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Behavioral Support Plans More than 40 disorders that cause intellectual disabilities can be treated to improve developmental outcomes. Pennhurst Group staff psychologists have helped improve the quality of life for individuals and families affected by disabilities in numerous state owned and operated facilities over the past 23 years on a nationwide basis by offering state of the art behavioral Support Plans. A good Behavior Support Plan has been described as a "work of art". The individuality of the plan is to be preserved at all costs. While there are many psychologists who can create a plan, the effectiveness of the plans has to do with many factors. There are three basic components involved in the creation of individualized Behavioral Support Plans: Phase 1. Conduct a functional assessment. Phase 2. Develop a working hypothesis concerning the function of the challenging behavior. Design and implement the individualized behavioral support plan. Phase 3. Provide Training for all staff including direct care staff in the implementation of the Behavioral Support Plan. This will be followed by steps to evaluate effectiveness and modify the support plan as needed. Each of these steps has additional requirements that will determine the functionality of the plans. The Reliability of the Data obtained in Phase one is rarely confirmed in the process. Occasionally, we see "computerized forms/programs" that some organizations or psychologists use and the outcome, is as you would expect to be leaves much to be desired. Templates are not generally used for the type of individualized plans that surveyors are reviewing in 2002 and beyond. Our staff and the quality assurance organization that we utilize will insure that this important subroutine is taken on each and every plan. Problems occur when Surveyors witness challenging behavior and then reference the Behavioral Support Plan in the record and find inconsistency with the desired outcomes. Using templates is a big red flag to experienced surveyors. Other agencies such as the DOJ have also sought major integration of the behavioral support plans with the facility psychiatric program services. A good Behavior Support Plan is crafted in this setting and tempered with implementation by excellent support staff. Competency based training is something that some organizations and psychologists are simply unfamiliar with but is essential to the outcomes all parties are seeking from this service. Because of the way that current regulations are written the survey process has been described as somewhat of an "artform" by some and has caught many large and responsible facilities unaware. Upon receipt of the 2567 form, most state owned and operated facilities only begin searching for solutions. Plans of Correction filed within ten days seldom address the proper solutions from the beginning and our experience is that a quick and definitive response with high caliber professionals can avoid complications arising that lead to higher costs. A brief outline of the procedure will show the steps that are involved. The Centers for Medicare & Medicaid Services (CMS) administration originally issued a revised facility survey protocol October 1, 1996. The new survey protocol calls for an outcomes-based, customer-focused approach to facility surveys. This new approach emphasizes customer responses and staff performance rather than review of facility records. While there are eight conditions of participation with which facilities must comply, the survey process stresses four of those categories of participation: active treatment services, client protection, client behavior and health care services. Client behavior is one of the current highlighted conditions of participation and to be certified to receive Medicaid funding, a facility must meet federal standards for 24-hour health care and continuous individualized positive Behavioral Support Plans for residents. In managing inappropriate client behaviors, facilities emphasize client safety, welfare, and the protection of human rights. In directing client behavior, ICFs/MR's must primarily focus on positive behavioral management programs that reward appropriate behavior, thereby eliminating undesirable behaviors. Use of more intrusive techniques is regulated under federal law and must be part of the client’s Individual Program Plan (IPP) in order to be applied. Such methods should never be used for disciplinary purposes or for the convenience of staff.
Licensing and Certifications The majority of psychologists are not qualified to serve as behavioral consultants for someone with mental retardation or another developmental disability simply because they do not have the specialized training and experience in applied behavior analysis or behavioral psychology and mental retardation/developmental disabilities (MR/DD) needed to provide effective behavioral treatment for people with MR/DD. This is why many facilities and states have difficulty with the survey process in this area. Licensure exhibits great variability from state to state in the areas of competence required and although the doctoral degree is a basic requirement in most states it alone does not indicate if an individual is qualified to serve as a behavioral consultant for someone with mental retardation. Information about State licensing is available from the Association of State and Provincial psychology Boards, P.O. Box 4389, Montgomery, AL 36103-4389. There are professional groups involved with the issue of behavioral consultants and their credentials as they pertain to this area of expertise including the Psychology Division of the American Association on Mental Retardation the MR/DD Division (Division 33) of the American Psychological Association. The American Board of Professional Psychology (ABPP), 750 1st Street NE, Washington, DC 20002, recognizes the specialty board of behavioral psychology. Candidates for ABPP certification need a doctorate in psychology, 5 years of experience, professional endorsements, and a passing grade on an examination. This board certification is indicated by "ABPP" and psychologists who have this kind of certification are called diplomats of the American Board of Professional Psychology (ABPP). As is the current trend in many other fields some organizations have been recently created to offer voluntary certification as well. One such organization is the Behavior Analyst Certification Board, Inc. Professionals with master’s or doctoral degrees who are certified under this program are called Board Certified Behavior Analysts (BCBA).
Supply and Demand Psychologists held about 166,000 jobs in 1998 nationwide. After several years of experience some psychologists enter private practice and currently about one half of psychologists are self-employed. This is about 5 times the average for professional workers and explains why there are so many consultants available. Employment of psychologists is expected to grow about as fast as the average for all occupations through 2008. (Please see the terms and conditions of use of this website for privacy policy)
Pennhurst Group, LLC, Suite 250, 300 N. Pottstown Pike Exton, Pennsylvania 19341 610-524-2400 Extension 15 Fax 610-524-0952 Email: info@pennhurstgroup.com Copyright © 2001 Pennhurst Group, LLC
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