Next Steps: Critical Time Transition Program

About this Program

Developed in collaboration with NYS Office of Mental Health (OMH), Next Steps: CTTP is an innovative, comprehensive, community-based care management program. Next Steps: CTTP supports youth with complex behavioral health needs, who experience barriers to hospital discharge or frequent hospital utilization for mental health services. Enrollment is up to 9 months, providing intensive support during the critical transition from hospital to home. Referrals to Next Steps: CTTP are only accepted directly from a hospital.

Next Steps Services & Supports

• Comprehensive Care Coordination
• Mental Health Counseling
• Behavioral Analysis & Support
• Family & Youth Peer Advocacy
• Educational Coordination
• Nursing Services
• Recreation Services
• Transitional Residential Beds

Youth must meet the following criteria for enrollment:

• Age 11–17 with complex needs, including mental health conditions, co-occurring substance use, and/or Intellectual or Developmental Disabilities.
• Boarding/social stay for 72+ hours or 3 hospital presentations within 30 days for mental health reasons, including CPEP, ED, or inpatient stays. Referrals may be made prior to 72 hours.
• Reside in Genesee, Livingston, Monroe, Orleans, Ontario, Seneca, Wayne, Wyoming, or Yates County.
• Have an anticipated discharge to home or another home-like, community-based setting.
• Youth and family are willing to actively participate weekly with the CTTP team and identified community providers.
• Do not require a higher level of care, such as RTF, inpatient psychiatric/medical care, or medical detox.
• Co-enrollment with HBCI, Youth ACT, CCR, RTF, or Health Home Care Management (HHCM) is not permitted. HHCM services may be pended during CTTP enrollment and resumed following discharge from CTTP.

Youth must be able to be safely supported in a restraint-free, community setting and:

• Not present acute risk for elopement, violence/aggression, suicidal or significant self-harming behavior, or fire setting.
• Be verbal and able to communicate needs.
• Be able to self-administer medication with supervision, be independent with ADLs, and not require 24/7 nursing care or monitoring due to a medical condition.
• Not require a higher level of care than a community-based setting.
• Not have been ordered to detention or for court-ordered clinical assessment or placement by Family or Criminal Court, require medical withdrawal management/medical detox, or require inpatient medical or psychiatric care

Locations

Monroe Campus

1183 Monroe Avenue
Rochester, NY 14620

Contact Information

Program Director:
Jason Goldwasser, LCSW
Intake Specialist:
Hannah Gefell, LMSW
CTTP@hillside.com

For details about this or any Hillside program, contact us 24 hours a day at 585-256-7500 or info@hillside.com

This Program is Supported by the New York State Office of Mental Health