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GEORGIA DEPARTMENT OF JUVENILE JUSTICE POLICY Department of

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					           GEORGIA DEPARTMENT                                Transmittal #                      Policy #
            OF JUVENILE JUSTICE                                  07-11                           8.31
 Applicability:                                     Related Standards & References:
 { } Administration                                 ACA Standards: 3-JTS-3A-15 thru 18, 3-JDF-3A-15 thru 18
 { } Field Services                                 NCCHC Juvenile Health Care Standards, 1999: Y-66
 {x} Secure Facilities                              Journal of the American Academy of Child and Adolescent
                                                    Psychiatry, Practice Parameters for the Prevention and
                                                    Management of Aggressive Behavior, Volume 41, Number 2
                                                    PPCT Management System, Inc., Pressure Point Control
                                                    Tactics Instructor Manual
                                                    Memorandum of Agreement Between the United States
                                                    Department of Justice and the Georgia Department of
                                                    Juvenile Justice, Citations 86, 87

                                                    Effective Date: 1/1/08
 Chapter 8: SAFETY, SECURITY AND CONTROL
                                                    Scheduled Review Date: 1/1/09
                                                    APPROVED:
 Subject: RESTRAINT OF YOUTH
 Attachments:
 A – Approved Mechanical Restraint Devices
 B – Restraint Flow Sheet
 C – Therapeutic Restraint Order
 D – Report of Youth Injuries and Addendum
                                                    ______________________________________________
                                                     Albert Murray, Commissioner

I.      POLICY:

        Department of Juvenile Justice staff shall use the minimum amount of physical control
        measures needed to restrain or maintain positive control of a youth. Authority for the use of
        physical control measures and restraint equipment shall rest with the facility/program/office
        Director or senior official present. Restraints shall always be utilized in the most humane and
        safe manner possible, with respect for the youth’s autonomy and dignity.

II.     DEFINITIONS:

        Director: For the purposes of this policy, the staff member responsible for the overall
        operation of a Regional Youth Detention Center (RYDC), Youth Development Campus
        (YDC), community-based office, or other DJJ owned, operated, or contracted facility or
        program.

        Escort: Accompanying a youth to another location within a secure facility.

        First Aid: Initial treatment given by a staff member trained in providing first aid to a sick or
        injured youth to preserve life, prevent further injury, or promote recovery.

        Injury Severity Rating: A numerical rating assigned by health care staff that indicates the
        extent of a youth’s injury.

        Mechanical Restraint Device:         Any device used to completely or partially constraint a
        person’s bodily movement.

        Physical Control Measures (PCM): A physical action taken by staff with the intention of
        maintaining positive control of a youth, enforcing lawful directives, and protecting self or
        others from injury. Physical interactions such as holding, restraining, subduing, and the use of
        a mechanical restraint device constitute physical control measures.
                   Chapter                                Subject                     Policy #      Page
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          Qualified Mental Health Professional (QMHP): Mental health staff with education, training
          and experience adequate to perform the duties required in accordance with professional
          standards. When the QMHP is required to provide individual counseling to youth with mental
          illness, the QMHP must have at least a master’s degree in a mental health related field and
          training and experience in the provision of mental health counseling.

          Restraint: The complete or partial constraint of a person’s bodily movement through physical
          or mechanical means.

          Restraint Chair: A chair device used, within the constraint of using the minimum physical
          control measures required, to restrict movement of a violent, out-of-control youth for the
          protection of the youth and/or others.

          Security Restraint: The initiation of a mechanical restraint device by security staff to
          maintain positive control of a youth whose behavior presents an imminent threat to the security
          of the facility and/or the safety of self or others.

          Therapeutic Restraint: An intervention specifically ordered by a Psychiatrist, Physician or
          Psychologist for youth with mental health problems whose behavior presents an imminent
          threat to the safety of self or others.

          Transport: Accompanying a youth to a location outside of a secure facility.

III.      PROCEDURES:

          A.   DJJ staff required to use physical control measures in the course of their job duties will be
               trained, through the Office of Training, in the techniques allowed by DJJ policy. Except
               in extreme emergencies, untrained staff should never be involved in the use of physical
               control measures.

