Transcript How to Build Collaboration and Consensus

What is
Collaboration
and how to use it.
Plus Consultation
and Collateral Contact,
and how all three fit
together.
For DDAs and partner providers. Specific to Idaho
(Please speak directly with Medicaid about billing questions.)
The Sense of the Goose
In the fall when you see geese heading south for the winter
flying along in the "V" formation, you might be interested in
knowing what science has discovered about why they fly
that way. It has been learned that as each bird flaps its
wings, it creates an uplift for the bird immediately following.
By flying in a "V" formation, the whole flock adds at least
71% greater flying range than if each bird flew on its own.
People who are part of a team and share a common
direction get where they are going quicker and easier,
because they are traveling on the thrust and trust of one
another.
Whenever a goose falls out of formation, it suddenly feels the
drag and resistance of trying to go through it alone and
quickly gets back into formation to take advantage of the
power of the flock.
If we have as much sense as a goose, we will share
information and adjust or make necessary changes with
those who have the same or similar goals.
When the lead goose gets tired, s/he rotates back in the wing
and another goose takes over.
It pays to share leadership and take turns doing hard jobs.
The geese honk from behind to encourage those up front to
keep their speed.
Words of support, encouragement, and inspiration help
energize everyone, helping them to keep pace in spite of the
day-to-day pressures and fatigue.
Finally, when a goose gets sick or is wounded by a gunshot
and falls out, two geese fall out of the formation and follow the
injured one down to help and protect.
If we have the sense of a goose, we will stand by each other
when things get rough, and even when they are not.
Author Unknown (some alterations from the original.)
Collaboration is required by rule.
People often talk about collaboration.
Research tells us that it is important and
often essential for significant, lasting
progress.
But what is it?
Is it Communication???
Communication usually falls within one of
four basic levels.
1.
2.
3.
4.
Damage Control
Education
Input/Feedback
Collaboration
Problems usually arise when:
 More communication was needed
than used, and
 When some of those involved say
they are doing one level and in
reality are doing another.
#1 Damage Control:
This often happens when:
 Someone assumes that less communication
and/or collaboration was needed than really
was…
or just thought they could get away with
less.
 There are critical errors, accidents,
unnecessary barriers, or wasted
time/money.
 This also occurs when the
individual/organization says/thinks it is doing
one level and is actually doing another.
[This is not
collaboration and is usually a bad thing]
#2 Education:
 This level of communication is often used by
organizations and agencies.
 Information is shared:
 With a release when confidential
 As public awareness or marketing, through
outreach and advertising, and
 whatever motivation through whatever
means anyone can come up with [This isn’t collaboration
either]
#3 Input/Feedback:
This is not only helpful but often required by
rule.
This may take place through:
 surveys,
 assessments,
 discussion groups.
 etc

[This isn’t collaboration]
#4 Collaboration:
Sometimes it is important to not only share and collect
information, but also to share goals, decisions,
ownership, plans, responsibility, and accountability.
Collaboration allows for and encourages all of this.
 It assures that everyone working with the child is “on
the same page.”
 It allows for one plan to support another for the
greater benefit of the child and family.
 In some situations it even allows for one umbrella plan
with additional supporting plans. It discovers
solutions and expands capacity for the child and
family. [This could be it]
Levels of Authority
 When there are assignments, it is imperative that
everyone understand their level of authority and
responsibility, to include who is responsible for
what, when?
 This is part of good, honest, effective
communication and collaboration.
So what in the world does this have to do with our
topic????

http://www.collaboration.me.uk/LEVELS_OF_AUTHORITY.php
One size does not fit all.
 Collaboration comes in many shapes, sizes, and of varying
duration. It may not make sense to develop a broad in-depth
collaboration when a short term coordinated effort is all that is
needed and more efficacious.
 For example, networking/communication may be all the is
required to receive important information from a hospital
about a past stay.
 Collaboration sometimes develops in developmental stages
which may include: …
 and will be discussed with an activity.
1. Competition
 Channeled and in the right situation, can help
groups or individuals stretch themselves and
excel.
 can support and encourage creativity. For
example, competition is an important aspect of
Special Olympics; and through honest dialogue, a
conflict of opinion resulting in consensus can
create remarkable solutions.
 in order to achieve true success, there must be a
balance between competition and cooperation and
at times even collaboration.
 Competition does not need to mean that you want
the worst for someone else, just the best from
yourself.
[This is not collaboration]
2. Networking/Communication
 As information begins to be shared and
communication increases, it benefits
everyone.
 There may be more of an interest in gaining
information than sharing at this stage.
 Trust will develop as more information and
resources are shared for the benefit of all.

