Bridging Safe Access to Big Sandy Appalachian Research and Defense Fund Big Sandy Health Care Mountain Comprehensive Care Center Bridging Safe Access to Big Sandy is supported by grant no. 2014-FW-AX-K001 of the Education, Training, and Enhancing Services to End Violence Against and Abuse of Women with Disabilities Grant Program awarded by the Office on Violence Against Women, U.S. Department of Justice. Table of Contents Introduction01 Vision and Mission Statements04 Values and Assumptions 05 Member Agencies 09 Contributions and Commitments 016 Decision Making018 Conflict Management 020 Confidentiality and Mandated Reporting 021 Communication Plan 024 Glossary and Key Terms 026 Work Plan 028 “We build too many walls and not enough bridges.” ~~Isaac Newton One very distinct feature of Floyd County, Kentucky is the West Prestonsburg Arch Bridge. It was built in 1928 by the Steel and Lebby Contracting Company of Knoxville, Tennessee.1 This bridge is on the National Register of Historic Places, it is also a very well-known landmark to the Big Sandy Region. As the home office for each member agency is located in Prestonsburg, the seat of Floyd County, our collaborative found it only fitting to use the bridge as our logo and to also incorporate it into our name. Thus, Bridging Safe Access to Big Sandy was chosen. Photo credits belong to Jeffery Damron, Prestonsburg, Kentucky.2 Bridging Safe Access to Big Sandy is a partnership that has been formed between Mountain Comprehensive Care Center (MCCC), Big Sandy Health Care, Inc. (BSHC), and Appalachian Research and Defense Fund (AppalReD). Our collaboration will be working together to focus our efforts toward building a “bridge to safe access” for individuals with behavioral health and/or developmental/intellectual disabilities who are survivors of interpersonal violence. Interpersonal violence is an umbrella term that encompasses domestic violence, sexual assault, dating violence, and stalking.3  It can occur within or outside a family setting.4 Beginning January 2016, Kentucky House Bill 85 will go into effect for individuals who are victims of Interpersonal Violence (Dating, Stalking, or Rape) to get an Interpersonal Protective Order against the perpetrator. This will be a great asset to our work, as the current eligibility for Emergency Protective Orders in Kentucky states that an order can be issued if the victim is married to, divorced from, or has children with the perpetrator. With administrative offices for Big Sandy Health Care, Inc. (BSHC), Appalachian Research and Defense Fund (AppalReD), and Mountain Comprehensive Care Center (MCCC) all located in Floyd County, Kentucky and services provided throughout the Big Sandy, these agencies have developed collaborative relationships over the past 20 years. These relationships were formed to respond to the immense needs of individuals with behavioral health and/or developmental/intellectual disabilities who are victims/survivors of sexual assault, interpersonal/dating violence, and stalking. Each partner agency brings a particular expertise to the collaboration, whether a disability organization, dual sexual assault and domestic violence organization, health care clinic, or legal service provider to meet the all-inclusive needs of victims/survivors within the Big Sandy area. While these relationships were informal referrals in the past, through multiple grant programs since 2010, these agencies have committed to Memoranda of Understanding or Letters of Commitment to provide a universal service network. Examples of these existing commitments include: * By way of the 2013 OVW Transitional Housing Assistance Program, MCCC is currently partnering with AppalReD to provide transitional housing, case management and supportive services for victims of sexual assault, domestic violence, dating violence and stalking in Floyd County. * As per the 2013 OVW Safe Havens: Supervised Visitation and Safe Exchange Grant Program, MCCC, BSHC, and AppalReD are all partnering with the Floyd County Fiscal Court to conduct planning activities and implement supervised visitation and exchange services to ensure the safety of underserved adult victims of domestic violence, sexual assault, dating violence, stalking and their children (who may have also experienced child abuse as a result). * Through grants awarded to MCCC including the 2013 SAMHSA Offender Reentry Program; 2013 Department of Labor Homeless Veterans Reintegration Program; and 2011 and 2013 Bureau of Justice Assistance, Second Chance Act Reentry Program for Adult Offenders with Co-Occurring Substance Abuse and Mental Health Disorders, BSHC and AppalReD are collaborating with MCCC to provide an array of comprehensive supportive services for the benefit of these program participants. * Finally, through the 2011 HRSA New Access Point, Healthcare for the Homeless grant, all partners, BSHC and AppalReD, provided letters of commitment so that eligible program participants could access their services from a holistic system of care. As we begin this next phase of our existing partnerships, we plan to strengthen our multidisciplinary collaborative relationships to increase organizational capacity to provide accessible, safe and effective services to individuals with