1. National PBIS Leadership Forum October 2013 Jennifer Parmalee, MPA Director of Children and Family Services Onondaga County Department of Mental Health Linda Brown Behavior Specialist OCM BOCES Patty Clark Pupil Services Director Syracuse City School District

2.  Urban district in Central New York  95,000 residents  31 schools in the SCSD 5 High Schools 6 Kindergarten – 8 th grade buildings 6 Middle Schools (6 th – 8 th ) 10 Elementary Schools  21, 000 students  85% Free and Reduced Lunch  20% Listed as Special Education

3. Braid Multi-Tier Support Systems PBIS RtI Promise Zone OnCare (SOC) Say Yes

4. TIER 3 4 Tiered Problem-Solving Framework Academic Behavioral TIER1 CORE CURRICULUM AND UNIVERSAL BEHAVIORAL EXPECTATIONS Core Instruction  Board of Education Adopted Core Curriculum  Differentiated instruction  Small guided groups  Centers/stations for skill-based practice Core Universal Interventions All settings, all students Preventive, proactive School Wide or Classroom Systems Strategic, Targeted Interventions Some students (at-risk) Group or individual delivery High efficiency/ Rapid response Function-based logic Strategic, Targeted Interventions Some students High efficiency / Rapid response Frequent progress monitoring SMALL GROUP, TARGETED INSTRUCTION TIER 2 SPECIALIZED INSTRUCTION & SERVICES INDIVIDUALIZED TARGETED INTERVENTIONS TIER 3 Intensive, Individually Designed Interventions Address individual needs of student High intensity/longer duration/daily Individualized Learning Plan (ILP) Intensive, Individually Designed Interventions Individually designed behavior plan Intense, sustainable prosocial strategies Function-based assessments Intense, durable strategies T4 8/9/2015

5. 4-Tiered System of Support Necessary Conversations (Teams) CICO SAIG Group w. individual feature Comple x FBA/BI P Universal Support SBIT-B TeamTier 4 Simp le FBA /BIP Univer sal Team WRA P Screening Team Plans SW & Class-wide supports Uses Process data; determines overall intervention effectiveness Standing team; uses problem-solving process for one youth at a time Uses Process data; determines overall intervention effectiveness Rev. 9.1.2009

6. Fidelity Measures SET 2003-2011; BoQ 2012 & 2013; Full district support 2010

7. Benchmarks for Advanced Tiers (BAT) 2012-2013 Schools SCORES By%SCORES By%

8. Onondaga Department of Mental Health  Oversight  Planning and Quality Improvement  Contract Management (95 programs) County (City) Demographics Population: 454,753 (138,560) Children ages 5-19: 95,308 (32,423) 95% of funding from State Authorities (OMH, OASAS OPWDD)

9. Syracuse Promise Zone  Mission  Match SCSD students emotional/behavioral needs with effective interventions  Keep SCSD students in class and ready to learn  Increase access to Mental Health Services in schools.  Expand Outpatient Mental Health Clinic Satellites to all schools in SCSD (10 additional sites since 2010 – 23 total)  Integrate Mental Health Clinicians into SCSD school based problem solving teams for youth at risk. (SBIT-B)  Expand access to family based care coordination services that link with the school team (current staff of 47 coordinators)  Expand access to skills based groups for youth at risk (CICO)  Establish uniform school based problem solving procedures and process to ensure right kids get right interventions at the right time.  Trained 14 schools in Screening and School Based Intervention Teams – Behavior protocols.  3 additional schools to be trained in 2013-2014

10. 5 Keys To Implementation MH Licensed Clinician in every school Clinician integrate into school team Problem Solving Teams at tier 2/3 Expand community services for youth at risk Systems to identify and intervene with youth at risk

11. Number of Schools Trained in Screening and SBIT-B

12. Data from teams 2012-2013  Screening reviewed 571 students through April 30, 2013  409 Tier 2 interventions / 218 Tier 3 Interventions / 1 Tier 4 Intervention  Clinics supported approximately 615 students in 23 schools in 2012-2013  On December 31, 2012, 60 students were receiving EBP (Trauma Focused CBT) (12 of 13 Clinicians Trained)  SBIT-B teams reviewed 71 students

13. Out of School Suspensions – PBIS Tier 1 Measure Change in Suspension Incidents Per 100 Students Compare September through April 2012 to April 2013

14. Days of Lost Instruction – PBIS Tier 1 Measure Change in Days of Lost Instruction Per 100 Students Compare September through April 2012 to April 2013

15. Out of School Suspensions – PBIS Tier 2 Measure Change in Suspension Incidents Per 100 Students Compare September through April 2012 to April 2013

16. Days of Lost Instruction – PBIS Tier 2 Measure Change in Days of Lost Instruction Per 100 Students Compare September through April 2012 to April 2013

17. Clinician Engagement (Sept – Dec 2012) Individual Psychotherapy Sessions

18. Top 5 Reasons for Referral to MH Service as of December 2012 (N=473)

19. Outpatient Mental Health Commitments  Donate 1.5 hours a week per school  Prioritize school functionality in treatment  Ability to interface with families help with who is the best person on the team to build a deeper partnership  Use of classroom data to progress monitor  Dedicated to delivering EBP (Trauma as focus..TF-CBT)  Consultation role on teams – support decision making for treatment, community mental health supports,

20. How Should Mental Health Look in Schools?  How should the mental health system integrate into the school system  What is the right amount of mental health services  What is the purpose and function of services  Who delivers the service  How are outcomes determined

21. Syracuse Benchmark of Interconnected Systems  Purpose: Assess Integration, Implementation of Mental Health within the 4 Tier Structure, Treatment Integrity  Function: Teams to gather data and use in systems and practice development/enhancement at all 4 tiers  How did we develop: BOQ, Literature review, NYS SEDL Guidelines