Joel L. Rubin, MSW, ACSW, CAE
NASW-Illinois Chapter Executive Director
Over the past several weeks of the pandemic, I have had the opportunity to speak with a wide range of social workers across our state working in every practice area imaginable. There have been so many stories of resilience, self-sacrifice and true leadership and professionalism. The following short vignettes reflect the experience of four social workers who truly reflect the essential nature of our work as a profession. All four responded to the following questions:
How have you changed your practice during the current pandemic?
If you are the CEO/ED of an agency or department head, what have you had to do financially to step afloat and keep operating?
What has this crisis told you about change and your leadership? And how is this connected to social work values?
Joseph Harper, LCSW, ACSW, DCSW, MBA, CADC, CCTP, CCHP-MH
Executive Director, Comprehensive Behavioral Health Center East St. Louis, IL
1. How have you changed your practice during the current pandemic?
Many of our services have moved to nontraditional service delivery models. Most of our staff are working remotely and keeping in touch with clients via telephone, Zoom, and other electronic mediums. Since a large percentage of the population we serve has limited access to the internet and phones, we have the clients come to our facility to meet virtually with our psychiatrist. The facility has moved to screening all staff and others who enter the facility in accordance with CDC guidelines. For our residential programs, we have had to reduce the number of individuals served to provide for social distancing. The facility was very fortunate in that our IT company moved very quickly to assist us is setting up remote access to our computer systems for employees working remotely. Some services still require in-person assessment like crisis intervention where the worker is needed to assess clients. We provide our staff with PPE for such events.
2. If you are the CEO/ED of an agency or department head, what have you had to do financially to step afloat and keep operating?
We have managed to maintain operations to this point by closely monitoring service delivery, expenses, and third party reimbursements. Our agency has been very fortunate to have received funds from the Paycheck Protection Program that will be helpful in maintaining operations over future months. We have received grant funding to assist with providing services during the COVID-19 pandemic. In addition, we have received donations of PPE from various sources.
3. What has this crisis told you about change and your leadership? And how is this connected to social work values?
Change is typically never easy. However, I have found that sharing your views and vision regarding service delivery with your coworkers helps to build consensus. Having respect for the dignity and worth of each person we serve helps to unite the team in pursuing excellence.
Latesha Newsom, LCSW, Behavioral Health Management Specialist, Blue Cross Blue Shield
How have you changed your practice during the current pandemic?
At Blue Cross and Blue Shield I work as a Behavioral Health Care Management Specialist. In my role, I provide care coordination services to individuals in the community and nursing home setting. The population I serve are children and adults who are diagnosed with mental health and/or substance abuse disorders. Since the pandemic, we have shifted to telehealth services where we provide telephonic outreaches to our members with Medicaid. We provide services that address the barriers not only in their physical health but also their overall wellbeing. We are seeing an increase in need for psychiatric services and hospitalizations. Therefore, we are outreaching the hospitals and working alongside the hospital social workers to provide support in finding placement for homeless members, those that need intensive residential treatment, and etc. We also have a community support team that is assisting with linkages to housing, food resources, and assisting members with applying for pandemic SNAP benefits.
If you are the CEO/ED of an agency or department head, what have you had to do financially to step afloat and keep operating?
I am not a CEO/ED but we have recently appointed a new CEO so our leadership is going through a transition at this time, but the company was prepared for it and navigating well.
What has this crisis told you about change and your leadership? And how is this connected to social work values?
This crisis has showed me that in leadership we must be able to adapt quickly and respond to the needs of the people that we serve as well as our employees. As we transitioned to working solely from home, the company provided us with all the necessary equipment so we can continue to meet the need of your members who are disenfranchised. The company has allowed flexible working schedules for those who have children at home or caring for loved ones. In addition, the company has also rolled out a mental health supports for its employees which include stress management and mediation sessions and is promoting the theme of self-care during these stressful times.
Jennifer Gentile, LCSW
Deputy Director, Bureau of Clinical Services, Division of Development Disabilities
Illinois Department of Human Services
How have you changed your practice during the current pandemic?
As a social worker, with a concentration on leadership and development in social services, I use my training to assess programmatic changes and how they support the outcomes we want to promote in service populations. Part of the responsibilities of the Division of Developmental Disabilities (DDD) is to administer the Medicaid Waiver for Home and Community Based Services to Illinoisans with Developmental Disabilities. As the Deputy Director of Clinical Services, for the Divisoin, I’ve been able to significantly contribute to the way that the DDD has changed its practices in response to the Covid-19 pandemic. For instance, balancing the implementation of person-centered planning rules and regulations in accordance with social distancing and compliance with federal regulations was no easy feat.
With a temporary amendment to our waiver, called an Appendix K, the DDD has empowered agencies to utilize technology, remote supports, and creative personal planning to meet individuals’ needs while still respecting social distancing rules. We went line-by-line through each regulation judging if the risk that is presented by suspending or adapting the rules was greater than the risk of contracting COVID-19.
