00:06:42 gillian mccarty: Gillian Burns abc case management 00:06:43 Tamara Hall: Tamara Hall Fayette County CPS 00:06:44 Marc Wilson: Marc Wilson, WVU CED Specialized Family Care 00:06:45 Regina Desmond: Gina Desmond, Senior Advocate Disability Rights of WV 00:06:47 Jodi Calissie: Jodi Calissie, Disability Rights of WV 00:06:56 Angela Martin: Angela Martin Housing Case Manager with Catholic Community Services in Mount Vernon, WA 00:06:57 Melanie Lane: Melanie Lane, WV DoHS 00:06:59 Cassandra Lee: Cassandra Lee - Aetna RN CM 00:06:59 Jennifer Lauler: Jennifer Lauler - Child Advocacy Center in Buckhannon and the ABC Program 00:07:01 Julianna Hayden: Julianna Hayden, Case Manager with A Journey Case Management and Advocacy 00:07:03 Heather Dodge: Heather Dodge Russell Nesbitt Services behavior support professional 00:07:10 Amy Pike: Amy Pike Disability Rights of WV 00:07:14 Sharon Engle: Sharon Engle, IDD Program Director at Potomac Highlands Guild 00:07:14 Teresa Hart: Teresa Hart - Valley Healthcare System out of Morgantown, WV. I am a Family and Children's Case Manager 00:07:26 Mary Wilson: Mary Lea Wilson, PAIS QI/Compliance Director 00:07:29 Margaret Heasley: Margaret Heasley, Aetna Better Health of WV 00:07:31 Nikki Dolly: Nikki Dolly- Aetna RN CM 00:07:35 Patricia Essama: Patricia Essama Case Manager Hope House 00:07:37 Teresa Bhaile: Teresa Bhaile - Positive Behavior Support, WVU CED 00:07:44 Tina McClung: Tina McClung, WVCED 00:07:45 Nichole Gullett: Nichole Gullett SHCMHC Mobile Crisis Person with Lived Experience 00:07:49 Tucker Riggleman: Tucker Riggleman Social Media & Marketing Specialist WVU CED 00:08:25 Megan Vance: Hello I am Megan Vance, Behavioral Health Navigator with Aetna's Mountain Health Promise Program 00:08:30 Nichole Gullett: Aprylle Buford southern highlands apryllebuford@shcmhc.com 00:09:31 Susan Given: Susan Given DRWV 00:10:29 Gillian's OtterPilot: Hi, I'm an AI assistant helping Gillian Burns take notes for this meeting. Follow along the transcript here: https://otter.ai/u/gcfl8kdg-XYZmaC6sr9XOutdL5o?utm_source=va_chat_link_1 You'll also be able to see screenshots of key moments, add highlights, comments, or action items to anything being said, and get an automatic summary after the meeting. 00:10:42 Brittney Nichol: Brittney Nichol- Clinical Services Director Russell Nesbitt Services Inc. 00:11:29 Brandon Kijewski: Brandon Kijewski, Clinical Supervisor Hopewell Community Services 00:11:45 Michelle curtis: Michelle Curtis, The Arc of the Mid Ohio Valley 00:11:57 Nichole Gullett: Jeremiah Nelson Mobile Crisis Case Manager Southern Highlands Community Mental Health Center jeremiahnelson@shcmhc.com 00:12:03 Suzanne Messenger: Suzanne Messenger, WV State Long-term Care Ombudsman 00:12:04 Lori McGinnis: Lori McGinnis-BSP at Russell Nesbitt Services 00:14:25 Tammy Taylor Lane: Tammy Taylor Lane, West Virginia Parent Training and Information Tammytlanewvpti@gmail.com 00:14:34 Pocahontas Clinic-Waiver: Sarah Graham, BSP with Seneca Health Services 00:14:42 Charity Carroll: Charity Carroll. Northwood Health Systems 00:16:02 Lora Evans: Lora Evans, Case Manager, DCR Bureau of Juvenile Services 00:20:29 Tamara Hall: what is bad too and not having enough people to get children on the spectrum to their most functioning level so they can lead better lives and not need that extra help after the age of 10 00:23:36 Brandon Kijewski: 2 things, I disagree that a diagnosis prevents someone from being a productive member of society, the support network and services available do that not the opposite; second having appropriate assessors cannot be overstated; for instance a case manager whose met a client one time in 3 months should not be someone whose answering all of these assessment questions that are technical and require very strong consideration and understanding 00:30:38 Michelle curtis: Agreed!!! 00:31:01 Gillian's OtterPilot: Add last minute items before the meeting ends: https://otter.ai/u/gcfl8kdg-XYZmaC6sr9XOutdL5o?utm_source=va_chat_link_3 00:31:34 Gillian's OtterPilot: Some key takeaways from the meeting transcript include: - There is a difference between behavioral and mental health services, but for many clients both are important rather than separating the two. It's better to think about developmental needs versus psychiatric etiology of symptoms. - Definitions of intellectual disability, developmental disability, and autism were discussed, emphasizing function over labels or numbers. Early intervention can help some children avoid lifelong diagnoses. - Assessing