This chapter applies to the use of student behavior interventions by: Public agencies; The Residential Boarding Education Program for At-Risk Youth (SEED School); The Regional Institutes for Children and Adolescents, as defined by COMAR 10.21.06.02; and Nonpublic schools. Regulations .05—.07 of this chapter do not apply to the Juvenile Services Education Program. In this chapter, the following terms have the meanings indicated. Terms Defined. Behavior intervention plan. “Behavior intervention plan” means a proactive plan designed to address problem behavior exhibited by a student in the educational setting through the use of positive behavioral interventions, strategies, and supports. “Behavior intervention plan” includes: Clear and specifically defined targeted behaviors; Data on the targeted behaviors, as collected through a functional behavior assessment; Specific methods of data collection for progress monitoring; and A hierarchy of responses to address student behavior. “Business day” has the meaning stated in COMAR 13A.05.01.03. Communicate. “Communicate” means to convey information verbally or nonverbally. “Communicate” includes, but is not limited to: Speech; Gestures; Symbols; and American Sign Language. “Department” means the Maryland State Department of Education. Debrief. “Debrief” means an intentional process wherein a restraint or seclusion incident is reviewed by school personnel in order to prevent future incidents and improve responses to the student’s challenging behavior. “Debrief” includes: Review of the events leading up to the restraint or seclusion incident; Analysis of school personnel’s compliance with an existing behavior intervention plan, Section 504 plan, or IEP; and Consideration of new or additional behavioral strategies to address the behavior that led to the use of restraint or seclusion. “Exclusion” means the removal of a student to a supervised area for a limited period of time during which the student has an opportunity to regain self-control and is not receiving instruction including special education, related services, or support. Functional Behavior Assessment. “Functional behavior assessment” means the systematic process of gathering information to guide the development of an effective and efficient behavior intervention plan for the problem behavior. “Functional behavior assessment” includes the: Identification of the functions of the problem behavior for the student; Description of the problem behavior exhibited in the educational setting; and Identification of environmental and other factors and settings that contribute to or predict the occurrence, nonoccurrence, and maintenance of the behavior over time. “Health care practitioner” means: A physician licensed to practice under Health Occupations Article, Title 14, Annotated Code of Maryland; A psychologist licensed to practice under Health Occupations Article, Title 18, Annotated Code of Maryland; A clinical social worker licensed to practice under Health Occupations Article, Title 19, Annotated Code of Maryland; A registered nurse licensed to practice under Health Occupations Article, Title 8, Annotated Code of Maryland; or A clinical professional counselor licensed under Health Occupations Article, Title 17, Annotated Code of Maryland. “IEP” means an individualized education program as defined and developed in accordance with COMAR 13A.05.01.03. “IEP team” has the meaning stated in COMAR 13A.05.01.03. Mechanical Restraint. “Mechanical restraint” means the use of any device or equipment to restrict a student's freedom of movement. “Mechanical restraint” does not include devices implemented by trained school personnel, or used by a student, that have been prescribed by an appropriate medical or related services professional and are used for the specific and approved purposes for which such devices were designed, including: Adaptive devices or mechanical supports used to achieve proper body position, balance, or alignment to allow greater freedom of mobility than would be possible without the use of such devices or mechanical supports; Vehicle safety restraints when used as intended during the transport of a student in a moving vehicle; Restraints for medical immobilization; or Orthopedically prescribed devices that permit a student to participate in activities without risk of harm. “Nonpublic school” means a school that receives funds from the Department for the purpose of providing special education and related services to students with disabilities. “Parent” has the meaning stated in COMAR 13A.05.01.03. Physical Restraint. “Physical restraint” means a personal restriction that immobilizes a student or reduces the ability of a student to move their torso, arms, legs, or head freely. “Physical restraint” does not include: Briefly holding a student in order to calm or comfort the student; Holding a student’s hand or arm to escort the student safely from one area to another; Moving a disruptive student who is unwilling to leave the area when other methods such as counseling have been unsuccessful; or Breaking up a fight in the school building or on school grounds in accordance with Education Article §7-307, Annotated Code of Maryland. “Positive behavior interventions, strategies, and supports” means the school-wide and individual application of data-driven, trauma-informed actions, instruction, and