MAINE |
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Standard or Definition |
Maine Department of Human Services
Bureau of Child and Family Services
10-148 Chapter 18: Rules for the Licensure of Residential Child Care Facilities
As of June, 2003 |
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Restraint Definition |
Mechanical Restraint. The restriction by mechanical means of a child's mobility and/or ability to use his/her hands, arms or legs except when such restriction is primarily for the treatment of physical injury.
Passive Physical Restraint. The least amount of direct physical contact required on the part of a staff member to prevent a child from harming himself/herself or others; approved methods of making such physical contact. |
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Restraint Exclusions |
The facility shall not permit the use of any form of restraint other than passive physical restraint without the prior approval of the licensing authority. |
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Chemical Restraint Definition |
Chemical Restraint. The use of psychotropic agents as a form of restraint. |
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Seclusion Definition |
No definition provided. |
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Seclusion Exclusions |
The facility shall not permit the seclusion of a child in a locked space. |
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Criteria for Restraint and Seclusion |
The facility shall allow the use of passive physical restraint only when one or more of the following exists:
- Threat of harm inflicted on staff or residents;
- Threat of harm inflicted on self; or
- Excessive and continuous damage to property
The facility shall not permit the use of any form of restraint other than passive physical restraint without the prior approval of the licensing authority.
Use of Psychotropic Medication: The facility which uses psychotropic medications shall ensure that usage of medication is in accordance with the goals and objectives of the child's service plan and shall not use such medication unless less restrictive alternatives have either been tried and failed or are diagnostically eliminated.
The facility shall not subject a child 14 years of age or over to the administration of a psychotropic drug against the child's wishes unless such administration is permitted emergency pharmacological intervention.
The facility shall not administer psychotropic medications as means of punishment or disciplining a child. |
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Monitoring Requirements |
No information provided. |
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Ordering and Initiation |
Chemical Restraint: The facility shall obtain from the prescribing physician a written initial report detailing the reasons for prescribing the particular medication, expected results of the medication and alerting facility staff to potential side effects. |
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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 |
Family Involvement. The facility shall adopt written policies of the facility's overall approach to family involvement which shall include procedures to assist the family of a child care in care to:
- Understand the policies of the facility;
- Understand their continuing responsibilities to their child;
- Adjust to the child's placement and separation;
- Understand the child's response to placement and separation.
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Notification of Rights and Restraint and Seclusion Policies and Procedures at admission |
Information Provided to Child. As part of the admission orientation the facility shall make available the following:
Consistent with the child's maturity and ability to understand, the facility shall make clear its expectations and requirements for behavior and shall explain the facility's criteria or successful participation in and completion of the program;
A copy of the rules governing conduct and consequences of inappropriate behavior by children in care is available.
Information Provided to Guardian(s). Prior to placement, whenever possible, the facility shall provide the guardians with written information which shall include: A description of behavior management and disciplinary practices at the facility. |
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Training |
The facility shall ensure that each direct service staff member receives in-service and external training during each full year of employment including:
- The facility's emergency and safety procedures on a semi-annual basis with review evacuation instructions every two months;
- The facility's administrative procedures and overall program goals;
- Acceptable behavior management techniques;
- Crisis management including the ability to recognize the symptoms of suicide;
- Psychotropic medications, if administered at the facility;
- Approved first aid instructions;
- Passive physical restraint, if used;
- Licensing rules pertinent to daily operation.
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Documentation |
No information provided. |
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Reporting |
Chemical Restraint: The facility shall obtain from either the prescribing physician or another physician a written report on each child receiving such medication at least every 30 days, based on actual observation of the child and review of the daily monitoring reports. Each report shall detail the reasons medication is being continued, discontinued, increased in dosage, decrease in dosage or changed. |
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Quality Improvement |
Program Evaluation. The facility shall adopt a written plan for the annual evaluationof the facility's operation which shall cover:
- General program effectiveness in relation to stated goals and community needs;
- General staff effectiveness and staffing patterns;
- Staff turnover rate;
- Review of grievances and complaints;
- Rationale for the grouping of children;
- Emergency and safety procedures;
- Frequency of unplanned discharges of children in care;
- Periodic assessment and evaluation of treatment services.
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