D.54 VA Handbook 5005-120 Part II Appendix G39.pdf

September 10, 2019 VA HANDBOOK 5005/120

PART II

APPENDIX G39

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APPENDIX G39. SOCIAL WORKER QUALIFICATION STANDARD

GS-0185

Veterans Health Administration

1. COVERAGE. The following are requirements for appointment as a social worker in the

Veterans Health Administration (VHA). These requirements apply to all social workers in the GS-0185 series, including those assigned to VA medical centers, Community-Based Outpatient Clinics (CBOCs), Readjustment Counseling Service (RCS)/Veteran Centers, Veterans Integrated Service Network (VISN) offices, and VHA Central Office.

2. DEFINITIONS.

a. Journey Level. The full performance level for this qualification standard is at the GS-11 grade level.

b. Creditable Experience. The candidate must have knowledge of current professional social work practices. To be creditable, the experience must have required the use of knowledge, skills, abilities, and other characteristics associated with current professional social work practice. The experience or education must be post-Masters of Social Work (MSW) degree. Experience and education satisfying this requirement must be active professional practice, which is paid/non-paid employment as a professional social worker, as defined by the appropriate state licensing board.

c. Quality of Experience. Experience is only creditable if it is obtained following graduation with a master’s degree in social work and if it includes work as a professional social worker directly related to the position to be filled. Qualifying experience must also be at a level comparable to social work experience at the next lower level

[d. Facility Size and Complexity. The size of the medical center, the type of program managed, and scope of responsibility are critical aspects of the assignments in the standard. The following definitions apply throughout the standard when discussing a small, moderate, and large social work service.

(1) Small. A small social work service is located in a VA facility which provides general medical services to Veterans, families, and caregivers and may have an affiliated health care system. Services include programs that are technical and complex.

Services may be delivered at a variety of VA sites.

(2) Moderate. A moderate social work service is located in a complex VA facility which provides general medical and specialty services to Veterans, families and caregivers and may have an affiliated health care system. Services include multi-faceted specialty care programs that are technical and complex. Services may be delivered at a variety of VA sites.

(3) Large. A large social work service is located in a highly complex VA facility which provides diverse services to Veterans, families and caregivers, and is typically an affiliated tertiary care health care system. Services include multiple specialty care programs and VA Centers of Excellence that are highly technical and complex

VA HANDBOOK 5005/120 September 10, 2019

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across the continuum of care. Services may be delivered at VA sites spanning a large geographic area.]

e. Advanced Practice Level. For all assignments above the full performance (journey) level, the higher-level duties must consist of significant scope, complexity (difficulty), and variety and be performed by the incumbent at least 25% of the time. Advanced Practice Level is defined as the ability to provide independent and expert clinical psychosocial and case management services in a specialized area of practice to Veterans who tend to have serious and severe crises, may lack any familial and community support, may be poor self-monitors, may frequently fail to comply with instructions and treatment, or may have major deficits in coping skills and require continuing professional psychological support.

The advanced practice or senior social worker has an increased depth and breadth of practice skills; has expertise in participating in the professional development of colleagues through mentorship and teaching; demonstrates leadership in developing and expanding professional intervention strategies; demonstrates leadership in defining and attending to professional practice issues; and has the ability to expand the conceptual knowledge of the profession. The advanced practice or senior social worker will make independent professional decisions and recommendations for agency action; the consequences to the Veteran of these decisions and actions may be quite serious. Work involves intensive social work services requiring the exercise of mature professional judgment and the flexible use of a wide range of complex social work practice skills not typically required in routine social work interventions. The advanced practice or senior social worker has mastered a range of specialized interventions and provides consultation to colleagues, renders professional opinions based on experience and expertise, develops new models of psychosocial assessment or intervention, and incorporates complex multiple causation in differential diagnosis and treatment. The advanced practice or senior social worker utilizes outcome evaluations to further treatment and designs system changes based on empirical findings.

f. Differentiating Independent Practice from Advanced Practice Level. Experience must be evaluated to differentiate between independent practice and advanced practice levels.

