OUR SERVICES

Behavior Support Services are a combination of learning based and systemic interventions and strategies to assist with the management of challenging behaviors that interfere with activities of daily living, social interactions, work, or similar situations resulting with an individual learning new skills and reducing or replacing problem behaviors. Services are authorized for individuals whose challenging behaviors are dangerous or disruptive and present a risk to the health and safety of the individual, peers, and others with a level of interruption to daily activities and community integration. A Positive Behavior Support Plan is used to address challenging behaviors that occur with interventions tied to specific goal(s) and objective(s). The purpose of a behavior support plan is to improve behavior over time. (PART III - CHAPTER 1800 SPECIFIC PROGRAM REQUIREMENTS FOR BEHAVIOR SUPPORT SERVICES- LEVEL 1 & LEVEL 2 SCOPE OF SERVICES; POLICIES AND PROCEDURES FOR COMPREHENSIVE SUPPORTS WAIVERS PROGRAM) STW’s goal is to partner, build rapport, assess, teach, and model the interventions, which empower families, providers, and their staff to become proficient in behavioral strategies, thereby assisting in the management and improvement of an individual’s behavior. Refer to the link below: https://dbhdd.georgia.gov/be-connected/community-provider-manuals https://dbhdd.georgia.gov/be-dbhdd/be-compassionate https://dch.georgia.gov/programs/hcbs

Behavior Support Service delivery includes structured tasks that consist of the following: • a comprehensive functional behavioral assessment of challenging behavior, • direct observation, • data collection, analysis, and graphing • development of a behavior support plan • competency-based staff and Provider training • routine review of behavior plan efficacy and adjustments to the plan based on review findings. These services are provided in settings where problem behaviors occur. That may include an individual’s own or family home, behavior supports provider office, outpatient clinics, facilities in which Community Access Services or Prevocational Services are provided, Support Employment work sites, residential, or other community settings. (PART III - CHAPTER 1800 SPECIFIC PROGRAM REQUIREMENTS FOR BEHAVIOR SUPPORT SERVICES- LEVEL 1 & LEVEL 2 SCOPE OF SERVICES; POLICIES AND PROCEDURES FOR COMPREHENSIVE SUPPORTS WAIVERS PROGRAM) Refer to the link below: https://dbhdd.georgia.gov/be-connected/community-provider-manuals https://dbhdd.georgia.gov/be-dbhdd/be-compassionate https://dch.georgia.gov/programs/hcbs

For general service questions, meeting request, CPI training please send to: adminservices@specialtransitionworks.com For documentation request, CABs questionnaire, data requests please send to: admindocs@specialtransitionworks.com

Yes, before starting services, we will request copies of guardianship documents (awarded by the courts) or pull copies from the IDD system to verify guardianship. Then we will forward consents via our HIPPA compliant system for an electronic signature to obtain a signature from the guardian or individual if they are deemed competent. Consents are sent annually as required by the law. We will not continue services if consents are not received or renewed. Note: This program applies to both the Adult and Adolescent programs.

This is dependent on when documentation is completed to approve services and funding is allocated. Generally, it can take approximately 2-6 weeks for funding to be applied dependent on the case or process. STW must secure funding prior to beginning services. Please check with your support coordinator or STW staff whether funding has been received. Note: This program applies to both the Adult and Adolescent programs.

The general outline listed below is a sample, however every case is different dependent on the need. We must complete a variety of assessments in order for the BSP to be completed. This is to include but is not limited to: • Functional Assessment Interview • Question about Behavioral Functions • The Assessment of Functional Living Skills • Data analysis • Complete observations (3 minimum) • Collect and analyze data from our observation • Train and collect data from the family/providers and CAG (must be/should be both if they have both, support employment etc.). • Meet with all support services in all areas. • Development of plan summarizing the assessments, graphs, and implementation • Ongoing training (via telehealth and/or in-person) • Evaluation of treatment and its effectiveness • Monthly and session update documentation (documentation is required by policy and billed monthly) Please note that coordinating schedules with staff and the individual in all program areas such as residential, day programs, and community takes time and requires a considerable amount of planning. Due to these variables, this may create a delay in the development, implementation, and/or training of that plan. Note: This program applies to both the Adult and Adolescent programs.

