PDD-25-13-00002-EP Amendments to Person-Centered Behavioral Intervention
6/19/13 N.Y. St. Reg. PDD-25-13-00002-EP
NEW YORK STATE REGISTER
VOLUME XXXV, ISSUE 25
June 19, 2013
RULE MAKING ACTIVITIES
OFFICE FOR PEOPLE WITH DEVELOPMENTAL DISABILITIES
EMERGENCY/PROPOSED RULE MAKING
NO HEARING(S) SCHEDULED
I.D No. PDD-25-13-00002-EP
Filing No. 594
Filing Date. May. 31, 2013
Effective Date. May. 31, 2013
Amendments to Person-Centered Behavioral Intervention
PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following action:
Proposed Action:
Amendment of section 633.16 of Title 14 NYCRR.
Statutory authority:
Mental Hygiene Law, sections 13.07, 13.09(b) and 16.00
Finding of necessity for emergency rule:
Preservation of public health, public safety and general welfare.
Specific reasons underlying the finding of necessity:
The emergency adoption of these amendments is necessary to protect the health, safety, and welfare of individuals receiving, or in need of, behavioral intervention services and staff providing services.
OPWDD recently promulgated regulations addressing person-centered behavioral interventions. The regulations included specific requirements regarding the development, monitoring, implementation, and approval of behavior support plans and regarding the qualifications of parties responsible for developing and monitoring the plans. The existing regulations specify that all new behavior support plans must comply with the new requirements, including the requirements regarding the qualifications of parties authorized to develop and monitor the plans, effective May 31, 2013.
Since the time that the person-centered behavioral intervention regulations were adopted, OPWDD has learned that some provider agencies have had difficulty recruiting parties who meet the qualifications contained in the regulations. The emergency/proposed regulations expand the minimum qualifications of parties authorized to develop and monitor behavior support plans and other plans to address co-existing psychiatric disorders. OPWDD expects that the emergency/proposed regulations will enable provider agencies to retain certain existing staff members, and to recruit and hire parties who possess other acceptable types of educational, training, and work experience that were not included in the original regulations.
If OPWDD did not promulgate these regulations on an emergency basis, some individuals who need behavioral intervention services would not be able to receive the services because some provider agencies would not be able to recruit staff or consultants who meet the qualifications contained in the original regulations. The absence of behavioral intervention services can lead to crisis situations with tragic consequences, including serious injury or death. Clearly the absence of behavioral intervention services could compromise the health, safety and welfare of individuals in need of those services, and others in their living, habilitation, and work environments.
OPWDD was not able to use the regular rulemaking process established by the State Administrative Procedure Act because it was not fully aware of the difficulties provider agencies encountered recruiting qualified staff within the necessary timeframes. The emergency regulations are being promulgated on May 31, 2013 to coincide with the compliance schedule of the original regulation on behavioral intervention. The original regulation required that all new behavior support plans meet specified requirements, including the requirements regarding the qualifications of parties authorized to develop and monitor the plans, effective May 31, 2013.
At this juncture, any delay will result in continued exposure to avoidable health and safety risks.
The emergency/proposed regulations also amend the original regulations to clarify that the use of physical intervention techniques and/or mechanical restraining devices to facilitate emergency evacuations/drills is not considered a restrictive/intrusive intervention that requires inclusion in a behavior support plan. The addition of this clarifying language will eliminate confusion that could have impeded the use of these techniques and devices during emergency evacuations and drills. In order to successfully evacuate a building during an emergency situation (such as a fire) it is sometimes necessary to use these techniques and devices. Reluctance to use the techniques and devices when warranted in an emergency (or a drill) because of the perception that such use might be precluded in the absence of a behavior support plan can have serious consequences for the health, safety and welfare of individuals receiving services and facility staff. Serious injury and death can result from delay or failure to successfully evacuate in an emergency.
Subject:
Amendments to Person-Centered Behavioral Intervention.
Purpose:
To expand minimum qualifications of parties authorized to develop and monitor behavior support plans & make technical changes.
