(a) Prohibition. Except as provided by this subchapter, the use of restraint or seclusion is prohibited.
(b) Use of personal or mechanical restraint or seclusion. The use of personal or mechanical restraint or seclusion is permissible on the facility's premises, and personal or mechanical restraint is permissible for transportation of an individual only if implemented:
  (1) in accordance with this subchapter;
  (2) when less restrictive interventions (such as those listed in the safety plan if there is one) are determined ineffective to protect other individuals, the individual, staff members, or others from harm;
  (3) in accordance with, and using only those safe and appropriate techniques as determined by the facility's written policies or procedures and training program as specified in subsection (e) of this section;
  (4) by staff members who have been trained in accordance with the applicable requirements specified in §415.257 of this title (relating to Staff Member Training);
  (5) in connection with the applicable evaluation and monitoring requirements specified in §415.266 of this title (relating to Observation, Monitoring, and Care of the Individual in Restraint or Seclusion Initiated in Response to a Behavioral Emergency);
  (6) in accordance with the applicable initiation and physician order requirements specified in §415.260 of this title (relating to Initiation of Restraint or Seclusion in a Behavioral Emergency);
  (7) in accordance with any alternative strategies and special considerations documented in the treatment plan pursuant to §415.259(c) of this title (relating to Special Considerations, Responsibilities, and Alternative Strategies);
  (8) when the type or technique of restraint or seclusion used is the least restrictive intervention that will be effective to protect the other individuals, the individual, staff members, or others from harm; and
  (9) is discontinued at the earliest possible time, regardless of the length of time identified in a physician's order.
(c) Facility requirements. A facility's use of restraint and seclusion is prohibited unless:
  (1) the facility adopts, implements, and enforces written policies and procedures, in accordance with this subchapter, governing the use of restraint and seclusion;
  (2) the facility adopts, implements, and enforces a staff member training program that meets the requirements of §415.257 of this title; and
  (3) staff members of the facility are trained and have demonstrated competence in the use of restraint and seclusion in accordance with the facility's written policies and procedures and training program before assuming direct care duties and before performing restraint and seclusion on the individual.
(d) Policy notification. Upon admission of an individual, or as soon as possible thereafter, the facility shall notify each individual and each individual's legally authorized representative (LAR), if any, of the facility's policies related to the use of restraint and seclusion. The policy notification may be a summary of the facility's policy. If an LAR cannot be notified, the facility shall document the reason in the individual's medical record.
(e) This subchapter represents minimum standards. The facility may, through its written policies and procedures, adopt more stringent standards that are consistent with this subchapter and do not conflict with:
  (1) DSHS rules;
  (2) state or federal laws; and
  (3) applicable accreditation standards.

Source Note: The provisions of this §415.254 adopted to be effective July 22, 2014, 39 TexReg 5581