Tenn. Comp. R. & Regs. 0465-02-12-.11 - USE OF RESTRICTIVE BEHAVIOR MANAGEMENT
(1) No
procedures shall be used for behavior management which results in physical or
emotional harm to the person supported.
(2) Corporal punishment, seclusion, aversive
stimuli, chemical restraint, and denial of a nutritionally adequate diet shall
not be used.
(3) Restraint
(physical holding, mechanical restraint), medications for behavior management,
time-out rooms, or other techniques with similar degrees of restriction or
intrusion must not be employed except as an integral part of an ISP.
(4) Restrictive or intrusive behavior
management procedures must not be used until after less restrictive
alternatives for dealing with the problem behavior have been systematically
tried or considered and have been determined to be inappropriate or
ineffective.
(5) Prior to the
implementation of a written program or behavior support plan incorporating the
use of a highly restrictive or intrusive technique, the program plan must be
reviewed and approved by the person supported or his/her legal representative
(conservator, parent, guardian, or legal custodian), with documentation of such
approval. A Human Rights Committee must also review and approve the written
program.
(6) When procedures such
as physical holding, mechanical restraint, and time-out are used in emergency
situations to prevent the person supported from inflicting bodily harm, more
than three (3) times within six (6) months, a behavioral assessment shall be
conducted by an appropriate professional. Recommendations shall be incorporated
into a written plan that is part of the ISP.
(7) Behavior management medications may be
used only when authorized in writing by a physician for a specific period of
time.
(8) The program plan for the
use of a mechanical restraint must specify the extent and frequency of the
monitoring schedule according to the type and design of the device and the
condition of the person supported.
(9) A person supported who is placed in a
mechanical restraint must be released for a minimum of ten (10) minutes at
least every two (2) hours and provided with an opportunity for freedom of
movement, exercise, liquid intake/refreshment, nourishment, and use of the
bathroom.
(10) Physical
restraint/physical holding may be used only until the person supported is
calm.
(11) A person supported who
is placed in time-out must be released after a period of not more than sixty
(60) minutes.
(12) The ability of a
person supported to exit from time-out must not be prevented by means of keyed
or other locks, and locations used for time-out must allow for the immediate
entry of staff.
Notes
Authority: T.C.A. ยงยง 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.
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