Community Counseling Center of Mercer County < Back Community Counseling Center of Mercer County Our Vision Community Counseling Center will be the region's leading innovative provider of behavioral and emotional health services by uniting resources to help people become effective contributors to the social, spiritual, and economic well being of our community. Improve behavioral health in your children and yourself. Our team specializes in recovery-oriented behavioral health services.

Bradford-Sullivan Early Childhood Coalition < Back Bradford-Sullivan Early Childhood Coalition The Bradford-Sullivan Early Childhood Coalition offers infomration about quality early care services and resources for families, businesses and the community. Research shows that high-quality childcare has a positive effect on children -rticularly at-risk children. The goal of the Early Childhood Coalition is to educate communities in understanding the importance of quality early childhood education and assist families in obtaining these quality programs. The Coalition stakeholders consist of dedicated individuals representing state and local government agencies, local non-profits agencies, businesses, schools, childcare providers andrents. Members strive to make a difference in our counties and to ensure every child is successful in school. early childhood education

Classic Rehabilitation < Back Classic Rehabilitation Occupational Therapy Physical TherapySpeech TherapySocial Workcontact info

Berks County Adult & Juvenile Probation < Back Berks County Adult & Juvenile Probation https://countyofberks.com/departments/juvenile-probation-office Juvenile Probation https://www.countyofberks.com/departments/apo Adult Probation

The Pennsylvania Dependency Benchbook for Judges and Legal Professionals < Back The Pennsylvania Dependency Benchbook for Judges and Legal Professionals The document is a comprehensive resource that combines Pennsylvania law, organized pragmatically to allow quick and efficient use, with a series of state and national best practices that will provide judges and practitioners, from the least to most experienced, with the best possible information to support children and families safely. Table of Contents and Best Practice Boxes Rev. 2014 Table of Contents and Best Practice Boxes Acknowledgments Committee Members ii Table of Contents and Best Practice Boxes Benchbook Overview xiii Ch. 1 The Charge for Pennsylvania’s Dependency System 1-1 Mission and Guiding Principles for Pennsylvania’s Dependency System 1-7 Ch. 2 The Role of Judges and Hearing Masters 2-1 2.1 Role of Judges 2-1 2.1.1 Oversight and Management of Individual Cases 2.1.2 Legal Safety Analysis for Judicial Decision-Making 2-1 2-3 2.1.3 Commitment and Leadership in System Improvement Efforts 2-6 2.1.4 Collaboration with the Child Welfare Agency and the Community 2-7 2.2. Role of the Hearing Master 2-8 Ch. 3 Jurisdiction 3-1 3.1 Overview 3-1 3.2 Dependency Jurisdiction in General 3-1 3.3 Divisional Responsibilities 3-2 3.4 Jurisdiction in Cases that Cross Borders 3-3 3.4.1 Inter-County Transfer Cases 3-4 3.4.2 Interstate Transfer 3-4 3.4.3 International Transfers 3-5 3.5 The Indian Child Welfare Act (ICWA) 3-5 Ch. 4 Right to Legal Representation 4-1 4.1 Overview 4-1 4.2 Legal