1. MissionStatement
PoliciesandProcedures
➢ ProgramIntendedOutcomes
➢ ProgramGoalsforInstruction
➢ ProgramEnhancementPlan
➢ Mannerofservicedelivery,suggestedinterventions,numberofsessions,content,andflow
2. JobDescription
➢ Application
➢ LettersofRecommendation
➢ ResumeandCertifications
➢ BackgroundScreening
➢ TrainingPeriod
➢ Expectations
➢ DressCode
➢ ProgramEvaluation
➢ SchedulingandMeetings
➢ GeneralOutingCurriculum
➢ OurCoreValues
➢ FeedbackSystem
➢ CulturalandIndividualDifferencesTraining
➢ Harassment
➢ AlcoholandDrugPolicy
➢ ProhibitionofFirearmsandWeapons
➢ MedicalTrainingRequirements
● RecertificationReimbursement
● CPRforOurClients
➢ ResponsibilityofLevels
● LeadInstructor
● SupportInstructor
● ProgramDirector
● ExecutiveDirector
➢ TechnicalSkills&EquipmentTraining
➢ TeachingSkills
➢ InterpersonalSkills
3. Client
➢ InitialClientAssessment
➢ WaiverandPhotoRelease
➢ AssessmentofLearningOutcomesandLevelsofProgram
➢ NaturalVersusArtificialConsequences
➢ AdequateWater,Nutrition,andClothing
➢ HIPAACompliance
➢ NoShowsandNoncompliance
➢ PlanforParentalInvolvement
➢ VisitationtoPrivateHomes
➢ Non-discriminationpolicy
➢ InvestigationReporting
➢ Consequences
4. Pre-TrekPoliciesandProcedures
➢ FirstAidKitCheckandCarCheck
➢ InstructorDebrief
➢ Instructor-to-ParticipantRatios
➢ WeatherandTerrainCheck
➢ AppropriateEquipment,Clothing,andFootwear
5. During-TrekPoliciesandProcedures
➢ IncidentReports
➢ HealthCareandDispensingMedication
➢ BehavioralManagement/PhysicalRestraint
➢ FirstAidProtocols
➢ ForestServiceRegulationsandPermittedLand
➢ 7PrinciplesofLeaveNoTrace
➢ AbuseReporting
➢ DetoxSymptoms
➢ Knife/Tool/OtherSafety
➢ LightningProtocol
6. SafetyandEmergencyActionPlan(EAP)
➢ EmergencyOn-CallChainofCommand
➢ MedicalEmergencies
➢ EvacuationProcedures
➢ SafetyHazards
➢ Self-harmandSuicideProtocol
➢ Lost-PersonProtocol
➢ ProgramSpecificWildernessMedicinePractices
7. VehicleOperations/SafetyandProcedures
PoliciesandProcedures
1. MissionStatement:PIVOTPointWNCprovidesmindfulness-centered, therapeuticwildernessexperiencestothoserecoveringfromsubstance usedisorderpromotingconnection,compassion,andcharacter.
➢ ProgramIntendedOutcomes
● Engagingparticipantsinaseriesofengagingscenariosdesignedto mitigatetheeffectsofstressorsgenerallyassociatedwithsubstanceuse andmisuse.
● Clientswillreducespecificproblembehaviorspresentedatreferraland targetedinindividualserviceplans.
● Clientswilldemonstrateimprovementintargetedskillsidentifiedinthe individualserviceplan.
● Asrelatedtoadjudicatedandcourt-involvedclients,participants will havenonewcomplaintsafteranoffensedateaftertheadmissiondateto PIVOTPointWNC.
● Clientswillreducecurrentsubstanceuse,willavoidfutureorexpanded substanceuse,andwillincreasepro-socialinteractionresultingin increasedpositiveoutcomesandreducedrecidivism.
➢ ProgramGoalsforInstruction
● PIVOTPointWNCuseshands-on,tangibleandpracticalactivities implementedinthenaturalenvironmenttochallenge,instruct,andprovide opportunitiesforparticipantstopracticepro-social,interpersonal, problem-solving,communicationandself-regulationskills.
● Clientsgenerallywillexperienceanincreaseinself-awareness,leadingto anincreasedrecognitionofbehavioralconsequencesandavailable choices.
● Clientswillhaveahigherlevelofaccountabilitybothtoselfandothers.
● Clientswilllearnhealthiercopingstrategiesleadingtoanincreased environmentalcontrol.
● Clientsareprovidedtangibleevidenceofsuccess,therebycorrecting negativeself-conceptionsandleadingtoamorepositiveself-concept.
● Clientslearncreativeproblem-solving,communicationandcooperation skills.
● Throughtherapeuticadventure,clientsfacilitaterealisticappraisalof individualstrengths,weaknesses,andself-imposedlimitations.This ultimatelyleadstobetterdecision-makingabilities.
➢ ProgramEnhancementPlan
● PIVOTPointwillincorporateFITAssessmentstohelptrackthe therapeuticalliancewithclientsinordertointervenewithclientswho aren’tfeelingheardandseenaswellastotrackwhenclientsarefeeling especiallyheardandseenbystafftobestmeetourclients.
● PIVOTPointstaffwillconsistentlybeworkingonstaffmanualsthat incorporatealllevelsoftrainingneededtobestserveclients.
● PIVOTPointgroupsarebasedoutofevidence-basedpracticesand curriculum.
➢ Mannerofservicedelivery,suggestedinterventions,numberofsessions, content,andflow
● PIVOTPointmeetsclientsatacentrallocationorpicksthemupfromtheir residencesiftransportationisanissue.
● Theprogramdurationvariesdependinguponthespecificcontract.
● Interventionsarebaseduponprogramcurriculum,parent,therapist,and clientgoalsandarerevisedandexpandeduponastherelationship developswiththeclient.
● InterventionsandgroupfacilitationisinformedbyGestaltprinciples, mindfulness-basedpractices,motivationalinterviewing,community resiliencemodel,andcognitivebehavioraltherapyamongothers.
2. JobDescription
➢ Application
● Anapplicationwillbeprovidedandkeptonfileforeachguideand employee.Ifanychangestoaguide’scriminalstatushappenduring employmentthentheyaretorelaythatinformationtotheProgram
Directorimmediately Failuretodosocouldresultindisciplinaryaction andultimatelyterminationonacase-by-casebasis.
