Section 400.4159. Resident restraint.

(1) An institution shall establish and follow written policies and procedures regarding restraint. These policies and procedures shall be available to all residents, their families, and referring agencies.

(2)   Resident restraint shall be performed in a manner that is safe, appropriate, and proportionate to the severity of the minor child’s behavior, chronological and developmental age, size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of trauma, and done in a manner consistent with the resident’s treatment plan.

(3)   The written policy shall include all of the following:

(a)   Procedures for the review of an incident of restraint within 48 hours by a level of supervision above the staff ordering or conducting the restraint to determine if the requirements of the institution’s procedures were adhered to in directing and conducting the restraint.

(b)    Procedures for the provision of sufficient and adequate training for all staff members of the institution who may use or order the use of restraint using the institution’s written procedures.

(c)   Procedures for recording restraints as an incident report.

(d)  Procedures for the review and aggregation of incident reports regarding restraints at least biannually by the institution’s director or designee.

(4)    The written policy shall only permit the licensee to restrain a child for the following circumstances:

(a)  To prevent injury to the child, self-injury, or injury to others.

(b)   As a precaution against escape or truancy.

(c)    When there is serious destruction of property that places a child or others at serious threat of violence or injury if no intervention occurs.

(5)   The written policy shall prohibit, at a minimum, any of the following aversive punishment procedures:

(a)   The use of noxious substances.

(b)   The use of instruments causing temporary incapacitation.

(c)   Chemical restraint as defined in the act.

(6)    Restraint  equipment  and   physical  restraint  techniques  shall   not  be  used   for punishment, discipline, or retaliation.

(7)   The use of a restraint chair is prohibited.

(8)    Resident restraint shall only be applied for the minimum time necessary to accomplish the purpose for its use as specifically permitted in subrule (2) of this rule. Approval of a supervisor shall be obtained when the restraint lasts more than 20 minutes.

(9)   The approval of the administrator or his or her designee shall be obtained prior to any use of material or mechanical restraints. A staff member shall be present continuously while material or mechanical restraint equipment is being used on a resident, and the staff member shall remain in close enough proximity to the restraint to intervene immediately in case of emergency to protect the safety of the resident.

(10)    A staff person shall document each use of material or mechanical restraint equipment in a written record and shall include all of the following information:

(a)  The name of the resident.

(b)     The  name  of   the  administrator   or  designee  who  authorized  the   use  of  the equipment, and the time of the authorization.

(c)   The time the restraint equipment was applied.

(d)  The name of the staff member who was responsible for the application.

(e)   A description of the specific behavior that necessitated its use.

(f)  The name of the staff person who was continuously with the resident.

(g)    The date and time of removal of the equipment and the name of the person removing the equipment.

History: 2015 AACS.