In the event that recommendations made by Mobile Training/Crisis Team are unsuccessful, services from the Training and Crisis Transition Home can be requested through DCH.  The Training and Crisis Transition Home is located in Oxford, Michigan.

When Can the Training and Crisis Transition Home be Utilized?

A CMHSP may request MDCH approval for the use of the Training and Crisis Transition Home once they have exhausted all local options of support and training and have utilized the services of the Center’s Mobile Training/Crisis Team.  Utilization of the Training and Crisis Transition Home will occur only after approval by MDCH and the Center.

What are the prerequisites for use of the Training and Crisis Transition Home?

The following conditions must be met prior to the utilization of the Training and Crisis Transition Home:

1. The CMHSP has arranged for the direct care staff to be trained in gentle approaches for interacting with and responding to individuals.
2. The CMHSP agrees to follow the recommendations of the Training and Crisis Transition Home Team.
3. The CMHSP reviewed or tried all local options which may include:
   • Adding resources
   • Use of expert advice
   • Change of direct service provider
   • Movement to a different smaller setting
4. The Center’s Mobile Training/Crisis Team has been utilized within the past three months and the CMHSP made a good faith effort in following its recommendations.
5. DCH approved the use of the Training and Crisis Transition Home.
6. The CMHSP is involved from the first day of service in the development of a training plan in preparation for supporting the individual after discharge from the Training and Crisis Transition Home.
7. The Center has received a signed Release of Information form.
8. The Center has received requested information which may include any or all of the following (electronic transmission would expedite the process) :
   • Contact information for physicians, including psychiatrists
   • Physical – Including blood work, medication list, other physical needs
   • Incident reports for the prior six months
   • Psychiatric Evaluations and Medication Reviews for the prior twelve months
   • Reports of psychiatric hospitalizations for the prior twelve months
   • Psychological Evaluation, current support plan and periodic reviews for the prior twelve months
   • School or vocational reports for the prior six months
   • Any reports of involvement with the justice system for the prior two years
   • Any recipient rights issue for the prior twelve months
   • Staffing pattern in current living environment including changes for the prior six months
   • Description of the current living environment – physical plant, who the individual lives with and a brief description of their needs
9. The need for medical or psychiatric hospitalization has been ruled out.
10. The Social Worker/Supports Coordinator from the Center has observed the individual.
11. The Center has approved the request for us of the Training and Crisis Transition Home within 48 hours of receipt of the packet of information.
12. Identification of which CMHSP staff will be involved in the process.
13. The CMHSP must commit to having at least two care-givers present in the Training and Crisis Transition Home the last week (40 hours each) of placement for training/mentoring purposes.  These caregivers must be carefully chosen since they must be capable of training and mentoring other care-givers once the individual returns home.  They must have completed “Working with People” conducted by the Center or a Center certified trainer.
14. The individual must have a physical examination by the current primary care physician within three days prior to admission to the Training and Crisis Transition Home.
15. The individual will be transferred to the Training and Crisis Transition Home by the CMHSP along with their personal effects and a 30 day supply of medication.

What Support is Provided During Temporary Placement in the Training and Crisis Transition Home?

Upon movement to the Training and Crisis Transition Home, the individual will have a temporary plan of services and supports based on the Center’s previous experience with the individual and the recommendations of the CMHSP.  Within one week, the individual will have been assessed by the Social Work/Supports Coordinator, the Psychiatrist, the Psychologist and the Nurse.  Other assessments will be determined based on need.  The individualized plan of services and supports will be developed within 7 days of admission.  Service planning and execution remain the responsibility of the CMHSP with the Center providing supplemental and augmented crisis plan services.

The individualized plan of services and supports will be based on a philosophy of Gentle Teaching.  Individuals served will be supported by strategies that:

• Teach that they are safe emotionally and physically
• Reduces events/interactions that make the individual feel unsafe or insecure
• Teach that they are valued, respected and loved
• Teach that it is good to value, respect and love others
• Teach that is it good to do things with and for others
• Provide predictability and structure to the day
• Provide the opportunity to make choices throughout the day
• Allow the individual to express their needs in a safe manner
• Emphasize community inclusion, if possible

Additional forms of treatment or support (OT services, sensory programming, counseling/therapy, etc.) will be provided as needed.

The Center’s treatment team (Social Work/Supports Coordinator, Psychologist, Nurse, and Home Manager) will conduct weekly reviews of the plan implementation, identify staff training needs, and debrief any challenging situations.  Unless determined otherwise, the psychiatrist will conduct weekly medication reviews.  The Center’s Social Work/Supports Coordinator will share information with the CMHSP and family/guardian weekly.

All attempts will be made to insure that the individual is able to engage in favorite activities, have access to favorite foods, and maintain contact with family and friends while living at the Training and Crisis Transition Home.

During the last week of placement, at least 2 care-givers from the CMHSP who have participated in a Center’s “Working with People” training session will work in the Training and Crisis Transition Home for 40 hours each.  The purpose of this experience is training and mentoring as well as assisting with the transition back home.  In the future, it is the Center’s plan to have on-site accommodations for the care-givers.

When will services terminate?

When it is determined that the needs are met or a maximum of 45 days will be elapsing, an exit meeting will be held in the week prior to discharge with representatives of the Center and CMHSP to share recommendations and to outline future support needs.  If, after 45 days, no progress or insufficient progress is being made to assure the safety of all, a meeting will be convened between the Center, CMHSP and DCH to determine next steps.

What is the staffing structure of the Home?

The home will provide 1:1 daytime staffing.  When three individuals are present, there will be three staff working during waking hours and two staff during sleep hours.  The home will have a manager, assistant manager and weekend supervisor so that other than the midnight shift, there will be a management leader on day and afternoon shifts.