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Missouri’s Interagency Statewide Planning Team: Improving Quality of Life for Individuals Across the
Lifespan
Terry Bigby and Diane Feeley Missouri SWPBS/University of Missouri
Julia LePage and Terri Rodgers Missouri DDDRachel Freeman, University of Kansas
Purpose of Presentation• Share the evolution of Schoolwide PBS
(SW-PBS) in Missouri• Describe how the statewide PBIS team
collaborated with professionals in mental health and developmental disabilities to– Form a statewide interagency planning process– Leverage limited funds for PBS across agencies
• Describe the tiered implementation training beginning in the MO Division of Developmental Disabilities (DDD)
MU
SW-PBSTrainers
Schools
1999 Training FormatThe Missouri Department of Elementary
and Secondary Education (DESE) local improvement grants (LIGs) are awarded
to districts to attend trainings throughout the year and during summer
institutes.
Staff from the University of Missouri PBS Center provides the trainers for these
activities.
History of MO SW-PBS
MU
SW-PBSTrainers
Schools
1999 2006
DESE
MO SW-PBSTrainers
in Regional Centers
Schools
MO SW-PBS 2006 - Present
Training Format22 Consultants in 9 regions, 5 Tier 2/3 consultants, state data/web consultant, state
coordinator and MU PBS personnel provide training/technical
assistance on standardized curriculum for multiple levels and stakeholders
ImplementUniversals
Identify Students
Describe Problem
Identify Function
Select & ProvideIntervention
Evaluate Outcomes
Collect & ReviewData
Schoolwide, Nonclassroom and Classroom Systems
Tier 1 implementedwith fidelity?
Tier 1 implementedwith fidelity?
Yes
No
Teacher/ParentNomination
Teacher/ParentNomination
Data Decision Rules
Data Decision Rules
ScreeningInstrumentScreening
Instrument
Teacher and Team collect dataTeacher and Team collect data
Team summarizes dataDescribe problem
Team summarizes dataDescribe problem
Obtain Attention
Obtain Attention
Escape/AvoidTasks
Escape/AvoidTasks
Escape/Avoid
Attention
Escape/Avoid
Attention
Function?Function?
MentoringMentoring Check InCheck OutCheck In
Check OutAcademicSupport(s)AcademicSupport(s)
Small Group
Social Skill
Small Group
Social Skill
EnvironmentalInterventions
EnvironmentalInterventions
FBABIP
Revised 10/12/2011
Current Statistics 2011-12• 700 schools representing 202 districts are active
participants – This is 29% of Missouri schools and 36% of
Missouri districts• Support from MO Department of Elementary &
Secondary Education• Dr. Tim Lewis, an MU professor and co-director of
the OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports, continues to be instrumental in providing ongoing technical assistance and guidance to the Missouri SW-PBS initiative.
Missouri’s Interagency Statewide Collaboration
Challenges of Disconnected System of Service Delivery
• No system to inform schools that other agencies are working with the child and family
• Agencies and schools do not work together to develop one plan with the child and family
• Often agency people feel that they are asked to take sides – parents vs. the school
• School personnel spending 60 - 120 minutes during meetings focusing only on the problems
Challenges of Disconnected System of Service Delivery (Continued…)
• Parents not sharing what it is like at home• Schools expecting parents to do it all - telling
them what to do instead of collaborating around goals and dreams for child
• “Too many words” or with “too much Jargon” because so many different systems are working to provide services to the child and family
Interagency Collaboration
• Started in 2008 • Agencies included:
– Missouri SW-PBS– Department of Elementary and Secondary Education
(DESE)• Office of Quality Schools• Office of Special Education• Missouri Schools for the Severely Disabled
– Department of Mental Health• Division of Developmental Disabilities (DDD)• Comprehensive Psychiatric Services
Leadership Team
FundingVisibility
Policy/Political Support
Training Coaching Evaluation
Active Coordination
Local School Teams/Demonstrations
State-wide Model for SWPBS
Tier 3 Interagency
System
Behavioral Expertise
Adapted From:
Placed Policy With PoliticalSupport and Added Tier 3 Interagency Systems
School Planning
Team
Add a Statewide Problem-solving System to Encourage Interagency Use of PBS Funds
Key Issues Related to Sustainability of Interagency Collaboration
Goal was to avoid common problems associated with interagency meetings and to follow key elements of sustainability & systems change:•Promote priority for a specific practice•Maximize contextual fit•Ensure efficacy of practices•Use data for continuous generation•Avoid over reliance on any one individual
Important Expectations for the Team
• The outcomes of the team process must address each agency’s agenda
• No group slowed down their own progress to wait for another group to “catch up”; instead, every agency proceeded with tasks at their own pace
• Goal was to remain aware of what was happening with training and technical assistance across agencies at all times
First Steps: Assessment and Brainstorming
MU
SW-PBSTrainers
Schools
1999 2006
DESE
MO SW-PBSTrainers
in Regional Centers
Schools
2008
DMH
CPS DDD
Interagency Collaboration – First Steps
Initial Goals of the Team
Work between agencies at the state level and information gleaned from working with schools and human service agencies across the state resulted in the identification of the following goals:• Develop a Common Language• Develop a Common Vision• Develop a Common Training
