411-325-0355 Restraint and Involuntary Seclusion of a Child (1) PROHIBITIONS. (a) Involuntary seclusion of a child is prohibited. (b) A child may not be placed in a restraint except as described in section (2) of this rule. (c) The use of any of the following types of restraint of a child is prohibited: (A) A restraint with any of the following characteristics: (i) Abusive. (ii) Aversive. (iii) Coercive. (iv) Demeaning. (v) Disciplinary. (vi) For convenience. (vii) Punishment. (viii) Retaliatory. (B) Chemical restraint. (C) Mechanical restraint. (D) Prone restraint. (E) Supine restraint. (F) Any restraint that includes the intentional and nonincidental use of a solid object, including the ground, a wall, or the floor, to impede a child’s movement, unless the restraint is necessary to gain control of a weapon. The use of a solid object is not prohibited when the object is used solely for the stability and support of the person placing the child in a restraint and the object does not apply pressure to the child’s body. (G) Any restraint that places, or creates a risk of placing, pressure on a child’s neck or throat. (H) Any restraint that places, or creates a risk of placing, pressure on a child’s mouth, unless the restraint is necessary for the purpose of extracting a body part from a bite. (I) Any restraint that impedes, or creates a risk of impeding, a child’s breathing. (J) Any restraint that involves the intentional placement of any object or a hand, knee, foot, or elbow on a child’s neck, throat, genitals, or other intimate parts. (K) Any restraint that causes pressure to be placed, or creates a risk of causing pressure to be placed, on a child’s stomach, chest, joints, throat, or back by a knee, foot, or elbow. (L) Any other action, the primary purpose of which is to inflict pain. (2) PERMISSIBLE USE OF RESTRAINT. (a) Except as otherwise provided in this rule, a child may only be placed in a restraint if the child’s behavior poses a reasonable risk of imminent serious bodily injury to the child or others and less restrictive interventions would not effectively reduce the risk. (b) A restraint may only be used on a child if: (A) The restraint is necessary to break up a physical fight or to effectively protect a person from an assault, serious bodily injury, or sexual contact; (B) The restraint uses the least amount of physical force and contact possible; and (C) The restraint is not a prohibited restraint described in section (1)(c) of this rule. (c) In addition to the restraints described in subsection (b) of this section, a child may be placed in a restraint if: (A) The restraint is used only for as long as the child's behavior poses a reasonable risk of imminent serious bodily injury; (B) The person placing the child in the restraint is trained, as described in section (3) of this rule, to administer the type of restraint used; (C) The program provider continuously monitors the child for the duration of the restraint; and (D) The restraint is performed in a manner that is safe, proportionate, and appropriate, taking into consideration the child's: (i) Chronological and developmental age; (ii) Size; (iii) Gender identity; (iv) Physical, medical, and psychiatric condition; and (v) Personal history, including any history of physical or sexual abuse. (d) The following restraints are not subject to the requirements described in subsections (b) or (c) of this section. (A) Holding the child’s hand or arm to escort the child safely and without the use of force from one area to another. (B) Assisting the child to complete a task if the child does not resist the physical contact. (C) The use of safeguarding equipment to address a child's medical condition or medical support need when the safeguarding equipment is included in a medical order written by the child's licensed health care provider and implemented consistent with the medical order. (D) The use of safeguarding equipment to address a child’s behavior support need when the safeguarding equipment is included in the child's Positive Behavior Support Plan. (E) The use of acceptable infant safety products. (F) The use of car safety systems, consistent with applicable state law. (e) In addition to the requirements described in subsection (c) of this section, if a program provider places a child in a restraint for more than 10 minutes, the program provider must: (A) Provide the child with adequate access to the bathroom and water at least every 30 minutes; and (B) Receive authorization for the continuation of the restraint by a Program Supervisor every five minutes after the first 10 minutes of the restraint. (i) The Program Supervisor must be trained in the ODDS-approved behavior intervention curriculum, specifically in the type of restraint being used. (ii) If the Program Supervisor is not on-site at the time the restraint is used, the Program Supervisor may provide the written authorization electronically. The written authorization must document why the restraint continues to be the least restrictive intervention to reduce the risk of imminent serious bodily injury in the given circumstances. (3) TRAINING REQUIREMENTS. With the exception of restraints described in section (2)(d) of this rule, each person placing a child in a restraint must be trained by a certified trainer using an ODDS-approved behavior intervention curriculum, to administer the type of restraint used. (4) POLICY AND PROCEDURE. A program provider must develop and implement written policies and procedures when a child