65G Documentation and Notification.

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Clement Armstrong
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1 65G Documentation and Notification. (1) Staff must document the following information in the individual s s record as soon as possible, but no later than the end of the work shift following the use of a reactive strategy: (a) The behavior that necessitated a ; (b) The used; (c) The date and time the was implemented and the time the strategy was terminated; and, (d) The person(s) who initiated, applied, authorized, and terminated the ; (2) The authorizing agent must review and sign the documentation within twenty-four hours or by the end of the next business day.

2 65G Documentation and Notification. (3) Service provider or facility must also document every use of a on the Reactive Report, APD Form 65G8-002 (August 2008), These Reports must be submitted within 30 days to the LRC chairperson, or designee, Copies of the Report made a part of the individual s record. (4) Agency Area Offices and DSIs must submit Reports electronically to the Central Office Senior Behavior Analyst on a monthly basis.

3 Last Slide Viewed 65G Access to Rules. (1) The provider or facility must maintain on-site a copy of Rule Chapter 65G-8, F.A.C, accessible by staff, clients, parents, guardians, and guardian advocates. (2) The requirements established in this rule chapter are to be incorporated into all staff pre-service training programs related to the use of reactive strategies.

4 65G Enforcement. (1) Use of a not authorized by or in violation of this rule chapter or any other provision of law is a violation of Section , F.S., The Bill of Rights of Persons with Disabilities, or Section , F.S., and is subject to the enforcement proceedings, penalties, and private rights of action provided therein. (2) A residential facility licensed under Section , F.S., that violates any provision or requirement of this rule chapter through the action of either facility management or staff, is subject to administrative disciplinary action authorized by Section , F.S. Specific Authority , (4)(h)2., (2) FS. Law Implemented (4)(h), (2) FS. History New

5 65G Documentation and Notification. To indicate "Yes", mark a "1" in the appropriate box REACTIVE STRATEGIES REPORT To indicate "No", Simply leave the box blank or enter a 0 Report for Month / Year: For "Duration", record # of minutes each lasted Date Form Completed: If there's a 15 minute break between procedures, then start new line Person Completing Form: used as part of a Death Please enter the appropriate information for each column below. Date Label the Behavior Operationally describe the behavior Name of Individual (last, first) Name of Site Type of Facility Area Name of Facility or Program

6 How do I fill in the Area on the reactive strategies report form? This cell has a pull down list of all of the areas. Pull down to find the area in which the reactive strategy was used Please enter the appropriate information for each c Area Name of Facility or Program Type of Facility Name of Site Name of Individual (last, first) Date

7 How do I fill in the Name of the Facility? Enter the name of the facility or program in which the reactive strategy was used. Please enter the full name even if it does not appear to fit in the cell. The name is in the spreadsheet even if you can not see all of it. Please enter the appropriate information for each c Area Name of Facility or Program Type of Facility Name of Site Name of Individual (last, first) Date

8 How do I fill in the Type of Facility? Please pull down the list and choose the type of facility that best b describes the facility or program where the was implemented. ADT-Active Active Day Treatment ALF- Licensed Assisted Living Facility Behavior Focus-Behavior focus home DDC- Developmental Disabilities Center Foster home- Licensed foster home IB- Intensive Behavioral Facility ICF Intermediate Care Facility Standard- Standard care home Other- Any other types of facilities or locations Please enter the appropriate information for each c Area Nam e of Facility or Program Type of Facility Name of Site Nam e of Individual (last, first) Date

9 How do I enter the name of the site? Please enter the name of the specific home or program site where the was used. If the name of the Facility and the name of the site are the same simply copy and paste the name from the Name of facility column. Please enter the appropriate information for each column below Area Name of Facility or Program Type of Facility Name of Site Name of Individual (last, first) Date Label the Behav

10 How do I enter the name of the Individual for whom the was needed? Enter the name of the individual who needed the use of the reactive strategy. Enter the last name, a comma and the first name of the individual Please enter the appropriate information for each co Area Name of Facility or Program Type of Facility Name of Site Name of Individual (last, first) Date

11 How do I fill in the Date on the reactive strategies report form? Please enter the date that this use of a was implemented. Use a new line for each new behavioral event that requires the use u of a. By rule a new event begins if there has been 15 minutes since the end of the previous use of a. Date Label the Behavior Operationally describe the behavior

12 How do I fill in Label the Behavior on the reactive strategies report form? Pull down and select the general category of behavior that directly resulted in the need to apply a Physical aggression to self and Self injurious Behavior -This is any behavior done by the individual that causes harm to themselves. This category includes SIB, SAB, substance abuse and ingestion/inhalation of toxic chemicals. Physical aggression to others- This is a physical act done by the individual that results in physical harm to another person. Property destruction. Elopement/wandering. Pica/Dangerous eating- Pica is the ingestion of nonnutritive items. Dangerous eating includes behaviors that involve eating in such a way as to produce immediate risk to the individual. This includes things such s as rapidly stuffing food, drinking so fast that the person chokes, eating wrapped food without first removing the e wrapper, ingesting fecal mater or urine, etc. Fire setting. Inappropriate sexual behavior. Other- Any behavior that does not fit in one of the previous categories. Be sure to specify in the next column what aspect of the behavior required the use of a. Date Label the Behavior Operationally describe the behavior

13 How do I fill in Operationally describe the Behavior on the reactive strategies report form? Please provide a brief description of the specific behavior that resulted in the application of a. This should be in observable terms. Write a brief description of what happened that led you to need to use a. Date Label the Behavior Operationally describe the behavior

14 How do I fill in the Did the individual die column? used as part of a Death If the individual died during or related to the use of a enter a 1 in this column. If no death occurred leave this cell blank or enter a 0. If you have entered a 1 in this column please be sure that you have completed the other required notifications and forms regarding the death of an individual.