Text of emergency/proposed rule:
Paragraph 633.16(b)(9) is amended as follows:
(9) Committee, behavior plan/human rights. A committee which has the responsibility to protect the rights of persons whose behavior support plans incorporate[s] the use of any restrictive/intrusive intervention and/or limitation on a person’s rights in order to prevent, manage, and/or control challenging behavior, and which exercises this responsibility through the process of reviewing and approving proposed behavior support plans.
Paragraph 633.16(b)(10) is amended as follows:
(10) Committee, informed consent. A committee which has the authority to give informed consent for a behavior support plan incorporating the use of any restrictive/intrusive intervention and/or the use of medication to treat a co-occurring diagnosed psychiatric disorder, or for short-term use of medication with no behavior support plan, when the individual lacks capacity to consent and there is no other authorized surrogate available (except for a court). (See subdivision (g) of this section.)
Paragraph 633.16(b)(23) is amended as follows:
(23) Intervention, physical. Those intervention techniques, or the adaptations of such, that either include[;] hands-on techniques that deflect, protect from, or release hits, kicks, or grabs by persons receiving services toward others in their environment; [,]…
Paragraph 633.16(b)(24) is amended as follows:
(24) Intervention, restrictive/intrusive. These interventions include the following: …
(iv) the use of medication for the [sole] purpose of preventing, modifying, or controlling challenging behavior that is not associated with a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder (see paragraph (j)(5) of this section); and
(v) other professionally accepted methods to modify or control behavior which are determined by agency/facility policy to be restrictive/intrusive interventions because they [impose] may present [a] risk to a person’s protection or encroach unduly on a person’s normal activities (e.g., response cost, overcorrection, negative practice, and satiation).
Physical [I]intervention techniques and/or mechanical restraining devices used to facilitate emergency evacuations/drills or medical/dental exams, procedures, and related healthcare activities (and to protect individuals, [and] healthcare providers, and others during such exams, procedures, and activities) are not considered to be restrictive/intrusive interventions that require inclusion in a behavior support plan. Such interventions may be incorporated in other individualized plans to address these situations.
Paragraph 633.16(b)(27) is amended as follows:
(27) Medication. For the purposes of this section, a pharmaceutical agent prescribed and used either to prevent, modify, or control challenging behavior, or to treat the symptoms of co-occurring diagnosed psychiatric [conditions] disorders, … (See paragraph (j)(5)(vi) of this section for requirements specific to the use of medications used to treat a co-occurring diagnosed psychiatric [condition] disorder.)
Paragraph 633.16(b)(29) is amended as follows:
(29) Plan, monitoring. A plan developed by a licensed psychologist, licensed psychiatric nurse practitioner, licensed clinical social worker, or a [B]behavioral [I] intervention [S]specialist[, licensed psychologist, or licensed clinical social worker, which] that identifies the target symptoms of a [diagnosed] co-occurring diagnosed psychiatric disorder [which] that are to be prevented, reduced, or eliminated. …
Existing paragraph 633.16(b)(32) is deleted and a new paragraph 633.16(b)(32) is added as follows:
(32) Specialist, Behavioral Intervention (BIS).
(i) Level 1 BIS. In order for a party to be a Level 1 BIS, the party must:
(a) have the following educational background:
(1) at least a Master’s degree from a program in a clinical or treatment field of psychology, social work, school psychology, or applied psychology as it relates to human development and clinical interventions, and documented training in assessment techniques and behavior support plan development; or
(2) a National Board certification in behavior analysis (BCBA) and a Master's degree in:
(i) behavior analysis; or
(ii) a field closely related to clinical or community psychology that is approved by OPWDD; or
(3) a New York State license in mental health counseling; and
(b) have at least five (5) years of experience:
(1) working directly with individuals with developmental disabilities, including the development, implementation, and monitoring of behavior support plans; and/or
(2) providing supervision and training to others in the implementation of behavior support plans.