➢ LettersofRecommendation
● Allguides/employeesofPIVOTPointWNCwillprovide recommendationstopersue.
➢ ResumeandCertifications
● GuidesmustcarryacurrentWFA/WFRcertificationinadditiontohaving acurrentadult/childCPRcertificationintheirpersonnelfile.
● Guidesmusthaveacurrentresumeintheirpersonnelfile.
● AtalltimesoneofthetwostaffonshiftmusthaveactiveWFRand adult/childCPR.
● JCPCwillbeinformedofanychangesinlicensureorcertification immediately
➢ BackgroundScreening
● ApplicantswillneedtocompleteaClearChecksbackgroundchecksupon hiringandannuallythereafter.
➢ TrainingPeriod
● Thetrainingperiodforallguideswillinvolveoneobservedunpaidtrek, twopaidsupport-facilitatedtreks,andonepaidassupportlead-facilitated trek(observedbytrainer/facilitator).
● Trainings,certifications,andfeedbackwillbetrackedforeachcontractor, volunteer,intern,andstaffmemberviathestaffmanualsandstaffprocess trackingspreadsheet.
➢ Expectations
● Allguidesareexpectedto:
● KeepappropriateboundarieswithclientsasdetailedintheSupport TrainingManual.
● Keepaprofessionalappearance.
● Bepunctualtoeverymandatorymeetingandouting.
● Followallpoliciesandprocedures.
● Properlydocumentbeforeandaftereverytrek.
➢ DressCode
● IndependentContractorsandStaffneedtowearactivityappropriate clothingthat’smindfulofpotentialclienthistoryoftraumaandbody imageissues.Participantsneedtowearactivityappropriateclothing.This includesclose-toedshoes.
➢ ProgramEvaluation
● FieldevaluationswillbecompletedusingtheFieldEvaluationform quarterly
● StaffManualsandthestaffprocesstrackingspreadsheetwillbeutilizedto constantlyevaluateandgivefeedbacktostaffaswellastohavethem completeallappropriatetrainingastheyarepromotedthroughthelevels.
➢ SchedulingandMeetings
● Guidesareexpectedtoattendamandatorycontractormeetingevery month.
● GuidesareexpectedtocheckinwiththeProgramDirectorfourdays beforeacommittedtrekdate.
➢ GeneralOutingCurriculum
● Eachoutingshouldconsistofaninitialcheckinconsistingofgettinga goodfeelforthegroupdynamics,whateveryoneisbringingtothetrek today,andincludingameditationorgroundingexerciseofsomesorttoset thetonefortheday.Throughouttheday,everymomentcanbean opportunitytocheckinandprocesswhatmightbecomingupfor everyone,useyourintuitionandfacilitationexperiencetodiveintothose momentswithcuriosityandexplorethroughmindfulnesswhateveryone’s experienceindividuallyandcollectivelymaybe.Thereshouldbebetween 3-5groupsduringeachtrek,sometimesmoredependingonthegroupand whatcomesupthroughouttheday.Everythingfromatoughuphill,a trickyrapid,initialfearofclimbing,atiffwithanotherclient,oracalm quietlakecanbeaninvitationtoprocessanddeepentheexperience.Each outingwillbe4-8hoursinlengthincludingtransportation.Facilitatorisin chargeofthat,nottheclients.
➢ OurCoreValues
● Intentionality(honesty,integrity,accountability,fairness,equity)
● Growth-oriented(community,organization,individuals)
● Team-oriented(allstars,captain,coach)
➢ FeedbackSystem
● GuideswillgiveeachotherfeedbackaftereachoutingandtheProgram Director,ExecutiveDirector,andleadguideswillgiveeachsupportstaff feedbackthreetimesthroughouttheirtimebeingsupportstaffonthe expectationsdetailedinthestafftrainingmanual.TheProgramDirector andExecutiveDirectorwillgivefeedbackthreetimestoleadguidesas wellbeforetheyareabletotransitiontomasterontheexpectations detailedinthestafftrainingmanual.
➢ CulturalandIndividualDifferencesTraining
● GuideswillhaveaccesstoClinicalFirstResponderTraining/Mental HealthFirstAid,EquityTraining,aswellasMotivationalInterviewing levels1and2.
➢ Harassment
● Sexualharassmentisunwelcomeconductofasexualnaturethatis persistentoroffensiveandinterfereswithanemployee'sjobperformance orcreatesanintimidating,hostileoroffensiveworkenvironment.Sexual harassmentisdefinedbythefederalEqualEmploymentOpportunity Commissionasunwelcomesexualadvances,requestsforsexualfavors, andotherverbalorphysicalconductofasexualnaturewhen,forexample: a)submissiontosuchconductismadeeitherexplicitlyorimplicitlyaterm orconditionofanindividual'semployment,b)submissiontoorrejection ofsuchconductbyanindividualisusedasthebasisforemployment decisionsaffectingsuchindividual,orc)suchconducthasthepurposeor effectofunreasonablyinterferingwithanindividual'sworkperformance orcreatinganintimidating,hostileoroffensiveworkingenvironment.
Sexualharassmentcanbephysicalandpsychologicalinnature.An aggregationofincidentscanconstitutesexualharassmentevenifoneof theincidentsconsideredonitsownwouldnotbeharassing.Physical assaultsofasexualnature,suchasrape,sexualbattery,molestationor attemptstocommittheseassaults,andintentionalphysicalconductthatis sexualinnature,suchastouching,pinching,patting,grabbing,brushing againstanotheremployee'sbodyorpokinganotheremployee'sbody.
Unwelcomesexualadvances,propositionsorothersexualcomments,such assexuallyorientedgestures,noises,remarks,jokes,orcommentsabouta person'ssexualityorsexualexperience.Preferentialtreatmentorpromises ofpreferentialtreatmenttoanemployeeforsubmittingtosexualconduct, includingsolicitingorattemptingtosolicitanyemployeetoengagein sexualactivityforcompensationorreward.Subjecting,orthreatsof subjecting,anemployeetounwelcomesexualattentionorconductor intentionallymakingperformanceoftheemployee'sjobmoredifficult becauseofthatemployee'ssex.Sexualordiscriminatorydisplaysor publicationsanywhereinPIVOTPointWNC'sworkplacebythe PIVOTPointWNCemployees/contractors.
● Violationsoftheharassmentpolicywillresultindisciplinaryactionand potentiallytermination.
