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This position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after complete review of the EDRP application. Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. Education: Have a master's degree in social work from a school of social work fully accredited by the Council on Social Work Education (CSWE). Graduates of schools of social work that are in candidacy status do not meet this requirement until the School of Social Work is fully accredited. A doctoral degree in social work may not be substituted for the master's degree in social work. Verification of the degree can be made by going to http://www.cswe.org/Accreditation to verify that the social work degree meets the accreditation standards for a masters of social work. Licensure: Persons hired or reassigned to social worker positions in the GS-0185 series in VHA must be licensed or certified by a state to independently practice social work at the master's degree level. Current state requirements may be found by going to http://vaww.va.gov/OHRM/T38Hybrid/. May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria). Grade Determinations: Senior Social Worker, GS-12 Experience/Education: The candidate must have at least two years of experience post advanced practice clinical licensure and should be in a specialized area of social work practice of which, one year must be equivalent to the GS-11 grade level. Senior social workers have experience that demonstrates possession of advanced practice skills and judgment. Senior social workers are experts in their specialized area of practice. Senior social workers may have certification or other post-masters training from a nationally recognized professional organization or university that includes a defined curriculum/course of study and internship or equivalent supervised professional experience in a specialty. Licensure/Certification: Senior social workers must be licensed or certified by a state at the advanced practice level which included an advanced generalist or clinical examination, unless they are grandfathered by the state in which they are licensed to practice at the advanced practice level (except for licenses issued in California, which administers its own clinical examination for advanced practice) and they must be able to provide supervision for licensure. Demonstrated Knowledge, Skills, and Abilities: In addition to the experience above, candidates must demonstrate all of the following KSAs: Skill in a range of specialized interventions and treatment modalities used in specialty treatment programs or with special patient populations. This includes individual, group, and/or family counseling or psychotherapy and advanced level psychosocial and/or case management. Ability to incorporate complex multiple causation in differential diagnosis and treatment within approved clinical privileges or scope of practice. Knowledge in developing and implementing methods for measuring effectiveness of social work practice and services in the specialty area, utilizing outcome evaluations to improve treatment services and to design system changes. Ability to provide specialized consultation to colleagues and students on the psychosocial treatment of patients in the service delivery area, as well as role modeling effective social work practice skills. Ability to expand clinical knowledge in the social work profession, and to write policies, procedures, and/or practice guidelines pertaining to the service delivery area. References: VA Handbook 5005, Part II, Appendix G39 The full performance level of this vacancy is GS-12. The actual grade at which an applicant may be selected for this vacancy is GS-12. Physical Requirements: See VA Directive and Handbook 5019, Employee Occupational Health Services. ["Work Schedule: Monday to Friday 7:30am to 4:00pm Telework: Available - This position is 100% telework (Not Virtual) - may be required to physically report to VA Sierra Nevada Health Care System occasionally. Virtual: This is not a virtual position. Functional Statement #: 000000 Relocation/Recruitment Incentives: Not Authorized EDRP Authorized: Contact V21CCOEEDRP@va.gov, the EDRP Coordinator for questions/assistance. Learn more Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required The Senior Social Worker provides veterans in the Home Based Primary Care (HBPC) Program with high quality case management, clinical psychosocial, advocacy, and to coordinate linkage with appropriate VA and community service providers / agencies as needed by the client. This is accomplished in collaboration with other members of the HBPC Team or other interdisciplinary treatment teams as appropriate i.e. Specialty Clinics, CLC, etc. Duties of the position include, but are not limited to: Develop an assessment of the veteran in collaboration with the interdisciplinary treatment team, the veteran, family members and significant others, whenever possible. The goal of the assessment is to highlight the veteran's strengths, limitations, and internal/external supports and service needs in order to optimize the veteran's functional status and safely maintain the veteran in his/her home. Assessment will include a home visit. It is the responsibility of the social worker, working within the interdisciplinary treatment team to develop a treatment plan with the veteran based on this assessment. Make initial contact within 14 working days of referral by RN and comprehensive assessment including patient information, clinical interventions and discharge plan are to be completed within 30 days of initial contact. Annual social work reassessments are to be completed within 30 days (+/-) of admission anniversary date. Appropriate interventions and decision making process identified in the comments sections of assessment. Responsible for developing the treatment plan and setting achievable treatment goals with the veteran/family in collaboration with the HBPC interdisciplinary treatment team members. Will include psychosocial problems onto the interdisciplinary treatment plan. Will attend weekly interdisciplinary care planning meetings. Ongoing assessments and updating treatment plans are done when necessary or on a quarterly basis given the changing needs as health status changes. Implement a plan of care addressing specific goals, plans and interventions to decrease stressors that negatively affect the patient and caregiver. Address the unique needs of homebound, frail, disabling/chronic and/or dying veteran. Collaborate with other service providers in reassessing the veteran's needs for non-institutional, institutional services/programs and entitlements Responsible for educating the veteran and/or caregiver of the available services and assisting them in establishing the appropriate referrals based on the veteran's preference or that of his surrogate decision-maker. Responsible for developing a resource file of VA and community social service programs and will refer the veteran to needed services. Educate and encourage the veteran/family to advocate on their own behalf, thus fostering a sense of independence and empowerment. Makes rapid assessments and develops crisis management plans to maintain patient in the home, for admission to acute, short term and/or long term placements. Provide education related to VA and community resources, benefits, Advance Directives/Living Wills, Advance Care Planning and Goals of Care Conversations and will refer veterans/families to the appropriate interdisciplinary team member for identified health education needs. Responsible for the coordination of the referrals of non-institutional services such as HBPC, ADHC/CADHC, home hospice, skilled and non-skilled homecare services in collaboration with the interdisciplinary treatment team members. Responsible for the coordination of the referrals of institutional placements in Adult Homes, Assisted Living Programs, CNH or VA-NHCU. This includes reviewing the progress notes from the other providers to accurately determine the strengths and limitations of each veteran being referred for non-institutional and institutional alternatives. Educate the veteran, their families and the team of all the options available to them and will collaborate with the veteran and family on the preferred option. Provide the veterans and their caregivers with ongoing supportive counseling. Enter all veteran/family contacts in the electronic record using appropriate formats and templates. Frequent travel is required throughout the VA Sierra Nevada Health Care System service area. Travel can be greater than 120 miles per day. Must have and maintain a valid unrestricted driver's license. Other duties as assigned by management."]

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