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Restrictive Procedure

The Department of Human Services’ (DHS) Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs (ODP) invites you to join the Statewide Quarterly Positive Approaches & Practices virtual meeting on January 24, 2024. The meeting will be held from 10:00 am – 3:00 pm and focus on restrictive procedures. OMHSAS and ODP will discuss restrictive procedures as they relate to the licensing of Community Residential Rehabilitation (CRR) services, Inpatient Psychiatric services, Long-Term Structured Residences (LTSR), Residential Treatment Facilities for Adults (RTF-A), and Community Homes. There will also be a panel presentation to review some of the strategies associated with the development of restrictive procedures, including tips for the creation of plans consistent with best practice strategies.

Please view the flyer for detailed session and registration information.

ODP Announcement 22-103 serves to inform Adult Autism Waiver (AAW) providers that there are specific regulations regarding restrictive procedures that must be followed. The Office of Developmental Programs (ODP) has been made aware that some AAW providers are implementing restrictive procedure plans for individuals being served in AAW without a corresponding BSP documented in the ISP in HCSIS. This practice is not allowed.

A restrictive procedure must always be part of the behavioral support component of the ISP as required by the AAW. In the AAW, the BSP is included in the ISP in HCSIS. The Desired Behavioral Outcomes (DBOs) of the BSP must be consistent with the Behavior Support Specialist service goals and objectives.

There must be an active Behavior Support Specialist goal for each DBO, and each Behavior Support Specialist goal must have a DBO. Additionally, every Behavior Support Specialist goal must have a corresponding Goal Attainment Scale (GAS) chart and be reported on at least quarterly in a Quarterly Progress Note (QPN).

To have a restrictive procedure plan in place for an AAW participant, the Behavior Support Specialist service must be in the ISP Service Details so that a BS qualified to provide services in the AAW can develop, implement, and train staff on the participant’s BSP and CIP with the goal of fading all restrictive procedures over time.

In the AAW, the Behavioral Specialist Service (BSS) is not bundled with the Residential Habilitation service as it is with other ODP waivers. Therefore, to meet the requirements above, AAW participants who are receiving residential habilitation services and have a restrictive procedure plan in place must also have active BSS authorized in their ISP. This ensures an AAW qualified BS is working with the participant when a restrictive procedure plan is in place.

Please refer to Chapter 6100 regulations § 6100.341 – 6100.346, Bulletin 00-21-01 Guidance for Human Rights Teams and Human Rights Committees and Attachment 2 — Individual Plans and Informed Consent for additional information. Any questions should be sent to the AAW Provider Support Inbox.