Georgia - Draft Document for State Advisory Panel Review

As promised, here is the full copy of the draft of the proposed rule for Restraint and Seclusion in Georgia schools. Special thanks go out to a very special lady for sharing this with us.

Please note that on the surface, this rule doesn't look too bad. But take a closer look, and you'll see that this proposed rule only suggests what schools "should" do to keep children and staff safe during restraints and/or seclusions, not what they MUST do. As such, this document is completely unenforceable and meaningless as written. However, change the "shoulds" to "must" or "shall" and you have a document that at least gives parents a leg to stand on if schools should decide "not" to follow proper procedures.

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools

Draft Document for State Advisory Panel Review
Page 1 of 8

Georgia Department of Education Guidance on the Use of Restraint and Seclusion Timeout for Students with Disabilities

Introduction

The Georgia Department of Education supports a positive approach to behavior that uses proactive strategies to create a safe school climate that promotes dignity and achievement for all students. In order to increase instructional time and improve student achievement for all students, it is essential that a positive schoolwide discipline or behavioral support system be developed and implemented in each school and program. When teachers and administrators implement a positive, schoolwide discipline program with fidelity, a safe learning environment is created and students are able to learn without the constant interruptions that occur when teachers are required to address discipline problems in the classroom.

While it is essential that a positive behavioral support program serve as the foundation for every school’s or program’s discipline program, it is clear that some students exhibit more severe behavioral challenges that may require more intensive and individualized behavioral interventions. For students with disabilities, these interventions should be clearly specified in the students’ Individualized Education Programs and/or Behavior Intervention Plans and implemented when less intensive intervention have not been successful in addressing the students’ behavioral problems. In situationsin which students with disabilities are a danger to themselves or others, it may be necessary to utilize significantly more intensive interventions such as restraint and seclusion timeout. The sole purpose of using restraint and seclusion should be to defuse the situation, protect the students and others from injury, and regain a safe and productive learning environment.

When considering the use of seclusion timeout and restraint, it is important to respect the dignity of the student and protect the safety of the student and staff. Restraint and seclusion timeout only be used with students with disabilities in situations when less intensive interventions have failed. These intensive interventions require diligent assessment, monitoring, documentation, and reporting by trained personnel. This guidance document provides information to administrators, staff and families on the use of restraint and seclusion timeout for students with disabilities. It is applicable to students with disabilities who are served in schools, Georgia Network for Educational and Therapeutic Support (GNETS), and state schools.

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 2 of 8

Definitions

The following definitions are provided related to restraint and seclusion timeout for students with disabilities:

1. Restraint refers to an intensive intervention that restricts the free movement of all or a portion of a student’s body. There are two types of restraint that are sometimes used in school systems: physical and mechanical.

Physical restraint involves direct physical contact that prevents or significantly restricts a student’s movement when the student is a danger to himself/herself or others. Restraint protects the safety of the student and others and includes techniques such as supportive holds. Physical restraint does not include the following actions:

* Providing the minimal contact necessary to physically escort a student from one area to another;
* Providing physical prompting to assist in completing a task/response if the student does not resist or resistance is minimal in intensity or duration;
* or Holding a student for a brief time in order to prevent an impulsive behavior that threatens the student’s immediate safety (e.g., running in front of a car).

Mechanical restraint means the use of any device or material attached to or adjacent to a student’s body that restricts normal freedom of movement and which cannot be easily removed by a student. Mechanical restraint includes, but is not limited to, safety harnesses and lap belts fastened behind the chair. It does not include:

* An adaptive or protective device recommended by a physician or therapist when used as recommended. For example, an adaptive chair with laptray can be used for positioning a student with a physical disability and is not considered restraint. If the chair is used to restrict the movement of the child due to behavior, it is considered restraint.

* Safety equipment used by the general student population as intended (e.g. seat belts,).

Although chemical restraints are used in clinical settings, they are not appropriate for use in schools or GNETS programs. Any medication prescribed for individual students should be administered as authorized by the student’s physician.

2. Seclusion timeout refers to an intervention that isolates and confines the student in a separate supervised area until he or she is no longer a danger to himself/herself or others. Seclusion timeout occurs in a specifically constructed or designated room or space that is physically isolated from common areas, typically has a locked door, and from which the student is physically prevented from leaving. Seclusion timeout may also be referred to as “isolated timeout” or “monitored seclusion”.

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 3 of 8

Seclusion timeout does not include in-school suspension, detention, or a student requested break in a different location in the room or in a separate room. It also does not include timeout, a behavioral intervention in which the student is removed from the learning activity to regain control of behavior because the student’s physical movement is not restricted.