➢ AlcoholandDrugPolicy
● Employeesandcontractorswillnotbepermittedtousealcoholordrugs beforeorduringanyPIVOTPointWNCexperience.Amandatorydrug screenwillberequiredintheeventofanaccidenthappeningwhilethey aredrivingthevehicle.PIVOTPointWNChastherighttodrugtestatany timeatwill.
● Ifthetestcomesbackpositive,theywillbeterminated.
➢ ProhibitionofFirearmsandWeapons
● PIVOTPointWNCstaffandfacilitatorswillneveruseorbeinpossession ofanyfirearmorotherweaponwhileworkingwithclientsnorwillthere everbeafirearmorweaponatanysiteorinanytransportationvehicle.
➢ MedicalTrainingRequirements
● Guideswillbenotifiedandalertedofrecertificationdatesandreimbursed after20facilitatedtreksfollowingthetrainingperiod.
● CurrentAdultandChildCPRisrequired.
● CurrentWFAorWFRisrequired.
➢ ResponsibilityofLevels
● LeadGuide
○ ReadFullTimeLeadStaffAppendixfordescriptionofrolesand responsibilitiesforfulltimeLeadStaff.ShiftLeadStaff
descriptionofrolesandresponsibilitiesinclude,butarenotlimited tothefollowing:
○ Demonstratesconsistentunderstandingandapplicationof MotivationalInterviewingLevel2.
○ DemonstratesconsistentunderstandingandapplicationofCFR: Alongwithimprovingtheirtherapeuticskillset,staffwillfeel supported,empowered,andprepared—factorsthatenhance performanceandimprovestaffretention.CFRCertifiedtraining alsopreparesstafftomoreeffectivelyhandleday-to-daytreatment issuesandtorespondtotheinevitablecrisesthatoccur.
○ DemonstratesWildernessFirstResponderpracticalskillsto maintainconfidenceandmakecriticalmedicaldecisionsina wildernesssetting.
○ DemonstratesworkingknowledgeofNCI+Preventioncourse: developmentofcommunicationskills,relationshipbuilding,skills neededtoidentifyescalatingbehaviors,andunderstandingclients.
○ Consistentlydemonstratesworkingknowledgeofweatherapps andutilizingittomakebothaplanandanalternativeplanforthe outing.
○ Consistentlydemonstrateseffective,timely,andclear communicationwithprogramstaffandreferralsourceregarding weather,gear,andoutingdetails.
○ CommunicateswithProgramDirectorandprogramstaff4days beforeeachoutingandincludesProgramDirectoronall communicationwithclientsandprogramstaff.
○ Candemonstratesetupandknockdownofallgearand consistentlyreturnsgearinitsoriginallocationandwithconsistent organization.“Leaveitthewayyoufoundit”.
○ ConsistentlyputsiPadwhereitbelongsanddemonstrates proficientworkingknowledgeofrelevantapps,documentation, andorganizationwiththedevice.
○ Consistentlydelegateswithclarity,context,andguidance.
○ Demonstratesworkingknowledgeofallitemsinthemedkitand utilizesthatknowledgeappropriatelybothinthefieldandin practicescenarios.
○ Reviewsandincorporatespreviousouting’sclientnotesintoouting planningandfacilitation.
○ Effectivelycommunicatesscopeofintentionsandexpectationsfor thedaywithsupportstaff/volunteers/interns.Additionallyoffers spaceforthefacilitationteaminordertomosteffectivelyshowup forclients.
○ Ensuresthatvolunteersandinternsareawareoftheirexpectations fortheday,the5inappropriateareasofsharing,andactive listeningvs.advicegiving.
○ Consistentlyshowsuptooutingsfed,rested,andgroundedforthe day.
○ Consistentlyappliesknowledgeabouteachclientfromtheirintake paperworktobestservethatclient.
○ Consistentlyandappropriatelyasksclientsaboutasthma,seizures, anddiabetesbeforeenteringthevehicle.
○ Maintainsboundariesandclientexpectationsduringtransportation.
○ Groupfacilitationexpectations
○ Consistentlyfacilitates3-5groupsperouting.
○ Introgroupbeginswithfoundationofwhatyou’recomingout therewithandestablishestoneandsafetyfortheday.
○ Maingroupcarriesmomentumofinitialtoneandexpectationsfor thedayandincorporatesactivelistening,motivationalinterviewing skills,concise/targetedquestionformat,andrepackswhatwas unpackedwiththeclients.
○ Consistentlyutilizesnatureandmetaphortohighlightandleverage theclientexperiencetoencouragebeingpresentinthemomentand buildself-awareness.
○ Consistentlyutilizesmeditationresourcesatleastonceperouting.
○ Consistentlyoffersspaceforsummary/conclusionofeachouting experienceand“closes”experiencethroughSMARTgoalsetting,
metaphoricreleaseofthingsthataren’tservingyou,gratitude, and/orformalintentionalreflection.
○ Consistentlyapproachesclientswithcongruence,unconditional positiveregard,andempathy.Thiscanbenotedthrough relationshipsandrapportformedwitheachclient.
○ Consistentlyandappropriatelyutilizestoneofvoicewithclients.
○ Consistentlyevaluatestheneedsofclientsandresponds effectively.
○ CandemonstratehowandwhentoadministerNarcanandidentify substancewithdrawalsignsandsymptoms.
○ Demonstratesworkingknowledgeofallemergencyprotocols.
○ Demonstratesfamiliaritywithexperientialgameresourcelistsand whenandwithwhomtousethem.
○ Demonstratesabilityandfamiliaritywithpopulationswithwhom weworkandhowtofacilitatetherapeuticadventureinavarietyof scenarios.
○ Consistentlyprovidesdetailedindividualizedoutingdebriefs incorporatingsupportstaff’snotesandperspectiveandrelaysall relevantinformationinatimelymanner Isavailabletoprovide followupconversationandreflectiontotheleadershipteamas needed.
○ CompletedallrequiredreadinganddiscussedwiththeProgram Director.
○ Demonstratesworkingknowledgeofneedsvs.wantsand Glassner’sneedsmodel.
○ Demonstratesworkingknowledgeofnonviolentcommunication training.
○ Consistentlypracticesappropriateself-care.
○ Exhibitsproficientknowledgeofthestagesofchangeandusesthat knowledgetoinformdelivery,reception,andexecutionof feedback.
