Mich. Admin. Code R. 400.4159

Current through Vol. 24-07, May 1, 2024

Section R. 400.4159 - Youth restraint; pregnant youth; reduction, prevention; prohibited restraints; elimination of restraints

Rule 159.

(1) A child caring institution, including private secure juvenile justice facilities, shall establish a process improvement and restraint reduction/elimination plan that:

(a) Includes documentation of each restraint.

(b) Requires staff training in approved crisis prevention and intervention techniques including:

(i) Prevention, de-escalation techniques, and non-violent responses to assaultive behavior.

(ii) Conflict management.

(iii) Minimizing trauma.

(iv) Staff emotional self-regulation techniques.

(c) Training must be conducted by certified trainers.

(d) Staff must complete refresher training annually or more frequently as needed.

(e) The agency must maintain documentation verifying staff training.

(f) The agency will review all restraints at least monthly.

(g) The agency shall establish a restraint reduction committee, including youth and family representation, for the purpose of analysis, process improvement, communication, and recognition of efforts to eliminate the use of restraints.

(2) The following restraints are strictly prohibited:

(a) Use of chemical restraints as defined in section 2b of the act, MCL 722.112b.

(b) Use of pressure point control and pain adherence techniques at the facility.

(c) Use of straightjackets, hogtying, and restraint chairs.

(d) Restraining youth to fixed objects, including beds or walls.

(e) Restraining youth in a prone position or any restraint that restricts the youth's airway.

(f) Using restraints for punishment, discipline, retaliation, or humiliation.

(g) Peer-on-peer discipline or utilizing the assistance of another youth to implement a restraint.

(3) For a youth who is pregnant, including a youth who is in labor, delivery, or postpartum recovery, mechanical restraints are prohibited. In addition, the following restraints are prohibited for use on pregnant youth:

(a) Abdominal restraints.

(b) Leg and ankle restraints.

(c) Wrist restraints behind the back.

(d) Four or five-point restraints.

(4) Only the least restrictive intervention necessary to prevent immediate harm to the youth or others may be used and must follow an individualized set of graduated interventions that avoid the use of restraints.

(5) In the event a restraint occurs, it must be performed in a manner that is safe, appropriate, and proportionate to the severity of the youth's behavior, chronological and developmental age, size, gender, physical condition, medical condition, psychiatric condition, and personal history, including any history of trauma, and must be done in a manner consistent with the youth's treatment plan.

(6) Restraint must not last longer than the minimal duration of time it takes for a youth to calm down and to restore safety.

(7) Staff must continuously monitor the youth's breathing and other signs of physical distress and take appropriate action to ensure adequate respiration, circulation, and overall well-being.

(8) When an emergency health situation occurs or the youth exhibits sign of physical distress during the restraint, staff must immediately obtain treatment for the youth.

(9) All restraints for child caring institutions, with the exception of those restraints allowed in R 400.4160 and R 400.4161, will be prohibited effective November 1, 2022.

Mich. Admin. Code R. 400.4159

2015 AACS; 2020 AACS; 2022 MR 10, Eff. 5/31/2022