What People Don't Get About My Job: The Counselor

"'Wow, you work with people with mental retardation and autism, that must be hard.' And it is."

I do forensic and clinical case management for children, teens, and young adults with intellectual disabilities. Most people have no idea what this means other than, "Wow, you work with people with mental retardation and autism, that must be hard." And it is. But what it really means is that in addition to understanding the cognitive, behavioral, and medical needs that arise from various disabilities and how best to meet those needs, I have to be an expert in the following:

-Juvenile court proceedings
-Criminal court proceedings
-Probation and pre-trial services
-Child protective services, foster, and adoption procedures
-Public and private mental health systems
-Drug and alcohol treatment
-Crisis response and mitigation
-Grief counseling (for clients and their families)
-Public and private health care systems
-Navigating private insurance
-Applying for, maintaining, and navigating Medicaid
-Applying for, maintaining, and appealing Supplemental Security Income
-Managing budgets/money as representative payee for someone's SSI benefits
-Special Education, including state and federal law
-General Education
-Vocational rehabilitation
-Disabilities rights and applicable state and federal laws
-Low-cost housing
-Mobility access

And that's just to do the job on behalf of the clients. On behalf of the state, I have to be able to:

-Appropriately assess needs and link with them to the appropriate service
-Manage a budget of several hundred thousand taxpayer dollars to fund services
-Audit vendors from both programmatic and fiscal aspects
-Write concise, thorough reports on an annual basis per client
-Liaise with outside and sister agencies
-Keep rigorous, HIPAA-compliant records
-Conform to reporting standards of the federal Centers for Medicare and Medicaid
-Conform to reporting standards for the state Department of Developmental Services

And all for a caseload of about 100 at any given time.