Last Week in Care Management

I cannot believe that I am currently experiencing my last day here with Care Management. Care Management was the first department I was ever involved with, and I was lucky enough to continue experiencing it all the way through to the (almost) end. I have learned so much more than I ever thought possible only being with them for about 2 or 3 days a week. I am proud to say that I was able to do treatment notes, as well as FF and progress notes, successfully on my own by the time I finished with Care Management. I remember the first treatment meeting I went to with Daria, a Care Manager on my team, being extremely lost and unsure of what I should be documenting and including in the notes. She then sat down with me to explain the proper way to write them including format and word choice. At this point, I was still lost with how to do so and needed assistance throughout the process. This past Tuesday, I went back out with Daria for a treatment meeting, FF, and a collateral with the parent. She left the notes completely up to me to complete, which was a slight panic at first. However, I sat down and looked over the notes I took at the meeting and completed them completely on my own for the first time! The next day in the office, she complimented the notes and stated how she didn't even need to change a thing. That definitely boosted my confidence and proved to myself that I have learned quite a lot while being here in Care Management with Bergen's Promise. 

The Future

Getting closer to the beginning of college and learning about social work more in depth, I began remembering reasons why I became interested in social work from the start. In my family, there are quite a few people with Autism or ADHD diagnoses, so mental health has been a large part of my family. Seeing the involvement within the community made me interested in a field that involved some of these aspects. As time came, figuring out a college and a major became necessary to do and researching about social work made me realize that it would be something that I would love to do. There are explanations about social work is an interesting major and carer to pursue. Since you will always be on the go, whether it's meeting with a family or other providers, you aren't just sitting at a desk all day everyday. There is always that excitement of something new occurring. Being a social worker also allows you to personally make a change in another's life. Sure, any other job will have you making an impact, but through social work, you get to see the progress someone is making directly. Seeing those you are helping also lets you know what is an issue in society and what should be fixed. For example, their is a major stigma around mental health, and since I work with youth who are affected by it, I can see that they are no different than you and me. This feeling is what made me interested in social work and the desire to be involved and stand for a change. I chose social work so I can help benefit the people and places around me, not myself.

Closing Weeks

With it being my last week in Care Management with Jen, I am excited to see what I will be finishing up and working on this week. I am working closely with two members on the team to complete progress notes and other paperwork. Jen and I are also watching carefully to see if there are any last minute opportunities to go out into the field with any of the care managers. I am also finishing up working on various Quality Assurance calls, such as the surveys to the current families that are receiving service that I am working on.

Quality Assurance Calls

Being in Community Resources, I do help assist in occasional Quality Assurance tasks. The latest task I was a part of was to call current families and see how they believe the services are going so far. If the Care Manager was to do this with the family at a meeting they already have scheduled, it could cause the family to be less honest, so they do not hurt the Care Manager's feelings. This would be the same case if the Care Manager Supervisor would do so. Due to this, they asked the interns to follow through with the calls so it would have a less biased answer. However, there is a lot of fall out when it comes to people answering surveys over the phone. In this case, the eight calls I was assigned to do all turned into voice-mails being left in hopes they would call back and do so. However, going into this, I was told this will most likely be the outcome.

Near the End

Nearing the end of my internship, it seems impossible that almost nine months has gone by. I have done a lot more in this internship that I ever imagined possible. I have shadowed families at CFT (Child Family Team Meetings) and FF (Face to Face) meetings, learned how to scan and file documents, made a variety of connections throughout the office, and so much more. This internship has definitely strengthened my interest in social work before going into college. It was extremely beneficial to have so many around me who went on quite the same path I hope to do one day. Whether it was deciding on a college social work program or which field of social work I wanted to go into, there was always somebody there to discuss it with. 

The Need for Social Workers

There is a major need for social workers in a wide variety of fields. For example, child, family, and school social work jobs are expected to increase by 15% between 2012 and 2022. That is an estimated 43,100 new jobs that would be created. However, even though there is a desperate need for more social workers in school settings with the increasing population of youth in schools, state and federal funding tend to hinder the employment growth. In terms of medical social workers, there is an estimated 27% increase, which is almost 39,200 new jobs. With this, there is an increased need of the study of geriatrics (working with the elderly generation), since the baby-boomers are continuing to age. Their families need assistance on finding a reasonable healthcare plan. With the rise in earlier diagnoses of mental illness, a 23% increase in mental health/substance abuse social work jobs. More people are being sentenced to treatment facilities than jail, so there is an increased number of social workers needed in these places. In general, there is a projected 19% increase in the need of healthcare/social service employees. Jobs are accessible with just a bachelor's degree, yet holding a master's degree gives one a step up from others, as well as the ability to practice in a wider variety of settings.

