S.F. 204 Section 1. Section 256.9, Code 2017, is amended by adding 1 the following new subsection: 2 NEW SUBSECTION . 61. Develop and approve, in cooperation 3 with the board of educational examiners and the area education 4 agencies, a training program that includes but is not limited 5 to the following: 6 a. A curriculum for practitioners and paraeducators 7 that includes evidence-based techniques and strategies for 8 preventing the use of restraint and seclusion by schools; 9 practices that keep school personnel and students safe 10 if physical restraint is necessary; positive behavioral 11 interventions, supports, and strategies; behavioral 12 antecedents, functional behavioral assessments, de-escalation 13 of challenging behaviors, and conflict prevention and 14 management; safe physical escort; first aid, including the 15 signs of medical distress, and cardiopulmonary resuscitation. 16 b. Certification in state restraint and seclusion policies 17 and procedures. 18 Sec. 2. NEW SECTION . 280.21C Seclusion and restraint 19 interventions —— requirements. 20 1. Definitions. For purposes of this section, unless the 21 context otherwise requires: 22 a. “Chemical restraint” means a drug or medication used on 23 a student to control behavior or restrict freedom of movement 24 that is not prescribed and administered by a licensed physician 25 or a qualified health care professional prescriber for the 26 standard treatment of a student’s medical or psychiatric 27 condition. 28 b. “Mechanical restraint” means the use of a device as 29 a means of restricting a student’s freedom of movement. 30 “Mechanical restraint” does not mean a device used by trained 31 school personnel, or used by a student, for the specific and 32 approved therapeutic or safety purposes for which such a 33 device was designed and, if applicable, prescribed, including 34 restraints for medical immobilization, adaptive devices or 35 -1- LSB 1809XS (5) 87 kh/nh 1/ 13

S.F. 204 mechanical supports used to allow greater freedom of mobility 1 than would be possible without the use of such devices or 2 mechanical supports, and vehicle safety restraints when used as 3 intended during the transport of a student in a moving vehicle. 4 c. “Physical escort” means the temporary touching or holding 5 of the hand, wrist, arm, shoulder, waist, hip, or back for the 6 purpose of inducing a student to move to a safe location. 7 d. “Physical restraint” means a personal restriction 8 that immobilizes or reduces the ability of a student to move 9 the student’s arms, legs, body, or head freely. “Physical 10 restraint” does not include a physical escort, mechanical 11 restraint, or chemical restraint. 12 e. “Positive behavioral interventions and supports” means 13 a school-wide systematic approach to embed evidence-based 14 practices and data-driven decision-making to improve school 15 climate and culture in order to achieve improved academic 16 and social outcomes, and increase learning for all students, 17 including those students with the most complex and intensive 18 behavioral needs; and which encompasses a range of systemic 19 and individualized positive strategies to reinforce desired 20 behaviors, diminish the reoccurrence of challenging behaviors, 21 and teach appropriate behaviors to students. 22 f. “Seclude” or “seclusion” means the involuntary 23 confinement of a student alone in a room or area from which the 24 student is physically prevented from leaving. “Seclude” or 25 “seclusion” does not include a time-out. 26 g. “Time-out” means a behavior management technique that 27 may involve the separation of a student from the group, in 28 a nonlocked setting, for the purpose of calming, and may be 29 written into an individualized education program. “Time-out” 30 does not mean seclusion. 31 2. Actions prohibited —— exceptions. 32 a. Except as provided in this section, a school employee, a 33 person under a contract to provide services to the school, or a 34 volunteer shall not impose on any student any of the following: 35 -2- LSB 1809XS (5) 87 kh/nh 2/ 13

