Current through Register Vol. 63, No. 3, March 1, 2024
(1) PROHIBITIONS.
(a) Involuntary seclusion of a child is
prohibited.
(b) A child may not be
placed in a restraint except as described in section (2) of this
rule.
(c) The use of any of the
following types of restraint of a child is prohibited:
(A) A restraint with any of the following
characteristics:
(i) Abusive.
(ii) Aversive.
(iii) Coercive.
(iv) Demeaning.
(v) Disciplinary.
(vi) For convenience.
(vii) Punishment.
(viii) Retaliatory.
(B) Chemical restraint.
(C) Mechanical restraint.
(D) Prone restraint.
(E) Supine restraint.
(F) Any restraint that includes the
intentional and nonincidental use of a solid object, including the ground, a
wall, or the floor, to impede a child's movement, unless the restraint is
necessary to gain control of a weapon. The use of a solid object is not
prohibited when the object is used solely for the stability and support of the
person placing the child in a restraint and the object does not apply pressure
to the child's body.
(G) Any
restraint that places, or creates a risk of placing, pressure on a child's neck
or throat.
(H) Any restraint that
places, or creates a risk of placing, pressure on a child's mouth, unless the
restraint is necessary for the purpose of extracting a body part from a
bite.
(I) Any restraint that
impedes, or creates a risk of impeding, a child's breathing.
(J) Any restraint that involves the
intentional placement of any object or a hand, knee, foot, or elbow on a
child's neck, throat, genitals, or other intimate parts.
(K) Any restraint that causes pressure to be
placed, or creates a risk of causing pressure to be placed, on a child's
stomach, chest, joints, throat, or back by a knee, foot, or elbow.
(L) Any other action, the primary purpose of
which is to inflict pain.
(2) PERMISSIBLE USE OF RESTRAINT.
(a) Except as otherwise provided in this
rule, a child may only be placed in a restraint if the child's behavior poses a
reasonable risk of imminent serious bodily injury to the child or others and
less restrictive interventions would not effectively reduce the risk.
(b) A restraint may only be used on a child
if:
(A) The restraint is necessary to break up
a physical fight or to effectively protect a person from an assault, serious
bodily injury, or sexual contact;
(B) The restraint uses the least amount of
physical force and contact possible; and
(C) The restraint is not a prohibited
restraint described in section (1)(c) of this rule.
(c) In addition to the restraints described
in subsection (b) of this section, a child may be placed in a restraint if:
(A) The restraint is used only for as long as
the child's behavior poses a reasonable risk of imminent serious bodily
injury;
(B) The person placing the
child in the restraint is trained, as described in section (3) of this rule, to
administer the type of restraint used;
(C) The in-residence caregiver or staff
continuously monitors the child for the duration of the restraint;
and
(D) The restraint is performed
in a manner that is safe, proportionate, and appropriate, taking into
consideration the child's:
(i) Chronological
and developmental age;
(ii)
Size;
(iii) Gender
identity;
(iv) Physical, medical,
and psychiatric condition; and
(v)
Personal history, including any history of physical or sexual abuse.
(d) The following
restraints are not subject to the requirements described in subsections (b) or
(c) of this section.
(A) Holding the child's
hand or arm to escort the child safely and without the use of force from one
area to another.
(B) Assisting the
child to complete a task if the child does not resist the physical
contact.
(C) The use of
safeguarding equipment to address a child's medical condition or medical
support need when the safeguarding equipment is included in a medical order
written by the child's licensed health care provider and implemented consistent
with the medical order.
(D) The use
of safeguarding equipment to address a child's behavior support need when the
safeguarding equipment is included in the child's Positive Behavior Support
Plan.
(E) The use of acceptable
infant safety products.
(F) The use
of car safety systems, consistent with applicable state law.
(e) In addition to the
requirements described in subsection (c) of this section, if an in-residence
caregiver or staff places a child in a restraint for more than 10 minutes, the
in-residence caregiver or staff must:
(A)
Provide the child with adequate access to the bathroom and water at least every
30 minutes; and
(B) Receive
authorization for the continuation of the restraint by a Program Supervisor
every five minutes after the first 10 minutes of the restraint.
(i) The Program Supervisor must be trained in
the ODDS-approved behavior intervention curriculum, specifically in the type of
restraint being used.
(ii) If the
Program Supervisor is not on-site at the time the restraint is used, the
Program Supervisor may provide the written authorization electronically. The
written authorization must document why the restraint continues to be the least
restrictive intervention to reduce the risk of imminent serious bodily injury
in the given circumstances.