Strategic Planning

Strategic Planning is a process that assists an agency with improving performance, solving organizational problems, building internal communications, and identifying where the agency wants to be at some point in the future and how it will get there. Missions would turn key organizational weaknesses into strengths, respond to trends in the community, and increase the effectiveness of current strategies. Each strategic plan should include a mission statement, which is a short phrase that simply states who they are helping and their goal. For an example, Bergen's Promise's mission statement is : "Healthy families, safe at home". It states who we are helping and how we want them to be (healthy families), as well as what we are wishing to accomplish (safe at home). It is short enough that one could easily remember it. Along with the mission statement, each agency should have a vision statement, which is a much more descriptive explanation on what they wish to accomplish. Every agency should have a strategic plan, regardless of their size. They should all have a plan of where they want to be in years to come, even if it just involves a plan to stay open. 

What is Social Work?

Social work is known to be a profession that is focused on serving those in need. The International Federation of Social Workers calls social work "an interrelated system of values, theory, and practice." Social workers must look at the problem from a variety of aspects, such as the individual's situation to the society, psychological, and political point of views. Social workers commonly are responsible for counseling, therapy, and education. They can work with "clients" in a public or private matter. Social workers can be found in a variety of locations, such as hospitals or schools. They can work with people of any age for numerous reasons, including mental health and counseling. 

Social Work Facts

Having been in a social work setting for the past seven months, I have learned a lot more about the job than I could ever imagine. Some quick facts include:

- Social workers could be found in hospitals, police departments, mental health clinics, military        facilities, or even high end corporations.
- More than 60% of mental health treatment is given by social workers.
- More than 600,000 people hold social work degrees.
- The need for social workers is expected to grow twice as fast as any other occupation.
- There are two U.S. Senators and four U.S. Representatives in office that are social workers.

Going into the field of social work, there are a majority of paths to follow, but they all have the same goal of helping others.

Child and Family Team (CFT)

Each child has their own child and family team (CFT), which is filled with both formal and informal supports. Formal supports would include their care manager and psychiatrist, while informal supports could be parents or any other friend or relative. It is detrimental for the youth to know who to contact if they are going through a crisis or just simply having a bad day. Those in their CFT are there for the child for whatever they need, even on good days when they need someone to let them know they did something they were proud of. CFT meetings allow these supports to voice what they have seen in the youth's life. They could recommend an increase in things such as meeting with a group to increase social skills to an increase/adjustment in medication. The youth is not present in the the CFT meetings since they discuss things in the meetings about the child, and sometimes it is better to bounce ideas off of the team before presenting them to the youth.

Progress Notes

After each child and family team meeting (CFT), progress notes are either created (after an initial meeting with the team) or updated from the last submission. The progress notes keep track of anything that has changed in the child's life since the last meeting and could be either positive or negative. Examples include, but are not limited to, an increase in social interactions, decrease in school attendance, or a even just a change in medication. This progress is then used to plan what is next for the child. If they have shown a decrease in school attendance, they might propose a goal to increase attendance by one more day than usual to be done before the next meeting. For things such a change in medication, they could just have plans to monitor it until the next meeting (about 90 days). Care managers must check in with the youth and parents every so often within the week, so a parent/guardian could voice their opinion on how it is going. 

Brain Injuries

Another requirement of the community resources team is posting news pieces on different topics throughout the year onto the Bergen ResourceNet. This month's post talks about brain injuries and tries to emphasize that not all brain injuries are sports related or are caused by traumatic events. Concussions or mild brain trauma can occur from a child simply falling off a swing set. It might seem that the child is fine initially, but it could put them at risk for future brain issues. Everyone assumes sports and brain injuries are directly related, but that is not always the case. Some brain injuries have nothing to do with sports and sports do not always cause brain injuries. 

Your Target Audience

Working in community resources, it is important to cater your posts in order to attract your "target audience." For example, when I am trying to attract teens, it's imperative to use a tactic that they would engage in and staying up to date. These include new social media (Snapchat, Instagram) and hashtags. Catering to audiences is also present when community resources makes folders to bring to events. The formatting of the cover page is different for teachers than it is for students or school nurses. You should use the one that will capture your specific audience's attention.

