12th Annual Conference on Advancing School Mental Health

What Works in Schools: Sustaining a National Community of Practice on Collaborative School Behavioral Health October

25-27, 2007 THE IMPLEMENTATION OF POSITIVE BEHAVIORAL INTERVENTIONS (PBIS) AND

SUPPORTS IN MARYLAND’S SCHOOLS

• Andrea Alexander, Maryland State Department of Education

• Susan Barrett, Sheppard Pratt Health System• Phil Leaf, Johns Hopkins University

Bills in Congress aim to strengthen, coordinate PBS efforts• State positive behavior support programs would get a boost in funding

and federal support under two proposals being considered in Congress. They are under committee review.

• The Reducing Barriers to Learning Act of 2007 (H.R. 3419) would establish an Office of Specialized Instructional Support Services in the Education Department that would award grants to states to hire coordinators to oversee specialized instructional support services, which could include all types of related services, such as speech, behavior and counseling therapy.

• The Positive Behavior for Effective Schools Act (H.R. 3407 and S. 2111) would add PBS language into a reauthorized NCLB, encouraging states and districts to use Title I money for PBS efforts.

• The proposals also would amend current programs that focus on substance abuse and violence to focus on prevention and improving school climates through positive behaviors. These bills also propose the creation of an Office of Specialized Instructional Support Services.

• Related service providers and supporters of PBS programs are thrilled with the bills, both of which promise to coordinate general and special education services aimed at improving non-academic programs that contribute to students' academic success

Stacy Skalski, Director of Public Policy, National Association of School Psychologists

quote from Education Week interview on Student Mental Health: The School’s Role April 25, 2007

“There are numerous school-based interventions that have proven effectiveness. SAMHSA has a great online

listing of evidenced based intervention model programs for children and adolescents that can be used in schools. Perhaps the most promising currently is Positive Behavior

Interventions and Supports (PBIS). Research on PBIS shows that when schools engage in system wide efforts to

provide positive behavior supports, students are more engaged and successful in school.”

What SW-PBS is…• Evidenced based practices imbedded in a

systems change process

• A prevention continuum

• A process with conceptual foundations in Applied Behavior Analysis (ABA)

• A framework for organizing mental health supports and services

PBS Systems Implementation LogicPBS Systems Implementation Logic

Leadership Team

FundingVisibility Political

Support

Training Coaching Evaluation

Active Coordination

Local School Teams/Demonstrations

Maryland PBIS Partnership and Collaboration

Maryland S tateDepartment of

E duc ation

S heppard P rattH ealthS ystem

J ohnsH opkins

U nivers ity

L oc alS c hool

S ystems

P o s itive B e h a v io r a lIn te r ve n tio n s a n d S u p p o r ts

PBIS Maryland - Our 9th Year!!!

• 3.5 State Coordinators

• 8 District Coordinators

• 700 schools projected to be involved by 2010

• 2.5 million hits on www.pbismaryland. org since March 2006

Maryland Organizational ModelSchool Level

– 559 PBIS Teams (one per school)- Team leaders (one per school)

- Behavior Support Coaches (383)

District Level (24)– Regional Coordinators

State Level– State Leadership Team

- Maryland State Department of Education (MSDE)- Sheppard Pratt Health System- Johns Hopkins Center for Prevention of Youth Violence- 24 Local school districts- Department of Juvenile Services, Mental Health Administration

– Management Team– Advisory Group

National Level– National PBIS Technical Assistance Center

- University of Oregon & University of Connecticut

State

District

School

Classroom

Student

Maryland’s Annual PBIS Training Events

• Spring Forum– March 27, 2007

• Coaches and New Team Institute– Coaches ~ July 9, 2007– Elementary ~ July 10 – 11, 2007– Secondary ~ July 11 – 12, 2007

• Returning Team by Region– Central Region 1 ~ July 16 – 17, 2007– Eastern Shore ~ July 17 – 18, 2007– Western Region ~ July 18 – 19, 2007– Central Region 2 ~ July 19 – 20, 2007– Southern Region ~ August 2 – 3, 2007

• Coaches Meetings (4/year)• Regional Team Leader/Coach Meetings (2/year)• Schools serving students with special needs - MANSEF

(2/year)• High Schools – (2/year)

PBIS Maryland’s Evaluation Processes

Establishing Measurable Outcomes

1. What schools have been trained and are active?

2. How well are schools implementing PBIS?3. What impact does PBIS have on student

behavior? Achievement?

