Health Care Department Operations Manual

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Chapter 1 – Health Care Governance and Administration

Article 4.2 – Professional Workforce: Medical Services

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1.4.2.1 New Medical Provider and Physician Manager Onboarding

  • Policy

    • All new civil service medical providers, including Physician and Surgeons, Physician Assistants (PA), and Nurse Practitioners (NP) who work in the California Department of Corrections and Rehabilitation (CDCR) shall be provided standardized onboarding which includes general and job-specific orientation and training.

    • California Correctional Health Care Services (CCHCS), CDCR shall provide standardized onboarding, which includes general and job-specific orientation and training, for all new physician managers.

    • All new registry medical providers, including Physician and Surgeons, PAs, and NPs, shall be provided standardized onboarding within the initial 14 days of their job start date not to exceed 40 hours.  This policy and procedure shall not be interpreted as altering or modifying existing laws and regulations governing civil service probationary periods or the provisions of any applicable bargaining unit contract.

  • Purpose

    • To maintain a comprehensive and standardized New Medical Provider Onboarding and New Physician Manager Onboarding process that:

    • Supports new medical providers and new physician managers with required orientation and training facilitated by experienced subject matter experts.

    • Facilitates adherence to applicable clinical guidelines and departmental standards.

    • Promotes job satisfaction and retention while increasing provider effectiveness and efficiency.

  • Applicability

    • This policy applies to all new medical providers and new physician managers with CCHCS, CDCR.

  • Responsibility

    • The Headquarters (HQ) Deputy Director Medical Services, and Deputy Medical Executive (DME), Clinical Policy and Provider Workforce are responsible for statewide planning, implementation, and evaluation of this policy at the HQ level within their unit.

    • Regional Health Care Executives and Regional DMEs are responsible for the implementation of this policy for the providers working at their designated regional office and those working at the subset of institutions within an assigned region.

    • The Chief Executive Officer and Chief Medical Executive (CME) are responsible for the implementation of this policy at the assigned institution.

  • Procedure Overview

    • The Credentialing and Privileging Support Unit shall notify the Education and Training Unit of all new civil service medical providers and new physician managers who shall then be enrolled and participate in all aspects of the standardized onboarding process, which is in addition to other standard training and orientation for new employees. New Civil Service Medical Providers shall participate in:

      • Institution orientation and training

      • Peer Mentorship

      • Shadowing and Proctoring

      • Headquarters organizational level orientation and training

      • Electronic Health Records System (EHRS) training

      • Dragon Dictation training (optional)

    • New registry medical providers shall participate in onboarding necessary to perform their assigned duties.  Appropriate onboarding may include some of the following including, but not limited to:

      • Institution or Telemedicine orientation and training

      • EHRS training

      • Dragon Dictation training (optional)

    • New physician managers shall participate in:

      • Headquarters New Physician Manager Onboarding orientation and training

      • New Physician Manager Peer Mentorship Program

    • The following tools shall be maintained and reviewed for updates as appropriate at least annually to ensure onboarding is properly supported with current information and resources:

      • Onboarding Checklist

      • Onboarding Plan Template

      • Onboarding Agenda and Curriculum

      • Physician Resource Library (PRL) Index & User Guide

      • Peer Mentor Guidelines

  • Procedure for New Civil Service Medical Providers

    • Onboarding shall commence after completion of the credentialing process and provisional clinical privileges have been granted.

      • Orientation and Training

        • The DME, or Assistant DME, and CME, or Chief Physician & Surgeon (CP&S), utilizing the Onboarding Checklist, the Onboarding Plan Template, and the PRL shall ensure each new civil service medical provider is properly oriented to all of the outlined areas over the course of the initial 12 weeks of onboarding.

        • It is the responsibility of the physician manager and supervisor to ensure the CDCR New Employee Orientation is completed during the same period. The Onboarding Checklist, the Onboarding Plan Template, and the Sample Schedule are located within the PRL.

