interconnected systems framework local implementation sites experiences and lessons learned lucille...

Interconnected Systems FrameworkLocal Implementation Sites

Experiences and Lessons Learned

Lucille Eber, Illinois PBIS NetworkJill Johnson, Illinois PBIS Network

Kelly Perales, Community Care Behavioral HealthBob Stevens, Charleston South Carolina

Mark Weist, University of South Carolina

October 25, 2012Center for School Mental Health

National Conference

Content for Today…

• How Multi-tiered Systems of Support (MTSS) can enhance mental health in schools

• Installing SMH through MTSS in Schools

• The Interconnected Systems Framework (ISF)

Why We Need MH Partnerships

• One in 5 youth have a MH “condition”

• About 70% of those get no treatment

• School is “defacto” MH provider

• JJ system is next level of system default

• Suicide is 4th leading cause of death among young adults

Why We Need MH Partnerships (cont.)

• At least twice as many youth need high levels of support than identified as EBD.

• Youth who are identified as EBD have experienced very poor outcomes

• Schools can’t do it alone; partnerships with communities are needed for success

Advancing Education Effectiveness: Interconnecting School Mental Health

& School-wide Positive Behavior Support

June 2012 – September 2013

Collaborative effort of the OSEP TA Center of PBIS, Center for School Mental Health, and IDEA Partnership(NASDE) bringing together national-level experts in the SMH and PBIS, state and district leaders, and selected personnel from exemplar sites currently implementing collaborative initiatives.

Advancing Education Effectiveness: Interconnecting School Mental Health

& School-wide Positive Behavior Support (cont.)

Publish a monograph that provides a summary and framework for interconnection, documents examples of success, and lays out a research, policy, and technical assistance agenda for the future.

The Context

• Over 18,000 schools engaged in implementation of SWPBIS (MTSS ) prevention based system

• Current focus on capacity to scale-up • MTSS as platform to install effective

interventions for youth w/or at-risk of EBD

The Context (cont.)

• Emphasis now on scaling with expansion and connection to other systems – i.e. academic, juvenile justice, mental health

• Emphasis on deliberate actions that foster connections w/families & community

“Expanded” School Mental Health

• Full continuum of effective mental health promotion and intervention for ALL students

• Reflecting a “shared agenda” involving school-family-community partnerships

• Collaborating community professionals (augment the work of school-employed staff

Positive Behavior Intervention and Support (www.pbis.org)

• Decision making framework to guide selection and implementation of best practices for improving academic /behavioral functioning

• Data-based, measurable outcomes, evidence-based practices, systems to support effective implementation

Core Features of a Response to Intervention (RtI) Approach

• Investment in prevention, screening and early intervention for students not at “benchmark”

• Multi-tiered intervention approach

• Use of progress monitoring and problem-solving process at all 3-tiers

• Research-based practices and active use of data for decision-making at all 3-tiers

• Use of progress monitoring and problem-solving process at all 3-tiers

ISF Defined– structure and process for education and mental health systems

to interact in most effective and efficient way.– key stakeholders in education and mental health system who

have the authority to reallocate resources, change role and function of staff, and change policy.

– strong interdisciplinary, cross-system collaboration.– tiered prevention logic as the overall organizer to develop an

action plan.– cross system problem solving teams that use data to decide

which evidence based practices to implement.– ongoing progress monitoring for both fidelity and impact. – active involvement by youth, families, and other school and

community stakeholders.

Structure for Developing an ISF:

A District/Community leadership that includes families, develops, supports and monitors a plan that includes:

– Community partners participating in all three levels of systems teaming in schools: Universal, Secondary, and Tertiary

– Team of SFC partners review data and design interventions that are evidence-based and can be progress monitored

– MH providers from both school and community develop, facilitate, coordinate and monitor all interventions through one structure

Old Approach New Approach

• Each school works out their own plan with Mental Health (MH) agency;

• District has a plan for integrating MH at all buildings (based on community data as well as school data);


• A MH counselor is housed in a school building 1 day a week to “see” students;

• MH person participates in teams at all 3 tiers;


• No data to decide on or monitor interventions;

• MH person leads group or individual interventions based on data;

SPARCS Integration

Jill Mathews-Johnson, MSW, LCSWIL PBIS Network

[email protected]

