Aspire Behavioral Care is a family of ABA providers devoted to supporting those ages 2-21 with developmental disabilities and their families. In the home and community, we provide individualized, quality care through high expertise, compassion, integrity and love. We are committed to these principles today, tomorrow and through the next generations. Please feel free to reach out to your child’s BCBA or Nancy Ruminski (Executive Director) if you have any questions or concerns about information within this handbook.
Aspire Behavioral Care Center
4760 Flintridge Dr. #200
Colorado Springs, CO 80918
Welcome to Aspire Behavioral Care! Aspire Behavioral Care was founded by Christina Rivera in 2013. Christina sought to create a company with true heart and compassion where building strong relationships with families was a priority. Aspire is committed to providing superior quality and unparalleled friendly, professional service in all aspects of our business.
Qualifications of Team Members Working with Your Child
All staff providing services to Aspire Behavioral Care’s families will be trained according to their previous education, experience and individual credentialing and will be held to Aspire Behavioral Care’s high standards of training and competency. All employees undergo a thorough background check and drug test before hire date. Aspire Behavioral Care adheres to all updated Best Practice Guidelines in working with children with developmental disorders and Autism Spectrum Disorders.
Board Certified Behavior Analyst (BCBA)
Every BCBA has earned a Bachelors and Master’s Degree. Additionally, prior to receiving their BCBA certification, they must complete 1500 clinical hours under the direct supervision of a Board Certified Behavior Analyst. Upon completion of the 1500 clinical hours, they must pass a rigorous written exam administered by their governing body, the Behavior Analyst Certification Board (BACB).
Initial Functional Behavior Assessment (FBA)
Assessments including but not limited to:
ABS – 2
Autism Social Skills
Essentials For Living
These assessments result in the initial report, including the behavior intervention plan, re-evaluations and progress reports as required by insurance carriers, parents or other funding agencies; the development and continued guidance in behavioral curriculum; curriculum development and monitoring; ongoing training and consultation of senior and behavior therapist(s); and leading facility treatment team meetings and parent training as assigned.
The BCBA that oversees your child’s development will also provide oversight and training of therapists as required by the BACB for a minimum of 5% of the time the therapist spends with your child (but can be more). The BCBA will provide modeling of the behavior plan, programming and reinforcement systems.
Board Certified Assistant Behavior Analyst (BCaBA)
Every BCaBA has earned a Bachelors or Master’s Degree. Additionally, prior to receiving their BCaBA certification, they must complete 1000 clinical hours under the direct supervision of a Board Certified Behavior Analyst. Upon completion of the 1000 clinical hours, they must pass a rigorous written exam administered by their governing body, the BACB. BCaBAs continue to receive supervision under the direction of a BCBA for 5% of their direct time as required by the BACB.
Job Description: Provides direct assistance to the Clinical Director by performing assessments including but not limited to:
Initial Functional Behavior Assessment (FBA)
Assessments including but not limited to:
ABS – 2
Autism Social Skills
Essentials For Living
Registered Behavior Technician (RBT)/Behavior Interventionist
Most of Aspire Behavioral Cares RBT have completed or are currently working on earning their Bachelors or Masters Degrees. Many have extensive experience working with children with developmental disabilities. Within 90 days of hire, Behavior Therapists must complete the 40- hour online Registered Behavior Technician course. Upon completion of the course, they must pass an oral competency exam and rigorous written exam overseen by the BACB (the governing body for ABA therapy).
Behavior Therapists will assist in the implementation of behavior treatment plans utilizing 1:1 applied behavior analysis principles in the home, center, and community settings. Staff is responsible for, but not limited to, implementing behavior prevention/intervention plans, collecting daily acquisition and behavior data, assisting in the development of program materials, taking client specific through the ABA Central Reach application and attending and participating in team meetings.
The following training/certificates must be obtained within 90 days of employment:
Registered Behavior Technician Certification
Medication Training (if applicable to position)
A Note on Mandated Reporting
All employees at Aspire Behavioral Care are mandated reporters. According to Colorado law, staff in childcare settings report known or suspected child abuse and neglect. See page 18-20 for more information on Mandatory Reported. Please contact the director for any concerns or questions.
ABA Therapy Modalities at Aspire Behavioral Care
Aspire Behavioral Care provides Applied Behavior Analysis (ABA) therapy in a variety of environments. In collaboration with the family and based on the client’s needs, the BCBA will determine the best place for the client to receive services and appropriate goals for each environment.
It is policy that all parents/guardians of Aspire Behavioral Care clients provide schedules for your child to attend at least 50% of the recommended hours found in the initial assessment report.
