22 VAC 40-151-800               Behavior Support:                 A Behavior Support Plan is appropriate when problematic thinking/feeling is manifested as externalized and seemingly out-of-control behavior. However, such a plan is not appropriate when problematic thinking/feeling is internalized or manifested as manipulative behavior, drug/alcohol abuse, or emotional withdrawal.   These latter behaviors may not have identifiable “triggers”, may not involve inappropriate levels of “anger and anxiety”, and (particularly in cases of manipulation and drug/alcohol abuse) may involve deliberately calculated misrepresentations by residents. A behavior support plan is appropriate for residents with histories of out-of-control behavior and for residents who first manifest those behaviors while in placement.            Recommended language change to 22 VAC 40-151-800.A:                  A. Within 30 days of admission, the provider shall develop and implement a written behavior support plan that allows the resident to self-manage his own behaviors, when the resident has history of out-of-control behaviors at intake. If a resident first manifests out-of-control behavior while in placement, the provider shall develop a written behavior support plan within 30 days of the incident. Each individualized plan shall include: