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| Individuals with Severe Behavioral Issues in the Community: A System for Comprehensive, Behavioral Support |
| Sunday, May 25, 2008 |
| 3:00 PM–4:20 PM |
| PDR 2 |
| Area: CSE/DDA; Domain: Service Delivery |
| Chair: Robin Williams (Sierra Regional Center) |
| Discussant: W. Larry Williams (University of Nevada, Reno) |
| CE Instructor: W. Larry Williams, Ph.D. |
| Abstract: Service delivery for individuals with challenging behavior within community settings is often fractured or disjointed given the multiple individuals, organizations and philosophies involved. This symposium will address delivery of comprehensive behavior support for individuals with disabilities and challenging behavior in normal community settings. Encompassed within that will be an overview of three programs which provide critical features and behavioral supports within Nevadas service delivery system. Issues with respect to coordinated services in a statewide initiative to reduce institutionalization to zero and provide wraparound, comprehensive support plans will be presented. In addition, methods for acquiring and maintaining funding, data collection, and current as well as future research initiatives and service coordination will be discussed. It is the intention of this symposium to provide practical strategies for implementing and sustaining integrated community, behavioral supports for challenging individuals. |
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| The Process of Change: Renewal of a Service Delivery System. |
| DONALD A. JACKSON (Nevada Division of Mental Health & Developmental Services), Robin Williams (Sierra Regional Center), W. Larry Williams (University of Nevada, Reno) |
| Abstract: As in most states, Nevada’s services for people with disabilities and significantly challenging behavior problems was lacking in the methods and procedures necessary to move to a fully community-based, full inclusion model of services. This paper will define the actuarial data, parameters of the existing service delivery system, and starting points for Nevada’s evolution to a comprehensive community support model. Data will be presented on service staff wages and education problems and the lack of adequate supervision and certification processes for providers. Gaps and duplications in services due to the lack of standardized and coordinated service entities and the absence of a functional protocol for minimal therapeutic and training methods and procedures will also be addressed. Based on this assessment, and framed in terms of the existing philosophical, economic, political, and social conditions, a blueprint for change was developed for Nevada’s service delivery system. A description of the resulting intervention protocols and strategies, and the system for ensuring the coordination of the various entities will be presented. |
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| Systems Change: Methods and Barriers to Coordinated Service Delivery. |
| SHARLET D. BUTTERFIELD (University of Nevada, Reno), Donald A. Jackson (Nevada Division of Mental Health & Developmental Services), Jeremy E. Rafacz (Sierra Regional Center) |
| Abstract: Based on the assessment of the gaps in community-based services in Nevada, it became apparent that new delivery strategies were required to address the need for positive behavioral supports, provider training, and crisis intervention and prevention services within the community. This portion of the symposium will describe the procedures developed to deliver these services and discuss some of the challenges these three programs experienced and continue to experience with respect to funding, organizing and providing wraparound, comprehensive support plans. The initial program is PBS-NV, a grant-funded organization designed to coordinate positive behavior programs for the state of Nevada. The second program is BECS-PBS, which addresses the unique issues involved in implementing behavior programs within provider agencies. The final program is an intensive services system within two regional centers for responding to crisis intervention and prevention services for individuals with disabilities. This presentation will discuss how to avoid overlap in providing services and how to coordinate services and supports for an individual with developmental disabilities. In addition, acquiring funding to support current initiatives and future services and research will be presented. |
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| Challenges Associated with Coordinating Data Monitoring Systems for Service Delivery. |
| JEREMY E. RAFACZ (Sierra Regional Center), Sharlet D. Butterfield (University of Nevada, Reno) |
| Abstract: Human service delivery models are responsible for developing, maintaining, and presenting information regarding the services they provide. Whether these service entities must answer to grant funding sources or governmental bodies results are necessary to validate the continued support of these efforts. Data will be presented on the development of comprehensive data collection systems that seek to capture the services provided in the community. Although each service entity was developed to address a pervasive need, namely individuals with behavioral challenges, the means by which this need was addressed differs. The presentation of data will specifically include demographics of the persons’ receiving services, types of service provided, quality of life measures, and the inclusion of crisis interventions into community settings. Case examples of successes will be provided in order to demonstrate the efficacy of a wraparound, comprehensive approach to service delivery. Additional discussion will consider the complications associated with compiling vast amounts of data, behavioral or not, and the implications for statistical analyses. |
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