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Case Manager
Overview
A Case Manager works as part of a multi-disciplinary service team with youth identified individuals 16 to 25 to assess their needs, develop a plan to achieve desired goals, and support youth in accomplishing their stated plans. Building positive supportive relationships with clients is central to the effectiveness of this position. The Case Manager will have flexibility to engage clients through the Road Warrior Project and support youth on his/her caseload both on-site and in the community. Some services will be provided within the group setting that is the Road Warrior stationary outreach at Outside In two nights a week. This Case Manager will primarily work individually with youth to remove barriers to youth success. Case Managers will advocate for and support youth in the utilization of services and resources available to assist in achieving their plans. They will Outside In Assessments with eligible participants and will aid in accessing resources and identifying individualized needs and goals. The frequency and duration of services will be based on each youth’s individual needs and will change, as youth needs change. The caseload for the Case Manager in this position will generally include at least 15 youth: with at least 10 active clients receiving weekly contact. Case Managers work closely with members of the Youth Department, as well as other teams at Outside In and other coordinating agencies.
The goal of Case Managers is to build relationship with youth living on the streets and connect them with supports and resources to increase health and remove barriers to achieving personal goals. Ultimately we hope to help young people build skills and healthy supports so that they may obtain and stabilize an income and living situation that supports self-sufficiency.
Specific Responsibilities:
Outreach
Work to engage youth into the Continuum, Adult System, or other eligible and available resources.
Offer youth referrals to other supportive services and assistance in accessing services and resources as youth are interested in exploring these options.
Assessment and Service Planning
Connect youth with Continuum Screening as needed.
Provide Intake Assessment and Mental Health Assessments as needed.
Educate youth about Continuum, Community, and Outside In options.
Provide agency/resource orientation and referrals.
Provide ongoing assessment and data collection.
Identify and utilize youth strengths.
Facilitate development of an Action (Service) Plan with each participant assigned to caseload.
Complete an Action Plan Review with the participant and other team members at least every 90-days.
Engage youth participants to involve supports, including other service providers, in planning whenever possible.
Youth Involvement and Empowerment
Involve and empower youth participants in generating community, community norms, and sense of ownership within Outside In activities and programs.
Support youth initiated activities and leadership.
Involve youth in maintaining group and program spaces as much as possible.
Case Management & Service Coordination
Meet with youth in the community and at Outside In for services.
Meet with youth individually on a regular basis, which may include evening and weekend appointments to accommodate youth schedules.
Provide advocacy for youth and physically assist youth in accessing the services and other resources they need and are willing to access.
Access flexible funding to assist in meeting needs and removing barriers to success.
Monitor youth participation in other services (employment, education, other activities, shelter, etc.) and youth progress on action steps including youth participation in Continuum resources.
Provide assistance to youth to obtain ID and benefits (food stamps, WIC, etc).
Support youth connection to mental health, alcohol and drug, employment, education, and housing resources and track all benchmarks in established systems.
Develop and maintain strong professional connections with other resources including: shelter, housing, alcohol and drug, mental health, employment and education, and other activity based resources.
Complete assessments and make referrals to relevant resources and services.
Coordinate all services of individual youth when needed.
Debrief with fellow staff about crisis situations.
Individual Counseling and Group Facilitation
Build positive relationships with youth through role modeling and mentoring.
Utilize harm reduction philosophy in problem solving to help residents identify healthier options.
Participate in crisis planning and crisis intervention, which may include after hours contact on an as needed basis.
Facilitate groups, as needed, on relevant topics (accessing community resources like ID or food stamps, change process skill development, alcohol and drug change support, independent living support, etc.).
Assist youth clients in individual and group life skill building through activities and resources.
Sub-Population Specialty
Have knowledge of issues and interventions of specific populations/issues that may include: pregnant and parenting, HIV+, Spanish-speaking or other language skills, alcohol and drug involvement, mental health, community justice, community involvement, sexual minorities, health care, employment, education programs.
Maintain up to date information about population/issue specific resources.
Build and maintain contacts at agencies providing resources.
Attend relevant community resource and information sharing groups.
Share information and resources with other Case Managers and other Youth Department staff.
Mental Health and/or Alcohol and Drug Treatment Support Services
Support Mental Health and/or Alcohol and Drug needs by connecting with Mental Health Specialists, Alcohol and Drug Specialists, Project Respond, and other services as needed.
Assist in coordinating Mental Health care and making referrals as needed, including completing referral for psychiatric services.
Support participants to follow-up on recommendations emerging from Mental Health Assessments.
Coordinate with Alcohol and Drug Specialist as needed, including following up on recommendations following Alcohol and Drug Assessment.
Support participants to follow-up on any mental health and/or alcohol and drug related goals on their Action Plan.
Assist in application for and maintaining benefits: including OHP, Verity Plus, SSI, etc.
Coordinate with Clinic Access Coordinators to monitor OHP coverage and any co-pay needs.
Coordinate with medical personnel as needed.
Participate in case / psychiatric consultation monthly.
System Coordination
Attend Youth Department Staff meetings regularly.
Establish and facilitate effective and regular communication systems, including coordinating via in-person, e-mail, and phone contacts. This includes serving as a conduit of information with teammates and between programs.
Coordinate shelter services for youth.
Participate in multi-agency coordination meetings as needed: Shelter Coordination, Road Warrior, etc. Obtain and share information about the goals, needs, and progress of youth.
Assist in referral and transfer of youth to other service systems.
Provide feedback to Outside In management about emerging issues of care not being met and trainings needs.
Participate in planning for development and improvement of available resources and services to remove barriers to youth success and replicate efficiencies and effective components.
Participate in system coordination and planning groups
Work with system providers to achieve desired outcomes.
Service Documentation
Maintain accurate and timely documentation of all services. This includes: assessments, re-assessments, service/action plans, reviews, progress notes, group documentation, exit summaries, billings, etc.
Complete all required statistics and reports in a thorough and timely manner.
General Job Performance Standards:
Meet regularly with supervisor.
Support agency goals.
Be able to work with a diverse population.
Be able to work both independently and as a member of a team.
Commitment to continual learning and quality performance.
Work assigned work schedule.
Perform all required documentation and information input in a professional, thorough, and timely manner.
Carry out job duties according to the time schedule established with supervisor.
Maintain professional boundaries and performance at all times.
Complete all job duties assigned.
Support the operational functioning of Outside In as a whole.
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