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NADD U.S. Policy Update (from the NADD Bulletin Volume X Number 1)
Complete listing
Enhanced Quality Assurance for Individuals with Developmental
Disabilities and Mental Health Issues in Washington State
Cheryl Strange, LMHC, MPA
David Kludt, MPA
Joan B. Beasley, Ph.D.
Unfortunately, it is not uncommon for individuals with multiple
service needs that occur across service systems to have difficulty in
accessing effective care. Often these individuals find gaps in the
system that are difficult to overcome. In response to the need to
improve services to individuals with developmental disabilities and
mental health needs, a cross systems approach to quality enhancement
and service implementation has been undertaken in the state of
Washington.
Washington State’s Department of Social and Health Services
(DSHS) maintains numerous levels of oversight and quality assurance
for all the services it provides. These structures include, but
are not limited to, certification and licensing of services,
facilities, and department subcontractors. An annual assessment of
clients is conducted to determine the appropriate level of care
needed and to develop a plan of care. The plan must be consistent
with identified need and assure that all services are provided by
qualified providers. Policies and procedures identify, resolve,
and define preventive measures regarding possible incidents of abuse,
neglect and/or exploitation of consumers with developmental
disabilities.
In addition to these routine quality assurance measures, the Division
of Developmental Disabilities (DDD) and the Mental Health Division
(MHD) are in the process of implementing the final stages of an
enhanced quality assurance process for individuals with developmental
disabilities who have co-existing mental health issues and who have
been discharged from a state psychiatric hospital. These
activities include four additional tiers of quality assurance:
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A DDD/MHD Cross Systems Committee;
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An Internal Oversight Review Team;
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Comprehensive reviews of a sample of randomly selected class members
conducted by regional DDD staff and the regional Mental Health
Regional Support Networks (RSNs); and
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DDD community follow-up reviews for class members during the year
following their discharge.
DDD/MHD Cross Systems Committee
The Cross Systems Committee (CSC) provides accountability for the
implementation of the cross system collaboration between
developmental disabilities and the network of providers responsible
for delivering- the state’s mental health program.
The CSC is chaired by the directors of the DSHS Mental Health
Division and the Division of Developmental Disabilities. Other
members include program management staff from DDD headquarters, MHD,
DDD field services management, and representatives from state
hospitals, the RSNs, and quality assurance staff from both divisions.
The committee meets quarterly to review and analyze program activity
data in order to monitor program performance and make policy level
recommendations for systemic improvements. The committee
conducts trend analyses, identifies service gaps, and identifies
funding needs to improve services and supports.
Regional Comprehensive Reviews of Randomly Selected Individuals
In order to assess the system as a whole, comprehensive reviews are
conducted on individuals discharged from the state psychiatric
hospital using a standardized assessment tool. These
individuals are randomly selected (10% annually) in each of the 6
DSHS regions. These reviews are conducted quarterly and include
an evaluation of the following 10 components:
1. Cross system crisis plans;
2. Functional analysis/Positive behavior support plans;
3. Care planning;
4. Incident reporting;
5. Residential services;
6. Vocational services;
7. Outpatient mental health services, including Medicaid State Plan
services and DDD-funded services;
8. In-patient mental health services;
9. Crisis stabilization services; and
10. Cross system collaboration.
Internal Oversight Review Team
The Internal Oversight Review Team (IORT) is a four-member team
made up of a psychiatrist with experience in the care and treatment
of individuals with developmental disabilities and co-occurring
mental illness; a licensed psychologist trained in the development
and implementation of plans of care, functional assessments and
positive behavior support plans; and two mental health professionals
who are also developmental disability specialists trained in cross
system crisis planning, enhanced crisis prevention and intervention
methodologies, and diversion activities.
The IORT meets quarterly and has the following responsibilities:
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Conduct system reviews and provide consultation at the request of the
DDD/MHD CSC to address areas of possible concern,;
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Maintain the standardized tool used by both divisions to assess
individual care and systemic issues; and
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Review results of the regional comprehensive reviews (10% annually).
At least annually, the IORT reviews individual cases where a
comprehensive review resulted in a referral for immediate action in
response to an imminent threat to the person’s health and
safety.