behaviors is important to understand their etiology, which could be psychiatric, developmental, environmental, or some combination. A systematic approach is needed. - The impact of medical conditions, stress, genetics, and the environment on brain development and cognitive/social skills was covered. Understanding etiology can help predict... See full summary - https://otter.ai/u/gcfl8kdg-XYZmaC6sr9XOutdL5o?utm_source=va_chat&utm_content=wrapup_v1&tab=chat&message=a5b77c19-286f-4956-b2b3-ae6469d73c86 00:35:50 Tamara Hall: an antecedent can be hard to determine if its mentalistic and based on a feeling or previous trauma so I agree 00:37:28 Brandon Kijewski: I feel like the trauma is a setting event and not a true antecedent, like the trauma makes it more likely that the loud noise causes the response, but the loud noise was the antecedent; I personally think thereโ€™s always an antecedent but sometimes theyโ€™re hard to figure out and we have to do due diligence to make sure we figure it out 00:38:01 Teresa Bhaile: Tamara, that's true. That's one of the reasons that determining the function of behaviors doesn't happen in a day or a week. It's up to the observer to notice patterns in behavior over time. 00:38:20 Lesley Cottrell: Reacted to "I feel like the trau..." with ๐Ÿ‘๐Ÿป 00:38:31 Lesley Cottrell: Reacted to "Tamara, that's true...." with ๐Ÿ‘๐Ÿป 00:38:58 Teresa Bhaile: Brandon, I agree with you. Trauma seems to be more of a setting event or slow trigger. 00:39:18 Tamara Hall: I think it's important to consider who is around or the time of the day when the behavior occurs. 00:39:51 Heather Dodge: I agree Tamara 00:39:53 Teresa Bhaile: Tamara, that is absolutely true. Here's another example of why looking for patterns over time is very helpful. 00:39:54 Michelle curtis: This chart is very helpful 00:40:04 Tamara Hall: that's true. My son has severe behaviors before he has a seizure. He becomes very physically aggressive 00:40:36 Lesley Cottrell: Reacted to "I think it's importa..." with ๐Ÿ‘๐Ÿป 00:41:04 Teresa Bhaile: Data collection is the most challenging aspect of behavioral health, I think. 00:41:55 Tamara Hall: its always burns me up when someone says so and so had a behavior and there was no reason for it. 00:41:55 Brandon Kijewski: Tamara, first Iโ€™m sorry to hear that but thatโ€™s exactly the thing there right? He is likely having a sensory response which is a true antecedent and the function is likely communication because heโ€™s trying to communicate this is coming; that data collection is crucial and each of those little details can be a puzzle piece 00:42:54 Tamara Hall: Its definitely sensory Brandon. I know people that have epilepsy that say they feel it coming on. 00:44:15 Brandon Kijewski: Absolutely; our people have insight and observation, sometimes we just canโ€™t see it or understand it and thatโ€™s where our jobs really make their hay 00:44:30 Teresa Bhaile: In the field of behavioral health, we believe that ALL behaviors are a form of communication. As Dr. Swager points out, we need to be detectives to determine exactly what our people are trying to tell us. 00:44:42 Julianna Hayden: Reacted to "In the field of beha..." with ๐Ÿ‘ 00:45:09 Tamara Hall: Reacted to "In the field of beha..." with ๐Ÿ‘ 00:45:33 Misha McShane: Reacted to "In the field of beha..." with โค๏ธ 00:46:26 Lesley Cottrell: I love seeing these comments among our group here. Quick question- how can we continue to be the detectives we need to be while balancing the other challenges in our jobs like deadlines, insurance coverage, types of behaviors that are harmful to others, etc. Where is that sweet spot to keep up the good fight and do the right work to figure out the etiology of the behavior in the line of fire (for lack of a better description)? 00:46:52 Lesley Cottrell: Please share what people do to keep this balance. 00:47:58 Teresa Bhaile: Any data is usually is better than no data. And since we cannot live with our clients, we have to count on those that do live with them in order to get that data. 00:48:28 Brandon Kijewski: I think the only way to really do it is to have, if I may be permitted a cliche, a village. Its too hard for one single person to observe so much; we have to have a support network of people all on the same page all trained appropriately all with he same buy-in if weโ€™re talking about family settings 00:48:50 Michelle curtis: thank you for mentioning...i definitely agree that it depends on the lens in which you're observing through. I love the true team approach/collaboration. More