Building Systemic Competencies for Children with Autism Spectrum Disorders

1
Building Systemic Competencies for Children with
Autism Spectrum Disorders

• One Individual at a Time

2
Introduction

• Welcome
• Presenters
• Carl E Clark Executive VP
• Karen Markle VP of Childrens Services
• Overview of Session Content

3
Facts about Autism

• Range of disorders with no known cause, cure or
  one proven method of treatment
• Every 20 minutes a child is diagnosed with autism
• 1 in 150 children are diagnosed
• Adolescents with Aspergers Syndrome are 7 times
  more likely to be in trouble with the law
• Only 15 of adults with ASD are gainfully
  employed

4
Facts about Autism

• In PA, 1 in 133 children were diagnosed with
  Autism in the School Year of 2006 2007.
• Autism is the fastest-growing developmental
  disorder in the country, with a registered growth
  rate of 10 to 17 every year.
• By 2013 the estimated cost of autism on the
  nations health care industry is expected to grow
  to 200 to 400 billion dollars every year.

5
NHS Overview

• NHS provides a continuum of services to children
  and adults in the following core areas
• Behavioral Health including Addictive Disease
• Intellectual/ Developmental Disabilities
• Juvenile Justice
• Elder Care
• Autism
• Therapeutic Family Care and Permanency Planning

6
NHS Childrens Services Continuum

• Early Intervention
• BHRS
• Stepping Stones
• Family Based Mental Health
• Outpatient
• Educational Services
• Juvenile Justice Services
• TFC/ MTFC/ Permanency Services
• ICM / TCM

7
Georgie

• Georgie is a 12 year old boy with a diagnosis of
  high functioning autism. He lives with a NHS
  foster family, receives medication management
  services through an NHS outpatient center and
  attends the NHS Autism School.

8
Brad

• Brad was a 16 year old male with extensive
  Juvenile Justice involvement and a lengthy
  placement history.
• He was referred to NHS and was originally denied
  admission to our secure care program.

9
Challenges in Traditional Models of Care

• Multiple intake services
• Lack of continuity in care and targeted outcomes
• Eclectic Treatment Approaches
• Transitions
• Treatment Disruptions
• Diffused Outcomes
• Inadequate systemic expertise

10
What is Needed?

• Cohesive Communication
• Supportive Treatment Approaches (vs. Counter
  Indicated)
• Clinical Navigation
• Systemic Navigation
• Treating the Family vs. Individual Members
• Shared Outcomes
• Merge categorical program strengths

11
Organizational Restructure

• NHS recognizes the need to structure the
  company around the individualized needs of
  consumers, and the complexity of care, treatment
  and support required.
• Strengths Challenges

12
Matrix Management

• Evolution of Structure
• Service Line Identification
• Program Standard Setting
• Intensive Communication
• Effective Professional Relationships
• Operational Clarity of Roles/Responsibilities

13
New Vision

• Sought to create the hourglass the
  integration point of all service lines
• Organized around a blueprint of collective,
  cohesive team of resources
• Minimized the system limitations created in
  funding silos

14
New Vision

• Define best practice standards and evidenced
  based programs
• Identify the non-negotiables in service delivery
• Establish outcome measures for every program

15
Components of Outcome Measures
16
Managing the Information

• Performance Quality Improvement Program
• Global Monitoring Plans
• Operational Leadership Group
• Executive Staff Meeting
• Monthly Organizational Reports
• County Director Meetings
• Service Line Meetings

17
Avoiding Organizational Stagnation

• Key Role of the External Autism Advisory Council
• Ensure best practice standards and service
  delivery models
• External perspective creates a healthy tension
• Derive dynamic synergy from national expertise
• Promotes brutal honesty within NHS
  unconstrained by Organization hierarchy/norms
• Membership

18
ADVISORY BOARD MEMBERS

• Peter Gerhardt, Ph.D.
• Dan Steere
• Ira M. Fingles
• Brenda Smith Myles, Ph.D.
• Barbara L. Kornblau
• Stephen Shore
• Diane Adreon
• Dennis Debbaudt
• Kari Dunn Buron

19
Integrators of Service Delivery

• Single portal of entry into a continuum of care
• Assessments
• Grand Rounds
• Clinical Consultation
• Transition / Aftercare
• Outcomes

20
Assessments

• Individualized Standard Assessments
• Goal Attainment
• Program Review Internal / External

21
Grand Round Process
22
Transition and Aftercare Planning

• Short term and Longest term Goals
• Natural Supports
• Leaders Followers
• Adaptation skills
• Compensatory Skills
• Measuring Success
• Supporting the Supporters
• Child / Family to Adult Preparation

23
Outcomes

• Outcomes brings us back to mission of service
• Includes
• Electronic Medical Records
• Office of Integrity Program
• PQI
• Training

24
Summary

• Key Points
• Challenges and Strategies for Success
• Questions