● Expectationsforsupportguideare:
○ Recognizethepotentialriskfactorsandwarningsignsforarange ofmentalhealthproblems,including:depression,anxiety/trauma, psychosisandpsychoticdisorders,substanceusedisorders,and self-injury.
○ Usea5-stepactionplantohelpanindividualincrisisconnectwith appropriateprofessionalhelp.
○ Interprettheprevalenceofvariousmentalhealthdisordersinthe U.S.andtheneedforreducednegativeattitudesintheir communities.
○ Applyknowledgeoftheappropriateprofessional,peer,social,and self-helpresourcesavailabletohelpsomeonewithamentalhealth challengetreatandmanageitandachieverecovery
○ Recognizeandconsistentlyexhibitcompassionformarginalized andunderservedpopulations.
○ Consistentlyexhibitsaworkingknowledgeofmotivational interviewing.
○ Knowsalltrailsthatwe’repermittedtogoon.
○ CanutilizeFITapp.
○ Canutilizeweatherappsandhasaconsistenttrackrecordofusing them.
○ Consistentlychecksclientgearbeforeenteringthevehicle.
○ Consistentlyshowsupinappropriateattireandwiththe appropriatepersonalgearfortheday.
○ Consistentlyturningincompletelyfilledoutclientpreandpost trektrackingintothecorrectfolder
○ Consistentlyholdshealthyandprofessionalboundarieswithclients bothemotionally,physically,andinthecar.
○ Consistentlydoesnottalkaboutthe5areasofinappropriate sharingwithstaff.Caneffectivelyredirectandholdboundaries whenclientsbringthemup.
○ Demonstratesabilityofsafetyplanningandappropriateredirection oftopicsoutsideofourscopeofpracticewheninthefieldifthe opportunityarises.
○ Demonstratesabilitytobuildrapportwithclients.
○ DemonstratesabilitytoutilizetheSATphone.
○ Demonstratesworkingknowledgeofallpoliciesandprocedures.
○ Demonstratesaworkingknowledgeofleadingthebackofahike.
○ Demonstratesaworkingknowledgeofknots,tarpsetup,andfire striking.
○ ConsistentlyteachesanddemonstratesLeaveNoTracePrinciples.
○ Consistentlyholdsboundariesaroundinappropriateinhalantsin thewoodsbeforeclientsgetintothevehicle.
○ Consistentlyasksclientsiftheyhavealloftheirpersonalgear whenexitingthevehicle.
○ Consistentlycleansandsanitizesvehicle.
○ Consistentlyshutsgaragedoorandgate.
○ ConsistentlythrowsawaytrashandalertsMattofanytowelsleft inthegarage.
○ Hasreadallrequiredreadings.
○ Consistentlydemonstratesworkingknowledgeofactivelistening andholdingspaceinthefield.
● ProgramDirector:marketingandclientdevelopmentoversight;logistics coordinator;administrativedirector;personneloversight,evaluation,and training.
3. Client
➢ InitialClientAssessment
● It’stheresponsibilityoftheProgramDirectortoupdateleadguidesonall medicalandpsychologicalinformationpertinenttotheclientsbeforeeach outing.
➢ WaiverandPhotoRelease
● It’stheresponsibilityoftheProgramDirectortoensurethatallwaivers, releases,andintakepaperworkarecompletedproperlyandthoroughly
➢ AssessmentofLearningOutcomesandLevelsofProgram
● PIVOTPointWNCimplementsFITAssessments.Guidesshouldhave eachparticipantcompletethisbeforeandaftereachtrek.
● PIVOTPointimplementspreandposttrektrackingformsbasedonour outcomes.
● PIVOTPointimplementsFITassessmentstotrackthetherapeuticalliance withstaffandclients.
● ClienttrackingweeklyandcreationandadherencetoIndividualized ServicePlanswillalsotracklevelofprogramandoutcomes.
➢ NaturalVersusArtificialConsequences
● Duetothedurationofastandardouting,clientsareresponsiblefortheir ownwaterandsnacksinadditiontoeatinglunchbeforetheouting.
➢ AdequateWater,Nutrition,andClothing
● Itistheresponsibilityoftheguiderunningthetrektoinstructclientson properclothingandfootwearandtoadviseforwateractivitiesandinform ofterrain.PIVOTPointWNCclientsareresponsibleforbringing appropriateclothingandadequatewaterontreks.
● Snacksmaybeprovidedbyguidesasavailable;butclientsareresponsible foreatingpre-trekandbringingany/allfoodandsnacksfortheday.
➢ HIPAACompliance
● Allclientpersonalinformation,disclosures,andinformationgatheredvia clientassessmentsheetoronatrekisnottobesharedorcommunicated withanyoneexcepttheExecutiveDirectorandProgramDirector. Non-complianceinthismayresultintermination.
● Guidesarenotallowedtobe“friends”or“followed”byclientsonsocial mediaortosocializewiththemoutsideofPIVOTPointoutings.
➢ NoShowsandNoncompliance
● PIVOTPointWNCwillappropriatelylogallnoshowsand noncompliance,alertfamiliesofclients,and/orcounselorsofreferring agencies.
● Aftertwononcompliantactivities,PIVOTPointwillconsidertermination.
➢ PlanforParentalInvolvement
● ParentsofDJJreferredyouthwillbeconsultedonIndividualService Plansalongwithcourtcounselorsandwillbedevelopedwithin30daysof intake.Communicationwillcontinuethroughouttheprogram.Staffwill
beavailable30minutespriortothestartofoutingsand30minutesafter outingsplanneddropofftimesforparentalcommunicationand involvement.
➢ VisitationtoPrivateHomes
● Staffwillcommunicatewithparentsofyouthrequiringindividualized pickupanddrop-off.Pickupwillbeatatimethatallowsthefacilitatorto arriveatCarrierPark30minutespriortooutingstarttime.
➢ Non-discriminationPolicy
● PIVOTPointdoesn’tdiscriminateorrefertoprogramsorindividualswho discriminatebasedonrace,color,sex,language,religion,politicalorother opinion,nationalorsocialorigin,property,birthorotherstatussuchas disability,age,maritalandfamilystatus,sexualorientationandgender identity,healthstatus,placeofresidence,economicandsocialsituation.
➢ InvestigationReporting
● PIVOTPointwillreportallethical,disciplinary,investigationofconduct, andanyabuseorneglectbyprogramstafftoDPSconsultantwithin5days oftheincident.PIVOTPointwillalsocontinuouslyupdateDPSonthe processoftheinvestigation.
