Peer Specialist

Job summary: Experienced Peer Specialist to work on a newly funded innovative Care Transition team that serves participants transitioning to the community from a higher level of care. As a member of the Pathway Home multi-disciplinary team the Peer Specialist position will work under the supervision of the Team Leader. The role will involve facilitating transition from one level of care to the community by addressing the preparatory needs of participants in the early stages of recovery, discharge planning, development of daily living skills, and coping mechanisms through team and individual work in the community.

The team will follow individuals into the community using the Pathway Home model of care to ensure that they become both linked and engaged with identified community providers and that their support network is sufficient to meet their needs. The Peer Specialist engages participants in peer-based services to identify and overcome barriers to community integration, utilizing a peer relationship to foster connection, trust, understanding and validation with community providers and supports.

The role will require on call coverage and a willingness to work flexible hours.

Job Responsibilities:

• Engagement beginning from referring location with involvement in transition planning, including a needs assessment of community transition supports essential to stabilizing the participant;
• Individual sessions with participants emphasizing prevention and preparing for independent community living and the promotion of optimum mental and emotional health. May require helping participants deal with issues associated with but not limited to family and social relationships; stress and symptom management; activities of daily living; medication management; and housing readiness;
• Provide intensive emotional and practical support to participants as they transition back into their communities and into a supportive housing and/or living environment;
• Work with participants and their housing providers to resolve clinical issues that are impacting on the participant’s ability to obtain, manage, and retain supportive housing;
• Assist and instruct participants in attending to daily living skills such as personal hygiene, grooming and laundry, nutrition/meal preparation, budgeting, and socialization tasks and skills needed to successfully live and work in the community environments of their choice and also in maintaining a safe living environment;
• Foster and maintain cooperative and collaborative relationships with community providers and network members to facilitate connections or re-connections to services and supports;
• Community navigation including accompanying to first behavioral health and medical appointment, travel training, reengagement in community care, referral to services with ability to identify and address potential services and barriers to obtain and maintain such services;
• Establish collaborative working relationships with referring treatment teams and other partners and plan with them for appropriate discharges for participants;
• Advocate with and for program participants to achieve personal goals and address barriers such as fear, stigma and communication disparities with community providers and supports;
• Provide on-call after hour crisis intervention services when needed to participants and their support network, including respite referrals and other diversion and stabilization services;
• Attend and participate in team meetings and supervisory sessions;
• Develop short-term person-centered treatment plans to assist participant towards achieving their goals;
• Monitor and record participant’s progress and modify plan according to needs and preference;
• Perform various needs assessment for essential ongoing community integration and support;
• Timely and accurate documentation of participant information within Health Information Technology platform
• Comply with all required in-service training and staff development;
• Perform other related duties as assigned;

Essential Knowledge,

Skills and Abilities

:

· Knowledge of Behavioral Health systems, Mental health legislation and regulations, and…