RES-CONTINUITY — BACB Resource: Continuity of Services Toolkit — Managing Service Interruptions, Transitions, and Discontinuations
What does RES-CONTINUITY say?
The BACB's Continuity of Services Toolkit is a comprehensive guide for preparing to support clients by providing continuity of services when faced with interruptions, transitions, or discontinuations. Service changes may include: discontinuing at client/stakeholder request, identifying that a client is not benefiting from services, transitioning to another practitioner within or outside the organization, or planned interruptions (e.g., leave of absence, medical leave) and unplanned interruptions (e.g., car accident, illness, unexpected staff changes).
STEP 1 — ASSESS: Take a critical look at your current plan for consistency, client protection, and ethics compliance. (a) List what's missing: service agreement, policies and procedures, task analyses, job aids, checklists. (b) Collect baseline data by asking your team: Are you aware of and following required processes? Are you using required documents? Do you feel comfortable with them? What feedback do you have? (c) Ensure RBT training highlights the importance of providing sufficient notice when discontinuing services, including potential negative impacts on clients. (d) Consider your scope of responsibility to protect clients from negative impacts of service interruptions — even unplanned events like car accidents or an RBT quitting without notice require policies and procedures to minimize harm. (e) Collect treatment-integrity data the next time you manage an interruption, transition, or discontinuation. (f) Present all collected data to relevant leaders, supervisors, BCBAs, and BCaBAs.
STEP 2 — DESIGN: Create or update your continuity plan. (a) Form a group of trusted individuals (BCBAs, BCaBAs, supervisors) to help manage and create documents and processes. Independent practitioners should ask a peer or mentor to review. (b) Notify BCBAs and BCaBAs of upcoming changes. (c) Establish timelines and schedule training dates. (d) Update/create documents including: service agreements, policies and procedures for interruptions/transitions/discontinuations, training plans for discussing emergencies and discontinuations with stakeholders, and a list of alternative local providers. (e) Develop checklists for: organizational considerations for service discontinuation and transition, discontinuing all behavior-analytic services, discontinuing services and transitioning to a different provider, transitioning to a different BCaBA/BCBA within an organization.
STEP 3 — IMPLEMENT: Put processes into action. (a) Prepare to answer questions, model new processes, and offer practice opportunities with feedback. (b) Train team using Behavioral Skills Training (BST): provide written instructions/job aids, model behavior during role play, have trainees practice, provide immediate feedback. (c) Focus training on: how to use checklists, how to have difficult conversations about discontinuation/transition, and how/when to document steps. (d) Collect treatment integrity data for following required processes and using documents. (e) Present collected data to relevant leaders and make adjustments.
STEP 4 — EVALUATE: Review effectiveness and make updates. (a) Determine how often to evaluate (quarterly recommended). (b) Ask team to provide feedback on processes and documents. (c) Review treatment integrity data. (d) Make updates as needed based on data and feedback.
TROUBLESHOOTING GUIDANCE: (a) Barriers to behavior-change programs — assess and address organizational, staffing, or family barriers that interfere with service delivery. (b) Unexpected interruptions in pay — have contingency plans for funding disruptions; maintain communication with funders. (c) When alternative providers are not available — maintain a current list of providers, consider telehealth options, provide family training as a bridge. (d) When clients decline referrals — document the client/stakeholder's decision, provide information about potential impacts, and follow up periodically.
SAMPLE TIMELINES: The toolkit includes sample 60-day and 90-day timelines for discontinuing or transitioning services, with specific milestone activities, responsible parties, and documentation requirements at each stage.
KEY ETHICS CODES REFERENCED: Code 3.14 (Facilitating Continuity of Services), Code 3.15 (Appropriately Discontinuing Services), Code 3.16 (Appropriately Transitioning Services). Also references Code 2.01, 2.08, 2.09, 2.19, 3.01, 3.11, and 3.12.
Official source: read the full text in the Ethics Code for Behavior Analysts (2022) (official document).