➢ Consequences
● PIVOTPointdoesnotuseanyhumiliation,verbalorphysicalabuseor intimidation,fearorphysicalpaininpracticeorasconsequences.Natural consequencesthatmothernatureprovidesaretheonlyformof consequencesthatPIVOTPointinvolves.
● IfaPIVOTPointstaffissuspectedofabuseorneglectthentheywill undergoaninvestigationandwillbesuspendedfromalloutingsuntilthe investigationiscomplete.
● DSSwillbeinformedimmediatelyofanyabuseorneglectby PIVOTPointstaffandjuvenileswillbetransferredtoadifferentstaff member.
● DPSconsultantwillbeupdatedimmediatelywithanyprogressonthe investigation.
➢ MedKitCheckandVehiclePre-Tripgoogleformshouldbefilledout pre-trekeverytrek
➢ Instructordebriefonpertinentmedicalandpsychologicalinformation
➢ Instructor-to-ParticipantRatios
● 2:10atmostatalltimes
➢ WeatherandTerrainCheck
● Guidesshouldensurethattheweatherandterrainareappropriateforthe participants.
➢ AppropriateEquipment,Clothing,andFootwearforallTreks
● Backpack
● Waterproofshoes/shoesthatcangetwet
● Changeofsocks
● Waterandsnacks
● Layers:windbreaker,baselayer,raingear,etc.
● ONLYwateractivities:ONLYclosed-toesshoes;NObootsorsandals; NOcottonclothingifpossible
5. During-TrekPoliciesandProcedures
➢ IncidentReports
● IncidentReportswillbeprovidedandshouldbefilledoutforany/all;
○ Field-RelatedIncidents
○ MinororMajorInjuries
○ Illnesses
○ Evacuations
○ BehavioralIncidents
⇻ AdverseReactions
⇻ PsychiatricEpisodes
⇻ Anger,Impulsivity,AggressiveBehavior
○ Suicide/Self-HarmReporting
○ Ifaclientgoesmissingformorethan15minutes.
○ CarAccident
● Incidentreportsshouldbefilledoutbythestaffmember,Program Director,andclientinvolvedintheincident.
30CumberlandAve.,Suite103|Asheville,NC 28801-2206|pivotpointwnc.org
➢ HealthCareandDispensingMedication
● PIVOTPointWNCstaffandfacilitatorsareexpectedtoworkwithinthe parametersoftheirWFRcertification.Theywillnotdispensemedication unlessitistomitigatelifethreateningsituationsundertheconfinesoftheir WFRcertification.
➢ BehavioralManagement/PhysicalRestraint
● AllfacilitatorswillutilizetheirCFRtrainingtopre-emptivelyestablish rapportthrougheffectivenonviolentcommunicationandappropriate behavioralmodeling.
● PIVOTPointWNCstaffarenotpermittedtoutilizephysicalrestraint.
➢ FirstAidProtocols
● FirstAidProtocolsshouldbefollowedperWFR/WFAinstructionunless otherwisestatedinPIVOTPointWNCPoliciesandProcedures.
➢ ForestServiceRegulationsandPermittedLand
● Pisgah(NSFS):WearepermittedtooperateinBlackBalsamKnobArea (accesstoFlatLaurelCreekTrail,TennentMountainaccessviaIvestor GapTrail/ArtLoebSpurTrain,ShiningRockWildernessviaIvestorGap Trail,andSamsKnob).WearealsopermittedforGraveyardFields,John RockTrailLoop,LookingGlassRock,BigEastForkTrail,PinnaclePark Trail,CatawbaFalls,andTwinFalls(fromPisgahHorseStablesareaor accessviaAveryCreekFallstrailheadonFSR477).
● DuPont:WearepermittedtoutilizeanyofthelandinDuPontStatePark.
● ConservationLands:Wearepermittedtoutilizeanyofthelandin conservationlands.
● GreenRiverGameLands
● Guideswillleadtherapeuticadventureoutingsin-linewithandinthe serviceofallapplicablePriorityUsepermitstipulations.
● Itistheguide’sresponsibilitytoutilizeLNTprinciples,landstewardship, andtosustainourmutuallybeneficialrelationshipwiththeselandsby beingrespectful.
➢ 7PrinciplesofLeaveNoTrace
● planaheadandprepare,
● travelandcampondurablesurfaces, 30CumberlandAve.,Suite103|Asheville,NC
● disposeofwasteproperly,
● leavewhatyoufind,
● minimizecampfireimpacts,
● respectwildlife,
● beconsiderateofothervisitors.
➢ AbuseReporting
● AnydisclosureofphysicalabuseshouldbereportedtotheExecutive DirectorandProgramDirectorimmediately.Itisnotyourjobtospeakto staffattheclient’sprogramaboutthedisclosure.
➢ DetoxSymptoms:DetoxsymptomsshouldbereportedtotheExecutiveDirector andthentheProgramDirectorimmediately.Alwayscall911incaseofan emergency Clientscanexperiencephysicalandemotionalwithdrawalsymptoms. Withdrawalfromalcoholortranquilizersisthemostdangerous,producing seizures,strokes,heartattacks,deliriumtremens,and/orresultingindeath. Withdrawalfromopiateslikeheroinandoxycontinmaybeextremely uncomfortablebutarenotdangerousunlesscombinedwithotherdrugs.Risk factorwithopiatesincreasesiftherearemultiplerelapseswithinashortperiodof timesocheckclienthistory
● AcuteWithdrawal
○ Alcohol:Intoxicationlookslikedifficultywalking,slurredspeech, loweredinhibitions,lowbloodpressure,orsmellingofalcohol. Mildtomoderatewithdrawallooksliketremors,nausea,anxiety, sweats,andsleepdisturbances.Severewithdrawallookslike deliriumtremens,visual/tactile/auditoryhallucinations,seizure, vomiting,diarrhea,anddeath.
○ Tranquilizers/Depressants:(benzodiazepinesi.e.valium,xanax, ativan,klonopin,andnon-benzodiazepinesi.e.barbituratesand rohypnol):Intoxicationlookslikedifficultywalking,slurred speech,sedation,unusualeyemovements,lowbloodpressure, drooling,andloweredinhibitions.Mildtomoderatewithdrawal lookslikeanxiety,sleepdisturbances,hypersensitivityto noise/light/touch,perceptualdisturbance,feelingsofunreality, memoryimpairment,achesandpains,andpalpitations.Severe
withdrawallookslikedepression,suicidalthoughts,agoraphobia, seizure,anddeath.
