1. (a) A residential psychiatric treatment center shall comply with the behavior guidance requirements of 7 AAC 50.435.
2. (b) As a part of the resident's assessment under 7 AAC 50.825(b) and development of the resident's treatment plan under 7 AAC 50.840, the residential psychiatric treatment center shall evaluate the history and experiences of the resident that may affect how the resident would respond to isolation or restraint, including any history of abuse, neglect, or other trauma, and shall develop a treatment plan for the resident that takes into account the factors described in this subsection and that seeks to avoid repeating or recalling the trauma or emotional harm to the resident if any use of restraint or isolation is anticipated to be used to manage the resident's behavior or if restraint or isolation are ever used in an emergency situation with the resident. The resident's caregivers shall be informed of the types or manner of restraint or isolation which should not be used with the particular resident.
3. (c) A residential psychiatric treatment center may not use restraint or isolation upon a resident for the convenience of the staff, or to compel the resident's cooperation with the resident's treatment plan;
4. (d) If a residential psychiatric treatment center uses restraint or isolation upon a resident, the facility shall direct its clinical staff to discuss the incident that led to the use of restraint or isolation with the resident, the resident's parents, the facility staff, involved in or affected by the incident, and any residents involved in or affected by the incident, to assist the resident and staff to understand why the incident occurred and what actions or responses could have prevented it. The discussion must occur within 24 hours after the incident.

5. (e) In the behavior-management log required by 7 AAC 50.435(j)(2)(F), and after the incident of restraint or isolation has ended, the residential psychiatric treatment center shall document

   1. (1) the specific and less restrictive alternatives used by staff before the incident to attempt to prevent the need for restraint or isolation of the resident; and
   2. (2) whether the type of behavior by the resident or the use of restraint or isolation as a response to the resident's behavior were anticipated in the resident's treatment plan;
6. (f) If either the type of behavior by the resident which led to the incident or the necessity to use restraint or isolation as a response were not previously anticipated, and were not specified in the resident's treatment plan, the residential psychiatric treatment center shall direct the facility's clinical staff to make and document a determination of whether the clinical staff should redesign the resident's treatment plan to better prevent similar behavior and to provide for specific and less restrictive alternatives to be used by staff in the future, and shall review the incident and any amendments to the treatment plan with the child's treatment team at the team's next scheduled meeting or sooner if the severity or repetition of the restraint episodes with the child warrant earlier review.

7. (g) The residential psychiatric treatment center shall

   1. (1) document the information gathered and the amendments to treatment plans made under (d) and (f) of this section in the resident's file and in a file that aggregates all incidents of restraint or isolation for all residents; and
   2. (2) make the records described in (1) of this subsection available to the division for review of the use of isolation or restraint by the facility as the division determines necessary to identify and prevent abuse or inappropriate or unnecessary use of isolation or restraint with residents.

(Eff. 6/21/2001, Register 158)