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["Behavior Services Work Product Review "]
[]
[]
[null,"Person Supported",null,null,null,null,"Date of Review"]
[null,"Behavior Analyst",null,null,null,null,"Assessment Completion Date"]
[null,"Reviewer",null,null,null,null,"BSP Latest Revision Date"]
[]
[null,"Behavior Services Assessment Report (BSAR) - Section 1.1 - Administrative"]
[]
["1.1.1 gh","Date(s) of assessment on first page.  "]
["(0-1)"]
[]
["1.1.2 g","Reason for Referral."]
["(0-1)"]
[null,"BA provides a statement of the referral question"]
[null,"from at least the person, conservator (if applicable) and "]
[null,"the ISC  and states how these questions will be answered.  "]
[]
["1.1.3 gh","Evaluation of historical behavioral procedures.  "]
["(0-1)"]
[null,"States formal or informal procedures historically used"]
[null,"and provides an estimate of their effectiveness"]
[null,"based on available information or states if uncertain or "]
[null,"Information is unavailable.  "]
[]
["1.1.4 g","History of the use of any behavioral safety"]
["(0-1)"," interventions.  "]
[]
[null,"Provider describes the historical frequency and "]
[null,"duration of behavioral safety interventions based on  "]
[null,"incident reporting, data from prior behavioral services,  "]
[null,"anecdotal report OR states no information is available.  "]
[]
["1.1.5 gh","The scope, frequency, and anticipated duration"]
["(0-1)","of behavior services.  "]
[]
["1.1.6 gh","Proposed ISP outcomes for replacement "]
["(0-1)","behaviors and improved quality of life.  "]
[]
[null,"\"See objectives\" is acceptable if they are included"]
[null,"in the person's ISP.  "]
[]
[null,"Behavior Services Assessment Report (BSAR) - Section 2.1 - Clinical"]
[]
["2.1.1 gh","Behaviors of concern are defined in observable"]
["(0-2)","and measurable terms.  "]
[]
[null,"Score 0 if terms describing internal states or private "]
[null,"events.  "]
[null,"Score 1 if at least 1/2 of the behaviors are described in "]
[null,"concrete, observable terms, but others are not.  "]
[null,"Score 2 if ALL behaviors are described in concrete, "]
[null,"observable terms.  "]
[]
["2.1.2 gh","Baseline and/or comparison data are "]
["(0-2)","provided.  "]
[]
[null,"Score 0 if baseline data are not provided.   "]
[null,"Score 1 if baseline data are provided, but do not "]
[null,"contain at least three data points.  "]
[null,"Score 2 if the baseline data contain three or more "]
[null,"data points.  "]
[]
["2.1.3 g","Data reliability of direct measures is accurately "]
["(0-2)","reported."]
[]
[null,"Score 0 if data reliability is not assessed using quantitative  "]
[null,"methods.  "]
[null,"Score 1 if data reliability is assessed, but the method for "]
[null,"the assessment was not optimal under the circumstances.  "]
[null,"Score 2 if data reliability is assessed and the method for"]
[null,"the assessment was optimal.  "]
[]
["2.1.4 h","Functional hypotheses for each target behavior "]
["(0-2)","are supported by analyses of direct and objective "]
[null,"measures."]
[]
[null,"Score 0 if there are no or obviously inaccurate "]
[null,"functional hypotheses OR the hypotheses are based"]
[null,"solely on indirect measures.  "]
[null,"Score 1 if direct measures are used, but hypotheses "]
[null,"are not supported by the data presented.  "]
[null,"Score 1 if direct measures are used AND hypotheses"]
[null,"are supported for 1/2 but not all target behaviors.  "]
[null,"Score 2 if direct measures are used AND hypotheses"]
[null,"are supported fpr ALL target behaviors.    "]
[]
["2.1.5","Hypotheses regarding motivating "]
["(0-2)","operations (e.g., discomfort, deprivation, "]
[null,"exposure) are stated for all relevant target "]
[null,"behaviors.   "]
[]
[null,"Score 0 if hypotheses regarding motivating operations"]
[null,"are not stated.  "]
[null,"Score 1 if hypotheses are not clear about their "]
[null,"effects on behavior OR do not address all "]
[null,"relevant target behaviors.  "]
[null,"Score 2 if hypotheses are clear about their effects on "]
[null,"behavior and address all relevant behaviors.   "]
[null,"Score 2 if the BA provides a plan to collect more data.  "]
[null,"Score NA if BA states there are no relevant influences."]
