Sec. 13a.08.04.05. General Requirements for the Use of Restraint or Seclusion  


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  • A. Use of Restraint.

    (1) Physical Restraint.

    (a) Except as provided in §A(1)(b) of this regulation, the use of physical restraint is prohibited in public agencies and nonpublic schools until there is an emergency situation and physical restraint is necessary to protect a student or other person from imminent, serious, physical harm after other less intrusive, nonphysical interventions have failed or been determined inappropriate.

    (b) Once physical restraint has been used or school personnel have made a student-specific determination that it may need to be used consistent with §A(1)(a) of this regulation, physical restraint may be included in a student’s behavioral intervention plan or IEP to address the student’s behavior in an emergency situation, provided that school personnel:

    (i) Review available data to identify any contraindications to the use of physical restraint based on medical history or past trauma, including consultation with medical or mental health professionals as appropriate;

    (ii) Identify the less intrusive, nonphysical interventions that will be used to respond to the student’s behavior until physical restraint is used in an emergency situation; and

    (iii) Obtain written consent from the parent, consistent with Education Article, §8-405, Annotated Code of Maryland.

    (c) Physical restraint shall be applied only by school personnel who are trained in the appropriate use of physical restraint consistent with Regulation .06C of this chapter.

    (d) In applying physical restraint, school personnel shall only use reasonable force as is necessary to protect a student or other person from imminent, serious, physical harm.

    (e) Physical restraint:

    (i) Shall be removed as soon as the student is calm; and

    (ii) May not exceed 30 minutes.

    (f) In applying physical restraint, school personnel may not:

    (i) Place a student in a face down position;

    (ii) Place a student in any other position that will obstruct a student's airway or otherwise impair a student's ability to breathe, obstruct a staff member's view of a student's face, restrict a student's ability to communicate distress, or place pressure on a student's head, neck, or torso; or

    (iii) Straddle a student's torso.

    (2) Mechanical Restraint.

    (a) The use of mechanical restraint is prohibited in public agencies and nonpublic schools unless a public agency or nonpublic school is certified by and meets the requirements of the Joint Commission for the Accreditation of Health Care Organizations.

    (b) Regulation .04 of this chapter does not prohibit school personnel from using a protective or stabilizing device:

    (i) As prescribed by a health professional; or

    (ii) For a student with a disability, in accordance with the student's IEP or behavior intervention plan.

    (3) Documentation of the Use of Restraint.

    (a) Each time a student is in a restraint, school personnel involved in the restraint shall debrief and document:

    (i) Other less intrusive interventions that have failed or been determined inappropriate;

    (ii) The precipitating event immediately preceding the behavior that prompted the use of restraint;

    (iii) The behavior that prompted the use of a restraint;

    (iv) The names of the school personnel who observed the behavior that prompted the use of restraint; and

    (v) The names and signatures of the staff members implementing and monitoring the use of restraint.

    (b) Documentation under §A(3) of this regulation shall include a description of the restraint event, including:

    (i) The type of restraint;

    (ii) The length of time in restraint;

    (iii) The student's behavior and reaction during the restraint; and

    (iv) The name and signature of the administrator informed of the use of restraint.

    (4) The documentation described in §A(3) of this regulation shall be maintained in the student's educational record and available for inspection by the student's parent or legal guardian in accordance with COMAR 13A.08.02.

    (5) Each time restraint is used, parents shall be provided oral or written notification within 24 hours, unless otherwise provided for in a student's behavior intervention plan or IEP.

    B. Use of Seclusion.

    (1) Except as provided in §B(2) of this regulation, the use of seclusion is prohibited in public agencies and nonpublic schools until there is an emergency situation and seclusion is necessary to protect a student or other person from imminent, serious, physical harm after other less intrusive, nonphysical interventions have failed or been determined inappropriate.

    (2) Once seclusion has been used or school personnel have made a student-specific determination that it may need to be used consistent with §B(1) of this regulation, seclusion may be included in a student’s behavioral intervention plan or IEP to address the student’s behavior in an emergency situation, provided that school personnel:

    (a) Review available data to identify any contraindications to the use of seclusion based on medical history or past trauma, including consultation with medical or mental health professionals as appropriate;

    (b) Identify the less intrusive, nonphysical interventions that will be used to respond to the student’s behavior until seclusion is used in an emergency situation; and

    (c) Obtain written consent from the parent, consistent with Education Article, §8-405, Annotated Code of Maryland.

    (3) Seclusion Room.

