Minnesota Minnesota

Community-Based Services Manual (CBSM)

Community-Based Services Manual (CBSM)


Successful Life Project

Page posted: 7/16/15

Page reviewed: 1/21/21

Page updated: 1/21/21

Legal authority

Jensen Settlement Agreement and Related Court Documents – June 23, 2011 (PDF)
Final Approval Order for Stipulated Class Action Settlement Agreement – Dec. 5, 2011 (PDF)
Amended Jensen Settlement Agreement Order and Second Amended Comprehensive Plan of Action – March 12, 2014 (PDF)

Background

For background information, refer to CBSM – Jensen Settlement Agreement.

Definitions

Effective environment checklist: Tool used to identify what a person needs in their environment to be successful.

Functional behavior assessment: Assessment used to better understand the purpose or reason for a person’s challenging behavior. This assessment defines the challenging behavior, identifies the situation in which it is most likely to occur/not occur and generates a hypothesis of why it occurs.

Positive behavior support plan: A plan to help all caregivers provide the same behavior support on a consistent basis. The plan is based on the functional behavior assessment and includes person-centered practices (e.g., understanding the person’s strengths, preferences and interests).

Positive behavior support – system evaluation tool: Assessment tool used by Successful Life Project clinicians that provides a brief snapshot of a person’s health, safety, quality of life and person-centered positive behavior supports.

Successful Life Project support agreement: Contract between the Successful Life Project and all team members that outlines expectations of support and participation for all people involved.

Program description

The Successful Life Project team includes board-certified behavior analysts, a registered nurse and a licensed social worker. The Successful Life Project provides individualized and consultative clinical support to people identified in the Jensen Settlement Agreement and their teams, as well as other people with severe behavioral challenges, including, but not limited to people who live in the same home as a person identified in the Jensen Settlement Agreement.

The services the Successful Life Project provides help a person prevent re-institutionalization and maintain the most integrated setting. This includes helping the person’s care providers use person-centered, positive behavior supports and address health or medication needs. These services can, by extension, improve a person’s overall quality of life.

Overview of services and supports

Based on the needs of the person and their team, services and supports may include:

  • · Assessments, health needs assessments (including review of medication regimens), comprehensive medical reviews or functional behavior assessments.
  • · Consultation/technical assistance.
  • · Data collection and analysis.
  • · Person-centered plan facilitation.
  • · Positive behavior support plan development.
  • · Training.
  • · Transition planning support.
  • Support levels

    To provide people and their team with the appropriate amount of support, the Successful Life Project groups people based on the level of support they need. Group assignments are fluid, and people move between support levels as needed. The different support levels are priority, secondary, proactive plus and proactive.

    Priority

    The Successful Life Project bases priority status on the challenges presented by the person’s behaviors and the capacity of their team. A person in the priority group typically has one of the following needs:

  • · Potential to lose their residential services/home.
  • · Significant risk factors (i.e., conditions or circumstances that could create a behavioral or medical crisis).
  • Secondary

    A person in the secondary group typically presents challenging behaviors, health needs and/or mental health needs, but their residential services/home is not threatened.

    Proactive plus

    A person typically is in the proactive plus group because the person, their provider(s) or any other member of their team needs technical assistance and/or consultation.

    Proactive

    The proactive group includes other people who are not in the priority, secondary and proactive plus groups.

    Services offered to priority and secondary groups

    The Successful Life Project offers the following services to people in the priority and secondary groups:

  • · Data collection/analysis.
  • · Development of positive behavior supports.
  • · Effective environmental checklist.
  • · Functional behavior assessment.
  • · Health assessment.
  • · Health education.
  • · Medication review.
  • · Mentoring for providers.
  • · Person-centered planning assistance.
  • · Plan reviews.
  • · Training.
  • · Transition planning.
  • · Regional workshops that target local needs.
  • · Stress management instructional workshops.
  • · Other person/diagnosis-specific technical assistance.
  • Services offered to proactive plus group

    The Successful Life Project offers the following services to people in the proactive plus group:

  • · Data collection/analysis.
  • · Effective environmental checklist.
  • · Medication review.
  • · Mental health assessment.
  • · Mentoring for providers.
  • · Technical assistance.
  • · Training.
  • Services offered to proactive group

    The Successful Life Project offers brief technical assistance to people in the proactive group.

    Intake process

    During intake, the Successful Life Project gathers relevant information about the person. The following is an outline of the Successful Life Project intake process:

    1. After a referral from a case manager or provider, the Successful Life Project supervisor assigns clinician(s) from the Successful Life Project to follow up with the referral.

    2. The assigned Successful Life Project clinician(s) contact the case manager or provider who made the referral to schedule a consultation call with all members of the person’s team.

    3. A consultation call is held to discuss the team’s current concerns about the person.

    4. After the consultation call, the Successful Life Project clinician(s) develop recommendations for the team on how to address their concerns.

    5. The Successful Life Project clinician(s) send the list of recommendations to the team and ask the team to decide how they want to move forward. If the person’s team wants to move forward with Successful Life Project support, the team:

  • · Signs the Successful Life Project support agreement
  • · Selects a starting process (e.g., positive behavior support – system evaluation tool, person-centered plan, functional behavior assessment, data collection and analysis, etc.).
  • 6. The assigned Successful Life Project clinician(s) initiate technical assistance.

    For more information on eligibility and the intake process, contact SuccessfulLifeProject.DHS@state.mn.us.

    Additional resources

    DHS – Person-centered practices, positive supports and the Jensen Settlement Agreement
    CBSM – Jensen Settlement Agreement
    DHS Bulletin #19-48-01: Successful Life Project (PDF)

    Additional Successful Life Project information

    Anxiety Disorders and Intellectual/Developmental Disability, DHS-7646A (PDF)
    Behavior Road Map (PDF)
    Communication and Intellectual/Developmental Disability, DHS-7646B (PDF)
    Depressive Disorders in People with Intellectual/Developmental Disabilities, DHS-7646C (PDF)
    Fetal Alcohol Spectrum Disorder, DHS-7676 (PDF)
    Mental Wellness for People with Intellectual or Developmental Disabilities, DHS-7647 (PDF)
    Personality Disorders and Intellectual/Developmental Disability, DHS-7646D (PDF)
    Social Skill Development in People with Intellectual/Developmental Disabilities, DHS-7646E (PDF)
    Stress Management for People with Intellectual or Developmental Disabilities, DHS-7648 (PDF)
    Trauma and Post-Traumatic Stress Disorder (PTSD), DHS-7646F (PDF)

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