Section 299.670  Consequences for Rule Violation

a)         Violations of this Part or of Program or unit rules shall be addressed through:  specific, time-limited treatment (e.g., anger management); reassignment of management status; a progressive process of behavioral restrictions; or all three.  The Behavior Committee shall determine which consequences are most appropriate.

1)         Treatment recommendations for rule violation must be logically related to the rule violation (e.g., anger management for reactive, anger-based aggression), must be available, and must have a reasonable expectation of success.

2)         The Behavior Committee may reassign residents to a more secure management status whenever rule violations indicate that they cannot be effectively managed at their current management status.

3)         Although progressive in nature, more severe behavioral restrictions may be imposed upon the increased risk of harm or disruption of Program security.  Behavioral restrictions may be the restriction of a right for a set period of time, removal of a privilege that the resident has earned through good behavior, or a combination of the two.  When possible, the behavioral restrictions should be intrinsically related to the violation of the rules (e.g., a violation of smoking rules could result in a restriction of smoking privileges).

b)         Upon determination that a resident has violated this Part or a Program or unit rule, the Behavior Committee shall determine appropriate management status, determine appropriate treatment recommendations, impose behavioral restrictions, or any combination thereof.  The Committee shall also establish time limits on the management status or behavioral restriction or conditions that must be met before removal from a behavior management status or behavioral restriction.

c)         Progressive discipline for residents involves counseling, warnings, and then either summary or formal restrictions.  When the severity of the misconduct warrants immediate restrictions, staff may initiate behavioral restrictions subject to approval by the Behavior Committee.  Whenever staff has reason to believe that a resident has misbehaved, staff shall inform the resident of the rule violation, the rule(s) that were violated and the fact that it was determined that the resident violated the rule(s), and offer one of the following:

1)         For minor rule violation only, counseling and warning may occur if staff determines that the resident is unfamiliar with the rule(s) or that the resident's behavior was a technical violation of the rule(s), and if staff determines that the objective of the rule(s) would not be met by behavior restrictions.  Counseling and warning may occur only once per rule.  Counseling is to help the resident identify the rule violations, the consequences of the rule violation and appropriate alternative behaviors. Warnings are to help the resident identify and modify the rule violation to avoid behavioral restrictions.  Counseling and warning shall be documented in the resident's clinical record, as shall be the resident's response to the counseling and warning.

2)         A summary restriction may be offered by the staff and may be accepted or rejected by the resident.  Staff must discuss the rule violation and proposed summary with the shift supervisor before offering the summary restriction to the resident.  If the summary restriction is rejected, a formal behavioral restriction shall be implemented.  Because a summary restriction can be rejected by the resident, it is not reviewable.  Summary restrictions cannot last more than 30 days.  A summary restriction may be determined inappropriate when it has been previously applied and was ineffective in reducing rule violation or when the Behavior Committee has determined that summary restriction is clinically contraindicated.

3)         A formal behavioral restriction is imposed when a summary restriction is rejected or when the shift supervisor has determined that summary restrictions are not appropriate.  Upon being notified of the application of a formal behavioral restriction, the resident may request a review of the formal behavioral restriction by the treatment team and/or to present information to the treatment team regarding the violation of rule(s), including aggravating or mitigating circumstances.  Such request must be in writing and submitted within 24 hours after the notification of formal behavioral restriction.  The restriction remains in effect during the review period.  The treatment team shall schedule a review within three working days.  The resident may present written documentation and discuss circumstances.  The resident does not have a right to an advocate, to confront witnesses or to present witnesses.  If the treatment team determines the formal behavioral restrictions to be reasonable, it will remain in effect.  If the treatment team determines the formal behavioral restriction to be unreasonable it may be increased, reduced or lifted.