Life Options, a program of Medical Education Institute, Inc.

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Answers From Our Expert: Work & Employment

Q: What can an ESRD Network do to improve vocational rehabilitation outcomes?

A: 1) Provide educational conferences for VR counselors and social workers. VR counselors are more likely to work well with people with kidney disease if they know what they need to know about kidney disease. At the same time, social workers are more likely to refer appropriate patients if they know more about the VR system. Everyone likes to be successful and success breeds a desire to have more success. Travel seems to be a barrier for VR counselors because of tight state budgets and social workers often have multiple demands on their time. If a Network covers a wide geographc area, the option of holding meetings in several areas should be considered. This could improve attendance. The ESRD Network of New York currently does training with VR counselors and with social workers that is well-attended and well-received.

2) Consult with or employ a VR counselor. The ESRD Network of New York hired a part-time VR counselor. She answers questions from patients, dialysis and transplant staff and VR counselors, and helps troubleshoot problems. The Network hired a counselor after a collaborative project with the International Center for the Disabled proved that having the same VR counselor go into clinics to recruit clients, counsel them while they were on dialysis, and work with staff to get the medical information the agency needed increased successful vocational outcomes.

3) Advocate for patients who are experiencing problems getting or keeping a job. Advocacy can be with employers, insurers, or even clinics. The ESRD Network of New England has helped a patient whose employer threatened termination, worked with Life Options to help a patient self-advocate for HMO coverage for home dialysis so she could keep her job, and encouraged a metropolitan clinic to establish an evening dialysis shift for working patients without which a patient would have lost his job.

4) Encourage facilities to offer evening dialysis. The ESRD Network of Florida surveyed clinics to learn barriers to evening dialysis, worked with administrators to address those barriers, and offered to inform patients about which clinics offered evening dialysis to increase that shift's utilization.

5) Encourage clinics to offer home dialysis. Provide patients with up-to-date information about services (center hemodialysis, home dialysis training, CAPD, CCPD, or home hemodialysis) clinics actually offer in addition to what clinics are certified to offer. Giving patients more information and choices helps expand their work opportunities.

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