§290jj — Title 42 The Public Health and Welfare | U.S. Code

§290jj Requirement relating to the rights of residents of certain non-medical, community-based facilities for children and youth

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER III–A— - SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION › Part Part I— - Requirement Relating to the Rights of Residents of Certain Non-Medical, Community-Based Facilities for Children and Youth › § 290jj

Last updated Apr 6, 2026|Official source

Summary

Require facilities that get federal funds to protect each child’s rights. They must keep kids safe from physical or mental abuse, corporal punishment, and from restraints or being locked away just for punishment or because it is easier for staff. Facilities that give inpatient psychiatric care to people under age 21 must follow part H. Facilities paid by Medicaid must still follow any other program rules that this law does not change. Physical restraints or locked isolation may only be used in true emergencies to keep someone safe after less-restrictive steps fail, and only by staff trained and certified by a state-recognized group under a state process the Secretary approves. Until the state sets up that process, the facility must use an interim plan that makes a trained supervisor check the child as soon as possible and no later than 1 hour after restraint starts and keep monitoring them the whole time. Using medicine to control behavior when it is not a normal medical or psychiatric treatment is banned. Mechanical restraints are banned. Seclusion may be used only when a staff member watches the child face-to-face the entire time and the facility has strong licensing or accreditation and internal controls. Medical immobilization, adaptive support, or medical protection are allowed. Stronger state or federal protections still apply. Definitions (short): mechanical restraint — a device that limits movement; physical escort — briefly holding a wrist, arm, shoulder, or back to guide a child to safety; physical restraint — holding that limits arms, legs, or head (not a physical escort); seclusion — locked isolation (not time out); time out — separating a child briefly in a non-locked space to calm as part of a treatment plan.

Title 42, §290jj

The Public Health and Welfare — Source: USLM XML via OLRC

(a)(1)A public or private non-medical, community-based facility for children and youth (as defined in regulations to be promulgated by the Secretary) that receives support in any form from any program supported in whole or in part with funds appropriated under this chapter shall protect and promote the rights of each resident of the facility, including the right to be free from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.

(2)Notwithstanding this part, a facility that provides inpatient psychiatric treatment services for individuals under the age of 21, as authorized and defined in subsections (a)(16) and (h) of section 1905 of the Social Security Act [42 U.S.C. 1396d], shall comply with the requirements of part H.

(3)A non-medical, community-based facility for children and youth funded under the Medicaid program under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.] shall continue to meet all existing requirements for participation in such program that are not affected by this part.

(b)(1)Physical restraints and seclusion may only be imposed on a resident of a facility described in subsection (a) if—

(A)the restraints or seclusion are imposed only in emergency circumstances and only to ensure the immediate physical safety of the resident, a staff member, or others and less restrictive interventions have been determined to be ineffective; and

(B)the restraints or seclusion are imposed only by an individual trained and certified, by a State-recognized body (as defined in regulation promulgated by the Secretary) and pursuant to a process determined appropriate by the State and approved by the Secretary, in the prevention and use of physical restraint and seclusion, including the needs and behaviors of the population served, relationship building, alternatives to restraint and seclusion, de-escalation methods, avoiding power struggles, thresholds for restraints and seclusion, the physiological and psychological impact of restraint and seclusion, monitoring physical signs of distress and obtaining medical assistance, legal issues, position asphyxia, escape and evasion techniques, time limits, the process for obtaining approval for continued restraints, procedures to address problematic restraints, documentation, processing with children, and follow-up with staff, and investigation of injuries and complaints.

(2)(A)Until such time as the State develops a process to assure the proper training and certification of facility personnel in the skills and competencies referred 11 So in original. Probably should be followed by “to”. in paragraph (1)(B), the facility involved shall develop and implement an interim procedure that meets the requirements of subparagraph (B).

(B)A procedure developed under subparagraph (A) shall—

(i)ensure that a supervisory or senior staff person with training in restraint and seclusion who is competent to conduct a face-to-face assessment (as defined in regulations promulgated by the Secretary), will assess the mental and physical well-being of the child or youth being restrained or secluded and assure that the restraint or seclusion is being done in a safe manner;

(ii)ensure that the assessment required under clause (i) take place as soon as practicable, but in no case later than 1 hour after the initiation of the restraint or seclusion; and

(iii)ensure that the supervisory or senior staff person continues to monitor the situation for the duration of the restraint and seclusion.

(3)(A)The use of a drug or medication that is used as a restraint to control behavior or restrict the resident’s freedom of movement that is not a standard treatment for the resident’s medical or psychiatric condition in nonmedical community-based facilities for children and youth described in subsection (a)(1) is prohibited.

(B)The use of mechanical restraints in non-medical, community-based facilities for children and youth described in subsection (a)(1) is prohibited.

(C)A non-medical, community-based facility for children and youth described in subsection (a)(1) may only use seclusion when a staff member is continuously face-to-face monitoring the resident and when strong licensing or accreditation and internal controls are in place.

(c)(1)Nothing in this section shall be construed as prohibiting the use of restraints for medical immobilization, adaptive support, or medical protection.

(2)This part shall not be construed to affect or impede any Federal or State law or regulations that provide greater protections than this part regarding seclusion and restraint.

(d)In this section:

(1)The term “mechanical restraint” means the use of devices as a means of restricting a resident’s freedom of movement.

(2)The term “physical escort” means the temporary touching or holding of the hand, wrist, arm, shoulder or back for the purpose of inducing a resident who is acting out to walk to a safe location.

(3)The term “physical restraint” means a personal restriction that immobilizes or reduces the ability of an individual to move his or her arms, legs, or head freely. Such term does not include a physical escort.

(4)The term “seclusion” means a behavior control technique involving locked isolation. Such term does not include a time out.

(5)The term “time out” means a behavior management technique that is part of an approved treatment program and may involve the separation of the resident from the group, in a non-locked setting, for the purpose of calming. Time out is not seclusion.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in subsec. (a)(3), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XIX of the Act is classified generally to subchapter XIX (§ 1396 et seq.) of chapter 7 of this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.