Comments on Restraint and Seclusion

Redefine “restraints for protective purposes”  in both 12VAC35-105 and 12VAC35-115 to include “ . . . using a mechanical device typically ordered or recommended by the treating professional to prevent or minimize the possibility of injury to compensate for a physical or cognitive deficit when the individual does not have the option to remove the device.  The device may limit an individual’s movement and prevent possible harm or it may create a passive barrier, such as a helmet, to protect the individual from injury.  As failure to insure proper use of such devices may increase to potential for injury or harm, the provider should take appropriate steps to ensure consistent and proper use as ordered or recommended.

As a restraint for protective purposes is described in the individual’s treatment plan, is not deemed “unnecessary” and falls more generally into the category of “necessary” protection from injury or harm, instances of their use (some of which are by intention hours long, eg a helmet that is worn during waking hours, or bedrails which are in place during the night) should not be included in the reporting required in 12VAC35-115-110 or 12VAC35-115-230 C.3.

Definition of “seclusion” in both 12VAC35-150 and 12VAC35-115 should be amended to include “the involuntary placement of an individual in an area secured by a door that is locked or held shut by a staff person , by physically blocking the door, or by any other physical means so the individual cannot leave the area a room meeting the specifications outlined in 12VAC35-105-1950 and only as permitted in 12VAC35-115-110 C. 3.