CHAPTER 1600 Behavioral Supports Consultation Services

CHAPTER 1600
SPECIFIC PROGRAM REQUIREMENTS
FOR
BEHAVIORAL SUPPORTS CONSULTATION SERVICES
SCOPE OF SERVICES
1601 General
Behavioral Supports Consultation Services are professional consultation services that assist the participant with significant, intensive challenging behaviors that interfere with activities of daily living, social interaction, work or similar situations. These services consist of behavioral supports professional evaluation, training, and intervention services. Evaluation services by the Behavioral Supports professional consultant include functional assessment of behavior and other diagnostic assessment of behavior. Training and intervention services by the Behavioral Supports professional consultant comprise direct skills training of participants as well as family education and training on Positive Behavioral Supports.
Behavioral Supports Consultation Services provide for the development of Behavioral Supports Plans for behavioral interventions for the reduction of maladaptive behaviors or the acquisition or maintenance of replacement behaviors for individuals with significant, intensive challenging behaviors. Intervention modalities described in plans must relate to the identified behavioral needs of the waiver participant, and specific criteria for remediation of the behavior must be established and specified in the plan. Behavioral Supports Consultation Services may not be provided to participants receiving Community Residential Alternative Services in the Comprehensive Supports Waiver (COMP).
Behavioral Supports Consultation services are provided by appropriately qualified individuals with expertise in behavioral supports evaluation and services for people with developmental disabilities. These services may be provided in a participant’s own or family home, the Behavioral Supports Consultant’s office, outpatient clinics, facilities in which Community Access or Prevocational Services are provided, Supported Employment work sites, or other community settings specific to community-based behavioral supports goals specified in the Individual Service Plan.
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1602 Special Requirements of Participation
1602.1 Individual Provider
In addition to those conditions of participation in the Medical Assistance Program as outlined in Part I, Policies and Procedures for Medicaid/PeachCare for Kids Manual applicable to all Medicaid providers, Section 106 (General Conditions of Participation), and PART II, Chapter 600 Policies and Procedures for the COMP Program, Behavioral Supports Consultation Services individual providers must meet the following requirements:
1. Provider Qualifications – Individual providers of Behavioral Supports Consultation services must meet the following Positive Behavioral Supports Specialist Standards:
a. Minimum of a Masters degree in psychology, education, social work or a related field;
b. Specialized training and education in behavioral analysis and positive behavioral supports for people with developmental disabilities by provision of evidence of a minimum of thirty-five (35) hours of training and education in behavior analysis and behavioral supports’ The required hours must include support by college transcripts of a minimum of 12 semester hours of graduate course credit or 18 quarter hours of graduate course credits in behavioral analysis, behavioral assessment, behavior modification, behavioral change procedure, behavior therapy, or behavioral practicum. The remaining required hours are supported by additional hours of graduate course credits in the courses listed above or in ethics in behavioral change procedures and/or copies of training certificates for workshops approved as continuing education for behavioral professionals on topics of applied behavior analysis or behavioral supports for individuals with developmental disabilities. Evidence of national certification as a Board Certified Behavior Analyst through documentation of a certificate from the Behavior Analyst Certification Board will suffice for these criteria;
c. At least two years experience in behavioral supports evaluation and services for people with developmental disabilities, with at least one year supervised by a qualified professional (1 year is equal to 1200 work hours).
A qualified professional is defined as an individual who meets
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the Developmental Disability Professional (DDP) definition of Behavior Specialist, Board Certified Behavior Analyst, or Psychologist (for DDP definitions, see Part II Policies and Procedures for COMP, Appendix I);
d. Agree to or provide required documentation of a criminal records check.
2. Licensed Professional Qualifications: All licensed professionals rendering Behavioral Supports Consultation Services must meet the Behavioral Supports Consultant education, training, and experience standards specified above as well as hold current applicable professional license in the State of Georgia.
3. Guidelines Requirement: Providers of Behavioral Supports Consultation services must comply with the guidelines and requirements for the provision of behavioral supports to individuals with developmental disabilities in the DBHDD Guidelines for Supporting Adults with Challenging Behaviors in Community Settings and Best Practice Standards for Behavioral Support Services (see Guidelines in Appendix B and the Best practice Standards at dbhdd.georgia.gov) in the delivery of these services; providers rendering Behavioral Supports Consultation services to participants under the age of eighteen years must comply with any guidelines and requirements in these DBHDD Guidelines that are applicable to children and adolescents with developmental disabilities.
4. Behavioral Support Consultation Services at Community Access and Prevocational Service Facilities – Providers can provide Behavioral Supports Consultation Services at facilities where Community Access and Prevocational Services are rendered; however, the services must be documented and billed separately, and any waiver participant receiving multiple services at a Community Access and Prevocational Service facility may not receive these services at the same time of the same day. The only exception is when a Behavioral Supports Consultant is conducting observation of a participant receiving Community Access or Prevocational Services at a facility for the development of a Behavioral Support Plan. The provider is responsible for documentation of the Behavioral Support Consultation Service at the facility as observation for the developmental of a Behavioral Support Plan.
