New Mexico Administrative Code › Title 8 - SOCIAL SERVICES › Chapter 321 - SPECIALIZED BEHAVIORAL HEALTH SERVICES › Part 11 - CRISIS TRIAGE CENTERS › Section 8.321.11.24 - RISK ASSESSMENT

Current through Register Vol. 35, No. 13, July 16, 2024
A. The CTC
				shall develop policies and procedures addressing risk assessment and mitigation
				including, but not limited to: assessments, crisis intervention plans,
				treatment, approaches to supporting, engaging, and problem solving, staffing,
				levels of observation and documentation. The policies and procedures must
				prohibit seclusion and address physical restraint, if used, and the CTC's
				response to clients that present with imminent risk to self or others,
				assaultive and other high-risk behaviors.
B. Use of seclusion is prohibited unless the
				facility is joint commission accredited, and unless the facility has obtained a
				prior waiver from the authority authorizing the facility to use seclusion. The
				use of physical restraint or seclusion must be consistent with federal and
				state laws and regulation (e.g., Section 32A-6A-10 NMSA 1978, concerning
				physical restraint and seclusion of minors).
C. Physical restraint, as defined in these
				regulations, shall be used only as an emergency safety intervention of last
				resort to ensure the physical safety of the client and others, and shall be
				used only after less intrusive or restrictive interventions have been
				determined to be ineffective.
D.
				Physical restraint shall not be used as punishment or for the convenience of
				staff.
E. Physical restraint is
				implemented only by staff who have been trained and certified by a CYFD or HCA
				recognized program in the prevention and use of physical restraint. This
				training emphasizes de-escalation techniques and alternatives to physical
				contact with clients as a means of managing behavior and allows only the use of
				reasonable force necessary to protect the client or other person from imminent
				and serious physical harm. Clients and youth do not participate in the physical
				restraint of other clients and youth.
F. Crisis intervention plans must document
				the use of physical restraints and address: the client's medical condition(s);
				the role of the client's history of trauma in their behavioral patterns;
				specific suggestions from the client regarding prevention of future physical
				interventions.
G. All clients
				physically restrained shall be afforded full privacy away from other clients
				receiving services.
H. A chemical
				restraint shall not be utilized under any circumstance. A chemical restraint is
				a drug or medication when it is used as a restriction to manage the client's
				behavior or restrict the client's freedom of movement, and is not a standard
				treatment or dosage for the client's condition. If a drug or medication is used
				as a standard treatment to address the assessed current symptoms and needs of a
				client with a particular medical or psychiatric condition, its use is not
				considered a chemical restraint.
I.
				Mechanical restraint shall not be utilized under any circumstances unless the
				facility is joint commission accredited, and unless the facility has obtained a
				prior waiver from the authority authorizing it to utilize mechanical restraint.
				Mechanical restraint is the use of a mechanical device(s) to physically
				restrict a client's freedom of moment, performance of physical activity or
				normal access to their body and is distinct from physical restraint. The use of
				mechanical restraint must be consistent with federal and state laws and
				regulation (e.g., Section 32A-6A-10 NMSA 1978, concerning mechanical restraint
				of minors).
J. The staff
				implementing the physical restraint shall conduct a debriefing, with the client
				present if possible, immediately following the incident to include the
				identification of the precipitating event, unsafe behavior and preventive
				measures with the intent of reducing or eliminating the need for future
				physical restraint. The debriefing shall be documented in the client's
				record.
K. The client's crisis
				intervention plan shall be updated: within 24 hours of admission or prior to
				discharge, whichever comes first; and following physical restraint use to
				incorporate the debriefing and changes needed to lessen the chance of the
				situation reoccurring.
L. Each
				incident of physical restraint shall be documented in the client's record
				including:
(1) the less intrusive
				interventions that were attempted or determined to be inappropriate prior to
				the incident;
(2) the precipitating
				event immediately preceding the behavior that prompted the use of physical
				restraint;
(3) the behavior that
				prompted the use of a physical restraint;
(4) the names of the mental health
				professional who observed the behavior that prompted the use of the physical
				restraint;
(5) the names of the
				staff members implementing and monitoring the use of physical restraint;
				and
(6) a description of the of the
				physical restraint incident, including the type and length of the use of
				physical restraint, the client's behavior during and reaction to the physical
				restraint and the name of the supervisor informed of the use of physical
				restraint.