10A ncac 28D .0209      TRAINING: EMPHASIS ON ALTERNATIVES TO RESTRICTIVE INTERVENTIONS

(a)  Facilities shall implement policies and practices that emphasize the use of alternatives to seclusion, physical restraint and isolation time-out.

(b)  Prior to providing services to people with disabilities, staff including service providers, employees, students or volunteers, shall demonstrate competence by successfully completing training in communication skills and other strategies for creating an environment in which the likelihood of imminent danger of abuse or injury to a person with disabilities or others, or to property is prevented.

(c)  Provider agencies shall establish training based on state competencies, monitor for internal compliance and demonstrate they acted on data gathered.

(d)  The training shall be competency based, include measurable learning objectives, measurable testing (written and by observation of behavior) on those objectives and measurable methods to determine passing or failing the course.

(e)  Formal refresher training shall be completed at least annually by each service provider.

(f)  Content of the training that the service provider plans to use shall be approved by the Division of MH/DD/SAS pursuant to Paragraph (g) of this Rule.

(g)  Staff shall demonstrate competence in the following core areas:

(1)           knowledge and understanding of the people being served;

(2)           recognizing and interpreting human behavior;

(3)           recognizing the effect of internal and external stressors that may affect people with disabilities;

(4)           strategies for building positive relationships with people with disabilities;

(5)           recognizing cultural, environmental and organizational factors that may affect people with disabilities;

(6)           recognizing the importance, and assisting people with disabilities in making decisions about their life;

(7)           skills in assessing individual risk for escalating behavior;

(8)           communication strategies for defusing and de-escalating potentially dangerous behavior; and

(9)           positive behavioral supports (providing means for people with disabilities to choose activities which directly oppose or replace behaviors which are unsafe).

(h)  Service providers shall maintain documentation of initial and refresher training for at least three years.

(1)           Documentation shall include:

(A)          who participated in the training and the outcomes (pass/fail);

(B)          when and where they attended; and

(C)          instructor's name.

(2)           The Division of MH/DD/SAS may request and review this documentation at any time.

(i)  Instructor Qualifications and Training Requirements:

(1)           Trainers shall demonstrate competence by scoring 100% on testing in a training program aimed at preventing, reducing and eliminating the need for seclusion, physical restraint and isolation time-out.

(2)           Trainers shall demonstrate competence by scoring a passing grade on testing in an instructor training program.

(3)           The training shall be competency-based, include measurable learning objectives, measurable testing (written and by observation of behavior) on those objectives and measurable methods to determine passing or failing the course.

(4)           The content of the instructor training the service provider plans to employ shall be approved by the Division of MH/DD/SAS pursuant to Subparagraph (i)(5) of this Rule.

(5)           Acceptable instructor training programs shall include but not be limited to presentation of:

(A)          understanding the adult learner;

(B)          methods for teaching content of the course;

(C)          methods for evaluating trainee performance; and

(D)          documentation procedures.

(6)           Trainers shall have coached experience teaching a training program aimed at preventing, reducing and eliminating the need for physical restraint, seclusion and isolation time-out at least one time, with a positive review by the coach.

(7)           Trainers shall teach a training program aimed at preventing, reducing and eliminating the need for seclusion, physical restraint and isolation time-out at least once annually.

(8)           Trainers shall complete a refresher instructor training at least every two years.

(j)  Service providers shall maintain documentation of initial and refresher instructor training for at least three years.

(1)           Documentation shall include:

(A)          who participated in the training and the outcomes (pass/fail);

(B)          when and where attended; and

(C)          instructor's name; and

(2)           The Division of MH/DD/SAS may request and review this documentation at any time.

(k)  Qualifications of Coaches:

(1)           Coaches shall meet all preparation requirements as a trainer.

(2)           Coaches shall teach at least three times the course which is being coached.

(3)           Coaches shall demonstrate competence by completion of coaching or train-the-trainer instruction.

(l)  Documentation shall be the same preparation as for trainers.

History Note:        Authority G.S 143B-147;

Temporary Adoption Eff. February 1, 2001;

Temporary Adoption Expired October 13, 2001;

Amended Eff. April 1, 2003;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 1, 2018.