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CALLING FOR COMMUNITY EMERGENCY SERVICES

Purpose

To ensure timely and appropriate activation of community emergency services (fire, rescue, emergency medical services, or police) in situations that threaten the health, safety, or well-being of students, staff, or others on site.

Policy Statement

In the event of urgent and/or life-threatening circumstances (as defined within), staff are authorized and expected to initiate emergency calls to 911 without delay. This policy applies to both students, staff, or others on site.

Procedures

  1. Direct Access to 911
    • If staff can access an outside telephone line, they are authorized to call 911 immediately for emergency assistance
  2. Indirect Access
    • If an outside telephone line is not accessible, staff will promptly notify the supervisor or available administrator, who will initiate the 911 call.
  3. Supervisor Notification for Non-Urgent Situations
    • If the circumstances are potentially dangerous, but not urgent and/or immediately life-threatening, staff will notify the supervisor for further instructions.
  4. Police Involvement
    • If the situation might require police intervention rather than fire/rescue or medical services, staff will notify the supervisor.
    • The supervisor is authorized to determine further action, including notifying external authorities or administration.

Special Note: When a staff member exhibits symptoms suggestive of a potential medical emergency (e.g., chest pain, shortness of breath, sudden confusion, loss of consciousness, severe allergic reaction), staff are authorized to initiate a 911 call immediately, even if the staff member verbally declines.  This decision prioritizes safety and ensures rapid medical evaluation by emergency responder.

Definitions

Urgent and/or Life-Threatening Circumstances
A situation that:

  • Poses an immediate and unexpected risk to health, life, or property, requiring urgent intervention from community services.
  • Cannot be safely or effectively managed by Hillcrest personnel, supervisors, managers, or administrators alone.
  • Represents a present and unfolding crisis that threatens lives or major property damage.

Examples

Examples of Urgent and/or Life-Threatening Circumstances (includes, but are not limited to):

  • A person (student, staff, or others on site) has lost consciousness, cannot breathe, or is bleeding heavily.
  • A person (student, staff, or others on site) exhibits symptoms suggestive of a serious medical emergency, such as chest pain, severe shortness of breath, sudden confusion, and severe allergic reaction.
  • A fire in a building.
  • Major storm damage threatening safety.

Examples of Situations Not Constituting Urgent/Life-Threatening Circumstances:

  • A student is verbally or physically threatening, destroying property, or running away.
  • A student or staff has minor symptoms that should be checked by a nurse, but are not serious or life-threatening.
  • Situations that may eventually require police intervention, but are not immediately dangerous.

 

 

INDIVIDUALIZED EDUCATION PLAN and COMPREHENSIVE TREATMENT PLAN (IEP/CTP/BSP)

At HEC, the IEP and CTP/BSP are developed as one working document with two parts. The process that has been developed meets the requirements of both the Department of Education and The Joint Commission, and the process actually begins prior to admission.

Before a student is admitted to an HEC program, an Intake Assessment and Preliminary Treatment Plan are completed by a member of the clinical staff so that staff are adequately
prepared to work with the student. During the six weeks following admission various assessments are done (see Basic Documentation Requirements) in order to develop a complete CTP/BSP. In the event a student is admitted without a current and valid IEP, the
Education Director or Academic Case Manager will work with his/her school district to develop an IEP within the same timeframe. This document is reviewed at least quarterly with input from the Treatment Team, the student, his/her referring agency and the student’s parent or guardian.

Hillcrest is committed to providing all special education and related services specified in each student’s IEP. These services are critical to addressing the unique needs of our students with disabilities. It is the policy of Hillcrest Educational Centers to provide make-up sessions for all related services missed due to provider absence in accordance with the Individualized Education Program (IEP) of each student. Missed sessions must be made up within a reasonable timeframe, not to exceed 90 days from the date of the missed session. A standardized digital log system shall be used to record and track all service sessions and will be regularly reviewed by Hillcrest administration.

Allergies

CHAPTER 7 – HEALTH CARE

ALLERGIES

APRIL 12, 2024

 

Students are assessed for possible allergies to foods, chemicals or other materials at the time of admission based on their annual physical assessment, medical history, specialist assessments/examinations, and allergy panels. When students have specific known allergens, nursing works with the kitchen staff to ensure no cross contamination occurs. We do not accept students with severe peanut allergies due to the risk it presents, unless they are admitted to our Highpoint campus, which is completely nut free. After admission, the medical staff continues to monitor for additional allergens that may not have been noted on admission, by doing frequent nursing assessments, annual physicals, and continuous monitoring. Known allergies are noted on the face sheet of each student’s individual master file, emergency medical file. A complete list of student allergies is circulated among staff at each campus.

 

As part of the employee orientation process, the nursing department informs new staff of allergies of the students in their care and the location of all allergy information. In addition, allergy lists are readily available in the students’ classrooms, dorms, nurses station, supervisors office, and staff lounges. Student information is confidential, so this information is located within staff information binders, and is not posted publicly in any location. Our allergy lists are updated as soon as any changes occur with any of the students in our care, and are reviewed on a weekly basis. This is communicated to staff in their shift stand up meetings before working with the students, as well replacing the allergy lists in all locations with the new information. 

 

SEVERE FOOD ALLERGIES

 

Purpose: To ensure that all departments are fully informed of student allergy and the necessary emergency treatment

 

Procedure: Prior to admission the Head Nurse will review all medical information for the presence of allergies. If this information is forthcoming during the interview/admission process then the information will be disclosed to the campus Head Nurse. During the campus nursing assessment, history of any allergies or sensitivities to food or drugs is reviewed with the student as well as any accompanying adult. This information is recorded on the nursing assessment, on the label of the chart, the medication administration record, physician’s orders and in the campus allergy list.The allergy list is then distributed to the kitchen, supervisor’s office and campus Emergency Manual. Allergy lists produced for use in program kitchens shall provide the first name and last initial only of the student. In the event that students’ first names and last initials are identical, the next letter of the last name shall be included to differentiate the students (ex. John D., John DO). The list should include any needed emergency treatment such as an epipen. Any specific treatment needed for severe allergens such as peanuts will be addressed on an individual basis with the Head Nurse, Director of Nursing, Director of Support Services, Nutritionist and staff.

STUDENT SUSPENSION AND DISCHARGE OF STUDENTS FROM HILLCREST PROGRAMS

STUDENT SUSPENSION AND DISCHARGE OF STUDENTS FROM HILLCREST PROGRAMS

 

Hillcrest Educational Centers does not suspend residential students for any reason. Hillcrest Educational Centers will utilize interventions in the Skills for Life Treatment Model and as indicated in Applied Behavioral Analysis up to and including Individualized Programming when appropriate to assist in behavior management and skill development.

