SPOA Application Case Study

SC placed call to Pa’s CG and friend Teresa Lim and for monitoring phone call because none of the numbers on file for Pa was in working order. She reported that the Pa is doing well and is taking a break from radiation and chemo. She Provided the SC with Pa’s new phone numbers. SC asked about Pa’s service and Teresa reported that the Pa is receiving her PAS service specified in her care plan. Teresa reported that the Pa is happy with her current service and do wish to make any changes right now. The Pa is satisfied with her services and feels they are meeting her needs. No falls, hospitalizations, changes in health status or medications were reported. The SC end call with Teresa and place call to Pa via language line interpreter Michelle. The

S: YMR stated that she had been living with her mother about one year, has is a newcomer. YMR lived with her maternal grandmother for many years back in her country. YMR stated that when she arrived to the U.S., she found out that her mother was pregnant, She shared that her mother did not want to tell her because she did not know how the client was going to react. YMR stated that she was happy because her mother had had four miscarries before. YMR explained that almost at the same time that she started living with her mother, the mother's partner and father of the child that her mother was going to have moved into her home. YMR stated that her mom used to work from 6am-12pm and the YMR spent a lot of time with her mother's partner. YMR stated that this man has

Today, MSC visited Maria at her residence for a face to face visit. When MSC walked in Maria was having a snack at the table. Maria waved and greeted her staff. MSC said, Hello, How are you?" She stated that she needs to talk to MSC in private after she finishes her food. MSC spoke wither Medical Direct Care Counselor Marie Rose. She stated that Maria has been doing good. He is cooperative at times, but requires redirection. Maria stated that she is medically stable and her behavior has improved over the past few months. She is communicates her wants and needs effectively. Maris continues to go to all of her medical appointments and enjoys attending program. Maria goes on all community inclusions and makes suggestions on places she would like to go. She struggles with balancing money, staff continues to assist her in budgeting.

Prior to meeting for the Problem Identification, Stage 1, Ms. Bellot and I spoke on the phone and I briefly explained what consultation and the collaboration efforts that would be needed in the process. She agreed to participate in the consultation process and she was asked to complete a Social History form to gather additional background information on Brianna. Ms. Bellot understood the questions and did not omit any answers.

On this date worker made an unannounced visit to the residence of Mr. Lawson Lovett, for the purpose of linking Mr. Bobby Lovett with VA nursing home application and information. When worker arrived, Mr. Bobby Lovett was cutting grass. Before worker could exit vehicle Mr. Bobby Lovett came to worker's car. Worker exited the vehicle and explained the reason for her visit. When worker gave Mr. Bobby Lovett the nursing home application he gave it back to worker and asked worker if she could help him fill out application because he did not have much education. Worker explained to Mr. Bobby Lovett she would assist with the application. However, he would need to gather documentation and sign application for Mr. Lawson Lovett since he was POA. Mr. Lovett gave worker his number and told her to call, they would set up a time to fill out

Aaron, you have demonstrated knowledge of Department policies and procedures and pose questions when concerns arise. You have demonstrated an understanding and practice of HIPAA laws as is evident in your ability to remain confidential with all investigations despite ongoing inquiries from those that are not authorized including Reporters and various family members. Aaron, you have demonstrated knowledge of the Department’s goals and also Division programs as evidenced by your investigative plans including requests for HCBS, assistance with Medicaid applications and reinvestigations, and care plan or provider changes. Many of these cases required follow up after case closure which you completed thoroughly. Throughout your hotline investigations,

On 02-04-16 at approximately 1030 hours, Phillips drove “Brandon” to the Department of Public Social Services office located at 980 N. Lake Avenue in Pasadena. “Brandon” wanted to pick up a cellular telephone through the Lifeline Telephone Program. “Brandon” returned with the cellular telephone and asked Phillips if she would drive him to his mother’s residence. Phillips agreed and drove “Brandon” to 1518 N. Fair Oaks Avenue.

Carl Fleischer, a 17 year old high school student was sent to the Social Workers office to discuss surrounding issues that might be the cause of his failing grades. Carl was very candid in his conversation with the Social Worker and admits to being an under achiever. Carl is not performing well academically which is a concern. The school Social Worker wanted to learn about Carl and asked him open and closed ended questions about is daily life style. Carl was very talkative in the conversation about himself and became detached when asked to talk more about why he felt he dad was a scumbag.

SC placed call to Pa and CG Annette on 01/5/16. SC asked Antoinette about her employment status with provider to be Sweet Home Health Care and she reported that she was still waiting to hear from the provider. SC informed Annette that it has been over 60 days since Pa’s was approved for service and has not us it. SC asked how Pa’s personal need is are being met and Antoinette reports that she is proving care to Pa. Annette said she did everything and is waiting for the agency. SC end call with Antoinette and placed call to agency. SC got the agency answering service and left detail message, identifying self, Pa, stated reason for calling, and contact informant.

CM received an email from Monica Guzman (Hunterdon Group Home- Assistant Executive Director) with carbon copy, Meghan Kelley (therapist at EMYL) regarding a scheduled transition date. CM was informed that Hunterdon Youth Services is ready to admit Jason (youth) on Thursday, 3/2/17 at 3:00pm. CM confirmed and will transport youth to Group Home. Ms. Guzman reported that the following documents are outstanding; school transfer card, psychiatric evaluation (within 1 year), updated physical form, and IEP/school records. CM stated that she will fax the IEP/School records to Ms. Guzman. CM will follow-up with Kerry Lopez (Child Study Team) regarding school transfer card.

Complainant states that on October 7, 2015, she went to the Oakwood Shores’ office because Henderson had failed to return her calls. Complainant spoke with Henderson and she was told her application had not be processed. Henderson said that he was turning her application over to Pamela (surname unknown) for completion. Complainant states that on October 10, 2015, she called Oakwood Shores asking for Pamela, but she was told Pamela worked at another

This worker went to the home of Michael Geisen. When this worker arrived this worker knocked three times and there was no answer. As this worker was witting a letter to Jessica, about this worker trying to get into contact with Jessica; Jessica came out the front door with towel wrapped around her. Jessica told this worker she was about to get into the shower. This worker gave Jessica her service plan. This worker had Jessica sign for receiving the service plan and the references this worker gave to Jessica. Jessica told this worker she needed to speak with this worker and was going to come to the office to speak to this worker. Jessica was upset with herself about not attending the IA. Jessica asked if there was another way to set a different

Circumstance: Ms. Smalls (MHP) made face to face contact with Mr. and Mrs. Gailliard (MHS) and Clarence.

Writer called Carmela to find when she will be free for us to meet and review her care plan. Carmela said she has an appointment with her counselor on the 20th at 1:45pm. Care manager told Carmela that I will come to her house at 12:30pm and later drop her off at her appointment. Carmela understood care manager.

I informed her that before I called her, I did some research in our system and I also talked with the Social Services Specialist/Certifier Case Manager, Donna.