The National VA Care Management and Social Work Services
Transcription
The National VA Care Management and Social Work Services
SUMMER 2015 The National VA Care Management and Social Work Services Newsletter Inside Edition: WASHINGTON, D.C. - VA Takes Part in White House Conference on Aging Conference on Aging 1 College Initiative 2 Homeless Outreach 3 In their Boots___ 4 SWANK 5 Portraits of Recovery 6 Equine Therapy 7 EMPOWER program 9 The White House Conference on Aging was held in Washington, D.C., on July 13, 2015. Secretary McDonald spoke on a panel titled Caregiving in America and the conference was attended by Laura Taylor, Acting Chief Consultant, Care Management and Social Work Services. The Conference can be viewed here. The White House has held a Conference on Aging each decade since the 1960s to identify and advance actions to improve the quality of life of older Americans. In addition to the attendees present, the event was also available by live stream. Over 600 watch parties were held nationwide. Long Term Services and Supports: Dr. Tom Edes and Dr. Barbara Jaramillo Winter 2014 Healthy Aging: Dr. Tom Edes, Dr. Hermes Florez, and Ms. Meg Kabat Elder Justice: Ms. Laura Taylor A significant number of older Veterans receive care and services through the VA. In addition, the family caregivers of older Veterans may be eligible for services and supports provided by the VA Caregiver Support Program. Participating in the White House Conference on Aging was an excellent way to raise visibility and awareness of VA programs and services for older Veterans and their family caregivers. BCT 10 In preparation for the event, the White House Conference on Aging formed four SW Intern Projects 11 federal interagency workgroups. The workgroups were structured around four Letter from the Editor 11 critical areas: long-term services and supports (including caregiving), retirement Editorial Board 12 security, healthy aging, and elder justice. The VA had robust representation in the workgroups as follows: Ms. Laura Taylor and Mr. Angelo McClain, CEO, National Association of Social Workers (NASW) at the White House Conference on Aging. Secretary McDonald speaking on panel titled “Caregiving in America”. 1 Innovative Program Partners Colleges, VA in Hudson Valley MONTROSE, NEW YORK - An innovative program pioneered by the VA Hudson Valley Health Care System, New York, is expanding, and its team has Social Workers leading the way to help America’s Heroes. The College Initiative—a partnership between VA Hudson Valley, Vassar College in Poughkeepsie, N.Y., and the Posse Foundation—kicked off in the summer of 2013. Its goal is to connect Veterans attending college with medical care and benefits they earned as a result of military service. Angel Rosario, the Operation Enduring Freedom/ Operation Iraqi Freedom/Operation New Dawn (OEF/ OIF/OND) Veterans Program Director for VA Hudson Valley, oversees the College Initiative effort. He said the program’s success can be summed up by one phrase: “Think big by starting small.” Angel Rosario, social worker and program manager of the OEF/ OIF/OND program for VA Hudson Valley, talks with a Veteran who attends Vassar College Sept. 5, 2014 (Photo by Jason Tudor) Since the program’s 2013 kickoff with 11 students, their population has blossomed and the College Initiative will grow by 30 students in the next three years, tallying 50 at Vassar. Rosario added, “We have been able to gain the trust of our Veterans, Posse Foundation, and Vassar College.” The case manager has been providing general case management, enrollment in VHA care, crisis intervention, and referrals to the Veterans Benefits Administration. The case manager also assists with coordination of medical and mental health services. More recently, the case manager was instrumental in taking the mobile clinics to the SUNY OCC campus where Veterans received care for medical and mental health services. Efforts included bringing mobile clinics to the campus, and offering VA enrollment, eligibility, counseling, gender -specific medical care, and more. Vassar also installed a computer and webcam in a private room on campus to allow for video telehealth. Recently, the VA Hudson Valley leadership sat with Posse students in a focus group to improve and tailor VA efforts. VA Hudson Valley and SUNY OCC are exploring placing video telehealth services on campus by Fall 2015. The annual OEF/OIF/OND summit that met with the first two cohorts at Vassar College in May provided great feedback on the program’s direction. “This is a true forward-thinking initiative,” Rosario proclaimed. “We received only compliments on the