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37.97.257    CHILD CARE AGENCY: RESIDENTIAL TREATMENT CENTER, SECLUSION

(1) Only child care agencies which operate a licensed residential treatment center may use seclusion as a method of intervention.

(2) A seclusion room is a single room in a child care agency treatment center in which a child may be confined.

(a) Seclusion may be used as a means of intervention only when the child is in danger of harming himself, others, or property.

(b) Seclusion shall be used only for the time needed to change the behavior necessitating its use. Seclusion shall not be used as punishment.

(3) Each child care agency which utilizes seclusion shall have a written statement of its seclusion policies which describe, at a minimum:

(a) the philosophy for use of the room;

(b) the procedure for admittance;

(c) emergency procedures for special circumstances occurring while the child is in placement (i.e., fire, internal or external disaster, etc.) ; and

(d) the method for children to express grievances regarding the use of seclusion;

(4) The child shall be informed of the reason for seclusion at the time of the child's placement in seclusion.

(5) Children shall not be placed in a seclusion room which has not been inspected and approved by the department.

(6) Records of the use of the seclusion room, policies for the operation and supervision of the room, the children's treatment records, staff records and the room itself shall be made available to the department for inspection.

(7) If the child care agency does not meet all requirements for the use of the seclusion room, the department shall give written notice of the specific deficiencies which shall be corrected. The child care agency shall cease secluding any children in the room until corrections are made and authorization is given by the department.

(8) When a seclusion room is used, the following physical requirements shall apply:

(a) the room shall be a minimum of 64 square feet to be occupied by one child only;

(b) the room shall be maintained in a clean and sanitary condition;

(c) all utility or ventilation switches, including electrical outlets, shall be outside the room. Switches will be restricted to operation by staff only;

(d) windows shall be of shatter resistant material;

(e) the room shall contain an observation window constructed of shatter resistant material;

(f) there shall be no features by which a child may be injured within the room;

(g) there shall be no more than one locked door between the child and staff;

(h) if soundproof, the room shall have an intercom system which shall be activated when in use;

(i) there shall be an approved ventilation system.

(9) A child may not be placed in seclusion unless:

(a) lesser restrictive alternatives have been attempted by staff and have failed to control the child;

(b) the child is in danger of harming himself, others, or property;

(c) the placement in seclusion has been approved by a qualified treatment practitioner authorized by the provider to place children in seclusion.

(10) Placement in seclusion may not exceed 1 hour unless specifically authorized by a psychiatrist. In no event may placement in seclusion exceed 24 hours. A child who requires seclusion in excess of 24 hours shall be transferred to an acute psychiatric care facility.

(11) A staff member with no other immediate duties shall continuously monitor the child placed in seclusion by visual or auditory means and shall remain within 20 feet of the room. If continuous monitoring is by auditory means, the staff member shall visually check on the child at least every 10 minutes.

(12) Upon the placement of a child in seclusion, the following minimum items shall be recorded, updated and maintained, if applicable:

(a) a written report which states the child's name, date, time of placement, staff member initiating the placement, qualified treatment practitioner authorizing placement and narrative describing the following: the precipitating event, child's behavior before placement, and actions taken by staff of a less restrictive nature in an attempt to control, calm or contain the child;

(b) written notation of visual checks at least every 10 minutes and notation of behavior and time occurring;

(c) notation regarding opportunity to use toilet facilities once per hour;

(d) notations regarding when the child had opportunity to exercise;

(e) notation as to medications administered, time given and staff administering;

(f) notation of all staff contact including a description of the resolution of the placement incident which results in the termination of seclusion.

(13) Staff of the residential treatment center who monitor or initiate the use of the room shall be trained in the use of seclusion and be specifically authorized by the facility.

History: Sec. 41-3-1103, 41-3-1142 and 53-4-111, MCA; IMP, Sec. 41-3-1103, 41-3-1142, 53-2-201, and 53-4-113, MCA; NEW, 1986 MAR p. 2080, Eff. 12/27/86; TRANS, from Dept. of SRS, 1987 MAR p. 1492, Eff. 7/1/87; TRANS, from DFS, 1998 MAR p. 663.

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