VA Mental Health Provider Venting / Problem-solving / Peer Support Thread

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I always get confused between Doximity and Doxy.Me. I think Doximity used to require that you either be a physician or be referred by a physician, but they relaxed that after the start of the pandemic. Or maybe that was Doxy.Me. It was one of the two.
 
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I know with the pandemic, they were approving this, at least for a period of time. I would hope the person cara referenced didn't get fired for this during COVID-19. Also, there's the possible issue of texting PHI, which is a big no-no.

It was before COVID.

We also use Doximity if VVC isn't working. But we were also issued VA cell phones during COVID, so we don't have to worry about cell numbers anymore.
 
It was before COVID.

We also use Doximity if VVC isn't working. But we were also issued VA cell phones during COVID, so we don't have to worry about cell numbers anymore.

Because it's the VA, are they flip phones that they were able to buy in bulk from Nokia back in 2005 that had been sitting in a warehouse in Kansas until this great opportunity?
 
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Because it's the VA, are they flip phones that they were able to buy in bulk from Nokia back in 2005 that had been sitting in a warehouse in Kansas until this great opportunity?
I got a new iPhone 11 but I wouldn't mind rocking something more nostalgic. Also got a new HP Elitebook 745 model which, while functional, is pretty terrible for whatever the govt contracting price was.
 
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I will say they've finally (seemingly) been able to work things out here in terms of giving IT the resources they need to get providers laptops and cellphones or doximity accounts so they can efficiently telework. I was actually surprised with the speed with which it happened...once the initial extended delay to receive the equipment was past.
 
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Are any of your VAs covering the new (ridiculous money-grab) MoCa certification training fee?

Yup, not only did psychologists get trained, but any provider who requested it got trained (including social workers which I had... feelings about).
 
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Yup, not only did psychologists get trained, but any provider who requested it got trained (including social workers which I had... feelings about).
My facility is supposedly covering the costs, but I switched to the SLUMS until I get confirmation from colleagues who got it reimbursed.
 
This is a question related to HBPC. I just started my new job as the HBPC psychologist at a rural VA and received a referral for a recently widowed Veteran who has been under the care of a MHC psychologist (his Mental Health Treatment coordinator) for more than 10 years for PTSD. Coming from a metro VA, what I learned in a larger VA system was that a psychologist from a different clinic doesn't interfere with established treatment when a Veteran's care is managed by a mental health treatment coordinator unless the referral is coming directly from the coordinator for specialty care that the coordinator does not offer (e.g. insomnia, eating disorder, substance misuse, chorionic pain...).

The MHC psychologist saw the Veteran about 6 weeks ago and has been out due to a family matter. The referring provider politely asked me to reach out to the Veteran and introduce myself, which seemed to be a reasonable request. My question is that would it be appropriate to provide grief counseling while his treatment coordinator is out. As of this moment, the date of her returning is uncertain. Any suggestions are welcomed, and any thoughts are gratefully appreciated. Thank you!
 
This is a question related to HBPC. I just started my new job as the HBPC psychologist at a rural VA and received a referral for a recently widowed Veteran who has been under the care of a MHC psychologist (his Mental Health Treatment coordinator) for more than 10 years for PTSD. Coming from a metro VA, what I learned in a larger VA system was that a psychologist from a different clinic doesn't interfere with established treatment when a Veteran's care is managed by a mental health treatment coordinator unless the referral is coming directly from the coordinator for specialty care that the coordinator does not offer (e.g. insomnia, eating disorder, substance misuse, chorionic pain...).

The MHC psychologist saw the Veteran about 6 weeks ago and has been out due to a family matter. The referring provider politely asked me to reach out to the Veteran and introduce myself, which seemed to be a reasonable request. My question is that would it be appropriate to provide grief counseling while his treatment coordinator is out. As of this moment, the date of her returning is uncertain. Any suggestions are welcomed, and any thoughts are gratefully appreciated. Thank you!


