SF 204 (LSB 1809XS (5) 87)

SENATE FILE 204

BY  BOLKCOM

A BILL FOR

An Act relating to physical restraint and seclusion practices, training, and prohibitions.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  Section 256.9, Code 2017, is amended by adding the following new subsection:
   NEW SUBSECTION.  61.  Develop and approve, in cooperation with the board of educational examiners and the area education agencies, a training program that includes but is not limited to the following:
   a.  A curriculum for practitioners and paraeducators that includes evidence-based techniques and strategies for preventing the use of restraint and seclusion by schools; practices that keep school personnel and students safe if physical restraint is necessary; positive behavioral interventions, supports, and strategies; behavioral antecedents, functional behavioral assessments, de-escalation of challenging behaviors, and conflict prevention and management; safe physical escort; first aid, including the signs of medical distress, and cardiopulmonary resuscitation.
   b.  Certification in state restraint and seclusion policies and procedures.
    Sec. 2.  NEW SECTION.  280.21C  Seclusion and restraint interventions —— requirements.
   1.  Definitions.  For purposes of this section, unless the context otherwise requires:
   a.  “Chemical restraint” means a drug or medication used on a student to control behavior or restrict freedom of movement that is not prescribed and administered by a licensed physician or a qualified health care professional prescriber for the standard treatment of a student’s medical or psychiatric condition.
   b.  “Mechanical restraint” means the use of a device as a means of restricting a student’s freedom of movement. “Mechanical restraint” does not mean a device used by trained school personnel, or used by a student, for the specific and approved therapeutic or safety purposes for which such a device was designed and, if applicable, prescribed, including restraints for medical immobilization, adaptive devices or mechanical supports used to allow greater freedom of mobility than would be possible without the use of such devices or mechanical supports, and vehicle safety restraints when used as intended during the transport of a student in a moving vehicle.
   c.  “Physical escort” means the temporary touching or holding of the hand, wrist, arm, shoulder, waist, hip, or back for the purpose of inducing a student to move to a safe location.
   d.  “Physical restraint” means a personal restriction that immobilizes or reduces the ability of a student to move the student’s arms, legs, body, or head freely. “Physical restraint” does not include a physical escort, mechanical restraint, or chemical restraint.
   e.  “Positive behavioral interventions and supports” means a school-wide systematic approach to embed evidence-based practices and data-driven decision-making to improve school climate and culture in order to achieve improved academic and social outcomes, and increase learning for all students, including those students with the most complex and intensive behavioral needs; and which encompasses a range of systemic and individualized positive strategies to reinforce desired behaviors, diminish the reoccurrence of challenging behaviors, and teach appropriate behaviors to students.
   f.  “Seclude” or “seclusion” means the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving. “Seclude” or “seclusion” does not include a time-out.
   g.  “Time-out” means a behavior management technique that may involve the separation of a student from the group, in a nonlocked setting, for the purpose of calming, and may be written into an individualized education program. “Time-out” does not mean seclusion.
   2.  Actions prohibited —— exceptions.
   a.  Except as provided in this section, a school employee, a person under a contract to provide services to the school, or a volunteer shall not impose on any student any of the following:
   (1)  Seclusion.
   (2)  Mechanical restraint.
   (3)  Chemical restraint.
   (4)  Aversive behavioral interventions that compromise health or safety.
   (5)  Physical restraint that is life-threatening, including but not limited to physical restraint that restricts breathing.
   (6)  Physical restraint if contraindicated based on the student’s disability, health care needs, or medical or psychiatric condition, as documented in a health care directive or medical management plan, a behavior intervention plan, an individualized education program, or other relevant record made available to the school district, accredited nonpublic school, or area education agency.
   b.  Physical restraint of a student, using only the amount of force necessary to protect the student or others from the threatened physical harm, may be implemented by school personnel qualified under subsection 3 only under the following conditions:
   (1)  The student’s behavior poses an immediate danger of serious physical harm to self or others.
   (2)  The physical restraint does not interfere with the student’s ability to communicate in the student’s primary language or mode of communication.
   (3)  Less restrictive interventions have been ineffective in ceasing the immediate danger of serious physical harm to the student or others, except in the case of a clearly unavoidable emergency circumstance posing an immediate danger of serious physical harm.
   (4)  The physical restraint is implemented in a manner that, based on research and evidence, is safe, appropriate, and proportionate to and sensitive to the student’s severity of behavior, chronological and developmental age, physical size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of physical or sexual abuse or other trauma.
   c.  The use of physical restraint shall immediately cease under any of the following conditions:
   (1)  A medical condition occurs putting the student at risk of harm.