Hillcrest Academy may suspend students for reasons consistent with, and following the protocols that are consistent with D.E.S.E. regulations as well as including the CSE for students placed at Hillcrest Educational Centers from New York State.

Hillcrest would follow the protocols outlined below related to Unplanned or Emergency Discharges. Additionally for New York state students Hillcrest will follow protocols outlined in 603 CMR 28.09 (12) which states that no student may be terminated until their LEA has assumed responsibility for the student and 8 CRR-NY 200.7(c)(2) which states that no student with a disability placed by a Committee on Special Education shall be removed or transferred from an approved out-of-state school without such recommendation by the Committee on Special Education.

When a discharge plan has been established, guardians and funding agencies, along with the youth (whenever possible) will be provided with a Clinical Discharge Summary that includes the disposition plan for the youth. All efforts will be made to obtain signature or alternative documentation to show that these stakeholders have received a copy. The Discharge Summary will include the following information as part of the disposition:

  • Identified plan for discharge placement/housing/home to which they are returning
  • Current psychotropic medications and any pertinent medication administration instructions or upcoming appointments
  • Plan for clinical and psychiatric care and any pertinent instructions or upcoming appointments
  • Contact information for emergency circumstances including any new or ongoing providers, local EMS providers (i.e. closest hospital to discharge placement), and any pertinent hotlines
  • If there are any gaps in services that are beyond the control of HEC, all efforts that were made to obtain services prior to discharge will be documented

Additionally, the Nursing Department and Educational Department also provide Discharge Summaries that provide information regarding medical and educational services.

 

There are three types of discharges from any Hillcrest program.

1) Planned Discharge

A discharge plan is established during the development of the initial Comprehensive Treatment Plan. The CTP will include goals, including the discharge goal, objectives and strategies.

The discharge plan may be modified at any CTP review, depending on the progression of treatment and the status of potential post-placement resources. The student’s parent/guardian and funding agency will be involved in all discharge planning activities. Discharge summary document is completed by the date of discharge. A copy of this summary is provided within the student’s discharge paperwork.

 

2) Unplanned Discharge

An unplanned discharge may occur when a student has been determined to be unmanageable within HECprograms. The need for an unplanned discharge can be determined only by the Executive Team in conjunction with the treatment team, the Program Director and the Clinical Director. An unplanned discharge is only considered when all other treatment options have been exhausted. The student’s parent/guardian and funding agency, including student’s local school district, will be involved in determining all significant changes in treatment, including the decision to conduct an unplanned discharge. Hillcrest will provide the student’s parent/guardian and funding agency with an identified timeline to find an alternate placement.

If a guardian or adult student (own guardian) signs out of Hillcrest’s care against medical advice, they will be provided with numbers for a crisis hotline as well as contact information for social service providers in their local area, should they need support. The numbers and information are located on the AMA form that the guardian or adult student will be signing, a copy of that form should be provided to them during this process. If Hillcrest feels an unplanned discharge presents a risk to the student or others, or would create a potentially abusive/neglectful situation, Hillcrest will contact the appropriate social service agency, crisis team, and/or law enforcement.

 

3) Emergency Discharge

An emergency discharge occurs only when a student has been determined to be exhibiting behavior requiring the care of a hospital or secure (i.e., locked) facility.

The need for an emergency discharge can only be determined by the consulting psychiatrist in conjunction with the Executive Team, the Treatment Team, and the Program Director.

The student’s parent/guardian and funding agency will be kept fully informed at every stage of an emergency discharge.

 

PLAN FOR FOLLOW-UP SERVICES

Hillcrest will work collaboratively with the student’s custodial agency to determine what aftercare services are necessary and/or preferable for the student being discharged from Hillcrest. Hillcrest will provide formal recommendations for time limited follow up services based on these conversations. However, it is the responsibility of the guardian to secure these services. Hillcrest will not be financially responsible for the provision of services after discharge.

Following discharge, Hillcrest makes every effort to track students’ status and progress for one year. The results are compiled into an annual outcome study.

 

STUDENT TUITION

A. Student Tuition Rates
Student tuition rates are established by the Commonwealth of Massachusetts Executive Office for Administration & Finance, Operational Services Division (OSD). This rate documentation is furnished to all agencies that engage in business with Hillcrest Educational Centers, Inc. According to our regulations, Hillcrest may not charge less than this rate that includes tuition and residential costs. These rates are on file in the HEC Business Office.

B. Attendance Forms
Student attendance is taken daily. The daily attendance forms are maintained at the campus and submitted to Accounts Receivable on the first day of the following month. These forms confirm the student’s attendance and identifies the specific nature of any and all absences if the student is not in attendance during the month, i.e. vacation, AWOL, hospitalization, home visits, etc.
C. Student Clothing
Most students placed by social service agencies are provided an allowance for initial and replacement clothing. Campus administrators may request the allotment when they plan to take the student shopping, and return the receipts so agencies may be billed. In situations where the student does not have a funding agency and the student’s placement is fully / privately funded by the parents / guardian, then the parents / guardians are required to provide clothing and/or clothing monies for students. The parents are sent a Parent Funded letter stating that they are responsible for any clothing costs.

D. Student Personal Funds
A student’s personal funds, those received from their agencies and/or received as allowance and/or accumulated wages from student jobs, are held in custody at the student’s campus or in a local bank account maintained for the student. The student can access these funds by following standard procedures, and all use of these funds by the student are approved and documented.

E. Securing 1:1 Funding
If student is decompensating generally the special emergency team meeting policy (explained below) will go into effect. This process takes care of the notification to the Executive VP, Vice President of Program Services and Clinical Director. The clinician and/or case manager is responsible for ensuring that the appropriate parties – guardian/funding source/managed care – know that this process is underway and the outcome of these meetings. 1:1 funding or ITU placement can be a recommendation of either of these meetings. The designated campus staff is then required to complete all necessary documentation and requests for funding, and ensure that the appropriate funding letter, agreeing to the funding is on record from the appropriate party before all service changes can be initiated.
When 1:1 staffing is required for the Day Program a separate 1:1 funding addendum is prepared for each funding source as needed, in addition to contracts or placement agreements already in place.

