Transition Planning: The Role of the CCBDD Behavior and Health Supports Department

1
Transition PlanningThe Role of the CCBDD
Behavior and Health Supports Department

• Richard Cirillo, Ph.D.
• Chief Clinical Officer
• Cuyahoga County Board of Developmental
  Disabilities

2
Composition of the Department

• Behavior and Health Supports consists of two
  basic service areas Behavioral Support and
  Nursing
• Current staff consists of approximately 55
  professional, paraprofessional, and support staff
• Behavioral staff include licensed psychologists,
  professional counselors, social workers, behavior
  support specialists, forensic system liaisons,
  and a human sexuality educator with a scope of
  practice clearly focused on individuals with
  developmental disabilities
• We do not provide psychiatric/pharmacological
  therapies

3
BHS Role in Transition Planning

• Assessment of behavioral needs
• Generally includes behavioral and related
  information collected from parents, consumer,
  teachers
• Team consultation on preparing for and
  implementing a successful transition
• Development of an individual specific behavior
  support plan if needed
• Training staff on the behavior support plan
• Resource for future consultation regarding
  behavioral issues

4
Getting a Referral

• Referrals for Behavioral Services are taken
  through the students SSA
• Ideally referral comes six months to a year
  prior to the anticipated transition to an adult
  service or job to allow for appropriate
  assessment, planning, and transition
• A longer period may be needed if a particularly
  difficult and/or gradual transition is
  anticipated.

5
What to expect

• The assessment is an important first step in
  planning
• Expect a review of past behavioral, educational,
  mental health and to a lesser extent medical
  history
• Allowing access to past providers of service can
  be particularly helpful in some cases
• Participation of parents and teachers in the
  assessment process is sought and valued

6
Results

• Written recommendations will be provided in most
  cases, and for any case if requested.
• Communication of results with SSA, family, and
  other stakeholders
• Training of staff as needed
• A continued relationship with the team until a
  the individual has been transitioned and/or there
  is no longer a need for behavior support

7
Philosophy of Behavioral Care

• A primary emphasis placed on maintaining health
  and safety
• Strong Protection of individual rights
• Any restriction that is to be placed on the
  individuals rights must have a clear
  relationship to health and safety, must be
  documented, and must first clear a Human Rights
  Committee
• A strength of the DD system, but in some cases
  can be difficult for families to understand.

8
A Least Restrictive Approach to Behavioral
Supports

• Behavior planning must rely first and foremost on
  positive and preventative strategies
• Are expectations of the individual appropriate?
• Is there a fit between the persons preferences,
  temperament, and abilities and the environment?
• Are staff appropriately trained and responding in
  line with the individuals needs?
• Seclusion or restraint are avoided and can be
  used only after positive methods have failed and
  there is a clear health and safety threat
  involved.
• Any plan with such aversive interventions in
  place must go through a formal planning and
  review process (two separate committee reviews
  before approval).
• In some cases, part of our transition planning
  may involve having the individual weaned off the
  use of seclusion or restraint as it may have been
  applied in a school setting

9
Remember

• Consultation with the Behavior and Health
  Supports Department can be requested at any time
• There is no charge to you for our services

10
Questions and Comments