          B.   The Control Management Continuum will be used as the guideline to the graduated levels
               of control measures authorized by DJJ. Within the continuum, staff will use the
               minimum amount of physical control measures needed to maintain positive control of a
               youth. (See DJJ 8.30, Use of Physical Control Measures)

          C.   Physical control measures, including the use of restraint devices, will be used as taught by
               the Office of Training. Staff will refrain from carrying youth in an attempt to move them
               from one place to another, except as taught by the Office of Training.

          D.   Staff will use the minimum amount of physical control measures, including restraint
               devices, necessary to maintain positive control of the youth. Inappropriate use of physical
               control measures shall be specifically prohibited.

          E.   Mechanical restraint devices will be routinely used for transport purposes. The routine
               use of mechanical restraint devices for the purpose of movement of a compliant youth
               outside of the confines of a secure facility will not be considered a use of physical control
               measures. (See DJJ 8.23, Transportation of Youth, for guidelines regarding the restraint
               of compliant youth during routine movement out of the facility.)
               Chapter                                 Subject                      Policy #      Page
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       F.    Field Services Staff:

             1.   Field services staff will not be authorized to use mechanical restraint devices.

             2.   Mechanical restraint devices will not be authorized during transportation with Field
                  Services staff.

{Revised by Directive #09-02, effective 3/1/09}
       G. The use of mechanical restraint devices will be for treatment/control purposes only when
            absolutely necessary, and never as a form of intimidation, retaliation, punishment, or as a
            substitute for staff supervision. A “cooling off” period may be used as a lesser alternative
            to the use of mechanical restraint devices. (See DJJ 16.3, Disciplinary Process)

             1.   Only approved mechanical restraint devices will be used to restrain youth. (See
                  Attachment A, Approved Mechanical Restraint Devices)

             2.   Mechanical restraint devices may be used only when:
                  • A youth is physically uncontrollable and constitutes a serious and imminent
                    danger to self or others;
                  • A youth is causing or threatening to cause physical harm or substantial property
                    damage that puts in jeopardy the safe operation of the facility;
                  • An escape attempt is imminent or in progress;
                  • Authorized by a Physician or licensed Psychologist for specific medical or
                    psychiatric reasons; or
                  • Transporting a youth.

             3.   Mechanical restraint devices will not be routinely used to escort or otherwise control
                  compliant youth.

                  a.    Mechanical restraint devices may be used for escort purposes only as a last
                        resort effort to ensure the safety of the youth or others.

                  b.    The use of mechanical restraint devices to escort a compliant youth must be an
                        intervention specified in a Mental Health Treatment Plan or Special
                        Management Plan that has been signed by the facility Psychiatrist or
                        Psychologist.

                  c.    The Mental Health Treatment Plan or Special Management Plan must include
                        written justification for the plan and be fully reviewed and re-authorized by
                        the Psychiatrist/Psychologist every 7 days for as long as the use of a restraint
                        device is considered a necessary intervention.

                  d.    Restraints used for escort purposes as an intervention in a Mental Health
                        Treatment Plan or Special Management Plan will not be considered a use of
                        physical control measures. No Special Incident Report will be necessary.

       H.    Whenever possible, the approval of the supervisor on duty will be obtained prior to the
             use of a mechanical restraint device. Emergency situations may require staff to
             immediately restrain a youth for the protection of the youth, staff, or others from injury.
            Chapter                                 Subject                      Policy #       Page
SAFETY, SECURITY, AND CONTROL                 RESTRAINT OF YOUTH                  8.31         4 of 12

        The emergency use of security restraints will be immediately reported to the senior
        official present. The emergency use of security restraints for longer than 30 minutes will
        be reported to the senior mental health staff member on duty/on call, and the licensed
        health care provider on duty/on call. The senior mental health staff member on duty/on
        call will determine if there are known mental health issues that should be considered
        when deciding to continue the restraint. This mental health consultation will not be
        considered to be the initiation of therapeutic restraint unless a therapeutic restraint order is
        specifically issued. Authorization to use a mechanical restraint device will be
        documented on the Restraint Flow Sheet (Attachment B).

