1 Restraint and Seclusion Overview of Federal Laws and Policies (2003) Prepared by Gary Gross, Beth Mitchell, & Aaryce Hayes Advocacy, Incorporated 7800 Shoal Creek Boulevard, Suite 171-E, Austin, TX ,
2 Resources/Background Information Center for Medicare and Medicaid Services (formerly Health Care Financing Administration) sets standards for all health care providers that receive Medicare and Medicaid - Licensing and certification of providers is conducted primarily by state ( regulatory ) agencies; also conduct investigations - The web site for the CMS is
3 Resources/Background Information HHS Office of Inspector General Report on State abuse and neglect laws which describes the important components of a State system for identification, tracking, investigation and resolution of abuse incidents. - The report finds that up to 90 percent of persons with disabilities reside in facilities, such as group homes, residential schools, and supervised apartments, that do not receive Medicare or Medicaid funding, and thus are not covered by CMS standards - State systems and laws for protecting persons with disabilities from abuse or neglect can vary significantly from State to State. - The report might be used as a guide to assess the adequacy of your state laws on abuse and neglect, including R/S. - The report is available on line at:
4 Resources/Background Information U.S. General Accounting Office (GAO) Report on Restraint and Seclusion The GAO's October 1, 1999 report confirms that there is no adequate system of R/S reporting at the state level, making it impossible to determine the true level of deaths and injuries that result from R/S abuses, and preventing independent agency investigations. - GAO called on HCFA to issue regulations which: (1) establish strict standards on the use of R/S in all facilities and (2) require reporting to P&As regarding all deaths and serious injuries among those with mental illness or mental retardation indicating whether R/S was used for investigation by P&As. - Report is available on line at: Then go to search GAO archives ; then type the following phrase in the search box (report number) HEHS "
5 Resources/Background Information Joint Commission on Accreditation of Health Care Organizations (JCAHO) surveys its accredited hospitals every 3 years to ensure compliance with JCAHO standards - See
6 Federal Statutory & Regulatory Protections Regarding Restraint and Seclusion
7 Federal Regulations regarding Restraint and Seclusion CMS issued three sets of regulations prior to effective date of Children s Health Act, which presumably will be revised to conform to CHA; one set of regulations was issued after the CHA, and other new regulations, covering other health care providers, are in the works. CMS has issued interpretative guidelines and questions and answers on the application of the regulations. They are both available at
8 Regulations for Hospitals 42 CFR (f) (CoP s) Coverage - the regulations, which became effective August, 2, 1999 (pre-cha), apply to all Medicare- and Medicaid-participating hospitals, which include shortterm psychiatric, rehabilitation, long-term, children s and alcohol-drug treatment facilities. They are interim final regulations and may be amended. This rule does not apply to the psyh under 21 rules unless those services are being provided in a hospital setting. Conditions of Participation issued in the form of COPs i.e., requirements that hospitals must meet for participation in Medicaid and Medicare.
9 Regulations for Hospitals 42 CFR (f) (CoP s) Emergency use only In the context of behavioral management, the rule specifies that R/S may only be used in emergency situations if needed to ensure the patient s safety and less restrictive interventions have been determined to be ineffective. Can not use for discipline, staff convenience or as a substitute for active treatment, and no PRNs. Different standards for medical and surgical care - Consistent with the approach used by JCAHO, the rule establishes different standards on the use of R/S in the context of acute medical and surgical care (e.g., to ensure that an IV or feeding tube will not be removed). Time limitations Maximum duration of R/S orders are based on age: adults 4 hours; children and adolescents ages 9 to 17 2 hours; and children under 9 1 hour.
10 Regulations for Hospitals 42 CFR (f) (CoP s) Restraint and Seclusion includes: 1. Physical Restraint 2. Mechanical Restraint 3. Drug Used as a Restraint 4. Seclusion/Escort No use permitted for discipline, staff convenience or as a substitute for active treatment, and no PRNs.
11 PHYSICAL RESTRAINT (CoP s) Includes any manual method or mechanical device, material or equipment attached or adjacent to the patient s body that he or she cannot easily remove that restricts the patient s freedom of movement or normal access to one s body.