Meeting a Family

Whether it be the first or fifth time you are meeting with the child and family team (CFT), the care manager must fill out this paper. It works as a place to write down any progress (good or bad) that the child has had since the last contact. This meeting also covers everything from life at home to any adjustments in medication. The note sheet covers a wide variety of domains, including home life, mental health, and physical health. After filling out this sheet, the notes must be updated in CYBER, a database that hold the information about the youth. The care managers work off of the notes they took in the meeting to update the notes. This is also how Medicaid is billed for the youth's services.

Teen Mental Health Awareness

I am currently working with the Community Resources Department and working with my supervisor for an event we are holding this May. Over the past few weeks, we have been coordinating with other local schools/groups to come up with ideas on how to approach this community service project. With the assistance of other event coordinators and organizations throughout Bergen County, we have joined together to help raise awareness and lower stigma in regards to a variety of topics on mental health. The flyer pictured was sent to local groups who were interested. This project includes meeting with an organization/agency in Bergen County to learn about the chosen topic. The chosen topic is completely up to the group. I figured this would be an excellent thing to bring to our school, so I am working with the Girls Helping Girls Club to bring it to Becton. My supervisor is beyond happy with Becton's involvement at Bergen's Promise and is ecstatic to have them participate in another.  After creating a presentation about what was learned during this whole process, all groups are invited to an event in May, where their presentation will be given in addition to others from schools throughout the county. Prizes and awards are also offered. By doing this project, the group will spread community awareness and reduce stigma. This is something I am very passionate about and I am beyond glad that Becton will be getting involved. 

Put Your Worries in a Box!

Just recently, my Community Resources supervisor Kathy went into the field and did an activity with a group of 4th and 5th graders, and then again with a high school. After a discussion, she had all the students write down something they were worried about and put it in the "worry box". She then left the building with the worries as if "taking all their worries away". After this encounter, Kathy had me sort the "worries" into different categories, documenting how many were in said category and examples of each. She sent this information back to the schools to give them insight into what they were nervous or anxious about. This not only let the school know what their kids are focused on in their age range, but also showed those in the school another support system. The main focus of Bergen's Promise going out into the community is to raise awareness to the New Jersey System of Care and show those in need that someone is there for them if they need it.

Filing

Once the documents are scanned into the computer, only a selected few need to be filed into the youth's folder. By scanning them into the computer, it allows for easier access to the information, rather than needing to look through the tangible folder in the file. It also makes it quicker to send the information to a supervisor or provider if it is already electronic. In order to save space and stay organized, most of the papers are discarded once they are scanned. The only papers that need to be filed are those that the youth, their parent, and the care manager had to sign, as well as any of the notes written down in a face to face meeting with the youth and family or the child and family team. It is important to keep any signed documents so you have the actual copy in the future.

Residential Treatment Centers

When a youth is no longer able to stay under the care of their family, for reasons such as the parent's inability to cater to the youth's needs or the lack of progress the youth seems to be making, they are recommended to move to a residential treatment center, also referred to as a RTC. A more common term for a RTC would be "rehab". In this case, it offers the youth a chance to receive therapy through a live-in health care facility. It could be for a variety of reasons, though some include substance abuse, mental illness, or other behavioral problems. RTCs are usually the last resort, in hopes that the youth will be able to manage his or her situation. Typically, the main goal is to keep the child at home while still receiving care (such as the Bergen Promise logo which is "Healthy families, safe at home"), but in some cases, that is not what is best for the youth and the unique situation. Sometimes, a residential treatment center is the only way to help the child get a more stable grasp on life. In cases I have seen within Bergen's Promise, they still are in contact with their parents, for keeping strong supports is extremely important to the child.

Webinars

Being part of the Community Resources team means constantly updating the Bergen ResourceNet with community events, professional developments, or webinars. Webinars are basically information sessions offered through the Internet, which allows people to have more flexibility. Instead of worrying about traveling to the event, they can simply register online and log in when the webinar is going to begin. Even though I am continuously entering webinars into the system for a variety of topics, I also get the chance to log in and experience them for myself. Today's webinar was on the topic of reaching your target audience on Instagram. Being in community resources, I have found that it is very important in how you attempt to approach your audience. Whether it be school, families, or the children themselves, there are many ways to cater your information to each party. This webinar discussed how to find prime times to post about your business, as well as different ways to promote your business on Instagram (Instagram stories, Instagram posts, Instagram ads, Instagram live). We all think of Instagram as a way to give others insight into our own lives, but there are other paths for businesses to be taking. They know that their target audiences are on social media, so it only makes sense to broaden their business's horizons to become more tech-savvy. 