Center Based Intervention: The Aspire Center is open from 8:30am-6:30pm Monday through Friday and 9-12pm on Saturday. Typically all clients begin services within the center to provide opportunities to build instructional control, increased opportunities to engage with peers, and a structured environment to work on any behavior of concern. Parents must sign their children into the center each day of their session.
Parents may choose to leave or stay in the lobby area of the center for the duration of the center. Since ABA sessions are typically at least 3 hours in duration, we encourage families to consider taking a break while your child is at therapy.
Home Based Intervention: Services provided within the home of the client occur for a variety of reasons. One reason is to generalize skills from the center to the home environment and to other adults within the child’s environment. Sometimes clients engage in behavior within the home or center that are not consistent across environments and working on skills in the home can provide opportunities to develop functional skills. A person who is 18 or over must be within the home at all times during the session.
Community Based Interventions: Services provided in the community provide the opportunity to work on generalized skills in environments other than the home and center. Staff are not allowed to transport clients and parents will be responsible for transportation for their child.
Parental Participation in Client Progress
Parents will be trained continuously during in-home interventions, in center meetings and community activities to ensure best treatment outcome. Parents will receive ongoing guidance on basic behavior principles and intervention strategies. Aspire Behavioral Care staff will be available to the parents continuously to ensure proper implementation throughout all settings. It is expected of the parents/caregivers to ensure that all mastered skills are generalized into the natural environment/home. Parents and all involved parties must adhere to the behavior prevention plan in order to optimize progress and for best outcome.
In Home Service Considerations
Provide a small table and 2 chairs (depending on child’s height).
Provide an area that is quiet and not distracting.
Separate siblings and pets from the area therapy is to take place in, unless the program/curriculum calls for the interaction of pets and/or siblings.
Community outings can be helpful in ensuring progress in social, communication and adaptive skills. These must be well planned; however, staff is only responsible for the client, not for siblings who may accompany the outing.
Aspire Behavioral Care staff is instructed to keep doors open during toileting and/or therapy in the client’s individual room or bathroom. The room door must be open at least 10 inches.
Aspire Behavioral Care staff is well trained in working through challenging behaviors. Parents and siblings should refrain from trying to assist during challenging behavior episodes. Staff will directly request your assistance in the event help is necessary. Please be very familiar with the Behavior Plan (BP).
Parents are required to adhere to the BP. Aspire Behavioral Care staff will train the parent on the BP but are only responsible for Aspire Behavioral Care staff’s implementation of the behavior plan.
Parents are required to ensure that there is another adult (18 and up) in the home with Aspire Behavioral Care staff at all times unless special arrangements have been made. Aspire Behavioral Care staff may not make the determination to waive this requirement. Siblings may be involved in sessions to foster sibling relationships. These peer/sibling interactions should be outlined by the staff/parent and may range from short periods to the entire session.
Aspire Behavioral Care will supply materials for most of the outlined materials (edible reinforcers not included). It is not Aspire Behavioral Care’s responsibility to supply ALL materials for each client’s behavior curriculum. On some occasions, Aspire Behavioral Care staff may request certain supplies (puzzles, books, etc.).
If your child is being toilet trained, you must supply rubber gloves, wet wipes, and all other necessary toileting materials needed for staff to successfully implement the training.
While the goal of any ABA program is to develop skills to graduate a client, there are times that a family, or Aspire, may come to the decision to terminate the relationship. A parent can choose at any time to end services with Aspire. If the decision were due to staffing concerns, scheduling issues, or programming questions we would ask for the opportunity to problem solve and develop a solution.
At times there may be situations in which Aspire Behavioral Care may observe criteria which can lead to a need to discuss the potential need for discharging a family from services. Some of the possible reasons that we may need to evaluate would be the following:
Progress has not been significant, measurable data to show progress on behavior for reduction or in socially significant behavior.
Therapy makes the symptoms persistently worse.
The patient demonstrates an inability to maintain long-term gains from the plan of treatment.
Cancellations or late arrival/pick up.
Aspire is committed to having a meeting with the family to determine if any changes in programming, scheduling or support would assist the child in progressing further. If it is mutually determined that changes could be made to assist the child’s growth, Aspire will make necessary adjustments, allowing for more time for progress to occur.
When a family leaves treatment through Aspire, if requested, the BCBA will write and send the family an exit report. If possible, coordination will occur with any future outside agencies.
Discharge Resulting from Chronic Attendance Issues
Discharge may occur when frequent absences are preventing consistent therapy and progress is not sustainable. See the following Cancellation Policy.