Monitoring Outcomes

• Team Implementation Checklist• SWIS• SET• Coaches Checklist• Staff Survey• Satisfaction Surveys• Implementation Phases Inventory (IPI)

Evaluation Tools

Access 2003 Database

• Data entry/storage• Report Generation

Evaluation Tools

Maryland website www.pbismaryland.orgVarious levels: Any user Team/coach

LSS Point of ContactState Team

Maryland Forms MatrixAccess DatabaseSWIS PBS surveys (www.pbssurveys.org)

How Well are Schools Implementing?

• Systems-wide Evaluation Tool (SET)– Annually– 7 Features of SW Implementation

• Implementation Phases Inventory (IPI)– Semi-annually – Levels of SW: Preparation, Initiation,

Implementation, and Maintenance

School-Wide Evaluation Tool35 Coaches trained as SET assessors

15 Contractual SET assessors

• 97 SETs completed 2004• 154 SETs completed 2005• 157 SETs completed 2006• 104 schools have at least two SET scores• 80% Total score is considered Maintenance Phase

(IPI)• All regions met 80% criterion across schools• 69% increase after one year of implementation

DATA

SET Scores by Region

42.52

25.00 29.0042.00

88.44 92.9086.60

95.58 91.04

0

20

40

60

80

100

Central Eastern Southern Special Western

Pre Post

% at phase

11.32%

9.47%

23.16%

56.05%

Preparation Initiation Implementation Maintenance

Cost Benefit: Middle School

Base Line - Office Referrals=2277Year One - Office Referrals=1322

Decrease in Office Referrals = 955

(42%)

Cost Benefit: Middle School

If one Office Referral takes 15 minutes for an administrator to process, then

955 x 15 = 14,325 minutes 238.75 hours or

40 daysof administrator time recovered and reinvested.

Cost Benefit: Middle School

If a student misses 45 minutes of instructional time/Office Referral, then

955 x 45 minutes= 42,975 minutes

716.25 hours or

119 days of instructional time recovered!!!!!

Next Steps in Evaluation

• Shifting to the BOQ-MD• PBIS Plus-MD • Continuous Improvement re: forms-MD• National sharing of expertise is sustainability of

PBIS-National• Continued funding and support of the National

Center’s ongoing research and evaluation-National

• APBS’ focus on research--National

Commonalities between School-Based Mental Health and SW-PBS

Shared Goals

Success for all youth at school, home, community

Academic/social/emotional success Safe, effective, supportive learning

environments Systemic approaches that are prevention

based Culturally Relevant interventions Focus on building skills and building on

strengths

Shared Challenges Quality of the fidelity of implementation of

interventions Low capacity for utilizing data-based decision

making Fragmentation of efforts on behalf of youth Few and/or inconsistent behavior practices in

schools that are proven to be effective Environments that are “toxic” for youth with

MH challenges (in the home, school, or community)

Shared Frustrations Behavior Support only structured in Special

Education Proactive approaches are considered and

implemented only after many failures Interventions are often based on what we have

instead of what the youth and family needs Related initiatives become new “silos” with

separate funding, training and implementation structures (i.e RtI, SEL, SBMH…)

Efforts to Build on Existing Initiatives in Maryland

USDE’s Mental Health Integration Grant-Round 1

• “Grants for the Integration of Schools and Mental Health Systems will provide funds to increase student access to high-quality mental health care by developing innovative approaches that link school systems with the local mental health system.”

