Reducing the Use of Seclusion and Restraints in Psychiatric Facilities
Centers for Medicare and Medicaid Services (CMS)
Satellite Broadcast and Webcast
Friday, September 23, 2005
1:00 PM –3:00 PM EDT
PLEASE ADJUST TIMES FOR YOUR TIMEZONE
This live satellite broadcast and Webcast will present Six Core Strategies to Reduce the Use of S/R © in inpatient mental health facilities that serve children and adults Recent changes in law and regulations regarding the use of S/R have created an impetus for service providers to reduce and even eliminate the use of these high risk interventions. Largely preventative, best practices that are effective and replicable have been identified but are not yet widely used on the local level.
The presentation will include a brief overview of the history of this initiative, emerging findings on effectiveness, a brief review of the core theories and literature that added support to the development of the six core strategies and recommendations for administrative and practice change.
Goals
- Inpatient mental health service providers have largely been left to their own devices in reducing the use of S/R. In many cases providers have continued to focus on how to use S/R interventions more safely. This session will provide an overview of Six Core Strategies © to reduce the use S/R in the first place. Provide overview of current CMS regulations and policies regarding seclusion and restraints in inpatient and residential settings.
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Objectives
After viewing this program, participants will be able to:
- Become familiar with the historical and current national and state efforts to reduce the use of seclusion and restraint.
- Understand the literature based theories and principles that provide the approach and foundation for the identification of the Six Core Strategies © to reduce and even eliminate S/R use.
- Give an overview of the Six Core Strategies © proven effective in reducing use including practical recommendations for administrative and clinical practice change. This will include a specific focus on the inclusion of child and adult service recipients in their own care.
- Understand the steps in developing a facility specific S/R Prevention Plan.
- Hear from two mental health facility providers on their experiences in reducing seclusion and restraint.
Target Audience
Mental Health Service Providers
CMS Regional Office and State Agency Psychiatric Facility Surveyors
National Mental Health Provider Associations
Faculty
Kevin Ann Huckshorn, RN, MSN, CAP, ICADC
NationalTechnicalAssistanceCenter (NTAC) for State Mental Health Planning
Jennifer Jones, RN, BSN
CMS PRTF program lead
David W. Eddinger, RN, MPH
CMS lead hospital survey and certification analyst.
Joan B. Gillece, Ph.D.
Project Director for the National Coordinating Center for the Seclusion and Restraint Reduction Initiative.
Tom Lane
Vice President of the Recovery Supports Division for New Horizons of the TreasureCoast.
Anthony J. Riccitelli
Chief Operating Officer of WorcesterStateHospital
Dr. Malini Patel
Medical Director of Community Psychiatric Services/Metro Suburban Network, Elgin Mental HealthCenter, Elgin, Illinois
Raul S. Almazar
Hospital Administrator of Elgin Mental HealthCenter.
Registration and Viewing Instructions
Individual and Site registration is available today. To obtain CEUs for viewing the training program you must go to the CMS website. For individual and site registration and viewing instructions go to:
Webcast Information
This program will have a live Webcast and will be available for viewing up to one year following September 23 at
Satellite Technical Specifications
This broadcast will be available on C and Ku Digicipher bands. Specific satellite technical specifications will are available at or can be obtained by calling 1-800-401-9387.
Handouts
Handouts for this broadcast will be available at the following website after September 9, 2005 at
JOIN THE CMS LIVE WEBCAST AND SATELLITE CONFERENCE!
Reducing the Use of Seclusion and Restraints in Psychiatric Facilities
Webcast and Satellite Broadcast
Friday, September 23, 2005
1:00 PM –3:00 PM EDT
On Thursday September 23, 1:00-3:00 p.m. EDT, the Center for Medicaid and State Operations/Division of Continuous Care Providers will sponsor a live webcast and satellite broadcast entitled “Reducing Seclusion and Restraints in Psychiatric Facilities.” This broadcast is designed to provide a brief overview of the history of this initiative, emerging findings on effectiveness, a brief review of the core theories and literature that added support to the development of the six core strategies and recommendations for administrative and practice change.
