210 Ind. Admin. Code 8-5-16

Current through October 31, 2024

Section 210 IAC 8-5-16 - Four-point or five-point restraints

Authority: IC 11-8-2-5; IC 31-31-8-2

Affected: IC 31-31-8

Sec. 16.

(a) Written policy, procedure, and practice provide that before any type of four-point or five-point restraint is used with a juvenile, with arms, head, and legs secured to a fixed object, advance approval must be obtained from the facility administrator, or their designee.

(b) Four-point or five-point restraints must be used only as a behavioral health intervention of last resort, and only when:

(1) the intervention is necessary to ensure the physical safety of the juvenile;

(2) other less restrictive interventions have been tried and found to be ineffective; or

(3) a juvenile's resistance to less restrictive intervention is reasonably anticipated.

(c) A juvenile should never be restrained face-down, hog-tied, or in a spread-eagle manner, and no restraint should ever be placed around the juvenile's neck.

(d) Restraints may be applied only by staff trained in their use.

(e) The health care authority, or their designee, must be notified as soon as possible and within fifteen (15) minutes of restraint application to:

(1) assess the juvenile's medical and mental health condition; and

(2) advise whether the juvenile should be referred to a medical or mental health unit or facility for emergency treatment.

(f) When a juvenile is restrained in a four-point or five-point position, the following minimum procedures will be followed:

(1) Direct visual observations by staff must be continuous.

(2) Medical or health trained staff must visually monitor the juvenile's condition, at least every fifteen (15) minutes.

(3) Restraint procedures are in accordance with guidelines approved by the designated health care authority and the mental health authority.

(4) Four-point or five-point restraint of a juvenile must end at the earliest possible time. A medical therapeutic restraint order must be obtained from a qualified mental health professional for all restraints necessary beyond one (1) hour.

(g) A critical incident report shall be completed for all incidents involving a four-point or five-point restraint of a juvenile.

(h) This is a mandatory standard.

210 IAC 8-5-16

Department of Correction; 210 IAC 8-5-16; filed 9/16/2022, 3:13 p.m.: 20221012-IR-210220072FRA