• Call for proposals posted in April 2005• Grant Due in May 2005• Notified of award in September 2005

1 of 20 funded projects (84 total applicants)

Maryland’s Strengths• Commitment from key local, state, and national

partners to collaborate and form an Alliance to advance school-mental health system integration in Maryland

• Strong support for children’s mental health and school mental health in the state

• A strong PBIS structure within the state and an interest in enhancing mental health support and resources for red and yellow zone youth

• State-wide needs assessment data indicated need for additional mental health training

Required Grant Components• Enhance collaboration between schools and mental

health systems to improve prevention, diagnosis and treatment for students

• Enhance crisis intervention, appropriate referrals and ongoing mental health services

• Training for school personnel and mental health providers

• Technical assistance and consultation to the school system, mental health agencies and families

• Provide linguistically appropriate and culturally competent services

• Evaluate the effectiveness of increasing student access to quality mental health services

Maryland School Mental Health Alliance (MSMHA)

• Maryland State Department of Education• Center for School Mental Health Analysis and Action -

University of Maryland• Center for Prevention and Early Intervention - Johns Hopkins

University• Governor’s Office for Children• Maryland Assembly on School-Based Health Care• Maryland Coalition of Families for Children’s Mental Health• Maryland Department of Juvenile Services• Mental Hygiene Administration Department of Health and

Mental Hygiene• Mental Health Association of Maryland

County Integration Teams• Comprised of families, educational staff, PBIS

leaders, child and adolescent mental health system representatives, leaders from the Department of Juvenile Services, and other community partners

• Responsible for pursing improved school-mental health system integration in their county through:

Active communication Needs assessment Resource sharing Problem solving

What does my county receive?• Train-the-Trainer Trainings for PBIS Coaches/Leaders to Enhance

Mental Health Identification and Referral and Effective Classroom Management for Students with Mental Health Concerns

• Access to the MSMHA website • Technical Assistance/Consultation from the CSMHA and other

Management Team Agenices/Organizations• Newsletter Highlighting the Five County Initiative• A Voice in Improving Mental Health Integration into PBIS Schools

in Maryland• More Focus on Red and Yellow Zone Youth• Resources to advance mental health identification and referral

and family involvement within the school setting• Hopefully Improved Academic and Emotional/Behavioral

Outcomes• Funding, $10,000

Creating and Sustaining Environments to Support Teaching and Learning in

Baltimore City

April Lewis, Baltimore City Public School System

Philip J. Leaf, Ph.D. Johns Hopkins Bloomberg School

of Public Health

COMPREHENSIVE

COORDINATED

COLLABORATIVE

COMMITTED

BCPSS required to partner with Johns Hopkins University,

Sheppard Pratt Health System, Inc., or another agency

approved by MSDE to develop a comprehensive safety plan.

PLAN NECESITATED BY CORRECTIVE ACTION MANDATED BY MSDE

BCPSS Goal 4: All students will be educated in learning environments that are safe, drug-free, and conducive to learning.

While the student is the central focus of the Baltimore City Public School System’s (BCPSS) efforts to create safe and supportive schools, BCPSS chose to develop a plan that considers the roles of staff, families, and community members in creating positive learning environments.

Parameters of the PlanThe Plan…• Focuses on changing the behaviors of adults• Recommends specific research-based strategies• Uses a multi-component approach• Includes universal prevention, targeted

prevention, and remedial efforts• Focuses on teaching and student support• Targets strategies at specific, identified needs • Identifies roles and responsibilities for

implementation and establishes a system-level management team to meet weekly to review data

Comprehensive Safety Plan Development

• A written plan was developed and approved by a Steering Committee chaired by the Student Services Officer and Dr. Leaf (JHU Center for the Prevention of Youth Violence) and including school system CEO, Mayor, State’s Attorney, Police and Health Commissioners, union representatives, community and parent advocates, local service providers and university faculty

• Includes workgroups work groups have school system and non-school system co-chairs

• Implementation is concurrent with development and emphasizes coaching and mentoring

• Involves a nine component prevention and intervention strategy

Collaboration and coordination are inherent in the process…

Comprehensive Safety Plan Development

• Supported training and mentoring of school teams

• Implementation is concurrent with development and emphasizes coaching and mentoring