Presenters and Topics
Time (EDT) / Topic / Presenter1:00 – 1:15 p.m. / Welcome and Introduction / Stan Stovall, Moderator
Thomas Hamilton, Director, Survey & Certification Group, CMSO
Kathryn Power, Director, CMHS, SAMHSA)
1:15 – 1:30 p.m. / Overview / Jennifer Jones, RN, PRTF Program Lead
Capt. David Eddinger, RN, Acute Care Services
1:30 – 2:00 p.m. / Theoretical Foundation for S/R Interventions
- Myths & Assumptions Regarding S/R
- The Public Health Prevention Approach Applied to S/R Reduction Efforts
- Trauma Informed Care
- The Principles and Practice of Recovery
Joan Gillece, PhD
2:00- 2:30 p.m. / Creating a Comprehensive S/R Prevention Plan (Six Core Strategies for Reducing S/R)
- Leadership Toward Organizational Change
- Use of Data to Inform Practice
- Workforce Development
- Use of S/R Prevention Tools
- Supporting Consumer and Advocate Roles in Inpatient Settings
- Use of Debriefing Tools
Tom Lane, Consumer Advocate
2:30 – 2:25 p.m. / Findings & Results / Kevin Huckshorn, RN, MSN
2:25 – 2:50 p.m. / Provider Testimonials / Raul Almazar RN, MA,. Administrator and Dr. Patel, Medical Director, Elgin Mental Health
Anthony Riccitelli, CEO
WorchesterStateHospital
2:45 – 3:00 p.m. / Question & Answer Session / Panel Members
Kevin Huckshorn, RN, MSN
Jennifer Jones, RN, PRTF Program Lead
3:00 p.m. / Conclusion / Stan Stovall, Moderator
Faculty Biographical Information
Kevin Ann Huckshorn, RN, MSN, CAP, ICADC
Ms. Kevin Ann Huckshorn, RN, MSN, CAP, ICADC, is theDirector of the Office of Technical Assistance at the National Association for State Mental Health Program Directors (NASMHPD) and the new NationalCoordinatingCenter for Seclusion and Restraint Reduction. Ms. Huckshorn is a licensed and certified mental health nurse and substance abuse clinician with practical knowledge from 24 years of professional frontline experience working in a variety of public and private mental health organizations and substance abuse programs.
Ms. Huckshorn has extensive experience in both in-patient and outpatient program development including consumer run projects; psychiatric rehabilitation treatment programs for persons with serious mental illness; and recovery-based mental health and substance abuse services. In her current role she manages multiple technical assistance projects, organizes state and national meetings, and monitors all services and products, from action plans to pragmatic tools and training for applying evidence-based practices. Ms. Huckshorn is a frequent speaker at national conferences related to behavior health. She also represents the state mental health agencies on the JCAHO Professional Advisory Committee for Behavioral Health and is on the editorial boards of two peer reviewed mental health publications.
Jennifer Jones, RN, BSN
Jennifer Jones transferred to the Centers for Medicaid and State Operations/Survey & Certification/Division of Continuing Care Providers from the Atlanta Regional Office’s Survey & Certification Review Branch where she surveyed nursing homes and ICF-MR facilities as well as conducted Federal Oversight/Support Surveys (FOSS) of state agency survey staff. Prior to entering federal service, Jennifer worked for BlueCross BlueShield (BCBS).
She was a Nurse Audit Specialist with CareFirst BCBS in Washington, DC in their Special Investigations Unit, where she investigated suspected provider fraud and over-utilization issues. She was a Medical Management Nurse with WellPoint BCBS of Georgia in their Preauthorization Division, where she conducted medical reviews and rendered pre-certification decisions. Jennifer’s clinical background is as an emergency room nurse who has worked in several emergency departments in the Washington DC Metro and Atlanta Metro areas. Jennifer is completing her Master’s degree in Public Health (MPH) at EmoryUniversity.
David W. Eddinger, RN, MPH
David W. Eddinger is a Captain in the United States Public Health Service. He received his BSN from the University of North Carolina at Greensboro and his Masters of Public Health from TulaneUniversity.
At CMS he serves as the lead hospital survey and certification analyst. In this role he works daily with issues related to hospital compliance with the CMS Hospital Conditions of Participation. Part of his duties include coordinating the development of the interpretive guidelines for the hospital Conditions of Participation including the Interpretive Guidelines for the Patients’ Rights Condition of Participation.He has over 25 years of experience in healthcare including:
- forensic psychiatric nursing
- oncological nursing
- medical surgical nursing
- community health nursing
- school nursing
- health promotion and disease prevention
- hospital safety & security management, and
- regulatory affairs.
Joan B. Gillece, Ph.D.
