Training Requirements for the Use of Non-Restrictive and Restrictive Intervention Strategies
Restrictive interventions include seclusion, physical restraint, isolation time-out and protective devices used to reduce behavior that is injurious to the person, others or property. Such interventions are to be used safely, in a manner that insures dignity and respect and only as a last resort. Such interventions should only be used by staff who have been trained in de-escalation prevention strategies and who have demonstrated competence in the use of restrictive procedures.
The Division of Mental Health, Developmental Disabilities and Substance Abuse Services (Division) is responsible for approving the content of curricula used by provider agencies to train staff in the use of non-restrictive and restrictive crisis intervention strategies. The requirements for training are outlined in the following statutes, rules, and policy.
RULES AND LAWS GOVERNING THE USE OF RESTRICTIVE INTERVENTIONS
G.S. § 122C-60 - Use of physical restraints or seclusion
Rules 10A NCAC 27E Section .0100 – Protections Regarding Interventions Procedures
Rule 10A NCAC 28D .0209 – Training: Emphasis on Alternatives to Restrictive Interventions
Rule 10A NCAC 28D .0210 – Training in Seclusion, Physical Restraint, and Isolation Time-Out
42 CFR 483 Subpart G – Condition of Participation for the Use of Restraint or Seclusion in Psychiatric Residential Treatment Facilities Providing Inpatient Psychiatric Services for Individuals Under Age 21
DHHS POLICY PROHIBITS THE USE OF FACE DOWN TECHNIQUES
- DHHS Secretary's Memo
- Implementation of Secretary's Memo
- Clarification
- Elimination of Prone or Face Down Position from Crisis Intervention Techniques
COMMUNICATION BULLETINS
Effective December 31, 2018, the North Carolina Interventions (NCI) curriculum is no longer an approved curriculum for training staff in the use of non-restrictive and restrictive crisis intervention strategies. The following communication bulletins were published to inform the LME-MCOs and providers about the phase-out of NCI and the need to transition to an alternative curriculum approved by the Division.
- 4/28/17 - JCB 247 – North Carolina Interventions (NCI) to be Released to the Public Domain July 1, 2017
- 7/10/18 - JCB 296 – Update to JCB 247 – North Carolina Interventions (NCI)
- 7/06/20 - JCB 368 – Compliance with Alternatives and Restrictive Intervention
CURRICULUM REVIEWS
Providers have the option of choosing from among the curricula approved by the Division or submitting a new curriculum for review. The List of Approved Curricula with contact information for the curriculum developer is updated as new curricula are approved. The Division’s approval of a curriculum does not reflect its endorsement thereof.
The Division expects compliance with all applicable rules and statutes governing the services and settings in which the curriculum is used, including documentation and reporting requirements and procedures that are governed by regulatory bodies such as the Centers for Medicare and Medicaid, the provider’s national accrediting organization or that are prohibited by state policy or have specific guidelines.
To submit an alternative curriculum for review, an application needs to be completed. The application crosswalks to the requirements in the statute and rule. The completed application should be sent to DMH.NCI@dhhs.nc.gov.
NCI CONTACT INFORMATION
If you have questions regarding training requirements for the use of non-restrictive and restrictive intervention strategies please contact us at DMH.NCI@dhhs.nc.gov.