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Classification & Qualifications Appeal Decisions

Washington, DC

U.S. Office of Personnel Management
Classification Appeal Decision
Under section 5112 of title 5, United States Code

Judy C. Duffey
Recreation Therapist
GS-638-9
Mental Health Department
Patient Care Directorate
Capt. James A. Lovell Federal Health Care Center
Veterans Health Administration
U.S. Department of Veterans Affairs
Chicago, Illinois
Recreation Therapist
GS-638-9
C-0638-09-01

Robert D. Hendler
Classification and Pay Claims
Program Manager
Agency Compliance and Evaluation
Merit System Accountability and Compliance

07/09/2015


Date

As provided in section 511.612 of title 5, Code of Federal Regulations (CFR), this decision constitutes a certificate that is mandatory and binding on all administrative, certifying, payroll, disbursing, and accounting officials of the Government.  The agency is responsible for reviewing its classification decisions for identical, similar, or related positions to ensure consistency with this decision.  There is no right of further appeal.  This decision is subject to discretionary review only under conditions and time limits specified in the Introduction to the Position Classification Standards (Introduction), appendix 4, section G (address provided in appendix 4, section H).

As indicated in this decision, our findings show the appellant's official position description (PD) does not meet the standard of adequacy described in section III.E. of the Introduction.  Since PDs must meet the standard of adequacy, the agency must revise the appellant's PD to reflect our findings.  The servicing human resources office must submit a compliance report containing the corrected PD and a Standard Form 50 showing the personnel action taken.  The report must be submitted within 30 days from the effective date of the personnel action to the OPM office that accepted the appeal.

Introduction

On October 1, 2014, the Office of Personnel Managements (OPM) Agency Compliance and Evaluation (ACE) Chicago office accepted a classification appeal from Ms. Judy C. Duffey.  The appellant’s position is currently classified as Recreation Therapist, GS-638-9, and is located in the Mental Health Department, Patient Care Directorate, James Lovell Federal Health Care Center(JALFHCC), Veterans Health Administration (VHA), U.S. Department of Veterans Affairs (VA), in Chicago, Illinois.  The appellant believes her position should be upgraded to the GS-11 grade level.  OPM received the agency’s complete administrative report on January 22, 2015.  We have accepted and decided this appeal under section 5112 of title 5, United States Code (U.S.C.). 

To help decide the appeal, we conducted telephone audits with the appellant and her supervisor on February 19, 2015, and had subsequent additional telephone and e-mail communications.  In reaching our decision, we carefully considered all of the information obtained from the interviews, as well as all other information of record provided by the appellant and her agency.

Background Information

The record shows the agency classified the appellant's position as Recreation Therapist, GS-638-10, in March 1996.  At the appellant's request, her work was re-evaluated on April 15, 2014, by the Veterans Integrated System Network 12 (VISN 12) human resources staff, which sustained that classification.  Believing her work warranted elevation to the GS-11 level, she appealed the VISN 12 decision to the VA's Office of Human Resources Management (OHRM).  On August 11, 2014, OHRM determined the position was properly classified as Recreation Therapist, GS-638-9.  Disagreeing with the title and grade OHRM assigned to her work, Ms. Duffey appealed to OPM.

General issues

The appellant believes her work supports the GS-11 grade due to her responsibilities as the Recreation Therapist subject matter expert (SME) for her facility’s Mental Health Intensive Case Management (MHICM) program, her case management responsibilities, and her responsibility for direct patient care.  She compares her work to other GS-638 position at her facility, states she performs the same work as some higher graded GS-185 Social Worker positions within the facility, and claims a high volume of work as support for the GS-11 level. 

By law, we must classify positions solely by comparing their duties and responsibilities to OPM PCSs and guidelines (5 U.S.C. 5106, 5107, and 5112).  Since comparison to PCSs and guidelines is the exclusive method for classifying positions, we cannot compare the appellant’s position to other title 5 positions, which may or may not be correctly classified, as a basis for deciding this appeal.  Further, OPM cannot compare duties and responsibilities of title 5 positions to duties and responsibilities described in functional statements for hybrid title 38 positions, like social workers, whose work is not subject to classification under the provisions of chapter 51 of title 5, U.S.C., and the PCSs issued by OPM under 5 U.S.C. 5105.  Therefore, we have considered the appellant’s statements only insofar as they are relevant to making the appropriate comparison to OPM PCSs and guidelines for title 5 positions.  In addition, volume of work cannot be considered in determining the grade of a position (The Classifier’s Handbook, chapter 5).

