Pivotal prefers to have persons with mental illness live in independent community settings, although alternatives are available when someone needs a setting that provides supervision and assistance with activities of daily living.
Adult Foster Care
Pivotal works with several AFC homes in the county for placement of those clients who need some level of supervision and assistance. The relationship with CMH and standard AFC providers is non-contractual, and providers receive payment for room and board from their residents and model payment dollars for specialized care from the State. Pivotal through its case management function, determines the needs for an AFC placement, helps secure the placement site, completes necessary paperwork for the provider and CMH record, and provides ongoing coordination and monitoring.
Specialized residential homes are similar to AFC homes in that both are considered dependent care settings, and both provide supervision and ensure the basic needs of the individual are met. However, there is a much higher level of supervision and monitoring in specialized residential programs, which utilize shift staff to ensure around the clock awake supervision. These programs often have built-in treatment and/or activity components. Unlike standard AFC, there is a contractional relationship between Pivotal and the specialized residential provider and Pivotal pays a per diem rate.
Supportive Housing Program
SHP is a collection of several housing grants awarded to Pivotal by the Department of Community Health and is jointly operated by Pivotal and Keystone Place, which is the county's lead agency in addressing housing and homelessness.
The grants have the goal of helping homeless individuals with serious mental illness to find safe and affordable housing and, using a housing first model, allow them to devote more time and energy toward their recovery by ensuring that their basic housing needs are attended to. Grant funded housing units (typically apartments) are based on agreements with various landlords and are scattered about the county. Program participants receive a rental assistance or subsidy so that no more than 30% of their income goes to rent. All housing units must pass initial and annual housing inspections to ensure they meet certain quality standards. Participants also receive a case management provided by Keystone Staff. While the intent of SHP is to provide temporary assistance so the individual can move onto permanent housing without grant supports as soon as possible, the program is not time limited.