Interconnected Systems Framework Systems Features

• Exploration and Adoption• Installation Phase• Initial Implementation• Full Implementation• Innovation and Sustainability

Fixsen, 2010

Pathway to ISF

• Youth and Family Service Director and IL PBIS TAC passion for ISF– Relationship built four years earlier in writing a

SSHS grant in Urbana • SAMSHA grant, Champaign County• Local leaders and administrators belief in need

for integration to address all students’ needs

Systems FeaturesExploration and Adoption

• At the building level– Admin team was meeting weekly and looking at the data

to determine needs• Gaps were identified – mental health

– Administrators, Community Elements Director for Youth Services and PBIS TAC met to determine intervention to meet needs and continued meeting every few weeks to set up system features

– Secondary Systems Team was formed

Organizational Structures

Administrative Team Centennial HS

&Secondary Systems

Team

LiaisonsJill & Juli

Community Elements

(United Way/708 Board/ACCESS

Intervention - SPARCS

• SPARCS – Structured Psychotherapy for Adolescents Responding to Chronic Stress – Mission of SPARCS: To enhance trauma focused

services available to traumatized children and adolescents (complex trauma)

– Group members – history of chronic interpersonal trauma, living with significant ongoing stressors, may or may not meet full criteria for PTSD and exhibit functional impairment.

http://sparcstraining.com/

SPARCS

• Evidenced informed intervention• 16-one hour groups• Adolescents 12-21• History of trauma (broadly defined)• Living with ongoing stressors• Exhibit functional impairment• Trauma Screening (TESI)

Installation Phase Systems Features

– Community mental health staff (Director and Program Coordinator) with the assistance of the PBIS TAC set up meetings with key school administrators (Principal, AP’s) to introduce SPARCS to them

• Follow-up meetings periodically to deal with larger system issues

– PowerPoint presentation of key program features presented to admins, school social workers, school psychologist and counselors

• Shifting of school-based staff roles/responsibilities discussed

The Nuts and Bolts– Discussion of potential target population and how data would be used

to identify students– Discussion on how referral process to community provider would

happen and who would communicate with student’s parents– Referral form and program flyers developed for school staff to share

with parents– One school contact person was identified for on-going communication

(mostly by email) and problem solving as issues arose• This person was key as she was responsive and reliable

– Community Elements workers were added to secondary systems team

Organizational StructuresIdentifying Students with Needs

• Data-based Decision Rules for Entrance– At Centennial, students are referred for SPARCS

because they are freshman/freshman status and• They have been through two tier two interventions and

have not responded• They are READY (alternative school) students

transitioning back to Centennial**• They have had multiple SASS contacts• Meet criteria for trauma experience as screened using

the TESI-SR (Traumatic Events Screening Inventory-Self Report)

** READY, Juvenile Detention & MH providers also providing across the community

Organizational StructuresFunding

• SAMHSA SOC Cooperative Agreement– ACCESS Initiative

• United Way of Champaign County• Medicaid billing (future)• Probation/Court Services (future

Organizational StructureAssessing Personnel Skills/Talents

• Community Elements personnel hired specifically to provide school-based supports

• School-based staff, with behavioral background, are present during group

• SPARCS trained – Ongoing support by national SPARCS trainers

Referral to Release Name to Community Elements

Referral for SPARCS

Back of Referral

School-Community PartnerInformation Sheet

Initial ImplementationSystem Features

• Secondary Systems Team meetings – Meeting twice a month

• to talk through systems response • to work through system implementation issues • to build rapport and building relationship• to communicate and implement with fidelity

• Liaisons that understand and can build relationships between the two systems

Initial ImplementationSystems Features

– The school staff initiated the referrals to the program by first identifying appropriate youth, contacting parents and receiving permission to provide student’s name to community provider

– Community mental health staff completed all intake paperwork and screenings with students/families and subsequent follow-up information

– School staff made sure each student arrived to the group on time– Community mental health works facilitated groups and one school

social worker sat in on the groups to assist with any issues as they may be related to school policy and staying connected with the students

– School staff tracked data to report at year end

Data Systems

• School– ODRs– ISS– OSS– Credits/Grades– Attendance– Additional SASS calls (future)

