Data Summary and Analysis of Clinical Social Work Program Implementation – Gretna
Kurt D. LaRose (first published May 2005; updated commentary 2011, 2018)
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 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 1between 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. There were no mental health services in the walkin center at the time, and the program that was there was not yet codified. 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.
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.
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).
“This analysis evaluates social work counseling and medical services—when offered together. It shows that onsite services can work! The value of mental health counseling cannot be measured in reducing symptoms only—not every life transformation requires a prescription. Sometimes a good bit of team work, coordination, and structure procedures with evaluations go a long way too. The value of onsite counseling services can be measured in dollars literally and by the lives that are rejuvenated into functional families, continued education, spiritual connectedness, and productive careers. This program implementation was a success, if nothing else were accomplished!” – K. LaRose
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.
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.
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.
NOTE: Article was originally published by LaRose in May 2005, titled as: “Data Summary and Analysis of Clinical Social Work Program Implementation at The FAMU School of Nursing Gretna Wellness Center”. | Rev 2011 | Rev. 2018 |
OTHER ONSITE PROGRAM EXAMPLES
Onsite counseling implementation services and program development services can be modeled after mulit-agency, multi-layered, multi-disciplinary, inter-disciplinary, public/private partnerships with paid and volunteer based programs. For other onsite mental health counseling services implementation and evaluation programs by LaRose, with program evaluation, program supervision, onsite professional development services, contract negotiations and other links to review:
- School Programming Examples
- Remote Server and Digital Server Set Up Example
- Teacher / Professional Development Example
- Digital Services Overlay and Data Management Example
- Other Program Implementation Services Examples