• Involves a nine component prevention and intervention strategy

• Utilizes multiple data sources to determine strengths, gaps, and needs

Collaboration and coordination are inherent in the process…

Agency Partners

CITYWIDE CITYWIDE COLLABORATIONCOLLABORATION

Academic CollaboratorsCrisis Management Teams

PCAB

Steering CommitteeWorkgroups

DISTRICT-WIDE COORDINATIONDISTRICT-WIDE COORDINATION

Management Team

CAO Cabinet

Staff Unions

Office for Safe and SupportiveLearning Environments

Executive Leadership Team

Crisis Management Teams

SCHOOLS, FAMILIES, SCHOOLS, FAMILIES, NEIGHBORHOODSNEIGHBORHOODS

Student Organizations

Parent Organizations

PBIS Team

Student Supportand School Improvement Teams

Community-based Organizations

STRUCTURES TO STRUCTURES TO SUPPORT SUPPORT

IMPLEMENTATION IMPLEMENTATION OF THE PLANOF THE PLAN

Key External Collaborators• Johns Hopkins Center for Youth Violence Prevention• Baltimore Mental Health Systems, Inc.• Family League of Baltimore City, Inc.• Baltimore Community School Connections• Department of Juvenile Services• Sheppard Pratt Health System, Inc.• Office of the State’s Attorney• Open Society Institute• Baltimore City Health Department• Mayor’s Office• Baltimore City Police Department• Department of Social Services• Towson University• Maryland State Department of Education• Parent and Community Advisory Board

Key Internal Collaborators• Chief Executive and Academic Officers• School Police• Office of Teacher Principal Quality• Office of Parent Involvement and School, Family, Community

Connections• Division of Research, Evaluation, Accountability, and Assessment• Office of Student Support Services• Suspension Services Unit• Curriculum and Instruction and Multicultural and Diversity

Programs• Related Services Unit• Office of School Improvement• Office of Early Childhood Programs• Area Officers, Principals, Teachers, and Students

Implementation Progress• Development of Plan, Steering Committee,

Management Team, and Workgroups• Professional development in positive behavioral

strategies given increase emphasis in system-wide and school professional development activities

• Workshops and coaching on Data-Driven Decision-making and Utilization of Interventions for SSTs, SITs, and PBIS Teams in 95 schools in school improvement

• Strategy for sharing data between School Police and other departments

• Conference planning for transition of youth from Department of Juvenile Services facilities

Implementation Progress• Expansion of PBIS• Enhanced incentives including work

stipends for over-age students in middle school and high school students

• Increased assessment capacity for truant students or with juvenile justice involvement

• Increased community support including mentoring of students

Comprehensive Safety Plan Components

• Data-based Decision-making• School-Family Engagement• Policies and Procedures• Curriculum and Instruction• Professional Development• Youth Development and Leadership• Intervention Services and Supports• Community Involvement• Safe Facilities• Unsafe School Choice Option

Implementation is concurrent with development…

Most Sections Contain…

• A Guiding Principle;• Background Information;• Applicability to the BCPSS;• Key Implementation Tips;• Shared Roles and Responsibilities;• Recommendations for Continued

Planning; and• Fiscal Status

THEMES…

• Data-based Decision-making• Emphasis on Creating Positive

Learning Environment and Rewording Positive Behaviors

• Family and Community Involvement• Professional Development• Communication• School Police Activities Integration

into Overall Plan

Cut across all workgroups

Development of Action Plans

• Strategies and Activities• Timelines for Implementation• Duties and Responsibilities• Oversight Responsibilities

Identified• Data and Evaluation Procedures

School-based Plans

• Integrated into the School Improvement Plan• Developed by teams including parents• Include an assessment of progress and needs

and must include/parent/family involvement• Utilize data for effective decision-making and

resource allocation• Should be viewed as dynamic rather than static

Resources: (Fixen, et al, 2005)“Implementation Research: A Synthesis of the

Literature http://mim.fmhi.usf.edu

(Kutash et al, 2006) “School-based Mental Health: An Empirical

Guide for Decision-Makers” http://rtckids.fmhi.usf.edu

(Bazelon Center, 2006)“Way to Go”….School Success for Children

with Mental Health Care Needs www.bazelon.org

www.pbismaryland.org

www.pbis.org

http://csmha.umaryland.edu,

Maryland State PBIS Coordinators:

Andrea Alexander, MSDE aalexander@msde.state.md.us

Susan Barrett, SPHSsbarrett@pbismaryland.org

Phil Leaf, JHUpleaf@jhsph.edu