15 How do I fill in the Serious injury to consumers column? used as part of a Death If the consumer who needed the use of a reactive procedure or any other consumer was injured during the behavioral upset event enter a 1 in this column. If no consumer injury occurred leave this cell blank or enter a 0 A serious injury is one that requires greater than first aide to treat it.

16 How do I fill in the Serious injury to staff column? used as part of a Death If the consumer who needed the use of a reactive procedure seriously injured a staff person during the behavioral upset event enter a 1 in this column. If no staff injury occurred leave this cell blank or enter a 0 A serious injury is one that requires greater than first aide to treat it.

17 How do I fill in the Use of Behavioral protective equipment, MD Rx for behavior column? used as part of a Death If the person is prescribed and receives a device to protect them from harming themselves and there is a prescription for that device from a medical doctor enter a 1 in this column. This refers to protective equipment to prevent or reduce the effects of a targeted behavior. The protective equipment in this category is NOT being used as a medical protective device to promote healing of a wound or injury

18 How do I fill in the Use of Behavioral protective equipment, FA completed column? used as part of a Death If behavioral protective devices are used, has the target behavior been subjected to a functional assessment. Enter a 1 for yes.

19 How do I fill in the Use of Behavioral protective equipment, LRC approved column? used as part of a Death If the LRC has reviewed and approved a behavioral intervention which includes the use of the specific behavioral protective equipment used in this event. Enter 1 for yes enter either a 0 or leave this cell blank for No

20 How do I fill in the Planned intervention column? used as part of a Death If the use of this particular is part of an LRC approved behavioral intervention for the identified behavior, enter 1 for yes enter either a 0 or leave this cell blank for No. If some other that the one approved by the LRC was used enter either a 0 or leave this cell blank for No.

21 How do I fill in the strategy, column? means enforced isolation or confinement of an individual in a room or area. It used as part of a Death does not mean time out or time out from positive reinforcement procedures as procedures as defined by this rule, or isolation resulting from medical conditions or symptoms of illness. Time out greater than 20 minutes is considered seclusion. Enter the number of minutes the person was in seclusion during this use of the reactive strategy.

22 How do I fill in the strategy, column? used as part of a Death This refers to the use of physical device to restrict an individual s s movement or restrict the normal function of the individual s s body. It includes the use of behavioral protective equipment regardless of who ordered the protective equipment. Enter the number of minutes that the mechanical restraint or behavioral protective device was applied to the individual.

23 How do I fill in the strategy, Manual Restraint column? used as part of a Death Manual restraint means the use of hands or body to immobilize a person s freedom of movement or normal access to his or her body for more than fifteen continuous seconds. Record the number of minutes that the person was maintained in manual restraint.

24 How do I fill in the Additional interventions required, Law Enforcement column? used as part of a Death If Law enforcement was involved in any way in the management of the behavioral episode enter a 1 in this column. For the purpose of this column there is no distinction based on who initiated the law enforcement response. Regardless of who made contact with them, if they were involved enter a 1.

25 How do I fill in the Additional interventions required, Baker Act column? used as part of a Death If the individual required emergency admission to a psychiatric facility, regardless of who initiated the referral for psychiatric evaluation enter a 1 in this column

26 How do I fill in the used as part of a, Chemical restraint column? used as part of a Death If a medical doctor orders medication to effect immediate control of an individual s s behavior and that medication is not already part of the medication regimen prescribed for this individual enter a 1 in this column.

27 How do I fill in the used as part of a, Stat meds used column? used as part of a Death If a medical professional orders medications that were already prescribed for the individual to be given at a dose than the person usually receives, as part of the intervention to effect immediate control of an different time or at a different dose than the person usually individual s s behavior OR if a PRN medication is given that has been prescribed to assist with reduction of behaviors that require the use of reactive strategies enter a 1 in this column

28 How do I fill in the Takes Routine Psychotropic, Psychotropic Med Prescribed column? used as part of a Death If the person required the use of a and receives psychotropic medications on an ongoing basis enter a 1 in this column

29 How do I fill in the Takes Routine Psychotropic, Psychotropic Med Prescribed column? used as part of a Death If the person required the use of a and receives psychotropic medications on an ongoing basis and the prescription for the psychotropic medications has been changed in the 30 days preceding this use of reactive procedures, enter a 1 in this column

Long Term Services Division. Supersedes: Policy Governing Behavior Support Service Planning, 1/19/96 and LTSD Behavior Support Policy Revision 6/23/00

Long Term Services Division. Supersedes: Policy Governing Behavior Support Service Planning, 1/19/96 and LTSD Behavior Support Policy Revision 6/23/00 Department of Health Long Term Services Division POLICY Policy Title: Psychotropic Medication Use Policy Number: Supersedes: Policy Governing Behavior Support Service Planning, 1/19/96 and LTSD Behavior