Ala. Admin. Code r. 660-5-49-.03
Current through Register Vol. 42, No. 11, August 30, 2024
Section 660-5-49-.03 - Behavior Management Interventions(1)Behavior Management Interventions - Interventions used to manage children's behaviors and must be authorized by the child and family planning team and documented in the individualized service plan. The most normalized least restrictive interventions must be used to manage behaviors before the more restrictive interventions are pursued. (a)General Guidelines. 1. General guidelines which apply to all behavior management interventions utilized by residential and non-residential providers, including foster family home, to manage children's behaviors include: (i) Interventions shall be based upon the needs of each individual child and supportive of the child's permanency goal as stated in the family's individualized service plan;(ii) Decisions regarding the use of specific interventions must be based upon an assessment that considers, among other things, whether the safety of the child and others can be adequately met by the proposed interventions, and the behavior is being managed with the minimum physical and psychological risk to the child and others;(iii) The parent(s) or other legally responsible person/agency and the age-appropriate child shall be informed of the purpose and benefits as well as the potential risk involved in behavior management interventions that will be used with a child;(iv) Behavior management interventions must be administered in a manner which assists in establishing safety and emotional well-being for the child, offers ways for the child to gain control and have needs met without risk to personal safety or the safety of others, and demonstrates respect for the child as a person of worth and value;(v) The child's behavior must be managed in a way that promotes the child's personal growth and assists in the development of a positive self-concept;(vi) Interventions which stress the use of praise, supportive feedback and rewards shall be the principle methods used, and these interventions must be managed in a way that encourages and leads to self-regulation by the child;(vii) The role of managing a child's behavior may be delegated to another child only when participating in an organized program of self-government which conforms to these standards and which is properly supervised by group home or residential staff;(viii) Medication is to be used only when needed to assist children in gaining control of their behavior and if medically indicated by a qualified physician as a method of therapeutic treatment and only as prescribed by the physician on the prescription;(ix) Seclusion and restraint are to be used only when alternative interventions have been unsuccessful or would not be practicable, and when needed to protect children from seriously harming themselves or others, including other children, staff, and family members, or needed to prevent substantial property damage;(x) The DHR worker, caregiver or others, as identified by the child and family planning team, will provide supportive services necessary to implement interventions in the least restrictive environment for the child; and(xi) Disagreements and grievances about the type of interventions being used will be addressed in a fair, timely, and impartial manner by both DHR and provider staff.(2)Prohibited Interventions - Interventions that infringe upon the rights of the child and family and that do not consider the child's individualized treatment needs are prohibited. Medication, seclusion, and restraint shall not be used as retaliation or punishment, for the convenience of providers and their staff or as a substitute for more appropriate and less restrictive interventions or because of inadequate staffing. The most normalized, least restrictive measures for controlling children's behavior must first be implemented before pursuing more restrictive measures. (a) Prohibited interventions include, but are not limited to: 1. Interventions that deny the child the right to humane care and protection from danger including abusive and neglectful actions of others and actions that prolong physical discomfort. Physical/corporal punishment, verbal abuse, threats or derogatory remarks about the child or the child's family must not be used;2. Interventions that conflict with Department of Human Resources policies regarding telephone/mail access and visiting;3. Interventions that withhold the basic necessities from a child (i.e., food, water, exercise, acceptable social interaction and age-appropriate activities);4. Interventions that allow a child's peers to carry out discipline and/or fail to provide the child with proper adult supervision and guidance;5. Interventions that deny the child opportunities for dignity, personal privacy and to live in a normalized environment;6. Interventions that are of a vindictive nature and/or used for retaliation;7. Interventions that are clearly not age-appropriate or are inappropriate for the child's abilities;8. The use of medication, seclusion or restraint when the intervention has not been authorized by the child and family planning team in the individualized service plan; more appropriate or less restrictive interventions have not been tried; and the intervention is used in a manner that is not in accordance with this policy. Author: Jerome Webb
Ala. Admin. Code r. 660-5-49-.03
New Rule: Filed August 6, 2003; effective September 10, 2003.Statutory Authority:R.C. v. Fuller case (R.C. v. Hornsby, No. 88-H-1170-N, Consent Decree) (M.D. Ala. Approved December 18, 1991).