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Conditional Release Planning for the Developmental Disabled Consumer – Regional Forensic Training April 19, 2013 PULLING IT ALL TOGETHER

PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

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Page 1: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Conditional Release Planning for the Developmental Disabled Consumer – Regional Forensic Training

April 19, 2013

PULLING IT ALL TOGETHER

Page 2: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Page 3: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Benefits Share limited resources

Share collective wisdom and expertise

Share the ‘anxiety’ of managing the case

Gain greater insight into how other systems function

Page 4: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Critical Teaming Outcomes

•Understanding expectations of the Court

•Promotion of Public Safety

•Shared responsibility in managing the case and risk at all points in the process

•Provision of available services in managing the case

Page 5: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Partners in Planning

• Forensic Monitor

• Developmental Disability Board Staff

• Providers

• Mental Health and/or Addiction Treatment Staff

• Guardian

• Family Members and other Natural Supports

• Prosecuting Attorney

• Defense Attorney

• Judge

Page 6: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Consumer

Natural Support Systems

Systems

Developmental Disabilities Consumer Driven System

Page 7: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Individual Service Plan & Behavioral Plan

Living Arrangements

Funding Source

Day Programming

Specialized Services

Medical Needs

Health Guidelines

Dietary Restrictions

Behavior Support

Source of Income

Safety Needs

Vocational/Educational Needs

Personal Satisfaction

Page 8: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Risk Management Risk Management is the identification, assessment, and prioritization of risks followed by the coordinated application of resources to minimize, monitor, and control the probability and/or impact of unfortunate events.

Page 9: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Indicators of Risk-Behavioral Healthcare Chronic, long term mental illness.

Untreated mental illness.

Non-compliance with treatment.

Physical healthcare issues.

Violent & aggressive behaviors.

Housing issues & homelessness.

Extreme poverty & hunger.

Lack of or loss of natural support system.

Multiple hospitalizations or institutionalization.

At risk of out of home placement.

Involvement with criminal justice system.

Involvement with multiple systems of care.

Lack of access to resources.

Exposure to trauma, abuse, and/or neglect.

Substance abuse/dependency

Page 10: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Indicators of Risk-Developmental Disabilities Disrupted living situation.

Medical problems.

Mental Health/substance abuse problems.

Involvement with criminal justice system.

Lack of access to necessary services.

Lack of basic necessities.

Exposure to trauma, abuse, and/or neglect.

Housing issues & homelessness.

Extreme poverty & hunger.

Lack of or loss of natural support system.

Social isolation.

Page 11: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Additional Indicators of Risk for the Dually Diagnosed • Indicators of risk for behavioral healthcare.

• Indicators of risk for developmental disabilities.

PLUS

• Chronic, highly disruptive community behavior.

• ‘Burned bridges’ with providers in different systems of care.

• Failed care and treatment planning.

• Non-compliance with care and treatment recommendations.

• Continual movement from one restricted setting to another. (i.e. jail to hospital to developmental center).

• No one system of care can meet needs or lacks resources to meet needs.

• Frustrated professionals.

Page 12: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Additional Criminogenic Risk* •Criminal History

•Education, Employment and Financial Situation

•Family and Social Support

•Peer Associations

•Neighborhood Problems

•Substance Use

•Criminal Attitudes and Behavioral Patterns

*Ohio Risk Assessment System: Community Supervision (ORAS-CST)

Page 13: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Tasks for Teams in Risk Management

Identify & Assess Risk

Problem Solving

Share Resources

Develop & Implement

Strategy with Common

Goals

Evaluate Outcome of

Strategy

Page 14: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Conditional Release Planning

Conditional Release Plan

Availability of Funding

Availability of Services

Level of Supervision

Needed

Identify, characterize, and assess threats

Determine risk

Static vs. Dynamic Risk Factors

Protective Factors: Conditions or interventions needed to manage or reduce those threats.

Availability of Housing – In or Out Of County

Page 15: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Understanding and Approval

Judge

Prosecuting Attorney

Defense Attorney

Boards

Page 16: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

When Things Go South

Teams can put crisis situations back together again!

Page 17: PULLING IT ALL TOGETHER...PULLING IT ALL TOGETHER Teaming The most effective tool in managing high risk cases is the use of collaboration in the planning and implementation process

Team Case Study