(ii) Level 2 BIS. In order for a party to be a Level 2 BIS, the party must meet the qualifications outlined in clauses (a),(b), or (c) as follows:
(a) The party must have a BCBA and a Master’s degree in:
(1) behavior analysis; or
(2) a field closely related to clinical or community psychology that is approved by OPWDD; or
(b) The party must:
(1) have either:
(i) a Master’s degree in a clinical or treatment field of psychology, social work, school psychology, applied psychology as it relates to human development and clinical intervention, or a related human services field; or
(ii) a New York State license in mental health counseling; and
(2) have or obtain OPWDD-approved specialized training or experience in functional assessment techniques and behavior support plan development; or
(c) The party must:
(1) have a Bachelor’s degree in a human services field; and
(2) have provided behavioral services for an agency in the OPWDD system as of, and continuously since, December 31, 2012; and
(3) either:
(i) is actively working toward a Master’s degree in an applied area of psychology, social work, or special education; or
(ii) completes at least one graduate-level course in an applied health service area of applied psychology, social work, or special education each year.
(iii) The qualifying Master’s degrees referenced in this paragraph, including any degree obtained through an online educational or distance learning program, must have been awarded by a regionally accredited college or university, or one recognized by the NYS Education Department as following acceptable educational practices. If the Master’s degree was awarded by an educational institution outside the United States and its territories, the party must provide independent verification of equivalency from one of the approved entities used by the NYS Department of Civil Service for educational equivalency reviews.
(iv) Notwithstanding any other provision of this section, parties who are employed by New York State and function in a title included in a New York State Civil Service title series shall provide behavioral services or supervision of such services described in this section as included in their job descriptions.
(v) Notwithstanding any other provision of this paragraph, a party may be considered a BIS in the event that OPWDD has approved a waiver of a specific required qualification upon application of a provider (See paragraph (c)(12) of this section).
Paragraph 633.16(d)(1) is amended as follows:
(1) Prior to the development of a behavior support plan to address challenging behavior that is not solely the result of a [diagnosed] co-occurring diagnosed psychiatric disorder, …
Paragraph 633.16(e)(9) is amended as follows:
(9) Nothing in this subdivision (633.16(e)) shall be construed to prevent the use of medication to prevent, modify, or control challenging …
Paragraph 633.16(f)(3) is amended as follows:
(3) … except for monitoring plans in which medication is used solely for the treatment of a co-occurring diagnosed psychiatric [condition] disorder. The term “psychiatric [condition] disorder” means those psychiatric [conditions] disorders which are recognized as such by the American Psychiatric Association or World Health Organization. For the purposes of this section, the term “co-occurring psychiatric [condition] disorder” does not refer …
Paragraph 633.16(g)(1) is amended by the addition of a new subparagraph (ii) and re-numbering of existing subparagraph (ii) to (iii) as follows:
(ii) Written informed consent is required prior to implementation of a physician's order for planned use of medication to treat a co-occurring diagnosed psychiatric disorder (See subparagraph 633.16(j)(5)(ii)). However, if written informed consent cannot be obtained within a reasonable period of time prior to the initiation or continuance of a medication, verbal consent may be accepted only for the period of time before written informed consent can be reasonably obtained. Verbal consent must be witnessed by two members of the staff, and documented in the person’s record. This verbal consent is valid for a period of up to 45 days and may not be renewed.
Paragraph 633.16(h)(3) and subparagraph 633.16(3)(iv) are amended as follows:
(3) Medication refusal. If an individual receiving services refuses to take medication to prevent, modify, or control challenging behavior or to treat a co-occurring diagnosed psychiatric [condition] disorder, …
(iv) If repeated attempts to resolve the issue of refusal of medication intended to modify or control challenging behavior or to treat a diagnosed psychiatric [condition] disorder are unsuccessful, and the agency considers the administration of the medication to be necessary for effective treatment of the individual’s [condition] disorder, …
Clause 633.16(j)(5)(i)(b) is amended as follows:
(b) The use of medication to prevent, modify, or control challenging behavior or to treat symptoms of a [diagnosed] co-occurring diagnosed psychiatric disorder shall not: …
Clause 633.16(j)(5)(i)(c) is amended as follows:
(c) The use of medication to prevent, modify, or control challenging behavior, or to treat a co-occurring diagnosed psychiatric disorder, not in conformance with this paragraph, …
Clause 633.16(j)(5)(i)(d) is amended as follows:
(d) A semi-annual medication regimen review that includes any medications prescribed to treat a co-occurring diagnosed psychiatric disorder, or to prevent, modify, or control[, modify or eliminate] challenging behavior(s), …
Clause 633.16(j)(5)(i)(f) is amended as follows:
(f) … (See subparagraph (b)(13[2])(ii) of this section for the basic elements of the information necessary for informed consent.)