   I.   Any youth who is mechanically restrained will be under the constant visual observation of
        a staff member who has the physical possession of the key.

        1.   Every 15 minutes, staff will assess the youth to ensure that the restraints are
             properly applied and that the youth is not in medical distress.

        2.   The Director or designee will evaluate and re-authorize the restraint status every 60
             minutes for as long as the restraint continues.
        3.   During the time of restraint, the youth will be offered fluids every 2 hours, meals
             during regular meal times, and a bed pan/urinal at least every 2 hours. Security staff
             will document these activities on the Restraint Flow Sheet.
             a.    Staff will feed the youth if he/she is unable to do so and report to health care
                   staff the amount of food consumed. (The food offered will not represent a
                   choking hazard and the youth will be fed in an upright position.) The health
                   care staff will document the amount of food consumed in the health record.
             b.    The bed pan/urinal will be offered by health care staff or a same-sex JCO.
   J.   Any youth restrained for more than 2 hours will be evaluated in person by a qualified
        mental health professional and a licensed health care professional who will:
        • Approve the continuation of the security restraint until the next review in 2 hours;
        • Initiate a therapeutic restraint; or
        • Develop a plan for alternative interventions and assist in the implementation of the
           plan, in consultation with the facility Director or designee.

   K.   The Restraint Flow Sheet will be used to document the use of a mechanical restraint
        device, for security or therapeutic purposes, for more than 15 minutes.

        1.   The Restraint Flow Sheet will not be required for the routine use of restraints to
             transport a youth to a location outside of a secure facility.

        2.   Documentation of all staff assessments, reviews, and checking of the restraints will
             be indicated on the Restraint Flow Sheet to include, at a minimum:
             •     Staff member’s initials or signatures;
             •     Exact time of the check or review;
             •     Findings and/or recommendations; and
             •     Any actions taken.
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   L.   Therapeutic restraints will be utilized only after the youth is evaluated by a qualified
        mental health professional (QMHP) and if sufficient staffing is available to meet the
        standards outlined in this policy. (If sufficient staffing is unavailable, staff will ensure
        that the youth remains safe and evaluate the youth for hospitalization.) The QMHP or a
        Registered Nurse with mental health training may initiate the therapeutic restraint;
        however, the continued use of the therapeutic restraint must be specifically ordered within
        1 hour by a Physician or Psychologist. (Verbal orders must be co-signed at the ordering
        clinician’s next site visit.)

        1.   The use of seclusion should be considered prior to the use of therapeutic restraints,
             when possible, because it is medically safer and preserves a greater degree of the
             youth’s autonomy.

        2.   The Therapeutic Restraint Order form (Attachment C) will be used by the ordering
             clinician to indicate the date and time of the order, type of mechanical restraint
             device to be used, maximum duration of the order, criteria for release, and level of
             observation.

        3.   Verbal and written orders for therapeutic restraint are limited to:
             • 1 hour for youth younger than age 9;
             • 2 hours for youth ages 9 to 17;
             • 4 hours for youth ages 18 and older.

             Re-evaluation of the need for restraints must occur in-person at least every 2 hours.
             The QMHP or Registered Nurse may perform the re-evaluation, but the ordering
             clinician must provide another order if the restraint episode is to continue.

             Re-evaluation of the need for restraints must be conducted in person by a
             Qualified Mental Health Professional (QMHP) at least every 15 minutes
             from the initiation of the therapeutic restraint unless the restraint is ordered
             in a Special Management Plan. If a therapeutic restraint is ordered as an
             intervention in a Special Management Plan, the QMHP will re-assess as
             directed in the Special Management Plan. The QMHP or Registered Nurse
             with mental health training may perform the re-evaluation, but the ordering
             clinician must provide another order if the restraint episode is to continue
             beyond the timeframe specified in the original therapeutic restraint order.

