Get What Is A Birf

Filling out the Behavior Intervention Report Form (BIRF) is essential for documenting incidents related to behavior interventions. This guide provides clear, step-by-step instructions tailored to assist users in completing the form accurately and effectively.

Follow the steps to complete the BIRF online.

1. Click the ‘Get Form’ button to access the BIRF online and begin the process of filling it out.
2. Enter your provider NPI or UMPI Number and include 001 as your designated three-digit Location Code Number. Then, use the enter button.
3. The provider name and address associated with the NPI/UMPI number and Location Code number will auto-populate in the Provider Information box.
4. Provide the provider telephone number where the Department of Human Services (DHS) can contact you regarding this incident.
5. Enter the provider email address for DHS contact and confirm this by re-entering the same email.
6. Select the type of service being provided to the person receiving services at the time of the intervention from the drop-down menu.
7. Input the first and last name of the individual completing and submitting the BIRF.
8. Read the affirmation statements carefully, check all applicable boxes, and respond to any accompanying questions.
9. Enter the required information about the person receiving services who experienced the intervention, including PMI Number, first name, middle initial, last name, date of birth, and gender.
10. Select all applicable diagnoses for the person using the provided checkboxes.
11. Choose the quantity of prescribed psychotropic medications from the drop-down menu.
12. Select all relevant documents present in the individual's service plan, including Positive Support Transition Plan and Functional Behavior Assessment.
13. Indicate if there are medical conditions contraindicating physical intervention by responding with yes or no.
14. Enter the date and time when the behavior intervention occurred along with selecting the location type from the drop-down menu.
15. Provide the exact address of the intervention location whenever possible, or indicate the nearest cross streets.
16. List the first and last names, along with the titles of all staff involved in the intervention.
17. Check all displayed behaviors that necessitated the intervention, identifying any that posed imminent threats.
18. Document the de-escalation efforts, including the time they took place, their duration, and a description of the actions performed to avoid escalation.
19. Select all intervention methods used in response to the displayed behaviors and provide details about their implementation.
20. Identify any other interventions that occurred and specify who initiated them using the available checkboxes and drop-down menu.
21. Indicate the need for specialized behavioral consultation and support services, responding with yes or no.
22. Provide a response about potential crisis respite placement plans by indicating yes or no.
23. State if there will be a temporary suspension from services by responding with yes or no.
24. Confirm if there will be termination from further services by indicating yes or no.
25. Identify any injuries that occurred during the incident, specifying who was affected, and select the appropriate injury care choice.
26. Conduct post-intervention debriefing sessions and select the individuals who were involved.
27. Complete all narrative fields thoroughly and upload a PDF copy of the person’s Positive Support Transition Plan if necessary.
28. Select all parties notified about the incident and provide details of those not listed, including notification dates and times.
29. Select the county or tribal lead agency funding the services from the drop-down menu.
30. Indicate the county or tribe where services were provided by making a selection from the drop-down menu.
31. To retain an immediate copy of the completed BIRF, click on the “Print Form” button on the last page before submission.
32. Submit the completed BIRF by clicking the “Submit” button found on the last page of the form.

Begin completing the BIRF online today to ensure accurate documentation and compliance with reporting requirements.