July 22, 2011 Office of the General Counsel Department of Developmental Services 500 Harrison Avenue Boston, MA 02118

COMMENTS OF THE PROVIDERS’ COUNCIL ON THE PROPOSED AMENDMENT OF REGULATIONS ON BEHAVIOR MODIFICATION AT 115 CMR 5.14

Thank you for the opportunity to submit comments on the proposed amendment of regulations on behavior modification (115 CMR 5.14). This proposed amendment would prohibit the use of aversive (Level III) behavioral interventions on a prospective basis. The Providers’ Council, formally known as the Massachusetts Council of Human Service Providers, Inc., is a statewide association of home- and community-based human services organizations that provide an array of essential services to one in ten Massachusetts residents. The Council is the state’s largest human services association, and the Council – as well as many of its members – is categorically opposed to the use of “Level III Interventions” with clients and consumers. The Council supports DDS’ proposed regulations to the extent that they prohibit the use of aversive therapy for individuals without an existing court-approved treatment plan. Further, we support efforts to accelerate the planned elimination of aversive treatment on individuals with disabilities. The use of “Level III Interventions” is an antiquated, outdated form of treatment and should be prohibited for such individuals. States across the country – including Arizona, California, Colorado, Connecticut, Florida, New Jersey, New York, North and South Dakota, Pennsylvania and Rhode Island – have banned the use of such practices. In fact, Massachusetts has the only school known to still use aversive treatment in the nation. The Council understands the difficulty for many concerned parents who are seeking an effective treatment for their loved ones and have resigned themselves to this form of treatment. However, we support the statements of Massachusetts’ Disability Law Center, Inc., which challenge assumptions that this is the best treatment option. We also support the position of the American Network of Community Options and Resources (ANCOR) that “Behavioral interventions that withhold regular meals, essential nutrition and hydration, intentionally inflict pain, use chemical or other restraint in lieu of positive programming; or which involve the
Providers’ Council • Human Services Providers’ Charitable Foundation, Inc. 250 Summer St., Ste. 237 • Boston, MA 02210 • p:617.428.3637 • f:617.428.1533 • e:info@providers.org

employment of techniques which produce physical or psychological pain, humiliation or discomfort must be eliminated.” Accordingly, the Council appreciates the efforts of the Department of Developmental Services to remove language from 115 CMR 5.14 that seems to acknowledge the need to use certain the most extreme aversive therapies in certain circumstances.1 Aversive therapies should not be used even in such circumstances, as they can cause permanent damage – including loss of life – to clients and consumers. The Council does remained concerned, however, about language this proposed amendment adds in section 115 CMR 5.14 (4)(b)(4). This section would grant “individual-specific exemptions allowing the use of Level III Aversive Interventions to reduce or modify behavior” if they have a court-approved treatment plan on September 1, 2011 that calls for such interventions. We would hope the Department of Developmental Services would instead cease all Level III Interventions after September 1, 2012. Thank you again for the opportunity to submit comments on the proposed amendment of regulations on behavior modification (115 CMR 5.14). We hope the Department of Developmental Services will ensure the safety of all clients in its care and join other states across the country in taking appropriate steps to end Level III Aversive Interventions in Massachusetts. Should you have any questions regarding our comments, we would be happy to discuss them with you in greater detail. Please contact me at your convenience. Sincerely,

Michael Weekes President/CEO Providers’ Council

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Deleted language: “…the Department recognizes that there are extraordinary cases in which there is a need to treat the most difficult or dangerous behavior problems … in such cases it may be necessary to use extraordinary behavior modification procedures which would otherwise involve too much risk or potential harm to the dignity, health or safety of the client to be permitted.”

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