What isWhat is

CollaborationCollaboration

and how to use it.and how to use it.Plus Consultation Plus Consultation

and Collateral Contact, and Collateral Contact,

what can be billed and how what can be billed and how all three fit together.all three fit together.

For DDAs and partner providers. Specific to IdahoFor DDAs and partner providers. Specific to Idaho

The Sense of the GooseThe Sense of the Goose

In the fall when you see geese heading south for the winter flying along in the "V" formation, you might be interested in knowing what science has discovered about why they fly that way. It has been learned that as each bird flaps its wings, it creates an uplift for the bird immediately following. By flying in a "V" formation, the whole flock adds at least 71% greater flying range than if each bird flew on its own.

People who are part of a team and share a common direction get where they are going quicker and easier, because they are traveling on the thrust and trust of one another.

Whenever a goose falls out of formation, it suddenly feels the drag and resistance of trying to go through it alone and quickly gets back into formation to take advantage of the power of the flock.

If we have as much sense as a goose, we will share information and move along or make necessary changes with those who have the same or similar goals.

When the lead goose gets tired, s/he rotates back in the wing and another goose takes over.

It pays to share leadership and take turns doing hard jobs.

The geese honk from behind to encourage those up front to keep their speed.

Words of support, encouragement, and inspiration help energize everyone, helping them to keep pace in spite of the day-to-day pressures and fatigue.

Finally, when a goose gets sick or is wounded by a gunshot and falls out, two geese fall out of the formation and follow the injured one down to help and protect.

If we have the sense of a goose, we will stand by each other when things get rough, and even when they are not.Author Unknown (some alterations from the original.)

Collaboration is required by rule.Collaboration is required by rule.

People often talk about collaboration.People often talk about collaboration.

Research tells us that it is important and Research tells us that it is important and often essential for significant, lasting often essential for significant, lasting

progress. progress.

But what is it?But what is it?

  Communication usually falls within one Communication usually falls within one of four basic levels.  of four basic levels.  

Problems usually arise when:Problems usually arise when: More communication was needed More communication was needed

than used, and than used, and When some of those involved say When some of those involved say

they are doing one level and in they are doing one level and in reality are doing another.reality are doing another.

#1#1 Damage Control:   Damage Control:   This often happens when: This often happens when: Someone assumes that less communication Someone assumes that less communication

and/or collaboration was needed than really and/or collaboration was needed than really was…was…

or just thought they could get away with or just thought they could get away with less.less.

There are critical errors, accidents, There are critical errors, accidents, unnecessary barriers, or wasted unnecessary barriers, or wasted time/money.  time/money.  

This also occurs when the This also occurs when the individual/organization says/thinks it is doing individual/organization says/thinks it is doing one level and is actually doing another.  one level and is actually doing another.  [This is not [This is not collaboration and is usually a bad thing]collaboration and is usually a bad thing]

  #2#2 Education: Education: This level of communication is often used by This level of communication is often used by

organizations and agencies. organizations and agencies. Information is shared:Information is shared: With a release when confidentialWith a release when confidential As public awareness or marketing, through As public awareness or marketing, through

outreach and advertising, andoutreach and advertising, and whatever motivation through whatever whatever motivation through whatever

means.  means.  [This isn’t collaboration either][This isn’t collaboration either]

  #3#3 Input/Feedback: Input/Feedback: This is not only helpful but often required by This is not only helpful but often required by

rule. rule. This may take place through: This may take place through: surveys, surveys, assessments, assessments, discussion groups.discussion groups. etcetc

[This isn’t collaboration][This isn’t collaboration]

  #4#4 Collaboration:  Collaboration:  Sometimes it is important to not only share and collect Sometimes it is important to not only share and collect

information, but also to share goals, decisions, information, but also to share goals, decisions, ownership, plans, responsibility, and accountability. ownership, plans, responsibility, and accountability.