DDD Community Follow-Up Reviews
DDD conducts community follow-up reviews for all clients discharged
from state psychiatric hospitals who have been in-residence for a
minimum of 90 days. These reviews include three face-to-face
reviews at 30, 90 to 180 days (at the discretion of reviewer), and
one-year post-hospital discharge. The review takes an in-depth
look at the person’s residential and vocational program
activities, and the person’s ability to retain resilience in
context of the core values of health, safety, competence, status,
choice and relationships.
The role of public policy is to incorporate effective strategies into
the fabric of the service delivery system in order for positive
outcomes to become permanent solutions. The enhanced process just
outlined provides a structural and strategic public policy approach
intended to indelibly change the way services individuals with dual
diagnosis are provided in the state of Washington.
Contact information:
Cheryl Strange, previously MH Program Manager, Division of
Developmental Disabilities, Aging & Disability Services
Administration, Department of Social & Health Services,
Washington State. Currently Assistant Director, Mental Health
Division, Health & Recovery Services, Department of Social &
Health Services, Washington State
strance@dshs.wa.gov
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Upcoming Conferences:
September
Ohio State 10th Annual MI/DD Conference , Mental Health Aspects
–Treatment & Support (September 18 & September 19, 2012)
Columbus, Ohio
October
NADD 29th Conference & Exhibit Show, (October 17 - 19, 2012)
Denver, Colorado
October 2013
NADD 30th Conference & Exhibit Show, Baltimore MD (October 23 -
October 25, 2013)
Complete Calendar |
New Educational Products:
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 Intellectual
Disability and Mental Health: A Training Manual in Dual Diagnosis
Sharon McGilvery, Ph.D. and Darlene Sweetland, Ph.D.
With the release of this book, Drs. McGilvery and Sweetland share
decades of experience working with individuals diagnosed with an
intellectual disability and co-occurring psychiatric disorders. Their
well-practiced approach takes into account the extremely complex
nature of working with dual-diagnosis. The authors provide
in-depth information about the diagnostic process, hands-on treatment
considerations, and their experience training thousands of people to
work passionately with these individuals. An important
contribution is their approach to addressing complicating factors in
identifying appropriate psychiatric diagnoses, as well as the problem
of the underreporting of psychiatric symptoms and disorders. Finally,
those working in a variety of contexts with these individuals will
benefit from the innovative approaches of looking at treatment and
intervention strategies that can be immediately implemented. 264 pages
Details:
ST11-053B
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 A
PRACTICAL GUIDE to Assessing Medical Issues Associated with
Behavior/ Psychiatric Problems in Persons with Intellectual
Disability – Revised in 2011
Ann R. Poindexter, M.D.
This book discusses medical/medication issues which may present as
behavioral/ psychiatric problems in individuals with intellectual
disability. Three self-directed instructional courses and
several illustrative case histories are included. 110 pages\
Details:
DA05-021BR
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Psychotherapy for Individuals with Intellectual Disability
Edited by: Robert J. Fletcher, DSW, ACSW
This book provides the reader with insightful and useful ways to
provide psychotherapy treatment for individuals who have intellectual
disability (ID). It brings together all three modalities
(individual, couple, and group), and a variety of theoretical models
and techniques are discussed. The first section, Individual
Therapy, offers a variety of approaches and techniques including
dialectical behavioral therapy, positive psychology,
mindfulness-based practice, and relaxation training. Also included in
this section are chapters on specialty populations including victims
of abuse, people who have Autism Spectrum Disorder, and people in
mourning. The second section is a chapter on group therapy addressing
trauma issues. The third section is on family and couple therapy. The
fourth section covers chapters on research, ethics, and
training. The individual authors are respected authorities in
the field of providing psychotherapy treatment for persons with ID
and all have contributed to the professional literature.
This book is a major contribution to the effort to make psychotherapy
available to individuals who have ID and should serve to further
stimulate interest in the provision of psychotherapy treatment for
individuals who have ID co-occurring with significant mental health problems.
