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Minnesota Department of Human Services Early Intensive Development and Behavioral Intervention Manual
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Intervention observation and direction

Page posted: 6/18/15

Page reviewed: 2/17/17

Page updated: 5/30/18

Legal authority

CMS-approved state plan amendment (PDF), Minn. Stat. §256B.0949


Intervention observation and direction: An EIDBI service that covers the clinical direction and oversight given by a qualified EIDBI provider to a lower-level EIDBI provider who is delivering individual intervention services.


Intervention observation and direction is provided for the direct benefit of the person based on his or her needs. The purpose of the service is to ensure treatment fidelity and integrity, as well as to inform any necessary treatment modifications. It provides face-to-face, real-time direction to a provider to maximize the effectiveness of:

  • • Data collection
  • Generalization of newly acquired skills
  • • Individual treatment plan (ITP) implementation
  • • Progress measurement
  • • Training or refining treatment techniques and strategies
  • • Understanding or determining the function of behaviors.
  • Level I, II and III home-based EIDBI providers may need regular observation and direction until they can competently and independently implement the person’s treatment strategies.

    Eligible providers

    The following EIDBI providers can deliver and bill for intervention observation and direction:

    A QSP can deliver this service to either a Level I, II or III provider.

    A Level I provider can deliver this service to either a Level II or III provider.

    A Level II provider can deliver this service to a Level III provider.


    Intervention observation and direction must include the physical presence of the person and/or his or her parent/primary caregiver whenever possible.


    The person and his or her parent/primary caregiver may not be physically present during intervention observation and direction only when:

  • • The EIDBI provider team needs to discuss sensitive topics (e.g., interfering behaviors, etc.) that would be more appropriate to discuss without the person and/or parent/primary caregiver present
  • • The safety or well-being of the person and/or his or her parent/primary caregiver would be compromised while the provider is delivering feedback or training (e.g., the person would be unsupervised for an extended period of time, etc.)
  • • The provider delivering observation and direction determines it would be more effective or efficient to train or deliver feedback to the provider without the person and/or parent/primary caregiver present.
  • These discussions must be necessary for effective treatment.


    When determining which provider to assign to a person and the level of observation and direction each provider needs, consider the:

  • • Barriers to the person’s progress
  • • Complexity and frequency of changes needed to the person’s treatment strategies
  • • Complexity of the person’s needs or behaviors
  • • Experience and training needs of individual staff
  • • Extent of parent/primary caregiver’s needs
  • • Person/family’s and individual staff’s cultural, ethnic and language preferences
  • • Person’s interfering behaviors
  • • Treatment intensity.
  • Case notes

    The provider must document intervention observation and direction provided to another provider in the person’s case notes. Documentation must include:

  • • Name and title (e.g., QSP, Level I) of the provider who delivered the observation and direction
  • • Name and title of the provider who received the observation and direction
  • • Date the observation and direction was provided
  • • Signatures of all providers involved
  • • Brief description of the observation and direction provided, including duration
  • • Subsequent actions or changes in service delivery the provider who received observation and direction must take.
  • For more information about case notes, see EIDBI – Health service records.


    If medically appropriate to the condition and needs of the person, intervention observation and direction may be provided via two-way, interactive video. For more information, see EIDBI – Telemedicine services.

    Service authorization and billing

    For authorization and billing information, including provider and service limits, see the:

    Additional resources

    EIDBI – Intervention
    EIDBI – EIDBI services

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    © 2018 Minnesota Department of Human Services Updated: 5/30/18 10:35 AM | Accessibility | Terms/Policy | Contact DHS | Top of Page | Updated: 5/30/18 10:35 AM