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5. Documentation Requirement: Providers, except for providers of participant-directed services, must document the following in the record of each participant receiving Behavioral Supports Consultation Services:
a. Specific activity, training, or assistance provided;
b. Date and the beginning and ending time when the service was provided;
c. Location where the service was delivered;
d. Verification of service delivery, including first and last name and title (if applicable) of the person providing the service and his or her signature;
e. Progress towards moving the participant towards independence by meeting the participant ISP, which includes person-centered goals, desired outcomes in the participant’s action plan, and the amount/type of assistance/support in the current Service Summary and the Health and Safety sections of the ISP.
6. Participant-Directed Services Documentation and other Requirements: Documentation and other requirements for providers of participant-directed services are specified in Part II Policies and Procedures for COMP, Chapter 1200.
1602.2 Agency Provider
In addition to those conditions of participation in the Medical Assistance Program as outlined in Part I, Policies and Procedures for Medicaid/PeachCare for Kids Manual applicable to all Medicaid providers, Section 106 (General Conditions of Participation), and PART II, Chapter 600 Policies and Procedures for the COMP Program, Behavioral Supports Consultation Services agency providers must meet the following requirements:
1. Types of Agencies: Agencies that provide Behavior Supports Consultation Services are:
 Accredited or Certified DD Service Agencies
2. Staffing Qualifications and Responsibilities: Agencies rendering Behavior Supports Consultation service must have staffing that meets the following:
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a. A designated agency director who must:
i. Have either a bachelor’s degree in a human service field (such as social work, psychology, education, nursing, or a closely related field) and five years experience in service delivery to persons with developmental disabilities, with at least two of these years serving in a supervisory capacity; or
ii. Have an associate degree in nursing, education, or a related field and six years experience in service delivery to persons with developmental disabilities, with at least two of these years serving in a supervisory capacity
b. Duties of the Agency Director include, but are not limited to:
i. Oversees the day-to-day operation of the agency
ii. Manages the use of agency funds
iii. Ensures the development and updating of required policies of the agency
iv. Manages the employment of staff and professional contracts for the agency
v. Designates another staff member to oversee the agency, in his or her absence
c. At least one agency employee or professional under contract with the agency must be a Developmental Disability Professional (DDP) (for definition see Part II Policies and Procedures for COMP, Appendix I) who has a minimum of a Masters degree in psychology, education, social work or a related field and meets the DDP definition of Behavior Specialist, Behavior Analyst, or Psychologist.
d. The same individual may serve as both the agency director and the Developmental Disability Professional
e. Duties of the DDP include, but are not limited to:
i. Overseeing the services and supports provided to participants;
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ii. Supervising the formulation of the participant’s plan for delivery of Behavior Supports Consultation Services;
iii. Supervising high intensity services
f. Provider agencies must have available a sufficient number of employees or professionals under contract that have been approved by the Division of Developmental Disabilities Behavior Supports Consultation approval process to provide Behavior Supports Consultation Services as specified in the Individual Service Plans of participants served.
g. Duties of the Behavioral Supports Consultants include all covered services in Section 1606
h. All employees within the agency or professionals under contract who provide the covered services must be approved by the Division of Developmental Disabilities Behavioral Supports Consultation approval process. The approval process requires providers to submit documentation (for review by the Division of Developmental Disabilities- Behavioral Services Unit) that the employee or professional under contract meets the following criteria and obtain written certification prior to billing for services provided by that consultant:
i. Minimum of a Masters degree in psychology, education, social work or a related field;
ii. Specialized training and education in behavioral analysis and positive behavioral supports for people with developmental disabilities by provision of evidence of a minimum of thirty-five (35) hours of training and education in behavior analysis and behavioral supports. The required hours must include support by college transcripts of a minimum of 12 semester hours of graduate course credits or 18 quarter hours of graduate course credits in behavior analysis, behavioral assessment, behavior modification, behavioral change procedures, behavior therapy, or behavioral practicum. The remaining required hours are supported by additional hours
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of graduate course credits in the courses listed above or in ethics in behavioral change procedures, and/or copies of training certificates for workshops approved as continuing education for behavioral professionals on topics of applied behavior analysis or behavioral supports for individuals with developmental disabilities. Evidence of national certification as a Board Certified Behavior Analyst through documentation of a certificate from the Behavior Analyst Certification Board will suffice for these criteria;
iii. At least one year experience in behavioral supports evaluation and service for people with developmental disabilities
iv. Attestation that consultant has successfully passed criminal background check.
i. Licensed Professional Qualifications: All licensed professionals rendering Behavioral Supports Consultation Services must meet the Behavioral Supports Consultant education, training, and experience standards specified above as well as hold current applicable professional license in the State of Georgia.
j. Guidelines Requirement: Providers of Behavioral Supports Consultation services must comply with the guidelines and requirements for the provision of behavioral supports to individuals with developmental disabilities in the DBHDD Guidelines for Supporting Adults with Challenging Behaviors in Community Settings and Best Practice Standards for Behavioral Support Services (see Guidelines in Appendix B and the Best Practice Standards at dbhdd.georgia.gov) in the delivery of these services; providers rendering Behavioral Supports Consultation services to participants under the age of eighteen years must comply with any guidelines and requirements in these DBHDD Guidelines that are applicable to children and adolescents with developmental disabilities.
