. In 2016, the North Shore - LIJ Health System, was

http://www.apa.org/ed/accreditation



renamed Northwell Health. Northwell Health is now New York’s largest private employer and

health care provider, with 23 hospitals and about 750 outpatient facilities.1

In 2013, Zucker Hillside Hospital opened a 130,000-square-foot, $125 million two-story

inpatient pavilion (the Behavioral Health Pavilion) which was constructed with the generous

support of North Shore-LIJ Health System trustees Donald and Barbara Zucker. It houses 115

inpatient beds — 22 for geriatric patients, 70+ for adults, and 21 for adolescents -- increasing ZHH

inpatient capacity to a total of 221 beds. This modern, patient-centered facility is surrounded by a

tranquil and sprawling environment that preserves the unique history of the Zucker Hillside campus,

located on the grounds of Long Island Jewish Medical Center (LIJMC).

In 2011, the Hofstra Northwell School of Medicine (now known as the Donald and Barbara

Zucker School of Medicine at Hofstra/Northwell) opened as the first new allopathic medical school

established in New York since 1963. Hofstra and Northwell Health have combined their respective

strengths and expertise, each sharing responsibility for the medical school's mission and success.

The new medical school combines Hofstra's academic infrastructure and expertise with Northwell's

clinical and graduate medical education programs. It also incorporates research conducted at The

Feinstein Institute for Medical Research, the research arm of Northwell Health. These components

provide the strong foundation for an excellent medical education experience.

The doctoral clinical psychology internship program began in 1966 with one half-time intern

at Hillside Hospital. The internship grew in size as did the psychology staff. By 1980 there were

eight psychology interns who took part in a general internship in clinical psychology. The size of

child and adolescent psychology staff expanded with the building of Schneider Children’s Hospital.

In 1986, the Clinical Child Track of the Internship was launched. Neuropsychology staff also

increased rapidly during this period and in 1987 the Clinical Neuropsychology Track was added.

1 "Northwell fact sheet dated May 2019" (PDF). Northwell About Us. May 2019. Retrieved 20 June 2019.

http://www.northshorelij.com/cs/Satellite?c=eHA_Content_C&cid=1228242790513&pagename=NSLIJ%2FCentral_Template


http://www.northshorelij.com/NSLIJ/lij

https://www.northwell.edu/sites/northwell.edu/files/2019-05/Northwell-Health-Fact-Sheet-May-2019.pdf



Additionally, the NSUH Hospital Department of Psychiatry was administratively subsumed under the

Department of Psychiatry at the Zucker Hillside Hospital in 2006 and its rich training resources were

added to the psychology internship program.

For the 2019-20 training year there are 11 interns: six in the Adult Psychology Track, three in

the Clinical Neuropsychology Track, and two in the Clinical Child Track. Approximately forty licensed

psychologists are involved in supervision and other training experiences for the internship. There

are over 400 alumni of the internship who occupy professional positions in academia, medical

centers, community mental health centers, the government, and other settings. Our psychology

postdoctoral fellowship programs – which include a program in Clinical Psychology with a

Geropsychology Emphasis and a specialty program in Clinical Child Psychology – have been

accredited by the American Psychological Association since 2005.

Zucker Hillside Hospital has an enviable history of research contributions in psychiatry and

psychology. In 1954, a Department of Experimental Psychiatry was established under the direction

of Max Fink, M.D. In 1959 Donald Klein, M.D. began his tenure as Director of Research during which

time some of the most influential psychopharmacological research of that era was conducted. In

1978 John Kane, M.D. became Director of Research. During the years that he directed the program

he and his colleagues garnered millions of dollars in funding from the National Institute of Mental

Health primarily to support research on Schizophrenia and other psychiatric disorders. Dr. Kane has

been Chairman of the Department of Psychiatry at the Medical Center since 1988 and is Vice

President of Behavioral Health Services for Northwell Health.

From the beginnings of Hillside Hospital to what has now evolved into the 20+ hospitals that

constitute Northwell Health, psychologists have played an integral role in clinical services and

research. We are delighted that you chose Long Island Jewish Medical Center - Zucker Hillside


Hospital for this very important year in your graduate education. You join a group of distinguished

individuals who have trained with us. We trust you will have a productive and satisfying year in the

internship.

Educational Goals, Their Assessment, and Assessment of the Internship Program

Program Model, Goal, and Competencies

The program is a practitioner-scholar model with the goal of developing competencies in

areas common to Health Service Psychology. The internship is designed to build upon a trainee’s

competencies in the recognized profession-wide competency areas. These include:

1. Research

2. Ethical and Legal Standards

3. Individual and Cultural Diversity

4. Professional Values, Attitudes, and Behaviors

5. Communication and Interpersonal Skills

6. Assessment

7. Intervention

8. Supervision

9. Consultation and Interprofessional/Interdisciplinary Skills

In addition to the above, our program also aims to develop program‐specific competencies

for interns admitted to each of the two specialty tracks. The competencies associated with the

Clinical Child Psychology and Neuropsychology internship tracks are:

• Competence in Clinical Neuropsychology (track specific)

• Competence in the principles of Clinical Child Psychology (track specific)


The Clinical Child Psychology track of the Internship is designed to adhere to the published

guidelines and recommendation for training in Clinical Child Psychology as articulated by the APA

Division 53’s Board of Directors. The Clinical Neuropsychology track of the Internship is designed to

adhere to guidelines recommended by the Houston Conference on Specialty Education and Training

in Neuropsychology (1998).

Diversity Education and Training

In accordance with the APA’s Standards of Accreditation (Standard II.A.2.c for internship

programs), the program implements a thoughtful and coherent plan to provide you with relevant

knowledge and experiences about the role of cultural and individual diversity in psychological

phenomena and professional practice. Cultural and individual diversity includes but is not limited to

age, disability, ethnicity, gender, gender identity, language, national origin, race, religion, culture,

sexual orientation, and social economic status. Consistent with Standard C-20-I, our program

integrates diversity into its didactic and experiential training which is based on the multicultural

conceptual and theoretical frameworks of worldview, identity, and acculturation, rooted in the

diverse social, cultural, and political contexts of society, and integrated into the science and practice

of psychology. You will be trained to respect diversity and to be competent in addressing diversity in

all professional activities including research, training, supervision/consultation, and service. The

program maintains a Diversity Training Council which includes trainees and which routinely reviews

the program’s education and training efforts in this area and takes steps to revise/enhance its

strategies as needed.

Communication with Doctoral Programs

We view the internship program as a partner to your graduate programs. Therefore,

evaluative communication must occur between the two training partners. Given this partnership, our


training program has adopted the practices included in the Communication Policy included in the

appendix.

Trainee Self-Disclosure

Consistent with the APA Ethical Principles of Psychologists and Code of Conduct (APA, 2010:

section 7.04), trainees are not required to disclose personal information within the supervisory

relationship or in educational seminars.

Since personal experiences, beliefs, and values may influence professional activities, an intern may

choose to disclose such information and is encouraged to do so as long as the intern believes that

the information has a bearing on professional functioning.

When appropriate, trainees are encouraged to explore historical influences and personal

information relevant to their clinical practice. Personal reactions in therapy sessions or seminars

may provide useful information about the progress of the treatment.

Voluntary personal disclosures that are pertinent to the trainee’s clinical role can be

valuable in a supervisory relationship. Trainees are encouraged to feel free to engage in personal

disclosures in supervision when they wish. The supervisory relationship is expected to be

characterized by mutual respect. Supervisors also may disclose personal experiences and reactions

if they are important in their clinical role, the supervisory alliance, or the trainee's competence.

Supervisors may notice significant incidents or patterns in intern professional behaviors that

suggests behaviors may be influenced by personal experiences, beliefs, and values. Supervisors may

ask interns to reflect on this in the specific context of promoting professional development.

Interns choose how much and what to disclose. Interns are not penalized for choosing not to

share personal information. Supervision is not psychotherapy.

As noted in the Ethical Principles, we may require self-disclosure of personal information

if the information is “necessary to evaluate or obtain assistance for students whose personal

problems could reasonably be judged to be preventing them from performing their training- or


professionally related activities in a competent manner or posing a threat to the students or

others” (APA, 2010).

Supervision

Each of you will receive at least 4 hours of supervision per week. One or more appropriately

trained and licensed doctoral level psychologists are involved in ongoing supervisory relationships

with each of you and have primary professional responsibility for the cases on which supervision is

provided. The supervisor(s) conduct at least 2 hours per week of individual supervision with you

during the course of the year. An intern will typically have different primary supervisors engaged in

providing individual supervision during the course of the training year. Supervisory hours beyond

the two hours of individual supervision can be in a group or individual format and are provided by

appropriately credentialed health care providers. The doctoral level psychologist supervisors

maintain overall responsibility for all supervision, including oversight and integration of supervision

provided by other mental health professionals with psychological research and practice.

Orientation Period

You will spend approximately one week at the start of the internship attending various

orientation presentations as well as learning your way around your placement settings and meeting

individually with supervisors. An orientation schedule will already have been sent to you before the

start of internship. Please make your best effort to engage fully in these experiences; it may be the

first impression you make on others here. There is a lot of new information to assimilate and we will

dedicate some meetings in July to review and to troubleshoot problems. You will be introduced to

the electronic medical record used at ZHH and to the staff at your various placements. Please make

an effort to learn the names of key personnel (e.g., clerical staff, staff in other disciplines, your

payroll timekeeper) and be sure to review emergency procedures and clinical coverage carefully

with your supervisors. There will be other required training modules over the course of the year.


Placements and Schedule

Your clinical placements have been selected carefully to balance your needs with available

training resources and service needs. You will likely have been informed of your specific placements

and any rotations before the start of the internship; a copy of all track’s placements may be found

in the Appendix. (Names and universities of current interns are listed with their consent.) Please

understand that changes sometime occur for reasons beyond our control; if a placement becomes

unavailable for any reason on an ongoing basis, we will work with you to select an alternative

placement during that time.

Once the orientation period ends, you are asked to create an Outlook calendar of your

schedule and to share it with your supervisors, your track leader and with the division secretary,

Ms. Sandy Arguello. This will make it easier for us to locate you if necessary and to plan meetings.

Please expect that at least 50% of your supervised experience will involve service-related

activities such as treatment/intervention, assessment, interviews, report writing, case

presentations, or consultations. At least 50% of service related activities will be direct client contact.

Supervision will be provided 10% of the total time worked per week. The specific breakdown of

treatment cases, assessments, case management, etc. will depend on your internship track and

your specific placements. Each supervisor will review the clinical experience at his/her placement

during the orientation week (or at the beginning of a new rotation). Please let your supervisor know

if anything is not clear about what is expected at that setting.

Weekly Activity Log

You are required to complete and sign a weekly log which indicates the time spent in various

training, clinical and administrative activities and to submit these logs to your track leader for co-

signature. These logs are filed and may be used for program analytics and in reporting to doctoral


programs, our accrediting bodies and upon attestation for licensure. A blank weekly log is included

in the appendix.

Assessing Your Progress

We understand that receiving constructive feedback about your performance is important.

This feedback includes assessment of your strengths as well as areas in which we feel you need

further development. Supervisors are encouraged to provide you with regular (formative) feedback

throughout the year and are specifically asked to give you formal (summative) feedback about your

performance when they discuss your progress in conjunction with their completion of the

Psychology Intern Competency Assessment Form. The Competency Assessment form is completed

by your supervisors at the conclusion of each major track rotation (i.e., in December and June ). The

Competency Assessment Form uses a series of graded evaluations reflecting increasing levels of skill

and professional independence. Evaluation is based on a combination of data sources including

direct observation (live or electronic), discussion, review of written work, case presentation, and

consultation with other staff. Your supervisors collaborate in guiding your experience and discuss

your progress in some of their track-specific meetings. Supervisors are also asked to discuss the

Competency Assessment Form with you and to provide verbal feedback. You will be asked to sign

the Competency Assessment Form acknowledging that it has been discussed with you. As noted, a

copy of the form is in the Appendix. At about the mid-way point through the internship, the director

of your respective track will write a letter to your graduate program’s Director of Clinical Training

summarizing your performance in the internship. The letter will be discussed with you by the track

director and you will be asked to co-sign the letter. We welcome a dialogue with your graduate

program and are happy to discuss any issues or concerns that the program may have. At the end of

the internship we will communicate with your graduate program about your progress in the

internship. Some graduate programs require that we send evaluations midyear and/or at the end of

internship.


Due Process

In the rare event that there are serious problems as an intern progresses through the

internship, Due Process Procedures for Psychology Interns have been outlined. A copy of these

procedures is in the Appendix. In essence, the procedures are designed to provide formal feedback

to the intern on what actions are required to help remediate serious problems in a series of graded

steps that involve relevant internship training staff.

Interns are employees of Northwell Health and are subject to corporate and Human

Resource policies. Interns are directed to hospital policies in general

(https://intranet.northwell.edu/NSLIJ/policies/Pages/default.aspx) and Human Resource policies

(https://intranet.northwell.edu/NSLIJ/hr/aboutus/HR%20PnP/Pages/default.aspx). All Northwell

policies are available on the employee intranet; you will have access to the intranet once you begin

the internship. There are some policy violations which are grounds for disciplinary action including

immediate dismissal. When issues of misconduct arise, our training program collaborates with the

Human Resources team to arrive at a resolution in a way that is as consistent as possible with our

training policies.

Work Load

The intern is expected to devote 32-37 hours per week (80% time) to clinical service delivery

(in the form of direct patient contact, documentation and related service such as consultation with

colleagues) and 4-8 hours per week (10-20% time, depending on track) in educational activities in

the form of didactics. Some weeks may exceed the above range, however, we aim for an average

that is reflected in a 40-50 hour work week. We attempt to inform incoming interns of their

assignments prior to the start date at which time much of the schedule will be described, however,

certain details of their time (e.g., which evening may be late) may only become clear as their

caseloads are filled. Please see the list of current assignments in the Appendix for more information

about their respective time requirements.

https://intranet.northwell.edu/NSLIJ/policies/Pages/default.aspx



https://intranet.northwell.edu/NSLIJ/hr/aboutus/HR%20PnP/Pages/default.aspx




Record Keeping

Our program documents and permanently maintains accurate records of the interns’

supervised training experiences and evaluations for future reference, certification, licensing, and

credentialing purposes.

The program is responsible for maintaining records of all formal complaints and grievances

against the program of which it is aware that have been submitted or filed against the program

and/or against individuals associated with the program since its last accreditation site visit.

Grievance Procedure

We hope that any problems related to the training program that might arise for interns will

be resolved informally, however there may be circumstances in which an intern feels that an issue

needs to be addressed in a formal way. A Grievance Procedure (a copy of which is in the appendix)

has been detailed for this purpose.

Trainee Conduct

Psychology staff and trainees are expected to follow the American Psychological

Association’s Ethical Principles of Psychologists and Code of Conduct 2002 with 2010 Amendments

(APA, 2010) a copy of which is in the Appendix. Further, staff and trainees are expected to follow

Personnel Guidelines for Conduct in Northwell Health’s Personnel Policies and Procedures Manual a

copy of which may be found on Northwell Health’s web site. Policies cover appearance (see

“Appearance Guidelines” in the Appendix) as well as conduct. All Northwell employees are required

to wear their badges visibly while on campus. The Northwell Health Employee Handbook will be

distributed during the orientation session run by the Department of Human Resources. Also, during

https://nslijhp.northshorelij.com/NSLIJ/hr/aboutus/HR%20PnP/Pages/default.aspx


https://intranet.northwell.edu/NSLIJ/hr/aboutus/EmployeeHandbook/EmployeeHandbook/Northwell%20Health%20Employee%20Handbook.pdf



orientation the Director of Training will broadly review relevant institutional policies and procedures.

You will also be required to complete certain online training modules during the course of the year

as part of the annual training of all Northwell Health staff. Of note, in advance of the flu season (as

determined by the New York State Department of Health) all Northwell employees are required to

either receive the influenza vaccine or to wear a mask in all patient areas throughout the flu season.

Criteria for Successful Completion of the Internship

Each of the competencies and associated objectives are outlined in the Psychology Intern

Competency Assessment Form, a copy of which may be found in the appendix. We expect that all

of the relevant competency areas will be rated at an “Intermediate” level of competence or higher

at midyear. If by midyear a competency area is rated lower than “Intermediate”, we will work with

the trainee to develop a remediation plan. The goal for intern evaluations done at the end of the

internship is that at least 80% of the relevant competency areas will be rated at a “High

Intermediate” level or higher and that none will be lower than Intermediate.

Please review the competencies and if you have any questions, speak with the leader of

your respective internship track. Also note that we have included guidelines from the Council of

Chairs of Training Councils: Comprehensive Evaluation of Student Competence. We utilize the

principles of this document in evaluation of competencies that are related to interpersonal

behavior.

Extended Training Policy

It is recognized that on occasion a psychology intern may not be able to complete all

requirements for the internship during the one year of paid employment because of medical

problems, maternity or extraordinary personal circumstances. Our policy regarding this may be

found in the Appendix.


Certificate of Completion

At the successful conclusion of the internship, each intern will receive a certificate attesting

to completion of the “Internship in Clinical Psychology”.

Feedback about the Internship from Interns

Feedback from interns about the internship has helped us to strengthen the program. At the

beginning of the internship year, interns are asked to select an intern representative to attend

monthly meetings of the Psychology Education and Training Committee and selected track-specific

training meetings where internship and other training matters are discussed. (Representatives may

rotate through the year.) The intern representatives solicit issues of concern from other interns that

can be shared with training leadership and also report back to interns on any new information or

policy changes. Time has been set aside for an optional monthly meeting of all psychology interns to

socialize and also review possible issues of concern with their intern representatives.

At approximately mid-year, the Training Director will meet with each of you individually to

“take the pulse” of your training experience. While it is understood that you may feel reluctant to

voice concerns while still an intern, you are encouraged to express your wishes and opinions which

may be useful in correcting or improving the experience for you or others. Intermittently

throughout the internship year, the Director of Psychology Training and track coordinators will

informally request feedback on issues of concern. In addition, please know that the Training

Director’s door is always open to consult or discuss any concerns.

Seminars are also evaluated. At the completion of an internship seminar or the end of the

year, interns are asked to complete seminar evaluation forms anonymously. Copies of these are

given to the seminar leaders and are discussed in training meetings in an effort to refine didactic

offerings.


At the end of the training year, all interns will be asked to complete an exit survey and will

have an exit interview with the Director of Psychological Services at which time further verbal and

written responses about the internship program are sought. (These responses are not identified by

source and are aggregated separately from the interns’ individual records.) Finally, interns will be

surveyed at least one year post internship as to the perceived usefulness of the internship program

in their subsequent professional activities and for requisite outcome data pertinent to APA

accreditation requirements.

Record Keeping

The program documents and permanently maintains accurate records of the interns’






General Issues Adult Track interns have offices on the second floor of the Kaufmann Building.

Neuropsychology Track Interns and Child Track Interns have offices in the lower level of the

Ambulatory Care Pavilion (ACP). These offices are on the ZHH campus and provide protected work

areas in addition to other office space made available for clinical work at the site of interns’ clinical

placements.

Paid Time Off


Interns currently accrue 20 days of paid time off and 8 designated national holidays. As per

Northwell Health policy for new hires, paid time is not available during the first three months of the

internship. The terms governing the accrual and use of paid time will be explained in detail during

orientation and/or at a specifically designated meeting. In general, prior to submitting a request for

time off, please discuss with your placement supervisors which dates you would like for vacation and

obtain their approval. Make sure that you take into consideration supervisors who you may not

have at the time of the request but who you will be working with when the request takes effect. (Do

not assume that you will automatically be allowed any requested time off; there may be

competition for popular dates or seasons and since service managers need to assure service

coverage, you may need to negotiate and/or compromise. You may also be tasked with arranging

coverage for your clinical duties while you are out. The earlier and more flexible your request is in

these circumstances, the more likely it is that the outcome will be successful.) Paid time off should

be requested in advance (except for extenuating circumstances) using a designated form (see

Appendix) submitted to the designated payroll manager who may differ depending on the intern’s

budget line. Please see the table of placements in the appendix to identify your payroll timekeeper.

We ask that you distribute your time off so that there is not a disproportionate amount of

coverage required on any one assignment, if possible. We ask that you do not take extended time

off during the last two weeks of internship in order to minimize service disruption and to avoid

lastminute problems. If there are extenuating circumstances, please speak with your track leader.

Northwell policy also prohibits “terminal leave”, i.e., taking off on the last day of work. Information

on paid time off (PTO) balances can be accessed online and can be obtained from the payroll office.

Interns with substantial work due at the end of the internship may have their internship attestation

withheld until all work is complete at the discretion of the Director of Psychology Training.

Timekeeping


Northwell Health has implemented automated workforce operations using Kronos® as it

eliminates manual paper-based timekeeping and scheduling processes. Kronos® utilizes daily

identification (i.e., badge swipe and finger imaging) to record work attendance, document time-off,

adjust work schedules and automate record-keeping for Payroll and Benefits purposes.

Psychology trainees are responsible for “badging in” (i.e., via badge-swipe and

fingerscan) once a day at one of the available Kronos stations. This signing-in indicates that the

trainee was at work that day. Unless there is also a communication of sick time or approved

paid time for that day, “badging in” will signify that the trainee worked the entire day. Any

permission to “flex” the time (e.g., leave early with no time off being deducted) must be

communicated clearly in an email by the manager with a copy to the time-keeper.

Every trainee will be bio-enrolled at a Kronos station and oriented as to how to badge in.

Efforts will be made by the TD to identify all Kronos stations that might be needed on any of the

trainee’s placements and they will added to the trainee’s profile.

Nevertheless, there may be circumstances in which travelling to an identified Kronos

station is counterproductive; in such cases, managers may allow trainees to “punch in”

electronically. If so, this must be done within the correct time frame and from a Northwell

Health device.

Sick Time Details regarding salary continuation during sick leave will be provided during your Benefits

orientation. If you are ill, you must notify the individual who is your designated “time keeper” (see

above) at the start of the business day and let the supervisors on your placements know that you

will not be in. You should also be prepared to cancel any patient appointments or – if impossible -

provide the necessary contact information to clerical staff. (It is advisable to keep a list of

deidentified phone numbers for patients and key supervisors whom you might need to contact in a

secure but accessible place.) You may be asked for a doctor’s note if you are out sick for three

consecutive business days. If you are out sick for longer than five consecutive business days, you


must apply for a medical leave through a third party insurer (you will receive details about this

during orientation) prior to or upon the commencement of such a leave in order to initiate a

“claim”. You must also notify the Director of Training of your request for leave. Before returning

from leave, you must be cleared for work by the Employee Health Service.

Conference Time

At the discretion of the Director of Psychology Training, up to five days of conference time

may be granted to interns to attend professional meetings and conferences. Make this request in

advance with supporting documentation (i.e., copy of a description of the conference). One of the

conference days may be used for doctoral dissertation oral defense.

Benefits

The details of the health benefits program will be discussed with you by the Department of

Human Resources, Benefits Office during the orientation period. (Please see the description of

current benefits at:

https://intranet.northwell.edu/NSLIJ/hr/Benefits/BenefitsByPop/2019%20Northwell%20Benefi

t%20Guide%20for%20Residents.pdf). Benefits eligibility begins on the first day of employment

although it may take some time to complete administrative matters before you obtain necessary

benefit documentation (e.g., health insurance card).

Medical and Psychiatric Emergencies

Administrative procedures exist for reporting and managing medical and psychiatric

emergencies and it is important that you are familiar with them. A copy of the procedures for

ambulatory services may be found in the Appendix and we urge you to have a copy of them with

you in the office(s) where you provide clinical services. Please also be sure to familiarize yourselves

https://intranet.northwell.edu/NSLIJ/hr/Benefits/BenefitsByPop/2019%20Northwell%20Benefit%20Guide%20for%20Residents.pdf





with any additional procedures for medical and psychiatric emergencies that are specific to your

assigned clinical sites.

In the appendix you will find a document containing the Health System-wide standardized

hospital safety codes. Note, you are expected to use these terms when calling the operator for any

emergency, so it is imperative that you are consistent with system terminology. For example, a

medical emergency would be called in as a "rapid response." Many of these codes are not

applicable to our operation here at ZHH. Furthermore, ZHH does not have overhead paging in all

areas, as is the case in other locales. However, it is still important that you have a working

knowledge of these codes, even those that are not applicable at ZHH, because you may be present

in another facility when they are utilized.

Telephones

When making calls outside the hospital system, dial 9, wait for a dial tone, and dial the

telephone number needed. ZHH telephone numbers work with area codes of either 718 or 516

followed by 470-#### (NSUH telephone numbers are usually of the form: 516-562-####). If you are

calling an extension in the same hospital, you only need to dial the four-digit extension number. (If

you are making calls to patients from your personal phone, be careful to block “caller ID”, usually by

dialing *67.)

Office-Based Voicemail:

A voice mail system is available to take messages when you are not available to take a call.

As a general rule, interns should give their primary office phone number as the best place to

be reached during working hours. If you are away for any extended period of time during

regular business hours, you should access your phone messages from another phone.

To Establish an Outgoing Message dial 5800 within the hospital; (If calling from someone

else’s phone, enter # followed by your full 10-digit telephone number when prompted and


then) enter your password (please use “12345" as your password); Press 8 (or “U”) to

change your setup options. Please record the following greeting (by pressing 4 on the

previous menu):

“Hello, this is the office of (names). Please leave a message. If you believe this is an

emergency, dial 911 or go to the nearest emergency room. If you need to speak with a staff

person during regular business hours push zero.”

Note: interns with offices/extensions in the child psych clinic will also need to include

clinicspecific information in their phone messages

To Retrieve Messages: You will know you have a message because a red light at the top of

the phone is illuminated and the phone reads “message waiting”.

From Your Own Office Phone: Dial 5800, then password (”security code”). Press 7 to

listen to messages.

From Another Phone: Dial 5800, enter #, your 10—digit extension number, then

password. Press 7 to listen to messages.

From Outside the Hospital: Dial 718-470-5800, enter #, your 10-digit extension number,

then password. Press 7 to listen to messages.

If you don’t want to be disturbed: Lift receiver, press “FWDA” button, enter 5800, and then

hang up. Your calls will automatically be directed into your voice mail box without ringing

your telephone.

For patients to whom your phone number is given the following should be told:

Emergency messages should not be left on your Voice Mail since there is no guarantee

that you will receive the message quickly during the day nor will the system be accessed

necessarily after hours or on weekends. Discuss with each of your placement


supervisors what instructions should be given to patients for emergencies during the

day, after-hours, and on weekends.

If you are sharing an office phone, patients should know that any message that is left

might be heard by this third party.

It is preferred that each intern access and delete his or her messages at least daily. (You

can, however, skip over messages without erasing them by pressing 8.)

Virtual (Phone Line) Voicemail:

Since the Adult and Neuropsychology Track Interns usually share office phones, a phone tree

will be set up which will allow outside callers to leave confidential messages for any of these interns

by calling 718/516-470-8490 and selecting the intern’s name from a menu. To retrieve these

messages, dial 5800 (or 718-470-5800 from outside), * and # and then enter an assigned mailbox

number when prompted. (the mailbox numbers will be distributed as soon as they are assigned.)

Remember, there is no physical phone associated with these numbers. Again, please make sure your

patients understand how frequently you check for these messages. You will not see any physical

notification that a message has been left for you on this line, so you will need to establish a routine

for checking for messages. In the Appendix you will find a summary of features of the phone

message system.

Long Distance Phone Calls

In the course of the internship year you may be given a PIN number through which you can

make long distance business calls. Press 20, then the PIN, then 9-1- and the long distance phone

number. Medical Center placed long distance phone calls – as all other calls - should only be made

for Medical Center business.


Pagers

All interns are assigned pagers. Most currently issued pagers are dual use; they function as

long-range as well as within-hospital pagers. You will receive instructions about using your pagers.

Be sure to check that your pager’s battery is functioning and that it is activated each day; discuss

expectations regarding after-hours availability with your placement supervisors. You are expected

to respond promptly when paged. We are currently exploring the possibility of offering you access

to a mobile app which replaces the pager if you wish.

Computers and Printers

Computer Hardware: Each intern office is equipped with a networked computer

workstation containing a desktop computer, local drive storage, a CD-ROM drive and a monitor. The

operating system is currently either Windows 7 Professional or Windows 10 and the workstations

are networked through a series of Northwell Health servers. You will be assigned a username and

password which will be required when you log on to the network. Since there may be more interns

than computers, interns are expected to share these resources. You will be able to log in to the

network from any computer in the system but you must obtain permission from the computer’s

primary user if it is not yours. You will be directed to save your work on a dedicated network drive.

Hospital policy limits the distribution, duplication and destruction of electronic information. Please

familiarize yourself with Information Services (IS) policies:

https://intranet.northwell.edu/NSLIJ/departments/IS/Toolbox/Pages/default.aspx. A copy

of the email policy of Northwell Health is in the Appendix. Report any error messages to

Information Systems (IS) (at extension 7272). IS service requests can be made here:

https://intranet.northwell.edu/NSLIJ/departments/IS/Pages/SubmitISTicket.aspx.

Software: You will find that your computer already has essential software installed. This

includes the programs which are part of Microsoft Office (i.e., Word, Excel, Access, and Outlook) as

well as Internet Explorer. There may be icons on your desktop which are not operational.

https://intranet.northwell.edu/NSLIJ/departments/IS/Toolbox/Pages/default.aspx


https://intranet.northwell.edu/NSLIJ/departments/IS/Pages/SubmitISTicket.aspx



Limitations on users’ privileges restrict installation and remote access.

Zucker Hillside Hospital currently uses proprietary software, MyAvatar, for creating and

reading the Electronic Medical Record (EMR). You will learn about this system and receive more

detailed documentation in separate orientation during your orientation period. Some of you may be

directed to request access to other EMR systems depending on your placements.

Connectivity: Each intern will have broadband access to the internet from the desktop. The

browser that is already installed on the computer is Microsoft's Internet Explorer. Try exploring our

own training pages: https://www.northwell.edu/research-and-education/graduate-

medicaleducation/training-program-psychology-northwell-health and Northwell Health website

(https://www.northwell.edu). Please note that computer use (like use of any hospital equipment) is

intended for work purposes only. Northwell Health’s IS team blocks access to certain websites and

monitors internet use.

Interns are encouraged to familiarize themselves with the website of Northwell Health that

is dedicated to staff which may be accessed by typing “intranet.northwell.edu” into the browser

address field. Hospital policies, library reference material, employee alerts, information about

benefits and other important material may be accessed at this site. This website also affords remote

access to Outlook email and calendar.

E-mail: As part of your setup, you will be issued an email account. Once an email id is

activated (usually the first initial followed by the first seven letters of your last name and

“@northwell.edu”), Microsoft Outlook will automatically open your profile when you log in

anywhere in the network. You are expected to check your Outlook email regularly; you are expected

to keep your schedule current on Outlook as well. Please contact IS staff at telephone extension

7272 if you require help in this matter. There is a “global directory” available in Outlook which is

useful for accessing any networked staff member via email.

Library Services: The hospital provides access to several searchable academic and medical

databases using OVID, Micromedex, MDConsult, Up-To-Date, Google Scholar, PubMed and many

other resources. There are some journals with full text articles available online through this service.

Additionally, many searches indicate which results are available at LIJ libraries and allows you to

https://www.northwell.edu/research-and-education/graduate-medical-education/training-program-psychology-northwell-health




https://www.northwell.edu/




Email, print or save the results of a search. A more extensive discussion and demonstration of these

resources will take place during orientation.

Printing:

ZHH-Kaufmann: All computers in the intern offices at the Kaufmann building should be

configured to send output to the network printer in the Xerox room on the second floor (Room

217D). This may need to be updated once after you log on for the first time; if you know how to

"add a network printer", select "\\xprt01\nh755-kauf02 ". Otherwise, contact the IS help desk at

extension 7272. The printer in Kaufmann 217D also serves as a fax machine and network scanner.