12 RESTRAINT (CoP s) Definition clarified all sorts of practices may constitute a physical restraint, the key consideration relating to how the material or practice is being used For example, tucking a patient's sheets in so tightly that he or she cannot move is restraining him or her. In that instance, a sheet is a restraint. Putting up side rails that inhibit the patient's ability to get out of bed when he or she wants to constitutes a restraint. Escorting the individual to an area
13 DRUG USED AS A RESTRAINT (CoP s) Is a medication used to control behavior or to restrict freedom of movement and is not a standard treatment for the patient s condition. A doctor orders a PRN medication for his patient in a detoxification program when he becomes violent. The medication is not a restraint because PRN medication is standard treatment to manage the violent behavior of individuals going through drug or alcohol withdraw
14 SECLUSION (CoP s) Any involuntary confinement to a room or area where one is physically prevented from leaving or assisting a person to an area (Escorting). It does not include confinement on a locked unit or ward, but does include separating an individual from others
15 Regulations for Hospitals 42 CFR (f) (CoP s) Who may issue order R/S may be ordered by either a physician or a licensed independent practitioner permitted by the State and hospital to order R/S without direct supervision. This will vary by state Assessments -- a physician or a licensed independent practitioner must see the patient and evaluate the need for the intervention within one hour after its initiation. Training - ongoing education and training required of all staff with direct patient contact; must cover safe and proper use of R/S and alternatives.
16 Regulations for Hospitals 42 CFR (f) (CoP s) Reporting -- hospitals must report to CMS any death: that occurs while a patient is in R/S, or where it is reasonable to assume that a death is a result of R/S. Under these regulations a hospital is permitted to make a subjective determination about cause of death when it occurs after R/S is discontinued; compare with psychiatric treatment facility regulations -- reporting of all deaths provided. CMS shares these reports with P&As. About 75 deaths have been reported to date nationwide.
17 General Provisions for Federally Funded Health Care Facilities (CHA) The Children s Health Act of 2000 (Public , Oct. 17, 2000) [Amends the Public Health Service Act, 42 U.S.C. 290aa, by adding sections ]
18 General Provisions for Federally Funded Health Care Facilities (CHA) Coverage The Act covers all public and private health care facilities which receive support from any program supported with funds appropriated to any Federal agency, including hospitals, nursing facilities, psychiatric facilities, and ICFs. When R/S Can Be Used R/S may only be imposed by a facility to ensure the physical safety of the resident or others and is not permitted for discipline, staff convenience or as a substitute for active treatment. Doesn t state anything about only in an emergency situation or PRN use Personal Escort is not considered a restraint Time-Out is not considered seclusion Allows medical immobilization, adaptive support and medical protective devices Orders - R/S may only be imposed upon the written order of a physician or other licensed independent practitioner permitted by the state and the facility to order such restraint or seclusion, that specifies the duration and circumstances under which the restraints are to be used.
19 General Provisions for Federally Funded Health Care Facilities (CHA) Regulations - HHS is required to issue regulations requiring facilities to: ensure adequate staffing levels, provide appropriate training for staff, and provide complete and accurate reporting on restraint-related deaths. Reporting - must, within seven days, "notify the appropriate agency, as determined by the Secretary [of HHS]," (which has not yet been done) of each death that occurs at each such facility while a patient is: restrained or in seclusion, occurring within 24 hours after the patient has been removed from restraints or seclusion, or where it is reasonable to assume that a patient s death is a result of such seclusion or restraint. Funding termination - A facility's failure to comply with any of the above provisions may result in its ineligibility for participation in federally supported programs.
20 Monitoring - Seclusion may only be used when a staff member is continuously face-to-face monitoring the resident. Special Provisions for Non-Medical Community- Based Facilities for Children (CHA) Coverage - Special provisions apply only to public and private non-medical, community-based facilities for children and youth (as defined in regulations to be issued by HHS) that receive support from programs funded under the Public Health Service Act. Even if other Federal Laws apply to a a facility, this Act must still be followed. Personal Restraint and Seclusion Only These interventions are permitted only in emergency circumstances (which is undefined) and to ensure the immediate physical safety of the resident or others. Escort not considered a restraint Time out not considered seclusion Allows medical immobilization, adaptive support and medical protective devices Mechanical and Chemical Restraints are Prohibited.
