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    Maryland Department of Health
    Developmental Disabilities Administration

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    Behavioral Supports

    The State-approved program has been Behavior Principles and Strategies (BPS) for more than two decades and is now being replaced by the MANDT System. DDA has selected this framework for behavior supports, as it is more current with the Administration’s philosophy which focuses on building healthy relationships, providing a more person-centered, values-based process that encourages positive interactions. Mandt promotes individual and organizational well-being and safety with both non-physical and physical interactions. Focus areas of the training include de-escalation during the crisis phase, Positive Behavior Supports and trauma-informed care to help direct support professionals in understanding human behavior.

    The following information outlines an introduction and timeline for the transition:

    The Developmental Disabilities Administration (DDA) provides participant-centered behavioral supports. Behavioral supports are an array of services to assist participants who without such supports are experiencing or are likely to experience difficulty in community living as a result of behavioral, social, or emotional issues. These services help understand an individual’s challenging behavior and what need it is communicating in order to develop a Behavior Plan to enhance the individual’s independence and inclusion in his/her community.

    DDA is committed to behavioral supports utilizing a Positive Behavioral Supports (PBS) model.  PBS emphasizes the use of non-restrictive procedures and commitment to the reduction of physical restraint. Additional key elements of PBS are:

    • Strategies chosen are based upon each participant’s needs, characteristics, and preferences.
    • Recommendations formed from the results of a person-centered plan and comprehensive functional behavior assessment.
    • Evidence-based treatment strategies utilized from the field of applied behavior analysis.
    • Proactive strategies used to improve a person’s quality of life.
    • Focus on family and organizational supports that promote long-standing change.

    Types of behavioral supports available include the following:

    Behavioral Support

    Behavioral Assessment

    Behavioral Assessment services identifies an individual’s challenging behaviors, and identifying co-occurring mental health issues that contribute to those behaviors, by collecting and reviewing relevant data, discussing the information with the individuals’ support team, and recommending one of three tiers for behavior supports and indicated in a Behavior Plan, if necessary.

    Behavioral Consultation

    Behavioral Consultation services oversee and monitor the implementation of recommendations developed under the Behavioral Assessment as indicated in the Behavior Plan.

    Behavioral Support Implementation Services

    Brief Support Implementation Services are a time-limited service to provide direct assistance and modeling to families, agency staff, and caregivers so they can independently implement the Behavior Plan.

    To Access Behavioral Supports: 
    Access to this service is contingent upon referral/authorization from the appropriate DDA Regional Office.

    Behavioral Respite

    Behavioral Respite is a highly structured intervention that provides intensive behavioral services in a well- controlled, behaviorally managed residential environment with the primary purpose of reducing the frequency, intensity, and duration of challenging behaviors and/or manage co-occurring mental health issues so that the individual is able to return to a community-based placement either through a DDA provider or family/caregiver.


    To Access Behavioral Respite:

    Access to this service is contingent upon referral/authorization from the appropriate DDA Regional Office. DDA has developed a list of criteria for appropriate referrals.

    Mobile Crisis

    Mobile crisis intervention services (MCIS) used in response to a behavioral, acute psychiatric or situational emergency that may result or has resulted in a harmful or potentially harmful outcome to a person who has been found eligible for DDA services and is currently receiving DDA services. MCIS includes expedited on-site evaluation/consultation, completion of an Initial Crisis Behavioral Assessment (within 24 hours of the intervention), coordination of services with locally based Emergency Departments, psychiatric units, acute care hospitals, state psychiatric hospitals, DDA licensed providers, Core Services Agencies, and other locally-based human and generic agencies.


    ​To Access Mobile Crisis:

    MCIS services are available 24/7/365 Statewide (accessed by calling 1-888-374- 3276. The call center is answered by a trained crisis intervention staff. The MCIS Team will present on site to a crisis within 1-3 hours.

    Behavior Support Providers

    • Humanim (serving the Central Region)
    • The Arc of Southern Maryland (serving the Southern Region)
    • The Arc of Washington County (serving the Western Region)
    • Somerset Community Services (serving the Eastern Shore)

    Please note that a number of licensed DDA provider agencies and also families have made the decision to use behavior support providers working outside these four providers. In some cases these providers may provide a different service delivery model. This choice is acceptable given that the providers meet all applicable COMAR standards. On the Eastern Shore it may also be possible to receive behavior support services from State employed psychology associates working under the supervision of a licensed psychologist.

    Recommended Website

    Code of Maryland Regulations (COMAR)

    Applicable COMAR regulations include COMAR 10.22.10.05 Behavior Plan (BP),
    Behavior Plan - http://www.dsd.state.md.us/comar/comarhtml/10/10.22.10.05.htm
    COMAR 10.22.10.06 Use of Restrictive Procedures –http://www.dsd.state.md.us/comar/comarhtml/10/10.22.10.06.htm

    COMAR 10.22.10.08 Use of Physical Restraint - http://www.dsd.state.md.us/comar/comarhtml/10/10.22.10.08.htm

    Behavioral Health Administration website for Core Service Agencies in Maryland

    https://health.maryland.gov/bha/Pages/Index.aspx

    Association for Positive Behavioral Supports

    http://www.apbs.org

    Webinars

    For questions and/or additional information contact Dr. Meg DePasquale, LCSW-C., DDA Headquarters at 410-767-5721, meg.depasquale@maryland.gov

     

    DDA At a Glance Documents

    ​Behavioral Respite At a Glance

    Mobile Crisis 988 At a Glance​

    Accepting Provider Applications for Two New Waivers - Community Supports and/or Family Supports Waivers

    Click here for Provider Application and more Info.

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