General Summary

Under general supervision independently works with individuals in the community who need case management services in developing, securing, and maintaining basic life needs and mental health treatment. Provides an array of services to assist individuals through assessment, service planning and delivery, and referral or linkage to other community resources. Interacts with all individuals in a respectful, dignified, therapeutic, adult, engaging, and culturally sensitive manner using identified counseling and communication skills. Conducts outreach with individuals off-site and at locations convenient to individual's needs. Schedules and arranges off-site services while remaining aware of various community safety issues.

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Makes initial contact/outreach with individuals referred/assigned. Conducts an assessment for case management services, completion of admission paperwork, and the initial development of a service plan involving needs, strengths, and goals.

2. Independently develops individualized support plan and coordinates/implements services.

• Within the first 90 days must make a home visit to the individual's home to evaluate the living conditions. If the individual is homeless, must meet the individual in a community setting of individuals choosing.
• Performs interventions that assist the individual in meeting short- and long-term goals. This involves transportation of the individual to community resource appointments, ongoing coordination of service/acquisition of resources, work with the family and other service providers as needed as well as outreach provision these services involve.
• During the course of provision of services the service plan will be reviewed and updated according to MHP and the Public Mental Health System requirements and in compliance with State regulations.

3. Works with individuals to develop budgets and assist with management of these through the representative payee system.

4. Attends regular and emergency team meetings. Maintains a highly flexible schedule to respond to individual needs. Exercises considerable independent judgement in determining the appropriate response to emergency needs of individuals.

5. Independently encounters a broad range of clinical/social/family dynamics and situations, many of an unpredictable nature. Secures support and presence of co-workers as needed when encountering suspect situations.

6. Collaborates with other staff team members. Assists other agency teams and team members as needed.

7. Actively participates in team meetings to ensure efficient and effective service provision. (Is this an EF?)

8. Provides crisis intervention and oversees the resolution of crisis. This may involve doing an emergency petition, working more closely with clinical treatment staff, transporting a patient to emergency mental health services

9. Responsible for meeting billing/service goals, ensuring accurate documentation in compliance with state regulations and PMHS/MHP requirements, following policies and procedures, and submitting on schedule. This includes but not limited to the ongoing development of service plans, annual assessments, progress notes for each contact and monthly summary notes

10. Attends all required and relevant training to remain current in best practices, including those required by state regulations and offered by BMHS or the Mental Hygiene Administration.