Missouri’s Interagency Statewide Planning Team: Improving Quality of Life for Individuals Across the Lifespan Julia LePage and Terri Rodgers Missouri DDD Rachel Freeman, University of Kansas

Purpose of Presentation Share how interagency collaboration is increasing in Missouri Describe the tiered implementation training beginning in the MO Division of Developmental Disabilities (DDD) Provide examples from organizations in Missouri who Are implementing PBS Are supporting individuals with disabilities

Challenges of Disconnected System of Service Delivery No system to inform schools that other agencies are working with the child and family Agencies and schools do not work together to develop one plan with the child and family Often agency people feel that they are asked to take sides – parents vs. the school School personnel spending 60 - 120 minutes during meetings focusing only on the problems   Challenges of current system listed above were identified by local agency partners during the 2010-2011 and 2011-2012 school years. No system to inform schools that other agencies are working with the child and family Agencies and schools do not work together to develop one plan with the child and family Often agency people feel that they are asked to take sides – parents vs the school School personnel spending 60 - 120 minutes during meetings focusing only on the problems Parents not sharing what it is like at home Schools expecting parents to do it all - telling them what to do instead of collaborating around goals, dreams for child and providing information about the child’s current status in relation to the goal, then outlining specific steps to reaching the goal “Too many words” because so many different systems are working to provide services to the child and family

Challenges of Disconnected System of Service Delivery (Continued…) Parents not sharing what it is like at home Schools expecting parents to do it all - telling them what to do instead of collaborating around goals and dreams for child “Too many words” or with “too much Jargon” because so many different systems are working to provide services to the child and family

Challenges of Disconnected System of Service Delivery (Continued…) Extra resources are required for each agency to develop similar training for staff Each agency must have their own experts or do with out expertise

Interagency Collaboration Started in 2008 Agencies included: Missouri SW-PBS Department of Elementary and Secondary Education (DESE) Office of Quality Schools Office of Special Education Missouri Schools for the Severely Disabled Department of Mental Health Division of Developmental Disabilities (DDD) Comprehensive Psychiatric Services Started in 2008 as a result of Missouri Schools for the Severely Disabled joining the SW-PBS initiative

Why Collaborate Across Systems? Share information and resources Increase effectiveness of services Establish regional interagency supports Leverage limited state funds

History of MO SW-PBS Training Format 1999 Training Format The Missouri Department of Elementary and Secondary Education (DESE) local improvement grants (LIGs) are awarded to districts to attend trainings throughout the year and during summer institutes. Staff from the University of Missouri PBS Center provides the trainers for these activities. MU SW-PBS Trainers Schools

Trainers in Regional Centers MO SW-PBS 2006 - Present 1999 2006 Training Format 22 Consultants in 9 regions, 5 Tier 2/3 consultants, state data/web consultant, state coordinator and MU PBS personnel provide training/technical assistance on standardized curriculum for multiple levels and stakeholders MU DESE MO SW-PBS Trainers in Regional Centers SW-PBS Trainers Schools Schools

Interagency Collaboration – First Steps Trainers in Regional Centers 1999 2006 2008 DMH MU DESE MO SW-PBS Trainers in Regional Centers SW-PBS Trainers CPS DDD Schools Schools

Interagency Collaboration 1999 2006 2011 DMH MU DESE MO SW-PBS Trainers in Regional Centers SW-PBS Trainers CPS DDD CommunityMental Health RO SB40 BRT Transition Coordinators Schools Schools Community Support Specialists

Missouri Interagency PBS Progress Self-assessment and action plan Interviews and focus groups Community mapping Pilot tool used to facilitate interagency planning Development of training resources in process Behavior Resource Team Members attend Summer Institute Tiered implementation of PBS Schools Organizations

Two Regional Interagency Pilots Awareness training in PBS for District team, Agencies in DD, Mental Health, Families, etc School-wide PBS tools to assist districts created and embedded within the statewide training system (this is created with the team but embedded in the SWPBS training systems) Assistance in helping regional teams create strategies that will improve PBS planning for individual students within regions Training Service Coordination Communication Etc.

Add a Statewide Problem-solving System to Encourage Interagency Use of PBS Funds Planning Team State Team District Team School Planning Team

Latest MO Mapping Example at the State Level Next Version of MO MAP

Combined Map: Home Counties With Meetings/Services Related to PBS

Mo DDD Tiered Supports Model Mo SW Model Regional Consultants - Unit of Implementation = School Building - System of Recognition (Bronze, Silver Gold) - Training designed for implementation phases - SET -ODR -Big ‘5’ School Team to design implementation of school wide Tier 1 and 2 strategies Mo DDD Tiered Supports Model Regional Behavior Resource Team Members - Unit of implementation = Agency or Family - System of Recognition of implementation -Trainings to be designed for Implementation phases -ASSET -EMT (incident reports) -Big ‘7’ Agency/Family team – design and implement systemic Universal Strategies Systems Data Like MO SWPBS, MO DDD Tiered Supports is designed around the central structures of data, systems, and practices developed across levels including-state level, regional level, local level, agency level, family level and individual level. DATA - Data will inform implementation of MO DDD Tiered Supports at all levels and phases. Similar to an office discipline referral collected in school settings, the MO DDD collects Event Management Tracker (EMT) indicator measures. These data have been organized in such a way to allow regional staff access to “ready” reports across informational indicators including: number of reportable incidents per type of incident, total number of incidents per month, number of incidents per day of the week, time of day of incidents, number of individuals producing the incidents, number of events by restraint type, number of events by location. These reports are available to be aggregated at the appropriate planning level - state, regional, agency, or individual. Regional Behavior Resource Team (BRT) personnel will support and coach providers and families to make data-based plans and decisions informing practices. Similar to the School-wide Evaluation Tool (SET) administered in school settings informing SWPBS implementation, the MO DDD is piloting the Agency Systems and Supports Evaluation Tool (ASSET), a tool to inform implementation of proactive, preventative and positive teaching systems and/or strategies currently in place at an agency level. Work towards a comparable tool to inform family planning is in progress. In addition, the MO DDD is standardizing tools and data-based processes statewide for prioritization of referrals as well as risk assessment. The availability of these data sets and reports will enable regional BRT to monitor effectiveness of services as well as implementation fidelity. Systems-Systems include the context of processes, supports, procedures, and rules that are in place supporting the implementation of a given practice or program.. Systematically, BRT staff across the state will implement training and coaching processes based on data. Behavior Resource Teams will be supported by professional behavior analysts regionally and by a state steering committee. This statewide committee will be supported and led by the MO DDD Chief Behavior Analyst (see Appendix B). Practices-MO DDD is taking a new approach to behavior problem solving by concentrating system-wide efforts on prevention and universal strategies of positive behavior supports and person centered planning in addition to specialized and intensive supports as necessary, using MO DDD’s Tiered Supports model. For example, state personnel will train standard practices of coaching and PBS implementation for BRT who will then train standard practices of coaching and PBS implementation for providers/families. These training/coaching practices at all levels will be informed by the data, systems, and tools previously described, guiding BRTs to focus families and/or agency staff on skill acquisition and person-centered, quality of life outcomes. Practices

MO Division of Developmental Disabilities (DDD) Tiered Supports Practices include: 3) Intensive individualized behavior supports-to be developed and implemented by licensed professionals. 2) Specialized strategies for common problem situations; and 1) Universal strategies-proactive, preventative, positive teaching based strategies for staff and families to Improve Quality of Life

An example of the DD Model in action The Rolla Behavior Resource Team and Tiered Supports Coaching with Future Care, a DD residential service provider