Nurse Practitioner

A. Standards of Obligation

To assist CDCR/CCHCS in its exercise of its duty to provide and manage medical healthcare services to the patient/youth of the State of California, Temporary/Relief Physician Assistants and Nurse Practitioners shall provide high quality services consistent with established and commonly accepted standards and principles of medical practice. Nothing in the Agreement shall supersede the common law rules for the interpretation of established and commonly accepted standards and principles of medical practice.

Providers shall adhere to the CDCR/CCHCS medical staff by-laws, rules, regulations, policies and procedures, and comply with universal infection control precautions.

B. Authorization

1. Authorization for Treatment

Temporary/Relief Physician Assistants and Nurse Practitioners shall agree that, as required by law, excluding emergency and primary care services, prior authorization must be obtained in writing from the respective CDCR/CCHCS Institution/Facility CEO/CME or designee, in accordance with CCHCS's Utilization Management Plan. Temporary/Relief Physician Assistants and Nurse Practitioners shall complete and return all forms required by CDCR regarding treatment of patient/youth. Authorization must be documented in the patient's/youth's medical record in all cases of essential services before considering any non-emergency specialty treatment, or any consultations by specialty Physicians, Physician Assistants, and/or Nurse Practitioners or diagnostic procedures not specifically stated in a CDCR/CCHCS prior authorization form.
 

2. Authorization for Transportation/Transfers

Temporary/Relief Physician Assistants and Nurse Practitioners shall agree that, as required by law, CDCR/CCHCS retains full authority to determine the manner in which a patient/youth is transported to the CDCR/CCHCS institutions/facilities or transferred to other healthcare facilities, after the course of treatment or therapy has been implemented or completed.

Temporary/Relief Physician Assistants and Nurse Practitioners shall not transfer a patient/youth to any facility without prior written authorization from the appropriate CDCR/CCHCS Institution/Facility CEO/CME or designee.

3. Experimental and Investigational Drugs and Procedures

Temporary/Relief Physician Assistants and Nurse Practitioners shall not perform on or administer to any patient/youth any experimental or investigational treatment, therapy, procedure or drug. Such treatment, unless it is otherwise permissible under law, is prohibited under Penal Code, Section 3502, and thus must have prior authorization by the Institution/Facility CEO/CME or designee and CDCR's Office of Legal Affairs. Temporary/Relief Physician Assistants and Nurse Practitioners shall agree to perform or administer only those medical services which are recognized as being in accord with generally accepted professional medical standards, or as being safe and effective for use in the treatment of an illness, injury or condition at issue, subject to the limitations described in this Agreement.

4. Exclusions and Limitations

a. Temporary/Relief Physician Assistants and Nurse Practitioners shall agree that no healthcare service or treatment shall be provided for those conditions specifically listed in California Code of Regulations (CCR), Title 15, Division 3, Chapter 1, Subchapter 4, Article 8, Section 3350.1. Physicians, Physician Assistants, and Nurse Practitioners, may request individual case exceptions for excluded or limited healthcare service or treatment by seeking prior approval of the Institution/Facility CEO/CME or designee.

b. Temporary/Relief Physician Assistants and Nurse Practitioners shall agree that any excluded healthcare service or treatment needed for pre-existing conditions shall be provided only in the event that the condition has become aggravated in such a manner that it poses a significant threat to the patient's/youth's current health and if not treated would result in morbidity and/or mortality. Temporary/Relief Physician Assistants and Nurse Practitioners shall acknowledge that the appeal must be recognized as medically necessary.

c. The CDCR/CCHCS Medical Standards of Care shall be used as a reference when prior authorization is granted.

5. Clinical Reviews At the request of the Institution/Facility's CEO/CME or designee, Temporary/Relief Physician Assistants and Nurse Practitioners shall perform clinical reviews to determine the quality of clinical care delivered. This includes clinical reviews of index cases (deaths, adverse outcomes etc.) for the purposes of determining clinical quality. As part of the clinical review process, Temporary/Relief Physician Assistants and Nurse Practitioners can also be required to participate in Professional Practice Committee activities and may be called as witnesses in Professional Practice activities. The process of clinical reviews may include the examination of written health records, discussion with Physicians, Physician Assistants, and/or Nurse Practitioners and CDCR/CCHCS supervisors and direct patient/youth examinations. The Temporary/Relief Physician Assistants and Nurse Practitioners who perform clinical reviews are required to be skilled in the preparation of written clinical review documents.

6. CCHCS shall provide a copy of the CDCR/CCHCS's formulary to be kept on file by the applicable Temporary/Relief Physician Assistants and Nurse Practitioners. Temporary/Relief Physician Assistants and Nurse Practitioners shall consult with CDCR physicians to assure that whenever possible only those medications which are on the CDCR's formulary are prescribed unless granted prior authorization is given by the Institution/Facility's CEO/CME or designee for deviation.

Salary : $70