Representation in Dependency Matters in Pennsylvania 4-2 4.2.1 Judge’s Role 4-2 4.2.2 Guardian Ad Litem (GAL) 4-2 4.2.3 Legal Counsel for the Child 4-3 4.2.4 Shared Case Management/Dual Jurisdiction 4-4 4.2.5 Counsel for Parents 4-4 4.3 Pro Se Parents 4-5 4.4 County Solicitors 4-6 4.5 Waiver of Counsel 4-7 v Table of Contents and Best Practice Boxes Rev. 2014 Ch. 5 Entering the Child Welfare System/Shelter Care Hearing 5-1 5.1 Overview 5-1 5.2 Commencement of Proceedings 5-2 5.2.1 Voluntary Placement with the Agency 5-3 5.2.2 Order for Protective Custody 5-3 5.3 Shelter Care Hearing 5-3 5.4 Counsel and Guardian Ad Litem (GAL) Appointments 5-8 5.4.1 Parent Counsel 5-8 5.4.2 Assignment of Guardian Ad Litem (GAL) and Child Counsel 5-8 5.5 Conducting the Hearing 5-9 5.5.1 Evidentiary Standard 5-10 5.6 Findings and Orders 5-10 5.7 Motions and Answers 5-11 Shelter Care Hearing Checklist 5-12 Shelter Care Hearing Benchcard Locating Fathers & Establishing Paternity Benchcard 5-15 5-17 Ch. 6 Adjudication 6-1 6.1 Overview 6-1 6.2 Dependency 6-1 6.3 Pre-Hearing Requirements and Considerations 6-2 6.3.1 Timing 6-2 6.3.2 Appointment of Counsel 6-3 6.3.3 Notification 6-3 6.3.4 Discovery 6-3 6.3.5 Pre-Adjudicatory Conference 6-4 6.3.6 Stipulations 6-4 6.3.7 Reports and Ex Parte Communication 6-5 6.3.8 Standing 6-5 6.4 Conducting the Hearing 6-6 6.5 Burden of Proof 6-6 6.6 Findings and Orders 6-6 Adjudicatory Hearing Checklist 6-8 Adjudicatory Hearing Benchcard 6-11 Ch. 7 Visitation 7-1 7.1 Overview 7-1 7.2 Visitation in Reunification Cases in General 7-1 7.3 Legal Requirements Governing Visitation 7-3 7.4 Sibling Visitation 7-4 7.5 Visitation Arrangements 7-4 vi Table of Contents and Best Practice Boxes Rev. 2014 7.6 Visitation and Contact with Incarcerated Parents 7.7 “Best Interests” Visitation in Non-Reunification Cases Oversight vs. Support Matrix Frequency & Duration Guide for Visitation Ch. 8 Incarcerated Parents 8.1 Overview 8.2 Engagement of Incarcerated Parents in Case Planning & Delivery of Services 8.3 Engagement & Participation of Incarcerated Parents in the Court Process 8.4 Visitation & Contact for Dependent Children of Incarcerated Parents Checklist of Suggested Questions for Hearings Involving an Incarcerated Parent Checklist for Hearings Involving an Incarcerated Parent 7-6 7-7 7-9 7-10 8-1 8-1 8-2 8-3 8-3 8-7 8-8 Ch. 9 Disposition 9-1 9.1 Overview 9-1 9.2 Preliminary Matters 9-2 9.3 Reports 9-2 9.4 Stipulations 9.5 Conduct of the Hearing 9.6 Educational Decision Makers (EDM) 9-4 9-4 9-7 9.6.1 When to Appoint an EDM 9.6.2 Persons Eligible for Appointment 9.6.3 Special Rules for Students with Disabilities 9-7 9-8 9-8 9.7 Findings and Orders 9-8 Disposition Hearing Checklist Disposition Hearing Benchcard 9-12 9-15 Ch. 10 Modification of Placement 10-1 10.1 Overview 10-1 10.2 Disposition of Motion 10-1 Ch. 11 Permanency Options 11-1 11.1 Overview 11.2 Reunification 11.3 Adoption 11.4 Permanent Legal Custodianship (PLC) 11.5 Permanent Placement with a Fit and Willing Relative 11.6 Another Planned Permanent Living Arrangement 11-1 11-1 11-3 11-5 11-7 11-9 vii Table of Contents and Best Practice Boxes Rev. 2014 Ch. 12 Permanency Hearing 12-1 12.1 Overview 12-1 12.2 Timing of Permanency Hearings 12-1 12.3 Pre-Hearing Conferences 12-3 12.4 Hearing Objectives 12-4 12. 