families need that! 00:49:00 Teresa Bhaile: Getting what we can is the important thing. If we can get ABC data, AWESOME! If all we can get is how many times a day (like a series of tick marks), then that's what we can get. 00:49:11 Brandon Kijewski: If its a residential setting, we have to do everything we can to train and endear the staff to understand why, buy in is the most important thing even more so than training because I can train all day; but if the staff doesnโ€™t buy in it wonโ€™t matter 00:49:46 Julianna Hayden: As a case manager I send out an email asking the routine questions I'm required to ask and then during the home visit I can just verify and go on to more in-depth assessments and time spending. During the time I spend with the client is often in the form of games that are designed to allow me to get to know the client on a deeper level. 00:50:27 Teresa Bhaile: Brandon, that's the key. We do need to figure out a way to impress upon our staffs how much collecting this data, then implementing the behavior plans will make the lives of staff easier. 00:50:59 Tamara Hall: I have seen individuals medicated to where they are zombies. 00:51:08 Julianna Hayden: Reacted to "I have seen individu..." with ๐Ÿ‘ 00:51:56 Patricia Essama: Thank you so much. I agree whole heartedly in agreement 00:54:27 Marc Wilson: Can you go back a slide again? 00:56:18 Julianna Hayden: Knowing how ASD and Schizophrenia interact would help because you could more easily determine which behaviors are most attributable to which diagnosis. 00:56:34 Brandon Kijewski: So is the behavior weโ€™re addressing the self harm? 00:57:59 Tamara Hall: I know an individual can have both these diagnoses. However, I remember learning initially it was not probable. However, I educated myself that it's possible to have both by reading case studies and reviewing genetics of families that had both diagnoses 00:58:47 Julianna Hayden: Gillian, I so agree!!!! 00:59:18 Tamara Hall: As a CPS worker and a parent of an autistic adult theres no where to pull from services locally for our adults 00:59:33 Julianna Hayden: Reacted to "As a CPS worker and ..." with ๐Ÿ‘ 01:00:18 Tamara Hall: I couldn't get help either. My son is a foot taller than me. He use to grab me by my hair and physically drag me 01:00:50 Tamara Hall: Completely understand Gillian 01:01:04 Megan Vance: So from what I am hearing, we could use more parental assistance for these individuals 01:01:41 Tamara Hall: I had parental training. However, my ex husband and the school did not. There was such a lack of consistency. 01:01:45 Lesley Cottrell: Reacted to "So from what I am he..." with ๐Ÿ‘๐Ÿป 01:01:50 Lesley Cottrell: Reacted to "I couldn't get help ..." with โค๏ธ 01:02:04 gillian mccarty: parental assistance and education for parents that isn't tied to a check but also proper health care professionals are needed 01:02:17 Julianna Hayden: Gillian, we are in the same boat. My son is 26 and has a diagnosis of autism, but after high school he cannot get any services. A IPE who had never met my son determined he was asperger and geared his functional assessment to produce that result so he didn't even qualify for IDD Waiver 01:02:20 Lesley Cottrell: Replying to "I had parental train..." Consistent training across levels - yes! 01:02:32 Julianna Hayden: Reacted to "I had parental train..." with ๐Ÿ‘ 01:02:36 Lesley Cottrell: Reacted to "parental assistance ..." with ๐Ÿ‘๐Ÿป 01:02:40 Lesley Cottrell: Reacted to "Gillian, we are in t..." with ๐Ÿ‘๐Ÿป 01:02:40 gillian mccarty: even if parents have the means the resources are scarce 01:02:57 Lauren Swager: multi-discliniary care that includes teams with all different types of providers is key all working together with the family collobratively is the key 01:03:06 Julianna Hayden: Reacted to "multi-discliniary ca..." with ๐Ÿ‘ 01:03:18 Heather Merritt: Reacted to "multi-discliniary ca..." with ๐Ÿ‘ 01:03:32 Tamara Hall: yes, Gillian a lack of financial resources and family to help were barriers for me when my son was little. 01:03:51 Julianna Hayden: Reacted to "yes, Gillian a lack ..." with ๐Ÿ‘ 01:03:57 Tamara Hall: Resources are a little better than what they were 20 years ago. 01:04:05 Kelly King: There is a lot of diagnostic overshadowing and far too many practitioners do just what you described, look, leave and write a script. 01:04:13 Megan Vance: I would love to see more day programs for individuals to learn independence skills as well as obtain BH and MH treatment. 01:04:19 Julianna Hayden: Or a psychiatrist who is taking new patients!!!! 