TwoDifferentModelsforImplementingPBSinOrganizationsSupportingPeopleWithDisabilities
ImplementingPerson-CenteredPracticesandPositiveBehaviorSupportinMinnesota
RachelFreeman,Ph.D.InstituteonCommunityIntegration
UniversityofMinnesota
Purpose
• StatewidePositiveSupportPlanning• Minnesota’sInfrastructureforImplementingPerson-CenteredPractices&PositiveBehaviorSupport
• EvaluationQuestions,DataCollectionSystems,andStories
StatewidePlanningTeamMeetsQuarterly(CoordinationIntraandInteragency)
OlmsteadSub-cabinet
DHSOlmsteadSteering
Committee
OlmsteadAgencyLeads
InteragencyCommittees
Data Systems Workgroup
Workgroup: Marketing & Communication
Workgroup: Preservice/Inservice
TA Workgroup Workgroup:
Inventory & Definitions Workgroup:
Crisis Prevention
Original Organization of Statewide Positive Support Plan 2015 -2016
ExamplesofAccomplishmentsFromStatewidePlanning
• StatewidePlanIncludedinOlmsteadPlan• ParallelDevelopmentofTrainingInfrastructure
• MinnesotaDepartmentofEducationPBIS• Organization-widePerson-CenteredPracticesandPBS
• FidelityofImplementationforPerson-CenteredPractices• StandardsofPracticeforPerson-CenteredPlanning• FidelityofImplementationToolsandTraining
• TrainingInfrastructureandLaunchforDiverseHumanServiceOrganizations
• Counties• PublicHealth• MentalHealth• ProvidersSupportingPeoplewithIntellectualandDevelopmentalDisabilities
ExamplesofAccomplishmentsFromStatewidePlanning(Continued)
• InventoryMeetingsStatewideonPoliciesandProceduresRelatedtoRestraint
• PositiveSupportsWebsite(MNPSP.ORG)• ParallelDevelopmentofEvaluationSystemsAcrossDHSandMDETrainingInfrastructures(Starting)
• PositiveBehaviorSupportNetwork• LedbyDepartmentofHumanServices,MinnesotaDepartmentofEducation&UniversityProfessionals
• PATHCompleted• FocusonInservice PreserviceRelatedIssues• PBSStateConference
StatewidePlanningTeamMeetsQuarterlyCoordinator:CarolAnthony
DataSystemsWorkgroup
Workgroup:Marketing&Communication
MNPBSNetworkMNPBSGathering
TAWorkgroupCoordinatorCA/RF
Workgroup:Inventory&Definitions
MDEPBIS
Revision to Statewide Communication Systems (2016 – 2019)
Person-CenteredPracticeWorkgroupCoordinator- SD
PositiveBehaviorSupportDHSCoordinator-AM
PositiveSupportExpansionWorkgroupCoordinator-CA
InfrastructureWorkgroup–CA/RF
MNGathering
NextStepsforStatewidePlanning:PositiveSupportStatewidePlanning
• LaunchNewTeams• UpdatetheLogicModel• ReviseActionPlan• ChairsFacilitateSelf-AssessmentandRecommendationsforChangesandSubmittoInfrastructureWorkgroup
• InfrastructureSummarizedChangestoLogicModelandSubmitstoTAWorkgroupforReview
• OversightGroupSubmitstoOlmsteadSubcabinet• FocusonAreasThatNeedAttention
PositiveBehaviorSupport
UniversalStage• TeachandEncourageCommunication• PredictableandProactiveSettings• EncourageandReinforceSocialSkills• Consensus-BasedTeamFocus• EmphasisonUsingDataForDecisions
SecondaryStage• EarlyInterventionandDataMonitoring• AdditionalSupportsforKeySocialSkills• Function-BasedDecisions• SimpleInterventions• MentalHealthandWellnessInterventions
TertiaryStage• IndividualizedPBSPlans• IntegratedwithOtherPositiveSupports(PCP,Trauma-InformedCare,DBT,Etc.)
