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December 1, 2017
Seclusion and Restraint reporting to Mercy Care Plan and Mercy Maricopa Integrated Care
Licensed behavioral health facilities (Level I), including out-of-state facilities, authorized to use seclusion and restraint must report each occurrence of seclusion and restraint and information on the debriefing subsequent to the occurrence of seclusion or restraint of an ALTCS SMI member, SMI, GMH/SA and Child member to Mercy Care Plan's and Mercy Maricopa Integrated Care's Quality Management Department within five (5) calendar days of the occurrence. The individual reports must be submitted on the Policy 962, Attachment A, Seclusion and Restraint Individual Reporting Form. This form is available on the MCP and Mercy Maricopa websites.
In the event that a use of seclusion or restraint requires face-to-face monitoring, a report detailing face-to-face monitoring must be submitted to Mercy Care Plan Quality Management and Mercy Maricopa Integrated Care (QM) along with Policy 962, Attachment A, Seclusion and Restraint Individual Reporting Form. The face-to-face monitoring form must include the requirements as per A.A.C. R9-21-204.
Each subcontracted licensed Level 1 Behavioral Health Inpatient Facility must also report the total number of occurrences of the use of seclusion and restraint for ALTCS SMI, SMI, GMH/SA and Child members that occurred in the prior month to Mercy Care Plan and Mercy Maricopa Integrated Care Quality Management by the 5th calendar day of the month. If there were no occurrences of seclusion and restraint for ALTCS SMI, SMI, GMH/SA and Child members during the reporting period, the report should so indicate.
In order to maintain consistency, all seclusion and restraint reported events for ALTCS SMI, SMI, GMH/SA and Child members are to be submitted via email directly to MMIC@Aetna.com or via fax to 1-855-224-4908.
DEFINITIONS RELATED TO SECLUSION AND RESTRAINT REPORTING
Drug Used As a Restraint: Means a pharmacological restraint as used in A.R.S. §36-513 that is not standard treatment for a client's medical condition or behavioral health issue and is administered to:
* Manage the client's behavior in a way that reduces the safety risk to the client or others;
* Temporarily restrict the client's freedom of movement as defined in A.A.C. R-21-101(26).
Mechanical Restraint: Means any device, article or garment attached or adjacent to a client's body that the client cannot easily remove and that restricts the client's freedom of movement or normal access to the client's body, but does not include a device, article, or garment:
* Used for orthopedic or surgical reasons; or
* Necessary to allow a client to heal from a medical condition or to participate in a treatment program for a medical condition as defined in A.A.C. R9-21-101(44).
Personal Restraint: Means the application of physical force without the use of any device for the purpose of restricting the free movement of a client's body, but for a behavioral health agency licensed as a Level 1 RTC or a Level 1 sub-acute agency according to A.A.C. R9-10-102 does not include:
* Holding a client for no longer than 5 minutes;
* Without undue force, in order to calm or comfort the client; or
* Holding a client's hand to escort the client from area to another as defined in A.A.C. R9-21-101(50).
Seclusion: Means the involuntary confinement of a behavioral health member in a room or an area from which the member cannot leave.
Seclusion of Individuals Determined to Have a Serious Mental Illness: Means the restriction of a behavioral health member to a room or area through the use of locked doors or any other device or method which precludes a member from freely exiting the room or area or which a member reasonably believes precludes his/her unrestricted exit. In the case of an inpatient facility, the grounds of the facility, or a ward of the facility does not constitute seclusion. In the case of a community residence, restricting a behavioral health member to the residential site, according to specific provisions of an Individual Service Plan or court order, does not constitute seclusion. 
As always, don't hesitate to contact your Mercy Care  or your Mercy Maricopa Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care Plan or Mercy Maricopa website.   

 
Thanks for all you do!

QB 3165

www.mercycareplan.com                        www.mercymaricopa.org