care provided by VA Hudson Valley. A few Veterans who are not new to the VA said this is the best VA experience they’ve encountered so far,” Rosario said. Meanwhile, the program continues to expand, thanks to a partnership with the State University of New York Orange Community College (SUNY OCC). The school asked for similar opportunities and will open up services to about 300 more students in the area. SUNY OCC also agreed to create an office on campus for the OEF/OIF/ OND VA Social Worker. Rosario revealed, “Plans are also in the works to expand the program to SUNY Orange in Middletown, N.Y. The relationships ensure that we take a proactive approach in serving this group of Veterans. These relationships have motivated our VA to find creative ways to deliver care to students at their college campuses and we are excited about that.” Rosario mentioned: “The Social Worker is providing oncampus services once a week and provides consultation to faculty on issues specific to Veterans’ academic challenges, as well as attending Veterans’ Club meetings.” 2 HCHV: One Veteran’s Story SAN ANTONIO, TEXAS- The South Texas Veterans Health Care System’s Health Care for Homeless Veterans Program (HCHV) has been identifying homeless Veterans via outreach since 1987. In fact, we were one of the original five test sites for the former “Mentally Ill Homeless Program.” We continue to identify the homeless needs in our city and colHermán Montalvo, laborate with stakeholders and comLCSW, ACSW, HCHV Coordinator, munity partners to address the myriMinority Veterans ad needs of our homeless VeterProgram ans. To paraphrase a familiar televiCoordinator. sion program: there are eight million San Antonio, TX stories in the HCHV program and this is just one of them. this self-motivated decision and its timing. HCHV had fulfilled its mission to transition this homeless Veteran from the street to his own apartment paid for by the income derived from his full-time job. In a devastating turn of events, he lost his job due to difficulty locating his birth certificate to validate US citizenship. He returned to our contracted facility, was referred and accepted back into the CWT program, and was reinstated in EMS. The multidisciplinary providers collaborated to give him an overarching umbrella of clinical support and guidance. However, the issue of his citizenship still hung over Mr. Lui’s return to employment. Mr. De Bona and this writer worked with the State Department, highlighting the positive effect the necessary documentation would have on Mr. Lui retaining his Federal employment. Weeks later, a formal letter arrived from the State Department confirming Mr. Lui’s birth to an American father and that Mr. Lui had been issued an American passport in the 1960s. This story involves Mr. Ronald Lui, an Asian-Pacific Islander and Army Veteran who first gained our attention when he presented to our Grant and Per Diem grantee’s Service Center in April 2013. He arrived without funds, housing, any specific contacts, or knowledge of the services available in San Antonio. A cursory assessment identified his birth in the Philippines and service in the US Army from 1973 to 1976 with an honorable discharge. Mr. Lui had never filed for compensation nor VA pension. His salient need was for housing and employment. He was admitted to our transitional bed facility nine days after arriving at VA. The assigned case manager, Mr. Anthony De Bona, LMSW, worked Mr. Ronald Lui closely with this Veteran to engender trust and a positive therapeutic alliance. This trust led to referrals to his primary care provider and our Compensated Work Therapy program (CWT) within a month. CWT accepted Mr. Lui and followed him closely while placed in Environmental Management Services (EMS). He distinguished himself as a dedicated and hard worker and, with the support of his contracted housing placement, continued with his numerous medical and behavioral health appointments. He also received dental services via the Homeless Veteran Dental Initiative Program. His dental care further accentuated his road to recovery. Mr. De Bona used the letter to assist Mr. Lui with receiving an official Texas identification card, thus establishing his identification and ensuring continued employment with VA. Today, he continues with his new HUD-VASH voucher apartment, his full time employment as an exemplary worker, and compliance with all his appointments and medications. In summary, this case remains open because it is the role of social work to stand by and support, at times gently prod, and demonstrate how issues are resolved within the parameters of the greater organization. I