        4.   Therapeutic restraints may be authorized by the facility Physician Psychiatrist or
             Psychologist as a therapeutic intervention in a Special Management Plan. The
             Special Management Plan must be fully reviewed per DJJ 12.22, Behavior and Risk
             Management and re-authorized every 7 days.
             a. Special Management Plans will never order re-evaluations intervals of
                longer than 60 minutes.

             b. The specific clinical rationale for therapeutic restraint episodes of more
                than 15 minutes duration will be documented as part of the Special
                Management Plan development in a Special Management Team Note.
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SAFETY, SECURITY, AND CONTROL                RESTRAINT OF YOUTH                 8.31        6 of 12


              c. When the therapeutic restraint is used as an intervention in a Special
                 Management Plan, the QMHP or Registered Nurse must obtain a Therapeutic
                 Restraint Order within one hour of the restraint being used. (Therapeutic
                 restraints will not be ordered on an “as needed” (p.r.n.) basis.)

        5.    Only approved mechanical restraint devices (Attachment A) will be used to
              therapeutically restrain youth. The restraint device will be applied in the most
              humane manner possible. Staff applying the restraint device will be specifically
              trained to do so.

        6.    A licensed health care professional of at least the level of a Registered Nurse will
              conduct an assessment of each youth therapeutically restrained every 15 minutes
              during the entire restraint episode to check vital signs, circulation, nerve damage,
              airway obstruction and/or psychological trauma. Documentation will be made on
              the Restraint Flow Sheet.

        7.    If a youth should remove the therapeutic restraints, he/she will be reassessed to
              determine whether restraints are still needed. Restraints will be re-applied only in
              those situations in which the youth has not regained control and still meets the
              clinical criteria for restraint. A new order for the therapeutic restraint must be
              issued.

        8.    Any youth who must be re-restrained must have a new order for the therapeutic
              restraint.

        9.    At the discretion of the ordering clinician, the youth will be released from restraints
              if he/she remains calm for 60 15 continuous minutes. If the youth requests removal
              from restraints, upon concurrence by the QMHP, the restraints may be removed.

        10.   Each youth will be evaluated by a masters-level qualified mental health professional
              as soon as possible (but always within 72 hours) after removal of the restraints.

        11.   Youth who require this level of care should be placed in an appropriate treatment
              setting as quickly as possible. The facility Director and QMHP will coordinate
              transfer to an appropriate treatment setting, as clinically indicated, in consultation
              with the District Director, Regional Administrator, and central office staff.

        12.   The Office of Behavioral Health will be notified of any youth who has 2 or more
              episodes of restraint in a 12-hour period.

   M.   In all instances where time permits and video cameras are available, use of physical
        control measures, including restraint devices, and other incidents with the likelihood of
        serious injury to a youth will be videotaped. (See DJJ 8.17, Video Cameras)

   N.   Application of Mechanical Restraint Devices:
            Chapter                                Subject                     Policy #      Page
SAFETY, SECURITY, AND CONTROL                RESTRAINT OF YOUTH                 8.31        7 of 12

        1.   Youth will be restrained only for the time necessary to gain control or to arrive at a
             final destination. Only approved mechanical restraint devices (Attachment A) will
             be used to restrain youth.

        2.   Only the minimum amount of control measures that is necessary will be used.
             Restraints will be applied as taught by the Office of Training.

        3.   More than one type of mechanical restraint devices may be used at one time (i.e.,
             handcuffs and shackles); however, the minimum amount of restraint will be used to
             maintain control. Mechanical restraint devices will be applied only in the following
             manner:
             a.    Handcuffs: wrist to wrist in the front or back, or attached to a waist belt in the
                   front only and double locked; and
             b.    Shackles: on two ankles only.
             Wrists and ankles will never be attached together or interlocked.

        4.   Youth will never be handcuffed or attached to any stationary object, except with the
             use of an approved restraint chair or bed restraints.

        5.   When a youth is physically or mechanically restrained, the head must be able to
             rotate freely, the airway must be unobstructed at all times, and the lungs must not be
             restricted by excessive pressure on the back.

