Community Transitions Coordinator

Job Title: Community Transitions Coordinator – [Aging and Disability Resource Connection (ADRC) of San Bernardino County] (Non-Exempt/Part Time)

Reports To: ADRC Program Manager

Location: San Bernardino

Salary: $31.97 to $34.62/per hour

San Bernardino County Department of Aging and Adult Services (DAAS) and Rolling Start, Inc. Center for Independent Living have formed a core partnership in the spirit of an Aging and Disability Resource Connection (ADRC). DAAS and RSI are developing protocols, practices and procedures that will enhance the community by providing a visible, reliable, no-wrong-door access point for information, referral, assistance with public and other benefits, options counseling, and transitions from long-term nursing home residence to community living arrangements as well as short-term service coordination.

The community transitions coordinator will be located at the Rolling Start office in San Bernardino but will be expected to travel throughout the county to various locations, including Rolling Start’s Victorville location and Senior Information & Assistance (SIA) offices up and down the hill.

Position Summary:

The Community Transition Coordinator provides information, supports consumers in decision making, and coordinates multiple services from a variety of organizations to successfully move older adults and individuals with disabilities from medical or residential facilities to community-based living options. The Community Transitions Coordinator will interact regularly with other ADRC partners to provide seamless, integrated services and empower independent, community-based living for older adults and persons with disabilities.

Essential Duties and Responsibilities:

• Works collaboratively with health plans to coordinate transition and diversion services, etc. under the CalAIM program;
• Conducts outreach to hospitals, nursing homes, and other medical and residential facilities to identify individuals who want to transition into the community;
• Outreach and marketing community events;
• Using a person-centered approach, interviews consumers to ascertain immediate and long-term needs for services;
• Develops consumer-driven transition plans in consultation with licensed care professionals and others identified by consumer;
• Coordinates transition from medical and residential care facilities;
• Liaisons with community agencies in San Bernardino County to arrange ancillary services and implement long-term services and supports;
• Works closely with Independent Living Specialists, AT Specialist and AT Coordinator to get transitioning consumers plugged into support services;
• Will assess what is needed for a successful transition, determine most appropriate funding source(s), e.g. health plan, Department of Rehabilitation transition/diversion fund, Community Living Fund or other community resources or grants to aid in the transition coordination;
• Collaborates with core and extended ADRC partners to implement the No Wrong Door approach to services;
• Enters consumer demographics and service activities into a database as part of the monitoring and evaluation process;
• If appropriate, offers peer advice and support to consumers;
• Performs other duties as assigned by supervisor.

Education and Work Experience:

• Bachelor’s degree required in area of social sciences and/or health-related field;
• 2-4 years related professional experience;
• Experience working with people with disabilities and/or older adults, preferably in an Independent Living Center or Aging and Adult services organization.

Interaction:

• Interacts with all levels of employees, consumers and/or outside agencies on a daily basis;
• Must possess the ability to interact effectively (influence, exchange and communicate information so it is understood) with consumers, employees at all levels of the organization as well as those outside the organization and provide appropriate communication to the target audience.

How To Apply: