Human Rights Committee

The purpose of the Human Rights Committee (HRC) is to safeguard the rights and freedoms of individuals receiving Behavioral Support Services through Indiana Medicaid Waiver Programs. The committee provides independent oversight of behavioral support strategies that propose the use of, or already include restrictive interventions (including chemical, manual, and/or mechanical restraint.) Restrictive measures must be reviewed and approved by the HRC before they can be implemented by a provider. 

Restrictive Interventions (Including Restraint)

Restrictive Interventions (including restraint) restrict the rights and/or freedoms of individuals with disabilities. Something is considered restrictive if it impedes on liberties available to all citizens. Some examples of limits on access are: possessions; spaces such as locked areas and off-limits areas; activities; community services; and people. Some examples of limits on movement are: bed rails; belts; mitts; braces, helmets, splints; therapeutic holds; and physical escort/transport through manual restraint. Additionally, any medication that is used to control behavior is considered a restriction.

A restriction may be considered when positive behavior support (non-restrictive) strategies have been ineffective in protecting the health, safety and welfare of the individual or another person, or preventing a legal sanction (eviction, arrest, and/or incarceration.) Restrictive interventions also include those intended for one individual, that could impact the rights of others in a shared environment. Furthermore, restrictions are intended to be temporary. The consideration of their use must be accompanied by a plan to decrease the use of the restriction and replace it with non-restrictive positive behavior support strategies. Adverse techniques as defined by the Bureau of Developmental Disabilities (Policy 460 1207 003) are forbidden.  

Behavioral Support Services

Behavioral Supports are a broad range of services and strategies to support individuals who face behavioral, social, or emotional challenges. Behavioral Support Services are intended to support individuals and their families in order to achieve self determination to the best of their ability.

The Human Rights Committee is authorized by the executive director or board of directors of Reach High Consulting and Therapy. They are exempt from liability as they serve an advisory function. Ideally, the committee should include a mix of consumers, family members, professionals, and community members. The HRC is required to have a minimum of four members and a maximum of nine members, comprised of the following:

  1. A Chairperson who is not affiliated with a Bureau of Developmental Disabilities Services approved provider entity, who coordinates the committee’s functions.
  2. At least one member who meets the qualifications as a Behavior Support Service Provider.
  3. At least one member who has an educational background (bachelor’s degree or higher) and one or more years of work experience in the field of developmental disabilities.
  4. At least one member with a developmental disability.

A quorum is required at any committee meeting where a decision involving individual rights and entitlements is made. For the purposes of the HRC, 75% committee member participation constitutes a quorum.

  1. Frequency: Meetings will be scheduled once a month at a time that is convenient for committee members.
  2. a. A special meeting may be requested in order to accommodate an emergency situation.
  3. Length: Meetings should last between one and two hours.
  4. Location: Meetings can be conducted in a HIPAA compliant video conference, in person, or a hybrid of the two to accommodate the needs of committee members.
  5. Preparation: Case information will be provided to committee members ahead of the scheduled meeting, for their review.
  6. Records: Minutes will be recorded.

In order for the committee to provide independent oversight, any member of the HRC acquainted with the individual whose rights and entitlements are being addressed must recuse themselves.  

Any individual whose rights are in question is assured the opportunity to be present and express their concerns at the HRC meeting. Accommodations must be provided to individuals wishing to attend an HRC committee meeting where their rights are in question. If needed, they will be provided a representative to support their communication or speak on their behalf. An individual (and/or their legal guardian,) their family member/s, service provider/s and members of their Individualized Support Team (IST) may present information to the HRC and answer questions from the committee; however, they are not permitted to participate in or be present for deliberation or the decision making process.

The HRC will review, may request revisions, approve or reject, and monitor any behavioral support strategy that includes restrictive intervention/s defined as:

  1. The restriction of individual rights and freedoms.
  2. The use of restrictive interventions or intrusive procedures, including restraint, “time-outs,” and aversive conditioning.
  3. The use of medication to control and/or manage behavior.