Limitations on the Use of Restraint and Seclusion Timeout:

Restraint and seclusion timeout:

1. Should only be used in situations when the student is in imminent danger of hurting himself/herself or others. When the student is no longer a danger to himself/herself or others, the restraint should be terminated and the student should be returned to the instructional activity. If seclusion timeout is being used, the student should be removed from the seclusion room and returned to the instructional activity.
2. Should not be used when the student is responsive to less intensive interventions and de-escalation techniques including verbal commands and directives that are outlined in the student’s IEP or Behavioral Intervention Plan (BIP).
3. Should not be used as a form of discipline or punishment, as a means to obtain compliance, or as a replacement for less restrictive alternatives.
4. Should not be used when students cannot be safely restrained or secluded.
5. Should not be used when the use of the intervention would be contraindicated due to the student’s psychiatric, medical, or physical conditions as described in the student’s Individualized Education Program or other medical and educational records.

Student and Staff Safety:

When using restraint and seclusion timeout, school staff should take all precautions necessary to ensure the safety of the student and the staff engaged in restraining or secluding the student. Restraint and seclusion timeout should be implemented in a safe and humane manner without any intent to harm or create undue discomfort to the student. Ensuring safety requires that staff be trained in the use of restraint techniques and that seclusion timeout rooms are safe and used in an appropriate manner. Observers or monitors should be present when the child is being secluded or restrained to observe the child’s physical status and to determine when the child is no longer a danger to himself/herself or others. Restraint and seclusion timeout should be immediately terminated if the child observed to be in distress. Documentation of each instance of seclusion timeout and restraint should be maintained.

Written Procedures:

Schools or programs that utilize restraint and seclusion timeout should develop written procedures that govern their use. The procedures should be reviewed with all school or program staff who will be utilizing restraint and seclusion timeout and parents should also be provided with information regarding these procedures.

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 4 of 8

School and program administrators should monitor the staff’s adherence to these procedures and should immediately address any situations in which the procedures are not being followed. Procedures should be reviewed at least annually and changes should be made as needed.

Staff Training:

Staff working with students with severe behavior challenges who are at risk of harming themselves or others should be trained in crisis management techniques and de-escalation strategies that can be used when students are in immediate physical danger to themselves or others. When these less intensive interventions are successful in de-escalating the situation, restraint and seclusion should not be used.

School or program staff, who participate in restraints, should successfully complete training in the use of restraints prior to restraining a student who is a danger to himself/herself or others. This training should be provided by a qualified trainer and the restraint approach used should be approved by the school or program administrator. In order to prevent injury to the students and staff, any staff not trained in restraints should not participate in the restraint of a student.

Staff should receive training in the restraint approach that is used in the school, school system, or program on a schedule that is prescribed by the training program and approved by the administrator. The school or program should maintain records of all restraint training completed by staff. The school or program administrators should monitor the use of seclusion and restraint to ensure implementation with fidelity. Coaching and follow-up training should be provided on an on-going basis and any situations in which the procedures are not being followed should be immediately addressed.

Staff participating in the seclusion of students should be trained in the school’s or program’s procedures used to seclude students in a safe manner. The importance of maintaining a safe seclusion room, providing constant visual monitoring during the seclusion, and documenting the seclusion using incident reports should be required and included in any training provided to the staff.

Parental Notification:

Parents should be clearly informed of a school’s or program’s use of restraint and seclusion timeout when their child is placed in the program or school and they should be informed each time in writing when restraint and seclusion has been used.

Upon entry into a school or program that uses restraint and seclusion timeout, the parent should be notified that these techniques are used only in situations in which the student is in immediate danger to himself/herself or others. The use of restraint and seclusion timeout should be clearly addressed in the development of the student’s Individualized Education Program or in the development of the Behavior Intervention Plan and the parents should be involved in the development of these documents. In addition, a program or school may choose

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 5 of 8

to obtain written parental consent at the beginning of each school year for their child to be restrained or placed in a seclusion room.

Parents should be notified as soon as possible when their child is removed from the school setting by law enforcement or medical personnel. The student’s parents or guardians should be notified each time the student is restrained or placed in a seclusion room. This notification should occur in writing and may include a copy of the incident report that is used to document the use restraint or seclusion. Parents and school staff may mutually agree that notification via e-mail or telephone is adequate. Regardless of the method used, the school should maintain documentation of the parent notification.

Ensuring Safe and Effective Use of Restraint:

When using restraint to protect students who are a danger to themselves or others, the following guidelines are recommended:

1. Less restrictive interventions outlined in the student’s IEP or Behavioral Intervention Plan (BIP) should first be used to de-escalate the behavior and he/she should only be restrained when these interventions prove unsuccessful.
2. Restraints should be conducted by staff who are trained in the restraint procedures that have been adopted by the school or program. Staff should know and utilize the prescribed procedures for requesting assistance.
3. The adults participating in the restraint should carefully observe the student to observe any physical distress and cease any action that may result in harm to the student.
4. When possible, all potentially dangerous materials such as jewelry, pencils, pens or other objects should be removed to ensure the student’s safety.
5. The student should be restrained in a manner that is safe to the student and the staff implementing the restraint.
6. The restraint should be removed as soon as the student is no longer a danger to himself/herself or others. Generally, students should be restrained for no longer than 10 minutes. If the restraint lasts longer than 10minutes, additional staff support should be provided and the documentation log should explain the extension beyond the time limit.
7. As soon as appropriate after the restraint is removed, the staff should discuss the incident leading up to the restraint with the student and discuss strategies that the student can use in the future to more effectively control his/her behavior.
8. When the student is no longer a danger to himself/herself or others, he/she should be returned to the instructional activity.
9. The restraint should be documented in an incident report that is turned in to the school or program administrator.