NADD # CT11-051B Details
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 Comprehensive
Competence-Based Parenting Assessment for Parents with Learning
Dificulties and Their Children
Maurice Feldman, PhD, Marjorie Aunos, PhD
This book presents an innovative, empirically-supported approach to
assessing parenting capacity of parents with learning difficulties
that can lead to more humane, fair and accurate child custody
decisions. The authors are leading researchers and
practitioners in this field haing worked with hundred of these
families. Many professionals working with these families
recognize that the current parenting capacity assessment approaches
are based on outdatd and invalid assumptions and methods. This
book addresses the unique assessment needs of these families and
includes detailed background information, rationales and methods.
NADD # DA10-050B Details
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 Working
with People with Challeging Behaviors: A Guide for Maintaining
Positive Relation
Nathan Ory
The material in this book introduces general practices
and specific solutions to behavior problems that will work with
people who display difficult and challenging behaviors regardless of
who they are. It is especially suitable for working with
individuals who have developmental or intellectual disabilities
coupled with a behavior disorder. The methods also apply to the
person with emotional or psychiatric disturbances, or another serious
mental health problem. Finally, they are helpful in providing
support to elderly individuals who display challenging behavior.
NADD # ST10-049B Details
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Human Needs and Intellectual Disabilities: Applications for Person
Centered Planning, Dual Diagnosis, and Crisis Intervention
Steven Reiss, Ph.D.
Human Needs and Intellectual Disabilities identifies the 12 human
needs most relevant to the lives of people with intellectual
disabilities, autism and related developmental disabilities. It
includes detailed, practical suggestions for caregivers or parents
interested in the happiness, quality of life, and self-determintion
of their loved ones or consumers. The book includes detailed,
practical suggestions for reducing episodes of challenging behavior
and psychiatric symptoms in people with a dual diagnosis
(intellectual disabilities and mental illness). It shows how to
substitute the language of individuality (e.g., "friendly
person") for the language of disability (e.g., "person with
disability"). It also reduces the tendency of planners to
confuse their own value system for that of the consumer. The
book includes scholarly reviews of dual diagnosis literature on
mental illness, prevalence, and assessment.
NADD # DA10-048B Details
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Positive Identity Development
Author: Karyn Harvey, PhD
Positive Identity Development is an exciting new approach to
treatment for individuals with intellectual disabilities. This
book provides a new theoretical perspective on treatment along with a
variety of innovative tools. It rejects reducing adults with
intellectual disabilities to a mere compilation of their behaviors
and promotes the use of a positive, therapeutic approach to each
unique individual. Psychologists, social workers and therapists
should be able to use the tools presented in this book to directly
enhance the effectiveness of the treatment they provide to adults
with intellectual disabilities. This book promotes well-being on
every level and explores a broad range of issues relevant to the life
and mental health of adults with intellectual disabilities
Mbr Price: $34.95
Non-Mbr: $39.95
NADD #CT09-047B Details |
 Down
Syndrome: When to Worry about Mental Health and What to Do About It
Robin Friedlander, M.D. & Peter Johnson, Ph.D.
NADD # FI09-044B Details |
 Working
with People who have Intellectual Disability and Behavioral
Problems: A Self-Study Guide for Interdisciplinary Team Members
Ann R. Poindexter, M.D. & Paul D. Kolstoe, Ph.D.
NADD # ST09-045B Details |
Multi-Media CDs of NADD 25th Annual Conference Presentations
Presentations recorded at NADD 25th Annual Conference are available
as multi-media CDs. These CDs contain the video and Power Point
from conference presentations and are a great tool for training
yourself and your staff. To order, or for additional
information, click here.
Community Networks of Specialized Care: Building Community
Capacity through Training and Education Lisa Holmes, Liz
Froese, MSW, Rosanne Stein, LLB, BSc, Sandi Bricker
NADD Competency-Based Dual Diagnosis Certification Program Robert
Fletcher, DSW, ACSW, FAAIDD; Donna McNelis, PhD; John McGonigle,
PhD; Kathleen Olson, PhD; Jarrett Barnhill, MD
Autism Spectrum Disorders: Separating the Data from the
Myths Ann R. Poindexter, MD
Diagnostic Systems for Use with People with ID Luis
Salvador-Carulla, MD, PhD, Robert J. Fletcher, DSW, ACSW, FAAIDD,
Sally-Ann Cooper, MD
The price for the above multimedia is: Member:
$49.95 Non-member: $59.95
To order, or for additional information, click
here.
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