Clause 633.16(j)(5)(i)(g) is amended as follows:
(g) Lack of informed consent for, or the refusal of, medication intended to prevent, modify, or control challenging behavior, or medication used to treat a co-occurring diagnosed psychiatric [condition] disorder, is addressed in subdivision (h) of this section.
Clause 633.16(j)(5)(ii)(a) is amended as follows:
(a) Medication to prevent, modify, or control[, or modify] challenging behavior, or to [prevent or reduce] treat symptoms of a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder, must be administered only as an integral part of a behavior support plan or monitoring plan, in conjunction with other interventions which are specifically directed toward the potential reduction and eventual elimination of the challenging behavior(s) or target symptoms of the [diagnosed] co-occurring diagnosed psychiatric [condition] disorder.
Clause 633.16(j)(5)(ii)(e) is amended as follows:
(e) Additional requirements concerning the use of medication to treat a co-occurring diagnosed psychiatric [condition] disorder are found in subparagraph (vi) of this paragraph.
Clause 633.16(j)(5)(iii)(a) is amended as follows:
(a) “As-needed” (also known as “PRN”) orders for medication to prevent, modify, or control challenging behavior, or to treat [reduce] symptoms of a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder, are considered planned use and must be incorporated in and documented as part of a behavior support plan or a monitoring plan.
Subclause 633.16(j)(5)(iii)(c)(1) is amended as follows:
(1) the conditions under which the “as-needed” medication is to be administered, including the nature and degree of the individual’s behavior(s) or symptoms, and the prescriber’s recommendations regarding proximity to any scheduled medication administration;
Clause 633.16(j)(5)(iii)(g) is amended as follows:
(g) Each use of an as-needed medication when used in conjunction with a restrictive physical intervention technique to prevent, modify, or control challenging behavior shall be reported electronically to OPWDD in the form and format specified by OPWDD.
Clause 633.16(j)(5)(iv)(a) is amended as follows:
(a) Medication may be administered in an emergency, without informed consent, with the express intent of controlling a person's challenging behavior or acute symptoms of a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder when: …
Clause 633.16(j)(5)(iv)(d) is amended as follows:
(d) The emergency use of medication to [manage] control challenging behavior or acute symptoms of a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder …
Clause 633.16(j)(5)(iv)(e) is amended as follows:
(e) Whenever it is or has been necessary to [utilize] use any medication to control challenging behavior or acute symptoms of a [diagnosed] co-occurring diagnosed psychiatric [condition] disorder in an emergency, …
Clause 633.16(j)(5)(iv)(f) is amended as follows:
(f) Each use of an emergency medication [solely] to control challenging behavior shall be reported electronically to OPWDD in the form and format specified by OPWDD.
Clause 633.16(j)(5)(v)(b) is amended as follows:
(b) In the absence of a behavior support plan [which] that incorporates the use of a specific medication(s) [, medication] to prevent, modify, or control challenging behavior, such medication may be administered on a short-term basis when all of the following conditions are met: …
Clause 633.16(j)(5)(v)(d) is amended as follows:
(d) … The program planning team shall determine if it is necessary to develop a behavior support plan to prevent, modify, or control the behavior or to modify an existing plan of services, or shall establish the criteria for a future decision that a plan will be needed. …
Clause 633.16(j)(5)(v)(e) is amended as follows:
(e) Without incorporation into a behavior support plan and written informed consent, the administration of the medication shall not continue for more than [30] 45 consecutive days [and no more than 45 days in a calendar year].