assistance to promote positive social and emotional growth while preventing or reducing challenging behaviors in an effort to encourage educational and social emotional success. Protective or Stabilizing Device. “Protective or stabilizing device” means any device or material attached or adjacent to the student's body that restricts freedom of movement or normal access to any portion of the student's body for the purpose of enhancing functional skills, preventing self-injurious behavior, or ensuring safe positioning of a person. “Protective or stabilizing device” includes: Adaptive equipment prescribed by a health professional, if used for the purpose for which the device is intended by the manufacturer; Seat belts; or Other safety equipment to secure students during transportation in accordance with the public agency or nonpublic school transportation plan. “Public agency” means the Department, a local school system, the Maryland School for the Deaf, the Maryland School for the Blind, or the Juvenile Services Education Program. “Restraint” means the use of a physical or mechanical restraint. “School personnel” means an individual employed by a public agency or nonpublic school as defined in this chapter. Seclusion. “Seclusion” means the confinement of a student alone in a room, an enclosure, or any other space from which the student is physically prevented from leaving during school hours. “Seclusion” does not include a behavior intervention plan of separating a student by placing the student: Into a nonlocked room from which the student is allowed to leave; or Within a separate location in a classroom from which the student is not physically prevented from leaving. “Section 504 plan” means a plan developed to provide a qualified student with a disability a free appropriate public education consistent with Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794) and its implementing regulation, 34 C.F.R. §104.33. “Serious physical harm” has the same meaning as “serious bodily injury” as defined in 18 U.S.C. §1365(h)(3). “Student with a disability” has the meaning stated in COMAR 13A.05.01.03. “Trauma-informed intervention” means an approach to behavior intervention that is informed by the recognition that the experience of trauma, including the experience of violence, abuse, neglect, disaster, terrorism, and war, may have a significant impact on an individual’s physical and emotional health and ability to function. General. School personnel are encouraged to use an array of positive behavior interventions, strategies, and supports to increase or decrease targeted student behaviors. School personnel shall only use exclusion, restraint, or seclusion: After less restrictive or alternative approaches have been: Attempted; or Determined to be inappropriate; In a humane, safe, and effective manner; Without intent to harm or create undue discomfort; Consistent with known medical or psychological limitations and the student's behavioral intervention plan; and Consistent with an evidence-based, trauma-informed crisis prevention intervention program. School personnel conducting an escort shall use a natural position and safe manner. This chapter does not prohibit: School personnel from initiating appropriate student disciplinary actions pursuant to Education Article §7-305, Annotated Code of Maryland, COMAR 13A.08.01.11, and COMAR 13A.08.03; or Law enforcement, judicial authorities, or school security personnel from exercising their responsibilities, including the physical detainment of a student or other person alleged to have committed a crime or posing a security risk in accordance with relevant law, regulation, policy, or procedures. School personnel may use exclusion to address a student's behavior: If the student's behavior unreasonably interferes with the student's learning or the learning of others; If the student's behavior constitutes an emergency and exclusion is necessary to protect a student or other person from imminent, serious physical harm after other less intrusive, nonphysical interventions have failed or been determined inappropriate; If exclusion is requested by the student; or If supported by the student's behavior intervention plan. A setting used for exclusion shall: Provide school personnel with the ability to see the student at all times; Provide adequate lighting, ventilation, and furnishings; and Be unlocked and free of barriers to prevent egress. School personnel shall monitor a student placed in exclusion and provide a student in exclusion with: An explanation of the behavior that resulted in the removal; and Instructions on the behavior required to return to the learning environment. School personnel shall ensure that each period of exclusion: Is appropriate to the developmental level of the student and the severity of the behavior; Provides support to increase the student’s self-regulation in order to return to the instructional setting; and Does not exceed 30 minutes. Parents and school personnel may at any time request a meeting to address the use of exclusion and to: Conduct a functional behavioral assessment; and Develop, review, or revise a student's behavioral intervention plan, Section 504 plan, or IEP. School personnel shall consider the need to initiate a referral to a Section 504 or IEP team if a nondisabled student has experienced excessive