Kansas Institute for Positive Behavior Support

1. Kansas Institute for Positive Behavior Support http://www.kipbs.org

2. Kansas Institute for Positive Behavior Support (KIPBS) • Operated out of all three Kansas Centers on Developmental Disability • Statewide plan, Federal Medicaid Funding (not a waiver) • Three Social and Rehabilitation Services target audiences • Mental Health • Child Welfare • Developmental Disabilities

3. KIPBS Mission • Train experts who will build capacity in their regions and across Kansas • Provide Kansans with access to online resources and instruction free of charge at different levels of complexity • Create unified network of professionals across services who support PBS and person-centered planning (PCP) throughout Kansas

4. Consultant Versus Facilitator • KIPBS students learn that their role is to work with teams to develop capacity • Facilitator rather than Expert-based model • The purpose of the Institute is to create systems change • Ongoing learning is valued and emphasized

5. KIPBS Graduates • Can bill Medicaid for PBS and person- centered planning services • Contribute 12 hours a year to the Institute in order to maintain eligibility for reimbursement • Submit potential applications to a Prior Authorization committee for approval

6. Technology-based Instruction • Students working full time who can access information in flexible manner • Students across diverse geographic locations in Kansas • Class time is devoted to application-based activities and case study development • Provides opportunities for students across Kansas to communicate with each other

7. Building Resources in Kansas • Level 1: Online materials introducing PBS • Level 2: Online instructional modules for agency inservice training • Level 3: Online instructional modules to train leaders in PBS • Additional resources will be available on the KIPBS website: • Newsletters for current updates on PBS • Information about PBS and PCP • Links to important related resources

8. Creating Different Types of Training • Expert-level training- building statewide internal capacity • Team-based training- creating teams that work effectively • Awareness-level training- introducing new people to the general concepts of positive behavior support and person-centered planning

9. KIPBS Technology Supports • Website containing links and resources • Online modules for levels available to all Kansans from website • Password protected communication page for instructors and mentors

10. Levels of Impact • Build expert level capacity building with small number of professionals who can bill Medicaid (e.g. 20 per year) • Provide statewide access to free inservice training materials online • Create easy to digest information about PBS to policy makers and agency directors • Develop state-wide, systems-level action plan with KIPBS professionals • Donated mentor time to stay eligible and bill • Monitor and supervise reimbursement system

11. National Advisory Board • Linda Bambara • Fredda Brown • Edward Carr • Albert Duchnowski • Rob Horner • Don Kincaid • Constance Lehman • Darlene Magito McClaughlin • Joe Reichle • Wayne Sailor • Travis Thompson

12. KIPBS Specialized Instruction 12 month training period resulting in: • A portfolio including PBS, PCP, and systems change case studies • Completion of online instructional modules • Two course exams • Field-based activities and onsite course supervision

13. Types of Instruction • Online Instruction • Conceptual Knowledge • Field based activities • Assessments, reflective activities, threaded discussions • Onsite Classes • Model and demonstrate concepts • Group discussions and dialogue • Practice using new skills • Mentors • Support development of portfolio • Additional individualized training as needed

14. Networking Activities • Two forums each year bringing all KIPBS professionals together • Experts connected via distance learning strategies • Smaller work groups addressing 3 areas: • Improving the KIPBS training • Current barriers to providing PBS • Brainstorming systems change in Kansas

15. KIPBS Online Modules

16. Content Map • Module 1: Introduction to PBS • Module 2: Introduction to Applied Behavior Analysis • Module 3: Measuring Behavior & Interpreting Data • Module 4: Person-Centered Planning • Module 5: Functional Behavioral Assessment

17. Content Map • Module 6: Designing Positive Behavior Support Plans • Module 7: Multi-component Interventions • Module 8: Emotional and Behavioral Health • Module 9: Systems Change • Module 10: PBS Facilitator Guidelines

18. KIPBS Toolbox • Problem solving strategy to tailor instruction and create flexible teaching • Provides access to specific strategies and information whenever a problem arises within a case study • Access to tools for facilitating the person-centered planning and PBS plans

19. Prior Authorization

20. TargetPopulation • Children who engage in socially inappropriate behaviors at such a frequency or intensity that they are at risk of out-of-home placement. Eligibility criteria include: • Developmental disability • Diagnosis of autism • Typically developing children who fit behavioral criteria • Children who have sustained a traumatically inflicted head injury

21. Prior Authorization Issues • Provider is qualified • Consumer meets the established guidelines • Diagnostic and behavioral • Medicaid eligible • Assessment of behavioral status • Identification of problem behaviors • Rating of behaviors • Identifying environments in which behaviors occur • Assessing risk of institutionalization or loss of LRE

22. Purposes of Prior Authorization • Control costs • Control provider quality • Track provider/consumer data • Prioritizing allocation of resources • Log and investigate complaints

23. Billing Codes • Total amount per year possible: $8,800 per case • Assessment (up to $1,200) • Intervention (up to $6,000) • Person-centered Planning (up to $1,600) • One year reimbursement per case (with possibility of extension based on approval) • Maximum of 6 open cases per facilitator

24. Project Evaluation • Descriptive Evaluation: for the purpose of replication • Project staff activities • Instructor and mentor activities • Professional (student) activities • Performance Evaluation: to evaluate changes in professional knowledge and skills • Online assessments • Field-based observations and activities • Portfolios • Exams (midterm and final) • Impact Evaluation: to evaluate effect on consumers • Consumer satisfaction ratings • Quality of life surveys • Review of behavior change data and PBS plans • Review of person-centered plans to document preferred lifestyle changes

25. Supervision of KIPBS Facilitators • Every student must complete three cases and submit before billing (to demonstrate skills are generalized) • Every case must include the PCP and PBS self assessment checklists • Three cases after students graduate are closely evaluated and must reach 80% • Random selection of cases for more intensive review after that period for each student • Review and investigate complaints sent to the Prior Authorization Committee

26. Evaluating Layers of Impact • Online and Website Impact • Traffic on modules (number of users, hits, & time spent on module) • Traffic on website (visits, hits, return visitors, domain analysis, mailing list, contacts via website email) • Training agencies to use online materials in innovative ways (regional workshops) • Number of children served (data on outcomes) • Self-assessment data and portfolio outcomes • Mentor action plan data (# of awareness trainings, systems change reports, mentors supporting students) • KIPBS state systems change action plans