21 Special Provisions for Non-Medical Community- Based Facilities for Children (CHA) Certification of Staff - R/S may only be imposed by an individual trained and certified by a state-recognized body defined in regulations to be issued by HHS and pursuant to a process determined appropriate by the state and approved by HHS in the prevention and use of physical restraint and seclusion and in specified related skills. Interim Procedures - Until the state develops a training and certification process, R/S may only be imposed if the facility assures that a senior staff person, who is competent to conduct a face-toface assessment (as defined in regulations issued by HHS), assesses the well-being of the child subject to R/S. That individual must conduct the assessment within one hour after the initiation of R/S and continue to monitor the intervention for its duration.
22 Special Provisions for Non-Medical Community- Based Facilities for Children (CHA) Reporting - Within 24 hours, covered facilities are required to provide a notification to the appropriate State licensing or regulatory agency, as determined by HHS, regarding all deaths occurring at the facility, and regarding the use of seclusion and restraint (in accordance with regulations to be issued by HHS). Regulations - HHS is required to issue within six months regulations which require states that license covered facilities to develop (within a one year period) licensing rules and monitoring requirements concerning behavior management practice. The regulations also will establish standards on the qualifications of staff involved in R/S and their training and certification, and on reporting of deaths. Funding termination - States which fail to comply with the Act s requirements shall be ineligible for participation in programs funded under the Public Health Service Act.
23 Regulations for Psychiatric Residential Treatment Facilities for Persons under 21 (42 CFR Part 483) Coverage facility other than a hospital that provides psychiatric services for persons under the age of 21, in an inpatient setting. Effective date and comment deadline - These interim final regulations were issued in January 2001 and amended in May 2001; they became effective on May 22, Restraint and seclusion - Same definitions as hospital regulations, but a personal restraint does not include briefly holding without undue force a resident in order to calm or comfort him or her, or holding a resident s hand to safely escort a resident from one area to another. Emergency is defined unanticipated resident behavior that places the resident of others at serious threat of violence or injury if no intervention occurs and that calls for an emergency safety intervention No use permitted for discipline, staff convenience or as a substitute for active treatment, and no PRNs.
24 Regulations for Psychiatric Residential Treatment Facilities for Persons under 21 (42 CFR Part 483) Who can issue orders? Orders for R/S must be issued by a physician or other licensed practitioner permitted by the state and the facility to order R/S and trained in the use of emergency safety interventions. The original rule authorized only a board certified psychiatrist or a physician licensed to practice medicine with specialized training and experience in the diagnosis and treatment of mental diseases.
25 Regulations for Psychiatric Residential Treatment Facilities for Persons under 21 (42 CFR Part 483) Assessments - Within one hour of the R/S initiation, a face-to-face physical and psychological assessment must be conducted by a physician or other licensed practitioner trained in the use of emergency safety interventions and permitted by the state and the facility to assess the physical and psychological well being of residents. The original rule had required that this assessment be conducted by a physician or a clinically qualified registered nurse. Duration of R/S - R/S use must be limited in duration based on the age of patient (identical to the hospital rules), and must be documented in detail in the resident s record. Notification to residents - The facility must provide incoming residents and/or parents/guardians with contact information for the local P&A as part of a notification on the facility s policy on R/S use.
26 Regulations for Psychiatric Residential Treatment Facilities for Persons under 21 (42 CFR Part 483) Monitoring - Staff must be physically present to continually monitor residents in R/S. Debriefing - Within 24 hours after the use of R/S, staff involved in the intervention, supervisory staff, and the resident must engage in a debriefing to discuss the circumstances resulting in the use of R/S and strategies to be used to prevent future R/S. Training The facility must require staff to have ongoing education, training and demonstrated knowledge regarding events that may trigger emergencies, alternatives to R/S, and safe use of R/S, including responding to signs of physical distress; staff must demonstrate their competencies on a semiannual basis.
27 Regulations for Psychiatric Residential Treatment Facilities for Persons under 21 (42 CFR Part 483) Reporting Facilities are required to report, unless prohibited by state law, directly to P&As (and to State Medicaid agencies) ANY: resident death, serious injury to a resident (as defined in the regulations); or suicide attempt of a resident. Regardless of whether the incident related to R/S Timing and Contents The reports must be made by the close of the next business day and include the name of the resident; a description of the occurrence; and the name, address and phone number of the facility.