Special/Emergency Team Meeting Policy:

1. Special Team Criteria
• Student is not in acute crisis, but Team wants to problem-solve around particular behaviors and/or treatment issues.
• Student is not compliant with medication.
• Student is not participating in therapy.
• Treatment Plan is not effective after review and amendment.

Participation: CCW-Day & Residential, Nursing, Clinical, Teacher or TA, Supervisor, Program Director, APD, Lead Clinician.
Notification: Psychiatrist, Clinical Director, ITU, Executive Vice President, Vice President of Program Services, Medical Director.

2. Emergency Team Criteria
• Student is in acute crisis.
• Student is at high risk/danger to themselves or others.
• Student is being considered for transfer to a more restrictive environment or emergency discharge.

Participation: CCW-Day & Residential, ITU, Clinical Director, Nursing, Nursing Coordinator, Clinician, Lead Clinician, Clinical Director, Program Director or APD (or Lead Clinician if the student is an ITU student), Executive Vice President, Vice President of Program Services, Teacher & TA, Supervisor, or Assistant.
Notification: Psychiatrist, Medical Director.

3. Protocols
• The Program Director or designee will decide whether or not to schedule a special/emergency team meeting.
• Emergency Team meetings should be conducted within 72 hours of the determination of the need for an Emergency Team meeting.
• The Program Director or designee will notify all staff according to criteria listed above.

F. Contracts
Contracts with public agencies and school districts are maintained in the Business Office. Student travel, which may be reimbursed by the agency and funding for students’ absence from program varies by contract.

EMPLOYER STANDARDS

Attendance and Punctuality

PURPOSE

The purpose of this policy is to ensure that all employees of Hillcrest Educational Centers adhere to standards of attendance and punctuality that are essential for service provision to our students, the safety and security of our work environment, and the effective operation of our organization. This policy outlines the expectations for attendance and punctuality, sets forth the procedures for call-outs, and outlines the consequences when standards are not met.

ATTENDANCE AND PUNCTUALITY EXPECTATIONS

Regular Attendance

All employees are expected to be a reliable staffing resource by maintaining regular attendance and demonstrating punctuality during their scheduled work hours.

Tardiness

Tardiness is defined as arriving one (1) minute late or more to your scheduled shift. Tardiness is disruptive to the workplace and impacts productivity. Employees are expected to arrive on time and be prepared to work for their scheduled shift. Employees who will be reporting to work after the start of their shift must notify their supervisor that they will be arriving late.

Early Departure

Employees are expected to remain at work for their entire work schedule. An early departure is disruptive to the workplace and impacts productivity. Employees who must leave work before the end of their scheduled shift must notify their supervisor and have this approved beforehand.

Unscheduled Absences for Urgent Reasons

In the event of an unscheduled absence for an urgent reason, employees are required to notify the supervisor on shift. Unplanned absences can be approved only under certain circumstances. Absences related to pre-scheduled activities, events, appointments, and commitments will not be considered approved absences as the employee had notice of these and should have requested time off in advance.

Unscheduled Absence for a Medical Reason

For any absence due to a medical reason in which the employee has no earned sick time available, employees are required to provide a medical certification from a healthcare professional to Human Resources. This certification should be submitted within seven (7) days of the employee’s return to work.

For any absence due to a medical reason exceeding three (3) consecutive days, employees are required to provide a medical certification from a healthcare professional to Human Resources. This certification should be submitted within seven (7) days of the employee’s return to work.

For more information related to earned sick leave, please refer to the Earned Sick Leave Policy.

CALL-OUT PROCEDURES

Employees must notify the supervisor on shift of any unscheduled absence at lease one (1) hour before the start of their scheduled shift to afford an opportunity to arrange for coverage and to minimize disruption to the team. Employees should not call-out to Human Resources. This is not in compliance with call-out procedures and will not be considered a proper notification. Should they do so, they will be directed to speak with their campus management instead.

Notification should be made via phone call to the supervisor on shift at the campus. If the supervisor cannot be reached, employees must leave a voicemail with a working phone number where they can be reached. The supervisor and/or the Administrator on duty will immediately place a return call once the message has been received.

Employees should provide a clear and concise reason for their calling out. If the details of the call out are sensitive in nature, the employee will be required to communicate the specific reason to the Administrator on duty. Human Resources will be notified by the Administrator on duty should it be deemed necessary.

CONSEQUENCES OF VIOLATIONS

Failure to adhere to this Attendance and Punctuality Policy will result in disciplinary action, including verbal warnings, written warnings, suspension, and termination of employment.

The following are subject to disciplinary action:

  • Patterns and frequency of concern in absences, tardiness, or early departures
  • Absences, tardiness, or early departures resulting in unpaid time for a shift or any portion of their shift
  • Not following the call out procedure

Supervisors will address attendance and punctuality issues promptly and consistently. If an employee faces extenuating circumstances, they should communicate this with their supervisor.

NO CALL-NO SHOW FOR A SCHEDULED SHIFT

No Call, No Show is defined as when an employee does not notify the supervisor on shift of their absence within at least one (1) hour before their scheduled shift and does not report to work for their shift.

Consequences of No Call, No Show

  • First incident of No Call, No Show will result in a Final Written Warning and a 3-Day Suspension
  • Second incident of No Call, No Show incidents will result in termination
  • Three (3) consecutive incidents of No Call, No Show will be an indication that the employee has abandoned their job and we will therefore consider this to be their voluntary resignation

REVIEW AND AMENDMENTS

Hillcrest Educational Centers may review and amend this Attendance and Punctuality Policy at any time. Employees have access, and are encouraged to review, the online Hillcrest Educational Centers Policies and Procedures platform for updated policy information.

This policy does not apply to absences covered by the Massachusetts Paid Family and Medical Leave Act, Family and Medical Leave Act (FMLA), Workers’ Compensation, or leave provided as a reasonable accommodation under the Americans with Disabilities Act (ADA). These exceptions are described in separate policies.

 

PROTOCOL FOR EMPLOYEE INJURED ON THE JOB

  1. When an injury occurs on the job, the employee completes an ART form within 24 hours of reported injury. On the ART Form, employee indicates whether or not they plan to seek medical attention.
  2. The program sends the ART Form, Incident Report, video, and when necessary, witness statements to Human Resources (HR).
  3. If the employee does not plan to seek medical attention, the injury is logged into the Injury Data sheet and ART form is filed.