Collaboration allows for and encourages all of this. Collaboration allows for and encourages all of this. It assures that everyone working with the child is “on It assures that everyone working with the child is “on

the same page.” the same page.” It allows for one plan to support another for the It allows for one plan to support another for the

greater benefit of the child and family. greater benefit of the child and family. In some situations it even allows for one umbrella In some situations it even allows for one umbrella

plan with additional supporting plans. It discovers plan with additional supporting plans. It discovers solutions and expands capacity for the child and solutions and expands capacity for the child and family. family. [This [This couldcould be it] be it]

Levels of AuthorityLevels of Authority

When there are assignments, it is imperative When there are assignments, it is imperative that everyone understand their level of that everyone understand their level of authority and responsibility, to include who authority and responsibility, to include who is responsible for what, when? is responsible for what, when?

This is part of good, honest, effective This is part of good, honest, effective communication and collaboration.communication and collaboration.

http://www.collaboration.me.uk/LEVELS_OF_AUTHORITY.phphttp://www.collaboration.me.uk/LEVELS_OF_AUTHORITY.php

One size does not fit all.One size does not fit all. Collaboration comes in many shapes, sizes, and of varying Collaboration comes in many shapes, sizes, and of varying

duration. It may not make sense to develop a broad in-depth duration. It may not make sense to develop a broad in-depth collaboration when a short term coordinated effort is all that is collaboration when a short term coordinated effort is all that is needed and more efficacious. needed and more efficacious.

For example, networking/communication may be all the is For example, networking/communication may be all the is required to receive important information from a hospital about required to receive important information from a hospital about a past stay. a past stay.

Collaboration sometimes develops in developmental stages Collaboration sometimes develops in developmental stages which which maymay include: … include: …

and will be discussed with an activity.and will be discussed with an activity.

1. Competition 1. Competition Channeled and in the right situation, can help Channeled and in the right situation, can help

groups or individuals stretch themselves and groups or individuals stretch themselves and excel. excel.

It can support and encourage creativity.  For It can support and encourage creativity.  For example, competition is an important aspect of example, competition is an important aspect of Special Olympics; Special Olympics;

however, in order to achieve true success, there however, in order to achieve true success, there must be a balance between competition and must be a balance between competition and cooperation and at times even collaboration. cooperation and at times even collaboration.

Competition does not need to mean that you want Competition does not need to mean that you want the worst for someone else, just the best from the worst for someone else, just the best from yourself. yourself. [This is not collaboration][This is not collaboration]

2. Networking/Communication 2. Networking/Communication

As information begins to be shared and As information begins to be shared and communication increases, it benefits communication increases, it benefits everyone.  everyone.  

There may be more of an interest in gaining There may be more of an interest in gaining information than sharing at this stage.  information than sharing at this stage.  

Trust will develop as more information and Trust will develop as more information and resources are shared for the benefit of all.   resources are shared for the benefit of all.  

[This isn’t collaboration, it could be collateral contact][This isn’t collaboration, it could be collateral contact]

3. Cooperation/Coordination 3. Cooperation/Coordination

Information sharing becomes more Information sharing becomes more formalized with structure and agreements; formalized with structure and agreements; though individual interests are maintained.though individual interests are maintained.    

More resources are shared and duplication More resources are shared and duplication is limited.is limited.

Coordination: Formalized sharing of Coordination: Formalized sharing of resources, information, and some resources, information, and some common goals. common goals.

[This isn’t collaboration, it could be collateral contact, it could be consultation][This isn’t collaboration, it could be collateral contact, it could be consultation]

4. Coordination/Partnership 4. Coordination/Partnership Resources are gathered to create, discover, or Resources are gathered to create, discover, or

access, new resources. access, new resources. The management of resources is progressively The management of resources is progressively

shared, becoming mutually beneficial, increasing shared, becoming mutually beneficial, increasing resource capacity for everyone. resource capacity for everyone.

This is a more formal and structured relationship with This is a more formal and structured relationship with signed agreements, to include resource management. signed agreements, to include resource management.

In many good partnerships a partner is as concerned In many good partnerships a partner is as concerned about their partner's success as their own.about their partner's success as their own.