28 ICF/MR Regulations (42 CFR and ) No use permitted for discipline, staff convenience or as a substitute for active treatment, and no PRNs. One hour limit in time out room (but emergency seclusion is not permitted) as part of approved time-out program; requires constant direct visual observation by staff. Emergency use of restraints only is permitted; may not exceed 12 hours; must be used as part of an individual program plan, in emergency or for specific medical reasons. Drugs may only be used to control behavior if approved by an interdisciplinary team, as part of individual program plan and only if harmful effects of behavior outweigh the potential harmful effects of the drugs. Training requirements are not addressed.
29 Nursing Home Regulations (42 CFR ) Right to be free of physical or chemical restraints imposed for discipline or convenience, and involuntary seclusion. No standards on when R/S can be used No standards on training, length of use or procedures. All alleged violations of rights involving abuse or neglect are reported to facility administrator and other officials as required by state law. Facility must investigate and take corrective action.
30 Regulations for Hospitals 42 CFR (F) (COP s) In December of 2006, after 6 years of revision, the final rule was published on the conditions of participation for hospitals.
31 Links to Restraint Materials on the Web Press Articles - The Hartford Courant articles that revitalized the battle to regulate the use of restraint. Includes valuable data base tracking deaths from the use of restraint across the nation. - Article on the improper use of restraint in nursing homes in Louisiana.
32 Links to Restraint Materials on the Web Listservs, Interest Groups - West Virginia Mental Health Consumer Association has page with many links to restraint/seclusion items. - Detailed info on the dangers of positional asphyxia. - Principles enunciated by Dr. Peter R. Breggin, Center for the Study of Psychiatry and Psychology, for the elimination of the use of restraint. - A list serve dedicated to discussion of issues relating to the use of restraint. - Children Injured by Restraint and Aversives. Organization of families concerned with harm to children from use of restraint and aversive. - Website dedicated to exposing abuse in mental health hospitals.
33 Links to Restraint Materials on the Web Position Statements, Guidelines - NAMI position statement on the use of restraint and seclusion. - American Academy of Pediatrics position statement on the use of restraint on children. American Hospital Association (AHA) and the National Association of Psychiatric Health Systems guidelines on the use of restraint and seclusion. - JCAHO Restraint Use Taskforce principles. - National Association of State Mental Health Program Directors on the use of restraint and seclusion. - American Academy of Child and Adolescent Psychiatry Policy Statement on the Prevention and Management of Aggressive Behavior in Psychiatric Institutions with Special Reference to Seclusion and Restraint. - American Geriatrics Society position statement of the use of restraint.
34 Links to Restraint Materials on the Web Federal Regulations - CMS Interpretative Guidelines for Hospital Conditions of Participation for Patients' Rights. State Statutes, Regulations, Policies - Massachusetts Department of Education regulations on the use of restraint in schools. - Tennessee DMHRR policy on the use of restraint. - New York statue on use of emergency restraint in psychiatric facilities. Wisconsin licensing policy regarding the reporting of deaths.
35 Links to Restraint Materials on the Web Restraint Policies of Schools and other Institutions - Example of a restraint policy from a nursing home. - Restraint policy of Amarillo Independent school District. - Jefferson County Colorado Policy on the use of restraint in schools. int.htm - Worcestershire County Council Policy on the Use of Restraint in Schools. ctions/procedur.htm - Australian state policy on the use of restraints in schools.
36 Links to Restraint Materials on the Web Studies and Reports - New York Commission on Quality of Care study of restraint and seclusion practices in psychiatric facilities. - HCFA newsletter for its campaign to reduce the use of restraint in nursing homes. - Question and answer fact sheet prepared by Institute on Community Integration, University of Minnesota. - Article by Dick Sobesy on death in restraint. - Report of New York State Office of Mental Health taskforce to reduce use of restraint. - FDA fact sheet on use of physical restraint devices. - Article by Dr. Donald Milliken on deaths caused by the use of restraint.