Subparagraph 633.16(j)(5)(vi) is amended and re-numbered as follows:
(vi) Medication use to treat a co-occurring diagnosed psychiatric [condition] disorder. [(a)] Medication may be used as part of the treatment for the symptoms of a co-occurring diagnosed psychiatric [condition] disorder, including challenging behavior that occurs exclusively or almost exclusively as a result of that [condition] disorder. In such circumstances, [T]the following requirements must be met:
[(1)](a) In order to be considered “medication to treat a co-occurring diagnosed psychiatric [condition] disorder,” the medication must be prescribed for the treatment of a specific psychiatric [condition] disorder, in a manner consistent with generally accepted psychiatric practice.
[(2)](b) The term “psychiatric [condition] disorder” means those psychiatric [conditions] disorders which are recognized as such by the American Psychiatric Association or World Health Organization. For the purposes of this section, the term “co-occurring psychiatric [condition] disorder” does not …
[(3)](c) …
[(4)](d) The use of the medication shall be consistent with accepted standards of clinical practice, including treatment of the symptoms of the diagnosed psychiatric [condition] disorder.
[(5)](e) The symptoms and diagnosis of the co-occurring psychiatric [condition] disorder must be documented.
[(6)](f) Target symptoms for the psychiatric [condition] disorder shall be identified …
[(7)](g) The use of medication and the target symptoms shall be specified and documented in a written monitoring plan. The plan [should] must specify how progress reflected in symptom reduction and relevant functional improvement, or lack of progress, will be measured and documented. …
[(8)](h) …
This notice is intended:
to serve as both a notice of emergency adoption and a notice of proposed rule making. The emergency rule will expire August 28, 2013.
Text of rule and any required statements and analyses may be obtained from:
Barbara Brundage, Director of Regulatory Affairs, OPWDD, 44 Holland Avenue, 3rd floor, Albany, NY 12229, (518) 474-1830, email: barbara.brundage@opwdd.ny.gov
Data, views or arguments may be submitted to:
Same as above.
Public comment will be received until:
45 days after publication of this notice.
Additional matter required by statute:
Pursuant to the requirements of the State Environmental Quality Review Act, OPWDD, as lead agency, has determined that the action described will have no effect on the environment, and an E.I.S. is not needed.
Regulatory Impact Statement
1. Statutory Authority:
a. OPWDD has the statutory responsibility to provide and encourage the provision of appropriate programs and services in the area of care, treatment, rehabilitation, education and training of persons with developmental disabilities, as stated in the New York State Mental Hygiene Law Section 13.07.
b. OPWDD has the statutory authority to adopt rules and regulations necessary and proper to implement any matter under its jurisdiction as stated in the New York State Mental Hygiene Law Section 13.09(b).
c. OPWDD has the statutory authority to adopt regulations concerning the operation of programs and provision of services and facilities pursuant to the New York State Mental Hygiene Law Section 16.00.
2. Legislative Objectives:
These emergency/proposed amendments further the legislative objectives embodied in sections 13.07, 13.09(b), and 16.00 of the Mental Hygiene Law. The emergency/proposed amendments would improve the quality of services in the OPWDD system and enable service providers to provide needed protections to individuals with challenging behaviors.
3. Needs and Benefits:
OPWDD recently promulgated regulations addressing person-centered behavioral interventions. The regulations included specific requirements regarding the development, monitoring, implementation, and approval of behavior support plans and regarding the qualifications of parties responsible for developing and monitoring the plans. The existing regulations specify that all new behavior support plans must comply with the new requirements, including the requirements regarding the qualifications of parties authorized to develop and monitor the plans, effective May 31, 2013.
Since the time that the person-centered behavioral intervention regulations were adopted, OPWDD has learned that some provider agencies have had difficulty recruiting parties who meet the qualifications contained in the regulations. The emergency/proposed regulations expand the minimum qualifications of parties authorized to develop and monitor behavior support plans, and other plans to address co-existing psychiatric disorders. OPWDD expects that the emergency/ proposed regulations will enable provider agencies to retain certain existing staff members, and to recruit and hire parties who possess other acceptable types of educational, training, and work experience that were not included in the original regulations.
