Care Coordination Division History

The Department of Social Service has a rich history, which parallels the history of University of Iowa Hospitals & Clinics. Throughout, it has been a leader in patient care. It has reflected the mission of UI Hospitals & Clinics and the social fabric that is Iowa. Most importantly, it has mirrored the unique contributions, skills, and talents of more than 500 staff members employed by the Department for more than 80 years. The UI Hospitals & Clinics Department of Social Service began as two separate departments: one, in what was then Psychopathic Hospital, started in September of 1920; and one in General Hospital in early 1921.

In the Psychopathic Hospital, the Department of Social Service was organized under Dr. Orton one month after the hospital was organized in September 1920. The hospital had 60 beds, which charged $6.50/day/bed. The social worker's primary function was to interpret the patient's life and milieu to the medical staff and help the patient reintegrate into the community. Margaret Moffit was the first director, and she was trained at Smith College School of Social Work. There were eight directors of Social Service from 1920-1974 when the social service departments in General Hospital and Psychiatric Hospital merged.

In 1926, social workers, psychiatrists and nurses began the "mobile mental health and hygiene clinics" providing services to 26 Iowa communities. By 1933, they had 2.5 full time employees in the department caring for approximately 1,400 patients per year. By 1974, the department grew to its present size of 10.0 psychiatric social workers. In 1974, those 10.0 full time employees cared for about 1,800 patients. In 1997-98 the department's full time employees in psychiatry cared for more than 5,200 patients.

In General Hospital, the Department of Social Service began directly in response to the experience of an eight-year-old boy named Johnny Gilmore. Johnny was suffering from poliomyelitis requiring operations on both of his legs. His legs were casted and his family was scheduled for a two-month follow-up appointment to remove the casts. Johnny did not return until 18 months later when his legs were so gangrenous that they required amputation. In order to prevent such an incident from reoccurring and under Dr. Steindler's leadership, the Department of Social Service was initiated. Its primary function was to assure patients receive follow-up care, including nursing care, and to make referrals to community agencies. The department's original charter included discharge planning and continuity of care.

By 1923, social workers began teaching medical students about the impact psychosocial issues play on a patient's medical condition. By 1927, social work students were in the department. In 1957, social workers began documenting their assessment and interventions into the patient's medical record.

Timeline of Social Service Program Development

• In 1974 the Interpreter/Translation Program began. This program assured that language interpreters were available to non-English speaking and deaf patients. Today, staff interpreters and the language bank can interpret in more than 30 languages making it a premiere program that is routinely consulted by other health care centers throughout the country.
• In 1975, the department partnered with Vocational Rehabilitation to establish a UI Hospitals & Clinics-based vocational rehabilitation counselor to receive and process applications.
• In 1976, the Post-Hospital Care Planning Unit began.
• In 1989, the Department of Social Service started the Health Care Benefits Assistance Program (HCBAP), which allows the department to initiate and monitor Medicaid and Social Security Disability applications at UI Hospitals & Clinics.
• In 1995, the department partnered with the Women's Infants and Children Program to establish a WIC Office at UI Hospitals & Clinics.
• In 1997, the department started the  Patient Medication Assistance Program (PMAP), which helps eligible patients obtain medications from pharmaceutical companies at no cost.
• In 1997, UI Hospitals & Clinics Department of Social Service began sponsoring a Senior Health Insurance Information Program (SHIIP) to assist individuals with information on Medicare benefits, claims, and supplemental insurance plans.
• In 1997 the UI Hospitals & Clinics Organ Donation Program was implemented. The Department of Social Service coordinates the established protocol and provides 24-hour "Family Support Person" services.
• In 2017, Social Services combined with Nurse Navigators, Utilization Management, and Level of Care to become the Care Coordination Division.

All of these activities reflect the department's original and continued mission/commitment to continuity of care by improving patients/families access to community resources.

Recent Accomplishments

The Care Coordination Division at UI Hospitals & Clinics has been productive over the past 10 years, while remaining committed to the core values and beliefs discussed earlier. The department has been centrally involved in

• Creating housing alternatives for patients/families
• Developing training programs and newsletters in the recognition and reporting of child and dependent adult abuse and domestic violence
• Developing institutional protocols and standards for HIV testing and counseling
• Establishing a Home Care Company
• Creating institution-wide policy/procedures for discharge planning
• Developing recommendations for a UI Hospitals & Clinics-based rehab program
• Establishing organizational guidelines to respond to staff with substance abuse problems
• Developing a University-wide employee assistance program known as Faculty and Staff Services

The staff members within the Care Coordination Division at UI Health Care are well positioned to meet present and future challenges because they have a solid set of core values to anchor them, a clear appreciation of why they exist, and an extremely dedicated team.