[]
["2.1.6 h","Functional hypotheses and replacement "]
["(0-2)","behaviors are presented in a clear and "]
[null,"understandable way.  "]
[]
[null,"Score 0 if the functions of target behaviors and "]
[null,"are not clearly stated. "]
[null,"Score 1 if the functions target behavior are clearly stated, but replacement behaviors are not clearly functionally equivalent or are not within the person's behavioral capacity.                                                  "]
[]
[]
[null,"Score 2 if functions of target behaviors are clearly stated AND replacment behaviors are clearly functionally equivalent and are within the person's behavioral capacity. "]
[]
[]
[null,"When non-functionally equivalent replacement behaviors "]
[null,"are accompanied by a valid explanation, 2 may be scored."]
[]
["2.1.7 g","Risk and benefit analysis and justification of "]
["(0-2)","restricted procedures or behavioral safety "]
[null,"interventions.  "]
[]
[null,"Score 0 if the analysis does not include a list of the "]
[null,"risks and benefits of each restricted procedure.   "]
[null,"Score 1 if the analysis contains a list of risks and benefits"]
[null," for each procedure, but does not include analysis of "]
[null,"alternatives to the procedure."]
[null,"Score 2 if the analysis contains a list of risks "]
[null,"and benefits of each restricted procedure and an analysis"]
[null,"of alternatives.  "]
[null,"NA if no restricted procedures.  "]
[]
["2.1.8 gh","Acheivable, measurable, and time-limited "]
["(0-2)","objectives are identified for target and "]
[null,"replacement behaviors.  "]
[]
[null,"Score 0 if objectives are not: 1)measureable, 2)have an"]
[null,"acheivable criterion, and 3) state an interval over which "]
[null,"the objective is to be achieved.  "]
[null,"Score 1 if at least half, but not all of the objectives meet "]
[null,"all three criteria.  "]
[null,"Score 2 if all objectives meet all three criteria.   "]
[]
["2.1.9 g","Recommendations for the COS to consider.  "]
["(0-2)"]
[null,"\"Appropriately\" means across all relevant areas of tx. "]
[null,"Score 0 if treatment or service recommendations do not "]
[null,"appropriately address at least 1/2 hypotheses, safety "]
[null,"concerns and data reliability problems identified in the "]
[null,"assessment.  "]
[null,"Score 1 if the recommendations appropriately address "]
[null,"1/2 but not all hypotheses, safety concerns and data "]
[null,"reliability problems.  "]
[null,"Score 2 if the recommendations appropriately address all"]
[null,"hypotheses, safety concerns, and data reliability problems."]
[]
[null,"Behavior Support Plan (BSP) - Section 1.2  - Administrative"]
[]
["1.2.1 g","Implementation date shown on first page of plan  "]
["(0-1) ","and is within 30 days of plan development "]
[null,"authorization.  "]
[]
[]
["1.2.2 gh","Consent for treatment is obtained prior to the "]
["(0-1) ","BSP implementation date regardless of whether "]
[null,"restricted interventions are used.  "]
[]
[null,"Consent form is attached to the BSP and date precedes"]
[null,"implementation date. Required as plan is initiated and "]
[null,"following a change or increase in restricted procedures.  "]
[null,"If conservator is unavailable, provider obtains assistance "]
[null,"from DIDD and documents resolution on consent form.  "]
[]
["1.2.3 gh","Behavior Support and Human Rights Committee"]
["(0-1)","approvals of restricted, special individualized, or "]
[null,"specialized behavioral safety interventions "]
[null,"are obtained prior to the BSP implementation"]
[null,"date. "]
[]
[null,"Approvals are attached to the BSP and dates of approval "]
[null,"precede the implementation date."]