behavioral health and/or developmental/intellectual disabilities who are victims/survivors of violence and abuse; and to identify needs within each organization. Our collaboration will develop a plan to address the identified needs that will build a strong foundation for our future work together. As our collaborative came to a name, Bridging Safe Access to Big Sandy, we knew we wanted our Vision and Mission Statements to be a reflection of “Bridging Services”. It was with that energetic force that our statements were conceived. Vision Statement “We envision a safe and accessible community that will bridge services within The Big Sandy Region, which will be tailored to the distinct needs and circumstances of individuals with behavioral health and/or developmental/intellectual disabilities, who are survivors of interpersonal violence6.” Mission Statement Bridging Safe Access to Big Sandy seeks to educate and create a community encompassing safe and accessible resources that are available to individuals with behavioral health and/or developmental/intellectual disabilities. Our collaborative seeks to achieve this by way of: * Identifying gaps, barriers, strengths, and resources within our agencies. * Empowering and welcoming survivors. * Educating and Cross-Training within our agencies to share resources. * Creating changes within our agencies to enhance our collaboration. * Creating changes within our agencies which result in more welcoming and accessible services for survivors. Bridging Safe Access to Big Sandy came together to make our agencies more accessible and welcoming for the individuals we serve. As we discussed our specific agency services, we recognized the need to determine our unique set of values and assumptions that we hold as separate agencies, as well as those to guide our work as a collaborative. As this process progressed, we determined, by consensus, the following values are most essential to the work we desire to achieve in our collaborative: Accessibility- We believe that individuals should have non-discriminatory access to services; we should make accommodations, when necessary; individuals of interpersonal violence should always feel welcome and understood, and we strive to create policies and procedures to make services for individuals more accessible. Collaboration- We believe that our entire work is in collaboration, in regards to all involved. Collaborating among our agencies, as well as with service providers, and those we serve will improve our efforts toward creating systemic change needed to increase accessibility in the Big Sandy Region. Communication- Communication is a very important aspect in disclosing violence, finding available resources, and in obtaining services. Individuals will be treated with dignity and respect. Internal communication among our agencies, amid our President/CEO/ Executive Directors, Vera, and OVW, will keep our collaborative focused upon improving our communication. Confidentiality- Our Collaboration will maintain the confidentiality of all individuals served by our separate agencies at all times. Our work, as a collaboration, may require that confidential and/or sensitive information will need to be shared within our group. At times, some of this information will need to be shared for the purpose of making changes within our individual agencies, so that individuals may be served in a manner that is more accessible. Bridging Safe Access to Big Sandy will adhere to a confidentiality agreement regarding any/all information that will be shared for the purpose of better serving our individuals. Any/all information shared, will be done so in a fashion that is respectful to the individuals we serve. Culturally Competent- In order to provide individualized services, we need to have the ability to understand, communicate with, and effectively interact with individuals across all cultures. Creating a culturally competent environment will reduce the fear of judgment and/or stigma when disclosing abuse. Dignity- We believe that every individual should be treated with dignity at all times throughout the process of accessing services. Educate- We believe in cross-training with our partner agencies, to ensure optimal services are received by individuals of interpersonal violence with behavioral health and/or developmental/intellectual disabilities. We plan to cross train in areas of Trauma Informed-Care, Cultural Diversity, and Dignity and Respect. Empowerment- We want individuals to feel safe and welcome in our agencies. We believe empowerment comes through a process of services, choice, and building self-confidence. We believe empowerment is to promote the individual to have a voice, to be understood, and to have a choice. Individualized- We believe every individual seeking services from agencies in our collaborative partnership should have support towards their individual goals. Our work as a collaborative will initiate the systemic change of policy and procedural change needed within our partner agencies to accommodate the personal needs/choice of our individuals. Inclusiveness- We believe that inclusiveness is all encompassing. When an individual comes to one of our agencies for services, we are aware of the different resources each agency