N.Y. Comp. Codes R. & Regs. tit. 18 § 442.2

Current through Register Vol. 46, No. 45, November 2, 2024

Section 442.2 - De-Escalation Rooms

(a) For the purpose of this section, a de-escalation room means a room approved by the Office of Children and Family Services where a child may voluntarily be placed for clinical purposes when the circumstances meet the needs identified in the child's support plan or individualized crisis intervention plan. De-escalation rooms may only be used to assist in calming a child's escalating behavior. De-escalation rooms shall not be used as a form of punishment or for the convenience of staff. An institution may use de-escalation room(s) only in accordance with the standards set forth in this section. The term de-escalation rooms, as used in this section does not apply to therapeutic sensory rooms.

(b) A child that is seriously depressed, has a cognitive or developmental disability or has a seizure disorder shall never be placed in deescalation rooms.

(c) Use of de-escalation rooms must be voluntary at the time the intervention is used and throughout its use. Voluntary means that any child being placed in a de-escalation room must agree to this intervention. Absent a risk/safety assessment and determination that the child is in imminent danger of inflicting self-harm, harming another individual,or the child's express request when such request is consistent with the child's individualized crisis intervention plan, the duration of a child placed in a de-escalation room shall not exceed two hours.

(d) Any instance where a child remains in a deescalation room for more than two hours in any 24-hour period, or is returned to a deescalation room two or more times during any seven-day period, must be approved by the director of the institution. In addition, the staff persons involved must discuss with their supervisors the events leading to the use of the de-escalation room, the reasons the period was prolonged or used frequently, and the child's continued request to be placed in the de-escalation room, or the imminent concern leading to the extended stay. A summary of such supervisory conference shall be recorded and kept in the child's case record.

(e) Every effort shall be made to return the child to the regular program of care as quickly as possible.

(f) A staff person(s) shall maintain supervision and direct visual observation of the child for the duration the child is in the de-escalation room.

(g) Each child in a de-escalation room shall have access to bathroom and toilet facilities. In no instance shall a child be prohibited from receiving regular meals.

(h) The agency's medical department must be alerted to each instance of placement of a child in a de-escalation room. Any child in a de-escalation room for two or more hours must be assessed by either a medical or mental health professional as soon as practicable upon exiting a de-escalation room, but no later than the next day if the instance occurred after the close of business hours.

(i) Each room used for de-escalation shall be heated, lighted, and ventilated as any other room in the facility and be located in a main program area, or within close proximity to a main program area. The de-escalation room is intended to be a soothing environment, and at a minimum, shall have:

(1) a door with an observation window made of an unbreakable material that allows a total view of the room;

(2) no exposed electrical outlets;

(3) conspicuous display of signage advising the child of their right to voluntarily enter and leave the de-escalation room at a time of their choosing; and.

(4) furniture that provides for a level of comfort to aid in de-escalation, while also considering potential risks associated with such furniture given that the nature of the room is to de-escalate children. Any room(s) used for de-escalation shall be inspected by the department architect to determine if the wall construction is sufficient to withstand attacks from a violent child.

(j) The de-escalating room(s) must be unlocked, and the youth must have access to a bathroom.

(k) Each use of the de-escalation room shall be documented in the child's case record; and

(i) Each authorized agency shall maintain daily records of the number of children who are placed in de-escalation room(s) . These records shall include the name and age of each such child, the reasons for the use of the deescalation room, other methods of intervention that have been tried and proved unsuccessful and steps that will be taken to reduce the time such child remains in a de-escalation room. This information shall be maintained so that it is easily accessible and shall be made available to the Office of Children and Family Services staff upon request.

N.Y. Comp. Codes R. & Regs. Tit. 18 § 442.2

Amended New York State Register December 23, 2015/Volume XXXVII, Issue 51, eff. 12/23/2015

Amended New York State Register March 31, 2021/Volume XLIII, Issue 13, eff. 3/31/2021