Kathleen Nilles, Special Education Resource Coordinator

1. Restrictive Procedures: New Statutory Provisions Pertaining to Physical Holding and Seclusion for Children with Disabilities Kathleen Nilles, Special Education Resource Coordinator

2. Introduction • In 2009, MN Statutes on Restrictive Procedures were passed and must be fully implemented in school districts by AUGUST 1, 2011. • Provisions pertain to physical holding and seclusion, and apply to children with disabilities in public schools.

3. Old Language Repealed as of August 1, 2011 “Regulated” or “Conditional” Procedures no longer in effect • Manual restraint • Mechanical or locked restraints • Time Out Procedures for Seclusion • Temporary delay or withdrawal of regularly scheduled meals or water, not to exceed 30 minutes • (Removal from planned instruction for periods over 30 minutes)

4. New Definitions Restrictive Procedures • Physical Holding • Seclusion • Emergencies only New!

5. New Definitions • Physical Holding - Means physical intervention intended to hold a child immobile or limit a child’s movement and where body contact is the only source of physical restraint. Minn. Stat.§125A.0941c • The term physical holding DOES NOT mean physical contact that (1) helps a child respond or complete a task; (2) assists a child without restricting the child’s movement; (3) is needed to administer an authorized health-related service or procedure; or (4) is needed to physically escort a child when the child does not resist, or resistance is minimal.

6. New Definitions • Seclusion - Means confining a child alone in a room from which egress is barred. • Not seclusion - Removing a child from an activity to a location where the child cannot participate in or observe the activity.

7. Old Language - Emergency To protect a pupil or other individual from: Physical injury Emotional abuse due to verbal and nonverbal threats and gestures Severe property damage New! Emergency To protect a child or individual from: Physical injury Serious property damage Minn.Stat.§125A.0941(e) New Definitions

8. Current Legal Provisions Maintained • Removal by peace officer: If a pupil who has an IEP is restrained or removed from a classroom, school building, or school grounds by a peace officer at the request of a school administrator or a school staff person during the school day twice in a 30-day period (calendar days), the pupil’s IEP team must meet to determine if the pupil’s IEP is adequate, or if additional evaluation is needed. • Minn.Stat.§121A.67

9. Current Legal Provisions Maintained • Functional Behavioral Assessment (FBA) Prior to using any (restrictive procedure), the IEP team must conduct a Functional Behavioral Assessment. The team must also document that it has ruled out any other treatable cause for the behavior, for example, a medical or health condition, for the interfering behavior. Minn. Rule 3525.2710

10. The Law and Behavioral Supports • Behavior Supports - School districts are encouraged to establish effective school-wide systems of positive behavioral interventions and supports. Minn. Stat. § 125A.0942 • “Positive behavioral interventions and supports” means interventions and strategies to improve the school environment and teach children the skills to behave appropriately. Minn. Stat. §125A.0941 (d)

11. The Law - Standards Repealed as of August 1, 2011 • Included in the IEP or in an emergency situation • Identify the frequency and severity of target behaviors • Identify at least two positive interventions implemented and the effectiveness of each • Design and implement regulated interventions based on present levels of performance, needs, goals and objectives, and document in the IEP • All behavioral interventions not covered in the IEP must be consistent with the district’s discipline policy • Emergency interventions used twice in a month or pupil’s pattern of behavior is emerging, then team meeting • Conditions for time out procedure • Parent’s right to withdraw consent for the BIP at any time.

12. MN Statute 125A.0942Standards for Restrictive Procedures • Restrictive Procedures may only be used in an emergency • The team can write the emergency use into the IEP to document situations, patterns, trends, however, the use of restrictive procedures may still only be used in response to a behavior that constitutes an emergency. Minn.Stat. § 125A.0942. Subds. 2(d) and 3.

13. MN Statute 125A.0942Standards for Restrictive Procedures Sample IEP statements: • “In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement physical holding to protect a child or other individual from physical injury or in the case of serious property damage.” • “In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement seclusion to protect a child or other individual from physical injury or in the case of serious property damage.” • “In an emergency situation only, staff trained in the safe implementation of Restrictive Procedures will implement physical holdingand/or seclusion to protect a child or other individual from physical injury or in the case of serious property damage.”

14. MN Statute 125A.0942Standards for Restrictive Procedures The IEP or BIP must also indicate how the parent wishes to be notified if a Restrictive Procedure is used. • “If staff utilize a Restrictive Procedure, the parent wishes to be notified of this use in the following way(s): (telephone call, email, written notice mailed home, other___________).”

