A new service model, Certified Community Behavioral Health Clinics (CCBHC), offer comprehensive, coordinated, and integrated care to individuals living with mental health and substance abuse treatment needs. CCBHCs provide outreach, increase access, improve services, and serve as a "one-stop-shop" to those who are currently underserved with mental health and substance use disorders.
The CCBHC Care Coordinator (bilingual Spanish) is responsible for ensuring that clients are connected with the services that they need and for collaborating with staff across the agency and with external agency partners.
Duties & Responsibilities:
The CCBHC Care Coordinator
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Provides initial screening of client needs and assists the client in connecting to needed resources.
- Connects client with community services and provides follow-up and monitoring to ensure continuity of care among internal providers and between internal and external providers.
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Facilitates internal and external collaboration to develop person-centered or family-centered integrated client treatment plans.
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Interacts with other team members to provide comprehensive and timely assistance in resolving issues that are barriers to the consumer receiving services.
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Documents and maintains accurate and timely case notes.
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Assists clients with making and coordinating appointments, and obtaining supports necessary to keep appointments.
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Facilitates communication between providers within a schedule that meets outlined timeframes.
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Develops and maintains close working relationships with community service providers.
Program Description:
- Care coordination consists of engagement and needs identification to coordinate care including referral, linkage, monitoring, and follow up.
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The focus of the interventions includes assisting the individual with 1) developing natural supports to promote community integration; 2) identifying service needs; 3) referring and linking to services and resources identified through the service planning process; 4) coordinating services identified on the IRP to maximize service integration and minimize service gaps; and 5) ensuring continued adequacy of the IRP to meet his/her ongoing and changing needs.
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The performance outcome expectations for individuals receiving this service include decreased hospitalizations, decreased incarcerations, and decreased episodes of homelessness, increased housing stability, increased participation in employment activities, and increased community engagement.
Program Specific Duties:
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Travel in Rockdale County
- Perform certain case management duties.
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Participates in interdisciplinary case staffing and staff meetings.
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Perform other discipline duties when appropriate and needed.
