What isCollaborationand how to use it. Plus Consultation and Collateral Contact, what can be billed and how all three fit together. For DDAs and partner providers. Specific to Idaho
The Sense of the Goose In the fall when you see geese heading south for the winter flying along in the "V" formation, you might be interested in knowing what science has discovered about why they fly that way. It has been learned that as each bird flaps its wings, it creates an uplift for the bird immediately following. By flying in a "V" formation, the whole flock adds at least 71% greater flying range than if each bird flew on its own. People who are part of a team and share a common direction get where they are going quicker and easier, because they are traveling on the thrust and trust of one another.
Whenever a goose falls out of formation, it suddenly feels the drag and resistance of trying to go through it alone and quickly gets back into formation to take advantage of the power of the flock. If we have as much sense as a goose, we will share information and move along or make necessary changes with those who have the same or similar goals. When the lead goose gets tired, s/he rotates back in the wing and another goose takes over. It pays to share leadership and take turns doing hard jobs.
The geese honk from behind to encourage those up front to keep their speed. Words of support, encouragement, and inspiration help energize everyone, helping them to keep pace in spite of the day-to-day pressures and fatigue. Finally, when a goose gets sick or is wounded by a gunshot and falls out, two geese fall out of the formation and follow the injured one down to help and protect. If we have the sense of a goose, we will stand by each other when things get rough, and even when they are not.Author Unknown (some alterations from the original.)
Collaboration is required by rule. People often talk about collaboration. Research tells us that it is important and often essential for significant, lasting progress. But what is it?
Communication usually falls within one of four basic levels. • Problems usually arise when: • More communication was needed than used, and • When some of those involved say they are doing one level and in reality are doing another.
#1 Damage Control: • This often happens when: • Someone assumes that less communication and/or collaboration was needed than really was… or just thought they could get away with less. • There are critical errors, accidents, unnecessary barriers, or wasted time/money. • This also occurs when the individual/organization says/thinks it is doing one level and is actually doing another. [This is not collaboration and is usually a bad thing]
#2 Education: • This level of communication is often used by organizations and agencies. • Information is shared: • With a release when confidential • As public awareness or marketing, through outreach and advertising, and • whatever motivation through whatever means. [This isn’t collaboration either]
#3 Input/Feedback: • This is not only helpful but often required by rule. • This may take place through: • surveys, • assessments, • discussion groups. • etc • [This isn’t collaboration]
#4 Collaboration: • Sometimes it is important to not only share and collect information, but also to share goals, decisions, ownership, plans, responsibility, and accountability. • Collaboration allows for and encourages all of this. • It assures that everyone working with the child is “on the same page.” • It allows for one plan to support another for the greater benefit of the child and family. • In some situations it even allows for one umbrella plan with additional supporting plans. It discovers solutions and expands capacity for the child and family. [This could be it]
Levels of Authority • When there are assignments, it is imperative that everyone understand their level of authority and responsibility, to include who is responsible for what, when? • This is part of good, honest, effective communication and collaboration. • http://www.collaboration.me.uk/LEVELS_OF_AUTHORITY.php
One size does not fit all. • Collaboration comes in many shapes, sizes, and of varying duration. It may not make sense to develop a broad in-depth collaboration when a short term coordinated effort is all that is needed and more efficacious. • For example, networking/communication may be all the is required to receive important information from a hospital about a past stay. • Collaboration sometimes develops in developmental stages which may include: … • and will be discussed with an activity.
1. Competition • Channeled and in the right situation, can help groups or individuals stretch themselves and excel. • It can support and encourage creativity. For example, competition is an important aspect of Special Olympics; • however, in order to achieve true success, there must be a balance between competition and cooperation and at times even collaboration. • Competition does not need to mean that you want the worst for someone else, just the best from yourself. [This is not collaboration]
2. Networking/Communication • As information begins to be shared and communication increases, it benefits everyone. • There may be more of an interest in gaining information than sharing at this stage. • Trust will develop as more information and resources are shared for the benefit of all. • [This isn’t collaboration, it could be collateral contact]
3. Cooperation/Coordination • Information sharing becomes more formalized with structure and agreements; though individual interests are maintained. • More resources are shared and duplication is limited. • Coordination: Formalized sharing of resources, information, and some common goals. • [This isn’t collaboration, it could be collateral contact, it could be consultation]
4. Coordination/Partnership • Resources are gathered to create, discover, or access, new resources. • The management of resources is progressively shared, becoming mutually beneficial, increasing resource capacity for everyone. • This is a more formal and structured relationship with signed agreements, to include resource management. • In many good partnerships a partner is as concerned about their partner's success as their own. • [This still isn’t collaboration; however we’re starting to get warmer, this could be a part of both consultation and collateral contact]
5. Coalition • Leadership & decision making is shared by all through a direct democratic or an indirect representative process. • Decision making and communication are formalized and clear. • More resources are developed, created, and discovered for the benefit of everyone in the coalition. • (This stage may not be as applicable in the some settings. May be similar to a co-op.)[This still isn’t collaboration. We are still getting warmer]
6. Collaboration • Written goals are shared by all involved. • All interventions are integrated & synergistic. • Communication & relationships are strong & clear. • The team shares a strong sense of purpose, accomplishment, responsibility, & accountability. • Strengths & resources, are shared and created & significantly amplified through the collaborative process. • Collaboration: Shared vision, mission, power, resources, and goals. [This could be it]
To build collaboration: • Take responsibility and give credit. (This is only one of many concepts that help to build collaboration.)