(3) TRAINING REQUIREMENTS. With the exception
of restraints described in section (2)(d) of this rule, each person placing a
child in a restraint must be trained by a certified trainer using an
ODDS-approved behavior intervention curriculum, to administer the type of
restraint used.
(4) POLICY AND
PROCEDURE. A program provider must develop and implement written policies and
procedures for the in-residence caregiver and staff to follow when a child is
placed in a restraint according to this rule.
(5) NOTIFICATION OF RESTRAINT.
(a) If an in-residence caregiver or staff
places a child in a restraint, except as provided in section (2)(d) of this
rule, the program provider or in-residence caregiver must provide the child's
case manager, attorney, court appointed special advocate, and parent or
guardian with:
(A) Verbal or electronic notice
that a restraint was used as soon as practicable following the restraint but
not later than the end of the next business day; and
(B) Written notice as described in subsection
(b) of this section as soon as practicable following the incident but not later
than the end of the next business day.
(b) WRITTEN NOTICE. The written notice must
include:
(A) A description of the restraint
including all of the following:
(i) The date
of the restraint.
(ii) The times
when the restraint began and ended.
(iii) The location of the
restraint.
(B) A
description of the child's activity that necessitated the use of the
restraint.
(C) The efforts the
in-residence caregiver or staff used to deescalate the situation and the
alternatives to restraint attempted before placing the child in the
restraint.
(D) The names of each
person who placed the child in the restraint and who monitored or approved the
placement of the child in the restraint including all of the following:
(i) Whether the person was trained as
required by section (3) of this rule to administer the type of restraint used,
the date of the person's most recent training, and a description of the types
of restraint the person is trained to use, if any.
(ii) If a person was not trained in the type
of restraint, or if the person's training was not current, a description of the
person's training deficiency and the reason the person without the proper
training was involved in the restraint.
(c) DEBRIEFING MEETING.
(A) When notification is required as
described in subsection (b) of this section, the program provider must hold a
debriefing meeting with each person involved in the restraint, the in-residence
caregiver, and with any other appropriate staff.
(B) The debriefing meeting must be held no
later than two business days following the date of the restraint.
(C) Written notes of each debriefing meeting
must be taken and provided to the child's case manager, attorney, court
appointed special advocate, and parent or guardian.
(6) If serious bodily injury or
the death of an in-residence caregiver or staff occurs in connection to the use
of a restraint, the program provider must provide ODDS with written
notification of the incident not later than 24 hours following the
incident.
(7) REPORTABLE INJURY.
(a) A program provider must maintain a record
for each incident in which a reportable injury arises from the use of a
restraint.
(b) If an in-residence
caregiver or staff places a child in a restraint and the child suffers a
reportable injury arising from the restraint, the program provider must
immediately provide ODDS and the child's attorney, court appointed special
advocate, and parent or guardian with written notification of the incident and
upon request, access to copies of all records related to the restraint,
including any photographs.
(8) INCIDENT REPORTING. In addition to the
notice requirements in section (5)(b) of this rule, all incidents involving
restraint must be documented in an incident report as required by OAR
411-323-0063.
(9) QUARTERLY
REPORTING. Beginning September 1, 2021, a program provider must provide to ODDS
data regarding the use of restraints in a quarterly report. The report must be
thoroughly and accurately completed using the ODDS approved form and submitted
quarterly.
(a) The quarterly report must
include the aggregate number of children served by the program provider across
all of their Host Home locations.
(b) ODDS shall make the quarterly report
available on ODDS' website.
(c)
Each program provider that submits a quarterly report under this section shall
make the quarterly report available to the public upon request at the program
provider's main office and on the program provider's website if the program
provider maintains a website.
(d)
Each program provider shall provide notice regarding how to access the
quarterly reports to a child's parent or guardian. The program provider shall
provide the notice upon the child's admission and at least two times each year
thereafter.
(e) Restraints
described in section (2)(d) of this rule are not subject to the reporting
requirements of this section.
Statutory/Other Authority: ORS
409.050,
427.104,
441.715,
430.662,
443.450 & 443.455
Statutes/Other Implemented: ORS
409.010,
418.519-418.529, 427.007,
427.104, 430.215, 430.610, 430.662, 441.705-441.720, 441.740, 441.745, 443.384,
443.392, 443.400-443.445, 443.450, 443.455, 443.880, 443.881 &
443.991