        6.   A restraint chair will only be used by staff trained in the use of the chair. A youth
             will only be placed in a restraint chair when he/she continues violent behavior after
             being restrained with a side waist chain and cuffs and is being physically held by
             staff. Staff will constantly monitor youth in a restraint chair to prevent possible
             tipping over. The chair will be located a safe distance from walls, doors and
             furniture to prevent head banging.

        7.   All restrained youth will be removed from the general population and public view to
             prevent embarrassment or ridicule.

   O.   In secure facilities, when behavioral health staff are on site, the youth will be evaluated
        within the same shift. When behavioral health staff are not on site, the youth will be
        evaluated upon staff arrival, but always within 72 hours of the incident. (For the purposes
        of this policy, behavioral health staff includes counseling staff and qualified mental health
        professionals.) Mental health emergencies will be reported to the on-call mental health
        staff member in accordance with DJJ 12.18, Staffing and On-Call Mental Health Services.

        1.   A Behavioral Health Evaluation will be conducted for the following incidents:
             • Self harm behaviors;
             • Outside mental health hospitalization; and
             • Use of physical control measures (level IV), including security or therapeutic
                restraints.
             Only a masters-level qualified mental health professional will be authorized to
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SAFETY, SECURITY, AND CONTROL                RESTRAINT OF YOUTH                 8.31        8 of 12

              conduct assessments of self harm behaviors.

        2.    A masters-level qualified mental health professional, at minimum, will conduct the
              Behavioral Health Evaluation when the special incident involved any self-harm
              behavior or mental health hospitalization (i.e., the Special Incident Report has a “D”
              or “E2” code).

        3.    Counseling staff will conduct the Behavioral Health Evaluation when the special
              incident involved the use of any physical control measure, including security
              restraints (i.e., the Special Incident Report has a “C” code).
        4.    If the Special Incident Report has a “C” code and a “D” or “E2” code, then a
              masters-level qualified mental health professional must conduct the Behavioral
              Health Evaluation.

        5.    The Professional Social Service Worker (PSSW) may conduct the Behavioral
              Health Evaluation, in accordance with their level of education and expertise, and as
              approved by the mental health program plan.

        6.    In circumstances in which staffing dictates another arrangement (i.e., smaller
              RYDCs with two qualified mental health professionals), the facility Director may
              re-assign these duties amongst behavioral health staff to ensure even workloads.

        6.    The Behavioral Health Evaluation will be documented in the Juvenile Tracking
              System (JTS).

        7.    Behavioral health staff should consider counseling and debriefing with the youth
              regarding the circumstances of the incident, and ways that future incidents could be
              prevented.

        8.    A copy of the Behavioral Health Evaluation will be placed in the health record as
              documentation of the encounter. A copy of the Behavioral Health Evaluation will
              be printed and filed with the Special Incident Report (SIR).

        9.    The evaluation will be conducted in an area that provides privacy and protects the
              confidentiality of the youth.

        10.   Allegations of child abuse, sexual abuse/exploitation, and neglect will be reported in
              accordance with DJJ 8.6, Reporting Child Abuse, Sexual Abuse/Exploitation, and
              Neglect.

   P.   Medical Examinations (in secure facilities):

        1.    All medical examinations and assessments as a result of a physical control measure
              will be conducted by health care staff of at least the level of a Registered Nurse.

        2.    In secure facilities, when health care staff are on site, youth will be escorted to
              medical no later than 2 hours after the time of the incident. When health care staff
              are not on site and the youth is not in distress, the youth will be examined upon staff
              arrival but always within 12 hours of the incident. The examination must be
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SAFETY, SECURITY, AND CONTROL               RESTRAINT OF YOUTH                 8.31        9 of 12

            promptly performed to ensure that the youth does not present injuries received after
            the actual use of physical control measures.

