1. S.T.E.P.S. Special Therapeutic Educational Program for Success Adams-Hanover Counseling agency collaborating with Central Dauphin School District to improve academic progress and service delivery to all students.

2. Philosophy Students with severe behavior problems do not necessarily have character flaws or are just “bad kids”. Students with severe behavior problems do not necessarily have character flaws or are just “bad kids”. These students are suffering from social skill deficits. These students are suffering from social skill deficits. Problem behavior is a skill deficit just like reading deficit, math deficit or writing deficit. Problem behavior is a skill deficit just like reading deficit, math deficit or writing deficit. The student needs to be taught how to take responsibility and resolve a real or perceived conflict appropriately. The student needs to be taught how to take responsibility and resolve a real or perceived conflict appropriately.

3. History 2002-2003 school year- Adams- Hanover had an existing relationship with Central Dauphin School District and worked collaboratively to develop an anger management program for students. This program was submitted to CBHNP for funding consideration- but was denied. 2002-2003 school year- Adams- Hanover had an existing relationship with Central Dauphin School District and worked collaboratively to develop an anger management program for students. This program was submitted to CBHNP for funding consideration- but was denied.

4. The team (agency and school district) went back to the drawing board to consider how the program could be implemented to support the students at Central Dauphin. The team (agency and school district) went back to the drawing board to consider how the program could be implemented to support the students at Central Dauphin. February 2003- A high school and a middle school anger management program was implemented and funded by the School District. February 2003- A high school and a middle school anger management program was implemented and funded by the School District.

5. 2003-2004 School year- During the course of this school year a total of 4 anger management groups were implemented to benefit the needs of students in the High School setting (2 groups), and Elementary School setting (2 groups). All groups were funded by the school district. 2003-2004 School year- During the course of this school year a total of 4 anger management groups were implemented to benefit the needs of students in the High School setting (2 groups), and Elementary School setting (2 groups). All groups were funded by the school district.

6. In the Spring of 2004- the school district and Adams-Hanover Mental Health agency collaborated to develop the current Model- STEPS (Special Therapeutic Educational Program for Success) which was implemented in the Fall of 2004. In the Spring of 2004- the school district and Adams-Hanover Mental Health agency collaborated to develop the current Model- STEPS (Special Therapeutic Educational Program for Success) which was implemented in the Fall of 2004.

7. Program changes A re-structuring of the emotional support classrooms to address the more serious behavior needs of our students. A re-structuring of the emotional support classrooms to address the more serious behavior needs of our students. Utilize an intensive social skill remedial instruction program in order to teach the skills necessary to overcome the deficit. Utilize an intensive social skill remedial instruction program in order to teach the skills necessary to overcome the deficit. Provide a structured classroom with a behavior management program and level system Provide a structured classroom with a behavior management program and level system

8. Collaborate with the community mental health agencies to provide intensive group therapy, social skills training, individual therapy, as well as, weekly parent updates. Collaborate with the community mental health agencies to provide intensive group therapy, social skills training, individual therapy, as well as, weekly parent updates. Extended beyond the classroom to include the family so that deeply entrenched unhealthy responses may be successfully re-patterned. Extended beyond the classroom to include the family so that deeply entrenched unhealthy responses may be successfully re-patterned.

9. Program Features Full time, self-contained model Full time, self-contained model Limited to 12 students (ideal number is 8) Limited to 12 students (ideal number is 8) Classroom behavior management system based on a point system and tangible rewards as reinforcers. Classroom behavior management system based on a point system and tangible rewards as reinforcers. Level system for a gradual increase in classroom and school wide privileges. Level system for a gradual increase in classroom and school wide privileges.

10. On-going training for all district staff who have students participating in STEPS- the training will prepare staff to receive the student back into the home school when behavior deficits have improved. On-going training for all district staff who have students participating in STEPS- the training will prepare staff to receive the student back into the home school when behavior deficits have improved.

11. Behavior Management System Point system Point system Individual contracts Individual contracts Classroom store Classroom store Level system Level system

12. Collaborative Features of the STEPS Program Academic collaboration Academic collaboration Therapeutic collaboration Therapeutic collaboration

13. Things we learned from our first year in operation!

14. Placement Students are considered for Steps on a continuum of services based on need. Students are considered for Steps on a continuum of services based on need. The student will have an educational classification of emotional disturbance. The student will have an educational classification of emotional disturbance. The student will have been involved in increasing degrees of support from less restrictive special education placements and have data to support a need for a more restrictive program. The student will have been involved in increasing degrees of support from less restrictive special education placements and have data to support a need for a more restrictive program.

