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Mental Health Transition Coordinator, CCMTP

The Transition Coordinator, CCMTP is a member of the Transition Team under the Comprehensive Class Member Transition Program (CCMTP) as a part of the Illinois Williams and Colbert Consent Decrees. The Transition Coordinator reports to the CCMTP Transition Team Leader.
 The CCMTP Transition Team works with Williams and Colbert Class Members to support safe transitions from institutional settings, such as nursing facilities and Specialized Mental Health Rehabilitation Facilities (SMHRFs), to living in the community in less restrictive environments with Thresholds support services in place. The Transition Team collaborates with the CCMTP interdisciplinary team to identify strategies to support Class Members in identifying personal goals to live in a more independent setting in the community. The Transition Team provides strong advocacy for Class Members and support linkage to needed community services and housing resources. The Transition Team provides client-centered, strengths-based, and trauma-informed services to Class Members with mental illness, co-occurring substance use disorders and physical health concerns, utilizing a harm reduction approach.


  • Assesses Class Member’s personal, medical, social, emotional, and environmental situation to plan for transition, linkage and treatment course.
  • Provides community support, engagement activities, transition linkage, case management and other services as need to support Class Members in addressing transition needs.
  • Provides brief interventions using evidence based psychosocial treatments, (CBT, MI) as clinically indicated.
  • Supports Class Members in developing independent living skills needed to transition to the community while utilizing a strength-based and client-centered approach.
  • Assists in all areas of the Comprehensive Class Member Transition Program, specifically in areas that include housing location, community integration, skill building, transition preparedness, and overall recovery support.
  • Advocates and assists class members with securing housing in a less restrictive setting in the community. This includes, but is not limited to obtaining identity documents, obtaining proof of benefits or income, searching for housing, completing housing application and subsidy paperwork.
  • Provides direct assistance to help Class Members move, obtain household items and explore their new community at the time of discharge.
  • Supports and assists class members in preparing their new housing by shopping for furniture and essential items for independent living.
  • Transports members to appointments as needed to prepare for discharge to the community.
  • Collaborates with the entire CCMTP team on transition planning, safety planning, clinical consultation, and problem solving to ensure and support safe transitions to independent living.
  • Serves as the primary Thresholds contact for the facilities where an assigned class member resides.
  • Collaborates with the Class Member’s support system regarding treatment in order to enhance the class member’s recovery.
  • Attends all transition related meetings, agency-wide meetings, CCMTP team meetings, treatment team and other meetings as assigned.
  • Facilitates discharge planning with the Class Member, employees of institutional settings, and CCMTP interdisciplinary team members.
  • Ensures all Thresholds procedures regarding the handling of members’ transition funds are followed and that both the members and Thresholds administration are assured that all safeguards, reports and accounting meet the highest standards.
  • Completes IM+CANS training and certification within 90 days of hire and complete needed annual re-certifications to maintain valid certification.
  • Completes accurate and detailed mental health assessments/other documentation based on timelines (i.e. IM CANS, Level of Care Utilization System or LOCUS) as required.
  • Participates in the development of the Class Member Comprehensive Service Plan in collaboration with the Quality Assurance & Care Coordination Team.
  • Maintains the quality, validity and confidentiality of personal health information and individual case records according to HIPAA, privacy practices and Thresholds standards.
  • Completes Medicaid compliant service notes in a timely manner.
  • Meets required productivity targets and completes all documentation within assigned time frames.
  • Provides accurate and timely information to their supervisor(s) on all class member and transition related topics.
  • Completes all assigned CCMTP paperwork in a timely fashion.
  • Perform other related duties and/or projects as assigned.


  • May be required to transport Class Members utilizing agency vehicle.


  • Bachelor’s degree required to meet rule 132 requirements for a Mental Health Professional (MHP).


  • Experience at working both independently and in a team-oriented, collaborative environment.
  • Demonstrated proficiency in the use of e-mail, data reporting, record keeping and MS Office applications.


  • Current and valid Driver’s License required.
  • Requires daily access to a personal vehicle and willingness to use vehicle for facilitating work activities.
  • Must obtain and maintain $100,000/$300,000/$100,000 liability insurance coverag Subject to validation every 6 months. Must be 23 years of age and must meet all insurance carrier’s requirements. Subject to annual Department of Motor Vehicles license verification.
  • Covid-19 Note
  • In the spirit of caring for one another and our community, please note that upon accepting an offer of employment from Thresholds, you will be required to share proof of a COVID-19 vaccination and booster upon eligibility. You may apply for a Medical or Religious Exemption in compliance with applicable laws and regulations.
  • Base Pay Rate - $22.25 - $25.25 hourly
  • Base Pay Rate - $46,270 - $52,510 annual
  • Generous Paid Time Office Policy (Vacation, Sick, and Personal Days) 
  • 4 Medical Insurance Plans 
  • Dental Insurance 
  • Vision Insurance 
  • 403(b) with 3% employer match 
  • Mileage Reimbursement 
  • Public Service Loan Forgiveness 
  • Supervision for Clinical Licensure at no cost (LSW, LCSW, LPC, LCPC)