CHAPTER 322. USE OF RESTRAINT AND SECLUSION IN CERTAIN HEALTH CARE FACILITIES

HEALTH AND SAFETY CODE

TITLE 4. HEALTH FACILITIES

SUBTITLE G. PROVISION OF SERVICES IN CERTAIN FACILITIES

CHAPTER 322. USE OF RESTRAINT AND SECLUSION IN CERTAIN

HEALTH CARE FACILITIES

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 322.001. DEFINITIONS. In this chapter:

(1) "Facility" means:

(A) a child-care institution, as defined by Section 42.002,

Human Resources Code, including a state-operated facility, that

is a residential treatment center or a child-care institution

serving children with mental retardation;

(B) an intermediate care facility licensed by the Department of

Aging and Disability Services under Chapter 252 or operated by

that department and exempt under Section 252.003 from the

licensing requirements of that chapter;

(C) a mental hospital or mental health facility, as defined by

Section 571.003;

(D) an institution, as defined by Section 242.002;

(E) an assisted living facility, as defined by Section 247.002;

or

(F) a treatment facility, as defined by Section 464.001.

(2) "Health and human services agency" means an agency listed in

Section 531.001, Government Code.

(3) "Seclusion" means the involuntary separation of a resident

from other residents and the placement of the resident alone in

an area from which the resident is prevented from leaving.

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.

SUBCHAPTER B. RESTRAINTS AND SECLUSION

Sec. 322.051. CERTAIN RESTRAINTS PROHIBITED. (a) A person may

not administer to a resident of a facility a restraint that:

(1) obstructs the resident's airway, including a procedure that

places anything in, on, or over the resident's mouth or nose;

(2) impairs the resident's breathing by putting pressure on the

torso; or

(3) interferes with the resident's ability to communicate.

(b) A person may use a prone or supine hold on the resident of a

facility only if the person:

(1) limits the hold to no longer than the period specified by

rules adopted under Section 322.052;

(2) uses the hold only as a last resort when other less

restrictive interventions have proven to be ineffective; and

(3) uses the hold only when an observer, who is trained to

identify the risks associated with positional, compression, or

restraint asphyxiation and with prone and supine holds and who is

not involved in the restraint, is ensuring the resident's

breathing is not impaired.

(c) Small residential facilities and small residential service

providers are exempt from Subsection (b)(3).

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.

Sec. 322.052. ADOPTION OF RESTRAINT AND SECLUSION PROCEDURES.

(a) For each health and human services agency that regulates the

care or treatment of a resident at a facility, the executive

commissioner of the Health and Human Services Commission shall

adopt rules to:

(1) define acceptable restraint holds that minimize the risk of

harm to a facility resident in accordance with this subchapter;

(2) govern the use of seclusion of facility residents; and

(3) develop practices to decrease the frequency of the use of

restraint and seclusion.

(b) The rules must permit prone and supine holds only as

transitional holds for use on a resident of a facility.

(c) A facility may adopt procedures for the facility's use of

restraint and seclusion on a resident that regulate, more

restrictively than is required by a rule of the regulating health

and human services agency, the use of restraint and seclusion.

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.

Sec. 322.053. NOTIFICATION. The executive commissioner of the

Health and Human Services Commission by rule shall ensure that

each resident at a facility regulated by a health and human

services agency and the resident's legally authorized

representative are notified of the rules and policies related to

restraints and seclusion.

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.

Sec. 322.054. RETALIATION PROHIBITED. (a) A facility may not

discharge or otherwise retaliate against:

(1) an employee, client, resident, or other person because the

employee, client, resident, or other person files a complaint,

presents a grievance, or otherwise provides in good faith

information relating to the misuse of restraint or seclusion at

the facility; or

(2) a client or resident of the facility because someone on

behalf of the client or resident files a complaint, presents a

grievance, or otherwise provides in good faith information

relating to the misuse of restraint or seclusion at the facility.

(b) A health and human services agency that registers or

otherwise licenses or certifies a facility may:

(1) revoke, suspend, or refuse to renew the license,

registration, or certification of a facility that violates

Subsection (a); or

(2) place on probation a facility that violates Subsection (a).

(c) A health and human services agency that regulates a facility

and that is authorized to impose an administrative penalty

against the facility under other law may impose an administrative

penalty against the facility for violating Subsection (a). Each

day a violation continues or occurs is a separate violation for

purposes of imposing a penalty. The amount of the penalty may

not exceed the maximum amount that the agency may impose against

the facility under the other law. The agency must follow the

procedures it would follow in imposing an administrative penalty

against the facility under the other law.

(d) A facility may contest and appeal the imposition of an

administrative penalty under Subsection (c) by following the same

procedures the facility would follow in contesting or appealing

an administrative penalty imposed against the facility by the

agency under the other law.

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.

Sec. 322.055. MEDICAID WAIVER PROGRAM. A Medicaid waiver

program provider, when providing supervised living or residential

support, shall comply with this chapter and rules adopted under

this chapter.

Added by Acts 2005, 79th Leg., Ch.

698, Sec. 1, eff. September 1, 2005.