offers; referrals are made accordingly, so that specific needs of individuals are met within our network. People First Language- We believe when speaking with and to the individuals we serve, our language must be plain, appropriate, and respectful. Individuals are not defined by their disability or abuse. Respect- We believe that every individual should be treated with respect at all times throughout the process of accessing services. Safety- We believe safety is much more than physical safety. Safety also includes, but is not limited to, emotional and environmental safety. It is with this understanding that we strive to create a safe and welcoming environment within our agencies for individual’s to seek accessible services. Self-Determination- We believe self-determination is the right of an individual to make their own choice. As a survivor, each individual has a right to make decisions independently. As service providers, we believe in allowing individuals to grow and heal through self-determination. Survivor- We believe a survivor is someone who is healing from sexual assault, dating violence, domestic violence, or stalking. There are many phases of the healing process. As survivors come to our agencies for services, we will offer a safe, welcoming, and accessible environment; so that we may meet them where they are on their path of healing and provide services to accommodate the healing process. The following are assumptions that our collaborative holds in respect to survivors of interpersonal violence who also have behavioral health and/or developmental/intellectual disabilities: * All individuals should be treated with dignity and respect, regardless of disability. * The perpetrator of violence may be within the individual’s direct caregiving circle and/or family. * Survivors with disabilities often have more barriers to overcome, as opposed to the general population survivor (less privacy due to direct caregiving needs, isolation, shame, fear of not being believed, may not cognitively understand the act of violence against them, and communication). * Individuals with disabilities are at a higher risk for interpersonal violence than that of the general population. * Education is vital in our effort to end the cycle of interpersonal violence. * Interpersonal violence affects the entire family, not just the survivor. * Accessibility is right for all, regardless of disability. * Interpersonal violence is never acceptable. Lead Agency: Mountain Comprehensive Care Center 104 South Front Street Phone: 606-886-8572 Prestonsburg, Kentucky 41653 Fax: 606-886-4316 www.mtcomp.org Mountain Comprehensive Care Center (MCCC), established in 1963, is a 501(c)(3), CARF accredited, non-profit corporation. MCCC is one of Kentucky’s 14 regional mental health and mental retardation boards serving the Big Sandy district. As part of its mission, MCCC serves individuals with disabilities which stem from behavioral health needs such as behavioral health and substance use diagnoses, as well as developmental and intellectual disabilities. Key adult services provided by MCCC include, but are not limited to: victim services; outpatient group, individual or family therapy; psychiatric services; crisis stabilization; peer support services; outpatient and residential substance abuse treatment; jail-based mental health and substance abuse treatment programs; offender re-entry services; safe haven and supervised visitation programs; transitional housing for victims; transitional housing for homeless veterans; Homeless Veterans Registration Program (employment); community support and rehabilitation services; therapeutic rehabilitation program for adults with severe psychiatric disabilities; and DUI program. In 2012, MCCC instituted the Homeplace Clinic, health care for the homeless center located in Johnson County and serving Floyd, Johnson, and Pike Counties. In addition, MCCC’s Healing Program is Big Sandy’s only Rape Crisis Center, which offers comprehensive services for victims of rape, sexual assault, domestic violence, and child abuse. Partner Agency: Big Sandy Health Care, Inc. 1709 Kentucky Route 321 Suite 2 Phone: 606-886-8546 Prestonsburg, Kentucky 41653 Fax: 606-886-8548 www.bshc.org Established in 1974 as a private, non-profit corporation, Big Sandy Health Care, Inc. (BSHC) remains committed to providing access to quality health and dental care to individuals of all ages. BSHC enhances patient care by promoting disease prevention and health education. Behavioral Health care is also available through its Licensed Clinical Psychologist and Licensed Clinical Social Worker providers. BSHC earned national recognition for the treatment of its diabetes and cardiovascular patients during the organization’s participation in the HRSA-sponsored Health Disparities Collaborative. In addition, the Bureau of Primary Health Care recognized BSHC for innovative technology through its use of the web-based Patient Electronic Care System. BSHC currently operates five community health centers and one dental clinic throughout Big Sandy Region. Partner Agency: Appalachian Research and Defense Fund (AppalReD) 120 North Front Ave. Phone: 606-886-3816 Prestonsburg, Kentucky 41653 Fax: 606-886-0079 www.ardfky.org Appalachian Research and Defense Fund (AppalReD), is a private non-profit law firm which provides free civil legal representation to low-income families and individuals in a 37 county region including the Big Sandy Region. AppalReD began in 1970, and today is the largest legal aid organization in Kentucky with a staff of 33 attorneys, 3 paralegals, and 24 support staff and is housed in 5 offices throughout the region with its administrative office located in Floyd County. AppalReD’s primary focus is to assist clients with obtaining the basic necessities of life (e.g. income, adequate food and health care); decent, safe, and sanitary housing and the protection of assets; guarding the rights of children; and the protection of family members from violence and abuse including protecting populations with special vulnerabilities. As we began work on our charter, we collectively decided that our work would be most effective if we created two groups: Core Team and President/CEO/Executive Director Team. The Core Team will meet weekly for a minimum of two hours each week. During this time, we will work on building the charter, indicators, focus groups/surveys, needs assessments, strategic planning, and implementation phases of the grant. On a quarterly schedule, the President/CEO/Executive Directors of each agency will come to the table for a meeting with the core team to discuss progress and phase of grant status. At this time, each quarter, we will share updates with key decision makers regarding the status of policy and procedure, and discuss which policies will need to be strengthened, enhanced, and created. Core Team Members Include: Robin Gray, Healing Program for Survivors of Sexual Assault and Domestic Violence Program Director, will serve as a core team member from Mountain Comprehensive Care Center. She has provided behavioral health services to survivors of sexual assault and domestic violence for 19 years, moving from a Therapeutic Rehabilitation Supervisor to Outpatient Therapist, Victim Services Therapist, and Clinical Director to her current position as Director. In this role, Ms. Gray provides administrative and clinical supervision to Healing Program therapists, serves as a resource to other clinicians throughout the agency regarding victim issues, and maintains and distributes clinical resources to ensure continuing education and utilization of the most current standards of care. Ms. Gray holds a Master’s in Social Work and is a Kentucky Licensed Clinical Social Worker, has extensive training through the Kentucky Association of Sexual Assault Programs, of which she is a Board member, and is a trauma-informed care and cultural diversity trainer. Darrell Riffe, Developmental and Intellectual Disabilities (D/ID) Director, will serve as a core team member from MCCC. He has been with MCCC since 2007. Mr. Riffe started as an adult day training instructor for adults with D/ID diagnoses. Since then, Mr. Riffe has been a case manager, a case manager supervisor, and now serves in the capacity of D/ID Director. The D/ID program offers residential, case management, community living supports, crisis response and day training services throughout the Big Sandy Region. Stephanie Clark, a registered nurse at the Eula Hall Health Center in Grethel, KY will represent Big Sandy Health Care as a core team member. In 2012, she graduated from Big Sandy Community & Technical College with an associate degree in nursing. Stephanie became employed at McDowell ARH Hospital where she was quickly promoted to charge nurse. She returned to BSHC in February 2014 (previously working as a LPN at Physicians for Women, another facility of BSHC) to work as a staff RN/Patient Care Coordinator. She provides care to patients in the family practice setting, supervises the nursing assistants, licensed practical nurses, and x-ray/ultrasound technicians in the absence of the nurse manager. Stephanie collaborates with clinic staff members and with Mountain Comprehensive Care Center to identify appropriate utilization of resources. Mrs. Clark spends her time working to identify all appropriate available community resources, interacting, planning and coordinating referrals to obtain the care management that is needed within the community. Mrs. Clark maintains continued clinical education credits and is up to date in her training of Basic Life Support, Advanced Life Support and Pediatric Advanced Life Support. Lacey Yegen, Staff Attorney with AppalRed, will participate on the core team. Ms. Yegen is a native of Maryland and a graduate of The Catholic University of America, in Washington, D.C. and University of Baltimore School of Law. She joined AppalRed Legal Aid in 2012. She currently serves as President of the Floyd County Bar Association and sits on the Board of Directors for the David School and Turning Point Domestic Violence Services (f/k/a Sandy Valley Abuse Center). She also worked extensively on the grant which brought to our area, Safe Haven, a supervised visitation center located in Floyd County, Kentucky. As part of her role at AppalRed Legal Aid, Ms. Yegen counsels and represents victims of domestic violence as well as individuals with disabilities and/or who are D/deaf or hard of hearing. Also representing AppalRed and member of