Develop a Common Vision
What can we start doing?• Focus on quality of life
‒ Start the conversation with the goal, not the problem. All schools and human service agencies must work with families to focus first on prevention – not on reaction
Develop Common Vision
• Improve quality of life across the lifespan• Foster interagency collaboration • Support delivery of evidence-based, outcome-
focused, person-centered services and supports • Share training resources • Increase professionals’ skills in implementing
positive behavior support and person-centered planning
• Leverage limited state funds
Develop a Common Language
• Identify terms we need to understand to facilitate collaborative work with children and families. ‒ Glossary of terms developed that will be used by
schools and human service agencies in Missouri
• Establish ongoing communication between families, agencies and families
Develop a Common Language
Glossary of terms developed that will be used by schools and human service agencies in MO
• Person-Centered Planning– Schools do not commonly use the term, Person-
Centered Planning. Yet, the Person-Centered Plan is the starting point for provision of services through the Division of Developmental Disabilities and Comprehensive Psychiatric Services
• Quality of Life
Develop a Common Language
Establish ongoing communication between families, agencies and schools• Schools and agencies identify one person
within each system to act as the contact.• Add the following to school enrollment
forms: “List other agencies currently working with your child”
Develop a Common Training System & Curriculum
• While MO SW-PBS was designing curriculum and training to develop Tier 2 system of support, collaboration with other state agencies was initiated to prepare for design of Tier 3 system of support.
• Common language incorporated in MO SW-PBS and Division of Developmental Disabilities (DDD) Tier 3 curricula
Develop a Common Training System & Curriculum
Shared Training Opportunities - what do we need to do to make this happen?
• DDD is developing training systems that are modeled after systems developed by MO SW-PBS.– DDD provides training for Behavior Resource Team
members during Monthly Meetings• Behavior Resource Team members attend
the trainings provided to schools by MO SW-PBS consultants.
• Schools and human service agencies will send information to one another about upcoming trainings.
The Assessment Resulted in the Following
• It was common for professionals to know about the interagency teams that were occurring within their own agency
• However, professionals in other agencies were not always aware of these interagency meetings
• The PBS team was curious about the extent to which interagency teams at the local and regional level “overlap”
• How do these teams relate to the SWPBS efforts (RPDCs) and to the BRT supports across the state
Location of RPDCs (SW-PBS Regional Trainers)
Systems of Care Interagency Meetings
Juvenile Justice Meetings
Community Transition Teams (for Students with Developmental Disabilities)
Assessing Overlap of Teams
Defining the Types of Training Needed
Four Levels of Integrated Training
1. Awareness Training in PBS2. Training for Professionals in PBS
(inservice)3. Training Facilitators to lead teams4. Training Experienced leaders who
will provide training in areas 1-3
Layers of Training Are Needed for Different Prevention Tiers
• Tier 1/Universal Interventions/Primary Prevention(Example: Training for teams in systems to create positive environments, teach communication and social skills, and collect data and intervene early)
• Tier 2/Secondary Prevention/Specialized (Example: Trainings for teams to use data for early identification of problem behavior and implementation of interventions that will support groups of individuals)
• Tier 3 or Tertiary Prevention(Example: Trainings for teams to create systems that address chronic and severe problem behavior)
Four Levels of Integrated Training
1. Awareness Training in PBS– Tier 1– Tier 2 – Tier 3
2. Training for Professionals in PBS (Preservice/inservice)
– Tier 1– Tier 2 – Tier 3
3. Training Facilitators to lead teams– Tier 1– Tier 2 – Tier 3
4. Training Experienced leaders who will provide training in areas 1-3
– Tier 1– Tier 2 – Tier 3
MU
SW-PBSTrainers
Schools
1999 2006
DESE
MO SW-PBSTrainers
in Regional Centers
Schools
2011
DMH
CPS DDD
Interagency Collaboration
CommunityMental Health
Community Support
Specialists
RO
BRT
SB40
TransitionCoordinators
First MO Interagency Task Orders
• Create Tertiary Level PBS Curriculum That Can Be Used Across Education, Human Services and Other Agencies
• Expand and Encourage Interagency Collaboration at State, Regional, and Local Levels
• Establish State Level Data-based Decision Making to Evaluate Impact of PBS in Missouri
• Ensure that Universities and Colleges Across Missouri Know About the Interagency Team and Can Access the PBS Curriculum
Two Regional Interagency Pilots • Awareness training in PBS for District team, Agencies in DD,
Mental Health, Families, etc• School-wide PBS tools to assist districts created and
embedded within the statewide training system (this is created with the team but embedded in the SWPBS training systems)
• Assistance in helping regional teams create strategies that will improve PBS planning for individual students within regions– Training– Service Coordination– Communication– Etc.
