GEORGIA CRISIS RESPONSE SYSTEM-DEVELOPMENTAL DISABILITIES

1. GEORGIA CRISIS RESPONSE SYSTEM-DEVELOPMENTAL DISABILITIES Charles Ringling DBHDD Region 5 Coordinator/ RC Team Leader

2. Goals of the GCRS-DD • To provide time-limited home and community based crisis services that support individuals with developmental disabilities in the community • To provide alternatives to institutional placement, emergency room care, and/or law enforcement involvement (including incarceration).

3. Behavior Related Crisis An individual with developmental disabilities and a behavior related crisis • Presents a substantial risk of imminent harm to self or others; AND • Is in need of immediate care, evaluation, stabilization or treatment due to the substantial risk; AND • Is someone for whom there currently exists no available, appropriate community supports to meet the needs of the person.

4. Developmental Disability For individuals currently on planning list or receiving DD services • Diagnosis of intellectual disability prior to age 18 or • Diagnosis of closely related developmental disability prior to age 22 years For other individuals • Screening indicative of a developmental disability

5. Responsibilities of Crisis Response System Providers Must develop and maintain detailed description for onsite operations • On-Site Stabilization, including intensive home supports and professional consultation • Referral and/or transport to intensive out-of-home crisis supports • Referral to hospital emergency department

6. Accessing the Crisis Response System • Available 24/7, 365, statewide. • Call the Georgia Crisis & Access Line (GCAL) @ 1-800-715-4225 • A telephone triage is completed. If possible the crisis is resolved by GCAL.

7. Mobile Crisis Team Dispatch If GCAL is unsuccessful in resolving the crisis through telephonic crisis intervention they • Document need for face-to-face intervention and • Dispatch a mobile crisis team • Immediately contact the support coordination agency and the DD service provider, if applicable

8. Mobile Crisis Team Requirement • Respond and arrive on site within 1 ½ hours of the GCAL dispatch. • Address the crisis situation to mitigate any risk to health and safety to the individual and/or others. • Rule out any medical causes that might be contributing to the crisis prior to recommending any intensive crisis supports involving behavioral interventions.

9. Mobile Crisis Teams • Mobile Crisis Team members are responsible for completing a comprehensive assessment of the current crisis situation. • This assessment process shall include interviews with the individual, care providers and/or family members, • Observation of the current environment, and review of behavior and individual support plans. • The LCSW on the team is responsible for ensuring that the assessment process is thorough and complete.

10. Mobile Crisis Teams • When the Mobile Crisis Team completes services in the home, the LCSW or a designated Social Worker (MSW) completes a written discharge plan that shall minimally include: • Summary of precipitating events • Clinical interventions • Response to clinical interventions • Recommendations for continued interventions • Referral for additional supports (if applicable)

11. Criteria to receive Intensive In-Home Supports • Mobile team unable to mitigate crisis in reasonable time OR • Crisis resolved but environment or individual’s lack of skills make another crisis imminent AND • Caregiver or provider staff not capable of providing necessary intervention and protection for individual or others in the home AND • Intensive supports will allow individual to avoid institutional placement

12. Intensive In-Home Supports • Services include but not limited to: • Implementation of behavior intervention strategies, safety plans, or behavior plans • Provision of one-to-one support • Modeling of interventions with family or provider staff • Assistance with environmental adaptations • Accompanying individual to appointments related to crisis response

13. Criteria to receive Intensive Out-of-Home Supports • All of the Intensive in-home supports criteria AND • The safety of others living in the home cannot be maintained through Intensive In-Home Supports OR • Extensive environmental modifications are needed as a result of the crisis and the individual cannot reside in home during that time

14. Intensive Out- of-Home Support Requirements For Crisis Support Homes • Intensive Out-of-Home Supports are provided by Crisis Support Homes, serving no more than four adult individuals simultaneously. • Individuals ages 10-17 receive out-of-home crisis support services in Temporary and Immediate Support (TIS) homes.

15. Discharge Planning • Begins at time of initial assessment and continues throughout utilization of the Crisis Response System. • Process includes collaboration with all applicable parties, family members/caregivers, providers, Support Coordination Agencies, Planning List Administrators, Regional Intake and Evaluation (I & E) Teams.

16. Who to contact Georgia Crisis & Access Line: 1-800-715-4225