Chapter 12: The Art of Collaboration
Remember! No identifying information when discussing clients.
Please answer the following questions when creating your journal entry. Feel free to use references, share links, media, pics, and other items that you feel would help your teammates.
- What types of agencies OUTSIDE of your agency do you partner with to provide client services?
- What gaps in service do you see for your clients? Are there services that are lacking in the community?
- Have you had an experience, or witnessed an experience where the social work goals directly conflicted with another service provider’s goals (teacher, attorney, doctor, nurse, etc.), and how did you navigate that?
- How can you ask for what you need or what your client needs, while also remaining professional?
Name: Polly Smith
Agency: Seminole County Public Schools, Pine Crest Elementary School
Over the years, the School Social Worker (SSW) has developed relationships with churches, local businesses, and other organizations to help meet the needs of the students. Many of the community partners want to donate nonperishable food, which is a vital need for the families we serve. We also get a lot of support at the beginning of the school year for school supplies, during Thanksgiving for food, and around the holidays for gift donations. Many of the students do not have their basic needs met a majority of the time, so this school is quite unique in that we have a large food, clothing, backpack, and hygiene supply “closet” that takes up an old classroom. During this summer semester, I will be working with the SSW to address some of the material needs we have identified, such as: larger size clothing and shoes, toothbrushes and toothpaste, lotion, shampoo and conditioner, hair care products, body wash, etc.
When asking for donations on behalf of the students, it is important for us to be upfront about the reality of poverty, while maintaining professionalism and dignity for the students. For example, we often see students that come to school with challenges like: clothes that have not been washed in several weeks, no underwear, hair that has not been done in weeks, bugs in their backpack, lice in their hair, or shoes that are falling apart and too small. While sharing these examples might be effective in getting donations, there are more professional ways to advocate for clients. For example, instead of focusing on the negative, I would focus on what the positive impact of donating clothes and hygiene supplies would be. Our families are doing the best they can, and focusing on what they are doing well is a better way to advocate for them.
We also are working to address the immaterial needs the students and families have, such as: housing security, transportation, parenting support/social support systems, disability resources, parenting education, economic stability, recreation activities, education support, etc.
Over the year, I have encountered many small and large situations in which our goals as social workers conflicted with the goals of the teacher, school administration, or parent. I have also witnessed and discussed many of these situations with my supervisor to get advice on how to professionally navigate these predicaments. The method of resolving the issue changes depending on the circumstances, but the goal is always to keep the students’ best interests central. As with anything, we utilize professional supervision to evaluate and improve for the next time.
As part of my research to help address the needs of the students and families, I found out that the Ounce of Prevention Fund and Florida Department of Health have a program to provide free books for young children to promote literacy. I submitted the SSW’s information on the application so that the school can receive books to give away throughout the year. Also- through this website you can order free information flyers and the Positive Parenting Guide! It was such an easy process. The physical parenting guide is in English, but they have Spanish and Haitian Creole electronic versions!
To order books: https://www.ounce.org/earlyliteracy.html
Positive Parenting Guide (and more): https://www.ounce.org/cappacket.asp
– Polly, I love how you have used your voice towards school staff to better assist the children and families. I agree and love how you said “instead of focusing on the negative, I would focus on what the positive impact of donating clothes and hygiene supplies would be. Our families are doing the best they can, and focusing on what they are doing well is a better way to advocate for them”. You are absolutely right, and I can tell you are doing great things for these students and their families. – Elizabeth
Name: Elizabeth Prophete
Agency: Orlando Health REACH
REACH with Orland Health, there are multiple agencies and providers that we partner up with to provide services for our clients. One service provider in particular that I found to be very beneficial would be the Mustard Seed. Many of the clients that we come across at REACH are clients who have multiple insecurities. Insecurities such as food, housing, bill payments, lack of insurance and health care, housing stability and other financial issues. At the Mustard Seed, they provide furniture and clothing. REACH has partnered with the Mustard Seed whereas if a family is in need of any of those items (clothing and or furniture) at a low cost. REACH staff is able to obtain it for free. I have had several cases at REACH where myself along with staff would go to the Mustard Seed and pick up a crib for a mother and some clothing for the baby. Many of the clients we serve are also non-US citizens and this is very beneficial for them.
When it comes to gaps in services, I would say it would be reliable transportation. This is a major gap within the community that we serve overall. I also feel that it also has to do with the state that we live in. At REACH and overall, Orlando Health, we at times can provide certain clients who are in need of a bus pass. Unfortunately, obtaining a pass is not an ongoing thing. It’s given once to assist with discharge and that’s it. Having reliable transportation helps clients get to and from their medical appointments and any other important events they need to attend. I see this as a bigger issue for families who just had their child(ren) discharged grom the NICU/PICU and or is medically complex. The parent/caregiver will have many follow up appointments for the child and it can be hard to follow. At time Medicaid medical transportation is not reliable. Sometimes this can lead to DCF being contacted for medical neglect. I think there should be something out in place to provide more reliable transportation for these cases.
