Social Worker (Home-Based Primary Care)

Department of Veterans Affairs

The EPVAHCS is looking for a Social Worker to be an active participant in the Home Based Primary Care interdisciplinary treatment team. The incumbent will work with patients who have a variety of medical and psychosocial needs to improve or maintain psychosocial functioning, provide initial and ongoing assessments of the patient and caregiver(s) and actively participates in interdisciplinary treatment team meetings, sharing observations aimed at enhancing quality of life in the home setting.

• Total Rewards of a Allied Health Professional The purpose of the incumbent's intervention is to help each patient and support system achieve an optimal level of functioning in the home setting. In cases where this may not be possible, the incumbent will provide education and assistance in linking the patient with community settings where his or her increasing care needs will be effectively met. The impact of social work services is to provide the highest quality of life in the least restrictive environment. Duties include but are not limited to: Develop an assessment of the veteran in collaboration with the interdisciplinary treatment team, the veteran, family members, and significant others, whenever possible Responsible for developing the treatment plan and setting achievable treatment goals with the veteran/family in collaboration with the HBPC interdisciplinary treatment team members. Collaborate with other service providers in reassessing the veteran's needs for non-institutional and institutional services/programs and entitlements and will educate the veteran and/or caregiver of available services and assist them in establishing appropriate referrals. Responsible for developing a resource file of VA and community social service programs and will refer the veteran to needed services. Educate and encourage the veteran/family to advocate on their own behalf, fostering independence and empowerment. Provide education related to VA and community resources, entitlements, and Advance Directives/Living Will, and will refer veterans/families to the appropriate interdisciplinary team member for identified health education needs. Responsible for the coordination of referrals for non-institutional services such as home hospice, skilled and non-skilled homecare services, as well as institutional placements in Adult Homes, Assisted Living Programs, CNH, or VA-NHCU, in collaboration with the interdisciplinary treatment team. Provide veterans and their caregivers with ongoing supportive counseling related to the psychosocial impact of coping with chronic/disabling illness(es), onset of a catastrophic illness and/or dying, or need for non-institutional or institutional services. Enter all veteran/family contacts in the electronic record using appropriate formats and templates in a complete, confidential, and professional manner and attend all required meetings Participate in the development of psychosocial risk indicators, evaluation criteria, collecting continuous quality improvement data, monitoring outcomes, and initiating corrective actions Participate in planning and developing policies, procedures, and goals relating to the psychosocial needs of Veterans Develop and implement an individualized plan for professional growth and development, including participation in professional organizations, workshops, seminars, and staff development programs. Work Schedule: 8:00 AM to 4:45 PM, Monday to Friday Recruitment/Relocation Incentives (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: This is an onsite position. Telework may be offered when deemed necessary by the department AD-HOC (Employees who telework on an occasional, episodic, or short-term basis, and have completed required telework training and telework agreement.) (Portion of day acceptable) Virtual: This is not a virtual position. Functional Statement #: 56070-F, 56071-F Permanent Change of Station (PCS): Not Authorized

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