Social Worker III - Adult Services

A. Primary Purpose of Organizational Unit

This position is assigned to the Adult Services Unit, which is part of the Nash County DSS. This unit provides services to adults residing in Nash County. This specific position will primarily provide Guardianship Services and Adult Protective Services for residents of Nash County.

B. Primary Purpose:

Guardianship involves the provision of services to individuals who are alleged to be incompetent and their families. It includes legal proceedings in which an adult is declared incompetent by the court and another party is given the responsibility for duties relative to the adult's personal affairs and/or property. The nature and scope of a guardian's responsibility are determined by the court, based on applicable provisions of the law and the circumstances of the individual case. Guardianship ends with the death of the incompetent adult or with a judicial restoration of the adult's competency.

The legal determination that an adult is incompetent means that the adult is considered incapable of making important decisions concerning his/her personal welfare and/or financial resources. The authority in this position is given to a guardian to. make decisions such as where the adult will live, including the geographical area and type of living arrangement; how the adult's income will be spent; and whether the adult will have recommended medical treatment or surgery. To the extent that the guardian is given authority over these and other areas of the adult's life, the adult no longer has the right to make decisions in those areas. Because of the effect of declaring an adult legally incompetent and giving authority to make decisions to guardian, guardianship should be considered only when other less drastic methods of assisting adults are not sufficient.

Protective Services for Adults is a multi-factored service based on an awareness of the vulnerability of some adults to abuse, neglect, and exploitation. Abuse means willful infliction of physical pain, injury, or mental anguish or unreasonable confinement, or the willful deprivation by a caretaker of services which are. necessary to maintain mental and physical health. Neglect refers to a disabled adult who is either living alone or not able to provide for himself or herself the services which are necessary to maintain mental or physical health or is not receiving services from his caretaker. Exploitation means the illegal or improper use of a disabled adult or his resources for another's profit or advantage. The protective service component consists of provisions in the state law for intervention in crisis situations in which  adults are reported to be in need of protection. It is the role of the social worker to ensure that the agency's actions are consistent with statutory and state requirements. Adults who are in need of this protection are persons 18 years of age or older with disabilities or handicaps such as age, physical, mental or socioeconomic, which have incapacitated them to such a degree that they are unable to take care of themselves and who have no one able or willing to assist them with the care of their needs.

C. Work Schedule

The normal work hours are from 8:00am until 5:00pm. The worker may have to work overtime on some occasions, for which compensatory time is earned.  This position serves in a rotation of after-hours/on-call duty. This position is part of a team of adult services workers that provide back up to each other in all positions, including investigating reports of adult abuse, neglect, and exploitation.  This position also serves intake duties on rotation with the other members of the team.

D. Change in Responsibilities or Organizational Relationship

This position remains in the Adult Service Unit. The adult protective service referrals are usually clients who have multiple problems which are unique and very complex. There has been an increase in referrals but a decrease in available resources to assist clients in being able to maintain their independence. 

75%         1.Guardianship Services

Chapter 35A of the General Statues contains North Carolina's law dealing with the adjudication of incompetency, a prerequisite for appointment of a guardian. Subchapter I of Chapter 35A contains procedures for the adjudication of incompetence. Provisions for appointment of a guardian(s) and the powers and duties of the guardian(s) are contained in Subchapter II.

It is important that the worker has knowledge about guardianship laws in order to use them appropriately in providing assistance to incompetent adults  and. their families and to understand a carry out the responsibilities which the department of social services may have in a guardianship case. The relevant statutes should be reviewed in preparation for each guardianship case in which the department is involved.

In addition to the requirements in the guardianship law, the Department of Health and Human Services has established rules regarding the  responsibilities of human services agencies in pursuing guardianship and in serving as guardian. The Social Worker has to be knowledgeable of policies and procedures that have been established by the state agencies when petitioning for guardianship and when the agency is appointed to serve as guardian.

The Social Worker must stay abreast of manual chapter that contains statutory requirements, state policies and the social work protective guidelines, and state general statutes when case managing guardianship cases.

The Social Worker uses the functional assessment to gather information for guardianship cases. This assessment is used to assist the worker in determining what type of guardianship is appropriate to meet the clients’ needs. This assessment also allows the worker to tailor the guardianship to fit the individual needs. The worker's functional assessment includes information related to the adult's capacity. Sometimes the information on the functional assessment provides a clearer picture of the adult's ability than the general diagnosis statement from a physician. The  combination of this information many times assist in determining in the adult guardianship is limited or full.