Like OPM, the appellant’s agency must classify positions based on comparison to OPM PCSs and guidelines.  The agency also has primary responsibility for ensuring that its positions are classified consistently with OPM appeal decisions.  If the appellant considers her position so similar to other title 5 positions that they all warrant the same classification, she may pursue the matter by writing to her agency headquarters human resources office.  In doing so, she should specify the precise organizational location, classification, duties, and responsibilities of the positions in question.  If the positions are found to be basically the same as hers, the agency must correct their classification to be consistent with this appeal decision.  Otherwise, the agency should explain to her the differences between her position and the others. 

The appellant and the supervisor initially certified the accuracy of the appellant’s PD.  Although the majority of actual regular and recurring duties and responsibilities associated with the 638 series are accurately described in the PD of record (PD# 06565-O), some of the duties and responsibilities associated with the appellants’ recreation therapy work, and much of the work associated with non-series and non-grade controlling work (i.e. GS-303, GS-1715, GS-186) overstate the difficulty and complexity of the work the appellant actually performs.

For example, the PD states the appellant plans, designs and implements new and innovative approaches to providing psychosocial rehabilitation services.  However the record shows the appellant uses established approaches which may be new to individual patients or to her MHICM team members, and modifies them to fit the needs of individual patients.  The PD also states the appellant negotiates on behalf of the veteran.  However, the record shows that the appellant has no authority to negotiate on behalf of the veteran, but rather advocates for them with regards to a variety of issues such as medication refills, interpersonal interactions, employee/employer relations, consideration for various programs and processes, and setting and achieving personal goals.  Further, the PD states the appellant performs nutritional evaluations and provides patient education associated with nutrition.  However, the record shows that the primary responsibility for evaluation of the nutritional needs of veterans rests with licensed Dietitians/Nutritionists within her facility.  The appellants’ responsibilities associated with veterans’ nutrition consists of using standard questionnaires to gather basic nutritional information for required annual reports or to alert the appropriate medical or mental health professional if she notices obvious signs of malnutrition in a veteran.  The PD also states the appellant reviews lab results and informs providers of significant or noteworthy changes.  However, the record shows that the appellant scans laboratory results looking for a low or high reading indicated by the letters “L”, and “H” and, if warranted, then alerts the appropriate medical or mental health professionals for further action. 

The PD states the appellant assembles pre-evaluation data, interprets medical record information and conducts a complete mental and physical evaluation of the veteran in order to develop a recovery-oriented treatment plan.  However, the record shows that initial mental and physical evaluations, diagnoses, and the establishment of parameters of care are performed and recorded in the patient's electronic medical record by licensed medical and mental health professionals prior to the veteran's acceptance into the program.  The record further shows that "interpretation" consists of the appellant reviewing the aforementioned record looking for established diagnoses and parameters of care, and that "complete mental and physical evaluation" involves the use of standardized questionnaires to gather routine information.

The PD states the appellant performs suicide risk analysis on veterans within the MHICM program.  However, the record shows that the initial analysis is performed by either a medical or mental health professional prior to veterans being admitted into the program.  With the exception of emergent situations, the analysis performed by the appellant involves the use of a standard questionnaire for annual reports which are added to the patient’s electronic medical record for consideration and action by a licensed medical or mental health professional.  While the PD states the appellant participates in research, the record shows the appellant does not.

The PD states the appellant develops and maintains professional standards.  However, the record shows that the appellant does not develop, or play a significant role in the development of, professional standards.  Rather she monitors for new and changing standards within her area of expertise, and shares these with her team members as appropriate.  The PD also states the appellant “makes an independent assessment of psychosocial, health care, financial, and housing needs of each veteran and formulates a psychosocial treatment plan that addresses the individual’s life recovery goals”.  However, the record shows that although the appellant does perform an independent assessment, her professional authority is limited to the scope of practice of her recreation therapist license, leaving her to rely on the diagnosis, prescription, and recommendation of licensed medical and mental health professionals when developing portions of her treatment plans involving other professional scopes of practice.  The record further shows that the appellants’ treatment plans are presented to her team members (i.e. one social worker, one vocational rehabilitation specialist, and two registered nurses) and supervisor who review and sign each treatment plan. 

