punishment must not be used.
Behavior-management programs must not employ techniques that may result in
denial of a nutritionally adequate diet.
(3) Physical restraint, drugs for behavior
management, time-out rooms, aversive stimuli, or other techniques with similar
degrees of restriction or intrusion must not be employed except as an integral
part of an Individual Program Plan that is designed by the client's Individual
Program Plan team to lead to a less restrictive way of managing, and ultimately
to the elimination of, the behavior.
(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
(5) Prior to the
implementation of a written program incorporating the use of a highly
restrictive or intrusive technique, the facility must document that the program
has been reviewed and approved by the client or the client's legal guardian and
the facility must appoint a Human Rights Committee to review and approve the
procedures used to prevent a client from inflicting bodily harm may not be
repeated more than three (3) times within six (6) months without being
incorporated into a written behavior-management program that is part of an
Individual Program Plan designed by the client's Individual Program Plan
(7) Behavior-management drugs
may be used only when authorized in writing by a physician for a specific
period of time.
restraint may be used only when authorized and supervised by a physician in
(9) A client placed in
chemical restraint must be under continuous staff observation.
(10) If the use of chemical restraint is
necessary beyond twenty-four (24) hours, the situation must be re-evaluated,
authorized and supervised by a physician in attendance.
(11) The program for the use of a mechanical
restraint must specify the extent and frequency of the monitoring according to
the type and design of the device and the condition of the client.
(12) A client placed in mechanical restraint
must be released for a minimum of ten (10) minutes at least every two (2) hours
and provided with an opportunity for motion, exercise, liquid intake and
restraint/physical holding may be used only until the client is calm.
(14) If the use of personal
restraint/physical holding is necessary beyond sixty (60) minutes, the
situation must be re-evaluated and authorized by a mental retardation
(15) The client in a
time-out room must be released after a period of not more than sixty (60)
(16) The ability of a
client to exit a time-out room must not be prevented by means of keyed or other
locks; and time-out rooms must allow for the immediate entry of
(17) Aversive stimuli may be
used only when the behavior of a client is likely to cause irreparable harm to
himself or others, the behavior precludes his or her development and less
negative procedures have, in the immediate past, been documented to be
ineffective in reducing or eliminating this particular behavior.