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Federal Health Agency Must Do More on Restraints, Seclusion

The federal government needs to do more about the use of restraints and seclusion in schools, the Interagency Autism Coordinating Committee said in a letter to U.S. Health and Human Services Secretary Kathleen Sebelius this week.

Children and adults, in particular those with disabilities, are sometimes isolated or restrained by another person or with tape, rope, or other devices with the intention of keeping them from hurting themselves or someone else. The committee said these practices affect those with autism spectrum disorders in particular.

A hat tip to Disability Scoop for cluing me into the committee's letter.

In particular, the committee said, two sections of the Children's Health Act of 2000 support regulation of restraint and seclusion at psychiatric residential treatment facilities, but Ms. Sebelius' agency has only published an interim final rule on the subject. The law also gives her agency power to regulate the use of restraint and seclusion with children who are at "non-medical, community-based facilities" and the committee wants her to start work on a rule addressing their use at those places, too.

This doesn't cover schools, however. And right now, only some individual states and school districts regulate restraint and seclusion at schools and other facilities. To that end, the committee also supports federal legislation regulating these practices.

The letter goes on to say that HHS should explore whether the Affordable Care Act, "which addresses the removal of barriers to providing home and community-based services," is another route to developing consistent policies about the use of restraints and seclusion.

It was at one of the committee's meetings earlier this year that the U.S. Department of Education said it would issue guidance on restraints and seclusion. It was due to be unveiled this fall.

And for the first time, the Education Department's Office of Civil Rights data collection, results of which should also be out later this year, will include information about restraints and seclusion. This could be incredibly valuable information. Even a Government Accountability Office report on the topic was a collection of anecdotes. Media accounts often only relate incidents that result in death or severe injury.

The committee wants Health and Human Services to convene a national interagency conference or summit on seclusion and restraint, collaborating with the departments of education and justice, to highlight alternatives and best practices.

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