Director of Housing Clinical Support Services

About NYC Health + Hospitals

Empower Every New Yorker — Without Exception — to Live the Healthiest Life Possible

NYC Health + Hospitals is the largest public health care system in the United States. We provide essential outpatient, inpatient and home-based services to more than one million New Yorkers every year across the city’s five boroughs. Our large health system consists of ambulatory centers, acute care centers, post-acute care/long-term care, rehabilitation programs, Home Care, and Correctional Health Services. Our diverse workforce is uniquely focused on empowering New Yorkers, without exception, to live the healthiest life possible.

At NYC Health + Hospitals, our mission is to deliver high quality care health services, without exception. Every employee takes a person-centered approach that exemplifies the ICARE values (Integrity, Compassion, Accountability, Respect, and Excellence) through empathic communication and partnerships between all persons.

Job Description

Housing for Health (HfH) at NYC Health + Hospitals (H+H) recognizes that the chronic health issues of unhoused individuals cannot be treated without stable housing. This initiative seeks to improve the health and wellbeing of New Yorkers by focusing on four strategic areas: housing navigation services, medical respite beds, affordable housing on hospital property, and social service support for patients in permanent housing.

Housing for Health is seeking a Director of Clinical and Support Services to provide a range of high-level clinical consultation, assessment, triage and coordination functions. In general terms, this position will be responsible for ensuring that patients are referred to appropriate housing options and that the necessary health and support services are established upon housing to facilitate improved health outcomes and housing retention. The individual will also support clinical management of the H+H medical respite facilities which provide interim housing, clinical services and case management for patients who are too sick to discharge to shelter after an inpatient stay.

Housing for Health is seeking Board Certified/Eligible Advanced Practice Practitioner candidates (Department Preferences for more details) with strong clinical skills and demonstrated experience working with people experiencing homelessness who have complex medical and/or behavior health conditions. Successful candidates should also possess strong connections to the network of community-based health and support services for homelessness in NYC, leadership skills, and exceptional communication and organizational ability. This position will work both independently and as a collaborative partner within the hospital system, Housing for Health team, government agencies, supportive housing providers and other community-based organizations.

MAJOR AREAS OF RESPONSIBILITY:

• Client Flow Management: This position will further develop and manage the process in which patients are identified for housing and referred to Housing for Health services. This involves frequent interactions with stakeholders throughout the health system, including but not limited to housing champions, clinical providers, social workers, nurses, community health workers and other staff within H+H hospitals and ambulatory care network to help facilitate appropriate referrals and to develop a continuous pipeline of patients in need of housing.
• Clinical Referral Assessment: This position will conduct clinical reviews of referrals for Housing for Health Housing Location and Placement services, which may include determining appropriate permanent housing options, level of care needed, prioritization of need, assessing for required medical and social service supports, working with home care agencies, and ensuring services are established at the time of patient move-in. The individual will also be responsible for liaising with referring care teams to confirm longitudinal care needs are met, guiding partners through the process of establishing long term care benefits for appropriate patients and liaising with licensed/certified home care agencies to ensure safe transitions into housing. As needed, the Director may liaise with NYC Human Resource Administration to ensure patients are qualified for the appropriate housing type.
• Respite Clinical Support: Housing for Health contracts for two medical respite programs with two non-profit vendors. The position will be responsible for referral management, including conducting assessments on patients referred to respite, determining eligibility, and liaising with vendor staff to facilitate transfer. The position will also work clinically at respite, overseeing care plans for patients, coordinating delivery of clinical services, determining medical clearance, and supporting vendor staff with discharge planning.
• System-wide Clinical Consultation: This position will provide skilled and timely clinical advice at multiple points throughout its housing system. This consultation may include providing advice to referring partners prior to Housing for Health referral, liaising between systemwide referral points and Housing Location and Placement Services vendor, and consultation with on-site providers at H+H contracted interim or permanent housing sites to problem solve specific client issues including triage of clinical need, and linkage to specialty care, primary care, behavioral health services, and other community resources.

Quality Improvement, Evaluation and Data Tracking: This position will be responsible for ensuring that patients/tenants are receiving high quality care throughout the housing journey aimed at achieving residential stability and improved health care outcomes. Additionally, this position would lead evaluations to determine if key metrics are being achieved and assist with data tracking and reporting as necessary.

Minimum Qualifications

1. A Master’s Degree from an accredited college or university in Public Health, Public, Hospital or Business

Administration, Health Care Specialization, Engineering, Social Services or a related discipline; and four (4)

years of progressively responsible experience relating to health care program planning, research, design,

operations, evaluation and analysis, one (1) year of which must have been in supervision or planning and/or

analysis; or

2. A Baccalaureate Degree from an accredited college or university in disciplines, as listed in #1 above; and five

(5) years of progressively, responsible experience relating to health care program planning, research, design,

operations, evaluation and analysis, one (1) year of which must have been in supervision or planning and/or

analysis; or

3. A satisfactorily equivalent combination of education and experience, in which 30 graduate-level semester

credits from an accredited college or university can be substituted for one year of experience. However, all

applicants must have at least a Bachelor’s Degree.

Department Preferences

Four (4) years of satisfactory, full-time experience in clinical practice

One (1) year experience working with patients experiencing homelessness in clinical or programmatic context

Board-certified (or board-eligible) and licensed to practice in NYS

Licensed/certificated to work as Advanced Practice Practitioner in NYS

Licensed to practice as LCSW in NYS

A Bachelor’s degree from an accredited college or university in a specialization or discipline consistent with project content; and

Medical degree (MD or DO)

or

Master of Social Work

Masters-level degree that is accredited for Physician Assistants/Associates or Advanced Practice Registered Nurses

Knowledge in Affordable and supportive housing policy and programs; basic understanding of managed care, value-based care and hospital payment mechanics; understanding of acute hospital and/or nursing home discharge planning processes including:

o Knowledge in community-based health care services, including eligibility and process for establishing Community-Based Long Term Care benefits, Assisted Living placements, skilled health care services and custodial home care

o Knowledge of range of clinical services available for patients experiencing homelessness, including specialist clinics, embedded clinics and street medicine programs

o Knowledge of population health, community health, and social determinants of health and/or health administration.

Basic understanding of core concepts in quality improvement, including driver diagrams, PDSA cycles, run charts, and causes of variation.

Microsoft Office Suite; Electronic Health Record, Epic, NowPow, and MyChart