PART I - Department of Behavioral Health and Developmental ...

. Grievancesi. Grievance, complaint and appeals of internal and external policies and processes are clearly written in languageaccessible to individuals served and are promulgated and consistent with all applicable DBHDD policies regardingComplaints and Grievances regarding community services. Notice of procedures is provided to individuals, staffand other interested parties, and providers maintain records of all complaints and grievances and the resolutions ofsame.c. Safety Interventionsi. Providers must work with each enrolled individual to develop, document, and implement, as needed, a crisis plan.ii. Providers must have a process in place to provide after-hours accessibility and have the ability to respond, face-tofaceas clinically indicated, to crisis situations that occur with enrolled individuals in a timely manner per thecontact/agreement with DBHDD. The Georgia Crisis and Access Line GCAL) are not to be used as the crisis orafter hour’s access for enrolled individuals. However, providers may utilize GCAL in order to gain access to higherlevels of care (e.g. Crisis Stabilization Units, other inpatient services, etc.) or facilitate coordination with GeorgiaEmergency Management Agency services (i.e. 911)iii. The organization must have established procedures/protocols for handling emergency and crisis situations thatdescribe methods for supporting individuals/youth as they transition to and from psychiatric hospitalization.iv. In policy, procedures, and practice, the provider makes it clear whether and under what circumstances the followingrestrictive interventions can be implemented based on the service(s) provided by the provider and licensurerequirements. In all cases, federal and state laws and rules are followed and include but are not limited to thefollowing:1. Use of adaptive supportive devices or medical protective devices;a. May be used in any service, support, and treatment environment; andb. Use is defined by a physician’s order (order not to exceed six calendar months).c. Written order to include rationale and instructions for the use of the device.d. Authorized in the individual resiliency/recovery plan (IRP).e. Are used for medical and/or protective reason (s) and not for behavior control.2. Time out (used only in co-occurring DD or C&A services):a. Under no circumstance is egress restricted;b. Time out periods must be brief, not to exceed 15 minutes;c. Procedure for time-out utilization incorporated in behavior plan;d. Reason justification and implementation for time out utilization documented.3. Personal restraint (also known as manual hold or manual restraint): The application of physical force, withoutthe use of any device, for the purpose of restricting the free movement of a person’s body;a. May be used in all community settings except residential settings licensed as Personal CareHomes;b. Circumstances of use must represent an emergency safety intervention of last resort affecting thesafety of the individual or of others;c. Brief handholding (less than 10 seconds) support for the purpose of providing safe crossing, safetyor stabilization does not constitute a personal hold;d. If permitted, Personal Restraint (ten seconds or more), shall not exceed five (5) minutes and thisintervention is documented.4. Physical restraint (also known as mechanical restraint): A device attached or adjacent to the individual'sbody that one cannot easily remove and that restricts freedom of movement or normal access to one'sbody or body parts.a. Prohibited in community settings except in community programs designated as crisis stabilizationunits for adults, children or youth;b. Circumstances of use in behavioral health, crisis stabilization units must represent an emergencysafety intervention of last resort affecting the safety of the individual or of others.5. Seclusion: The involuntary confinement of an individual alone in a room or in any area of a room where theindividual is prevented from leaving, regardless of the purpose of the confinement. The practice of"restrictive time-out" (RTO is seclusion and may not be utilized except in compliance with the requirementrelated to seclusion. The phrase "prevented from leaving" includes not only the use of a locked door, butalso the use of physical or verbal control to prevent the individual from leaving.a. Seclusion may be used in the community only in programs designated as crisis stabilizationprograms for adults, children or adolescents;b. Circumstances of use in behavioral health crisis stabilization programs must represent anemergency safety intervention of last resort affecting the safety of the individual or of others;FY2013 Provider Manual for Community Behavioral Health Providers