Current through Register Vol. 54, No. 45, November 9, 2024
Section 5240.6 - Restrictive procedures(a) The following restrictive procedures are prohibited: (2) Aversive conditioning.(3) Pressure-point technique.(5) Mechanical restraint.(6) A restrictive procedure that is not the least restrictive procedure.(7) A restrictive procedure that does not maintain a child's, youth's or young adult's welfare and dignity.(8) A restrictive procedure that limits a child's, youth's or young adult's access to food, drink or toilet.(b) An IBHS agency that uses restrictive procedures shall have written policies and procedures that identify the specific restrictive procedures that may be used and when such restrictive procedures may be used.(c) A manual restraint shall only be used in an emergency situation to prevent self-injury or injury to others by a child, youth or young adult and only after:(1) Every attempt has been made to anticipate and de-escalate the behavior.(2) Less intrusive techniques and resources appropriate to the behavior have been tried and failed.(d) A manual restraint may not: (1) Apply pressure or weight on a child's, youth's or young adult's respiratory system.(2) Use a prone position.(e) The position of the manual restraint or the staff person applying a manual restraint shall be changed at least every 10 minutes during the application of the manual restraint.(f) A trained individual who is not applying the manual restraint shall observe and document the physical and emotional condition of the child, youth or young adult at least every 10 minutes during the application of the manual restraint.(g) A manual restraint shall be discontinued when the child, youth or young adult is no longer an imminent danger to self or others.(h) Within 24 hours of using a manual restraint on a child, youth or young adult, an IBHS agency shall notify the treatment team.(i) An IBHS agency shall document the use of a manual restraint in the child's, youth's or young adult's individual record in accordance with § 5240.41(a)(12) (relating to individual records).(j) An IBHS agency that uses manual restraints shall have policies and procedures for the use of manual restraints that shall include the following:(1) Appropriate use of the manual restraint, including prohibitions on the use of a manual restraint.(2) Required use of less intrusive techniques and resources appropriate to the behavior prior to the use of a manual restraint.(3) Immediate discontinuation of the manual restraint when the child, youth or young adult is no longer an imminent danger to self or others.(4) The staff who may authorize the use of a manual restraint.(5) How the use of a manual restraint will be monitored.(k) An IBHS agency shall require yearly training that is approved by the Department for staff who administer a restrictive procedure that includes the following: (1) De-escalation techniques and strategies.(2) Proper use of the restrictive procedure, including what is appropriate for the age and weight of a child, youth or young adult.(3) Demonstrated experience in the proper use of the restrictive procedure, including practice on other staff.(4) A testing process to demonstrate the ability to properly apply the restrictive procedure.(l) An IBHS agency shall keep a record of each staff person's training in the use of restrictive procedures in each staff person's personnel file in accordance with § 5240.42(b)(2) (relating to agency records).(m) An IBHS agency that provides training to parents, legal guardians or caregivers on the use of restrictive procedures that are included in the child's, youth's or young adult's ITP shall use trainings approved by the Department and have policies and procedures that address training parents, legal guardians or caregivers on the use of restrictive procedures. This section cited in 55 Pa. Code § 5240.41 (relating to individual records); and 55 Pa. Code § 5240.73 (relating to training requirements for staff who provide individual services).