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 197-5-7 - PROCEDURES FOR REVIEW AND APPROVAL OF POSTIVE SUPPORT PLANS AND BEHAVIOR MANAGEMENT PLANS
Universal Citation: 14 ME Code Rules ยง 197-5-7
Current through 2024-38, September 18, 2024
5.07-1 Review Levels and Review Teams
A. There are
three different review tiers for Positive Support Plans and Behavior Management
Plans, based on the level of restriction proposed. Planning Teams are
responsible for obtaining the designated level of approval prior to
implementation of any plan.
1. The Planning
Team, the Person or Guardian, and Case Manager must review and approve all
plans before they are implemented or sent for further review.
2. A Review Team is responsible for review
and disposition of all Behavior Management Plans at Level 3 or above.
3. The Statewide Review Panel is responsible
for review of all Behavior Management Plans at Level 5, prior to review by the
Commissioner or designee.
B. Review Teams must be maintained as
governed by a memorandum of understanding between the Department, the
Protection and Advocacy Agency and the Maine Developmental Services Oversight
and Advisory Board. Each team shall be composed of:
1. A representative from the
Department;
2. A representative
from the Protection and Advocacy Agency; and
3. A representative designated by the Maine
Developmental Services Oversight and Advisory Board; and
C. A Statewide Review Panel shall be
designated and governed by a memorandum of understanding between the
Department, the Protection and Advocacy Agency and the Maine Developmental
Services Oversight and Advisory Board.
5.07-2 Review Procedures
A.
Review Requirements
1. Positive Support Plans at Levels 1 and 2
may be implemented with Planning Team, including Case Manager
approval.
2. Each proposed plan
must be reviewed at the appropriate level corresponding to the most intrusive
proposed restriction of Rights or the use of Restraint before it can be
implemented.
3. At each level of
review, the requirements for the preceding level of review must have been met
and approval obtained.
4. Any
member of the Planning Team may request review or involvement by an
Advocate. The Advocate must be notified when a Planning Team
is considering a Behavior Management Plan at Level 3 or above.
5. Plans requiring approval at Level 3 and
above must have the approval and signature of the Case Manager and Case
Management Supervisor.
B.
Review Team Practices
Behavior Management Plans at Level 3 and above require consideration by the Review Team. The voting members of the Review Team are the representatives from the Department and the Maine Developmental Services Oversight and Advisory Board. The Protection and Advocacy representative is a participating non-voting member of the Review Team. The Review Team's role is to ensure compliance with and raise concerns related to, the applicable statutes and regulations.
1. The
approval of the Behavior Management Plan at Level 3 and above requires both
voting members to vote in favor of the Behavior Management Plan or the Behavior
Management Plan with conditions.
2.
The Review Team may require additional information prior to approval of any
plan.
3. The voting members of the
Review Team have the discretion to determine duration of Behavior Management
Plan approval to a maximum of one year. If less than one year, the duration of
Behavior Management Plan approval must be indicated in writing.
4. The voting members of the Review Team may
elect to approve part of a plan, or provide time-limited or conditional
approval based on written conditions to be met as defined by the voting members
of the Review Team.
5. If either
voting member of the Review Team does not approve all or part of a Behavior
Management Plan, the voting members of the Review Team must specify the reasons
for disapproval in writing.
6. The
Case Manager or Case Management Supervisor must participate in the review
process.
7. After initial approval
of a Behavior Management Plan, the Review Team may refer cases for continued
monitoring to the Planning Team, the Case Manager and the case management
supervisor. The Review Team must review for approval each Behavior Management
Plan at least once a year.
8. The
Review Team may, at its discretion, refer any Behavior Management Plan for
review by the Statewide Review Panel. The Review Team should consider a
referral in cases where resources are an issue in meeting the Person's support
needs without the use of Behavior Management.
9. No Behavior Management Plan component
requiring approval at Level 3 or above shall be implemented without appropriate
approval as provided by these regulations.
10. Each Review Team must establish a process
for review and disposition of Behavior Management Plans requested for
emergencies. The Review Team may grant written provisional approval of all or
part of an emergency Behavior Management Plan. Provisional approval must be
agreed upon by the representative of the Department and Maine Developmental
Services Oversight and Advisory Board and must not exceed sixty (60) days.
After sixty (60) days the Planning Team must meet all regular requirements for
review and disposition of the Behavior Management Plan.
C.
Exceptions
Behavior Management Plans requiring approval at Level 5 are rare exceptions and must meet a higher standard of review and approval. Level 5 Behavior Management Plans must have been approved by the Review Team and reviewed by the Statewide Review Panel before being submitted to the Commissioner for disposition.
1. Prior
to submitting a Behavior Management Plan for initial approval at Level 5, the
Planning Team is required to seek a second opinion from a licensed psychologist
or psychiatrist. At the discretion of the Review Team a second opinion may be
requested before any annual review.
a. That
clinician shall meet with the Person and the Person's support staff and confer
with the Person's family if they are involved, and the Guardian, if there is
one, and Correspondent, if one has been appointed.
b. The clinician must provide a written
opinion of the potential risks and benefits of the proposed program.
c. If the clinician providing the second
opinion concurs in the need for the program, the Statewide Review Panel will
review the plan and make recommendations to the
Commissioner.
2. If the
Commissioner approves the Behavior Management Plan, the Review Team will assume
responsibility for monitoring the Behavior Management Plan.
3. Level 5 Behavior Management Plans must
comply with the foregoing review and approval requirements.
5.07-3 Data Collection and Monitoring
A. The
Department shall be responsible for collecting and tracking data regarding
Behavior Management Plans in each region as directed within the memorandum of
understanding governing the statewide Review Teams.
B. The Statewide Review Panel will be
responsible for monitoring for quality and consistency.
1. The Statewide Review Panel will examine
all new Behavior Management Plans at Level 4 for quality assurance purposes,
including concerns regarding the review process, inconsistencies or quality of
Behavior Management Plans.
2. The
Statewide Review Panel may request data regarding Behavior Management Plans.
The team may also request a random sample of Behavior Management Plans for a
quality review.
3. The Statewide
Review Panel shall review and advise the Department regarding interventions
that may put consumers at risk and assure that applicable policies, regulations
and laws are being followed.
4. The
Statewide Review Panel will provide an annual report to the Commissioner
regarding all active and approved Level 5 Behavior Plans.
Disclaimer: These regulations may not be the most recent version. Maine may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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