Social Worker, PT - Palliative Care

QUALIFICATIONS

1. Is a graduate of a Master’s program in social work accredited by the Council on Social Work Education and holds current certification in the State of Michigan or has a Master’s degree in psychology, sociology, counseling, human services or other field related to Social Work who would be supervised by an LMSW.
2. Current State of Michigan Social Work License (LMSW or LLMSW) and Drivers License.
3. Advanced Care Planning Facilitator Certification or willing to obtain within one year of hire.

SUMMARY OF JOB RESPONSIBILITIES

Coordinates social work services for the palliative care program in community based palliative care setting. Provides supportive counseling, anticipatory guidance and assistance to patients and their families with personal, psychosocial, psychoeducation, and environmental difficulties related to the patient’s illness. Educates the community regarding Advanced Care Planning and assist with completion of advanced care directives in collaboration with the Charted Coalition.

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ESSENTIAL FUNCTIONS AND DUTIES (other duties may be assigned)

1. Knowledge of the palliative care concept and philosophy.
2. Assesses the psychosocial status of patients/families/caregivers related to the patient’s illness and environment in the patient’s identified residence.
3. Assesses risk and intervenes clinically to identify potential for complicated grief and explores anticipatory bereavement related to possible death and multiple aspects of loss and adaption along the continuum of illness.
4. Plans, develops and carries out interventions based on the psychosocial assessment.
5. Evaluates the effectiveness of planned interventions and Manages IDT patient plan of care for palliative care consultation service.
6. Provides strength based, person centered and family centered, comprehensive psychosocial assessment.
7. Provides psychosocial interventions with the highest integrity related to cultural appropriateness and developmental stage along the continuum of illness including;
   1. Supportive Counseling
   2. Psychoeducation
   3. Anticipatory guidance
   4. Advocacy
   5. Facilitation of family meetings
   6. Linkage to community resources
   7. Non-pharmacological pain and symptom management
8. Provides clinical guidance and consultation to interdisciplinary team, prompting continuity of care and primary palliative care as well as safe and comprehensive care coordination and discharge planning as indicated.
9. Formulates hypotheses about nature and etiology of problems.
10. Negotiates with patient/family/caregiver to establish goals.
11. Identifies service lines and providers at risk for compassion fatigue and vicarious trauma and will implements self-care strategies.
12. Provides education and facilitates completion of Advance Care Planning with Palliative Care patients and individuals in the community in a variety of settings.
13. Manages and enhances community partnerships. Facilitates educational opportunities with focus on primary palliative care, including Advance Care Planning for clinical and ancillary providers.
14. Collects and maintains data representing Advance Care Planning initiatives and impact.  Reports to Charted Coalition, grant and other stakeholders within established timelines.
15. Reviews and uploads Advance Directive documents to the Great Lakes Health Connect repository.
16. Responsible to organize, coordinate and network with local Advance Care Planning facilitators to strengthen outreach and education.
17. Participates in System Improvement and Quality Initiatives.
18. Identifies services, clinics, etc. needing enhanced palliative care and formulates strategies for addressing this need. Identifies and addresses disparity within and barriers to effective palliative care.
19. Follows standard precautions/infection control policies.
20. Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.  Ability to interpret a variety of instructions furnished in written, oral, diagram, or scheduled form.