Child Psychology and Neuropsychology interns may have printers in individual offices and

may also be connected to local network printers.

Administrative Issues

Psychological Services Secretarial Staff The Psychology Office’s secretary is Ms. Sandy Arguello (extension 8390). She will assist you

with day-to-day requests such as obtaining office supplies, recording your hours, maintenance

problems in your office, trouble-shooting, and routine administrative issues. If there are issues that

the secretary is unable to resolve, contact Dr. Turkel (at 470-8387). Neuropsychology and Child

track interns are housed in the lower level of the ACP. If there are problems related to offices there,

the front desk at the child clinic may also be asked for assistance.

Neuropsychology Interns: Neuropsychology interns are usually only at the ZHH campus on

Wednesdays. The rest of the week, they may seek assistance from clerical staff at their primary

work site (1554 Northern Boulevard). Ms. Meghan McDonald (at 516-477-2517) may be helpful with

payroll issues.


Child Interns: Administrative and office-related issues are handled locally by the designated

person, Ms. Reena Carmen, Program Director (470-8437) as well as Jeannine Todaro, Office

Manager (470-3529) at the Office of Child and Adolescent Psychiatry in the Clinic area of the ACP

(room 270).

Parking (ZHH)

There are several options for parking at ZHH. To park in any of the designated Zucker Hillside

parking lots you must get a sticker for your car. You will be directed to obtain this sticker during the

orientation period. Your badge will be programmed to open the gates to the ZHH campus. (A) The Parking Garage: A seven-floor indoor parking garage is available for the use of

staff at LIJ, The Zucker Hillside Hospital and the Cohen Children’s Medical Center. This garage is

accessed via 74th avenue (east of 263rd Street). Your ID Badge will be needed for you to drive in and

out of this garage. This is the preferred parking area for staff. Please note that after 8am it becomes

very difficult to find a spot.

(B) On-Campus Parking: The On-Campus Parking Lot is located in the large open area on

the east side of the Kaufmann Building. A guard checks that cars in this lot have the appropriate

staff sticker. Be sure to park only in spaces that are not explicitly reserved. (There is reserved

parking for those with handicapped permits as well as reserved parking for licensed medical staff.)

If you park in a space that is not for you, security will put a hard-to-scrape-off notice on the driver’s

side indicating you have parked illegally! There are parking spots in other areas of the campus but it

is important to confirm with security that you may park in those areas before doing so.

(C) There is also ample parking available on the local streets.

Text Alerts

Interns may sign up at:

https://nslijhp.northshorelij.com/NSLIJ/departments/HSIDE/Lists/TextAlertRequest/TextAlertReq_F

orm.aspx?source=/NSLIJ/Utilities/SubmittedFormResults.aspx?formsstatus=sent to receive text

https://nslijhp.northshorelij.com/NSLIJ/departments/HSIDE/Lists/TextAlertRequest/TextAlertReq_Form.aspx?source=/NSLIJ/Utilities/SubmittedFormResults.aspx?formsstatus=sent





messages of hospital news, announcements and upcoming events. Interns may also enter their

preferred cell-phone number on the Employee Self Service site to receive for rapid communication

from the system.

Mailboxes

Mailboxes are provided for all of the psychology interns in Psychological Services office in

the Kaufmann Building at ZHH (room 205). Mail should be checked regularly especially for those

interns who spend large amounts of time away from the Kaufmann Building. Interns may have

additional mailboxes at specific clinical placement areas outside of Kaufmann.

Food

There is a small food service area in the Au Bon Pain located on the main floor of the

Ambulatory Care Pavilion. Its hours of operation are 8:30AM – 4PM on Monday through Friday.

There are also vending machines there and in locations at the Littauer Building. The Cohen

Children’s Medical Center has a large cafeteria on the lower level and there is a kosher cafeteria at

the Parker Jewish Geriatric Center (located past Long Island Jewish Hospital on Lakeville Road). A

refrigerator and microwave are available for use in the Kaufmann building second floor. (Please do

not use the refrigerator to store food for longer than a few days.) A refrigerator and microwave are

also available in the Child Clinic.

Pay

Trainees are paid on a semi-monthly basis (i.e., on the 7th and 22nd of the month). All

payments are through direct deposit which you will be guided to set up at the start of the

internship. You will be shown how you may access your virtual paychecks and paystubs (and other

benefits-related information) through Northwell Health’s intranet.

https://aaaess.northshorelij.com/vpn/tmindex.html



Keeping Track of Where You Are

Historically, it has been a challenge to keep track of the whereabouts of all of our interns.

Please share your Outlook calendar with the division secretary (Ms. Arguello) as well as with your

supervisors and track leaders. Keep this updated as your schedule changes. If your personal address

or phone number changes during the internship year, kindly notify the secretary. Also, please obtain

replacement batteries for your pager as needed from the secretary.

Additionally, a "call list" may be assembled and distributed for use in the event of any critical

incidents that require rapid communication of instructions. We may activate the call list in a trial

mode to confirm that it is operational.

Fire Alarms - ZHH

At the Zucker Hillside Hospital, alarms will sound in the building where a fire alarm has been

triggered and everyone is required to evacuate that building according to protocol upon hearing

that alarm. You are responsible to learn (from your supervisor) what the evacuation protocol is for

each clinical area to which you are assigned and to ask how you can be of service should the

situation arise. The policy regarding fire safety may be found on Healthport or at:

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%

20Life%20Safety%20Management%20Plan.pdf.

Keys Keys for offices and units can be obtained from the clerical staff in charge of your office

area. The secretary in conjunction with your track director will determine from your placement

schedule which keys you need during your clinical assignments.

Access to Inpatient Units at ZHH

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%20Life%20Safety%20Management%20Plan.pdf





All interns will have access to and egress from the inpatient units on the ZHH campus. Entry

to the units is achieved via the ID badge swipe. Egress from units is via ID badge swipe and

keypunch of the intern’s PIN (i.e., mmdd from your Date of Birth) followed by the pound (#) sign.

Inpatient units are equipped with double doors which must be opened and closed in sequence to

prevent patient elopement. Interns will also be briefed about precautions taken while entering and

exiting patient units.

Credit Union

You are eligible to use the services of the Bethpage Federal Credit Union (BFCU) including

direct deposit of your check into the credit union. Bethpage FCU is one of the country’s leading

community credit unions and the largest in New York State, serving the Long Island community for

75 years. If you open an account, you will have full access to all Bethpage branches as well as the

Bethpage call center and Bethpage Online Banking. Bethpage has 33 full-service branches across

Long Island and one in midtown Manhattan. To learn more about Bethpage products and services,

visit https://www.bethpagefcu.com/ or any Bethpage branch. To find a local Bethpage branch, visit

http://www.bethpagefcu.com/branches-atms.aspx?src=top_nav.

The Division of Psychological Services is happy to welcome you to what we hope is an enjoyable and stimulating year. This handbook has been designed to help you cope with all the information you will be getting at the beginning of the internship. It does not provide the answers to all of your questions, but we hope it will orient you and help you know where to find answers. It is always good to start with your

supervisors or the internship training director. Do not be embarrassed to ask questions or to request help with clinical or administrative problems.

https://www.bethpagefcu.com/




http://www.bethpagefcu.com/branches-atms.aspx?src=top_nav



APPENDIX LIST

A. Psychology Intern Competency Assessment Form

B. Comprehensive Evaluation of Student Competence

C. Communication Policy Between Internship and Doctoral Programs

D. Grievance Procedure

E. Due Process Procedures for Psychology Interns

F. Extended Training Policy

G. Weekly Activity Log (blank)

H. Professional Standards and Guidelines (distributed electronically):

1. APA 2002 Ethical Principles of Psychologists and Code of Conduct

2. Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients

3. PsycARTICLES - Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists

4. Enhancing Your Interactions with People with Disabilities

I. Phone System Information

J. Vacation Request Form

K. Summary of Benefits

L. Fire safety information

M. Hospital Safety Codes

N. Map of Zucker Hillside Hospital campus

O. Ambulatory Emergency Procedures

P. EMAIL Policy

Q. Appearance Guidelines

R. Training Table of Organization

S. Table of 2019-20 Clinical Placements

APPENDIX A

This form was developed by Elihu Turkel, PsyD., at Long Island Jewish Medical Center – The Zucker Hillside Hospital. (June 2017)

COMPETENCY RATINGS DESCRIPTIONS

NA Not applicable for this training experience/Not assessed during training experience

A Advanced/Skills comparable to autonomous practice at the licensure level. Rating expected at completion of postdoctoral training. Competency attained at full psychology staff privilege level, however as an unlicensed trainee, supervision is required while in training status.

HI High Intermediate/Occasional supervision needed. A frequent rating at completion of internship. Competency attained in all but non-routine cases; supervisor provides overall management of trainee's activities; depth of supervision varies as clinical needs warrant.

I Intermediate/Should remain a focus of supervision Common rating throughout internship and practica. Routine supervision of each activity.

E Entry level/Continued intensive supervision is needed Most common rating for practica. Routine, but intensive, supervision is needed.

R Needs remedial work

INTERNSHIP IN CLINICAL PSYCHOLOGY LONG ISLAND JEWISH MEDICAL CENTER – THE ZUCKER HILLSIDE HOSPITAL

PSYCHOLOGY INTERN COMPETENCY ASSESSMENT FORM

Trainee ___________________ Supervisor ____________________ Training Year ___________

Training Period: Training Experience __________________________________________

ASSESSMENT METHOD(S) FOR COMPETENCIES _____ Direct Observation _____ Review of Written Work _____ Videotape _____ Review of Raw Test Data _____ Audiotape _____ Discussion of Clinical Interaction _____ Case Presentation _____ Comments from Other Staff

AREA (AS PER SOA)

COMPETENCY (AS PER IR C-8 I where applicable) RATING

RESEARCH

Demonstrates the substantially independent ability to critically evaluate and disseminate research or other scholarly activities (e.g., case conference, presentation, publications) at the local (including the host institution), regional, or national level.

A HI I E R NA

ETHICAL AND LEGALSTANDARDS

Is knowledgeable of and acts in accordance with each of the following: the current version of the APA Ethical Principles of

Psychologists and Code of Conduct; relevant laws, regulations, rules, and policies

governing health service psychology at theorganizational, local, state, regional, and federallevels; and

relevant professional standards and guidelines.

A HI I E R NA

Recognizes ethical dilemmas as they arise, and applies ethical decision-making processes in order to resolve the dilemmas.

A HI I E R NA

Conducts self in an ethical manner in all professional activities. A HI I E R NA


AREA (AS PER SOA)


INDIVIDUAL AND CULTURAL DIVERSITY

Demonstrates: an understanding of how his/her own

personal/cultural history, attitudes, and biases mayaffect how he/she understands and interacts withpeople different from him/herself;

demonstrates knowledge of the current theoreticaland empirical knowledge base as it relates toaddressing diversity in all professional activitiesincluding research, training,supervision/consultation, and service;

demonstrates the ability to integrate awareness andknowledge of individual and cultural differences inthe conduct of professional roles (e.g., research,services, and other professional activities). Thisincludes the ability apply a framework for workingeffectively with areas of individual and culturaldiversity not previously encountered over the courseof his/her career. Also included is the ability towork effectively with individuals whose groupmembership, demographic characteristics, orworldviews create conflict with his/her own

A HI I E R NA

Demonstrates the ability to independently apply his/her knowledge and approach in working effectively with the range of diverse individuals and groups encountered during internship.

A HI I E R NA

PROFESSIONAL VALUES,ATTITUDES AND

BEHAVIOR

Engages in self-reflection regarding one’s personal and professional functioning; A HI I E R NA

Engages in activities to maintain and improve performance, well-being, and professional effectiveness A HI I E R NA

Actively seeks and demonstrates openness and responsiveness to feedback and supervision. A HI I E R NA Responds professionally in increasingly complex situations with a greater degree of independence as (s)he progresses across levels of training.

A HI I E R NA

COMMUNICATION AND INTERPERSONAL SKILLS

Develops and maintains effective relationships with a wide range of individuals, including colleagues, communities, organizations, supervisors, supervisees, and those receiving professional services.

A HI I E R NA

Produces and comprehends oral, nonverbal, and written communications that are informative and well-integrated; demonstrates a thorough grasp of professional language and concepts.

A HI I E R NA

Demonstrates effective interpersonal skills and the ability to manage difficult communication well. A HI I E R NA


AREA (AS PER SOA)


ASSESSMENT

Selects and applies assessment methods that draw from the best available empirical literature and that reflect the science of measurement and psychometrics; collects relevant data using multiple sources and methods appropriate to the identified goals and questions of the assessment as well as relevant diversity characteristics of the service recipient.

A HI I E R NA

Interprets assessment results, following current research and professional standards and guidelines, to inform case conceptualization, classification, and recommendations, while guarding against decision-making biases, distinguishing the aspects of assessment that are subjective from those that are objective.

A HI I E R NA

Communicates orally and in written documents the findings and implications of the assessment in an accurate and effective manner sensitive to a range of audiences.

A HI I E R NA

INTERVENTION

Establishes and maintains effective relationships with the recipients of psychological services. A HI I E R NA

Develops evidence-based intervention plans specific to the service delivery goals. A HI I E R NA

Implements interventions informed by the current scientific literature, assessment findings, diversity characteristics, and contextual variables.

A HI I E R NA

Demonstrates the ability to apply the relevant research literature to clinical decision making. A HI I E R NA

Modifies and adapts evidence-based approaches effectively when a clear evidence-base is lacking, A HI I E R NA

Evaluates intervention effectiveness, and adapts intervention goals and methods consistent with ongoing evaluation

A HI I E R NA

SUPERVISION Applies knowledge of supervision models and practices in direct or simulated practice with psychology trainees, or other health professionals.

A HI I E R NA

CONSULTATION AND INTERPROFESSIONAL INTERDISCIPLINARY

SKILLS

Demonstrates knowledge and respect for the roles and perspectives of other professions. A HI I E R NA

Applies this knowledge in direct or simulated consultation with individuals and their families, other health care professionals, interprofessional groups, or systems related to health and behavior.

A HI I E R NA


AREA (AS PER SOA)


TRACK SPECIFIC AREA: CLINICAL

NEUROPSYCHOLOGY

Demonstrates knowledge of neuropsychological and developmental theory and theories of cognitive processing

A HI I E R NA

Demonstrates knowledge of neuropsychological assessment and consultation A HI I E R NA Demonstrates capacity to administer and score tests of cognitive functioning A HI I E R NA Demonstrates knowledge of brain-behavior relationships and neurological, psychiatric and medical disorders that have cognitive consequences

A HI I E R NA

Demonstrates capacity to integrate psychological and neuropsychological theories/thought. A HI I E R NA Demonstrates knowledge of evidence based cognitive remediation treatments A HI I E R NA

TRACK SPECIFIC AREA: CLINICAL CHILD

PSYCHOLOGY

Demonstrates knowledge of empirically supported assessment, treatments, and appropriate treatment matching for children and adolescents.

A HI I E R NA

SUPERVISOR COMMENTS

SUMMARY OF STRENGTHS

AREAS OF ADDITIONAL DEVELOPMENT OR REMEDIATION, INCLUDING RECOMMENDATIONS


CONCLUSIONS

GOAL: PRIOR TO 12 MONTHS GOAL: AT 12 MONTHS

All competency areas will be rated at a level of competence of I or higher. No

competency areas will be rated as R or E.

At least 80% of competency areas will be rated at level of HI or higher. No competency areas will be rated as R or E. Note:

exceptions would be specialty area rotations that would take a more intensive course of study to achieve this level of competency and the

major supervisor, training director and trainee agree that a level of I is appropriate for that particular rotation, e.g. a neuropsychology

rotation for a general track trainee. The trainee HAS successfully completed the above goal. We have reviewed this

evaluation together. The trainee HAS NOT successfully completed the above goal. We have made a joint

written remedial plan as attached, with specific dates indicated for completion. Once completed, the rotation will be re-evaluated using another evaluation form, or on this form, clearly marked with a different color ink. We have reviewed this evaluation together.

Supervisor ________________________________ Date ___________ TRAINEE COMMENTS REGARDING COMPETENCY EVALUATION (IF ANY): I have received a full explanation of this evaluation. I understand that my signature does not necessarily indicate my agreement. Trainee ____________________________________ Date ___________

REMEDIAL WORK INSTRUCTIONS In the rare situation when it is recognized that a trainee needs remedial work, a competency assessment form should be filled out immediately, prior to any deadline date for evaluation, and shared with the trainee and the director of training. In order to allow the trainee to gain competency and meet passing criteria for the rotation, these areas must be addressed proactively and a remedial plan needs to be devised and implemented promptly.

APPENDIX B

The Comprehensive Evaluation of Student-Trainee Competence in

Professional Psychology Programs

I. Overview and Rationale

Professional psychologists are expected to demonstrate competence within and across a number

of different but interrelated dimensions. Programs that educate and train professional

psychologists also strive to protect the public and profession. Therefore, faculty, training staff,

supervisors, and administrators in such programs have a duty and responsibility to evaluate the

competence of students and trainees across multiple aspects of performance, development, and

functioning.

It is important for students and trainees to understand and appreciate that academic competence

in professional psychology programs (e.g., doctoral, internship, postdoctoral) is defined and

evaluated comprehensively. Specifically, in addition to performance in coursework, seminars,

scholarship, comprehensive examinations, and related program requirements, other aspects of

professional development and functioning (e.g., cognitive, emotional, psychological,

interpersonal, technical, and ethical) will also be evaluated. Such comprehensive evaluation is

necessary in order for faculty, training staff, and supervisors to appraise the entire range of

academic performance, development, and functioning of their student-trainees. This model

policy attempts to disclose and make these expectations explicit for student-trainees prior to

program entry and at the outset of education and training.

In response to these issues, the Council of Chairs of Training Councils (CCTC) has developed

the following model policy that doctoral, internship, and postdoctoral training programs in

psychology may use in their respective program handbooks and other written materials (see

http://www.apa.org/ed/graduate/cctc.html). This policy was developed in consultation with

CCTC member organizations, and is consistent with a range of oversight, professional, ethical,

and licensure guidelines and procedures that are relevant to processes of training, practice, and

the assessment of competence within professional psychology (e.g., the Association of State and

Provincial Psychology Boards, 2004; Competencies 2002: Future Directions in Education and

Credentialing in Professional Psychology; Ethical Principles of Psychologists and Code of

Conduct, 2002; Guidelines and Principles for Accreditation of Programs in Professional

________________________________________ This document was developed by the Student Competence Task Force of the Council of Chairs of Training Councils (CCTC) (http://www.apa.org/ed/graduate/cctc.html) and approved by the CCTC on March 25, 2004. Impetus for this document arose from the need,

identified by a number of CCTC members that programs in professional psychology needed to clarify for themselves and their student-trainees

that the comprehensive academic evaluation of student-trainee competence includes the evaluation of intrapersonal, interpersonal, and professional development and functioning. Because this crucial aspect of academic competency had not heretofore been well addressed by the

profession of psychology, CCTC approved the establishment of a "Student Competence Task Force" to examine these issues and develop

proposed language. This document was developed during 2003 and 2004 by a 17-member task force comprised of representatives from the various CCTC training councils. Individuals with particular knowledge of scholarship related to the evaluation of competency as well as relevant

ethical and legal expertise were represented on this task force. The initial draft of this document was developed by the task force and distributed

to all of the training councils represented on CCTC. Feedback was subsequently received from multiple perspectives and constituencies (e.g., student, doctoral, internship), and incorporated into this document, which was edited a final time by the task force and distributed to the CCTC

for discussion. This document was approved by consensus at the 3/25/04 meeting of the CCTC with the following clarifications: (a) training

councils or programs that adopt this "model policy" do so on a voluntary basis (i.e., it is not a "mandated" policy from CCTC); (b) should a training council or program choose to adopt this "model policy" in whole or in part, an opportunity should be provided to student-trainees to

consent to this policy prior to entering a training program; (c) student-trainees should know that information relevant to the evaluation of

competence as specified in this document may not be privileged information between the student-trainee and the program and/or appropriate representatives of the program.

http://www.apa.org/ed/graduate/cctc.html


Psychology, 2003; Guidelines on Multicultural Education, Training, Research, Practice, and

Organizational Change for Psychologists, 2002).

II. Model Policy

Students and trainees in professional psychology programs (at the doctoral, internship, or

postdoctoral level) should know – prior to program entry, and at the outset of training – that

faculty, training staff, supervisors, and administrators have a professional, ethical, and potentially

legal obligation to: (a) establish criteria and methods through which aspects of competence other

than, and in addition to, a student-trainee's knowledge or skills may be assessed (including, but

not limited to, emotional stability and well being, interpersonal skills, professional development,

and personal fitness for practice); and, (b) ensure – insofar as possible – that the student-trainees

who complete their programs are competent to manage future relationships (e.g., client, collegial,

professional, public, scholarly, supervisory, teaching) in an effective and appropriate manner.

Because of this commitment, and within the parameters of their administrative authority,

professional psychology education and training programs, faculty, training staff, supervisors, and

administrators strive not to advance, recommend, or graduate students or trainees with

demonstrable problems (e.g., cognitive, emotional, psychological, interpersonal, technical, and

ethical) that may interfere with professional competence to other programs, the profession,

employers, or the public at large.

As such, within a developmental framework, and with due regard for the inherent power

difference between students and faculty, students and trainees should know that their faculty,

training staff, and supervisors will evaluate their competence in areas other than, and in addition

to, coursework, seminars, scholarship, comprehensive examinations, or related program

requirements. These evaluative areas include, but are not limited to, demonstration of sufficient:

(a) interpersonal and professional competence (e.g., the ways in which student-trainees relate to

clients, peers, faculty, allied professionals, the public and individuals from diverse backgrounds

or histories); (b) self-awareness, self-reflection, and self-evaluation (e.g., knowledge of the

content and potential impact of one's own beliefs and values on clients, peers, faculty, allied

professionals, the public, and individuals from diverse backgrounds or histories); (c) openness to

processes of supervision (e.g., the ability and willingness to explore issues that either interfere

with the appropriate provision of care or impede professional development or functioning); and

(d) resolution of issues or problems that interfere with professional development or functioning

in a satisfactory manner (e.g., by responding constructively to feedback from supervisors or

program faculty; by the successful completion of remediation plans; by participating in personal

therapy in order to resolve issues or problems).

This policy is applicable to settings and contexts in which evaluation would appropriately occur

(e.g., coursework, practica, supervision), rather than settings and contexts that are unrelated to

the formal process of education and training (e.g., non-academic, social contexts). However,

irrespective of setting or context, when a student-trainee's conduct clearly and demonstrably (a)

impacts the performance, development, or functioning of the student-trainee, (b) raises questions

of an ethical nature, (c) represents a risk to public safety, or (d) damages the representation of

psychology to the profession or public, appropriate representatives of the program may review

such conduct within the context of the program's evaluation processes.

Although the purpose of this policy is to inform students and trainees that evaluation will occur

in these areas, it should also be emphasized that a program's evaluation processes and content

should typically include: (a) information regarding evaluation processes and standards (e.g.,

procedures should be consistent and content verifiable); (b) information regarding the primary

purpose of evaluation (e.g., to facilitate student or trainee development; to enhance

self-awareness, self-reflection, and self-assessment; to emphasize strengths as well as areas for

improvement; to assist in the development of remediation plans when necessary); (c) more than

one source of information regarding the evaluative area(s) in question (e.g., across supervisors

and settings); and (d) opportunities for remediation, provided that faculty, training staff, or

supervisors conclude that satisfactory remediation is possible for a given student-trainee. Finally,

the criteria, methods, and processes through which student-trainees will be evaluated should be

clearly specified in a program's handbook, which should also include information regarding due

process policies and procedures (e.g., including, but not limited to, review of a program's

evaluation processes and decisions).

APPENDIX C

Policy Regarding Communication Between the Internship and Doctoral Program Training Directors

Communication between doctoral training programs and internship programs is of critical importance to the

overall development of competent new psychologists. The doctoral internship is a required part of the doctoral

degree, and while the internship faculty assess the student performance during the internship year, the doctoral

program is ultimately responsible for evaluation of the student’s readiness for graduation and entrance to the

profession.

Therefore, evaluative communication must occur between the two training partners. Given this partnership,

our training program has adopted the following practices:

• All students will be informed of the practice of communication between the doctoral program Training

Director/Director of Clinical Training (or faculty designate) and internship Training Director (or designate).

It should be emphasized that this communication is consistent with discussion among trainers throughout

the students’ graduate training (e.g., practicum supervisors).

• Once a student has been matched with an internship site, the internship and doctoral program Directors will

communicate about the specific training needs of the student, so that the internship Director has sufficient

information to make training decisions to enhance the individual student’s development.

• During the internship year, the Directors of the two programs will communicate as necessary to evaluate

progress in the intern’s development. This will include a minimum of two formal evaluations (one at mid-

year and one at the end of the year), and may also include regular formal (written) or informal

communication.

• The student/intern has the right to know about any written communication that occurs and can also request

and should receive a copy of any written information that is exchanged. The intern will be given a signed

copy of his/her formal evaluation following a formal feedback meeting. The intern will be asked to co-sign

the evaluation and may add comments, after which a copy will be mailed to the doctoral program Training

Director/Director of Clinical Training.

• In the event that problems emerge during the internship year, i.e., an intern fails to make expected progress,

the Directors of the two programs will communicate and document the concerns and the planned resolution

to those concerns. Both doctoral training program and internship program policies for resolution of training

concerns will be considered in developing necessary remediation plans. Progress in required remediation

activities will be documented and that information will be communicated to the doctoral program Director.

APPENDIX D

Rev. 6/24/16


Long Island Jewish Medical Center, The Zucker Hillside Hospital Northwell Health PSYCHOLOGY TRAINEE GRIEVANCE PROCEDURE Informal Problem Resolution: It is the policy of the training program and of Northwell Health to foster sound trainee/supervisor relations by encouraging open communication and reconciliation of work-related problems or concerns. It is the training program’s belief that most complaints about working conditions, supervision, co-workers or other work-related problems can best be handled through informal and private discussion between the trainee and his/her supervisor or track director. A trainee or supervisor may request that the Training Director (TD) provide informal consultation to assist in determining the appropriate course of action. Such consultation may serve to resolve the conflict or may result in the trainee choosing to escalate the matter to a more formalized intervention. In the event that more formal resolution is needed, the following procedure should be used. Step 1: The trainee is encouraged to discuss any complaint with his/her immediate psychology supervisor in person. This should take place within 10 working days of the occurrence which triggered the complaint although consideration will be given if there are personal reasons for longer delays. The supervisor is expected to give his/her decision within 10 working days of receiving the complaint. If an issue does not arise in a setting where the trainee is being supervised, it should be addressed first to the Program Director, Track Director or Coordinator (in the case of fellowship, internship and externship, respectively). If a trainee reasonably believes that discussing his/her complaint with his/her immediate supervisor would be futile, the trainee may move to the next step in the grievance process. The Step 2 grievance should be requested within five working days of the supervisor’s response to the initial complaint; however personal reasons for a longer delay will be considered. Step 2: In the event of the failure of the above to resolve the matter, a formal grievance should be pursued. Formal grievances should be made in writing to the TD or to another member of the Education and Training Committee (ETC) if the Training Director is the source of the trainee's grievance. The TD will notify the Director of Psychological Services of the grievance. The TD may render a decision on the grievance without consult or may constitute a Grievance Committee to hear the case and deliberate the outcome. The Grievance Committee will consist of three faculty members representing training sites. In special circumstances, the committee may be limited to representation from the site within which the trainee is placed. Individuals named in the grievance will not serve on the Grievance Committee in that matter. The trainee and relevant faculty will be notified of the date of the Committee’s review and will be given the opportunity to provide the Committee with any information regarding the grievance. The Committee will meet with the parties involved, and may do so at one time or separately. If a Committee is convened, the Committee will determine the outcome of the grievance. A

Rev. 6/24/16

decision will be reached within five working days after the meeting of the Grievance Committee or of the TD being informed of the complaint. The decision will be presented in writing to the trainee. If the trainee is not satisfied, he/she may proceed to the next step (3) within ten business days of the rendered decision. Step 3: The Training Director will submit a written request for the trainee to meet with the Director of Psychological Services. After the grievance has been heard, the employee will receive a written decision within 15 workdays and will be communicated to all involved parties and to the Grievance Committee. If the problem has not been resolved to the employee’s satisfaction, he/she may take the grievance to Step 4 within five working days of receiving the Step 3 determination. Step 4: The Director of Psychological Services will schedule an appointment with the Vice Chairman of Psychiatry and the Human Resources designated representative. The trainee must be available to testify. After the grievance has been heard, the trainee will receive a final and binding decision in writing within 15 workdays after the meeting. _____________________________ In the event that the grievance involves any member of the ETC (including the TD), that member will recuse himself or herself from serving on the Grievance Committee due to a conflict of interest. A grievance regarding the TD may be submitted directly to the Director of Psychological Services for review and resolution in consultation with the Grievance Committee. Trainees must exercise good faith in processing complaints and cooperate in any investigation. The trainee submitting the complaint will be encouraged to provide relevant information including documents, names of witnesses, etc. A trainee does not have the right to have an attorney or other outside individual (non-employee) present during the internal investigation or during a grievance meeting. Some grievances may extend outside of the scope of the Division of Psychological Services and may require procedures governed by Human Resources policy and involve report to managers other than psychology training staff. The TD will consult with the department of Human Resources as needed to determine whether other procedures pertain and to maintain consistency with institutional policies to the extent possible. The health system will not tolerate any form of coercion or retaliation against a trainee who processes a complaint under this policy, or who cooperates with an investigation. This policy and its procedures should not, however, be construed as preventing, limiting or delaying the health system from taking disciplinary action against any individual in circumstances where such action is deemed appropriate.

Any findings resulting from a review of a grievance that involves prohibited conduct as described in the Health System Human Resources Policies and Procedure manual (Title: Conduct in the Workplace/ Progressive Discipline, Part V, Section 3), will be submitted to the Director of Psychological Services for appropriate personnel action.

