Tenn. Comp. R. & Regs. 0465-02-11-.13

Current through October 22, 2024

Section 0465-02-11-.13 - USE OF RESTRICTED BEHAVIOR INTERVENTIONS

(1) The facility must ensure that restricted behavior interventions are not provided until unrestricted interventions have been systematically tried or considered and have been determined to be inappropriate or otherwise contraindicated.

(2) The facility must ensure that restricted behavior interventions are only provided through an approved written intervention plan.

(3) If restricted interventions are provided, the written intervention plan must:

(a) Be based upon a functional assessment;

(b) Utilize the least intrusive effective intervention that supports the person supported in developing alternative behaviors;

(c) Include procedures to reinforce the person supported for interacting in more adaptive, effective ways so that the need for the challenging behavior is reduced;

(d) Include information on the functional assessment, treatment rationale, procedures, generalization and maintenance strategies, data collection, and schedule for progress review;

(e) Include measurable criteria for fading or removing the restricted intervention based on progress;

(f) Clearly define all responsibilities for implementing components of the plan;

(g) Clearly describe for staff:

1. The description of the behavior;

2. Situations in which the behavior is likely to occur;

3. Signs and signals that occur prior to the behavior and what staff should do to reduce the likelihood of the behavior occurring;

4. How staff should respond when the behavior occurs;

5. What staff should do to encourage appropriate responses;

6. What information staff should document; and

7. Crisis intervention or emergency procedures, as applicable;

(4) The facility must ensure that the written intervention plan is reviewed and approved by appropriately constituted Behavior Support and Human Rights Committees prior to its implementation.

(5) The facility must ensure that staff who implement the written intervention plan are trained to competency on implementing the plan.

(6) The facility must ensure that staff implementation of the plan is monitored regularly and reported as part of progress notes at least monthly.

(7) The facility must ensure that in the provision of behavior services, restraint or protective equipment is used only to protect the person supported or others from harm and when other less intrusive methods have been ineffective or are contraindicated.

(8) The facility must ensure that in the provision of behavior services, the programmatic restraint or protective equipment is used only as part of any approved intervention plan for which consent has been obtained.

(9) The facility does not employ the following devices or practices in the provision of behavior services:

(a) Restraint vests, camisoles, body wraps;

(b) Devices that are used to tie or secure a wrist or ankle to prevent movement;

(c) Restraint chairs or chairs with devices that prevent movement;

(d) Removal of mobility aids, such as a wheelchair or walker, of the person supported;

(e) Protective equipment that restricts or prevents movement or the customary use/functioning of the body or body part to which it is applied;

(f) Protective equipment that impairs or inhibits visual or auditory capabilities or prevents or impairs speech or other communication modalities;

(g) Any actions, including seclusion or restraints imposed as a means of coercion, discipline, convenience or retaliation;

(h) Corporal punishment, denial of a nutritionally balanced diet or any other procedures that may result in physical or emotional harm to the person supported;

(i) Restraint rooms; and

(j) Aversive stimuli.

Tenn. Comp. R. & Regs. 0465-02-11-.13

New rules filed July 6, 2016; effective 10/4/2016.

Authority: T.C.A. §§ 4-4-103, 4-5-202, 33-1-201, 33-1-302, 33-1-303, 33-1-305, 33-1-309, 33-2-301, 33-2-302, 33-2-404, 33-2-407.