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Responsible for assisting individuals residing in nursing facility or SMHRF care to prepare for and implement steps to transition to permanent supportive housing in the community. Provides case management and therapeutic interventions that facilitate illness self-management, skill building, identification of natural supports, and use of community resources. Uses intensive outreach strategies to engage participants in services. Monitors participants’ symptoms and medications regularly. Implements crisis services in consultation with supervisor/psychiatrist and makes sure that participants are safe and obtain timely access to services. Serves as a liaison with other systems of care, including nursing facility staff and collaborating treatment providers. Documents all services using program standards.
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