The Spinal Cord Injury & Disorders/Traumatic Brain Injury/Polytrauma Coordinator is a Social Work Program Coordinator whose primary responsibilities are to facilitate efficient and appropriate delivery of care across episodes of care within the Central Alabama Veterans Health Care System. They manage the daily operation of the program, develops policies and procedures for program operation and prepares reports and statistics for facility, VISN, and national use. Program Management Develops a system to identify SCl/D, TBI, and Polytrauma patients served by the facility and community who belong in this special disability group. This may involve use of Spinal Cord Injury and Disorders Outcomes Registry, VISTA and CPRS records, VSSC TBI Tracking Application, Health Factors, and contacts within the community. Serves as the point of contact for all inquiries regarding the SCl/D, TBI, Polytrauma programs. This may include stakeholders (e.g. veterans, caregivers, community hospitals and nursing homes, Paralyzed Veterans of America, the Defense and Veterans Brain Injury Center and Congressional inquiries. Coordinates an annual comprehensive preventive health evaluation for each enrolled SCl/D patient at the SCI Center or at appropriate SCI Outpatient Support Clinics. Develops a procedure for referrals between the SCI Center or Polytrauma Rehabilitation Center/Polytrauma Network Site and local VA and/or community hospitals and facilitates appropriate and timely inter-facility transfers. Establishes and monitors performance standards for the SCl/D, TBI, and Polytrauma programs that promote quality and efficiency in service to the veterans in coordination with the overall goals of the medical center and national SCl/D and TBI programs. Researches community resources that are available to provide continuity of care an to enhance the quality of life of the veteran. Disseminates information of resources throughout the VISN. Develops and implements a plan for outreach to extend services to veterans with SCl/D, TBI, and Polytrauma who may benefit from care, but who do not presently use the VA for their healthcare needs. Establishes collaborative relationships with physicians, nurses, and other disciplines to foster their involvement in the care of veterans with SCl/D, TBI, and Polytrauma. Identifies gaps in services and develops a plan, in consultation with SCl/D, TBI, and Polytrauma staff and other departments as appropriate that will make available the best possible resources in meeting program needs. Clinical Social Work Services Completes psychosocial evaluation/ assessment and periodic reassessments of each patient served, which provides a comprehensive social database to identify psychological, social, and vocational needs and the appropriate treatment and services to be provided. Develops and implements realistic and achievable social work treatment goals, as part of the interdisciplinary treatment plans, which reflect an ability to effectively utilize a broad range of treatment modalities. The incumbent will be expected to travel for clinical support for the SCI/D and TBI programs. Provides individual, family, and group counseling aimed at helping the veteran and his family find practical solutions to complex problems. Manages and coordinates provisions of the following services as appropriate: Activities of Daily Living; Personal Care Attendant (Homemaker); Nutritional Management; Prosthetic Appliances; Medical Supplies; Vocational Rehabilitation; Leisure and/or Avocational Interests; Transportation and Finances: Home Evaluations; Housing Alternatives; and Identification, Development, and Utilization of Community Resources. Maintains a current, productive network of referral resources to include substance abuse treatment, outpatient medical/psychiatric care, etc. and with Veterans Service Organizations, including Paralyzed Veterans of America. Provides advanced directive information and education to the veteran and family, assisting the veteran in preparing such documents, as requested. Providing daily management of the requirements of TBI EPRP Quality Supporting Indicators. Assisting the medical directors of the SCI/TBI/Polytrauma program with action plans to decrease the missed opportunity and no-show rates. Patient, Stakeholders, and Staff Education Provides consultation to other staff, patients, and their families regarding the appropriate level of care for patients with SCl/D, TBI, Polytrauma, and special rehabilitation-related needs. Shares expertise and provides consultation to professional staff throughout the facility on SCl/D, TBI, Polytrauma related issues. Maintains an ongoing education program for patients, students and staff to facilitate understanding of medical treatment, including clinical practice guidelines, long term care, psychosocial problems facing the SCl/D and TBI/Polytrauma populations home care psychosocial adjustment, and caregiver issues specific to SCl/D and TB. Work Schedule: 8AM - 4:30PM Telework: Not Available Virtual: This is not a virtual position. Position Title/Functional Statement #:Social Work Program Coordinator/PD50801 Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized 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.