[This isn’t collaboration, it could be collateral contact]
3. Cooperation/Coordination
 Information sharing becomes more
formalized with structure and agreements;
(though individual interests are maintained).
 More resources are shared and duplication
is limited.
 Coordination: Formalized sharing of
resources, information, and some
common goals.

[This isn’t collaboration, it could be collateral contact, it could be consultation]
4. Coordination/Partnership
 Resources are gathered to create, discover, or
access, new resources.
 The management of resources is progressively
shared, becoming mutually beneficial, increasing
resource capacity for everyone.
 This is a more formal and structured relationship with
signed agreements, to include resource
management.
 In many good partnerships a partner is as concerned
about their partner's success as their own.

[This still isn’t collaboration; however we’re starting to get warmer, this could be a part of
both consultation and collateral contact]
5. Coalition
 Leadership & decision making is shared by
all through a direct democratic or an indirect
representative process.
 Decision making and communication are
formalized and clear.
 More resources are developed, created, and
discovered for the benefit of everyone in the
coalition.

(This stage may not be as applicable in the some settings. May be similar to a co-op.)
[This still isn’t collaboration. We are still getting warmer]
6. Collaboration
 Written goals are shared by all involved.
 All interventions are integrated & synergistic (The whole is
greater than the sum of the individual parts).
 Communication & relationships are strong & clear.
 The team shares a strong sense of purpose,
accomplishment, responsibility, & accountability.
 Strengths & resources, are shared & created &
significantly amplified through the collaborative
process.
 Collaboration: Shared vision, mission, power,
resources, & goals. [This could be it]
To build collaboration:
 Take responsibility and give credit.
(This is only one of many concepts that help to build collaboration).
 For treatment collaboration:
 Everyone providing treatment and/or care
for the child would be on the same page.
 Plans and interventions would be mutually
supportive. (This requires close and ongoing communication
and dialogue.)
 Plans would be supportive for the child and
family.
 In some situations there may be an umbrella
plan, such as the IFSP.
For example: A child who receives speech
therapy from an SLP and communication
and behavioral therapy from a
developmental therapist:
The parent, speech therapist and
developmental therapist would dialogue and
plan the interventions. The intervention
provided by the SLP would support the
needs, interests and resources of the parent
and child as well as the behavioral plan from
the developmental therapist. etc.
To Build Collaboration
 Communicate: "Real listening shows
respect. It creates trust. As we listen, we not
only gain understanding, we also create the
environment to be understood. And when
both people understand both perspectives,
instead of being on opposite sides of the
table looking across at each other, we find
ourselves on the same side looking at
solutions together". Stephen R. Covey
Consultation
Families are a lot like a hanging mobile, when one
piece is pulled to a new position as soon as the
pull stops, family dynamics and equilibrium return
the individual back into “balance with the family.”
Overwhelming research demonstrates that the best
intervention and often the only lasting intervention
must involve the family and sometimes can not
occur effectively without the family learning new
ways to interact and at times even act as cotherapists .
Comparison of Collateral Contact
and IBI Consultation
724. COLLATERAL CONTACT.
 Collateral contact is consultation with or
treatment direction given to a person with a
primary relationship to a participant for the
purpose of assisting the participant to live in
the community. Collateral contact must: ( )

01. Conducted by Agency
Professionals. Be conducted by agency
professionals qualified to deliver services
and be necessary to gather and exchange
information with individuals having a primary
relationship to the participant. ()
724. COLLATERAL CONTACT.
 02.
Face to Face or by Telephone. Be
conducted either face-to-face or by
telephone when telephone contact is the
most expeditious and effective way to
exchange information. Collateral contact
does not include general staff training,
general staffings, regularly scheduled
parent-teacher conferences, general
parent education, or treatment team
meetings, even when the parent is
present. ( )
724.
COLLATERAL CONTACT.
 03.
On the Plan of Service. Have a
goal and objective stated on the plan of
service that identifies the purpose and
outcome of the service and is conducted
only with individuals specifically identified on
the plan of service. Program Implementation
Plans are not required for collateral contact
objectives. ( )
804.
IBI CONSULTATION.
 Professionals may provide IBI consultation to
parents and other family members, professionals,
paraprofessionals, school personnel, child care
providers, or other caregivers who provide therapy
or care for an IBI eligible child in other disciplines
to assure successful integration and transition
from IBI to other therapies, services, or types of
care. IBI consultation objectives and methods of
measurement must be developed in collaboration
with the person receiving IBI consultation.
804.

IBI CONSULTATION.
01. Service Delivery Qualification. IBI
consultation must be delivered by an IBI
professional who meets the requirements in
Section 420 of these rules. ( )

02. Measurable Progress. IBI
consultation must result in measurable
improvement in the child's behavior. It is not
intended to be used for educational
purposes only. ( )
804.

