Social Work Information For Member Clinics

Description of Service

The Primary Care Network’s Social Work program endeavours to establish self-management skills for patients who need community supports such as applying to a government program, finding a family physician, or assisting with navigating emergent-type government funding.

Who is Eligible?

Physician members of the GPPCN can make referrals for individuals 14 years and older. PCN Registered Social Workers can assist patients with:

  • Government applications such as AISH and AISH appeals, CPP, CPP-D, OAS, EI, Income Support. This includes helping patients find resources to help such as family and peers, building health-related skills to re-access health resources again in the future without reliance on a program or person.
  • Housing resources.
  • Teaching self-advocacy skills to navigate government organizations the patient is involved with (ex. WCB, AISH, CPP).
  • Promoting self-efficacy skills to improve clinical outcomes when the patient has multiple providers related to health outcomes.
Exclusion Criteria
  • Legal advice-this relates to any type of legal interpretation of any order that may be in place such as but not limited to mediation, No Contact Orders, Child Protection Orders, Probation Orders, any other court mandated orders.
  • Guardianship/Trustee applications or advice—these types of requests should always be referred to the Office of the Public Guardian and Trustee (OPGT) and providers who may provide capacity assessment such as family physician, psychiatrists, and credentialed capacity assessors.
  • Diagnostic assessments, advice, or interpretation.
  • Psychological assessments-Social Workers do not provide testing in psychometrics, interpretation of these types of assessments, nor the assessment or interpretation of any other psychological/mental health-based test or measure including Psych-Ed assessments, Neuro-psych assessments, and Capacity Assessments.
  • WCB or other insurance casework-we assist the patient with self-advocacy skill-building techniques, nominal assistance with filling out applications and other paperwork.
Referral Process & Referral Requirements

A referral for social work can be made using the PCN Central Referral Form. Once referrals are received, they are reviewed by our mental health navigator to confirm that the patient is appropriate for PCN services.

What to Expect

Once the patient is connected to a social worker, you will receive progress updates back periodically as well as a discharge update upon completion of the service. Often within the scope of social work services, we require coordination and support from providers such as physicians and specialists and may request communication to support social work goals and application processes (Ex. AISH Medical, Income Support). We invite you to contact us at any time for further information about your patient’s progress by contacting our social workers at 780-539-9204.

How to Prepare Your Patient For The Appointment

Please discuss and inform your patient of their referral to social work at PCN and why the referral is being made. Please query other social services the patient is accessing and if they are already connected to a community social worker (Ex. Home Care; medical social workers in in-patient settings). It can be helpful to include any information pertaining to financial concerns, medical history, housing concerns, and programming or community resources presently being accessed by the patient.

FAQs

What if I refer a patient who does not fit within the scope of social work at the PCN?
Our social workers will then engage the patient in navigation and referral to the appropriate agency to maximize patient’s experience, their time, and personal disclosures. Our social workers strive for a warm transfer in referral and will update the patient’s physician of the agency referred to and any further treatment plans or termination of service.

Do PCN Social Workers provide mental health therapy?
No, within the PCSP and PPP mental health therapists are available to be referred to specifically. Social workers within our team can also internally refer to mental health therapy when appropriate.

Is there a cost for social work services?
There is no cost to the patient to access social work at the PCN.

Can PCN Social Workers provide case management for a patient going through WCB?
No. GPPCN social workers can assist your patient in navigating this government agency including teaching and supporting self-advocacy.

Can PCN Social Workers provide home visits?
No. We can provide phone, virtual, and in-person appointments to meet all accessibility requirements.

Can PCN Social Workers provide community outreach, such as attending community appointments with my patient?
Where and when this is a required support, social workers will help the patient navigate accessing community resources where this is available. Teaching, supporting, and practicing self-advocacy and efficacy skills are frequently engaged in social work at the PCN.