Transcript Restrictive Procedures - Saint Paul Public Schools

Restrictive Procedures: New
Statutory Provisions Pertaining to
Physical Holding and Seclusion
for Children with Disabilities
Kathleen Nilles, Special Education Resource Coordinator
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.
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Repealed as of August 1, 2011
“Regulated” or “Conditional” Procedures no longer
in effect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)
New Definitions
Restrictive Procedures
• Physical Holding
• Seclusion
New!
• Emergencies only
New Definitions
• Physical Holding - Means physical intervention
intended to hold a child immobile or limit a child’s
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 child’s
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.
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.
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)
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 pupil’s IEP team must meet to
determine if the pupil’s IEP is adequate, or if
additional evaluation is needed.
•
Minn.Stat.§121A.67
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
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)
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 district’s discipline policy
• Emergency interventions used twice in a month or pupil’s
pattern of behavior is emerging, then team meeting
• Conditions for time out procedure
• Parent’s right to withdraw consent for the BIP at any time.
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/or
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 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
MN Statute 125A.0942
Standards 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
Standards for Restrictive Procedures
A school that uses physical holding or seclusion
shall meet the following requirements:
1.
2.
3.
4.
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)
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:
1.
2.
3.
4.
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 child’s behavioral and physical status.
Minn. Stat. § 125A.0942, Subd. 3(4)(I-iv)
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 child’s IEP or BIP.
Minn. Stat. § 125A.0942, Subd. 2(b) and 2(d)
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 child’s IEP
or BIP (still on an emergency basis only).
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
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.
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
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)
MN Statute 125A.0942
Standards for Restrictive Procedures
 Seclusion rooms must be approved by local
authorities and registered with the
Commissioner (MDE)
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)
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 child’s 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
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 child’s ability to
breathe, including prone
restraint
Minn. Stat. § 125A.0942, Subd. 4
Prohibited Procedures
• May not be used under any circumstances:
 Denying or restricting a child’s access to
equipment or devices such as walkers,
wheelchairs, hearing aids and communication
boards that facilitate the child’s 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 child’s 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 face-down position on a bed or
mat.”
The Crisis Prevention Institute, Inc.
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.
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
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.
First Steps
District Restrictive Procedures Plan - Each building will
receive and keep publicly accessible a restrictive
procedures plan for children that includes:
1.
2.
3.
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
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 building’s
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.
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
First Steps
•
•
•
•
Obtaining emergency medical assistance
The physiological and psychological impact of physical holding an
seclusion
Monitoring and responding to a child’s 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
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
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
• [email protected], 651-263-7070