exclusion, to determine if the student has a disability that may require the provision of accommodations, modifications, or special education and related services. School personnel shall ensure the implementation of appropriate procedures, in accordance with COMAR 13A.08.03, if a student with a disability has experienced an excessive period of exclusion that may result in a change of placement. Use of Restraint. Physical Restraint. The use of physical restraint is prohibited in public agencies and nonpublic schools unless: Physical restraint is necessary to protect the student or another individual from imminent, serious physical harm; and Other less intrusive, nonphysical interventions have failed or been demonstrated to be inappropriate for the student. Physical restraint shall only be implemented and monitored by school personnel who are trained in the appropriate use of physical restraint consistent with Regulation .06C of this chapter. In applying physical restraint, school personnel shall only use reasonable force as is necessary to protect a student or other person from imminent, serious physical harm. Physical restraint: Shall be removed as soon as the student no longer poses a threat of imminent, serious physical harm; and May not exceed 30 minutes. In applying physical restraint, school personnel may not: Place a student in a face down position; Place a student in any other position that will obstruct a student's airway or otherwise impair a student's ability to breathe, obstruct school personnel’s view of a student's face, restrict a student's ability to communicate distress, or place pressure on a student's head, neck, or torso; or Straddle a student's torso. Mechanical Restraint. The use of mechanical restraint is prohibited in public agencies and nonpublic schools unless a public agency or nonpublic school is accredited by and meets the requirements of the Joint Commission. Section A(2)(a) of this regulation does not prohibit school personnel from using a protective or stabilizing device: As prescribed by a health professional; or For a student with a disability, in accordance with the student's IEP or behavior intervention plan. Documentation of the Use of Restraint. Each time school personnel use restraint on a student, school personnel involved in the restraint shall debrief and document the incident using a form developed by the Department that includes: Other less intrusive, nonphysical interventions that have failed or been determined inappropriate; The precipitating event immediately preceding the behavior that prompted the use of restraint; The behavior that prompted the use of a restraint; The type of restraint; The length of time in restraint; The student’s behavior and reaction during the restraint; The names of the school personnel who observed the behavior that prompted the use of restraint; The names and signatures of the school personnel implementing and monitoring the use of restraint; and The name and signature of the administrator informed of the use of restraint. The debrief and documentation shall occur as soon as possible after the event. The documentation described in §A(3) of this regulation shall be maintained in the student's educational record and available for inspection by the student's parent or legal guardian in accordance with COMAR 13A.08.02. Each time restraint is used, parents shall be provided oral or written notification within 24 hours. Use of Seclusion. The use of seclusion is prohibited in public agencies. The use of seclusion is prohibited in nonpublic schools unless: Seclusion is necessary to protect the student or another individual from imminent, serious physical harm; Other, less intrusive interventions have failed or been demonstrated to be inappropriate for the student; A qualified health care practitioner is on-site and is directly observing the student during the seclusion; and The health care practitioner concludes that seclusion is not contraindicated for the physical, psychological, or psychosocial health of the student. Before a health care practitioner may use seclusion as a behavioral health intervention for a student in a nonpublic school, the health care practitioner shall: Receive training in all topics required under Regulation .06 of this chapter; and Be clinically familiar with the student. Seclusion Room. At a minimum, a room used for seclusion shall: Be free of objects and fixtures with which a student could self-inflict bodily harm; Provide school personnel an adequate view of the student from all angles; and Provide adequate lighting and ventilation. The door of a seclusion room shall not be fitted with a lock unless it releases automatically when not physically held in the locked position by school personnel on the outside of the door. School personnel shall: Remain in close proximity to the door of a seclusion room at all times; Actively observe a student placed in seclusion at all times; and Provide a student placed in seclusion with: An explanation of the behavior that resulted in the removal; and Instructions on the behavior required to return to the learning environment. Seclusion shall only be implemented and monitored by school personnel trained in the appropriate use of seclusion consistent with Regulation .06C of this chapter. A seclusion event: Shall be appropriate to the student's developmental level