Project Director, National Coordinating Center for the Seclusion and Restraint Initiative
National Association of State Mental Health Program Directors/
NationalTechnicalAssistanceCenter for State Mental Health Planning
66 Canal Center Plaza, Suite 302
Alexandria, VA 22314
Phone: 703-739-9333, ext. 157
Fax: 703-548-9517
Email:
Dr. Gillece is new Project Director for the NationalCoordinatingCenter for the Seclusion and Restraint Reduction Initiative. The CoordinatingCenter works with the eight state grantees to implementing best practice alternatives to seclusion and restraint in facilities serving adults, child and forensic populations. Prior to coming to National Association of State Mental Health Program Directors, Dr. Gillece was the Director of Special Needs Populations for Maryland’s Mental Hygiene Administration. She was responsible for developing and sustaining services for Maryland citizens who have serious mental illness and may also be incarcerated in local detention centers, homeless, suffering form a co-occurring substance abuse disorder or be deaf. She has been successful in obtaining private, state, local, and federal funding to create a patchwork pf services for Special Needs Populations.
Dr. Gillece also recently obtained funding to develop a program for pregnant, incarcerated women and their newborns. This program, Tamar’s Children, is designed to break the intergenerational cycle of despair, poverty, addiction, and criminality. She has spoken extensively on developing model systems of care through partnerships across agencies. Dr. Gillece has provided consultation to numerous states on developing innovative institutional and community based systems of care for individuals with co-occurring disorders in the justice system via GAINS Center and the National Institute of Corrections.
Thomas Lane
Vice President, Recovery Supports & Forensic Services
New Horizons of the TreasureCoast
4500 Midway Road
Ft. Pierce, FL 34981
Phone: 772-468-5600
Fax 772-468-5633
Email:
Mr. Thomas ‘Tom’ Lane serves as the Vice President of Recovery Supports and Forensic Services at New Horizons of the TreasureCoast. Before joining the National Alliance for the Mentally Ill (NAMI) as director of the Office of Consumer Affairs, Mr. Lane worked as director of the Forest Park Drop In Center, a peer-run project at SouthFloridaStateHospital. He also served as vice chair and chair of the NAMI National Consumer Council.
While living in New Mexico, he founded, worked in, and advocated for the first independent, consumer-run drop-in center in Albuquerque in collaboration with NAMI New Mexico. Other achievements include the design and implementation of a statewide outreach campaign, the Consumer Involvement Project, and the initiation of a Peer Bridger program at the University of New Mexico’s MentalHealthCenter. Mr. Lane is particularly interested in the intersection of law enforcement, justice systems, and mental health systems and is a nationally recognized consumer expert in this area. Mr. Lane is a consumer living with bi-polar disorder, and a recovered substance abuser. In addition to serving the NAMI national office, he is active in the NAMIBrowardCounty affiliate and serves on the NAMI Florida Board of Directors.
Anthony J. Riccitelli
Chief Operating Officer
WorcesterStateHospital
305 Belmont Street
Worcester, MA01604
Phone: 508-368-3461
Fax: 508-363-1515
Email:
Mr. Riccitelli is currently the Chief Operating Officer of WorcesterStateHospital. He has led his executive team to reducing use of restraint and seclusion at their hospital by over 75% in a two-year period. He is a member of the Massachusetts Department of Mental Health’s committee on Restraint and Seclusion Reduction and ViolenceFreeHospitals and Technical Expert Panel. Prior to this appointment, Mr. Riccitelli was the Superintendent of the JohnC.CorriganMentalHealthCenter and the Director for the Department of Mental Health’s Fall River Case Management Site Office.
He has also worked for the Department of Mental Health’s Division of Forensic Mental Health Services, as Southeast Area Forensic Director with oversight of the Department’s Court based forensic evaluation clinics and inpatient forensic programs. Preceding his tenure with the Department of Mental Health, Mr. Riccitelli worked in the private sector and was the Director of the Secure Care Program, providing inpatient forensic evaluation and treatment.
Dr. Malini Patel
Dr. Malini Patel is the Medical Director of Community Psychiatric Services/Metro Suburban Network, Elgin Mental Health Center, Elgin, Illinois and is also Clinical Associate Professor of Psychiatry andBehavioral Sciences at Rosalind Franklin University of Medicine and Science/the Chicago Medical School, North Chicago, Illinois. She is board certified with added qualifications in Addiction Psychiatry and serves as an examiner for the American Board of Psychiatry and Neurology.
