1. (1) If a provider or the developmental center uses an intrusive behavior intervention, the intrusive behavior intervention shall be:

   1. (a) identified in the behavior support plan; and
   2. (b) used immediately after a person engages in an unwanted target behavior identified in the behavior support plan.

2. (2) An intrusive behavior intervention includes:

   1. (a) aversive stimulus;
   2. (b) contingent rights restriction;
   3. (c) deprivation;
   4. (d) emergency rights restriction;
   5. (e) enforced compliance;
   6. (f) manual restraint;
   7. (g) mechanical restraint;

   8. (h) physical guidance;

      1. (i) response-cost;
   9. (j) restitutional overcorrection;

   10. (k) satiation;

       1. (l) seclusion; and
   11. (m) seclusion room.

3. (3) To include an intrusive behavior intervention in the behavior support plan, a provider or the developmental center shall describe the:

   1. (a) method of intervention;
   2. (b) safety and efficacy monitoring procedure; and
   3. (c) time limitation or individualized release criteria.

4. (4) Individualized release criteria for manual restraint, mechanical restraint, seclusion, and seclusion room shall be based on:

   1. (a) a predetermined behavior that shall be achieved; or
   2. (b) a predetermined amount of time spent in restraint or seclusion.

5. (5) Aversive stimulus shall be free from any procedure or action that is degrading, humiliating, harsh, punitive, painful, or abusive. A provider and the developmental center may not use:

   1. (a) a device that transmits an electric shock to the person;
   2. (b) heat or cold exposure; or
   3. (c) any procedure or action likely to result in psychological or physical trauma.

6. (6) Except when approved by a provider administrator or a qualified behavior professional as described in Subsection (6)(a), use of a manual restraint, mechanical restraint, or seclusion may not exceed one hour.

   1. (a) If the predetermined behavior release criteria in the person's behavior support plan is not met within one hour of beginning the restraint or seclusion, one additional hour may be approved.
   2. (b) The team and the provider peer review committee shall review any use of restraint or seclusion that exceeds one hour.
   3. (c) Any time that the person spends asleep shall be counted toward the predetermined amount of time in the release criteria.
   4. (d) Total time spent in restraint or seclusion may not exceed two hours in a 24-hour period.

7. (7) Staff shall complete:

   1. (a) detailed documentation of each use of a manual restraint, mechanical restraint, or seclusion; and
   2. (b) any observation requirement included in the behavior support plan.

8. (8)(a) A provider or the developmental center shall submit each mechanical restraint, seclusion, or seclusion room included in the behavior support plan to the State Behavior Review Committee for review.

   1. (b) The State Behavior Review Committee must approve the intervention before it may be used.

9. (9) A manual restraint shall be used as described in Rule R501-1 and this section.

   1. (a) A manual restraint program or procedure may be used after approval by the State Behavior Review Committee and the Division Human Rights Council.

   2. (b) Intervention training programs currently approved by the State Behavior Review Committee include:

      1. (i) Crisis Prevention Intervention (CPI);
      2. (ii) Safety Care;
      3. (iii) Supports Options and Actions for Respect (SOAR)
      4. (iv) the Mandt System; and
      5. (v) the Professional Assault Response Training (PART).

10. (10) A provider shall only use a mechanical restraint as described in Subsections (10)(a) through (c).

    1. (a) A safety and efficacy monitoring procedure shall ensure a person's health and safety. Each procedure shall:

       1. (i) be individualized;
       2. (ii) include a method to monitor the person before, during, and after use of a mechanical restraint; and
       3. (iii) include observation and documentation of the person's status at a minimum of 15-minute intervals.
    2. (b) A mechanical restraint device includes a helmet, gloves, mitts, splints, and any wrist or ankle binding.

    3. (c) A mechanical restraint device does not include:

       1. (i) a device commonly used to ensure a person's safety, such as seatbelts or protective sporting equipment;
       2. (ii) medically necessary equipment related to a health condition used to promote healing or to prevent injury; and
       3. (iii) a protective helmet used to limit injury to a person during a seizure or for another medical reason.

11. (11) Seclusion shall be used as described in Rule R501-1 and this subsection.

    1. (a) A seclusion room may be used as follows:

       1. (i) A provider licensed through the Office of Licensing may use a seclusion room as described in Rule R501-1.
       2. (ii) A provider not licensed through the Office of Licensing and the developmental center may use a seclusion room as described in Rule R501-1 and use the seclusion room for an adult or child.
       3. (iii) The developmental center may not use a seclusion room as an emergency behavior intervention as described in 42 CFR 483.450(c)(1)(i), incorporated by reference in Rule R529-3.
    2. (b) To include seclusion or a seclusion room in a behavior support plan, a provider must describe the individualized release criteria for each intervention as described in Subsection (3).
    3. (c) Staff shall maintain constant visual and auditory observation of a person during each seclusion and use of a seclusion room.

12. (12) The division director must approve the use of a seclusion room before that intervention may be used.

    1. (a)(i) A provider or the developmental center shall request that the State Behavioral Review Committee review the use of a seclusion room in a behavior support plan.

       1. (ii) The behavior support plan shall include a procedure for ensuring:

          1. (A) the person's health and safety;
          2. (B) that staff maintain constant visual and auditory observation of the person;
          3. (C) observation and documentation of the person's status at a minimum of 15-minute intervals; and
          4. (D) that staff open the door if the person falls asleep before release from the seclusion room.

    2. (b) The State Behavior Review Committee may recommend that a behavior support plan include that a provider be allowed to shut a door or hold a door shut during use of the seclusion room.

       1. (i) The recommendation shall be based upon adequate justification and documentation.
       2. (ii) The use of a seclusion room as a behavior intervention shall help the person be more safely served within the division support system.
    3. (c) The State Behavioral Review Committee shall send a behavior support plan and committee recommendation to the Division Human Rights Council for review.
    4. (d) The division director may approve use of a seclusion room on a case-by-case basis after reviewing the recommendation of the State Behavioral Review Committee and Division Human Rights Council.

KEY: people with disabilities, behavior

Date of Last Change: July 23, 2025

Notice of Continuation: June 24, 2024

Authorizing, and Implemented or Interpreted Law: 26B-6-403