OR

4.If the employee does wish to seek medical attention, the injury is reported to the workers’ compensation carrier, logged into the Injury Data sheet, and an employee injury folder is created.
Next Steps :

  • If immediate care is necessary, the employee should go to the designated occupational health provider. If this necessity falls outside of the hours of operation of the provider, the employee should go to Urgent Care or the Emergency Room.
  • If immediate care is not necessary, HR will contact the employee within one business day and schedule an appointment with the designated occupational health provider.
  • If the on the job injury constitutes a medical emergency, the employee should go to the nearest Emergency Room.

5. The employee is responsible for arriving at occupational health provider appointments at the designated time.
6. The employee  is required to contact HR immediately following the appointment to notify them of the outcome.
7. If the employee is placed out of work, HR explains workers’ compensation, the impact on their compensation, and confirms the date and time of their next occupational health provider appointment.
8. If the employee is cleared for modified duty, HR coordinates with the program administration to determine whether or not the restrictions can be accommodated. While every effort is made to identify modified duty work for staff who are injured on the job, it is not guaranteed and will depend on availability of modified duty work.
Next Steps:

  • If modified duty is available and approved, HR communicates with the employee regarding the program location and schedule of the available modified duty. HR also communicates with the workers’ compensation carrier that the employee will be compensated at 100% of their current base pay.
  • If the modified duty is not available or not approved, HR communicates with the employee regarding remaining out of work, conveys the impact, HR communicates with the employee regarding remaining out of work, conveys the impact on their compensation, and confirms the date and time of the next occupational provider appointment. HR also communicates with the workers’ compensation carrier that the employee is remaining out of work.
  • If the employee declines to modified duty assignment, HR notifies the program and the workers’ compensation carrier, communicates with employee regarding the impact on their compensation, and confirms the date and time of their next occupational health provider appointment.

9. As the employee remains out of work or on modified duty, HR and the designated program administrator continues to communicate with the employee based on the attached Out of Work Expectations for On the Job Injuries. HR maintains communication via email notifications to program administration regarding employee’s status.
10. The ability to work modified duty may be impacted by the employee’s adherence to the conditions of their modified duty agreement. Employees who fail to comply with those conditions may have their modified duty assignment discontinued.
11. The policies and procedures of Hillcrest Educational Centers apply during the modified duty period. Employees on modified duty who do not meet the expectations of those policies and procedures may be subject to discipline.
12. To mitigate the risk of future injury, a debrief is completed for all on the job injuries that meet one of the following criteria:

  • The employee was out of work for 7 or more days
  • The employee is injured in their first 90 days
  • The employee is injured 3 or more items in a 12-month period
  • At the request of the Program Director or Executive Leadership
  • At the request of the injured employee

A debrief includes a review of documentation and available video footage. The injured employee, a member of HR, and a program administrator participate in the debrief through active discussion. A Therapeutic Crisis Intervention instructor may also participate in the debrief when relevant. The debrief is documented via the On the Job Injury Debrief Form and kept on file by the Workplace Safety and Wellness Specialist. As a result of the debrief, the employee may be required to participate in learning activities, enhanced supervision, or other support mechanisms aimed at injury reduction. Data from debriefs conducted will be recorded and analyzed in the aggregate for the purpose of identifying areas for performance improvement focusing on the mitigation of on the job injury risk. These areas may include, but are not limited to, policy and protocol creation and revision, skill enhancement identification , organization wide learning activities and communications, and environmental modifications.
13. When the employee is cleared to return to work full duty, HR confirms with the employee they are cleared to return for their next regularly scheduled shift. HY additionally notifies the program of the employee’s return.

OUT OF WORK EXPECTATIONS FOR EMPLOYEES INJURED ON THE JOB

  1. An employee out of work on workers’ compensation is required to make a phone call to and speak with  their program’s Assistant Program Director (APD) or other administrator designee no less than once every week, Monday through Friday between the hours of 8:30am to 4:30pm. Leaving a message does not qualify as a contact. The Assistant Program Director will be responsible for reaching out to the employee by telephone and email on Friday afternoon by 3 PM if they have not been contacted by the employee that week. Any relevant information gathered during the contact will be shared by the campus with the Human Resources Department. Additionally, any paperwork or updates on the employee’s status after follow up appointments will be communicated directly to the Human Resources Department. HR will then provide the campus any and all work status updates.
  2. An employee out on workers’ compensation is to return any outreach from the workers’ compensation carrier within 24 hours. This contact may occur in whichever format is preferred by the employee.
  3. An employee out of work on workers’ compensation is to return any outreach from the workers’ compensation carrier within 24 hours. This contact may occur in whichever format preferred by the employee.
  4. Confirmed occupational health appointments related to the on the job injury are not to be rescheduled without first consulting HR.
  5. Requested medical documentation is to be returned to HR within 24 hours of the request.
  6. Once the employee is cleared to return to work, they are expected to report for their next regularly scheduled shift.

Failure to abide by these expectations may negatively impact staffing due to an unnecessary delay in return to work. For this reason, disciplinary action may result.

Workplace Safety and Wellness Specialist
Gayle Murphy
Phone: (413)499-7924 x 144
Email: gmurphy@hillcrestec.org

Administrative Offices-ask to speak with Human Resources Dept:
Phone: (413) 499-7924

DRUG AND ALCOHOL POLICY

Introduction:

Chemical and alcohol dependency creates serious ethical concerns for HEC where the vital concern for the safety and quality of care to our students cannot be compromised. HEC is committed to maintaining an alcohol and drug free work place and to that end has adopted the attached policy emphasizing education of all employees along with the rehabilitation and re- integration of chemically dependent employees, who are willing to go into recovery, to the workplace.

Pre-employment Testing:

As a condition of employment all new employees will be tested for drugs after a job offer has been extended and the offer accepted by the prospective employee. Offers of employment will be conditional upon a successful pre-employment drug screening. Testing will be completed as part of the pre-placement physical exams which are conducted by an outside Occupational Health provider. A prospective employee who fails the pre-employment drug or alcohol screening will not be considered for employment at that time. The offer will be rescinded.

Policy:

It is the policy of Hillcrest Educational Centers to assure the safety and well being of its students and employees in a drug free work place by:

• Prohibiting the manufacture, use, sale, trafficking, purchase, transfer, distribution, dispensation or possession of any illegal drug by an employee while on duty or on HEC properties;
• Prohibiting the diversion of student medications;
• Encouraging self-identification of chemically dependent employees;
• Actively intervening with those that do not self-identify;
• Promoting rehabilitation by therapeutic treatment; and re-entry to the workplace for staff who “self-identify” a substance abuse problem or concern.

