National PBIS Leadership ForumOctober 2013

Jennifer Parmalee, MPADirector of Children and Family ServicesOnondaga County Department of Mental Health

Linda BrownBehavior Specialist OCM BOCES

Patty ClarkPupil Services DirectorSyracuse City School District

Syracuse City School District

Urban district in Central New York 95,000 residents 31 schools in the SCSD 5 High Schools

6 Kindergarten – 8th grade buildings6 Middle Schools (6th – 8th)10 Elementary Schools

21, 000 students 85% Free and Reduced Lunch 20% Listed as Special Education

Braid Multi-Tier Support Systems

PBIS

RtIPromise Zone

OnCare (SOC)Say Yes

TIER 3

4 Tiered Problem-Solving FrameworkAcademic Behavioral

TIER1

CORE CURRICULUM AND UNIVERSAL BEHAVIORAL

EXPECTATIONS

CORE CURRICULUM AND UNIVERSAL BEHAVIORAL

EXPECTATIONS

Core Instruction Board of Education Adopted

Core Curriculum Differentiated instruction Small guided groups Centers/stations for skill-based

practice

Core Universal Interventions • All settings, all students• Preventive, proactive• School Wide or Classroom Systems

Strategic, Targeted Interventions• Some students (at-risk)• Group or individual delivery• High efficiency/ Rapid response• Function-based logic

Strategic, Targeted Interventions• Some students• High efficiency / Rapid response• Frequent progress monitoring

SMALL GROUP, TARGETED INSTRUCTION

TIER 2

SPECIALIZED INSTRUCTION & SERVICES

INDIVIDUALIZED TARGETED

INTERVENTIONS

TIER 3

Intensive, Individually Designed Interventions• Address individual needs of student• High intensity/longer duration/daily • Individualized Learning Plan (ILP)

Intensive, Individually Designed Interventions• Individually designed behavior plan• Intense, sustainable prosocial strategies• Function-based assessments• Intense, durable strategies

T4

04/20/23

4-Tiered System of Support

Necessary Conversations (Teams)

CICO

SAIG

Group w. individual

feature

Complex

FBA/BIP

Universal

Support

SBIT-B Team

Tier 4

Simple

FBA/BIP

Universal

Team

WRAP

Screening Team

Plans SW & Class-wide supports

Uses Process data; determines overall

intervention effectiveness

Standing team; uses problem-solving

process for one youth at a time

Uses Process data; determines overall

intervention effectiveness

Rev. 9.1.2009

Fidelity Measures

SET 2003-2011; BoQ 2012 & 2013; Full district support 2010

Benchmarks for Advanced Tiers (BAT) 2012-2013

Schools

SCORES

By

%

Onondaga Department of Mental Health

Oversight Planning and Quality Improvement Contract Management (95 programs)

County (City) DemographicsPopulation: 454,753

(138,560)Children ages 5-19: 95,308

(32,423)

95% of funding from State Authorities (OMH, OASAS OPWDD)

Syracuse Promise Zone Mission

Match SCSD students emotional/behavioral needs with effective interventions

Keep SCSD students in class and ready to learn Increase access to Mental Health Services in schools.

Expand Outpatient Mental Health Clinic Satellites to all schools in SCSD (10 additional sites since 2010 – 23 total)

Integrate Mental Health Clinicians into SCSD school based problem solving teams for youth at risk. (SBIT-B)

Expand access to family based care coordination services that link with the school team (current staff of 47 coordinators)

Expand access to skills based groups for youth at risk (CICO)

Establish uniform school based problem solving procedures and process to ensure right kids get right interventions at the right time. Trained 14 schools in Screening and School Based

Intervention Teams – Behavior protocols. 3 additional schools to be trained in 2013-2014

5 Keys To Implementation

MH Licensed Clinician in every school

Clinician integrate into school team

Problem Solving Teams at tier 2/3

Expand community services for youth at risk

Systems to identify and intervene with youth at risk

Number of Schools Trained in Screening and SBIT-B

Data from teams 2012-2013 Screening reviewed 571 students through April

30, 2013 409 Tier 2 interventions / 218 Tier 3

Interventions / 1 Tier 4 Intervention

Clinics supported approximately 615 students in 23 schools in 2012-2013

On December 31, 2012, 60 students were receiving EBP (Trauma Focused CBT) (12 of 13 Clinicians Trained)

SBIT-B teams reviewed 71 students

Out of School Suspensions – PBIS Tier 1 Measure

Change in Suspension Incidents

Per 100 Students

Compare September

through April 2012

to April 2013

Days of Lost Instruction – PBIS Tier 1 Measure

Change in Days of Lost Instruction

Per 100 Students

Compare September

through April 2012

to April 2013

Out of School Suspensions – PBIS Tier 2 Measure

Change in Suspension Incidents

Per 100 Students

Compare September

through April 2012

to April 2013

Days of Lost Instruction – PBIS Tier 2 Measure

Change in Days of Lost Instruction

Per 100 Students

Compare September

through April 2012

to April 2013

Clinician Engagement (Sept – Dec 2012) Individual Psychotherapy Sessions

Top 5 Reasons for Referral to MH Service as of December 2012 (N=473)

Outpatient Mental Health Commitments Donate 1.5 hours a week per school

Prioritize school functionality in treatment

Ability to interface with families help with who is the best person on the team to build a deeper partnership

Use of classroom data to progress monitor

Dedicated to delivering EBP (Trauma as focus..TF-CBT)

Consultation role on teams – support decision making for treatment, community mental health supports,

How Should Mental Health Look in Schools?

How should the mental health system integrate into the school system What is the right amount of mental health services What is the purpose and function of services Who delivers the service How are outcomes determined

Syracuse Benchmark of Interconnected Systems Purpose: Assess Integration, Implementation

of Mental Health within the 4 Tier Structure, Treatment Integrity

Function: Teams to gather data and use in systems and practice development/enhancement at all 4 tiers

How did we develop: BOQ, Literature review, NYS SEDL Guidelines