Section 22-A500. PURPOSES AND APPLICATION

 

500.1The purpose of these rules is to:

 

(a)Provide a safe and therapeutic environment for consumers;

 

(b)Significantly reduce the incidence of emergencies that necessitate the use of restraints and seclusion;

 

(c)Establish positive, trusting relationships among consumers, families of consumers, and mental health provider staff;

 

(d)Employ restraints and seclusion in an emergency, only in accordance with this chapter, and other applicable federal and District laws and regulations;

 

(e)Reduce and minimize the use of restraints and seclusion in an emergency in favor of less restrictive behavior management techniques;

 

(f)Promote, facilitate and implement the use of consumer's advance instructions regarding treatment preferences in the event of a psychiatric emergency;

 

(g)Facilitate appropriate placements and transfers for consumers, as necessary, such that the degree of control over consumers in the treatment environment reduces or eliminates the need for repeated or sustained use of restraints and seclusion in an emergency;

 

(h)Promote, facilitate, and implement initial and continuing education and training programs for mental health provider staff charged with applying, monitoring, and documenting the use of restraints and seclusion in an emergency; and

 

(i)Aid in the development of internal and external quality improvement processes to identify and implement ways in which the use of restraints and seclusion in an emergency may be reduced or eliminated in favor of more positive behavioral management techniques with less potential risk.

 

500.2The rules in this chapter are applicable to all mental health providers in the District. For purposes of this chapter, a mental health provider (MH provider(s)) is any entity that:

 

(a)Is operated, licensed, or certified by the Mayor to provide mental health services or mental health supports; or

 

(b)Has entered into an agreement with the Mayor to provide mental health services or mental health supports.

 

500.3Consumers have the right to be free from restraints or seclusion, of any form, imposed as a means of coercion, discipline, convenience, or retaliation by staff.

 

500.4Restraints include devices and techniques designed and used to control a consumer's behavior in an emergency, as further described in § 502.

 

500.5Seclusion is the involuntary confinement of a consumer in a room or area where the consumer is physically prevented from leaving, as further described in § 503.

 

500.6An "emergency" which may require the use of restraints or seclusion occurs when a consumer experiences a mental health crisis and is presenting an imminent risk of serious injury to self or others.

 

500.7Restraints and seclusion, as further described in §§ 503 and 504 of this chapter, may only be used during an emergency by trained staff, in accordance with the requirements of this chapter, working at one of the following:

 

(a)A hospital when administering inpatient or emergency psychiatric services;

 

(b)A residential treatment center (RTC) certified pursuant to 29 DCMR § 948 or under contract with the District to provide mental health services to District residents;

 

(c)Site-based mental health crisis emergency programs certified by the Department of Mental Health (DMH); or

 

(d)DMH contracted psychiatric crisis stabilization programs.

 

500.8Except for the MH providers specifically identified in § 500.7, restraints and seclusion may not be used by any other MH provider under any circumstances. An MH provider not specifically authorized to use restraints or seclusion must comply with the requirements of §§ 519, 520 and 521 of this chapter.

 

500.9Restraints and seclusion shall not include:

 

(a)General protective security measures including, without limitation, locked wards, or other special security measures adopted in youth residential treatment centers, maximum security psychiatric hospitals or forensic units in psychiatric hospitals, or specific security measures ordered by a court;

 

(b)Time-out as further described in § 504.2; or

 

(c)Protective measures as further described in § 517.

 

 

authority

Sections 114 and 209 of the Mental Health Service Delivery Reform Act of 2001, effective December 18, 2001 (D.C. Law 14-56; D.C. Official Code §§ 7-1131.14 and 1231.09 (2001 ed.)).

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).