Code of Maine Rules › 14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 197 - OFFICE OF AGING AND DISABILITY SERVICES › Chapter 5 - REGULATIONS GOVERNING BEHAVIORAL SUPPORT, MODIFICATION AND MANAGEMENT FOR PEOPLE WITH INTELLECTUAL DISABILITIES OR AUTISM IN MAINE › Section 197-5-5 - BEHAVIOR MANAGEMENT (Levels 3-5)

Current through 2024-29, July 17, 2024
When a Planning Team proposes a Behavior Management Plan,
				  that Planning Team is responsible for adhering to requirements in Behavior
				  Management Planning. Conditions for use of Behavior Management and Behavior
				  Management Practices as outlined in Section
				  5.05-1. Planning Teams must meet
				  additional requirements, as outlined in Section
				  5.05-4, for Behavior Management
				  Plans when those plans include the use of Restraint. Planning Teams are
				  responsible, as outlined in Section
				  5.05-5, for monitoring the Behavior
				  Management Plan and also for documenting the planned accommodations as
				  described in Section
				  5.05-6, when a Behavior Management
				  Plan might have an impact on others.
5.05-1
Behavior Management
				Planning
A.
Requirements for
				Planning Team to Act
When a Person's Challenging Behavior presents a threat of
				  Imminent Risk of harm or danger to the Person or the community, or threatens
				  loss of placement, the Planning Team must act to ensure the Person's safety.
				  The Planning Team must continue to evaluate and implement the Positive Support
				  Plan while Emergency Intervention is utilized or a Behavior Management Plan is
				  developed and implemented.
When a Person is subject to a court order or conditions of
				  probation and the Planning Team decides that the Service Provider will need to
				  use interventions that restrict the Person's rights in order to enforce those
				  orders or conditions a Behavior Management Plan must be developed that is
				  consistent with the court order.
B.
Requirements for Updated Functional
				Assessment
Whenever the Planning Team determines that the use of
				  Behavior Management is indicated, the Planning Team must obtain an Updated
				  Functional Assessment which must be used in development of the Behavior
				  Management Plan. When a Behavior Management Plan continues to be deemed
				  necessary by the Planning Team, the Functional Assessment must be updated at
				  least every three years.
An Updated Functional Assessment may be new or a review of
				  the original Functional Assessment and must be developed or updated by or under
				  the supervision of a Psychiatrist, a Psychologist or Psychological Examiner, a
				  Licensed Clinical Social Worker, a Licensed Clinical Professional Counselor, or
				  a Board Certified Behavior Analyst. The process for the Updated Functional
				  Assessment must include, but is not limited to:
1. Meeting and observing the
				Person;
2. Interviewing the
				Correspondent and Guardian (if either has been appointed), and direct support
				professionals; and
3. A review of
				the Person's record.
C.
Requirements for a Behavior Management Plan
Behavior Management Plans must describe all planned
				  interventions which include restrictions of Rights or the use of Restraint.
				  Behavior Management Plans must be developed by or in consultation with a
				  qualified professional who must be a psychiatrist, a licensed psychologist or
				  psychological examiner, a Licensed Clinical Social Worker, Licensed Clinical
				  Professional Counselor, or a Board Certified Behavior Analyst.
The Behavior Management Plan must be approved by the Planning
				  Team and shall include, but is not limited to:
1. Consent by the Guardian;
2. A concise and accurate description of each
				specific Challenging Behavior that makes it clear to an objective observer what
				the Challenging Behavior looks like;
3. A description of the baseline measurements
				of the frequency, duration, intensity and/or severity of each Challenging
				Behavior; and
4. A precise
				description of the intervention(s) to be utilized, in language that is
				understandable to the people implementing the Behavior Management Plan. The
				description of interventions must include:
a.
				Identification of any precursor behavior or predictive event that occurs prior
				to the Challenging Behavior;
b.
				Instructions to staff on how to respond to each precursor behavior or
				predictive event in order to reduce the likelihood that the Challenging
				Behavior will occur;
c.
				Instructions on how to implement the Behavior Management
				technique(s);
d. Indicators for
				when the Behavior Management technique(s) should cease and the Person can be
				supported to return to normal activities;
e. A description of strategies, which will be
				conducted or overseen by the qualified professional who provides consultation
				on the Behavior Management Plan, to ensure that the Behavior Management Plan
				will be consistently implemented. A plan for documentation of training and
				supervision of staff must be included. Training must be offered to others who
				may be supporting the Person, including family members, Guardians or
				Correspondents;
f. A description of
				the method of recording and measuring the frequency, duration, intensity and/or
				severity of episodes of the Challenging Behavior and the use and effect of
				interventions, including (if applicable) strategies implemented to address
				precursor behaviors or predictive events;
g. The identification of a method for the
				quarterly evaluation and documentation of the effectiveness of the Behavior
				Management Plan, including input from direct support professionals and others
				involved in implementing the plan;
h. Criteria for the discontinuation of the
				Behavior Management 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; and
i. A
				description of the methodology that will be used to reduce the intrusiveness of
				interventions used and eventually fade out the use of the Behavior Management
				Plan.