Transcript FAMILIES, EDUCATION & TREATMENT

FAMILIES, EDUCATION &
TREATMENT
STUDENT’S BRIDGE TO SUCCESS
May 5, 2006
Presenters
Gwyn Devendorf, Director of Special Education,
Wallenpaupack Area School District
AnnaBeth Fish, Student
MaryAnn Fish, Parent
Gail Learn, Director, Child & Adolescent Services,
Tri-County Human Services Center
Presenters (cont.)
Marnell Fortuner, Teacher, R.D. Wilson Elementary
School SBPH Program
James Martin, Deputy Administrator, LackawannaSusquehanna Counties MH/MR Office
Denise Stoneroad, Coordinator, Child & Adolescent
Partial Hospitalization Programs
Mary Jane Yevics, Family Advocate for The
Advocacy Alliance.
PRESENTATION OUTLINE

INTRODUCTION OF PRESENTERS & OUTLINE

A PARTNERSHIP FOR SCHOOL BASED PARTIAL
HOSPITALIZATION

PARENT’S & STUDENT’S VOICES
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HISTORY & DEVELOPMENT OF SBPHP
-MH & EDUCATION PERSPECTIVE
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PROGRAM MODEL & OPERATION

CLINICAL & EDUCATIONAL COMPONENTS
OUTLINE CONTINUED

KEYS TO SUCCESS

WHAT WE HAVE LEARNED
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WHAT WE WOULD CHANGE
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QUESTIONS FOR THE PANEL
School Based Partial Hospitalization
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A Day Treatment Program combining mental
health treatment and education.
Less intense and acute than an inpatient
psychiatric hospital or MH residential
treatment facility.
More intensive than outpatient mental health
treatment
PARTNERS IN THE
COLLABORATION
L-S & W COUNTIES
MH OFFICES
N.E.I.U. #19
DPW & PDE
LOCAL
TRI-COUNTY
SCHOOL DISTRICTS
HUMAN SERVICES
PARENTS, STUDENTS
& ADVOCACY GROUPS
Parent & Student Voices
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What were the strengths of the SBPH
Program?
Which components benefited you or your
child/adolescent most?
Sharing thoughts and experiences…
Family, Education and Treatment:
Student’s Bridge to Success
May 5, 2006
2006 Pennsylvania School-Based
Behavioral Health Conference
Background / Location
Background/ Population
County
Population
(2000
Census)
Lackawanna 213,295
2413
MH
Served
(FY 200405)
11,132
Susquehanna 42,237
164
1,690
Wayne
Total
233
2,810
2,351
15,173
47,722
303,254
MR
Served
(FY
2004-05)
MH Total Served
Fiscal Year 2004-05
Children
and Youth
Lackawanna 3,298
(29.8%)
Susquehanna 587
(34.7%)
Wayne
753
(68.5%)
Total
4,638
(30.6%)
Joinder
Adult
Aged
6,799
(61.5%)
963
(57%)
140
(12.8%)
9,155
(60.3%)
960
(8.7%)
140
(8.3%)
205
(18.7%)
1,380
(9.1%)
MR Total Served
Fiscal Year 2004-05
Children
and Youth
Lackawanna 1,279
(53%)
Susquehanna 61
(37.2%)
Wayne
130
(55.8%)
Total
1,470
(52.3%)
Joinder
Adult
Aged
997
(41.3%)
83
(50.6%)
90
(38.6%)
1,170
(41.6%)
137
(5.7%)
20
(12.2%)
13
(5.6%)
170
(6.1%)
Service Delivery System/ Structure
Service Delivery System/
Structure
• Lackawanna-Susquehanna County
Mental Health/ Mental Retardation
Program Administrative Office
• Policy Development
• Contract Management
• Planning and Development
Service Delivery System/
Structure
• Service Delivery
• Contracted Services
• 22 Providers Delivering Mental
Health Services
Service Delivery System/
Structure
• Service Delivery
• Mental Health Contracted Services include:
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Intensive Case management
Partial Hospitalization
Outpatient Treatment
Inpatient Treatment
Behavioral Health Rehabilitation Services
Emergency Services
Crisis Intervention
Family Based Services Resource Coordination
Resource Coordination
Vocational Services
Partial Hospitalization Services
within the Joinder Program
• Provider System
• Four (4) Providers deliver a range of
Partial Hospitalization Services:
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Center Based Programs
School Based Programs
After School Programs
Acute
Early Childhood
Current Utilization Statistics
• 413 Child and Adolescent Partial
Hospitalization Program Slots within the
Joinder Program
• Average Length of Stay is 9-16 Months
• Average Daily Attendance is 405 students
• 887 Unduplicated children and Adolescents
were served in Fiscal Year 2004-2005
throughout the Joinder Program
School Based Partial Hospitalization
Program Development
• Lackawanna/ Susquehanna/Wayne Counties
had three school Based Partial
Hospitalization Programs in existence prior
to 1993
• Elk Lake- 5-12 years old
• Wallenpaupack- 10-14 Years old
• Western Wayne 5-12 Years old
School Based Partial Hospitalization
Program Expansion in 1993
• Department of Education Request:
• Eliminate Center Based Option for 57
Adolescents
• Transition the Center Based Program to a
School Based Program within local School
Districts
Creation of The Partnership
• Meeting was held with:
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Department of Education
Bureau of Special Education
Intermediate Unit #19
Local School Superintendents
Local Mental Health System
Creation of The Partnership
• Partnership’s Charge:
• Create School Based Options for 57
Adolescents within a nine (9) month period
of time- The next School Year
Reasons for moving program from
Center-Based to School-Based
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Difficulty of re-entering students from center to
home school
Students not able to mainstream, integrate in
regular education
Students not able to participate in extracurricular, co-curricular activities
Center far from student’s home – making it
difficult for family and LEA involvement
Educational Components
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Special Education Teacher and Teacher Assistant
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Emotional Support Program with related services
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Individual Education Programs
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Access to general education curriculum
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Access to special area classes, clubs, activities, extra and cocurricular activities and sports
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Communication and collaboration among all staff
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Administrative support and active involvement - willingness to be
flexible
Community Needs …(Educational
perspective)
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Space for Classroom and Therapy rooms
Understanding of therapeutic elements of
program
Respect for each discipline
Willingness by administrators to adjust
rules
Acceptance of students from other
districts as your own
PROGRAM MODEL TODAY
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SBPH in the Continuum of Care
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Who does it serve?