Staff, while on the job or on Hillcrest property, are prohibited from using or having alcohol, drugs or drug paraphernalia in their possession. Staff who possess or who appear to be under the influence of alcohol or drugs, will be immediately relieved of their duties and will be subject to disciplinary action, up to and including dismissal. Staff who come to work under the influence of drugs or alcohol, and who are non-compliant with the policy will be terminated.

It is the responsibility of every employee to report suspicions of drug or alcohol use to their supervisor immediately upon suspicion of abuse. The reporting employee will be required to provide a written statement before the end of the shift that details the behavior, verbal interactions or physical characteristics (including odors) that have led to the suspicion. Staff reporting suspicion of abuse will be provided with the maximum confidentiality possible under the circumstances, but we cannot guarantee that reports will remain confidential due to HEC’s need to investigate and take appropriate remedial and/or disciplinary action.

Failure to adhere to this policy may result in disciplinary action up to and including termination of the employee and notification of law enforcement where appropriate.

Staff may be required to submit to drug and/or alcohol testing under the following circumstances:

• Staff has admitted use of drugs or alcohol in recent hours; or
• Staff admits that s/he is currently under the influence of alcohol or drugs; or
• Designated Advisor has completed assessment using tools provided by Human Resources
and has determined that staff is unfit for work.
• Inappropriate or concerning physical or verbal interaction with a student and/or staff
accompanied by erratic or disturbing behavior where there is reason to believe the staff member is impaired.
• Accident with a HEC vehicle or with personal vehicle while on HEC business, or damage to company property and there is reason to suspect the driver is impaired.

Staff who do not comply with the drug and alcohol testing will be considered to have resigned from their position and the resignation will be accepted immediately. Staff who are found to be under the influence of drugs and/or alcohol by the medical provider will be terminated from HEC.

Procedure for Self-identified employees:

Those staff who are not under the influence of drugs and/or alcohol at the time of disclosure, but may be undergoing disciplinary action for other issues such as attendance, who disclose a possible substance abuse problem and request assistance, may be granted a leave of absence to obtain treatment. Accumulated benefit time will be utilized, if available, to undergo

rehabilitation treatment under the guidelines of FMLA, and disability insurance may also be available if employee meets policy criteria.

An employee who successfully completes an approved rehabilitation program and is medically cleared to return to work, will meet with the Director of Human Resources, regarding conditions of return, which will include compliance with an aftercare plan outlined by the medical/clinical provider.

Employees who disclose in the course of an investigation or who are under the influence of drugs or alcohol at the time of disclosure are not considered to be “self identified”, and will be terminated.

Applicability:

This policy applies to all employees of HEC and to those contractors who provide services to
HEC.

Definitions:

Drug, for the purposes of this policy, is broadly defined and includes the following:
• Any illegal drug or substance
• Any over-the-counter medication that may include alcohol;
• Any prescribed medication; that causes drowsiness or alters mood; and has not been disclosed prior to the start of shift.
• Any illegal or prescription chemical not prescribed for the user or possessor;
• Any alcoholic beverage;
• Any chemical/substance causing psychological/behavioral change whether illegal or unlawful.

Drug related misconduct, for the purposes of this policy, is broadly defined and includes the following:
• Possession or unlawful distribution of illegal or unlawful drugs or alcohol, while on HEC
premises or while attending to the business of HEC;
• Use of drug(s) or alcohol while on duty other than medication legally prescribed for the
user or legally sold over-the-counter;
• Misuse of any prescribed or over the counter medication.
• Failure to notify his or her immediate supervisor when reporting for duty or in the course of the work shift if the use of drug(s) or alcohol may adversely affect an employee’s or medical staff member’s performance (e.g., drowsiness, memory alterations);
• Reporting to work under the influence of drug(s) or alcohol other than a therapeutic
dosage of a legally prescribed drug or over-the-counter medication;
• Use of drug(s) or alcohol off HEC’s premises that adversely affects the employee’s work
performance, his/her own safety, and the safety of the students or reputation of the employer in the community;
• Failure to report suspicions of drug or alcohol abuse of co-workers;
• Inappropriate behavior due to the influence of alcohol or drugs when on agency related
business, such as conferences, trainings, meetings, or when attending functions on behalf of the agency.

Designated Advisors are individuals identified at each HEC facility. They will be responsible for implementation and administration of this policy, will act as a resource within the facility and
will be listed with the Director of Human Resources at HEC. Each campus will have at least two designated advisors at the Assistant Program Director or Program Director level. There will be a
list available at each campus of agency advisors should the campus advisors be unavailable.

Where the terms “designated advisor” are used in this policy, they shall be understood to refer to the appropriate authorized official in any area in question.

Identification and Education:

Identification of chemically dependent co-workers is the responsibility of each employee. Intervention with chemically dependent employees is the responsibility of the Designated Advisor, designated by each program, and assisted by the Supervisor. Upon request by the Director of Human Resources, designated advisors will receive periodic training in techniques of behavior documentation and intervention with chemically dependent employees. The success of the prevention program depends heavily on identification.

An effective identification process requires:
• Recognizing the signs of chemical dependency;
• Being aware that the chemical dependency problem exists;
• Understanding that chemically dependent colleagues are helped by identification and
intervention;
• Understanding that chemically dependent colleagues are done serious harm by toleration
and accommodation.

To meet these requirements, HEC will arrange for designated advisors to be trained in Drug and Alcohol Prevention including identification of chemical dependency. A “Summary of Specific Behaviors” indicating possible chemical dependency is available in Human Resources.

Drug Related Misconduct:

Designated advisors are responsible for initial investigation of all suspected drug/alcohol related misconduct. The designated advisor will be briefed on the facts and circumstances of all suspected drug/alcohol related misconduct by the quickest available means. All testing, medical procedures and/or treatment in connection with suspected drug/alcohol related misconduct is to be performed by the approved provider. The procedure for investigation “Screening For Drug(s)/Alcohol” is available in Human Resources.

Should an employee be found to be under the influence of drugs and/or alcohol by the medical provider, the employee will be terminated effective immediately from HEC. Upon receipt of medical documentation that states the employee successfully completed an approved rehabilitation program, the employee can reapply for open positions at HEC Employment will be at HEC’s discretion, and if offered employment, the employee must agree in writing, to conditions of return, with the Director of Human Resources. Conditions of return will include documented compliance with an aftercare plan that has been medically/clinically designed for
the former employee.

