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KANSAS
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Standard or
Definition
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KANSAS CHILD CARE LICENSING AND REGISTRATION LAWS
Chapter 65. PUBLIC HEALTH
Article 5. MATERNITY CENTERS AND CHILD CARE FACILITIES
As of February, 2003
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Restraint
Definition
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“Restraint” means the application of any devices, other than human
force alone, to any part of the body of a youth in care for the purpose of
preventing the youth from causing injury to oneself or others.
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Restraint
Exclusions
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None.
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Chemical Restraint
Definition
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None.
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Seclusion
Definition
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“Involuntary seclusion” means the removal of a youth from other youths
to a separate locked room or quarters.
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Seclusion
Exclusions
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None.
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Criteria for
Restraint and Seclusion
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Each facility shall establish and implement written
policies and procedures that govern the use of restraint. These policies and procedures shall include
the following:
- Limitations on the use of physical restraint to instances of
justifiable self-defense, protection of the youth or others, or the protection of
property;
- permission to use physical restraint only if all other less
restrictive methods of controlling the youth’s dangerous behavior were attempted and
failed;
- a statement that chemical agents are not to be used by secure
residential treatment facility personnel;
- a statement that psychotropic medications are not to be used for
disciplinary reasons; and
- a statement that psychotropic medications are to be administered
only when medically necessary upon order of the youth's physician.
The restraints selected shall be the least restrictive
measure necessary to prevent Injury to the youth or others.
Restraint or involuntary seclusion shall never be used
for punishment or for the Convenience of staff. Restraint or involuntary seclusion shall not be
used for more than three consecutive hours without medical reevaluation of its
necessity, except between the hours of 12:00 midnight and 8:00 AM, unless necessary for
the safety and well-being of the youth.
Involuntary seclusion shall be permitted within a
secure residential treatment facility only when a youth is out of control,
continually refuses to obey reasonable and lawful requests, or behaves in a
way that presents a threat to self or others.
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Monitoring
Requirements
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Each secure residential treatment facility shall:
- ensure that at least one youth care staff member is in
the proximity of each youth in involuntary seclusion at all times, with direct, physical
observation at least every 15 minutes. At the time of each observation, all of the following activities shall occur:
- Interactive intervention shall be attempted, unless the youth is sleeping;
- the result of the
intervention shall be recorded; and
- the condition of
the youth shall be recorded;
- ensure constant supervision if a youth is considered
suicidal.
Electronic or auditory devices shall not be used to replace staff
supervision of youth in involuntary seclusion.
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Ordering and
Initiation
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Restraint.
- Each secure residential treatment facility that uses
restraint shall develop and ensure implementation of a comprehensive policy
on the use of each restraint. The policy shall identify the following:
- The forms of restraint in use at the secure residential treatment
facility, clearly demonstrating that each specified form of restraint is required
to appropriately serve youth;
- specific criteria for the use of each form of restraint;
- the staff members authorized to approve the use of each form of
restraint;
- the staff members authorized and qualified to administer or apply
each form of restraint;
- the approved procedures for application or administration of each
form of restraint;
- the procedures for monitoring any youth placed in each form of
restraint;
- any limitations on the use of each form of restraint, including
time limitations;
- the procedures for immediate, continual review of restraint
placements for each form of restraint, except passive physical restraint; and
- procedures for comprehensive record keeping concerning all
incidents involving the use of restraint, including incidents of passive physical
restraint if it is used in conjunction with or leads to the use of any other form
of restraint.
Seclusion.
- Each secure residential treatment facility shall
establish and implement written Policies and procedures that govern the use of involuntary seclusion.
