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Restrictive Procedures: Statutory Provisions Pertaining to Physical Holding and Seclusion for Children with Disabilities

Jen Fielder, School Psychologist Designs for Learning

Introduction
In 2009, MN Statutes on Restrictive Procedures were passed and needed to be fully implemented in school districts by AUGUST 1, 2011.

Updated as of July 1, 2013.


Provisions pertain to physical holding and seclusion, and apply to children with disabilities in public schools.

Old Language
Repealed as of August 1, 2011 Regulated or Conditional Procedures no longer in effect
Manual restraint Mechanical or locked restraints Time Out Procedures for Seclusion Temporary delay or withdrawal of regularly scheduled meals or water, not to exceed 30 minutes (Removal from planned instruction for periods over 30 minutes)

Restrictive Procedures: New Definitions


Old Definitions Conditional Procedures
Manual restraint Mechanical or locked restraint Time-out procedures for seclusion Temporary delay or withdrawal of regularly scheduled food or water not to exceed 30 minutes

New Definitions Restrictive Procedures


Physical Holding Seclusion Emergencies Only

New Definitions
Physical Holding
Physical intervention intended to hold a child immobile or limit a childs movement where body contact is the only source of physical restraint, and where immobilization is used to effectively gain control of a child in order to protect the child or other person from injury

New Definitions
Physical Holding does not mean physical contact that:
Helps a child respond or complete a task Assists a child without restricting the childs movement Is needed to administer an authorized healthrelated service or procedure Is needed to physically escort a child when the child does not resist or the childs resistance is minimal

Physical Holding

Must be the least intrusive Must be for duration of emergency only Must not be for discipline or punishment

New Definitions
Prone Restraints
Can be used until August 2015 Means placing a child in a face down position May only be used on children age five or older School districts must report each incident of their use of prone restraint within 5 business days using the Prone Restraint Reporting Form provided by MDE

New Definitions
Seclusion
Means confining a child alone in a room from which egress is barred Removing a child from an activity to a location where the child cannot participate in or observe the activity is not seclusion

Seclusion
No time out language Seclusion means confining a student in a room from which egress is barred
Egress may be barred by an adult locking or closing the door in the room or preventing the child from leaving the room.

Removing a child from an activity to a location where a child cannot participate in or observe the activity IS NOT seclusion.

Current Definitions
Old Language Emergency To protect a pupil or other individual from:
Physical injury Emotional abuse due to verbal and nonverbal threats and gestures Severe property damage

Current Language Emergency To protect a child or individual from:


Physical injury

Minn.Stat.125A.0941(e)

New Definitions
Emergency
Means a situation where immediate intervention is needed to protect a child or other individual from:
Physical injury

The Law: Emergencies Only


Restrictive Procedures may only be used in an emergency Restrictive procedures may be written into a childs IEP or BIP
However, the use of restrictive procedures may still only be used in response to behavior that constitutes an emergency

2013 MDE Report on Restrictive Procedures


186 out of 329 traditional districts; 3 of 3 intermediate districts; 14 of 18 cooperatives, and 13 of 124 charter schools reported some use 127,561 total student population (sped eligible) 16,604 physical holds of 2318 of separate students 5236 uses of seclusion of 790 separate students

MDE Report
Students with EBD or ASD most frequently subjected to Restrictive Procedures Higher use in Intermediates and Co-ops Higher use for ages 6-10 and for males Higher use for African American and American Indian

MDE Report
Prone Restraint: 1756 incidents for 256 students (average of 6.86 uses per student)

Legal Provisions
Functional Behavioral Assessment (FBA) Prior to using any (restrictive procedure), the IEP team must conduct a Functional Behavioral Assessment. The team must also document that it has ruled out any other treatable cause for the behavior, for example, a medical or health condition, for the interfering behavior.
Minn. Rule 3525.2710

Positive Behavior Intervention Supports


School districts are encouraged to establish effective school-wide systems of positive behavior interventions and supports PBIS: Interventions and strategies to improve the school environment and teach children the skills to behave appropriately

MN Statute 125A.0942 Standards for Restrictive Procedures


Restrictive Procedures may only be used in an Emergency The team can write the emergency use into the IEP to document situations, patterns, trends; however, the use of restrictive procedures may still only be used in response to a behavior that constitutes an emergency.
Minn.Stat. 125A.0942. Subds. 2(d) and 3.

