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Home > Behavioral Health > Behavior Support and Intervention > Standard or Definition

 
 

MARYLAND

Standard or Definition COMAR 16.05.02 State Operated Residential facilities

Restraint Definition "Restraint" means a mechanical device or a chemical agent which, when used, limits movement of a youth's body or temporarily disables the youth.

Restraint Exclusions

None.

Chemical Restraint Definition None.
Seclusion Definition "Locked door seclusion" means the placement of a youth in a locked individual room, separate from the youth's room, where a youth is kept for a period of time.

Seclusion Exclusions None.
Criteria for Restraint and Seclusion

·         A facility employee may not place a youth in locked door seclusion as punishment.

·         A facility employee may place a youth in locked door seclusion only:

       (1) When it is clearly necessary to protect the youth or other individuals or to prevent escape; and

       (2) After less restrictive methods have been tried or cannot reasonably be tried.

·         Time Limitations

(1) A youth may not remain in locked door seclusion more than 24 hours without the review and approval of the superintendent or the duty officer, who shall provide a written explanation for the decision. If one of these administrators was involved in the incident, the other one makes the determination.

(2) After the decision has been made to keep a youth in locked door seclusion for more than 24 hours, the youth shall be seen by the superintendent or the duty officer at least once during each 12-hour period.

(3) The maximum stay in seclusion as a result of a single incident may not exceed 72 hours, unless a declared written emergency is issued by the superintendent.

·         Release. A youth shall be released from locked door seclusion when the youth no longer fits the criteria for placement in locked door seclusion.

·         A facility employee may not apply any restraint to a youth as punishment.

·         A facility employee may apply restraints to a youth only for:

(1) The protection of the youth or other individuals;

(2) The prevention of escape.

Monitoring Requirements A facility's policy, based upon the facility's physical structure and personnel, shall describe:

(1) The permissible locations for locked door seclusion;

(2) The supervision that shall be provided when locked door seclusion or restraints are used;

(3) The services or treatment considered appropriate as a result of a youth's conduct; and

(4) A process for releasing a youth from locked door seclusion or restraints.

Ordering and Initiation Use by an employee of locked door seclusion or restraint is governed by the policy applicable to the facility.

In-person Assessment None.
Debriefing A facility's policy shall address a youth's right to:

(1) A hearing before an impartial hearing officer;

(2) Advance written notice of the:

(a) Date, time, and location of the hearing, and

(b) Availability and name of a child advocate;

(3) Be heard and present witnesses;

(4) Confront adverse witnesses;

(5) Appeal the decision; and

(6) Expungement of the records from the youth's file if the youth prevails at the hearing.

Family & Guardian Notification None.
Notification of Rights and Restraint and Seclusion Policies and Procedures at admission None.
Training

None.

Documentation None.
Reporting None.
Quality Improvement None.



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