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| Montana Administrative Register Notice 37-519 | No. 3 02/10/2011 | |
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BEFORE THE DEPARTMENT OF PUBLIC HEALTH AND HUMAN SERVICES OF THE STATE OF
TO: All Concerned Persons 1. On September 23, 2010 the Department of Public Health and Human Services published MAR Notice No. 37-519 pertaining to the public hearing on the proposed adoption, amendment, and repeal of the above-stated rules at page 2108 of the 2010 Montana Administrative Register, Issue Number 18. 2. The Department of Public Health and Human Services will make reasonable accommodations for persons with disabilities who wish to participate in this rulemaking process or need an alternative accessible format of this notice. If you require an accommodation, contact Department of Public Health and Human Services no later than 5:00 p.m. on February 17, 2011 to advise us of the nature of the accommodation that you need. Please contact Gwen Knight, Department of Public Health and Human Services, Office of Legal Affairs, 3. The notice is amended to address comments from Legislative Services on the department's statement of reasonable necessity. All rules remain as proposed. 4. The statement of reasonable necessity is amended as follows: RULE I YOUTH CARE FACILITY (YCF): QUALITY ASSESSMENT This rule requires review of youth satisfaction surveys; documented incidents of physical escorts and physical restraints; and documentation of complaints, grievances, incident reports and medication errors. Youth input from satisfaction surveys aid the facility in improving its services for future clients. Trends seen in records on physical escorts and physical restraints will assist facilities in determining what measures are needed to reduce their use. Reviewing serious incident reports, grievances, and medication errors will guide facilities in how to prevent future occurrences. The department believes these three components are basic for any good quality assurance system. Alternatives include providing no framework for a quality assessment program, which the department believes will not serve the facilities' clients. RULE II YOUTH CARE FACILITY (YCF): CHILD ABUSE OR NEGLECT AND SERIOUS INCIDENTS Staff at all facilities that provide care to youth are statutorily mandated to report any suspected incident of child abuse or neglect under 41-3-201, MCA, regardless of the facility's response to the incident. The department believes that youth care facilities should have procedures for reporting and conducting internal investigations in order to take corrective action and prevent further occurrences. RULE IV YOUTH CARE FACILITY (YCF): YOUTH TO AWAKE STAFF RATIOS Under this rule, facilities have flexibility in determining the number of staff that are needed during the nights based on client needs. For instance, one additional staff person may be needed because a particular youth consistently tries to escape at night, or another youth likes to sneak into other youths' rooms and steal items. The facility may not need additional staff when those behaviors are not present. The department believes that Rule IV will result in cost savings for facilities. RULE VI YOUTH CARE FACILITY (YCF): YOUTH RIGHTS RULE XXVII YOUTH CARE FACILITY (YCF): SEARCHES RULE XXVIII YOUTH CARE FACILITY (YCF): CONTRABAND These rules copy the requirements in current rules for youth shelter facilities seen in ARM 37.97.815 through 37.97.820, and are proposed to apply to all facility types. Article II, section 15, of the Montana Constitution provides that all youth have the same fundamental rights as adults except when explicitly stated in other laws. The proposed rules assist in protecting those rights. Many facilities deal in delinquent behavior and must balance the youths' rights while protecting the safety of other youth residents. Alternatives include having no enumerated rights and procedures, which may result in arbitrary and possibly illegal actions by facilities. RULE XXVI YOUTH CARE FACILITY (YCF): CASE RECORDS
This rule consists of merging current ARM 37.97.216, 37.97.528, and 37.97.843 into one rule. It does not contain any new major requirements. There are small discrepancies in the current rules in that some may require more documentation than the others. Rule XXVI clarifies these discrepancies by requiring all of the documentation mentioned in these rules. RULE XXX YOUTH CARE FACILITY (YCF): POTENTIAL WEAPONS The department merged the requirements of ARM 37.97.522 and 37.97.837 into Rule XXX. Weapons can include conventional ones not used for hunting purposes, and reconfigured objects that can be used to harm others. Many youth served in youth care facilities have serious emotional disturbances; therefore, access to weapons must be limited to protect the life and safety of other youth and staff. RULE XXXI YOUTH CARE FACILITY (YCF): INFECTION CONTROL This rule is very general and provides the facilities flexibility in creating their own infection control procedures. These procedures are needed so that youth and staff are protected from communicable diseases that may lead to sickness, disability, or death. Depending on their ages, many youth are susceptible to contracting bacterial and viral infections due to their young development. Also, youth may not be up to date on required vaccinations. Anywhere where many people congregate leads to higher risks of infections such as Norovirus. For these reasons, the department is proposing Rule XXXI. Without it, the department is not assured that the facilities are safe for youth. RULE XXXII YOUTH CARE FACILITY (YCF): ANIMALS AND PETS This rule is needed because youth may have service animals or animals may be used as part of therapy. Visits from personal pets that reside in the youths' homes may aid in improving their emotional well-being. There are a variety of reasons why pets may be at youth care facilities. The procedures listed in Rule XXXII assist in preventing diseases and injury that may occur when humans are in contact with animals. The department decided that banning all animals was not an option. Youth with disabilities are legally protected under federal law to bring service animals with them. Animals also assist with treating youth who are dealing with mental and behavioral issues. RULE XXXVI YOUTH CARE FACILITY (YCF): FOOD PREPARATION AND HANDLING Depending on certain circumstances, some local health authorities may require a youth care facility to have a licensed food service. Absent a license, this rule provides minimal food safety requirements for hand washing, food temperature control, and kitchen sanitation. Cleanliness, especially with hands, is needed to prevent handlers of food from transmitting E. coli. To preserve the quality of food, hot and cold food items must be kept at certain temperatures to prevent spoilage and the growth of bacteria. Kitchens must be kept in a clean and sanitary state to prevent contamination of food when in contact with equipment, and cross-contamination with other food items. 5. Concerned persons may submit their data, views, or arguments concerning the proposed action in writing to: Gwen Knight, Office of Legal Affairs, Department of Public Health and Human Services, P.O. Box 4210, Helena MT 59604-4210; no later than 5:00 p.m. on February 24, 2011. Comments may also be faxed to (406) 444-9744 or e-mailed to dphhslegal@mt.gov. /s/ Michelle Maltese /s/ Anna Whiting Sorrell Michelle Maltese Anna Whiting Sorrell, Director Rule Reviewer Public Health and Human Services Certified to the Secretary of State January 31, 2011
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