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

1
Restrictive Procedures New Statutory Provisions
Pertaining to Physical Holding and Seclusion for
Children with Disabilities

• Kathleen Nilles, Special Education Resource
  Coordinator

2
Introduction

• In 2009, MN Statutes on Restrictive Procedures
  were passed and must be fully implemented in
  school districts by AUGUST 1, 2011.
• Provisions pertain to physical holding and
  seclusion, and apply to children with
  disabilities in public schools.

3
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• Repealed as of August 1, 2011
• Regulated or Conditional Procedures no longer
  in effect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)

4
New Definitions

• Restrictive Procedures
• Physical Holding
• Seclusion
• Emergencies only

New!
5
New Definitions

• Physical Holding - Means physical intervention
  intended to hold a child immobile or limit a
  childs movement and where body contact is the
  only source of physical restraint. Minn.
  Stat.125A.0941c
• The term physical holding DOES NOT mean physical
  contact that (1) helps a child respond or
  complete a task (2) assists a child without
  restricting the childs movement (3) is needed
  to administer an authorized health-related
  service or procedure or (4) is needed to
  physically escort a child when the child does not
  resist, or resistance is minimal.

6
New Definitions

• Seclusion - Means confining a child alone in a
  room from which egress is barred.
• Not seclusion - Removing a child from an activity
  to a location where the child cannot participate
  in or observe the activity.

7
New 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

• New! Emergency
• To protect a child or individual from
• Physical injury
• Serious property damage
• Minn.Stat.125A.0941(
  e)

8
Current Legal Provisions Maintained

• Removal by peace officer If a pupil who has an
  IEP is restrained or removed from a classroom,
  school building, or school grounds by a peace
  officer at the request of a school administrator
  or a school staff person during the school day
  twice in a 30-day period (calendar days), the
  pupils IEP team must meet to determine if the
  pupils IEP is adequate, or if additional
  evaluation is needed.
• Minn.Stat.121A.67

9
Current Legal Provisions Maintained

• 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

10
The Law and Behavioral Supports

• Behavior Supports - School districts are
  encouraged to establish effective school-wide
  systems of positive behavioral interventions and
  supports. Minn. Stat. 125A.0942
• Positive behavioral interventions and supports
  means interventions and strategies to improve the
  school environment and teach children the skills
  to behave appropriately.
• Minn. Stat. 125A.0941 (d)

11
The Law - Standards Repealed as of August 1, 2011

• Included in the IEP or in an emergency situation
• Identify the frequency and severity of target
  behaviors
• Identify at least two positive interventions
  implemented and the effectiveness of each
• Design and implement regulated interventions
  based on present levels of performance, needs,
  goals and objectives, and document in the IEP
• All behavioral interventions not covered in the
  IEP must be consistent with the districts
  discipline policy
• Emergency interventions used twice in a month or
  pupils pattern of behavior is emerging, then
  team meeting
• Conditions for time out procedure
• Parents right to withdraw consent for the BIP at
  any time.

12
MN Statute 125A.0942Standards 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.

13
MN Statute 125A.0942Standards 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/or seclusion
  to protect a child or other individual from
  physical injury or in the case of serious
  property damage.

14
MN Statute 125A.0942Standards 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___________).

15
MN Statute 125A.0942Standards for Restrictive
Procedures

• Restrictive Procedures may only be used by
• Licensed special education teacher
• School social worker
• School psychologist
• Behavior analyst (certified by the National
  Behavior Analyst Cert. Board)
• Person with MA degree in behavior analysis

16
MN Statute 125A.0942Standards for Restrictive
Procedures

• Restrictive Procedures may only be used by
• Other licensed educational professionals,
  paraprofessionals, or mental health professionals
  who have completed a state approved training
  program

17
Standards for Restrictive Procedures

• A school that uses physical holding or seclusion
  shall meet the following requirements
• Must be the least intrusive intervention that
  effectively responds to the emergency
• Must end when the threat of harm ends and the
  staff determines that the child can safely return
  to the classroom or activity
• Staff must directly observe the child and
• 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)

18
Standards for 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
• 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.
• Minn. Stat. 125A.0942, Subd. 3(4)(I-iv)

19
New Standards

• 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.
• Minn. Stat. 125A.0942, Subd. 2(b) and 2(d)

20
New Standards - IEP Team Meetings

• An IEP team meeting must be held
• When restrictive procedures are used twice in 30
  calendar days
• When a pattern emerges and restrictive procedures
  are not included in the childs IEP or BIP (still
  on an emergency basis only).

