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The Keys to Success:
Building Cross-Systems Partnerships
Office of Specialized Services
Mission Statement
The Office of Specialized Services (OSS) is committed to the educational, social, physical, and emotional well-being of students within the School District of Philadelphia. The OSS provides comprehensive special education, behavioral health, school health, and prevention/intervention programs which are aligned with the educational and organizational goals as outlined in the District’s Declaration of Education.
Office of Specialized ServicesSupport to Regions and Schools
• OSS Regional Team Support • Professional Development • Professional Steering Committees
• Resource Coordination • Emergency Response • Targeted Problem Solving
The School District of Philadelphia: Fast Facts
8th Largest District in Country 268 Schools; 12 Regional Sub-Districts 180,000 Students Percentage of Students by Race/Ethnicity: African-American- 65.3%,
Asian- 4.9%, Latino-13.1%, Native American- .2%, Caucasian-16.4% 73% of Students Eligible for Free/Reduced Lunch Over 125 Schools with ESOL and/or Bilingual Programs, over 10,000
Students Enrolled Average Student-Staff Ratio for Pupil Support Service Staff:
Nurses: 1- 930; Counselors: 1- 530; Psychologists 1- 1,650
The School District of Philadelphia:Special Education Snapshot (‘ ’04- 05)
District State Total Sp Ed Enrollment 12.6% 14.4%
Enrollment by Disability Specific Learning Disability Mental Retardation
58.0% 13.9%
54.4% 9.9%
Emotional Disturbance 10.4% 9.6% Speech/Language Autism
8.4% 3.2%
16.3% 2.8%
Other 6.1% 7%
The School District of Philadelphia:Special Education Snapshot (‘ ’04- 05)
District State Special Education Students in
Regular Education Settings
Itinerant (Outside Reg Ed <21%) 21.7% 44.4% Part-Time (Outside Reg Ed 21-60%) 42.1% 35.2% Full-Time (Outside Reg Ed > 60%) 32.3% 16.1%
SE Students in Other Settings 3.9% 4.3%
The School District of PhiladelphiaSpecial Education Snapshot:
Race/Gender
District Sp Ed Students in
Regular Education By Ethnicity (0’4-’05)
American Indian/Alaska Native 0.2% 0.3% Asian/Pacific Islander 5.5% 1.7% African American (Non-Latino) 64.9% 65.7% Latino 15.5% 15.7% Caucasian (Non-Latino) 14.0% 16.6%
Students in Regular Education By Gender (Current)
Male 51.2% 66.3% Female 47.8% 33.7%
Building Resilient Schools:A Systems Approach
• School-Wide Effective Behavior SupportModels
• Social Skills/ Character Education Curricula • School-Wide Resource Coordination • Emphasis on Small Group Intervention and
Classroom Consultation• Partnering to Develop Continuum of
Behavioral Health Supports
A New Support Paradigm
Additional ResourcesRobust Infrastructure
l
ll i
l
Universa Prevention
Sma GroupIntervent on
TargetedIndividuaSupport
School-Based CSAP Tiers II & III Behavioral
Health
CSAP Tier I School-Based CM
SWEBS & School- Social
Skills Wide Curricula
Comprehensive StudentiAss stance Process- CSAP
CSAP is a systematic mechanism of identification, intervention, referral assistance, and support/follow-up, including continuing care supports
CSAP has a school-wide component and 3 tiers of progressive support
Each tier has 4 phases: referral, team planning, intervention and recommendations, and follow-up
CSAP views caregivers as essential partners
RTI CSAP
Tier I: All Students Tier I: All StudentsResearch Based InstructionResearch Based Instruction PM through CBM PM through CBM
Small Group Supplemental Instruction for Students for Whom General Instruction
Tier II: Students for Whom Tier I Not Adequate (4 weeks) Instruction Not Adequate Tier II: Students for Whom Small Small Group Group Instruction via Supplemental Instruction Tier I Not Adequate 8-12 Weeks (1-2 Rounds)
Individualized Intervention Plan with Instructional Staff,
Tier III: Students for Whom Tier II Specialists, Parent, Student Instruction Not Adequate (4-8 weeks)Individualized InstructionLonger Duration (Sp Ed) Tier III: Students for Whom Individualized
Tier II Instruction in Gen Ed Setting Not Adequate (Sp Ed)
Creating a Continuum of K- 8 Support:
School-Based Case Management
Collaboration with the Department of Human Services
Consultation & Education (C & E) Specialist Program: • Program History:
Began as Pilot in 1998 with one Provider in 3 Schools Currently 14 Providers in 200 Schools
• Program Description: Provides short- term (120 day) school-based case management, consultation, and groups Majority of schools serviced are elementary; some secondary
• Program Funding: Program-Funded; District (30%) and DHS (70%) All Children Eligible Regardless of Insurance
Program Demographics05-06 YTD
Total Closed Cases= 2,256Ethnicity:
African-American = 1598Asian = 16Latino = 385Caucasian = 213Other = 44
Gender:Male = 1706Female = 550
Number Served by Grade Level:Kindergarten through 5 Grade = 16106 through 8th Grade = 4959 through 12th Grade = 151
Program Outcomes05-06 YTD
Short Term School-Based Case Management Provided to 3,666 Students
C&E Consultations Provided to 10,537 Children
1,347 Children Referred for Behavioral Health Services
1,021 Children/Families Referred for Community-Based Services (e.g. Housing, Welfare Benefits, Recreation, Food/Emergency Services, Church- Related Support, Kinship Care Services)
540 Children Seen in Groups(Anger Management, Grief/Loss)
Creating a K- 8 Continuum:
School-Based Behavioral Health
Collaboration with Community Behavioral Health (CBH)
• Program History: Began as Pilot in ‘02-’03 Year at 6 Schools; Currently in 28 Schools
