As an organization that promotes and protects the human rights of people with developmental disabilities and actively supports their full inclusion and participation in the community throughout their lifetimes, The Arc of Virginia strongly believes that all people have the right to be treated with dignity, respect, and freedom from harm. Seclusion and restraint—whether physical, mechanical, or chemical—are traumatic practices that should only be used as a last resort, if at all, and never as a means of discipline, convenience, or control. Our philosophy is rooted in the understanding that positive, person-centered supports, trauma-informed care, and meaningful relationships are the foundation of safe and inclusive environments. The regulations must clearly reflect this commitment by setting strong safeguards, limiting the use of restrictive practices, and promoting alternatives that uphold each person’s autonomy and humanity. The Arc of Virginia appreciates the opportunity to provide input on changes to the Department of Behavioral Health and Developmental Disabilities’ restraint and seclusion regulations.

Our recommendations are: 

• Recommend prohibiting the use of mechanical or pharmacological restraints in all community settings. 

• 12VAC35-115-110(C)(B) - Add language to ensure proper use of mechanical supports, preventing providers from using voluntary supports as tools for restraint and seclusion.

• We agree with 12VAC35-115-110(C)(4), but are concerned that it may be difficult to identify when restraint, seclusion, or time out is being used as punishment or matter of convenience. We recommend that a third individual review the documentation detailed in 12VAC35-115-110(C)(13)(c) to confirm the necessity of the actions taken.

• 12VAC35-115-110(C)(14) - the Department clarify that limitations for restraint and seclusion are the maximum limitations, and people should not be left in restraints or seclusion for four, two, or one hour simply because they can.

  • Add language that clarifies when another occurrence of restraint or seclusion can happen again to avoid multiple or back-to-back occurrences.

  • Add language to define when it is absolutely necessary to a person’s health and safety that restraint or seclusion continue beyond the limitations and what actions a provider must take to get an extension approved.

• Providers should be responsible for notifying the restrained or secluded person’s guardian, if such person has one, whenever restraint or seclusion is used.

We agree with the recommendations made by Jennifer Fidura to:

• 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 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 ensure proper use of such devices may increase the potential for injury or harm, the provider should take appropriate steps to ensure consistent and proper use as ordered or recommended

Again, The Arc of Virginia appreciates the opportunity to provide input and will gladly answer any questions at lgerken@thearcofva.org.