5 Conduct of the Hearing 12-7 12.5.1 Courtroom Management 12-7 12.5.2 Persons in Attendance 12-10 12.6 Matters to be Determined 12-12 12.6.1 Continuing Necessity of Placement 12-13 12.6.2 Appropriateness of Placement 12-13 12.6.3 Appropriateness, Feasibility, and Extent of Compliance with the Permanency Plan 12-14 12.6.4 Progress Toward Alleviating Circumstances Requiring Placement 12-14 12.6.5 Appropriateness and Feasibility of Current Placement Goal 12-15 12.6.6 Likely Date that Placement Goal Might Be Achieved 12-16 12.6.7 Reasonable Agency Efforts to Finalize Permanency Plan 12-16 12.6.8 Whether the Child is Safe 12-16 12.6.9 Services Needed to Help Older Youth Transition to Independence 12.6.10 Educational, Health Care, and Disability Need of the Child 12-17 12-18 12.6.11 Whether a TPR Petition Should Be Filed 12-20 12.6.12 When and How the Child Will Achieve Permanency 12-22 12.7 Admissibility of Evidence, Reports and Other Documents 12-22 12.8 Findings and Orders 12-23 Permanency Hearing Checklist/Questions 12-27 Permanency Hearing Benchcard 12-33 Ch. 13 Permanency Hearing to Consider Change of Goal (“Goal Change Hearing”) 13-1 13.1 Overview 13-1 13.2 Initiating the Goal Change 13-1 13.3 Goal Change to Adoption 13-3 13.4 Change to Other Permanency Goals 13-4 13.5 Effects of Goal Change 13-6 13.6 Evidentiary Issues in Goal Change Hearings 13-7 13.7 Findings and Orders 13-8 viii Table of Contents and Best Practice Boxes Rev. 2014 Ch. 14: Termination of Court Supervision 14.1 Overview 14.2 Timing of Termination of Supervision 14.3 Reasons for Termination of Supervision 14.4 Circumstances Requiring Special Consideration 14.4.1 Children Turning 18 14.4.2 Custody Orders 14.4.3 Shared Case Responsibility 14.4.4 Transfer of Court Jurisdiction 14.5 Findings and Orders Checklist of Suggested Questions Termination of Supervision Benchcard Ch. 15: Resumption of Jurisdiction 15.1 Overview 15.2 Method of Request and Review 15.3 Timing of Hearing 15.4 Jurisdiction 15.5 Counsel & Guardian Ad Litem Appointments 15.6 Service 15.7 Standing 15.8 Conduct of the Hearing 15.9 Burden of Proof/Evidentiary Standard 15.10 Placement & Service Options 15.11 Review Hearings 15.12 Findings and Orders 14-1 14-1 14-2 14-4 14-5 14-5 14-7 14-7 14-8 14-10 14-11 14-15 15-1 15-1 15-2 15-2 15-2 15-3 15-3 15-4 15-4 15-5 15-5 15-6 15-7 Ch. 16 Termination of Parental Rights 16-1 16.1 Overview 16-1 16.2 Jurisdiction of the Court 16-2 16.3 TPR Petitions 16-3 16.4 Scheduling of TPR Hearings 16-3 16.5 Service and Notice 16-3 16.6 Appointment of Counsel 16-5 16.7 Discovery 16-5 16.8 Continuances 16-6 16.9 TPR Methods 16-6 16.9.1 Relinquishment Under the Alternative Procedure (Consent) 16-7 16.9.2 Voluntary Relinquishment 16-8 16.9.3 Involuntary Termination 16-8 16.10 Grounds for Involuntary Termination 16-9 ix Table of Contents and Best Practice Boxes Rev. 2014 16.11 Additional Considerations in Involuntary Termination Cases 16-12 16.11.1 Parent-Child Bond Issues 16-12 16.11.2 Putative Fathers 16-14 16.11.3 Incarcerated Parents 16-14 16.12 Decree of Termination of Parental Rights 16-16 Sample Voluntary Relinquishment of Parental Rights Colloquy 16-17 TPR Benchcard 16-19 Ch. 17 Appeals 17-1 17.1 Overview 17-1 17.2 CFT Rules at a Glance 