Physician Assistant Lvl I

New York City Health and Hospitals Corporation

Outposted Therapeutic Housing Units Program (OTxHU)

Since 2016, Correctional Health Services (CHS) has been the direct provider of health care in the New York City jails. Deeply committed to human dignity and patient rights, CHS is part of the NYC Health + Hospitals system and is a key partner in the City’s efforts to reform the criminal-legal system. Our in-jail clinical services include medical, nursing, and mental health care; pharmacy services; substance-use treatment; social work; dental and vision care; discharge planning; and reentry support.

Given the high visibility of this initiative, we are seeking the highest caliber health care professionals in key clinical services to staff our Outposted Therapeutic Housing Units (OTxHU). To be located in three NYC Health + Hospital acute care facilities, the OTxHU is a pioneering approach to safely increasing access to high quality clinical care for patients in custody who have complicated health conditions. OTxHUs will bridge the gap in the continuum between care provided in the jails and inpatient hospitalization, with admission to and discharge from the OTxHU in accordance with a patient’s clinical needs. CHS will be the primary health care providers on these units and the NYC Department of Correction will provide security and custody management.

The OTxHU at NYC Health + Hospitals/Bellevue in Manhattan will be the first of this unique, groundbreaking project to open with a planned completion date as early as the end of 2024. This is an incredible opportunity to be part of a passionate and motivated team providing care to some of the City’s most marginalized, vulnerable people.

*To help support continuity of operations and care, staff selected to work in the OTxHU may also be required to work in CHS locations within the jails. Additionally, while CHS seeks the most qualified individuals for these positions, preference will be given to equally qualified, internal candidates.

• Time: 8:00 AM - 4:30 PM
• Days: Monday to Friday
• Location: OTxHU-Bellevue/Rikers Island

Under supervision of the Site Medical Director, the Physician Assistant will provide comprehensive, compassionate, and thoughtful care to patients with complex chronic disease in the New York City jail system, under the supervision of physician leadership. The Physician Assistant will provide general primary care including conducting histories and physicals, diagnosing and treating acute and chronic illnesses, and evaluating the need for consult services. The Physician Assistant will participate in an interdisciplinary team under supervision of a Site Medical Director for patients who have chronic medical conditions or physical disabilities who do not require acute inpatient admission.

Responsibilities include:

• Diagnose and treat acute and chronic illnesses. Evaluate the need for consult services and submit the prioritized consult when indicated.
• Complete comprehensive histories and physicals on all new admissions including documentation of problem list, diagnosis, orders (e.g. labs, imaging and referrals) and ordering appropriate medications where applicable.
• Evaluate patients requesting sick call, schedule follow-ups and update medication orders. Update problem lists and reconcile patient orders at all visits.
• Implement plans for patientcare utilizing protocols approved by the Medical Director and/or treatment plans reflecting the current standard of care.
• Request radiology exams, lab tests, EKGs when clinically indicated and interpret these results based on clinical findings and in consultation with supervisors where appropriate.
• Review all specialty consults and hospital returns to ensure that the standard of care is met and recommendations of the consultant are implemented.
• Perform chart reviews and summaries for patients transferring facilities including updating problem lists, rewriting medication orders, and reconciling orders and consults as needed.
• Generate special needs referrals and documentation as needed (for patients with (disabilities, dietary restrictions, heat sensitivity, or other relevant flags).
• Teach patients about their medical conditions and treatments; counsel on risks and benefits of different treatment decisions; witness, sign, and document patient refusals of care.
• Ensure that all progress notes and orders are signed before the end of the shift.
• Respond to emergencies in a timely and professional manner.
• Notify the staff MD and Urgicare about 3 hour runs and EMS activation.
• Complete special housing rounds when assigned.
• Be familiar with quality of care and population health indicators. Take appropriate action to meet or exceed standards.
• Maintain clinical competency by participating in all CME and CHS training and in-service requirements.
• Maintain your schedule as directed with particular attention to punctuality and timely notification of absences.
• Adhere to policies and procedures of CHS and be familiar with them by reviewing them as needed.
• Complete tasks as delegated by a Site Medical Director or other supervising clinical team member.
• Maintain and provide documentation of all required credentials.
• Maintain professional attitude and appearance.
• Adhere to Occupational Health Services requirements.

Minimum Qualifications

1. Valid limited permit to practice as a Physician Assistant issued by the New York State Education Department (NYSED); or

2. Valid license and current registration to practice as a Physician Assistant issued by the NYSED; and

3. Possession of a valid Life Support certification (e.g., Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS)) is required in the appropriate practice area through the American Heart Association (AHA) within sixty (60) calendar days of appointment to the title

Department Preferences

• Experience working with patients in a skilled nursing facility or other residential setting
• Experience working with patients who have serious mental illness
• Experience working with patients who carry substance use diagnoses; knowledge of harm reduction approaches to care; and familiarity with medications to treat opioid use disorder
• Experience leading quality improvement initiatives
• Understanding of trauma-informed care
• Skilled in patient-centered shared decision making
• Skilled in communicating risks and benefits of clinical interventions and assessing capacity to make informed decisions.
• Active BLS and ACLS certifications
• Infection Control Certification
• Excellent interpersonal communication skills and ability to work collaboratively within a multidisciplinary team, as well as with NYC DOC staff
• Flexible disposition

NYC Health and Hospitals offers a competitive benefits package that includes:

• Comprehensive Health Benefits for employees hired to work 20+ hrs. per week
• Retirement Savings and Pension Plans
• Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts
• Loan Forgiveness Programs for eligible employees
• College tuition discounts and professional development opportunities
• College Savings Program
• Union Benefits for eligible titles
• Multiple employee discounts programs
• Commuter Benefits Programs