Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 130 - Medicaid Coverage; Home and Community-Based Waiver Services
Article 2 - Home and Community-Based Waiver Services; Nursing Facility and ICF/MR Level of Care
7 AAC 130.229 - Use of restrictive intervention
Universal Citation: 7 AK Admin Code 130.229
Current through November 28, 2024
(a) A home and community-based waiver services provider may use restrictive intervention as a response
(1) when a recipient's behavior is
unanticipated and presents an imminent danger to the recipient's safety or to
the safety of others; or
(2) if
justified for safe management of the recipient's behavior that requires
intervention as described in the support plan developed in accordance with
7
AAC 130.217 and
7
AAC 130.218
(A) when
other types of intervention have been tried and documented as ineffective for
behavior management; and
(B) if the
type of intervention is safe, proportionate to the recipient's behavior, and
appropriate to the recipient's chronological and developmental age, size,
gender, and physical, medical, and psychological
condition.
(b) The provider shall develop and implement written policies and procedures that address
(1) the use of restrictive
intervention in regard to the recipient population served by the
provider;
(2) a prohibition on the
use of
(A) seclusion as a restrictive
intervention; and
(B) prone
restraint;
(C) chemical
restraint;
(3) training
in the use of restrictive intervention;
(4) documentation of each event that involves
the use of restrictive intervention;
(5) supervision of individuals that use
restrictive intervention while recipients are in the care of or receiving
services from the provider; and
(6)
monitoring and evaluation of each use of restrictive
intervention.
(c) The provider must have on file written verification that each direct care worker has received training appropriate to the type of restrictive intervention the provider has allowed that direct care worker to use.
(d) A provider that uses restrictive intervention shall document in the recipient's record
(1) the date and time;
(2) the duration of time each type of
restrictive intervention was used;
(3) a description of the behavior that led to
the use of restrictive intervention;
(4) a rationale for, and a description of,
each type of restrictive intervention used;
(5) the recipient's response to each type of
restrictive intervention used; and
(6) the name of each staff member involved in
the restrictive intervention.
(e) The provider shall maintain a record of restrictive intervention that documents
(1)
the event or circumstances that necessitated the use of restrictive
intervention;
(2) the type of
restrictive intervention used;
(3)
the type of care provided to the recipient while a restrictive intervention is
applied; and
(4) the outcome for
the recipient and for the staff involved in the event.
(f) The provider shall develop and implement a system to manage and report the use of restrictive intervention that includes
(1) a plan for documenting and tracking the
use of restrictive intervention;
(2) requirements for reporting, as a critical
incident under
7
AAC 130.224,
(A) the
misuse of restrictive intervention; and
(B) the use of restrictive intervention that
resulted in the need for medical intervention;
(3) a protocol for analyzing the use of
restrictive intervention each calendar quarter;
(4) a procedure for taking corrective action
based on the analysis; and
(5) a
process for summarizing the quarterly analyses and corrective action taken
under this subsection; the summary must be submitted to the department with the
provider's application to renew certification under
7
AAC 130.220, or upon request.
(g) In this section
(1) "restrictive intervention" means an
action or procedure that limits an individual's movement or access to other
individuals, locations, or activities;
(2) "seclusion" means the involuntary
confinement of an individual alone in a room or an area from which the
individual is physically prevented from having contact with others or
leaving.
(3) "chemical restraint"
(A) means the use of medication to restrict
freedom of movement in order to manage or control behavior, for disciplinary
purposes, or for the convenience of the provider;
(B) does not include medication prescribed
for the purpose of managing behavior by an individual listed in 7 AAC
130.2270)(3) and administered in accordance with the applicable requirements
of7 AAC
130.227.
Authority:AS 47.05.010
AS 47.07.030
AS 47.07.040
Disclaimer: These regulations may not be the most recent version. Alaska may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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