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Data Summary and Analysis of Clinical Social Work Program

Implementation at The FAMU School of Nursing Gretna Wellness Center

[See the Powerpoint Slide Show Here]

 

Kurt D. LaRose, MSW

May 3, 2005

(Updated commentary added 2011)

 

INTRODUCTION:  The following graphs highlight various components and aspects of the social work program [that used to operate] at the FAMU School of Nursing Gretna Wellness Center (the facility was closed several years after this report was originally generated)The Center is [was] a walk-in medical care center that provides primary care in a rural North Florida County.  The Social Work program was added to the Center via a partnership between the Center and The Florida State University College of Social Work and the first Clinical Intern placed there created the mental health (and case management) services in conjunction with the medical team and onsite Advanced Nurse Practitioner.  The partnership provided insight into how the medical model and the bio-psycho-social-spiritual model, once unified for the interests of patients, can have positive outcomes.  The Social Work program began in January of 2005 at the Center as a first time field placement opportunity through the Florida State University College of Social Work.  In the first four months of the program’s implementation a multitude of administrative, program development and client-centered services were provided.  In this summary the general client centered services are highlighted, dollar values are assigned to the services that were provided, and a segment of the report factors in limited administrative dollar values.  The Wellness Center is [was] open two days per week for client services; many case management and administrative services were provided during days the clinic was closed.  This report concludes with a summary, a discussion about cost/benefit analysis limitations, and a disclosure as to the data sources used to generate this report.

 

[NOTE:  With the 2011-2012 commercial developments in the community the need for rural mental health services is likely to be increasingly necessary].

Text Box: One-hour increments were estimated for all mental health clients who were seen weekly and one-hour increments were estimated for all case management clients.  For clients who received both services, CM hours are reduced by one hour for each week MH services were also provided.  During the course of the internship a total of 260 hours of direct client contact was recorded.  The remaining 252 hours (of the total 512 internship requirement) were relegated to administrative and program development tasks.  Dollar Value estimates for administrative social work tasks can be found in the latter pages of this report. 
Text Box: It is important to note that there were multiple mental health consultations during the course of the Fall 05 SOW internship.  Three Licensed Clinical Social Workers (LCSW) who were consulted in weekly “supervision” meetings provided consultation at their private practice office(s) in Tallahassee.  In the normal operations of the private practice, it was routine for a Psychiatrist, Marriage & Family (M/F; Systems) professional and a Play Therapist (TX) to attend the supervision meetings (with each expert attending one meeting per month).  Each expert was paid to provide case consultation (staffings) by the private practice LCSW’s.  Other consultations occurred at random, as needed and often occurred via telephone.
Text Box: Mental health services were provided under the direction of multiple professionals and frequent supervision.  Evidenced based practice methodologies were utilized on a case by case basis relying heavily on pre and posttest assessment instruments with known strong psychometric properties.  “Children” is, of course, not a mental health typology.  These cases are separately noted (but included in this graph) based upon the uniqueness of children’s issues.  Two children presented to the social worker with mental health concerns and/or requests for medication, via parent and/or school identification, however neither child actually had mental health pathology.  The third case presented with an apparent mental health concern requiring medication intervention (provided via referral).  “Assessed” means the client was seen on no more than two occasions and a full written treatment plan was either not developed and/or not implemented, even as interventions were applied. Due to the brief nature of services a formal diagnostic impression was never made for these two cases.
Text Box: 78% of the clients served at the Center received case management (CM) services, with a significant amount of time invested in finding and utilizing multiple medication patient assistance programs for patients who were previously dependent upon available sample medications.  Multitudes of other CM services were provided (see “Service Provision” graph in this document). 
Text Box: 22% of the clients who were directly served during the social work (SOW) internship at the Center received mental health (MH) services.  These clients were identified via in-house referrals from the on-site ARNP, with three referrals made from the rural North Florida communities of Gretna, Quincy, and Chattahoochee.

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Text Box: “This analysis evaluates social work counseling and medical services—when offered together.  The value of mental health counseling cannot only be measured in reducing symptoms—not every life transformation requires a prescription.  The value of counseling can be measured in dollars and by the lives that are rejuvenated into functional families, continued education, spiritual connectedness, and productive careers.”
- K. LaRose
When people change, society benefits - in realized dreams and in realized dollars.