[This still isn’t collaboration; however we’re starting to get warmer, this could be a part of [This still isn’t collaboration; however we’re starting to get warmer, this could be a part of both consultation and collateral contact]both consultation and collateral contact]

5. Coalition   5. Coalition   Leadership & decision making is shared by Leadership & decision making is shared by

all through a direct democratic or an indirect all through a direct democratic or an indirect representative process.  representative process.  

Decision making and communication are Decision making and communication are formalized and clear.  formalized and clear.  

More resources are developed, created, and More resources are developed, created, and discovered for the benefit of everyone in the discovered for the benefit of everyone in the coalition.  coalition. 

(This stage may not be as applicable in the some settings. May be similar to a co-op.)(This stage may not be as applicable in the some settings. May be similar to a co-op.) [This still isn’t collaboration. We are still getting warmer][This still isn’t collaboration. We are still getting warmer]

6. Collaboration 6. Collaboration Written goals are shared by all involved.  Written goals are shared by all involved.   All interventions are integrated & synergistic. All interventions are integrated & synergistic. Communication & relationships are strong & Communication & relationships are strong &

clear.  clear.   The team shares a strong sense of purpose, The team shares a strong sense of purpose,

accomplishment, responsibility, & accomplishment, responsibility, & accountability.  accountability.  

Strengths & resources, are shared and Strengths & resources, are shared and created & significantly amplified through the created & significantly amplified through the collaborative process.  collaborative process.  

Collaboration: Shared vision, mission, Collaboration: Shared vision, mission, power, resources, and goals. power, resources, and goals. [This could be it][This could be it]

To build collaboration:To build collaboration:

Take responsibility and give credit.Take responsibility and give credit.

(This is only one of many concepts that help to build collaboration.)(This is only one of many concepts that help to build collaboration.)

For treatment collaboration: For treatment collaboration: Everyone providing treatment and/or care Everyone providing treatment and/or care

for the child would be on the same page. for the child would be on the same page. Plans and interventions would be mutually Plans and interventions would be mutually

supportive. supportive. (This requires close communication and dialogue.)(This requires close communication and dialogue.) Plans would be supportive for the child and Plans would be supportive for the child and

family. family. In some situations there may be an umbrella In some situations there may be an umbrella

plan, such as the IFSP.plan, such as the IFSP.

For example: A child who receives speech For example: A child who receives speech therapy from an SLP and communication therapy from an SLP and communication and behavioral therapy from a and behavioral therapy from a developmental therapist:developmental therapist:

The parent, speech therapist and The parent, speech therapist and developmental therapist would dialogue and developmental therapist would dialogue and plan the interventions. The intervention plan the interventions. The intervention provided by the SLP would support the provided by the SLP would support the needs, interests and resources of the parent needs, interests and resources of the parent and child as well as the behavioral plan from and child as well as the behavioral plan from the developmental therapist. etc.the developmental therapist. etc.

Communicate: "Real listening shows Communicate: "Real listening shows respect. It creates trust. As we listen, we not respect. It creates trust. As we listen, we not only gain understanding, we also create the only gain understanding, we also create the environment to be understood. And when environment to be understood. And when both people understand both perspectives, both people understand both perspectives, instead of being on opposite sides of the instead of being on opposite sides of the table looking across at each other, we find table looking across at each other, we find ourselves on the same side looking at ourselves on the same side looking at solutions together". Stephen R. Coveysolutions together". Stephen R. Covey

To Build Collaboration

ConsultationConsultation

Families are a lot like a hanging mobile, when one Families are a lot like a hanging mobile, when one piece is pulled to a new position as soon as the piece is pulled to a new position as soon as the pull stops, family dynamics and equilibrium return pull stops, family dynamics and equilibrium return the individual back into “balance with the family.”the individual back into “balance with the family.”

Overwhelming research demonstrates that the best Overwhelming research demonstrates that the best intervention and often the only lasting intervention intervention and often the only lasting intervention must involve the family and sometimes can not must involve the family and sometimes can not occur effectively without the family learning new occur effectively without the family learning new ways to interact and at times even act as co-ways to interact and at times even act as co-therapists .therapists .