Where are the programs located?
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How is the program funded?
TRI-COUNTY HUMAN SERVICES
CONTINUUM OF CARE FOR
CHILDREN & ADOLESCENTS
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Student Assistance Programs
School Outreach Programs
Community & School Based Outpatient
Sites
Acute & After School Partial Hospitalization
Programs
Continuum of Care
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Summer Partial Hospitalization Programs
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Family Based In-Home Services
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Intensive Case Management & Resource Coordination
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BHRS & Autism Programs
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Wilderness Adventure
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Center Based PHP
April,2006
Ages of Students Currently in SBPH
Total = 101 Students
18
16
16
14
13
12
12
10
10
9
10
8
8
6
4
2
6
5
2
2
6
7
4
4
0
0
5
8
9
10
11
12
13
14
15
16
17
18
April, 2006
Sex of Students
Female
31%
Male
69%
Axis I Diagnosis
2004-2005
14
Behavior Disorders
2
Adjustment Disorders
17
Attention Deficit Disorders
Discharge
Admit
3
PDD
6
Anxiety Disorders
18
Mood Disorders
0
5
10
15
20
Locations of Host Schools
9 School Sites
Elk Lake
Mountain
View
Forest City
R.D. Wilson
Western Wayne
High School
Carbondale
Valley View
Mid Valley
Wallenpaupack
Home School District At Admission
2004-2005
Other
North Pocono
Mid Valley
Lakeland
Scranton
Valley View
Forest City
Susquehanna
Montrose
Carbondale
Elk Lake
Blue Ridge
Wayne Highlands
Wallenpaupack
Western Wayne
17 School Districts utilized School Based PHP
Educational Status at Admission
2004-2005
Other
3%
Res. Tx.
3%
Regular Ed.
41%
Home Bound
6%
Learn. Sup.
14%
Center Based
Emot. Sup.
8%
Sch. Based
Emot. Sup.
25%
EDUCATIONAL STATUS AT
DISCHARGE 2004-2005
School Based
Emot. Sup..
26%
Regular Ed.
13%
Other
10%
Learning
Support
13%
Home Bound
2%
RTF
Center Based
Quit School
10%
PHP
2%
14%
Graduated
10%
Mainstreaming & Inclusion
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Data Collection since 1992
1992-1993: 100% Mainstreamed in Specials
(Art, Music, Physical Education, etc.) *
1992-1993: 80% mainstreamed in at least one
academic subject*
2005-2006: 95% mainstreamed in Specials*
2005-2006: 78 % mainstreamed in at least one
acaemic subject*
*After completion of diagnostic period
Length of Stay
2004-2005
31+ months
15%
0-6 months
53%
20-30 months
9%
13-19 months
7%
7-12 months
16%
*Discharged Students Only
Most Common
Reasons For Referral

