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Parent Child Interaction Therapy Program Development and Services - - PowerPoint PPT Presentation

Jan 13, 2024 238 likes •685 views

Parent Child Interaction Therapy Program Development and Services Funding Opportunity 2019-2021 Presentation by : Laurie Theodorou, LCSW Early Childhood Mental Health Policy Specialist Child and Family Behavioral Health November 6 th and

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Parent Child Interaction Therapy Program Development and Services Funding Opportunity 2019-2021

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Presentation by : Laurie Theodorou, LCSW Early Childhood Mental Health Policy Specialist Child and Family Behavioral Health November 6th and November 14th

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Goals of this Webinar

  • Brief overview of PCIT
  • Why OHA is supporting further expansion
  • Outline of new funding structure
  • Who can apply
  • How to apply
  • What are the expectations
  • Resources regarding PCIT training and fidelity

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What is Parent Child Interaction Therapy (PCIT)?

  • PCIT was developed in the early 1970s PCIT in Oregon by Dr.

Sheila Eyberg

  • Two-phase therapeutic approach:
  • 1. Enhance a secure attachment between the child and caregiver
  • 2. Reduce disruptive or challenging behaviors that get in the way of daily

living

  • Key Characteristics:

– Consistency – Safe – Structured – Short-Term (16-20 weeks) – Predictable for the child and caregiver

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What does delivery of PCIT look like?

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Populations for which Standard PCIT has been shown to be effective:

  • Children ages 2 - 6 years old
  • Children diagnosed with ODD, ADHD and other Disruptive Behavior

Disorders

  • Children on the Autism Spectrum
  • Child welfare involved children and caregivers
  • Children in foster care and their foster parents
  • Families from all over the world

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Well supported Adaptations Requiring Additional Training

  • PCIT-Toddler for 12-24 months
  • Older Child Protocols- 7 & 8

years

  • Children with Selective Mutism
  • Children with Anxiety
  • Teacher Child Interaction

Training- TCIT

PCIT effectiveness is being tested for:

  • Providing PCIT via

telemedicine

  • Intensive PCIT
  • PCIT-Care limited

session model

  • Others

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Oregon PCIT Outcomes 2017-2018

Reduction in Intensity of Problem Behaviors for Graduated Families

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20 40 60 80 100 120 140 160

Met research criteria for treatment completion

146 pre-tx 89 post-tx

114 or less is the goal

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Families Who Left Treatment Early

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110 115 120 125 130 135 140 145 150 155

Attended 4 or more PCIT sessions and did not meet treatment completion criteria

150 pre-tx 126 post-tx Statistically significant decrease in Problem Behavior Intensity

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Need for PCIT Victims of Child Abuse 2017

  • 45.1 % of all victims were younger than

6 years old.

  • 4,295 Victims were 2-6 years old

2017 Child Welfare Data book https://www.oregon.gov/DHS/CHILDREN/CHILD-ABUSE/Documents/2017-Child-Welfare-Data- Book.pdf

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235,800 Oregon Children ages 0-5 yrs.

National estimates - 12-16 % of all children 0-6 would benefit from mental health services Oregon data – only 6% are receiving mental health services

2017 County Data Book, Status of Oregon Children & Families (Children First for Oregon) https://www.cffo.org/wp-content/uploads/2017/11/Data-Book-2017.pdf by county Wheeler- 49 children – Multnomah- 46,192 children

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History of PCIT funding

  • 2004 Oregon Commission on Child and Families awarded a grant to
  • ne county mental health agency to do a pilot PCIT project
  • 2009 PCIT pilot expanded to include 4 counties
  • 2013 Oregon Legislature earmarked some of the new investment

funds for expanding PCIT to all areas of the state

  • 2018 PCIT is provided in ~45 locations, 19 counties, 2 PCIT-

Internationally certified Regional Trainers (Level II)

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PCIT Sites 2018

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Yellow Sun = OHA PCIT site Blue Sun= other PCIT site Number = Multiple sites Red Star=Trainer(s)

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New Request for Information Rationale

  • Alignment of funding to amount of services provided
  • Increase transparency
  • Increase access
  • Reduce barriers to fidelity implementation
  • Improve PCIT training infrastructure
  • Increase prioritization of brief evidence-based dyadic mental health

treatment

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This Funding Structure Is Different

2004-2019

  • RFP process
  • Flexible
  • Each proposer estimated

their cost

  • Site level training

emphasis

  • Funding process unclear

2019-2021

  • RFI process
  • Standardized & Specific
  • Modules of funding based
  • n data
  • System level training

emphasis

  • Transparent process

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Funding Priorities

1. Current PCIT programs- maintain fidelity and outcomes 2. Access in rural or underserved areas- increase availability 3. Child welfare involved families- prioritize access 4. Cross agency integration- get PCIT to where the children are 5. Sustainable PCIT implementation and training- continue to develop coordinated system

