Adult Community Integration
Assistance Plus Community Integration is a service for adults who meet MaineCare Section 17 eligibility criteria. The service is for individuals with needs related to their mental health diagnosis.
Care Coordinators assist each individual in the creation and coordination of a person-centered treatment plan focused on meeting each specific need of that person (including, but not limited to, housing, medication management, therapy, educational/vocational, and social/emotional needs).
Adult Care Coordinators and Health Home Coordinators are required to have a MHRT/C (Mental Health Rehabilitation Technician Certification). In addition, they are provided with ongoing quality clinical supervision and learning opportunities to stay current with the latest policies and practices.
Assistance Plus Care Coordinators are able to;
- Advocate for each client’s needs with service providers and other organizations,
- Develop an individualized service plan with clients and guardians when applicable,
- Monitor the effectiveness of services, natural supports, and resources,
- Promote independence with a focus on maintaining the least restrictive environment possible – providing for each client’s active participation at home, and their community,
- Identify and offer referrals and available resources to target and address each need that the client and/or guardian may have,
- Build and bridge client/guardian relationships with broader community resources who can partner to enhance each client’s physical and mental health care needs,
- Support clients with obtaining MaineCare when needed,
- Support and assist client/family/guardians in navigating complex social services (for example, Social Security benefits, housing resources/applications, HEAP, and WRAP applications), and/or
- Coordinate transportation to and from medical and behavioral health appointments
Community Integration Eligibility Criteria
- For those without an eligible diagnosis of schizophrenia or schizoaffective disorder, a clinical letter attesting to the need for Community Integration due to the following at-risk criteria:
- Homelessness
- Psychiatric hospitalization
- Criminal justice involvement
- Residential mental healthcare placement
Other Eligibility Criteria:
- Proof of ‘Blue Paper’.
- Discharge from PNMI within 2 years of referral date.
- 2 or more psychiatric admissions (min. 72 hrs inpatient within 2 yrs. of referral date.)
Assistance Plus provides these services throughout Mid-Coast, Central, and Western Maine (Franklin, Kennebec, Knox, Lincoln, Somerset, Sagadahoc, Oxford, Penobscot, and Waldo Counties.)
Contact Us for more information.