UNITY HOUSE OF CAYUGA COUNTY INC.
BEHAVIOR PLAN POLICY
10/26/09
Updated 7/1/12; 3/22/13; 5/15/13
Policy
It is the policy of Unity House to empower staff with the tools to effectively manage
challenging behavior. It is the intent of Unity House to encourage and permit the full
exercise of individual rights. There are instances when an individual threatens to harm or
is dangerous to him/her, others, or property and it may be in the best interest of the
individual to restrict movement or privileges.
All staff with direct care responsibilities and their supervisors will be trained in
emergency procedures (SCIP-R) within three months of their hire date. This policy will
provide consistent procedures for the development and implementation of behavior plans
that incorporate restrictive interventions and the development and implementation of
behavior guidelines designed to assist the staff in effectively managing challenging
behaviors on an individual basis. This policy emphasizes the utilization of non-restrictive
procedures to address the behavioral needs of consumers.
Table of Contents
I.
II.
III.
Behavior Support Plans
Behavior Monitoring Plans
Human Rights Committee
a. HRC and ICC Process
P. 2
P. 2
P. 3
P. 4
Criteria
(Administrative Memorandum April 1, 2013 Person-Centered Behavioral
Intervention)
 Functional Behavioral Assessment (functional assessment or functional analysis
of behavior) must be conducted before a behavior support plan is developed.
 Functional Assessment must be completed by a clinician with training in
assessment techniques.
 Behavior support/monitoring plans must be developed by a licensed psychologist
or applied behavior sciences specialist, LCSW.
 Behavior management support plans will contain all the elements identified in the
04-01-13 OPWDD Administrative Memorandum.
 Plans must be reviewed by the HRC for clinical soundness, and alignment with
PWDD regulation for restrictive plans.
 Support team with the clinician will review the plans semi-annually.
 All staff will receive training specific to the behavioral support plan before it is
implemented.
1
Tools & Resources
 April 1, 2013 OPWDD Administrative Memo: Person-Centered Behavioral
Intervention
 Behavior Data tracking form
 HRC Review form
 BSP/Monitoring Plan format document
Procedures
Behavior Support Plan (BSP):
A behavior support plan is created to modify a person’s challenging behavior in order to
increase his/her quality of life. A BSP includes pro-active and re-active (or rights
restrictive) techniques for addressing the target behavior during a crisis. For the Behavior
Support Plan format, see Appendices.
When a prescription is written for a PRN medication that will alter a consumer’s
behavior, the Program Manager in conjunction with the Program RN will develop
administration guidelines for that PRN medication only (see Nursing Policy 200.8
Guidelines for the Administration of PRN Behavior Changing Medications). The
Program Manager will be responsible for ensuring the PRN is identified in the IPOP. The
administration guidelines will be included in the Behavior Support Plan that is developed
and reviewed per this policy.
A functional behavioral assessment must be completed by a clinician prior to the
development of a behavior support plan. The plan needs to specifically include a
description of the target behavior and include a hierarchy of behavioral approaches,
strategies and supports to address the behavior(s) requiring intervention, with preferred
methods being positive approaches, strategies and supports, include a plan for alternative
adaptive behaviors, provide a methods for collection of behavioral data and a schedule to
review the effectiveness of the plan. The behavior support plan must be developed by a
clinician with training in behavior management techniques. All rights
restrictive/intrusive behavior support plans are reviewed by the Unity House Behavior
Management Committee. All plans are reviewed at least semi-annually by the plan
author, in conjunction with the support team.
Behavior Support Plans are maintained for 10 years. For specific information on purging
and filing BSP’s, see the Historical File Policy.
Behavior Monitoring Plan (BMP):
A Behavior Monitoring Plan identifies the target symptoms of a diagnosed co-occurring
psychiatric disorder which are to be prevented, reduced or eliminated. The plan shall
specify interventions that will be used to address associated challenging behaviors that
may occur and methods by which progress in symptom control and functional
improvement will be measured, documented, and reviewed.
2
A functional behavioral assessment is not required for a Behavior Monitoring Plan;
however, the Monitoring Plan must be completed by a clinician such as licensed
psychologist, LCSW or Behavioral Intervention Specialist. All plans are reviewed at
least semi-annually by the plan author, in conjunction with the support team.
Behavior Support Plans are maintained for 10 years. For specific information on purging
and filing BSP’s, see the Historical File Policy.
The following types of Behavior Support/Monitoring Plans need to be reviewed by the
HRC:


Highly Restrictive plans which include: Restriction of rights; exclusionary timeout; required (forced) relaxation; and restrictive personal interventions as
identified in the SCIP-R policy
Minimally restrictive plans which include: planned ignoring; special supervision;
locking devices; overcorrection; response cost; non-exclusionary time out;
escorts; mechanical restraining devices; and psychotropic medication except for
monitoring plans in which medication is used solely for the treatment of a cooccurring diagnosed psychiatric condition.
Human Rights Committee:
It is the policy of Unity House that all restrictive/intrusive behavior plans are reviewed by
the Unity House Human Rights Committee. The HRC consists of a minimum of four
members and must have a psychologist or BIS, a clinician, licensed, certified or
registered in NYS, and an advocate, consumer, guardian or family member preferable
with no ownership, relationship or interest in the agency. At least three of these
participants must be available to approve a plan.
The purpose of the Unity House HRC is to determine if the quality of the individual’s life
is likely to be enhanced or made worse by the BSP’s implementation. The committee
must verify that all required components are included in the BSP. The committee chair
will verify that approval does not exceed 1 year and that written informed consent is
obtained prior to the implementation of that approved BSP. The committee must
specifically review plans that include the use of mechanical restraining devices that are
not commercially available or modifications of available devices and any modifications
of intermediate and restrictive physical intervention techniques. The committee shall
review and make suggestions to the agency’s management and/or governing body about
its policies, practices and programs as they relate to behavioral support.
The IRA program manager and site nurse in conjunction with the plan author will collect
and review behavioral data quarterly. The plan must be reviewed at each service plan
review and updated accordingly (at least semi-annually). The program manager is
responsible for ensuring this occurs.
3
Unity House HRC and ICC Process: There are seven documents that need to be
submitted for approval. These documents need to be submitted for HRC and ICC, just
HRC, or just ICC approval. Those documents are as follows:
1. Unity House HRC review form (see Appendices)
2. Capacity to give informed consent (see informed consent policy)
3. Informed consent for treatment (see informed consent policy) (make sure all
restrictive interventions are listed, not just medications)
4. Behavior Support Plan
5. One year behavior data: Summarize behavior data in a monthly format, do not
send all behavior data tracking or dates of each time target behavior was
observed, overview of target behavior and progress only
6. Two year psychotropic medication history: Only include psychotropic medication
history and DO NOT just print history from Foothold. List date, change and
reason for changes to psychotropic meds
7. Most recent psychiatry consultation report
NOTE: To obtain the “Capacity to Give Informed Consent” (#2) and Informed Consent
for Treatment (#3), please refer to Unity House Informed Consent Policy.
Once all the previously identified documents are gathered, the Program Manager is
responsible for sending them to the HRC. The Program Manager will be identified as the
primary contact person. Once the committee has responded, the Program Manager will
be responsible for sending copies of the plan to all involved parties (parents, service
coordinator, Day Hab, Employment…).
4