Because PDs must meet the minimum standard of adequacy as described on pages 10 – 11 of the Introduction, the appellant’s PD must be updated so there is a clear understanding of the duties and responsibilities representing the approved classification.  Regardless, an OPM decision classifies a real operating position and not simply a PD.  We have decided this appeal based on an assessment of the actual work assigned to and performed by the appellant.

Position information

The appellant is the recreation therapy (SME) for the MHICM team.  As such, she is responsible for designing, organizing, implementing, evaluating, and advising on the recreation therapy portions of treatment plans developed by other case managers on her MHICM team; leads weekly socialization and education groups; provides psychosocial and rehabilitative services to veterans within her local MHICM program; and is responsible for keeping abreast of new and updated recreation therapy laws, standards, and practices, reviewing and sharing this information with her local MHICM team as appropriate.

The appellant performs case management within the parameters of her professional scope of practice; agency and facility policies and SOPs; and advice, guidance, and direction from licensed and/or certified professionals within her facility and on her team.  She uses established techniques and approaches, adapting them to meet the needs of specific cases, some of which may be new to some veterans.  She uses recreation activities to increase the physical, mental, and social functionality of veterans assigned to her, and incorporates psychosocial activities designed to assist them in adjusting to change, frustration, stress, anger, hostility and other personal and interpersonal issues.  

As a case manager, the appellant uses a variety of sources such as the veteran’s electronic medical record; interviews with veteran, medical and mental health staff, and individuals and organizations associated with the veteran; standard assessment forms; and direct observation to gather information about the veteran’s condition and limitations.  She uses this information to assist her in determine the veteran’s functional level, goals, and interest; forecast likely levels of recovery; and design individual therapeutic treatment plans to meet the established goals of the veterans.  She also assesses the veterans’ interpersonal environments (i.e. home, long-term care facilities, job sites, etc.) looking for problematic social structure, behavior, and functionality associated with the veterans’ family, caregivers, social groups, work environment, etc.  As the Mental Health Treatment Coordinator (MHTC), the appellant provides information regarding recovery objectives and goals for each veteran in her assigned caseload.

The appellant monitors each veteran within her case load for signs and symptoms of abnormal medical, nutritional, mental health, and chemical abuse issues; alerts the appropriate medical and/or mental health professional for appropriate follow-up action and advice; and records all observations, data, and test results in the veteran’s electronic medical record.  As discussed previously, the appellant reviews their electronic medical record looking for the letters “H” or “L” indicating a high or low laboratory result, and alerts the appropriate medical or mental health professional for further action.  She also performs annual and out-of-cycle nutritional reviews to obtain information concerning diet and nutrition for annual reports.  If nutritional issues or concerns are present, she alerts the appropriate medical and/or mental health professional for further action.

The appellant assists her veterans in their efforts to transition from VA programs and processes to local, State, community, and private programs and processes in an effort to re-integrate them into society.  She models appropriate attitudes, social interactions, and behaviors such as riding the bus, shopping, making and attending appointments, and other common processes and interactions with individual, groups, and organizations.  The appellant keeps her assigned veterans, and their caregivers, apprised of a variety of products, programs, and services available to them and assists with completing application processes.  She acts as liaison between her veterans and the Veteran’s Benefits Administration; reminds her veterans and caregivers of scheduled appointments; and uses Government-owned vehicle to transport her veterans to and from appointments and various services.

The appellant maintains regular communication with each veteran within her caseload, monitors their status and progress, and responds appropriately to their needs and issues.  The appellant advocates for her veterans with respect to issues such as medications, funding, housing, employment, and other programs and processes both inside and outside the VHA system.  As previously discussed, if the appellant encounters issues or situations with her veterans beyond her scope of practice, she alerts the appropriate medical or mental health professional and records her observations in the patients’ electronic medical record.  She is also kept aware of the general condition and progress of MHICM program participants outside her assigned caseload in order to assist with or take over cases as needed.