S.F. 204 (1) Seclusion. 1 (2) Mechanical restraint. 2 (3) Chemical restraint. 3 (4) Aversive behavioral interventions that compromise 4 health or safety. 5 (5) Physical restraint that is life-threatening, including 6 but not limited to physical restraint that restricts breathing. 7 (6) Physical restraint if contraindicated based on the 8 student’s disability, health care needs, or medical or 9 psychiatric condition, as documented in a health care directive 10 or medical management plan, a behavior intervention plan, an 11 individualized education program, or other relevant record made 12 available to the school district, accredited nonpublic school, 13 or area education agency. 14 b. Physical restraint of a student, using only the amount 15 of force necessary to protect the student or others from 16 the threatened physical harm, may be implemented by school 17 personnel qualified under subsection 3 only under the following 18 conditions: 19 (1) The student’s behavior poses an immediate danger of 20 serious physical harm to self or others. 21 (2) The physical restraint does not interfere with the 22 student’s ability to communicate in the student’s primary 23 language or mode of communication. 24 (3) Less restrictive interventions have been ineffective in 25 ceasing the immediate danger of serious physical harm to the 26 student or others, except in the case of a clearly unavoidable 27 emergency circumstance posing an immediate danger of serious 28 physical harm. 29 (4) The physical restraint is implemented in a manner that, 30 based on research and evidence, is safe, appropriate, and 31 proportionate to and sensitive to the student’s severity of 32 behavior, chronological and developmental age, physical size, 33 gender, physical condition, medical condition, psychiatric 34 condition, and personal history, including any history of 35 -3- LSB 1809XS (5) 87 kh/nh 3/ 13

S.F. 204 physical or sexual abuse or other trauma. 1 c. The use of physical restraint shall immediately cease 2 under any of the following conditions: 3 (1) A medical condition occurs putting the student at risk 4 of harm. 5 (2) The student’s behavior no longer poses an immediate 6 danger of serious physical harm to the student or others. 7 (3) Less restrictive interventions would be effective in 8 ceasing such immediate danger of serious physical harm. 9 d. Upon the initial implementation of physical restraint 10 of a student, school personnel shall contact key identified 11 school employees for help from within the attendance center 12 either immediately at the onset of an emergency situation or, 13 if it is reasonable under the particular circumstances for 14 school personnel to believe that diverting attention from the 15 situation would increase the risk to the safety of the student 16 or to the safety of others, as soon as possible once the 17 circumstances no longer support such a belief. 18 e. If, in an emergency situation in which a student’s 19 behavior poses an immediate danger of serious physical harm 20 to the student or others, less restrictive interventions 21 have proven ineffective in ceasing the immediate danger, a 22 student may be placed in seclusion under all of the following 23 conditions: 24 (1) The seclusion does not interfere with the student’s 25 ability to breathe or communicate. 26 (2) A practitioner, paraeducator, or health professional 27 carefully, continuously, and visually monitors the student 28 while the student is in seclusion. 29 f. Emergency seclusion shall not be used longer than 30 necessary, based on research and evidence, to allow a student 31 to regain composure to the point that the emergency situation 32 necessitating the use of emergency seclusion ceases and 33 generally no longer than fifteen minutes for an elementary 34 school student or twenty minutes for a secondary school 35 -4- LSB 1809XS (5) 87 kh/nh 4/ 13

S.F. 204 student. If an emergency seclusion lasts longer than fifteen 1 minutes for an elementary school student or twenty minutes for 2 a secondary school student, the school district or nonpublic 3 school must provide for the following: 4 (1) Additional support, which may include a change of 5 staff, or introducing a nurse, specialist, or additional key 6 identified school employees. 7 (2) Documentation to explain the extension beyond the time 8 period specified in this paragraph “f” . 9 3. Qualifications of individuals imposing physical restraint 10 or seclusion. School personnel imposing physical restraint or 11 seclusion on a student in accordance with this section shall 12 meet the following conditions: 13 a. Be trained and certified under a training program 14 approved under section 256.9, subsection 61, except in the case 15 of clearly unavoidable emergency circumstances when trained and 16 certified school personnel are not immediately available due to 17 the unforeseeable nature of the emergency circumstance. The 18 principal of an attendance center shall identify one or more 19 key school employees who shall be trained and certified under a 20 training program approved under section 256.9, subsection 61. 21 b. Engage in continuous visual monitoring of the student as 22 provided in subsection 2, paragraph “e” . 23 4. Prohibition on use of physical restraint or seclusion as 24 planned intervention. 25 a. Except as provided in paragraph “b” , the use of physical 26 restraint or seclusion as a planned intervention shall not be 27 written into a student’s individualized education program or 28 any other planning document prepared for an individual student 29 unless agreed upon by school administrators, the parent or 30 guardian of the student, and the individualized education team 31 or other key identified school employees and the following 32 conditions have been met: 33 (1) All parties to the agreement have considered less 34 restrictive means to address behavioral concerns that would 35 -5- LSB 1809XS (5) 87 kh/nh 5/ 13