   (2)  The student’s behavior no longer poses an immediate danger of serious physical harm to the student or others.
   (3)  Less restrictive interventions would be effective in ceasing such immediate danger of serious physical harm.
   d.  Upon the initial implementation of physical restraint of a student, school personnel shall contact key identified school employees for help from within the attendance center either immediately at the onset of an emergency situation or, if it is reasonable under the particular circumstances for school personnel to believe that diverting attention from the situation would increase the risk to the safety of the student or to the safety of others, as soon as possible once the circumstances no longer support such a belief.
   e.  If, in an emergency situation in which a student’s behavior poses an immediate danger of serious physical harm to the student or others, less restrictive interventions have proven ineffective in ceasing the immediate danger, a student may be placed in seclusion under all of the following conditions:
   (1)  The seclusion does not interfere with the student’s ability to breathe or communicate.
   (2)  A practitioner, paraeducator, or health professional carefully, continuously, and visually monitors the student while the student is in seclusion.
   f.  Emergency seclusion shall not be used longer than necessary, based on research and evidence, to allow a student to regain composure to the point that the emergency situation necessitating the use of emergency seclusion ceases and generally no longer than fifteen minutes for an elementary school student or twenty minutes for a secondary school student. If an emergency seclusion lasts longer than fifteen minutes for an elementary school student or twenty minutes for a secondary school student, the school district or nonpublic school must provide for the following:
   (1)  Additional support, which may include a change of staff, or introducing a nurse, specialist, or additional key identified school employees.
   (2)  Documentation to explain the extension beyond the time period specified in this paragraph “f”.
   3.  Qualifications of individuals imposing physical restraint or seclusion.  School personnel imposing physical restraint or seclusion on a student in accordance with this section shall meet the following conditions:
   a.  Be trained and certified under a training program approved under section 256.9, subsection 61, except in the case of clearly unavoidable emergency circumstances when trained and certified school personnel are not immediately available due to the unforeseeable nature of the emergency circumstance. The principal of an attendance center shall identify one or more key school employees who shall be trained and certified under a training program approved under section 256.9, subsection 61.
   b.  Engage in continuous visual monitoring of the student as provided in subsection 2, paragraph “e”.
   4.  Prohibition on use of physical restraint or seclusion as planned intervention.
   a.  Except as provided in paragraph “b”, the use of physical restraint or seclusion as a planned intervention shall not be written into a student’s individualized education program or any other planning document prepared for an individual student unless agreed upon by school administrators, the parent or guardian of the student, and the individualized education team or other key identified school employees and the following conditions have been met:
   (1)  All parties to the agreement have considered less restrictive means to address behavioral concerns that would meet the emergency standards described in subsection 2, paragraph “b”.
   (2)  The individualized education team or other key identified school employees have conducted a research-based, individualized functional behavioral assessment and implemented a corresponding positive intervention plan that addresses preventative measures used to reduce or prevent emergencies and is written into the student’s individualized education program or a planning document prepared for the individual student.
   5.  School responsibilities.  The board of directors of each school district and the authorities in charge of a nonpublic school shall do the following:
   a.  Establish policies and procedures that ensure school personnel and parents and guardians are aware of the state board of education’s rules, the department’s guidance, and the school district’s or school’s policies, as appropriate, regarding seclusion and physical restraint.
   b.  Establish policies and procedures to be followed after each incident involving the imposition of physical restraint or seclusion upon a student, including but not limited to the following:
   (1)  Procedures to provide to the parent or guardian of the student, with respect to each such incident, a verbal or electronic communication on the same day as each such incident and, within twenty-four hours of each such incident, written notification.
   (2)  Procedures to ensure that the person who imposed a physical restraint or seclusion, the adult witnesses, a representative of the administration, a school mental health professional, and at least one family member or the guardian of the student participate in a debriefing session. The procedures shall ensure that the student who was physically restrained or secluded is given the opportunity to discuss the student’s perspective about the event with a trusted adult who will communicate to the debriefing session group.
   c.  The debriefing session described in paragraph “b”, subparagraph (2), shall occur as soon as practicable, but not later than five school days following the imposition of physical restraint or seclusion unless it is delayed by written mutual agreement of the parent or guardian and the school district or nonpublic school.
   (1)  Each adult witness in the proximity of the student immediately before and during the time of the physical restraint or seclusion but not directly involved shall submit the witness’s observations in writing for the debriefing session.
