- Department of Developmental Services
Dear DDS Community,
On Friday, February 21, 2020, the Secretary of State’s Office published a significant revision to the regulations of the Department of Developmental Services (DDS), replacing the Department’s existing regulations governing behavioral treatment with new Positive Behavior Support (PBS) regulations, designed to increase the independence and autonomy of people with disabilities.
The updates are made to Title 115 in the Code of Massachusetts Regulations (115 CMR) Chapter Two, entitled “115 CMR 2.00: Definitions,” and Chapter Five, entitled “115 CMR 5.00: Standards to promote dignity.” The regulations address many issues including the rights of individuals, general principles of service provision, legal competency and guardianship, informed consent, emergency restraint, behavioral treatment, and medication administration.
Much progress has been made in understanding behavior and designing treatment strategies for individuals with intellectual disability since the prior regulations were promulgated in the late 1980s and early 1990s. Further, the evolution of “second generation” psychoactive medications to treat symptoms of mental illness in individuals with disabilities has transformed the field and treatment options.
PBS is a regulatory framework - not a prescription - designed to encourage systems change and improve individual treatment. The goal is to support individuals to grow to their maximum potential.
PBS incorporates established principles of applied behavior analysis (ABA), including both functional behavioral assessment (FBA) and evidence-based interventions; further emphasizes person-centered planning; and recognizes current values in the field of intellectual and developmental disabilities. Using positive approaches, PBS views behavior as individual’s response to his or her situation, and an expression of needs and preferences.
Chapter Five also updates the Department’s restraint regulations, recognizing that restraint is not treatment, but rather a response to an emergency situation. The Department’s regulations will continue to prohibit “chemical restraint” and includes a limited category of “prohibited practices.”
These updates to Chapter 5 will bring DDS into contemporary practice with the national field of developmental disability work and reflects a commitment to systemic quality improvement.
Throughout the development of these regulations, DDS conducted public hearings and met with stakeholders, which resulted in changes to the draft regulations. We are grateful for the extensive feedback from the community to make these regulations clear and concise.
DDS will continue to work collaboratively and closely with stakeholders to implement these new regulations and bring changes and improvements to practices throughout the Massachusetts system. To assist with the implementation, DDS will be conducting a web-based survey for each provider to complete. Please watch for an email in the next few days for the instructions and link for the survey.
Michelle Harris, Deputy Assistant Commissioner for Policy and Planning is helping to facilitate implementation and can be reached at michelle.harris@mass.gov or (617) 624-7502 if you have any questions.
Thank you.
Jane F. Ryder, Commissioner
Department of Developmental Services