our core team is Kristie Stephens, Chief Legal Secretary and Domestic Violence Coordinator. Mrs. Stephens is a lifelong resident of Eastern Kentucky. She has 16 years of experience as a legal assistant and joined AppalRed Legal Aid in 2008. Mrs. Stephens has an active role in the day-to-day operations of the Prestonsburg Office and oversees the Domestic Violence Committee for the agency. As Domestic Violence Coordinator, she plans and organizes an annual informational conference which helps to educate professionals and the community about domestic violence. Mrs. Stephens also serves as a participant on several councils, including the Big Sandy Elder Abuse Council and the Floyd County Domestic Violence Council. The final core team member is Kimberly Sparks, Project Director. She has 7 years experience as a grant director, 13 years in elementary education in which she taught children with disabilities. Mrs. Sparks has been with MCCC since 2014. She began working with the Developmental/Intellectual Disabilities program as an adult day training instructor for individuals with D/ID diagnoses. She is also a Volunteer Victim Advocate with the Healing Program. Mrs. Sparks is currently a member of the Floyd County Domestic Violence Council, Elder Abuse Council, and the Families First Council. She also serves as a member of the Project Safe networking group, and is a representative of a statewide Structural Development and Sustainability committee with Project Safe. President/CEO/Executive Director Team Members: Representing Mountain Comprehensive Care Center is Promod Bishnoi, President/Chief Executive Officer since 2007. Mr. Bishnoi graduated from Morehead State University, a key institution in eastern Kentucky, with Masters Degrees in Health Care administration and Business Administration. In positions of CFO and CEO, Mr. Bishnoi has 23 years experience working with health, behavioral health and victim services for individuals with disabilities, as well as varied funding sources and regulatory bodies. His vision to meet gaps in care for persons with disabilities has nearly tripled MCCC’s budget from $15 to $42 million in 7 years. As such, he will be a key change agent for the project. Ancil Lewis, Chief Executive Officer of Big Sandy Health Care since 1998 oversees the administrative direction of the agency including recruitment, contract negotiations and management of physicians, mid-level providers, pharmacists, dentists, the psychologist and licensed social workers. Mr. Lewis has a Master of Business Administration, Master of Social Work-Health Systems, and Master of Arts –Sociology. He also has 26 years experience providing direct care services as a Social Worker, Director of Social Services, Clinical Manager, and Outpatient Therapist for persons with co-occurring substance abuse and mental health disorders, as well as an Adult Psychiatric Program Director, Director of Crisis Outreach and Psychiatric Emergency Services, Director of Social Services and Allied Health, and now as CEO. He has also recently served as the Board Chair of the Kentucky Primary Care Association. Robert Johns, is the Executive Director of Appalachian Research and Defense Fund. Mr. Johns relocated to Kentucky and began his position on January 30, 2015.  Mr. Johns has spent his entire career working in legal services for the poor.  He previously worked in Southeastern Ohio Legal Services (SEOLS) for 18 years with the last 15 as the Managing Attorney of the Steubenville, Ohio office.  SEOLS is the legal services program that serves Appalachian Ohio.  Mr. Johns began his legal career as an AmeriCorps attorney with Advocates for Basic Legal Equality (ABLE) in Findlay, Ohio.  Mr. Johns is a graduate of the George Washington University Law School and the University of Notre Dame.  Building a collaboration means becoming a team. As a team, everyone has a job and is responsible for contributing to the success of the team. Bridging Safe Access to Big Sandy is an exceptional team with strong contributions and commitments to making our region more accessible for those we serve. We realize that alone we provide services, together, we can change the way services are provided. Partner Commitments: * A minimum of 8 hours per month in-person meeting time. * To change, create, strengthen policies and procedures in our agencies * Actively communicate with collaboration and home agency Executives. * Attend Vera/OVW scheduled meetings. * Participate in Cross-Trainings. * Actively participate in all areas of planning, development, and implementation, as well as put into effect changes developed in our strategic plan. * Approve all deliverables/reports prior to submitting to OVW. * Safeguard that the resources committed to this process by their respective agencies are sustained beyond grant period. Lead Agency Commitments: * Employ the Project Director to coordinate, facilitate, and lead the collaboration. * Manage all fiscal aspects of grant. * Support the collaborative with technical assistance/equipment for meetings and/or webinars. President/Chief Executive Officer/Executive Director Commitments: * Commit to attend quarterly meetings with Core Team to discuss phase and progress of grant. * Acknowledge that we are working to create, enhance, and