The appellant performs annual and as-needed suicide risk assessments on her assigned veterans and, barring any obvious issues or concerns, includes these documents in their electronic medical record.  If issues and/or concerns arise during an assessment, the appellant alerts appropriate medical and mental health professionals.  The appellant explains the use of advanced directives to her veterans and their caregivers, and assists them in completing these documents.  The appellant performs reviews of her assigned veterans using the Northwest Program Evaluation Center evaluation document, and records related information using the appropriate MHICM program reporting mechanism.

The appellant serves as an on-call coordinator and a member of the 24-hour coverage MHICM team to address emergency issues and situations involving her veterans, as well as other veterans both inside and outside the MHICM program.  She coordinates with the appropriate medical or mental health professional (i.e., physician, nurse, psychiatrist, social worker, etc.) for advice, action, and direction during emergencies, as well as regarding professional situations and issues outside her scope of practice, and records all findings and information in the patient’s electronic medical record.

The appellant provides a variety of educational pamphlets and documents (i.e. smoking cessation, planning sound diet, and physical activities, etc.) to her assigned veterans and caregivers, answers basic questions, and directs them to the appropriate medical or mental health professional for further information and action if indicated.  The appellant also prepares and submits a variety recreation therapy and case-management reports and correspondence for a wide range of individuals, groups, and organizations within and outside of the VHA and maintains a variety of mental health databases.

Series, title and standard determination

The appellant spends limited amounts of time (less than 25 percent each) performing non-professional work in the GS-186 Social Services Aid and Assistant Series (i.e., interviewing the veteran and others to determine what Federal, State, and local programs and services are needed, assisting veterans with the application process, informing the team’s social worker SME of specific concerns, etc.); lower-graded, non-professional work in the GS-185 Social Worker series (i.e. performing work focused primarily on casework methodology; answering factual questions and providing interpretations and explanations of agency policies and procedures associated with the veteran; assisting new program participants with understanding, adjusting, and accepting their new responsibilities, etc.); the GS-1715 Vocational Rehabilitation Series (i.e., identifying aptitude of veterans, locating appropriate employment opportunities, educating veterans and potential employers concerning physical and functional expectations and limitations, assisting with work-related training needs, providing financial counseling, etc.); and the GS-303 Miscellaneous Clerk and Assistant Series (i.e., collecting and storing information in a variety of program databases, preparing a variety of reports and correspondence, reminding veterans of scheduled appointments, etc.).

However the aforementioned duties are neither series nor grade controlling and, therefore, will not be addressed further in this decision.  In this regard, work may be grade-controlling only if is officially assigned on a regular and continuing basis; it is a significant and substantial part of the overall position (i.e., occupying at least 25 percent of the employee’s time); and the higher level knowledge and skills needed to perform the work would be required in recruiting for the position if it became vacant (Introduction section III.J).  In this particular case, the appellant’s primary duties are associated with the GS-638 Recreation Therapy Series (i.e. professional work aimed at providing therapy and promoting physical and mental rehabilitation), and the GS-636 Rehabilitation Therapy Assistant Series (i.e. non-professional therapy prescribed by medical or mental health professionals), which are performed with equal regularity.  However, since work associated with the GS-636 series is integral to and supportive of the GS-638 series work which represents the purpose of the position’s existence, we find the appellant’s higher-graded GS-638 duties are series and grade controlling for the purposes of this appeal, and the position is properly graded by application of the directly applicable Multiseries Position Classification Standard (PCS) for Therapist Series, GS-0633/0639 (Multiseries PCS).  

The appellant asserts her agency failed to properly extend the grading criteria of the Multiseries PCS to cover her work, which she believes exceeds the highest grade in that PCS, by using the PSCs for the GS-185 Social Worker Series, the GS631 Occupational Therapist Series, and the GS-630 Dietitian and Nutritionist Series.  She further asserts her agency disregarded its own Human Resources Management Letter # 05-96-01 (HRML #05-96-01) which encouraged cross-applying the GS-630 and the GS-631 PCSs to extend the grading criteria of the Multiseries PCS, as a way to maintain the GS-10 grade level for her position.