look forward to providing Synergy+ readers updates as Mr. Lui progresses with VA and our community partners. Meanwhile, HCHV case managers continue to put Veterans first: to engender an empathic, trusting, and caring relationship; to build a relationship where the Veteran is part of the solution and not part of the problem (quoting Eldridge Cleaver); and where a homeless Veteran can appreciate his role in the treatment plan and contribute to the resolution of his identified needs and concerns. Mr. Lui’s case is Veteran-centered case management and social work at its best. Lastly, we can convince our Veterans that we have a choice in life if they are willing to accept their roles as change agents and to channel their energies to address plausible and appropriate goals with the support of those assigned to assist them. Mr. Lui progressed so well that in October 2013, he voluntarily discharged into his own local permanent residence. He was ecstatic, as was his treatment team, with 3 In their Boots MANCHESTER, NEW HAMPSHIRE - It is Tuesday at 3:00 p.m. A frustrated Veteran walks into your office and says, “I’ve been all over this medical center, waiting in all kinds of lines, talking to all kinds of people, and I still can’t get the help I need!” This is a scenario that most of us have heard at some time or another. Most VA staff work tirelessly in the job they do every day. Outside of that perspective, it is difficult to know the Veteran and caregiver experience. Social Workers are embedded throughout our Medical Centers, yet despite our best efforts, we often don’t know what our colleagues do, or what resources they have in another part of our campus. What if you and staff from throughout your Medical Center had the chance to see what Veterans experience and what resources and assistance are available? of what a Veteran might experience coming to the VA. Ninety-two percent said they learned something new about VA programs after the activity. If you have any questions on this activity please contact Kristin Maxwell, Manchester VA Medical Center at 603624-4366 ext. 6483. “Being in a Wheelchair gave me a different perspective of what the Medical Center looks like from that vantage point and how accessible things are” A work group of primarily Social Workers at the Manchester VA Medical Center created an interactive activity to simulate common Veterans’ experiences. The activity is called “In Their Boots” and is modeled after a domestic violence awareness activity called “In Her Shoes.” “In Their Boots” was developed over many months and rolled out to all Manchester VA Medical Center staff during the annual Social Work Day on March 27, 2015. The activity assigns a small group to a Veteran scenario, each with a name. Tom, Bill and Vivian are just a few of the scenarios. Once assigned to a Veteran scenario, participants read a card that describes a little about “your” situation as the group’s participants become the Veteran and share his/her experience. Each card in the scenario ends either directing the group to another task or service or provides a choice of next steps. Depending on the Veteran group’s selection, the scenario will guide the group through a possible outcome, other referrals or choices. The Veteran group walks through the Medical Center to identified areas that are marked as different services. Not only does the Veteran group choose a particular path, but also has the experience of trying to find that service or finding someone to help the group determine where to go, much like many Veterans’ experiences. All scenarios have an end: some are positive and others are not, with the intent to be as realistic as possible. This group of Manchester VAMC staff are in the scenario of “Tom”, a Veteran with ALS. The activity was extremely well received and staff enjoyed the interactive and realistic components of the experience. Ninety percent of those who completed this activity said they believe they have a better understanding 4 SWANK HealthCare Courses In their Boots - Continued Swank HealthCare has approximately 25 courses accredited by NASW that are available to VHA MSWs at no additional cost and are completed in VA Talent Management System (TMS). EES has established a national contract with Swank HealthCare for employee access to more than 500 online health care continuing education/continuing medical education courses. These high-demand courses – most of which are accredited – cover a broad range of current topics and clinical competencies and are integrated into the VA Talent Management System (TMS). Using the TMS will allow VHA staff ready access to courses in the office or