Now that the Commonwealth has moved behavioral services to a licensed status, it must be noted that these regulations are not compliant with the Department of Health Professions (DHP) regulations. These DBHDS regulations were last updated prior to the Board of Medicine’s licensure of Behavior Analysts (LBA) and Assistant Behavior Analysts (LABA). Applied Behavior Analysis (ABA) services can provide a highly effective and efficient service to support recovery and independence, and DBHDS should include LBAs and LABAs in these practice areas, as well as within the human right regulations.

In order to protect consumer rights, the implementation of behavioral assessments as well as the design and monitoring of behavior interventions must be completed by licensed professionals (including LBAs and LABAs) operating within their scope of practice in accordance with DHP regulations. Implementation of such interventions requiring a higher level of training, experience and knowledge of behavioral sciences can only be done under delegation with specific schedules of oversight. The definitions in these regulations should be updated to clarify the process by which behavioral assessments and interventions can be developed and implemented, and by whom.

Throughout the document all uses of the term mental retardation should be changed to Developmental Disability. This has been the generally accepted standard nationwide for many years.

Time out is a punishment procedure, and its use should be severely limited. DBHDS should specify that its use is allowed only after assessment and development of an intervention plan by a licensed professional operating within his/her scope of practice and training. DBHDS should further specify that any person subjected to time out must be evaluated by a licensed professional with specific trauma-informed care training as this type of procedure can easily result in trauma for the person placed in time out. DBHDS should consider moving regulations regarding time out to the seclusion and restraint section with similarly limited use, required reporting of each use, and a required debriefing process after each use which includes participation of the licensed professional who assessed and developed the plan that uses time out.