S.F. 204 meet the emergency standards described in subsection 2, 1 paragraph “b” . 2 (2) The individualized education team or other key 3 identified school employees have conducted a research-based, 4 individualized functional behavioral assessment and implemented 5 a corresponding positive intervention plan that addresses 6 preventative measures used to reduce or prevent emergencies and 7 is written into the student’s individualized education program 8 or a planning document prepared for the individual student. 9 5. School responsibilities. The board of directors of each 10 school district and the authorities in charge of a nonpublic 11 school shall do the following: 12 a. Establish policies and procedures that ensure school 13 personnel and parents and guardians are aware of the state 14 board of education’s rules, the department’s guidance, and 15 the school district’s or school’s policies, as appropriate, 16 regarding seclusion and physical restraint. 17 b. Establish policies and procedures to be followed after 18 each incident involving the imposition of physical restraint 19 or seclusion upon a student, including but not limited to the 20 following: 21 (1) Procedures to provide to the parent or guardian of 22 the student, with respect to each such incident, a verbal or 23 electronic communication on the same day as each such incident 24 and, within twenty-four hours of each such incident, written 25 notification. 26 (2) Procedures to ensure that the person who imposed 27 a physical restraint or seclusion, the adult witnesses, a 28 representative of the administration, a school mental health 29 professional, and at least one family member or the guardian 30 of the student participate in a debriefing session. The 31 procedures shall ensure that the student who was physically 32 restrained or secluded is given the opportunity to discuss the 33 student’s perspective about the event with a trusted adult who 34 will communicate to the debriefing session group. 35 -6- LSB 1809XS (5) 87 kh/nh 6/ 13

S.F. 204 c. The debriefing session described in paragraph “b” , 1 subparagraph (2), shall occur as soon as practicable, but 2 not later than five school days following the imposition of 3 physical restraint or seclusion unless it is delayed by written 4 mutual agreement of the parent or guardian and the school 5 district or nonpublic school. 6 (1) Each adult witness in the proximity of the student 7 immediately before and during the time of the physical 8 restraint or seclusion but not directly involved shall submit 9 the witness’s observations in writing for the debriefing 10 session. 11 (2) The debriefing session shall include the following: 12 (a) Identification of antecedents to the physical restraint 13 or seclusion and consideration of relevant information in the 14 student’s records, and such information from teachers, other 15 professionals, the parent or guardian, and student. 16 (b) Planning to prevent and reduce reoccurrence of the use 17 of physical restraint or seclusion, including consideration 18 of the results of any functional behavioral assessments, 19 whether positive behavior plans were implemented with 20 fidelity, recommendations of appropriate positive behavioral 21 interventions and supports to assist school personnel 22 responsible for the student’s individualized educational 23 program or other planning document prepared for the individual 24 student. 25 (c) A plan to have a functional behavioral assessment 26 conducted, reviewed, or revised by qualified professionals, the 27 parent or guardian, and the student. 28 (3) Information communicated by a student attending a 29 debriefing session in accordance with this subsection shall not 30 be used against the student in any disciplinary, criminal, or 31 civil investigation or proceeding. 32 6. Prohibition against retaliation. The board of directors 33 of a school district and the authorities in charge of a 34 nonpublic school, and the employees of such school district 35 -7- LSB 1809XS (5) 87 kh/nh 7/ 13

S.F. 204 or nonpublic school, shall not retaliate against any person 1 for having reported or having provided information regarding a 2 violation of this section or a violation of the rules adopted 3 by the state board for the implementation of this section. 4 Sec. 3. STATE MANDATE FUNDING SPECIFIED. In accordance 5 with section 25B.2, subsection 3, the state cost of requiring 6 compliance with any state mandate included in this Act shall 7 be paid by a school district from state school foundation aid 8 received by the school district under section 257.16. This 9 specification of the payment of the state cost shall be deemed 10 to meet all of the state funding-related requirements of 11 section 25B.2, subsection 3, and no additional state funding 12 shall be necessary for the full implementation of this Act 13 by and enforcement of this Act against all affected school 14 districts. 15 EXPLANATION 16 The inclusion of this explanation does not constitute agreement with 17 the explanation’s substance by the members of the general assembly. 18 This bill establishes training requirements, procedures, 19 and prohibitions relating to the use of physical restraint and 20 seclusion by school districts and accredited nonpublic schools. 21 TRAINING CURRICULUM AND CERTIFICATION BY DEPARTMENT. The 22 director of the department of education is required to develop 23 and approve, in cooperation with the board of educational 24 examiners and the area education agencies, certification in 25 state restraint and seclusion policies and procedures and 26 a training program that includes but is not limited to a 27 curriculum for practitioners and paraeducators that includes 28 evidence-based techniques and strategies for preventing the 29 use of physical restraint and seclusion by schools; practices 30 that keep school personnel and students safe if physical 31 restraint is necessary; positive behavioral interventions, 32 supports, and strategies; behavioral antecedents, functional 33 behavioral assessments, de-escalation of challenging behaviors, 34 and conflict prevention and management; safe physical escort; 35 -8- LSB 1809XS (5) 87 kh/nh 8/ 13

