Due Process and Grievance Policy
San Mateo Medical Center
Medical Psychiatry Services
Due Process and Grievance Policies
SUBJECT: Procedures for resolving conduct and performance problems within the Psychology training program.
PURPOSE: This due process document provides trainees (practicum students, psychology interns, and psychology Fellows) and staff with definitions and appropriate courses of action to respond to problems with conduct or performance. It also reviews available options for remediation and due process. During the orientation period, trainees will be informed of all policies/procedures and will receive in writing Medical Psychiatry Services’ expectations related to professional functioning. The training director will also discuss these expectations in both group and individual settings. Primary supervisors will explain evaluation procedures to trainees at the start of the training year, which will include how and when evaluations will be conducted.
If a trainee fails to meet accepted standards of conduct or performance, he/she may be subject to corrective or disciplinary action. Corrective action includes verbal and written counseling, warning letters, and letters of reprimand. Disciplinary actions include suspensions of clinical duties, disciplinary letters and dismissal.
DUE PROCESS POLICY AND PROCEDURES:
DEFINITIONS:
Defining Conduct Problems:
Conduct problems include but are not limited to: absence without leave; conviction of a criminal offense which is substantially related to the trainee’s position; dishonesty; damage to public property or waste of public supplies or time through willful misconduct; insubordination; sexual harassment; disrespectful or discourteous conduct toward a County officer or official, another employee or member of the public; excessive absenteeism or tardiness; impairment due to being under the influence of alcohol or drugs while at work or the use of alcohol or drugs during working hours except where such drugs have been prescribed and are being used in accordance with specific instructions from a licensed physician; or failure to meet the terms of his/her contract.
Defining Performance Problems:
Trainee performance problems may include but are not limited to (1) an inability and/or unwillingness to acquire and integrate professional standards into one’s repertoire of professional behavior; (2) an inability to acquire professional skills in order to reach an acceptable level of competency; (3) an inability to control personal stress, strong emotional reactions, and/or psychological dysfunction which interfere with professional functioning; or (4) a lack of self-awareness and the impact of personal feelings or judgments, which interfere with clinical duties. These various deficits may be demonstrated by specific behaviors or characteristics such as:
NOTICE OF IDENTIFIED PROBLEMS:
During the course of the training year as supervisors evaluate each trainee’s clinical performance, problems of conduct or performance may be identified. If such a problem is identified, the primary supervisor will provide a verbal notification to the trainee and will meet with the trainee informally to address the subject and identify what actions, if any, may need to be taken in the future to address the problem. Documentation of this meeting will be limited to supervisory notes maintained by the supervisor.
If it appears that the trainee is unable to understand or resolve the problem within a reasonable time after informal discussion with the trainee about the problem, a formal written notice will be provided to the trainee by his or her primary supervisor. For problems of a more serious nature, a written notice may be provided sooner, possibly contemporaneously with the initial discussion. The written notice will include a description of the trainee’s unsatisfactory conduct or performance and actions needed by the trainee to correct his/her behavior(s). The letter will also specify a time line for correcting the problem and what sanction(s) may be implemented if the problem is not corrected. The trainee is also notified of his/her right to be heard on the matter and right to appeal a determination regarding sanctions.
REMEDIATION PROCEDURES FOR IDENTIFIED PROBLEMS:
Resolving Conduct Problems:
When a trainee is alleged to have engaged in misconduct, an investigation will be conducted to determine whether the allegations are true and whether corrective or disciplinary action is warranted. This investigation will include, at the minimum, an interview with the trainee to allow him/her the opportunity to be heard and to answer the allegations. This interview will be conducted jointly by the primary supervisor and secondary supervisor. If it is determined that disciplinary action (suspension, disciplinary letter or dismissal) is warranted, a discussion will be held with the training director and program director. The trainee will then be issued a written notice stating (1) the nature of the disciplinary action to be taken against the trainee, (2) the charges against him/her, and (3) the reasons for the disciplinary action. The trainee may formally appeal the imposition of the disciplinary action as described below.