• Mental Health– Youth group survey results– (2012-2013) Strengths and Difficulties Questionaire, TESI-R

and YOQ

OutcomesSchool Data – Office Discipline Referrals

Student 1 Student 2 Student 3 Student 4 Student 50

1

2

3

4

5

6

7

8

9

10

ODR Comparison 14 Weeks Before Intervention and 14 Weeks on Intervention

ODR Total 14 Weeks Before InterventionODR Total 14 Weeks On Intervention

Students

Num

ber o

f ODR

s

100%↑

23%↓ 25%↓

66%↓

45%↓

37% Re-ductionOverall

OutcomesSchool Data – In-School and Out-of-School Suspension

Total Number ISS Total Number OSS0

5

10

15

20

25

ISS and OSS 14 Weeks Before vs 14 Weeks During Intervention for Group

BeforeAfter

Offenses

Tota

l Num

ber

25% ↓

23%↓

OutcomesSchool Data – Tardies and Absences

Studen

t 1

Studen

t 2

Studen

t 3

Studen

t 4

Studen

t 50

10203040506070

Unexcused Tardies by Se-mester

First Semester Un-excused TardiesSecond Semester Unexcused Tardies

Students

Num

ber

Studen

t 1

Studen

t 2

Studen

t 3

Studen

t 4

Studen

t 505

1015202530

Absences by Semester Excused and Unexcused

First Semester AbsencesSecond Semester Absences

Students

Num

ber

OutcomesSchool Data - Grades

A B C D F012345

Student 1 Grades by Se-mester

Total Semester 1Total Semester 2

Grades

Num

ber

A B C D F0

1

2

3

4



Grades

Num

ber

A B C D F012345



Grades

Num

ber

A B C D F0246

Student 3 Grades by Semester


Grades

Num

ber

A B C D F0

4

Student 5 Grades by Semester


GradesN

umbe

r

Staff Feedback

• Mental Health Providers– Positives

• Being part of Tier II team helpful• Having school staff facilitate arrival/departures from

group very helpful

– Future Improvements• Need to improve communication with school staff

when events occur with students in group• Having one dedicated administrator is essential to

coordination• Need more time prior to group start to get to know

students/families

Student FeedbackStudent Survey Results

1=strongly agree 2=disagree 3= don’t know 4=agree 5=strongly agree

Skills were helpful to me:a) Mindfulness 3.8b) Self-sooth/distract 4.4c) LET ‘M GO 4.0d) MAKE A LINK 4.2

Have used skills outsideof group 4.4

Student Feedback Continued

• What was the best part of group?“It helped me to make better choices and not get

into trouble”“That you can talk about stress level and feelings”“It allowed me to share”“It helped me to identify my sources of anger”“I liked that it had structure, that we had a lesson

plan that we followed and I liked the handbook”“Food”

Expansion

• Feeder middle school• Other Champaign high school• Alternative school (that Centennial refers out

to or receives students back from

• Additional sites in: Rantoul and Urbana

How Do We Get Things Started?

SPARCS

Embedding SPARCS in All Three Tiers

How Do We Get Change to Occur?Lessons Learned

• Stakeholders

• Liaisons who:– understand both systems– are open to integration– have “power” in at least one system

StudentOutcomes

Decision Makers

Liaisons

Admin-istrators

Field Staff

How Do We Get Change to Occur?Lessons Learned

• Schedule meetings with stakeholders – Bi-monthly “Secondary Systems” meetings– Monthly/Quarterly administrative meetings

• Allows all stakeholders to have voice• Keeps communication lines open

• Establish procedures and protocols• System where academic and behavior interventions linked• Create true partnerships

– Stakeholders need to be seen as viable members in both settings (team membership, professional development)

• Student and family voice• Make interventions sustainable

– Funding – Part of system of support

PAPBS Network Tertiary Demonstration Project

• Community Care as affiliated partner in the PA Positive Behavior Support (PBS) Network

• History of PA SBBH Community of Practice• History of Community Care transformation of

children’s behavioral health services

Pennsylvania’s Community of Practice (CoP) on

School Based Behavioral Health (SBBH)

The CoP on SBBH was initially established in 2006 through the Bureau of Special Education (BSE) as a means by which to address school-based behavioral health.