A Note About Cancellations
Research demonstrates the highest rates of growth occur when children attend ABA therapy regularly. Inconsistent therapy attendance is one of the greatest reasons that children plateau prematurely and regress in areas where they previously gained skills. Your child’s BCBA has created an individualized program to meet their behavioral, developmental and social-emotional growth needs. We are committed to doing everything we can to help them succeed. In order to accomplish the goals in their programs, consistent attendance is essential.
Ideally, any child receiving ABA therapy would attend 100% of scheduled sessions. We understand however, that emergencies come up and illness occurs making 100% attendance difficult. Aspire Behavioral Care’s attendance goal for each child is for no less than 95% of scheduled therapy sessions to be completed. For example, if a child were scheduled for 12 ABA therapy sessions a month, a 95% attendance goal would be attending 11 of the scheduled 12. Over a 3-month period, the goal would be to attend at least 34 sessions out of 36.
Of course, we understand illness arises. We want to do our part too. Aspire will work to reschedule missed sessions to ensure your child is receiving the highest standard of ABA therapy possible when they have missed due to illness or emergencies.
Since we take your child’s therapy seriously, we have implemented a comprehensive attendance policy for our staff. You can rely on your child’s team to be in attendance for therapy session. If your child’s therapist is sick, your child will have an opportunity to make up their session with their therapist within the next two weeks including the option of a session on Saturdays at the Aspire Center or another staff that knows your child will cover that session.
Parents with consistent cancellations may have services placed on hold or be given an attendance improvement plan. Upon completion of the improvement plan, services will continue as usual. If parents do not adhere to the attendance improvement plan, services may be terminated.
A “no-show” is defined as when a child’s appointment is scheduled and he or she is not brought to the center for the session, or RBT’s arrive at the home and the child is not home. Following one no-show, Aspire Behavioral Care’s Clinical or Executive Director will contact the responsible party (Parent/Guardian/case manager, etc.) to discuss the attendance policy. If there is a second “no-show” within a 3-month period, the clients’ services will be suspended for a period of 30 days. Please be advised, Aspire Behavioral Care reserves the right to terminate services due to inconsistent attendance. All instances of 2 no-shows or greater will be reviewed by the Aspire Behavioral Care Clinical and Management team to determine appropriate action.
Tardiness is defined as dropping off or picking up your child 15 minutes or more before or after their scheduled therapy time. If you arrive 15 minutes late, your session will be cancelled. After two excessive late drop offs or pick ups(dropping off or picking up) within a 4-week period, services will be suspended for one week. After services resume, if additional tardiness occur, a staff and parent meeting will be scheduled to re-evaluate Aspire Behavioral Care’s ability to continue servicing the client. The conditional status will last three (3) months and will be lifted if your family meets scheduling/service obligations without further violation of the cancellation policy during this period. Unfortunately, if the agreed terms of the policy are not met, Aspire may change or discontinue the services provided to your child.
It is not our goal or our desire to discontinue services, and we will work with you to identify solutions to ensure your child receives consistent therapy. Aspire Behavioral Care strives to work with every parent to ensure maximum service hours are being provided.
Exit Summary/Discharge Procedures
A client is discharged from services due to determination that the person has met the therapeutic goals defined in his/her Care Plan or has ceased to benefit from the program/services. The discharge process will typically involve a gradual decrease in the number of sessions received as well as additional parent training to ensure goals have been transferred to the in-home/community setting. This is subject to change based on parent and client needs. Aspire Behavioral Care will coordinate the discharge with the parents/guardians and/or the agency having made the initial referral. A discharge report will be completed and copied to the parent/caregiver. Please see your child’s BCBA for more information.
Scheduling and How to Make Scheduling Changes
Our scheduler will do our best to accommodate your desired schedule for ABA therapy. Our typical session times are Monday through Friday: 9-12pm, 12-3pm and 3:30-6:30pm however we do offer slight variability to these session times in order to accommodate families as best as we can. We typically have a higher volume of clients during evening hours so it may take some time to place your child in an evening slot.
We understand that when school is out, parents may want to move to an earlier session time. We can accommodate most changes however we cannot guarantee that you will have your evening slot when school resumes. Please keep this in mind when making any changes over breaks.
All schedule changes must go through scheduling at 719.822.3512 or via email. If you inadvertently contact your child’s RBT or BCBA regarding scheduling changes, they will direct you to scheduling. If you are not able to reach our scheduler when you call, please leave a detailed message. You can also contact scheduling via email at: scheduling@ABColorado.com.
If your child has only a fever, with no other symptoms, we welcome them at Aspire as long as it is 100.9 Fahrenheit or less. An Aspire staff member will call parents to come pick up their child if any of the above criteria are met. In home sessions will be cancelled if anyone in the home is displaying any of the above criteria.
