Respite Community Health Worker

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The Community Health Worker (CHW) provides intensive case management services in the Respite Program to individuals who have mental health, substance use and/or co-occurring disorders. These services are designed to be maximally flexible in supporting individuals to implement their Community Support Plan and the skills and resources needed for community tenure. The CHW is at the helm of organizing and coordinating resources and services in response to healthcare needs across multiple settings, inclusive of both LTSS and SDH needs.

This role drives outreach and engagement, health and wellness coaching, as well as community and social services connections in partnership with Person Served and their care teams.

• Drives referrals to any community or social services that align with a person served’s needs and goals as outlined in their Respite Community Support Plan (CSP).
• Collaborates closely with PCP and other providers, including but not limited to community resources, to assure appropriate referrals based on level of care needed which optimize outcomes and minimize risk.
• Assists persons served in improving daily living skills so they can perform them independently or access services to support them in doing so.
• Provides temporary assistance with transportation to essential medical and behavioral health appointments while transitioning to community-based transportation resources (e.g., public transportation resources, PT-1, etc.).
• Accompanies persons served to essential health care appointments, as needed.
• Assists with obtaining benefits, housing, and health care.
• Collaborates with Emergency Services Programs/Mobile Crisis Intervention (ESP/MCIs) and/or outpatient providers; including working with ESP/MCIs to develop, revise and/or utilize crisis prevention plans and/or safety plans.
• Fosters empowerment, recovery, and wellness, including forming connections to recovery-oriented peer support and/or self-help support and services.
• Collaborates with Respite Clinical Supervisor to manage all care transitions through collaboration with person served, community provider staff, ICT, and hospital staff to ensure a safe discharge plan and a well-coordinated implementation of that plan.
• Completes required Service Notes and case documentation in electronic health record to ensure accurate and timely billing of services.
• Participates in routine multidisciplinary team meetings.
• Completes all assigned courses on Vinfen Learning Management System and other training/in service/workshops in best practices as assigned by supervisor.
• Support person served with taking medications as prescribed under the MAP system
• Performs other related duties, as assigned.

• Highly sensitive to the needs of people with disabilities and able to connect with and engage assigned members
• Flexible and ability to work well as a team member
• Ability to follow instructions
• Adequate communication skills and willing to work cooperatively with a variety of people in a various community settings
• Strong commitment to respect the right and ability of people served to live, work, have meaningful relationships, and receive the resources and supports needed in their community of choice
• Knowledge of person-centered, strengths-based, recovery-oriented values and principles and modalities
• Knowledge of clinical and psychiatric rehabilitation values, principles, and techniques
• Knowledge of health risks of prevalence with adults with SMI/SUD
• Knowledge of health promotion and clinical care coordination techniques
• Knowledge of motivational interviewing, stage of change, and harm reduction techniques
• Knowledge of trauma-informed and culturally responsive services
• Sensitivity to cultural, religious, ethnic, disability, and gender issues
• Skills and competence to establish supportive trusting relationships with program participants
• Knowledge of human, legal, civil rights, community, and other resources
• Knowledge of empowerment and self-advocacy techniques
• Knowledge of available community health, mental health, and SUD services and resources
• Ability to triage/balance competing priorities
• Ability to make independent judgments and decisions
• Ability to work in a professional and confidential capacity
• Ability to work independently and as member of a multidisciplinary team

Established in 1977, Vinfen is a nonprofit, health and human services organization and a leading provider of community-based services to individuals with mental health conditions, intellectual and developmental disabilities, brain injuries, and behavioral health challenges. Our services and advocacy promote the recovery, resiliency, habilitation, and self-determination of the people we serve. Vinfen's 3,500 dedicated employees are experienced, highly-trained professionals who provide a full range of supportive living, health, educational, and clinical services in over 550 sites throughout Massachusetts and Connecticut.

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