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
Universal Citation: MT Admin Rules 37.97.172
Current through Register Vol. 18, September 20, 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.
(3) All TGHs must provide physical restraint training and comply with this rule.
52-2-111, 52-2-603, 52-2-622, MCA; IMP, 52-2-113, 52-2-603, 52-2-622, MCA;
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