15. MN Statute 125A.0942Standards for Restrictive Procedures • Restrictive Procedures may only be used by: • Licensed special education teacher • School social worker • School psychologist • Behavior analyst (certified by the National Behavior Analyst Cert. Board) • Person with MA degree in behavior analysis

16. MN Statute 125A.0942Standards for Restrictive Procedures • Restrictive Procedures may only be used by: • Other licensed educational professionals, paraprofessionals, or mental health professionals who have completed a state approved training program

17. Standards for Restrictive Procedures A school that uses physical holding or seclusion shall meet the following requirements: • Must be the least intrusive intervention that effectively responds to the emergency; • Must end when the threat of harm ends and the staff determines that the child can safely return to the classroom or activity; • Staff must directly observe the child; and • The staff person who implements or oversees the physical holding or seclusion shall document, as soon as possible after the incident concludes. Minn. Stat. § 125A.0942, Subd. 3(1-4)

18. Standards for Restrictive Procedures Each time physical holding or seclusion is used, the staff person who implements over oversees the physical holding or seclusion shall document, as soon as possible after the incident concludes: • A description of the incident that led to the physical holding or seclusion; • Why a less restrictive measure failed or was determined by staff to be inappropriate or impractical; • The time the physical holding or seclusion began and the time the child was released; and • A brief record of the child’s behavioral and physical status. Minn. Stat. § 125A.0942, Subd. 3(4)(I-iv)

19. New Standards A school shall make: • Reasonable efforts to notify the parent on the same day a restrictive procedure is used; or • If unable to provide same-day notice, notice is sent within two days by: written means, electronic means or as otherwise indicated by the parent in the child’s IEP or BIP. Minn. Stat. § 125A.0942, Subd. 2(b) and 2(d)

20. New Standards - IEP Team Meetings • An IEP team meeting must be held: • When restrictive procedures are used twice in 30 calendar days • When a pattern emerges and restrictive procedures are not included in the child’s IEP or BIP (still on an emergency basis only).

21. New Standards - IEP Team Meetings During the IEP Team meeting, the team must: • Conduct or review a functional behavioral analysis (FBA); • Review data; • Consider developing additional or revised PBIS; • Consider actions to reduce the use of restrictive procedures; • Modify the IEP or BIP as appropriate; • Review any known medical or psychological limitations that contraindicate the use of a restrictive procedure • Consider whether to prohibit that restrictive procedure; and • Document any prohibition in the IEP or BIP. Minn. Stat. § 125A.0942, Subd. 2 c

22. Documentation - Custom Website The district has created a custom website for documentation on the use of restrictive procedures. The website can be accessed through: www.connect.spps.org Custom Websites Restrictive Procedures Additional info and training to follow.

23. Standards for Restrictive Procedures • Each School District must have a Restrictive Procedures Plan to include: • A list of the Restrictive Procedures the school intends to use • How the school will monitor and review the use of Restrictive Procedures, including a post-use debriefing and convening an oversight committee • Written description and documentation of the staff training completed by the District Minn. Stat. § 125A.0942, Subd. 1

24. New Standards - Room Used for Seclusion Only rooms that have been identified to be used for seclusion may be used for that purpose. The District has identified rooms in school buildings that meet the standards, has received notice from local authorities that each room for seclusion and the locking mechanisms comply with applicable building, fire and safety codes, and has registered each room with MDE prior to its use for seclusion. Minn. Stat. § 125A.0942, Subd. 3(5)(I-iv)

25. MN Statute 125A.0942Standards for Restrictive Procedures • Seclusion rooms must be approved by local authorities and registered with the Commissioner (MDE)

26. New Standards - Room Used for Seclusion A room used for seclusion must: • Be at least six feet by five feet; • Be well-lit, well ventilated, adequately heated, and clean; • Have a window that allows staff to directly observe a child in seclusion; • Have tamperproof fixtures, electrical switches located immediately outside the door, and secure ceilings; • Have doors that open out and are unlocked, locked with keyless locks that have immediate release mechanisms, or locked with locks that have immediate release mechanisms connected with a fire and emergency system; and • Not contain objects that a child may use to injure the child or others. Minn. Stat.§125A.0942, Subd. 3 (5) (i-vi)

27. Prohibited Procedures • May not be used under any circumstances: • Corporal punishment • Requiring a child to assume and maintain a specific physical position, activity or posture that induces physical pain • Totally or partially restricting a child’s senses as punishment • Presenting an intense sound, light or other sensory stimuli using taste, smell,substance or spray as punishment Minn. Stat. § 125A.0942, Subd. 4

