6VAC35-101-1070. Behavior management.
A. A behavior management program shall be implemented. Behavior management shall mean those principles and methods employed to help a resident achieve positive behavior and to address and correct a resident's inappropriate behavior in a constructive and safe manner in accordance with written procedures governing program expectations and the residents' and employees' safety and security.
B. Written procedures governing this program shall provide the following:
1. A listing of the rules of conduct and behavioral expectations for the resident;
2. Orientation of residents as required by 6VAC35-101-800 (admission and orientation);
3. The definition and listing of a system of privileges and sanctions that is used and available for use. Sanctions (i) shall be listed in the order of their relative degree of restrictiveness; (ii) may include a "cooling off" period where a resident is placed in a room for no more than 60 minutes; and (iii) shall contain alternatives to room confinement;
4. The specification of the staff members who may authorize the use of each privilege and sanction;
5. Documentation requirements when privileges are applied and sanctions are imposed;
6. The specification of the processes for implementing such procedures; and
7. Means of documenting and monitoring of the program's implementation including, but not limited to, an on-going administrative review of the implementation to ensure conformity with the procedures.
C. When substantive revisions are made to the behavior management program, written information concerning the revisions shall be provided to the residents, and direct care staff shall be oriented on the changes prior to implementation.
D. The facility administrator shall review the detention center's behavior intervention techniques and procedures at least annually to determine appropriateness for the population served.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1080. Disciplinary process.
A. Procedures. Written procedures shall govern the disciplinary process that shall contain the following:
1. Graduated sanctions and progressive discipline;
2. Training on the disciplinary process and rules of conduct; and
3. Documentation on the administration of privileges and sanctions as provided in the behavior management program.
B. Disciplinary report. A disciplinary report shall be completed when it is alleged that a resident has violated a rule of conduct for which room confinement, including a bedtime earlier than that provided on the daily schedule, may be imposed as a sanction.
1. All disciplinary reports shall contain the following:
a. A description of the alleged rule violation, including the date, time, and location;
b. A listing of any staff present at the time of the alleged rule violation;
c. The signature of the resident and the staff who completed the report; and
d. The sanctions, if any, imposed.
2. A disciplinary report shall not be required when a resident is placed in his room for a "cooling off" period, in accordance with written procedures, that does not exceed 60 minutes.
C. Review of rule violation. A review of the disciplinary report shall be conducted by an impartial person. After the resident receives notification of the alleged rule violation, the resident shall be provided with the opportunity to admit or deny the charge.
1. The resident may admit the charge, in writing, and accept the sanction (i) prescribed for the offense or (ii) as amended by the impartial person.
2. The resident may deny the charge and the impartial person shall:
a. Meet in person with the resident;
b. Review the allegation with the resident;
c. Provide the resident with the opportunity to present evidence, including witnesses;
d. Provide, upon the request of the resident, for an impartial staff member to assist the resident in the conduct of the review;
e. Render a decision and inform the resident of the decision and rationale supporting this decision;
f. Complete the review within 12 hours of the time of the alleged rule violation, including weekends and holidays, unless the time frame ends during the resident's scheduled sleeping hours. In such circumstances, the delay shall be documented and the review shall be conducted within the same time frame thereafter;
g. Document the review, including any statement of the resident, evidence, witness testimony, the decision, and the rationale for the decision; and
h. Advise the resident of the right to appeal the decision.
D. Appeal. The resident shall have the right to appeal the decision of the impartial person.
1. The resident's claim shall be reviewed by the facility administrator or designee and shall be decided within 24 hours of the alleged rule violation, including weekends and holidays, unless the time frame ends during the resident's scheduled sleeping hours. In such circumstances, the delay shall be documented and the review shall be conducted within the same time frame thereafter. The review by the facility administrator may be conducted via electronic means.
2. The resident shall be notified in writing of the results immediately thereafter.
E. Report retention. If the resident is found guilty of the rule violation, a copy of the disciplinary report shall be placed in the case record. If a resident is found not guilty of the alleged rule violation, the disciplinary report shall be removed from the resident's case record and shall be maintained as required by 6VAC35-101-330 (maintenance of residents' records).
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1090. Physical restraint.
A. Physical restraint shall be used as a last resort only after less restrictive interventions have failed or to control residents whose behavior poses a risk to the safety of the resident, others, or the public.
1. Staff shall use the least force deemed reasonable to be necessary to eliminate the risk or to maintain security and order and shall never use physical restraint as punishment or with the intent to inflict injury.
2. Staff may physically restrain a resident only after less restrictive behavior interventions have failed or when failure to restrain would result in harm to the resident or others.
3. Physical restraint may be implemented, monitored, and discontinued only by staff who have been trained in the proper and safe use of restraint.
4. For the purpose of this section, physical restraint shall mean the application of behavior intervention techniques involving a physical intervention to prevent an individual from moving all or part of that individual's body.
B. Written procedures shall govern the use of physical restraint and shall include:
1. The staff position who will write the report and time frame;
2. The staff position who will review the report and time frame;
3. Methods to be followed should physical restraint, less intrusive interventions, or measures permitted by other applicable state regulations prove unsuccessful in calming and moderating the resident's behavior; and
4. An administrative review of the use of physical restraints to ensure conformity with the procedures.
C. Each application of physical restraint shall be fully documented in the resident's record including:
1. Date and time of the incident;
2. Staff involved;
3. Justification for the restraint;
4. Less restrictive behavior interventions that were unsuccessfully attempted prior to using physical restraint;
5. Duration;
6. Description of method or methods of physical restraint techniques used;
7. Signature of the person completing the report and date; and
8. Reviewer's signature and date.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1100. Room confinement and isolation.
