C.M.R. 14, 197, ch. 5, app 197-5-THREE
The Functional Assessment of the Person must address the Challenging Behavior and the justification for the use of In-Home Stabilization. The justification must include the history of the Challenging Behavior and the types of problems it poses and how the In-Home Stabilization addresses those problems.
A. The proposed use of In-Home Stabilization must be described in an In-Home Stabilization Plan which includes:
1. A clear description of the specific Challenging Behavior that initiates a period of In-Home Stabilization.
2. Criteria that will be used for assessment of discontinuing the In-Home Stabilization.
3. Criteria that will be used for assessment of continuing the In-Home Stabilization.
4. The identity of who will conduct the assessment of risk and a description of when those assessments will occur.
5. A description of how staff will support the Person to transition to regular activities after the period of In-Home Stabilization by offering full access to the greater community, including opportunities to interact with members of the broader community, to seek employment and work in competitive integrated settings, and to engage in community life to the same degree as individuals not receiving services.
B. The proposed use of In-Home Stabilization for a period not to exceed one hour is a Level 2 intervention. A Level 2 In-Home Stabilization Plan must be derived from the Functional Assessment and incorporated into the Positive Support Plan. A plan for In-Home Stabilization of one hour or less must have the approval of the Planning Team and the Case Manager prior to implementation.
C. The proposed use of In-Home Stabilization for a period greater than one hour, but not to exceed 24 hours, is a Level 3 intervention. The use of a Level 2 In-Home Stabilizations three times or more during any two week period of time requires review and approval as a Level 3 Plan. A Level 3 In-Home Stabilization Plan must be incorporated into the Behavior Management Plan, and is subject to all requirements for Behavior Management Planning, review and approval prior to implementation
D. In-Home Stabilization at Level 2 or Level 3 must not be applied cumulatively. Once the criteria for safety have been met, or the identified time period has expired, In-Home Stabilization must end and the Person must be supported to transition to regular activities, or be supported to seek emergency medical attention.
E. When the Planning Team identifies a need for In-Home Stabilization beyond 24 hours, the Planning Team must submit an In-Home Stabilization Plan for a Level 4 intervention. The Level 4 In-Home Stabilization Plan must be justified by the Functional Assessment and documentation of prior interventions. The Level 4 In-Home Stabilization Plan must be incorporated into a Behavior Management Plan proposed for review at Level 4. A Level 4 In-Home Stabilization Plan must include, but is not limited to:
1. All information required in the In-Home Stabilization Plan in Part (A), above.
2. A safety assessment describing the criteria to be used at the end of the 24-hour period to determine if there is a need for continued In-Home Stabilization.
3. A plan for in-person safety assessment of the Person by the qualified professional overseeing the plan.
C.M.R. 14, 197, ch. 5, app 197-5-THREE