STAFF MEMBER’S USE OF PERSONAL MEDICATION

Staff who need to use over-the-counter or prescription medications must ensure that students cannot gain access to the medication. Staff may not carry their medications on their persons. Staff must turn their medications in to the Nursing Station for safekeeping, or keep them locked in their cars.

USE OF TOBACCO AND ELECTRONIC SMOKING PRODUCTS

Hillcrest Educational Centers (HEC) is committed to providing a safe and healthy workplace and promoting the health and wellness of all employees. In accordance with Massachusetts Department of Education requirement and motivated by our responsibility to provide a healthy environment for employees and to model healthy behavior for the students we serve, HEC has adopted the following tobacco-free and vape-free policy.

Policy Statement

HEC prohibits the use of all tobacco products and all electronic smoking devices (including vaping products) on all HEC property and in all HEC-affiliated environments. This policy applies to all employees, contractors, consultants, visitors, volunteers, student interns, and temporary employees.

“Tobacco products” include, but are not limited to:

  • cigarettes
  • cigars
  • pipes
  • smokeless tobacco
  • any other product containing tobacco or nicotine unless FDA-approved for cessation

“Electronic smoking devices” include any electronic product that delivers nicotine or other substances via aerosol or vapor, including but not limited to:

  • e-cigarettes
  • e-cigars
  • e-pipes
  • vape pens
  • e-hookahs

Prohibited Areas and Situations

Use of tobacco products and electronic smoking devices is prohibited at all times:

  • While on campus, off campus on field trips, participating in community activities, or during any activities involving the children we serve.
  • In all interior spaces owned, rented, or leased by HEC.
  • On all outside property or grounds owned or wholly leased by HEC, including parking lots and outdoor areas. This prohibition also applies to private vehicles while they are on HEC property.
  • Within eyesight of any HEC campus or facility.
  • In all vehicles owned or leased by HEC
  • By all contractors, consultants, or their employees while working on HEC premises.
  • By all visitors, including vendors and customers, while on HEC premises.
  • By all temporary employees and student interns while on HEC premises.

Purpose of Prohibiting Electronic Smoking Devices

In addition to supporting HEC’s tobacco-free workplace, this policy also prohibits electronic smoking devices to:

  • Prevent involuntary exposure to aerosols, vapors, and other byproducts.
  • Ensure compliance with a consistent, clear, smoke-free environment.
  • Support the health and wellness of staff and students.

Enforcement

Failure to abide by this policy will result in disciplinary action, up to and including termination (see Discipline Policy).

Support for Tobacco and Nicotine Cessation

HEC is committed to supporting employees who wish to stop using tobacco or nicotine products. Assistance may include:

  • Resources through our health insurance provider
  • Support through the Employee Assistance Program (EAP)
  • Participation in wellness programs

EMPLOYEE DRESS & PERSONAL PRESENTATION

It is the policy of HEC that each employee’s dress, grooming, and personal hygiene be appropriate to the work situation and adhere to basic requirements for professionalism, safety, and comfort. It is equally important that our employees serve as positive role models for our students. One of the skills we teach our students is appropriate personal presentation for daily living; therefore, it is imperative that staff adhere to the standards outlined below.

This policy is non-inclusive. Additional standards may apply at a specific work site based on the needs of that site, student population, or safety considerations. An employee’s position and job responsibilities may also inform applicable dress and presentation expectations.

Failure to comply with this policy may result in corrective or disciplinary action, up to and including termination, consistent with HEC’s Personnel Policy Manual. A supervisor may require an employee to adjust their personal presentation or change clothing in order to remain on shift.

Grooming styles, clothing, and accessories that are dictated by religion, ethnicity, disability, or other protected characteristics will not be restricted, provided they can be reasonably accommodated, do not pose a direct safety risk, and do not create undue hardship for the organization.

General Standards

 All HEC staff must comply with the following standards unless otherwise specified:

  • An HEC identification badge must be worn and visible at all times while on duty, whether on or off the work site. Identification badges may not be altered in any manner.
  • Body and hair (including facial hair) must be clean and groomed.
  • Staff must be free of body odor and maintain good oral hygiene.
  • Clothing must be clean, professional in appearance, and in good condition. Dirty, ragged, frayed, holey, or worn-out clothing is not acceptable.
  • Clothing must fit appropriately. Clothing that is excessively tight or excessively loose is not permitted.
  • Long, baggy shorts are not allowed.
  • Pants may not be worn below the waist or hipline.
  • Sweatpants (cotton jersey material with drawstring or elastic waist) and pajama-style flannel pants may not be worn.
  • Leggings or other spandex/lycra garments may not be worn as pants. Yoga pants may not be worn.
  • Clothing must be modest and provide adequate coverage from neck to mid-thigh at a minimum. All shirts must have sleeves. Necklines must be modest; plunging necklines or visible cleavage are not permitted.
  • Clothing must appropriately cover the body during physical activity, including exercise, student interaction, or restraints.
  • Slogans or designs on clothing must conform to HEC standards and must not conflict with HEC’s mission. Clothing may not display offensive or inappropriate language or imagery, or content depicting or suggesting sex, violence, gangs, discrimination, tobacco, alcohol, or drugs.
  • Footwear must be appropriate to the position and provide adequate protection and safety. Shoes must cover the entire foot, including toes and heel, and have a solid sole. Sandals, flip-flops, clogs, crocs, five-finger shoes, ballet-style shoes, high-heeled shoes, and similar footwear are not permitted.  Work boots are not permitted unless required by specific role.
  • Undergarments (including bras, sports bras, panties, briefs, and boxers) may not be visible and may not be worn as outer clothing.

Hair and Safety Restraint of Hair

For staff working in direct care roles or other positions involving close physical interaction with students, hair should be worn in a manner that minimizes safety risks. Hair that extends below the shoulders, or is otherwise long enough to be easily grabbed or pulled by a student, should be securely restrained while on duty (e.g., tied back, braided, or otherwise contained).

Hair restraints must be secure, professional in appearance, and appropriate for the work environment. Hair accessories must not create a safety concern (e.g., rigid clips, sharp pins, or accessories that could be grabbed or pulled.)