17-1 17.3 Trial Judge’s Role in Expediting Appeals 17-2 Ch. 18 Adoption 18-1 18.1 Overview 18-1 18.2 Jurisdiction 18-2 18.3 Pre-Adoption Requirements 18-3 18.4 Adoption Hearings 18-4 18.4.1 Preliminary Matters 18-4 18.4.2 Attendance at Hearing 18-5 18.4.3 Testimony and Investigation 18-5 18.5 Adoption Orders 18-6 Sample Questions for the Adoption Hearing 18-7 Ch. 19 General Issues 19-1 19.1 Overview 19-1 19.2 Aggravated Circumstances 19-2 19.2.1 “Aggravated Circumstances” Defined 19-2 19.2.2 Procedures in Aggravated Circumstances Cases 19-3 19.2.3 Timing of Hearing 19-3 19.2.4 Effect of Determination 19.3 Family Finding 19-4 19-5 19.4 Family Group Decision Making (FGDM) 19-10 19.4.1 Benefits of FGDM 19-11 19.4.2 The FGDM Process 19-12 19.4.3 The Court’s Role 19-14 19.5 Common Pleas Court Management System (CPCMS) 19-16 19.5.1 Management Reports 19-17 19.5.2 Statistical Reports 19-18 19.6 Children in the Courtroom 19-19 19.6.1 Talking to Children in Court 19-21 19.6.2 Children as Witnesses 19-22 x Table of Contents and Best Practice Boxes Rev. 2014 19.7 Transitioning Youth 19-24 19.7.1 Independent Living Services for Transition Youth 19-25 19.7.2 Transition Planning for Older Youth 19-26 19.7.3 Educational Issues for Transitioning Youth 19-27 19.7.4 Youth Opting to Remain in Care Past Age 18 19-28 19.7.5 IL Aftercare Services 19-30 19.8 Court Appointed Special Advocates (CASA) 19-30 19.8.1 CASA Appointments 19-30 19.8.2 CASA Duties and Responsibilities 19-31 19.8.3 CASA Resources 19-32 19.9 Planning and Funding Services: The Needs Based Plan and Budget (NBPB) 19-32 19.9.1 Best Interests and Reasonable Efforts Findings 19-33 19.9.2 County Planning and Budgeting Process 19-34 Ch. 20 Overview of Federal and State Child Welfare Legislation 20-1 20.1 Adoption Assistance and Child Welfare Act of 1980 20-1 20.2 Adoption and Safe Families Act (ASFA) 20-1 20.3 Child Abuse Prevention and Treatment Act (CAPTA) 20-2 20.4 Foster Care Independence Act (Chafee) 20-3 20.5 Fostering Connections to Success and Increasing Adoptions Act of 2008 20-4 20.6 Interstate Compact on the Placement of Children (ICPC) 20-6 20.7 Indian Child Welfare Act 20-7 20.8 The Multi-Ethnic Placement Act – MEPA 20-8 20.9 The Pennsylvania Adoption Act 20-9 20.9.1 Voluntary Relinquishment of Parental Rights 20-9 20.9.2 Involuntary Termination of Parental Rights 20-10 20.9.3 Relinquishment of Parental Rights under the Alternative Procedure 20-11 20.10 The Child Protective Services Law 20-11 20.11 The Pennsylvania Juvenile Act 20-14 Benchcards Resources and References Glossary and Acronyms Bibliography xi

PA Families Board Application PFI 2024 < Back PA Families Board Application PFI 2024 PFI Board of Directors Application 2024 .pdf Download PDF • 165KB

Assessment and Treatment of Eating Disorders Webinar WPIC PITT < Back Assessment and Treatment of Eating Disorders Webinar WPIC PITT Anorexia Nervosa and Bulimia Nervosa comprise the major eating disorders. Diagnosis and treatment require an understanding of the complex interaction of biological, psychological, familial, and social factors related to etiology. This program will address the assessment of eating disorders, including morbidity. In addition, the indication for varying treatment strategies will be discussed.