and severity of the behavior; May not restrict the student's ability to communicate distress; and May not exceed the shorter of: 30 minutes; or A point in time during which the student no longer poses a threat of imminent, serious physical harm. Documentation of Seclusion. Each time a student is placed in seclusion, school personnel involved in the seclusion incident shall debrief and document the incident using a form developed by the Department that includes: Other less intrusive interventions that have failed or been determined inappropriate; The precipitating event immediately preceding the behavior that prompted the use of seclusion; The behavior that prompted the use of seclusion; and The length of time in seclusion; The student's behavior and reaction during the seclusion; and The names and signatures of the school personnel implementing and monitoring the seclusion; and The name and signature of the administrator informed of the use of seclusion. The documentation described in §B(8) of this regulation shall be maintained in the student's educational record and available for inspection by the student's parent or legal guardian in accordance with COMAR 13A.08.02. Each time seclusion is used, school personnel shall provide the student's parent with verbal notification or send written notice within 24 hours. Referral to a Student Services, Section 504, or IEP Team. If restraint or seclusion is used for a student who has not been identified as a student with a disability, the student shall immediately be referred to the school's Student Support, Section 504, or IEP team. If restraint or seclusion is used for a student with a disability, and the student's Section 504 plan, IEP, or behavior intervention plan does not include the use of restraint or seclusion, the Section 504 or IEP team shall meet within 10 business days of the incident to consider: The need for a functional behavioral assessment; Developing appropriate behavioral interventions; Implementing a behavioral intervention plan; Training for school personnel; and Revisions to the Section 504 plan or IEP. If the behavior of a student with a Section 504 plan or IEP is adversely affected after the use of restraint or seclusion, the student’s 504 or IEP team shall convene a meeting on an expedited basis or at the earliest opportunity to discuss alternative behavioral health treatments. Student with an IEP. For a student who has an IEP and is placed in seclusion, the IEP team, in consultation with the health care practitioner who observed the seclusion, shall review the student's physical, psychological, and psychosocial health history to determine whether seclusion is contraindicated for the student. A determination under this paragraph shall be made: At each annual review of the student's IEP; and Within 10 days of a student's placement being changed. Physical restraint or seclusion may be included in a student’s behavioral intervention plan, Section 504 plan, or IEP to address the student’s behavior in an emergency situation, provided that school personnel: Determine restraint or seclusion has been used with the student; Review available data to identify any contraindications to the use of physical restraint or seclusion based on medical history or past trauma, including consultation with medical or mental health professionals as appropriate; Identify the less intrusive, nonphysical interventions that will be used to respond to the student’s behavior until physical restraint or seclusion is used in an emergency situation; and Obtain written consent from the parent, consistent with §C(9) of this regulation. If restraint or seclusion is used for a student with a disability, and the Section 504 plan, IEP, or behavior intervention plan includes the use of restraint or seclusion, the student's IEP or behavior intervention plan shall specify how often the Section 504 or IEP team shall meet to review or revise, as appropriate, the student's Section 504 plan, IEP, or behavior intervention plan. When a Section 504 or IEP team meets to review or revise a student's Section 504 plan, IEP, or behavior intervention plan, as specified in §C(4) of this regulation, the Section 504 or IEP team shall consider: Existing health, physical, psychological, and psychosocial information, including any contraindications to the use of restraint or seclusion based on medical history or past trauma; Information provided by the parent; Observations by teachers and related service providers; The student's current placement; and The frequency and duration of restraint or seclusion incidents and behavior events that occurred since the IEP team last met. The local school system or nonpublic school shall provide the parent of the student with written notice in accordance with COMAR 13A.05.01.12A when a Section 504 or IEP team proposes or refuses to initiate or change the student's Section 504 plan, IEP, or behavior intervention plan that includes the use of restraint or seclusion. Parental Consent. The Student Support, Section 504, or IEP team shall obtain the written consent of the parent if the team proposes to include restraint or seclusion in the behavior intervention plan, Section 504 plan, or IEP to address the student’s behavior. If the parent does not provide written consent, the team shall send the parent written notice within 5 business days of the