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Pennsylvania’s Integration of Mental Health and Positive Behavior Interventions and Supports (PBIS). A Community of Practice Approach using Social Entrepreneurism to Scale Social Impact. Ron Sudano, Ed.S . NCSP – PA Training and Technical Assistance Network

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pennsylvania s integration of mental health and positive behavior interventions and supports pbis

Pennsylvania’s Integration of Mental Health and Positive Behavior Interventions and Supports (PBIS)

A Community of Practice Approach using Social Entrepreneurism to Scale Social Impact

Ron Sudano, Ed.S. NCSP – PA Training and Technical Assistance Network

Kelly Perales, LCSW – Community Care Behavioral Health

big ideas
Big Ideas
  • Community of Practice
    • Intentional integration of Mental Health and PBIS
  • Social Entrepreneurism
    • SWPBS to initiate and expand Mental Health Supports for ALL children and youth
  • Innovation
    • Distributed Leadership & Contribution
    • Affiliated Network
    • Tertiary Demonstration Project
communities of practice a conceptual framework
Communities of Practice:A Conceptual Framework

“Groups of people who share a concern, a set of problems or a passion about a topic, and who deepen their understanding and knowledge of this area by interacting on an ongoing basis.”

(Etienne Wenger, Richard McDermott, William Snyder,

A Guide to Managing Knowledge,

Cultivating Communities of Practice, 2002, p. 4)

what is a community of practice
What is a Community of Practice?
  • Based on relationships and natural bonds
  • Supportive and convening functions enable a collective intelligence
  • Share learning at all levels to escalate progress
  • Create new knowledge grounded in ‘doing’ the work
  • Reflect a “pull” versus a “push”
  • Sponsors of the National Community of Practice on School Behavioral Health are the IDEA Partnership funded by OSEP and housed at NASDSE and the Center for School Mental Health funded by HRSA and housed at the University of Maryland.

www.ideapartnership.org

www.sharedwork.org

communities of practice a variety of activities
Problem-solving

Requests for Information

Seeking Experience

Reusing Assets

Mapping Knowledge

Coordination and Synergy

Discussing Developments

Documentation Projects

Visits

Identifying Gaps

Communities of Practice:A Variety of Activities
pa state leadership team
PA State Leadership Team

The state leadership team was founded in 2006 and the following departments, agencies and stakeholder groups represent a partial list.

  • Pennsylvania Department of Labor and Industry
    • Office of Vocational Rehabilitation
  • Pennsylvania Department of Public Welfare
    • Office of Mental Health and Substance Abuse Services
  • Pennsylvania Governor’s Commission on Children and Families
  • Pennsylvania Intermediate Unit (PAIU) Special Education Directors
  • Pennsylvania Network for Student Assistance Services
  • Pennsylvania Training and Technical Assistance Network (PaTTAN)
  • Pennsylvania Youth Leadership Network
  • Philadelphia Public Citizens for Children and Youth
  • Value Behavioral Health
  • Youth and Family Training Institute
  • Allegheny County Department of Human Services
  • Bureau of Autism Services
  • Community Care Behavioral Health
  • Devereux Center for Effective Schools
  • Disability Rights Network of Pennsylvania
  • Education Law Center
  • Juvenile Court Judge’s Commission
  • Mental Health Association of Pennsylvania
  • Office of Child Development and Early Learning
  • Pennsylvania Community Care Providers
  • Pennsylvania Department of Education
    • Bureau of Special Education
    • Division of Student Services and Safe Schools
  • Pennsylvania Department of Health
    • Bureau of Drug and Alcohol Programs
scaling swpbs pennsylvania s approach

Promoting the entrepreneurial pursuit of social impact

Scaling SWPBSPennsylvania’s Approach

(Adapted from - John Kalafatas: Approaches to Scaling Social Impact)

slide8

Mission Statement

The mission of the Pennsylvania Positive Behavior Support Network (PAPBS Network), through training and technical assistance, is to support schools and their family and community partners to create and sustain comprehensive, school-based behavioral health support systems in order to promote the academic, social and emotional well-being of all Pennsylvania’s students. The network’s goal is to ensure that all schools have the necessary technical assistance, collaborative opportunities, and evaluative tools needed to overcome non-academic barriers to learning and achieve competence and confidence in advancing academic, social, and emotional success for all students.

slide9

Definition: What is Scaling Social Impact?

John Kalafatas: Approaches to Scaling Social Impact.

http://www.caseatduke.org/knowledge/scalingsocialimpact/frameworks.html

slide10

Pennsylvania’s Strategy

Impact through Direct Service  Impact through Indirect Influence

  • Promote a Model
  • MH & SWPBS Integration
  • Influence Public Policy
  • Establish a Social Movement
  • Change/Create Markets
  • Increase Quantity and/or Quality of Impact
  • Diversify Communities Served
  • Diversify Services Offered
  • Expand Geographically

GOALS for Scaling MH & SWPBS

  • Technical Assistance
  • Knowledge Dissemination
  • Partnerships/Alliances
  • Packaging/Licensing
  • Research & Public Policy Development
  • Influencing Public Awareness, Norms or Behaviors
  • Direct Advocacy & Lobbying
  • Convening Networks
  • Organizational Branching and/or Affiliation
  • Expanding Organization’s Delivery Capacities (via volunteers, technology, etc.)