strengthen policies and procedures to make our services more accessible to individuals who have behavioral health and/or developmental disabilities and who are survivors of Interpersonal Violence. Project Director Commitments: * Facilitate weekly meetings. * Inform all members of the collaborative via weekly emails regarding status of deliverables, meetings, and/or webinars. * Attend Vera/OVW webinars, conferences, and meetings as scheduled. * Participate in Vera TA conference calls and site visits. * Send monthly updates to member agency CEO/ President/ ED. * Facilitate quarterly meetings for CEO/ President/ ED. * Draft and submit all deliverables to the Grant Program Officer for review before submitting to OVW. * Complete and submit semi-annual reports to OVW. The core team will be the decision making authority for Bridging Safe Access to Big Sandy. The responsibility of this team is to direct our collaborative efforts while: * Developing the charter document * Developing needs assessment, surveys, and leading focus groups, drafting changes to or creating new policies and/or procedures. * Executing the Implementation plan * Developing deliverables * Developing any grant adjustment notifications The core team will approve all documents before submitting them to our President/CEO/Executive Director team, Vera, and OVW. The President/CEO/Executive Director team has the authority to determine which policies and procedures will be enhanced, strengthened, or created. With these procedural changes, accessibility shall increase throughout the Big Sandy Region for the individuals we serve. The Project Director has the authority to oversee the daily operations of the grant, maintain a bi-weekly conference call with the Vera TA, submit deliverables to Vera, and OVW once the core team has approved them. It is also within the Project Director’s authority to plan and facilitate all weekly, quarterly, and Vera/OVW meetings. Bridging Safe Access to Big Sandy has decided to use consensus as our decision making process. This model is most common among our member agencies and was agreed upon by our core team members. When making decisions, we will: * Address the issue * Have a discussion in round table format (allowing quality time for each participant to participate in the discussion) * Vote at the end of discussion by showing a thumb sign o Agreement = thumb up sign o Do not fully support decision, however vote to pass the issue = sideways thumb o Do not agree to pass the issue = thumb down * At the end of discussion, consensus will be met when all members are showing a thumb up or sideways thumb When consensus cannot be attained, we will table voting until the next meeting * If consensus cannot be attained after two meetings, we will resort to the conflict management plan. Bridging Safe Access to Big Sandy is a very small group; we have 6 members in our core team. We are comprised of only 3 agencies, Mountain Comprehensive Care Center, Big Sandy Health Care, and Appalachian Research and Defense Fund. Given that our team is limited to only 6 members, we chose a conflict resolution plan that is simple, yet agreeable to our small size. Our core team has chosen to always show respect, dignity, equality, couth, and patience when having discussions around the table. It is very important that we remain focused on the work we are committed to doing. We realize that there will be times when we have different opinions, different views and desire different outcomes. When there is a disagreement, we have strategies in place to resolve those issues. We believe having conversation is the best way to address conflict. In that, we want our conversation to be open, honest, forthcoming, and non-confrontational. Our strategies for handling conflict within our internal group (core team) will include: * When disagreements occur, our core team will have conversation about the topic. Each representative will hear the point being made by the other member. * Red Card = Core team members will use a red card to write their concern, as not to interrupt the conversation. This card will be placed to the side until the member speaking has finished. At this time, conversation will continue having all sides/points of view heard. * If consensus cannot be met after the red card discussion, the issue at hand will be tabled until the next meeting. * If there is still no resolution after the following meeting, the core team will have a conference call with Vera TA to seek assistance in resolution. When there is conflict between our internal (core team) and external (President/CEO/Executive Director team) teams, we will have members of both teams present and engage in a conference call with our Vera TA to assist in finding a solution. When our agencies come together to improve or create systemic change, there at times may be sensitive information discussed. In our roles as representatives of Bridging Safe Access to Big Sandy, we realize that we will be sharing information about our individual programs and agencies. At all times, any and all information shared within our collaborative shall remain private and confidential. At no time shall any information be shared outside of our collaboration. Any information received regarding