Mich. Admin. Code R. 400.4163 - Health status assessment; notification; debriefing; reporting

Rule 163.

(1) The agency shall develop and implement written procedures for health status screening, notifications, debriefing, and reporting when a restraint, including an emergency restraint, or seclusion is used.
(2) Health status screening of the youth will occur immediately after seclusion or restraint by staff assigned to this screening, as defined in agency policy. If the youth has any physical complaints or if the screening staff has any concerns, depending on the severity of the complaint or concerns, the staff will arrange for the youth's health needs to be met immediately by any of the following actions:
(a) Consultation with the on-call or onsite nursing staff.
(b) Referral for an off-site health assessment.
(c) Contacting emergency medical services.
(3) Notification must be made to the following individuals in the event of a restraint or seclusion:
(a) If a restraint or seclusion does not involve injury or medical intervention, or an injury that does not give rise to a serious injury as defined by section 8 of the child protection law, 1975 PA 238, MCL 722.628, the following individuals shall be notified within 12 hours:
(i) The youth's parent or parents or legal guardian or guardians, including the MCI Superintendent, if applicable.
(ii) The youth's child and family caseworker.
(iii) The youth's attorney or guardian ad litem.
(iv) The youth's advocate, if applicable.
(v) Any other individual appropriate for notification.
(b) If a restraint or seclusion results in serious injury, the following individuals shall be notified as soon as possible but no later than 6 hours after the incident:
(i) The youth's parent or parents or legal guardian or guardians, including the MCI Superintendent, if applicable.
(ii) The youth's child and family caseworker.
(iii) The youth's attorney or guardian ad litem.
(iv) The youth's advocate, if applicable.
(v) Any other individual appropriate for notification.
(c) The notification shall include all the following:
(i) The date and time of the restraint or seclusion.
(ii) A brief summary of events that led to the restraint or seclusion.
(iii) The actions taken following the restraint or seclusion, including any medical services provided.
(iv) A plan for debriefing following the incident, including how the notified individual will be engaged in the debriefing process.
(4) The agency shall implement a debriefing protocol containing the following characteristics:
(a) Consistent with trauma-informed principles.
(b) Consistent with the agency's crisis prevention and intervention processes.
(c) Inclusive of involved youth, caregivers, and staff directly involved in the incident, as well as supervisors, management, and agency leadership.
(d) Informs ongoing quality improvement in the treatment of the individual youth.
(e) Informs ongoing quality improvement in the agency's programs, policies, and practices.
(5) An agency will provide an incident report on a form prescribed by the department for each incident involving the use of seclusion or restraint. The initial report shall be submitted to the department within 24 hours of the incident occurring. A final incident report shall be submitted no later than 72 hours after the incident has occurred.
(6) If mechanical restraint was used, the report must also include the following:
(a) Name of administrator or designee who approved equipment use.
(b) Time of the authorization.
(c) Specific rationale for use.
(d) Time equipment was applied and removed, if different than the time of the overall incident.
(e) Name of the staff member who applied the equipment.
(f) Name or names of staff member or staff members continuously present with the youth throughout mechanical restraint use.
(7) The facility administrator shall review the use of restraint and seclusion on a quarterly basis to ensure that staff only use it as a temporary response to behavior that threatens immediate harm to the youth or others. Based upon the administrative review, a process improvement plan shall be implemented to address:
(a) Strategies to prevent use of restraints and seclusions for youth.
(b) Improvements to staff competency in non-physical crisis prevention and intervention techniques.
(8) The agency's policies and procedures shall be provided and explained to all youth, their families, and referring agencies upon admission.

Notes

Mich. Admin. Code R. 400.4163
1983 AACS; 2015 AACS; 2022 MR 10, Eff. 5/31/2022

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