IBI CONSULTATION.
03. Evidence of Progress. Persons who
receive IBI consultation must meet with the IBI
professional, agree to follow an IBI Implementation
Plan, and provide evidence of progress. ( )

04. Individualized. IBI consultation may not
be reimbursed when it is delivered to a group of
parents. IBI consultation is specific to the unique
circumstances of each child.
 Collateral Contact is delivered by a variety
of professionals to people who have primary
relationships with a child eligible for DDA
services.
 IBI Consultation is delivered only by IBI
Professionals to children eligible for
Intensive Behavioral Intervention (IBI).
 Some of the similarities and differences
between the two services are described as
follows:
Similarities





Collateral Contact and IBI Consultation:
Promote generalization and coordination within the
child’s natural environments.
Are delivered to persons with a primary
relationship to the child.
Require a goal and objective authorized in an
Individualized Program Plan.
Are specific to each child and may not be
reimbursed for group training.
Are not included in the 22 hour/week limitation
under the Medicaid state plan that includes
Developmental Therapy, IBI, and other therapies
provided by the DDA.
Differences
 Measurable
improvement is not
required for
Collateral Contact.
IBI Consultation
must result in
measurable
improvement in a
child’s skills and
positive behaviors
for continued
authorization.
Differences
 Collateral Contact
may be provided by
any DDA
professional.
IBI Consultation may
only be provided by
an IBI Professional.
Differences
 The professional
delivering Collateral
Contact is not
responsible to assure
that the person
receiving collateral
information will carry
out an Implementation
Plan and collect data.
The IBI Professional is
responsible to
develop an IBI
Implementation Plan that
the person receiving IBI
Consultation can carry out,
develop a data collection
method for that person, and
assure that the person
receiving IBI Consultation
knows how to carry out the
Implementation Plan and
collect data.
Differences
 The person
receiving collateral
contact doesn’t have
to collect data for
the professional.
The person
receiving IBI
Consultation must
collect data and
report back to the
IBI Professional on
a regular basis
about the child’s
progress.
Differences
 Collateral Contact
doesn’t require an
Implementation
Plan.
IBI Consultation
requires an
Implementation
Plan.
♪
 Collateral contact under developmental
therapy can serve a similar function and
provide a similar benefit as consultation
under IBI.
So what does this mean?
 How can we use collateral to improve
outcomes for children and families?
 How can we use consultation to improve
outcomes for children and families?
 How can we use collaboration to improve
outcomes for children and families?
 What are you going to do differently?
RECAP
The 2 C’s of Success
 Consultation Family members are the most
important members of the therapy team.
 Intensive Behavioral Intervention (IBI) is a shortterm program (36 months) designed to develop
positive behaviors through direct, individualized
intervention and through teaching parents (and
other caregivers) hands-on skills to successfully
manage the child’s problem behaviors. IBI
Consultation is provided by an IBI Professional to
teach caregivers (e.g., parents, daycare/school
personnel) how to implement IBI techniques.
 By learning and utilizing therapeutic techniques,
parents gain critical hands-on skills in managing
difficult behaviors that may not respond to typical
parenting methods. These skills will carry
forward, empowering families to manage
behaviors long after the child is finished with any
particular services.
 When all caregivers use the same techniques, the
consistency developed will ensure that problem
behaviors will be reacted to in a similar manner
across all settings - results will be much more
successful.
 Permanent changes in a child’s behavior
requires repetition and positive
reinforcement - isolated treatment by a
therapist is much less likely to make a
significant, long lasting difference.
 Collaboration Getting everyone on the
same page, with individual input, and in
full support of the plan.
 Through collaboration, we ensure the same
methods are being used across settings.
For example, if a certain communication
method (e.g., PECS, signs) is being taught
and used in one setting, by collaborating we
make sure all settings use this same
system.
 Collaboration refers to therapists working
with parents and other therapists, teachers
or caregivers to ensure consistent therapy
goals and methods. The consistency
gained through collaboration will reduce
confusion and frustration for the child.
 Consultation and Collaboration can make a
tremendous difference in your life and the
life of your child. Consistency between
people, environments and methods will help
to successfully generalize and maintain
improvement in behavior, promote
integration, and transition from one
intervention to other therapies, services, or
types of care.
 Ensure the 2 C’s are in place.
 Remember to use collateral in lieu of
consultation when needed.
Now that we understand
Collaboration better…
How do you collaborate
with parents?
Who should be involved in the
collaboration regarding a child’s
treatment and/or intervention?
Given the group of people just mentioned:
What would this collaboration look like?
How could you help assure it happens?
What difference might it make?
How do we document
accurately?
Any more questions?