Certification/Accreditation for IDD/MH: Raising the Bar

1. Certification/Accreditation for IDD/MH: Raising the Bar Robert Fletcher, DSW, NADD-CC Michael Schroeder, NADD-DDC NADD Ohio Conference - September 2016

2. Standards for Quality-ID/MH 4 Separate but interrelated competency-based quality standards programs: Accreditation for programs Certification for clinicians Certification for direct support professionals (DSP) Certification for specialists September 2016

3. Quality Standards are Important to: Provide monitoring and feedback on state-of the art and best practice support & treatment; Assist organizations, clinicians, person receiving services, families/advocates & insurance companies to make informed choices about quality of services; September 2016

4. Purpose of Program Provide a workforce and system with a demonstrated level of expertise; Assure that public and private healthcare dollars are purchasing effective services; Assist families/advocates to make informed choices about services. September 2016

5. Purpose of Program Promote & advance the field of DD/ID & MH by establishing competencies to ensure the highest standard of care; Develop & coordinate a system of evaluation and credentialing for programs and personnel at all levels; September 2016

6. Purpose of Program Increase effectiveness of supports, diagnosis, and treatment ; Recognize programs, clinicians, specialists and support staff that achieve full certification through the NADD review process. September 2016

7. What Is Accreditation Designation that a program is providing quality services; “Seal of Quality” that reflects that a program of an organization has met a standard of care, support, and/or treatment. September 2016

8. What Is Credentialing Review process designed to establish standards of practice; Identifies skills, knowledge, values, and attributes needed in a particular field. September 2016

9. Partner • The Accreditation and Certification Programs were developed by NADD in association with the • National Association of State Directors of Developmental Disability Services (NASDDDS) September 2016

10. Committee Participants Contributors from United States and Canada Professionally diverse Different agency types represented September 2016

11. Program Accreditation September 2016

12. Vision of Program Accreditation • Provide monitoring/ feedback in best practice care for facilities, clinicians, families, self-advocates and support staff that will improve the level of expertise in assessment, treatment and support; • Set standards to assist providers, clinicians, consumers, families/advocates and HMO’s to make informed choices about quality of services. September 2016

13. Areas of Accreditation • Treatment and treatment plans that: • Are team-based • Use positive approaches and PBS • Use best-practices • Measure response to interventions (data driven) • Integrated with other disciplines (medicine, gastroenterology, neurology, sleep) • Are driven by person & family—voice and choice September 2016

14. Areas of Accreditation • Organizational code of ethics • Training for staff, family & persons with ID/MI • Emergency interfaces with Emergency Departments, 911 & local police • Demonstrates cultural competency practices September 2016

15. 18 Module Competency : Areas and Scoring September 2016

16. 18 Module Competency : Areas and Scoring September 2016

17. Cost • Application fee $ 500 • Surveyor fee $2000/per surveyor/day • Annual fee $ 1000 for 3 years September 2016

18. Clinical Credential September 2016

19. Purpose of Clinical Credential • To recognize clinical personnel who have documented quality care and treatment for persons with ID and MI; • To create an awareness of best practices; • To promote excellence in clinical treatment & support for persons with ID/MI. • To improve consumer outcomes September 2016

20. Who Is Eligible? This effort targets professionals who either provide or design clinical supports for persons with ID and MI Mental health clinicians Behavioral health clinicians September 2016

21. Who Is Eligible? • Clinicians must have one of the following licenses in the USA or Canada: (equivalent accepted) • State/provincial license as a PhD, PsyD, or EdD Psychologist; • State license, BCBA, or governing body recognition as an Applied Behavior Analyst; • State license as a Physician; • State license as a Master’s level: Mental Health Counselor; Marriage & Family Counselor: Addictions Counselor. September 2016

22. Who Is Eligible? • State license as a Licensed Independent Clinical Social Worker; • State license as a Physician’s Assistant, Advanced Practice RN, or Nurse Practitioner (or clinical equivalent); • Other similar credentialing. We recognize that there is a huge variety of professionals with very different educational backgrounds to provide clinical support to persons with ID/MI who may qualify for this certification September 2016

23. Alternative Qualifications • Professionals with a Master’s level degree in a related field or RNs are eligible with additional experience as noted below and a through explanation of the experience base. September 2016

24. Required Experience • The applicant will have 5 years experience in support of persons with intellectual disabilities and mental health/addiction issues • This can include internships and externships • With Master’s Level professionals or RNs, 7 years is required. September 2016

25. Stages of Clinical Certification Process • Application & clinical portfolio • Submission of work sample • Interview • Response to case vignette provided by NADD September 2016

26. Application • 3 letters of reference about the applicant’s clinical skills, ethics, and experience with DD/MI persons • 1 copy of the license (unless waived) • 1 complete resume • Application fee, $375 • NADD membership number September 2016

27. Application Process • The certification committee shall review the materials and respond to the applicant within 60 days. • If accepted, the applicant will then be required to submit 1 work sample of clinical supports designed/provided by the applicant September 2016

28. Possible Information for Work Sample • Diagnosis • Multi-modal or biopsychosocial approach • Positive Supports • Modification of the Environment • Therapy • Psychopharmacology • Lifespan issues September 2016