APPENDIX E

Psychology Trainee Due Process Procedure: Page 1/6

Psychological Services

The Zucker Hillside Hospital Long Island Jewish Medical Center

Northwell Health

PSYCHOLOGY TRAINEE DUE PROCESS PROCEDURE Trainees are evaluated informally within their first three months and formally before the six-month and twelve-month points of the training year as well as on an ongoing basis. (The term “trainee” in this document includes psychology externs, psychology interns and postdoctoral psychology fellows.) The training program aims to develop professional competence. Conceivably, trainees could be seen as lacking the competence for eventual professional practice due to a serious deficit in skill or knowledge, or due to problematic behaviors that significantly impact their professional functioning. In such cases, the training program will help trainees identify these areas and provide remedial experiences or recommended resources in an effort to improve the trainees’ performance to a satisfactory degree. The problem identified may be of sufficient seriousness that the trainee would not get credit for the training program unless that problem was remedied. Training Review Committee Should this become a concern either due to the seriousness of the problem or its persistence despite repeated local feedback and assistance, the problem must be brought to the attention of the Training Director (TD) by the program or track leader at the earliest opportunity in order to allow the maximum time for more thoughtful remedial efforts. The TD will inform the trainee of staff concern, and convene a meeting of the Training Review Committee within ten business days of being notified of the problem. (If the trainee is an extern or intern, the TD will also apprise the training director of the trainee’s graduate program or his/her designee who will be invited to join the Training Review Committee.) The TD will consult with the department of Human Resources as needed to determine whether other actions are required and to maintain consistency with institutional policies to the extent possible. The Training Review Committee will consist of the trainee’s current and past supervisors, the leaders of his or her program or section and an unrelated member of the training faculty. The trainee will be notified of the date of the Committee’s review and will be given the opportunity to provide the Committee with any information regarding the questionable performance or behavior. The review shall not be considered a formal hearing and therefore shall not be subject to any formal rules of evidence or procedure. The introduction of any relevant information, including witnesses, shall be determined by the Training Director. Decision of the Training Review Committee If the Training Review Committee determines that the deficit or problem is serious enough that it could prevent the trainee from fulfilling the exit criteria, and


thereby prevent him or her from receiving credit for the training program, the trainee will be placed on probationary status by the Training Review Committee. If a trainee on probationary status fails to achieve stated goals within a specified time frame (which will be based on learning and performance needs) he/she will be dismissed from the program. Probation and Remediation

a. The trainee, the trainee's supervisor(s), the track Director or Coordinator, the TD, and the Training Review Committee will produce a remediation plan specifying the kinds of knowledge, skills and/or behavior that are necessary for the trainee to develop or remediate in order to remedy the identified problem. The Training Review Committee may require the trainee to participate in particular learning experiences or may issue guidelines for the type of experiences the trainee should undertake in order to remedy such a deficit. The plan will stipulate the duration of probationary status as well as the frequency and nature of supervisory meetings during that time. The members of the Training Review Committee will sign this plan; the trainee will either sign the plan or it will be noted that (s)he declined to do so. A copy of the plan will be placed in the trainee’s file along with a summary of the proceedings. If and when the problems have been resolved with no adverse action, the probation and remediation process will not be reported externally except if otherwise directed by the Department of Human Resources or the Office of Legal Affairs. In the case of an extern or intern, a copy of the remediation plan will be forwarded to the clinical training director of the trainee’s graduate program or his/her designee. If applicable as per contractual agreement, the training program will also notify and consult with Association of Psychology Postdoctoral and Internship Centers (APPIC). (See the standardized remediation plan template which follows this document.)

b. The trainee and the supervisor will report to the Training Review

Committee on a regular basis, as specified in the plan (but not less than every two months) regarding the trainee's progress. The TD may elect to convene a meeting of the Training Review Committee before the end of the probationary period.

c. The trainee may be removed from probationary status by a

determination of the Training Review Committee when the trainee's progress in resolving the problem(s) specified in the plan is sufficient. Removal from probationary status indicates that the trainee's performance is at the appropriate level to receive credit for the training program.


Actions Following Probation a. Termination: If a trainee on probation fails to make progress, or, if it

becomes apparent that it will not be possible for the trainee to receive credit for the training program (even if this precedes the end of probation), as per the determination of the Training Review Committee, the TD will so inform the trainee in writing at the earliest opportunity and (unless there is cause for more immediate action – see below) the trainee will be terminated from the program. Termination from the training program will coincide with termination of the trainee’s employee status with the Health System. (In the case of an extern or intern, the doctoral program director will be notified in writing of every decision regarding the trainee’s status.) If applicable as per contractual agreement, the training program will also notify the Association of Psychology Postdoctoral and Internship Centers (APPIC) and request release from the obligations of the national internship match. If a Trainee is dismissed before the completion of his/her academic year, the TD will determine the number of months of credit to be given the trainee for that academic year. Denial of credit may be required to be reported to future training programs, employers or licensing and administrative agencies.

b. Continued Probation: At the conclusion of the stipulated time frame or earlier if so determined by the Training Review Committee, if a trainee has met the requirements set forth by the remediation plan or has made progress deemed sufficient by the Committee, the trainee may then be monitored during a time-limited period (up to 3 months or as determined by the TD) of enhanced supervision. The TD will provide the trainee with written notice of this decision. During this period the probation is continued with further support. In this case, a revised plan will be written for this period which will be placed in the trainee’s file (and in the case of an extern or intern, forwarded to the director of his/her doctoral program). During this maintenance period, the trainee will continue to meet with supervisors and to follow the recommended goals for the new plan.

c. Reinstatement: The Training Review Committee may elect to reinstate the trainee to regular status at the satisfaction conclusion of probation. The reinstatement will be communicated to the trainee in writing and does not preclude future actions if problems arise.

Appeal: A trainee may appeal the Training Committee's decision to the Director of Psychological Services within ten business days of being terminated or of any disciplinary action taken. At the time the trainee is notified of the above outcome, the trainee will be notified of his/her right to appeal these actions. The appeal request must be in writing and shall include all information the trainee would like taken into consideration in evaluating his/her appeal as well as the trainee's


justification for the appeal. The Director shall determine the need for any additional documents or testimony from the parties.

Within ten business days from the initiation of the appeal, the Director of Psychological Services will review the appeal and render the appeal decision, which will be communicated in writing to all involved parties (including the doctoral program director if applicable), and to the Training Review Committee. Should the Director be recused from deliberation due to a conflict of interest, the Associate Chairman of the Psychiatry Department (or designee) will render the appeal decision. The Director may accept, reject or modify the action taken, or take any other action that the he deems appropriate under the circumstances. The decision of the Director will be final and binding upon all parties.

Prohibited Conduct: Prohibited conduct by a trainee should be brought to the attention of the TD in writing. Any person who observes such behavior, whether staff or trainee, has the responsibility to report the incident. Prohibited conduct is described in the Policy and Procedure Manual (Title: Conduct in the Workplace/ Progressive Discipline, Part V, Section 3) and includes but is not limited to:

• Incompetence and/or misconduct, including professional misconduct

• Insubordination

• Possession of a weapon on health system property

• Illegal use of drugs,

• Stealing, fighting, gambling or possession of gambling devices

• Abandonment of position

• Excessive tardiness and/or absenteeism

• Falsification of time record

• Sexual harassment and/or any other unlawful harassment or discrimination

• Inappropriate use of the Internet and electronic mail

• Violation of the health system’s Codes of Professional and Ethical Conduct

• The TD, the supervisor, and the trainee may address infractions of a very

minor nature.

• Any significant infraction or repeated minor infractions must be documented in writing and submitted to the TD, who will notify the trainee of the complaint. A written record of the complaint and action become a permanent part of the


trainee's training file. Per the procedures described above, the TD will call a meeting of the Training Review Committee to review the concerns, after providing notification to all involved parties. All involved parties will be encouraged to submit any relevant information that bears on the issue, and, if deemed suitable by the Committee, invited to attend the Training Review Committee meeting(s).

• In the case of prohibited conduct in the performance of patient care duties,

the TD may seek advisement from appropriate Health System resources in compliance with system policies, including Risk Management, Human Resources and/or Legal Counsel. If warranted, the trainee may be placed on administrative paid leave pending the results of an investigation and will receive written notification of this leave as soon as is practicable. Such leave is not considered an adverse action and is not subject to hearing or appeal.

• Following a careful review of the case, the Training Review Committee may

recommend no action, probation or dismissal of the trainee. Dismissal would reflect the determination by the Training Review Committee that the trainee’s conduct is not subject to remediation. If a probationary period is recommended it shall include the same procedures described above. A violation of the probationary agreement could necessitate the dismissal of the trainee's appointment at NSLIJHS. Dismissal (whether after unsuccessful remediation efforts or upon determination that the trainee’s conduct is not subject to remediation) may be appealed in accordance with the procedure given above.

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APPENDIX F

Division of Psychological Services, Department of Psychiatry Long Island Jewish Medical Center

The Zucker Hillside Hospital


1. Successful completion of the psychology externship, internship or fellowship

requires a year long, full-time training experience. It is recognized that on occasion a psychology trainee may not be able to complete this requirement during the 12 consecutive months because of medical problems or for extraordinary personal reasons. Given that trainees are accepted for one year only, extended leave1

therefore could jeopardize successful completion of training requirements.

2. At the discretion of the Psychology Education and Training Committee in conjunction with the Department of Psychiatry, a trainee who has not completed a year’s worth of training activity because of medical disability or extraordinary personal circumstances may be given the opportunity to complete training via an additional training period.

3. A request for extended training must be made in writing to the Director of

Psychology Training and can be submitted at any point in advance of the expected leave but no later than one week upon returning from leave. The Education and Training Committee and The Director of Psychological Services (or a designee) will review the request and made a determination as to whether extended training will be offered. The decision will take into consideration the reasons for the request for extended training and the availability of staff and other existing resources to support extended training.

4. If extended training is granted, it must be completed within one year following the

originally scheduled end of the training.

1 The Education and Training Committee will determine the exact amount of time that constitutes “extended leave” which would jeopardize successful completion of the training taking into account the trainee’s performance, pattern of attendance, training needs as well as regional licensure requirements if applicable.

APPENDIX G

Long Island Jewish Medical Center – The Zucker Hillside Hospital Clinical Psychology Training Program

Weekly Activity Log

Name of Trainee:

Program: Externship Internship Fellowship

Track: Child Adult Geropsych Neuropsychology

Placements: Millieu ‐ Adol. InptAdult Inpt APH GPH Eat. Dis. Med. Psych.

Clinic ‐ DBT Perinatal Child OPD Anx Clinic Gero Clinic Child OPD Eval OCD Center Neuro ‐ ETP Movmnt Epil. ZHH Cons. Transitions Neuro Other

Week beginning: Days Off (vacation, sick, conference):

Supervision & Training Activities (Received by Intern)

Hours

Mon Tue Wed Thu Fri

Individual Supervision (supvsr: )




Seminar:

Seminar:

Seminar:

Seminar:

Case Conference/Grp Spvn:

Other:

Intervention & Other Activities Provided by Intern

Hours Intervention

Assessment

Case Management

Test Scoring

Collaterals

Consultation

Documentation

Family Psychotherapy

Group Psychotherapy

Individual Psychotherapy

Intake

Conducting Supervision

Team Meeting

Telephone Contact

Other:

Trainee Signature:

Track Leader Signature:

APPENDIX H

1. APA 2002 Ethical Principles of Psychologists and Code of Conduct (with 2010 amendments)https://www.apa.org/ethics/code/ethics-code-2017.pdf

2. Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients 2012https://www.apa.org/pubs/journals/features/amp-a0024659.pdf

3. Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologyhttps://apastyle.apa.org/manual/related/guidelines-multicultural-education.pdf

4. Enhancing Your Interactions with People with Disabilitieshttps://www.apa.org/pi/disability/resources/publications/enhancing-your-interactions.pdf

https://www.apa.org/ethics/code/ethics-code-2017.pdf

https://www.apa.org/pubs/journals/features/amp-a0024659.pdf

https://apastyle.apa.org/manual/related/guidelines-multicultural-education.pdf



https://www.apa.org/pi/disability/resources/publications/enhancing-your-interactions.pdf



APPENDIX I

APPENDIX J

Human Resources 1111 Marcus Avenue, Suite LL20 Lake Success, New York 11042

Tel (516) 734-7000

EMP 120 – Request for Paid T ime Off Form Revised: December 20, 2017

REQUEST FOR PAID TIME-OFF

PURPOSE:

The “Request for Paid Time-Off” Form is used to schedule paid time-off, or time away from work with pay.

WHO COMPLETES THIS FORM:

Employees who are entitled to days-off with pay who are not using the myTIME Request for Time-Off feature inmySelfService.

HOW TO COMPLETE AND SUBMIT THIS FORM:

Employees may access this form on the Intranet. An employee who needs to schedule paid time-off needs tocomplete the form in advance, discuss the request with his/her supervisor and obtain supervisory approval. Thesigned form is then maintained in the employee’s departmental file.

INSTRUCTIONS:

The employee must complete the form with the following information:

a. Name

b. Date

c. Department

d. Based on the number of hours accrued:

Number of days off requested

Equivalent number of hours

Date(s)

The employee must then discuss the request with his/her supervisor

Once the dates are agreed upon, the employee and his/her supervisor sign and date the form

A copy is maintained in the employee’s department file

APPENDIX KSummary of Benefits

Also see: https://intranet.northwell.edu/NSLIJ/hr/Benefits/BenefitsByPop/2019%20Northwell%20Benefit%20Guide%20for%20Residents.pdf

Disclaimer: The above is intended only as a summary of the benefits provided by North Shore-LIJ Health System as of November 2014. This is based on eligibility, which is fully outlined in the Summary Plan Descriptions and the New Hire Benefits package. The health system reserves the right to add, amend, or terminate any benefit at its sole discretion. Please refer to the Summary Plan Descriptions for details. Health & Welfare benefits become effective the first of the month following 32 days of employment.

Benefits Package Highlights 2015

Benefit Group 2 - House Staff

HEALTH AND WELFARE BENEFITS Choice of two Medical Plans through United Healthcare Prescription Drug Plan through Express Scripts Choice of two Dental Plans through Cigna Vision Plan through Davis Vision Health Care and Dependent Care Flexible Spending Accounts (FSAs) through Wage Works Short-Term Disability - 12 weeks of salary continuation through The Hartford – 50% Employer Paid, 60%

Buy-Up Long-Term Disability Plans through Guardian Life Insurance/Accidental Death and Dismemberment through Aetna – 1.5 times base salary up to $500,000 Supplemental Life – 1 to 5 times base salary up to 1 million Dependent Life Insurance for Spouse and Children through Aetna

ADDITIONAL/VOLUNTARY BENEFITS Accident Insurance Cancer Insurance Critical Illness Insurance Fraud SafeGuard Insurance Pet Insurance Pre-Paid Legal Services Select Life Insurance

RETIREMENT PROGRAM 403(b)

Voluntary employee contributions on a pre-tax and post-tax basis, up to annual IRS dollar limits

WORK/LIFE BENEFITS 20 days of Paid Time-Off (PTO) Discounts and Wellness Programs including: free smoking cessation, discounted gym memberships, free

counseling services, Federal Credit Union membership, and other employee services

Note: All requests for leave, other than disability, are reviewed by the Department Chairman on a case-by-case basis. All time away from formal graduate medical education, other than allocated PTO, may lead to shortfall in the time needed to complete the requirements of both the residency program and the corresponding certifying Board. In such situation, additional months of training may be necessary.

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See also

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%20Lif

e%20Safety%20Management%20Plan%202017.pdf

APPENDIX L

Fire Safety

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%20Life%20Safety%20Management%20Plan%202017.pdf


SECTION: Fire Safety Management Plan

POLICY#:EC.01.01.01.3

ORIGINATION DATE: 1/01 PAGE 1 OF 2

APPROVED BY: Safety Committee

SUBJECT: Fire Extinguishers / Types of Fire LAST REVISION DATE: 01/17

Types of Fire Extinguishers

Portable fire extinguishers are an important part of every fire safety program. Extinguishers are provided throughout the hospital (approximately every 75’) and are clearly marked and conveniently located. They are designed to combat fires, are easy to operate, and if used in the early stages of a fire, will prevent additional damage.

Class A Pressurized Water Extinguisher (2 ½ gallons) • Silver in color• Used on class A fires

Class BC Carbon Dioxide Extinguisher • Red color• Used for class B and C fires• Large funnel-like opening on the hose to expel cold CO2 under pressure

Class ABC Multipurpose Dry Chemical Extinguisher • Red color• Used for class A, B and C fires• Smaller funnel-like opening on hose to expel a dry chemical under pressure

Class K Wet Chemical Extinguisher • Silver color• Used for Kitchen grease fires

Nonferrous Water Mist • White color• Used in MRI locations

Note: All extinguishers have labels indicating type, classification of fires, and operating instructions.

To help remember how to operate fire extinguishers remember the code phase P.A.S.S.

Pull the pin and break the seal Aim low at the base of the fire Squeeze the handle to activate the extinguisher Sweep the nozzle slowly at the base of the fire


POLICY#:EC.01.01.01.3




• Water extinguishers (silver) are located in cabinets or attached to wall brackets generally in officeareas.

• Carbon-dioxide fire extinguishers (red with cone-shaped nozzles) are generally located inpreoperative areas, laboratories and engineering spaces.

• Multipurpose dry chemical extinguisher are located throughout the campus• Kitchens are equipped with Ansul Systems• Nonferrous are used in MRI locations

Types of Fires

The classification of fire depends on the type of fuel involved. Basically there are five classes of fires: A, B, C, D (flammable metals) and K. At the Medical Center we are concerned with all except class D.

Class “A” Fires that involve combustibles such as paper, wood, cloth, anything that burns and leaves an ash can normally be extinguished by cooling.

Class “B” Fires involve flammable liquids, such as gasoline, oil, alcohol, benzene, which is best extinguished by smothering. (This includes food on the stove fires).

Class “C” Fires involve energized electrical equipment, appliances and wiring in which the use of non-conductive agent prevents injury.

Class “K” Fires involve cooking grease.

APPENDIX M

GUIDE TO HOSPITAL CODES

STANDARDIZATION for North Shore-LIJ

Employees

New Emergency, Clinical and Security Codes Description of Actions for Each Code

Frequently Asked Questions

Table of Contents

ABOUT NEW HOSPITAL CODES ..…………….. 3 FREQUENTLY ASKED QUESTIONS …………… 3 I. EMERGENCY CODES

Code Amber …………………………………… 4 Code Flight …………………………………… 5 Code Decon …………………………………… 6

Code Red …………………………………….... 6

II. SECURITY CODES Code Gray ……………………………………... 9

Code Green ……………………………………. 9

Code HEICS …………………………………... 9 “All Clear” ………………………………….... 9

III. CLINICAL CODES Code Blue ……………………………………... 9 Code Fusion …………………………………… 9 Code Stroke …………………………………… 9 Code Trauma …………………………………. 9 Code White …………………………………..... 9 Rapid Response ….............................................. 9 STAT Response …………………………………….... 9

2

3

About the Hospital Codes Standardization

North Shore-LIJ continuously strives to create a safe environment for patients, their families and employees. In order for the health system to continue to provide the highest quality patient care, it is standardizing all hospital emergency, security, and clinical codes starting April 1, 2010. It is every employee’s responsibility to learn each code and be in compliance with its requirements.


Why is North Shore-LIJ standardizing its hospital codes? In order to ensure the organization delivers quality care across all hospitals and medical facilities, the hospital codes must be unified. Today, some of our hospitals use different codes for the same incident, causing confusion among employees and community-based physicians who work at multiple locations. By standardizing each code across the organization, all employees and community-based physicians will be knowledgeable about each code, and comfortable responding.

When do the “new” hospital codes take effect? The codes described in this guide will take effect on April 1, 2010.

Who is affected by the “new” hospital codes? All North Shore-LIJ employees working at a hospital, regardless of his/her role at the hospital must learn each code and the actions associated with it.

I know other hospital codes (such as Dr. Red) that are not outlined in this guide. What happened to those codes? Some hospitals were using alternative codes for the same incidents as described in this guide. Only the hospital codes outlined in this guide are to be used starting April 1, 2010. All other codes are no longer being used.

What if my co-workers and I have our own department codes that we prefer? All hospitals will use the same codes as outlined in this guide. Department codes or abbreviated codes will not be permitted after April 1, 2010.

How will I remember each code? North Shore-LIJ has produced a wallet-size “codes card” containing each code and the proper actions for every hospital employee. This card may be carried as part of the uniform until the employee becomes comfortable.

Where can I get a “codes card”? If you did not already receive a codes card, please contact your safety office or your Human Resources department to obtain a card.

Where may I obtain more information about my hospital’s codes? Please contact your site’s Safety Office for specific information related to your hospital.

I. EMERGENCY CODES

Code Amber Pediatric or Infant has been abducted or is missing

Procedure: In response to a “Code Amber”, which is an unauthorized removal of an infant/pediatric patient from the unit, the hospital will initiate its lockdown procedures as outlined in the Security Management Plan.

Upon verification, the involved nursing unit should notify Security, utilizing the appropriate STAT Extension, and provide the physical description of the infant/pediatric patient (i.e., race, gender, age, unit of origin), and the physical description of the abductor (i.e., race, gender, age, height, build and clothing worn) if known.

Example: 3 Monti, infant female, 24 hours old. Abductor: White female, 25-30 years old, 5’3” – 5’5” tall, medium build wearing a long black coat and carrying a shopping bag.

The Nursing team will keep detailed notes of time and notification, and will seal off the unit, allowing no-one in or out until the “All Clear” is sounded. Nursing and Security teams will carry out the established “Code Amber” policies and procedures.

Communications will be asked to announce a “Code Amber” over the public address system, and provide the identifying information. Voice Communications will announce the “Code Amber” via the overhead P/A system as per site policy.

After hearing a “Code Amber” announcement, all employees should be looking for an abductor as described in the overhead announcement, and should immediately report any suspicious observations associated with the description of the abductor to Security at the appropriate extension. If possible, the suspected abductor should be followed to determine a vehicle description and the license plate number.

The Hospital Incident Command System (HICS) will be implemented as indicated by the hospital’s Comprehensive Emergency Management Plan (CEMP). All “Code Amber” events will be documented and reviewed, as per protocol, through either the Site Safety Committee or the Site PICG.

4

Code Flight Adult patient has eloped or is missing

Procedure: To establish a plan to assist the clinical staff in locating a missing patient, and assist in the safe return of the patient to the appropriate patient care unit.

1) When it is discovered that a patient is missing, the team member will dialthe Stat extension, and notify Communications of a “Code Flight,” statingthe nursing unit location of the missing patient.

2) Communications will immediately make notifications as per their protocol,including an overhead announcement.

3) After the overhead announcement is made, all employees are to follow thehospital’s “Code Flight” procedures, which include communication of thepatient’s description, and the monitoring of hallways, entrances and exits,and the overall hospital campus. In every incident, the Nurse Manager willbe notified.

4) After notification, Security will respond to the area where the patient wasreported missing. Security will verify if the patient is: a danger tothemselves or others; not capable of consent to discharge (i.e. a pediatricpatient, or a patient with an altered mental state). Security will obtain anaccurate physical description of the patient. The description will include thepatient’s sex, race, complexion, age, height, weight, build, hair, eyes,clothing, mental state and direction of travel.

5) If, in the judgment of the responsible clinician on site, (i.e. MD, RN), thenotification procedure (see number 8) can be implemented immediately.

6) The verifying security guard will broadcast, via radio, the physicaldescription on the security frequency.

7) When a missing patient is located on the hospital property, the appropriatepatient care unit will be notified, and the unit representative will be asked toescort the patient back to the unit. If a representative is unable to respond ina timely manner, the search team will attempt to persuade the patient toreturn to the unit voluntarily.

8) If the patient is unwilling to return to the unit of origin and meets thecriteria of a pediatric patient, or a patient with an altered mental state, thesecurity desk officer will be notified. The desk officer will contact thepatient unit for origin, and request an MD or RN to respond, or betransported to the scene for clinical intervention. Members of the searchteam are to monitor the patient until clinical assistance arrives.If the patient is not located on the hospital property, additional notificationswill be made, as per site policy, that includes the following;

! The Director of Security! The local Police department or Precinct! The Nurse Manager/Designee will be informed of the action taken, and

the progress being made5

! For Inpatient Psychiatric Patients (only), notify the Director of InpatientServices (Psychiatry).

! The Nurse Manager/Designee will notify the Administrator-on-Dutyand ensure the patient’s family and physician have been notified(determine if missing/eloped patient arrived home safely).

! North Shore-LIJ Network Emergency Management (NEM) – 516-719-5000They will be provided with the physical description of the missing patient,and informed of who was notified.

9) A Security Incident Report will be completed in a timely manner by theSecurity Department designee. The report will include all appropriateactions taken, all notifications, the name and shield number of the notifiedpolice officers, and the case number from Police Department havingjurisdiction.

Code DECON Activation of Decon response team due to an external event

Procedure: Upon notification of an incident involving chemical, biological or nuclear contamination, or a contaminated patient(s), a Code Decon announcement will be made over the public address system. The decontamination team will respond as per the DECON Annex of the hospital’s Comprehensive Emergency Management Plan (CEMP) and implement DECON procedures as appropriate. The Hospital’s Incident Command System (HICS) will be implemented.

Code Red Fire

Procedure: The phrase “Code Red” will be used to designate a fire situation, and will provide supplemental support to the hospital’s fire alarm system. The code phrase will be announced three times over the public address system, in conjunction with all fire alarms, with the exception of weekly alarm tests. When announced overhead, the code phrase will be accompanied by a location (i.e. “Code Red, Tower Building, 6th Floor, South Stair”). The fire alarm “all-clear” (series of single bells), which designates resolution of the alarm condition, must also be backed-up by an overhead announcement.

6

7

The hospital team is required to dial the hospital’s stat extension, and give their name and location immediately after activating a fire alarm. Once this information is relayed to the hospital switchboard operator, the P.A. announcement will be made. If the operator receives no call, an announcement will be made based on the fire alarm bell code. If the fire alarm systems malfunctions, or has been deactivated for servicing, it is especially important that the location of a fire be given to the Switchboard Operator for announcement purposes. Under such circumstances, the Switchboard Operator will notify the Boiler Room, and the Boiler Room Watch Engineer will notify the Fire Department.

The code phrase should also be used by employees in the immediate area of a fire, to avoid yelling “fire” and possibly causing panic with the patients. Employees should call aloud the established code phrase and the fire location, i.e. “Code Red, Room 258.”

Employees should respond to a “Code Red” announcement in the same manner as the mechanical fire alarm. Note: Upon activation of a “Code Red” staff must ensure that all corridor and patient room doors are closed, in addition to all other doors.

Staff Fire Response Fire in your area:

! Locate fire; call aloud “Code Red” and the involved location to alertemployees in the area; remove anyone in immediate danger

! Rescue or evacuate anyone in the immediate area of the fire! Activate fire alarm; pull the fire pullbox station nearest to the fire site! Call the hospital “stat” line switchboard at the hospital’s stat extension;

state name, location and type of fire; verify alarm! If you hear a fellow team member call out “Code Red” and have not heard

the fire bells, respond by activating the nearest pullbox and make thenotification to the Communications department

! Turn off oxygen and electrical equipment in the area of fire (away from thearea of fire; provide oxygen support for patients on oxygen; callRespiratory Therapy for backup as warranted)- Confine fire by closing windows, doors (but do not lock)- Clear corridors and close corridor doors; control traffic in the area- Use appropriate fire extinguishers

! Wait for instructions from Fire Response Team or Fire Department – donot evacuate patients except in case of immediate danger.

If feasible, mark the closed door to the room containing the fire, preferably with red tape.

8

An easy method to remember basic fire procedures is: R.A.C.E.

Remove anyone in immediate area of danger (while calling aloud “Code Red” and the location of the fire to employees in the area). Activate alarm: Pull the fire alarm pullbox nearest to the fire site. Dial the hospital’s stat extension to report fire situation and exact location. Confine the fire (e.g. close windows and doors, but do not lock). Extinguish fire (attempt to extinguish small fire with proper extinguisher and without endangering yourself). If necessary, evacuate horizontally to adjacent safe smoke compartment, and then if necessary, vertically.

Fire in another area of hospital: ! Identify location of fire! Close doors and windows to avoid draft! Clear corridors! Man telephones, extinguishers and oxygen shut-off valves! Remain in your area! Control traffic in your area! Remain calm and reassure patients! Wait for further instructions

Additional procedures: ! In the event of a fire, if the fire/smoke doors on magnetic hold open do not

automatically close, employees should manually close the doors.Employees should also ensure that these fire/smoke doors are not breacheduntil the “all clear” is announced.

! Visitors should remain with patients in the room.! Employees must terminate non-essential activities, telephone conversations.! Narcotics, records, valuables should be secured.! In units/areas with special exit door locking arrangements (e.g. Psychiatry

Unit, Infant Protection Systems), employees should be posted at unitentrance doors to facilitate the entry of emergency responders, or a way outin the event of fire/medical/safety emergency.

! Do not use elevators.! Evacuation decisions will be made by ranking fire responder,

Administration, Hospital Incident Command, or the Fire Department.

II. SECURITY CODES

Code Gray Security Stat – plus announce location

Code Green Security Stat – plus announce location because of violence with weapon

Code HICS Activation of EOP – plus activation level (I, II, III, IV)

“All Clear” Announced twice following resolution of incident

Note: Please ensure you are familiar with your site’s security and safety manual.

III. CLINICAL CODES

Code Blue Adult Cardiac/Respiratory Arrest – plus announce location

Code Fusion Transfusion Emergency – plus announce service and location

Code Stroke Activation of Stroke Team – plus announce location

Code Trauma

Activation of Trauma Team – plus announce level and location

Code White Pediatric Cardiac/Respiratory Arrest – plus announce location

Rapid Response Activation of Rapid Response Team – plus announce medical/surgical/pediatric

and location

STAT Response

Announce Service STAT to location – (service e.g. Respiratory, OB, Cath Lab)

9

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APPENDIX OElectronic Medical Library

Handbook Appendix: Page 204


APPENDIX P

Ambulatory Emergency Procedures

General Statement of Purpose:

When an ambulatory service physician makes a decision to admit a patient to the inpatient

service or via the Easy Access Program (hereafter, EZAP), established safety procedures

consistent with other routes of admission to the hospital should be established. The physician

will also make a determination regarding transport resources needed for a safe transport.

Procedure for Ambulatory Services:

Voluntary Admission

When a patient presently in an ambulatory setting requires inpatient hospitalization and is

agreeable to hospitalization, the physician will call Central Intake to obtain a room assignment.

After 5pm a page is made to the A.D.N and Central Intake /A.D.N will then inform the receiving

unit of the pending admission. The referring physician will complete the legal papers with the

patient and sign Part B. The physician or staff member will escort the patient to the unit. The

Physician or designated staff member will provide a handoff communication to a clinician on the

receiving inpatient treatment team. The admission search will be conducted by the inpatient staff

when the patient arrives on the unit.

When the outpatient physician determines additional assistance is needed to safely escort the

patient to the unit, the physician or designee will call a “22” stating “ambulatory transport”. The

caller must provide the operator with the standard nomenclature to identify the location. A

Patient Engagement Specialist will respond to provide support during the transport and arrival to

the unit. Clerical staff should be notified to send an email to the ambulatory psychiatric

emergency distribution list notifying front desks of the location of the “ambulatory transport.”

Involuntary Admission

Following the physician’s decision to admit an involuntary patient to the inpatient service the

clinician involved in the situation calls or directs that a “22” is called stating “ambulatory

psychiatric emergency.” The caller must provide the operator with the standard nomenclature to

identify the location. A call is also made to the Northwell Health EMS (718-747-4911) to

provide transport to the LIJ ED. The clinician or delegate will communicate to the Northwell

Northwell Health The Zucker Hillside Hospital

PATIENT CARE SERVICES

POLICY TITLE: Inpatient Admission from ZHH Ambulatory Services and EZAP

Prepared by: ZHH Policy and Procedure Committee Approval Date: 1/13/17 Effective Date: 1/13/17

Last 11/14/12 Revised/Reviewed: 1/15/14

Pg 1 of 2

Health EMS any identified patient safety risk that would prompt a decision by EMS to also call

911 to request an N.Y.P.D. response. It is the role of the clinician or their designee who called

the “ambulatory psychiatric emergency” to meet the patient engagement specialist, nursing

director or A.D.N and security upon arrival, provide the team with a brief assessment of the

situation, as well as any concerns, e.g., potential for aggression, impulsivity or flight. The

responsibility for the direction of the ambulatory psychiatric emergency response is assigned the

Director of Patient Care Services or A.D.N. until the arrival of the program director. Once the

program director arrives, the Director of Patient Care Services or A.D.N. will brief the director

prior to leaving the area. The clinician on site must remain as a consultant until the situation is

resolved.