FACTORS Consents must be signed prior to, or the same day services start (during the initial meeting). Funding dictates how often we go and when visits are conducted (this means funds must be available before services are rendered, not after). Scheduling availability of the guardian and provider The willingness of the guardian and provider to collect data and participate in the assessment process. This includes collecting and submitting data. SOLUTIONS Once your team has been assigned you can always reach out to the assigned BSS team members and obtain assistance to complete consent forms prior to the initial meeting. Consent forms are typically sent 1 month in advance. It is important to follow-up with your SC and STW staff regarding funding allocation. We provide convenience (i.e., virtual, telephonic and in-person) at varying times to help with the process. It is important to attend scheduled appointments. You will benefit more from BSS services through the efforts and your consistent participation. We will help you every step of the way through this journey. Note: This program applies to both the Adult and Adolescent programs.

As a Medicaid provider we are required to document services rendered. At the end of each session, we will forward a progress /site visit note for you to review which documents our presence and participation of the session. Managers and supervisors will at times receive session notes in order to inform and provide updates of our observation. Managers and supervisors can sign on behalf of staff. Otherwise, session notes will be forwarded to the staff who participated and were present during the delivery of the service. Note: This program applies to both the Adult and Adolescent programs.

We monitor progress and changes in the behaviors. This informs us whether the interventions are effective or if adjustments are needed. This is part of our analyzing process. Once we complete the review, we will provide a monthly report (also known as a behavioral summary) to you and other stakeholders. You can always request a copy from your team. Note: This program applies to both the Adult and Adolescent programs.

Data should be submitted monthly, at the end of the month and/or first week of every month. During sessions, we may ask to review with you the data collected thus far. This will assist with the competency and accuracy of your collection. For example: It is June 30th, we ask that you submit your data between July 1st- 5th. This occurs every month. If you delay the submission of your data, this delays the process of developing our monthly reports. Note: This program applies to both the Adult and Adolescent programs.

It is STW’s goal to release reports at the end of every quarter by the dates outlined below. Jan- Mar-1st Quarter– expected release April 15th-30th Apr-Jun 2nd Quarter– expected release July 15th 31st Jul-Sept 3rd Quarter– expected release October 15th- 31st Oct- Dec. 4th Quarter– expected release January 15th-31st Please note once you have been assigned to a team, you can always make a direct request from your BSS team to provide a monthly report before the release date to review current progress. Note: This program applies to both the Adult and Adolescent programs.

Yes, it is imperative to the success of the program that staff, guardians and providers participate in the development and implementation of the plan. This is to include monthly visits, sessions, reviewing data and attending training. Note: This program applies to both the Adult and Adolescent programs.

No, we do not replace staff, nor do we become staff. It is expected that staff will remain present during the entire session with BSS staff and work with the BSS staff members. BSS staff will not be left alone with the individual. Our BSS staff are trained to terminate sessions if at any point the staff leaves the premises and/or refuses to attend or participate in the session. Note: This program applies to both the Adult and Adolescent programs.

Yes, you can terminate services at any time. Please provide termination in written form to your BSS team lead and support coordinator/PLA if applicable. Please be aware that BSS services are provided in all program areas. It is also the individual’s choice and documented guardians’ choice to terminate. We will need to verify whether services can be terminated and assess the impact as behavioral support also impacts the funding for support. Our team will begin the discharge process and inform the regional behavioral department of the request. Note: This program applies to both the Adult and Adolescent programs.

Yes, you may. We understand the stressors of carrying and managing the care of your loved ones. Please maintain contact with your team during this pause. Please note after 30-60 days of no contact with the team the discharge policy will be in effect. Also check with your assigned SC and Medicaid wavier regarding their funding policy. Funding may be terminated due to inactivity. Note: This program applies to both the Adult and Adolescent programs.

After obtaining required documents: STW will submit the documents to your insurance/ program provider to obtain approval for services. This approval will allow us to complete the required assessments, justifying behavioral services and the need for services. This assessment can take between 8 – 10 hours to complete (case by case). This assessment must be completed in the allotted time (generally, providers are given up to 3 months to complete). It is important that staff and guardians participate in the assessment process and maintain scheduled appointments, to prevent delays and/or expiration. Once the assessment has been completed, it is once again submitted to the insurance/program provider for treatment. This second approval will detail how often and how long sessions can be completed. Depending on the need and guidelines, some individuals are awarded 2, 3 or 4 times a week sessions. Ninety percent of sessions are done in-person. Parent and staff training are part of the session. The adolescent program is subject to the same guidelines as stated under "all programs" .

