04/04/2018
You Asked....We Answered
Our home health agency employs an LSW and a social worker assistant. What supervision has to be documented for the LSW? What job duties can a social worker assistant perform?
You Asked:
Our home health agency employs an LSW and a social worker assistant. What supervision has to be documented for the LSW? What job duties can a social worker assistant perform?
We Answered:
Below is the CoP for Medical Social Workers in home health and what it says about social work supervision. Please see the bold areas. The supervision is related to the social worker (MSW) overseeing the plan of care for the patient. The social worker (MSW) is the one who should determine if it is appropriate for the social worker assistant to fulfill the plan of care, or if they, themselves, need to meet the patient’s needs. If the social worker (MSW) assigns the social worker assistant to the case, they then need to continue to supervise the social worker assistant to make sure they are continually able to meet the needs of the patient. In most cases this supervision is a meeting between the social worker (MSW) and the social worker assistant ,and the social worker can document in the patient’s chart that plan of care is being met by the social worker assistant.
Note this important point: In Ohio a social worker assistant, has a two year associate’s degree from a technical or state college, not a baccalaureate degree, but according to the CoP’s, a social worker assistant must have a bachelor’s degree in social work, psychology, sociology or other field related to social work and has one year of experience in healthcare or two years in a non-healthcare setting. As a result, in Ohio the social work assistant designation would not meet the qualifications under the CoPs.
484.34 Condition of Participation: Medical Social Services
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If the agency furnishes medical social services, those services are given by a qualified social worker or by a qualified social work assistant under the supervision of a qualified social worker, and in accordance with the plan of care. The social worker assists the physician and other team members in understanding the significant social and emotional factors related to the health problems,
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participates in the development of the plan of care,
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prepares clinical and progress notes,
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works with the family,
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uses appropriate community resources,
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participates in discharge planning and in-service programs,
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and acts as a consultant to other agency personnel.
Interpretive Guidelines §484.34
Medical social services, when required by the plan of care, must be available on a visiting, not consultative, basis in a patient’s place of residence.
Either the social worker or a social work assistant may make the initial visit to the HHA patient. Information gathered during the home visit is reviewed by the social worker who makes suggestions to the physician for additions to the plan of care.
The social worker may provide the patient with approved professional services or assign the care to the assistant, providing supervision as required. (See §484.2.)
Probes §484.34
How does the HHA confirm that patients’ social service needs are adequately met, including those services provided under arrangement or contract?
Condition of Participation 484.2
Supervision means authoritative procedural guidance by a qualified person for the accomplishment of a function or activity. Unless otherwise specified in this part, the supervisor must be on the premises to supervise an individual who does not meet the qualifications specified in §484.4
Condition of Participation 484.4
Social work assistant. A person who:
(1) Has a baccalaureate degree in social work, psychology, sociology, or other field related to social work, and has had at least 1 year of social work experience in a health care setting; or
(2) Has 2 years of appropriate experience as a social work assistant, and has achieved a satisfactory grade on a proficiency examination conducted, approved, or sponsored by the U.S.Public Health Service, except that these determinations of proficiency do not apply with respect to persons initially licensed by a State or seeking initial qualification as a social work assistant after December 31, 1977.
Social Worker. A person who has a master’s degree from a school of social work accredited by the Council on Social Work Education, and has 1 year of social work experience in a health care setting.
If you have a question you would like to see featured in You Asked..We Answered, email Nisha Hammel, Director of Advocacy at nhammel@leadingageohio.org , or Anne Shelley, Director of Professional Development & HH/Hospice Regulatory Relations, at ashelley@leadingageohio.org.