Restraint Rules for Children's Psychiatric Residential Treatment Centers The Health Care Financing Administration (HCFA now called CMS) has released federal regulations governing the use of restraint and
C H A P T E R 5 RESTRAINT AND SECLUSION I. INTRODUCTION 5.1 A. Scope of Chapter... 5.1 B. Restraint and Seclusion Laws... 5.1 Federal Law... 5.1 California Law... 5.1 Must Comply with All Laws... 5.2 C.
Page 1 of 45 FED - N0000 - Initial Comments Title Initial Comments CFR Type Memo Tag FED - N0100 - USE OF RESTRAINT AND SECLUSION Title USE OF RESTRAINT AND SECLUSION CFR 483.354 Type Condition Subpart
A Comparison of CMS Psychiatric Hospital Regulations and In the tables on the following pages we have provided a detailed comparison of the requirements of 42 CFR Part 482, Section 482.13 Patients Rights
Professional Treatment Services in Facility-Based Crisis Program Children and Adolescents Medicaid and North Carolina Health Choice (NCHC) Billable Service WORKING DRAFT Revision Date: September 11, 2014
IDENT NPSY000028 Type of Document: Policy Type of Policy: Cross Organizational Applicability: RN/MD/MHT/LPN Sponsor s Dept: Nursing Title of Sponsor Director of Specialty Nursing Title of Approving Official:
Nonviolent Crisis Intervention Training and Maine Department of Education Chapter 33: Rule Governing Physical Restraint and Seclusion 10850 W. Park Place, Suite 600 Milwaukee, WI 53224 USA 800.558.8976
603 CMR 46.00: PREVENTION OF PHYSICAL RESTRAINT AND REQUIREMENTS IF USED Section 46.01: Scope, Purpose and Construction 46.02: Definitions 46.03: Use of Restraint 46.04: Policy and Procedures; Training
s on Restraint and Seclusion/ Nonviolent Crisis Intervention Training Program 10850 W. Park Place, Suite 600 Milwaukee, WI 53224 USA 800.558.8976 888.758.6048 TTY (Deaf, hard of hearing, or speech impaired)
CHAPTER 2015-177 Committee Substitute for Committee Substitute for House Bill No. 1055 An act relating to child protection; amending s. 39.2015, F.S.; providing requirements for the representation of Children
VIRGINIA Current Statutes, Regulations, Policies, and/or Guidance Statutes 8 Va. Admin. Code 20-670-130 (Education; State Board of Education; Regulation Governing the Operation of Private Day School for
The amended regulations set out below were approved by the Board of Elementary and Secondary Education on December 16, 2014, and take effect on January 1, 2016. (Until such date, a current version of 603
DEPARTMENT OF HEALTH AND HUMAN SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES PSYCHIATRIC UNIT CRITERIA WORK SHEET RELATED MEDICARE PROVIDER NUMBER ROOM NUMBERS IN THE UNIT FACILITY NAME AND ADDRESS
Report to The Vermont Legislature Report on the Repurposing of the Woodside Juvenile Rehabilitation Center In Accordance with Act 146 Sec. C 10: Woodside Juvenile Rehabilitation Center Submitted to: Submitted
4.16. Freedom from Restraints and Abuse. WEST VIRGINIA Downloaded January 2011 4.16.a. General. Each resident shall be free from mental and physical abuse, and free from chemical and physical restraints
INPATIENT HOSPICE CARE Information Source: Medicare Benefit Policy Manual /Chapter 9 - Coverage of Hospice Services Under Hospital Insurance Web link: http://www.cms.hhs.gov/manuals/downloads/bp102c09.pdf
Connecticut Valley Hospital s Restraint and Seclusion Prevention and Reduction Initiative Connecticut Valley Hospital 615 Bed State Operated Inpatient Psychiatric Hospital Provide services to adults Treatment
17a-453a-1 2 DEPARTMENT OF MENTAL HEALTH AND ADDICTION SERVICES General Assistance Behavioral Health Program The Regulations of Connecticut State Agencies are amended by adding sections 17a-453a-1 to 17a-453a-19,
I. Purpose The purpose of this policy is to create a statewide policy that applies to all school districts regarding the use of positive behavior intervention and supports, and the limited use of restraint
STATE OF NEVADA Department of Administration Division of Human Resource Management CLASS SPECIFICATION TITLE GRADE EEO-4 CODE LICENSED PRACTICAL NURSE III 33* C 10.364 LICENSED PRACTICAL NURSE II 31* C
