Social Worker -Patient Aligned Care Team (PACT)

Full Job Description

To provide Social Work Case Management services in the community to the veteran population enrolled at the John D. Dingell VA Medical Center.

Services include provision of high quality case management, clinical treatment, in-home & nursing home assessments/ clinical reviews, crisis intervention, advocacy, and coordination of linkages to other appropriate VA or community service providers and/or agencies as needed by the patient.

Clinical social work is provided in accordance with facility and procedure to include VHA Handbook guidelines for PACT with emphasis on comprehensive team approach to delivery of social work services with focus on "longitudinal" preventive health care, health promotion, coordination and chronic disease management to ensure health concerns are managed as defined by the veteran.

Services include inpatient/outpatient service delivery in accordance with the PACT model of care.

Additionally, another major focus will be on those individuals participating in the following programs: Homemaker Home Health Aide, Veterans Directed Programs and Contract Nursing Homes to ensure timely access these services, and the completion of a comprehensive initial assessment.

This is accomplished in collaboration with members of the interdisciplinary treatment team including medical providers, nursing and supportive staff.

Clinical social work is provided according to assigned work area and in accordance with facility policy and procedure to include inpatient service delivery.

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met.

Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education.

Have a master's degree in social work from a school of social work fully accredited by the Council on Social Work Education (CSWE).

Graduates of schools of social work that are in candidacy status do not meet this requirement until the School of Social Work is fully accredited.

A doctoral degree in social work may not be substituted for the master's degree in social work. Licensure.

Persons hired or reassigned to social worker positions in the GS-0185 series in VHA must be licensed or certified by a state to independently practice social work at the master's degree level.

English Language Proficiency. Social workers must be proficient in spoken and written English in accordance with VA Regulations. Grade Determinations: Experience and Licensure.

Appointment to the GS-11 grade level requires completion of a minimum of one year of post-MSW experience equivalent to the GS-9 grade level in the field of health care or other social work-related settings, (VA or non VA experience) and licensure or certification in a state at the independent practice level.

Education.

In addition to meeting basic requirements, a doctoral degree in social work from a school of social work may be substituted for the required one year of professional social work experience in a clinical setting.

Demonstrated Knowledge, Skills, and Abilities.

In addition to the experience above, candidates must demonstrate all of the following KSAs: Knowledge of community resources, how to make appropriate referrals to community and other governmental agencies for services, and ability to coordinate services.

Skill in independently conducting psychosocial assessments and treatment interventions to a wide variety of individuals from various socio-economic, educational, and other backgrounds.

Knowledge of medical and mental health diagnoses, disabilities and treatment procedures (i.e.

acute, chronic and traumatic illnesses/injuries, common medications and their effects/side effects, and medical terminology) to formulate a treatment plan.

Skill in independently implementing different treatment modalities in working with individuals, families, and groups who are experiencing a variety of psychiatric, 8 medical, and social problems to achieve treatment goals.

Ability to provide consultation services to new social workers, social work graduate students, and other staff about the psychosocial needs of patients and the impact of psychosocial problems on health care and compliance with treatment.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. The full performance level of this vacancy is GS-11.

The actual grade at which an applicant may be selected for this vacancy is the GS-11. Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Services. Major Duties:

VA Careers - Social Work: https://www.youtube-nocookie.com/embed/enRhz_ua_UU Total Rewards of a Allied Health Professional Screening/Assessment- The social worker will develop an assessment of the veteran in collaboration with the interdisciplinary treatment team, the veteran, family members and significant others.

The initial assessment will be completed in a timely manner upon initial receipt of social work consult.

The goal of the assessment is to highlight the veteran's strengths, limitations, and internal/external supports and service needs, (specific to the injury and current medical status) to ensure and optimize the veteran's functional status and living environment.

All services provided in collaboration with other disciplines including providers nursing and support staff.

Treatment Planning/Goal Setting- The social worker is responsible for developing the treatment plans and setting achievable treatment goals with the veteran/family.

The in-patient social worker will work collaboratively with the veteran's assigned Firm/clinic social worker as appropriate for discharge planning, and community services.

The treatment plan will be completed and updated as needed to reflect specifies related to change in the patient's condition/plans.

Referrals to service providers- Throughout the course of treatment the social worker is the subject matter expert of VA and community resources.

The social worker will collaborate with other service providers in reassessing the veteran's needs.

The social worker is responsible for educating the veteran and/or caregiver of the available services and assisting them in establishing the appropriate referrals based on the veteran's preference or that of his surrogate decision-maker.

Resource Usage/Development- The social worker is responsible for using the current social work resource file of VA and community social service programs and enhancing the content to the benefit of veterans.

The social worker will maintain resource directories sufficient to meet variety of situations and conditions across age and gender specific needs.

Advocacy- Social worker understands the intimidation of bureaucracy and will act as an advocate when it serves the best interest of the veteran/family.

When appropriate and feasible, social worker will educate and encourage the veteran/family to advocate on own behalf, thus fostering a sense of independence and empowerment.

Crisis Intervention- Social worker is experienced in making rapid assessments and developing crisis management plans for referral to appropriate MH services.

Social worker has access to multiple resource directories in addition to previously developed resources to meet the demands of a crisis.

In the event of a medical or psychiatric emergency, staff will follow facility protocols.

Work Schedule: Fulltime, Mon-Fri 8a-4:30p Recruitment Incentive (Sign-on Bonus): Not Authorized Permanent Change of Station (Relocation Assistance): Not Authorized Pay: Competitive salary and regular salary increases.

When setting pay, a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade).

Paid Time Off: 37-50 days of annual paid time offer per year (13-26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual, based on prior [work experience] or military service experience.

Parental Leave: After 12 months of employment, up to 12 weeks of paid parental leave in connection with the birth, adoption, or foster care placement of a child.

Child Care Subsidy: After 60 days of employment, full time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66.

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement) Telework: Yes - as determined by the agency policy.

Virtual: This is not a virtual position. Functional Statement #: 91758-A Permanent Change of Station (PCS): Not Authorized