Additional First MO Interagency Task Orders
• Create 2 Glossy Brochures About the Interagency Efforts for Dissemination
• Gather information from Local, Regional, and Statewide Professionals to Guide Implementation
• Modify a District tier 2 & 3 self assessment checklist that includes interagency planning in addition to other district-level considerations
First MO Interagency Task Orders (Continued)
• Expand Tiered Training Systems in Developmental Disabilities– Medicaid Reimbursement for Organizations to
Implement Tiers 1 & 2 – Tier 3 Can Only Be Facilitated by BCBA Certified
Professionals)– Create a Training System Similar to Statewide PBIS
Products and Outcomes
• Logic model, draft task orders, and mission statement
• Modification of a district self assessment and implementation planning checklist for tiers 2 & 3 that includes interagency collaboration
• Team member audit of a tier 3 interagency training system in Kansas using online modules, onsite classes, mentoring observations, and intervention fidelity
Products and Outcomes (Continued)
• Policy document --how PBS can be implemented from a tiered perspective within the DD system
• Development of a tool similar to the Schoolwide Evaluation Tool (SET) – Agency Systems Supports Evaluation Tool (ASSET)
• Software program designed – “Big Seven” for Agencies – To provide data-based decision making in general
using Incident Reports
Products and Outcomes (Continued)
• Human subjects design outlining a plan for disseminating a qualitative study of interagency collaboration in MO
• First glossy brochure describing the purpose of the Missouri Interagency Statewide Team
• Training materials created for regional team (ie. Kirksville awareness PBS materials), meeting minutes, and perceptions of individuals participating in process thus far
Products and Outcomes (Continued)
• State interagency professionals visited two state schools implementing SW-PBS; during this visit information was gathered about how to begin structuring interviews, focus groups, and tool development
Working Smarter Not Harder
Using Already Existing Developmental Disability Resources to Establish Data, Systems, and Practices for Preventing
Problem Behavior and Increasing Quality of LIfe
Development of Division of Developmental Disabilities (DDD) Tiered Supports Systems
• 1:1 crisis behavior management ineffective and expensive-”focus on putting out fires”
• System wide approach necessary for effectiveness and best use of resources– Modeling after Mo-SW state level systems- “not re-
inventing the wheel”– Person Centered Process – focus on QOL – To implement must have training, coaching, mentoring
and system support
Systems
Data
Practices
Missouri Division of Developmental Disabilities (DDD) Tiered Support Work Structure
MO Division of Developmental Disabilities (DDD) Tiered Supports Practices include:
• 3) Intensive individualized behavior supports-
to be developed and implemented by licensed professionals.
• 2) Specialized strategies for common problem situations; and
• 1) Universal strategies-proactive, preventative, positive teaching based strategies for staff and families to use
Other System Modifications That Support Implementation
• Licensure required for practice of Applied Behavior Analysis (with exemption for IDEA)
• Medicaid Waiver services to fund additional assistance with implementation of model– Behavior Analysis services – for development of
Intensive Individualized supports – Person Centered Strategies Consultation - to
develop, around an individual, implementation of universal strategies that improve quality of life
MO DDD Expected Outcomes
• Development and implementation of universal strategies will:– Advance quality of life outcomes – Improve processes and practices– Support communication and consistency for all
individuals (those served and those supporting) – Reduce occurrences and severity of crisis
situations
Missouri Division of Developmental Disabilities Tiered Supports Model
What? Applied Behavior Analysis
What? Focused teaching strategies
What? Proactive, preventive, positive & teaching based strategies for staff and families to use consistently and continuously
Additional Example of Interagency PBS Awareness Brochure
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