For general service questions, meeting request, CPI training please send to: adminservices@specialtransitionworks.com For documentation request, CABs questionnaire, data requests please send to: admindocs@specialtransitionworks.com

It takes approximately 10-12 hours to complete a BSP plan. On average, these hours are scheduled over 2-3 months. We do this so as not to overwhelm the families, the providers, and their caregivers. In addition, our goal is to obtain accurate information. Therefore, we attempt to schedule times that are convenient and allow for undivided attention. We want this experience to be pleasurable and a form of relief, not an additional burden.

Below is a sample of a schedule (this sample schedule may vary case by case): Ideal schedule of services (approximately 1.5 - 2 hours per session) 1 session – Initial meeting review consents/rights, begin FAI, contact CAG/CAI/CLS, if applicable. 2 session –Finish FAI, implement data collection and train guardian/provider to collect. 3 session –Review, analyze data, complete QABF: observation 1 4 session – Start AFLS, observe at CAG: observation 2 5 session – Finish AFLS, collect CAG data, complete observation 3 6 session – Analyze all data and create BSP plan. 7 session – Train all staff, in all program areas including families. If there are cancellations and/or staff are not able to participate in the full length of the session, please note this will delay the process, as any parts that are not completed in the current session will continue and be completed in the next.

We are a hybrid program. This means we provide both telehealth and in-person sessions. We utilize resources in the most effective way possible in efforts not to exhaust the resources available yet ensure success. As it relates to the adult program, please note that funding dictates how often visits are conducted each month and the BSS team’s participation, including additional meetings such as ISP’s, SIS, and CAB’s. It is expected that each individual will receive an in-person visit once per quarter after the initial 2-3 visits. This allows the team an opportunity to build rapport with the individual, family/ provider and lessen reactivity by our presence in the environment. This also allows time for providers, families, and individuals to determine if BSS services is the right fit for them. A general rule of thumb as it depends on funding: • For adolescents it is 90% in person and 10% telehealth • For adults it is 30% in person and 70 % telehealth

Services start with the 1st initial session. It is at this time consents are reviewed, and the assessments begin. It is our goal to keep to the state 90-day policy as well as our own. Therefore, it is important that guardians/providers help us do our part, by honoring scheduled appointments, maintaining participation in sessions, and submitting necessary documentation in a timely fashion. If we are not able to complete the BSP during the expected timeframe, a discharge may be initiated. Additional factors that may initiate discharge (this will include, but is not limited to): • Disinclined to collect data and or provide data, this is to include collecting baseline data with the clinician. • The BSS clinician is unable to make contact between 30-60 days of attempts. • Refusal to sign consents. • Refusal and or refusing to allow BSS clinicians to complete observations of behavior. • Request to implement interventions that are not evidence-based practices and or places the individual in harm. • Lack of session participation • Frequent session cancellations • No shows and or frequent no shows. • Aversion to collaborating with behavioral team and or follow recommendations. It is important to note that unexpected events occur, please communicate with your team via email as soon as possible and note any delays or concerns that may be preventing your participation. This will allow the BSS team to adjust and assist you. To ensure quality services STW will enforce this policy with no exceptions.

Therapeutic consultations are dependent on the funding awarded to each individual. Also, individuals’ behavioral challenges and needs dictate the funding allocated. Some individuals are awarded one session per month, others may be awarded 2 or 3 sessions per month. This does not include trainings, crisis support and team meetings. These would fall under the category “as needed” and “when needed”- there is no limit for these services, however funding budgets are considered prior to delivery.

After obtaining required documents: STW will submit the documents to your insurance/ program provider to obtain approval for services. This approval will allow us to complete the required assessments, justifying behavioral services and the need for services. This assessment can take between 8 – 10 hours to complete (case by case). This assessment must be completed in the allotted time (generally, providers are given up to 3 months to complete). It is important that staff and guardians participate in the assessment process and maintain scheduled appointments, to prevent delays and/or expiration. Once the assessment has been completed, it is once again submitted to the insurance/program provider for treatment. This second approval will detail how often and how long sessions can be completed. Depending on the need and guidelines, some individuals are awarded 2, 3 or 4 times a week sessions. Ninety percent of sessions are done in-person. Parent and staff training are part of the session. The adolescent program is subject to the same guidelines as stated under "all programs".