Developing Effective Crisis Response Plans Including Transition Waupaca County Manawa, WI November 1 - PowerPoint PPT Presentation

Loading...

PPT – Developing Effective Crisis Response Plans Including Transition Waupaca County Manawa, WI November 1 PowerPoint presentation | free to download - id: 1f759f-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Developing Effective Crisis Response Plans Including Transition Waupaca County Manawa, WI November 1

Description:

Dennis Dornfeld. Alan Stauffer. Pat Enright. Tiffany Dorst. Principles of Collaborative Systems of Care. Family/Consumer ... Marsha Miller (mentor) 555-5026 ... – PowerPoint PPT presentation

Number of Views:80
Avg rating:3.0/5.0
Slides: 36
Provided by: ValuedGate1136
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Developing Effective Crisis Response Plans Including Transition Waupaca County Manawa, WI November 1


1
Developing Effective Crisis Response Plans
Including TransitionWaupaca County Manawa, WI
November 16, 2005
  • Dan Naylor
  • Don Olander
  • Jay Klemann
  • Dennis Dornfeld
  • Alan Stauffer
  • Pat Enright
  • Tiffany Dorst

2
Principles of Collaborative Systems of Care
  • Family/Consumer centered approach
  • Consumer involvement throughout the process
  • Building resources on natural and community
    supports
  • Strength-based approach
  • Providing unconditional care
  • Collaborating across systems
  • Using a team approach across agencies
  • Being gender/age/and culturally responsive
  • Ensure safety
  • Promoting self-sufficiency
  • Focus on education and employment where
    appropriate
  • A belief in growth, learning and recovery
  • Being oriented to outcomes

3
Wisconsins Collaborative Systems of Care for
Children Families (updated 4/05)
ISPs 21 (2included in )
Developing CSTs 9
Managed Care 2
CSTs 10 (2 included in )
CST ISP 2 (included in totals for CSTs ISPs)
4
Collaboration with Families
  • Voice Families are listened to and heard in all
    phases of the planning process
  • Access Families have valid options. No services
    are withheld for categorical reasons.
  • Ownership Families agree with and commit to any
    plan concerning them.

5
Qualifications for Team Involvement
  • To qualify for team involvement, individuals
    should
  • Have a role in the lives of the child family
  • Be supportive of the consumer
  • Be supported for membership by the consumer
  • Be committed to participate in the process
    including regular team meeting attendance
  • Participate in discussions
  • Be involved in the Plan of Care

6
Informal/Natural Supports as Team Members
  • Emphasize the importance of natural supports as
    team members with the participant at time of
    referral and screening
  • Make natural support recruitment an ongoing team
    goal
  • Dont give up it may take months and require
    creative planning

7
Potential Members of Teams
8
Levels of Team Involvement
  • Assessment, Planning, and Crisis Response
    Planning
  • Teams meet every 1 2 weeks for 45 minutes to 1
    hour
  • Phase may last approximately 2 3 months
  • Plan Implementation Monitoring
  • Teams meet as often as necessary, typically every
    3 5 weeks
  • Phase may last approximately 6 12 months
  • Transition Closure
  • Teams may meet every 2 3 months while
    transitioning out of the formal team process

9
Transition Out of the Process
  • The intent of the team is not to solve every
    problem that the consumer or the providers have,
    rather to develop skills, gain knowledge and
    identify and access resources necessary to meet
    the needs.
  • Once this process is working and doesnt
    necessitate team support, the formal team process
    should end.
  • This doesnt mean that services arent necessary
    or that supports arent needed. It simply means
    the consumer has voice, access and ownership.