Presently, the CoP includes membership of approximately 52 individuals including representatives from the Pennsylvania Departments of Education, Health, and Public Welfare in addition to youth serving provider agencies, managed care organizations, advocates, and youth and family members.

The Commonwealth of Pennsylvania

• Local control for counties and school districts• Behavioral health managed care organizations

– Carve out – County choice

• Community Care– Over half of the counties– Oversight from stakeholders

• Office of Mental Health and Substance Abuse Services (OMHSAS)– Systems of Care– Integrated Children’s Service Planning

54© 2010 Community Care

Pennsylvania Mental HealthContinuum of Care

Inpatient

Residential Treatment Facility (RTF)

Individualized Residential Treatment (IRT)/TFC/CCR Host Home

Behavioral Health Rehabilitation Services (BHRS)

Family Based Mental Health Services (FBMHS)

Family Based Partial Hospital School-Based Mental Health (SBMH)

Outpatient

Intensive Case Management/Resource Coordination (ICM/RC)

Crisis Services (Mobile Crisis, Emergency Room, and Walk-in Crisis Centers)

• Stakeholder input regarding current BHRS and children’s service delivery– Families– Educators– County partners – child serving systems

• Unique opportunity to partner with Department of Welfare and OMHSAS

• Transformation of children’s services– Partnership with oversight– Stakeholder input– Development of program description template


History of the Development ofSchool Based Behavioral Health (SBBH) Team Service

A Clinical Home Model

Accountable Clinical Home

• Accountable TO the family and FOR the care• Accessible, coordinated, and integrated care• Comprehensive service approach • Increased accountability and communication• Single point of contact for behavioral health• School is “launching pad” for services delivered in all

settings• Youth continue on the team with varying intensity of

service

SBBH Service Components

CLINICAL INTERVENTIONS

CASE MANAGEMENT

CRISIS INTERVENTION

CASE CONSULTATION AND TRAININGfor educational staff

SBBH Team Components

LICENSED MASTER’S PREP

CLINICIANS (MHP)

EXPERIENCEDBACHELOR’S PREP WORKERS (BHW)

ADMIN AGENCY SUPPORT

CONSULTATION TO MHPS PRN

Community Care Support of SBBH Teams

LEARNING COLLABORATIVE

TRAINING

TECHNICAL ASSISTANCE

EVIDENCE-BASED PRACTICES

COACHINGMODEL FIDELITY

CARE MANAGEMENT

Learning CollaborativeA Community of Practice for Providers

• Training, case consultation, coaching – stability of workforce, integrity of practices, fidelity to model

• Platform – – Family systems theory and interventions– Resiliency/recovery principles and supports– Trauma informed care– Identification of co-occuring disorders– Positive behavior interventions and supports


District and Community Leadership Team

• Quarterly meetings• Stakeholder representation – System of Care• Implementer’s blueprint• Systems, data and practices• Scaling and sustainability

Time Line

School Year Activity

2008-09 •Community Care engaged district through ICSP regarding SBBH Team

2009-10 •SBBH Team begins work within district – September 2009•District and Community Leadership Team is established, district commitment signed, tertiary demonstration project begins – spring 2010

2010-11 •Tier One SWPBIS is fully implemented with kickoff at the start of the school year•Tier Two training begins in the spring of 2011 with some implementation

2011-12 •All three tiers are being implemented at both elementary schools•Montrose Junior High receives Tier One training in fall, with “soft” kickoff in January 2012•Discussion of SBBH Team model expanding into Junior and Senior High

Montrose

• Jr High implementation• SBBH and school collaboration – doing more

with less – reallocation of resources• Fiscal and clinical responsibility• Community connections and partners

– ICSP - SOC

1-5% 1-5%

5-10% 5-10%

80-90% 80-90%

Tertiary, Tier 3, Individual

Child Outcomes SurveyStrengths and Difficulties Q.Teacher feedbackAcademic data

Tertiary, Tier 3, Individual

•Guidance counselors see individual students•SBBH Team

Secondary, Tier 2 Group/Individual

Data from Tier One teamProgress monitoringData decision rules

Secondary, Tier 2 Group/Individual

•Guidance counselors run Targeted groups•IST•CICO•mentoring

Universal, Tier 1 Whole School ODRs, teacher nominations,Card system, MMS,

(lessons learned)

Universal, Tier 1, Whole school

•Guidance counselors teach “I Can Problem Solve” lessons•Treehab D and A awareness•Bully prevention/Character Ed•Peer Mediation

Montrose Elementary SchoolsK-6th Grade

Data Practices

Scranton School District

Year One2009-10

Year Two2010-11

Year Three2011-12

Year Four2012-13

Year Five2013-14

Year Six2014-15

District and Community Leadership Team established. District commits to implementing SWPBIS with fidelity across the district.

