Current through Rules and Regulations filed through March 20, 2024
1.The C & A CSU shall have policies and procedures regarding authorized entry to or exit from the unit.
2.The C & A CSU shall have policies and procedures to protect and respect individuals' rights and privacy while conducting searches.
3.Control of potentially injurious items shall be clearly defined in policy to include, but may not be limited to:
a.Prohibition of flammables, toxins, ropes, wire clothes hangers, sharp-pointed scissors, luggage straps, belts, knives, shoestrings, or other potentially injurious items;
b.Management of housekeeping supplies and chemicals, including procedures to avoid access by individuals during use or storage. Whenever practical, supplies and chemicals shall be non-toxic and/or non-caustic.
4.Safeguard the use and disposal of nursing and medical supplies including drugs, needles and other "sharps" and breakable items.
5.Except as otherwise provided by law, weapons shall be prohibited at the C & A CSU. The C & A CSU shall post notices regarding the prohibition of weapons at all entrances to the facility and shall have written protocols addressing the same.
6.The C & A CSU shall develop and implement policies and practices, consistent with Departmental policy, that describe interventions to prevent crises and minimize incidents when they do occur, that are organized in a least to most restrictive sequence. The written policies and procedures shall:
a.Emphasize positive approaches to interventions;
b.Protect the health and safety of the individual served at all times;
c.Specify the methods for documenting the use of the interventions; the admission assessment shall contain an assessment of past trauma or abuse, how the individual served would prefer to be approached should he or she become dangerous to him/ herself or to others, and the findings from this initial assessment shall guide the process for determining interventions.
7.The C & A CSU shall develop and implement internal policies and practices for use of time-out, seclusion or restraint that are consistent with federal and state laws, rules, regulations and DBHDD policy:
a.Seclusion or 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 individual and others, and shall be used only after less restrictive interventions have been determined to be ineffective;
b.Seclusion or restraint shall not be used as punishment or for the convenience of staff;
c.Seclusion and restraint shall not be implemented simultaneously;
d.All individuals placed in restraints shall be afforded full privacy away from other individuals receiving services;
e.Chemical restraint as defined in the Code of Federal Regulations shall not be utilized under any circumstances;
f.Staff, individuals and their legal guardian shall be debriefed immediately following an episode of seclusion or restraint, identifying the circumstances leading up to the seclusion or restraint;
g.The individual's IRP shall be updated following the debriefing of what led to a seclusion or restraint episode, including changes that could be made to prevent the situation or better support the individual if future issues occur.
8.The C & A CSU shall develop policies and procedures for implementing suicide prevention interventions addressing: screening, assessments, crisis safety plans, staffing, levels of observation and documentation in accordance with DBHDD policy:
a.Policies and procedures shall require constant visual observations of persons clinically determined to be actively suicidal;
b.A person assessed to be potentially suicidal shall be on a higher level of supervision;
c.Modifications or removal of suicide prevention interventions shall require clinical justification determined by an assessment and shall be specified by the attending physician and documented in the clinical record;
d.A registered professional nurse or other licensed/certificate clinician may initiate suicide prevention interventions prior to obtaining a physician/psychiatrist's order, but in all instances must obtain an order within one (1) hour of initiating the intervention;
f.Staff shall be debriefed immediately following a suicide attempt, identifying the circumstances leading up to the suicide attempt;
g.The individual's IRP shall be updated following the debriefing of what led to the suicide attempt, including changes that could be made to prevent the situation from reoccurring or to better support the individual if future issues do occur;
9.Other high-risk behaviors such as assaultive behavior shall be addressed in the C & A CSU policies and procedure.
O.C.G.A. Secs. 16-11-127, 37-1-29, 37-3-162, 37-3-165, 37-7-162, 37-7-165.