10
Summary of Strengths Needs Assessment
  • Living situations
  • Basic needs and financial status
  • Child family/consumer situation
  • Mental health
  • Social interaction
  • Access to community resources
  • Cultural involvement
  • Spiritual status
  • Educational/vocational status
  • Legal involvement
  • Medical status
  • AODA status
  • Crisis response

11
Plan of Care Development
  • The service coordinator schedules meetings with
    the family team to develop the plan
  • The team reviews process principles, and
    identifies the strengths of the individual and
    team member.
  • The team reviews each domain, identifying
    strengths, needs, and the current level of
    functioning.
  • The team prioritizes the needs
  • The team develops the Plan of Care to include
  • Present level of functioning
  • The goals, objectives and activities
  • Who will be involved
  • How services will be paid for
  • How outcomes will be evaluated

12
Crisis Response Plan Development
A crisis occurs when adults dont know what to
do. Carl Shick
  • Expect that an individual with multiple needs
    living in the community will experience crisis.
  • Consider the most challenging act(s) that could
    happen
  • Review historical strength-based information
    regarding strategies that have worked
  • Pre-plan interventions with people and/or
    agencies who may be involved in the safety issue
  • Develop a protocol of who will be notified, in
    what time frame, including responsibilities and
    communication procedures
  • Establish a blame free time in which team
    members cannot fault each other for the crisis
  • Develop a process for evaluating the crisis
    response plans use within two weeks of the event.

13
Role of Service Coordinator
  • Assure Team Completes the Assessment and Plan of
    Care
  • Central Team Contact
  • Ensure the Plan of Care is Monitored
  • Ensure Reassessment and Plan of Care Updates
  • Share Outcomes

14
Service Coordination Meeting Facilitation
Responsibilities
  • Open the meeting, welcome team members
  • Review and add to the agenda
  • Set meeting time limit
  • Prioritize agenda items if necessary
  • Ensure notes are taken and plan for distribution
  • Keep team focused, moving through the agenda
  • Keep track of time
  • Facilitate discussions and conflict resolution
  • Ensure member participation
  • Assist team in decision-making
  • Set agenda, time, and place of next meeting

15
When to Use Different Decision-Making Methods
Adapted from The Team Handbook Sholtes, 1996
16
Barriers to Collaboration
  • I dont have signed releases to share or obtain
    information
  • Theres no money available to pay for services
    for needs identified in the Plan
  • If I make an exception for one participant, it
    wouldnt be fair for the others
  • My workload is too large I dont have time!
  • My boss is pressuring me to stay in the office
    increase face-to-face time
  • Ive never been involved in Wraparound and dont
    know anything about it
  • Ive been involved before it wasnt beneficial
  • I must maintain professional boundaries with
    clients
  • I cant stand working with that person/agency!

17
Principles for Conflict Management
  • Encourage equal participation we are in this
    together
  • Actively listen you are important and valued
  • Separate fact from opinion challenge categorical
    statements
  • Separate people from the problem use the board
  • Focus on the big picture reaffirm goals,
    principles, values
  • Build consensus

Adapted from Conflict Management, Hendricks, 1989
18
Evaluation
  • Develop Plan of Care
  • Include Measurable, Attainable Goals, and Who
    will do What by When
  • Use Plan of Care to Monitor Progress
  • Team Effectiveness Survey
  • Provider Satisfaction Survey
  • Family Closure Survey

19
Sampling of Outcomes/Benefits
  • Majority of children remain in their home, school
    community
  • Family advocacy informal support services are
    available
  • Communication, collaboration, and coordination
    have improved in responding to the needs of other
    children and families
  • Other funding sources have been leveraged
  • Child abuse and neglect prevention
  • Family preservation and support
  • Targeted case management intensive in-home
    therapy
  • Other grant and foundation funds requiring
    collaboration
  • Funds have shifted to lesser cost
    alternatives/pooling of funds
  • Several beneficial workshops/trainings have been
    provided
  • Less duplication of services, workload is shared
  • A shift toward outcome-based activities has
    occurred
  • Participant involvement in development,
    implementation, and evaluation of activities has
    resulted in more community ownership of process

20
Client Alumni Involvement
  • Informal Resource
  • Advocacy
  • Support Groups
  • Coordinating Committee Membership
  • Screening Committee Membership

21
The Coordinating CommitteeSuggested Membership
  • Human Services representing AODA, mental health,
    developmental disabilities, family support, child
    welfare, and juvenile justice systems
  • Consumers/individuals representing the target
    population (min 25 of membership)
  • Representation from
  • Education School Districts, CESA, School Board,
    Head Start
  • Health Department
  • Domestic Violence Program
  • Law Enforcement
  • Probation Parole
  • Vocational/Technical School
  • Clergy
  • County Board
  • Regional Office Representation
  • UW Extension
  • Private Business
  • Additional Community Groups as desired

