The Primary Care Mental Health Integration (PCMHI) Social Worker functions as a co-located, collaborative, and integrated behavioral health provider, delivering brief, triage, and consultation-based services to Veterans, Primary Care providers, and Patient Aligned Care Team (PACT) members within Primary Care. General mental health service delivery for a wide range of concerns, resolving problems within the primary care service context. The PCMHI Social Worker: The incumbent completes thorough psychosocial assessments and includes pertinent information in all the required areas of functioning in order to determine appropriate diagnoses and other treatment-related conclusions. Clinical assessments are found to be appropriate to the referral question. Conclusions are found to be reasonably substantiated by interviews, observations, historical data, collateral data (i.e. from outsides sources such as other treatment providers, family members, etc.) and other data when indicated. The incumbent provides a DSM diagnosis to determine the psychosocial functioning and needs of Veterans and/or their families. He/She must be able to utilize this assessment in facilitating the Veteran's maximum use of treatment for attainment of the highest level of independence that is possible and practicable. The incumbent participates in the development of the individual plan of care at interdisciplinary care meetings for assigned panel of patients. The incumbent will have general knowledge on VA and community resources, and will collaborate with other services providers as necessary. He/She applies their general knowledge of Veterans' benefits and services related to special programs, service connection compensation, and non-service connected VA pensions. The incumbent develops a resource file of VA and community resources and collaborates with other VA social workers to keep the file comprehensive and current. He/She coordinates community- based services, including information and referral for services from other VA programs, other government programs, and community agency programs. The incumbent facilitates referrals based upon Veteran need and eligibility. The incumbent provides emergency/crisis interventions that are provided to Veterans in an effort to stabilize. He/She engages in rapid assessments and develops crisis management plans. Interventions are appropriate to the level of need and would involve a range of services including facilitation of transfer of care to the appropriate level based on Veteran need as well as referral to other VA resources or community agencies. The incumbent provides education related to VA and community resources, entitlements, and care/end of life planning and counsels Veterans regarding advance directives/living wills and participates in facility outreach activities in order to disseminate needed information to Veterans, VA staff, and community agencies to strengthen service linkages. The incumbent delivers service from a Veteran-centric perspective and acts as an advocate on behalf of the Veteran when it serves the best interest of the Veteran/family. When appropriate and feasible, he/she educates and encourages the Veteran/family to advocate on their own behalf in order to promote a sense of independence and empowerment. The incumbent provides psychoeducation and/or short- term psychotherapy as individual, group and/or family interventions when clinically indicated/appropriate and when of therapeutic benefit to the recipients. He/She is willing to be successfully trained and implement Evidenced Based Psychotherapies and regularly utilizes measurement-based screenings (i.e. GAD-7; PHQ-9). The interventions are provided with emphasis on development of a positive and appropriate therapeutic relationship which is sensitive to the clinical, cultural, developmental and spiritual needs of Veterans, are empirically supported and/or are theoretically appropriate. The incumbent provides consultation to other treatment team and staff members regarding psychosocial needs of Veterans and/or their families and the impact of the identified psychosocial problems on the Veteran's health care planning, compliance with treatment, and discharge planning. He/She performs measurement- based care instrumentation and screenings regularly and routinely, psychological testing and/or exempt testing (based on hospital privileges or scope of practice) when it is clinically appropriate to a treatment question as part of an assessment. The incumbent documents direct Veteran care at a minimum of 80% of the time allotted to direct care in the clinician's weekly profile. This time includes individual therapy, groups, family therapy, couples therapy, and direct clinical phone calls with the Veteran. The incumbent provides case management services to Veterans and their families throughout the continuum of care. The incumbent possesses a thorough knowledge in use of medical and mental health diagnoses, disabilities, and treatment procedures, including acute, chronic and traumatic illnesses, common medications and their effects/side effects, and medical terminology. Work Schedule: Monday - Friday, 8:00 a.m. - 4:30 p.m. Telework: This is not a virtual position, however some telework is negotiable upon hire Financial Disclosure Report: Not required ***************************THIS IS A BARGAINING UNIT POSITION**************************
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.