Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 101 - MAINECARE BENEFITS MANUAL (FORMERLY MAINE MEDICAL ASSISTANCE MANUAL) › Chapter II - Specific Policies By Service › Section 144-101-II-18 - RULES GOVERNING IMPLEMENTATION OF THE TRADE ADJUSTMENT ASSISTANCE PROGRAM › Subsection 144-101-II-18.11 - BEHAVIORAL INTERVENTIONS

Current through 2024-29, July 17, 2024
A provider of services under this Section must comply
						with the following provisions in planning for and carrying out any intervention
						to correct or modify a member's behaviors.
18.
					 11-01
Process for Review and Approval of Behavioral
					 Interventions
Use of a particular intervention to change or eliminate a
						specific behavior of a member requires a written plan, incorporated within the
						member's Care Plan, that is developed, reviewed, and approved as follows.
A. Functional Behavior Assessment:
					 The use of an intervention must always be preceded by a Functional Analysis of
					 Behavior and documented efforts to address the dangerous or maladaptive
					 behavior by the use of positive techniques or less intrusive approaches, which
					 have been tried systematically and determined to be ineffective.
B. Clinician Input: An intervention that is
					 mildly or moderately intrusive as defined in section 18. 11-02, must be
					 developed and approved by a licensed clinician who has direct experience
					 working with individuals with a brain injury and is approved by the DHHS
					 Program Manager for Brain Injury.
C. Planning Team Review: A planning team must
					 meet to review proposed interventions and approve their use. The planning team
					 must include:
(1) the individual and
					 guardian, where one has been appointed;
(2) the Care Coordinator, who will be
					 responsible for coordinating the inclusion of any other relevant individuals;
					 and
(3) representatives from every
					 site at which the behavioral treatment procedure is to be implemented. Prior to
					 approval, the team must evaluate factors that may be contributing to the
					 occurrence of the behavior, which may include:
1. Illness, Disease, Medication
					 Interaction;
2. Impact of brain
					 injury on behavior;
3. Psychiatric
					 conditions; and
4. Significant life
					 events.
In the event that factors such as those listed above
						exist, the planning team may still determine that a behavioral plan is
						indicated, but the planning team shall include, as part of the plan, its
						rationale for so deciding.
D. Documentation in Care Plan: The behavioral
					 intervention procedure must be documented in the Care Plan, and must include
					 all of the following elements:
1. A concise
					 and accurate identification and description of the specific behavior(s) to be
					 addressed and the behavioral goal;
2. A Functional Analysis of Behavior
					 including the history of the behavior and what positive methods have been
					 utilized in the past;
3. A
					 description of the baseline measurements of the frequency, duration, intensity
					 and/or severity of the behavior(s);
4. A concise and precise description of the
					 methodology for consistently implementing the plan;
5. A description of the means of recording
					 and measuring of the frequency, duration, intensity and/or severity of episodes
					 of the specific behavior(s) and the use of interventions;
6. A schedule for periodic review by the
					 planning team of the plan which shall be at least semiannually;
7. Criteria for the discontinuation of the
					 plan, whether because it has been successful, its continued implementation is
					 unlikely to be successful, or it is causing the individual more harm than
					 benefit. There may be behavioral plans which show slow progress. These plans
					 may require implementation and monitoring over an extended period of time.
E. Department Oversight
					 Committee Review:All Plans involving mildly or moderately intrusive
					 interventions require review and approval by a Department oversight committee
					 consisting of the Program Manager of Brain Injury Services and at least two
					 other Department staff with expertise in the behavioral health field. Review
					 shall be conducted both initially and on a semi-annual basis.
F. Written Consent: The intervention must be
					 approved, in writing, by the individual or by the guardian, when one has been
					 appointed. Such written consent must be incorporated within the Care Plan.
					 Withdrawal of approval requires immediate termination of the intervention.