Advanced Crisis Solutions
Client & Caregiver Information

ACS provides assistance to clients with their toileting and hygiene needs as necessary.

ACS does not offer emergency crisis response services. Responsibility for managing crisis behavior outside direct ACS involvement falls to the primary caregiver. However, ACS is committed to providing training and resources to support caregivers in managing such situations safely and effectively. This training encompasses techniques for redirecting, deescalating, and managing crisis behavior when it arises.

• After being accepted into the program, the consumers eligibility status with FNRC changes resulting in them no longer being eligible for FNRC services.

• After being accepted into the program, the consumer’s health status declines to a degree that the program can no longer safely meet their medical needs.

• After being accepted into the program, it is determined that the consumers behavioral challenges are too dangerous to safely manage, and the safety of ACS workers are at risk.

• The consumer, family, residential provider, and/or FNRC has requested a discharge from the program due to dissatisfaction with the service.

• Components of the service contract between the ACS and the primary caregiver are not upheld, and attempts to resolve the problems are unsuccessful.

• The consumer’s behavior has stabilized and he/she no longer needs the level of service contracted.

Advanced Crisis Solutions' administrative offices operate Monday to Friday, 9:00am to 4:00pm. Direct client services are available Tuesday to Saturday, 8:00am to 8:00pm, excluding certain holidays. ACS does not render services during the following holidays:

• New Year’s Day

• President’s Day

• Independence Day

• Memorial Day

• Labor Day

• Thanksgiving Day

• Day After Thanksgiving Day

• Christmas Eve

• Christmas Day

ACS staff may accompany clients in the family or provider’s vehicle. ACS staff cannot transport clients in their personal vehicles, but occasionally, an approved ACS company vehicle may be used, with prior planning and approval.

ACS does not own or operate residential programs for children or adults.

ACS does not offer out of home respite care but provides in-home behavioral respite services.

Services are primarily home-based but may extend to community settings when appropriate, subject to advance planning and ACS approval for safety and behavioral strategy implementation.

If an unusual incident occurs during direct work with the consumer, ACS will notify the parents/provider at the conclusion of the shift or as soon as reasonably possible. ACS will verbally inform the regional center of the unusual incident within twenty-four (24) hours and provide a written description of the incident to the regional center within forty-eight (48) hours of the incident. Unusual incidents may include but are not limited to: injuries; accidents; medication errors; involvement of law enforcement; use of crisis management procedures; a significantly dangerous behavioral episode; etc.

Services are offered in the client’s family home, residential facility, supportive living home, and occasionally in hospital or school settings.

At ACS, we strongly believe that utilizing “hands-on” crisis management should only be considered as a last resort when an individual’s or their primary caregiver’s safety and well-being are under immediate danger. We recognize that the individuals referred to our organization often are experiencing a behavioral crisis and may display behavior such as aggression towards others, self-injury, and property damage. Therefore, we have been trained to implement two distinct crisis management programs, Ukeru and Professional Crisis Management (PCM), which are essential in ensuring that individuals receive the necessary support during times of crisis without compromising their health and safety.

Ukeru is a restraint-free crisis management program that uses non-verbal communication and specialized tools to safely handle crises. It was created by care providers and clinicians with a focus on trauma-informed care.

PCM is a crisis management system that includes specific protocols for preventing and de-escalating crisis situations to prevent problematic behaviors from occurring in the first place. It’s important to note that PCM physical procedures are only utilized when certain criteria are met. These include continuous aggression towards others, continuous self-injury, or continuous high magnitude disruptions. If the consumer’s behavior is non-continuous or of low magnitude and has no potential for harm, PCM physical procedures are not used. The procedures are a last resort for ACS, and we always use the least intrusive but most effective procedure within the hierarchy. PCM Physical Crisis Management procedures from least restrictive to most restrictive include:

1. Transportation Procedures

2. Vertical Immobilization Procedures

3. Horizontal Immobilization Procedures

Whenever a physical or hands-on technique is employed, ACS shall promptly notify the regional center verbally within 24 hours of the behavioral incident. Additional, a written GER/SIR shall be submitted within 48 hours of the behavioral emergency. The GER/SIR shall provide a detailed account of the events leading up to the behavioral incident, the nature of the behavior that required the use of PCM, the redirection techniques attempted before initiating crisis management, the specific procedure utilized, the duration of the behavioral incident and crisis management procedure, and the events that transpired following the behavioral incident’s resolution.

In instances where a client relocates from their home for medical emergencies , behavioral emergencies, medical evaluations, vacations, or other reasons, ACS will evaluate if services can be continued on a case-by-case basis. ACS shall determine whether services may be sustained in the new setting, temporarily paused until the client’s return, or ultimately terminated.

Families/providers are expected to participate in monthly training, provide a safe work environment, and be receptive to feedback.

The program includes behavioral assessments, crisis stabilization plan, behavioral training, behavioral respite, behavioral skill building, and adding new community resources and services.

12 - 24 Months

Phase 1: Assessment Phase
First 3 Months of Service

• Conduct meetings with primary caregivers to discuss the case, services, and identify initial service goals.

• Collect baseline data and complete the Adaptive Behavior Assessment System (ABAS) and Functional Behavioral Assessment (FBA).

• Develop and complete a Crisis Stabilization Plan within 90 days of starting services.

• Provide primary caregiver with behavioral training.

Phase 2: Implementation Phase
Middle 6 Months of Service

• Implement the Crisis Stabilization Plan.

• Continue primary caregiver behavioral training.

• Continue identifying and/or adding new community resources and services.

Phase 3: Fading Phase
Last 3 Months of Service

• Meed with Advanced Crisis Solutions (ACS), Far Northern Regional Center (FNRC), and primary caregivers to discuss fading crisis stabilization services while maintaining long-term crisis stabilization.

• Continue primary caregiver behavioral training.

*If complete crisis stabilization has not occurred within the 12-month time period, extending crisis stabilization services for additional 12-months will be considered.