Procedure for storing and administering children’s medications and delegation of medication administration are in compliance with Section 12-38-132, CRS of the Nurse Practice Act.
Health Records (intake forms) are required and kept in each child’s file. This record must contain all known information about drug reactions, allergies, medications, and special diets or conditions.
Children are not allowed to self-administer any medications (both prescribed and over the counter).
When it is essential that medication be given during programming time at the center, an “Administering Medication” form must be completed by the parents and a health care plan completed by the child’s doctor. This form must be completed and returned to the executive director before any medication can be given. All medications brought to the clinic must be in the original containers. The bottle must state the correct dose, child’s name, and frequency to be given. Only staff who have completed all required courses and been delegated by the RN may administer medications to children. Any time medication given to a child must be documented in the medical binder at the time it is administered.
Aspire Behavioral Care will be closing the ABC Center and in-home sessions on the following holidays:
New Year’s Day
New Years Eve: The center and in-home sessions are cancelled for any session beginning after 3:30 pm.
If there are any additional days Aspire is closed, all families will be informed in advance of those changes.
Aspire Behavioral Care follows the snow day delay policy of Academy School District 20. The policy is in effect for both the in-center sessions and all in home session. We do not follow D20 school closures. During school breaks, families will be notified by their BCBA of any delays or closures.
This information can be obtained through local news radio (e.g. KVOR), television stations (e.g. KRDO), and online from the news stations as well as on our facebook page and our website.
If D20 closes, the center will be placed on a 2-hour delay (open at 10:30) The Executive Director/CEO will determine by 9:30 am if the center will remain on the delayed start or close for the day. Any sessions before 12 will start 2 hours later than usual (8:30am sessions start at 10:30am, 9 am sessions start at 11 am). This will not impact sessions that start at 12 pm or later.
All families and staff will be notified by their respective BCBA or the scheduler of any delay or closure.
Safety Of Your Child
When your child arrives at the center it is important to remember to sign them in on the patient sign in. It is important to know which children and staff are in the building at all times as this information could be necessary in the event of an emergency.
While a client is at the clinic or during an in-home session, our staff are performing 1:1 therapy. During this time the staff is expected to remain within “an arm’s length” or in the “line of sight” at all times. The expected distance is determined by your child’s needs.
Emergency Contact Information Sheet
All clients will have an emergency form filled out when they initially begin services through Aspire Behavioral Care. Please inform the front desk of any updates to phone numbers or emergency contacts in case you are unavailable.
Authorized Pick Up List
Each client will have an authorized pick up list. The first time a new person picks up that child they must show the front desk their photo ID. The ID will be copied and attached to the form to ensure that all members of the child’s team and administration ensure the appropriate person is picking up your child. If an unauthorized person attempts to pick up your child, they will be verbally informed that they are not on the pickup list and that the child will not be able to be released to them. At this point in time they will be asked to leave the premises. In the case of a family emergency a call to the front office with a description of the person with their FULL name can be placed on a list HOWEVER they will still be required to show a photo id.
Whether indoor, outside, or in-home, your child is always monitored to reduce the chance of an accident or injury from occurring. Accidents occasionally occur and are always reported to the parent. If emergency medical care is necessary, the following steps will be taken:
Contact parent or guardian. (If parents do not answer a message will be left).
If necessary, contact emergency contacts in child’s paperwork.
Contact Aspire Behavioral Care’s on call nurse or call 911 (depending on the severity of injury)
Because your child’s safety is our greatest concern, we will not hesitate to call 911 to ensure their well-being.
Once parents have been contacted, or child is receiving proper medical care, an incident report documenting what occurred will be written by your child’s RBT or BCBA.
Reasons for Incident Reports
Aspire Behavioral Care takes all injuries to families or staff seriously. If any injury is sustained, an Incident Report will be completed by the staff member involved or that witnessed the event. Feedback will be given to the staff member as to how the incident could have been avoided.
Incidents will be written under the following circumstances:
Injury to a person receiving services
Lost or missing persons receiving services
Medical emergencies involving persons receiving services
Hospitalization of persons receiving services
Death of person receiving services
Errors in medication administration
Incidents or reports of actions by persons receiving services that are unusual and require review
Allegations of abuse, mistreatment, neglect, or exploitation
Use of safety control procedures
Use of emergency control procedures
Stolen personal property belonging to a person receiving services
All incident reports will be completed in Central Reach and stored under the individual’s personal electronic file. All incident reports must be completed no later than 24 hours after the incident occurred. A copy of the incident report must be provided to the family within 24 hours.
