REPORTS TO:  Clinical Services Manager

SUPERVISES:  Social Work Assistant, if applicable (Clinical aspects).  Assists in supervision of Homemaker/ Home Helper services.

WORKS CLOSELY WITH:  Health Care Delivery Staff, Team Assistant, Reimbursement, Intake and Referral. 

EMPLOYMENT STATUS:  Exempt, salaried

SUMMARY OF DUTIES:  Provides a wide range of services in the home or community that enhance or restore the patient's/family's capacity for dealing with health or medically related problems.  Is as a member of the health team and coordinates services with team members. 

JOB REQUIREMENTS:  MSW from an accredited School of Social Work with one year experience in a health care setting.  Certified as LMSW or LISW in the State of Iowa, car, driver's license and adequate insurance as outlined in the personnel policies.  Required is a physical examination completed at the time of employment with a physician's statement of the employee's ability to perform the duties of the job.  Annual TB testing is required.  All offers of employment are conditioned upon the result of a criminal background check conducted by the Iowa Division of Criminal investigation, as required by law and a negative finding on the Office of Inspector General’s Excluded Provider List.

Must have the ability to lift 35 lbs from floor to counter 3 times (to simulate lifting into trunk of car).  Lift 50 lbs from floor to counter 1 time.  Lift 50 lbs from counter to floor 1 time.  EE needs to be able to sit on floor fully and get back up.  Ability to carry 35 lbs up and down a flight of stairs.  Push/pull 35 lbs on a 2 wheel cart.

WORK ENVIRONMENT AND EQUIPMENT: Work is performed in VNA office and clients' homes with the employee driving from home to home during the work period.  The clients' homes are throughout Johnson County, and within a fifty-mile radius of the agency.  The driving requirements include in-town and highway driving in good and inclement weather.

SKILLS AND KNOWLEDGE:  The employee will demonstrate skill and knowledge in providing medical social services for resolution of psychosocial problems occurring as a result of acute and/or chronic illnesses.  The employee will demonstrate organizational skills required to manage several client appointments and necessary follow-up each day; the employee will demonstrate the ability to communicate effectively in the English language, both orally and in writing, and the ability to communicate effectively with individuals from a variety of backgrounds.

PHYSICAL/COGNITIVE DEMANDS:  The employee will perform the duties of the job at the client's home during employed hours.  The duties will include visiting with clients in the home setting and visiting various community sites to evaluate services or coordinate services.    These duties require the physical demands of climbing stairs, standing, lifting, stooping, reaching, driving, etc., with or without the use of assistive/adaptive devices.  The employee will demonstrate the ability to maintain and update professional knowledge base and the ability to assimilate and utilize agency information regarding policy and procedure changes.  The employee will demonstrate competence in professional decision-making skills within the parameters of Social Work Licensure Act, including the ability to make appropriate assessments, problem-solve, prioritize, establish Plans of Care and evaluate their effectiveness.    The employee will demonstrate the ability to use technology effectively and appropriately, including laptop computers and communication devices (cell phones, voicemail, and electronic mail).   

ESSENTIAL DUTIES:  To be performed satisfactorily with or without reasonable accommodation.  The following duties are normal for this position.  While this list is intended to be an accurate reflection of the job, it is not to be construed as exclusive or all-inclusive.  Other duties may be required and assigned by the employer.

Core Social Work Duties

1. Provides skilled and health promotion social services to individuals and families in the home setting, assessing social, emotional and financial factors to estimate the capacity and potential to cope with problems of daily living, providing or coordinating services that enhance or restore the patient's/family's capacity for dealing with problems, and participating in discharge planning as applicable.

2. Completes home visits of homemaking clients at referral and every 3 months.  Completes general social work evaluation of client functional status, client social and environmental status, and homemaking needs.  Uses agency guidelines to determine available services and frequency.  Prepares/ updates homemaking care plans.  

3. Maintains knowledge of community resources.   Initiates referrals as appropriate, and coordinates services to meet needs of individuals and families while ensuring protection of privacy/confidentiality rights.

4. Works as member of a team to carry out VNA mission of promoting optimal patient function for the individual regardless of ethnic or cultural background or sexual orientation/preferences.   Communicates and demonstrates respect for each individual, and assists other VNA staff in understanding and working with patients with varying lifestyles, cultures, health practices, and living environments.

5. Complies with agency policies regarding the maintenance and preparation of records and reports and provides patient medical, geographical, financial and statistical information as needed by the agency.

6. Completes and generates all necessary documentation accurately within the timelines determined by Medicare and other regulatory body requirements.  Examples of documentation include but are not limited to the plan of care, evaluation visits, routine visits and Health Promotion admissions.

7. Administers the VNA Lifeline medical alert services program.  Acts as liason between VNA and the Lifeline control center.   Takes referrals, enrolls subscribers, installs Lifeline equipment, and trouble-shoots as needed.  Works with reimbursement staff to ensure adequate billing, and coordinates distribution of any grants for lifeline subsidies.

8.Completes the annual visits to update patient consents and registration documents.   

9. Works with Reimbursement and Clinical Services Managers and uses agency   tracking reports to determine clients due for registration updates.  Obtains orders as needed and establishes home visits to complete updates in a timely manner.

10.  Completes Advanced Care Planning facilitation training and acts as resource for staff and patients.  Educates patients and family members in advance directive options, facilitates completion of advance directives and obtains copies for VNA.  Facilitates completion of IPOST advance directives as appropriate.

11. Facilitates communications between DHS and VNA regarding Waivers, In Home Health Worker (IHHW) and Consumer Directed Attendant Care (CDAC) approvals and services.  Informs VNA Clinical and Financial staff regarding approvals, changes, and discontinued services.   Keeps copy of all waiver decision paperwork and provides copies to appropriate VNA staff.  Assists with problem solving with DHS staff as needed. 

12. Represents the agency in community activities, meetings as required.  Attends DHS multidisciplinary meetings monthly.

13. Coordinates use of small anonymous donation/ grant monies for utility assistance,

      transportation assistance, medication donations, and other patient needs.

Secondary Social Work Duties

14. Assists with staff education for aide and clinical staff.   

15. Assists with intake duties in the absence of the Intake and Referral Coordinator.

16.  Prepares VNA annual grant applications and completes grant reports under the direction of the Executive Director.

General Staff Functions

17. Participates in in-service programs as required.  Participates in agency group meetings, staffing, and projects as required.

18.  Participates in evaluation of agency services, as assigned.

19. Maintains, upgrades knowledge through Continuing Education programs, review of literature, etc., applicable to home and community health.

20. Maintains current CPR training and knowledge of expected performance in emergency situations.

21. Performs other duties as necessary, including required participation in VNA emergency/ disaster plans.