More than 30 years ago, Children's Hospital's Social Work Department consisted of one social worker, a tiny office located in the back of an elevator shaft and an annual caseload of a little more than 400 patients. Today, Children's Hospital employs more than a dozen social workers, who, from their suite of offices on the Second Floor of the Koppel Plaza, assist several thousand patients and families each year.

The growing numbers of cases and social workers are not the only changes evident. Since 1973, social work responsibilities have also increased – and have changed dramatically. Social workers assist families with basic needs (clothing, food, transportation, financial referrals, etc.), but more significantly, they provide a wealth of additional services, including supportive counseling, crisis intervention, discharge planning, case coordination, information and referral, and language and hearing-impaired interpretation services.

The Social Work Department also helps patients and families deal with the emotional stress of a child's illness or injury. Social workers help by teaching therapeutic coping techniques to patients and families and by referring them to community resources so families may receive ongoing assistance post discharge from Children's Hospital. Sometimes emotions can become more complicated when detailed medical information is presented to already stressed parents, and a social worker is often of assistance in these situations.

"Sometimes we serve as a liaison between physicians and patients and their families, because they may feel overwhelmed, anxious or unable to understand the information provided," said Beverly Schneider, Director of Social Work.

It is important to convey medical information accurately to all patients and families. The increase in non-English-speaking families in East Tennessee has made interpretation services necessary to meet the needs of this diverse population. The Social Work Department provides the resources needed for a non-English-speaking patient and family both to communicate with and to understand medical staff.

In 1997, when the hospital first began offering in-person Spanish interpretation, there was an average of eight requests per month. In the last six months of 2007, the hospital averaged 401 requests per month. "It's not at all unusual for the interpreters to be assisting four to five patients and families simultaneously, with others waiting. The need has grown exponentially," Schneider said.

Social workers also use the services of the Knoxville Center for the Deaf for hearing-impaired patients and families.

The role of a social worker is not one that can be easily defined because of the broad range of situations involved. Many cases are opened for families with basic needs – an aspect of Social Work that may be unfamiliar to many people. On the other end of the spectrum are the more sensitive cases regarding such issues as abuse and neglect – the types of cases that the public typically identifies with the Social Work profession. In these situations, social workers are actively involved in various ways, including working with outside agencies such as the Knoxville Police Department and the Department of Child Services.

"We do what we can to alleviate the stress of the situation, but we do not investigate the circumstances," Schneider said. "We assist the investigating agencies and serve as a liaison between the agencies and staff."

The Social Work Department also staffs specific areas of the hospital to help with situations that may arise. Areas covered are the Haslam Family Neonatal Intensive Care Unit; the Goody's Pediatric Intensive Care Unit; the Second, Third and Fourth floors; the Scott M. Niswonger Emergency Department; Children's Home Health Care; the Children's Hospital Rehabilitation Center; the Hematology/Oncology Clinic; and the James S. Bush Outpatient Care Center.

Children's Hospital offers several services administered by the Social Work Department to help families with basic needs. The meal program was developed for families who arrive at Children's Hospital for unexpected medical care and for families with financial need. Those in an emergency situation or those who have traveled a long distance on short notice may benefit from the meal program, which is funded by private community and employee donations.

The Nancy Beltz Special Services Fund, established in memory of the former Director of Materials Management at Children's Hospital, assists families in ways that will benefit a patient and perhaps speed recovery. For example, the Special Services Fund has helped families on occasion with utility bills and or with the purchase of coal to ensure patients would be discharged to an adequately heated home. The program has helped families with individual need-based circumstances so that the child's health is not jeopardized once at home, due to a situation such as lack of heat. This fund also is financed through private community and employee donations.

The Clothing Closet is another service of the hospital for families who may have had to leave home unexpectedly and are without a clean change of clothing. The Children's Hospital Volunteers collect clothing donations as well as basic toiletry items, such as shampoo and toothpaste, for families in need.