Rules & Regulations of the State of Tennessee
Title 0465 - Intellectual and Developmental Disabilities
Subtitle 0465-02 - Intellectual and Developmental Disabilities, Department of
Chapter 0465-02-14 - Minimum Program Requirements for Intellectual and Developmental Disabilities Respite Care Services
Section 0465-02-14-.07 - USE OF RESTRICTIVE BEHAVIOR MANAGEMENT

(1) No procedures shall be used for behavior management which results in physical or emotional harm to the person supported.

(2) Corporal punishment, seclusion, aversive stimuli, chemical restraint, and denial of a nutritionally adequate diet shall not be used.

(3) Restraint (physical holding, mechanical restraint), medications for behavior management, time-out rooms, or other techniques with similar degrees of restriction or intrusion must not be employed except as an integral part of an ISP.

(4) Restrictive or intrusive behavior management procedures must not be used until after less restrictive alternatives for dealing with the problem behavior have been systematically tried or considered and have been determined to be inappropriate or ineffective.

(5) Prior to the implementation of a written program or behavior support plan incorporating the use of a highly restrictive or intrusive technique, the program plan must be reviewed and approved by the person supported or his/her legal representative (conservator, parent, guardian, or legal custodian), with documentation of such approval. A Human Rights Committee must also review and approve the written program.

(6) When procedures such as physical holding, mechanical restraint, and time-out are used in emergency situations to prevent the person supported from inflicting bodily harm, more than three (3) times within six (6) months, a behavioral assessment shall be conducted by an appropriate professional. Recommendations shall be incorporated into a written plan that is part of the ISP.

(7) Behavior management medications may be used only when authorized in writing by a physician for a specific period of time.

(8) The program plan for the use of a mechanical restraint must specify the extent and frequency of the monitoring schedule according to the type and design of the device and the condition of the person supported.

(9) A person supported who is placed in a mechanical restraint must be released for a minimum of ten (10) minutes at least every two (2) hours and provided with an opportunity for freedom of movement, exercise, liquid intake/refreshment, nourishment, and use of the bathroom.

(10) Physical restraint/physical holding may be used only until the person supported is calm.

(11) A person supported who is placed in time-out must be released after a period of not more than sixty (60) minutes.

(12) The ability of a person supported to exit from time-out must not be prevented by means of keyed or other locks, and locations used for time-out must allow for the immediate entry of staff.