California s Protection & Advocacy System Toll-Free (800) 776-5746 Compilation of Select Laws & Regulations Regarding Behavioral Restraint & Seclusion February 2014, Pub. #5457.01 i Disability Rights California
The Florida Senate BILL ANALYSIS AND FISCAL IMPACT STATEMENT (This document is based on the provisions contained in the legislation as of the latest date listed below.) BILL: CS/SB 998 Prepared By: The
Patient s Bill of Rights When you apply for or receive mental health services in the State of Texas, you have many rights. Your most important rights are listed on these six pages. These rights apply to
I. PURPOSE 414 MANDATED REPORTING OF CHILD NEGLECT OR PHYSICAL OR SEXUAL ABUSE The purpose of this policy is to make clear the statutory requirements of school personnel to report suspected child neglect
TITLE 7 CHAPTER 1 PART 13 HEALTH HEALTH GENERAL PROVISIONS INCIDENT REPORTING, INTAKE, PROCESSING AND TRAINING REQUIREMENTS 126.96.36.199 ISSUING AGENCY: New Mexico Department of Health. [188.8.131.52 NMAC - Rp,
OUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE Brief Coverage Statement Outpatient Substance Use Disorder (SUD) Fee-For-Service (FFS) Treatment Services are available for the treatment of substance
Keep Your Mind and Body Healthy: Understanding Mental Health Providers, Care and Coverage Our mental health is a vital part of our overall well-being. It affects how we think, how we feel, and how we act.
POLICY #414 MANDATED REPORTING OF CHILD NEGLECT OR PHYSICAL OR SEXUAL ABUSE I. PURPOSE The purpose of this policy is to make clear the statutory requirements of school personnel to report suspected child
Haddonfield 5530 / Page 1 of 10 5530 SUBSTANCE ABUSE (M) The following procedures are established in implementation of Policy No. 5530, Substance Abuse. A. Definitions 1. Evaluation means those procedures
Public Act No. 15-226 AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR MENTAL OR NERVOUS CONDITIONS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section
STATEMENT OF CONSIDERATION RELATING TO 907 KAR 15:070 Department for Medicaid Services Amended After Comments (1) A public hearing regarding 907 KAR 15:070 was not requested and; therefore, not held. (2)
Financing integrated Healthcare in Washington as of: April 23. 2012 E & M Codes CPT Code 99201-99205 99211-99215 Est. Pt Diagnostic Code May be used only with physical Federally Qualified Health Centers
Mental Health and Substance Abuse Bulletin COMMONWEALTH OF PENNSYLVANIA * DEPARTMENT OF PUBLIC WELFARE SUBJECT BY The Use of Seclusion and Restraint in Mental Health Facilities and Programs NUMBER: OMHSAS
907 KAR 9:005. Level I and II psychiatric residential treatment facility service and coverage policies. RELATES TO: KRS 205.520, 216B.450, 216B.455, 216B.459 STATUTORY AUTHORITY: KRS 194A.030(2), 194A.050(1),
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-12-25 Baltimore, Maryland 21244-1850 Center for Medicaid and State Operations/Survey
Disruptive Student Behavior - Use of Physical Restraint and Seclusion This regulation provides guidelines for the use of physical intervention, physical restraint, and seclusion techniques in order for
Section XX. Definitions. Section 303(g)(2)(G) of the Controlled Substances Act (21 U.S.C. 823(g)(2)(G)) is amended (1) by striking clause (ii) and inserting the following: (ii) The term qualifying practitioner
Attachment III RELATED LAWS, REGULATIONS AND POLICIES The requirements and expectations for incident management and reporting detailed in this bulletin are related to a variety of laws, regulations, and
MANDATED REPORTING OF CHILD NEGLECT OR PHYSICAL OR SEXUAL ABUSE I. PURPOSE The purpose of this policy is to make clear the statutory requirements of school personnel to report suspected child neglect or
Medicaid Emergency Psychiatric Demonstration Demonstration Design and Solicitation Under the authority of section 2707 of the Patient Protection and Affordable Care Act of 2010 (Affordable Care Act), the