01:04:36 Kelly King: We have moved from psychotherapy to psychopharmacology. 01:05:18 Tamara Hall: My step nephew believes he is on the spectrum. However, its so difficult finding a psychiatrist willing to do the appropriate testing. 01:05:21 Lora Evans: A team of medical, education, and parenting - whether video or in person may overcome some issues with data collection. Resources at a one-stop shop for lack of a better phrase - would benefit many and avoid duplication. Everything is so spread out and ultimately diluted it is sometimes hidden from those who need the resource. 01:05:24 Kelly King: The opposite is when someone is admitted to a psychiatric hospital and additional diagnoses are slapped on them, apparently for insurance purposes. 01:05:40 Julianna Hayden: Reacted to "A team of medical, e..." with ๐Ÿ‘ 01:05:50 Julianna Hayden: Reacted to "The opposite is when..." with ๐Ÿ‘ 01:06:08 Michelle curtis: excellent point Lauren 01:06:22 Julianna Hayden: Reacted to "excellent point Laur..." with ๐Ÿ‘ 01:06:29 Kelly King: PA had Dual .diagnosis Treatment Teams that include a psychiatrist but you have to leave your regular psychiatrist. In my experience that are just another poor but very expensive service, 01:08:01 Michelle curtis: Can Psychiatrists get compensated for participating in IEPs and IPPs - do they have the time? 01:08:16 Lauren Swager: they do not michelle. which is a problem 01:08:20 Kelly King: Replying to "Gillian, we are in tโ€ฆ" Weโ€™re there assessments earlier that had different information? Check in with you .family to Family Health Information Center to see if they can help brainstorm solutions. 01:09:08 Lesley Cottrell: As we close, please let me know if you need a certificate of attendance for todayโ€™s session. Please also fill out the evaluation if you have a chance: https://wvu.qualtrics.com/jfe/form/SV_5prsa8fnrbadXb7 01:09:24 Teresa Bhaile: The PBS Program has Brainstorming Services for any individual who resides in West Virginia. 01:09:26 Michelle curtis: yes please Leslie 01:09:31 Julianna Hayden: I do need a certificate please 01:09:35 Tamara Hall: I feel like they treat patients like cash cows not people who need appropriate treatment and meds that actually work. For example, I have a friend whose psychiatrist spends less than 5 minutes with his child. The doctor is like meds aren't working? Lets increase it. smh 01:09:39 Crystal Norman: certificate please 01:09:49 Nichole Gullett: I need a certificate 01:09:50 Nichole Gullett: I need a certificate apryllebuford@shcmhc.com 01:09:50 Tamara Hall: Yes, I need a certificate 01:09:54 Julianna Hayden: Reacted to "I feel like they tre..." with ๐Ÿ‘ 01:10:00 Tamara Hall: Tamara.l.hall@wv.gov 01:10:04 Sharon Engle: I need a certificate 01:10:19 Kelly King: Sadly, not all psychiatrists (like every other field) are not cut out of the same high quality cloth. 01:10:26 Pocahontas Clinic-Waiver: I would like a certificate, please. Sarah Graham with Seneca Health Services. 01:10:32 Melanie Lane: I need a certificate, thank you 01:11:00 Heather Dodge: I need one: hdodge@rns-watch.org 01:11:04 Kelly King: FYI there is research on the increase in schizophrenia in cat owners. The belief is that toxoplasmosis is at play. 01:11:17 Carla Lilly: I need a certificate, thank you - 01:11:47 Marc Wilson: I would like a certificate of attendance please and a copy of the PPT if possible. 01:11:57 Julianna Hayden: Reacted to "I would like a certi..." with ๐Ÿ‘ 01:12:11 Julianna Hayden: Replying to "I would like a certi..." the PPT would be awesome 01:12:45 Reem Hannora: Replying to "I would like a certi..." Yes Please 01:13:06 Reem Hannora: Certificate Please 01:13:14 Lesley Cottrell: Will also send these and shared resources by follow up email. Resources and slides from the last sessions are also here: https://cedwvu.org/education/echo-series/. 01:13:15 Tina McClung: I would like a certificate. Thank you 01:13:28 natalie manners: certificate please 01:13:32 Kelly King: Look at the work of William Walsh. 01:13:34 Candi Snyder: Can you please re-send the link to the evaluation please ? 01:14:02 Lesley Cottrell: You bet: https://wvu.qualtrics.com/jfe/form/SV_5prsa8fnrbadXb7 01:14:32 Michelle curtis: Wow 01:14:52 Kelly King: Guess and check treatment. That scary. We are doing the med trials at home and it really is scary when you have missed the mark. 01:15:38 Kelly King: Fantastic, thank you! 01:16:00 Tamara Hall: Great conversation. Ty everyone. Ty for your time. 01:16:13 Candi Snyder: Thank-you 01:16:20 Tamara Hall: Bye everyone