SBBH Teams begin implementation at Frances Willard Elementary, George Bancroft Elementary, and Scranton High. A Tier Three support.

Frances Willard Elementary, George Bancroft Elementary, and Scranton High all receive training to implement Tier One SWPBIS.

Frances Willard Elementary, George Bancroft Elementary, and Scranton High all implement Tier One SWPBIS.

Frances Willard Elementary reaches implementation fidelity.

Frances Willard Elementary receives training for implementation of Tier Two and begins implementation.

Frances Willard Elementary implements three tiers of Interconnected Systems Framework.

Isaac Tripp Elementary, McNichols Plaza Elementary, and South Scranton Intermediate all receive training to implement Tier One SWPBIS.

Isaac Tripp Elementary, McNichols Plaza Elementary, and South Scranton Intermediate all implement Tier One SWPBIS.

George Bancroft Elementary and Scranton High receive training for implementation of Tier Two and begin implementation

Scranton High receives training and begins implementation of RENEW.

SBBH Teams begin implementation at Northeast Intermediate, John F. Kennedy Elementary, McNichols Plaza Elementary, and John G. Whittier Elementary.

John F. Kennedy Elementary, John G. Whittier Elementary, and Northeast Intermediate all receive training to implement Tier One SWPBIS.

John F. Kennedy Elementary, John G. Whittier Elementary, and Northeast Intermediate all implement Tier One SWPBIS.

Tier 3/Tertiary Interventions 1-5%1-5% Tier 3/Tertiary Interventions

•SBBH Team•Outpatient therapy•SB Partial•Guidance – individual support•SAVES/school aged mothers

Tier 2/Secondary Interventions 5-15%5-15% Tier 2/Secondary Interventions

•SAP•Guidance – groups•Community Partners – groups•Resource Officer

Tier 1/Universal Interventions80-90%

80-90% Tier 1/Universal Interventions•SWPBIS•Drug and Alcohol Prevention

School-Wide Systems for Student Success:A Response to Intervention (RtI) Model:

Resources

Illinois PBIS Network, Revised May 15, 2008. Adapted from “What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/school-wide.htm

Needs

Scranton High School

Key features• Systems

– District and building teaming models – Facilitation, technical assistance, coaching– Stakeholder participation and buy-in

• Practices– Mental health and school staff work in an integrated way to support

students across tiers– Using assessment and screening in order to determine which EBPs to

use, progress monitor– One plan for both education and mental health

• Data– Shared decision rules– Used for decision making with all stakeholders at the table – school, mental health,

other child serving systems, family

OutcomesChange in Family Functioning

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Change at 3 mos Change at 6 mos Change at 9 mos

Not Implementing Low Fidelity High Fidelity

Impr

ovin

g

OutcomesChange in Child Functioning

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1.8

Change at 3 mos Change at 6 mos Change at 9 mos


Impr

ovin

g

Outcomes – SDQ-PChange in Difficulties Score

-3.5

-3.0

-2.5

-2.0

-1.5

-1.0

-0.5

0.0

0.5

1.0

Change Q1 Change Q2


Impr

ovin

g

Outcomes – SDQ-TChange in Difficulties Score

-4.0

-3.5

-3.0

-2.5

-2.0

-1.5

-1.0

-0.5

0.0

0.5

1.0

Change Q1 Change Q2

Impr

ovin

g


The Smith Family

• Jason was referred to the SBBH Team in November. He is a seven-year-old first grader who was having difficulty coming to school and being separated from his mother.

• When he was four, Jason and his family were in a car accident in a rural area. The members of the family were taken to different hospitals and Jason did not know where his mom was or if she was okay.

• Every day, since the first day of school, Jason’s mom would bring him into the school and the school staff would literally have to peel Jason off of his mother and hold him so she could leave.

