California Code of Regulations › Title 22 - Social Security › Division 5 - Licensing and Certification of Health Facilities, Home Health Agencies, Clinics, and Referral Agencies › Chapter 8.5 - Intermediate Care Facilities/Developmentally Disabled-Habilitative › Article 3 - Services › Section 76869 - Developmental Program Services-Behavior Management Program

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Behavior management programs shall be
				  approved by the Department of Developmental Services prior to implementation in
				  accordance with Sections
				  76856 and
				  76857(a)(12).
(b) No facility shall modify its approved
				  behavior management program prior to obtaining the written approval of the
				  Department of Developmental Services.
(c) Facilities which use behavior management
				  programs as part of their total service shall have:
(1) A written description of the behavior
				  management program.
(2) A written
				  assessment conducted by the interdisciplinary professional staff/team to
				  identify maladaptive behaviors which require management. This assessment shall
				  address the following areas:
(A) Social and
				  emotional status.
(B) Communication
				  skills.
(C) Physical and mental
				  status.
(D) Cognitive and adaptive
				  skills.
(E) An identification of
				  the maladaptive behaviors.
(F) A
				  baseline data collection system which addresses the maladaptive
				  behaviors.
(G) An analysis of the
				  maladaptive behaviors identified in terms of their antecedents and
				  consequences.
(3) A
				  written behavior management plan available to all facility staff, the client if
				  appropriate, or the client's representative, if lawful. This plan shall
				  include:
(A) Long range goals.
(B) Behavioral objectives that are
				  time-limited, measurable, observable, and complement the long-range
				  goals.
(C) Behavioral objectives
				  which specify:
1. The name of the primary
				  person providing the intervention.
2. The place of intervention.
3. The reinforcement(s) to be used to elicit
				  adaptive behaviors.
4. The type(s)
				  of interventions to be used.
(4) A written document that shall clearly
				  justify, prior to the use of behavioral interventions that:
(A) The procedure to be used is the least
				  restrictive and most effective intervention for the maladaptive
				  behaviors.
(B) The environment
				  where the behavior change is to occur which is designed to avoid stigma and to
				  support and reinforce adaptive behaviors is specified.
(C) A specific choice from different behavior
				  interventions that has been made based on relative effectiveness.
(D) The undesirable long-term and short-term
				  effects which may be associated with the procedures have been
				  identified.
(E) The conditions
				  under which the procedure is contraindicated have been identified.
(F) The social, behavioral and status
				  benefits that can be expected have been specified.
(G) The rights of the developmentally
				  disabled person were and are protected in accordance with Sections
				  4503
				  and
				  4505
				  of the Welfare and Institutions Code.
(H) All legal and regulatory requirements
				  have been met.
(I) There is a plan
				  to decrease the restrictiveness of the program.
(J) A recommended treatment hierarchy which
				  identifies the maladaptive behavior warranting the most immediate attention has
				  been developed.
(5) A
				  written monthly report of progress that shall include:
(A) The amount of progress attained in
				  achieving each behavioral objective.
(B) A determination as to whether the program
				  should be continued as designed, or amended.
(C) In those instances when it can be
				  demonstrated that behavioral programs utilizing only positive reinforcement do
				  not result in the desired adaptive behavior, mild restrictive interventions may
				  be employed. Such interventions shall be limited to:
(1) Contingent observation.
(2) Extinction.
(3) Withdrawal of social contact.
(4) Fines.
(5) Exclusion time-out, with the client in
				  constant visual observation.