○ Opioids:(heroin,methadone,codeine,vicodin,percocet, oxycontin,morphine,etc.):Intoxicationlookslikesedation, pinpointpupils,lowbloodpressure,slowedpulse,itchingand scratching.Mildtomoderatewithdrawallookslikerunnyeyesand nose,sweating,yawning,restlessness,sleepdisturbances,dilated pupils,nausea,weakness,goosebumps,aches,cramps,jointpain, vomiting,diarrhea,hotandcoldflashes,fatigue,anddrug-seeking behavior.Thereisnoseverewithdrawal.
○ Stimulants:(cocaine,methamphetamine,MDMA,dexedrine, etc.):Intoxicationlookslikeagitation,irritability,dilatedpupils, finetremor,sweating,rapidspeechandmovement.Mildto moderatewithdrawallookslikeanxiety,agitation,depression, fatigue,extendedsleepandincreasedappetite.Severewithdrawal lookslikepsychosisandsuicidalthoughts.
● Post-AcuteWithdrawal(usuallylastsfortwoyears)
○ Anxiety,depression,moodswings,irritability,tiredness,variable energy,lowenthusiasm,variableconcentration,andsleep disturbances.
➢ Knife/Tool/OtherSafety:Guidesandclientsshouldfollowalltoolsafety protocols.Clientscanonlyuseonetoolatatimeandmustreturnthetool/knifeto theguidebeforereceivinganothertool.Clientscannotpassatooltoanother client.Guidesshouldbeawareofwhohaswhattoolatalltimes.Guidesshould beawareofwhichclientsshouldnotbeholdingtools(self-harmorsuicide concerns).Clientsshouldcutoveralogorthegroundbutnotoverortowards themselves.Don’tallowcuttingonrocksorotherhardsurfaces.Don’tsplitwood withknives.
➢ LightningProtocol:LightningisaveryrealthreatonPIVOTPointWNCTreks. Guidesshouldbeawareoftheweatheratalltimestoensuresafetyofthemselves andthegroupbyfollowingallsafetyproceduresandusingtheirbestjudgment.
Teachyourclientshowtoenterintoalightningdrillpriortoanemergency drill.LightningtendstostrikethetallestobjectintheareasoPIVOTPoint’s
protocolistogotothelowestpossibleplaceandavoidbeingthehighestornear thehighestpointofanareawhenlightningisathreat.Avoidrocks,trees,cracks, andcrevicesifpossible.Whenamongtrees,seekanareainwhichtherearemany treesofcomparableheight.Positionyourselfmidwaybetweentrees,awayfrom treetrunks,limbsandrootsystemsifpossible.Role-modelingproperlightning drillistheresponsibilityofPIVOTPointguides.Guidesshouldbeginmoving towardslightningdrilliflightningflashesandthunderhavelessthan30-40 secondsbetweenthem.5secondsequals1milesowhenthelightningis within15secondsthenguidesshouldhaveeveryoneinthelightningdrill.
Lightningdrillinvolvedspreadingout15feetapartwitheveryoneinsight. Guidesshouldbeasfarapartaspossiblewithkeepingclientsinsight. Removemetalobjectsandkeepawayfromthebody.Communicationdevices andknivesshouldbestoredawayfromthebody.Placeinsulationsuchasa backpackorsweatshirtunderyourselftoinsulatefromgroundcurrentand reduceabilitytoconductelectricity.Keepyourhandsofftheground.Crouch orsitlowandhavefeettogether,kneesbent,witharmsrestingonknees.The groupshouldremaininlightningpositionuntil15minutesafterthelast countof15secondsbetweenthunderandlightning.
6. SafetyandEmergencyActionPlan(EAP)
➢ EmergencyOn-CallChainofCommand
● GuidesshouldALWAYScall911first.
● Secondcallshouldbeoncall
● TheoncallwillcallDPSimmediatelyintheeventofanemergency involvingacourt-referredyouthoutingresultinginaseriousinjurytoor deathofastaffmember,intern,contractor,juvenile,visitor,orvolunteer.
○ DPSWesternAreaOffice:828-296-4742
● ThirdcallshouldbetotheExecutiveDirector828-748-8424
➢ MedicalEmergencies
● Followtheemergencyon-callchainofcommandprocedurefor emergencies
● Whenrequestingnon-emergencyassistanceorcommunicatinga non-emergencyrelatedincidentcalloncall
● DocumentationisKEY Signs,symptoms,times,medications,details,etc. WewillprovideSOAPnotesinyourmedkits.
● FrontCountrymedicalaccessisanythingthat’swithintwohoursof hospitalcare.Backcountrymedicalaccessisanythingmorethantwo hoursofhospitalcare.Decisionsmadebyguidesshouldreflectthis knowledgeandfollowappropriateprocedure.
● Withinthefrontcountry;guidesareexpectedtoexercisestandardfirstaid practicesandonlytoprovidefirstaidtreatmentwithintheboundsoftheir training(i.e.WFA,WFR,WAFA,EMT)exceptasindicatedin PIVOTPointWNCpoliciesandprocedures.
➢ EvacuationProcedures:Injuredperson(s)duringoutingswillbeimmediately stabilizedandcaredforbyon-siteguidesinaccordancewiththeguide's wildernessmedicinetraining(WFR/WFA/EMT).Ifitisdeemedthatahigher levelofcareisrequired,thoseaffectedwhoareabletomovesafelywillbe transportedbacktovehicleandtakentoMissionHospitalinAshevilleNCusing evacuationrouteslistedinourEAPplan.Thoseinjuredpartieswhocannotbe safelymovedwillbestabilizedonsiteandawaithigherlevelemergencycare.
➢ SafetyHazards
● Creekcrossingprotocol:clientsMUSTwearshoeswhencrossingcreeks atalltimes.Guiderunningthetrekshouldassisteveryparticipantin crossingthecreek.
➢ Self-harmandSuicideProtocol
● LowLevelofConcern:Ifaclientexpressessuicidalthoughtsor self-harmthoughtsbutthisisaregularoccuranceforthemandtheyreport aplanandhighabilitytokeepthemselvessafe.Averbalsafetypact shouldbeagreeduponbetweenstaffandclientandshouldbefollowedup oneveryhouruntilthetrekisoverandthenshouldbereportedtothe ExecutiveDirectorandProgramDirector.