NOTICE OF PRIVACY PRACTICES Effective Date: April 14, 2003 UNIVERSITY OF CALIFORNIA DAVIS HEALTH SYSTEM THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN
CHAPTER 9: NURSING HOME RESPONSIBILITIES REGARDING COMPLAINTS OF ABUSE, NEGLECT, MISTREATMENT AND MISAPPROPRIATION 9.1. PURPOSE Effective protection of residents in long term care facilities from abuse,
1 1 1 1 1 1 1 0 1 CABINET FOR HEALTH AND FAMILY SERVICES Department for Medicaid Services Division of Healthcare Facilities Management (Amended After Comments) 0 KAR :0. Reimbursement for Level I and II[Payments
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. (Adopted 4-14-03; revised December 2006) If
RESTRAINT USE and PATIENT CARE Orientation for Housestaff OBJECTIVES: Upon completion of this education program, participants will be able to: 1. Define the term restraint. 2. Identify 5 alternatives to
R 5530/Page 1 of 12 R 5530 The following procedures are established in implementation of Policy No. 5530, Substance Abuse. A. Definitions 1. Evaluation means those procedures used by a certified or licensed
Department of Defense INSTRUCTION NUMBER 6490.04 March 4, 2013 USD(P&R) SUBJECT: Mental Health Evaluations of Members of the Military Services References: See Enclosure 1 1. PURPOSE. In accordance with
Stopping Restraint & Seclusion in Schools: For My Child and All Children Leslie Morrison Director of Investigations and Grant Management Leslie.Morrison@disabilityrightsca.org Rebecca Cervenak Staff Attorney
R 5530/Page 1 of 17 M R 5530 [See POLICY ALERT Nos. 125, 133, 144, 145, 157, 173, 179 and 204] The following procedures are established in implementation of Policy 5530, Substance Abuse. A. Definitions
5530/page 1 of 7 M [See POLICY ALERT Nos. 105, 121, 144 156, 157, 161, 179 and 204] 5530 SUBSTANCE ABUSE The Board of Education recognizes that a student s abuse of harmful substances seriously impedes
Florida Medicaid: Mental Health and Substance Abuse Services Beth Kidder Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration House Children, Families, and Seniors Subcommittee
R Robbinsville Board of Education REGULATION Section: s Regulation 5530: Substance Abuse (M) Edited: September 2014 Page 1 of 12 R 5530 SUBSTANCE ABUSE (M) The following procedures are established in implementation
INDEPENDENT SCHOOL DISTRICT #877 POLICY Buffalo-Hanover-Montrose INDEX TITLE Employee/Personnel SERIES NO. 400 Mandated Reporting of Child Neglect or POLICY TITLE Physical or Sexual Abuse CODE NO. 414.
Hardin-Houston Local School District Bylaws & Policies 5630.01 - POSITIVE BEHAVIOR INTERVENTION AND SUPPORTS AND LIMITED USE OF RESTRAINT AND SECLUSION The Board is committed to the District-wide use of
Clinical Considerations for Involuntary Mental Health Treatment of Adults in Oklahoma Brandon Schader, M.D. Medical Director for Crisis Stabilization Oklahoma County Crisis Intervention Center Oklahoma
AN ACT RELATING TO HEALTH INSURANCE; AMENDING A SECTION OF THE NEW MEXICO INSURANCE CODE TO PROVIDE FOR FREEDOM OF CHOICE OF HOSPITAL AND PRACTITIONER TO INCLUDE LICENSED PROFESSIONAL MENTAL HEALTH COUNSELORS
Adopted: December 18, 2006 MSBA/MASA Model Policy 532 Orig. 2003 Revised: 9/18/2007, 01/18/2011, 06/16/2014 Rev. 2013 532 USE OF PEACE OFFICERS AND CRISIS TEAMS TO REMOVE STUDENTS WITH IEPs FROM SCHOOL
RULES OF THE TENNESSEE DEPARTMENT OF MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES CHAPTER 0940-05-47 MINIMUM PROGRAM REQUIREMENTS FOR ALCOHOL AND DRUG OUTPATIENT DETOXIFICATION TREATMENT FACILITIES TABLE
AMENDMENT OF THE REGULATIONS OF THE COMMISSIONER OF EDUCATION Pursuant to Education Law sections 101, 207, 3208, 3602, 4002, 4308, 4355, 4401, 4402 and 4403 1. The emergency rule amending paragraphs (3)
Page 1 of 8 Patients Bill of Rights A Handbook for Patients of Fairview Legislative Intent: It is the intent of the Legislature and the purpose of this statement to promote the interests and well-being
Minnesota Patients Bill of Rights Legislative Intent It is the intent of the Legislature and the purpose of this statement to promote the interests and well-being of the patients of health care facilities.