   (2)  The debriefing session shall include the following:
   (a)  Identification of antecedents to the physical restraint or seclusion and consideration of relevant information in the student’s records, and such information from teachers, other professionals, the parent or guardian, and student.
   (b)  Planning to prevent and reduce reoccurrence of the use of physical restraint or seclusion, including consideration of the results of any functional behavioral assessments, whether positive behavior plans were implemented with fidelity, recommendations of appropriate positive behavioral interventions and supports to assist school personnel responsible for the student’s individualized educational program or other planning document prepared for the individual student.
   (c)  A plan to have a functional behavioral assessment conducted, reviewed, or revised by qualified professionals, the parent or guardian, and the student.
   (3)  Information communicated by a student attending a debriefing session in accordance with this subsection shall not be used against the student in any disciplinary, criminal, or civil investigation or proceeding.
   6.  Prohibition against retaliation.  The board of directors of a school district and the authorities in charge of a nonpublic school, and the employees of such school district or nonpublic school, shall not retaliate against any person for having reported or having provided information regarding a violation of this section or a violation of the rules adopted by the state board for the implementation of this section.
    Sec. 3.  STATE MANDATE FUNDING SPECIFIED.  In accordance with section 25B.2, subsection 3, the state cost of requiring compliance with any state mandate included in this Act shall be paid by a school district from state school foundation aid received by the school district under section 257.16. This specification of the payment of the state cost shall be deemed to meet all of the state funding-related requirements of section 25B.2, subsection 3, and no additional state funding shall be necessary for the full implementation of this Act by and enforcement of this Act against all affected school districts.
EXPLANATION
The inclusion of this explanation does not constitute agreement with
the explanation’s substance by the members of the general assembly.
   This bill establishes training requirements, procedures, and prohibitions relating to the use of physical restraint and seclusion by school districts and accredited nonpublic schools.
   TRAINING CURRICULUM AND CERTIFICATION BY DEPARTMENT. The director of the department of education is required to develop and approve, in cooperation with the board of educational examiners and the area education agencies, certification in state restraint and seclusion policies and procedures and a training program that includes but is not limited to a curriculum for practitioners and paraeducators that includes evidence-based techniques and strategies for preventing the use of physical restraint and seclusion by schools; practices that keep school personnel and students safe if physical restraint is necessary; positive behavioral interventions, supports, and strategies; behavioral antecedents, functional behavioral assessments, de-escalation of challenging behaviors, and conflict prevention and management; safe physical escort; and first aid, including the signs of medical distress, and cardiopulmonary resuscitation.
   DEFINITIONS. The bill defines “chemical restraint” to mean a drug or medication used on a student to control behavior or restrict freedom of movement that is not prescribed and administered by a licensed physician or a qualified health care professional prescriber for the standard treatment of a student’s medical or psychiatric condition; “mechanical restraint” to mean the use of devices as a means of restricting a student’s freedom of movement, but not devices used by trained school personnel or a student for therapeutic or safety purposes for which such devices were designed and, if applicable, prescribed.
   “Physical escort” means the temporary touching or holding of the hand, wrist, arm, shoulder, waist, hip, or back for the purpose of inducing a student to move to a safe location; “physical restraint” means a personal restriction that immobilizes or reduces the ability of an individual to move the individual’s arms, legs, body, or head freely, but does not include a physical escort, mechanical restraint, or chemical restraint; “positive behavioral interventions and supports” means a school-wide systematic approach to embed evidence-based practices and data-driven decision-making to improve school climate and culture in order to achieve improved academic and social outcomes, and increase learning for all students, and which encompasses a range of systemic and individualized positive strategies to reinforce desired behaviors, diminish reoccurrence of challenging behaviors, and teach appropriate behaviors to students; “seclude” or “seclusion” means the involuntary confinement of a student alone in a room or area from which the student is physically prevented from leaving, but does not include a time-out; and “time-out” means a behavior management technique that may involve the separation of a student from the group, in a nonlocked setting, for the purpose of calming, and may be written into an individualized education program.
   ACTIONS PROHIBITED —— EXCEPTIONS. Except in emergency situations, the bill prohibits a school employee, person under contract to provide services to the school, or volunteer from imposing on any student seclusion, mechanical restraint, chemical restraint, aversive behavioral interventions that compromise health or safety, physical restraint that is life-threatening or contraindicated based on the student’s documented disability, health care needs, or medical or psychiatric condition.
