(a) Purpose. The purpose of protective intervention is to ensure the service recipient's safety, if physical, emotional, medical, financial, legal, or community participation issues place the service recipient at risk.
(b) Elements of protective intervention plan. The protective intervention plan is part of the Individual Plan (Plan) developed with the participation of the service recipient and Personal Support Team (Team).
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(1) The protective intervention plan:
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(B) describes preventative supports, services, and actions to be taken to reduce or eliminate safety risks as needed, including:
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(C) describes detailed instructions and procedures to be taken by staff and Team members during a situation that places the safety of the service recipient or others at risk, including:
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(i) procedures that keep the service recipient and others who may be affected as safe as possible;
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(ii) steps to defuse, reduce, or eliminate the harm or injury; and
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(iii) protocols for securing assistance from other Team members or provider agency staff;
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(D) includes education components that:
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(i) assess and identify educational objectives and specify how the objectives relate to the challenging issues;
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(ii) describe teaching methods in sufficient detail to provide clear direction to support staff to assist the service recipient in learning relevant skills; and
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(iii) affirm the dignity of the service recipient;
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(E) prescribes staff training when additional training is needed;
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(F) identifies methods and time frames to evaluate the effectiveness of the protective intervention plan;
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(G) is revised when circumstances change or the plan is no longer effective;
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(H) treats the service recipient with dignity and is reasonable, humane, practical, not controlling, and the least restrictive alternative; and
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(I) is submitted to the positive support field specialist and Human Rights Committee (HRC) for review at least annually if the plan imposes a restrictive procedure.
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(2) The Team may request the services of appropriate professionals, if needed, in the development of protective intervention plans.
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(3) Staff instructions regarding management of risks or challenging issues are prohibited unless developed by the Team per OAC 340:100-5-57.
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(4) Staff meets all training and in-service requirements set forth in
OAC 340:100‑3‑38.
(c) Serious risk or dangerous behavior. If a protective intervention plan addresses challenging behaviors that create risk of physical injury or harm to the service recipient or others, creates a risk of involvement in the civil or criminal processes, or places at serious risk the service recipient's physical safety, environment, relationships, or community participation, the protective intervention plan must be developed and overseen by the Team and an appropriately licensed professional or a family trainer approved by Developmental Disabilities Services Division (DDSD) with the assistance of the positive support field specialist.
(d) Restrictive or intrusive procedures. If the Team determines restrictive or intrusive procedures, per OAC 340:100-1-2, are essential for safety, the Team must develop a protective intervention plan with the assistance of a DDSD positive support field specialist.
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(1) In addition to requirements of OAC 340:100-5-57(b), each protective intervention plan containing a restrictive or intrusive procedure must:
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(A) include sufficient justification for the use of a restrictive or intrusive procedure, including:
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(i) current information on the severity of the problem;
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(ii) summary of relevant incident reports over the last six months; and
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(iii) any other related information;
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(B) address any limitations placed on the service recipient's access to goods, services, and activities, and document the Team's plan to restore access;
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(C) include instructions to staff on how to:
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(i) calm the service recipient during dangerous or disruptive episodes;
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(ii) take appropriate action to protect the service recipient, staff, and others when the service recipient's behavior is dangerous;
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(iii) call for assistance when necessary; and
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(iv) prevent the misuse of restrictive and intrusive procedures;
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(E) include a description of methods to help the service recipient develop skills that serve the same function as, or reduce or eliminate the possibility of, the dangerous behavior or serious risk. These methods must be individualized and provide clear direction to support staff to develop the service recipient's pro-social and coping skills.
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(2) The Team must submit each protective intervention plan containing a restrictive or intrusive procedure to the HRC and Statewide Behavior Review Committee (SBRC).
(e) Physical management. Physical management, per OAC 340:100-1-2, is used only to prevent physical injury. Any protective intervention plan that includes a physical management component requires the Team to:
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(1) identify whether the service recipient has any health concerns related to the use of physical management or any other intrusive method proposed;
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(2) ask the service recipient's physician or the University of Oklahoma College of Pharmacy to assess whether the current medication regimen would pose any risk for the service recipient under the stress of the physical management procedure;
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(3) include in the planning sessions a DDSD approved trainer of physical management procedures.
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(4) identify any situation in which physical management procedures cannot be used as such use would be unsafe or ineffective;
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(5) comply with OAC 340:100-5-57(f); and
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(6) submit the protective intervention plan to the SBRC or resource center Behavior Review Committee (BRC) per
OAC 340:100-3-14. The SBRC or resource center BRC notifies the Team:
(f) Emergency intervention. Emergency intervention is the use of a restrictive or intrusive procedure not included in a protective intervention plan in response to an unanticipated and unpredictable situation or event or the sudden occurrence of an event so severe and dangerous that urgent action precludes less restrictive measures. Physical management, per OAC 340:100-1-2, is used only during emergencies to ensure physical safety and prevent injury.
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(1) Emergency intervention:
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(A) cannot be used as a substitute for positive approaches or a protective intervention plan; and
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(B) is used for no longer than necessary to eliminate the clear and present danger of serious physical harm to the service recipient or others.
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(2) Physical management must be terminated as soon as the service recipient is calm or the threat has ended and must not exceed two minutes at a time.
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(3) When responding to an emergency, no one may authorize or use an amount of force that exceeds that which is reasonable and necessary under the circumstances to protect the service recipient or others.
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(4) Any person who has reason to believe that abuse has occurred is responsible to contact the appropriate authorities.
(g) Expedited approval of restrictive or intrusive procedures. After the first use of an emergency restrictive or intrusive procedure, if the Team in consultation with the positive support field specialist determines the use of a restrictive or intrusive procedure must be continued to ensure the safety of the service recipient or others, the positive support field specialist or DDSD director of psychological and behavioral supports may provide temporary immediate approval of continued use of restrictive or intrusive procedures.
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(1) The DDSD case manager contacts the positive support field specialist to request expedited approval of restrictive or intrusive procedures to protect the service recipient or others from serious physical harm.
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(2) The positive support field specialist approves or denies the request for use of emergency interventions using Form 06MP042E, Request for Expedited Approval of Restrictive Procedures.
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(A) If the expedited request is approved, the positive support field specialist assists the Team in ensuring needed structure and training are in place for safe and proper implementation of the emergency interventions.
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(B) Expedited approval of use of emergency interventions lasts no longer than 45 days.
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(3) Form 06MP042E must provide sufficient information to demonstrate positive supports were attempted, and the danger of severe harm still exists. At a minimum, required information includes all incident reports from the last three months, with details on the harm caused and other indications of severity, as well as a description of existing positive supports and services.
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(4) A trainer of DDSD approved physical management procedures provides training regarding the authorized intrusive procedure.
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(5) To continue using the temporarily approved restrictive or intrusive, procedure, the Team must submit, within 25 days following approval, a protective intervention plan that incorporates the requested procedures. If the submitted protective intervention plan does not receive SBRC approval, SBRC may extend the expedited approval if SBRC determines conditions warrant extension for a maximum of 45 additional days.