The primary duty involves providing professional and individualized case management services, information, and referrals to assist clients in achieving and maintaining health, mental health, and housing stability within a permanent supportive housing program. This includes conducting comprehensive psychosocial assessments, developing individualized service plans, and linking clients to necessary health, mental health, and substance use disorder services.
Requirements summary
Candidates must have at least one year of experience working with homeless individuals combined with a social work/mental health related bachelor's degree, or a minimum of two years of direct mental health or intensive case management services experience. Applicants must also possess current knowledge of resources for homeless populations, support The Salvation Army's mission, and obtain CPR/First Aid certification and TB clearance prior to hire.
The Salvation Army, an international movement, is an evangelical part of the universal Christian church. Its message is based on the Bible. Its ministry is motivated by the love of God. Its mission is to preach the gospel of Jesus Christ and to meet human needs in His name without discrimination.
Position Summary
The Salvation Army Diane and John Mullin Hope Center Apartments is a 65-unit permanent supportive housing program with on-site property management and case management services. The ICMS Case Manager’s primary duty is to provide professional and individualized case management services, information, and referrals designed to assist clients with achieving and maintaining health, mental health, and housing stability.
Essential Functions
Project a client-centered approach and provide excellent customer service that is sensitive to the challenges that homeless persons with a range of medical and behavioral health issues face as they move into and maintain permanent supportive housing.
Employ a “whatever it takes approach” to assist clients in their transition from homelessness to permanent housing, motivating, and encouraging clients to work toward their goals, and providing ongoing client support.
Assist individuals at every stage of the housing stabilization process. The services provided must be flexible to meet the individual needs of clients. The intensity of services shall be regularly monitored and adjusted based on each client’s level of functioning and acuity of needs. Case management will range from highly intensive individualized support as clients transition from homelessness to permanent housing to less intense support for activities related to maintaining housing and supportive services.
Services provided shall include outreach and engagement; intake and assessment; individualized service planning; housing and rental assistance; linkages to health, mental health, substance use disorder services and other supportive services; ongoing monitoring and follow-up; assistance with benefits establishment, transportation, and legal issues; crisis management; eviction prevention; client education; housing location services; coordination and collaboration with community partners.
Outreach/Engagement: Process and accept referrals through the Coordinated Entry System (CES), establishing rapport and building a trusting relationship with the potential client and determining whether the potential client is appropriate for the permanent supportive housing program.
Intake and Assessment: Conduct intake and enrollment activities with eligible clients, including assisting with gathering other program eligibility documentation, housing application documents, lease agreement, project intake forms, and enrollment.
Move-In Assistance: Coordinate move-in and orient new tenants to their unit/building, including meetings with onsite supportive services staff and other residents, and review of rules and responsibilities included in lease and other documents.
Client Support Services: Assist clients with accessing services to address their immediate needs (e.g., access to food, clothes, and other basic necessities).
Conduct a Department of Health Services (DHS)-approved comprehensive psychosocial assessment within two (2) business days of the client’s enrollment. Assessments must be conducted face-to-face and must include an evaluation of the clients’ medical, psychosocial, environmental, legal, financial, education, strengths and needs, and available resources.
Develop and implement an individualized case management services plan (ISP) with the client based on the client’s psychosocial assessment and/or reassessment. The ISP shall address the needs identified in the psychosocial assessment and describe client’s goals, steps to reach goals, timeframes for completing goals, and disposition of each goal as it is met or changed.
Conduct DHS-approved comprehensive psychosocial re-assessments and update ISP on an ongoing basis, but not less than once every three (3) months. Updates to the ISP must include development of new goals, progress made on achieving stated goals, and any changes to goals, steps and/or target dates. ISP and case notes shall be entered into the Homeless Management Information System (HMIS), and the Case Manager is responsible for participating in routine HMIS and other staff training.
Maintain regular ongoing client contact and tailor the intensity of services provided, including the frequency of face-to-face and home visits conducted, to client’s level of functioning and acuity of needs. The frequency of visits will vary and may require a minimum of three (3) or more face-to-face visits per week at initial engagement and no less than once every three (3) months after clients are stable in housing and fully engaged in supportive services. Utilize best practices, including trauma-informed care, harm reduction model, and cultural competency.
Ensure clients are linked to and accessing health, mental health, and substance use disorder services as needed including assisting clients with establishing a medical home and maintaining continuity with their medical home.
Assist clients with maintaining medication and treatment regimens, including accompanying clients to appointments with health, mental health and/or other care providers.