● MidLevelofConcern:Ifaclientexpressessuicidalthoughtsor self-harmthoughtsandtheyfeelunsureoftheirabilitytokeepthemselves safethenawrittensafetypactshouldbemadebetweentheclientandthe staffandsignedbytheclientsayingthattheycankeepthemselvessafefor acertainagreeduponamountoftime.Ex:Iftheclientfeelsasthoughthey
cankeepthemselvessafeuntiltheendofthetrekthenstaffwouldwrite“I willkeepmyselfsafeuntilIreturntothehousetoday.”andbothwillsign it.Ex2:Iftheclientfeelsasthoughtheycanonlyagreetokeep themselvessafeforanhour(anyamountoftimehere)thenthat’swhat youwouldwriteinsteadandbothsignandthenit’stheresponsibilityof PIVOTPointWNCguidetosetanalarmontheirwatchandcheckinafter thatamountoftimehaspassedtowriteanewwrittencontract.Once returnedtothehouseitshouldbereportedtotheExecutiveDirectorand ProgramDirector.Ifaclientstopsbeingabouttocommittoaperiodof timetokeepthemselvessafethentheyaremovedto“HighLevelof Concern''(seebelow).
● HighLevelofConcern:Ifaclientisunwillingtocommittoaperiodof timetokeepthemselvessafeORisactivelyself-harming/tryingtocommit suicidethenguideshouldremainwithinarm’slengthtomitigateany furtherorlastingbodilyharm.Ifanotherguideispresent,theyshould immediatelycalltheExecutiveDirectorandProgramDirector.Ifthe self-harmisseriousenoughthenemergencyservicesmustbecalled.The ExecutiveDirectorandProgramDirectorshouldbealertedateverystep andshouldhelpmaketheplandependentonthecircumstancesandon communicationwiththeclient’sprogrammanager/clinicaldirector. ➢
Lost-PersonProtocol
● Lost-PersonProtocolshouldbeactivatedafteraclienthasbeenoutof sightfor15minutes.
● Inthissituationoneguideandotherclientsshouldnothikeanyfurther awayfromtheoriginalpointwheretheywerenoticedtobeoutofsight. Theyshouldremainwheretheyarefortheoriginal15minutesthatthe clientisoutofsight.Oncethatwindowhaspassedoneguideshould contacttheExecutiveDirectorandProgramDirector.Thatguideshould sendSATphonecoordinatesandreceiveconfirmation.Theotherguide shouldsearchfortheclientfor45additionalminutesmakingitonehour aftertheclientwasoriginallynoticedtobeoutofsight.IfNOTfound,the guideandgroupshouldreturndownthemountaintothevehicle.Ifthe clientisnotfoundatthevehicleoralongthewaythenemergency
7.
servicesshouldbecontacted TheExecutiveDirectorandProgram Directorshouldbeinformedofany/allupdatesalongtheway. ➢
● SpineAssessment
○ PIVOTPointWNCguidesshouldNEVERclearaspineinthe field.
● Reductionofadislocation
○ PIVOTPointWNCguidesshouldNEVERreduceadislocationin thefield
● PrescriptionMedicationAdministration
○ PIVOTPointWNCguidesshouldchecktoseeifanyclientshave epinephrineorallergiesbeforeeverytrip
○ PIVOTPointWNCguideswithWFRcertificationsshouldprovide epinephrinefromthefirstaidkidpertheirWFRinstructionwerea client’sairwaytobeobstructedbyanallergicreaction (anaphylaxis).
● CessationofCPR
○ PIVOTPointWNCguidesshouldnotceaseadministeringCPR untilemergencyservicesarrive.
● WoundCare
○ PIVOTPointWNCguidesshouldfollowwoundcareprocedures pertheirrespectiveWFA/WFRcertificationinstructions.
● RemovalofImpaledObjects
○ PIVOTPointWNCguidesshouldNEVERremoveanimpaled objectinthefield.Iftheimpaledobjectiskeepingtheclientfrom movingthenstaffshouldremainwheretheyareuntilemergency servicesarrive.
● Everydriverofacompanyvehicleshouldbeclearedwithinsurance beforedriving.
● Mustbeatleast25yearsoldandhave3-5yearsofdrivingexperience.
● Can’thaveanymajorviolationsoverthepast5years(racing,vehicular manslaughter,driving25ormoreover)
➢ OperatingCompanyVehicles
● AssessmentandTraining
● DrugandAlcoholPolicy
○ Alldriversaresubjecttorandomdrugandalcoholscreening. Failuretocomplywithrequestscouldresultindisciplinaryaction uptoandincludingtermination.
➢ Pre-TripChecks
● Driversmustfilloutavehiclepre-tripcheckformbeforeeverytime drivingacompanyvehicle.
● Driversshouldchecktirepressure,gaslevel,andallpaint/windowsofthe carbeforedriving.
➢ ClientTransportandPassengerSafety
● Driversmusthaveavaliddriver’slicenseintheirpossessionatalltimes whenoperatingcompanyvehicles.
● Driversarenotallowedtousecellphoneswhiledrivingincludingtext messaging.
● Alldriversresponsibleforthetransportationofpassengersmustmaintain firstaidandCPRcertifications.
● Alldriversmustadheretoallstate,local,andfederallawsregardingthe operationofamotorvehicleincludingbutnotlimitedtospeedpostings, signs,androadconditions.
● Vehiclesmustbelockedwhenunattended.
● Driverswillensurethatallpassengersarewearingaseatbeltwhilethe vehicleisinoperation.Ifapassengerremovestheirseatbelt,thedriver shouldpullthecaroverandstopandnotcontinuedrivinguntilall passengersareincompliance.
● Nosmokingoreatinginthevehiclesatanytime.
● Passengersmustkeeptheirarmsandlegsinsidethevehicleatalltimes. Passengersmustnotthrowanythingoutofthevehicle.
● Eachvehiclemustmaintainafirstaidkit,jumpercables,andnecessary equipmenttochangeatire.
➢ AccidentProcedures
● Mandatorydrugscreeningafteranaccidentfromadesignatedfacility.
