Social Worker (Home Based Primary Care)

Summary The Home-Based Primary Care Program is a comprehensive specialty interdisciplinary care team that delivers primary care to Veteran patients in a longitudinal rather than episodic fashion and that has as its focus: prevention; health promotion; coordination; and chronic disease self-management in their home/community. The medical social worker functions as a proactive care coordinator with a panel of Veterans to ensure that health care meets the needs – as defined by the Veteran. Qualifications The basic requirements for employment as a VHA social worker are prescribed by statute in 38 U.S.C. 7402(b)(9) – as amended by section 205 of Public Law 106-419 – enacted November 1 – 2000 To qualify for appointment as a social worker in VHA – all applicants must meet the following: 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 to verify that the social work degree meets the accreditation standards for a master 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 Failure to Obtain License or Certification: In all cases – social workers must actively pursue meeting state prerequisites for licensure or certification starting from the date of their appointment Failure to become licensed or certified within the prescribed amount of time will result in removal from the GS‑0185 social worker series and may result in termination of employment Loss of Licensure or Certification: Once licensed or certified – social workers must maintain a full – valid – and unrestricted independent license or certification to remain qualified for employment Loss of licensure or certification will result in removal from the GS‑0185 social worker series and may result in termination of employment Physical Requirements: See VA Directive and Handbook 5019 – Employee Occupational Health Services English Language Proficiency: Candidates must be proficient in spoken and written English to be appointed as authorized by 38 U.S.C. 7403(f) 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: In addition to the basic requirements for employment – the following criteria must be met when determining the grade of candidates Senior Social Worker – GS‑12: Experience/Education: The candidate must have at least two years of experience 8 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‑master's 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 Assignments: For all assignments above the full performance level – the higher‑level duties must consist of significant scope – complexity (difficulty) – and variety and be performed by the incumbent at least 25% of the time Senior social workers are licensed or certified to independently practice social work at an advanced level Senior social workers typically practice in a major program area such as but not limited to: Polytrauma Rehabilitation Center or Polytrauma Network Site a Spinal Cord Injury Rehabilitation Center – or a national VHA referral center – such as a national Center for Post‑Traumatic Stress Disorder or a national Transplant Center – or other program areas of equivalent scope and complexity The senior social worker may be assigned administrative responsibility for clinical program development and is accountable for 9 clinical program's effectiveness and modification of service patterns Assignments include clinical settings where they have limited access to onsite supervision such as CBOCs or satellite outpatient clinics The senior social worker collaborates with the other members of the treatment team in the provision of comprehensive health care services to Veterans – ensures equity of access – service – and benefits to this population – and ensures the care provided is of the highest quality The senior social worker provides leadership – direction – orientation – coaching – in‑service training – staff development – and continuing education programs for assigned social work staff They serve on committees – work groups – and task forces at the facility – VISN – and national level – or in the community as deemed appropriate by the supervisor – Social Work Executive or Chief of Social Work Services This assignment is to be relatively few in number based on the size of the facility/service and applying sound position management This assignment must represent substantial additional responsibility over and above that required at the full performance grade level and cannot be used as the full performance level of this occupation Reference: For more information on this qualification standard – please visit The full performance level of this vacancy is GS‑12 The actual grade at which an applicant may be selected for this vacancy is the GS‑12. Duties VA Careers – Social Work: Total Rewards of an Allied Health Professional The Senior Social Worker for the HBPC is responsible for developing and directing medical social work services serving primarily housebound medically complex older adults – Veterans – and their families in their homes/community in the local area The incumbent works collaboratively with the HBPC team in assessment – treatment planning – organizing – managing – and evaluating the social work services needed to further the mission of the Veteran's self‑identified whole health goals in providing exceptional health care to improve the health and well‑being of the Veterans served by the team GENERAL DESCRIPTION OF ASSIGNED DUTIES INCLUDE BUT ARE NOT LIMITED TO: Develops – adapts – and directs social work services to meet the changing needs of the HBPC Team and any specialty clinics at the VA DoD CBOC while engaging with patient and family to address bio‑psycho‑social needs Will be responsible for tracking and managing internal HBPC medical social work consults and troubleshooting data management Coordinates medical social work services – including home visits and referrals to community resources – and provides support services in these areas and serves as an advocate for Veterans while addressing system and psychosocial barriers to care to track opportunities for quality improvement that should be tracked and adapted to improve processes May provide support to Primary Aligned Care Team as directed by the supervisor The Senior Social Worker is a seasoned clinician with advanced clinical skills and knowledge in medical – psychiatric – geriatric – and rehabilitation specialties Provides independent and expert clinical psychosocial and case management services in a specialized area of practice (Home Based Primary Care) to Veterans who tend to have serious and severe crises – may lack any familial and community support – may be poor self‑monitors – may frequently fail to comply with instructions and treatment – or may have major deficits in coping skills and require continuing professional psychological support Must be able to ethically weigh the needs of individual patients and overall program function – including difficult resource ethics questions that have far‑reaching impact for individuals and the health care system – and an ability to maintain an objective point of view is also required when confronted with the often‑conflicting expectations of staff – VAPAHCS – and patient/family demands Other duties as assigned Motor Vehicle Operator (MVO) Licensure: Must possess a current – unrestricted driver's license Driver Safety within 90 days of start of employment Work Schedule: M‑F 8:00 am – 4:30 pm or as determined by the supervisor Compressed/Flexible: This may be authorized at the supervisor's discretion Pay: Competitive salary and regular salary increases When setting pay – a higher step rate of the appropriate grade may be determined after consideration of higher or unique qualifications or special needs of the VA (Above Minimum Rate of the Grade) Paid Time Off: 37–50 days of annual paid time off per year (13–26 days of annual leave – 13 days of sick leave – 11 paid Federal holidays per year) Selected applicants may qualify for credit toward annual leave accrual – based on prior work experience or military service experience Parental Leave: After 12 months of employment – up to 12 weeks of paid parental leave in connection with the birth – adoption – or foster care placement of a child Child Care Subsidy: After 60 days of employment – full‑time employees with a total family income below $144,000 may be eligible for a childcare subsidy up to 25% of total eligible childcare costs for eligible children up to the monthly maximum of $416.66 Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA Insurance: Federal health/vision/dental/term life/long‑term care (many federal insurance programs can be carried into retirement) Telework: Not Authorized Virtual: This is not a virtual position Functional Statement #: 01200‑F #J-18808-Ljbffr U.S. Department of Veterans Affairs