05/13/2026
Behavior is communication.
When someone begins wandering, withdrawing, yelling, resisting care, pacing, becoming emotionally reactive, or struggling with daily routines, there is often a deeper reason behind it. Behaviors are frequently connected to confusion, fear, grief, trauma, anxiety, unmet needs, overstimulation, medical changes, mental health concerns, dementia, PTSD, TBI, or other forms of brain change.
These moments are not simply “bad behaviors.” They are often signs that a person is struggling to communicate what they are feeling, needing, or experiencing.
In Oregon, Medicaid covered Behavior Support Services (BSS) are available through APD K Plan services for qualifying individuals. BSS supports the individual while also helping caregivers, providers, families, and support teams better understand behaviors and respond in more successful, person centered ways.
Behavior Support Services qualify for individuals experiencing:
• Wandering or exit seeking.
• Increased confusion or emotional distress.
• Verbal escalation or reactive behaviors.
• Resistance to care, medications, meals, or routines.
• Sleep disturbances or sundowning behaviors.
• Anxiety, fear, paranoia, or trauma responses.
• Social withdrawal or isolation.
• Pacing, restlessness, or repetitive questioning.
• Difficulty adjusting after hospitalization, illness, relocation, or loss.
• Behaviors connected to dementia, TBI, mental health, or brain change.
• Increased stress within the care environment.
• Caregiver burnout, placement concerns, or repeated conflict between caregivers and the individual.
Behavior Support Services provide:
• Caregiver and staff education.
• Communication and approach recommendations.
• Person centered behavior planning.
• Environmental observations and recommendations.
• Hands on coaching and support.
• Meaningful activity and engagement ideas.
• Real time problem solving and guidance.
• Support focused on improving quality of life for both the individual and the care team.
BSS is not about punishment, control, or forcing compliance. The focus is understanding the individual, reducing distress, improving communication, strengthening caregiver confidence, and creating calmer, safer, and more positive daily interactions for everyone involved.
Families, caregivers, providers, Adult Foster Homes, Assisted Living Facilities, Residential Care Facilities, Memory Care communities, and in home support teams can speak directly with the individual’s Medicaid or APD Case Manager to request a Behavior Support Services referral.
Behavior Support Services are Medicaid covered through Oregon APD K Plan services for qualifying individuals, meaning there is no direct out of pocket cost to the family, caregiver, provider, or community when approved through Medicaid services.
Oregon DHS/APD Request for Behavior Support Services with Positive Pathways Behavior Consults.
