Friedman Carli, Crabb Caitlin
Carli Friedman, The Council on Quality and Leadership; and Caitlin Crabb, Department of Disability and Human Development, University of Illinois at Chicago.
Intellect Dev Disabil. 2018 Jun;56(3):171-187. doi: 10.1352/1934-9556-56.3.171.
Restraint, restrictive interventions, and seclusion are hotly contested practices with inconclusive evidence of their effectiveness. Because the use of restraint and seclusion on people with intellectual and developmental disabilities (IDD) is controversial and its effectiveness doubtable, this study was conducted to explore if and how they were permitted in Medicaid HCBS 1915(c) waivers, the largest providers of long-term services and supports (LTSS) for people with IDD. To do so, 111 fiscal year 2015 IDD waivers from across the nation were examined to determine if and how states permitted restraint, restrictive interventions, and seclusion. Findings revealed an overwhelming majority of waivers permitted the use of restraint (78.4%) and restrictive interventions (75.7%). A smaller proportion (24.3%) allowed the use of seclusion.
约束、限制干预措施和隔离是备受争议的做法，其有效性证据尚无定论。由于对智力和发育障碍者（IDD）使用约束和隔离存在争议且其有效性存疑，本研究旨在探讨在医疗补助家庭和社区基础服务1915（c）豁免项目（为IDD患者提供长期服务和支持（LTSS）的最大提供者）中，约束和隔离是否被允许以及如何被允许。为此，研究人员审查了2015财年来自全国各地的111份IDD豁免项目，以确定各州是否允许以及如何允许使用约束、限制干预措施和隔离。研究结果显示，绝大多数豁免项目允许使用约束（78.4%）和限制干预措施（75.7%）。允许使用隔离的比例较小（24.3%）。
