Nebraska Administrative Code
Topic - HEALTH AND HUMAN SERVICES SYSTEM
Title 404 - DEVELOPMENTAL DISABILITIES SERVICES
Chapter 5 - CORE REQUIREMENTS FOR ALL CERTIFIED AND INDEPENDENT PROVIDERS OF SERVICES
Section 404-5-007 - RESTRICTIVE MEASURES

Universal Citation: 404 NE Admin Rules and Regs ch 5 ยง 007

Current through September 17, 2024

To the fullest extent possible, a participant's rights may not be suspended or restricted. If a restrictive measure is necessary:

(A) The restrictive measure determined necessary for one participant must not unreasonably affect other individuals who receive services in that setting;

(B) The restrictive measure must not be used as punishment, for the convenience of staff, due to a shortage of staff, as a substitute for habilitation, or as an element of a positive behavior support plan;

(C) The restrictive measure must be the least restrictive and least intrusive possible;

(D) There must be a goal of reducing and eliminating the restrictive measure;

(E) Prior to proposing a restrictive measure, there must be documented evidence that other less restrictive methods had been applied by trained staff and failed, unless a participant's behavior resulted in an immediate and serious threat to the health and safety;

(F) The participant or their legal representative, if applicable, must give consent to the restrictive measure;

(G) The restrictive measure must be safe for the participant; and

(H) The restrictive measure must be documented in the participant's individual support plan (ISP).

007.01 REVIEW AND APPROVAL OF RESTRICTIVE MEASURE. Prior to implementation of a restrictive measure, the provider must ensure review and approval by the individual support planning team and rights review committee, except where the provider is not required under this Title to have a rights review committee.

007.02 RESTRAINTS. The use of mechanical and physical restraints is prohibited unless required by law.

007.02(A) EMERGENCY SAF ETY INTERVENTION. An emergency safety intervention is allowed to respond to an emergency safety situation. The provider must document all incidents of emergency safety interventions and give the documentation to the participant's individual support planning team and provider rights review committee to review that the emergency safety intervention was appropriate rather than an instance of mechanical or physical restraint.

007.02(B) EXCEPTION. Devices used to provide support for the achievement of functional body position or proper balance, and devices used for specific medical and surgical (as distinguished from behavioral) treatment are not considered restraints.

007.02(C) PROHIBITED METHOD. The provider must prohibit the use of:
(i) Mechanical restraint;

(ii) Physical restraint, except when used as emergency safety intervention;

(iii) Chemical restraint;

(iv) Aversive stimuli;

(v) Corporal punishment;

(vi) Seclusion;

(vii) Verbal abuse;

(viii) Physical abuse;

(ix) Emotional abuse;

(x) Denial of basic needs;

(xi) Discipline;

(xii) Implementation of an intervention of a participant in services by another participant in services; or

(xiii) Other means of intervention that results in, or is likely to result in injury to the participant.

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