Dr. Patel is a Distinguished Fellow of the American Psychiatric Association. She serves on the Illinois
Psychiatric Society Governmental Affairs Committee and is a councilor on the Illinois Psychiatric Society Executive Committee and the American Association of Psychiatric Administrators Committee. Dr. Patel has published regularly in peer reviewed journals and has presented nationally andinternationally on topics related to addictions, administrative+ restraints.
Raul S. Almazar
Raul S. Almazar is the Hospital Administrator of Elgin Mental Health Center. Mr. Almazar holds a Bachelors Degree in Nursing and Masters of Arts Degree in Psychology. Prior to joining ElginMentalHealthCenter, Mr. Almazar served as Director of Nursing at Chicago-ReadMentalHealthCenter, another state operated facility. Mr. Almazar has extensive Psychiatric management experience, having held positions as Director of Patient Services, Director of Clinical Services, Director of Nursing and Clinical Nurse Manager. Mr. Almazar also has held business positions as Associate Administrator and President of his own behavioral health company.
Reducing the Use of Seclusion and Restraints in Psychiatric Facilities
Satellite Broadcast
TECHNICAL FACT SHEET
DATE: / September 23, 2005TEST TIME: / 12:30 – 1:00 p.m. EDT
11:30 – 12:00 p.m. CDT
10:30 – 11:00 a.m. MDT
9:30 – 10:00 a.m. PDT
PROGRAM TIME: / 1:00 – 3:00 p.m. EDT
12:00 – 2:00 p.m. CDT
11:00 – 1:00 p.m. MDT
10:00 - 12:00 p.m. PDT
WEBCAST TROUBLESHOOTING NUMBER:
SATELLITE TROUBLE
NUMBER: / 703-812-8816
410-786-3618
CMS Digital Network: / Channel 712
Individuals and Sites outside of the CMS satellite network who wish to set up a site for this program or view this broadcast via webcast should go to cms.internetstreaming.com to register. Handouts can also be found atthat website
Guidance for Locating Downlink Sites
In general, there are 2 major formats for satellite transmission - digital and analog. CMS uses both analog and digital formats, CMS’s Digital network is a closed network which can only be viewed by its ten regional offices and several State survey agencies in regions VIII, IX, and X. The Digital format that CMS uses is called Digicipher. CMS is also capable of transmitting and receiving programs in KU-band and C-band analog. Ku-band and C-band have been in use for many years, can be received by thousands of ‘steerable’ analog dishes nationwide. C-band is the oldest transmission signal and the most widely used. NOTE: This is NOT ‘video conferencing,’ which is carried by telephone lines.
Locating an Analog Downlink Site
Potential Analog Downlink Sites: There are thousands of steerable analog downlink dishes nationwide at public schools, colleges, libraries, hotels, television stations, restaurants, private residences, etc. A few calls should locate one near you.
Here are some places to start calling:
- Your Local Cable and Satellite Television Provider: Contact your local cable/satellite television distributor, which is probably listed under “Television -- Cable & Satellite.” Ask to speak with the programming staff and inquire about their willingness to simulcast the broadcast on your area's public access channel. Advise them that this broadcast is free of charge. Satellite television distributors may be able to provide you with a list of public institutions such as libraries, community centers, health care centers, and public schools that subscribe to their services. You may also wish to contact your local public TV station and ask that they download and air the program on their station.
- Public Libraries: Larger public libraries are a good place to check for satellite downlink facilities. Check library listings in the local government section of the blue pages of your local telephone directory.
- Educational Institutions: Universities, community colleges, and large public high schools often have satellite downlink capabilities.
- Hotels and Business Centers: Large hotels that frequently host conventions in business districts, may be able to receive satellite broadcasts. These hotels may charge a fee for viewing.
- Health Care Facilities: Many hospitals and health maintenance organization (HMO)
offices have satellite reception capabilities.
- Copy Centers: Commercial office supply centers may also have satellite capabilities.
What Information Do I Need to Give the Site Contact Person?
When you contact an analog site, you will need to give the contact person the satellite coordinate information. The coordinates for the broadcast should be made available from the Central Office contact approximately 30 days prior to the broadcast.Here is the information you will need to provide:
- Transmission Type:
- Satellite:
- Orbital Location:
- Transponder:
- Polarity:
- Downlink Frequency:
- Satellite Help Hotline:
- Broadcast Schedule:
- Test Signal:
- Broadcast Title:
Reserving a Downlink Site