6 Colo. Code Regs. § 1011-1-5-23
Current through Register Vol. 47, No. 11, June 10, 2024
Section 6 CCR 1011-1-5-23 - SECURE ENVIRONMENT23.1 COMPLIANCE Any facility that has one or more resident care units that are secured to prohibit free egress of residents shall comply with the standards in this section in addition to all other applicable requirements of this chapter.
23.2 There shall be a designated team to evaluate placement of a resident in a secure environment. The team shall include, at a minimum, the director of nursing or designee, a social services staff member, the administrator or designee and an individual (with mental health or social work training as appropriate to the needs of the residents) who is not a facility staff member. A) In emergent situations, initial placement may proceed without the input of a non facility staff member provided a full team evaluation is completed within seven days of placement.B) A placement facility as defined in section 2 of this chapter shall have an individual from its contracting designated facility on the evaluation team for evaluations of clients referred by the designated facility.23.3 MENTAL HEALTH PLACEMENT FACILITIES Any facility that is a placement facility as defined in this chapter shall also comply with 2 CCR 502-1, section 21.280 , Care and Treatment of Persons with a Mental Health Disorder in a Designated Facility. In the case of conflicting regulations, the stricter shall apply.
23.4 PRE-ADMISSION SCREENING AND PLACEMENT A) In order to place a resident into a secure environment, the facility shall ensure that all of the following requirements are met:1) An evaluation team finds, based on available evidence, that:a) The resident is a serious danger to self or others, or b) The resident habitually wanders or would wander out of buildings and is unable to find the way back, or c) The resident has a significant behavioral health issue that seriously disrupts the rights of other residents; and in all casesd) Less restrictive alternatives have been unsuccessful in preventing harm to self or others.2) A practitioner has authenticated the placement;3) Written findings and the factual basis for the placement are documented in the health information record; and4) The resident or resident representative has given informed, written consent. a) If the placement team designated in section 23.2 determines that a resident lacks the requisite decisional capacity to make an informed placement decision and has no resident representative, the facility shall, within 30 days of placement, petition the appropriate court to have a guardian appointed for the resident.B) Placement in a secure environment shall be based solely on the physical and psychosocial needs of the resident and shall be the least restrictive alternative available.23.5 A facility shall have written programs to support the residents it admits, as required by section 23.9.23.6 Residents of a secure environment shall be allowed to have visitors and participate in organized activities.23.7 PLACEMENT EVALUATION A) A resident's placement in or restriction to a secure environment shall terminate in a timely manner when the condition or behavior justifying the placement have diminished to the extent that the criteria in section 23.4 are no longer met, or when consent is terminated or withdrawn, or if the facility and practitioner determine that such continued placement could adversely affect resident health or safety. 1) The facility shall provide the same notice and appeal rights required by section 15.6 before moving a resident out of a secure environment.B) The evaluation team described in section 23.2 shall re-evaluate the placement of each resident 30 days after initial placement and no less often than every 180 days thereafter. 1) Individuals under involuntary mental health placement under Section 27-65-101, C.R.S., et seq., shall be evaluated in accordance with 2 CCR 502-1, §21.280 Care and Treatment of Persons With a Mental Health Disorder in a Designated Facility.C) For residents with behavioral health issues whose conditions have stabilized, the facility may continue placement in the secure environment if the evaluation team finds that placement is necessary to meet the resident's individual needs.23.8 STAFFING The facility shall provide a sufficient number of qualified staff to meet fully the needs of residents in the secure environment, particularly on the night shift.
A) Staff in the secure environment shall be experienced and trained in the particular needs and care of its residents.B) For residents in the secure environment, the facility shall ensure there is time and staff dedicated to meet the social, emotional and recreational needs of the residents and the social and emotional needs of their families in coping with the resident's illness.C) For residents with mental illness, the facility shall provide staff who have demonstrated knowledge and skill in caring for residents with mental illness.23.9 PROGRAMS In addition to meeting the special medical and nursing needs of each resident in the secure environment, the facility shall provide social services and activity programs especially designed for those residents to avoid programmatic isolation.
A) Activities and social services programs shall include the opportunity for regular interaction with residents not residing in the secure environment and regular interaction with the community outside the facility.23.10 SECLUSION Residents of the secure environment may not be locked into their rooms. If a placement facility confines to a room any individual who is under involuntary mental health placement, the facility shall comply with 2 CCR 502-1, Section 21.280.42, Use of Seclusion.
23.11 PHYSICAL SPACE In addition to the physical plant requirements of these regulations, the facility shall provide at least 10 square feet per resident (excluding hallways) of common areas within the secure environment.
A) The facility shall identify its method for securing the area and establish and implement procedures for monitoring the effectiveness of the security system.B) Any facility that has an outside area or yard that residents in the non-secure areas of the facility may use shall establish a secure outside area for residents of the secure environment.