Comparison of Collateral Comparison of Collateral Contact and IBI ConsultationContact and IBI Consultation

724. 724. COLLATERAL CONTACT.COLLATERAL CONTACT. Collateral contact is consultation with or Collateral contact is consultation with or

treatment direction given to a person with a treatment direction given to a person with a primary relationship to a participant for the primary relationship to a participant for the purpose of assisting the participant to live in purpose of assisting the participant to live in the community. Collateral contact must: ( )the community. Collateral contact must: ( )

01. 01. Conducted by Agency Conducted by Agency ProfessionalsProfessionals. Be conducted by agency . Be conducted by agency professionals qualified to deliver services professionals qualified to deliver services and be necessary to gather and exchange and be necessary to gather and exchange information with individuals having a primary information with individuals having a primary relationship to the participant. ()relationship to the participant. ()

724. 724. COLLATERAL CONTACT.COLLATERAL CONTACT. 02. 02. Face to Face or by Telephone. Be Face to Face or by Telephone. Be

conducted either face-to-face or by conducted either face-to-face or by telephone when telephone contact is the telephone when telephone contact is the most expeditious and effective way to most expeditious and effective way to exchange information. Collateral contact exchange information. Collateral contact does not include general staff training, does not include general staff training, general staffings, regularly scheduled general staffings, regularly scheduled parent-teacher conferences, general parent-teacher conferences, general parent education, or treatment team parent education, or treatment team meetings, even when the parent is meetings, even when the parent is present. ( )present. ( )

724. 724. COLLATERAL CONTACT.COLLATERAL CONTACT.

03. 03. On the Plan of ServiceOn the Plan of Service. Have a goal . Have a goal and objective stated on the plan of service and objective stated on the plan of service that identifies the purpose and outcome of that identifies the purpose and outcome of the service and is conducted only with the service and is conducted only with individuals specifically identified on the plan individuals specifically identified on the plan of service. Program Implementation Plans of service. Program Implementation Plans are not required for collateral contact are not required for collateral contact objectivesobjectives. . ( )( )

804. 804. IBI CONSULTATION.IBI CONSULTATION.

Professionals may provide IBI consultation to Professionals may provide IBI consultation to parents and other family members, professionals, parents and other family members, professionals, paraprofessionals, school personnel, child care paraprofessionals, school personnel, child care providers, or other caregivers who provide therapy providers, or other caregivers who provide therapy or care for an IBI eligibleor care for an IBI eligible child in other disciplines child in other disciplines to assure successful integration and transition to assure successful integration and transition from IBI to other therapies, services, or types of from IBI to other therapies, services, or types of care. IBI consultation objectives and methods of care. IBI consultation objectives and methods of measurement must be developed in collaboration measurement must be developed in collaboration with the person receiving IBI consultation.with the person receiving IBI consultation.

804. 804. IBI CONSULTATION.IBI CONSULTATION.

01. 01. Service Delivery QualificationService Delivery Qualification. . IBI consultation must be delivered by an IBI IBI consultation must be delivered by an IBI professional who meets the requirements in professional who meets the requirements in Section 420 of these rules. ( )Section 420 of these rules. ( )

02. 02. Measurable ProgressMeasurable Progress. IBI . IBI consultation must result in measurable consultation must result in measurable improvement in the child's behavior. It is not improvement in the child's behavior. It is not intended to be used for educational intended to be used for educational purposes only. ( )purposes only. ( )

804. 804. IBI CONSULTATION.IBI CONSULTATION.

03. 03. Evidence of ProgressEvidence of Progress. Persons who . Persons who receive IBI consultation must meet with the IBI receive IBI consultation must meet with the IBI professional, agree to follow an IBI Implementation professional, agree to follow an IBI Implementation Plan, and provide evidence of progress. ( )Plan, and provide evidence of progress. ( )

04. 04. IndividualizedIndividualized. IBI consultation may . IBI consultation may not be reimbursed when it is delivered to a group not be reimbursed when it is delivered to a group of parents. IBI consultation is specific to the of parents. IBI consultation is specific to the unique circumstances of each child. unique circumstances of each child.