22
The Coordinating CommitteeSuggested
Responsibilities
  • Prepare Interagency Agreement renew every 3
    years
  • Assess how the program relates to other service
    coordination programs, taking steps to avoid
    duplication of services
  • Identify and address gaps in service
  • Be involved in the review (screening) of
    referrals
  • Establish operational policies procedures
    ensure they are monitored and adhered to
  • Ensure quality, including consumer agency
    satisfaction
  • Plan for sustainability of the system change
    beginning year 1
  • Ensure any realized savings from substitute care
    budgets are reinvested in the community-based CST
    process
  • Establish target group to be served
  • Be a liaison to the agency/group you represent on
    the committee
  • Attend and participate in Committee meetings and
    activities
  • Develop a plan for sustaining the process

23
A Summary of Steps forDeveloping a Collaborative
System of Care
  • Identify partners develop polices
  • Determine target population
  • Determine process for referral enrollment
  • Identify and train service coordinators
  • Implement the team process
  • Establish monitoring evaluation processes
  • Ensure sufficient collaborative funding
  • Develop a collaborative plan for sustainability

24
www.wicollaborative.org
25
Crisis Response Planning
26
The Benefits of Crisis Response Planning
  • Reduces stress
  • Provides safety
  • Teaches skills
  • Strengthens team
  • Controls outcomes

27
Who should have a Crisis Response Plan?
  • Considered for everyone enrolled in CST/ISP
  • Past current incidents requiring emergency
    response
  • Behaviors creating a risk to safety
  • Team member request

28
Crisis Response Plans Before you Begin
  • Make sure team members understand the purpose of
    a Crisis Response Plan distinguish between
    Crisis/Safety issues and Plan of Care issues

29
Crisis Response Plan Development
A crisis occurs when adults dont know what to
do. Carl Shick
  • Expect that an individual with multiple needs
    living in the community will experience crisis.
  • Consider the most challenging act(s) that could
    happen
  • Review historical strength-based information
    regarding strategies that have worked
  • Pre-plan interventions with people and/or
    agencies who may be involved in the safety issue
  • Develop a protocol of who will be notified, in
    what time frame, including responsibilities and
    communication procedures
  • Establish a blame free time in which team
    members cannot fault each other for the crisis
  • Develop a process for evaluating the crisis
    response plans use within two weeks of the event.

30
Creating Crisis Response Plans Brainstorming
  • Consider the most challenging situations that
    have occurred or may occur distinguish between
    safety/crisis issues Plan of Care issues
  • Consider strategies/interventions that have
    worked in the past
  • Consider strengths of the child, family, team
    community brainstorm possible interventions

31
Creating Crisis Response Plans Developing the
Document
  • Include date created/updated
  • Begin with brief summary of important information
  • Consider results of brainstorming order
    interventions from least to most restrictive
  • Describe the intervention
  • Clarify who is responsible for what
  • Include backups
  • Dont stop at contact law enforcement, or call
    911. Develop options through these
    interventions with agency representatives

32
Creating Crisis Response Plans The Final Details
  • Discuss a process for evaluation of the Crisis
    Response Plan
  • Get signatures from individuals and agencies
    involved in the plans development
  • Discuss distribution and release of information

33
Sample School Crisis Response Plan
  • Past behaviors/situations considered crises or
    safety concerns Usually starts with refusal to
    comply with a request or to follow routine. Can
    escalate quickly to swearing, physical
    aggressiveness, destruction of property, and
    self-harm.
  • Mental Health Diagnoses ADD Intermittent
    Explosive Disorder Mild Developmental Disability
  • Rx (include name of doctor prescribing Lithobid,
    Trazodone, Trileptol, Risperdal Dr. Bob
  •  
  • Progressive list of interventions to respond to a
    Crisis/Safety situation
  •   If at any time, Billys behavior escalates to
    the point of harming himself, someone else, or
    destroying property, go directly to Step 5
  •  Praise Billy for following requests and
    routines. Some reinforcers include verbal
    praise, tokens, star for his chart, physical
    contact (e.g. hugs), and edible treats (cottage
    cheese, cereal, cookies, etc.)
  • If Billy refuses to comply with a request or
    routine, he usually physically distances himself
    from others (e.g. pushing his chair away from the
    table, crossing his arms and putting his head
    down). Allow Billy a 5-minute refusal. Billy
    knows that he has this five minutes to regroup
    and come back to join the class.
  • If Billys behavior escalates to the point of
    swearing or physical aggressiveness, he will be
    escorted to the time out room and given up to 30
    minutes to deescalate and rejoin the class.