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PCIT is Reimbursable by Medicaid and Commercial Insurance as a Mental Health Treatment

  • Family therapy (90846, 90847)
  • Psychotherapy with client and/or family member

(90832,90834, 90837)

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PCIT Modules of Funding

  • Established PCIT Program
  • Satellite PCIT site
  • Area of Unmet Healthcare Need (Oregon office of Rural Health, 2017)
  • Expanded PCIT Team (4 options)
  • New Program Development/New Location
  • Within Agency PCIT Trainer
  • Regional PCIT Trainer
  • PCIT Innovation Module

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Requirements for all Proposers

  • Proposers must be enrolled as an Oregon Behavioral

Health Medicaid Provider

OR

  • Contract with an Oregon Behavioral Health Medicaid

Provider

AND

  • Currently serve families with Medicaid eligible children 2

through 6 years of age

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Minimum Staffing and Administration

  • 2 QMHP, .3 FTE ea.

devoted to PCIT

  • Clerical and

Administration support, incl. data collection

  • 80 families, 4 or more

PCIT sessions

  • Serve minority

families in the same proportion as live in the county

  • Actively collaborate

with early childhood serving community partners

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Maintain Fidelity Implementation

✓ OHA approved PCIT first year intensive training ✓ On-going monthly PCIT Consultation ✓ Certification within 2 yrs. ✓ Maintain certification ✓ Use Eyberg Child Behavior Inventory consistently ✓ Use Dyadic Parent-Child Interaction Coding System consistently ✓ Documentation in Electronic Health Records of adherence to PCIT protocols ✓ Appropriate and safe PCIT-specific therapy space ✓ Participate in PCIT fidelity reviews ✓ Attend PCIT Conference and Oregon PCIT National Expert Conference calls consistently

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Main Location

Full PCIT Program, 2 QMHP, Administration etc.

Satellite PCIT Locations

Adequate space for PCIT Minimum 1 QMHP, 5+ hours. per week 20 clients per biennium Employed by, or contracted with the Main Location Receives training and supervision as part of Main PCIT Location May be located in early learning center, DHS office, primary care, space rented to increase access to mental health services or other

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  • Additional funding for areas in Oregon where

– There is no or limited access to PCIT services and – There is a demonstrated mental health shortage

  • An Area of Unmet Mental Health Need means a

service area which has less than 1 Mental Health provider per 1,000 people as determined by the Oregon Areas of Unmet Health Care Need Report, August 2018

  • To determine if your agency falls in a healthcare

shortage area, please review this following link

https://www.ohsu.edu/xd/outreach/oregon-rural-health/data/upload/2017-AUHCN-Report.pdf HEALTH SYSTEMS DIVISION Child and Family Behavioral Health

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Oregon Areas of Unmet Health Care Need Report Office of Rural Health, August 2017

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New PCIT Site Funding Module

Develop Programs In:

  • Locations with Areas of

Unmet Need

  • Areas with few or no

PCIT trained providers

  • Areas that can capitalize
  • n unique community

partnerships and referral streams

Requirements:

  • Train 2 QMHP providers in

PCIT

  • Provide fidelity PCIT
  • Make necessary room

adaptations and purchase necessary equipment and toys

  • Documentation of ongoing

training and consultation

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Stackable funding Modules

Main Location-Established 2 QMHP, 80+ Families

1 Addl. QMHP 20+ families Update Training - certification 2 QMHA 40 or more sessions

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Optional Expanded Team- Modules

  • A. Additional QMHP PCIT staff
  • B. Train 1 PCIT certified staff

as Within Agency Trainer

  • C. Update training for PCIT

staff to certify by PCIT-I

  • D. Train 2 QMHA as PCIT

❖ New and Established PCIT Programs ❖ Expand PCIT beyond minimum requirements ❖ May qualify for one

  • r more

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2.5.1 PCIT Optional Expanded Team

A) Receive Training and Supervision each Additional QMHP Deliverables per Additional QMHP funded

 56 hours of OHA approved PCIT training before November 30th, 2019  28 or more hours of PCIT consultation per biennium  4 or more hours of statewide PCIT Consortium calls per year, for 2 years  Each PCIT clinician attend Oregon PCIT conference  Provision of PCIT to 20 or more families for 4 or more sessions each biennium.  Purchase additional assessment tools required for PCIT expanded team

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2.5.1 PCIT Optional Expanded Team

B) Train 1 Certified PCIT Therapist to be certified as a Within Agency (Level I) Trainer

Deliverables

Completion of 8 hours didactic training which meets the PCIT International Trainer requirements http://www.pcit.org/trainer-requirements.html Monthly follow-up consultation to the Level I Trainer Course with a Certified Master Trainer or Level 2 Trainer Supervise a therapist-in-training to complete at least one PCIT case to graduation criteria while under consultation from a Certified Level II or Master Trainer. Complete all Level I Within Agency training requirements and competencies within 2 years. Maintain Level I Trainer certification by completing at least 6 hours of PCIT International authorized Continuing Education credit every 2 years.