15. The student will have a need for a full time, self-contained educational setting, with a highly structured environment, classroom behavior plan and level system for privileges. The student will have a need for a full time, self-contained educational setting, with a highly structured environment, classroom behavior plan and level system for privileges. The student should be eligible to receive mental health services through medical access. The student should be eligible to receive mental health services through medical access.

16. Parent signs permission to treat forms from Adams-Hanover for placement in STEPS. Parent signs permission to treat forms from Adams-Hanover for placement in STEPS.

17. Referral Process School teams must maintain documentation and data to show utilization of all available resources at the students home school prior to the referral to STEPS. School teams must maintain documentation and data to show utilization of all available resources at the students home school prior to the referral to STEPS. A student should have received several documented incidents for serious behavior violations and lack of improvement from interventions attempted at the current level of service. A student should have received several documented incidents for serious behavior violations and lack of improvement from interventions attempted at the current level of service.

18. The school team reviews the students overall educational progress and makes a referral to the District Social worker for a full time emotional support placement. The school team reviews the students overall educational progress and makes a referral to the District Social worker for a full time emotional support placement. The District STEPS program committee meets on an average of twice a month to review referrals, evaluate student progress and trouble-shoot problems. The District STEPS program committee meets on an average of twice a month to review referrals, evaluate student progress and trouble-shoot problems.

19. A representative from the referring school can attend the STEPS meeting to share documentation, data and concerns. A representative from the referring school can attend the STEPS meeting to share documentation, data and concerns. The STEPS committee reviews the referral and considers whether the STEPS program is a good match for the student. If not, other options are provided to meet the needs of the student. The STEPS committee reviews the referral and considers whether the STEPS program is a good match for the student. If not, other options are provided to meet the needs of the student.

20. Placement Process IEP meeting is held to discuss the need for a more restrictive level of service. IEP meeting is held to discuss the need for a more restrictive level of service. The students needs are discussed and the STEPS classroom can be considered on the continuum of services when less restrictive strategies have not been effective. The students needs are discussed and the STEPS classroom can be considered on the continuum of services when less restrictive strategies have not been effective.

21. When possible, the STEPS teacher or STEPS classroom therapist will be given an opportunity to observe the student prior to placement and review academic levels, behavior and functional behavioral assessment. When possible, the STEPS teacher or STEPS classroom therapist will be given an opportunity to observe the student prior to placement and review academic levels, behavior and functional behavioral assessment. It is extremely important to have the student and family fully understand the STEPS program and the level system process for the student to find success. It is extremely important to have the student and family fully understand the STEPS program and the level system process for the student to find success.

22. The Adams-Hanover therapist or school liaison will meet with the family at that initial meeting to explain the therapeutic components of STEPS and assist the family in applying for additional mental health services that may be available. The Adams-Hanover therapist or school liaison will meet with the family at that initial meeting to explain the therapeutic components of STEPS and assist the family in applying for additional mental health services that may be available.

23. Funding During the 2004-2005 school year- During the 2004-2005 school year- –Central Dauphin agreed to continue to partially fund the mental health components of the program. –When appropriate, Adams-Hanover obtained funding through Medical Access. –Adams-Hanover worked with families (without Medical Access) who could be appropriate to receive these services in an attempt to obtain this funding. –Adams-Hanover continued to abide by the Freedom of choice for providers given to all children and families.

24. Funding During the 2005-2006 school year- During the 2005-2006 school year- –Central Dauphin agreed to continue to partially fund the program on a month to month basis but due to budget restraints the team was advised that we may have to cut back on the “in school” services. – As before, when appropriate, Adams-Hanover obtained funding through Medical Access. Approval was given to consider out patient services for some of the STEPS students. –Adams-Hanover worked with families (without Medical Access) who could be appropriate to receive these services in an attempt to obtain this funding. –Adams-Hanover continued to abide by the Freedom of choice for providers given to all children and families.

25. Unfortunately the students who did not have Medical Access or were funded through another agency, had the opportunity to participate in the STEPS program but did not have the total intensive therapeutic program support that was available to the students who were fully enrolled and participating in the program. Unfortunately the students who did not have Medical Access or were funded through another agency, had the opportunity to participate in the STEPS program but did not have the total intensive therapeutic program support that was available to the students who were fully enrolled and participating in the program.