A social worker practicing at the independent level has a generalized knowledge of practice, (which is required for all social workers at the full performance level and above.), whereas the social worker practicing at the advanced level has specialized knowledge of practice typically related to a particular diagnosis or patient population. The advanced practice social worker can be further differentiated from the independent practice social worker by their ability to expand clinical knowledge in the profession, provide consultation and guidance to colleagues, role model effective social work practice skills, teach or provide orientation to less experienced social workers, develop innovations in practice interventions, and provide clinical supervision for social work licensure or certification. A social worker with advanced practice skills and personal qualifications that meet the standard for the senior social worker will have passed an advanced generalist or clinical Association of Social Work Boards (ASWB) examination and be assigned to a position that requires use of the advanced practice skills in order to be considered for the senior social worker grade.

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g. Part-Time Experience. Part-time experience is creditable according to its relationship to the full-time work week. For example, one week of full-time credit is equivalent to two weeks of part-time work.

h. Fellowships or Post-Graduate Training. Fellowship and post-graduate training programs are typically in a specialized area of clinical practice, i.e., group or family practice. Training as a fellow or post-graduate may be substituted for creditable experience on a year-for-year basis.

i. Practicum in a VA Setting. A VHA practicum experience may not be substituted for experience, as the practicum (field placement) is completed prior to graduation with a master’s degree in social work.

3. BASIC REQUIREMENTS. The basic requirements for employment as a VHA social worker are prescribed by statute in 38 U.S.C. § 7402(b)(9), as amended by section 205 of Public Law 106-419, enacted November 1, 2000. To qualify for appointment as a social worker in VHA, all applicants must meet the following:

a. Citizenship. Be a citizen of the United States. (Non-citizens may be appointed when it is not possible to recruit qualified citizens in accordance with chapter 3, section A, paragraph 3g this part).

b. Education. Have a master’s degree in social work from a school of social work fully accredited by the Council on Social Work Education (CSWE). Graduates of schools of social work that are in candidacy status do not meet this requirement until the School of Social Work is fully accredited. A doctoral degree in social work may not be substituted for the master’s degree in social work. Verification of the degree can be made by going to http://www.cswe.org/Accreditation to verify that the social work degree meets the accreditation standards for a masters of social work.

c. Licensure. Persons hired or reassigned to social worker positions in the GS-0185 series in VHA must be licensed or certified by a state to independently practice social work at the master’s degree level. Current state requirements may be found by going to http://vaww.va.gov/OHRM/T38Hybrid/.

[(1) Exception. VHA may waive the licensure or certification requirement for persons who are otherwise qualified, pending completion of state prerequisites for licensure/certification examinations. This exception only applies at the GS-9 grade level. For the GS-11 grade level and above, the candidate must be licensed or certified. At the time of appointment, the supervisor, chief social work or social work executive will provide the unlicensed/uncertified social worker with the written requirements for licensure or certification, including the time by which the license or certification must be obtained and the consequences for not becoming licensed or certified by the deadline.]

(a) For appointments at the GS-9 grade level, VHA social workers who are not licensed or certified at the time of appointment must become licensed or certified at the independent, master’s level within three years of their appointment as a

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social worker. Most states require two years of post-MSW experience as a prerequisite to taking the licensure/certification exam, and VHA gives social workers one additional year to pass the licensure/certification exam. In states such as California, Washington, and others where the prerequisites for licensure exceed two years, social workers must become licensed at the independent, master’s level within one year of meeting the full state prerequisites for licensure.

(b) A social worker who does not yet have a license that allows independent practice must be supervised by a licensed independent practitioner of the same discipline who is a VA staff member and who has access to the electronic health record.

(c) Different states have different levels of licensure or certification, making it difficult for VHA staff to determine the independent practice level. Each state, Puerto Rico, and the District of Columbia completed surveys identifying the level of licensure or certification allowing independent practice. Copies of the surveys are on file in the VHA Office of Care Management and Social Work Services, and a summary spreadsheet of the levels of licensure or certification is available to social work professional standards board members for purposes of determining whether the social worker’s level of licensure or certification meets the VHA qualification standards. All states except California use a series of licensure exams administered by the ASWB. Information can be found at https://www.aswb.org/.