Accessories, Jewelry, and Tattoos

  • Facial jewelry is not permitted, with the exception of one small stud on the side of the nose.
  • Eyebrow, lip, tongue, and other facial piercings may not be worn or must be plugged using clear plastic plugs that are not readily visible.
  • Earrings must be limited to studs only.
  • Large ear lobe piercings must be plugged with a solid plug.
  • Jewelry or accessories that could present a safety risk—such as necklaces, bracelets, or other items that could be grabbed by a student—are not permitted.
  • Wallet chains and studded clothing are not allowed.
  • Exposed tattoos must conform to HEC standards and may not include offensive or inappropriate imagery or language, or content depicting or suggesting sex, violence, gangs, discrimination, tobacco, alcohol, or drugs.
  • Hats and sunglasses may not be worn indoors unless required for safety purposes. Baseball-style hats worn outdoors must be worn with the brim facing forward. Hillcrest-logoed hats may be worn when required for safety while working with certain students.
  • Clothing or accessories that raise a therapeutic concern for students or are determined by management to be unprofessional are not permitted.

 Exceptions and Appeal Process

  • Exceptions may be made on a case-by-case basis for safety purposes as indicated in a student’s individual treatment plan or behavior plan.
  • Supervisors are responsible for determining whether clothing, grooming, or accessories meet the expectations outlined in this policy.
  • Disagreements regarding interpretation or application of this policy may be addressed through the appeal procedures outlined in HEC’s Personnel Policy Manual.

 Specific Standards:

 Supervisors

In addition to the general standards, supervisors must wear business casual attire. Polo shirts, collared shirts, business casual blouses, and/or sweaters are required. Hats may not be worn at any time. Jeans may be worn provided they are clean and in good condition (not dirty, ragged, frayed, holey, or worn out). Special occasions, meetings, or visitors may require more formal attire.

 Departmental Staff (Teachers, Clinicians, Nurses)

Departmental staff must dress in business casual attire and present themselves professionally at all times. Jeans may be worn if they are clean and in good condition. Special occasions, meetings, or visitors may require more formal attire.

Campus Administration

Campus administrators must dress in business casual attire and present themselves professionally at all times. Jeans may be worn on Fridays provided they are clean and in good condition. Special occasions, meetings, or visitors may require more formal attire.

Administrative Office Staff

Administrative office staff are required to wear business casual attire Monday through Thursday. Collared shirts are required where applicable. Athletic apparel (including sweatpants, sweatshirts, or workout attire) may not be worn. Shorts may not be worn at any time. Friday is a more casual day, and jeans may be worn if clean and in good condition. HEC reserves the right to suspend Casual Friday if standards are not met. Advance notice will be provided if business attire is required on a Friday.

Because Administrative Office staff do not have direct care responsibilities and are open to the public during business hours, the general standards apply with the following exceptions:

  • Jewelry such as bracelets, necklaces, and hoop earrings may be worn.
  • High-heeled shoes may be worn; however, shoes that give the appearance of a bare foot are not permitted.
  • Facial jewelry restrictions remain in effect as outlined above.

Senior Managers/Executives

Business attire is required at all times. Sports coats are required for men. Ties should be worn during formal interactions, including community events and external business functions. Jeans may not be worn. Polo shirts may be worn when not engaged in formal interactions. Hillcrest-logoed shirts are preferred; other shirts may be worn provided they do not display sports-related logos or logos of other organizations.

Staff in Specialized Positions

Cooks, housekeepers, maintenance staff, and nursing staff must wear clothing and footwear appropriate to their role and safety requirements. Supervisors will provide guidance and determine appropriateness.

FUNDS AND ACCOUNTABILITY

HEC has established credit accounts with various commercial establishments. These have been established strictly for business purposes as a convenience for staff. Personal use of these accounts is prohibited and may result in termination and possible legal action. All staff provided with HEC funds will be held accountable for such funds; receipts must properly document all purchases.

STUDENT SUBSTANCE ABUSE PREVENTION/SCREENING POLICY

Overview: Due to the high risk of substance use in the population of students that Hillcrest Educational Centers (HEC) serves, HEC is committed to the prevention, identification and treatment of substance use. Abstinence from all drugs and alcohol is expected of students at all times throughout their placement at HEC (including home and community visits). Services focused upon supporting abstinence, psychoeducation, and preventing future substance use are provided to all students in care. HEC does not provide primary treatment for substance use, and therefore has very limited specific substance use treatment services.  Based on results of screening or any subsequent assessment, substance use treatment may be deferred, referred out, or if significant, may be cause for recommending a change in placement.  Student’s, whose use is identified as instrumental or more serious, are planned for on an individualized basis utilizing the following treatment recommendations. Students determined to be habitual and compulsive users of one or more substances are likely to need alternative placement. 

Please note:  HEC does not admit students who are in need of detoxification or rehabilitation related to Substance Use Disorder, or students for whom this is the primary treatment need. Students that have secondary treatment needs related to substance use (i.e. trauma reactive youth who engage in experimental substance use) will be considered for admission. 

Substance Use Screening:  Within 24 hours of admission, a substance use screening tool will be administered to all youth by clinical staff.  Hillcrest currently utilizes the CRAFFT Screening Tool.  

Clinicians utilize the CRAFFT Provider Guide and scoring indicators to determine next steps.  CRAFFT scoring indicates the following:

0 = Client who report no use of alcohol or drugs; provide praise and encouragement to the youth.

0 or 1 = Client who reports any use of alcohol or drugs; encourage client to stop and provide brief advice regarding the adverse health effects of substance use utilizing psychoeducational materials.

2 to 6 = Client is identified with a “positive” screening; score indicates that the client is at high-risk for having an alcohol or drug-related disorder and requires further assessment. 

For youth whose CRAFFT screening indicates a need for further assessment, Hillcrest utilizes the Substance use Subtle Screening Inventory (SASSI).  The full assessment tool will be utilized within the first 45 days of placement. Stakeholders and collaterals will also be contacted during the diagnostic period. Findings from this screening and any subsequent full assessment will be included in the youth’s Diagnostic Psychosocial Assessment, which is due within 45 days of admission. Along with consideration of the other components of the student’s diagnostic psychosocial assessment, and in consultation with the treatment team,  treatment recommendations are proposed.  When indicated, a course of treatment will be included in the student’s Comprehensive Treatment Plan (CTP). 

Ongoing Treatment: Hillcrest provides psychoeducation to students with a history of substance use in addition to the recommended interventions listed within the SASSI IF these interventions are within the scope of Hillcrest’s treatment.  These recommendations are utilized to develop their comprehensive treatment and are reviewed quarterly for progress and revision. As noted above, for identified treatment needs outside of the scope of Hillcrest’s treatment, other steps may need to be taken.

