ACSW / LCSW & Discharge Planning

Job Description

Job Description

Salary : $45.00

Master Social Worker (MSW) is responsible for coordinating discharge planning and facilitating community outreach for individuals transitioning from a Mental Health Rehabilitation Center (MHRC) to the community. This role involves providing clinical support, case management, and counseling services to patients, ensuring a smooth transition to less restrictive settings, and connecting individuals with community resources and support services. The MSW will collaborate with interdisciplinary teams, engage with families, and support patients in reintegrating into their communities while maintaining continuity of care and promoting long-term recovery.

Schedule :

Monday - Friday 9 : 00 AM - 5 : 30 PM

Job Responsibilities

Discharge Planning and Coordination

• Conduct Comprehensive Assessments : Evaluate patients mental health, social needs, and recovery goals upon admission and throughout the treatment process. Prepare patients for discharge by assessing their readiness, treatment progress, and any continuing care needs.
• Develop Discharge Plans : Create and implement detailed, individualized discharge plansin collaboration with patients, their families, and the interdisciplinary treatment team. These plans should address mental health needs, community support, housing, employment, and other critical aspects of post-discharge life.
• Coordinate Care Transitions : Work with external service providers, such as outpatient clinics, psychiatrists, case managers, housing programs, and social services, to ensure continuity of care upon discharge. Ensure that the appropriate referrals are made for follow-up mental health care, medication management, and supportive services.
• Advocate for Patients : Act as an advocate for patients by ensuring they have access to necessary resources, including health services, transportation, housing, vocational services, and other community supports to aid in their reintegration.
• Monitor Post-Discharge Success : Follow up with patients post-discharge to assess their progress and ensure that their needs are being met in the community. Provide short-term counseling or coordinate with outpatient providers to ensure ongoing mental health support.

Community Outreach and Resource Development

Clinical Support and Counseling :

Collaboration with Interdisciplinary Team :

Quality Improvement and Compliance :

Requirements and Qualifications :

Skills and Abilities :

Physical Requirements :

Work Environment :