The Smith Family cont.

• Once referred to the team, they were immediately able to work with Jason and his family to create strategies to help him separate more smoothly.

• Jason found the SBBH Team office/room a safe place to be. His mother also spent time there to help create a nice transition area.

• After the Holiday break, Jason began riding the bus for the fist time, accompanied by one of the BHWs from the team.

• Soon, Jason was able to ride the bus on his own, increasing his confidence and allowing him some relief from his anxiety.

Child Outcomes Survey (COS) Family Functioning:Child X

11/2

9/11

12/1

3/11

12/2

7/11

1/10

/12

1/24

/12

2/7/

12

2/21

/12

0

1

2

3

4

5

6

7

8

9

10

Solve Problems Shared Decisions

Leve

l of S

ucce

ss

Child Outcomes Survey (COS) Child Functioning and Therapeutic Inventory: Child X

11/2

9/11

12/1

3/11

12/2

7/11

1/10

/12

1/24

/12

2/7/

12

2/21

/12

0

1

2

3

4

5

6

7

8

9

10

FAMILY PEERS SCHOOL TASKS ave inventory

Leve

l of S

ucce

ss

Child Outcomes Survey (COS) Overall Wellness:Child X

11/2

9/11

12/1

3/11

12/2

7/11

1/10

/12

1/24

/12

2/7/

12

2/21

/12

0

2

4

6

8

10

12

14

Day

s

Strength and Difficulties-Parent Report: Child X

11/1/11 2/1/120.00

1.00

2.00

3.00

4.00

5.00

6.00

7.00

8.00

9.00

10.00

Emotional Symptoms Conduct Problems Hyperactivity Peer ProblemsProSocial

Subs

cale

Sco

re

Strength and Difficulties-Teacher Report: Child X

11/1/11 2/1/120

1

2

3

4

5

6

7

8

9

10

Emotional Symptoms Conduct Problems Hyperactivity Peer ProblemsProSocial

Subs

cale

Sco

re

Lessons Learned

• Return on investment• Funding efficiency• Scaling and sustaining SBBH Teams – size• Community “politics”

SBMH ConferenceOctober 2012

Bob Stevens, Charleston, SC

Charleston County, SC• 45,000 students in 78 schools.• Over 100 miles from the most distant schools• Rural, inner city, and suburban schools• Student Population: 46% African American; 46% Caucasian; 3%

Mixed; Asian 2%; 1% Native Amer.; 1% other• 14% Identify themselves as Latin or Hispanic• 60% receive free or reduced meals• 9.5% have IEP’s• 6% not English proficient • Historically in CCSD schools; nurses, guidance counselors, a few

contracted mental health counselors, para-professional behavior support staff; school psychologists not school based.

Tier 3/Tertiary Interventions 1-5%•Individual students•Assessment-based•High intensity

1-5% Tier 3/Tertiary Interventions• Individual students• Assessment-based• Intense, durable procedures

Tier 2/Secondary Interventions 5-15%•Some students (at-risk)•High efficiency•Rapid response•Small group interventions• Some individualizing

5-15% Tier 2/Secondary Interventions• Some students (at-risk)• High efficiency• Rapid response• Small group interventions• Some individualizing

Tier 1/Universal Interventions 80-90%•All students•Preventive, proactive

80-90% Tier 1/Universal Interventions• All settings, all students• Preventive, proactive

School-Wide Systems for Student Success:A Response to Intervention (RtI) Model

Academic Systems Behavioral Systems

Illinois PBIS Network, Revised May 15, 2008. Adapted from “What is school-wide PBS?” OSEP Technical Assistance Center on Positive Behavioral Interventions and Supports. Accessed at http://pbis.org/schoolwide.htm

Old Mental Health Provider Job Description

• Provides services on IEP• Maintains channels of communication with principals

and teachers• Provides assistance in crisis situations• Maintains communication with students, parents,

educational personnel, and community• Provides and participates in in-service• Conducts seminars for parents • Other duties as assigned.