Reporting of Child Abuse or Neglect
Colorado law requires that staff in childcare settings report known or suspected child abuse and neglect. Staff who willfully fail to report can be punished and be liable for damages. Assistance from your county department of social services is always available to parents. The telephone number to report abuse: El Paso County, Human Services Department, 105 North Spruce Colorado Springs, CO 80905, 719-444-5700.
Child Abuse Reporting for Parents and Staff
Under the “Child Protection Act of 1987” (CRS 19-3-301) in the Colorado Children’s Code, child care center workers are required to refrain from abuse and report suspected child abuse or neglect. The law at 193-304 states that if a child care worker has “reasonable cause to now or suspect that a child has been subjected to abuse or neglect or who has observed the child being subjected to circumstances or conditions which would be reasonable result in abuse or neglect shall immediately report or cause a report to be made of such fact to the county department or local law enforcement agency.”
Mistreatment, Abuse, Neglect & Exploitation (MANE)
Aspire Behavioral Care prohibits the abuse, mistreatment, neglect, or exploitation (MANE) of any of our clients and employees.
"Mistreatment" means an act or omission, which threatens the health, safety, or welfare of a person.
“Abuse” can be Physical-hitting, slapping, pushing, kicking, burning, or confining or Sexual-sexual activity or touching without consent or understanding.
“Neglect” occurs when a caretaker fails to make sure that the individual in his/her charge has adequate food, clothing, shelter, psychological care, physical care, medical care, or supervision.
"Exploitation" means an illegal or improper action affecting a person or use of the person's resources for another person's profit or advantage.
Aspire Behavioral Care monitors to detect instances of mistreatment, abuse, neglect, or exploitation through the review of:
• Occurrence/Incident Reports
• Verbal or written reports of any unusual or dramatic changes in behavior; and
• Verbal or written reports from clients, volunteers, instructors, advocates, parents/guardians, or caregivers.
All allegations of instances of mistreatment, abuse, neglect, or exploitation should be recorded on an Occurrence/Incident Report within 24 hours of the allegation. Procedures should be followed for an Occurrence/Incident with the addition that:
All contacts and follow-ups should be documented on an Occurrence/Incident Report and copies kept in the individual’s file as well as in the Supervisor’s file. Aspire Behavioral Care will not conduct an investigation into allegations of MANE by individuals outside of the program. All allegations of MANE involving a person with a developmental disability will be reviewed by the Community Centered Boards’ Human Rights Committee as well as by local law enforcement as necessary. Local law enforcement will review all other allegations of MANE involving other individuals. If there are allegations of MANE by individuals within the program (employees, clients), those individuals will be immediately dismissed from the program and only allowed to return if the allegation is not substantiated. ABC will consult with the appropriate agencies to ensure the safety of all individuals and to provide the necessary victim supports. ABC employees and volunteers will be informed of all applicable state law and agency policies and procedures during training and annually thereafter.
No individual will be coerced, intimidated, threatened, or retaliated against because the individual, in good faith, makes a report of suspected mistreatment, abuse, neglect, or exploitation or assists or participates in any manner in an investigation of such allegations in accordance with Section 8.608.8 D of the Code of Colorado Regulations.
“Abuse” or “child abuse or neglect” means an act or omission in one of the following categories which threatens the heath or welfare of a child: skin bruising, bleeding, tissue swelling, or death; any molestation, sexual exploitation, or prostitution; any case in which a child is in need of services because the child’s parents, legal guardian, or custodian fails to take the same actions to provide adequate food, clothing, shelter, medical care, or supervision that a prudent parent would take.
Review of allegations/suspicions will be done via Director case review on the same day of the report being made, but the ultimate decision will lay with the Colorado State agency the report was submitted to.
It is not the staff’s role to investigate suspected abuse – only to report it. Persons who make a good faith report are immune from civil and criminal liability. Additionally, the law provides for the protection of the identity of the reporting party.
If the suspected abuse/neglect is reported about an Aspire Behavioral Care staff member, the staff member will be removed from all sessions and an internal investigation will be completed regardless of whether the allegation is substantiated with the Colorado State agency. Parents and state agency will be notified immediately. A safety plan for the child/adult may be put in place if necessary.
Codes of Conduct and Grievance Procedures
BACB Code of Conduct
Aspire Behavioral Care acts in accordance with the professional and ethical standards set forth in the Behavior Analyst Certification Board’s Guidelines for Responsible Conduct.