      • Peer Mentorship

        • New medical providers shall be assigned a peer mentor who shall serve as a non-managerial point of contact, with whom the new provider can connect. This will help to enculture new providers into the organization’s values, assist with acclimation to their new environment, aid in preventing burnout and increase collegiality by creating a positive atmosphere that encourages growth and support during the onboarding period.

      • Shadowing and Proctoring (for new medical providers involved in direct patient care)

        • New medical providers shall, in the first three weeks of employment, be assigned to a variety of providers across clinical settings with the purpose of shadowing and observing how care is delivered in the various unique correctional settings and how the care teams interact within the Complete Care Model.

        • After the third week of employment, new medical providers may begin seeing patients while being proctored by the CP&S or CME.

      • Headquarters Onboarding

        • ETU staff shall maintain a rolling training calendar and publish a listing of upcoming HQ Onboarding and EHRS training dates for at least a six-month period. An HQ-based training program consisting of the Learning Management System (LMS), remote, and in-person didactic sessions shall be developed and maintained by ETU to include all topics designated to HQ as outlined in the Onboarding checklist.

      • Electronic Health Record Training

        • A training program consisting of approximately 16 hours of basic EHRS training via LMS shall be completed prior to the new provider participating in any direct patient care.

        • After the completion of basic EHRS training and a minimum of two to three weeks of direct patient care and EHRS utilization, the new medical provider shall attend an in-person or virtual eight-hour Optimization training to ensure familiarity and competency with the EHRS and its ancillary electronic documentation requirements.

    • Direct Patient Care Responsibilities during the Onboarding Period

      • Clinical Responsibilities

        • Once the new medical provider has been successfully oriented to all clinical service areas and spent time shadowing and proctoring, they shall be allowed to practice independently with an abbreviated schedule with support from the CP&S and CME as needed. There should be a gradual increase in the number of clinical encounters assigned each day over the course of at least a four-week period before the new provider is expected to perform at full capacity consistent with their experienced peers.

      • Afterhours or Provider On-Call Responsibilities during the Onboarding period

        • On-call duties shall begin no earlier than six to eight weeks after the hire start date with backup support from the CP&S or CME for a minimum of four on-call shifts.

      • Within 90 days of the new civil service medical provider hire date, the institution CP&S or CME shall ensure completion of the Onboarding Checklist, review, sign, and submit the completed checklist to Medical Services at ETU@cdcr.ca.gov as indicated on the form.

  • Procedure for Registry Providers

    • Institution Orientation and Training

    • Registry medical providers shall obtain up to 40 hours of onboarding, typically provided within the initial 14 days of their contract assignment. The 40 hours of initial onboarding shall be paid at the adjusted contract rate. The specific number of hours of onboarding to be provided for registry providers is determined by their area of specialty.

    • It is the responsibility of the physician manager and supervisor to ensure the Registry Medical Provider completes the Registry Medical Provider Onboarding Curriculum and Certification.

  • Procedure for New Physician Managers

    • Onboarding shall commence after completion of the credentialing process.

    • Orientation and Training

      • The hiring authority or physician manager shall ensure that the new physician manager completes the New Physician Manager Onboarding curriculum and the Physician Manager Mentor Program within the first 12 months of their new position.

    • Peer Mentorship

      • The new physician manager shall be assigned a peer mentor who shall serve as a non-supervisory point of contact to help enculture new leaders into the organization’s values, assist with acclimation to their new environment, aid in preventing burnout and increase collegiality by creating a positive atmosphere that encourages growth and support during the onboarding period.

  • References

    • California Code of Regulations, Title 15, Division 3, Chapter 1, Subchapter 5, Article 4, Section 3435, In-Service Training

    • California Department of Corrections and Rehabilitation, Department Operations Manual, Chapter 3, Article 18

  • Revision History

    • Effective: 12/2017

    • Revised: 06/02/2025