remotely, and course completions will be automatically recorded in employee learning records. In addition to providing comprehensive and immediate employee access to Swank HealthCare’s large catalog of clinical education and training content, the EES contract leverages learning resources across all VHA. This single, national contract has allowed other VHA organizations to cancel work on new or existing contracts for this content, resulting in significant cost avoidance to VHA. Two separate group scenarios. Each reviewing the next step in their journey “In their Boots”. Below, you can access a complete course catalog (updated monthly) of all accredited and general staff education offerings currently in the TMS. We want your feedback on these courses! Send comments/feedback to [email protected] and you may see yourself quoted in an upcoming article regarding this training! Get Started! Course Catalog Frequently Asked Questions How to Take a Course Manchester VAMC staff work in groups to walk through various scenarios choosing the path they want their care to take. 5 Portraits of Recovery COLOMBIA, MISSOURI- The Social Worker and the Supervisor of the Psychosocial Rehabilitation (PSR) team wanted to reduce the stigma of homelessness by putting real faces and real stories to Veterans who were utilizing services through PSR. After months of preparation and deliberation, Portraits of Recovery was established. This project is a look into the lives of Veterans on the road to recovery utilizing services in the PSR programs. PSR services include all homeless, vocational, peer support and Veteran Justice Out Reach programs. Every location the Veteran was photographed in was significant to them - some were of their new homes, and some were the jobs they had been laid off from that eventually led to their homelessness. Portraits of Recovery has been featured in many conferences across Mid-Missouri, and will be featured as artwork in the Harry S. Truman Memorial Veterans' Hospital. Shown are a few samples - the project has grown since inception, and now features over 10 different Veterans' stories. Photos and design by Travis Weger, Visual Information Specialist, Truman VA. Concept and interviews by Jessie Holdinghaus, LCSW, Truman VA. PSR Supervisor- Sarah Froese, LCSW, Truman VA 6 A Star Inside Us REDDING, CALIFORNIA The story of Candi and her horse, Doc, has many lessons and reminders for social workers and VA staff who work with Veterans. As Coordinator for the VA's Caregiver Support Program in far Northern California, my clients are Care Partners of wounded Veterans. Doc and Candi’s story is a reminder to me that the bePatricia Gomez-Gillard, lief Care Partners have in the LCSW and Caregiver Veteran's ability to cope with Support Coordinator at the their illness is paramount to VA Northern California Healthcare System the Veteran's recovery. When Care Partners, family and medical/mental health clinicians show confidence in not only the Veteran's ability to recover, but to overcome and succeed, the Veteran often rises to the occasion. And as Candi did with Doc, the best communication sometimes occurs when one watches carefully for body language; listens with ears, heart and intuition. The best communication can occur when we do not speak at all. “DOC” One Spot is a 17 year-old Registered Appaloosa horse, nick-named “Doc”, who has won dozens of ribbons and medals for barrel and pole racing. He and his human companion, Candi Tucker, Administrative Officer for the VA Outpatient Clinic in Redding, California, since 1980 travel throughout California every weekend during Gymkhana season participating in races. What makes this unusual is that Doc is completely blind. Candi became Doc’s human companion when he was 5 years old and she immediately trained and began racing him. Doc repeatedly won. one eye he was completely blind and on the other eye they could try an expensive operation with no guarantees. She was also instructed by the specialists to immediately stop riding or racing Doc; and suggested that he might eventually need to be euthanized as the anxiety related to his blindness would lead him to experience significant discomfort and behavioral issues that would make life dangerous for him, his caretakers, and anyone who might walk near him. After an overnight race in Paradise, California, in July 2008, Doc was in a temporary corral encircled by a portable electric fence next to Candi’s camper trailer when she was awakened at 3:00 a.m. to noise outside. Candi found Doc tangled in the electric wire, shaking and shivering and immediately took him to a local veterinarian. After numerous tests with equine