Part XIII. Behavior Support and Management
Article 3
Supervision
6VAC35-41-1290. Behavior management.
A. Each facility shall implement a behavior management program. Behavior management shall mean those principles and methods employed to help a resident achieve positive behavior and to address and correct a resident's inappropriate behavior in a constructive and safe manner in accordance with written procedures governing program expectations, treatment goals, and residents' and employees' safety and security.
B. Written procedures governing this program shall provide the following:
1. A description of the rules of conduct and behavioral expectations for the resident;
2. Orientation of residents as provided in 6VAC35-41-770 (orientation to facility rules and disciplinary procedures);
3. A description of a system of privileges and sanctions that is used and available for use.
4. Specification of the staff members who may authorize the use of privileges and sanctions; and
5. Documentation requirements when sanctions are imposed.
C. Written information concerning the procedures of the provider's behavior management program shall be provided prior to admission to prospective residents, legal guardians, and placing agencies. For court-ordered and emergency admissions, this information shall be provided to:
1. Residents within 12 hours following admission;
2. Placing agencies within 72 hours following the resident's admission; and
3. Legal guardians within 72 hours following the resident's admission.
D. When substantive revisions are made to procedures governing management of resident behavior, written information concerning the revisions shall be provided to:
1. Residents prior to implementation; and
2. Legal guardians and placing agencies prior to implementation.
E. The facility administrator or designee shall review the behavior management program and procedures at least annually to determine appropriateness for the population served.
F. Any time residents are present, staff must be present who have completed all trainings in behavior management.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-1300. Behavior support.
A. Each facility shall have a procedure regarding behavior support plans for use with residents who need supports in addition to those provided in the facility's behavior management program that addresses the circumstances under which such plans shall be utilized. Such plans shall support the resident's self-management of his own behavior and shall include:
1. Identification of positive and problem behavior;
2. Identification of triggers for behaviors;
3. Identification of successful intervention strategies for problem behavior;
4. Techniques for managing anger and anxiety; and
5. Identification of interventions that may escalate inappropriate behaviors.
B. Individualized behavior support plans shall be developed in consultation with the:
1. Resident;
2. Legal guardian, if applicable;
3. Resident's parents, if applicable;
4. Program director;
5. Placing agency staff; and
6. Other applicable individuals.
C. Prior to working alone with an assigned resident, each staff member shall review and be prepared to implement the resident's behavior support plan.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-1310. Timeout.
A. A facility may use a systematic behavior management technique program component designed to reduce or eliminate inappropriate or problematic behavior by having a staff require a resident to move to a specific location that is away from a source of reinforcement for a specific period of time or until the problem behavior has subsided (timeout) under the following conditions:
1. The provider shall develop and implement written procedures governing the conditions under which a resident may be placed in timeout and the maximum period of timeout.
2. The conditions and maximum period of timeout shall be based on the resident's chronological and developmental level.
3. The area in which a resident is placed shall not be locked nor the door secured in a manner that prevents the resident from opening it.
4. A resident in timeout shall be able to communicate with staff.
5. Staff shall check on the resident in the timeout area at least every 15 minutes and more often depending on the nature of the resident's disability, condition, and behavior.
B. Use of timeout and staff checks on the residents shall be documented.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-1320. Physical restraint.
A. Physical restraint shall be used as a last resort only after less restrictive interventions have failed or to control residents whose behavior poses a risk to the safety of the resident, others, or the public.
1. Staff shall use the least force deemed reasonable to be necessary to eliminate the risk or to maintain security and order and shall never use physical restraint as punishment or with the intent to inflict injury.
2. Staff may physically restrain a resident only after less restrictive behavior interventions have failed or when failure to restrain would result in harm to the resident or others.
3. Physical restraint shall be implemented, monitored, and discontinued only by staff who have been trained in the proper and safe use of restraint.
4. Physical restraint shall mean the application of behavior intervention techniques involving a physical intervention to prevent an individual from moving all or part of that individual's body.
B. Written procedures governing use of physical restraint shall include:
1. The staff position who will write the report and timeframe;
2. The staff position who will review the report and timeframe; and
3. Methods to be followed should physical restraint, less intrusive interventions, or measures permitted by other applicable state regulations prove unsuccessful in calming and moderating the resident's behavior.
C. All physical restraints shall be reviewed and evaluated to plan for continued staff development for performance improvement.
D. Each application of physical restraint shall be fully documented in the resident's record including:
1. Date and time of the incident;
2. Staff involved;
3. Justification for the restraint;
4. Less restrictive behavior interventions that were unsuccessfully attempted prior to using physical restraint;
5. Duration;
6. Description of method or methods of physical restraint techniques used;
7. Signature of the person completing the report and date; and
8. Reviewer's signature and date.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-41-1330. Chemical agents.
Staff are prohibited from using pepper spray and other chemical agents to manage resident behavior.
Statutory Authority
§§ 16.1-309.9, 66-10, and 66-24 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.