RESOLVE PROGRAM PARTIAL HOSPITALIZATION DECEMBER 9 by yaofenjin

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									WELCOME
    Colonial Intermediate
           Unit 20

•   Jan Cunningham, Psy. D.
•   Ron Prator, Ph.D.
•   Jean Parkansky, M. ED.
•   Rachel Butler-Pardi, LSW


May 2006
          Demographics

• Pennsylvania: 29 Intermediate Units (IU). Each
  responsible for a specific region.

• IU 20: Northampton/Monroe/Pike Counties:
   – Covering 1200 square miles


• 13 Districts / 3 Counties
   – 79,000 public and 9,000 nonpublic school students
      Intermediate Units
             » Traditional Services


•   Curriculum Development
•   Educational Planning
•   Instructional Materials/Trainings
•   Continuing Education
•   Pupil Personnel Services (O.T. P.T.,
    Speech, Vision)
         – Intermediate Units

              (Early 1990’s)

• State changes in philosophy regarding Center-
  Based Educational Programs (IU 20 operated
  Shull School for Children with Behavioral
  Challenges: Losing certification because not a
  center-based program)
• System changes in District funding to IU’s
  (District obligation to IU’s became a matter of
  negotiation rather than a fixed percentage)
         Birth of
     Resolve Services

• Partial Hospitalization Program
       Historic Model
•   Center/Community Based
•   Treatment Oriented Exclusively
•   Lack of Outcome Data
•   Lack of Integrative Services
•   Lack of Academic Progress
•   High Turnover of staff
  Historic School-Based
         Models
• Six adults in one classroom each
  working with one child
• Multiple providers in one
  classroom/school
• Exclusive from School Community
        Resolve

• 1993
• Approx. 75-100 Adolescents
  identified (from Shull school) who
  had mental health Axis I. diagnoses
• Seven (7) school-based Partial
  Hospitalization Programs Opened
 Resolve Services
Serving Northampton / Monroe /
        Pike Counties

    Solution Focused
                                         Adherence to CASSP
        Therapy
                                             Principles

                          Partial
                       Hospitalization
                         Program




                       Collaborative
                          Model
                                   Expectations
               TREATMENT                                              EDUCATION
(Master Level Clinician) ( (Bachelor- Degreed Tech.)   (Certified Sp.Ed.Teacher) (Para-professional)


- Partnership with family                              - Partnership with family
- “Fit”; child’s needs match the services              - Services meet the child’s needs in the
   we offer and at the appropriate level                  least restrictive environment
- Inform of rights and responsibility                  - Inform of rights and responsibility
- Comprehensive treatment plan identifying             - Comprehensive ER/IEP identifying
  strengths and needs                                    strengths and needs, behavior support plan
- Individual therapy (2 times per week)                - Individual instruction
- Group therapy (2 times per week)                     - Small group instruction
- Recognize client’s resources and                     - Recognize different learning styles
  strengths
- Therapy delivery in a creative, enthu-               - Curriculum delivery in a creative, multi-
  siastic, meaningful way                              modal fashion
- Successes reinforced                                 - Positive behavioral supports
- County MH/MR, MCO, and school                        - Ongoing involvement from school district
  district are all updated
- Measurable outcomes                                  - Measurable outcomes
- Supports in place to foster success                  - Supports in place to foster success
  (i.e., clinical supervision, administrative            (i.e., OT, PT, Speech, Job Coach)
   supervision, clinical psychiatrist, drug &
   alcohol specialist)
- Discharge planning that is detailed and              - Transition planning that is detailed and
  comprehensive                                          comprehensive
     CIU20 School-Based
    Partial Hospitalization
            Program
• School-based
• Education administered concurrently with treatment
• Integrative
• Quick initiation of service
• Fully integrated into school community
• Outcome measures designed/utilized
• Transition program
• Family, student, treatment staff, and school are equal
  partners
• Academic improvement sustained
• Minimal staff turnover
  Current Program
• 20 sites (Elementary, Middle, High School)
• Remote sites
• Special Education/Regular
  Education Population

  – Served by CIU 20 PHP: 80% Special
    Education students & 20% regular
    education students
            Partial Hospital
               Services
•   Individual Therapy (minimum twice weekly)
•   Group Therapy (minimum twice weekly)
•   Family therapy/support
•   Case Management
•   Psychiatric Care (24/7)
•   Therapeutic Activities
•   20-day treatment team meetings
•   Individualized Educational Services
•   Psychological Services
•   Neurological Services
•   Utilization Review
•   Summer Hospitalization Program
•   Full Integration of Services
•   Supervision/Administrative and Clinical at all Levels
Diagnostic Categories
               6%

          8%              19%


    7%                                Disruptive
                                      ADHD
                                      Bipolar
                                      Depression

                                22%   Thought
         25%                          Anxiety
                                      Autistic