The standard nomenclature to identify the location is as follows:

ACP- Ambulatory Care Pavilion

ACP, basement, child clinic

ACP, first floor, centers

ACP, second floor, PACE program

ACP, second floor, adult partial hospital

ACP, second floor, gero clinic

ACP, second floor, gero partial

Sloman- Adult Clinic, Medical Clinic

Sloman, basement, adult clinic

Sloman, first floor, medical clinic

Sloman, first floor, adult clinic

Sloman, first floor, Clozapine clinic

Sloman, second floor, adult clinic

Littauer- ARS (includes MMTP and DAEHRS), Social Work

Littauer, first floor, ARS

Littauer, second floor, Social Work

Research - Psychiatry Research

Research, BHP, basement, room #

Research, ACP, first floor, room#

It is the ambulatory staff’s responsibility to secure the immediate area from other patients, staff

or visitors, alert security to notify them that EMS has been called, to call the LIJ Psych ED to

give a verbal handoff and to subsequently notify family contacts as appropriate. For the purpose

of informing all outpatient areas and aiding in directing the responding team, the ambulatory

support staff will also send an email to an Ambulatory Reception distribution specifying the

location of the ambulatory psychiatric emergency.

Procedure for EZAP:

When Central Intake books an appointment for a Patient Admission via EZAP, Central Intake

will inform the ADN and the receiving unit of the pending admission. The MD will assess the

patient in the EZAP office. Following the assessment and presuming the patient will be

admitted, the physician will call the receiving unit to request escort to the unit from the EZAP

office, the physician will provide handoff communication to the receiving RN. Staff designated

by the unit nurse will pick up the patient from the EZAP office and search the patient’s

belongings prior to entry to the unit.

APPENDIX Q Email Policy

Page 1 of 11 900.11 03/05/19

POLICY/GUIDELINE TITLE:

Electronic Communications Policy

ADMINISTRATIVE POLICY AND PROCEDURE MANUAL

POLICY #: 900.11 CATEGORY: Information Services

Site Approval Date: 03/05/19

Site Implementation Date: 03/05/19

Effective Date: 9/2008

Last Revised/Reviewed: 3/15/18 Prepared by: Office of the CIO – IS Policy and Procedure Committee

Notations: Previously Titled: Electronic Mail (E-Mail Acceptable Use)

GENERAL STATEMENT of PURPOSE

The purpose of this policy is to establish the guidelines for the acceptable use of Northwell Health (“Northwell”) electronic communications such as email, instant messaging, texting, social media, and online virtual meeting. This policy outlines the guidelines for using these or similar systems on Northwell’s Enterprise Network.

POLICY

It is the policy of Northwell to permit the use of electronic communications such as email, instant messaging, social media platforms, and online virtual meeting platforms for authorized Northwell use as long as approved security controls and required business agreements are in place.

SCOPE

This policy applies to all Northwell Health employees, as well as medical staff, volunteers, students, trainees, physician office staff, contractors, trustees and other persons performing work for or at Northwell Health; faculty and students of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell conducting research on behalf of the Zucker School of Medicine on or at any Northwell Health facility; and the faculty and students of the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies.

DEFINITIONS

Electronic Communication: This refers to, but is not limited to, email, text messaging, and online multimedia platforms such as videoconferencing.

Page 2 of 11 900.11 03/05/19

Highly Sensitive Information: Protected Health Information (PHI) or any information that, if lost, corrupted, disclosed to, or accessed by an unauthorized person, or disclosed or accessed by unauthorized means, may (i) violate federal, state, and/or local law, (ii) cause significant harm, injury, or damage to another person or entity, or (iii) cause financial loss to another person or entity. Examples include, but are not limited to, Social Security numbers, credit card data, and driver’s license information. Refer to the 900.12 Data Classification and Handling Policy.

Instant Messaging (IM): An electronic method of communicating that enables immediate correspondence between two or more users in the form of text messages. Messages are exchanged by typing them on a computer or a mobile device with instant messaging software installed. This may be hosted either internally or externally through a service provider (such as AIM, MSN, or Google).

Messages: Refers to communications sent via phone, text, conferencing platforms, email or other electronic method.

Personally Identifiable Information (PII): Any information about an individual maintained by an agency, including (i) any information that can be used to distinguish or trace an individual’s identity, such as name, Social Security number, date and place of birth, mother‘s maiden name, or biometric records; and (ii) any other information that is linked or linkable to an individual, such as medical, educational, financial, and employment information:

1. Name, such as full name, maiden name, mother’s maiden name, or alias2. Personal identification number, such as Social Security number (SSN), passport number,

driver‘s license number, taxpayer identification number, patient identification number,and financial account or credit card number

3. Address information, such as street address or email address.4. Asset information, such as Internet Protocol (IP) or Media Access Control (MAC)

address or other host-specific persistent static identifier that consistently links to aparticular person or small, well-defined group of people

5. Telephone numbers, including mobile, business, and personal numbers6. Personal characteristics, including photographic image (especially of face or other

distinguishing characteristic), x-rays, fingerprints, or other biometric image or templatedata (e.g., retina scan, voice signature, facial geometry)

7. Information identifying personally owned property, such as vehicle registration numberor title number and related information

8. Information about an individual that is linked or linkable to one of the above (e.g., date ofbirth, place of birth, race, religion, weight, activities, geographical indicators,employment information, medical information, education information, financialinformation)

All PII shall at all times be subject to all applicable laws, including, without limitation, the New York State Social Security Number Protection Law, New York State Labor Law, and Fair Credit Reporting Act. This includes all PII relating to members of the Northwell workforce. All PII that is also PHI shall, at all times, also be subject to all applicable laws and Northwell policies regarding PHI, as set out above.

Page 3 of 11 900.11 03/05/19

Protected Health Information (“PHI”): Any oral, written, or electronic individually identifiable health information. PHI is information created or received by Northwell that (i) may relate to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the payment for the provision of health care to an individual; and (ii) identifies the individual who is the subject or based on which there is a reasonable basis tobelieve that the individual who is the subject can be identified. The Health Insurance Portabilityand Accountability Act (HIPAA) further clarifies that PHI includes information that identifies theindividual by one or more (depending on context) of the following 18 identifiers:

1. Names;2. Geographic subdivisions smaller than a state, including street address, city, county, precinct,

Zip code, and their equivalent geocodes, except for the initial three digits of a Zip code incertain situations;

3. All elements of date (except year) for dates directly related to an individual, including birthdate, discharge date, date of death; and all ages over 89 and all elements of dates indicativeof such age, except that such ages and elements may be aggregated into a single category ofage 90 or older;

4. Telephone numbers;5. Fax numbers;6. Electronic mail addresses;7. Social Security numbers;8. Medical record numbers;9. Health plan beneficiary numbers;

10. Account numbers;11. Certificate/license numbers;12. Vehicle identifiers and serial numbers;13. Medical device identifiers;14. Web Universal Resource Locators (URLs);15. Internet Protocol (IP) address numbers;16. Biometric identifiers, including finger and voice prints;17. Full face photographic images and any comparable images; and18. Any other unique identifying number, characteristic, or code.

Sensitive Information: Any information that, if lost, corrupted, disclosed to, or accessed by an unauthorized person, or disclosed or accessed by unauthorized means, may cause harm, injury, or damage to another person or entity. Examples include, but are not limited to, a number of personally identifiable information data elements that are not highly sensitive. Refer to the 900.12 Data Classification and Handling Policy.

Suspicious Email: Any email that contains the following: 1. Requests for sensitive or highly sensitive information (such as PHI, PII, or personal

financial information) from an unknown source or for an unknown purpose.

Page 4 of 11 900.11 03/05/19

2. Requests for sensitive or highly sensitive information from a person who shouldotherwise not be able to request the information or does not have a need to know.

3. Requests for your personal or company issued username and password.4. Executables or command files (files that have an .exe, .vbs, .bat, or .com at the end of the

filename) without a workforce member’s understanding of the program’s source orpurpose.

5. Receipt of hyperlinks pointing to an unknown destination, as determined by hovering themouse over the hyperlink.

6. Any other email that may be deemed mistrustful.

Virtual Meeting Platform: A technology that allows multiple users to communicate either via audio, video, or both to hold meetings. This may also include the sharing of screens and interactive features such as polls and file transfers.

Workforce Members: All those entities covered in the Scope section above.

PROCEDURES/GUIDELINES

1. Generala. Electronic communications must be protected from unauthorized use and may be monitored

to detect or prevent security breaches and maintain the confidentiality of data. Electroniccommunication content and use may also be monitored and audited by Information Services(IS) staff members to support operational, maintenance, auditing, security, and investigativeactivities.

b. The use of electronic communications must be consistent with Northwell policies andprocedures including the Code of Ethical Conduct, HR policies, and all relevant industrystandards and applicable laws.

c. Message and email addresses must be reviewed and confirmed before sending to ensure thatthe message or email is delivered to the appropriate recipient(s).

d. Messages or emails that contain offensive, inappropriate, or otherwise objectionable contentare not allowed.

e. The forwarding of chain letters, spam, advertisements, or other non-work related orinappropriate messages is not allowed.

f. Messages (including phone calls and emails) suspected to be fraudulent must be reported tothe IS Service Desk.

g. Workforce members must not click on or open suspicious links or attachments in emails ortext messages.

h. Access to personal email is prohibited from the Enterprise network.i. Workforce members who request patients to send/receive email or text messages that may

contain PHI, must first have the patient sign form VD032, and keep the completed form onfile.

Page 5 of 11 900.11 03/05/19

2. Emaila. Northwell email is intended for business use. Minimal personal use is permitted, provided

it does not interfere with the performance of the workforce member’s work-related dutiesand responsibilities, and is not illegal, unlawful, or inappropriate.

b. All emails are subject to monitoring and deletion by Northwell Information Services staff.Northwell email users should have no expectation of privacy.

c. Obscuring, disguising, misrepresenting or otherwise hiding one’s identity or role withinNorthwell in an email is forbidden.

d. Non-Northwell employees who have been issued Northwell email addresses must notpurport to be Northwell employees.

e. Email accounts are provisioned to Voluntary Physicians upon their request, approval bycredentialing and verification of a signed Confidentiality Agreement and solely inconnection with providing professional services to Northwell Health and/or its patients.

f. Emails are to be considered an extension of Northwell and must be writtenprofessionally.

g. All information within emails, including attachments, must be handled according to the900.12 Data Classification and Handling Policy.

h. Sensitive or highly sensitive information (such as PHI and PII) must not be sent in anemail unless required and must include only the minimum amount necessary.

i. All emails sent from Northwell that contain sensitive or highly sensitive information mustbe encrypted. To specifically encrypt an email, type either “PHI” or “SECURE” into thesubject line. Alternatively, use the “Encrypt & Send” button in Outlook.

j. Elements of PHI must not be included in the email subject line.k. Third party email services such as AOL, Optimum, Yahoo, or Gmail, may not be used to

communicate sensitive or highly sensitive information, such as no PHI.l. Email must be retained only for as long as required by business needs, regulatory

requirements, and local, state, or federal law. Specific requirements can be found in the100.97 Records Retention and Destruction Policy.

m. In the event that an email containing patient information is inadvertently delivered to thewrong recipient (for example, due to an incorrect email address), Corporate Compliancemust be notified immediately.

n. Automatic forwarding of internal Northwell emails to external addresses is prohibited.o. All files received via email must be scanned by Information Services using the enterprise

anti-virus and anti-malware tools.p. All requests to develop and distribute any form of digital, print, or multimedia internal

communication within Northwell Health to cross-functional groups of more than 100employees and/or voluntary physicians shall be submitted to the Internal Communicationsteam, part of the organization’s Department of Marketing and Communications. Refer to100.38 Internal Communications, External Communications and Media Placement policy.

q. All emails going outside of Northwell must have an email confidentiality disclaimerappended in the footer that stipulates conditions of what the recipient may or may not dowith the email. This disclaimer is automatically appended to all outgoing email.

r. When in doubt about whether or not a communication is subject to attorney-client privilegeor another privilege, the Office of Legal Affairs must be consulted before sending the email.

s. Emails regarding quality assurance information must contain the following footer:“CONFIDENTIAL Education Law 6527; Public Health Law 2805, J., K., L., M.”

Page 6 of 11 900.11 03/05/19

t. Unauthorized access, interception, or disclosure of email is prohibited.u. Public representation or statement of Northwell issued through an email, unless granted

specific approval from the Public Relations Department, is prohibited.v. Email backups are performed in accordance with standard Northwell backup procedures.w. Email is archived for long-term storage by the Information Services Department, and may

be monitored, reviewed, and restored at the discretion of authorized individuals at eachfacility. The email system is intended for business purposes and all emails remain theproperty of Northwell.

x. Email communication with patients is subject to all Northwell Health policies, as well as thefollowing requirements:

i. All patients must sign a Consent to E-Mail and Text Communications form priorto receiving email communication from a Northwell Health care provider, givingtheir consent to have their protected health information transmitted via email.Refer to the 800.02 Release of Protected Health Information (e.g., MedicalRecord) for Living Patients Policy. The office or facility that intends to email thepatient must first give the patient the form to read and sign. The office or facilitymust retain a copy of the signed consent form for 6 years. Refer to the 100.97Records Retention and Destruction Policy.

ii. With the exception of appointment scheduling, email communication is only totake place with patients previously seen and evaluated in the practice or by theclinician.

iii. Email communication with patients must be used only for non-emergency, non-urgent, or non-critical information.

iv. Copies of all email communications relative to ongoing medical care of thepatient must be maintained as part of the patient’s medical record. All clinically-relevant online clinician-to-patient email communications must be a permanentpart of the patient’s medical record.

3. Instant Messaging and Text Messaginga. Instant messaging and text messaging are acceptable forms of communication for

business purposes. Only Northwell-approved secure texting solutions may be used for thetransmission of sensitive or highly sensitive information, such as PHI or PII, whether inthe form of text, photos, videos, or audio recordings of patients.

b. Clinicians are not permitted to text patient care orders regardless of the texting solution.

c. It is permitted to text appointment reminders with written patient consent, although thePatient Portal is a preferred method of communication. The message may contain thephysician name, location, phone number and date/time of service, but no other PHI.

4. Online Multimedia Sharing Platformsa. Online multimedia platforms such as videoconferencing, WebEx, and GoToMeeting may

be used with both internal and external users provided the following guidelines arefollowed:

i. Passwords must be required to join the meeting.ii. Sensitive and highly sensitive information can only be shared as required, and

must comply with the minimum necessary requirement.

Page 7 of 11 900.11 03/05/19

iii. Only those with an executed Business Associate Agreement (BAA) or Non-Disclosure Agreement (NDA) on file are authorized to view sensitive and highlysensitive information. It is the responsibility of the meeting host to ensure that anythird-party attendee who may be exposed to sensitive or highly sensitiveinformation is authorized to do so. The meeting host may contact the Office ofLegal Affairs and/or Procurement to ensure that an executed BAA or NDA is onfile.

iv. Meetings that contain sensitive or highly sensitive information must not beallowed to be recorded or downloaded.

v. Participants must be aware of their surroundings to prevent the possibility ofinadvertently sharing confidential (highly sensitive, sensitive, or internal)information. Examples include whiteboards or documents in view of the cameraduring videoconferencing, computer file names visible on the desktop, or otherdata visible on the computer.

ENFORCEMENT

Users should report any violations of this policy immediately to their respective managers. If appropriate, the violation should be escalated and reported to the IS Service Desk or the Office of Corporate Compliance HelpLine. Anyone found in violation of this policy may be subject to disciplinary action, up to and including termination of employment or engagement, as applicable, in consultation with Human Resources.

CONTACT INFORMATION What Where Northwell Health Service Desk (516) (718) (631) 470-7272Northwell Health Service Desk Email [email protected] IT Security Hotline Email [email protected] Office of Corporate Compliance HelpLine (800) 894-3226Office of Corporate Compliance Website www.northwell.ethicspoint.com

REFERENCES to REGULATIONS and/or OTHER RELATED POLICIES • #100.009 Payment Card Industry Data Security Standards PCI DSS IT Security Policy• #100.010 Payment Card Industry Data Security Standards PCI DSS Governance Policy• #100.38 Internal Communications, External Communications and Media Placement Policy• #100.97 Records Retention and Destruction Policy• #800.02 Release of Protected Health Information (e.g., Medical Record) for Living Patients• #800.42 Confidentiality of Protected Health Information• #900.12 Data Classification and Handling Policy• #VD032 Consent to E-Mail and Text Communications Form.• Health Information Technology for Economic and Clinical Health (HITECH) Act• Health Insurance Portability and Accountability Act (HIPAA), Security Final Rule, 45 CFR

164.312(e)(1) Transmissions Controls• Human Resources Policy 5-3 Conduct in the Workplace/Progressive Discipline

mailto:[email protected]


http://www.northwell.ethicspoint.com

Page 8 of 11 900.11 03/05/19

• Human Resources Policy 12-1 Termination of Employment: Voluntary, Involuntary• Human Resources Policy 13-3 Electronic Communications Systems• Human Resources Policy 13-11 Social Media Acceptable Use Policy

CLINICAL REFERENCES/PROFESSIONAL SOCIETY GUIDELINES N/A

ATTACHMENTS Appendix A – Guidelines For Internal Northwell Email Appendix B – Standard Email Design Guidelines

FORMS N/A

APPROVAL:

Northwell Health Policy Committee 03/05/19

System PICG/Clinical Operations Committee 03/05/19 Standardized Versioning History: *=Policy Committee Approval; ** =PICG/Clinical Operations Committee Approval *09/08; **04/09; *08/10 **09/10 **Provisional approval **01/14 **2/22/18 **3/15/18 03/05/19 Expedited Approval Granted by:

Winifred Mack, SVP/Operations – Chair, Northwell Policy CommitteeMorris Rabinowicz, MD, Co-Chair, - System PICG/Clinical Operations Committee

Page 9 of 11 900.11 03/05/19

Appendix A - Guidelines for Internal Northwell Email

1. Volume• To the extent possible, the amount and frequency of emails to employees should be

minimized, with a particular emphasis on reducing broadly distributed emailannouncements.

• Alternate means of sharing information should be utilized, such as the Employee Intranetand the myNorthwell mobile app.

• Messages should be consolidated into existing email channels such as the weekly E-NewsBulletins and monthly Leader E-Newsletter.

2. Distribution Lists• All requests to develop and distribute any form of digital, print or multimedia internal

communication within Northwell Health to groups of more than 100 employees and/orvoluntary physicians outside the sender’s department must be submitted to the InternalCommunications team, part of the organization’s Department of Marketing andCommunications.

3. Content• Never send an email that requires the receiver to enter personal information such as their

full social security number, birth date, credit card number, Northwell ID or password.• Every effort should be made to avoid or minimize the use of “clickable links” or

attachments in emails. Where clickable links are unavoidable, they must be kept to aminimum and have clear URLs that clearly identify the link.

• When appropriate, clickable email links should be replaced with instructions on how tonavigate to the destination via the employee Intranet – particularly when privateemployee information is involved (e.g., mySelfService, benefits open enrollment).

• While clickable links may be warranted in some instances, they should not be used underthe following circumstances:

o Sensitive information (user id, passwords, or private employee information) isbeing requested.

o There are time limits or deadlines associated with the request, a sense of urgencyto respond, or a threat/penalty for failure to respond.

o The email evokes strong emotions such as fear, curiosity or anger.o You do not know the sender and/or are not expecting the email.

When these conditions exist, together with clickable links, they may be indicative of a phishing email – a malicious attempt to steal confidential email – and should therefore be avoided.

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4. General Use• Never open emails from an unrecognized sender. Delete them without opening.• Never click on embedded website links that you don't recognize or open embedded files

if you are not expecting them.• Report suspected phishing emails by either clicking on the “Report Phishing” button in

Outlook or forwarding the email to [email protected].

5. Style• Wherever possible, internal communications email sent on behalf of Northwell email

should follow the design guidelines in Appendix B below.

6. Vendor Generated Emails• Where system generated emails will be sent out on behalf of Northwell by an outside

vendor that is unable to adhere to the design guidelines in Appendix B, an internal, pre-communication email should be sent out to end users making them aware that an externalvendor will be contacting them and that the request is legitimate.


Page 11 of 11 900.11 03/05/19

Appendix B – Standard Email Design Guidelines

APPENDIX R

Appearance Guidelines

TH

E Z

UC

KE

R H

ILL

SID

E H

OS

PIT

AL

App

eara

nce

Pla

n

Dep

art

men

tal

Gu

idel

ines

, E

ff. 7

-5-1

0*

(Appli

es t

o a

ll e

mplo

yee

s, s

tuden

ts, v

olu

nte

ers,

and a

gen

cy s

taff

whil

e on d

uty

on a

nd o

ff H

osp

ital

pre

mis

es)

(Acc

om

modat

ions

for

reli

gio

us

or

oth

er l

egit

imat

e re

ason

s w

ill

be

mad

e b

y H

um

an R

esourc

es o

n a

cas

e b

y c

ase

bas

is, if

nec

essa

ry)

Clo

thin

g;

Foot

wea

r; a

nd

Acc

esso

ries

Dep

artm

ents

/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Ban

dana

s or

”D

u” R

ag

s

NO

Bod

y Pi

erci

ngs:

Vis

ible

N

O

Blo

uses

: Rev

ealin

g, S

heer

N

O

Dre

sses

(No

shor

ter t

han

2 in

ches

abo

ve th

e kn

ee)

YES

Hat

/Hea

ddre

ss (A

ccep

tabl

e on

ly fo

r rel

igio

us o

r oth

er a

utho

rized

reas

ons)

N

O

ID B

adge

(Wea

r abo

ve th

e w

aist

; pho

to m

ust f

ace

forw

ard;

mus

t use

a re

com

men

ded

lany

ard,

cl

ip o

r non

-mag

netic

hol

der)

YE

S

Jew

elry

: Ear

rings

(Max

imum

2 e

arrin

gs p

er e

ar; n

ot m

ore

than

1 1

/2" i

n le

ngth

and

/or

diam

eter

) YE

S

Jew

elry

: Fac

ial (

Eye

brow

, nos

e, c

heek

, lip

jew

elry

) N

O

Jew

elry

: Gen

eral

(Not

func

tiona

lly re

stric

tive

or d

ange

rous

to jo

b pe

rform

ance

; not

hing

ex

cess

ive

or n

oisy

) YE

S

Pant

s: C

apri

NO

Pant

s: C

lose

Fitt

ing

Stre

tch

Pant

s (L

eggi

ngs,

Stir

rup)

N

O

Pant

s: D

enim

/Jea

ns (A

ll co

lors

) N

O

Pant

s: G

ener

al (A

nkle

leng

th/c

rop

or lo

nger

) YE

S

Clo

thin

g;

Foot

wea

r; a

nd

Acc

esso

ries

Dep

artm

ents

/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Pant

s: K

haki

YE

S

Unl

ess

othe

rwis

e di

rect

ed; M

ust b

e w

orn

with

shi

rt &

tie

Pant

s-Sw

eat

NO

Perf

ume/

Col

ogne

/Afte

r Sha

ve/H

and

Lotio

n (In

mod

erat

ion

or a

void

ed a

ltoge

ther

) YE

S

Polo

Shi

rt

NO

Scru

bs

NO

Shirt

s: M

idrif

f/Tan

k/H

alte

r N

O

Shoe

s: B

ackl

ess

(Mus

t pro

vide

saf

e, s

ecur

e fo

otin

g &

offe

r pro

tect

ion

agai

nst h

azar

ds)

YES

Shoe

s: S

anda

ls; F

lip F

lops

/Tho

ng

NO

Shor

ts

NO

Skirt

s-G

ener

al (M

ust b

e no

sho

rter t

han

2 in

ches

abo

ve th

e kn

ee)

YES

Snea

kers

/Ath

letic

Sho

es

NO

Snea

kers

-Hig

h To

p N

O

Sung

lass

es

NO

Swea

t sui

ts

NO

Tatto

os: V

isib

le

NO

U

nles

s m

odes

t/dis

cree

t

Clo

thin

g;

Foot

wea

r; a

nd

Acc

esso

ries

Dep

artm

ents

/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Ties

(Nea

t, pr

oper

ly ti

ed, a

nd w

orn

to th

e to

p sh

irt b

utto

n)YE

S

T-Sh

irts

NO

Wal

kman

s/R

adio

s/iP

ods/

Blu

e To

oth

devi

ces/

Hea

dset

s N

O

Ref

er t

o N

SL

IJH

S P

erso

nal

Appea

rance

poli

cy.

*S

ubje

ct t

o r

evis

ion.

APPENDIX S Psychology Training Table

Dire

ctor

of

Psyc

holo

gy

Trai

ning

Dr.

Elih

u Tu

rkel

FELL

OW

SHIP

(APA

)

INTE

RN

SHIP

EXTE

RN

SHIP

SER

VIC

E FE

LLO

WS

SER

VIC

E FE

LLO

WS

Dire

ctor

: Clin

ical

Ps

ycho

logy

Pro

gram

(Ger

oEm

phas

is)

Dr.

Ash

a P

atel

Neu

rops

ycho

logy

Dr.

Pau

l Mat

tis

Dire

ctor

: Clin

ical

C

hild

Pro

gram

Dr.

Pet

er D

’Am

ico

Neu

rops

ycho

logy

Tr

ack

Dr.

Pau

l Mat

tis

Chi

ld P

sych

olog

y Tr

ack

Dr.

Ste

ph

an

ie S

olo

w

Adul

t Psy

chol

ogy

Trac

kD

r. E

lihu

Tu

rke

l

Chi

ld P

sych

olog

yD

r. S

tep

ha

nie

So

low

Ger

opsy

chol

ogy

Dr.

Rita

Rya

n

Adul

t Psy

chol

ogy

Dr.

Jim

my

Kim

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

SS

UP

ER

VIS

ING

P

SY

CH

OLO

GIS

TS

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

SS

UP

ER

VIS

ING

PS

YC

HO

LOG

IST

S

Fe

llow

5 E

xte

rns

12

Ext

ern

s

4 E

xte

rns

3 E

xte

rns

Inte

rnIn

tern

Inte

rnIn

tern

Inte

rnIn

tern

Inte

rn

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

S

Inte

rnIn

tern

Inte

rnIn

tern

ETP

Dr.

Kris

ten

Can

dan

Col

lege

Dr.

Ca

nd

ice

La

Lim

a

OC

D &

Bip

olar

Dr.

An

tho

ny

Pin

toD

r. A

liosn

Gilb

ert

Tra

um

aD

r. M

aye

r B

elle

hse

n

2 E

xte

rns

10

Ext

ern

s

4 E

xte

rns

2 E

xte

rns

Fe

llow

Fe

llow

Su

bst

an

ce A

bu

seD

r. M

on

ica

Th

om

as

TB

A

CEN

TER

S FE

LLO

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APPENDIX T2018-19 Clinical Placements

Note: Interns names and universities are listed with their consent

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Handbook

for the

Doctoral Internship in Clinical Psychology

2019 – 2020


Director of Psychological Services Stewart Lipner, Ph.D. Director of Psychology Training and Adult Internship Track Elihu Turkel, Psy.D. Associate Director of Training, Clinical Child Psychology Stephanie Solow, Psy.D. Associate Director of Training, Clinical Neuropsychology Paul Mattis, Ph.D., ABPP

Clinical Psychology Internship Handbook 2019-2020

OVERVIEW ............................................................................................................................................... 3

EDUCATIONAL GOALS, THEIR ASSESSMENT, AND ASSESSMENT OF THE INTERNSHIP PROGRAM ............. 6

PROGRAM MODEL, GOAL, AND COMPETENCIES .................................................................................................... 6 DIVERSITY EDUCATION AND TRAINING ................................................................................................................. 7 COMMUNICATION WITH DOCTORAL PROGRAMS ................................................................................................... 7 TRAINEE SELF-DISCLOSURE ............................................................................................................................... 8 SUPERVISION .................................................................................................................................................. 9 ORIENTATION PERIOD ...................................................................................................................................... 9 PLACEMENTS AND SCHEDULE .......................................................................................................................... 10 WEEKLY ACTIVITY LOG ................................................................................................................................... 10 ASSESSING YOUR PROGRESS ............................................................................................................................ 11 DUE PROCESS ............................................................................................................................................... 12 WORK LOAD ................................................................................................................................................ 12 RECORD KEEPING .......................................................................................................................................... 13 GRIEVANCE PROCEDURE ................................................................................................................................. 13 TRAINEE CONDUCT ........................................................................................................................................ 13 CRITERIA FOR SUCCESSFUL COMPLETION OF THE INTERNSHIP ................................................................................. 14 EXTENDED TRAINING POLICY ........................................................................................................................... 14 CERTIFICATE OF COMPLETION .......................................................................................................................... 15 FEEDBACK ABOUT THE INTERNSHIP FROM INTERNS ............................................................................................... 15 RECORD KEEPING .......................................................................................................................................... 16

GENERAL ISSUES .................................................................................................................................... 16

PAID TIME OFF ............................................................................................................................................. 16 TIMEKEEPING ............................................................................................................................................... 17 SICK TIME .................................................................................................................................................... 18 CONFERENCE TIME ........................................................................................................................................ 19 BENEFITS ..................................................................................................................................................... 19 MEDICAL AND PSYCHIATRIC EMERGENCIES ......................................................................................................... 19 TELEPHONES ................................................................................................................................................ 20 VIRTUAL (PHONE LINE) VOICEMAIL: ................................................................................................................. 22 LONG DISTANCE PHONE CALLS ........................................................................................................................ 22 PAGERS ....................................................................................................................................................... 23 COMPUTERS AND PRINTERS ............................................................................................................................ 23

ADMINISTRATIVE ISSUES ....................................................................................................................... 25

PSYCHOLOGICAL SERVICES SECRETARIAL STAFF ................................................................................................... 25 PARKING (ZHH) ........................................................................................................................................... 26 TEXT ALERTS ................................................................................................................................................ 26 MAILBOXES .................................................................................................................................................. 27 FOOD ......................................................................................................................................................... 27 PAY ............................................................................................................................................................ 27 KEEPING TRACK OF WHERE YOU ARE ................................................................................................................ 28 FIRE ALARMS - ZHH ...................................................................................................................................... 28 KEYS ........................................................................................................................................................... 28 ACCESS TO INPATIENT UNITS AT ZHH ............................................................................................................... 28 CREDIT UNION ............................................................................................................................................. 29

APPENDIX LIST ....................................................................................................................................... 30


Overview

The Doctoral Internship in Clinical Psychology at Long Island Jewish Medical Center, The

Zucker Hillside Hospital (ZHH) affords an opportunity for training in diverse clinical settings located

at Zucker Hillside Hospital, The Cohen Children’s Medical Center (CCMC), Long Island Jewish

Hospital (LIJH) and North Shore University Hospital (NSUH). All these settings are part of Northwell

Health. The internship program has been accredited by the American Psychological Association (APA)

since 1979 and is accredited through 2020. (Our most recent site visit occurred in October 2013.)

Questions related to the program’s accredited status should be directed to the Commission on

Accreditation:

Office of Program Consultation and Accreditation American Psychological Association

750 1st Street, NE, Washington, DC 20002 Phone: (202) 336-5979 / E-mail: [email protected]

Web: www.apa.org/ed/accreditation

Hillside Hospital was initially founded in 1927 in Hastings-on-Hudson as “Hastings Hillside

Hospital.” Looking to expand its facility, the Hospital moved to Queens in 1942 and opened on the

Glen Oaks campus where it resides today. In 1972, Hillside merged with Long Island Jewish Hospital

to form “Long Island Jewish-Hillside Medical Center.” In 1983 Schneider Children’s Hospital was

established as another division of Long Island Jewish Medical Center along with the existing Hillside

Hospital and Long Island Jewish Hospital divisions. North Shore University Hospital (NSUH) and Long

Island Jewish Medical Center merged in 1997 to form the North Shore - LIJ Health System. In 2002

Hillside Hospital was renamed “Zucker Hillside Hospital” (ZHH) in recognition of the generosity of

the Zucker family’s support and their sponsorship of the Zucker Hillside Ambulatory Care Pavilion

(ACP). In 2010 Schneider Children’s Hospital was renamed the Steven and Alexandra Cohen

Children's Medical Center (CCMC) of New York. In 2016, the North Shore - LIJ Health System, was




renamed Northwell Health. Northwell Health is now New York’s largest private employer and

health care provider, with 23 hospitals and about 750 outpatient facilities.1

In 2013, Zucker Hillside Hospital opened a 130,000-square-foot, $125 million two-story

inpatient pavilion (the Behavioral Health Pavilion) which was constructed with the generous

support of North Shore-LIJ Health System trustees Donald and Barbara Zucker. It houses 115

inpatient beds — 22 for geriatric patients, 70+ for adults, and 21 for adolescents -- increasing ZHH

inpatient capacity to a total of 221 beds. This modern, patient-centered facility is surrounded by a

tranquil and sprawling environment that preserves the unique history of the Zucker Hillside campus,

located on the grounds of Long Island Jewish Medical Center (LIJMC).

