Behavior Management Committee G-08

PURPOSE:

The purpose of this policy is to ensure all individuals receiving intellectual and/or developmental disability (IDD) services are free from unnecessary or inappropriate use of medications and other restrictive interventions to manage interfering behavior or to treat diagnosed mental illness. This will be accomplished through the development and ongoing support of a Behavior Management Committee (BMC). Any plan submitted to BMC shall be developed by the individual/guardian and their support team.

POLICY:

The targeted case management (TCM) and/or community service provider (CSP) will complete initial and ongoing assessment of the use of medications and other restrictive interventions to manage interfering behavior or a behavioral health disorder through a BMC as required by the provisions of K.A.R 30-63-23. The committee shall protect and preserve the dignity and rights of individuals who receive IDD services through the evaluation and management of safeguards, assessment, and periodic reviews.

DEFINITIONS:

Restrictive Interventions are those which limit the rights of individuals served.

Psychotropic Medications are those which are prescribed for the purpose of treating diagnosed behavioral health conditions as defined in the Diagnostic and Statistical Manual of Mental Disorders or Diagnostic Manual-Intellectual Disability

Safeguards include assessment and modifications needed to ensure the use of positive behavior programming, environmental modifications and/or accommodations and informed consent has been obtained.

Management is when restrictive interventions are used to manage specific behaviors.

PROCEDURES:

1. BMC membership shall be made up of a selected number of individuals receiving services, legal guardians, family members, interested citizens, and CSPs; at least 1/3 of whom shall not be associated with the provider.
2. Each committee shall have a designated chairperson who would be responsible for:
   1. Organizing volunteers and scheduling meetings;
   2. Training volunteers;
   3. Preparing documents for meetings;
   4. Facilitating the meeting;
   5. Documenting and distributing committee decisions;
   6. Following up on tasks and questions posed by the
3. The committee will review and approve any plan that restricts the rights of an individual.
4. The committee will review any plan that utilizes psychotropic or other medications to alter behavior and/or address symptoms of a behavioral health condition. The BMC does not have the ability to deny any physician’s order.
5. The committee will review safeguards which have been taken to minimize, reduce or avoid the use of medications or other restrictive interventions to manage interfering behavior to include:
   1. Documentation that positive behavior programming has been utilized which includes consultation with professionals and the individual’s support network.
   2. Least restrictive intervention and reasonable environmental modifications and/or accommodations have been identified and tried.
   3. Medications are administered as prescribed.
   4. Verification that the individual and their legal guardian have been informed of the risks, side effects, and benefits of any medication and/or restrictive intervention used to manage behavior and that voluntary, informed consent has been obtained.
   5. “PRN” or “as needed” psychotropic medications will be used only when prescribed by a licensed health care professional with the express consent of the individual served or by his/her guardian. By whom and under what conditions the “PRN” medication is to be given must be clearly spelled out in the plan.
6. The committee will review documentation at least every 365 days to ensure on-going need of medications or other restrictive interventions to manage interfering behavior. The committee will:
   1. 1. Review behavior data including frequency of occurrence and severity of the specific behavior(s) to be treated by the medication or other restrictive intervention.
      2. Verify when psychotropic medication is used to treat a diagnosed mental illness, the medication has been prescribed and is being managed by a psychiatrist. The prescription and management may be done by or under direction of a physician only when requested and agreed to by the individual/guardian.
      3. Provide recommendations for re-evaluation or consideration of a second opinion regarding reduction of medications or restrictive intervention when appropriate.
      4. Approval will be documented by the committee member signatures.
7. Prior to initiation of medications and other restrictive interventions designed to address the documented need, the CSP will ensure that a BMC has reviewed and consented to the interventions; a copy of the BMC approval with the submitted plan shall be maintained in the individual’s records.
8. When identified, the chairperson will report findings of non-compliance of restrictions to the CSP and the Sedgwick County Developmental Disability Organization (SCDDO) Quality Assurance Department. In the event of neglect notification will be made as outlined in SCDDO policy G-06.
9. The TCM and other CSP’s are responsible for gathering information and submitting it to the BMC chairperson for review, as well as providing any additional information that may be requested. The TCM and CSP will follow the plan through the BMC process.
10. For individuals who do not have access to a TCM service provider, the current CSPs shall work together to establish or engage a BMC to develop, review, and approve any plan that restricts the rights of an individual and any plan that utilizes psychotropic or other medications to alter behavior.
11. When discontinuation of a plan is warranted, the CSP following the plan shall re-submit the plan to the TCM to engage the BMC with explanation of the discontinuation.