Ensuring Safe and Effective Use of Seclusion Timeout:

When secluding students who are a danger to themselves or others, the following guidelines are recommended:

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 6 of 8

1. Less restrictive interventions outlined in the student’s IEP or Behavioral Intervention Plan (BIP) should first be used to de-escalate the behavior and he/she should only be placed in seclusion timeout when these interventions prove unsuccessful.
2. Seclusion timeout should be conducted by staff who are trained in the seclusion procedures that have been adopted by the school or program. All staff should be informed of who to immediately contact when seclusion timeout is required. All staff should be clearly informed as to who can make the determination to place the student in the seclusion timeout room.
3. The seclusion timeout room should provide a student with a safe environment in which he/she can regain control before returning to the classroom or other setting. Seclusion timeout rooms should meet the following standards:
* Be of adequate size to allow the students to lie down.
* Allow for visual monitoring by staff supervising the seclusion and, if possible, auditory monitoring of the student.
* If a lock is placed on the seclusion timeout room door, it should be designed to allow the student to escape the room in emergency situations.
* Provide adequate lighting and ventilation.
* Be free of safety hazards such as electrical outlets, glass windows, lighting fixtures or fire sprinklers within reach.
* Be clean and in good repair.
* Meet all fire and safety codes of the city and county in which the facility is located.
4. The student should be escorted to the seclusion timeout room in a manner that is safe to the student and to the adults involved in the removal.
5. Prior to placement in the seclusion timeout room, all potentially dangerous materials such as belts, shoes and/or shoelaces, jewelry, pencils, pens or other objects should be removed.
6. While in the seclusion timeout room, the adults supervising the seclusion should maintain constant visual contact/monitoring of the student. The door to the seclusion room should only be locked in the most extreme situations in which the student cannot be contained in the room. If a lock is placed on the seclusion room door, it should be designed to allow the student to escape the room in emergency situations.
7. Generally, elementary students should be placed in seclusion for no longer than fifteen minutes and middle and high school students for no longer than twenty minutes. If seclusion lasts longer that the above recommended times, additional staff support should be provided and the documentation log should explain the extension beyond the time limit.
8. When the student is no longer a danger to himself/herself or others, he/she should be removed from the seclusion room and escorted back to the classroom or other location.
9. The seclusion should be documented in an incident report and the school administrator should immediately be informed of the seclusion.

Role of Law Enforcement and Emergency Medical Personnel:

In situations in which the student is a danger to himself or others , it may become necessary to seek assistance from law enforcement and/or emergency medical personnel. Nothing in this

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
Page 7 of 8

guidance document should be construed to interfere with the duties of law enforcement or emergency medical personnel.

Parents should be informed as soon as possible when students are removed from the school or program setting by emergency medical or law enforcement personnel.

Required Documentation:

The use of restraint and seclusion timeout should be carefully documented by adult staff participating in and supervising the restraint or seclusion. Documentation of restraint or seclusion timeout should be provided using an incident report that is completed for each student in each instance in which the student is restrained or placed in a seclusion room. This report should minimally include the following:
* Date;
* Student’s Name;
* Precipitating Behavior;
* Less Restrictive Intervention Implemented Prior to Restraint or Seclusion;
* Observations of Student’s Behavior and Physical Status;
* Injuries to the Student or Staff;
* Total Time Spent in Restraint or Seclusion;
* and Staff Signature.

These incident reports should be reviewed by school or program administrators and other staff, as appropriate, on a weekly basis. Monthly summary reports should be maintained to document the use of restraint and seclusion. This monthly summary report should be signed by the school administrator and maintained on file in the school.

Analysis and Evaluation of the Use of Restraint and Seclusion Timeout:

Information from the incident reports should be used to regularly assess the effectiveness of these techniques. When a student repeatedly must be restrained or placed in a seclusion timeout room, or when the amount of time spent being restrained or secluded exceeds the recommended times, the staff should determine if the interventions are effectively meeting the student’s needs.

There are several actions that the staff may undertake. They include:

* Reviewing Individualized Education Program (IEP), Functional Behavioral Assessment, and/or Behavioral Intervention Plan to re-assess the interventions that are in place to address the student’s behavioral difficulties;
* Consulting with other professionals such as social workers, psychologists, or psychiatrists to examine other interventions that may be more suitable in meeting the student’s needs;
* and/or Considering other placement options which may be more appropriate to address the student’s needs.

Draft Document for State Advisory Panel Review
Georgia Department of Education
Kathy Cox, State Superintendent of Schools
Draft Document for State Advisory Panel Review
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