In 2011, the Hofstra Northwell School of Medicine (now known as the Donald and Barbara

Zucker School of Medicine at Hofstra/Northwell) opened as the first new allopathic medical school

established in New York since 1963. Hofstra and Northwell Health have combined their respective

strengths and expertise, each sharing responsibility for the medical school's mission and success.

The new medical school combines Hofstra's academic infrastructure and expertise with Northwell's

clinical and graduate medical education programs. It also incorporates research conducted at The

Feinstein Institute for Medical Research, the research arm of Northwell Health. These components

provide the strong foundation for an excellent medical education experience.

The doctoral clinical psychology internship program began in 1966 with one half-time intern

at Hillside Hospital. The internship grew in size as did the psychology staff. By 1980 there were

eight psychology interns who took part in a general internship in clinical psychology. The size of

child and adolescent psychology staff expanded with the building of Schneider Children’s Hospital.

In 1986, the Clinical Child Track of the Internship was launched. Neuropsychology staff also

increased rapidly during this period and in 1987 the Clinical Neuropsychology Track was added.

1 "Northwell fact sheet dated May 2019" (PDF). Northwell About Us. May 2019. Retrieved 20 June 2019.



http://www.northshorelij.com/NSLIJ/lij




Additionally, the NSUH Hospital Department of Psychiatry was administratively subsumed under the

Department of Psychiatry at the Zucker Hillside Hospital in 2006 and its rich training resources were

added to the psychology internship program.

For the 2019-20 training year there are 11 interns: six in the Adult Psychology Track, three in

the Clinical Neuropsychology Track, and two in the Clinical Child Track. Approximately forty licensed

psychologists are involved in supervision and other training experiences for the internship. There

are over 400 alumni of the internship who occupy professional positions in academia, medical

centers, community mental health centers, the government, and other settings. Our psychology

postdoctoral fellowship programs – which include a program in Clinical Psychology with a

Geropsychology Emphasis and a specialty program in Clinical Child Psychology – have been

accredited by the American Psychological Association since 2005.

Zucker Hillside Hospital has an enviable history of research contributions in psychiatry and

psychology. In 1954, a Department of Experimental Psychiatry was established under the direction

of Max Fink, M.D. In 1959 Donald Klein, M.D. began his tenure as Director of Research during which

time some of the most influential psychopharmacological research of that era was conducted. In

1978 John Kane, M.D. became Director of Research. During the years that he directed the program

he and his colleagues garnered millions of dollars in funding from the National Institute of Mental

Health primarily to support research on Schizophrenia and other psychiatric disorders. Dr. Kane has

been Chairman of the Department of Psychiatry at the Medical Center since 1988 and is Vice

President of Behavioral Health Services for Northwell Health.

From the beginnings of Hillside Hospital to what has now evolved into the 20+ hospitals that

constitute Northwell Health, psychologists have played an integral role in clinical services and

research. We are delighted that you chose Long Island Jewish Medical Center - Zucker Hillside


Hospital for this very important year in your graduate education. You join a group of distinguished

individuals who have trained with us. We trust you will have a productive and satisfying year in the

internship.

Educational Goals, Their Assessment, and Assessment of the Internship Program

Program Model, Goal, and Competencies

The program is a practitioner-scholar model with the goal of developing competencies in

areas common to Health Service Psychology. The internship is designed to build upon a trainee’s

competencies in the recognized profession-wide competency areas. These include:

1. Research

2. Ethical and Legal Standards

3. Individual and Cultural Diversity

4. Professional Values, Attitudes, and Behaviors

5. Communication and Interpersonal Skills

6. Assessment

7. Intervention

8. Supervision

9. Consultation and Interprofessional/Interdisciplinary Skills

In addition to the above, our program also aims to develop program‐specific competencies

for interns admitted to each of the two specialty tracks. The competencies associated with the

Clinical Child Psychology and Neuropsychology internship tracks are:

• Competence in Clinical Neuropsychology (track specific)

• Competence in the principles of Clinical Child Psychology (track specific)


The Clinical Child Psychology track of the Internship is designed to adhere to the published

guidelines and recommendation for training in Clinical Child Psychology as articulated by the APA

Division 53’s Board of Directors. The Clinical Neuropsychology track of the Internship is designed to

adhere to guidelines recommended by the Houston Conference on Specialty Education and Training

in Neuropsychology (1998).

Diversity Education and Training

In accordance with the APA’s Standards of Accreditation (Standard II.A.2.c for internship

programs), the program implements a thoughtful and coherent plan to provide you with relevant

knowledge and experiences about the role of cultural and individual diversity in psychological

phenomena and professional practice. Cultural and individual diversity includes but is not limited to

age, disability, ethnicity, gender, gender identity, language, national origin, race, religion, culture,

sexual orientation, and social economic status. Consistent with Standard C-20-I, our program

integrates diversity into its didactic and experiential training which is based on the multicultural

conceptual and theoretical frameworks of worldview, identity, and acculturation, rooted in the

diverse social, cultural, and political contexts of society, and integrated into the science and practice

of psychology. You will be trained to respect diversity and to be competent in addressing diversity in

all professional activities including research, training, supervision/consultation, and service. The

program maintains a Diversity Training Council which includes trainees and which routinely reviews

the program’s education and training efforts in this area and takes steps to revise/enhance its

strategies as needed.

Communication with Doctoral Programs

We view the internship program as a partner to your graduate programs. Therefore,

evaluative communication must occur between the two training partners. Given this partnership, our


training program has adopted the practices included in the Communication Policy included in the

appendix.

Trainee Self-Disclosure

Consistent with the APA Ethical Principles of Psychologists and Code of Conduct (APA, 2010:

section 7.04), trainees are not required to disclose personal information within the supervisory

relationship or in educational seminars.

Since personal experiences, beliefs, and values may influence professional activities, an intern may

choose to disclose such information and is encouraged to do so as long as the intern believes that

the information has a bearing on professional functioning.

When appropriate, trainees are encouraged to explore historical influences and personal

information relevant to their clinical practice. Personal reactions in therapy sessions or seminars

may provide useful information about the progress of the treatment.

Voluntary personal disclosures that are pertinent to the trainee’s clinical role can be

valuable in a supervisory relationship. Trainees are encouraged to feel free to engage in personal

disclosures in supervision when they wish. The supervisory relationship is expected to be

characterized by mutual respect. Supervisors also may disclose personal experiences and reactions

if they are important in their clinical role, the supervisory alliance, or the trainee's competence.

Supervisors may notice significant incidents or patterns in intern professional behaviors that

suggests behaviors may be influenced by personal experiences, beliefs, and values. Supervisors may

ask interns to reflect on this in the specific context of promoting professional development.

Interns choose how much and what to disclose. Interns are not penalized for choosing not to

share personal information. Supervision is not psychotherapy.

As noted in the Ethical Principles, we may require self-disclosure of personal information

if the information is “necessary to evaluate or obtain assistance for students whose personal

problems could reasonably be judged to be preventing them from performing their training- or


professionally related activities in a competent manner or posing a threat to the students or

others” (APA, 2010).

Supervision

Each of you will receive at least 4 hours of supervision per week. One or more appropriately

trained and licensed doctoral level psychologists are involved in ongoing supervisory relationships

with each of you and have primary professional responsibility for the cases on which supervision is

provided. The supervisor(s) conduct at least 2 hours per week of individual supervision with you

during the course of the year. An intern will typically have different primary supervisors engaged in

providing individual supervision during the course of the training year. Supervisory hours beyond

the two hours of individual supervision can be in a group or individual format and are provided by

appropriately credentialed health care providers. The doctoral level psychologist supervisors

maintain overall responsibility for all supervision, including oversight and integration of supervision

provided by other mental health professionals with psychological research and practice.

Orientation Period

You will spend approximately one week at the start of the internship attending various

orientation presentations as well as learning your way around your placement settings and meeting

individually with supervisors. An orientation schedule will already have been sent to you before the

start of internship. Please make your best effort to engage fully in these experiences; it may be the

first impression you make on others here. There is a lot of new information to assimilate and we will

dedicate some meetings in July to review and to troubleshoot problems. You will be introduced to

the electronic medical record used at ZHH and to the staff at your various placements. Please make

an effort to learn the names of key personnel (e.g., clerical staff, staff in other disciplines, your

payroll timekeeper) and be sure to review emergency procedures and clinical coverage carefully

with your supervisors. There will be other required training modules over the course of the year.


Placements and Schedule

Your clinical placements have been selected carefully to balance your needs with available

training resources and service needs. You will likely have been informed of your specific placements

and any rotations before the start of the internship; a copy of all track’s placements may be found

in the Appendix. (Names and universities of current interns are listed with their consent.) Please

understand that changes sometime occur for reasons beyond our control; if a placement becomes

unavailable for any reason on an ongoing basis, we will work with you to select an alternative

placement during that time.

Once the orientation period ends, you are asked to create an Outlook calendar of your

schedule and to share it with your supervisors, your track leader and with the division secretary,

Ms. Sandy Arguello. This will make it easier for us to locate you if necessary and to plan meetings.

Please expect that at least 50% of your supervised experience will involve service-related

activities such as treatment/intervention, assessment, interviews, report writing, case

presentations, or consultations. At least 50% of service related activities will be direct client contact.

Supervision will be provided 10% of the total time worked per week. The specific breakdown of

treatment cases, assessments, case management, etc. will depend on your internship track and

your specific placements. Each supervisor will review the clinical experience at his/her placement

during the orientation week (or at the beginning of a new rotation). Please let your supervisor know

if anything is not clear about what is expected at that setting.

Weekly Activity Log

You are required to complete and sign a weekly log which indicates the time spent in various

training, clinical and administrative activities and to submit these logs to your track leader for co-

signature. These logs are filed and may be used for program analytics and in reporting to doctoral


programs, our accrediting bodies and upon attestation for licensure. A blank weekly log is included

in the appendix.

Assessing Your Progress

We understand that receiving constructive feedback about your performance is important.

This feedback includes assessment of your strengths as well as areas in which we feel you need

further development. Supervisors are encouraged to provide you with regular (formative) feedback

throughout the year and are specifically asked to give you formal (summative) feedback about your

performance when they discuss your progress in conjunction with their completion of the

Psychology Intern Competency Assessment Form. The Competency Assessment form is completed

by your supervisors at the conclusion of each major track rotation (i.e., in December and June ). The

Competency Assessment Form uses a series of graded evaluations reflecting increasing levels of skill

and professional independence. Evaluation is based on a combination of data sources including

direct observation (live or electronic), discussion, review of written work, case presentation, and

consultation with other staff. Your supervisors collaborate in guiding your experience and discuss

your progress in some of their track-specific meetings. Supervisors are also asked to discuss the

Competency Assessment Form with you and to provide verbal feedback. You will be asked to sign

the Competency Assessment Form acknowledging that it has been discussed with you. As noted, a

copy of the form is in the Appendix. At about the mid-way point through the internship, the director

of your respective track will write a letter to your graduate program’s Director of Clinical Training

summarizing your performance in the internship. The letter will be discussed with you by the track

director and you will be asked to co-sign the letter. We welcome a dialogue with your graduate

program and are happy to discuss any issues or concerns that the program may have. At the end of

the internship we will communicate with your graduate program about your progress in the

internship. Some graduate programs require that we send evaluations midyear and/or at the end of

internship.


Due Process

In the rare event that there are serious problems as an intern progresses through the

internship, Due Process Procedures for Psychology Interns have been outlined. A copy of these

procedures is in the Appendix. In essence, the procedures are designed to provide formal feedback

to the intern on what actions are required to help remediate serious problems in a series of graded

steps that involve relevant internship training staff.

Interns are employees of Northwell Health and are subject to corporate and Human

Resource policies. Interns are directed to hospital policies in general

(https://intranet.northwell.edu/NSLIJ/policies/Pages/default.aspx) and Human Resource policies

(https://intranet.northwell.edu/NSLIJ/hr/aboutus/HR%20PnP/Pages/default.aspx). All Northwell

policies are available on the employee intranet; you will have access to the intranet once you begin

the internship. There are some policy violations which are grounds for disciplinary action including

immediate dismissal. When issues of misconduct arise, our training program collaborates with the

Human Resources team to arrive at a resolution in a way that is as consistent as possible with our

training policies.

Work Load

The intern is expected to devote 32-37 hours per week (80% time) to clinical service delivery

(in the form of direct patient contact, documentation and related service such as consultation with

colleagues) and 4-8 hours per week (10-20% time, depending on track) in educational activities in

the form of didactics. Some weeks may exceed the above range, however, we aim for an average

that is reflected in a 40-50 hour work week. We attempt to inform incoming interns of their

assignments prior to the start date at which time much of the schedule will be described, however,

certain details of their time (e.g., which evening may be late) may only become clear as their

caseloads are filled. Please see the list of current assignments in the Appendix for more information

about their respective time requirements.








Record Keeping

Our program documents and permanently maintains accurate records of the interns’






Grievance Procedure

We hope that any problems related to the training program that might arise for interns will

be resolved informally, however there may be circumstances in which an intern feels that an issue

needs to be addressed in a formal way. A Grievance Procedure (a copy of which is in the appendix)

has been detailed for this purpose.

Trainee Conduct

Psychology staff and trainees are expected to follow the American Psychological

Association’s Ethical Principles of Psychologists and Code of Conduct 2002 with 2010 Amendments

(APA, 2010) a copy of which is in the Appendix. Further, staff and trainees are expected to follow

Personnel Guidelines for Conduct in Northwell Health’s Personnel Policies and Procedures Manual a

copy of which may be found on Northwell Health’s web site. Policies cover appearance (see

“Appearance Guidelines” in the Appendix) as well as conduct. All Northwell employees are required

to wear their badges visibly while on campus. The Northwell Health Employee Handbook will be

distributed during the orientation session run by the Department of Human Resources. Also, during






orientation the Director of Training will broadly review relevant institutional policies and procedures.

You will also be required to complete certain online training modules during the course of the year

as part of the annual training of all Northwell Health staff. Of note, in advance of the flu season (as

determined by the New York State Department of Health) all Northwell employees are required to

either receive the influenza vaccine or to wear a mask in all patient areas throughout the flu season.

Criteria for Successful Completion of the Internship

Each of the competencies and associated objectives are outlined in the Psychology Intern

Competency Assessment Form, a copy of which may be found in the appendix. We expect that all

of the relevant competency areas will be rated at an “Intermediate” level of competence or higher

at midyear. If by midyear a competency area is rated lower than “Intermediate”, we will work with

the trainee to develop a remediation plan. The goal for intern evaluations done at the end of the

internship is that at least 80% of the relevant competency areas will be rated at a “High

Intermediate” level or higher and that none will be lower than Intermediate.

Please review the competencies and if you have any questions, speak with the leader of

your respective internship track. Also note that we have included guidelines from the Council of

Chairs of Training Councils: Comprehensive Evaluation of Student Competence. We utilize the

principles of this document in evaluation of competencies that are related to interpersonal

behavior.


It is recognized that on occasion a psychology intern may not be able to complete all

requirements for the internship during the one year of paid employment because of medical

problems, maternity or extraordinary personal circumstances. Our policy regarding this may be

found in the Appendix.


Certificate of Completion

At the successful conclusion of the internship, each intern will receive a certificate attesting

to completion of the “Internship in Clinical Psychology”.

Feedback about the Internship from Interns

Feedback from interns about the internship has helped us to strengthen the program. At the

beginning of the internship year, interns are asked to select an intern representative to attend

monthly meetings of the Psychology Education and Training Committee and selected track-specific

training meetings where internship and other training matters are discussed. (Representatives may

rotate through the year.) The intern representatives solicit issues of concern from other interns that

can be shared with training leadership and also report back to interns on any new information or

policy changes. Time has been set aside for an optional monthly meeting of all psychology interns to

socialize and also review possible issues of concern with their intern representatives.

At approximately mid-year, the Training Director will meet with each of you individually to

“take the pulse” of your training experience. While it is understood that you may feel reluctant to

voice concerns while still an intern, you are encouraged to express your wishes and opinions which

may be useful in correcting or improving the experience for you or others. Intermittently

throughout the internship year, the Director of Psychology Training and track coordinators will

informally request feedback on issues of concern. In addition, please know that the Training

Director’s door is always open to consult or discuss any concerns.

Seminars are also evaluated. At the completion of an internship seminar or the end of the

year, interns are asked to complete seminar evaluation forms anonymously. Copies of these are

given to the seminar leaders and are discussed in training meetings in an effort to refine didactic

offerings.


At the end of the training year, all interns will be asked to complete an exit survey and will

have an exit interview with the Director of Psychological Services at which time further verbal and

written responses about the internship program are sought. (These responses are not identified by

source and are aggregated separately from the interns’ individual records.) Finally, interns will be

surveyed at least one year post internship as to the perceived usefulness of the internship program

in their subsequent professional activities and for requisite outcome data pertinent to APA

accreditation requirements.

Record Keeping

The program documents and permanently maintains accurate records of the interns’






General Issues Adult Track interns have offices on the second floor of the Kaufmann Building.

Neuropsychology Track Interns and Child Track Interns have offices in the lower level of the

Ambulatory Care Pavilion (ACP). These offices are on the ZHH campus and provide protected work

areas in addition to other office space made available for clinical work at the site of interns’ clinical

placements.

Paid Time Off


Interns currently accrue 20 days of paid time off and 8 designated national holidays. As per

Northwell Health policy for new hires, paid time is not available during the first three months of the

internship. The terms governing the accrual and use of paid time will be explained in detail during

orientation and/or at a specifically designated meeting. In general, prior to submitting a request for

time off, please discuss with your placement supervisors which dates you would like for vacation and

obtain their approval. Make sure that you take into consideration supervisors who you may not

have at the time of the request but who you will be working with when the request takes effect. (Do

not assume that you will automatically be allowed any requested time off; there may be

competition for popular dates or seasons and since service managers need to assure service

coverage, you may need to negotiate and/or compromise. You may also be tasked with arranging

coverage for your clinical duties while you are out. The earlier and more flexible your request is in

these circumstances, the more likely it is that the outcome will be successful.) Paid time off should

be requested in advance (except for extenuating circumstances) using a designated form (see

Appendix) submitted to the designated payroll manager who may differ depending on the intern’s

budget line. Please see the table of placements in the appendix to identify your payroll timekeeper.

We ask that you distribute your time off so that there is not a disproportionate amount of

coverage required on any one assignment, if possible. We ask that you do not take extended time

off during the last two weeks of internship in order to minimize service disruption and to avoid

lastminute problems. If there are extenuating circumstances, please speak with your track leader.

Northwell policy also prohibits “terminal leave”, i.e., taking off on the last day of work. Information

on paid time off (PTO) balances can be accessed online and can be obtained from the payroll office.

Interns with substantial work due at the end of the internship may have their internship attestation

withheld until all work is complete at the discretion of the Director of Psychology Training.

Timekeeping


Northwell Health has implemented automated workforce operations using Kronos® as it

eliminates manual paper-based timekeeping and scheduling processes. Kronos® utilizes daily

identification (i.e., badge swipe and finger imaging) to record work attendance, document time-off,

adjust work schedules and automate record-keeping for Payroll and Benefits purposes.

Psychology trainees are responsible for “badging in” (i.e., via badge-swipe and

fingerscan) once a day at one of the available Kronos stations. This signing-in indicates that the

trainee was at work that day. Unless there is also a communication of sick time or approved

paid time for that day, “badging in” will signify that the trainee worked the entire day. Any

permission to “flex” the time (e.g., leave early with no time off being deducted) must be

communicated clearly in an email by the manager with a copy to the time-keeper.

Every trainee will be bio-enrolled at a Kronos station and oriented as to how to badge in.

Efforts will be made by the TD to identify all Kronos stations that might be needed on any of the

trainee’s placements and they will added to the trainee’s profile.

Nevertheless, there may be circumstances in which travelling to an identified Kronos

station is counterproductive; in such cases, managers may allow trainees to “punch in”

electronically. If so, this must be done within the correct time frame and from a Northwell

Health device.

Sick Time Details regarding salary continuation during sick leave will be provided during your Benefits

orientation. If you are ill, you must notify the individual who is your designated “time keeper” (see

above) at the start of the business day and let the supervisors on your placements know that you

will not be in. You should also be prepared to cancel any patient appointments or – if impossible -

provide the necessary contact information to clerical staff. (It is advisable to keep a list of

deidentified phone numbers for patients and key supervisors whom you might need to contact in a

secure but accessible place.) You may be asked for a doctor’s note if you are out sick for three

consecutive business days. If you are out sick for longer than five consecutive business days, you


must apply for a medical leave through a third party insurer (you will receive details about this

during orientation) prior to or upon the commencement of such a leave in order to initiate a

“claim”. You must also notify the Director of Training of your request for leave. Before returning

from leave, you must be cleared for work by the Employee Health Service.

Conference Time

At the discretion of the Director of Psychology Training, up to five days of conference time

may be granted to interns to attend professional meetings and conferences. Make this request in

advance with supporting documentation (i.e., copy of a description of the conference). One of the

conference days may be used for doctoral dissertation oral defense.

Benefits

The details of the health benefits program will be discussed with you by the Department of

Human Resources, Benefits Office during the orientation period. (Please see the description of

current benefits at:

https://intranet.northwell.edu/NSLIJ/hr/Benefits/BenefitsByPop/2019%20Northwell%20Benefi

t%20Guide%20for%20Residents.pdf). Benefits eligibility begins on the first day of employment

although it may take some time to complete administrative matters before you obtain necessary

benefit documentation (e.g., health insurance card).

Medical and Psychiatric Emergencies

Administrative procedures exist for reporting and managing medical and psychiatric

emergencies and it is important that you are familiar with them. A copy of the procedures for

ambulatory services may be found in the Appendix and we urge you to have a copy of them with

you in the office(s) where you provide clinical services. Please also be sure to familiarize yourselves






with any additional procedures for medical and psychiatric emergencies that are specific to your

assigned clinical sites.

In the appendix you will find a document containing the Health System-wide standardized

hospital safety codes. Note, you are expected to use these terms when calling the operator for any

emergency, so it is imperative that you are consistent with system terminology. For example, a

medical emergency would be called in as a "rapid response." Many of these codes are not

applicable to our operation here at ZHH. Furthermore, ZHH does not have overhead paging in all

areas, as is the case in other locales. However, it is still important that you have a working

knowledge of these codes, even those that are not applicable at ZHH, because you may be present

in another facility when they are utilized.

Telephones

When making calls outside the hospital system, dial 9, wait for a dial tone, and dial the

telephone number needed. ZHH telephone numbers work with area codes of either 718 or 516

followed by 470-#### (NSUH telephone numbers are usually of the form: 516-562-####). If you are

calling an extension in the same hospital, you only need to dial the four-digit extension number. (If

you are making calls to patients from your personal phone, be careful to block “caller ID”, usually by

dialing *67.)

Office-Based Voicemail:

A voice mail system is available to take messages when you are not available to take a call.

As a general rule, interns should give their primary office phone number as the best place to

be reached during working hours. If you are away for any extended period of time during

regular business hours, you should access your phone messages from another phone.

To Establish an Outgoing Message dial 5800 within the hospital; (If calling from someone

else’s phone, enter # followed by your full 10-digit telephone number when prompted and


then) enter your password (please use “12345" as your password); Press 8 (or “U”) to

change your setup options. Please record the following greeting (by pressing 4 on the

previous menu):

“Hello, this is the office of (names). Please leave a message. If you believe this is an

emergency, dial 911 or go to the nearest emergency room. If you need to speak with a staff

person during regular business hours push zero.”

Note: interns with offices/extensions in the child psych clinic will also need to include

clinicspecific information in their phone messages

To Retrieve Messages: You will know you have a message because a red light at the top of

the phone is illuminated and the phone reads “message waiting”.

From Your Own Office Phone: Dial 5800, then password (”security code”). Press 7 to

listen to messages.

From Another Phone: Dial 5800, enter #, your 10—digit extension number, then

password. Press 7 to listen to messages.

From Outside the Hospital: Dial 718-470-5800, enter #, your 10-digit extension number,

then password. Press 7 to listen to messages.

If you don’t want to be disturbed: Lift receiver, press “FWDA” button, enter 5800, and then

hang up. Your calls will automatically be directed into your voice mail box without ringing

your telephone.

For patients to whom your phone number is given the following should be told:

Emergency messages should not be left on your Voice Mail since there is no guarantee

that you will receive the message quickly during the day nor will the system be accessed

necessarily after hours or on weekends. Discuss with each of your placement


supervisors what instructions should be given to patients for emergencies during the

day, after-hours, and on weekends.

If you are sharing an office phone, patients should know that any message that is left

might be heard by this third party.

It is preferred that each intern access and delete his or her messages at least daily. (You

can, however, skip over messages without erasing them by pressing 8.)

Virtual (Phone Line) Voicemail:

Since the Adult and Neuropsychology Track Interns usually share office phones, a phone tree

will be set up which will allow outside callers to leave confidential messages for any of these interns

by calling 718/516-470-8490 and selecting the intern’s name from a menu. To retrieve these

messages, dial 5800 (or 718-470-5800 from outside), * and # and then enter an assigned mailbox

number when prompted. (the mailbox numbers will be distributed as soon as they are assigned.)

Remember, there is no physical phone associated with these numbers. Again, please make sure your

patients understand how frequently you check for these messages. You will not see any physical

notification that a message has been left for you on this line, so you will need to establish a routine

for checking for messages. In the Appendix you will find a summary of features of the phone

message system.

Long Distance Phone Calls

In the course of the internship year you may be given a PIN number through which you can

make long distance business calls. Press 20, then the PIN, then 9-1- and the long distance phone

number. Medical Center placed long distance phone calls – as all other calls - should only be made

for Medical Center business.


Pagers

All interns are assigned pagers. Most currently issued pagers are dual use; they function as

long-range as well as within-hospital pagers. You will receive instructions about using your pagers.

Be sure to check that your pager’s battery is functioning and that it is activated each day; discuss

expectations regarding after-hours availability with your placement supervisors. You are expected

to respond promptly when paged. We are currently exploring the possibility of offering you access

to a mobile app which replaces the pager if you wish.

Computers and Printers

Computer Hardware: Each intern office is equipped with a networked computer

workstation containing a desktop computer, local drive storage, a CD-ROM drive and a monitor. The

operating system is currently either Windows 7 Professional or Windows 10 and the workstations

are networked through a series of Northwell Health servers. You will be assigned a username and

password which will be required when you log on to the network. Since there may be more interns

than computers, interns are expected to share these resources. You will be able to log in to the

network from any computer in the system but you must obtain permission from the computer’s

primary user if it is not yours. You will be directed to save your work on a dedicated network drive.

Hospital policy limits the distribution, duplication and destruction of electronic information. Please

familiarize yourself with Information Services (IS) policies:

https://intranet.northwell.edu/NSLIJ/departments/IS/Toolbox/Pages/default.aspx. A copy

of the email policy of Northwell Health is in the Appendix. Report any error messages to

Information Systems (IS) (at extension 7272). IS service requests can be made here:

https://intranet.northwell.edu/NSLIJ/departments/IS/Pages/SubmitISTicket.aspx.

Software: You will find that your computer already has essential software installed. This

includes the programs which are part of Microsoft Office (i.e., Word, Excel, Access, and Outlook) as

well as Internet Explorer. There may be icons on your desktop which are not operational.






Limitations on users’ privileges restrict installation and remote access.

Zucker Hillside Hospital currently uses proprietary software, MyAvatar, for creating and

reading the Electronic Medical Record (EMR). You will learn about this system and receive more

detailed documentation in separate orientation during your orientation period. Some of you may be

directed to request access to other EMR systems depending on your placements.

Connectivity: Each intern will have broadband access to the internet from the desktop. The

browser that is already installed on the computer is Microsoft's Internet Explorer. Try exploring our

own training pages: https://www.northwell.edu/research-and-education/graduate-

medicaleducation/training-program-psychology-northwell-health and Northwell Health website

(https://www.northwell.edu). Please note that computer use (like use of any hospital equipment) is

intended for work purposes only. Northwell Health’s IS team blocks access to certain websites and

monitors internet use.

Interns are encouraged to familiarize themselves with the website of Northwell Health that

is dedicated to staff which may be accessed by typing “intranet.northwell.edu” into the browser

address field. Hospital policies, library reference material, employee alerts, information about

benefits and other important material may be accessed at this site. This website also affords remote

access to Outlook email and calendar.

E-mail: As part of your setup, you will be issued an email account. Once an email id is

activated (usually the first initial followed by the first seven letters of your last name and

“@northwell.edu”), Microsoft Outlook will automatically open your profile when you log in

anywhere in the network. You are expected to check your Outlook email regularly; you are expected

to keep your schedule current on Outlook as well. Please contact IS staff at telephone extension

7272 if you require help in this matter. There is a “global directory” available in Outlook which is

useful for accessing any networked staff member via email.

Library Services: The hospital provides access to several searchable academic and medical

databases using OVID, Micromedex, MDConsult, Up-To-Date, Google Scholar, PubMed and many

other resources. There are some journals with full text articles available online through this service.

Additionally, many searches indicate which results are available at LIJ libraries and allows you to









Email, print or save the results of a search. A more extensive discussion and demonstration of these

resources will take place during orientation.

Printing:

ZHH-Kaufmann: All computers in the intern offices at the Kaufmann building should be

configured to send output to the network printer in the Xerox room on the second floor (Room

217D). This may need to be updated once after you log on for the first time; if you know how to

"add a network printer", select "\\xprt01\nh755-kauf02 ". Otherwise, contact the IS help desk at

extension 7272. The printer in Kaufmann 217D also serves as a fax machine and network scanner.

Child Psychology and Neuropsychology interns may have printers in individual offices and

may also be connected to local network printers.

Administrative Issues

Psychological Services Secretarial Staff The Psychology Office’s secretary is Ms. Sandy Arguello (extension 8390). She will assist you

with day-to-day requests such as obtaining office supplies, recording your hours, maintenance

problems in your office, trouble-shooting, and routine administrative issues. If there are issues that

the secretary is unable to resolve, contact Dr. Turkel (at 470-8387). Neuropsychology and Child

track interns are housed in the lower level of the ACP. If there are problems related to offices there,

the front desk at the child clinic may also be asked for assistance.

Neuropsychology Interns: Neuropsychology interns are usually only at the ZHH campus on

Wednesdays. The rest of the week, they may seek assistance from clerical staff at their primary

work site (1554 Northern Boulevard). Ms. Meghan McDonald (at 516-477-2517) may be helpful with

payroll issues.


Child Interns: Administrative and office-related issues are handled locally by the designated

person, Ms. Reena Carmen, Program Director (470-8437) as well as Jeannine Todaro, Office

Manager (470-3529) at the Office of Child and Adolescent Psychiatry in the Clinic area of the ACP

(room 270).