Once the agency has been appointed guardian of an adult, the worker must keep in mind the liability the agency carries as decisions are made for the agency's ward. The worker in consultation with supervisor and director gathers all information involving the request and a decision is made based on that information, keeping in mind what the ward's wishes might have been as long as their wishes do not put them in a dangerous environment.

The Guardianship/APS Worker is required to complete yearly functional assessment as well as yearly status reports for the court. The worker has to gather and assemble a variety of information regarding the ward and their needs: medical, dental, psychologic examination, and documentations from the professionals. The guardian's performance of duties must be reported as they are set forth in the order of appointment. The worker reports the ward's condition, needs, and development as well as gathering information to assess whether or not the ward's competency can be restored.  The worker is charged with the gathering of information to see if there may be a more suitable person that could serve as guardian re: family member or friend.

25%  2.Adult Protective Services:

General Statutes, Article 6 of Chapter 108A of the North Caroling Protection of the Abused, Neglected, or Exploited Disabled Adults mandates that the director of the county department of social services promptly and thoroughly evaluate all reports which allege that a disabled adult is being abused, neglected (by self or by caretaker), or exploited; determine the need for protective services and the scope of such services; provide or arrange for the provision of protective services; and initiate appropriate court proceedings to provide protective services for disabled adults who lack the capacity to consent to services. The worker in this position is designated to carry out the legally mandated responsibility of the director.

In carrying out this responsibility, the Guardianship/APS social worker strives to provide services that will adequately protect the person while at the same time minimize the loss of individual freedom. To affect this delicate balance, the Guardianship/APS social worker operates in a relatively independent fashion, often making life and death decisions using professional judgment. Because the Guardianship/APS social worker  intervenes under the dual mandate of making people safe while maintaining their freedom of choice, very often the service plan which is most safe is least desired, and the plan which is most desired may be the least safe.

According to statutes, an adult protective services client must be a disabled adult over the age of 18 (or a lawfully emancipated minor) that is physically or mentally incapacitated. Protective services clients have as wide range of  characteristics as any other group in society and the client population includes the elderly, alcoholic, mentally handicapped, mentally incompetent due to senile dementia or dementia secondary to alcoholism, victims of Alzheimer's Disease, the mentally ill; paranoid schizophrenic, dependent personality victims of head or other physical trauma, the homeless, transient, and the confused. The APS worker must be able to work with this divergent client population as the primary front-line intervener going into the client's home setting to provide essential services at times without the consent of the client. Services needs include but are not limited to are food, clothing, shelter, legal and medical needs, income counseling for mental or social problems, emergency medical treatment, commitment to mental health facilities, in-home aide services, transportation, payee ship of income checks, and guardianship. 

The Intake Social Workers take reports from caller and complete the APS referral form. The supervisor assigns cases to the APS social worker following legal mandate requiring that the protective service evaluation be initiated within 24 hours for emergency reports and 72 hours for non-emergencies in emergency situations, immediate social work interventions may be needed. The majority of the work time is spent in direct Service provision which includes interviewing, assessing, evaluating, mobilizing, and advocating. Service areas required are:

Assessment/Evaluation and Legal

The Guardianship/APS social worker completes a thorough social work assessment of all clients evaluating social environment, mental/emotional physical health, ADL (activity of daily living), IADL (instrumental activity of daily living), and economic while at the same  time critically evaluating the factors which prompted the protective service referral. The end results of this process are to substantiate the report and provide protective services or to unsubstantiated the report and either offer needed services if the client consents or to terminate services if the client does not consent or if additional services needs are not indicated. If the report is substantiated and the client cannot consent, then the Guardianship/APS social worker is involved in a number of legal and court matters on behalf of the client and agency. The Guardianship/APS social worker in consultation with supervisor can obtain short-term judicial authorization to protect the client who lacks the capacity to consent to essential services. These protective services court orders include emergency or non-emergency ex-parte. When long term intervention is needed, the Guardianship/APS social worker may petition the court for incompetency or guardianship proceedings involves the Guardianship/APS worker as primary witness at the hearing. The Guardianship/APS social worker may also take out involuntary commitment papers for those clients who are a danger to themselves or others. The use of any of these legal treatment alternatives requires careful assessment and evaluation because they are the most restrictive plan and involve depriving the client of basic freedom. The Guardianship/APS social worker is usually the initiator of such legal actions, but decisions regarding the alternatives are made in consultation with the supervisor, medical, legal and mental health professionals unless an emergency situation encountered in the field requires that the Guardianship/APS social worker make an immediate, independent decision to protect the life or well-being of the adult. The Guardianship/APS social worker must be thoroughly and continuously trained in the protective services and guardianship laws, policy, and social work practice. Because of the wide range of diversity of APS adults and wards situations, instructions are often related and involves researching laws.

