GENERAL FUNCTIONS: Member of the multi-disciplinary team providing comprehensive mental health services to clients transitioning from Psychiatric Hospitals, Nursing Homes, Specialized Mental Health Rehabilitation Facilities, and community clients in need of a higher level of care.  Must be comfortable going into client’s living arrangement and driving client’s in personal vehicle. Must be comfortable with adapting to the changing needs of client’s and providing crisis intervention as needed. Must maintain compliance of all clinical documentation, must attain/maintain established productivity targets, and must complete all clinical documentation in a timely manner.

ESSENTIAL FUNCTIONS:

·       Conduct and complete assessments, including IM-CANs, LOCUS, and SLOF to determine need/appropriateness for services, and coordinate/collaborate with ACT team regarding linkage to services identified.

• Provide and assist clients with referrals, linkages, and follow-up services as needed
• Maintain efficient communication and collaboration with ACT team including AD of Clinical and Crisis Services, Team Lead, ACT Nurse, Employment Specialist and CRSS.
• Responsible for maintenance of all clinical documentation related to caseload assigned and aid with overall ACT caseload as needed.
• Achieve required productivity targets and complete documentation in a timely manner, including clinical documentation, service reporting, and billing.  
• Maintain and update client’s pertinent information within the MH electronic care system i.e. face sheets, contacts, demographics, consents, and diagnoses.
• Will provide community individual support and community support group services, medication training, skill building, crisis intervention and case management services with clients using a recovery model in a home/community-based model.
• Provide vocational, work readiness and educational support services that enable consumers to find and keep jobs within integrated work settings.
• In conjunction with ACT team, keep client’s family, guardian, and other Envision Unlimited staff informed of the client’s progress, including emergency room visits, hospitalizations, and medication changes/adjustments.
• Provide information to outside agencies as requested to coordinate and assure the appropriateness of services.

·       Provide and document crisis interventions as needed, within 24 hours of an incident, and complete an incident reports when necessary.

·       Attend all staffings/team meetings to coordinate care for clients in the ACT program.

·       Make efforts withing span of control to follow and maintain fidelity model and maintain compliance with DHS, CARF, and other government regulations

·       Other duties as assigned.