A bachelor's degree in social work, psychology, human services, or a related field, or an associate's degree combined with education and relevant experience demonstrating the required knowledge and skills.
Ability to maintain professional boundaries and personal stability while working with high-acuity behavioral health populations in unsupervised community settings.
A valid Rhode Island driver's license, a clean driving record, and proof of liability insurance; driving records are reviewed at hire and periodically thereafter.
Ability to read, write, and communicate professionally in English.
Ability to work independently with individuals in psychiatric crises, including people experiencing active psychosis, suicidal ideation, or co-occurring substance use disorders, while using sound judgment and de-escalation skills.
Knowledge of community-based treatment and rehabilitation for individuals with severe and persistent mental illness.
Working knowledge of BHDDH, Medicaid, CCBHC, and JCAHO standards applicable to the role.
Ability to build therapeutic relationships while maintaining professional boundaries.
Strong written and verbal communication, active listening, and collaborative problem-solving skills.
Ability to work independently in community settings and exercise sound clinical judgment.
Proficiency with electronic health record documentation, such as NextGen or an equivalent system.
Ability to travel regularly to client homes, medical facilities, pharmacies, courts, and community settings; stand, walk, and drive for extended periods; navigate stairs, narrow spaces, and outdoor terrain in all weather; assist clients with activities of daily living, including bending, kneeling, stooping, reaching, and lifting up to 25 pounds; sit for documentation work; operate a computer and standard office equipment; communicate clearly through speech and hearing; and meet close- and distance-vision, peripheral-awareness, depth-perception, and focus-adjustment requirements.
Responsibilities
Provide wraparound case management services and additional support to clients whose DLA scores do not warrant a more intensive level of care.
Collaborate with clients and the treatment team to identify needs, connect clients with community resources, coordinate services, and support stability and well-being.
Provide wraparound case management, care coordination, and community-based support to adults living with severe and persistent mental illness and co-occurring disorders, integrating medical, behavioral, vocational, and substance-use support.
Serve as the primary care coordinator for a caseload of severe and persistent mental illness clients and manage comprehensive care management, care coordination, health promotion, transitional care, and individual and family support.
Coordinate, transport, accompany, and schedule medical, dental, and specialty appointments in collaboration with the team psychiatrist and nurse, and assist clients with treatment follow-through based on their needs.
Support medication adherence by coordinating deliveries, accompanying clients to pharmacies, providing phone prompts, monitoring medication, and using motivational interviewing as appropriate.
Assist the hospital liaison and/or team nurses with discharge planning and ensure clients are seen by a licensed provider within seven days after discharge from inpatient care, partial hospitalization, or a long-term care facility.
Counsel clients on chronic disease management, medication purpose, and symptom management in alignment with guidance from their primary and specialty care teams.
Help clients secure and maintain food, housing, benefits, hygiene, transportation, financial management, and legal advocacy to support independence and safety.
Serve as a community liaison and advocate in collaboration with schools, landlords, legal guardians, family members, DCYF, OOHA, law enforcement, judicial personnel, healthcare providers, and social service systems.
Participate as an active member of the multidisciplinary treatment team, contributing to treatment-planning meetings, case reviews, and collaborative care coordination.
Maintain documentation, clinical paperwork, and productivity standards in compliance with CCBHC, BHDDH, Medicaid, Joint Commission, and organizational requirements, and support preparation for BHDDH certification site visits.
Immediately escalate safety concerns, significant declines in client functioning, unsafe or unsanitary living conditions, and other conditions outside acceptable norms to a supervisor.
Assist with grocery shopping when medically indicated under the direction of clients’ medical and/or psychiatric providers, such as for diabetes management.
Help clients identify substance-use triggers, build relapse-prevention skills, and strengthen support systems.
Conduct and supervise urine toxicology screens and breathalyzer tests as directed, including court-ordered supervised screens.
Discuss the physical, medical, and pharmacological dimensions of substance use and recovery under the guidance of clients’ substance-use-disorder providers.
Assess clients’ educational and vocational interests, capabilities, and readiness for referral to the Vocational Specialist.
Participate in ongoing education, training, and professional development relevant to the role and client population.
Serve on organizational committees and workgroups as assigned.
Support implementation of new or enhanced services, procedures, and policies as the organization evolves toward the CCBHC model.
Desired Qualifications
Experience working with clients with severe and persistent mental illness and co-occurring disorders in a community setting.
Bilingual fluency in Portuguese or Spanish and English, in written and spoken communication.
Familiarity with Rhode Island vocational benefit programs and supported employment frameworks.
The ACT- Adult General Outpatient Community Treatment Specialist provides wraparound case management services to clients who may need additional support and assistance, but whose DLA scores do not warrant placement at a more intensive level of care. The Community Treatment Specialist works collaboratively with clients and the treatment team to identify their needs, connect them with appropriate community resources, coordinate services, and support their overall stability and well-being.
