Social Work - Veteran Health Indiana
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Veteran Health Indiana


Social Work

Social Work Service provides all eligible Veterans and their families with high quality psychosocial services that maximize community adjustment and social functioning. Social Work’s holistic approach assists to provide timely and cost effective services focused on enhancing customer satisfaction.

To accomplish our mission, Social Work is committed to:
• Work collaboratively with other disciplines as an integral part of the health care team
• Psychosocial assessments and treatment
• Provide comprehensive case management
• Provide patient and family education to enhance wellness
• Develop and coordinating VA and community resources and community partnering
• Identify and engaging potential customers through community outreach
• Promote staff development and training
• Participate in research and program evaluation
• Provide graduate training to social work interns through academic affiliates

Advance Directives Durable Power of Attorney

We believe it is extremely important for our Veterans to play an active role in their medical treatment. One way to do this is to complete an Advance Directive Durable Power of Attorney. Please follow this link for additional information Advance Directive Durable Power of Attorney.

Social Workers are involved in helping the patient resolve problems and concerns which interfere with a satisfactory life adjustment and maximal use of available treatment. Social Workers play a key role in coordinating Veteran’s care to ensure they are receiving the highest quality care available. They work closely with the Veteran, family, interdisciplary teams providing medical care, as well as community agencies and resources.

Amyotrophic Lateral Sclerosis (ALS) Social Work:

ALS Social Workers have specialized training and experience focusing on health related issues and their impact on physical, emotional, social and spiritual functioning. Social work provides screening, assessment and intervention to patients and their families, empowering them to deal with the stresses that accompany a diagnosis of ALS. As part of the multidisciplinary treatment team, the Clinical Social Worker provides the following services;  Psychosocial Assessment, Patient & Family Education, Counseling and Emotional Support, Advanced Directive Consultation, Community Resource Referrals, Home Health and Hospice Care Coordination, Social Security & VA Disability Benefit Guidance and Advocacy, and Support Group Referrals.

Community Rehabilitation Section (Homeless and Vocational Rehabilitation)

The Community Rehab Section homeless programs offer a variety of services to assist a Veteran and family who are experiencing homelessness. Services include case management to assist with accessing community shelters, short term residential housing programs as well as community or VA resources. The VA also partners with community agencies to provide a range of temporary housing options who provides case management for up to two years. Lastly, there are permanent Section 8 housing vouchers for those who qualify.

Additionally, Vocational rehabilitation includes a variety of services that assist people in gaining or maintaining employment. Eligibility is usually limited to persons who have “substantial handicap” to employment because of a physical or mental disability.

Dialysis Social Work

The Dialysis Social Worker provides social work services to veterans receiving care in the outpatient Dialysis Clinic or as inpatients admitted for chronic renal failure at the Richard L. Roudebush VAMC. In collaboration with the interdisciplinary medical team, the Dialysis Social Worker evaluates the veteran’s presenting psychosocial problems and facilitates access to the resources that can most appropriately minimize the veteran’s psychosocial stressors. The Dialysis Social Worker will assist veterans in understanding and accessing diagnosis-specific healthcare entitlements, such as:
• Medicare, Part A, B and D for patients starting dialysis
• Medicare regulations and benefit periods
• Medicare coverage for kidney transplantation
• Private health insurance and COBRA, including benefits, coverage extensions, eligibility and time frames

Additionally, the Dialysis Social Worker functions as an educator to the veteran and his/her family or caregiver, providing information on:
• The functions of the kidney
• The process and causes of developing chronic renal failure and the impact on one’s overall health
• The common causes of death for those receiving dialysis
• The commons side effects to dialysis and chronic renal failure
• The common treatment options for people suffering chronic renal failure

The Dialysis Social Worker completes Psychosocial Assessments for Organ Transplant candidates as consulted, and works in coordination with referring medical staff to insure that veterans understand the organ-matching process, VA transplant regulations, complications post-transplant and myths regarding organ donation. Finally, the Dialysis Social Worker weaves supportive counseling throughout the continuum of renal care, ensuring that veterans, their families and caregivers optimize coping to life altering illnesses.

Medical Social Work

The Inpatient Medicine Social Worker provides social work, care coordination and discharge planning services to veterans admitted to inpatient medicine at the Richard L. Roudebush VAMC. In collaboration with the interdisciplinary inpatient medical treatment teams, the Inpatient Medicine Social Worker works to ensure that veterans transition efficiently from an inpatient level of care to the appropriate discharge level of care (e.g., outpatient with home health care, assisted living, extended care facility). By involving and educating caregivers and families throughout the inpatient episode and the discharge process, the Inpatient Medicine Social Worker works to optimize the social supports available to the veteran to promote maximum recovery and functioning. The Inpatient Medicine Social worker evaluates psychosocial needs of medically high risk veterans, assisting with the coordination of outpatient services at VA and in the community. Finally, the Inpatient Medicine Social Worker offers grief and adjustment-to-illness counseling, to help veterans and families cope with the emotional consequences of health problems.