team meeting that states: The parent has the right to either consent or refuse to consent to the use of restraint or seclusion; and If the parent does not provide written consent or a written refusal within 15 business days of the team meeting, the team may implement the proposed use of restraint or seclusion. Written Refusal. If the parent of a student with an IEP provides written refusal, the IEP team may use the dispute resolution options listed in Education Article, §8-413, Annotated Code of Maryland, to resolve the matter. If the parent of a student with a Section 504 plan or behavior intervention plan from a Student Services team provides written refusal, there is no right to the dispute resolution options listed in the Education Article, §8-413, Annotated Code of Maryland, to resolve the matter. Each public agency and nonpublic school shall develop policies and procedures to address: A continuum of positive behavioral interventions, strategies, and supports for use by school personnel before exclusion, restraint, or seclusion; The prevention of self-injurious behaviors; Methods for identifying and defusing potentially dangerous behavior; The use and documentation of exclusion consistent with Regulation .04 of this chapter; The use of restraint consistent with Regulation .05A of this chapter; The use of seclusion consistent with Regulation .05B of this chapter; and The notification, review, and recommendation requirements consistent with §§E and F of this regulation. Each public agency and nonpublic school shall annually review policies and procedures and provide them to school personnel and parents as described in COMAR 13A.08.01. Professional Development. Each public agency and nonpublic school shall provide professional development to school personnel designated by a school administrator to use restraint or seclusion on this chapter and the appropriate implementation of policies and procedures developed in accordance with §A of this regulation. At the beginning of each school year, each public agency and nonpublic school shall identify school personnel authorized to serve as a school-wide resource to assist in ensuring proper administration of exclusion, restraint, and seclusion. The school personnel described in §C(1) and §C(2) of this regulation shall receive training in current professionally accepted practices and standards regarding: Positive behavior interventions strategies and supports, including methods for identifying and defusing potentially dangerous behavior; Trauma-informed intervention; Functional behavior assessment and behavior intervention planning; Exclusion; Restraint and alternatives to restraint; Seclusion; Symptoms of physical distress and positional asphyxia; First aid and cardiopulmonary resuscitation (CPR); and Individualized behavior interventions based on student characteristics, including disability, medical history, and past trauma. The professional development described in §C(3) of this regulation shall include a written examination and physical demonstration of proficiency in the described skills and competencies. Monitoring and Compliance. Each public agency and nonpublic school shall develop policies and procedures on: Monitoring the use and documentation of exclusion, restraint, and seclusion; and Receiving and investigating complaints regarding exclusion, restraint, and seclusion practices. The Department may monitor and request any information regarding any matter related to exclusion, restraint, or seclusion implemented by a public agency or nonpublic school. The Department shall provide written notice of the requested information and specify the time and the manner in which the public agency or nonpublic school shall respond to the request. Notice of Student’s Tenth Incident of Physical Restraint or Seclusion. If a student enrolled in a public school is physically restrained ten times or more in a school year, the public school shall provide notice to the Department and the local school system at the earliest opportunity, but not longer than 4 business days after the student's tenth incident of physical restraint and every tenth incident thereafter. If a student placed in a nonpublic school by the local school system is physically restrained or placed in seclusion ten times or more in a school year, the nonpublic school shall provide notice to the Department and the local school system at the earliest opportunity, but not longer than 4 business days after the student's tenth incident of physical restraint or seclusion and every tenth incident thereafter. If a student enrolled in a public agency that is not a public school is physically restrained ten times or more in a school year, the public agency shall provide notice to the Department at the earliest opportunity, but not longer than 4 business days after the student's tenth incident of physical restraint and every tenth incident thereafter. Review, Assessment, and Recommendations. Within 10 business days from receipt of notice from a public school or nonpublic school under §E(1) and (2) of this regulation, the local school system shall: Review the student's case, including the circumstances of each incident of physical restraint or seclusion; Assess the public school’s or nonpublic school's pattern of behavioral health interventions to evaluate whether the public school or nonpublic