The Community Treatment Specialist is the direct service backbone of EBCAP's high acuity programs delivering wraparound case management, care coordination, and community-based support to adults living with Severe and Persistent Mental Illness (SPMI) and co-occurring disorders. As part of EBCAP's transition to a Certified Community Behavioral Health Clinic (CCBHC) model, the Specialist integrates support across medical, behavioral, vocational, and substance use domains to advance whole-person care.
Care Coordination
· Serve as the primary care coordinator for a caseload of SPMI clients, managing the full scope of health home services including comprehensive care management, care coordination, health promotion, transitional care, and individual and family support.
· Assist clients in coordinating, transporting, accompanying and scheduling medical, dental and specialty appointments in collaboration with the team psychiatrist and nurse; assist with follow-through on treatment based on client needs.
· Support consistent medication adherence through direct assistance including scheduling deliveries, pharmacy accompaniment, phone prompting, medication monitoring, and motivational interviewing as appropriate.
· Assist the hospital liaison and/or team nurses to facilitate discharge planning and ensure clients are seen by a licensed provider within seven (7) days of any inpatient, partial hospitalization, or long-term care facility discharge.
· Provide counseling on chronic disease management, medication purpose, and symptom management aligned with the client's primary and specialty care team's guidance.
· Assist clients in securing and maintaining the necessities of daily life — food, housing, benefits, hygiene, transportation, financial management, and legal advocacy — to support the highest possible level of independence and safety.
Community Support & Advocacy
Serve as a community liaison and advocate collaborating with schools, landlords, legal guardians, family members, DCYF, OOHA, law enforcement, judicial personnel, healthcare providers, and social service systems.
Participate as an active member of the multidisciplinary treatment team, contributing to treatment planning meetings, case reviews, and collaborative care coordination.
Maintain documentation, clinical paperwork, and productivity standards in compliance with CCBHC, BHDDH, Medicaid, Joint Commission, and organizational requirements; support preparation for BHDDH certification site visits.
Immediately escalate to supervisor any safety concerns, significant declines in client functioning, unsafe or unsanitary living conditions, or other conditions outside acceptable norms.
Provide assistance with grocery shopping where medically indicated under the direction of the client’s medical and/or psychiatric providers (e.g., diabetes management).
Substance Use Support
Assist clients in identifying triggers, building relapse prevention skills, and strengthening support systems.
Conduct and supervise urine toxicology screens and breathalyzer tests as directed, including court-ordered supervised screens.
Discuss the physical, medical, and pharmacological dimensions of substance use and recovery under the guidance of the client’s substance use disorder providers.
Vocational Support
Assess client’s educational and vocational interests, capabilities, and readiness to refer to the Vocational Specialist
Organizational Participation
Actively participate in ongoing education, training, and professional development relevant to the role and client population.
Serve on organizational committees and workgroups as assigned.
Support implementation of new or enhanced services, procedures, and policies as EBCAP evolves toward the CCBHC model.
This is an entry-level role.
Bachelor's degree in social work, psychology, human services, or a related field; or an associate’s degree with a combination of education and relevant experience demonstrating the required knowledge and skills.
Demonstrated ability to maintain professional boundaries and personal stability when working with high-acuity behavioral health populations in unsupervised community settings.
Valid Rhode Island driver's license with a clean driving record; proof of liability insurance. Driving record reviewed at hire and periodically thereafter.
Ability to read, write, and communicate professionally in English.
Core Competencies
Capacity to work independently with individuals in psychiatric crises, including those with active psychosis, suicidal ideation, or co-occurring substance use disorders, while maintaining sound judgment and de-escalation skills.
Knowledge of community-based treatment and rehabilitation for individuals with SPMI.
Working knowledge of BHDDH, Medicaid, CCBHC, and JCAHO standards applicable to this role.
Demonstrated ability to build therapeutic relationships while maintaining professional boundaries.
Strong written and verbal communication; active listening and collaborative problem-solving skills.
Ability to work independently in community settings and exercise sound clinical judgment.
Proficiency with electronic health record documentation (NextGen or equivalent).
Preferred Qualifications
Experience with working with clients with SPMI and co-occurring disorders in a community setting
Bilingual fluency in Portuguese or Spanish and English (written and spoken).
Familiarity with RI vocational benefit programs and supported employment frameworks.
This is a highly active, community-based role. The Community Treatment Specialist regularly travels to client homes, medical facilities, pharmacies, courts, and community settings throughout the service area, requiring extended periods of standing, walking, and driving. The role involves navigating varied environments including stairs, narrow spaces, and outdoor terrain in all weather conditions. The Specialist must be able to assist clients with tasks of daily living, which may include bending, kneeling, stooping, reaching, and lifting up to 25 pounds using proper technique. The ability to sit for periods of documentation work, operate a computer and standard office equipment, and communicate clearly through speech and hearing is required. Specific vision requirements include close and distance vision, peripheral awareness, depth perception, and the ability to adjust focus.