A. Written procedures shall govern how and when residents may be confined to a locked room for both segregation and isolation purposes.
B. Whenever a resident is confined to a locked room, including but not limited to being placed in isolation, staff shall check the resident visually at least every 30 minutes and more often if indicated by the circumstances. Staff shall conduct a check at least every 15 minutes in accordance with approved procedures when the resident is on suicide watch.
C. Residents who are confined to a room, including but not limited to being placed in isolation, shall be afforded the opportunity for at least one hour of physical exercise, outside of the locked room, every calendar day unless the resident's behavior or other circumstances justify an exception. The reasons for any such exception shall be documented.
D. If a resident is confined to his room for any reason for more than 24 hours, the facility administrator or designee shall be notified.
E. If the confinement extends to more than 72 hours, the (i) confinement and (ii) steps being taken or planned to resolve the situation shall be immediately reported to the director or designee. If this report is made verbally, it shall be followed immediately with a written, faxed, or secure email report in accordance with written procedures.
F. Room confinement, including isolation or administrative confinement, shall not exceed five consecutive days except when ordered by a medical provider.
G. When confined to a room, the resident shall have a means of communication with staff, either verbally or electronically.
H. The facility administrator or designee shall make personal contact with each resident who is confined to a locked room, including being placed in isolation, each day of confinement.
I. During isolation, the resident is not permitted to participate in activities with other residents and all activities are restricted, with the exception of (i) eating, (ii) sleeping, (iii) personal hygiene, (iv) reading, and (v) writing.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1110. Administrative confinement.
A. Residents shall be placed in administrative confinement only by the facility administrator or designee, as a last resort for the safety of the residents. The reason for such placement shall be documented in the resident's case record.
B. Residents who are placed in administrative confinement shall be housed no more than two to a room. Single occupancy rooms shall be available when indicated for residents with severe medical disabilities, residents suffering from serious mental illness, sexual predators, residents who are likely to be exploited or victimized by others, and residents who have other special needs for single housing.
C. Residents who are placed in administrative confinement shall be afforded basic living conditions approximating those available to the facility's general population and, as provided for in approved procedures, shall be afforded privileges similar to those of the general population. Exceptions may be made in accordance with established procedures when justified by clear and substantiated evidence. If residents who are placed in administrative confinement are confined to a room or placed in isolation, the provisions of 6VAC35-101-1100 (room confinement and isolation) and 6VAC35-1140 (monitoring restrained residents) apply, as applicable.
D. Administrative confinement means the placement of a resident in a special housing unit or designated individual cell that is reserved for special management of residents for purposes of protective custody or the special management of residents whose behavior presents a serious threat to the safety and security of the facility, staff, general population, or themselves. For the purpose of this section, protective custody shall mean the separation of a resident from the general population for protection from or for other residents for reasons of health or safety.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1120. Chemical agents.
Staff are prohibited from using pepper spray and other chemical agents to manage resident behavior or maintain institutional security.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1130. Mechanical restraints.
A. Written procedure shall govern the use of mechanical restraints. Such procedures shall be approved by the department and shall specify:
1. The conditions under which handcuffs, waist chains, leg irons, disposable plastic cuffs, leather restraints, and a mobile restraint chair may be used;
2. That the facility administrator or designee shall be notified immediately upon using restraints in an emergency situation;
3. That restraints shall never be applied as punishment or a sanction;
4. That residents shall not be restrained to a fixed object or restrained in an unnatural position;
5. That each use of mechanical restraints, except when used to transport a resident or during video court hearing proceedings, shall be recorded in the resident's case file or in a central log book; and
6. That a written record of routine and emergency distribution of restraint equipment be maintained.
B. Written procedure shall provide that (i) all staff who are authorized to use restraints shall receive training in such use, including how to check the resident's circulation and how to check for injuries and (ii) only trained staff shall use restraints.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1140. Monitoring restrained residents.
A. Written procedure shall provide that when a resident is placed in restraints, staff shall:
1. Provide for the resident's reasonable comfort and ensure the resident's access to water, meals, and toilet; and
2. Make a direct personal check on the resident at least every 15 minutes and more often if the resident's behavior warrants, such checks shall include monitoring the resident's circulation in accordance with the procedure provided for in 6VAC35-101-1130 B.
B. When a resident is placed in mechanical restraints for more than two hours cumulatively in a 24-hour period, with the exception of use in routine transportation of residents, staff shall immediately consult with a health care provider and a mental health professional. This consultation shall be documented.
C. If the resident, after being placed in mechanical restraints, exhibits self-injurious behavior, (i) staff shall immediately consult with and document that they have consulted with a mental health professional and (ii) the resident shall be monitored in accordance with established protocols, including constant supervision, if appropriate. Any such protocols shall be in compliance with the procedures required by 6VAC35-101-1150 (restraints for medical and mental health purposes).
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.
6VAC35-101-1150. Restraints for medical and mental health purposes.
Written procedure shall govern the use of restraints for medical and mental health purposes. Written procedure shall identify the authorization needed; when, where, and how restraints may be used; for how long; and what type of restraint may be used.
Statutory Authority
§§ 16.1-309.9, 16.1-322.7, and 66-10 of the Code of Virginia.
Historical Notes
Derived from Virginia Register Volume 29, Issue 25, eff. January 1, 2014.