Mental Health State Overview, Regional Map, Children’s Bureau, Federal Information < Back Mental Health State Overview, Regional Map, Children’s Bureau, Federal Information Office of Mental Health and Substance Abuse Services OMHSAS Our Goals: - Transform the children’s behavioral health system to a family-driven system and youth-driven. - Implement services and policies to support recovery and resiliency in the adult behavioral health system - Assure that behavioral health services and supports recognize and accommodate the unique needs of older adults. Deputy Secretary's Office717-787-6443 Regional Mental Health/Substance Abuse Field Offices Central Field Office:717-705-8395717-705-8386 (fax) Northeast Field Office:570-963-4335570-963-3050 (fax) Southeast Field Office:610-313-5844610-313-5845 (fax) Western Field Office:412-565-5226412-565-5393 (fax) Bureau of Children’s Behavioral Health Services https://www.dhs.pa.gov/contact/DHS-Offices/Pages/OMSHAS-Childrens%20Behavioral%20Health%20Services.aspx Contact Information: Scott Talley, DirectorP. O. Box 2675, Harrisburg, PA 17105-2675 Receptionist: 717-705-8289 Fax: 717-705-8268 Bureau Organization - Division of Operations and Service Delivery : responsible for working with the OMHSAS Field Offices, County MH/IDD/EI Programs, Behavioral Health Managed Care Organizations BHMCO and provider agencies in the development and management of children’s behavioral health services -Division of Policy, Planning, and Program Development : responsible for working with state agencies and family and youth advocacy organizations in the development of policy, integrated planning, and review of service descriptions for new programs. Supporting priorities: Establish child and family teams and implementation of high-fidelity wraparound through the work of the Youth and Family Training Institute YFTI Create home and community-based alternatives to residential treatment Partner with the Department of Education DOE to support the development of effective school-based supports and interventions, including the Student Assistance Program SAP and Positive Behavioral Interventions and Supports PBIS Develop a process for identifying and implementing evidence-based practices, promising practices , and culturally relevant practices Develop strategies to address the needs of transition-age youth Create behavioral health competency to honor the strengths and address the unique individualized needs of infants and toddlers as well as children and adolescents: In the Child Welfare System OCYF https://www.dhs.pa.gov/contact/DHS-Offices/Pages/OCYF-Bureau%20of%20Child%20and%20Family%20Services.aspx In, or at risk of entering, the Juvenile Justice System https://www.pccd.pa.gov/Juvenile-Justice/Pages/default.aspx https://www.dhs.pa.gov/Services/Children/Pages/Juvenile-Justice.aspx In the Drug and Alcohol Substance Abuse System DDAP https://www.ddap.pa.gov/pages/default.aspx With Fetal Alcohol Spectrum Disorder FASD https://www.dhs.pa.gov/Services/Mental-Health-In-PA/Pages/FASD.aspx#:~:text=What%20is%20FASD%3F,mother%20drank%20alcohol%20during%20pregnancy . Who are Deaf or Hard-of-Hearing ODHH https://www.dli.pa.gov/Individuals/Disability-Services/odhh/Pages/default.aspx With Traumatic Brain Injury TBI https://www.health.pa.gov/topics/programs/Pages/Head-Injury.aspx With Autism Spectrum Disorder https://www.dhs.pa.gov/Services/Disabilities-Aging/Pages/Autism-Services.aspx or other Neuro-Developmental Disorder/Intellectual Developmental Disorder IDD https://www.dhs.pa.gov/providers/Providers/Pages/Developmental-Programs.aspx With Physical Disabilities DOH https://www.health.pa.gov/Pages/default.aspx At Risk for Suicide https://preventsuicidepa.org/ FEDERAL The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. https://www.samhsa.gov/ Centers for Medicare & Medicaid Services https:// www.cms.gov/

Headstart.gov < Back Headstart.gov Website for Locating Head Start Learming Centers Nationwide.Early childhood education

HCSIS Services and Supports Directory < Back HCSIS Services and Supports Directory The HCSIS Services and Supports Directory is a tool for individuals with mental retardation, their families, and circle of support to locate services and service providers in the Commonwealth of Pennsylvania. The directory can help you locate particular service providers or search for services and supports provided in an individual's community. This directory does not include information on all providers but only of those that have chosen to be listed in it. This directory also provides information about specific services funded by the Office of Developmental Programs (ODP) under the home and community-based waiver programs.

