Behavioral Services Clause Samples

Behavioral Services. Any treatment or care related to autistic disease of childhood, hyperkinetic syndrome, learning disabilities, behavioral problems and mental retardation, which extend beyond traditional medical management are NOT COVERED, except as provided in Certificate Sections 3.16 and 3.17. If a Member has coverage under the Autism Spectrum Disorder Services Rider, and requires services under such Rider, the terms and conditions of such Rider will determine the behavioral services available for the Member.
Behavioral Services. Any treatment or care related to autistic disease of childhood, hyperkinetic syndrome, learning disabilities, behavioral problems and mental retardation, which extend beyond traditional medical management are not covered, except as provided in the Policy.
Behavioral Services. Behavioral services address challenging behaviors that interfere with a Child’s functioning. Behavioral services also educate the Child’s family about, and train the family in managing, the Child’s behavioral health disability. A qualified paraprofessional under appropriate supervision, including clinical supervision, as required by the model of treatment, will assist the family and Child in implementing the behavioral interventions. Behavioral services include: i. Implementation of skill-based interventions for the remediation of behaviors or improvement of symptoms, including the implementation of a positive behavior plan and modeling interventions for the Child’s family for the benefit of the Child to assist them in implementing the strategies; ii. Development of functional skills to improve self-care, self-regulation, or other functional impairments by intervening to decrease or replace non-functional behavior that interferes with daily living tasks; iii. Family psychoeducation of the Child and their family about how to manage the Child’s behavioral health symptoms; and iv. Support to address behaviors that interfere with the achievement of a stable and permanent family life and educational objectives in an academic program in the community.
Behavioral Services. (BSS) coordination, initially provided by a Behavior Consultant, and ensuring all BSS activity for Individuals meets the requirements of services in OAR Chapter 411 division 046 rules. Contractor’s Healthcare Coordinator responsibilities for BSS include: (1) Development of a Behavior Plan based on the evaluation and completed within 15 days of admission. The Behavior Plan must: i. Address at a minimum the behaviors noted as referenced in the definition for Target Group; ii. Identify, as needed, a crisis stabilization and emergency plan to prevent or minimize injuries, property damage, placement failure and emergency hospitalizations; iii. Identify Individual-specific intervention and strategies that caregivers can implement, and are incorporated into the activity plans; iv. Be reviewed at least monthly and modified as needed, based on feedback from direct caregivers, SPT and the Individual’s responses; and v. Ensure all documentation related to Behavior Support Services meets OAR Chapter 411 division 046 rules. (2) Partner with the Service Planning Team on behavioral education, and interventions, which shall then be communicated through individualized Behavior Plans to direct care staff; (3) Assures appropriate documentation in resident record for behavioral observations/interactions related to successful progress in behavior management. Documents in resident chart significant issues for smooth transition between shifts; (4) Development of and implementation of Individualized Behavioral training and monthly review of Individual Behavioral Plans with Contractor’s direct care staff. (5) Be On-Call and Available, as specified in the Behavior Plan, for Individuals at risk of or needing crisis interventions; and (6) Oversee implementation of Managed Risk Agreements as defined in OAR 411-054-0036 (6).