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37.97.259    CHILD CARE AGENCY: RESIDENTIAL TREATMENT CENTER, CHEMICAL RESTRAINT

(1) A child care agency shall not use chemical restraint without first being licensed by the department to operate a residential treatment center.

(2) Chemical restraint of a child may be used only if the child is a danger to himself or others and cannot be controlled by any other type of restraint.

(3) Each child care agency which uses chemical restraint shall have written policies governing the use of such restraint. The policies shall describe at a minimum:

(a) the philosophy for use of chemical restraint;

(b) the procedures for use of chemical restraint;

(c) the emergency evacuation procedures for special circumstances occurring while a child is in restraint (i.e. fire, natural disaster) ; and

(d) the method for children to express grievances regarding use of chemical restraint.

(4) A residential treatment center which uses chemical restraint shall ensure that such restraint is administered by intramuscular injection by a person qualified and trained in the administration of intramuscular injections.

(a) A child who is capable of accepting an oral administration of chemical restraint shall not be deemed to require chemical restraint.

(5) A residential treatment center which uses emergency chemical restraint shall ensure that each administration of chemical restraint is specifically ordered by a physician who has personally examined the child.

(a) There shall not be standing orders related to the use of chemical restraint.

(b) The child shall be monitored continuously by a person trained and qualified to observe potential adverse side effects. This person shall have no other immediate responsibilities.

(6) A physician shall authorize each use of chemical restraint prior to the administering of such restraint.

(7) When a child in care requires chemical restraint on more than three occasions during a 30-day period an emergency meeting shall be held to discuss the appropriateness of the child's continued placement at the agency. This meeting shall take place within 24 hours of the third incident requiring chemical restraint and shall include the chief administrator of the agency or his/her representative, a physician and all appropriate staff. A report of this meeting, signed by all persons attending, shall be filed in the child's case record and a copy sent to the placing agency.

(a) The agency shall make every effort to notify the placing agency and the child's parent(s) or guardian of this situation. If possible, a representative of the placing agency and the child's parent(s) or guardian shall attend the emergency meeting.

(b) Documentary evidence of the attempt to notify the placing agency and the child's parent(s) or guardian shall be placed in the child's case record.

(8) Chemical restraint shall not be used as punishment.

History: Sec. 41-3-1103, 41-3-1142 and 53-4-111, MCA; IMP, Sec. 41-3-1103, 41-3-1141, 41-3-1142, 53-4-111 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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