21
New Standards - 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
• Consider whether to prohibit that restrictive
  procedure and
• Document any prohibition in the IEP or BIP.
• Minn. Stat. 125A.0942, Subd. 2 c

22
Documentation - Custom Website

• The district has created a custom website for
  documentation on the use of restrictive
  procedures.
• The website can be accessed through
• www.connect.spps.org ? Custom Websites
  ?Restrictive Procedures
• Additional info and training to follow.

23
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

24
New Standards - 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.
• Minn. Stat. 125A.0942, Subd. 3(5)(I-iv)

25
MN Statute 125A.0942Standards for Restrictive
Procedures

• Seclusion rooms must be approved by local
  authorities and registered with the Commissioner
  (MDE)

26
New Standards - Room Used for Seclusion

• A room used for seclusion must
• Be at least six 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.
• Minn. Stat.125A.0942, Subd. 3 (5) (i-vi)

27
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
• Minn. Stat. 125A.0942, Subd. 4

28
Prohibited Procedures

• The list of prohibitions
• similar, except
• Faradic skin shock

• are substantially
• NEW!
• Interacting with a child in a manner that
  constitutes sexual abuse, neglect, or physical
  abuse under section 626.556 (reporting of
  maltreatment of minors)
• Physical holding that restricts or impairs a
  childs ability to breathe, including prone
  restraint
• Minn. Stat. 125A.0942, Subd. 4

29
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

30
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

31
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 face-down position on a bed
  or mat.
• The Crisis Prevention Institute, Inc.

32
First Steps

For any student that is enrolled in our programs,
we 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 easy IEP.
33
First Steps
Steps for amending the IEP and BIP to address new
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 EasyIEP 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

34
First Steps
If the student has seclusion or physical holds as
a part of their plan, insert the Emergency
Restrictive Procedures sample language under
the Crisis Plan section of the BIP Send home the
Prior Written Notice for the parent signature.

35
First Steps

• District Restrictive Procedures Plan - Each
  building will receive and keep publicly
  accessible a restrictive procedures plan for
  children that includes
• 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
• A written description and documentation of the
  training staff completed
• Minn. Stat. 125A.0942, Subd. 1

36
First Steps

• District Restrictive Procedures Plan - There
  will be one plan accessible to all schools in the
  District.
• Each building will complete a one-page addendum,
  identifying the specific restrictive procedure(s)
  your building 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 return a
  copy of the addendum to no later than Sept. 30,
  2011.

37
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

38
First Steps

• Obtaining emergency medical assistance
• The physiological and psychological impact of
  physical holding an seclusion
• Monitoring and responding to a childs physical
  signs of distress when physical holding is being
  used
• Recognizing the symptoms of and interventions
  that may cause positional asphyxia when physical
  holding is used.
• Minn. Stat. 125A.0942, Subd. 2(a) and Subd. 5

39
First Steps

• Training requirements for use of restrictive
  procedures shall be met through
• Nonviolent Crisis Intervention and Restrictive
  Procedures Skills Training - This includes an
  eight-hour introductory training, plus annual
  refreshers
• Restrictive Procedures Standards and
  Documentation Training

40
Restrictive Procedures

• MDE Restrictive Procedures Standards Q and A
• Minnesota Department of Education Website
  Restrictive Procedures Page
• education.state.mn.us ? Accountability Programs
  ? Compliance and Assistance ? Restrictive
  Procedures
• Kathleen.Nilles_at_spps.org, 651-263-7070