    (a) At a minimum, a room used for seclusion shall:

    (i) Be free of objects and fixtures with which a student could self-inflict bodily harm;

    (ii) Provide school personnel an adequate view of the student from all angles; and

    (iii) Provide adequate lighting and ventilation.

    (b) The door of a seclusion room shall not be fitted with a lock unless it releases automatically when not physically held in the locked position by school personnel on the outside of the door.

    (4) School personnel shall:

    (a) Remain in close proximity to the door of a seclusion room at all times;

    (b) Actively observe a student placed in seclusion at all times; and

    (c) Provide a student placed in seclusion with:

    (i) An explanation of the behavior that resulted in the removal; and

    (ii) Instructions on the behavior required to return to the learning environment.

    (5) Seclusion shall only be applied by school personnel trained in the appropriate use of seclusion consistent with Regulation .06C of this chapter.

    (6) A seclusion event:

    (a) Shall be appropriate to the student's developmental level and severity of the behavior;

    (b) May not restrict the student's ability to communicate distress; and

    (c) May not exceed 30 minutes.

    (7) Documentation of Seclusion.

    (a) Each time a student is placed in seclusion, school personnel involved in the seclusion event shall debrief and document:

    (i) Other less intrusive interventions that have failed or been determined inappropriate;

    (ii) The precipitating event immediately preceding the behavior that prompted the use of seclusion;

    (iii) The behavior that prompted the use of seclusion; and

    (iv) The names and signatures of the staff members implementing and monitoring the seclusion.

    (b) The documentation under §B(7) of this regulation shall include a description of the seclusion event, including:

    (i) Justification for initiating the use of seclusion;

    (ii) The length of time in seclusion;

    (iii) The student's behavior and reaction during the seclusion; and

    (iv) The name and signature of the administrator informed of the use of seclusion.

    (8) The documentation described in §B(7) of this regulation shall be maintained in the student's educational record and available for inspection by the student's parent or legal guardian in accordance with COMAR 13A.08.02.

    (9) Unless otherwise provided for in the student's behavior intervention plan or IEP, each time seclusion is used, school personnel shall provide the student's parent with verbal notification or send written notice within 24 hours.

    C. Referral to a Pupil Services or IEP Team.

    (1) If restraint or seclusion is used for a student who has not been identified as a student with a disability, the student shall immediately be referred to the school's pupil services team or an IEP team.

    (2) If restraint or seclusion is used for a student with a disability, and the student's IEP or behavior intervention plan does not include the use of restraint or seclusion, the IEP team shall meet, in accordance with COMAR 13A.08.03, within 10 business days of the incident to consider:

    (a) The need for a functional behavioral assessment;

    (b) Developing appropriate behavioral interventions; and

    (c) Implementing a behavioral intervention plan.

    (3) If restraint or seclusion is used for a student with a disability, and the IEP or behavior intervention plan includes the use of restraint or seclusion, the student's IEP or behavior intervention plan shall specify how often the IEP team shall meet to review or revise, as appropriate, the student's IEP or behavior intervention plan, in accordance with COMAR 13A.05.01 and 13A.08.03.

    (4) When an IEP team meets to review or revise a student's IEP or behavior intervention plan, as specified in §C(3) of this regulation, the IEP team shall consider:

    (a) Existing health, physical, psychological, and psychosocial information, including any contraindications to the use of restraint or seclusion based on medical history or past trauma;

    (b) Information provided by the parent;

    (c) Observations by teachers and related service providers;

    (d) The student's current placement; and

    (e) The frequency and duration of restraints or seclusion events that occurred since the IEP team last met.

    (5) The local school system or nonpublic school shall provide the parent of the student with written notice in accordance with COMAR 13A.05.01.12A when an IEP team proposes or refuses to initiate or change the student's IEP or behavior intervention plan that includes the use of restraint or seclusion.

    (6) Parental Consent.

    (a) The IEP team shall obtain the written consent of the parent if the team proposes to include restraint or seclusion in the behavior intervention plan or IEP to address the student’s behavior.

    (b) If the parent does not provide written consent, the IEP team shall send the parent written notice within 5 business days of the IEP team meeting that states:

    (i) The parent has the right to either consent or refuse to consent to the use of restraint or seclusion; and

    (ii) If the parent does not provide written consent or a written refusal within 15 business days of the IEP team meeting, the IEP team may implement the proposed use of restraint or seclusion.

    (c) If the parent provides written refusal, the IEP team may use the dispute resolution options listed in Education Article, §8-413, Annotated Code of Maryland, to resolve the matter.