Northeast Philadelphia Children and Adults with ADHD < Back Northeast Philadelphia Children and Adults with ADHD Mission/ObjectivesCHADD's primary objectives are: to provide a support network forrents and caregivers, to provide a forum for continuing education, to be a community resource and disseminate accurate, evidence-based information about AD/HD torents, educators, adults, professionals, and the media, to promote ongoing research, and to be an advocate on behalf of the AD/HD community.The mission of CHADD is stated as CHADD CARES. Specifically, CHADD works to improve the lives of people affected by AD/HD through:Collaborative LeadershipAdvocacyResearchEducation andSupportGoals/PrioritiesCHADD has three current priority objectives: (1) to serve as a clearinghouse for evidence-based information on AD/HD, (2) to serve as a local face-to-face family support group for families and individuals affected by AD/HD, and (3) to serve as an advocate for appropriate public policies and public recognition in response to needs faced by families and individuals with AD/HD.In addition to our informative Web site, CHADD also publishes a variety of printed materials to keep members and professionals current on research advances, medications and treatments affecting individuals with AD/HD. These materials include Attention! magazine, the CHADD Information and Resource Guide to AD/HD, News From CHADD, a free electronically mailed current events newsletter, as well as other publications of specific interest to educators, professionals andrents.History of the OrganizationCHADD was founded in 1987 by a small group ofrents of children with AD/HD and two treating psychologists in Plantation, Florida (near Miami). Theserents came together because they felt frustrated and isolated, and there were few places to turn for support and information about AD/HD.Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) was founded in 1987 in response to the frustration and sense of isolation experienced byrents and their children with AD/HD. At that time, one could turn very few places for support or information. Many people seriously misunderstood AD/HD. Many clinicians and educators knew little about the disability, and individuals with AD/HD were often mistakenly labeled "a behavior problem," "unmotivated," or "not intelligent enough."Individuals and families dealing with AD/HD turn to CHADD, the national organization representing individuals with AD/HD, for education, advocacy and support. AD/HD is medically and legally recognized as a treatable yet potentially serious disorder, affecting up to three to five percent of all children, and approximately two to four percent of adults.Today, children with AD/HD are eligible for special education services or accommodations within the regular classroom when needed, and adults with AD/HD may be eligible for accommodations in the workplace under the Americans with Disabilities Act. CHADD is a success story, inspired by the desire of countlessrents to see their children with AD/HD succeed. From onerent support group in Florida, the organization grew dramatically to become the leading non-profit national organization for children and adults with AD/HD.The organization has a small national staff, which manages the day-to-day responsibilities, while its Board of Directors sets policy and oversees the organization's well being. The organization is composed of dedicated volunteers from around the country who play an integralrt in the association's success by providing support, education and encouragement torents, educators and professionals on a grassroots level through CHADD chapters. Along with its growth in membership and reputation, CHADD has retained thession and commitment of its founders.

Support in a Crisis and/or When You Feel Alone Military < Back Support in a Crisis and/or When You Feel Alone Military Support in a Crisis and/or When You Feel Alone Throughout your life, you are likely to face and overcome any number of crises. You may experience the loss of a loved one, you may go through a divorce or you may experience a natural disaster. Knowing who to turn to for support during a crisis can help you feel less overwhelmed and more able to manage your feelings and reactions. Depending on the nature of the crisis, you may need direction as to the next steps to take, you may need medical support, or you may just need a listening ear and a shoulder to lean on or you just may need to VENT! The next time you face a crisis on your own, use these tips to help you cope while it's happening and recover more quickly afterward: Let others know you need support, and be specific about what you need. Tell a trusted friend or relative about the crisis. Don't assume that the people close to you know that you need help. (they probably do not know) The more specific you are, the more likely you are to find the kind of help you need. Develop a strong support system, and consider joining a support group . New and old friends, neighbors, classmates, or people from your military unit may be happy to assist you once they know you need help. There are groups for almost every difficult situation, such as natural disasters, specific illnesses, the death of a relative, or divorce. Express your feelings. You may want to keep a journal or send short email messages about your feelings to people you trust. These can help you feel connected to people without actually seeing them. Be patient with yourself, and try to keep up your routines. You may need more time to deal with a crisis if you don't have a partner or support network of family or friends. Having a schedule for your activities will help to keep you moving forward in a crisis. Reduce your stress. Ways to decrease stress include eating healthy meals, getting plenty of rest, and exercising regularly. Many people find they can decrease stress by meditating, reading a book, journaling, and listening to music. Crafts, hobbies, and learning to do something new can also take your mind in a different direction! Libraries and craft groups may also be helpful. Most of the time we cannot alter our circumstances. It is what it is. But, anything that can take your mind into a new direction instead of wanting to focus on the