Mich. Admin. Code 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.
Notes
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No prior version found.