Staff Access
 

MGH Resources & Information

Community Resource Center

Inpatient Med/Surg Resource Specialist

Supporting MGH SS Department Social Workers

Inpatient Med/Surg Resource Specialist: Grace Santana, 617-643-8327, or contact via Voalte.

• To Refer
  • This role accepts referrals from MGH Social Service Department inpatient med/surg staff – please do not share contact information to other providers, patients/family.
  • We appreciate Epic referrals, but e-mail, Voalte, phone or page are also welcome.
    • Epic Instructions – place an Epic AMBULATORY referral to “MGH Social Work Community Resource Specialist – Main Campus”. Please specify patient type: Inpt Med/Surg (this helps us direct the consult to Karen). Feel free to call/Voalte/email/page to share additional information you may not want in the record or if request is time-sensitive.

• How it works
• Grace works a hybrid schedule and can talk with patients on the phone or in person during admission.
• Assessment at SW discretion - you gather needed information for her or she assesses, just let us know.
• This role accepts referrals from Department of Clinical Social Work staff – please do not give contact information to other providers, to patients/family directly, etc.
• Assists with
1. Individual Adult shelter referrals
• Please complete this Individual Shelter referral form OR let the resource specialist know if you'd like a direct disussion with pt or family.
• Will call shelters and relay status to SW
• Other types of emergency shelter:
• Medical respite/Barbara McInnis House – please refer to case management
• Family shelter (Emergency Assistance or EA) – family must refer themselves: call 866-584-0653, Mon to Fri 8-4
2. Medical leave/disability education – explains eligibility, benefits and how to apply for MA Paid Family and Medical Leave (PFML), federal Family and Medical Leave Act (FMLA), SSDI/SSI, and state short term disability- EAEDC. This role unfortunately cannot offer hands-on application assistance.
3. Transportation- assist with applying for MassHealth PT-1, The Ride 30 Day Medical Necessity and educating patients how to use them (patients set up their own rides); can also investigate any other transportation options.
• PT-1 - refer for assessment* OR complete this PT-1 referral form
  • We may ask for help to identify the authorizing provider to give us the information we need to submit (see PT-1 referral form)
• The Ride 30 Day Medical Necessity - refer for assessment OR complete the 30DMN form and we'll submit and follow-up.
• Verbal permission for The Ride - we ask for verbal permission to share PHI with the MBTA (as we’ll be sharing medical information with a non-medical agency). Karen can obtain this directly from patient or SW can ask patient and let us know.
4. Delivering sweats for discharge when patient has no clothes and no one to bring any
5. Elder Service referrals - will call elder service agencies to request evaluation for service (at home after discharge.)
6. Consults to inpatient med/surg staff for all other types of resource needs. (Notary requests- see next bullet)
• Notary referrals - please consult the Med/Surg resource specialist for assist with notarizing paperwork. Reminder: we appreciate it if you would confirm in advance that patient has ORIGINAL (not copy or pic) of CURRENT ID. It is helpful if you are able to attend. Please discuss situations where you may not be present. Reminder we don't notarize wills. More information: Notary
• Additional Information - Feel free to contact the Med/Surg resource specialist with quesitons.

 

rev 10/24