Community Transition Support Program

PROGRAM HOURS: Blended Case Management services will be provided 24-hours a day, seven days a week for at-risk individuals. On-call services available outside of normal working hours.

SERVICE DESCRIPTION: The program offers a wide array of person-centered, hope-filled services in the community, corrections, inpatient environment, and outpatient settings. Services include assessment of needs and strengths, crisis intervention, conflict resolution, diversion, service planning, referral, linkage and follow-up. Engagement and relationship development are key components of the service. The program will combine intensive case management and resource coordination to deliver comprehensive care and support in a recovery-oriented manner. This program is intended for clients that are diagnosed with a mental illness and who are involved to some degree in the criminal justice system, either as part of discharge planning after release from prison or as a resource to divert from the criminal justice system prior to or in lieu of incarceration.

The goal of this service is to transition individuals to other supports and services as soon as feasible by enhancing supports, skills, and treatment engagement.

Mission, Objectives, Values:


Promote recovery by preventing incarceration and/or hospitalization, decreasing time in jail for individuals with mental illness, and assertively engaging through seamless blended case management services. These services will be provided regardless of an individual’s age, sex, religion, creed, or their location.



Target Population: Adults involved or at risk of involvement in the criminal justice system with a wide variety of needs including mental health, serious mental illness (SMI), co-occurring developmental disabilities, or co-occurring substance abuse disorders. These individuals may be engaged in the community, during interactions with law enforcement, in the hospital, corrections, and/or engaged in outpatient services.

Capacity: Blended Case Management team with 6 case managers, one Team Leader and one assistant Team leader with the potential to expand to two teams based on volume of cases and growth of program.