   Physical restraint, using only the amount of force necessary to protect the student or others from the threatened harm, may be implemented only if the student’s behavior poses immediate danger of serious physical harm to self or others, the physical restraint does not interfere with the student’s ability to communicate, less restrictive interventions have been ineffective, except in the case of a clearly unavoidable emergency circumstance, and the physical restraint is performed in a manner that is safe, appropriate, and proportionate to and sensitive to the student’s severity of behavior, chronological and developmental age, physical size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of physical or sexual abuse or other trauma.
   The use of physical restraint must immediately cease when a medical condition occurs putting the student at risk of harm, the student’s behavior no longer poses immediate danger of serious physical harm to the student or others, and less restrictive interventions would be effective in stopping such immediate danger of serious physical harm.
   Upon the initial implementation of physical restraint, school personnel must contact key identified employees for help from within the attendance center either immediately at the onset of an emergency situation or as soon as possible.
   Seclusion may be used in an emergency situation in which a student’s behavior poses immediate danger of serious physical harm to the student or others and restrictive interventions have proven ineffective in ceasing the immediate danger. However, the seclusion cannot interfere with the student’s ability to breathe or communicate, and a practitioner, paraeducator, or health professional must carefully, continuously, and visually monitor the student while the student is in seclusion.
   Emergency seclusion shall not be used longer than necessary, generally no longer than 15 minutes for an elementary school student or 20 minutes for a secondary school student. For longer periods, schools must provide for additional support, which may include a change of staff, or introducing a nurse, specialist, or additional key identified school employees, and documentation to explain the extension beyond the time limit.
   QUALIFICATIONS OF INDIVIDUALS IMPOSING PHYSICAL RESTRAINT OR SECLUSION. School personnel imposing physical restraint or seclusion must engage in continuous visual monitoring of the student and, except in the case of clearly unavoidable emergency circumstances when school personnel trained and certified are not immediately available, must be trained and certified in state physical restraint and seclusion policies and procedures. The school principal must identify at least one or more school employees who shall be trained and certified under a training program approved by the department.
   PROHIBITION ON THE USE OF PHYSICAL RESTRAINT OR SECLUSION AS PLANNED INTERVENTION. The use of physical restraint or seclusion as a planned intervention shall not be written into a student’s education plan or any other planning document for an individual student unless agreed upon in writing by school administrators, the parent or guardian of the student, and the individualized education team or other key identified school employees; the parties to the agreement considered less restrictive means to address behavioral concerns that would meet the emergency standard; and the individualized education team or other key identified school employees have conducted a research-based, individualized functional behavioral assessment and implemented a corresponding positive intervention plan that addresses preventative measures used to reduce or prevent emergencies and is written into the student’s individualized education program or other planning document prepared for the individual student.
   SCHOOL RESPONSIBILITIES. The board of directors of each school district and the authorities in charge of a nonpublic school are to establish policies and procedures that ensure school personnel and parents and guardians are aware of the state and local rules, guidance, or policies, as appropriate, regarding seclusion and restraint.
   School districts and nonpublic schools also must establish policies and procedures to be followed after each incident of physical restraint or seclusion, verbal or electronic notification of the parent or guardian on the same day as the incident, followed by written notification within 24 hours of the incident; procedures to ensure that parties to the incident participate in a debriefing session; and procedures for giving the student who was restrained or secluded the opportunity to discuss the event with a trusted adult who will communicate to the debriefing session group.
   The debriefing session shall occur as soon as practicable, but not later than five school days following the imposition of physical restraint or seclusion unless it is delayed by written mutual agreement.
   Adult witnesses who were not directly involved in the incident shall submit their observations in writing for the debriefing session. The debriefing session shall include identification of antecedents to the physical restraint or seclusion and consideration of relevant information in the student’s records; planning to prevent and reduce reoccurrence of the use of physical restraint or seclusion; a plan to have a functional behavioral assessment conducted, reviewed, or revised by qualified professionals, the parent or guardian, and the student; and, when a student attends a debriefing session, information communicated by the student may not be used against the student in any disciplinary, criminal, or civil investigation or proceeding.
   PROHIBITION AGAINST RETALIATION. School districts and nonpublic schools, and their employees, are prohibited from retaliating against any person for having reported or having provided information regarding a violation of the bill, or a violation of the rules adopted by the state board for the implementation of the bill.
   STATE MANDATE. The bill may include a state mandate as defined in Code section 25B.3. The bill requires that the state cost of any state mandate included in the bill be paid by a school district from state school foundation aid received by the school district under Code section 257.16. The specification is deemed to constitute state compliance with any state mandate funding-related requirements of Code section 25B.2. The inclusion of this specification is intended to reinstate the requirement of political subdivisions to comply with any state mandates included in the bill.