(a) A facility must conduct a debriefing as quickly as possible but no later than 24 hours following every incident involving the use of physical restraint.
(b) Attendees of the debriefing shall include, at minimum:
(1) The consumer who was physically restrained, unless the consumer voluntarily declines;
(2) The authorized consumer representative, if applicable;
(3) The staff involved in the incident;
(4) An administrator or their designee; and
(5) The facility's Qualified Behavior Modification Professional.
(c) The debriefing may also include individuals requested by the consumer. Those individuals shall be invited to the debriefing but are not required to attend the debriefing.
(d) The debriefing may also include the clients' rights advocate and a regional center representative with approval from the consumer. Those individuals shall be invited to the debriefing but are not required to attend the debriefing.
(e) The debriefing shall include:
(1) Assisting the consumer with identifying the precipitant of the incident and suggesting methods of more safely and constructively responding to the incident, unless the consumer voluntarily declines;
(2) Assisting the staff in understanding the precipitants to the incident and developing alternative methods of helping the consumer avoid or cope with those incidents;
(3) Identifying what led to the incident and what factors contributed to the incident leading to the use of physical restraint;
(4) Assessing alternative methods of responding to the incident that may have avoided the use of physical restraint;
(5) Evaluating whether staff used emergency interventions consistent with the facility Emergency Intervention Plan, the Individual Behavior Supports Plan, Individualized Emergency Intervention Plan, and staff training;
(6) Devising treatment interventions to address the root cause of the incident, its consequences, and modifying the Individual Behavior Supports Plan and/or the Individualized Emergency Intervention Plan accordingly;
(7) Evaluating whether the consumer was in physical restraint for the least amount of time necessary;
(8) Evaluating the effectiveness of less restrictive de-escalation strategies that were attempted and if they were not effective or were counterproductive, that they are discontinued;
(9) Determining whether the consumer's physical and psychological well-being and right to privacy were addressed appropriately;
(10) Considering treatment for any trauma that may have been experienced by the consumer as a result of the incident;
(11) Identifying alternative ways of helping the consumer avoid or cope with difficult situations such as those that led to the use of physical restraint; and
(12) Identifying the need to do a new Functional Behavior Assessment, revise or refine the Individual Behavior Supports Plan and Individualized Emergency Intervention Plan, retrain staff, and/or investigate risk factors.
(f) Documentation of the debriefing meeting must include:
(1) Findings from the activities in Subsections (e)(1)-(12);
(2) Any revisions needed to the Individual Behavior Supports Plan and Individualized Emergency Intervention Plan to better serve the consumer;
(3) The consumer's refusal to participate in the debriefing activities, if applicable;
(4) The physical and psychological well-being of any person who observed the physical restraint, with the consent of the person or person's authorized representative, if the person is incapacitated; and
(5) Evidence that less restrictive, nonphysical strategies or interventions were attempted first and without success.
(g) If the consumer who was physically restrained voluntarily declines to participate in the debriefing meeting as described in Subsections (a)-(e), the administrator shall offer the consumer a subsequent meeting with the team described in Subsection (b) within 72 hours of the physical restraint. During this meeting:
(1) The team must conduct the activity described in Subsection (e)(1); and,
(2) Review with the consumer the debriefing information required by Subsections (e)(2)-(12).
(h) Documentation of the subsequent meeting must include:
(1) The date(s) the meeting was offered if the consumer voluntarily declines to participate in the meeting;
(2) The date and time the meeting occurred;
(3) Participants involved;
(4) Findings from the activities in Subsection (e)(1); and
(5) Any consumer input on activities in Subsections (e)(2)-(12).
(i) If physical restraint is used on more than three (3) occasions within a three-month period and/or the recurrence of the consumer's dangerous behavior can be anticipated, the Individual Behavior Supports Team shall meet and discuss the consumer's Individual Behavior Supports Plan, ongoing support and transition needs, and alternatives to physical restraint. The Individual Behavior Supports Plan must be updated with any revisions as specified in Subsections (e) and (g) within five (5) business days.
Credits
Note: Authority cited: Sections 4698 and 4698.1, Welfare and Institutions Code. Reference: Sections 4698 and 4698.1, Welfare and Institutions Code; and Section 1180.4, Health and Safety Code.
History
1. New section filed 6-25-2021 as a deemed emergency; operative 6-25-2021 (Register 2021, No. 26). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
2. New section refiled 4-25-2022 as a deemed emergency; operative 4-25-2022 (Register 2022, No. 17). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
3. New section refiled 7-25-2022 as a deemed emergency; operative 7-25-2022 (Register 2022, No. 30). Pursuant to Welfare and Institutions Code section 4698.1(b), a Certificate of Compliance must be transmitted to OAL by 6-25-2023 or emergency language will be repealed by operation of law on the following day.
4. Updating certificate of compliance information in History 1, 2 and 3.
5. Certificate of Compliance as to 7-25-2022 order, including amendment of section, transmitted to OAL 5-30-2023 and filed 7-12-2023; amendments effective 7-12-2023 pursuant to Government Code section 11343.4(b)(3) (Register 2023, No. 28).
This database is current through 5/17/24 Register 2024, No. 20.
