Section 29-6273. BEHAVIOR MANAGEMENT

 

6273.1Facilities are encouraged to establish behavior management strategies, in accordance with the resident's age and level of development, to provide rewards and praise for appropriate behavior as well as negative consequences for inappropriate behavior. Such strategies may include, but are not limited to:

 

(a)A points or token economy system in which points or tokens are used to purchase privileges; and

 

(b)An oral or written contract between the facility and the resident to help the resident acquire self-discipline.

 

6273.2The facility shall develop and follow written policies and procedures regarding the discipline of residents, including but not limited to the:

 

(a)Rules each resident shall follow;

 

(b)Reasonable discipline that may be administered for violating those rules, which shall relate to and be proportionate to the unacceptable behavior, and reflect the nature of real world experiences, as appropriate to the resident's age and level of development;

 

(c)Resident's right to appeal a disciplinary decision through the grievance process; and

 

(d)Procedures for appealing a disciplinary decision.

 

6273.3The facility shall ensure that the policies and procedures regarding the discipline of residents are explained to each resident as soon as practicable, but in no event later than forty-eight (48) hours after admission.

 

6273.4Only staff who have received specific training in acceptable methods of discipline shall utilize discipline. The facility shall maintain documentation of such training within each staff member's personnel record.

 

6273.5Only staff who are known to the resident shall administer discipline to the resident.

 

6273.6The facility shall inform the resident of the nature of and the reason for the discipline prior to administering the discipline.

 

6273.7The facility shall administer discipline as soon as practicable after the violative behavior occurs and after allowing the resident to explain his or her violative behavior.

 

6273.8Discipline shall not be arbitrary or capricious and shall be consistent among residents.

 

6273.9The facility shall document in the resident's case record any disciplinary action and shall include the following:

 

(a)The nature of the violative behavior warranting discipline;

 

(b)The date of the violative behavior warranting discipline;

 

(c)The type of discipline administered;

 

(d)The date the discipline was administered;

 

(e)The name and title of the person who administered the discipline;

 

(f)The resident's response to the discipline; and

 

(g)Any appeal and the outcome of the appeal.

 

6273.10Approved forms of discipline include, but are not limited to:

 

(a)Time-outs;

 

(b)The elimination or withholding of an allowance provided by the facility but not yet paid;

 

(c)Requiring the resident to prepare a written report about the violative behavior, including the lessons learned, the appropriate ways in which the resident could respond if the situation were to arise again, and the way in which the resident would respond if the situation were to arise again;

 

(d)The prohibition against attendance at or participation in planned activities;

 

(e)The prohibition against the use of entertainment devices, including but not limited to televisions, radios, and computers;

 

(f)Restrictions on contact with friends; and

 

(g)Restrictions on day or weekend passes.

 

6273.11A time-out is the placement of a resident in a specific location within the facility that is visibly monitored by staff. The length of the time-out shall be determined by the resident's age and level of development, and shall not be for more than thirty (30) minutes, unless otherwise provided by the administrator. Under no circumstance may the facility place a resident in a time-out for more than sixty (60) minutes.

 

6273.12The facility shall prohibit unusual or extreme methods of discipline, including but not limited to:

 

(a)Corporal punishment;

 

(b)Physical exercise;

 

(c)Requiring or forcing a resident to maintain an uncomfortable physical position, or requiring or forcing a resident to engage in repetitive physical movements;

 

(d)Group discipline for the behavior of fewer than all residents;

 

(e)Verbal abuse, ridicule, or humiliation;

 

(f)The denial of social, mental health, educational or casework services;

 

(g)The deprivation of any meal;

 

(h)The use or denial of any medication;

 

(i)The denial of visitation, mail, or telephone contact with a resident's family, attorney, or guardian ad litem;

 

(j)The denial of sleep;

 

(k)Requiring the resident to remain silent for long periods of time;

 

(l)The deprivation of civil rights provided by law, including, where applicable, the right to privacy, the right to freedom of association, the right to vote, the right to practice or not practice religion or faith of choice, the right to be free from unreasonable search and seizure, the right to be free from sexual harassment, and the right to be free from discrimination, including the right to equal access to services regardless of race, religion, ethnicity, sexual orientation, disability, or gender;

 

(m)The denial of shelter, clothing, bedding, restroom facilities, or other essential personal needs;

 

(n)The withholding of the resident's funds, from whatever source, excluding an allowance not yet paid;

 

(o)Locked isolation;

 

(p)Organized social ostracism, including but not limited to codes of silence;

 

(q)Continuing discipline when signs of severe emotional or physical distress are apparent;

 

(r)Barring the resident from entry to the facility, locking a resident out of the facility, or expulsion of the resident from the facility; and

 

(s)Assigning any unduly physically strenuous, harsh, or degrading work.

 

source

Final Rulemaking published at 48 DCR 8675, 8735 (September 21, 2001).