Parking (ZHH)

There are several options for parking at ZHH. To park in any of the designated Zucker Hillside

parking lots you must get a sticker for your car. You will be directed to obtain this sticker during the

orientation period. Your badge will be programmed to open the gates to the ZHH campus. (A) The Parking Garage: A seven-floor indoor parking garage is available for the use of

staff at LIJ, The Zucker Hillside Hospital and the Cohen Children’s Medical Center. This garage is

accessed via 74th avenue (east of 263rd Street). Your ID Badge will be needed for you to drive in and

out of this garage. This is the preferred parking area for staff. Please note that after 8am it becomes

very difficult to find a spot.

(B) On-Campus Parking: The On-Campus Parking Lot is located in the large open area on

the east side of the Kaufmann Building. A guard checks that cars in this lot have the appropriate

staff sticker. Be sure to park only in spaces that are not explicitly reserved. (There is reserved

parking for those with handicapped permits as well as reserved parking for licensed medical staff.)

If you park in a space that is not for you, security will put a hard-to-scrape-off notice on the driver’s

side indicating you have parked illegally! There are parking spots in other areas of the campus but it

is important to confirm with security that you may park in those areas before doing so.

(C) There is also ample parking available on the local streets.

Text Alerts

Interns may sign up at:

https://nslijhp.northshorelij.com/NSLIJ/departments/HSIDE/Lists/TextAlertRequest/TextAlertReq_F

orm.aspx?source=/NSLIJ/Utilities/SubmittedFormResults.aspx?formsstatus=sent to receive text






messages of hospital news, announcements and upcoming events. Interns may also enter their

preferred cell-phone number on the Employee Self Service site to receive for rapid communication

from the system.

Mailboxes

Mailboxes are provided for all of the psychology interns in Psychological Services office in

the Kaufmann Building at ZHH (room 205). Mail should be checked regularly especially for those

interns who spend large amounts of time away from the Kaufmann Building. Interns may have

additional mailboxes at specific clinical placement areas outside of Kaufmann.

Food

There is a small food service area in the Au Bon Pain located on the main floor of the

Ambulatory Care Pavilion. Its hours of operation are 8:30AM – 4PM on Monday through Friday.

There are also vending machines there and in locations at the Littauer Building. The Cohen

Children’s Medical Center has a large cafeteria on the lower level and there is a kosher cafeteria at

the Parker Jewish Geriatric Center (located past Long Island Jewish Hospital on Lakeville Road). A

refrigerator and microwave are available for use in the Kaufmann building second floor. (Please do

not use the refrigerator to store food for longer than a few days.) A refrigerator and microwave are

also available in the Child Clinic.

Pay

Trainees are paid on a semi-monthly basis (i.e., on the 7th and 22nd of the month). All

payments are through direct deposit which you will be guided to set up at the start of the

internship. You will be shown how you may access your virtual paychecks and paystubs (and other

benefits-related information) through Northwell Health’s intranet.




Keeping Track of Where You Are

Historically, it has been a challenge to keep track of the whereabouts of all of our interns.

Please share your Outlook calendar with the division secretary (Ms. Arguello) as well as with your

supervisors and track leaders. Keep this updated as your schedule changes. If your personal address

or phone number changes during the internship year, kindly notify the secretary. Also, please obtain

replacement batteries for your pager as needed from the secretary.

Additionally, a "call list" may be assembled and distributed for use in the event of any critical

incidents that require rapid communication of instructions. We may activate the call list in a trial

mode to confirm that it is operational.

Fire Alarms - ZHH

At the Zucker Hillside Hospital, alarms will sound in the building where a fire alarm has been

triggered and everyone is required to evacuate that building according to protocol upon hearing

that alarm. You are responsible to learn (from your supervisor) what the evacuation protocol is for

each clinical area to which you are assigned and to ask how you can be of service should the

situation arise. The policy regarding fire safety may be found on Healthport or at:

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%

20Life%20Safety%20Management%20Plan.pdf.

Keys Keys for offices and units can be obtained from the clerical staff in charge of your office

area. The secretary in conjunction with your track director will determine from your placement

schedule which keys you need during your clinical assignments.

Access to Inpatient Units at ZHH






All interns will have access to and egress from the inpatient units on the ZHH campus. Entry

to the units is achieved via the ID badge swipe. Egress from units is via ID badge swipe and

keypunch of the intern’s PIN (i.e., mmdd from your Date of Birth) followed by the pound (#) sign.

Inpatient units are equipped with double doors which must be opened and closed in sequence to

prevent patient elopement. Interns will also be briefed about precautions taken while entering and

exiting patient units.

Credit Union

You are eligible to use the services of the Bethpage Federal Credit Union (BFCU) including

direct deposit of your check into the credit union. Bethpage FCU is one of the country’s leading

community credit unions and the largest in New York State, serving the Long Island community for

75 years. If you open an account, you will have full access to all Bethpage branches as well as the

Bethpage call center and Bethpage Online Banking. Bethpage has 33 full-service branches across

Long Island and one in midtown Manhattan. To learn more about Bethpage products and services,

visit https://www.bethpagefcu.com/ or any Bethpage branch. To find a local Bethpage branch, visit

http://www.bethpagefcu.com/branches-atms.aspx?src=top_nav.

The Division of Psychological Services is happy to welcome you to what we hope is an enjoyable and stimulating year. This handbook has been designed to help you cope with all the information you will be getting at the beginning of the internship. It does not provide the answers to all of your questions, but we hope it will orient you and help you know where to find answers. It is always good to start with your

supervisors or the internship training director. Do not be embarrassed to ask questions or to request help with clinical or administrative problems.








APPENDIX LIST

A. Psychology Intern Competency Assessment Form

B. Comprehensive Evaluation of Student Competence

C. Communication Policy Between Internship and Doctoral Programs

D. Grievance Procedure

E. Due Process Procedures for Psychology Interns

F. Extended Training Policy

G. Weekly Activity Log (blank)

H. Professional Standards and Guidelines (distributed electronically):

1. APA 2002 Ethical Principles of Psychologists and Code of Conduct

2. Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients

3. PsycARTICLES - Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists

4. Enhancing Your Interactions with People with Disabilities

I. Phone System Information

J. Vacation Request Form

K. Summary of Benefits

L. Fire safety information

M. Hospital Safety Codes

N. Map of Zucker Hillside Hospital campus

O. Ambulatory Emergency Procedures

P. EMAIL Policy

Q. Appearance Guidelines

R. Training Table of Organization

S. Table of 2019-20 Clinical Placements

APPENDIX A


COMPETENCY RATINGS DESCRIPTIONS

NA Not applicable for this training experience/Not assessed during training experience

A Advanced/Skills comparable to autonomous practice at the licensure level. Rating expected at completion of postdoctoral training. Competency attained at full psychology staff privilege level, however as an unlicensed trainee, supervision is required while in training status.

HI High Intermediate/Occasional supervision needed. A frequent rating at completion of internship. Competency attained in all but non-routine cases; supervisor provides overall management of trainee's activities; depth of supervision varies as clinical needs warrant.

I Intermediate/Should remain a focus of supervision Common rating throughout internship and practica. Routine supervision of each activity.

E Entry level/Continued intensive supervision is needed Most common rating for practica. Routine, but intensive, supervision is needed.

R Needs remedial work

INTERNSHIP IN CLINICAL PSYCHOLOGY LONG ISLAND JEWISH MEDICAL CENTER – THE ZUCKER HILLSIDE HOSPITAL

PSYCHOLOGY INTERN COMPETENCY ASSESSMENT FORM

Trainee ___________________ Supervisor ____________________ Training Year ___________

Training Period: Training Experience __________________________________________

ASSESSMENT METHOD(S) FOR COMPETENCIES _____ Direct Observation _____ Review of Written Work _____ Videotape _____ Review of Raw Test Data _____ Audiotape _____ Discussion of Clinical Interaction _____ Case Presentation _____ Comments from Other Staff

AREA (AS PER SOA)


RESEARCH

Demonstrates the substantially independent ability to critically evaluate and disseminate research or other scholarly activities (e.g., case conference, presentation, publications) at the local (including the host institution), regional, or national level.

A HI I E R NA

ETHICAL AND LEGALSTANDARDS

Is knowledgeable of and acts in accordance with each of the following: the current version of the APA Ethical Principles of

Psychologists and Code of Conduct; relevant laws, regulations, rules, and policies

governing health service psychology at theorganizational, local, state, regional, and federallevels; and

relevant professional standards and guidelines.

A HI I E R NA

Recognizes ethical dilemmas as they arise, and applies ethical decision-making processes in order to resolve the dilemmas.

A HI I E R NA

Conducts self in an ethical manner in all professional activities. A HI I E R NA


AREA (AS PER SOA)


INDIVIDUAL AND CULTURAL DIVERSITY

Demonstrates: an understanding of how his/her own

personal/cultural history, attitudes, and biases mayaffect how he/she understands and interacts withpeople different from him/herself;

demonstrates knowledge of the current theoreticaland empirical knowledge base as it relates toaddressing diversity in all professional activitiesincluding research, training,supervision/consultation, and service;

demonstrates the ability to integrate awareness andknowledge of individual and cultural differences inthe conduct of professional roles (e.g., research,services, and other professional activities). Thisincludes the ability apply a framework for workingeffectively with areas of individual and culturaldiversity not previously encountered over the courseof his/her career. Also included is the ability towork effectively with individuals whose groupmembership, demographic characteristics, orworldviews create conflict with his/her own

A HI I E R NA

Demonstrates the ability to independently apply his/her knowledge and approach in working effectively with the range of diverse individuals and groups encountered during internship.

A HI I E R NA

PROFESSIONAL VALUES,ATTITUDES AND

BEHAVIOR

Engages in self-reflection regarding one’s personal and professional functioning; A HI I E R NA

Engages in activities to maintain and improve performance, well-being, and professional effectiveness A HI I E R NA

Actively seeks and demonstrates openness and responsiveness to feedback and supervision. A HI I E R NA Responds professionally in increasingly complex situations with a greater degree of independence as (s)he progresses across levels of training.

A HI I E R NA

COMMUNICATION AND INTERPERSONAL SKILLS

Develops and maintains effective relationships with a wide range of individuals, including colleagues, communities, organizations, supervisors, supervisees, and those receiving professional services.

A HI I E R NA

Produces and comprehends oral, nonverbal, and written communications that are informative and well-integrated; demonstrates a thorough grasp of professional language and concepts.

A HI I E R NA

Demonstrates effective interpersonal skills and the ability to manage difficult communication well. A HI I E R NA


AREA (AS PER SOA)


ASSESSMENT

Selects and applies assessment methods that draw from the best available empirical literature and that reflect the science of measurement and psychometrics; collects relevant data using multiple sources and methods appropriate to the identified goals and questions of the assessment as well as relevant diversity characteristics of the service recipient.

A HI I E R NA

Interprets assessment results, following current research and professional standards and guidelines, to inform case conceptualization, classification, and recommendations, while guarding against decision-making biases, distinguishing the aspects of assessment that are subjective from those that are objective.

A HI I E R NA

Communicates orally and in written documents the findings and implications of the assessment in an accurate and effective manner sensitive to a range of audiences.

A HI I E R NA

INTERVENTION

Establishes and maintains effective relationships with the recipients of psychological services. A HI I E R NA

Develops evidence-based intervention plans specific to the service delivery goals. A HI I E R NA

Implements interventions informed by the current scientific literature, assessment findings, diversity characteristics, and contextual variables.

A HI I E R NA

Demonstrates the ability to apply the relevant research literature to clinical decision making. A HI I E R NA

Modifies and adapts evidence-based approaches effectively when a clear evidence-base is lacking, A HI I E R NA

Evaluates intervention effectiveness, and adapts intervention goals and methods consistent with ongoing evaluation

A HI I E R NA

SUPERVISION Applies knowledge of supervision models and practices in direct or simulated practice with psychology trainees, or other health professionals.

A HI I E R NA

CONSULTATION AND INTERPROFESSIONAL INTERDISCIPLINARY

SKILLS

Demonstrates knowledge and respect for the roles and perspectives of other professions. A HI I E R NA

Applies this knowledge in direct or simulated consultation with individuals and their families, other health care professionals, interprofessional groups, or systems related to health and behavior.

A HI I E R NA


AREA (AS PER SOA)


TRACK SPECIFIC AREA: CLINICAL

NEUROPSYCHOLOGY

Demonstrates knowledge of neuropsychological and developmental theory and theories of cognitive processing

A HI I E R NA

Demonstrates knowledge of neuropsychological assessment and consultation A HI I E R NA Demonstrates capacity to administer and score tests of cognitive functioning A HI I E R NA Demonstrates knowledge of brain-behavior relationships and neurological, psychiatric and medical disorders that have cognitive consequences

A HI I E R NA

Demonstrates capacity to integrate psychological and neuropsychological theories/thought. A HI I E R NA Demonstrates knowledge of evidence based cognitive remediation treatments A HI I E R NA

TRACK SPECIFIC AREA: CLINICAL CHILD

PSYCHOLOGY

Demonstrates knowledge of empirically supported assessment, treatments, and appropriate treatment matching for children and adolescents.

A HI I E R NA

SUPERVISOR COMMENTS

SUMMARY OF STRENGTHS

AREAS OF ADDITIONAL DEVELOPMENT OR REMEDIATION, INCLUDING RECOMMENDATIONS


CONCLUSIONS

GOAL: PRIOR TO 12 MONTHS GOAL: AT 12 MONTHS

All competency areas will be rated at a level of competence of I or higher. No

competency areas will be rated as R or E.

At least 80% of competency areas will be rated at level of HI or higher. No competency areas will be rated as R or E. Note:

exceptions would be specialty area rotations that would take a more intensive course of study to achieve this level of competency and the

major supervisor, training director and trainee agree that a level of I is appropriate for that particular rotation, e.g. a neuropsychology

rotation for a general track trainee. The trainee HAS successfully completed the above goal. We have reviewed this

evaluation together. The trainee HAS NOT successfully completed the above goal. We have made a joint

written remedial plan as attached, with specific dates indicated for completion. Once completed, the rotation will be re-evaluated using another evaluation form, or on this form, clearly marked with a different color ink. We have reviewed this evaluation together.

Supervisor ________________________________ Date ___________ TRAINEE COMMENTS REGARDING COMPETENCY EVALUATION (IF ANY): I have received a full explanation of this evaluation. I understand that my signature does not necessarily indicate my agreement. Trainee ____________________________________ Date ___________

REMEDIAL WORK INSTRUCTIONS In the rare situation when it is recognized that a trainee needs remedial work, a competency assessment form should be filled out immediately, prior to any deadline date for evaluation, and shared with the trainee and the director of training. In order to allow the trainee to gain competency and meet passing criteria for the rotation, these areas must be addressed proactively and a remedial plan needs to be devised and implemented promptly.

APPENDIX B

The Comprehensive Evaluation of Student-Trainee Competence in

Professional Psychology Programs

I. Overview and Rationale

Professional psychologists are expected to demonstrate competence within and across a number

of different but interrelated dimensions. Programs that educate and train professional

psychologists also strive to protect the public and profession. Therefore, faculty, training staff,

supervisors, and administrators in such programs have a duty and responsibility to evaluate the

competence of students and trainees across multiple aspects of performance, development, and

functioning.

It is important for students and trainees to understand and appreciate that academic competence

in professional psychology programs (e.g., doctoral, internship, postdoctoral) is defined and

evaluated comprehensively. Specifically, in addition to performance in coursework, seminars,

scholarship, comprehensive examinations, and related program requirements, other aspects of

professional development and functioning (e.g., cognitive, emotional, psychological,

interpersonal, technical, and ethical) will also be evaluated. Such comprehensive evaluation is

necessary in order for faculty, training staff, and supervisors to appraise the entire range of

academic performance, development, and functioning of their student-trainees. This model

policy attempts to disclose and make these expectations explicit for student-trainees prior to

program entry and at the outset of education and training.

In response to these issues, the Council of Chairs of Training Councils (CCTC) has developed

the following model policy that doctoral, internship, and postdoctoral training programs in

psychology may use in their respective program handbooks and other written materials (see

http://www.apa.org/ed/graduate/cctc.html). This policy was developed in consultation with

CCTC member organizations, and is consistent with a range of oversight, professional, ethical,

and licensure guidelines and procedures that are relevant to processes of training, practice, and

the assessment of competence within professional psychology (e.g., the Association of State and

Provincial Psychology Boards, 2004; Competencies 2002: Future Directions in Education and

Credentialing in Professional Psychology; Ethical Principles of Psychologists and Code of

Conduct, 2002; Guidelines and Principles for Accreditation of Programs in Professional

________________________________________ This document was developed by the Student Competence Task Force of the Council of Chairs of Training Councils (CCTC) (http://www.apa.org/ed/graduate/cctc.html) and approved by the CCTC on March 25, 2004. Impetus for this document arose from the need,

identified by a number of CCTC members that programs in professional psychology needed to clarify for themselves and their student-trainees

that the comprehensive academic evaluation of student-trainee competence includes the evaluation of intrapersonal, interpersonal, and professional development and functioning. Because this crucial aspect of academic competency had not heretofore been well addressed by the

profession of psychology, CCTC approved the establishment of a "Student Competence Task Force" to examine these issues and develop

proposed language. This document was developed during 2003 and 2004 by a 17-member task force comprised of representatives from the various CCTC training councils. Individuals with particular knowledge of scholarship related to the evaluation of competency as well as relevant

ethical and legal expertise were represented on this task force. The initial draft of this document was developed by the task force and distributed

to all of the training councils represented on CCTC. Feedback was subsequently received from multiple perspectives and constituencies (e.g., student, doctoral, internship), and incorporated into this document, which was edited a final time by the task force and distributed to the CCTC

for discussion. This document was approved by consensus at the 3/25/04 meeting of the CCTC with the following clarifications: (a) training

councils or programs that adopt this "model policy" do so on a voluntary basis (i.e., it is not a "mandated" policy from CCTC); (b) should a training council or program choose to adopt this "model policy" in whole or in part, an opportunity should be provided to student-trainees to

consent to this policy prior to entering a training program; (c) student-trainees should know that information relevant to the evaluation of

competence as specified in this document may not be privileged information between the student-trainee and the program and/or appropriate representatives of the program.



Psychology, 2003; Guidelines on Multicultural Education, Training, Research, Practice, and

Organizational Change for Psychologists, 2002).

II. Model Policy

Students and trainees in professional psychology programs (at the doctoral, internship, or

postdoctoral level) should know – prior to program entry, and at the outset of training – that

faculty, training staff, supervisors, and administrators have a professional, ethical, and potentially

legal obligation to: (a) establish criteria and methods through which aspects of competence other

than, and in addition to, a student-trainee's knowledge or skills may be assessed (including, but

not limited to, emotional stability and well being, interpersonal skills, professional development,

and personal fitness for practice); and, (b) ensure – insofar as possible – that the student-trainees

who complete their programs are competent to manage future relationships (e.g., client, collegial,

professional, public, scholarly, supervisory, teaching) in an effective and appropriate manner.

Because of this commitment, and within the parameters of their administrative authority,

professional psychology education and training programs, faculty, training staff, supervisors, and

administrators strive not to advance, recommend, or graduate students or trainees with

demonstrable problems (e.g., cognitive, emotional, psychological, interpersonal, technical, and

ethical) that may interfere with professional competence to other programs, the profession,

employers, or the public at large.

As such, within a developmental framework, and with due regard for the inherent power

difference between students and faculty, students and trainees should know that their faculty,

training staff, and supervisors will evaluate their competence in areas other than, and in addition

to, coursework, seminars, scholarship, comprehensive examinations, or related program

requirements. These evaluative areas include, but are not limited to, demonstration of sufficient:

(a) interpersonal and professional competence (e.g., the ways in which student-trainees relate to

clients, peers, faculty, allied professionals, the public and individuals from diverse backgrounds

or histories); (b) self-awareness, self-reflection, and self-evaluation (e.g., knowledge of the

content and potential impact of one's own beliefs and values on clients, peers, faculty, allied

professionals, the public, and individuals from diverse backgrounds or histories); (c) openness to

processes of supervision (e.g., the ability and willingness to explore issues that either interfere

with the appropriate provision of care or impede professional development or functioning); and

(d) resolution of issues or problems that interfere with professional development or functioning

in a satisfactory manner (e.g., by responding constructively to feedback from supervisors or

program faculty; by the successful completion of remediation plans; by participating in personal

therapy in order to resolve issues or problems).

This policy is applicable to settings and contexts in which evaluation would appropriately occur

(e.g., coursework, practica, supervision), rather than settings and contexts that are unrelated to

the formal process of education and training (e.g., non-academic, social contexts). However,

irrespective of setting or context, when a student-trainee's conduct clearly and demonstrably (a)

impacts the performance, development, or functioning of the student-trainee, (b) raises questions

of an ethical nature, (c) represents a risk to public safety, or (d) damages the representation of

psychology to the profession or public, appropriate representatives of the program may review

such conduct within the context of the program's evaluation processes.

Although the purpose of this policy is to inform students and trainees that evaluation will occur

in these areas, it should also be emphasized that a program's evaluation processes and content

should typically include: (a) information regarding evaluation processes and standards (e.g.,

procedures should be consistent and content verifiable); (b) information regarding the primary

purpose of evaluation (e.g., to facilitate student or trainee development; to enhance

self-awareness, self-reflection, and self-assessment; to emphasize strengths as well as areas for

improvement; to assist in the development of remediation plans when necessary); (c) more than

one source of information regarding the evaluative area(s) in question (e.g., across supervisors

and settings); and (d) opportunities for remediation, provided that faculty, training staff, or

supervisors conclude that satisfactory remediation is possible for a given student-trainee. Finally,

the criteria, methods, and processes through which student-trainees will be evaluated should be

clearly specified in a program's handbook, which should also include information regarding due

process policies and procedures (e.g., including, but not limited to, review of a program's

evaluation processes and decisions).

APPENDIX C

Policy Regarding Communication Between the Internship and Doctoral Program Training Directors

Communication between doctoral training programs and internship programs is of critical importance to the

overall development of competent new psychologists. The doctoral internship is a required part of the doctoral

degree, and while the internship faculty assess the student performance during the internship year, the doctoral

program is ultimately responsible for evaluation of the student’s readiness for graduation and entrance to the

profession.

Therefore, evaluative communication must occur between the two training partners. Given this partnership,

our training program has adopted the following practices:

• All students will be informed of the practice of communication between the doctoral program Training

Director/Director of Clinical Training (or faculty designate) and internship Training Director (or designate).

It should be emphasized that this communication is consistent with discussion among trainers throughout

the students’ graduate training (e.g., practicum supervisors).

• Once a student has been matched with an internship site, the internship and doctoral program Directors will

communicate about the specific training needs of the student, so that the internship Director has sufficient

information to make training decisions to enhance the individual student’s development.

• During the internship year, the Directors of the two programs will communicate as necessary to evaluate

progress in the intern’s development. This will include a minimum of two formal evaluations (one at mid-

year and one at the end of the year), and may also include regular formal (written) or informal

communication.

• The student/intern has the right to know about any written communication that occurs and can also request

and should receive a copy of any written information that is exchanged. The intern will be given a signed

copy of his/her formal evaluation following a formal feedback meeting. The intern will be asked to co-sign

the evaluation and may add comments, after which a copy will be mailed to the doctoral program Training

Director/Director of Clinical Training.

• In the event that problems emerge during the internship year, i.e., an intern fails to make expected progress,

the Directors of the two programs will communicate and document the concerns and the planned resolution

to those concerns. Both doctoral training program and internship program policies for resolution of training

concerns will be considered in developing necessary remediation plans. Progress in required remediation

activities will be documented and that information will be communicated to the doctoral program Director.

APPENDIX D

Rev. 6/24/16


Long Island Jewish Medical Center, The Zucker Hillside Hospital Northwell Health PSYCHOLOGY TRAINEE GRIEVANCE PROCEDURE Informal Problem Resolution: It is the policy of the training program and of Northwell Health to foster sound trainee/supervisor relations by encouraging open communication and reconciliation of work-related problems or concerns. It is the training program’s belief that most complaints about working conditions, supervision, co-workers or other work-related problems can best be handled through informal and private discussion between the trainee and his/her supervisor or track director. A trainee or supervisor may request that the Training Director (TD) provide informal consultation to assist in determining the appropriate course of action. Such consultation may serve to resolve the conflict or may result in the trainee choosing to escalate the matter to a more formalized intervention. In the event that more formal resolution is needed, the following procedure should be used. Step 1: The trainee is encouraged to discuss any complaint with his/her immediate psychology supervisor in person. This should take place within 10 working days of the occurrence which triggered the complaint although consideration will be given if there are personal reasons for longer delays. The supervisor is expected to give his/her decision within 10 working days of receiving the complaint. If an issue does not arise in a setting where the trainee is being supervised, it should be addressed first to the Program Director, Track Director or Coordinator (in the case of fellowship, internship and externship, respectively). If a trainee reasonably believes that discussing his/her complaint with his/her immediate supervisor would be futile, the trainee may move to the next step in the grievance process. The Step 2 grievance should be requested within five working days of the supervisor’s response to the initial complaint; however personal reasons for a longer delay will be considered. Step 2: In the event of the failure of the above to resolve the matter, a formal grievance should be pursued. Formal grievances should be made in writing to the TD or to another member of the Education and Training Committee (ETC) if the Training Director is the source of the trainee's grievance. The TD will notify the Director of Psychological Services of the grievance. The TD may render a decision on the grievance without consult or may constitute a Grievance Committee to hear the case and deliberate the outcome. The Grievance Committee will consist of three faculty members representing training sites. In special circumstances, the committee may be limited to representation from the site within which the trainee is placed. Individuals named in the grievance will not serve on the Grievance Committee in that matter. The trainee and relevant faculty will be notified of the date of the Committee’s review and will be given the opportunity to provide the Committee with any information regarding the grievance. The Committee will meet with the parties involved, and may do so at one time or separately. If a Committee is convened, the Committee will determine the outcome of the grievance. A

Rev. 6/24/16

decision will be reached within five working days after the meeting of the Grievance Committee or of the TD being informed of the complaint. The decision will be presented in writing to the trainee. If the trainee is not satisfied, he/she may proceed to the next step (3) within ten business days of the rendered decision. Step 3: The Training Director will submit a written request for the trainee to meet with the Director of Psychological Services. After the grievance has been heard, the employee will receive a written decision within 15 workdays and will be communicated to all involved parties and to the Grievance Committee. If the problem has not been resolved to the employee’s satisfaction, he/she may take the grievance to Step 4 within five working days of receiving the Step 3 determination. Step 4: The Director of Psychological Services will schedule an appointment with the Vice Chairman of Psychiatry and the Human Resources designated representative. The trainee must be available to testify. After the grievance has been heard, the trainee will receive a final and binding decision in writing within 15 workdays after the meeting. _____________________________ In the event that the grievance involves any member of the ETC (including the TD), that member will recuse himself or herself from serving on the Grievance Committee due to a conflict of interest. A grievance regarding the TD may be submitted directly to the Director of Psychological Services for review and resolution in consultation with the Grievance Committee. Trainees must exercise good faith in processing complaints and cooperate in any investigation. The trainee submitting the complaint will be encouraged to provide relevant information including documents, names of witnesses, etc. A trainee does not have the right to have an attorney or other outside individual (non-employee) present during the internal investigation or during a grievance meeting. Some grievances may extend outside of the scope of the Division of Psychological Services and may require procedures governed by Human Resources policy and involve report to managers other than psychology training staff. The TD will consult with the department of Human Resources as needed to determine whether other procedures pertain and to maintain consistency with institutional policies to the extent possible. The health system will not tolerate any form of coercion or retaliation against a trainee who processes a complaint under this policy, or who cooperates with an investigation. This policy and its procedures should not, however, be construed as preventing, limiting or delaying the health system from taking disciplinary action against any individual in circumstances where such action is deemed appropriate.

Any findings resulting from a review of a grievance that involves prohibited conduct as described in the Health System Human Resources Policies and Procedure manual (Title: Conduct in the Workplace/ Progressive Discipline, Part V, Section 3), will be submitted to the Director of Psychological Services for appropriate personnel action.

APPENDIX E


Psychological Services

The Zucker Hillside Hospital Long Island Jewish Medical Center

Northwell Health

PSYCHOLOGY TRAINEE DUE PROCESS PROCEDURE Trainees are evaluated informally within their first three months and formally before the six-month and twelve-month points of the training year as well as on an ongoing basis. (The term “trainee” in this document includes psychology externs, psychology interns and postdoctoral psychology fellows.) The training program aims to develop professional competence. Conceivably, trainees could be seen as lacking the competence for eventual professional practice due to a serious deficit in skill or knowledge, or due to problematic behaviors that significantly impact their professional functioning. In such cases, the training program will help trainees identify these areas and provide remedial experiences or recommended resources in an effort to improve the trainees’ performance to a satisfactory degree. The problem identified may be of sufficient seriousness that the trainee would not get credit for the training program unless that problem was remedied. Training Review Committee Should this become a concern either due to the seriousness of the problem or its persistence despite repeated local feedback and assistance, the problem must be brought to the attention of the Training Director (TD) by the program or track leader at the earliest opportunity in order to allow the maximum time for more thoughtful remedial efforts. The TD will inform the trainee of staff concern, and convene a meeting of the Training Review Committee within ten business days of being notified of the problem. (If the trainee is an extern or intern, the TD will also apprise the training director of the trainee’s graduate program or his/her designee who will be invited to join the Training Review Committee.) The TD will consult with the department of Human Resources as needed to determine whether other actions are required and to maintain consistency with institutional policies to the extent possible. The Training Review Committee will consist of the trainee’s current and past supervisors, the leaders of his or her program or section and an unrelated member of the training faculty. The trainee will be notified of the date of the Committee’s review and will be given the opportunity to provide the Committee with any information regarding the questionable performance or behavior. The review shall not be considered a formal hearing and therefore shall not be subject to any formal rules of evidence or procedure. The introduction of any relevant information, including witnesses, shall be determined by the Training Director. Decision of the Training Review Committee If the Training Review Committee determines that the deficit or problem is serious enough that it could prevent the trainee from fulfilling the exit criteria, and


thereby prevent him or her from receiving credit for the training program, the trainee will be placed on probationary status by the Training Review Committee. If a trainee on probationary status fails to achieve stated goals within a specified time frame (which will be based on learning and performance needs) he/she will be dismissed from the program. Probation and Remediation

a. The trainee, the trainee's supervisor(s), the track Director or Coordinator, the TD, and the Training Review Committee will produce a remediation plan specifying the kinds of knowledge, skills and/or behavior that are necessary for the trainee to develop or remediate in order to remedy the identified problem. The Training Review Committee may require the trainee to participate in particular learning experiences or may issue guidelines for the type of experiences the trainee should undertake in order to remedy such a deficit. The plan will stipulate the duration of probationary status as well as the frequency and nature of supervisory meetings during that time. The members of the Training Review Committee will sign this plan; the trainee will either sign the plan or it will be noted that (s)he declined to do so. A copy of the plan will be placed in the trainee’s file along with a summary of the proceedings. If and when the problems have been resolved with no adverse action, the probation and remediation process will not be reported externally except if otherwise directed by the Department of Human Resources or the Office of Legal Affairs. In the case of an extern or intern, a copy of the remediation plan will be forwarded to the clinical training director of the trainee’s graduate program or his/her designee. If applicable as per contractual agreement, the training program will also notify and consult with Association of Psychology Postdoctoral and Internship Centers (APPIC). (See the standardized remediation plan template which follows this document.)

b. The trainee and the supervisor will report to the Training Review

Committee on a regular basis, as specified in the plan (but not less than every two months) regarding the trainee's progress. The TD may elect to convene a meeting of the Training Review Committee before the end of the probationary period.

c. The trainee may be removed from probationary status by a

determination of the Training Review Committee when the trainee's progress in resolving the problem(s) specified in the plan is sufficient. Removal from probationary status indicates that the trainee's performance is at the appropriate level to receive credit for the training program.


