Writing a Safety Crisis Plan - dmh.mo.gov · when writing a Safety Crisis Plan Components of a...

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Operationalizing DD 4.300 Series #02 Writing a Safety Crisis Plan

Transcript of Writing a Safety Crisis Plan - dmh.mo.gov · when writing a Safety Crisis Plan Components of a...

Page 1: Writing a Safety Crisis Plan - dmh.mo.gov · when writing a Safety Crisis Plan Components of a Safety Crisis Plan and their purpose. Quick Review of DD 4.300 HCBS Compliance for the

Operationalizing DD 4.300 Series #02

Writing a Safety Crisis Plan

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Objectives

Today you will learnA Quick Review of DD4.300Definitions of “Reactive Strategies” and “Safety Crisis Plan”Answers to some common questions regarding Safety Crisis PlansCommon factors that should be considered when writing a Safety Crisis PlanComponents of a Safety Crisis Plan and their purpose

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Quick Review of DD 4.300

HCBS Compliance for the use of reactive strategies and restrictive interventionsResponsibilities across the system

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DD 4.300 Requirements

Used 1 Reactive strategy that is restrictive OR history of need

Safety Crisis Plan

Reactive Strategy Threshold ReachedRST - Use of 5 or more reactive

strategies that are restrictive in 1 month period

Planning Team Review

Reactive Strategy Threshold Reached for 3 Consecutive

Quarters

Consider Referral to RBSRC

Reactive Strategy Threshold Reached

for 3 or more Quarters in a 2 year

period

Team required to consider Behavioral

ServicesNOTE 1 – Behavior Services can be

considered any time in the process and it is recommended that consideration

be given as early as possible

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Reactive strategies, restrictive interventions and rights restrictions

Are related, sometimes one strategy is all three, sometimes notContext is important and must be consideredRestrictive Interventions is a CMS term and definition

Rights restrictions

Restrictive interventions

Reactive Strategies

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Classifying Strategies: Reactive Strategies

Reactive strategies

Rights restrictions

Restrictive interventions

• Is it used in response to an undesirable behavior?

• Is the aim of the strategy to bring about an immediate change in the environment, situation or behavior?

• (To reduce risk associated with the behavior?)

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Classifying Strategies: Restrictive Interventions

Reactive strategies

Rights restrictions

Restrictive interventions

• Is it an intervention that restricts movement, access to other individuals, locations, activities, or personal objects?

• Is it an intervention that restricts rights?

• Does it employ aversive methods?

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Classifying Strategies: Rights Restrictions

Reactive strategies

Rights restrictions

Restrictive interventions

• Does it place a limitation of any general liberties that are available to all citizens?

• Does it limit freedom of movement?• Does it limit choice?• Does it limit communication with

others?• Does it limit leisure activities,

personal property or $, access to parts of the home or community?

• Does it limit any of the rights assured to clients of the Department of Mental Health?

• Does it promote treating the person with respect, dignity and least restrictive environment?

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The Requirements

Safety Crisis Plan

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Plan to prevent crisisRespond appropriately if it happens

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Common Questions

Who is qualified to create an SCP?Who writes the plan?Who is responsible for the plan?Who initiates the plan?Who approves the plan?

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Common Questions

Who is qualified to create an SCP?

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Common Questions

Who writes the plan?

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Common Questions

Who is responsible for the plan?

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Common Questions

Who initiates the plan?

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Common Questions

Who approves the plan?

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Who Makes up the Planning Team?

All the people (including the individuals themselves) that work together to support

an individual living in the community

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What makes a

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What we typically think…

The Crisis Cycle

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But it could be…

The Crisis Cycle

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We also don’t realize…

The Crisis Cycle

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The Crisis Cycle

Argument with housemate No gas to go out

Another argument with housemate Staff are coercive 1:1 staff within arms

reach

Make up with Housemate

Watches favorite TV show instead

Goes for a walk Staff check-in frequently (stay close)

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What To Do?

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What to Do?

Crisis Event

<--over the course of minutes or hours-->

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What to Do?

Plan and Prevent

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VSSHORT

seconds to minutes

LONGhours to

days

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Hey, what do you think?

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Putting it All Together into a Plan

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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Putting it All Together

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CONCLUSION

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Contacts

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v ERABAMelantha Witherspoon

[email protected]

CRABALucas Evans

[email protected]

WRABA Rita Cooper

[email protected]


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