If you are the CEO/ED of an agency or department head, what have you had to do financially to step afloat and keep operating?
The DDD has increased payments to our residential providers to cover increased costs of staffing and supplies. In an effort to avoid losing capacity in our system, we have also issued retainer payments to many services that are not able to operate in full force. We have encouraged providers to think creatively about service provision. For instance, in order to keep operating in a safe and socially distant way, many residential providers have changed their staffing patterns to a “live-in” model. Some agencies are requiring staff to live in their group homes for upwards of 3 weeks. This reduces the risk of bringing the virus into the home.
During this crisis, I have worked closely with the CEOs of our provider agencies. Every day I am humbled and inspired by our Direct Support Professionals and agency leaders that are being creative and responsible in ensuring our individuals are safety supported.
What has this crisis told you about change and your leadership? And how is this connected to social work values?
As a social worker, I take an individual’s right to self-determination and human relationships very seriously. Many of the rules that we suspended to be in accordance with the Shelter in Place order, like the right to have visitors, superseded these core social work values. While this was a challenging decision to make, social workers have a responsibility, not only to our individual client, but the society at large. If the DDD allowed one individual in a home have a visitor, it could be potentially putting that individual’s roommate at risk.
Social workers also have an obligation to resolve this conflict in a socially responsible way. We took each right that was temporarily suspended and coupled it with a method to mitigate the potential negative side effects. Additionally, like all good social work practices, it was done in concert. The DDD reached out across the nation and contacted other states’ Division of Developmental Disabilities, self-advocates, families and various other stakeholders. We also worked in concert with feedback from Associations and advocacy groups.
What I have learned most from this experience is that our community partners are relieved to know that they aren’t in this alone. During challenging times, empathy is a universal language and leadership begins with listening.
Melissa Bercier, PhD, LCSW, Founder & President Couch Clarity, P.C., Elmhurst, IL
1. How have you changed your practice during the current pandemic?
We had to practically pivot overnight from a traditional "on the couch" and walk and talk group practice to an online teletherapy practice in order to accommodate our clients and our team's safety.
We had to first implement policies and procedures for teletherapy (which our practice had never done before), train our team, notify our clients, and then create Informed Consents for Teletherapy for our clients to sign prior to starting this method.
We also sought advice from our attorneys to ensure that we were legally following the correct protocols.
We signed up for Doxy.me and DocuSign to virtually "see" our clients and allow for our clients to now sign forms virtually (which we always did our paperwork in person with the clients prior to COVID-19), making sure everything was HIPAA compliant for the safety of our clients.
In order to also support our team's mental health, we also began a group chat through texting; regular Zoom meetings with the team; 1:1 check-ins with myself and each individual team member regularly; and on Monday's we have one of our team members lead a Mindfulness and Meditation group for our team to help us all start off the week on the right foot.
Our team was also encouraged to create their own process support groups through Zoom without their supervisors present.
2. If you are the CEO/ED of an agency or department head, what have you had to do financially to step afloat and keep operating?
We contacted our accountant right away to discuss any questions we had regarding the EIDL and the PPP loans to see if they were in our best interest
Our CFO contacted all of our landlords to discuss rent options for our 5 buildings that are now no longer in use
We were in the final stages of construction for our fifth building in Glen Ellyn, and put a pause on purchasing any big items that were needed to complete the decor of that building
Our CFO kept in close contact with the insurance companies we work with to confirm the ability to use teletherapy codes for all of our clients and to navigate the timing of payments (which were delayed initially due to COVID-19)
3. What has this crisis told you about change and your leadership? And how is this connected to social work values?
Fortunately I have always been the type of leader that loves change and encourages a challenge! Although, this type of change was very stressful due to the seriousness of COVID-19 and my concern for the health and safety of our team and our clients. This abrupt change enabled us to really tighten up our policies and procedures quickly as well as really helped us grow together emotionally as a team, even from afar. Because we experienced this pandemic all together at the same time, we were able to help each other manage through. Each person certainly handles the stress differently and I was able to see where each of us could help the other during our individual times of struggle. If you allow the change, you can see the pin-holes that need to be mended, otherwise if there is no change, it can be difficult to see where you can grow because of the lack of opportunity or vision. As a leader, I feel that this crisis gave me the opportunity to be a role model in implementing processes quickly, calmly and creatively.
As a leader, I not only serve my team, but I serve our clients which in turn serves our communities that we work within. We were able to pivot our entire model in order to continue our commitment and compassion for our clients in a supportive and non-stressful way. We made sure to have a seamless transition for our clients because we respect and care about their mental health deeply. We wanted to ensure our clients had seamless and continued treatment with us so we made sure our insurance companies had a plan for the coding and billing of our clients and we also planned to waive a certain amount of fees if the insurance companies made a decision not to pay for teletherapy. To protect our integrity and competence as a practice, we began regular team group Zoom meetings to train and be present for any concerns or questions regarding the switch to teletherapy as well as checking in with our clients to make sure they were transitioning well or had any suggestions for changes within our process.