Actions Following Probation a. Termination: If a trainee on probation fails to make progress, or, if it

becomes apparent that it will not be possible for the trainee to receive credit for the training program (even if this precedes the end of probation), as per the determination of the Training Review Committee, the TD will so inform the trainee in writing at the earliest opportunity and (unless there is cause for more immediate action – see below) the trainee will be terminated from the program. Termination from the training program will coincide with termination of the trainee’s employee status with the Health System. (In the case of an extern or intern, the doctoral program director will be notified in writing of every decision regarding the trainee’s status.) If applicable as per contractual agreement, the training program will also notify the Association of Psychology Postdoctoral and Internship Centers (APPIC) and request release from the obligations of the national internship match. If a Trainee is dismissed before the completion of his/her academic year, the TD will determine the number of months of credit to be given the trainee for that academic year. Denial of credit may be required to be reported to future training programs, employers or licensing and administrative agencies.

b. Continued Probation: At the conclusion of the stipulated time frame or earlier if so determined by the Training Review Committee, if a trainee has met the requirements set forth by the remediation plan or has made progress deemed sufficient by the Committee, the trainee may then be monitored during a time-limited period (up to 3 months or as determined by the TD) of enhanced supervision. The TD will provide the trainee with written notice of this decision. During this period the probation is continued with further support. In this case, a revised plan will be written for this period which will be placed in the trainee’s file (and in the case of an extern or intern, forwarded to the director of his/her doctoral program). During this maintenance period, the trainee will continue to meet with supervisors and to follow the recommended goals for the new plan.

c. Reinstatement: The Training Review Committee may elect to reinstate the trainee to regular status at the satisfaction conclusion of probation. The reinstatement will be communicated to the trainee in writing and does not preclude future actions if problems arise.

Appeal: A trainee may appeal the Training Committee's decision to the Director of Psychological Services within ten business days of being terminated or of any disciplinary action taken. At the time the trainee is notified of the above outcome, the trainee will be notified of his/her right to appeal these actions. The appeal request must be in writing and shall include all information the trainee would like taken into consideration in evaluating his/her appeal as well as the trainee's


justification for the appeal. The Director shall determine the need for any additional documents or testimony from the parties.

Within ten business days from the initiation of the appeal, the Director of Psychological Services will review the appeal and render the appeal decision, which will be communicated in writing to all involved parties (including the doctoral program director if applicable), and to the Training Review Committee. Should the Director be recused from deliberation due to a conflict of interest, the Associate Chairman of the Psychiatry Department (or designee) will render the appeal decision. The Director may accept, reject or modify the action taken, or take any other action that the he deems appropriate under the circumstances. The decision of the Director will be final and binding upon all parties.

Prohibited Conduct: Prohibited conduct by a trainee should be brought to the attention of the TD in writing. Any person who observes such behavior, whether staff or trainee, has the responsibility to report the incident. Prohibited conduct is described in the Policy and Procedure Manual (Title: Conduct in the Workplace/ Progressive Discipline, Part V, Section 3) and includes but is not limited to:

• Incompetence and/or misconduct, including professional misconduct

• Insubordination

• Possession of a weapon on health system property

• Illegal use of drugs,

• Stealing, fighting, gambling or possession of gambling devices

• Abandonment of position

• Excessive tardiness and/or absenteeism

• Falsification of time record

• Sexual harassment and/or any other unlawful harassment or discrimination

• Inappropriate use of the Internet and electronic mail

• Violation of the health system’s Codes of Professional and Ethical Conduct

• The TD, the supervisor, and the trainee may address infractions of a very

minor nature.

• Any significant infraction or repeated minor infractions must be documented in writing and submitted to the TD, who will notify the trainee of the complaint. A written record of the complaint and action become a permanent part of the


trainee's training file. Per the procedures described above, the TD will call a meeting of the Training Review Committee to review the concerns, after providing notification to all involved parties. All involved parties will be encouraged to submit any relevant information that bears on the issue, and, if deemed suitable by the Committee, invited to attend the Training Review Committee meeting(s).

• In the case of prohibited conduct in the performance of patient care duties,

the TD may seek advisement from appropriate Health System resources in compliance with system policies, including Risk Management, Human Resources and/or Legal Counsel. If warranted, the trainee may be placed on administrative paid leave pending the results of an investigation and will receive written notification of this leave as soon as is practicable. Such leave is not considered an adverse action and is not subject to hearing or appeal.

• Following a careful review of the case, the Training Review Committee may

recommend no action, probation or dismissal of the trainee. Dismissal would reflect the determination by the Training Review Committee that the trainee’s conduct is not subject to remediation. If a probationary period is recommended it shall include the same procedures described above. A violation of the probationary agreement could necessitate the dismissal of the trainee's appointment at NSLIJHS. Dismissal (whether after unsuccessful remediation efforts or upon determination that the trainee’s conduct is not subject to remediation) may be appealed in accordance with the procedure given above.

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APPENDIX F

Division of Psychological Services, Department of Psychiatry Long Island Jewish Medical Center

The Zucker Hillside Hospital


1. Successful completion of the psychology externship, internship or fellowship

requires a year long, full-time training experience. It is recognized that on occasion a psychology trainee may not be able to complete this requirement during the 12 consecutive months because of medical problems or for extraordinary personal reasons. Given that trainees are accepted for one year only, extended leave1

therefore could jeopardize successful completion of training requirements.

2. At the discretion of the Psychology Education and Training Committee in conjunction with the Department of Psychiatry, a trainee who has not completed a year’s worth of training activity because of medical disability or extraordinary personal circumstances may be given the opportunity to complete training via an additional training period.

3. A request for extended training must be made in writing to the Director of

Psychology Training and can be submitted at any point in advance of the expected leave but no later than one week upon returning from leave. The Education and Training Committee and The Director of Psychological Services (or a designee) will review the request and made a determination as to whether extended training will be offered. The decision will take into consideration the reasons for the request for extended training and the availability of staff and other existing resources to support extended training.

4. If extended training is granted, it must be completed within one year following the

originally scheduled end of the training.

1 The Education and Training Committee will determine the exact amount of time that constitutes “extended leave” which would jeopardize successful completion of the training taking into account the trainee’s performance, pattern of attendance, training needs as well as regional licensure requirements if applicable.

APPENDIX G

Long Island Jewish Medical Center – The Zucker Hillside Hospital Clinical Psychology Training Program

Weekly Activity Log

Name of Trainee:

Program: Externship Internship Fellowship

Track: Child Adult Geropsych Neuropsychology

Placements: Millieu ‐ Adol. InptAdult Inpt APH GPH Eat. Dis. Med. Psych.

Clinic ‐ DBT Perinatal Child OPD Anx Clinic Gero Clinic Child OPD Eval OCD Center Neuro ‐ ETP Movmnt Epil. ZHH Cons. Transitions Neuro Other

Week beginning: Days Off (vacation, sick, conference):

Supervision & Training Activities (Received by Intern)

Hours

Mon Tue Wed Thu Fri





Seminar:

Seminar:

Seminar:

Seminar:

Case Conference/Grp Spvn:

Other:

Intervention & Other Activities Provided by Intern

Hours Intervention

Assessment

Case Management

Test Scoring

Collaterals

Consultation

Documentation

Family Psychotherapy

Group Psychotherapy

Individual Psychotherapy

Intake

Conducting Supervision

Team Meeting

Telephone Contact

Other:

Trainee Signature:

Track Leader Signature:

APPENDIX H

1. APA 2002 Ethical Principles of Psychologists and Code of Conduct (with 2010 amendments)https://www.apa.org/ethics/code/ethics-code-2017.pdf

2. Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients 2012https://www.apa.org/pubs/journals/features/amp-a0024659.pdf

3. Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologyhttps://apastyle.apa.org/manual/related/guidelines-multicultural-education.pdf

4. Enhancing Your Interactions with People with Disabilitieshttps://www.apa.org/pi/disability/resources/publications/enhancing-your-interactions.pdf

https://www.apa.org/ethics/code/ethics-code-2017.pdf

https://www.apa.org/pubs/journals/features/amp-a0024659.pdf







APPENDIX I

APPENDIX J

Human Resources 1111 Marcus Avenue, Suite LL20 Lake Success, New York 11042

Tel (516) 734-7000

EMP 120 – Request for Paid T ime Off Form Revised: December 20, 2017

REQUEST FOR PAID TIME-OFF

PURPOSE:

The “Request for Paid Time-Off” Form is used to schedule paid time-off, or time away from work with pay.

WHO COMPLETES THIS FORM:

Employees who are entitled to days-off with pay who are not using the myTIME Request for Time-Off feature inmySelfService.

HOW TO COMPLETE AND SUBMIT THIS FORM:

Employees may access this form on the Intranet. An employee who needs to schedule paid time-off needs tocomplete the form in advance, discuss the request with his/her supervisor and obtain supervisory approval. Thesigned form is then maintained in the employee’s departmental file.

INSTRUCTIONS:

The employee must complete the form with the following information:

a. Name

b. Date

c. Department

d. Based on the number of hours accrued:

Number of days off requested

Equivalent number of hours

Date(s)

The employee must then discuss the request with his/her supervisor

Once the dates are agreed upon, the employee and his/her supervisor sign and date the form

A copy is maintained in the employee’s department file

APPENDIX KSummary of Benefits

Also see: https://intranet.northwell.edu/NSLIJ/hr/Benefits/BenefitsByPop/2019%20Northwell%20Benefit%20Guide%20for%20Residents.pdf

Disclaimer: The above is intended only as a summary of the benefits provided by North Shore-LIJ Health System as of November 2014. This is based on eligibility, which is fully outlined in the Summary Plan Descriptions and the New Hire Benefits package. The health system reserves the right to add, amend, or terminate any benefit at its sole discretion. Please refer to the Summary Plan Descriptions for details. Health & Welfare benefits become effective the first of the month following 32 days of employment.

Benefits Package Highlights 2015

Benefit Group 2 - House Staff

HEALTH AND WELFARE BENEFITS Choice of two Medical Plans through United Healthcare Prescription Drug Plan through Express Scripts Choice of two Dental Plans through Cigna Vision Plan through Davis Vision Health Care and Dependent Care Flexible Spending Accounts (FSAs) through Wage Works Short-Term Disability - 12 weeks of salary continuation through The Hartford – 50% Employer Paid, 60%

Buy-Up Long-Term Disability Plans through Guardian Life Insurance/Accidental Death and Dismemberment through Aetna – 1.5 times base salary up to $500,000 Supplemental Life – 1 to 5 times base salary up to 1 million Dependent Life Insurance for Spouse and Children through Aetna

ADDITIONAL/VOLUNTARY BENEFITS Accident Insurance Cancer Insurance Critical Illness Insurance Fraud SafeGuard Insurance Pet Insurance Pre-Paid Legal Services Select Life Insurance

RETIREMENT PROGRAM 403(b)

Voluntary employee contributions on a pre-tax and post-tax basis, up to annual IRS dollar limits

WORK/LIFE BENEFITS 20 days of Paid Time-Off (PTO) Discounts and Wellness Programs including: free smoking cessation, discounted gym memberships, free

counseling services, Federal Credit Union membership, and other employee services

Note: All requests for leave, other than disability, are reviewed by the Department Chairman on a case-by-case basis. All time away from formal graduate medical education, other than allocated PTO, may lead to shortfall in the time needed to complete the requirements of both the residency program and the corresponding certifying Board. In such situation, additional months of training may be necessary.

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See also

https://intranet.northwell.edu/NSLIJ/policies/LIJMC/Environment%20of%20Care%20Manual/Fire%20Lif

e%20Safety%20Management%20Plan%202017.pdf

APPENDIX L

Fire Safety




POLICY#:EC.01.01.01.3




Types of Fire Extinguishers

Portable fire extinguishers are an important part of every fire safety program. Extinguishers are provided throughout the hospital (approximately every 75’) and are clearly marked and conveniently located. They are designed to combat fires, are easy to operate, and if used in the early stages of a fire, will prevent additional damage.

Class A Pressurized Water Extinguisher (2 ½ gallons) • Silver in color• Used on class A fires

Class BC Carbon Dioxide Extinguisher • Red color• Used for class B and C fires• Large funnel-like opening on the hose to expel cold CO2 under pressure

Class ABC Multipurpose Dry Chemical Extinguisher • Red color• Used for class A, B and C fires• Smaller funnel-like opening on hose to expel a dry chemical under pressure

Class K Wet Chemical Extinguisher • Silver color• Used for Kitchen grease fires

Nonferrous Water Mist • White color• Used in MRI locations

Note: All extinguishers have labels indicating type, classification of fires, and operating instructions.

To help remember how to operate fire extinguishers remember the code phase P.A.S.S.

Pull the pin and break the seal Aim low at the base of the fire Squeeze the handle to activate the extinguisher Sweep the nozzle slowly at the base of the fire


POLICY#:EC.01.01.01.3




• Water extinguishers (silver) are located in cabinets or attached to wall brackets generally in officeareas.

• Carbon-dioxide fire extinguishers (red with cone-shaped nozzles) are generally located inpreoperative areas, laboratories and engineering spaces.

• Multipurpose dry chemical extinguisher are located throughout the campus• Kitchens are equipped with Ansul Systems• Nonferrous are used in MRI locations

Types of Fires

The classification of fire depends on the type of fuel involved. Basically there are five classes of fires: A, B, C, D (flammable metals) and K. At the Medical Center we are concerned with all except class D.

Class “A” Fires that involve combustibles such as paper, wood, cloth, anything that burns and leaves an ash can normally be extinguished by cooling.

Class “B” Fires involve flammable liquids, such as gasoline, oil, alcohol, benzene, which is best extinguished by smothering. (This includes food on the stove fires).

Class “C” Fires involve energized electrical equipment, appliances and wiring in which the use of non-conductive agent prevents injury.

Class “K” Fires involve cooking grease.

APPENDIX M

GUIDE TO HOSPITAL CODES

STANDARDIZATION for North Shore-LIJ

Employees

New Emergency, Clinical and Security Codes Description of Actions for Each Code


Table of Contents

ABOUT NEW HOSPITAL CODES ..…………….. 3 FREQUENTLY ASKED QUESTIONS …………… 3 I. EMERGENCY CODES

Code Amber …………………………………… 4 Code Flight …………………………………… 5 Code Decon …………………………………… 6

Code Red …………………………………….... 6

II. SECURITY CODES Code Gray ……………………………………... 9

Code Green ……………………………………. 9

Code HEICS …………………………………... 9 “All Clear” ………………………………….... 9

III. CLINICAL CODES Code Blue ……………………………………... 9 Code Fusion …………………………………… 9 Code Stroke …………………………………… 9 Code Trauma …………………………………. 9 Code White …………………………………..... 9 Rapid Response ….............................................. 9 STAT Response …………………………………….... 9

2

3

About the Hospital Codes Standardization

North Shore-LIJ continuously strives to create a safe environment for patients, their families and employees. In order for the health system to continue to provide the highest quality patient care, it is standardizing all hospital emergency, security, and clinical codes starting April 1, 2010. It is every employee’s responsibility to learn each code and be in compliance with its requirements.


Why is North Shore-LIJ standardizing its hospital codes? In order to ensure the organization delivers quality care across all hospitals and medical facilities, the hospital codes must be unified. Today, some of our hospitals use different codes for the same incident, causing confusion among employees and community-based physicians who work at multiple locations. By standardizing each code across the organization, all employees and community-based physicians will be knowledgeable about each code, and comfortable responding.

When do the “new” hospital codes take effect? The codes described in this guide will take effect on April 1, 2010.

Who is affected by the “new” hospital codes? All North Shore-LIJ employees working at a hospital, regardless of his/her role at the hospital must learn each code and the actions associated with it.

I know other hospital codes (such as Dr. Red) that are not outlined in this guide. What happened to those codes? Some hospitals were using alternative codes for the same incidents as described in this guide. Only the hospital codes outlined in this guide are to be used starting April 1, 2010. All other codes are no longer being used.

What if my co-workers and I have our own department codes that we prefer? All hospitals will use the same codes as outlined in this guide. Department codes or abbreviated codes will not be permitted after April 1, 2010.

How will I remember each code? North Shore-LIJ has produced a wallet-size “codes card” containing each code and the proper actions for every hospital employee. This card may be carried as part of the uniform until the employee becomes comfortable.

Where can I get a “codes card”? If you did not already receive a codes card, please contact your safety office or your Human Resources department to obtain a card.

Where may I obtain more information about my hospital’s codes? Please contact your site’s Safety Office for specific information related to your hospital.

I. EMERGENCY CODES

Code Amber Pediatric or Infant has been abducted or is missing

Procedure: In response to a “Code Amber”, which is an unauthorized removal of an infant/pediatric patient from the unit, the hospital will initiate its lockdown procedures as outlined in the Security Management Plan.

Upon verification, the involved nursing unit should notify Security, utilizing the appropriate STAT Extension, and provide the physical description of the infant/pediatric patient (i.e., race, gender, age, unit of origin), and the physical description of the abductor (i.e., race, gender, age, height, build and clothing worn) if known.

Example: 3 Monti, infant female, 24 hours old. Abductor: White female, 25-30 years old, 5’3” – 5’5” tall, medium build wearing a long black coat and carrying a shopping bag.

The Nursing team will keep detailed notes of time and notification, and will seal off the unit, allowing no-one in or out until the “All Clear” is sounded. Nursing and Security teams will carry out the established “Code Amber” policies and procedures.

Communications will be asked to announce a “Code Amber” over the public address system, and provide the identifying information. Voice Communications will announce the “Code Amber” via the overhead P/A system as per site policy.

After hearing a “Code Amber” announcement, all employees should be looking for an abductor as described in the overhead announcement, and should immediately report any suspicious observations associated with the description of the abductor to Security at the appropriate extension. If possible, the suspected abductor should be followed to determine a vehicle description and the license plate number.

The Hospital Incident Command System (HICS) will be implemented as indicated by the hospital’s Comprehensive Emergency Management Plan (CEMP). All “Code Amber” events will be documented and reviewed, as per protocol, through either the Site Safety Committee or the Site PICG.

4

Code Flight Adult patient has eloped or is missing

Procedure: To establish a plan to assist the clinical staff in locating a missing patient, and assist in the safe return of the patient to the appropriate patient care unit.

1) When it is discovered that a patient is missing, the team member will dialthe Stat extension, and notify Communications of a “Code Flight,” statingthe nursing unit location of the missing patient.

2) Communications will immediately make notifications as per their protocol,including an overhead announcement.

3) After the overhead announcement is made, all employees are to follow thehospital’s “Code Flight” procedures, which include communication of thepatient’s description, and the monitoring of hallways, entrances and exits,and the overall hospital campus. In every incident, the Nurse Manager willbe notified.

4) After notification, Security will respond to the area where the patient wasreported missing. Security will verify if the patient is: a danger tothemselves or others; not capable of consent to discharge (i.e. a pediatricpatient, or a patient with an altered mental state). Security will obtain anaccurate physical description of the patient. The description will include thepatient’s sex, race, complexion, age, height, weight, build, hair, eyes,clothing, mental state and direction of travel.

5) If, in the judgment of the responsible clinician on site, (i.e. MD, RN), thenotification procedure (see number 8) can be implemented immediately.

6) The verifying security guard will broadcast, via radio, the physicaldescription on the security frequency.

7) When a missing patient is located on the hospital property, the appropriatepatient care unit will be notified, and the unit representative will be asked toescort the patient back to the unit. If a representative is unable to respond ina timely manner, the search team will attempt to persuade the patient toreturn to the unit voluntarily.

8) If the patient is unwilling to return to the unit of origin and meets thecriteria of a pediatric patient, or a patient with an altered mental state, thesecurity desk officer will be notified. The desk officer will contact thepatient unit for origin, and request an MD or RN to respond, or betransported to the scene for clinical intervention. Members of the searchteam are to monitor the patient until clinical assistance arrives.If the patient is not located on the hospital property, additional notificationswill be made, as per site policy, that includes the following;

! The Director of Security! The local Police department or Precinct! The Nurse Manager/Designee will be informed of the action taken, and

the progress being made5

! For Inpatient Psychiatric Patients (only), notify the Director of InpatientServices (Psychiatry).

! The Nurse Manager/Designee will notify the Administrator-on-Dutyand ensure the patient’s family and physician have been notified(determine if missing/eloped patient arrived home safely).

! North Shore-LIJ Network Emergency Management (NEM) – 516-719-5000They will be provided with the physical description of the missing patient,and informed of who was notified.

9) A Security Incident Report will be completed in a timely manner by theSecurity Department designee. The report will include all appropriateactions taken, all notifications, the name and shield number of the notifiedpolice officers, and the case number from Police Department havingjurisdiction.

Code DECON Activation of Decon response team due to an external event

Procedure: Upon notification of an incident involving chemical, biological or nuclear contamination, or a contaminated patient(s), a Code Decon announcement will be made over the public address system. The decontamination team will respond as per the DECON Annex of the hospital’s Comprehensive Emergency Management Plan (CEMP) and implement DECON procedures as appropriate. The Hospital’s Incident Command System (HICS) will be implemented.

Code Red Fire

Procedure: The phrase “Code Red” will be used to designate a fire situation, and will provide supplemental support to the hospital’s fire alarm system. The code phrase will be announced three times over the public address system, in conjunction with all fire alarms, with the exception of weekly alarm tests. When announced overhead, the code phrase will be accompanied by a location (i.e. “Code Red, Tower Building, 6th Floor, South Stair”). The fire alarm “all-clear” (series of single bells), which designates resolution of the alarm condition, must also be backed-up by an overhead announcement.

6

7

The hospital team is required to dial the hospital’s stat extension, and give their name and location immediately after activating a fire alarm. Once this information is relayed to the hospital switchboard operator, the P.A. announcement will be made. If the operator receives no call, an announcement will be made based on the fire alarm bell code. If the fire alarm systems malfunctions, or has been deactivated for servicing, it is especially important that the location of a fire be given to the Switchboard Operator for announcement purposes. Under such circumstances, the Switchboard Operator will notify the Boiler Room, and the Boiler Room Watch Engineer will notify the Fire Department.

The code phrase should also be used by employees in the immediate area of a fire, to avoid yelling “fire” and possibly causing panic with the patients. Employees should call aloud the established code phrase and the fire location, i.e. “Code Red, Room 258.”

Employees should respond to a “Code Red” announcement in the same manner as the mechanical fire alarm. Note: Upon activation of a “Code Red” staff must ensure that all corridor and patient room doors are closed, in addition to all other doors.

Staff Fire Response Fire in your area:

! Locate fire; call aloud “Code Red” and the involved location to alertemployees in the area; remove anyone in immediate danger

! Rescue or evacuate anyone in the immediate area of the fire! Activate fire alarm; pull the fire pullbox station nearest to the fire site! Call the hospital “stat” line switchboard at the hospital’s stat extension;

state name, location and type of fire; verify alarm! If you hear a fellow team member call out “Code Red” and have not heard

the fire bells, respond by activating the nearest pullbox and make thenotification to the Communications department

! Turn off oxygen and electrical equipment in the area of fire (away from thearea of fire; provide oxygen support for patients on oxygen; callRespiratory Therapy for backup as warranted)- Confine fire by closing windows, doors (but do not lock)- Clear corridors and close corridor doors; control traffic in the area- Use appropriate fire extinguishers

! Wait for instructions from Fire Response Team or Fire Department – donot evacuate patients except in case of immediate danger.

If feasible, mark the closed door to the room containing the fire, preferably with red tape.

8

An easy method to remember basic fire procedures is: R.A.C.E.

Remove anyone in immediate area of danger (while calling aloud “Code Red” and the location of the fire to employees in the area). Activate alarm: Pull the fire alarm pullbox nearest to the fire site. Dial the hospital’s stat extension to report fire situation and exact location. Confine the fire (e.g. close windows and doors, but do not lock). Extinguish fire (attempt to extinguish small fire with proper extinguisher and without endangering yourself). If necessary, evacuate horizontally to adjacent safe smoke compartment, and then if necessary, vertically.

Fire in another area of hospital: ! Identify location of fire! Close doors and windows to avoid draft! Clear corridors! Man telephones, extinguishers and oxygen shut-off valves! Remain in your area! Control traffic in your area! Remain calm and reassure patients! Wait for further instructions

Additional procedures: ! In the event of a fire, if the fire/smoke doors on magnetic hold open do not

automatically close, employees should manually close the doors.Employees should also ensure that these fire/smoke doors are not breacheduntil the “all clear” is announced.

! Visitors should remain with patients in the room.! Employees must terminate non-essential activities, telephone conversations.! Narcotics, records, valuables should be secured.! In units/areas with special exit door locking arrangements (e.g. Psychiatry

Unit, Infant Protection Systems), employees should be posted at unitentrance doors to facilitate the entry of emergency responders, or a way outin the event of fire/medical/safety emergency.

! Do not use elevators.! Evacuation decisions will be made by ranking fire responder,

Administration, Hospital Incident Command, or the Fire Department.

II. SECURITY CODES

Code Gray Security Stat – plus announce location

Code Green Security Stat – plus announce location because of violence with weapon

Code HICS Activation of EOP – plus activation level (I, II, III, IV)

“All Clear” Announced twice following resolution of incident

Note: Please ensure you are familiar with your site’s security and safety manual.

III. CLINICAL CODES

Code Blue Adult Cardiac/Respiratory Arrest – plus announce location

Code Fusion Transfusion Emergency – plus announce service and location

Code Stroke Activation of Stroke Team – plus announce location

Code Trauma

Activation of Trauma Team – plus announce level and location

Code White Pediatric Cardiac/Respiratory Arrest – plus announce location

Rapid Response Activation of Rapid Response Team – plus announce medical/surgical/pediatric

and location

STAT Response

Announce Service STAT to location – (service e.g. Respiratory, OB, Cath Lab)

9

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APPENDIX OElectronic Medical Library



APPENDIX P

Ambulatory Emergency Procedures

General Statement of Purpose:

When an ambulatory service physician makes a decision to admit a patient to the inpatient

service or via the Easy Access Program (hereafter, EZAP), established safety procedures

consistent with other routes of admission to the hospital should be established. The physician

will also make a determination regarding transport resources needed for a safe transport.

Procedure for Ambulatory Services:

Voluntary Admission

When a patient presently in an ambulatory setting requires inpatient hospitalization and is

agreeable to hospitalization, the physician will call Central Intake to obtain a room assignment.

After 5pm a page is made to the A.D.N and Central Intake /A.D.N will then inform the receiving

unit of the pending admission. The referring physician will complete the legal papers with the

patient and sign Part B. The physician or staff member will escort the patient to the unit. The

Physician or designated staff member will provide a handoff communication to a clinician on the

receiving inpatient treatment team. The admission search will be conducted by the inpatient staff

when the patient arrives on the unit.

When the outpatient physician determines additional assistance is needed to safely escort the

patient to the unit, the physician or designee will call a “22” stating “ambulatory transport”. The

caller must provide the operator with the standard nomenclature to identify the location. A

Patient Engagement Specialist will respond to provide support during the transport and arrival to

the unit. Clerical staff should be notified to send an email to the ambulatory psychiatric

emergency distribution list notifying front desks of the location of the “ambulatory transport.”

Involuntary Admission

Following the physician’s decision to admit an involuntary patient to the inpatient service the

clinician involved in the situation calls or directs that a “22” is called stating “ambulatory

psychiatric emergency.” The caller must provide the operator with the standard nomenclature to

identify the location. A call is also made to the Northwell Health EMS (718-747-4911) to

provide transport to the LIJ ED. The clinician or delegate will communicate to the Northwell

Northwell Health The Zucker Hillside Hospital

PATIENT CARE SERVICES

POLICY TITLE: Inpatient Admission from ZHH Ambulatory Services and EZAP

Prepared by: ZHH Policy and Procedure Committee Approval Date: 1/13/17 Effective Date: 1/13/17

Last 11/14/12 Revised/Reviewed: 1/15/14

Pg 1 of 2

Health EMS any identified patient safety risk that would prompt a decision by EMS to also call

911 to request an N.Y.P.D. response. It is the role of the clinician or their designee who called

the “ambulatory psychiatric emergency” to meet the patient engagement specialist, nursing

director or A.D.N and security upon arrival, provide the team with a brief assessment of the

situation, as well as any concerns, e.g., potential for aggression, impulsivity or flight. The

responsibility for the direction of the ambulatory psychiatric emergency response is assigned the

Director of Patient Care Services or A.D.N. until the arrival of the program director. Once the

program director arrives, the Director of Patient Care Services or A.D.N. will brief the director

prior to leaving the area. The clinician on site must remain as a consultant until the situation is

resolved.

The standard nomenclature to identify the location is as follows:

ACP- Ambulatory Care Pavilion

ACP, basement, child clinic

ACP, first floor, centers

ACP, second floor, PACE program

ACP, second floor, adult partial hospital

ACP, second floor, gero clinic

ACP, second floor, gero partial

Sloman- Adult Clinic, Medical Clinic

Sloman, basement, adult clinic

Sloman, first floor, medical clinic

Sloman, first floor, adult clinic

Sloman, first floor, Clozapine clinic

Sloman, second floor, adult clinic

Littauer- ARS (includes MMTP and DAEHRS), Social Work

Littauer, first floor, ARS

Littauer, second floor, Social Work

Research - Psychiatry Research

Research, BHP, basement, room #

Research, ACP, first floor, room#

It is the ambulatory staff’s responsibility to secure the immediate area from other patients, staff

or visitors, alert security to notify them that EMS has been called, to call the LIJ Psych ED to

give a verbal handoff and to subsequently notify family contacts as appropriate. For the purpose

of informing all outpatient areas and aiding in directing the responding team, the ambulatory

support staff will also send an email to an Ambulatory Reception distribution specifying the

location of the ambulatory psychiatric emergency.

Procedure for EZAP:

When Central Intake books an appointment for a Patient Admission via EZAP, Central Intake

will inform the ADN and the receiving unit of the pending admission. The MD will assess the

patient in the EZAP office. Following the assessment and presuming the patient will be

admitted, the physician will call the receiving unit to request escort to the unit from the EZAP

office, the physician will provide handoff communication to the receiving RN. Staff designated

by the unit nurse will pick up the patient from the EZAP office and search the patient’s

belongings prior to entry to the unit.

APPENDIX Q Email Policy

Page 1 of 11 900.11 03/05/19

POLICY/GUIDELINE TITLE:

Electronic Communications Policy

ADMINISTRATIVE POLICY AND PROCEDURE MANUAL

POLICY #: 900.11 CATEGORY: Information Services

Site Approval Date: 03/05/19

Site Implementation Date: 03/05/19

Effective Date: 9/2008

Last Revised/Reviewed: 3/15/18 Prepared by: Office of the CIO – IS Policy and Procedure Committee

Notations: Previously Titled: Electronic Mail (E-Mail Acceptable Use)

GENERAL STATEMENT of PURPOSE

The purpose of this policy is to establish the guidelines for the acceptable use of Northwell Health (“Northwell”) electronic communications such as email, instant messaging, texting, social media, and online virtual meeting. This policy outlines the guidelines for using these or similar systems on Northwell’s Enterprise Network.

POLICY

It is the policy of Northwell to permit the use of electronic communications such as email, instant messaging, social media platforms, and online virtual meeting platforms for authorized Northwell use as long as approved security controls and required business agreements are in place.

SCOPE

This policy applies to all Northwell Health employees, as well as medical staff, volunteers, students, trainees, physician office staff, contractors, trustees and other persons performing work for or at Northwell Health; faculty and students of the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell conducting research on behalf of the Zucker School of Medicine on or at any Northwell Health facility; and the faculty and students of the Hofstra Northwell School of Graduate Nursing and Physician Assistant Studies.