Drug screens may be ordered for alcohol, amphetamines, cocaine, morphine, marijuana, phencyclidine, benzodiazepines, methadone, barbiturates, and tricyclic antidepressants by the treating psychiatrist or pediatrician.  An order for drug screening may occur as a means of supporting treatment goals for any student assessed to be instrumental or more serious in their use.  Additionally, a drug screening may occur if any student is suspected or disclosed to have engaged in substance use (at any point during their treatment and placement at HEC). Drug testing requires consent of the student’s guardian and is implemented according to the agency drug testing policy. 

Students who are believed to be under the influence or who have disclosed present substance use (other than from nicotine or as prescribed by a physician) will be assessed by the campus nursing staff or taken to urgent care or emergency department for assessment if indicated. Suicide risk should be considered as a possible motivator for acute substance misuse and the agency suicide prevention policy should be utilized when indicated. 

 

Drug Testing Procedure 

Overview: Drug testing will occur according to the treatment plan, or as ordered by the physician based on the recommendations/outcome of the clinical assessment process. Once consent is obtained, nursing staff will complete the mouth swabs and urine collection for testing. If students do not return to campus when there is a nurse on campus, the supervisor on duty will obtain and store the specimens as instructed. 

General Procedure: When a student has been identified in need of drug testing, the following process must occur prior to drug testing: 

  1. The Clinical Department will notify the Nursing Department of the assessed need for drug screening and what drugs should be included in the screening panel. 
  2. The psychiatrist or the physician will be notified by nursing, and if in agreement, an order will be written for the specific drugs that the student will be tested for. 
  3. The Clinical Department will notify the parent/guardian of the findings and recommendations from the Substance Use Screening and obtain consent from the guardian for any drug testing that has been recommended. The guardian and/or primary family contact will also be informed of the process. 
  4. The Clinical Department will inform the Nursing Department when consent has been given for drug testing. 

 

Procedure After Testing is Complete

  1. Nursing will forward a copy of the test results in the form of personal notification 

to the administrative staff, supervisor on duty, the psychiatrist and the appropriate clinician within 24 hours after testing. This can be via email, voice mail or in person. 

  1. The student’s clinician, or designee, will notify the guardian and/or primary family contact of the outcome of the test. 
  2. Nursing will clearly note the results in a log for future identification and date of the test for the student. These results will also be uploaded to the nursing file uploads within the student’s chart.  
  3. The rest of the treatment team will be notified within 7 days by the clinical designee.  

Procedure if Student Returns to Campus After a Home Leave With Physical Symptoms With Suspicion of Drug Use: 

On the occasion when a student returns to a campus with physical evidence of substance use, i.e., elevated vital signs, altered mental state, and there is suspect of drug use: 

  1. Nursing will do an assessment noting the student’s physical state, and if a consent is in place do a drug test. The student will be transferred to the ER for further evaluation and possible treatment if deemed necessary. 
  2. If nursing is not on campus, the supervisor on duty will notify the Campus Administrator and notify the nurse on call.  The nurse will consult and may instruct the supervisor to send the student to the emergency room for further evaluation if deemed necessary.. 

Maintenance of Skin Integrity with Restrictive and Supportive Equipment

This protocol is to ensure the maintenance of healthy skin integrity with the use of any restrictive or supportive equipment; including but not limited to splints, wraps, casts and helmets.
Due to possible skin breakdown with the use of any restrictive or supportive equipment the skin must be cared for and checked regularly to minimize any break in the skin integrity..
1. Staff and student are to keep the area under and around the equipment clean and dry.
2. Staff when removing equipment for changing, showers or scheduled breaks in equipment use should carefully inspect all areas and complete an informational to document the assessment.
3. Report any areas of concern to nursing for evaluation and assessment, looking for redness, irritations, breaks in the skin, rash, bruising or chafing include this observation on an informational as well as calling Nursing to verbally report this at the time it is noted.
4. Nursing is to assess and document twice daily on all areas affected by the use of restrictive or supportive equipment for all students and document the assessment.
5. Areas of concern reported or assessed are to be cleaned, treated with appropriate first aid, documented and reported to the Physician.
6. Measurements of areas along with pictures may be needed to track healing and or progression of breaks in skin integrity, if infection is possible cultures may be taken and sent for testing.

CRITERIA FOR CLINICAL RESPONSIBILITIES • Psychologist

GENERAL CLINICAL RESPONSIBILITIES
To receive clinical responsibilities at Hillcrest Educational Centers, psychologists must meet the criteria established Section 6, Human Resources, of the Policy and Procedures Manual, which for psychologists include:
1. Current licensure as a psychologist or certification as a school psychologist by the Massachusetts Department of Education.

2. Specialized graduate training of at least 60 credit hours in an APA accredited program in clinical counseling or school psychology.

3. The equivalent, as determined individually for each applicant by the HEC Human Resources Dept. and/or the Director of Psychiatric Services, or 30 hours per year of professional-level activities to maintain, improve, and enhance practice skills in psychology:
(a) during the previous year for those not currently privileged;
(b) during the period since completion of the last application for those currently privileged.

Qualified activities include, but are not limited to, the following:
participation in professional development programs,
professional reading,
the provision of education/training/supervision to others,
conducting research,
presentation of workshops and papers at national/regional conferences, and
publication of articles and books.

Psychologists who have completed their PhD less than one year prior to application for clinical responsibilities must participate in the equivalent of minimally three hours of such activities each month.

GENERAL PRIVILEGES INCLUDE:

1. Psychological assessments (including perceptual-motor, cognitive, emotional, social, and mental status evaluations).
2. Individual psychotherapy.
3. Differential psychological diagnoses.

SPECIAL CLINICAL RESPONSIBILITIES

Special clinical responsibilities may be granted to psychologists who document evidence of training/education, supervision, experience, and competent practice in the service areas of special clinical responsibilities as follows:

1. Ninety hours of education/training in the service area. A three-credit graduate course will constitute 30 hours of education/training.
2. One year of practice in the service area supervised by a licensed psychologist or other qualified professional.
3. Current, competent, professional-level practice in the service area.

Once granted, special clinical responsibilities are renewed for psychologists who are recommended for a special privilege by their supervisor and peer reviewer, and who document the equivalent of ten hours of professional-level activities per year since the previous application to maintain and improve skills in a service area of each special privilege.

Special Clinical responsibilities include:

1. Family therapy.
2. Group therapy.
3. Neuropsychological testing and diagnosis.
4. Psychological consultation.
5. Forensic assessment and opinion.
6. Behavior Modification therapy.
7. Risk Assessment Treatment for Sex Offender
8. Risk Assessment Treatment for Fire Setting
9. Other (as specified)