Although our relationship involves very personal interactions and discussions, we need you to realize that we have a professional relationship rather than a social one. According to our professional code of ethics, it is not acceptable for RBTs/therapists or BCBAs to accept gifts or meals and cannot attend family or site events such as birthday parties, weddings, funerals, religious services, etc., unless doing so explicitly for the purpose of providing assessment, or treatment during those events, and has been approved in advance. If an employee does an outing with a client they are responsible for their own transportation and cannot transport clients in their own vehicle. If, at any time and for any reason you are dissatisfied with our clinical relationship, please do not hesitate to discuss the situation Aspire Behavioral Care’s Executive Director 719.822-3634. If we are ever unable to resolve any clinical/ethical issues, you may report these to the:
Behavior Analyst Certification Board, Inc.
1705 Metropolitan Boulevard, Suite 102
Tallahassee, Florida 32308
Aspire Behavioral Care assumes a proactive role in the prevention, facilitation, and resolution of complaints and grievances, including implementing educational programs that will assist facility staff in handling difficult situations. The role in resolving a complaint, grievances, or inquiry will vary, depending upon the situation. The use of the grievance procedure shall not prejudice the future provision of appropriate services or supports. No individual shall be coerced, intimidated, threatened or retaliated against because the individual has exercised his or her right to file a grievance or has participated in the grievance process.
Families can submit grievances 24 hours per day, either orally or in writing, to the Supervisor, Director, or CEO. The Supervisor/Director or CEO shall contact the family within 24 hours of receipt of the grievance to acknowledge receipt. An investigation of the grievance and responds to the family will be available in writing/email within fifteen (15) working days of the submittal of the grievance.
If the patient is dissatisfied with the finding, the family may request, the grievance be forwarded to the BACB, the BBB or state health officials.
At Aspire Behavioral Care, we welcome mediation through the Better Business Bureau. Please contact the BBB at (719) 636-1155. You can also contact the Colorado Department of Human Services, via telephone at 303-866-3755 or via mail at: The Colorado Department of Human Services, Division of Child Care, 1575 Sherman St., Denver, CO, 80203. Toll free: 800-799-5876
Aspire Behavioral Care develops individualized behavior preventative and intervention plans for each client within their initial assessment. Behavior plans include a clear description of the behavior, frequency or duration of the baseline, preventative and intervention strategies, expected reduction of behavior and the function of each behavior addressed. The plan is reviewed and updated as new baseline data has been collected.
If the review of the behavior plan yields new intervention strategies that must be implemented, the BCBA, in charge of the plan/client will update the plan, and review/train the new implementations with staff and parents. The team will review critical behavior and further problem solving will include the family unit. In the event that reduction of behaviors is not achieved at Aspire Behavioral Care, staff will contemplate outsourcing further specialists to assist the team. As described in the “restraint” policy below, they are viewed as a last resort measure to keep the staff and client safe only. Under no circumstance will any families be mistreated, force-fed, verbally abused or hurt due to toileting accident, severe behavior or any other compliance issues.
Emergency Control Procedures
Emergency Control Procedures (ECP) will only be used to keep the person receiving services and others safe.
Only staff/independent contractors who have been trained in approved intervention techniques should use an Emergency Control Procedure.
Behaviors requiring Emergency Control Procedures are those which are infrequent and unpredictable.
Emergency Control Procedures shall not be employed as punishment or for the convenience of staff/independent contractors, or as a substitute for services, supports or instruction.
Within 24 hours after use of an Emergency Control Procedure the responsible staff/independent contractors will write and submit an incident report (follow incident report process) with an attached “Emergency Control Procedure Record”.
The Emergency Control Procedure Record will contain the following information:
Description of the Emergency Control Procedure employed, including beginning and ending times.
An explanation of why the procedure was judged necessary.
An assessment of the likelihood that the behavior prompting the procedure is likely to recur.
Within three days of the use of an Emergency Control Procedure, the parent or legal guardian or authorized representative will be notified by the staff of the program approved service agency.
Aspire Behavioral Care has chosen to utilize Professional Crisis Management (PCM) as it’s Crisis Management Tool. Aspire Behavioral Care staff will only implement a restraint to keep the client from causing damage to self, others and only severe property destruction.
Aspire Behavioral Care supports and adheres to new guidelines brought forth by Colorado Code of Regulations 301-45. This is in accordance with CRS 26-20-108, CRS 22-2-107 1(a) and CRS 22-2-107 1(c) which became effective December 2009. This includes, but is not limited to, mechanical or chemical restraints and includes seclusion (neither of which Aspire Behavioral Care engages in). Aspire does not use prone restraints.
Physical management interventions should always be applied in the least restrictive manner that is safe, with the minimum physical force necessary for safety and stability.
