One Care Plan Advocate

Old Colony Elder Services•Brockton, MA

About The Position

OCES is seeking a One Care Plan (OCP) Advocate to empower people with disabilities to meet their Long Term Services and Supports (LTSS) needs through assessment, person-centered care planning, advocacy, and participation on each consumer’s Interdisciplinary Care Team (ICT). OCES provides information and coordination of services to older adults and individuals with disabilities, supporting their independence, dignity, and ability to live safely and remain active in their communities. The Advocate conducts initial and ongoing assessments of OCP enrollees’ health and functional status; develops or helps develop the LTSS component of an Individual Care Plan (ICP); and participates as a full member of the ICT. The role includes facilitating appropriate community LTSS and resources, including Personal Care Attendant services; identifying community-based alternatives to institutional care; and, when requested by the ICT, monitoring community services and participating in assessments of facility-based LTSS and related accommodation, accessibility, or equipment needs. The Advocate represents enrollees’ needs, identifies communication and support needs, advocates for them, and educates enrollees and the ICT about LTSS. When an enrollee’s needs fall outside the Advocate’s or LTSC’s expertise, the Advocate helps identify a more appropriate LTSS Coordinator. The position offers a 35-hour work week with some flexibility and a standard Monday–Friday schedule. It involves frequent travel between work sites and routine communication by phone, in person, and in writing. Applicants need reliable transportation, a home computer with internet access, and a mobile phone, and must be able to lift up to 25 pounds at times.

Requirements

Bachelor’s degree in social work or a related field.
Current Social Work License (LSW or higher).
Minimum two years of experience in behavioral health or case management.
Considerable knowledge of social work principles and practices and the social, emotional, and physical processes of aging.
Ability to earn the confidence of elders and their families; obtain personal information through interviews; draw appropriate conclusions; and make suitable recommendations.
Ability to establish and maintain harmonious working relationships with consumers and staff.
Ability to interpret, understand, and adhere to complex regulations, standards, and procedures.
Knowledge and skill necessary to work successfully within an interdisciplinary team.
Ability to communicate clearly, orally and in writing.
Reliable means of transportation, a computer at home with internet access, and a mobile phone.
Ability to lift up to 25 pounds at times.

Nice To Haves

LMHC preferred.

Responsibilities

Conduct initial and ongoing assessments of OCP enrollees’ health and functional status.
Develop or assist in developing the LTSS component of an Individual Care Plan (ICP) and participate as a full member of the Interdisciplinary Care Team (ICT).
Help identify a more appropriate LTSS Coordinator when an enrollee has needs outside the Advocate’s or LTSC’s expertise.
Facilitate appropriate community LTSS and resources, including Personal Care Attendant services.
Identify community-based alternatives to long-term institutional care.
Monitor, upon request from the ICT, the provision and effectiveness of community services according to the ICP.
Represent enrollees’ needs by identifying communication and support needs, advocating for enrollees, and educating the ICT and enrollees about LTSS.
Participate, upon request from the ICT, in assessing the appropriateness of facility-based LTSS, including accommodation, accessibility, and equipment needs.
Perform other duties as assigned.