For treatment collaboration: • Everyone providing treatment and/or care for the child would be on the same page. • Plans and interventions would be mutually supportive. (This requires close communication and dialogue.) • Plans would be supportive for the child and family. • In some situations there may be an umbrella plan, such as the IFSP.
For example: A child who receives speech therapy from an SLP and communication and behavioral therapy from a developmental therapist: The parent, speech therapist and developmental therapist would dialogue and plan the interventions. The intervention provided by the SLP would support the needs, interests and resources of the parent and child as well as the behavioral plan from the developmental therapist. etc.
To Build Collaboration • Communicate: "Real listening shows respect. It creates trust. As we listen, we not only gain understanding, we also create the environment to be understood. And when both people understand both perspectives, instead of being on opposite sides of the table looking across at each other, we find ourselves on the same side looking at solutions together". Stephen R. Covey
Consultation Families are a lot like a hanging mobile, when one piece is pulled to a new position as soon as the pull stops, family dynamics and equilibrium return the individual back into “balance with the family.” Overwhelming research demonstrates that the best intervention and often the only lasting intervention must involve the family and sometimes can not occur effectively without the family learning new ways to interact and at times even act as co-therapists .
724. COLLATERAL CONTACT. • Collateral contact is consultation with or treatment direction given to a person with a primary relationship to a participant for the purpose of assisting the participant to live in the community. Collateral contact must: ( ) • 01. Conducted by Agency Professionals. Be conducted by agency professionals qualified to deliver services and be necessary to gather and exchange information with individuals having a primary relationship to the participant. ()
724. COLLATERAL CONTACT. • 02. Face to Face or by Telephone. Be conducted either face-to-face or by telephone when telephone contact is the most expeditious and effective way to exchange information. Collateral contact does not include general staff training, general staffings, regularly scheduled parent-teacher conferences, general parent education, or treatment team meetings, even when the parent is present. ( )
724. COLLATERAL CONTACT. • 03. On the Plan of Service. Have a goal and objective stated on the plan of service that identifies the purpose and outcome of the service and is conducted only with individuals specifically identified on the plan of service. Program Implementation Plans are not required for collateral contact objectives. ( )
804. IBI CONSULTATION. • Professionals may provide IBI consultation to parents and other family members, professionals, paraprofessionals, school personnel, child care providers, or other caregivers who provide therapy or care for an IBI eligiblechild in other disciplines to assure successful integration and transition from IBI to other therapies, services, or types of care. IBI consultation objectives and methods of measurement must be developed in collaboration with the person receiving IBI consultation.
804. IBI CONSULTATION. • 01. Service Delivery Qualification. IBI consultation must be delivered by an IBI professional who meets the requirements in Section 420 of these rules. ( ) • 02. Measurable Progress. IBI consultation must result in measurable improvement in the child's behavior. It is not intended to be used for educational purposes only. ( )
804. IBI CONSULTATION. • 03. Evidence of Progress. Persons who receive IBI consultation must meet with the IBI professional, agree to follow an IBI Implementation Plan, and provide evidence of progress. ( ) • 04. Individualized. IBI consultation may not be reimbursed when it is delivered to a group of parents. IBI consultation is specific to the unique circumstances of each child.
Collateral Contact is delivered by a variety of professionals to people who have primary relationships with a child eligible for DDA services. • IBI Consultation is delivered only by IBI Professionals to children eligible for Intensive Behavioral Intervention (IBI). • Some of the similarities and differences between the two services are described as follows:
Similarities • Collateral Contact and IBI Consultation: • Promote generalization and coordination within the child’s natural environments. • Are delivered to persons with a primary relationship to the child. • Require a goal and objective authorized in an Individualized Program Plan. • Are specific to each child and may not be reimbursed for group training. • Are not included in the 22 hour/week limitation under the Medicaid state plan that includes Developmental Therapy, IBI, and other therapies provided by the DDA.
Differences IBI Consultation must result in measurable improvement in a child’s skills and positive behaviors for continued authorization. • Measurable improvement is not required for Collateral Contact.
Differences • Collateral Contact may be provided by any DDA professional. IBI Consultation may only be provided by an IBI Professional.
Differences The IBI Professional is responsible to develop an IBI Implementation Plan that the person receiving IBI Consultation can carry out, develop a data collection method for that person, and assure that the person receiving IBI Consultation knows how to carry out the Implementation Plan and collect data. • The professional delivering Collateral Contact is not responsible to assure that the person receiving collateral information will carry out an Implementation Plan and collect data.
Differences The person receiving IBI Consultation must collect data and report back to the IBI Professional on a regular basis about the child’s progress. • The person receiving collateral contact doesn’t have to collect data for the professional.
Differences • Collateral Contact doesn’t require an Implementation Plan. IBI Consultation requires an Implementation Plan.
♪ • Everything done through consultation in IBI can be done through collateral contact through Developmental Therapy.
So what does this mean? • How can we use collateral to improve outcomes for children and families? • How can we use consultation to improve outcomes for children and families? • How can we use collaboration to improve outcomes for children and families? • What are you going to do differently?