[]
[null,"Behavior Support Plan (BSP) - Section 2.2 - Clinical"]
[]
["2.2.1 gh","Treatment is not in conflict with a "]
["(0-2)"," person-centered philosophy.  "]
[]
[null,"Score 0 if the plan's interventions interfere with  "]
[null,"quality of life, limit choice, are disrespectful of the "]
[null,"person, uses punishment excessively, or address"]
[null," behaviors that are not socially significant.  "]
[null,"Score 1 if the plan is not entirely incompatible with, "]
[null,"but does little to facilitate a satisfying quality of life.  "]
[null,"Score 2 if the plan minimizes the use of punitive "]
[null,"procedures and is likely to improve quality of life.  "]
[]
["2.2.2","The contingency between replacement behaviors "]
["(0-2)","and planned reinforcement is clearly stated.  "]
[]
[null,"Score 0 if the circumstances under which reinforcement"]
[null,"are to be provided are unclear.  "]
[null,"Score 1 if the circumstances under which reinforce-"]
[null,"ment is to be provided are clear for at least 1/2, but "]
[null,"not all replacement behaviors.  "]
[null,"Score 2 if the circumstances under which reinforce-"]
[null,"ment is to be provided are clear for all replacement "]
[null,"behaviors.  "]
[]
["2.2.3 gh","At least one functionally equivalent replacement"]
["(0-2)","behavior is addressed in the plan for each "]
[null,"function identified in the assessment.  "]
[]
[null,"Score 0 if functionally equivalent replacement"]
[null,"responses are not inccluded in the BSP.  "]
[null,"Score 1 if at least 1/2, but not all functions of behavior"]
[null," are addressed.  "]
[null,"Score 2 if all functions are addressed.  "]
[]
["2.2.4 h","Treatment is consistent with functional "]
["(0-2)","hypotheses."]
[]
[null,"Score 0 if reinforcement for replacement behaviors AND"]
[null,"responses to target behaviors are inconsistent with "]
[null," function(s) identified in the assessment.  "]
[null,"Score 1 if interventions are functionally consistent for "]
[null,"at least 1/2, but not all replacement and target behaviors."]
[null,"Score 2 if interventions are functionally consistent for"]
[null,"ALL replacement and target behaviors.  "]
[null,"NA if assessment contains explanation for not using"]
[null,"functional interventions.  "]
[]
["2.2.5","Generalization and/or fading procedures are "]
["(0-2)","sufficient to aid the person in gaining "]
[null,"independence from staff intervention and "]
[null,"restricted procedures.  "]
[]
[null,"Score 0 if the plan is not individualized or is inadequate"]
[null,"to help the person gain independence.  "]
[null,"Score 1 if the plan addresses independence from staff"]
[null,"intervention OR restricted procedures, but not both.  "]
[null,"Score 2 if the plan addresses independence from staff"]
[null,"intervention AND restricted procedures.  "]
[]
["2.2.6 gh","Treatment procedures are clearly written."]