The one time I had a goal that conflicted with a goal that was established by the SW and Client, would be when a mother wanted a home health aide to assist with her daughter after they had been involved in a bad accident. I expressed to staff as it was the client’s wish, which they understood, and the client was able to reach out to one provider. Unfortunately, inpatient staff did not feel that the family would qualify due to the child’s injuries not being as severe. Unfortunately, the client was denied due to her insurance when she did try to obtain those services. But she was able to manage by having a family member move in to assist.
Making a professional request on behalf of the client should always be done professionally. As a Social Worker, my job is to assist the client as best as I can and in the safest way as possible. I have to remember that it’s not about me and about the client and be able to advocate for them as best as I can and always maintain professionalism. If I ever feel that I may not be able to compose myself, I need to relax and take a breath and if needed, consult with my superior.
Link to the Mustard Seed:
Furniture & Clothing Bank Orlando | Mustard Seed Of Central Florida (mustardseedfla.org)
Elizabeth- Yeah transportation is a huge issue here- we do not have sufficient public transportation and it came out recently that Orlando is the worst rated city in the US for walkability (source). That is super interesting to hear that some families have had a DCF report on medical neglect due to transportation barriers. With you working for DCF I’m curious to know more about that if you want to share! -Polly
(Yes Polly! Unfortunately it’s very common. There are children who are classified as being medically needy and have numerous appointments for an endocrinologist, cardiologist, primary care, doctor, G-tube and more. Some parents rely on medical transportation via Medicaid but I’m always hearing complaints that it’s never on time etc. and so they miss appointments or are not consistent with their appointments which at time leads to a DCF report because they feel the parents/caregiver are being negligent towards the child’s medical needs. Yes at times it’s true and at other times it a transportation barrier and overwhelming situation alone when dealing with a medically complex child.) – Elizabeth
@ Elizabeth: we have definitely learned in our role as an intern in the healthcare industry that the insurance plan and companies dictate what services the patient can and cannot receive. This is a huge barrier when it comes to being able to advocate for the patients.
Name: Alicia Henry
Agency: Orlando Health, Health Central
When it comes to discharge planning, various agencies are involved to ensure that patients receive what they need for ongoing care after discharge. These agencies include skilled nursing facilities, assisted living facilities, dialysis centers, transportation agencies, home health agencies, outpatient therapy agencies, wound care agencies, durable medical equipment agencies, and rehabilitation facilities.
The services that patients need after discharge depend on the medical staff’s suggestion and the patient’s insurance plan. The patient’s insurance plan determines the services they can obtain. The only service that I have observed to be lacking in the community during my internship and work at DCF is a scarcity of Medicaid beds at skilled nursing facilities for clients with Medicaid.
Due to the patient’s insurance plan, there have been numerous occasions where the social worker’s and the doctor’s goals differed. In my current role at DCF, I’ve dealt with this scenario and continue to do so. The families would inform the hospital staff that they could not offer the necessary level of care for the patient to return home. The case managers would threaten the family, telling them that if they did not come to pick up the patient, a DCF report of neglect would be filed.
When families call DCF out of fear of a report being filed, I assure them that if they inform medical professionals that they are unable to satisfy the patient’s needs, they will not face a neglect charge. I would additionally remind the hospital that it is their responsibility to ensure the patient’s safe discharge and that if the family informs them that they are unable to provide the level of care the patient requires and they send them home knowing this, a DCF report will be filed against them for medical neglect.
In circumstances where the client’s needs are not being met, I have set up a collaborative meeting with all involved parties so that we can work as a team in the client’s best interests. In my years of experience, I’ve discovered that there is often a lack of knowledge about the roles and expectations of the various agencies, and once these collaborative meetings take place, everyone has a better understanding of what each agency does and how we can work together to meet the needs of the clients.
What is collaboration? Why it’s important, examples and tips (jostle.me)
Alicia- Do you think that there are insufficient beds at skilled nursing facilities for Medicaid patients because of Florida’s decision to not expand Medicaid? I don’t know a whole lot about this area but I see so many examples of how Florida’s restricted Medicaid impacts people. It’s such a shame- I bet a lot of the dilemmas you see at your internship and work could be avoided if the state prioritized Medicaid coverage. -Polly
@ Polly- The limited Medicaid beds does not have anything to do with Florida’s decision to expand Medicaid. Most facilities have limited Medicaid beds because Medicaid pays a lower rate for Medicaid patients. The healthcare industry is about making a profit, so having to many Medicaid beds will cut into their profit margin.
@Alicia- I love the fact that you have meetings and educating other die to their lack or knowledge and understanding of certain things. Some type of multidisciplinary staffing is always a great way to communicate between parties in assisting the families.