DEFINITIONS

Electronic Communication: This refers to, but is not limited to, email, text messaging, and online multimedia platforms such as videoconferencing.

Page 2 of 11 900.11 03/05/19

Highly Sensitive Information: Protected Health Information (PHI) or any information that, if lost, corrupted, disclosed to, or accessed by an unauthorized person, or disclosed or accessed by unauthorized means, may (i) violate federal, state, and/or local law, (ii) cause significant harm, injury, or damage to another person or entity, or (iii) cause financial loss to another person or entity. Examples include, but are not limited to, Social Security numbers, credit card data, and driver’s license information. Refer to the 900.12 Data Classification and Handling Policy.

Instant Messaging (IM): An electronic method of communicating that enables immediate correspondence between two or more users in the form of text messages. Messages are exchanged by typing them on a computer or a mobile device with instant messaging software installed. This may be hosted either internally or externally through a service provider (such as AIM, MSN, or Google).

Messages: Refers to communications sent via phone, text, conferencing platforms, email or other electronic method.

Personally Identifiable Information (PII): Any information about an individual maintained by an agency, including (i) any information that can be used to distinguish or trace an individual’s identity, such as name, Social Security number, date and place of birth, mother‘s maiden name, or biometric records; and (ii) any other information that is linked or linkable to an individual, such as medical, educational, financial, and employment information:

1. Name, such as full name, maiden name, mother’s maiden name, or alias2. Personal identification number, such as Social Security number (SSN), passport number,

driver‘s license number, taxpayer identification number, patient identification number,and financial account or credit card number

3. Address information, such as street address or email address.4. Asset information, such as Internet Protocol (IP) or Media Access Control (MAC)

address or other host-specific persistent static identifier that consistently links to aparticular person or small, well-defined group of people

5. Telephone numbers, including mobile, business, and personal numbers6. Personal characteristics, including photographic image (especially of face or other

distinguishing characteristic), x-rays, fingerprints, or other biometric image or templatedata (e.g., retina scan, voice signature, facial geometry)

7. Information identifying personally owned property, such as vehicle registration numberor title number and related information

8. Information about an individual that is linked or linkable to one of the above (e.g., date ofbirth, place of birth, race, religion, weight, activities, geographical indicators,employment information, medical information, education information, financialinformation)

All PII shall at all times be subject to all applicable laws, including, without limitation, the New York State Social Security Number Protection Law, New York State Labor Law, and Fair Credit Reporting Act. This includes all PII relating to members of the Northwell workforce. All PII that is also PHI shall, at all times, also be subject to all applicable laws and Northwell policies regarding PHI, as set out above.

Page 3 of 11 900.11 03/05/19

Protected Health Information (“PHI”): Any oral, written, or electronic individually identifiable health information. PHI is information created or received by Northwell that (i) may relate to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the payment for the provision of health care to an individual; and (ii) identifies the individual who is the subject or based on which there is a reasonable basis tobelieve that the individual who is the subject can be identified. The Health Insurance Portabilityand Accountability Act (HIPAA) further clarifies that PHI includes information that identifies theindividual by one or more (depending on context) of the following 18 identifiers:

1. Names;2. Geographic subdivisions smaller than a state, including street address, city, county, precinct,

Zip code, and their equivalent geocodes, except for the initial three digits of a Zip code incertain situations;

3. All elements of date (except year) for dates directly related to an individual, including birthdate, discharge date, date of death; and all ages over 89 and all elements of dates indicativeof such age, except that such ages and elements may be aggregated into a single category ofage 90 or older;

4. Telephone numbers;5. Fax numbers;6. Electronic mail addresses;7. Social Security numbers;8. Medical record numbers;9. Health plan beneficiary numbers;

10. Account numbers;11. Certificate/license numbers;12. Vehicle identifiers and serial numbers;13. Medical device identifiers;14. Web Universal Resource Locators (URLs);15. Internet Protocol (IP) address numbers;16. Biometric identifiers, including finger and voice prints;17. Full face photographic images and any comparable images; and18. Any other unique identifying number, characteristic, or code.

Sensitive Information: Any information that, if lost, corrupted, disclosed to, or accessed by an unauthorized person, or disclosed or accessed by unauthorized means, may cause harm, injury, or damage to another person or entity. Examples include, but are not limited to, a number of personally identifiable information data elements that are not highly sensitive. Refer to the 900.12 Data Classification and Handling Policy.

Suspicious Email: Any email that contains the following: 1. Requests for sensitive or highly sensitive information (such as PHI, PII, or personal

financial information) from an unknown source or for an unknown purpose.

Page 4 of 11 900.11 03/05/19

2. Requests for sensitive or highly sensitive information from a person who shouldotherwise not be able to request the information or does not have a need to know.

3. Requests for your personal or company issued username and password.4. Executables or command files (files that have an .exe, .vbs, .bat, or .com at the end of the

filename) without a workforce member’s understanding of the program’s source orpurpose.

5. Receipt of hyperlinks pointing to an unknown destination, as determined by hovering themouse over the hyperlink.

6. Any other email that may be deemed mistrustful.

Virtual Meeting Platform: A technology that allows multiple users to communicate either via audio, video, or both to hold meetings. This may also include the sharing of screens and interactive features such as polls and file transfers.

Workforce Members: All those entities covered in the Scope section above.

PROCEDURES/GUIDELINES

1. Generala. Electronic communications must be protected from unauthorized use and may be monitored

to detect or prevent security breaches and maintain the confidentiality of data. Electroniccommunication content and use may also be monitored and audited by Information Services(IS) staff members to support operational, maintenance, auditing, security, and investigativeactivities.

b. The use of electronic communications must be consistent with Northwell policies andprocedures including the Code of Ethical Conduct, HR policies, and all relevant industrystandards and applicable laws.

c. Message and email addresses must be reviewed and confirmed before sending to ensure thatthe message or email is delivered to the appropriate recipient(s).

d. Messages or emails that contain offensive, inappropriate, or otherwise objectionable contentare not allowed.

e. The forwarding of chain letters, spam, advertisements, or other non-work related orinappropriate messages is not allowed.

f. Messages (including phone calls and emails) suspected to be fraudulent must be reported tothe IS Service Desk.

g. Workforce members must not click on or open suspicious links or attachments in emails ortext messages.

h. Access to personal email is prohibited from the Enterprise network.i. Workforce members who request patients to send/receive email or text messages that may

contain PHI, must first have the patient sign form VD032, and keep the completed form onfile.

Page 5 of 11 900.11 03/05/19

2. Emaila. Northwell email is intended for business use. Minimal personal use is permitted, provided

it does not interfere with the performance of the workforce member’s work-related dutiesand responsibilities, and is not illegal, unlawful, or inappropriate.

b. All emails are subject to monitoring and deletion by Northwell Information Services staff.Northwell email users should have no expectation of privacy.

c. Obscuring, disguising, misrepresenting or otherwise hiding one’s identity or role withinNorthwell in an email is forbidden.

d. Non-Northwell employees who have been issued Northwell email addresses must notpurport to be Northwell employees.

e. Email accounts are provisioned to Voluntary Physicians upon their request, approval bycredentialing and verification of a signed Confidentiality Agreement and solely inconnection with providing professional services to Northwell Health and/or its patients.

f. Emails are to be considered an extension of Northwell and must be writtenprofessionally.

g. All information within emails, including attachments, must be handled according to the900.12 Data Classification and Handling Policy.

h. Sensitive or highly sensitive information (such as PHI and PII) must not be sent in anemail unless required and must include only the minimum amount necessary.

i. All emails sent from Northwell that contain sensitive or highly sensitive information mustbe encrypted. To specifically encrypt an email, type either “PHI” or “SECURE” into thesubject line. Alternatively, use the “Encrypt & Send” button in Outlook.

j. Elements of PHI must not be included in the email subject line.k. Third party email services such as AOL, Optimum, Yahoo, or Gmail, may not be used to

communicate sensitive or highly sensitive information, such as no PHI.l. Email must be retained only for as long as required by business needs, regulatory

requirements, and local, state, or federal law. Specific requirements can be found in the100.97 Records Retention and Destruction Policy.

m. In the event that an email containing patient information is inadvertently delivered to thewrong recipient (for example, due to an incorrect email address), Corporate Compliancemust be notified immediately.

n. Automatic forwarding of internal Northwell emails to external addresses is prohibited.o. All files received via email must be scanned by Information Services using the enterprise

anti-virus and anti-malware tools.p. All requests to develop and distribute any form of digital, print, or multimedia internal

communication within Northwell Health to cross-functional groups of more than 100employees and/or voluntary physicians shall be submitted to the Internal Communicationsteam, part of the organization’s Department of Marketing and Communications. Refer to100.38 Internal Communications, External Communications and Media Placement policy.

q. All emails going outside of Northwell must have an email confidentiality disclaimerappended in the footer that stipulates conditions of what the recipient may or may not dowith the email. This disclaimer is automatically appended to all outgoing email.

r. When in doubt about whether or not a communication is subject to attorney-client privilegeor another privilege, the Office of Legal Affairs must be consulted before sending the email.

s. Emails regarding quality assurance information must contain the following footer:“CONFIDENTIAL Education Law 6527; Public Health Law 2805, J., K., L., M.”

Page 6 of 11 900.11 03/05/19

t. Unauthorized access, interception, or disclosure of email is prohibited.u. Public representation or statement of Northwell issued through an email, unless granted

specific approval from the Public Relations Department, is prohibited.v. Email backups are performed in accordance with standard Northwell backup procedures.w. Email is archived for long-term storage by the Information Services Department, and may

be monitored, reviewed, and restored at the discretion of authorized individuals at eachfacility. The email system is intended for business purposes and all emails remain theproperty of Northwell.

x. Email communication with patients is subject to all Northwell Health policies, as well as thefollowing requirements:

i. All patients must sign a Consent to E-Mail and Text Communications form priorto receiving email communication from a Northwell Health care provider, givingtheir consent to have their protected health information transmitted via email.Refer to the 800.02 Release of Protected Health Information (e.g., MedicalRecord) for Living Patients Policy. The office or facility that intends to email thepatient must first give the patient the form to read and sign. The office or facilitymust retain a copy of the signed consent form for 6 years. Refer to the 100.97Records Retention and Destruction Policy.

ii. With the exception of appointment scheduling, email communication is only totake place with patients previously seen and evaluated in the practice or by theclinician.

iii. Email communication with patients must be used only for non-emergency, non-urgent, or non-critical information.

iv. Copies of all email communications relative to ongoing medical care of thepatient must be maintained as part of the patient’s medical record. All clinically-relevant online clinician-to-patient email communications must be a permanentpart of the patient’s medical record.

3. Instant Messaging and Text Messaginga. Instant messaging and text messaging are acceptable forms of communication for

business purposes. Only Northwell-approved secure texting solutions may be used for thetransmission of sensitive or highly sensitive information, such as PHI or PII, whether inthe form of text, photos, videos, or audio recordings of patients.

b. Clinicians are not permitted to text patient care orders regardless of the texting solution.

c. It is permitted to text appointment reminders with written patient consent, although thePatient Portal is a preferred method of communication. The message may contain thephysician name, location, phone number and date/time of service, but no other PHI.

4. Online Multimedia Sharing Platformsa. Online multimedia platforms such as videoconferencing, WebEx, and GoToMeeting may

be used with both internal and external users provided the following guidelines arefollowed:

i. Passwords must be required to join the meeting.ii. Sensitive and highly sensitive information can only be shared as required, and

must comply with the minimum necessary requirement.

Page 7 of 11 900.11 03/05/19

iii. Only those with an executed Business Associate Agreement (BAA) or Non-Disclosure Agreement (NDA) on file are authorized to view sensitive and highlysensitive information. It is the responsibility of the meeting host to ensure that anythird-party attendee who may be exposed to sensitive or highly sensitiveinformation is authorized to do so. The meeting host may contact the Office ofLegal Affairs and/or Procurement to ensure that an executed BAA or NDA is onfile.

iv. Meetings that contain sensitive or highly sensitive information must not beallowed to be recorded or downloaded.

v. Participants must be aware of their surroundings to prevent the possibility ofinadvertently sharing confidential (highly sensitive, sensitive, or internal)information. Examples include whiteboards or documents in view of the cameraduring videoconferencing, computer file names visible on the desktop, or otherdata visible on the computer.

ENFORCEMENT

Users should report any violations of this policy immediately to their respective managers. If appropriate, the violation should be escalated and reported to the IS Service Desk or the Office of Corporate Compliance HelpLine. Anyone found in violation of this policy may be subject to disciplinary action, up to and including termination of employment or engagement, as applicable, in consultation with Human Resources.

CONTACT INFORMATION What Where Northwell Health Service Desk (516) (718) (631) 470-7272Northwell Health Service Desk Email [email protected] IT Security Hotline Email [email protected] Office of Corporate Compliance HelpLine (800) 894-3226Office of Corporate Compliance Website www.northwell.ethicspoint.com

REFERENCES to REGULATIONS and/or OTHER RELATED POLICIES • #100.009 Payment Card Industry Data Security Standards PCI DSS IT Security Policy• #100.010 Payment Card Industry Data Security Standards PCI DSS Governance Policy• #100.38 Internal Communications, External Communications and Media Placement Policy• #100.97 Records Retention and Destruction Policy• #800.02 Release of Protected Health Information (e.g., Medical Record) for Living Patients• #800.42 Confidentiality of Protected Health Information• #900.12 Data Classification and Handling Policy• #VD032 Consent to E-Mail and Text Communications Form.• Health Information Technology for Economic and Clinical Health (HITECH) Act• Health Insurance Portability and Accountability Act (HIPAA), Security Final Rule, 45 CFR

164.312(e)(1) Transmissions Controls• Human Resources Policy 5-3 Conduct in the Workplace/Progressive Discipline



http://www.northwell.ethicspoint.com

Page 8 of 11 900.11 03/05/19

• Human Resources Policy 12-1 Termination of Employment: Voluntary, Involuntary• Human Resources Policy 13-3 Electronic Communications Systems• Human Resources Policy 13-11 Social Media Acceptable Use Policy

CLINICAL REFERENCES/PROFESSIONAL SOCIETY GUIDELINES N/A

ATTACHMENTS Appendix A – Guidelines For Internal Northwell Email Appendix B – Standard Email Design Guidelines

FORMS N/A

APPROVAL:

Northwell Health Policy Committee 03/05/19

System PICG/Clinical Operations Committee 03/05/19 Standardized Versioning History: *=Policy Committee Approval; ** =PICG/Clinical Operations Committee Approval *09/08; **04/09; *08/10 **09/10 **Provisional approval **01/14 **2/22/18 **3/15/18 03/05/19 Expedited Approval Granted by:

Winifred Mack, SVP/Operations – Chair, Northwell Policy CommitteeMorris Rabinowicz, MD, Co-Chair, - System PICG/Clinical Operations Committee

Page 9 of 11 900.11 03/05/19

Appendix A - Guidelines for Internal Northwell Email

1. Volume• To the extent possible, the amount and frequency of emails to employees should be

minimized, with a particular emphasis on reducing broadly distributed emailannouncements.

• Alternate means of sharing information should be utilized, such as the Employee Intranetand the myNorthwell mobile app.

• Messages should be consolidated into existing email channels such as the weekly E-NewsBulletins and monthly Leader E-Newsletter.

2. Distribution Lists• All requests to develop and distribute any form of digital, print or multimedia internal

communication within Northwell Health to groups of more than 100 employees and/orvoluntary physicians outside the sender’s department must be submitted to the InternalCommunications team, part of the organization’s Department of Marketing andCommunications.

3. Content• Never send an email that requires the receiver to enter personal information such as their

full social security number, birth date, credit card number, Northwell ID or password.• Every effort should be made to avoid or minimize the use of “clickable links” or

attachments in emails. Where clickable links are unavoidable, they must be kept to aminimum and have clear URLs that clearly identify the link.

• When appropriate, clickable email links should be replaced with instructions on how tonavigate to the destination via the employee Intranet – particularly when privateemployee information is involved (e.g., mySelfService, benefits open enrollment).

• While clickable links may be warranted in some instances, they should not be used underthe following circumstances:

o Sensitive information (user id, passwords, or private employee information) isbeing requested.

o There are time limits or deadlines associated with the request, a sense of urgencyto respond, or a threat/penalty for failure to respond.

o The email evokes strong emotions such as fear, curiosity or anger.o You do not know the sender and/or are not expecting the email.

When these conditions exist, together with clickable links, they may be indicative of a phishing email – a malicious attempt to steal confidential email – and should therefore be avoided.

Page 10 of 11 900.11 03/05/19

4. General Use• Never open emails from an unrecognized sender. Delete them without opening.• Never click on embedded website links that you don't recognize or open embedded files

if you are not expecting them.• Report suspected phishing emails by either clicking on the “Report Phishing” button in

Outlook or forwarding the email to [email protected].

5. Style• Wherever possible, internal communications email sent on behalf of Northwell email

should follow the design guidelines in Appendix B below.

6. Vendor Generated Emails• Where system generated emails will be sent out on behalf of Northwell by an outside

vendor that is unable to adhere to the design guidelines in Appendix B, an internal, pre-communication email should be sent out to end users making them aware that an externalvendor will be contacting them and that the request is legitimate.


Page 11 of 11 900.11 03/05/19

Appendix B – Standard Email Design Guidelines

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/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Ban

dana

s or

”D

u” R

ag

s

NO

Bod

y Pi

erci

ngs:

Vis

ible

N

O

Blo

uses

: Rev

ealin

g, S

heer

N

O

Dre

sses

(No

shor

ter t

han

2 in

ches

abo

ve th

e kn

ee)

YES

Hat

/Hea

ddre

ss (A

ccep

tabl

e on

ly fo

r rel

igio

us o

r oth

er a

utho

rized

reas

ons)

N

O

ID B

adge

(Wea

r abo

ve th

e w

aist

; pho

to m

ust f

ace

forw

ard;

mus

t use

a re

com

men

ded

lany

ard,

cl

ip o

r non

-mag

netic

hol

der)

YE

S

Jew

elry

: Ear

rings

(Max

imum

2 e

arrin

gs p

er e

ar; n

ot m

ore

than

1 1

/2" i

n le

ngth

and

/or

diam

eter

) YE

S

Jew

elry

: Fac

ial (

Eye

brow

, nos

e, c

heek

, lip

jew

elry

) N

O

Jew

elry

: Gen

eral

(Not

func

tiona

lly re

stric

tive

or d

ange

rous

to jo

b pe

rform

ance

; not

hing

ex

cess

ive

or n

oisy

) YE

S

Pant

s: C

apri

NO

Pant

s: C

lose

Fitt

ing

Stre

tch

Pant

s (L

eggi

ngs,

Stir

rup)

N

O

Pant

s: D

enim

/Jea

ns (A

ll co

lors

) N

O

Pant

s: G

ener

al (A

nkle

leng

th/c

rop

or lo

nger

) YE

S

Clo

thin

g;

Foot

wea

r; a

nd

Acc

esso

ries

Dep

artm

ents

/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Pant

s: K

haki

YE

S

Unl

ess

othe

rwis

e di

rect

ed; M

ust b

e w

orn

with

shi

rt &

tie

Pant

s-Sw

eat

NO

Perf

ume/

Col

ogne

/Afte

r Sha

ve/H

and

Lotio

n (In

mod

erat

ion

or a

void

ed a

ltoge

ther

) YE

S

Polo

Shi

rt

NO

Scru

bs

NO

Shirt

s: M

idrif

f/Tan

k/H

alte

r N

O

Shoe

s: B

ackl

ess

(Mus

t pro

vide

saf

e, s

ecur

e fo

otin

g &

offe

r pro

tect

ion

agai

nst h

azar

ds)

YES

Shoe

s: S

anda

ls; F

lip F

lops

/Tho

ng

NO

Shor

ts

NO

Skirt

s-G

ener

al (M

ust b

e no

sho

rter t

han

2 in

ches

abo

ve th

e kn

ee)

YES

Snea

kers

/Ath

letic

Sho

es

NO

Snea

kers

-Hig

h To

p N

O

Sung

lass

es

NO

Swea

t sui

ts

NO

Tatto

os: V

isib

le

NO

U

nles

s m

odes

t/dis

cree

t

Clo

thin

g;

Foot

wea

r; a

nd

Acc

esso

ries

Dep

artm

ents

/Offi

ces

(Oth

er th

an In

patie

nt/N

ursi

ng/C

ampu

s Su

ppor

t Ser

vice

s)

Ties

(Nea

t, pr

oper

ly ti

ed, a

nd w

orn

to th

e to

p sh

irt b

utto

n)YE

S

T-Sh

irts

NO

Wal

kman

s/R

adio

s/iP

ods/

Blu

e To

oth

devi

ces/

Hea

dset

s N

O

Ref

er t

o N

SL

IJH

S P

erso

nal

Appea

rance

poli

cy.

*S

ubje

ct t

o r

evis

ion.

APPENDIX S Psychology Training Table

Dire

ctor

of

Psyc

holo

gy

Trai

ning

Dr.

Elih

u Tu

rkel

FELL

OW

SHIP

(APA

)

INTE

RN

SHIP

EXTE

RN

SHIP

SER

VIC

E FE

LLO

WS

SER

VIC

E FE

LLO

WS

Dire

ctor

: Clin

ical

Ps

ycho

logy

Pro

gram

(Ger

oEm

phas

is)

Dr.

Ash

a P

atel

Neu

rops

ycho

logy

Dr.

Pau

l Mat

tis

Dire

ctor

: Clin

ical

C

hild

Pro

gram

Dr.

Pet

er D

’Am

ico

Neu

rops

ycho

logy

Tr

ack

Dr.

Pau

l Mat

tis

Chi

ld P

sych

olog

y Tr

ack

Dr.

Ste

ph

an

ie S

olo

w

Adul

t Psy

chol

ogy

Trac

kD

r. E

lihu

Tu

rke

l

Chi

ld P

sych

olog

yD

r. S

tep

ha

nie

So

low

Ger

opsy

chol

ogy

Dr.

Rita

Rya

n

Adul

t Psy

chol

ogy

Dr.

Jim

my

Kim

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

SS

UP

ER

VIS

ING

P

SY

CH

OLO

GIS

TS

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

SS

UP

ER

VIS

ING

PS

YC

HO

LOG

IST

S

Fe

llow

5 E

xte

rns

12

Ext

ern

s

4 E

xte

rns

3 E

xte

rns

Inte

rnIn

tern

Inte

rnIn

tern

Inte

rnIn

tern

Inte

rn

SU

PE

RV

ISIN

G

PS

YC

HO

LOG

IST

S

Inte

rnIn

tern

Inte

rnIn

tern

ETP

Dr.

Kris

ten

Can

dan

Col

lege

Dr.

Ca

nd

ice

La

Lim

a

OC

D &

Bip

olar

Dr.

An

tho

ny

Pin

toD

r. A

liosn

Gilb

ert

Tra

um

aD

r. M

aye

r B

elle

hse

n

2 E

xte

rns

10

Ext

ern

s

4 E

xte

rns

2 E

xte

rns

Fe

llow

Fe

llow

Su

bst

an

ce A

bu

seD

r. M

on

ica

Th

om

as

TB

A

CEN

TER

S FE

LLO

W

CEN

TER

S FE

LLO

W

CEN

TER

S FE

LLO

W

CEN

TER

S FE

LLO

W

INPA

TIEN

T FE

LLO

W

APPENDIX T2018-19 Clinical Placements

Note: Interns names and universities are listed with their consent

Adu

lt In

tern

ship

Tra

ck A

ssig

nmen

ts: 2

018-

19

INTE

RN

PA

YRO

LL T

IMEK

EEPE

R

PRIM

AR

Y PL

AC

EMEN

T Se

cond

ary

Plac

emen

t R

otat

ion

1 Ju

ly 2

, 201

8 –

Dec

. 31,

201

8

Rot

atio

n 2

Jan.

2, 2

019

– Ju

ne 2

8, 2

019

12 M

onth

s (7

-8 h

rs/w

eek)

Laur

en A

tlas

Yesh

iva

- Clin

ical

Sa

ndy

Arg

uello

(s

argu

ell@

north

wel

l.edu

)

Inpa

tient

: Low

3 (G

ener

al

Adu

lt)

Dr.

Jim

my

Kim

71

8-4

70-4

844

Ger

opsy

chia

try

Part

ial

Hos

p D

r. A

sha

Pat

el

718-

470

-46

96

Perin

atal

D

r. L

isa

Tes

ta

718-

470

-87

74

Dori

Bren

der

Long

Isla

nd U

nive

rsity

- Po

st

Sand

y A

rgue

llo

(sar

guel

l@no

rthw

ell.e

du)

Adu

lt Pa

rtia

l Hos

p D

r. A

dee

na

Gab

riel

71

8-4

70-8

072

Inpa

tient

: Low

3 (G

ener

al

Adu

lt)

Dr.

Jim

my

Kim

71

8-4

70-4

844

DB

T D

r. L

isa

Tes

ta

718-

470

-87

74

Hann

ah E

san

Yesh

iva

– Cl

inic

al/H

ealth

Sand

y A

rgue

llo

(sar

guel

l@no

rthw

ell.e

du)

Inpa

tient

: 2 W

est (

Wom

en)

Dr.

Ka

lli F

eld

man

71

8-4

70-8

995

Adu

lt Pa

rtia

l Hos

p D

r. A

dee

na

Gab

riel

71

8-4

70-8

072

Ger

o C

linic

D

r. R

ita R

yan

or

desi

gne

e

718-

470

-84

49

Cath

erin

e (G

lass

) N

obile

Ye

shiv

a - C

linic

al

Sand

y A

rgue

llo

(sar

guel

l@no

rthw

ell.e

du)

Ger

opsy

chia

try

Part

ial

Hos

p D

r. A

sha

Pat

el

718-

470

-46

96

Inpa

tient

: 1 W

est

(Ado

lesc

ent)

Dr.

Alis

on T

ebb

ett

718-

470

-57

38

Perin

atal

D

r. L

isa

Tes

ta

718-

470

-87

74

Jeff

rey

Gol

dman

Ho

fstr

a Sa

ndy

Arg

uello

(s

argu

ell@

north

wel

l.edu

)

Inpa

tient

: 1 W

est

(Ado

lesc

ent)

Dr.

Alis

on T

ebb

ett

718-

470

-57

38

Ger

opsy

chia

try

Part

ial

Hos

p D

r. A

sha

Pat

el

718-

470

-46

96

OC

D C

ente

r D

r. A

ntho

ny

Pin

to

718-

470

-83

86

Yoni

na S

loch

owsk

y Lo

ng Is

land

Uni

vers

ity -

Post

Sand

y A

rgue

llo

(sar

guel

l@no

rthw

ell.e

du)

Adu

lt Pa

rtia

l Hos

p D

r. A

dee

na

Gab

riel

71

8-4

70-8

072

Inpa

tient

: 2 W

est (

Wom

en)

Dr.

Ka

lli F

eld

man

71

8-4

70-8

995

Ger

o C

linic

D

r. R

ita R

yan

or

desi

gne

e

718-

470

-84

49

























Neu

rops

ycho

logy

Inte

rnsh

ip T

rack

Ass

ignm

ents

: 201

8-19

NEU

RO

PSYC

H. R

OTA

TIO

N

Psyc

hoth

erap

y Pl

acem

ent

INTE

RN

PA

YRO

LL T

IMEK

EEPE

RC

ycle

1

(Jul

y 2

2018

– O

ctob

er 3

1,

2018

)

Cyc

le 2

(N

ovem

ber 1

, 201

8 –

Febr

uary

28,

201

9)

Cyc

le 3

(M

arch

1, 2

019

– Ju

ne 2

8, 2

019)

12

Mon

ths

Leig

h El

izab

eth

Colv

in

Teac

hers

Col

lege

, Co

lum

bia

U

Meg

han

McD

onal

d (m

mcd

ona1

@no

rthw

ell.e

du)

Gen

eral

Neu

rolo

gy

(Dr.

Eric

a M

eltz

er)

Epile

psy

(Dr.

Yae

l Cuk

ier)

Tran

sitio

ns

(Dr.

Ros

ann

e P

achi

laki

s)

Early

Tre

atm

ent

Prog

ram

(D

r. K

ristin

Ca

nda

n

718-

470

-42

38)

Yose

fa A

llegr

a Eh

rlich

CU

NY

- Que

ens

Meg

han

McD

onal

d (m

mcd

ona1

@no

rthw

ell.e

du)

Epile

psy

(Dr.

Yae

l Cuk

ier)

Tr

ansi

tions

(D

r. R

osan

ne

Pac

hila

kis)

Gen

eral

N

euro

logy

(D

r. E

rica

Mel

tzer

)

Early

Tre

atm

ent

Prog

ram

(D

r. K

ristin

Ca

nda

n

718-

470

-42

38)

Aliz

a Ja

cob

CUN

Y - Q

ueen

s El

izab

eth

Mira

nda

(em

irand

a1@

north

wel

l.edu

) Tr

ansi

tions

(D

r. R

osan

ne

Pac

hila

kis)

G

ener

al N

euro

logy

(D

r. E

rica

Mel

tzer

) T

BA

Ger

iatr

ic

Psyc

hiat

ry C

linic

(D

r. R

ita R

yan

71

8-4

70-8

449

)













Chi

ld P

sych

olog

y In

tern

ship

Tra

ck A

ssig

nmen

ts: 2

018-

19

INTE

RN

PA

YRO

LL T

IMEK

EEPE

R

RO

TATI

ON

PLA

CEM

ENTS

A

MB

ULA

TOR

Y C

AR

E R

otat

ion

1 (2

0 hr

s/w

eek)

Ju

ly 2

, 201

8 –

Dec

. 31,

20

18

Rot

atio

n 2

(20

hrs/

wee

k)

Jan.

2, 2

019

– J

une

28, 2

019

12 M

onth

s (2

0 hr

s/w

eek)

Ju

ly 2

, 201

8 –

June

28,

20

19

Sara

Cin

es

Fairl

iegh

Dic

kins

on

AC

P R

oom

212

T

el: 7

18-4

70-4

836

P

ager

91

7-44

8-1

336

Chr

istin

e K

eene

(c

keen

e@no

rthw

ell.e

du)

Ado

lesc

ent I

npat

ient

D

r. A

lison

Teb

bet

t 71

8-4

70-5

738

Pedi

atric

Psy

chol

ogy

(16

hrs)

D

r. A

my

Na

del

718-

470

-32

83

Min

i Rot

atio

n TB

D

(Wed

9-1

2)

Prim

ary

Supe

rvis

or

Dr.

Pete

r D’A

mic

o (J

uly-

Dec

embe

r)

718-

470-

8352

Dr.

Bar

bara

Lib

ov

(Jan

uary

-Jun

e)

718-

470-

4831

Gro

up T

hera

py: D

BT

Mul

tifam

ily

Rac

hel G

oldm

an

Yes

hiva

Uni

vers

ity

AC

P R

oom

211

T

el: 7

18-4

70-4

866

P

ager

91

7-44

8-1

559

Chr

istin

e K

eene

(c

keen

e@no

rthw

ell.e

du)

Pedi

atric

Ps

ycho

logy

(16

hrs)

D

r. A

my

Na

del

718-

470

-32

83

Min

i Rot

atio

n W

omen

’s U

nit (

4 hr

s)

Dr.

Kal

li Fe

ldm

an

718-

470-

5766

Ado

lesc

ent I

npat

ient

D

r. M

adel

ine

McG

ee

718-

470

-57

39

Prim

ary

Supe

rvis

or

Dr.

Bar

bara

Lib

ov

(Jul

y-D

ecem

ber)

71

8-47

0-48

31

Dr.

Pete

r D’A

mic

o (J

anua

ry-J

une)

71

8-47

0-83

52

Gro

up T

hera

py: F

amily

Li

fe S

kills









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