Newly Designed Job Description• Participate in building based activities that support the School Improvement Plan• Participate in Secondary and Tertiary intervention planning meetings• Participate in development and implementation of strategies and activities related

to PBIS• Use data to determine effectiveness of research based intervention (pre and post)• Use the three tiered approach to intervention planning to enter, progress monitor,

and exit youth from interventions (based on data)• Providing coaching and professional development for staff

Job Description (New, cont.)• Provide conflict resolution training, drug and alcohol education, and

social skills training based on secondary or tertiary team• Provide direct services to children in crisis• Provide school social work services to children as determined in the

IEP process based on a continuum of preventative interventions• Develop and maintain working relationships with students, parents,

educational personnel, and community• Participate in the development of Tertiary interventions in the form of

FBA/BIP or wraparound teams

Common Trends

• Moving from reactive to preventative• Time efficient and least restrictive• Moving from Tier 1 to leading Tier 2/3• Facilitating Tier 3 Interventions• Serving students needs vs. “labeled”

populations• Systems approach• Intervention vs. Referral to Professional

Developing Charleston’s - Interconnected Systems Framework

Low LevelCommunication between Providers

ToCollaboration with Providers

ToHigh level

Integration of Providers

Developing an Integrated Systems Framework

School-based Mental Health in Charleston SC

Developing an Integrated Systems Framework School-based Mental Health in Charleston SC

The Evolution in Charleston, SC

• Mental health counselors when supported by Medicaid

• Part-time guidance in many schools which focused primarily on academic counseling.

• Very limited number of social workers in the district office working in the Office of Exceptional Children supporting identified students

• School psychologists assigned to multiple schools with “testing” as priority.

From 0 to 60 in two yearsExpanded Mental Health

• Federal Counseling Grant• Charleston Promise Neighborhood • Medical University of South Carolina• Climate Grant• Gear Up Grant• Allocation from General Operating Fund• Community In Schools Support

ISF

• SSW, MH, CIS developing new roles in CCSD schools

• Integrating with current systems, creating new systems

• Existing Teams – School Leadership– PBIS– TEAM Two– CORE (Tier 3)

• External Partners

Use Data to Drive Activities

• Data that will lead to intervention before referral– At-Risk Alert System– SWIS– Social Emotional Measures

Intervention Vs. Referral• ARAS (pronounced “air-us”) is the At-Risk Alert System: a

data tool developed by Charleston County School District as part of a federal Safe Schools/Healthy Students grant.

• Helps identify students potentially at-risk by using existing academic & behavior data.

• Transforms data into reports to support effective decision making.

• Provides composite views of magnitudes of risk factors existing for students and schools.

• Supports a variety of student support models.

Risk Indicators

• ARAS uses student academic and behavior data currently available in PowerSchool and other district data bases as indicators to assess potential risk.

• For each of eight indicators, students are assigned to

one of three levels: – Level 1 (Motivated/Low Risk)– Level 2 (Vulnerable/Moderate Risk)– Level 3 (Critical; High Risk)

Use Data to Monitor Practices

Tier Three

Tier Two

Tier One

Academic Social Emotional

Mental Health

Physical

What Services are Delivered

Professional Physica

l Health

College/Career Preparation

Professional M

ental Health

Basic Needs/R

esources

Family Engagement/Stre

ngthening

Academic Assis

tance

Enrichment/M

otivation

Community Service

Behavior Interventions

Life Skills/

Social Development0

20

40

60

80

100

120

140

160

180

# of Services

Initially Focus on Tier One Se

ptem

ber

October

Novem

ber

Decem

ber

Janua

ry

Febr

uary

Mar

ch

April

May

June

Augus

t

0

20

40

60

80

100

120

# of Level 1 Services by Month

# of Services

PBIS Problem Solving Logic used by CCSD for School-based Social Workers

1. Establish Ground Rules2. Start with Data3. Match Practices to Data4. Align Resources to Implement Practices

Lewis, PBIS Missouri

Common TrendsFrom Illinois and Pennsylvania

adopted in Charleston, SC • Moving from reactive to preventative• Time efficient and least restrictive• Moving from Tier 1 to leading Tier 2/3• Facilitating Tier 3 Interventions• Serving students needs vs. “labeled”

populations• Systems approach• Intervention vs. Referral to Professional

interconnected systems framework local implementation sites experiences and lessons learned lucille...

Documents

expanded school mental

success slide

mental health emphasis

effective implementation

treatment school

work of school

community partnerships

youth wor atrisk of