Transcript School-Based Behavioral Health (SBBH): Best Practices for

The School District of
Philadelphia
Qu i c k T i m e ™ a n d a T I F F (U n c o m p re s s e d ) d e c o m p re s s o r a re n e e d e d to s e e t h i s p i c t u re .
Building Cross-Systems Partnerships
Office of Specialized Services
Support to Regions and Schools
• OSS Regional Team Support
• Professional Development
• Professional Steering Committees
• Resource Coordination
• Emergency Response
• Targeted Problem Solving
The School District of Philadelphia:
Fast Facts
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8th Largest District in Country
268 Schools; 12 Regional Sub-Districts
180,000 Students
Percentage of Students by Race/Ethnicity: African-American- 64.8%,
Asian- 5.5%, Latino- 15.5%, Native American- .2%, Caucasian-14.0%
73% of Students Eligible for Free/Reduced Lunch
Over 125 Schools with ESOL and/or Bilingual Programs, over 10,000
Students Enrolled
Average Student-Staff Ratio for Pupil Support Service Staff:
Nurses: 1- 930; Counselors: 1- 530; Psychologists 1- 1,650
Building Resilient Schools:
A Systems Approach
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School-Wide Effective Behavior Support
Models
Social Skills/ Character Education Curricula
School-Wide Resource Coordination
Emphasis on Small Group Intervention and
Classroom Consultation
Partnering to Develop Continuum of Flexible
Behavioral Health Services that Support
Inclusion
A New Support Paradigm
Robust Infrastructure
CSAP Tiers II & III
Additional Resources
Targeted
Individual
Support
School-Based
Behavioral Health
CSAP Tier I
SchoolWide
Small Group
Intervention
Universal Prevention
School-Based CM
SWEBS &
Social
Skills
Curricula
Comprehensive Student
Assistance Process- CSAP
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CSAP is a systematic mechanism of identification,
intervention, referral assistance, and support/follow-up,
including continuing care supports
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CSAP has a school-wide component and 3 tiers of
progressive support
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Each tier has 4 phases: referral, team planning,
intervention and recommendations, and follow-up
CSAP views caregivers as essential partners
Creating a Continuum of K- 8 Support:
School-Based Case Management
Collaboration with the Department of Human Services
Consultation & Education (C & E) Specialist Program:
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Program History:
Began as Pilot in 1998 with one Provider in 3 Schools
Currently 14 Providers in 200 Schools
Program Description: Provides short- term (120 day) school-based case
management, consultation, and groups
Majority of schools serviced are elementary; some secondary
Program Funding: Program-Funded; District (30%) and DHS (70%) All
Children Eligible Regardless of Insurance
Program Outcomes
05-06 YTD
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Short Term School-Based Case Management Provided to 3,666
Students
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C&E Consultations Provided to 10,537 Children
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1,347 Children Referred for Behavioral Health Services
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1,021 Children/Families Referred for Community-Based Services
(e.g. Housing, Welfare Benefits, Recreation, Food/Emergency
Services, Church- Related Support, Kinship Care Services)
540 Children Seen in Groups(Anger Management, Grief/Loss)
Contracted Emotional Support
Classes (k-12)
Program History
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Philadelphia School District unable to staff ES classrooms in 1998
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School District contracted services in 1999 (one class)
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September of 2000 - increased to 13 classes
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2006-2007: 52 classes serviced by 2 separate agencies
Program Design
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Lead Teacher/Counselor
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Assistant Teacher/Counselor
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Behavior Manager
Program Funding
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School District of Philadelphia
Creating a K- 8 Continuum:
School-Based Behavioral Health
Collaboration with Community Behavioral Health (CBH)
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Program History: Began as Pilot in ‘02-’03 Year at 6 Schools;
Currently in 28 Schools
• Program Description: Replacement of Traditional
School-Based Wraparound/TSS; Provides Flexible Services via
11 member Team
• Program Funding: MA Funded Through Community Behavioral
Health; 60-Day Review Cycle
SBBH Team Structure (N =11)
Clinical Manager: master’s level
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clinical supervision
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case triage
