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● Conduct initial intake or assessment of clients and clients’ families and. or periodic reassessments.
● Ensure that clients are connected to primary medical care and other appropriate services.
● Collect periodic medical updates for clients.
● Follow up- with clients and referral organizations regarding client contact and progress with referral organization.
● Work with clients to break through barriers to clients goals and assist clients in advocating for themselves and in moving forward self-sufficiency.
● Monitor clients progress toward their goals via regularly scheduled telephone contact and/or face-to-face home and office visits, and document via progress notes.