Behavior Issues at school and at home
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Impulsivity and Attention related issues
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Depression, Anxiety and other mental health
issues
School Refusal and Truancy
Reason For Discharge
2004-2005
Other
10%
Improve/Grad.
49%
Juvenile
Delinquency
2%
Foster Care
6%
MHRTF
6%
Withdrew
6%
Deterioration
21%
Funding for the SBPHP
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Collaborative approach = collaborative
funding.
Shared costs
MH Treatment funded by Medical
Assistance, third party insurance and
County MH Funding
Education Costs are paid by home school
districts
PROGRAM MODEL
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Therapeutic Milieu
Special Education
Psycho-Education
MH Treatment
Therapeutic Classroom
Crisis Prevention & Intervention
Integration & Mainstreaming
Demographics of Programs
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Age/Grade Levels
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School Districts
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Number of Students per Program
Physical Set-Up
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Educational Component
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Clinical Component
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Staff Complement
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Clinical
Educational
Referral Process
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Criteria
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Medical Necessity Statement
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Orientation Procedure
Treatment Team Members
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Family Members
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Clinical Staff
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Educational Staff
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Support Systems
Clinical Components
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Individual, Group & Family Therapies
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Crisis Intervention
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Behavior Modification System
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Treatment Planning and Reviews
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Psychiatric Staffing
Behavior Management System
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Homework
Morning Routine
Reading
Social Studies
Lunch
Recess
Mathematics
Group Therapy
TOTAL
6 points
4 points
6 points
4 points
4 points
4 points
6 points
6 points
40 points
Behavior Management System
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Level 3: 36-40 points
*full privileges
*full recess
*choice of milk at lunch
*walk independently to activities/restroom
Level 2: 29-35 points
*most privileges
*full recess
*no chocolate milk
*walk with class to activities/restroom
Level 1: 0-28 points
*no privileges
*no recess
*no chocolate milk
*escorted to activities/restroom by adult
M. FORTUNER
TIME
8:30-9:00
9:00-10:30
10:3011:30
2005-2006
DAY 1
Morning
Routine:
ROOM 316
DAY 2
(breakfast,
PARTIAL PROGRAM
DAY 3
DAY 4
DAY 5
DAY 6
lunch count,
attendance,
check homework,
restroom)
Reading Reading Reading Reading Reading Reading
Math
Math
Math
Math
Math
Math
11:3012:00
Student
Lunch
Student
Lunch
Student
Lunch
Student
Lunch
Student
Lunch
Student
Lunch
12:0012:30
Recess
Recess
Recess
Recess
Recess
Recess
12:30-1:15
Social Studies/
Finish-Up Work
Social Studies/
Finish-Up Work
1:15-2:15
Group
Therapy
2:30-3:00
Dismissal
Group
Therapy
Dismissal
Social Studies/
Finish-Up Work
Social Studies/
Finish-Up Work
Group
Therapy
Group
Therapy
Dismissal
Dismissal
Social Studies/
Finish-Up Work
Group
Therapy
Dismissal
Social Studies/
Finish-Up Work
Group
Therapy
Dismissal
*Students leave at varying times for specials and mainstreaming per grade level
Discharge/Transition Procedure
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Planning Meetings
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Follow-Up Services
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Transition Session
Support Systems
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School Districts
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Children & Youth Services
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Juvenile Probation
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Other Therapeutic Programs
Key Components
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Team Approach
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Building Resiliency
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Family Involvement
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Communication
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Flexibility
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Inclusive
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Psychiatrists travel to schools
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Cost-Effectiveness
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MH Staff in Schools
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Education AND Treatment
Focus on Consumer
Satisfaction & Outcomes
Advocacy Perspective on School
Based MH Services
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Trends of Contacts regarding Family Contacts –
Issues of Reintegration & Academic Catch-up
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Consumer/Family Satisfaction Team Data
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Advocacy Partnership W/Families & Providers
Advocacy Perspective
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School Based PH as a step up or step down
provides families w/a continuum of care.
Continuing the “Best CASSP Practice” of Least
Intrusive/Least Restrictive – Community Based
Report from the Action Alliance
Tri-County Human Services Consumer
Satisfaction Tool & Results
4th Quarter 2005, results from 47 surveys were:
- 92% gave positive scores for “Rate the
care you received”
- 70% gave positive scores for “Would
recommend to family and friends.”
- Some other key drivers included: staff
listening closely, feeling safe during treatment,
and being treated with courtesy and respect.
Consumer Satisfaction
Demographics
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55 % were completed by the patient
11% were completed by the Patient & a
Staff person,
34% were completed by Family Member &
patient
What things work?
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Ability to mainstream but still have access to
primary therapist (in the same building) while
adjusting and knowing “ safety net is there and
make transitioning easier”.
Various extracurricular activities: sports cheerleading , music, art club, etc.
Access to public school advantages; quality of
supplies, books, learning materials, etc. and
teacher’s qualifications and understanding of
inclusion.
Areas for more opportunity

Special vs. alternative vs. regular education

Enhance transition services

Increased Public Awareness about SBPHP
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Continue to Assess Outcomes
FAMILIES, EDUCATION &
TREATMENT
STUDENT’S BRIDGE TO SUCCESS
May 5, 2006