1. 111 Alegent Health Mental Health Services Omaha NE & Council Bluffs IA

2. Alegent Health Mental Health Services Acute Geriatric 7% Acute C/A Residential Partial/School 33% Acute Adult Special Care 60% Alegent Health Mental Health Services Omaha NE & Council Bluffs IA Over 6,300 patients served in the 2008 Fiscal Year  In the first quarter of 2001 (January through March), there were 167 Seclusion/Restraint events. In the last quarter of 2007 (October through December), there were only 42 events  The Alegent Health Mental Health has experienced a 56.23% reduction in the number of Seclusion/Restraint events since presenting Trauma Informed Care to staff throughout the service line in July 2005

3. Alegent Health Mental Health Services Alegent Health Mental Health Services Restraint/Seclusion Rate by Quarter Alegent Health Mental Health Services Omaha NE & Council Bluffs IA

4. Alegent Health Mental Health Services Significant Events in Our Trauma Informed Care Transformation 1999 2003 2004 2005 2006 2007 2008 2009 R/S data collection begins and benchmark goals set Leadership Development Training (Coaching) Best Practice S/R Planning Team formed System-wide S/R Review Team formed Intermittent Explosive Child training for therapists S/R policy revised, tracking tool revised, Self- Control Strategies developed Leadership attend NTAC training on Violence/Coercion Free Environments Staff attend TIC symposium Shift to motivational, strength-based treatment planning and sensory- based strategies Motivational Interviewing training for staff Formal S/R Debriefing tool and Patient Safety forms implemented Co-sponsor consumers in Peer Support Specialist training TIC Storyboard tours Alegent, TIC theme for Gathering the Harvest Presentation to Trauma Informed Nebraska Core Measures Pilot begins TIC Statement of Philosophy distributed CPI training required for Security Ethnography Study Completed S/R CBT developed, CPI expanded, forms and score cards revised Peer Specialists integrated into direct care Expanded TIC Champion team and TIC TOC Talking Points Patient First Surveys implemented Teaching Model development TIC Steering Team formed Champion Team formed Alegent Health Mental Health Services Omaha NE & Council Bluffs IA