is placed in a restraint according to this rule. (5) NOTIFICATION OF RESTRAINT. (a) If a program provider places a child in a restraint, except as provided in section (2)(d) of this rule, the program provider must provide the child’s case manager, attorney, court appointed special advocate, and parent or guardian with: (A) Verbal or electronic notice that a restraint was used as soon as practicable following the restraint but not later than the end of the next business day; and (B) Written notice as described in subsection (b) of this section as soon as practicable following the incident but not later than the end of the next business day. (b) WRITTEN NOTICE. The written notice must include: (A) A description of the restraint including all of the following: (i) The date of the restraint. (ii) The times when the restraint began and ended. (iii) The location of the restraint. (B) A description of the child’s activity that necessitated the use of the restraint. (C) The efforts the program provider used to deescalate the situation and the alternatives to restraint attempted before placing the child in the restraint. (D) The names of each person who placed the child in the restraint and who monitored or approved the placement of the child in the restraint including all of the following: (i) Whether the person was trained as required by section (3) of this rule to administer the type of restraint used, the date of the person's most recent training, and a description of the types of restraint the person is trained to use, if any. (ii) If a person was not trained in the type of restraint, or if the person's training was not current, a description of the person's training deficiency and the reason the person without the proper training was involved in the restraint. (c) DEBRIEFING MEETING. (A) When notification is required as described in subsection (b) of this section, the program provider must hold a debriefing meeting with each person involved in the restraint and with any other appropriate staff. (B) The debriefing meeting must be held no later than two business days following the date of the restraint. (C) Written notes of each debriefing meeting must be taken and provided to the child's case manager, attorney, court appointed special advocate, and parent or guardian. (6) If serious bodily injury or the death of staff occurs in connection to the use of a restraint, the program provider must provide ODDS with written notification of the incident not later than 24 hours following the incident. (7) REPORTABLE INJURY. (a) A program provider must maintain a record for each incident in which a reportable injury arises from the use of a restraint. (b) If a program provider places a child in a restraint and the child suffers a reportable injury arising from the restraint, the program provider must immediately provide ODDS and the child’s attorney, court appointed special advocate, and parent or guardian with written notification of the incident and upon request, access to copies of all records related to the restraint, including any photographs. (8) INCIDENT REPORTING. In addition to the notice requirements in section (5)(b) of this rule, all incidents involving restraint must be documented in an incident report as required by OAR 411-323-0063. (9) QUARTERLY REPORTING. Beginning September 1, 2021, a program provider must provide to ODDS data regarding the use of restraints in a quarterly report. The report must be thoroughly and accurately completed using the ODDS approved form and submitted quarterly. (a) If a program provider delivers services in more than one 24-hour residential setting, the quarterly reports must separate the data for each 24-hour residential setting that serves five or more children. (b) If the site-specific data for a given 24-hour residential setting is not included in the quarterly report because the program provider serves fewer than five children in that setting, the quarterly report must include the aggregate number of children served by the program provider across all of its 24-hour residential settings and the reporting requirements described in this section still apply to any of the program provider's other settings serving five of more children. (c) ODDS shall make the quarterly report available on ODDS' website. (d) Each program provider that submits a quarterly report under this section shall make the quarterly report available to the public upon request at the program provider’s main office and on the program provider’s website if the program provider maintains a website. (e) Each program provider shall provide notice regarding how to access the quarterly reports to a child's parent or guardian. The program provider shall provide the notice upon the child’s admission and at least two times each year thereafter. (f) Restraints described in section (2)(d) of this rule are not subject to the reporting requirements of this section. Statutory/Other Authority: ORS 409.050, 427.104, 441.715, 430.662, 443.450 & 443.455 Statutes/Other Implemented: ORS 409.010, 418.519-418.529, 427.007, 427.104, 430.215, 430.610, 430.662, 441.705-441.720, 441.740, 441.745, 443.384, 443.392, 443.400-443.445, 443.450, 443.455, 443.880, 443.881 & 443.991 History: APD 7-2024, amend filed 02/26/2024, effective 02/26/2024 APD 15-2023, temporary amend filed 08/29/2023, effective 09/01/2023 through 02/27/2024 APD 19-2022, adopt filed 04/13/2022, effective 04/15/2022 APD 46-2021, temporary adopt filed 10/19/2021, effective 10/20/2021 through 04/17/2022