In this case, I would say that this is fine. Two factors, one, the other provider is out for an uncertain amount of time and the patient has a somewhat acute issue. Two, you re technically treating a different issue, grief vs. PTSD. While they may interact, they are separate issues. Now, if you were being asked to continue a PE/CPT protocol or something, that's a different discussion, but I do not think it's an ethical problem to see them for acute grief related issues.
 
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In this case, I would say that this is fine. Two factors, one, the other provider is out for an uncertain amount of time and the patient has a somewhat acute issue. Two, you re technically treating a different issue, grief vs. PTSD. While they may interact, they are separate issues. Now, if you were being asked to continue a PE/CPT protocol or something, that's a different discussion, but I do not think it's an ethical problem to see them for acute grief related issues.
Agreed, and you can clarify with the pt at the outset the reason you're contacting them and what the scope of your potential work with them would be.
 
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Sorry for bombarding everyone with new questions. This is a situation that never happened to me before and hopefully won't in the future. I just got an email from payroll letting me know that my first paycheck will be delayed (recently transferred to a new VA). In the email, it states: "there was a NTE (Not to exceed date) in DFAS that did not lift before Payroll Processing. This has been corrected and a special pay ticket has been entered. The ticket is a 3 day ticket so you should received your pay on Monday or Tuesday. We apologize for this inconvenience."

First, my start date was delayed for two weeks, which means that I did not have any income for two weeks after I had already relocated and made myself available to work for the initially agreed start date. IMHO, this is unacceptable. I have bills need be paid and I was expecting a paycheck this Friday. Has anything like this happen to anyone before? What can I do about it?
 
First, my start date was delayed for two weeks, which means that I did not have any income for two weeks after I had already relocated and made myself available to work for the initially agreed start date. IMHO, this is unacceptable. I have bills need be paid and I was expecting a paycheck this Friday. Has anything like this happen to anyone before? What can I do about it?

Welcome to the VA. Personally, I am not sure if there is much to do. I had an issue during fellowship where HR screwed up some computer entry and I was not in the system as an employee anymore. Took about a month to fix without paychecks. Got it all retroactively, but they did not move quickly.
 
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Sorry for bombarding everyone with new questions. This is a situation that never happened to me before and hopefully won't in the future. I just got an email from payroll letting me know that my first paycheck will be delayed (recently transferred to a new VA). In the email, it states: "there was a NTE (Not to exceed date) in DFAS that did not lift before Payroll Processing. This has been corrected and a special pay ticket has been entered. The ticket is a 3 day ticket so you should received your pay on Monday or Tuesday. We apologize for this inconvenience."

First, my start date was delayed for two weeks, which means that I did not have any income for two weeks after I had already relocated and made myself available to work for the initially agreed start date. IMHO, this is unacceptable. I have bills need be paid and I was expecting a paycheck this Friday. Has anything like this happen to anyone before? What can I do about it?
I'm so sorry this happened to you. Unfortunately, it is common. I've seen it happen to staff and trainees multiple times. Leadership has tried to push to get an extra check cut quickly when this has happened and I've never seen that actually work. Usually the back pay was included in the next paycheck. It's really unacceptable.
 
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Sorry for bombarding everyone with new questions. This is a situation that never happened to me before and hopefully won't in the future. I just got an email from payroll letting me know that my first paycheck will be delayed (recently transferred to a new VA). In the email, it states: "there was a NTE (Not to exceed date) in DFAS that did not lift before Payroll Processing. This has been corrected and a special pay ticket has been entered. The ticket is a 3 day ticket so you should received your pay on Monday or Tuesday. We apologize for this inconvenience."

First, my start date was delayed for two weeks, which means that I did not have any income for two weeks after I had already relocated and made myself available to work for the initially agreed start date. IMHO, this is unacceptable. I have bills need be paid and I was expecting a paycheck this Friday. Has anything like this happen to anyone before? What can I do about it?
I had this happen to me on fellowship as well unfortunately. Paycheck was delayed another three weeks. I was enraged. Tried to take it to different levels, but in typical VA fashion, there's no set hierarchy and no way to get to anyone to yell at. The people I did speak with were blatantly uninterested in me paying my bills on time. My TD did offer help if I was in financial distress, but I'm not sure who would if you're not in training. Sorry I can't be of more help.
 
