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Provide services to formerly chronically homeless persons with a severe mental disability who are living at Palo Duro I & II to increase participant stability and self-sufficiency, a high housing retention rate, and reducing participant use of shelters, hospital, and jail. Establish cooperative relationships with local shelters, hospitals, and law enforcement to identify and recruit perspective participants. Monitor the resident’s progress and needs while living at PDI and II, link residents to and coordinate resources, conduct discharge planning, and track participants who have exited the program. Support the appropriate and timely documentation necessary for housing eligibility, maintain accurate progress notes and alerts.