D.C. Mun. Regs. tit. 22, r. 22-B3522

Current through Register Vol. 71, No. 49, December 6, 2024

Rule 22-B3522 - BEHAVIOR SUPPORT

3522.1

The CRFPID shall designate and use a specially constituted committee(s) to review, identify, address and monitor person's behavior and their rights that the committee(s) deems at risk. This committee shall be called the Human Rights Committee (HRC).

3522.2

The HRC required under this section shall consist of representatives of CRFPID staff, parents, legal guardians, persons as appropriate and qualified individuals who have either experience or training in contemporary practices to change people behavior, and persons with no ownership or controlling interest in the CRFPID.

3522.3

Programs approved by the HRC and established by the CRFPID in accordance with this section shall be implemented only with the written informed consent of the person, the person's parent or the person's legal guardian.

3522.4

A behavior support plan shall, if necessary, be developed as part of the ISP in response to behavioral or medical needs identified through the habilitative assessment process which shall specify all interventions.

3522.5

A CRFPID may use restrictive intervention, through physical and/or pharmacological means only if such intervention is justified and included in a behavior support plan or is otherwise utilized in accordance with this section.

3522.6

The behavior support plan shall be developed by a health care provider licensed in psychology or psychiatry, and shall be implemented as prescribed in the ISP.

3522.7

The use of restrictive intervention is permitted on a time-limited basis provided that less restrictive methods to safeguard persons and/or property have been attempted and failed or if there is no time to attempt less restrictive methods under one or more of the following conditions:

(a) When a person's health or safety is at risk;

(b) When intervention is court ordered;

(c) When health-related protection is ordered by a physician;

(d) As a means to protect a person or others from harm; or

(e) As a means of preventing the destruction of property.

3522.8

A person for whom physical restrictive intervention is being utilized must be visually monitored at all times and the method of intervention examined at least every five (5) minutes by a staff person trained in the use of the type of intervention used for a maximum duration of thirty (30) minutes. Monitoring shall be documented. The use of restrictive intervention shall be employed for no longer than thirty (30) minutes and shall be discontinued as soon as the person is stable if less than thirty (30) minutes.

3522.9

The CRFPID shall document the initiation, monitoring and termination of the intervention, including a chronological update of the person's outward mental and physical status.

3522.10

Physical intervention shall be used so as not to cause injury to the person, to cause the least possible discomfort and to impose the least possible restriction given its purpose.

3522.11

A person for whom restrictive intervention has been employed shall be provided the opportunity for liquid intake and toileting as well as other necessary functions, if needed. Restrictive intervention may continue if disrupted when it is feasible and for the welfare of the person.

3522.12

The CRFPID shall closely monitor any person who has been prescribed psychotropic medications for responses and any adverse consequences. Monitoring shall be documented in writing and accessible to government officials.

3522.13

Psychotropic medications may not be given on an as-needed basis (PRN).

3522.14

Restrictive intervention cannot be used in lieu of adequate staffing or to discipline a person. The following are prohibited:

(a) Prevention of contacts and visits with attorney, probation officer, placing agency representative, minister or chaplain;

(b) Any action that is humiliating, degrading, harsh, punitive, painful, or abusive that causes undue trauma or deprivation of rights, that is used as a means of coercion, discipline, or retaliation, or that is used solely or primarily for the convenience of staff;

(c) Corporal punishment;

(d) Subjection to unsanitary living conditions;

(e) Deprivation of opportunities for bathing or access to toilet facilities, except as ordered by a licensed physician for a legitimate medical purpose and documented in the person's record;

(f) Deprivation of appropriate services and treatment;

(g) Deprivation of health care;

(h) Administration of laxatives, enemas, or emetics except as ordered by a physician or other professional acting within the scope of their license for a legitimate medical purpose and documented in the person's record;

(i) Applications of aversive stimuli;

(j) Deprivation of drinking water or food necessary to meet a person's daily nutritional needs except as ordered by a licensed physician for a legitimate medical purpose and documented in the person's record;

(k) Prohibition on contacts and visits with family or legal guardian except as permitted by other applicable state regulations or by order of a court of competent jurisdiction;

(l) Delay or withholding of incoming or outgoing mail except as permitted by other applicable state and federal regulations or by order of a court of competent jurisdiction;

(m) Deprivation of opportunities for sleep or rest except as ordered by a licensed physician for a legitimate medical purpose and documented in the person's record;

(n) Mechanical devices used to restrict a person's movement such as straightjackets, shackles and belted jackets that the person cannot remove;

(o) Seclusion or time-out rooms;

(p) The use or application of painful stimuli; and

(q) The use of any restraint which is not time-limited. Restraints must be removed as soon as the person is no longer an imminent threat to himself or others.

3522.15

The CRFPID shall maintain records documenting any time behavior intervention were used including why it was used, what was done, who was involved, and other information to show compliance with this section.

D.C. Mun. Regs. tit. 22, r. 22-B3522

Final Rulemaking published at 39 DCR 3280, 3304 (May 8, 1992); as amended by Final Rulemaking published at 44 DCR 7445, 7447 (December 5, 1997); amended by Final Rulemaking published at 68 DCR 4282 (4/23/2021)