Development of Service Plan

The overall treatment goal is to protect the individual in the least restrictive manner. Service plans can range from providing for supportive services (in-home aide, day care, etc.) to enable the individual to remain in home (least restrictive), to securing involuntary commitment to mental facilities or filing an incompetence petition to secure guardianship of the individual (most restrictive). The Guardianship/APS social worker is responsible for the development of service plans, in consultation with supervisor and staffing with other peers. Assistance is given through supervisor consultation and staffing.

Implementation

The Guardianship/APS social worker implements the service plan by assessing appropriate and available services, presenting options to the adult, and encouraging the adult decision-making with the focus on problem solving and independent actions. When more restrictive plans are indicated, the Guardianship/APS social worker directs and coordinates the overall plan, securing any necessary medical or psychiatric evaluation, legal consultation, or other services. The involvement of other services and professionals initiated at the discretion of the Guardianship/APS social worker in consultation with supervisor or staffing.

Counseling/Therapy

Protecting such a divergent adult population requires a broad range of counseling and treatment techniques and modalities. The Philadelphia Geriatric Center Mental Status Questionnaire is utilized on all APS Evaluations. Majority of all protective services clients require supportive counseling in goal direction and communicating empathetic understanding. Many clients require reality therapy and some require assertive case work techniques. Most need encouragement to express feelings, needs, desires, and to become involved in setting and working toward goals.

Monitoring/Maintenance

Guardianship/APS social worker monitors the on-going progress and appropriateness of the service plan and implements necessary changes when a situation or adult improves or deteriorates. The function includes monitoring things such as the effectiveness of in-home services, day care, and recovery from medical  intervention, adherence to taking prescribed medications, or adjustment to changes in their own life styles.

Consultation/ Community Liaison

Most consultation centers around adult-related problems and is provided for family and other informal- support systems, as well as for  other professionals, agencies, and persons including but not limited to doctors, nurses, attorneys, psychiatrists, health officials, hospital,  home health, mental health, vocational rehabilitation, housing authority, treatment centers, legal services, landlords, business contacts, supply resources, (churches, Salvation Army, Faith Christian Ministry, etc.) and court. The purpose of such consultation is to advocate for the adult, to promote the goals of the service plan  and to provide for the needs and protection of the adult. Each time the Guardianship/APS social worker interacts in a professional capacity with individuals, other professionals and other agencies, the worker is a community liaison. Successful interaction  establishes the credibility and competence of the Guardianship/APS social worker and builds a network of professional  and agency contacts with ultimately results in more effective service delivery. Contacts may include all listed in the above paragraph and others.

Teaching/Training

The Guardianship/APS social worker assists in training new staff as needed. Guardianship/APS social worker is also involved in giving educational presentations concerning the function of adult protective services to various community groups on topics such as Elder Abuse and Crisis Definition and Intervention.

Other Duties

1. Employee will be expected to work in emergency shelter and/or perform related disaster tasks and perform tasks requested by their immediate supervisor.
2. Employee will be required to perform other duties as assigned by unit and agency leadership.
3. Employee will serve as back-up to the other services in the unit.
4. Employee will serve in on-call rotation after hours coverage.
5. Employee with serve in rotation for adult services intake.

B. Other Position Characteristics

Accuracy Required in Work

Accuracy must prevail in the position because of dealings with protective services situations, court actions, and guardianship cases. The worker must be accurate in interpreting rules, regulations, and state laws.

Consequence of Error

Since this position carry the responsibilities of making decisions regarding actions that should be taken on adult protective services cases, legal actions and guardianship cases, if errors are made, it could cause irreparable harm or death.

Instructions Provided to Employee

Instructions are provided in written and oral forms. Bi-monthly unit meetings and Adult Protective Services staffing are held to develop and receive instructions on policies and procedures. Worker also has scheduled conferences with supervisor. Instructions are provided by the State through manuals and administrative letters. The worker attends appropriate workshops regarding policy, procedure, and social work trends. Worker also has scheduled conferences with supervisor. Instructions are provided by the State through manuals and administrative letters. The worker attends appropriate workshops regarding policy, procedures, and social work trends. Worker receives instruction by attending regional support group quarterly meetings.