Cyber

Cyber is the database Bergen Promise uses to hold the information about each youth who receives services. Each youth is then assigned a Cyber ID, which allows workers to discuss their information while disclosing the name. It avoids any HIPAA violations, as well as it being a way to keep everything organized. In the data base, the workers input different things such as progress notes for the child and a service plan. During this process, they are also in charge of meeting with the families and documenting everything that is being done and said. Along with keeping everything updated on Cyber, the care managers are responsible for keeping the youth's charts updated on the private server. This includes updating the service plan reports, making sure all necessary documents are there (birth certificate, social security number, insurance card, etc.), and that the family is being contacted at least a few times a month to check in. Some care managers have 20 plus children so keeping organized is very important to make sure everything is being completed on time.

Children's Dental Health

Being in Community Resources, we are responsible for updating the Bergen ResourceNet with the monthly wellness topic. This month's topic is children's dental health, since February is National Children's Dental Health Month. They also work to relate this wellness topic to other information on the Bergen ResourceNet, so in this case, different dentists or clinics that are free or low of charge to Bergen County Residents. The post includes information such as why children's dental health is important and how it affects a child's overall wellness. Tooth decay could lead to malnutrition, since the child will not be able to chew and digest the food and get the nutrients necessary from it. The post also includes proper oral health tips such as brushing your teeth twice a day for two minutes, lowering your soda intake (since the sugar continues to stick to the tooth surface), and changing your toothbrush regularly (about every 3-4 months). Even though dental health seems to have a slight impact on the child overall, it actually shows to have much more of one than I initially thought. Tooth decay and other dental issues on baby teeth could only lead to dental issues in permanent teeth or even gum disease. As stated before, it also could lead to lack of nutrients since food cannot be digested properly. It also could leave the child more vulnerable to pain and lower self-esteem. 

Carf Anniversary

Bergen's Promise recently celebrated their 16th anniversary as a company, as well as their first anniversary of being accredited by CARF. CARF stands for Commission on Accreditation of Rehabilitation Facilities and is an international, non-profit organization that was founded in 1966 by a U.S. Social and Rehabilitation Services commissioner. By being accredited, Bergen's Promise is being recognized for their human-services. In order to be accredited, an organization must show numerous areas of practice, such as behavioral health and psycho-social rehabilitation. Child and youth services and other community services are other aspects that are considered when applying to be accredited by CARF. This accreditation is also what attracts other providers to work with the company as well as families looking for services. It shows that Bergen's Promise has been consistently dedicated to helping their community and will only continue to do so in the future. 

Bergen ResourceNet

As a member of the community resources team, I now am now responsible for updating the Bergen ResourceNet with new community events or professional trainings onto the website. This allows others throughout Bergen County to see events going on near them and a chance to go out and find natural supports. This also lets professionals go to trainings to learn about certain topics such as dealing with youth with ADHD, OCD, or anxiety. It is very important to keep the website extremely current, so the public knows everything that is going on. The community resources supervisor emails the community resource team randomly throughout the day with new things to input, as well as the website itself having a tab where the public can send us events we might not have heard about. The Bergen ResourceNet makes sure the public is aware of different events or trainings occurring all throughout Bergen County to allow the public to get involved. It also uploads things such as summer camps or other child care services. Each county in New Jersey has their own version of Bergen ResourceNet. 

Community Resources

In my first week of my new rotation in Community Resources, they started it off easy by having me stuff folders with various resources. In each folder, there were documents that included phone numbers for different agencies around Bergen County as well as information about the services Bergen's Promise offers their youth and families. These folders are used to provide information for new families. There are also other folders with varying information for others to hand out such as school nurses and teachers. The type of folder I was filling was just the typical folder a family is given when they are contemplating receiving services from Bergen's Promise or immediately after they start services. Aside from just doing the folders, my supervisor, Kathy, had another member of Community Services, Liz, give me an insight into Bergen Resource Net, a website that has information about all the types of services offered in Bergen County. It also features upcoming events for families, such as holiday parties, as well as other group meetings such as group therapy for varying reasons. Community Resources works on updating the calendar and putting more events in. This allows anyone who goes onto the website to see current things going on in their community. 

Scanning

As I become more and more comfortable around the office, other care managers have started assigning me documents to scan into the computer. These documents include any progress notes they write after meeting with a family and signature pages of those who were present at the meeting. By having me scan the documents into the care manager's folder, it allows the care managers to save time in the office and be able to go out and meet with their families. After scanning the documents into the computer and putting them into the care manager's folder, they are then reorganized according to the youth they pertain to.