The ASWB is the association of boards that regulates social work. ASWB develops and maintains the social work licensing examination used across the country and is a central resource for information on the legal regulation of social work. The ASWB offers three examinations. The master’s examination is generally used by states for the independent practice level of licensure or certification, while the advanced generalist and the clinical examinations are used for the advanced practice level of licensure or certification. Differences between the master’s and the advanced exams demonstrate the expectation that advanced practice social workers will have a more sophisticated knowledge of practice theory and its application.

(2) Failure to Obtain License or Certification. In all cases, social workers must actively pursue meeting state prerequisites for licensure or certification starting from the date of their appointment. Failure to become licensed or certified within the prescribed amount of time will result in removal from the GS-0185 social worker series and may result in termination of employment.

(3) Loss of Licensure or Certification. Once licensed or certified, social workers must maintain a full, valid, and unrestricted independent license or certification to remain qualified for employment. Loss of licensure or certification will result in removal from the GS-0185 social worker series and may result in termination of employment.

d. Grandfathering Provision. The following is the standard grandfathering policy for all title

38 hybrid qualification standards. Please carefully review the qualification standard to determine the specific education and/or licensure/certification/registration requirements that apply to this occupation.

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(1) All persons employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure or certification that are part of the basic requirements of the occupation. For employees who do not meet all of the basic requirements in this standard, but who met the qualifications applicable to the position at the time they were appointed to it, the following provisions apply:

(2) Such employees in an occupation that requires a licensure or certification, may be reassigned, promoted up to and including the full performance (journey) level, or changed to lower grade within the occupation, but may not be promoted beyond the journey level or placed in supervisory or managerial positions.

(3) Employees who are appointed on a temporary basis prior to the effective date of the qualification standard may not have their temporary appointment extended or be reappointed, on a temporary or permanent basis, until they fully meet the basic requirements of the standard.

(4) Employees initially grandfathered into this occupation, who subsequently obtain additional education and/or licensure/certification/registration that meet all of the basic requirements of this qualification standard must maintain the required credentials as a condition of employment in the occupation.

(5) If an employee who was retained in an occupation listed in 38 U.S.C. § 7401(3) under this provision leaves that occupation, the employee loses protected status and must meet the full VA qualification standard requirements in effect at the time of reentry to the occupation.

NOTE: If social workers covered under the grandfathering provision of the 1991 Federal law regarding licensure or certification of VHA social workers leave the GS- 0185 social work series, they lose the grandfathering protection. If they choose to return at a later date to the GS-0185 series, they must be licensed or certified to qualify for employment as a social worker.

e. Physical Requirements. See VA Directive and Handbook 5019, Employee Occupational Health Services.

f. English Language Proficiency. Candidates must be proficient in spoken and written

English to be appointed as authorized by 38 U.S.C. § 7403(f).

4. GRADE DETERMINATIONS. In addition to the basic requirements for employment, the following criteria must be met when determining the grade of candidates.

a. Social Worker, GS-9 [ ]

(1) Experience, Education, and Licensure. None beyond the basic requirements.

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(2) Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, the candidate must demonstrate all of the following KSAs:

(a) Ability to work with Veterans and family members from various socioeconomic, cultural, ethnic, educational, and other diversified backgrounds utilizing counseling skills.

(b) Ability to assess the psychosocial functioning and needs of Veterans and their family members, and to formulate and implement a treatment plan, identifying the Veterans problems, strengths, weaknesses, coping skills, and assistance needed.

(c) Ability to implement treatment modalities in working with individuals, families, and groups to achieve treatment goals. This requires judgment and skill in utilizing supportive, problem solving, or crisis intervention techniques.

(d) Ability to establish and maintain effective working relationships and communicate with clients, staff, and representatives of community agencies.

(e) Fundamental knowledge of medical and mental health diagnoses, disabilities, and treatment procedures. This includes acute, chronic, and traumatic illnesses/injuries; common medications and their effects/side effects; and medical terminology.