specialists, he was diagnosed with Equine Recurrent Uveitis (ERU), a progressive eye condition that results in horse blindness. The veterinarians stated that it appeared, based on the condition of his eyes, that Doc had been afflicted with the disorder for some time. They advised Candi that in After much soul searching and time with Doc, Candi decided that if Doc was able to race and win races just weeks before his diagnosis, he was clearly capable of racing, despite his blindness. She decided she would try to continue working with him, rather than “put him out to pasture” or euthanize him. Candi covered his eyes with a fly mask, so that other riders and audience members would be aware that he was blind. She began to include vocal cues to help Doc get in and out of the horse trailer; such as stomping her foot on the step up and guiding him gently into the trailer. Doc would then follow her lead and enter his trailer. When they raced, in addition to using leg pressure to direct him to go right or left, Candi added vocal cues for example, “here” for a sharp turn, or “over” for a quick 7 A Star Inside Us - Continued weave between a pole. Candi states that Doc’s hearing has become especially acute and when he hears the latch on the arena gates open and close, he seems to know he is getting ready to race. She says his ears perk up and he appears to be excited when he hears the announcer call their names. During the race, he seems to fly with joy. And after the race, Candi can tell he is calm and enjoying himself because he holds his head high, he knickers in response when she speaks to him, and he cocks his hips and feet, which is often a sign of relaxation in horses. Candi hopes that Veterans and VA staff will be inspired by Doc’s story. She would also like to generate more interest in equine therapy groups. “The VA has contracted with various equine therapy groups around the country. For instance, Stable Hands is a group in Yreka, California that has contracted with the VA.” Stable Hands, has a program, Horses Helping Heroes, where military Veterans can recover strength and confidence while developing horsemanship skills. Horses Helping Heroes is built on the foundation of Veteran peer support and utilizes the camaraderie between Veterans to provide a healing environment under the guidance of a licensed occupational therapist and certified therapeutic riding instructors,” says riding instructor Marcia Cushman-Perkins. Information about VAcontracted equine therapy groups in Northern California may be obtained by contacting Candi at (530) 247-7977 or email [email protected]. Candi hopes to continue racing Doc until he decides he is done. She says that his courage, trust in her, and his perseverance is inspiring. Candi is aware that the story could have turned out quite differently. If she had given up on him, and followed the advice of the veterinarians, he probably would not be alive today. “Doc is an amazing horse who has taught me a lot,” said Candi. “You are in charge of how you adapt to life’s difficulties. Doc has shown me that anyone can find positive aspects of life, even with physical or mental health challenges. We all have a star inside us, waiting to excel. We just need a little support and encouragement. ” Candi Tucker racing her blind horse “Doc” in competition. 8 EMPOWER: Establishing Multiple Programs and Opportunities for Women Engaged in Recovery LEAVENWORTH, KANSAS - The EMPOWER project was developed in response to the Domestic Violence/ Intimate Partner Violence (DV/IPV) Outreach Challenge invitation from the Office of Women’s Health Services and the Office of Care Management & Social Work Services The challenge highlighted the disproportionate impact that DV/IPV has on women and the need for both VA and community-based services to assist women Veterans with rehabilitation. The purpose of EMPOWER is to centralize programs for women Veterans in need of DV/IPV assistance under one umbrella and provide an emphasis on whole recovery. EMPOWER will serve to increase awareness about DV/IPV, support the implementation of VA’s DV/IPV Assistance Program, and strengthen VA’s partnerships and relationships with the community. The goal of the project is to exceed expectations in the following areas: Community Involvement, Effectiveness, Innovation, Exportability, and Alignment. The EMPOWER outreach events were designed to create awareness in both the community and Veteran population. competitive 3.1 mile run or a recreational walk. Over 200 people registered and proceeds were directed to local DV agencies that provide care and shelter to individuals and families, including