Weeks of March 3-13, 2008

I am behind on my blogs so I am writing about things I wanted to share that have happened. Please remember if this gets confusing that I am talking about the weeks of March 3 through March 13, and I will try to be as exact as I can about the days.

Up until this point I have slowly started helping more with supervision of the group and running activities. My supervisor, Amanda, had to take two weeks off work for medical reasons starting around February 28th, so one of the case managers who runs Hoosier House on Thursdays, Pam, took over Hoosier House. Before Amanda left she made packets for both of us on what to do, how to do it, and everything we needed to get it done! I don't know how she keeps track of everything she does, but she seems to always be prepared for everything! While she was gone Amanda wanted me to start the progress notes every morning (they are done for everyone everyday) and enter the consumers' daily times into the computer.

When each consumer begins at Cummins they sit with their case managers, therapists, doctors, and/or whoever else is needed to develop their treatment plan. The treatment plan includes all the goals and objectives the consumer will work towards while at Cummins, everything they are expected to accomplish, and how long the consumer will need services. Every day at Hoosier House the consumers are working on one of the goals and objectives on their plans (it is the same one everyday). So in the morning on the progress note I fill in the consumer's name, their consumer ID number, and which goal and objective they are working on (i.e. Goal 2, Objective 1). The consumer writes an individual goal for that day on the note as well (anything from be nicer, learn something new, to practice daily skills or learn how to balance my checkbook). Before the consumer leaves that day they go back to the note and write whether they achieved their goal, and they sign it. Then the supervisor fills in different things about their behavior, appearance, mood, attitude, and other things from a checklist on the page.

For billing purposes each consumer must also sign in every morning what time they got there, and every time they leave they must also sign out. Sometimes they leave to go see the nurse for medicine, or they have appointments with their therapists or the job coach. Each of these people bill for the short time the consumer is with them so we have to make sure insurance is not being double billed. A consumer cannot be at the nurse's office for 15 minutes getting a shot and be in Hoosier House at the same time, so we have to be exact about these things. When the consumer leaves for the day they sign their time out as well. Some consumers come everyday, some only come a few days or one day a week. It all depends on what their treatment plan says they need, and what insurance will pay for. Most of the people there have Medicaid (otherwise it would be EXTREMELY expensive to pay out of pocket!).

Long story short, I am in charge of all this. At the same time I run canteen in the morning. Canteen is like a small snack bar with sodas, chips, snacks, fruit, etc. that the consumers pay for. The proceeds from this buys more snacks, food for free lunch Wednesday, and food for regular lunch (lunch costs $2.00). You wouldn't otherwise think about it, but canteen helps teach budgeting and money-management , as well as problem-solving skills.

I figured I would describe alot of this in detail because I know so many of my peers are in practicums where they do nothing like this, and are curious about these kind of details in my kind of setting. We all are writing about our experiences with the clients, but not about the little things. We have to remember that as social workers so much of our work is paperwork. The mandatory paperwork and documentation is different at every business. I know some out there may not even do progress notes, or deal yet with the goals and objectives we have learned about. When I first dealt with this in the workplace I was so excited to actually see what I was learning from school being directly applied on the job! Here's a quote that I heard once that everyone should remember when it comes to the hours and hours of paperwork and documentation necessary in social work and all health care fields, "If it's not written down, then it did not happen". Remember, everything has to be documented!

Week 2 integration question

I know I have already wrote about this shortly before, but I am trying to go back through and answer all the integration questions up-to-date, so I answered this more thoroughly:

How could doing research for classes impact your relationship with your clients?

When I first thought about this question I realized it could be understood a few different ways, and each could provoke vastly differing answers.

The first way I interpreted this question was to suggest that I was just doing any kind of research at the library for a class, and how the information I found in my research would come into play with my relationship with my clients.

The next way I interpreted this question was to suggest that I would do direct research on or with my clients, and how this would impact our relationship afterward. I believe the question is meant this second way.

Now that I had an idea of what the question meant, I first thought that doing direct research on or with my clients would actual hinder our relationship. I thought my doing the research would change their perception or idea of me.

The other day I had my mid-point visit at my practicum with my supervisor and Erika. We got to talking about my learning plan and different things I can do to improve it. Something was brought up about me maybe doing a mock eco-map or genogram with my clients. The more we talked about it the more I realized it would be good for my clients as well as myself to do direct research like that. This would help me connect more personally, as well as help the client realize more about themselves. So, in the end I say that doing direct research with my clients could improve our relationship.

3-18-08 integration question

What are the time frames needed for developing a treatment planning your agency from the time that the client enters your program. Who dictates that policy?

Cummins policies on clinical documentation timelines are:
1st appointment- Intake assessment, CSDS data sheets, Bio-psychosocial assessment, diagnostic impression, integrated clinical summary, and preliminary service plan

The Individualized Service Plan needs to be completed by the client's 6th visit. The plan will dictate the goals and objectives of each client, and will determine how long the client will need services.

The Director of County Operations and Cummins corporate staff dictate these policies.

3-16-08

I keep logging in to write about something that happened at work, then I start thinking about all the reflection questions and other experiences I have not wrote about that i need to catch up on, and I get overwhelmed then log out. So what I am going to do is try to at least stay current, and catch up on other experiences as I can. I will try to keep it from getting confusing as much as I can so please bear with me...

I'm not sure if I have explained much about what I do, but I work in Hoosier House at Cummins. We have adults with severe mental illnesses who otherwise would sit at home all day by themselves. They come to Hoosier House to have some structure in their day, and to learn a variety of Adult Daily Living (ADL) Skills. Each day we structure their time with a morning group, nutrition group, lunch, and two afternoon groups. Besides the nutrition group, all the groups vary each day, from social skills, budgeting, current events, coping skills, stress management skills, self care skills (hygiene), recovery lifestyle, exercise, etc.

The actual description published in the Hoosier House pamphlet says:

“Hoosier House is a Psychosocial Program for consumers of mental health services in Hendricks County. Hoosier House provides members with daily opportunities to engage in meaningful work that directly benefits all members. The work provides members the opportunity to focus on strengths, self-determination, and personal empowerment, develop adult daily living skills, and further knowledge. Hoosier House has a goal to concentrate on the recovery of the members and help members to reach their individual potentials through education, ADL skills, and social skills groups.”

One of the big differences between what I do and what many other people do is that the clients I work with (we call them consumers) will be my clients all semester while most everyone else will only work with their clients temporarily, or for a somewhat short period of time. Some people only see their clients a few times total, or maybe work with them for a couple weeks. I will see my clients everyday for the entire course of my practicum.