Resolving Performance Problems:
If informal notice to the trainee does not resolve a performance problem, a meeting will be held with the primary and secondary supervisor, the trainee, and the training director. The purpose of the meeting will be to clarify the expectations and develop a written plan of improvement specifying steps needed to improve clinical performance and the time frame for re-evaluation. The written plan of improvement, which the training program will provide to the trainee, will also list the steps the training program may take to assist the trainee in improving. Steps that the training program may take to assist the trainee in improving performance may include, but are not limited to: (1) Schedule modification (e.g. reducing patient load); (2) Increasing or modifying supervision; (3) Recommending professional psychological assistance/consultation; (4) Temporary suspension of direct clinical services; (5) Administrative review of clinic policies and procedures; (6) Academic coursework; or (7) Additional reading(s).
REVIEW AND HEARING PROCEDURES:
If the above steps (informal notice, formal written notice, and written plan of improvement) do not result in the necessary level of improvement, the following procedures will be instituted.
APPEAL: Should a trainee wish to appeal a disciplinary action, the trainee should file a formal appeal in writing with all supporting documents and submit it to the program director. The appeal must be submitted within seven calendar days from verbal or written notification to the trainee of the disciplinary action. Thereafter, the trainee will meet with the training director to review additional information, and outline any factual inaccuracies or disagreements with circumstances of the issue or the disciplinary action. The training director will then make a recommendation to the program director to sustain, modify, or rescind the disciplinary action. That program director will then notify the trainee in writing of his/her decision on the appeal, which is final.
GRIEVANCE POLICY AND PROCEDURES:
PURPOSE: Trainees have a right to express concerns about the training program or Medical Psychiatry Services (MPS) staff members, and the MPS training program has the right and obligation to respond to such grievances.
A. Informal Grievance Procedure
In the event a trainee has complaints about the training program, a trainee can:
B. Formal Grievance Procedure
If the informal grievance procedure does not resolve the issue, the trainee may file a formal written grievance with all supporting documents and submit it to the training director. Within ten (10) calendar days of the training director receiving the formal grievance, the training director will initiate Review Procedures as described below and notify the trainee that such procedures have been initiated.
Review Procedures
Medical Psychiatry Services
Due Process and Grievance Policies
SUBJECT: Procedures for resolving conduct and performance problems within the Psychology training program.
PURPOSE: This due process document provides trainees (practicum students, psychology interns, and psychology Fellows) and staff with definitions and appropriate courses of action to respond to problems with conduct or performance. It also reviews available options for remediation and due process. During the orientation period, trainees will be informed of all policies/procedures and will receive in writing Medical Psychiatry Services’ expectations related to professional functioning. The training director will also discuss these expectations in both group and individual settings. Primary supervisors will explain evaluation procedures to trainees at the start of the training year, which will include how and when evaluations will be conducted.
If a trainee fails to meet accepted standards of conduct or performance, he/she may be subject to corrective or disciplinary action. Corrective action includes verbal and written counseling, warning letters, and letters of reprimand. Disciplinary actions include suspensions of clinical duties, disciplinary letters and dismissal.
DUE PROCESS POLICY AND PROCEDURES:
DEFINITIONS:
Defining Conduct Problems:
Conduct problems include but are not limited to: absence without leave; conviction of a criminal offense which is substantially related to the trainee’s position; dishonesty; damage to public property or waste of public supplies or time through willful misconduct; insubordination; sexual harassment; disrespectful or discourteous conduct toward a County officer or official, another employee or member of the public; excessive absenteeism or tardiness; impairment due to being under the influence of alcohol or drugs while at work or the use of alcohol or drugs during working hours except where such drugs have been prescribed and are being used in accordance with specific instructions from a licensed physician; or failure to meet the terms of his/her contract.