26. Analysis of Intensive Treatment Program Vs. Traditional BHRS services outpatient Therapists in STEPS classroom were available every day- throughout the day. Therapists in STEPS classroom were available every day- throughout the day. Therapist is on site and able to be immediately involved in implementing crisis plan. Therapist is on site and able to be immediately involved in implementing crisis plan. Collaborative educational plan which integrates therapeutic components into the curriculum. Collaborative educational plan which integrates therapeutic components into the curriculum. Consistent personal collaboration with school and family. The school teacher, paraprofessional and therapist plan and intensely work to incorporate skills and concepts into the every day themes. Consistent personal collaboration with school and family. The school teacher, paraprofessional and therapist plan and intensely work to incorporate skills and concepts into the every day themes. BHRS therapists are available one to two hours per week. BHRS therapists are available one to two hours per week. BHRS therapist needs to be contacted and frequently by the time the therapist arrives, the Mental Health crisis has been contained and difficult to recreate for problem solving and resolution. BHRS therapist needs to be contacted and frequently by the time the therapist arrives, the Mental Health crisis has been contained and difficult to recreate for problem solving and resolution. Often times the IEP and Treatment plan have not been worked on collaboratively Often times the IEP and Treatment plan have not been worked on collaboratively BHRS services often provide confusion to the family and the school because there can be as many as four individual therapists working with the student to achieve a goal. BHRS services often provide confusion to the family and the school because there can be as many as four individual therapists working with the student to achieve a goal..

27. Cost Analysis Cost analysis STEPS vs. BHRS Cost analysis STEPS vs. BHRS BHRS BHRS 6 children x 40 weeks x 20 hours weeks TSS x $29.20 =$140,160/year 6 children x 40 weeks x 1 hour/week BSC x $49=$11,760/year 6 children x 40 weeks x 2 hours/week MT x $43.60=$20,928/year TOTAL=$172,848/year STEPS STEPS 6 children x 40 weeks x 30 hours/week x $18/hour (rate)=$129,600 Difference Difference BHRS$172,848 STEPS$129,600 ------------ Savings$43,248 $43,248 x 6 classroom (36 children served)=$259,488 in savings $43,248 x 6 classroom (36 children served)=$259,488 in savings Notes: Notes: The STEPS includes having a Masters level staff at site ALL day. The BHRS model involves primary interaction with a bachelor’s level staff versus all interaction by a master’s level staff. The STEPS allows for maximum collaboration between the school and mental health staff.

28. Why provide an Education program with Therapeutic Support? STEPS is a creative and innovative level of service delivery to meet the needs of students who require a more intensive level of emotional and behavior support at or above the “Wrap around level” STEPS is a creative and innovative level of service delivery to meet the needs of students who require a more intensive level of emotional and behavior support at or above the “Wrap around level” From a mental health perspective, STEPS is a more efficient delivery of service compared to “Wrap” because students are able to get all their needs met. From a mental health perspective, STEPS is a more efficient delivery of service compared to “Wrap” because students are able to get all their needs met. Currently the inadequate delivery of services with only the available supports from BHRS frequently leads to a need for a more intensive level (i.e. partial or in-patient hospitalization). Currently the inadequate delivery of services with only the available supports from BHRS frequently leads to a need for a more intensive level (i.e. partial or in-patient hospitalization). Educationally, students requiring a more intensive level of mental health support, frequently need to be placed out of district to address the high level of specially designed instructions and program modifications. Educationally, students requiring a more intensive level of mental health support, frequently need to be placed out of district to address the high level of specially designed instructions and program modifications.

29. STEPS is not a Partial Program- Students have continued access to all of their District’s educational curriculum. Students have continued access to all of their District’s educational curriculum. It is the Least Restrictive Environment with the supports provided in the Home School District. It is the Least Restrictive Environment with the supports provided in the Home School District. Family Friendly setting- Parents are more familiar with school setting. Family Friendly setting- Parents are more familiar with school setting. The students have more opportunity for inclusion with typical peers. The students have more opportunity for inclusion with typical peers. STEPS is a higher level of services than BHRS but less than a Partial Program. STEPS is a higher level of services than BHRS but less than a Partial Program.

30. Removal from STEPS Once students are in the STEPS program, they must work their way through the five step level system. When they are at level five, they begin the transition process to return to either the general or special education classes in the school. Once students are in the STEPS program, they must work their way through the five step level system. When they are at level five, they begin the transition process to return to either the general or special education classes in the school. When they have successfully completed the transition process, a meeting is held to discuss the students educational needs and an program is developed. When they have successfully completed the transition process, a meeting is held to discuss the students educational needs and an program is developed.

31. Parental requests for removal from STEPS will be consider as any parent request for removal from special education services. If the disagreement can not be resolved at the school level IEP meeting, the parents or district can request mediation or move forward with a due process hearing. Parental requests for removal from STEPS will be consider as any parent request for removal from special education services. If the disagreement can not be resolved at the school level IEP meeting, the parents or district can request mediation or move forward with a due process hearing.

32. End Thank you! Thank you!