28. The list of prohibitions similar, except: Faradic skin shock are substantially NEW! Interacting with a child in a manner that constitutes sexual abuse, neglect, or physical abuse under section 626.556 (reporting of maltreatment of minors) Physical holding that restricts or impairs a child’s ability to breathe, including prone restraint Minn. Stat. § 125A.0942, Subd. 4 Prohibited Procedures

29. Prohibited Procedures • May not be used under any circumstances: • Denying or restricting a child’s access to equipment or devices such as walkers, wheelchairs, hearing aids and communication boards that facilitate the child’s functioning, except when temporarily removing the equipment or device as needed to prevent injury to the child or others or serious property damage to the equipment or device, in which case the equipment or device shall be returned to the child as soon as possible

30. Prohibited Procedures • May not be used under any circumstances: • Interacting with a child in a manner that constitutes sexual abuse, neglect, or physical abuse (maltreatment of minors) • Withholding regularly scheduled meals or water • Denying access to bathroom facilities • Physical holding that impairs a child’s ability to breathe Minn. Stat. § 125A.0942, Subd. 4

31. Prohibited Procedures “Especially dangerous positions include face-down floor restraints, or any position in which a person is bent over in such as way that it is difficult to breathe. This includes a seated or kneeling position in which a person being restrained is bent over at the waist, and it also includes any face-down position on a bed or mat.” The Crisis Prevention Institute, Inc.

32. First Steps For any student that is enrolled in our programs, we need to look at the IEP and BIP to see if there is conditional procedures language. If there is, you will need to contact the parent to explain the need to amend the IEP as soon as possible. We cannot wait until we rewrite the IEP. You should start this process as soon as you have access to the student on easy IEP.

33. First Steps • Steps for amending the IEP and BIP to address new • Restrictive Procedures guidelines: • Contact the parent to explain the need to amend the IEP to address • Minn. Stat. ､ 125A.0942, Subd. 2(d) for documenting the • emergency use of restrictive procedures. • Document contact in EasyIEP • Amend the IEP • Delete all language referring to Conditional Procedures under the • Program Modification and Accommodations section • Go into the BIP and delete any language pertaining to • conditional procedures

34. First Steps • If the student has seclusion or physical holds as a part of their plan, insert the Emergency Restrictive Procedures sample language under the Crisis Plan section of the BIP • Send home the Prior Written Notice for the parent signature.

35. First Steps District Restrictive Procedures Plan - Each building will receive and keep publicly accessible a restrictive procedures plan for children that includes: • The list of restrictive procedures the school intends to use; • How the school will monitor and review the use of restrictive procedures, including conducting post-use debriefings and convening an oversight committee; and • A written description and documentation of the training staff completed Minn. Stat. § 125A.0942, Subd. 1

36. First Steps District Restrictive Procedures Plan - There will be one plan accessible to all schools in the District. Each building will complete a one-page addendum, identifying the specific restrictive procedure(s) your building will use, and the members of your building’s post-use debriefing team. (This team could be comprised of 2-4 staff members that might include special education teachers, social workers and/or building administrators.) Buildings will be asked to identify one contact person for restrictive procedures and return a copy of the addendum to no later than Sept. 30, 2011.

37. First Steps Train staff to ensure qualified staff are available to implement restrictive procedures. To meet requirements of the new statute, staff who use restrictive procedures shall complete training in the following skills and knowledge areas: • Positive behavioral interventions • Communicative intent of behaviors • Relationship-building • Alternatives to restrictive procedures, including techniques to identify events and environmental factors that may escalate behavior • De-escalation methods • Standards for using restrictive procedures

38. First Steps • Obtaining emergency medical assistance • The physiological and psychological impact of physical holding an seclusion • Monitoring and responding to a child’s physical signs of distress when physical holding is being used • Recognizing the symptoms of and interventions that may cause positional asphyxia when physical holding is used. Minn. Stat. § 125A.0942, Subd. 2(a) and Subd. 5

39. First Steps Training requirements for use of restrictive procedures shall be met through: • Nonviolent Crisis Intervention and Restrictive Procedures Skills Training - This includes an eight-hour introductory training, plus annual refreshers • Restrictive Procedures Standards and Documentation Training

40. Restrictive Procedures • MDE Restrictive Procedures Standards Q and A • Minnesota Department of Education Website: Restrictive Procedures Page education.state.mn.us  Accountability Programs  Compliance and Assistance  Restrictive Procedures • Kathleen.Nilles@spps.org, 651-263-7070