(3) [Entry Level] Assignments. Individuals assigned as GS-9 grade level social workers are considered to be at the entry level and are closely supervised, as they are not yet functioning at the independent practice level conferred by independent licensure or certification. Social workers at the GS-9 entry level are typically assigned to program areas that do not require specialized knowledge or experience. Duties may include but are not limited to: identifying behaviors or symptoms of abuse, neglect or exploitation;

providing education on advance directives and advanced care planning; providing social work case management; acting as an advocate with appropriate VA and community service providers/agencies when it serves the best interest of the Veteran and family members/caregiver; assessing the psychosocial functioning and needs of Veterans and their family members identifying the Veteran’s strengths, weaknesses, coping skills and psychosocial acuity, in collaboration with the Veteran, family, and interdisciplinary treatment teams; maintaining a current network of internal and external resources to educate the Veteran and/or family members/caregivers and assist with the appropriate referrals. Since social workers at this level are not practicing at an independent level, they should not be assigned to program areas where independent practice is required, such as in a CBOC, unless there is a licensed social worker in the program area who can provide supervision for practice. GS-9 social workers provide psychosocial services in the assigned area under supervision.

b. Social Worker, GS-11 [ ]

(1) Experience and Licensure. Appointment to the GS-11 grade level requires completion of a minimum of one year of post-MSW experience equivalent to the GS-9 grade level in the field of health care or other social work-related settings, (VA or non-

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VA experience) and licensure or certification in a state at the independent practice level.

NOTE: For appointment licensure or certification at this level please refer to paragraph 3c.

OR

(2) Education. In addition to meeting basic requirements, a doctoral degree in social work from a school of social work may be substituted for the required one year of professional social work experience in a clinical setting.

(3) Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, candidates must demonstrate all of the following KSAs:

(a) Knowledge of community resources, how to make appropriate referrals to community and other governmental agencies for services, and ability to coordinate services.

(b) Skill in independently conducting psychosocial assessments and treatment interventions to a wide variety of individuals from various socio-economic, cultural, ethnic, educational and other diversified backgrounds.

(c) Knowledge of medical and mental health diagnoses, disabilities and treatment procedures (i.e. acute, chronic and traumatic illnesses/injuries, common medications and their effects/side effects, and medical terminology) to formulate a treatment plan.

(d) Skill in independently implementing different treatment modalities in working with individuals, families, and groups who are experiencing a variety of psychiatric, medical, and social problems to achieve treatment goals.

(e) Ability to provide consultation services to new social workers, social work graduate students, and other staff about the psychosocial needs of patients and the impact of psychosocial problems on health care and compliance with treatment.

(4) [Full Performance Level] Assignments. This is the full performance level. Social workers at this level are licensed or certified to independently practice social work.

Incumbents are assigned to all program areas, including but not limited to: inpatient or outpatient medicine, surgery, mental health, neurology, rehabilitation medicine, and geriatrics. Employees provide professional, independent social work services in the assigned area. Duties include but are not limited to: assessing and documenting identified behaviors or symptoms of abuse, neglect, exploitation and/or intimate partner violence; use of clinical social work skills and knowledge to maintain Veteran privacy and confidentiality per policies, handbooks or directives; and acts as an advocate with appropriate VA and community service providers and agencies when it serves the best interest of the Veteran and family members/caregiver. Incumbent independently assesses the psychosocial functioning and needs of Veterans and their family members, identifying the Veteran’s strengths, weaknesses, coping skills, and