● Ifothervehiclesorpropertywasinvolvedoranyonewasinjured911 shouldbecalledimmediately DONOTADMIT RESPONSIBILITY/FAULT Iftheothervehicleisnotoccupiedthedriver mustmakeanattempttolocatetheownerandifunsuccessfulmustleavea notewithallinformationnecessarytocontact.Ensuresafetyofallclients. CalltheExecutiveDirectorandtheProgramDirector.Documentthe accidentwithpictures,listofdamages,location,andanyotherpertinent information.
● Ifnoothervehiclesorpropertywereinvolvedthenthedrivershould; ensuresafetyofallclients,andreporttheaccidentimmediatelytothe ExecutiveDirectorandProgramDirector.Drivershoulddocumentall damagestothevehicleandpropertywithpicturesandwrittendescription. Iftherewasadomesticanimalinvolvedthenthedrivershouldattemptto calltheownerbeforeleavingthescene.Ifunabletocontacttheowner,the drivershouldcontactthelocalhumanesocietyoranimalcontrol.
● Inbothinstances;filloutanaccidentreportform.
➢ OvernightEvents
○ TBD
8. ConfidentialityandRecordRetention
● PIVOTPointWNCwillkeepallstaffandclientrecordsfor10years.
● PIVOTPointWNC’sstaff,facilitators,independentcontractors,and volunteerswillallcomplywithHIPAAstandards.Adiscretionagainst HIPAAcompliancecanresultininvestigationandtermination.
9. COVIDProtocols
● Thermaltemperaturestakenandhandssanitizedbeforeenteringthe vehicle.Whileinthevehicle,masksshouldbeproperlyworn,windows¼
ofthewaydownforairflow,maximizedistancing,anddeepcleanedwith anti-viralanti-bacterialcleaningsolutionaftereverytrek.
● AllPIVOTPointWNCguideswillbefollowingstatefederaland healthcareprofessionalguidelinesforfacilitatortravelacrossstatelines. GuideswillberequiredtobetestedforCOVIDonceamonth; reimbursementforRangeUrgentCaretestingavailableonacase-by-case basisandtobediscussedwiththeProgramDirector
Appendix A
Full Time Lead Staff Roles & Responsibilities
The Lead Staff is responsible for the overall execution and facilitation of PIVOTPoint WNC outings They will report directly to Master Staff for task supervision and to the Program Director for leadership supervision This description reflects the general guidelines, guardrails, and expectations of the position Other tasks and responsibilities will surface as time and organizational needs shift
Position Structure
This position is for 4 days/week at approximately 32 hours a week. Block Scheduling will be either Wednesday through Saturday or Monday, Wednesday, Thursday, Friday During block scheduling there will be no more than 2 sequential outings for any 1 staff barring staffing needs and concerns for coverage Staff will occasionally shift from one block to another depending on programmatic needs
Key Responsibilities
The Lead Staff will have two key sets of responsibilities: those carried out during days on the trail and those carried out on days off the trail.
Days spent on the trail
The Lead Staff is responsible for leading the provision of constant safety, risk assessment, and therapeutic management of clients during outings. Comfort with each population with whom we work and the best practices in providing targeted, relevant therapeutic support is paramount. This Includes,but is not limited to:
● Planning, developing, and delivering therapeutic processing under the direct support of Master Staff and with the supervisor of Program Director in conjunction with intake/assessment paperwork, additional referral documentation, and in alignment with the PIVOTPoint Program curriculum. Group facilitation will be based around the education, scaffolding, practice, and implementation of the following skills: effective and compassionate communication, prosocial behavior, active listening, inter- and intra-personal relationship building, problem-solving, and self-regulation skills.
● Pre-trek review of activities for the day with co-staff (including back up plans, delegation of safety checks and client-related protocols, and perceived/anticipated client outcomes)
● Engage in consistent rapport building with clients, including serving as a mentor to clients in group facilitation through active client engagement throughout the duration of their programming
● Engage in consistent rapport building with Support Staff, including serving as a mentor in their ongoing training and development from Support to Lead Staff
Experience with the following is fundamental to our work – we will provide resources to assist in the development of this knowledge base: Cognitive Behavioral Therapy, Gestalt Therapy, Community Resilience Model, Motivational Interviewing, Acceptance Commitment Therapy, Mindfulness-Based Practices, and various psycho-ed and experiential education groups
Lead Staff is responsible for final sign off and incorporation of Support Staff field notes and pre- and post-trek paperwork While the primary responsibility of the Support Staff, your role requires more than proficient wilderness first aid and SAT phone skills Lead Staff must have an up-to-date knowledge of PIVOTPoint WNC Policies & Procedures prior to, and throughout duration of employment Availability for bi-monthly meetings is expected
Days spent off the trail
Administrative hours (defined as any time spent not on trail with clients) will comprise of peer-led workshops, client case studies, and extensive familiarity with the organization’s policies, practices, intentions, and goals Assignments will be discussed and delegated on a case-by-case basis and in consideration of the strengths of each Lead Staff We will create projected tasks for each team member and the organization as a whole and co-create accountability check points to track progress Organizational tasks may include, but are not limited to:
● Client documentation upkeep and review,
● Regular check-ins regarding tasks, skills, feedback, and case conceptualizations with Master Staff and peer staff
● Monthly strategy plans for community outreach and engagement
● Administrative and logistical support as needed (permit updates; gear and maintenance oversight; client relationship management; etc)
This role requires:
● A willingness to participate in staff meetings and trainings with authenticity and accountability, navigating the giving and receiving of feedback with respect and implementing feedback in a timely manner
● Excellent communication skills and accountability
● Training, knowledge, and/or experience facilitating groups informed by the therapeutic theories that PIVOTPoint WNC is informed by and is capable and invested in creating meaningful group topics
● Exemplary ability to work and communicate well with others in professional settings and with clients and families
● Practice self-care & resiliency and live and work in alignment with our values & mission
● Being “at home” in the woods; and being comfortable with any of the following: paddling, climbing, mountain biking, and camping
● Possess the ability to hold healthy therapeutic boundaries
● Someone who demonstrates a commitment to their own growth and development regarding emotional regulation, grounding and core value alignment Whether through personal therapy, group work, experiential courses, etc
● Themselves and can speak from a peer-delivered services perspective about the value of therapeutic work
I have read, understood, and will adhere to all of these Policies and Procedures. Furthermore, I understand that the information and parameters set forth herein may evolve and shift as the organization evolves and shifts. At such time, updated and amended Policies and Procedures documents will be provided for review, comprehension, and adherence.