1. POSITIVE PRACTICES RESOURCE TEAM ALLOCATION PROCESS Purpose: To identify and develop system capacity and resources that will be dedicated to address issues pertaining to a person’s behavioral support needs.

2. STARTLING STATISTIC!! 20-35% of all people with mental retardation 20-35% of all people with mental retardation have a psychiatric disorder - compared to have a psychiatric disorder - compared to 16-20% among the general population.

3. The National Institute of Mental Health (NIMH) ……mental health disorders occur substantially more often in person with mental retardation than they do in population without mental retardation. ……mental health disorders occur substantially more often in person with mental retardation than they do in population without mental retardation. The full range of psychopathology that exists in the general population also exists in persons with mental retardation. The full range of psychopathology that exists in the general population also exists in persons with mental retardation.

4. Why So Prevalent? Negative social conditions throughout life Negative social conditions throughout life Rejection by others/stigmatization and the lack of acceptance in general Rejection by others/stigmatization and the lack of acceptance in general Limited coping skills associated with language difficulty Limited coping skills associated with language difficulty Inadequate social supports Inadequate social supports High frequency of central nervous system impairment High frequency of central nervous system impairment

5. IMPACT Disrupts family and peer relationships Disrupts family and peer relationships Interferes with educational/vocational progress Interferes with educational/vocational progress Jeopardizes residential placements Jeopardizes residential placements Bottom Line – greatly reduces a person’s quality of life Bottom Line – greatly reduces a person’s quality of life Summation: It is imperative that people receive an accurate diagnosis and appropriate treatment/supports

6. Criteria For Referral A person with a developmental disability who is demonstrating escalating at-risk behavioral challenges. A person with a developmental disability who is demonstrating escalating at-risk behavioral challenges. Person the support team determines may be at risk for needing enhanced levels of support that are not readily available or known to the team. Person the support team determines may be at risk for needing enhanced levels of support that are not readily available or known to the team.

7. OMHSAS & OMR Collaboration Recovery Principle Everyday Lives Principle Principle that guides all interventions/interaction Principle that guides all interventions/interaction Consumer centered and self determined Consumer centered and self determined Driven by the belief that people need to have hope, connectedness, support, knowledge, value, purpose, and meaning in life Driven by the belief that people need to have hope, connectedness, support, knowledge, value, purpose, and meaning in life  Principle that guides all supports and services  Person centered  Driven by the belief that people, with or without a disability, want to be treated with dignity, respect, and have a life that includes choice, control, and relationships

8. Positive Practices Guides for Support Environment – Recognize that the person’s environment meets their needs and may influence their behavior. Environment – Recognize that the person’s environment meets their needs and may influence their behavior. Communication- Recognize that behavior is an attempt to communicate and promote assisting people to find ways to express themselves and be understood. Communication- Recognize that behavior is an attempt to communicate and promote assisting people to find ways to express themselves and be understood.

9. Guides to Support, cont’d. Assessment - Recognize the need for prompt assessment, diagnosis, and treatment of a person’s physical and psychiatric needs. Assessment - Recognize the need for prompt assessment, diagnosis, and treatment of a person’s physical and psychiatric needs. Hanging in There – Service and support staff need to have the ability to hang in there and continually reevaluate the environment, communication factors, and reassess needs. Hanging in There – Service and support staff need to have the ability to hang in there and continually reevaluate the environment, communication factors, and reassess needs.

10. System Resources Advocacy Staff (PP&A; ARC; etc.) Advocacy Staff (PP&A; ARC; etc.) Consultant Staff Consultant Staff County Staff County Staff Families/Friends Families/Friends Health Care Quality Units (HCQU) Health Care Quality Units (HCQU) Office of Autism Affairs Office of Autism Affairs OMR and OMHSAS Staff (Regional Offices; State Hospitals; State Centers) OMR and OMHSAS Staff (Regional Offices; State Hospitals; State Centers) Positive Practices Resource Team (PPRT) Positive Practices Resource Team (PPRT)

11. POSITIVE PRACTICES RESOURCE TEAM PPRT utilizes staff assigned to State Hospitals and State Centers demographically by region. PPRT utilizes staff assigned to State Hospitals and State Centers demographically by region. Skills and experience of PPRT cover a wide range in the positive approaches areas: Skills and experience of PPRT cover a wide range in the positive approaches areas: Psychiatrist; Psychologist; Nurses; Pharmacist; Social Worker; Direct Support Service; Recreation Therapist; Educator/Trainer; Spiritual/Pastoral Support Psychiatrist; Psychologist; Nurses; Pharmacist; Social Worker; Direct Support Service; Recreation Therapist; Educator/Trainer; Spiritual/Pastoral Support