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psychosocial acuity. In collaboration with the Veteran, family/caregiver, and interdisciplinary treatment team, the social worker facilitates the delivery of health care services. The social worker identifies family/caregiver stressors, conducts assessment and provides specific interventions. The incumbent provides case management and care coordination to facilitate appropriate delivery of health care services, incorporates complex multiple causation in differential diagnosis and treatment of Veterans, including making psychosocial and psychiatric diagnoses within approved clinical privileges or scope of practice. The social worker links the Veteran with services, resources, and opportunities, in order to maximize the Veteran’s independence, health, and well-being. The social worker conducts timely assessment of at-risk Veterans in crisis to identify immediate needs, evaluate risk, and initiate safety plan as appropriate. The social worker provides interventions independently with Veterans and their families/caregivers who are experiencing a wide range of complicated medical, behavioral health, financial, legal, and psychosocial problems. They provide a range of interventions and treatment modalities which may include individual, group, and/or family counseling or psychotherapy. They independently formulate and implement a treatment plan including measurable, achievable goals identifying the Veterans’ needs, strengths, weaknesses, coping skills, and psychosocial acuity. Social workers serve on committees, work groups, and task forces at the facility and VISN level or in the community. They provide subject matter consultation to colleagues and students on the psychosocial treatment of Veterans offering professional opinions based on experience, expertise and role modeling effective social work practice skills. The social worker establishes and maintains ongoing education programs for Veterans, community agencies, students, and staff, to facilitate understanding of social work interventions specific to the Veteran/Military population.

c. Senior Social Worker, GS-12

(1) Experience/Education. The candidate must have at least two years of experience post advanced practice clinical licensure and should be in a specialized area of social work practice of which, one year must be equivalent to the GS-11 grade level. Senior social workers have experience that demonstrates possession of advanced practice skills and judgment. Senior social workers are experts in their specialized area of practice. Senior social workers may have certification or other post-masters training from a nationally recognized professional organization or university that includes a defined curriculum/course of study and internship or equivalent supervised professional experience in a specialty.

(2) Licensure/Certification. Senior social workers must be licensed or certified by a state at the advanced practice level which included an advanced generalist or clinical examination, unless they are grandfathered by the state in which they are licensed to practice at the advanced practice level (except for licenses issued in California, which administers its own clinical examination for advanced practice) and they must be able to provide supervision for licensure.

(3) Demonstrated Knowledge, Skills, and Abilities. In addition to the experience above, candidates must demonstrate all of the following KSAs:

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(a) Skill in a range of specialized interventions and treatment modalities used in specialty treatment programs or with special patient populations. This includes individual, group, and/or family counseling or psychotherapy and advanced level psychosocial and/or case management.

(b) Ability to incorporate complex multiple causation in differential diagnosis and treatment within approved clinical privileges or scope of practice.

(c) Knowledge in developing and implementing methods for measuring effectiveness of social work practice and services in the specialty area, utilizing outcome evaluations to improve treatment services and to design system changes.

(d) Ability to provide specialized consultation to colleagues and students on the psychosocial treatment of patients in the service delivery area, as well as role modeling effective social work practice skills.

(e) Ability to expand clinical knowledge in the social work profession, and to write policies, procedures, and/or practice guidelines pertaining to the service delivery area.

(4) Assignments. For all assignments above the full performance level, the higher-level duties must consist of significant scope, complexity (difficulty), and variety and be performed by the incumbent at least 25% of the time. Senior social workers are licensed or certified to independently practice social work at an advanced level. Senior social workers typically practice in a major program area such as but not limited to:

Polytrauma Rehabilitation Center or Polytrauma Network Site; a Spinal Cord Injury Rehabilitation Center, or a national VHA referral center, such as a national Center for Post-Traumatic Stress Disorder or a national Transplant Center, or other program areas of equivalent scope and complexity. The senior social worker may be assigned administrative responsibility for clinical program development and is accountable for clinical program effectiveness and modification of service patterns. Assignments include clinical settings where they have limited access to onsite supervision such as CBOCs or satellite outpatient clinics. The senior social worker collaborates with the other members of the treatment team in the provision of comprehensive health care services to Veterans, ensures equity of access, service, and benefits to this population, ensures the care provided is of the highest quality. The senior social worker provides leadership, direction, orientation, coaching, in-service training, staff development, and continuing education programs for assigned social work staff. They serve on committees, work groups, and task forces at the facility, VISN and national level, or in the community as deemed appropriate by the supervisor, Social Work Executive or Chief of Social Work Services. This assignment is to be relatively few in number based on the size of the facility/service and applying sound position management. This assignment must represent substantial additional responsibility over and above that required at the full performance grade level and cannot be used as the full performance level of this occupation.