OPWDD determined that the emergency/proposed regulations are needed because some individuals who need behavioral intervention services would not be able to receive the services as some provider agencies would not be able to recruit staff or consultants who meet the qualifications contained in the original regulations. A lack of behavior support services can present unnecessary risks for crises and tragic consequences, including serious injury or death. OPWDD expects that the emergency/proposed regulations will enhance the health, safety, and welfare of individuals in need of services and those in their living, habilitation, and work environments.
The emergency/proposed regulations also amend the original regulations to clarify that the use of physical intervention techniques and/or mechanical restraining devices to facilitate emergency evacuations/drills is not considered a restrictive/intrusive intervention that requires inclusion in a behavior support plan. The addition of this clarifying language will eliminate confusion that could have impeded the use of these techniques and devices during emergency evacuations and drills. In order to successfully evacuate a building during an emergency situation (such as a fire) it is sometimes necessary to use these techniques and devices. Reluctance to use the techniques and devices when warranted in an emergency (or, when necessary, during a drill) because of the perception that such use might be precluded in the absence of a behavior support plan can have serious consequences for the health, safety and welfare of individuals receiving services and facility staff.
In addition, the emergency/proposed regulations include non-substantive changes to ensure consistency in the use of clinical terminology and correct typographical errors in the existing regulations. The emergency/proposed regulations also clarify reporting requirements on reporting the use of PRN medications consistent with existing OPWDD policy requirements.
4. Costs:
a. Costs to the Agency and to the State and its local governments:
There are no anticipated impacts on Medicaid rates, prices or fees. Consequently, there is no impact on the federal government, New York State or local governments due to changes in Medicaid expenditures. There are no costs to OPWDD as a provider of services.
b. Costs to private regulated parties:
There are no initial capital investment costs. The original regulations included potential for initial non-capital expenses related to the costs of hiring new staff and/or consultants to develop and monitor behavioral intervention services, and training existing staff; however, the emergency/proposed regulations expand the minimum qualifications of parties authorized to develop and monitor behavior support plans, and other plans to address co-existing psychiatric disorders. OPWDD expects that the emergency/proposed regulations will enable provider agencies to retain certain existing staff members. This change creates potential for savings as the need to orient and train new staff will be avoided. In addition, there may be some cost savings resulting from employing individuals with lesser qualifications.
5. Local Governmental Mandates:
There are no new requirements imposed by the rule on any county, city, town, village; or school, fire, or other special district.
6. Paperwork:
There are no new paperwork requirements associated with the emergency/proposed regulations.
7. Duplication:
The proposed amendments do not duplicate any existing State or Federal requirements that are applicable to services for persons with developmental disabilities.
8. Alternatives:
OPWDD considered alternative combinations of education and credentials to establish qualifications for parties authorized to develop and monitor behavior support plans, and determined that the qualifications included in the emergency/proposed regulations achieve the proper balance of expanding the pool of qualified parties and enabling agencies to provide needed behavioral intervention services, without compromising the quality of services provided.
9. Federal Standards:
The proposed amendments do not exceed any minimum standards of the federal government for the same or similar subject areas.
10. Compliance Schedule:
The emergency regulations are being promulgated on May 31, 2013 to coincide with the compliance schedule of the original regulations on person-centered behavioral intervention. The original regulations required that all new behavior support plans meet specified requirements, including the requirements regarding the qualifications of parties authorized to develop and monitor the plans, effective May 31, 2013.
Regulatory Flexibility Analysis
OPWDD is not submitting a Regulatory Flexibility Analysis for small businesses and local governments for these emergency/proposed regulations because the regulations will not impose any adverse economic impact or significant reporting, recordkeeping, or other compliance requirements on small businesses. There are no professional services, capital, or other compliance costs imposed on small businesses as a result of these amendments.
OPWDD recently promulgated regulations addressing person-centered behavioral interventions. The regulations included specific requirements regarding the development, monitoring, implementation, and approval of behavior support plans and regarding the qualifications of parties responsible for developing and monitoring the plans. The purpose of the emergency/proposed regulations is to expand minimum qualifications of parties authorized to develop and monitor behavior support plans for individuals with intellectual disabilities.
