(a) Prohibition. Except as provided by this subchapter,
the use of restraint or seclusion is prohibited.
(b) Use of personal or mechanical restraint or seclusion.
The use of personal or mechanical restraint or seclusion is permissible
on the facility's premises, and personal or mechanical restraint is
permissible for transportation of an individual only if implemented:
(1) in accordance with this subchapter;
(2) when less restrictive interventions (such as those
listed in the safety plan if there is one) are determined ineffective
to protect other individuals, the individual, staff members, or others
from harm;
(3) in accordance with, and using only those safe and
appropriate techniques as determined by the facility's written policies
or procedures and training program as specified in subsection (e)
of this section;
(4) by staff members who have been trained in accordance
with the applicable requirements specified in §415.257 of this
title (relating to Staff Member Training);
(5) in connection with the applicable evaluation and
monitoring requirements specified in §415.266 of this title (relating
to Observation, Monitoring, and Care of the Individual in Restraint
or Seclusion Initiated in Response to a Behavioral Emergency);
(6) in accordance with the applicable initiation and
physician order requirements specified in §415.260 of this title
(relating to Initiation of Restraint or Seclusion in a Behavioral
Emergency);
(7) in accordance with any alternative strategies and
special considerations documented in the treatment plan pursuant to §415.259(c)
of this title (relating to Special Considerations, Responsibilities,
and Alternative Strategies);
(8) when the type or technique of restraint or seclusion
used is the least restrictive intervention that will be effective
to protect the other individuals, the individual, staff members, or
others from harm; and
(9) is discontinued at the earliest possible time,
regardless of the length of time identified in a physician's order.
(c) Facility requirements. A facility's use of restraint
and seclusion is prohibited unless:
(1) the facility adopts, implements, and enforces written
policies and procedures, in accordance with this subchapter, governing
the use of restraint and seclusion;
(2) the facility adopts, implements, and enforces a
staff member training program that meets the requirements of §415.257
of this title; and
(3) staff members of the facility are trained and have
demonstrated competence in the use of restraint and seclusion in accordance
with the facility's written policies and procedures and training program
before assuming direct care duties and before performing restraint
and seclusion on the individual.
(d) Policy notification. Upon admission of an individual,
or as soon as possible thereafter, the facility shall notify each
individual and each individual's legally authorized representative
(LAR), if any, of the facility's policies related to the use of restraint
and seclusion. The policy notification may be a summary of the facility's
policy. If an LAR cannot be notified, the facility shall document
the reason in the individual's medical record.
(e) This subchapter represents minimum standards. The
facility may, through its written policies and procedures, adopt more
stringent standards that are consistent with this subchapter and do
not conflict with:
(1) DSHS rules;
(2) state or federal laws; and
(3) applicable accreditation standards.
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