Housing and Community Support Specialist

Boston Medical Center (BMC); Boston (MA); Sur place; USD 48 000 - 60 000; Plein temps

Résumé du poste

Boston Medical Center’s Living Well at Home Program (LWAH) provides high-quality housing case management services to support clients in obtaining and maintaining tenancy and living healthy lives in independent housing. Boston Medical Center and its affiliated providers and Community Health Centers serve tens of thousands of patients who face housing issues or are experiencing homelessness.

New initiatives across the health system have led to the expansion of LWAH services, including the

Qualifications

• Bachelor’s degree in a behavioral health or related field or two years of relevant work experience or lived experience of homelessness or behavioral health conditions.

Responsabilités

• Provides intensive stabilization support on-site in a congregate setting in Cambridge.
• Builds rapport, trust, and positive-relationships with patients through collaborative, culturally-responsive, patient-centered approaches.
• Initiates face-to-face contact through assertive outreach with eligible patients to describe role and begin screening.
• Works with patients and providers to set goals for housing plan and overall care using motivational interviewing.
• Provide patients and their support network with education and training about behavioral health and recovery with support from clinical care teams.
• Establishes strong professional rapport with housing providers, care team and other service providers.
• Regularly consults with full care team regarding complex patient situations to refine the individualized service plan.
• Mitigate tenancy issues by collaborating with patient, property manager, landlord, care team, and others.
• Assist patients in addressing barriers with supports including health, behavioral health, finances, housing, transportation, food, and community resources.
• Collaborate with crisis intervention providers and state agencies to develop, revise, and use patient safety plans.
• Assist patients with acquiring, storing, and organizing files to be housing-ready.
• Assist patients in obtaining housing through housing search, applications, and interviews.
• Serve as the primary connection for landlords and property management throughout housing process.

Formation

Bachelor’s degree in a behavioral health or related field

Description du poste

Position: Housing & Community Support Specialist

Department: Behavioral Health/Population Health

Schedule: 40 hours per week, On-site

Position Summary

Boston Medical Center’s Living Well at Home Program (LWAH) provides high-quality housing case management services to support clients in obtaining and maintaining tenancy and living healthy lives in independent housing. Boston Medical Center and its affiliated providers and Community Health Centers serve tens of thousands of patients who face housing issues or are experiencing homelessness. New initiatives across the health system have led to the expansion of LWAH services, including the formation of a new Community Support Program for Homeless Individuals. As part of the LWAH team, the Housing and Community Support (HCS) Specialist will provide case management services to high-risk patients with behavioral health diagnoses who are experiencing long-term homelessness. The HCS Specialist will help patients maintain stable housing in a congregate setting. Responsible for engaging and enrolling complex patients into services; providing advocacy and case management services; providing specialty services to support a member in becoming “housing-ready” and supporting patients in identifying and obtaining housing opportunities; supporting the development of an interdisciplinary care plan based on identified patient needs; facilitating access to social service resources; monitoring the patient’s progress; and problem-solving with patients to accelerate/enhance access to housing and community-based supports. HCS Specialists provide community-based one-on-one support in collaboration with family, social supports, and their health care team, both pre- and post-tenancy.

Job Responsibilities

• Provides intensive stabilization support on-site in a congregate setting in Cambridge.
• Builds rapport, trust, and positive-relationships with patients through collaborative, culturally-responsive, patient-centered approaches.
• Initiates face-to-face contact through assertive outreach with eligible patients to describe role, explain participation benefits and begin screening process.
• Works with patients and providers to set goals for patient’s housing plan and overall care and provides guidance for patient to achieve those goals utilizing skills such as motivational interviewing.
• Providing patients and their support network with education, educational materials, and training about behavioral health and substance use disorders and recovery with support from clinical care teams.

Service And Care Coordination

• Establishes strong professional rapport with all stakeholders involved in patient case, including housing providers, property managers, care team and other service providers.
• Regularly consults with full care team, including patient social work, care management staff, primary clinical staff, behavioral health teams and other providers regarding complex patient situations, demonstrating an understanding of how to solicit and incorporate feedback from a variety of stakeholders in order to continuously develop and refine the patient’s individualized service plan.
• Mitigate any issues with tenancy promptly by collaborating with patient, property manager, landlord, care team, other service providers, and other relevant parties.
• Assists patient in addressing and overcoming barriers with a range of concrete supports, including but not limited to: physical health, behavioral health, financial assistance, child-care and caregiver support, housing, support with utility bills, food, financial entitlements, clothing, transportation, food pantries, violence prevention, social isolation and any other appropriate community resources.
• Collaborating with crisis intervention providers, state agencies, and outpatient providers, including working with these providers to develop, revise, and utilize patient safety/crisis plans
• Assists patients with acquiring, storing, and organizing files and documentation to be “housing-ready”.
• Assists patients in obtaining housing through exhaustive housing search, submission of applications, mitigation of barriers on applications, and support of patients with housing interviews, applying a driven and relentless approach to assisting clients in obtaining and maintaining housing.
• Serves as the primary connection for landlords and property management through all stages of the housing process from pre-tenancy to post-tenancy stabilization.

Performance And Team Expectations

• Conducts and updates thorough needs assessment to capture all relevant patient information in compliance with MassHealth regulations.
• Develops comprehensive, individualized service plan with patient that is based on relevant patient needs and goals, has identified housing, clinical, and community-based interventions and services, and has clearly defined and measurable goals.
• Records and monitors the participants’ progress toward goals within specific time frames.
• Presents patients at case review meetings succinctly and logically.
• Demonstrates the ability to function and communicate professionally within an inter-disciplinary team.
• Ensures that documentation in all platforms (including BMC’s electronic medical record) is up-to-date, detailed, and accurate, complying with all data entry, data integrity, and data tracking requirements for BMC.
• Develops discharge plans with patients and other providers to ensure safe and healthy transitions from services.
• Participates with other staff in activities that include community outreach, presentations to community organizations, development of materials, and staff meetings.
• Attends regularly scheduled supervision and other program assigned meetings.
• Participates in all training activities as designated by the Living Well at Home Director, Clinical Housing Manager, or Senior Operations Manager.

JOB REQUIREMENTS

• Bachelor’s degree in a behavioral health or related field OR Two years of relevant work experience OR Lived experience of homelessness or behavioral health conditions