Veterans, experiencing violence in their interpersonal relationships. Volunteers from EKHCS were on-hand to educate the participants about the VA services available to Veterans who were dealing with DV/IPV. Volunteers also distributed program materials informing participants about related VA programs and eligibility. Celebrity Appearance VA event On Wednesday, May 6, 2015, the Women’s Health Center (WHC) at the Dwight D. Eisenhower VA welcomed NASCAR driver Jennifer Jo Cobb for a speaking engagement. Ms. Cobb shared with EKHCS Veterans and staff how she was inspired to create Driven2Honor, a nonprofit organization dedicated to inspiring, empowering, and honoring women in the military. Information about Driven2Honor can be found at http:// www.driven2honor.com/ 5K Run Community Event On Saturday, May 2, 2015, VA Eastern Kansas Health Care System (EKHCS) joined with Race4 Domestic Violence Prevention (Race4DVP) to raise awareness of the issue of DV/IPV in our community. The 5K run took place in a community setting and the activities included a Driven2Honor recognizes the outstanding sacrifice of military women by presenting them with a VIP race day experience. This year a EKHCS Veteran was the recipient of the VIP race day experience at the Kansas City Speedway on May 8, 2015. EMPOWER Project Goals Outreach Challenge goals established by VA Central Office were considered when developing the EMPOWER project. The goals include achieving a high level of community involvement, demonstrating effective impact, developing an innovative project design and exportability of the project to other VA facilities. Photos By: Joe Roe 9 Behavior Couples Therapy for Substance Use Disorders: A Reflection of Practice, Trust and Understanding BUFFALO, NEW YORK - More and more, we are seeing the positive impact of evidence-based practice for the treatment of Substance Use Disorders (SUD). Multiple randomized studies show that when compared to individual treatment alone, Behavioral Couples Therapy (BCT) for SUD leads to less alcohol and drug use, fewer substance-related problems, and better relationships. In one Jennifer Walton, study, compared to individual treatLCSW-R, CASAC ment, BCT-SUD resulted in signifiSocial Worker cantly fewer cases that relapsed, fewVA WNY Healthcare er days of drug use, fewer drugSystem related arrests and hospitalizations, and longer time to relapse. Couples in BCT-SUD also had more positive relationship adjustment on multiple measures and fewer days separated due to relationship discord (O’Farrell and Fals-Stewart, 2000, pp.51-54). My journey with BCT started in August 2013, when I completed BCT-SUD training. when symptoms are beginning, and actions the Veteran can take to support continued recovery, such as going to an Alcoholics Anonymous or Narcotics Anonymous meeting daily. It also includes actions the spouse or partner can take to receive additional support, like attending an Al-Anon support group or contacting the therapist with concerns. One Veteran and his fiancée were referred by the Judge of the Buffalo Veteran’s Treatment Court to outpatient Substance Abuse Treatment Services and BCT-SUD therapy. The couple’s relationship and communication before BCT-SUD therapy was severely strained because of his substance use. They no longer spent any quality time together and the partner did not trust the Veteran because he was dishonest about the money he spent on drugs, spent significant periods of time away from their home and her, and was using drugs. This mistrust was a significant factor in bringing the couple to BCT-SUD. The Veteran was able to maintain sobriety, complete Veteran’s Treatment Court, and re-build his relationship with his fiancé. The Veteran gave many accolades for this approach to treatment: “We learned so much by working with Jennifer! She made sure that we applied the strategies we learned to our daily lives. From our promise to each other and then our communication exercises, my fiancé and I have new skills that will be used for the rest of our lives. For that, my family is forever grateful.” There are many facets to the success of BCT-SUD therapy: the couple’s commitment to making their relationship work, to weekly home practice assignments, and to a daily trust discussion; and finally, the reward of the couple’s commitment to recovery and their improved relationship. Dr. Timothy O’Farrell, a VA expert on BCT said, “Often external motivation can gradually become internal motivation which can be further reinforced by taking part in BCT.” Dr. O’Farrell received his first grant for BCT in 1978 and has published over 250 articles. For more information, please see the