["(0-2)"]
[null,"Score 0 if treatment procedures are not written in a "]
[null,"manner that can be easily understood by Direct "]
[null,"Support Professionals. "]
[null,"Score 1 if  1/2 or more of the treatment procedures "]
[null,"are written appropriately, "]
[null,"Score 2 if ALL treatment procedures are written "]
[null,"appropriately. "]
[]
["2.2.7 gh","Treatment procedures are practical for direct "]
["(0-2)","support professionals to follow.  "]
[]
[null,"Score 0 if less than 1/2 of treatment procedures are "]
[null,"practical for implementation by Direct Support "]
[null,"Professionals. "]
[null,"Score 1 if 1/2 or more of the procedures are practical.   "]
[null,"Score 2 if ALL treatment procedures are practical.  "]
[]
[]
[null,"Clinical Service Monthly/Quarterly Reviews (CSMR/CSQR) - Section 1.3  - Administrative "]
[]
["1.3.1 gh","Clinical Service Reviews are completed by the "]
["(0-1)","20th of the month following the month of "]
[null,"service and include dates of service.  "]
[]
["1.3.2 gh","Number of units used/approved during the "]
["(0-1)","foregoing month with an explanation of "]
[null,"discrepancies.  "]
[]
["1.3.3 g","Frequency and duration (as applicable) for all "]
["(0-1)","uses of restricted, special individualized, "]
[null,"behavioral safety, and specialized behavioral "]
[null," safety interventions.  "]
[]
[null,"Score 0 if reports are grossly inaccurate.  "]
[]
[null,"Clinical Service Monthly/Quarterly Reviews (CSMR /CSQR) - Section 2.3  - Clinical "]
[]
["2.3.1 gh","Graphic displays of data contain objective "]
["(0-2)","and relevant information related to target "]
[null,"and replacement behaviors.  "]
[]
[null,"Score 0 if graphs are not included for all relevant "]
[null,"behavioral parameters (frequency and/or "]
[null,"duration). "]
[null,"Score 1 if relevant graphs are provided for 1/2, but not all "]
[null,"relevant behavioral parameters.  "]
[null,"Score 2 when graphs include relevant and objective"]
[null,"behavioral parameters and will aid with treatment"]
[null,"decisions."]
[]
["2.3.2 gh","Data are displayed in relation to baseline"]
["(0-2)","or other comparison measures.  "]
[]
[null,"Baseline must contain at least 3 data points.  "]
[null,"Score 0 if no baseline measures are provided.  "]
[null,"Score 1 if baseline measures are provided for 1/2 "]
[null,"or more of graphs provided.  "]
[null,"Score 2 if baseline measures are provided for ALL graphs. "]
[]
["2.3.3","Data graphs include legend, labeled x and y "]
["(0-2) ","axes and labeled phase change and event lines.  "]
[]
[null,"Score 0 if graphs do not include a legend, labeled x and y axes, AND treatment phase change lines.  "]
[]
[null,"Score 1 if graphs have a legend, labeled axes AND phase lines.  "]
[null,"change lines.  "]
[null,"Score 2 if graphs include the above and event lines representing significant life or other treatment changes.  Explanatory title may be substituted for legend.  "]
[]
[]
[]
[]
["2.3.4","Data points for graphic displays represent "]
["(0-2)","equivalent measures.  "]
[]
[null,"Score 0 if absences or missing data are not accounted "]
[null,"for or data are not reported in equal time intervals "]
[null,"on all graphs.   "]
[null,"Score 1 if at least 1/2 of graphs provided meet the "]
[null,"above criterion.   "]
[null,"Score 2 if all graphs meet the above criterion. "]
[]
[null,"Additional Requirements for Clinical Service Quarterly Reviews (CSQR) - Section 1.4  - Clinical "]
[]
["2.3.5","Behavioral functions are reassessed using direct"]
["(0-2)","behavioral measures when behavioral objectives  "]
[null,"have a finding of \"not met, continue.\"  "]
[]
[null,"Score 0 if data are analyzed regarding function for less "]
[null,"than 1/2 of target behaviors or functions are  inaccurate.  "]
[null,"Score 1 if data are analyzed and appropriate changes  "]
[null,"in function are made for 1/2, but not ALL target behaviors.  "]
[null,"Score2 if data are analyzed with appropriate changes are "]
[null,"made for ALL target behaviors.  "]
[null,"Score NA if the finding occurred because of inadequate "]
[null,"BSP implementation or adequate progress is being made."]
[]
["2.3.6 g","Data and implementation reliability are "]
["(0=2)","accurately reported.  "]
[]
[null,"Score 0 if there is no assessment of data or "]
[null,"implementation reliability OR the assessments are "]
[null,"obviously inaccurate.  "]
[null,"Score 1 if data OR implementation reliability are not "]
[null,"assessed or both are assessed informally.  "]
[null,"Score 2 if both are assessed quantitatively.  Percentage"]
[null,"of visits with adequate reliability acceptable.  "]
[]
["2.3.7","Overall assessment of the effectiveness of each"]
["(0-2)","named procedure in the BSP."]