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Unfortunately, I'm going to have to agree with everyone above--I've seen it happen multiple times, and I've never once seen anyone be able to resolve it immediately. I'm actually surprised they were willing/able to get a new check cut after "only" 3 business days. In the situations I've seen, it usually was just added in to the next check (i.e., 2 weeks later). It's particularly difficult for trainees and, like you, new/early career folks.
 
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This has been corrected and a special pay ticket has been entered. The ticket is a 3 day ticket so you should received your pay on Monday or Tuesday. We apologize for this inconvenience."
Super sorry this is happening! I’d be enraged too. Hate to say it but administratively, this might already be a best case scenario in that somebody caught the mistake, corrected it (instead of pass the buck), and you should be reasonably confident to get paid early next week.

I would definitely be using some on the clock time to call landlords or creditors and see if you can get extensions or have any past due fees waived. Good luck sorting out your bills and the good news is that once you’re in the system, you shouldn’t have any more payroll problems.
 
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I actually stopped getting paid during my second year of fellowship. They had me incorrectly listed as a one year fellow so once that ended they terminated me. I felt like Milton from Office Space because I had just kept showing up, haha. Fortunately they fixed it pretty quickly.
 
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I actually stopped getting paid during my second year of fellowship. They had me incorrectly listed as a one year fellow so once that ended they terminated me. I felt like Milton from Office Space because I had just kept showing up, haha. Fortunately they fixed it pretty quickly.

This was actually my issue as well. They entered me in the same way as all of the 1-year fellows. But, on the flip side, they also erroneously entered me in a different database as a physician, so I had a parking spot about 20 feet from the entrance for the duration of my fellowship.
 
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But, on the flip side, they also erroneously entered me in a different database as a physician, so I had a parking spot about 20 feet from the entrance for the duration of my fellowship.
Wonder where the psychologists and social workers parked lol!
 
Sorry for bombarding everyone with new questions. This is a situation that never happened to me before and hopefully won't in the future. I just got an email from payroll letting me know that my first paycheck will be delayed (recently transferred to a new VA). In the email, it states: "there was a NTE (Not to exceed date) in DFAS that did not lift before Payroll Processing. This has been corrected and a special pay ticket has been entered. The ticket is a 3 day ticket so you should received your pay on Monday or Tuesday. We apologize for this inconvenience."

First, my start date was delayed for two weeks, which means that I did not have any income for two weeks after I had already relocated and made myself available to work for the initially agreed start date. IMHO, this is unacceptable. I have bills need be paid and I was expecting a paycheck this Friday. Has anything like this happen to anyone before? What can I do about it?

This is fairly common in VA and completely unacceptable. In true VA fashion, nothing will change.

Also, if they ever over pay you even 1 dollar prepare yourself to be harassed to no end until you cut them a check. And believe me from personal experience, they will make it as difficult as humanly possible to pay them money and clear your name from all kinds of government debt lists and various financial threats.
 
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In a lot that required a long walk or a short shuttle ride. I somehow got parking reserved for ER docs.
I took the bus 75% of the time to my fellowship bc parking was stupid expensive and even the best parking was not guaranteed. As a result, guaranteed parking was a dealbreaker when I was looking at faculty positions and startup packages. I landed at my top choice w. a super-secret pass to the best secure parking on campus. It gave me valet access too, but I never used it because it felt wrong.

As for the VA and pay....yeah, it's a mess. I spent a year in the system and it took them many weeks to get my submitted paperwork into the actual system (so I could get paid, an ID, insurance, etc). Then on the way out, they screwed up my paperwork, which I only found out 6 months later when they tried to get me to pay 6mon worth of health insurance premiums. It was the gift that kept on giving bc I also had to re-file my city and state taxes bc they claimed I worked there another year and owed thousands more in taxes.
 