issue may be a way to help you. Box breathing, attending a church, synagogue, or place of worship, and becoming involved in activities is another possibility. Brainstorm other ideas! Focus on the things you can control and change. In a crisis, you may feel that many aspects of your life are out of your control and they be as well. Focus on the things you can accomplish, and work to make improvements in those areas. Feeling like you are in control of some things may make it easier for you to deal with the things you cannot control. It may take some time to find those things you can control so get a notebook, and keep working on a list. List what you can control, change, or stop doing. You decide what to list! Finding support if you are ill or injured Experiencing a medical crisis comes with its own unique challenges and circumstances, but with some careful thought and planning, you may feel better prepared for them. Keep in mind that most of us do not go about planning for disasters of any kind, however, it is a good idea in some ways. The following tips are designed to help you find support if you are feeling unable to cope on your own: Make a list of people who could help in a health crisis. Work with healthcare providers to draw up a list of needs you may have, such as hospital visits, home health care, and transportation to appointments. Most entities have access to provide you with a social worker. List the people who could do the tasks, so you'll have an idea just how many people you might need. Find a friend or relative who can help you manage your care. In a health crisis, you may have more needs than you can manage effectively on your own. Look for a friend or relative who can help. Remember for some things, like phone calls, research, etc. you can ask someone who does not even live around you! Also, we have the option to order groceries, etc. so someone could just pick it up and drop it off! Think about whether you would benefit from using a patient advocate. Patient advocates speak on a patient's behalf and help monitor his or her medical care. They may help research your treatment options, work with your doctors and nurses, and negotiate with your insurance company. They also have experience to help you anticipate and understand other needs you may have done the road. Look into national organizations that can help. Many national groups help people cope with specific health conditions. To find groups for people with your health concern, search the Internet for the name of your condition and "organization" or "association." You can also get a referral from your doctor. And remember! someone can also do that for you if they have a phone and access to the internet! VA Caregiver Support Program https://www.caregiver.va.gov/ If you feel overwhelmed or unable to cope No one should have to struggle alone. Sharing your feelings with family and friends and reaching out to clergy or counselors can be productive and therapeutic, especially in times of crisis. Today there are many help and warm lines and chat lines for people to use as well. Sometimes it is comforting to speak to someone who does not know you. There is no shame or weakness in acknowledging that you're having trouble coping. Not reaching out is a much worse choice when you are vulnerable. The military can provide you with further resources and help you connect with a non-medical counselor. You can reach them by phone at 800-342-9647 at the National Resource Directory. Finally, remember that even if you feel alone, you aren't alone. There are many people - whether you know them now or not - and organizations that are ready and willing to provide the support you need. By planning ahead and reaching out to them, you'll be better able to manage if and when you are faced with a crisis, which may bring great peace of mind in the present. Crisis Symptom Reporting Guide When the Veteran you care for is in a medical crisis, your ability to observe symptoms and report accurately could be lifesaving. During this stressful time, you may find it difficult to think or function as clearly as you normally would. Below is a list that will help you remember what to look for during a crisis. It is a good idea to read this list ahead of time so you have some idea of what to expect, and then tuck a copy in the patient file you created for the Veteran for later reference. What time did the problem start? What was the Veteran doing when the problem started? Do you know or suspect what might have caused the problem? What was the first symptom that you noticed? What other symptoms/complaints do you remember? Did the symptoms come on abruptly or gradually? Was the Veteran given any medication or medical treatment just before the problem started? If so, what was it? Did the Veteran say anything about how he or she felt when the problem started and/or as it progressed? What was it? Does the Veteran have a history of this kind of problem? If so, what was the previous diagnosis? What did you do to try to help the Veteran between the time the problem arose and the time you arrived in the emergency room or the doctor’s office? Did something work well? Seem to make things worse? When to Call for Help. When is a crisis a crisis? When should you call someone else for help? Get help whenever the Veteran is in medical distress and you aren’t sure what to do. Call your local rapid-response number (e.g., 911) or an ambulance if the Veteran: Is unconscious. Has unexplained chest pain or pressure. Is having trouble breathing or is not breathing at all. Has no pulse. Is bleeding severely. Is vomiting blood or bleeding from the rectum. Has fallen and may have broken bones. Has had a seizure. Has a severe headache and/or slurred speech. Has pressure or severe pain in the abdomen that does not go away. Is unusually confused or disoriented. and lastly, if you just feel something is not right but you cannot put your finger on it! Go with your gut. Also Call for Help If: Moving the Veteran could cause further injury. The Veteran is too heavy for you to lift or help. Traffic or distance would cause a life-threatening delay in getting to the medical center. Much of this list came from a list on the http://www.va.gov/ website from some years ago.