Administrative Rules of Montana › Department 37 - PUBLIC HEALTH AND HUMAN SERVICES › Chapter 37.97 - LICENSURE OF YOUTH CARE FACILITIES › Subchapter 37.97.1 - General Requirements › Rule 37.97.172 - YOUTH CARE FACILITY (YCF): USE OF CRISIS INTERVENTION AND PHYSICAL RESTRAINT STRATEGIES

Current through Register Vol. 13, July 5, 2024
(1) The YCF shall
				have written policies and procedures governing the appropriate use of crisis
				intervention and physical restraint strategies, including but not limited to
				the use of de-escalation techniques and physical restraint methods if used by
				provider.
(2) The crisis
				intervention and physical restraint strategies policies and procedures must
				comply with the following:
(a) Crisis
				prevention and verbal and nonverbal de-escalation techniques are the preferred
				methods and must be used first to manage behavior. All staff working directly
				with youth must be trained in de-escalation techniques. This training must be
				documented in each staff member's personnel file.
(b) Physical restraint may only be used to
				safely control a youth until the youth can regain control of the youth's own
				behavior. Physical restraint must only be used in the following circumstances:
(i) when the youth has failed to respond to
				de-escalation techniques and it is necessary to prevent harm to the youth or
				others; or
(ii) when a youth's
				behavior puts themselves or others at substantial risk of harm and the youth
				must be forcibly moved.
(c) Physical restraint must be used only
				until the youth has regained control and must not exceed 15 consecutive
				minutes. If the youth remains a danger to self or others after 15 minutes, the
				youth's record must include written documentation of attempts made to release
				the youth from the restraint and the reasons that continuation of restraint is
				necessary.
(d) Physical restraint
				may be used only by employees who are documented to be specifically trained in
				crisis intervention and physical restraint techniques.
(e) YCF policies and procedures must prohibit
				the application of a physical restraint if a youth has a documented physical
				condition that would contradict its use, unless a health care professional has
				previously and specifically authorized its use in writing. Documentation must
				be maintained in the youth's record.
(f) YCF policies and procedures must require
				the documentation of:
(i) the behavior which
				required the physical restraint;
(ii) the specific attempts to de-escalate the
				situation before using physical restraint;
(iii) the length of time the physical
				restraint was applied including documentation of the time started and
				completed;
(iv) the identity of the
				specific staff member(s) involved in administering the physical
				restraint;
(v) the type of physical
				restraint used;
(vi) any injuries
				to the youth resulting from the physical restraint; and
(vii) debriefing completed with the staff and
				youth involved in the physical restraint.
(g) YCF policies and procedures must require
				that whenever a physical restraint has been used on a youth more than four
				times within a seven-day period, lead clinical staff members or treatment team
				members will review the youth's situation to determine the suitability of the
				youth remaining in the YCF, whether modification to the youth's plan is
				warranted, or whether staff need additional training in alternative therapeutic
				behavior management techniques. The YCF shall take appropriate action as a
				result of the review.