individuals will be for the sake of improving accessibility within our partner agencies and the Big Sandy Region. At all times, we will be mindful of why, when, what, and how we collect and share information. At the beginning of each weekly, quarterly, or special called meeting, each representative in attendance shall sign a confidentiality agreement.7 As we move into focus groups, surveys, and needs assessment, we will be mindful about the identity and information of those individuals we serve. Identifying information will not be disclosed. The only time confidentiality will be broken, will be when a written release by the individual has been signed or by mandatory reporting laws. Mandatory Reporting Mountain Comprehensive Care Center, Big Sandy Health Care, and Appalachian Research and Defense Fund are all mandatory reporters in the state of Kentucky. Bridging Safe Access to Big Sandy representatives understand and adhere to the mandatory reporting laws for children, elderly, and adults with disabilities in the state of Kentucky. Mandated reporters include, but are not limited to physicians, law enforcement officer, nurse, social worker, cabinet personnel, coroner, medical examiner, alternate care facility employee, or caretaker.8 According to KRS 209A9, a victim of spouse abuse who is a “vulnerable” adult may be served under that section of KRS 209. Thus, a court would be able to order emergency services without the victim’s consent. “Vulnerable adult means: a person 18 or older who, because of mental or physical dysfunction, is unable to manage his own resources, carry out the activity of daily living, or protect himself from neglect, exploitation, or a hazardous or abusive situation without assistance.”10 Bridging Safe Access to Big Sandy believes in the rights and confidentiality of individuals we serve. As part of informed consent, upon intake with MCCC, each individual is given a “Client Rights and Confidentiality”11 notice. This notice explains the rights each individual has, what their responsibilities are as an individual seeking services, and the process of mandatory reporting. Individuals are informed that there may be times in which information they disclose may not be kept in confidence. These times include: * If an individual12 is being abused, neglected or exploited, or is abusing, neglecting or exploiting someone else, we are obligated by law to report to the proper authorities. * If an individual becomes a danger to themselves or to others, or if they threaten to hurt someone, we are obligated by law to report to the proper authorities. * If the court orders medical records of an individual, we are obligated to release that information. We will attempt to notify individuals if this occurs. Those individuals taking part in the needs assessment will be informed of our confidentiality rights and that commitments to confidentiality are guarded by mandatory reporting requirements. Should disclosure occur, the person disclosing will be informed of our obligation to report to the proper authorities. However, we will also explain how we will assist anyone who needs advocate or legal service, if so desired. Communication is essential to the success of Bridging Safe Access to Big Sandy as we strive to remove barriers to accessibility. We believe in keeping communication open, honest, respectful, showing dignity and couth at all times. Our plan has been broken into three sections: internal, external, and media. Internal Plan * Internal plan refers to core team members. * Core team will have working meetings 2 hours per week. * Project Director will schedule, arrange, and facilitate all work meetings. Any information needed for meeting will be announced prior to the meeting via email. * If a core member is absent from a meeting, the meeting will still be held. The member missing the meeting will contact the Project Director prior to the next scheduled meeting to discuss events/information from the missed meeting. * Webinars will be announced via email to core team members as they are scheduled by Vera. Project Director will follow up with email, as well as arrange location and technical support needed for webinar. * All partners have a binder to keep information filed and easily accessible. External Plan * Each representative is responsible for sharing information from Bridging Safe Access to Big Sandy with in their respective agency. * President/CEO/Executive Director and Vera TA will meet quarterly to be informed of progress regarding charter, surveys, focus groups, needs assessment, and implementation phases of the project. * Project Director will maintain bi-weekly contact with Vera TA to discuss project progress and to receive feedback on deliverables. * All deliverables will be presented to President/CEO/Executive Director and Vera TA for feedback before submitting to OVW. * The Project Director will be the contact person for all OVW communication. * Community Partners will meet quarterly with Project Director for updates and discuss project status. Media Plan * Project Director will prepare public announcements for radio and newspaper. * Press release in regards to Bridging Safe Access to Big Sandy will be directed to lead agency.13 * Media requests in regards to Bridging Safe