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LOUISIANA |
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Standard or Definition |
LOUISIANA ADMINISTRATIVE CODE
Title 48 - Chapter 79
Sections 7901 - 7923 and 7951-7969
As of July, 2003 |
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Restraint Definition |
Restraint - the extraordinary restriction of a client's freedom or freedom of movement.
Passive Physical Restraint - the least amount of direct physical contact required on the part of a staff member to prevent a client from harming himself/herself or others. |
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Restraint Exclusions |
None. |
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Chemical Restraint Definition |
Psychotropic Medication - prescription medication given for the purpose of producing specific changes in mood, thought processes, or behavior. They exert specific effects on brain function and can be expected to bring about specific clinically beneficial responses in clients for whom they are prescribed. The term as used in this policy does not include all drugs which affect the central nervous system or which may have behavioral effects; i.e., anticonvulsants or hormones. |
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Seclusion Definition |
Seclusion is not permitted, except for "Time Out" Regulations, which consist of Time-Out Procedure - the isolation of a client for a period of less than 30 minutes in an unlocked room. |
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Seclusion Exclusions |
None. |
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Criteria for Restraint and Seclusion |
A Provider shall not use any form of mechanical, physical or chemical restraint. Passive physical restraint shall only be utilized when the child's behaviors escalate to a level of possibly harming himself/herself or others.
Passive physical restraints are only to be performed by two (2) trained staff personnel in accordance with an approved curriculum. A single person restraint can be initiated in a life threatening crisis with support staff in close proximity to provide assistance.
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Monitoring Requirements |
A provider shall ensure that a direct service staff who is an appropriately qualified professional is assigned to each client and given responsibility for and authority over:
- supervision of the implementation of the client's service plan;
- integration of the various aspects of the client's program;
- recording of the client's progress as measured by objective indicators;
- reviewing the client's service plan on a quarterly basis; and
- monitoring any extraordinary restriction of the client's freedom, including use of any form of restraint, any special restriction on a client's communication with others and any potentially harmful treatment or behavior management technique applied to the client.
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Ordering and Initiation |
No information provided. |
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In-person Assessment |
No information provided.
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Debriefing |
No information provided. |
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Family & Guardian Notification |
No information provided. |
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Notification of Rights and Restraint and Seclusion Policies and Procedures at admission |
Copies of the behavior management policy, the prohibited response policy and the punishment policy, including restraint prohibitions and time out procedures, shall be provided in triplicate upon admission. The child and parent(s) or legal guardian(s) shall sign all three (3) copies. The child and parent(s) or legal guardian(s) shall retain one copy each and the Provider shall retain the other copy in the child's record. |
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Training |
A Provider shall document that all support and direct care employeesreceive training on an annual basis in the following topics:
- provider's administrative procedures and programmatic goals;
- provider's emergency and safety procedures including medical emergencies;
- children's rights;
- detecting and reporting suspected abuse and neglect.
Direct care employees shall receive additional annual training to includebut not be limited to the following topics:
- implementation of treatment plans;
- reporting critical incidents;
- health practices;
- detecting signs of illness of dysfunction that warrant medical or
- nursing intervention;
- basic skills required to meet the health needs and problems of the children;
- crisis de-escalation and the management of aggressive behavior including acceptable and prohibited responses;
- passive physical restraint which is to include a practice element in the chosen method;
- safe administration and handling of all medication including psychotropic drugs, dosages and side effects.
All direct care staff shall have documentation of current certification inCPR and First Aid.
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Documentation |
A Provider shall have a written record for each child that shall include administrative, treatment and educational data from the time of admission until the time the child leaves the Provider. All children's records shall be available for inspection by the Department of Social Services. A child's case record shall include reports of any incidents of abuse, neglect, accidents or critical incidents, including use of passive physical restraints.
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Reporting |
A Provider shall ensure that all providers of professional and special services:
- record all significant contacts with the child;
- provide quarterly written summaries of the child's response to the service, the child's current status relative to the service and the child's progress;
- participate, as appropriate, in the development, implementation and review of treatment plans and aftercare plans and in the interdisciplinary team responsible for developing such plans;
- provide services appropriately integrated into the overall programand provide training to direct service staff as needed to implement treatment plans;
- provide child assessments/evaluations as needed for treatment plan development and revision.
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Quality Improvement |
A Provider shall ensure that a qualified Treatment Plan Manager is assigned toeach child and given responsibility for and authority over reviewing and approving quarterly status reports of the successes and failures of the child's program, including the child's educational program, with recommendations for any modifications deemed necessary. These reports may be prepared by designated staff, but the Treatment Plan Manager shall also sign and date the report.
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