STRATEGIES for Scaling MH & SWPBS

Adapted from: John Kalafatas: Approaches to Scaling Social Impact.

http://www.caseatduke.org/knowledge/scalingsocialimpact/frameworks.html

slide11

PA SCALERS

Situational Organization

ContingenciesCapabilities

Labor needs

-

Staffing

Public Support

+

Communicating

Potential Allies

+

Alliance-Building

Supportive Public Policy

+

Lobbying

Scale

of

Social

Impact

Start-up Capital

-

Earnings Generation

Dispersion of Beneficiaries

-

Replication

Strength of Economic Incentives

Stimulating Market Forces

+

Adapted with permission: Bloom, P. N. & Chatterji, A. K. (In press, 2008). Scaling Social Entrepreneurial Impact. Fuqua School of Business, Center for the Advancement of Social Entrepreneurship: Duke University. Retrieved January 18, 2008 from http://www.fuqua.duke.edu/centers/case/knowledge/scalingsocialimpact/articlespapers.html

+ High valence

- Low valence

lessons learned
Lessons Learned
  • Broad representation on State Leadership Team
  • Develop evaluation plan from beginning based on interests of stakeholders
  • Commitments from central office and building-level administrators
  • Ideal: secure commitment from mental health agency to participate at all 3 tiers of support
  • Establish leadership infrastructure to roll-out
  • Plan for scaling-up
slide13

Tertiary Demonstration

Project

Integrating PBIS and Mental Health Services

School Based Behavioral Health (SBBH ) Teams

what is community care
What is Community Care?

Non-profit behavioral health managed care organization (BHMCO)

Public health mission

Transformation of mental health services to children and families

Affiliated partner in PA PBS Network – have co-director and coordinator

Partnering with school districts for integration of services, along with other child serving systems

goals of sbbh team program
Goals of SBBH Team Program
  • To provide services that are more flexible than traditional services in meeting unique behavioral needs of youth and families
  • To provide a behavioral health home for youth and families through availability of care in school, home and community settings as needed
  • To improve communication among youth, family, educators, clinicians and other child serving systems
goals of sbbh team program1
Goals of SBBH Team Program
  • To maximize integration of behavioral health services, school intervention programs and family and community resources
  • To improve access to service for youth returning to district schools from partial hospitalization, inpatient care, RTF or out of home placement
  • To support school staff with training and case specific consultation
how is sbbh different
How is SBBH different?
  • Quicker access to assessment and service
  • No requirement for a specific prescription of SBBH hours
  • Greater flexibility in types of interventions and intensity of service delivered
  • Any team staff can intervene with a youth
how is sbbh different1
How is SBBH different?
  • Focus on resiliency concepts, understanding of trauma informed care and structural family therapy
  • Increased qualifications for staff - licensure, experience and ongoing training
how is sbbh different2
How is SBBH different?
  • Enhanced integration with school interventions via positive behavioral supports
  • 24/7 availability for phone crisis response
  • Evaluation component is included
behavioral health home concept
Behavioral Health Home Concept
  • Increased accountability via clinical home
  • School is “launching pad” for services that can be delivered in all settings
  • Comprehensive service approach
  • Youth continue on the team with varying intensity of service
who can receive sbbh team services
Who Can Receive SBBH Team Services?
  • Youth, 5-18 years, and their families
  • Have a serious emotional or behavioral disturbance (internalizing or externalizing)
  • Receive Medical Assistance
  • Community Care member
  • School related problems not required
  • IEP not required
  • ASD diagnosis on case by case basis
where and when is service delivered
Where and when is service delivered?
  • School is the physical location of team
  • Services may extend into home and community settings on evenings, weekends and during summers
  • 24/7 availability for crisis intervention
sbbh service components
SBBH Service Components
  • Clinical interventions
  • Case management
  • Crisis intervention
  • Case consultation & training for teachers
team composition
Team Composition
  • Mental Health Professionals
  • Behavioral Health Workers
  • Consultant
  • Clinical director
sbbh evaluation plan
SBBH Evaluation Plan
  • Assessment of impact of SBBH Team on:
    • Academic performance – grades, attendance, behavior
    • Child functioning at home/community and school
    • Family satisfaction
    • Service utilization and cost
sbbh evaluation plan1
SBBH Evaluation Plan

Child Outcomes Survey (COS)

Completed by families monthly and at discharge

Measures child functioning and family perception of treatment process

Strengths and Difficulties Questionnaire (SDQ)

1 page questionnaire with 25 items related to emotional symptoms, conduct, peer problems and prosocial behavior

Completed by families and teachers at admission, quarterly and at discharge

tertiary demonstration project
Tertiary Demonstration Project

Three districts who would have a SBBH Team at the start of the 2009-10 school year were invited to participate

Logic of having Tier 3 services and beginning Tier 1 in order to build three tiered system

District/community leadership teams were established that included mental health partners at the table from the beginning

Districts committed to implementing SWPBS at all three tiers across the district

current status
Current Status

2 of 3 districts were trained in Tier 1 and “kicked off” at the start of the 2010-11 school year in those buildings that have SBBH Team

Use blueprint to develop action plan for other buildings to begin process as well as assess needs for mental health across tiers

Planning for training and implementation of Tier 2 during this school year in those buildings implementing Tier 1

Full integration of mental health