Under the direction of the Director of Conflict Free Case Management, the Clinical Service Planner will conduct individual plans of services for individuals with mental illness, co-occurring substance use disorders, children with serious emotional disturbance and/or all persons with intellectual/developmental disabilities in the office and in the community. The Clinical Service Planner will assist eligible individuals to design and implement strategies for obtaining services and supports that are goal-oriented and individualized. The Clinical Service Planner will communicate and consult with a variety of supports regarding program issues, assess clinical needs, and makes recommendations for supports services and treatment through linkage, advocacy, coordination, and monitoring of the individuals plan of service to ensure the individual is gaining access to needed services. The Clinical Service Planner will communicate and consult with staff from internal and external community resources and persons in a responsive, effective, and efficient manner to focus on process and outcomes. This position is part of a staff pool that serves to fulfill the agency’s Crisis Stabilization Service. This may require on-call hours including nights, weekends, and holidays.

• Planning and/or facilitating planning using person-centered principlesThe person-centered plan of service is produced by a coordinated effort by the staff member and the consumer in response to the assessment and describes the plan for delivering services to the consumer. The plan of service should include behaviorally defined and measurable objectives; person-centered service goals; interventions and supports that require consumer actions and identify scope, frequency, and duration; the use of available natural supports and specific discharge criteria. This also includes a crisis plan for the consumer. The plan will be periodically reviewed and amended with a re-assessment of the consumer’s progress, or lack thereof, in response to the plan of service goals, objectives, intervention/supports, discharge criteria, and the medical necessity for seeking the continuation of care. This may result in a change of level of care and/or episode of care discharge.
• Linking to, coordinating with, follow-up of, advocacy with, and /or monitoring Specialty Services and Supports, and other community services/supportsConnecting the consumer with all the appropriate resources, both internal and external, and coordinating care, services or benefits provided to the consumer. Coordinating services with the consumers’ personal care physician and the qualified health care providers. This also includes assisting the consumer in the development and maintenance of natural supports, while also facilitating appropriate community residential and institutional placement for individuals served.
• Monitoring ServicesTracking of the consumer’s response to their individual person-centered plan of service and monitoring compliance and progress with all supports and services agreed to in the person- centered service plan. Monitor all services received, review cases, professional and consultant staff, advocates, attorneys, and other interested parties according to signed released of information and the IPOS. Monitoring consumer medication in consultation with the Prescriber and/or staff nurse, ensuring the consumer is compliant with their medication intervention and monitoring potential side effects of the medications. Consults with and assist clinical staff regarding service deliver and coordination of cases, while participating in clinical case conference as requested to provide clinical expertise that results in treatment recommendations and increase coordination of care
• Support ServicesActing as a consistent link into the system for the consumer and/or their family including educating persons served and supports regarding disability, treatment options and regimens, use of medication, management along with ensuring persons served and support are knowledgeable of 24-hour crisis services, while ensuring that the implementation of clinical practice is completed in accordance with the principles of evidence-based practices and models of care. This includes attitudes and values, as well as knowledge and skills.
• Maintenance of the key elements of the individual consumer record
  In coordination of services, the clinical record will be managed by the planner/monitor and the individuals direct service providers. The planner/monitor is responsible to assure the record is updated with releases, consents and obtaining clinical information. They are to assure that the consumers’ confidentiality of information is maintained and that all parties are to have knowledge of what is in the clinical record. Documentation is to comply with all requirements (content, timeliness, legibility, QM indicators, MDCH indicators). Must maintain 95% compliance on average for entire caseload