Whenever a hold or escort is implemented, all involved staff must closely and continuously look for indicators of harm or distress. The person’s breathing must be checked at least every 30 seconds. A restraint will be released immediately if there is an incorrect hold or breakdown of a hold. A restraint will be released as soon as the emergency is over or when the maximum time criteria is met (15 minutes).
An administrator must be notified if a restraint is exceeding 15 minutes. Any person who has a restraint lasting longer than 15 minutes (with administrator approval), will be reviewed by the Interdisciplinary Team (IDT) within 48 hours of the incident.
The following procedures will be adhered to at Aspire Behavioral Care to ensure that the use of restraints is utilized only when necessary.
Staff will be trained on blocking techniques and procedures to limit potential exposure to aggressive actions and to ensure their safety and that of the child.
Staff will be trained to utilize antecedent strategies to limit potential for escalation to the point of the need for a restraint.
Staff will follow and use PCM strategies when necessary to prevent imminent and immediate threat to the client or others in the area.
Only staff who have successfully completed PCM will be permitted to perform holds on children. Holds will only be done in a last case scenario, in conjunction with a parent approved behavior plan and under the guidance of the BCBA and Clinical Director.
If a restraint is utilized, the following documentation will be completed and provided to the family within 5 calendar days of the use of a restraint. The following items will be listed in the documentation:
The antecedent to the student’s behavior if known;
A description of the incident;
Efforts made to deescalate the situation;
Alternatives that were attempted;
The type and duration of the restraint used;
Injuries that occurred, if any
The staff present and staff involved in administering the restraint.
A copy of the written report on the use of restraint shall be placed in the student’s confidential file.
Professional Crisis Management (PCM)
Aspire Behavioral Care uses a safety system called Professional Crisis Management (PCM). PCM is a system that uses prevention, de-escalation, intervention and post crisis strategies before in order to keep the client and others safe. PCM includes antecedent strategies, de-escalation strategies, transportation and restraint systems that were developed by BCBAs in 1981 using biofeedback principles and safe biomechanical movements to ensure the safety of clients and others during crisis situations. This system can only be used by those that are certified in PCM under the training and certification of a PCM trainer. PCM uses strategies to keep the client, staff members and other clients safe.
It is the policy of ABC to ensure adherence to the provisions of Colorado Revised Statutes (Sections 25.5-10-218 through 231, C.R.S. and 10 C.C.R. 2505-10 Section 8.604.2) concerning the rights, benefits and privileges of persons funded in whole or part through the Division for Intellectual and Developmental Disabilities (DIDD).
You have the right to receive considerate, respectful and compassionate care in a safe setting regardless of age, gender, race, national origin, religion, sexual orientation, gender identity or disability. You have the right to receive care in a safe environment free from all forms of abuse, neglect, or mistreatment. You have the right to be called by your proper name and to be in an environment that maintains dignity and adds to a positive self-image. You have the right to be told the names of all health care team members directing and/or providing your care.
You have the right to be told by your therapist about the benefits and risks (if any) of treatment, and the expected outcome of treatment, including unexpected outcomes.
You have the right to a reasonably safe and secure environment. You have the right to humane, medical care and treatment.
You have the right of elimination of forced, coercive and otherwise involuntary sterilization. You have the right to fair employment practices, right to vote, and the right to personal property.
You have the right to give written informed consent before any intervention begins.
You can expect full consideration of your privacy and confidentiality in care discussions, exams, and treatments.
You have the right to access protective and advocacy services in cases of abuse or neglect.
You, your family, and friends with your permission, have the right to participate in decisions about your care, your treatment, and services provided, including the right to refuse treatment to the extent permitted by law.
You have the right to communication that you can understand. Information given will be appropriate to your age, understanding, and language. If you have vision, speech, hearing, and/or other impairments, you will receive additional aids to ensure your care needs are met.
You have the right to be involved in a discharge plan. You can expect to be told in a timely manner of discharge, transfer to another facility, or transfer to another level of care. Each individual receiving services shall have a Behavior Plan developed by the BCBA.
You can expect that all communication and records about your care are confidential, unless disclosure is permitted by law.
You have the right to see or get a copy of all records.
You have the right to request a list of people to whom your personal health information was disclosed.
You have the right to give or refuse consent for recordings, photographs, films, or other images to be produced or used for internal or external purposes other than identification, diagnosis, or treatment.
You have the right to withdraw consent up until a reasonable time before the item is used.
In Colorado, clients and their therapists have a confidential and privileged relationship. We do not disclose anything that is observed, discussed or related to clients. In addition, we limit the information that is recorded in your file to protect your privacy. Any communication used on a portable electronic device (including cell phone calls, text messages, and email are protected using a password). We provide all staff an aspire email which can be used to communicate with families. We need you to be aware that the confidentiality has limitations as stipulated by law including the following:
• We have your written consent to release information.