BCT-SUD SharePoint, which is filled with information for clinicians and patients, and includes information on current BCT-SUD providers: http://vaww.mentalhealth.va.gov/ebp/bct-sud.asp. The goal of therapy is to improve interpersonal communication skills and relationship satisfaction. The curriculum consists of 12 one-hour sessions using a structured, manualized protocol. On a daily basis, couples use the Trust Discussion, in which the Veteran and his/her partner confirm his/her intention to maintain sobriety for the next 24 hours, and the partner acknowledges his/her effort and continued support. The Promises describe the couple’s commitment to work together through respectful interactions. This includes no threats of separation or divorce while engaged in BCT-SUD therapy and no angry touching or threats of violence. Discussions of the past are limited, focusing on the present and future. Couples participate in all sessions and complete home practice assignments. Engaging in Shared Rewarding Activities is encouraged to rebuild fun in the relationship. Shared Rewarding Activities are sober activities that both find enjoyable, such as going for a walk, watching a movie, or going out for dinner. A Relapse Prevention Plan is developed with the therapist to support continued abstinence. The Relapse Prevention Plan includes information on who to contact Donna Sherman, LCSW-R- Substance Abuse Treatment Services Program Supervisor, and Barry Chapman, LCSW-R- Buffalo Veteran’s Treatment Court Representative, presenting award to Jennifer Walton, LCSW-R, CASAC-Social Worker in Buffalo, NY Substance Abuse Treatment Services Program. 10 2014-2015 VA STUDENT INTERN PROJECTS PROJECT TITLE STUDENT VA Social Work Student Internship Projects The VA Care Management and Social Work Services’ Quality, Safety and Value (QSV) Committee collected over 30 student project summaries from the 20142015 cohort of VA social work graduate student interns. As in previous years, the projects reflected dedication, professionalism and diversity of interests displayed by the social work students placed at VA facilities. Please click on Student Projects 20142015 for link to full summaries which can be found on the CM/SWS SharePoint. Mikaela Harf VA Puget Sound HCS Caregiver Support Program: Process Evaluation and Improvement Vielka Pamerleau, Caitlin Aspel, Elena Wash VA Long beach HCS Smoking Cessation Group Melissa Bares Northport VAMC Mariela Bodon Ramos Albany Stratton VAMC Natalie Carter, Michelle Dean, Allison Gibbs, Quatysha Jackson, Michelle Northrop, Xue Meyer, Emily Taylor, Candace Turner McGuire VAMC Addressing Racism by Focusing on Covert Microaggressions Katie Culpepper Michael E. Debakey VAMC (Houston, TX) Caregiver Resource Guide: A Prevention of Caregiver Burnout Erin Cummings Interactive Voice Response system Social Work Advance Directive Documentation Post 9-11 Veteran Homelessness in Southern Arizona Zachariah Giguere Mammogram Test Results Reporting Amanda Grunwald Uncontrolled Diabetes among VA Primary Care Patients VA Palo Alto HCS S. Arizona VA HCS (Tucson, AZ) Wm. S. Middleton VAMC (Madison, WI) Kelley Haskins VA Puget Sound VAMC Brandon Haygood, Nhien Dutkin Atlanta VAMC Caregiver Support Group: Managing all Caregiver Roles Tiffany Kresl VA Loma Linda HCS The Effects of the Media on Atlanta Veterans Affairs Medical Center: A Qualitative Research Study Hilda Massie Atlanta VAMC Advanced Directive Project Brittany Munson, Holly Powell and Michele Romano West Palm Beach VAMC HUD VASH Program Review Michael Ogunsusi Fort McPherson Laura Faye Perkins Cincinnati VAMC Claire Piassa, Christie Allen Albany Stratton VAMC Ian Pocock VA Puget Sound HCS Military Sexual Trauma & Recovery Improving inclusivity, Welcoming Environment, and Equitable Health Care for Lesbian, Gay, Bisexual and Transgender (LGBT) Veterans. The Pursuit of Happiness Cannabis Policy and Opioid Maintenance Treatment for Veterans Mindfulness and Metaphors in Motion Themes emerging from group discussion process Our sincere thanks and congratulations to the student interns, their practicum sites and supervisors, as well as the National Care Management and Social Work Services’ Quality, Safety and Value Project Subcommittee past and current members for their contributions – LeAnn Bruce, Erin Butler, Barbara Harter, Katie Herrera, Robert Larson and Page Lessy. SITE Coping with Agitated Behaviors in Dementia: A guide for Caregiver Kaitlin Saverese Austin VA CBOC Afifa Yusufi, Deb Wertheim Albany Stratton VAMC Jennifer Bachand VA Loma Linda HCS Carmen Macias VA Loma Linda HCS SW Intern Handbook and Resource Manual The Impact of Social Support of