RESTRAINT REDUCTION INITIATIVES: CURRENT EVENTS AND COMING ATTRACTIONS

1
RESTRAINT REDUCTION INITIATIVES CURRENT EVENTS
AND COMING ATTRACTIONS

• Aaryce Hayes
• June 22, 2007

2
SB 325

• SB 325 by Sen. Judith Zaffirini, Rep. Elliott
  Naishtat, and Rep. Suzanna Hupp was passed by the
  Texas Legislature in the 79th session, 2005.
• SB 325 was a comprehensive piece of legislation
  related to the use of involuntary emergency
  interventions.

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Facilities and Programs Impacted by SB 325

• Child-care institutions, e.g. halfway houses,
  residential treatment centers, emergency
  shelters, and therapeutic camps
• ICFs
• Mental health facilities
• Chemical dependency treatment facilities
• Assisted living facilities
• Nursing homes,
• and Medicaid Waiver programs (HCS)

4
SB 325 Provisions

• HHSC agencies revised rules in accordance with SB
  325 mandates
• Rules must include
• Definitions in SB 325 for emergency and seclusion
• Prohibition on restraints that obstruct airways
  impair breathing interferes with a persons
  ability to communicate
• Restrictions on prone or supine holds
• Permit prone and supine holds only as
  transitional
• Define acceptable restraint holds
• Govern use of seclusion
• Develop practices to decrease the frequency of
  restraint and seclusion

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SB 325 PROVISIONS

• REQUIRED HHSC TO FACILIATATE A WORKGROUP TO
• Develop best practices
• Common data collection elements
• See HHSC report dated Nov /06 http//www.hhsc.sta
  te.tx.us/about_hhsc/reports/search/search_dateorde
  r.asp

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STATE HOSPITALS

• The State Hospitals developed a restraint
  reduction workgroup
• State hospitals researched and utilized tools to
  ascertain their
• readiness to change and share information about
  successes and barriers.

7
Hogg Training Institute 9/06

• The Hogg Foundation hosted a free two and-a-half
  day training institute in September, 2006 for
  organizations committed to preventing, reducing,
  and eliminating their use of seclusion and
  restraint.
• 330 participants representing twenty-nine private
  agencies, state agencies, and advocacy groups
  across Texas.
• Agencies sent leadership teams including their
  top administrative staff, e.g. Chief Executive
  Officers and Directors of Nursing, Quality
  Improvement Director.
• Ms. Kevin Ann Huckshorn, of the NASMHPD,
  National Coordinating Center to Reduce and
  Eliminate the Use of Seclusion and Restraint led
  the training institute using the curriculum
  "Creating Violence Free and Coercion Free Mental
  Health Treatment Environments for the Reduction
  of Seclusion and Restraint."

8
SR Reduction Leadership Group

• The Hogg Foundation for Mental Health
• convened a s-r reduction leadership group
  starting 2/9/07 to provide leadership that will
  sustain momentum in the field generated by recent
  activities around the state.
• The group includes consumers, family members,
  mental health advocates, representatives from
  state agencies, public and private providers of
  group homes for children, intermediate care
  facilities, psychiatric hospitals, juvenile
  justice facilities.

9
STATE INCENTIVE GRANTS

• HHSC applied for a State Incentive Grant for
  Texas to Build capacity for Alternatives to
  Restraint and Seclusion.
• It is likely the grant will address reduction of
  restraint and seclusion in three to four state
  hospitals.
• Technical assistance and training efforts are
  anticipated to benefit all settings and programs
  which use emergency interventions

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MORE SB 325 REVISIONS

• SB 325 mandates health and human service agencies
  revise regulations in accordance with the best
  practice recommendations developed by the
  workgroup.
• See the 3/07 HHSC report at http//www.hhsc.state
  .tx.us/about_hhsc/reports/search/search_dateorder.
  asp
• DSHS has scheduled a stakeholder meeting on the
  psychiatric hospital regulations, is June 26,
  2007 from 2-5pm in the auditorium of the Moreton
  Bldg, 1100 W 49th St. Austin, Tx. 78756.

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WHAT IF

• What if
• we developed a means of sharing difficult
  situations and behaviors with each other to
  assist each other in resolving the concerns and
  sharing our successes and challenges????