Home health agencies provide in-home services to help individuals recover from an illness or injury, regain their independence and become as self-sufficient as possible.
Home Health Agencies
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Crisis Debriefing
Crisis Debriefing:
The debriefing process is the most important component of crisis intervention and prevention and is therefore a required component of the crisis services provided to each individual. Regardless of whether the immediate issue has been addressed and stabilized, if this process does not occur, the cycle is likely to continue.
The CMHC crisis team will coordinate and lead the debriefing meeting. It is expected that these meetings will occur very quickly after the event to ensure that all the information is collected and to allow the team to determine the next steps.
It is important that the individual be able to participate in this process as much as possible to ensure that it remains person-centered. All individuals who are involved with the individual should be included to contribute and provide input to the process.
- Debriefing analysis of a situation and subsequent recommendations and intensive planning as facilitated by the regional ID crisis team to help prevent further incidents/crises.
- Debriefing meetings are coordinated by the CMHC crisis staff and are required to occur within 7 days of the initial crisis contact.
- The debriefings should include all parties that may be able to assist the consumer in identifying the cause of the crisis as well as solutions.
Crisis Services Offered
Crisis Services Offered:
A variety of services are available and are provided based on the needs of the individual. Since the crisis system addresses individuals who are in waiver programs as well as individuals who are not receiving any other supports, the service array will vary for individuals, depending on what type of supports they are already able to access through other means.
When an individual is experiencing a crisis that requires immediate intervention to address the health, safety, and welfare of the individual. A mobile response may be provided by the CMHC I/DD crisis team to provide immediate services and technical assistance where the individual is located.
Person-Centered Planning-is provided by CMHC crisis teams, and these staff are often referred to as intensive case managers. Person-centered planning helps to assess and mitigate risk while determining what is important to and important for the participant. In order to gain the needed information to guide the team through the planning process and identify what an individual’s needs are, assessments may also be provided to provide needed information.
Functional assessments, environmental assessments, and psychological assessments can provide the team with the information needed to identify the appropriate supports needed. Behavior support plans can be developed to address significant challenges which interfere with daily life.
The crisis team may also provide technical assistance and resource linkage to assist individuals with identifying and locating the needed supports.
Individuals who do not receive residential supports may be eligible for respite to provide relief for an individual providing care when no other funding source is available.
Purpose of Crisis Services Through CMHC’s
The purpose of services through Community Mental Health Centers (CMHC’s) is to:
In addition to the array of services available to individuals who are experiencing a behavioral health emergency, Kentucky also provides additional supports for individuals with an intellectual or developmental disability.
These services are designed to be time-limited services to augment the existing community services and successfully guide the individual through a time of crisis.
The goal of these services is not only, but also, to address the immediate crisis, but to provide the individual and their caregivers with tools to prevent future crisis and provide individuals with “the good life.”
GField 23 – Scenario
Scenario 1:
You receive an email from the Case Manager for JW, an individual on your caseload who lives with a Family Home Provider through the Supports for Community Living waiver. The Case Manager informs you JW has been offered a position working 20 hours per week in dietary at the local hospital. Vocational services were agreed to at his last Person-Centered Service Planning meeting. JW will be earning $10.00 per hour and his employer requires a direct deposit into a bank account. What documentation does JW need to provide to his employer?
What process does the GSSW need to follow regarding the direct deposit requirement of the individual’s paycheck?
Ask the Case Manager to obtain the documentation from the employer required for direct deposit of JW’s paycheck.
How long does the GFSOS and GSSW have to complete the budget process for JW upon receipt of the funds from the employer or notification of KYGFIS message for an update or work allowance?
Three (3) working days.
Scenario 2:
After a serious car accident at age 20, Jamal has been receiving services through the Acquired Brain Injury (ABI) waiver for the past two years and living in a house with his grandmother. The ABI waiver is for adults with an acquired brain injury who can benefit from intensive rehabilitation services. The services are designed to help participants re-enter the community and function independently. As a result of his cooperation with his Team, and the services provided through the ABI waiver, Jamal no longer requires the services and plans to enroll at the local community college in the Fall.
What are the steps the GSSW will take to create his new budget to include expenses related to attending the community college?
- Determine Jamal’s monthly income and expenses.
- Determines other expenses of the individual under guardianship that are not on a monthly basis.
- Uses the budget link within KYGFIS to:
- Calculate monthly amounts for these expenses; and,
- Calculate a net amount.
- Save the completed budget in KYGFIS to submit for review to the GFSOS.
How often is the budget reviewed?
The budget is reviewed at least annually or when needed.
Phase V: Recovery / Action: Restoration & Re-Integration
This lesson focuses on how to help the individual return to a pre-crisis level of functioning. It is important that staff take every precaution to ensure that the individual’s dignity and respect are maintained throughout a crisis episode and that their reputation is harmed as little as possible as a result.
- Support the person in crisis.
- Identify others affected by the situation.
- Plan to resume regular activities.
Phase IV: Vent & De-escalate / Action: Stabilization
This section addresses staff response as the crisis begins to de-escalate. Emphasis is placed on emotionally responsible caregiving.
- Identify what venting is and how we can use venting to help a client.
- Evaluate what type of support a person needs during a crisis.
- Determine how mindfulness impacts physical and mental health.
Phase III: Acceleration to Peak/ Action: Intervention
In this lesson, we will explore staff behavior influences a crisis situation. We’ll discuss specific ways staff can help alleviate the underlying problem leading to the crisis. This section also explores ways in which many persons with disabilities experience loss and the role that plays in crisis development.
- This lesson is NOT
- Crisis Prevention Institute
- The Mandt System
- Safe Crisis Management
- Using restraints
Phase I: Calm / Action: Prevention
This lesson will review ways to enhance a person’s life through person-centered planning, focusing on gifts and dreams, to reduce stress and negative emotions. We will discuss including person-centered planning principles in the crisis prevention planning process. We will also explore ways to maintain calm.
- Prevent crises.
- Help the individual manage an episode with as little disruption as possible.
- Develop natural supports and decrease reliance on formal systems.
- The key to prevention is the building of supportive and emotionally responsible interactions between support providers and those receiving supports.
Understanding the Role of the Brain in Behavior
The brain plays a crucial role in crisis prevention. In a crisis, your brain will want to make decisions, not always the best ones. There is science behind how people react to stressful situations, and we can use it to our advantage. Stress management may reduce health problems linked to stress, which include cognitive problems and a higher risk for Alzheimer’s disease and dementia. It can also help you predict when you are likely to be stressed. Reaching out can help you become more resilient and better manage stress, potentially protecting your brain health.
This is Your Brain on Emergencies | Blogs | CDC. https://blogs.cdc.gov/publichealthmatters/2016/11/this-is-your-brain-on-emergencies/
Protect your brain from stress – Harvard Health. https://www.health.harvard.edu/mind-and-mood/protect-your-brain-from-stress
Calming Your Brain During Conflict – Harvard Business Review. https://hbr.org/2015/12/calming-your-brain-during-conflict
Mental Health Promotion and Prevention | Youth.gov. https://youth.gov/youth-topics/youth-mental-health/mental-health-promotion-prevention