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administrative oversight and liaison to school administration
Clinicians: master’s level
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behavior intervention planning with CSAP/Interagency team
Care Coordinator/ Case Manager:
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care coordination and linkages to services and supports
BH Professionals:
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behavior plan implementation
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progress monitoring
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ensures ongoing communication with school and SBBH staff
Psychiatrist:
 part-time
 supervision
 medication consultation
Creating a K- 8 Continuum:
Children Achieving through Re-Education
(CARE)
Collaboration with Community Behavioral Health (CBH)
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Program History: Began as Pilot at 1 Site in ‘02-’03 Year;
Currently in 8 Sites Serving 9 out of 12 regions
Program Description: Based on “Re-Education” Model
Services Provided in 3 Classrooms Per Site
(Adult- Student Ratio: 3-10)
Students Assigned via Regional Feeder Pattern
Full-Time to CARE Classroom (6-12 months)
Program Funding: Clinical Component Funded Through Community
Behavioral Health; Educational Component Funded through SDP
CARE
Clinical Team Structure
Clinician: master’s level; provides behavior intervention planning,
treatment and crisis intervention; linkage to family and other providers
Mental Health Workers: provide behavior plan implementation, progress
monitoring, ensures communication between school and CARE staff
Clinical Manager: master’s level; provides clinical supervision and
intervention, case triage, administrative oversight and liaison to school
administration.
Care Coordinator: provides care coordination and linkages to community
services and supports
Psychiatrist: part-time; provides supervision, medication consultation
Therapeutic Emotional Support
Classrooms (TESC)
Collaboration with Community Behavioral Health (CBH)
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Program History: Began in ‘04-’05; Currently in 14 District ES
Classrooms
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Program Description: Provides MH Therapist in Lieu of
Therapeutic Staff Support
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Program Funding: Funded via CBH
Secondary
Behavioral Health Pilot
Creating a 9-12 Continuum:
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Program History: Begun in ‘05- ‘06 Year at 20 Sites
Program Description and Funding: Provides on-site, flexible direct
services (individual, group, classroom consultation)
Works with leadership team to support CSAP Development and
Resource Coordination
3 Program Types:
• SDP Funded External Contracted Model (N= 12)
.5 FTE Agency Master’s Level Clinical SW
• SDP Funded Internal Interdisciplinary Model (N= 7)
.5 FTE SDP Master’s Level Clinical SW and Intern Team
• Hybrid “Deluxe” Model (N= 1)
.5 FTE SDP Funded Master’s Level Clinical SW and
Intern Team; Outpatient Individual/ Group Services
(CBH)
Secondary Behavioral Health
Preliminary Outcomes
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Over 800 Students Served October - March via Individual and Group
Sessions
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Impact Analysis of External Model (N=12) Using Fall Cohort
(Treatment) and Spring Cohort (Control)
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Comparison Between ‘05 Performance Indicators and ‘06
Performance Indicators
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71% Higher Rate of Increase in Absences Between Years for Control
Group
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11% Increase in Number of Suspensions Between Years for Control
Group
Benefits of Cross-Systems
Collaboration
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Services are Accessible for Families
Stigma is Reduced
Services are Integrated with Child’s Other
Natural Contexts (Ecological Approach)
Collaboration Between Systems More
Likely
The Challenges of CrossSystems Collaboration
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Increased Complexity
Philosophical and Training Differences
Family Involvement
Funding
Language Issues
Policy Issues
Space
Supplies
Lessons Learned
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Time is needed to develop the partnerships
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Relationships are mutually beneficial
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Interns provide a bridge between youth
and older employees
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Rich learning opportunities exist
at multiple levels
Contact Information
Linda Williams, Administrator
[email protected]
Amy Maisterra, Director
Behavioral Health
[email protected]
Office of Specialized Services
School District of Philadelphia
440 N. Broad Street, 2nd Floor
Philadelphia, PA 19130
(215) 400-4170