Incumbent is an independent Clinical Social Worker assigned to Oklahoma City VA Medical Centers' Primary Care Clinics. The distance from the VA Oklahoma City Hospital requires interfacing with outside health care systems, community based programs, home health agencies, VA contract nursing homes, VA per diem programs and county agencies. Duties include but are not limited to: Screening/Assessment-The social worker will complete an assessment of the veteran in collaboration with the interdisciplinary treatment team, the veteran, family members and significant others. The goal of the assessment is to identify needs and formulate a plan to meet those needs. The incumbent demonstrates an understanding of the range of treatment and skills needed for all adult patients including geriatric patients related to their physical limitations, psychological needs and age associated illnesses and conditions. The incumbent must have an understanding of the problems of advancing age and respect for the diversification of the aging veteran population, being sensitive to human growth and development, age-appropriate needs and concerns of the geriatric veteran and be able to provide current and advanced techniques to the treatment of this veteran population. It is the responsibility of the Social Worker, working within the interdisdplinary treatment team, to share in the development of a treatment plan with the veteran based on this assessment. Treatment Planning/Goal Setting_- The Social Worker is responsible for contributing to the development of the treatment plan and setting achievable treatment goals with the veteran and family members/caregiver. Referral to service providers - Throughout the course of treatment, the Social Worker is the subject matter expert on VA and/or 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 family members/caregivers 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 refer the veteran to needed services. Advocacy-The Social Worker understands the intimidation of bureaucracy and will act as an advocate when it serves the best interest of the veteran and family members/caregiver. When appropriate and feasible, the Social Worker will educate and encourage the veteran to advocate on his/her own behalf, thus fostering a sense of independence and empowerment. Crisis Intervention -The Social Worker is experienced in making rapid assessments and developing crisis management plans. The 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 the protocol of his/her respective clinic and the facility at Oklahoma City VA Medical Center. Education/Health promotion and prevention - The Social Worker provides education related to VA and community resources, entitlements, Advance Directives/Living Will and will refer veterans and family members/caregiver to the appropriate interdisciplinary team member for identified health education needs. Coordination of non-institutional and institutional services -The Social Worker will review the progress notes from the other providers to accurately determine the strengths and limitations of each veteran. The Social Worker will educate the veteran, their family members/caregiver and the team of all the options available to them and will collaborate with the veteran and family members/caregiver on the preferred option. Supportive counseling-The Social Worker will provide the veterans and their family members/caregiver with ongoing supportive counseling. The purpose of such counseling is to deal with the psychosocial impact of coping with chronic/ disabling illness (es), onset of a catastrophic illness mental illness( es), etc. Work Schedule: Between the hours of 8:00 am to 4:30 pm, Monday through Friday. Irregular tours and/or Saturday work may be required. Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.