Assist clients with obtaining income and/or establishing benefits, including coordinating the completion and submission of applications for health insurance benefits (e.g., Medi-Cal, Medicare, Covered California, etc.), disability benefits (e.g., Supplemental Security Income [SSI], Supplemental Security Disability Income [SSDI], etc.), and other sources of financial assistance, (e.g., Unemployment, General Relief [GR], etc.). Provide advocacy on behalf of clients, as appropriate.
Provide one-on-one assistance in life skills training with the aim of gaining, restoring, improving, and/or maintaining daily independent living, social/leisure, and personal hygiene skills.
Lead on-site adult educational, health and wellness, and skill building classes, covering topics such as personal financial management training, household maintenance, nutrition, cooking, laundry, use of community resources, (e.g. banks, libraries, public transportation), responsible tenancy, “green” practices, resume building, and interview skills, interpersonal skills, conflict resolution, and stress management.
Assist clients with locating and securing employment and volunteer and/or educational opportunities; obtaining basic needs, such as clothing and food; life skills and community participation, including providing group programming in these areas; gaining, restoring, improving and/or maintaining daily independent living, social/leisure, and personal hygiene skills.
Assist clients with budgeting and money management including assistance with household budgeting; assistance with overcoming bad credit, no credit, and/or eviction histories; and arranging for representative payees for clients who require assistance in money management and/or are at-risk for non-payment of rent.
Assist clients with monitoring any legal issues and making appropriate referrals to overcome any barriers to accessing and maintaining permanent housing and supportive services (e.g., credit history, criminal records, and pending warrants).
Provide transportation, as needed, by means of bus fare/pass, agency vehicle(s), or private vendor. Assist clients with increasing their capacity to meet their own transportation needs.
Monitor and follow-up with clients and service providers to confirm timely completion of referrals and linkages, access to services, and maintenance of services.
Participate on team providing 24-hour/7 days a week on-call crisis intervention services for ICMS clients and educate clients on the appropriate use of crisis intervention services versus 911 emergency calls, etc.
Educate clients on tenant rights and responsibilities including, but not limited to, how to communicate effectively with ICMS staff and property management staff and other entities; when and how to report maintenance problems or disclosure of financial problems; importance of complying with lease agreement, program policies, and house rules; importance of paying rent, budgeting appropriately, and participating in representative payee system; responsibility for apartment/house maintenance; getting along with neighbors; and crisis services resources.
Provide eviction prevention counseling, advocacy and intervention to develop and implement strategies to facilitate the early identification of issues that jeopardize clients’ housing stability and the assistance needed by tenants to prevent evictions. And work with property management staff and County and local partners to help clients resolve issues that threaten their housing stability. Meet jointly with clients and property management staff to address issues and develop plans for improvement. Document within the clients’ records all eviction prevention interventions provided.
For clients who are transitioning out of ICMS (e.g., moving out of the area, family reunification, or change in housing needs), ICMS staff shall coordinate activities with other service providers to ensure that the client receives assistance with relocating to other affordable housing and linking to ongoing primary health care, behavioral health services, and other supportive services. These activities shall be conducted with the cooperation and/or authorization of the client to be noted within case closure documentation.
Develop and foster links with other social service agencies to provide clients with access to the broadest possible range of supportive services. Attend training and meetings as deemed necessary. Must be able to work evenings, weekends and holidays.
Other duties include maintaining all elements of client folders with emphasis on accuracy, thoroughness, and timeliness.
Perform all other duties as assigned.
Working Conditions
Ability to walk, stand, bend, squat, climb, kneel and twist on an intermittent or sometimes continuous basis.
Ability to grasp, push, pull objects such as files, file cabinet drawers, and reach overhead.
Ability to operate computer, fax and telephone.
Ability to lift up to 25 lbs.
This position may involve driving to appointments/training opportunities and transporting clients in a company vehicle to appointments, therefore the ability to drive a motor vehicle is required.
Minimum Qualifications
Must have at least one year of experience working with homeless individuals AND have a social work/mental health related bachelor’s degree, or have a minimum of two years of experience providing direct mental health or intensive case management services.
Current knowledge of and interest in homeless populations and available supportive resources.
Understand and support the mission of The Salvation Army.
Must obtain CPR and First Aid certification prior to employment.
TB-cleared prior to hire.
Skills, Knowledge & Abilities
Driving Test, clean MVR check.
Knowledge of HMIS preferred.
Proficient in Microsoft Office applications, and ability to type 45 wpm. Basic math skills.
Ability to actively listen and take genuine interest in helping homeless individuals to address and reduce barriers to independence.
Good time management and communication skills, both verbal and written. Professional telephone etiquette.
Meet deadlines, work with attention to detail.
Strong interpersonal skills with both clients and staff in a professional, respectful manner.
