Afi 44 172
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Apprentice
3-Level
Apprentice 3-Level
Complete initial skills course located at JBSA-FSH METC
Journeyman
5-Level
Journeyman 5-Level 👉 to obtain
Complete a min of 12 mo upgrade training (9 mo for retrainees)
Craftsman
7-Level
Craftsman 7-Level 👉 to obtain
Selection to SSgt Complete 7-Level CDC Complete 7-Level JQS core tasks Complete min 12 mo OJT Complete 6 mo OJT retrainees
superintendent
9-Level
Superintendent 9-Level 👉 must obtain
SMSgt
Purpose of MHC - A
Performs biopsychosocial assessment
Purpose of MHC - B
Performs spec duty assess & screenings as requested Personnel reliability program (PRP) Presidential support program (PSP) Military training instructor (MTI) Military training leader (MTL) Security clearances, etc.
Purpose of MHC - E
Provides disaster mental health and pre-exposure prep
Purpose of MHC - I
Administers neurocognitive testing as required by the AF for pre-deployment and post-injury
Elements of MHC
Provides a wide variety of group and individual treatment therapies in an outpatient setting
ADAPT Program - 1
Responds to concerns about a members use of alcohol or drugs
ADAPT Program - 2
Seeks to FIRST prevent problems with drugs and alcohol from occuring
ADAPT Program - 3
Performs comprehensive substance abuse assessments
Mental health career development course writer
Uses experience along with recommendations provided by career field managers (CFM) in the mental health services career field to help create a training course
Mental health SERE Tech
Aid psychologists by thoroughly screening cadre candidates through comprehensive psych testing and intensive interview processes
Community Action Board
Promote the AF as a positive way of life Promote collaboration amount helping agencies Identify gaps in service
Integrated delivery system - A
Supports AF CAIB activities by assessing, identifying, and prioritizing AF community concerns
Integrated delivery system - D
Develops and implements collaborative community initiatives using the IDS approved 6 step methodology and template
Integrated delivery system - F
Establishes standardized key indicator metrics to monitor, evaluate, and report AF-wide institutional risk factors and helping-agency counseling workload data
Air Force Medical System (AFMS) Mission
To enable medically fit forces, provide expeditionary medics, and improve the health of all we serve to meet our nations needs
AFMS Strategic Goals
Readiness Better care Better health Best value
AFMS command structure - surgeon general
Designates the Air Force Medical Operations agency (AFMOA) as the responsible organization for execution Medical operation policies
AFMS command structure - Air Force Medical Operations Agency (AFMOA)
Provides corporate level guidance for implementation and execution of medical operation policies in conjunction with the MAJCOM surgeons
AFMS command structure - MTF (military treatment facility) commander
Responsible for all MTF resources & collections Identifies needs and manages resources to care for all eligible individuals Identifies all non-resources pt needs & reports to HQ/USAF
AFMS command structure
Squadron commander
Air expeditionary force - functions
Meet combatant commander requirements Provide airman deployment predictability Maintain home station readiness
Air expeditionary force - aeromedical evac
System for moving pt's via fixed-wing aircraft I.e. c-130 hurcules & c-17 globemaster III
Air expeditionary force - medical evacuation (medevac)
Army's system for moving pt's via fixed rotary aircraft I.e. Blackhawk
AE Mission Priorities - routine
Pt's that can be utilized for the movement of pt's
Levels of medical care (echelons) - level 2
Increased medical capability, implied impatient bedspace Basic primary care, optometry, dental, lab, x-ray, COSC, and mental health
Behavioral Health Rapid Response (BHRRT)
Provide rapidly deplorable mental health manpower, resources & equipment Provide small scale contingency ops & respond to provide psychological 1st aid Can support high risk population of 2000 or greater
Band C 1:3
Logistics and plans Medical (critical & surgical care) Chaplain (catholic & orthodox)
Band D 1:2
Medical (mental health services)
Mental health techs are in D band
Divided into 3 cycles of 6 months each
Air reserve component
Made up of ANG, AFR, and AD Air Force
Duress systems (internal)
Notify the front desk or other location In mental health that is continually manned during patient care hours in the event of an emergency
Duress system (external)
Is usually located at the front desj
Duties and responsibilities
For personal being certified, re-certified or otherwise evaluated for PRP\PSP, the entire health record must be reviewed in order to determine if PDI exists
Medical profile rating of one
Indicates a person is fully qualified to perform duties worldwide. Called "world - wide qualified"
Medical profile ratings of two or three
"Great areas" and require a screening of the person's medical records by a specialist and/or patient interview/assessment
Medical profile rating of four
Most severe and indicates severe limitations in members ability to perform duties In any category generally indicates a member will meet a medical evaluation board to determine appropriateness of continued duty
S category (psychiatric)
Applies to the mental health flight
PRP qualified personnel must have
In S - one profile documented on the AF form 422
PDI (identify potentially disqualifying information)
Past/present drug or alcohol abuse Evidence of emotional instability Character behavior disorders Medical conditions requiring treatment with narcotics, sedatives, or tranquilizers I
PRP personal mental health records 1
AF form 745 is placed on the right side of the record on top of the section containing the standard form 600 (SF600)
PRP personal mental health records
AF form 745 will serve as a flag signifying the requirement to follow special procedures during and after health care is provided for personal on PRP
Suspension
Immediately relieves member of duties not to exceed 30 days
Temporary decertification
Occurs when there are disqualifying factors that can be resolved within 180 days, can be extended up to 270 days, in 30 day increments
Security clearances F
No matter the circumstances, I'm sure local policies followed some members right to privacy is protected and they're aware of their rights
Security clearance, an investigator must have
A case number, badge number or a civilian equivalent to case number I.e. court order
Mobility restrictions (MR) are annotated on
AF form 469
Considered disqualifying for deployment
Any current or previous diagnosis or psychotic or bipolar disorder, or diagnosis associated with psychotic symptoms
Providers are required to initiate AF form 469 profile when prescribing the following medications
Antipsychotics, lithium, benzodiazepines, barbiturates/anticonvulsants, medications with special storage considerations such as refrigeration, medications that require lab monitoring
Screening one
Screen all deploying members records for MH/ADAPT/FAP visits prior to the appointment and establish appointments as needed for further assessment
Screening two
Members with a psychiatric disorder, listed in previous section, in remission or whose residual symptoms do not compare duty performance may be considered for the deployment duties if they have demonstrated a pattern of stability without significant symptoms for at least three months prior to deployment
Screening 3
If a patient with an open MH record has not been seen in three months, then the patient will need to be evaluated in person by mental health provider to assessability prior to clearance. If the chart has been closed within three months, the MHP will review the chart and determine if the member is cleared for the appointment or requires an in person evaluation
Pre-Deployment
Perform a pre-deployment baseline neurocognitive assessment within 12 months before deployment using the designated DOD neurocognitive assessment instrument (A.N.A.M.)