Section 5107 of title 5, U.S.C., requires that positions be classified by the use of directly applicable PCSs when such PCSs are published.   Thus, the appellant’s position must be classified by application of the aforementioned Multiseries PCS.  The cross-series comparison proposed by the appellant in support of her appeal may only be done when the work performed in a position so substantially and significantly exceeds the highest level described in the directly applicable published PCS that consideration of an additional grade is warranted.  As discussed in the grade determination section of this appeal, we find that the appellant’s work meets, but does not exceed, the highest grade level described in the directly applicable Multiseries PCS.  Therefore, cross-application of the PCSs identified by the appellant is neither necessary nor appropriate. 

The appellant believes her position should be titled “Recreation Therapist Case Manager” due to her case management responsibilities.  However since titles specified in PCSs must be used for all official purposes, the appellant’s position is properly titled Recreation Therapist as required by the Multiseries PCS.  The agency is free to use the appellant’s proposed title, should it wish to do so, for unofficial purposes, such as an organizational title.

Grade determination

The multi-series PCS describes the general characteristics of each grade level from GS-5 to GS-9 and uses two criteria for grading purposes:  Nature of the assignment (which includes knowledge required and complexity of the work), and Level of responsibility (which includes supervisory controls, guidelines, and contacts).  Qualification requirements are not described separately but have been reflected as appropriate in both the nature of the assignment and the level of responsibility.

Nature of the assignment

This factor measures the difficulty and complexity of the work performed by therapists.  It includes (1) the scope and difficulty of the assignment, (2) the skills and knowledge required to plan and carry out treatment programs, and (3) the personal contacts involving patients, physicians, and related professional personnel.  At lower grade levels, the therapist gains skill in working with patients and in applying the treatment concepts, practices, and procedures which are basic to the specialized field of therapy.  At higher grade levels, the therapist applies a higher degree of professional competence, skill and judgment in planning and carrying out treatment for a variety of patients who are acutely ill or who have a combination of severe physical or mental disabilities with secondary complications.

GS-9 therapists plan and carry out a full range of treatment where therapeutic objectives are complex and the procedures involved require the application of highly specialized skills and knowledge.  Established treatment procedures are not applicable or must be substantially adapted; and applied with critical concern for patients who are acutely ill or have a combination of severe mental or physical disabilities with secondary complications.  Frequent modifications are made in the graduated treatment plan in response to subtle but significant changes in the condition of the patient.  GS-9 therapists devise or adapt their approach to carry out treatment with severely disabled patients.  They regularly employ unusual motivational techniques to obtain the participation of the patient in his/her rehabilitation.  GS-9 therapists may coordinate and employ several therapies simultaneously to accomplish complex treatment objectives.  They perform complex evaluations and tests, the results of which are used by physicians to determine whether surgical, medical, or psychiatric procedures are appropriate.  Such tests involve prolonged and highly specialized procedures requiring skill in application, accuracy in evaluating sensitive reactions, and a thorough understanding of the pathology of the physical or mental disability as well as the psychological and physiological implications.

The nature of the appellant’s assignment meets, but does not exceed the GS-9 level, the highest level described in the PCS.  Like the GS-9 therapists, the appellant typically works with patients who have a combination of severe medical and mental health issues.  She is a case manager who uses her knowledge of the recovery model of care, specialized skills in recreation therapy obtained through education and training, and extensive experience to design and update treatment plans and to react to subtle changes in individual veterans’ condition.  Like the GS-9 therapist, she coordinates the planning and implementation of treatments utilizing multiple therapies simultaneously (i.e. behavior modeling, social integration, exercise therapy, medication monitoring and regulation, de-compensation control, etc.).  She monitors and varies the technique, degree, and intensity of therapy to match the needs of each patient, constantly adjusting and replacing techniques and approaches to reach the desired therapeutic goals of each patient based primarily on her own knowledge and experience.  Comparable to the GS-9 therapist, the appellant conducts long and short-term clinical observation of patients (i.e. medication usage and therapeutic effect, addiction control, interpersonal interaction, social integration, etc.) and provides detailed evaluation of associated data which she, or other medical and behavioral health professionals, may use to determine future courses of treatment. 