• We are verbally directed by you to tell someone else situations-must sign an interagency release form.
• We determine that you are a danger to yourself or others.
• We have reasonable grounds to suspect abuse or neglect of a child, disabled adult, or an elder adult.
• We are ordered by a judge to disclose information.
Destruction of Records
Aspire Behavioral Care keeps client files confidential at all times and adheres to HIPAA and FERPA guidelines. Aspire Behavioral Care data will be appropriately managed across the entire service attendance span of the client. When data is no longer needed, the destruction of the data is critical. After a client and/or staff exits services or employment with Aspire Behavioral Care the data will be archived for 6 years after the client/staff has exited in accordance with HIPAA regulations (45 CFR 164.316(b)(2)). At this point all hard copy data will be destroyed using an on-site industrial shredder that renders all data unreadable in all parts. Data destruction is an integral part of Aspire Behavioral Care’s high quality data management and taken serious.
All data that may have been kept on flash drives etc. will be permanently deleted with recovery/possibilities. And fully physically destroyed as all data becomes obsolete/outdated.
Personal Needs Fund (PNF)
Personal funds are properly handled in accordance with 10 C.C.R. 2505-10 Section 8.609.5 and Title 25.5-6-411 C.R.S. of the Code of Colorado Regulations. Proper management of personal funds and personal property is critical to the following. Implementing and advancing the service delivery system’s goals of providing persons with a developmental disability the full opportunity to be included in community life, to make increasingly sophisticated and responsible choices, to exert greater control over his or her life, to establish and maintain relationships and a sense of belonging, to experience personal security and self-respect, and to develop and exercise competencies and talents. Ensuring that the rights of a person to manage his or her own money and to be free from exploitation and abuse are upheld. Establishing practices that, when followed, offer providers and legally authorized representatives protection against improper use or mismanagement of funds.
Employees are prepared to handle the personal needs funds of persons who may not be able to manage the funds for themselves. If the person elects to have the provider handle the personal needs funds, the person or the legally authorized representative and the residential provider must sign an Authorization Form (PNF-2 or 3). This form assigns the provider fiduciary responsibility for the safeguarding and care and management of the person’s funds. 2. Individuals who do not wish their funds to be managed by the provider must sign the Exclusion Agreement (PNF-1). The provider shall maintain a system of accounting for expenditures from an individual’s personal needs funds. This accounting system (ledgers) must be adequate for audit by the supervisor and guardian of client. Individual account ledgers must be maintained on file for an individual’s personal needs funds. These ledgers must: Identify all withdrawals and deposits, contain appropriate authorizing signatures for each withdrawal or deposit, be available for review and auditing, upon request, by the individual, his or her legally authorized representative, the case management agency, and account for all personal needs funds under the control of the provider including petty cash, trust fund accounts, and individual checking or saving accounts where the provider cosigns withdrawals. The provider will maintain receipts for all expenditures of $5.00 or more. Providers are encouraged to also maintain receipts for withdrawals under $5.00.
Aspire Behavioral Care is a certified provider with the Colorado State Medicaid system, Blue Cross/Blue Shield and Tricare. Other possible payment methods include the following: money orders, checks and purchase orders. It is the families’ responsibility to contact their insurance carrier to ensure ABA services are covered. You must inform us if there is a change in your insurance carrier. If you fail to provide us with updated information and your insurance denies a claim, you may be held responsible for those charges.
The parent/guardian is responsible to update Aspire Behavioral Care immediately with any changes in insurance coverage. If there is a change in insurance and you fail to contact us, you may be charged the fees listed below. Please see Statement of Financial Responsibility for more information.
Aspire Behavioral Care obtains prior authorization for all initial assessment service from each client’s insurance carrier. Upon completion of the FBA and written report of behavior needs, Aspire Behavioral Care will request ongoing services which are usually rendered for 6-month time periods. Aspire Behavioral Care gathers information about parent/guardians co-payment responsibilities and will share that information in writing with the parent/guardian. You are not to exceed the units advised in your service plan.
Invoices will be sent out on the last day of the month in which co-pays and/or cancellation fees are rendered. Payment of services are due within seven days of receiving invoice. If payment is not collected services may be cancelled until payment is received. If payment is not received within 7 days 10% interest will be added each day until your bill is paid. You can pay at front desk, on our website under "pay your bill" or submit payment via check to 4760 Flintridge Drive Suite 200 Colorado Springs, CO. 80918.