Provides social work services to patients and families in collaboration with the health care team consistent with VNSNY Home Care policies. Works under general supervision.
- Assesses clients and/or family psychosocial status, social work needs and living conditions utilizing professional knowledge, skills of observations and interviewing skills.
- Establishes the social work component of the patient/family plan of care based on goals mutually acceptable to the client, family and significant others. Makes referrals to other community services, as necessary.
- Travels to patients' homes and/or other facilities with varying environments (e.g., elevated buildings, walk-ups, care facilities, single/multiple family homes, presence of pets, etc.) using approved transportation options to deliver direct service to the client.
- Provides psychosocial work services to patient and/or family, including short-term individual counseling, community resource planning, and crisis intervention. Responds to emergent psychosocial patient and family needs, as requested.
- Provides advocacy to patient and/or family, e.g., assistance in obtaining entitlements and community services.
- Provides social work services in accordance with VNSNY policies, practices, procedures and Standards of Social Work Practice, which may require standing, stooping, sitting, crouching, bending and stretching to deliver patient care, as needed.
- Initiates and maintains verbal and written communication according to VNSNY Home Care policy, including the preparation of clinical and progress notes, to ensure optimal quality care.
- Manages social work planning for a caseload of patients prescribed by the physician and other team members from assessment to discharge. Maintains productivity sufficient to meet program goals.
- Assists the physician and other team members in understanding the significant social and emotional factors related to the patient's health problems.
- Participates in the development of treatment plans and revises the goals as needed. Coordinates approaches to patient and/or family care with other team members.
- Consults with and educates the patient and family regarding the treatment plan, self-care techniques and prevention strategies.
- Utilizes appropriate community resources and serves as a liaison between VNSNY and other community agencies.
- Participates in discharge planning.
- Assumes responsibility for continued professional growth, such as in-service programs.
- Transports and utilizes VNSNY designated/supplied carrying case weighing up to 30 lbs. (as needed) to and from patient homes/care facilities, VNSNY offices and other locations.
- Acts as a resource to VNSNY staff.
- Participates in special projects and other related duties, as required.
For Gender Affirmation Program only:
- Follows up with patients after discharge, as needed.
Current registration to practice as a Licensed social worker in New York State required. Valid driver's license or NYS Non-Driver photo ID card, may be required as determined by operational/regional needs.
Master's degree in Social Work after successfully completing a prescribed course of study at a graduate school of Social Work accredited by the Council on Social Work Education and the Education Dept. and who is certified or licensed by the Education Dept to practice Social Work in New York State required.
Minimum of one year of social work experience in a health care setting required. Bilingual skills may be required, as determined by operational needs.
For Gender Affirmation Program only: Experience with the LGBTQ+ populations preferred.
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