Collateral Contact is delivered by a variety Collateral Contact is delivered by a variety of professionals to people who have primary of professionals to people who have primary relationships with a child eligible for DDA relationships with a child eligible for DDA services. services.

IBI Consultation is delivered only by IBI IBI Consultation is delivered only by IBI Professionals to children eligible for Professionals to children eligible for Intensive Behavioral Intervention (IBI). Intensive Behavioral Intervention (IBI).

Some of the similarities and differences Some of the similarities and differences between the two services are described as between the two services are described as follows:follows:

SimilaritiesSimilarities Collateral Contact and IBI Consultation:Collateral Contact and IBI Consultation: Promote generalization and coordination within the Promote generalization and coordination within the

child’s natural environments.child’s natural environments. Are delivered to persons with a primary Are delivered to persons with a primary

relationship to the child.relationship to the child. Require a goal and objective authorized in an Require a goal and objective authorized in an

Individualized Program Plan.Individualized Program Plan. Are specific to each child and may not be Are specific to each child and may not be

reimbursed for group training.reimbursed for group training. Are not included in the 22 hour/week limitation Are not included in the 22 hour/week limitation

under the Medicaid state plan that includes under the Medicaid state plan that includes Developmental Therapy, IBI, and other therapies Developmental Therapy, IBI, and other therapies provided by the DDA.provided by the DDA.

DifferencesDifferences

Measurable Measurable improvement is not improvement is not required for required for Collateral Contact. Collateral Contact.

IBI Consultation must result in measurable improvement in a child’s skills and positive behaviors for continued authorization.

DifferencesDifferences

Collateral Contact Collateral Contact may be provided by may be provided by any DDA any DDA professional.professional.

IBI Consultation may IBI Consultation may only be provided by only be provided by an IBI Professional.an IBI Professional.

DifferencesDifferences

The professional The professional delivering Collateral delivering Collateral Contact is not Contact is not responsible to assure responsible to assure that the person that the person receiving collateral receiving collateral information will carry information will carry out an Implementation out an Implementation Plan and collect data. Plan and collect data.

The IBI Professional is The IBI Professional is responsible to responsible to develop an IBI develop an IBI Implementation Plan that Implementation Plan that the person receiving IBI the person receiving IBI Consultation can carry out,Consultation can carry out,develop a data collection develop a data collection method for that person, and method for that person, and assure that the person assure that the person receiving IBI Consultation receiving IBI Consultation knows how to carry out the knows how to carry out the Implementation Plan and Implementation Plan and collect data.collect data.

DifferencesDifferences

The person The person receiving collateral receiving collateral contact doesn’t have contact doesn’t have to collect data for to collect data for the professional. the professional.

The person The person receiving IBI receiving IBI Consultation must Consultation must collect data and collect data and report back to the report back to the IBI Professional on IBI Professional on a regular basis a regular basis about the child’s about the child’s progress.progress.

DifferencesDifferences

Collateral Contact Collateral Contact doesn’t require an doesn’t require an Implementation Implementation Plan. Plan.

IBI Consultation IBI Consultation requires an requires an Implementation Implementation Plan.Plan.

♪♪

Everything done through consultation in IBI Everything done through consultation in IBI can be done through collateral contact can be done through collateral contact through Developmental Therapy.through Developmental Therapy.

So what does this mean?So what does this mean?

How can we use collateral to improve How can we use collateral to improve outcomes for children and families?outcomes for children and families?

How can we use consultation to improve How can we use consultation to improve outcomes for children and families? outcomes for children and families?

How can we use collaboration to improve How can we use collaboration to improve outcomes for children and families?outcomes for children and families?

What are you going to do differently?What are you going to do differently?

How do we document How do we document accurately?accurately?

Any more questions?Any more questions?