Since the time that the person-centered behavioral intervention regulations were adopted, OPWDD has learned that some provider agencies, including small provider agencies, have had difficulty recruiting parties who meet the qualifications contained in the regulations. OPWDD expects that the expanded minimum qualifications will enable provider agencies to retain certain existing staff members, and to recruit and hire parties who possess other acceptable types of educational, training, and work experience that were not included in the existing regulations.
The emergency/proposed regulations also amend the original regulations to clarify that the use of physical intervention techniques and/or mechanical restraining devices to facilitate emergency evacuations/drills are not considered restrictive/intrusive interventions that require inclusion in a behavior support plan.
In addition, the emergency/proposed regulations include non-substantive changes to ensure consistency in the use of clinical terminology and to correct typographical errors in the existing regulations. The emergency/proposed regulations also clarify reporting requirements on reporting the use of PRN medications consistent with existing OPWDD policy requirements.
The emergency/proposed regulations will have no adverse impact, or impose additional costs, paperwork, or compliance requirements, on small businesses or local governments.
Rural Area Flexibility Analysis
OPWDD is not submitting a Rural Area Flexibility Analysis for these emergency/proposed regulations because the regulations will not impose any adverse impact or significant reporting, record keeping, or other compliance requirements on public or private entities in rural areas. There will be no professional services, capital, or other compliance costs imposed on public or private entities in rural areas as a result of the amendments.
OPWDD recently promulgated regulations addressing person-centered behavioral interventions. The regulations included specific requirements regarding the development, monitoring, implementation, and approval of behavior support plans and regarding the qualifications of parties responsible for developing and monitoring the plans. The purpose of the emergency/proposed regulations is to expand minimum qualifications of parties authorized to develop and monitor behavior support plans for individuals with intellectual disabilities.
Since the time that the person-centered behavioral intervention regulations were adopted, OPWDD has learned that some provider agencies, particularly those providing services in rural areas, have had difficulty recruiting parties who meet the qualifications contained in the regulations. OPWDD expects that the expanded minimum qualifications will enable provider agencies to retain certain existing staff members, and to recruit and hire parties who possess other acceptable types of educational, training, and work experience that were not included in the existing regulations. OPWDD expects that this will be particularly helpful to providers in rural areas where access to licensed clinicians and other professionals is often limited.
The emergency/proposed regulations also amend the original regulations to clarify that the use of physical intervention techniques and/or mechanical restraining devices to facilitate emergency evacuations/drills are not considered restrictive/intrusive interventions that require inclusion in a behavior support plan.
In addition, the emergency/proposed regulations include non-substantive changes to ensure consistency in the use of clinical terminology and to correct typographical errors in the existing regulations. The emergency/proposed regulations also clarify reporting requirements on reporting the use of PRN medications consistent with existing OPWDD policy requirements.
The emergency/proposed regulations will have no adverse impact, or impose additional costs, paperwork, or compliance requirements, on public or private entities in rural areas.
Job Impact Statement
OPWDD is not submitting a Job Impact Statement for this emergency/proposed rule making because the rule making will not have a substantial adverse impact on jobs or employment opportunities.
OPWDD recently promulgated regulations addressing person-centered behavioral interventions. The regulations included specific requirements regarding the development, monitoring, implementation, and approval of behavior support plans and regarding the qualifications of parties responsible for developing and monitoring the plans. The purpose of the emergency/proposed regulations is to expand minimum qualifications of parties authorized to develop and monitor behavior support plans for individuals with intellectual disabilities.
Since the time that the person-centered behavioral intervention regulations were adopted, OPWDD has learned that some provider agencies have had difficulty recruiting parties who meet the qualifications contained in the regulations. OPWDD expects that the expanded minimum qualifications will enable provider agencies to retain certain existing staff members, and to recruit and hire parties who possess other acceptable types of educational, training, and work experience that were not included in the existing regulations. The emergency/proposed regulations are not expected to have any impact on jobs and employment opportunities.
