San Francisco VA is recruiting for a full-time Senior Social worker (Primary Care and Distance) PACT, in their Santa Rosa Community Based Outpatient Clinic. The incumbent based at the Santa Rosa CBOC provides social work services to the Veteran population presenting in Primary Care at the Santa Rosa CBOC. This can include PACT team assignment and same day urgent care/triage for all PACT teams there. Additionally, the incumbent provides remote PACT social work coverage to San Francisco VA Medical Center or other Community Based Outpatient Clinics (CBOC) as needed, up to 49% of the time at maximum. This coverage would be provided by phone, Telehealth options, or upon occasion, on site. Services consist of advanced skill level assessments and interventions to address complex psychosocial issues including: coping in the community, assessment of suspected abuse, especially elder abuse and issues related to capacity; interventions such as counseling to patients and families around adjustment to disability, chronic illness , loss and end of life issues; crisis intervention; advance directive education; coordination of linkages to appropriate VA or community service providers/agencies; short-term, focused case management; and consultation to multidisciplinary team members on the psychosocial aspects of illness and individualized patient care. Services are timely, comprehensive and effectively coordinated with all other health care providers. Psychosocial assessment and intervention is integrated within a complex treatment plan, Continuity of care is key. The incumbent contributes significantly to longitudinal care. Advanced practice social work assessment and intervention skills assure patient safety, completion of referrals, and firm hand-offs to resource agency programs and providers in the setting of complex, high risk patient presentation and care. Volume and/or acuity require social work expertise in geriatrics including management of competency and functional decline, multiple medical and high-risk psychosocial issues. The ability to practice independently within this context is critical. Work Schedule: Monday through Friday, 8:00am to 4:30pm Telework: Some telework may be approved as determined by the service. 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.