Clinical Behavioral Retreat Proposed Action Items

  1. Ways to support families dealing with challenging behaviors by preventing problems:
  • Coordinate services by connecting families with clinicians proactively before problems arise.
  • Develop work groups between DDS and school systems to improve public relations
  • Simplifythe process for obtaining eligibility for intellectual disability(already in progress)
  1. Better supporting families during behavioral challenges by responding through crisis management:
  • Encourage that a risk assessment component is placed into behavior support plans
  • Educate first responders about the effects of intellectual disability and autism spectrum disorders on behaviors of concern
  • Simplify behavior support plans to make them easier for families to understand
  • Develop a debriefing protocol for post-crisis use, as learning tool to reduce future incidents
  • Assign coaches and mentors to families during the peak periods in crises
  1. Best practices to provide positive behavioral support plans to families:
  • Provide competency training for families to better understand the basics of behavior plans
  • Improve standards and vetting practices for DDS qualified providers(already in progress)
  • Develop an interview process and questionnaire for the qualifying of providers(already in progress)
  • For quality assurance, offer families and case managers a means of rating the behavioral services they have received (e.g., surveys)
  • Guide more generalist providers to do work with individuals with intellectually disability and autism spectrum disorders
  • Consistency between regions in what they are doing and supplying to families as well as what families are being told. Policies should be designed statewide rather than from Region to Region.
  • Follow through for families from the ages of 3-18.
  1. Ways to safeguard quality assurances:
  • Consumers of services should determine the quality indicators for the services they need/use
  • Offer families education on a variety of topics so they can be better self-advocates
  • The case manager, the team, the agency to establish contact with psychiatric providers before or when they write the first prescription.
  • Strongly encourage support team members, especially families, toask questions of those prescribing medications regarding the reasons why a person should/should not, take medication.
  • Educating the psychiatric providers about our new direction, comprehensive approach, etc.
  • To coordinate care between agencies and to make records more accessible from agency to agency.
  • Encourage comprehensive services where behavioral supports, individual counseling, and family therapy are used in conjunction with or replace psychotropic medications
  • Develop ongoing credentialing for qualified providers
  • Require qualified providers to have oversight from supervisors outside of DDS
  • Provide a consumer corner and blog to the DDS website, as a vehicle to educate families and link families together for social support
  • Develop short videos (e.g., 10 to 15 minutes) and brochures for parents and families to learn about services, positive behavioral supports, etc.
  • Reach out to adult education centers, community colleges, and recreation centers in each town or region to provide education and supports to those with intellectual disability
  1. Coordinating care by holistically understanding the person-served:
  • Ask providers to give us information on the types of interventions they are using
  • Educate qualified providers about the importance of a functional behavioral assessment. More specifically, help them to understand that an FBA should be wide in scope to include medical, cognitive, psychological, and social issues, beyond just a data-driven approach.
  • Develop a flow chart of the positive behavioral support approach (e.g., fromthe referral process to developing a plan and then providing consultations) and tie it to the use of the template
  • Encourage aninterdisciplinary team approach to disperse the responsibilities of behavioral interventions
  • Ensure that behavioral providers establish contact and consider the significant individuals in the consumer’s life, such as siblings, parents, etc.
  1. Relationships and strengths building: Discovering opportunities to enrichen the lives individuals through positive behavioral supports:
  • Emphasize the importance of non-contingent activities (irrespective of behavior) on well-being
  • Encourage the use of community mentoring to increase a sense of independence, as well as reducing the demands/dependence on families
  • Promote the use of monthly activities calendars for individuals, agencies, and regions. Recreation staff may be helpful with this task.

Tolisano DDS 10-28-13