                    13%
       Achievement
                      Achievement


8

     7.3

7
              6.5
                                             6.2
6

                                    5.3

5



4



3



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1



0
    Grade   Reading                 Math   Spelling
                                 0
                                     10
                                          20
                                               30
                                                    40
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                                                              60
                                                                   70
                                                                                     80
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             re
                                                                                                             Diagnostic Scales




               ss
                  i      on


                   In
                     te
                       rn
                         al


               E
                   xt
                      er
                        na
                          l
                                                                                                                                 Diagnostic Scales




                      To
                        ta
                          l
                                                                                      Referred
                                                                                                 Normative


                                                                        CIU 20 PHP
Competency Scales
                           Competency Scales

                                                       Normative
                                                       Referred
                                                       CIU 20 PHP

60




50




40




30




20




10




0
     Activities   Social              School   Total
   MEASURING OUTCOMES
• Purpose
  Assess Quality
  Accountability
  Describe Process
  Plan for individuals
  Plan programmatically
  Feedback to staff, morale
    Achievement
    Comparisons
                          Achievement Comparisons

                                                                             Pre
                                                                             Post

8

    7.3

7                         6.9
                  6.5
                                                              6.2      6.2
6                                                       5.7
                                           5.3

5



4



3



2



1



0
          Grade     Reading                      Math           Spelling
Affective Disorders
                           Affective Disorders                   Pre
                                                                 Post
64



63



62



61



60



59



58



57



56



55
     Depression/Anxiety   Depression/Withdrawn   Internalizing
     ADHD & Disruptive
        Disorders
              ADHD & Disruptive Disorders
                                                               Pre
                                                               Post
65


64


63


62


61


60


59


58


57


56


55
       ADHD       Oppositional Defiant      Conduct Disorder
              Parent Survey
•   “My son’s teachers deserve to get an award for the excellent job they
    do.”
•   “This class has been a god-send.”
•   “My son’s team is so wonderful! They are so helpful and willing to listen
    and include me in my son’s treatment. When I call they listen (no
    matter what) and act immediately. I am treated with the most respect
    possible. Thank you for this team, they have made a difference in our
    lives.
•   “The team goes above and beyond their duties.”
•   “Thank you for making my child stronger and more independent.”
•   “These services prevented my daughter from being in a psychiatric
    hospital. Thank you!”
•   “ My mother passed away in October. My daughter’s therapist was very
    aware of the close relationship between the two. Her therapy team was
    there immediately for her and offered support whenever she needed
    it. This truly made the death easier for her. Thank you all. “
            Resolve
             2006
     Continuum of Services
•   Partial Hospitalization
•   Truancy Prevention
•   After School Program
•   Provider 50
•   Emotional Support
•   Individual Counseling
•   Alternative Education

                Currently serving 600-700 students with Mental Health needs
       Remote Sites
• IU-7: 2 Partial Hospitalization
         Programs

• Collaboration: IU-18

• Billing Services: IU-15
  Resolve West Project
• Historic Perspective: Informal
  conversations among like minded
  individuals
• Recognition of need
     Lack of cohesive services
              -especially lack of education for
         children in traditional partials
              -children absent from school for
         long periods of time
              -significant portion of students
         with mental health needs being placed
         in approved private schools out of the
         area
              -increased identification of
         students with mental health needs
            How to begin
• Initial conversations with county to
  discuss the model. Shift of thinking for
  county personnel to view IU as a provider of
  mental health services.
• Conversations with Districts to
  discuss model. Shift of thinking for school
  personnel to have mental health services provided
  in the school - Especially in their school.
               Planning
• Identify a site
  – Space
     • Treatment and time-out room
     • Enough square footage to meet DPW and PDE
       regulations for the number of students per class
  – County and state agreement
     (partner all the way)
  – Apply for licensure
  Build it and they will
           come
• Identification of Program Director
  and mental health and special
  education supervisors
  – Need a marriage of mental health and
    special education (understanding of
    integrative model)
            Nitty Gritty
• Hire appropriate personnel (including psychiatrist,
  psychologist)
• Obtain referrals
• Meet training requirements
• Develop policy and procedures
• Arrange transportation, meals, other house-keeping
• Have a plan for transition
• Set an opening date
• Set up a billing system or contract for service
                 Today…
• 2 sites   (capacity of 20 students)
  – Supervision contract/collaboration between
    both IU’s
  – Preparation to transition full supervisory
    responsibility to IU-7. They are in the
    process of obtaining an independent license
  – On-going contract with IU-7 for billing
  – Tremendous support on all levels from
    Districts and Outside provider Agencies
QUESTIONS
   Thank you

• Contact Information:

  Colonial Intermediate Unit #20
  6 Danforth Drive
  Easton, PA 18045-7899
  610-252-5550

								
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