Code of Maine Rules
14 - DEPARTMENT OF HEALTH AND HUMAN SERVICES
197 - OFFICE OF AGING AND DISABILITY SERVICES
Chapter 5 - REGULATIONS GOVERNING BEHAVIORAL SUPPORT, MODIFICATION AND MANAGEMENT FOR PEOPLE WITH INTELLECTUAL DISABILITIES OR AUTISM IN MAINE
Section 197-5-10 - THE USE AND REVIEW OF SAFETY DEVICES
Current through 2024-38, September 18, 2024
5.10-1 Principles
Use of each Safety Device must be reviewed individually according to the process set out in this regulation. The purpose of the Safety Device, the impact its use has upon the person for whom it is prescribed or recommended, and the degree of intrusiveness the device imposes must be determined on an individual basis. Safety Devices that impose a greater degree of intrusiveness upon the person and have a greater impact upon the mobility of the person or the comfort of the person warrant a higher degree of scrutiny and oversight. Any Safety Device must impose the least possible restriction consistent with the purpose of insuring safety. Safety Devices may never be used as punishment, for staff convenience, or as a substitute for teaching the person new skills or abilities that would eliminate the underlying risk that gives rise to the request for the use of the device.
Review of the use of a Safety Device pursuant to this rule does not require a finding of a Challenging Behavior.
Except as provided in Section 5.10-7, a Safety Device may not have as its purpose, in whole or in part, the provision of Behavior Management.
5.10-2 Specific Examples of Devices Usually Considered to be Safety Devices:
The following is a list of devices or protective garb that could be considered to be Safety Devices:
Non-exclusivity of the Lists of Devices Above: The devices listed above are not intended to describe every Safety Device that might be used or devised. Planning Teams and qualified professionals may suggest other Safety Devices and those Safety Devices may be utilized if they meet the definition of a Safety Device under state law and this regulation. Review Teams may use the lists above as guidance in judging by analogy whether the purpose and use of any proposed device qualifies the device as a Safety Device as defined above.
5.10-3 Review Process
Any use of a Safety Device must be reviewed at least once per year by the Review Team. Any preliminary requirements for review, as set out in Section 5.10-3(A), must be renewed each year prior to reapproval by the Review Team. Any member of the Review Team may require that use of a Safety Device be reviewed more frequently. If review takes place more frequently than annually, any consent, approval, or recommendation that is a preliminary requirement for review must be current at the time of the review.
All initial and renewal requests for permission to use a Safety Device must be submitted on a standard form made available by the Department. Each request for permission must be accompanied by the written recommendation of a physician, and any required consents for the use of the Safety Device. The request form must clearly identify the Safety Device and must describe the conditions of use of the device and the anticipated frequency of its use. The request form must include a place for the Review Team to indicate approval or disapproval of the Safety Device and must include a mailing address and fax number to which the approval can be sent.
Each request for permission to use a Safety Device must have its own professional authorization that refers specifically to that Safety Device. Any consent and Planning Team approval required to use a Safety Device must refer specifically to the Safety Device for which the consent or approval is being given. Safety Devices that are normally used in pairs, such as gloves or foot straps, do not need separate requests.
The approval of a Safety Device requires both voting members to vote in favor of the plan or the plan with conditions. The Review Team may require additional information prior to approval of a Safety Device.
The Review Team shall make a determination of approval or disapproval within thirty (30) calendar days of its receipt of the request for approval and all completed supporting or accompanying documentation necessary to conduct the review.
The person or entity requesting approval to use a Safety Device is responsible for notifying the Person's Planning Team of the decision made by the Review Team. The Planning Team may designate a member of the team to receive this notification.
5.10-4 Use of Safety Related Devices or Practices that Do Not Need Approval of the Review Team
The following safety related devices or practices are not uses of Safety devices for the purpose of this rule and therefore are not subject to the above requirements in these regulations.
5.10-5 Requirements for the Use of a Therapeutic Device
5.10-6 Distinctions Between Safety Devices, Devices that are Utilized for Behavioral Management, and Therapeutic Devices.
When the same device or apparatus meets the definition of a Therapeutic Device, a device for behavioral management, or a Safety Device the Person's Planning Team should initially render a classification. Notwithstanding this initial classification, the Review Team may exercise its own discretion in classifying any device, intervention, or practice.
5.10-7 Helmets Used to Prevent or Diminish the Degree of Injury to a Person Engaging in Self Injurious Behavior
A helmet whose primary purpose is to protect a Person from self-injurious behavior or to diminish the degree of injury of a person engaged in self-injurious behavior, or whose purpose is to prevent a person from biting others, is presumed to be part of a Level 3 Behavior Management Plan for the first year of its use. The use of the helmet during that year is subject to the requirements for review under Section 5.10-3. A Review Team may exercise its discretion to classify the use of a helmet for the purposes enumerated in this paragraph as a Safety Device if after the expiration of the first year of the device's use it concludes that the primary purpose of the use of the helmet is as a Safety Device and that review of the use of the helmet as behavior intervention is no longer necessary.
5.10-8 Use of Monitoring Devices for Safety
Monitoring devices must only be considered after less intrusive techniques have been tried and failed. Motion detectors, sound monitoring, and video monitoring devices must be supported by a history of a lack of environmental awareness and/or a related medical diagnosis, such as Dementia.
Every effort must be made to maintain privacy and confidentiality in the use of these devices. The plan must include procedures used to maximize privacy and maintain confidentiality.