       3.   Health care staff will use the following Injury Severity Ratings to indicate the extent
            of the youth’s injuries:

                 Rating   Definition
                   1      No visible injury or pain
                   2      Injury or pain requiring first aid treatment only
                   3      Injury or pain requiring in-facility/program medical treatment beyond
                          first aid
                   4      Injury or pain requiring assessment/treatment as an outpatient at an
                          outside medical facility; or, requires a level of care that, if the mid-
                          level provider or physician was not present, the youth would be
                          referred to an outside medical provider (e.g., sutures or x-ray)
                   5      Injury or pain requiring assessment/treatment as an inpatient at an
                          outside medical facility
                   6      Injury resulting in the death of a youth

            If a youth suffers from two or more injuries from a single incident, the injury
            severity rating will reflect the most serious injury.
      {Revised by Directive #08-02}
            When a youth is assessed as an outpatient at an outside medical facility, the health
            care provider will assign the injury severity rating based upon the outside medical
            facility’s disposition.

            1. The health care staff will complete a Report of Youth Injuries (DJJ 8.5,
               Attachment D) indicating an injury severity rating of at least 4 and that the youth
               was sent to an outside medical facility.
            2. When the youth returns from the outside medical facility, the health care staff
               will complete a Report of Youth Injuries Addendum (DJJ 8.5, Attachment D) to
               indicate the findings of the outside medical facility.

            3. When the outside medical facility conducts only a physical assessment, all
               findings indicate no injury and there was no treatment rendered, the injury
               severity rating on the Report of Youth Injuries Addendum may be 1, indicating
               no injury. If there was treatment rendered, the health care staff will determine
               the injury severity rating based upon the level of treatment required.

            4. When the outside medical facility conducts a physical assessment and other
               laboratory or radiological tests, regardless of the findings of the tests, the injury
               severity rating on the Report of Youth Injuries Addendum will be 4, indicating
               that the youth received assessment/treatment as an outpatient.

            5. When the outside medical facility conducts a physical assessment and other
               laboratory or radiological tests with a finding of injury, the injury severity rating
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SAFETY, SECURITY, AND CONTROL                RESTRAINT OF YOUTH                   8.31        10 of 12

                on the Report of Youth Injuries Addendum will be 4, indicating that the youth
                received assessment/treatment as an outpatient.

            6. If the youth is admitted to the outside medical facility, the injury severity rating
               on the Report of Youth Injuries Addendum will be 5, indicating hospital
               admission.

            Any changes made to an injury severity rating will only be made on the Report of Youth
            Injuries Addendum. The original Report of Youth Injuries will not be changed.
            When a Report of Youth Injuries Addendum is completed, the health care staff completing
            the Addendum will immediately forward a copy to the facility Director. The facility
            Director will ensure that the SIR database is updated to reflect the new injury severity
            rating.

            When a youth is assessed as an outpatient at an outside medical facility, the health
            care provider will assign the injury severity rating based upon the outside medical
            facility’s disposition. (For example, if the outside medical facility assessment
            indicates that there is no injury and there was no treatment, the injury severity rating
            will be “1”)

            Only health care staff of at least the level of a Registered Nurse will assign and
            revise an injury severity rating. Health care staff’s decisions will not be
            compromised. (See DJJ 5.8, Documentation Standards and DJJ 11.40, Medical
            Autonomy)

       4.   Health care staff will use a digital camera to photograph the youth’s injuries.
            (Every effort will be made to make the photograph not identifiable to the youth.)
            The photograph will be downloaded into the SIR Database. (See Digital Camera
            Training Guide)

       5.   The examination will be conducted in an area that provides privacy and protects the
            confidentiality of the youth.

       6.   The youth’s verbatim statement, injury severity rating, and details regarding any
            injuries suffered will be documented using the Report of Youth Injuries
            (Attachment D). The original Report of Youth Injuries will be placed in the health
            record as documentation of the medical encounter. A copy of the Report of Youth
            Injuries will be filed in a confidential file along with the SIR.

       7.   If there is a need to revise the injury severity rating (e.g., after diagnostic testing), or
            new information becomes available, the health care provider will complete the
            Report of Youth Injuries Addendum (Attachment D) and submit it to the facility
            Director. The original Addendum will be placed in the health record, with a copy
            attached to the SIR. The facility Director will ensure that the new injury severity
            rating is entered into the SIR Database.