the Length of Homelessness Lifestyle Curriculum for the Prevention and Control of Diabetes Karen Moore VA Loma Linda HCS Dementia…Now What?: Caregiver Education and Support Group (Non-institutional Care VA Adult Day Health Care) Bo Chamunee and Joanna Rodriguez Sepulveda Ambulatory Care Center Development of a Benefits Guide for Community Residential Care Mathew Kaplan Collecting Caregiver Data During Universal Assessment Brittany Madigan Effectiveness of Women's Health Self-Esteem Group Jessica Tapia Outcomes for Older Adults in the Coping with Stress Group Hayley Schleifstein MHICM Program Satisfaction Survey Eliane Spagnoletto Cognitive-Behavior Therapy for Depression: A Group Facilitation Manual for Clinicians Alison Antony Michelle Abdennour and Sean Chandler Dementia Intervention VA Greater Los Angeles HCS VA Greater Los Angeles HCS Sepulveda Ambulatory Care Center Sepulveda Ambulatory Care Center Sepulveda Ambulatory Care Center VA Greater Los Angeles HCS VA Greater Los Angeles HCS Letter from the Editor Dear Colleagues, It’s with optimism and promise that I leave SYNERGY+ in the capable hands of Jana Seay, LCSW and our new Assistant Editor Tiel Keltner, JD. each new edition. My hope moving forward is that front line staff spread the edition to their teammates across the country, and that program managers, executives and chiefs encourage their staff to write articles to highlight their programs and facilities. During my tenure with SYNERGY and then SYNERGY+ I have seen both expansion and change within Care Management and Social Work Services. This edition showcases services in New York, Missouri, New Hampshire, Texas, Kansas and California. Where are my collaborators from Oregon, Georgia, Michigan and Florida? And all of the others? SYNERGY+ relies on the field. Throughout that time, staff around the country continued to pour their time and effort in collaborating with SYNERGY+ and writing articles that expressed their passion and focus. We have remarkable folks doing outstanding work and I am amazed with Finally a special thanks to Laura Taylor, Lorn Gingrich and Jennifer Silva for the encouragement and support over the last four years. Lesley S. Reece, LCSW, Social Work Supervisor, Salisbury VAMC Happy Reading. 11 Editorial Staff Editor-in-Chief: Lesley Reece, LCSW Supervisory Social Worker W.G. (Bill) Hefner VAMC, Salisbury, NC Assistant Editor: Jana Seay, LCSW Supervisory Social Worker Women Veterans Program Manager Central Texas Veterans Health Care System Editorial Board: Laura Taylor, LSCSW Acting Chief Consultant Care Management and Social Work Services Office of Patient Care Services, VACO Jennifer Koget, LCSW, BCD Acting National Director, VA Social Work Care Management and Social Work Services Office of Patient Care Services, VACO Lorn Gingrich, LCSW-R, BCD Social Work Program Manager Care Management and Social Work Services Office of Patient Care Services, VACO Margaret Kabat, LCSW-C Acting National Director of Caregiver Support Program Care Management and Social Work Services Office of Patient Care Services, VACO Jennifer Perez, LICSW Acting National Director of Transition and Care Management Care Management and Social Work Services Office of Patient Care Services, VACO Melissa J. Harding, LCSW Chair, Care Management and Social Work Services Leadership Council Social Work Executive New Mexico Veterans Health Care System, Albuquerque, NM Heather Luper, MSW, LCSW-C Acting Program Manager National Intimate Partner Violence Assistance Program Case Management and Social Work Services Public Relations Subcommittee: Jennifer Silva, LCSW-S Assistant Chief, Social Work Service Central Texas Veterans Health Care System Chair, Public Relations Committee Jennifer Molleker, LSCSW OEF/OIF/OND Social Worker VA Eastern Kansas Health Care System Topeka, KS Jennifer Smentek, LISW OEF/OIF/OND Social Worker Iowa City VA Health Care System Waterloo, IA Tiel Keltner, JD VISN 20 Health System Specialist Vancouver, WA Publishers: Lesley Reece, LCSW and Jana Seay, LCSW Share your ideas, pictures and stories! We invite submissions from social work chiefs, program executives, and staff for consideration for this coming issue. Please send with your Chief’s/SW Executive’s approval to [email protected] and [email protected] By: November 1, 2015 SYNERGY+ provides an excellent opportunity to share information with thousands of peers and VA stakeholders. SYNERGY+ welcomes articles on leadership and innovation in practice relating to Care Management and Social Work within the Department of Veterans Affairs. Talented SW/CM photographers are encouraged to submit digital photography for use in SYNERGY+ 12