Skip Maine state header navigation

Agencies | Online Services | Help

Skip First Level Navigation | Skip All Navigation

Chapter 33 Stakeholder Meeting

August 17, 2011
Cross Office Building, Room 103

Attendees:

Ansley Newton, MDOE, Facilitator
Jonathan Braff, MDOE
Angela Wing, The Children’s Center
Nancy Cronin, Maine Developmental Disabilities Center
Barbara Gunn, Director, Southern Penobscot Regional Program
Diane Howard, Attorney, Disability Rights Center of Maine
Alison Marchese, Director of Special Services, Scarborough School Department
Steve Spear, MDOE
Jonathan Kimball, Woodfords
Sandra MacArthur, MSBA
Debbie Gilmer, Syntiro
Jude Herb, Parent
Dean Bailey, Sweetser

Review of Sections 3.0 Seclusion and 4.0 Restraint

The group devoted the entire meeting to reviewing the drafts of these sections, developed at the previous meeting.  The review prompted lengthy and intense discussions around several key issues, including but not limited to:

  • Time limits for restraint and seclusion
  • How many adults must be present during a seclusion
  • How shall incidences of restraint and seclusion be monitored
  • When and how shall assistance be sought from outside the school (i.e., the police)
  • When shall assistance from parents be sought
  • What is the role of local emergency response policy
  • Should a secluded student be allowed to leave the seclusion location at will
  • In what subsections should agreed upon language be placed
  • What is the proper sequence of the subsections

 

This discussion resulted in the following work product, with some follow-up issues remaining:

 

3.0 SECLUSION

3.1 Permitted Uses of Seclusion

Seclusion shall be used only as an emergency intervention when the behavior of a student presents imminent risk of injury or harm to the student or others.
 
[Any use of seclusion requires a referral to the appropriate team, a scheduled debriefing, a functional behavioral assessment, and the development of or updates to a behavior support plan that seeks to establish conditions that reduce the use of seclusion. Parents must be invited to participate in the development of a behavior support plan and/or a debriefing. All uses of seclusion and the development of or changes to a behavior support plan require notification to parents (section 1.3).]  move to planful response

Refer to seclusion training and crisis prevention training standards, documentation, notification and prohibitions sections of these rules.

4.0      PHYSICAL RESTRAINT

4.1 Permitted uses of Physical Restraint

Physical restraint shall be used only as an emergency intervention when the behavior of a student presents imminent risk of injury or harm to that student or others.  
Protective equipment or devices that are part of a treatment plan prescribed by a licensed health care provider for treatment of a chronic condition are not prohibited by these regulations

. Refer to physical restraint training and crisis prevention training standards, documentation, notification and prohibitions sections of these rules.

 

 

 

3.2 Prohibitive Uses of Seclusion

Seclusion shall not be used for punitive purposes, staff convenience or to control challenging behavior.  Seclusion shall not be used to prevent property destruction or disruption of the environment in the absence of imminent risk of injury or harm to the student or others.

Seclusion is not timeout.  Refer to definitions for the distinction between the two terms (      ). 

4.2 Prohibited Forms and Uses of Physical Restraint

Physical restraint shall not be used for punitive purposes, staff convenience or to control challenging behavior. Physical restraint shall not be used to prevent property destruction or disruption of the environment in the absence of imminent risk of injury or harm to that student or others.

Any physical restraint that restricts the free movement of the diaphragm or chest or that restricts the airway so as to interrupt normal breathing or speech of students is prohibited.

Restraints that rely on pain for control, including but not limited to joint hyperextension, excessive force, unsupported take-down (e.g. tackle), the use of any physical structure (e.g. wall, railing or post), punching and hitting are prohibited.

Mechanical and chemical restraints shall not be used when their purpose is to manage or address a student’s behavior. Aversive procedures shall not be used under any circumstances.

Prescribed assistive devices are not considered mechanical restraints when used as prescribed. Their use shall be supervised by qualified and trained individuals in accord with professional standards.

Prescribed medications administered by a health care provider consistent with a student’s health care plan are permitted.

3.3 Monitoring of Students in Seclusion

Seclusion shall require that at least one adult be physically present to monitor the student at all times.  Students shall be continuously monitored until the student no longer presents imminent risk of injury or harm to self or others.

In the event of an injury the local policy for emergency response shall be initiated. 

3.4 Termination of Seclusion

The staff involved in the use of seclusion shall continually assess for signs that the student is no longer presenting imminent risk of harm to self or others and then the emergency intervention shall be discontinued as soon as possible. Time shall be recorded consistent with the requirements of the documentation section of these rules and local policy.

The covered entity may request assistance from parents at any time during the incident.

If attempts to release from seclusion have been unsuccessful and a student is still presenting behaviors that create an imminent risk of harm to self or others, then the covered entity may request assistance from parents, caregivers, case managers, crisis intervention teams, local EMS, or other community resources.  

In the event that seclusion continues more than 30 minutes, an administrator or their designee shall determine whether continued seclusion is warranted, and shall continue to monitor the status of the seclusion every 10 minutes until the seclusion is terminated. 

4.3 Monitoring Students in Physical Restraint

The use of physical restraint shall require the presence of at least two adults at all times except when, for safety reasons, waiting for a second adult is precluded. Students shall be continuously monitored until the student no longer presents imminent risk of injury or harm to self or others. 

In the event of an injury the local policy for emergency response shall be initiated.

4.4 Termination of Physical Restraint

The staff involved in the use of physical restraint shall continually assess for signs that the student is no longer presenting imminent risk of harm to self or others and then the emergency intervention shall be discontinued as soon as possible. Time shall be recorded consistent with the requirements of the documentation section of these rules and local policy.

The covered entity may request assistance from parents at any time during the incident. 

If attempts to release from physical restraints have been unsuccessful and a student is still presenting behaviors that create an imminent risk of harm to self or others, then the covered entity may request assistance from others outside of the school community, such as parents, caregivers, case managers, crisis intervention teams, local EMS, or other community resources.  

In the event that the restraint continues more than 10 minutes, an administrator or their designee shall determine whether continued restraint is warranted, and shall continue to monitor the status of the restraint until it is terminated. 

3.5 Location of Seclusion

Any area in which seclusion takes place shall be a minimum of 60 square feet with adequate light, heat, and ventilation and of normal room height. If the seclusion takes place in a designated seclusion room, an unbreakable observation window shall be located on a wall or door to permit continuous observation of the student and any staff member in the seclusion room.

In the event that a room is used, the door to that room shall not be locked, latched, or otherwise secured. 

4.5 Exclusions

Those restraints used by law enforcement officers or school resource officers employed by a police department in the course of their professional duties are not considered mechanical restraints subject to these regulations.

 

Items needing followup:

  • Aversive procedures needs to be defined.
  • Should 4.1 and 4.2 be switched?
  • Monitoring becomes 3.3 and termination 3.4 [Completed]
  • Where did the requirement for 60 square feet come from?
  • Does the school approval process dictate a minimum size for office space?
  • Should there be a statement regarding the relationship between restraint and seclusion, and the possible transition from one to the other?
  • Should the exclusion section be moved to 4.2?
  • Can students voluntarily leave the seclusion location?
  • Should we expand/enhance the section that describes a “room?”
  • The final document should use the word shall rather than will or may. [Completed]

 

Next meeting

The next meeting is set for September 16 from 9:00 to 3:00 in room 103.