519

519.1 Each MH provider shall establish, maintain, and adhere to written policies and procedures regarding the use of restraints and seclusion for consumers that comply with applicable federal and District laws and regulations. A MH provider that is not specifically authorized to use restraint and seclusion pursuant to §500.7 shall establish a policy strictly prohibiting the use of restraints and seclusion at any time, although the policy shall also require reporting of the use of restraint or seclusion and staff training.

519.2 The written policies and procedures for the MH providers identified in §500.7 shall describe the following:

(a) How respect for consumers and their families will be maintained prior to, during, and after the utilization of any method of restraint or seclusion;

(b) The use of a consumer's advance instructions regarding treatment preferences in the event of a psychiatric emergency and how those treatment preferences will be honored.

(c) The process or opportunity for a consumer who is in restraints or seclusion to maintain personal care, participate in personal care processes, engage in normal bodily functioning (including access to toilets), receive nourishment and fluids, exercise limbs, have a systematic release of restrained limbs, and receive other necessary care during and immediately after the utilization of any restraints or seclusion;

(d) The process for ensuring and monitoring the safety and hygiene of a consumer who is in restraints or seclusion;

(e) The DMH-approved policy for face-to-face monitoring required by §505.2 for MH providers using restraints and seclusion simultaneously;

(f) The process for monitoring the space used for restraint or seclusion to ensure a comfortable room temperature and necessary light at all times;

(g) How the physical, mental, and emotional well being of the consumer will be promoted and maintained at all times during the use of restraint and seclusion;

(h) How the consumer's modesty, appropriate visibility to others, and comfortable body temperature will be maintained and monitored at all times during the use of restraint and seclusion;

1. (i) Which staff are responsible for examining and monitoring the consumer prior to, during, and after the utilization of any method of restraint or seclusion;
2. (j) Which staff have authority to order the initiation of and discontinuation of restraints and seclusion;
3. (k) What techniques staff should use prior to using restraints or seclusion;
4. (l) What assistance shall be provided to a consumer who has been placed in restraints or seclusion to assist the consumer in meeting the criteria for discontinuation of the restraints or seclusion, which staff are responsible for providing this assistance, and documentation requirements;
5. (m) Which staff are responsible for reporting any injuries or death of a consumer being placed in or while in restraints or seclusion;
6. (n) The training requirements for all staff that have direct contact with consumers as required by these rules;
7. (o) The process for debriefing the consumer and the consumer's family, if appropriate, and MH provider staff following the use of any restraint or seclusion;
8. (p) The process for reviewing compliance with the MH provider's restraint and seclusion policy by all MH provider staff;
9. (q) The process for complying with reporting requirements and other external mandates regarding the use of restraints or seclusion on consumers; and
10. (r) Information on how a consumer may contact the District's Protection and Advocacy program, including the name of the program and its address and phone number.519.3 MH providers shall include consumers and families in formulating the MH provider's restraint and seclusion policy.519.4 Each MH provider shall ensure that all MH provider staff, including administrative, clerical, and support staff, comply with the MH provider's restraint and seclusion policy.

SOURCE: Emergency and Proposed Rulemaking published at 51 DCR 8691 (September 3, 2004)[EXPIRED]; as amended by Emergency and Proposed Rulemaking published at 51 DCR 11863 (December 31, 2004)[EXPIRED]; as amended by Emergency and Proposed Rulemaking published at 52 DCR 5957 (June 24, 2005)[EXPIRED]; as

amended by Final Rulemaking published at 52 DCR 7229 (August 5, 2005).