Access to Big Sandy will be directed to lead agency. Abuse—for our work, we define abuse as the state of Kentucky defines it14. Abuse means the infliction of injury, sexual abuse, unreasonable confinement, intimidation, or punishment that result in physical pain or injury, including mental injury. Advocacy—trained advocates who assist victims of interpersonal violence and/or child abuse in hospital emergency rooms and/or accompanies victims to court proceedings. Behavioral Health— is a term that covers the full range of mental and emotional well-being – from the basics of how we cope with day-to-day challenges of life, to the treatment of mental illnesses, such as depression or personality disorder, as well as substance use disorder and other addictive behaviors15. Collaboration—when interdisciplinary agencies form a partnership that will result in systemic changes in each agency that could not be achieved as an individual agency. Confidentiality—legal and ethical duty to keep all information about individuals private, not to be disclosed with a third party unless the individual gives consent permitting disclosure or unless it is required by state mandatory reporting laws. Consensus—a mutual agreement within a working group for decision making purposes. Culturally Competent— Cultural Competence refers to the process by which individuals and systems respond respectfully and effectively to people of all cultures, languages, classes, races, ethnic backgrounds, religions, and other diversity factors in a manner that recognizes, affirms, and values the worth of individuals, families, and communities and protects and preserves the dignity of each16. Developmental Disability--a broader term that includes ASD (autism spectrum disorders), epilepsy, cerebral palsy, developmental delay, fetal alcohol syndrome (or FASD) and other disorders that occur during the developmental period (birth to age 18). Exploitation--for our work, we define exploitation as the state of Kentucky defines it.17 Exploitation means obtaining or using another person’s resources, including but not limited to funds, assets, or property, by deception, intimidation, or similar means, with the intent to deprive the person of those resources. Individual— for our work, individual is defined as a person with behavioral health and/or developmental intellectual/disabilities. Informed Consent—for our work, informed consent is a patient's consent to medical/clinical treatment after being properly advised of their rights and responsibilities as an individual and the Kentucky Mandatory Reporting Laws. Intellectual Disability-- refers to general mental capability and involves the ability to reason, plan, solve problems, think abstractly, comprehend complex ideas, learn quickly, and learn from experience.  Interpersonal Violence— is an umbrella tern that encompasses domestic violence, sexual assault, dating violence and stalking. Neglect—for our work, we define neglect as the state of Kentucky defines it.18 Neglect means a situation in which an adult is unable to perform or obtain for him/herself the goods or services that are necessary to maintain his/her health or welfare, or the deprivation of services by a caretaker that are necessary to maintain the health and welfare of an adult. Systematic Change—our work as a collaborative, is to create policy change within our agencies that support accessibility for persons with disabilities who are survivors of interpersonal violence. Trauma Informed—a system of care, in which services are “wrapped” around a survivor. It is when you think, “What has happened to you?” rather than, “What is wrong with you?” Vulnerable Adult-- a person 18 or older who, because of mental or physical dysfunction, is unable to manage his own resources, carry out the activity of daily living, or protect himself from neglect, exploitation, or a hazardous or abusive situation without assistance. Deliverable/Activity Time Frame * Building Collaboration/Charter * March – July 2015 * Needs Assessment Planning * July – August 2015 * Conduct Needs Assessment * September – November 2015 * Needs Assessment Report * December 2015 * Strategic Planning * January – February 2016 * Implementation * Begins March 2016 1 http://pdfhost.focus.nps.gov/docs/NRHP/Text/89000397.pdf 2 http://www.the-h-word.com/ 3Interpersonal violence is an umbrella tern that encompasses domestic violence, sexual assault, dating violence and stalking. www.thepca.org/what-is-ipv/ 4http://www.justice.gov.sk.ca/DIVA 5 Kentucky House Bill 8--Appendix 6 Interpersonal Violence is an umbrella term that encompasses domestic violence, sexual assault, dating violence, and stalking. www.thepca.org/what-is-ipv/ 7 Bridging Safe Access to Big Sandy Confidentiality Agreement--Appendix 8 RAINN—Kentucky Mandatory Reporting Laws – http://apps.rainn.org/ —Appendix 9 KRS 209A 10 KRS 209 11 Mountain Comprehensive Care Center Client Rights and Confidentiality -- Appendix 12 Individual—for our work, individual is defined as a person with behavioral health and/or developmental intellectual/disabilities. 13 Media Policy--Appendix 14 KRS 209 15 http://www.carolinashealthcare.org/what-is-behavioral-health 16 http://cultureconnectionsnj.org/what-is-cultural-competence/ 17 KRS 209 18 KRS 209