Optum By United Behavioral Health 2015 Mississippi Coordinated Access Network (CAN) Medicaid Level of Care Guidelines is a behavioral intervention program, provided in the context of a therapeutic milieu,
INCIDENT MANAGEMENT PROGRAM POLICY AND PROCEDURE STATEMENT Policy Title: Incident Management Program Regulatory Reference: OPWDD Part 624 and Part 625 Date: Revised January 3, 2014 POLICY It is our mission
PPA 419 Aging Services Administration Lecture 6b Nursing Home Reform Act of 1987 (OBRA 87) The 1987 Nursing Home Reform Act In a 1986 study, conducted at the request of Congress, the Institute of Medicine
Adopted: MSBA/MASA Model Policy 532 Orig. 2003 Revised: Rev. 2011 532 USE OF PEACE OFFICERS AND CRISIS TEAMS TO REMOVE STUDENTS WITH IEPs FROM SCHOOL GROUNDS [Note: School districts are required by statute
Medicaid IMD Exclusion and Options for MHDS February 29, 2012 This white paper is intended to provide policy guidance regarding the impact and options associated with the Medicaid Institution for Mental
H.R 2646 Summary and S. 1945 Comparison TITLE I ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS It establishes an Office of the Assistant Secretary for Mental Health and Substance Use
SECTION 3 SCHOOL ADMINISTRATION 3.10 Goals and Objectives 3.30 Chain of Command 3.30-E Exhibit Organizational Chart for Administration 3.40 Superintendent 3.50 Administrative Personnel Other Than the Superintendent
IOWA PLAN F BEHAVIAL HEALTH RE: Professional Criteria and Medicaid Reimbursable Outpatient Services by Professionals The purpose of this document is to clarify who can provide which outpatient services
ARTICLE 4.1. COMMUNITY MENTAL HEALTH CENTERS; CERTIFICATION Rule 1. Definitions 440 IAC 4.1-1-1 Definitions Sec. 1. The following definitions apply throughout this article: (1) "Accreditation" means an
REPORTING AND INVESTIGATING ABUSE AND NEGLECT IN ILLINOIS This publication is made possible by funding support from the Centers of Medicare and Medicaid Services, the Illinois Department of Public Health
Donald M. Berwick, MD Administrator, Centers for Medicare & Medicaid Services Department of Health and Human Services PO Box 8010 Baltimore, MD 21244-1850 Attention: CMS 3202-P Submitted electronically
Minnesota Patients Bill of Rights Legislative Intent It is the intent of the Legislature and the purpose of this statement to promote the interests and well-being of the patients of health care facilities.
5530/Page 1 of 6 5530 M The Board of Education recognizes that a pupil s abuse of harmful substances seriously impedes that pupil s education and threatens the welfare of the entire school community. The
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Maryland As of July 2003, 638,662 people were covered under Maryland's Medicaid/SCHIP programs. There were 525,080 enrolled in the Medicaid
STATE AGENCIES RECORDS SCHEDULE S4: HEALTH RECORDS (Revised: 11/2010) STATE OF CONNECTICUT Connecticut State Library Office of the Public Administrator 231 Capitol Avenue, Hartford, CT 06106 www.cslib.org/publicrecords
12/04/2006, 7/2/2007, Page 1 of 20 I. Purpose: A. To ensure facility/organizational provider applicants meet ValueOptions of California (VOC) credentialing criteria. B. This policy replaces ValueOptions,