New Rules for Children in Medicaid Psychiatric Care
HHS Secretary Tommy Thompson on Monday announced that HCFA has issued an interim final rule that creates new guidelines for the use of restraints and seclusion for children under the age of 21 at psychiatric residential treatment facilities that administer Medicaid's inpatient psychiatric benefit. The interim final rule, which took effect yesterday, amends a Jan. 18 regulation outlining which facilities must comply with the rules and provides a definition of restraint that is consistent with the Children's Health Act of 2000. The new rule also requires that any use of restraints or seclusion at Medicaid psychiatric facilities be used only on the order and under the supervision of a physician, registered nurse or other licensed health professional. Further, the interim final rule requires that Medicaid psychiatric facilities report to HCFA any deaths involving restraints or seclusion. HHS is developing a similar set of standards for the use of restraints at non-medical, community-based facilities for children and youths, as mandated by the Children's Health Act. Thompson said, "This action will help protect vulnerable young people in certain Medicaid facilities from the risks of serious injury and death that are caused by the inappropriate use of restraints. By developing a broader regulation covering other kinds of facilities, we will reach more children who need this type of protection" (HCFA release, 5/21).