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2.5.1 PCIT Optional Expanded Team

C) Recalibration/Certification Preparation

Deliverables per QMHP funded for updated training

 PCIT therapists trained before 2011 with two completed PCIT cases and not yet certified Complete 16 hours of PCIT International Training update skillsets to the most current protocols for PCIT International certification requirements Certified by PCIT International within 2 years from recalibration training Attend 28 or more hours of PCIT Consultation per biennium Provide PCIT services to 20 clients for 4 or more PCIT sessions per biennium

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2.5.1 PCIT Optional Expanded Team

D) Train 2 QMHA staff to provide PCIT- specific in-home skills building

Deliverables for 2 PCIT QMHA

 2 QMHA staff receive 16 hours of PCIT training each in Adjunct in-home skills building  Each QMHA PCIT trained staff provide 20 PCIT specific in-home skills building sessions per biennium  Documentation in Electronic Health Records of Adjunct in-home skills building which addresses the PCIT-specific treatment plan goals  Documentation in Electronic Health Records of PCIT QMHA and primary QMHP communicating and collaborating on behalf of clients to address treatment goals

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Additional Funding Modules

Provide Within Agency Training

  • Certification as PCIT Within Agency Trainer by PCIT International or the UC

Davis Training Center

  • Train 2 or more QMHP to provide fidelity PCIT each biennium
  • Ongoing training and PCIT consultation for PCIT team
  • Provide PCIT to 10+ families
  • Document ongoing PCIT consultation and collaboration with Oregon Regional
  • r Master Trainer

Regional Trainer

  • Certification by PCIT International to train and supervise therapists external to

their own program or agency

  • Authorized by a licensing board to provide clinical supervision
  • PCIT training and supervision which meets PCIT International Certification

Guidelines for 24 or more clinicians

  • Other requirements

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Hypothetical Examples

Basic Established PCIT Program 1 location, 2 therapists, 80 clients 1 Implementation Module ~ $60,500 Administrative costs 18% ~ $10,890 Biennium total $71,390

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New PCIT Program Development Program Development, Training, and PCIT suite 1st year 1 New PCIT Location Module ~ $46,800 1 location, 2 therapists, 80 clients 1 Implementation Module ~ $60,500 Administrative costs 18% ~ $19,314 Biennium total ~ $126,614

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Large Established PCIT Program Estimate 2 full Program locations (2 therapists, 80 clients each location) 2 Implementation Modules ~ $121,000 4 Satellite Locations (20 addl. Clients each location) 4 Satellite Modules ~ $ 61,600 2 of the Satellite Locations meet AUN 2 Area of Unmet MH Need Modules ~ $ 20,000 6 Additional PCIT QMHP (20 addl. clients each) 6 Expanded Team (A) Modules ~ $ 50,400 Within Agency Trainer (provide PCIT training and consultation) 1 Level I certified Module ~ $ 20,300 Administrative costs 18% ~$ 49,194 Estimated biennium total ~ $322,494

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Low Population Areas Interagency Collaboration Regional Agency Satellite Satellite Satellite Satellite

Regional Agency Subcontract with providers in different counties or

  • agencies. Provide Admin,

reporting, other supports Satellites Contracted with regional agency. Meet requirements as a group Participate in training/consultation/ supervision as a group Report to Regional Agency

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Innovation Module

  • No more than one per program
  • Only open to established PCIT Programs
  • Must employ 2 or more certified PCIT QMHP
  • Program must have served 60 or more families in most recent

biennium

  • Must have adequate Fidelity Review rating in past two OHA fidelity

reviews

  • Demonstrate community need for a PCIT adaptation
  • Must contract with researcher or Master trainer
  • Additional application requirements

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PCIT-Toddler Intensive Family Coaching Internet PCIT

Other PCIT Adaptation

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Expenses

Included

  • PCIT training -authorized

trainer

  • ECBI & other tools for PCIT
  • Room build & maintenance
  • PCIT equipment & toys
  • PCIT Consultation- Staff time
  • Conference & Certification
  • PCIT related travel
  • Outreach to referral sources
  • PCIT for uninsured families
  • Reporting & Administration-