school could use less restrictive behavioral health interventions; and Share the local school system's recommendations with the Department and the public school or nonpublic school. Within 10 business days from receipt of notice from a public agency under §E(3) of this regulation, the Department shall: Review the student's case, including the circumstances of each incident of physical restraint; Assess the public agency's pattern of behavioral health interventions to evaluate whether the public agency could use less restrictive behavioral health interventions; and Share the Department's recommendations with the public agency. Corrective Action. The Department shall require a public agency or nonpublic school to submit a corrective action plan, within a time period prescribed by the Department, if a public agency or nonpublic school: Fails to comply with any provision of this chapter; or Reports to the Department that a student has been physically restrained or placed in seclusion ten times or more in a school year. The Department may require different or additional student specific or systemic corrective action within a prescribed time period as determined appropriate by the Department. Restraint and Seclusion Data Reporting. On or before December 1 each year, each public agency and nonpublic school shall submit to the Department a report for the prior school year on: The number of physical restraint incidents, disaggregated by the student's jurisdiction, disability, race, gender, age, and type of placement; The number of physical restraint incidents for each student who had at least one physical restraint or seclusion incident, disaggregated by jurisdiction, disability, race, gender, age, and type of placement; For nonpublic schools, the number of seclusion incidents, disaggregated by the student's jurisdiction, disability, race, gender, and age; and For nonpublic schools, the number of seclusion incidents for each student who had at least one physical restraint or seclusion incident, disaggregated by jurisdiction, disability, race, gender, and age. To determine the number of incidents for the report required under §A(1) of this regulation: A seclusion incident shall be considered ended if at any point during the incident the student is no longer prevented from leaving or is removed from a room, an enclosure, or other space; and If, after a seclusion incident has ended in accordance with §A(2)(a) of this regulation, the public agency or nonpublic school determines that it is necessary to place the student in seclusion again, the subsequent confinement of the student in a room, enclosure, or other space shall be considered a separate incident. On or before December 1 each year, each nonpublic school shall: Personally observe and review seclusion rooms to ensure compliance with Regulation .05B(4) of this chapter; Review training plans for the use of seclusion with Regulation .06C of this chapter; and Report to the Department regarding findings made under §A(3)(a) and (b) of this regulation. The Department shall verify the accuracy of a report from any public agency or nonpublic school that reports no physical restraint or seclusion incidents under §A(1) of this regulation. If the Department is unable to verify the accuracy of a report submitted by a public agency or nonpublic school, the Department shall make recommendations for improvements in data collection and positive behavioral interventions at the public agency or nonpublic school. Positive Behavioral Interventions Data Reporting. On or before December 1 each year, each public agency and nonpublic school shall submit to the Department a report on steps taken to encourage positive behavioral interventions, including: The professional development provided to designated school personnel related to positive behavioral interventions, strategies, and supports and trauma-informed interventions for the prior school year; For nonpublic schools, the policy changes made to further reduce the use of seclusion incidents during the prior school year; and The policy changes or new professional development opportunities designed to further increase positive behavioral interventions and reduce physical restraint or seclusion incidents in the upcoming school year. Education Article, §§2-205, 7-301, 7-303—7-305, 7-307, 7-308, 7-1101—7-1104, and 8-405, Annotated Code of Maryland Effective date: June 23, 2003 (30:11 Md. R. 789) Regulation .01 amended effective November 13, 2023 (50:22 Md. R. 977) Regulation .02B amended effective May 7, 2007 (34:9 Md. R. 827); October 5, 2009 (36:20 Md. R. 1531); July 16, 2018 (45:14 Md. R. 697); November 13, 2023 (50:22 Md. R. 977) Regulation .03 amended effective November 13, 2023 (50:22 Md. R. 977) Regulation .04 amended effective November 13, 2023 (50:22 Md. R. 977) Regulation .04A, D amended effective October 5, 2009 (36:20 Md. R. 1531) Regulation .05 amended effective July 16, 2018 (45:14 Md. R. 697); November 13, 2023 (50:22 Md. R. 977) Regulation .05A, B amended effective October 5, 2009 (36:20 Md. R. 1531) Regulation .05C amended effective May 7, 2007 (34:9 Md. R. 827) Regulation .06 amended effective November 13, 2023 (50:22 Md. R. 977) Regulation .06C amended effective October 5, 2009 (36:20 Md. R. 1531); July 16, 2018 (45:14 Md. R. 697) Regulation .07 adopted effective November 13, 2023 (50:22 Md. R. 977)