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Restrictive and Prohibited Measures

DODD, county boards of developmental disabilities, and service providers across Ohio work to provide support to people with developmental disabilities in a way that offers opportunities to exercise choice about things that affect their everyday lives.

Restrictive measures are used as a last resort to keep people safe from a risk of harm or legal sanction. They may only be included in a person’s service plan with the approval of a human rights committee.

Prohibited measures may never be used.

Risk of harm includes a direct and serious risk of physical harm to the person or someone else. The person must causing or very likely to begin causing physical harm. They must also be capable of causing physical harm to themselves or others. 

Risk of legal sanction includes the risk of eviction, arrest, or incarceration.

Prohibited Measures

Prohibited measures include the following. 

  • Use of a prone restraint, a method of intervention where a person is placed face down touching any surface for any amount of time
  • Use of a manual restraint or mechanical restraint that has the potential to inhibit or restrict a person’s ability to breathe or that is medically contraindicated, meaning the measure would go against the medical needs of the person
  • Use of a manual restraint or mechanical restraint that causes pain or harm
  • Disabling a person’s communication device
  • Denying someone breakfast, lunch, dinner, snacks, or beverages
  • Placing a person in a room with no light
  • Subjecting someone to damaging or painful sound
  • Applying an electric shock to someone
  • Subjecting a person to any humiliating or derogatory treatment
  • Squirting someone with any substance to get them to do something or as a consequence for their behavior
  • Using any restrictive measure for punishment, retaliation, instruction, or teaching for the convenience of providers or as a substitute for specialized services

For full definitions of prohibited measures, read OAC 5123:2-2-06.

Restrictive Measures

Restrictive measures include the following. 

  • Manual restrains, or using your hands to control the actions of someone by restricting their movement, with sufficient force to cause the possibility of injury. This also includes holding or disabling someone’s wheelchair or other mobility device.

Manual restraints never include prone restraint, which means placing a person face down touching any surface for any amount of time.

If a manual restraint is necessary to keep a person safe, the person must be under constant visual supervision by staff, and the restraint must end immediately once the risk of harm has passed.

Manual restraint does not include a method that is routinely used during a medical procedure for patients without developmental disabilities.

  • Mechanical restraint means using a device to control the actions of someone by restricting their movement. Mechanical restraints never include prone restraint.

If a mechanical restraint is necessary to keep a person safe, the restraint must end immediately once the risk of harm has passed.

Mechanical restraints do not include

    • a seatbelt in a vehicle or safety seat,
    • a medically necessary device like a gait-belt,
    • or a method that is routinely used during a medical procedure for patients without developmental disabilities.
  • Time-out means confining a person to a room or area and prohibiting them from leaving the room by applying physical force, closing a door, or constructing another barrier, even if a provider remains in the room with the person.
  • Chemical restraint means a medication prescribed for the purpose of modifying, diminishing, controlling, or altering a specific behavior.

Chemical restraint does not include medications prescribed for the treatment of a diagnosed disorder, or medications prescribed for treatment of a seizure disorder, or medication that is routinely prescribed in conjunction with a medical procedure for patients without developmental disabilities.

For full definitions of restrictive measures, read OAC 5123:2-2-06.