Civilian employee treatment
The civilian employee is eligible for an emergency intake at no expense Follow up care can be obtained at the expense of the patient an off base facility
The joint commission mission
To continuously improve the safety and quality of care provided to the public through the provision of healthcare accreditation and related services that support performance improvement in healthcare organizations
The joint commission
Nations leading accreditor of health care and behavioral health organizations Accreditation demonstrates quality in response to demand from all agencies
Find focused functions: ethics, rights, and responsibilities
Promoting considerations of clients values Informing clients of their responsibilities in the care process managing business practices in an ethical manner safeguarding clients rights regarding respect to informed consent, resolution of complaints, and confidentiality are included
Client focused functions: provision of care, treatment, and services
Addresses assessment of clients education of client and family direct client care monitoring and determining outcomes of care coordination of follow up
Client focused functions: medication management
Addresses medication use, including availability, prescribing, and ordering preparation and dispensing administration and monitoring of effect
Client focused functions: surveillance, prevention, and control of infection
Addresses how mental health program identifies and reduces the risk of acquiring and transmitting infections areas include these findings and how infections are reported
Effective leadership depends on performance the following processes
Governance, management, improving safety and quality of care
Management of the environment of care
Crucial factor in providing care, achieving good outcomes in improving safety of clients
Purpose of unit effectiveness inspection
Helps assess the ability of medical units to fulfill their peacetime and wartime missions, to include evaluation of medical care and support of the host wing's mission
Inspection areas
Mental health consultation to command behaviorbehavioral health program management care of the mental health patient alcohol and drug abuse prevention and treatment program management care of the substance abuse patient
Mental health consultation to command
Only qualified credentialed/privileged LIP perform CDE commanders were required to consult with provider prior to a CDE referral provided at least two working days notice
care of the mental health patient
MHC info sheet and informed consent form signed and dated by the patient and were present in the MHC record signed release of info was obtained as required all active MH records were reviewed every six months
ADAPT program management
Outcome metrics were collected at 3, 6, 12 months post discharge from intensive outpatient (IOP), partial hospitalization (PHP), or inpatient programs to assess patient's progress
Care of the substance abuse patient
Assessments were conducted within 7 duty days of referral
Inspection ratings
4 - meets criteria 3 - minor discrepancy/minor deficiency 2 - major discrepancy/ a program requirement was absent or flawed 1 - critical discrepancies\program requirements were absent or flawed 0 - programmatic failure\programs are not adequately managed\critical deficiencies existed N/A - not scored
Electronic health records (EHR)
Will be established for each patient seen in the MHC
Previous hard copy of MH records will not be
Integrated into the EHR; instead open hardcopy record will be transferred to the gaining installation MHC when the service member PCS's
New regulations IAW AFI 44-172 state
That FAP records will be maintained separately from MHC records and documented IAW AFI 40-301
All MHP's will use the intake note template and follow up note template
IAW AFI 44-172
Treatment plans will be completed
With patients and integrated in MH notes by the third session and will include clear explanations of the goals, therapeutic modalities, and outcome measures. Treatment plans will be reviewed regularly.
Documentation that will be included in the EHR
Privacy information sheets behavioral logs collateral contacts administrative documentation clinical notes documenting hi -interest meetings psychological testing interpretation reports Med Evaluation Board (med) narrative summaries termination/transfer notes release of information request CDE reports in an administrative recommendation memos MH documentation from outside MTF MHC
Documentation That cannot be placed in the EHR is kept in a two-part folder labeled as such in the top right corner
Patients last name, first name, middle initial and pay grade Regular Air Force or service members family member prefix and sponsors Social Security number
MH hardcopy records must be kept in a properly secure location within the clinic
Records will be kept under a double lock system
Permanent decertification
A formal action that takes place when factors cannot be resolved in the near future
Security clearances E & B
A mental health evaluation may be indicated in some instances depending on the information collected security Clearance checks may sometimes require members be evaluated by mental health
Mobility
Providers will evaluate and determine a clients suitability, fitness for duty, and deployability at every clinical meeting. Changes in status must be recorded along with justification and rationale
Management of information
Support decision-making improve client outcomes these standards can be used on paper base, electronic or hybrid record systems assess info on the science of care and treatment services
Management of Human Resources
Assesses if clinic provides qualified/competent staff right number of staff for mission experience/education and abilities confirmed during orientation Ongoing in-services and evaluation of staff competence
PRP is responsible for
ensuring those working with nukes, weapon systems, or critical components meet standards
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