29. Application Process • If the work sample is accepted, the candidate will participate in an interview with 2 members of the certification committee or other designees. • This interview shall include resolution of any remaining questions from the work sample. September 2016

30. Vignette Format • Presenting problem & goals • Social history • Family psychiatric history • Mental health history • Current diagnosis • Mental health conditions • Addiction conditions • Other co-morbid conditions • Medical history • Current medications, psychiatric medications and side effects • Legal involvement, if any • Person-centered description • Mental status description September 2016

31. Also in the Interview • The applicant will be presented 1 vignette and then be required to verbally respond with a case formulation and treatment plan; • This interview may occur in person, at a conference, via web-based video conferencing, or telephone. September 2016

32. Additional Benefit “The NADD competency-based clinical certification has provided me with an avenue to verify a dual diagnosis specialty. My ability to provide clinical supports to individuals supported both by medical assistance and private insurances has been expanded by allowing me to gain access to closed insurance networks. These networks had been closed to me prior to receiving this certification, allowing this population to remain largely unserved outside of community mental health centers.” • Alyse Kerr, MS, NCC, LPC, NADD-CC September 2016

33. Areas of Consideration • Ethics • Lifespan • Positive environment/behavior support • Psychopharmacology • Ruling out medical issues • Substance use • Assessment/Diagnosis • Therapy September 2016

34. Receiving & Maintaining Clinical Certification • If an applicant completes all stages successfully, NADD Clinical Certification is granted. • All applicants shall attest to following the ethical standards of their profession as well as state, province, or country ethics and regulations. September 2016

35. Continuing Certification • All Board Certified members shall obtain 10 hours of CE/CME activity every 2 years in ID/MH • This may be obtained in any manner that is recognized by the profession of the member. e.g., a psychologist must obtain CEs approved by the American Psychological Association; • Attending conferences, special training sessions, or web based learning are all acceptable; • Published scholarly activity in ID/MH and training others in ID/MH is accepted. • The member must retain these records for 5 years as the Certification Committee will conduct random checks of members each year. September 2016

36. Frequently Asked Questions • We addressed many of the Frequently Asked Questions here: • http://acp.thenadd.org/manuals/ccp-faq.pdf September 2016

37. Direct Support Professional Credentialing September 2016

38. DSP Certification • Develop certification for Direct Support Professionals working with individuals who have IDD/MI; • Identify competencies to evaluate the DSP’s knowledge, values, skill, and ability working with people with IDD/MI; • Increase the capacity of DSPs to work with individuals with IDD/MI; • Acknowledge the importance of the DSP in providing treatment and support to people with IDD/MI. September 2016

39. DSP Considerations Workforce • Age / Education / Background • Earnings • Turnover • Variability in Experience Credential • Affordable • Achievable • Comprehensive • Meaningful September 2016

40. Goals • Ensure use of best practices in providing supports to individuals who are dually diagnosed; • Evaluate existing curricula and certification programs, supplemented with relevant IDD/MI information; • Identify competency areas, operationalize applicable skills, and develop an application and evaluation process for credentialing. September 2016

41. Skills & Key Indicators • Acknowledge diverse backgrounds • Person-centered language • Self-directed supports • Agency/state or province policies & guidelines • Elements of critical thinking & communication in each area September 2016

42. Competency Standards in Five Areas • Assessment and Observation • Behavior Supports • Crisis Prevention and Intervention • Health and Wellness • Community Collaboration and Teamwork September 2016

43. Assessment and Observation • Knowledge and assessment of the observation process; • Use of assessment and observational tools; • Behavior assessment; • Documentation and communication related to assessment and observation. September 2016

44. Behavior Support • Knowledge and assessment of the causes and functions of challenging behavior. • Maintaining a supportive physical and social environment. • Responding to challenging behavior. • Teaching new behaviors and skills. September 2016

45. Crisis Prevention and Intervention • Knowledge and use of crisis prevention strategies; • Knowledge and use of crisis intervention strategies. • Documentation and communication related to crisis situations. • Managing stress and burnout. September 2016

46. Health and Wellness • Knowledge of health and wellness. • Knowledge of intellectual and developmental disabilities, mental health/addiction and co-occurring disorders. • Use and implications of medication. • Illness management and recovery. • Documentation and communication related to health and wellness. September 2016

47. Community Collaboration and Teamwork • Knowledge of Service Systems; • Communication Across Systems; • Building Positive and Cooperative Relationships; • Promoting Person-Centered Support, Informed Consent and Advocacy. September 2016

48. Certification ProcessPrerequisite Criteria • Employment history • Completed 1000 hours of work with individual(s) with IDD or MI (either paid or unpaid). • Must have worked for at least one full calendar year • Is an employee in good standing • in compliance with all agency and state/provincial requirements • completed required pre-service /pre-employment trainings • not under disciplinary review or employee probation September 2016

49. Code of Ethics • Person-Centered Supports • Promoting Physical and Emotional Well-Being • Integrity and Responsibility • Confidentiality • Justice, Fairness, Equity • Respect • Relationships • Self-Determination • Advocacy September 2016

50. On-line Application • Summary of experience; • Summary of education/continuing education coursework; • Letter of recommendation from supervisor; • Letter of recommendation from a person supported or the person’s representative; • Letter will be used to assure that knowledge, skills, values, and ethical behavior are addressed. September 2016