The Nursing Home Support Specialist is responsible for assisting clients of a Skilled Nursing Facility (SNF) or Intermediate Care Facility (ICF) who have serious medical/nursing needs, along with a severe, disabling mental illness, who would otherwise be at risk of frequent hospitalizations due to their psychiatric illness. This is accomplished by using an assertive case management outreach approach based on the Rehabilitation Model. Services include housing acquisition, intensive case management, psychiatric rehabilitation, supportive counseling, crisis intervention, resource acquisition, service coordination and development of a natural support system. The hours of employment are Monday through Friday, 8:30am to 5:00pm, though hours may vary depending on the needs of the clients, including possible evenings and weekends. This position requires transporting client in personal automobile. This position may require participation in 24-hour on call crisis intervention activities on a rotating basis.
Education: Minimum of a Bachelor’s degree (Master’s preferred) in psychology, social work, counseling or related mental health field.
Experience: Two years of experience in mental health field and/or experience working with adults with chronic mental illnesses preferred.
Licensure, Certification and/or Registration: Must obtain and maintain certification in CPR, First Aid and CPI.
Requirements: Must have an automobile, a valid Missouri Class E driver’s license with a clean driving record and current automobile insurance with required coverage limits.
- Assesses and monitors a client’s adjustment to community living.
- Monitors client participation and progress in organized treatment programs to assure the planned provision of services according to the client’s individual treatment plan.
- Participates in the development or revision of a specific individualized treatment plan including completion of the DLA-20 as well as timely and thorough communication to assessor regarding potential goals and objectives.
- Provides individual assistance to clients in accessing needed mental health services including accompanying clients to appointments to address medical or other health needs.
- Coordinates monthly psychiatry appointments within SNF or ICF and more often, if necessary.
- Assesses clients’ level of risks, strengths, and weaknesses and interviews clients, reviews records, and confers with other professionals to evaluate clients’ preparedness for independent living.
- Encourages medication compliance and provides education regarding medications and monitoring of side effects.
- Provides individual assistance to clients in accessing a variety of public services, including financial and medical assistance and housing, including assistance on an emergency basis and directly helping to meet needs for food, shelter and clothing.
- Assists the client to access and utilize a variety of community agencies and resources to provide ongoing social, educational, vocational and recreational supports and activities.
- Intercedes on behalf of individual clients within the community-at-large to assist the client in achieving and maintaining their community adjustment.
- Maintains contact with clients who are hospitalized and participates in and facilitates discharge planning.
- Trains, coaches and supports in daily living skills, including housekeeping, cooking, personal grooming, accessing transportation, keeping a budget, paying bills and maintaining an independent residence.
- Assists with the training/consultation of SNF or ICF staff, particularly in the area of behavior management
- Assists in creating personal support systems that include work with family members, legal guardians or significant others regarding the needs and abilities of a client.
- Encourages and promotes recovery efforts, client independence/self-care and responsibility.
- Provides support to families in the area such as treatment planning, dissemination of information, linking to services and parent guidance.
- Provides holistic, person-centered care.
- Develops and supports wellness and recovery goals in collaboration with the individual served.
- Provides services to clients which are determined to be appropriate based on GAF score and level of care.
- Performs job duties with an efficient use of time based on client’s needs as well as meeting efficiency requirements based on budget parameters.
- Notifies Program Director of any changes in client’s conditions.