S.F. 204 and first aid, including the signs of medical distress, and 1 cardiopulmonary resuscitation. 2 DEFINITIONS. The bill defines “chemical restraint” to mean 3 a drug or medication used on a student to control behavior 4 or restrict freedom of movement that is not prescribed and 5 administered by a licensed physician or a qualified health 6 care professional prescriber for the standard treatment of 7 a student’s medical or psychiatric condition; “mechanical 8 restraint” to mean the use of devices as a means of restricting 9 a student’s freedom of movement, but not devices used by 10 trained school personnel or a student for therapeutic or 11 safety purposes for which such devices were designed and, if 12 applicable, prescribed. 13 “Physical escort” means the temporary touching or holding 14 of the hand, wrist, arm, shoulder, waist, hip, or back for 15 the purpose of inducing a student to move to a safe location; 16 “physical restraint” means a personal restriction that 17 immobilizes or reduces the ability of an individual to move the 18 individual’s arms, legs, body, or head freely, but does not 19 include a physical escort, mechanical restraint, or chemical 20 restraint; “positive behavioral interventions and supports” 21 means a school-wide systematic approach to embed evidence-based 22 practices and data-driven decision-making to improve school 23 climate and culture in order to achieve improved academic 24 and social outcomes, and increase learning for all students, 25 and which encompasses a range of systemic and individualized 26 positive strategies to reinforce desired behaviors, diminish 27 reoccurrence of challenging behaviors, and teach appropriate 28 behaviors to students; “seclude” or “seclusion” means the 29 involuntary confinement of a student alone in a room or area 30 from which the student is physically prevented from leaving, 31 but does not include a time-out; and “time-out” means a 32 behavior management technique that may involve the separation 33 of a student from the group, in a nonlocked setting, for the 34 purpose of calming, and may be written into an individualized 35 -9- LSB 1809XS (5) 87 kh/nh 9/ 13

S.F. 204 education program. 1 ACTIONS PROHIBITED —— EXCEPTIONS. Except in emergency 2 situations, the bill prohibits a school employee, person under 3 contract to provide services to the school, or volunteer from 4 imposing on any student seclusion, mechanical restraint, 5 chemical restraint, aversive behavioral interventions that 6 compromise health or safety, physical restraint that is 7 life-threatening or contraindicated based on the student’s 8 documented disability, health care needs, or medical or 9 psychiatric condition. 10 Physical restraint, using only the amount of force necessary 11 to protect the student or others from the threatened harm, 12 may be implemented only if the student’s behavior poses 13 immediate danger of serious physical harm to self or others, 14 the physical restraint does not interfere with the student’s 15 ability to communicate, less restrictive interventions have 16 been ineffective, except in the case of a clearly unavoidable 17 emergency circumstance, and the physical restraint is performed 18 in a manner that is safe, appropriate, and proportionate to and 19 sensitive to the student’s severity of behavior, chronological 20 and developmental age, physical size, gender, physical 21 condition, medical condition, psychiatric condition, and 22 personal history, including any history of physical or sexual 23 abuse or other trauma. 24 The use of physical restraint must immediately cease when 25 a medical condition occurs putting the student at risk of 26 harm, the student’s behavior no longer poses immediate danger 27 of serious physical harm to the student or others, and less 28 restrictive interventions would be effective in stopping such 29 immediate danger of serious physical harm. 30 Upon the initial implementation of physical restraint, 31 school personnel must contact key identified employees for help 32 from within the attendance center either immediately at the 33 onset of an emergency situation or as soon as possible. 34 Seclusion may be used in an emergency situation in which a 35 -10- LSB 1809XS (5) 87 kh/nh 10/ 13