The policies And procedures shall include provisions that meet the following
conditions and Requirements:
- Permit the use of involuntary seclusion if all other less
restrictive methods to prevent immediate, substantial bodily injury to the youth or others
have been attempted and have failed to prevent immediate and substantial bodily
injury to the youth or others and if all alternative measures to prevent
injury are not sufficient to accomplish this purpose;
- require a written order by the program director of the secure
residential treatment facility, physician, psychologist, or other approved staff
member each time a youth is placed in or released from involuntary seclusion;
- ensure that no more than one youth is placed in an involuntary
seclusion room at any one time;
- provide for a search of each youth and removal of any items that
may be used to injure oneself or others before admission to the involuntary
seclusion room;
- ensure that each youth is provided appropriate clothing at all
times;
- ensure that each youth in involuntary seclusion is provided with a
mattress on a clean, level surface above floor level;
- ensure that each youth receives all meals and snacks normally
served and is allowed time to exercise and perform necessary bodily functions;
- ensure that each youth has prompt access to drinking water and
washroom facilities;
- ensure that the designated staff member on duty makes appropriate
entries in the youth’s records regarding the use of involuntary seclusion;
- If a youth requires more than 48 consecutive hours of
involuntary seclusion or more than 72 cumulative hours of involuntary
seclusion within any seven-day period, or is placed on suicide watch, an
emergency staff meeting shall be held to discuss the appropriateness of the
youth’s individual plan of care.
- Participants in the emergency staff meeting shall include the
following:
- The youth, if behavior permits;
- the program director or
the program director's designee;
- a physician, clinical
psychologist, or clinical social worker who has assessed the youth;
- any other appropriate
staff member.
- The results of the emergency staff meeting shall be recorded and
maintained on file.
- All youth care staff and program personnel shall be
informed at all times of the current status of each youth in involuntary seclusion.
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In-person
Assessment
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The facility shall provide for an assessment of the need for continued
involuntary seclusion at each shift change and for documentation of the
reasons that involuntary seclusion is continued.
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Debriefing
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Family &
Guardian Notification
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The youth’s parents or legal guardian shall be notified of the
emergency staff meeting and invited to participate. Documentation of notifications
shall be kept in the youth’s record.
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Notification of
Rights and Restraint and Seclusion Policies and Procedures at admission
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Training
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Each youth care staff member shall receive a minimum of eight hours of
orientation training before assuming any responsibility for supervising youth and
an additional 32 clock hours of orientation training before assuming independent
responsibility for supervision of youth. Orientation training shall include all of the
following topics:
- Accident and injury prevention;
- child abuse, neglect, and exploitation reporting requirements;
- crisis management and intervention;
- emergency and safety procedures to follow in the event of an
emergency, bomb threat, fire, tornado, riot, or flood;
- facility policies and procedures;
- first aid, including rescue breathing;
- health, sanitation, and safety measures;
- job duties and responsibilities;
- the rights of the youth;
- observation of symptoms of illness and communicable diseases;
- policies regarding behavior management, use of restraints, and
involuntary seclusion;
- problem solving methods;
- report writing methods;
- security procedures; and
- suicide prevention.
Each program director and each person having contact with youth shall
complete a minimum of 40 clock hours of in-service training per year. In-service
training shall include the following topics:
- Accident and injury prevention;
- child abuse symptoms and reporting requirements;
- child care practices;
- child psychosocial growth and development;
- first aid, including rescue breathing;
- the rights of the youth;
- licensing regulations;
- observations of symptoms of illness and communicable diseases;
- suicide prevention;
- use of restraints and seclusion; and
- crisis management.
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Documentation
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The licensee shall ensure that policies and procedures are developed
that govern documentation of all special incidents, including the taking of hostages
and the use of restraint. The policies and procedures shall require submission of a
written report of all special incidents to the program director or the program
director's designee. Each report shall be submitted no later than the conclusion of that shift.
A copy of the report shall be kept in the youth’s record.
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Reporting
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A copy of the report of any incident that involves the taking of
hostages, the death or injury of a youth, or criminal charges against a youth
or staff member shall be submitted to the department and the placing agent.
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Quality Improvement
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