34
  • 4. If Billy is not able to re-join the
    class after 30 minutes, he will be removed from
    school.
  • The following individuals can be contacted in
    this situation
  •          Jo
    Susan Smith (parents) 555-2503
  •          Don
    Jones (family advocate) 555-5120
  •          Marsha
    Miller (mentor) 555-5026
  • If the above individuals are not available, and
    Billy has not committed a crime (e.g. property
    destruction, harming someone) he will receive 11
    supervision by school staff (if possible) until
    someone can be reached to come get Billy. If 11
    supervision is not possible, move on to step 5
  • 5. Contact law enforcement (555-3321) to
    transport Billy to the Work Release Center.
  • Once there, the officer should contact DHS intake
    (555-3303). A social worker or on-call staff
    will come over as soon as possible. Note to
    responding officer Billy has a cognitive
    disability it is important to be firm with him,
    but to also use very simplistic language dont
    try and reason with him
  • Social worker/on-call staff If Billy is o.k. to
    go home, try and contact one of the individuals
    listed under 4A to come and get Billy. If no one
    can be reached by 330 OR if it is determined
    that Billy should not go home, the following
    options should be considered
  •          Village of Learning daycare center
    (to be used only for a few hours and if Billy is
    not a danger to
  • self or others)
  •          County receiving home (see Child
    Family Unit supervisor - Beth)
  • Hospitalization at St. Elizabeths (if
    hospitalization is needed)
  • This Safety Plan has been distributed to DHS
    Crisis On-Call Unit and Child Family Unit,
    Sheriffs Department, Police Department,
    Riverview School, Jo Susan Smith, Integrated
    Services team members

35
Example Crisis Response Plan for an Adult
  • Begin this plan when Betty is at risk
    of drinking. Betty should be considered at
    risk when she and her husband Tom are arguing
    Betty hasnt taken her medications as prescribed
    or Betty shows signs of being depressed.
  • Important Information Betty is a
    diabetic
  • The following steps are to be used
    progressively
  • If the issue is regarding medication or signs of
    depression, Tom will talk with Betty and try to
    resolve the issue with her. If Tom is at work,
    Betty can contact him there (555-6789).
  • Bettys mother, Patti, will call every evening at
    500 (555-4567) as a check-in. If there is no
    answer, Patti will go to the home. If Patti
    isnt able to do this, Bettys friend Karen
    should be contacted (555-1234) to make the visit.
  • 3. Important If Betty is found to be in need of
    immediate medication attention or is suicidal, go
    immediately to step 4.
  • If Betty is not in need of emergency care,
    but would like additional support, the county
    24-hour crisis line may be called
    (1-800-123-4567).
  • 4. If Betty is suicidal call the Sheriffs
    Department (555-5555) tell them Betty has a
    safety plan on file. The Department of Human
    Services will be contacted and will assess
    Bettys situation. (Note Susie Que is Bettys
    therapist and Dr. Bob is her psychiatrist)
  • If Betty does not need to be hospitalized, some
    options include
  • Going home with her husband, Tom (555-2222)
  • Staying with her mother Patti for a day or
    overnight (555-4567)
  • Staying with her friend Karen for a day or
    overnight (555-1234)
  • If Betty needs to be hospitalized, her preference
    is Mercy Medical Center (555-7777). She has been
    hospitalized here in the past, most recently on
    12/20/02.
  • If Betty is in need of medical attention Call
    911. Betty prefers to be treated at Berlin
    Hospital (555-0911). Betty is a client at Berlin
    Hospital Dr. Bill is her family doctor.
About PowerShow.com