Current through Reg. 50, No. 13; March 28, 2025
(a) Only staff who have successfully
completed competency-based training on the use of restraints may implement
restraint procedures. Staff who implement restraint procedures must also
complete training on person-specific instructions and other measures regarding
restraints contained in an individual's crisis intervention plan or other
plan.
(b) The following conditions
must be met before a PCP may order a restraint in response to a behavioral
crisis:
(1) the individual's behavior
constitutes a behavioral crisis;
(2) if no PBSP, desensitization plan, or
other preventive measures are in place, staff have considered the level of
imminent risk of violence or injury and have applied a graduated range of
less-restrictive approved procedures as safety permits and the measures have
not reduced the risk of imminent physical harm to the individual or
others;
(3) if a PBSP,
desensitization plan, or other preventive measures are in place, the
individualized procedures for prevention, de-escalation and a graduated range
of less restrictive measures have been followed, as safety permits, but have
not reduced the risk of imminent physical harm to the individual or others;
and
(4) if a helmet, mittens with
ties, wristlets, or other mechanical restraints will be used to prevent
self-injury in a behavioral crisis:
(A) an
approved crisis intervention plan allowing the use of the mechanical restraint
must be in place; or
(B) the use of
the mechanical restraint must be approved by the individual's psychologist or
board certified behavior analyst (BCBA) or the psychologist or BCBA on call,
the administrator on duty, and the director of psychology or behavioral
services.
(c)
If a mechanical restraint is used in accordance with subsection (b)(4)(B) of
this section, its use must be reviewed by the chairperson of the facility's
human rights committee as soon as possible but within 24 hours after initiation
of the restraint.
(d) A
psychotropic medication may be ordered as a chemical restraint in response to a
behavioral crisis, but only if immediate use of the medication is essential to
prevent or mitigate the danger of the individual's harmful behavior and the
following conditions have been met:
(1) the
individual is experiencing a behavioral crisis;
(2) a graduated range of less restrictive
alternatives to stop the behavior and protect the individual and others has
been attempted, as safety permits, but has not reduced the risk of imminent
physical harm to the individual or others;
(3) the requirements of any component of the
ISP have been followed but have not reduced the risk of imminent harm to the
individual or others;
(4) a
psychiatrist or PCP has determined that early administration of a regularly
prescribed psychotropic medication instead of chemical restraint is not a
reasonable option; and
(5) a
psychiatrist or PCP approves and orders the use of the chemical
restraint.