MN Statute 125A.0942 Standards for Restrictive Procedures

Sample IEP statements:


In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement physical holding to protect a child or other individual from physical injury or in the case of serious property damage. In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement seclusion to protect a child or other individual from physical injury or in the case of serious property damage. In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement physical holding and seclusion to protect a child or other individual from physical injury or in the case of serious property damage.

MN Statute 125A.0942 Standards for Restrictive Procedures

The IEP or BIP must also indicate how the parent wishes to be notified if a Restrictive Procedure is used.
If staff utilize a Restrictive Procedure, the parent wishes to be notified of this use in the following way(s): (telephone call, email, written notice mailed home, other___________).

MN Statute 125A.0942 Standards for Restrictive Procedures

Restrictive Procedures may only be used by:


Licensed teacher School social worker School psychologist Behavior analyst (certified by the National Behavior Analyst Cert. Board) Person with MA degree in behavior analysis Para Educator that has been CPI trained

Standards for Restrictive Procedures


A school that uses physical holding or seclusion shall meet the following requirements: 1. Must be the least intrusive intervention that effectively responds to the emergency; 2. Must end when the threat of harm ends and the staff determines that the child can safely return to the classroom or activity; 3. Staff must directly observe the child; and 4. The staff person who implements or oversees the physical holding or seclusion shall document, as soon as possible after the incident concludes.
Minn. Stat. 125A.0942, Subd. 3(1-4)

Standards for Restrictive Procedures


Each School District must have a Restrictive Procedures Plan to include:
A list of the Restrictive Procedures the school intends to use How the school will monitor and review the use of Restrictive Procedures, including a post-use debriefing and convening an oversight committee Written description and documentation of the staff training completed by the District
Minn. Stat. 125A.0942, Subd. 1

Standards for Documenting Restrictive Procedures


Each time physical holding or seclusion is used, the staff person who implements over oversees the physical holding or seclusion shall document, as soon as possible after the incident concludes:
1. A description of the incident that led to the physical holding or seclusion; Why a less restrictive measure failed or was determined by staff to be inappropriate or impractical; The time the physical holding or seclusion began and the time the child was released; and A brief record of the childs behavioral and physical status.

2.
3. 4.

Minn. Stat. 125A.0942, Subd. 3(4)(I-iv)

Notification to Parents
A school shall make:
Reasonable efforts to notify the parent on the same day a restrictive procedure is used; or If unable to provide same-day notice, notice is sent within two days by:
Written means; Electronic means; or As otherwise indicated by the parent in the childs IEP or BIP

IEP Team Meetings


An IEP Team Meeting must be held:
When restrictive procedures are used twice in 30 days
OR

When a pattern emerges and restrictive procedures are not included in a childs IEP or BIP

IEP Team Meetings


During the IEP Team Meeting, the team must:
Conduct or review a functional behavioral analysis (FBA) Review data Consider developing additional or revised PBIS Consider actions to reduce the use of restrictive procedures Modify the IEP or BIP as appropriate Review any known medical or psychological limitations that contraindicate the use of a restrictive procedure

Room Used for Seclusion


A room used for seclusion must:
Be at least 6 feet by five feet Be well lit, well ventilated, adequately heated, and clean Have a window that allows staff to directly observe a child in seclusion Have tamperproof fixtures, electrical switches located immediately outside the door, and secure ceilings Have doors that open out and are unlocked, locked with keyless locks that have immediate release mechanisms, or locked with locks that have immediate release mechanisms connected with a fire and emergency system; and Not contain objects that a child may use to injure the child or others

Room Used for Seclusion


Only rooms that have been identified to be used for seclusion may be used for that purpose.
The District has identified rooms in school buildings that meet the standards, has received notice from local authorities that each room for seclusion and the locking mechanisms comply with applicable building, fire and safety codes, and has registered each room with MDE prior to its use for seclusion.

