In Brief

Without the amendment, the rule would only have allowed restraint and seclusion orders in these facilities to be given by psychiatrists or physicians with experience and training in mental health, limiting psychologist's scope of practice and negating existing state laws that grant psychologists the authority to give these orders.

The rule states that "other licensed practitioners" may give the order as long as they are trained in the use of restraint and seclusion--considered emergency safety interventions--and permitted by both the state and the facility to issue such orders.

The rule also requires that the "least restrictive emergency safety intervention that is most likely to be effective" be ordered.

In addition, the rule amends the definition of "personal restraint" to clarify that it does not include briefly holding a resident (without undue force) in order to calm or comfort the person or holding a resident's hand to safely escort him or her from one area to another.

The notice of the amendments to the interim final rule appeared in the May 22 Federal Register, (66 Fed. Reg. 28110). HCFA is accepting comments on the amendments through July 23.

Comments (one original and three copies) can be mailed to: Health Care Financing Administration, Department of Health and Human Services, Attention: HCFA-2065-IFC2, P.O. Box 8010, Baltimore, MD 21244-8010.

--J. COHEN