Contract Updates: Residential Providers and Ancillary Service Providers

1. Contract Updates: Residential Providers and Ancillary Service Providers

2. Purpose • Clarify contractual expectations for regional office/Targeted Case Management (TCM) entities and residential/ancillary providers • Increase collaboration between providers, families, community resources and natural supports • Improve use of positive practices to improve quality of life and reduce crisis behaviors • Improve transition planning and implantation of plan for individuals requiring psychiatric hospitalization and crisis services • Reduce 30 day notices due to inability support • Reduce psychiatric hospitalization and crisis • Reduce reliance on intensive supervision for challenging behaviors

3. New elements in contract • Cause to terminate services requires attempts to address the situation with less restrictive means and in collaboration with the regional office and TCM entity • Participation in reviews and technical assistance by regional office and TCM entities • To prevent 30 day notices to terminate services and future crisis situations • To develop and implement systems and practices to more successfully support individuals

4. Examples of what Cause to terminate services might be: • Demonstrated implantation of positive, proactive strategies to address situations resulting in challenging behaviors (As documented in Profess notes, data collections, team meeting minutes, ISP addendums) • Positive, proactive strategies developed by team and with TCM and regional office involvement (& ancillary service providers) • Positive, proactive strategies used by support team consistently and correctly • Implementation of positive, proactive strategies is checked on frequently and problems resolved • Formal implementation review process with data collection consistently carried out by supervisors and administration or provider agencies with TCM and regional office assistance • Data collected to evaluate the effectiveness of these strategies • Accuracy of data collected is part of implementation review process • Requests for assistance from TCM, regional office, natural supports, ancillary services when problem situations are experienced

5. New elements • Requirement that the residential provider who gives notice continues to support the individual in the residence until an alternative support provider can be located, with assistance by the regional office to develop interim strategies for safe support

6. What might be interim strategies for support and assistance be? • Extra assistance in the form of consultation, modeling, staff training from the regional office technical assistance positions; BRT, CLC, FSC, TAC, PR, QE RN • Approval of short term additional service such as; • CIST for roommates to have additional community time, teach strategies to respond to problems from roommate • PCSC hours for all in home to assist in system and practice evaluation and changes for all • Licensed behavior professional to develop the BSP with team • Additional staffing hours for home to implement new strategies • Arranging temporary alternative housing for person

7. What is meant by continue to support? • Sometimes 30 days is not enough time to find and transition to another provider, the criteria is new provider is supporting person – not a number of days has elapsed since notice given – could this be reworded? • Provider must accept return from hospital or crisis unit • The regional office and TCM will secure an appropriate alternative service provider

8. New Elements • Requires increased transition planning and supports when an individual: • Utilizes crisis services, or • Is admitted to a psychiatric hospital, or • Moves to another residential provider

9. New Elements • Specifies increased collaboration with regional office and governmental entities like TCM and County Boards

10. What does collaboration look like? • Early, frequent communication when problems are starting, when transitioning to new provider, when using ancillary service providers, when hospitalization or crisis services are required • Utilization of regional office technical assistance, ancillary services, natural supports to problem solve and implement strategies • Active involvement of providers, TCM, regional office, guardian in transition planning from hospital, crisis service or between residential providers • Providing opportunities for new provider staff to visit current living situation, shadow support staff, participation of new provider in these opportunities