ER, Hospitalization and Urgent Care Entry Form

***FORM UPDATE FY 25***

Some fields have been removed to shorten the form and streamline data collection.

If there are any questions, please let your IT dept. know. 

Thanks.  

 

Please enter your full name.

Add a fourth email for someone who needs a copy of the form responses or leave blank.

K. Type of Report
N. Person Recommending the Visit
O. Was 911 used?
Q. When was the guardian notified?
R. Is there an Unusual Incident Report associated with this visit?
Z. Disposition from ER/Hospital
Please provide the following information in question "ZE":

1. What led up to the event described above?

2. What was the exact issue that caused the event?

3. What was staff's immediate response to the event?

4a. What testing was done?

4b. What was the results of the testing?

5. What treatment was ordered as a result of the testing?

6. Is there any follow-up needed related to this event?

Please give a brief, specific description that includes all requested information (see instruction above).

Family Peer Support 4224R (Joliet, IL)

APPLY NOW

Position: Family Peer Supporter

Location: Joliet, IL

Shift: Weekdays, 2 evening shifts per week

Salary: $40,500-$45,500

POSITION OVERVIEW:

Under the direction and supervision of the program director, the Pathways to Success Family Peer Supporter (FPS), will provide families of Pathways enrolled youth with behavioral health needs with services and supports. FPSs will support the family and the youth in their home and community, advocate for services, and assist the caregiver with increasing their ability to understand their child’s behavioral health needs and supports available to the family. A FPS is someone who has lived experience or experience as a caregiver or a child with special needs, preferably behavioral health needs.

ESSENTIAL FUNCTIONS:

  • Assisting the family to engage in services and supports
  • Assisting the family in systems navigation and breaking down barriers to services
  • Involving the family with all care and decision-making
  •  Providing information about the child’s needs and strengths
  • Setting goals, designing and implementing and evaluating outcomes of programs
  • Supports the family during times of crisis
  • Responsible for the timely submission of Medicaid mental health billing
  • Participates in weekly team meetings
  • Traveling from various locations within the community to provide the family and youth with supports

SKILLS AND ABILITIES:

  • Excellent interpersonal skills, cultural competency, and experience with diverse populations
  • Strongly self-motivated
  • Strong communication skills
  •  Teaching skills, non-judgmental personality, and empathic listening skills
  • Ability and knowledge of basic computer programs for service documentation and report writing

QUALIFICATIONS:

  • High school diploma or GED
  • Lived experience or experience as a caregiver of a child with special needs
  • Experience navigating child-serving systems and supporting, educating and advocating for families involved with child-serving systems preferred

Contact: Qualified candidates email resume to Justina Nava at jobs@trinityservices.org

APPLY NOW