• Program Description: Replacement of Traditional School-Based Wraparound/TSS; Provides Flexible Services via 11 member Team
• Program Funding: MA Funded Through Community Behavioral Health; 60-Day Review Cycle
SBBH Team Structure (N =11)
Clinical Manager: master’s level clinical supervision case triage administrative oversight and liaison to school administration
Clinicians: master’s level behavior intervention planning with CSAP/Interagency team
Care Coordinator/ Case Manager: care coordination and linkages to services and supports
BH Professionals: behavior plan implementation progress monitoring ensures ongoing communication with school and SBBH staff
Psychiatrist: part-time supervision medication consultation
Preliminary Evaluation:Sample Demographics
Sample: Program participants, Age 5- 9, enrolled in program the 2002-2003 Academic year (N= 6 SBBH Sites)
Methodology: Examine Academic and Behavior Indicators Year Prior to Enrollment, Year Enrolled, And Year Subsequent to Enrollment
Student Sample Size: N= 97 Demographics:
By Ethnicity African American 91.8% Caucasian 8.2%
By Gender Male 82.5% Female 17.5%
By ProgramRegular Education 70%Special Education 30%
Preliminary Program Outcomes:Behavior
Suspensions: % Students Aged 5-9 Suspended 1 or More Times
All Program Children Participants
‘01- ‘02 (Year prior to Entry) 4% 29% ‘02- ‘03 (Year of Entry)* 8% 52% ‘03- ‘04 (Next Academic Year) 9% 44%
* (Suspensions hypothesized to be primary reason for school-based referral)
Preliminary Program Outcomes: Academics
Reading Performance on Nationally-Normed Standardized Test(TerraNova) by NCE
All Program Children Participants
‘01- ‘02 (Year Prior to Entry) 43.9 34.5 ‘02- ‘03 (Year of Entry) 40.9 35.1 ‘03- ‘04 (Next Academic Yr) 42.9 40.5
Preliminary Program Outcomes: Least Restrictive Environment
Too Much Variability in Diagnosis to Look at Differential Performance
Initial Trends: Decreased Level of Service Over Years Served
Important Implications for Further Research
Creating a K- 8 Continuum:Children Achieving through Re-Education
(CARE)
Collaboration with Community Behavioral Health (CBH)
Program History: Began as Pilot at 1 Site in ‘02-’03 Year;Currently in 8 Sites Serving 9 out of 12 regions
Program Description: Based on “Re-Education” ModelServices Provided in 3 Classrooms Per Site
(Adult- Student Ratio: 3-10)Students Assigned via Regional Feeder Pattern
Full-Time to CARE Classroom (6-12 months) Program Funding: Clinical Component Funded Through Community
Behavioral Health; Educational Component Funded through SDP
CARE Clinical Team Structure
Clinician: master’s level; provides behavior intervention planning,treatment and crisis intervention; linkage to family and other providers
Mental Health Workers: provide behavior plan implementation, progress monitoring, ensures communication between school and CARE staff
Clinical Manager: master’s level; provides clinical supervision and intervention, case triage, administrative oversight and liaison to school administration.
Care Coordinator: provides care coordination and linkages to community services and supports
Psychiatrist: part-time; provides supervision, medication consultation
Creating a K- 8 Continuum: Therapeutic Emotional Support Classrooms (TESC)
Collaboration with Community Behavioral Health (CBH)
Program History: Began in ‘04-’05; Currently in 14 District ES Classrooms
Program Description: Provides MH Therapist in Lieu of Therapeutic Staff Support
Program Funding: Funded via CBH
Creating a 9-12 Continuum: SecondaryBehavioral Health Pilot
Program History: Begun in ‘05- ‘06 Year at 20 Sites Program Description and Funding: Provides on-site, flexible direct
services (individual, group, classroom consultation) Works with leadership team to support CSAP Development andResource Coordination 3 Program Types:
• SDP Funded External Contracted Model (N= 11) .5 FTE Agency Master’s Level Clinical SW
• SDP Funded Internal Interdisciplinary Model (N= 7) .5 FTE SDP Master’s Level Clinical SW and Intern Team
• Hybrid “Deluxe” Model (N= 1) .5 FTE SDP Funded Master’s Level Clinical SW and
Intern Team; Outpatient Individual/ Group Services(CBH)
Secondary Behavioral HealthPreliminary Outcomes
Over 800 Students Served October - March via Individual and Group Sessions
Impact Analysis of External Model (N=12) Using Fall Cohort (Treatment) and Spring Cohort (Control)
Comparison Between ‘05 Performance Indicators and ‘06 Performance Indicators
71% Higher Rate of Increase in Absences Between Years for Control Group
11% Increase in Number of Suspensions Between Years for Control Group
Benefits of Cross-SystemsCollaboration
Services are Accessible for Families
Stigma is Reduced Services are Integrated with Child’s Other
Natural Contexts (Ecological Approach) Collaboration Between Systems More
Likely
Project Partners l i i i i lBrenda B. Tay ntendent Anne Zembroskor, Assoc ate Super
Amy Maisterra, Director, Behavioral Health Office of Specialized Services School District of Philadelphia
, Patr ck Kay or Community Behavioral Health School District of Philadelphia
Cathy Bolton, PhD P : (215) 400-4170 Director of Continuous Quality Email: [email protected] Improvement, Department of BH
[email protected] P: (215) 413-3100 Email: [email protected]
Ernest Bailey, Program Manager Department of Human Services, Division of Community Based Prevention Services
David S. Mandell, Sc.D., Assistant Professor
Center for Mental Health Policy and Services Research
P: (215) 599-6350 University of Pennsylvania School Email: [email protected] of Medicine
P: (215)662-2504 Email: [email protected]
