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<chapter num="02" heading="Limits on Use of Restraints and Seclusion; Prohibition of Abuse" title_num="16" subtitle_num="18">
  <regulation prefix="Regulation" num=".01" heading="Definitions.">
    <paragraph num="A.">
      <text>In this chapter, the following terms have the meanings indicated.</text>
    </paragraph>
    <paragraph num="B.">
      <text>Terms Defined.</text>
      <paragraph num="(1)">
        <text>Abuse.</text>
        <paragraph num="(a)">
          <text>“Abuse” means:</text>
          <paragraph num="(i)">
            <text>The physical injury of a youth by any employee under circumstances that indicate the youth's health or welfare is significantly harmed or at risk of being significantly harmed; or</text>
          </paragraph>
          <paragraph num="(ii)">
            <text>Sexual abuse of a youth, whether or not physical injuries are sustained.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(b)">
          <text>“Abuse” does not include providing a youth with nonmedical religious remedial care and treatment recognized by State law.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(2)">
        <text>“Department” means the Department of Juvenile Services.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>“Duty officer” means the individual designated by the superintendent to make decisions during the superintendent's absence or when the superintendent is unavailable.</text>
      </paragraph>
      <paragraph num="(4)">
        <text>“Employee” means any Department employee or any volunteer providing direct or indirect services to a youth in a facility.</text>
      </paragraph>
      <paragraph num="(5)">
        <text>“Facility” means a residential program operated and managed by the Department.</text>
      </paragraph>
      <paragraph num="(6)">
        <text>“Locked door seclusion” means the placement of a youth in a locked individual room, separate from the youth's room, where a youth is kept for a period of time.</text>
      </paragraph>
      <paragraph num="(7)">
        <text>“Restraint” means a mechanical device or a chemical agent which, when used, limits movement of a youth's body or temporarily disables the youth.</text>
      </paragraph>
      <paragraph num="(8)">
        <text>“Sexual abuse” means any act that involves sexual molestation or exploitation of a youth by an employee and includes incest, rape, or a sexual offense in any degree, sodomy, and unnatural or perverted sexual practices.</text>
      </paragraph>
      <paragraph num="(9)">
        <text>“Superintendent” means the individual who manages a facility.</text>
      </paragraph>
      <paragraph num="(10)">
        <text>“Youth” means any individual under care in a facility.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".02" heading="Prohibition of Abuse.">
    <text>Acts of abuse at a facility are prohibited.</text>
  </regulation>
  <regulation prefix="Regulation" num=".03" heading="Use of Locked Door Seclusion.">
    <paragraph num="A.">
      <text>A facility employee may not place a youth in locked door seclusion as punishment.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A facility employee may place a youth in locked door seclusion only:</text>
      <paragraph num="(1)">
        <text>When it is clearly necessary to protect the youth or other individuals or to prevent escape; and</text>
      </paragraph>
      <paragraph num="(2)">
        <text>After less restrictive methods have been tried or cannot reasonably be tried.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>Time Limitations.</text>
      <paragraph num="(1)">
        <text>A youth may not remain in locked door seclusion more than 24 hours without the review and approval of the superintendent or the duty officer, who shall provide a written explanation for the decision. If one of these administrators was involved in the incident, the other one makes the determination.</text>
      </paragraph>
      <paragraph num="(2)">
        <text>After the decision has been made to keep a youth in locked door seclusion for more than 24 hours, the youth shall be seen by the superintendent or the duty officer at least once during each 12-hour period.</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The maximum stay in seclusion as a result of a single incident may not exceed 72 hours, unless a declared written emergency is issued by the superintendent.</text>
      </paragraph>
    </paragraph>
    <paragraph num="D.">
      <text>Release. A youth shall be released from locked door seclusion when the youth no longer fits the criteria for placement in locked door seclusion.</text>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".04" heading="Use of Restraints.">
    <paragraph num="A.">
      <text>A facility employee may not apply any restraint to a youth as punishment.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A facility employee may apply restraints to a youth only for:</text>
      <paragraph num="(1)">
        <text>The protection of the youth or other individuals;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Secure transportation; or</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The prevention of escape.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <regulation prefix="Regulation" num=".05" heading="Facility Policy.">
    <paragraph num="A.">
      <text>Use by an employee of locked door seclusion or restraint is governed by the policy applicable to the facility.</text>
    </paragraph>
    <paragraph num="B.">
      <text>A facility's policy shall address a youth's right to:</text>
      <paragraph num="(1)">
        <text>A hearing before an impartial hearing officer;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>Advance written notice of the:</text>
        <paragraph num="(a)">
          <text>Date, time, and location of the hearing, and</text>
        </paragraph>
        <paragraph num="(b)">
          <text>Availability and name of a child advocate;</text>
        </paragraph>
      </paragraph>
      <paragraph num="(3)">
        <text>Be heard and present witnesses;</text>
      </paragraph>
      <paragraph num="(4)">
        <text>Confront adverse witnesses;</text>
      </paragraph>
      <paragraph num="(5)">
        <text>Appeal the decision; and</text>
      </paragraph>
      <paragraph num="(6)">
        <text>Expungement of the records from the youth's file if the youth prevails at the hearing.</text>
      </paragraph>
    </paragraph>
    <paragraph num="C.">
      <text>A facility's policy, based upon the facility's physical structure and personnel, shall describe:</text>
      <paragraph num="(1)">
        <text>The permissible locations for locked door seclusion;</text>
      </paragraph>
      <paragraph num="(2)">
        <text>The supervision that shall be provided when locked door seclusion or restraints are used;</text>
      </paragraph>
      <paragraph num="(3)">
        <text>The services or treatment considered appropriate as a result of a youth's conduct; and</text>
      </paragraph>
      <paragraph num="(4)">
        <text>A process for releasing a youth from locked door seclusion or restraints.</text>
      </paragraph>
    </paragraph>
  </regulation>
  <annotations>
    <annotation type="Authority">Human Services Article, §§9-226—9-229, Annotated Code of Maryland</annotation>
    <annotation type="History" subtype="Administrative History">Effective date: June 22, 1992 (19:12 Md. R. 1136)</annotation>
    <annotation type="History" subtype="Administrative History">Chapter recodified from COMAR 16.05.02 to COMAR 16.18.02 effective June 18, 2007 (34:12 Md. R. 1067)</annotation>
  </annotations>
</chapter>