A. Behavior Support provides systematic behavior assessment, Behavior Support Plan development, consultation, restructuring of the environment and training for people whose maladaptive behaviors are significantly disrupting their progress in learning, self-direction, or community participation and/or are threatening to require movement to a more restrictive setting or removal from current services. This service also includes consultation and training provided to families and employees working with the person. The desired outcome of the service is long-term behavior change.B. If at any time a person's needs exceed the scope of the services provided through Behavior Support, the person will be referred to other appropriate services to meet their needs.C. This service is not restricted by the age of the person; however, it may not replace educationally related services provided to people when the service is available under Early Periodic Screening Diagnostic and Treatment, Individuals with Disabilities Education Act, or other sources such as an Individualized Family Service Plan (IFSP) through First Steps or is otherwise available. All other sources must be exhausted before waiver services can be approved. This does not preclude a Behavior Consultant from observing a person in their school setting, but direct intervention cannot be reimbursed when it takes place in a school setting.D. Behavior Support must be provided on a one (1) Behavior Support employee to one (1) person ratio. This service is not intended to provide one-on-one supervision and does not replace other direct support staff required as part of another service being received at the same time.E. Behavior Support Evaluation/Functional Behavior Assessment by the Behavior Support Consultant consists of: 1. An on-site visit, at home and during service provision, to observe the person and their interactions in their environment and with others;2. Interview with the person, family, staff, and others who know them best;3. Assessment where the behavior(s) occur, any antecedents or consequences of the behavior(s), frequency of the behavior(s), and how the behavior(s) impact the person's environment and life; and4. Recommendation(s) to determine if the development of a Behavior Support Plan is warranted or if informal training of employees and other caregivers on basic positive behavior support techniques is sufficient to address the presenting behavior(s).F. Functional Behavioral Assessments must be updated at least every two (2) years or when information is submitted and approved to justify another Behavior Support Evaluation. Justification may include, but is not limited to, changes of providers or the Behavior Support Plan documents substantial changes to:1. The person's circumstances (living arrangements, school, caretakers);2. The person's skill development;3. Performance of previously established skills; and4. Frequency, intensity, or types of challenging behaviors.G. A medical evaluation for physical and/or medication issues must be conducted prior to completion of the Functional Behavior Assessment and before a Behavior Support Plan can be implemented. The evaluation must be conducted by a licensed physician or nurse practitioner to rule out any underlying medical conditions that may be causing the behavior(s) to occur. If the Functional Behavior Assessment determines the person exhibits maladaptive behaviors that significantly disrupt the person's life, the Behavior Consultant shall develop a Behavior Support Plan. The Behavior Support Plan identifies target behaviors and outlines a plan to assist the person in developing positive behavior to replace or reduce challenging/dangerous behaviors.H. Behavior Support Plans can only be developed by the person who conducted the Functional Behavior Assessment.I. Behavior Support Plans must be updated at least every two (2) years and must be updated at the same time the Functional Behavior Assessment is updated.