• PlansAreMonitored- Data-BasedDecisionMaking• TeamsMonitorProgressofEachPerson
OrganizationalWorkforceDevelopment
PersonCenteredPractices&Planning
PositiveBehaviorSupport
ImplementingMulti-TieredSystemsofSupport
Person-CenteredPractices&Planning
OrganizationalWorkforce
Person-CenteredPractices&Planning
OrganizationalWorkforceDevelopment
Person-CenteredPractices&Planning
PositiveBehaviorSupportTertiaryStage• InDepthPerson-CenteredPlans• IntegratedPlans(PCP,PBS,Trauma-informedTherapy)
• TeamsMonitorPlanProgress
PrimaryStage• UniversalPerson-CenteredStrategies• EncourageSelfExpression• Self-DeterminationandChoiceMaking• MeaningfulParticipationintheCommunity
SecondaryStage• MonitorPCTActionPlans• AdditionalQualityofLifeStrategies• IncreaseStrategiesforSupportingIndependenceandCommunityInvolvement
• MentalHealthandWellnessInterventions
ImplementingMulti-TieredSystemsofSupport
PositiveBehaviorSupport
OrganizationalWorkforce
Organizational WorkforceDevelopmentPositiveBehaviorSupport
UniversalStage• AlignPoliciestoPerson-CenteredPractices• ReviseJobDescriptions,andPerformanceEvaluations• IntegratePerson-CenteredPracticesandPBSWithNewOrientationandOngoingInstruction
• UseDataforDecisionMaking
SecondaryStage• MonitoringandEarlyIntervention• TrainingTargetedforGroups• TargetedStrategiestoImproveSpecificSettings• SimpleProblemSolvingforChallengingSituationsThatOccurinMoreThanOneSituation
TertiaryStage• TailorProblemSolvingforSpecificProblematicSituations• IndividualizeTrainingandMentoringtoAddressUniqueSettingsWhereProblemsOccur
• ImproveSupervisionandMentoringforLocationsExperiencingChallenges
• EstablishMatching/HiringTailoredtoIndividualizedPlans OrganizationalWorkforce
ImplementingMulti-TieredSystemsofSupport
Person-CenteredPractices&Planning
Person-CenteredPractices&PBSInstituteonCommunityIntegration(https://mnpsp.org/training-materials/)• Team-BasedActionPlanning&DataSystems• PBSMulti-TieredCurriculum• KeyContactTraining• Person-CenteredPlanning&PBSFacilitatorTraining• RegionalTrainerMentoring
SupportDevelopmentAssociates(SDA)(http://sdaus.com/resources)• UniversalPerson-CenteredPractices• CoachesTrainingSystem• Person-CenteredThinkingTraining• PictureofaLifePlanningTraining
PRACTICES
SupportingStaff Behavior
SupportingAll People
OUTCOMES
Improving Quality of Life
SupportingDecisionMaking
14
TeamsInvolvedinSystemsChangeAcrosstheLifespan(ChildrenandAdults)Including:
ProviderOrganizationsResidentialHomeSettingsEmploymentSettings
PublicHealthOrganizationCountyTeamsMentalHealth
Cohort2ASt.LouisCountyRegion(County&3Organizations)IntegratedModelCohort2B
WestCentral(5Counties,PublicHealthDept.,2Organizations)IntegratedModel
Cohort1SupportDevelopmentAssociatesPerson-centeredPracticesModel1County,3Organizations
MinnesotaStatewidePlanforBuildingRegionalCapacity
TrainingLayers• TeamTraining• RegionalTrainers• Person-centeredThinkingTrainers/CoachTraining
• PictureofaLifePlanners/Trainers
• PBSFacilitators
StatewideTeam
Cohort2Region1
RegionalTrainer
Organization1KeyContact
Organization2KeyContact
Organization3KeyContact
Organization4KeyContact
Cohort2Region2
RegionalTrainer
Organization1KeyContact
Organization3KeyContact
Organization4KeyContact
Organization2KeyContact
MinnesotaTrainingInfrastructureCommunicationPathway
Leadership Team
Visibility
Training Mentoring Evaluation
Active Coordination
Start Small and Build on Success
Organization and County Model for Planning
Interagency & Natural Supports
PCP, PBS (Other PS)
Expertise
FundingPoliticalSupport&Policy
AssessingOrganizationalData• AlignmentofOrganizationalPolicies• OrientationStaffDevelopment&Performance• SurveysandOtherDocumentationRelatedto
– QualityofLife– Climate– Stress
• InformationaboutOtherPositiveSupportsUsedinOrganization
• QualityofLifeEvaluation• IncidentReports(PreparationinYear1)• Injuries,SickDays• InformationRelatedtoRetention,WorkersCompensation,StaffInjury
Evaluation&DataSystemsOrganization-WideEvaluation RelatedEvaluationData/ToolsWhatimpactdidthetraininghaveoncapacitybuilding?
Numberofcoaches,keycontactsNumberofstaffinvolvedinimplementationNumberofpeoplesupported
Whatarethestrengthsandneedsoftheorganization?
Person-centeredorganizationaldevelopmenttoolQualityofsocialandphysicalenvironment
Howwellarethepracticesimplemented? Fidelityofimplementationchecklist(Quarterly)Onsiteevaluation
Aretheimprovementsinconceptualknowledgeofstaff?
Pre/posttestsforstaffusingDC/CDS
AretherechangesinbehaviorofStaffandPeopleLivingandWorkinginaSetting?
Directobservationofstaffperson-centeredpractices(Quarterly)Directobservationofpeoplesupported(Quarterly)Incidentreports,restraint,911calls,etc.(Quarterly)Organizationaldata(retention/tenure,etc.)
