1. Emergency Contact Forms

2. Emergency Contact Forms
If an emergency situation occurs that requires the immediate use of emergency safety interventions, staff must notify the student’s parents within 24 hours. Regardless of whether parental consent has been obtained, a copy of the Emergency Contact Form, signed by the LEA, must be submitted to the Emergency Safety Interventions Committee designee within 24 hours.
Even if you have parental consent and was established in the BIP that emergency interventions could be used we still need one. Last year our district submitted 63 Contact forms.

3. Emergency Contact Forms
Any use of Emergency Safety Interventions must be documented on Physical Intervention Logs or Time Out Logs and be reported to the Canyons School District Emergency Safety Interventions Committee.
Last year our district logged 218 different uses of Emergency Safety Interventions. 29% of all Emergency interventions were reported to the committee through Emergency Contact forms. So we can improve.

4. Emergency Contact Forms
Remember all three of the following criteria must be met prior to use of emergency safety interventions:
There is imminent risk of serious harm to a student or some other person.
There is no other practical way to prevent harm.
The risk of NOT intervening is greater than the risk of intervening.
*Under no circumstances should emergency physical intervention be used for convenience or as punishment.

5. Emergency Contact Forms
Who is on the District Emergency Safety Interventions Committee?
Each committee includes at least two administrators, at least one parent or guardian of a student enrolled in the LEA, appointed by the LEA, and at least two certified educational professionals with behavior training and knowledge in both state rules and LEA discipline policies
In Canyons school district we have two different committees. One general education and one special education. There were several reasons for this. The main reason is that the issues in special education differ from General education.

6. Emergency Contact Forms
What do the Emergency Safety Committees do?
State Law says-
Shall meet often enough to monitor the use of emergency safety intervention in the LEA. Shall determine and recommend professional development needs.
Shall develop policies for local dispute resolution processes to address concerns regarding disciplinary actions.
An LEA shall have procedures for the collection, maintenance, and periodic review of documentation or records of the use of emergency safety interventions at schools within the LEA

7. Emergency Contact Forms
What do the Emergency Safety Committees do?
Each committee reviews the data around Emergency Safety Interventions or Emergency Contact Forms.
Each committee is looking for-
Was the use of emergency safety intervention justifiable?
Did we violate a student’s right to be free from restraint?
What can be done to support this student so this does not happen again?
What can be done to support this team so this does not happen again?
These committees are meant to help teams and schools. They are meant to be another recourse for schools. Next slide

8. Emergency Contact Forms
The committee discusses these things based on the information in the Emergency Contact form. It is important that these forms contain clear and sufficient information for the committee.

9. 2 time a week, 3 times a month, 4 times a year.
At the top student information
Contextual data
functional behavioral information
One person stability hold, Seclusionary time out.

10. What can we do, if the situation presents itself again, to help us not need the emergency intervention.
Steps,
Say the proactive intervention is a visual schedule, then in steps we would say, Jane Doe (SLP) will create the visual schedule after getting the schedule from Mr. Fulano (teacher).
I would recommend calling the guardians as soon as it is safe to do so. That way if the behavioral event last a long time, or there is a problem, the guardians are already aware of the situation.

11. Emergency Contact Forms
Common issues identified by the committees
When filling out the Emergency Contact Form remember-
Remember the student information on the top of the form.
Stick to the facts. Write only what you know happened. Was it observed? Was it measurable?
Take the preventative proactive intervention section seriously. This is an opportunity for the team to debrief and discuss what can be done to avoid the need for Emergency interventions in the future. Please write realistic preventative proactive interventions.
Example - offer more choices to student, use a visual schedule with student, work on self soothing strategies.
Non-example- Nothing, Bus needs to be on time, give me more staff, change of placement.
Although change of placement and staffing may be issues within the classroom, this section is not the appropriate place to discuss those concerns.

12. Look at some examples. These are based on several real experiences
Look at some examples. These are based on several real experiences. So if you recognize parts of this, that’s because this was your experience but don't be surprised if someone else here believes that it is their experience. This is not meant to criticize or down play what these teams have done to fill out the forms, I just borrowed their experience. The most common issue is the ABC portion filled out as an anecdotal report. Sometimes it is difficult for the committees to see the progression of events. This is also the section we get the most questions about.

13. Same experience just written down in a format that is easier to see the progression of what happened. In an ABC format.

14. Your turn. Here is another Example based on real experiences, take this form and re-write it in the ABC format.