Defining Performance Problems:
Trainee performance problems may include but are not limited to (1) an inability and/or unwillingness to acquire and integrate professional standards into one’s repertoire of professional behavior; (2) an inability to acquire professional skills in order to reach an acceptable level of competency; (3) an inability to control personal stress, strong emotional reactions, and/or psychological dysfunction which interfere with professional functioning; or (4) a lack of self-awareness and the impact of personal feelings or judgments, which interfere with clinical duties. These various deficits may be demonstrated by specific behaviors or characteristics such as:
- Not acknowledging, understanding, or addressing problems when identified;
- The problem is not merely a reflection of a skill deficit which can be rectified by academic or didactic training;
- The quality of services delivered by the trainee is negatively affected;
- The problem is not restricted to one area of professional functioning;
- Disproportionate amount of attention by training personnel is required;
- The trainee’s behavior does not improve within a reasonable period of time in response to feedback or remediation efforts.
NOTICE OF IDENTIFIED PROBLEMS:
During the course of the training year as supervisors evaluate each trainee’s clinical performance, problems of conduct or performance may be identified. If such a problem is identified, the primary supervisor will provide a verbal notification to the trainee and will meet with the trainee informally to address the subject and identify what actions, if any, may need to be taken in the future to address the problem. Documentation of this meeting will be limited to supervisory notes maintained by the supervisor.
If it appears that the trainee is unable to understand or resolve the problem within a reasonable time after informal discussion with the trainee about the problem, a formal written notice will be provided to the trainee by his or her primary supervisor. For problems of a more serious nature, a written notice may be provided sooner, possibly contemporaneously with the initial discussion. The written notice will include a description of the trainee’s unsatisfactory conduct or performance and actions needed by the trainee to correct his/her behavior(s). The letter will also specify a time line for correcting the problem and what sanction(s) may be implemented if the problem is not corrected. The trainee is also notified of his/her right to be heard on the matter and right to appeal a determination regarding sanctions.
REMEDIATION PROCEDURES FOR IDENTIFIED PROBLEMS:
Resolving Conduct Problems:
When a trainee is alleged to have engaged in misconduct, an investigation will be conducted to determine whether the allegations are true and whether corrective or disciplinary action is warranted. This investigation will include, at the minimum, an interview with the trainee to allow him/her the opportunity to be heard and to answer the allegations. This interview will be conducted jointly by the primary supervisor and secondary supervisor. If it is determined that disciplinary action (suspension, disciplinary letter or dismissal) is warranted, a discussion will be held with the training director and program director. The trainee will then be issued a written notice stating (1) the nature of the disciplinary action to be taken against the trainee, (2) the charges against him/her, and (3) the reasons for the disciplinary action. The trainee may formally appeal the imposition of the disciplinary action as described below.
Resolving Performance Problems:
If informal notice to the trainee does not resolve a performance problem, a meeting will be held with the primary and secondary supervisor, the trainee, and the training director. The purpose of the meeting will be to clarify the expectations and develop a written plan of improvement specifying steps needed to improve clinical performance and the time frame for re-evaluation. The written plan of improvement, which the training program will provide to the trainee, will also list the steps the training program may take to assist the trainee in improving. Steps that the training program may take to assist the trainee in improving performance may include, but are not limited to: (1) Schedule modification (e.g. reducing patient load); (2) Increasing or modifying supervision; (3) Recommending professional psychological assistance/consultation; (4) Temporary suspension of direct clinical services; (5) Administrative review of clinic policies and procedures; (6) Academic coursework; or (7) Additional reading(s).
REVIEW AND HEARING PROCEDURES:
If the above steps (informal notice, formal written notice, and written plan of improvement) do not result in the necessary level of improvement, the following procedures will be instituted.
- A committee composed of the program director, training director, primary supervisor, and secondary supervisor will be formed.
- The committee will schedule a time to meet, and will notify the trainee of the meeting time and of his/her right to appear and be heard at the committee meeting. Timely requests by the trainee to reschedule the meeting will be accommodated if good cause is shown.