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k. Behavioral Support Consultation Services at Community Access and Prevocational Service Facilities: Providers can provide Behavioral Supports Consultation Services at facilities where Community Access and Prevocational Services are rendered; however, the services must be documented and billed separately, and any waiver participant receiving multiple services at a Community Access and Prevocational Service facility may not receive these services at the same time of the same day. The only exception is when a Behavioral Supports Consultant is conducting observation of a participant receiving Community Access or Prevocational Services at a facility for the development of a Behavioral Support Plan. The provider is responsible for documentation of the Behavioral Support Consultation Service at the facility as observation for the developmental of a Behavioral Support Plan.
l. Documentation Requirement: Providers, except for providers of participant-directed services, must document the following in the record of each participant receiving Behavioral Supports Consultation Services:
i. Specific activity, training, or assistance provided;
ii. Date and the beginning and ending time when the service was provided;
iii. Location where the service was delivered;
iv. Verification of service delivery, including first and last name and title (if applicable) of the person providing the service and his or her signature;
v. Progress towards moving the participant towards independence by meeting the participant ISP, which includes person-centered goals, desired outcomes in the participant’s action plan, and the amount/type of assistance/support in the Current Service Summary and the Health and Safety sections of the ISP.
m. Participant-Directed Services Documentation and other Requirements: Documentation and other requirements for providers of participant-directed
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services are specified in Part II Policies and Procedures for COMP, Chapter 1200.
1603 Licensure
The provider of Behavioral Supports Consultation Services must have any applicable professional license as required by Georgia Code Title 43, for:
1. Psychologist (OCGA 43-39-1); or
2. Licensed Professional Counselor (OCGA 43-10A-1); or
3. Licensed Clinical Social Worker (OCGA 43-10A-1); or
4. Psychiatrist (OCGA 43-24-20).
1604 Special Eligibility Conditions
The need for Behavioral Supports Consultation Services must be related to the individual participant’s disability, therapeutic in nature, and tied to a specific goal in the Intake and Evaluation Team approved Individual Service Plan (ISP).
1605 Prior Approval
Behavioral Supports Consultation Services must be authorized prior to service delivery by the operating agency at least annually in conjunction with the Individual Service Plan (ISP) development and with any ISP revisions.
1606 Covered Services
Reimbursable Behavioral Supports Consultation Services include the following based on the assessed need of the participant and as specified in the approved ISP:
1. Functional assessment of behavior and other diagnostic assessment of behavior.
2. Development, training, and monitoring of Positive Behavioral Supports plans with specific criteria for the acquisition and maintenance of appropriate behaviors for community living and behavioral intervention for the reduction of maladaptive behaviors.
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3. Intervention modalities related to the identified behavioral needs of the participant.
4. Participant-specific skills or replacement behavior acquisition training.
5. Family education and training on Positive Behavioral Supports.
1607 Non-Covered Services
1. Services that duplicate any family education or training provided through Natural Supports training (NST) Services.
2. Services that occur simultaneously or on the same day as NST Services.
3. Services to participants receiving Community Residential Alternative Services in the Comprehensive Supports Waiver.
4. Services in a hospital.
5. Restrictive behavioral interventions, including chemical or mechanical restraints and seclusion, prohibited by state law or regulations.
6. Transportation to and from these services is not included in the rate.
7. Payment is not made, directly or indirectly, to members of the individual’s immediate family, except as approved as indicated in Part II Policies and Procedures for COMP, Chapter 900
8. Payment is not made for those goods and services covered by the State Medicaid Plan except where a participant’s need exceeds State Plan coverage limits and exceptions to the coverage limits are not available.
9. Services provided by an agency staff member who has not been approved prior to Behavioral Supports Consultation service delivery by the DBHDD, Division of Developmental Disabilities Behavioral Supports Consultation approval process.
1608 Basis for Reimbursement
The reimbursement rate for Behavioral Supports Consultation Services
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is found in Appendix A.
A. A unit of service is 15 minutes.
B. The annual maximum number of units is 104.
C. The annual maximum is $2,450.24.
Self-Directed
Limit: 1 unit = $1.00
Annual maximum = $2,450
1609 Participant-Direction Options
A. Participants can choose the self-direction option with Behavioral Supports Consultation Services.
B. An individual serving as a representative for a waiver participant in self-directed services is not eligible to be a participant-directed provider of Behavioral Supports Consultation Services.
C. For details on participant-direction, see Part II Policies and Procedures for COMP, Chapter 1200.
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