Guides, Regulations, Policies, and Reference Used by Employee

Service Information System Manual

A Model for Excellence in Adult Services

A Guide to Recordkeeping for Adult Services Social Worker

Model for Prevention and Remediation of Elder Abuse
Adult Protective Services Basic Skills

Social Services and Related Laws of North Carolina
Agency Personnel Handbook

Instruction from Director, Assistant Director, Program Administrator, and Regional Consultant

Supervision Received by Employee

This employee receives supervision by scheduled conferences, meetings, informal interactions, reports, and an annual performance appraisal. Review for quality is also received through periodic random case review and reading of assessment and reassessment completed on all active cases by supervisor. The random monitoring is done by Regional Consultant, Medicaid Consultant, and Division of Facility Services Consultant.

Variety and Purpose of Personal Contacts

The employee has contact with unit staff and other staff within the agency. Since the majority of worker time is field, contacts will be made with adults in their private home as well as private office of worker. Worker will make contacts with local health care providers, out of county health care providers, mental health, crisis organizations, churches, civic organizations, State Office personnel, law enforcement, doctor, nurses, hospital social workers, court officials, and the general public. These contacts may be needed as information is gathered in order to complete an Adult Protective Service evaluation and assessment or guardianship case. Worker will service as agency representative on various committees and will act as liaison between the numerous persons and agencies involved in the delivery of services to the adult and advocate for the adult's rights. Employee will also handle and  resolve complaints from adults, interpret programs, policies, and procedures on an individual basis.

Physical Effort

Employee must have the stamina to continue at maximum performance at all times. At times, efforts are needed in assisting clients with mobility. Physical effort is needed for employer to move within the agency, climb stairs, and use office equipment described in #9 below on a frequent basis.

Work Environment and Condition

Work is performed in the field and in a private office in the agency. Employee is placed in unpleasant, dangerous and hostile situations when evaluating abuse, neglect, and exploitation or complaints in facilities Employee is occasionally exposed to infectious diseases such as scabies, head lice, flu, AIDS, TB, etc. All staff are aware of precautions to take when such events occur.

Machine, Tool, Instruments, Equipment and Materials Used 

Employee uses copy/fax machine, calculator, computer, automobile, telephone, manuals, and camera in order to perform duties.

Visual Attention, Mental Concentration, and Manipulative Skills

All areas of this job require close visual attention because accuracy is very important. The activities performed in this job requires most intense mental concentration in areas such as engaging client trust, determining the reality of the situation, problem solving, goal planning, and interpreting legal mandates as it applies to each case situation. Employee must have physical dexterity required to successfully and efficiently operate machinery and tools outlined in #9.

Safety for Others

See #8 above for issues confronting this employee.

Dynamics of Work

Programs are periodically affected by changes in methodology, guidelines, legislation, laws, and shifting program emphasis. Worker will receive guidance and appropriate supervision as these changes occur.

1. The worker should have considerable knowledge of basic social worker techniques and practices and their application to specific casework, group work, and community problems, and of governmental and private organizations and resources in the community.

2. Knowledge of human behavior and socio-economic problems and their treatment in order to access plan and set goals for clients, help them obtain autonomous function and effectively utilize their own problem solving and coping capacities to affect change.

3.   Knowledge in client advocacy to establish initial linkage between clients and resource systems.

4.  Knowledge to the developmental states and developmental tasks of individual and medical and psychological diagnosis, particularly as it relates to the elderly and disabled population.

5. Ability to recognize, accept, and cope with hostility, anger, loss, and pain encountered in working with dysfunctional individuals and families.

6. Ability to establish and maintain effective working relationships with administration, supervisors, as well as administrators and owners, of domiciliary homes, clients in her case load, and their families, civic medical religious, state consultants, and social organizations to maintain present resources and develop new resources.

7.  Ability to operate a motor vehicle, must have a vehicle available to use at work with vehicle insurance. Must have valid driver's license.

8. The ability for worker to perform duties outlined in the description, and other related duties as required.

BSW or Bachelor's Degree in Human Service field or Gerontology preferred.

Required Minimum Training

Master's degree in social work from an accredited school of social work; Bachelor's degree in social work from an accredited school of social work and one year directly related experience; Master's degree in a human services field and one year of directly related experience; Bachelor's degree in human services field from an accredited college or university and two years directly related experience; Bachelor's degree from an accredited college or university and three years of directly related experience.

 

Salary : $54,975 - $88,531