Residential Intake & Discharge Specialist

Schedule:
Monday-Friday 8:30-5:00 and Wednesdays 8AM-4:30PM, some hybrid work, no working weekends and paid holiday’s off.
The Residential Intake & Discharge Care Specialist organizes intakes and discharge plans for MH/SUD clients at Telos, El Dorado Center (EDC), Casa Pacific (CP), and Second Story

The Residential Intake/Discharge Specialist (IDS) collaborates with the client’s care team and Intake and Discharge Manager to:

• Facilitate client intakes on day of arrival with transportation to and from programs. If a client is coming from a hospital, community, jail or other, the IDS will greet the client upon intake at the program(s) for a warm intake, program tour and complete all intake paperwork with each client.
• On the day of arrival, IDS assures a trauma informed approach with each client. Programs will have client charts ready for each client and IDS will complete all paperwork with client signatures and explanations of what they are signing.
• IDS will:
• Meet each client within the first 2-3 days of arrival to identify transition and discharge plans.
• Connect with clients before their concurrent reviews are extended.
• Meet with clients at Telos (due to short program stay) to confirm bed availability every other day or as needed.
• Work in collaboration with the Residential MH Intake/Discharge team and program staff to coordinate concurrent reviews and program extensions.
• Maintain regular communication with the Encompass Intake & Discharge team, County coordinators/care teams, and Encompass Program teams to ensure shared understanding of clients’ individual discharge plans, needs, and next steps.
• Engage with the clients to discuss next desired steps: Mental health, SUD, or other co-occurring programs, etc.
• Ensure County Access appointments are completed for Telos and EDC within the first two days or sooner of arrival to the program for clients interested in services.
• Populate the census with new County Coordinator Name, ACCESS dates and other pertinent information.
• May do light mobility assessments (instruction provided by nurse or manager) at Telecare and other programs and report back to the Intake Discharge Manager
• Opportunity to work in an environment to make a positive impact on individuals that are in various mental health crises

Discharge Linkages

• Refer clients to alternative housing in the community (e.g., Board and Cares, Shelters, Sober living programs, Section 8 housing, bus tickets for in and out of state placements)
• Help clients access basic needs, including benefits, SSI, food, tents, clothing, etc.
• Provide linkages to Outpatient services
• Support Step-down options, including other residential programs, alternative housing, or community options.
• Provide crisis intervention if client needs an administrative discharge.
• Transport discharged clients to Sobering Center, next steps, other programs, MH/SUD or community (tent and sleeping bag) who may be in crisis
• Provide intake and discharge team with email discharge updates/plans as instructed and needed on a daily basis.
• Provide clients with reality based, trauma informed, client centered interventions.
• Respond with integrated knowledge, coping skills and practices for both crisis and relapse prevention.
• Assist program managers with discharges and collaboration with staff.
• Assist clients with referrals to SUD, SLE for waitlists, and transition into other placements both higher and lower levels of care (Telecare, B&C, Community and SUD)
• Daily assignment, duties, and responsibilities may change rapidly and may require readjustments on short notice.
• Working as a collaborative team member to accomplish the duties and responsibilities that the position requires.

Assigned Programs and Meetings

Maintain client contact at following intervals to monitor discharge plans

• Telos - minimum 3 x or more weekly
• EDC- minimum 2 x or more weekly
• Casa P- minimum 1 x or more weekly

Intake & Discharge Care Specialists attend:

• Daily 8:30AM program check-in meetings
• All Treatment team meetings
• Telecare meetings, if needed
• Weekly intake pre-huddles (8AM on Wednesday’s)

Duties

• Collaborate with the Encompass intake & discharge team to ensure client discharges/transfers & intakes are well coordinated and adhere to Trauma Informed practices in a fast-paced environment.
• Transport clients to and from programs and other necessary duties to support the clients. Several transports can occur per day depending on the number of intakes and discharges.
• Occasionally pick up medications from pharmacy.
• Train / shadow Interns that are part of the intake discharge team
• Support coordination of transportation with the county to appointments and transfers to the next level of care.
• Provide cross training on intakes and discharges and support needs if another team member is out.
• Transport Casa Pacific clients to first appointments for H&P or Physicians report within two weeks of date of arrival to program to satisfy DHCS requirements.
• Ensure clients are discharged and transferred in a timely manner with each Program
• Coordinate and manage data collected from pre-authorizations, AVATAR, and psychiatric evaluations to develop and write concurrent reviews if needed. Deliver to County QI and Program Managers for review.
• Coordinate Medi-Cal / Medi -Medi eligibility with each client.
• Help write preauthorization's, interviews and full cycle intakes and discharges.

Coordinate Med-Cal Eligibility

• Support client phone calls at Telos as well as in person appointments with follow up to Intake & Discharge team and county.
• Populate each client’s Medi-Cal and Medi-Medi number on the census.
• Look up current clients Medi-Cal status every two weeks for all current clients in programs to maintain eligibility and flag Intake & Discharge team if any have lapsed.
• Collaborate with Encompass Intake & Discharge team to discharge referred clients with best communication practices, procedures, and gather all required paperwork for incoming programs.
• Check paperwork thoroughly before passing along to each program.

Wages & Benefits:
We prioritize the well-being of our team as much as the community we serve. Our comprehensive health benefits reflect this commitment. We offer full-time employees medical and dental insurance plan that ensures peace of mind for themselves and their families. We go beyond traditional care by also offering our employees acupuncture and chiropractic, embracing a holistic approach to health that aligns with our values of care and compassion.

Our team’s future matters just as much as the present. That’s why we offer a 403(b) retirement plan, providing a foundation for a secure retirement. We also recognize the need for work-life balance, so Encompass offers a competitive package of 17 vacation days, 12 sick days, and 14 additional paid holidays. These benefits are thoughtfully pro-rated for part-time positions, affirming our commitment to fairness and flexibility.

About Us:
At Encompass Community Services we provide our community with a wide range of services related to family & social well-being, early childhood education, behavioral health, housing and more. Every day through these services we work to make health, education and housing more equitable for all people in Santa Cruz County. For more than 50 years our work has touched generations by helping people have access to education, rebuild relationships, restore their health and regain dignity.