Similar to the GS-9 therapist, she uses her understanding of the full range of recreation therapy theory and techniques to make treatment decisions and provide guidance to patients, team members, and medical and mental health professionals both inside and outside her facility.  As the recreation therapy SME for her MHICM team, she is responsible for keeping the team apprised of new rules, techniques and procedures related to her filed of expertise and meets regularly with other MHICM case managers to review and to sign off on each other team members’ treatment plans as they pertain to her scope of practice. 

Therefore, this factor is credited at the GS-9 level

Level of responsibility

This factor includes (1) the nature of available guidelines, and (2) the supervision provided through guidance and review of work, decisions, and recommendations.  Included in this factor are such considerations as the extent of the therapist's responsibility for (1) performing evaluations of patients having acute or severe physical or mental disabilities; (2) planning the treatment; (3) modifying treatment plans; and (4) adapting treatment procedures.  The extent to which the professional judgment of the therapist is relied upon by medical personnel is an important consideration in determining the level of responsibility.  At lower grade levels, therapists adhere to established methods, practices, and treatment procedures of the specialized field of therapy.  At higher grade levels, therapists make final decisions in revision of treatment programs because of frequent changes in the condition of the patient and response to treatment. Therapists at higher grade levels have authority to adapt or modify treatment procedures, and employ new approaches and techniques to carry out treatment where objectives are difficult to achieve because of the severity and complexity of the patient's disabilities.

GS-9 therapists work with a high degree of independence.  They exercise independent professional judgment in planning and carrying out a treatment program to meet complex treatment objectives.  On the basis of their professional knowledge and experience, GS-9 therapists independently exercise originality in solving problems not covered by the guides and make adaptations and modifications of treatment plans and specific treatment activities and procedures without supervisory guidance or review to meet the complex and highly varying needs of the patients.  The tests and evaluations performed by GS-9 therapists require extreme care and accuracy in determining patient's reactions.  Results of such tests are frequently used by physicians as the basis for medical, surgical, or psychiatric procedures.  The work of GS-9 therapists is reviewed for general professional adequacy through the supervisor's occasional observance of work performance and through review of reports.  

The appellant’s level of responsibility meets, but does not exceed the GS-9 level, the highest level described in the PCS.  Similar to the GS-9 therapist, The appellant uses an intimate knowledge of guidelines, as well as extensive experience in the field of recreation therapy and case management, to appropriately interpret and apply a wide variety of agency, facility, and state policies, SOPs, program requirements, and laws related to the MHICM program without endangering her patients or placing her agency at risk.  Because available guidance (i.e. Joint Commission standards, Commission on Accreditation of Rehabilitation Facilities [CARF], JALFHCC, etc.) are extensive and complex, they require careful consideration and application to meet, and yet stay within, professional and program goals and parameters.

Similar to the GS-9 level, with respect to the appellants’ recreation therapy work (i.e. evaluation of a patient’s ability to engage in physical or social activities; condition, trends, and estimates of potential improvements; etc.), the information gathered, conclusions arrived at, treatment plans developed, and professional recommendations offered have an influence on the design and implementation of recreation therapy processes inside her local MHICM program.  State and local organizations and agencies benefit from updated information and processes she shares with them which they use in coordinating their programs and processes with those of VHA.  Like the GS-9 level therapist, the appellant is a behavioral health case manager who is responsible for an assigned number of veterans within the MHICM program.  She reviews all available clinical information, conducts interviews, performs short and long-term observations, monitors veterans for subtle changes in condition, and constantly evaluates and adjusts the treatment plan to meet both patient and program goals and objectives based on her knowledge and skill as the MHICM recreation therapy SME.

Like the GS-9 therapist, the appellant’s supervisor does not directly observe her work, and only reviews reports intermittently to confirm that the appellant’s professional work supports general MHICM program requirements and goals.  Supervision is primarily administrative and focused on leave approval, time and attendance, and completion of annual performance reviews.

Therefore, this factor is credited at the GS-9 level.

Summary

By application of the grading criteria in the Multiseries PCS, we find both factors, Nature of the assignment and Level of responsibility, are properly evaluated at the GS-9 level. Therefore, the position is graded at that level.

Decision

The appellant’s position is properly classified as Recreation Therapist, GS-638-9.

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