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Behavior management plans are developed and monitored by licensed professionals or board certified professionals to address behaviors, to ensure the participant can obtain maximum gains from services being delivered. Plans may include therapeutic medication, interventions that include positive reinforcement, verbal cues and rewards.
If restrictive procedures, such as the use of routine, sedative, or psychotropic medications to control behavior, the removing or restricting of access to personal property, and the use of restraint are used as a behavior modification technique, the provider's policies and procedures must clearly state when and how the procedures are implemented.
In the case of participants who are minors or persons who are incapacitated, as determined by a court, informed consent for use of restrictive programs, practices, or procedures must be obtained from the participant’s legal guardian or representative (see 9.3 Participant Information), in accordance with state law, to act on behalf of the participant.
Informed consent, signed by the participant or the participant’s representative, for restrictive procedures must be indicated on a separate document from the general programmatic consents obtained when a participant enters the program. The consent lists the risks and benefits of the restrictive interventions and states how the restrictive interventions are monitored and faded.
Standing or as-needed programs to control inappropriate behavior are not permitted. All interventions addressing the control of inappropriate behaviors must be justified by the assessment and the participant’s current level of behavior.
A behavior management plan:
- must be developed and signed by a licensed professional (see Appendix B Post-Acute Rehabilitation Core Services – Modality and Staff Qualifications for provider qualifications);
- must identify the triggers and prevention strategies that are incorporated into the plan;
- must be reviewed and approved by the interdisciplinary team (IDT) member and CRS counselor, as indicated by an attendance sheet with the IDT members’ signatures and a short summary of the team’s discussion before the plan is implemented by the IDT;
- must be written in a manner that can be understood by the participant and staff;
- must provide evidence that staff members were trained before implementing the behavior management plan;
- must indicate that a licensed professional must oversee the staff members who implement the plan; and
- must be incorporated into the participant’s Individualized Program Plan.