Structured Decision Making ® System for Adult Protective Services

Agenda System development and goals Intake assessments Safety assessment Strengths and needs assessment

The SDM ® System for Adult Protective Services

Development Six counties Dakota, Hennepin, Olmsted, Ramsey, Steele, Washington Collaborative development

Model Goals 1.Promote the safety of vulnerable adults. 2.Improve needs identification for vulnerable adults. 3.Decrease the incidence (recurrence) of self-neglect and mistreatment by others.

Benefits Improves transparency in decision making Improves consistency of decision making Verifies and directs decision making

What is the system? Strengths and Needs Safety Intake

Client-Centered Practice Engagement Research Clinical Judgment Structure

SDM ® Intake Assessment

Intake: Step 1 Identifies report types and categories of allegations. Definitions for report types create greater consistency and equity in determining which reports require a protective response. Provides specific criteria for consistent routing of reports.

Intake: Step 2 Decision trees correspond with report types. Definitions create greater consistency and equity in response time determination. Overrides allow workers to increase or decrease priority based on individual circumstances.

Intake Policy

Intake Assessment Walk-Through

N = 34 Inter-Rater Reliability

Questions?

SDM ® Safety Assessment

Are factors present that result in current danger of harm to the vulnerable adult (VA)? If so, can immediate interventions be recommended* to mitigate the danger? If not, are emergency interventions required to ensure safety?

SDM ® Safety Assessment Current Danger Factors + Immediate Safety Interventions = Safety Decision

SDM ® Safety Assessment If any current danger factors are marked “yes” for either the vulnerable adult or the caregiver, consider interventions. If all current danger factors are marked “no” for both the vulnerable adult and the caregiver, consider the vulnerable adult safe.

Policy

Safety Assessment Walk-Through

Inter-Rater Reliability

Safety Plan Documentation is required for all cases in which the safety assessment results in a decision of conditionally safe or unsafe. Safety planning for the vulnerable adult should be based on the results of the safety assessment.

Questions?

SDM ® Strengths and Needs Assessment/ Reassessment

Strengths and Needs Helps all workers consistently consider each strength and need of the client (and the caregiver, if applicable) in an objective format. A service-planning reference for workers and supervisors.

Strengths and Needs Mechanism for monitoring service referrals made to address identified problems. Assesses changes in client functioning when followed by periodic reassessments.

Policy

Strengths and Needs Assessment Walk-Through

Inter-Rater Reliability N = 35

Questions?

Review of Key Points SDM assessments are decision-support instruments, not forms. The SDM model guides decisions; workers make decisions. Definitions are important.

Questions?