This regulation governs the use of physical holds by staff at mental health (MH) provider facilities in the District of Columbia. It defines physical holds, permits their use without a physician's order for up to 15 minutes in emergencies involving physical violence, and requires a physician's order for holds exceeding 15 minutes (not to exceed one hour total). Facilities must assign an observer during any hold, follow specified procedural requirements for longer holds, and conduct post-event analysis and treatment team debriefing for holds exceeding 15 minutes.
View official source511 PHYSICAL HOLDS 511.1 A physical hold is the application of physical force by a trained or qualified staff person without the use of any mechanical device, for the purpose of restraining free movement of a consumer's body. A physical hold does not include briefly holding without due force a consumer in order to calm or comfort him or her, or holding a consumer's hand to safely escort him or her from one are to another. 511.2 A trained or qualified staff person may use physical holds, without a physician's order, for up to fifteen (15) minutes in an emergency where physical violence against self, another person, or property is occurring. A physical hold is used solely for the purpose of preventing harm to the consumer, the staff person, others or property. 511.3 The attending or treating physician shall order any use of a physical hold that will last longer than fifteen (15) minutes. 511.4 A second trained or qualified staff person shall be assigned to observe the consumer during the use of a physical hold. 511.5 For any use of a physical hold longer than fifteen (15) minutes, the procedures set forth in §§ 506.3, 506.6, 506.7, 506.8, 506.9, 506.10, and 506.11 of this chapter shall be followed. 511.6 Any order for a physical hold shall not exceed a total of one (1) hour. 511.7 The MH provider shall conduct a post event analysis and a treatment team debriefing in accordance with the requirements of §§ 509 and 510, respectively, for any use of a physical hold longer than fifteen (15) minutes. SOURCE: Emergency and Proposed Rulemaking published at 51 DCR 8691 (September 3, 2004)[EXPIRED]; as amended by Emergency and Proposed Rulemaking published at 51 DCR 11863 (December 31, 2004)[EXPIRED]; as amended by Emergency and Proposed Rulemaking published at 52 DCR 5957 (June 24, 2005)[EXPIRED]; as amended by Final Rulemaking published at 52 DCR 7229 (August 5, 2005). District of Columbia Municipal Regulations Mental Health 22-A DCMR § 511