Aretherechangesinuniversalqualityoflife? Qualityofsocialandphysicalenvironmentinterviews
ExpansionofOrganization-WideImplementationinMinnesota:Person-CenteredPractices&PositiveBehaviorSupport
2015 2016 2017- Estimates
Regions 1 3 3-4
Teams 4 16 20
TotalCoaches 44 167 207
KeyContacts 6 24 34
PBSFacilitators 0 6 12
PCTTrainersByRegion
4 14 18
TotalActive PCTTrainersinMN
46 66 86
DescriptiveDataforOrganization-wideImplementation
0
5
10
15
20
25
30
35
40
Teams KeyContacts PBSFacilitators PCTTrainersbyRegion
Num
ber
TypeofRoleinImplementation
StatewideOrganization-wideImplementationGrowthPatternOverTime
2015
2016
2017
DescriptiveDataforCoachesbyRegionandPCTTrainersAcrosstheState
0
50
100
150
200
250
TotalCoachesbyRegion MNPCTTrainers
Num
ber
TypeofRoleinImplementation
OverallNumberofCoachesbyRegionandTotalPCTTrainersAcrossMN
2015
2016
2017
FidelityofImplementation:MNTeamChecklist
WhiteFormTeamImplementationAcrossPositiveSupports
BlueFormPBSSubscaleItems
PinkFormPerson-centeredPracticeItems
DomainsforOverallFidelity• Team• StaffCommitment• Self-Assessment• ActionPlanning• StaffDevelopment• Evaluation• Visibility
State-WideMinnesotaTeamChecklist– Overall
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8 Agency9 Agency10 Agency11 Agency12
State-WideMinnesotaTeamChecklist– Overall2016-2017
Baseline
1stfollow-up
Percen
tCom
plete
Agencies
State-WideMinnesotaTeamChecklistPerson-CenteredPracticesSubscale
Percen
tCom
plete
OrganizationsInvolved
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8 Agency9 Agency10 Agency11 Agency12
MinnesotaTeamImplementationChecklistPerson-CenteredPracticesSubscale– Cohort2
Baseline
5Months
State-WideSummaryofMinnesotaTeamChecklist–PositiveBehaviorSupportSubscale
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8 Agency9 Agency10 Agency11 Agency12
MNTeamImplementationChecklistPositiveBehaviorSupportSubscale
Cohort2byAgencyBaseline
5months
Percen
tCom
plete
OrganizationsInvolved
Cohort2TeamBaselineDataPerson-CenteredPositiveOnsiteEvaluationTool
Percen
tCom
plete
OrganizationsCompletingtheOnsiteEvaluation
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Agency1 Agency2 Agency3 Agency4 Agency5 Agency6 Agency7 Agency8
Cohort2BaselineDataforOnsiteEvaluations2016-2017
BaselineOnsiteEvaluation
Person-CenteredPracticesSocialEngagement
PositiveSocialBehaviors
FinalStagesofDirectObservationMeasure
Person-CenteredValuesinaMentalHealthClubhouse
Times of Day
Free Time Outside
Activities Before Lunch During Lunch After Lunch End of the Day
Pers
on-C
ente
red
Val
ues
Respect Each Other
Respect Each Person’s Personal Space
Smoke in Designated Areas, Tip Your Servers
Move Out of the Way for Someone Trying to Get Through,
Allow People Time to Finish Lunch Peacefully
Check if Others are Finished Before Starting to Clean Up
Jump In and Offer to Help!
Take Care of our Space
Pick Things Up That Are on the Ground
Throw Garbage in Can, Clean up After Yourself
Pushing in Chairs Keep a Clean Table Clean up your Dishes, Push in your Chairs
Tidy Up and Organize
Work Together
Share Information and Ideas
Help Carry Things for Other People
Offer to Help to Finish Tasks
Help Each Other get Stuff Done!
Offer to Help People Who May Need It
Share the Tasks so People Don’t Always Have to do the Same Thing
Appreciate Diversity Learn About
Each Other’s Uniqueness
Be Sensitive to What Other People Would Like to Do
Know That We all do Things |Differently!
Everybody Moves at Their Own Pace
Be Aware that Others Have Different Eating and Clean-Up Rituals and Routines Than You
Be Sensitive to People’s Routines as We Clean up
StatusofState-WideOutcomeData• ObservationSystemsinPlacefor2Outof12Teams• BehaviorIncidentReportingSystemDatabyRegion• StateandRegionalQualityCouncilsareWorkingonQualityofLifeMeasurement
• IndividualPerson-CenteredPlansandPBSPlansareImplementedWithinTrainingContext
• TeamsareWorkingonOrganization-WideDataCollectionSystems• ProviderOrganizationsPreparingtoImproveIncidentReportingSystems• Retention-TenureDataareAssessed• SurveysandQualityofLifeDataareAssessed
ContactInformationRachelFreemanEmail:[email protected]
RachelFreeman,Ph.D.InstituteOnCommunityIntegration,UniversityOfMinnesota,Pattee Hall,Room110A,150PillsburyDr.S.E.MinneapolisMN55455
ThanksforYourTime!!!
PresentationandAdditionalToolsAreAvailable!
Presentationhttps://new.apbs.org/conference
AdditionalToolsandResourceshttps://mnpsp.org/training-materials/
Preparationofthis[presentation/report]wassupported,inpart,bycooperativeagreementJPK%50470fromtheMinnesotaDepartmentofHumanServices.TheUniversityofMinnesotaundertakingprojectsundergovernmentsponsorshipareencouragedtoexpressfreelytheirfindingsandconclusions. Pointsofvieworopinionsdonot,thereforenecessarilyrepresentofficialMNDHSpolicy.
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