S.F. 204 student’s behavior poses immediate danger of serious physical 1 harm to the student or others and restrictive interventions 2 have proven ineffective in ceasing the immediate danger. 3 However, the seclusion cannot interfere with the student’s 4 ability to breathe or communicate, and a practitioner, 5 paraeducator, or health professional must carefully, 6 continuously, and visually monitor the student while the 7 student is in seclusion. 8 Emergency seclusion shall not be used longer than necessary, 9 generally no longer than 15 minutes for an elementary school 10 student or 20 minutes for a secondary school student. For 11 longer periods, schools must provide for additional support, 12 which may include a change of staff, or introducing a nurse, 13 specialist, or additional key identified school employees, and 14 documentation to explain the extension beyond the time limit. 15 QUALIFICATIONS OF INDIVIDUALS IMPOSING PHYSICAL RESTRAINT 16 OR SECLUSION. School personnel imposing physical restraint 17 or seclusion must engage in continuous visual monitoring of 18 the student and, except in the case of clearly unavoidable 19 emergency circumstances when school personnel trained and 20 certified are not immediately available, must be trained and 21 certified in state physical restraint and seclusion policies 22 and procedures. The school principal must identify at least 23 one or more school employees who shall be trained and certified 24 under a training program approved by the department. 25 PROHIBITION ON THE USE OF PHYSICAL RESTRAINT OR SECLUSION 26 AS PLANNED INTERVENTION. The use of physical restraint or 27 seclusion as a planned intervention shall not be written into 28 a student’s education plan or any other planning document for 29 an individual student unless agreed upon in writing by school 30 administrators, the parent or guardian of the student, and 31 the individualized education team or other key identified 32 school employees; the parties to the agreement considered less 33 restrictive means to address behavioral concerns that would 34 meet the emergency standard; and the individualized education 35 -11- LSB 1809XS (5) 87 kh/nh 11/ 13

S.F. 204 team or other key identified school employees have conducted a 1 research-based, individualized functional behavioral assessment 2 and implemented a corresponding positive intervention plan 3 that addresses preventative measures used to reduce or prevent 4 emergencies and is written into the student’s individualized 5 education program or other planning document prepared for the 6 individual student. 7 SCHOOL RESPONSIBILITIES. The board of directors of each 8 school district and the authorities in charge of a nonpublic 9 school are to establish policies and procedures that ensure 10 school personnel and parents and guardians are aware of the 11 state and local rules, guidance, or policies, as appropriate, 12 regarding seclusion and restraint. 13 School districts and nonpublic schools also must establish 14 policies and procedures to be followed after each incident 15 of physical restraint or seclusion, verbal or electronic 16 notification of the parent or guardian on the same day as the 17 incident, followed by written notification within 24 hours of 18 the incident; procedures to ensure that parties to the incident 19 participate in a debriefing session; and procedures for giving 20 the student who was restrained or secluded the opportunity to 21 discuss the event with a trusted adult who will communicate to 22 the debriefing session group. 23 The debriefing session shall occur as soon as practicable, 24 but not later than five school days following the imposition of 25 physical restraint or seclusion unless it is delayed by written 26 mutual agreement. 27 Adult witnesses who were not directly involved in the 28 incident shall submit their observations in writing for the 29 debriefing session. The debriefing session shall include 30 identification of antecedents to the physical restraint or 31 seclusion and consideration of relevant information in the 32 student’s records; planning to prevent and reduce reoccurrence 33 of the use of physical restraint or seclusion; a plan to have 34 a functional behavioral assessment conducted, reviewed, or 35 -12- LSB 1809XS (5) 87 kh/nh 12/ 13

S.F. 204 revised by qualified professionals, the parent or guardian, 1 and the student; and, when a student attends a debriefing 2 session, information communicated by the student may not be 3 used against the student in any disciplinary, criminal, or 4 civil investigation or proceeding. 5 PROHIBITION AGAINST RETALIATION. School districts and 6 nonpublic schools, and their employees, are prohibited from 7 retaliating against any person for having reported or having 8 provided information regarding a violation of the bill, or 9 a violation of the rules adopted by the state board for the 10 implementation of the bill. 11 STATE MANDATE. The bill may include a state mandate as 12 defined in Code section 25B.3. The bill requires that the 13 state cost of any state mandate included in the bill be 14 paid by a school district from state school foundation aid 15 received by the school district under Code section 257.16. The 16 specification is deemed to constitute state compliance with 17 any state mandate funding-related requirements of Code section 18 25B.2. The inclusion of this specification is intended to 19 reinstate the requirement of political subdivisions to comply 20 with any state mandates included in the bill. 21 -13- LSB 1809XS (5) 87 kh/nh 13/ 13