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Ah, yes, the shuttle ride to the parking lot! The VA I did my fellowship at required a 20 min bus ride to the parking lot for lesser employees like trainees. Good thing it was 20 min closer to my apartment. I also included those 20 min as my tour time. Seemed fair to me.

One thing I LOVE about working at a CBOC: great parking.
 
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I’m inching toward my first eligibility for a step increase based on tenure. Is there something that I should be doing in advance besides reminding my supervisor? Thanks!
 
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I’m inching toward my first eligibility for a step increase based on tenure. Is there something that I should be doing in advance besides reminding my supervisor? Thanks!

Unless things have changed, step increases happen automatically through HR based on your SCDs. I don't believe your supervisor really does anything for it.
 
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I’m inching toward my first eligibility for a step increase based on tenure. Is there something that I should be doing in advance besides reminding my supervisor? Thanks!
Nope, not that I've ever run into. Like WisNeuro said, it should be something that happens automatically through HR. If you have an "Annual Review" TMS items to complete, go ahead and know those out of the way if you haven't already, just in case.
 
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I’m inching toward my first eligibility for a step increase based on tenure. Is there something that I should be doing in advance besides reminding my supervisor? Thanks!

Just check your pay stub after your anniversary date to see if it has taken place or look at MyPay. I honestly forgot about my first step increase till I noticed a bit more in take home pay.
 
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Anyone know the CPT code for time spent on replying to secure messages? Thanks a million :)
 
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Anyone know the CPT code for time spent on replying to secure messages? Thanks a million :)
98970-98972

Hope you get paid soon. Do you have a government car or are you on mileage reimbursement? Dealing with the travel folks is always fun.
 
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I had this happen to me on fellowship as well unfortunately. Paycheck was delayed another three weeks. I was enraged. Tried to take it to different levels, but in typical VA fashion, there's no set hierarchy and no way to get to anyone to yell at. The people I did speak with were blatantly uninterested in me paying my bills on time. My TD did offer help if I was in financial distress, but I'm not sure who would if you're not in training. Sorry I can't be of more help.
Ah, yes, the 'circular hierarchy' of unaccountability at VA.

Sally (in HR): 'That's not MY area...you need to talk to Tim in the Tinkertoy Service.'

Tim (Tinkertoy Specialist [GS-8]): 'Uh...no, that's not right...ya see, last year they took that away from us. You really need to fill out an FU-99 request and bring it with you when you go see Frank in Flogistics.'

Frank in Flogistics: 'Aw geez, we get this all the time. They told you wrong! Who you really need to see is Sally in HR. And, actually, you'll have better luck if you fill out a F-ME-99 form prior to presenting Sally with the FU-99 form...everyone appreciates a little humility in this process and, well...here at the VA, the 'F' procedures generally follow a specific order of operations (and generally flow downhill with respect to the organizational chart).'
 
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Oh, oh, here's my story about that.

I had a tech issue and called the national helpline. They told me that my local IT would have to resolve it. My local IT resolved it by... telling me to call the national helpline.
 
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Oh, oh, here's my story about that.

I had a tech issue and called the national helpline. They told me that my local IT would have to resolve it. My local IT resolved it by... telling me to call the national helpline.
The degree of effort and ingenuity that many workers and departments at VA display in order to clearly delineate what they are NOT responsible for is truly impressive at times.
 
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98970-98972

Hope you get paid soon. Do you have a government car or are you on mileage reimbursement? Dealing with the travel folks is always fun.
Thank you so much, Sanman!
Payroll requested "special funds" that showed in my account on Tuesday and became available on Wednesday morning.
Our census is so low, and I usually borrow a car from another team member when they are not traveling. Last week, I had to arrange a vehicle for a day with Transportation and learned to avoid having to do that unless I have to. Hoping to get an assigned vehicle in the future but I am only doing 1-3 visits a day. We are operating at a very very very slow pace. It frustrates me.
 