Oncology Social Work

The Oncology Social Worker provides psychosocial services to cancer patients, their families, and caregivers.   The goal is to connect patients and their loved ones to all the essential resources to guide them through the cancer journey.  The Oncology Social Worker works closely with the multidisciplinary teams in the follow clinics:  Hematology, Medical Oncology, Radiation Oncology and other specialty clinics that may touch the cancer patient.  Our cancer program serves many Veterans throughout Indiana, along with all individuals from the Illiana VAHCS.  The goal is to enhance the cancer care of the whole patient.  This includes assistance with, but not limited to the following areas:
• Adjustment to illness support
• Crisis Intervention
• Talking to one's family about cancer
• Education regarding VBA entitlement benefits
• Information, education and referral to appropriate community resources
• Improve communication with the health care team
• Financial challenges and need for assistance
• Limited social supports
• Health behaviors interfering with illness self-management, such as smoking, alcohol, drug use, diet, exercise, cognitive abilities
• Advance Directives
• Transportation and lodging assistance during treatment
• Help with activities of daily living
• Referrals to extended care services – including home care, hospice, adult day care and caregiver respite
• Life as a cancer survivor

Our cancer program serves many Veterans throughout Indiana, along with all individuals from the Illiana VAHCS.  The Oncology Social Worker also assists with the evaluation needed for a Stem Cell Transplant. 

Operation Enduring Freedom/Operation Iraqi Freedom /Operation New Dawn

The Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Program oversees all transition activities and the coordination of care and services for OEF/OIF veterans treated at the facility. This program is specifically for those who have served in combat or combat support operations, during a period of war after the Gulf War, or against a hostile force after November 11, 1998.

The OEF/OIF Program utilizes an integrated care model inclusive of the following components:

Care Management - Team of clinical Social Workers and/or Nurses, as well as a Transition Patient Advocate, who provides assistance helping the patient navigate and access their VA healthcare and other benefits. All military treatment facility referrals are coordinated through this team into VA healthcare services

Readjustment and Recovery Services - Team of Psychiatrists, Clinical Nurse Specialists, Psychologists, and Clinical Social Workers who provides medication evaluation and management, as well as individual, family, and group counseling services. Readjustment and recovery services fall under the Psychiatry/Mental Health service line.

Primary Care Services - Team of Physicians and Nurses who specialize in understanding common medical conditions and circumstances resulting from combat deployment. These providers have specialized knowledge of environmental health exposures as well as multi-faceted complexities of the transition process.
Veterans Benefits Administration—Team of representatives from the VA Regional Office working within our Seamless Transition Integrated Care Clinic to assist OEF/OIF veterans with the pursuit of benefits following their separation from active duty.

Veterans House/Hoptel (Veteran lodging):

The Veterans House, located on our Cold Spring Road Campus, offers a safe, comfortable and homelike environment for Veterans receiving extended outpatient medical care as well as family members of hospitalized Veterans. It features 28 fully furnished guest rooms with private baths, a common kitchen and dining area, laundry and recreation rooms.

Veterans House guests must reside at least 50 miles from the VA Medical Center, be medically stable, and able to care for themselves independently or have a caretaker who can provide assistance. Referrals for lodging must be made through a VA case manager or other clinical provider.

(*This program was made possible in part by a generous grant from the Lilly Endowment and from donations by many service and community organizations who wanted to support our Veterans. There is no cost to the Veteran or family member to stay at the Veterans House but donations are accepted and appreciated.)

The Hoptel service is a contract the VA has with a local hotel. This will be paid for by the Richard L. Roudebush VA Medical Center for those eligible Veterans who reside outside a 50-mile radius of Indianapolis, Indiana and who travel to the medical center for outpatient surgery, chemotherapy, radiation treatments, and other procedures. Eligible Veterans will be referred to the hotel by the Hoptel Program Support Assistant.  A confirmation number shall be provided to the Veteran for check-in.

VHA Caregiver Support Program

There are an estimated 65.7 million caregivers who are providing unpaid care to for a loved one or a friend. Caregivers may experience a great deal of stress, depression, anxiety, financial stressors, or neglect their own personal healthcare needs. The VA recognizes the daily sacrifices made by caregivers who provide care to veterans, and the important role of caregivers in providing physical, emotional and other support to wounded, ill and injured Veterans; helping them to remain in their homes. The VHA Caregiver Support Program offers comprehensive assistance, and support services to family caregivers.

If you are a caregiver of a Veteran, the VA is here to support you. Call 1-855-260-3274 toll-free to reach VA’s Caregiver Support Line for support and information regarding VA services that may help you while you care for your Veteran (Monday through Friday, 8:00 am-11:00 pm ET, and Saturday, 10:30 am-6:00 pm).

Other Social Work Support

The Indianapolis VAMC has social workers supporting Veterans in other programs with Psychiatry Service 

Contact Info


  • VAMC

Contact Number(s)

  • 317-988-4619

Hours of Operation

  • Mon - Fri, 8 a.m. - 4:30 p.m.