Staff time

Excluded

  • Non-PCIT activities or

staff time

  • General expenses

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Application Components

Application Form

➢ Includes applicant contact and profile information ➢ Agency minimum requirements to ensure the agency is able to deliver the intervention at the time of the award ➢ Documentation of Enrollment as OHA Behavioral Health Provider ➢ Authorizing signature ➢ Three community references (letters and contact information)

Specific Module of funding deliverable form(s)

➢ To ensure applicants understand the deliverables expected from grant receipt ➢ Some modules require additional documentation

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Letters should demonstrate:

  • Each applicant is

required to submit three letters of support from community partners

  • 1. The agency’s ability to be

successful in reaching the target population for PCIT in adequate numbers

  • 2. The community partner’s

commitment to being a strong referral source to PCIT services

  • 3. The community partner’s

satisfaction with the partner relationship and services provided by the agency

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Timeline

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Event Date Time Pre-Proposal Webinar November 6th , 2018 November 14th, 2018 2:00 pm PST 10:00 am PST Link to full Request for Information document available https://www.oregon.gov/oha/HSD/OHP/Pages/Provi ders.aspx November 16th, 2018 First day applications may be submitted December 3rd, 2018 8 am PST Questions / Requests for Clarification Period December 3rd-20th 2018 Application Period Closes (Proposal Due) January 11th, 2019 5 pm PST RFI Protest Period Ends January 11th, 2019 Opening of Applications January 14th, 2019 TBA Issuance of Notice of Intent to Award (approx.) January 25th , 2019 TBA Award Protest Period Ends 7 calendar days after Notice of Intent to Award 2019-2021 PCIT funding July 1, 2019-June 30th 2021 Initial 40 hrs. training of new PCIT clinicians and modifications for basic PCIT suite completed November 30th, 2019

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Reminder

This is an overview of the changes to the PCIT funding and the amounts used in the examples are only estimates. Final amounts of award may be more or less than in the examples The full list of Requirements will be included in the Request for Information (RFI)

The Final Authority is the Executed Contract

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PCIT Training

Contact Jackson County Mental Health, Alejandra Moreno, MA, MS, certified PCIT International Level II Trainer MorenoAJ@jacksoncounty.org

Jackson County Mental Health (JCMH) has a PCIT training team contracted to provide PCIT training and on-going supervision to qualifying Oregon programs. Trainee travel and time expenses are covered by their agencies.

Contact Lifeworks NW, Erin Sewell, LCSW, certified PCIT International Level II Trainer Erin.Sewell@lifeworksnw.org

LWNW may have training slots available on a limited basic for therapists not employed by LWNW

Contract with a certified PCIT Master Trainer or Level II trainer from

  • utside Oregon. http://www.pcit.org/pcit-trainings or https://pcit.ucdavis.edu/

Additional costs will be incurred and are the responsibility of the applicant agency. If you have questions whether or not an upcoming PCIT workshop follows the current PCIT Training Guidelines, please contact: John Paul Abner – JPAbner@milligan.edu

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PCIT Information

PCIT International- http://www.pcit.org/

  • Training and Certification requirements
  • Comprehensive lists of PCIT Research
  • Purchase PCIT required manuals and materials
  • videos of PCIT, find PCIT Providers, and more

Parent-Child Interaction Therapy- Required reading. Cheryl McNeil and Toni

  • L. Hembree-Kigin, Springer Press, 2010

UC Davis Children’s Hospital- https://pcit.ucdavis.edu/about-us/ Parent-Child Interaction Therapy With At-Risk Families- U.S. Dept. of

HHS, Administration for Children & Families, Children’s Bureau Issue Brief- https://www.childwelfare.gov/pubs/f-interactbulletin/

California Evidence-based Clearinghouse for Child Welfare-

http://www.cebc4cw.org/

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Other Resources

  • Oregon Health Plan Provider Enrollment -

https://www.oregon.gov/oha/HSD/OHP/Pages/Provider-Enroll.aspx

  • Oregon Early Childhood Diagnostic Crosswalk

https://www.oregon.gov/oha/HPA/dsi-tc/Documents/DevScreeningFollowUp- Oregon-Early-Childhood-Diagnostic-Crosswalk.pdf

  • Diagnostic Classification of Mental Health and Developmental Disorders of

Infancy and Early Childhood (DC: 0-5) by Zero to Three http://www.zerotothree.org/

  • Diagnostic and Statistical Manual of Mental Disorders, Fifth edition, (DSM-

5); http://www.dsm5.org/psychiatrists/practice/dsm

  • International Statistical Classification of Diseases and Related Health

Problems (ICD), 10th revision

  • Oregon’s legislature approved funding for lines 1-469 of the prioritized list

for January 1, 2017. http://www.oregon.gov/oha/herc/pages/prioritizedlist.aspx

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Questions? Email: laurie.l.theodorou@state.or.us