Chart Audits

When a youth "graduates" from the program or leaves the care for any other circumstance, their care manager must close their file. By law, Bergen's Promise must keep the youth's information for so many years. When a youth is being closed, the care managers must fill out a "chart audit" which is a checklist to make sure all of the proper files are in the child's folder. It keeps track of meetings held and any outside service requests. By doing the chart audit, the company is making sure they have the necessary paperwork and that it is easy to access if needed. After being trained by a fellow care manager, I have been working on closing the files for any youths my team's care managers still have open. 

Out in the Field

I luckily have had the opportunity to shadow care managers on my team here at Bergen's Promise. It's very interesting to sit in with a family and discuss a child's progress since the last time they met with their care manager. When in a meeting with a youth and family (commonly referred to as a "face to face"), the care managers focus on more than just the child and what they are going through. They make sure to ask the family about anything else going on that could affect the child's mood or daily life. For example, the addition of another child into the family or a move of residency could affect the child even if it wasn't their decision. They focus on how they are going to move on from the circumstances they are currently in, with the child's future in mind. Luckily, in the meetings I have shadowed so far, the children have shown immense progress. Seeing the children grow and focus on their lives is such a pleasant thing to see. These children, even at the young age of 6 or 7, are being responsible and very cooperative with their care. Despite some being rather hesitant at the start, they grow to appreciate the help they are getting in life, even if they don't say so until years later. 

What Do I Do?

While in supervision with my mentor, Jennifer, I was recommended a book that she believed to be "very beneficial" as a beginner in the social service field. The book covers several topics, separated by chapters, such as "how to conduct the first interview with a child" or "how to assess children for neglect, abuse, or sexual abuse". The author, Susan Lukas, talks about her personal experience in the field as licensed social worker and recommends specific advice on how to deal with those situations. While reading, something that stood out to me was that one should try to ask who, what, when, where, and how rather than simply "why". As someone who will potentially be involved in this career, it seems that asking "why do you feel that way" or "why did he/she do such a thing" seems like a quicker way to fully understand how the person feels and why they are here receiving this assistance. However, as I read along, Lukas explains how it is much more beneficial to avoid those situations where the "client/patient" begins to express their own emotions. Especially in initial meetings, it is better, as a social worker, to first understand what actually happened in the event rather than just their personal reaction to it. After only two chapters, I have already learned so much and believe I will learn so much more.

Share the Care!

When a youth is under the care of a care manager here at Bergen's Promise, bringing up the joint care with BHH (Behavioral Health Home) could be a difficult subject to discuss with the family. If a care manager believes their youth could benefit from this treatment, they could easily refer them to BHH. By creating these referral "cards", the process of referring a child to BHH services becomes even more simple. It allows those BHH members to easily have the Cyber ID of the child, which they could look up in the database "Cyber" that the company uses for confidentiality. By not writing the child's name directly on the card, only those members who have access to "Cyber" would know who the youth actually is. It ensures the confidentiality and makes sure their personal information isn't available to the wrong people. And in case of any questions the BHH team has about a specific youth, they have access to the care manager who is responsible for the referred child. These cards allow for an easier method for care managers to refer a youth to BHH, while also allowing BHH to stay organized and have all the information necessary.

Wellness Committee

Each month, the Wellness Committee, which consists of workers throughout the office who volunteer to be a part of it, acknowledge a topic to bring awareness to. January's topic happens to be financial wellness so one of my tasks this week was to decorate the Wellness Board. By doing so, I learned myself what it means to be financially well and ways to save rather than spend. The Wellness Committee works to ensure that staff members take care of themselves and not just those they are helping. They educate the office on ideas that everyone should be spending time on such as volunteering, eating healthy, and mental/physical health. The board, along with the topic of discussion in their monthly meetings, changes monthly and allows everyone to take a break from their day and focus on issues in their own lives. 

Bringing Happiness to the Families of Bergen County!

Just recently, the National Honor Society from Becton joined forces with Bergen's Promise by donating gifts for the families of Bergen County. The event was hosted at their Hackensack office on Monday, December 11th and let kids have a personal experience with "Santa". Each kid went home with a gift they had requested, which were all donated by either the NHS, a neighboring company, or staff members. At the event, children had the opportunity to spend some festive time with their families, eat snacks, and do arts and crafts. Care managers and supervisors from the office came by to show their spirit and enhance the experience for all the children. It was a very successful event!

Welcome!

Welcome to my blog! Here I will be sharing my experiences from my internship at Bergen's Promise. Hope you enjoy!