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Minnesota positive supports
Minnesota positive supports
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This field is for validation purposes and should be left unchanged.
Person seeking supports:
Guardian (if applicable):
Contact phone:
Contact email:
Location (City, state)
Today’s Date:
MM slash DD slash YYYY
Case manager (if applicable):
Preferred start date
MM slash DD slash YYYY
Has the person and/or team agreed additional support is needed?
Yes
No
Support options (select all that apply)
Person Centered Plan: A compilation of information gathered through interview with the person the plan is for, and people who have contact with the person. Hours vary by number of people close to the person to interview and communication style of the person. (986)
Untitled
Functional Behavior Assessment (FBA): A report summarizing information on target behaviors, likely antecedents, suggested responses, purpose of the behavior and includes information on contributing factors (i.e. medical, mental health, environmental). Waiver funded only. Typically 8-10 billed hours for observations, interviews with people who closely know the individual, and compiling of written documentation. (983)
Positive Behavior Support: This typically takes place after a FBA and allows our Behavior Professionals and Behavior Analysts to implement a positive behavior support plan by training staff and/or family members, as applicable, in an approach to address targeted behaviors. Waiver funded only. Hours vary by type and number of behaviors and the number of people to train on techniques. (983)
Positive Support Specialist: This support includes 1:1 teaching/modeling of skills within the persons’ supported natural environment. The specialist typically works the person supported and their caregivers between 5-25 hours per week.
Other
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What waiver funding options are available?
CDCS
CADI
DD
Other
Describe what success looks like at the conclusion of working together.
What else would you like to share with us?