Prohibited Procedures
May not be used under any circumstances:
Corporal punishment Requiring a child to assume and maintain a specific physical position, activity or posture that induces physical pain Totally or partially restricting a childs senses as punishment Presenting an intense sound, light or other sensory stimuli using taste, smell, substance or spray as punishment

Prohibited Procedures
May not be used under any circumstances:
Denying or restricting a childs access to equipment or devices such as walkers, wheelchairs, hearing aids and communication boards that facilitate the childs functioning, except when temporarily removing the equipment or device as needed to prevent injury to the child or others or serious property damage to the equipment or device, in which case the equipment or device shall be returned to the child as soon as possible

Prohibited Procedures
May not be used under any circumstances:
Interacting with a child in a manner that constitutes sexual abuse, neglect, or physical abuse (maltreatment of minors) Withholding regularly scheduled meals or water Denying access to bathroom facilities Physical holding that impairs a childs ability to breathe
Minn. Stat. 125A.0942, Subd. 4

Prohibited Procedures
Especially dangerous positions include face-down floor restraints, or any position in which a person is bent over in such as way that it is difficult to breathe. This includes a seated or kneeling position in which a person being restrained is bent over at the waist, and it also includes any facedown position on a bed or mat.

The Crisis Prevention Institute, Inc.

What Should Schools Do Now?


MDE Sample Restrictive Procedures Plan Schools that intend to use restrictive procedures shall maintain and make publicly accessible a restrictive procedures plan for children that includes at least the following:
The list of restrictive procedures the school intends to use How the school will monitor and review the use of restrictive procedures, including conducting post-use debriefings and convening an oversight committee; and

What Should Schools Do Now?


District Restrictive Procedures Plan - There will be one plan accessible to all sites in the District.
Each District will identify the specific restrictive procedure(s) the site will use and the members of your buildings post-use debriefing team. (This team could be comprised of 2-4 staff members that might include special education teachers, social workers and/or building administrators.) Buildings will be asked to identify one contact person for restrictive procedures and submit the information to the Special Education Director no later than Sept. 30, 2013.

What Should Schools Do Now?


Obtain written notice from local authorities that each room for seclusion and the locking mechanisms comply with applicable building, fire, and safety codes
Must be done before using a room for seclusion Includes both unlocked and locked rooms for seclusion

What Should Schools Do Now?


Register each room for seclusion with MDE
Must be done before using a room for seclusion Includes both unlocked and locked rooms for seclusion

What Should Schools Do Now?


For any student that is enrolled in the District, you need to look at the IEP and BIP to see if there is conditional procedures language. If there is, you will need to contact the parent to explain the need to amend the IEP as soon as possible. We cannot wait until we rewrite the IEP. You should start this process as soon as you have access to the student on Sped Forms.

What Should Schools Do Now?


Steps for amending the IEP and BIP to address current Restrictive Procedures guidelines: Contact the parent to explain the need to amend the IEP to address Minn. Stat. 125A.0942, Subd. 2(d) for documenting the emergency use of restrictive procedures. Document contact in Sped Forms or Parent Contact Log Amend the IEP Delete all language referring to Conditional Procedures under the Program Modification and Accommodations section Go into the BIP and delete any language pertaining to conditional procedures

First Steps
Train staff to ensure qualified staff are available to implement restrictive procedures. To meet requirements of the new statute, staff who use restrictive procedures shall complete training in the following skills and knowledge areas:
Positive behavioral interventions Communicative intent of behaviors Relationship-building Alternatives to restrictive procedures, including techniques to identify events and environmental factors that may escalate behavior De-escalation methods Standards for using restrictive procedures

Resources Available from MDE


Minnesota Department of Education Website Restrictive Procedures Page
Education.state.mn.us > School Support > Compliance and Assistance > Restrictive Procedures

Restrictive Procedures Plan


Documentation Questions?

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