Social Services Counselor

Social Services Counselor -

The incumbent is part of a global public health organization and is expected to support the Florida Department of Health in Clay County in its mission to protect, promote and improve the health of all people in Florida through integrated state, county and community efforts and its vision to be the Healthiest State in the Nation. Furthermore, the incumbent is expected to incorporate the agency values of Innovation, Collaboration, Accountability, Responsiveness and Excellence in all aspects of their work.

Serves as a case manager for the Ryan White program at the Florida Department of Health in Clay County. The goal of this position is to improve and promote access to client-centered services delivered in a culturally competent manner, promote treatment adherence counseling to ensure readiness for and adherence to complex HIV treatments, ensure there are no gaps in care by engaging in care coordination and linkage to care, and promote and support independence and self-sufficiency for all clients in the program.

This position will be guided by all applicable Ryan White and FDOH guidelines. This position requires daily in-office or field work.

Key activities of medical case management include but are not limited to:

• Completes initial comprehensive assessment of service needs, development of a comprehensive, individualized care plan, timely and coordinated access to medically appropriate levels of health, prevention, and support services and continuity of care.
• Completes re-enrollment in Ryan White program and documents interactions according to HRSA standards.
• Uploads all supporting documentation into CAREWARE.
• Aids with medical service referrals needing approval through the area office.
• Assists with the coordination of scheduling follow up visits with outside providers and the County Health Department Clinic.
• Continuous client monitoring to assess the efficacy of the care plan.
• Re-evaluation of the care plan at least every six months, with adaptation as necessary.
• Re-evaluation is uploaded and documented appropriately in CareWARE and HMS
• Make referrals to health educator.
• Conducts ongoing assessment of the client's and the client's key family members' needs and personal support systems.
• Treatment adherence counseling to ensure readiness for and adherence to complex HIV treatments and to ensure an understanding of the importance of compliance with medical appointments for monitoring.
• Client-specific advocacy and/or review of service use.
• Maintains 500/501 certification through annual refresher trainings to be able to accurately give and interpret HIV results.

Key activities of non-medical case management include but are not limited to:

• Ensuring all clients have access to clinical and support services.
• Incumbent works in partnership with private and public partner agencies and stakeholders, and other HIV/AIDS Service Organizations including Community based organizations.
• Responsible for identifying clients for core Ryan White (RW) eligibility and overseeing the AIDS Drug Assistance Program (ADAP).
• Understands and uses HMS, CAREWARE, and Provide Enterprise (ADAP) for data input.
• Accurately and timely completes and documents all client encounters in HMS, State, RWHAP systems (Provide), and any other system as determined by the program.
• Completes and documents all client encounters in HMS, State, RWHAP systems (Provide), and any other system as determined by the program.
• Complete financial eligibility determination in accordance with State of Florida requirements for clients of DOH-Clay and other eligible clients for enrollment to the Ryan White and ADAP programs.
• Ensures that all clients are screened for other payor sources including, but not limited to, Medicaid, Medicare, or other available public or private programs at the time of eligibility enrollment and re-enrollment.
• Verifies income, residence, clinical status, recertify, and unenroll appropriate clients in time frames as specified by HRSA, RWHAP, and State of Florida standards and per those protocols set forth.

Community Involvement:

• Represent FDOH-Clay at Ryan White and HIV/AIDS events in the area and participate in monthly community…