Reviewing the proposed behavior intervention will begin with information about an individual and their case. Case information will be provided to committee members ahead of the scheduled meeting, for their review. Case information will include the following:

  1. Statement of concern.
    • A history of the concern (behavior of concern.)
  2. An individual’s most recent Functional Behavior Assessment and Behavioral Support Plan.
  3. Any current data on the behavior.
  4. Historical information about the behavior and the non-restrictive strategies used to demonstrate the ineffectiveness of non-restrictive strategies.
    • Any incident reported in the last 12 months reported to the Bureau of Developmental Disabilities.
  5. A detailed description and definition of the proposed restrictive intervention (including medication.)
  6. Risk/benefit analysis of restrictive intervention.
  7. Description of the staffing requirements.
  8. A fading/reduction plan for restrictive interventions and the use of any medications, to be replaced with positive behavioral supports (to be reviewed at least every 90 days.)
  9. Individual and/or Guardian concerns.
  10. Other concerns.
  11. Plans for follow up and review.
  12. Individual and/or Guardian Informed Consent.

The HRC will review the cases that it receives. Once the HRC has reviewed the case/s, the committee will have an opportunity to discuss the case with any individuals in attendance. Further review and discussion of the plan continues after any individuals, guardians, family members, advocates, service providers, and team members in attendance have left.

Based on review and discussion, the HRC makes decision/s based on applicable policy, standards, and directives. They can approve or reject a proposed behavioral support strategy that includes restrictive intervention/s. If the HRC approves a restrictive intervention, they might do so with specific conditions. If they reject a proposal, they might include suggestions and options on how to reconsider behavioral support strategies. Another possibility is that the HRC might need more information in order to make a decision. It is important to note that in addition to the duties described above, members of the HRC will also be monitoring the fading/reduction plans of previously approved behavior support strategies that include restrictive intervention/s.

The Human Rights Committee will maintain a process for emergency situations that require expedient review and decision. In these circumstances, the HRC may establish procedures allowing reviews to be conducted by subcommittee, telephone, mail, and/or electronic mail, or other methods; however, the minimum number of contacts must equal 75%, the quorum defined in the HRC policy/bylaws. When emergency procedures have been used, they must be reviewed and discussed at the next full meeting of the HRC where the committee will decide whether to rescind or approve the decision. The chairperson of the HRC will determine when it is in an individual’s best interest to conduct an emergency review.

Reach High Consulting and Therapy’s Human Rights Committee has been created and is administered pursuant to the following administrative codes, governing policies, and documents:

Bureau of Developmental Disabilities Services (2020)

  • Behavior Support Services: Service Definition and Standards

Bureau of Quality Improvement Services (2012):

  • Behavioral Interventions

Division of Disability and Rehabilitative Service Waiver Manual (2020)

Division of Disability and Rehabilitative Service Policy Manual (2011):

  • Policy Number: 460 0228 025: Use of Restrictive Interventions, Including Restraint
  • Policy Number: BDDS 460 0221 007: Behavioral Support Plan
  • Policy Number: BDDS 460 0221 012: Human Rights Committee
  • Policy Number: BDDS 460 0228 022: Protection of an Individual’s Rights
  • Policy Number: BDDS 460 1207 003: Aversive Techniques
  • Policy Number: BQIS 460 0301 008: Incident Reporting and Management

Indiana Administrative Code

  • Title 460: Division of Disability and Rehabilitative Service
    • Article 6. Supported Living Services and Supports
      • Rule 10. General Administrative Requirements for Providers
        • 460 IAC 6-10-12 Human rights committee
        • 460 IAC 6-10-13 Emergency behavioral support
      • Rule 18. Behavioral Support Services
        • 460 IAC 6-18-3 Written policy and procedure standards
        • 460 IAC 6-18-7 Human rights committee
      • Rule 35. Applied Behavior Analysis Services
        • 460 IAC 6-35-8 Human rights committee