12. Positive Practices Resources Team (PPRT) Allocation Process The referral for assistance will be made from any source including: The referral for assistance will be made from any source including:  Advocates  Counties/Administrative Entities  Families  OMHSAS Field Offices  OMR Customer Service Line  Self-Advocates  State Hospitals

13. PPRT Process Cont’d… The Regional Program Office will forward the referral form (Resource Allocation Analysis Form) along with a summary of the person’s current situation to the PPRT Coordinators. OMR Area Directors will be copied on this referral. The Regional Program Office will forward the referral form (Resource Allocation Analysis Form) along with a summary of the person’s current situation to the PPRT Coordinators. OMR Area Directors will be copied on this referral.

14. PPRT Process Cont’d… The PPRT Coordinators will review with OMHSAS & OMR Regional Office leads to determine next steps. The PPRT Coordinators will review with OMHSAS & OMR Regional Office leads to determine next steps. If a decision is made to meet with the person’s support team the PPRT Coordinators will identify PPRT members to be assigned. The assignment will be based on skill/experience strengths and availability. A team lead will be assigned. If a decision is made to meet with the person’s support team the PPRT Coordinators will identify PPRT members to be assigned. The assignment will be based on skill/experience strengths and availability. A team lead will be assigned.

15. PPRT Process Cont’d… The PPRT Coordinators will contact the PPRT members to provide information ad discuss activities. The PPRT lead will coordinate actions with the Regional Office. The PPRT Coordinators will contact the PPRT members to provide information ad discuss activities. The PPRT lead will coordinate actions with the Regional Office. Information obtained will be shared with PPRT members and on site visits conducted after reviewing information and discussing ideas with the PPRT Coordinators. Information obtained will be shared with PPRT members and on site visits conducted after reviewing information and discussing ideas with the PPRT Coordinators.

16. PPRT Process, cont’d. The PPRT members will explain their role and acknowledge the efforts of the support team. The PPRT members will explain their role and acknowledge the efforts of the support team. The PPRT members will then ask the support team for an update and begin to collaboratively bring together suggestions to address the challenges. The PPRT members will then ask the support team for an update and begin to collaboratively bring together suggestions to address the challenges. The PPRT lead will begin to compile a work plan identifying actions to be taken, target dates, and responsible person. The PPRT lead will begin to compile a work plan identifying actions to be taken, target dates, and responsible person. A copy of the work plan will be shared with the provider, the PPRT Coordinators, and the Regional Office. A copy of the work plan will be shared with the provider, the PPRT Coordinators, and the Regional Office.

17. PPRT Process Cont’d… The Regional Office Risk Management Committee will review the status of each work plan until a desired outcome is achieved. The Regional Office Risk Management Committee will review the status of each work plan until a desired outcome is achieved.

18. PPRT Process Cont’d… The PPRT Coordinators or involved Regional Office Staff will update the PPRT on outstanding issues during weekly PPRT update calls. The PPRT Coordinators or involved Regional Office Staff will update the PPRT on outstanding issues during weekly PPRT update calls. Information tracked by the PPRT Coordinators will be incorporated into reviews by the Statewide Positive Practices Committee and OMR and OMHSAS Program Offices. Information tracked by the PPRT Coordinators will be incorporated into reviews by the Statewide Positive Practices Committee and OMR and OMHSAS Program Offices.

19. PPRT – Regional Office Perspective Number of referrals Number of referrals Status of people referred Status of people referred Focus from the Region perspective Focus from the Region perspective

20. PPRT Leads Gretchen Hathaway, OMHSAS ghathaway@state.pa.us ghathaway@state.pa.usghathaway@state.pa.us 717-772-7526(office) / 717-649-6682(cell) 717-772-7526(office) / 717-649-6682(cell) Fred Lokuta, OMR flokuta@state.pa.us Fred Lokuta, OMR flokuta@state.pa.usflokuta@state.pa.us 570-443-4244(office) / 570-233-3520(cell) 570-443-4244(office) / 570-233-3520(cell) Ellen Wagner, OMR elewagner@state.pa.us elewagner@state.pa.us 570-372-5659(office) / 570-809-3765(cell) 570-372-5659(office) / 570-809-3765(cell) PPRT PP –1/10/07