[]
[null,"Score 0 if assessment of each procedures is not provided "]
[null,"or assessments are inaccurate based on data provided.  "]
[null,"Score 1 if assessment is accurate for at least 1/2, but not "]
[null,"all procedures.  "]
[null,"Score 2 if assessment is accurate for all data provided.  "]
[]
["2.3.8 gh","Progress for each behavioral objective is "]
["(0-2)","assessed and adjusted as appropriate.  "]
[]
[null,"Score 0 if less than 1/2 of objectives are assessed "]
[null,"and adjusted as appropriate.  "]
[null,"Score 1 if 1/2 or more of the objectives are "]
[null,"assessed and adjusted as appropriate.  "]
[null,"Score 2 if ALL objectives are assessed and adjusted.  "]
[]
["2.3.9","Completion of action steps identified in the BSAR"]
["(0-2)","or last quarterly review.   "]
[]
[null,"Score 0 if critical steps or adjustments regarding new problem behaviors, sources of data or implementation reliability, or other barriers to treatment are not carried out.                                                                                                        Score 1 if some minor actions were not carried out, but all actions involving treatment were carried out.                                                    Score 2 if all identified steps have been carried out .                                                                                      "]
[]
[]
["2.3.10","Clinical Interpretation of quarterly review data. "]
["(0-2)"]
[null,"Score 0 if the notes fail to explain changes or extraneous variables affecting behavior.                                                                             Score 1 if minor extraneous variables were not explained, but all variables related to findings of no progress or outlier data are explained.                                                       Score 2 if all data are explained.                                                                                       "]
[]
[]
["2.3.11h","Identification of new action steps.  "]
["(0-2)"]
[null,"Score 0 if critical steps or adjustments regarding new problem behaviors, sources of data or implementation reliability, or other barriers to treatment are not identified..                                                                                       Score 1 if some minor actions were not identified but aactions involving treatment were identiifed.                                                                 Score 2 if all appropriate steps are identified.                                                                                       "]
[]
[]
[null,"Other Requirements"]
[]
["1.4.1 gh","Provider's signature, credentials, and the date  "]
["(0-1)","are included on all behavior services documents."]
[]
["1.4.2 gh","Training is documented including the name, date  "]
["(0=1)","and type of training provided.  "]
[]
["1.4.3h","List of recommendations and projected outcomes "]
["(0-1)","for the upcoming ISP year.  "]
[]
[null,"Required in the last CSQR before the annual ISP review.  "]
[]
["1.4.4h","Contact notes are completed as required in PM."]
["(0-1)","(PM 12.2)"]
[]
[null,"Required in the last CSQR before the annual ISP review.  "]
[]
[{"$f":"(M293+M302+M313+M324)","v":0},"If green.  the reviewer assesses progress on the three most severe behaviors and replacements formally and informally.   "]
[null,"If yellow, reviewer  will make an informal assessment of progress on the three most severe behaviors and replacements.    "]
[null,"If red, no assessment of progress is to be made.   "]
