Our goal is to better meet the needs of individuals experiencing serious mental illness and their families by addressing the individual’s physical, mental, substance use and wellness goals.
The following central tenets help to achieve this goal consistently and routinely:
- Use a multidisciplinary team that shares information and collaborates to deliver a holistic, coordinated plan of care
- Improve psychosocial and physical health outcomes to improve enrollee’s quality of life
- Take a person-centered approach, and engage and respect individuals and families in their health care, recovery and resiliency
- Respect, assess and use the cultural values, strengths, languages and practices of individuals and families in supporting an individual’s health goals
Natalis Outcomes Behavioral Health Home Services include the following:
- Referral to community social support
- Transitional Services – Chemical Dependency (CD) support, homelessness support, navigating healthcare system, mental health transitional support
- Health promotion and wellness
- Care Coordination – Psychology and psychiatry services, therapy, CD treatment
- Patient and family support
- Accessing resource – Transportation, supportive employment, housing
Who is Eligible?
- Actively enrolled in medical assistance or a PMAP
- Have a diagnosed or potential serious mental illness or serious and persistent mental illness
- Have a current diagnostic assessment (within 1 year). And if client does not, Natalis Outcomes can provide services for diagnostic assessment.
- Those who are not currently engaged in Targeted Case Management (TCM) or Assertive Community Treatment (ACT)
Key Services Provided:
- Offer motivational interviewing towards setting meaningful personal goals
- Maintain regular person-to-person contact with enrollee to build personal trust
- Seek permission to work with and engage family members and friends
- Assist with scheduling transportation to and from health related appointments
- Involve in interdisciplinary community based care to support independent living
- Provide transitional care needs; from institutional to community based settings
- Attend medical, dental and behavioral appointments and service encounters
- Work with enrollees to secure short term residential care & housing
- Support vocational skills training and employment seeking activities
- Work with enrollees to complete and review program entitlement applications
- Support medication management and adherence with medication therapy
- Communicate with enrollee’s providers, e.g., PCP, DDS, RD, RN, LicSW, etc.
- Refer to specialty care services as needed, i.e. psychotherapy