Job Description

Job Description

POSITION OVERVIEW

This position is responsible for delivering high-quality outreach, engagement, case management, and care coordination; maintaining accurate and timely documentation; and providing exceptional, client-centered service to both clients and partners.

Positions available in Baltimore County & Howard County, Maryland

RESPONSIBILITIES

• Canvass and monitor outdoor and public areas where unhoused persons congregate to develop rapport, monitor for safety and health needs, engage clients in services, and support community members.
• Following referral requests, investigate a specified area or attempt to locate and engage one or more specific person(s).
• Earn and maintain clients’ trust through consistency, integrity, honesty, managing expectations, unconditional positive regard, and persistent follow-up; impart this approach throughout the team through role modeling, coaching, and close consultation.
• Partner with other service providers, community members, businesses and others who interact with unhoused persons to connect unhoused persons to needed services.
• Continuously seek new insights, options, and approaches to reach hard-to-engage clients with the philosophy that we never give up on anyone.
• Throughout client engagement and enrollment in services, develop a comprehensive history and needs assessment to understand their priority needs across all domains of well-being (income, housing, mental health, addictions, medical, family/social, educational, vocational, etc.).
• Develop creative, individualized, clinically-informed interventions to meet clients’ needs.
• Effectively and supportively manage client expectations about resources (availability, process to access, etc.)
• Educate and support clients and their families in regards to: harm reduction, nutrition, medication, addictions common mental health and chronic medical conditions, and health maintenance and preventative care.
• Provide training in communicable disease prevention; prevention of sexually transmitted diseases, including HIV/AIDS, as needed and if credentialed.
• Assess acute health problems of clients to determine the most appropriate health care provider and make referrals.
• Refer clients to other providers, coordinate with providers, and advocate for clients as needed.
• De-escalate crisis situations, help clients plan for and prevent crises, and seek assistance as appropriate.
• Provide on-call duty as needed on nights and weekends and during emergencies.
• Implement and follow program policies and procedures in alignment with contract and regulatory requirements.
• Complete up-to-date, quality documentation following PEP, HMIS, and other approved policies and procedures.
• Participate in outreach-related meetings, client care conferences, policy and systems improvement workgroups/committees as determined by the Outreach Manager.
• Maintain expertise in Housing First, Harm Reduction, Motivational Interviewing, Trauma/Resilience, Peer Support, Person-Centered Care Coordination/Case Management, Street Medicine, and other relevant models of care.
• Utilize program resources effectively and equitably.
• Effectively utilize staff equipment and supplies and maintain them in good condition.
• Initiate professional development and clinical consultation to improve clinical insights and methods regarding mental wellness, addictions, and medical needs of the unhoused population.
• Engage in professional development and advocacy to improve case management processes and systems navigation, especially benefits, housing, legal, and employment support systems.

PRINCIPAL ACCOUNTABILITIES

Client engagement

Service planning and coordination

Improvements in client safety and well-being

Housing placements, increasing client income, obtaining identity documents, and client enrollment in necessary clinical services

EDUCATION, WORK EXPERIENCE AND JOB REQUIREMENTS

Education: High School Diploma and/or equivalent work experience.

Skill Requirement: One to six months OJT required for efficient job performance.

Job Requirements: Excellent communication, problem solving and organizational skills.

Certified Peer Specialist or Community Health Worker certification required within 18 months of hire.

COMMENTS

Must exhibit experience, familiarity and sensitivity to working with persons who are actively using drugs and persons with serious mental illness including psychosis.

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