[]
[]
[null,null,"Behavior","Reveiwer's Informal Assessment",null,null,"Percentage of Non-Overlapping Data Points"]
[]
["Assessment of Behavioral Progress",null,null,"0 = No progress                    1=Minimal Progress                                              2-Substantial Progress",null,null,null,"Number of Treatment Data Points","Number Not Overlapping with Baseline",null,null,"PNDP"]
["Target Behavior 1",null,null,null,null,null,null,null,null,null,null,{"$f":"I412/H412","v":{"$error":"#DIV/0!"}}]
["Target Behavior 2",null,null,null,null,null,null,null,null,null,null,{"$error":"#DIV/0!"}]
["Target Behavior 3",null,null,null,null,null,null,null,null,null,null,{"$error":"#DIV/0!"}]
["Replacement Behavior 1",null,null,null,null,null,null,null,null,null,null,{"$error":"#DIV/0!"}]
["Replacement Behavior 2",null,null,null,null,null,null,null,null,null,null,{"$error":"#DIV/0!"}]
["Replacement Behavior 3",null,null,null,null,null,null,null,null,null,null,{"$error":"#DIV/0!"}]
[null,null,"Total %",{"$f":"AVERAGE(D412:F417)/2","v":{"$error":"#DIV/0!"}},null,null,null,null,null,"Total %",null,{"$f":"AVERAGE(L412:L417)","v":{"$error":"#DIV/0!"}}]
[]
["WPR Subscale Totals"]
["BSAR Admin",null,"BSAR Clinical",null,"BSP Admin",null,"BSP Clinical",null,"CSQR/CSMR Admin",null,null,"CSQR/CSMR Clinical"]
[{"$f":"AVERAGE(M11,M17, M24,M32,M154,M35,M41)/1","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(M53,M62,M72,M86,M101,M116,M130,M141,M154)/2","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(M161,M171,M180)/1","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(M194,M206,M216,M229,M241,M251,M260)/2","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(M267,M271,M278)/1","v":{"$error":"#DIV/0!"}},null,null,{"$f":"AVERAGE(M293,M302,M313,M324,M339,M350,M359,M339,M368,M374,M379,M384)/2","v":{"$error":"#DIV/0!"}}]
[]
["Overall Avg Admin",null,"Overall Avg Clinical",null,"Other Requirements"]
[{"$f":"AVERAGE(A422,E422,I422)","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(C422,G422,L422)","v":{"$error":"#DIV/0!"}},null,{"$f":"AVERAGE(M389,M392,M397,M402)","v":{"$error":"#DIV/0!"}}]
[]
[null,"BSAR Admin",null,{"$f":"A422","v":{"$error":"#DIV/0!"}},"Quality Assurance","2.A.4",{"$f":"(D427*0.25)+(D428*0.75)","v":{"$error":"#DIV/0!"}},"4.D.3",{"$f":"M180/1","v":0}]
[null,"BSAR Clinical",null,{"$f":"C422","v":{"$error":"#DIV/0!"}},null,"2.A.5",{"$f":"D430","v":{"$error":"#DIV/0!"}}]
[null,"BSP Admin",null,{"$f":"E422","v":{"$error":"#DIV/0!"}},null,"2.B.2 ",{"$f":"AVERAGE(M161,M171, M392)/1","v":{"$error":"#DIV/0!"}}]
[null,"BSP Clinical",null,{"$f":"G422","v":{"$error":"#DIV/0!"}},null,"2.B.3 ",{"$f":"D431","v":{"$error":"#DIV/0!"}}]
[null,"CSQR/CSMR Admin",null,{"$f":"I422","v":{"$error":"#DIV/0!"}},null,"2.B.5 ",{"$f":"M402/1","v":0}]
[null,"CSQR/CSMR Clinical",null,{"$f":"L422","v":{"$error":"#DIV/0!"}},null,"2.D.6 and 2.D.7",{"$f":"D432","v":{"$error":"#DIV/0!"}}]
[null,"Overall Avg Admin",null,{"$f":"A425","v":{"$error":"#DIV/0!"}},null,"Admin Factor",{"$f":"AVERAGE(D433,E425)*0.25","v":{"$error":"#DIV/0!"}}]
[null,"Overall Avg Clinical",null,{"$f":"C425","v":{"$error":"#DIV/0!"}},null,"Clinical Factor",{"$f":"D434*0.75","v":{"$error":"#DIV/0!"}}]
[null,"Other Requirements",null,{"$f":"E425","v":{"$error":"#DIV/0!"}},null,"Domain 2 ",{"$f":"SUM(G433:G434)*6","v":{"$error":"#DIV/0!"}}]

{"sheet":"Sheet2","index":1,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}

{"sheet":"Sheet3","index":2,"n_rows":0,"n_cols":0,"rows_kept":0,"cut":false,"hidden":false,"merged":[]}