       8.   When the youth requires confinement immediately following the incident, a
            Registered Nurse will provide a brief visual assessment of the youth no more than 2
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SAFETY, SECURITY, AND CONTROL                RESTRAINT OF YOUTH                 8.31        11 of 12

              hours after the time of the incident, at the location where he/she is being confined.
              (When a Registered Nurse is not on site and the youth is not in distress, the youth
              will be examined upon staff arrival but always within 12 hours of the incident.)
              This assessment will be documented using the Report of Youth Injuries. When the
              youth has regained self-control, he/she will be examined fully in privacy as
              previously outlined and the examination documented using the Report of Youth
              Injuries Addendum.

        9.    Health care staff will log each evaluation/examination on the Help Request
              Encounter Log.

        10.   Allegations of child abuse, sexual abuse/exploitation, and neglect will be reported in
              accordance with DJJ 8.6, Reporting Child Abuse, Sexual Abuse/Exploitation, and
              Neglect.

        11.   Medical attention will be given immediately to any injuries suffered as a result of
              use of physical control measures. If the youth is in distress and health care staff are
              not present, the youth will be immediately transported to the emergency room.

        12.   A youth may refuse treatment for an injury resulting from an incident, but he/she
              cannot refuse to be examined by health care staff. Health care staff will attempt to
              examine the youth at a later time when he/she is more cooperative. Health care staff
              will document any refusal of examination or treatment.

   Q.   Restraint equipment will be maintained in a secure area that is readily available to staff,
        as designated by the Director.

        1.    The facility Director will ensure that a sufficient amount of operable, clean restraint
              equipment is readily available. Each facility will have at least 10 sets of handcuffs,
              leg irons, and belly chains. In addition, each facility will have a number of flex
              cuffs at least equal to 120% of its bed capacity.

        2.    The Designated Mental Health Authority and Mental Health Treatment Team will
              evaluate the population needs of the facility annually to recommend to the Director
              of the Office of Behavioral Health Services the number and type of therapeutic
              restraint equipment needed. If there is a change in the Designated Mental Health
              Authority, Psychologist or Psychiatrist, the needs will be re-evaluated.

        3.    All restraint equipment must be checked by the Shift Supervisor at the beginning of
              every shift to assure that it is operable and that sufficient numbers are available.
              Inoperable equipment will be immediately removed from the inventory and the
              Director notified. These checks will be documented on the shift report.

        4.    Restraint equipment will be stored in a locked cabinet, on a shadow board, with an
              inventory form posted on the outside.

        5.    Each facility will establish a checkout system of all restraint equipment to establish
              accountability for equipment use.
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      SAFETY, SECURITY, AND CONTROL                  RESTRAINT OF YOUTH                   8.31        12 of 12

              6.    Logs will be maintained of all emergency and routine distributions of restraint
                    equipment to include:
                    • Restraint equipment checked out;
                    • Staff member’s name;
                    • Date and time the equipment was checked out; and
                    • Date and time the equipment was returned.

         R.   Use of mechanical restraint devices for security or therapeutic purposes will be reported
              as a use of physical control measures in accordance with DJJ 8.30, Use of Physical
              Control Measures and DJJ 8.5, Special Incidents. Use of mechanical restraint devices for
              routine transportation and escort purposes (pursuant to a treatment plan) will not be
              considered a use of physical control measures.

              Each YDC will conduct a meeting with its administrative staff regarding Special Incident
              Reports each business day.

              Each RYDC will conduct a meeting with its administrative staff regarding Special
              Incident Reports regularly.

              A Qualified Mental Health Professional will be included in the SIR meeting or there will
              be a consultation with a QMHP if one is not available for the meeting. The QMHP will
              assure appropriate coding of the SIR in regards to security versus therapeutic restraints.

         S.   All employees authorized to use physical control measures will read this policy and sign
              the “Employee Certification of Compliance with the Use of Physical Control Measures
              Policy” in accordance with DJJ 8.30, Use of Physical Control Measures.


IV.      LOCAL OPERATING PROCEDURES REQUIRED: YES

				
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