- The trainee’s school/faculty liaison will be notified of the meeting and of the written plan of improvement.
- At the committee meeting, the trainee will be asked to respond to a prepared list of specific concerns identified in writing. This response will include (1) any factual inaccuracies identified in the documentation or disagreements with the documented concerns and (2) any proposed action or suggestion that the trainee may have regarding the concerns. These written concerns will be provided to the trainee before the scheduled meeting.
- After the trainee is excused from the meeting, the committee will make a determination about the trainee’s clinical competence and will make written recommendations to the program director. The recommendation will be either to (1) continue the trainee in the program; (2) continue the trainee conditionally (i.e., placed on probation); or (3) terminate the trainee from the program. The program director will then adopt, reject, or modify this recommendation and notify the trainee of his/her decision.
- If the trainee is conditionally continued in the program, the committee will reconvene in 30 days to review the trainee’s progress. After that review, the committee will then make a recommendation to the program director to either continue the trainee in the program or terminate the trainee from the program. The program director will then adopt, reject, or modify this recommendation and notify the trainee of his/her decision.
- Should a trainee disagree with the decision made in Steps 5 or 6, he/she should submit a formal appeal, as described below.
APPEAL: Should a trainee wish to appeal a disciplinary action, the trainee should file a formal appeal in writing with all supporting documents and submit it to the program director. The appeal must be submitted within seven calendar days from verbal or written notification to the trainee of the disciplinary action. Thereafter, the trainee will meet with the training director to review additional information, and outline any factual inaccuracies or disagreements with circumstances of the issue or the disciplinary action. The training director will then make a recommendation to the program director to sustain, modify, or rescind the disciplinary action. That program director will then notify the trainee in writing of his/her decision on the appeal, which is final.
GRIEVANCE POLICY AND PROCEDURES:
PURPOSE: Trainees have a right to express concerns about the training program or Medical Psychiatry Services (MPS) staff members, and the MPS training program has the right and obligation to respond to such grievances.
A. Informal Grievance Procedure
In the event a trainee has complaints about the training program, a trainee can:
- Discuss the issue with the staff member(s) involved.
- If such informal discussion does not resolve the issue, the trainee may discuss the concern with the training director, who may then consult with the program director and/or other staff members. If the concerns involve the training director, the trainee can consult with the program director directly. The training director (or program director, as appropriate) will follow up with the trainee regarding the grievance within a reasonable time.
B. Formal Grievance Procedure
If the informal grievance procedure does not resolve the issue, the trainee may file a formal written grievance with all supporting documents and submit it to the training director. Within ten (10) calendar days of the training director receiving the formal grievance, the training director will initiate Review Procedures as described below and notify the trainee that such procedures have been initiated.
Review Procedures
- A Review Panel will be formed, consisting of the training director, assistant training director, trainee’s primary supervisor, and the trainee who filed the grievance.
- Within fourteen (14) calendar days, the Review Panel will meet to review the grievance and to examine any supporting documents related to the grievance.
- Within seven (7) calendar days after the completion of the review, the Review Panel will generate a written report and submit it to the program director, which will include any recommendations for further action. Recommendations made by the Review Panel will be made by majority vote if a consensus is not reached.
- Within seven (7) calendar days of receipt of the recommendation, the program director will either accept or reject the Review Panel’s recommendations. If the program director rejects the recommendation, he/she may refer the matter back to the Review Panel for further deliberation or issue a decision which revises the panel’s recommendations.
- If referred back to the Review Panel, a revised report will be presented to the program director within ten (10) calendar days of the receipt of the program director’s request of further deliberation/revisions. The program director will then make a decision regarding what action is to be taken and inform the training director and assistant training director.
- The training director will then inform the trainee, staff members involved, and any other members of the training staff as necessary of the decision and any action taken or to be taken.
- If the trainee objects to the program director’s decision, the trainee has the right to submit an appeal to the program director, who will determine if a new Review Panel should be formed to re-examine the grievance or if the decision should be upheld.