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Thank you so much, Sanman!
Payroll requested "special funds" that showed in my account on Tuesday and became available on Wednesday morning.
Our census is so low, and I usually borrow a car from another team member when they are not traveling. Last week, I had to arrange a vehicle for a day with Transportation and learned to avoid having to do that unless I have to. Hoping to get an assigned vehicle in the future but I am only doing 1-3 visits a day. We are operating at a very very very slow pace. It frustrates me.
Not sure about your catchment area, drive times, and expectations, but 2-3 visits/day sounds average for many HBPC folks nationally. I have had a very low census as well since the pandemic began.
 
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Not sure about your catchment area, drive times, and expectations, but 2-3 visits/day sounds average for many HBPC folks nationally. I have had a very low census as well since the pandemic began.
Thanks! That doesn't make me feel so bad anymore. :)
So far I have a small caseload of 14 patients. My visits are in the range of 20 - 70 miles.
It will make my life easier if I have an assigned vehicle. Transportation told me that is a car currently available. The program coordinator has the authority to request it; however, the program coordinator told me that Transportation won't give us another car due to my small caseload and instructed me to arrange sharing vehicle with the team. It is still too early at a new VA, and I don't want to make big waves. So I will do my best to follow the flow. Taking long lunches and leaving at 4:30 every day is new to me. With this kind of pace, some people do as little as possible to get a day by. It is a federal job that I signed up for. So...(deep sigh)
 
Hoping to get an assigned vehicle in the future but I am only doing 1-3 visits a day. We are operating at a very very very slow pace. It frustrates me.
I moved to a different VA role after about 16 months in my first staff role so if you end up feeling like this isn't the best fit but want to stay in the VA, keep up with staff departures for possible internal openings before things hit USAJobs as well as postings with other VAs if you are able to relocate. And EDRP can be transferred if the next position authorizes it.

Every facility and local job market is gonna be different but I would bet that a regular BHIP/MHC role will open up sooner than later if that's your cup of tea.
 
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I moved to a different VA role after about 16 months in my first staff role so if you end up feeling like this isn't the best fit but want to stay in the VA, keep up with staff departures for possible internal openings before things hit USAJobs as well as postings with other VAs if you are able to relocate. And EDRP can be transferred if the next position authorizes it.

Every facility and local job market is gonna be different but I would bet that a regular BHIP/MHC role will open up sooner than later if that's your cup of tea.
Thanks, summerbabe! I am keeping my eye out for HBPC, CLC, and/or any gero positions. :)
 
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Anyone has insight to share about possible pros and cons of these 100% virtual jobs?
 
Anyone has insight to share about possible pros and cons of these 100% virtual jobs?

The benefit of working from home is schedule and hours flexibility. And VA virtual positions are NOT very flexible, from what I've heard.
 
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Anyone has insight to share about possible pros and cons of these 100% virtual jobs?

It really depends on what the position is. At my VA, it is mostly for the outpatient CBOC folks. The plus side, as ERG mentioned, is some flexibility, no commute, and perhaps the possibility to live where you would like. The biggest downside is the live TMS stuff, particularly the quarterly BLS stuff, can be a huge pain if you are never on site. They are starting to go back to the two year BLS cert for some remote people, but it has been a fight. Our medical director tried to get them to allow HBPC to switch over and got push back. So, the occasional half day devoted to driving to a facility to complete BLS is a part of our lives at the moment.
 
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It really depends on what the position is. At my VA, it is mostly for the outpatient CBOC folks. The plus side, as ERG mentioned, is some flexibility, no commute, and perhaps the possibility to live where you would like. The biggest downside is the live TMS stuff, particularly the quarterly BLS stuff, can be a huge pain if you are never on site. They are starting to go back to the two year BLS cert for some remote people, but it has been a fight. Our medical director tried to get them to allow HBPC to switch over and got push back. So, the occasional half day devoted to driving to a facility to complete BLS is a part of our lives at the moment.
That is really good to know. It took me 2 hours to complete the BLS last time. I "killed" the baby multiple times LOL
 
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